bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reactivation of latent human cytomegaloviral infection in critically ill patients
Authors: Uladzimiravich Harbachou Viktar , Ivanovna Dmitrachenko Tatyana , Mikhailovich Semenov Valery , Kanstantinavich Yahorau Siarhei , Yurievich Martov Vladimir , Viktorovich Kornilov Artem 
Published: April 2023

Background & objectives:
Human cytomegalovirus (HCMV) is a frequent participant in the infectious process in critically ill patients. This study aimed to determine the incidence of HCMV reactivation in critically ill patients and estimate the clinical effect of reactivation on the course of the pathological process.

Methods:
To determine the incidence of HCMV reactivation, plasma and sputum samples were collected from 82 critically ill patients. HCMV reactivation was determined by quantitative PCR together with the presence of circulating HCMV IgG in the plasma. The statistical analysis of clinical data employed methods of descriptive (median with 95% confidence interval; minimum and maximum values, interquartile range) and nonparametric statistics [Mann-Whitney U test, odds ratio (OR), Kaplan–Meier survival analysis].

Results:
HCMV reactivation was found in 36.6 per cent of cases. An association between the presence of sepsis and the development of HCMV reactivation (P<0.001), as well as higher HCMV viral loads in septic patients, was found. There was also an association between the presence of HCMV DNA and the subsequent development of sepsis (OR=1.504). The involvement of HCMV in the emerging immunological shifts manifested by a decrease in CD8+ T-lymphocytes (P=0.01) and an increase in the immunoregulatory index (P=0.03) was found.

Interpretation & conclusions:
HCMV reactivation can influence the course of bacterial pathology with a deteriorating effect on such groups of patients. Monitoring the viral load of latent HCMV can be helpful in the assessment of the host immune status, the course of the pathological process, and its clinical prognosis.
Prevalence of hepatitis B & C infections in prospective blood donors deferred due to history of jaundice
Authors: Khan Mohd. Fawad Farooq , Afzal Kamran , Arif S. H. , Shahin Shadma 
Published: April 2023

Background & objectives:
As per national guidelines, prospective blood donors with a history of jaundice of unknown cause are deferred permanently to prevent the transmission of hepatitis B and C. The validity of this guideline was tested by comparing prevalence rates of hepatitis B and C in prospective blood donors deferred due to a history of jaundice, with that of donors who were found fit.

Methods:
Blood samples of 212 consecutive donors (male, n=203) deferred due to a history of jaundice were studied for hepatitis B and C by rapid test kits as well as by chemiluminescence (n=115) or ELISA (n=97). Consecutive healthy donors (n=549; male, n=518) were also studied by ELISA (n=266) or chemiluminescence (n=283).

Results:
The cumulative prevalence detected by rapid test kit and ELISA/chemiluminescence tests of hepatitis B (n=10) and C (n=2) among donors deferred due to a history of jaundice (n=212) was 5.7 per cent [95% confidence interval (CI): 2.9, 9.9]. The prevalence of reactive results among healthy donors (n=549) by ELISA/chemiluminescence tests was 3.3 per cent (95% CI: 1.9, 5.2), which included hepatitis B (n=15) and hepatitis C (n=3) cases. Compared to healthy donors, the odds of seropositivity among jaundice-deferred donors was 1.7 (95% CI: 0.8, 3.6), P=0.15. For rapid test-negative deferred donors, the odds of seropositivity by ELISA/chemiluminescence declined to 0.4 (0.1, 1.5), P=0.19.

Interpretation & conclusions:
The prevalence rates of hepatitis B and C in prospective blood donors deferred due to a history of jaundice of unknown aetiology did not differ significantly from that in healthy donors. The current practice of permanently deferring such donors depletes valuable donor pool. A strategy of rejecting only those donors who are found reactive on pre-donation testing by rapid test needs further validation.
Identification of hepatitis B virus genotypes detected in Lahaul & Spiti district of Himachal Pradesh, India
Authors: Pacholi Sanchita , Chandra Bishwal Subasa , Barde Pradip V. 
Published: April 2023

Background & objectives:
Infection by hepatitis B virus (HBV) results in acute or chronic hepatitis. Based on sequence differences of eight per cent or more, HBV is divided into 10 genotypes (A to J) and 35 sub-genotypes. Molecular characterization of the circulating HBV genome has helped in understanding the epidemiology and its clinical importance. Spiti valley in Himachal Pradesh, which shares its border with Tibet, is one of the most HBV prevalent areas in India. Since information about the circulating genotype/s of HBV in this area is limited, this study was conducted to identify the circulating HBV genotypes.

