bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cardiovascular Risk Profiling Using the Globorisk Calculator among Noncommunicable Disease Patients Attending Primary Health Centers of a Tertiary Care Teaching Hospital in South India: A Cross-Sectional Analytical Study
Authors: Kar Sitanshu S. , Kannusamy Sivaranjini , Rehman Tanveer , Murali Sharan , Laxminarayanan Subitha , Balachander Jayaraman 
Published: March 2024

Background:
Cardiovascular diseases (CVDs) account for over three-quarters of all deaths taking place in developing nations.

Objective:
The present study aims to stratify noncommunicable disease (NCD) patients using the Globorisk chart for predicting their 10-year risk of a major (fatal or nonfatal) CVD event and to estimate the level of agreement between this country-specific chart and the existing World Health Organization (WHO)/International Society of Hypertension (ISH) risk strata.

Methods:
A record-based cross-sectional analytical study was conducted in 2018 among adults attending the NCD clinic of one rural and one urban primary health center in Puducherry. Laboratory and office risk calculators of the Globorisk chart were used to calculate the risk.

Results:
The median age (interquartile range (IQR)) of the 760 study participants was 58 (50–65) years. When calculated using the Globorisk prediction chart, 22.1% (n = 168) of the participants had a <10% risk for any CVD event in the next 10 years, whereas the same risk was found in 71.1% (n = 540) by using the WHO/ISH risk chart. There was no agreement found between the two risk charts (k = 0.0174; P-value = 0.26).

Conclusion:
The Globorisk chart was found to identify more patients as belonging to the higher risk category as compared to WHO/ISH charts.
Women’s Empowerment in the Context of Rural West Bengal: An Index Construction with Exploratory Factor Analysis
Authors: Chakraborty Sandipta , Paul Bobby , Bandyopadhyay Lina , Jana Dipankar , Bhattacharyya Madhumita 
Published: March 2024

Background:
Women’s empowerment, a precondition of sustainable development, is a multidimensional and complex concept, often described with three interrelated components: resources, agency, and achievement. There is no universal construct for women’s empowerment; rather, it has been assessed based on the context. It had been hardly explored in rural West Bengal.

Objectives:
This study was formulated to construct a women’s empowerment index (WEI), in rural West Bengal, and assess the reliability of the index.

Methods:
A community-based cross-sectional study focusing on Women’s Empowerment, Child Health and Nutrition (WE-CHANT) was conducted in a community development block in West Bengal. Mother (of reproductive age)–child (6–59 months) pairs were recruited from 20 villages by two-stage sampling (n = 268). Mothers were interviewed. Exploratory factor analysis (EFA) with oblique rotation was conducted with 25 measurement variables to construct the WEI. The internal consistency was assessed with Cronbach’s alpha, item-rest, average inter-item, inter-domain, and domain-to-index correlation.

Results:
A 12-item (factor loading ≥0.40) WEI comprising three domains—decision-making power, attitude toward gender-based violence (GBV), and social independence—was constructed with acceptable internal consistency (Cronbach’s alpha = 0.747). The multidimensionality of the index was also observed.

Conclusion:
A concise agency-based WEI was constructed, where decision-making power was explored as the major domain. This index in the context of rural West Bengal could be further utilized to assess women’s empowerment and elicit its association with resources and achievements.
Mental Health Disorders among Children and Associated Parental Stress: A Cross-Sectional Study in Pediatric OPD of Burdwan Medical College, West Bengal
Authors: Sarkar Anisha , Rahaman Sk. Moshihur , Das Dilip K. , Banerjee Niladri 
Published: March 2024

Background:
Identification of mental health disorders during childhood is crucial for healthy ‘adult roles’ in the society, so this study aimed to estimate the magnitude of ‘any mental health disorder’ and to find out its correlates among children attending the pediatric out-patient department (OPD) of a medical college in West Bengal and to estimate parental stress among their parents.

Materials and Methods:
It was a descriptive cross-sectional study done in the pediatric OPD of Burdwan Medical College, West Bengal, during July–December, 2021. The calculated size of 288 children aged between 4 and 12 years and attending with either of their parents was selected through systematic random sampling. One of their parents (preferably mother) was interviewed using a schedule, containing a pre-validated pediatric symptom checklist and parental stress scale. Ethical clearance was obtained from the Institutional Ethics Committee. Data were analyzed using SPSS-v23.

