bluuebunny/crossref_metadata_2025 huggingface dataset:
Accuracy of various tests alone and in combination to differentiate IHH from CDGP
Authors: Mishra Pratap Kumar , Mishra Ipsita , Choudhury Arun Kumar , Baliarsinha Anoj Kumar , Mangaraj Swayam Sidha , Jena Sweekruti , Mohanty Binoy Kumar
Published: June 2022

Context:

Constitutional delay in growth and puberty (CDGP) is a normal physiological variant of delayed puberty in both sexes and is the most common cause of delayed puberty. Idiopathic hypogonadotropic hypogonadism (IHH) is due to deficiency in or insensitivity to gonadotropin-releasing hormone (GnRH) with normal structure and function of the anterior pituitary after exclusion of secondary causes of hypogonadotropic hypogonadism. To differentiate CDGP from IHH is crucial because it not only helps in decision making in management but also lessen anxiety of the parents.

Aim:

In this study we aimed to find out the accuracy of hormonal tests used individually as well as in various combinations to distinguish cases of IHH from CDGP.

Methods:

A cohort of 34 boys with delayed puberty were recruited in this study. Detailed history, clinical examination, hormonal analysis including basal serum testosterone, inhibin-B, LH, FSH as well as GnRH analogue stimulated gonadotrophins and testosterone along with hCG stimulated testosterone was done. At 6 monthly follow-up, detailed clinical examination was repeated and the cohort was followed until 2 years.

Results:

Out of the 29 boys taken for final analysis, CDGP was diagnosed in 23 boys and IHH in 6 boys. Basal LH, basal inhibin-B, 3 hours post leuprolide LH and 72 hours post hCG testosterone were significantly higher in CDGP than IHH. However, no statistically significant difference was observed between basal FSH, basal testosterone and 3 hours post leuprolide FSH between these two groups. When basal LH (cut-off <0.565 IU/L) and basal inhibin-B (cut-off <105 pg/ml) were taken together the sensitivity and specificity were increased to 100% as was for the combination of basal LH (cutoff <0.565 IU/L) and 3 hours post leuprolide LH (cutoff <6.16 IU/L) for diagnosis of IHH. Both combinations have PPV of 100% and NPV of 100%. A combination of 3 hours post leuprolide LH with 72 hours post hCG testosterone also has good sensitivity (100%), specificity (96%), PPV (90%) and NPV (100%).

Conclusion:

Differentiating IHH from CDGP is a challenging task due to considerable overlap in their clinical as well as hormonal profiles. Therefore we suggest that a combination of basal LH and basal inhibin-B may be considered as a useful screening tool to differentiate IHH from CDGP rather than the cumbersome and invasive stimulation tests.
Incorporating Integrated Personalised Diabetes Management (iPDM) in Treatment Strategy
Authors: Kalra Sanjay , Bantwal Ganapathi , Sahay Rakesh Kumar , Bhattacharya Saptarshi , Baruah Manash P. , Sheikh Shehla , Lathia Tejal
Published: June 2022

Diabetes is a global public health concern. Vigilant monitoring and effective management of glycaemic variations are essential to prevent complications of diabetes. Effectively incorporating monitoring strategies in management of diabetes is a serious challenge. Patient-centered approach is necessary to customise monitoring and therapy of diabetes. This has been made possible by integrating technology with personalised therapeutic strategy. The integrated personalised diabetes management (iPDM) is a holistic, patient-centered approach that focuses on personalising diabetes management to streamline therapy and improve outcome. iPDM helps strengthen the care process, facilitates communication between patients and their healthcare team, and integrates digital tools that visualise and analyse data. The five E’s which includes enthusiasm, education, expertise, empathy and engagement are the key pillars of a strong foundation for the iPDM model. iPDM model is a convenient and easily accessible tool that shifts the management paradigm from an “algorithmic” to “personalized” care to optimise treatment outcomes. Structured self-monitoring of blood glucose (SMBG) should be available as part of the self-management process for people with sub-optimally controlled type 2 diabetes, including those not on insulin therapies. Different SMBG regimens should be followed based on factors such as diabetes type, treatment approach (diet, oral antidiabetic medication, or insulin), glycaemic control, available resources, and patient’s level of education.
Diabetic Retinopathy
Authors: Mounirou Bassirou A. M. , Adam Nouhou D. , Yakoura Abba K. H. , Aminou Mahamane S. M. , Liu Yu T. , Tan Li Y.
Published: June 2022

Diabetic retinopathy (DR), substantially impacts the quality of life of diabetic patients, it remains, in developed countries, the leading cause of vision loss in working-age adults (20–65 years). Currently, about 90 million diabetics suffer from DR. DR is a silent complication that in its early stages is asymptomatic. However, over time, chronic hyperglycemia can lead to sensitive retinal damage, leading to fluid accumulation and retinal haemorrhage (HM), resulting in cloudy or blurred vision. It can, therefore, lead to severe visual impairment or even blindness if left untreated. It can be classified into nonproliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR). NPDR is featured with intraretinal microvasculature changes and can be further divided into mild, moderate, and severe stages that may associate with diabetic macular oedema (DME). PDR involves the formation and growth of new blood vessels (retinal neovascularisation) under low oxygen conditions. Early identification and treatment are key priorities for reducing the morbidity of diabetic eye disease. In the early stages of DR, a tight control of glycemia, blood pressure, plasma lipids, and regular monitoring can help prevent its progression to more advanced stages. In advanced stages, the main treatments of DR include intraocular injections of anti-vascular endothelial growth factor (VEGF) antibodies, laser treatments, and vitrectomy. The aim of this review is to provide a comprehensive overview of the published literature pertaining to the latest progress in the treatment of DR.
Field Testing of Synthetic Growth Charts in 1–60-Month-Old Indian Children
Authors: Mehta Sajili , Oza Chirantap , Karguppikar Madhura , Khadilkar Vaman , Khadilkar Anuradha
Published: June 2022