Methods:
The surface and partial reverse transcriptase gene regions were sequenced using 14 hepatitis B surface antigen-positive samples.

Results:
Out of the 14 hepatitis B surface antigen-positive samples 11 sample gave quality sequence for further analysis. All the 11 samples belonged to subtype ayw2. The phylogenetic and recombination analysis revealed that five out of 11 samples were of genotype CD1 and the rest six were of genotype D3.

Interpretation & conclusions:
The CD1 recombinant sub-genotype might have immigrated during past or present transcontinental migration between the adjacent countries. Further studies using full-genome sequencing and high sample size will be helpful to understand this epidemiology and to combat the high prevalence of HBV in the area.
Cost-effectiveness analysis of ‘test and treat’ policy for antiretroviral therapy among heterosexual HIV population in India
Authors: Singh Malkeet , Sharma Aman , Bahuguna Pankaj , Jyani Gaurav , Prinja Shankar 
Published: April 2023

Background & objectives:
The World Health Organisation recommended immediate initiation of antiretroviral therapy (ART) in all adult human immunodeficiency virus (HIV) patients regardless of their CD4 cell count. This study was undertaken to ascertain the cost-effectiveness of implementation of these guidelines in India.

Methods:
A Markov model was developed to assess the lifetime costs and health outcomes of three scenarios for initiation of ART treatment at varying CD4 cell count <350/mm3, <500/mm3 and test and treat using health system perspective using life-time horizon. A few input parameters for this model namely, transition probabilities from one stage to another stage of HIV and incidence rates of TB were calculated from the data of Centre of Excellence for HIV treatment and care, Chandigarh; whereas, other parameters were obtained from the published literature. Total HIV-related deaths averted, HIV infections averted and incremental cost-effectiveness ratio per quality adjusted life years (QALYs) gained were calculated.

Result:
Test and treat intervention slowed down the progression of disease and averted 18,386 HIV-related deaths, over lifetime horizon. It also averted 16,105 new HIV infections and saved 343,172 QALYs as compared to the strategy of starting ART at CD4 cell count of 500/mm3. Incremental cost per QALY gained for the immediate initiation of ART as compared to ART at CD4 cell count of 500/mm3 and 350/mm3 was

JOURNAL/ijmer/04.03/02223309-202212000-00002/math_2MM1/v/2023-05-19T183840Z/r/image-tiff

46,599 and 80,050, respectively at reported rates of adherence to the therapy.

Interpretation & conclusions:
Immediate ART (test and treat) is highly cost-effective strategy over the past criteria of delayed therapy in India. Cost-effectiveness of this policy is largely because of reduction in the transmission of HIV.
The need for targeted behavioural HIV-related interventions for transgender women in India
Authors: Lodge William , Klasko-Foster Lynne , Mimiaga Matthew J. , Biello Katie B. 
Published: April 2023

Background & objectives:
Transgender women (TGW) in India are at high risk of HIV infection. Despite behavioural interventions aimed at reducing HIV risk, no literature synthesis exists so far to evaluate their potential for reducing HIV incidence in India This review was aimed to identify and evaluate HIV-focussed behaviour change interventions for TGW in India.

Methods:
Literature from three databases were reviewed up to June 2, 2021, for studies describing behavioural interventions for HIV prevention among TGW in India. The inclusion criteria were studies that included TGW and reported intervention effects on HIV prevention-related behaviour. Data were analyzed descriptively.

Results:
Of the 146 articles screened, only three met the inclusion criteria. All three interventions were at the open pilot trial stage and included other high-risk groups (e.g. men who have sex with men). The interventions used behavioural counselling, increased sexually transmitted infection screening and sexual healthcare visits and leveraged community-based organizations to improve the outcomes. All these interventions showed modest improvements in health-seeking behaviour and access to services. However, none specifically targeted TGW.

