Miracle-dz/UniFAR-FTUs huggingface dataset:
Prevalence of gestational diabetes mellitus in rural Haryana: A community-based study

Background and Objectives: Gestational diabetes mellitus (GDM) is a global health concern as it affects health status of both mother and fetus. In India, prevalence of GDM varies in different populations and no data is available from rural Haryana. This study was undertaken to determine the prevalence of GDM and risk factors associated with it in rural women of Haryana. Materials and Methods: Nine hundred and thirteen women, with estimated gestational age above 24 weeks from a rural block of Haryana who consented to participate were given a standardized 2-h 75-g oral glucose tolerance test (OGTT). Pro forma containing general information on demographic characteristics, educational level, gravida, family history of diabetes, and past history of GDM was filled-up. A World Health Organization (WHO) criterion for 2-h 75-g OGTT was used for diagnosing GDM. Results: GDM was diagnosed in 127/913 (13.9%) women with higher mean age as compared to non-GDM women. Majority (78.4%) of the women were housewives, rest engaged in agriculture (9.2%) and labor (5.5%). Women with gravida ≥3 and positive family history of diabetes had significantly higher prevalence of GDM. History of macrosomia (birth weight ≥4 kg) was significantly associated with prevalence of GDM (P = 0.002). On multiple logistic regression analysis, risk factors found to be significantly associated with GDM were maternal age >25 years, gravida >3, history of macrosomic baby, and family history of diabetes. Conclusion: The prevalence of GDM has been found quite high in rural Haryana. Appropriate interventions are required for control and risk factor modifications.
Latino Caregivers of Relatives with Alzheimer's Disease

Abstract This review of the literature discusses the experience of Latinos who provide care to a family member with Alzheimer's Disease and Related Disorders (ADRD). This discussion is imperative in light of the present demographic changes and in light of current findings suggesting that the risk for dementia is significantly higher for Hispanic elderly. All studies reviewed reported that the ADRD Latino caregiver is most likely to be a female caring for her parents or her parents-in-law. Despite the relatively low availability of informal support and the high levels of depression among ADRD Latino caregivers, most studies reported that ADRD Latino caregivers underutilize formal services. The major implications of the present review are that a heterogeneous perspective of the Latino community should be adopted by taking into consideration within group differences. In addition, systematic study of outreach and therapeutic interventions aimed specifically towards ADRD Latino caregivers is recommended.
Increased expression of collagen receptors: α1β1 and α2β1 integrins on blood eosinophils in bronchial asthma

Background Eosinophils are one of the major effector cells in bronchial asthma. Their infiltration of airways correlates with the asthma severity. Recruitment and activation of eosinophils are partially mediated by integrins α4β1 and α4β7. Collagens type I and IV constitute important components of extracellular matrix and vascular basement membrane, respectively. Therefore, collagen‐binding integrins (α1β1 and α2β1) may also play a role in eosinophil lung infiltration.
Estimation of magnesium in patients with functional hypoparathyroidism

Context: It is evident that about 30-50% of patients with Vitamin D deficiency (VDD) do not manifest develop secondary hyperparathyroidism (SHPT). A number of theories have been proposed to explain this lack of SHPT, including hypomagnesemia. Settings and Design: Retrospective review of laboratory database. Materials and Methods: We evaluated the differences in serum magnesium (Mg) levels among those with VDD with or without SHPT. A retrospective review of 6255 laboratory data of bone mineral profiles performed in the period of 2007–2013. After excluding patients with hypercalcemia, renal dysfunction/unknown kidney function and primary hypothyroidism, the remaining 1323 patient data were analyzed. SHPT was defined as serum parathyroid hormone >65 in those with VDD. Statistical Analysis Used: ANOVA and Wilcoxon tests as appropriate to compare means. Multivariate logistic regression to analyze relation between variables and outcome of SHPT. Results: We noted that 55% patients (n = 727) had VDD, and among those who had VDD, 23% (n = 170) were hypocalcemic (corrected serum calcium <8.5). Patients with VDD who did not exhibit SHPT were 56% (n = 407). The mean (±standard deviation) serum Mg levels in the entire cohort (n = 1323) was 1.94 ± 0.26 mg/dl and 1.95 ± 0.26 mg/dl in VDD cohort and 2 ± 0.31 mg/dl in the VDD-hypocalcemic cohort. There was no statistical difference in the Mg levels among those with SHPT compared to those without SHPT (P = 0.14). Serum calcium and phosphorus were lower in those with SHPT (P = 0.06 and P < 0.001, respectively). In multivariate logistic regression, serum calcium (P = 0.043), phosphorus (P < 0.001) and severe VDD (P < 0.001) independently correlated with occurrence of SHPT in VDD. Conclusions: Serum Mg levels did not explain the functional hypoparathyroidism seen in about half of the patients with VDD. A low normal serum calcium and phosphorus levels are more likely to be associated with VDD patients who develop SHPT.
Novel drug discovery strategies for gout

