bluuebunny/crossref_metadata_2025 huggingface dataset:
The purpose of the text is the effectiveness/benefits of dragon fruit and guava fruit that can lower blood glucose levels in type 2 Diabetes Mellitus patients
Authors: Listrianah  , Muzakar  , Susyani  , Mulyaningsih Novellyna , Eliza  , Sriwiyanti
Published: August 2024

Introduction:

Diabetes mellitus (DM) is a serious chronic degenerative disease caused by insufficient insulin hormone, or the body’s ineffective use of the insulin produced, with clinical symptoms such as polyphagia, polydipsia, polyuria, weight loss, and weakness accompanied by blood sugar levels ≥ 200 mg/dL and fasting blood sugar ≥ 126 mg/dL.

Material and Method:

This was a quantitative study with a quasi-experimental design.

Results:

Most of the respondents were female (70%) either in the treatment group or (60%) in the comparison group and had an average age between 45 and 59 years (50%). The average decrease in blood sugar level was 69.40 mg/dL. Red guava (NAMBUIRA) showed an effect on the blood sugar levels in type 2 DM patients at Talang Ratu Palembang Public Health Center (P = 0.000).

Conclusion:

NAMBUIRA pudding contains antioxidants and is rich in fiber and had an effect on reducing blood sugar levels in patients with type 2 DM at Talang Ratu Public Health Center of Palembang.
The Risk of COVID-19 in Patients of Chronic Kidney Disease with Cognitive Dysfunction Like Alzheimer Disease
Authors: Ganesan Vinothkumar , Nehru Mohanraj , Shankar Geethamalini , Prabhu Venkataraman
Published: August 2024

Background:

The universal risk to mankind, coronavirus disease 2019 (COVID-19), shares etiological cofactors with a variety of diseases, including anemic chronic kidney disease patients (CKD) with cognitive dysfunction like Alzheimer disease (AD). Understanding the shared links between COVID-19 and CKD, as well as cognitive impairment such as AD, might aid in designing therapeutic ways to combat both. Given the need of developing COVID-19 medicine, the connection and symptoms of CKD with cognitive impairment have been reviewed here, with a focus on memory and learning disturbance.

Objective:

COVID-19 and CKD with cognitive dysfunction share angiotensin-converting enzyme 2 receptors, and AD indicators include amyloid, tau protein, and glycogen synthase kinase-3β. Anemia in patients with CKD and pulmonary fibrosis is frequently treated with recombinant human erythropoietin (rHuEPO). Through nitric oxide stimulation, neuroprotection, and various organ hypoxias, rHuEPO promotes red blood cells (RBC) growth while also assisting oxygen delivery.

Results and Conclusions:

In COVID-19, rHuEPO may be advantageous. The common etiological variables and manifestations outlined in this review could aid in the development of therapeutic options for COVID-19 and CKD with cognitive impairment, such as AD, and so help to eliminate the ongoing universal risk.
Effect of Centella asiatica L. Extract on Apoptosis and Bcl-2 Immunoexpression of Pyramidal Cells in Traumatic Brain Injury Rat Model
Authors: Nafiisah  , Prihatno MM Rudi , Novrial Dody
Published: August 2024

Background:

Traumatic brain injury therapy still has many shortcomings. The slow repair of post-traumatic pyramidal cells causes the need to find new alternatives to deal with the consequences of traumatic brain injury. This study aims to determine the effect of Centella asiatica L. extract in increasing pyramidal cells repair, assessed from the apoptosis and B-cell lymphoma 2 (Bcl-2) immunoexpression of pyramidal cells in traumatic brain injury rat model.

Methods:

This research was conducted during July 3–17, 2020 and used a true experimental research design with a posttest-only controlled group design. Rats were divided into five groups, that is, normal group, group treated with traumatic brain injury, and groups treated with traumatic brain injuries and given extracts of C. asiatica (L.) dose of 150, 300, and 600 mg/kg bw/day. Brains from each group were taken to examine the apoptosis and Bcl-2 immunoexpression of pyramidal cells at day 7. This study used Kruskal–Wallis test and post hoc Mann–Whitney test.

Results:

Based on the statistical analysis results, there was a significant correlation between the Bcl-2 immunoexpression and apoptosis of pyramidal cells in traumatic brain injury rat model with different doses of C. asiatica (L.) extract (P < 0.05). Dose of 600 mg/kgBW was the most effective in decreasing apoptosis and increasing Bcl-2 immunoexpression of pyramidal cells in traumatic brain injury rat model.

Conclusion:

This study proved that C. asiatica (L.) extract can decrease apoptosis and increase Bcl-2 immunoexpression of pyramidal cells in traumatic brain injury rat model.
Association between Type of Diet, Extent of Sweet Consumption and Status of Physical Activity with Presence of Type II Diabetes Mellitus
Authors: Ilamathi K.R. , Aditi R. , Daya A. Praveena , Ramkumar M. , Umeshkumar P. M. , Bargavi R.
Published: August 2024

