bluuebunny/crossref_metadata_2025 huggingface dataset:
Vibration Fatigue Testing Procedure of High Strength MARS 600 Steel Fillet Welds Using Stainless Steel Consumable Electrode
Authors: Men Ilya , Naroditsky Dmitry
Published: May 2023

Implementation of high strength steels in welded structural designs in the automotive, defence and construction industries is constantly increasing. Prolonged usage of such structures requires deep understanding of welded joint fatigue as well as a reliable and feasible life estimation methods development. Conventional fatigue testing methods often require costly, expensive in maintenance, high loading capacity equipment. They are also commonly restricted to specific specimen geometry and are time consuming due to the limit of a single specimen per test setup. This work presents high cycle fatigue (HCF) testing of high strength MARS 600 welded steel using a quick, simple and efficient resonance fatigue testing (RFT) method. The specimen is a simple cantilever fillet welded to a base plate using austenitic stainless steel 307L consumable electrode. Electrodynamic shaker is used for harmonic base excitation at a constant operating frequency. Several specimens welded to the common base are tested simultaneously, allowing completion of a high number of cycles and statistics in a relatively short time period. A hybrid, practical research approach combining experimental, finite element analysis (FEA), numerical and analytical calculations is presented. Fracture mechanics approach for fatigue life assessment is implemented. Crack growth calculation is based on the Paris - Erdogan law. Reduction in structural integrity due to crack propagation causes a reduction in natural frequency and transmissibility. The change in gain is evaluated via the open crack FEA model and integrated into the crack propagation algorithm. Resonance search, track and dwell module (RSTD) for maintaining constant gain throughout the test is not required. Fatigue life Wohler (SN) curve is constructed. Standard weld fatigue data is often provided for direct loading (tensile stress) and for different stress ratio (R) values. Corrections for mean stress and loading application are required. Current fully reversed (R = -1), indirect loading (bending stress) test results may be readily applied for random vibration fatigue analyses post processing. As expected, actual fatigue life results are higher compared to standard design curves, implying correctness of the manufacturing welding process of examined specimens. The presented procedure is of interest for research as well as for industrial welding processes testing, optimization and qualification.
Green Synthesis and Characterizations of Chromium Oxide Nanoparticles (Cr2O3 NPs) Derived from Pomegranate Husk and its α-Amylase Inhibitory and Antioxidant Properties
Authors: Cheah Shi Yan , Tey Lai Hock , Aminuzzaman Mohammod , Phang You Kang , Chan Yu Bin , Djearamane Sinouvassane , Wong Ling Shing , Watanabe Akira
Published: May 2023

A disease of imbalanced control of blood glucose levels due to impairment of insulin secretion or acceptance is known as diabetes mellitus. It could be induced by the high intake of sugar in diets, or by genetic background, or both. The antioxidant, which plays a role in neutralising free radicals, is crucial as the free radical could increase the chances of getting diabetes through several pathways. Injection of insulin and anti-diabetic drugs are common approaches to treating diabetes, but unfortunately, many side effects have been reported. Green synthesis of metal oxide nanoparticle, which is one of the applications of nanotechnology, could be a promising method in combating diabetes as it is biocompatible, less toxic, and has large surface to volume ratio. In this study, green synthesis and characterization of Cr2O3 NPs were carried out. The Cr2O3 NPs were shown to be spherical in shape, with an average size that falls within 100 nm. The EDX spectrum indicated that only chromium (Cr) and oxygen (O) were present in the sample. Other characterization techniques such as FTIR and UV-VIS spectroscopy were conducted. For ABTS and DPPH assays, Cr2O3 NPs exhibited highest free radical scavenging properties at 74.57% and 84.12% at 30 minutes and 60 minutes at the concentrations of 5 mg/mL and 1 mg/mL, respectively. Lastly, Cr2O3 NPs showed 95.28 % at the concentration of 0.25 mg/mL in α-amylase inhibition assay.
Studies on Dielectric, Super-Capacitive and Photoluminescence Properties of Metal Organic Frameworks Subjected to Varying Temperature and Frequencies
Authors: Kanaginahal Gangadhar M. , Mahale Rayappa Shrinivas , Shamanth Vasantha Kumar , Sharath P.C. , Shashanka Rajendrachari
Published: May 2023

Metal organic frameworks when subjected to varying temperatures and frequencies. The analysis indicate the presence of guest molecules enhance the dielectric constant. The dielectric constant increase to a limit with the rise in temperature but it reduces gradually. The increase in frequencies enhance the peaks of permittivity towards higher temperatures. Shortening of ion diffusion also enhances the capacitance and a better contact between the electrode and active substance increases the electrochemical performance. Luminescence, the color depends on particle size, the structure and intermolecular packing of atoms in material. This paper gives an overview of MOFs studied based on their dielectric, super-capacitive and photo-luminescence when subjected to varying temperatures and frequencies.
Laboratory Studies on the Influence of Ionic Strength on Particle Transport Behavior in a Saturated Porous Medium
Authors: Bennacer Lyacine , Nassim Kernou , Djilali Benmammar
Published: May 2023

