bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract 109: Long-range PCRs and MLPA for molecular analysis of large rearrangements in 21 hydroxylase deficiency
Authors: Ravichandran Lavanya , Korula Sophy , Asha H S , Varghese Deny , Parthiban R , Johnson Jabasteen , Cherian Kripa Elizabeth , Jebasingh Felix , Kapoor Nitin , Mathai Sarah , Simon Anna , Rajaratnam Simon , Paul Thomas V , Thomas Nihal , Chapla Aaron
Published: August 2024

Background: Genetics of 21 hydroxylase deficiency is complex with pseudogene derived point mutations and rearrangements in the CYP21A2 gene. 20-30% of these mutations are due to large 30kb deletion forming chimeric genes and large gene conversion. In general, MLPA is the choice of technique in molecular analysis of large deletions and duplications.

Aim and Objectives: To evaluate long-range PCRs, restriction digestion, ASPCR and MLPA to identify various chimeric forms of CYP21A2 gene.

Results: In this study, 24.2% (n=16/66) were identified with large rearrangements based on long-range PCR and restriction digestion results. Thirteen subjects were positive for chimeric genes described in 21-hydroxylase deficiency. Junction site analysis with both MLPA and ASPCR results revealed that ASPCR could detect the actual extent of rearrangement in all the chimeric genes while MLPA could miss two of the chimeric genes in four subjects.

Conclusion: In this study, MLPA as a direct stand-alone technique has shown to be inadequate in identifying the extent of some rearrangements in the CYP21A2 gene. Since, it is crucial to differentiate various chimeric forms of this gene; we recommend a multistep approach including long-range PCR, restriction digestion and ASPCR/MLPA to interpret and understand the associated phenotypic severity in 21-hydroxylase deficiency.
Abstract 120: Prevalence of hypogonadism in men with type 2 diabetes mellitus and its association with insulin resistance, metabolic and clinical parameters
Authors: Singh Jaspreet , Sahoo Abhay , Kanwar JayaBhanu , Mangaraj Swayamsidha , Swain Jayshree
Published: August 2024

Background: Hypogonadism is commonly found in men with type 2 diabetes mellitus (T2DM). The inverse association between testosterone and insulin resistance is also reported.

Aims and Objectives: To investigate the prevalence of hypogonadism in men with T2DM and to evaluate the association between hypogonadism with insulin resistance along with metabolic and clinical parameters.

Methods: This is a cross sectional study of 257 consecutive men with T2DM. Hypogonadism is defined on the symptoms as defined in the androgen deficiency in aging male questionnaire (ADAM) along with low calculated testosterone levels (calculated by vermeulen equation taking total testosterone, albumin and sex hormone binding globulin). Insulin resistance is measured by HOMA-IR, QUICKI.

Results: The overall prevalence of hypogonadism in our cohort was 11.67%. 86.67% patients had hypogonadotropic hypogonadism while rest were hypergonadotropic hypogonadism. There is a significant inverse correlation of fasting Insulin (r=-0.198, p<0.001), HOMA IR (r=-0.288, p<0.001) and BMI (r=0.139, p<0.001) with testosterone levels. On linear regression analysis, HOMA IR was independently associated with testosterone levels (odds ratio= -5.185; 95% CI= -8.29 -to -2.075) even after adjusting for age, BMI, HBA1c and lipid levels. Among chronic complications, only diabetic retinopathy was significantly associated with presence of hypogonadism.

Conclusion: In our recruited population, hypogonadism was found in 11.67% of individuals. Markers of insulin resistance were independently associated with hypogonadism among T2DM men.
Abstract 142: Endocrine neoplasia type 2B with a rare mutation: A case report
Authors: Garg Umesh Kumar , Mathur Nitish , Sahlot Rahul , Sharma Balram , Saran Sanjay , Gora Anamika , Yadav Suchitra , Mathur Sandeep Kumar
Published: August 2024

Introduction: Multiple Endocrine Neoplasia (MEN) type 2 is a rare familial endocrine syndrome. MEN 2B syndrome, the least common subtype of MEN 2 syndrome, is characterized by medullary carcinoma of thyroid (MTC), pheochromocytoma and absence of hyperparathyroidism. Identifying the responsible mutation have prognostic consequences. Majority of MEN2B cases occur due to de-novo mutation with 95% cases involving codon 918, and codon 883, 2-3% cases.

Objective: Identification of the genetic mutation in patient presented with MTC, and bilateral adrenal pheochromocytoma.

Methods: Whole Exome Analysis was performed to identify the genetic defect. The variants were prioritized using standard open-source computational pipelines.

Results: Whole exome sequencing and computational analysis identified a non-synonymous single nucleotide polymorphism T1991C in the exon 13 of RET gene on chromosome 10, resulting in a missense mutation (p.M664T) in the protein responsible for phenotypic expression known as MEN 2B syndrome.

Conclusion: MTC and bilateral pheochromocytoma are indications for detailed clinical and genetic examination of the proband. Bilateral adrenalectomy, followed by total thyroidectomy and prophylactic central neck dissection was done along with lifetime hormone supplementation. This is a rare mutation reported in MEN2B (A Rare Syndrome) which usually involve codon 918 and 883.
Abstract 148: Preoperative determinants of length of stay in people with type 2 diabetes mellitus undergoing an elective CABG: An observational single centre study
Authors: Fatema Zareen , Rajesh Shalini , Khadilkar Kranti , Shivprasad K S , Kannan S , Basavaraj G S
Published: August 2024

Background: 22-48% of the CABG performed are attributed to diabetic patients suffering from CAD. There is a paucity of Indian studies on the influence of preoperative HbA1c on postoperative CABG outcome, in T2DM patients. Some discord exists among studies looking at the above associations.

