bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sciatica masquerading parathyroid carcinoma
Authors: Nellaiappar P , Hussain Zahir , Parvathy N. Ananda , Venkatesh N. Susruta , Ramalingam A. Karthick 
Published: March 2023

Primary hyperparathyroidism is detected in the Western world in an asymptomatic stage due to routine calcium screening. In India, patients are still diagnosed with various symptoms such as bone disease and renal disease and only 5.6% are in the asymptomatic stage. A 48-year-old female came with complaints of right hip pain of 1-month duration. She had low back pain a year ago radiating to both thighs. The pain was not suggestive of inflammatory arthritis, and the autoimmune profile was negative. The pain progressively worsened, and the patient became bedridden. General examination revealed left-sided neck swelling that moved with deglutition. Right lower-limb movement was restricted by severe pain. Magnetic resonance imaging of the lumbar spine revealed a diffuse altered signal intensity involving the entire spine, bilateral pelvis, and femur with hypointense on both T1 and T2 images suggestive of marrow infiltrative disorder. Her serum calcium was 12.7 mg/dl and serum phosphorus was 1.9 mg/dl. The patient's alkaline phosphatase was 2919 IU/L. Her parathyroid hormone level was 2095 pg/ml. The patient was diagnosed to have hyperparathyroidism. 99mTc-sestamibi parathyroid single-photon emission computed tomography–computed tomography was suggestive of left superior parathyroid adenoma. The surgical endocrinologist did a left superior parathyroidectomy. Postoperatively, she developed hypocalcemia. It was managed with intravenous calcium infusion, oral calcium, and oral calcitriol. Six weeks after surgery, the pain in the right hip decreased significantly, and she was able to walk without support. Histopathological examination of the removed parathyroid was suggestive of parathyroid carcinoma.

The following core competencies are addressed in this article:
Practice-based learning and improvement, Medical knowledge.
The effect of social media addiction on burnout among health-care students and professionals in Saudi Arabia
Authors: Badri Hatim Matooq , Aboalshamat Khalid Talal , Abdouh Ismail Mahmoud , Quronfulah Baraa Sami , Mahmoud Mahmoud Abdulrahman , Rajeh Mona Talal , Badawoud Amal Mohammad , Alzhrani Abdullah Muhammad 
Published: March 2023

Introduction:
The rapid growth of information technology and the widespread use of smartphones has created the perfect environment for social media addiction, a condition that affects all members of society, including health-care students and professionals. Current evidence suggests that the direct and indirect effects of social media addiction on human health could include, among other things, burnout. This study aimed to investigate the possible relationship between social media addiction and burnout among health-care students and professionals in Saudi Arabia.

Materials and Methods:
A cross-sectional study design was used with an online questionnaire distributed to health-care students and professionals via social media platforms. A convenience sampling method was used to collect the data. The questionnaire consisted of three sections measuring demographic variables, social media addiction, and burnout.

Results:
The 789 participants who completed the questionnaire had a mean age of 25.77 years (± 8.26) and came from 22 cities in Saudi Arabia. Students had significantly higher scores for social media addiction than interns/residents (P = 0.018) or specialists/consultants (P < 0.001). Participants were found to experience different levels of burnout, reporting no/mild burnout (34.98%), moderate burnout (35.49%), high levels of burnout (23.83%), and severe burnout (5.7%). A significant direct relationship between social media addiction and burnout was found (F [1,787] = 91.877, P < 0.001, R
2 = 0.105).

Conclusion:
The findings provide insight into the prevalence of social media addiction and burnout among health-care students and professionals and the possible association between two variables. There is a need for further research comparing the correlation between social media addiction and burnout in different groups (i.e., students, interns/residents, and specialists/consultants), as well as identifying factors that affect social media addiction and burnout among these groups.

The following core competencies are addressed in this article:
Medical knowledge, Interpersonal and communication skills, and Professionalism.
The Status of Insulin Access in Middle East-North Africa Region
Authors: Odhaib Samih Abed , Masood Shabeen Naz , Shegem Nadima , Khalifa Suha Falah , Abi Saad Michele , Eltom Mohamed , Belkhadir Jamal , Sandid Mohammad , Iraqi Hinde , Sedaghat Sara , Abdul-Kareem Hazim , Ali Mansour Abbas , Kamel Mesbah Sayed , Bilal Ahmed 
Published: March 2023

Background and Objective:
The current situation in the Middle East-North Africa (MENA) region makes it very difficult for many countries to have an effective policy to ensure the availability and affordability of different insulin types for many individuals with diabetes mellitus in any individual country. This article comprehensively reviews the possible barriers to insulin access in countries of this region and provides some solutions to mitigate these barriers.

