bluuebunny/crossref_metadata_2025 huggingface dataset:
Objects May Be Closer than They Appear: Significant Host Galaxy Dispersion Measures of Fast Radio Bursts in Zoom-in Simulations
Authors: Orr Matthew E. , Burkhart Blakesley , Lu Wenbin , Ponnada Sam B. , Hummels Cameron B.
Published: September 2024

We investigate the contribution of host galaxies to the overall dispersion measures (DMs) for fast radio bursts (FRBs) using the Feedback in Realistic Environments (FIRE-2) cosmological zoom-in simulation suite. We calculate DMs from every star particle in the simulated L* galaxies by ray-tracing through their multiphase interstellar medium, summing the line-of-sight free thermal electron column for all gas elements within ±20 kpc of the galactic midplane. At z = 0, we find average (median) host-galaxy DMs of 74 (43) and 210 (94) pc cm−3 for older (≳10 Myr) and younger (≲10 Myr) stellar populations, respectively. Inclination raises the median DM measured for older populations (≳10 Myr) in the simulations by a factor of ∼2 but generally does not affect the younger stars deeply embedded in H ii regions except in extreme edge-on cases (inclination ≳85°). In kinematically disturbed snapshots (z = 1 in FIRE), the average (median) host-galaxy DMs are higher: 80 (107) and 266 (795) pc cm−3 for older (≳10 Myr) and younger (≲10 Myr) stellar populations, respectively. FIRE galaxies tend to have higher DM values than cosmological simulations such as IllustrisTNG, with larger tails in their distributions to high DMs. As a result, FRB host galaxies may be closer (lower redshift) than previously inferred. Furthermore, constraining host-galaxy DM distributions may help significantly constrain FRB progenitor models.
Long-term treatment of metastatic adenoid cystic carcinoma with sequential brachytherapy and stereotactic body radiotherapy
Authors: Zhong Allison Y. , Kim Sangwoo S. , Hopper Austin , White Greg , Miyauchi Sayuri , Jones Riley N. , Scanderbeg Dan , Mell Loren K. , Weihe Elizabeth , Boutros Nathalie , Doggett Stephen W. , Sharabi Andrew B.
Published: September 2024

Adenoid cystic carcinoma is a malignancy that is difficult to treat and often metastasizes to the lung. Systemic chemotherapies are not effective for this tumor type, thus local therapies are frequently used. Here, we report a case demonstrating the use of extensive ablative interventions in controlling the progression of metastatic adenoid cystic carcinoma. A patient with adenoid cystic carcinoma developed numerous metastases to his lungs and liver. Local ablative therapies including interstitial brachytherapy and SBRT were used to treat approximately 80 different metastases over the course of a decade. Over 850 brachytherapy seeds were implanted in this patient, and the tumor control and patient outcome were good. As of the most recent follow-up in March 2024, the patient has survived for approximately 12 years since his diagnosis of adenoid cystic carcinoma. To our knowledge, this case represents the most brachytherapy treatments reported in a single patient. It highlights the utility of interstitial brachytherapy and SBRT in treating extensive lung and liver metastases.
Could Madelung disease be a cause of stroke? A rare case report
Authors: Tosunoğlu Bünyamin , Altıkardeş Melih , Arık Elif Pınar , Kaya Nilay , İnan Levent Ertuğrul
Published: September 2024

Multiple symmetric lipomatosis (MLS), also known as Launois-Bensaude syndrome or Madelung disease, is a rare metabolic condition characterized by generally symmetrical, non-encapsulated fat accumulations in the patient’s body.

Is there a link between neurological disorders and multiple symmetric lipomatosis, as we demonstrate with our 75-year-old male patient who had an ischemic stroke and was also diagnosed with MLS? Our goal here is to provide an answer to this question.
Two new species of Metacampanella (Agaricales, Marasmiaceae) from China and Mongolia
Authors: Hou Wei-nan , Ganbaatar Burenbaatar , Bau Tolgor
Published: September 2024

Metacampanella is an important genus in the Marasmiaceae family. We collected specimens during our investigations in China and Mongolia. Through morphological and molecular phylogenetic analyses, we identified two new species of this genus: Metacampanella subtricolor and Metacampanella coprophila. In addition, we identified Metacampanella tricolor as a novel combination. Molecular systematic studies support these results. Illustrated descriptions, taxonomic discussions, and keys to the genus are provided.
Hearing Evaluations in Children With Retinoblastoma Treated With Intra-arterial Carboplatin Chemotherapy: A Single Institution Review
Authors: Davis Mary Elizabeth , Guarini Edith , O'Connor Kerri , Francis Jasmine H. , Abramson David H.
Published: September 2024

Purpose

To determine whether the administration of intra-arterial carboplatin affected the hearing of children with retinoblastoma.

Methods

Children with retinoblastoma who were treated with intra-arterial carboplatin chemotherapy were included. Hearing tests before chemotherapy including tympanometry, distortion product otoacoustic emissions, and audiogram (if achievable) were performed and repeated 3 to 9 months after concluding intra-arterial therapy. The study was approved by the institutional review board. Patients were identified from the retinoblastoma clinic when the treatment plan included intra-arterial carboplatin chemotherapy. Children were excluded if they had previous intra-arterial carboplatin or preexisting hearing loss but were included if they had systemic carboplatin and dosing was available. Tympanometry was performed to rule out inner ear fluid. All examinations were performed by a certified audiologist with the same equipment, calibrated regularly by a certified technician.