Aims and Objectives: Aim of the study was to find any association between HbA1c and total length of stay (LoS) in hospital and other perioperative outcomes in Indian diabetic patients following CABG.

Results: It was retrospective study including 229 patients within six month. The mean duration of T2DM was 8.4 years and mean HbA1c was 8.2. There was statistically significant difference (p <0.05) found between the groups divided based on total LoS (≤10 and >10 days) with HbA1c, duration of T2DM, haemoglobin and insulin requirement on the day of surgery. Age, mean insulin requirement preoperatively, DM duration, Hb, hypothyroidism and other macrovascular complications as preoperative parameters showed a significant correlation with total LoS. On linear regression, age, other macrovascular complications and preoperative insulin requirement were found to be predictors for LoS.

Conclusion: This retrospective study revealed that preoperative HbA1c would be associated with prolonged hospital stay following CABG surgery, paving way for further prospective studies.
Abstract 149: Hyperphosphatemic familial tumoral calcinosis due to homozygous mutation at Leu366Arg: First case report
Authors: Shukla Ajay , Gupta Sushil Kumar
Published: August 2024

Background: Hyperphosphatemic familial tumoral calcinosis (HFTC) is a rare disabling autosomal recessive metabolic disorder characterized by hyperphosphatemia and manifestations ranging from progressive deposition of calcium phosphate crystals in the skin, soft tissues and bone, and hyperostosis. The most common cause of HFTC is related to loss-of-function mutations in GALNT3 (Polypeptide N-Acetylgalactosaminyl transferase 3) gene causing defective glycosylation of FGF23.

Material and Methods: A 16 year boy presented with lump in the left gluteal area and hyperphosphatemia. Serum ionized calcium, alkaline phosphate, intact PTH, 25-OH vitamin D, serum creatinine and C terminal FGF 23, magnetic resonance imaging of hip, dental CBCT , bone mineral density at lumbar spine and hip by dual x-ray absorptiometry (DEXA) BMD, and 99Tc MDP bone scan, followed by next generation sequencing (NGS) and Sanger's sequencing.

Results: A 16 year otherwise healthy boy presented with hard painless lump in the left gluteal area and hyperphosphatemia for last one year. His parents had third degree consanguinity with ancestral roots in Middle East. Father has small calcinosis in the right hand and mother was asymptomatic. Child had no associated bone pain, proximal muscle weakness, fracture or constitutional symptoms. S. phosphorus was 6.98mg/dl (normal: 3.5–5.5) with inappropriately increased TRP (95%) and TMP-GFR (7.2). Serum ionized calcium, alkaline phosphate, intact PTH, 25-OH vitamin D and serum creatinine were normal. MRI showed 5.7x3.7x3 cm lobulated heterogenous hypointensity near left greater trochanter. This mass was excised and showed tissue calcification. 99Tc-MDP bone scan and bone density parameters were normal. CBCT scan maxilla and mandible showed generalized hypercementosis with irregular root morphology. Serum C-terminal FGF 23 was 2401 RU/ml (normal: <150). NGS revealed normal FGF23 and Alpha Klotho genes. Exon 5 of GALNT3 gene showed homozygous mutation at Leu 366 Arg. GALNT3 Leu 366 Arg mutation causing HFTC has been described as compound heterozygous.

Conclusion: This is the first case report of homozygous mutation at Leu366Arg causing HFTC.
Abstract 155: Vitamin D dependent rickets type II: Our experience and systematic review
Authors: Manjunath
Published: August 2024

Background: Hereditary vitamin D resistant rickets, is a rare autosomal recessive disease caused by variants affecting VDR gene. We aimed to describe our experience and systematically review the world literature.

Objective: To evaluate the phenotypic and genotypic spectrum of VDDR2.

Methods: The clinical and genetic spectrum of VDDR2 were analyzed.

Results: Six patients of VDDR 2 were included. The mean age at the development of rachitic changes was 12±3.79 months. Baseline biochemistry revealed hypocalcemia (6.67±1.5 mg/dl), hypophosphatemia (3±1.5 mg/dl) with elevated serum alkaline phosphatase (3579±845 IU/ml) and PTH (372±183 pg/ml). Three novels variants in VDR gene were detected (p.N444D=1, p.I268T=1, p.H85R=1, p.H355TfsTer7=1).
A systematic review (probands 112) revealed alopecia in majority of patients (81.2%). Complete response to oral therapy with supra-physiological dose of calcitriol and high dose of oral calcium was observed in 32.5% of cases. Recurrent variants specific to geographical locations were p.Lys45Glu (Africa); p.Cys41Tyr, p.Gln152Ter (Asia); p.Gln356Ter (Europe); p.Gln259Glu (Latino). Patients with variants in ligand binding domain (LBD) had better response to oral therapy compared to cases with DBD variants.

Conclusion: Patients with VDDR2 presents in infancy with alopecia. Higher complete response rate to oral therapy can be anticipated in cases with variants affecting LBD.
Abstract 1: Efficacy and safety of novel non-steroidal mineralocorticoid receptor antagonist finerenone in the management of diabetic kidney disease: A meta-analysis
Authors: Dutta Deep , Surana1 Vineet , Bhattacharya2 Saptarshi , Aggarwal3 Sameer , Sharma4 Meha
Published: August 2024

Background: Data are scant on use of finerenone in diabetic kidney disease (DKD). We undertook this meta-analysis to address this knowledge-gap.

