bluuebunny/crossref_metadata_2025_split huggingface dataset:
Baseline electrocardiographic findings as predictors of outcome in hospitalized patients with COVID-19
Authors: Abdelwahab Heba W. , Arafa Sherif , Shaltout Shaker W. , El Hoseiny Mahmoud , Alemam Doaa S. , Elmaria Marwa O. 
Published: May 2022

Introduction
The impact of coronavirus disease-2019 (COVID-19) on the heart is variable, but cardiac damage is associated with a bad prognosis. The mechanism behind the association between COVID-19 and cardiovascular diseases is not clear, but most of these patients reported with diseased immune system.

Patients and methods
This retrospective study included 70 hospitalized (moderate and severe) RT-PCR-positive COVID-19 patients. Data were retrieved from Mansoura University quarantine records from October 2020 to December 2020. The 12-lead channel conventional ECG collected at the first time after the patients were admitted to the hospital was used.

Results
About 94.3% of studied patients were in sinus rhythm, premature ventricular contractions were found in 2.9%. Atrial fibrillation was present in 4.3% and multifocal atrial tachycardia in 1.4%. Ischemic changes were found in 25.7% of the studied patients. About 14.3% had conduction defects. In this study, ECG ischemic changes only were significantly correlated with progress of respiratory support needed during hospitalization (44.4% of mechanically ventilated patients had ECG ischemic changes), mortality (P=0.04), and higher D-dimer level.

Conclusion
Baseline ECG ischemic changes associated with worse outcome of moderate and severe COVID-19 patients. Continuous monitoring of ECG changes in COVID-19 patients is recommended as it can provide an important assessment of COVID-19 severity.
Coronavirus disease 2019-associated pneumonia
Authors: Farghaly Shereen , Hassany Sahar , Abdeltawab Doaa , Abdelaal Azza , Bakkar Lamees M. 
Published: May 2022

Context
Since the emerging coronavirus disease 2019 (COVID-19) pandemic in Wuhan, China, it has spread aggressively around the world. There is the need to perform several studies from different populations to identify the risk factors.

Aims
To distinguish patients at risk of severe COVID-19-associated pneumonia and to identify early clinical and laboratory predictors for severe pneumonia.

Patients and methods
This is a retrospective cohort study of patients with confirmed COVID-19. Patient data including demographic, clinical, laboratory, and radiological were collected from stored computer data and patients’ medical records. Clinically, in this study patients have been classified into severe and nonsevere patients.

Results
Out of 108 included patients, 57 were severe cases. Obesity was also an independent risk factor of severity in age less than 60 years. Inflammatory indices [C-reactive protein (CRP), D-dimer, ferritin) were also significantly elevated in the severe group at initial presentation (P<0.001, 0.001, 0.001, respectively). The optimum cutoff of CRP, D-dimer, and ferritin to predict COVID-19 severity was more than or equal to 20.76 mg/l, more than or equal to 0.51 μg/ml, and more than or equal to 338.25 ng/l, respectively.

Conclusion
Male sex, old age, obesity, and multiple comorbidities are independent risk factors for COVID-19-associated severe pneumonia. Elevated inflammatory indices (CRP, D-dimer, and ferritin) are independent laboratory predictors for COVID-19 severity. So careful monitoring of male, obese, and old age with multiple comorbidities with regular monitoring of inflammatory markers is recommended.
Efficacy of ivermectin in patients with coronavirus disease 2019 pneumonia with severe and critically ill status
Authors: Elesdoudy Ahmed A. 
Published: May 2022

Aim
The aim was to assess the efficacy of ivermectin in the treatment of patients with coronavirus disease 2019 pneumonia with severe and critically ill status.

Patients and methods
This retrospective study was performed on 50 patients admitted in ICU and high-dependency unit of Ibrahim Bin Hamad Hospital, United Arab Emirate. All patients were subjected to the following on admission: careful history taking, general and local examinations, routine laboratory studies (complete blood count, liver function tests, and kidney function tests), other laboratory tests such as C-reactive protein and D-dimer, and chest radiography. All patients received ivermectin in doses of 0.2 mg/kg on first and third days.