Results

Twenty-two children (32 eyes) were evaluable. Because most children are diagnosed at a young age and are unable to participate in an audiogram, distortion product otoacoustic emission measurement was the primary measurement. No child displayed hearing loss.

Conclusions

Intra-arterial chemotherapy with carboplatin did not cause ototoxicity in any child by distortion product otoacoustic emission measurement in contrast to systemic chemotherapy where ototoxicity is common. Distortion product otoacoustic emission levels were essentially unchanged from before to after intra-arterial chemotherapy in children with retinoblastoma. These findings suggest that intra-arterial carboplatin does not affect outer hair cell function, and distortion product otoacoustic emission tests can provide useful information when monitoring children at risk of developing carboplatin ototoxicity.

[
J Pediatr Ophthalmol Strabismus
. 2025;62(1):27–32.]
Effect of Posterior Keratometry and Corneal Radius Ratio on the Accuracy of Intraocular Lens Formulas After Myopic LASIK/PRK
Authors: Zheng Yuxing , Zhang Jiaqing , Han Xiaotong , Huang Ruoxuan , Wen Ling , Ye Jinfeng , Huang Yiguo , Qiu Xiaozhang , Chen Xiaoyun , Tan Xuhua , Luo Lixia
Published: September 2024

Purpose:

To investigate the impact of back-to-front corneal radius ratio (B/F ratio) and posterior keratometry (PK) on the accuracy of intraocular lens power calculation formulas in eyes after myopic laser in situ keratomileusis (LASIK)/photorefractive keratectomy (PRK) surgery.

Methods:

A retrospective, consecutive case series study included 101 patients (132 eyes) with cataract after myopic LASIK/PRK. Mean prediction error (PE), mean absolute PE (MAE), median absolute error (MedAE), and the percentage of eyes within ±0.25, ±0.50, and ±1.00 diopters (D) of PE were determined.

Results:

The Barrett True K-TK formula exhibited the lowest MAE (0.59 D) and MedAE (0.48 D) and the highest percentage of eyes within ±0.50 D of PE (54.55%) in total. In eyes with a B/F ratio of 0.70 or less and PK of −5.70 D or greater, the Potvin-Hill formula displayed the lowest MAE (0.46 to 0.67 D).

Conclusions:

The Barrett True-TK exhibited the highest prediction accuracy in eyes after myopic LASIK/PRK overall. However, for eyes with a low B/F ratio and flat PK, the Potvin-Hill performed best.

[
J Refract Surg
. 2024;40(9):e635–e644.]
Misclassification of Eyes With Progressive Keratoconus Using the KISA% Index
Authors: Hammoud Bassel , Dupps William J. , Scarcelli Giuliano , Randleman J. Bradley
Published: September 2024

Purpose:

To determine the misclassification rate of the keratoconus percentage (KISA%) index efficacy in eyes with progressive keratoconus.

Methods:

This was a retrospective case-control study of consecutive patients with confirmed progressive keratoconus and a contemporaneous normal control group with 1.00 diopters or greater regular astigmatism. Scheimpflug imaging (Pentacam HR) was obtained for all patients. KISA% index and inferior-superior (IS) values were obtained from the Pentacam topometric/keratoconus staging map. Receiver operating characteristic curves were generated to determine the area under the receiver operating characteristic curve (AUROC), sensitivity, and specificity values.

Results:

There were 160 eyes from 160 patients evaluated, including 80 eyes from 80 patients with progressive keratoconus and 80 eyes from 80 control patients. There were 20 eyes (25%) with progressive keratoconus misclassified by the KISA% index, with 16 eyes (20%) of the progressive keratoconus cohort classified as normal (ie, KISA% < 60). There were 4 eyes (5%) with progressive keratoconus that would classify as having “normal topography” using the published criteria for very asymmetric ectasia with normal topography of KISA% less than 60 and IS value less than 1.45. All controls had a KISA% index value of less than 15. The optimal cut-off value to distinguish cohorts was 15.31 (AUROC = 0.972, 93.75% sensitivity). KISA% index values of 60 and 100 achieved low sensitivity (80% and 73.75%, respectively).

Conclusions:

The KISA% index misclassified a significant proportion of eyes with progressive keratoconus as normal. Although highly specific for clinical keratoconus, the KISA% index lacks sensitivity, does not effectively discriminate between normal and abnormal topography, and thus should not be used in large data analysis or artificial intelligence–based modeling.

[
J Refract Surg
. 2024;40(9):e614–e624.]
Association Between Systemic Levels of Vascular Endothelial Growth Factor and Optical Coherence Tomography Biomarkers in a Non-Neovascular Age-Related Macular Degeneration Cohort
Authors: Lisker-Cervantes Andres , Gill Zafar , Patnaik Jennifer L. , Gnanaraj Ramya , Lynch Anne M. , Palestine Alan G. , Mathias Marc , Manoharan Niranjan , Mandava Naresh , de Carlo Forest Talisa E.
Published: September 2024

Background and Objective

Investigate associations between systemic vascular endothelial growth factor (VEGF) and optical coherence tomography (OCT) biomarkers in eyes with complete retinal pigment epithelium and outer retina atrophy (cRORA) secondary to non-neovascular age-related macular degeneration.