Results:
The median age of the children was 7 years (5–8 y.). The majority of them were male (57.6%), lived in urban areas (59.0%), and lived in joint families (57.6%). One-fifth (20.5%) of the children were found to have any mental health disorder (AMHD). Living in an urban area (aOR = 2.5, 95% CI: 1.1–5.7), belonging to a nuclear family (aOR = 3.6, 95% CI: 1.7–8.1), and belonging to a family with social problems (aOR = 7.8, 95% CI: 2.3–27.2) were significant correlates of AMHD. Parental stress [median: 60 (55–63)] was found significantly higher (P < 0.001) among parents of children with AMHD as compared to the parents of others.

Conclusion:
The magnitude of AMHD was high in this study, indicating toward the necessity of implementing opportunistic screening and appropriate public health action.
Reserve drug as first-line management: Topical interferon α-2b for vernal keratoconjunctivitis
Authors: Haral Saurabh Ramdas , Khan Taskin , Gupta Vishnu S , Ukalkar Madhura Sanjay 
Published: March 2024

Purpose:To elucidate the efficacy and safety profile of interferon α-2b in vernal keratoconjunctivitis (VKC).Methods:In this prospective interventional study, VKC patients fulfilling the inclusion and exclusion criteria were included and their signs and symptoms were scored based on the Clinical Scoring System. Patients were treated with topical interferon α-2b eye drop (1 MIU/ml) QID dosing for 6 weeks. Changes in symptoms and signs were evaluated at 2, 4, 8 weeks and 6 months after initiating treatment. A higher score meant severe disease, and a decline in score meant improvement in clinical signs and symptoms. Categorical variables were presented in number and percentage (%) and continuous variables as mean ± standard deviation (SD). Post-medication total subjective symptom score (TSSS) and total objective sign score (TOSS) were compared with baseline, and aP-value of <0.05 was considered significant. Possible ocular and systemic complications were evaluated.Results:The study included 40 patients (32 male and eight female) with a mean age of 8.05 ± 2.33 years. Mean baseline TSSS and TOSS were 6.71 ± 0.564 and 6.59 ± 0.262, respectively, which reduced to 2.71 ± 0.011 (P= 0.040) and 2.96 ± 0.210 (P= 0.032), respectively, at 4 weeks and further reduced to 0.42 ± 0.552 and 0.47 ± 0.434, respectively, at 8 weeks. After 6 months of stopping the drug, mean TSSS and TOSS did increase to 2.80 ± 0.820 (P= 0.044) and 2.50 ± 0.520 (P= 0.030), respectively, but was still statistically significant improvement compared to the baseline. Also, no ocular or systemic side effects were observed anytime during the study period.Conclusion:Eye drop interferon α-2b (1 million IU/ml) is a safe and effective option as first-line monotherapy for VKC. No side effects and recurrence were observed for 6 months.
Prognosis of concurrent endoscopic dacryocystorhinostomy and nasal septoplasty for chronic dacryocystitis with moderate nasal septum deviation
Authors: Zhang Junge , Ming Shuai , Qing Huiling , Han Wei , Li Shichao 
Published: March 2024

Context:
The prognosis of combined septoplasty and endoscopic dacryocystorhinostomy (En-DCR) for moderate nasal septum deviation (NSD) has not yet been fully investigated.

Purpose:
To evaluate whether septoplasty improves the prognosis of En-DCR for moderate NSD.

Settings and Design:
A retrospective cohort study in a real-world clinical setting.

Methods:
The postoperative FICI DCR ostium grading scores and functional and anatomical information at 1, 2, 3, and 6 months were determined for consecutive patients with chronic dacryocystitis (CD) and moderate NSD who underwent En-DCR.

Statistical Analysis Used:
Univariate and generalized estimating equation multivariate analyses were used to compare the outcomes of the septoplasty and non-septoplasty groups.

Results:
En-DCR and septoplasty were concurrently performed for 32 (20.1%, 32/158) cases. The total FICI DCR ostial scores for the septoplasty and non-septoplasty groups were highest at the first (4.97 ± 0.177 vs. 4.97 ± 0.176, P > 0.05) and lowest at the sixth (4.41 ± 1.341 vs. 4.50 ± 1.355, P > 0.05) postoperative months. At the end of follow-up, the two groups showed comparable proportions of patients requiring definitive intervention for the ostium (6.3% vs. 7.1%, P > 0.05), comparabe functional success rates (87.5% vs. 90.5%, P > 0.05) and anatomical success rates (93.8% vs. 92.9%, P > 0.05). Only the non-septoplasty group experienced nasal mucosal adhesions (3.2%, 4/126).