Methods: Electronic databases were searched for RCTs involving diabetes-patients receiving finerenone compared to controls. Primary outcome was changes in urine albumin-creatinine ratio (UACR). Secondary outcomes were time to kidney failure (decline in GFR by >40% from baseline over 4 weeks), time to end-stage kidney disease, hospitalization for any cause, death and adverse events reported.

Results: From initially screened 79 articles, data from 7 RCTs involving 13,783 patients was analysed [3 in active control group (ACG) defined as having eplerenone/spironolactone as active comparator; 4 in passive control group (PCG) defined as having placebo as controls]. Patients receiving finerenone had greater percentage lowering of UACR from baseline as compared to PCG [MD -23.82% (95%CI:-24.87– -22.77);P<0.01;I2=96%] at 90 days, after 2 years [MD-37.9% (95%CI:-38.09– -37.71);P<0.01] and 4 years [MD -25.20%(95%CI:-25.63– -24.77);P<0.01] of treatment. Patients receiving finerenone has lower chance of >40% decline in GFR [OR 0.83 (95%CI:0.75 – 0.92);P<0.01; I2=0%]. Patients receiving finerenone had lower occurrence of cardiovascular death, non-fatal myocardial infarction, non-fatal stroke or hospitalization for heart failure, as compared to placebo/eplerenone [OR0.86 (95%CI: 0.78 – 0.95);P=0.003;I2=0%]. TAEs was similar [RR 0.97 (95%CI:0.88–1.07);P=0.56;I2=0%], but SAEs significantly lower [RR 0.91 (95%CI:0.84– 0.97);P<0.01;I2=0%] in finerenone-group compared to controls.

Conclusion: This meta-analysis provides reassuring data on beneficial impact of finerenone in reducing UACR and GFR decline as compared to placebo in albuminuric DKD. We still lack head-to-head comparison of renal outcomes of finerenone vs eplerenone/spironolactone in DKD.
In Vitro Effects of Curcumin in Free and Phytosomal Forms on the Expression of T Helper1 and Regulatory T Cells’ Transcription Factors in Collagen-Induced Arthritis
Authors: Nosratabadi Reza , Ranjkesh Mahdi , Safari Mohammad , Ramezani Mahnaz , Zainodini Nahid , Mahmoodi Merat
Published: August 2024

Background:

Curcumin as a polyphenolic compound has a potential capacity to reduce autoimmune reactions by skewing the balance of Thelper1 (Th1)/regulatory T cells (Treg) toward Treg cells. However, the low absorption and bioavailability of this agent have prompted researchers to use various drug delivery systems such as phytosomes to reduce these drawbacks. To date, few studies have evaluated the effects of phytosomal curcumin (nano-curcumin) on immune responses. Hence, we compared the modulatory effects of curcumin in free and phytosomal form on the expression of Th1 and Treg transcription factors, T-bet (T-box-containing protein) and Foxp3 (forkhead box p3), respectively, in a collagen-induced arthritis model (CIA).

Materials and Methods:

Following the induction of CIA, splenocytes were isolated and re-stimulated with collagen in the absence or presence of two different doses of curcumin in free and phytosomal form. Then, expression of T-bet and Foxp3 was assessed by real-time PCR.

Results:

The expression of T-bet was reduced in curcumin and phytosomal curcumin groups rather than in the untreated group. The level of T-bet was not significantly different between free and phytosomal groups. Moreover, mRNA expression of Foxp3 enhanced after treatment with curcumin, while phytosomal curcumin groups showed no difference in comparison with the untreated group.

Conclusion:

curcumin in nano/free form showed a modulatory effect on the expression of T-bet. However, only free-form enhanced Foxp3 expression, which could be owing to the low amount of curcumin in the phytosomal complex rather than free-form at the same dose or due to leakage of curcumin from the complex.
A New Index for Assessment of Severity and Extent of Gingival Pigmentation; A Diagnostic Cross-Sectional Study According to Inter and Intra-Observer Variability
Authors: Nejad Azadeh Esmaeil , Meimandi Mansoor , Yaghmaei Hasti , Hatami Masoud , Madihi Saeed
Published: August 2024

Background:

Classification of gingival pigmentation (GP) is often performed using gingival pigmentation index (GPI), melanin pigmentation index (MPI), oral pigmentation index (DOPI), melanin index (MI), or physiologic/pathologic GPI. However, the internal and external reproducibility of these indexes have not been evaluated. This study aimed to introduce a new simple and applicable GPI and assess its internal and external reproducibility.

Materials and Methods:

This diagnostic cross-sectional study was conducted on 40 patients with maxillary and mandibular GP. Patients were in the age range of 12–60 years, and degree of GP was determined by four periodontists using DOPI, MI, MPI, GPI and the new index namely the severity and extension of gingival melanotic pigmentation index (SEMPI) under similar environmental and lighting conditions. The inclusion criteria were in the age range of 12–60 years and presence of melanin pigmentation (physiologic or pathologic) in the gingival margin, papilla, or attached gingiva. The exclusion criteria were systemic diseases, vascular lesions, hemochromatosis, amalgam tattoo, hyperbilirubinemia, or use of medications causing nonmelanotic pigmentation (hemoglobin, iron, and amalgam).

Results:

The Fleiss kappa between all examiners for all indexes at 0, 7, and 14 days was higher than 0.8, indicating high agreement among the examiners. The Spearman’s correlation coefficient for all indexes was positive and high at 0, 7, and 14 days (P < 0.001).