Background: India is termed as the diabetic capital of the world and modifiable risk factors such as unhealthy dietary behaviors and inadequate physical activity play an important role in the control of diabetes. Objectives: To describe the pattern of diet consumption among Type II diabetic patients who were treated in a Tertiary care Hospital in South India. To describe the nature and extent of sweet consumption and to assess the relationship between nature of diet and sweet consumption among them. Materials and methods: A hospital based cross-sectional analytical study done among 368 adult Type II diabetic patients treated in a tertiary care hospital in South India during May 2020 to Dec 2021. Participants were recruited through consecutive sampling and data were collected using a pretested semi-structured questionnaire. Chi-square test was done to find out association between categorical variables and P value <0.05 was considered to be statistically significant. Results: Out of 368 participants, 227 (61.7%) belong to 50 to 69 years followed by 83 (22.6%) in 30 to 49 years age group, 187 (50.8%) were females and 181 (49.2%) were males, 90 (24.5%) were vegetarians, and 278 (75.5%) were non-vegetarians. Sweet consumption in the past 1 month was observed more (54%) among non-vegetarians. Mean ± SD of FBS level among vegetarians versus non-vegetarians was 123 ± 25.6 and 135 ± 34.5. Mean ± SD of PPBS level among vegetarians versus non-vegetarians was 189.4 ± 48.3 versus 208.6 ± 57.4. Conclusion: Participants following vegetarian diet with less sweet consumption and with more involvement in physical activity were observed to have a better diabetic control.
Estimation of Demographic Parameters of COVID-19 Patients Admitted in a Tertiary Care Hospital, Jaipur
Authors: Babu Gudise Chitti , Chundawat Bhagwati , Pareek Rajeev , Kadali Ramana Murty , Thakur Ajit
Published: August 2024

Background:

COVID-19 is a pandemic disorder spreading rapidly worldwide. Most of the countries were affected by the COVID-19 during the year 2020. Demographic data are important to understand the impact of COVID-19 across the country and also provide information on an appropriate response, planning, and allocation of resources. This study aims to assess the demographic data of COVID-19 patients admitted and treated in a tertiary care hospital, Jaipur.

Materials and Methods:

This is a retrospective study conducted in a tertiary care hospital in Jaipur. A total of 1149 patients’ data like age, gender, area they belong to, duration of the treatment, etc., were collected from the medical records department (MRD) department between July 1, 2020 and September 30, 2020. The data were expressed as counts, number, and percentage (%). The data were analyzed using Excel software.

Results:

Out of 1149 patients, 70% were males and 30% were females, respectively, and mean ± SD (standard deviation) of age was 44.23 ± 3.57. Most of the cases were obtained from Jaipur 63%, Bikaner 5.4%, Ajmer 4.4%, Alwar 2.6%, Sawai Madhopur 2.6%, Dausa 2.3%, Nagaur 2.3%, Bharatpur 2.1%, and Karauli 1.7%, respectively, and remaining places reported <1.5% cases. Also 40 to 80 years age groups were most affected. About 32.4% mild, 55.7% moderate, and 11.8% severe cases were reported.

Conclusions:

More male patients were affected when compared with female patients. Age and other disease conditions have a positive correlation with COVID-19. Older people should take extra precautions and avoid going to markets, parties, etc., unless it is essential. Early identification and detection of COVID-19 helps in better treatment and preventing the conversion of mild cases into moderate or severe cases and prevents the transmission from one to another.
Vitamin D Status of Type 2 Diabetic Patients in Oujda North-East Morocco
Authors: Hsaini Asmae , Aboussaleh Youssef , Ahami Ahmed , Bikri Samir
Published: August 2024

Background:

Several researches have shown that vitamin D deficiency is significantly linked to common chronic diseases such as diabetes mellitus.

Aims:

This study aimed to assess the relationship between vitamin D insufficiency and type 2 diabetes risk factors in oriental Morocco patients with type 2 diabetes (T2DM).

Methods:

In the present cross-sectional study, 114 T2DM patients (diagnosed more than 6 months earlier) attending diabetes center in Oujda North-East Morocco between December 1, 2016 and May 30, 2018 were enrolled. Sociodemographic data (age, gender, education, etc.) and medical data (duration of illness, glucose level, type of treatment, etc.) were collected from patients using a structured questionnaire. In addition, anthropometric measurements and fasting blood samples from each patient were taken. Glucose, 25(OH) vitamin D, and creatinine were measured in obtained serum. Statistical analysis was carried out using SPSS software.

Results:

The mean age of study participants was 63.20 ± 9.37 with a male/female ratio of 2; the mean body mass index is about 22.65 ± 3. The mean concentration of 25(OH) D was 15.68 ±9.35 ng/mL. At the same time, there was a deficiency in vitamin D of 74.10% among patients with type 2 diabetes. The result shows that vitamin D level was significantly associate with sex, duration of diabetes, and body mass index (P<0.05).

Conclusion:

The present study highlighted the vitamin D deficiency is prevalent in T2DM Moroccan patients. However, vitamin D deficiency can lead to T2DM complications.
Modified Technology for a New Generation Stroke Rehabilitation Module by Transcutaneous Vagal Nerve Stimulation Therapy − A Critical Analysis
Authors: Chacko Leena , Delani Janseya , Prabhu Rajaram , Maheshwari Raman Uma , Fahad Alharbi Hanan , Rajamani Yoga , Bhupathyraaj Mullaicharam
Published: August 2024

