bluuebunny/crossref_metadata_2025_split huggingface dataset:
Oral versus intravenous maternal hydration in isolated third trimester oligohydramnios
Authors: Zafar Humaira , Naz Mubashra , Fatima Umber , Shahzad Uzma , Fatima Anees , Yasmeen Attiya 
Published: September 2020

Background: To study the effect of oral and intravenous maternal hydration in patients with isolated oligohydramnios in terms of mean change in amniotic fluid.Methods: A total number of 38 patients included in the study which fulfill the selection criteria. Patients were randomly divided in two groups. Amniotic fluid index (AFI) of all patients was measured before the hydration therapy according to the method of Phelan et al. In maternal oral hydration (Group A), every patient was instructed to drink two liters of water over two hours daily for 1 week. In intravenous hydration (Group B), every woman infused two liters of 0.9% normal saline in two hour daily for 1 week. After 48 hours and 1 week of oral and intravenous hydration, the AFI was reassessed by the same observer. Patients were monitored closely for sign and symptoms of fluid overload. Data was stratified for mean difference in improvement in amniotic fluid index.Results: After oral hydration therapy AFI was 5.926±0.4593 after 48 hours and 8.286±0.6000 after 7 days in Group A. In Group B AFI was 5.784±0.4622 after 48 hours and 7.868±0.2810 after 7 days of intravenous hydration. P value after 48 hours is 0.348 and p=0.014 after 7 days means oral hydration therapy significantly increase amniotic fluid index.Conclusions: Oral maternal hydration significantly increase the amniotic fluid index in patients with isolated oligohydramnios. It is simple, safe and non-invasive method.
A case control study of serum vitamin D levels in alopecia areata
Authors: Naidu Bobbili Tarun Kesava , Baddireddy Kavya 
Published: September 2020

Background: Alopecia areata is an autoimmune disorder of anagen hair follicle leading to distressing and relapsing non-scarring hair loss. Vitamin D is an immunomodulator and plays a role in regulating normal hair cycle. Recent evidence suggests inconsistent association between vitamin D deficiency and alopecia areata.Methods: This case control study included 70 newly diagnosed cases of alopecia areata and 70 healthy controls. Competitive chemiluminescence immunoassay was used to determine and compare the serum vitamin D (25‑hydroxyvitamin D) levels between these groups. Also, the serum vitamin D levels correlation with severity of the disease was studied. ANOVA test and student t test were used for the statistical analysis.Results: Serum Vitamin D levels were significantly decreased in alopecia areata patients than in controls (p<0.05). There was no stastically significant relationship between serum 25-OH Vitamin D levels and severity of the disease (p=0.06).Conclusions: Prevalence of serum 25 (OH) deficiency was significantly higher in alopecia areata group. However no significant relation was found with disease severity.
Evaluating substance use in an urbanizing town of mid hills of Northern India
Authors: Singh Ajay K , Verma Kushel , Guleria Amit , Puri Shalini , Sharma Ankit , Sharma Vaishali 
Published: September 2020

Background: Substance use is emerging as a major cause of morbidity and mortality across the world. Solan, a fast urbanizing town of India has witnessed mushrooming of industries and educational institutes. A surge in the persons booked under the Narcotic Drug and Psychoactive Substance Act 1985 led us to look into the determinants of the substance use in this region.Methods: We undertook a cross sectional study of one year secondary data analysis of 750 substance users screened at the de-addiction centre of Solan Hospital. The data mining was done by the cluster analysis technique. SPSS 16 and STATA 13 software were employed.Results: Mean age of users was 31 years with dominance of males (89.20 %), two third of total users were married, 75% were unemployed, 42% had upper school level education. About 60 and 38% were using cannabis and chitta (a synthetic opioid) respectively. Only 2% were consuming tobacco and alcohol. 62% of substance users had the fear of legal action and 44% had no family history of substance use. 39% had only single parent, 54% had started substance use under peer pressure and duration of use varied between 6 to 24 months. Alcohol and cannabis were used more in urban and rural areas respectively. 63 and 70% had family history and experience of peer pressure respectively.Conclusions: Cluster analysis has generated substance specific socio-demographic determinants of substance use which would help in planning appropriate substance use alleviation strategies.
Association of ocular biometric parameters with diabetic retinopathy
Authors: Utaal Shubhneek Kaur Dhillon , Chopra Rupali , Batra Nitin 
Published: September 2020