Conclusion:

Considering the high agreement among the examiners for all indexes and at all-time points as well as the positive, strong correlations among them, it seems that the new index is useful for classification of GP.
Comparative analysis of treponemal specific chemiluminescence test and rapid card test for screening of syphilis in blood donors – A tertiary center study
Authors: Jain Ankita , Sharma Anjali , Aradhana Bhargava , Sunil Ranga
Published: August 2024

BACKGROUND:

Screening for transfusion-transmitted infections (TTIs) is an important step for the safety of blood transfusion. Major TTIs for which screening is done are hepatitis B surface antigen, antibody to hepatitis B virus, hepatitis C virus, human immunodeficiency virus, syphilis, and malaria. The aim of this study was to compare the diagnostic accuracy of treponemal-specific chemiluminescence test and rapid card test for the screening of syphilis by taking Treponema pallidum hemagglutination assay (TPHA) as a gold standard test.

MATERIALS AND METHODS:

This was a cross-sectional study. All the routine blood donors were screened according to the National Blood Transfusion Council guidelines. One hundred and twenty syphilis serology-positive samples were obtained either by rapid card test immunochromatographic test/chemiluminescence assay or both. These samples were further tested by TPHA (gold standard test). Statistical analysis was done using the Mcnemar test, DeLong et al. test, and Chi-square test P < 0.05 was considered statistically significant.

RESULTS:

The sensitivity and specificity of both chemiluminescence and rapid card test were comparable (P < 0.0001) and the diagnostic accuracy of chemiluminescence and rapid card test was 95.83% and 94.58%, respectively.

CONCLUSION:

Both chemiluminescence and rapid card tests show comparable performance, so it is concluded to use rapid card test as a reliable backup in remote areas, peripheral blood bank setup, and in emergency situations where timesaving is lifesaving.
Effectiveness of oral calcium to prevent citrate-related toxicity during peripheral blood hematopoietic stem cell collection – An experience from a tertiary care center
Authors: Sahoo Dibyajyoti , Noushad Shahida , Basavarajegowda Abhishekh
Published: August 2024

BACKGROUND:

Apheresis procedures use citrate as an anticoagulant to ensure the fluidity of extracorporeal blood. Citrate-related toxicities are common adverse effects in peripheral blood stem cell (PBSC) collections as they are lengthy procedures resulting in prolonged citrate exposure. Intravenous (IV) calcium administration during therapeutic apheresis procedures is commonly used to reduce the citrate-related toxicity in adults and pediatric population. Very few literature on the use of oral calcium for the prevention of citrate toxicity during PBSC collection are present.

OBJECTIVE:

The objective of this study was to evaluate the effect of prophylactic oral calcium in reducing citrate-related toxicities during PBSC collections.

MATERIALS AND METHODS:

A prospective cross-sectional study was carried out at a tertiary care hospital of Southern India. All participants received calcium carbonate – 1 g before and at each 100 ml of collection. Preprocedure, interim, and postprocedure serum calcium were measured. All procedures were done using Spectra Optia. The ACD (acid-citrate-dextrose) rate were between 1:8 to 1:14 and were adjusted for inlet draw rate. The total blood volume processed between 2.5 to 3 based on body weight. Reduction in calcium levels and adverse reactions due to hypocalcemia were observed. Data were analyzed using SPSS 23 software.

RESULTS:

The majority of the procedures were undisturbed and tolerable to oral calcium. A total of 97.3% of the study subjects did not experience any symptoms of hypocalcemia. Only 2.7% (One autologous and one allogenic donor) had symptoms attributable to hypocalcemia though they had preprocedure calcium >9 mg/dl. Pre- and postprocedure calcium were compared using a paired t-test which was statistically significant.

CONCLUSION:

Prophylactic oral calcium in PBSC collection is an effective and easy way to the prevention of citrate-related adverse effects without affecting technical performance and product efficacy.
Disaster Preparedness and First Aid Response: The Role of Emergency Nurses
Authors: Olorunfemi Olaolorunpo , Adesunloye Olufunke Beatrice
Published: August 2024

Emergency nurses are pivotal in disaster preparedness and first aid response, being the first healthcare providers on the scene during emergencies. Their ability to assess situations swiftly, triage patients effectively, and collaborate with other professionals ensures timely and efficient care. They also contribute significantly to disaster preparedness by participating in drills and training, and by assisting in developing and implementing emergency response plans. Natural catastrophes harmed about 2 billion people worldwide between 2008 and 2018. According to the World Health Organization, countries and governments must always have catastrophe preparations and emergency health experts on hand. This review article aimed to examine the current level of disaster preparedness among nurses, to analyze some of the factors influencing nurses’ emergency preparedness and to define the roles of emergency nurses in both rapid first aid deployment and long-term disaster impact reduction. The data for this review paper are from published studies. Electronic databases of MEDLINE, PubMed, and Google Scholar were searched using the keywords: disaster preparedness, first aid response, emergency nurses, roles of nurses, and disaster response, and literature were retrieved and screened for eligibility. The date limit considered in the literature search was from 2018 to 2024 to capture only the variables identified in the study. The review revealed four issues which are (1) the Haddon Matrix Model, (2) current level of disaster preparedness among nurses, (3) roles of emergency nurses in disaster management, and (4) analyzing emergency preparedness and first aid impact of nurses in disasters. In conclusion, addressing these issues through targeted training, resource allocation, and policy implementation can enhance the overall preparedness of nurses in responding to disasters and improving outcomes for those affected. Ensuring that nurses are well-prepared, adequately trained, and equipped with the necessary resources, healthcare systems can better mitigate the impact of disasters and provide timely and effective care to those in need. This not only benefits the individuals directly affected by disasters but also strengthens the resilience of communities and healthcare systems as a whole.
Awareness Regarding the Health Benefits of Millet and Its Consumption among the Population
Authors: Kulkarni Meenal , Patil Purva , Saoji Ajeet
Published: August 2024

Background and Aim:

Although there are national initiatives such as the National Mission for Sustainable Agriculture and the Millet Mission, there is a significant knowledge gap present among the people related to the importance and advantages of millets, inculcating their use in practice. Hence, the present study was conducted to assess the knowledge about the health benefits of millets and practices regarding its consumption and to determine the association between sociodemographic factors and the consumption of millets.

