bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Study to Evaluate the Efficacy of Dexamethasone as an Adjuvant in Ultrasound-Guided Bilateral Superficial Cervical Plexus Block using 0.25% Bupivacaine in Patients Undergoing Thyroid Surgeries under Entropy-Guided General Anesthesia
Authors: Satish Kumar M. N. , Archana M. , Dayananda V. P. , Surekha C. , Ramachandraiah R. 
Published: July 2022

Context:
Ultrasound-guided bilateral superficial cervical plexus block (BSCPB) is a technique described for thyroid surgeries for postoperative analgesia as the surgery can cause severe pain and discomfort. Perineural dexamethasone is known to prolong analgesic duration and reduce postoperative nausea/vomiting.

Aims:
To assess the efficacy of dexamethasone as an adjuvant to BSCPB with 0.25% bupivacaine on isoflurane consumption, intraoperative hemodynamic parameters, and postoperative analgesia in patients undergoing thyroid surgeries under general anesthesia.

Settings and Design:
This was a randomized control trial.

Subjects and Methods:
Eighty patients were randomized to two equal groups using random number table into Group A with BSCPB receiving 20 mL of 0.25% bupivacaine and Group B with BSCPB receiving 19 mL of 0.25% bupivacaine + injection dexamethasone 4 mg in the preinduction period. Hemodynamic parameters, isoflurane consumption, postoperative visual analog scale (VAS) score, and antiemetic effect over 24 h were compared between two groups.

Statistical Analysis Used:
Microsoft excel data sheet, Chi-square test, and independent t-test were used for statistical analysis.

Results:
The intraoperative hemodynamic parameters were comparable between the two groups. There was a significant difference in mean VAS score between two groups from 6 h to 20 h postoperatively. The time of rescue analgesic in Group A was 7.09 ± 1.04 min and Group was 13.19 ± 1.46 min with P < 0.0001. In Group A, 40% had nausea and 35% had vomiting, and in Group B, 7.5% had nausea and 5% had vomiting.

Conclusions:
Preinduction ultrasound-guided BSCPB with bupivacaine and dexamethasone provides longer duration of postoperative analgesia and lesser nausea and vomiting compared to bupivacaine alone.
Cordblood Vitamin A Levels and Intraventricular Hemorrhage Outcomes in Preterm Infants
Authors: Ogbe Emmanuel Augustine , Anigilaje Emmanuel Ademola , Olateju Eyinade Kudirat , Offiong Uduak Mayen , Sanni Usman Abiola , Airede Kaareem Iwunmole 
Published: July 2022

Background and Aims:
Intraventricular hemorrhage (IVH) is a major complication of preterm birth and large haemorrhages may yield significant future disability. Although multifactorial, prematurity and low birth weight are the most important risk factors for IVH. Furthermore, being “born too soon” affects the accretion of Vitamin A (VA) which is essential for normal brain development. We sought out to estimate VA nutrient levels among preterm newborn infants at birth and establish any relationship with IVH occurrence and grade severity.

Methods:
Ninety infants were recruited over a 6-month period. VA levels were determined by the enzyme-linked immunosorbent assay using cord blood and IVH was assessed by transcranial ultrasound scan done on the 7th day of life. Data analysis was by the Statistical Package for the Social Sciences IBM (SPSS) version 21. P < 0.05 was considered statistically significant.

Results:
The infants' median interquartile ranges for gestational age, birth weight, and cord blood VA levels were 32 weeks (4.25 weeks), 1580 g (650 g), and 0.31 μmol/L (0.19 μmol/L), respectively. The prevalence of VA deficiency, low VA, and sufficient VA was 67.8%, 25.5%, and 6.7%, respectively. IVH was found in 8 (9.20%) infants, with incidence rates of 5.70%, 2.30%, and 1.10% for Grades I, II, and III, respectively. Although statistically insignificant, the occurrence of IVH was only among infants with abnormal VA status at birth (P = 0.65).

