bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Characteristics and Immunosuppression Management in Kidney Transplant Recipients Infected with Severe Acute Respiratory Syndrome Coronavirus 2 Infection - An Observational Study
Authors: Somasundaram Kiruthika , Thoppalan Balasubramaniyan , Chellaiah Vasudevan , Kumar R. P. Senthil , Murugesan V. , Thirumavalavan S. 
Published: June 2022

Background:
COVID-19 infected kidney transplant patients need specialist care in tailoring their immunosuppression drugs alongside routine care.

Methods and Materials:
This is an observational data from a single center of 12 kidney transplant recipients (KTR) who were hospitalized with COVID-19 from April 2020 to November 2020. The demographics, COVID treatment including immunosuppressive drug regimen were reviewed. Their graft function during the stay, at the time of discharge, and 30 days after discharge was also reviewed.

Results:
Of 12 patients included, 83% were male patients. The median age was 37 years and the median time since transplant was 42 months. Common comorbidities were diabetes (50%), hypertension (50%), and cardiovascular disease (8%). Ninety-two percent had triple immunosuppressive regimen whereas 8% were in steroid-free protocol. Fifty percent had mild COVID, 8% had moderate disease, and 41% has severe COVID which was managed with institution-specified protocol. Steroids dose was increased in all patients. Antimetabolite was uniformly withdrawn in all patients irrespective of disease severity. Acute kidney injury was noted in 50% of patients which recovered to baseline at discharge. Graft function at 2 weeks and 30 days after discharge was stabilized close to their baseline value. Mortality was 8%.

Conclusion:
Reduction of immunosuppression, especially the withdrawal of antimetabolites, was found to be safe without graft rejection in KTRs.
Stretching the Limits
Authors: Panwar Pankaj , Bansal Devanshu , Maheshwari Ruchir , Chaturvedi Samit , Desai Pragnesh , Kumar Anant 
Published: June 2022

Context:
Optimum main renal artery (RA) length before first branching needed to achieve single lumen during laparoscopic donor nephrectomy (LDN) is not known.

Aims:
The aim of the study is to identify optimal minimum length of RA before first branching which can be safely harvested as a single lumen in LDN.

Settings and Design:
This is a single institutional, retrospective study.

Materials and Methods:
Records of consecutive left LDNs performed at our institute from January 2016 to June 2019 were reviewed. RA length was measured from preoperative computed tomography angiogram. We clipped RA using two Hem-o-lok® and one titanium clip while maintaining constant mild upward traction. Primary outcome was to identify lowest RA length at which chances of achieving a single lumen were maximum. Secondary outcomes included minimum RA length below which single lumen could not be achieved and incidence of intraoperative vascular complications.

Statistical Analyses:
Receiver operator characteristic curve was plotted according to donor RA length. Likelihood ratio positive (LR+) was used to identify optimum length of RA above which chances of achieving single lumen were maximum.

Results:
Four hundred and eighty-eight donors with single RA underwent left LDN during study period. LR +of achieving single lumen after clipping was maximum at 10mm cutoff. Single lumen could not be achieved below 6–7 mm cutoff. There were no vascular complications or re-explorations.

Conclusions:
Main left RA length ≥10 mm before first branching is most likely to yield single lumen for implantation with our technique.
A Clinical Study of the Pattern of Dermatoses among Schoolgoing Children Attending a Tertiary Care Center in North Karnataka
Authors: Chitapur Umamaheshwari G. , Athanikar Sharatchandra B. , Kikkeri Naveen Narayanshetty , Prabhu Sweta R. 
Published: June 2022

Introduction:
Pediatric dermatoses are a distinct group of disorders, comprising skin problems encountered during childhood and adolescence.

Objectives of the Study:
This study aimed to assess the clinical pattern and prevalence of various dermatoses among schoolgoing children in a tertiary care center in North Karnataka.

Materials and Methods:
Patients in the age group of 5–14 years with skin diseases attending dermatology outpatient department were enrolled in this study. A predesigned pro forma was used for all cases. A detailed history was taken. Clinical examination and relevant laboratory investigations were done to confirm the diagnosis in doubtful cases.

