bluuebunny/crossref_metadata_2025 huggingface dataset:
Intake, digestibility, and ingestive behavior of sheep fed with thornless Mandacaru, cactus pear genotypes Orelha de Elefante Mexicana and Miúda
Authors: Silva Maria Vitória Serafim da , Aguiar Emerson Moreira de , Silva José Geraldo Medeiros da , Melo Airon Aparecido Silva de , Cardoso Daniel Barros , Costa Marcone Geraldo , Costa Filho José Hamilton da , Ramalho Adriana Margarida Zanbotto
Published: February 2023

This study aimed to evaluate the intake, digestibility, and ingestive behavior of sheep fed with different species of forage cacti. Fifteen sheep (17.27kg ± 1 kg) were distributed in a completely randomized experimental design with three treatments and five replicates. The treatments were diets on a dry matter basis composed of 430.9 g kg-1 of thornless Mandacaru cactus (Cereus hildmannianus), 525.7 g kg-1 of cactus pear cv. Orelha de Elefante Mexicana (Opuntia stricta) and 492.1 g kg-1 of cactus pear cv. Miúda (Nopalea cochenillifera) in addition to Sabiá hay (Mimosa caesalpiniaefolia) (194.7 to 233.8 g kg-1), plus concentrate feed. The intake of the dry matter, organic matter, ether extract, neutral detergent fiber, total carbohydrates, non-fiber carbohydrates, total digestible nutrients and voluntary water intake in g day-1 was not differ (p > 0.05) by experimental diets. There were no differences (p > 0.05) in digestibility coefficients of the dry matter, organic matter, neutral detergent fiber, total carbohydrates, non-fiber carbohydrates, and total digestible nutrients between the experimental diets. The feeding times differed (p < 0.05) between diets, with a higher value for the Opuntia diet, while the rumination times, feeding efficiency, and rumination efficiency did not differ (p > 0.05). The cactus Cereus and Opuntia and Nopalea have similar nutritional value in sheep’s diet.
Growth curves of broilers fed different nutritional relationships using the Gompertz model
Authors: Freitas Luís Filipe Villas Bôas de , Bertechini Antonio Gilberto , Clemente Alisson Hélio Sampaio , Fernandes Felipe Augusto , Bauth Diego Alexsander , Fernandes Tales Jesus
Published: February 2023

The study aimed to evaluate performance and growth curves of broilers fed different nutritional relations. A total of 1,440 Cobb-500 male day-old chicks were assigned to eight treatments in a 2 x 2 x 2 factorial arrangement with six replicates of 30 birds each. The main factors were nutritional density (control and high), lysine source (HCl and sulfate), and calcium pidolate (presence and absence). Analyses were made for body weight gain (BWG), and feed conversion rate (FCR) at 21, and 42 days of age. The growth curves were adjusted by weighing a bird per plot every three days. Data for BWG were tested by ANOVA to evaluate the effects of treatments and their interactions at 5% significance, and the Gompertz model was adjusted by NLS. Birds fed a high nutritional density had higher BWG and lower FCR. Calcium pidolate and different sources of lysine did not influence the FCR of broilers, however a triple interaction was evidenced for BWG at 1 to 42 days of age. The day with maximum gain adjusted by Gompertz of all treatments was at the 32nd day of age and the maximum weight (A) was around 5.85 kg.
Quality of refrigerated raw milk according to the bulk transport conditions
Authors: Felipus Nadine Cristina , Bajaluk Sergio Antonio Bogdano , Thaler Neto André , Knob Deise Aline , Alessio Dileta Regina Moro
Published: February 2023

Technical regulations that determine milk quality standards in Brazil establish the minimum criteria that the processing industry's raw material must present. These rules can challenge the logistics sector (transport) to maintain adequate milk conservation levels. We aimed to evaluate the influence of bulk transport and storage conditions on refrigerated raw milk quality. The experiment was carried out in a dairy industry in Santa Catarina State. Information and samples of refrigerated raw milk were collected from dairy farms, from isothermal compartments of milk trucks, and from the industry's storage silo. These samples were submitted to microbiological analysis, somatic cell count (SCC), and physicochemical analysis. The results were evaluated by ANOVA and multivariate analysis (factor analysis). The transport of raw milk in bulk and the transfer of raw material to the industrial silo worsened the milk's microbiological quality (p < 0.0001) for standard plate count (SPC) and psychrotrophic microorganism count (PMC), without affecting, the physicochemical characteristics of the milk (p > 0.05). Poor hygienic conditions in milk storage rooms, in the refrigeration bulk tanks of the dairy farms, and during the transport, as well as the transport on longer routes, were related to higher SPC and psychrotrophic count while receiving milk by the dairy industry with higher temperatures was only associated with higher SPC.
Effects of a monocomponent protease from Bacillus licheniformis on broiler performance, digestibility, and carcass yield
Authors: Carneiro André Luís Machado , Café Marcos Barcellos , Carvalho Fabyola Barros de , Oliveira Helder Freitas de , Carvalho Deborah Pereira , Carvalho Genilson Bezerra de , Gomides Larissa Paula Silva , Stringhini José Henrique
Published: February 2023

