bluuebunny/crossref_metadata_2025 huggingface dataset:
A new species of velvet worm of the genus Oroperipatus (Onychophora, Peripatidae) from western Amazonia
Authors: Montalvo-Salazar Jorge L. , Bejarano M. Lorena , Valarezo Alfredo , Cisneros-Heredia Diego F.
Published: June 2024

The diversity of Neotropical velvet worms (Onychophora, Neopatida) is significantly underestimated, particularly within the Andean clade represented by the genus Oroperipatus, the last species of which was described more than 70 years ago. Here, we describe a new species of Oroperipatus from the Amazonian lowlands of Ecuador, bringing the total number of described species on mainland Ecuador to seven and in western Amazonia to three. The new species, Oroperipatus tiputinisp. nov., can be distinguished from its congenerics by the following combination of characters: two variations of primary papillae alternated between dorsal plicae; four scale ranks in the apical piece of primary papillae; reduced fifth spinous pad of legs IV and V; four supraocular papillae; occasionally reduced anterior papilla; males with two crural tubercles per leg in the first pregenital pair and a single crural tubercle per leg in the next pair; and some accessory papillae with one lateral rudimentary apical piece. We also discuss novel morphological similarities and differences with other Neopatida genera, as revealed by scanning electron microscopy (SEM).
PRÉAUT, une belle aventure
Authors: Saint-Georges Catherine
Published: June 2024

Ayant entendu parler de PRÉAUT dès mes années d’internat, j’ai par la suite rapidement rencontré plusieurs membres fondateurs de l’association, dont la pensée, le dynamisme et la créativité, aux confins de la clinique et de la recherche, m’ont stimulée, jusqu’à me trouver moi-même embarquée dans l’aventure et même diverses aventures, en tant que clinicienne et chercheuse…
Michael D. Watkins
Authors: Venne Jean-François
Published: June 2024

Michael D. Watkins est titulaire d’un doctorat en sciences de la décision de l’Université Harvard. Il enseigne actuellement le leadership et les changements organisationnels à l’International Institute for Management Development, en Suisse. Intitulé The First 90 Days , son célèbre ouvrage sur la transition des nouveaux gestionnaires a été traduit en 23 langues et vendu à plus de 1,5 million d’exemplaires.
PDG en terre étrangère
Authors: Auger Claudine
Published: June 2024

En octobre 2023, Andrea Marazzi a été nommé directeur de la stratégie commerciale, des opérations et des lancements de produits chez Novartis US. L’Italien d’origine a rejoint les rangs de l’entreprise pharmaceutique en 2001, gravissant les échelons en Europe et au Canada. Il partage ici sa réflexion sur la manière de réussir une expérience en terre étrangère.
Renouveler la confiance des femmes
Authors: Venne Jean-François
Published: June 2024

Les femmes accordent de moins en moins leur confiance aux employeurs au fur et à mesure que leur carrière progresse, et les mesures d’équité et d’inclusivité ratent souvent leur cible. Ce constat frappant émerge d’une récente étude américaine.
Prise de décision : quand le passé ressurgit
Authors: Fralich Russell , Ahmadsimab Alireza , Gril Emmanuelle
Published: June 2024

Les expériences que les personnes ont vécues en début de carrière auraient bel et bien une influence déterminante sur les décisions qu’elles prennent plus tard. Ce nouvel éclairage vient changer la donne, tant pour les gestionnaires eux-mêmes que pour leur organisation.
Pour une saine gestion des coûts
Authors: Laurin Claude , Réal Jacques , Brouillette Marie-Claude
Published: June 2024

Au cours des dernières années, plusieurs entreprises ont dû réagir rapidement face à l’accroissement de leurs coûts. La solution rapide ? Augmenter le prix de vente de leurs produits et services afin de transférer la facture à la clientèle. Mais est-ce réellement ce qu’il faut faire ?
New refinements of Becker-Stark inequality
Authors: Wang Suxia , Zhao Tiehong
Published: June 2024

This paper deals with the well-known Becker-Stark inequality. By using variable replacement from the viewpoint of hypergeometric functions, we provide a new and general refinement of Becker-Stark inequality. As a particular case, the double inequality

   \begin{document}$ \begin{equation*} \frac{\pi^2-(\pi^2-8)\sin^2x}{\pi^2-4x^2}<\frac{\tan x}{x}<\frac{\pi^2-(4-\pi^2/3)\sin^2x}{\pi^2-4x^2} \end{equation*} $\end{document}

for $ x\in(0, \pi/2) $ will be established. The importance of our result is not only to provide some refinements preserving the structure of Becker-Stark inequality but also that the method can be extended to the case of generalized trigonometric functions.
B Cells of Early-life Origin Defined by RAG2-based Lymphoid Cell Tracking under Native Hematopoietic Conditions
Authors: Fujisaki Keiko , Okazaki Shogo , Ogawa Shuhei , Takeda Miyama , Sugihara Eiji , Imai Kenichi , Mizuno Seiya , Takahashi Satoru , Goitsuka Ryo
Published: June 2024