Results
The age range of the studied group was from 35 and 107 years, with a mean age of 61.8±14.07 years. The sex distribution of the studied group was 29 (58%) males and 21 (42%) females. The clinical condition deteriorated in 18 (36%) patients, improved in eight (16%) patients, and remained the same in 24 (48%) patients. Three (6%) patients had bronchial asthma, eight (16%) patients had chronic kidney disease, 20 (40%) patients had diabetes mellitus, 20 (40%) patients had hypertension, two (2%) patients had hypothyroidism, seven (14%) patients had ischemic heart disease, and 14 (28%) patients did not have any comorbidities. Regarding the progress of patients’ symptoms, shortness of breath deteriorated in 18 (36%) patients, improved in eight (16%) patients, and remained the same in 24 (48%) patients. The cough symptom deteriorated in 18 (36%) patients, improved in eight (16%) patients, and remained the same in 24 (48%) patients. Radiology (chest radiograph) showed deterioration in 18 (36%) patients, improvement in eight (16%) patients, and remained the same in 24 (48%) patients. There was no statistically significant difference before and after using ivermectin with respect to temperature (P=0.058), pulse (P=0.101), respiratory rate (P=0.054), white blood cell count (P=0.058), lymphocyte count (P=0.09), C-reactive protein (P=0.177), and D-dimer (P=0.087).

Conclusion
The use of ivermectin did not significantly improve resolution of symptoms, outcome, radiology, or laboratory markers. The findings do not support the use of ivermectin for treatment of severe coronavirus disease 2019.
Could chest ultrasonography replace chest radiography in outpatient chest clinic?
Authors: Ahmed Mostafa K. , Bayoumi Hassan A. , Abdelaleem Nermeen A. , Mohamed Marwan N. 
Published: May 2022

Objective
Plain chest radiography is the commonest ordered investigation in chest outpatient clinic; however, it is time consuming and may be expensive in some settings. With the availability of chest ultrasonography (CUS) at bedside, CUS might be used instead of plain chest radiography in outpatient settings. Still there is controversy regarding CUS as the primary investigation in outpatient chest clinics.

Patients and methods
Consecutive patients referred to the outpatient chest clinic of Assiut University between March 2018 till June 2020 who were proposed to have computed tomography (CT) chest after plain chest radiography were asked to participate in the study. The included patients had CUS with a pulmonologist who was blind to the chest radiography and chest CT results. CUS was done using a convex probe of ultrasonography in all chest anatomical planes for any finding that may help in the diagnosis. The plain chest radiography results also were recorded. Both results were compared with chest CT results as the gold standard investigation.

Result
A total of 101 patients were included in the study. There were 18% female patients, with mean age of 49.4±17.9 years. The final diagnosis was lung malignancy, pneumonia, bronchiectasis, chronic obstructive lung diseases, pulmonary embolism, pleural effusion, interstitial lung disease, and other miscellaneous causes. CUS were normal in 14 cases, with a sensitivity of 89.5% and a specificity of 80%, whereas chest radiography was normal in 20 cases, with a positive finding in 81 cases, with a sensitivity of 83.3% and a specificity of 80%, in comparison with chest CT.

Conclusion
CUS may be the primary investigation in chest outpatient clinic with good accuracy and rapid patient diagnosis.
Semiquantitative Chest computed tomography score in novel coronavirus-infected patients
Authors: Arora Abhishek J. , Komatlapalli Srirammurthy , Thakur Rajani 
Published: May 2022

Context
Quantitative and semiquantitative indicators of lung involvement in coronavirus disease 2019 (COVID-19) could help to stratify patients and thus help in triaging and speeding up the entire workflow in hospitals as patients with higher severity scores require early therapeutic intervention and critical care.

Objective
To calculate computed tomography (CT) severity score for COVID-19 infection based on lobar involvement by the disease and correlate this score with oxygen saturation levels (SpO2) of the patients and to further predict oxygen therapy requirement in patients with various scores.

Settings and design
This was a prospective study.

Patients and methods
This was a prospective study on 154 RT-PCR-proven novel coronavirus (SARS-CoV-2)-infected (COVID-19) patients. SpO2 values of all the patients were obtained within 6 h of scan. All of the scans were reviewed, and the degree of lobar involvement was used to produce a semiquantitative CT score.

