bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Crushed Brick on some Properties of Modified Reactive Powder Concrete
Authors: Saeed Rosul Hussein , Aljalawi Nada Mahdi Fawzi
Published: June 2024

Abstract. Much trash, similar to clay bricks, concrete, and mortar, is made when things are built or torn down. A cheap and eco-friendly way to eliminate this trash is to recycle it into new building materials. Construction and removal waste is turned into recycled aggregates after being smashed, ground, dried, and graded. This paper shows the findings of a study that looked into using crushed bricks as aggregates. The bricks were taken from the demolition of different places and then crushed until they were no bigger than 10 mm. Micro steel fibres (1% by volume of the concrete) and crushed bricks (25% and 50%) of the original reactive powder concrete were added to the mix instead of fine sand and micro steel fibres before the casting. To look into several properties of the standard and reactive powder concrete, including their density, compressive strength , and Flexural strength . compressive strength of modified reactive powder concrete ( MRPC) with 25% crushed bricks increased by 7.22% and 6.73% more than compressive strength of the standard reactive powder concrete at age 7 days and 28 days of testing respectively and Flexural strength increasing by 33.96%and 27.6% more than Flexural strength of the standard reactive powder concrete at age 7 days and 28 days of testing respectively . The compressive strength slightly decreasing by 8.43% and 7.69% at age 7 days and 28 days of testing respectively when 50% crushed bricks were used instead sand and Flexural strength decreasing by 16.03% and 14.92% less than reference mixture when 50% crushed brick incorporated. Moreover, modified reactive powder concrete was less dense than the reactive powder concrete that was first made.
A Numerical Assessment of the Belleville Spring Strength Behaviour
Authors: Hayder Ali Noor Alhuda , Nasser Mohammed Ali , Jadee Khudhayer J.
Published: June 2024

This research presented a numerical assessment for a a selected theoretical design of single and stacked Belleville spring taken into consideration the strength behaviour. Theoretical and numerical analysis focused on two main factors which are the spring force and the variation of the stress at a specific locations across the spring section related to the deflection. This research chose the spring design dimensions according to the Belleville spring standard. The numerical simulation are done by employing ANSYS APDL 2018 software based on the same design and selected material properties. The comparison between the finding shows a good match with deviation less about, where the variation for a single spring being less than 10.9%, and the deviations being about 11.8% and 12.8% for two and three parallelly stacked discs. On the other hand, the divergence was approximately 12.4% and 12.2% for two and three discs stacked in series. The stress distribution results across the spring section shows at the final deflection of (1.15 mm), the maximum von Mises stress is concentrated at the upper surface of the inner hole of the spring, this stress is reduced in value when goes deeply through the thickness of the disc, till reach the minimum value at the middle section of the thickness.
Evaluation of the effect of COVID-19 infection in pregnancy and puerperium in a suburban medical college in West Bengal, India
Authors: Mukherjee Jayeeta , Burman Sougata Kumar , Sarkar Suvobrata , Chowdhury Ranita Roy , Talukder Anirban , Bera Gairik
Published: June 2024

ABSTRACT

Background:

The pandemic of SARS-CoV-2 was a novel situation, there was no conclusive knowledge, particularly concerning its effect on pregnant women and infants. Eminent obstetric organizations have introduced an array of guidelines to assist clinicians in countering this prior unknown outbreak. The primary objective of this study was to summarize the clinical characteristics, complications, and maternal and neonatal outcomes of COVID-19 during pregnancy and puerperium.

Methods:

This was a cross-sectional observational study conducted in the Outpatient/Emergency/Inpatient or COVID ward in the Department of Obstetrics and Gynaecology, of a tertiary hospital in Nadia district, West Bengal, India, from 1.7.2020 to 30.6.2021 including 104 pregnant or puerperal mothers with laboratory-confirmed, i.e., RT-PCR or Rapid Antigen Test positive reports after informed consent. The obstetric outcome, modes of delivery, and neonatal status including any complications or SNCU admission within six weeks postpartum were recorded.

Results:

The majority were in the ≥ 20–24 years age group, primigravida, residents of Nadia with no significant travel or contact history. 73.08% were affected in the third trimester and the comorbidities detected were chiefly anemia (15.38%), hypertensive or chronic liver diseases, and hypothyroidism. 45.19% of the mothers were asymptomatic while the other complaints were fever (18.27%), cough (11.55%), anosmia and/or ageusia (10.58%), sore throat (9.61%), respiratory distress, loose stools, and chest pain. The medical complications were predominantly low SpO2, convulsions, pneumonitis, and two maternal deaths. The obstetric complications were preterm birth (26.9%), pre-eclampsia/eclampsia (17.3%), antepartum (3.9%) and postpartum hemorrhage (4.4%), and sepsis (5.8%). Fourteen mothers had first-trimester termination, 63 had vaginal deliveries, and the rest had cesarean section. Out of 90 neonates, most were in the range of ≥ 2–2.5 kg birth weight and normal 1-min APGAR score. None tested positive for COVID-19 RTPCR and no detectable congenital anomaly or neonatal death was recorded.
Study of the effectiveness of telemedicine-based pulmonary rehabilitation in recovered patients of COVID-19 pneumonitis
Authors: Prageeth N. P. , Wadhwa Ranjan K. , Gupta Neeraj K. , Popalwar Harshanand , Badhal Suman , Kumar Banoth K.
Published: June 2024

ABSTRACT

Objective:

To determine the effectiveness of the telemedicine-based pulmonary rehabilitation programme in COVID-19 pneumonitis.

