bluuebunny/crossref_metadata_2025_split huggingface dataset:
A randomized controlled trial comparing two antenatal care regimes in the management of mild to moderate gestational diabetes in a low-middle income country
Authors: Reddy Tamma A. , Nirupama Shiny , Raj Arathy , Tirkey Richa S. , Yenuberi Hilda , Mahasampath Gowri , Rathore Swati , Mathew Jiji E. 
Published: September 2024

ABSTRACT

Context:
The prevalence of gestational diabetes mellitus (GDM) in the Indian subcontinent has increased exponentially, especially after new diagnostic criteria. Identifying women who need close monitoring is a challenge. Ultrasound has been used to guide therapy but its use in the management of GDM has been used indiscriminately due to paucity of information. The use of ultrasound to guide the number of antenatal visits for adequate glycemic control has not been researched adequately. There is also a need to contrive antenatal care strategies that can obtain optimal neonatal outcomes without burdening the health system in low-middle income countries (LMIC).

Aims:
Our study was to compare pragmatic standard management of GDM with an ultrasound-guided regime (USGR) to prevent neonatal complications to ensure optimal care.

Settings and Designs:
A randomized controlled trial was done in a tertiary hospital between May 2019 and September 2021 in South India.

Methods and Materials:
Five hundred and eighty-eight women were randomized to a standard regime or USGR.

Statistical Analysis:
χ2 and t-test were used to compare outcomes.

Results:
Maternal and neonatal outcomes between standard and ultrasound USGR showed no significant difference in outcomes. Fetuses in USGR with AC ≥ 70th centile had macrosomia (3.59% vs 26.67%, P < 0.001), increased severity of diabetes (2.97% vs 16.67%, P < 0.001), 3rd- and 4th-degree perineal tear (2.95% vs 27.27%, P < 0.001). The increased number of visits did not decrease adverse outcomes.

Conclusion:
This small well-designed study did not show any advantage with USGR as compared to the pragmatic simple standard regime, in the treatment of women with GDM.
Prevalence of hypothyroidism among postmenopausal women in an urbanised village of northern India: A cross-sectional study
Authors: Sharma Priyanka , Verma Anita 
Published: September 2024

ABSTRACT

Introduction:
Hypothyroidism is among the most prevalent endocrine disorders worldwide. Its risk increases with menopause. The prevalence of hypothyroidism among menopausal women in India is unknown, as conclusive data are scarce. The present study was conducted to find out the prevalence of hypothyroidism among menopausal women in Delhi, India, and study the socio-demographic factors associated with it.

Methods:
This was a cross-sectional community-based study done among 282 menopausal women in an urbanised village in Delhi, India. Women with a previously known history of diagnosed thyroid disorders were also included in the study. Informed written consent was obtained from all participants. A socio-demographic profile was gathered by questionnaire and blood samples were collected and analysed for thyroid hormone levels.

Results:
The mean age of study participants was 51.1 years. The prevalence of hypothyroidism among postmenopausal women was 27.3% (77) with 19.9% (56) previously diagnosed and 7.3% (21) diagnosed by the present study. Out of 56 previously diagnosed hypothyroid study participants, only 26 (46.4%) participants had thyroid hormones in a normal range. Age, socio-economic status and literacy status were found to be significantly associated with hypothyroidism.

Conclusion:
About three postmenopausal women out of 10 were found to be hypothyroid. Nation-wide data were required to estimate the true burden of thyroid disorders in this population. The prevalence increased with age underscoring the need for further research to have conclusive evidence regarding this association. Hypothyroid women who are on treatment should undergo regular evaluation of thyroid hormones so that appropriate dose adjustments can be made for pharmacological therapies.
Risk factors of urolithiasis: A hospital-based retrospective study
Authors: Paluchamy Thenmozhi , Rani N Dilli , Bhuvaneswari G , Tamilselvi S 
Published: September 2024

ABSTRACT

Aim:
Urolithiasis is the most prevalent urinary tract disease, posing a global public health concern. The escalating prevalence and recurrence rates of urolithiasis are attributed to lifestyle modifications, such as reduced physical activity and dietary habits. This retrospective study aims to explore the risk factors associated with urolithiasis among individuals diagnosed with this condition.

