bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence of Depression among Married Women in a Rural Area of North Kerala: A Cross-sectional Study
Authors: Lamiya K. K. , Haveri Sheela P. , Mundodan Jesha Mohammedali
Published: July 2024

Depression is a common illness, it being the fourth-leading cause of disability in the world. The global lifetime prevalence falls between 8% and 12%, with female preponderance. A cross-sectional study was designed to assess the burden of depression among married women in a rural setting in North Kerala and identify its sociodemographic risk factors. The sample size was calculated to be 453 (prevalence = 24.9%; error = 20%; design-effect = 1.5). Systematic random sampling was used to select the participants from the eligible couple register. They were interviewed using MINI and Montgomery–Ashberg Depression Rating Scales. Descriptive analysis showed that 24.2% was suffering from current depression, mostly mild and none severe. Two percent reported past depression and 5.4% experienced spousal violence. Poor family support, experience of domestic violence, morbidity, and older spouses were found to be significant risk factors. The provision of mental health services by trained personnel and strict vigilance against the marriage of girls below the legal age and domestic violence are need of the hour.
Effect of Combined Intervention of Yoga and Physiotherapy as Compared to Only Physiotherapy on Lower Limb Muscle Strength, Balance and Range of Motion among Elders with Compromised Stair Climbing in Puducherry - A Parallel Arm Non-Randomized Control Trial
Authors: Gupta Roopmala , Sahu Swaroop Kumar , Barathi Arivarasan , Kumar Navin , Naik Dukhabandhu , Roy Gautam
Published: July 2024

The activity of daily living (ADL) related to stair climbing is one of the most compromised ADLs among the elders. It requires good muscle strength, balance, and range of motion (ROM) in the lower limb. We aimed to investigate the effects of Yoga complemented with physiotherapy (Intervention group) compared to only physiotherapy (control group) on lower limb muscle strength, balance, and ROMs among elders with ADL limitation in stair climbing. Sixty-five community-dwelling elders with compromised stair climbing were enrolled. Elders who consented to yoga along with physiotherapy were enrolled in the intervention arm. Data were collected and analyzed following 12 weeks of intervention. Endline assessment showed that the intervention group had more improvement in all test scores and ROMs as compared to the control group, although there were improvements in both arms as compared to baseline. Considering the beneficial effects of both interventions, yoga can be added to gain additional advantages.

Trial Registration:

Indian Clinical Trials Registry number CTRI/2021/08/035825.
Japanese Encephalitis Virus Infection among Wild Caught Vectors Mosquitoes and Domestic Pigs in Northern West Bengal, India
Authors: Ballav Sudeep , Biswas Asit Kumar , Saha Pabitra , Guha Ushnish , Pramanik Tulsi , Maji Ardhendu Kumar , Guha Subhasish Kamal
Published: July 2024

Background:

Japanese encephalitis (JE) is an emerging zoonotic disease caused by JE virus (JEV) and transmitted to humans from pigs or aquatic birds by vector mosquitoes in southeast Asian countries. In this study, JEV infection rate among vector mosquitoes and domestic pigs was determined by detecting viral RNA and anti-JEV antibody (immunoglobulin G), respectively.

Materials and Methods:

A total of 146 pool mosquitoes of Culex
vishnui subgroup and 278 pig blood samples were analyzed by reverse transcriptase polymerase chain reaction and enzyme-linked immunosorbent assay methods, respectively. E and premembrane (PrM) gene of JEV detected among vectors were sequenced and a phylogenetic tree was constructed.

Results:

Five (5.81%) pools of Culex
tritaeniorhynchus were positive for JEV with pooled infection rate 1.70/1000 mosquitoes. A total of 108 (38.84%) blood samples were positive for anti-JEV antibody. Phylogenetic analysis revealed that our own E and PrM gene sequence of JEV belonging to Genotype III and showed 96.95% sequence similarities with the vaccine strain SA14-14-2.

Conclusion:

It was observed that domestic pigs of northern West Bengal were highly infected with JEV. Hence, the transmission should be blocked by pig vaccination. A pilot study may be undertaken for mass vaccination of the prevailing pig population to observe any reduced rate of JEV transmission from both pig to pig and pig to human.
Research on Antimicrobial Resistance in the Last 15 Years, India: A Bibliometric Analysis
Authors: Yadav Shikha , Sharma Mayank ,   Point Prevalence Survey Team, Rajesh Kavita , Dudhraj Vibhor , Anand Shailja , Kaur Suneet , Bahl Arti
Published: July 2024

Effective antimicrobials play an important element in modern medicine’s success in treating infections, without which the patients would be put at risk. Along with the naturally occurring process of antibiotic resistance, the misuse/overuse of these antibiotics also leads to them losing their effectiveness. It limits the treatment options as the microbe that had previously been sensitive becomes resistant. This bibliometric study was performed by searching the Scopus database according to a specific search strategy. A total of 4200 articles were retrieved from the search, and after applying inclusion and exclusion criteria, 1355 articles were included in the study. All of the bibliometric variables examined in this study revealed significant growth in this research field, especially during COVID-19, in terms of increasing scientific output and research collaboration. The study findings indicate an adequate quality and amount of antimicrobial resistance (AMR) research on microbiology and pharmacodynamics in India, whereas more research needs to be conducted on measures to tackle AMR, its public health, and policy aspects.
Rapidly Progressing Rhino-orbito-cerebral Mucormycosis with Concomitant Pulmonary Mucormycosis in a Post-COVID-19 Diabetic Subject
Authors: Dhawan Vaishali Bodhraj , Manoj Megha
Published: July 2024