An important goal of stroke rehabilitation is to improve the quality of life, enhancing functional independence, and active participation in daily routine activities. Stroke is a cerebral vascular event with rapidly developing clinical signs of global disturbances with no apparent cause other than a vascular origin. A stroke occurs when the blood vessels in the brain are blocked or burst, which prevents the blood and oxygen from reaching brain tissues. Symptoms of stroke in body parts are controlled by damaged areas of the brain and the main symptoms show involuntary muscle tightening, paralysis, and restricted physical abilities. Other complications depend upon the damage to part of the brain. Enhancing plasticity by triggering neuromodulators with paired motor training provides the basis for transcutaneous vagal nerve stimulation (TVNS) therapy. TVNS to activate the neuromodulatory networks of cortical neurons shall be achieved by the battery-powered device with electrodes and adhesive backing which can be positioned on the skin in specific areas. The device delivers electrical impulses which activate the vagal nerve and enhance the plasticity of cortical neurons. This article emphasizes vagal nerve stimulation paired with rehabilitation therapy, which combines a device that stimulates vagal function which promotes motor function, and rehabilitation training to facilitate a speedy recovery. This technology is precise and consistent in developing pro plasticity neuromodulators and improves the daily performance of the affected individual.
Perceived Wellness Measured by the National Wellness Institute’s Wellness Focus Survey Tool among Women in Al Ain, UAE
Authors: Al Awar Shamsa , Khair Howaida , Osman Nawal , Ucenic Teodora-Elena , Sallam Gehan , Maki Sara , Ganesh Aishwarya
Published: August 2024

Objectives:

While there is a plethora of women’s studies conducted on psychosocial variables such as mental health, quality of life, and burden of care, there is a dearth of studies on the dimension of “wellness,” particularly from the Arabian Gulf population. This study was designed to investigate perceptions of personal wellness among women residing in the United Arab Emirates (UAE) using six dimensions of wellness, namely; Spiritual, Emotional, Intellectual, Occupational, Physical, and Social. The related aim was to examine the relationship between perceived wellness and socio-demographic characteristics.

Methods:

This online cross-sectional study was carried out from August 2021 to October 2021 among women residing in the UAE. The outcome measure included the National Wellness Institute’s Wellness Focus Survey Tool, which was adapted to suit local dialect and social modesty. The newly adapted questionnaire was translated into Arabic. The study also included pertinent socio-demographic variables.

Results:

A total of 325 women living in Al Ain, UAE participated in the study. Out of the participants, 60.8% were Emiratis, aged between 31 and 40 years (37.3%) and married (57.8%). The participants were mainly employed (59.7%) and most of them lived in private (61.5%) accommodation. The analysis reveals the following ranking order of the six dimensions of wellness; Spiritual (mean = 4.30, SD = 0.84), followed by Social (mean = 4.05, SD = 0.85), Occupational (mean = 3.93, SD = 1.05), Emotional (mean = 3.76, SD = 0.91), Intellectual (mean = 3.73, SD = 1.01), and Physical (mean = 2.41, SD = 1.04). Among the women’s characteristics, age and marital status were found to be significantly associated with the Emotional Dimension. Moreover, nationality and accommodation were significantly associated with the Intellectual Dimension. Overall, using factor analysis of the instrument, we found that only one component was sufficient to adequately explain either the Occupational or Spiritual Dimensions, while two components were needed to explain each of the following; Intellectual, Emotional, Social, and Physical dimensions of wellness.

Conclusion:

Wellness is of great importance to UAE women, with significant associations with some socio-demographic characteristics. The Spiritual Dimension, in particular, was perceived to be of highest importance, closely followed by Social, Occupational, Emotional, Intellectual, and Physical dimensions. In particular, age and marital status had significant association with the Emotional Dimension, while nationality and accommodation were significantly associated with the Intellectual Dimension. These findings are of importance to future endeavors that are aimed towards the betterment of the quality of life of women in the UAE, by indicating which spheres of wellness are prioritized and which ones require further scrutiny.
Correlation between Selected Inflammatory Biomarkers in Geriatric Anemias − A Case–Control Study
Authors: Dubey Deepak , Raghavan Vijayashree
Published: August 2024

Introduction:

Anemia in the geriatric age group is a prevalent disorder, with a complex pathophysiology. In this study, we try to evaluate the correlation between selected inflammatory biomarkers [interleukin 6 (IL-6), C-reactive protein (CRP), and hepcidin (HA)] in geriatric anemia.

Materials and methods:

Case–control hospital-based study conducted in individual age 60 to 80 years at Chettinad Hospital and Research Institute. One hundred participants are included in this study, where 50 in case group with anemia and 50 in control group without anemia. A one-time blood sample is collected and was evaluated for complete blood count, serum ferritin, vitamin B12, HA, IL-6, and serum CRP.

Results:

There is a significant association between inflammatory markers IL-6, CRP, HA, and geriatric anemia, which shows statistical significance with P-value <0.001, values in group case are following 6.60 ± 4.42 pg/mL, 3.79 ± 4.25 mg/L, 3.97 ± 2.16 ng/mL, 8.87 ± 1.95, and in control 3.22 ± 2.33 pg/mL, 2.02 ± 3.28 mg/L, 2.77 ± 0.85 ng/mL, and 12.39 ± 1.26. Final diagnosis most common, unexplained anemia with 25 (50.0%), followed by anaemia of chronic disease (ACD) 11 (22.0%) ACD with iron deficiency anaemia (IDA) occur in 6 (12.0%), 5 (10.0%) cases of pure IDA, and 3 (6.0%) megaloblastic anemia.

