bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lung Cancer Treatment in Traditional Chinese Medicine
Authors: Zhang Chu-Chu , Liu Su-Ying , Liu Jie , Yang Pei-Ying , Lin Hong-Sheng , Zhang Ying 
Published: July 2023

Objective:
This article discusses the following aspects, including the history of traditional Chinese medicine (TCM) in the treatment of lung cancer, the breakthrough in the theory of TCM in treatment of lung cancer, clinical study of TCM in treating lung cancer, microscientific interpretation of TCM treatment for lung cancer and the prospect of TCM in treating lung cancer.

Materials and Methods:
In this paper, through a systematic search, combing traditional Chinese medicine prevention and treatment of lung cancer ancient books and modern literature.

Results:
A series of large sample and multi-centered clinical studies have proved that TCM comprehensive treatment significantly improves the clinical efficacy for lung cancer. “TCM treatment system for non-small cell lung cancer” based on staged and standardized integration of TCM and Western medicine has been well developed and popularized in practice. Furthermore, in virtue of the international cooperation platform established by the National Cancer Institute of the United States, the scientific connotation of TCM in the prevention and treatment of lung cancer is systematically and deeply studied, thereby promoting the research and development of new Chinese drugs for lung cancer.

Conclusions:
Nowadays, TCM has realized a landmark breakthrough in treating lung cancer, bringing benefits to all lung cancer patients.
Endometrial cancer risk factors, treatment, and survival outcomes as per the European Society for Medical Oncology (ESMO) - European Society of Gynaecological Oncology (ESGO) - European Society for Radiotherapy and Oncology (ESTRO) risk groups and International Federation of Gynecology and Obstetrics (FIGO) staging: An experience from developing world
Authors: Gupta Nidhi , Pandey Awadhesh , Dimri Kislay , Sehgal Alka , Bhagat Ranjeev , Suraj  , Gill Gurbir 
Published: July 2023

ABSTRACT

Introduction:
There is limited data on endometrial cancer from developing countries. The risk groups as defined by the ESMO-ESGO-ESTRO and their recommendations for adjuvant treatment have redefined the management protocols. In this retrospective analysis, the outcomes are assessed in the light of the new risk groups and FIGO staging.

Material Methods:
One hundred and two patients of endometrial cancer reporting to the Department of Radiation Oncology from 2015 to 2019 were analysed retrospectively. Patients were stratified as per the ESMO-ESGO-ESTRO risk groups and FIGO staging. Patients were analysed for demographic profile, histopathology details, FIGO stage, treatment modalities received as per the ESMO-ESGO-ESTRO risk groups and the outcomes in terms of disease free survival and overall survival.

Results:
A total of 102 patients were analysed. The mean age at presentation was 57.7 years. Seventy four percent (74.41%) were stage I patients, 14.7 % were stage II, 8.8% were stage III and remaining 2% were stage IV. The mean disease free survival for the patients in FIGO stage I, II, III and IV were found to be 63.5 (59.9 – 67) months, 60.5 (54.2 – 66.9) months, 30.9 (21.5 – 40.2) months and 15.4 (7.8 – 23.0) months respectively. The 5-year overall survival of patients in Stage I was 90.3%. The 3-year mortality of Stage III patients was 58.3%. While there was no mortality observed among Stage II patients, none of the Stage IV patient survived beyond 20 months. The 5-year disease-free survival for patients in Low Risk (LR) group, Intermediate Risk (IR) group and High Risk (HR) group was found to be 91.3%, 90% and 87% respectively. None of the patient in High Intermediate Risk (HIR) group experienced progression of disease and 33.3% patients in advanced group were disease free at 2 years follow-up. The multivariate analysis showed that lymph node involvement is significantly associated with disease-free (p=0.03) and overall survival (p=0.04).

Conclusion:
Even in the developing world, majority of patients present in early stage with survival outcomes comparable to the West. FIGO stage and lymph node involvement continue to be the most important prognostic markers for disease outcomes.
Delineating and sparing the ileal conduit in adjuvant radiotherapy for bladder cancer with modulated radiotherapy
Authors: Goyal Shikha , Vias Poorva , Periasamy Kannan , Madan Renu , Trivedi Gaurav , Devana Sudheer Kumar , Prashar Himani , Khosla Divya 
Published: July 2023

ABSTRACT

Purpose:
We undertook a prospective planning study to describe the delineation of ileal conduit (IC) loop on radiotherapy planning computed tomography (RTP CT) scan as an organ at risk (OAR) and its sparing using volumetric modulated arc therapy (VMAT) during adjuvant irradiation of bladder malignancies.