Conclusions:
In patients with CD and moderate NSD, nasal septoplasty did not impact En-DCR prognosis, but reduced the complications. Skilled surgeons should reconsider septoplasty in the absence of otolaryngological indications.
Tumor DNA sampling from aqueous humor in retinoblastoma – A report from South Asia
Authors: Meel Rachna , Sangwan Sushil K , Agrawal Sahil , Kashyap Seema , Sharma Arundhati 
Published: March 2024

Purpose:
Retinoblastoma (RB) is the most common intraocular tumor in pediatric age group. The role of genetics has been explored in predicting survival prognosis, but its role in predicting globe salvage remains largely unexplored. We hereby aim to isolate cell-free DNA (cfDNA) from aqueous humor (AH) in RB eyes and validate its use for genetic studies.

Methods:
AH was obtained from 26 eyes undergoing enucleation (arm A) or intravitreal chemotherapy (arm B). Isolation of cfDNA was done using QIAamp® Circulating Nucleic Acid kit, and the cfDNA was utilized for targeted sequencing of RB1 gene.

Results:
We could isolate cfDNA in all eyes (72% unilateral and 28% bilateral) with a distribution peak between 140 and 160 bp and a mean concentration of 27.75 ng/µl for arm A and 14 ng/µl for arm B. Targeted sequencing done on four samples showed RB1 gene mutations, namely, inframe deletion (c. 78-80del, p.Pro29del), start-loss mutation (c.1A>T, p.Met1?), nonsense mutations (c.2236G>T, p.Glu746Ter), (c.1659T>A, p.Cys553Ter), and (c.2065C>T, p.Gln689Ter), and novel missense mutations (c.672C>A, p.Asp224Glu) and c.692C>T (p.Pro231Leu). Genetic profile of cfDNA extracted from AH and genomic DNA from the tumor tissue was comparable.

Conclusion:
Our study supports the previous reports that AH may be used as a source of tumor-derived cfDNA. This is the first report from South Asia on isolation and genetic analysis of cfDNA from AH of RB eyes and, therefore, a big step forward in paving the role of tumor genetics in RB. Further studies are required to elucidate concordance between the tumor and AH genetic profile.
Quantitative and comparative analysis of thermography parameters in posterior scleritis, choroiditis, and controls
Authors: Kawali Ankush , Khanum Aayesha , Mishra Sai Bhakti , Sanjay Srinivasan , Mahendradas Padmamalini , Shetty Rohit 
Published: March 2024

Purpose:
To compare various ocular thermography parameters in posterior scleritis (PS), choroiditis (choroidal granuloma [CG], Vogt–Koyanagi–Harada [VKH] syndrome), central serous chorioretinopathy (CSCR), and healthy controls.

Methods:
This retrospective, observational, comparative study evaluated cases undergoing ocular thermography between April 2017 and October 2023. The study groups included cases of PS, CG, and VKH, while the control group comprised CSCR cases and healthy individuals. Various thermography parameters were assessed, which were as follows: Ocular surface temperature (OST), central corneal temperature (CCT), average scleral temperature (ST), nasal scleral temperature (nST), temperature difference between both the eyes (∆t), and difference between scleral and corneal temperatures (ST – CCT, nST – CCT).

Results:
It was found that ∆t was significantly higher in the PS group compared to the CG (P = 0.005), CSCR (P = 0.0001), and control groups (dilated control: P =0.006, undilated control: P = 0.0001). ST – CCT and nST – CCT were significantly higher in the undilated control and CSCR groups and significantly lower in the PS group. ST – CCT and nST – CCT showed less difference in the affected eyes compared to contralateral healthy eyes of PS and CG cases. OST, CCT, ST, and nST displayed statistically insignificant differences across all groups.