An experimental study has been undertaken to investigate the effect of flow velocity and ionic strength on the transport of suspended particles (SP) and their deposition in a saturated porous medium. The SP injections were carried out using a laboratory column filled with sand and a pulse injection method. Ionic strengths varying between 0 and 600 mM (NaCl) have prospected. Two velocities were tested: 0.15 and 0.30 cm/s. Selected polydisperse particles diameters ranging from 0.27 to 5 μm and a median diameter (dp50) equal to 2.25 μm were used. An analytical solution of the convection–dispersion equation with first-order deposition kinetics was used to describe the experimental breakthrough curves and to identify the transport parameters. The results show that the increase of ionic strength promotes the retention of the SP in the porous medium. In addition, retention is more important when the flow velocity is low. The deposition kinetics coefficient increases with increasing ionic strength and flow velocity.
Impact of Anti-Tuberculosis Drug Use on Treatment Outcomes in Patients with Pulmonary Fluoroquinolone-Resistant Multidrug-Resistant Tuberculosis: A Nationwide Retrospective Cohort Study with Propensity Score Matching
Authors: Choi Hongjo , Jeong Dawoon , Kang Young Ae , Jeon Doosoo , Kang Hee-Yeon , Kim Hee Jin , Kim Hee-Sun , Mok Jeongha
Published: May 2023

Background: Effective treatment of fluoroquinolone-resistant multidrug-resistant tuberculosis (FQr-MDR-TB) is difficult because of the limited number of available core anti-TB drugs and high rates of resistance to anti-TB drugs other than FQs. However, few studies have examined anti-TB drugs that are effective in treating patients with FQr-MDR-TB in a real-world setting.Methods: The impact of anti-TB drug use on treatment outcomes in patients with pulmonary FQr-MDR-TB was retrospectively evaluated using a nationwide integrated TB database (Korean Tuberculosis and Post-Tuberculosis). Data from 2011 to 2017 were included.Results: The study population consisted of 1,082 patients with FQr-MDR-TB. The overall treatment outcomes were as follows: treatment success (69.7%), death (13.7%), lost to follow-up or not evaluated (12.8%), and treatment failure (3.9%). On a propensity-score-matched multivariate logistic regression analysis, the use of bedaquiline (BDQ), linezolid (LZD), levofloxacin (LFX), cycloserine (CS), ethambutol (EMB), pyrazinamide, kanamycin (KM), prothionamide (PTO), and para-aminosalicylic acid against susceptible strains increased the treatment success rate (vs. unfavorable outcomes). The use of LFX, CS, EMB, and PTO against susceptible strains decreased the mortality (vs. treatment success).Conclusion: A therapeutic regimen guided by drug-susceptibility testing can improve the treatment of patients with pulmonary FQr-MDR-TB. In addition to core anti-TB drugs, such as BDQ and LZD, treatment of susceptible strains with later-generation FQs and KM may be beneficial for FQr-MDR-TB patients with limited treatment options.
Targeted TLR9 Agonist Elicits Effective Antitumor Immunity against Spontaneously Arising Breast Tumors
Authors: Miller Caitlyn L , Sagiv-Barfi Idit , Neuhöfer Patrick , Czerwinski Debra K , Bertozzi Carolyn R , Cochran Jennifer R , Levy Ronald
Published: May 2023

Spontaneous tumors that arise in genetically engineered mice recapitulate the natural tumor microenvironment and tumor-immune coevolution observed in human cancers, providing a more physiologically relevant preclinical model relative to implanted tumors. Similar to many cancer patients, oncogene-driven spontaneous tumors are often resistant to immunotherapy, and thus novel agents that can effectively promote antitumor immunity against these aggressive cancers show considerable promise for clinical translation, and their mechanistic assessment can broaden our understanding of tumor immunology. In this study, we performed extensive immune profiling experiments to investigate how tumor-targeted TLR9 stimulation remodels the microenvironment of spontaneously arising tumors during an effective antitumor immune response. To model the clinical scenario of multiple tumor sites, we used MMTV-PyMT transgenic mice, which spontaneously develop heterogeneous breast tumors throughout their 10 mammary glands. We found that i.v. administration of a tumor-targeting TLR9 agonist, referred to as PIP-CpG, induced a systemic T cell–mediated immune response that not only promoted regression of existing mammary tumors, but also elicited immune memory capable of delaying growth of independent newly arising tumors. Within the tumor microenvironment, PIP-CpG therapy initiated an inflammatory cascade that dramatically amplified chemokine and cytokine production, prompted robust infiltration and expansion of innate and adaptive immune cells, and led to diverse and unexpected changes in immune phenotypes. This study demonstrates that effective systemic treatment of an autochthonous multisite tumor model can be achieved using a tumor-targeted immunostimulant and provides immunological insights that will inform future therapeutic strategies.
LncRNA gadd7 promotes mitochondrial membrane potential decrease and apoptosis of alveolar type II epithelial cells in hyperoxia-induced lung injury by promoting MFN1
Authors: Liu Guoyue , Yin Cunzhi , Qian Mingjiang , Xiao Xuan , Wu Hang , Fu Fujian
Published: May 2023

