bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effect of Traditional and Ultraconservative Access Cavities On the Increase in Surface Area of Root Canal After Instrumentation: An in Vitro Study
Authors: Jaleo Hayder Abdul-Jaleel , Al-Huwaizi Hussain F.
Published: August 2023

Introduction: In this study, we aimed to evaluate the impact of ultraconservative and traditional endodontic access cavities on the total percentage increase in the surface area of root canals. Methods: Endodontic instrumentation was performed on 30 simulated maxillary first premolars with two roots using traditional and ultraconservative access cavities via ProTaper Next rotary files. The pre- and postinstrumentation photographs of the root canals were analyzed blindly using Fiji software to determine the percentage increase in surface area. Results: A significant increase in the surface area of the root canal was observed with an ultraconservative endodontic access cavity compared to a traditional access cavity. The difference between the palatal and buccal roots was not significant, but there was a significant difference among the coronal, middle, and apical thirds of the root canal. Conclusion: Ultraconservative access cavities have a significant impact on the increase in surface area of the root canal after instrumentation.
Efficacy and Safety of Novel Thiazolidinedione Rivoglitazone in Type-2 Diabetes a Meta-Analysis
Authors: Dutta Deep , Kadian Jyoti , Maisnam Indira , Kumar Ashok , Bhattacharya Saptarshi , Sharma Meha
Published: August 2023

No meta-analysis has analyzed the safety and efficacy of rivoglitazone in type-2 diabetes (T2DM). We undertook this meta-analysis to address this knowledge gap. Electronic databases were searched for RCTs involving T2DM patients receiving rivoglitazone in the intervention arm, and placebo/active comparator in the control arm. The primary outcome was to evaluate changes in HbA1c. Secondary outcomes were to evaluate alterations in glucose, lipids, and adverse events. From initially screened 24 articles, data from 3 RCTs (3591 patients) that fulfilled all criteria was analzsed. HbA1c was significantly lower with standard-dose (1 mg/d) [MD-0.86% (95%CI:-1.11–-0.61); P < 0.01; I2 = 87%] and high-dose (1.5-2 mg/d) [MD-0.97%(95%CI:-1.03–-0.90); P < 0.01; I2 = 19%] rivoglitazone compared to placebo. When compared to pioglitazone (30-45 mg/d), HbA1c lowering was comparable with standard-dose [MD 0.05%(95%CI:-0.01 – 0.11); P = 0.08; I2 = 11%], but superior with high-dose [MD -0.11%(95%CI:-0.18– -0.04); P < 0.01; I2 = 0%] rivoglitazone. Triglycerides were significantly lower with standard-dose [MD-17.95 mg/dl (95%CI:-34.23–-1.66); P = 0.03; I2 = 0%] and high-dose [MD-40.41 mg/dl (95%CI:-72.90– -7.93);P = 0.01;I2 = 71%] rivoglitazone compared to placebo. Adiponectin significantly improved with standard-dose [MD 7.94 ng/ml (95%CI: 5.48–10.39); P < 0.01;I2 = 98%] and high-dose [MD 13.82 ng/ml (95%CI: 8.16–19.48); P < 0.01; I2 = 100%] rivoglitazone compared to placebo. hsCRP was significantly lower with standard-dose [MD -1.00 mg/L (95% CI: -1.20 – -0.80); P < 0.01; I2 = 6%] and high-dose [MD -1.50 mg/L (95%CI:-1.59– -1.40); P < 0.01; I2 = 0%] rivoglitazone compared to placebo. Treatment-emergent adverse events with standard-dose [Risk ratio (RR) 1.16 (95%CI: 0.84 –1.60); P = 0.38; I2 = 0%] and high-dose [RR1.34 (95%CI: 0.99–1.83); P = 0.06; I2 = 0%] rivoglitazone was comparable to placebo. Severe adverse events with standard-dose [RR1.88 (95%CI: 0.69–5.12);P = 0.22;I2 = 0%] and high-dose [RR 1.27 (95% CI: 0.45 – 3.59); P = 0.68; I2 = 0%] rivoglitazone was comparable to placebo. This meta-analysis highlights the good glycaemic efficacy and safety of both standard and high-dose rivoglitazone, and appears to be better than lobeglitazone in T2DM.
Association of TCF7L2 Variants in Type 2 Diabetes Mellitus with Hypertriglyceridemia – A Case-Control Study
Authors: Gunavathy Nagarajan , Balaji Ramanathan , Kumaravel Velayutham
Published: August 2023

Background:

Type 2 Diabetes Mellitus (T2DM) is a chronic metabolic condition involving various genetic and environmental factors leading to impaired insulin secretion, resulting in hyperglycemia. The transcription factor 7-like 2 (TCF7L2) gene is an element of the Wnt signaling pathway that plays an important role in glucose and lipid metabolism. The aim of this study is to evaluate the association of TCF7L2 rs7903146 and rs12255372 polymorphisms in T2DM with hypertriglyceridemia.

Methods:

We investigated the effect of rs7903146 and rs12255372 on T2DM with high triglyceride (TG) levels in 60 patients and 20 controls. The anthropometric measurements and biochemical tests were assessed. Peripheral blood samples were collected, and genomic DNA was extracted. The genotyping of TCF7L2 polymorphisms was carried out using polymerase chain reaction (PCR)-based direct sequencing and allele-specific PCR methods. The T2DM patients and controls were compared by means of the t-test, Chi-square test, odds ratio (OR), and 95% confidence interval (CI) using Epi Info v7.

