bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prediction of pre-eclampsia in diabetic pregnant women
Authors: Kumar Ashok , Vanamail Perumal , Gupta Ram Kumar , Husain Syed Akhtar 
Published: April 2024

Background & objectives:
Gestational or preexisting diabetes is one of the risk factors of pre-eclampsia. Both are responsible for higher maternal and fetal complications. The objective was to study clinical risk factors of pre-eclampsia and biochemical markers in early pregnancy of women with diabetes mellitus (DM)/gestational diabetes mellitus (GDM) for the development of pre-eclampsia.

Methods:
The study group comprised pregnant women diagnosed with GDM before the 20 wk of gestation and DM before pregnancy and the control group had age-, parity- and period of gestation-matched healthy women. Sex hormone-binding globulin (SHBG), insulin-like growth factor-I (IGF-I) and 25-hydroxy vitamin D [25(OH)D] levels and the polymorphism of these genes was evaluated at recruitment.

Results:
Out of 2050 pregnant women, 316 (15.41%) women (296 had GDM and 20 DM before pregnancy) were included in the study group. Of these, 96 women (30.38%) in the study group and 44 (13.92%) controls developed pre-eclampsia. Multivariate logistic regression analysis indicated those who belonged to the upper middle and upper class of socio-economic status (SES) were likely to be at 4.50 and 6.10 times higher risk of developing pre-eclampsia. The risk of getting pre-eclampsia among those who had DM before pregnancy and pre-eclampsia in their previous pregnancy was about 2.34 and 4.56 times higher compared to those who had no such events, respectively. The serum biomarkers [SHBG, IGF-I and 25(OH)D] were not found to be useful in predicting pre-eclampsia in women with GDM. To predict risk of development of pre-eclampsia, the fitted risk model by backward elimination procedure was used to calculate a risk score for each patient. Receiver operating characteristic (ROC) curve for pre-eclampsia showed that area under the curve was 0.68 (95% confidence interval: 0.63-0.73); P<0.001.

Interpretation & conclusions:
The findings of this study suggested that pregnant women with diabetes were at a higher risk for pre-eclampsia. SES, history of pre-eclampsia in previous pregnancy and pre-GDM were found to be the risk factors.
Radiological evaluation of metastatic lymph nodes in carcinoma cervix with emphasis on their infiltrative pattern
Authors: Dhamija Ekta , Baby Akhil , Bhatla Neerja , Pulappadi Vishnu Prasad , Kumar Mukesh , Kumar Sunesh , Kumar Lalit , Sharma Dayanand 
Published: April 2024

Background & objectives:
Imaging has been added to the International Federation of Gynecology and Obstetrics (FIGO) 2018 staging system of cervical carcinoma. This study was performed to assess the impact of imaging in staging and to ascertain the prevalence and pattern of nodal metastasis on contrast-enhanced computed tomography (CECT) in patients with cervical carcinoma who were treated based on FIGO 2009 staging system.

Methods:
This retrospective study was conducted to evaluate all patients with biopsy-proven cervical carcinoma who underwent CECT of abdomen at a tertiary cancer centre in north India from April 2017 to April 2019 and for whom either baseline or follow up scans were available. In patients with enlarged or necrotic lymph nodes, the location, size and pattern of infiltration of adjacent organs were recorded.

Results:
A total of 602 patients of cervical carcinoma had undergone CT during the study period, of whom 138 (22.9%) underwent CT at baseline and 464 (77.1%) patients during follow up. The FIGO (2009) stage distribution at the time of presentation was stage IB: 109 (18.1%); stage IIA: 14 (2.3%), stage IIB: 118 (19.6%), stage IIIA: 12 (2%), stage IIIB: 277 (46%), stage IVA: 20 (3.3%) and stage IVB: 52 (8.6%). Ninety of the 138 (65.22%) patients underwent a stage shift according to the FIGO 2018 because of the presence of enlarged lymph nodes at baseline scan. Sixteen (2.7%) patients had infiltrative nodal masses most commonly involving the blood vessels (n=14) followed by ureter (n=8), bones (n=5), muscle and bowel (n=3, each). The majority (14/16) of these patients presented with vague abdominal pain, discomfort and vomiting, while two had bone pain.