Introduction: The increasing prevalence of gout has been accompanied by a growing number of patients intolerant to or with disease refractory to available urate-lowering therapies. These difficult-to-treat patients currently represent about 3 – 5% of people with gout in Europe and the United States, which highlights the need for emerging treatments to effectively lower urate levels. Areas covered: In this review, the authors describe the putative pharmacological targets to lower urate levels. Furthermore, the authors discuss various strategies used to discover novel molecules or to improve available drugs used to treat gout. Expert opinion: Major advances in our understanding of urate renal transport from in vitro, animal and genetic studies could lead to the development of novel uricosuric drugs. Targeting one or several urate transporters such as urate transporter 1, organic anion transporter 4 and 10 and glucose transporter 9 is promising. Moreover, design of small molecules capable of blocking the site activity of enzymes other than xanthine oxidase and involved in the purine pathway could generate novel hypouricemic drugs. Finally, polyethylene glycol (PEGylation) can significantly extend the biological half-life of drugs and reduce antigenicity and immunogenicity of proteins. The technology has been successfully applied to an uricase (pegloticase), but the drug was immunogenic in some patients. Strategies to decrease the immunogenicity of a PEG–uricase are important for developing next-generation uricase.
Glucagon-like peptide 1 and dysglycemia: Conflict in incretin science

Although GLP-1 (glucagon like peptide-1) based therapies (GLP-1 agonists and dipeptidyl peptidase-4 inhibitors) is currently playing a cornerstone role in the treatment of type 2 diabetes, dilemma does exist about some of its basic physiology. So far, we know that GLP-1 is secreted by the direct actions of luminal contents on the L cells in distal jejunum and proximal ileum. However, there is growing evidence now, which suggest that other mechanism via “neural” or “upper gut” signals may be playing a second fiddle and could stimulate GLP-1 secretion even before the luminal contents have reached into the proximities of L cells. Therefore, the contribution of direct and indirect mechanism to GLP-1 secretion remains elusive. Furthermore, no clear consensus exists about the pattern of GLP-1 secretion, although many believe it is monophasic. One of the most exciting issues in incretin science is GLP-1 level and GLP-1 responsiveness. It is not exactly known as to what happens to endogenous GLP-1 with progressive worsening of dysglycemia from normal glucose tolerance to impaired glucose to frank diabetes and furthermore with increasing duration of diabetes. Although, conventional wisdom suggests that there may be a decrease in endogenous GLP-1 level with the worsening of dysglycemia, literature showed discordant results. Furthermore, there is emerging evidence to suggest that GLP-1 response can vary with ethnicity. This mini review is an attempt to put a brief perspective on all these issues.
Metformin in gestational diabetes: An emerging contender

Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance occurring first time during pregnancy. Its prevalence is simultaneously increasing with the global rise of diabesity. GDM commonly develops, when maternal glucose metabolism is unable to compensate for the progressive development of insulin resistance, arising primarily from the consistently rising diabetogenic placental hormones. It classically develops during the second or third trimester. Theoretically, insulin sensitizers should have been the ideal agent in its treatment, given the insulin resistance, the major culprit in its pathogenesis. Fortunately, majority of women can be treated satisfactorily with lifestyle modification, and approximately 20% requires more intensive treatment. For several decades, insulin has been the most reliable treatment strategy and the gold standard in GDM. Metformin is effective insulin sensitizing agent and an established first line drug in type 2 diabetes currently. As it crosses the placenta, a safety issue remains an obstacle and, therefore, metformin is currently not recommended in the treatment of GDM. Nevertheless, given the emerging clinically equivalent safety and efficacy data of metformin compared to insulin, it appears that it may perhaps open a rather new door in managing GDM. The aim of this review is to critically analyze, the safety and efficacy data of metformin regarding its use in GDM and pregnant mothers with polycystic ovarian disease, which has emerged in past decades.
Helicobacter pylori infection prevalence: Is it different in diabetics and nondiabetics?

Background: Helicobacter pylori (HP) infection plays a significant role in the development of gastrointestinal complications and has a significant role in systemic inflammation. It has some extragastrointestinal manifestations like endocrine diseases. In this study, we aimed to compare the prevalence of HP infection in diabetic and nondiabetic individuals. Materials and Methods: In this cross-sectional study, 218 nondiabetic and 211 diabetic patients referring to Shahid Beheshti Hospital of Qom between March 2013 and 2014 were studied. The patients were divided into two HP+ and HP− groups based on serological immunoglobulin G antibody against HP and the association between diabetes, and HP infection was evaluated. Data were analyzed using independent t-tests, Chi-square, Fisher's exact and Mann–Whitney tests. Results: The prevalence of HP seropositive was 65.9% versus 50.5% in diabetic and nondiabetics, respectively, and the difference was statistically significant (P = 0.001). Conclusions: This study showed a higher prevalence of HP infection in diabetic patients.
Social-psychological and physical environmental factors in groups differing by levels of physical activity: A study of Scottish adolescent girls

Few studies have addressed factors influencing Scottish adolescent girls’ participation in physical activity (PA). Participants (N = 352) aged 11 to 16 years completed surveys measuring PA participation and potential social-psychological and physical-environmental correlates. Data were analyzed separately by two age groups (11-13 and 14-16 years). For younger girls, mother’s participation, perceived importance, and home equipment use were higher among those higher in PA. For older girls, perceived importance, home equipment use, neighborhood perceptions, and use and enjoyment of local facilities were higher among girls higher in PA. It seems that older girls place less importance on significant others and move toward autonomy away from the home.
Selective preservation of anterior pituitary functions in patients with Sheehan's syndrome

Background: Sheehan's syndrome manifests as hypopituitarism following a child birth usually preceded by postpartum hemorrhage. The symptoms range from vague feelings of ill health to symptoms of a full blown panhypopituitarism. A large series of such patients is not described in the literature. Materials and Methods: We present the details of ten women with partial Sheehan's syndrome. They presented with post-partum hemorrhage and lactation failure. Results: After delivery, seven out of ten patients had regular menstrual cycles indicating preservation of gonadotroph function. Lactotroph, thyrotroph, and somatotroph failure were present in all and corticotrophs preservation was documented in four out of ten patients. The hypophysial magnetic resonance imaging (MRI) confirmed empty sella in all. Conclusion: lactotroph, somatotroph and thyrotroph failure are common in patients with Sheehan's syndrome. In addition to known preservation of gonadotroph axis, corticotroph axis may be preserved in some of these patients arguing against the universal treatment of these patients with glucocorticoids.
Methyl-aminolevulinate photodynamic therapy for the treatment of erythroplasia of Queyrat in 23 patients