Materials and Methods:
Fifteen patients with bladder malignancy needing adjuvant radiotherapy postoperatively and having normal renal function underwent delayed phase RTP CT from June 2020 to March 2021, with certain modifications (Foley’s catheter through stoma, additional delayed scans). We identified the course of ureters, external stoma, IC, and uretero-ileal (right and left) anastomotic sites. VMAT plans were generated.

Results:
A step-by-step description is given. Genitourinary OARs include kidneys, ureters, uretero-ileal anastomoses, and IC. The contrast on delayed scan opacifies ureters and IC. IC can be seen three-dimensionally as a structure with two fixed ends (blind proximal end anterior to the right sacroiliac joint and the open distal end over the right anterior abdominal wall in parasagittal location) and a 15–20 cm hanging intraabdominal loop that lies adjacent to the right iliac vessels. For prescription doses (PD) of 50.4 gray and 54 gray, respectively, VMAT plan achieved IC dose maximum to less than PD and V50 lower than 10 cc. Stoma sparing traditionally used as a surrogate for IC sparing is insufficient due to the variable intraabdominal location of IC loop.

Conclusions:
Delineation of IC as an OAR is feasible with slight modifications in the RTP protocols. VMAT (or other forms of intensity modulated radiation therapy) can help IC sparing and should be considered when it lies in close proximity to target volumes and the risk of additional morbidity is considerable.
Satisfaction among patients seeking services at an urban health training center during the COVID-19 pandemic in South Delhi, India
Authors: Das Aritrik , Bhandari Yukti , Singh Suraj P. , Sharma Priyanka , Kumar Mukesh , Khongsit Aereosonva , Khokhar Anita , Tiwari Poornima , Pardeshi Geeta 
Published: July 2023

ABSTRACT

Background:
The COVID-19 pandemic has posed challenges to the provision of routine health services. As we continue providing non-COVID services, it is essential that the community perceives them to be satisfactory and safe to ensure optimum uptake. The objective of the study was to determine the satisfaction and perceived safety among patients availing services at an urban health training center (UHTC) during the COVID-19 pandemic in South Delhi.

Methods:
UHTC, Aliganj caters to a population of over 6000, in an urbanized village of South Delhi. A pre-designed, semi-structured questionnaire incorporating the North Indian OPD Satisfaction Scale along with questions on sociodemographic details and perception of safety was used. Systematic random sampling was used to select the patients from the study population which included those above 18 years attending UHTC from November–December 2020. Exit interviews were done by a trained independent interviewer to reduce bias. Data were analyzed in SPSS using Chi-square and Fisher’s Exact tests.

Results:
Out of 218 patients, 161 (73.7%) were satisfied, 174 (79.8%) felt safe to visit UHTC during the pandemic and 143 (65.6%) felt both satisfied and safe. Patients were dissatisfied with screening for COVID-19 (29.5%), amenities (47.1%), cleanliness (51.8%), and waiting and registration (62.9%).

Conclusion:
The majority of patients were satisfied and found the UHTC services safe. A large proportion of patients found location, doctor–patient interaction, and COVID-appropriate behavior at the center to be satisfactory, but there was scope to improve waiting and registration, cleanliness, and effectiveness of screening for COVID.
Short-term multifactorial intervention (STEMI): An approach using structured blood glucose monitoring (BGM) and conventional therapies in persons with diabetes
Authors: Zelada Henry , Recklein Carol L. , McGill Janet B. 
Published: July 2023

ABSTRACT

Background:
Achieving glucose and glycosylated hemoglobin (HbA1c) targets have been shown to reduce long-term microvascular complications of diabetes; however, suboptimal glucose control is common. We tested whether glucose control could be improved within 8 weeks by employing structured blood glucose monitoring (BGM) qid in addition to seven times per day prior to visits for diabetes education and medication management that occurred every 2–4 weeks.

Methods:
This single-center, prospective study was conducted on 78 adults with either type 1 diabetes (T1D) or type 2 diabetes (T2D), HbA1c >8%, and serum creatinine (sCr) <2.0 mg/dl. HbA1c was checked at baseline, Week 2, Week 4, and at Week 8. Patients were evaluated by a physician and a certified diabetes educator (CDE) at baseline, Week 2, and Week 4 for treatment adjustments and lifestyle advice based on a review of BGM done qid plus 7-point profiles conducted before Weeks 2, 4, and 8. Study outcomes were change in HbA1c from baseline to Week 8 and change in mean glucose on the 7-point profile from Week 2 to Week 8. These were compared using one-way repeated measures ANOVA.

