bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lower serum ferritin levels and higher inattentiveness in attention deficit hyperactivity disorder in a case–control study
Authors: Anand Bhogaraju , Sireesha Chemarthi Venkata 
Published: May 2022

Introduction:
Attention deficit hyperactivity disorder (ADHD) has hyperactivity, impulsivity, and inattentiveness. Brain iron stores influence dopamine synthesis and behavior. Serum ferritin is a marker for iron stores. Few studies are there on serum ferritin levels in ADHD, and the results showed either way as low or equal to controls. Contradictory results were observed in two published Indian studies, hence the need for the study.

Aims and Objectives:
The objectives of this study were to compare serum ferritin and hematological indexes between children with ADHD and normal controls and also to compare ADHD subscales in two of ADHD groups divided on a cutoff serum value of below 15 ng/ml (World Health Organization criteria).

Materials and Methods:
Children with ADHD without comorbidities were compared with controls at a child and adolescent psychiatry unit, Hyderabad, India, after ethics committee approval. The assessments included Conners' Parent Rating Scale (CPRS)-Revised (S), serum ferritin, and hematological indexes.

Results:
Two-three children with ADHD and 38 normal children as controls participated. The mean (standard deviation [SD]) of serum ferritin levels in the ADHD group 28.26 (16.46) and controls 23.06 (18.88) was not statistically significant. Significantly higher mean values (14.60) on cognitive/inattention subscale was noticed In below (15 ng/ml) serum ferritin level group compared to the mean (11.50) in above (15 ng/ml) serum ferritin group. Negative nonsignificant correlation (r = −0.366) between cognitive-inattention subscale of ADHD and serum ferritin levels was noticed.

Conclusions:
Iron-deficiency state showed higher inattentiveness on CPRS subscale than noniron-deficiency state. There is a weak negative correlation between serum ferritin and inattentiveness.
Outcome of idiopathic pulmonary fibrosis with pregnancy
Authors: Esmaeel Hend M. , Ali Rasha A. , Mahmoud Hamza A. , Gadallah Doaa 
Published: May 2022

Background
Idiopathic pulmonary fibrosis (IPF) is a chronic pulmonary disease with an unknown etiology. It is uncommon in women of childbearing age. Limited data are available regarding the outcome of IPF with pregnancy.

Objectives
To evaluate both maternal and neonatal outcomes among pregnant women with IPF in comparison with pregnant asthmatic patients. Analysis of potential factors associated with unfavorable outcomes was done.

Patients and methods
This prospective case–control study recruited 20 pregnant women with IPF and 43 asthmatic pregnant controls. Demographics and disease-related parameters were recorded. Functional and radiological evaluations were performed. Watchful peripartum follow-up and precise management in a multidisciplinary team were done. Maternal and neonatal outcomes were evaluated with an analysis of prognostic factors for unfavorable outcomes.

Results
The mean age (SD) of study patients was 31.2 (6.4) years. Seven (35%) cases showed moderate functional impairment, and nine (45%) cases showed severe impairment. All cases required oxygen therapy by the third trimester. Five (25%) cases required ICU admission during the peripartum period. A total of 15 (75%) cases needed domiciliary oxygen upon discharge from the hospital (unfavorable maternal outcome) with no maternal mortality recorded. Overall, 11 (55%) cases were associated with neonatal complications (unfavorable neonatal outcome). The degree of functional impairment showed a significant association with neonatal outcome (P=0.02). Both maternal and neonatal outcomes were significantly better in the control group than in cases (P<0.001).

Conclusion
Pregnancy course in patients with IPF can be associated with adverse effects on maternal and neonatal outcomes and disease progression. However, collaborative management can minimize maternal mortality.
Severity scoring systems and different biochemical markers as predictors of mortality in the respiratory ICU
Authors: El-Kholy Maha M. , Sadek Samiaa H. , El-Morshedy Reham M. , Ali Alaa S. 
Published: May 2022

Background
Predicting mortality and outcome of critically ill patients is an interesting point for research, so different acuity scores, such as Acute Physiology and Chronic Health Evaluation II, Simplified Acute Physiology Score II (SAPS II), Mortality Probability Model II (MPM II), and Sequential Organ Failure Assessment (SOFA), and biochemical markers are under investigation for its assessment.

