bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antidepressant-Induced Sexual Dysfunction
Authors: Donthu Raj Kiran , Manohar Shivanand J , Thunga Ravish 
Published: April 2021

Background:
Antidepressant drugs are frequently associated with sexual dysfunction. Sexual side effects affect the patients' quality of life and in the long term and can lead to noncompliance and relapse. However, studies covering many antidepressants with different mechanisms of action are scarce.

Aims:
The aim of this study is to compare the rates of sexual dysfunction among patients taking escitalopram, desvenlafaxine, and mirtazapine.

Settings and Design:
Cross-sectional study.

Materials and Methods:
Arizona Sexual Experience Scale (ASEX), Hamilton Rating Scale for Depression (21 items), and State and Trait Anxiety Inventory.

Statistical Analysis Used:
Fisher's exact t-test, Chi-square test, and analysis of variance depending on the type of variable.

Results:
Eighty-four participants (42 males and 42 females) completed all instruments. Of these, 28 were taking escitalopram (13.93 ± 5.15), 28 were taking desvenlafaxine (76.79 ± 25.39), and 28 were taking mirtazapine (16.88 ± 3.88). A substantial number of patients (40.5%, n = 34) had sexual dysfunction. The prevalence of sexual dysfunction varied across the drugs; escitalopram (60.7%), desvenlafaxine (35.7%), and mirtazapine (25%). Regression analysis revealed that the significant factor for sexual dysfunction was the type of antidepressant used. The mirtazapine group's total ASEX score was significantly lower than the scores for escitalopram and desvenlafaxine (χ2 = 7.807, P = 0.020).

Conclusion:
The incidence of sexual dysfunction is substantially high during antidepressant treatment. The rates of sexual dysfunction differed among antidepressants having different mechanisms of action. Mirtazapine-induced lesser sexual dysfunction compared to desvenlafaxine and escitalopram.
Caregiver Burden and Psychiatric Morbidity Among Caregivers of Children with Thalassemia Major
Authors: Prajapati Nisha Kanaiyalal , Samani Mukesh Jyantilal , Jani Arpit Madhusudanbhai 
Published: April 2021

Background:
Caregivers of children with thalassemia major experience higher caregiver burden and psychiatric morbidity.

Aims:
The aims of this study were as follows: (1) to assess the caregiver burden and psychiatric morbidity among caregivers of children with thalassemia major and (2) correlation between caregiver burden and psychiatric morbidity.

Settings and Design:
This was an observational, cross-sectional study carried out at the tertiary care hospital setup among 245 caregivers of children with thalassemia major.

Subjects and Methods:
Sociodemographic details of children and their caregivers and clinical variables of children were obtained. The Caregiver Burden Scale and General Health Questionnaire (GHQ)-12 were applied. Psychiatric diagnosis was made after clinical interview as per the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.

Statistical Analysis Used:
Chi-square test, t-test, analysis of variance, and Pearson coefficient correlation were used for statistical analysis.

Results:
33.06% were having severe burden, 30.61% moderate-to-severe burden, 27.34% mild-to-moderate burden, and 8.97% were having little or no burden. 13.46% of caregivers had psychiatric illness, out of which 8.57% had major depressive disorder, 4.08% generalized anxiety disorder, and 0.8% alcohol use disorder. “Weakly positive correlation” (P = 0.0284) was found between GHQ score and burden score.

Conclusions:
Higher caregiver burden and presence of psychiatric morbidity among caregivers of thalassemia children suggest that caregivers should be screened at regular intervals for early detection and management of psychiatric morbidity. Social and professional networks for psychosocial support and self-help groups should be planned for caregiver burden.
Graft and Survival Outcome in Renal Transplant Patients Receiving Cyclosporine and Azathioprine Versus Tacrolimus and Mycophenolate Mofetil
Authors: Sathish Renuka , Marisiddappa Limesh , Kedlaya Prashant , Nagaraj Vinod , Kruthika D. M. 
Published: April 2021

There is paucity of data on long-term outcome of renal transplantation across different immunosuppression groups.