Results:
Of the 78 patients, 64.1% had T2D, 50% were women, and 72% were Caucasian. Mean age (±SD) was 51.3.5 ± 11.1 years, and median diabetes duration was 9 (5–17) years. The percentage of patients using insulin increased from 58.9% at baseline to 67.9% at Week 8. The mean (±SD) HbA1c was 9.53% (±1.71) at baseline, declined -1.38% from baseline to week 8 (CI -1.62 to -0.14, P < 0.001). The mean (±SD) glucose on the 7-point profile was 187 (±52) mg/dl at Week 2, and 157 (±5) mg/dl at Week 8. (P < 0.01).

Conclusions:
An intensive glucose optimization program using structured BGM qid plus 7-point profiles, diabetes education, and conventional anti-diabetic therapies was successful in reducing HbA1c by 1.38% over 8 weeks in patients with poor glucose control.
Psychiatric morbidities among patients with type-2 diabetes mellitus attending outpatient department in a rural area of North India
Authors: Majeed Mudassir , Gupta Rajiv K. , Kumari Rashmi , Langer Bhavna , Mir Mehak T. , Mahajan Richa , Gupta Riya , Bala Jyoti , Manhas Sakshi , Sumaira  
Published: July 2023

ABSTRACT

Background:
Both diabetes mellitus and psychiatric morbidities are widely prevalent diseases which show a discerning upward trend globally. Coexistence of diabetes and psychiatric morbidities usually manifests as impaired quality of life and poor treatment adherence.

Objectives:
The study aimed to estimate the prevalence of psychiatric morbidities among rural diabetic patients and to determine their association with different variables.

Methodology:
The present cross-sectional study was conducted in CHC of Rural Health Block attached with PG Department of Community Medicine GMC (Government Medical College) Jammu. The eligible diabetic patients attending medical outpatient department services were enrolled using a consecutive sampling method. DAS scale was used to assess psychiatric morbidity among the study subjects.

Results:
The findings revealed that the prevalence of psychiatric morbidity in the study participants was 38.9%, 68.5% and 25.64% for depression, anxiety and stress, respectively. Psychiatric morbidities were slightly higher in female patients and were significantly associated with age, marital status, sedentary lifestyle, history of substance abuse, duration of diabetes, presence of complications and underlying morbidities (P < 0.05).

Conclusions:
The prevalence of anxiety and depression among rural diabetic patients was found to be quite high. Diabetic patients need thorough screening for psychiatric evaluation, and there is an urgent need for psychiatric counselling at regular intervals.
Assessment of emotional stress among patients suffering from obstructive sleep apnea: A cross-sectional study
Authors: Shyamsukha Bhawna , Nimonkar Sharayu V. , Belkhode Vikram M. , Paul Priyanka , Godbole Surekha 
Published: July 2023

ABSTRACT

Background:
Obstructive sleep apnea (OSA) is a sleep disorder in which the upper airway is partially or completely blocked during sleep. As a result, sleep arousal and arterial oxygen saturation are reduced. According to the epidemiological survey, OAS is relatively common among people that may be associated with psychiatric illnesses.

Objectives:
The primary objective was to evaluate the stress level among patients suffering from OSA. The secondary objective was to compare the gender preference for stress among patients suffering from OSA.

Materials and Methods:
A cross-sectional study, approved by the Institutional Ethics Committee, was performed to assess emotional stress among patients suffering from OSA. The study involved 20 participants diagnosed with OSA and reported to the Respiratory Department. The stress levels of the study participants were evaluated with a validated, Perceived Stress Scale (PSS) questionnaire given by the American Sociological Association (ASA).

Result:
The stress levels presented by the study participants showed that 40% (n = 8) subjects had moderate stress and 60% (n = 12) had severe stress and 30.3% of females depicted emotional stress and 26.2% of males for the same.