Conclusion:

Significant correlation between inflammatory biomarkers in geriatric anemias. Inflammatory biomarkers (CRP, IL-6, HA) will not only help in categorizing geriatric anemia but also eventually leads to specific targeted treatment protocol.
Whom to Blame for Brain Health and Appetite Slump in Toddlers? A Narrative Review
Authors: Seshan Vidya , Valsaraj Blessy Prabha , Raghavan Divya , Arulappan Judie , Matua Gerald Amandu , Cyril Sofia , Prince Emi John
Published: August 2024

Food preference in children depends on the interplay between genetic and environmental factors. Exposure to flavors during prenatal and postnatal period through amniotic fluid, breast milk, and weaning foods have been identified as possible influences on food preference and acceptance in children. Therefore, maternal nutrition has a strong influence on the child’s food preference early in life.

Aim:

The authors carried out a narrative review to understand the contribution of maternal nutrition on the food preferences in children in later life.

Methods:

The authors retrieved the articles from SCOPUS, Medline, Science Direct, CINAHL, EBSCO, and PubMed central databases. The key words including food preferences, food choice, and acceptance of food, pregnant women, toddlers, and food culture were used to identify the appropriate articles. The authors included in the review, full-text articles, published in English language between 1995 and 2018. In total, six articles, which met the inclusion criteria, were included in the final review.

Results:

The results revealed that there is a very strong connection between the exposure to flavors during prenatal and postnatal period and food preference and acceptance in children in later life. The olfactory and gustatory exposures to flavors during prenatal period through maternal diet, and during postnatal period through breast milk and weaning foods determines the food preferences in childhood.

Conclusion:

We conclude that maternal nutrition has a strong influence on the child’s food preference early in the life, therefore effective strategies should be designed to increase healthy feeding choices during the prenatal and postnatal periods.
Comparative and Correlative Study of Hematologic Parameters and Selective Inflammatory Biomarkers in Psoriasis
Authors: Arunadevi D. , Raghavan Vijayashree , Nott Anand
Published: August 2024

Introduction:

Studies show that hematologic parameters can be used as biomarkers in systemic inflammatory skin diseases.

Materials and methodology:

A case–control study was performed between April 2018 and April 2019 on 55 newly diagnosed (age: 20–60 years), untreated, biopsy proven psoriasis patients and 55 healthy nonpsoriatic individuals with no family history of psoriasis as controls. Sociodemographic details and clinical features from the 55 patients with psoriasis were collected using a questionnaire. Severity of psoriasis was assessed by psoriasis area and severity index (PASI) score. Blood samples of 110 study subjects were analyzed for the following parameters: red blood cell indices, hemoglobin, platelet count and mean platelet volume (MPV), white blood cell count, differential count, and neutrophil to lymphocyte ratio (NLR). Along with this, fibrinogen, D-dimer, and erythrocyte sedimentation rate (ESR) were also analyzed for all the samples. Highly sensitive C-reactive protein (hs-CRP) was analyzed. Student t test for independent samples was used to compare the data obtained from the patients and the controls. Patients were divided into two groups: one group having PASI < 10 and the other group PASI > 10.

Results:

Student t test performed on psoriasis patients showed that the two groups were significantly different (P < 0.05) in the levels of red blood cell count, mean corpuscular volume, neutrophils, lymphocytes, NLR, red-cell distribution width (RDW), MPV, ESR, fibrinogen, and D-dimer. Out of 55 cases, hs-CRP is reactive for 11 patients from PASI < 10 (n = 36) compared to 19 patients from PASI > 10 (n = 19; P = 0.010) and had a positive correlation with MPV, ESR. RDW, NLR and ESR, ESR can be used to assess the disease severity of psoriasis and assess the response to treatment. Along with clinical PASI score, these simple, less expensive biomarkers can be effectively employed in place of other biomarkers such as hs-CRP for management of the disease.
Effectiveness of Nurse-Led Educational Intervention on Knowledge Regarding Management of Chronic Kidney Disease among Patients
Authors: Shobha Kadabahalli Rajanna , Sams Larissa Martha , Arulappan Judie , Alharbi Hanan Fahad
Published: August 2024

Background: Chronic kidney disease (CKD) is defined as kidney damage or glomerular filtration rate (GFR) <60 mL/min/1.73 m2 for 3 months or more, irrespective of the cause. CKD can progress to end-stage renal disease (ESRD), which requires renal replacement therapy (RRT) and is associated with morbidity and mortality at all stages. Nurse-led educational interventions play an essential role in improving the awareness of patients, thereby enhancing their quality of life. Purpose: The study assessed the effectiveness of nurse-led educational intervention (NLEI) on knowledge of patients with CKD. Methods: The patients’ level of knowledge was assessed using an 18-item Chronic Kidney Disease Patient Awareness Questionnaire. An NLEI was administered to 50 patients with CKD. The data were analyzed using Statistical Package for the Social Sciences (SPSS) version 21. Discussion: The pretest mean knowledge score was 40.42 and SD was ±4.09. The posttest mean knowledge score was 62.52 and SD was ±4.29. The paired t-test showed t = 26.35, df = 49. Significant association was found between the knowledge of patients and their dietary habits @ P ≤ 0.05. Conclusions: NLEI was effective in enhancing the knowledge of CKD patients. This implies that when appropriately implemented, the CKD patients will reap the benefits of NLEI, which has the potential to improve their health status.
Statistical Models for Estimating Linear Growth Velocity
Authors: Chilyabanyama Obvious N. , Chilengi Roma , Ngaruye Innocent , Iqbal Najeeha Talat , Bosomprah Samuel
Published: August 2024

