bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preclinical Mechanisms of Topical PRN473, a Bruton Tyrosine Kinase Inhibitor, in Immune-Mediated Skin Disease Models
Authors: Xing Yan , Chu Katherine A , Wadhwa Jyoti , Chen Wei , Zhu Jiang , Bradshaw J Michael , Shu Jin , Foulke Matthew C , Loewenstein Natalie , Nunn Philip , By Kolbot , Phiasivongsa Pasit , Goldstein David M , Langrish Claire L 
Published: July 2021

Abstract
The expression of Bruton tyrosine kinase (BTK) in B cells and innate immune cells provides essential downstream signaling for BCR, Fc receptors, and other innate immune cell pathways. The topical covalent BTK inhibitor PRN473 has shown durable, reversible BTK occupancy with rapid on-rate and slow off-rate binding kinetics and long residence time, resulting in prolonged, localized efficacy with low systemic exposure in vivo. Mechanisms of PRN473 include inhibition of IgE (FcεR)–mediated activation of mast cells and basophils, IgG (FcγR)–mediated activation of monocytes, and neutrophil migration. In vivo, oral PRN473 was efficacious and well tolerated in the treatment of canine pemphigus foliaceus. In this study, we evaluated in vitro selectivity and functionality, in vivo skin Ab inflammatory responses, and systemic pharmacology with topically administered PRN473. Significant dose-dependent inhibition of IgG-mediated passive Arthus reaction in rats was observed with topical PRN473 and was maintained when given 16 h prior to challenge, reinforcing extended activity with once-daily administration. Similarly, topical PRN473 resulted in significant dose-dependent inhibition of the mouse passive cutaneous anaphylaxis IgE-mediated reaction. Multiday treatment with topical PRN473 in rodents resulted in low-to-no systemic accumulation, suggesting that efficacy was mainly due to localized exposure. Reduced skin Ab inflammatory activity was also confirmed with oral PRN473. These preclinical studies provide a strong biologic basis for targeting innate immune cell responses locally in the skin, with rapid onset of action following once-daily topical PRN473 administration and minimal systemic exposure. Dose-dependent inhibition in these preclinical models of immune-mediated skin diseases support future clinical studies.
Cardiovascular Risk Factors in Children and Adolescents with Congenital Adrenal Hyperplasia
Authors: Hashemi Dehkordi Elham , Khaheshi Sara , Mostofizadeh Neda , Hashemipour Mahin 
Published: July 2021

Background:
Congenital adrenal hyperplasia (CAH) is an autosomal recessive disorder caused by impaired steroidogenesis. Glucocorticoid treatment with increased androgens may lead to cardiovascular and metabolic effects in these patients. In this study, we investigated the relationship between cardiovascular risk factors and androgen levels in children and adolescents with CAH due to 21 hydroxylase deficiency.

Materials and Methods:
A cross-sectional study of 78 patients (37 boys and 41 girls) with CAH aged 3–17 years. Anthropometric, body mass index (BMI), systolic (SBP), and diastolic (DBP) blood pressure were measured. Fasting blood glucose with plasma insulin and lipids were measured, and insulin resistance (HOMA-IR) calculated using the homeostasis assessment model. Furthermore, testosterone, Dehydroepiandrosterone sulfate (DHEAS), and 17-Hydroxyprogesterone (17OHP) were investigated.

Results:
The mean SBP and DBP were 112.01 ± 19.13 and 69.77 ± 7.56, respectively. The mean of HOMA-IR in patients was 2.25 ± 1.46. The frequency of patients with overweight and High HOMA index were, respectively, 33.3% and 29.3%. The correlation analysis between clinical characteristics and androgen serum levels showed that DBP and BMI had a significant positive correlation with 17OHP. The median regression analysis showed, only DBP in the adjusted model had a significant positive effect with 17OHP level (P < 0.05), and no significant relationship was observed for other characteristics.

Conclusion:
A significant association was found between BMI and DBP with serum concentrations of 17-OHP, suggesting that elevated 17-OHP can lead to an increased risk of cardiovascular disorders in children and adolescents with CAH.
Role of human papillomavirus 6 & 11 in condyomata acuminata in Indian patients
Authors: Singh Mini P. , Rungta Tripti , Saikia Uma Nahar 
Published: July 2021

Background:
Condylomata acuminata, commonly known as genital wart is a sexually transmitted disease caused by Human Papillomavirus (HPV). The positivity of HPV6/11 in condylomata acuminata in western literature varies from 80-90% however, there is a paucity of Indian literature.