Background:

Malnutrition among under-five children (U5C) in India is a major public health problem due to double burden caused by nutritional transition. WHO cut-offs are adopted as global growth standards which define how children should grow in condition of optimal nutrition and health. Growth references which are representative of population-specific existing growth patterns need to be updated regularly which is cumbersome; hence, the author’s group published ‘synthetic growth references’ for Indian children of age 0–18 years.

Objectives:

The objective of this study is to field test the new synthetic growth references in U5C for height-for-age, weight-for-age and body mass index (BMI)-for-age against WHO charts in urban and rural Indian children to estimate prevalence of various indices of malnutrition.

Methods:

A cross-sectional anthropometric assessment of apparently healthy rural and urban Indian U5C attending vaccination centre was performed using standard protocols. They were converted to Z-scores using WHO and Indian synthetic growth references. The equality of proportion of parameters of malnutrition was tested by McNemar’s test and P value <0.05 was considered significant.

Results:

WHO charts significantly overestimated stunting and malnutrition as compared to synthetic references with difference in sensitivity of 7.2% and 8.5%, respectively, and converse for over-nutrition by 2.1%. The most commonly affected parameter of malnutrition was underweight. Stunting was significantly higher in rural population using both cut-offs (P < 0.05).

Conclusion:

The synthetic references limit the spread of weight and BMI and do not overestimate stunting and wasting. They may be more useful for identification of malnutrition and may thus be recommended for routine screening in Indian U5C.
Anti-angiogenic therapy in ovarian cancer: current situation & prospects
Authors: Liu Yinping , Luo Yi , Cai Meiling , Shen Peijun , Li Jun , Chen Hailin , Bao Wei , Zhu Yaping
Published: June 2022

Ovarian cancer (OC) is one of five leading causes of cancer related death among women worldwide. Although treatment has been improving, the survival rate has barely improved over the past 30 years. The fatality rate is due to asymptomatic early signs and the lack of long-term effective treatment strategies for advanced disease. Angiogenesis is an important process in tumour growth and metastasis and is the creation of new blood vessels from existing blood vessels. It is a dynamic and complex process involving various molecular regulatory pathways and multiple mechanisms. The inhibition of angiogenesis has become a recognized therapeutic strategy for many solid tumours. While benefits in progression-free survival have been observed, the OS is far from satisfactory for OC patients who receive antiangiogenic therapy. In this article, the present research status of angiogenesis in OC was reviewed and the reasons for poor antiangiogenic therapeutic effects was explored with the aim to identify potential therapeutic targets that may improve the effect of antiangiogenic therapies.
Concurrent dengue infections: Epidemiology & clinical implications
Authors: Sirisena P.D.N.N. , Mahilkar Shakuntala , Sharma Chetan , Jain Jaspreet , Sunil Sujatha
Published: June 2022

Multiple dengue virus (DENV) serotypes circulating in a geographical area most often lead to simultaneous infection of two or more serotypes in a single individual. The occurrence of such concurrent infections ranges from 2.5 to 30 per cent, reaching as high as 40-50 per cent in certain dengue hyper-endemic areas. Concurrent dengue manifests itself differently than mono-infected patients, and it becomes even more important to understand the effects of co-infecting serotypes in concurrent infections to ascertain the clinical outcomes of the disease progression and transmission. In addition, there have also been reports of concurrent DENV infections in the presence of other arboviral infections. In this review, we provide a comprehensive breakdown of concurrent dengue infections globally. Furthermore, this review also touches upon the clinical presentations during those concurrent infections categorized as mild or severe forms of disease presentation. Another aspect of this review was aimed at providing insight into the concurrent dengue incidences in the presence of other arboviruses.
Inhibitors of Gq signalling down-regulate β-catenin expression & function in human colon cancer cells
Authors: Forghani Nasim , Najafi S. Mahmoud A.
Published: June 2022

Background & objectives:

β-catenin signalling plays a key role in maintaining normal cellular physiology, and therefore, its deregulation can lead to many human diseases including cancers. Previously, we have shown that the activation of Gq signalling positively regulates β-catenin by inhibiting glycogen synthase kinase-3 beta and increasing the stability of β-catenin protein, however, these results were mainly based on overexpression experiments in either Xenopus oocytes or HEK293T cells. The present study was undertaken to evaluate the modulation of Gq signalling in human colon cancer cells.

Methods:

Gq signalling in SW480 and HT-29 colon cancer cells was specifically blocked to investigate the interaction between β-catenin and the Gq signalling pathways. GP antagonist-2A (a commercially available peptide) and a minigene expression construct encoding a peptide corresponding to the C-terminal 11 amino acids of Gαq were used to block Gq signalling. β-catenin expression and function were examined by western blotting, immunofluorescence microscopy, and quantitative real-time PCR experiments.

Results:

Transfection of cells with either of the blockers significantly decreased both β-catenin protein levels and β-catenin-mediated transcriptional activities. In addition, the migration of SW480 cells was reduced in the presence of the Gq blockers.