Conclusion:
It is advisable to focus on temperature differences between the affected and healthy eyes, or the difference between the central corneal and scleral temperature of the affected eye, utilizing parameters such as ∆t, ST – CCT, and nST – CCT. These composite parameters offer a more effective approach than individual measurements like OST, CCT, ST, and nST. Thermography can serve as a screening tool to suspect and differentiate PS.
Locality is the strongest predictor of expert performance in image-based differentiation of bacterial and fungal corneal ulcers from India
Authors: Rosenberg Christopher R , Prajna Venkatesh , Srinivasan Muthiah K , Lalitha Prajna C , Krishnan Tiru , Rajaraman Revathi , Venugopal Anitha , Acharya Nisha , Seitzman Gerami D , Rose-Nussbaumer Jennifer , Woodward Maria A , Lietman Thomas M , Campbell John Peter , Keenan Jeremy D , Redd Travis K ,   On behalf of the Corneal Ulcer Image Interpretation Study Group
Published: March 2024

Purpose:
This study sought to identify the sources of differential performance and misclassification error among local (Indian) and external (non-Indian) corneal specialists in identifying bacterial and fungal keratitis based on corneal photography.

Methods:
This study is a secondary analysis of survey data assessing the ability of corneal specialists to identify acute bacterial versus fungal keratitis by using corneal photography. One-hundred images of 100 eyes from 100 patients with acute bacterial or fungal keratitis in South India were previously presented to an international cohort of cornea specialists for interpretation over the span of April to July 2021. Each expert provided a predicted probability that the ulcer was either bacterial or fungal. Using these data, we performed multivariable linear regression to identify factors predictive of expert performance, accounting for primary practice location and surrogate measures to infer local fungal ulcer prevalence, including locality, latitude, and dew point. In addition, Brier score decomposition was used to determine experts’ reliability (“calibration”) and resolution (“boldness”) and were compared between local (Indian) and external (non-Indian) experts.

Results:
Sixty-six experts from 16 countries participated. Indian practice location was the only independently significant predictor of performance in multivariable linear regression. Resolution among Indian experts was significantly better (0.08) than among non-Indian experts (0.01; P < 0.001), indicating greater confidence in their predictions. There was no significant difference in reliability between the two groups (P = 0.40).

Conclusion:
Local cornea experts outperformed their international counterparts independent of regional variability in tropical risk factors for fungal keratitis. This may be explained by regional characteristics of infectious ulcers with which local corneal specialists are familiar.
Pain: A Necessary Evil? (Anesthetic Management of Congenital Pain Insensitivity Syndrome)
Authors: Vijapurkar Swati Keshav , Gade Sandeep , Karoo Khushbu , Rath Amrita 
Published: March 2024

Abstract
Congenital insensitivity to pain with anhidrosis (CIPA) is a rare autosomal disorder. It is characterized by systemic insensitivity to pain, unexplained fever, and psychiatric manifestations. Anesthetic management of these cases is a challenge to the anesthetist due to the various implications associated with it. In this case report, we describe the anesthetic management of a 3-year-old child with CIPA and report the implications and challenges faced
Anti-retroviral therapy adherence in India (2012-18): A systematic review and meta-analysis
Authors: Basu Saurav , Marimuthu Yamini , Garg Suneela , Saravanakumar Velusamy , Ganesh Balasubramanian 
Published: March 2024

Abstract

Background:
India has 2.1 million people living with HIV/AIDS (PLHIV). The objective of this study was to ascertain the extent of anti-retroviral therapy (ART) adherence and reasons for nonadherence among PLHIV in India.

Methods:
We conducted a systematic review and meta-analysis using the following criteria: (1) Observational or experimental studies conducted in India and (2) English language studies. Published during January 2012–June 2018 with data collection during the same period (3). 95% ART adherence rate (primary outcome). We reviewed bibliographic databases (PubMed, Scopus) and extracted relevant data. The forest plot was used to display the meta-analysis results. Analyses were performed in Stata 14 using the “Metaprop_one” function.

Results:
A total of 511 records were identified after removing duplicates, 59 full-texts were screened of which 15 studies were included in the meta-analysis. Only one study was conducted in rural India, with <95% adherence reported by all its participants. The PLHIV reported several reasons for their ART nonadherence including forgetfulness (8/15), running out of pills (3/15), distance from the health center and associated travel (2/15), alcohol abuse (3/15), concealment of HIV status from family (2/15, felt stigma (2/15), depressive symptoms (2/15), and fear of side-effects (2/15). The overall pooled estimate of ART adherence was 54.1% (95% confidence interval [CI] 27%–81%), while among facility-based studies, the ≥95% adherence rate was significant higher. 62% (95% CI 46%–0.78%).