Two experiments were carried out to evaluate the effects of protease addition to the diet of broilers at a higher level (1× or 2×) than the nutritional value proposed for the enzyme. The first experiment, 1280 day-old chicks (Cobb500®) were randomly allocated (randomized block design, 2×2+1 factorial arrangement), five treatments, eight replicates containing 32 birds/replicate. Treatments consisted: control diet without protease (CD); CD + 1× nutritional value of the enzyme (CDM1); CD + 2× nutritional value of the enzyme (CDM2); CDM1 + protease; and CDM2 + protease. The experimental period was 42 days. The mean weight (AFW), feed intake (FI), weight gain (WG), feed conversion, and carcass yield were evaluated. Significant differences were observed for AFW, WG, FI, abdominal fat yield, and feet percentage in the carcass. In the second experiment, 120 Cobb500® chicks at 14 days of age were allotted in a completely randomized design, 2×2+1 factorial arrangement, five treatments, six replicates with four birds/replicate. The treatments were consistent with the first experiment. Significant improvements in the nitrogen balance were observed for the broilers that received protease. The use of the enzyme tested is recommended with the recommended nutritional matrix, improving the zootechnical indices of broilers.
Simulation Study of Reverse Osmosis Membrane for Seawater Desalination
Authors: Abu Bakar Nurul Anis Dzakirah , Abdullah Zalizawati , Kasmuri Nor Hazelah , Subari Fuzieah , Hanipah Suhaiza Hanim
Published: February 2023

Seawater desalination can be applied in Malaysia to overcome water supply issues which majorly due to water pollution. The desalination using membrane technology highly depends on the design of the membrane, operating conditions of the process, and the feed characteristics of the seawater. The aim of this research is to identify the effect of these factors on the performance of the reverse osmosis membrane in desalinating seawater in Malaysia. The simulation study is conducted by using the IMS Design program. The reverse osmosis (RO) membrane process that consists of three membrane stages arranged in series is designed accordingly. The effect of operating temperature, feed concentration, feed pH, and membrane stages on the salt rejection and permeate flux are evaluated. As a result, an increase in temperature and feed concentration reduces the salt rejection percentage, while increasing the permeate flux. However, there is no significant effect of feed pH on the salt rejection percentage and permeate flux since the type of membrane used is able to operate in a wide pH range. Lastly, the four stages membrane increases the permeate recovery and permeate flux but reduces the percentage of salt rejection.
Landfill Gas Resource Assessment - An Adaptation from Oil and Gas Exploration Technique
Authors: Wan Bakar Wan Zairani , Japperi Nur Shuhadah , Amir Zulhelmi , Sauki Arina , Ahmad Fuad Mohd Fazril Irfan
Published: February 2023

Landfill Gas (LFG) composed of approximately 50% methane and 50% carbon dioxide is known as one of the Greenhouse Gases (GHGs) that could pollute the environment and contribute to the global warming. In the conventional approach, volume of methane is approximated from its emission using the Intergovernmental Panel on Climate Change (IPCC) 2006 First-order Decay (FOD) model. This model has been formalized as a USEPA landfill gas emission model (LandGEM) in 2005 and IPCC Waste Model in 2006. LandGEM is a Microsoft Excel based software application that uses a first-order decay rate equation to calculate methane and LFG generation. It is the most widely used LFG model and is the industry standard. However, the software requires a number of parameters estimates such as organic content, disposal data and rates, site closure dates, expansion schedules or collection efficiencies and knowledge of waste composition. Inaccuracies in the estimates can result in large errors in predicting future recovery, which could affect the production system. This research evaluate the potential of deploying the volumetric estimation technique in oil and gas exploration to locate methane accumulation location and estimate the volume prior to its emission to the atmosphere on the Air Hitam Landfill as the case study. The gross rock volume is an approximation of the total area covered by the landfill, while porosity and water saturation are simulated estimations. The result gives an approximation of 1.65 billion standard cubic feet (BSCF) of LFG in-place that could generate 25,948 tonnes of methane worth RM6 to RM8 millions of carbon credit and RM55 millions of revenues from electricity sale.
Evaluation of Growth and Yield Performance of Castor Hybrids Under Southern Dry Region in Sri Lanka
Authors: Amarasinghe Y. P. J. , Wijesinghe G. , Pushpakumara R. W. , Liyanage I. R. , Dilhani R. K. R.
Published: February 2023

Castor oil is considered as a highly important industrial oil due to its unique chemical structure and properties. Although it is not yet commercially grown in Sri Lanka, there is a high potential of promoting castor cultivation in marginal lands. Due to growing interest among the private sector to initiate commercial scale cultivation, there is an immediate necessity to introduce promising castor varieties despite traditional varieties are presently grown. With this objective two castor hybrids, namely; Jiaxiang No.6 (JX-6) and Zibi No.5 (ZB5) were received from China and field evaluation was carried out at Grain Legumes and Oil Crops Research and Development Center, Angunakolapelessa (GLORDC) during 2021/22 Maha season. The experiment was layout in a Randomized Complete Block Design (RCBD) with four replicates, where a local cultivar was used as a check variety. The results revealed, plant height at flowering was not significantly different (P=0.05) among the tested genotypes. Since the local cultivar is having a perennial growth habit, significantly higher (P=0.05) branching was observed. The number of racemes per plant was significantly high (P=0.05) in the local cultivar, while average raceme length and number of fruits per raceme were significantly high (P=0.05) in both hybrids. Additionally, hybrids had higher 100 seed weight ranging from 20.82-23.1g. Hence, a significantly higher (P-0.05) seed yields has been revealed by the hybrid varieties Interestingly, both hybrids showed severe disease susceptibility specially for fusarium wilt, in which the local cultivar showed high degree of resistance. Considering the yield performance, only the hybrid of Jx-6 was selected as a promising hybrid to initiate commercial scale cultivations.
Regional mapping and qualitative petroleum resource assessment of the Magdalen Basin, Gulf of St. Lawrence, Quebec, Prince Edward Island, New Brunswick, Nova Scotia, and Newfoundland and Labrador
Authors: Atkinson E A
Published: February 2023