Aim
The aim of this study were to compare between different ICU scores, for predicting mortality and to assess validity of some biochemical markers such as C-reactive protein (CRP), neutrophil–lymphocytic ratio (NLR), platelet to lymphocyte ratio, red cell distribution width, and mean platelet volume in the assessment of ICU outcome.

Patients and methods
This prospective cross-sectional study included 104 patients. The patients were subdivided into survivor and nonsurvivor groups. Acute Physiology and Chronic Health Evaluation II and SAPS II scores of the patients were recorded on the first day of admission to respiratory ICU, while SOFA and MPM II scores were recorded on the first and third (SOFA72, MPM72) days of ICU admission, where both groups were compared in terms of different ICU acuity scores as well as some biochemical markers. Sensitivity and specificity of each parameter for predicting mortality were calculated.

Results
The nonsurvivor group included 41 (39.4%) patients. All model scores as well as CRP and NLR were significantly higher in the nonsurvivor group; SOFA72 score had the highest sensitivity of 94.8% with an area under the roc curve (AUR) of 0.94 while the MPM72 score had the highest specificity of 91% with an AUR of 0.81 with a cutoff value of 5 and16, respectively.

Conclusion
While SOFA72 score has the highest sensitivity, MPM72 score has the highest specificity for predicting ICU mortality. NLR and CRP values are independent prognostic factor for hospital mortality in critically ill patient.
Malignant solitary fibrous tumors
Authors: Nidhal Belloumi , Imen Bachouche , Mouna Mlika , Mehdi Abdennadher , Abdallah Fatma Chermiti Ben , Sarra Zairi , Hazem Zribi , Faouzi Mezni , Adel Marghli , Soraya Fenniche 
Published: May 2022

Introduction
Thoracic solitary fibrous tumors (SFTs) are usually pleural-based lesions and diagnosed incidentally. The authors, hereby, report two cases of symptomatic SFT of the pleura with locally aggressive potential.

Case 1
A 63-year-old male patient presented with chief complaints of dyspnea at rest and thoracic pain. Computed tomography scan revealed a mass of the right visceral pleura with multiloculated pleural effusion. Microscopic examination with immunostaining of the resected mass confirmed the diagnosis of malignant SFT. Local recurrence occurred after 5 months.

Case 2
A 32-year-old patient had a massive tumor of the left hemithorax, invading the descending aorta and thoracic vertebrae, causing a shifting of the heart and mediastinum. A needle transcutaneous biopsy confirmed the diagnosis of SFT. Considering the respiratory failure, surgical treatment was preceded by a general preparation. The patient died few days before the operation owing to respiratory distress.

Conclusion
This paper sustains the heterogeneity of these tumors. SFT of the pleura could have malignant potential at first presentation or in a young patient.
Predictors of reintubation in respiratory intensive care unit patients
Authors: El-Shenawy Olfat , Metwally Mohamed , Abdelaleem Nermeen , Ali Mahmoud 
Published: May 2022

Background
Weaning and extubation follow each other in clinical practice, and are two isolated processes that pose distinct problems. Extubation failure is the need for reinstitution of ventilatory support within 24 to 72 hours of planned removal of endotracheal tube. Nearly 20% of patients require reintubation. Reintubation is more serious and may be associated with more adverse effect than the initial intubation procedure. Patients needing reintubation had significantly increase the duration of mechanical ventilation as well as ICU, hospital stay and mortality.

Objective of the study
To predict risk factors of reintubation in respiratory patients.

Patients and methods
The present study was a prospective observational study. It involved 100 mechanically ventilated patients who were admitted to RICU with different respiratory diseases. All patients met the criteria for readiness to wean: 50 patients need to be reintubated (group 1), and the other 50 patients were successfully extubated without needing for reintubation within 48–72 hours of extubation process (group 2). Different clinical, laboratory analysis, hemodynamic and respiratory variables, ventilator parameter and SAPS II score were collected in both groups.