Rationale and Objective:
The study looks at long-term outcomes in renal transplant patients receiving azathioprine, cyclosporine combination (Group 1) with mycophenolate mofetil and tacrolimus (Group 2) with terms of patients and graft survival. We also analyzed the spectrum of infections across the two groups.

Study Design:
A retrospective observational study was conducted from 1995 to 2014 at St. John's Medical College and Hospital, Bengaluru. Patients received treatment as per standard protocol.

Setting and Participants:
Renal transplant recipients who regularly visited outpatient department.

Analytical Approach:
Statistical analysis was done by using SPSS 19 software. Continuous variables were analyzed using Student's t-test. Pearson's correlation test used for correlating variables. Kaplan–Mere curve used for calculating survival.

Primary Outcomes:
Rejection rates were similar across both the groups. The patient survival was 65% and 70% in Group 1 and 2 at 5 years, respectively. Graft survival was 65% and 75% in Group 1 and 2 at 5 years.

Secondary Outcome:
Bacterial and fungal infections were more common in Group 1, whereas viral infections were more in Group 2. In addition, infections tend to occur early in Group 2.

Limitations:
Single center, retrospective study.

Conclusion:
Patient and graft survival were similar across both the groups.
Perceptions and Attitude Toward Cadaveric Organ Donation Among Health-Care Professionals at a Tertiary Health-Care Setting
Authors: Da Silva Kenneth Xavier , Dsouza Delia Basil , Mascarenhas Von Richard , Kankonkar Prajoth Narayan , Vaz Frederick Satiro , Kulkarni Manojkumar S. 
Published: April 2021

Introduction:
Organ donation provides a life-saving opportunity for those individuals with organ failure who have no other options. The knowledge, attitude, and practices of medical professionals play a vital role in promoting the positive impact of organ donation. Therefore, it is necessary to understand and assess the knowledge and attitude about cadaveric organ donation among the medical health professionals.

Objectives:
To assess the knowledge, attitude, and practices of health-care professionals toward cadaveric organ donation and to know their awareness regarding legislations pertaining to cadaveric organ donation.

Materials and Methods:
A self-administered questionnaire was filled out by consenting consultants, resident doctors, and nurses working at a tertiary health-care setting, to evaluate their knowledge, attitude, and practices regarding cadaveric organ donation. Data were analyzed and summarized as frequencies and proportions.

Results:
Majority (74%) of the participants were females and most (67.8%) of them below 40 years of age. Hindus comprised 55.2% and Christians 41% of the study population. All consultants, 99.1% of resident doctors and 83.1% of nurses were familiar with the concept of cadaveric organ donation. Although willingness to donate organs was expressed by a majority of the health-care professionals, only a few have actually taken the initiative and pledged to donate their organs.

Conclusion:
The knowledge of the health-care professionals pertaining to cadaveric organ donation was found to be relatively good, whereas their attitude was found to be favorable. As far as practices were concerned, they were found to be unsatisfactory. Awareness level regarding legislations pertaining to organ donation was relatively high.
Use of Panel Reactive Antibodies for Immunological Risk Stratification and Its Correlation with Antecedent Events in Live Donor Kidney Transplant
Authors: Gadde Ashwini B. , Mahapatra Amit , Tiwari Assem , Sethi Sidharth Kumar , Jha Pranaw Kumar , Jain Manish , Yadav Dinesh , Bansal Dinesh , Bansal Shyam B 
Published: April 2021

Background:
Panel reactive antibody (PRA) is a screening test to identify the immunological sensitization of the transplant recipients. The current study focuses on the role of PRA in immunological risk stratification in live donor kidney transplant and its correlation with antecedent events and posttransplant outcomes.

Methods:
This was a prospective, single-center, observational study. All patients with end-stage renal disease between January 1, 2016, and October 1, 2016, were included. The patient's sensitization history and other immunological workup were recorded. Patients were followed up for 6 months.

Results:
PRA positivity was seen in 29/185 (15.7%) patients. Female sex (P = 0.004), longer duration renal replacement therapy (P = 0.037), and hepatitis C virus infection positivity (P = 0.047) were significantly associated with PRA positivity. Only 3/87 (3.4%) patients who had no history of sensitizing events had high PRA. Less number of patients in PRA-positive group received transplant as compared to PRA-negative group (12/29; [41.4%] vs. 143/156 [91.7%, P < 0.0001]). In transplanted patients, there was no significant difference between PRA-positive and PRA-negative group in terms of serum creatinine (1.22 ± 0.26 mg/dl vs. 1.30 ± 0.38 mg/dl, P = 0.63) and number of acute rejection (1 vs. 6, P = 0.507).