Conclusions:
Despite low median cord blood VA level of preterm infants in this study, there is no impact on IVH occurrence or grade severity. Further study with larger sample size is warranted.
Correlations of demographical and clinicopathological features with patient outcome of pancreatic ductal adenocarcinoma: A retrospective study (2010-2018) from a Libyan Cohort
Authors: Eddfair Mona Mohmed , Abdulrahman Othman , Alqawi Omar , Assidi Mourad , Buhmeida Abdelbaset , Elturki Abdulfattah , Jebriel Abdalla , Elfagieh Mohamed , Ermiah Eramah 
Published: July 2022

ABSTRACT

Objective:
The aim of the study was to study the correlations of demographical and clinicopathological variables of patients with pancreatic ductal adenocarcinoma (PDAC) and evaluate the association of these variables with patients’ survival outcomes.

Patients and Methods:
A retrospective analysis of 123 patients with PDAC were diagnosed and treated at the National Cancer Institute, Misurata, Libya during the 2010–2108 period. Data for demographics, clinicopathological, biological variables, risk factors, presentation, treatment, and survival-related data were collected from the patients’ medical records.

Results:
The mean age of patient was 61.2 years (range: 19–90 years) and most of patients (80.5%) were aged >50 years. For gender distribution, PDAC was more frequent in males (59.3%). Abdominal pain was the most frequent presenting symptom (84.6%) and 78% (96 patients) among them had head tumors. Most patients (80.5%) presented with unresectable tumor at diagnosis. Disease-free survival was better in patients with early stage (P < 0.0001), low-grade tumor (P = 0.001), resectable tumor (P < 0.0001), and with carcinoembryonic antigen levels <5 ng/ml (P = 0.004). Multivariate Cox’s regression analysis showed that tumor stage is an independent poor survival factor (P = 0.002). Age at diagnosis, gender, family history, and position of tumor did not show any significant associations with patient outcome.

Conclusion:
Libyan patients with PDAC had different demographics, clinicopathological, and biological variables. Typically, they presented with unresectable tumor, advanced stages, and had very short survival times. These results urge us to conduct in-depth biomolecular research studies to identify effective early diagnostics and therapeutics biomarkers in order to fight this disease before it escalates.
Histopathological evaluation of minor salivary gland aberrations in oral squamous cell carcinoma
Authors: Bhola Ridhi , Narwal Anjali , Kamboj Mala , Devi Anju , Anand Rahul , Chatterjee Shreya 
Published: July 2022

ABSTRACT

Background:
Oral squamous cell carcinoma (OSCC) is one of the most established oral cancers in India, with high morbidity and mortality. The most common etiological agent associated with it is tobacco (in any form), which releases chemical carcinogens that affect not only the oral epithelial lining but also deep stromal structures such as minor salivary glands. They may cause changes in ductal or acinar part of gland depending on tumor grade, thus providing a fertile soil for tumor growth and recurrence.

Aims and Objective:
To observe the frequency of minor salivary gland changes associated with tobacco as well as to measure the length and depth of ductal involvement in routine tissue sections of OED and OSCC.

Materials and Methods:
A total of 94 hematoxylin and eosinstained archival slides which included cases of well, moderate, and poorly differentiated OSCC and oral epithelial dysplasia were histopathologically evaluated to observe changes in different components of minor salivary gland. Ductal hyperplasia, ductal metaplasia, mucous pooling within duct, acinar degeneration, pattern of malignant cell invasion (single/clusters), inflammatory infiltrate, eosinophilic cuffing around the gland, and glandular/vascular involvement were evaluated in each slide and correlated with different grades of OSCC.

