bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Comparative Study between Propofol-fentanyl versus Propofol-suxamethonium for Ease of Endotracheal Intubation in Children
Authors: Mikailu Alfa , Atiku Mamuda , Abdurrahman Ahmad , Salahu Dalhat , Adesope Saheed 
Published: September 2023

Background:
Following propofol induction, suxamethonium tremendously improves intubating conditions in children and has been the gold standard agent for this purpose. However, suxamethonium could be absolutely contraindicated in some patients. Fentanyl, a short acting opioid, has been investigated as a suitable alternative with varying results.

Aim and Objectives:
This study compares the ease of tracheal intubation between propofol-suxamethonium (1.5 mg/kg) and propofol-fentanyl (3 mcg/kg) during general anaesthesia among children.

Patients and Methods:
In this double-blind randomised controlled study, 84 ASA I or II patients booked for elective surgery under general anaesthesia requiring tracheal intubation were randomised into two groups (F and S). Induction was with propofol 3 mg/kg over 30 s followed by either fentanyl 3 mcg/kg or suxamethonium 1.5 mg/kg. Two minutes later, there was an attempt at intubation and intubating conditions were assessed using Steyn’s modification of Helbo-Hansen’s score (ease of laryngoscopy, jaw relaxation, coughing, vocal cord position, and limb movement).

Results:
All patients in both groups had successful intubation at the first attempt. Patients in group S (suxamethonium) had significantly better overall intubating conditions compared to those in group F (fentanyl) (p=0.0001), 85.7% in group S compared to 21.4% in group F had excellent intubation condition. None of the patients in the two groups demonstrated fair or poor intubation condition.

Conclusion:
A combination of propofol-fentanyl can be used as an alternative to propofol-suxamethonium to ease intubation in paediatric patients.
The use of McGrath MAC Video Laryngoscope Versus McCoy Laryngoscope in Adults with Anticipated Difficult Airway Undergoing Elective Surgery
Authors: Adamu Bilkisu , Yakubu Saidu Yusuf , Muhammad Rabiu Isah 
Published: September 2023

Background:
Difficult airway management remains one of the most challenging clinical situations encountered by anaesthetists.

Aim:
The study compared the effectiveness of the McGrath MAC video laryngoscope to the McCoy® laryngoscope in patients with difficult airway.

Materials and Methods:
Following the institution’s ethical approval, the randomised controlled trial was conducted involving 74 adults with American Society of anaesthesiologists’ physical status (ASA) grading of I-III scheduled for elective surgery. The Patients were randomised into either group MVL (McGrath MAC) or group MCC (McCoy) and intubated after preoxygenation with 100% oxygen and administration of IV propofol and suxamethonium. The Intubation Difficulty Score (IDS), success rate of intubation, time to intubation, number of optimising manoeuvres and complications was assessed. Statistical analysis was performed using the statistical Package for Social Sciences (SPSS) version 24.0 computer software (IBM SPSS Statistics, IBM Corp. NY, United States). Numerical and categorical data were compared using the student’s t-test and Chi square (χ2) test respectively. A value of P < 0.05 was considered statistically significant.

Results:
Lower IDS scores were noted in the McGrath group; 54.1% vs. 5.4% of patients had IDS score of 0 in the McGrath and McCoy groups respectively, (P < 0.001). Overall success rate was higher in the McGrath group (100% vs. 89.1%), P = 0.040.

Conclusion:
Lower IDS scores and improved intubation success rate was achieved with the McGrath compared with the McCoy laryngoscope in patients with predicted difficult airway. The McGrath has proved to be useful in managing patients with difficult airway.
Comparative Accuracy and Complications of Palpation-Guided Versus Ultrasound-Guided Core Needle Biopsy of Palpable Breast Lumps in Ahmadu Bello University Teaching Hospital, Zaria
Authors: Gana Stephen Gboya , Yusufu Lazarus , Abur Peter Pase , Olarinoye-Akorede Sefiya Adebanke , Bello Nafisa 
Published: September 2023

Background:
Breast lumps are a common complaint by women. Palpable breast lumps are accessible to core needle biopsy (CNB) with the aim of obtaining tissue for histologic diagnosis. CNB is achievable either by palpation guidance or image guidance. The superiority of either technique in returning an accurate diagnosis has not been demonstrated in our centre.