Poor linear growth among infants is still a global public health issue. Linear growth velocity has been variously suggested as a more robust measure for growth over the classical measure of attained height for age. In this study, we systematically reviewed available literature for models used in estimating linear growth velocity. We searched Medline, Embase, Cochrane methodology register, Joanna Briggs Institute EBP, through the Ovid interface, and PubMed database to identify relevant articles that used statistical models to estimate linear growth velocity among infants. Longitudinal studies published in English were included. Two reviewers independently screened the titles and abstracts to identify potentially eligible studies. Any disagreements were discussed and resolved. Full-text articles were downloaded for all the studies that met the eligibility criteria. We synthesized literature using the preferred reporting items for systematic review and meta-analyses guidelines for the most used statistical methods for modelling infant growth trajectories. A total of 301 articles were retrieved from the initial search. Fifty-six full-text articles were assessed for eligibility and 16 of which were included in the final review with a total of 303,940 infants, median sample size of 732 (interquartile range: 241–1683). Polynomial function models were the most used growth model. Three (18.8%) of the articles modelled the linear growth. Two (12.5%) articles used mixed-effects models and another two (12.5%) used the Jenss-Bayley growth models to model linear growth. Other models included residual growth model, two-stage multilevel linear spline model, joint multilevel linear spline model, and generalized least squares with random effects. We have identified linear mixed-effects models, polynomial growth models, and the Jenss-Bayley model as the used models for characterizing linear growth among infants. Linear mixed-effects model is appealing for its robustness even under violation of largely robust even to quite severe violations of model assumptions.
Dietary fiber intake and physical activity incidence among Saudi University female students
Authors: Alarifi Sehad N.
Published: August 2024

Aim: In this study, we assessed the adequacy of dietary fiber intake among female undergraduate students in Saudi Arabia. Settings and Design: This cross-sectional study was based on a self-reported questionnaire answered by 161 female volunteer undergraduates at Shaqra University (Female Community Colleges, Al-Quwayiyah city). Their fiber intake and physical activity levels were assessed against their body mass index (BMI) and academic levels. Methods and Material: Fiber intake was measured using a short food frequency questionnaire. Physical activity was measured using the short form of the International Physical Activity Questionnaire. According to the standard scoring, level of physical activity was classified into three categories: low, moderate, and high. Statistical Analysis Used: Descriptive statistics were used to characterize variables made focused in this study. Some data were categorical in nature, and frequency counts (f) and percentage (%) highlighted the eventual results including the utilization of the crosstabulation technique which utilized also mean and standard deviation for scale measurements. Accordingly, Kruskal-Wallis H Test was utilized in the treatment of categorical variables while variance analysis was utilized for those with scale measures. Results: It is well documented that fiber is beneficial for health and can prevent various diseases. Therefore, the results show that most participants attended the Humanities College (72.0%), followed by the Community College and Applied Medical Sciences College, with 19.3% and 8.7%, respectively. A proportion of 41.6% of the students were in their second year of college. We showed that most participants engaged in high activity levels. The BMI of 46.0% of the individuals was within normal levels. A proportion of 75.8% of females had a fiber intake of less than 18 g/day, which is considered a low level. Low fiber consumption had positive associations with college affiliation, academic levels, and BMI. Conclusion: Although fiber consumption was poor among the participants, most of them were highly active. This study indicates a need to raise awareness among university students of the adequate levels of fiber intake and the associated health benefits.
Evaluate Cerebral Performance Score in Survival Outcome of Patients with In-Hospital Cardiac Arrest
Authors: Devi A. Akila , Sundaresan S. , Kanniammal C. , Ramakrishnan T.V.
Published: August 2024

Introduction:

Cardiac arrest remains one of the primary causes of death in the United States, affecting about 350,000 patients every year. Many previous studies have recommended that nearly two-thirds of the patients with out-of-hospital cardiac arrest and a quarter of the patients with in-hospital cardiac arrest (IHCA) died out of neurologic damage.

Objectives:

(1) To evaluate the cerebral performance score in the survival outcome among patients with IHCA. (2) To associate the cerebral performance score in survival outcome among patients with IHCA with their demographic variables.

Materials and methods:

Nonexperimental descriptive research design was used. Study was conducted in all the intensive care units of General Hospital and Research Center, Chennai, India. A total of 125 samples were selected with nonprobability purposive sampling technique.

Results:

The number of patients with poor neurologic outcome was 93 (74.4%) and number of patients with good neurologic outcome was 32 (25.6%). In multiple regression analysis, “total cholesterol level” at the P-value of 0.05, there is high significant association between clinical variable and the level of cerebral performance score among patients with IHCA. It means that the total cholesterol level is highly influencing the cerebral performance scores.