Interpretation & conclusions:
CECT at baseline helps in accurately assessing the stage in cervical carcinoma. It helps in the identification of lymph node metastasis in cervical carcinoma, which is crucial for guiding accurate management.
Association of hyperglycaemia at-admission & diabetes mellitus with 28 day mortality in patients admitted with moderate-severe SARS-CoV-2 infection: A retrospective study
Authors: Kurian Navya Mary , Yadav Subhash Chandra B. , Gurjar Mohan , Mishra Prabhakar , Sanjeev Om P. , Azim Afzal , Gupta Devendra , Hashim Zia , Verma Alka , Bhatia Eesh , Ghatak Tanmoy , Singh Ratender Kumar , Nath Alok , Sahoo Saroj Kumar , Dabadghao Preeti , Gupta Sushil 
Published: April 2024

Background & objectives:
The association between hyperglycaemia at admission, diabetes mellitus (DM) status and mortality in hospitalized SARS-CoV-2 infected patients is not clear. The purpose of this study was to determine the relationship between DM, at-admission hyperglycaemia and 28 day mortality in patients admitted with moderate-severe SARS-CoV-2 infection requiring intensive care.

Methods:
All consecutive moderate-to-severe patients with SARS-CoV-2 infection admitted to the intensive care units (ICUs) over six months were enrolled in this single-centre, retrospective study. The predicators for 28 day mortality were analysed from the independent variables including DM status and hyperglycaemia at-admission.

Results:
Four hundred and fifty two patients with SARS-CoV-2 were admitted to the ICU, with a mean age of 58.5±13.4 yr, 78.5 per cent being male, HbA1c of 7.2 per cent (6.3-8.8) and 63.7 per cent having DM. Overall, 28 day mortality was 48.9 per cent. In univariate analysis, mortality in diabetes patients was comparable with non-diabetes (47.9 vs. 50.6%, P=0.58), while it was significantly higher in hyperglycaemic group (60.4 vs. 35.8%, P<0.001). In multivariate Cox regression analysis, after adjusting for age, sex and comorbidities, hyperglycaemia at-admission was an independent risk factor of mortality [hazard ratio (HR) 1.45, 95% confidence interval (CI) (1.06-1.99), P<0.05].

Interpretation & conclusions:
This study showed that the presence of hyperglycaemia at-admission in critically ill SARS-CoV-2 patients was an independent predictor of 28 day mortality. However, the findings may be susceptible to unmeasured confounding, and more research from prospective studies is required.
Evaluation of Madras Diabetes Research Foundation-Indian Diabetes Risk Score in detecting undiagnosed diabetes in the Indian population: Results from the Indian Council of Medical Research-INdia DIABetes population-based study (INDIAB-15)
Authors: Deepa Mohan , Elangovan Nirmal , Venkatesan Ulagamathesan , Das Hiranya Kumar , Jampa Lobsang , Adhikari Prabha , Joshi Prashant P. , Budnah Richard O. , Suokhrie Vizolie , John Mary , Tobgay Karma Jigme , Subashini Radhakrishnan , Pradeepa Rajendra , Anjana Ranjit Mohan , Mohan Viswanathan , Kaur Tanvir , Dhaliwal Rupinder Singh ,   for the ICMR-INDIAB Collaborative Study Group
Published: April 2024

Background & objectives:
Screening of individuals for early detection and identification of undiagnosed diabetes can help in reducing the burden of diabetic complications. This study aimed to evaluate the performance of Madras Diabetes Research Foundation (MDRF)-Indian Diabetes Risk Score (IDRS) to screen for undiagnosed type 2 diabetes in a large representative population in India.

Methods:
Data were acquired from the Indian Council of Medical Research–INdia DIABetes (ICMR–INDIAB) study, a large national survey that included both urban and rural populations from 30 states/union territories in India. Stratified multistage design was followed to obtain a sample of 113,043 individuals (94.2% response rate). MDRF-IDRS used four simple parameters, viz. age, waist circumference, family history of diabetes and physical activity to detect undiagnosed diabetes. Receiver operating characteristic (ROC) with area under the curve (AUC) was used to assess the performance of MDRF-IDRS.

Results:
We identified that 32.4, 52.7 and 14.9 per cent of the general population were under high-, moderate- and low-risk category of diabetes. Among the newly diagnosed individuals with diabetes [diagnosed by oral glucose tolerance test (OGTT)], 60.2, 35.9 and 3.9 per cent were identified under high-, moderate- and low-risk categories of IDRS. The ROC-AUC for the identification of diabetes was 0.697 (95% confidence interval: 0.684-0.709) for urban population and 0.694 (0.684-0.704) for rural, as well as 0.693 (0.682-0.705) for males and 0.707 (0.697-0.718) for females. MDRF-IDRS performed well when the population were sub-categorized by state or by regions.