Invasive fungal sinusitis is a highly lethal infection in an immunocompromised population that can spread rapidly to involve the adjacent structures by direct invasion or through vascular invasion. Involvement of cerebral parenchyma by vascular invasion is a devastating complication in these patients which may lead to vasculitis, thrombus formation, cerebritis, or abscess formation. Here, we present a case of a young male with uncontrolled diabetes mellitus who initially presented with COVID-19 lung disease and later developed sinonasal mucormycosis complicated with left orbital cellulitis and pulmonary mucormycosis.
A Randomized Control Trial Study to Assess the Effectiveness of Interpersonal Psychotherapy on Symptom Reduction and Relapse Prevention for Depression among the Depression Patients
Authors: Varadharasu Sivasankari
Published: July 2024

Background:

Depression is a serious illness; approximately 40%–60% of patients develop relapse, and this risk increases up to 90%. Interpersonal psychotherapy (IPT) is an effective method to minimize depressive symptoms and relapse.

Objectives:

This randomized control trial study is designed to assess the effectiveness of IPT on depression symptom reduction and relapse prevention.

Materials and Methods:

Three hundred depressed patients from a selected psychiatric hospital in UP, India, were recruited by a simple random sampling technique that randomly allocated 150 participants to the experimental group and 150 to the control group by tossing a coin. Depressive symptoms were assessed using the Hamilton Depression Rating Scale, which has 17 items. On the 2nd day of the trial, the experimental group received IPT. It helped the participants recognize their emotions and urge themselves to express them, both of which had a direct positive impact on their sad mood. The IPT efficacy assessment was done at the end of the 4 weeks of the intervention, and the relapse prevention assessment was undertaken 4 months later. The control group was kept with the actual treatment modalities and psychoeducation sessions, and they were assessed in the same way as the experimental group.

Results:

Findings illustrated that the reduction of depressive symptoms with (t = 33.61) (P = 0.0000) and relapse prevention with (t = 2.7484) (P = 0.0067) are significant, respectively. Furthermore, symptom reduction and relapse prevention had an association with some demographical data at P < 0.05, 0.001.

Conclusion:

IPT is an effective intervention for reducing depressive symptoms and preventing relapse.
Nurturing Tomorrow’s Antibiotic Stewards: An Innovative School Campaign to Combat Antimicrobial Resistance in Delhi
Authors: Sharma Sangeeta , Gupta Renu , Bablani Vineeta , Bahl Arti
Published: July 2024

Antimicrobials are lifesaving medicines, but their misuse drives antimicrobial resistance. Schools, as educational hubs wield transformative potential in fostering responsible antimicrobial behavior among students and the broader community. An online campaign targeted Delhi schools, training teachers as master trainers who, in turn, educated 359,940 students. Significant pre- to post-test score improvements were observed among teachers (6.98–8.14; P < 0.01) and students (5.20–6.56; P < 0.01). The campaign received excellent feedback (85%), with 966 students participating in the “IDEAthon” competition. While a single session improved knowledge, continuous engagement and activities are imperative for sustained behavioral change in antibiotic usage.
The Impact of Alternate Methodological and Structural Assumptions on Results of Cost-effectiveness Analysis: Empirical Evidence using Three Indian Economic Evaluations
Authors: Sharma Deepshikha , Aggarwal Arun Kumar , Bahuguna Pankaj , Prinja Shankar
Published: July 2024

Background:

Despite advancement in methods and application of economic evaluations (EEs), there are several uncertainties.

Objectives:

To assess the impact of alternate methodological and structural assumptions for four key principles of EE, on the results of cost-effectiveness analysis.

Materials and Methods:

Three previously published model-based EEs were used: (1) Integrated Management of Neonatal and Childhood Illnesses (IMNCIs) intervention; (2) intervention for multiple myeloma, and (3) safety-engineered syringes (SES) intervention. A series of empirical analyses was undertaken to assess the impact of alternate assumptions for discount-rate, time-horizon, study perspective, and health outcome measure, on incremental cost-effectiveness ratio (ICER), and interpretation of cost-effectiveness.

Results:

Increasing discount rate resulted in an increase in ICERs, for all three case-studies; however, there was no change in the conclusions. Using shorter time-horizons resulted in a significant increase in ICERs, the multiple myeloma intervention remained cost-ineffective, SES intervention became cost-ineffective, whereas IMNCI intervention remained cost-effective, despite a three-fold increase in ICER. On using disability adjusted life years instead of quality adjusted life years, ICERs increased to 0.04, 2 and 4 times for SES, IMNCI and multiple myeloma interventions, respectively. On analyzing results from a societal perspective, a decline in ICERs was observed. The decline was significant for IMNCI where the intervention turned dominant/cost-saving. In the other two case-studies decline in ICERs was modest, 32% for multiple myeloma, and 4% for SES.