Interpretation & conclusions:

The results of this study further support the positive role of Gq signalling in regulating β-catenin expression and function and may provide a new means of preventing β-catenin-mediated carcinogenesis by blocking heterotrimeric G proteins.
Detection & analysis of inflammatory cytokines in tears of patients with lacrimal duct obstruction
Authors: Wang Dan , Xiang Nan , Hu Wei Kun , Luo Ban , Xiao Xiang Tian , Zhao Yin , Li Bin , Liu Rong
Published: June 2022

Background & objectives:

Tear proteomic changes can be a candidate etiopathogenesis of lacrimal duct obstruction diseases (LDODs). Studies on proteomics have focused primarily on nasolacrimal duct obstruction, and some specific inflammatory cytokines such as interferon (IFN)-α2a, interleukin (IL)-8 and IL-10, have not been investigated. In addition, differences in inflammatory cytokines in tears according to the LDOD subtype have not been reported. This study aimed to quantitatively compare inflammatory cytokines in tears from patients with LDOD and investigate tear-cytokine differences among different LDOD subtypes.

Methods:

Tear samples were collected from both eyes of 30 patients with unilateral LDOD five patients with prelacrimal obstruction, five with acute dacryocystitis and 20 with chronic dacryocystitis. The contralateral eyes were used as controls. IFN-α2a, IFN-β, IFN-γ, IL-17A, IL-6, IL-8, tumour necrosis factor-alpha (TNF-α), vascular endothelial growth factor (VEGF)-A, induced protein-10 (IP-10) and monocyte chemotactic protein-1 (MCP-1) were quantified in all samples.

Results:

The expression of eight cytokines (except for IP-10 and MCP-1) were significantly increased in the affected eyes compared with those in the control eyes. The levels of nine inflammatory cytokines (except for IP-10) in the affected eyes of patients with chronic dacryocystitis were higher than those in the affected eyes of patients with prelacrimal obstruction. In addition, patients with chronic dacryocystitis presented significantly higher IFN-γ level than those with prelacrimal obstruction or acute dacryocystitis.

Interpretation & conclusions:

Specific pro-inflammatory cytokines were increased in tears of patients with LDOD compared with those in the controls. The specific cytokine profiles observed in the tears of individuals with different LDOD subtypes may be associated with the unique aetiopathogenesis of these conditions.
Molecular mechanisms of zika virus pathogenesis
Authors: Bhagat Reshma , Kaur Guneet , Seth Pankaj
Published: June 2022

Zika virus (ZIKV), member of the family Flaviviridae belonging to genus Flavivirus, is an arthropod-borne virus. The ZIKV is known to cause severe congenital birth defects in neonates. Due to a large number of worldwide outbreaks and associated neurological complications with ZIKV, a public health emergency was declared by the World Health Organization on February 1, 2016. The virus exhibits neurotropism and has a specific propensity towards neural precursor cells of the developing brain. In utero ZIKV infection causes massive cell death in the developing brain resulting in various motor and cognitive disabilities in newborns. The virus modulates cell machinery at several levels to replicate itself and inhibits toll like receptors-3 signalling, deregulates microRNA circuitry and induces a chronic inflammatory response in affected cells. Several significant advances have been made to understand the mechanisms of neuropathogenesis, its prevention and treatment. The current review provides an update on cellular and molecular mechanisms of ZIKV-induced alterations in the function of various brain cells.
The side effects of immune checkpoint inhibitor therapy on the endocrine system
Authors: Goyal Itivrita , Pandey Manu Raj , Sharma Rajeev , Chaudhuri Ajay , Dandona Paresh
Published: June 2022

Immune checkpoint inhibitors (ICIs) are a relatively newer class of drugs approved for the treatment of malignancies such as melanoma, renal, bladder and lung cancer. Immune-related adverse events (IrAEs) involving the endocrine system are a common side effect of these drugs. The spectrum of endocrine adverse events varies by the drug class. Cytotoxic T-lymphocyte–associated antigen-4 inhibitors commonly cause hypophysitis/hypopituitarism, whereas the incidence of thyroid disease is higher with programmed cell death (PD)-1/ ligand (PD-L) protein 1 inhibitors. The focus of this review is to describe the individual endocrinopathies with their possible mechanisms, signs and symptoms, clinical assessment and disease management. Multiple mechanisms of IrAEs have been described in literature including type II/IV hypersensitivity reactions and development of autoantibodies. Patients with pre-existing autoimmune endocrine diseases can have disease exacerbation following ICI therapy rather than de novo IrAEs. Most of the endocrinopathies are relatively mild, and timely hormone replacement therapy allows continuation of ICIs. However, involvement of the pituitary–adrenal axis could be life-threatening if not recognized. Corticosteroids are helpful when the pituitary–adrenal axis is involved. In cases of severe endocrine toxicity (grade 3/4), ICIs should be temporarily discontinued and can be restarted after adequate hormonal therapy. Endocrinologists and general internists need to be vigilant and maintain a high degree of awareness for these adverse events.
Effects of continuous-combined oral drospirenone- estradiol on blood pressure, body weight & lipid profile in early menopausal women
Authors: Đogo Aleksandar , Dožić Branko , Vujović Svetlana , Srebro Dragana , Dožić Ivan
Published: June 2022

Background & objectives

Drospirenone (DRSP) is a progestin with antimineralocorticoid and anti-androgenic activity. When administered in combination with estradiol (E2), it relieves menopausal symptoms. The aim of this study was to evaluate the effects of DRSP/E2 on the reduction of cardiovascular risk factors in menopausal women with hypertension.