Results:

The HbA1c was found to be 9.7 ± 2.1 and 5.4 ± 0.5% in patients and controls, respectively. The average TG levels (P < 0.005) in patients were 205.2 ± 145.7 and 106.4 ± 27.4mg/dl in controls. Significant evidence of association was found in T2DM patients having high TG levels with rs7903146 CT/TT (OR: 4.89; P = 0.0105) and rs12255372 GT/TT (OR: 5.23; P = 0.0101) genotypes when compared to controls.

Conclusion:

The results of this study show that TCF7L2 rs7903146 CT/TT and rs12255372 GT/TT genotypes are significantly associated with the risk of hypertriglyceridemia in individuals with T2DM among the studied population.
Cardiac Autonomic Neuropathy in Prediabetes: A Case-Control Study
Authors: Gujjar Pavan , Ravikumar Y. S. , Nagendra Lakshmi , Boro Hiya , Bhattacharya Saptarshi
Published: August 2023

Introduction:

Early detection and diagnosis of diabetic autonomic neuropathy, especially cardiac autonomic neuropathy (CAN), have gained attention recently because of their elevated cardiovascular mortality risk. Although the connection between type 2 diabetes mellitus and autonomic neuropathy is well established, evidence is emerging that the association might predate the stage of prediabetes.

Objective:

The present study was undertaken to compare the prevalence of CAN in prediabetes versus that in normoglycemic controls.

Materials and Methods:

The study population was selected by purposive sampling from individuals attending a tertiary care hospital from January 2018 to June 2019. Fifty individuals with prediabetes diagnosed by the American Diabetes Association’s glycated haemoglobin criteria and 50 age- and gender-matched healthy controls were recruited. CAN was assessed by standard cardiovascular reflex tests, as described by Ewing and Clarke. Changes in R-R with deep breathing, Valsalva manoeuver, and changes in blood pressure (BP) in response to standing and sustained handgrip were evaluated. Three-time domains [standard deviation of normal-to-normal intervals (SDNN), root mean square of successive RR intervals (rMSSD) and percentage of successive normal to normal R-R (NN) intervals that differ by more than 50 ms (pNN50)] and four frequency domain indices [very low-frequency band (VLF), low-frequency band (LF), high-frequency band (HF), LF/HF ratio) of heart rate variability (HRV)] were examined.

Results:

The mean heart rate was 71.37 ± 7.94 and 65.59 ± 8.73 beats/min in patients with prediabetes and controls, respectively (P < 0.05). All three-time-domain indices of HRV were significantly lower in persons with prediabetes compared to controls. The peak frequency of LF, peak power of LF, normalised unit of LF, and LF/HF ratio was significantly lower in subjects with prediabetes than in controls. There was no difference in the traditional cardiovascular autonomic reflex testing.

Conclusion:

Our study demonstrates the presence of subclinical autonomic dysfunction in persons with prediabetes. Early detection of CAN in prediabetes can have future implications for cardiovascular risk reduction.
Prevention of Type 1 Diabetes: Current Perspective
Authors: Pande Arun K. , Dutta Deep , Singla Rajiv
Published: August 2023

People living with type 1 Diabetes (T1D) and their families have poor perception of health related quality of life. Therapies for T1D are becoming better with time, but they still involve a lot of effort. Prevention of T1D, if successful, has potential to change lives of millions of families across the globe. Type 1 diabetes is an autoimmune disease with underlying genetic predisposition for autoimmunity against beta cell antigens upon exposure to an environmental trigger. Identifying underlying primary antigen responsible for initiating autoimmune cascade, avoiding environmental trigger and modifying immunity has all been used as strategies for preventing or delaying onset of type 1 diabetes. Primary prevention for type 1 diabetes is hindered by difficulty in identifying at-risk population and also due to lack of effective preventive strategy. Secondary prevention, in children with presence of autoimmunity, has recently received a boost with approval of Teplizumab, an immunity modifying drug by its Anti-CD3 action. Application of preventive strategies would also change based on country specific incidence, prevalence and availability of health resources. In current review, an update on preventive strategies for type 1 diabetes is being discussed as well as their applicability in Indian context.
Determinants of post discharge mortality among hospitalized COVID-19 patients
Authors: Kumar Gunjan , Talukdar Arunansu , Turuk Alka , Bhalla Ashish , Mukherjee Subhasis , Bhardwaj Pankaj , Bhatnagar Tarun , Mukherjee Aparna ,   The NCRC Study Team
Published: August 2023

Background & objectives:

The post-acute effects of COVID-19 are continually being updated. This investigation was conducted to evaluate the determinants of post discharge mortality in hospitalized COVID-19 patients, especially 18-45 yr of age.

Methods:

A series of three nested case-control analyses was conducted on follow up data collected in the National Clinical Registry for COVID-19 between September 2020 and February 2023 from 31 hospitals. Matching (1:4) was done by the date of hospital admission ±14 days for the following comparisons: (i) case-patients reported as dead vs. controls alive at any contact within one year follow up; (ii) the same in the 18-45 yr age group and (iii) case-patients reported as dead between the first and one year of follow up vs. controls alive at one year post discharge.