Conclusion:

We observed a significant impact of using alternate assumptions on ICERs which can potentially impact resource-allocation decisions. Our findings provide strong argument in favor of standardization of processes and development of country-specific guidelines for conduct of EE.
Recent Amendment in the Medical Termination of Pregnancy Act in India: Empowering Women’s Health
Authors: Sinha Anuvi , Sinha Ratnesh
Published: July 2024

In 1971, the Medical Termination of Pregnancy (MTP) Act was implemented to deal with unsafe abortions, fetal complications, and maternal mortality. In India, it is estimated that more than half of all abortions are unsafe leading to infection, hemorrhages, injury to internal organs, and sometimes maternal death. To address these issues, the MTP Act was amended in 2021 to promote uniformity, accessibility, availability, affordability, and quality of MTP services with appropriate management in case of any adverse event.
Paternal Alcohol Consumption and Childhood Malnutrition: A Community-based Participatory Case–control Study among Adivasis in Rural South India
Authors: Menon Gopal , Mathias Priyanka , Wurdeman Taylor , Dahake Ritwik , Elamanna Jiji , Pathayakandi K. Shabeer , Starr Jacqueline R. , Devi P. Shylaja ,   ASHWINI Research Team
Published: July 2024

Background:

Childhood malnutrition in India remains among the highest in the world. Adult alcohol consumption and severe malnutrition have increased among indigenous people in South India. However, the association between them is poorly understood.

Objectives:

We aimed to evaluate this association, which could help design better intervention strategies.

Methods:

This case–control observational study was conducted in the Nilgiri district in South India. Cases included children aged 1–5 years with moderate malnutrition. Controls were defined as children in the same age group with normal weight-for-age. A questionnaire was used to collect data on demographics, socioeconomic status (SES), and parental education. The WHO Alcohol Use Disorders Identification Test (AUDIT) questionnaire was used to estimate parental alcohol use. Health-care workers collected data from within the community.

Results:

The baseline demographics of the children in the control (n = 250) and case groups (n = 177) were similar. Paternal age and AUDIT scores were not different in the two groups. SES was lower in the malnourished group, while maternal education among cases was significantly lower. Maternal and paternal education were associated with childhood malnutrition (odds ratio [OR]: 0.728 [95% confidence interval (CI): 0.583–0.903] and OR: 0.753 [95% CI: 0.589–0.957], respectively). After adjustment for covariates, paternal alcohol use was associated with a higher risk of malnutrition (OR: 1.56 [95% CI: 1.00–2.47]), which SES partly mediated.

Conclusion:

Paternal alcohol consumption is associated with childhood malnutrition, partially mediated by lower SES. Furthermore, lower SES appeared to be strongly associated with paternal alcohol consumption.
Universalization of Healthcare for Non-Communicable Diseases in India – Promise of Health and Wellbeing, Insurance for Universal Health Coverage
Authors: Biswas Bijit , Bashar MD. Abu , Kulkarni Muralidhar M. , Khan Imran Ahmed
Published: July 2024

Noncommunicable diseases (NCDs) pose a significant global health and economic burden, necessitating universal health coverage (UHC). Out-of-pocket (OOPs) payments for healthcare, particularly in low- and middle-income countries lacking social protection and health insurance, contribute to impoverishment and catastrophic expenditure. This scoping review aimed to assess the state of UHC for NCDs in India, including the progress made, coverage of government health insurance schemes, challenges faced, and their potential solutions. A literature search was performed in major databases such as PubMed, Ovid, Web of Science, Embase, Cochrane Library, and Google Scholar using appropriate keywords. Findings indicated that UHC remains a distant dream in India with a disproportionately high NCD burden and a substantial portion of health-care expenses (80% outpatient, 40% inpatient) relying on OOP expenditures, causing financial hardship. Limited universal social security exacerbates health-care access challenges. The coronavirus disease-2019 pandemic has further hindered NCD services and UHC progress. The Ayushman Bharat program, featuring health and wellness centers and the Pradhan Mantri Jan Arogya Yojana, aims to address primary health-care needs and provide NCD coverage in India. Despite this, challenges persist, including inadequate availability of essential medicines and technologies in health-care facilities, as well as gaps in rural health-care access. Telemedicine services like “eSanjeevani” have been implemented to improve access in remote areas. To achieve UHC for NCDs in India, it is crucial to strengthen primary health-care, ensure medicine availability, enhance human resources, establish a referral system, address social determinants, and implement social protection.
A First Report on the Isolation and Characterization of a Highly Potential Indigenous Mosquitocidal Bacterium (Bacillus thuringiensis Subspecies Israelensis VCRC B647) from Red Soil, India
Authors: Bora Bhagyashree , Lukose Jibi , Gangmei Kakhuangailiu , Sivaprakasam Manikandan , Vijayakumar Abhisubesh , Mandodan Sahadiya , Padmanaban Hemaladkshmi , Kunnikuruvan Aneha , Ashokkumar Mathivanan , Krishnamoorthy Vijayalakshmi , Subbiah Poopathi
Published: July 2024

Background:

To control mosquito vectors causing human diseases, bacterial biopesticides are currently in use. Indeed, the recent development of resistance to these bacterial agents has impeded its applications. Under these circumstances, the search for novel bacterial agents with mosquitocidal activity is unavoidable. In this study, a novel mosquitocidal bacterium was isolated from red soils of agricultural field.

Objectives:

The objective of this study was to isolate and identify new mosquitocidal bacteria from the natural environment.