Methods:

A retrospective study was conducted at the Clinical Center of Serbia. The participants were 64 menopausal women [mean age=49.19±4.62 yr, mean body mass index (BMI)=25.08±2.94 kg/m2, mean amenorrhoeic period=2.48±2.46 yr]. The effects of DRSP 2 mg/E2 1 mg on 24 h blood pressure (BP) variability, heart rate (HR), anthropometric characteristics and hormone and lipid levels were evaluated in early menopausal women with previously untreated stage 1 hypertension. All analyses were carried out before and after six and 12 months of therapy.

Results:

DRSP/E2 significantly reduced daytime BP values during six and 12 months of therapy. The reductions in systolic and diastolic BPs ranged from about −4.50 to −8.50 and from −4.00 to −5.00 mmHg, respectively. There were no significant changes in nocturnal 24 h BPs. DRSP/E2 significantly reduced HR daytime and night-time during the follow up period. DRSP/E2 significantly lowered the BMI, concentrations of total cholesterol, low-density lipoprotein cholesterol and apolipoprotein B, while high-density lipoprotein cholesterol and apolipoprotein concentration increased.

Interpretation & conclusions

Continuous long-term therapy with DRSP 2 mg/E2 1 mg significantly lowered 24 h systolic and diastolic BPs and reduced the risk of cardiovascular disease in early menopausal women with stage 1 hypertension. Timely initiated menopausal hormone therapy can have beneficial effects on BP and can reduce the incidence of cardiovascular disease in menopausal women.
Smoking & risk of advanced liver fibrosis among patients with primary biliary cholangitis
Authors: Wijarnpreecha Karn , Werlang Monia , Panjawatanan Panadeekarn , Pungpapong Surakit , Lukens Frank J. , Harnois Denise M. , Ungprasert Patompong
Published: June 2022

Background & objectives:

Studies have suggested that smoking may accelerate the progression of fibrosis among patients with primary biliary cholangitis (PBC), although the data are limited. The current review was undertaken with the aim to comprehensively analyze this possible association by identifying all relevant studies and summarizing their results.

Methods:

A comprehensive literature review on MEDLINE and EMBASE databases was performed from inception through February 2019 to identify all relevant studies. Eligible studies included cross-sectional studies that recruited patients with PBC and collected data on the smoking status and presence or absence of advanced liver fibrosis for each participant. Odds ratios (OR) with 95 per cent confidence intervals (CI) was desirable for inclusion or sufficient raw data to calculate the same for this association. Adjusted point estimates from each study were extracted and combined together using the generic inverse variance method of DerSimonian and Laird. I
2 statistic, which quantifies the proportion of total variation across studies was used to determine the between-study heterogeneity.

Results:

Three cross-sectional studies with 544 participants were included. The pooled analysis found a significantly increased risk of advanced liver fibrosis among patients with PBC who were ever-smokers compared to those who were nonsmokers with the pooled OR of 3.00 (95% CI, 1.18-7.65). Statistical heterogeneity was high with I
2 of 89 per cent.

Interpretation & conclusions:

This meta-analysis found that smoking is associated with a significantly higher risk of advanced liver fibrosis among patients with PBC. Further prospective studies are still required to determine whether this association is causal.
High soluble interleukin-2 receptor values in Indian paediatric & adult controls – Need for population-specific threshold in the diagnosis of haemophagocytic lymphohistiocytosis
Authors: Dinand Veronique , Sachdeva Anupam , Sharma Sakshi , Prasad Alpana , Pant Deepanjali , Sachdev Anil , Ganguly Nirmal Kumar
Published: June 2022

Background & objectives:

Elevated soluble interleukin-2 receptor (sIL2R) is a diagnostic criterion for haemophagocytic lymphohistiocytosis (HLH). International guidelines propose a 2400 U/ml cut-off or individual laboratory-defined cut-off. However, sIL2R normal values are so far not known in Indians. So, this study was undertaken to measure sIL2R in healthy children and adults to establish age-related reference values.

Methods:

Healthy controls and cases (participants with persistent fever, organomegaly, cytopenias and biochemical markers of HLH) were prospectively enrolled. Serum sIL2R was measured by double-sandwich enzyme immunoassay in a standardization batch to determine the optimum cut-off value using receiver operator characteristic curve and was subsequently validated.

Results

One hundred and forty six age- and sex-matched children (80 controls and 66 suspected HLH cases) and 55 adults (49 controls and 6 suspected HLH cases) were prospectively enrolled. The optimal sIL2R cut-off ≥23 ng/ml was defined as raised sIL2R in the standardization batch. No controls had sIL2R ≥23 ng/ml in the validation batch. In healthy controls, median sIL2R (interquartile range) decreased with increasing age from 9.0 ng/ml (6.6-13.4) below five years of age to 3.2 ng/ml (2.8-5.1) in adults. Proposed upper limit of normal value for sIL2R is 17.4 ng/ml in less than five year, 12.2 ng/ml in 5-9 yr, 6.7 ng/ml in 10-17 yr and 5.2 ng/ml in ≥18 yr. sIL2R accuracy to diagnose HLH marginally improved with age-appropriate cut-off.