The Geological Survey of Canada conducted a broad regional study of the Magdalen Basin in the Gulf of St. Lawrence, as part of the Marine Conservation Targets initiative. MCT is a national initiative to protect more of Canada's offshore areas, and resource
assessment and related regional mapping are part of the review process. This study assembled a large seismic and geologic database that allowed new regional mapping of several key horizons in this basin. Digital seismic data was donated by industry, and reprocessing undertaken both in-house and with
contractors. Wells were correlated and tops from literature were used to indentify regional reflection packages. Regionally consistent two-way time interpretations add to confidence. Depth conversion used regional time-depth functions from literature, which were developed from refraction data, with
a residual correction for the water column. Nine regional depth maps and eight isopach maps were produced, including Pre-Horton Basement, Horton Group Isopach, Base Windsor Group, Top Salt, Top Bradelle Formation, Bradelle / Cumberland Isopach, and Top Cable Head Formation. These maps illustrate
that the Pre-Horton basement is about 15 km deep in the centre of the basin. Two main trends are visible in the Horton Grabens, which may relate to basin formation, and no significant reactivation of deeper Appalachian structure is observed. In the basin centre, the more robust Base Windsor
Unconformity horizon reaches about 12 km deep, and a key reservoir and source sequence in the Bradelle Formation reaches 7 km. These maps are useful for considering regional stratigraphy. The new mapping also constrained basin models and became the input for our Qualitative Petroleum Potential map.
Basin modelling reveals scenarios where oil may be preserved. The petroleum potential of the region is highest north of Îles de la Madeleine and southeast of Îles de la Madeleine and northwest of Cape Breton.
Abstract 1
Authors: PuspalataAgroiya  , Alrawahi Abdul Hakeem , Gupta Lokesh
Published: February 2023

Introduction: Central serous chorioretinopathy (CSCR) is an underdiagnosed retinal disorder characterized by well-definedmacular neurosensory retinal detachment and/or detachment of retinal pigment epithelium. However, it is quitesurprising that, we found only one case report in previous literatures describing CSCR in a patient who receivedsteroid therapy for GO. We report two cases where patients developed recurrent CSCR while under systemicsteroid therapy for severe thyroid ophthalmopathy.

Case 1: A 34 years old man with severe thyroid orbitopathy complained of profound reduction in vision in right eyemore than left eye within one month of start of intravenous methylprednisolone (IVMP). He completed 12 cycles of weekly IVMP followed by rituximab infusion because of inadequate response to steroids. His bestcorrected visual acuity (BCVA) in both eyes dropped from 6/6 to 1/60. Fundus examination showed small andhyperemic optic nerve head with thickened nerve fibre layer in both eyes and right serous macular detachmentwith punctate yellow sub-retinal deposits. Optical coherence tomography (OCT) confirmed the diagnosis ofCSCR in right eye. Finally Orbital radiation was advised to save remaining vision in both eyes. His BCVA improved to right eye 6/18 and left eye 6/6.

Case 2: A 34 years old man with Grave’s disease of 6 months duration complicated by severe orbitopathy presentedwith blurring of vision and central scotoma of left eye after 2 weeks of start of oral prednisolone 80 mg/day intapering doses. His BCVA in left eye dropped from 6/6 to 6/9 with marginal improvement in orbitiopathy andsubjective symptom. Fundus examination showed a ring reflex with subretinal fluid at fovea in the left eye. OCT revealed typical lesions consistent with CSCR in left eye. There was marked improvement in proptosisafter decompression surgery with stable BCVA of 6/6 both eyes over the next follow ups.

Conclusion: As it is a frequently encountered sight threatening disorder related to systemic GCs. It’s important forendocrinologists and ophthalmologists to be mindful about the possible complication of CSCR while treatingGrave’s Orbitopathy.
Abstract 101
Authors: Jena Sweekruti
Published: February 2023

Background: Studies have reported considerably different rates in terms of the incidence of polycystic ovary (PCO) morphology in patients with PCOS. There are inconsistent results regarding the effects of PCO morphology on clinical and biochemical features in PCOS patients. Understanding the metabolic and biochemical differences between patients with and without polycystic ovary (PCO) morphology can guide better management of the patients. The group found to have a worse metabolic/ biochemical profile can be considered for close follow up with respect to the occurrence of future cardiovascular adverse event.

Objective: To determine the biochemical and hormonal differences in polycystic ovary syndrome (PCOS) patients with and without polycystic ovary (PCO) morphology.

Methods: Patients with PCOS diagnosed as per Rotterdam Criteria, presenting to Dept. of Endocrinology, SCBMCH between July 2021 to September 2022 were included. Relevant history, anthropometry and peripheral blood samples were taken from patients in the follicular phase spontaneous menstrual cycles / de novo sample in amenorrheic women including total testosterone (T), follicle stimulating hormone (FSH), luteinizing hormone (LH), 17-OHP, DHEAS, AMH, Thyroid profile, S. Prolactin, hsCRP. Patients will be segregated into two groups based on USG pelvis, one with PCO morphology fulfilling criteria and one with PCO morphology not fulfilling criteria and biochemical and hormonal parameters will be statistically analysed.