Materials and Methods:

Soil samples were collected during 2021–2022 from Tirupathur district of Tamil Nadu, South India. The samples were bioprocessed for culturing the bacterial colony in a suitable culture medium (Nutrient Yeast Salt Medium), and after 72 h, the bacterial cell mass was removed and lyophilized. Bioassays (mosquito toxicity assays) were carried out to screen the bacterial colonies for mosquitocidal effect. The potential colony was further analyzed, and identified for its application in mosquito control.

Results:

The new isolate screened from red soil was identified as Bacillus thuringiensis subspecies israelensis (VCRC B647) as per the ilvD gene sequence analysis. The strain was found to be potentially effective in controlling mosquito larvae, and further biochemical analyses, bacterial growth, biomass, and protein content were investigated. The new isolate did not show any toxic effect on nontarget aquatic organisms.

Conclusion:

It is significant to depict that the mosquitocidal action of this new isolate (Bti) is highly significant than the reference strain of Bti-H14. It is concluded that this is the first report that an indigenous strain of Bti VCRC B647 is very effective in mosquito control.
Compositional characteristics of the gut microbiome in patients with uremia
Authors: Wu Zirui , Bian Mingjie , Zhang Hong , Wang Mengli , Wang Peng , Shao Yunxia , Shen Liang , Zhu Guoping
Published: July 2024

During acute or chronic uremia, the cumulative harmful effects of uremic toxins result in numerous health problems and, ultimately, mortality. Previous research has identified that uremic retention solutes originate from the gut microbiome, indicating that uremia may be closely associated with gut microbiome dysbiosis. To deepen our understanding of the compositional characteristics of the gut microbiome in patients with uremia and thereby promote precision medicine in the treatment of uremia, we conducted a study of the compositional characteristics of the gut microbiome in 20 patients with uremia. The gut microbiome diversity of uremic patients and the control group showed certain differences. Nonmetric multidimensional scaling analysis showed that the beta diversity of the gut microbiome of uremic patients was significantly different from that of the healthy control individuals, with a distinct clustering effect in the uremic patient group, and it also showed a similarly distinct clustering effect in the healthy control group. The Chao1 index and Sobs index were significantly lower in the uremic patient group than in the healthy control group (P < 0.05). By analyzing the composition and abundance distribution of the gut microbiome in the uremic patient group and healthy control group, we found that the relative abundance of the gut microbiome constituents Fusobacteriota, Enterobacteriaceae, Oscillospirales, Ruminococcaceae, and Lachnospiraceae was significantly increased in the intestines of uremic patients. We also detected the rare taxa Erysipelotrichaceae, which was present only in the uremic patient group. Predictive functional analysis suggested that an increased abundance of Ruminococcaceae and Lachnospirales, which are associated with indoxyl sulfate and phenylacetyl glutamine, and an increased abundance of Oscillospirales, which is associated with pyruvate metabolism, in uremic patients may strongly influence the gut environment according to renal function, resulting in dysbiosis associated with uremic toxin production. Rare taxa such as Erysipelotrichaceae have been suggested to be detrimental to intestinal disease. Further research into these gut microbiomes may provide new ideas for the prevention and treatment of uremia with the gut microbiome.
Dyskeratosis congenita with squamous cell carcinoma of the tongue: A rare case report
Authors: Sneha S , Sudha S , Nair Resmi G. , Dyuthi G
Published: July 2024

Dyskeratosis congenita is a rare inherited bone marrow failure disorder characterized by a classic triad: nail dystrophy, reticulate skin pigmentation, and oral leukoplakia. Patients with dyskeratosis congenita have also been described as having gastrointestinal, genitourinary, neurological, ophthalmic, pulmonary, and skeletal abnormalities. Also, 80% of patients are affected with oral leukoplakia and these areas are more prone to develop into oral squamous cell carcinoma. We hereby report a rare case of oral squamous cell carcinoma of the tongue in a young male patient with dyskeratosis congenita.
Monkeypox: red alert for the dentists?
Authors: Yasmeen Subuhi , Noor Rana
Published: July 2024

COVID-19 pandemic is persisting around the world, meanwhile another threat to public health is Monkeypox, a viral zoonotic disease that has exploded, leading to the rise in unpredictable clinical cases from non-endemic countries along with the already-known endemic countries for it. In this article, we have discussed about the 2022 outbreak of human Monkeypox and its entanglement for dental practice including the role of the dentist for early detection, diagnosis, and management of this multi-country disease.
Very Short Answer Questions (VSAQs): A relatively new novel tool for the assessment of cognition
Authors: Piryani Rano Mal , Piryani Suneel
Published: July 2024

Very Short Answer Questions (VSAQs) are a quite new tool used for the assessment of cognition. VSAQ consists of a clinical vignette followed by the lead in question. These are free-response types of questions that need very short responses. Students have to construct or generate their answers between one and five words. VSAQs are authentic, acceptable, valid, reliable, discriminatory, and a cost-effective method of assessment. A larger magnitude of knowledge, understanding of concepts, and application of knowledge can be assessed in a shorter period compared with Single Best Answer Questions (SBAQs). Evidence has supported “VSAQs have many surpluses over SBAQs.” This novel tool of assessment is very useful, so it needs to be integrated into formative and summative assessments of undergraduate medical curriculum.
Evaluation of the Impact of a Pharmacist-Conducted Hypertension Clinic
Authors: Mohammed Jameez Ummer , Thomas Dixon , Baker Danial
Published: July 2024

ABSTRACT

Background:

Hypertension can lead to cardiovascular and other health complications. Many hypertensive patients in the community may receive poor care and monitoring due to financial and other concerns. Pharmacists could support patients in improving their health outcomes. This research aims to assess the impact of pharmacist-led hypertensive clinics in a community pharmacy setting.