Conclusion:

Assessment of neurologic status is a major determinant of functional outcome of postcardiac arrest patient. However, measures of neurologic status do not directly replicate overall outcome after cardiac arrest. Inclusion of neurologic outcome measures the neuroprognostication of patient.
Effect of Probiotic Supplementation on Glycemic Control Among GDM − Study Protocol for a Randomized Clinical Trial
Authors: Ramanathan Kavitha , Jagadeesh Nalini Sirala , Vishwanath Usha , Dayal Celina
Published: August 2024

Background:

Diabetes is the ninth leading cause of death among women globally causing 2.1 million deaths per year. Pregnancy complicated with gestational diabetes mellitus (GDM) causes physiological resistance to insulin that predisposes to maternal (pregnancy-induced hypertension, macrosomia, and obstructed labor due to shoulder dystocia) and fetal (macrosomia, birth injuries, hypoglycemia, respiratory distress) complications associated with the GDM. Given the complications associated with GDM in South India, the study hypothesized that a novel idea of probiotics supplementation as adjunct therapy with comprehensive intervention would show considerable improvement in maternal glycemic control among GDM.

Methods/Design:

It is a single-center, double-blind randomized controlled trial. Study population: Expectant women with GDM in their second trimester were randomized to control and intervention group.

Intervention:

The package included supplementation with probiotics (probiotic capsules with routine care), while the control group: received a placebo capsule (placebo capsule with routine care) to GDM women. The study participants were followed up till delivery. Outcome measures: Maternal blood glucose levels as fasting and postprandial blood glucose levels are measured at the 20th, 32nd, and 40th weeks of gestational age. Secondary outcome measures: Maternal parameters are monitored at their regular follow-up visits, and neonatal parameters are measured after delivery. Statistical analysis: Descriptive and inferential analyses were performed that satisfied the per protocol compliance using the recent version of Statistical Package for the Social Sciences.

Conclusion:

Probiotic supplementation is one of the emerging trends that shows a significant impact on maternal blood glucose levels, which will in turn have beneficial effects on maternal and neonatal morbidity and mortality. In a developing country like India, with the growing burden of diabetes and GDM, developing an innovative effective intervention that promotes glycemic health that can easily be replicated across various settings will become a priority. If the intervention is concluded to be effective, this study would become a guideline model to reinforce probiotics as an intervention to treat GDM and contribute to improved maternal and neonatal health in South India.
Rapid and slow, twist and turn wing beating: Think of Wilson’s disease
Authors: Mahajan Ojas , Giri Anamika , Saldhana Chrisann , Kumar Sunil
Published: August 2024

An uncommon autosomal disease, Wilson’s disease wherein excess copper gets accumulated in numerous human tissues, especially the brain, liver, and cornea of the eyes. Wilson’s disease, usually believed to affect adolescents and young adults around the age of 40. There are multiple diverse clinical manifestations of Wilson’s disease, but hepatic involvement and neuropsychiatric symptoms are the most prominent. The disease is degenerative, and if ignored, it can lead to liver impairment, complications with the central nervous system, and even death. Life-threatening complications and major long-term impairment may be minimized with early diagnosis and treatment.
Serum uric acid as a biomarker in predicting outcome in patients of acute ischemic stroke: A cross-sectional study at limited resources rural setup
Authors: Khanna Shivam , Kumar Sunil , Acharya Sourya , Shukla Samarth , Hulkoti Vidyashree , Patel Mansi , Gupte Yash , Verma Prerna
Published: August 2024

Background: The role of serum uric acid is controversial when considering it as a risk factor for acute ischemic stroke as it has antioxidant as well as free radical producing properties. This study was conducted to establish a correlation between acute ischemic stroke and serum uric acid levels. We also tried to find the relation between severity and mortality in stroke patients with their serum uric acid levels. Methods: In this cross-sectional study, 80 patients of acute ischemic stroke during the period of September 2019 to September 2021 were enrolled. The National Institutes of Health Stroke Scale (NIHSS) and Glasgow coma scale (GCS) scores were calculated at the time of admission and modified Rankin Scale (mRS) scores at a 3-month follow-up period. A correlation of serum uric acid levels with these scores was assessed. Results: Mean serum uric acid level was 5.9 ± 1.5 mg/dL in cases and statistically significant cut-off value of serum uric acid level as 7.35 mg/dL was obtained for labeling patients of acute ischemic stroke as severe according to the NIHSS scale. A cut-off of 5.95 mg/dL was obtained for serum uric acid as an indicator of mortality, according to the mRS scale. Patients with higher NIHSS, mRS scale scores, and poor GCS scores (score 3 to 8) had significantly elevated serum uric acid levels. Conclusion: Serum uric acid can be a noninvasive and cost-effective tool for assessing acute ischemic stroke severity and predict mortality.
Spectrum of renal diseases in the elderly, above age 50
Authors: Sengar Pratishtha , Gupta Pallav
Published: August 2024

Background:

The spectrum of kidney diseases varies in the elderly population with frequent inconsistencies between clinical presentation and histopathological diagnosis. The immunofluorescence (IF) may provide additional information in such situations.

Aims:

The purpose was to study the spectrum of kidney diseases in patients above 50 years undergoing renal biopsy and utility of light chain (LC) IF in the diagnosis.

Settings and Design:

This was a retrospective, crosssectional, singlecenter-based study.

Material and Methods:

The clinical details, histopathological findings, and LC IF pattern in native renal biopsy of patients above 50 years were noted.

Statistical Analysis:

Continuous variables were presented as mean ± standard deviation (SD). Categorical variables were expressed as frequencies and percentages.

Results:

A total of 205 patients were included in the study. The most common clinical presentation was acute kidney injury/rapidly progressive glomerulonephritis (AKI/RPGN) (49%). Glomerular diseases (72%) were more common. Crescentic glomerulonephritis (21%) and membranous nephropathy (MN) (19%) were the most common glomerulopathy. LC restriction was observed in LC cast nephropathy (LCCN), primary amyloidosis, and LC also helped in classifying the cases of MPGN-type morphology.