During the perinatal period, the immune system sets the threshold to select either response or tolerance to environmental Ags, which leads to the potential to provide a lifetime of protection and health. B-1a B cells have been demonstrated to develop during this perinatal time window, showing a unique and restricted BCR repertoire, and these cells play a major role in natural Ab secretion and immune regulation. In the current study, we developed a highly efficient temporally controllable RAG2-based lymphoid lineage cell labeling and tracking system and applied this system to understand the biological properties and contribution of B-1a cells generated at distinct developmental periods to the adult B-1a compartments. This approach revealed that B-1a cells with a history of RAG2 expression during the embryonic and neonatal periods dominate the adult B-1a compartment, including those in the bone marrow (BM), peritoneal cavity, and spleen. Moreover, the BCR repertoire of B-1a cells with a history of RAG2 expression during the embryonic period was restricted, becoming gradually more diverse during the neonatal period, and then heterogeneous at the adult stage. Furthermore, more than half of plasmablasts/plasma cells in the adult BM had embryonic and neonatal RAG2 expression histories. Moreover, BCR analysis revealed a high relatedness between BM plasmablasts/plasma cells and B-1a cells derived from embryonic and neonatal periods, suggesting that these cell types have a common origin. Taken together, these findings define, under native hematopoietic conditions, the importance in adulthood of B-1a cells generated during the perinatal period.
Investigating the effect of levothyroxine replacement on cholesterol levels in hypothyroid patients
Authors: Moradi Leila , Zaman Ferdos , Tangestani Makieh , Amiri Fatemeh , Sedaghat Ali R.
Published: June 2024

ABSTRACT

Introduction:

Effects of levothyroxine therapy on the lipid profile of hypothyroid patients lead to decrease in the risk of cardiovascular diseases and mortality.

Objective:

Overt or subclinical hypothyroid dysfunction has negative effects on lipid metabolism and leads to hypercholesterolemia that in turn increases the risk of cardiovascular diseases and mortality. In this matter, several interventional studies investigated the effects of levothyroxine therapy on the lipid profile of hypothyroid patients, and conflicting results have been obtained. The current research aims to investigate the effect of levothyroxine replacement on cholesterol levels in hypothyroid patients.

Methods:

The present prospective study examined 112 patients (mean age of 43.80 ± 14.36 years) with overt hypothyroidism. To do so, 72.3% of patients were females. Levothyroxine replacement therapy was prescribed for patients, and they were examined monthly to evaluate the effects of therapy on their lipid profiles. After reaching normal thyroid stimulating hormone (TSH), the patients’ laboratory parameters, including TSH, total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and triglycerides, were surveyed.

Results:

After Levothyroxine therapy, there was a significant reduction in mean TSH (62.03 vs. 2.33 ± 1.95; P < 0.0001), triglycerides (145.57 ± 88.65 vs. 121.91 ± 59.52, P = 0.002), cholesterol (203.90 ± 53.73 vs. 166.65 ± 40.07, P < 0.0001), and serum LDL (123.61 ± 45.03 vs. 95.99 ± 24.20, P < 0.0001), but the mean value of serum HDL did not show any significant change (54.18 ± 16.60 vs. 51.59 ± 18.38, P = 0.274).

Conclusions:

Levothyroxine therapy has beneficial effects on lipid profile in patients with overt hypothyroidism because it decreases serum triglyceride, total cholesterol, and LDL. However, levothyroxine therapy does not significantly change HDL levels.
Characteristics associated with perceived level of confidence managing diabetes among United States adults with diabetes: A retrospective cross-sectional study
Authors: Cornelison Bernadette , Aqel Osama , Axon David R.
Published: June 2024

ABSTRACT

Objectives:

Identifying characteristics associated with patients’ confidence managing diabetes may aid the primary care provider in offering diabetes self-management education and support to patients. This analysis assessed the relationship between demographic, health, economic, access to care, satisfaction with care, and healthcare utilization characteristics with patients’ confidence managing diabetes.

Methods:

United States adults with diabetes in the 2020 Medical Expenditure Panel Survey were included in this retrospective cross-sectional analysis. Characteristics related statistically to patients’ confidence managing diabetes in multivariable logistic regression analysis were reported.

Results:

Among the 1,516 eligible individuals, 76.3% stated they were very confident/confident with their diabetes management. Adults who perceived their health positively (odds ratio 2.3, 95% confidence interval [CI] 1.3–3.9), completed ≥30 min moderate/vigorous exercise five times weekly (odds ratio 1.6, 95% CI 1.0–2.6), had at least one inpatient discharge in 2020 (odds ratio 3.5, 95% CI 1.5–8.1), said it was not difficult to telephone their usual provider (odds ratio 3.3, 95% CI 1.4–7.8), and had no emergency room visits in 2020 (odds ratio 2, 95% CI 1.1–3.3) had higher odds of stating they were very confident or confident with their diabetes management.

Conclusion:

The characteristics associated with being very confident/confident managing diabetes should be considered by primary healthcare physicians and other healthcare professionals when helping patients manage diabetes.
Role of plasma exchange in a post-partum case of severe thrombotic thrombocytopenic purpura with acute kidney injury
Authors: Bharti Jyoti , Chandra Tulika , Solanki Archana , Singh Ashutosh , Reddy D. Himanshu , Agarwal Mallika
Published: June 2024