Statistical analysis used
Scatter plot correlation and receiver operator characteristic curve analysis were performed.

Results
CT score and SpO2 values of patients were plotted in the scatter plot chart, and Pearson correlation coefficient (r) was calculated, which was −0.836, suggesting a strong negative correlation. A total of 46 patients were given oxygen therapy, and they had SpO2 value less than or equal to 94%, with CT score ranging from 10 to 22. Receiver operator characteristic curve analysis was done to determine and reach an optimum cutoff value of 11 for oxygen therapy requirement, with a sensitivity and specificity of 95.83 and 95.58%, respectively.

Conclusions
CT score in COVID-19-infected patients has a strong negative correlation with SpO2, and it definitely helped to predict the requirement of oxygen therapy in our study.
Assessment of the diaphragmatic mobility by chest ultrasound in patients with chest deformities before and after pulmonary rehabilitation program
Authors: Saeed Adel M. , Nofal Ahmed A.G. , Gomaa Ashraf Adel , Ezzelregal Hieba Gamal 
Published: May 2022

Context
Chest wall malformations (CWMs) are a broad group of elevated-morbidity anomalies that were classified by Acastello into kyphoscoliosis, ankylosing spondylitis, and pectus excavatum. The diaphragm, as the major respiratory muscle, is affected by these CWMs, leading to respiratory insufficiency and failure. Ultrasound is the modality of choice used in assessing diaphragmatic mobility and monitoring its effects in the four mentioned diseases.

Aims
In this study, an assessment of the diaphragmatic mobility via chest ultrasound was performed in patients with chest deformities before and after a pulmonary rehabilitation program.

Settings and design
This was an observational comparative study.

Patients and methods
This study included 40 patients with acquired and developmental chest wall deformities, nonsmokers and individuals with no cardiopulmonary disorders. Chest wall deformity was diagnosed by chest radiograph posteroanterior and lateral views, whereas the severity of the deformity was detected by calculating Cobb’s angle in comparison with the severity of spirometry with respect to the forced vital capacity. Spirometry was performed in these patients before and after the pulmonary rehabilitation program, along with a chest ultrasound, to follow up their diaphragmatic excursion and compare the results.

Statistical analysis used
SPSS program (Statistical Package for Social Sciences), software, version 20, was used.

Results
A marked decrease in the right range of movement (ROM) of the diaphragmatic copula (P=0.001) as well as a marked decline in the left ROM of diaphragmatic copula in the patient group (P=0.029) were detected. Moreover, a marked improvement in the right as well as the left ROM, diaphragmatic thickness and maximal inspiratory pressure was detected after rehabilitation (P=0.001). Cobb’s angle higher than 43° has been statistically proposed as a cut-off value for predicting mortality, while maximal inspiratory pressure less than 55% has been statistically proposed as a cut-off value for predicting mortality after the operation.

Conclusions
CWMs restrict the chest wall skeletal structure as well as the spine, with its joints, and thus interfere with diaphragmatic mobility. Ultrasound represents a good, reliable, and real-time tool for assessing diaphragmatic mobility and monitoring response to rehabilitation programs.
Liquid Biopsy-Detecting Molecular Targets in Cancer Management
Authors: Ravindran Nithya 
Published: May 2022

ABSTRACT
Liquid biopsies are newer diagnostic tests conducted on blood samples to detect biomarkers shed by tumors, such as cancer cells or portion of tumor DNA. Liquid biopsies are not to replace surgical biopsies but are complementary in the diagnosis and treatment of cancer. The circulating tumor DNA and intact circulating tumor cells are the two main components that are targeted during a liquid biopsy. Information from the liquid biopsy is used to determine the best-individualized cancer therapy to track how a patient is responding to treatment, or to discover whether there is recurrence of cancer. This review summarizes the main techniques and applications of liquid biopsy in cancer.
Evaluation of nuclear factor E2-related factor 2 in patients with alopecia areata
Authors: Bakry Ola A. , El Hefnawy Sally M. , El Naggar Doha , Seleit Iman 
Published: May 2022

Background
Alopecia areata (AA) is a common dermatologic disease with autoimmune etiology. Systemic and tissue oxidative stresses are present in AA. Nuclear factor-E2-related factor 2 (Nrf2) is a transcription factor that stimulates transcription of antioxidant genes.

