Authorship Diversity in General Surgery Related Cochrane Systematic Reviews

Background This study sought to determine the gender and country diversity in authorship representation in the authorship of Cochrane systematic reviews related to General Surgery.   Methods We searched and extracted data from the Cochrane Library on 3 September 2022 using ‘keyword:General surgery’, and included published reviews, protocols, and withdrawn publications. We extracted authors’ details and searched online to determine their gender, attempting to capture at least one webpage demonstrating it. Authors whose gender could not be ascertained were excluded from gender-based analyses. For graphical representation, we used a choropleth-style map. We treated a collaborative author group belonging to a single country, e.g., MRC Clinical Trials Unit (UK), as a single author. A second author independently cross-verified the extracted data.   Result Two hundred and fifty publications with a total of 1420 authors were included in the current study. Four authors had affiliation to two countries. The leading five represented nations (Figure 1A) in authorship were United Kingdom (n=562, 39.4%), China (n=163, 11.5%), Italy (n=144, 10.1%), Canada (n=91, 6.4%), and United States of America (n=89, 6.2%).   Syria is the only country among all the low-income countries which had authorship representation and constituted 0.34% (n=5) of all the authors. India (n=8, 0.6%) and Nigeria (n=2, 0.1%) were the only countries from lower-middle income groups who had representation. Male (n=957) to female (n=453) ratio in this study was 2.11:1 (Figure 1B). Sex data for ten authors couldn’t be retreived and were categorized as ‘unknown’ group.  There were 169 (67.3%) male and 82 (32.6%) female first authors (sex ratio 2.06:1). One study had designated two authors as co-first authors. Women (n= 81) constituted 32.4% of all the corresponding authors (sex ratio 2.06:1). One article didn’t have any designated corresponding author. One hundred and fifty (60%) studies didn’t have any female representation in any lead author (corresponding or first author) position. Fifty-eight (23.2%) studies didn’t have any female authors at all, whereas in contrast there were only eight studies (3.2%) which did not have any male authors.   Conclusion Authors from high-income countries continue to be the largest contributors to Cochrane systematic reviews in General Surgery, source of one of the highest quality evidence. There is extremely poor representation of female authors and authors from low and low-middle-income countries. Active capacity-building efforts are needed in several countries for advancing authorship diversity

Conventional and variant origin of the transverse cervical artery in a select kenyan population

Data from previous studies have highlighted on the use of transverse cervical artery (TCA) flaps as posterior neck musculocutaneous flaps in  reconstructive surgeries. General preference of flap selection relies heavily on the neurovascular supply of the flap in question and even though known, the transverse cervical artery has been shown to vary among populations, therefore affecting its use as a potential flap. Additionally, variant points of origin of the trans-cervical artery have been shown to predispose to brachial plexus compression. Our data on the same, however, remains partly elucidated and therefore a study aimed at describing the conventional and variant origin of the TCA in a Kenyan population would aid in deciding on its use as musculocutaneous flaps and determining the possible prevalence of brachial plexus compression because of its variant origin. The origin of the transverse cervical artery was studied bilaterally in 26 adult Kenyan cadavers in the Department of Human Anatomy, University of Nairobi. As regards their origin, the different types were photographed and grouped into five: Types I to V relative to its origin. The data collected was then analysed using SPSS version 21 and findings presented as percentages. The findings were presented in a bar graph and pie chart. The TCA was present in all the 26 cadavers studied. Type I origin of the TCA was the most common (71.15%) while type V was the least (1.92%). While type I origin occurred mostly on the left limbs, the other types were more prevalent on the right side. The significant variant origin of the TCA and its resultant aberrant course should be important considerations during the planning of posterior neck musculocutaneous flaps as well as in understanding brachial plexus compression associated with its variant origin. Key Words: Anatomy, Transverse cervical artery

Stereological Estimation and Zonal Distribution of the Hepatotoxic Effects of Doxorubicin on the Female Albino Rat (Rattus Norvegicus)

