bluuebunny/crossref_metadata_2025_split huggingface dataset:
Osteoarthritis of the knee joint and its association with metabolic syndrome: A case control study
Authors: Motwani Rohini , Bodla Arvind Kumar , Peddamadyam Shravan Kumar , Chandrupatla Mrudula , Cherukuri Nagesh , Lakkireddy Maheshwar , Rathod Gunvanti , Challa Sai Ram , Rao Chowdavarapu Raghavendra , Arora Abhishek , Eppakayala Srikanth , Krishna Arcot Reddy Vamsi 
Published: January 2025

ABSTRACT

Background:
Osteoarthritis of the knee joint (OAK) represents a leading cause of pain, functional limitation, and diminished quality of life, particularly among older adults. The association between metabolic syndrome (MetS) and OAK is of growing interest due to the potential impact of MetS components on joint health. While evidence suggests that MetS and its components may influence the development of osteoarthritis (OA), the specific relationship between MetS and the likelihood of progressing to a stage of OAK that requires Total knee replacement (TKA) remains underexplored.

Aim:
This study aimed to evaluate the association between osteoarthritis of the knee joint (OAK) and metabolic syndrome (MetS) and to know whether the presence of MetS (or its components) increases the risk of OAK requiring Total knee replacement (TKA).

Methodology:
It is a cross-sectional study that includes patients (males and females) above 50. Data collection was done including demographic details, medical history, physical examinations, and laboratory tests. OAK (≥grade 2 Kellgren-Lawrence) and severe OAK (≥grade 3 Kellgren-Lawrence) were evaluated based on radiological findings.

Statistical Analysis:
Mean, standard deviation, frequencies, and percentages were calculated for baseline characteristics. To analyze the association between qualitative factors and MetS, the Chi-Square test was used. For comparing quantitative factors, the unpaired t-test was employed. A P value of less than 0.05 was considered statistically significant.

Results:
The study involved 107 primary osteoarthritis patients categorized into cases (N = 57), requiring TKA, and controls (N = 50), not requiring TKA. MetS was significantly more prevalent among cases than controls, with 68.4% of cases and 36% of controls testing positive for MetS (P = 0.001). The odds of having MetS were 3.9 times higher in the cases compared to the controls.

Conclusion:
The results of our research could shed light on how MetS affects the onset and course of OAK, guiding primary care and prevention measures. It might also emphasize how critical it is to treat MetS symptoms to lessen the severity of OAK. Understanding whether MetS or its components are linked to an increased risk of TKA could provide crucial insights into preventive and therapeutic strategies for managing severe OAK.
Fortifying defenses: Tactical safety protocols for COVID-19 sub-variant JN.1 in healthcare and laboratory settings
Authors: Sheereen Shazima , Manva Mohnish Z. , Sheereen Shamama 
Published: January 2025

ABSTRACT

Introduction:
Primary care physicians are crucial in fighting COVID-19, especially with the emergence of the new JN.1 sub-variant.

Measures to Reduce Risk:
Given your direct exposure to infected patients, it is imperative to establish a protocol for triaging patients with respiratory symptoms and to uphold a minimum distance of 2 meters between patients and primary care physicians. Patients suspected or diagnosed with the JN.1 sub-variant should be advised to wear surgical masks for their protection and others protection. Primary care physicians must also use personal protective equipment (PPE) and maintain strict hand hygiene practices when dealing with these patients. Patient samples should be treated as high risk for contamination, and laboratory procedures should be meticulously evaluated for potential hazards. PPE should be tailored to the procedure.

Conclusion:
To protect the health and well-being of primary care physicians, who play a critical role in addressing the challenges, it is essential to strictly adhere to infection control measures.
Serum hepcidin level with iron profile assay might replace bone marrow iron study as a diagnostic tool for evaluation of anemia in elderly without chronic renal disease
Authors: Manna Sukdev , Chakrabarti Sankha Shubhra , Singh Rohit , Gambhir Indrajeet Singh 
Published: January 2025

ABSTRACT

Background:
The bone marrow iron study is the gold standard for differentiation of the two most common causes of anemia i.e. iron deficiency anemia (IDA) and anemia of chronic disease (ACD) in the elderly. However, it is often not feasible to do bone marrow examination (BME) in every elderly anemic patient, due to its invasive nature. Hepcidin, a liver-derived peptide, has been identified as the key systemic regulator of iron homeostasis. Our study highlights the potential diagnostic role of serum hepcidin in the evaluation of anemia in elderly.

