bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of oral lactoferrin as a source of iron supplementation in correction of anemia in pediatric patients with chronic kidney disease stages 2–4
Authors: El-Farsy Mohamed S. , El-Hakim Ihab Z. , Al-Arian Rawan A. 
Published: September 2022

Background
Children with chronic kidney disease (CKD) have multiple risk factors for anemia such as primary erythropoietin deficiency, blood loss, decreased red blood cell (RBC) survival, bone marrow suppression, iron deficiency, inflammation and infection, malnutrition, hyperparathyroidism, vitamin B12 and folate deficiency, aluminum toxicity, and carnitine deficiency. This study was performed to evaluate the effect of oral bovine lactoferrin on patients with iron deficiency with CKD stages 2–4.

Patients and methods
This follow-up cohort clinical study was conducted on children with CKD in the conservative clinic, Pediatric Nephrology Unit, Children's Hospital, Ain Shams University. It included 45 pediatric patients with CKD stages from 2 to 4 for 6 months without a control group. This is a follow-up case study in which all the included patients were on erythropoietin therapy ranging from 150 to 300 IU/kg once per week. The patients were subjected to history and laboratory evaluation, including hemoglobin (Hb), serum iron, serum ferritin, and total iron-binding capacity (TIBC), which were done for the patients at baseline and 6 months after treatment with bovine lactoferrin for 6 months.

Results
Blood Hb and RBC volume were significantly increased beginning from first month after oral lactoferrin therapy, serum iron and serum ferritin were significantly increased 6 months after intervention, and serum TIBC was significantly decreased after intervention. The current study had shown no significant difference between males and females regarding laboratory changes 6 months after intervention. Laboratory improvements were significantly lowest among cases with stage 4, followed by stage 3, and the highest among cases with stage 2. There was a decrease in all anemia clinical manifestations after 6 months of lactoferrin administration; the differences were significant only in easy fatigability, constipation, and gastrointestinal upset, which were the most frequent adverse effects.

Conclusion
Oral lactoferrin was found to be effective in treating iron-deficiency anemia regarding blood Hb, blood RBCs, serum iron, serum ferritin, and TIBC in association with erythropoietin therapy. The effect declines with the progression of CKD.
Association between Serum Fibroblast Growth Factor 21 and Presence of Allostatic Load among Industrial Workers
Authors: Ravibabu Kalahasthi , Nagaraju Raju , Balachandar Rakesh , Adepu Vinay Kumar 
Published: September 2022

BACKGROUND:
Fibroblast growth factor 21 (FGF21) mediates metabolic changes and chronic stress. Allostatic load (AL) is an imbalance between repetitive exposure to stress and adaptive response. This study examined the association between FGF21 and the presence of AL among industrial workers.

METHODS:
The study is cross-sectional and observational. Parameters data were collected from 169 male industrial workers. AL was assessed using neuroendocrine (cortisol and Dehydroepiandrosterone sulfate), cardiovascular (systolic blood pressure, diastolic blood pressure, and heart rate), metabolic (total cholesterol, triglyceride, high-density lipoprotein-cholesterol, and low-density lipoprotein-cholesterol), and anthropometric (waist-hip ratio and body mass index) measurements. Serum FGF21 was analyzed using the ELISA method. The data were analyzed using SPSS version 20.

RESULTS:
The results of the study showed that 43.2% and 56.8% of workers had low and high AL, respectively. Serum (natural logarithm) Ln-FGF21 was significantly elevated in workers with high AL when compared to moderate and low AL. The association between serum FGF21 and AL was analyzed using the linear regression model. The model indicated that age (β = 0.143, P = 0.038) and serum FGF21 (β = 0.162, P = 0.045) were significantly associated with AL. In high AL condition, the receiver operating characteristic area under the curve for Ln-FGF21: 0.656 (95% confidence interval: 0.570–0.742, P = 0.001) was found to be higher as compared to moderate and low AL.

