ABSTRACT
Dementia is a syndrome of cognitive impairment that affects an individual's ability to live independently. The number of people living with dementia worldwide in 2015 was estimated at 47.47 million. The American Academy of Neurology (AAN) criteria for human immunodeficiency virus (HIV)-associated dementia (HAD) require an acquired abnormality in at least two cognitive (non-motor) domains and either an abnormality in motor function or specified neuropsychiatric/psychosocial domains. HIV is the most common cause of dementia below 60 years of age. Citation frequencies are commonly used to assess the scholarly impact of any scientific publication in bibliometric analyses. It helps depict areas of higher interest in terms of research frequency and trends of citations in the published literature and identify under-explored domains of any field, providing useful insight and guidance for future research avenues. We used the database "Web of Science" (WOS) to search for the top 100 cited articles on HIV-associated dementia. The keywords "HIV dementia" and "HIV-associated neurocognitive disorders" (HAND) were used. The list was generated by two authors after excluding articles not pertaining to HIV dementia. The articles were then assigned to authors to extract data to make tables and graphical representations. Finally, the manuscript was organized and written describing the findings of the bibliometric study. These 100 most cited articles on HIV dementia were published between years 1986 and 2016. The highest number of the articles was from 1999 (n=9). The year 1993-2007 contributed consistently two publications to the list. The articles are from 42 journals, and among them, the Annals of Neurology (n=16) and the Journal of Neurology (n=15) published most of the articles. Justin C. McArthur with 25 publications contributed the highest number of papers to the list by any author. The USA collaborated in the highest number of publications (n=87). American institutes were leading the list with the most publications. The Johns Hopkins University collaborated on 37 papers. The most widely studied aspect of HIV dementia was pathogenesis. Incidence and prevalence, clinical features, and pre- and post-highly active antiretroviral therapy (HAART) era were also discussed in the articles. Beyond America, the research should be expanded to low-income countries and those affected more by HIV. Therefore, other countries and their institutes should participate more in HIV-associated dementia research. Anticipating the rising resistance to existing antiretrovirals, we should develop new therapeutic options. There is room for research in many aspects of HIV dementia care.
ABSTRACT
Introduction Urethroplasty is the gold standard treatment for urethral stricture disease resulting from pelvic fractures, urethral manipulation, and straddle injuries. Post-operative morbidity depends on the presence of urethral catheterization with or without a suprapubic catheter (SPC). Urethral healing at the anastomotic site can be easily assessed using retrograde pericatheter urethrography (RPU). Post-operative removal of the catheter is traditionally performed on the 21st day following urethroplasty. However, some controversy still exists regarding the best feasible time of proper urethral healing and its assessment utilizing simple techniques. The duration of anastomotic healing differs depending on the type of procedure performed, but whether there is any significant difference in duration of healing at the anastomotic site according to the etiology of short-segment stricture urethra is still a dilemma. Materials and methods This was a descriptive case-series conducted for a duration of six months from September 2019 to February 2020 at the urology department of a tertiary care hospital in Karachi, Pakistan. A sample population of 135 patients aged 20-50 years with posterior urethral stricture who underwent posterior urethroplasty with disease duration of >12 months was included in the study. All patients were put on the next operation theater (OT) list for urethroplasty. After surgery, the patients were catheterized and were kept in the ward under observation for 48 hours and discharged on the 2nd post-operative day. All patients were followed weekly and RPU was performed on the 21st day following urethroplasty to assess the presence of extravasation and the collected data was entered into the proforma by the investigators. All statistical analysis was performed using Statistical Package for Social Sciences (SPSS) version 23.0. Results The mean age of our participants was 32.8±6.02 years. The mean duration of the procedure was 26.3±7.14 months. Extravasation cases were observed in less than one-fifth (n=22 out of 135, 16.3%) of the posterior urethral stricture patients in our study. Conclusions It is to be concluded that extravasation is fairly common in patients who undergo posterior urethroplasty. The prevalence varies depending on the assessment method, likely reflecting the treatment of somatic symptoms.