Design:

Prospective intervention study.

Setting:

Rehabilitation outpatient department, Tertiary-Care institute.

Participants:

Consecutive sample of patients (N = 50) in recovered COVID-19 infection.

Intervention:

Six weeks of telemedicine-based pulmonary rehabilitation in recovered patients of COVID-19 infection.

Outcome Measures:

All patients were clinically assessed by six minutes walk test (6MWT), Modified Medical Research Council Scale (mMRC), 30s-STS and SF 36 at zero week and six weeks post-intervention.

Statistical Analysis:

Difference in means of pre- and post-intervention was compared using paired t-test. A P value <0.05 was considered statistically significant.

Results:

The 6MWT, mMRC Scale, 30 seconds sit-to-stand test, and WHO QoL scale-SF 36 were assessed and post-rehabilitation sessions, all the patients’ showed improvement in the prescribed parameters. After six weeks of respiratory rehabilitation, the distance covered in the 6MWT was significantly longer than that of before the intervention. There was a significant difference between zero and six weeks during the PR intervention. mMRC and 30s-STS results showed a significant difference between zero and six weeks (2.36 ± 0.598, 4.54 ± 1.94. Quality of life improved significantly after six weeks of pulmonary rehabilitation in eight domains of the SF-36.

Conclusion:

Six-week pulmonary rehabilitation programme delivered through telemedicine platform improves respiratory function, QoL and anxiety in patients with post-COVID-19 pneumonia during a recovery phase.
Frequency of self reported abortion and associated factors in Iran
Authors: Zendehdel Mozhgan , Jahanfar Shayesteh , Hamzehgardeshi Zainab
Published: June 2024

ABSTRACT

Background:

There are few reliable Iranian-induced abortion data. The aim of this paper was to investigate the prevalence and socioeconomic characteristics of women and men who report having had or been a partner in an abortion.

Materials and Methods:

A cross-sectional survey of women and men aged 15–49 years referred to the health center that randomly selected from 110 health center that was used.

Results:

Data from 1520 women and men surveys were analyzed. One in 10 women and one in 12 men had experienced or been a partner in an abortion. In adjusted analyses, women and men in the 34–49 age group [adjusted odds ratio (AOR) 0.62, 95% (CI) 0.41, 0.96], the importance of religion in fertility (AOR = 0.42; 95% CI 0.26, 0.67), dissatisfied general health (AOR = 0.52; 95% CI 0.32, 0.87), and history of unwanted pregnancy for twice (AOR = 2.32; 95% CI 1.43, 3.77) and history of unwanted pregnancy for three-time or more (AOR = 2.69; 95% CI 1.59, 5.49) were associated with significantly increased odds of abortion. Haven’t heard of medication abortion, that is, abortion with tablets (AOR = 0.43; 95% CI 0.29, 0.67) was associated with significantly reduced odds of abortion.

Conclusions:

The findings contribute to scarce information about abortion in Iranian. Due to the high prevalence of abortion and the country’s population growth policy, Iranian women need a full range of sexual and reproductive health services, including contraceptive counseling and accessible abortion care.
A study on awareness and perception about perinatal death auditing among health care workers in two districts of Karnataka State, India
Authors: Harsha Kumar HN , Baliga Shantaram B. , Kushtagi Pralhad , Kamath Nutan , Rao Suchetha S.
Published: June 2024

ABSTRACT

Background:

To start perinatal death auditing, doctors should have good knowledge about it.

Objectives:

To know the awareness and perceptions of doctors about different aspects of perinatal death auditing like 1) different types of contributors; 2) high-risk approach; 3) consequences; 4) documentary requirements; and 5) existing system of mortality meeting/child death reviews.

Methodology:

The perinatal death auditing project was implemented in two districts of Karnataka state. As a part of the pre-intervention survey, awareness and perceptions of doctors and a few health care administrators were explored. They were requested to participate in the study. Those who consented were approached in their hospitals and interviewed. Trained medical social workers conducted the interviews. Awareness was scored from 0 to 3 with 0 being no knowledge and 3 being good knowledge. Perceptions were scored from 0 to 3 with 0 being no negative perceptions and 3 being fear of legal consequences. The responses were documented, scored, and described.

Results:

Though 22 doctors were eligible, only 16 consented to participate in the study. Knowledge of doctors about different contributors was inadequate. They were apprehensive about legal consequences. They knew that documentation could protect them and be useful in a court of law. They were not clear about the conduct of mortality meeting/existing system of child death reviews.

Conclusion:

Knowledge was inadequate. They were apprehensive about legal consequences. Training of doctors and allaying apprehensions are required for starting perinatal death auditing.
Ferric carboxymaltose: A game changer in the management of iron deficiency anaemia in pregnancy
Authors: Sharma Nalini , Kharkongor Dimple , Sundaram Shanthosh P. , Karnatak Ruchi , Basu Ritisha , Mishra Shweta , Sharma Aryan , Singh Santa A. , Charaimuriya Birangana , Gowda Namita
Published: June 2024

ABSTRACT

Anaemia is a well-known global health concern in the South Asian countries, and it is estimated that India has the utmost prevalence of anaemia and maternal deaths due to iron deficiency anaemia. This study aims to assess the efficacy and safety of intravenous ferric carboxymaltose (FCM) in antenatal women with anaemia in the second and third trimesters of pregnancy.