Background: To study the association of ocular biometric parameters {Spherical equivalent (SE), Axial length (AL), Anterior chamber depth (ACD) and Corneal curvature (CC)} with diabetic retinopathy (DR) in subjects with Type 2 diabetes mellitus (DM).Methods: This prospective observational study was conducted in the Outpatient Department of Ophthalmology of a tertiary care teaching hospital in North India. The study included 100 subjects having various grades of DR as cases and 100 diabetics without DR as controls. The SE was assessed using objective autorefraction, while AL, CC and ACD were measured using the NIDEK AL SCAN. International Clinical Diabetic Retinopathy Disease Severity Scale was used for grading of DR.Results: A total of 181 eyes in the study group and 200 eyes in the control group were analysed. Progressive decrease in the mean AL was observed with the increasing severity of DR (p=0.017). Deeper ACD had a negative correlation with severity of DR (p=0.037). No statistically significant difference was observed for AL and ACD with the incidence of DR (p=0.147 and p=0.091 respectively). Likewise, there was no significant relation of DR with SE or CC.Conclusions: Longer AL and deep ACD were protective against progression to the severe forms of DR. However, there was no correlation of AL and ACD with the incidence of DR. The SE and CC were not found to be significant determinants for either development or severity of DR.
Study the role of hepcidin in diagnosis of iron deficiency anemia in young females of northern India
Authors: . Shaveta , Bansal Sanjiv Kumar , Patel Seema 
Published: September 2020

Background: Iron deficiency is one of the most common nutritional disorder. Maintenance of body iron status is an integral part of healthcare in young female of reproductive age group. Thereby early detection could lead to early intervention and reduce its comorbidity. Indeed, an ideal screening test should be capable of identifying iron deficiency long before developing anemia. Henceforth, the present study was aimed to determine utility of serum hepcidin in iron deficiency and to access the baseline value of hepcidin in young female.Methods: This sectional study was conducted in the Department of biochemistry SGT Medical College Hospital and Research Institute, Budhera, Gurugram. It included non-pregnant female students of age 18-25 years with normal RBC indices and hemoglobin >12 gm%. Estimation of serum hepcidin-25 was by ELISA.Results: The reference range of hepcidin established in this study was 12.14-139.89 ng/ml for females with the mean being 42.4±29.13 ng/ml. It showed higher discriminating power in evaluating iron status in young healthy women (AUC 0.984) with best combination of diagnostic sensitivity (95.7%) and specificity (93.2%) at a cut off of >15.7 ng/ml. Serum hepcidin identified 17% of young healthy females with normal hemoglobin to have functional or storage iron deficiency.Conclusions: The prevention of iron deficiency anemia remains insufficient worldwide especially among underprivileged women and children Therefore, estimation of serum hepcidin may be considered as a valuable tool in assessing iron status in young healthy female population who are the prime target group for iron supplements to reduce comorbidity associated with iron deficiency and anemia.
Imaging spectrum of renal masses on multi-slice computed tomography
Authors: Thakor Dipak R. , Rana Yashpal R. , Sheth Megha M. 
Published: September 2020

