bluuebunny/crossref_metadata_2025_split huggingface dataset:
Micropulse diode laser cyclophotocoagulation in refractory pediatric glaucoma
Authors: Helmy Hazem 
Published: January 2022

Aim
The aim of this study was to investigate the safety and long-term efficiency of high-energy-level micropulse diode laser application in the treatment of refractory pediatric glaucoma patients.

Patients and methods
This is a prospective, noncomparative case series study that included 90 eyes of 90 pediatric patients with glaucoma who were refractory to surgery. Micropulse transscleral cyclophotocoagulation with a high energy level was performed in all cases. The primary outcome measure was intraocular pressure reduction, whereas the secondary outcome measures were complications, number of medications, need for repeated treatment, and number of repetitions over a 24-month follow-up period.

Results
The mean age of the patients was 5.97±2.63 years, with 57.8% of the cases being females. Primary congenital glaucoma represented 44% of the cases. The intraocular pressure decreased from 27.44±4.3 to 12.38±1.46, 14.72±4.11, 16.96±5.57, 15.76±3.75, 15.01±1.33, and 15.07±1.31 mmHg at 1, 3, 6, 12, 18, and 24 months postoperatively, respectively (P≤0.001). Qualified success was achieved in 77.8% of the cases, whereas complete success was reported in 22.2% of the cases. One session of treatment was sufficient in 46.4% of the cases, whereas a second session was needed in 27.8% of the cases, and a third session was needed in 7.8% of the cases. Repetition of treatment was performed at 6 months in 40.6% of the cases. The number of needed sessions and the number of postoperative medications as well as the success rate did not depend on the etiology of refractory pediatric glaucoma. None of the patients lost vision or had more than two lines decrease of best-corrected visual acuity. No major complications were met. However, uveitis occurred in 25.6% of the cases and subconjunctival hemorrhage in 5.6% of the cases; both were completely treated with medical treatment. Antiglaucoma treatment was significantly decreased postoperatively from three to two types of antiglaucoma eyedrops (P≤0.001).

Conclusion
Micropulse transscleral cyclophotocoagulation with a high energy level is a safe and long-term effective tool to control refractory pediatric glaucoma. Neither the type nor the cause of refractory glaucoma affects the success rate of this procedure.
Efficacy of Posterior Sub-Tenon's Capsule Injection Compared to Intravitreal Injection of Triamcinolone Acetonide for Treatment of Diabetic Macular Edema
Authors: Ibrahim Mohamed Hamdy Ghazy , Salman Abdelrahman Gaber , Said Azza Mohamed Ahmed , Al-Feky Mariam Ahmad , Moustafa Moustafa ElHusienni 
Published: January 2022

Background:
Diabetic macular edema (DME) is defined as a retinal thickening in one-disc diameter of the center of the macula. It is a number of microvascular retinal changes that lead to blood-retinal barrier disruption, causing leakage of fluid and plasma components into the inner and outer plexiform layers.

Aim of the Work:
To conduct a systematic review and a meta-analysis estimating the efficacy and complications of posterior sub-Tenon's capsule injection of triamcinolone acetonide (STTA) compared to intravitreal injection of triamcinolone acetonide (IVTA) for management of DME.

Materials and Methods:
A comprehensive literature search was conducted using the databases Google Scholar, PubMed, MEDS, web of science, EMBASE, and Cochrane Library for published studies from January 01, 2000 to September 01, 2019. This meta-analysis included ten studies. They were randomized controlled clinical trials, and about 343 patients with DME (469 eyes) participated in these studies.

Results:
This study demonstrated a statistically significant change in the mean of best-corrected visual acuity (BCVA) improvement and central macular thickness (CMT) reduction in both groups when comparing the baseline to 1- and 3-month follow-ups after the injection, though with no statistically significant difference in the IVTA compared to the STTA group. At a 6-month follow-up, both groups showed no significant differences in the BCVA and CMT compared to the baseline. Both groups showed no statistical differences in the BCVA or CMT over the follow-up periods. Regarding intraocular pressure (IOP) changes, the present study showed that the mean IOP was elevated in both groups at 1- and 3-month follow-ups after the injection compared to their baseline. There was a statistically significant difference between both groups at 1 and 3-months. The IOP was more elevated in the IVTA compared to the STTA group. At a 6-month follow-up, both groups showed no significant difference in the IOP elevation compared to the baseline. IOP elevation was the most reported adverse effect in all included studies. Cataract formation is also reported in some studies, though no other complications, such as endophthalmitis, vitreous hemorrhage, and/or retinal detachment, are reported in any of the studies.