Conclusions:
PRA positivity is not uncommon in live donor kidney-transplant patients. Previous transplants, pregnancies, and multiple blood transfusions are important sensitizing events. PRA testing was useful in identifying high-risk patients and evaluating them further. There was no difference in short term outcomes between PRA-positive and PRA-negative groups after exclusion of high-risk patients from transplantation.
A Qualitative Approach to Understand the Knowledge, Beliefs, and Barriers Toward Organ Donation in a Rural Community of Haryana - A Community Based Cross-Sectional Study
Authors: Misra Puneet , Malhotra Sumit , Sharma Nitika , Misra M. C. , Vij Arti , Pandav C. S. 
Published: April 2021

Introduction:
Organ transplantation is the therapeutic modality available for people with end-organ failure. However, only 10% of the need for transplantation is met globally. There are different factors that influence organ donation by people.

Objective:
This study was planned with an aim to understand the beliefs and knowledge of a rural community toward organ donation and the identification of barriers for organ donation.

Materials and Methods:
A qualitative community-based cross-sectional study was carried out among the adults of a rural area of Ballabgarh block of district Faridabad, Haryana. There were four groups of participants based on age and gender. Data collection was done through focused group discussion.

Results:
Several themes emerged and various reasons that were facilitators/barriers for donation of organ by people were listed: unawareness on what organs can be donated, misuse of donated organs by black marketing, organ donation by people having any comorbidity, no religious prohibition on organ donation, and disfigurement of body after organ donation.

Conclusion:
People consider organ donation a noble act. However, there are various myths and misconceptions as well as unawareness of procedure regarding organ donation that leads to lower rate of organ donation. Awareness campaigns should be organized to take care of such issues.
Renal Angiographic Evaluation of Prospective Renal Donors
Authors: Jose Nisha , Jayaprakash Varadharajan , Deiva A. , Sai Venkata , Jayakumar M 
Published: April 2021

Introduction:
In countries without a well-developed deceased donor program, living donors form the backbone of the renal replacement strategy. Computed tomography (CT) angiography forms an integral part of the predonation evaluation. The course, number, and morphometric evaluation of the renal vasculature provided by CT angiography help to identify which kidney to harvest and which kidney to exclude from the donation. The characteristics of the Indian renal donor are a rarely studied topic with only a few studies on the same to date.

Methodology:
This is an observational study done over a period of 3 years noting the clinical and morphometric characteristics of the renal donors from a database.

Results:
In this study, 57 prospective living renal donors were included. Most donors were women. The length of the renal artery and renal vein was shorter in this cohort than in previously known statistics. The diameter of the renal vessels was also smaller than previous data. The left side kidney was more commonly harvested compared to the right.

Conclusion:
Renal angiographic morphometric data among the Indian population were different from previously known statistics. Angiographic data correlated well with intraoperative findings in the majority of patients.
Cytomegalovirus Disease in Post-Renal Transplant Patients
Authors: Yadav Poonam , Yadava Kamlesh , Tandon Neeraj , Prasad Narayan , Dhole T. N. 
Published: April 2021

Background:
Cytomegalovirus is an important viral pathogen causing infection in immunodeficient patient especially in solid organ transplant like renal transplant. This study aims to evaluate the prevalence and clinical impact of CMV infection in renal transplant patients in a tertiary care hospital in Northern India.

Materials and Methods:
145 renal transplant patients were tested for cytomegalovirus DNA by polymerase chain reaction (PCR) and for presence of IgM and IgG antibody against cytomegalovirus by ELISA. PCR amplified product were detected by Agarose gel electrophoresis.