Conclusion:
There is a high psychological stress level among patients suffering from OSA. The females had higher predictions when compared to males. Such patients should be offered an intervention program aimed at stress management to enhance their quality of life.
Assessment of quality of routine immunization in rural areas of Doiwala Block, Dehradun
Authors: Kumar Prakash , Katre Rohit , Singh Pallavi , Singh Mahendra , Saxena Vartika 
Published: July 2023

ABSTRACT

Background:
India initiated Expanded Programme on Immunization (EPI) in 1978 and was renamed to Universal Immunization Programme (UIP) in 1985 and subsequently integrated with National Rural Health Mission (NRHM) in 2005. Many studies have shown that health workers involved in immunization are more concerned towards coverage than the quality of immunization services provided.

Aims and Objectives:
This study aimed to assess the quality of routine immunization services in rural areas of Doiwala Block of Dehradun, Uttarakhand.

Material and Methods:
It was a cross-sectional study conducted for a duration of one year. Study participants included Auxillary Nurse Midwives (ANMs), Accredited Social Health Activists (ASHAs), Anganwadi Workers (AWWs) and parents/caregivers of children aged 12–23 months residing in that area who had received immunization services on the day of the survey. Institutional ethics committee clearance was obtained before the start of the study. A P value of <0.05 was considered as statistically significant.

Results:
ASHAs at two centres in low-performing centres had never undergone any training for routine immunization but there was no statistically significant difference found between high and low-performing centres (P > 0.05). The most common vaccine not available was the Bacillus Calmette–Guérin (BCG) vaccine. The majority of clients at both high (92%) and low-performing centres (96%) said that they never waited for at least 30 min post-vaccination at the vaccination site for observation.

Conclusion:
The study highlights that most of the ANMs at the immunization centre were having good knowledge and were adequately trained for maintaining cold chains at session sites.
Impact of ‘Get it to 100%’, a hepatitis B vaccination campaign amongst the health-care workers: A 5-year multimodal interventional study in a large tertiary care public sector teaching hospital, India
Authors: Priyadarshi Ketan , Rajshekar Deepashree , Madigubba Haritha , Dhodapkar Rahul , Dhandapani Sarumathi , Sastry Apurba Sankar 
Published: July 2023

Background:
The World Health Organization recommends administering the hepatitis B virus (HBV) vaccine at least for high-risk adults including health-care workers (HCWs). Active intervention through hospital-wide vaccination campaign may be necessary to augment the vaccine coverage, instead of merely having a hospital vaccination policy.

Materials and Methods:
The study was an interventional type, where hepatitis B vaccination campaign ‘Get it to 100%’ was implemented in a tertiary care hospital for 5 years, through multimodal interventions. Subsequently, the impact of hospital-wide HBV vaccination campaign to improve compliance amongst HCWs was evaluated.

Results:
HCWs being ‘vaccinated’ were increased from 45.6% (4398) to 84.2% (8126); not-vaccinated reduced from 54.4% (5253) to 15.8% (1525) and HCWs protected against HBV improved from 2.5% (240) to 50.2% (4843) with significant yearly increase. Doctors (63.9%), followed by nurses (57.7%) were more compliant, while defaulters were observed maximum for other staff (78.8%) and housekeeping staff (64.5%).

Discussion:
The hospital infection control and prevention unit at our institute was earmarked as designated centre for HBV vaccination campaign, which was instrumental in implementing the various components of the multimodal interventions such as making the resources (vaccines and titre testing) available free-of-cost, mandatory induction vaccination of HCWs at the timing of joining, educational intervention and conducting several vaccination camps such as department-specific on-site camps and student camps (at the time of joining).

Conclusions:
The authors urge to implementation of a mandatory national policy for HBV immunisation amongst HCWs, which will result in their protection from contracting the virus from occupational exposures.
Clinicoradiological correlation of Endotracheal secretion culture in each case of suspected VAP: a need of the present to combat drug-resistance
Authors: Vishwakarma Sumit , Gupta Munesh Kumar , Yadav Ghanshyam , Das Badri Prasad , Nayak Sudhansu Sekhar 
Published: July 2023

Background:
Ventilator-associated pneumonia (VAP) in intensive care unit (ICU)-admitted patients is a life-threatening event, caused by a diverse range of microbes having varied susceptibility to different classes of antibiotics.

Materials and Methods:
We enrolled patients admitted in trauma ICU on mechanical ventilation for >48 h. Modified clinical pulmonary infection score (≥6) having a significant bacterial count (≥105 cfu/ml) in endotracheal (ET) secretions was used to diagnose VAP. Subsequently, we did antibiotic susceptibility testing by the modified Kirby–Bauer method, and the results were interpreted per Clinical and Laboratory Standards Institute guidelines.

