bluuebunny/crossref_metadata_2025 huggingface dataset:
Du bâton de berger à la souris d’ordinateur : quand les savoir-faire administratifs bousculent les savoir-faire pastoraux dans le sud-est de la France
Authors: Richard-Frève Émilie
Published: January 2025

Cet article présente les résultats d'une recherche réalisée, entre le début des années 2000 et 2020, dans le milieu pastoral du sud-est de la France. Il analyse l'évolution d’un groupe professionnel confronté à une bureaucratisation croissante du travail et à des transformations importantes dans ses formes d’organisations sociales. Il décrit une « mise en bureau » du métier qui a induit des recompositions d’identités, un changement des pratiques et de l’éthos professionnel, le tout générant des tensions fortes sur ce qu’il est possible de faire et d’être en tant que berger. Cette bureaucratisation a également transformé les habiletés nécessaires pour pratiquer le métier, conduisant à la maîtrise de savoirs considérés comme exogènes, et transformant les formes de hiérarchisation sociale. Or, contre toute attente, ces savoirs et nouvelles pratiques du métier sont plus acceptés avec le temps. Cet article analyse comment ce contexte de bureaucratisation a permis un processus d’individualisation chez les bergers, entraînant une prise de distance plus importante des individus avec le groupe, ses normes, le travail et son éthique initiale.
Quelle résilience des savoirs des éleveurs de la pédiplaine septentrionale du Cameroun face au défi climatique ?
Authors: Wina Laurent Mininamou
Published: January 2025

L’élevage, en particulier bovin, associé à l’activité agricole occupe une place fondamentale du point de vue des populations de l’Extrême-Nord du Cameroun. La présente étude, menée dans deux terroirs de la pédiplaine de l’Extrême-Nord (Gawar, Moutourwa), vise à mieux comprendre les perceptions des éleveurs et agro-éleveurs du changement climatique et à analyser les stratégies qu’ils développent à partir des savoirs endogènes et résilients pour y faire face. Les données ont été collectées au moyen d’entretiens individuels et de focus group auprès de 10 familles d’éleveurs et agro-éleveurs (80 enquêtés), appuyés d’une recherche documentaire variée. Les résultats montrent que ces derniers réagissent en développant des stratégies adaptées qui reconduisent des connaissances séculaires tout en les améliorant.
Pourquoi les femmes disparaissent-elles des yourtes ?
Authors: Lacaze Gaëlle
Published: January 2025

Cet article analyse comment les transformations de trente dernières années ont profondément affecté le mode de vie pastoral nomade mongol et la division sexuelle du travail qui y dominait. Il exemplifie ces mutations à travers différents éléments ethnographiques principalement issus de recherches effectuées dans le désert de Gobi. Il montre comment les stéréotypes genrés issus des traditions pastorales nomades mongoles se déploient dans les transformations socialistes et postsocialistes, surtout depuis 2010 et le développement de l’exploitation des ressources minières. Cette dernière période questionne les possibilités de résistance et de résilience du système pastoral nomade extensif pratiqué en Mongolie. Cet article part de la division « complémentaire » du travail dans le pastoralisme nomade, ainsi que des représentations genrées auxquelles elle renvoie, pour déboucher sur les transformations engendrées par l’idéologie socialiste, selon laquelle l’émancipation des femmes constituait un indice de progrès, et enfin sur les changements contemporains, qui divisent les ménages entre les hommes seuls sur les campements ruraux et les femmes assignées aux espaces urbains. La disparité ville-campagne, qui implique une différence entre modes de vie nomade et sédentaire, signifie d’ores-et-déjà une opposition genrée entre un masculin rural et un féminin urbain. Or, cette dernière configuration fragilise l’élevage nomade tandis que le PIB de la Mongolie se nourrit chaque année davantage des ressources minières qui pourraient alors s’avérer la seule alternative face au sous-aménagement urbain et au fort taux de chômage en ville pour les jeunes peu diplômés, en particulier pour les hommes. La transmission des savoirs et savoir-faire pastoraux s’en trouve donc compromise.
Le tricolore enflammé
Authors: Bottini Giorgio
Published: January 2025

Cet article propose une analyse comparative de la trajectoire du parti Frères d’Italie et de la biographie de l’actuelle Présidente du Conseil des ministres, Giorgia Meloni, au prisme des relations d’identification réciproque reliant le parti et sa leader. Il s’intéresse à la construction de narrations, aux dispositifs d’autoreprésentation et à la création d’imaginaires. Une attention privilégiée est accordée à l’autobiographie de Meloni, Mon itinéraire, à la stratégie élaborée par son parti sur le long terme ainsi qu’à l’évolution de sa tactique politique au cours de cette dernière décennie. Plus particulièrement, il se penche sur les continuités et discontinuités vis-à-vis de la tradition du post-fascisme, sur sa place par rapport à la droite italienne, sur la recherche d’une distinction à l’égard du populisme, sur sa place hégémonique au sein de la famille du conservatisme européen ainsi que sur les premières indications de sa politique culturelle en matière de redéfinition de l’identité nationale.
Psychosocial Factors of Adolescent Survivors of Human Trafficking in East India
Authors: Shamsudeen Sheeba , Gupta Preeti , Sayeed Neha , Munda Sanjay Kumar
Published: January 2025

Introduction:

Human trafficking is referred to as modern-day slavery and is a human rights violation. India is home to 14 million survivors of trafficking, making it one of the most extensive destination grounds for the trafficking of young girls. Empirical studies on trafficking survivors’ demographic profiles and psychosocial factors are scarce in the Indian context.

