bluuebunny/crossref_metadata_2025_split huggingface dataset:
Medial Patellofemoral Ligament Reconstruction
Authors: Das Pinaki , Karmakar Arnab 
Published: May 2022

Abstract
Patellofemoral dislocations are commonly encountered knee ailment. Although majority of the patients are managed conservatively, depending on the patients’ demands and predisposing factors, patients with recurrent dislocations often require surgical intervention. The main aim of any surgical procedure should be to restore the anatomy of the soft tissue as well as the bony elements. We here describe a technique which combines transverse patella double tunnel technique with tibial tuberosity distalization and medicalization to reconstruct the medial patellofemoral ligament using a free autologous semitendinosus graft.
Double Trouble
Authors: Lavadi Raj Swaroop , Venkatachalaiah Ranjitha , Prasad Madhva 
Published: May 2022

Abstract
A 46-year-old female came to the gynecology outpatient department with heavy and prolonged menstrual bleeding. The examination revealed a thyroid mass and tachycardia. Systemic and gynecological examinations were insignificant. Laboratory tests revealed a deranged thyroid profile which was further explored by performing magnetic resonance imaging. This revealed a functioning pituitary microadenoma producing thyroid-stimulating hormone (TSH). This entity is known as a TSHoma. Ultrasonography of the abdomen and pelvis showed increased endometrial thickness. The patient was treated with antithyroid medication and has undergone Mirena intrauterine contraceptive device insertion. The patient is planned for a hysterectomy when the thyroid profile is normalized.
Late presentation of lane-hamilton syndrome in a 33 year old female
Authors: Mishra Sarvesh Chandra , Gupta Aviral , Sharma Srishti , Gupta Archna 
Published: May 2022

Abstract
Lane-Hamilton syndrome (LHS) is a rare syndromic association between idiopathic pulmonary hemosiderosis and celiac disease (CD). It is usually seen in children below 15 years of age. It can occasionally be seen in adults. We present the case of a 33-year-old female patient who presented with recurrent episodes of hemoptysis to the pulmonary outpatient department. She also gave a history of having frequent loose stools. She was admitted and investigated thoroughly and was found to be suffering from LHS which is a rare disease. High-resolution computed tomography (HRCT) of the chest and duodenal biopsy helped in concluding the diagnosis. She was started on gluten-free diet (GFD) and has responded well with no episodes of hemoptysis on 9-month follow-up and is in good general condition. This case highlights the importance of keeping a high index of suspicion of LHS in a young patient presenting with unexplained hemoptysis and diarrhea. In a known case of CD presenting with hemoptysis, a HRCT chest aids in the diagnosis of LHS. A GFD is the mainstay of long-term treatment, and adherence to this diet shows remarkable improvement in the symptoms of the patient and their overall general condition.
Concurrent Coronary, Left Ventricle, and Cerebral Thrombosis – A Trilogy
Authors: Bhandari Monika , Pradhan Akshyaya Kumar , Vishwakarma Pravesh , Sethi Rishi 
Published: May 2022

Abstract
Left ventricular (LV) thrombus is a known complication of acute myocardial infarction (AMI), especially anterior wall MI and leads to systemic thromboembolism. However, increase in the rates of coronary perfusion either by thrombolysis or percutaneous interventions have reduced its incidence. Concurrent stroke and MI are seen in 0.009% of cases. The occurrence of AMI with LV thrombus with or without stroke mandates the combination of antiplatelet and antithrombotic therapy. Hitherto, there are no randomized studies in the setting of AMI with LV thrombus comparing dual (single antiplatelet plus oral anticoagulant [OAC]) and triple therapy (dual antiplatelet therapy with OAC). There are no large randomized trials as well to delineate the optimal therapy for simultaneous cardiac and cerebral infarction. We hereby, report an unusual case of a young patient who presented with triple combo of acute anterior wall MI, LV thrombus, and ischemic stroke and discuss the challenges in management in this scenario.
Knowledge, attitude, and practice of techniques of breastfeeding among new mothers
Authors: VERMA Himanshu , SINGH Sirshti , BAHUGUNA Nitika , DAHIYA Mukul , SHAH Jyoti 
Published: May 2022

Objective:
The present study aims to evaluate aims to assess the knowledge, attitude, and practice of primiparous mothers in the immediate postpartum period regarding breastfeeding techniques which will be helpful in forming awareness and training programs.