Results:

The one year post discharge mortality was 6.5 per cent (n=942). Age [≤18 yr: adjusted odds ratio (aOR) (95% confidence interval [CI]): 1.7 (1.04, 2.9); 40-59 yr: aOR (95% CI): 2.6 (1.9, 3.6); ≥60 yr: aOR (95% CI): 4.2 (3.1, 5.7)], male gender [aOR (95% CI): 1.3 (1.1, 1.5)], moderate-to-severe COVID-19 [aOR (95% CI): 1.4 (1.2, 1.8)] and comorbidities [aOR (95%CI): 1.8 (1.4, 2.2)] were associated with higher odds of post-discharge one-year mortality, whereas 60 per cent protection was conferred by vaccination before the COVID-19 infection. The history of moderate-to-severe COVID-19 disease [aOR (95% CI): 2.3 (1.4, 3.8)] and any comorbidities [aOR (95% CI): 3 (1.9, 4.8)] were associated with post-discharge mortality in the 18-45-yr age bracket as well. Post COVID condition (PCC) was reported in 17.1 per cent of the participants. Death beyond the first follow up was associated with comorbidities [aOR (95%CI): 9.4 (3.4, 26.1)] and reported PCC [aOR (95% CI): 2.7 (1.2, 6)].

Interpretation & conclusions:

Prior vaccination protects against post discharge mortality till one year in hospitalized COVID-19 patients. PCC may have long term deleterious effects, including mortality, for which further research is warranted.
Effectiveness of Self-reflection Enhancement Strategy on Self-concept and Skill of Coping with Stress among Upper Primary School Students
Authors: Alias Musthafa M. N. Mohamedunni , Dewtwal Manoj Kumar , Stephen Rini E.
Published: August 2023

Introduction:

Swami Vivekananda is the symbol of the self-concept who has propagated the Indian Knowledge System in western countries. His life philosophy become more relevant during the pandemic period when people are distressed due to various adversities. In the present study, a strategy was developed based on the philosophy and methodology of Swami Vivekananda to improve the self-concept and skill of coping with stress among upper primary school students. Materials and Methods: 240 sixth-standard students were selected as the sample. Students were allotted four classes and two classes were randomly assigned as the experimental group and two as the control group. Assessments were done using the Self-Concept Rating Scale (SCRS) and The Pandemic Stress Coping Scale (PSCS). The experiment group was treated with the Self-Reflection Enhancement Strategy (SRES) for one month.

Discussion:

The experimental groups have improved their self-concept P =0.05) and stress coping skills (P =0.05) compared to the control group.

Conclusion:

The Self-Reflection Enhancement Strategy is found to be very much effective in enhancing the self-concept and coping skills among students.
New Quantum Spin Perspective and Space-Time of Mind-Stuff
Authors: Vyas Rakshit P. , Joshi Mihir J.
Published: August 2023

The fundamental building block of the loop quantum gravity (LQG) is the spin network which is used to quantize the physical space-time in the LQG. Recently, the novel quantum spin is proposed using the basic concepts of the spin network. This perspective redefines the notion of the quantum spin and also introduces the novel definition of the reduced Planck constant. Implications of this perspective are not only limited to the quantum gravity, but also found in the quantum mechanics. Using this perspective, we propose the quantization of the space-time of the mind-stuff. Similarity between the physical space-time and the space-time of the mind-stuff provides novel notions to study the space-time scientifically as well philosophically. The comparative study between the physical-space-time and the space-time of the mind-stuff is also given.
Effect of Mindfulness-based Interventions on Mental Health of Women with Infertility
Authors: Dalal Smarika
Published: August 2023

Background:

By instinct, human beings have desire to propagate their genes. Infertility can be very painful for the individuals. The men and women with this medical condition are not just battling physiological problems but also dealing with psychological, emotional, and social battles, including low self-esteem, stress, depression, frustration, hopelessness, anxiety, feeling of guilt and worthlessness, insecurity in marital relationship, marital discords and lesser marital satisfaction. Women population is more vulnerable to the psycho-social consequences of infertility. Though many research studies have been conducted to investigate the psycho-social impact of infertility on women, the research literature on the combative role of mindfulness-based interventions on mental health of women have been limited. Mindfulness as a psycho-therapeutic intervention has been shown to be effective in chronic conditions like cancer, diabetes, anxiety, depression and pain. The mindfulness-based interventions in individuals with chronic conditions can assist them to accept the condition and overcome the psychological issues that arise due to the physical health conditions. Infertility is a physical health condition that has strong psychological consequences. Thus, there is a need to study the impact of these interventions on women population suffering from infertility. The purpose of the present study is to explore the effect of mindfulness-based interventions on the mental health of the women with infertility.

Objective:

In light of the foregoing history, the current review's research question is “Are mindfulness-based interventions effective in improving mental health of women with infertility?”

Methods:

This is a narrative review guided by systematic approach to searching. Prominent research databases were used to locate empirical articles reporting on the efficacy of mindfulness-based therapies on mental health of infertile women between 2000 and 2020. There were no restrictions on participant demographics including age, sex, geography, socioeconomic status, or year of publication. Only empirical studies which investigated mindfulness-based interventions on mental health (anxiety, stress, depression, quality of life and psychological well-being) of infertile women were included in the review.