Patients and Methods

Cross-sectional study of patients with cRORA. OCT images and blood samples were collected at study enrollment. OCT images were evaluated for biomarkers. Systemic VEGF levels were measured using a standard multiplex assay.

Results

Study included 187 eyes from 96 patients. Lower levels of systemic VEGF were significantly associated with retinal pseudocysts (RPs) and sub-retinal hyper-reflective material (SHRM), a median of 7.7 pg/mL and 6.1 pg/mL for patients with the imaging biomarkers compared to those without (10.3 pg/mL [
P
= 0.004] and 9.3 pg/mL [
P
= 0.02], respectively).

Conclusion

This novel study shows that lower systemic VEGF levels were associated with SHRM and RP, which was shown to correspond to an intermediate stage of the atrophic process in age-related macular degeneration. Systemic VEGF could be a useful biomarker and therapeutic target for eyes with cRORA.

[
Ophthalmic Surg Lasers Imaging Retina
2025;56:23–29.]
Cystic lymphangiomas of the cecal cause intussusception in adults
Authors: Kha Vo-Van , Mai Anh Hoang , Thuy Duong Quach , Quang Duy Ngo , Hai Anh Nguyen Thi , Duy Hung Nguyen , Minh Duc Nguyen
Published: September 2024

Lymphangiomas are rare benign lymphatic malformations. Even though these neoplasms can arise from any location and age, most of them are dominant in the head and neck of children. On the other hand, lymphangiomas are exceedingly rare in adults, especially in the gastrointestinal tract. Gastrointestinal tract lymphangiomas account for only about 1% of lymphatic malformations. Although there have been increasing cases of gastrointestinal lymphangiomas reported in recent years, cecal lymphangiomas causing intussusception in adults are rarely mentioned. In this article, we report a 27-year-old female patient with cecal lymphangiomas detected by imaging modalities and confirmed via postoperative histopathological examination.
A novel homozygous splicing mutation in AK7 causes multiple morphological abnormalities of sperm flagella in patients from consanguineous Pakistani families
Authors: Hussain Ansar , Zhang Huan , Zubair Muhammad , Shah Wasim , Khan Khalid , Ali Imtiaz , Raza Yousaf , Zeb Aurang , Abbas Tanveer , Ahmed Nisar , Rahim Fazal , Mustafa Ghulam , Uddin Meftah , Ullah Nadeem , Abbas Musavir , Khan Muzammil Ahmad , Ma Hui , Yang Bo , Shi Qing-Hua
Published: September 2024

Multiple morphological abnormalities of the flagella (MMAF) represent a severe form of sperm defects leading to asthenozoospermia and male infertility. In this study, we identified a novel homozygous splicing mutation (c.871-4 ACA>A) in the adenylate kinase 7 (AK7) gene by whole-exome sequencing in infertile individuals. Spermatozoa from affected individuals exhibited typical MMAF characteristics, including coiled, bent, short, absent, and irregular flagella. Transmission electron microscopy analysis showed disorganized axonemal structure and abnormal mitochondrial sheets in sperm flagella. Immunofluorescence staining confirmed the absence of AK7 protein from the patients’ spermatozoa, validating the pathogenic nature of the mutation. This study provides direct evidence linking the AK7 gene to MMAF-associated asthenozoospermia in humans, expanding the mutational spectrum of AK7 and enhancing our understanding of the genetic basis of male infertility.
Evaluation of Anal Position Indexes from Anal Dimple and Neoanus at Sphincter Muscle Complex in Children with High Anorectal Malformations in Kano, Nigeria
Authors: Liman Bilyaminu Ibrahim , Mohammed Muhammad Aminu , Anyanwu Lofty-John Chukwuemeka , Abdullahi Lawal Barau , Aji Sani Ali , Aliyu Muhammad Salele , Sa’ad Bashir , Jalo Rabiu Ibrahim , Mamuda Atiku , Hassan Mujahid Muhammad , Usman Abubakar Nagoma
Published: September 2024

Background:

Anorectal malformations (ARMs) comprise a spectrum of congenital anomalies that continue to present a challenge to patients, caregivers and paediatric surgeons. The main objective of this study was to determine the anal position index (API) from anal dimple and neoanus at the sphincter muscle complex in children with high ARM.

Methods:

Using a cross-sectional study design, the API was assessed from anal dimple and neoanus at the sphincter muscle complex in children with high ARM. All eligible children with high ARM who presented to AKTH during the study period were recruited into the study.

Results:

Forty eligible patients with an age range of 8 months to 108 months were recruited. Twenty-five were males (62.5%) with a male: female ratio of 1.7:1. The mean pre-operative API using anal dimple was 0.47 ± 0.05, while that of the post-operative API using neoanus was 0.53 ± 0.04. There was a statistically significant difference between the two indices (t = −11.8, P < 0.01). There was also a statistically significant difference amongst male and female indices P < 0.05, but there were no significant differences between different age groups.

Conclusion:

This study has shown that there was a statistically significant difference between the pre-operative API and post-operative API; thus, the position of the anal dimple does not significantly predict the central position of the sphincter muscle complex.
COVID-19 pandemic impact on mental and professional cognition: A questionnaire survey on a sample of GP trainees and GPs
Authors: Zhang Haiyan , Huang Jiabao , Zhang Kouxing
Published: September 2024

ABSTRACT

Background:

Since the outbreak of 2019 coronavirus disease (COVID-19), general practitioners (GPs) have been working in the frontline under psychological and physical pressure. This study aims to evaluate the psychological health, career prospective, attitudes toward educational mode changes, and knowledge about COVID-19.