CONCLUSIONS:
FGF21 was significantly increased in high AL conditions when compared to low and moderate AL among workers. Therefore, we recommended that FGF21 could be used as a potential biomarker to screen and protect strategy against high AL.
Knowledge and Awareness About Preanesthetic Evaluation for Performing Procedures under General Anesthesia among Dental Students - A Cross-Sectional Study
Authors: Kavitha Pasala , Saikiran Kanamarlapudi Venkata , Elicherla Sainath Reddy , Anchala Karthik , Prasanth Punamalli Symon , Nuvvula Sivakumar 
Published: September 2022

BACKGROUND:
Lack of knowledge on preanesthetic evaluation before any general anesthesia (GA) procedures will lead to uncertainty in the outcome of the surgery. Hence, the present study aimed to evaluate the knowledge and awareness about preanesthetic evaluation for performing procedures under GA among dental graduates.

METHODS:
A 13-item questionnaire was prepared from the standardized method using focus group discussion. The questionnaires were sent to 1020 students (508 house surgeons, 512 postgraduates) through the registered E-mail address and WhatsApp as a Google form link. We received 246 responses at the end of 2 weeks, and finally, 509 responses were received at the end of 4 weeks. The data from the responses were collected, and descriptive analysis was done using a Microsoft Excel sheet (Version 2016). A Chi-square test was performed to compare the responses from house surgeons and postgraduates.

RESULTS:
A total of 523 responses out of 1020 were received within a period of 4 weeks. From this, 14 responses were excluded from the final analysis due to repeated responses and the final analysis was done using 509 responses (270 postgraduates [53%] and 239 house surgeons [47%]). More than half of the participants had insufficient knowledge regarding preanesthetic evaluation.

CONCLUSION:
The knowledge and awareness were good among the dental postgraduate students compared to house surgeons but implementing that in practice was relatively negligible. Therefore, understanding the importance of preanesthetic evaluation can help the students to reduce potential risk and improves the quality of life among the patients.
Libyan Medical Students' Knowledge, Attitude, and Barrier Toward Clinical Research
Authors: Atia Ahmed , Al-Abbasi Fatima , Benneama Maram , Ammoush Aya , Al-Ghrabi Amani 
Published: September 2022

BACKGROUND:
Undergraduate involvement in research necessitates better understanding of their potential, as well as the anticipated barriers they will face. The objective of this study was to assess medical undergraduates' knowledge, attitudes, and research barriers.

METHODS:
This was a cross-sectional study conducted on medical students from the University of Tripoli, Libya, where a self-administered questionnaire was used to evaluate the students' knowledge, attitudes, and perceived barriers. Filled questionnaires were received from the medical undergraduates of different faculties of medical specialties. Data were analyzed using descriptive statistics.

RESULTS:
A total of completed questionnaires were received from 120 undergraduate medical students. The overall result of knowledge among them was encouragingly good (51%). Majority of the students taught that the main barriers in conducting research were lack of awareness (71.7%), lack of self-interest (56.7%), lack of faculty encouragement for research (84.2%), insufficient time (59.2%), and difficulty in obtaining resources and data for research (68.3%).

CONCLUSION:
Participants in the current study showed a moderate knowledge level with associated positive attitudes toward research. This attitude needs to be transformed into better knowledge and appropriate practice.
DNA Vaccine Construct Formation using Mycobacterium-Specific Gene Inh-A
Authors: Anwar Summayya , Qureshi Javed Anver , Shahzad Mirza Imran , Zaman Muhammad Mohsin , Jilani Aeman 
Published: September 2022

BACKGROUND:
Tuberculosis (TB) remains a highly contagious disease and a leading cause of death worldwide. It is caused by Mycobacterium tuberculosis and Mycobacterium bovis. TB infection is still uncontrolled because of the unavailability of an effective vaccine, co-infection with HIV, lengthy treatment, and the emergence of resistant forms of M. tb like multi/extreme drug resistance strains. TB is mainly a disease of underdeveloped countries because of inadequate health facilities. The development of the new state of modern art vaccine-like DNA vaccine is a promising approach to control TB. The DNA vaccine can be used alone or in combination with Bacille Calmette Guerin (BCG). The objective of the current study is to develop an M. tb gene inh-A based DNA vaccine.

METHODS:
The immunodominant gene (Rv1484/INH-A) was amplified using sequence-specific primers. The amplified product was cloned into Topo 2.1 polymerase chain reaction vector, confirmed through restriction digestion and sequence analysis. Finally, subcloned into mammalian expression pVAX1 vector.