Results: Total 68 PCOS patients were recruited as per inclusion criteria. Out of total, 37 patients had PCO morphology on USG as per Rotterdam criteria (Group I) and 31 patients did not fulfill USG criteria of PCOS (Group II). The two groups were similar with respect to age and BMI. Mean serum levels of LH and LH/FSH ratio of Group I were significantly higher than Group II. Serum Testosterone and androstenedione levels were higher in Group II but not statistically significant. Total Cholesterol and S. Triglyceride levels were significantly higher in Group II. Mean HOMA-IR was higher in Group II. Mean AMH levels were higher in Group II. Mean hs CRP level were higher in Group I but not statistically significant.

Conclusion: The group of patients without diagnostic PCO morphology had a worse metabolic profile in terms of dyslipidemia and insulin resistance as compared to the group with diagnostic PCO morphology. Hence, a more careful follow up must be considered in terms of cardiovascular risk assessment in this group.
Abstract 103
Authors: Padhariya Krunal , Sachan Alok
Published: February 2023

We report a case of 57-year old gentleman, a known case of hypertension and type 2 diabetes mellitus, who was diagnosed to have Graves’ disease in 2020. He was diagnosed as a case of Graves’ disease whenhe was evaluated for weight loss and generalized weakness, with elevated T3, T4, suppressed TSH and diffuse uptake on Tc 99m thyroid scan. He was started on Carbimazole and became euthyroid. About 5 months from the onset of thyrotoxicosis, he developed swelling over both the eyes (clinical activity score of 2/7). He was treated symptomatically with eye drops and head end elevation. However, his symptoms got worse after a few days and he developed eye pain (spontaneous as well as gaze evoked) associated with conjunctival redness (CAS 3/7). He was started on IV methyl prednisolone therapy [500 mg weekly for 6 weeks followed by 250 mg weekly for 6 weeks]. CT scan orbit and MRI orbits were suggestive of bulky rectus muscles with spared tendons. As relief was not evident, he was continued on oral prednisolone therapy. After some time, he was given a 2nd course of IV methyl prednisolone therapy (7 doses of 1 gm each). However, he had progressive loss in vision with CAS 7/7 in both eyes with compressive optic neuropathy. At this stage he was advised orbital radiotherapy and 20 Gy [2 GY *10 FRACTIONS] has been given by 3D CRT technique. He was simultaneously started on mycophenolate mofetil 500 mg bd. Oral prednisolone (10 mg per day) was continued. His vision partially improved after radiation therapy. CAS slowly improved. In this case of Graves’ disease with ophthalmopathy and optic nerve compression, despite collective efforts of Endocrinologists and Ophthalmologists, outcome was not satisfactory.
Abstract 105
Authors: Kaur Kirandeep , Sridharan Kalyani
Published: February 2023

Background: 46 XX testicular disorder of sex development (DSD) is rare disorder with incidence of 1;20,000 in new-born males. Majority of cases occur due tothe translocation of the sex-determining region of the Y chromosome (SRY) to X chromosome. Presentation is usually in adolescence or adulthood when they present with poor development of secondary sexual characters or with infertility. We have presented a case of 46 XX male and discussed the management.

Case presentation: A 20-year-old male presented to us with complaints of poor development of secondary sexual characteristics. He was born with unambiguous male genitalia and was assigned male sex of rearing. He identified himself as He and assumed a male gender role. He attained puberty at 16 years of age. On examination, he was short in height (below 3rd centile for his age and sex) and underweight. He had absent facial hair, sparse axillary hair, and no gynecomastia. Genital examination showed virilization with pubic hair tanner stage 4, stretched penile length normal as per age, with completely fused and well-developed scrotumbut small-sized testicles (3cc bilateral). On hormonal investigation, he was found to have hypergonadotropic hypogonadism. Usual causes of hypergonadotropic hypogonadism like Klinefelter’s syndrome, and local infective, infiltrative or benign causes like varicocelewere suspected. Ultrasound of the scrotum was normal ruling out local causes. Karyotype showedthe presence of XX sex chromosome and Fluorescent in situ hybridization studies showed SRY gene translocation to the short arm of chromosome X – leading to 46XX sex reversal. Patient was started on testosterone replacement and considering the risk of gonadoblastoma; a bilateral orchidectomy was done. Poor fertility prospects were explained.

Conclusion: This case describes a rare case of 46 XX DSD with sex reversal due to SRY gene translocation. SRY is a sex-determining gene present on Y chromosome and its presence causes bipotential gonads to develop into testis. 46 XX DSD should be considered a differential in any patient presenting with small testicular size and poor secondary sexual characteristics.
Abstract 11
Authors: Yadav Suchitra , Gora Anamika , Mathur Sandeep , Sharma Balram , Saran Sanjay
Published: February 2023

Introduction: Turner Syndrome (TS) is the most common sex chromosome abnormality of female, occurs in one in 2500 live born females. TS combines characteristic physical features with complete or partial absence of X chromosomes, frequently accompanied by cell mosaicism.

Objective: The aim of the study is to describe the clinical phenotype, prevalence of congenital anomalies and autoimmune conditions in patients with turner syndrome.

