bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of glycemic status among hypercholesterolemic patients on atorvastatin in a tertiary care hospital – A retrospective study
Authors: Nalini R. , Ramya J. Ezhil , Karthick R. 
Published: May 2024

INTRODUCTION:
Statins are effective in reducing low-density lipoprotein cholesterol and are favorable in primary and secondary prevention of cardiovascular disease. Recent large trials have linked the use of statins and increased incidence of new-onset diabetes mellitus, the possibility of worsening of glucose level in individuals with diabetes following statin therapy, and this possibility is increased with the use of atorvastatin. This study was undertaken to analyze the possibility of the diabetogenic potential of atorvastatin among hypercholesterolemic patients.

MATERIALS AND METHODS:
This retrospective cohort study was conducted in the cardiology department from July 2019 to December 2019. Patients on atorvastatin for more than 6 months with normoglycemia on commencement of therapy were included. The occurrence of prediabetes or new-onset diabetes mellitus after atorvastatin therapy is the outcome of the study. Adverse drug effects to atorvastatin were also recorded and WHO-UMC causality assessment was performed. Descriptive statistics were performed for baseline and demographic characteristics.

RESULTS:
Sixty study participants were included in the study. Eighteen (30%) study participants developed prediabetes with an HbA1c value of 5.97 ± 0.22 and 17 (28%) of participants developed new-onset diabetes mellitus with an HbA1c value of 7.24 ± 0.50. Atorvastatin at dose of 40 mg was found to be the most frequently prescribed dose.

CONCLUSION:
Atorvastatin has a dose-dependent risk of developing new-onset diabetes mellitus. Hence, the following statin therapy glycemic status should be periodically monitored especially in patients with a large dose of atorvastatin and also in patients with higher risk factors for diabetes.
Pro-apoptotic, anti-metastatic, and anti-telomerase activity of Tinospora cordifolia and its active polysaccharide arabinogalactan during Benzo(a)pyrene-induced lung carcinogenesis
Authors: Mohan Vandana , Ashwani Koul 
Published: May 2024

BACKGROUND:
The present study aims to unravel the pro-apoptotic, anti-metastatic, and anti-telomerase activity of aqueous extract of Tinospora cordifolia stem (Aq.Tc) and its active component arabinogalactan (AG) during Benzo(a)pyrene [B(a)P]-induced lung tumorigenesis in mice.

MATERIALS AND METHODS:
Lung tumors were induced in male BALB/c mice using B(a)P as a carcinogen. Animals were administered twice with 50 mg/kg b.wt (i.p.) dosage of B(a)P at the 2nd and 4th week of the study. Mice were orally treated with Aq.Tc and AG on alternate days at a dose of 200 mg/kg b.wt and 7.5 mg/kg b.wt, respectively, for continuous 22 weeks.

RESULTS:
Oral administration of animals with Aq.Tc and AG suppressed the development of lung carcinogenesis by modulating the mRNA and protein expressions of different apoptotic genes; bcl-2, bax, caspase 3, and caspase 9. The pro-apoptotic proficiency of Aq.Tc and AG was further confirmed by DNA agarose gel electrophoresis showing fragmentation in B(a)P + Aq.Tc group and smear formation in B(a)P + AG group. In contrast to the control group, an increase in tumor invasion factors such as matrix metalloproteinases-2 (MMP-2) and MMP-9 was also observed in B(a)P treated animals. Nevertheless, Aq.Tc and AG treatment effectively mitigated the B(a)P-induced upregulation of MMP-2 and MMP-9. The activity of the telomerase enzyme was also observed to be upregulated in B(a)P treated animals which consecutively found to get normalized with the parallel administration of Aq.Tc and AG.

CONCLUSION:
Aq.Tc and AG successfully mitigated the altered expression of apoptosis, metastasis, and telomerase activity-associated genes during pulmonary carcinogenesis.
Intraoperative Analgesic Requirement using Surgical Plethysmographic Index Guidance in Lumbar Spine Surgeries: A Comparative Study
Authors: Kshirsagar Sujit Jagannath , Butiyani Pallavi , Sarkar Adnanali , Dangat Geetanjali , Prakash Lisa , Girishkumar G. , Raut Prathmesh 
Published: May 2024

Context:
The surgical plethysmographic index (SPI) has been introduced as a measure of the balance between nociception and anti-nociception. The SPI is proposed for the titration of intraoperative analgesic drugs during general anesthesia.

