bluuebunny/crossref_metadata_2025_split huggingface dataset:
Study of Noninduction Immunosuppression in Intermediate-Risk Living Donor Kidney Transplantation in Rural Population of India - A Retrospective Observational Study
Authors: Data Ankit , Gadekar Kshitija G. , Mogal Vajed R. , More Abhijeet S. , Kulkarni Sudhir Gajanan 
Published: April 2022

Introduction:
Kidney transplant is a costly affair, especially in a developing country like India. The current study was carried out with the aim to analyze the clinical outcome retrospectively in terms of acute rejection (AR), graft survival, and patient survival in intermediate-risk recipients undergoing first renal transplant with Tacrolimus (TAC), Mycophenolic acid (MPA), and corticosteroid based triple maintenance immunosuppression in one of the most underprivileged population of the country who has to bear the cost of the induction agent not covered by any government scheme.

Materials and Methods:
It is a retrospective observational study. We included 101 patients, out of which 42 were in basiliximab group and 59 patients did not receive any induction agent. Apart from the induction, agent rest of the Immunosuppression protocol was same in all patients. The primary endpoint of the study was number of biopsy-proven AR within 1st year of transplantation. The secondary endpoints were patient and graft survival by 1 year.

Results:
Human leukocyte antigen mismatch and mean age of the patients in basiliximab group were significantly higher than noninduction group; otherwise, both groups were similar in all other baseline parameters. There was no significant difference between AR (21.43% v/s 18.64%), graft survival (97.30% v/s 98.15%), and patient survival (88.10% v/s 91.52%) at 1 year.

Conclusion:
Our study suggests that Induction immunosuppression may not be necessary for patients undergoing intermediate-risk living donor kidney transplant in the current scenario of TAC and MPA-based maintenance immunosuppression.
Knowledge, Attitude, and Practice toward Prevention and Management of COVID-19 among Indian Nurses
Authors: Rastogi Aayushi , Syed Sabin , Bansal Akanksha , Ramalingam Archana , Sharma Tarika , Kumar Vinay , George Mini , Varshney Mohit 
Published: April 2022

Background:
To plan suitable policy against COVID-19 pandemic, it is important that the nurses have updated knowledge related to prevention, diagnosis, treatment, and management of COVID-19 and have an optimistic attitude and good practices in managing the patients during the pandemic crisis. Thus, we conducted a study on the knowledge, attitude, and practices (KAP) related to COVID-19 among Indian nursing professionals.

Methodology:
A cross-sectional study was conducted from April 22 to May 22, 2020 using a pretested 37-item-self-reported e-questionnaire among nursing professionals above 18 years of age, working in health-care setting across 25 states. The questionnaire consisted of four sections: demographic details, knowledge (26 items), attitude (6 items), and practice (5-itmes). KAP questionnaire was shared through e-mail, SMS, and WhatsApp groups.

Results:
A total of 1182 participants responded to the online survey with 94% completion rate. The study analyzed the data for 1110 nurses with a mean age of 30 ± 6.7 years and 68% being females. The mean KAP score was 16.82 ± 3.3, 9.77 ± 2.03, and 18.37 ± 3.29, respectively. Knowledge was significantly correlated with attitude (r = 0.1316) and practice (r = 0.1526). Practice and attitude were also found to be positively correlated (r = 0.4398). Good knowledge related to COVID-19 was significantly affected by age, gender, location, and type of facility (<0.01).

Conclusion:
The study raised concerns regarding poor knowledge, anxiety, and fear from COVID-19 duty affects the health-care workers (HCWs) performance and provides resistance in working. A comprehensive training program for HCWs focuses more in terms of infection, prevention, control, and management and maintaining good mental health is required.
Knowledge and Practices of Blood Donors regarding COVID-19
Authors: Sharma Tarika , Raza Vaseem , Kumari Manglam , Srivastava Swati , Ponnappan Karthik 
Published: April 2022

Introduction:
COVID-19 pandemic has threatened the safety of both donors and recipients thus negatively impacting the blood donation process. Home confinement limits the ability of donors to attend blood services and the staff to take part in collection teams as well. The restrictions and limitations of large gatherings also reduce the number of large blood drives and campaigns.