Methods:

An online anonymous questionnaire survey was carried out on GP trainees and GPs from June 2022 to September 2022. The survey mainly consisted of four parts: 1) general information; 2) level of knowledge about COVID-19; 3) psychological and physical health impact; and 4) changes in professional perception.

Results:

The total knowledge score of 43 GP trainees and 38 GPs was 334 and 283, respectively, without significant difference (z = -0.839, P = 0.402). There was no statistical difference between the scores of GP trainees and GPs for each subindicator of mental and physical disorders. Eleven GP trainees and four GPs had severe psychological disorder subindexes. Severe somatization disorder subindexes were found in eight GP trainees and five GPs. Also, 67.44% of GP trainees and 52.63% of GPs had a positive attitude toward GP career. Moreover, 62.79% of GP trainees and 52.63% of GPs considered the epidemic had no impact on their professional cognition. Among GP trainees, 62.8% and 32.6% considered the epidemic had no or slight impact on their academic activities, respectively. Also, 53.5% and 44.2% of GP trainees partially and fully approved online teaching, respectively. The most popular forms were live and recorded courses.

Conclusions:

COVID-19 pandemic had no noticeable impact on their physical and mental health and their attitude toward GP career.
Surviving the storm: Wave-wise comparison of the pandemic’s impact on mental health dynamics, sleep patterns, and preventive behaviors among coronavirus patients in Northern India
Authors: Yadav Jaivinder , Sharma Rajni , Kumar Krishan , Rana Devender , Yadav Suman , Sharma Akhilesh , Saini Lokesh , Sharma Divyansh , Saxena Aryan , Patra Pratap , Sexena Muskaan , VikasSuri
Published: September 2024

ABSTRACT

Background:

Different clinical manifestations were revealed by the distinct waves of the coronavirus. The pandemic had a multifaceted impact on mental health, sleep patterns, and associated fear.

Materials and Methods:

It was an observational online survey using by using Google Forms in the city of Chandigarh between April 2020 and April 2021 across three waves of the coronavirus outbreak (first wave from March 2020 to May 2020, second wave from June 2020 to January 2021, and third wave from February 2021 to April 2021). Fear of coronavirus disease (COVID), preventive behaviors, insomnia-related problems, and impact of the event were assessed by using standardized scales.

Results:

The participants who were infected during the first phase exhibited significantly higher levels of distress, loss of control over their reactions, increased fear of coronavirus and sleep problems, and also greater adherence to preventive behaviors compared to those who were infected during the second and third waves. A tendency to emerge post-traumatic stress disorder (PTSD) was seen in 68 (58.1%) of the participants (Peritraumatic Distress Inventory (PDI) score >14) and 34 (29.1%) of all the participants (PDI score >23). Overall, 66 (56.4%) participants reported having insomnia. About 24 people (20.5%) had clinical concerns about PTSD, 20 people (17.1%) had probable PTSD diagnoses, and 16 people (13.7%) experienced a severe coronavirus disease 2019 (COVID-19) pandemic impact on their lives.

Conclusion:

The first wave of COVID-19 had a greater psychological impact than subsequent waves. Further research must fill important gaps in our knowledge of the clinical range and long-term effects.
Blended learning: An innovative teaching strategy to teach dermatology to the family medicine residents of a teaching hospital
Authors: Masood Sadia , Bhombal Swaleha Tariq , Ghulam Unzela
Published: September 2024

ABSTRACT

Context:

Medical educators face different challenges in this digital era with the pressure for clinical practice as well as teaching. In blended learning Internet technologies are used along with face-to-face teaching to deliver learning methodologies.

Objective:

To assess the efficacy of the blended learning dermatology course on Family Medicine residents at a teaching hospital. Methodology: It was interventional (pre and post) study with purposive sampling. All the Family Medicine residents enrolled at The Aga Khan University Hospital participated in the study after giving consents. The course covered most common skin conditions. Multiple slide sessions, online lectures, clinical presentations, case-based scenarios, and quizzes were included in the course. Knowledge was assessed through pre- test by multiple choice questions. Post tests were taken after completion of the modules to assess the improvement in the knowledge of residents about basic dermatological conditions by multiple choice questions. After completion of sessions a survey questionnaire was administered to evaluate the perception of participants about blended learning strategy.

Results:

The tests scores were significantly higher in the post test. The majority of the residents were satisfied with the course delivery. A statistically significant difference was found between pre and post test results with a P value 0.000.

Conclusions and Recommendation:

Blended learning is an effective and innovative teaching strategy that helped family medicine residents to enhance their learning more effectively. We recommend that this method of teaching strategy should be used in other clinical disciplines in different contexts.didifferent contexts.
Effectiveness and safety of intravenous labetalol in severe pre-eclampsia and eclampsia at a teaching institution in Chhattisgarh
Authors: Jain Rachna , Jogi Sangeeta Raman
Published: September 2024

ABSTRACT

Introduction:

Severe hypertension in pregnancy deserves prompt recognition and urgent effective reduction in order to reduce the risk of complications such as eclampsia and HELLP syndrome and to achieve desirable neonatal outcomes. There is a need for effective and safe parenteral antihypertensive treatment.