Background: Multi-slice computed tomography (MSCT) is the mainstay for preoperative assessment of many complex renal masses in current clinical practice. Benign renal processes may simulate malignant renal tumors and could be defined correctly by CT. MSCT has also an important role in tumor staging. The purpose of this article is to understand the imaging spectrum of renal masses on MSCT and assess the usefulness of CT in surgical planning and management.Methods: Studied 500 patients with suspected renal lesions who underwent MSCT during the period July 2017 to July 2020 at state-of-art imaging center. CT imaging was done in those patients in whom clinical examination and ultrasonography (USG) revealed possibility of diagnosis of renal masses for further detailed evaluation and deciding management.Results: Out of 500 total subjects, the common age group in this study is 51 to 60 years (25%). Male preponderance (59%) was noted. The most common presentation was pain (84%) followed by lump (29.4%) and haematuria (17.8%). Malignant masses (51%) were more common followed by benign (39%) and inflammatory masses (10%) respectively. Renal cell carcinoma has more incidence (30%) followed by simple cyst (20%). Calcification (19.6%), perinephric extension (78%) and vascular invasion (21.5%) are more common in malignant masses. Conclusion: MSCT is the modality of choice for the diagnosis of renal masses and deciding management approach in current practice. Detection of tumoral spread, invasion of surrounding organs and vascular structure are better with CT. MSCT also has a role in postoperative follow-up of renal masses.
Metabolic syndrome in south Indian population with skin tags: a hospital-based case control study
Authors: Naidu Bobbili Tarun Kesava , Baddireddy Kavya 
Published: September 2020

Background: Metabolic syndrome is a constellation of several clinical and laboratory cardiovascular risk factors that have been linked with numerous medical and dermatologic conditions. Recent evidence suggests a strong association between skin tags and insulin resistance and obesity, yet there is a paucity of data on relation of skin tags with metabolic syndrome as a whole. Aim of the study was to evaluate the strength of association between skin tags and metabolic syndrome.Methods: 70 patients with skin tags and an equal number of age and gender matched controls were enrolled in a hospital-based case control study. Anthropometric measures, blood pressure, fasting glucose, high density lipoprotein cholesterol and triglycerides were measured. Metabolic syndrome was diagnosed by the presence of 3 or more of the south Asian modified national cholesterol education program’s adult panel III criteria. Statistical analysis was performed using chi square test, and odds ratio was calculated. P≤0.05 were considered significant.Results: Metabolic syndrome was significantly more common in patients with skin tags than in controls (70% vs. 26%, p<0.001). Triglycerides and waist circumference values were significantly increased in cases as compared to controls (p<0.05). There was no statistically significant difference in the high-density lipoprotein levels, fasting blood glucose levels and presence of hypertension among cases and controls.Conclusion: Skin tags when present in multiple could be an early warning sign for Metabolic syndrome. They serve a cutaneous marker to initiate early detection and intervention of at-risk patients for cardiovascular disorders.
Screening beyond conventional serological markers for hepatitis B and C viruses in cirrhosis: an entity overlooked
Authors: . Manjri , Katyal Virender , Yadav Deepak , Goyal Sandeep 
Published: September 2020

We aimed to emphasise the role of screening beyond conventional serological markers (HBsAg and Anti HCV antibodies for chronic viral hepatitis B and C respectively) in patients with cirrhosis. Patients with cirrhosis of liver are often labelled as having cryptogenic cirrhosis (CC), if no etiology is found. In chronic viral hepatitis B and C (CHB and CHC) induced cirrhosis, HBsAg and Anti HCV antibodies respectively are usually done to rule out the viral infections however their absence have been documented in subset of patients having these infections. In this regard, we hereby present a case labelled as CC and developed HCC; later on, further evaluation turned out to be having both CHB and CHC. A 51-year-old male with diabetes presented with index episode of hemetemesis. On further evaluation he was diagnosed to have cirrhosis of liver. No etiology was found and he was labeled as cirrhosis secondary to Non-alcoholic steatohepatitis (NASH)/cryptogenic cirrhosis. Later on, he developed hepatocellular carcinoma (HCC). We evaluated the patient with HBV DNA and HCV RNA levels keeping possibility of occult hepatitis B (OBI)/ seronegative hepatitis C infection despite HBsAg and Anti HCV antibodies being negative. Both levels were found to be raised and we attributed cirrhosis to dual hit by CHB and CHC. Patient was managed with antiviral drugs successfully with no recurrence of HCC and control of blood sugar levels. We hereby stress that screening beyond the HBsAg and Anti HCV antibodies should be done in all cases of liver cirrhosis in which etiology is not found on initial screening.
A case report: remdesivir effective in the treatment of severe category COVID-19
Authors: Pandya Hetal , Jain Archit , Reddy Pradeep , Shah Aarsh 
Published: September 2020