Results:

Seventeen papers were considered in the review which involved 983 females. Depression, anxiety, stress, quality of life and psychological well-being were taken as measures of mental health of infertile women. The studies have confirmed that the mindfulness-based interventions are highly helpful for women with infertility. The interventions have successfully reduced stress, anxiety and depressive symptoms among the participants as well as enhanced their quality of life and psychological well-being.
A SEER data-based nomogram for the prognostic analysis of survival of patients with Kaposi’s sarcoma
Authors: Li Wanghai , Wang Ling , Zhang Yan , Liu Yulong , Lin Yinsheng , Li Chengzhi
Published: August 2023

Background:

This study developed the first comprehensive nomogram for predicting the cancer-specific survival (CSS) of patients with Kaposi’s sarcoma (KS).

Methods:

Data on the demographic and clinical characteristics of 4143 patients with KS were collected from the Surveillance, Epidemiology, and End Results (SEER) database and used for the prognostic analysis. The patients were randomly divided into two groups: training cohort (n = 2900) and validation cohort (n = 1243). Multivariate Cox regression analysis was used to identify the predictive variables for developing the first nomogram for the survival prediction of patients with KS. The new survival nomogram was further evaluated using the concordance index (C-index), area under the time-dependent receiver operating characteristic curve (AUC), net reclassification improvement (NRI), integrated discrimination improvement (IDI), calibration plotting, and decision curve analysis (DCA).

Results:

A nomogram was developed for determining the 3-, 5-, 8-, and 10-year CSS probabilities for patients with KS. The nomogram showed that tumor stage had the greatest influence on the CSS of patients with KS, followed by demographic variables (race, marital status, and age at diagnosis) and other clinical characteristics (surgery status, chemotherapy status, tumor risk classification, and radiotherapy status). The nomogram exhibited excellent performance based on the values of the C-index, AUC, NRI, and IDI as well as calibration plots. DCA further confirmed that the nomogram had good net benefits for 3-, 5-, 8-, and 10-year survival analyses.

Conclusions:

In this study, by using data from the SEER database, we developed the first comprehensive nomogram for analyzing the survival of patients with KS. This nomogram could serve as a convenient and reliable tool for clinicians to predict CSS probabilities for individual patients with KS.
Comparison of first-line immunotherapy efficacy between advanced lung squamous cell carcinoma and pulmonary lymphoepithelioma-like carcinoma: A propensity score matching multicenter study
Authors: Zhou YuBin , Huang Jian , Lan Jun , Hu Hao , Yuan Zihao , Dong Longyan , Deng Huiyin , Yue Li-ao , Xiao Yi , Yang Xiongwen
Published: August 2023

Background:

Compared with other lung squamous cell carcinomas (LUSC), pulmonary lymphoepithelioma-like carcinoma (pLELC) is closely associated with Epstein–Barr virus (EBV) infections with a unique molecular profile and immune microenvironment. This study was thus established to compare the treatment response and effectiveness of immunotherapy between pLELC and LUSC.

Material and Methods:

We enrolled 31 patients with pLELC and 116 with LUSC receiving first-line immunotherapy at three centers in China and compared the treatment response and effectiveness of immunotherapy. Propensity score matching (PSM) was used to balance the differences in baseline data between the two groups.

Results:

Before PSM, progression-free survival and overall survival were longer in the pLELC group than in the LUSC group (progression-free survival: hazard ratio (HR), 1.67, 95% CI: 1.05–2.63, P = 0.028; overall survival: HR, 1.90, 95% CI: 1.06–3.40, P = 0.028). This remained unchanged after PSM (progression-free survival: HR, 1.79, 95% CI: 1.02–3.15, P = 0.044; overall survival: HR, 2.20; 95% CI: 1.10–4.37, P = 0.022).

Conclusion:

pLELC showed a clinically meaningful survival benefit compared with traditional LUSC following immunotherapy. Subsequent studies should consider the role of the EBV in the tumor immune microenvironment of pLELC.
Prediction of local tumor progression after microwave ablation for early-stage hepatocellular carcinoma with machine learning
Authors: Ren He , An Chao , Fu Wanxi , Wu Jingyan , Yao Wenhuan , Yu Jie , Liang Ping
Published: August 2023

Objectives:

Local tumor progression (LTP) is a major constraint for achieving technical success in microwave ablation (MWA) for the treatment of early-stage hepatocellular carcinoma (EHCC). This study aims to develop machine learning (ML)-based predictive models for LTP after initial MWA in EHCC.

Materials and Methods:

A total of 607 treatment-naïve EHCC patients (mean ± standard deviation [SD] age, 57.4 ± 10.8 years) with 934 tumors according to the Milan criteria who subsequently underwent MWA between August 2009 and January 2016 were enrolled. During the same period, 299 patients were assigned to the external validation datasets. To identify risk factors of LTP after MWA, clinicopathological data and ablation parameters were collected. Predictive models were developed according to 21 variables using four ML algorithms and evaluated based on the area under the receiver operating characteristic curve (AUC) with 95% confidence intervals (CIs).

Results:

After a median follow-up time of 28.7 months (range, 7.6-110.5 months), 6.9% (42/607) of patients had confirmed LTP in the training dataset. The tumor size and number were significantly related to LTP. The AUCs of the four models ranged from 0.791 to 0.898. The best performance (AUC: 0.898, 95% CI: [0.842 0.954]; SD: 0.028) occurred when nine variables were introduced to the CatBoost algorithm. According to the feature selection algorithms, the top six predictors were tumor number, albumin and alpha-fetoprotein, tumor size, age, and international normalized ratio.