Method:
A retrospective hospital-based study involving 60 participants meeting the inclusion criteria was conducted. The participants were selected through convenience sampling from the urology, nephrology, and medical wards at Saveetha Medical College and Hospital. Demographic variables were collected, and the risk factors were assessed using a checklist on one-to-one interviews.

Results:
The study unveiled that most participants (68%) were male. Eighty percent of participants had the risk factor of decreased water intake, 74% consumed excess tomatoes, 56% had a history of recurrent urinary tract infections, 64% consumed an excessive amount of salt daily, 72% experienced a decreased urine output, 53% had a habit of alcohol consumption, and 45% included milk and milk products in their daily diet. A small percentage (5%) had a family history of urolithiasis. Additionally, 6% were undergoing Siddha treatment.

Conclusion:
The findings from this study underscore the significant factors contributing to urolithiasis. They can inform public health campaigns to raise awareness about lifestyle modifications, dietary changes, and hydration protocols contributing to kidney stone formation.
Estimation of urea, uric acid and creatinine levels in patients of primary hypothyroidism – A cross-sectional study
Authors: Gali Bhagyashree , Bubanale Vanishree S. 
Published: September 2024

ABSTRACT

Background:
The thyroid gland is one of the largest endocrine glands in the body, secreting thyroxine (T4) and triiodothyronine (T3). Mild hypothyroidism can have negative consequences for a variety of tissues, even though clinically the patients are euthyroid. Many research studies were conducted to evaluate the serum creatinine levels of people with hypothyroidism; however, relatively little research was conducted to evaluate serum urea and serum creatinine levels in subclinical hypothyroidism. As a result, the current study was carried out to investigate urea, uric acid, and creatinine levels in hypothyroidism.

Objectives:
Our study aimed to determine and correlate the levels of urea, uric acid and creatinine in newly diagnosed primary hypothyroidism cases.

Materials and Methods:
In this cross-sectional study, 96 newly diagnosed cases of primary hypothyroidism were included. The findings were correlated with 20–60-year-old and sex-matched cases. Serum urea was determined by the kinetic method (Glutamate Dehydrogenase Method), serum uric acid by the uricase method and serum creatinine by Jaffe’s method in Erba’s Mannheim fully automated analyser.

Result:
This study showed a positive correlation between uric acid and thyroid stimulating hormone (TSH) and a negative correlation between urea and creatinine. There was no statistical significance in the mean values of urea, uric acid and creatinine but an increased level of urea, uric acid and creatinine was seen in the age group 20–30 years when compared with the other age groups.

Conclusion:
The study concludes that serum urea showed a positive correlation with TSH, whereas uric acid and creatinine showed a negative correlation with TSH, and there was no statistical significance in the mean values of urea, uric acid and creatinine in hypothyroid patients.
Improving access to utilize the healthcare services facilitated by ASHAs, ANMs and medical officers of PHC among scheduled tribe pregnant women: An interventional study
Authors: Ade Anju Damu , Guthi Visweswara Rao , Kondagunta Nagaraj , Kumar D. S. Sujith , Deekala Ravisankar , Vallepalli Chandrasekhar , Prathyusha T V D 
Published: September 2024

ABSTRACT

Introduction:
Early marriages, early childbirth, low BMI and high incidence of anaemia are known factors for high maternal mortality among tribal pregnant women.

Materials and Methods:
This was a mixed method study (qualitative and quantitative) undertaken to evaluate educational intervention package among tribal pregnant women in Chittoor District of Andhra Pradesh State in South India. A baseline household survey with the help of a semi-structured questionnaire was conducted in both intervention group (n = 109) and control group (n = 119) of ST habitations. An educational intervention was implemented through health education approach to bring about awareness and behavioural change among pregnant women regarding healthcare practices and utilization of health services. Qualitative data collection tool included semi-structured FGD. Quantitative data was analysed using SPSS version 26.0. Content analysis was done for qualitative data.