Abstract Erythroplasia of Queyrat (EQ) is an intraepithelial squamous cell carcinoma localized on the mucosal or transitional surfaces. Standard therapy usually consists of the surgical removal of the cancer. The use of non-invasive alternative procedures, such as photodynamic therapy (PDT), has been considered for the treatment of EQ, although only a few reports regarding isolated cases or small series exist. We describe our cumulative experience with PDT, using topical methyl-aminolevulinate (MAL), for the management of 23 male patients with EQ of the glans penis and/or prepuce. Patients underwent two consecutive weekly MAL-PDT sessions, with the second session postponed in seven patients because of an excessive local reaction. Nineteen patients obtained a complete clinical remission without any sign of recurrence over an average post-treatment period of 18 months (range, 8–30 months). Cosmetic outcome was excellent in most patients, while dyschromic changes occurred in four cases. All patients experienced transient local adverse reactions and 22 of them reported severe or very severe symptoms during the session.
Is there really a link between diabetes and the ingestion of fructose

Fructose naturally occurs in fruits, so this carbohydrate is an inevitable constituent of a healthy, balanced diet. Compared with glucose, the monosaccharide fructose leads to a lower rise in blood sugar concentration after it is consumed and has minimal dependence on insulin for its metabolism. Hence, until recently, many researchers have perceived fructose to be a healthier alternative to other carbohydrates that contain glucose; these include the complex carbohydrate starch and the simple sugar sucrose, which contains an equal amount of glucose and fructose. By contrast, worry now exists among some researchers that fructose and fructose containing sugars, such as sucrose and high-fructose corn syrup (HFCS), are a major cause of fat accumulation in the liver (i.e. intrahepatocellular lipid). It is claimed that the accumulation of fat in the liver occurs more when ingesting sources of fructose than when ingesting sources of glucose, and so leads to greater hepatic insulin resistance and ultimately to type 2 diabetes (Stanhope & Havel 2008; Stanhope et al. 2009; Lim et al. 2010; Lustig 2010, 2013).
Focus group discussion with private sector doctors in the eThekwini Metro of KwaZulu-Natal on the management of HIV/AIDS patients

Abstract Background: Highly active antiretroviral treatment (HAART) is essential in the treatment of HIV/AIDS; however, a holistic approach to HIV/AIDS management is important. This study was done to confirm the findings of two studies done previously in the eThekwini Metro of KwaZulu-Natal on private sector doctors' management of HIV-infected patients and to obtain more in-depth information about their nonpharmacological management of HIV-infected patients. Methods: Two focus group discussions were conducted amongst private sector doctors in the eThekwini Metro, after obtaining their consent. The focus group sessions were scripted, audio-taped and transcribed verbatim. Prevalent themes were identified and reported. Results: Eight doctors participated. Of the total patient population seen annually by the majority of the doctors, an average of 43.8% was HIV infected. Doctors in this study managed their patients both pharmacologically and nonpharmacologically. Seventy-five per cent of doctors indicated that the taste of medicine played an important role in nonadherence to treatment, but all agreed that cultural beliefs also influenced the patient's adherence to medication. Theft of medicines and the out- of-stock situation prevented antiretroviral drug access, which impacted negatively on adherence. Five doctors mentioned that depressed patients abused alcohol, resulting in nonadherence. One doctor reported that he used the biopsychosocial approach to improve adherence in his patients. Doctors indicated that the disability grant given by the South African Government caused patients not to adhere to treatment in order to maintain a CD4 count of 200 or less so as to qualify for the grant. Conclusions: The study confirmed the previous study findings in that it showed that private sector doctors manage their HIV-infected patients both pharmacologically and nonpharmacologically. It further provided new and interesting information with regard to the nonpharmacological methods employed in HIV/AIDS management, that is the incorporation of cultural beliefs in the management of HIV-infected patients to improve adherence to treatment, and the role of the disability grant and pharmaceutical formulations in contributing to nonadherence by HIV-infected patients.
What do patients do before it starts? Coping with mental health problems on a CBT waiting list