The mortality and morbidity rates of ovarian cancer (OC) are high, but the underlying mechanisms of OC have not been characterized. In this study, we determined the role of Rho GTPase Activating Protein 30 (ARHGAP30) in OC progression. We measured ARHGAP30 abundance in OC tissue samples and cells using immunohistochemistry (IHC) and RT-qPCR. EdU, transwell, and annexin V/PI apoptosis assays were used to evaluate proliferation, invasiveness, and apoptosis of OC cells, respectively. The results showed that ARHGAP30 was overexpressed in OC tissue samples and cells. Inhibition of ARHGAP30 suppressed growth and metastasis of OC cells, and enhanced  apoptosis. Knockdown of ARHGAP30 in OC cells significantly inhibited the PI3K/AKT/mTOR pathway. Treatment with the PI3K/AKT/mTOR pathway inhibitor buparlisib simulated the effects of ARHGAP30 knockdown on growth, invasiveness, and apoptosis of OC cells. Following buparlisib treatment, the expression levels of p-PI3K, p-AKT, and p-mTOR were significantly decreased. Furthermore, buparlisib inhibited the effects of ARHGAP30 upregulation on OC cell growth and invasiveness. In conclusion, ARHGAP30 regulated the PI3K/AKT/mTOR pathway to promote progression of OC.
Determinants of an integrated cervical cancer screening services in primary healthcare: sharing lessons from Kisumu, Kenya
Authors: Akpan Eyo , Abinya Nicholas , Odhiambo Everlyne , Ekpo Ernest
Published: May 2023

Background: The successful integration of cervical cancer screening service (CCASS) into primary healthcare’s routine services depends on locality-specific and context-based service determinants. Objective: This paper aims to identify the abovementioned determinants and discusses how health administrators can manage their influence on CCASS delivery at the primary healthcare level. Methods: We conducted in-depth face-to-face interviews using a structured questionnaire with CCASS nurse providers and managers in four randomly selected primary health facilities. Information on the method(s) of screening utilised, the challenges faced, and the changes observed in CCASS provision were collected. Service managers were asked how they managed unplanned CCASS disruption, factors influencing CCASS replication, and aftercare support to cancer-affected women. Nurse providers were interviewed on the management of CCASS awareness and critical changes required to sustain CCASS service effectiveness. We used a constant interactive and inductive approach for data analysis.Results: Nine thematic categories of CCASS determinants were identified: ‘cultural’, ‘socioeconomic’, ‘individual’, ‘health system’, ‘evidence-based operations’, ‘outcome-based resourcing’, ‘workflow improvement and standardisation’, ‘inclusive partner’s management’, ‘utilisation’. These determinants were grouped into three domains: ‘conceptual’, ‘outcomes’, and ‘growth’ domains, to correspond to clusters of determinants that are likely to influence the CCASS lifecycle in its formative, continuous delivery or productivity, and reproductive phases.Conclusions: The findings show that sustaining an efficient integrated CCASS delivery at the PHC level requires phase-appropriate continuous adaptive improvements of service determinants within that locality.
A narrative inquiry into women's experiences of menstruation at the workplace in Namibia
Authors: Mbongo Emilia Ndapandula , Miranda Helena , Haikera Hertha
Published: May 2023

Background. Menstruation’s effects on workplace productivity and its impact on women’s careers are rarely discussed in public discourse. This paper presents an analysis of thirteen women’s accounts of their menstrual experiences at work.Objectives. The study aimed to understand women’s lived experiences of menstruation in the workplace in Namibia and to make recommendations for best practices and policy formulation to help female employees cope with menstruation at work in Namibia.Materials and Methods. The study adopted a qualitative, phenomenological narrative inquiry research design, and thirteen participants working in various institutions and companies in Namibia were selected through a snowball sampling procedure. Individuals who agreed to participate in the study were given a link to a Google document containing reflective questions.Results. Thematic analysis was used to analyze the narratives. The study findings show that most participants experienced various menstrual-related symptoms ranging from unbearable physical pain or discomfort to heavy bleeding and psychological distress. Menstruating women face workplace challenges, such as a lack of emergency sanitary products and unsupportive superiors.Conclusions. Based on the narratives analyzed, we conclude that menstrual-related symptoms affect work productivity. Participants highlighted that they perform better and are considerably more productive on their non-menstrual days. Participants advocated for a shift in policy to allow flexibility to work from home or get menstrual leave when experiencing severe menstrual symptoms. Such a change will go a long way in making the workplace more accommodating to women.
Hepatitis B vaccination status and associated factors among health science students
Authors: Nguyen Binh Thanh , Vo Lan Y , Nguyen Tap Van , Vo Minh Cong , Pham Tinh Dang , Nguyen Han Thi Ngoc , Boyer-Chu Lynda , Huynh Giao
Published: May 2023

Objective:

To evaluate hepatitis B virus (HBV) vaccine coverage and its associated factors among health science students in Vietnam.

Methods:

This cross-sectional study involving 459 health science students at Tra Vinh University was conducted between April and June 2022. Data were collected using a structured questionnaire with items on sociodemographic characteristics, knowledge and attitude about HBV, and vaccination status. A multivariable logistic regression model was used to explore the factors associated with vaccination status.

Results:

The majority of participants were female (65.8%) and enrolled at the medical school (56.2%). A total of 30.3% participants received the full dose of the HBV vaccine. The percentages of participants with sufficient knowledge and positive attitudes toward HBV infection were 75.2% and 43.4%, respectively. Vaccination was 11.8 times higher in sixth-year medical students than any healthcare student in their first-year [adjusted odds ratio (aOR) 11.8, 95% CI 3.1-45.1, P<0.001], and the coverage was also significant higher in those who had sufficient knowledge (aOR 2.0, 95% CI 1.1-3.9, P<0.05) and positive attitudes (aOR 3.0, 95% CI 1.9-4.8, P<0.05) than in their counterparts.

