bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment outcome in smear-positive pulmonary tuberculosis patients treated with a fixed-dose drug combination regimen in comparison with a separate regimen
Authors: Nazari Seyed Saeed Hashemi , Fallah Saeid , Raeisi Vahideh 
Published: May 2023

Context
The number of tuberculosis (TB) patients and multidrug-resistant species of Mycobacterium tuberculosis are increasing worldwide. Effective treatment is still the key factor to control TB in the society.

Aims
The aim of the study was to compare the efficacy of fixed-dose combination (FDC) and separate drug (SD) in the treatment of TB.

Settings and design
The study was a randomized, clinical trial carried out on 331 smear-positive TB patients in the Golestan province, Iran.

Patients and methods
Diagnosis and monitoring method was direct observation of sputum smears under a light microscope, which was used at the end of the second, third, fourth, fifth, or sixth months during the treatment.

Statistical analysis
used Sputum smear conversion rate at the end of second months and therapy outcome at the end of the treatment period were compared in both groups of the study by using the Poisson regression model and calculation incidence rate ratio.

Results
Sputum smear conversion rate at the end of the second month of the treatment had no significant difference between two groups. Success rate at the end of the treatment period was 89.36% in the intervention group and 95.65% in the nonintervention group which had significant difference (P=0.03). Adverse event incidence rate was 5.44% in all studied cases during the period of treatment. It had significant difference between the group who received FDC (8.93%) and the other who received SD (1.86%).

Conclusion
SD had better efficacy than FDC drugs in the treatment of TB patients.
Evaluation of serum levels of interleukin-10 and transforming growth factor-β1 among Egyptian children with wheezy asthma phenotype
Authors: Zedan Magdy M.E. , Zedan Mohamed M. , El-Said Afaf M. , Badran Ahmed M.H. , Wahba Yahya 
Published: May 2023

Background
Asthma is known to be a heterogeneous disease that forms a problem in asthma management. Symptom-based asthma phenotyping with endotyping of the proposed phenotype is a trial to solve this problem. Asthma phenotypes and endotypes facilitate research, establish genetic associations, identify biomarkers, and test for new lines of treatment.

Aim
To clarify the cytokine profile of wheezy asthma phenotype which could pave the way to personalize asthma medicines according to symptom-based asthma phenotypes.

Patients and methods
A case–control study was conducted in 50 asthmatic patients presented solely with wheezes with a mean±SD of age of 9.54±2.81 years and 50 healthy controls, with a mean±SD of age of 8.98±2.79 years. The studied cases and controls underwent assessment of serum levels of interleukin-10 (IL-10), transforming growth factor-β1 (TGF-β1), total serum immunoglobulin E (IgE), peripheral eosinophilic percent, and pulmonary function tests.

Results
Wheezy asthma phenotype showed significant increase in parental smoking, positive family history, total serum IgE, peripheral eosinophilic percent, and TGF-β1 compared with controls. However, serum IL-10 showed significant decrease in cases versus controls. Asthmatics with allergic rhinitis showed significant increase in total serum IgE and peripheral eosinophilic percent compared with non-allergic rhinitis asthmatics.

Conclusion
Wheezy asthma phenotype showed significant increase of serum TGF-β1 as a promoting effect of airway remodeling, significant decrease in serum IL-10, and significant increase of both total serum IgE and eosinophilic percent. This throws a light on the importance of asthma phenotyping according to symptomatology, as a trial toward tailoring asthma medications.
Pharmacoprophylactic equivalence of rifapentine compared with isoniazid
Authors: Joob Beuy , Wiwanitkit Viroj 
Published: May 2023

Background
Tuberculosis is an important infection and is still the most important problem worldwide. The prevention of infection is an important consideration. Focusing on the risk group, HIV-infected patient group is an important risk population for getting tuberculosis. The use of pharmacoprophylaxis has become a new concept in preventive medicine against tuberculosis for HIV-infected population. The classical regimen is the isoniazid regimen. However, the new introduction of combined rifapentine and isoniazid has become a new alterative preventive measure that can help prevent tuberculosis among HIV-infected cases. The alternative is reported for its efficacy and also mentioned for the shorter period of drug use.

