bluuebunny/crossref_metadata_2025_split huggingface dataset:
Audit of risk factors of drug-sensitive, drug-resistant tuberculosis disease, a case-control study of patients registered under NTEP, Gujarat
Authors: Shah Viral , Yogesh M , Kothari Deep R , Gandhi Rohankumar B , Nagda Jay J 
Published: September 2024

ABSTRACT

Background:
Characterizing risk factors for drug-resistant tuberculosis (TB) is critical to guide targeted interventions in high-burden settings like India. We aimed to identify socioeconomic, lifestyle, and clinical factors associated with drug-sensitive and drug-resistant TB acquisition.

Materials and Methods:
A comparative cross-sectional study recruited 350 bacteriologically confirmed TB patients registered under the National Tuberculosis Elimination Program (NTEP) in Gujarat, India, and 300 matched participants without active/past TB. Multinomial logistic regression analyzed risk factors for 200 drug-sensitive and 150 drug-resistant TB cases compared to participants without active or past TB.

Results:
Key factors independently associated with higher adjusted odds ratios (aOR) of both TB types included low socioeconomic status (SES) (drug-sensitive TB: aOR 1.7, 95% CI 1.2-2.5; drug-resistant TB: aOR 2.2, 95% CI 1.3-3.7), crowding (>5 persons/room) (drug-sensitive TB: aOR 1.6, 95% CI 1.1-2.3; drug-resistant TB: aOR 1.9, 95% CI 1.2-2.9), undernutrition (drug-sensitive TB: aOR 1.6, 95% CI 1.1-2.3; drug-resistant TB: aOR 2.0, 95% CI 1.2-3.2), smoking (drug-sensitive TB: aOR 1.5, 95% CI 1.0-2.3; drug-resistant TB: aOR 1.7, 95% CI 1.1-2.7), and indoor air pollution (drug-sensitive TB: aOR 1.5, 95% CI 1.0-2.2; drug-resistant TB: aOR 1.8, 95% CI 1.2-2.8).

Conclusion:
Marked social determinants and clinical risks drive heightened susceptibility for both TB types in India, while prior inadequate treatment and nosocomial exposures selectively enable additional drug resistance. Holistic prevention policies jointly targeting transmission, vulnerability, and curative factors are imperative.
How sleep duration impacts cognitive status among Indian population aged ≥45 years: Evidence from Longitudinal Aging Study India (LASI)
Authors: Halder Pritam , Kathirvel Srinath , Mamgai Anshul , Pal Saumyarup , Bisoi Sayani , Chattopadhyay Ankita , Rajan Abin K. 
Published: September 2024

ABSTRACT

Introduction:
An aging population is associated with an increased risk of cognitive decline. Sleep duration, both excess and deficiency, is a risk factor for cognitive impairment. Therefore, this study was conducted to assess the relationship between sleep duration and cognition in the Indian population.

Methods:
This study was a secondary analysis of the first wave of the Longitudinal Aging Study in India (LASI) conducted across India in all 34 states and union territories. Sleep duration was calculated using sleep and wake times, whereas cognition was measured as a composite cognitive index. Both univariable and multivariable linear regressions were performed on the composite cognitive score. Subgroup analyses were conducted based on sex and age groups (45-59 years and ≥60 years).

Results:
The median (IQR) cognition score was 25 (20-30). A sleep duration of ≤4 hours was associated with a decrease in cognition status of 1.15 points (1.57-0.72), and a sleep duration of ≥9 hours was associated with a decrease of 0.93 points (1.25-0.60). Subgroup analysis revealed that this relationship remained consistent across both genders and both age groups.

Conclusion:
Both long and short durations of sleep were seen to be associated with a decrease in cognition scores among Indian adults, in both sexes and both age groups. Thus, proper sleep duration can help in the prevention of declining cognition as one ages and the development of dementia.
Prevalence of malignancy in thyroid nodules with AUS cytopathology: A retrospective cross-sectional study
Authors: Alshalaan Abdullah M. , Elzain Waleed A. D. , Alfaifi Jaber , Alshahrani Jaber , Al Qahtani Mohammed Mana M. , Al Qahtani Hind A. A. , AlFlan Mohammed A. , Alshehri Shubayli H. H. , Al Asim Ahmed A. , Abonukhaa Afnan A. S. , Alshamrani Ali Saleh R. , Mustafa Alam Eldin Musa 
Published: September 2024

ABSTRACT

Background:
Category III (AUS; Atypia of Undetermined Significance) of The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) was established to describe thyroid nodule features that are neither benign nor cancerous.