Conclusions:

The majority of students were not fully vaccinated against HBV, indicating they were vulnerable to the disease. Administrators and authorities should reinforce health education messages aimed at encouraging all students to get vaccinated with the HBV vaccine, enhance their awareness and knowledge of HBV, and improve attitudes toward HBV infection prevention.
Antibiotic resistance and molecular typing of clinical Staphylococcus aureus isolates from Malaysian military hospital
Authors: Junaidi Nor Syaza Syahirah Amat , Shakrin Nik Noorul Shakira Mohamed , Huri Mohammad Fahmi Daman , Kamarudin Ahmad Zakwan , Desa Mohd Nasir Mohd , Yunus Wan Mohd Zin Wan
Published: May 2023

Objective:

To determine the antibiotic resistance profile (ARP) of Staphylococcus (S.) aureus isolates and molecular typing of the methicillin-resistant S. aureus (MRSA) isolates from Tuanku Mizan Armed Forces Hospital (TMAFH), Kuala Lumpur.

Methods:

The ARP and presence of the pvl gene were determined for 209 S. aureus isolates from clinical specimens. Of these, 123 were methicillin-susceptible S. aureus (MSSA) isolates and 86 were MRSA isolates. All MRSA isolates were characterized using SCCmec typing and spa typing. Descriptive analysis was performed to compare the demographic data with the phenotypic and genotypic variables of the S. aureus isolates.

Results:

No vancomycin-intermediate and -resistant S. aureus (VISA and VRSA, respectively) were detected among the study isolates. The MSSA isolates showed low resistance rates to all tested antibiotics, were commonly invasive (28/42, 66.7%), and mostly harboured pvl (35/42, 83.3%). Meanwhile, MRSA isolates showed high resistance to penicillin (86/86, 100%), ampicillin (86/86, 100%), sulbactam/ampicillin (86/86, 100%), cefuroxime (81/86, 94.19%), cefoperazone (76/86, 88.37%), azithromycin (56/86, 65.12%), and erythromycin (54/86, 62.79%). The majority of MRSA isolates were of SCCmec type IVh (65/86, 75.58%), spa type t032 (55/85, 63.95%), and grouped into spaCC-t022 (66/85, 77.65%). The t032 type was found to be associated with resistance traits to azithromycin and erythromycin (P<0.05). We also found several spa types that are typically associated with hospital-, community-, and livestock-associated MRSA co-existing in our MRSA population.

Conclusions:

This study reflected the consistent absence of VISA and VRSA and corroborated the clonal shifting of MRSA isolates in the Malaysian MRSA isolates.
Acute Telogen Effluvium: A Post-COVID-19 Sequela
Authors: Shendre Mohan Eshwar Rao , Thejaswi Sanjay Ramachandra , Mendagudli Chanabasappa , Nair Veena Ullas , Rajesh Supriya
Published: May 2023

Background:

Telogen effluvium (TE) is characterized by an abrupt onset of diffuse and self-limited shedding of normal club hairs, usually seen 2–3 months after a triggering event. One of the manifestations of SARS-CoV-2 has been new-onset diffuse hair loss in patients previously infected with it, clinically compatible with TE. Thus, the present study attempts to establish hair loss as one of the sequelae of COVID-19 infection.

Objective:

The objective of the study was to find out the presence of hair loss in COVID-19 infection-recovered patients during the second wave of the pandemic.

Materials and Methods:

Google Forms was prepared with relevant questions regarding COVID-19 infection, the presence of hair loss, and aggravating and relieving factors, if any. These forms were distributed to 114 COVID-19-positive patients above 18 years of age who were diagnosed with COVID-19 infection during the second wave, and the data were collected and analyzed.

Results:

Out of 114 participants, majority were female. 83.8% of the participants had significant viremia symptoms. Seventy-two percent of the patients complained of hair loss. Among them, 66.7% of the patients noticed worsening hair loss after 3 weeks of COVID-19 infection, 21.7% noticed within 2–3 weeks of infection, and the remaining 11.7% noticed the same within a week of infection. 50.1% of the patients had associated stress and 12.3% had comorbidities.

Conclusion:

The onset of TE after COVID-19 further impairs the quality of life of patients despite recovery from the primary illness. Identifying COVID-19 infection as a potential cause of hair loss will help in educating the patients about the transient nature of the condition.
A Retrospective Study to Analyze the Pattern of Referrals to the Department of Dermatology, Venereology, and Leprosy at a Tertiary Care Center in Karnataka
Authors: Somaiah Savitha , Manjunath Sneha , Nagesh T S
Published: May 2023

Background:

Dermatology is mainly considered as an outpatient specialty. In an institutional set up, the patients who are hospitalized in nondermatology departments may have skin diseases. The patients visiting other outpatient departments might have skin disorders. Such patients are referred to the department of dermatology and can be diagnosed and treated better in dermatology departments.

Objectives:

The objective was to analyze the pattern of referrals to the department of dermatology, venereology, and leprosy from other departments of the hospital.

Materials and Methods:

The records of the department of dermatology, venereology, and leprosy were analyzed for referrals between September 2019 and February 2020.

Results:

There were 214 males (46.8%) and 188 (53.2%) females in the study. The mean age of the patients in the study was 40.9 ± 20.8 years. Maximum number of referrals were received from the department of general medicine (192 cases, 47.7%), followed by general surgery (64 cases, 15.9%). Infections and infestations accounted for 183 (45.5%) cases out of the 402 referrals, and eczematous disorders were seen in 58 (14.4%) cases. The referring departments mentioned their dermatological diagnosis in 24% of the cases and were found to be correct in 18% of cases.