Aim:
The current survey was undertaken soon after the official announcement of nationwide lockdown to assess the COVID-19-related knowledge and expressed practices about precautions among blood donors visiting blood bank.

Materials and Methods:
This was a cross-sectional survey conducted on 109 blood donors visiting blood bank in the month of March–April 2020. Data were collected using structured knowledge questionnaire and expressed practice checklist. After collecting data, the donors were provided with information related to COVID-19, and its precautions as per the guidelines from the Ministry of Health and Family Welfare, India. The obtained data were analyzed using the SPSS software version 22.

Results:
In terms of knowledge, it was found that 51.3% donors had very good knowledge, 42.3% had good knowledge, whereas 6.4% donors had poor knowledge about COVID-19. With regard to practices related to COVID precautions, it was noticed that most (90.82%) of the donors followed best practices, 9.18% donors followed good practices, whereas none of the donor followed poor practices. A significant positive correlation (P ≤ 0.01) was found between knowledge and practice score of blood donors. Significant association was seen in knowledge with educational status (P = 0.003) and practice with place of residence (P = 0.010).

Conclusion:
Based on the findings, it was concluded that 51.3% donors had very good knowledge, whereas 6.4% donors had poor knowledge about COVID-19. With regard to the practices related to COVID precautions, most (90.82%) of the donors followed best practices, 9.18% donors followed good practices, whereas none of the donor followed poor practices. Hence, the health-care professionals must take active steps to disseminate correct and updated information to blood donors regarding COVID-19 and related precautions.
Correlation of Immunohistochemical Expression of p16, Ki-67, and p53 with Histopathological Diagnosis of Noninvasive Cervical Lesions
Authors: Ogbu Christian C. , Ndukwe Chinedu Onwuka , Chiemeka Michael Emeka , Madubuike Kingsley C. , Ukah Cornelius Ozobia 
Published: April 2022

Background:
There is a high burden of cervical cancer in our environment. Most patients present late when the prognosis is guarded. Hence, accurate diagnosis of preinvasive lesions from cervical biopsies is important for clinical decisions and patient management. The aim of the study is to correlate the expression of p16INK4a, p53, and Ki-67 with histopathological diagnosis of noninvasive cervical lesions.

Materials and Methods:
The paraffin blocks of all cervical biopsies (excluding cases histologically diagnosed as invasive lesions) seen in two histopathology laboratories in Nnewi, Southeast Nigeria, over a 10-year period (2011–2020) were retrieved from the archives of both facilities. The cases were subjected to immunohistochemistry using p16INK4a, Ki-67, and p53 monoclonal antibodies.

Results:
There were 23 normal/reactive (45.1%), 6 low-grade squamous intraepithelial lesion (11.8%), and 22 hIL (43.1%). There is a very strong positive correlation between p16INK4a expression and the histopathological diagnosis (Spearman's correlation = 0.98). There is a strong positive correlation between Ki-67 expression and the histopathological diagnosis (Spearman's correlation = 0.70). There is a weak positive correlation between p53 expression and histopathological diagnosis (Spearman's correlation coefficient = 0.40).

Conclusion:
p16INK4a shows the best correlation with histopathological diagnosis of noninvasive cervical lesions and may be a very useful adjunct to H and E for diagnosing preinvasive cervical lesions. However, p53 correlates poorly with histopathologically diagnosed noninvasive cervical lesions and therefore may not be diagnostically useful.
Histopathological Spectrum of Skin Lesions in the Elderly
Authors: Ndukwe Chinedu Onwuka , Ndukwe Chinwe Chioma , Uzoigwe Joseph Chukwuma , Eni Anthony Onyeka , Nnamani Christian Sunday , Nwokoro Onyekachi Chibueze , Chiemeka Michael Emeka 
Published: April 2022

Background:
There are only a few epidemiological studies published on skin disorders in the elderly within the Nigerian context and none from the Southeast Region of the country. In addition, none of these studies has considered the pattern and frequency of histopathologically diagnosed geriatric skin lesions. Hence, we attempted to determine the frequency as well as the age and gender distributions of histologically diagnosed dermatological diseases in geriatric population from skin biopsies submitted to the histopathology department of a tertiary care hospital in Southeast Nigeria.

Materials and Methods:
This is a cross-sectional retrospective hospital-based study involving all skin biopsies of patients 60 years and above, received at the Department of Histopathology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria, from January 2004 to December 2019.