Conclusion:
STTA injection has a comparable effect to the IVTA injection and carries a lower risk of intraocular complications. It is considered an easy, safe, and valid alternative to intravitreal injection for the treatment of DME.
Changes in Peripapillary Blood Flow after Dorzolamide 2%/Timolol 0.5% versus Latanoprost 0.005%/Timolol 0.5% using Optical Coherence Tomography Angiography
Authors: El-Saied Heba Magdy Ahmed , Elhalim Wael E. Abd , Abdelhamid Mohamed , Elessawy Kareem Bakr 
Published: January 2022

Purpose:
The purpose is to compare the changes in the peripapillary blood flow in primary open-angle glaucoma (POAG) after administration of dorzolamide 2%/timolol 0.5% fixed combination versus latanoprost 0.005%/timolol 0.5% fixed combination, using spectral-domain optical coherence tomography angiography (OCTA).

Patients and Methods:
In this prospective, comparative, nonrandomized study, patients with POAG received simultaneous treatment with dorzolamide 2%/timolol 0.5% fixed combination in the right eye (Group 1) and latanoprost 0.005%/timolol 0.5% fixed combination in the left eye (Group 2) for 1 week. Intraocular pressure (IOP) was measured using applanation tonometry; and peripapillary capillary density and retinal nerve fiber layer (RNFL) thickness was assessed using OCTA before starting treatment and 1 week after the treatment.

Results:
IOP reduction was superior in Group 2; however, this was not statistically significant. Both groups showed an increase in the peripapillary capillary density and RNFL thickness after 1 week of the treatment as evaluated by OCTA angiography. However, this increase was not statistically significant. There was only a statistically positive correlation between IOP reduction and increase in the superior-hemiradial peripapillary capillary density (P = 0.037) in Group 1 and between IOP reduction and increase in the total RNFL thickness and superior hemi-RNFL thickness (P = 0.044, 0.032, respectively) in Group 1.

Conclusion:
Intraocular pressure decreased in both groups with no significant difference between both groups. There was more increase in radical peripapillary capillary density and RNFL thickness following treatment in dorzolamide 2%/timolol 0.5% group compared to the other groups; however, the difference between the two groups was not statistically significant.
Clinical and histopathological aspects of lichenoid dermatitis in patients of retroviral diseases
Authors: Tambe Swagata A. , Zambare Uddhao S. , Nayak Chitra S. , Patil Priyanka D. , Chhonkar Aditi 
Published: January 2022

Context:
Lichen planus (LP) is known to be associated with viral infections such as hepatitis B and C, but its association with HIV is rarely reported. Lichenoid drug eruptions have been implicated as the side effects of anti-retroviral therapy.

Aims and Objectives:
The aim of this study is to study demographics, clinical, histological, and immunological profile of the HIV patients presenting with lichenoid dermatitis.

Subjects and Methods:
HIV patients presenting with LP such as lesions were evaluated with complete history and physical examination. Demographic profile of patients was studied with features such as age, sex, duration of disease, distribution of the lesions, CD4 count, concomitant medications, associated comorbidities, and response to the treatment.

Results:
Twenty-one HIV patients presenting with LP such as lesions were studied. Of these, 20 patients had LP and one patient had lichenoid drug reaction. The age of the patient ranged from 40 to 60 years with no sex predilection. The duration of lesions ranged from 15 days to 7 years. Eleven patients had simultaneous cutaneous and oral involvement, five patients had only oral involvement and four patients of LP and one patient of lichenoid drug reaction had only cutaneous lesions. All the patients were on antiretroviral therapy, mainly on lamivudine, zidovudine, and nevirapine. Almost all the patients had CD4 count of more than 250 at the time of presentation. One patient was diagnosed to have lupus erythematosus and LP overlap. Patients were treated with oral medications such as corticosteroids, methotrexate, and dapsone and topical medications such as corticosteroids and calcineurin inhibitors.