Conclusion:

The common dermatological conditions are often undiagnosed or misdiagnosed by nondermatologist, leading to incorrect treatment, and contributes to delay in treatment. By focusing on improving the training of undergraduate and postgraduate students in the conditions for which dermatology referrals are usually sought might help in improving their knowledge and later help them treat patients better.
Vitiligo: Prevalence, Clinical Patterns, and Efficacy of Narrow Band Ultraviolet B Phototherapy
Authors: Phulari Yoganand Jagannath , Kukreja Ram , Hiremath Ravishekar N , Patil Chetan C , Patel Priyanka
Published: May 2023

Background:

Vitiligo denotes an acquired primary, usually progressive, melanocytopenia of unknown etiology, and clinically manifested by circumscribed achromic macules often associated with leukotrichia.

Objective:

The objective was to assess the prevalence and various clinical patterns of vitiligo and to study the efficacy of narrow-band ultraviolet B (NB-UVB) radiation.

Materials and Methods:

A prospective case series study was carried out at dermatology outpatient department (OPD), of tertiary care center in Central India on 50 patients of Vitiligo, who were diagnosed clinically, age ranging from 5 to 70 years of age. A thorough history and clinical examination as per institutional protocol was done for all the patients included in the study. Patients were exposed to NB-UVB rays in a phototherapy unit (Dermaindia Spiegel Series) with a standard protocol. Two scores designed for the assessment of vitiligo are Vitiligo Area Severity Index and Wallace Rule of Nines.

Results:

During the period of two years, 6638 patients were seen in dermatology OPD, out of which 129 patients were having vitiligo clinically. Thus, the prevalence of vitiligo was 1.9% in our study. The mean age in male was 40.4 years and that of female was 30.85 years. The female-to-male ratio was 2:3. 6% had a positive family history of vitiligo. The most common site affected was leg (pretibial region) (48%). Two patients (4%) were in Category– 0, 12 patients (24%) were in Category– I, 24 patients (48%) were in Category-II, and 12 patients (24%) were in Category– III, when graded according to their improvement. Forty-five patients (90%) had vitiligo vulgaris, two patients (4%) had segmental vitiligo, and one patient (2%) each of acrofacial vitiligo, lip-tip vitiligo, and focal vitiligo. On comparing the level of significance before treatment and after 2 months of treatment, after 4 and 6 months of treatment, and before treatment and at the end of treatment, it was found that the results were statistically highly significant. Thus, indicating that the improvement in the disease after NB-UVB therapy is statically significant.

Conclusion:

Our study found 1.9% prevalence of vitiligo among patients attending OPD. On comparing the level of significance, before treatment and at the end of treatment, it was found that the results were statistically highly significant with respect to improvement. Side effects were minimal in our participants. Thus, our study concludes that NB-UVB radiation is an effective and safe therapy for vitiligo.
Pomelo Juice–Drug Interactions: A Word of Caution
Authors: Shetty Greeshma V , Girish PN , Rao KP Gopalakrishna , Menon Ashok
Published: May 2023

The main of this article is to study the interactions of certain commonly used drugs with pomelo juice which is commonly consumed as easily available fruit or fruit juice in certain parts of India. Relevant literature was identified by searching PubMed and other articles on the web. Various search words which were used are “Grapefruit,” “pomelo,” “drug interactions,” and “juice-drug interactions.” Inclusion criteria included grapefruit juice–drug interaction studies and pomelo juice–drug interactions. Exclusion criteria were articles actually irrelevant to the juice–drug interaction topics. After reviewing the summary of each article, few articles were directly excluded because of actually irrelevant topics. Finally, eight articles were selected as reference articles and certain data were obtained and our opinion about the same is mentioned in the present article. The full text of each included article was critically reviewed, and valuable information was summarized by data interpretation. Pomelo “(Citrus maxima/Citrus grandis)” is the largest citrus fruit from the family Rutaceae and the principal ancestor of the grapefruit. It is a natural, nonhybrid citrus fruit native to Southeast Asia. Pomelo is commonly consumed and used for festive occasions throughout Southeast Asia. It has also been found to have drug interactions similar to grapefruit. The fruit is large, 15–25 cm in diameter, and weighing 1–2 kg. It has a thicker rind than the grapefruit and is divided into 11–18 segments. Pomelo is closely related to grapefruit and extensively studied and contains furanocoumarins which have been identified as inhibitors of cytochrome P450 3A4 in grapefruit juice in vitro. The fruit was first described in 1750 by Griffith Hughes, and in 1789, Patrick Browne referred to it as “forbidden fruit” or “smaller shaddock.” Its taste also varies from sour or bitter to sweet. The fruit is nearly round or slightly pear shaped in clusters similar to grapes, 10–15 cm wide with smooth, finely dotted peel, up to 1 cm thick. The pulp is yellow or pink to red, which has 11–14 segments with thin membrane. The fruit is very juicy. The fruit presents with pointed seeds about 1.25 cm in length. In Karnataka, a type of pomelo named Devanahalli pomelo (Gi registered) is exclusively grown in the region around Devanahalli taluk, Bangalore, as an exotic crop variety. It is locally known as chakkota. Besides, pomelo has many names such as batabi lebu or jambura in Bengali and chakotra in Hindi-speaking states. In the present pandemic outbreak, in-home consumption of packaged fruit juices has increased among people in the cities, whereas in-home consumption of easily grown and easily available fruits such as pomelo, grapes, apples, and their juices has increased among people in the villages. Hence, caution is required while consuming pomelo juice (similar to grapefruit juice) with certain drugs.
Urticaria with Immunoglobulin G4-Related Disease: An Association or Coincidence?
Authors: Sahana Nemmar Chandra shekarabhatta , Kanathur Shilpa , Shanmukhappa Asha Gowrappala , Revathi T N
Published: May 2023