Aim:
This study aimed to compare the diagnostic accuracy and complications of palpation-guided versus ultrasound-guided CNB techniques in palpable breast lumps.

Materials and Methods:
This was a randomised, controlled, comparative study. Consenting patients were randomised into either a palpation-guided or an ultrasound-guided group. All patients subsequently had open surgical biopsy, which represented the control group. Data analysis was done using SPSS, version 21.

Results:
Each CNB group had 40 patients. In the palpation-guided group, 24 (54.55%) lumps were benign and 13 (29.55%) were malignant, whilst seven (15.90%) were inconclusive. In the ultrasound-guided group, 31 (65.96%) lumps were benign and 15 (31.91%) were malignant, whilst one (2.13%) was inconclusive. The sensitivity and specificity for palpation-guided CNB were 92.9% and 100%, respectively. The sensitivity and specificity for ultrasound-guided CNB were 100% each. There was no statistically significant difference in sensitivity between the two groups (P value of 0.4828). One patient (2.5%) in the ultrasound-guided CNB group had a hematoma.

Conclusions:
This study has shown that CNB has high diagnostic accuracy and low complications in the management of breast lumps, either by palpation-guided or ultrasound-guided techniques. There was no significant difference in accuracy or complications of CNB using either technique.
Presentation and Management of Orbito-Ocular Malignancies in a Tertiary Institution in Southwest Nigeria
Authors: Alabi Adewumi Olabimpe , Alabi Adegboyega Sunday , Sowunmi Anthonia Chima , Ololade Kehinde O. , Adegboyega Bolanle Comfort , Habeebu Muhammad Yaqub M. , Fatiregun Omolara Amina , Akinsola Folasade Bolanle 
Published: September 2023

Purpose:
The aim of this study was to review the management of orbito-ocular malignancies in the Departments of Radiotherapy and Ophthalmology, Lagos University Teaching Hospital, between January 1997 and December 2011 in comparison to previous and recent studies globally.

Materials and Methods:
This was a retrospective study of orbito-ocular malignancies seen at the Departments of Radiotherapy and Ophthalmology, Lagos University Teaching Hospital from 1997 to 2011. Case files and treatment cards were retrieved through the Medical Records department and the information required was extracted with the aid of a data extraction form.

Results:
A total of 98 cases with histologically confirmed orbito-ocular malignancies seen during the 15-year study period were analysed. Retinoblastoma (51 [52.0%]) was the most common orbito-ocular malignancies seen in children, whereas squamous cell carcinoma of the conjunctiva (25 [25.5%]) was the most common in adults. Seventeen (17%) patients had a combination of radiotherapy, surgery, and chemotherapy. Thirty (33%) had enucleation, whereas 33 (36%) had exenteration. Thirty-six patients had chemotherapy, whereas 44 patients benefited from radiotherapy, and radical treatment was offered to 24 patients. Total radical treatment dose was 35–65 Gy in 20–35 fractions over 4–7 weeks. Most of the patients (84 [85.7%]) were lost to follow up. Five (5.1%) died from disease progression and four (4.1%) are still alive and on regular follow-up.

Conclusion:
This study showed that the use of multimodality treatment was implemented but did not improve survival because the majority of patients presented late. The need for a collaborative effort in early detection and prompt referral for treatment of cancer cases cannot be overemphasised.
Immunohistochemical Profiling of HER-2/neu, Steroid Hormone Receptors and KI-67 Biomarkers in a Cohort of Nigerian Women with Breast Cancer
Authors: Ayandipo Omobolaji O. , Ogun Gabriel O. , Adepoju Olalekan J. , Afuwape Oludolapo O. , Fatunla Ebenezer O. , Orunmuyi Akintunde T. 
Published: September 2023

Background:
Progressive improvement in the accuracy of profiling of hormone receptors in breast cancer provides the basis for targeted endocrine therapy, a major pillar of multimodal breast cancer treatment. However, the disparity in findings from comparatively smaller sample-sized studies in West Africa has led to somewhat conflicting conclusions and recommendations.