Methods:

The study was an interventional exploratory design in a community pharmacy in Dubai, UAE. All eligible patients who consented were enrolled in the study, making it a population-based study. Patients’ blood pressure (BP) was measured before starting the intervention and measured monthly for a minimum of 6 months of care. Measuring BP, physician referral for management of hypertension, lifestyle, diet, and medication counseling were the interventions provided by the researcher on a case-to-case basis as needed in each patient encounter. Toward the end of the study, a patient satisfaction survey was conducted. The survey form showed internal consistency, Cronbach’s alpha = 0.895.

Results:

About 30 patients were provided pharmacy services by a pharmacist for 613 months. All patients’’ BP were monitored monthly. Patients showed reductions in their systolic and diastolic BP levels with the continued care of the pharmacist. (The mean systolic BP significantly decreased from 155 mmHg (standard deviation (SD) = 14.4, median = 151) at baseline to 128 mmHg (SD = 3.1, median = 129) with a P = 0.001. The mean diastolic BP showed a decrease from 95 mmHg (SD = 8.4, Median = 93) at baseline to 82 mmHg (SD = 1.2, Median = 81) with a P = 0.17. The participants showed a high level of patient satisfaction. Some were willing to pay for the pharmacist’s professional service.

Conclusion:

In conclusion, the study has shown the impact of pharmacist-led antihypertensive clinics in systolic BP control and achieving high patient satisfaction. The study generated insights into participant cooperation with pharmacist services and needs. More research on different outcomes is planned for future studies, including systematic pharmacotherapy work-up, patient medication adherence, and other clinical outcomes in the study population.
Diflubenzuron Mass Concentration Determination Method in Pesticides Using High-Performance Liquid Chromatography
Authors: Saponenko Vadim , Nazhmetdinov Azamat
Published: July 2024

ABSTRACT

Aims:

Pesticides are actively used in agriculture to protect crops from pests, and accurate determination of the concentration of their active ingredient is critical to ensuring their efficacy and safety. The research aims to develop a methodology that will enable the accurate determination of the mass concentration of diflubenzuron, a widely used active ingredient in pesticide formulations. This is achieved through the use of high-performance liquid chromatography (HPLC).

Methods:

The proposed method for determining the mass concentration of diflubenzuron using HPLC was developed through a series of experiments and optimisation steps. The sample preparation procedure was optimised to extract the maximum amount of diflubenzuron from the pesticide formulation.

Result:

The chromatography conditions were optimised to separate diflubenzuron from other components in the sample matrix. A calibration approach was established for accurate quantification of diflubenzuron in the sample based on peak area measurements. The developed method can be widely used in agriculture, where accurate determination of diflubenzuron concentrations in pesticide formulations is critical for proper application and regulatory compliance. Both regulatory organizations and pesticide manufacturers can use it for batch-release testing and quality control to evaluate the efficacy and safety of pesticide products. In addition, the method can serve as a valuable tool for researchers and analysts working with pesticide residues in crops and environmental monitoring studies.

Conclusion:

The optimised sample preparation, chromatography conditions, and calibration approach provide reliable and reproducible results.
Factors associated with refusing hemoperfusion in patients with acute paraquat poisoning
Authors: Zhang Minghao , Zhao Shunzhong , Sun Mingji , Zhang Wei , Wang Boliang
Published: July 2024

Background:

Paraquat poisoning remains a critical public health issue with no established effective treatment. Hemoperfusion (HP) has been recognized for its potential to remove toxins and is widely employed in several developing countries for managing acute paraquat poisoning cases. However, the reluctance of some patients to undergo this recommended treatment has been observed but not thoroughly investigated. This study aimed to explore the factors associated with the refusal of HP in patients suffering from paraquat intoxication.

Materials and Methods:

In this retrospective study, data of 358 patients with acute paraquat poisoning were analyzed in Xi’an, China. The outcome of our study was mortality, and the influential factors were age, gender, marital status, educational level, symptoms at presentation, and laboratory findings. A logistic regression model was utilized to explore the independent risk factors.

Results:

In a total of 358 paraquat-poisoned patients, the significant differences were found between patients who underwent HP and those who did not, particularly regarding mean age (48.02 years vs. 42.32 years; P = 0.01), mental disorders (15.6% vs. 6.1%; P = 0.01), poisoning severity score (2.36 vs. 2.57; P = 0.03), organ failure (10.9% vs. 23.5%; P = 0.02), and mechanical ventilation (18.8% vs. 33.3%; P = 0.02). Patients who refused HP exhibited a higher mortality (20.3% vs. 10.9%; P = 0.03) compared to those who received HP. Age (odds ratio (OR), 1.76; 95% confidence interval (CI): 1.01–3.82; P = 0.01) and history of mental disorders (OR, 2.81; 95% CI: 1.19-6.61; P = 0.02) were identified as significant independent predictors for the refusal of HP.