Interpretation & conclusions:

Paediatric controls in India showed higher sIL2R levels than most studies conducted in other countries, except for some reports in Chinese and Russian populations. Age-appropriate reference values of sIL2R in a specific population may be considered to determine elevated sIL2R as a marker of HLH.
Serum levels of osteoprotegerin, RANK-L & vitamin D in different stages of osteoarthritis of the knee
Authors: Naik Sanjukta , Sahu Suchanda , Bandyopadhyay Debapriya , Tripathy Sujit
Published: June 2022

Background & objectives:

Osteoarthritis (OA) is the 11th leading cause of disability in the modern world, but till date, there have been no effective markers for monitoring the progression of OA. The three proteins RANK/RANK-Ligand and Osteoprotegerin (OPG) have been found to be the key regulators of bone metabolism. Interaction of RANK-Ligand with its receptor RANK triggers differentiation of osteoclasts leading to bone resorption. OPG on the other hand is protective as it is expressed by osteoblasts and bind RANKL with higher affinity preventing its interaction with RANK. The levels of these serum proteins are regulated by vitamin D and parathyroid hormones. Therefore, the present study, aimed to study the association of serum RANKL, OPG and vitamin D with disease severity in patients with knee OA.

Methods:

It was a cross-sectional study where 80 (43 women and 37 men) newly diagnosed subjects with OA knee were recruited. They were classified into four grades based on K-L grading and into two groups as early (grade 1+grade 2) and advanced (grade 3 + grade 4) based on the disease progression.

Results:

On comparing the biochemical parameters among the four grades decreasing vitamin D levels were seen with increasing severity of knee OA; an increasing trend of RANKL with increase in the severity of OA was seen; OPG was found to be elevated more in the early stages of OA. We also observed a strong association of RANKL/OPG ratio with disease severity.

Interpretation & conclusions:

Overall the results suggest that OPG may be considered as an early marker of the diseases.
Mycoplasma genitalium
Authors: Raj J. Stephen , Rawre Jyoti , Dhawan Neha , Khanna Neena , Dhawan Benu
Published: June 2022

Mycoplasma genitalium (MG) is an emerging sexually transmitted pathogen. It is an important cause of nongonococcal urethritis in men and is associated with cervicitis and pelvic inflammatory disease in women, putting them at risk of infertility. Multiple factors that aid pathogenesis of MG include its ability of adhesion, gliding motility, and intracellular invasion by means of the tip organelle. Through intracellular localization and antigenic variation, MG could result in treatment-resistant chronic infection. There are limited data on the prevalence of MG in Indian patients with urogenital syndromes. Recently, a high prevalence of extra genital infection with MG has been reported. Molecular assays are the major diagnostic techniques of MG infection. Antimicrobial agents such as macrolides, along with fluoroquinolones, are the treatment of choice for MG infections. The issue of drug resistance to azithromycin and fluoroquinolones in MG is rising globally. As molecular tests are becoming available for MG, both for the diagnosis and the detection of antimicrobial resistance, any patient with MG infection should then be tested for antimicrobial resistance. Consideration of MG as a cause of sexually transmitted disease in the Indian population is crucial in diagnostic algorithms and treatment strategies. The purpose of this review is to understand the prevalence of MG in different clinical scenarios, molecular mechanisms of pathogenesis, current status of antimicrobial resistance, and its impact on MG treatment.
“Bouncing back to life
Authors: Rajan Sukanya , Navaneetham Janardhana , Sanjeeva G. N.
Published: June 2022

Background:

Most research on adolescent focuses on the risk associated with the illness. Very little research has been carried out on adolescents who have been diagnosed with HIV since birth. With recent advances with ART treatment, life span of these children has increased, and there are lots of protective factors in the environment influencing the resilience. The present study has focused on the resilience among the adolescence with respect to the living arrangement, i.e., in institutionalized care and extended family.

Methodology:

The current study follows an exploratory research design with the aim of comparing resilience among adolescents living in the institutional setup and those living with their families–parents and extended families. Adolescents receiving ART treatment from a tertiary care hospital constitute universe and were selected purposively for the study. Resilience was measured using Child and Youth Resilience Measure.

Results:

The results indicated that 70% of the female and majority of them belong to Hindu religion. For majority, the mode of transmission is mother to child. There is no statistically significant difference between the resilience with respect to the living arrangement. However, respondents are resilient.

Conclusion:

This study has given a space for resilience for different groups of adolescents with respect to the living arrangement.
Vulvar syringoma
Authors: George Reenu T , Raghuveer Chekuri , Degulamadi Veeresh , Murthy Sambashivaiah Chidambara
Published: June 2022

Syringomas commonly occur in women over the face, neck, and chest. They are usually asymptomatic and mainly of cosmetic concern. The vulva is an uncommon site for syringomas. A 45-year-old woman had asymptomatic lesions over the face, of 28 years duration and presented with vulvar papules, associated with severe pruritus for the past 2 months. Clinical and histopathological examination confirmed them to be syringomas. Coexistent facial and vulvar syringomas are rare. Further, vulvar syringomas presenting as pruritus vulvae is still rarer. We report a case with severe pruritus vulvae causing sufficient distress to seek medical care, which is remarkably unusual.
Emerging and re-emerging sexually transmitted diseases
Authors: Balaji Sivaraman , Bhargava Aradhana , Aggarwal Sumit
Published: June 2022