Methods:

A single-arm prospective cohort (before–after) study among 60 antenatal women with moderate to severe anaemia in the second and third trimesters was conducted from December 2020 to December 2022, and the eligible women were given 1000 mg of intravenous FCM injection. Efficacy was assessed by rate of improvement in haemoglobin and ferritin at 2 weeks post infusion. Safety analysis was done by assessing adverse drug reactions and foetal heart monitoring during the infusion.

Results:

A total 60 antenatal women with a median gestational age of 32.5 weeks at presentation received 1000 mg of intravenous FCM. There was a rise in mean haemoglobin from 8.05 gm% pre-infusion to 10.93 gm% 2 weeks post infusion, showing a mean rise of 2.88 gm%. Similar improvement was noted in mean serum ferritin levels from 25.92 pre-infusion to 253.96 post FCM infusion. There were no reports of drug-related major adverse effects in the mother or the foetus.

Conclusions:

FCM is found to be safe and effective treatment with rapid replenishment of haemoglobin and ferritin levels in a single dose, which makes it suitable and compels consideration as the first choice for treatment of iron-deficiency anaemia.
Trend analysis of caesarean sections using modified Robson’s classification in a teaching institution in Uttarakhand
Authors: Choudhary Deepti , Saxena Namrata , Gupta Vineeta
Published: June 2024

ABSTRACT

Background:

Globally, the rising caesarean section (CS) rate is of great concern as it is associated with increased maternal morbidity and mortality in subsequent pregnancies. It is essential to reanalyze the CS trend and curb the rising menace using a standardized uniform auditing system. This study aimed to analyze and evaluate the trend of CS using Modified Robson’s Ten Group classification system (RTGCS) in a teaching institution in Uttarakhand.

Methodology:

This cross-sectional study from October 2022 to March 2023 included 260 women undergoing elective or emergency CS. Data on maternal demographics, obstetrics, labour, and fetal outcomes were recorded. Indications for CS were analyzed using modified RTGCS.

Results:

The overall CS rate for the study period at our hospital was 31.4%. The major contributors to CS were Group 2 (21.5%), Group 10 (21.5%), and Group 5 (20.7%), while Group 6 and Group 8 contributed 10% and 7.6%, respectively. Group 9 had the least share (1%) in the study population. The two main indications for which CS was performed were prior Lower Section Caesarean Section (LSCS) and fetal distress, contributing to 24.6% and 19.2%, respectively. CS for breech presentation was done in 16% of the total cases.

Conclusion:

Modified RTGCS is an easy and effective method for auditing CS, preventing unnecessary procedures, and improving maternal care. Its implementation is crucial in addressing the increasing prevalence of CS and ensuring better maternal and fetal outcomes.
Effect of psychoeducation in late life depression: A randomized controlled trial
Authors: Singh Archana , Srivastava Shrikant , Singh Bhupendra
Published: June 2024

ABSTRACT

Background:

Depression is one of the leading causes of disability worldwide, and after the global pandemic COVID-19, it has become even more worse. The treatment of depression should involve pharmacological treatment along with the various kinds of psychotherapies (non-pharmacological management). This study aims to determine the result of psychoeducation in late-life depression by using Hamilton Depression Rating Scale 17 items (HAMD) and Geriatric Depression Scale (Hindi version) (GDS-H).

Material and Methods:

The study was registered on the Control Trial Registry of India (CTRI) via CTRI/2019/05/018956. It is a prospective randomized controlled trial of 4 weeks, where 154 patients aged more than 60 years were randomized into two groups, case group (A) (n = 83) who received psychoeducation along with treatment as usual, whereas control group (B) (n = 71) who received placebo along with treatment as usual. The patients were assessed using Hamilton Depression Rating Scale 17 items (HAMD), Geriatric Depression Scale (Hindi version) (GDS-H) on baseline visit (Day 0), on first follow-up (Day 14), and second follow-up (Day 28). Hindi Mental Status Examination (HMSE) was used on the baseline visit to rule out primary cognitive impairment.

Results:

The results were analyzed, and it was concluded that both the groups have significant decrease in HAMD-17 and GDS-30 scores over a period of time with a P-value of <0.001 in both.
Effect of shift work on dietary habits and occupational stress among nurses in a tertiary care centre: An observational study
Authors: Shrivastava Ragini , Shrivastava Pranjal , Pathak Tanusha , Nagar Jagrati , Jiwane Rekha , Chouhan Sunil , Shrivastava Asha
Published: June 2024

ABSTRACT

Introduction:

Shift work comprises work hours other than 9 am to 5 pm. Healthcare jobs such as nursing have been associated with shift work, which can affect their overall health status. Due to excessive workload and instability in working hours, nurses are also prone to higher occupational stress.

Materials and Methods:

A descriptive study, Cornell Medical Index (CMI) questionnaire, 24-h recall method, and occupational stress score (OSS) were used to assess overall health, calorie intake, and occupational stress among nurses working in a tertiary care centre in Central India.

Results:

The mean age of participants in the control and study groups was 43.2 ± 6.059 years and 43.93 ± 5.20 years, respectively. Neither of the group’s participants had poor nutritional status. CMI health scores revealed poor mental health among the study group. Severe occupational stress was observed in 57% of participants, and 33% had moderate occupational stress. Among the causes of occupational stress, 92% cited unfavourable work conditions, and 88% pointed out the workload. Poor peer relations and low status were cited by 77% and 57% of participants.

