bluuebunny/crossref_metadata_2025_split huggingface dataset:
Frequency and Determinants of Hypogonadism and Erectile Dysfunction in Men with Newly Detected Type 2 Diabetes
Authors: Selim Shahjada , Lona Hafiza , Imran Shahed , Rahman Mahbubur , Mahjabeen Samira , Mustari Marufa 
Published: February 2023

Introduction:
Hypogonadism in males is characterized by low serum testosterone (T) levels together with clinical symptoms and is more common in diabetes mellitus (DM). Association between DM and hypogonadism has been studied in different populations but is not clearly known in Bangladeshi population.

Objectives:
The objective of this study was to find out the frequency and determinants of hypogonadism and erectile dysfunction (ED) in men with newly detected type 2 DM diabetes (T2DM).

Materials and Methods:
A cross-sectional study encompassing 1940 newly T2DM male patients (age: 42.57 ± 7.4 years; body mass index [kg/m2]: 26 ± 5.1; mean ± standard deviation) was carried out in the Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University, to see hypogonadism. Measurement of serum total testosterone (TT), sex hormone-binding globulin (SHBG), luteinizing hormone (LH), and follicle stimulation hormone (FSH) was measured by chemiluminescent technology.

Results:
Among hypogonadal subjects, according to calculated Free Testosterone (cFT) and Androgen Deficiency in the Aging Male (ADAM) criteria, the frequency of hypogonadotropic hypogonadism was 80% which, on the basis of TT and ADAM criteria, was 92.5%. There was no significant difference for hypogonadism among either the hemoglobin A1c (HbA1c) categories (P = 0.23) or age groups (P = 0.9). Hypogonadal and eugonadal groups significantly differed both according to TT and ADAM (81.5% vs. 43.4%, P = 0.01) and cFT and ADAM (93.3% vs. 47.7%, P ≤ 0.001) criteria for ED. There was a significant difference between the groups for SHBG (21.7 ± 11.6 vs. 30.71 ± 22, P = 0.05) by TT and ADAM criteria. Similarly, cFT and ADAM criteria also revealed a statistically significant difference for SHBG (38.04 ± 19.90 vs. 25.28 ± 19.37 nmol/l, P = 0.03) and total cholesterol (211.40 ± 44.7 vs. 191.3 ± 32.64 mg/dl, P = 0.04). However, in both the groups, LH, follicle-stimulating hormone (FSH), HbA1c, fasting blood sugar, 2 h after 75 g glucose, triglyceride, high-density lipoprotein, and low-density lipoprotein did not differ significantly. cFT significantly correlated with age (r = [FIGURE DASH]0.3503, P = 001) and SHBG (r = [FIGURE DASH]0.37, P ≤ 0.01) whereas TT with SHBG (r = 0.58, P = 0.01). By multiple regression, ED and SHBG were significant predictors for hypogonadism (P = 0.01 and 0.03, respectively).

Conclusion:
It was concluded that a significant number of newly detected male T2DM subjects have symptoms of hypogonadism judged on the basis of TT, cFT, and ADAM scores. Poor glycemic control may affect gonadal and erectile functions. This aspect should be considered while diagnosing male subjects as T2DM.
Intraperitoneal onlay mesh versus laparoscopy-assisted ventral hernia patch mesh repair in small primary ventral hernias
Authors: Kanuri Harish , Dey Ashish , Mittal Tarun , Tripathi Shikhar , Malik Vinod K. 
Published: February 2023

Aims:
The aim of this study is to compare and evaluate short-term outcomes of laparoscopy-assisted composite patch mesh repair versus laparoscopic intraperitoneal onlay mesh in small primary midline ventral hernias.

Materials and Methods:
Eighty consecutive patients with small (<2 cm) midline ventral hernia admitted to the Department of General and Laparoscopic surgery at Sir Ganga Ram Hospital, New Delhi, from January 2017 to May 2019 were included in the study and randomised into two groups. Group A included patients who underwent laparoscopic intraperitoneal onlay mesh repair with the classical barrier flat mesh and Group B patients underwent laparoscopy-assisted ventral hernia patch-mesh repair. Parameters assessed at the follow-up were early post-operative pain by Visual Analogue Scale score, wound complications, early recurrence and hospital stay.

Results:
Early post-operative pain was more in the laparoscopic intraperitoneal onlay mesh group and the difference was statistically significant. Usage of additional analgesia in the post-operative period was required only in the laparoscopic intraperitoneal onlay mesh group. There was a statistically significant difference between the two groups in terms of hospital stay.

