bluuebunny/crossref_metadata_2025 huggingface dataset:
Contemporary Treatment Practices for Subacute Sclerosing Panencephalitis: A Nationwide Survey Among Adult and Pediatric Neurologists in India
Authors: Garg Divyani , Makharia Archita , Agarwal Ayush , Garg Ajay , Srivastava Achal K
Published: December 2024

Background and Objectives:

Subacute sclerosing panencephalitis (SSPE) is a progressive disorder caused due to the persistence of mutant measles virus in the brain. Treatment strategies for SSPE remain largely undefined, and there exists no information on how neurologists are currently managing SSPE.

Methods:

A survey-based study was conducted among Indian neurologists managing pediatric and adult patients with SSPE. A questionnaire-based survey was circulated by email regarding respondent demographics, preference for disease-modifying strategies, and symptomatic therapy.

Results:

Survey response was obtained from 298 neurologists (responder rate 9.5%) and eventually analyzed from 266 respondents who managed SSPE in routine practice. This included 222 (83.5%) adult and 44 (16.5%) pediatric neurologists from 21 states of India. Ninety-five respondents (35.7%) indicated that they always advised Isoprinosine (inosine pranobex) to their patients. Regarding interferon therapy, 121 (45.5%) reported never advising it, whereas 56 (21.1%) always advised it. For myoclonus, the most frequently used first-line drug was valproate (181, 68%), followed by levetiracetam (58, 21.8%). Most (150, 56.4%) of the respondents favored personalized therapy for the individual patient in terms of the duration of disease-modifying treatment. The patient follow-up was reported to be poor, with most (171, 64.3%) of the patients following up only occasionally and 24 (9%) respondents indicating that patients are lost to follow-up promptly after the initial visit.

Conclusions:

While SSPE remains a vaccine-preventable illness and the focus should be on prevention through vaccination, there is an unmet urgent need among Indian neurologists for better-defined treatment strategies for patients with SSPE.
Effect of Collagen Cross-linkers on Dentine Biomodification and Durability of Resin-dentine Bond: An In vitro Microtensile Bond Strength Study
Authors: Buch Aastha , Mathur Somil , Bagda Kamal
Published: December 2024

Introduction:

Dental composites, commonly used for restorations, face high failure rates (15%–50%) within 10 years, largely due to dentine’s complex structure. Factors such as hydrophilic monomer use and inadequate collagen infiltration weaken bond strength. This study investigates the effectiveness of the natural cross-linker quercetin, comparing its impact on bond strength to other agents.

Materials and Methods:

Thirty freshly extracted human molars that met the inclusion and exclusion criteria were collected and stored in 0.1% thymol solution. Teeth were randomly divided into five experimental groups: I – quercetin, II – carbodiimide, III – grape seed extract (GSE), IV– ethanol and V – water wet bonding (control). The enamel surface of the molars was ground to expose mid-coronal dentine. Acid etching with 37% phosphoric acid, rinsing for 45–60 s, and blot drying was done. Thereafter, the respective collagen cross-linking agent was applied for 1 min. A bonding agent was applied and light cured. Incremental nanohybrid light-cured composite build-up (4–6 mm) was done. Resin-dentine sticks of approximately 9.0 mm × 1.0 mm × 1.0 mm were prepared and secured in an acrylic jig. The tensile force was applied using a universal testing machine at a speed of 0.5 mm/min at the tooth–restoration interface. Samples for delayed testing were stored in artificial saliva till testing after 6 months. Microtensile bond strength was calculated as F/A (MPa).

Results:

Immediate testing showed significantly higher strength values for quercetin, carbodiimide and GSE as compared to ethanol and water wet bonding. There was no significant difference in the strength at 6-month intervals for quercetin, carbodiimide and GSE. Ethanol and control groups showed a statistically significant reduction in the bond strength after 6 months.

Conclusion:

Biomodification of dentine matrix using various collagen cross-linkers may contribute to long-term resin–dentine bonds.
Frequency of Insulin Omission and It’s Associated Factors in Patients with Type 2 Diabetes Mellitus on Insulin Therapy
Authors: Islam Mohammad Aminul , Dutta Mita , Tabassum Maliha , Ashrafuzzaman S. M.
Published: December 2024

Background:

Poor adherence to prescribed insulin regimen leads to poor glycemic control. This study was intended to see the frequency of insulin omission and it՚s associated factors among patients with inadequate glycemic control on insulin therapy.

Methods:

This cross-sectional observational study enrolled 384 patients with type 2 diabetes on insulin therapy recruited by convenient sampling from the Department of Endocrinology of BIRDEM General Hospital. As per study protocol, investigation reports were collected from patient records. Data were analyzed by SPSS version 25.

Results:

Forty-six percent of patients had some form of insulin omission. A documented event of one or more episodes of hypoglycemia (70.7%) was found to be the prime reason behind the omission of insulin. Worsened glycemic control (fasting plasma glucose, 2-h postprandial glucose, and glycated hemoglobin) and health hazard (obesity) were statistically significantly higher among the subjects who omitted their insulin. Only a few people in the insulin omission group were compliant with diet (2.8%), exercise (5.1%), and weekly self-monitoring of blood glucose (2.8%). Only 22.5% and 21.3% knew about target blood glucose and the insulin dose adjustment, respectively, in the omission group.