Materials and methods
In the present report, the authors performed a clinical mathematical modeling study to determine the pharmacoprophylactic equivalence of rifapentine compared with isoniazid, with special referencing to the HIV-infected population. First, the comparison of required dosage, period of treatment, as well as prophylactic end point is primarily performed and then appraisal on pharmacoprophylactic equivalence of rifapentine compared with isoniazid is done based on mathematical adjustment for required dosage, period of treatment, and prophylaxis end point.

Results
Based on the appraisal, the final pharmacoprophylaxis equivalence is 1 rifapentine dosage is equal to 4.002748–8.005496 isoniazid dosage or 1 mg rifapentine is equal to 0.00143 week of drug use.

Conclusion
Based on the derived pharmacoprophylactic equivalence, rifapentine can help lower required isoniazid dosage and period of prophylactic drug use in prevention of tuberculosis for HIV-infected case.
Screening for pulmonary mycosis
Authors: Gupta Rajesh , Singla Puneet , Goel Nidhi , Gupta Anupama , Singh Pardeep , Gupta Raghav 
Published: May 2023

Introduction
Prevalence of pulmonary mycosis is increasing because of increase in the number of susceptible people, increasing awareness toward these infections, and improved methods of laboratory diagnosis. Inflammation of airway and microbiology of various respiratory infections can be studied using sputum and bronchoalveolar lavage (BAL). The advantage of sputum examination is that it is a noninvasive procedure as compared with BAL.

Objective
To explore the pulmonary mycosis and compare the yield of induced sputum and BAL for detecting pulmonary mycosis.

Patients and methods
The present study was conducted on 98 patients of all age groups and sex who underwent bronchoscopy in the Department of Respiratory Medicine, in association with the Department of Microbiology. Sputum/induced sputum and BAL were collected in sterile vials and sent to the microbiology for examination for fungal species. In microbiology, sputum/BAL samples were subjected to direct microscopy and cultured on Sabouraud dextrose agar. Culture was observed daily until 21 days for any fungal growth.

Discussion
Of 98 patients, 60 were detected with fungal infection via sputum, whereas 64 of 98 patients were detected positive for fungal infection via BAL. Yield of sputum compared with the BAL for diagnosis of fungal infection showed sensitivity of 85.93%, specificity of 85.29%, positive predictive value of 91.66%, negative predictive value of 76.31%, and accuracy of 85.71%.

Conclusion
Results were slightly better with BAL, but the difference was not much significant.
Demographic and clinical factors affecting health-related quality of life in patients with pulmonary tuberculosis in Jazan, Saudi Arabia
Authors: Shalabey Heba Mohmmed , Mohammed Hedya Said , Darraj Majid , Hassan Azza Mohammed 
Published: May 2023

Introduction
Despite the abundant literature about health-related quality of life (HRQOL) in patients with active pulmonary tuberculosis (PTB) and the scarcity of published literature in KSA, this is the first study to assess the 6-min walk test, sputum examination, and tuberculin test for patients with PTB in correlation with HRQOL domains.

Patients and methods
The study aimed to measure HRQOL among patients with PTB and to identify the demographic and the clinical factors that may affect HRQOL. A cross-sectional study using the WHO-BREF 26-item questionnaire was carried out on 114 patients with PTB at a secondary hospital in Jazan from September 2018 to September 2019.

Results
There was a significant association between the overall perception of health and health status of patients. The social domain had the lowest scores, followed by the environmental, psychological, and lastly, the physical domains. The influence of comorbidities has a significant correlation with the environmental and social domains for HRQOL in patients with PTB. A significant correlation was found between the 6-min walk test and physical and psychological domains. However, sputum smear examination and tuberculin test did not significantly relate to HRQOL domains.

Conclusion
A decrease of the four domains in the assessment of the HRQOL in PTB has been noted in relation to some demographic and clinical factors.
Characteristics and outcome determinants in patients with pulmonary tuberculosis in ICU
Authors: El Assal Gehan M. , AbdelFattah Eman B. , Nabil Mohamed M. 
Published: May 2023

Background
Severe tuberculosis requiring intensive care unit care is rare but commonly known to be of bad prognosis. The acute respiratory failure due to pulmonary infections is a common cause for ICU admission. However, despite their high mortality rate, the TB-related critical conditions are rarely reported. Most studies on critical care TB cases were not conducted in high TB burden areas and were retrospective in nature.