Background: Doxorubicin is an anti-neoplastic agent widely indicated for a variety of cancers. One of its adverse effects is hepatotoxicity which presents with hepatocyte necrosis, sinusoidal dilation, and fibrosis. However, there remains a dearth in the quantification and zonal distribution of this damage. Methods: Twenty-three adult female Wister albino rats were placed into baseline, control, and experimental group receiving 2.5mg/kg bodyweight Doxorubicin intra-peritoneally thrice weekly for 3-weeks. Rats were sacrificed on days 0, 7, 14 and 21 and livers harvested for processing. Masson’s Trichrome was used in staining 7 µm thick sections. Images were taken and analyzed via STEPanizer, and data entered into SPSS for analysis. Results: Rats treated with Doxorubicin had increased liver to body weight ratios from 5.00% at baseline to 6.15%, 6.69% and 7.56% on days 7, 14 and 21 (p=0.090). There was a decrease in hepatocyte densities from 51.88/mm2 to 48.61/mm2, 46.65/mm2 and 42.24/mm2 on day 7, 14 and 21 (p=0.779). Collagen fiber deposition increased from 0.12±0.06 cm3 to 0.47±0.55 cm3, 1.64±0.11 cm3 and 1.88±0.24 cm3 on days 7, 14 and 21 (p=0.009). Deposition was greatest periportally and least pericentrally. Volume of sinusoidal spaces increased from 5.46±0.50 cm3 to 5.49±0.15 cm3, 5.53±0.24 cm3 and 5.50±0.17 cm3 on days 7, 14 and 21 respectively (p=0.827).  Sinusoids were larger pericentrally than periportally. Conclusion: Doxorubicin administration is associated with an increase in volume density of fibrotic tissue and sinusoidal spaces but decrease in hepatocytes. The quantitative changes presented may facilitate histopathological grading of Doxorubicin-induced hepatotoxicity

The IJMS World Conference of Medical Student Research and an Overview of the IJMS Volume 10 Issue 2

We introduce the first IJMS World Conference of Medical Student Research as a unique opportunity for medical students and early-career scientists around the globe to share the results of their research in an online worldwide platform, aimed at increasing accessibility to research for medical students and creating bonds of collaborations between participants and future scientists and leaders of medical research education. This is also the second issue of the 10-year anniversary of the Journal, and we describe in summary the published research and experiences of this issue.&nbsp

Gender analysis on drivers of cigarette consumption in Kenya: two-part model approach

Background Objectively, this study conducted a gender demographic and psychosocial analysis on drivers of cigarette consumption in Kenya. Methods The study heavily relied on data from Kenya Global Adult Tobacco Survey 2014. The data was analyzed using the probit regression and OLS technique to determine the relationship between the predictor and response variables. The results were tested against the stated hypothesis at 1% and 5% level of significance. Results The study revealed that smoking policy at indoor workplaces had a significant ( ρ< 0.050) and reducing ( β=-0.3723) effect on the male smoking participation as compared to female smoking participation. However, opinion about increase in cigarette tax had a significant effect on the probability of both male (ρ=0.000) and female (ρ=0.000) smoking participation. The average consumption weighted price per pack, negatively (β=-0.2046) and significantly (ρ< 0.050) affected the probability of female smoking participation while it positively (β=0.1248) and significantly (ρ< 0.010) affected the male smoking intensity. The study found that drivers such as age (β=0.2360, ρ< 0.050) , years spent in education (β=0.0527, ρ< 0.050) , presence and number of children (β=-0.4543, ρ< 0.010) and household size (β=0.3284, ρ< 0.050) had significant influence on the general (male and female) smoking intensity. Male's opinion on cigarette tax adjustment had a significant ( ρ< 0.050) and reducing (β=-0.2973 ) effect on their smoking intensity. Conclusions Thus, strengthening the adherence of smoking policy not only in indoor workplaces but also in open spaces and public utilities will help to reduce both smoking participation and smoking intensity among males and females. Cigarette tax adjustments have been proven to be the most effective way of reducing tobacco use among males and females. This is mainly achieved through price increase of cigarettes and thus resulting in reduction in Tobacco use among men and women