Interpretation & conclusions:
Performance of MDRF-IDRS is evaluated across the nation and is found to be suitable for easy and effective screening of diabetes in Asian Indians.
Diagnostic performance of combined use of automated breast volume scanning & hand-held ultrasound for breast lesions
Authors: Liu Jialin , Zhou Yang , Wu Jialing , Li Peng , Liang Xinyu , Duan Haonan , Wu Xueqing , Hou Xiukun , Li Xiaofeng 
Published: April 2024

Background & objectives:
Breast cancer being one of the most common malignant tumours among women, diagnostic modalities for early detection of the same become of paramount importance. In this context, the hand-held ultrasound (HHUS) and automated breast volume scanner (ABVS) could provide valuable information for clinicians to diagnose breast diseases. This study aimed to compare and evaluate the diagnostic performance of combined use of HHUS and ABVS for the differentiation of benign and malignant breast lesions.

Methods:
A total of 361 female patients, who underwent both HHUS and ABVS examinations were included in this study. ABVS and HHUS images were interpreted using the American College of Radiology Breast Imaging-Reporting and Data System (BI-RADS). The distributions of the BI-RADS categories and pathology results were shown as specific numbers. Kappa coefficients test (κ) was calculated to compare the diagnostic results amongst the ABVS, HHUS and ABVS combined with HHUS. The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of the three diagnostic methods were calculated and their respective diagnostic performance was analyzed by receiver operator characteristic curve.

Results:
Of a total of 431 lesions, 153 (35.5%) were malignant and 278 (64.5%) were benign. With respect to the pathology results, the value of κ was 0.713 (P<0.001) for HHUS, κ=0.765 (P<0.001) for ABVS and κ=0.815 (P<0.001) for HHUS+ABVS. The sensitivity, specificity, accuracy, PPV and NPV for HHUS combined with ABVS were 96.08 (147/153), 88.49 (246/278), 91.18 (393/431), 82.12 (147/179) and 97.62 per cent (246/252) respectively. For HHUS, these were 90.20 (138/153), 84.17 (234/278), 86.31 (372/431), 75.82 (138/182) and 93.98 per cent (234/249) respectively; and for ABVS these were 92.16 (141/153), 87.05 (242/278), 88.86 (383/431), 79.66 (141/177) and 95.28 per cent (242/254), respectively. There was no significant difference amongst these three methods, but the diagnostic performance of HHUS combined with ABVS was better than, or at least equal to, that of HHUS or ABVS alone.

Interpretation & conclusions:
The results of this study suggest that ABVS is a promising and advantageous modality for breast cancer detection. Furthermore, the combination of HHUS and ABVS showed a more comparable diagnostic performance than HHUS or ABVS alone for distinguishing between benign and malignant breast lesions.
Assessment of prevalence and need for screening of diabetic retinopathy using non-mydriatic fundus camera in rural and tribal diabetic populations in Maharashtra
Authors: Jain Pranjal , Shukla Ajay K , Singh Smita , Sheikh Azhar M , Malwe Gaurav 
Published: April 2024

Purpose:
To assess the prevalence of DR and the need for screening and management of DR with medical management of diabetes in rural and tribal population in Maharashtra.

Methods:
The known diabetics of rural area and tribal area were screened at corresponding primary health centers, subcenters, and village level with the help of local healthcare workers using a portable non-mydriatic fundus camera. The prevalence of blindness among known diabetics in rural area was 1.29%, and 0.84% in tribal area.

Results:
In the rural area, the prevalence of diabetic retinopathy (DR) was 5.67% (n = 776), out of those 18.18% had sight threatening diabetic retinopathy (STDR). The prevalence of DR was 7.73% (n = 711) in tribal areas, out of those, 30.90% had STDR.

Conclusions:
The significant risk factors were identified to be the duration of diabetes and poor glycemic control. Implementation of targeted interventions for screening and management are required to reduce the risk of blindness among known diabetics in rural and tribal areas.
Outcomes after giant peripheral retinotomy and anterior flap retinectomy for rhegmatogenous retinal detachments with advanced proliferative vitreoretinopathy using small gauge vitrectomy
Authors: Agarwal Aniruddha , Menia Nitin Kumar , Markan Ashish , Sallam Ahmed B , Habib Ahmed , Mansour Ahmed , Iovino Claudio , Peiretti Enrico , Demirel Sibel , Tawfiq Mohamed Ahmed , Hanout Mostafa , Gupta Vishali , Ghazi Nicola , Sengupta Sabyasachi 
Published: April 2024

Purpose:
To analyze the visual and anatomical outcomes for eyes with rhegmatogenous retinal detachment (RRD) and advanced proliferative vitreoretinopathy (PVR) undergoing giant peripheral retinotomy (GPR) using 25-gauge pars plana vitrectomy (PPV).