Conclusions:

High frequency of insulin omission due to several lifestyle-related factors and lack of structured diabetic education predisposed the patients to poor glycemic control.
Neuroprotective Role of Transchalcone in Parkinson‘s Disease through AMP-activated Protein Kinase-mediated Signaling Pathway
Authors: Cheng Yao , Hussain Shaik Althaf , Alrubie Turki Mayudh , Zhang Xiaomin
Published: December 2024

Parkinson’s disease (PD) is a gradually worsening neurodegenerative condition marked by the deterioration of dopaminergic neurons, motor dysfunction, and mitochondrial dysfunction. Trans-chalcone, a natural flavonoid, has shown promise in various disease models because of its antioxidant and anti-inflammatory features. This study investigates the neuroprotective effects of transchalcone in a rat model of PD, focusing on its impact on the activation levels of AMP-activated protein kinase (AMPK) signaling pathway, sirtuin1 (SIRT1) and peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC1α) proteins, and mitochondrial-inflammatory responses. Male Sprague Dawley rats were allocated into five groups Control, Control plus transchalcone, PD, PD plus transchalcone, PD plus compound-C, and PD plus Compound-C and trans-chalcone. PD was induced using intranigral 6-hydroxydopamine injection. Trans-chalcone (100 μg/kg) and compound-C (20 mg/kg) were intraperitoneally administered daily for 4 weeks in PD rats. Motor function was assessed using rota-rod and grid tests. Striatal dopamine and cytokines (interleukin 1-beta [IL-1 β], IL-10) and p65-nuclear factor kappa-B (NF-κB) levels were measured with enzyme-linked immunosorbent assay. Mitochondrial function was evaluated by fluorometric techniques. The expression of phosphorylated AMPK, PGC-1α, and SIRT1 was analyzed by Western blotting. Trans-chalcone treatment significantly improved motor function, evidenced by increased latency to fall in the rota-rod test and recovered traversal time in the grid test. It also restored dopamine levels, enhanced mitochondrial function (reduced reactive oxygen species levels, increased membrane potential, and adenosine triphosphate production), normalized cytokines (IL-1 β, IL-10) and p65-NF-κB, and upregulated the proteins expression in rats with PD. Inhibition of AMPK activity with compound-C suppressed the neuroprotective impacts of trans-chalcone, highlighting the contribution of AMPK signaling pathway in its mechanism of action. Neuroprotective and mitoprotective impacts of trans-chalcone were mostly mediated through the activation of AMPK-SIRT1-PGC1α pathway. These results indicate that trans-chalcone could be a promising therapeutic agent for PD, warranting further investigation to assess its efficacy and safety in human patients.
Revolutionizing Cataract Surgery with Advanced Techniques
Authors: Dudani Ajay , Israni Anjali , Dudani Krish , Dudani Anadya
Published: December 2024

ABSTRACT

Background:

Cataract is the predominant reversible factor leading to blindness globally, affecting approximately 95 million individuals. The surgical procedure to replace a cloudy lens with an artificial lens is typically performed using local anaesthesia. Ultrasonic phacoemulsification is the conventional method used to fragment the nucleus of the lens. Thus far, randomized controlled trials (RCTs) have not demonstrated the superiority of the femtosecond laser compared to phacoemulsification for this specific purpose. In addition to the traditional single-focus type, the range of artificial intraocular lenses includes lenses with multiple foci, extended-depth-of-focus (EDOF) lenses, and astigmatism-correcting lenses.

Aims and Objectives:

This article presents three distinct chop techniques that vary depending on the severity of the cataract. The goal is to minimize damage to the endothelial cells and maximize visual improvement after surgery.

Materials and Methods:

patients were classified according to the grade of nuclear sclerosis. The patients with soft grade 1 cataract underwent ‘Hydropop” technique. Patients with grade 2 nuclear sclerosis underwent phcoemulsifictaion using “Half Stop-Chop’ technique. Patients with Grade 3 and grade 4 nuclear sclerosis underwent phacoemulsification using “Petal by Petal’ technique.

Results:

All patients who underwent phacoemulsification had a good visual outcome and full segmental nuclear fragment management was done without causing any endothelial and posterior capsular complication.

Conclusion:

In order to improve patient outcomes, safety, and efficiency, phacoemulsification is a crucial part of modern cataract surgery. Newer innovations in different techniques of nuclear management only enable good visual outcome while reducing the learning curve.
One-to-One Observation: Pilot Study on Practical Aspects of Manual Small Incision Cataract Surgery Training for Residents in Tertiary Eye Care Hospital
Authors: Raghunandan Nithya , Ramadevi K. S. , Joseph Rachel , Kumar G. Manoj
Published: December 2024

ABSTRACT

Background:

Cataract surgery and surgical training has undergone extensive revolution over years. Phacoemulsification is the surgery of choice. However, in developing countries, residents begin surgical training with small incision cataract surgery (SICS). SICS is a stepping stone to acquire good intraocular awareness and eventually perform phacoemulsification surgeries. Through this study we emphasize the need for one-to-one monitoring of surgeries performed by residents. The objective analysis of their surgical performance was based on the International Council of Ophthalmology Ophthalmology Surgical Competency Assessment Rubrics (ICO OSCAR).

Aims and Objectives:

Primary objective: To improvise the ophthalmic surgical training of the residents by one to one monitoring of the first 20 surgeries performed by the trainee. Secondary objective: To ensure the best possible outcome with the least number of complications in the resident surgical cases.