Objective
To investigate the role of Nrf2 in systemic oxidative stress in AA.

Patients and methods
A case–control study was designed. A total of 30 cases with AA and 30 age-matched and sex-matched healthy participants were included. Cases were diagnosed clinically and by dermoscopy and evaluated according to the severity of the alopecia tool score. Nrf2, total oxidant capacity (TOC), and total antioxidant capacity (TAC) were measured by enzyme-linked immunosorbent assay, and the oxidative stress index (OSI) was calculated.

Results
Serum Nrf2 and TAC were significantly lower in AA than the control group (P<0.001 for both), whereas TOC and OSI were significantly higher in AA than the control group (P<0.001 for both). There was a significant negative correlation between TAC and age (r=–0.5, P=0.004). High Nrf2 serum level was significantly associated with positive hair pull test (86.7%), whereas low Nrf2 was significantly associated with alopecia totalis (P=0.02 for both). There was a significant positive correlation between Nrf2 and TAC (r=0.4, P=0.01) and a significant negative correlation between Nrf2 and TOC (r=–0.3, P=0.01) and between Nrf2 and OSI (r=–0.4, P=0.01).

Conclusion
Nrf2 is lower in AA than control, indicating that systemic oxidative stress may be, at least in part, owing to low Nrf2. The use of Nrf2 activators may be beneficial in the treatment of AA, which needs further studies.
Study of prevalence of skin prick test positivity for food allergens in chronic urticaria patients attending a tertiary care center in South India
Authors: Itty Abin Abraham , Sridharan Rajiv , Thyvalappil Anoop , Sudhamani Bindurani , Divakaran Binoo 
Published: May 2022

Background
Skin prick testing (SPT) provides information about the presence of specific immunoglobulin E (IgE) to protein and peptide antigens and maybe helpful to identify the triggering food items in chronic urticaria.

Objective
The aim of this study was to determine the prevalence of food allergy among chronic urticaria patients, by doing SPT with commercially available 20 food allergens.

Patients and methods
All consecutive patients with recurrent urticarial wheals of more than 6 weeks of duration and age more than 12 years and were included. SPT was done using 20 allergens in the study patients after detailed examination. Complete blood count and total serum IgE were checked.

Results
In all, 62.9 % of chronic urticaria patients had positive SPT to food allergens. No statistically significant association was found between SPT results and demographic parameters, duration of disease, urticaria activity score, or serum IgE levels. In 31.46% (28) patients who had suspected food allergy, only 7 (25%) had a positive SPT result to the corresponding allergen.

Conclusion
SPT s may be used as a screening test to evaluate food allergy in chronic urticaria patients. The results should better be validated with specific IgE and food challenge tests.
Onychomycosis in chronic liver disease
Authors: Elmansoury Eman Adel , Ebrahim Adel Ali , Othman Talaat Abdelrazek , Hamed Ahmed Mohamed 
Published: May 2022

Background
Nail changes including onychomycosis are clues to many systemic diseases. The prevalence of this disease is variable worldwide and in different patient groups.

Objective
To study the prevalence of onychomycosis among chronic liver disease (CLD) patients, the association of risk factors in that patient category with onychomycosis, the causative fungal species, and antifungal susceptibility of the most common species isolated.

Patients and methods
Six hundred and eighty patients with CLD were screened for nail abnormalities clinically suggestive of onychomycosis. Demographic data and risk factors associated with CLD were investigated. Samples were mycologically identified, and antifungal susceptibility was tested for the most common isolated species.

Results
Prevalence of onychomycosis among CLD patients was 9.4%. Advancing age, low platelet count, positive Hepatitis C virus (HCV) or Hepatitis B virus (HBV), and high alanine aminotransferase (ALT) level showed significant association with onychomycosis in CLD patients. Dermatophytes were the most common cause (57.7%) of onychomycosis in CLD patients. Terbinafine was the most potent antifungal, as 80% of dermatophytes were susceptible to it.