Methods:
In this retrospective multi-center study, patients with RRD with either anteroposterior or circumferential retinal shortening and advanced PVR requiring more than 90-degree GPR with/without relaxing retinotomy were included. Subjects of either gender, any age group, and with complete surgical notes were included. Outcome measures of the study included anatomical success (i.e. complete retinal re-attachment) at 6 months using survival analysis, visual outcomes, and post-operative complications.

Results:
Forty-one eyes of 41 patients (33 males) with a mean age of 44.9 ± 21.4 years were included. At 6 months follow-up, anatomical success was seen in 29 eyes (70.7%) with a cumulative re-attachment rate of 66% (95% confidence interval = 48 = 79%). All re-detachments occurred at ≤6 months with a peak at 4–6 months (n = 9). Twenty-three eyes (56%) achieved ambulatory vision (5/200) or better. Direct perfluorocarbon liquid-silicone oil exchange was performed in 20 eyes. Intra-operative complications included persistent retinal folds (2 eyes), subretinal air (1 eye), and subretinal bleed (1 eye). Eleven eyes (26.8%) developed secondary glaucoma (2 eyes required a drainage device), and hypotony of ≤6 mmHg was noted in 3 eyes (7.3%). Corneal decompensation was noted in 8 eyes (19.5%), and 3 eyes (7.3%) underwent re-surgery for re-RRD.

Conclusion:
After GPR using small gauge PPV, two-thirds achieve anatomical success, and over half have ambulatory vision, but overall post-operative complications can occur in more than half of the eyes.
Ophthalmologic profile of patients with systemic sclerosis
Authors: Choudhary Sandeep , Chattopadhyay Arghya , Gupta Pankaj , Mehta Aditi , Jain Siddharth , Machhua Sanghamitra , Minz Ranjana W , Bansal Reema , Sehgal Shobha , Pandav Surinder S , Sharma Shefali K 
Published: April 2024

Purpose:
To study the ophthalmologic manifestations of systemic sclerosis (SSc) and its correlation with autoantibody profile.

Methods:
A cross-sectional study on 200 eyes of 100 consecutive adult patients diagnosed with SSc was performed at a tertiary care center in Northern India. The examination of ocular adnexa, anterior segment, and posterior segment with slit-lamp biomicroscopy, tear film break-up time (TBUT), Schirmer’s II test, and choroidal thickness measurement by swept-source ocular coherence tomography was done. Autoantibody profile was available for 85 patients, and its statistical association with the ocular examination findings was analyzed.

Results:
In total, 100 patients (93 females and 7 males) were included. The mean age was 45.11 ± 11.68 years, and the mean disease duration was 6.93 ± 3.68 years. Meibomian gland disease was more commonly found in patients with the diffuse subtype of SSc (P = 0.037). Choroidal thickness was increased in 34% and decreased in 7% (reference range = 307 ± 79 µm) patients. Reduced TBUT, meibomian gland dysfunction, and eyelid stiffness had a statistically significant association with the presence of anti-Scl-70 antibody (P = 0.003, <0.0001, and 0.004, respectively). These patients had ocular fatigue, foreign body sensation, and burning sensation. No significant association was noted with the presence of SS-A/Ro and SS-B/La antibodies.

Conclusion:
This study highlights the need for an active comprehensive ophthalmic evaluation. Approximately 75% of the patients in our cohort had ocular involvement to varying extent. An isolated presence of anti-Scl70 antibody was also found to have a positive association with dry eye disease.
COVID-19 Impact on Senior Residents: Perceptions and Experiences of Physical Medicine and Rehabilitation Trainees
Authors: Tham Shuen-Loong , Ratha Krishnan Rathi , Kong Keng He , Nuez Odessa Setiota 
Published: April 2024

Abstract

Introduction:
Due to a surge of cases from the COVID-19 pandemic, senior residents (SRs) from the Physical Medicine and Rehabilitation Residency (PM and R) Programme, in a tertiary hospital, were deployed to manage COVID-19 cases. This was a stark difference to their usual job scope and training. This qualitative study used a phenomenological approach to understand the perceptions and experiences of PM and R SRs in a Singapore-based tertiary hospital during the COVID-19 pandemic.

Materials and Methods:
The study was conducted from 1st June 2020 to 30th November 2020. Eleven participants were enrolled through purposive sampling. Semi-structured in-depth interviews were conducted and transcribed. Using an inductive approach, the data were coded, and thematic analysis was performed.