Materials and Methods:
A cross-sectional survey was used. A total of 120 primiparous mothers with a mean age of 24.92 years participated in the survey and filled the questionnaire related to the knowledge, attitude, and practice of techniques of breastfeeding.

Results:
Results revealed that 48.3% of new mothers were not aware of the correct techniques to initiate breastfeeding, whereas 68.3% of subjects reported that during latching, the baby's upper and lower lip should be everted. The majority of new mothers were aware of breastfeeding techniques with some misconceptions as in our culture, most of the breastfeeding information passed from generation to generation.

Conclusion:
The level of awareness about feeding skills among primiparous mothers can be further improved by antenatal counseling or training from health-care workers during the gestational period. This will further help new mothers to educate and will provide adequate information which will decrease the myths.
Omicron
Authors: SHABAN Mostafa , SHABAN Marwa Mamdouh , RAMADAN Osama , MOHAMMED Huda Hamdy 
Published: May 2022

Objective:
The current study aimed to assess the knowledge and attitudes of nurses toward the current COVID-19 pandemic and Omicron variant.

Materials and Methods:
A cross-sectional online survey was used. Totally 277 Egyptian nurses completed an electronic questionnaire comprising demographics with 5 items, nurses' knowledge on Omicron with 18 questions, and nurses' attitudes on Omicron with 5 questions. The data collected were expressed using numbers, percentages, and mean and standard deviation.

Results:
The mean age of nurses was 27 ± 5 years, nearly 50% of the nurses were bachelor degrees. The total score of correct answers related to knowledge was 75%, showing the different degrees of knowledge about Omicron. The majority of nurses showed positive attitudes toward controlling and managing the COVID-19 pandemic.

Conclusions:
Egyptian nurses have average knowledge about Omicron and a positive attitude toward controlling the COVID-19 pandemic. There should be scope for further assessment to enhance understanding about COVID-19. Moreover, health education programs should be developed for nursing staff to improve information, beliefs, behaviors, and attitudes towards the Omicron variant in particular and the COVID-19 pandemic in general.
Study on the Take‐over Performance of Level 3 Autonomous Vehicles Based on Subjective Driving Tendency Questionnaires and Machine Learning Methods
Authors: Kim Hyunsuk , Kim Woojin , Kim Jungsook , Lee Seung‐Jun , Yoon Daesub , Kwon Oh‐Cheon , Park Cheong Hee 
Published: May 2022

AbstractLevel 3 autonomous vehicles require conditional autonomous driving in which autonomous and manual driving are alternately performed; whether the driver can resume manual driving within a limited time should be examined. This study investigates whether the demographics and subjective driving tendencies of drivers affect the take‐over performance. We measured and analyzed the reengagement and stabilization time after a take‐over request from the autonomous driving system to manual driving using a vehicle simulator that supports the driver's take‐over mechanism. We discovered that the driver's reengagement and stabilization time correlated with the speeding and wild driving tendency as well as driving workload questionnaires. To verify the efficiency of subjective questionnaire information, we tested whether the driver with slow or fast reengagement and stabilization time can be detected based on machine learning techniques and obtained results. We expect to apply these results to training programs for autonomous vehicles' users and personalized human–vehicle interfaces for future autonomous vehicles.
A Mapping Review on the Uptake of the COVID-19 Vaccine among Adults in Africa Using the 5As Vaccine Taxonomy
Authors: Kalu Michael E. , Oyinlola Oluwagbemiga , Ibekaku Michael C. , Adandom Israel I. , Iwuagwu Anthony O. , Ezulike Chigozie J. , Nwachukwu Ernest C. , Uduonu Ekezie 
Published: May 2022