Abstract Data from a patient survey on self-help and coping strategies during waiting time for CBT are reported. Individuals on an outpatient treatment centre waiting list received a short questionnaire assessing problem-related activities carried out in the interval before therapy (mean waiting time 69 days). A total of 306 patients with a wide range of reliably diagnosed mental disorders were assessed. Results showed that the vast majority of patients (~95%) instigated at least one form of coping or self-help activity related to their mental problem. Resource-orientated strategies were most often reported (88%), but ‘seeking information about the problem’ was also highly prevalent. About one third of persons reported additional health-care utilization. Higher rates of symptom distress and depression were associated with additional health-care utilization and with more passive coping strategies such as distraction. Active self-help strategies contributed to poorer depression outcome and were, thus, no indicator of good prognosis. Other coping strategies were not linked to outcome variables. It can be concluded that problem-related processes do start before treatment. A more systematic integration of self-help activities into the case-formulation and more systematic research on the related (motivational) processes are recommended.
Novel targeted therapies for the treatment of penile cancer

Introduction: The treatment of penile cancer has changed over the past decade in that it was primarily a surgically managed disease and those with locally advanced or metastatic disease uniformly had a very poor prognosis. However, with the use of better traditional systemic chemotherapeutic agents in the neoadjuvant and adjuvant settings, the disease-specific survival and general outlook has improved. However, there is still a large group of patients who will progress even while on systemic therapy. It is in those patients where the application of targeted therapies has been investigated with some experiencing partial or even complete responses. With the improvement seen in patients with chemotherapy refractory disease, the application of novel targeted agents in the neoadjuvant setting may have a resultant positive impact on patient survival. Areas covered: This review includes research pertaining to targeted therapies, biomarkers and signaling pathways involved with penile cancer. The article was based on a literature search using the keywords ‘penile cancer’ and ‘targeted therapies’. Expert opinion: Penile cancer at the advanced stages of the disease has a high mortality. The utilization of novel targeted therapies in these situations is warranted in combination with, or sequentially with, traditional cytotoxic chemotherapy to improve the patient survival rate. Personalized therapy is nearly here for penile cancer and should be made real within the next decade.
Etanercept provides an effective, safe and flexible short- and long-term treatment regimen for moderate-to-severe psoriasis: a systematic review of current evidence

The treatment of psoriasis requires long-lasting intervention. Conventional treatments for psoriasis comprise topical, phototherapeutic and systemic modalities, such as methotrexate or cyclosporine. Biological therapies are advocated by treatment guidelines for the use in moderate-to-severe psoriasis, when conventional treatments have failed, are contraindicated or are associated with severe adverse events. Etanercept is an anti-TNF recombinant fusion protein that has emerged as a standard biologic treatment option for moderate-to-severe psoriasis. The present review summarizes data from pivotal and post-marketing randomized controlled etanercept trials to treat moderate-to-severe psoriasis for 24 weeks and longer. During the first 12 weeks, etanercept can be administered in different dosing regimens: 50 mg twice weekly (BIW) and 50 mg once weekly. Although both regimens are effective, it has been shown that the 50 mg BIW dosage leads to higher response rates at week 24. In addition, after 24 weeks' treatment etanercept provides the unique possibility of continuous or intermittent long-term treatment programmes. The medium- to long-term efficacy of etanercept was consistent, regardless of whether etanercept therapy was interrupted or continuous. Taking the chronic nature of psoriasis into account, this flexibility in dosing regimen bestows a key advantage in facilitating individualisation of long-term treatment according to patient needs.
Temperature Dependence of the Activation Volume of Secondary Relaxation in Glass Formers

We study a nonmonotonic behavior with temperature of the activation volume ΔV𝛽 of secondary relaxation in PPGE [Poly[(phenyl glycidyl ether)-co-formaldehyde]] and PVAc [Poly(vinyl acetate)] glass formers. Our results show that the non-monotonic behaviour of secondary relaxation does not depend on the type of the secondary relaxation. Moreover, the study of secondary relaxation under pressure at isothermal paths shows two different behaviours of ΔV𝛽 in the glassy state (which describe two different types of glasses); for temperatures higher than the glass transition temperature (Tg), ΔV𝛽 increases with a decrease of the temperature while at temperatures lower than Tg, ΔV𝛽 decreases with a decrease of the temperature.