Results
The mean age of reintubated patients was (66.06±10.3 years) and most of them were males (58%). We found that heamoglobin level (11.4±1.93) and Albumin level (2.47±0.61 g/dl) were significantly lower in reintubated group. Also, PH (7.11±0.032) and PaO2 (38.3±4.85 mmHg) at time of first intubation were significantly lower in reintubated cases. Half (50%) of reintubated cases expressed difficult weaning. On the other hand, 64% in non reintubated patients expressed simple weaning. Age (≥64 years old), PH (≤7.13), PaO2 (≤45) at first intubation, SAPS II Score, hemoglobin level (≤10.1), albumin level (≤3.1) were independent predictors of reintubation in respiratory ICU patients.

Conclusion
Age, arterial PH, PaO2 at first intubation, SAPS II Score, hemoglobin, albumin, higher length of ICU stay and hospital stay were an independent predictors of reintubation in respiratory ICU patients.
Self-Assessment Quiz
Authors: Moleyar Vishnu Sharma 
Published: May 2022

ABSTRACT
Intra thoracic tumors can lead to a variety of para-neoplastic manifestations which is often overlooked. Awareness about the para-neoplastic manifestations and the possible intra thoracic causes for the same will lead to early diagnosis and appropriate management. In this self assessment quiz we have discussed regarding the para-neoplastic manifestations in Carcinoid tumor.
Unexplained Fever, Weight Loss, and Worsened Dyspnea with Pulmonary Hypertension as the Presenting Symptoms of Mixed Connective Tissue Disease with Interstitial Lung Disease
Authors: Patil Shital , Gondhali Gajanan , Narwade Ganesh 
Published: May 2022

ABSTRACT
Pulmonary manifestations of mixed connective tissue disease (MCTD) include as bronchiolitis, bronchiectasis, and interstitial lung disease with or without pulmonary hypertension. Tuberculosis (TB) is the most common diagnosis in India in the presence of constitutional symptoms such as cough, fever, and weight loss with lung parenchymal abnormality, irrespective of microscopic or nucleic acid amplification test abnormalities due to high tuberculosis prevalent tropical setting. In this case report, a 35 year old female presented with constitutional symptoms and lung parenchymal nodules, interstitial involvement with lung fibrosis and pulmonary hypertension. Mediastinal window documented necrotic mediastinal lymph nodes, without negative mycobacterial microscopic (smear examination) or genome documentation (Gene Xpert MTB/RIF). She had received empirical anti tuberculosis treatment for three months without clinical or radiological response, resulted in progression of disease with clinical and radiological worsening and referred to our unit for further workup. Bronchoscopy guided evaluation for tropical screen including bacterial, fungal and tuberculosis with malignancy was inconclusive. Vasculitis and CTD workup documented antinuclear antibody (ANA) test strongly positive with very highly raised titres, with positive antigen as U1 small nuclear ribonucleoprotein particle, SSA/RO, single strand DNA, and Scl 70. Treatment initiated with systemic steroids, tadalafil, mycophenolate and diuretics, and satisfactory clinical response documented as near complete resolution of pulmonary parenchymal abnormalities in 24 weeks and pulmonary hypertension in 12 weeks. Pulmonary manifestations of MCTD are common, underestimated in the presence of constitutional symptoms, and early pickup of entity in course of illness will have good outcome with excellent prognosis.
Vitamin-D receptor expression in cutaneous warts
Authors: Tawfik Noha Z. , Abdel Rahman Asmaa A. , Mansour Sahar F. , Gomaa Amal H.A. 
Published: May 2022

Background
Warts are common viral skin infections with a high prevalence rate in both children and adults. Vitamin-D receptors (VDR) are expressed abundantly in the skin and affect cell differentiation, proliferation, and apoptosis. Vitamin D is believed to regulate epidermal cell proliferation and formation of antimicrobial peptides. There is escalating evidence showing that vitamin D3 has a significant role in the immune-system regulation through VDR.

Objective
To study the expression of VDR in cutaneous warts.

Patients and methods
This cross section study included 30 patients of viral warts. Shaved biopsies were taken from the wart lesions and the perilesional skin. Immunohistochemical stain was done for demonstration of VDR expression using a scoring system, depending on the percentage of stained cells and the intensity of staining.