Interpretation & conclusions:
The scoping review highlights the need for behavioural interventions for HIV prevention tailored to TGW in India. This study emphasizes the need for research to move to the next stage of intervention development and testing utilizing more rigorous evaluation methods, such as a randomized controlled trial.
Indian VenaSeal™ Experience Study Extension: Outcomes of Nonthermal, Nontumescent Endovenous Ablation (VenaSeal™) for the Treatment of Truncal Reflux in Varicose Vein Disease – An Indian Perspective with 2-Year Follow-up
Authors: Shah Rutvij Asitkumar , Bedi S Varinder , Yadav R Ajay , Agarwal Sandeep , Satwik Ambarish , Srivastava Apurva , Chaudhary Nikhil Vilas 
Published: April 2023

Background:
Varicose vein disease is a common disease in nearly 37.25% of Indian population affecting quality of life. Endovenous thermal ablation has been the first-line treatment for superficial venous reflux. A new technique, available now, is nonthermal, nontumescent vein sealing system (VenaSeal™), which comprises endovenous delivery of cyanoacrylate tissue adhesive into the vein causing obliteration of lumen and has shown better results in terms of safety and efficacy. Being a new modality, only a handful of institutes across India perform this procedure and there is a scarcity of Indian data on its outcomes.

Aims and Objectives:
To evaluate the outcomes of VenaSeal™ glue ablation in terms of vein occlusion rates and improvement in VCSS score.

Materials and Methods:
The Indian VenaSeal Experience Study was carried out a year back, which was a single-center prospective study of 50 patients over 1 year and 4 months with 3 and 6 months of follow-up, and we aimed to evaluate the outcomes of VenaSeal™ glue ablation in terms of vein occlusion rates and improvement in venous clinical severity score (VCSS). This is an extension of that study with 200 patients (378 limbs) with similar parameters for outcome evaluation.

Results:
The study showed the mean age of study group to be 48.6 years and majority (87%) had an early varicose vein (C2/C3) disease. The average length of vein treated per limb was 62.6 cm and the average glue used per limb was 3.05 ml. All patients showed improvement in VCSS score averaging 2.3 ± 1.6 (P < 0.0001, n = 378) with target vein occlusion rate of 98% at 6 months (n = 182), 97% at 12 months (n = 126), and 95% at 2 years (n = 98).

Conclusion:
VenaSeal™ glue ablation procedure is a promising and effective modality for the treatment of varicose veins with excellent treatment success rates and maximum patient acceptability. However, complications such as severe phlebitis and anaphylaxis have been reported. It is a feasible option under local anesthesia, does not require tumescence, and hence an efficient outpatient department-based procedure.
Factors Predicting the Outcome of Musculoskeletal Injuries Associated with Vascular Trauma at a Tertiary Care Trauma Centre in South India
Authors: Kataria Hanish , Premkumar Prabhu , Samuel Vimalin , Selvaraj Dheepak , Stephen Edwin 
Published: April 2023

Introduction:
Vascular injuries are uncommon in civilian settings and present after blunt and or penetrating trauma. These injuries require timely intervention to prevent loss of limb or life. The impact of vascular injuries is well described in the Western population; however, there is a lack of evidence of factors predicting the outcomes of vascular injuries associated with musculoskeletal trauma in the Indian population.

Methods:
The retrospective data of consecutive trauma patients presenting to our emergency/outpatient department were collected over 5 years from January 2014 to December 2019 from our electronic medical records. After clinical assessment and/or radiological findings, patients were considered for either nonoperative management or vascular repair. Orthopedic intervention preceded vascular repair to attain skeletal stabilization and to protect vascular repair. Outcomes were measured in terms of baseline demographic variables, clinical determinants, pattern of injury, type of management, limb salvage, and primary or secondary amputations and mortality.

Results:
There were a total of 109 (92%) males and 3 (8%) females with an age range from 11 to 71 years (median = 35.5). The majority of the injuries were in the 30–50 years age group (n = 50, 50%). Limb salvageability was attained in 81 (72.3%) patients. Twenty patients (17.9%) underwent primary amputations and 11 (9.8%) patients required secondary amputations. Blunt trauma, lower limb involvement, multiple fractures, the Mangled Extremity Severity Score (MESS), and popliteal artery injury were significant predictors of limb salvageability. Stepwise multiple regression analysis identified multiple fractures (P = 0.011) and MESS (P = 0.000) as ultimate predictors of limb outcome.