Method: Data was collected from patients presenting in endocrinology OPD at SMS Medical College Jaipur. Of 100 cases the mean age of diagnosis was 9.6 years (range 0-17) years. The most common problem that bring patients to the clinic was short stature (75%), and delayed puberty (25%). There were 24 patients with other congenital abnormalities cardiac defect in 6%, 12% with ear abnormality and remaining with skeletal and eye defect. Significant number 45% had associated autoimmune condition (including T1DM, coeliac disease, hypothyroidism).

Conclusion: Most common presentation of turner syndrome is short stature. TS is associated with other congenital abnormalities most common being ear abnormalities and most common autoimmune condition being coeliac disease.
Abstract 110
Authors: Suryadevara Varun , Priyamvada PS , Govindarajalou Ramkumar , SadishkumarKamalanathan  , Sahoo Jayaprakash , Naik Dukhabandhu
Published: February 2023

Background and Objectives: Chronic kidney disease-mineral bone disease (CKD-MBD) is a common yet neglectedlong-term complication of CKD. The primary objective of this study was to compare the proportion of patients with low trabecular bone score (TBS) in the CKD patients with diabetes mellitus (CKD-DM) andthe CKD patients without DM (CKD-NDM). The secondary objectives weretocomparebone mineral density (BMD) and morphometric vertebral fractures (VF) between the two groups.

Methods: Patients ofCKD with an estimated glomerular filtration rate (eGFR)< 60 mL/min/1.73 m2 were recruited. They were classified into the CKD-DM or the CKD-NDM group based on the presence of DM. Both groups were matched for age and gender. A detailed history was taken, and a physical examination was done to rule out secondary causes of osteoporosis. Serum creatinine, electrolytes, 25-hydroxyvitamin-D [25 (OH)D], and intact parathyroid hormone (iPTH) were analysed. Areal BMD was assessed using Hologic Discovery Wi dual-energy X-ray absorptiometer. TBS was estimated from spine BMD images using TBS iNsight software v 3.1.1 (Medimaps, Geneva). A dorsolumbar spine radiograph was performed to look for morphometric VFs.

Results: 316 participants with CKD (158- diabetic and 158 non-diabetic) were included. The baseline characteristics were comparable between the two groups except for a higher BMI, higher waist circumference, higher eGFR, lower magnesium, and lower 25(OH)D in the CKD-DM group. The proportion of patients with low bone turnover (iPTH levels < 80 pg/ml) was higher in the CKD-DM group (34.2% vs 27.1%). The proportion of patients with low TBS was similar between the two groups (39.86% vs 41.83%). The BMD at lumbar spine (LS) [0.977 (0.877-1.128) vs 0.945 (0.814-1.148) g/cm2] and distal forearm (FA) [0.689 (0.618-0.736) vs 0.661 (0.576-0.731) g/cm2] were also comparable between the two groups. However, BMD at femur neck (FN) [0.707 (0.624-0.798) vs 0.665 (0.586-0.768) g/cm2] and total hip (TH) [0.862 (0.760-0.951) vs 0.811 (0.713-0.916) g/cm2] were higher in the CKD-DM group. The prevalence of morphometric VF was similar between the two groups (8.5% vs 5.2%).

Conclusion: In this cohort of pre-dialysis stage 3-5 CKD patients, the prevalence of low TBS, BMD at LS and distalFA was similar between the CKD-DM and the CKD-NDM groups. The BMD at FN and TH was higher in CKD with DM compared to CKD without DM.
Abstract 111
Authors: Kolla Bharathi , Kalra Pramila
Published: February 2023

Background: As per international Olympic guidelines, transmen are allowed to compete in the male category without restrictions. For transwomen it was decided that the testosterone levels should be less than 10 nmol/L for a least period of 12 months. Muscle strength also plays a role along with testosterone in sports. No data is available with regards to muscle strength after gender affirming hormonal therapy in India. The aim of this prospective study was to assess the change in body composition and muscle strength after GAHT.

Methods: This study was conducted over a period of one year in Endocrine OPD. Body composition was assessed by BIA (Bioelectrical impedance analysis) using Omron HBF 375 Karadascan in both cisgender (assigned gender at birth) and transgender (identified gender) settingsfor each participant both at baseline and at 6 months. Muscle strength was assessed using a handheld dynamometer (active force dynamometer) both at baseline (treatment naïve) and after 6 months of starting hormonal therapy.

Results: A total of 21 trans females and 6 trans males were included. Among transwomen in both cis and trans settings there was increase in the whole-body fat, visceral fat and decrease in the skeletal muscle and muscle strength with a mean difference of (cis setting whole body fat + 2.1; visceral fat + 1.01; muscle % - 2.370, trans setting – whole body fat + 2.533; visceral fat + 1.22; muscle % - 2.5380) (p=< 0.001 for all). Among transmen in both cis and trans settings there was decrease in the whole-body fat, visceral fat and increase in the skeletal muscle and muscle strength with a mean difference of (cis setting – whole body fat – 0.76; visceral fat – 1.34; muscle % + 2.2 and in trans setting – whole body trans-fat – 1.06; visceral fat – 1.67; muscle % + 2.7) (p < 0.005 for all).