Results:
Ten participants (90.9%) cited negative impacts of COVID-19 on their training. Four key themes with corresponding subthemes were identified: (1) curtailed training, (2) career in jeopardy, (3) psychological distress caused by uncertainties and (4) role fulfilment. An overarching concept of ‘ Struggles: Front-stage versus back-stage’ experienced by the SRs was derived from the themes and data.

Conclusions:
The interdependent relationship of these issues necessitates the multifaceted support of the frontline training physician. The pandemic exerted a significant effect on the mental health of people worldwide. We explored the public and personal roles and duties borne by the training PM and R physicians and the struggles that emerge from them. In humanising the training of frontline physicians, and acknowledging their familial and societal roles, we can lay down steps to better assist training doctors in the next pandemic/epidemic.
Rehabilitation of Traumatic Brain Injury among Sportspersons
Authors: Akoijam Joy Singh , Laimujam Sobhasini Devi 
Published: April 2024

Abstract
Traumatic brain injury (TBI) in sports, encompassing sport-related concussions (SRCs) and more severe injuries, poses a significant challenge globally. This review explores the challenges of TBI in sports, focusing on mild TBIs and SRC. Over 70% of TBIs are mild, presenting diverse challenges with a lack of consensus on rehabilitation. Diagnosis is challenging, and prognosis varies. Assessment tools like Sports Concussion Assessment Tool-5th Edition aid in sideline evaluation, and management involves rest and personalised rehabilitation. Prevention involves rule enforcement, education, ongoing research exploring neuroimaging techniques and the use of novel assessment tools. Collaborative, individualised approaches are crucial for TBI rehabilitation in sports. Further research is needed to refine strategies and enhance preventive measures.
Evaluation of Wrinkle and Dermal Thickness in the Forearm before and after Picosecond Laser Therapy
Authors: Wardhani Putri Hendria , Prakoeswa Cita Rosita Sigit , Listiawan Muhammad Yulianto 
Published: April 2024

Abstract

Background:
Skin wrinkles are generated as a result of the aging process. Dermal thickness underneath a wrinkle decreases absolutely. Approximately 20% of dermal thickness disappears as people become elderly. In recent times, people have attempted to reduce wrinkles using various procedures. Currently, available picosecond lasers in dermatology can create mechanical stress and the energy can be fractionated via diffractive lens arrays (DLA). An emerging indication for the picosecond laser includes photorejuvenation. Non-ablative laser skin rejuvenation therapy demonstrates the dermis can be safely reconstructed by only irradiating the skin surface with a laser. The clinical effects of picosecond pulse laser have been frequently reported, but few studies have included histological investigation.

Aims and Objectives:
This study aimed to evaluate wrinkle and dermal thickness in the forearm before and after picosecond laser therapy.

Materials and Methods:
Twenty healthy male and female subjects between 36 and 55 years old with wrinkles in the forearm who met the sample requirements and were willing to participate were recruited in this study. Clinical examination and biopsy for histopathological examination were carried out before and 4 weeks after therapy, then treatment was carried out using a picosecond laser.

Results:
At 1-month follow-up, a significant improvement was noted in wrinkle and dermal thickness (P < 0.05).

Conclusions:
This picosecond 755 nm alexandrite laser with DLA was found to be very effective in treating wrinkles, which was confirmed by a dermatologic assessment from forearm photographic assessment scaled and dermal thickness improvement.
Evaluation of Orthodontic Retention Protocol among Orthodontist and General Dentist-A Cross-Sectional Survey
Authors: Kumar S Ojass , Srinidhi S , Visshishta J , Sirisha Sapasetty , Ranganathan Sukanya , Priya K , Moulvi SMM , Mani Bhuvaneswari 
Published: April 2024

ABSTRACT

Aim:
The current study was conducted with the aim of evaluating the retention protocol followed by orthodontists in India.

Material and Methods:
A cross-sectional web-based questionnaire survey was carried out to evaluate the retention protocol. To determine the sample size, a pilot study was carried out, and the final sample arrived was 250 subjects. The current study’s inclusion criteria took into account those who had finished their BDS&MDS (Orthodontist).

Results:
The data were statistically examined when the surveys were received and completed. The choice for fixed retainers was 67.4%. Retainer wear time preferences ranged widely, with 60% preferring 12–18 hours. The initial post-retention check appointment was planned by the majority of orthodontists (47.6%) within the next three months. Recall appointments for retention checks were only planned by the majority of orthodontists (56.3%) once every three months. Regular involvement by patients at their retention check appointments was (38%).

Conclusion:
The most commonly used and preferred type of retainer is fixed retainer, and dentist preferences range around 12–18 hours of wear time. Furthermore, the duration of the retainer wear preferred by most orthodontists/dentists is 10 months to 2 years.