bluuebunny/crossref_metadata_2025_split huggingface dataset:
A prospective, observational study to assess the feasibility and safety of supine percutaneous nephrolithotomy under regional anesthesia for obese patients with a body mass index ≥30
Authors: Morsy Samer Mahmoud , Abdelaziz Islam Nasser , Rammah Ahmed Mohamed , Labana Mahmoud Abdelaziz , Hussein Hussein Aly 
Published: September 2022

Introduction:
Besides being a risk factor for urolithiasis, obesity is a challenge in the treatment of urolithiasis from the perspective of both the surgeon and the anesthetist. In this study, we tried to assess the feasibility and safety of supine percutaneous nephrolithotomy (PCNL) under regional anesthesia in obese patients with a body mass index (BMI) ≥30.

Methods:
This was a prospective observational study and included 51 obese patients (BMI ≥30 kg/m2) with renal stones planned for PCNL. All patients underwent supine PCNL under regional anesthesia with the standard technique. A decision for totally tubeless or a tubeless PCNL was made at the end of the procedure and the intraoperative and postoperative data were recorded. All patients underwent computed tomography (CT) imaging at 1 month after surgery to assess the stone-free status and the need for additional treatment.

Results:
The mean age of the patients was 53.2 ± 8.09 years, and the mean BMI was 34.4 ± 2.369 kg/m2. The mean operative time was 73.3 ± 26.2 min, the mean hospital stay was 58.3 ± 22.1 h, and the mean postoperative Visual Analog Score (VAS) for pain was 3.8 ± 1.4. The stone-free rate was 68.6% on the follow-up CT performed after 1 month, and 31.4% of the patients had significant residual fragments which required re-treatment either by retrograde intrarenal surgery (RIRS) in 19.6% (either as primary RIRS for the residual calculi in one patient [1.9%] or as RIRS for post shock wave lithotripsy (SWL) or alkalinization failure in 9 patients), SWL in 21.6%, or urine alkalinization in 7.8%.

Conclusion:
Supine PCNL under regional anesthesia, in this subgroup of obese patients, was found to be feasible and safe with satisfactory stone-free rates and minimal postoperative pain.
A 46,XX Karyotype in Men with Infertility
Authors: Kouvidi Elisavet , Tsimela Hara , Lazaros Leandros , Manola Kalliopi N. , Zachaki Sophia , Dobrescu Ruxandra , Sfakianoudis Konstantinos , Tsoni Theodora , Katsidi Christina , Tsarouha Haralambia , Kanavakis Emmanuel , Mavrou Ariadni 
Published: September 2022

ABSTRACT
46,XX male sex reversal syndrome is a rare genetic cause of male infertility. We report on two new cases of this syndrome in men presenting with hypogonadism and infertility. Cytogenetic and molecular analysis was performed in both patients. An extensive review of the literature for 46,XX male sex reversal syndrome cases related to infertility was also performed to fully characterise this syndrome. Genetic analyses showed translocation of the SRY on Xp chromosome and complete absence of all Azoospermia factor (AZF) genetic regions. All patients included in the review presented hypergonadotropic hypogonadism. Small testes were the most common clinical characteristic present in 90.2% of the patients, followed by small penis (31.8%), gynecomastia (26.8%) and poor hair distribution (15.4%). The presence of the SRY was identified in 130/154 (84.4%) patients: in 98.5% of cases, it was translocated on the Xp chromosome and in 1.5% on an autosome. All patients were azoospermic, due to the lack of AZF genetic regions. Males with normal phenotype and primary hypogonadism should be properly evaluated by the physicians and must be referred for cytogenetic and molecular analysis to exclude or confirm 46,XX male sex reversal syndrome. More cases of this syndrome with SRY translocated on an autosome are needed to identify if these patients have different characteristics than those with SRY translocated on Xp chromosome. Whole genome analysis of these patients is required to elucidate the genetic differences which are responsible for the phenotypic variability of the syndrome.
Comparison of Treatment outcomes following Ovarian Stimulation with Intrauterine Insemination in Minimal or Mild Endometriosis versus Unexplained Infertility
Authors: Sarkar Sharmistha , Joseph Treasa , Yadav Bijesh , Kamath Mohan Shashikant , Kunjummen Aleyamma Thayparmbil 
Published: September 2022

ABSTRACT

Background:
Infertility is a global health issue. The variation in the prevalence of unexplained infertility is attributed to the choice of investigation. There remains a knowledge gap on the impact of minimal and mild endometriosis on treatment outcomes following intrauterine insemination (IUI).