Results:
Out of 145 transplant patients CMV Viremia was detected by PCR in 16(11.0%) patients. Two patients died in the study period in which one patient had HBV and other had HCV infection. IgM antibody against CMV was detected in one out of 145 donors while IgG anti-CMV antibody was detected in all 145 donors and recipients by ELISA. Two out of 145 transplant recipients had positive CMV PCR in pre-transplant period, and both had positive CMV PCR in post-transplant period. Out of sixteen positive patients histopathology changes of CMV disease was found in 2 patients (12.5%).

Conclusion:
Cytomegalovirus disease is major cause of morbidity and mortality in renal transplant patients. PCR to detect specific CMV genome sequences is important tool for early diagnosis and specific anti viral therapy. In our study out of 145 transplant patients, CMV Viremia was detected by PCR in 16 patients (11.0%). Two patients in the study period died, in which one patient had HBV and other had HCV infection, remaining patients survived with varying range of serum creatinine levels. Diagnostic histological changes of CMV is seen only in minority of cases(12.5%) who are positive by PCR for CMV.
Prevalence and Risk Factors for Postrenal Transplant Hyperparathyroidism
Authors: Sampathkumar Krishnaswamy , Rajiv Andrew , Kumar Shakthi , Selvan Kadhir 
Published: April 2021

Introduction:
Chronic kidney disease (CKD) commonly results in secondary hyperparathyroidism. Even after a successful renal transplant, residual parathyroid overactivity persists. We studied its prevalence and risk factors in Indian patients.

Patients and Methods:
Patients who underwent renal transplantation in our unit from 2013 to 2019 and completed 3 months of the posttransplant period were included. We excluded patients with advanced allograft dysfunction and those on medications with the potential impact of divalent cations. A detailed history, physical examination, and laboratory parameters were obtained.

Results:
There were 110 subjects, of whom 78% were male. The mean age group was 38 ± 12 years. Chronic glomerulonephritis was the most common etiology of CKD (54%). Posttransplant vintage was 48 ± 44 months. The mean serum parathyroid hormone (PTH) level was 135 ± 176 pg/ml. Sixty-seven percent of them had raised serum PTH levels above 70 pg/ml. The patients were asymptomatic. Hypercalcemia and hypophosphatemia were rare. The mean 25 OH Vitamin D levels were low (23 ± 8 ng/ml) with 41% of the subjects showing either deficiency or insufficiency. Higher serum PTH levels were significantly associated with female sex, lower estimated glomerular filtration rate, and lower serum 25 OH Vitamin D levels. Serum parathormone levels were significantly negatively correlated with serum calcium (r2
= −0.39. P = 0.0003) and Vitamin D levels (r2
= −0.50. P = 0.002).

Conclusions:
Posttransplant hyperparathyroidism (PTHP) persists even after many years of normal allograft function. Hypercalcemia and hypophosphatemia are insensitive tests to identify the condition. Vitamin D deficiency has a strong correlation with PTHP.
Study of Prevalence of Internet Addiction among Adolescents in a Cantonment School
Authors: Kumar Surinder , Singh Harpreet , Shankar Prerna , Chail Amit 
Published: April 2021

Background:
More Indians have access to mobile phones than toilets. Concerns have been raised for addictive potential of Internet. There are few Indian studies on the prevalence of Internet addiction (IA) among adolescents. The present study aimed to assess the prevalence of IA among adolescents and its association with sociodemographic variables in a cantonment school.

Methodology:
It was a cross-sectional study among students of the age group of 10–19 years in Western Maharashtra. Sociodemographic data were collected using a self-administered questionnaire. Young's IA test was used to diagnose IA. Statistical analysis was done using Chi-square test and odds ratio.

Results:
A total of 1325 students participated in the study. Among these, 2.5% had scores above 69 (addicted). Among those with scores > 69, 85% were boys, average daily Internet use was 5.3 h in last 1 year. Use for academics, online gaming, and social media were the most common reasons for current use among the study sample. Risk factors included watching pornography, online gaming, use of Internet due to loneliness or boredom, use in Internet café, permanent login status, accessing Internet > 4 h daily, and consumption of tobacco or alcohol by any of the parents. The possible protective factors included using Internet only for academics, restricting Internet use to < 2 h, and having a playground nearby and playing there.