Materials and Methods:

Following institutional ethics committee approval, a semi-structured, pretested, prevalidated questionnaire was used to collect data via interviews of patients coming to the general outpatient department of a district hospital. Besides sociodemographic information, it also covered questions related to the participant’s knowledge and practices regarding the consumption of millets.

Results:

Only 23% of the participants had consumed any kind of millets. The most common reason for nonconsumption was the nonavailability of the millets followed by the family custom of not eating. Only 20.2% had moderate-to-good knowledge regarding the health benefits of millets. A statistically significant association was found between the consumption of millets and the type of family and level of education (P < 0.05).

Conclusion:

A significant knowledge gap was present among the population related to the health benefits of millets. The proportion of consumption of millets among the population was found to be low.
Potential Strategies to Improve the Quality of the Framework of Programmatic Assessment in Medical Education: Raising the Bar
Authors: Shrivastava Saurabh RamBihariLal , Hidayah Rachmadya Nur
Published: August 2024

Assessment in medical education has a special role as it ascertains the acquisition of desired knowledge, skills, and learning outcomes expected from a medical graduate who will be a part of the health-care team. Programmatic assessment has gained wide attention, as it maximizes assessment for learning and also aids in the development of a strong assessment system, which enables teachers to take a data-driven decision about each student during the high-stakes assessment. In the case of programmatic assessment, the quality of the assessment is judged with the help of elements such as coherence, continuous, comprehensive, feasibility, purpose-driven, acceptability, and transparency. In conclusion, programmatic assessment has been linked with multiple benefits for the student, the teachers, and the administrators. However, to optimize the process of attainment of learning outcomes, it is the need of the hour that educators should take specific measures to augment the quality of all the elements of the assessment framework in programmatic assessment.
Medicolegal and Ethical Perspectives in the Use of Narcoanalysis in Criminal Investigations in India
Authors: Vaswani Vina , Shenoy Venkatkrishna , Ifeanyichukwu Akuma
Published: August 2024

This article delves into the strengths and weaknesses of the use of narcoanalysis in criminal investigation in India, from a forensic lens, also bringing with it ethical perspectives. The article shows the interconnectedness of forensic medicine, ethics, and narcoanalysis highlighting the intricate relationship between scientific investigation and ethicolegal processes in the pursuit of truth in criminal cases. The use of narcoanalysis in crime investigation may be less harmful but there is a significant amounts of mental coercion. The article concludes that the interconnectedness collectively contributes to the quest for justice; however, emphases are placed on the importance of adhering to ethical standards and respecting individual rights.
A Descriptive Study of Orgasm in Sexual Satisfaction and Intimacy among Females in India
Authors: Ramasubramanian R Vikhram , Veerabalajikumar
Published: August 2024

Background and Aim:

Orgasm is the peak of sexual arousal or behavior, whenever the peak of satisfaction is attained. Sexual satisfaction refers to the subjective experience of pleasure, contentment, and fulfillment related to one’s sexual activities and relationships and intimacy is the heart and soul of a close relationship. India is a diverse country with unique cultural, social, and economic factors that can impact women’s experiences in terms of intimacy and sexual satisfaction. The aim is to find out the relationship between orgasm in sexual satisfaction and intimacy among females in India.

Materials and Methods:

A descriptive research design is used for the present study. Through simple random sampling, 128 females who were married, people who can understand English, and who provided informed consent were selected for the study. The study was conducted from April 2022 to March 2023. The 20-item New Sexual Satisfaction Scale and the 36-item personal assessment of intimacy in relationships, and a semi-structured interview schedule were administered. Data were statistically analyzed using the statistical package for social services software, Version 26.0. A simple percentage analysis was used. The correlation was calculated for the variables. The Pearson correlation method was used to find the relationship between variables. A one-way ANOVA was employed to find out the significant mean difference between the demographic variables with a 95% confidence level, and P < 0.05 was considered statistically significant.

Results:

The result reveals that there is a relationship between intimacy and sexual satisfaction. Researchers found that there is a significant difference between sexual satisfaction and age, educational qualification, family type, place of living, and orgasm.

Conclusion:

There exists a positive correlation between intimacy and sexual satisfaction. This study helps to create awareness and promote intimacy, orgasm, and sexual satisfaction among Indian females.
Effectiveness of Mobile Call Reminders and Health Information Booklet to Improve Postnatal Blood Glucose Monitoring among Mothers with Gestational Diabetes Mellitus Receiving Care from a Tertiary Health Centre, Puducherry - A Randomized Controlled Trial
Authors: Manoharan Nandhini , Jayaseelan Venkatachalam , Kar Sitanshu Sekhar , Jha Nivedita
Published: August 2024

Background:

In India, around 10% of mothers with gestational diabetes mellitus (GDM) develop diabetes within months after delivery. But only 29% of them undergo blood glucose testing in the postnatal period. Our study aimed to compare the proportion of mothers with GDM who got postnatal blood glucose checked at 8 weeks among mothers who received health education booklets and mobile reminders.

