bluuebunny/crossref_metadata_2025_split huggingface dataset:
Splenic Injuries in Native Africans
Authors: Ogbuanya Aloysius Ugwu-Olisa , Ajuluchuku Uzoamaka Esther , Nnadozie Ugochukwu Uzodimma , Otuu Onyeyirichi , Umezurike Daniel Akuma , Kwento Nwanneka 
Published: November 2022

Background:
Splenic trauma has emerged as a major global health burden, especially in developing nations with limited diagnostic and therapeutic facilities. The current trend toward nonoperative management (NOM) and adoption of splenic salvage whenever feasible calls for local evaluation of our current practice. The aim of this study was to document the epidemiology and outcomes of management of splenic injuries in our setting.

Patients and Methods:
This was a multicenter, prospective study of epidemiology and outcomes of patients with splenic injuries recruited over 10 years in southeast Nigeria.

Results:
Approximately 66% of all patients with abdominal injuries sustained splenic trauma. A total of 313 patients with splenic trauma were recruited; 226 (72.2%) were managed operatively (OM) and 87 (27.8%) conservatively (NOM). Majority (75.7%) had blunt abdominal trauma (BAT), while 24.3% sustained penetrating injuries. Sonographic grading showed that 46 (14.7%), 58 (18.5%), 79 (25.2%), 106 (33.9%), and 24 (7.7%) patients had grades I, II, III, IV, and V injuries, respectively. Isolated splenic injuries occurred in 172 (55%) patients, and the rest (141, 45%) had associated intra-abdominal injuries. Two-thirds (67.1%) were aged 16–45 years. In the OM group, 178 (78.7%) had total splenectomy, while 48 (21.3%) had splenic salvage. There was a statistically significant difference (P = 0.022) in the rate of postoperative complications between the splenectomy and splenorrhaphy groups. The overall mortality rate was 4.5%. Major predictors of morbidity and mortality were high-grade splenic injuries, total splenectomy, multiple injuries, advanced age, and comorbidities.

Conclusion:
Splenic injuries complicate approximately two-thirds of all abdominal injuries in our environment and majority of these injuries were due to BAT. In this study, majority had OM and splenic salvage rate was relatively low.
A Comparative Study of Intrathecal Hyperbaric Bupivacaine 0.5% with Morphine and Dexmedetomidine in Lower Limb Orthopedic Surgeries
Authors: Ashfi Shadab , Haque Azizul , Kumar Mukesh , Lakra Ladhu 
Published: November 2022

Background:
Pain and its alleviation have been a challenge for humans for centuries. Sub arachnoid block is most commonly practiced method for anaesthesia for lower limb surgeries. Adjuvants like opioids and alpha 2 agonists have proven benefits in augmentation of effects of local anaesthetics for spinal anesthesia. The aim of this study was to compare the effects of morphine and dexmedetomidine for sub arachnoid block in lower limb orthopaedic surgeries.

Material and Methods:
This is a prospective randomised controlled trial done in 120 patients who were posted for lower limb orthopaedic surgery. Along with bupivacaine, Group A received intrathecal dexmedetomidine while group B received intrathecal morphine.

Results:
the demographic profile was comparable in both the groups. The mean duration of motor block in Group A was 359.33 ± 34.4 and in Group B was 265.71 ± 28.47. The duration of rescue analgesia was almost double in Group A as compared to Group B with P < 0.0001 (CL 95%).

Conclusion:
Intrathecal dexmedetomidine and morphine both provided good postoperative analgesia. Dexmedetomidine provided a longer duration of analgesia than morphine, thereby increasing the time for first rescue analgesia, but at the cost of greater side effects.
Knowledge, Attitude, and Practices about Antimicrobial Usage and Resistance Among the Second-Year MBBS Students
Authors: Suryawanshi Sonali Pradeep , Dawane Jayshree Shriram , Pandit Vijaya Anil , Khatavkar Pallawi Shashank 
Published: November 2022

Antibiotic resistance is the burning issue and to curtail it is the need of the time, efforts are going on in all the direction. It is essential to assess the knowledge, attitude and practices of the medical undergraduate about the antimicrobial use and resistance for doing modifications in the current methods of teaching for encouraging the rational use.

Objectives:
To determine the prevalence of self medication practices of antibiotics among the second year medical students. To evaluate the knowledge of medical students about antibiotic resistance. To explore the solutions to curb the growing problem of antimicrobial resistance.