ABSTRACT.
Uptake of a vaccine is complete if individuals are aware of the associated risks of the vaccine, accept the vaccine, and respond positively to the nudges (activation) to increase the uptake, and respond when the vaccine is made accessible and affordable. We mapped systematically the existing literature concerning the 5As—acceptability, accessibility, affordability, awareness, and activation—of COVID-19 vaccination among adults and, specifically, older adults (55 years and older) in Africa. We searched multiple databases from 2020 to December 2021. Using predefined inclusion and exclusion criteria, two reviewers screened citations, conducted title and abstract screening, and extracted data independently. We included 68 articles conducted in 33 African countries, primarily cross-sectional studies (n = 49, 72%). None of the articles focused on older adults only, but 22 articles (32%) included at least one older adult (55 years and older) in their sample size. Acceptance (n = 58, 85%) was the most commonly researched aspect of vaccine uptake, followed by accessibility (n = 17, 25%), awareness (n = 13, 19%), and affordability (n = 5, 7.0%). We found only one report on activation. Factors affecting acceptance of the COVID-19 vaccine in Africa were grouped into sociodemographic factors; knowledge-, attitude-, and belief-related factors; a COVID-19 vaccine efficacy and safety concern factor; and trust in government and public health authorities. The governments of African nations should focus on strategies to influence the modifiable factors identified in this review. More studies are needed to evaluate the impact of nudges (activation) to improve COVID-19 vaccine uptake in African nations.
Axillary nodal metastasis and resection margins as predictors of Loco Regional Recurrence in Breast Cancer Patients
Authors: O Ayandipo O , J Adepoju O , O Ogun G , O Afuwape O , Y Soneye O , B Ulasi I 
Published: May 2022

Background: Surgical resection margins (RM), axillary nodal involvement and lymph node ratio (LNR) determine loco-regional control (LRC) in breast cancer management. Late presentation precludes breast conservation therefore surgical option is usually mastectomy and adjuvant chemoradiation minimize loco-regional recurrence (LRR).
Objective: We investigated the prognostic role of lymph nodes positive for malignancy (pN), LNR and RM on LRR of breast cancer in a tertiary hospital in Ibadan, Nigeria.
Methods: Longitudinal cohort study of 225 females with breast carcinoma managed and followed up for 5-years with end point of LRR or not. Chi-square test and logistic regression analysis were used to evaluate the interaction of resection margin and proportion of metastatic lymph nodes with LRR. The receiver-operator curve was plotted to determine the proportion of metastatic lymph nodes which predicted LRR.
Results: Ninety-nine percent had modified radical mastectomy and 163 (72.4%) had negative resection margins. A mean of 11 axillary lymph nodes were harvested at surgery. The age, positive resection margin and number of harvested nodes with malignant cells are associated with LRR. The overall 5-year LRR rate was 16%.
Conclusion: LRR is dependent on lymph node involvement as well as and tumor aggressiveness.
Keywords: Recurrence; breast cancer; Ibadan; Axillary nodes; resection margins.
Maternal and neonatal outcomes of grand multiparity in Khartoum, Sudan
Authors: Abdelmageed Elmugabil , Bahaeldin Hassan , Nadiah Alhabrdi , Abdelbagi Ahmed , Duria Rayis , Ishag Adam 
Published: May 2022

Objectives: Grand multiparity is a major health problem that leads to adverse maternal and perinatal outcomes. We aimed to assess the maternal and perinatal outcomes of grand multiparity.
Methods: A case-control study was conducted in Saad Abualila Hospital, Khartoum, Sudan from February to December 2019. The cases were grand multiparous (≥ 5 deliveries) women. The controls were women with low parity (multiparous women who delivered two to four times). Maternal and perinatal characteristics were compared between the two groups. Logistic regression analysis was performed.
Results: There was a significant association between grand multiparity and higher maternal age (adjusted odds ratio [AOR]=1.19, 95% confidence interval [CI]=1.16-1.23), lower education level (AOR=3.38, 95% CI=2.49-5.58) and lower antenatal care attendance (AOR=1.73, 95% CI=1.02-2.92). Grand multiparous women were at increased risk for Anemia (AOR=1.48, 95% CI=1.08-2.03), diabetes mellitus (AOR=10.61, 95% CI=4.89-23.00), caesarean delivery (AOR=1.87, 95% CI=1.40-2.48), preterm birth (AOR=1.90, 95% CI=1.37-2.62) and admission to the neonatal intensive care unit (AOR=3.8, 95% CI=1.95-7.75).
Conclusions: Grand multiparity was associated with poor maternal and neonatal outcomes. Development of a national health program addressing family planning, health education and improvement of antenatal, intrapartum and neonatal care are needed.
Keywords: Grand multiparity; multiparous; maternal outcome; neonatal outcome; Sudan.
Mentorship during transition period: a challenge for newly qualified midwives in Limpopo province of South Africa
Authors: Simane-Netshisaulu Khathutshelo , Maputle Maria , Mutshinyalo Netshikweta Lizzy , Shilubane Hilda 
Published: May 2022