Aim:
The aim of this study was to compare treatment outcomes following ovarian stimulation (OS) and intrauterine insemination (IUI) between minimal and mild endometriosis versus unexplained infertility.

Settings and Design:
A retrospective analysis of women undergoing OS with intrauterine insemination during the year 20142020 in the Department of Reproductive Medicine and Surgery, Christian Medical College, Vellore, was considered for the study.

Materials and Methods:
Women with minimal and mild endometriosis or unexplained infertility diagnosed by diagnostic hysterolaparoscopy were included for the analysis. Univariate and multivariate analysis was done. The primary outcome was live birth rate (LBR) per cycle. The secondary outcomes measured were clinical pregnancy rate (CPR) , cumulative LBR (CLBR) per women, cumulative CPR (CCPR) per women and miscarriage rate.

Statistical Analysis Used:
The baseline parameters were compared using a t-test for continuous data, and categorical data were compared using the Chi-square/Fisher's exact test as appropriate. The outcomes were assessed using logistic regression analysis and expressed as odds ratio (OR) with 95% confidence intervals (CI).

Results:
There were no significant differences in CPR per cycle (14.28% vs. 18.8%, OR: 0.71; 95% CI: 0.401.28) and LBR per cycle (14.28% vs. 16.6%, OR: 0.84; 95% CI: 0.461.51) between the endometriosis and unexplained infertility groups. The cumulative LBR per woman and CCPR per woman also did not show any significant difference in between the two groups.

Conclusion:
The current study did not find any significant differences in cumulative LBR and CPR following OS-IUI in women with minimal or mild endometriosis and unexplained infertility.
A Rare Case of Mosaic Ring Turner Syndrome with Horseshoe Kidney
Authors: Pritti Kumari , Mishra Vineet , Patel Hetvi 
Published: September 2022

ABSTRACT
Rearranged X chromosomes in Turner syndrome (TS) generally present with a mild phenotype, but in cases of ring X chromosomes, the incidence of intellectual disability and other congenital abnormalities can be significantly higher depending on the size of the ring and the involvement of X-inactive specific transcript (XIST) region. Here, we report a 17-year-old female who was referred for a cytogenetic analysis because of primary amenorrhoea. The patient, of normal intelligence, had been found to have traits of TS, especially short stature and some rare findings such as horseshoe kidney and short fourth toe. Cytogenetic analysis showed a mosaic 45, X/46, X and r(X) karyotype. Fluorescence in situ hybridisation analysis using sex chromosome probes permitted us to identify the marker as a ring X chromosome, detected in 30% of cells. The r(X) might include the XIST locus, which would have caused X-inactivation of this abnormal ring chromosome leading to mild phenotype in our patient but with atypical features present in the form of horseshoe kidney and short fourth toe.
Sperm Quality Parameters and Oxidative Stress
Authors: Khan Imtiaza 
Published: September 2022

ABSTRACT

Background:
Assessment of male fertility needs evaluation of sperm quality parameters, namely sperm count, viability, motility and morphology.

Aims:
The present study aimed to analyse and correlate oxidative stress with sperm quality parameters.

Settings and Design:
The male Wistar albino rats, weighing between 100 and 150 g, were employed in the present study under the Committee for the Purpose of Control and Supervision of Experiments on Animals guidelines with ethical clearance from the Institutional Ethical Committee. These rats were categorised into four groups with six rats in each as control and test animals.

Materials and Methods:
Young male Wistar albino rats, weighing between 100 and 150 g, were divided into four groups of six rats each. The first group of rats served as control (n = 6) and was maintained under normal laboratory condition and was provided with clean drinking water, whereas rats in the second (n = 6), third (n = 6) and fourth (n = 6) groups were orally intubated with sodium fluoride of 100 ppm, 200 ppm and 300 ppm, respectively, for 40 days.

Statistical Analysis Used:
After the treatment period of 40 days, animals were sacrificed and alterations in sperm quality parameters were analysed by complete randomised design SAS 9.4 and Statistical Package for the Social Sciences (SPSS) IBM 17 and judged significant if P < 0.05.

Results:
In the experiment, a negative correlation emerged between sperm motility, viability, count versus malondialdehyde (MDA) levels, whereas the level of MDA has a positive correlation with sperm abnormalities. Sperm motility, viability and count were positively correlated with activities of superoxide dismutase and catalase, whereas decreased activities of antioxidants were related to increased sperm morphological abnormalities.