Subjects and Methods:

We studied the effectiveness and safety of intravenous labetalol use in severe hypertension in pregnancy and post-partum period in a teaching hospital in Chhattisgarh in 101 women. IV labetalol was given as bolus doses till the blood pressures were controlled. Neonatal outcomes were recorded, and adverse effects such as hypotension, hypoglycemia, and neonatal asphyxia were documented.

Results:

Intravenous labetalol given as a single bolus of 20 mg was efficacious in controlling blood pressures in 93 out of 101 (93%) women, and the rest were controlled with 1 or 2 additional doses in 1–3 hours. No neonatal deaths happened beyond the 13 intrauterine fetal deaths at presentation. No women developed any episodes of hypotension, tachycardia of more than 100, or nausea or vomiting on labetalol.

Conclusion:

Intravenous labetalol, even as a single bolus dose, is highly efficacious and is free of any major adverse effects.
Primary care perspectives on leptin and adiponectin in north Indian families with metabolic syndrome
Authors: Singhal Arjun Kumar , Singh Gaurav , Singh Shravan Kumar , Karunanand Busi , Siddique Merajul Haque , Kumar Naveen
Published: September 2024

ABSTRACT

Background:

Urbanization, sedentary lifestyles, and dietary changes have all contributed to an increase in the prevalence of metabolic syndrome (MetS) in Indian populations during the past 10 years. Numerous markers have been investigated to determine if a person is at risk for developing MetS, with the bulk of them having to do with adipose tissue. Recently, adiponectin and leptin, two biomarkers with a high correlation to cardiometabolic health or disease, are of particular interest.

Methods:

In the general population of India, 100 persons were included. Body mass index (BMI), waist circumference, systolic and diastolic blood pressure, fasting blood glucose, plasma lipids, adiponectin, leptin, insulin, and the homeostasis model were measured to assess insulin resistance. We used binary logistic regression analysis to determine the connection between the researched factors and MetS and Spearman’s analyses to evaluate correlations.

Results:

In all, 200 participants (100 men and 100 women) were enrolled in the study. Men’s and women’s median ages were 53 and 48, respectively (P < 0.05). Men had significantly greater WHR, SBP, and DBP (P < 0.05, respectively). Women had significantly higher levels of triglycerides, LDL, insulin, adiponectin, leptin, and HOMA-IR (P < 0.05, respectively). Leptin-to-adiponectin ratio was significantly and positively correlated with BMI (r = 0.597, P < 0.001), waist circumference (r = 0.576, P < 0.001), triglycerides (r = 0.190, P = 0.001), insulin levels (r = 0.329, P < 0.000), and HOMA-IR (r = 0.301, P < 0.000).

Conclusion:

In this study, higher levels of LAR, together with higher levels of leptin and lower levels of adiponectin, were found to be significantly linked with MetS. To properly determine whether LAR can be a predictor of MetS, independent of confounding factors, research with adequate design must be conducted.
Effectiveness of a training program in improving knowledge and skills about selected common neurological disorders among primary healthcare doctors: The Karnataka Brain Health Initiative (KaBHI) in India
Authors: Mailankody Pooja , Parthasarathy Rajani , Randeep D , Rao Girish N. , Paplikar Avanthi , Johnson Annie Nithiya Vathani , Varghese Feba , Govindaraj Sarath , Shahed Rehan , Vasudev Aparna , Boopalan Deenadayalan , Kulkarni Girish B. , Kalkonde Yogeshwar , Sinha Sanjib , Alladi Suvarna ,   on behalf of the Karnataka Brain Health Initiative (KaBHI) Consortium
Published: September 2024

ABSTRACT

Introduction:

Neurological disorders are the leading causes of death and disability globally. In low-middle-income countries such as India, there is a wide treatment gap for neurological disorders. To address this gap, an initiative known as the Karnataka Brain Health Initiative (KaBHI) was developed in collaboration with the public health system of the state of Karnataka in India.

Method:

A structured hybrid training program was conducted for 120 medical doctors working in the Primary Health Centers (PHCs) in the public health system in three districts of Karnataka. Pre- and post-training evaluation was conducted to assess physicians’ knowledge and skills for evaluating patients with common neurological conditions.

Results:

Of 120 PHC doctors, 111 (92%) scored below the passing score of 50 points out of 100 before the training program. After the training, all trainees scored above this cut-off. The study found a significant improvement in knowledge and skills after the training (before training: 40.48 ± 7.92, after training: 66.28 ± 8.98 (P < 0.001) mean difference = 25.81), and was comparable among the PHC doctors in all three districts.

Conclusions:

Our study shows the feasibility of training primary care doctors in the public health system to manage selected common neurological disorders. The training program can potentially help to reduce the treatment gap for neurological disorders in India.
Comparison of quality-adjusted life years (QALYs) of end-stage patients with gastrointestinal cancers receiving conventional therapies with recipients of supportive-palliative care package
Authors: Vaziri Samira , Esfehani Kourosh Javdani , Hamidi Reza , Amiri Hassan , Naghshbandi Mobin , Rezai Mahdi , Mohammadi Fatemeh
Published: September 2024

ABSTRACT

Objective:

This study aimed to compare the quality-adjusted life years (QALYs) of patients with gastrointestinal (GI) cancer after receiving palliative and supportive care.