Results:
We enrolled 389 patients in this study. Amongst these, we noted VAP events in 87 patients with an incidence of 15.62/1000 days of ventilators. Gram-negative rods were the predominant microbes causing VAP. Acinetobacter
baumannii-calcoaceticus
complex (n = 30) followed by Klebsiella
pneumoniae (n = 27) and Pseudomonas
aeruginosa (n = 19) was the predominant isolate. All nine isolated Staphylococcus aureus strains were methicillin-resistant S. aureus (MRSA). About 48.72% (38/78) of the Gram-negative microbes were meropenem sensitive. All strains of A. baumanii and P. aeruginosa were sensitive to polymyxin B, whereas all isolated MRSA strains were sensitive to vancomycin and linezolid. In addition, drug-resistant epidemiological important bacterial pathogens were also isolated from ET secretions.

Conclusion:
VAP is caused by a diverse group of multidrug-resistant microorganisms; however, drug-resistant microbes also colonise the in situ ET tubes. Therefore, accurate diagnosis of VAP and its differentiation from ET tube colonisation is a need of present times as appropriate treatment of actual VAP cases will reduce the burden of drug-resistant microbes in ICU settings.
An algorithm-based active cleansing protocol can reduce the bowel preparation time for screening colonoscopy: A propensity score matching study
Authors: Ishibashi Fumiaki , Suzuki Sho , Tanaka Ryu , Kobayashi Konomi , Kawakami Tomohiro , Nagai Mizuki , Mochida Kentaro , Morishita Tetsuo 
Published: July 2023

Abstract

Background:
Methods that minimize the time for on-site bowel preparation before colonoscopy are needed. We prospectively validated that a novel algorithm-based active cleansing (ABAC) protocol could reduce the time for preparation compared with the conventional method.

Methods:
This was an open-label, multicenter, prospective comparative study from April to October 2021. The study compared the bowel preparation time for colonoscopy between patients instructed with the ABAC protocol and control groups. Patients in the ABAC protocol group as well as the control group were administered 2000 mL of polyethylene glycol (PEG) within 2 hours. After the first two hours, patients in the protocol group voluntarily took 300 ml of the solution without the instruction of nursing staff depending on the number of defecations in the first 2 hours. The intervention and control groups were adjusted for background characteristics by propensity score matching (PSM).

Results:
After adjustment by PSM, 174 patients in each of the two groups were included in the final analysis. In the intention-to-treat analysis, the preparation time was significantly shorter in the intervention group than that in the control group (126.3 ± 32.7 min vs. 144.9 ± 39.9 min, P = 0.018). The proportion of additional PEG intake was significantly higher in the intervention group (16 [9.2%] vs. 6 [3.4%], P = 0.047). The number of defecations was also higher in the intervention group than in the control group (7.8 ± 2.5 vs. 6.3 ± 2.2, P = 0.001).

Conclusions:
Simple active instruction protocol is effective to reduce on-site bowel preparation time and nursing staff labor for colonoscopy.
Effect of alkaline treatment with sodium hydroxide on wettability and bioactivity of some commercial dental implants
Authors: Morad Mohamed S. , El-Safty Samy , Elbahrawy Eman 
Published: July 2023

Aim/Objectives
The aim of this study was conducted to evaluate the effect of NaOH alkaline treatment on wettability and bioactivity of some commercial dental implants.

Background
The surface of titanium dental implants plays an important role in their success. Wettability is one of the crucial surface characteristics for osseointegration.

Methods
In this study, three commercial titanium dental implants are grouped by their types into 3 groups (n=10). Each group is divided into 2 subgroups (n=5) according to alkaline treatment. Each experimental specimen is immersed in 5 mL of 5M NaOH solution for 24h at 60°C, then put in an incubator for 24 h to dry at 40°C. All specimens are subjected to surface wettability test through measuring static contact angle (CA) by sessile drop technique and in vitro bioactivity test through immersion into a simulated body fluid (SBF) at 37°C and 7.4p H for 7 days. Then characterized by Scanning Electron Microscope and Energy Dispersive X-ray. Student t-test is used for pair-wise comparisons. The significance level is set at P≤0.05.

Results/Conclusions
The alkaline surface treatment of Ti dental implants significantly enhances their surface wettability and bioactivity by formation of a porous network structure at a nano scale from sodium titanate hydrogel layer on the surface.