Conclusion:
Revascularization is critical to the success of limb salvage in patients with traumatic vascular injury. Concomitant orthopedic injuries pose significant challenges and are associated with a high risk of limb loss. Multiple fractures and MESS score ≥6 prognosticates poor limb salvageability.
Effects of Nutritional and Socioeconomic Status on Puberty
Authors: Oyewole Omosalewa A. , Adediran Adekunle S. , Oduwole Abiola O. 
Published: April 2023

Context:
The onset of puberty is determined by genetic and environmental factors like socioeconomic and nutritional status. Previous studies have shown a disparity in the effect of socioeconomic factors on menarche and sexual maturation.

Aim:
This study was carried out to determine the effect of nutrition and socioeconomic status (SES) on puberty.

Settings and Design:
It is a descriptive, cross-sectional study among adolescent female secondary school students in Abeokuta, Nigeria.

Materials and Methods:
Subjects selected responded to questions on the proforma. Body mass index (BMI) was calculated from weight and height that were measured.

Statistical Analysis:
The data were analyzed using Microsoft ExcelR (Microsoft Corporation SP2 software microsoft office 2010 professional plus (PC) Intel Corporation's 386 microprocessor Redmond, Washington, USA) 2010 and SPSS 22.0 (SPSS Inc., Illinois, USA).

Results:
Participants' mean age and BMI were 14.4 ± 1.9 years and 19.1 ± 2.9 kg/m2, respectively. Subjects from high socioeconomic class (SEC) attained puberty and menarche earlier (12.0 ± 1.5 and 12.9 ± 1.5 years) than those from low SEC (13.5 ± 1.3 and 13.7 ± 1.1 years). These were statistically significant for breast development and menarche. Nutritional status had a negative correlation (r = -0.098) with menarcheal age but positive with pubic hair (r = 0.702) and breast development (r = 0.306).

Conclusion:
The mean age of menarche occurred earlier in this study when compared to most previous studies in Nigeria. Improved SES and nutritional status influenced the early age of onset of puberty and attainment of menarche.
A biochemical research focused on the association of the levels of oxidative stress and nitric oxide with premalignant disorders and oral squamous cell carcinoma
Authors: Sachdev Rohan , Garg Kriti , Mehrotra Vishal , Shwetam Samiksha , Saxena Shubhra , Srivastava Akash 
Published: April 2023

Context:
The reactive oxygen species such as superoxide radicals (O2 •), hydroxyl radicals (OH•), and hydrogen peroxide play a vital role in the pathogenesis of human cancer development and have become one of the areas of key interest in the field of biochemical analysis.

Aims:
The present study was designed to determine the significance of oxidative stress and levels of nitric oxide (NO) in patients with premalignant disorders and oral squamous cell carcinoma (OSCC), by evaluating the levels of lipid peroxidation products, antioxidants, and NO products.

Settings and Design:
The present study was conducted on 280 patients for 2 years. These patients were divided into 4 groups, Group I (n = 70, control), Group II (n = 70, oral submucous fibrosis), Group III (n = 70, OSCC), and Group IV (n = 70, OL).

Subjects and Methods:
The levels of lipid peroxidation products, antioxidants, and NO products were determined by colorimetric methods.

Statistical Analysis Used:
Paired t-test was used to compare the mean.

Results:
Lipid peroxidation products such as lipid hydroperoxide and malondialdehyde and NO products such as nitrite (NO2–), nitrate (NO3–), and total nitrite (TNO2–) were significantly elevated, whereas enzymatic and nonenzymatic antioxidants were significantly lowered in OSCC, oral submucous fibrosis, and oral leukoplakia when compared to normal healthy participants. The P values were calculated and came as statistically significant (<0.05).

Conclusions:
Antioxidant enzyme impairment and NO status may be considered as one of the factors responsible for oral cancer pathogenesis and may serve as a promising biomarker and therapeutic target for minimizing malignant transformation in oral premalignant disorders.
A comparison of the outcomes following intra-articular steroid injection alone or arthrocentesis alone in the management of internal derangement of the temporomandibular joint
Authors: Singh Surya Udai , Prasad Rajendra B. , Punga Rohit , Datta Rahul , Singh Neeraj 
Published: April 2023

Context:
One of the main causes of chronic facial pain is temporomandibular disorders (TMDs) which may turn out to be a major cause for disability. The two types of treatment strategies may be undertaken to counter temporomandibular joint (TMJ) disorders, namely conservative management and surgical intervention. Surgical management can be classified into invasive open methods and minimally invasive procedures such as arthrocentesis, intra-articular steroid injection, and arthroscopy.