Results:
During the study period, 751 skin biopsies were received in the histopathology department. Of these, 142 were from patients who were older than 60 years. Thus, the overall share of geriatric patients was 18.9%. The mean age at presentation was 71.1 ± 8.6 years. The M: F was 1:1, and most of the patients belonged to the age group of 60–69 years (69 cases, 48.6%). The mean age of the male patients was 72.1 ± 9.5 years. In the female patients, it was 70.1 ± 7.5 years. The most common disease category was neoplasms (91, 64.1%). Most neoplasms were malignant. There were 67/142 (47.2%) malignant lesions. The most common was Squamous cell carcinoma (SCC) (30 cases) which is 21.1% of all geriatric skin biopsies and 44.8% of malignant skin biopsies. This is closely followed by melanoma (29 cases).

Conclusion:
Malignant neoplasms, benign neoplasms, and papulosquamous disorders are the three most common histologically diagnosed skin lesions in our geriatric population. The most common skin malignancies in this group of patients are SCC and malignant melanoma.
Quality of Life and Psychiatric Comorbidity in Vitiligo
Authors: Benny Deepthi , Makkuni Anoop , Thyvalappil Anoop , Mathew Pretty , Sridharan Rajiv , Druhin A V. 
Published: April 2022

Abstract

Background:
Vitiligo is a common, acquired, idiopathic, depigmenting disorder with a profound effect on the patient's quality of life (QoL).

Purpose:
The objective of the study was to measure the QoL of patients with vitiligo using the dermatology life quality index (DLQI) and to assess psychiatric comorbidity in vitiligo patients using the General Health Questionnaire-28 (GHQ-28).

Methods:
Sixty patients above 16 years of age with vitiligo were enrolled. Age, sex, occupation, marital status, duration of disease, extent of involvement, visibility of lesions, details of treatment, duration of treatment, and response to treatment were collected. Independent t-test and ANOVA were used to test for significance of continuous variables and Chi-square test for categorical variables. Correlation between DLQI and GHQ-28 was assessed using Spearman's rho correlation coefficient.

Results:
Females scored higher than males on overall GHQ-28 scores and in individual domains of anxiety/insomnia, social dysfunction, and severe depression. Unmarried participants had higher scores compared to married subjects in all dimensions of DLQI and GHQ-28, indicating worse QoL and mental health.

Conclusion:
More than half of vitiligo patients had psychiatric comorbidity. There was a strong correlation between DLQI and GHQ-28 score, indicating strong association of QoL impairment with psychological problems. Proper counseling of patients of vitiligo along with specific treatment may be prudent.
Public Knowledge and Attitude toward Vitiligo in Saudi Arabia
Authors: Algarni Malak A. M. , Alqarni Waleed A. , Alghanemi Logain G. , Alnashri Maryam M. , Alghanemi Rand G. , Mleeh Nouf T. 
Published: April 2022

Abstract

Background:
Knowledge and positive attitude toward vitiligo would foster support for affected individuals, improving their sense of well-being and possibly treatment outcome.

Purpose:
To evaluate the levels of public knowledge and attitude toward vitiligo among Saudis.

Methods:
A cross-sectional study among 12,181 participants. Data were collected using a self-administered questionnaire enquiring about knowledge, attitude, and perceptions in vitiligo.

Results:
The response rate was 95.4%. Most respondents had heard about vitiligo (96.9%). The median knowledge score was four out of eight and median attitude score was six out of eight. Social media/Internet was the most commonly reported source of information (34.7%), followed by family/friends/acquaintances (30%). Higher proportions of correct responses were recorded regarding the noninfectious nature of vitiligo (85.0%) and whether vitiligo was dangerous or connected to skin cancer (63.4%). However, unsatisfactory responses were found regarding the immunological basis of the condition: only 24.3% knew that vitiligo was an immune disease and 24.5% knew about the role of heredity in vitiligo. The majority of respondents did not mind employing patients with vitiligo (89.0%). Only 40.6% responded that they would marry someone with vitiligo. Positive attitude was significantly common in respondents aged 31–50 years (P < 0.01), women (P < 0.01), and those who had a university degree or higher (P < 0.05).