Results
The expression of VDR was markedly increased in wart lesions with a statistically significant difference between wart lesions and perilesional skin. There was no relation between the VDR expression in warts or perilesional area with different variables such as sex, age, number, size, site of warts or disease duration.

Conclusion
The high expression of VDR in cutaneous warts may be related to the epidermal hyperplasia in wart lesions that support the effectiveness of usage of intralesional vitamin-D injection in the treatment of warts. Further large scale studies may be needed to confirm the present results.
Can skin affection be a clue to COVID-19? results from a dermatology outpatient clinic in Egypt
Authors: Mostafa Pakinam I.N. , Alieldin Lobna G. , El-Kalioby Mona 
Published: May 2022

Background
Coronavirus disease 2019 (COVID-19)-infected individuals can be asymptomatic or have mild symptoms. Cutaneous affection with COVID-19 is a unique presentation.

Objective
To describe the clinical presentations of skin affection in COVID-19-confirmed patients attending a dermatology outpatient clinic.

Patients and methods
A retrospective analysis was performed on the medical records of a single dermatology outpatient clinic described cutaneous presentations associated with COVID-19 infection in patients attending in the period from October 2020 to December 2020.

Results
A total of 44 COVID-19-positive patients presented with skin affection. The most common presentation was urticaria (24, 54.5%), followed by herpes simplex (seven, 15.9%), herpes zoster (four, 9.1%), papulosquamous (three, 6.9%), papulovesicular (two, 4.6%), acral lesions (two, 4.6%), leukocytoclastic vasculitis (one, 2.3%), and Kawasaki-like disease (one, 2.3%). Nine (20.5%) patients had asymptomatic COVID-19 infection, 24 (54.5%) patients had mild COVID-19, nine (20.5%) patients had moderate COVID-19, and two (4.5%) patients had severe COVID-19. Among patients with COVID-19 symptoms (35, 79.5%), seven (20%) patients presented with the cutaneous presentation before the onset of COVID-19 symptoms, whereas in the rest of the patients, cutaneous affection was simultaneous with COVID-19 symptoms (28, 80%).

Conclusion
Cutaneous affection can be the striking presentation for COVID-19 requiring dermatological consultation. Awareness and early recognition of skin affection associated with COVID-19 are required. Dermatologists should follow all of the precautions and use adequate personal protective equipment during their outpatient practices. Skin presentations, notably urticaria, can precede the systemic and respiratory symptoms of COVID-19. Severe mucocutaneous herpes simplex can occur with COVID-19 and require prompt medical treatment.
Can invasive diagnostic methods be reduced by magnetic resonance imaging in the diagnosis of diaphragmatic injuries in left thoracoabdominal penetrating injuries?
Authors: Alizade Elchin , İlhan Mehmet , Durak Görkem , Kaan Gok Ali Fuat , Ertekin Cemalettin 
Published: May 2022

Aim:
In this study, we aimed to investigate the effect of magnetic resonance imaging (MRI) in detecting diaphragmatic injury by comparing preoperative computed tomography (CT) and MRI imaging results with diagnostic laparoscopy/thoracoscopy results in patients with left thoracoabdominal penetrating injury. We investigated whether MRI reduces the rate of unnecessary surgery by examining its sensitivity and specificity.

Materials and Methods:
Patients with left thoracoabdominal penetrating injuries who applied to the Emergency Surgery Unit of Istanbul University Istanbul Faculty of Medicine between November 2017 and December 2020 were evaluated. Patients who underwent emergency surgery, who could not undergo MRI or CT for any reason or who could not be operated on were excluded from the study. Preoperative MRI and CT images of patients who underwent diagnostic laparoscopy/thoracoscopy due to left thoracoabdominal injury in our clinic were evaluated retrospectively by a radiologist who did not know the surgical results. MRI results of the cases were compared with surgical findings and CT images.