Results:
The findings of this study show that awareness and utilization with respect to various services facilitated by ASHAs, ANMs and medical officers are improved postintervention among tribal pregnant women, and the various reasons for non-utilization of services were lack of awareness, long distance of health facility, no transportation, poor socio-economic status, inadequate facilities at PHC, etc.,

Conclusion:
This study shows that intervention to improve awareness and health services utilization, and continuous health education should be imparted to all the pregnant mothers. For this healthcare providers like ASHA and ANM and medical officers should be trained and motivated to educate the community.
High fiber diet versus polyethylene glycol in management of chronic constipation in children with cerebral palsy: A randomized controlled trial
Authors: Arya Vandana , Khyalia Sailesh , Bhalla Kapil 
Published: September 2024

ABSTRACT

Background:
Constipation is one of the most common gastrointestinal symptoms in patients with cerebral palsy. This study was conducted with the aim to compare the efficacy of a high fiber diet and polyethylene glycol in the management of chronic constipation in children with cerebral palsy.

Methodology:
An open-label randomized controlled trial was conducted in the Department of Pediatrics of a tertiary care hospital in Northern India among cerebral palsy children aged 1–6 years having chronic constipation. Seventy children were enrolled in the study (35 in each group). Group A children received high fiber diet as per the diet chart prepared by the dietician. Group B received polyethylene glycol (0.5–1 g/kg/day) for a period of three months. At the end of four weeks and three months, all children were assessed for clinical improvement and both groups were compared in terms of stool frequency, consistency of stool, fecal incontinence, palpation of hard stool per abdomen, blood in stool, pain on defecation and overall satisfactory outcome. Satisfactory outcome was defined as defecation > two times weekly, soft stool, no pain on defecation, no palpation of hard stool on abdominal examination, no fecal incontinence, and no blood in stools. Children were also assessed for any adverse effects.

Results:
Baseline parameters and GMFCS were comparable in the two groups. Both group patients showed significant improvement in symptoms of constipation at the end of four weeks and three months compared to baseline. However, there was no significant difference between the two groups in terms of satisfactory outcome and parameters like frequency of stool, consistency of stool, palpation of hard stool, fecal incontinence, and blood in stools.

Conclusion:
A high fiber diet can be considered a good alternative to polyethylene glycol for the management of chronic constipation in children with cerebral palsy.
Depression among older adults who developed acute coronary syndrome (ACS) during hospitalization for non-cardiac illness: A prospective observational study
Authors: David Arun , Vijayakumar Priya , Vijayakumar M 
Published: September 2024

ABSTRACT

Background:
Atypical presentations of ACS delay its recognition and treatment in the older adults. During hospitalization, depression and functional decline, which is unique to older adults, leads to poor clinical outcome. Steps taken for its prevention is unlikely to become a priority for the Cardiologist. This study was conducted to identify depression among older adults who developed ACS during hospitalization for noncardiac illness and their outcome.

Methods:
310 older adults with ACS were included from 26 June 2020 to 13 October 2020. Subjects were divided into those admitted primarily due to an ACS (Group I, n = 94) and those developing ACS after admission for noncardiac illness (Group II, n = 216). Co morbidities, medications, investigations, management, clinical outcome, Geriatric Depression Scale was compared between the two groups at the time of admission, after 30 days and after 6 months.

Results:
Majority of them were admitted due to acute kidney injury (27.1%) in group II and had a non ST elevation ACS (90.2%). Optimum management was given to a lesser extent because of the clinical condition of these patients. Depression during hospitalization, during follow up and poor clinical, functional and cognitive outcome was more in group II.

Conclusion:
Optimum medical management was not given to considerable number of patients because of atypical presentations, clinical condition, along with functional and cognitive decline which resulted from depression. Clinicians must be vigilant for the development of depression when an older adult is admitted to the hospital, as early detection and optimum management provides better clinical outcome.
Knowledge, attitudes, practices, and sociocultural factors influencing cervical cancer screening and vaccination among women in rural communities of Gujarat: A mixed-methods study
Authors: Murugan Yogesh , Bhavana BM , Ekka Anurag , Gandhi Rohankumar , Dhaduk Kishorkumar Muljibhai 
Published: September 2024

ABSTRACT

Background:
Cervical cancer is a leading cause of cancer mortality among women in India. Screening can help in early detection and improve outcomes. However, uptake remains low, especially in rural areas. Understanding multidimensional factors influencing screening in local contexts is essential to promote equitable access. This study examined knowledge, attitudes, practices, and sociocultural factors associated with cervical cancer screening and vaccination in rural India.