Conclusion:

This study highlights the harmful effects of shift work on health of nurses. These negative effects are usually linked to poor diet and stress, which can be induced by overwork, poor sleep, or both. This study found that high workload is the main cause of occupational stress. Sleep disruption, lack of exercise and excess work load are major contributors for occupational stress and unhealthy eating habits. More awareness regarding importance of good diet and stress management may aid in improving health of nurses working in shifts.
Impact of metamorphoses from desk to E-commute – an acumen of professionals: A cross-sectional study
Authors: Patnaik Asmita , Behera Tapas R. , Pradhan Srabani , Mohapatra Debjyoti , Mohanty Smaraki
Published: June 2024

ABSTRACT

Introduction:

The deadly pandemic COVID-19 has brought the world to a standstill. Due to worldwide lockdown, economy was severely compromised. Everyone was in fear of the consequences that would be faced. Many unprecedented changes happened because of this pandemic. People confined themselves at home to maintain social distancing and mitigation of risk factors. This posed many challenges to the individuals or work force with, and many times the work was compromised.

Objectives:

To explore the current and changes in work pattern and to assess the overall quality of life of professionals working from home.

Materials and Methods:

A cross-sectional study was conducted by circulating a structured questionnaire through online platform. A snowball sampling method was adopted. Totally, 520 respondents participated in this study.

Results:

Out of 520 participants, males accounted for 57.9% and 41.3% were females. Majority (45.8% males and 40.9% females) were engaged in the software or IT companies. A higher proportion of males were engaged in administration (6%), architecture (10%) and transportation (5.3%) sector, whereas more females were engaged in finance (10.7%) and law (3.3%) sector. 73.1% males worked for more than 12 hours a day in contrast to only 26.9% of females. As the working hours are reducing, the overall quality of life of the participants was increasing significantly with P = 0.008. For those with moderately increased work-life balance, near about half of the participants had overall quality of life between 50 and 75% (P < 0.001).

Conclusions:

In order to increase efficiency at work place, definite laws should be in place to protect the mental as well as overall well-being of professionals working from home. Elaborative research in this field is required in order to generalize the results.
Spatial auto-correlation and endemicity pattern analysis of crimes against children in Tamil Nadu from 2017 to 2021
Authors: Debata Ipsita , Panda Prem Sagar , Karthikeyan E , Tejas J , Shruthi K , Kumar V Siva , Thirunavukkarasu D
Published: June 2024

ABSTRACT

Background:

A child is a nation’s supreme asset and future. India homes 444 million children, aged between 0 and 18 years, contributing to 19% of the world’s children. Crime against children is detrimental to their mental and physical health and affects their growth and development. The National Crime Record Bureau recently reported that a crime targeting children happens every 4 minutes. There is a paucity of literature regarding the burden of crime against children. To understand the magnitude and spatial distribution of crime against children, a retrospective surveillance study was conducted in the state of Tamil Nadu, India, from 2017 to 2021.

Materials and Methods:

This is a cross-sectional analytical type of study conducted in KIMSRC, Chengalpattu, Tamil Nadu. The data from the yearly crime review bulletin of Tamil Nadu from 2017 to 2021 were cleaned, transformed, and analyzed using Python v3.8 and subjected to geospatial auto-correlation and hotspot analysis using the Getis-Ord Gi* in ArcGIS Pro v3.1. The endemicity pattern was studied through cluster analysis with Hierarchical Density Based Scanning in Python and visualization in ArcGIS pro v3.1 in the study area.

Results:

In Tamil Nadu, only one hotspot district in 2017 [Tiruppattur (95% confidence, P < 0.05)] and one hotspot in 2020 [Villupuram (90% confidence, P < 0.1)] were identified, with others being insignificant. The districts which show very high prevalence of crimes against children are Chennai, Ranipet, Chengalpattu, Viluppuram, Tiruvannamalai, Vellore, Tiruppattur, Krishnagiri, Dharmapuri, Salem, Cuddalore, Thanjavur, Tiruchirappalli, Karur, Tiruppur, Coimbatore, Dindigul, Pudukkottai, Sivaganga, Tenkasi, Thoothukkudi, Tirunelveli, and Kanniyakumari.

Conclusion:

This study identifies key areas within the state of Tamil Nadu which have a high prevalence of crimes against children and also areas that are hotspots for such crimes. Greater resources and measures can now be targeted toward these areas by stakeholders, which can help in the reduction of crimes against children.
Comparison of indirect cyanmethaemoglobin method and TrueHb haemometer point of care test with direct cyanmethaemoglobin (gold standard) method for strengthening anaemia detection at primary health care level
Authors: Khurana Rupinder , Aggarwal Arun Kumar , Thungapathra M. , Sagar Vivek
Published: June 2024

ABSTRACT

Introduction:

The most reliable indicator for anaemia diagnosis at the population level is haemoglobin (Hb) estimation. The direct cyanmethaemoglobin method is considered the gold standard method for haemoglobin estimation. However, for resource constraint areas like primary health care (PHC) level, either blood samples are transported on filter paper for Hb testing (indirect cyanmethaemoglobin method) in laboratory or point of care testing is commonly used. Therefore, a comparative analysis of haemoglobin estimation of direct with indirect cyanmethaemoglobin method and also with TrueHb (Wrig Nanosystems Pvt. Ltd.) haemometer was done to strengthen anaemia diagnosis at the PHC level.