Aim:
The aim of the present study was to determine the role of HPV 6 & 11 in Condylomata acuminata in Indian patients.

Methods:
A total of 22 formalin fixed parafilm embedded (FFPE) tissue was collected from the cases of condylomata acuminata which was histologically diagnosed and was used to detect HPV 6 and 11 by PCR.

Results:
Of these 14/22 patients (63.6%) were positive for HPV 6 or 11; HPV 6 alone in eight (36.3%) and HPV 11 in six (27.2%).

Conclusion:
The high HPV 6 and 11 PCR positivity suggests their definitive role in causation of condylomas cases. This important HPV infection is preventable by prophylactic vaccination.
A study of CD10 positivity of stromal cells in core needle biopsy specimen of breast cancer patients and its relation with histological grade and lymphovascular invasion
Authors: Boler Anup K. , Akhtar Sana , Bandyopadhyay Arghya , Bandyopadhyay Goutam 
Published: July 2021

Background:
In core needle biopsy (CNB) often the histological grade of invasive breast carcinoma is under-estimated due to heterogeneity of epithelial component. Stroma is relatively homogenous throughout the tumor and strong CD10 stromal positivity is proposed to be associated with high tumor grade.

Aims and Objectives:
The aim of this work was to study the expression of CD10 in stromal cells of invasive carcinoma of breast, no specific type (NST) in CNB specimens, and analyze its association with final histological grade and lymphovascular invasion (LVI).

Materials and Methods:
A total of 50 cases of invasive carcinoma of breast, NST were studied for 18 months. CNB specimens were graded according to modified Scarff–Bloom–Richardson (SBR) system and CD10 positivity was assessed in stromal cells. Mastectomy specimens were also similarly graded. Relation of stromal CD10 positivity with histological grading and LVI was studied.

Statistics:
Associations between the variables were studied by Chi-square test. A value of P< 0.05 was considered to be statistically significant.

Results:
On CNB 46% patients had a grade 2 tumor, followed by 30% grade 3 and 24% grade 1 tumor. Strong CD10 positivity was seen in 40% cases, 32% showed weak positivity and 28% were negative for CD10 in stromal cells in CNB specimen. On evaluation of mastectomy specimen 48% of the patients had a grade 2 tumor, followed by 40% grade 3 tumor and 12% grade 1 tumor. Strong CD10 positivity was found to be significantly associated with final grade 3 tumor (P < 0.001) and LVI (P = 0.005).

Conclusions:
There was underestimation of histological grade on CNB, while strong stromal CD10 positivity in CNB was significantly associated with final grade 3 tumor and LVI.
Assessment of Knowledge and Awareness of Public School Teachers Towards Learning Disabilities in Children - An Institutional Based Cross-Sectional Study in Dharmapuri District, Tamil Nadu
Authors: Madhamani Arunachalam , Joseph Alex 
Published: July 2021

Introduction:
Literature indicates that the incidence of specific learning disabilities among Indian children has been rising. Scholars have been paying much attention to teachers’ knowledge which is largely associated with early identification and treatment of learning disabilities.

Objectives:
This study aimed to understand the knowledge and awareness of public-school teachers, about learning disabilities among children, in Dharmapuri district of Tamil Nadu, India.

Material and Methods:
A cross-sectional study was done among 200 school teachers in Dharmapuri district to achieve the desired objectives using structured and self- administered questionnaire.

Results:
The knowledge of teachers regarding learning disabilities among children was found to be moderate among the majority of the teachers (45%), where as substantially large number of participants showed an adequate level of knowledge (33.5%), and rest of the participants (21.5%) have shown an inadequate level of knowledge. A vast majority of participants (73.5%) were aware of the learning disability amongst children. The educational qualification (P value < 0.001) and experience (P value < 0.05) of the teachers had a significant association between knowledge level.