Materials and Methods:

Conducted at Firoozgar Hospital in Tehran, Iran, this observational study included 500 end-stage gastrointestinal cancer patients. The study divided these patients into two groups: 250 utilized palliative medicine services, while the remaining 250 did not. The study compared the conditions of patients in both groups.

Results:

Among those receiving palliative care, only 21% underwent chemotherapy, significantly lower than the 55% in the non-palliative care group (P < 0.001). Hospital mortality rates were considerably reduced in the palliative care group, with 115 patients (46%) compared to 200 patients (80%) in the non-palliative group (P < 0.001). The average hospital stay for patients receiving palliative care was 25.11 ± 5.12 days, significantly shorter than the 96.42 ± 14.15 days in the non-palliative group (P < 0.001). The EuroQol 5-Dimensions 3-Levels (EQ-5D-3L) questionnaire scores showed that patients in the palliative care group experienced significantly better outcomes in pain and mood symptoms, but no significant difference was observed in physical function compared to the non-palliative group.

Conclusion:

Palliative medicine is recommended for gastrointestinal cancer patients as it can significantly reduce unnecessary hospital referrals and length of hospitalization.
A randomized controlled trial comparing two antenatal care regimes in the management of mild to moderate gestational diabetes in a low-middle income country
Authors: Reddy Tamma A. , Nirupama Shiny , Raj Arathy , Tirkey Richa S. , Yenuberi Hilda , Mahasampath Gowri , Rathore Swati , Mathew Jiji E.
Published: September 2024

ABSTRACT

Context:

The prevalence of gestational diabetes mellitus (GDM) in the Indian subcontinent has increased exponentially, especially after new diagnostic criteria. Identifying women who need close monitoring is a challenge. Ultrasound has been used to guide therapy but its use in the management of GDM has been used indiscriminately due to paucity of information. The use of ultrasound to guide the number of antenatal visits for adequate glycemic control has not been researched adequately. There is also a need to contrive antenatal care strategies that can obtain optimal neonatal outcomes without burdening the health system in low-middle income countries (LMIC).

Aims:

Our study was to compare pragmatic standard management of GDM with an ultrasound-guided regime (USGR) to prevent neonatal complications to ensure optimal care.

Settings and Designs:

A randomized controlled trial was done in a tertiary hospital between May 2019 and September 2021 in South India.

Methods and Materials:

Five hundred and eighty-eight women were randomized to a standard regime or USGR.

Statistical Analysis:

χ2 and t-test were used to compare outcomes.

Results:

Maternal and neonatal outcomes between standard and ultrasound USGR showed no significant difference in outcomes. Fetuses in USGR with AC ≥ 70th centile had macrosomia (3.59% vs 26.67%, P < 0.001), increased severity of diabetes (2.97% vs 16.67%, P < 0.001), 3rd- and 4th-degree perineal tear (2.95% vs 27.27%, P < 0.001). The increased number of visits did not decrease adverse outcomes.

Conclusion:

This small well-designed study did not show any advantage with USGR as compared to the pragmatic simple standard regime, in the treatment of women with GDM.
Prevalence of hypothyroidism among postmenopausal women in an urbanised village of northern India: A cross-sectional study
Authors: Sharma Priyanka , Verma Anita
Published: September 2024

ABSTRACT

Introduction:

Hypothyroidism is among the most prevalent endocrine disorders worldwide. Its risk increases with menopause. The prevalence of hypothyroidism among menopausal women in India is unknown, as conclusive data are scarce. The present study was conducted to find out the prevalence of hypothyroidism among menopausal women in Delhi, India, and study the socio-demographic factors associated with it.

Methods:

This was a cross-sectional community-based study done among 282 menopausal women in an urbanised village in Delhi, India. Women with a previously known history of diagnosed thyroid disorders were also included in the study. Informed written consent was obtained from all participants. A socio-demographic profile was gathered by questionnaire and blood samples were collected and analysed for thyroid hormone levels.

Results:

The mean age of study participants was 51.1 years. The prevalence of hypothyroidism among postmenopausal women was 27.3% (77) with 19.9% (56) previously diagnosed and 7.3% (21) diagnosed by the present study. Out of 56 previously diagnosed hypothyroid study participants, only 26 (46.4%) participants had thyroid hormones in a normal range. Age, socio-economic status and literacy status were found to be significantly associated with hypothyroidism.

Conclusion:

About three postmenopausal women out of 10 were found to be hypothyroid. Nation-wide data were required to estimate the true burden of thyroid disorders in this population. The prevalence increased with age underscoring the need for further research to have conclusive evidence regarding this association. Hypothyroid women who are on treatment should undergo regular evaluation of thyroid hormones so that appropriate dose adjustments can be made for pharmacological therapies.
Risk factors of urolithiasis: A hospital-based retrospective study
Authors: Paluchamy Thenmozhi , Rani N Dilli , Bhuvaneswari G , Tamilselvi S
Published: September 2024

ABSTRACT

Aim:

Urolithiasis is the most prevalent urinary tract disease, posing a global public health concern. The escalating prevalence and recurrence rates of urolithiasis are attributed to lifestyle modifications, such as reduced physical activity and dietary habits. This retrospective study aims to explore the risk factors associated with urolithiasis among individuals diagnosed with this condition.