Conclusion:

The results of this study showed that elderly individuals and those with a history of mental disorders were independently associated with refusing HP in patients with acute paraquat poisoning.
Negative association of apelin plasma levels with epicardial fat thickness in patients with stable angina and acute myocardial infarction: A case–control study
Authors: Babapour Behzad , Doustkami Hossein , Avesta Leli , Kiamehr Peyman , Aslani Mohammad Reza
Published: July 2024

Background:

Apelin is one of the endogenous peptides that play a key role in the homeostasis of cardiovascular diseases. The purpose of the current study was to evaluate the correlation between apelin levels and epicardial fat thickness (EFT) in patients with stable angina and acute myocardial infarction (AMI).

Materials and Methods:

In a case–control study, 90 patients nominated for angiography were enrolled in the study and divided into three groups: healthy subjects without angiographic findings (Con), stable angina pectoris group (SAP), and acute AMI group. Data collected from all subjects included biochemical, echocardiographic, and angiographical parameters. The Gensini score analyzed the severity of coronary artery disease (CAD).

Results:

A decrease in adjusted apelin levels was evident in the AMI and SAP groups compared with healthy individuals (for both P < 0.001), especially in the AMI group. In addition, a detectable negative association was identified between apelin and Gensini score (r = −0.288, P = 0.006), Ck-MB (r = −0.300, P = 0.004), EFT (r = −0.300, P = 0.004), and troponin-T (r = −0.288, P = 0.006).

Conclusion:

Myocardial injury in patients with CAD appears to play a significant role in apelin concentration independent of the role of adipose tissue, which requires further studies.
Correlation of 25-Hydroxyvitamin D Deficiency with Ferritin, Thyroid-Stimulating Hormone, and Other Biochemical Parameters of Women in Baghdad Province
Authors: Fadhel Alaa Abbas , Khaleel Khaleed J.
Published: July 2024

Background:

The importance of vitamin D in facilitating the absorption of calcium and phosphorus from the intestines and maintaining appropriate levels of these minerals in the blood for normal bone mineralization is well-established.

Objectives:

Beyond its role in bone health, vitamin D has been shown to exert a significant influence on various biochemical processes and may impact the development of certain diseases, including infections, obesity, heart disease, and certain cancers. This study aimed to investigate the differences in vitamin D levels among women from Baghdad province and its potential associations with ferritin and thyroid-stimulating hormone (TSH).

Materials and Methods:

This cross-sectional study involved 171 apparently healthy women, categorized into two age groups: the menstrual age group (group A, mean age 36.4 ± 9.2) and the menopausal age group (group B, mean age 57.7 ± 8.4). Vitamin D levels, serum ferritin levels, and hemoglobin levels were assessed to understand the interplay between these parameters.

Results:

The results revealed that both groups exhibited low levels of vitamin D (group A: 916.56 ± 8.33; group B: 16.86 ± 10.45), low serum ferritin (group A: 11.9 ± 10.66; group B: 28.2 ± 13.67), and low hemoglobin levels (group A: 10.97 ± 1.74; group B: 11.42 ± 1.68). Notably, the results observed no significant differences in all studied parameters between these groups, except for serum ferritin (P < 0.05). Additionally, the finding demonstrated a significant positive association between vitamin D and serum ferritin levels in both groups (group A, r = +0.569, P < 0.000; group B, r = +0.405, P < 0.01). Also, there was a significant moderate positive correlation between vitamin D and hemoglobin levels (group A, r = +0.43, P < 0.001; group B, r = +0.312, P < 0.04). However, no significant correlation was found between vitamin D and TSH, urea, and creatinine levels.

Conclusion:

The implications of this study suggest that vitamin D deficiency may serve as a useful predictor and have an adverse effect on anemia in women.
Estimation of IL-8, IL-38, Vitamin D, TPO Ab, and CRP Levels in Iraqi Hashimoto Thyroiditis Patients
Authors: Iqbal Mayada Noori , Samanje Jaleel
Published: July 2024

Background:

Hashimoto’s disorder is an autoimmune disease affecting cells of the thyroid gland via the diffusion of the lymphocytes into thyroid cells. Calcitriol is the active form of Vit.D3; there were a strong correlation between low Vit-D levels and development of autoimmune diseases exists and calcitriol supplementation might play a protective role in the pathophysiology of autoimmune diseases.

Objectives:

This study aimed to estimate the levels of interlukin-8 (IL-8), interlukin-38 (IL-38), Vitamin D, thyroid peroxidase (TPO) Ab, and c-reactive protein (CRP) in Iraqi patients suffering from Hashimoto disease.

Materials and Methods:

In this study, 90 individuals (males and females) were enrolled, and divided into two groups: Hashimoto’s disorder group (60) patients and the healthy control group (30) persons were checked by the physician with the aid of medical history. The levels of TSH, Vit.D3, anti-TPO Ab, T4, IL-8, and IL-38 were measured for all the study groups.

Results:

A highly significant reduction (P < 0.001) was shown in mean levels of Vit D, T4, and IL-38 among the patient’s group in comparison with the controls, whereas a significant reduction (P < 0.05) was revealed in mean levels of CRP among patients in comparison with the controls. Also, the results showed a highly significant elevation (P < 0.001) in mean levels of TSH, IL-8, and anti-TPO antibodies among the Hashimoto disease group in comparison with the controls.