Conclusions:

Out of the four ML models, the CatBoost model performed best, and reasonable and precise ablation protocols will significantly reduce LTP.
An overview of current advances of PD-L1 targeting immuno-imaging in cancers
Authors: Chen Yunhao , Guo Yujiao , Liu Zhiguo , Hu Xiaokun , Hu Man
Published: August 2023

The programmed death protein 1/programmed cell death ligand 1 (PD-1/PD-L1) pathway plays a significant role in immune evasion. PD-1 or PD-L1 immune checkpoint inhibitors (ICIs) have become a standard treatment for multiple types of cancer. To date, PD-L1 has served as a biomarker for predicting the efficacy of ICIs in several cancers. The need to establish an effective detection method that could visualize PD-L1 expression and predict the efficacy of PD-1/PD-L1 ICIs has promoted a search for new imaging strategies. PD-L1-targeting immuno-imaging could provide a noninvasive, real-time, repeatable, dynamic, and quantitative assessment of the characteristics of all tumor lesions in individual patients. This study analyzed the existing evidence in the literature on PD-L1-based immuno-imaging (2015-2022). Original English-language articles were searched using PubMed and Google Scholar. Keywords, such as “PD-L1,” “PET,” “SPECT,” “PET/CT,” and “SPECT/CT,” were used in various combinations. A total of nearly 50 preclinical and clinical studies of PD-L1-targeting immuno-imaging were selected, reviewed, and included in this study. Therefore, in this review, we conducted a study of the advances in PD-L1-targeting immuno-imaging for detecting the expression of PD-L1 and the efficacy of ICIs. We focused on the different types of PD-L1-targeting agents, including antibodies and small PD-L1-binding agents, and illustrated the strength and weakness of these probes. Furthermore, we summarized the trends in the development of PD-L1-targeting immuno-imaging, as well as the current challenges and future directions for clinical workflow.
Soluble DPP4 can act as a diagnostic biomarker in Hashimoto’s thyroiditis with thyroid papillary carcinoma
Authors: Zhang Yan , Zhang Qiao , Zheng Yingying , Chen Jiaxi , Liu Nian , Liu Kai , Song Wengang
Published: August 2023

Background:

Hashimoto’s thyroiditis (HT) is an independent risk factor for papillary thyroid carcinoma (PTC), but the underlying mechanism remains unknown. The incidence of PTC in patients with HT is significantly elevated, and the presence of both HT and PTC contributes to a higher rate of misdiagnosis.

Materials and Methods:

Gene ontology (GO) enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were performed on the thyroid nodule gene chip dataset from GEO Datasets. Serum and clinical data from 191 patients with thyroid nodules at the affiliated hospital were collected for analysis. Experimental techniques, including real-time quantitative PCR, ELISA, immunohistochemistry (IHC), and enzyme activity detection, were used to measure the level of dipeptidyl peptidase 4 (DPP4) in thyroid nodule tissues and serum.

Results:

Thyroid nodules in patients with HT and PTC exhibit high levels of DPP4, along with elevated concentrations of soluble DPP4 in the serum. These findings demonstrate the potential predictive value of soluble DPP4 for PTC diagnosis.

Conclusions:

The concentration and enzymatic activity of soluble DPP4 in serum can serve as diagnostic biomarkers for patients with HT-associated PTC.
Seroprevalence and incidence of primary dengue infection and its correlation with fetomaternal prognosis in Western Rajasthan
Authors: Prakash Prabhu , Gupta Ekta , Nareda Pooja , Gupta Eshank , Agarwal Richa , Ashopa Vishakha , Beelwal Anjali
Published: August 2023

Background:

Viral hemorrhagic fevers are becoming increasingly common in the tropics and subtropics. Dengue fever is currently the most important arthropod-borne viral disease because of its widespread distribution in more than 100 countries and its potential for extensive outbreaks of life-threatening disease.

Material and Methods:

This study was a hospital-based cross-sectional study conducted in the Microbiology Laboratory of Maternal and Child Tertiary Care Hospital in Western Rajasthan, India, between January 2021 and December 2021. Institutional Ethical Committee permission was obtained. All patients with clinical suspicion of dengue-like illness (DLI), attending outpatient department (OPD) or inpatient department (IPD), were included in the study after obtaining their written consent. A blood sample was collected, and the Dengue Duo rapid card test was conducted for the detection of nonstructural protein 1 (NS1) antigen and immunoglobulin (Ig) M or IgG antibody estimation. All positive samples were tested for IgM enzyme-linked immunosorbent assay (ELISA) test using MAC-ELISA.

Results:

Of 250 positive sample, the distribution of cases as per clinical features was as follows: all cases presented with fever (100%) followed by myalgia (24.5%), headache (16.06%), hemorrhagic manifestation (13.25%), rash (8.84%), and bleeding gums (2.01%). Thrombocytopenia was seen in 30.40% (76/250) of dengue fever cases. NS1 antigen was detected in 157 cases (62.80%) followed by IgG in 84 cases (33.60%), IgM in 77 cases (30.80%), NS1+IgG in 27 cases (10.80%), NS1 + IgM in 16 cases (6.40%), and NS1 + IgM + IgG in five cases (2%). Of 250 samples, 77 cases were IgM positive and 173 were IgM negative by the Dengue Duo card test. Among the 173 Dengue Duo IgM card negative, 131 cases (79.39%) were also detected negative by IgM ELISA and 42 cases (49.41%) were detected positive by IgM ELISA. The sensitivity was 50.59%, the specificity was 79.39%, the positive predictive value (PPV) was 55.84%, the negative predictive value (NPV) was 75.72%, and the diagnostic accuracy was 69.90%. The case fatality of the cases was 2.35%.