Materials and Methods:
The framework for understanding the life-cycle of medicines of the World Health Organization (WHO) was adopted for this review with country-specific modifications. PubMed was used as an initial search builder using the country name and insulin as query terms in (title/abstract) for articles written in (English and French) which dealt with humans only between (2000–2022). Out of (578) published articles, only (42) articles were relevant and dealt with insulin access. Additional search through references of these articles and the websites of international health organizations added additional (32) references to have (79) references for the review.

Review (Results):
The countries in the MENA are lagging in the (Research, Development, and Innovation) and production of insulin and insulin delivery systems. There are some attempts by some countries to develop their national plan with the help of some big insulin manufacturers, with a suboptimal outcome. The local insulin production in some countries did not reach full national coverage. The difficult regional economic and political situations in many countries in the MENA imposed negatively on their citizens’ insulin access, availability, affordability, cost, and insurance plans.

Conclusions:
There is a suboptimal level of insulin access for individuals with diabetes in the MENA countries, especially in the low-resourced countries. There is an urgent need to adopt country-specific healthcare policies to ensure uninterrupted insulin access and improved availability, with a lower affordable cost for individuals with diabetes from the public and private sectors.
Serum Human Placental Lactogen and Prolactin May Not Be Associated with Aberrant Glucose Homeostasis in GDM
Authors: Alam Mohammad Fakhrul , Jahan Sharmin , Hasan Mashfiqul , Sultana Nusrat , Hossain Mahmudul , Uddin Mohammad Farid , Hasanat Muhammad Abul 
Published: March 2023

Background:
Gestational diabetes mellitus (GDM) shows insufficient β-cell compensation for insulin resistance (IR) during late pregnancy, whereupon derangements of human placental lactogen (hPL) and prolactin (PRL) have a presumed role in its pathogenesis.

Aims:
To assess the relationship of serum hPL and PRL with IR and β-cell function in GDM and pregnant women with normal glucose tolerance (NGT).

Materials and Methods:
This cross-sectional study was performed with 40 women with GDM and an equal number of pregnant women with NGT who were diagnosed on the basis of the WHO 2013 criteria during 24–40 weeks of gestation. hPL was measured by an enzyme-linked immunosorbent assay (ELISA); PRL and fasting insulin were measured by a chemiluminescent immunoassay. Equations of homeostatic model assessment (HOMA) were used to calculate the indices of IR (HOMA-IR) and β-cell function (HOMA-B).

Results:
No statistically significant difference was found between the GDM and NGT groups in circulating concentrations of either hPL (6.01 ± 1.76 vs. 5.92 ± 2.10 mg/L, mean ± SD; P = 0.852) or PR [180.27 (125.95–306.20) vs. 166.87 (134.24–284.70) ng/mL, median (IQR); P = 0.704]. There was no relationship of circulatory levels of hPL and PRL with glucose values at different time points during oral glucose tolerance test as well as with AUCglucose (P = NS for all). On multiple regression analysis, neither hPL nor PRL emerged as a significant predictor for fasting insulin, HOMA-IR, and HOMA-B in GDM (P = NS for all).

Conclusions:
Circulating concentration of hPL and PRL may not be a potential determinant of IR and β-cell dysfunction in GDM.
Relationship between Serum Sialic Acid Concentration and Diabetic Nephropathy in Egyptian Patients with Type 2 Diabetes Mellitus
Authors: El Badawy Ayman M. , Mansour Ahmed E. , Elsayed Marwa S. , Abdelmoniem Rasha O. 
Published: March 2023

Aim:
Diabetic nephropathy is a major microvascular complication of diabetes mellitus (DM), and it is the most common cause of end-stage renal disease worldwide. Sialic acid is considered as an acute-phase reactant. Serum sialic acid level was found to be increased in diabetic nephropathy patients. We aimed to measure the serum sialic acid concentration in patients with type 2 DM and to assess if it could be used as an early marker of diabetic nephropathy.