Material and Methods:
A Cross sectional, Unicentric, observational, questionnaire based survey study carried out from June 2021 to Sept 2021. Conventional sample method was used and phase II MBBS students willing to take part in the study were included. After obtaining the IEC clearance study was started. Questionnaire was prepared consisting of the various aspects like knowledge, attitude and perception of the antimicrobial use and resistance. The questionnaire was validated by subject experts for its content and relevance and the necessary changes were incorporated in the final one. The questionnaire was distributed as a Google form before they receive any teaching on antibiotics in their pharmacology classes as a Pre-test and after the exposure as post-test. Participation was voluntary and they were asked to complete the questionnaire anonymously. Returning of the completed Google form was accepted as consent by the participating students. Statistical analysis done with software SPSS.

Results:
Students had the knowledge about antibiotics and resistance. They had consumed it in last one year and completed the course of the antibiotics is the positive outcome. Small number shows confusion about use during viral infection, in pain, during cough& cold. Causes of antibiotic resistance needs special attention. In 20% it was not clear that skipping the doses can contribute to antimicrobial resistance.

Conclusion:
Repeated knowledge intervention are essential to increase the awareness of the problem arising due to the irrational use even to the undergraduate students.
Quality and Regulation Standards for Positron Emission Tomography Equipment and Bone Marrow Cell Separator as Medical Devices in India
Authors: Pandey Nidhi , Jain Gaurav Kumar , Thakkar Arti R , Walia Ramanpreet 
Published: November 2022

Introduction:
Indian medical devices regulations have drastic changes since 2018. Few amendments have been incorporated in 2020. However, certain devices which are still not regulated and there are no quality checkpoints available for scrutiny from Central Drug Standard Control Organization, Delhi. This manuscript aims to provide quality checklist for two medical devices, positron emission tomography equipment, and bone marrow cell separator which are neither categorized nor regulated by the central drug standard control organization, Delhi.

Methods:
The quality checklist for the selected medical devices has been prepared by the survey based evaluation and quality tests have been identified by various methods available in the literature for checking risks associated with medical devices.

Results and Discussion:
Following quality checklist steps such as designing of primary checklist, quality assurance parameter evaluation for pet medication fabricating plant and equipment qualification criteria was identified with cross referencing and literature search.

Conclusion:
the new regulations would increase the accountability of the manufacturers and the importers to provide an assurance of safety to the customer. It needs to be incentivized by giving preference in public healthcare procurement instead of seeking USFDA and CE approvals. For the import of medical devices, the application should be reviewed based on risk analysis as suggested for these two devices. Further, local manufacturing of medical devices should be encouraged in India for reduced the cost of the medical devices.
Antidiabetic and Hepatoprotective Activity of a Novel Polyherbal preparation against Streptozotocin-Induced Diabetes Rats and its Formulation into a Tablet Dosage Form
Authors: Jayaraju K. Jyothsna , Ishaq B. Mohammed 
Published: November 2022

Context:
Diabetes is estimated to affect 79.4 million individuals in India by 2030.

Aim:
A polyherbal mixture containing hydroalcoholic extracts of Cinnamomum zeylanicum (CZ) bark, Eugenia jambolana (EJ) seed, Vinca rosea (VR) entire plant, and Gymnema sylvestre (GS) leaves was tested for anti-diabetic and hepatoprotective properties in different proportions.

Materials and Methods:
In normal and diabetic rats, the anti-diabetic and hepatoprotective efficacy was evaluated. Male and female Albino Wistar rats weighing 150–200 g were utilized in the experiment. Streptozotocin (60 mg/kg, i.p.) was used to induce diabetes. Group 1 acts as a normal control, Group 2 as a diabetic control, and Group 3 as a standard control, all animals of Group 3 were given Glibenclamide at a dose of 5 mg/kg p. o. Diabetic rats in groups 4–7 and 8–11 were given polyherbal preparations (PHPs) containing a combination of the above-mentioned plants in different proportions at doses of 200 and 400 mg/kg body weight, respectively, for dosage optimization and to determine the most efficacious and safe dose. The treatments were administered for a total of 28 days. Blood was drawn on the 7th, 14th, 21st, and 28th days to determine diabetic and hepatoprotective indicators such as body weight, blood glucose (BGL) levels, liver glycogen, total protein, urea, creatinine, serum glutamic oxaloacetic transaminase, and serum glutamic pyruvic transaminase. On the 28th day of the research, rats were sacrificed, and the pancreas examined for histological results.