Objectives:
This study investigates the immunohistochemical (IHC) profile of breast cancer specimens for estrogen receptor (ER), progesterone receptor (PR), human epidermal receptor-2 (HER2)/neu, and Ki-67 in a tertiary hospital in Ibadan, Nigeria over 12 years.

Materials and Methods:
We reviewed 998 IHC reports, documented clinicopathologic parameters, computed patterns of biomarkers, and stratified them based on the American Society of Clinical Oncology/College of American Pathologists recommendations. Descriptive analysis including frequency, mean, and median were generated from the data extracted.

Results:
Out of the 998 cases, 975 (97.7%) were females and 23 (2.3%) were males. The mean age was 48.84 ± 11.99 years. Open biopsies were the most common types of specimens (320, 41.6%): lumpectomy and incisional biopsy of ulcerated, fungating or unresectable tumours. In those cases, 246 (32.0%) were samples of breast-conserving or ablative surgical extirpation (mastectomy/wide local excision/quadrantectomy), and 203 (26.4%) were obtained by core needle biopsies. Invasive ductal carcinoma was the most common histopathological type (673, 94.5%). The majority of graded tumours were intermediate grade (444, 53.5%). Four hundred and sixty-nine (48.4%) were ER positive, 414 (42.8%) were PR positive, and 180 (19.4%) were HER2/neu positive. Three hundred and thirty-four (34.0%) were triple-negative. Eighty-nine cases had Ki-67 staining done, and of these 61 (68.5%) had positive nuclear staining.

Conclusion:
Steroid hormone receptors and HER-2/neu proportions in our cohort are likely to be more representative than the widely varied figures hitherto reported in the sub-region. We advocate routine IHC analysis of breast cancer samples as a guide to personalized endocrine therapy.
Open Ureteric Exploration in Aminu Kano Teaching Hospital
Authors: Sani Auwal , Abdullahi Muzzammil , Yunusa Bashir , Mashi Sharfuddeen Abbas , Aji Sani Ali , Alhassan Sani Usman 
Published: September 2023

Background:
Open ureteric exploration is an important procedure in urology employed in the management of ureteric obstruction from various causes. Ureteric obstruction is a common urological problem leading to significant morbidity and may lead to obstructive nephropathy in patient with bilateral obstruction or obstruction in a solitary kidney.

Objective:
The study aims to determine the demographics of patients who underwent open ureteric exploration, indications, and complications associated with open ureteric exploration.

Materials and Methods:
This is a retrospective review of all patients who had open ureteric exploration between January 2012 and September 2015. A total of 41 patients had the procedure within this period. Their case notes were retrieved; relevant information was collected with a structured proforma and analyzed with SPSS version 17.

Result:
In the 41 patients reviewed, the age range was 3 to 70 years with mean age of 33.1 ± 12.14. The commonest age group was 21 – 30years accounting for about 32% (n = 13). Male patients account for 68% (n = 28) while females 32% (n = 13). The indications were ureteric stone 58%, ureteric stricture 23% and external compression 19%. The commonest site of obstruction was the distal ureter 84% (n = 36). Ureterolithotomy was the predominant definitive procedure performed in 58% (n = 24). About 24% (n = 9) of patients developed complications, which includes urinary tract infections (UTI), post-operative intestinal obstruction and surgical site infections.

Conclusion:
The distal ureter was the commonest site of obstruction while the commonest procedure was ureterolithotomy. Open ureteric exploration is still an important option in the management of ureteric obstruction especially in resource constrain areas.
Evaluation of Surgical Glove Perforation and Sharps Injury in Oral and Maxillofacial Surgery
Authors: Osodin Timothy E. , Akadiri Oladimeji A. , Akinmoladun Victor I. 
Published: September 2023

Introduction:
The risk of exposure to infections during surgery is partly mitigated by gloving. However, perforation can reduce the effectiveness of gloving as a barrier to exposure. This study aimed at investigating the frequency of surgical glove perforation and factors predictive of these in our oral and maxillofacial surgical practice.

Materials and Methods:
The study was carried out at the National Hospital and the University of Abuja Teaching Hospital, Abuja, Nigeria. Consenting patients requiring oral surgical interventions were consecutively recruited into the study. Similarly, surgeons and their assistants who consented to the study were also enlisted in the study. At the end of every surgical procedure, gloves used by the surgeons and the assistants were tested for perforation. Variables investigated included the rate of perforations, the influence of the type of gloving, single versus double gloving, type of anaesthesia, and duration of surgery on rates.