Methods:
A mixed methods study was conducted among 400 women aged 18–60 years in rural Maharashtra. Quantitative data were collected on knowledge, attitudes, and screening practices by using a structured questionnaire. Qualitative data were gathered through in-depth interviews with 30 participants on perspectives influencing screening. Quantitative data were analyzed using descriptive statistics and logistic regression. Thematic analysis was done for qualitative data. The integration provided complementary insights.

Results:
Quantitative results showed poor knowledge (17% had good knowledge) and positive attitudes (64%) but low screening uptake (9%). Qualitative findings revealed limited awareness, stigma around gynecological exams, gender inequities, fear, fatalism, and low prioritization of self-care as screening barriers.

Conclusion:
Multifaceted strategies addressing knowledge gaps, gender roles, stigma, and access are required to improve cervical cancer screening in marginalized rural communities. Mixed methods provide comprehensive evidence for designing context-specific interventions.
Serum retinol binding protein 4 in individuals with essential hypertension and type 2 diabetes: A cross-sectional study
Authors: Jadhao Anand G. , Gaikwad Kapila B. , Yadav Ravi R. 
Published: September 2024

ABSTRACT

Background:
Cardiometabolic disorders, notably primary hypertension and type 2 diabetes, present substantial global health challenges. The intricate interplay between metabolic and cardiovascular pathways has prompted extensive research into molecular mechanisms linking these conditions. The adipokine Retinol Binding Protein 4 (RBP4), initially recognized for retinol transport, has emerged as a potential biomarker in the network of metabolic and cardiovascular dysfunction. Recent studies implicate RBP4 in insulin resistance and its complications, including hypertension. This study explores RBP4 dynamics in patients with primary hypertension and type 2 diabetes, aiming to contribute valuable insights into diagnostic and therapeutic advancements in managing these interconnected disorders.

Methods:
This cross-sectional study, conducted over 2 years in a tertiary healthcare centre of North India, aimed to investigate the serum concentration of Retinol Binding Protein 4 (RBP4) in 119 participants diagnosed with primary hypertension and type 2 diabetes. Ethical guidelines were strictly followed, and comprehensive clinical assessments, including blood pressure measurements, were performed. RBP4 levels were quantified using an ELISA kit, alongside markers of insulin resistance. Statistical analyses, involving t-tests and correlation assessments, sought to unravel potential associations between RBP4, insulin resistance, and blood pressure parameters using SPSS 20.0.

Results:
The study comprised 61 healthy control (HC) participants and 58 individuals diagnosed with both essential hypertension and type 2 diabetes (EH+T2D). EH+T2D participants were on average older (45.71 ± 9.29 years vs. 40.34 ± 9.47 years, P = 0.002). Dyslipidemia prevalence was markedly higher in EH+T2D (72.4% vs. 11.4%, P < 0.0001), accompanied by disrupted lipid profiles. Serum RBP4 concentration was significantly elevated in EH+T2D (49.17 ± 19.37 mg/L, P < 0.0001), suggesting its potential role in the shared pathophysiology of primary hypertension and type 2 diabetes. Pearson’s correlation analysis revealed associations between RBP4 levels, metabolic, and cardiovascular parameters, underscoring its potential as a link between these conditions.

Conclusion:
Elevated serum RBP4 levels suggest its potential as a novel biomarker in the shared pathophysiology of primary hypertension and type 2 diabetes. The correlation analysis highlights the intricate interplay between metabolic, lipid, and cardiovascular parameters, emphasizing the need for holistic interventions.
Prevalence of inadequate fruit and vegetable consumption and associated food choice motives among adults in an urban population in Kerala
Authors: Abraham Shilpa Sara , Mohandas K Sreelakshmi 
Published: September 2024

ABSTRACT

Background:
Existing literature does not account for food choice motives associated with the non-communicable disease risk factor of an unhealthy diet, primarily characterised by inadequate fruit and vegetable consumption, among adults residing in Kochi Municipal Corporation. Our study aims to measure the prevalence of inadequate fruit and vegetable consumption in this urban population and to identify priority food choice motives among individuals at risk.

Methods:
A community-based cross-sectional study was conducted among 300 adults (mean age 46 years, men 50%) selected by cluster sampling. Information on socio-demographic variables, diet, and food choice motives was collected through a pre-tested structured interview schedule. Binary logistic regression analysis was done to identify factors associated with inadequate fruit and vegetable consumption.