Aims:
This study aimed to compare the requirement of intraoperative analgesic consumption between SPI-guided analgesia and conventional analgesia practices, requirement of rescue analgesics and to study recovery time.

Subjects and Methods:
In this double-blind, randomized control study, 64 patients undergoing lumbar spine surgery were randomly divided into SPI-guided analgesia group (SPI) and conventional practice group (control). In the SPI group, patients received injection fentanyl bolus of 0.5 μg/kg whenever SPI value increased above 50. While in the conventional group, injection fentanyl 0.5 μg/kg was administered according to conventional clinical practice.

Statistical Analysis Used:
The statistical significance of difference of various categorical variables across two groups was tested using the Chi-square test. For assessing intergroup statistical significance of difference of various continuous measurements, independent sample t-test was used.

Results:
Intraoperative fentanyl requirement was 119.53 ± 16.48 μg in the conventional group and 142.97 ± 24.78 μg in SPI-guided group (P < 0.05). The difference was statistically significant. The mean recovery time in conventional group was 13.03 ± 1.03 min, and for SPI group, it was 13.53 ± 1.14 min (P > 0.05).

Conclusions:
We can conclude that SPI guidance may not always help in decreasing the dose of intraoperative opioid consumption. It should be used in combination with hemodynamic parameters. SPI guidance may not affect recovery time.
Comparison among Intrathecal Nalbuphine and Fentanyl in Combination with Chloroprocaine 1% for Short Surgical Lower Limb Procedures – A Prospective Randomized Control Trial
Authors: Sherikar Priti , Osheen Minna J , Mitragotri Milon , Gangadhar Arunima 
Published: May 2024

Background:
Preservative-free chloroprocaine (CP) 1% is being investigated for short surgeries but lacks immediate postoperative analgesia. Adding opioids to local anesthetic increases the quality of spinal anesthesia with prolongation of postoperative analgesia.

Aim:
The aim of this study is to compare the postoperative analgesic efficacy of intrathecal nalbuphine versus intrathecal fentanyl as an adjuvant to chlorprocaine 1% for short surgical lower limb procedures.

Materials and Methods:
After ethical committee approval, a prospective randomized double-blind comparative study was conducted on 90 patients of the American Society of Anesthesiologists classes 1 and 2, aged between 18 and 60 years who were scheduled for elective short surgical lower limb procedures. Group CP (n = 30) received CP 1% 40 mg (4 ml) plus saline (0.5 ml), Group CP with fentanyl (CF) (n = 30) received CP 1% 40 mg (4 ml) plus fentanyl 25 mcg (0.5 ml), and Group CP with nalbuphine (CN) (n = 30) received CP 1% 40 mg (4 ml) plus nalbuphine 0.8 mg (0.5 ml) intrathecally. After performing subarachnoid block, the parameters observed were – Onset, height, duration of sensory and motor blockade, duration of postoperative analgesia, hemodynamics, and adverse effects between the three groups noted.

Results:
The onset of sensory and motor block (min) is faster in Group CF (4.2 ± 0.2, 3.4 ± 0.4) compared to Group CN (4.8 ± 0.4, 3.7 ± 0.4) and Group CP (6.2 ± 0.4, 4 ± 0.4) (P < 0.001). The total sensory duration and motor duration are prolonged in Group CN (96.5 ± 5.2, 90 ± 3.9) compared to Group CF (94 ± 4, 87 ± 4.5) and Group CP (77 ± 3, 74 ± 4.5) (P < 0.001). The duration of postoperative analgesia was prolonged in Group CN (130 ± 5.3) compared to Group CF (111 ± 6.2) and Group C (93 ± 4.2) (P < 0.001).