ABSTRACT

Thrombotic thrombocytopenic purpura (TTP) is a life-threatening disease present with the classic pentad of microangiopathic hemolytic anemia (MAHA), fever, neurologic changes, thrombocytopenia, and renal dysfunction. In a diagnostic dilemma, therapeutic plasma exchange (TPE) is a choice of life-saving intervention. In this, we assess the efficacy of TPE in a suspected case of post-partum TTP. A 27 years old female was admitted in an emergency on day 8 after a lower segment cesarian section (LSCS) with unresponsive behavior for 3 days and with TTP. She was normal 32 days back with her second, 7-month pregnancy. Ultrasonography (USG) showed an umbilical cord around the neck of the baby. On the fifth post-operative day, she was shifted to emergency with fever, generalized anasarca, gastrointestinal tract (GI) bleeding, low platelet count, and low Hb, with a poor Glasgow coma scale (GCS) of 6. On the bases of serum urea and serum creatinine, she presented acute kidney injury with encephalopathy. At emergency, she was unresponsive to mechanical ventilation and supportive treatment; hence, therapeutic plasma exchange was performed. After eight TPE cycles, the patient presented with an improved hematological and renal profile with good GCS. TPE is helpful and life-saving for suspected TTP patients with AKI.
Assessment of mass drug administration for lymphatic filariasis elimination in the Armori and Chamorshi blocks of Gadchiroli District, Maharashtra: A cross-sectional study
Authors: Inkane Swapnil , Gill Naresh , Shaikh Kamran , Choudhari Sonali G. , Maroju Revathi G.
Published: June 2024

ABSTRACT

Context:

Medical colleges regularly examine mass drug administration (MDA) programs to determine their effectiveness and pinpoint areas for development. These analyses frequently show a discrepancy between the program’s coverage and actual drug use. This study was conducted in the Chamorshi and Armori blocks of the Gadchiroli District in Maharashtra.

Aim:

This study aimed to find out the coverage and compliance of MDA in the Chamorshi and Armori blocks of Gadchiroli, Maharashtra.

Settings and Design:

This study was a cross-sectional study.

Materials and Methods:

Thirty houses from each of the three randomly chosen villages and a ward were surveyed in each implementing unit. Thus, a total of 120 households’ worth of data were gathered and examined. Information was gathered from each individual in the chosen home at the individual level.

Statistical Analysis Used:

Data were collected and duly filled out on questionnaire forms, which were then entered in Microsoft (MS) Excel. Statistical Package for the Social Sciences (SPSS) version 16.0 (Chicago) was used as a statistical tool in the analysis.

Results:

Consumption rates in rural areas were much higher than in urban areas. A minimum consumption rate was found in the 2- to 5-year-old age range.

Conclusions:

In this study, the percentage of coverage and compliance rates was 89.5% and 99.4% and 90.81% and 99.2% for the Armori and Chamorshi blocks, respectively. In comparison, coverage was better in rural areas than in urban areas. The MDA program must therefore be significantly strengthened in urban areas, particularly by guaranteeing improved compliance through monitored drug consumption.
Current and future therapeutic approaches of CFTR and airway dysbiosis in an era of personalized medicine
Authors: Upadhyay Kirti , Nigam Nitu , Gupta Surbhi , Tripathi Surya Kant , Jain Amita , Puri Bipin
Published: June 2024

ABSTRACT

Cystic fibrosis (CF) is a life-threatening genetic disorder caused by mutations in the CFTR gene. This leads to a defective protein that impairs chloride transport, resulting in thick mucus buildup and chronic inflammation in the airways. The review discusses current and future therapeutic approaches for CFTR dysfunction and airway dysbiosis in the era of personalized medicine. Personalized medicine has revolutionized CF treatment with the advent of CFTR modulator therapies that target specific genetic mutations. These therapies have significantly improved patient outcomes, slowing disease progression, and enhancing quality of life. It also highlights the growing recognition of the airway microbiome’s role in CF pathogenesis and discusses strategies to modulate the microbiome to further improve patient outcomes. This review discusses various therapeutic approaches for cystic fibrosis (CFTR) mutations, including adenovirus gene treatments, nonviral vectors, CRISPR/cas9 methods, RNA replacement, antisense-oligonucleotide-mediated DNA-based therapies, and cell-based therapies. It also introduces airway dysbiosis with CF and how microbes influence the lungs. The review highlights the importance of understanding the cellular and molecular causes of CF and the development of personalized medicine to improve quality of life and health outcomes.
COVID-19 pandemic – Cocktail of variants, a study from Northern India
Authors: Chaudhary Preeti , Gulati Neelam , Gupta Varsha , Garg Rajni , Walia Sohini , Dhawan Isha , Thakur Bhuwaneshwar
Published: June 2024

ABSTRACT

Context:

The aim of the study was to identify and monitor the circulating strains of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the samples received at our center and update the existing national and international genomic surveillance data.

Introduction:

SARS-CoV-2 is no exception to the basic nature of the viruses ability to change and evolve. Since its first report in December 2019 from Wuhan, China, multiple variants of the virus have emerged and been reported. Five variants of concern have been recognized and reported by the Centers for Disease Control and Prevention, which are associated with variable degrees of transmissibility and mortality.

Materials and Methods:

Nasopharyngeal and oropharyngeal swabs received in viral transport medium at the Viral Research Diagnostic Laboratory were processed for reverse transcription-polymerase chain reaction for SARS-CoV-2. Whole genome sequencing (WGS) was performed for selective positive samples using Oxford Nanopore sequencing technology, using MinKNOW software for data acquisition.

Statistical Analysis:

The clades were assigned using Nextclade v2.4.1 software. The statistical analysis was calculated using OpenEpi version 3, an open-source calculator, and two by two.

Results:

Variants reported over the study period included Alpha, Kappa, Delta, and Omicron. Delta dominated in the year 2021, while Omicron was the dominant variant in 2022. In both the dominant variants, asymptomatics contributed to around 30–40% of positives. Intensive care unit admissions and mortality were higher in the Delta variant, while vaccination history and travel history were higher in the patients with Omicron variant.