Aims and Objectives:

The study determined the various forms of human trafficking and the sociodemographic profile while assessing the psychosocial factors related to pretrafficking, during trafficking, and posttrafficking phases of adolescent female survivors of human trafficking in East India.

Materials and Methods:

A cross-sectional descriptive study was conducted with 30 adolescent girls aged from 13 to <18 years rescued from human trafficking using the Trafficking Victim Identification Tool to collect data on psychosocial factors related to human trafficking.

Statistical Analysis:

The analysis was conducted using SPSS version 25. Descriptive statistics were used to calculate the frequency and percentages to assess the sociodemographic and psychosocial factors of adolescent survivors of human trafficking.

Results:

The results show that most adolescents had experienced physical abuse before trafficking. Most were trafficked by family members or relatives who promised them economic opportunities. During trafficking, most were locked up against their will, experienced physical and sexual violence at the hands of their trafficker, and had no fixed working hours. Most survivors were rescued within 1–3 months of trafficking and had low suicide ideation. In addition, most survivors were unmarried, had primary education, were Hindi-speaking unemployed, Hindu, and from a rural background.

Conclusion:

The study shows that the most pressing psychosocial factors among survivors of human trafficking include physical abuse before trafficking, physical and sexual abuse by traffickers, and being trafficked by known persons with a promise of economic opportunity. As trafficking is an unrelenting public and mental health concern that transcends all social classes and demographics, further dialogue is needed on survivors’ long-term consequences as the world wakes up to the reality of this modern form of slavery.
Assessment of Day Care Centers under Public Mental Health Program in a District of Kerala: An Observational Study
Authors: Sathiaseelan Ramkumar G. , Kumar Prasad R
Published: January 2025

Introduction:

Day care is a component of service provisioning for persons with severe mental illness living in the community. This study assesses day care centers under a public mental health program in a district of Kerala.

Methods:

We did a documentary review of program documents to describe how the day care program had envisaged its structure, function, and expected outcome. Field visits were made to assess the centers on the same attributes. The lead staff members and all program attendees were interviewed. The sociodemographic and clinical profile was assessed while disability was measured using the WHODAS 2.0 12-item Scale.

Results:

The two centers were assessed 8 years after their inception. The centers functioned as drop-in-type social care facilities located on local government premises, and each center was serviced by a nursing personnel, a nursing attendant, and a social work personnel who worked as an occupational therapist and program coordinator for both centers. The estimated cost of running each center was 20 lakhs/year. Occupational therapy activities were geared toward day engagement and did not aspire to impart vocational skills or employment opportunities onsite or outside and almost all work-based occupational therapy activities fizzled out after a limited trial. Centers catered to both persons with mental illness and intellectual developmental disorders. There was no formal exit plan for the attendees, the mean duration of attendance was 4.4 ± 2.63 years, the total attendees since inception were 75, and the currently active number was 28. Nonspecific reasons and family inconvenience were noted as reasons for disengagement. Disability assessment revealed a mean score of 8.45 ± 6.8 (median 6.5, range 0–27), indicating low levels of disability, although 60% were formally certified with median disability of 60%. Overall, staff opined, based on their interactions with the attendees’ families, that day care attendance offered benefits over routine outpatient care in terms of providing a meeting place outside the home for recreation and socialization.

Discussion:

Our assessment concludes that the modest benefits that attendees get from the centers are derived largely from the socializing and companionship that the meeting place provides. We suggest that more such drop-in centers can be started with a lesser cost outlay while at the same time upgrading the existing ones with more resources to derive greater benefits than from the current meeting place orientation.
Correlation of the cycle threshold value of SARS-CoV-2 by RT-PCR with biomarker levels in the prognosis of patients hospitalized with COVID-19
Authors: Singhal Shweta , Rana Geetika , Singh Atul K. , Pal Shekhar , Thaledi Shweta
Published: January 2025

ABSTRACT

Background and Objective:

The COVID-19 disease caused by SARS-CoV-2 was declared as pandemic by WHO soon after its emergence in 2019. This virus was known to cause serious clinical symptoms and severe illness. By using RT-PCR, which reports the cycle threshold value, the disease is diagnosed, whereas for the severity of the disease, biomarker levels, like IL-6, CRP, D-dimer, serum ferritin and serum procalcitonin, can be measured. We, thus, aimed to explore any potential correlation of the cycle threshold value and biomarker level with the outcome of COVID-19-positive hospitalized patients.

Method:

Patients with the cycle threshold (Ct) value <35 were included in the study and their initial Ct values were noted. Different biochemical parameters, such as C-reactive protein (CRP), serum ferritin, D-dimer, Interleukin-6 and serum procalcitonin, were assessed for severity. They were classified according to Ct value into three groups: Group 1 >30.0, Group 2 20.0–30.0 and Group 3 <20.0.

Results:

The study included 370 hospitalized COVID-19 patients with a mean age (mean ± SD) of 51.08 (16.58%) years and 250 (67.5%) males and 120 (32.4%) females. Comparison of data with outcome shows that IL-6, CRP amongst the biomarker and Ct value (deduced by RT-PCR test) were significantly correlated with the mortality (P value < 0.05). The ROC curve was also plotted for these parameters, which shows that IL-6, CRP, PCT and Ct value were better prognostic marker. Poor prognosis was found in Group 2 (Ct value 20.0–30.0) patients compared to Group 1 and Group 3. There was significant correlation (P value < 0.05) between Ct value and outcome of the patient.