Conclusion: Transwomen on treatment for at least 6 months showed increase in whole body fat, visceral fat, decrease in total muscle and muscle strength when compared to baseline. As there is significant reduction in muscle strength among transwomen, taking testosterone value alone into consideration for allowing them into sports is not fair. Among transmen there was increase in muscle mass and muscle strength, but it was less when compared to cis-men. It is justified to consider to take muscle strength into criteria along with testosterone levels for tanswomen.
Abstract 112
Authors: Vivek Marrapu Venkata
Published: February 2023

Introduction: Primary hyperparathyroidism is a metabolic bone disease characterized by hypercalcemia, hypophosphatemia, and inappropriately elevated PTH due to autonomous production of parathormone by a parathyroid adenoma, hyperplasia or rarely, carcinoma. We report a case of primary hyperparathyroidism presenting as giant cell tumor.

Clinical Case: A 33-year-old male presented with swelling ofmandible for the last 1 year for which he was operated. Histopathology revealed giant cell tumor. After resection of mandibular swelling, he developed pain and swelling in left ankle for the last 2 months. On evaluation, he was found to have an expansile lyticlesionin the lower half of tibia and fibula. He underwent bone curettage and Histopathology revealed giant cell tumor. Skeletal survey was done later which showed multiple lytic lesions, and he was referred to endocrinology. On evaluation, he was found to have corrected serum calcium 15.46 mg/dl, phosphate 2.57 mg/dl, alkaline phosphatase (ALP) 2831 IU/ml, iPTH 645.5 pg/ml, 25(OH)D 11.18 ng/ml, and serum creatinine 0.9 mg/dl. His serum prolactin was 6.74 ng/ml. Ultrasonography (USG) of abdomen revealed normal study. CECT Abdomen revealed tiny 1-2 mm calculi in Bilateral kidneys. He did not have gallstone disease or pancreatitis. USG of neck and 99m Tc-sestamibi scan localized right inferior parathyroid adenoma. Based on above findings a diagnosis of primary hyperparathyroidism due to parathyroid adenoma was made.

Discussion: Brown tumor is a manifestation of hyperparathyroidism and is not a tumor. They are usually multiple and present in long as well as in flat bones. However, osteoclastoma (giant cell tumor) is a neoplasm of bone and manifest as a solitary lytic lesion in long bone. Brown tumor and osteoclastoma are indistinguishable on imaging and histology; however, calcium profile can differentiate between the two disorders.
Abstract 113
Authors: Budhwar Vijay , Dutta Susmita , Mukhopadhyay Pradip , Ghosh Sujoy
Published: February 2023

Background: Exact etiology forFibro Calculous Pancreatic Diabetes (FCPD) is not well understood, hypothesised to be a multifactorial, with role of both genetic and environmental components. Few genetic mutations have been postulated to be associated with FCPD in previous studies, serine protease inhibitor Kazal type 1 gene (SPINK1) being the most common. Association of Cationic trypsinogen (PRSS1), Anionic trypsinogen (PRSS2), Chymotrypsinogen C (CTRC), Cystic fibrosis transmembrane conductance regulator (CFTR) gene mutations too have been observed, though the data is very scarce & conflicting. We are not aware of a single study which has comprehensively looked into various mutations together.

Objectives: To look for panel of known genetic mutations (SPINK, PRSS1, PRSS2, CTRC & CFTR) in FCPD patients

Methods: This cross-sectional study was carried out from July 2021 to October 2022. Patients attending Endocrine OPD who fulfilled the Mohan et al criteria for FCPD were recruited for the study. DNA was isolated from whole blood using commercially available kits. Quantification and purity of the isolated DNA was determined in duplicate by measuring absorbance at 260 nm and 280 nm using a Bio Spectrometer. The allele-specific PCR and nested PCRwas performed followed by Agarose gel electrophoresis and Sanger sequencing method confirmed mutation positive sample.

Results: Overall 13/30 (43%) patients have been detected positive for known mutations. Maximum mutations were found in SPINK gene. While 8/30 (27%) patients were SPINK mutation positive, 4/30 (13%) patients were PRSS mutation positive and one patient was positive for CTRC mutation. No mutation was detected in CFTR gene in these 30 patients.

Among SPINK gene mutations, SPINK N34S mutation is the most common, detected in 6 (20%) patients. SPINK 1 IVS1-37T>C and SPINK1 P55S mutations were detected in 2 patients each & SPINK 1 IVS3+2T>C was detected 01 patient. Those two patients who were positive for SPINK1 P55S had SPINK N34S mutation as well. Similarly one out of the two patients positive for SPINK 1 IVS1-37T>C mutation, also had SPINK N34S mutation. Only patient who had SPINK 1 IVS3+2T>C mutation positivity, was also positive for SPINK N34 S & PRSS1N29I.

Among PRSS1 gene mutations, PRSS1N29I is the most common, detected in 04 patients. One patient has PRSS1 R122H mutation positivity; however, that patient was also positive for PRSS1N29I gene mutation. Only one patient was positive for CTRC gene in CTRC EXON 2-3. No mutation wasdetected in CTRC promoter region & other Exons.

Conclusion: In our study of 30 FCPD patients, 43% patients are associated with various known genetic mutations. SPINK mutations are most common (27%) with SPINK N34S being most common (20%). PRSS mutations are the second most common mutations, seen in 13% patients with PRSS1N29I being present in all such cases.
Abstract 119
Authors: Naushad Altaf Ali , Kalra Pramila
Published: February 2023

Background: Congenital hypogonadotropic hypogonadism (CHH) is a rare genetic disorder characterized by infertility and the absence of puberty. In patients with CHH, the genetic profile is heterogeneous, and more than 40 genes are involved either alone or in combination with one another. Mutations in the FN3 (fibronectin-3) superfamily of genes encode proteins involved in GnRH neuron ontogeny. One such gene is the NDNF (neuron derived neurotropic factor) gene which has been established in mouse and zebrafish knockout models to manifest with altered GnRH migration and also in humans recently as CHH with anosmia or hyposmia.