Immunoglobulin (Ig) G4-related disease is a recently described fibro-inflammatory disease with diverse clinical manifestations but consistent and characteristic histopathological features across multiple organ systems and skin, leading to tissue sclerosis and ultimately organ failure if not treated adequately. Here, we report a case of 56-year-old male patient presenting with urticarial lesions and generalized itching for 4 months. Routine investigations showed elevated 24-h urine protein, absolute eosinophil count, serum IgE, reversed albumin: globulin ratio, and “M” spike on serum electrophoresis. Renal biopsy showed storiform fibrosis, diffuse dense inflammatory cells (plasma cells and eosinophils), and IgG4-positive cells on immunohistochemistry which was histologically highly suggestive of IgG4-related chronic tubulointerstitial nephritis. Quick response was seen with oral corticosteroids.
Workplace Breastfeeding Support and Breastfeeding Practices among Healthcare Professionals
Authors: Ranjitha R , Maroof Khan Amir , Rajoura Om Prakash , Shah Dheeraj
Published: May 2023

Introduction:

Working mothers face striking challenges in breastfeeding. It is important to focus on them to further improve breastfeeding rates.

Aim and Objectives:

To assess the workplace breastfeeding support and breastfeeding practices of healthcare professionals.

Methodology:

We conducted a cross-sectional study among two hospitals in East Delhi. All mothers having at least one child aged six months to five years and currently employed as healthcare personnel were included. For a sample size of 100, population proportionate to size sampling was done among two hospitals. The participants were randomly selected from a list of healthcare personnel. Employee perception of breastfeeding support questionnaire (EPBS-Q) was used to assess the workplace breastfeeding support. Chi-square test was used to compare proportions, logistic regression, and survival analysis to find the association between workplace breastfeeding support and IYCF parameters.

Results:

The proportion of mother who perceived poor workplace breastfeeding support was 37%. The mean (SD) score obtained was 103.48 (8.93). The early initiation of breastfeeding within one hour was practiced by 54%, exclusive breastfeeding for at least six months by 60%, and timely initiation of complementary feeding for six to eight months by 64% mothers. Workplace breastfeeding support was significantly associated with exclusively breastfeeding for at least six months.

Conclusions:

More than one-third of mothers perceived poor workplace breastfeeding, and it was associated with exclusive breastfeeding.
An Evaluation of Malaria Surveillance System in Punjab, India, 2020
Authors: Sharma Sahil , Goel Kapil , Kaushal Kanica , Grover Gagandeep S. , Dikid Tanzin , Singh Gurinder B.
Published: May 2023

Background:

India accounted for 6% of global burden of malaria with 95% population residing in malaria endemic areas. However, Punjab is in the malaria elimination phase with annual parasite incidence (API) <1/1000 population.

Objectives:

We evaluated malaria surveillance system in Punjab using CDC’s updated guidelines for evaluating public health surveillance systems to provide recommendations for strengthening the existing system and to overcome the challenges in the path of malaria free Punjab.

Methods:

We chose two districts of Punjab, Amritsar (lowest API) and Mansa (highest API), interviewed stakeholders, and performed a retrospective desk review. We evaluated the overall usefulness of the system and assessed seven attributes at state, district, health facility, and village level during July–August 2020.

Results:

In Punjab, there was progressive decline in the malaria cases from 2,955 cases in 2009 to 1,140 in 2019 and no malaria deaths since 2011. Regarding various attributes, overall score for flexibility was good (85.9%); average for simplicity (77%), acceptability (74%), data quality (74%), and timeliness (70%); and poor for representativeness (59%) and stability (57%).

Conclusions:

Malaria surveillance system was useful in analyzing the trends of morbidity and mortality and for generating data to drive policy decisions. To improve stability, representativeness, and acceptability, surveillance staff should not be engaged in supplemental work, and reports from private sector must be ensured. Supportive supervision and regular trainings should be carried out regarding reporting formats, guidelines, and timely epidemiological investigations to improve timeliness, data quality, and simplicity.
Quest for Biomarkers of Positive Health: A Review
Authors: Indrayan Abhaya , Vishwakarma Gayatri , Verma Saumya , Sarmukaddam Sanjeev , Tyagi Asha
Published: May 2023

The positive health of a person can be defined as the ability to live long in good health, possibly with no activity limitation. No method is yet available for its objective assessment in individuals, and we propose a framework in this communication that can operationalize this concept. Instead of distal factors, such as diet and lifestyle because these are subjective and difficult to measure, we concentrate on the objectively measurable biomarkers such as immunity level, endorphins, and handgrip strength. The focus is on the major parameters that may protect from diseases and infirmity and can be assessed by noninvasive methods. A combination of such parameters may signify positive health. This may be a novel way to measure positive health at the individual level. In this communication, we briefly review the literature and identify a few major biomarkers that provide a protective shield and could determine the status of positive health at the individual level. This exercise demonstrates that the assessment of the positive health of a person is feasible. A scale based on these and other relevant parameters can be developed later that could quantitatively measure the exact level of positive health. As the exact combination of the parameters that protects from ailments is not fully known yet, a framework such as this may help in identifying the data gaps that require attention in this context. The proposed framework may initiate a discussion on indicators of positive health and characterize the parameters for intervention that could increase a healthy life.
Effect of Self-Directed Learning Module and Assessment on Learning of National Health Programme by Medical Undergraduates – A Mixed Methods Evaluation
Authors: Rajalakshmi M , Ganapathy Kalaiselvan
Published: May 2023