Conclusion:

Early diagnosis and treatment can prevent mortality in pediatric and pregnant females suffering from dengue and dengue-like illness. Facility and availability of ELISA kits should be adequate for early confirmation of suspected dengue patients by ELISA test.
Urinary incontinence prevalence and factors associated with patients talking with doctors about urine control
Authors: Min Elissa E. , Thomas Joseph
Published: August 2023

Objectives:

Patient perceptions of their doctors may influence talking to them about urinary incontinence (UI). We estimated prevalence of UI among Medicare beneficiaries and assessed association between beneficiaries’ demographic and clinical characteristics and whether they spoke to their doctor about UI and association between beneficiaries’ perceptions of their doctor and whether they spoke to their doctor about UI.

Methods:

This study was approved by the Purdue University Institutional Review Board (IRB) and determined exempt, category 4 (protocol number 1907022503, approval on August 5th, 2019). Medicare Current Beneficiary Survey (MCBS) 2016 data were analyzed. Beneficiaries who indicated that they lost urine control 2–3 times a month or above were classified as experiencing UI. An 11-item patient perception of their physician scale was created based on MCBS items. Perceptions were categorized as favorable or unfavorable. SAS version 9.4 for Unix was used for all analyses. PROC LOGISTIC was used to assess multi-variable association between beneficiaries’ perceptions of their doctors and talking to their doctor about UI.

Results:

Among 7466 persons meeting inclusion criteria, 1856 (24.9%) had UI. The perception of doctor scale scores ranged from 15 to 44, with mean score = 36.57 (standard deviation = 5.29). The scale Cronbach alpha reliability was 0.93. Using sensitivity and receiver operating characteristic analysis, a cutoff of 30 or higher was identified as a favorable perception. Beneficiaries with favorable perceptions of their doctor were more likely to speak to their doctor about experiencing UI than beneficiaries with unfavorable perceptions (odds ratio = 1.55, 95% confidence interval = 1.03 to 2.35, P-value = 0.038).

Conclusion:

Overall, the more favorable the perception of their physicians, the more likely beneficiaries were to speak to them about their UI.
Clinical, laboratory profile and outcomes in children with snakebite from Eastern India
Authors: Pattanaik Biswajit , Mahapatra Chinmaya , Karthika IK , Satapathy Amit K. , John Joseph , Das Rashmi R. , Dwibedi Bhagirathi , Mahapatro Samarendra , Gulla Krishna M.
Published: August 2023

Background:

Snakebite remains a significant public health problem worldwide, particularly in rural areas with unexpected morbidity and mortality. This study evaluated the clinical, laboratory profile and outcomes in children with snake bites from Eastern India.

Methods:

This was a retrospective case record-based study between January 2017 and December 2021. The clinical features, complications, laboratory profiles and outcomes were analysed.

Results:

Thirty children with snake bites were admitted during this study period. There was a male predominance with a ratio of 2.3:1. The mean age of presentation was 10.4 years. About 60% of bites occurred during the rainy season between July and September. Most bites (96%) were on lower limbs, predominantly showing vasculotoxic features followed by neurotoxic and a combined presentation. In this study, around 53% received anti-snake venom (ASV) before reaching our centre; the median time to reach our centre was 13 h. Complications such as acute kidney injury (AKI), cellulitis, shock and coagulation abnormalities were common in those who arrived early (before 6 h) than in those who reached late (after 6 h). Similarly, the mean duration of hospital stay was less for those seeking medical attention early as compared to those reaching late for treatment (4.7 days vs. 7.2 days). Twenty-six out of 30 (86.7%) were discharged without any sequelae, 3 (10%) children were left against medical advice and one died.

Conclusions:

Snakebite remains a major health problem in children causing significant morbidity and mortality. Children, in general, especially males, are particularly vulnerable because of their playful and explorative nature and considerable time spent in outdoor activities. Preventive measures, education about avoiding traditional first aid methods and early administration of ASV reduce complications, duration of hospital stay and avoid the use of antibiotics.
Consumption of energy drinks and their effects on sleep quality among medical students
Authors: Alshumrani Ranya , Shalabi Bashayer , Sultan Abdulsamad , Wazira Lamar , Almutiri Sarah , Sharkar Azzam
Published: August 2023

Background and Objectives:

Energy drinks contain caffeine, which causes genuine concern among health professionals and authorities about their negative health effects. Their effect on sleep quality specifically was not well studied. In our study, we aim to assess the prevalence of energy drink consumption and its effect on the quality of sleep among Saudi medical students.

Materials and Methods:

A cross-sectional study was done on 260 medical students who were in their first till the sixth academic year at King Abdulaziz University Jeddah, Saudi Arabia. An online questionnaire was distributed as a Google form including demographics, the beverage questionnaire (BEVQ-15), and the Pittsburgh sleep quality index (PSQI).