Interpretation and Conclusion:

This study depicts that low Ct value and elevated levels of IL-6 and CRP can be used as a screening tool to detect the mortality in COVID-19 patients as they are significantly correlated with the mortality.
Are all tuberculosis deaths correctly attributed due to tuberculosis? Analysis of causes of death (COD) using verbal autopsy: A cross-sectional study in Puducherry
Authors: Mohan Reenaa , Rajalakshmi M , Kalaiselvan G
Published: January 2025

ABSTRACT

Background:

State Task Force National Tuberculosis Elimination Programme (STF-NTEP) wanted to ascertain the cause of death of tuberculosis (TB) patients was due to TB. Hence, this study was done to determine the cause of death among TB patients using verbal autopsy.

Material and Method:

The community-based cross-sectional study was conducted among the closest caregivers of the reported TB death cases using a verbal autopsy questionnaire. A list of TB deaths was extracted from Puducherry’s State Tuberculosis Office (STO). The VA questionnaires were reviewed by two trained faculties and experts independently who were also asked to code the cause of death according to the International Classification of Diseases – 10th Revision. Data were analysed using the SPSS software receiver operator curve (ROC) curve and Cohen’s kappa statistics with 95% confidence interval (CI) were applied to compare agreement between the raters.

Results:

Out of 307 TB deaths, 143 were contacted and the remaining were migrated, missing or not available. Among them 34.9% of the declared TB deaths are not due to TB. Cohen’s kappa = 0.4; 95% CI: (0.858–0.985) showed moderate agreement between the raters. Experts’ review was used as a reference standard to compare rater agreements. The Predictive accuracy of Rater 2 (area under the curve [AUC] −0.953; P value <0.001) was slightly higher than Rater 1 (AUC −0.942; P value <0.001).

Conclusion:

The findings of the study have clearly indicated that 34.9% of the declared TB deaths are not due to TB.
A study on awareness regarding cigarettes and other tobacco products act (COTPA Act) among hospital staff of medical college, Kanpur: A mixed method study
Authors: Yadav Aradhana , Sonam  , Kaur Samarjeet , Barman Santosh K. , Barman Seema
Published: January 2025

ABSTRACT

Context:

In 2003, the government of India formulated “the cigarettes and other tobacco products Act (prohibition of advertisement and regulation of trade and commerce, production, supply, and distribution) (COTPA)”. The aim of the study is to evaluate hospital staff’s knowledge of the COTPA Act and their enablers and hurdles using qualitative analysis.

Settings and Design:

This study was conducted in GSVM Medical College, and this was a convergent parallel mixed-methods study, with a quantitative component (cross-sectional survey) complemented by a qualitative component (descriptive study).

Methods and Material:

A pre-tested, semi-structured, face-validated questionnaire was incorporated into the Epicollect5 application for data collection. The qualitative study was conducted among 11 hospital staff.

Statistical Analysis Used:

The collected data were imported into a Microsoft Excel spreadsheet and analysed with Jamovi version 2.0. To determine associations between variables, appropriate tests of significance were applied. For qualitative analysis, an interview guide was prepared.

Results:

On quantitative analysis, hospital personnel’s overall awareness of any tobacco control law was 59.4%, with 56.6% being tobacco abusers and 69.5% being non-abusers. On qualitative analysis by in-depth interview framework analysis, decalogues were taken from the responses provided by the participants. After that, the decalogues were divided into three keynotes which were openers, hurdles, and recommendations.

Conclusions:

Study demonstrates that more than half of the employees are already aware of COTPA Act but still need more coordinated effort from all responsible authorities of medical institute to increase COTPA Act awareness.
Efficacy of ultrasonography and mammography in detecting features of breast cancer
Authors: Alshoabi Sultan Abdulwadoud , Alareqi Amal A. , Gameraddin Moawia , Gareeballah Awadia , Alsultan Kamal D. , Alzain Amel F.
Published: January 2025

ABSTRACT

Introduction:

Breast cancer (BC) is considered one of the most commonly diagnosed cancers. Early detection is critical for effective management. This study aims to assess the utility of ultrasonography (US) and mammography (MG) in detecting BC features.

Methods:

This retrospective cross-sectional study involved the electronic records of 263 female patients diagnosed with BC. The mean age was 45.71 ± 12.25 years (17–90 years). A cross-tabulation test was performed to correlate the presence of each malignant feature (Yes/No) on both US and MG and the final ultrasonography diagnosis (benign/malignant). The compatibility between the presence of each feature on both imaging techniques was measured by the percentage of agreement in reporting the feature that was reported as Kappa. The sensitivity and specificity for each feature were calculated, and the receiver operating characteristic curve was used to measure the area under the curve for each feature on both modalities.

Results:

The strong compatibility between the two techniques was 87.1%, 94.29%, 66.92%, 79.85%, 77.56%, 77.18, and 79.84% for irregular shape, uncircumscribed, spiculated margins, tissue distortion, nipple retraction, skin thickening, and the presence of lymphadenopathy, respectively (P < 0.001). Boxplots show that the sensitivity of the US ranged from 37% to 95%, and the specificity ranged from 27% to 91%. However, MG’s sensitivity ranged from 44% to 93%, and the specificity ranged from 36% to 73%.