Subjects and Methods:
This was a cross-sectional study that was carried out on 40 patients subdivided into 3 groups, first group involved 25 patients with diabetic nephropathy, second group involved 15 patients without diabetic nephropathy and the third group involved 10 patients serving as control group. All patients were selected from those attending the outpatient diabetic clinic at Benha University Hospital between July 2017 and July 2018. Mean and standard deviation (±SD) were used for quantitative data, and t test, Fisher extract test, and regression analysis were used for statistical analysis. A P value <0.05 was considered statistically significant, whereas >0.05 statistically insignificant.

Results:
On comparing patients with diabetic nephropathy with the control group patients we found that serum sialic level is increased and this was statistically significant and also in diabetic patients with nephropathy when compared to diabetic patients without nephropathy. The age of the onset of the discovery of diabetes and the duration of diabetes had no impact on serum sialic acid level.

Conclusion:
This study showed that serum sialic acid level is significantly increased in patients with diabetic nephropathy, and it is positively correlated with the glycemic control parameters and negatively correlated with estimated glomerular filtration rate, and it could be used as an early predictor of albuminuria and decrease of creatinine clearance.
Real-World Evidence of Generic Dapagliflozin
Authors: Sethi Bipin K. , Kalra Sanjay , Bhattacharya Supratik , Kumar Anand , Rai Madhukar , Srivastava Manoj Kumar , A Srinath , Budhwar Ajay , Jain Savita , Rastogi Harish Mohan , Gandhi Pramod , Kumar G. Vijay , Georje Joe , Abhyankar Mahesh V. , Prasad Ashish , Sarda Prashant 
Published: March 2023

Objective:
The objective was to evaluate the clinical experience and treatment patterns of generic dapagliflozin usage in different patient profiles in Indian settings.

Materials and Methods:
A retrospective, multicentric, real-world study included patients with type 2 diabetes mellitus (T2DM) (aged >18 years), inadequately controlled by existing antidiabetic therapy and receiving generic dapagliflozin as an add-on to existing oral antidiabetic drug(s) with or without insulin or switch therapy. Baseline characteristics and treatment-related outcomes were retrieved from the medical records and analyzed.

Results:
A total of 1935 patients were included, of which 1279 (66.1%) were males. The mean age was 57.4 years, and around half of the patients (51.4%) were aged from 45 to 60 years. Hypertension (55.9%) and dyslipidemia (19.8%) were the common comorbidities. The majority (n = 1122; 60%) of patients received dapagliflozin in combination with one or two antihyperglycemic drugs. More than half of the patients received metformin (56.8%) or sulfonylurea (52.3%) in combination with dapagliflozin. A dose of 10 mg (93.4%) was the most commonly used dose of dapagliflozin. The mean levels of glycated hemoglobin, fasting plasma glucose, and postprandial plasma glucose were significantly reduced to 1.1% (1.0–1.1), 30.5 mg/dL (29.2–31.9), and 57.5 mg/dL (55.1–59.9), respectively, after the initiation of dapagliflozin. A total of 1935 patients experienced weight changes during the treatment, of which 90.5% of patients showed weight loss. Hypoglycemic events were reported in 12.5% of patients. Physician global evaluation of efficacy and tolerability showed a majority of patients on a good-to-excellent scale (97.3% and 97.1%).

Conclusion:
Generic dapagliflozin showed a significant improvement in glycemic parameters and reduced body weight with low hypoglycemic events. The administration of dapagliflozin provided a good-to-excellent efficacy and tolerability profile in patients with T2DM. To the best of our knowledge, this is the first study confirming the efficacy, safety, and usefulness of generic dapagliflozin in patients with T2DM.
A Proposed Evaluation Plan for the Diabetes Prevention and Control Program
Authors: Ramani Vinod K 
Published: March 2023

Introduction:
India is projected to be the diabetes capital by the next decade, and Asians are predisposed to central obesity and visceral adiposity which puts them at additional risk for diabetes.

Materials and Methods:
The proposed evaluation plan draws reference from the non-communicable disease prevention and control program, implemented by the Karnataka Health Systems Development & Reforms Project (KHSDRP), Directorate of Health Services, Government of Karnataka (GoK) in collaboration with the World Bank, New Delhi, during the period 2012 to 2016. This evaluation will be conducted by an external agency in consultation with the Medical Officer/Investigator.