Aims:
The aim of this study is to compare the efficacy of Kenacort (Triamcinolone) as an intra-articular corticosteroid injection and arthrocentesis for lysis and lavage, for the treatment of the temporomandibular joint disorders.

Subjects and Methods:
Twenty patients with internal derangement of temporomandibular joint (IDTMJ) not responding to conservative management and meeting the inclusion criteria randomly underwent either intra-articular steroid injection or arthrocentesis and the results of the two procedures were evaluated and compared.

Statistical Analysis Used:
Unpaired t-test, repeated-measures ANOVA. A value of P < 0.05 is considered to be statistically significant.

Results and Conclusion:
Both procedures turned out to be successful in reducing pain and improving mouth opening, both in a short-term and a long-term use. Upon comparison in our series of patients, arthrocentesis was noted to be a better treatment modality in the long term for the management of IDTMJ.
Comparative evaluation of efficacy of skin staples and conventional sutures in closure of extraoral surgical wounds in neck region
Authors: Pandey Narayan Dutt , Singh Ashok Kumar , Choudhary Amit Kumar , Jina Gitanjali , Thakare Amar , Supe Narendra B. 
Published: April 2023

ABSTRACT

Background:
The development of the skin stapling technique for surgical wound closure is less time-consuming than the conventional sutures.

Aim:
This study aims to evaluate the efficacy of skin staples and 4-0 prolene conventional suture in closure of extraoral surgical wounds in neck region in elective maxillofacial surgery.

Materials and Methods:
The study was conducted on a total of 60 patients, who were equally divided into three groups. In Group 1, wound closure was done using skin staples; in Group 2, wound closure was done using 4-0 prolene suture, and in Group 3, wound closure was done using both skin staples and 4-0 prolene suture. These groups were compared in terms of rate of wound closure; early postoperative pain; pain on the removal of staple and suture; rate of removal of staple and suture; scar evaluation by the clinician, patient, and two-blind observers on 15th day, 1 month, 3 months, and 6 months.

Results:
The rate of closure was significantly faster in staple group than in suture group. There was no significant difference in the postoperative pain, pain on removal and rate of removal between the two methods of closure. However, within the groups, more postoperative pain was observed in wound with incision length of >5 cm. Initially, on 10th postoperative day, the appearance of scar was significantly better in suture group but after 6 months, scar was better in staple group.

Conclusion:
The staple method of wound closure appears to be better than conventional suture in terms of rate of closure and scar appearance.
A retrospective study on factors affecting the dropout rate among temporomandibular joint internal disc derangement patients in India - A single-institution experience
Authors: Bansal Shallu , Bansal Saurabh , Aggarwal Vikrampal , Verma Dinesh Kumar , Pahari Kaushal Charan , Talib Huzefa S. 
Published: April 2023

ABSTRACT

Introduction:
Patients suffering temporomandibular joint internal disc derangement (IDD) ignore appointments after the first examination or after the first or second sessions of initial treatment. The dropout rate for these patients varies from 36% to 78% as per literature. Unfortunately, very few studies have investigated the dropout rate of these patients. Hence, the present study was undertaken to find out the dropout rate among these kinds of patients.

Material and Methods:
A retrospective study was done from June 2008 to December 2017 by collecting the records of the patients who were diagnosed to have IDD. Outcome variables included were age, sex, distance traveled, occupation, and education.

Results:
Out of 1021 patients 766 patients were included in the study after fulfilling the inclusion and exclusion criteria. The data were analyzed using Chi-square test. The level of significance was set at <0.05. In this study, there is slight male predominance (52.8%) and 63.1% (21–40 years) were among young adults and the patients in the age group of 21–30 years had shown good compliance, Postgraduate has shown the highest follow-up rate when compared with graduates and school level and the difference was found to be statistically significant. People in the job had shown good compliance when compared with business class and retired people and the patients within 50 km had shown the maximum follow-up with a statistically significant difference (P < 0.01).

Conclusion:
This study has shown that the dropout rate of treatment in temporomandibular joint disorder is affected by age, sex, distance traveled, occupation, and education.