Materials and Methods:

This was a cross-sectional study. A total of 90 participants above 9 years of age, who visited the outpatient department (OPD) of health centre, Kheri and gave consent were included. Comparative analysis was done between Hb concentration assessed by indirect cyanmethaemoglobin method and TrueHb haemometer device against the gold standard method.

Results:

The mean Hb value estimated by direct method, TrueHb haemometer and indirect methods (filter paper A, B and C) was 11.42 ± 1.59 g/dl, 11.52 ± 1.54 g/dl, 10.66 ± 1.52 g/dl, 9.84 ± 1.50 g/dl and 10.19 ± 1.62 g/dl, respectively. There was no significant difference found between the mean Hb concentration estimated by the direct method and the TrueHb haemometer device. However, there was a significant difference in mean Hb values between the direct method and the indirect method. Therefore, regression analysis was done to estimate the correction factor for the indirect method.

Conclusion:

TrueHb metre device gave promising results in comparison to the gold standard method and can be used if resource permits in PHC centres. Indirect methods of haemoglobin estimation can be an alternative in resource-constraint settings, specifically for surveys. However, further studies are required for the validation of the indirect method.
‘Seven Plus One’ a unique approach to assess the knowledge, attitude and practices for dengue prevention and control among frontline workers of a teaching institution in Rishikesh, Uttarakhand
Authors: Kumar Santosh , Mishra Ashutosh , Singh Dharanidhar
Published: June 2024

ABSTRACT

Background:

Dengue which is an arboviral disease transmitted by Aedes aegypti mosquito, drastically affected communities worldwide. It has been showing consistently a rising trend in developing country like India.

Study Objectives:

To assess the knowledge, attitude and practices (KAPs) related to the prevention and control of dengue fever (DF) among frontline staff members at a medical teaching institution in Rishikesh, Uttarakhand.

Materials and Methods:

A community-based cross-sectional study was conducted at a medical teaching institution in Rishikesh, Uttarakhand. Out of 830 frontline workers only 208 workers were recruited in a study by the simple random selection method. A semi-structured interview questionnaire was applied to assess the KAPs of participants. Attitude was assessed by four-point Likert scaling. Statistical analysis was done using SPSS version 23 for Windows.

Results:

A total of 208 participants were interviewed. Majority were male (70.2%) with the age group of 31 to 45 years (71.2%). Majority (50.5%) of participants were educated up to higher secondary and working as a security guard (78.8%). Most (72.6%) of the respondents said the rainy season was the most common outbreak season for dengue. Most (63.6%) of the participants were aware that dengue is transmitted by mosquitoes. The majority (49%) of participants strongly agreed that dengue is a fatal disease.

Conclusion:

There is an urgent need to prevent and control the epidemics of dengue by adoption of seven plus one model which contributes in reducing the overall burden in healthcare delivery system.
A literature review on the impact of concierge medicine services on individual healthcare
Authors: Alhawshani Salman , Khan Safeer
Published: June 2024

ABSTRACT

The concept of concierge medicine, established in 1996, stands out for its focus on enhancing accessibility to healthcare providers and customized medical services. It is centered on key principles such as giving priority to quality and individualized care, managing a smaller group of patients to ensure improved service accessibility, and nurturing enhanced continuity in personalized treatment. This review explores various aspects of how concierge medicine impacts healthcare, encompassing areas such as patient satisfaction and involvement, health outcomes, preventive care, healthcare expenses, and ethical and legal considerations. While the affirmative influence of concierge medicine on individual healthcare has been evidenced in terms of patient contentment, active patient participation, preventive care, and early identification of illnesses, there remains a dearth of research data to firmly establish the correlation between concierge medicine and health-related outcomes. Moreover, comprehensive longitudinal studies focusing specifically on the economic and policy implications of concierge medicine are currently lacking. Therefore, further research, particularly in the domain of health economics, is crucial to comprehensively comprehend the implications of this approach. Similarly, there is a necessity for studies that can conduct a comparative analysis between the concierge medicine model and traditional healthcare models, aiming to draw more robust and definitive conclusions.
Effect of different endometrial preparation methods on pregnancy outcome of FET in women with a normal menstrual cycle
Authors: Guan Hui-Juan , Tang Huai-Yun , Li Hui , Song Hang , Zhao Jia-Hui , Song Jia , Zhang Shuai , Tang Li-Sha
Published: June 2024

ABSTRACT

Objective:

This study aims to explore the relationship between different endometrial preparations and pregnancy outcomes among patients with regular ovulatory cycles in order to find the best endometrial preparation methods in the freeze–thaw embryo transfer (FET) cycle.

Materials and Methods:

This is a retrospective study to investigate FET pregnancy outcomes in women who had a regular menstrual cycle, were younger than 35 years old, and underwent a modified natural cycle (mNC), ovulation induction (OI), or a hormone replacement treatment (HRT) cycle. A total of 1071 frozen cycles were included for analysis.

Results:

The implantation rate and live birth rate (LBR) in the OI group show a significant difference when compared to the mNC and HRT groups (P < 0.01). After adjusting for confounding factors, the logistic regression analysis revealed that the number of embryos transferred, the embryo stage, and quality were significantly associated with clinical pregnancy rate and LBR. The LBR was additionally affected by the mode of the endometrial preparation; the OI cycle could increase LBR.