Conclusion:

US and MG images show similar morphological changes, enhancing diagnostic accuracy in breast lesions. US characterizes echogenicity, provides real-time imaging, and uses color and pulsed Doppler techniques for vascularity and lymphadenopathy detection, while MG is better for identifying different calcification types.
An unusual presentation of rhinosporidiosis in the lacrimal sac – A case report and a literature review
Authors: Muni Raja Ayyakutti , Marappan Harikrishnan , Asim Najma
Published: January 2025

ABSTRACT

Rhinosporidiosis is a rare granulomatous disease affecting the nasal mucosa, nasopharynx, skin and eyes due to Rhinosporidium seeberi. Lacrimal Sac involvement is very rare. Hence, we report an unusal presentation of rhinosporidiosis in lacrimal sac area in an adult male patient who presented with painless boggy swelling in lacrimal sac area with positive history of bath in pond and diagnosis was confirmed with histopathological examination. To prevent the recurrence, the patient was treated with 5% Povidone Iodine intra operatively and use of oral Dapsone (100 mg/day) for three months post-operatively.
Exploring smartphone utilization patterns, addiction, and associated factors in school-going adolescents: A mixed-method study
Authors: Ladani Hemangi M. , Yogesh M , Trivedi Nidhi S. , Gandhi Rohankumar B. , Lakkad Dhruv
Published: January 2025

ABSTRACT

Background:

Smartphone use and addiction among adolescents is an emerging public health concern. This study aimed to assess smartphone use, addiction, patterns of use, and associated factors among adolescents.

Methods:

An institutional-based mixed-method study was conducted among 560 adolescents aged 15–19 years. Data were collected on smartphone use, and addiction assessed by a Short Version of the Smartphone Addiction Scale (SAS-SV), patterns of use, and correlations with demographic factors, physical health, and psychological symptoms. Statistical analysis included percentages, logistic regression, and tests of significance. A P value of < 0.05 is considered significant.

Results:

Smartphone use prevalence was 89.8% [95% CI (87.09%–92.49%)], and addiction prevalence was 64% [95% CI (62.66%–72.34%)] among users. Factors associated with smartphone use are statistically significant based on adjusted odds ratios (AOR), which were urban residence [2.5 (1.8–3.8)], use of handsfree kit [2.04 (1.56–2.95)], illiterate father’s education [2.7 (1.9–7.8)], illiterate [2.38 (1.98–5.7)], primary/secondary educated [2.15 (1.06–4.3)] mother’s education, and addiction [3.2 (1.7–4.3)]. Addicted users showed higher use for gaming, videos, and social media (P < 0.05). No significant physical or psychological health differences were found between addicted and non-addicted groups.

Conclusions:

Smartphone addiction (SA) was highly prevalent among adolescents. Use patterns, such as gaming and social media, as well as perceptions of harm, were implicated in addiction risk. Tailored interventions are required to address this emerging public health problem among adolescents.
Predictive value of platelet parameters for early-onset pre-eclampsia: A prospective cohort study in a teaching institution in Gujarat, India
Authors: Thakkar DipenKumar , Shihora Jeel , Gandhi Rohankumar , Parmar Rahul , Yogesh M
Published: January 2025

ABSTRACT

Background:

Early-onset pre-eclampsia is associated with severe maternal and perinatal complications. Identifying novel biomarkers for early prediction is crucial for timely intervention and improved outcomes. This study aimed to evaluate the predictive value of platelet parameters, namely mean platelet volume (MPV), platelet distribution width (PDW), and platelet count (PC), for early-onset pre-eclampsia.

Methods:

A prospective cohort study was conducted at a tertiary care hospital in Gujarat, India. Pregnant women (n = 712) between 14 and 18 weeks of gestation were enrolled and followed up until delivery. MPV, PDW, and PC were measured at enrollment. The primary outcome was the development of early-onset pre-eclampsia (<34 weeks). Receiver operating characteristic (ROC) curves were used to evaluate the predictive value of platelet parameters.

Results:

The prevalence of early-onset pre-eclampsia was 5.3%. Women who developed early-onset pre-eclampsia had significantly higher MPV and PDW and lower PC at 14–18 weeks compared to those who remained normotensive. The combination of MPV > 10.2 fL, PDW > 16.5 fL, and PC < 180 × 103/µL had the highest predictive value (AUC: 0.951, sensitivity: 71.1%, specificity: 99.1%). Individual platelet parameters also demonstrated good predictive ability.

Conclusion:

Platelet parameters, particularly MPV, PDW, and PC, measured at 14–18 weeks of gestation, have good predictive value for early-onset pre-eclampsia. Incorporating these parameters into routine antenatal screening could improve the early identification of at-risk women. Further research is needed to validate these findings and evaluate the cost-effectiveness of implementation.
Osteoarthritis of the knee joint and its association with metabolic syndrome: A case control study
Authors: Motwani Rohini , Bodla Arvind Kumar , Peddamadyam Shravan Kumar , Chandrupatla Mrudula , Cherukuri Nagesh , Lakkireddy Maheshwar , Rathod Gunvanti , Challa Sai Ram , Rao Chowdavarapu Raghavendra , Arora Abhishek , Eppakayala Srikanth , Krishna Arcot Reddy Vamsi
Published: January 2025

ABSTRACT

Background:

Osteoarthritis of the knee joint (OAK) represents a leading cause of pain, functional limitation, and diminished quality of life, particularly among older adults. The association between metabolic syndrome (MetS) and OAK is of growing interest due to the potential impact of MetS components on joint health. While evidence suggests that MetS and its components may influence the development of osteoarthritis (OA), the specific relationship between MetS and the likelihood of progressing to a stage of OAK that requires Total knee replacement (TKA) remains underexplored.