Method:

A retrospective hospital-based study involving 60 participants meeting the inclusion criteria was conducted. The participants were selected through convenience sampling from the urology, nephrology, and medical wards at Saveetha Medical College and Hospital. Demographic variables were collected, and the risk factors were assessed using a checklist on one-to-one interviews.

Results:

The study unveiled that most participants (68%) were male. Eighty percent of participants had the risk factor of decreased water intake, 74% consumed excess tomatoes, 56% had a history of recurrent urinary tract infections, 64% consumed an excessive amount of salt daily, 72% experienced a decreased urine output, 53% had a habit of alcohol consumption, and 45% included milk and milk products in their daily diet. A small percentage (5%) had a family history of urolithiasis. Additionally, 6% were undergoing Siddha treatment.

Conclusion:

The findings from this study underscore the significant factors contributing to urolithiasis. They can inform public health campaigns to raise awareness about lifestyle modifications, dietary changes, and hydration protocols contributing to kidney stone formation.
Estimation of urea, uric acid and creatinine levels in patients of primary hypothyroidism – A cross-sectional study
Authors: Gali Bhagyashree , Bubanale Vanishree S.
Published: September 2024

ABSTRACT

Background:

The thyroid gland is one of the largest endocrine glands in the body, secreting thyroxine (T4) and triiodothyronine (T3). Mild hypothyroidism can have negative consequences for a variety of tissues, even though clinically the patients are euthyroid. Many research studies were conducted to evaluate the serum creatinine levels of people with hypothyroidism; however, relatively little research was conducted to evaluate serum urea and serum creatinine levels in subclinical hypothyroidism. As a result, the current study was carried out to investigate urea, uric acid, and creatinine levels in hypothyroidism.

Objectives:

Our study aimed to determine and correlate the levels of urea, uric acid and creatinine in newly diagnosed primary hypothyroidism cases.

Materials and Methods:

In this cross-sectional study, 96 newly diagnosed cases of primary hypothyroidism were included. The findings were correlated with 20–60-year-old and sex-matched cases. Serum urea was determined by the kinetic method (Glutamate Dehydrogenase Method), serum uric acid by the uricase method and serum creatinine by Jaffe’s method in Erba’s Mannheim fully automated analyser.

Result:

This study showed a positive correlation between uric acid and thyroid stimulating hormone (TSH) and a negative correlation between urea and creatinine. There was no statistical significance in the mean values of urea, uric acid and creatinine but an increased level of urea, uric acid and creatinine was seen in the age group 20–30 years when compared with the other age groups.

Conclusion:

The study concludes that serum urea showed a positive correlation with TSH, whereas uric acid and creatinine showed a negative correlation with TSH, and there was no statistical significance in the mean values of urea, uric acid and creatinine in hypothyroid patients.
Improving access to utilize the healthcare services facilitated by ASHAs, ANMs and medical officers of PHC among scheduled tribe pregnant women: An interventional study
Authors: Ade Anju Damu , Guthi Visweswara Rao , Kondagunta Nagaraj , Kumar D. S. Sujith , Deekala Ravisankar , Vallepalli Chandrasekhar , Prathyusha T V D
Published: September 2024

ABSTRACT

Introduction:

Early marriages, early childbirth, low BMI and high incidence of anaemia are known factors for high maternal mortality among tribal pregnant women.

Materials and Methods:

This was a mixed method study (qualitative and quantitative) undertaken to evaluate educational intervention package among tribal pregnant women in Chittoor District of Andhra Pradesh State in South India. A baseline household survey with the help of a semi-structured questionnaire was conducted in both intervention group (n = 109) and control group (n = 119) of ST habitations. An educational intervention was implemented through health education approach to bring about awareness and behavioural change among pregnant women regarding healthcare practices and utilization of health services. Qualitative data collection tool included semi-structured FGD. Quantitative data was analysed using SPSS version 26.0. Content analysis was done for qualitative data.

Results:

The findings of this study show that awareness and utilization with respect to various services facilitated by ASHAs, ANMs and medical officers are improved postintervention among tribal pregnant women, and the various reasons for non-utilization of services were lack of awareness, long distance of health facility, no transportation, poor socio-economic status, inadequate facilities at PHC, etc.,

Conclusion:

This study shows that intervention to improve awareness and health services utilization, and continuous health education should be imparted to all the pregnant mothers. For this healthcare providers like ASHA and ANM and medical officers should be trained and motivated to educate the community.
Non-alcoholic fatty liver disease (NAFLD) integration into India’s NCD program – Obstacles and solutions for the implementation of guidelines at the national level
Authors: Kaushal Kanica
Published: September 2024

ABSTRACT

Individuals who have non-alcoholic fatty liver disease (NAFLD) are at high risk of metabolic comorbidities and can put a significant strain on healthcare systems. If not managed in a timely manner, NAFLD can lead to sustained healthcare costs, economic losses, and reduced health-related quality of life. In India, the Ministry of Health and Family Welfare recognized the need for a comprehensive approach to prevent NAFLD and integrated public health measures into the existing National Program for Prevention and Control of Non-Communicable Diseases (NP NCD). However, 3 years after the integration, there is no clear measure of the extent of implementation of this program, and the exact facilitators and barriers to implementing the program are yet to be determined. The next step toward providing comprehensive and effective healthcare services to those affected by NAFLD is the implementation of NAFLD guidelines under the NP NCD. The article emphasizes the importance of replacing old reporting formats with updated ones that incorporate NAFLD. It also highlights the need for healthcare personnel and community health workers to receive multiple trainings. While measuring waist circumference (WC) and identifying patients who need referral poses challenges, we can overcome them by updating the Non-Communicable Disease (NCD) application to include NAFLD, recording WC in registers, and using up-to-date reporting formats.
High fiber diet versus polyethylene glycol in management of chronic constipation in children with cerebral palsy: A randomized controlled trial
Authors: Arya Vandana , Khyalia Sailesh , Bhalla Kapil
Published: September 2024