Conclusions:

Endometrial preparation methods affect the LBR in women with a regular menstrual cycle. The OI cycle had an advantage in the LBR of FET.
Seroepidemiology of hepatitis B virus (HBV) and relationship to serum transaminase levels in Indian population
Authors: Kumar Manoj , Seema Kumari , Kumar Dinesh , Kumar Abhay , Sharma Ashok Kumar , Boipai Manju , Rani Aysha
Published: June 2024

ABSTRACT

Background:

Hepatitis B virus (HBV) infection is a serious public health issue that must be addressed.

Aim:

The goal of this study was to investigate the correlation between serological status for hepatitis Be antigen (HBeAg)/anti-HBe, serum transaminase levels, and serum HBV-DNA in patients with chronic HBV infection.

Methods:

A retrospective observational study with 620 patients with persistent HBV infection (mean age, 36.35 years; 506 men) was conducted. All patients tested positive for hepatitis B surface antigen (HBsAg). Liver profile, HBeAg, and anti-HBe antibody tests were conducted for all patients. Additionally, serum HBV DNA was examined using a DNA assay in these individuals.

Results:

Of 620 patients, 114 (18.39%) were HBeAg-positive and 506 (81.61%) HBeAg-negative. A detectable level of HBV DNA was found in 89.79% of HBeAg-positive/anti-HBe negative patients compared to HBeAg-negative/anti-HBe positive carriers 33.69% (P value <0.0001). The median viral load was significantly higher in HBeAg-positive cases (4.72 log10 copies/mL) than in HBeAg-negative individuals (4.23 log10 copies/mL; P = 0.997). Additionally, a higher proportion of HBeAg-positive samples (P = 0.0001) had HBV-DNA levels above 10,000 copies/mL.
A baseline cross-sectional study to assess patient satisfaction (18–60 years) toward Apli Chikitsa (free of cost medical laboratory tests) services provided at an urban health training center: A PPP model
Authors: Rawat Shalini , Sangam Rohan , Shelke Pallavi , Gokhe Seema S Bansode
Published: June 2024

ABSTRACT

Introduction:

Assessing satisfaction with healthcare services is one of the cornerstone methods to evaluate success and identify obstacles during the process for the patients. Identifying crucial information helps in course correction and better healthcare delivery to the patients. Apli Chikitsa is a novel PPP model-based free of cost laboratory service made available to the patients by the municipal corporation. Around 150 blood tests are offered free of cost and through peripheral dispensaries to the patients. The present study was undertaken to assess the satisfaction of patients with the service and service-related aspects.

Methodology:

A cross-sectional observational urban health center-based study was undertaken to assess the satisfaction of patients toward the Apli Chikitsa laboratory service. Institutional ethics committee clearance was obtained before commencing the study. Four hundred patients availing of the laboratory services were enrolled by alternate sampling method. A semistructured questionnaire was administered; five-point Likert scale was used to assess satisfaction toward the service and related aspects. Results were summarized using tables and charts, and percentages and proportions were used wherever necessary. Data were analyzed using Microsoft Excel.

Results:

Among the study participants, overall satisfaction was observed among 71.25%, and 100% satisfaction was observed in relation to cost of service, maintenance of privacy and confidentiality, and getting all the requested tests done. The problem of overcrowding (96.75%) was observed by a majority. Satisfaction was low regarding the cleanliness of toilets (48.75%).

Conclusion:

Based on the findings, it can be concluded that the overall satisfaction is the Apli Chikitsa laboratory service is good, and it is a good model for replication for laboratory service delivery in peripheral areas away from tertiary care centers. Overcrowding should be managed, and cleanliness of toilets to done at frequent intervals, along with proper and visible use of signages, should be done to improve the satisfaction of the patients.
Prevalence and correlates of cognitive impairment among an urban geriatric population of Haryana
Authors: Kumar Neelam , Kumar Mukesh , Vinay  , Saha Arup , Rathee Manjeet , Jyotsana  , Singh Tarun
Published: June 2024

ABSTRACT

Background:

Severe Cognitive Impairment (CI) is a major cause of disability and dependency among the elderly worldwide, and it has a significant impact not only on individuals but also on families, communities, and societies. Early identification and management of CI are critical in geriatric medicine. Prevalence data is often scarce, and this hinders the ground-level implementation of preventive health programs.

Objectives:

The objective was to find the prevalence of CI and its covariates among the urban geriatric population of Haryana.

Materials and Methods:

This was a community-based cross-sectional study conducted among 300 geriatric participants residing in an urban area of Rohtak district, Haryana. Hindi Mental State Examination (HMSE) tool was used to assess CI. Data were analyzed using IBM Corp, released 2020, IBM SPSS statistics for windows Ver 20, Armonk, NY.

Results:

The prevalence of geriatric CI was found to be 27.3% and was found to be significantly associated with age, female gender, scheduled and backward caste (BC), widowhood, and low educational status and is not engaged in any occupation, low socioeconomic status, teetotalism, economic dependency, physical dependency on others, and chronic morbidity.