Conclusion:
These results suggest that MDA causes a decline in sperm motility, count and viability and an increase in morphological abnormalities via oxidative damage of membrane lipids.
E-Z Point
Authors: Shukr Ghadear , Gonte Madeleine R. , Webber Victoria E. , Zwain Omar , Eisenstein David 
Published: September 2022

ABSTRACT

Background:
Over half of all fatal complications occur during primary laparoscopic entry. In our practice, we developed a novel modification of closed LUQ entry at Palmer's point and designated it “E-Z” entry.

Aims:
To evaluate the risks and safety of left subcostal entry, a technique we have designated ’E-Z’ entry at our institution.

Settings and Design:
A retrospective chart review was conducted at a tertiary care medical centre of patients who underwent laparoscopic procedures by a single surgeon known to perform left subcostal entry for the last 10 years, using the E-Z entry technique.

Materials and Methods:
Retrospective chart review and description of surgical technique.

Statistical Analysis Used:
Simple descriptive statistics and univariate two-group comparisons.

Results:
One hundred ninety-eight laparoscopic cases were identified as performed by a single surgeon in the last 10 years: 149 underwent umbilical entry and 49 underwent E-Z entry. The average number of previous abdominal surgeries was higher in the E-Z entry group compared to the umbilical group, 1.3 versus 0.5, respectively (P = 0.003). The umbilical entry group had no complications. One complication was noted with the E-Z entry technique, in which the Veress needle was noted to perforate the liver capsule but was managed expectantly.

Conclusion:
We propose the E-Z entry technique for Veress needle entry as an ergonomic and easily reproducible entry technique in the left upper quadrant in the setting of suspected intraperitoneal adhesions.
Effect of Reproductive and Lifestyle Factors on Anti-Mullerian Hormone Levels in Women of Indian Origin
Authors: Banerjee Kaberi , Thind Amardeep , Bhatnagar Nisha , Singla Bhavana , Agria Kiran , Bajaj Payal , Jindal Anshu , Arora Sunita , Goyal Poonam , Mittal Bhavana , Malhotra Keshav , Pai Hrishikesh , Malhotra Jaideep , Goel Pallaavi , Jindal Nikita 
Published: September 2022

ABSTRACT

Background:
Infertility is a world-wide problem and one third females. Over the years, anti-mullerian hormone (AMH) has emerged as a major marker of ovarian reserve. There is also increasing interest in determining the factors which can impact AMH levels.

Aims:
To correlate the association of reproductive and lifestyle factors on AMH levels in women of Indian origin.

Settings and Design:
Multicentric cross sectional study.

Materials and Methods:
The study was conducted using data extracted from the patient records of seven private fertility practices located in North India. Women who were attending these clinics for fertility treatment were requested to fill the questionnaire related to reproductive and lifestyle factors.

Statistical Analysis used:
Our outcome variable was level of AMH measured in the past 3 months, and was assessed as normal or low. All analyses were conducted using STATA 17.

Results:
We found a direct association of low AMH with increasing age, short cycles, amenorrhea and women with family history of premature menopause. We found a direct correlation of high AMH and women with polycystic ovary syndrome and those whose partners had Oligoasthenoteratozoospermia (OATS) or azoospermia. There was no correlation with smoking, sleep, diet, body mass index, cell phone or laptop use in our study.

Conclusion:
Reproductive and lifestyle factors may affect ovarian reserve and but there was a dearth of human studies in this area. To the best of our knowledge this is the first human study on the effect of AMH on Laptop and Cell phone use. We urgently need more studies to confirm or refute our findings so that we can counsel our patients well.
Ayurved management of a case of intensive Dadru (dermatophytosis)—A case report
Authors: Lakkawar Medha C. , Gaikwad Pratima R. , More Anand B. , Rai Shalini 
Published: September 2022

Introduction:
Dermatophytosis (tinea) infections are superficial fungal diseases caused by dermatophytes, a fungus genus that penetrates and grows in dead keratin leading to reddish-colored erythematous cutaneous eruptions in circular lesions presenting with itching. If neglected, fungal infections are more likely to come back and can cause the emergence of more severe conditions. Relapses and recurrences demonstrate that the pathogenic organism is not simply eradicated, demanding more research to create new therapeutic options. Numerous medications used in Ayurveda are thought to have the Krimighna effect, which can result in a more effective course of therapy. Dermatophytosis can be simulated with Dadru Kushtha because the clinical characteristics of the disease are more closely related to those of dermatophytosis.