Conclusion:

The trend tracking of these variants has been important in view of public health, enabling early interventions to control the spread of the disease and foresight in preparation for the situation.
Study of cognitive functions and their association with depression in type II diabetes mellitus
Authors: Jain Akhilesh , Sunder Shyam , Jain Nitesh , Yadav Neelam , Saini Ashok , Yadav Kuldeep S.
Published: June 2024

ABSTRACT

Introduction:

Individuals with diabetes have higher risk of developing depression, cognitive impairment, and dementia compared to those who do not have diabetes. The present study aims to assess the level of cognitive functions and the presence of depression in diabetes patients and healthy controls. The study also explores the level of cognition among the normal control, diabetes without depression, and diabetes with depression.

Methods:

In the present study, the presence of depression and the level of cognitive functions of 59 cases of diabetes mellitus type-2 were compared with an age- and gender-matched control group of 40 individuals. Clinical and demographic details were recorded on a semi-structured performa. Montreal Cognitive Assessment (MoCA) and Patient Health Questionnaire-9 (PHQ-9) were applied to both diabetes patients and healthy controls to assess the level of cognitive functions and the presence of depression, respectively.

Results:

On applying odds ratio (OR), it was observed in the present study that there were 93.50% more chances [OR 1.935 with 95% confidence interval (CI) being 0.481–7.789] of depression among diabetic cases as compared to the control group. Similarly, the chance of MoCA score being less than 26 was twice among the diabetic group as compared to the control group (OR 2.208 with 95% CI being 0.702–6.946). On application of the Chi-square test, the association of depression was significant with HBA1C level, level of education, and presence of complications.

Conclusions:

Patients with diabetes had almost double the risk of developing depression and poor cognitive functions as compared to the healthy control. High HbA1C level, level of education, and presence of complication in diabetes had a positive statistical association with depression. Thus, it is advisable to investigate patients with diabetes for the presence of depression and cognitive dysfunction by applying simple tools.
Methylene blue for hemolytic crisis in patients with met-hemoglobinemia secondary to hemoglobin volga: A case series
Authors: Capito Joseph C. , Skaff Brianna N. , Kinney Alexandra R. , Ashcraft Amie M.
Published: June 2024

ABSTRACT

There is a rare subset of patients with a genetically abnormal hemoglobin structure initially discovered in the Volga region of Europe known as Volga anemia. Key features of this condition include compromised delivery of oxygen to peripheral tissues and altered red blood cells that have a higher likelihood of being broken down or hemolyzed, which can lead to significant hemolytic anemia. Methylene blue is a dye that acts as a reducing agent of oxygen and is commonly used in toxic states that lead to methemoglobin build-up. This paper explores the pathophysiology of this genetic condition and documents three cases across two patients—a father and son—when methylene blue was used during an anemic crisis.
Prevalence of alpha-1 antitrypsin deficiency in patients with acute exacerbation of chronic obstructive pulmonary disease: Insights from a prospective study
Authors: Rayees AK , Chetambath Ravindran , Ibrahim Ramseena , Kumar Anoop
Published: June 2024

ABSTRACT

Background:

Alpha-1 antitrypsin (AAT) deficiency is a genetic risk factor for chronic obstructive pulmonary disease (COPD) but prevalence data in acutely exacerbated Indian patients is limited. This study determined AAT deficiency rates and correlations with inflammation and lung function among hospitalized patients with COPD.

Methods:

A total of 106 patients hospitalized for acute COPD exacerbations were prospectively enrolled from June 2016 to February 2018 in Kerala, India, excluding any with known AAT deficiency. Serum AAT levels were quantified and correlated with C-reactive protein (CRP) levels as well as postbronchodilator spirometry.

Results:

Mean serum AAT level was 1.48 ± 0.27 g/L. No AAT deficiency cases were identified, although AAT and CRP both significantly increased during flares. AAT levels positively correlated with FEV1, FVC, and FEV1/FVC ratios. Patients with lower AAT had worse pulmonary status.

Conclusion:

Despite finding no AAT deficiency in this regional Indian cohort, further studies across expanded, more diverse populations are warranted to definitively establish prevalence nationwide. Temporal monitoring of AAT kinetics could help gauge exacerbation trajectories.
C-reactive protein and thrombocytopenia as essential early indicators: Subtle approach to neonatal sepsis
Authors: Kotpal Ruchi , Jindal Sonal
Published: June 2024

ABSTRACT

Introduction:

Early diagnosis of neonatal sepsis is very essential part of newborn care to prevent mortality and decrease morbidity in newborns.

Aim:

The aim of this study is to correlate an increase in C-reactive protein (CRP) titre and a decrease in platelet count with an increased incidence of neonatal septicemia, for an effective subtle approach in neonatal septicemia.

Materials and Methods:

A retrospective study was conducted in the neonatal intensive care unit (NICU) of a tertiary care hospital from Jan 2022 to July 2023. Neonates admitted to the NICU with suspected sepsis were screened for sepsis. Screening was done by taking blood culture samples before administration of antibiotics, serum samples for CRP and blood samples for platelet count.

Result:

A total of 270 newborns with suspected sepsis were included in the study. Blood culture positivity was seen in 27.7 (27/75) cases. About 32.9% (89/270) of the neonates with suspected sepsis and 61.3% (46/75) neonates with confirmed sepsis had raised CRP; 32.2% (87/270) neonates with suspected sepsis and 64% (48/75) with confirmed sepsis had decreased platelet count. Both an increase in CRP and a decrease in platelets were seen in 61.3% (46/75) of confirmed cases.