Methods:

We conducted a randomised controlled trial among 165 mothers with GDM receiving care from a tertiary health centre between January 2020 and June 2021. Mothers with GDM in the intervention 1 arm received a health education booklet in the third trimester, those in intervention 2 arm received mobile call reminders at the fourth and fifth weeks postpartum, control arm received standard care advised in the hospital; they were followed up at 8 weeks postnatally. We used Chi-square test to compare the effectiveness of intervention and standard care. Relative risk with a 95% confidence interval was calculated to measure the strength of association. A P value <0.05 was considered statistically significant.

Results:

A total of 161 participants (97.58%) completed the study; Out of 55 mothers with GDM in each arm, 30 (56.60%) in the booklet arm, 23 (42.59%) in the mobile reminder arm, and 13 (24.07%) in the standard care arm had undergone postnatal blood glucose monitoring at 8 weeks. There was a statistically significant difference in the postnatal blood glucose monitoring in the booklet arm (RR: 2.21 [1.35–3.64], P value <0.002) compared to the control arm, but the difference was not significant in the mobile reminder arm (1.65 [0.96–2.86], P value 0.072).

Conclusion:

Health education booklet and mobile call reminders effectively improved postnatal visit compliance compared to standard care. We can diagnose mothers with GDM progressing to diabetes in the postnatal period by implementing these interventions.
Short Stature: Understanding the Stature of Ethnicity in Height Determination
Authors: Mittal Madhukar , Gupta Parul , Kalra Sanjay , Bantwal Ganapathi , Garg Mahendra K
Published: August 2024

Height is a polygenic trait with a high degree of heritability. Most (95%) children with short stature (defined as height below the third percentile) and poor growth (growth velocity <5 cm/year) do not have an endocrine disorder. The genetic basis for stature potential has been evaluated in recent years and is increasingly being recognized as a major basis for variation in height between different ethnic populations. Numerous genome-wide association studies have identified hundreds of loci linked to human growth. Apart from the genetic factors, various environmental, nutritional, hormonal, and socioeconomic factors also influence the height, and stature of individuals varies between different geographical locations and ethnic groups. Ethnically different populations might respond differently to the same environmental factors and thus the final height in different ethnic groups is different. This review covers in detail the short stature of African Pygmies and Andamanese Islanders along with the possible causative factors responsible for the variation in height in these ethnic groups.
Efficacy and Safety of Levoketoconazole in Managing Cushing’s Syndrome: A Systematic Review
Authors: Patra Shinjan , Dutta Deep , Nagendra Lakshmi , Raizada Nishant
Published: August 2024

No systematic review has holistically analysed the efficacy and safety of levoketoconazole, a novel purified 2S,4R enantiomer of ketoconazole, believed to be 15- to 25-fold more potent than ketoconazole for managing Cushing’s syndrome (CS). We undertook this meta-analysis to address this knowledge gap. Electronic databases were searched for studies involving patients with CS receiving levoketoconazole in the intervention arm. The primary outcome was to evaluate changes in mean 24-hour urine-free cortisol (mUFC) levels. Secondary outcomes were to evaluate alterations in cortisol and adverse events. SONICS study showed that normalisation of mUFC was seen in 61%, 55%, and 41% of the patients at the end of 6, 9, and 12 months therapy, respectively. The LOGICs study showed that withdrawal of levoketoconazole was associated with a significant increase in mUFC from 81.3 ± 35.7 to 220.8 ± 333.5 nmol/24h. The late-night salivary-cortisol (LNSC) increase during the drug withdrawal phase was 2.6 nmol/L in the placebo group (PG) compared to 2.2 nmol/L in the levoketoconazole group (LG) (P < 0.05). Re-initiation of levoketoconazole in original LG was associated with a decrease in mUFC from 224.3 ± 341.3 to 135.6 ± 87.3 nmol/24h. Initiation of levoketoconazole in the original PG was associated with a decrease in mUFC from 537.9 ± 346.0 to 141.3 ± 130.3 nmol/24h. Normalisation of mUFC was observed in 50.0% patients in LG compared to 4.5% in the placebo group. The median time for the response was 25 days. The median time to loss of therapeutic response was significantly shorter for PG (24 days) compared to LG (62 days) (P < 0.0001). Levoketoconazole has good efficacy and safety in CS. Bigger and longer studies are warranted to establish its superiority over ketoconazole.
Age and Disease Duration Independent Cardiac Autonomic Neuropathy in Patients with Diabetic Foot Complications
Authors: Wadhera Sarthak , Rastogi Ashu , Dutta Pinaki , Gupta Ankur , Bhadada Sanjay K.
Published: August 2024

Introduction:

Cardiac autonomic neuropathy (CAN) in people with diabetes is associated with high mortality. We aimed to study age and disease duration, independent prevalence of CAN in people with diabetic foot complications.

Methods:

530 patients with diabetes were screened to undergo CAN assessment (automated CANS-analyser). CAN was defined as “early”, “definite,” or “severe” according to the Toronto consensus. History pertaining to autonomic symptoms, prior cardiovascular events (CVE), and assessment for peripheral neuropathy was done. Participants were grouped into those with diabetic foot complication (group A, n = 82) [Charcot foot (n = 42), diabetic foot ulcer (n = 40)]; with DPN without foot complications (group B, n = 82); and without DPN or foot complications (group C, n = 82).