Since the first cases were reported in December 2019, infection with the severe acute respiratory corona virus 2 (SARS-CoV-2) has become a worldwide pandemic. COVID-19 the illness caused by SARS-CoV-2 is overwhelming health care systems globally. In the absence of a proven effective therapy, current management consists of supportive care, including invasive and noninvasive oxygen support and off-label or compassionate-use therapies, including anti-retrovirals, anti-parasitic agents, anti-inflammatory compounds, and convalescent plasma. Amongst these experimental therapies, remdesivir a broad-spectrum antiviral drug has shown some promising results. We present a successfully treated patient of severe acute respiratory illness by SARS-CoV-2 with remdesivir along with standard management protocol. Reporting a case with aim to add favoring evidence for remdesivir in the treatment of SARS-CoV-2.
Metformin and nitrosamine impurities
Authors: P. V. Ajith Kumar , M. Deepa 
Published: September 2020

Metformin is considered as gold standard anti-diabetic drug and is the preferred initial pharmacologic agent for most of the patients with type 2 diabetes mellitus. Metformin is cheap, widely available and safe, backed by pharmaco-epidemiological evidence of more than 60 years regular use in clinical practice. Due to its durable efficacy, once initiated, metformin will be continued as long as it is tolerated and not contraindicated. It has got additional benefits on cholesterol, liver, cardio vascular system and cancer. Recent evidence and recall of metformin extended release formulation due to detection of excess amount of cancer-causing nitrosamine impurities has created concern among health care providers and patients. Adherence to regulatory guidelines and use of approved technologies in manufacturing and quality control may help in solving the issue.
Awareness and utilization of health insurance among patients of a tertiary care centre in South India
Authors: Luke Swetha , Vincent Jose 
Published: September 2020

Background: While health insurance may seem like just another form to fill, it has proven to be a literal life saver in case of medical catastrophes, saving those subscribed from possible health expense induced poverty. The objective of this study is to assess the proportion of patients aware of the provision of health insurance and have subscribed to them.Methods: Cross sectional study conducted in a tertiary care center based in South India during the period July 2019 to September 2019. Convenience sampling with a sample size of 58was used. Data collected with the help of an interviewer administered semi-structured questionnaire.Results: Awareness of the provision of health insurance was found to be as high as 89.7%. But only 51.7% were found to be subscribed to a health insurance plan. Of which 70% had joined a Government insurance scheme and 30% had a private health insurance.Conclusions: While a basic level of awareness is present, that itself does not lead to subscription to an insurance plan. The public should be exposed to the newer, more affordable government led plans which best suit their financial situations.
Knowledge and attitude of rural community towards the respiratory diseases
Authors: B. P. Satish Kumar , Zuber Mohammed , Johns Anwitha , V. Vinod Kumar 
Published: September 2020

Background: Respiratory diseases are considered as one of the major public health problems in developing countries like India. Among all illness in adults, heart, cancer, diabetes and chronic lung diseases are the major cause of mortality and morbidity in India. Since majority of the Indian population resides in rural areas, assessment of knowledge and attitude in that region regarding respiratory diseases are essential.Methods: A descriptive study was conducted using restructured and pretested questionnaire to assess the knowledge and attitude of the rural people. Descriptive statistics were used to represent the study characteristics. Chi-square test was used to assess the association among the study variables with p-value of <0.05 which was statistically significant.Results: Total 467 participants enrolled in the study out of which 39.4% were male and 60.6% were female. The mean age of the participants was 44.7±16.1 years, where majority of participants belongs to the age group 38-47 years. Overall the knowledge of the participants was found to be poor 6%, average 49.5% and good (44.5%). Statistically significant association between the literacy level and the knowledge on respiratory diseases was found.Conclusions: Although knowledge and attitude of the people towards the respiratory diseases are encouraging, there is a need for long term educational program. The findings of this study can guide the public health authorities in making and implementing decisions to reduce the health problems related to respiratory diseases.
Serosurveys for SARS-CoV-2: need of the hour
Authors: Madan Siddharth , Yadav Nisha , Sethi Maansi , Rana Gunjan , Sharma Akshi , Bajpai Vidhi 
Published: September 2020