Conclusion:
Although overall attitude toward vitiligo patients was positive, there were gaps in the knowledge, particularly regarding the nature of the disease. More awareness and education are required to improve attitude toward vitiligo patients, with an aim to improve their overall well-being.
Factor Structure of the Bengali Version of Atopic Dermatitis Burden Scale for Adults
Authors: Agrawal Ekta , Gautam Ashish K. , Shaikh Abdur R. , Dutta Souvik , Dey Samit , Mukherjee Shyamal K. , Saha Sangita , Mandal Sanjukta , Ghosh Shubhamoy , Koley Munmun , Saha Subhranil 
Published: April 2022

Abstract

Background:
Atopic dermatitis (AD) is associated with increased burden and reduced health-related quality of life (HRQoL); however, there is no available Bengali questionnaire assessing the same.

Purpose:
We aimed to develop the Bengali version of the questionnaire and examine its cross-cultural adaptability considering linguistic equivalence.

Methods:
A multicentric, mixed methods, cross-sectional study was conducted through the consecutive sampling at the outpatients of three homeopathy hospitals in West Bengal. The Bengali version of the questionnaire was produced by standardized forward-backward translations. Psychometric analysis was run to examine its factor structure, validity, and reliability. Reliability was examined using internal consistency (n = 230). Construct validity was examined by the exploratory factor analysis (EFA; n = 115) using the principal component analysis (PCA; varimax rotation). Subsequently, confirmatory factor analysis (CFA; n = 115) was performed to verify the model fit.

Results:
The internal consistency (Cronbach's α =0.876 (95% confidence interval 0.851–0.898)), test-retest reliability and concurrent validity – all were within the acceptable limits. The Kaiser-Meyer-Olkin (KMO = 0.793) and Bartlett's test of sphericity (Chi-square: 1038.981 at 153° of freedom, P < 0.001) both suggested adequacy of the sample. In factor analysis using varimax, all the items loaded above the prespecified value of 0.4 and identified five components, explaining 68.3% of the variation. The goodness-of-fit of the 5-components model in CFA was also acceptable (comparative fit index = 0.858, Tucker Lewis index = 0.823, root mean square error of approximation = 0.102, and standardized root mean square residual = 0.188).

Conclusion:
The Bengali version of the questionnaire consisting of 18 items and framed within five components appeared to be a valid and reliable instrument measuring disease burden and HRQoL in adults suffering from AD.
Prevalence of Topical Corticosteroid Use without Prescription in Saudi Arabia
Authors: Al-Aojan Shaikah , Al-Marzoug Alanoud , Alaujan Abdulrahman , Abanmi Samiah , AlJasser Mohammed I. 
Published: April 2022

Abstract

Background:
Misuse of topical corticosteroids (TCS) is common and constitutes a serious problem in many parts of the world where they can be obtained without prescription. Limited studies have been performed in Saudi Arabia to address this issue.

Purpose:
We aim to study the prevalence, predisposing factors, and adverse consequences of TCS use without prescription in Saudi Arabia.

Methods:
A cross-sectional study was performed using an Arabic questionnaire distributed through social media applications in May 2020 in Saudi Arabia. Individuals aged 18 years and above who used TCS within the last 2 years were included. The questionnaire consisted of detailed questions about TCS use and demographic information.

Results:
A total of 720 participants completed the questionnaire. TCS were used without prescription by 43.1% of respondents. Being female was the only identified risk factor for the use of TCS without prescription. The main reason for purchasing TCS without prescription was that the problem seemed too trivial to consult a physician (36.6%). The most common conditions for which TCS were used were treatment of pruritus without skin disease (23.7%) and cosmetic reasons (19.9%). Side effects were reported in 25.6% of participants. The most common side effects were hypopigmentation, itching, redness, and skin sensitivity.

Conclusion:
The use of TCS without prescription is prevalent in Saudi Arabia. We recommend that local health authorities regulate the use of TCS.
Quality of Life and Psychological Aspects of Patients with Hidradenitis Suppurativa in Saudi Arabia
Authors: Alsharif Sahar , Khan Zakaria , Almuntashri Fahad , Alghamdi Ahmad 
Published: April 2022

Abstract

Background:
Hidradenitis suppurativa (HS) is a chronic recurrent painful auto-inflammatory skin disease of the terminal hair follicle, causing nodules, abscesses, sinus tracts, and scars on intertriginous areas.