Background: Mentorship is a process in which structured support is provided to new graduates of the profession to facilitate theireffective transitional journey to professional autonomy.
Objectives: To explore and describe the mentoring process as experienced by newly qualified midwives and experienced midwivesduring thetransition period.
Methods: Aqualitative approach was used. Five hospitals were selected from Limpopo province. The study was conducted in a maternity unit of each selected hospital. Population comprised of all newly qualified midwives as well as all experienced midwives working at institutions under study. Non-probability, purposive sampling method was used to select twenty-five newly qualified and twenty-five experienced midwives working in maternity wards of selected hospitals. In-depth face-to-face interviews were conducted for data collection.
Results: Ineffective mentoring processes were reported, where only a few experienced midwives seemed ready to provide informal and unstructured support to graduates. Experienced midwives recognised their mentoring role however, felt they did not have sufficient knowledge and skills regarding mentoring process. Shortage of staff and increased workload were reported as challenges which negatively affected the mentoring process.
Conclusion: Mentoring is an effective process for facilitation of graduates’ transition process to become registered autonomous midwifery practitioners. However, they were not effectively mentored; consequently, negatively affecting their development to professional maturity.
Keywords: Experienced midwives; mentoring; mentor; newly qualified midwives.
Prevalence and determinants of cardiac arrhythmias and conduction anomalies in adults aged ≥ 40 years in Jimma Town, Southwest of Ethiopia: a cross-sectional study
Authors: Tadesse Bukata Iyasu , Tegene Elsa , Gobena Teshome , Markos Woldesenbet Yohannes 
Published: May 2022

Background: The prevalence of cardiac arrhythmia (CA) in the Ethiopian population is unknown. A community study was conducted to assess the magnitude and predictors of CAs in adults aged≥40 years in Jimma Town.
Methods: A community-based cross-sectional study was conducted in Jimma town from May to July 2017. A total of 634 adults aged 40 years or older were selected using a systematic sampling technique from six kebeles of the Town. Study participants were screened for CA using a 12-lead ECG machine. Face-to-face interviews, anthropometric, important clinical measurements were performed. Data analysis was done using SPSS for windows version 21.0.
Results: A total of 634 study participants, significant CA occurred in 217 individuals (34.2%). Conduction abnormalities and sinus bradycardia were the commonest findings (25.4%). Premature beats (ventricular 1.9%, atrial 1.1%) and atrioventricular nodal reentrant tachycardia (2.1%) were the next most frequent arrhythmias. Arrhythmias were independently associated with smoking(AOR=1.9;P=.047), hypertension(AOR=1.5;P=.02), heart failure(AOR=2.06;P=.023), priorstroke(AOR=4.9;P=.001), previous history of MI(AOR=1.78;P=.039), vigorous intensity activities(AOR=0.56;P=.024), solidified vegetable oil consumption(AOR=3.5;P=.004), and occupation(pensioner, none)[AOR=1.7;P=.017].
Conclusion: CA is highly prevalent in Jimma. Hypertension and history of heart diseases are the most potent predictors of cardiac arrhythmia. Large-scale screening for early detection of arrhythmia has important implications for treatment.
Keywords: Cardiac arrhythmia; prevalence; risk-factors; 12-lead ECG; Jimma Town.
Exploring the use of p53 protein expression as an indicator of oesophageal cancer severity from a high incidence rural area of Africa
Authors: J Ndebia Eugene , Ngonyama Thandazile , Molaoa Steve 
Published: May 2022