Objective
To identify potential prognostic factors and determinants of patient outcome in cases with pulmonary TB admitted to ICU.

Subjects and methods
This was a prospective observational study conducted on 51 patients with active pulmonary TB who required ICU admission for at least 24 h in ICU unit of Abbassia Chest Hospital during the period from January 1, 2018 till December 31, 2018. All patients were subjected to history and clinical examination, radiological and laboratory workup, and APACHI II score. Patients were diagnosed and managed according to National TB Control Guidelines in Egypt. Hospital course, complications and ICU stay period were monitored and were correlated to the outcome.

Results
Mean age of all studied patients was 42.9±16.4 years, 35 male (68.6%) and 16 females. There was Statistically significant correlation between patient outcome, and APACHE II score, arterial blood gases, duration of mechanical ventilation and the total ICU stay in days respectively. ICU complications occurred in 72.5% of patients and they were significantly correlated with patient outcome.

Conclusion
Pulmonary TB requiring ICU is rare but markedly of bad prognosis. Patients commonly admitted to ICU due to respiratory failure, sepsis, multi organ failure, ARDS and massive hemoptysis. Bad prognosis was related to respiratory failure, high APACHE II score, need for mechanical ventilation and its duration, ICU stay and related complications. Mechanical ventilation and APACHE II score were found to be predictors of mortality.
Adding steroids in severe community-acquired pneumonia treatment
Authors: Wafy Safaa , Bayoumi Hassan , El-Naser Shaimaa A. 
Published: May 2023

Background
Community-acquired pneumonia (CAP) is the most serious respiratory infection and the leading cause of death from infectious disease around the world.

Objective
The aim of this study was to evaluate the impact of adjuvant systemic steroids on mortality, complications, and duration of hospitalization in severe CAP.

Patients and methods
In a cross-sectional, randomized, controlled clinical trial conducted in the Chest Department at the Respiratory Intensive Care Unit during the period between September 2017 and September 2018. Patients were diagnosed as having severe CAP rapidly assessed by infectious disease society of America/American thoracic society (IDSA/ATS) 2007 were included in this study.

Results
A total of 50 patients were included in this study. These patients were randomly divided into two groups: Group I (steroid group), and group II (control group). The mean age was 55±16.01 and 58.8±20.92 years, respectively. The use of steroids in the treatment of severe CAP is associated with significant improvement in renal, liver, and erythrocyte sedimentation rate parameters with more rapid clinical, radiological, and ultrasonographic resolution. There was a significant reduction in time to clinical stability in group I compared with group II (4.35±1.24 vs 6.54±1.99 days; P=0.02). However, steroid therapy do not affect the duration of ICU stay, need of noninvasive or invasive mechanical ventilation, and duration of hospitalization.

Conclusion
Adding steroids in severe CAP treatment significantly decreases both complications and mortality.
Effect of cigarette smoking on serum testosterone level among male smokers
Authors: El Salam Mohamed A.A. , Zaki Shady , Mousa Mohamed S. , Motawi Ahmed 
Published: May 2023

Objective
Smoking is considered as a growing epidemic worldwide, and it was found to have negative influence on health, causing a variety of diseases in both sexes, such as pulmonary fibrosis, chronic obstructive pulmonary disease, cerebrovascular and cardiovascular disorders, pulmonary and extrapulmonary malignancies, infertility, erectile dysfunction, recurrent abortions, and teratogenicity. In addition, several studies have been conducted owing to concerns on its effect on the endocrinal system in males, especially its effects on testosterone levels; however, this concern is still debatable, and all reported results were conflicting.

Patients and methods
Herein, the cohort study was conducted on a subgroup of smoking males (n=155) to evaluate its effect on serum total testosterone (T), estradiol (E2), as well as T/E2 ratio compared with a non-smoking control group (n=134).