Results:
Ductal hyperplasia, inflammatory cell infiltrate, mucous pooling, and pattern of malignant cell infiltration came out to be statistically significant with the highest percentage of changes being observed in poorly differentiated squamous cell carcinoma > moderately differentiated squamous cell carcinoma> well differentiated squamous cell carcinoma>oral epithelial dysplasia. Further, the results of this study suggest that extension of dysplasia or squamous cell carcinoma from overlying oral epithelium along salivary gland ducts is an uncommon finding. Conclusion: Hence, histopathological interpretation for OED and OSCC should also include changes related to associated minor salivary gland tissue as detection and eradication of the putative precursors are the best way of decreasing the overall morbidity caused by tumors.
Psychosocial impact and coping strategies of frontline healthcare workers in Western Rajasthan during COVID-19 pandemic
Authors: Kumari Kamlesh , Chaudhary Kriti , Chhabra Swati , Bhatia Pradeep , Kamal Manoj , Kishan Rama , Verma Manoj , Kumar Ashok 
Published: July 2022

Background and Aims:
Coronavirus disease-2019 (COVID-19) pandemic-related stress is an important but under-rated issue needing attention. Stress and causative factors vary between the regions and individuals depending on the availability of resources, socio-cultural differences, and individual perceptions. We aimed to study the psychosocial impact and coping strategies among the healthcare workers (HCWs) in Western Rajasthan during COVID-19 pandemic.

Material and Methods:
This questionnaire-based observational study, consisting of 59 questions in 6 sections, was conducted to identify stress, causative factors, coping strategies, and experiences of HCWs working in personal protective equipment (PPE). Chi-square test was used to compare the responses between different subgroups.

Results:
Majority of the HCWs felt responsible for treating COVID-19 patients (98.8%), but also felt that it was affecting their safety (81.4%). On subgroup analysis, doctors were found to be more stressed than nursing staff (P = 0.004). Major stressors included concerns about infecting family members and lack of specific treatment for COVID-19 (87.5%). Family support was found to be a major stress-relieving factor (97.3%). Most HCWs suggested that comfortable quarantine stay, adequate supply of PPE, and equipments would help in reducing stress.

Conclusion:
Frontline HCWs in Western Rajasthan were under significant stress during COVID-19 pandemic. We found that stress-causing factors and coping strategies varied between different subgroups based on profession, gender, and age. We recommend conducting such studies in different regions of the world to develop relevant and region-specific strategies to help HCWs cope with stress more efficiently, thereby, strengthening the healthcare system to deal with future pandemics.
Histopathological Assessment of Colonoscopic Biopsies in Patients with Bleeding Per Rectum
Authors: Khassaf Mustafa Bani , Qasim Ban Jumaah 
Published: July 2022

Background:
Lower gastrointestinal (GI) bleeding is usually defined as bleeding from the GI tract distal to the ligament of Treitz, and it is usually suspected when patients present with hematochezia, or maroon stools per rectum. It has various causes, which often require colonoscopic biopsy for their conclusive diagnosis.

Aim of Study:
To determine the histopathological changes of colonoscopic/sigmoidoscopic biopsies in patients presenting with bleeding per rectum according to the age, gender, clinical symptoms, and endoscope findings.

Materials and Methods:
In retrospective and prospective studies, 58 cases of colonic tissue paraffin blocks from patients with BPR were collected from Teaching Laboratories of Al-Imamain Al-Kadhumain (AS) Medical City. From each block, sections of 5 um thickness were taken and stained with the routine HandE stain.

Result:
The mean age of the cases with BPR was (44.5 ± 15.7) years, with an M:F ratio of 2.2:1. The most common diagnosis was nonspecific colitis 13(22.4%) cases followed by 7 (12%) cases diagnosed as ulcerative colitis. There is a significant difference in the distribution of final diagnosis according to the patient's gender and age with a p value of (0.03) and (<0.001), respectively. There is a significant difference in the relationship between final diagnosis and colonoscopic findings (P = 0.004).

Conclusion:
In this study, the most common etiology of BPR was nonspecific colitis, ulcerative colitis, hyperplastic polyp, and internal hemorrhoid. There is a significant correlation between final diagnosis and colonoscopic findings.
Detection of Toxoplasma Gondii Oocysts in Contaminated Soils Using Polymerase Chain Reaction Analysis in Duhok City Iraq
Authors: Abdullah Arshad Mohammad , Merza Narmin Saeed , Merza Ahmed Saeed 
Published: July 2022

Background:
The impact of the acquisition of Toxoplasmosis from the environment through ingestion of oocyst from the soil, food, or water contamination remains worrisome worldwide.