Results:
BGL levels and serum liver enzymes were significantly reduced when a polyherbal mixture including CZ: EJ: VR: GS: 2: 1: 2: 2 at 400 mg/kg was administered. The optimum PHP ratio was then translated into tablet formulations (F1-F9) and tested for quality control characteristics. The weight, hardness, thickness, friability, and disintegration time of polyherbal tablets were all found to be within acceptable pharmacopeial parameters. Formulation F8, which included 20% sodium starch glycolate, had a disintegration time of 291 s. Formulation F8 was further tested for description, hardness, friability, and disintegration time during a 3-month accelerated stability testing. The results of a short-term stability investigation were likewise positive and comparable to the original formulation.

Conclusion:
As a result, the produced polyherbal formulation F8 may be utilized as a solid dosage form that is stable, patient-friendly, and cost-effective.
Clinicopathological Spectrum of Ophthalmic Lesions in a Tertiary Care Hospital
Authors: Patel Nirali , Mushtaq Iqra , Lad Yesha Parimalbhai , Iqbal Banyameen , Singh Madhuri , Gore Charusheela Rajesh 
Published: November 2022

Background:
The knowledge of the spectrum of ophthalmic lesions would be helpful to ophthalmologists and pathologists in shaping the strategy for the diagnosis and management of ophthalmic lesions.

Aim
The aim of this study was to explore the morphological, clinical, and histological diversity of ocular lesions, as well as the frequency and incidence of ocular lesions in a tertiary care hospital, and to compare these findings with those of similar studies conducted worldwide.

Materials and Methods
It is a retrospective study of patients reporting ophthalmic complaints in the department of ophthalmology at a tertiary care center in western Maharashtra from 2015 to 2022.

Results
The majority of cases were in 31 to 40 years of age with an m: f ratio was 1:1. Eyelid was the most common site affecting 45 cases (45%), followed by periorbital and cornealconjunctiva in 20 cases each (20%). The majority of cases (52%), which were nonneoplastic lesions, were benign (34%) and malignant (14%). Infectious lesions were most frequent among nonneoplastic lesions (55.77%), followed by inflammatory lesions (30.77%), cystic lesions (11.54%), and hemorrhagic lesions (1.92%). Among the benign lesions, pterygium was the most common (32.35%), followed by dermoid cysts (17.65%). Sebaceous gland carcinoma was the most frequent of the malignant lesions (28.57%), followed by squamous cell carcinoma and ocular surface squamous neoplasia (21.43% each).

Conclusion
The most frequent lesions in our study were nonneoplastic, followed by benign and malignant lesions. In 85% of cases, the clinical and histological diagnoses matched. Clinicopathological correlation has benefitted in the early diagnosis and management of ophthalmic lesions.
Phytochemical analysis and potential applications of the ethanol and aqueous-ethanol extracts of some selected plant in family Zingiberaceae plants for cosmeceutical and health-promoting food
Authors: Powthong Pannapa , Lektrakul Warangkana , Juntrapanukorn Bajaree , Luprasong Chitradee , Monton Chaowalit 
Published: November 2022

Background:
The rhizomes of the Zingiberaceae family are a vegetable widely used in many Asian nations, and their therapeutic properties have been acknowledged in many traditional recipes.

Aims and Objectives:
Investigate the in vitro biological effect of the aqueous-ethanol and ethanol crude extract received from three medicinal plants in the family Zingiberaceae.

Materials and Methods:
Three species of Zingiberaceae plants including Curcuma longa L., Curcuma zedoaria (Christm.) and Curcuma aromatica Salisb.were gathered and evaluated for their phytochemical contents, anti-inflammatory and anti-oxidant characteristics using the aqueous-ethanol (30:70%) and ethanol (95%) extraction and varying according to single and mixed extracts (1:1:1 and 2:1:1 ratio respectively) for determining the synergistic effects.

Results:
It was indicated that extracts of the three selected plant contained at least 5 from 13 phytochemical constituents. The single aqueous-ethanol extract of C. aromatica Salisb. and synergy achieved at 1:1:1 ratio of aqueous-ethanol extract showed the highest effective anti-inflammatory activity. The greatest antioxidant activity was found in a single ethanol extract of C. zedoaria (Christm.) and synergistically obtained at a 1:1:1 ratio of aqueous-ethanol extract. Furthermore, we discovered that combination extract produced greater outcomes than utilizing the mono extract alone.