Conclusion:
In our study, prevalence of IA is around 2.5%. The possible risk and protective factors can be targets of intervention and further study.
“A Randomized Controlled Single Blind Clinical Trial to Evaluate Effectiveness of Empirical Treatment with Albendazole in Delaying Disease Progression among Human Immunodeficiency Virus Positive Antiretroviral Therapy Naïve Patients at an Antiretroviral Therapy Center of a Tertiary Care Hospital”
Authors: Sindhu Apoorva , Ramakrishnan T. S. , Sashindran V. K. , Khera Anurag 
Published: April 2021

Introduction:
Parasitic opportunistic infections are widely accepted to accelerate the progression of human immunodeficiency virus (HIV) infection to acquired immunodeficiency syndrome. A large number of interventions are needed to delay HIV progression and improve the health status of HIV patients. The cheapest, simplistic, and practical intervention in a resource-limited setting like India, where HIV and helminth co-infection is common, is deworming.

Methodology:
The participants were assesses for their eligibility and recruited into two study arms. Both groups were followed for 1 year. CD4 count was assessed at baseline, 6 months, and 12 months. Study participants assigned to the treatment group were treated at 0, 3, 6, and 9 months with tablet Albendazole (400 mg) for 3 days. Study participants assigned to the control arm were given Placebo (Tablet Calcium 500 mg) for 3 days at 0, 3, 6, and 9 months.

Results:
In both treatment group and the placebo control group, the mean CD4 count was found to be declining. The mean decline in CD4 count of the intervention group was 72 cells/mm3 at 6 months and 85 cells/mm3 at 1 year. Similarly, the mean decline of CD4 count in the control group was 94 cells/mm3 at 6 months and 120 cells/mm3 at 1 year. We found that the mean difference in CD4 count between the intervention group and control group was −31.66 cells/mm3, −9.98 cells/mm3 and 24.87 cells/mm3 at baseline, 6 months, and 1 year, respectively. Our results are consistent with various other studies conducted in Uganda and Africa, as well as Cochrane systematic review.

Conclusion:
We conclude that empirical treatment with Albendazole in HIV-positive antiretroviral therapy naïve patients has no significant influence on delaying the progression of HIV disease.
Efficacy of Ultrapulse Carbon Dioxide Laser Ablation Versus 30% Trichloroacetic Acid in Xanthelasma Palpebrarum - A Randomised Controlled Trial
Authors: Das Niyor Mukuta , Subramaniyan Radhakrishnan , Arora Sandeep , Dabas Rajeshwari , Janney Manasa Shettisara , Lal Sandeep V 
Published: April 2021

Context:
Xanthelasma palpebrarum (XP) is the most common cutaneous xanthoma that develops around the eyes. A number of treatment modalities have been tried for its removal, but none are truly satisfactory. Trichloroacetic acid (TCA) is commonly used in Indian setting as it is easily available and cost-effective whereas carbon dioxide (CO2) laser has been tried increasingly due to its favorable cosmetic outcome.

Aims:
This study aims to compare the efficacy of ultrapulse CO2 laser ablation with 30% TCA in the treatment of XP.

Setting and Design:
Prospective, interventional, randomized study at a Dermatology Centre of a Tertiary Level Hospital from January 2017 to June 2018.

Methods:
Seventy-four patients with 100 lesions of XP were divided into two groups of flat and elevated lesions. Each group was further randomly divided into two subgroups and administered CO2 laser once a month and 30% TCA once in 2 weeks respectively for 3 months. Patients were clinically assessed at baseline and then at monthly intervals using visual analog scale (VAS), patient satisfaction score (PSS), and standardized photographs. The follow-up was done at the end of 3 and 6 months.

Statistical Analysis and Results:
Mean PSS and VAS score of TCA and laser in flat and elevated lesions were compared using independent group Student's t-test. Response to laser in elevated lesions was found to be statistically better whereas in flat lesions the response to TCA and laser were similar. Recurrence was 17% and 6% at 3 months' follow-up and 24% and 11% at 6 months' follow-up in TCA and laser groups, respectively.

Conclusions:
The end results of ultrapulse CO2 laser and 30% TCA are comparable in flat lesions of XP. In elevated lesions, laser has better efficacy, requires fewer sittings with lesser chance of recurrence.