Methodology:
Hundred elderly patients (≥60 years of age) having iron deficiency anemia (IDA) or anemia of chronic disease/inflammation (ACD) were the study subjects with 15 age-matched healthy controls. All patients were evaluated with history, clinical examination, routine investigations (complete blood count, liver, and kidney function tests), iron profile, and serum hepcidin. The bone marrow iron study was done in every patient to categorize them as IDA and ACD.

Results and Discussion:
Serum iron, TIBC, MCV, ferritin, and serum transferrin saturation values were differing significantly between IDA and ACD groups. Serum hepcidin levels can be used confidently to differentiate ACD from IDA (P value <0.001). At serum concentration, 198.82 ng/mL sensitivity of hepcidin to differentiate ACD from IDA was 93.9% and specificity was 92.2%. A subset of patients is misdiagnosed when the serum hepcidin level is used as a sole marker, and this also holds true for serum ferritin.

Conclusion:
Though serum hepcidin level correlates well with serum iron profile and also serum hepcidin appears to be a useful marker to differentiate ACD from IDA in terms of both sensitivity and specificity, the combined assessment of serum hepcidin and iron profile appears to be a better marker than ferritin and hepcidin alone. This could replace the use of bone marrow iron staining as a diagnostic tool in anemia in elderly.
Early childhood caries and their association with serum iron, serum ferritin, serum albumin, and Vitamin D
Authors: Megha Vasundhara , Shukla Jeevendra Nath , Singh Rajat Kumar , Mukherjee Chitrita Gupta , Anand Siddharth , Singh Aparna 
Published: January 2025

ABSTRACT

Aim:
The present study aimed to correlate the association between serum iron, serum ferritin, serum albumin, and Vitamin D with early childhood caries (ECC).

Materials and Methods:
This study was a single-blinded randomized control trial. A total of 200 children aged between 3–6 years were screened for ECC, according to the AAPD guidelines. Out of 200 children, a total of 177 children fulfilled the inclusion criteria. They were divided into two groups: Group 1 consisted of 99 children with ECC and Group 2 (control group) with 78 children. The decayed, extracted because of caries, and filled primary teeth (deft) index were recorded from these children. Blood samples (approximately 2 ml) were collected by an expert nurse in the morning to determine serum levels of iron, ferritin, albumin, and Vitamin D. The data was statistically analyzed using the Mann–Whitney U test, and P value 0.05 was considered significant.

Results:
The mean deft score was 4.83 (±3.54). The mean value of serum iron was 64.66 (±8.35) μg/dl, serum albumin 3.88 (±0.57) gm/dl, and serum ferritin 29.19 (±42.11) ng/ml in ECC children, whereas mean serum iron was 67.78 (±6.17), serum albumin 3.82 (±0.62) gm/dl, and serum ferritin 26.38 (±23.04) ng/ml in caries-free children. Statistically, no significant relationship was observed between serum iron (P = 0.066), serum albumin (P = 0.448), and serum ferritin (P = 0.192) with ECC. The mean value of Vitamin D was 17.44 (±7.59) ng/ml in ECC children and 35.9 (±9.56) in caries-free children who were significantly low in comparison with the non-ECC subjects (P < 0.0001).

Conclusion:
The present study suggests no relationship between serum iron, serum albumin, and serum ferritin with ECC, whereas Vitamin D had an inverse relationship with ECC.

Clinical Significance:
This study sets a benchmark for the dental fraternity and other health specialists to analyze serum iron, serum ferritin, serum albumin, and Vitamin D levels, while generally treating pediatric patients with or without dental caries. Oral health education campaigns should be conducted for public awareness about the importance of iron, ferritin, albumin, and Vitamin D.
Improving neonatal outcome by studying the incidence of maternal group B streptococcus colonization among pregnant women: A prospective observational study
Authors: Rajan Priyank , Sanklecha Mukesh , Gandhi Saloni , Soni Kaushal , Wanjari Mayur , Mittal Gaurav 
Published: January 2025

ABSTRACT

Aims and Objectives:
Group B streptococcus (GBS) colonization during pregnancy can lead to invasive infections in neonates including meningitis or sepsis. The major risk factor for neonatal disease is the rectovaginal colonization of GBS during pregnancy and delivery. The objectives of this study were as follows: 1) to screen antenatal patients at 35–37 weeks of gestation for GBS colonization, 2) to determine the prevalence of GBS among pregnant women, 3) to formulate an antibiotic policy with respect to antepartum antibiotic prophylaxis and empiric choice of antibiotics for early onset neonatal sepsis, and 4) to ascertain the maternal and neonatal outcomes in pregnant women with positive GBS colonization.