Objectives:
This study aims to evaluate the rate of thyroid malignancy in patients diagnosed with AUS at the Armed Forces Hospital Southern Region (AFHSR), Saudi Arabia.

Method:
The patients (508) diagnosed with AUS in their thyroid nodules underwent fine-needle aspiration cytology (FNAC). Data were collected through a chart-based approach, reviewing patients’ medical records and relevant information.

Results:
Among the cases, the majority were females (84.6%). Among the different age groups, individuals between 40 and 50 years had the highest prevalence of thyroid nodules (32.5%). Approximately 27% of patients exhibited tumor sizes larger than 4 cm. FNAC results revealed 16.5% benign, 26% AUS, and 22.4% follicular neoplasm cases. Histopathology indicated 54.1% of benign and 37.2% of malignant cases. Papillary carcinoma accounts for 80.4% of all malignant cases. A significant correlation was observed between FNAC and postoperative histopathology (P value < 0.05). Hypoechoic nodules exhibited 33.9% of malignant cases, and calcification was observed in 25% of the cases. A significant association was found between malignancy and echogenicity and between malignancy and calcification (P value = 0.003 and 0.001, respectively).

Conclusion:
The findings of this study identify malignancy in thyroid nodules with AUS cytopathology, particularly in the Southern region of Saudi Arabia. The correlation between pre-surgery FNAC and postoperative histopathology supports FNAC’s diagnostic value. Additionally, echogenicity and calcification can potentially contribute to predicting nodule malignancy.
A clinical study of rhino-orbital-cerebral mucormycosis during the COVID-19 pandemic in western Maharashtra
Authors: Manade Varsha Vivek , Kotecha Megha R. 
Published: September 2024

ABSTRACT

Background:
The aim of the study was to describe the epidemiology and study the risk factors, clinical presentation, management, and outcome of rhino-orbital-cerebral mucormycosis (ROCM) in terms of mortality, exenteration, eye salvage, and vision salvage.

Methods:
This retrospective, observational study was carried out over a period of two months. A detailed history was noted, and an ophthalmological examination was done. The diagnosis was done by Potassium hydroxide (KOH) mount and fungal culture. Magnetic resonance imaging (MRI) of the orbit, brain, and paranasal sinuses were performed. Medical (intravenous amphotericin B, posaconazole), surgical (retrobulbar amphotericin B injection, exenteration, Functional Endoscopic Sinus Surgery (FESS)), or combined management was evaluated, and clinical outcomes was noted.

Results:
The mean age of patients was 54.2 years and the male-to-female ratio was 1.77/1. The most common underlying risk factor for ROCM was uncontrolled diabetes mellitus (70%), followed by the use of corticosteroids for the management of coronavirus disease 2019 (COVID-19) infection in 68% of patients. The most common clinical presentation was diminution of vision followed by eschar, ptosis, and proptosis. Medical and FESS were done in all patients; exenteration was done in 12% of patients. Sixty-six percent of patients were alive with regression of ROCM, 20% of patients were alive with residual, 8% of patients were alive with the progression of ROCM, and 6% of patients had expired. Among the ones who are alive, the ocular outcome was orbital exenteration in 12.76%, the eye was salvaged in 25.53 and vision salvage was achieved in 61.70%.

Conclusion:
ROCM affects older males. Immunosuppression due to COVID-19 infection, diabetes mellitus, and corticosteroid use in the management of COVID-19 are the main risk factors for the development of ROCM. Antifungal therapy along with surgical debridement decreases mortality.
Dapsone-induced haemolysis among leprosy patients on MDT from an endemic area of central India
Authors: Naik Krutika P. , Ganguly Satyaki , Shukla Arvind K. , Chhabra Namrata , Prabha Neel , Ahmed Ghazal 
Published: September 2024

ABSTRACT

Background and Aim:
Haemolysis due to dapsone as a part of MDT in leprosy patients has been long recognized. However, the frequency and severity of this side effect and factors associated with it have not been well documented. We planned to determine the frequency of dapsone-induced haemolysis in leprosy patients on MDT and various risk factors associated with it.

Materials and Methods:
This was a hospital-based retrospective analysis, conducted on 36 treatment completed or partially treated or on treatment leprosy patients in a tertiary care centre in Chhattisgarh.