Results:
This study included a total of 550 patients. The most common pattern of dermatoses was infections and infestations constituting 40.5% (223 cases). The other common dermatoses in order of prevalence were eczema/dermatitis constituting 14.4% (79 cases), papulosquamous disorders: 6.9% (38 cases), hypersensitivity disorders: 6.2% (34 cases), and pigmentary disorders: 5.1% (28 cases). Among the infections and infestations, fungal infections were most common (14%), followed by parasitic infestations (13.8%), viral infections (8.7%), and bacterial infections (4%). Pityriasis alba was the most common eczematous disease.

Conclusion:
The most common pattern of dermatoses seen in our study was infections and infestations, followed by eczematous disorders. A detailed knowledge about the pattern of dermatoses among schoolgoing children will help us in implementing essential changes in health education and disease control strategies in the area concerned.
Successful Use of Acitretin in an Indian Child with Lipoid Proteinosis
Authors: Kote Shraddha P. , Chopkar Apoorva Dhananjay , Supekar Bhagyashree Babanrao , Mukhi Jayesh Ishwardas 
Published: June 2022

Introduction:
Lipoid proteinosis is a rare autosomal recessive disease, characterized by deposition of Periodic Acid[FIGURE DASH]Schiff-positive hyaline material in the skin, mucous membrane of the upper aerodigestive tract, and different organs of the body, resulting in varied clinical manifestations.

Case Report:
We report a case of lipoid proteinosis in a 7-year-old boy who responded well to oral acitretin therapy.

Discussion:
Lipoid proteinosis is a rare disease entity, and very few reports have been mentioned in the literature based on its treatment modalities, with each treatment showing varied success rates. Oral acitretin can prove useful in cases of failure or inadequate response to other treatment, as seen in our case.
Efficacy and Safety of 10,600 Nm Fractional Carbon Dioxide Laser Versus 88% Phenol in Treatment of Idiopathic Guttate Hypomelanosis
Authors: Deepadarshan K. , Harish M. R. , Shashikumar B. M. , Chandran Priyanka R. 
Published: June 2022

Abstract

Background:
Idiopathic guttate hypomelanosis (IGH) is a common benign acquired leukodermic dermatosis characterized by multiple, discrete, hypopigmented-to-depigmented macules. Various treatment modalities were tried for this condition with varied results.

Purpose:
This study was conducted to compare the efficacy and safety of fractional carbon dioxide laser and 88% phenol in the treatment of IGH.

Methods:
A total of 40 patients with five IGH macules on each side were treated with one session of fractional carbon dioxide laser on the right side and a single application of 88% phenol on the left side and were assessed monthly for 3 months. The improvement in pigmentation was graded as ≤25% - poor, 26%–50% - minimal, 51%–75% - good, and >75% - excellent response.

Results:
A total of 32 patients completed the study. Out of the 160 macules treated with laser, 16 (10%) macules showed an excellent response and 40 (25%) showed a good response, and 40 (25%) and 48 (30%) macules in the phenol group showed excellent and good improvement, respectively. Side effects such as persistent scabbing and ulceration were seen only on the phenol side.

Conclusion:
Single application of 88% phenol was more efficacious than one session of fractional carbon dioxide laser in inducing pigmentation in IGH macules in this study. However, fractional carbon dioxide laser can be considered a safer alternative modality.
Assessment of the Saudi Arabian Telemedicine Experience During the COVID-19 Pandemic
Authors: Alsharif Sahar H. , Alsharif Nizar , Alassiri Rimaz , Khouj Ghaidaa , Alshareef Noura , Aloufi Anwaar , Hussain Arwa 
Published: June 2022

Abstract

Background:
COVID-19 is a pandemic disease that spreads rapidly. The World Health Organization recommended social distancing to prevent disease transmission. Telemedicine was one of the most important tools used during the pandemic to provide health-care services. Different clinics, including dermatology clinics, tended to use telehealth and online tools. In addition, various dermatological conditions were diagnosed and treated by family physicians using the telemedicine applications of the Saudi Ministry of Health (MOH).

Purpose:
The present study aimed to evaluate the efficacy of family physicians using telemedicine to diagnose and manage different dermatological conditions. Specifically, we aimed to identify the common dermatological conditions that family physicians faced during the COVID-19 pandemic, as well as the use of the various telemedicine applications launched by the Saudi MOH. We also intended to assess the need for dermatologists in the telemedicine applications of the Saudi MOH and suggest possible improvements to the telemedicine process and related Saudi MOH applications for sustainable online health care.