Conclusion:
We conclude that intrathecal nalbuphine prolongs postoperative analgesia maximally compared to intrathecal fentanyl as an adjuvant to CP 1% for short surgical lower limb procedures.
Perception of human rights in health care: A cross-sectional study among tribal young adults of Puruliya, West Bengal
Authors: Khatoon Sajda , Johnson Annie , Bhattacharya Paramita , Mukherjee Nirmalya , John Denny , Jayanna Krishnamurthy 
Published: May 2024

ABSTRACT

Background:
Human rights provide a universal foundation for pursuing justice in public health in order to achieve the dignity of all individuals. In spite of international attempts to promote human rights in the context of health, a significant portion of India’s indigenous population continues to have a limited understanding of these rights.

Objective:
This study aims to analyze tribal people’s attitudes towards human rights in health care. The population consists of tribal residents from Manbazar – I and Puncha Blocks in the Puruliya district of West Bengal, India. Tribal young adults between the ages of 18 and 35 were the subject of a cross-sectional study.

Methods:
A pretested questionnaire was used to collect data. MS Excel and SPSS 27 were used for analysis. A descriptive analysis was carried out.

Results:
The participants’ mean scores for awareness, accessibility and communication, autonomy and sexual and reproductive health and sexual and reproductive health rights (SRHR) were 8.06, 15.76, 7.35 and 32.52 revealing a moderate perception level among the young adult tribal population in the selected blocks.

Conclusion:
A holistic focus of the governmental and other non-governmental organizations towards the tribals is required. Introducing various aspects of human rights in healthcare in the education curriculum along with community outreach would by all likelihood improve the perception of ‘Human Rights’ and thus help in better utilization of various services including health among tribal populations in India.
A study to assess the effect of yoga and diet on Framingham risk score among high-risk cardiovascular subjects
Authors: Saboo Neha , Rao Aayushee , Kacker Sudhanshu 
Published: May 2024

ABSTRACT

Introduction:
Cardiovascular diseases (CVDs) are a cluster of disorders of blood vessels and the heart. As a form of physical activity, yoga postures, and pranayama have been shown to be beneficial in various health conditions, i.e. hypertension, prediabetes, and diabetes among high-risk subjects. This study aimed to evaluate the impact of yoga and diet on the Framingham risk score (FRS) among high-risk cardiovascular subjects.

Materials and Methods:
The experimental interventional study was conducted at “RUHS College of Medical Sciences” and Associated Group of Hospitals”, Jaipur among high-risk cardiovascular subjects. FRS was used as a measurement for the outcome of interest at baseline and six months of yoga diet intervention in the study and control groups.

Results:
Mean age of participants was 48.43 ± 6.4 years. Baseline values (mean ± SD) of FRS 24.59 ± 10.15 after six months of yogic lifestyle 15.1 ± 7.05. After six months of yogic lifestyle FRS scores and estimated 10-year cardiovascular risk were statistically significantly (P < 0.0001) decreased. Pearson correlation analysis results depict that FRS correlation. There was a strong positive correlation between the FRS score and total cholesterol (r = 0.787; P < 0.001) and a negative strong correlation between the FRS score and high-density lipoprotein was observed (r =−0.621; P < 0.002).

Conclusion:
The findings of this study conclude that six months of yoga and diet lifestyle intervention significantly decreased FRS among high-risk CVD subjects compared to the control group.
Repurposing surgical wards in pandemics – An appraisal of outcomes of COVID-19 patients treated in Orthopaedic wards
Authors: Behera Prateek , Ahmad Zainab , Dubepuria Amol , Mishra Nitu , Chatterjee Anirban , Santoshi John A. , Haq Rehan Ul , Sharma Jai Prakash 
Published: May 2024

ABSTRACT

Background:
The COVID-19 pandemic resulted in a shift in the way healthcare resources were used. While India faced limited effects in the first COVID wave primarily due to strict lockdown of the county, it was one of the worst affected in the second wave and at one time reported the highest number of daily cases. To address the lack of intensive care units (ICU) beds, the surgical wards of our institute were repurposed to take care of patients requiring supplementary oxygen and other supportive care till either they improved or an ICU bed was available. The medical personnel in charge of the surgical wards were entrusted with the care of patients with support from intensive care support teams (ICST).

Aims:
We aimed to examine the clinical details of patients admitted in the repurposed orthopaedic wards during the second COVID wave and to evaluate the factors that might affect the clinical outcomes in such patients.