Conclusion:

In our study, both raised CRP and decreased platelet count were seen in around 60% of confirmed cases of sepsis. So, CRP titre and platelet count can be used as early, rapid diagnostic markers for confirmed sepsis.
Exploring physicians’ expectations of telehealth services implementation in primary care: An application of the social cognitive theory
Authors: Qashqary Mohammed Esmail
Published: June 2024

ABSTRACT

Background:

Understanding healthcare professionals’ expectations in telehealth is crucial for successful implementation. The present study used an adaptation of the antecedents-expectations model, supported by the social cognitive theory to evaluate physicians’ expectations regarding the implementation of telehealth in primary healthcare (PHC) and to investigate the potential influence, on expectations, of a prior telehealth experience (antecedents) during the Coronavirus disease 2019 (COVID-19) pandemic.

Materials and Methods:

A questionnaire-based survey was conducted online, targeting PHC physicians. Expectations covered four telehealth performance domains including public health and health promotion, Care Quality and Workflow Organization, Patient’s Convenience and Engagement and Providers’ Value and Training. Antecedents included six domains including gain in self-efficacy, gain in knowledge, gain in participation/engagement, gain in experience, enjoyment and satisfaction. Stepwise linear regression was performed to analyse the effect of antecedents on overall expectations.

Results:

A total of 54 physicians participated in the study. The mean expectation score was 114.15/154 (SD = 28.26), with highest expectations concerning cost-effectiveness, care timeliness and patients’ convenience. A previous experience with smart apps and dedicated telehealth platforms was associated with lower expectations scores. Expectations scores were positively correlated with antecedents scores; however, satisfaction was the sole independent factor of overall expectations (regression coefficient B = 4.40, 95%CI: 3.11–5.68).

Conclusion:

The findings highlight the significance of previous experience and various antecedents in shaping physicians’ expectations about telehealth. These insights can inform the development of strategies and interventions to enhance healthcare professionals’ expectations and facilitate the successful implementation of telehealth services.
Adherence to weekly iron folic acid supplementation and associated factors among adolescent girls – A mixed-method study
Authors: Y. Nisha Maheswari , Kandasamy Sunitha , J. Ezhil Ramya , Subbiah Padmavathi , Davidson Prathiksha D. , Gopal Muthukrishnan , Velappan Lakshmi K. , Kalyanaraman Shantaraman
Published: June 2024

ABSTRACT

Context:

Despite the Weekly Iron folic acid supplementation (WIFS) program, the prevalence of anaemia among adolescent girls remains high. Phase 1 Indian Council of Medical Research (ICMR) task force study conducted in 2016 in Kallur showed that the IFA provision rate for adolescent girls was 72% but the consumption rate was only 15% in the Kallur area. The present study was done to identify the gaps for the difference between provision and consumption rate of weekly IFA tablets among adolescent girls using the WHO conceptual framework in home-based settings.

Materials and Methods:

This crosssectional study with a mixedmethod design was conducted from October 2020 to December 2021. Quantitative data were collected from 972 adolescent girls and their parents using a structured pretested questionnaire, whereas qualitative exploration was done by focus group discussions. Descriptive analysis and bivariate analysis were used to analyse the quantitative data. Qualitative data were analysed and integrated with quantitative results.

Results:

The overall number of girls who were aware of Iron Folic acid therapy (IFAT) was 704 (72%). However, only 132 (13%) adolescent girls were found to be adherent to IFA therapy. Multivariable regression analysis revealed that side effects encountered on intake of IFAT (Odds ratio (OR) =0.5, P = 0.009) were associated with higher rates of nonadherence, whereas regular supply (OR = 13.6, P = 0.000), health education to parents (OR = 2.76, P = 0.002), and experiencing benefits (OR = 1.72, P = 0.006) were associated with higher rates of adherence. These were substantiated by qualitative findings.

Conclusions:

Ignorance on the impact of anaemia on adolescent health, fear of side effects, unpleasant effects experienced on intake of Iron folic acid (IFA), and inadequate counselling determines the adherence to weekly IFA supplements among adolescent girls.
Assessing NESTROFT as a preliminary screening tool for thalassemia in the Malayali tribes of Dharmapuri district, Tamil Nadu, India
Authors: Pichamuthu Bala Ganesh , Arunachalam Kantha Deivi , Kosalram Kalpana
Published: June 2024

ABSTRACT

Background:

Mutations affecting transcription, translation, or beta-globin stability, among other stages of beta-globin production, cause beta-thalassemia.

Methods:

Beta-thalassemia results in a high red blood cell count with a low mean corpuscular volume (60–70fl) and mean corpuscular hemoglobin (19–23pg), and Naked Eye Single Tube Red Cell Osmotic Fragility Test (NESTROFT) is recommended for mass screening of populations. Among tribals in Dharmapuri district, this cross-sectional analysis evaluated the efficacy of RBC and NESTROFT against HPLC, regarded as the gold standard, in a study involving 484 subjects.

Results:

Findings indicated that out of the 484 samples, 73 tested positive for the beta-thalassemia trait through HPLC. The NESTROFT test demonstrated 87% sensitivity, 98.5% specificity, a positive predictive value of 99.3%, and a negative predictive value of 73.3%. In the multivariate analysis, NESTROFT and hemoglobin showed high significance with P values of 0.003 and 0.000, respectively.