Conclusions:
The appearance of LP such as lesions in HIV patients is a rare occurrence with 11 cases of LP reported till date. Our case series of 20 patients will throw light on possible etiology and difficulties in the management of LP such as lesions in HIV patients.
Early Intervention within 24 h Using Anterior Midline Single Incision with Dual Plating for Bicondylar Tibial Plateau Fractures Schatzker Type V and VI
Authors: Singhi Prahalad Kumar , Raju Sivakumar , Thangamani Vinoth , Velur Nagendra Reddy Sudeep Kumar , Muthu Chidambaram 
Published: January 2022

Introduction:
Schatzker Type V and VI fractures are high-velocity injury; they are bicondylar fractures of proximal tibia with significant articular involvement multiple displaced condylar fracture lines, metaphysiodiaphyseal extension with comminution with high incidence of compartment syndrome and soft tissue injury. Span, scan and plan, and later open reduction and internal fixation with dual incision dual plating is gold standard; Midline incision is considered as history and associated with complications.

Purpose:
The purpose of the study is to evaluate functional outcome in Type V and VI Schatzker bicondylar tibial plateau fractures, with early intervention using anterior midline approach and Dual plating.

Materials and Methods:
We analyzed retrospectively 35 patients from 2015 to 2018 at our tertiary center. All patients were operated within 12–24 h of injury using anterior midline approach and dual plating. Patients were evaluated radiologically (coronal alignment using medial proximal tibial angle, sagittal alignment using posterior proximal tibial angle and condylar width) functional and clinical assessment was done using Rasmussen and visual analog scale scoring at regular intervals till the last follow-up.

Results:
Bony union was achieved at average of 14 weeks (12–20 weeks), 80% patient had excellent and good results. 22% of patient needed bone grafting which was done primarily and 11.1% patient required an additional split skin graft and flap surgery. Complications such as deep and superficial infection were seen in 8.5%, knee stiffness (range of motion <90°) in 8.5%, and varus/valgus malalignment in 14.4% was seen. None of our patients had deep vein thrombosis (DVT). Average of hospital stay was 5.6 days only.

Conclusion:
Early intervention with single-incision anterior midline approach with dual plating for complex Type V and VI Schatzker bicondylar tibial plateau fractures can still be considered as a method of treatment when intervened early. The excellent functional outcome in this study, lower rate of complications, less incidence of DVT and shorter hospital stay are well comparable to dual incision technique.
A Qualitative Study of Impediments to Total Knee Replacement among Indians with Severe Knee Osteoarthritis
Authors: Reddy Maryada Venkateshwar , Mulpur Praharsha , Guravareddy Annapareddy Venkata , Gudapati Dinesh , Reddy Vinai Yeruva , Dinakar Mridula 
Published: January 2022

Objective:
The objective of this study is to determine the barriers for seeking a total knee replacement (TKR) in Indians with osteoarthritis, despite an increasing need for the surgery.

Materials and Methods:
Interviews were conducted with 350 Indian patients (109 males, 241 females) who underwent TKR at a tertiary care orthopedic center. The interviews were conducted with each individual based on a questionnaire of 18 questions, which emphasized the patient's reasoning and perceptions regarding TKR. Questions were asked after the patients were admitted but before undergoing TKR. Pain severity and disability before receiving TKR were measured with the Lequesne Index and Oxford Knee Score.

Results:
Patients requiring TKR were undergoing surgery 13 months after being advised for surgery. Multiple barriers in choosing surgery were identified: (i) wanting to manage pain and disability for as long as possible, (ii) loss of autonomy in making the decision to undergo surgery, (iii) financial issues in affording surgery, (iv) belief that the patients themselves are unfit for surgery and fear of postsurgical complications and morbidity.

Conclusions:
Despite there being several barriers to the surgical treatment of knee osteoarthritis, physicians must develop strategies to help bridge the gap between patients requiring TKR and the patients electing to undergo the surgery.
Head and Neck Trauma
Authors: Prabhakar Abhilash Kundavaram Paul , Abraham Sisha Liz , Hazra Darpanarayan , Nekkanti Ankita Chowdary 
Published: January 2022

Background:
Head and neck trauma is an increasing cause of morbidity and mortality in India. The mode of trauma has varies with geographical progress and it is important to understand the factors associated with severe head injury among this cohort.

Methods:
This was a retrospective observational study of all adult trauma patients with head and neck trauma presenting to our emergency department (ED). Details of the incident, injuries and outcome were analyzed.