Results
Our results have shown that there was a significant statistical difference between smoker and non-smoker groups concerning serum total testosterone (T), estradiol (E2), and subsequently T/E2 ratio, with P values of 0.002, less than 0.001, and less than 0.001, respectively. In addition, there was a statistically significant negative correlation between the duration of smoking and T. However, there was no correlation between duration of smoking and either E2 or T/E2 ratio.

Conclusion
Thus, the current study added further evidence to the unsettled debate suggesting negative harmful effects of smoking on serum testosterone level.
Evaluation of human allergen-specific immunoglobulin G, total immunoglobulin E, hematological parameters, and lung function in mill workers exposed to grain dust in South-East Nigeria
Authors: Uzoma Ijeoma C. , Ugwu Christian , Ozoamusi Elvira , Okhuevbie Daniel , Okenwa Chinenye 
Published: May 2023

Background
The incidence of allergy among mill workers has been a public health concern over the years. The human allergen-specific immunoglobulin G (IgG) and the total immunoglobulin E (IgE) are markers for allergic disorders and are important in health monitoring of individuals exposed to allergens. Nonadherence to health and safety precautions by grain workers has led to an increase in respiratory symptoms and other pathologies.

Aim
The aim is to assess human allergen-specific IgG and total IgE concentrations, hematological parameters, and lung functions in factory workers exposed to grain dust for effective health monitoring.

Patients and methods
A total of 69 patients were enrolled; 29 of them were controls whereas 40 were mill workers. Blood samples collected from the patients were analyzed using Mindray autoanalyzer for full blood count, whereas ELISA method was used for the estimation of human allergen-specific IgG and total IgE. The spirometric lung function test was evaluated using Micro 1 Spirometer.

Results
Lung function was significantly decreased compared with the control (P<0.05) in values of forced vital capacity (%Pred) and forced expiratory volume in 1 s (%Pred). But no significant difference was observed for the forced expiratory volume in 1 s/forced vital capacity ratio (%Pred). Additionally, the hematological parameters showed an increase in red blood cells, hemoglobin, packed cell volume, mean corpuscular volume, mean corpuscular hemoglobin concentration, and mean corpuscular hemoglobin of mill workers compared with the control group (P<0.05). The total IgE in mill workers and the control group showed no significant difference; however, the human allergen-specific IgG was increased in mill workers than in the control group.

Conclusions
Human allergen-specific IgG level may be a better indicator of allergy in mill workers.
A Qualitative Study of the Psychological Experiences of Health Care Workers During the COVID 19 Pandemic
Authors: Dang Priyanka , Grover Naveen , Srivastava Prashant , Chahal Savita , Aggarwal Ashish , Dhiman Vishal , Kaloiya Gauri Shanker 
Published: May 2023

Background:
Health-care workers (HCWs) are at the forefront of managing the massive responsibility of public health response to COVID-19. The aim of the present study was to explore the psychological experiences of these frontline HCWs.

Methods
: A qualitative study was carried out with 24 frontline HCWs posted in COVID-19 wards, using purposive and snowball sampling methods. Data were collected using focus group discussions and individual interviews, which were transcribed and analyzed using Braun and Clarke's six-phase framework of thematic analysis.

Results:
HCWs were overburdened. It caused them to experience symptoms of depression and anxiety. Most of them showed positive appraisal coping and believed that people would have to learn to live with it.

Conclusions:
Continued support for professional help is needed for HCWs at present and in the aftermath of the pandemic.
Knowledge and Perceived Ability to Deal with Physical Comorbidities in Substance Use Disorders
Authors: Sharma Nidhi , Ghosh Abhishek , Pillai Renjith R. , Subodh B. N. , Basu Debasish , Mattoo Surender Kumar , Basu Aniruddha , Shah Raghav , Roub Fazle 
Published: May 2023

Background:
Despite the magnitude and impact of co-occurring physical and substance use disorders (SUDs) and evidence of effectiveness of integrated care, the training for management of comorbidities has been neglected. Our objective was to examine the effectiveness of 1-day continuing medical education (CME) in this area on participants' perceived and objective knowledge and skills.