Conclusion:
For primary midline ventral hernia, with defect size <2 cm, laparoscopy-assisted composite patch mesh repair is feasible and safe. It causes less pain and necessitates less usage of additional analgesia enabling patients to be discharged earlier.
Stress, subjective well-being and its link to the academic performance amongst medical students of a tertiary care setting
Authors: Periasamy Panneerselvam , Vajiravelu Suganthi , Gunasekaran Sasikala 
Published: February 2023

Background:
Understanding medical students' mental health using subjective well-being indicators is important because it will allow for the creation of positive psychology-based intervention techniques as well as the implementation of main and secondary psychiatric disorder prevention procedures for medical students. These indicators may help to improve the overall quality of health care provided by these future professionals to the general public.

Aims:
The aim of the present study was to assess the levels of stress and subjective well being as well as factors related to it and their link to the academic performance amongst medical students of a tertiary care setting.

Materials and Methods:
This is a 3-month cross-sectional survey that took place amongst medical students at a tertiary care medical college in Salem, India, between January and March 2022. Students from all academic years, from first year to internship, were included in this study. The study included all students who were willing to participate and gave their informed consent.

Results:
Of the total 492 respondents, 288 (58.5%) were females and 204 (41.5%) were males. 29.7% of the study participants belonged to the first year of the MBBS course. 43.9% of the study participants possess a very good academic performance and majority (86.6%) of the students have regular attendance towards classes.

Conclusion:
Taken together, the findings of studies like these could inform preventive interventions aimed at reducing medical students' distress and promoting future doctors' well-being.
Pigmented medulloepithelioma of the optic nerve: A challenging diagnostic entity
Authors: El Mehdi Tiabi , Siham Chariba , Imane Kamaoui , Noufissa Benajiba , Amal Bennani 
Published: February 2023

ABSTRACT
Because of its rarity, the diagnosis of optic nerve medulloepithelioma poses a real diagnostic challenge. Medulloepithelioma is a congenital tumor that derives from the primitive medullary epithelium present in the neural tube and the optic vesicle. Its classical location is the ciliary body. Cases of retinal or optic nerve locations have been rarely reported in the literature. Only 11 cases have been published in the English literature. Herein, we report the case of a 2-year-old boy who underwent enucleation of the right eye for a presumed diagnosis of right-eye retinoblastoma, based on the presence of leukocoria on ophthalmological examination. Pathological examination showed an optic nerve medulloepithelioma. A review of the literature is also discussed in our work.
Prevalence of Keratoconus on Screening of Egyptian LASIK Candidates: A Retrospective Multicenter Study
Authors: Abd-Elaziz Khaled , Eissa Sherif , Salah Yehia , Azzam Sarah 
Published: February 2023

PURPOSE:
This is a retrospective multicenter study to report the incidental discovery of keratoconus (clinical and subclinical) in a screening of laser vision correction (LVC) surgery candidates.

METHODS:
This retrospective multicenter study was conducted on patients presenting for LVC in four Egyptian governorates (Cairo-Giza-6th of October-Beni Suef) during the year 2018. The patients were examined using the Pentacam HR (OCULUS Optikgeräte GmbH, Wetzlar, Germany) or Sirius (Costruzione Strumenti Oftalmici, Italy). The following parameters were evaluated: the axial curvature map, keratometry (Kmax and K2 on the posterior surface), minimum corneal thickness, anterior elevation, posterior elevation, Baiocchi–Calossi –Versaci index (Sirius), index of height decentration, and BAD-D (Pentacam). The prevalence of keratoconus cases was reported and data were analyzed.

RESULTS:
A total of 46 out of 782 candidates presenting for LVC in 2018 were incidentally discovered as clinical or subclinical keratoconus cases and were excluded from performing the LVC procedure.

CONCLUSION:
Screening of LVC candidates for keratoconus is a crucial tool to detect the incidence of the disease in the Egyptian population.
Obstacles and Challenges Facing Iraqi Women Ophthalmologists
Authors: Rattan Suzan A. , Mutashar Mahir K. , AnNasseh Muhannad G. , Al-Attar Zaid 
Published: February 2023

PURPOSE:
The purpose of this study was to address disparities between male and female Iraqi ophthalmologists in terms of personal circumstances, professional profiles, and attitudes toward work and family life.