Results:
In our study, 86% (95% CI: 82.07-89.93) of participants reported inadequate fruit and vegetable consumption. The food choice motives of “price” [aOR 2.99, 95% CI: 1.32–6.78], “health” [aOR 2.56, 95% CI: 1.08–6.24], and “sensory appeal” [aOR 2.20, 95% CI: 1.06–4.56] were found to be significantly associated with inadequate fruit and vegetable consumption per day (P < 0.05).

Conclusion:
The high prevalence of inadequate fruit and vegetable consumption in this urban community necessitates targeted and comprehensive educational campaigns that highlight the health benefits and sensory appeal of fruits and vegetables, as well as the affordability of seasonal produce, to ensure adequate intake of these foods.
Outcomes and Dose-Response Ratio of Surgery on Three Muscles in Large-Angle Exotropia
Authors: Nabie Reza , Manouchehri Vahideh , Lesan Parinaz 
Published: September 2024

Purpose:
To evaluate the efficacy of three-muscle surgery for the treatment of large-angle exotropia with particular attention to the success rate and mean dose-response ratio.

Methods:
In a retrospective study, medical records were reviewed for 48 patients with exodeviation between 50 and 80 prism diopter (PD) who underwent bilateral lateral rectus recession as well as one medial rectus resection. Sex, age at surgery, presence of amblyopia, amount of preoperative and postoperative deviation, total amount of recessed and resected muscles, dose-response ratio, and associated vertical deviations were analyzed.

Results:
The mean age of patients at surgery was 25.4 ± 14.3 years old (range, 1–55). The mean preoperative deviation was measured 62.8 ± 7.5 PD (range, 50–80 PD). The mean amount of total recession and resection was 23 ± 1.3 mm. After a mean follow-up of 15 ± 25 months (range, 3–144), 85.4% of patients were within 10 PD of orthophoria. The mean postoperative deviation decreased to 3.8 ± 7.5 PD (range, 0–30 PD). A mean dose-response ratio of 2.5 ± 0.3 PD/mm (range, 0.9–3.1 PD/mm) was found. Of all patients, 14.6% demonstrated undercorrection.

Conclusion:
Simultaneous surgery on three muscles is an effective method in resolving large-angle exotropia and results in excellent outcomes with low risk of undercorrection.
Choroidal Features of Healthy Iranian Individuals
Authors: Banafsheafshan Ali , Zeidabadinejad Haniyeh , Mirghorbani Masoud , Faghihi Hooshang , Pour Elias Khalili , Riazi-Esfahani Hamid 
Published: September 2024

Abstract

Purpose:
To assess subfoveal choroidal thickness (SFCT) and choroidal vascularity index (CVI) profile in the Iranian healthy population and assessment of the inter-eye difference in this regard.

Methods:
In a cross-sectional study, 141 healthy subjects underwent an assessment of refraction and best-corrected visual acuity (BCVA), axial length (AL), and measurement of the intraocular pressure. The imaging of the choroid was performed using the enhanced-depth imaging mode of Spectralis optical coherence tomography from the foveal slab to measure SFCT and calculate CVI.

Results:
A total of 282 eyes of 141 healthy subjects (59.6% men, mean age of 60.86 ± 11.46 years) enrolled in the current study. The mean SFCT of the right and left eye was 247.40 ± 70.37 and 251.25 ± 72.19, respectively. The mean CVI of the right and left eye was 62.63 ± 3.77 and 63.19 ± 3.91, respectively. None of the measured parameters had statistically significant differences between the left and right eyes. In both univariate and multivariate regression analysis, CVI was significantly associated with BCVA (P < 0.001) but was not associated with age, spherical equivalent (SE), gender, central macular thickness (CMT), and SFCT. In univariate regression analysis, SFCT was significantly associated with age, refraction (P = 0.02), BCVA (P = 0.003), AL (P < 0.001), and CVI (P = 0.02) but not significantly associated with gender and CMT. In multivariate analysis, age (P < 0.001), gender (P = 0.001), and AL (P < 0.001) were significantly associated with SFCT, but SE, BCVA, CVI, and CMT were not significantly associated.

Conclusions:
This was the first investigation to assess the SFCT and CVI simultaneously in the Iranian population to establish a normative database for future studies. CVI was less variable than SFCT in a healthy population, and no statistically significant differences existed between the left and right eyes.