Case Report: A male child aged seven years and three months, born of second-degree consanguinity, presented with complaints of small sized penis and bilateral undescended testes since birth. There was no significant antenatal history nor any history suggestive of salt wasting, virilization or failure to thrive in infancy. At nine months of age, he underwent diagnostic laparoscopy & bilateral orchidopexy. Child had normal developmental milestones and was cheerful and attentive in class.

The child on examination had facial dysmorphism with triangular facies and prominent ears, normal vital signs and no midline defects. Anthropometry was essentially normal and SMR was notable for micropenis, 1cc right inguinoscrotal testis and non-palpable left testis with hypoplastic scrotum and an EMS of 6.5. He also had synkinesia with normosmia. Rest of the systemic examination was normal. Clinical diagnosis of congenital hypogonadotropic hypogonadism was considered. Review of prior investigations showed low gonadotropins recorded at mini-puberty, XY karyotype and an hCG stimulation test with non-stimulable testosterone (59.6 ng/dL). Prior USG showed right inguinal canal and left intra-abdominal testes with normal adrenals. The thyroid, GH and cortisol axes tested normal. Genetic analysis with whole exome sequencing showed heterozygous pathogenic mutation of exon 4 of NDNF gene.

Conclusion: This case highlights thephenotypeofanovelmutation involving the NDNF gene that has been recently implicated in CHH in humans. This patient had clinical and biochemical features of hypogonadotropic hypogonadism with normosmia and synkinesia, along with facial dysmorphism. This phenotypic combination has not been described previously with this gene mutation.
Abstract 123
Authors: Nair Vineet , Kalra Sanjay , Gupta Nishul , Nair Akanksha , Vasan Pallavi , Agarwal Bharat
Published: February 2023

Background: Higher diabetes distress is often associated with poor glycemic control andcompromised diabetes self-care. This study highlights the significance of evaluating diabetesdistress through a digital therapeutics platform and the association of diabetes distress with HbA1c.

Methods: De-identified data of 1600 participants with Type 2 Diabetes Mellitus (T2DM) enrolledin Fitterfly Diabetes Digital Therapeutics Program across India (557 females and 1043 males withmean age = 47.65 years and SD = 11.50) were analyzed. The change in diabetes distress wasanalyzed using 17-item Diabetes Distress Scale (DDS) with participants reporting high distress (Score ³3.0), moderate distress (Score 2.0-2.9), and little or no distress (Score < 2.0). HbA1c values were collected at the beginning of the program. Virtual consultations with psychologistswere provided to each participant as part of the Fitterfly Diabetes program along with severaldigital interventions and expert-led care. Spearman correlation was used on SPSS for statisticalanalysis and P < 0.05 was considered as statistically significant.

Results: Diabetes distress was reported to be high among 21% (355/1600), moderate among 25% (398/1600) and low among 54% (867/1600) of participants. Analysis of DDS subscalesshowed that high-moderate level of emotional distress, regimen distress, physician distress, interpersonal distress was present in 60.37% (966/1600), 58.68% (939/1600), 32.56% (521/1600), and 30.43% (487/1600) respectively. At the beginning of the program, HbA1c atbaseline was found to be significantly correlated with overall distress (r = 0.18, P = 0.001), emotional burden (r = 0.17, P = 0.001), physician distress (r = 0.108, P = 0.001), regimen distress (r = 0.179, P = 0.001) and interpersonal distress (r = 0.091, P = 0.001).

Conclusion: The study highlighted the wide prevalence of high-moderate levels of diabetes distress amongpeople with T2DM. Pre-program HbA1c level showed significant correlation with overall distressand subscale distress scores. This showed that diabetes distress level was significantlyassociated with the glycemic control among participants. Fitterfly Diabetes digital therapeuticsprogram can help in providing easy access to multidisciplinary teams including trained clinicalpsychologists for reducing diabetes distress, thereby assisting the physicians to provide a holisticdiabetes care with better outcomes.
Abstract 126
Authors: Arunava Ghosh , Piyas Gargari , Nisha Batra , Subhankar Chowdhury , Satinath Mukhopadhyay
Published: February 2023

Background: Octreotide long-acting release (LAR) is a medication used for acromegaly thatcan normalize insulin-like growth factor-1 (IGF-1) and serum growth hormone (GH) levels, leadto tumor shrinkage, and improvement of symptoms of disease activity. Previous studies arelacking regarding the long-term efficacy in Indian populations. This retrospective study aimed toevaluate its effectiveness in a cohort of Indian patients with acromegaly.

Methods: Overall, 26 patients with acromegaly, who received regular octreotide LARtreatment at least 6 times at SSKM & IPGMER Hospital between 2017 and 2022, were included. Epidemiological characteristics, acromegaly activity, IGF-1 levels, MRI data pre and posttreatment were collected for investigation.