Results:
During the 3-month study, the ED attended to 16,169 patients with 2022 being trauma victims. Among them, 51.4 3% (n = 835) adults who sustained head, face or neck trauma and hence were included in the final analysis. Overall, RTA s were the predominant mode of injury (81.2% (n = 678), followed by fall on level ground (6.5%; n = 54), fall from height (5.1%; n = 43) and assault (3.7%; n = 31). A history of consuming alcohol prior to the incident was obtained in 16.2% (135) of the patients. Head, face, and neck injuries were seen in 74.9% (n = 626), 64.1% (n = 536), and 4.9% (n = 41) of patients respectively. Bivariate analysis showed male sex (90.3% vs. 76.8%; unadjusted odds ratio [OR]: 2.81, 95% confidence intervals [CI]: 1.19–6.64; P = 0.018) and pedestrian injuries (19.4% vs. 8.5%; unadjusted OR: 2.57, 95% CI: 1.30–5.07; P = 0.006) to have a statistically significant association with sustaining severe head injury.

Conclusion:
Head and neck trauma comprises a significant proportion of patients with trauma with RTA and falls being the most common causes. Among patients with head and neck trauma, males and pedestrians have an increased odds of sustaining severe head injury (Glasgow Coma Scale ≤8).
Hamartomas of Body
Authors: Mohapatra Debahuti , Biswal Rupanita , Biswal Tapan 
Published: January 2022

Introduction/Background:
Hamartoma is a mass of disorganized tissue indigenous to the particular site. Although traditionally considered as developmental malformations, many hamartomas have clonal chromosomal aberration that is acquired through somatic mutation, thus now considered to be neoplastic. They arise virtually in all organs, either sporadically or in association with autosomal dominant syndrome.

Materials and Methods:
A retrospective study was carried out in a tertiary care health institute for 3-year period (January 2013 to December 2016), which included all visceral hamartomas from head to toe. Detailed clinicoradiological and pathological examination was done along with ancillary tests for definite diagnosis.

Observation:
The study included nine cases, categorized site wise as head and neck (one case of cystic lymphangioma), cardiothoracic (one case of chondroid hamartoma), gastrointestinal tract (GIT) (one case of Brunner's gland hamartoma), hepatic (one case of cystic lymphangioma), and genitourinary tract (four cases of angiomyolipoma [AML] and one case of myelolipoma). The age ranged from 1 year to 70 years showing a male predilection. The tumors were variable sized ranging from 0.5 to 20 cm in dimension either solitary or multiple. Some large tumors clinically masqueraded as malignant tumors and presented with complications. The postsurgical course and prognosis of all patients were uneventful.

Conclusion:
Hamartomas are usually not associated with significant morbidity but for the size and location of the tumor. Despite slow-growing and self-limiting behavior, some predispose to malignancy especially in the epithelioid AML and familial GIT hamartoma or may be seen associated with malignancy in syndromic forms.
End-Stage Renal Disease and Dilated Cardiomyopathy: A Retrospective Analysis in Renal Transplant Patients
Authors: Goyal Vipin Kumar , Moin Khayyam , Deganwa Mangilal , Garg Vishnu Kumar , Nimje Ganesh 
Published: January 2022

ABSTRACT

Background:
End-stage renal disease is the last stage of progressive renal failure that is almost always accompanied by cardiovascular complications such as systemic and/or pulmonary hypertension, atherosclerosis, dilated cardiomyopathy (DCM), valvular regurgitation, and so on. Among these, DCM is a common preoperative echocardiographic finding that necessitates specialized treatment.

Materials and Methods:
Patients with DCM who underwent renal transplantation using an intraoperative goal-directed strategy for fluids, inotropes, and vasopressors were included in this retrospective study. The demographics of the patients, their preoperative comorbidities, investigations, echocardiographic data, intraoperative parameters, and postoperative data and complications were all recorded and analyzed.

Results:
Hypotension was the most common intraoperative complication in 10 out of 22 patients (95% confidence interval: 0.24–0.66). There were no other major cardiopulmonary complications in any of the patients. There were no renal complications, such as delayed graft function or acute tubular necrosis, in any of the patients.

Conclusions:
Fluids, inotropes, and vasopressors must all be managed carefully during the perioperative period in DCM patients. The use of advanced dynamic indices is critical not only for achieving goals but also for avoiding complications.
The Use of Telemedicine in Mitigating the Effects of Reduced Antenatal Care Visits during the COVID-19 Infection Lockdown in Nigeria
Authors: Mbachu Ikechukwu Innocent , Ejikunle Samson Dayo , Pauline Mbachu Chioma Ngozichukwu , Okohue Jude Ehiabhi , Umeononihu Osita Samuel , Ojiyi Chukwuemeka , Obiagwu Hilary , Ukah Marcel Chukwuemeka , Osuagwu Ihechinyerem Kelechi 
Published: January 2022

Aims and Objectives:
The study evaluated the use of telemedicine in the management of pregnant women during the COVID-19 in Nigeria.