METHODS:
A Google Form-based questionnaire was released on a social media platform including 500 ophthalmologists between September 1, and December 1, 2021. The survey included three domains: (1) demographic characteristics, (2) clinical practice profile, and (3) career satisfaction and work/family balance.

RESULTS:
The study included a total of 209 specialists, with a response rate of 45.5%. About 69.4% of them were 45 years and younger. The female-to-male ratio was 1:1.6, 188 (90%) were married and 186 (88.9%) had children. Women ophthalmologists worked fewer hours, days, and operations than male ophthalmologists (P = 0.091). Moreover, women ophthalmologists in private practice were considerably underrepresented. General ophthalmologists represented 77%. The number of women ophthalmologists with subspecialty degrees was far less 9 (11.5%) than males 38 (29.2%), P = 0.003, and they performed significantly fewer operations than male ophthalmologists (P = 0.001). Family duties were the biggest deterrent for female ophthalmologists. For males, the private clinic is an obstacle to acquiring a specialty degree in 45.6%, but for women, it is just 25.7%. Overall satisfaction was 65.1%. Women respondents were less satisfied with their practice (P = 0.009) and thought that they are facing more challenges (0.007). Men believed they had less time to spend with family, implying that women sacrifice working time/income to satisfy family obligations and expectations. Work-life balance is achieved by limiting work hours and including family members.

CONCLUSION:
Women ophthalmologists in Iraq might be facing greater obstacles to their professional advancement than their male counterparts. Female doctors were working fewer hours and doing fewer surgical procedures, and they were less likely to pursue subspecialty certification.
Identification and Sequencing of ISAba2 of Acinetobacter baumannii Isolated from Baghdad Hospitals
Authors: Muhsin Salah Sabah , Bakir Wasan Abdul-Elah , Sabbah Majeed Arsheed 
Published: February 2023

Background:
The ability of multidrug-resistant Acinetobacter baumannii to survive in any situation including the acquisition of many different kinds of virulence factors and antibiotic resistance genes is the primary source of worry in hospital settings. Despite their low hydrolysis capability, oxacillinase (OXA) types are often associated with genetic factors such as insertion sequences (ISs) in order to enhance carbapenemase production and mobilization. As a result, assessing the frequency of IS genes in A. baumannii is extremely essential in many hospitals and medical institutions.

Aims:
The goal of this work is to find the IS ISAba2, which may have a role in antibiotic resistance in extensively drug-resistant (XDR) A. baumannii.

Methods:
The polymerase chain reaction (PCR) was used to confirm the presence of A. baumannii by identifying the bla

OXA-51
gene. According to the current Clinical and Laboratory Standards Institute recommendations (2020), antimicrobials are determined using the Kirby–Bauer disc diffusion technique on Mueller-Hinton agar. The molecular research of ISAba2 includes PCR and Sanger sequencing of the PCR results.

Results:
Among 38 A. baumannii isolates, 23 (61%) and 25 (66%) were resistant to meropenem and imipenem, respectively. The bla

OXA-51
gene was detected in all 21 XDR strains tested; furthermore, ISAba2 was found in all 21 XDR-analyzed A. baumannii isolates.

Conclusions:

ISAba2 has a high predominance between extreme drug-resistant A. baumannii. The identification of these parameters can assist in the control of infection and decrease of the microorganism's prevalence rate.
The Role of Retinol-Binding Protein 4 in Women Infected with Toxoplasma gondii
Authors: Ali Rajaa Abd , Al-Kuraishi Azhar Hatif , Farhan Fatin Shallal 
Published: February 2023

Background:
Ocular toxoplasmosis mainly affected people in the second to fifth decades, as a result of acute or reactivate congenital or postnatally acquired infection. Retinol binding protein 4 (RBP4) is a protein transporter for retinol (Vitamin A) from the liver to peripheral tissue. Because of its function in vision RBP4 has become a target for ophthalmology research.

Objectives:
Identification of the role of RBP4 parameter in women infected with acute toxoplasmosis.

Methodology:
One hundred and fifteen blood samples were collected from aborted women, who were suspected of having toxoplasmosis for the period October 2020 to March 2021; in addition, 25 samples were collected from apparently healthy women to use as a healthy control group. All sera were investigated for the presence of anti-Toxoplasma IgM, IgA and IgG antibodies, all IgG-positive samples (50 samples) were neglected. IgM and IgA-positive samples (40 serum samples) out of 115 samples were used as toxoplasmosis case group (acute toxoplasmosis), while the negative IgM, IgA, and IgG aborted women samples were used as aborted nontoxoplasmic control group (25 serum samples). The samples from healthy women that gave negative results for the three antibodies were used as the healthy control group.