RESULTS:
The inh/A-pVAX1 construct was again confirmed through restriction digestion and sequence analysis. The rightly oriented constructs were selected, and these will be used for in Vivo DNA vaccine immunization studies.

CONCLUSITONS:
DNAvaccine can be used alone or in combination with BCG. DNA vaccines have enough potential to be used with TB treatment and reduce the treatment time in future.
Determination of the Level of Von Willebrand Factor and ADAMTS13 in Sickle Cell Anaemia Patients in Steady State
Authors: Kingsley Akaba , Ofonime Essien , Enobong Uboh , Iquo Ibanga 
Published: September 2022

Background:
Sickle cell anaemia (SCA) is a hypercoagulable state with alteration in the haemostatic parameters and may contribute to thrombosis in a steady state. The levels of von Willebrand factor (VWF) and ADAMTS13 antigen in the steady state as markers of thrombotic risk have not been fully investigated in our environment.

Aim:
Evaluation of the level of VWF and ADAMTS13 as a marker of thrombotic risk in SCA subjects in the steady state at UCTH, Calabar.

Subjects and Methods:
This is a comparative study carried out at UCTH, Calabar. Sixty SCA patients were evaluated in the steady state with apparently healthy controls matched for age and sex VWF. Ag, and ADAMTS13. Ag was evaluated using Assay Pro enzyme-linked immunosorbent assay kit. Data was analysed with IBM Statistical Package for Social Sciences Chicago Software version 26.

Results:
The median age of SCA and controls were 23 years and 20 years, respectively (P = 0.962). There were no significant differences in their sex distribution (P = 0.063). The mean ± standard deviation (SD) of VWF in the steady state and control were 1.34 ± 0.23 IU/mL and 1.41 ± 0.23 IU/mL with no significant difference in their mean (P = 0.864). The mean ± SD of ADAMTS13 in the steady state and control were 0.44 ± 0.06 μg/L and 0.62 ± 0.10 μg/L, respectively, with no significant difference in their mean (P = 0.171).

Conclusion:
There was no significant difference between VWF. Ag, ADAMTS13, and VWF. Ag: ADAMTS13 antigen ratio in SCA in the steady state and control. There is a need for further research to determine their functionality.
Remineralization Activities of Toothpastes with and without Aloe Vera with Different Ratios of Fluoride on Demineralized Enamel
Authors: Yikici C , Özcan S 
Published: September 2022

AIM and Background:
The aim of this in-vitro study was to evaluate and compare the efficacy of both pure aloe vera and commercially available toothpastes with different fluoride compounds and different fluoride amounts on artificial initial enamel lesions by Vicker's microhardness values. In the study, 72 extracted human molar teeth were divided into mesiodistal and 144 specimens were prepared using the vestibule and palatal/lingual surfaces of the teeth. After the surface treatments and initial microhardness measurements, all the specimens were placed in a demineralizing solution (pH: 4.5) for 7 days, resulting in artificial initial enamel lesion, and were randomly assigned to eight groups (n = 18). After the teeth were subjected to pH cycle for 14 days, microhardness measurements were repeated and the data were recorded.

Materials and Methods:
Statistical analyzes were performed using MedCalc Statistical Software version 12.7.7. The significance level was determined to be 0.05.

Results:
In the statistical results, when the microhardness values after demineralization and post-cycle were compared, Groups B1 and A2 showed the lowest values, while Groups A3 and B3 did not show a significant difference in terms of microhardness values after demineralization and post-cycle, and only Group B4 showed statistically significantly higher values.

Conclusions:
This study emphasized the remineralization effects of fluoride on initial enamel lesions. It can be said that toothpaste containing 1450 ppm fluoride and aloe vera provides an effective remineralization and sodium monofluorophosphate formulation may have a synergistic effect with aloe vera.
Comparison of Propofol-Fentanyl and Propofol-Ketamine for Sedoanalgesia in Percutaneous Endoscopic Gastrostomy Procedures
Authors: Duran M , Dogukan M , Tepe M , Ceyhan K , Sertkaya M , Uludag O , Yilmaz N 
Published: September 2022

Background:
Percutaneous endoscopic gastrostomy (PEG) procedures are performed under sedation in critically ill patients who cannot be fed orally.