Conclusions:
Despite the universal provision of free of cost ART to all PLHIV in government health facilities in India, suboptimal adherence to treatment persists in nearly half of these patients.
A Randomized Comparative Study to Evaluate the Efficacy of Dexmedetomidine used as an Adjuvant to Isobaric 1% 2-Chloroprocaine in Parturients Undergoing Elective Lower Segment Cesarean Section under Subarachnoid Block
Authors: Thada Beena , Sethi Surendra K. , Meena Yogesh K. , Rathore Mukut , Yadav Ratan L. 
Published: March 2024

Background and Aims:
Preservative-free 1% 2-chloroprocaine (2-CP) is an amino-ester local anesthetic (LA), suitable for short duration daycare or ambulatory surgeries. Dexmedetomidine as an adjuvant may enhance the efficacy of LA. Our study aimed to evaluate the analgesic efficacy and safety of intrathecal dexmedetomidine as an adjuvant to 1% 2-CP in parturients undergoing elective lower segment cesarean section (LSCS).

Material and Methods:
After obtaining approval from the Institutional Ethics Committee and informed written consent, 100 term parturients aged 18–35 years, belonging to American Society of Anesthesiologists (ASA) physical status II, undergoing elective LSCS were randomly allocated into two groups. Group CD received 1% preservative-free 2-CP 3 ml (30 mg) +0.5 ml dexmedetomidine (5 µg) diluted in (normal saline) NS, while Group C (n = 50) received 1% preservative-free 2-CP 3 ml (30 mg) +0.5 ml NS. Among the various parameters noted, duration of sensory block was the primary outcome measure while the onset of sensory block, highest dermatomal level achieved, time to achieve highest dermatomal level, time to two-segment regression, onset and duration of motor block, duration of analgesia, Visual Analog Scale (VAS) score, Apgar score, hemodynamic changes, and side effects were secondary outcome measures.

Results:
Both groups were comparable with respect to demographic profile, onset of sensory block, onset and duration of motor block. The duration of sensory block (100.12 ± 15.41 versus 71.68 ± 4.68 min) (<0.0001) as well as the duration of analgesia (113.08 ± 13.74 versus 81.60 ± 8.28 min) (<0.0001) were significantly prolonged in Group CD compared to Group C. Apgar score of newborns, hemodynamic parameters, and adverse effects were comparable in two groups.

Conclusion:
Intrathecal dexmedetomidine (5 µg) as an adjuvant to preservative-free 1% 2-CP results in a prolonged duration of both sensory block and analgesia for LSCS without affecting motor block characteristics.
A Double-Blinded Prospective Randomized Control Study of Preoperative Administration of Intravenous Mephentermine Vs Intramuscular Mephentermine in Preventing Post-Spinal Hypotension in Caesarean Section
Authors: Datta Sagnik , Chattopadhyay Suman , Mandi Arun K. , Bhar Debasish 
Published: March 2024

Context:
Mephentermine by intramuscular route prevents post-spinal anesthesia hypotension. However, the intravenous route had not been tried earlier for this prophylactic purpose.

Aims:
Comparing the safety and efficacy of intravenous and intramuscular routes of mephentermine in preventing maternal hypotension during cesarean section (CS). The primary objective was to compare the incidences of hypotension.

Methods and Material:
ASA II term parturients posted for CS were randomized into three groups. Group I received intravenous mephentermine 10 mg just before spinal and 1 ml normal saline (NS) by intramuscular route 10 minutes before spinal. Group M received intramuscular mephentermine 15 mg 10 minutes before spinal and 1 ml NS by the intravenous route just before spinal. Group C received 1 ml NS intramuscularly 10 minutes before spinal and 1 ml NS by the intravenous route just before spinal. The vital parameters, episodes of hypotension, adverse events, and neonatal parameters were assessed.

Results:
During midterm analysis, it was found that Group I had significantly higher adverse effects, so data collection was stopped, with a total intake of 25 patients in Group M, 22 patients in Group I, and 20 patients in Group C, respectively. The incidence of hypotension was less with the use of IM (8%) and IV (22.7%) mephentermine compared to the control group (P value: <0.05). Group I had significantly more adverse events like headache (59%), chest pain (36.36%), and ST changes compared to other groups (P value: <0.001).

Conclusions:
We conclude that the intramuscular route is better for preventing post-spinal hypotension in cesarean section with lesser maternal side effects and a better Apgar score.