Substantial increase in the outbreaks of sexually transmitted infections (STIs) and associated mortalities have raised international concerns. Concurrent with the escalation of established STIs, developing epidemics and outbreaks of newly emerging sexually transmissible pathogens pose serious problems for people and added burden and challenges for public health practitioners and researchers. Importantly, most of the emerging STIs are frequently found among vulnerable groups, such as men having sex with men and human immunodeficiency virus patients, which may result in large outbreaks in the near future. Furthermore, enhanced spread of antimicrobial resistance among these pathogens ever more limits treatment options for STIs. Thus, it is the optimal time to consider whether an infectious agent is sexually transmissible and develop treatment protocol for handling new STIs with pandemic potential. In this review, we explore emerging STIs, their current epidemiological status, and future perspective.
Study of genital manifestations of Stevens Johnson Syndrome/Toxic Epidermal Necrolysis
Authors: Gulanikar Anirudha , Abrol Arundha , Sagar Saujanya
Published: June 2022

Background:

Stevens-Johnson syndrome/Toxic Epidermal Necrolysis (SJS/TEN) are severe mucocutaneous reactions, considered as variants of same pathologic process. It is characterized by epidermal blisters, necrosis and sloughing predominantly of drug induced etiology. Due to severe cutaneous reactions, the genital manifestations associated with SJS/TEN are less studied. The chronic sequelae of genital manifestations results in severe gynecological, urological and sexual related complications, and have a great impact on the quality of life of patients.

Aims And Objectives:

To study the genital manifestations associated with SJS/TEN.

Materials and Methods:

Patients of SJS/TEN attending the Out-patient and In-patient Department of Skin and VD in a tertiary care hospital, having genital manifestations were included in the study. Genital examination of all patients were observed and recorded with a follow up for 6 months.

Results:

A total of 30 patients, twelve males (40%) and eighteen females (60%), were included. Genital manifestations were observed in 18 (60%) patients, with a male:female ratio of 1:2, i.e. males 6 (36.66%) and females 12 (63.33). All patients presented in the acute stage of the disease. Four female patients (33.3%) developed chronic manifestations in the form of labial synechiae in 2 (16.66%), vaginal synechiae in 1 (8.33%), vaginal strictures in 1 (8.33%) patient. None of the male patients developed chronic sequelae.

Conclusion:

SJS/TEN are rare diseases, but the mucocutaneous involvement, especially of genitourinary system and their long-term sequelae have a major impact on the quality of life of affected patients. The genital manifestations are largely preventable by means of proper awareness and early intervention.
Myofibroblasts in odontogenic cysts and tumors
Authors: Pinisetti Soujanya , Tadi Durgaprasad , Manyam Ravikanth
Published: June 2022

Objective:

The objective of this study was to assess immunohistochemically the presence of myofibroblasts both qualitatively and quantitatively in odontogenic cysts and tumors and to compare with the control cases of squamous cell carcinoma and to correlate the results with biologic behavior of these lesions.

Materials and Methodology:

Formalin-fixed, paraffin-embedded blocks of odontogenic cysts and tumors were retrieved from institutional archives. The sample size is 40; these include ten cases of odontogenic keratocyst (OKC) (n = 10), five cases of dentigerous cyst (n = 5), ten cases of solid ameloblastoma (n = 10), and five cases of unicystic ameloblastoma (n = 5). Ten cases of squamous cell carcinoma (n = 10) served as control. Sections were taken and stained immunohistochemically using alpha-smooth muscle actin for evaluation of myofibroblasts. The number of positive stromal cells was evaluated both for quantitative and qualitative analyses.

Results:

The present study showed that the mean number of myofibroblasts among the odontogenic cysts and tumors was higher in locally aggressive lesions such as OKC (23.79 ± 19.95), solid ameloblastoma (26.38 ± 17.00), and unicystic ameloblastoma (20.74 ± 14.86) which were comparable to squamous cell carcinoma (21.49 ± 9.76) when compared to benign lesions like dentigerous cyst which showed the least number of myofibroblasts (13.1 ± 7.71). Qualitatively, the staining intensity of myofibroblasts showed a significant variation within the same lesion and among different lesions. There was a distinct difference in the morphology, pattern of arrangement, and distribution of myofibroblasts among the studied lesions.

Conclusion:

We conclude that the increase in the number of myofibroblasts could be one of the contributory factors for the locally aggressive behavior of benign lesions such as ameloblastomas and OKCs. Further studies are suggested to understand the mechanism by which these important cellular elements exert their effects on stromal and epithelial tissue compartments.
p120 regulates E-cadherin expression in nasal epithelial cells in chronic rhinosinusitis
Authors: Li X.-L. , Feng Q.-M. , Yang H.-N. , Ruan J.-W. , Kang Y.-F. , Yu Z.-E. , Liu J.-X. , Chen A.-N. , Cui Y.-H. , Liu Z. , Lu X.
Published: June 2022