Materials and Methods:
This case report documents the case of a 37-year-old female patient with complaints of red circular patches and elevated edges over genitals, groin, flanks, axilla, and forehead regions with severe itching diagnosed with Dadru Kushtha. The case was intervened with Ayurvedic Shaman (pacifying therapy) and Bahirparimarjana chikitsa (external therapy).

Result:
A significant reduction was observed in Kandu, Daha, Raga, number and size of Mandala, and Pidaka after treatment and after follow-up.

Conclusion:
Dermatophytosis can be successfully treated with Ayurvedic oral and topical treatments, dietary and lifestyle limitations, and personal hygiene.
Advanced Medical Directives or Written Living Wills Among Saudi Intensive Care Units, Current Practice and Need to Optimization
Authors: Alsayed Eyad Fareed , Tayeb Baraa O , Boker Abdulaziz 
Published: September 2022

Background:
Ethical dilemmas are mostly developed in critically ill patients near the end of life. The point where the treating physician decides to withhold the intensive medical support represents a daily challenge on the current intensive care medicine. Considering patients' wishes in near-death events and their vision, through writing an advance medical directive (also known as Living Will), was introduced early in the developed western countries. On the other hand, it is not easy to talk about near-death events in many other regions of the world, mainly because of cultural and religious differences.

Objectives:
The study aimed to explore the current practice regarding near-death events in one of the Middle Eastern countries, particularly in Saudi Arabia. The main objectives of this study were measuring the involvement of patient's wishes in near-death medical decisions and analyzing the need and usefulness of encouraging the practice of writing advance medical directives in this demographic area.

Methods:
The data were obtained from a group of Saudi intensivists, who are dealing the most among other groups of physicians with near-death events, almost daily. They were affiliated with ten hospitals or intensive care units in Saudi Arabia. Data were collected during the period from March 2018 to July 2018. It was done based on participants' knowledge. Due to the low response rate, data were analyzed using descriptive statistics only.

Results:
A total of 51 physicians working in different intensive medical care units had responded to our survey. About 88% of them were male, 47% aged between 31 and 40 years of age; with different levels of experience (45% were residents, 35% worked as a senior registrars and 20% were consultants' intensivists). Although in Saudi Arabia, a (living will) be not considered legal writing, 31.35% of the respondents had seen many cases where patients openly discussed their near-death wishes with the family members. From the respondents, 84.31% believed that a living will tend to help in their decision-making, and 92.16% considered living wills helpful in making the final call regarding withholding/withdrawing the treatment. According to 72.55% of them, the presence of living wills would help in decreasing the near-death anxiety and depression among family members of a deceased patient and tend to help ease out the situation as they consider it as a final wish of the patient.

Conclusion:
It is concluded that the patient's wishes are essential in making an end-of-life decision; they should be represented by the patient and should also be respected by the clinical staff. However, more studies needed to explore the willingness of the general population in this culture to express their wishes and the best method to elicit these wishes should be sought, with respect to the cultural and religious beliefs and differences.
Remote Programming of Cochlear Implants
Authors: Aljazeeri Isra , Saleh Shaza , Alkahtani Maram , Almuhawas Fida , Abdelsamad Yassin , Hagr Abdulrahman 
Published: September 2022

Objectives:
This work aimed to study the feasibility and stakeholders' satisfaction with remote programming (RP) of cochlear implants.

Materials and Methods:
This prospective study was conducted in a tertiary referral ear specialist center. The audiological and speech outcomes of the patients were measured. The satisfaction of all stakeholders, including remote experts (REs), local hosts (LHs), and patients/families, was evaluated through detailed questionnaires.

Results:
Twenty-two RP sessions for 15 patients were included. The satisfaction levels of LH, REs, and patients/families with the RP sessions were all above 6/10, 5/10, and 7/10 Likert scale, respectively (with 10/10 being the most satisfied). All stakeholders would recommend RP to others. There was no statistically significant difference in the audiological outcomes including for Pure Tone Average (PTA4), speech reception threshold, and word recognition score between the session preceding RP, RP session and the session after the RP (Wilcoxon test, P value ranging from 0.06 to 0.73). Data logging after the RP session showed a higher duration of speech processor usage (mean difference 0.64 h/day, Wilcoxon test, P = 0.006).