Conclusion:

NESTROFT’s high sensitivity is particularly noteworthy due to the absence of research among the Malayali tribes in the Dharmapuri district. Adoption of this preliminary test shows promise in detecting the disease at the local level, providing important information for early detection, especially considering the sizeable tribal population.
Assessing satisfaction, quality of life, and HbA1c changes in type 1 diabetes patients who are using freestyle libre glucose monitoring
Authors: Alsahli Majed A. , Alalwan Abdulaziz , Aburisheh Khaled H. , Alarifi Faisal F. , Alshaya Hesham M. , Alkholaif Abdulrahman F. , Shadid Abdulrahman M. , Alsahli Saud A. , Alsahly Abdullaziz A. , Alkhalifah Mohammed K.
Published: June 2024

ABSTRACT

Introduction:

Type 1 diabetes mellitus (T1DM) is a chronic auto-immune disease in which loss of pancreatic islet β-cells leads to the deficiency of insulin in the body thus resulting in enhanced blood sugar levels. Effective blood glucose monitoring is crucial in T1DM management to prevent complications, particularly hypoglycemia.

Method:

The study adopted a cross-sectional survey to assess satisfaction and quality of life among T1DM patients using the freestyle libre continuous glucose monitoring (FSL-CGM), and a retrospective cohort study design to evaluate changes in HbA1c over a year.

Result:

The study involved 98 Saudi subjects, with 46.9% (n = 46) being male. The results indicated a high level of user satisfaction, with more than 85% of the participants responding positively, yielding a total satisfaction score of 30.86. User satisfaction with FSL-CGM was found to be significantly associated with the level of education. The use of FSL-CGM was also found to significantly improve the patients’ quality of life. However, the levels of HbA1c had an impact on both satisfaction and quality of life. Before using the FSL-CGM system, the mean HbA1c was 9.83%, which significantly decreased to 8.63% after using the system (P-value <0.001).

Conclusion:

The study’s findings align with previous literature on satisfaction and quality of life, but there are conflicting results regarding the reduction of HbA1c levels using FSL-CGM. Given the limited sample size, future research could explore the topic more comprehensively, potentially utilizing a longitudinal study design to better measure changes in HbA1c level.
Evaluation of trend and mortality pattern of communicable diseases in a teaching institution in Kerala
Authors: Rajina K. R. , Madhavikutty Geethadevi , Philip Sairu , Raj P. Jasna , Gireesh C. G.
Published: June 2024

ABSTRACT

Context:

Even in this era of epidemiologic transition communicable disease is still a major public health problem. Surveillance and timely prevention and control activities are the key to the reduction of morbidity and mortality of communicable diseases. Identifying the trend in communicable diseases and pattern of mortality for a period of ten years will be an insight into the ongoing surveillance.

Aim:

In this study we have analysed data from 2013 to 2022 to evaluate the trend and mortality pattern of communicable diseases in a teaching institution in Kerala.

Settings and Design:

A retrospective record-based cross-sectional study conducted at the Department of Community Medicine, Government Medical College, Kottayam.

Methods and Material:

All confirmed communicable disease cases reported from 2013 to 2022 were included in this study except COVID-19-positive cases. The communicable diseases were grouped as: airborne, waterborne, vector-borne, zoonosis, bloodborne diseases and others. SPSS version 20.0 software, Microsoft Word, and Excel were used in data handling and analysis.

Results:

Total cases reported were 48124. The majority of the morbidity was due to airborne diseases (17585,37%) followed by waterborne diseases (6381, 13%). The total number of deaths reported was 1842. Airborne and zoonotic diseases together accounted for more than 50% of the mortality. Case fatality rate of zoonosis (20.2%) was the highest followed by bloodborne diseases (10.2%).

Conclusions:

Communicable diseases still continue as a public health problem contributing to morbidity and mortality. Airborne diseases and zoonotic diseases constitute the maximum mortality.
Maternal isoimmunization associated fetal anemia: A case report
Authors: Jiandani Farah , Bhalerao Anuja , Somalwar Savita , Chindhalore Prajakta , Jaiswal Yashika
Published: June 2024

ABSTRACT

Maternal isoimmunization occurs when a pregnant woman develops an immune reaction due to the inheritance of a red-cell antigen, which is paternally derived and can result in fetal anemia, hemolysis, fetal death, and hydrops fetalis as the antibodies might travel through the placenta and get adhered to the antigens present in the erythrocytes of the fetus. This report highlights a rare case of Rh isoimmunization leading to fetal anemia in a 26-year-old female and evaluates the impact of intrauterine transfusion (IUT) in terms of the gestational age at delivery along with the mode of delivery, procedural complications, and overall survival rate of the fetus. In conclusion, the most frequent cause of fetal anemia is Rh alloimmunization, which should be taken into consideration while making a differential diagnosis throughout the assessment. Improvements in IUT procedures and earlier detection of the MCA-PSV by Doppler ultrasonographic examination have also contributed to better results.
Gait analysis and geriatric syndromes: An association among elderly patients attending a teaching hospital of Delhi
Authors: Maity Suman , Das Himadri , Chakrawarty Avinash , Devanbu Vinoth Gnana Chellaiyan
Published: June 2024

ABSTRACT

Background:

Gait abnormalities are prevalent, affecting a substantial portion of the elderly population, and leading to mobility limitations, reduced quality of life, falls, hospitalizations, and premature death.

Objectives:

The study aims to assess gait patterns among individuals aged 75 years and above attending the geriatric OPD of a tertiary care hospital in New Delhi and evaluate their association with various geriatric syndromes.

Materials and Methods:

This cross-sectional study, conducted at a tertiary care hospital in Delhi, from May 2019 to November 2021, involved 100 participants aged 75 and above. It encompassed a thorough assessment protocol covering demographics, health history, clinical and functional evaluations, depression, cognition, balance, frailty, urinary incontinence, polypharmacy, nutrition, comorbidities, and gait analysis.