Aim:

This study aimed to evaluate the association between osteoarthritis of the knee joint (OAK) and metabolic syndrome (MetS) and to know whether the presence of MetS (or its components) increases the risk of OAK requiring Total knee replacement (TKA).

Methodology:

It is a cross-sectional study that includes patients (males and females) above 50. Data collection was done including demographic details, medical history, physical examinations, and laboratory tests. OAK (≥grade 2 Kellgren-Lawrence) and severe OAK (≥grade 3 Kellgren-Lawrence) were evaluated based on radiological findings.

Statistical Analysis:

Mean, standard deviation, frequencies, and percentages were calculated for baseline characteristics. To analyze the association between qualitative factors and MetS, the Chi-Square test was used. For comparing quantitative factors, the unpaired t-test was employed. A P value of less than 0.05 was considered statistically significant.

Results:

The study involved 107 primary osteoarthritis patients categorized into cases (N = 57), requiring TKA, and controls (N = 50), not requiring TKA. MetS was significantly more prevalent among cases than controls, with 68.4% of cases and 36% of controls testing positive for MetS (P = 0.001). The odds of having MetS were 3.9 times higher in the cases compared to the controls.

Conclusion:

The results of our research could shed light on how MetS affects the onset and course of OAK, guiding primary care and prevention measures. It might also emphasize how critical it is to treat MetS symptoms to lessen the severity of OAK. Understanding whether MetS or its components are linked to an increased risk of TKA could provide crucial insights into preventive and therapeutic strategies for managing severe OAK.
Fortifying defenses: Tactical safety protocols for COVID-19 sub-variant JN.1 in healthcare and laboratory settings
Authors: Sheereen Shazima , Manva Mohnish Z. , Sheereen Shamama
Published: January 2025

ABSTRACT

Introduction:

Primary care physicians are crucial in fighting COVID-19, especially with the emergence of the new JN.1 sub-variant.

Measures to Reduce Risk:

Given your direct exposure to infected patients, it is imperative to establish a protocol for triaging patients with respiratory symptoms and to uphold a minimum distance of 2 meters between patients and primary care physicians. Patients suspected or diagnosed with the JN.1 sub-variant should be advised to wear surgical masks for their protection and others protection. Primary care physicians must also use personal protective equipment (PPE) and maintain strict hand hygiene practices when dealing with these patients. Patient samples should be treated as high risk for contamination, and laboratory procedures should be meticulously evaluated for potential hazards. PPE should be tailored to the procedure.

Conclusion:

To protect the health and well-being of primary care physicians, who play a critical role in addressing the challenges, it is essential to strictly adhere to infection control measures.
Infertility and risk of ovarian cancer: A systematic review and meta analysis
Authors: Sambasivam Indra , Jennifer H. Gladius , Chinnaiyan Saravanan
Published: January 2025

ABSTRACT

Post-modernization has increased infertility globally. Infertility can cause ovarian, breast, and endometrial cancers. Recent studies have shown that a substantial proportion of couples undergoing infertility treatment develop cancer. However, existing studies yielded inconsistent results. Therefore, we conducted a meta-analysis to determine whether infertility increases the risk of ovarian cancer. Our systematic review and meta-analysis intended to identify the association between ovarian cancer and infertility based on the existing research. In accordance with PRISMA guidelines, this review contains studies on infertility and ovarian cancer as an outcome measure among ovarian cancer groups and those not having cancer. Two authors independently retrieved the articles through electronic databases such as PubMed and Scopus. This review includes 25 studies published worldwide between 2001 and 2022. This systematic review has been registered with the International Prospective Registry of Systematic Reviews (PROSPERO) (CRD CRD42021288860). The systematic review included 25 articles, while the meta-analysis included four. In total, data from 84,49,557 participants in 25 studies were extracted (21 cohort studies and 4 case-control studies). The global prevalence of ovarian cancer among women with a history of infertility was 0.5%. The calculated OR of developing ovarian cancer as a result of infertility was 1.35 (95% CI: 0.92–1.97). The pooled odds ratio of developing ovarian cancer as a result of infertility drug use was 0.93 (95% CI: 0.94–2.46). Pooled effect was shown to be stable and reliable by cumulative meta-analysis. The current meta-analysis showed that women who used infertility drugs had a higher risk of developing OC than those having a history of infertility.
Serum hepcidin level with iron profile assay might replace bone marrow iron study as a diagnostic tool for evaluation of anemia in elderly without chronic renal disease
Authors: Manna Sukdev , Chakrabarti Sankha Shubhra , Singh Rohit , Gambhir Indrajeet Singh
Published: January 2025

ABSTRACT

Background:

The bone marrow iron study is the gold standard for differentiation of the two most common causes of anemia i.e. iron deficiency anemia (IDA) and anemia of chronic disease (ACD) in the elderly. However, it is often not feasible to do bone marrow examination (BME) in every elderly anemic patient, due to its invasive nature. Hepcidin, a liver-derived peptide, has been identified as the key systemic regulator of iron homeostasis. Our study highlights the potential diagnostic role of serum hepcidin in the evaluation of anemia in elderly.

Methodology:

Hundred elderly patients (≥60 years of age) having iron deficiency anemia (IDA) or anemia of chronic disease/inflammation (ACD) were the study subjects with 15 age-matched healthy controls. All patients were evaluated with history, clinical examination, routine investigations (complete blood count, liver, and kidney function tests), iron profile, and serum hepcidin. The bone marrow iron study was done in every patient to categorize them as IDA and ACD.