Methods:
The cross-sectional study was conducted across Saudi Arabia among family physicians and general practitioners to assess their perception of using telemedicine for dermatology-related consultations. The self-administered survey questionnaire contained 16 questions in five sections.

Results:
A total of 302 family medicine and general physicians completed the questionnaire. Altogether, 165 (54.6%) physicians reported that they had never used telemedicine before the COVID-19 pandemic, while 12.9% reported frequent to continuous use. During the pandemic, 86.8% of family and general physicians used telemedicine for dermatological consultations. The most used methods were phone calls (57.6%) and the SEHA application (42.7%). A total of 96.4% of participants reported that they dealt with dermatological conditions before the COVID-19 pandemic. Interestingly, about 99% of family physicians reported that they faced difficulty diagnosing dermatology-related consultations. Telemedicine was frequently used by all physicians in the central region compared with 76.7% of those in the western region (P = 0.035).

Conclusion:
Family physicians in Saudi Arabia increased their telemedicine practicing during the pandemic. Different telemedicine tools were used, such as phone calls, virtual clinics, and Saudi MOH applications (SEHA, TETAMMAN, TABAUD, TAWAKKALNA). The majority of family physicians faced difficulty diagnosing dermatological conditions. In addition, most reported that dermatologists should be part of health-care facilities and telemedicine centers to deal with dermatology-related consultations.
Burnout Syndrome in Dermatology Residents
Authors: Shadid Asem M. , Aldosari Batal M. , Algarni Abdullah M. , Dahmash Abdulmajeed Bin , Altalhab Saad , Alharithy Ruaa 
Published: June 2022

Abstract

Background:
Burnout is defined by three dimensions: emotional exhaustion (EE), depersonalization (DP), and low personal feelings of achievement (PA). It is a prolonged response to chronic emotional and interpersonal stressors on the job. If unrecognized, the costs to the health-care system can be enormous.

Purpose:
The aim of this study is to investigate the prevalence of burnout levels and predictors among dermatology residents and the risk factors associated with it.

Methods:
Validated measure of burnout (Maslach Burnout Inventory–Human Services Survey), alongside the possible risk factors of burnout, was distributed to all dermatology board training residents in all affiliated centers in Riyadh, Saudi Arabia. The response rate was 96.2% with 51 residents completing the survey out of 53.

Results:
High EE was present in 41.2% of dermatology residents, a low sense of PA in 45.1%, while high DP was the least prevalent at 13.7%. Satisfaction with career was significantly associated with risk of high EE (odds ratios [OR] = 0.61, 95% Confidence interval [CI] = 0.15–22.3), risk of high DP (OR = 0.34, 95% CI = 0.08–0.316), and risk of low PA (OR = 0.86, 95% CI = 0.52–6.1). The average number of sleeping hours was also associated with risk of high EE (OR = 0.87, 95% CI = 0.54–3.88), risk of high DP (OR = 0.76, 95% CI = 0.5–1.41), and risk of low PA (OR = 0.86, 95% CI = 0.52–6.1). Our findings report high over all burnout in 7.8% of the respondents.

Conclusion:
EE and feelings of low PA were seen at a high rate among dermatology residents, while DP was the least prevalent across all burnout dimensions. Average daily sleeping hours alongside satisfaction with life/work balance, career, and salary showed a statistically significant association with DP, low PA, EE, and overall burnout. Protected time to pursue academic interests, for example, research and teaching, and a fair distribution of on-call hours per month, as well as a number of clinics per week may explain the rate of burnout in our study. These findings can be applied in the improvement of training programs to reduce the burnout rate among residents.
Skin Cleansing and Wound Care Practice in Patients with Epidermolysis Bullosa
Authors: Alheggi Ashjan , Alzakry Leena , Khunayn Rawan Bin , Alshareef Rahaf , Al-Khalid Yara 
Published: June 2022

Abstract

Background:
Epidermolysis bullosa (EB) is a group of genodermatoses characterized by fragile skin that may progress to erosions, blisters, and open nonhealing wounds. Understanding home skincare practices and topical products use among patients with EB is necessary to optimize management outcomes and quality of life.