Materials and Methods:

It was a cross sectional, observational study done in the tertiary care eye hospital in South Bengaluru from May 2023 to August 2023. Six residents, who were to begin their surgical training in our institute, were observed by three senior skilled faculty surgeons. At the end of each surgery, ICO OSCAR structured questionnaire was given to each resident for self evaluation, and the assessment made by the resident was re analysed by the observing faculty on the postoperative day one based on the outcomes of surgery.

Results:

The significant observations made by senior skilled faculty surgeons has been summarized as verbatim quotes. We describe the performance of the candidate during surgery as per ICO-OSCAR scoring, 2-novice; 3-beginner; 4-advanced beginner, 5-competent. This structured procedure of candidate observation and assessment was followed for the first twenty surgeries performed by the residents who have enrolled in the study. The data was entered in Microsoft-EXCEL version 10 and analysed.

Conclusion:

We conclude that one is to one monitoring by the senior faculty surgeon during the initial few cases plays a pivotal role in the surgical learning curve of the residents and observations of our study can be used for future modifications to improvise the postgraduate training program in ophthalmology.
Biliary atresia with splenic malformation with associated ductal plate malformation and duodenal atresia: A case report
Authors: Mukherjee Raktim , Halder Aniket , Das Suman Kumar , Mukherjee Suchandra , Chatterjee Uttara
Published: December 2024

Biliary atresia (BA) is the most common cause of the obstructive type of neonatal cholestasis that requires prompt surgical intervention. About 10% of neonates with BA have other congenital anomalies, of which splenic malformation (BASM) is a well-known distinct sub-group. There is sparse literature on the association of duodenal atresia and ductal plate malformation (DPM) in patients of BASM. We describe a BASM associated with DPM and duodenal atresia in a 35-day-old infant, who succumbed at 40 days, before portoenterostomy could be performed. Duodenal atresia can be one of the associated malformations associated with BASM and ductal plate abnormalities. In our case, the child did not survive.
Invasive micropapillary urothelial carcinoma of the renal pelvis presenting as nonfunctional kidney: A unique presentation and review of the literature
Authors: Shahin Mohammed , Tripathy Sagar R. , Nayak Prasant , Ram Prasanna , Ayyanar Pavithra
Published: December 2024

Micropapillary urothelial carcinoma of the renal pelvis is a rare and aggressive variant and poses a diagnostic challenge, especially related to the site and histomorphology of the tumor. A 60-year-old female presented with right pelvic-ureteric junction obstruction and a nonfunctioning right kidney. She underwent a simple right nephrectomy. The microscopy examination revealed a high-grade tumor of the renal pelvis, predominant micropapillary architecture. The tumor infiltrated into the kidney, renal sinus, perinephric fat, adrenal gland, and Gerota’s fascia. Extensive lymphovascular and perineural invasions were also noted. On immunohistochemistry, tumor cells were positive for GATA-binding protein 3, cytokeratin 7, and cytokeratin 20, while negative for paired box gene 8, cluster of differentiation 10, mammaglobin, and alpha-methylacyl-CoA racemase. The p63 was positive in the conventional areas and negative in the micropapillary pattern. We reported an additional case of micropapillary urothelial carcinoma of the renal pelvis, literature review, and discussed the differential diagnosis. Immunonegativity of p63 in the micropapillary component was an additional finding.
Hemangiomatosis of the spleen in a patient with Klippel-Trenaunay syndrome: A case report
Authors: Lanjewar Dhaneshwar Namdeorao , Chothani Kinalee Prafullbhai , Vaishnav Mitsu Vinay , Rao Gyaneshwar
Published: December 2024

Hemangiomatosis of the spleen is a benign vascular condition occurring as a manifestation of systemic angiomatosis. It is usually associated with Klippel-Trenaunay syndrome (KTS), which is a rare congenital malformation characterized by a triad of varicose veins, bony and soft tissue hypertrophy, and cutaneous and visceral hemangiomas and/or venous malformations. The association of splenic hemangiomatosis with KTS is less documented in the literature. In this report, we describe a 63-year-old female who presented with massive splenomegaly, the histopathology of which showed features of diffuse hemangiomatosis. Based on the histopathological diagnosis, a retrospective evaluation of the patient was carried out and she was diagnosed as KTS. To the best of our knowledge, this is the first report in the Indian literature describing splenic hemangiomatosis in a patient with KTS.
Effect of Integrated Yoga and Naturopathy Intervention in a Patient with Osteoid Osteoma: A Case Report
Authors: Deepa Y. , Vijay A. , Thamizhmaran T. D. , Nivethitha L. , Mooventhan A.
Published: December 2024

Osteoid osteoma is a benign bone-forming tumor that is, typically solitary, which makes up 10%–14% of all benign tumors and 2%–3% of all primary bone tumors. Complementary and alternative treatments, such as yoga and naturopathy (YN), have grown in popularity among patients with musculoskeletal disorders to reduce pain and other symptoms. However, there is no known study that reported its effect on osteoid osteoma. Hence, this study aimed to evaluate the effect of YN on pain, mental health, quality of sleep (QoS), and quality of life in patients with osteoid osteoma. A 25-year-old man who was diagnosed with osteoid osteoma visited our hospital on May 8, 2023, with the chief complaints of severe pain in his left leg radiating to the calf muscles and ankle joint and fungal infection on his left palm and both feet. Patients underwent comprehensive YN interventions, and assessments were taken at baseline (day 1), posttreatment (day 9), and after the follow-up period (40 days). The patient showed a better improvement in the outcomes measured, such as reduction in weight, body mass index, warmth, erythema, tenderness, and swelling; reduction in the Visual Analog Scale for pain, perceived stress scale score, and the Pittsburg Sleep Quality Index score; and increase in the Short Form-12 score. This finding suggests that YN interventions are useful in the treatment of osteoid osteoma patients in easing their pain, stress, and depression while enhancing their physical and mental wellbeing and QoS.
Evaluating oral health status in elderly Irula tribes of Tamil Nadu by using the Geriatric Oral Health Assessment Index
Authors: Sukumar Margret Beaula Alocious , Peter Roshni Mary , Joseph Alex
Published: December 2024