Conclusions:

AKI/RPGN was the most common indication for renal biopsy in patients above 50 years. Crescentic GN and MN were the frequent glomerular pathology. LC IF is a useful adjunctive tool to classify various renal diseases.
Tumor budding is a valuable prognostic parameter in endometrial carcinomas
Authors: Ocal Irfan , Guzelis Ismail
Published: August 2024

Background:

Tumor budding (TB) is a morphological finding believed to play an important role in determining the prognosis in many cancers.

Aim:

Our aim is to evaluate the prognostic importance of TB in endometrial carcinomas.

Settings and Design:

Two-hundred-eleven endometrial cancers were obtained from 2008 to 2015 that were comprised of those having undergone surgical staging with a hysterectomy and at least 5 years followed up.

Material and Methods:

All hematoxylin and eosin stained slides were reevaluated for the status of TB.

Statistical Analysis:

Nonparametric tests, the Kaplan–Meier method, the Log-rank test, and Cox proportional hazard regression were used.

Results and Conclusion:

TB was found to correlated with larger diameter (P = 0.000), nonendometrioid (P = 0.038), mixed cell types (P = 0.005), higher grade (P = 0.000), deeper invasion of the myometrium (P = 0.000), cervical stromal invasion (P = 0.000), advanced pT (P = 0.011), lymph node involvement (P = 0.000), lymphovascular invasion (P = 0.000), and advanced stage (P = 0.000). The presence of TB worsens the 5-year overall survival (OS) (P = 0.0001). In cases such as grade 1, pT1, or stage 1 endometrial carcinomas, the presence of TB decreases the OS rate (P = 0.00017, P = 0.0016, P < 0.0001). Our result suggested that the presence of TB adversely affects the prognosis. It was concluded that TB could be a valuable prognostic parameter.
Lésion d'Antopol-Goldman (Antopol-Goldman lesion)
Authors: Swati Sharma , Arun Chawla , Anupam Choudhary , K Udupa Chethana Babu , Kanthilata Pai , Vishwapriya M Godkhindi
Published: August 2024

Lésion d'Antopol-Goldman (Antopol-Goldman lesion) is a rare condition characterized by renal pelvic subepithelial hematoma simulating a neoplastic process. A 71-year-old lady presented with macroscopic hematuria and hypoenhancing mass lesion at the upper pole of left kidney. The patient underwent a radical nephrectomy for suspected renal cell carcinoma. Macroscopically a 3.5cm circumscribed hemorrhagic mass lesion was noted flush with the upper pole pelvicalyceal system. Microscopic examination revealed a pelvic subepithelial (suburothelial) organizing hematoma. Extensive sampling did not reveal any neoplastic etiology. The adjacent renal parenchyma and renal vessels were unremarkable. Antopol-Goldman lesion is a diagnostic quagmire, often culminating in unnecessary nephrectomy. This is a rare entity, and clinical awareness as a differential of renal filling defect can preclude a nephrectomy, we hereby discuss its clinico-pathological and treatment implications.
Erythrophagocytosis in a patient with B-cell acute lymphoblastic leukemia with t(12;21) (p13.2; q22.1); ETV6-RUNX1
Authors: Sharma Sunita , Gaur Kavita , Srivastav Srijan , Mandal Piali
Published: August 2024

Erythrophagocytosis (EP) is extremely rare in de novo acute lymphoblastic leukemia (ALL). We document a rare case, which in addition, showed extensive blast vacuolization. A detailed literature review has also been incorporated with the aim of unraveling the prognostic import of our morphological observations if any. A five-year-old male presented with fever and progressive pallor for 1 month. He had hepatosplenomegaly and bicytopenia. Peripheral smear examination showed 43% blasts. Nuclear and cytoplasmic vacuolations were seen in 75% blasts and EP in 4% blasts. The blasts showed block positivity on periodic acid-Schiff (PAS) stain. Marrow aspirate smears showed 58% blasts displaying a similar morphology. Flow cytometry showed features of a common acute lymphoblastic leukemia antigen (CALLA) positive B-cell ALL with aberrant, dim CD 33 expression in 53.4% of the gated blasts. Fluorescence in situhybridization showed translocation (12; 21) (p13;q22). The patient responded well to standard induction therapy. To conclude, EP is rarely seen in de novo ALL and is associated with a favorable translocation, t(12;21).
Myocardial bridging – Sudden unexpected death of a young girl
Authors: Aden Durre , Phulware Ravi Hari , Mittal Sachin , Ahuja Arvind
Published: August 2024

Myocardial bridging (MB) is a relatively uncommon congenital anomaly where a segment of the coronary artery dips inside the myocardium and takes a tunneled course under a bridge of the myocardium. This leads to the compression of the coronary artery during systole resulting in hemodynamic changes and their clinical manifestations. However, it is an incidental finding but can present with multiple complications like myocardial ischemia, infarction, and sudden death, primarily when associated with other risk factors like left ventricular hypertrophy of the heart. Therefore, a careful examination of the heart is essential for evaluating the clinical significance of the MB. Here, we presented a case of a 30-year-old young female who had a sudden death, and her histological examination of the heart showed MB of left anterior descending coronary artery (LAD).
Glomus tumor of the crissum
Authors: Zheng Yuanyin , Liu Xiaobin , Mao Yingyu , Lin Maohua
Published: August 2024