Conclusion:

Hashimoto disease caused highly significant decreases in mean levels of Vit. D, T4, IL-38, and CRP, whereas there was a highly significant increase in the levels of TSH, IL-8, and anti-TPO antibodies.
Molecular Detection of Van A and bap Genes in Staphylococcus Species Isolated from Hemodialysis Patients with Blood Stream Infections
Authors: Hawi Shahad Ali , Abdulrahman Thanaa Rasheed , Mahdi Hasanain Tuama
Published: July 2024

Background:

Bloodstream infections (BSIs) are a frequent consequence of hemodialysis caused by bacterial pathogens associated withStaphylococcusspp. especiallyStaphylococcus aureusfollowed by coagulase-negative Staphylococci, which can produce biofilms, and also show its ability to increase resistance to vancomycin.

Objectives:

Estimate the percentage ofStaphylococcusspp. associated with BSIs in hemodialysis (HD) patients. Study the antibiogram pattern of isolates and detection of the resistance genevan Aand virulencebapgene.

Materials and Methods:

A total of 120 blood samples, 60 from patients on hemodialysis and 60 patients suspected of bacteremia, were collected. The isolation of bacteria was performed by blood samples inoculated in BacT/ALERT bottles and then subcultured on blood agar. Identification and antibiotic sensitivity testing detection were performed by the Vitek-2 system; then a conventional polymerase chain reaction forvan Aandbapgenes was done.

Results:

The percentage ofS. aureuswas 64.7% within the group of HD patients followed byStaphylococcus lentus11.8%,Staphylococcus hemolyticus8.8%, andStaphylococcus hominis5.9%, whereas in non-HD patients’ group,S. aureuswas 50.0% andS. lentus25.0%. AllStaphylococcusspp. was completely resistant to vancomycin in HD and non-HD patients. The percentage ofvan Agene was 91.2% and 83.3% within HD and non-HD patients, respectively. The percentage ofbapgene was 55.9% and 58.3% within HD and non-HD patients, respectively.

Conclusion:

Staphylococcus aureusis the most common bacterium that causes bacteremia in dialysis patients, while other types contribute with a lower frequency.
Linking the Defect of Gamma-Aminobutyric Acid Type A Receptor Subunit Delta Gene to the Microsatellite Instability in Colorectal Cancer
Authors: Mamoori Afraa Jawad , Alkafaji Haider A.
Published: July 2024

Introduction:

There is primitive data suggest the role of gamma-aminobutyric acid type A receptor subunit delta (GABRD) in the pathogenesis of colorectal cancer. This research aimed to investigate the role of GABRD in patients with microsatellite instability (MSI)-associated colorectal cancer.

Materials and Methods:

In total, 58 patients diagnosed with MSI-associated adenocarcinoma of colorectal cancer participated in this study. The level of GABRD expression in both cancerous and noncancerous colonic and rectal tissue was done first by immunohistochemistry and then confirmed by quantitative real-time polymerase chain reaction (PCR). In addition, GABRD expression level was correlated with other pathologic parameters of patients.

Results:

Overall, 72.41% of cases expressed a high level of GABRD at the genetic level, and 67.24% expressed GABRD at the protein level. Moreover, the adjacent normal tissue did not show specific expression of GABRD protein by immunohistochemical analysis. Also, this study demonstrates a significant correlation between GABRD expression to the advanced stages of MSI-associated adenocarcinoma of colorectal cancer.

Conclusion:

GABRD can be a new and important diagnostic marker in patients with MSI and can be targeted for the treatment of patients with colorectal cancer having MSI. Further studies with larger sample sizes and in vitro studies will be of great value to uncover the pathway by which this gene controls the defect in mismatch repair (MMR) genes.
Tracking the Phylogenetic Origins of Proteus mirabilis and P. vulgaris in Iraq
Authors: Hassan Asraa Ali , Naji Hassan Fadhil
Published: July 2024

Background:

Common gram-negative rod-shaped bacteria called Proteus spp. are widely known for their swarming motility and urease activity. It is the main pathogen that causes complicated urethral tract infections.

Objectives:

Proteus mirabilis and P. vulgaris isolates were isolated, and the positions of the bla
TEM, bla
CTX-M, and bla
SHV genes on the P. mirabilis isolates’ genomes were identified. The MEGA X10.2.4 software tool was employed to achieve this, and the genetic trees of P. mirabilis were created. Additionally, the isolates that represent the prevalence and degree of pathogenicity of these bacteria in Iraq were used to produce biofilms.

Materials and Methods:

A total of 210 urine samples from various patients who were hospitalized in general hospitals in Iraq between September 2021 and July 2022 were collected and yielded forty isolates of P. mirabilis and P. vulgaris. Traditional methods and the VITEK 2 compact were used to identify the isolates, which were given the names PM1 to PV40.

Results:

The results showed that all isolates were biofilm-forming, with the following ratios: 5 (15%) were weak, 31 (5.77%) were medium, and 4 (5.7%) were strong. The matching of this study isolates with NCBI-Gen bank global strains found that four isolates (PM1, PM2, PM3, and PM4) were originated in India, two isolates (PM5 and PM8) were originated in Iraq, and one (PM6) isolate was originated in Egypt.