Results:

In this study of elderly individuals, the mean age was 78.56 years, and the mean BMI was 23.11. The participants had an average of 1.74 comorbidities, with hypertension being the most prevalent (62%), followed by diabetes (25%), chronic obstructive airway disease (COAD) (11%), and coronary artery disease (15%). Geriatric assessments revealed varying proportions of frailty (34%), polypharmacy (40%), and urinary incontinence (9%). The mean scores for activities of daily living, instrumental activities of daily living, nutritional status, cognitive function, Timed Up and Go Test, and depression scale were also reported. Various gait parameters demonstrated significant correlations with these geriatric factors, including frailty, comorbidities, BMI, and mobility scores.

Conclusion:

The study identified significant associations between gait patterns and various geriatric syndromes, emphasizing the importance of gait analysis in assessing the health and mobility of elderly individuals.
Nurture clinic: Promoting mental health of children and adolescents
Authors: Govindan Radhakrishnan , Rajeswari Bingi , Kommu John Vijay Sagar
Published: June 2024

ABSTRACT

Background:

Nurses play an important role in multidisciplinary teams while treating children and adolescents with mental health issues. Nurses should recognize and capitalize on the client’s and family’s strengths as they develop interventions, provide education, and refer to resources as appropriate.

Materials and Methods:

It is a mixed-method research, with an initial qualitative phase of obtaining data by in-depth interviews of parents on caring for children and adolescents with mental illness followed by quantitative assessment of the level of care dependency and implementation of need-based nursing interventions to the children and adolescents with mental illness.

Results:

A total of 235 boys and 123 girls received the interventions. The majority of them (51.4%) were boys aged between 6 and 12 years and the highest diagnosis was attention deficit and hyperactivity disorder (ADHD) (34%). The need-based interventions required were nutrition (90%), prevention of injury and infection (83%), and positive and productive engagement (80%). Other interventions included self-care, physical activity, and medication.

Conclusion:

Need-based nursing interventions help in promoting the mental health of children and adolescents. This approach may be extended to primary care facilities and community mental healthcare by nurses.
Hypophosphatemic osteomalacia due to cadmium toxicity in silverware industry: A curious case of aches and pains
Authors: Roy Ayan , Saha Taurja , Sahoo Jayaprakash , Das Abanti
Published: June 2024

ABSTRACT

Hypophosphatemic osteomalacia in an adult often gives clinical diagnostic challenges. Usually, they are caused by either tumor-induced osteomalacia or due to genetically mediated hypophosphatemia, particularly X-linked hypophosphatemia. However, heavy metal toxicity, leading to global proximal renal tubular dysfunction, is a rare cause, and in particular, cadmium toxicity is rarely encountered in clinical practice. The presence of bony pain and neurological deficit, along with a classical exposure history, provides the diagnostic clue. In this background, here we present a middle-aged man who had severe bony pains all over his body and lower back stiffness for five years. He underwent an initial workup as a suspected spondyloarthropathy but was later on, found to have hypophosphatemic osteomalacia and severe proximal renal tubular dysfunction. Further, the workup revealed elevated FGF-23. His occupational history revealed prolonged exposure to cadmium fumes in the silverware industry. He improved moderately with treatment; however, significant renal damage is still present. This case highlights the importance of considering cadmium toxicity in proper clinical and occupational contexts in the evaluation of hypophosphatemic osteomalacia in an adult.
Ten-year risk of cardiovascular events among the adult population of West Tripura District of India by the Framingham risk score: A cross-sectional study
Authors: Paul Ashit Kumar , Das Dilip Kumar , Bhattacharjya Himadri , Paul Dhruba Prasad , Kundu Bhargabi
Published: June 2024

ABSTRACT

Background:

Cardiovascular diseases (CVDs) are the leading causes of mortality worldwide. Predicting the 10-year risk of cardiovascular events (CVEs) may save lives through timely intervention. Framingham risk scoring (FRS) can effectively predict this risk.

Objectives:

This study aimed to estimate the 10-year risk of CVE using FRS and to estimate the prevalence of CVD risk factors and their associations with FRS among adults in the West Tripura District of India.

Methodology:

This community-based cross-sectional study was conducted from 1 November 2019 to 30 November 2021 in the West Tripura District of India, using FRS 2008 and a pretested interview schedule among 290 individuals aged ≥ 30 years chosen by multistage sampling.

Result:

The majority, that is 61.7%, of the study subjects had low risk, 18.6% had intermediate risk and 19.7% had high risk of CVE within 10 years. The prevalence of hypertension was 55.6%; diabetes mellitus, 55.9%; smoking, 96.2%; dyslipidaemia, 34.3%; alcohol consumption, 96.2%; physical inactivity, 54%; and obesity, 64.6%. The bivariate analysis detected a significant association of FRS with age, sex, residence, literacy, marital status, obesity, smoking, alcoholism, blood pressure (BP), high-density lipoprotein cholesterol (HDL-C) and glycaemic status of the study subjects. The logistic regression analysis has identified age >50 years, male sex, hypertension, smoking and diabetes mellitus as significant determinants of high FRS.