ABSTRACT

Background:

Constipation is one of the most common gastrointestinal symptoms in patients with cerebral palsy. This study was conducted with the aim to compare the efficacy of a high fiber diet and polyethylene glycol in the management of chronic constipation in children with cerebral palsy.

Methodology:

An open-label randomized controlled trial was conducted in the Department of Pediatrics of a tertiary care hospital in Northern India among cerebral palsy children aged 1–6 years having chronic constipation. Seventy children were enrolled in the study (35 in each group). Group A children received high fiber diet as per the diet chart prepared by the dietician. Group B received polyethylene glycol (0.5–1 g/kg/day) for a period of three months. At the end of four weeks and three months, all children were assessed for clinical improvement and both groups were compared in terms of stool frequency, consistency of stool, fecal incontinence, palpation of hard stool per abdomen, blood in stool, pain on defecation and overall satisfactory outcome. Satisfactory outcome was defined as defecation > two times weekly, soft stool, no pain on defecation, no palpation of hard stool on abdominal examination, no fecal incontinence, and no blood in stools. Children were also assessed for any adverse effects.

Results:

Baseline parameters and GMFCS were comparable in the two groups. Both group patients showed significant improvement in symptoms of constipation at the end of four weeks and three months compared to baseline. However, there was no significant difference between the two groups in terms of satisfactory outcome and parameters like frequency of stool, consistency of stool, palpation of hard stool, fecal incontinence, and blood in stools.

Conclusion:

A high fiber diet can be considered a good alternative to polyethylene glycol for the management of chronic constipation in children with cerebral palsy.
Depression among older adults who developed acute coronary syndrome (ACS) during hospitalization for non-cardiac illness: A prospective observational study
Authors: David Arun , Vijayakumar Priya , Vijayakumar M
Published: September 2024

ABSTRACT

Background:

Atypical presentations of ACS delay its recognition and treatment in the older adults. During hospitalization, depression and functional decline, which is unique to older adults, leads to poor clinical outcome. Steps taken for its prevention is unlikely to become a priority for the Cardiologist. This study was conducted to identify depression among older adults who developed ACS during hospitalization for noncardiac illness and their outcome.

Methods:

310 older adults with ACS were included from 26 June 2020 to 13 October 2020. Subjects were divided into those admitted primarily due to an ACS (Group I, n = 94) and those developing ACS after admission for noncardiac illness (Group II, n = 216). Co morbidities, medications, investigations, management, clinical outcome, Geriatric Depression Scale was compared between the two groups at the time of admission, after 30 days and after 6 months.

Results:

Majority of them were admitted due to acute kidney injury (27.1%) in group II and had a non ST elevation ACS (90.2%). Optimum management was given to a lesser extent because of the clinical condition of these patients. Depression during hospitalization, during follow up and poor clinical, functional and cognitive outcome was more in group II.

Conclusion:

Optimum medical management was not given to considerable number of patients because of atypical presentations, clinical condition, along with functional and cognitive decline which resulted from depression. Clinicians must be vigilant for the development of depression when an older adult is admitted to the hospital, as early detection and optimum management provides better clinical outcome.
Knowledge, attitudes, practices, and sociocultural factors influencing cervical cancer screening and vaccination among women in rural communities of Gujarat: A mixed-methods study
Authors: Murugan Yogesh , Bhavana BM , Ekka Anurag , Gandhi Rohankumar , Dhaduk Kishorkumar Muljibhai
Published: September 2024

ABSTRACT

Background:

Cervical cancer is a leading cause of cancer mortality among women in India. Screening can help in early detection and improve outcomes. However, uptake remains low, especially in rural areas. Understanding multidimensional factors influencing screening in local contexts is essential to promote equitable access. This study examined knowledge, attitudes, practices, and sociocultural factors associated with cervical cancer screening and vaccination in rural India.

Methods:

A mixed methods study was conducted among 400 women aged 18–60 years in rural Maharashtra. Quantitative data were collected on knowledge, attitudes, and screening practices by using a structured questionnaire. Qualitative data were gathered through in-depth interviews with 30 participants on perspectives influencing screening. Quantitative data were analyzed using descriptive statistics and logistic regression. Thematic analysis was done for qualitative data. The integration provided complementary insights.

Results:

Quantitative results showed poor knowledge (17% had good knowledge) and positive attitudes (64%) but low screening uptake (9%). Qualitative findings revealed limited awareness, stigma around gynecological exams, gender inequities, fear, fatalism, and low prioritization of self-care as screening barriers.

Conclusion:

Multifaceted strategies addressing knowledge gaps, gender roles, stigma, and access are required to improve cervical cancer screening in marginalized rural communities. Mixed methods provide comprehensive evidence for designing context-specific interventions.