Methods:
This was a retrospective review of records of patients admitted in the repurposed orthopaedic wards between 16 April 2021 and 20 May 2021. Details related to demography, COVID-19 presentation, COVID-19-related management and clinical course, including transfers to ICUs, and outcomes in terms of either discharge to home or death were recorded. They were analysed using statistical software.

Results:
One hundred and twenty three patients were treated during the said period. Twenty patients died during treatment, resulting in a mortality rate of 16.3%. Age, gender, RT-PCR status, pre-existing comorbidities, SpO2 at admission, method of supplemental oxygen supply, total leukocyte counts, haemoglobin values, serum C-reactive protein, Lactate dehydrogenase (LDH) and creatinine values had no statistically significant association with death of a patient during treatment.

Conclusion:
Based on the results, one can state that clinicians of surgical specialities having background knowledge of internal medicine from undergraduate education can manage patients of COVID-19 with support from ICST with reasonable outcomes. In case of future pandemics, surgical wards can be repurposed to tide over exigencies. Additionally, primary care physicians, who are often the first point of contact for patients, can allay their apprehensions adequately in future pandemics, thus preventing widespread panic and burdening of healthcare resources.
Contraceptive knowledge, prevalence of contraception use, and the association between sex education and contraception knowledge among university students in Michigan, USA
Authors: Jahanfar Shayesteh , Zendehdel Mozhgan 
Published: May 2024

ABSTRACT

Background:
The danger of sexual activities among adolescents is worrisome worldwide. This study aimed to delineate total contraception knowledge of university students and the prevalence of contraceptive use, in addition to the association between sex education in school and the students’ contraception knowledge.

Materials and Methods:
A school-based cross-sectional study was carried out.

Results:
The mean total level of contraceptive knowledge was 16.53 ± 2.38, which ranged from 5 to 18. In response to which method was the most suitable for the youngsters, 36.3% responded pills, 49.2% condoms, 6.3% injection, 0.7% withdrawal, 0.5% periodic abstinence, and 5.9% other. Adjusted to sociodemographic characteristics and other confounders, students with a history of sex education in school tended to have a higher level of contraceptive knowledge than those without [AOR: 1.06; 95% CI: 0.15, 2.64]. Moreover, adjusted to the characteristics of one-night stands, students with a high level of contraceptive knowledge agreed that one-night stands were OK compared with those without the knowledge [AOR: 0.65; 95% CI: 0.16, 1.13].

Conclusion:
Although the total contraceptive knowledge was satisfactory, more attention should be paid to male students’ education. Modern and long-term effective contraceptive methods had better be included in the training program.
Etiological and clinical profiles of patients with dysphagia: A teaching institution experience
Authors: Goyal Sandeep , Jitender  , Garg Manjri , Bala Renu 
Published: May 2024

ABSTRACT

Background:
Dysphagia can involve any structure from the mouth to the lower esophageal sphincter. The etiologies vary from benign causes to malignant lesions. There is dearth of data regarding dysphagia in our population.

Methods:
A total of 208 patients with complaints of dysphagia were screened for the study. After ruling out neurological/local oropharyngeal causes of dysphagia, 200 patients with suspected esophageal dysphagia (ED) were recruited in the study. Dysphagia was graded as per the dysphagia scoring system. All patients underwent upper gastro-intestinal endoscopy and were evaluated for the presence of mechanical and non-mechanical causes of ED.

Results:
The mean age of patients with dysphagia was 53.8 ± 15.4 years. with males and females being 82 and 118, respectively. The mean duration of the symptom was 7.2 ± 10.6 months (median 3 months). Ninety-eight patients (49%) having dysphagia were in the age group of 56–65 years. The dysphagia score was 0 among 58, and 4 among 26 subjects. Foreign body sensation was the most frequent chief complaint in 90 (45%) patients. Ninety-six (48%) and 104 (52%) patients had mechanical and non-mechanical causes of dysphagia, respectively. Among mechanical causes of dysphagia, 68 patients (70.8%) had esophageal growth and 28 (29.2%) had esophageal stricture. Sixty-seven patients had squamous cell carcinoma. Among non-mechanical causes, 50 (48.1%) had globus sensation, 24 (23.1%) had hiatus hernia, and 16 (15.4%) functional dysphagia.