Results:

Coffee was found to be the most favorite (56.5%) caffeinated beverage among medical students, 46.2% reported a sleep duration of 5 h, and 15% reported a sleep latency of more than 30 min. Also, 19.3% were found to have reduced sleep efficiency (less than 74%) and 82.6% used sleep medication once a week. Male students had a significantly higher mean frequency of drinking Energy & Sports drinks (Red Bull, code red, Gatorade, etc.) compared to females. Moreover, 74.6% of the medical students studied had poor sleep quality, with no relationship found between sleep quality and participant demographics, favorite caffeinated beverages, BEVQ-15 scale scores, or the frequency of energy drink consumption. In contrast, the PSQI and BEVQ-15 scores showed a significant positive correlation.

Conclusion:

Students at the university level should be educated on the causes of poor sleep quality and the effect of energy drinks on sleep quality. More research on a larger sample of Saudi university students is needed to determine the scope of the problem.
Scourge of out-of-pocket expenditure on health: A study on its burden and predictors in a rural community of West Bengal
Authors: Ghosh Pritam , Sadhukhan Sanjoy K. , Dasgupta Aparajita , Paul Bobby , Ghose Sauryadripta , Biswas Aloke
Published: August 2023

Introduction:

Globally, one-third of current health expenditure had been out-of-pocket expenditure (OOPE). The health system financing of almost all low- and middle-income countries including India rely heavily on out-of-pocket (OOP) payments for health care. OOPE on health payments is particularly hard on any community, especially the poor leading to incomplete or even no treatment during their ill health. This study estimated OOPE among residents of a rural community in West Bengal and explored the associated factors with high OOP expenses.

Methods:

A community-based cross-sectional study was conducted in a rural community in Singur, West Bengal from June 2019 to February 2020. The study was done among 398 villagers selected from 15 clusters or villages. Households were randomly selected in each village. All members of the selected households were interviewed. SPSS was used for data analysis both for descriptive and inferential statistics.

Results:

Only 14.6% of morbid persons had catastrophic expenditure. The incidence of catastrophic expenditure was higher among those who opted for private practitioners and or ayurveda, yoga and naturopathy, unani, siddha, and homeopathy (AYUSH) facilities. There was zero catastrophic expenditure for the unqualified sector. There was an increasing trend of OOP payments among the lower socioeconomic groups. Again, low-income individuals had a higher share in cumulative expenditure (Gini coefficient of 0.35). Most of the participants (78.4%) had no health insurance coverage.

Conclusion:

Promotion for higher utilization of public health facilities may reduce the burden of OOP expenses. Government health insurance schemes must be widened with the inclusion of coverage of outpatient services. Integrating AYUSH services in the public sector is another option to reduce OOP expenses.
Resilience and self-compassion among persons with depressive disorders: Prerequisite for a positive mental health approach
Authors: Dan V Hubert , Ponnuchamy Lingam , Anand Nitin K. , Bhaskarapillai Binukumar , Sharma Manoj K.
Published: August 2023

Background:

Treatment gap for common mental health problems, especially of the depressive disorders is consequential in developing countries like India. Positive mental health domains like resilience and self-compassion have been long hailed as protective factors against depression and viable for use in therapeutic aspects. The objectives were to find an association between resilience, self-compassion, and depression.

Methods:

The study was conducted using a cross-sectional design among 75 respondents who were seeking treatment for major depressive disorders from a tertiary care center during the second wave of COVID-19. Three scales were administered online, namely Beck’s Depression Inventory-II (BDI-II), Connor Davidson Resilience Scale (CD RISC-25), and Self-Compassion Scale-Short Form (SCS-SF). Spearman’s rank correlation test, Chi-square with Fisher’s exact test, and Kruskal Wallis H test were used to study the relationships and differences in average scores with respect to the severity of depression.

Results:

Most of the respondents had moderate depressive features along with moderately high levels of resilience (CD RISC 25) and self-compassion (SCS-SF) scores. Resilience and self-compassion were found to have no significant relationship with respect to the severity of depression. There was a weakly positive correlation between resilience and self-compassion among those with moderate and severe depression.

Conclusion:

Since the individuals with depression had higher scores on resilience and self-compassion, the levels of depression remained at moderate levels of severity despite the devastating impact of the second wave of COVID-19 in the Indian sub-continent. Results are to be interpreted with respect to psychosocial contexts arising during the COVID-19 pandemic. Mental health programs can incorporate the variables of resilience and self-compassion in intervention among individuals with depression which have likely been beneficial in their process of recovery.
Inflammatory markers in geriatric anemia: A study from North India
Authors: Shastri Malvika , Kotru Mrinalini , Raizada Alpana , Mahajan Bhawna , Jain Rajat , Sikka Meera
Published: August 2023

Background:

Inflammation has several effects in the geriatrics with reference to iron deficiency anemia (IDA), anemia of chronic disease (ACD), and unexplained anemia (UA). Whether hyperinflammation is part of their pathogenesis or just incidental is unknown. Data are limited regarding inflammatory patterns in IDA, ACD, and UA in anemic geriatrics and inflammation as a component of UA. There is little known about the overlap of inflammation between ACD and UA.

Objective:

The study was undertaken to find the proportion of anemic geriatric patients, aged ≥60 years with raised serum levels of inflammatory markers and their study within IDA, ACD, and UA.

Materials and Methods:

Seventy-five anemic geriatric patients were evaluated for raised serum levels of inflammatory markers: high sensitive C-reactive protein (hsCRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interleukin-8 (IL-8) along with serum ferritin (SF).