Results and Discussion:

Serum iron, TIBC, MCV, ferritin, and serum transferrin saturation values were differing significantly between IDA and ACD groups. Serum hepcidin levels can be used confidently to differentiate ACD from IDA (P value <0.001). At serum concentration, 198.82 ng/mL sensitivity of hepcidin to differentiate ACD from IDA was 93.9% and specificity was 92.2%. A subset of patients is misdiagnosed when the serum hepcidin level is used as a sole marker, and this also holds true for serum ferritin.

Conclusion:

Though serum hepcidin level correlates well with serum iron profile and also serum hepcidin appears to be a useful marker to differentiate ACD from IDA in terms of both sensitivity and specificity, the combined assessment of serum hepcidin and iron profile appears to be a better marker than ferritin and hepcidin alone. This could replace the use of bone marrow iron staining as a diagnostic tool in anemia in elderly.
Early childhood caries and their association with serum iron, serum ferritin, serum albumin, and Vitamin D
Authors: Megha Vasundhara , Shukla Jeevendra Nath , Singh Rajat Kumar , Mukherjee Chitrita Gupta , Anand Siddharth , Singh Aparna
Published: January 2025

ABSTRACT

Aim:

The present study aimed to correlate the association between serum iron, serum ferritin, serum albumin, and Vitamin D with early childhood caries (ECC).

Materials and Methods:

This study was a single-blinded randomized control trial. A total of 200 children aged between 3–6 years were screened for ECC, according to the AAPD guidelines. Out of 200 children, a total of 177 children fulfilled the inclusion criteria. They were divided into two groups: Group 1 consisted of 99 children with ECC and Group 2 (control group) with 78 children. The decayed, extracted because of caries, and filled primary teeth (deft) index were recorded from these children. Blood samples (approximately 2 ml) were collected by an expert nurse in the morning to determine serum levels of iron, ferritin, albumin, and Vitamin D. The data was statistically analyzed using the Mann–Whitney U test, and P value 0.05 was considered significant.

Results:

The mean deft score was 4.83 (±3.54). The mean value of serum iron was 64.66 (±8.35) μg/dl, serum albumin 3.88 (±0.57) gm/dl, and serum ferritin 29.19 (±42.11) ng/ml in ECC children, whereas mean serum iron was 67.78 (±6.17), serum albumin 3.82 (±0.62) gm/dl, and serum ferritin 26.38 (±23.04) ng/ml in caries-free children. Statistically, no significant relationship was observed between serum iron (P = 0.066), serum albumin (P = 0.448), and serum ferritin (P = 0.192) with ECC. The mean value of Vitamin D was 17.44 (±7.59) ng/ml in ECC children and 35.9 (±9.56) in caries-free children who were significantly low in comparison with the non-ECC subjects (P < 0.0001).

Conclusion:

The present study suggests no relationship between serum iron, serum albumin, and serum ferritin with ECC, whereas Vitamin D had an inverse relationship with ECC.

Clinical Significance:

This study sets a benchmark for the dental fraternity and other health specialists to analyze serum iron, serum ferritin, serum albumin, and Vitamin D levels, while generally treating pediatric patients with or without dental caries. Oral health education campaigns should be conducted for public awareness about the importance of iron, ferritin, albumin, and Vitamin D.
Improving neonatal outcome by studying the incidence of maternal group B streptococcus colonization among pregnant women: A prospective observational study
Authors: Rajan Priyank , Sanklecha Mukesh , Gandhi Saloni , Soni Kaushal , Wanjari Mayur , Mittal Gaurav
Published: January 2025

ABSTRACT

Aims and Objectives:

Group B streptococcus (GBS) colonization during pregnancy can lead to invasive infections in neonates including meningitis or sepsis. The major risk factor for neonatal disease is the rectovaginal colonization of GBS during pregnancy and delivery. The objectives of this study were as follows: 1) to screen antenatal patients at 35–37 weeks of gestation for GBS colonization, 2) to determine the prevalence of GBS among pregnant women, 3) to formulate an antibiotic policy with respect to antepartum antibiotic prophylaxis and empiric choice of antibiotics for early onset neonatal sepsis, and 4) to ascertain the maternal and neonatal outcomes in pregnant women with positive GBS colonization.

Material and Methods:

A prospective observational study was conducted among 50 obstetric patients at 35–37 weeks of gestation attending the outpatient and inpatient departments of a tertiary care hospital. High vaginal and rectal swabs were collected and immediately transported to the microbiology lab and were sent for culture and sensitivity testing using the standard culture methods. The incidence of positive cultures was noted and was taken up as a reference for statistical calculations.

Results:

Out of the 50 vaginal samples, one sample showed GBS positivity having a prevalence of 2%. Rectal swabs did not grow GBS for all samples. Neither the pregnant woman nor the newborn showed any symptoms or signs due to GBS. GBS grown in vaginal culture was highly sensitive to benzyl penicillin and other penicillins, cephalosporins, clindamycin, daptomycin, vancomycin, meropenem, and linezolid.