Conclusion:

According to the results of this investigation, P. mirabilis and P. vulgaris isolates from various geographical areas show varying degrees of virulence factors. Therefore, additional researches are required to create a genetic diversity map of P. mirabilis and P. vulgaris due to variable frequencies in the sequencing of bla
TEM, bla
CTX-M, and bla
SHV genes of the isolates.
Prevalence of Cognitive Impairment among Iraqi Patients with Ankylosing Spondylitis
Authors: Altemimi Zahraa Hussein , Gorial Faiq I.
Published: July 2024

Background:

Ankylosing spondylitis (AS) is the prototype of spondyloarthropathies and one of the common rheumatic diseases (RDs). Various degrees of cognitive impairment have been reported with most autoimmune RDs.

Objectives:

To estimate the prevalence of cognitive impairment in AS patients and its relationship to disease activity and functional limitations and the effect of various sociodemographic and clinical characteristics on cognitive function in AS patients.

Materials and Methods:

This case–control study comprised 100 patients with AS and 100 healthy subjects who were matched for age, gender, and educational level. Private interviews were conducted with participants to complete the questionnaire and evaluate cognitive function using the 6-item Cognitive Impairment Test (6-CIT) and the Montreal Cognitive Assessment (MoCA).

Results:

According to MoCA, 48% of AS patients and 16% of healthy controls were cognitively impaired (P= 0.001). By 6-CIT, 6% of the AS group had cognitive impairment, whereas all 100 controls had normal cognitive function (P= 0.029). There was a significant direct correlation between 6-CIT score with marital status (P= 0.020), BMI (P= 0.021), and Bath Ankylosing Spondylitis Disease Activity Index (P= 0.008) and inverse correlation with employment (P= 0.015), education (P= 0.008), and family income (P= 0.12). There was significant direct correlation between MoCA with employment (P= 0.009), education (P= 0.005), family income (P= 0.022), and use of non-steroidal anti-inflammatory drugs (NSAIDs) (P= 0.008) and inverse correlation with marital status (P= 0.002).

Conclusions:

Patients with AS have a higher degree of cognitive impairment than healthy individuals. It is associated with disease activity, lower socioeconomic status, being widowed, and obesity. Use of NSAIDs is associated with lower cognitive impairment.
Incidental Thyroid Carcinoma in Thyroidectomy Specimen with Clinical Correlation in Iraqi Patients
Authors: Al-Sabbagh Wafaa Redha Mohammed , Al-Taee Zahraa Ali Saleh , Al-Mosawi Fatin Hasim
Published: July 2024

Background:

Incidental thyroid carcinoma is a clinically unsuspected carcinoma that was discovered by histopathological examination of a thyroidectomy specimen removed for benign diseases.

Objectives:

To evaluate the frequency of incidental thyroid carcinoma in the thyroidectomy specimens and how to avoid its sequel in Iraq.

Materials and Methods:

A retrospective study of 104 cases of total and subtotal thyroidectomy for benign diseases was collected from Al-Sader teaching hospital during 2019–2022, reviewed by two pathologists for incidental primary malignancy, and analyzed using SPSS version 27.

Results:

Incidental thyroid malignancy was detected in 10.54% of all cases. It had been found in 13.8% of multinodular goiter (MNG) cases. Eight cases out of eleven (72.7%) of incidental malignancies were detected in total thyroidectomy specimens and the same percentage of them were detected in MNG cases. Ten out of eleven cases (90.9%) of incidental carcinoma were papillary carcinoma type (six cases were micropapillary type and four cases were conventional type of papillary carcinoma) with one case of follicular carcinoma.

Conclusion:

MNG does not mean the absence of carcinoma in the thyroid gland. Total thyroidectomy is the best surgery to avoid complications of unsuspected carcinoma and the sequel of another surgery.
Serum Elabela Level as a Reliable Biomarker for Predicting of Liver Fibrosis in Iraqi Patients with Chronic Hepatitis C
Authors: Ali Eham Amer , Al-Bayati Ali Abdulateef Hasan , Farhan Salman Alea
Published: July 2024

Background:

Elabela is a newly discovered peptide hormone that has been implicated in liver disease.

Objective:

The main objective of the current work is to assess whether variations in blood Elabela levels among chronic hepatitis C (CHC) patients from Iraq might be used as a biomarker for liver fibrosis.

Materials and Methods:

A case-control study was conducted in Baghdad, Iraq. The overall sample size (n = 80) that met the inclusion criteria was divided into two groups as follows: 40 patients who were diagnosed with CHC and 40 healthy matched individuals. The aspartate aminotransferase-to-platelet ratio index (APRI) was used to identify the group of patients at risk for liver fibrosis. The routine complete blood count, liver function, and serum Elabela tests were performed. Serum Elabela level was evaluated by using the enzyme-linked immunosorbent assay technique.

Results:

Serum Elabela was significantly higher in the CHC group (33.89 ± 8.51 ng/mL) than in the control group (18.11 ± 5.27 ng/mL). In addition, the percentage of CHC patients at a high risk of developing fibrosis was 42.5%. Also, the high-risk fibrosis group showed a significantly higher concentration of Elabela and APRI than the other groups (low-risk and control) at P < 0.0001. Alanine aminotransaminase and aspartate aminotransaminase showed a high increase while a low decrease in both Hb and platelet count against the healthy group (P < 0.0001).

Conclusion:

High serum Elabela level in CHC patients compared to the control group was associated with liver fibrosis and could be used clinically as a reliable biomarker to determine the high-risk patient in need of invasive liver biopsy and hazardous therapeutics.