Purpose:
The purpose of this study was to assess home bathing, skincare routines, and topical product used in patients with EB.

Methods:
Cross-sectional, observational study data were collected from patient-directed questionnaires in the Saudi EB registry. Data collection and statistical analyses were conducted using Microsoft Excel and SPSS-V.25.

Results:
Thirty-seven patients (62% males; mean age 14; [2 months–36] years) were enrolled. EB subtypes included EB simplex (n = 13), junctional EB (n = 6), and dystrophic EB (n = 13); five patients had unknown type. Twenty-one patients (57%) dislike multilayer wound dressings and/or find that they exacerbate the blistering during summer and in hot climates. Almost one-quarter of participants reported lancing a few of the intact blisters, and 5.4% did not lance any. Bath additives ranged from barely effective to potentially cytotoxic solutions of vinegar and sodium hypochlorite solution. Around 1/3rd of participants reported the use of topical antibiotics with no alternation or rotation on dirty wounds, and 8.1% of our cohort reported the use of antibiotics on intact skin.

Conclusion:
Education is needed for EB patients and their families on lancing of blisters and topical antibiotic use, especially in light of increasing antibiotic resistance. Dressing modification for EB patients living in the Gulf region countries, particularly during hot and humid months, may be helpful.
A descriptive study on child sexual abuse act in India
Authors: Singh Ranjana , Koushal Vipin , Bharti Bhavneet 
Published: June 2022

ABSTRACT

Background:
Child sexual abuse (CSA) is a significant public health problem. Health care professionals can play an important role in the identification and reporting of such cases. This study was conducted to assess the awareness level among doctors working in a medical Institute about CSA.

Materials and Methods:
This is a cross-sectional descriptive study. Data was collected using a closed-ended structured questionnaire. Descriptive analysis was done to compute percentages and frequencies. Respondents’ educational qualification, as well as the relationship between their level of education and their awareness of child abuse, was also assessed.

Results:
Nearly 70% of respondents came across child abuse cases, wherein sexual abuse was found to be the commonest (58%), followed by physical abuse (28%). Nearly 40% of child abuse cases were reported in the hospital where they worked, while 15% of child abuse cases occurred in other hospital areas. The study also revealed that 81% of respondents had knowledge about child sexual abuse. However, only 34% were aware of the repercussions of non-reporting of a child abuse case. Nearly 64% of respondents had an idea about an online complaint system for child abuse, and 70% were aware of the availability of a one-stop centre at a respondent’s hospital. The majority (68%) were aware of the POCSO (Protection of Children from Sexual Offences) Act on sexual abuse. On seeking information regarding evidence of anal sexual abuse among children and adolescents, 36% were completely aware, and 13% were partly aware of it.

Conclusion:
There is a need for continued education and advancement of all health care professionals to improve the diagnosis and reporting of CSA.
A cross-sectional study to assess the prevalence of anosmia and ageusia and its association with disease severity among COVID-19 affected patients in Salem, Tamil Nadu
Authors: Rajamani Shanmugasundaram , Ranganathan Rangabashyam S. , Kanaguraju Kirubhakaran , Shanmugaraja Karthick 
Published: June 2022

ABSTRACT

Introduction:
An epidemic of the severe acute respiratory syndrome was started in 2019 in Wuhan city, China. Due to international trade and travel, this disease has become a pandemic across the world. The agent causing this disease was named Corona Virus Disease 2019 by (COVID-19) by the World Health Organization (WHO). The following study was done with the objective of estimating the prevalence of anosmia and ageusia and its association with disease severity among COVID-19 affected individuals.

Materials and Methods:
A cross-sectional analytical study was conducted among COVID-19 patients in a tertiary hospital in Salem, Tamil Nadu. The data were collected using a semi-structured questionnaire, which consisted of demographic details such as age, gender, and place, clinical symptoms, and signs such as fever, loss of taste, breathing difficulty, loss of smell, sore throat, and fatigability, vital signs, and co-morbidities.

Results:
In this study, we found that the severity of the disease (according to CT chest scores) among the study participants had a statistically significant association with breathlessness and headache.