Conclusion:
In light of the findings, it is essential to spread the awareness and knowledge about the learning disabilities of children among teachers. The government should take necessary policy directions in raising awareness and knowledge of various learning disabilities among parents, teachers and peer groups so that these children will be handled in a better way in the social circle. This also should be included as a part of curriculum in teachers’ training programs.
Severe or not so severe? The gravity of geriatric trauma
Authors: Abhilash Kundavaram Paul Prabhakar , Pradeeptha Sharon , Cris Andrea , Hazra Darpanarayan , Jindal Anmol , Selvan Jagadesha 
Published: July 2021

Background:
Due to associated comorbidities, the elderly population is more vulnerable to injuries with complications. This study was done to assess the severity of trauma and outcome of injuries among these patients presenting to the Emergency Department (ED).

Materials and Methods:
This was a retrospective cohort study. We included all patients aged more than 60 years, who presented to the ED with trauma in the year 2018. Details of the mode of trauma, severity of injuries and outcome were analysed.

Results:
During the study period a total of 7666 trauma patients presented to ED, among which 879 (879/7666: 11.4%) were in the geriatric age group. The mean age was 68.9 (SD: 7) years with 90.8% being young-old (60–79 years) and 9.2% being old-old (>80 years). Common modes of injuries were road traffic accidents (RTA) (64%) fall on level ground (FLG) (20%) and fall from height (FFH) (8%). Most of them had Injury Severity Score (ISS) and New Injury Severity Score (NISS) score of 0–7, i.e.: 62% and 51%, respectively. On multivariate logistic regression analysis RTA, FFH FLG and triage priority 1 patients were associated with trauma in the old-old as compared to the young–old age groups significantly. Independent risk factors associated with severe trauma were seen RTA, FLG and priority 1 patients. Forty-four per cent patients were managed by the ED team alone. Trauma speciality departments referred to included orthopaedics (47%), neurosurgery (22%), trauma surgery (14%), plastic surgery (8%) and hand reconstruction surgery (6%). About half of the population under study was discharged stable (44%), of which the majority belonged to the young-old category (44.1%). The in-hospital mortality rate was 0.5% (4/879).

Conclusion:
This study shows the gravity of multiple injuries sustained by the geriatric age group with RTA, FLG and FFH being the predominant causes of trauma. The NISS highlights the severity of injuries in the old and the frail.
Comparative role of tenofovir versus entecavir for treating patients with hepatitis B virus-related acute on chronic liver failure
Authors: Hossain Sharker M. S. , Mahtab Mamun A. , Das Dulal C. , Noor-E-Alam Sheikh M. , Mamun Ayub A. , Khan Md. Sakirul I. , Akbar Sheikh M. F. , Rahman Md Zakiur , Rahman Salimur 
Published: July 2021

Introduction:
The aim of the study was to compare the safety and efficacy of tenofovir versus entecavir for treatment of naive acute on chronic liver failure (ACLF) due to hepatitis B virus (HBV) (ACLF-B).

Methods:
Thirty-two patients aged 14-65 years were enrolled in the study. Diagnosis of ACLF was confirmed by clinical condition, biochemical analysis, and virological data. The causes of both chronic liver damages and acute insult in all patients were HBV. They were expressing HBV DNA in the sera, positive for IgM anti-HBc, had increased levels of serum bilirubin, compromised prothrombin time; and more than 50% patients had encephalopathy. The standard dose of tenofovir and entecavir was given.

Results:
The antiviral effects of tenofovir and entecavir were evident as most patients became negative for HBV DNA in the sera after 90 days of therapy. Also, the levels of serum bilirubin, CTP (Child-Turcotte-Pugh) and MELD (model for end-stage liver disease) score exhibited significant improvement due to antiviral therapy. Although the improvement of liver functions, and liver damages were detected in patients receiving both tenofovir and entecavir, the survival of the patients was significantly higher in those receiving tenofovir compared to entecavir-treated patients.