Conclusion:

Based on our findings, screening the patients with routine rectovaginal swabs may not be necessary in our population. Also, empiric treatment with antibiotics for GBS in symptomatic mothers cannot be justified, and hence, GBS should be considered as an insignificant pathogen.
Empowering India’s fight against cervical cancer: Harnessing routine HPV immunisation
Authors: Bhattacharya Sudip , Garg Suneela , Gopal K Madan
Published: January 2025

ABSTRACT

Cervical cancer, driven by human papillomavirus (HPV) infection, presents a significant health challenge in India, marked by high morbidity and mortality rates among women. This systemic review synthesises the latest research on HPV epidemiology in India, evaluates the effectiveness of existing vaccination programmes and compares India’s strategies with those of countries that have successfully mitigated cervical cancer burden. Despite available vaccines targeting high-risk HPV types, vaccine coverage remains suboptimal due to challenges, such as accessibility, vaccine hesitancy and socioeconomic barriers. Comparative analysis suggests that school-based and community engagement strategies could enhance vaccination efforts. Addressing India’s cervical cancer burden requires a multifaceted approach that includes expanding HPV vaccination coverage, implementing public awareness campaigns and adopting best practices from global successes. Economic analyses affirm the cost-effectiveness of such strategies, highlighting the potential for significant public health and financial benefits.
HPV vaccination knowledge, attitude, and practices among physicians in a teaching hospital, Karachi
Authors: Memon Sehrish Habib , Tariq Bhombhal Swaleha
Published: January 2025

ABSTRACT

Context:

Cervical cancer is a global public health problem. It is the fourth most common cancer in women globally. Human papillomavirus (HPV) vaccine has reduced the incidence of HPV-related illness in the past decade. However, for the vaccination programs to be successful, recommendation by the primary care physicians is essential.

Aims:

The aim of this study was to evaluate the knowledge, attitude, practices, and barriers toward HPV vaccination among physicians practicing at a teaching hospital in Karachi, Pakistan.

Settings and Design:

This is a cross-sectional study carried out with a sample size of 165 among doctors practicing in Family medicine, Internal medicine, Pediatrics, and Gynecology outpatient clinics at a teaching hospital.

Methods and Material:

Physicians were approached in outpatient clinics, and a pilot-tested coded questionnaire was filled by them. Statistical Analysis Used: Data were analyzed using SPSS version 19.

Results:

Results show 22.4% males and 77.6% females participated in the study. 20% were internists, 35.2% were family physicians, 18.8% were pediatricians, and 26.1% were gynecologists. In terms of knowledge, 67.2% physicians showed good knowledge. In terms of attitude, it was found that 90.9% of physicians showed positive attitude toward prescribing HPV vaccine. However, only 37.5% physicians prescribed HPV vaccine to patients. Cost of vaccine, time constraints, and lack of knowledge among female patients were recognized as the most common barriers against prescribing the vaccine.

Conclusions:

From these results, we can infer that overall practices of our physicians are lacking, with respect to prescribing the HPV vaccine. Positive attitude should be taken as an advantage, and overcoming the barriers should be considered as the next step for improvement of our practice.
Knowledge, attitude and acceptability for long-acting reversible contraceptive (LARC) methods among women attending contraception counselling sessions: A cross-sectional study
Authors: Gupta Paridhi , Mahey Reeta , Varun Neha , Kaur Maninder , Kumar Arun , Yadav Satyam
Published: January 2025

ABSTRACT

Aims:

To study the knowledge, attitude, and acceptability of Long-acting Reversible Contraceptive (LARC) methods among women attending contraception counselling sessions.

Settings and Design:

A cross-sectional study conducted in the family planning clinic of a tertiary care hospital.

Methods and Material:

Women aged 18–45 years attending contraception counselling sessions were included. Baseline knowledge about LARC methods was assessed. They were given information about LARC methods. Acceptability was assessed on a scale of 0–10.

Results:

Among four LARC methods, awareness about copper intrauterine devices (CuIUD), DMPA injection, subdermal implant and Mirena was 95%, 55.50%, 27% and 3%, respectively. Around 4% were unaware of the LARC method. Of total, 76.50% women procured the LARC methods information from health care workers, whereas 40% attained from friends, family members, neighbors, or colleagues. After counseling, the majority (58%) were willing for subdermal implant. About 27.50% and 13.50% were willing for copper IUD insertion and injection DMPA, respectively. None was willing for Mirena. Acceptability of various LARC methods was scaled on an acceptability score from 0 to 10. For Cu IUD, implanon and DMPA, the acceptability score was 10 in 50%, 40.17% and 25%, respectively.

Conclusions:

There are still gaps of knowledge about benefits and safety of available LARC methods. To improve wide coverage and more acceptability of LARC methods, involvement of health care workers and addition of subdermal implants to contraceptive counseling should be considered.
Long-term antibody responses to COVAXIN and COVISHIELD vaccines in rheumatoid arthritis patients and healthy control population – A cross-sectional study
Authors: Parimi Vijaya Prasanna , Pyati Anand , Eerike Madhavi
Published: January 2025

ABSTRACT

Background:

Rheumatoid arthritis (RA) is a chronic autoimmune disease that causes inflammation and damage in the joints. It often requires treatment with disease-modifying antirheumatic drugs (DMARDs) to manage symptoms and prevent progression. The study investigates the long-term antibody responses to COVAXIN and COVISHIELD vaccines in RA patients.

Methodology:

This cross-sectional study (IEC approval no: AlIMS/BBN/IEC/AUG/2021/60-R dated Sept 05, 2022, and Ref No: 799/U/IEC/ESICMC/F490/09/2022 dated Oct 31, 2022) enrolled 103 diagnosed RA patients receiving DMARDs and 183 healthy controls. The participants who completed 1 year after the second dose of vaccination were included, and detailed information on demographic, medical, and vaccination were collected. Laboratory investigations included complete blood count, inflammatory markers, and antispike antibody levels. Statistical analyses assessed differences between COVAXIN and COVISHIELD subgroups, considering DMARDs usage and disease duration.