Background: The epithelial barrier plays an important role in the regulation of immune homeostasis. The effect of the immune environment on E-cadherin has been demonstrated in previous studies. This discovery prompted new research on the targeting mechanism of E-cadherin in chronic rhinosinusitis (CRS). Methods: E-cadherin and p120 expression was determined by quantitative RT–PCR, and western blot. The interaction between E-cadherin and p120 was assessed by immunofluorescence staining and coimmunoprecipitation assays. Human nasal epithelial cells (HNECs) were cultured with submerged methods and transfected with p120-specific small interfering RNA. In other experiments, HNECs differentiated with the air-liquid interface (ALI) method were stimulated with various cytokines and Toll-like receptor (TLR) agonists. The barrier properties of differentiated HNECs were determined by assessing fluorescent dextran permeability. Results: E-cadherin and p120 expression was decreased in HNECs from patients with CRS, and the p120 protein expression level was positively correlated with that of E-cadherin. Two isoforms of p120 (p120-1 and p120-3) were expressed in HNECs, with p120-3 being the main isoform. Knocking down p120 in HNECs cultured under submerged conditions significantly reduced the E-cadherin protein expression. The Rac1 inhibitor NSC23766 reversed the protein expression of E-cadherin in p120 knockdown experiments. Inflammatory mediators, including IL-4, TNF-α, TGF-β1, LPS and IFN-γ, reduced E-cadherin and p120 protein expression and increased paracellular permeability. Dexamethasone abolished the downregulation of E-cadherin and p120 caused by inflammatory mediators. Conclusions: p120 is involved in regulating E-cadherin protein expression in CRS. Dexamethasone may alleviate the reduction in E-cadherin and p120 protein expression caused by inflammatory mediators.
Association between Pathogenic Variants of Diarrheagenic Escherichia coli and Growth in Children under 5 Years of Age in the Global Enteric Multicenter Study
Authors: Das Rina , Palit Parag , Haque Md Ahshanul , Ahmed Tahmeed , Faruque A. S. G
Published: June 2022

There is a lack of information highlighting associations between different pathogenic variants of diarrheagenic Escherichia coli and childhood growth. Pathogenic variants of E. coli from stool samples, collected from 22,567 children enrolled in the Global Enteric Multicenter Study from December 2007 to March 2011, were detected by real-time polymerase chain reaction. We estimated the associations of different pathogenic variants of diarrheagenic E. coli with child growth. The association between an explanatory variable and the outcome variable was assessed using multiple linear regression, where the dependent variables were height-for-age, weight-for-age, and weight-for-height z-scores, and the independent variable was the presence of different pathogenic variants of diarrheagenic E. coli. After adjusting for potential covariates, such as age, gender, diarrhea, breastfeeding status, mother’s education, number of under-5 children, handwashing practice, handwashing material, source of drinking water, wealth index, available toilet facility, copathogens, comorbidity, time, and study site, the multivariable model identified a negative association between different pathogenic variants of diarrheagenic E. coli and child growth. Our analyses may provide the cornerstone for prospective epidemiologic investigation for the development of preventive measures for diarrheagenic E. coli and combat childhood undernutrition.
Surveillance as a Core Intervention to Strengthen Malaria Control Programs in Moderate to High Transmission Settings
Authors: Fountain Alison , Ye Yazoume , Roca-Feltrer Arantxa , Rowe Alexander K. , Camara Alioune , Fofana Aissata , Candrinho Balthazar , Hamainza Busiku , Ndiop Medoune , Steketee Richard , Thwing Julie
Published: June 2022

New tools are needed for malaria control, and recent improvements in malaria surveillance have opened the possibility of transforming surveillance into a core intervention. Implementing this strategy can be challenging in moderate to high transmission settings. However, there is a wealth of practical experience among national malaria control programs and partners working to improve and use malaria surveillance data to guide programming. Granular and timely data are critical to understanding geographic heterogeneity, appropriately defining and targeting interventions packages, and enabling timely decision-making at the operational level. Resources to be targeted based on surveillance data include vector control, case management commodities, outbreak responses, quality improvement interventions, and human resources, including community health workers, as they contribute to a more refined granularity of the surveillance system. Effectively transforming malaria surveillance into a core intervention will require strong global and national leadership, empowerment of subnational and local leaders, collaboration among development partners, and global coordination. Ensuring that national health systems include community health work can contribute to a successful transformation. It will require a strong supply chain to ensure that all suspected cases can be diagnosed and data reporting tools including appropriate electronic devices to provide timely data. Regular data quality audits, decentralized implementation, supportive supervision, data-informed decision-making processes, and harnessing technology for data analysis and visualization are needed to improve the capacity for data-driven decision-making at all levels. Finally, resources must be available to respond programmatically to these decisions.
Impact of the COVID-19 pandemic on adherence to infection prevention and control measures between 2019 and 2021 in Swiss sentinel private practices: repeated cross-sectional surveys
Authors: Lehmann Iza , Peytremann Arnaud , Mueller Yolanda
Published: June 2022

AIMS OF THE STUDY: The COVID-19 pandemic has shown the importance of infection prevention and control (IPC) measures in health care settings, including primary care. We aimed to describe how it influenced adherence to infection prevention and control measures in private practices in the Swiss sentinel network (Sentinella). METHOD: An online cross-sectional survey was sent to the 181 Sentinella practices in 2021 that included questions on the practice’s spatial organisation, staff habits and vaccination coverage, ventilation, mask wearing, hand hygiene, as well as triage and separation of patients with suspected infection. Results were compared with those of a 2019 survey conducted in the same setting. RESULTS: We received 127 valid questionnaires (70.2% response rate). At the time of the study, SARS-CoV-2 vaccination was underway among physicians (51.3%). Between 2019 and 2021, an absence of specific recommendations on mask wearing for staff (55.7%) changed into a recommendation for continuous wearing (93.7%); hand hygiene improved, especially upon arrival at the practice (63.9% vs 85.8%; p <0.001) and before examining patients (74.6% vs 88.2%; p <0.010); impossibility of distancing symptomatic patients dropped (27.9% vs 3.9%, p <0.001); and ventilation and cleaning improved (p <0.001). CONCLUSIONS: The COVID-19 pandemic led to important changes in adherence to the recommended IPC measures.
Tristan et le démon de midi
Authors: Gorecka-Kalita Joanna
Published: June 2022