Aim:
We compared the efficacy and safety of propofol-fentanyl and propofol-ketamine for deep sedation in patients undergoing PEG. Retrospective Study.

Materials and Methods:
The study was conducted from 1 January 2013 to 31 December 2018 in Adıyaman University. The patients given propofol-fentanyl (0.5–1.2 mg/kg and 0.2–1 μg/kg, respectively) for sedo-analgesia were designated Group F, and those who received propofol-ketamine (0.2–0.6 mg/kg and 0.5–1 mg/kg, respectively) were placed in Group K. The demographic and hemodynamic characteristics, recovery times, perioperative complications, and need for additional doses were recorded.

Results:
Seventy-one patients who underwent PEG were analyzed. The age, sex, American Society of Anesthesiologists (ASA) score, comorbidities, duration of anesthesia, and duration of the PEG procedure were similar in the two groups. Recovery time was longer in Group K. The total propofol dose was 64 mg in Group F and 35 mg in Group K. Additional doses of propofol were administered to 12 patients in Group F, compared to none in Group K. The mean blood pressure values were higher in Group K at all-time points. The perioperative complication rate was higher in Group F. Desaturation was observed in 9 (22.5%) patients in Group F and in 3 (9.6%) patients in Group K. Hypotension was observed in 4 (10%) patients in Group F.

Conclusion:
Propofol-ketamine should be preferred for sedoanalgesia during PEG procedures because of the lower dose of propofol, more stable blood pressure, and greater peripheral oxygen saturation. In addition, we believe ketamine-propofol is safer based on its low complication rate.
Correlation Between Prostate Volume and Prostate-Specific Antigen in Nigerian Men with Symptomatic Histologically-Diagnosed Benign Prostatic Hyperplasia
Authors: Aigbe E , Irekpita E , Ogbetere FE , Alili UI 
Published: September 2022

Background:
Prostate-specific antigen (PSA) is elevated in the serum of most men with prostatic diseases. Benign prostatic hyperplasia (BPH) is the commonest of these diseases. The degree of enlargement of the prostate may determine the amount of PSA elaborated. Several reports in some parts of the world have shown a significant correlation between prostate volume (PV) and PSA. However, only a few reports have been documented in Nigeria, especially in the South-South region.

Aim:
This research aimed to ascertain if there is any correlation between prostate volume (PV), total PSA (tPSA), and free PSA (fPSA) in men with histologically diagnosed BPH. This knowledge may help in the estimation of PV from a given PSA.

Patients and Methods:
This prospective hospital-based study was carried out in a southern Nigerian tertiary hospital between November 2017 and October 2018. Eighty (80) eligible and consenting patients participated in the study and were enrolled at first contact in the urology clinic. Each patient's blood was taken for PSA estimation. The prostate volume was estimated by transrectal ultrasound scan (TRUS). Those who had tPSA values greater than 4 ng/mL whose biopsy report showed prostate malignancy were excluded from the study. A proforma was used to collect patients' sociodemographic and clinical information. Data were entered and analyzed with Statistical Package for Social Sciences version 22 (SPSS Inc., Chicago, IL, United States). For all statistical tests, P < 0.05 was regarded as significant.

Results:
The mean age of the patients for this study was 68.03 years. The mean prostate volume was 87.9 mL with a range of 34 to 234 mL. The mean tPSA was 5.5 ng/mL with ranges of 1.1 to 21.1 ng/mL. There was a significant correlation between PV and tPSA with a P value of 0.0001. This correlation was also shown between PV and fPSA with a P value of 0.0001.

Conclusion:
There is a statistically significant correlation between PV and PSA (both free and total) in men with symptomatic histologically diagnosed BPH. This finding showed that larger benign prostate glands elaborated greater amounts of PSA. It may, therefore, be appropriate to say that it is not in all cases of elevated serum tPSA that the possibilities of malignancy or inflammation should be entertained.
A Comparison of Goldmann Applanation Tonometry and Rebound Tonometry Measurements Among Patients Attending a Glaucoma Clinic in Southwest Nigeria
Authors: Ashano O , Oderinlo O , Ogunro A , Ashano E 
Published: September 2022

Background:
The accurate measurement of intraocular pressure (IOP) is a fundamental basic examination in daily ophthalmic practice and is important in managing many ophthalmic diseases and conditions such as glaucoma, uveitis, and following trauma. Accurate measurement of IOP is particularly important in glaucoma because the intraocular pressure is the most important modifiable risk factor in its management.