Materials and Methods:
It was a cross-sectional study of CMEs conducted in a tertiary care center with a pre-post assessment design. Assessment included rating perceived knowledge and skill on a five-point scale and objective multiple-choice questions. Subjective feedback on qualitative aspects of the CME was taken. Out of total 154 participants, 69 completed pre-post assignments that included interactive lectures through multimodal presentations and problem-based learning. Pre-post comparisons were done by paired t-test and Wilcoxon signed-rank test.

Results:
Pre-CME assessment showed low mean scores (4.04 [1.75]) in objective (assessment to be added) and limited perceived knowledge and ability. However, objective knowledge assessment showed a significant improvement (P < 0.001) after the CME. Perceived knowledge and skills showed a significant positive (P < 0.001, all comparisons) change in all the four (CME-1) and seven (CME-2) domains assessed. CME was perceived to be excellent in terms of the practical value of material (60.3%), able to meet its stated objectives (60.3%), quality of instructions (58.8%), and organization of material (60.3%).

Conclusion:
CME is a viable option for training of psychiatrists to address the unmet need for treating co-occurring physical and SUDs. Future studies with experimental designs should determine the effectiveness of the components of CMEs.
Felt Needs of the Caregivers for the Home Based Care for their Family Members with Severe Mental Illnesses
Authors: Kartikeyan Deepika , Majhi Gobinda , Kumar Vijay K. G. 
Published: May 2023

Background:
Home-based care for persons with severe mental illness is a family-focused approach and addresses the caregiver's responsibility. It is cost-effective compared to the inpatient hospital settings, and it also allows the patients to stay with families in their communities while treatment is going on. In this context, this study aimed to explore the barrier to access mental health services and the caregivers' felt needs for home-based care for their family members with severe mental illness.

Methods:
This study adopted a cross-sectional descriptive design with 60 caregivers of family members with severe mental illnesses. Quantitative data were collected through a semi-structured interview schedule prepared and validated for this study, and the severity of illness was measured using the Clinical Global Impression Scale.

Results:
Caregivers faced difficulty in traveling along with their family members to the hospital for treatment (76.7%), accessibility issues (65%), and problems in mobilizing the patient to the hospital (54%). The majority of the caregivers (75%) preferred home-based care to manage the illness of the patient, with a focus on pharmacotherapy (83.3%), and the patient considered there should be appropriate training at home (63.3%).

Conclusion:
The majority of the caregivers felt the need for home-based care with a preference for both pharmacotherapy and self-care for their family members with severe mental illnesses.
A Qualitative Study to Explore Various Meanings of Mental Distress and Help-Seeking in the Yamuna Valley, North India
Authors: Rawat Meenal , Jadhav Sushrut , Bayetti Clement , Mathias Kaaren 
Published: May 2023

Context:
In rural India, mental healthcare remains limited due to scant state services and incongruency between provider- and patient-framing distress. Help-seeking by people with mental health problems is related to how meanings of distress are understood differently by individuals, based on their interaction with various actors in the community and the available cultural explanation within their local ecologies.

Methodology:
This study examines the mutually constituted relationship between meanings of mental distress and help-seeking among people residing in the Upper Yamuna Valley, Uttarakhand, North India. This qualitative study builds on six in-depth interviews with people with severe mental health issues and one person with epilepsy, referred as people with psychosocial disability (PPSD) in the study. The data analysis was iterative and followed thematic approach.

Results:
The study found that personal belief based on one's experience, such as negative self-judgment and wider cultural explanations, such as supernatural beliefs, as well as gender roles, impacted the way people address their mental health problems, in turn shaping their help-seeking behavior. Participants lost hope for a cure after years of trying to find an effective solution. Moreover, lack of access to care and remoteness of the mountainous area made help-seeking and recovery feel impossible.

Conclusions:
This study underscores the need for researchers and policy professionals to explore the local context and culture to improve care and treatment quality. The study also explains that personal explanation of psychosocial problems and help seeking are not unidirectional. It is a complex phenomenon layered with the local contexts which should be addressed in clinical practice, as well as future research. Finally, clinicians' training should address the local cultural language of distress to identify the problem and suggest an effective solution.