Results:
The relevant reports will officially benefit the District Program Officer and District Health Officer of Davangere and Dakshina kannda districts, Karnataka, India, where the program is being implemented.

Conclusion:
The results of this plan will benefit health promotion planning by the Health Department including building of community advocacy for the promotional initiatives.
Correlation of Plasma Magnesium with Insulin Resistance in Type 2 Diabetes
Authors: Adeleye Jokotade , Esan Arinola , Azeez Taoreed Adegoke , Sonuga Oyebola Oluwagbemiga 
Published: March 2023

Introduction:
Insulin resistance (IR) is a core component of the pathophysiology of type 2 diabetes mellitus (DM). Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) is the most commonly used marker of IR. Plasma magnesium is a relatively cheap analyte and has been linked with the pathophysiology of IR. This study primarily was aimed at evaluating the possible use of plasma magnesium as a surrogate marker of IR in type 2 diabetes.

Materials and Methods:
The study was a hospital-based cross-sectional study carried out at a tertiary hospital in South-western Nigeria between March and September 2018. The study was conducted on 70 persons with diabetes, and age- and sex-matched 70 controls who met the eligibility criteria were recruited into the study. Ethical approval was obtained and informed consent was obtained from the participants. Fasting plasma glucose, fasting plasma insulin, and plasma magnesium were measured using standard protocols. HOMA-IR was determined using the appropriate formula. Data analysis was carried out using the Statistical Package for Social Sciences software, (SPSS) version 22.

Results:
The mean age of the participants was 53.34 ± 9.57 years and that of the gender-matched controls was similar. Frequency of hypomagnesemia was significantly higher in the participants compared with controls (25.7% vs. 5.7%; P < 0.001). Similarly, a significantly greater proportion of the study participants (62.9%) had IR as expected compared with just 8.7% of the controls. The mean plasma magnesium (mg/dL) among the participants was significantly lower than that of the controls (1.73 ± 0.16 vs. 1.87 ± 0.14; P < 0.001). As expected, the mean HOMA-IR in the participants was significantly higher than that of the controls (2.64 ± 0.91 vs. 1.71 ± 0.32; P<0.001). There was a statistically significant negative correlation between plasma magnesium and IR among the participants (r=−0.443; P<0.001). However, among the controls, there was no statistically significant correlation between plasma magnesium and HOMA-IR (r=−0.034; P = 0.778).

Conclusion:
Plasma magnesium was found to correlate significantly with IR and may be used as a surrogate marker of IR in persons with type 2 DM but not in the general population.
Vitamin D Deficiency and Diseases
Authors: Mahmood Yasir , Waris Nazish , Fawwad Asher , Basit Abdul 
Published: March 2023

Objective:
Vitamin D deficiency is claimed to be associated with many diseases in the world population. Many studies reported that vitamin D deficiency is quite prevalent in Pakistan. The aim of this review is to describe the current status of vitamin D deficiency in healthy individuals and in different disease conditions in this country.

Materials and Methods:
Search engines such as “Google Scholar,” “Medline,” and “PubMed” were used by applying key words such as vitamin D deficiency and different disease conditions in the Pakistani population. In this study, people with vitamin D levels less than 30 ng/mL were reported as being vitamin D deficient.

Results:
A total of 82 studies were included: Among these, 12 studies showed vitamin levels less than 30 ng/mL in healthy individuals (male and female) and 70 studies in different disease conditions. It was found that about 64.6% of healthy subjects had vitamin D levels less than 30 ng/ml. Moreover, 70 studies showed vitamin D deficiency in some diseases, such as musculoskeletal, bone, and periodontal problems, nursing mothers and children, tuberculosis (TB), diabetes, cardiovascular problems, and some type of cancers.