Results:
Out of 36 patients, 83.3% showed a fall in haemoglobin from the baseline value (pre-treatment values). Dapsone was stopped in 33.3% of patients with a significant fall in haemoglobin. We found that the mean haemoglobin concentration for all patients fell from 13.05(+/−1.8) g/dl to 11.8(+/−1.9) g/dl (P < 0.05) which was statistically significant. A total of 25% of patients were labelled as confirmed cases of dapsone-induced haemolysis as per our definition.

Conclusion:
Our results underline the need to incorporate haematological investigations in leprosy management protocol, especially in primary care settings where the majority of leprosy patients are managed.
Effectiveness of communication in promoting utilisation of breast cancer screening services among women working in Anganwadi centres
Authors: Swathi HJ , Mokhasi Varsha R. , Raghavendra BL , Vinayaka HJ 
Published: September 2024

ABSTRACT

Background:
Breast cancer is the most common cancer among females, worldwide. Cancer screening in developing countries is mainly opportunistic type, characterized by low coverage and over-screening of women with increased access to health care services. This study was thus designed to understand the various factors preventing the participation and utilization of breast cancer screening, thereby study the different approaches for encouraging their participation and also the effectiveness of different ways of communication to Anganwadi Workers (AWW) and Anganwadi Helpers (AWH) in increasing breast cancer screening uptake at cancer screening camps.

Settings and Design:
It was a mixed-method study design among Anganwadi workers and helpers.

Methods and Material:
The study included 376 Anganwadi workers working in Kolar and Bangarpete Talukas. The trained Anganwadi supervisor followed by the respective PHC medical officer (in the intervention group) invited the AWW and AWH for breast cancer screening and only through Anganwadi supervisor (in control group). Those women (AWW and AWH) who did not attend the breast cancer screening camp were listed and contacted through mobile phone to find out the reasons for the same.

Statistical Analysis Used:
The data were analysed using SPSS statistics version 22; Chi-square and logistic regression were used to test significance.

Results:
There were 186 subjects in the intervention and 190 subjects in the control group. The mean (SD) age in intervention and control groups was 43.7 (8.5) and 44.2 (8.7) years, respectively. Amongst the 376 women (AWW and AWH) invited for the breast cancer screening service from both the groups, a total of 238 (63.2%) of them attended screening camp. The screening uptake was more in the intervention group (73.4%) compared with the control group (53.6%). This difference across the two groups (20%) was found to be statistically significant. The sub-category ‘anxiety’ (31.9%) was reported to be the highest barrier and least was in the sub-category ‘no replacement’ (4.3%). The sub-categories are also supported by verbatim quotes.

Conclusions:
The uptake of screening was more in the intervention group (73.4%) compared with the control group (53.6%). This difference of 20% was found to be statistically significant on univariate analysis (P < 0.001). After adjusting for confounders, it was found that both the approaches were equally effective.
The reference value of serum vitamin B12 among An-Najah National University
Authors: Alnees Mohammad , Kharraz Lubna , Awwad Mahdi , Najajra Duha , Hamdeh Nizar Abu , Darwish Abdalaziz , Shabaro Aseel , Hazzam Rola , Saleem Asma , Qaffaf Shatha , Hmiedan Dalia , Abuhayyat Sima , Kawasme Abdalla , Shekha Reem , Bawwab Majd 
Published: September 2024

ABSTRACT

Background:
Serum vitamin B12 plays a crucial role in cellular growth, DNA synthesis, and maintaining a healthy nervous system. Its deficiency can lead to various health issues, including cardiovascular problems. The reference range for vitamin B12 varies between populations due to cultural, genetic, and dietary differences.

Methods:
A cross-sectional study was conducted on 127 healthy An-Najah National University students aged between 18 and 25. Blood samples were collected, and a questionnaire assessed factors affecting vitamin B12 levels. Serum vitamin B12 levels were measured using ACCUBIND ELIZA microwells.

Results:
The study found a reference range for serum vitamin B12 of 136–640 pg/mL (5th to 95th percentile) among the studied population, which differed from the manufacturer’s claimed range of 200–835 pg/mL. Gender did not significantly affect the reference intervals.