Results:
The RBP4 serum level was reflected a significant decrease 1.84 ± 0.44 ng/ml in aborted toxoplasmic cases when compared with aborted nontoxoplasmic and healthy control groups; 2.85 ± 0.60, 3.90 ± 0.62 ng/ml, respectively.

Conclusion:
There was a highly significant decrease in RBP4 serum levels in acute toxoplasmosis-infected women. This decreasing may be one of the indirect effects of Toxoplasma gondii infection on their hosts. Furthermore, this level can be used as aid test for the detection for toxoplasmosis.
Interferon-Gamma
Authors: Hamza Sabreen Hamodi , Ashoor Zainab Fadhel , Rahmah Abbas Mahdi 
Published: February 2023

Background:
Acromegaly is a rare endocrine disease, its incidence is 4-6 per million per years while its prevalence is 40-60 per million. The distinctive facial characteristics are prognathism prominent forehead, and large hands and feet. This happens after the fusion of growth plates; separating acromegaly from gigantism that occurs before growth plates are closed. Interferon-gamma was checked in (80) acromegalic patients (50% are diabetics and 50% are non-diabetics) while (40) persons were regareded as healthy control group being non-diabetic, non-acromegalic.

Aim of the study:
To find out impact lnterferon-gamma in diabetic acromegalic versus non-diabetic acromegalic patients.

Methods:
Eighty acromegalic subjects were enrolled in across sectional study by measuring the level of lnterferon-gamma in the sera of diabetics and non-diabetics as 39 are diabetics while the remaining 41 patients are non-diabetic.

Result:
lnterferon-gammais high among diabetic acromegalic patients when compared with non-diabetic acromegalic subjects.

Conclusion:
Interferon gamma is high in acromegalic diabetic patients, nondiabetic acromegalic patients, and controls (100%, 97.6%, and 97.5%, respectively). Interferon gamma is elevated in patients with acromegaly only in the age group of 30–39 years, but in those with diabetes, the elevation is noticed later within the age group of 40–49 years as if concomitant diabetes delays its elevation.
The Need of Modifying Current Teaching in Pathology Practical Classes – A Study from Second Professional MBBS Student's Perspective in North India
Authors: Yadav Vandna , Shrimal Rimjhim , Kumar Vinod , Deshmukh Abhay Vilas 
Published: February 2023

Background:
The main goals of teaching in second professional MBBS Pathology practical classes is to provide a framework for the description of the disease and to provide students with knowledge of the functional and structural changes in order that disease pathogenesis is well understood.

Aims:
It was a cross sectional descriptive study which aimed to find out the importance of teaching in pathology practical classes in the MBBS curriculum as well as to assess the student's perception regarding subject understanding.

Materials and Methods:
Two hundred and sixteen students of 2nd MBBS who had already completed 1st year and were about to appear in university examination in the year 2020 were included. An extensive questionnaire was prepared regarding 2nd-year pathology teaching. The feedback from students was obtained and analyzed.

Results:
About 67.5% of students found pathology practical classes more interesting than theory classes. 88% of students were confident to interpret CBC reports. Almost half (50%) did not visit the histopathology section while; only 12% and 38% of students were confident to collect blood and urine samples of the patient. About 83% and 93% of students found gross specimen and clinical charts useful in teaching. 63.88% of students suggested to increase the number of practical hours in pathology.

Conclusion:
Our study has emphasized the importance of teaching in pathology practical classes as important for better understanding in clinical subjects. As the competency-based curriculum is being starting from 2019 batch and onward, this elaborative study, especially in the practical aspects in the subject Pathology can act as a baseline to get access to the effectiveness of the new curriculum in the coming years.
Modelo de cálculo de costos logísticos, mediante la representación de diagramas de flujo para las microempresas ecuatorianas
Authors: Guamán César Augusto Valladares , Morán Alexandra Elizabeth Vaca , Moreno Jenny Patricia Núñez , Sánchez María Alejandra Jácome , Briones María Carmen Muñoz 
Published: February 2023