Conclusion:
The current status of vitamin D deficiency in the healthy population and in several diseases and conditions is thoroughly discussed in this review. This review could be helpful in understanding the status of vitamin D and the different aspects of vitamin D research in this population.
Prevalence of Thyroid Dysfunction and Anti–thyroid Peroxidase Antibody in Gestational Diabetes Mellitus
Authors: Karat Arun , Radhakrishnan Chandni , Thulaseedharan Nallaveetil K. , Kalam Suneetha 
Published: March 2023

Background:
Gestational diabetes mellitus (GDM) and thyroid dysfunction are the two common endocrine disorders affecting pregnancy. Some association was hypothesized between GDM and thyroid dysfunction in the literature. The main aim of this study was to unveil this metabolic interplay as better understanding may facilitate early diagnosis and intervention thereby limiting major fetal and maternal adverse events. Here we estimated the prevalence of abnormal thyroid function and anti–thyroid peroxidase (anti-TPO) antibody and also studied the risk factors for thyroid disorders in patients with GDM.

Materials and Methods:
This cross-sectional study was conducted between February 2014 and January 2015. A total of 100 consecutive pregnant women diagnosed to have GDM as per the American Diabetes Association 2013 recommendations were recruited and thyroid stimulating hormone, free triiodothyronine (T3), free thyroxine (T4), and anti-TPO antibody assays were done. Details regarding pregnancy outcome and any complications if present were also obtained and analyzed. The prevalence is expressed as proportions, and the statistical significance of risk factors was assessed using the chi-square test and independent t-test.

Results:
Abnormal thyroid function was detected in 31 (31%) patients, which includes 17 cases of subclinical hypothyroidism (54%), 10 hypothyroidism (32%), 2 (6%) subclinical hyperthyroidism, and one case each of isolated low T3 and isolated low T4. Anti-TPO antibody was positive in 35 patients (35%). History of GDM in previous pregnancy, family history of diabetes mellitus, presence of clinically detectable thyroid gland enlargement, and presence of anti-TPO antibody in serum were found to increase the risk of thyroid dysfunction. Majority of the subjects had uneventful delivery, and no significant increase in maternal or fetal complications was reported.

Conclusions:
This study showed a high prevalence of thyroid dysfunction and anti-TPO antibody in GDM patients. The significant thyroid abnormalities detected were subclinical hypothyroidism and hypothyroidism. The risk of thyroid dysfunction is elevated in patients with the presence of anti-TPO antibody. This scenario provides a strong ground to recommend meticulous assessment of thyroid function in GDM patients.
Non-communicable Disease Risk Factors among Garment Factory Workers in Bangladesh
Authors: Bhowmik Bishwajit , Kamruzzaman Md , Siddiquee Tasnima , Samad Mohammad A. , Khan Farook A. , Rashid Habibur , do Moreira Nayla C. V. , Alim Abdul , Khan Fazla A. , Milon Sarowar U. , Robed Mohammad A. , Hossain Abul H. , Hussain Akhtar , Khan Abul K. A. 
Published: March 2023

Aim:
Many studies identified numerous health problems among industrial workers, in general, and garment workers. But a health problem with a specific focus on non-communicable disease (NCD) risk factors for Bangladeshi garment workers is lacking.

Objective:
The aim of this article is to investigate the NCD risk factors among garment workers in Bangladesh.

Materials and Methods:
A total of 4736 randomly selected garment workers aged ≥15 years in the Gazipur district of Bangladesh were investigated in a cross-sectional study from April 2014 to November 2014. Sociodemographic, anthropometric, and clinical details, including type 2 diabetes mellitus (T2DM) and hypertension (HTN), and albuminuria were collected by using a structured interviewer-administered questionnaire.

Results:
Among the study participants, the mean age was 27.6 ± 8.0 years. About 16.1% of the participants were underweight (body mass index <18.5 kg/m2), 15.8% were overweight (≥23.0–24.9 kg/m2), and 21.2% (≥25.0 kg/m2) were obese. The prevalence of central obesity based on waist circumference (male ≥90 cm and female ≥80 cm) and waist–hip ratio (male ≥0.90 and female ≥0.80) was 24.9% and 62.1%, respectively. The prevalences of T2DM (random blood glucose: ≥11.1 mmol/L), HTN (≥140/90 mmHg), and albuminuria (≥1+) were 7.0%, 13.9%, and 5.1%, respectively. The rates of general obesity and central obesity were significantly higher in females, and smoking habits, albuminuria, T2DM, and HTN were significantly higher in males. Increased age, male gender, general obesity, and central obesity were significantly associated with T2DM and HTN.

Conclusion:
The prevalences of T2DM, HTN, obesity, and albuminuria were common in study participants. Long-term follow-up studies of these workers are therefore warranted.