Conclusion:

Adults living in the West Tripura District of India have a high prevalence of CVD risk factors. About one-fifth of this population has a high risk of CVE in 10 years. Controlling hypertension, smoking and diabetes mellitus may help reduce this risk.
Non-vitamin K oral antagonist (NOAC) compared to vitamin K antagonist (VKA) in left ventricular thrombus
Authors: Al-Kaf Fahmi , Al Basiri Saleh , Al Ash’hab Yasser , Otain Mohammad , Al Askary Hafed , Al Khushail Abdullah , Robert Asirvatham Alwin , Al Fagih Ahmed
Published: June 2024

ABSTRACT

Background:

Thromboembolic events are serious left ventricular thrombus (LVT) complications. Despite the limitations of vitamin K antagonist (VKA) drugs, it continues to be the recommended oral anticoagulation for LVT. Recently, nonvitamin K oral antagonist (NOAC) has gained popularity as an off-labeled treatment for systemic embolism prevention in LVT.

Objective:

In this study, we aim to compare the outcomes (stroke and bleeding) of warfarin versus NOAC therapy in patients with LVT.

Methods:

This retrospective cohort study compares NOAC and VKA therapy in LVT patients. We enrolled 201 patients with an echocardiography-confirmed LVT from January 2018 to December 2022. Patients who received NOAC therapy (NOAC, n = 77) were compared to VKA patients (VKA, n = 124). The primary endpoint was a composite of stroke, minor and major bleeding.

Results:

The median follow-up time was 17 months (25th–75th percentiles: 8–38). On unmatched analysis, both groups had no difference in major bleeding (log-rank, P = 0.61) and stroke (log-rank, P = 0.77). However, all bleeding events were higher with NOAC (log-rank, P = 0.01). On matched analysis, there was no difference between both groups in the overall bleeding events (P = 0.08), major bleeding (P = 0.57), and stroke (P = 0.66). Minor bleeding was significantly lower in the VKA group (P = 0.04).

Conclusion:

In patients with LVT, NOAC was as effective as VKA in stroke prevention without increasing the risk of major bleeding.
Drug susceptibility testing and line probe assay of first-line anti-tuberculosis drugs among presumptive tuberculosis patients attending a secondary care hospital in Bhubaneswar
Authors: Singh Khusbu , Barik Braja S. , Das Shritam , Hussain Tahziba , Gupta Bhawna , Das Dasarathi , Pati Sanghamitra
Published: June 2024

ABSTRACT

Background:

Pyrazinamide (PZA) is important for identification in multi-drug-resistant tuberculosis patients before starting therapy. PZA drug susceptibility testing (DST) is essential for the management of drug-resistant and susceptible TB patients.

Aims:

The degree of drug resistance among TB patients and discrepancy between DST results of the phenotype and genotype were assessed.

Materials and Methods:

Socio-demographic and clinical profiles of TB patients recruited in the study were documented. Sputum samples were processed for diagnosis using TrueNat Xpert MTB, TrueNat Xpert MTB Plus, and MGIT culture.

Results:

Rifampicin (RIF) line probe assay (LPA) showed the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 100%, whereas isoniazid (INH) LPA testing showed a sensitivity of 85.7%, a specificity and PPV of 100%, and NPV of 94.8%. The gene mutation for RIF resistance was between the codon, 530–533 of rpoB gene, and that for INH resistance was at the codon, 315 of katG gene.

Conclusion:

Our findings demonstrated high prevalence of mono- and poly-drug resistance as well as pyrazinamide resistance.
A critical evaluation of contents, labeling, and cost of hand sanitizers marketed in India during COVID-19 pandemic
Authors: Piparva Kiran G. , Dutta Siddhartha , Singhal Shubha , Shah Rima
Published: June 2024

ABSTRACT

Background:

Antiseptics were introduced a long time ago, but their significance was noteworthy during the COVID-19 pandemic. Hand sanitizer plays a pivotal role as a preventive measure. Multiple national authorities have advocated for the application of Alcohol-Based Hand Sanitizers (ABHS). During the pandemic, a surge in demand and limited supply prompted numerous manufacturers to ramp up production. Consequently, it is imperative to scrutinize the composition, labeling, and price of hand sanitizers.

Aims and Objective:

To assess the contents, labeling, and price of hand sanitizers available in the Indian market.

Methodology:

Hand sanitizers, both online and offline, marketed in India between May 2019 and May 2022 were included. Hand sanitizers by local manufacturers without labeling were excluded. Contents and labeling of hand sanitizers were evaluated as per World Health Organization (WHO) recommendations. Price was assessed as a percentage cost variation.

Result:

Out of 79, the majority (98.73%) were ABHS, and 28.20% of them met the recommended criteria for “Adequate” alcohol concentration. Ethyl alcohol emerged as the most prevalent (69.23%), often accompanied by emollients, humectants, fragrances, and color additives. Notably, 69.62% of the hand sanitizers featured comprehensive labeling, while incomplete labels lacked essential details under “Warning and Cautions.” The average price of hand sanitizers was Rs 505.11 ± 255.36.

Conclusion:

Choosing ABHS with appropriate alcohol concentrations in line with recommendations is crucial. To ensure the proper and safe use of hand sanitizers, individuals should follow the instructions provided on the product labels; both manufacturers and regulators are responsible for adhering to standards for hand sanitizers made available to the public.
Rotating solutions to the incompressible Euler–Poisson equation with external particle
Authors: Alonso-Orán Diego , Kepka Bernhard , L. Velázquez Juan J.
Published: June 2024

We consider a two-dimensional, incompressible fluid body, together with self-induced interactions. The body is perturbed by an external particle with small mass. The whole configuration rotates uniformly around the common center of mass. We construct solutions, which are stationary in a rotating coordinate system, using perturbative methods. In addition, we consider a large class of internal motions of the fluid. The angular velocity is related to the position of the external particle and is chosen to satisfy a non-resonance condition.