Conclusion:
The study highlights the importance of establishing local reference values for laboratory tests like vitamin B12 due to variations in demographics. Further research in different Palestinian regions and age groups with larger sample sizes is recommended to refine these reference values.
Are we really hesitant toward routine immunization: Findings from a cross-sectional study in urban area in the tribal dominant state of India
Authors: Kiran Kumari A. , Kujur Anit , Kumar Dewesh , Sagar Vidya , Kumari Neelanjali , Anand Prerna , Soren Santosh K. , Ragini Kumari J. , Kujur Manisha , Sahu Surendra 
Published: September 2024

ABSTRACT

Background:
Vaccine hesitancy has been inching up and its root cause lies in the factors that influence the vaccination. The present study was conducted to find out the proportion and factors contributing to vaccine hesitancy for routine childhood vaccinations in the slum population.

Methods:
A community-based cross-sectional study was carried out among 210 children between the age group of 0 and 59 months residing in the urban slums of Ranchi in 2021. Data were collected during the household visit by interviewing the parents using a predesigned pretested interview schedule which was developed based on the validated version of the vaccine hesitancy survey questionnaire originally developed by the World Health Organization Strategic Advisory Group of Experts’ working group on vaccine hesitancy. Associations between variables were analyzed using logistic regression.

Results:
A total of 210 children whose parents had given consent were included in our study. The majority of the families, 188 (89.5%), were not hesitant while only 22 (10.5%) were vaccine hesitant. Tribal children and unreserved category children had adjusted odds ratio of 4.41 (95% CI, 1.61–45.46) and 7.75 (95% CI, 1.07–56.08) for the delay as against their reference category.

Conclusions:
Most of the children were vaccinated in our study area and the families have shown confidence in vaccines. Although there were delays in vaccination and the reasons for the delays must be addressed to prevent these vaccine-hesitant populations from turning into vaccine-refusal population. Uniformity in vaccination days in different health facilities in slum areas, appropriate antenatal information, and counseling regarding childhood vaccinations, widespread awareness, and improving mother’s education can help address the issue of vaccine hesitancy.
Comparative study of the relationship between empathy and motivation among undergraduate students of new curriculum and old curriculum
Authors: Sanga Aradhana , Ranjan Rajiv , Sanga Prerna , Kumari Rita , Sandhya Kumari , Kujur Babita 
Published: September 2024

ABSTRACT

Background:
The new competency-based curriculum incorporates the social sciences and humanism to the basic and clinical sciences, thus giving an integrated approach to medical education. Comparing the empathy score with the motivation level across the two curricula was thus planned to assess the current status.

Method:
A cross-sectional qualitative study using an Internet-based electronic survey containing both an academic motivation scale to assess the motivation level and Jefferson’s scale of empathy was used to assess empathy score.

Result:
From the above study, we concluded that males have a higher empathy score across both the curricula. >95% of students of both categories belonged to the High Intrinsic High Control motivational category. The empathy scores were slightly higher among the CBME (Competency Based Medical Education) group compared to the non-CBME group, but it was not statistically significant. In subgroup analysis, Phase 3 was found to have a significant association.

Conclusion:
The majority of the students fall in the High Intrinsic High Control category, where they have the next highest level of empathy. Phase 2 was found to have a significant association; it could be because of the positive effects of AETCOM classes on the ready-to-enter clinical exposure batch. The study also revealed that while motivation and empathy are generally linked, outliers existed, particularly among participants with low initial motivation but high empathy. This suggests a potential association between extrinsic motivation and empathy, possibly influenced by external factors.
A clinical comparative study on carbamylated haemoglobin as a surrogate marker to differentiate acute kidney injury from chronic kidney disease
Authors: Keshava H. K. , Sultana Sana , Suhas G. C. , Chadrashekhar H. R. 
Published: September 2024

ABSTRACT

Introduction:
Carbamylated haemoglobin is the result of reaction of isocyanate with N-terminal valine residues of the α and β chains of haemoglobin. Carbamylated haemoglobin concentration is dependent on the degree and duration of uraemia and thus may potentially serve as a marker to differentiate acute kidney injury (AKI) and chronic kidney disease (CKD).

Methods:
A hospital-based prospective clinical comparative study was conducted in an urban tertiary medical care centre. Carbamylated haemoglobin was estimated in a total of 60 patients, 30 each of chronic kidney disease and acute kidney injury. The comparison of the carbamylated haemoglobin levels among the CKD and AKI groups was done using Mann–Whitney test. The mean value of carbamylated haemoglobin among the CKD group was 240.71 ± 75.64 μgVH/g, whereas among the AKI group, it was 67.15 ± 17.05 μgVH/g. These values are statistically significant with P < 0.001.