Results:
At a minimum of three operators per procedure, a total of 154 participants were involved in the study and 895 gloves were used. The number of glove perforations was 117(13.1%) with 82 (70.1%) involving the surgeons. There were 58/117 (49.6%) cases of perforation involving the dominant hand. Forefinger glove perforation accounted for 62 (52.9%) cases. Wire-related perforations were 72 (61.5%). Overall, nine cases of percutaneous injury were recorded. Duration of operation and double gloving were the predictive factors for perforations.

Conclusion:
Risk of sharps injury was relatively high due to the high incidence of glove perforation.
Shear bond strength of thermoviscous bulk-fill composite to sound dentin
Authors: Beheiry Aya M. El , Hasan Mostafa M. A. , Abdalla Ali I. 
Published: September 2023

Aim
To evaluate the shear bond strength of Thermoviscous bulk-fill and Nano-hybrid composites to sound dentin surface after application of self-etch adhesive.

Materials and methods
Thirty freshly extracted sound human molars were used. The teeth roots were embedded in self-cure acrylic resin till the cervical line, The occlusal enamel was cut off to expose the sound dentin surface, The prepared specimens were randomly divided into three groups according to the type of composite (n=10 each): Futurabond DC adhesive (one-step self-etch adhesive) was applied in all groups using a disposable micro-brush and light cured for 10 s. The three groups were: G1, in which Grandio without preheating, was used, G2, in which Grandio with preheating, was used and G3, in which Viscalor-bulk, was used. Composite was applied to dentin using Teflon mold surrounded by metallic ring of 3 mm diameter and 4 mm height. All specimens were stored in artificial saliva at 37ºC for one week. All specimens were subjected to thermocycling in water bath at 5ºC and 55ºC with a dwell time of 30 and 20 s transfer time for 500 thermal cycles which corresponds to 6 months of clinical service. The shear bond strength of specimens was measured using an instron machine at a cross head speed of 0.5 mm/min. The debonded surfaces were examined under a stereomicroscope at a magnification 50X to determine the mode of failure. All data were collected, tabulated, and statistically analyzed.

Results
Group 2 recorded a statistically significant highest shear bond strength values (16.19±3.81) Mpa among tested groups, followed by Group 1 recording (12.41±4.89) Mpa while the lowest shear bond strength values were found in Group 3 with mean values of (11.99±4.07) Mpa. One-way ANOVA test was used to compare the three tested groups at a level of significance P less than or equal to 0.05. A negative correlation between cohesive mode of failure and shear bond strength was recorded for the three tested groups.

Clinical significance
We safely recommend using nanohybrid composites than bulk fill ones particularly in stress bearing areas.

Conclusion of the study
Shear bond strength of Nano-hybrid composite better than Thermoviscous bulk-fill composite using self-etch adhesive to sound dentin surface.
Neurocognición con pertinencia cultural, diabetes y deterioro cognitivo en adultos mayores Kiches
Authors: Solval Mis Angel Romeo 
Published: September 2023

PROBLEMA: ¿cuál es la relación existente entre diabetes mellitus con el deterioro cognitivo de adultos mayores Kiches? OBJETIVO: establecer la correlación existente entre diabetes mellitus con el deterioro cognitivo de adultos mayores Kiches MÉTODO: se realizó un estudio transversal de tipo descriptivo y correlacional en 2 municipios del departamento de Quetzaltenango, 59 mujeres y 25 hombres, todos que se auto identificaron pertenecientes al pueblo maya Kiche. RESULTADOS: con un 5% de error, chi calculado de 13.80 y un chi de tabla de 9.49 que sí existe una correlación entre diabetes y el deterioro cognitivo, un 29% presenta alguna dificultad cognitiva en su mayoría (23%) presenta un deterioro cognitivo leve. CONCLUSIÓN: el deterioro cognitivo en adultos mayores sí está asociado a la diabetes mellitus tipo 2 y ésta afecta principalmente a mujeres. El 23% presenta deterioro cognitivo leve, un 6% deterioro cognitivo moderado, no se encontró deterioro cognitivo severo.
Royal bedchambers in the Republic
Authors: Fraikin Miara 
Published: September 2023