ABSTRACT

Introduction:

Oral diseases are a significant global health issue, with over 3.5 billion cases worldwide. Caries and periodontitis are primary contributors to tooth loss, which not only incurs significant rehabilitation costs but also profoundly affects overall well-being. Tribal communities represent a notable indigenous segment, comprising 8.6% of India’s total population, primarily concentrated in the central and western regions. This study assesses the oral health-related quality of life (OHRQoL) among the elderly Irula population by using the Geriatric Oral Health Assessment Index (GOHAI).

Methods:

A cross-sectional research was undertaken in the Irula settlements of Thiruvallur district, Tamil Nadu, focusing on inhabitants over 60 years who had lived there for at least 6 months. People who were chronically ill or who refused to agree were excluded. Data were gathered using a questionnaire that included demographic information, economic status, personal habits, and health issues. OHRQoL was evaluated using the GOHAI, and descriptive statistics such as range, mean, and standard deviation (SD) for continuous variables were used. To account for possible confounders such as age, education, and socioeconomic status, multivariate analysis was performed using logistic regression.

Results:

This study results comprised mostly females (76.4%) and individuals aged 60–64 years (44.8%). Most participants were Hindu (94.1%), married (72.5%), and illiterate (61.9%). A majority lived in nuclear families (87.6%) and were agricultural laborers (60.0%). Many participants never experienced limitations in eating due to dental issues (64.0%). Gender, education, and physical comorbidities significantly influenced OHRQoL, with females and those with higher education reporting better quality of life.

Conclusion:

The study underscores the significant impact of oral health on the quality of life among the elderly Irula population. Factors such as gender, education, and physical comorbidities play crucial roles in OHRQoL. The findings highlight the need for targeted oral health interventions and further research to address disparities and improve oral health outcomes in this underserved population.
Size estimation and vulnerability assessment of transgender people in Manipur, North-east India: A cross-sectional study
Authors: Suriya Phanjoubam , Rajkumari Bishwalata , Sharma Choudhurimayum Robedi
Published: December 2024

ABSTRACT

Context:

Transgender people commonly faced stigma which has been linked to violence, abuse, and discrimination, often forcing them to remain hidden.

Objectives:

This study plans to estimate the size of the transgender population and to assess the vulnerability and risk of transgender people in the society.

Methods:

This cross-sectional study was conducted among 171 transwomen aged 18 years and above residing in two districts in Manipur recruited using the respondent-driven sampling (RDS) method. Interviews were conducted using a semistructured questionnaire, and the multiplier method was applied for the size estimation. Descriptive statistics were generated. Ethical approval for the study was obtained from the institutional ethics committee.

Results:

The mean ± SD age of realization of their sexual identity and age of expressing gender identity was 9.06 ± 2.9 and 17.3 ± 2.7 year, respectively. The reported network size was found to be 40.37 ± 38.7, and the estimated size of the transgender population was found to be 2201 (95% CI 1987.6–2403.1). Most of the respondents (157, 91.8%) had ‘Ever experienced harassment due to their sexual identity’, with the majority (138, 87.9%) reporting ‘verbal abuse’, while (108, 63.1%) reported ‘sexual abuse’ and 43.9% of them said they had a ‘psychological effect’ due to the abuse.

Conclusion:

The majority of the respondents had faced some form of harassment or abuse due to their gender identity, leading to the psychological effect on them. There is an urgent need for developing a comprehensive measure focusing on mainstreaming the transgender persons by creating an enabling environment for their holistic development.
Unsupported walking with only half of the brain due to severe porencephaly
Authors: Finsterer Josef
Published: December 2024

ABSTRACT

A patient with a history of Asian flu, mumps meningo-encephalitis, and skull-base fracture and severe porencephaly who was able to walk without assistance, has not been reported. The patient is a 65 year-old male with a history of Asian flu at 6 months of age, Mumps meningoencephalitis at 6 years of age, structural epilepsy since 15 years of age, traumatic brain injury with skull-base fracture at 51 years of age, arterial hypertension, diabetes, hyperlipidemia, previous alcoholism, and polyneuropathy. He presented with only mild right-sided spastic hemiparesis, dysarthria, decreased tendon reflexes in the lower limbs, spastic-ataxic gait, but he was able to walk unassisted. Cerebral MRI showed massive porencephaly with left lateral and third ventricular hydrocephalus. It was concluded, that patients with severe hemihydrocephalus since childhood may still be able to walk without support.
Evaluation of the long-term effects of COVID-19 on pulmonary functions in recovered patients
Authors: Naja K , Meena Durga Shankar , Kumar Deepak , Dutt Naveen , Bohra Gopal K. , Gadepalli Ravisekhar , Banerjee Mithu , Garg Mahendra K. , Misra Sanjeev
Published: December 2024

ABSTRACT

Background:

It is documented that COVID-19 survivors have prolonged morbidity and functional impairment for many years. Data regarding post-COVID-19 lung functions is lacking from the Indian population. We aim to evaluate the lung functions in such patients after 3–6 months of hospital discharge.