Conclusion:

Age, female gender, scheduled and backward caste, widowhood, low educational status, nil employment status, low socioeconomic status, teetotalism, economic dependency, physical dependency on others, and chronic morbidity were found to be important correlates of CI. Further analytical studies can focus on these aspects for an early targeted preventive approach.
Albendazole and praziquantel combination versus albendazole alone in children with multiple neurocysticercosis: An open labelled randomized controlled trial
Authors: Rani Vijay , Gehlawat Virender K. , Arya Vandana
Published: June 2024

ABSTRACT

Context:

The efficacy of the combination of albendazole and praziquantel has not been thoroughly studied in multiple neurocysticercosis in children.

Objective:

To compare the efficacy and safety of albendazole and praziquantel combination versus albendazole alone in the treatment of children with multiple neurocysticercosis in terms of proportion of cysts undergoing complete resolution or calcification at 6-month follow-up.

Materials and Methods:

A total of 52 children, aged 1–14 years, with newly diagnosed two or more active neurocysticercosis were randomized to either group A or B. Group A (n = 26) received albendazole plus praziquantel, and Group B (n = 26) received albendazole alone. At the end of 6 months, a repeat MRI brain was performed to see for the resolution of cysts and was classified as complete resolution, calcified, or persistence of viable and noncalcified cysts.

Results:

The proportion of cysts undergoing complete resolution was higher in Group A (23/60 [38.33%]) than in Group B (19/65 [29.23%]), but the difference was not statistically significant. The proportion of cysts undergoing calcification was also comparable in Group A (20/60 [33.33%]) and Group B (20/65 [30.77%]). Both groups had comparable safety profiles.

Conclusion:

Albendazole and praziquantel combination therapy is as effective as albendazole alone in terms of complete resolution of viable cysts and calcification of cysts.

Trial registration: CTRI/2021/12/038492.
Application of Fusobacterium nucleatum as a biomarker in gastrointestinal malignancies
Authors: Yu Long-Chen , Li Ya-Ping , Xin Yue-Ming , Mao Mai , Pan Ya-Xin , Qu Yi-Xuan , Luo Zheng-Dong , Zhang Yi , Zhang Xin
Published: June 2024

The morbidity and mortality of gastrointestinal (GI) malignancies are among the highest in the world, posing a serious threat to human health. Because of the insidious onset of the cancer, it is difficult for patients to be diagnosed at an early stage, and it rapidly progresses to an advanced stage, resulting in poor treatment and prognosis. Fusobacterium nucleatum (F. nucleatum ) is a gram-negative, spore-free anaerobic bacterium that primarily colonizes the oral cavity and is implicated in the development of colorectal, esophageal, gastric, and pancreatic cancers via various intricate mechanisms. Recent development in novel research suggests that F. nucleatum may function as a biomarker in GI malignancies. Detecting the abundance of F. nucleatum in stool, saliva, and serum samples of patients may aid in the diagnosis, risk assessment, and prognosis monitoring of GI malignancies. This editorial systematically describes the biological roles and mechanisms of F. nucleatum in GI malignancies focusing on the application of F. nucleatum as a biomarker in the diagnosis and prognosis of GI malignancies to promote the clinical translation of F. nucleatum and GI tumors-related research.
T1 colorectal cancer management in the era of minimally invasive endoscopic resection
Authors: Jiang Shirley Xue , Zarrin Aein , Shahidi Neal
Published: June 2024

T1 colorectal cancer (CRC), defined by tumor invasion confined to the submucosa, has historically been managed by surgery. Improved understanding of recurrence and lymph node metastases risk, coupled with advances in endoscopic resection techniques, have led to an increasing capacity for organ-sparing local excision. Minimally invasive management of T1 CRC begins with optical evaluation of the lesion to diagnose invasive disease and quantify depth of invasion, which informs therapeutic decision making. Modality selection between various available endoscopic resection techniques depends upon lesion characteristics, technique risk-benefit profiles, and location-specific implications. Following endoscopic resection, established histopathology features determine the risk of recurrence and subsequent management including surveillance or adjuvant surgical excision. The management of non-operative candidates deviates from conventional recommendations with emerging treatment strategies in select populations.
Advancements in breath-based diagnostics for pancreatic cancer: Current insights and future perspectives
Authors: Tez Mesut , Şahingöz Eda , Martlı Hüseyin Fahri
Published: June 2024

Recent decades have seen a concerning surge in carcinogenic diseases, with cancer cases and deaths on the rise globally. Conventional diagnostic methods are often invasive and time-consuming, highlighting the need for fast, accurate, and painless alternatives. Non-invasive exhaled breath analysis emerges as a promising solution, with over 200 volatile organic compounds (VOCs) detected in exhaled air, showing potential as biomarkers for various diseases, including cancer. Despite the lack of standardized methodologies, advancements in analytical instruments have expanded detection capabilities, reaching 3500 VOCs. Studies have identified specific VOC patterns associated with different cancers, offering hope for non-invasive diagnosis. Techniques such as gas chromatography-mass spectrometry and electronic noses show promise in distinguishing between healthy individuals and cancer patients. However, further research and standardization are needed to realize the full clinical potential of breath-based diagnostics, particularly in the early detection of challenging cancers like pancreatic cancer.
Advances in targeted therapy for human epidermal growth factor receptor 2 positive in advanced gastric cancer
Authors: Jiang Ya-Kun , Li Wei , Qiu Ying-Yang , Yue Meng
Published: June 2024