This letter is regarding tackling the highly infectious coronavirus disease (COVID-19).Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread across the globe, causing a worldwide pandemic. The total number of cases across the globe is about 11.6 million with over 5 lakh deaths. The number of individuals detected is always less than the actual number of infected, in nearly all respiratory viral pandemics. Rapid Point-of-Care Antigen detection test can detect SARS-CoV-2 early in the field setting. It has moderate sensitivity and high specificity yet limited availability. This test can be employed in the hospitals and containment zones and would aid in contact tracing, isolation of the affected individuals, localized containment and directing quarantine measures. IgG antibodies usually appear after one week of onset of infection and may last for several months. Serosurveys that detect these antibodies using Enzyme-linked immunosorbent assay (ELISA) help in the assessment of asymptomatic infection in close contacts, enhance the current understanding of the spread of disease, individual’s immune status and in identifying potential plasma donors. Case fatality rate is positively associated with SARS-CoV-2 seroprevalence as was demonstrated in the survey conducted in the Spanish population. Immuno-compromised patients, healthcare workers, relatively young working population comprising of bankers, media persons, individuals working at airports, overseas operations and industries, staff in municipal bodies, shopkeepers, vendors, courier services, telecommunication offices, drivers of hospital ambulances, hearse vans, buses, auto-rickshaw, taxies; bus conductors, farmers, electricity workers, migrant labourers who have travelled back from urban and peri-urban areas to rural/tribal; inhabitants of hard to reach areas, prisoners, densely populated regions of the country as well as natives after coming in contact with returned migrant; police and security personnel, those staying in institutional settings and hostels and inhabitants of containment zones should all be tested for the presence of antibodies against the virus.
Bernhard Rudolf Conrad von LANGENBECK - founder and first Chairman of the German society of surgeons(to the 210th of birthday)
Authors: Andreev Alexander Alekseevich , Ostroushko Anton Petrovich 
Published: September 2020

Langenbek was born in 1810 in the family of a rural pastor. At 19, he entered the medical faculty of the University of Gttingen, where he graduated with the title of doctor. In 1834, Mr .. He received a doctorate in medicine and after doing scientific practice in Belgium, France and England. In 1838, Bernhard Langenbeck received the title of Privatdocent, in 1841 he was elected extraordinary professor of the Department of Pathological Anatomy of the University of Gttingen, becoming an assistant clinic. B. Langenbek, is developing a number of surgical interventions that bring him wide popularity in the surgical world. Since 1841, B. Langenbek - head of the Department of Surgery in Kiel, then in Berlin. He is the pioneer of German scientific surgery, ensuring its rapid scientific progress in Germany.

Langenbek operates a lot on bones and joints, performs plastic surgeries, pharynx and larynx extirpation, resection of the tongue, removal of the uterus, ovariotomy, etc. Today, more than 20 surgical methods associated with the name of B. Langenbek are known, and a retractor proposed by B. Langenbek is used; hemostatic tourniquet developed by F. Esmarch and Langenbeck.
Langenbeck advocated regular postgraduate education, the establishment of a higher educational institution for military doctors, created the Red Cross Society committee in Germany, the scientific society of military doctors, founded the scientific journal Archive of Clinical Surgery, the German Society of Surgeons, whose first chairman was from 1872 to 1885 Langenbek was awarded the title of Major General and the rank of Actual Privy Councilor. September 29, 1887 Langenbek "suddenly died of a blow." On June 8, 1892, the grand opening of the Langenbeck House, which became the property of the German Society of Surgeons, took place in Berlin. Bernhard Langenbeck remains the first magnitude star among the luminaries of German surgery.