Conclusion
Patients with CLD are at risk of developing onychomycosis especially with the following risk factors: advancing age, decreased platelet count, testing positive for HCV or HBV, and high ALT. For onychomycosis in patients with CLD, dermatophytes were the most common cause, and terbinafine was the drug of choice in treatment.
Nutritional Supplements
Authors: Saoji Ajeet , Saoji Prachi Ajeet , Hajare Shilpa , Dharmadhikari Pranita 
Published: May 2022

Background:
The haphazard use of supplements without proper consultation from a health expert can lead to side effects, especially in youngsters. These supplements have very few regulations nationwide, and practically, no effort has been taken to make the public aware of its ill effects, besides warnings issued by the manufacturing companies on the products.

Methodology:
A cross-sectional study among 2nd -3rd MBBS students studying in a medical college was carried out to study the prevalence of use of supplementary nutrition, its type, source of information, and preferred type of supplements.

Results:
The overall proportion of dietary supplement use among medical college students participated in this study was 29.4%. Multivitamins, protein powders, and energy drinks were the most preferred type and the reasons mentioned for intake were for general well-being to avoid future illness and muscle-building purpose.

Conclusion:
More awareness among frequent and haphazard users who are on supplementary nutrition without any medical opinion should be incorporated to avoid side effects created by unregulated nutritional supplements available in market.
Biology Students’ Questioning Behaviour in Relation to Their Achievement in Biology in Barkin Ladi, Local Government Area, Plateau State
Authors: Ezekiel D.P. , Yilshik O.M. , Joseph M. 
Published: May 2022

This study investigated the relationship between senior secondary two students’ questioning behaviour and their achievement in Biology in Barkin Ladi Local Government Area of Plateau State. The research design was partly an ethnographic research design through observation and narrative survey. The study also incorporated a correlational research design in which the correlation coefficient was computed to determine the relationship between the variables. The population of the study comprised all the fifteen (15) senior secondary schools in Barkin Ladi. A sample of two senior secondary schools out of fifteen senior secondary schools was selected using purposive sampling technique. Blooms’ category system was used to transcribe students’ questions. The research instruments were observation using Audiotape recorder and Biology Achievement Test (BAT). The audiotape recorded students’ questions were coded by two science education specialist in University of Jos while the test items were also scrutinized by two biology teachers at the secondary school level. The reliability of the BAT was determined using split-half method and it yielded 0.80. The research questions were answered using descriptive statistics while Pearson Product Moment Correlation was used in testing the Null hypothesis at 0.05 level of significant. The findings indicated that a high positive linear relationship exists between the raw number of students’ questions and their achievement scores in Biology. The findings equally showed that students asked mostly low level questions and the types of questions that students ask during biology lesson does not depend on gender. Consequently, the study recommended among other things, the training and re-training of teachers as well as students on how to ask thought provoking questions to facilitate students’ performance, teaching and learning of Biology in Senior Secondary schools.
Family Instability as a Predictor of Academic Performance Among Secondary School Students in Oshodi/Isolo Local Government Area of Lagos State, Nigeria
Authors: Alabi M.A. , Jimoh J.A. , Biwai Y. , Lasisi A.K. 
Published: May 2022

The research investigated Family instability as a predictor of academic achievement of secondary school students. survey research design of expo- facto type was used for the study. A total of 200 participants were randomly sampled for the study. Data were collected with self-developed family instability questionnaire, while the students’ scores in mathematics and English were used as academic achievement data. The reliability of the instrument was measured through pilot testing and Cronbach’s alpha test was employed to check the consistency and accuracy of the measurement scale. A reliability coefficient of 0.73 was obtained, which indicates that the items in the instrument measured similar concept. Three hypotheses were raised and tested at 0.05 level of significance. The data were analyzed using Pearson product moment statistics method. The result of the analysis showed a significant relationship between family instability and academic achievement of secondary school students (junior, senior). On the basis of the findings it was recommended among others that that couples should avail themselves of the services of marriage counselors in the resolution of marital disputes.