Conclusion:
This prospective study with limited number patients provides a challenge to assess the real potential of tenofovir over entecavir as therapeutic option for ACLF-B by conducting a multicenter clinical trial enrolling patient of different races and background.
Epidemiological study of adverse events following immunization in under 5 year children
Authors: Pagar Vikrant S. , Chavan Sushant S. , Patil Sarika P. , Borde Anant , Kinge Amol D. , Khargekar Naveen 
Published: July 2021

Background:
The present study was conducted to study the socioeconomic and the demographic profile of children reporting with adverse events following immunization (AEFI) along with the determinants associated with AEFIs, based on investigation of each case and to assess the proportion of programmatic errors linked with AEFI cases.

Materials and Methods:
Record-based cross–sectional study conducted among sample of 118 cases of AEFI were reported. The case reports of all AEFI cases were procured and analyzed to identify factors associated with reported AEFI. The questionnaires related with preliminary investigation reports (PIRs) including forensic evidence of death cases were analyzed. Percentage analysis of data was done by proportions, measures of central tendencies, and Chi-square test.

Results:
Most of the cases reported were between 0 and 3 months of age constituting 39%. AEFI was seen more in male child than female. more than half of cases of AEFI were recorded following immunization with OPV/DPT/HBV together (66.94%). Most common AEFI reported were convulsion (68.64 %) and fever (58.47%) followed by local swelling at site of injection (11.86%). More than half of the cases of AEFI occurred within 12 hours of immunization (61.88%). Birth weight of most cases of AEFI were in the range between 2 and 2.4 kg (44.06%), followed by range between 2.5 and 2.9 kg (32.20%), the mean of birth weight was 2.51 kg.

Conclusion:
Convulsion was the most commonly reported AEFI, majority of AEFI occur within 12 h of immunization. Most of the AEFI were recorded following immunization with OPV/DPT/HBV together.
Drug utilization pattern and factors associated with polypharmacy and excessive polypharmacy in geriatric medical out-patients at a rural health training centre in India
Authors: Nitya S. , Ramya G. , Kiruthika Sivagourounadin , Meenakshi R , Devi Jayabalan Nalini , Suganya Ganesan , Pravin S. 
Published: July 2021

Context:
Multiple chronic illnesses associated with ageing population demands the role of polypharmacy. Drug utilization study in terms of description of drug use pattern in the geriatric patients aids in monitoring polypharmacy as well as to determine the factors contributing to it.

Objectives:
To analyse the drug utilization pattern in geriatric patients at a rural health training centre.

Subjects and Methods:
A cross-sectional study was conducted in a rural health centre to assess the drug utilization pattern using the WHO core drug prescribing indicators. Polypharmacy was defined as usage of 5-8 drugs and excessive polypharmacy as intake of 10 or more drugs. The drugs were coded using Anatomical Therapeutical Chemical classification. Univariate and bivariate analysis were done using SPSS to present the data.

Results:
Among 207 patients, 29.5% were on polypharmacy and 1.5% patients on excessive polypharmacy. About 75% of patients had one or more comorbid medical condition. A total number of 829 drugs were prescribed and the average number of drugs per prescription was 4.02.

Conclusion:
The drug utilization pattern analysis in the geriatric patients reveals deviation of the average number of drugs per prescription from the WHO standard recommendation. The most common comorbid condition among the geriatric patients was diabetes mellitus. This drug utilization study imparts knowledge about the use of polypharmacy, comorbidities and the pattern of commonly used drugs among the geriatric patients in rural area. Periodic assessment of the pattern of drug utilization in the elderly aids to improve the prescribing pattern and minimize patient harm.
Lifestyle and behavioral changes during nationwide lockdown in India—A cross-sectional analysis
Authors: Singh Vishwambhar , Raghav Pankaja , Singh Garima , Pritish Baskaran T. B , Bishnoi Anil , Gautam Vedangi , Chaudhary Ashvanee Kumar , Kumar Ashutosh , Kumar Sagar , Sahu Suraj 
Published: July 2021

Introduction:
After almost two months of reporting the first case of the novel coronavirus disease (COVID-19) in the country, the nationwide lockdown in India was initiated on 24th of March 2020, to curtail the spread of the SARS-CoV-2 infection in the country. While this lockdown had been in place for almost 3 months, the people of the nation have experienced changes in their routine lives in a wide range of activities, including personal behaviours. This study was conducted to identify the impacts that the lockdown had on the lifestyle and behavioural aspects of Indians during the lockdown.

Methods:
It was a cross sectional study, conducted by online survey. Data collection was done for the period of 3 months.