Background: The expression of p53 has been associated with the severity of other types of cancer. There is scanty information when it comes to oesophageal cancer.
Objective: This study aimed to explore the use of p53 protein expression as an indicator of oesophageal cancer severity from a high-risk incidence in the African rural population.
Methods: Fifty-one patients newly diagnosed with oesophageal cancer were recruited from the endoscopic unit at Nelson Mandela Academic Hospital in Mthatha, South Africa. The serological expression of p53 was measured using the ELISA method and the severity of oesophageal cancer expressed in grade was obtained from the histopathology report from patient’s oesophageal biopsies.Results: We found that the expression of p53 was equally distributed among the histological grades of cancer with the value of 2495 pg/mL ± 1736 pg/ mL for lower grades and 2520 ± 1539 pg/mL for higher grades. Furthermore, we found that the level of p53 expression was equally distributed in patients from grade 1, 2, 3, and 4.
Conclusion: The expression of p53 protein does not vary according to the histological grade of oesophageal cancer in the given population, therefore may not be helpful as a prognostic factor.
Keywords: Exploring the use of p53 protein expression; as an indicator of oesophageal cancer severity; from a high incidence rural area of Africa.
Metabolic syndrome and its components among HIV/AIDS patients on Antiretroviral Therapy and ART-Naïve Patients at the University of Calabar Teaching Hospital, Calabar, Nigeria
Authors: Ojong Ebot , Iya Bassey , Djeufouata Jules , Ndeh Forwah , Nsonwu Augusta , Njongang Vigny , Etukudo Maisie , Usoro Chinyere , Ekpo Julie 
Published: May 2022

Background: Although an increasing access to ART in sub-Saharan Africa has made it possible for HIV/AIDS patients to live longer, clinicians managing such patients are faced with the challenge of drug-related metabolic complications.
Methods: A cross -sectional study was carried out at the University of Calabar Teaching Hospital, Nigeria, on three groups of participants; namely HIV patients on ART, ART-naïve patients and HIV negative subjects (n =75). Demographic and anthropometric data were collected using a well-structured questionnaire while biochemical parameters were measured using colorimetric methods.
Results: The highest prevalence of MS was associated with the HIV/AIDS patients on ART (i.e. 32.0 %, and 50.3% for NCEP-ATP III and IDF criteria respectively). Patients on ART had significant increases (p< 0.05) in waist to hip ratio, FPG, serum TG and LDL-c; and a significantly higher (p< 0.05) prevalence of hypertension, diabetes, low HDL-c and hypertriglyceridaemia compared to the ART-naïve patients. Low serum HDL-c was the most prevalent form of dyslipidaemia in allthree groups and the most prevalent component of MS in HIV patients.
Conclusion: ART increases the risk of MS and CVD. HIV/AIDS patients on ART should be advised on lifestyle modifications and undertake regular assessment of their cardiovascular risk factors.
Keywords: HIV/AIDS patients; antiretroviral therapy; ART-Naïve patients; Calabar Teaching Hospital; Calabar; Nigeria.
Factors affecting adherence to anti-retroviral therapy among women attending HIV clinic of a tertiary health institution in SouthEastern, Nigeria
Authors: C Opara Hope , N Iheanacho Peace , Nebo Blessing , A Ingwu Justin , J Anetekhai Chinenye , N Anarado Agnes 
Published: May 2022

Background: Strictly adherence to antiretroviral therapy (ART) is needed to achieve viral suppression. Studies have focused on HIV positive pregnant women’s adherence. Factors affecting non-pregnant HIV positive women’s adherence has been understudied in Enugu
Objective: The study objective was to identify factors affecting adherence to ART among HIV positive women attending retroviral clinic of a tertiary hospital in Enugu.
Methods: Using a descriptive cross-sectional design, a pre-tested structured questionnaire was used for data collection among 286 HIV positive women aged 18 years and above. Data were analyzed using descriptive statistics of proportions, percentages, and means. Responses with a mean score of ≥2.5 were taken as important factor affecting adherence.
Results: Overall adherence was 56.2%. Participants were considered adherent if they took ≥95% of their prescribed ART. Lack of transport fare (2.69 ±1.36), long-distance to clinic (2.82±1.26), health workers’ poor attitude (2.74±1.28), and lack of partners’ and parents’ support (2.57±1.05) affected adherence negatively while ease in renewing prescription and minimal side effects of drugs enhanced adherence. Enfuvirtide (21.1%) and Lamivudine (17.4%) were drugs that were mostlyskipped.
Conclusions: Adherence to ART was low among the women attending the HIV clinic in Enugu. Adherence counseling and education should be provided before ART initiation. Strategies to reduce stigma, increase family support, and improve healthcare providers’ attitudes should be employed.
Keywords: Adherence; anti-retroviral therapy; factors; women; HIV Clinic; Enugu.