El análisis de los costos en la gestión logística es fundamental para garantizar las operaciones del negocio, disponer de información fehaciente en torno a las erogaciones establecidas en la cadena de sumisitos permite direccionar esfuerzos a la optimización logrando mayores niveles de eficiencia. El desarrollo de la presente investigación tuvo como propósito esencial el incorporar un esquema de cálculo de costos para los procesos logísticos mediante la utilización de diagramas de flujo, aplicables a las microempresas ecuatorianas. El procedimiento consistió en identificar las actividades secuenciales que integran el proceso de preparación de pedidos con sus respectivos tiempos de ejecución y responsables. Se representó el proceso en un flujograma mediante la simbología ANSI, adicionando al formato global epígrafes que refieren al costo total. Se cuantificaron los costos logísticos por minuto, estableciendo los desembolsos generados a nivel de responsables de cada actividad, y gastos logísticos incidentes en el proceso. Se procedió a la inducción de un algoritmo básico para determinar la repetición del proceso, el costo diario y mensual. El modelo de cálculo permitió estipular un costo por proceso de 0,53 centavos de dólar correspondiente a un tiempo de duración de 10 minutos. Las repeticiones máximas del proceso por periodo fueron de 48, lo que permitió determinar un costo diario de 25,25 dólares y un costo mensual total de 505,00 dólares. Está información aportará a la inducción de parámetros de retroalimentación y optimización de costos en las microempresas ecuatorianas
Catechol-O-Methyltransferase (COMT) Enzyme Level In Preoperative Anxiety Patients
Authors: Hamonangan Nasution Akhyar , Lelo Aznan 
Published: February 2023

Background: Incidence of perioperative anxiety is very high, many preoperative patient experience anxiety . Thiamine acts as an essential nutrition funtionate as cofactor enzyme in most of mitochondria in brain. Brain is very susceptible to thiamine deficiency because its dependency on mitochondrial ATP production. Decreased ATP production result in inhibition of COMT activity. Low COMT levels indicated tendency for anxiety. The aim of this study is to determine the effect of thiamine in increasing COMT enzyme levels in patient with preoperative anxiety
Methods : A true experiment with pretest-posttest control group and double-blind design conducted at the Department of Anesthesia and Intensive Care of University of North Sumatra in August 2019. The 60 patients were analyzed which were planned for and done an elective surgery under general anesthesia. Preoperative anxiety was measured with Amsterdam Preoperative Anxiety and Information Scale (APAIS) and COMT enzyme level measured by ELISA assays.
Results : The results showed that from 64 patients had incidence of preoperative anxiety in this study was 48.3%. We found that there is significant differences in COMT enzyme levels in thiamine group compared to control (p value = 0.001). In addition, it was seen that in thiamine group had an increased COMT levels from 0.96 ng/dL to 1.78 ng/dL, while in control group there also slight increasing from 0.44 ng/dL to 0.78 ng/dL. This show that increase in COMT levels is greater in thiamine group than control group.
Conclusion : Thiamine can cause increasing COMT enzyme levels in patients scheduled for elective surgery with preoperative anxiety under general anesthesia
Use of Chest X-Ray (CXR) in Covid-19 Screening as A Modalities
Authors: Prabowo Adityo 
Published: February 2023

Background: As of March 11, 2020, the number of confirmed cases in China had reached 80,955 with the death toll reaching 3,162. So far, Covid-19 tends to infect people who have comorbid diseases such as heart disease, diabetes mellitus, cancer and chronic respiratory diseases as well as people over 60 years of age. Several cases of Covid-19 have also been reported in pregnant women.
Method: Radiographic technologies and tools including chest X-Ray and Computed Tomography (CT) are applied for initial screening and the follow-up because they provide detailed diagnoses with specific pathological features for staging and treatment settings. Not infrequently cases of Covid-19 are found in pregnant women because during pregnancy women’s condition becomes very vulnerable to infection with pneumonia pathogens due to physiological changes during pregnancy that result in a decrease in the immune system. Although the clinical symptoms are the same as for non-pregnant women and there are no aggravating factors, pregnant women are prone to hypoxia.
Results: Chest x-ray (CXR) is a radiographic projection tool that can help diagnose conditions or abnormalities in the thoracic cavity. Due to the spread of Covid-19, it is important to recognize the common Covid-19 imaging findings and the abnormal pneumonia that occurs over time on CXR results. CXR can be used to diagnose patients with acute respiratory distress as the first line of evaluation for Covid-19 patients 19.
Conclusion: CXR can be a screening modality in Covid-19 patients including pregnant women. However, it is necessary to keep in mind that the CXR examination can have an impact on the fetus. Even though the risk is small, pregnant women who will undergo a Covid-19 examination or evaluation need special attention. In addition, it is necessary to consider other examinations that can be carried out especially on pregnant women, which do not have the effect of radiation