Results:

Symptoms of autonomic dysfunction were prominent in people with foot complications than the other groups. Resting heart rate was significantly greater in those with foot complications [99.89 ± 26.71 (group A) vs. 86.99 ± 22.24 (group B) vs. 88.32 ± 17.08 (group C); P = 0.001]. The prevalence of CAN was 75.6% in group A (51.2% early, 12.2% definite, 12.2% severe), 57.2% in group B (45.1% early, 12.2% severe) and 58.5% in group C (43.9% early, 1.2% definite, 13.4% severe) (P = 0.002). Patients with foot complications were more likely to have CAN (75.6% vs. 57.9%, P < 0.001). Charcot foot had higher prevalence of CAN (78.6%) as compared with those with DFU (72.5%) or without DFU or DPN (57.9%), P < 0.001.

Conclusion:

CAN is present in more than two-third of patients with diabetes and foot complications with highest prevalence in Charcot neuroarthropathy.
Kayser-Fleischer-like rings in patients with hepatic disease
Authors: Chhikara Chetan , H Vijaya Pai , C Ganesh Pai
Published: August 2024

Purpose:

The aim of this work was to study Kayser-Fleischer [KF]-like rings in patients with hepatic or cholestatic liver disease and to find out the relation between serum bilirubin level and the presence of KF like ring in these patients.

Methods:

In this study, we evaluated patients with hepatic and cholestatic liver diseases with total Serum bilirubin levels >10 mg/dl. These patients were evaluated for the presence or absence of KF like ring.

Results:

A total of 67 patients with total bilirubin >10 mg/dl were included in the study. Patients were divided into 3 groups based on total S. bilirubin level: Group 1 with S. bilirubin >30 mg/dl, Group 2 with S. bilirubin >20 - <30 mg/dl and Group 3 with S. bilirubin >10 - <20 mg/dl at baseline evaluation. On follow-up they were divided into 3 groups based on the serum bilirubin level. Group 1- >20 mg/dl, Group 2- >10 - <20 mg/dl, Group 3- <10 mg/dl. KF like ring was seen in 98.5% of patients with high total S. bilirubin level. KF like ring disappeared in 87.5% of patients with reduction in the total S. bilirubin level to less than 10 mg/dl.

Conclusion:

KF like ring was seen in 98.5% of patients with high total S. bilirubin, disappeared in 87.5% of patients with reduction in the total S. bilirubin level to less than 10 mg/dl. There was no significant difference between the Total S. bilirubin levels, age, gender and KF Like Ring.
Investigation of an anticancer activity of combination of interferon-alpha and gemcitabine on pancreatic cancer cells
Authors: Isayev Orkhan , Sokolova Darina V. , Anisimova Natalia Yu , Spirina Tatiana S. , Gasimov Eldar
Published: August 2024

Pancreatic ductal adenocarcinoma (PDAC) is still a clinical challenge due to its deteriorated prognosis. Therefore, new combination chemotherapeutic approaches are of research interest. In this work, we attempted to characterize the effects of gemcitabine and interferon-alpha as well as the combination of both on the metabolic, pro-apoptotic, and proliferative activity of MiaPaca and Panc-1 cells. We showed that the exposure of both drugs in combination increases effectively the metabolic activity of cells of MiaPaca and Panc-1 cell lines compared to the monotherapies. Based on the data from the analysis of apoptosis, the underlying molecular effect of metabolic and proliferative inhibition is an increase in the number of cells in the early apoptosis. These data can be of interest in the context of future preclinical research.
Assessment of quality of voice after 3D conformal hypofractionated radical radiotherapy in early-stage glottic cancer: A prospective study
Authors: Singh Shalini , Kumar Viney , Nautiyal Vipul , Gupta Meenu , Bansal Saurabh , Ahmad Mushtaq
Published: August 2024

Purpose:

The purpose of this study was to evaluate the short-term outcomes in terms of oncological outcomes, toxicities, and impact of quality of voice on livability of early glottic cancer (EGC) (T1) patients after hypofractionated radiotherapy.

Material and Methods:

30 patients of early glottic carcinoma, staged cT1a-T1bN0M0 with Eastern Cooperative Oncology Performance Status (ECOG PS ≤ 2). Exclusion criteria included ECOG PS > 2, T2–T4 disease, and any other head and neck malignancy. Voice Handicap Index-10 (VHI-10) was used to score voice outcomes of patient’s pre- and post-radiation.

Results:

All the subjects were predominantly smokers (80%) having hoarseness of voice as the most common presenting complaint (76.7%) followed by dry cough (13.3%) and foreign body sensation (10%). On posttreatment response assessment, there has been a significant reduction in VHI-10 scores from pre-radiotherapy (RT) to 6, 12, and 24 weeks post-radiation completion in all three domains (functional, emotional, and physical), as well as total scores, with a significant P value (<0.05) being observed.

Conclusion:

The use of modest hypofractionated regimen (63 Gy in 28 fractions) in patients of early glottic disease (T1a and T1b) posttreatment completion provides good oncological outcomes with better quality of voice being observed.
Validation testing of OUTPATSAT-35RT questionnaire to assess satisfaction in patients on outpatient radiotherapy in a large Indian cohort
Authors: Manjali Jifmi J. , Keluskar Geyata , Patel Ruchi , Bano Nazia , Shaikh Farnaz , Malhotra Rahat , Mani Shaktivel , Kumar Anuj , Sinha Shwetabh , Krishnamurthy Revathy , Dasgupta Archya , Chatterjee Abhishek , Tibdewal Anil , Pathak Rima , Mummudi Naveen , Wadasadwala Tabassum , Laskar Sarbani G. , Sarin Rajiv , Agarwal Jai Prakash , Gupta Tejpal
Published: August 2024

Background:

This study reports the psychometric properties of OUTPASAT-35RT questionnaire from a large Indian cancer cohort treated with ambulatory radiotherapy (RT) at a tertiary-care comprehensive cancer center.