Conclusion:
Dysphagia is a common problem with varied etiologies. The esophageal growth and globus sensation are among the predominant causes of ED. We stress that all patients of dysphagia must be meticulously investigated.
Reasons and extent of delay in the diagnosis of pulmonary tuberculosis after the appearance of symptoms
Authors: Ahmad Zuber , Zubair Ishma , Ahmad Shahbaz , Zuber Nibras , Salar Wamiq 
Published: May 2024

ABSTRACT

Objective:
Delay in the diagnosis of tuberculosis (TB) is a significant problem at both individual and community levels. Delayed diagnosis of TB contributes to more severe disease manifestations, higher risk of death, and higher disease transmission in the community. We conducted this study to assess the extent and associated reasons for delay in diagnosis of pulmonary TB.

Methods:
This study was conducted in the Department of TB and Respiratory Diseases, J. N. Medical College, Aligarh, from June 2020 to May 2022. A total of 2053 new pulmonary TB patients, who first consulted any private healthcare provider (HCP) for treatment, were enrolled in the study. The required information was collected by interview technique using a predesigned questionnaire.

Results:
A total of 2053 patients were enrolled in the study. There was a significant delay of more than 2 weeks in the diagnosis of pulmonary TB after the onset of symptoms in 94% of patients. The extent of delay ranged from 8 days to 240 days with a mean of 36.33 days. The delay in visiting the HCPs by the patient was not significant. Only 5.85% of patients had a significant delay of more than 2 weeks in seeking any health care after the appearance of symptoms. A delay by HCP contributed to a greater portion of the total delay, with a mean of 31.77 days. The main reason for the delay by HCPs was not investigating TB. The hospital delay was not significant. The mean hospital delay was 5.82 days.

Conclusion:
The delay in the diagnosis of TB in India is very high. A delay by HCPs contributes to a greater portion of the total delay. Information, Education and Communication (IEC) activities will play an important role in reducing the delay. All HCPs should be actively involved in subjecting the suspects to TB diagnosis at the earliest possible as per National Tuberculosis Elimination Programme (NTEP) guidelines.
Comparison of the effect of intra-dermal injection of botulinum toxin and normal saline in the treatment of facial skin pores
Authors: Pazyar Nader , Ashoori Saeed , Mahdianrad Atefeh , Seyedtabib Maryam 
Published: May 2024

ABSTRACT

Background and Purpose:
Skin pores (SPs) are normal and benign skin structures that are mostly located on the face (nose, cheeks, etc.) that cause many aesthetic concerns or complaints. One known effective treatment is botulinum toxin A (BTXA), which is also approved for the treatment of strabismus, blepharospasm, muscle spasm, cervical dystonia, glabella wrinkles, and primary axillary hyperhidrosis. Therefore, the aim of this study was to compare the effect of intra-dermal injection of botulinum toxin and normal saline serum (NSS) in the treatment of large facial pores.

Methods:
The study included 25 people who referred to the skin clinic of Imam Khomeini Hospital in Ahvaz from June 2021 to January 2022 for the treatment of large facial skin pores. Randomly, some subjects were injected with botulinum toxin at ten points, and each point was equivalent to 2.5 units of Masport (500 units vial of Masport diluted with 10 ml of NSS). Some other people were injected with 0.05 ml of NSS by intra-dermal injection at ten points. Finally, the data were analyzed using SPSS-Ver. 22 software.

Results:
Based on optical coherence tomography results, it was determined that the diameter of facial pores decreased significantly (P = 0.011). Dermoscopy showed a significant decrease in the average size of facial pores (P < 0.011), and also, the pore score decreased significantly (P = 0.021). In addition, the results showed that the size of skin pores and facial fat on both sides of the face did not decrease significantly from the patients’ point of view (P = 0.71).

Conclusion:
Based on the results of the present study, it can be concluded that intra-dermal injection of botulinum toxin is an effective and safe method to control facial pores, which showed acceptable results after 3 months.