Conclusion:
Our results demonstrate that screening for chosen Zingiberaceae plant extracts is a favorable representation of the value of screening for cosmetically and medicinal purposes.
Development of a model for predicting mortality of breast cancer admitted to Intensive Care Unit
Authors: Huang Renfeng , Wu Wanming , Guo Yan , Ou Linyang , Gong Xumeng , Yang Chuansheng , Lei Ruiwen 
Published: November 2022

Background: There is still not a mortality prediction model built for breast cancer admitted to intensive care unit (ICU).
Objectives: We aimed to build a prognostic model with comprehensive data achieved from eICU database.
Methods: Outcome was defined as all-cause in-hospital mortality. Least absolute shrinkage and selection operator (LASSO) was conducted to select important variables which were then taken into logistic regression to build the model. Bootstrap method wasthen conducted for internal validation.
Results: 448 patients were included in this study and 79 (17.6%) died in hospital. Only 5 items were included in the model and the area under the curve (AUC) was 0.844 (95% confidence interval [CI]: 0.804-0.884). Calibration curve and Brier score (0.111, 95% CI: 0.090-0.127) showed good calibration of the model. After internal validation, corrected AUC and Brier score were 0.834 and 0.116. Decision curve analysis (DCA) also showed effective clinical use of the model. The model can be easily assessed on website of https://breastcancer123.shinyapps.io/BreastCancerICU/.
Conclusions: The model derived in this study can provide an accurate prognosis for breast cancer admitted to ICU easily, which can help better clinical management.
Keywords: Breast neoplasms; intensive care unit; prognosis.
Investigation of 13q14.3 deletion by cytogenetic analysis and FISH technique and miRNA-15a and miRNA-16-1 by real time PCR in chronic lymphocytic leukemia
Authors: Yılmaz Melike , Dilhan Kuru R , Erdoğan Isil , Soysal Teoman , Hacıhanefioglu Seniha , Baykara Onur 
Published: November 2022

Background: The most frequent cytogenetic aberration is 13q14.3 deletion in Chronic Lymphocytic Leukemia (CLL). HsamiR-15a/hsa-miR-16-1 are tumor suppressor miRNAs encoded from 13q14.3 region.
Objectives: The aim of this study was to investigate the 13q14.3 deletion using molecular and cytogenetic techniques and association with miRNA-15a/miRNA-16-1.
Materials And Methods: We used peripheral blood samples of 30 CLL patients who were either induced and or non-induced with DSP30+IL-2 to determine 13q14.3 deletion by karyotyping and iFISH. Expression levels of hsa-miR-15a/miR-16-1 were measured using qRT PCR and compared with deletions.
Results: 13q14.3 deletion was detected in 8.6% of cases by karyotyping and in 65% by iFISH. Mosaic forms (monoallelic+biallelic) were observed in 50% of cases. Besides determining common chromosome abnormalities such as add(2)(q37), t(2;7) (p11.2;q22), del(6)(q13q21), del(6)(q25), add(9)(q21), del(11)(q23), t(11;14)(q13;q32), del(13)(q11q12), del(13)(q12q14), add(14)(q23), del(14)(q23), t(14;19)(q32;q13.1), del(15)(q23), del(17)(p12), t(18;22)(q21;q11.2), add(21)(p13) and t(17;21)(q11.2;122), we also determined t(1;13)(q32;q34), inv(2)(p25q21), del(13)(q22q32), t(14;19) (q24;q13), dup(17)(q21q23), der(21;21)(p13;p13) which have not been reported previously. Mitotic index data was found statistically significant and DSP30+IL-2 increased mitotic index by 2.5 folds. Association between decreased miR-16-1 expression and deletions was statistically significant.
Conclusion: We suggest that cytogenetic and iFISH analyses are complementary and use of DSP30+IL-2 is effective .in CLL. Decreased expression of hsa-miR-16-1 is remarkable.
Keywords: CLL; miR-15a/miR-16-1; 13q14.3 deletion.
Quality of life among cancer patients at Queen Elizabeth and Kamuzu Central Hospitals in Malawi: a cross-sectional double-center study
Authors: Chiwanda Banda Jonathan , B Chagomerana Maganizo , Udedi Michael , Sinjani Muula Adamson 
Published: November 2022