Material and Methods:
A prospective observational study was conducted among 50 obstetric patients at 35–37 weeks of gestation attending the outpatient and inpatient departments of a tertiary care hospital. High vaginal and rectal swabs were collected and immediately transported to the microbiology lab and were sent for culture and sensitivity testing using the standard culture methods. The incidence of positive cultures was noted and was taken up as a reference for statistical calculations.

Results:
Out of the 50 vaginal samples, one sample showed GBS positivity having a prevalence of 2%. Rectal swabs did not grow GBS for all samples. Neither the pregnant woman nor the newborn showed any symptoms or signs due to GBS. GBS grown in vaginal culture was highly sensitive to benzyl penicillin and other penicillins, cephalosporins, clindamycin, daptomycin, vancomycin, meropenem, and linezolid.

Conclusion:
Based on our findings, screening the patients with routine rectovaginal swabs may not be necessary in our population. Also, empiric treatment with antibiotics for GBS in symptomatic mothers cannot be justified, and hence, GBS should be considered as an insignificant pathogen.
HPV vaccination knowledge, attitude, and practices among physicians in a teaching hospital, Karachi
Authors: Memon Sehrish Habib , Tariq Bhombhal Swaleha 
Published: January 2025

ABSTRACT

Context:
Cervical cancer is a global public health problem. It is the fourth most common cancer in women globally. Human papillomavirus (HPV) vaccine has reduced the incidence of HPV-related illness in the past decade. However, for the vaccination programs to be successful, recommendation by the primary care physicians is essential.

Aims:
The aim of this study was to evaluate the knowledge, attitude, practices, and barriers toward HPV vaccination among physicians practicing at a teaching hospital in Karachi, Pakistan.

Settings and Design:
This is a cross-sectional study carried out with a sample size of 165 among doctors practicing in Family medicine, Internal medicine, Pediatrics, and Gynecology outpatient clinics at a teaching hospital.

Methods and Material:
Physicians were approached in outpatient clinics, and a pilot-tested coded questionnaire was filled by them. Statistical Analysis Used: Data were analyzed using SPSS version 19.

Results:
Results show 22.4% males and 77.6% females participated in the study. 20% were internists, 35.2% were family physicians, 18.8% were pediatricians, and 26.1% were gynecologists. In terms of knowledge, 67.2% physicians showed good knowledge. In terms of attitude, it was found that 90.9% of physicians showed positive attitude toward prescribing HPV vaccine. However, only 37.5% physicians prescribed HPV vaccine to patients. Cost of vaccine, time constraints, and lack of knowledge among female patients were recognized as the most common barriers against prescribing the vaccine.

Conclusions:
From these results, we can infer that overall practices of our physicians are lacking, with respect to prescribing the HPV vaccine. Positive attitude should be taken as an advantage, and overcoming the barriers should be considered as the next step for improvement of our practice.
Knowledge, attitude and acceptability for long-acting reversible contraceptive (LARC) methods among women attending contraception counselling sessions: A cross-sectional study
Authors: Gupta Paridhi , Mahey Reeta , Varun Neha , Kaur Maninder , Kumar Arun , Yadav Satyam 
Published: January 2025

ABSTRACT

Aims:
To study the knowledge, attitude, and acceptability of Long-acting Reversible Contraceptive (LARC) methods among women attending contraception counselling sessions.

Settings and Design:
A cross-sectional study conducted in the family planning clinic of a tertiary care hospital.

Methods and Material:
Women aged 18–45 years attending contraception counselling sessions were included. Baseline knowledge about LARC methods was assessed. They were given information about LARC methods. Acceptability was assessed on a scale of 0–10.

Results:
Among four LARC methods, awareness about copper intrauterine devices (CuIUD), DMPA injection, subdermal implant and Mirena was 95%, 55.50%, 27% and 3%, respectively. Around 4% were unaware of the LARC method. Of total, 76.50% women procured the LARC methods information from health care workers, whereas 40% attained from friends, family members, neighbors, or colleagues. After counseling, the majority (58%) were willing for subdermal implant. About 27.50% and 13.50% were willing for copper IUD insertion and injection DMPA, respectively. None was willing for Mirena. Acceptability of various LARC methods was scaled on an acceptability score from 0 to 10. For Cu IUD, implanon and DMPA, the acceptability score was 10 in 50%, 40.17% and 25%, respectively.