Tristan i demon południa

Artykuł proponuje odczytanie średniowiecznych powieści o Tristanie autorstwa Béroula i Thomasa z Anglii w świetle doktryny acedii Ewagriusza z Pontu. Punktem wyjścia jest pojęcie „demona południa”, rozumianego przez Ewagriusza jako demon popychający mnicha do acedii – stanu apatii i duchowego odrętwienia. Dzisiaj terminem tym określa się często „kryzys wieku średniego”, dotykający żonatych mężczyzn i skłaniający ich do poszukiwań erotycznych i seksualnych. Analiza zmierza do udowodnienia, że początków pomieszania tych dwóch pojęć można szukać już w średniowiecznej legendzie Tristana, zwłaszcza w wersji Thomasa. W istocie, często przywoływana melancholia Tristana przypomina acedię zdefiniowaną przez Ewagriusza, z jej podstawowymi cechami – niestabilnością, niestałością, pragnieniem nowości i wiecznym poczuciem niespełnienia.

Tristan and the Noonday Demon.
The paper analyses medieval Tristan romances by Béroul and Thomas of Britain in the light of Evagrius of Pontus’doctrine of acedia. The starting point is the concept of ‘Noonday Demon’: understood by Evagrius as the devil tempting the monk into acedia –a state of listlessness and spiritual torpor. It is used today to describe a ‘midlife crisis’ affecting married men in their erotic and sexual behaviour. The analysis tends to prove that the confusion between these two meanings can be traced back to the medieval Tristan legend, especially in Thomas’ version: in fact, Tristan’s supposed melancholy resembles acedia as defined by Evagrius, with its essential characteristics: instability, inconstancy, desire of novelty and perpetual dissatisfaction.
Ukoronowanie życzeń i „prawda prawdziwa”. Postać Ćitrangady w dziełach Rabindranatha Tagore’a i Rituparno Ghosha
Authors: Dżugaj Blanka Katarzyna
Published: June 2022

Celem artykułu jest przyjrzenie się reinterpretacjom klasycznej opowieści o księżniczce Ćitrangadzie w kulturze bengalskiej na przykładzie dzieł Rabindranatha Tagore’a oraz Rituparno Ghosha. Zgodnie z przekazem eposu Mahabharata Ćitrangada była bierną kobietą pozwalającą, by to ojciec decydował o jej cielesności. Nieco inaczej jej historię przedstawia Rabindranath Tagore w dramacie tanecznym z 1892 roku. Jego Ćitrangada staje się kobietą świadomie kształtującą swoją płeć biologiczną i wykraczającą poza sztywne ramy kobiecości sformułowane przez tradycje hinduizmu. Jeszcze dalej w reinterpretacji tej opowieści posunął się reżyser Rituparno Ghosh. Przenosząc historię księżniczki z pałacu do sali operacyjnej, Ghosh wpisał się nie tylko w dyskurs feministyczny, ale też w narrację dotyczącą transpłciowości i miejsca przedstawicieli tzw. trzeciej płci we współczesnym społeczeństwie indyjskim. Reinterpretacje historii Ćitrangady to rezultat zastępowania narracji tworzonej z perspektywy mężczyzn wywodzących się z klas uprzywilejowanych społecznie głosem tzw. Innych: kobiet i osób nieheteronormatywnych.

The Crowning Wish and the Truth of Thruth. The Figure of Chitrangada in the Works of Rabindranath Tagore and Rituparno Ghosh. The aim of this article is to look at the reinterpretations of the classic tale of Princess Chitrangada in Bengali culture, based on the works of Rabindranath Tagore and Rituparno Ghosh. According to Mahabharata Chitrangada was a passive woman, who allowed her father to decide about her body. Rabindranath Tagore, in the dance drama from 1892, presents her story in a different manner. His Chitrangada becomes a woman consciously shaping her biological sex and going beyond the rigid framework of femininity formulated by the traditions of Hinduism. Director Rituparno Ghosh went even further in reinterpretation of this story. By moving the story of the princess from the palace to the operating room, Ghosh entered not only into the feminist discourse, but also into the narrative of transgenderism and the place of representatives of the so-called the third sex in modern Indian society. Reinterpretations of the Chitrangada history are the result of replacing the narrative created from the perspective of men from socially privileged classes with the voice of the so-called Others: women and non-heteronormative people.
Cultural Conceptualizations of shame & dishonor in Early Poetic Arabic (EPA)
Authors: Pietrzak Bartosz
Published: June 2022

Persisting in a binary relationship with honor, shame was an important element of the pre-Islamic Arabic social evaluation system. In my study, I analyzed the two most important EPA concepts parallel to English shame – ˁayb and ˁār – applying the Cultural Linguistic approach. Based on the analyses on corpus of Early Arabic poetry and Classical Arabic dictionaries, I represented cultural schemata encoding the knowledge shared by pre-Islamic Arabs about those phenomena. The paper presents also metaphoric, metonymic, and image-schematic models, which account for the specifics of associated linguistic frames. Moreover, I posit a hypothesis on the existence of a schema subsuming the honor- and shame-dishonor-related schemata in form of social evaluation of usefulness, which seems to correspond to the historical and linguistic data.