Introduction: Many cancer patients experience psychosocial challenges that affect quality of life during the trajectory of their disease process. We aimed at estimating quality of life among cancer patients at two major tertiary hospitals in Malawi.
Methods: The study was conducted among 398 cancer patients using semi-structured questionnaire. Quality of life was measured using EQ-5D-3L instrument.
Results: Mean age was 45 years ± 12.77. Pain (44%) was the most prevalent problem experienced by cancer patients. About 23% had worst imaginable health status on the subjective visual analogues scale. Attending cancer services at QECH (AOR=0.29, 95% CI: 0.17-0.54, p<0.001) and having normal weight (AOR=0.25, 95% CI: 0.08-0.74, p = 0.012), were associated with improved quality of life. A history of ever taken alcohol (AOR= 2.36, 95% CI: 1.02-5.44, p = 0.045) and multiple disease comorbidities (AOR= 3.78, 95% CI: 1.08-13.12, p = 0.037) were associated with poor quality of life.
Conclusion: Loss of earning, pain, marital strife, sexual dysfunction, were among the common psychosocial challenges experienced. History of ever taken alcohol and multiple comorbidities were associated with poor quality of life. There is need to integrate psychosocial solutions for cancer patients to improve their quality of life and outcomes.
Keywords: Cancer patients; quality of life.
Association between physical exercise and all-cause and CVD mortality in patients with diabetes: an updated systematic review and meta-analysis
Authors: Liu Xinmin , Wu Zhen , Li Ning 
Published: November 2022

Objectives: Physical activity is recommended in guidelines for treatment for diabetes, but the association between physical activity and mortality among diabetic patients has not been extensively studied.
Methods: Databases were searched from inception to July 10, 2020. Prospective studies were selected to evaluate the association between physical activity and risk for total and cardiovascular diseases (CVD) mortality among diabetic patients. Data were pooled using random-effect model to calculate the relative risks (RRs) with 95% confidence intervals (CIs).
Results: We included 16 eligible studies involving with 155,203 diabetic participants and 13,821 cases of death. Our study suggested that physical activity in diabetic patients may decrease risk for all-cause (RR 0.57, 95% CI 0.49-0.67) and CVD mortality (RR 0.55, 95% CI 0.34-0.68). The summary RR for CVD events was 0.65 (95% CI 0.41-1.03). Furthermore, the reductions in all-cause mortality were more significant in diabetic patients with old age (> 60 years) (RR 0.46, 95% CI 0.29 -0.75), higher body mass index (BMI ≥ 28) (RR 0.53, 95% CI 0.42-0.69) and shorter duration of diabetes (RR 0.45, 95% CI 0.24-0.84).
Conclusion: Physical activity reduced the risk of total and CVD mortality among patients with diabetes, in particular in diabetic patients with old age (> 60 years), obesity and shorter duration of diabetes.
Keywords: Physical activity; mortality; CVD; diabetes.
Prevalence and correlates of erectile dysfunction among long-distance commercial vehicle drivers and commercial motorcycle riders in Ibadan Nigeria: a comparative cross-sectional study
Authors: Adesola Adekunle , Imhasoloeva Martins , Akinsulore Adesanmi 
Published: November 2022

Background: Erectile dysfunction (ED) is a global public health problem that affects the quality of life, interpersonal, occupational, and social functioning of sufferers. Despite being high-risk groups, there is a paucity of data on erectile dysfunction among commercial vehicle drivers and motorcycle riders.
Objectives: We aimed to determine and compare the prevalence and factors associated with ED among long-distance commercial vehicle drivers (CVDs) and commercial motorcycle riders (CMRs) in Ibadan, Nigeria.
Methods: We used a comparative cross-sectional study design to enroll eligible male respondents in selected motor/motorcycle parks within Ibadan metropolis. Interviewer administered questionnaires were used to elicit sociodemographic/health-related characteristics, and ED status among participants. Data was analyzed using STATA version 12. Chi-square and Binary logistic regression were conducted to explore the association between ED and other covariates. Analyses were performed at 5% significance level.
Results: The prevalence of ED was significantly higher among motorcycle riders than vehicle drivers (71.4% vs 47.4%, p =0.001). Predictors of ED among CMRs were monogamous marriage type and history of perineal injury; while among CVRs were aged above 40-years, history of perineal injury, and current use of alcohol.
Conclusion: There is a need for public education and awareness programmes on ED to reduce the burden and improve well-beingin these populations.
Keyword: Erectile dysfunction; commercial motorcycle riders; long-distance commercial vehicle drivers; Southwest Nigeria.