Cranial neurolymphomatosis and its oncologic counterparts: Case series on malignant cranial nerve neuropathies

Neurolymphomatosis occurs due to the infiltration of a nerve by malignant cells. Cranial neurolymphomatosis is a rare disease process associated with non-solid tumors (i.e., lymphoma, leukemia, etc.). Cranial neurolymphomatosis presents with single or multifocal neuropathy. Primary cranial neurolymphomatosis is defined as the initial presenting symptom leading to a new diagnosis of cancer. Secondary cranial neurolymphomatosis is defined as cancer progression with spread to a cranial nerve. While cranial neurolymphomatosis is a recognized cause of cranial nerve neuropathies, a myriad of other malignancies can also lead to similar clinical manifestations. This case series elucidates not only the classical presentations associated with cranial neurolymphomatosis but also introduces other oncologic entities that may compromise cranial nerve functions. A descriptive case series is presented on six patients with malignancy-related cranial neuropathy who came to a tertiary-care center from 2018 to 2022. 5/6 (83.3%) of patients presented with primary cranial neuropathy. Diffuse large B-cell lymphoma was the most prevalent malignancy observed in 3/6 (50.0%) cases. Other malignancies observed include non-Hodgkin lymphoma, monoclonal B-cell lymphocytosis, and peripheral T-cell lymphoma. The most affected cranial nerve was the trigeminal nerve in 4/6 (66.6%) individuals. Multiple cranial neuropathies were seen in 2/6 (33.3%) of patients. The most common neuroradiographic finding was a lesion to Meckel’s cave. Other cranial nerves affected include the optic, facial, and vestibulocochlear nerves. Diagnostic modalities utilized included magnetic resonance imaging and 18 F-fluoro-2-D-glucose positron emission tomography-computerized tomography. Cerebrospinal fluid analysis for flow cytometry may also have diagnostic value in patients with increased disease burden. Treatment was guided according to individual malignancy and 2/6 (33.3%) patients achieved complete remission, 2/6 (33.3%) died within 1 year, and 1/6 (16.6%) were referred to hospice. Cranial neuropathy may be the first symptom of a neoplastic process; thus, prompt recognition and treatment may improve morbidity and mortality

Marginal effects of determinants of smoking participation among young adults in Kenya: A by gender logistic regression analysis

Smoking causes a huge health and economic burden to society; this effect is even more pronounced for a developing country like Kenya. Despite the fact that tobacco use is preventable, the number of tobacco related deaths in Kenya is still a health challenge. Every year, more than 6,000 Kenyans die of tobacco induced diseases, while approximately 220,000 children and almost 2.7 million adults continue to smoke each day. Objectively, this study focused on the analysis of marginal effects of determinants of smoking participation among young adults in Kenya. It employed data from Kenya GATS 2014. Specifically, Logistic regression analysis was done on both young male and female adults smoking participation. The study revealed cigarette prices had a marginally and reducing significant effect on the likelihood of young male (β= -0.00383, ρ<0.001) and female (β= -0.00003, ρ<0.050) adults participation in smoking while tax on cigarette, evidently, had a significant (ρ<0.001) and reducing marginal (β= -0.1198) effect on the young male decision to smoke as compared to young female decision to smoke. Education also had a significant and decreasing marginal influence on the tendency of young male (β= -0.03986, ρ<0.001) and female (β= -0.00003, ρ<0.050) adults decision to smoke. Employed young adults showed to have a declining and significant (ρ<0.000) marginal effect on their smoking participation. Therefore, price and tax on cigarette are very effective measures in reducing smoking participation among young male and female adults in Kenya. Funding This research was funded by the Center for Tobacco Control In Africa in collaboration with International Development and Research Center as Tobacco Control Project Grant