Subjects and Methods:
This was a cross-sectional study conducted among medical practitioners that care for pregnant women and a self-administered online questionnaire (google form) was used to obtain relevant information from the respondents. Data were analyzed using Stata software version 16.

Results:
A total of 138 medical practitioners participated in the study. The mean age of the participants was 41.30± 7.5 years. Seventy (51.47%) work in national public tertiary health institutions while 27(19.85%) work in-state public tertiary and 19(13.97%) in private specialist hospitals. There was a significant reduction in the number of patients seen during the period when compared to the number before the pandemic(p=0.013). Fifty-one (36.96%) of the medical practitioners said they practiced telemedicine, with the majority 41(80.39%) using audio calls.

Conclusion:
The use of telemedicine was poor among the medical practitioners despite the drop in antenatal attendance.
Clinical Characteristics of Crohn's Disease in a Cohort from Saudi Arabia
Authors: Qari Yousef A. 
Published: January 2022

Objective:
In Saudi Arabia, there are limited studies on the clinical characteristics of patients specifically with Crohn's disease (CD). This study was conducted to describe the clinical characteristics of CD at a tertiary care center in Jeddah, Saudi Arabia.

Methods:
This retrospective study included all patients aged >14 years who had a definitive diagnosis of CD and were managed at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, between 2012 and 2018. Data were collected for the following categories: clinical, laboratory, radiological, histological features at presentation, and disease-related complications.

Results:
The study included 245 newly diagnosed CD patients, aged 14–73 years (median: 26.3 years). All subjects presented with abdominal pain. Majority of the patients (59.7%) received a definitive diagnosis of CD >3 months after the onset of symptoms; 15.1% were initially suspected to have intestinal tuberculosis. Diarrhea and bleeding per rectum were reported in 60.8% and 49.7% of the patients, respectively. Sacroiliitis was the most frequent extraintestinal manifestations (11.4%). In terms of disease location, the terminal ileum (L1) was the most affected area (46.9%). Twenty-five patients had perianal disease, of which 40% had complex fistulae and 36% had perianal abscesses. The majority had hemoglobin levels >10 g/dl (74.1%), decreased serum iron (69.6%) and ferritin (50.5%) levels, and elevated erythrocyte sedimentation rate (68.2%) and C-reactive protein (82.2%).

Conclusions:
The majority of the patients in our cohort presented with the characteristic quartet of abdominal pain, weight loss, fever, and diarrhea. This study also found a significant number of patients with CD in Saudi Arabia experience diagnostic delay, which may contribute to disease morbidity and complications. These findings highlight the need for future studies to determine factors influencing this diagnostic delay.
Antibiotic-Resistance Genes in E. coli strains in GCC Countries
Authors: Bindayna Khalid Mubarak , Joji Ronni Mol , Ezzat Hicham , Jahrami Haitham Ali 
Published: January 2022

Background:Antimicrobial resistance (AMR) inEscherichia coliis an alarming issue worldwide, including in the Gulf Cooperation Council (GCC) countries, yet the prevailing gene patterns have not recently been reviewed. This study was conducted to determine and report on the dominantE. coliantimicrobial resistant gene patterns in GCC countries.Method:A scoping review identified the predominant AMR genes in GCC countries: CTX M, TEM, SHV, NDM, OXA, and VIM genes. For the systematic review, two authors independently searched Scopus, PubMed, Google Scholar, Science Direct, and Web of Science for interventional, clinical, or observational studies on the chosen AMR-conferring genes inE. colipublished from GCC countries between January 2013 and June 2019, when the last search was carried out. The search strategy followed the PRISMA guidelines. The risk of bias was assessed using a 6-item standardized checklist. Random-effects modeling was used for all analyses.Results:A total 32 studies were included in the final synthesis of evidence. Overall, CTX-M (53.8%) was the most prevalent gene in the region followed TEM (40.6%), NDM-1 (28.4%), OXA (24.3%), VIM (8.5%), and SHV (7.8%). Most included studies were from Saudi Arabia: CTX-M was again most common with a prevalence of 46.8% from 5442 isolates.Conclusion:The risk of bias analysis showed a mean quality score of 4.25 ± 0.75, indicating high-quality in studies included in this meta-analysis. This review found that CTX-M gene is the most common AMR-conferring gene inE. colistrains from most GCC countries.