Conclusions:
There are still gaps of knowledge about benefits and safety of available LARC methods. To improve wide coverage and more acceptability of LARC methods, involvement of health care workers and addition of subdermal implants to contraceptive counseling should be considered.
Long-term antibody responses to COVAXIN and COVISHIELD vaccines in rheumatoid arthritis patients and healthy control population – A cross-sectional study
Authors: Parimi Vijaya Prasanna , Pyati Anand , Eerike Madhavi 
Published: January 2025

ABSTRACT

Background:
Rheumatoid arthritis (RA) is a chronic autoimmune disease that causes inflammation and damage in the joints. It often requires treatment with disease-modifying antirheumatic drugs (DMARDs) to manage symptoms and prevent progression. The study investigates the long-term antibody responses to COVAXIN and COVISHIELD vaccines in RA patients.

Methodology:
This cross-sectional study (IEC approval no: AlIMS/BBN/IEC/AUG/2021/60-R dated Sept 05, 2022, and Ref No: 799/U/IEC/ESICMC/F490/09/2022 dated Oct 31, 2022) enrolled 103 diagnosed RA patients receiving DMARDs and 183 healthy controls. The participants who completed 1 year after the second dose of vaccination were included, and detailed information on demographic, medical, and vaccination were collected. Laboratory investigations included complete blood count, inflammatory markers, and antispike antibody levels. Statistical analyses assessed differences between COVAXIN and COVISHIELD subgroups, considering DMARDs usage and disease duration.

Results:
Among RA patients, both COVAXIN and COVISHIELD groups exhibited low disease activity. No significant (P > 0.05) differences were found in IL-6, CRP, or antispike antibody levels between COVAXIN and COVISHIELD subgroups in RA patients and healthy controls. Notably, 89% of female RA patients received COVISHIELD. Co-morbidities, including hypothyroidism (44%), were prevalent in COVISHIELD-received RA patients. Antibody concentration varied significantly among DMARDs usage groups in COVAXIN-vaccinated RA patients, with a notable difference between three-drug and HCQ-alone regimens. However, no such difference was observed in the COVISHIELD group. Disease duration did not significantly impact antispike antibody concentration in either of the vaccination group.

Conclusion:
RA patients had a decreased antibody response, 1 year after receiving the second dose of the COVID-19 vaccine. Nonetheless, there was no discernible difference in the antispike antibody concentration between the COVISHIELD and COVAXIN vaccination groups. Additionally, immunosuppressive medications significantly impact serological responses to these vaccines.
Frequency and Correlates of Elevated Serum Carbohydrate Antigen 19-9 Levels in a Cohort of Nigerians with Type 2 Diabetes Mellitus
Authors: Lawal Abimbola O. , Adeleye Jokotade O. , Esan Arinola , Sonuga Oyebola O. 
Published: January 2025

Abstract

Background:
Elevated levels of serum carbohydrate antigen (CA) 19-9 previously associated with pancreatic cancer have also been found in nonmalignant disorders including type 2 diabetes mellitus (T2DM). Serum CA 19-9 levels were found to correlate with glycemic control among Asian and Caucasian T2DM populations but have not been well investigated among the sub-Saharan African populace, especially Nigerians.

Aim:
This study was conducted to determine the frequency of elevated serum CA 19-9 levels among the African population with T2DM and its relationship with short- and long-term glycemic control.

Materials and Methods:
This was a case–control study of 64 T2DM Nigerian patients and 64 age and sex-matched apparently healthy controls. Demographic data, anthropometric measurements, and blood samples for serum CA 19-9, glycated hemoglobin, and fasting plasma glucose were analyzed in all participants. Data were analyzed using Statistical Package for Social Sciences version 25.0.

Results:
The median serum CA 19-9 level of cases was higher than that of the controls (12.80 U/mL vs. 8.0 U/mL; P = 0.287). The frequency of elevated serum CA 19-9 was significantly higher in the cases than that of the controls (15.6% vs. 4.7%; P = 0.046). The unadjusted logistic regression showed cases were three times more likely to have elevated serum CA 19-9 [odds ratio (OR) 3.76; 95% confidence interval (CI) (1.00–14.39)], whereas adjusted logistic regression showed T2DM was associated with higher odds of elevated CA 19-9 [adjusted odds ratio = 9.075; 95% CI (1.068–77.100)], which is statistically significant. Elevated fasting plasma glucose increased the odds of elevated serum CA 19-9, but was not statistically significant.