Objective:
This study aimed to apply the molecular method for the detection of the occurrence of Toxoplasma oocysts by polymerase chain reaction (PCR) from different soil samples in Duhok province, Kurdistan region of Iraq.

Materials and Methods:
In this study, the occurrence of soil contamination with Toxoplasma gondii oocysts was recorded in different Duhok City's areas by collecting 144 soil samples from different places.

Results:
Only seven samples (4.86%) were identified as T. gondii oocysts using microscopical identification and confirmed at the molecular level via PCR analysis using a fragment of 122 bp as a target of B1 gene. No significant difference was observed among soil types; parks showed the highest percentage 2.77%, followed by playgrounds (1.38%), whereas rubbish dumps accounted for 0.96%.

Conclusion:
The current study showed, a low percentage of T. gondii oocysts are recorded in soil samples as compared with other studies worldwide, but there is still the risk of infection among people who ramble at these places remains, especially among children who play with soil at these places.
Patients Characteristic, Indications, and Complications of Permanent Pacemaker Implantation
Authors: Ahmed Mousa Haji 
Published: July 2022

Background:
Permanent pacemaker implantation is a relatively safe procedure that significantly improves morbidity and mortality among patients with bradyarrhythmias. This study was conducted to determine the patients’ characteristics, indications, and complications of pacemaker implantation.

Materials and Methods:
This was a single-center, prospective study conducted in Azadi Heart Center, Duhok, Iraq between March 2013 and March 2020. All patients who had indications for permanent pacemaker implantation according to the current guidelines (AHA/ACC) were included and followed up for at least 1 year.

Results:
The study included 396 patients (242 males [61%] and 154 females [39%]) with a mean age of 65 ± 16 years. The most common presenting symptom was dizziness (63%). Atrioventricular block was the most common indication for pacing in 249 cases (63%), followed by sick sinus syndrome (SSS) in 138 patients (34.8%). The most common mode of pacing was DDD in 234 patients (59%). Among all patients undergoing permanent pacemaker implantation, 17 patients (4.25%) developed early and late complications. The most common early complication was pocket hematoma seen in four patients (1%), followed by pneumothorax in three patients (0.75%). Among late complications, painful shoulder was the most common affecting four patients (1%).

Conclusions:
Pacemaker implantation is a relatively safe procedure with a low complication rate. Elderly males were the most common group receiving permanent pacemaker. Dual-chamber (DDD) pacing mode was the most commonly used mode.
Knowledge, Attitude, and Practice of Junior Doctors about Thalassemia in Babylon Province
Authors: Baqer Ola Musadaq , Al-Humairi Ameer Kadhim 
Published: July 2022

Background:
Thalassemia is a chronic condition that is caused by hereditary defects in hemoglobin production. Thalassemia is classified into two major categories, named α- and β-thalassemia, according to the hemoglobin gene defect. Premarital screening in the family members, followed by prenatal diagnosis is the most effective strategy for control of thalassemia. The most important thing is the determination of the traits or carriers of thalassemia. In our country, doctors acquired knowledge about thalassemia when they were students in medical college and after graduation, they worked in different hospitals. Some of them had worked in the thalassemia unit whereas others had not.

Objectives:
To assess the knowledge, attitude, and practice of junior doctors about thalassemia in Babylon province.

Methodology:
A cross-sectional study was conducted on 200 junior doctors (resident doctors and permanent doctors) who had different years of experience and places of work in Babylon province. The knowledge, attitude, and practice were assessed according to scoring by a group of researchers.

Results:
A cross-sectional study of 200 junior doctors (resident and permanent doctors), whose age ranged from 24 to 34 years with a mean age of (27.5 ±2.27) years. Most of the junior doctors were females: 145 (72.5%) worked in the emergency department 107 (53.5%). There were 92 (46%) junior doctors who possessed adequate knowledge about thalassemia. There were a significant association between knowledge and age, position/job, and smoking: P = 0.01, 0.02, and 0.04, respectively. The doctors had a positive attitude and good practice about thalassemia, 65 (32.5%) and 84 (42%) respectively. Regarding attitude, there is a significant association between it and position/job, P = 0.02 and in practice there is a significant association between it and gender, which is more in females (P = 0.02).