Results: The study registered 26 patients, including 10 men (38%) with a mean age 33 years. After octreotide LAR therapy, 82% of the patients achieved IGF-1 control (<250 ng/dL). 15 patients had reduction in features of disease activity; at baseline 83% patients had clinicallyactive disease. MRI data at both baseline & current (minimum of 6 months following initiationof therapy) was available in 14 patients; 6 had reduction in tumor size by 50% & 8 had reduction < 50% on MRI compared to baseline. During the follow-up, 1 of the patients discontinuedoctreotide LAR.

Conclusions: Our study revealed that octreotide LAR therapy is effective in normalizing IGF1 levels in Indian acromegaly patients. It is also effective agent in alleviating symptoms andinducing tumor shrinkage. It should be recommended for post-surgical residual disease, and alsobe considered as primary therapy for selected cases, mainly for those with a low probability ofsurgical cure or those with contra-indications for surgery.
Abstract 129
Authors: Joy Elsa , LancyMorries  , John Anulekha Mary , Joseph Mariamma , Francis Anju K , Finny Philip
Published: February 2023

Background: Proper insulin administration technique plays an important role in achieving optimal glycaemic control. Errors in administration can lead to both hypoglycaemia and hyperglycaemia related problems.

Objective: To identify the common errors in insulin administration and to associate it with glycaemic control, hypoglycaemic events and relation to insulin injection site complications.

Methods: Cross sectional descriptive study was conducted among 100 diabetic patients attending the Endocrinology OPD of a tertiary care hospital over a period of 1 month. A structured and detailed questionnaire was prepared to collect data on patient profile, laboratory parameters and practices of insulin administration. Data was analysed using SAS ODA software.

Results: There were a total of 100 patients. There were 50 men and 50 were above the age of 60 years. Mean HbA1c was 8.86 ± 1.84. Fourteen common errors in insulin administration were enquired for in each subject. Most of our patients were well aware of the cold chain (98%) but 55% did not check the expiry date before buying insulin. Though 95% stored insulin correctly 39% were not aware of how to carry insulin while travelling. Insulin was injected into the wrong site (41%) and 84 did not rotate the injection site resulting in injection site complications (40%). Skin fold was not pinched up appropriately by 76 and the wrong angle of injection was used by 58% of our subjects. Insulin syringes and needles were inappropriately recapped by 85% of our patients. 64% of patients did not change insulin syringes / needles at healthy intervals. There were 20 patients who experienced hypoglycemia but severe hypoglycemia was seen in only 4 subjects. There was no difference in the error rates with respect to gender, age or duration of diabetes. Errors being so ubiquitous we were not able to establish any meaningful association with HbA1c levels.

Conclusion: Insulin administration is a sure way of controlling hyperglycemia. However inappropriate techniques of insulin administration and storage can negate the glucose lowering efficacy of the drug. Insulin errors are to be looked for and tackled carefully in order to achieve optimal glycemic control.
Abstract 132
Authors: Raghuraman R , Saikia Uma Kamal , Bhuyan Ashok Krishna , Baro Abhamoni
Published: February 2023

Background: PSIS is a rare entity characterized by a triad of an absent or hypoplastic anterior pituitary, thin or absent infundibulum and/ or ectopic posterior pituitary. PSIS has multiple theories for its cause: perinatal injury/ genetic abnormalities/ multifactorial causing defective pituitary development leading to MPHD.

Objective: The primary objectives were to evaluate the clinical characteristics, hormonal abnormalities of the pituitary stalk interruption syndrome (PSIS) patients at presentation and determining the predictors for Multiple Pituitary Hormone Deficiency (MPHD). The secondary objectives were to assess the response of rGH therapy and development of new pituitary hormonal deficiencies during follow up.

Methods: This retrospective longitudinal study involves 14 PSIS patients confirmed radiologically presenting to Endocrinology department in Gauhati Medical College, Guwahati, Assam from 2017 to 2022. All other causes of pituitary hormonal deficiencies were excluded. Statistical data were analyzed using XLSTAT software with chi squared test and t test, Pearson correlation for categorical and continuous variables respectively. Descriptive analysis was expressed in terms of mean, median and percentages.

Results: Majority of the PSIS patients were male (n = 10, 71%) with median age of presentation (12.15 years) and short stature being the most common presenting complaint (n = 13, 93%) and one patient (2-month child) presented with hypoglycemia. Midline defects seen were micropenis (n = 4, 29%), cleft lip (n = 1, 7%) and single central incisor (n = 1, 7%). Among the hormonal axis, GH deficiency was the most common (n = 14, 100%) followed by T4 (n = 5, 36%), cortisol (n = 4, 29%) deficiency and none had Diabetes Inspidus. Gonadotropin (Gn)(n = 2) deficiency was seen in 2/4 patients with delayed puberty. Among radiological characteristics, anterior pituitary hypoplasia is most common (n = 13) followed by ectopic posterior pituitary bright spot (PPBS) (n = 11), thinned out stalk (n = 5) and absent PPBS (n = 3). The predictors of MPHD were hyperprolactinemia (x2 -7.77, p-0.005) and midline defects (x2 -4.66, p- 0.03). On follow up, 4 patients developed new hormonal deficiencies with T4 deficiency (n = 2), cortisol def (n = 2) and Gn deficiency (n = 1). Patients showed good response to rGH therapy with initial mean requirement of 0.20 mg/kg/week with mean height velocity- 12.78 cm in 1st year (p < 0.001) and significant increase in IGF1 and height SDS (p < 0.001).

Conclusions: PSIS causes MPHD and diagnosing and following up these patients is important for early identification of new hormonal deficiencies and optimal hormone replacement.