Methods:

In this prospective observational study, patients were assessed 3 to 6 months post-discharge and underwent standardized pulmonary function tests (PFTs) and CT Thorax if required. The following parameters were measured and correlated with the disease severity: Forced Vital Capacity (FVC), Forced Expiratory Volume in the First Second (FEV1), Forced Expiratory Flows at 25 and 75% of FVC (FEF25%-75%), Peak Expiratory Flow (PEF) and FEV1/FVC.

Results:

A total of 52 post-COVID-19 patients were enrolled in the study, with a median age of 43 years (78.8% males). 44.2% of patients had mild disease, 26.9% had moderate disease and 23.1% had severe disease at hospital admission. A restrictive pattern was seen in 20.8% of patients. The mean value of FEV1 and FVC decreased as the disease severity increased. FEV1: mild-3.21 ± 0.71, moderate-2.62 ± 0.61 and severe- 2.51 ± 0.72, P = 0.02; FVC: mild-3.69 ± 0.81, moderate-3.04 ± 0.71 and severe- 2.93 ± 0.87, P = 0.02. After adjusting the confounding factors, the mean pulmonary function values were lower in the patients who required oxygen support, with a significant difference in FEV1, FVC, PEF and FEF 25–75% with P values of 0.025, 0.046, 0.028 and 0.007, respectively. 66.67% had abnormal HRCT findings. Age and high LDH were correlated with HRCT abnormality with P values of 0.015 and 0.024. Age >50 years was found to be an independent predictor of the subsequent development of abnormality on the HRCT thorax.

Conclusions:

Patients with COVID-19 pneumonia, which required oxygen, especially severe disease at the time of hospitalization, had a higher rate of abnormal spirometry than patients with mild symptoms. Follow-up CT scans obtained within six months of disease onset showed abnormalities in more than half of patients, particularly elderly patients.
The association between underlying conditions, risk factors, risk markers, and post-COVID conditions ≥6 months after COVID-19: A systematic review
Authors: Hill Aisha , Morford Madelon , Saydah Sharon , Logan Pamela , Raso Danielle , Stone Erin C. , Taliano Joanna , Koumans Emilia H. , Varechtchouk Olga
Published: December 2024

ABSTRACT

Introduction:

While various demographic factors and underlying medical conditions are associated with the development of post-COVID conditions within a month after SARS-CoV-2 infection, less is known about factors associated with post-COVID symptoms that persist for 6 months or more. The aim of this review was to determine the association between underlying conditions, other risk factors, health behaviors, and the presence of symptoms ≥6 months after COVID-19.

Methods:

Studies reporting on post-COVID symptoms were searched in databases, including Medline, EMBASE, Global Health, PsycInfo, Scopus, CINAHL, Proquest, and WHO COVID-19 literature, from the beginning of the pandemic until November 2022. Studies were included if they reported on symptoms ≥6 months after COVID-19 and a relevant measure of association (adjusted or unadjusted odds or risk ratio).

Results:

A total of 17 studies with 109,293 participants met the inclusion criteria; they were conducted in China (3), Italy (3), Spain (3), Russia (2), France (1), Germany (1), Sweden (1), Scotland (1), United Kingdom (1), and the United States (1). When compared to males, female participants were at an increased risk of post-COVID-19 symptoms (risk ratio (RR): 1.24; adjusted odds ratio (aOR): 3.08). Underlying conditions, including COPD/lung disease, overweight status or obesity, hypertension, cardiovascular disease, and asthma, were identified as possibly being associated with an increased risk of post-COVID symptoms.

Conclusion:

Female gender and certain underlying medical conditions were associated with an increased risk of post-COVID symptoms ≥6 months after COVID-19. Further research is needed to better understand some of these associations and identify groups that are at increased risk for persistent post-COVID conditions.
Dual burden of TB and mental ill-health: Prevalence and associated factors of anxiety and depression among TB patients in Gujarat
Authors: Chauhan Ajay , Pandya Apurvakumar , Bhatt Deepti , Salaliya Vibha , Trivedi Rutu , Kapadia Dixit , Shukla Prachi , Shah Amar , Chaudhary Siddharth , Joshi Chandrashekhar , Pandey Vivekanand
Published: December 2024

ABSTRACT

Context:

The coexistence of tuberculosis (TB) and mental disorder presents a daunting public health challenge. Studies suggest that TB patients often experience co-morbid mental health problems, highlighting a dual burden of illness. However, due to limited research in Gujarat, we cannot draw definitive conclusions or develop targeted mental health interventions for this population.

Aim:

To investigate the prevalence of depression, anxiety, and associated factors among TB patients from Gandhinagar and Surat cities in Gujarat, India.

Settings and Design:

The cross-sectional research was conducted in two cities in Gujarat, Gandhinagar and Surat, between October 2021 and July 2023.

Methods and Material:

Demographic information, anxiety and depressive symptoms, and perceived TB stigma were assessed at baseline (within 1 month of treatment initiation) and at the endpoint (6 months posttreatment) using a self-constructed tool for assessing risk factors and standardized instruments, namely, the Patient Health Questionnaire-4, and the Perceived TB Stigma Scale (12 items).