Conclusion:
The doctors had adequate knowledge, positive attitude, and good practice about thalassemia: 92 (46%), 65 (32.5%), and 84 (42%), respectively.
Medical and Social Analysis of Preschool Children Under the Age of Six Years at Secondary and Tertiary Care after Home Accidents in Hilla City
Authors: Nsaif Aya Kadium , Al-Joborae Sijal Fadhil Farhood 
Published: July 2022

Background:
Accidents mainly occur at home, children are the most vulnerable to in any household.

Objectives:
The goals of this study were to identify the commonest causes of home accidents that necessitate secondary and tertiary care admission. And to find out social variables related to home accidents.

Patients and Methods:
It is a descriptive hospital-based cross-sectional study which was carried out on a convenient sample of 200 preschool children who were cared for Emergency Department in Babylon Maternity and Pediatrics Hospital and Imam Sadik General Teaching Hospital whose mothers accepted to participate in this study. It was conducted over a period of four months from April 1 to August 1, 2021. Data were collected through interviewing the participants who were asked to give their verbal consent to a structural questionnaire containing information about sociodemographic factors, child, and family variables. The information was analyzed using SPSS version 24.

Result:
The rate of home accidents (falls and blows by forceful sticks) among children under the age of six years were 55.50% and 24.50%, respectively. From the different investigated factors, Paternal educational level showed significant relation to home accidents, and other variables (maternal educational level, number of family members, and home size) were found to be risk factors for home injuries.

Conclusion:
Falls were the commonest cause of unintentional injuries; in children, home accidents are still the major problem and jeopardize the lives of children. Home accidents among children under the age of six years are increasing and this issue requires more attention and effort.
Visual Evoked Potential Findings and Correlation between Visual Evoked Potential and Clinical Severity in Children with Autism Spectrum Disorder
Authors: Hamdan Farqad Bader , Shareef Hula Raoof , Jasim Hamida Salim 
Published: July 2022

Background:
Autism spectrum disorder (ASD) is a heterogeneous behavioral disorder that is characterized by qualitative deficits in social communication and interaction and restricted, repetitive behavioral patterns, activities, and interests. For an optimum outcome in children with autism, early intervention (preferably before three years of age) is essential. Hence, there is a critical need to improve the awareness of ASD to enable earlier detection and intervention. The present study aims at achieving the following: (1) Investigating neural transmission within the visual system using visual evoked potentials (VEPs) as an index of the myelination process of the visual pathway. (2) Correlating the changes in the VEPs with the clinical severity of autism. (3) Investigating the possible gender differences in VEPs in autistic children.

Materials and Methods:
The study was conducted on 60 preschool children (11 females and 49 males) who were recruited from the autism center and the pediatric neurology ward and who met the DSM-V criteria for autism in the Pediatric Hospital for the period from 12 December 2019 to 1 June 2021. Their mean age was 4.5±1.17 years. Another 50 (40 males and 10 females) age- and gender-matched normally developed children served as the control group. Both groups were subjected to a detailed history, as well as complete physical and neurological examinations. The VEPs were assessed for all of them. The autistic children were excluded from the study if they had any motor, visual impairment, inborn errors of metabolism, epilepsy, other chronic medical or neurological disorders, or if they were taking medications during the period of study.

Results:
The P100 wave latency of the VEPs was significantly prolonged in both eyes of autistic children as compared with that of the control group. The N75-P100 amplitude was significantly lower in the left but not the right eye of patients when compared with those of normally developed children. Neither the P100 wave latency nor the N75-P100 amplitude of both eyes was associated with the gender or severity of illness.

Conclusion:
There are distinct changes in VEPs in autistic children, especially the abnormal prolongation of conduction time, suggesting that autistic children may have brainstem and visual pathway dysfunction. Gender and disease severity score have no impact on VEPs.