Results:
Carbamylated haemoglobin values were elevated in relation to renal dysfunction, and it significantly correlated with chronicity of kidney disease. Mean CarHb among the CKD group was significantly high in comparison to the AKI group with statistical significance, with a P value of <0.001.

Conclusion:
It was significantly attributed in this study that carbamylated haemoglobin >100 μgVH/g is diagnostic of CKD and a value <100 μgVH/g is diagnostic of AKI. Thus, in this study, it can be concluded that carbamylated haemoglobin is a useful marker to differentiate AKI from CKD.
Serum zinc level in liver cirrhosis with hepatic encephalopathy and its correlation with different stages of hepatic encephalopathy
Authors: Kumar Divakar , Prasad Manoj Kumar , Kumar Sandeep , Aziz Tarique , Prasad Manohar Lal , Sinha Rashmi , Guria Rishi T. , Kumar Abhay , Vidyapati  , Kumar Sameer , Kumar Pramod 
Published: September 2024

ABSTRACT

Background:
Hepatic encephalopathy (HE) severe complication of liver cirrhosis with high mortality. Few studies have found zinc deficiency in liver cirrhosis and HE patients and found it as a precipitating factor for the development of HE. This study was done to measure the serum zinc level in patients with liver cirrhosis with HE and a correlation was obtained between serum zinc level with grades of HE.

Material and Methods:
A cross-sectional observational study was done on 150 patients with liver cirrhosis with HE at a tertiary care center in Jharkhand. All cases were evaluated by history taking, clinical examination, and a questionnaire and classified into different WHC grades of HE and CPC classes of cirrhosis. Routine blood investigations, imaging studies, and morning serum zinc levels were done for all patients.

Results:
Majority of patients with liver cirrhosis with HE had zinc deficiency. There was a statistically highly significant (P < .00001) association between low serum zinc levels and WHC grades of HE. The serum zinc levels in different classes of cirrhosis showed highly significant differences (P < .00001). The mean serum zinc level was significantly low in patients who died (35.56 ± 11.65 vs 48.36 ± 10.91, P < .0001). The study revealed a strong positive correlation (r = .88, P = .048) between serum zinc and serum albumin levels.

Conclusion:
Serum zinc is deficient in patients with liver cirrhosis and HE. Zinc deficiency is significantly associated with higher severity of cirrhosis and higher grades of HE. All patients with liver cirrhosis with HE and hypoalbuminemia should be evaluated for zinc deficiency.
The prevalence of short inter-pregnancy interval and its associated risk factors among women attending primary health care centers of NGHA in Jeddah, Saudi Arabia: A cross-sectional study
Authors: Hemedy Rawan A. , Wali Razaz M. , Alsulimani Fatemah A. 
Published: September 2024

ABSTRACT

Background:
The inter-pregnancy interval (IPI) refers to the time between one pregnancy and the next. Studies have shown that IPIs shorter than 18 months are linked to negative outcomes, such as preterm delivery, infant mortality, and small-for-gestational-age birth. The aim of this study was to measure the prevalence and risk factors of short inter-pregnancy intervals among women receiving care at primary health centers in Jeddah, Saudi Arabia.

Methods and Material:
This is a cross-sectional study conducted at primary health care centers among mothers with a history of giving birth to at least one child and having two successive pregnancies. The data was collected through face-to-face interviews using a structured questionnaire. Statistical analysis was carried out using RStudio (R version 4.3.0).

Results:
A total of 300 responses were analyzed. The prevalence of short IPI was 36.0%, 31.0% had prolonged IPI, and 33.0% had optimal IPI. Lower educational level, unemployment as a student, low or middle income, a rise in the number of children, typically more than six, and an increase in the number of male offspring, mostly four or more, lack of breastfeeding, and breastfeeding duration have all been identified as statistically significant risk factors for short IPIs.

Conclusions:
Short inter-pregnancy interval is prevalent in Jeddah city, which can negatively impact the perinatal outcomes. Addressing the risk factors and providing proper education in antenatal and postnatal clinics to reduce the number of unintended pregnancies can help in decreasing the number of short inter-pregnancy intervals and improving maternal and fetal outcomes.