Results:

The study population had a mean age of 31.57 ± 12.34 years. The prevalence of anxiety and depression symptoms was found to be 10.5% (749) and 5% (359), respectively, at the baseline. TB patients with high perceived TB stigma and who had been sick for over six months were 3.1 times more likely to experience anxiety symptoms (Adjusted Odds Ratio (AOR) = 3.10, 95% CI: 2.22, 4.23) and 1.6 times more likely to experience symptoms of depression (Adjusted Odds Ratio (AOR) = 1.60, 95% CI: 1.12, 2.53). Gender, occupation, and socioeconomic level were significantly associated with both anxiety and depression (P < 0.05). Being single (AOR: 3.29; 95% CI: 2.45–7.53), low socioeconomic status (AOR: 5.41; 95% CI: 2.44–7.97), and being on TB treatment (AOR: 4.35; 95% CI: 1.83–15.65) were strongly associated anxiety and depressive symptoms.

Conclusion:

The findings of the current study indicate that TB patients experience a considerable burden of symptoms of both anxiety and depression. It highlights the need for incorporating mental healthcare support within TB care programmes.
Assessment of morbidity profile among workers of metallurgy factories processing aluminium in Howrah district of West Bengal
Authors: Biswas Debasish , Sau Manabendra , Paik Gautam , Madhwani Kishore P. , Samanta Amalendu
Published: December 2024

ABSTRACT

Introduction:

Workers who work in metallurgy factories processing aluminium are at risk of exposure to various kinds of metals and chemicals.

Objective:

To describe sociodemographic characteristics and to find out morbidity profile of study participants .

Methods:

A cross-sectional O bservational descriptive study was conducted in two aluminium processing metallurgy factories in Howrah district of Indian state of West Bengal. The sample size for the proposed research study was 424 workers. Data were collected through a predesigned and pretested questionnaire and were subsequently analyzed by using suitable statistical package.

Results:

The mean age of the workers was 45.46 years with standard deviation of 10.25 years. Maximum (28.54%) respondents had completed primary standard, and majority of respondents were from upper middle class (34.67%). 16.75% of workers reported that they suffered from communicable disease s, and 76.42% of participants reported noncommunicable diseases. 63.44% of study participants were overweight. This study showed musculoskeletal discomfort in different joints and body parts in 23.35% of participants; 2.82% of participants had ventilatory defects of lung. 3.07% of participants were suffering from hearing loss, and 5.90% of participants had refractive error of eyes.

Conclusions:

Noncommunicable disease burden was higher than communicable diseases among study participants. Almost one out of four participants reported musculoskeletal discomfort in different joints and body parts.
Disseminated tuberculosis masquerading as a psychiatric illness—A case report
Authors: Bhaskar Shalini , Noh Mimi N. M.
Published: December 2024

ABSTRACT

Tuberculosis (TB) can affect any organ, and at times more than one organ in any sequence, in which case it is referred to as disseminated tuberculosis (DTB). We report a patient who presented primarily for psychiatric symptoms of three months’ duration, which later turned out to be a case of DTB involving the central nervous system as well as the spine and lungs. Case Presentation: An elderly lady with subacute onset and worsening behavioural changes of three months’ duration was referred for exclusion of organic brain disease. The neurological and respiratory examination, chest X-ray, electroencephalogram (EEG), and MRI of the brain were normal. She, however, had elevated C-reactive protein, ESR, and raised CSF opening pressure on lumbar puncture. The CSF cell counts, biochemistry, and cultures were within normal limits. Unable to detect a neurological cause for her illness, she was advised to consult a psychiatrist. Two months later she reported to us again, this time essentially for back pain. Investigations for the back pain (including CT spine) revealed a T12 compression fracture with irregularity of the left T12 pedicle and a para-spinal fluid collection. Pus drained from the collection showed mycobacterium tuberculosis bacteria on staining with ZN stain. The CT scan thorax also showed left lower lobe consolidation and a pleural effusion. Contrast CT scan brain revealed subtle meningeal enhancement at the right parietal region. With standard treatment with a four-drug anti-TB regimen (along with a short course of dexamethasone), she improved well. This case report indicates that the initial clinical presentation of TB in general, as well as DTB, can be misleading, resulting in delay in diagnosis and in initiating treatment.
Prevalence and risk factors of gastroesophageal reflux disease among adults attending primary healthcare in Bahrain
Authors: Alqassab Dhuha F. , Hasan Maryam J. , AlSaadoon Ayman M. , AlMuqahwi Aysha J. , AlAwadhi Farah A. , Bahram Samya A. , Alsayyad Adel S.
Published: December 2024

ABSTRACT

Background:

Gastroesophageal reflux disease (GERD) is one of the most diagnosed digestive disorders, with much-conducted research assessing its prevalence and risk factors associated with it worldwide. However, there are no published previous studies to determine such disease and its burden in Bahrain. Hence, this study aims to estimate the prevalence and evaluate the risk factors associated with GERD among adults attending primary care in Bahrain.

Material and Methodology:

A total of 385 adults aged 18 years and above participated in this descriptive cross-sectional study in the period from 1st to 27th of April 2023. The sample was collected randomly through an interview-based validated questionnaire from 10 health centers selected randomly. The questionnaire consisted of three sections: Demographic characteristics, risk factors that are associated with GERD and (GERD-Q) questionnaire with a scoring rate for the diagnosis of GERD, in which a score of 8 or more gives us the diagnosis of GERD.

Results:

A response rate of 93.6% was accomplished. Most of the participants were female (53.2%), Bahraini (88.6%), university-educated (50.9%) and married (71.2%). The mean age of the participants was 41.5 (SD = ±14.4 years). The prevalence of GERD was 41.5% which was statistically significant associated with family history of GERD, history of hypertension, sleeping within less than 1 hour after dinner, bariatric surgery and use of NSAIDs or Aspirin regularly (P < 0.05).