Results:

Among RA patients, both COVAXIN and COVISHIELD groups exhibited low disease activity. No significant (P > 0.05) differences were found in IL-6, CRP, or antispike antibody levels between COVAXIN and COVISHIELD subgroups in RA patients and healthy controls. Notably, 89% of female RA patients received COVISHIELD. Co-morbidities, including hypothyroidism (44%), were prevalent in COVISHIELD-received RA patients. Antibody concentration varied significantly among DMARDs usage groups in COVAXIN-vaccinated RA patients, with a notable difference between three-drug and HCQ-alone regimens. However, no such difference was observed in the COVISHIELD group. Disease duration did not significantly impact antispike antibody concentration in either of the vaccination group.

Conclusion:

RA patients had a decreased antibody response, 1 year after receiving the second dose of the COVID-19 vaccine. Nonetheless, there was no discernible difference in the antispike antibody concentration between the COVISHIELD and COVAXIN vaccination groups. Additionally, immunosuppressive medications significantly impact serological responses to these vaccines.
Frequency and Correlates of Elevated Serum Carbohydrate Antigen 19-9 Levels in a Cohort of Nigerians with Type 2 Diabetes Mellitus
Authors: Lawal Abimbola O. , Adeleye Jokotade O. , Esan Arinola , Sonuga Oyebola O.
Published: January 2025

Background:

Elevated levels of serum carbohydrate antigen (CA) 19-9 previously associated with pancreatic cancer have also been found in nonmalignant disorders including type 2 diabetes mellitus (T2DM). Serum CA 19-9 levels were found to correlate with glycemic control among Asian and Caucasian T2DM populations but have not been well investigated among the sub-Saharan African populace, especially Nigerians.

Aim:

This study was conducted to determine the frequency of elevated serum CA 19-9 levels among the African population with T2DM and its relationship with short- and long-term glycemic control.

Materials and Methods:

This was a case–control study of 64 T2DM Nigerian patients and 64 age and sex-matched apparently healthy controls. Demographic data, anthropometric measurements, and blood samples for serum CA 19-9, glycated hemoglobin, and fasting plasma glucose were analyzed in all participants. Data were analyzed using Statistical Package for Social Sciences version 25.0.

Results:

The median serum CA 19-9 level of cases was higher than that of the controls (12.80 U/mL vs. 8.0 U/mL; P = 0.287). The frequency of elevated serum CA 19-9 was significantly higher in the cases than that of the controls (15.6% vs. 4.7%; P = 0.046). The unadjusted logistic regression showed cases were three times more likely to have elevated serum CA 19-9 [odds ratio (OR) 3.76; 95% confidence interval (CI) (1.00–14.39)], whereas adjusted logistic regression showed T2DM was associated with higher odds of elevated CA 19-9 [adjusted odds ratio = 9.075; 95% CI (1.068–77.100)], which is statistically significant. Elevated fasting plasma glucose increased the odds of elevated serum CA 19-9, but was not statistically significant.

Conclusion:

The frequency of elevated serum CA 19-9 was significantly higher in persons with T2DM and had a significant positive association with diabetes status among a cohort of Nigerians with T2DM.
Management of subtrochanteric femur fracture secondary to nonossifying fibroma
Authors: Kulkarni Shrihari L. , Daragad Manjunath , Patil Raviraj , Indikar Amanulla
Published: January 2025

This case report presents the unique occurrence of a pathological fracture in the subtrochanteric area of the left femur in a 7-year-old boy, attributed to a nonossifying fibroma (NOF). NOFs are benign bone lesions commonly found in pediatric patients, but complications leading to fractures are relatively rare. The clinical presentation, diagnostic workup, and management of this case are discussed to highlight the importance of recognizing and addressing such conditions in the pediatric population.
Challenges and perceived solutions in implementing competency-based undergraduate curriculum: A qualitative study
Authors: Ray Kuntala , Choudhari Sonali , Roy Hironmoy
Published: January 2025

BACKGROUND:

Competency-based medical education (CBME) is being implemented across India in medical colleges from the 2019 batch. Several new components are introduced which require focused faculty training and handholding at times. This study was conducted to explore the challenges faced by faculty and students of Phase 1 and Phase 2 MBBS during the implementation of a competency-based undergraduate curriculum with regard to curriculum planning and delivery, teaching–learning, and assessment; to determine the perceived/proposed solutions by the faculty and students to overcome the said challenges.

METHODS:

An exploratory qualitative study was done at the Institute of Postgraduate Medical Education and Research, Kolkata among the faculty members and students of first and second phase of the MBBS CBME batch. This study was done over 10 months. Nonprobability purposive sampling was employed in the study. Free listing was done initially to elicit the views of faculty members to meet the intended objectives. Visual Anthropac software was used to identify the salient variables using Smith’s Salience Score.

RESULTS:

Twenty faculty members participated in the free listing and pile sorting. Moreover, total of 18 students also participated in the focus group discussion. A total of 20 responses were obtained about the key aspects of CBME, of which 15 were identified as the salient variables depending on the cutoff value of 0.15 (Smith’s Salience Score) and subjected to pile sorting. Similarly, 13 challenges were identified in the implementation of the program during the free listing, and all were included in the second stage of pile sorting.

CONCLUSION:

The majority of the responses by faculty and students being positive indicate that CBME is the need of the decade. Organizing orientation/sensitization sessions, following timetables, daily feedback, preparing the universal assessment tool, and emphasizing attitudes, ethics, and communication through a case-based module was the proposed solution.