Conclusion:
The frequency of elevated serum CA 19-9 was significantly higher in persons with T2DM and had a significant positive association with diabetes status among a cohort of Nigerians with T2DM.
Challenges and perceived solutions in implementing competency-based undergraduate curriculum: A qualitative study
Authors: Ray Kuntala , Choudhari Sonali , Roy Hironmoy 
Published: January 2025

BACKGROUND:
Competency-based medical education (CBME) is being implemented across India in medical colleges from the 2019 batch. Several new components are introduced which require focused faculty training and handholding at times. This study was conducted to explore the challenges faced by faculty and students of Phase 1 and Phase 2 MBBS during the implementation of a competency-based undergraduate curriculum with regard to curriculum planning and delivery, teaching–learning, and assessment; to determine the perceived/proposed solutions by the faculty and students to overcome the said challenges.

METHODS:
An exploratory qualitative study was done at the Institute of Postgraduate Medical Education and Research, Kolkata among the faculty members and students of first and second phase of the MBBS CBME batch. This study was done over 10 months. Nonprobability purposive sampling was employed in the study. Free listing was done initially to elicit the views of faculty members to meet the intended objectives. Visual Anthropac software was used to identify the salient variables using Smith’s Salience Score.

RESULTS:
Twenty faculty members participated in the free listing and pile sorting. Moreover, total of 18 students also participated in the focus group discussion. A total of 20 responses were obtained about the key aspects of CBME, of which 15 were identified as the salient variables depending on the cutoff value of 0.15 (Smith’s Salience Score) and subjected to pile sorting. Similarly, 13 challenges were identified in the implementation of the program during the free listing, and all were included in the second stage of pile sorting.

CONCLUSION:
The majority of the responses by faculty and students being positive indicate that CBME is the need of the decade. Organizing orientation/sensitization sessions, following timetables, daily feedback, preparing the universal assessment tool, and emphasizing attitudes, ethics, and communication through a case-based module was the proposed solution.
Self-assessment in postgraduate dental education and practice as a learning tool: A questionnaire study
Authors: Sangappa Sunila B. , Jain Rohit , Das Tamal , Jithendra Ashwini 
Published: January 2025

BACKGROUND:
Self-assessment (SA) as a learning skill ascends engagement in learning but also promotes learners to take responsibility in understanding their current performance and revise on shortcomings. Pedagogical strategies involving the role of self-assessment skills at varied levels of curriculum, classroom, portfolios, and reflective writing are evidenced in the literature. Health-care providers have to continuously implement changes and keep upgrading their knowledge to fetch better results during their professional career actuating the necessity of SA during students’ training. Although recommendations from the Commission on Dental Accreditation to incorporate self-assessment as early as in predoctoral education have been emphasized, the need to enforce it in the Indian curriculum is not realized. The purpose of this study was to ascertain dental postgraduate students’ perceptions of self-assessment and how it related to their performance in the classroom and in the clinic.

MATERIAL AND METHODS:
This is a cross-sectional study to assess the awareness and perception of SA, carried out among 120 dental postgraduate students. Over a three-month period, postgraduate students from our institution across all three years participated. A prevalidated, self-administered structured questionnaire that was pilot tested and further given to the participants was used to collect the data. Data were interpreted and analyzed.

RESULTS:
With an overall mean score of 4.101 ± 0.352, the relevance of employing self-assessment as a learning tool obtained the highest mean score among 2nd-year postgraduate dental students (4.167 ± 0.306) and the lowest among 1st-year postgraduate dental students (3.975 ± 0.477). A one-way analysis of variance test revealed that the total year-wise mean score difference was statistically significant. The mean score for using self-assessment as a learning tool varied significantly between 1st-year postgraduate students and those in their 2nd and 3rd years, but not significantly between 2nd- and 3rd-year postgraduate students, according to a post hoc test conducted among the study groups. This expression of results implies that postdoctoral students highly value SA skills as necessary for achieving a competent endpoint.

CONCLUSION:
The importance of self-assessment abilities in one’s academic and clinical performance is greatly valued by study participants. To comprehend the use of SA skills and quantify their utilization in performance evaluation, training programs are required.