Conclusion:
In the era of coronavirus disease 2019 pandemic, RP of confidence interval (CI) can be a safe, feasible, and satisfactory alternative to classical in-office programming sessions. Further studies and efforts should be done to make the RP an available option for CI recipients to save time and cost.
Organism Growth and Antibiotic Treatment for Patients Diagnosed with Deep Neck Space Infection in Asir Central Hospital, Saudi Arabia, 2022
Authors: Najmi Albaraa Abdullah , Alqahtani Mubarak Shaie , Najmi Ali H. , Gohal Norah M. , Al Hamoud Mohammed A. , Alqahtani Abdulrahman J. , Alzahrani Mohammed , Mubarki Musleh , Magboul Nasir A. 
Published: September 2022

Background:
Deep neck infections (DNIs) are characterized by inflammation in the deep spaces and fasciae of the head and neck, with or without pus. Parapharyngeal, infratemporal, pterygomaxillary, temporal, parotid, masticator, submandibular, visceral, carotid sheath, peritonsillar-pharyngeal mucosal, retropharyngeal, danger, and prevertebral spaces are the different types of DNIs. These infections are potentially fatal, and they spread quickly, causing serious problems. Even in recent research on DNSI cases, potentially life-threatening complications have been recorded at a rate of 10%–20%.

Objective:
The objective of this study was to identify the most common organisms causing DNIs in Asir Central Hospital (ACH), Saudi Arabia in addition to identifying the most common sensitive antibiotic using to treat DNIs in ACH.

Results:
Data were retrieved from the records of 108 patients with DNIs (67.6% males, 91.7% Saudis). These included 23 patients in the pediatric group (21.3%) and 85 patients (78.7%) in the adult group. The most common sites for neck abscesses in the whole sample included the submandibular abscess (46.3%). Two types of DNIs were predominating in the pediatric group, including submandibular abscess and anterior neck abscess (30.4% for each type), while submandibular neck abscess was the most common type in the adult group (50.6%). Regarding the previous onset of a recent infection, a total of 67 infections were reported in 63 patients. Upper respiratory tract infections represented the majority of infectious conditions (77.6%) followed by dental infections (22.4%). Among the whole sample, the most commonly isolated pathogen was Staphylococcus species (n = 14, 13.0%), of which 12 Staphylococcus aureus isolates were detected. The 25 isolates with positive cultural growth had undergone culture sensitivity analysis; these showed sensitivity to 89 antibiotics. Bacterial isolates were predominantly sensitive to vancomycin (n = 16, 18.0%), linezolid (n = 14, 15.7%), and ciprofloxacin (n = 13, 14.6%).

Conclusion:
DNIs in children feature different characteristics from those in adults regarding severity and preceding illness. However, the causative microorganisms and antibiotics sensitivity were similar. S. aureus and vancomycin were the most common bacteria and sensitive antibiotic, respectively.
VZŤAH MEDZI SPIRITUALITOU A VÝSKYTOM DEPRESÍVNYCH PRÍZNAKOV U SENIOROV
Authors: Sováriová Soósová Mária , Mauer Boris 
Published: September 2022

Východiská: Svet v súčasnosti čelí globálnemu nárastu starnúcej populácie, čo súvisí s nárastom disability a zvyšovaním výdavkov na sociálnu a zdravotnú starostlivosť. Depresia je jednou z najčastejších príčin disability. Súčasné výskumy poukazujú na významný dosah spirituality a religiozity vo vzťahu k depresii a duševnému zdraviu. Cieľ: Analyzovať vzťah medzi spiritualitou a výskytom depresívnych príznakov u seniorov. Metódy: Emitovaná bola Škála spirituality a Zungov sebahodnotiaci dotazník depresie. Pearsonov korelačný koeficient, analýza rozptylu a lineárna regresná analýza boli použité na analýzu dát. Výsledky: Vo vzorke 250 seniorov, miera závažnosti depresívnej symptomatológie signifikantne stúpala s vekom, u seniorov žijúcich osamele, so základným vzdelaním a tých, ktorí sa nepovažovali za spirituálnu alebo náboženskú osobu. Signifikantne vyššia miera spirituality s kladnou valenciou bola zaznamenaná u starších seniorov, žien, vysokoškolsky vzdelaných a tých, ktorí sa považovali za veľmi spirituálnu alebo náboženskú osobu. Nižšia frekvencia depresívnych symptómov bola signifikantne predikovaná vyššou mierou spirituality, vyšším vekom a nižším vzdelaním. Podobný efekt vo vzťahu k depresívnym prejavom mala aj vnímaná dôležitosť náboženstva, v živote seniorov, modlitby a čítanie náboženskej literatúry. Závery: Spiritualita/náboženstvo bolo identifikované ako malý, ale signifikantný protektívny faktor v prevencii depresie. Vzhľadom na to sa ako vhodné javí aplikovanie spirituálnych/náboženských intervencií do starostlivosti o seniorov.