Conclusions:

The prevalence of GERD was 41.5%, which is higher than in the Middle East, East Asia and Western countries. Many modifiable risk factors where associate with it which deserves the conduction of national prevention programs and educational campaigns to prevent this disease and its complications. Further studies are needed to assess other risk factors and the effect of GERD on the overall health status and quality of life.
Comparative Study on Recovery and Post-Operative Analgesic Efficacy from Fentanyl- Versus Dexmedetomidine-Based Anesthesia in Head and Neck Cancer Surgery
Authors: Mohanty Liza , Kumar Ravi , Tugave Deepak , Agrawal Anagha , Patel Sejal , Tanwar Monika , Patil Lalit
Published: December 2024

ABSTRACT

Background:

Effective post-operative analgesia and swift recovery are critical for patients undergoing head and neck cancer surgery. This study compares the recovery profiles and analgesic efficacy of fentanyl-based anesthesia versus dexmedetomidine-based anesthesia in this patient population.

Materials and Methods:

A randomized controlled trial was conducted with 120 patients undergoing head and neck cancer surgery. The patients were divided into two groups: Group F (n = 60) received fentanyl-based anesthesia, while Group D (n = 60) received dexmedetomidine-based anesthesia. Recovery profiles were assessed using the Modified Aldrete Score, and post-operative pain was evaluated using the Visual Analog Scale (VAS) at 1, 6, 12, and 24 hours post-surgery. Secondary outcomes included total opioid consumption and the incidence of adverse effects.

Results:

Group D demonstrated a significantly faster recovery time, with 85% achieving a Modified Aldrete Score of ≥9 within 30 minutes post-surgery compared to 65% in Group F (P < 0.05). Post-operative VAS scores were significantly lower in Group D at all time points (P < 0.01), with mean scores of 2.5 ± 1.2 at 1 hour, 2.0 ± 1.0 at 6 hours, 1.5 ± 0.8 at 12 hours, and 1.0 ± 0.5 at 24 hours. Group F had mean scores of 4.0 ± 1.5, 3.5 ± 1.3, 3.0 ± 1.1, and 2.5 ± 0.9, respectively. Total opioid consumption was also lower in Group D (50 mg morphine equivalents) compared to Group F (75 mg morphine equivalents) (P < 0.05). Adverse effects were comparable between the groups.

Conclusion:

Dexmedetomidine-based anesthesia provides superior post-operative analgesia and faster recovery compared to fentanyl-based anesthesia in head and neck cancer surgery. It may be a preferred option for optimizing patient outcomes in this surgical population.
Comparative Analysis of Surface Roughness and Design Features of Titanium Dental Implants on Primary Stability and Osseointegration
Authors: Dhulipalla Ravindranath , Boyapati Ramanarayana , Katuri Kishore K. , Marella Yamuna , Adurty Chaitanya , Kolaparthy Lakshmikanth
Published: December 2024

ABSTRACT

Objective:

This study aimed to evaluate the impact of the surface roughness and design features of titanium dental implants on primary stability and osseointegration.

Methods:

Sixty titanium dental implants were categorized into three groups based on their surface roughness: smooth (Subgroup A1), moderately rough (Subgroup A2), and highly rough (Subgroup A3). Each roughness category was further divided into three design subgroups: cylindrical (B1), tapered (B2), and hybrid (B3). Primary stability was assessed using insertion torque and resonance frequency analysis (RFA). Osseointegration was evaluated through histological and histomorphometric analyses, measuring bone-to-implant contact (BIC) and bone area fraction occupancy (BAFO) at 4, 8, and 12 weeks post-implantation in rabbit models.

Results:

Highly rough-surface implants (Subgroup A3) demonstrated significantly higher insertion torque and ISQ values than smooth (Subgroup A1) and moderately rough (Subgroup A2) implants (P < 0.001). Among the design features, tapered implants (Subgroup B2) exhibited the highest insertion torque and ISQ values (P < 0.001). Histological and histomorphometric analyses revealed that highly rough-surface implants (Subgroup A3) and tapered implants (Subgroup B2) had the highest BIC and BAFO percentages at all time points (P < 0.001).

Conclusion:

These findings indicate that both surface roughness and implant design significantly influence primary stability and osseointegration.
Optimizing Assisted Reproductive Techniques: The Role of L-Carnitine, Acetyl-L-Carnitine, and IMSI in Managing High-Sperm DNA Fragmentation
Authors: Kamble Chitra , More Aakash , Dakre Sudhanshu
Published: December 2024

ABSTRACT

This case reports a couple with infertility due to male factor asthenozoospermia and increased sperm DNA fragmentation along with a slightly thin endometrial lining of the female partner. The male partner received 1 g/day of acetyl-L-carnitine and 2 g/day of L-carnitine for 3 months, following which sperm motility was improved, and DFI was reduced from 45% to 20%. Intracytoplasmic morphologically selected sperm injection (IMSI) was utilized during the in vitro fertilization (IVF) cycle to utilize sperms with optimal morphological characteristics for fertilization selectively. To improve endometrial receptivity, the female partner underwent estrogen and platelet-rich plasma (PRP) treatment and the endometrial thickness increased from 6.5 mm to 8 mm, improving endometrial receptivity. A frozen embryo transfer was then carried out after 1 month of the initial cycle. Two weeks after the transfer, a subsequent serum β-hCG level measured 302 mIU/mL, indicating a pregnancy. This case demonstrates the importance of the combined management of acetyl-L-carnitine and L-carnitine supplementation alongside IMSI and PRP in treating the complex etiology of both male and female infertility and leading to successful IVF pregnancy. The systematic approach to focus on aspects that included improving sperm quality as well as the endometrium was therefore important in yielding the result.
A randomized, double-blind, placebo controlled study to evaluate the effect of alpha-lipoic acid on inhibition of ADP-and collagen-induced platelet aggregation ex vivo in diabetic neuropathy patients on gabapentin or pregabalin
Authors: Pingali U , Sravanasandya P , Mekala P , Yareeda S , Sireesha K , Khan I
Published: December 2024