Conclusion:
The symptoms of headache and breathlessness have statistically significant associations with disease severity that can be used in any setting to classify the COVID-19 case as who is eligible for home isolation, and who is eligible for admission or to be referred.
Poverty, undernutrition and morbidity: The untold story of tea-garden workers of Alipurduar district, West Bengal
Authors: Yasmin Shamima , Sau Manabendra , Patra Manas , Sinha Nirmalya , Baur Baijayanti 
Published: June 2022

ABSTRACT

Background:
There is a paucity of information on health and nutritional status of tea-garden workers of West Bengal, which is crucial to meet their health needs by formulating appropriate public health interventions.

Objectives/Aims:
The objective of this study is to assess the morbidity pattern and nutritional status of tea-garden workers of West Bengal, India.

Materials and Methods:
The present cross-sectional study was conducted among 463 tea-garden workers of randomly selected three tea gardens of Alipurduar district of West Bengal, India, chosen by multi-stage sampling. Pre-designed and pre-tested questionnaire was used to collect information on socio-demographic and other variables by means of interview. Physical examination and anthropometric assessment were performed. The haemoglobin was estimated by the ‘filter paper cyanmethemoglobin method’. Morbidities were assessed on the basis of history, clinical examination, evaluation of medical records if any and relevant laboratory investigations and classified and coded as per the 10th revision of the international classification of the diseases. Morbidity profile and nutritional status were assessed through history taking, clinical examination, review of medical records if any, anthropometric assessment and laboratory investigations.

Statistical Analysis:
Simple proportion was used for interpretation of point prevalence. Chi-square test was applied as the test of significance wherever applicable.

Results:
Out of total 463 tea-garden workers, majorities (76%) were female and from backward social class (81.2%). More than half (55.9%) were illiterate and three-fourth (67.2%) belonged to lower income quartile. Anaemia was found widespread (87.9%) and more than one-third (36.1%) of the tea-garden workers were found undernourished. Also 43.8% of the workers had airway obstruction as measured by peak expiratory flow rate. Majority (69.8%) of the garden workers had any form of morbidity. Non-communicable diseases (24.2%), musculoskeletal disorders (17.9%), skin disorders (17.7%), respiratory morbidities (16.2%), febrile illness (12.3%), gastro-intestinal disorders (8.6%), ocular problems (8.4%), vitamin and micronutrients deficiencies were found the common morbidities among tea-garden workers. Scheduled tribe caste, undernutrition and anaemia were found independent determinants of any morbidity among the tea-garden workers.

Conclusions:
Morbidities, anaemia and under-nutrition were found very much prevalent among tea-garden workers of West Bengal, which necessitates urgent public health interventions through multi-disciplinary approach in a focussed manner with an aim to improve the overall quality of life of the tea-garden workers.
Molecular pathways in glioblastoma-derived stem cells to identify effective drug agents: A bioinformatics study
Authors: Mirzaei Tahereh , Sheikholeslami Seyed Amir , Bereimipour Ahmad , Jalili Arsalan , Zali Alireza , Sharbati Sheida , Kaveh Vahid , Salari Sina 
Published: June 2022

ABSTRACT

Background and Aim:
Glioblastoma multiform (GBM) is considered as one of the malignant brain tumors that affect a wide range of people every year. Cancer stem cells, as essential factors, are resistant to chemotherapy drugs and complicate treatments. Therefore, finding critical molecular pathways in GBM-derived stem cells, and selecting the appropriate drug agents can prove more effective treatment approaches for GBM.

Method:
In this study, using RNA-Seq data, we performed continuous bioinformatics analyses and examined the up-and down-regulated genes from GBM-derived stem cells samples. Afterward, we separated the signaling pathways using the KEGG database and measured the protein interactions with the STRING database. Then, using the Drug matrix database, we nominated drugs that could affect these genes.

Results:
The first 20 pathways on tumorigenesis and 41 up-regulated and 73 down-regulated genes were selected. These genes were most active in the pathways involved in cell division, metabolism, cytoskeleton, cell adhesion molecules, and extracellular space. We then examined the candidate genes and the approach of the drugs that target these genes. Chlorambucil, cyclosporine A, doxorubicin, and etoposide were selected as the drug agents.

Conclusion:
Using integrated bioinformatics analyses, it was found that prominent genes in the cell cycle and cytoskeletal pathways are more expressed in cancer stem cells and that Chlorambucil, cyclosporine A, doxorubicin, and etoposide can be effective compounds to attenuate these cells.