Results:
The study found that a huge number of participants had significant changes in their diet, sleep, bowel habits and also their personal traits. Also, the lockdown had improved interpersonal relationships and helped people explore their hobbies or even acquire a new skill (about 25% of the participants). More than 90% of the participants perceived decrease in air pollution and a majority reported increase in personal hygiene (74.2%), perceived decrease in crime rates (67.3%) as benefits of lockdown.

Conclusions:
It would be recommended to include variables to screen for mental health issues among the general population.
Clinico-bacteriological and antibiotic drug resistance profile of chronic suppurative otitis media at a tertiary care hospital in Western Rajasthan
Authors: Kombade Sarika Prabhakar , Kaur Navneet , Patro Sourabha Kumar , Nag Vijaya Lakshmi 
Published: July 2021

Background:
Chronic suppurative otitis media (CSOM) is a major cause of hearing disability and morbidity in poor socioeconomic developing countries with prevalence of 4%. Indiscriminate use of antibiotics and poor follow up of patients has resulted in treatment failure, emergence of resistant strains, super infection, intra-cranial and extra-cranial complications in CSOM patients. Staphylococcus aureus, P. aeruginosa, Proteus spp. and Klebsiella spp. are most common organisms causing infection. Knowledge of microbial profile and susceptibility pattern is essential for efficacious treatment of this disorder.

Objective:
To determine the clinico-bacteriological profile of CSOM, to analyze the susceptibility pattern of various antibiotics and to evaluate the in vitro efficacy of aminoglycosides over fluoroquinolones against the aerobic bacterial isolates from CSOM.

Methods:
We studied 153 clinically suspected CSOM cases from March 2018 to October 2018 in Microbiology and Otorhinolaryngology department. The ear swabs were aerobically cultured and identification of the isolate was done by standard bacteriological methods.

Results:
Safe type CSOM was a major cause of disease. Moderate (35.3%) and mild degree (32.7%) of hearing loss was seen in most of the CSOM cases. The culture positivity rate was 82.4% and the most common isolate was P. aeruginosa (55.8%) followed by S. aureus (27.5%). P. aeruginosa, A. baumannii and Enterobacteriaceae spp. showed high sensitivity to colistin, piperacillin-tazobactam, ceftazidime-tazobactam and good sensitivity for cefepime and amikacin; 33.3% S. aureus isolates were Methicillin-resistant which was sensitive to gentamicin, vancomycin and linezolid.

Conclusion:
Knowledge of the spectrum of microorganisms causing ear discharge is important for effective treatment.
Awareness and attitude about basic life support among medical school students in Jeddah University, 2019
Authors: Alghamdi Yousef Abdulwahab , Alghamdi Tariq Ahmad , Alghamdi Fahad Saleh , Alghamdi Amal Hassan 
Published: July 2021

Objectives:
To measure the level of knowledge and awareness towards basic life support (BLS) among students in preclinical years at Jeddah University (JU), and to determine their willingness to participate in BLS training in the near future.

Subjects and Methods:
A cross-sectional study was conducted among first-, second-, and third-year medical students of JU. A 27-item questionnaire measured the level of awareness and knowledge about BLS, including: 1) basic Information (seven items); 2) rescue reflex (eight items); and 3) CPR technique and process (12 items). Demographic and academic data, experience and exposure to BLS, and attitude regarding BLS (six items) were analysed as factors of adequate knowledge.

Results:
One hundred and four male students participated and 65 (62.5%) of them were in the second academic year. The correct answers varied from 10.6% to 67.3%, with eight items having <30% correct answers; and seven items showed >50% correct answers. Mean (SD) and median (P75) overall knowledge scores were 37.86 (13.92) and 37.04 (44.44) out of 100, respectively. Twenty-four (23.11%) participants attended a training course in BLS and 13 (12.5%) have ever performed BLS, either voluntarily or not voluntarily, and 18 (17.3%) felt that their current knowledge was sufficient. Knowledge level showed no statistically significant association with any of the investigated factors.

Conclusion:
There is an urgent need to integrate BLS courses to medical students to enrich their knowledge and improve resuscitation skills and ensure implementation of correct resuscitation techniques.