Emerging therapeutic methods represented by targeted therapy are effective supplements to traditional first-line chemoradiotherapy resistance. Human epidermal growth factor receptor 2 (HER2 ) is one of the most important targets in targeted therapy for gastric cancer. Trastuzumab combined with chemotherapy has been used as the first-line treatment for advanced gastric cancer. The safety and efficacy of pertuzumab and margetuximab in the treatment of gastric cancer have been verified. However, monoclonal antibodies, due to their large molecular weight, inability to penetrate the blood-brain barrier, and drug resistance, lead to decreased therapeutic efficacy, so it is necessary to explore the efficacy of other HER2 -targeting therapies in gastric cancer. Small-molecule tyrosine kinase inhibitors, such as lapatinib and pyrrotinib, have the advantages of small molecular weight, penetrating the blood-brain barrier and high oral bioavailability, and are expected to become the drugs of choice for perioperative treatment and neoadjuvant therapy of gastric cancer after validation by large-scale clinical trials in the future. Antibo-drug conjugate, such as T-DM1 and T-DXd, can overcome the resistance of monoclonal antibodies despite their different mechanisms of tumor killing, and are a supplement for the treatment of patients who have failed the treatment of monoclonal antibodies such as trastuzumab. Therefore, after more detailed stratification of gastric cancer patients, various gastric cancer drugs targeting HER2 are expected to play a more significant role.
Unveiling the secrets of gastrointestinal mucous adenocarcinoma survival after surgery with artificial intelligence: A population-based study
Authors: Song Jie , Yan Xiang-Xiu , Zhang Fang-Liang , Lei Yong-Yi , Ke Zi-Yin , Li Fang , Zhang Kai , He Yu-Qi , Li Wei , Li Chao , Pan Yuan-Ming
Published: June 2024

BACKGROUND

Research on gastrointestinal mucosal adenocarcinoma (GMA) is limited and controversial, and there is no reference tool for predicting postoperative survival.

AIM

To investigate the prognosis of GMA and develop predictive model.

METHODS

From the Surveillance, Epidemiology, and End Results database, we collected clinical information on patients with GMA. After random sampling, the patients were divided into the discovery (70% of the total, for model training), validation (20%, for model evaluation), and completely blind test cohorts (10%, for further model evaluation). The main assessment metric was the area under the receiver operating characteristic curve (AUC). All collected clinical features were used for Cox proportional hazard regression analysis to determine factors influencing GMA’s prognosis.

RESULTS

This model had an AUC of 0.7433 [95% confidence intervals (95%CI): 0.7424-0.7442] in the discovery cohort, 0.7244 (GMA: 0.7234-0.7254) in the validation cohort, and 0.7388 (95%CI: 0.7378-0.7398) in the test cohort. We packaged it into Windows software for doctors’ use and uploaded it. Mucinous gastric adenocarcinoma had the worst prognosis, and these were protective factors of GMA: Regional nodes examined [hazard ratio (HR): 0.98, 95%CI: 0.97-0.98, P < 0.001)] and chemotherapy (HR: 0.62, 95%CI: 0.58-0.66, P < 0.001).

CONCLUSION

The deep learning-based tool developed can accurately predict the overall survival of patients with GMA postoperatively. Combining surgery, chemotherapy, and adequate lymph node dissection during surgery can improve patient outcomes.
Impact of baseline hepatitis B virus viral load on the long-term prognosis of advanced hepatocellular carcinoma treated with immunotherapy
Authors: Pan Di , Liu Hao-Nan , Yao Zhi-Yuan , Chen Xiao-Xiao , Li Yu-Qi , Zhu Jing-Jing , Han Zheng-Xiang , Qin Xiao-Bing
Published: June 2024

BACKGROUND

Although the combination of lenvatinib and PD-1 inhibitors has become the standard regimen for the treatment of advanced hepatocellular carcinoma (HCC), real data on the impact of baseline hepatitis B virus (HBV)-DNA levels on the clinical efficacy of this regimen is still limited.

AIM

To evaluate the effectiveness of camrelizumab combined with lenvatinib in patients with HCC at varying levels of HBV-DNA.

METHODS

One hundred and twenty patients with HCC who received camrelizumab and lenvatinib treatment were categorized into two cohorts: HBV-DNA ≤ 2000 (n = 66) and HBV-DNA > 2000 (n = 54). The main outcomes measured were overall survival (OS) and progression-free survival (PFS), while additional outcomes included the rate of objective response rate (ORR), disease control rate (DCR), and any negative events. Cox proportional hazards regression analysis revealed independent predictors of OS, leading to the creation of a nomogram incorporating these variables.

RESULTS

The median PFS was 8.32 months for the HBV-DNA ≤ 2000 group, which was similar to the 7.80 months observed for the HBV DNA > 2000 group (P = 0.88). Likewise, there was no notable variation in the median OS between the two groups, with durations of 13.30 and 14.20 months respectively (P = 0.14). The ORR and DCR were compared between the two groups, showing ORR of 19.70% vs 33.33% (P = 0.09) and DCR of 72.73% vs 74.07% (P = 0.87). The nomogram emphasized the importance of antiviral treatment as the main predictor of patient results, with portal vein tumor thrombus and Barcelona Clinic Liver Cancer staging following closely behind.

CONCLUSION

The clinical outcomes of patients with HBV-associated HCC treated with camrelizumab in combination with lenvatinib are not significantly affected by HBV viral load.