Materials and Methods:

Adults with a pathologically proven diagnosis of cancer undergoing fractionated RT (≥10 fractions) with the ability to read and understand English, Hindi, or Marathi were accrued after written informed consent. Patients were administered a language-appropriate version of OUTPATSAT-35RT along with European Organization for Research and Treatment of Cancer (EORTC) generic quality-of-life questionnaire (QLQ-C30) at conclusion of RT (±3 days). Psychometric properties of OUTPATSAT-35RT were analyzed.

Results:

A total of 314 patients were accrued between 2018 and 2020. A negligible floor effect (<2%) but a high ceiling effect (>15%) was observed for OUTPATSAT-35RT. Multi-trait analysis revealed satisfactory validity and reliability of the questionnaire. Pearson’s correlation coefficient (PCC) of individual item score with own scale was >0.4 suggesting good convergent validity. Discriminant validity was satisfactory as the PCC with its own scale/own domain was greater than with other scales of the same domain and other domains of OUTPATSAT-35RT, respectively. Correlation of scales of OUTPATSAT-35RT with scales of QLQ-C30 demonstrated acceptable divergent validity (all values of PCC <0.3). Cronbach’s alpha was >0.7 suggesting good internal consistency. Test–retest reliability was good with intra-class coefficient being >0.7. Economic status was the only socio-demographic factor correlating significantly with OUTPATSAT-35RT scores; satisfaction of patients with the delivery of care increased with increasing family income.

Conclusion:

The psychometric properties of OUTPATSAT-35RT were found to be acceptable and satisfactory during validation testing in a large Indian cohort.
Evaluation of gross target volumes in CECT vs MRI in head and neck cancer and its implication on concordance indices and dose-volume parameters of IMRT treatment plan
Authors: Deshmukh Milind , Jain Bharati M. , Singh Ashok , Kalbande Pallavi , Tayade Atul , Datta Niloy R.
Published: August 2024

Background:

Although radiotherapy treatment planning (RTP) for head and neck cancers (HNCs) is based on contrast enhanced computed tomography (CECT), soft tissue contrasts are better evident on magnetic resonance imaging (MRI). We therefore evaluated dose-volume histogram (DVH) parameters along with concordance index (ConI), conformity index (CI), and homogeneity index (HI) of planning target volume (PTV) of GTV delineated on CECT vs MRI in HNCs enrolled for intensity modulated radiotherapy (IMRT).

Methodology:

Forty consecutive HNCs were enrolled in this study. All underwent CECT and MRI simulations with immobilization devices. GTVp and GTVn were delineated independently on CECT and MRI images. Corresponding MRI volumes were then copied to CECT. IMRT plans were generated on the CECT incorporating PTV margins. DVH parameters of PTVpn for both CECT and MRI were compared. In addition, mean (±SD) percentage difference of GTVp, GTVn, GTVpn, ConI, CI, and HI were evaluated using paired t-test.

Results:

The GTVp (P = 0.005), GTVn (P = 0.009), and GTVpn (P < 0.001) delineated on MRI were found to be significantly larger than GTV delineated on CECT. In eight patients, GTV outlined on CECT were larger than MRI. Significant mean differences in CECT vs MRI of CI (P < 0.001), HI (P < 0.001), ConI (P < 0.001), and DVH parameters (D2, D95, D98, V95, and V100 all P < 0.001; D50: P = 0.009) were noted.

Conclusion:

The GTVs and corresponding PTVs were significantly larger on MRI compared to CECT. This resulted in significant differences in DVH parameters, CI, ConI, and HI. This could be improved by co-registered MRI-CECT volumes during routine IMRT treatment planning for HNCs.
Receptor subtype and outcome of breast cancer – Single-center experience from North India
Authors: Banday Saquib Z. , Ayub Maniza , Rasool Malik T. , Ahmed Sheikh Z. , Banday Aaqib Z. , Naveed Shah , Guru Faisal R. , Mir Mohmad H. , Akhter Shareefa , Bhat Mudasir H. , Yaseen Syed B. , Afroz Fir , Bhat Gull M. , Lone Mohammad M. , Aziz Shiekh A.
Published: August 2024

Aims/Objectives:

In resource-limited settings, data regarding the impact of molecular/receptor subtypes on breast cancer (BC) are sparse. In this single-center retrospective study from north India, we analyze the outcomes of various molecular subtypes of BC.

Materials and Methods:

Females with biopsy-proven BC who were treated at our State Cancer Institute from 2014-2018 were included. Data regarding clinicopathological parameters and follow-up details were evaluated. For data analysis, cancers were categorized into 4 subtypes: HR+HER2–, HR+HER2+, HR–HER2+, and HR–HER2–.

Results:

Among 944 patients included, HR+HER2– (49.1%) and HR+HER2+ (13.1%) were the most and least common subtypes, respectively. The receptor subtype significantly impacted overall survival (OS). HR+HER2– cancers had the best outcomes while HR–HER2– cancers fared worst (3-yr OS of 94.3% and 69.1%, respectively). On subgroup analysis, the molecular subtype continued to significantly impact OS in patients with tumor grades II and III, disease stages II and III, and age groups of <40 and 40-60 years, respectively (HR–HER2– cancers had the lowest cumulative survival in each subgroup). In patients with metastatic BC, all molecular subtypes except HR+HER2– had a dismal prognosis.

Conclusions:

Overall and across various subgroups, patients with triple-negative BC had the poorest outcomes. Ensuring optimal treatment utilization including affordable access to personalized tailored therapy is the need of the hour to improve long-term outcomes in these patients.