Background:

Competency-based medical education (CBME) curriculum in India has introduced many new concepts like a foundation course, early clinical exposure, and self-directed learning (SDL). Sometimes SDL simply means self-study. Self-directed learning as defined by Knowles is a process in which individuals take the initiative with or without the help of others in diagnosing their learning needs, setting their own learning goals, identifying appropriate learning resources, and selecting appropriate learning strategies. SDL is seen as a prerequisite for life-long learners, especially medical graduates. We found poor uptake of SDL sessions in terms of learning and attendance by students. To develop and assess the effect of the SDL module in Community Medicine for Phase -3 MBBS students.

Materials and Methods:

The study design was a program development and evaluation design. The program development consists of free listing and Nominal Group Technique (NGT). The evaluation design consists of a formative assessment, an end-of-module assessment, and feedback from undergraduate students, postgraduates, and faculties. Data collection procedure: SDL module was developed, agreed and implemented among undergraduates of Phase – 3 MBBS students.

Results:

Free listing was conducted among undergraduate students who had completed the phase 3 MBBS examination and Nominal Group Technique was conducted among the faculties (n = 7) and Postgraduates of the Department of Community Medicine (n = 2) to explore the appropriate topics for SDL in Community Medicine. The topic with the highest ranking and which was finalized for preparation of the SDL module was “National Health Programme”. Three fourth 118 (75%) of the students scored ≥50% at the end of the module assessment. Manual content analysis for the feedback was categorized into three themes such as facilitating factors, challenges, and solutions.

Conclusions:

Effective implementation and assessment of SDL sessions are one of the new concepts in the CBME curriculum.
Systemic Review and Meta-Analysis to Evaluate Therapeutic Effectiveness of Interferon Beta-1b in Hospitalized COVID-19 Patients
Authors: Nayudu Greeshma Sai Sree , Benny Mamkoottathil , Thomas Grace , Adil Khan Maria , Basutkar Roopa Satyanarayan
Published: May 2023

The COVID-19 pandemic has caused havoc in the health sector. Inflammatory cytokines play an important role in the disease condition. Existing evidence has provided certain insights into the repurposing of the drugs. This meta-analysis and systematic review aimed to explore the efficacy of the administration of interferon beta-1b (IFN β-1b) and standard care versus only standard care as the therapeutic agent for managing COVID-19 patients who are severely ill. The search was conducted in the following databases: Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Scopus, and Google Scholar, which were published during the period January 1, 2020, to February 16, 2023. All the included three studies were independently assessed for eligibility. The modified data extraction form of Cochrane were used. The quality of the three included studies was assessed using the Cochrane risk of bias tool. GradePro software was used to summarize the quality grading of the primary outcome measures. The time taken for clinical improvement was (MD: -3.28 days; 95% CI: -5.65, -0.91; P value = 0.007) when treated with IFN β-1b. The duration of hospital stays (MD: -2.43 days; 95% CI: -4.45, -0.30; P value = 0.03), and need for intensive care unit (ICU) admission (RR: 0.71; 95% CI: 0.52, 0.97; P value = 0.03) was statistically significant. Interferon beta-1b is proven to reduce the duration of hospital stay, and the improved clinical status may become a cornerstone of COVID-19 treatment.
QTc Interval of Healthcare Workers from India: Baseline and Effect of Hydroxychloroquine Prophylaxis during the COVID-19 Pandemic
Authors: Gutte Shreyas , Gurjar Mohan , Sanjeev Om Prakash , Bhadauria Dharmendra , Kapoor Aditya , Mishra Prabhaker , Azim Afzal , Poddar Banani
Published: May 2023

Background:

The aim of this study was to access the incidence of prolonged QTc interval and changes, if any, among Indian healthcare workers (HCWs) taking hydroxychloroquine (HCQ) prophylaxis while managing coronavirus disease 2019 (COVID-19) cases.

Methods:

At the beginning of the COVID-19 pandemic, as per the Indian Council of Medical Research (ICMR) policy, HCWs were advised to take HCQ as prophylaxis after getting an electrocardiogram (ECG) while being posted to look after COVID-19 patients. A follow-up ECG was repeated for those who took HCQ. The normal upper limit for QTc interval of 460 milliseconds (ms) for females and 450 ms for males was considered.

Results:

A baseline ECG was analyzed for 250 HCWs with a median age of 35 (30–43) years. The median QTc was 410 (395–421) ms with the prevalence of prolonged QTc of 1.8% in females and 0% in males. A follow-up ECG after HCQ intake for 43 HCWs was further analyzed. They had a median age of 35 (31–39) years and took an average dose of HCQ of 2372 ± 839 mg. Pre- and post-HCQ chemoprophylaxis QTc interval (ms) was as follows: 408 (386–419) and 405 (387–417), with P = 0.434, respectively.