Purpose:
This study aims is to determine the effect of HS on patients' psychology and quality of life in the Makkah population.

Methods:
This is a cross-sectional, multi-center study conducted on HS patients who visited the dermatology clinic during 2017−2020. A total of 165 patients participated in the study by completing a questionnaire consisting of demographic data, the dermatology life quality index, depression, anxiety, and stress score.

Results:
In total, 147 patients were included in the final analysis, and the mean age of the participants was 32.0 ± 10.6. HS had a very large effect on the quality of life of 32% of the participants. Quality of life was worse with the number of flares per year (P < 0.003) and with axillary and perianal involvement, (P < 0.018 and P < 0.024, respectively). Moreover, a higher level of depression was associated with a higher body mass index (P < 0.020).

Conclusion:
HS had a large effect on the quality of life regardless of Hurley stage and was correlated with the number of flares per year and area of disease involvement.
Pregnancy and Neonatal Outcome with Maternal Exposure to Finasteride
Authors: BinJadeed Hessah F. , Alajlan Abdulmajeed 
Published: April 2022

Abstract

Background:
Finasteride, a type II 5-α reductase inhibitor, is approved for the management of benign prostate hyperplasia and male pattern hair loss. Finasteride is used off-label for female pattern hair loss. In utero fetal exposure to finasteride might lead to external genital anomalies in males.

Purpose:
The aim of this study is to assess the outcomes of in utero finasteride exposure.

Methods:
We report seven pregnant women with maternal exposure to finasteride. A detailed history was obtained from patients after delivery.

Results:
In one woman who was pregnant with twin boys, one boy died at the 16th week of gestation and the other delivered at the 34th week of gestation with hypospadias. Another woman had threatened abortion and delivered a normal healthy baby girl. A third had induced elective abortion in the 9th week of gestation. The outcomes of the other four pregnancies were completely healthy, three girls and one boy.

Conclusion:
External genital anomalies may occur in male fetuses exposed in utero to finasteride depending on the timing of exposure.
Microneedling with Topical 5-Fluorouracil in the Localized Stable Vitiligo – Is This the Way Out? – Our Experience
Authors: Singrodia Ankit K. , Mehta Rajesh Datt , Sharma Divya , Choudhary Paras , Ghiya Bhikamchand Chand , Bai S Jyothi 
Published: April 2022

Abstract

Background:
Vitiligo is a dermatological challenge with a major socio-psychological concern. Despite the availability of numerous medical and surgical treatment options, a single universally reliable therapeutic modality is yet to emerge due to the variability of response rate in different patients.

Purpose:
The objective of this study was to assess the safety and efficacy of microneedling along with topical 5-fluorouracil (5-FU) solution application in localized stable vitiligo.

Methods:
This open, nonrandomized, single-arm study was enrolled with 100 patients with localized stable vitiligo. Microneedling with topical 5-FU solution application was performed on 204 patches. The procedure was performed fortnightly for maximum 6 months.

Results:
At the end of 3 months, good to excellent (Grade IV) repigmentation was noted in 106 patches (51.96%) and Grade I to Grade II repigmentation was seen in 56 (27.45%) patches whereas at the end of follow-up, 128 (62.74%) patches showed good to excellent response.

Conclusion:
In conclusion, the results of this study showed that needling with 5-FU is a simple, cost-effective, and well-tolerated procedure which can be used as an alternative or additive modality in the treatment of localized stable vitiligo.
Prurigo Pigmentosa
Authors: Samarkandy Sahal J. , Alharbi Bader A. , Almalki Basel B. , Alamri Samer A. 
Published: April 2022

Abstract
Prurigo pigmentosa (PP) was originally reported in Japan. It is an uncommon inflammatory skin disorder that usually involves the neck and trunk and characterized by a sudden eruption of pruritic indurated macules, papules, and Vescio papules that involute, leaving a reticulated pigmentation. It commonly affects young adult females. PP was initially thought to have a predilection for the Asian race, however several cases have been reported worldwide. The exact etiology of PP is yet unclear. However, it has been associated with ketosis and a ketogenic diet. Oral antibiotic is a major treatment in this disorder, while topical steroid and antihistamines are not successful.