Results:
A total of 43 (41 males, mean age: 31, range: 15–57) patients were included in the study. The most common physical examination finding was lateral injury. The diaphragmatic injury was detected in 13 (30%) cases during surgical interventions. Laparoscopic repair was performed in 11 (84%) cases and thoracoscopic repair was performed in 2 (15%) cases with diaphragmatic injuries. MRI images of 14 (32%) cases were found to be compatible with diaphragmatic injury, in 1 of them no injury was observed during surgical intervention. According to these data, the sensitivity of MRI was calculated as 100%, specificity 94%, positive predictive value 86%, and negative predictive value 100%. The mean hospital stay was 6 days (1–30) in all cases.

Conclusion:
In our study, MRI was found to have high specificity and sensitivity in detecting diaphragmatic injuries. The number of negative laparoscopy/thoracoscopy can be reduced by performing surgical intervention only in cases with positive or suspected diaphragmatic injury on MRI. Results should be supported by conducting new studies with larger case series with normal MRI findings and long follow-ups.
Community-Based Cross-Sectional Study of the Relationship between Sars-Cov-2 Antibody Titres and Clinico-Epidemiological Profile of Population above 6 Years of Age in the Pimpri Chinchwad, Pune, Maharashtra
Authors: Pandve Harshal T. , Bawa Mukesh S. , Desale Atul V. , Gaikwad Shruti R. , Patil Tushar , Dadewar Abhaychnadra A. 
Published: May 2022

Context:
COVID-19 response needs to be enlightened with representative data regarding the humoral response to the virus, and its relationship with the clinico-epidemiological profile of the general population.

Aims:
To estimate the titres of IgG antibodies against SARS-CoV-2 and study the factors associated with the same among the general population of the Pimpri Chinchwad Municipal Corporation area.

Settings and Design:
Population-based cross-sectional study was carried out among the general population aged 6 years and above in the Pimpri Chinchwad Municipal Corporation area.

Methods and Material:
A total of 10,082 individuals from 106 wards of the PCMC area were studied between June 16, 2021 and June 26, 2021. The survey form questionnaire included sociodemographic details, COVID-19 exposure history, symptoms, tests, and vaccination status. About 3 to 5 ml blood samples were collected from each subject. Testing of samples was done using ABBOTT CMIA, SARS-CoV-2 quant assay—sensitivity 92.7% and specificity 99.9%.

Statistical Analysis Used:
Frequency analysis was done for sociodemographic variables, and antibody titres. An appropriate test of association was applied to the association between antibody titres and the sociodemographic and clinical profile of participants.

Results:
Antibody titres were significantly higher in males, aged 45 years and above, participants of upper socioeconomic class, participants residing in elite areas, subjects with a history of COVID-like symptoms in the past, and those who were vaccinated.

Conclusions:
Anti-SARS-CoV-2 IgG antibodies titres were found to be significantly associated with age, sex, socioeconomic status, area of residence, vaccination status, and history of COVID symptoms.
Assessment of Teaching Effectiveness of Science Ethical Issue Concepts in Basic Science and Technology Curriculum in Junior Secondary School, Gombe State
Authors: Samuel O. Akinola , Sani A. Umar , Oluwatosin A. Veronica 
Published: May 2022

The study assessed the level of classroom conduciveness, appropriateness of stated performance objectives, teacher’s instructional techniques and evaluation procedures for effective teaching of science ethical issues in Junior Secondary School (JSS) basic science and technology curriculum. Ex post facto type of descriptive research design was adopted for this study. The study population comprised all the 286 public Junior Secondary Schools in Gombe State, Nigeria. One hundred and thirty-five schools were selected through simple random sampling techniques from three senatorial districts in Gombe State of which 45 JSS were selected from each district. Three hundred and fifty lessons on science ethical issues concepts in basic science and technology curriculum in Junior Secondary School in Gombe State were observed using Classroom Teaching Observation Schedule (r= 0.83) and adopting descriptive research. Findings indicated that classrooms were not conducive, instructional objectives not appropriate, ineffective instructional strategies and poor evaluation methods. It was recommended that basic science and technology teachers should pay more attention to ethical issues of science and technology in basic science and technology curriculum in Junior Secondary Schools in Nigeria to enhance students’ good citizenship in the society.