Background:

Diabetic peripheral neuropathy (DPN) is a chronic microvascular complication in diabetic mellitus patients due to chronic hyperglycemia, resulting in platelet hyperactivity and dyslipidemia. Alpha-lipoic acid (ALA) is a potent antioxidant which has antiplatelet activity and lipid-modulating characteristics and plays a major role in the prevention of disease progression.

Aim:

To evaluate the effect of ALA on inhibition of platelet aggregation and lipid profile.

Settings and Design:

This was a prospective, randomized, double-blind, placebo-controlled study conducted at the Department of Clinical Pharmacology and Therapeutics at a tertiary care hospital.

Materials and Methods:

We recorded efficacy parameters including changes in inhibition of platelet aggregation, lipid profile, blood sugars, and glycated hemoglobin over 12 weeks of ALA (600 mg once daily orally) supplementation in DPN patients on gabapentin (300 mg twice daily [BD]) or pregabalin (75 mg BD) compared to placebo. We used Student’s t-test paired and unpaired for within-group and between-group comparisons, respectively.

Results:

A total of 52 study participants (males = 22, females = 30) with a mean age 55.63 ± 7.5 years were randomized to receive either ALA or placebo. Between-group analysis at 12 weeks showed that ALA significantly inhibited both collagen-induced platelet aggregation (from 32.61 ± 8.00 to 24.88 ± 5.30; P < 0.001) and adenosine diphosphate-induced platelet aggregation (from 34.00 ± 6.97 to 25.96 ± 6.45; P < 0.001) compared to placebo. Significant reduction in total cholesterol, low-density lipoprotein cholesterol, very low-density lipoprotein cholesterol, and triglycerides was found in the ALA group at 12 weeks compared to baseline. No serious adverse events were reported.

Conclusion:

ALA, an antioxidant, demonstrated a protective effect against DPN by the virtue of its inhibitory effect on platelet aggregation and lipid-modulating effects and was found to have good safety.
Evaluation of Serum Kallistatin Levels in Women with Preeclampsia and its Role in Assessing Preeclampsia Severity
Authors: Mahdi Rangeen Badri , Al-Maini Esraa Hameed
Published: December 2024

Background:

Preeclampsia (PE) is a hypertension condition that often manifests after 20 weeks of gestation. It is regarded as a leading cause of death among mothers and babies globally.

Aim:

To evaluate how serum kallistatin affects PE severity.

Patients and Methods:

A case–control study that included three groups of 95 third trimester pregnant women with viable fetuses was chosen. Group M (32 mild PE), Group S (31 severe PE), and Group C (32 control pregnant normotensives). Serum kallistatin, complete blood count, liver, and renal functions were compared between groups, at An Al-Yarmouk Teaching Hospital Obstetrics and Gynecology.

Results:

The concentrations of serum kallistatin in severe PE were markedly lower than those in mild and normotensive pregnant women. (1.79, 3.24, and 4.55, P < 0.001). Kallistatin accurately predicted mild, severe, and normotensive PE. All healthy women’s parameters did not correlate with kallistatin. In PE, age, gestational age, and platelets correlated directly with kallistatin, but systolic and diastolic blood pressure, alanine transaminase, aspartate aminotransferase, and total serum bilirubin correlated inversely. Kallistatin had higher sensitivity than specificity and comparable negative to positive predictive values.

Conclusions:

Mother’s serum kallistatin is inversely related to PE severity and significantly lower in PE patients than normotensives. Kallistatin’s sensitivity and specificity for predicting PE in normotensive women were 93.7% and 68.8%, respectively, using a threshold value ≤3.92 ng/ml using a threshold value ≤2.136 ng/ml, 90.3%, and 93.8% predicted severe PE from mild PE, respectively.
Sofpironium bromide: A comprehensive review of its efficacy and safety in patients with primary axillary hyperhidrosis
Authors: Pathak Shiksha , Pandit Eshit , Patil Anant
Published: December 2024

Excessive perspiration as caused in axillary hyperhidrosis is a cause of great discomfort to affected patients as it causes social embarrassment, limitations to work and relationships, and an overall impaired quality of life. Keeping this in mind, recent studies have been conducted to better understand its etiopathogenesis, risk factors, symptoms, and possible treatment modalities. Primary axillary hyperhidrosis (PAH) is currently being treated using available topical and systemic pharmacotherapy, injectables, newer devices, and surgical measures. Sofpironium bromide is an anticholinergic agent. It has emerged as a promising treatment for PAH. It acts by binding to M3 receptors on sweat glands thereby decreasing sweating. Its efficacy and safety have been evaluated in clinical trials. This article aims to focus on characteristics of sofpironium bromide including mechanism of action, safety, and evidence of its efficacy and compare it with existing treatment modalities for PAH through a comprehensive literature using databases including PubMed and Google Scholar.