Aim:
To compare intraocular pressure (IOP) measurements obtained with the Goldmann applanation (GAT) tonometer to intraocular pressure measurements obtained with the iCare rebound tonometer (RBT) and evaluate the suitability of the iCare tonometer for routine clinical use among adult patients attending a glaucoma clinic in Southwest, Nigeria.

Patients and Methods:
The study was a comparative cross-sectional study. A total of 132 eyes of 132 patients were recruited for the study. Three consecutive IOP measurements were obtained with each of the instruments by the same observer. A difference in IOP of ± 3 mmHg between the two instruments was considered clinically significant in this study.

Results:
The mean IOP measurement from GAT was 15.18 mmHg (±4.26 mmHg) and 16.32 mmHg (±4.48 mmHg) from RBT. The mean central cornea thickness was 520.66 μm (±33.34). Pearson's correlation (r = 0.84) revealed a strong statistically significant correlation between GAT and RBT measurements and paired student t-test revealed a statistically significant difference in the means of IOP obtained by the GAT and RBT. There was a tendency for RBT to yield higher IOP measurements.

Conclusion:
The intraocular pressure measurements obtained with iCare RBT and GAT though strongly correlated, showed statistically significant differences in the means. The impact of central cornea thickness on measurements obtained by GAT and RBT was statistically insignificant. The iCare rebound tonometer, cannot replace GAT for routine use in the glaucoma clinic.
Dexmedetomidine versus tramadol for preventing postanesthesia shivering following major maxillofacial surgery
Authors: Shafshak Wafaa M. , Arida Emad E.A. , Zanaty Ola M.E. , Elkhayat Mohammed 
Published: September 2022

Background and aims
Shivering is distressing to the patient and discomforting to the attending anesthesiologist, with a varying degree of success. Various drugs and regimens have been used to abolish the occurrence of shivering. This study aims to study and compare the efficacy of dexmedetomidine and tramadol in the prevention of post general anesthesia shivering in patients undergoing major maxillofacial surgery.

Patients and methods
The study was carried out on 64 adult patients, in the age group from 20 to 60 years of both sexes, American Society of Anesthesiology physical status I and II, admitted at the Maxillofacial Surgery Department at Alexandria Main University Hospital and scheduled for major maxillofacial surgery lasting for more than 4 h. Patients were randomly divided into two equal groups of 32 patients each, using sealed envelopes. This study was a single-blinded study. Group I patients received intravenous dexmedetomidine 1.0 μg/kg 15 min before wound closure. Group II patients received intravenous tramadol 0.1 mg/kg 15 min before wound closure. Vital signs such as heart rate, blood pressure, oxygen saturation, core body temperature, and surface body temperature were observed and recorded on arrival to the postanesthesia care unit, 5, 10, 15, 20, 30 min, 1, 3, 6 h after surgery. Any incidence, occurrence, and duration of shivering was recorded and intensity of shivering using the four-point scale. Statistical analysis of the data were fed to the computer and analyzed using IBM SPSS software package, version 20.0. Qualitative data were described using number and percent. Quantitative data were described using range (minimum and maximum), mean, SD, and median. Significance of the obtained results was judged at the 5% level.

Results
There was no statistically significant difference between the two groups regarding demographic data, duration of anesthesia and oxygen saturation. Heart rate was statistically significantly lower in group I (dexmedetomidine) than in group II (tramadol group) (P≤0.001). There was a statistically significant difference in blood pressure between the two groups being lower in group I (dexmedetomidine). Core and surface body temperature were statistically significantly lower in group I (dexmedetomidine); there was no significant difference in either occurrence, intensity, or duration of shivering.

Conclusions
intravenous dexmedetomidine and tramadol seems to possess antishivering properties and were found to reduce the occurrence of shivering in patients undergoing general anesthesia.