Conclusion:

Among Indian HCWs, the prevalence of prolonged QTc is 1.8% and 0% in females and males, respectively. HCQ intake as chemoprophylaxis for COVID-19 did not affect their QTc interval.
Attention to the Bone Health of a Neglected Rural-Tribal Population in India: A Pilot Study
Authors: Raj Vikash , Barik Sitanshu , Raj Manish
Published: May 2023

Objective:

The aim of this pilot study was to analyze the need and feasibility of conducting prospective research on the epidemiological factors of bone mineral density (BMD) in the at-risk population in a rural and tribal-dominated area based on a screening test.

Methods:

This community-based retrospective cross-sectional study was based on data from the medical records from July 2021 to September 2021 at community camps organized in a rural area of Deoghar district of Jharkhand, India, and the at-risk patients who had undergone ultrasound-based BMD measurement were included in this study.

Results:

The mean age of the patients (N = 216) was 68.2 ± 10.2 years (range 35–73 years) with a mean T-score of -0.83 ± 0.09 (range -2.78–0.3, 95% CI 0.19). 70.3% (n = 152) of the patients were diagnosed as either osteopenic or osteoporotic based on the T-score. 14.8% (n = 32) of the patients had a comorbidity making them susceptible for low BMD. BMD was significantly low in patients above 60 years of age (t - 3.36, P – 0.0005), presence of comorbidity (t – 3.12, P – 0.001), and urban population (t - -1.93, P – 0.02).

Conclusion:

Although DEXA remains the study of choice, QUS can be used in primary healthcare systems in the developing world for the purposes of screening. Females, elderly, and urban residence have an increased chance of low BMD. This pilot study shows that a large-scale prospective study analyzing various aspects of bone health including dietary and lifestyle practices is the need of the hour.
Assessment of Home-Based Care for Young Child (HBYC) Program in Aspirational Districts of Madhya Pradesh, India: A Cross-Sectional Study
Authors: Das Priyanka , Singh Manish , Sakalle Shailesh K. , Bhargava Saurabh , Khanna Rajat , Ganvir Dipak R. , Singh Ravindra , Goel Nimisha , Yadav Vivek , Bhat Ashfaq A.
Published: May 2023

Context:

In 2018, Government of India initiated Home-Based Care for Young Child (HBYC) program having five quarterly structured home visits for children age 3 to 15 months to promote early childhood development. Assess knowledge and practices of Accredited Social Health Activist (ASHAs), other health functionaries, and mothers related to HBYC. Cross-sectional evaluation design with ASHAs, AWWs, ANMs, ASHA, and mothers of 3 to 15 month’s children as participants.

Material and Methods:

Knowledge and practices of 801 ASHAs, 200 other health functionaries, and 787 mothers were assessed on exclusive breastfeeding, complementary feeding, hand washing, iron folic acid (IFA) and oral rehydration solution (ORS) supplementation, danger referral signs in eight aspirational districts of Madhya Pradesh.

Results:

88% ASHAs had correct knowledge on ORS, 85% on complementary feeding, 85% on adequacy of IFA, and 47% on danger signs which required child referral. Similarly, 85% of mothers had knowledge on exclusive breastfeeding, 40% mothers knew about complementary feeding, and only 18% knew correct ORS preparation. Statistically significant association was observed between ASHAs home visits and availability of ORS with mothers and their knowledge on correct Initiation of IFA (p < 0.001).

Conclusion:

Findings of study confirmed majority of health functionaries were aware about roles, responsibilities, and key tasks under HBYC. However, there observed a gap in knowledge transfer by health functionaries and thus inadequate translation of knowledge into practices among mothers on HBYC. This necessitates the need of appropriate actions from health system strengthening to capacity building to accelerate uptake of HBYC program.
A Validation Study on the Physiological Parameters Recorded by COVIDBEEP - An Indigenous Remote Health Monitoring System Designed for COVID-19 Care in India
Authors: Taranikanti Madhuri , Mudunuru Aswin Kumar , Fatima Farheen , Maddur Srinivas , Bandaru Rajiv Kumar , Taranikanti Sai Shriya , Guntuka Rohith Kumar , Yerra Aruna Kumari , Dhanunjaya G , Raju A. P.
Published: May 2023

Background:

COVID-19 pandemic has affected mankind globally. After the three waves since March 2020, the threat continues instilling fear in the minds. Vital parameter monitoring through remote health monitoring system (RHMS) becomes critical for effective disease management and manpower safety and confidence. In a low resource setting like India, a comprehensive, wearable, and remotely operable device that is economical was required to be introduced for COVID-19 care. Present study validated the remote health monitoring device named COVIDBEEP with gold standard equipment.

Materials and Methods:

Six parameters, namely heart rate, SpO2, respiratory rate, temperature, blood pressure, and ECG were acquired in the supine position using the devices.

Result:

Analysis was performed using Graph Pad Prism. Intraclass correlation coefficients were used to measure concurrent validity. Bland–Altman graphs were plotted to know the agreement for each vital parameter. Confidence limits were set at 95%. All the parameters recorded from the devices showed a significant correlation with an “r” value between 0.5 and 0.9 with P value between 0.001 and 0.0002. Bland–Altman plots showed a minimum bias of 0.033 for heart rate and maximum of 3.5 for systolic blood pressure and respiratory rate.

Conclusion:

The association between the parameters recorded by the devices strengthened as the time of collection of data increased. Agreement between the two methods in 95% confidence interval was also proven to be significant for the parameters. Therefore, the indigenously developed COVIDBEEP has shown good validity in comparison to standard monitoring device.