This article takes a fresh look at the royal bedchambers of Stadholder-King William III (1650-1702) in his residences in the Republic. By placing their spatial and functional development in a Dutch-English perspective, it arrives at a new interpretation of these bedchambers.
Until 1689, the stadholder residences were predominantly characterized by the French arrangement of antechamber, bedchamber, cabinet and wardrobe. The bedchamber, the only room that contained a bed, was probably also used to receive guests. New analysis of the surviving inventories makes clear that the Stadholder-King’s apartments at Het Loo, Huis te Dieren and Breda Castle contained not one but two bedchambers. In all three cases the second bedchamber dated from the renovations carried out in the wake the Glorious Revolution of 1689, which saw Willem III crowned king of England, Scotland and Ireland.
The comparative research that underpins this article shows how, in contrast to the Dutch Republic, where most stadholder apartments had just one bedchamber, English royal apartments after the restoration of the monarchy in 1660 consistently featured two bedchambers. Examples include Whitehall, Winchester and Windsor. Charles II (1660-1685) introduced the French custom of the ‘great bedchamber’ for ceremonial and representational purposes. Charles also laid down the ceremonial use of the bedchamber in dedicated bedchamber court decrees. When Willem III became king of England, he tailored his own court decrees to this ceremonial usage. He also emulated his uncle Charles’s architectural arrangement, by creating a great and a little bedchamber in his royal apartments at Hampton Court and Kensington Palaces.
The substantial similarities in spatial organization between Breda Castle and Windsor Castle indicate a shared English royal layout. Following the example of Charles II of England, ‘Sijn Majt’ [His Majesty’s] bedchamber’ in Breda functioned as the ceremonial bedchamber of the Stadholder-King. In the palaces of Huis te Dieren and Het Loo the rooms of the English royal apartment could not be replicated one-on-one. In the inventory for Het Loo, the differentiation between ‘bedcamer’ and ‘slaepcamer’ does however suggest a division between a ceremonial bedchamber and a private bedchamber for sleeping. This article consequently argues that in introducing two bedchambers, Stadholder-King Willem III was modelling himself on his English predecessor Charles II. Although originally based on the ceremonial use of the bedchamber at the French court, when Willem introduced two bedchambers at Breda Castle, Huis te Dieren and Het Loo, he was presenting himself as king of England.
How does emotional intelligence act on institutional policies? A new set of behaviors
to facilitate implementation of the Recovery and Resilience Plan (RRP) in local health units in Italy
Authors: Cioffi Francesca , Cerbo Marina , Spandonaro Federico , Casati Giorgio , Sgroi Daniela , Corea Gerardo , Moscogiuri Rossella , Delle Monache Lina 
Published: September 2023

BackgroundThe main contribution of this article is establishing a set of behaviors and successful actions experimenting the Ipacs’ (Insti-tutional & Public Coaching Services) methodology on implementation of the National Recovery Plan (NRP), approved in Italy in 2021 to overcome the socio-economic impact of the pandemic. This research is aimed at pointing out emotional intelligence (EI) behaviors related to the activities of the NRP with respect to the National Health System (NHS).Participants and procedureFifty-six professionals were provided with an integrated pathway with coaching, participative art and mentoring from Janu-ary to June 2022. A “core set” of 5 soft skills – communication, result orientation, teamwork, networking, and emotional intelligence – was measured before and after an integrated coaching pathway. Each soft skill related to the following three systemic objectives through pre-defined, related activities: 1) defining and introducing new roles in the health community houses; 2) implementing a new systemic communication in oncology; 3) facilitating the management of chronicity through a new IT platform. We observed that the Giunti test (Org-EIQ) and Ipacs’ test enlighten the same emotional intelligence indicators of behaviors considered by the investigated coaching integrated pathway.ResultsForty-eight percent of them increased in all 5 core skills. Results were measured at least in one of the two tests. These re-sults were possible thanks to the changes in abilities of self- introspection, in communicating and sharing common goals, to achieve high standard results in conditions of uncertainty, to understand non-verbal feedback and give feedback.ConclusionsEmotional intelligence acted as a meta skill to pursue a “new model of man” with a new self-schema, self-image and set of behaviors.