Results:

Raised markers were seen in 94.7% of anemic geriatric patients.IL-8 was raised most frequently followed by TNF-α, IL-6, hsCRP, and SF. No distinct inflammatory profile could be elicited between ACD and UA. The hyperinflammatory profile irrespective of the underlying etiology of geriatric anemia suggests that aging per se is pro-inflammatory state.

Conclusion:

Geriatric anemia can be thought to develop on background of subclinical low-grade inflammation along with superimposed nutritional deficiencies or chronic diseases.
Brenner tumors of the ovary: A case series in a teaching institute center
Authors: Sahu Alaka , Toppo Anupa , Mohapatra Kaustav , Panda Sagarika
Published: August 2023

Brenner tumors of the ovary are very rare, and mostly benign. Borderline Brenner tumors are rare and malignant Brenner tumors are even much rarer with a worse prognosis. This study was carried out in the Department of Pathology, VSSIMSAR, Burla, Odisha over a period of 3 years. A histopathology study was done in all the cases, while immunostaining was done in selected cases only. A total of seven cases were studied, out of which four (57.14%) cases were diagnosed as benign Brenner tumors, two (28.57%) cases as borderline Brenner tumors, and one (14.28%) case as malignant. Histopathology study is the gold standard for diagnosis of Brenner tumor, with the aid of immunostain whenever necessary.
Serum versican as a potential biomarker in patients with uterine fibroids: A study from Eastern India
Authors: Jasti Pratima , Kumari Suchitra , Singh Sweta , Anudeep PP
Published: August 2023

Objective:

Versican is a chondroitin sulphate proteoglycan with raised expression at site of inflammation, and uterine fibroids are associated with local inflammation. Hence, this study aimed to estimate serum Versican levels in pre-menopausal women with uterine fibroids to evaluate its diagnostic efficiency.

Materials and Methods:

This case–control study included forty uterine fibroid cases and 40 healthy controls. Cases clinically evaluated with USG findings, that is number, location of fibroid and volume calculated by prolate ellipse formula a × b × c × 0.523 (a – height, b – width, c – depth). Biochemical investigations, that is serum Versican levels, were estimated by ELISA with total cholesterol, HDLc and LDLc. Triglycerides by fully automated chemistry analysers. Serum biochemical parameters were compared and correlated with volume of fibroid. Area under receiver operating characteristic curve was calculated along with cut-off value to determine diagnostic potential of Versican, differentiating women with fibroids.

Results:

In the present study, patients with fibroids had decreased levels of serum Versican (79.43 ± 18.60) as compared to healthy controls (101.81 ± 28.24, P < 0.001). There was a statistically significant negative correlation (r = - 0. 307, P = 0.04) between serum Versican level and volume of fibroid. Area under ROC was 0.726 (95% CI: 0.616-0.836; P = 0.001). The best cut-off value for serum Versican level was 96.90 ng/ml with 90% sensitivity and 48% specificity.

Conclusion:

Serum Versican levels were found significantly lower in women with fibroid with a negative correlation with volume of fibroid uterus. Furthermore, extensive study would help in substantiating diagnostic potential of serum Versican in fibroid uterus patients.
Erythema elevatum diutinum with lower limb neuropathy: A rare presentation
Authors: Kumar N. Ashok , Dhanaraj Manoharan , Srinivasan Shreya , Narendra Raksha Raja
Published: August 2023

Nodular lesions can be seen in a wide range of conditions such as infections, granulomatous conditions, neutrophilic disorders, vasculitis, benign tumours and malignant conditions. These numerous aetiologies behind the occurrence of nodular lesions signify the importance of thorough work-up of the patient to diagnose the underlying reason behind the clinical condition. Erythema elevatum diutinum (EED) is a rare vasculitis with variable clinical presentation, the diagnosis of which can be challenging. Extracutaneous signs such as arthralgias, oral and penile ulcers, involvement of the eye and neuropathy have all been linked to it. Various systemic illnesses, infectious diseases, autoimmune diseases, haematological abnormalities and plasma cell dyscrasias are also associated with EED. Such extracutaneous signs in EED patients indicate that the condition may involve several organ systems. Patients with EED should be assessed for systemic manifestations to ensure focused care, since extracutaneous forms of EED may comprise deposition of circulating immune complexes.
Examining the determinants of health and long-term care for older adults in India through a socio-ecological model – A qualitative assessment
Authors: Jamwal Sonalika , Golechha Mahaveer , Bohra Tasneem
Published: August 2023

Background:

Ageing is associated with multiple long-term health problems and requires medication management, support with activities of daily living, and attention to psychological needs. This study aimed at exploring the enablers and barriers and psychosocial determinants of long-term care.

Methods:

A qualitative study, using semi-structured interviews and thematic analysis, was carried out from February to June 2018. One-on-one in-depth interviews were carried out with 28 participants, including care recipients (n = 12), caregivers (n = 12), and primary-care physicians (n = 4) at the Community Health Centre in the state of Jammu and Kashmir of India.

Results:

Attention from family members, leisure activities, faith in the healthcare provider, and a positive attitude towards life were found to be enablers of long-term care. Resource constraints and alienation from the community were barriers. Incorporating the psychosocial needs of care recipients and problems faced by family caregivers is essential in providing good quality care to individuals with chronic illness.

Conclusion:

The lack of a targeted, nationwide policy has resulted in considerable variability in long-term care services across the country. There is an urgent need to make long-term care an integral part of the Indian health system utilizing a holistic framework to address the health needs of older adults and implementing it through an equitable community-based comprehensive primary health and community-based model.