Glomus tumor is a rare mesenchymal neoplasm arising from the modified smooth muscle cells of the glomus body. Primary crissum glomus tumor is extremely rare without any published in the literature. In this article, we report the first case of primary crissum glomus tumor in an 80-year-old man with recurrent anal pain for 8 years, increased pain for 1 year. Rectal MRI for inflammatory lesions (sinus tract). Microscopic examination showed the tumor cells were arranged in sheets and nests, surrounding blood vessels and nerve bundles. At high magnification, the neoplastic cells show regular round shape with light eosinophilic and translucent cytoplasm. The cell boundary is clear, the nucleus is round and located in the center. The stroma of the tumor shows hyaline degeneration. Immunohistochemically, the tumor cells were positive for smooth muscle actin, h-caldesmon, Calponin, synaptophysin, Collagen IV and CD34, but completely negative for HMB45, S100, EMA, desmin, CgA and CD56. The histologic features and immunohistochemical profile supported a diagnosis of primary crissum glomus tumor. The patient was asymptomatic and disease free after the procedure.
Immunohistochemical expression of cyclooxygenase-2 in oral lichen planus and normal oral mucosa
Authors: Baby Tibin K. , Bindhu P. R. , Pillai Rekha Krishna , Jayanthi P.
Published: August 2024

Background:

Oral lichen planus (OLP) is a chronic inflammatory disease for which the pathogenesis is complex and not fully understood; autoimmunity has been suggested as a causative factor. World health organization (WHO) has classified OLP as a potentially malignant lesion. Cyclooxygenase-2 (COX-2) is an inducible key enzyme that generates prostanoids which play a critical role in inflammation, immunopathology; also considered as a malignant potential marker.

Aims:

The present study was conducted to analyze and compare epithelial COX-2 expression in OLP clinical subtypes and normal oral mucosa to evaluate its role in the pathophysiology of the disease process.

Methods:

This retrospective immunohistochemistry (IHC) study was performed on tissue sections of 30 OLP and 10 normal oral mucosae for COX-2 expression.

Statistical Analysis Used:

Descriptive and comparative statistical methods were done using 'one-way Analysis of Variance (ANOVA), 't' and Chi-square tests.

Results:

All the OLP showed epithelial COX-2 expression; strong expression was noted in 80% of the OLP while normal oral mucosa sections showed no expression. Cox-2 expression was significantly higher in erosive lichen planus compared to reticular lichen planus.

Conclusions:

Strong expression of COX-2 in OLP suggested its important role in pathogenesis. Although COX-2 has been connected to malignant development and autoimmunity, as the malignant development in OLP is quite rare, this study suggests that increased levels of COX-2 seen here may support an autoimmune cause of the disease process.
Comparison of primary follicular lymphoma of gastrointestinal tract and secondary involvement
Authors: Masih Dipti , Chandramohan Jagan , Sigamani Elanthenral , Fouzia N.A. , Korula Anu , Simon Ebby , Joseph A.J. , Pulimood Anna , Manipadam Marie Therese
Published: August 2024

Primary follicular lymphoma of the gut (PFL-GI) is a rare entity. This study aims to compare the clinicopathologic features of PFL-GI with cases of gastrointestinal involvement by disseminated nodal follicular lymphoma. This is a retrospective study with 6 cases of primary follicular lymphoma and 8 cases of secondary involvement of the gut, over a period of 9 years. The slides and blocks were retrieved and reviewed. Clinical data was obtained from hospital records. Clinicopathologic features were compared. PFL-GI cases had a slightly higher median age group (p value 0.23) and no gender predilection when compared to cases with secondary involvement which showed a female preponderance. Para-aortic lymphadenopathy was seen in all secondary cases whereas none of the primary cases showed significant lymphadenopathy. The only microscopic feature that was different was the presence of hollowed out pattern of immunostaining for follicular dendritic cells seen in all cases of PFL-GI but in none of the secondary cases
Evaluation of the histopathologic status of rectal adenocarcinoma and its regional lymph nodes after neoadjuvant therapy, and its relation to the duration of disease-free survival
Authors: Karimi Farnaz , Tabriz Hedieh Moradi , Amoli Hadi Ahmadi , Nazar Elham , Vaezi Amir Abbas
Published: August 2024

Introduction:

Colorectal cancer is one of the most common malignant tumors and has a relatively poor prognosis. Lymph node involvement is considered the most important prognostic factor.

Materials and Methods:

During a retrospective cohort study, 132 patients with locally advanced rectal cancer who underwent neoadjuvant chemoradiotherapy followed by surgery for resectable rectal cancer from 2010 to 2015 in Sina hospital were reviewed.

Results:

Multivariable analysis was performed and shown the clinical stage was not a representative factor for disease-free survival (P = 0.187), but Dworak Tumor Regression Grading were significantly associated with higher disease-free survival (P = 0.000) in stage II and stage III. The total number of retrieved lymph nodes and involved lymph nodes in the same clinical stage were statistically associated with higher mean disease-free survival in patients (P = 0.000 in both conditions).

Conclusion:

In the same clinical stage, increasing the Dworak Tumor Regression Grading reduced the risk of rectal cancer recurrence. Increasing total number of retrieved lymph nodes and involved lymph nodes, 2.14 times and 3.87 times increased the risk of recurrence, respectively.