bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of Glycated Hemoglobin Levels with Severity of Diabetic Foot Ulcer and Bacterial Profile
Authors: Jawzali Jwan Ibrahim , Muhammadamin Muhammad Nuraddin , Othman Darya Yousef , Ikram Dalia Dler 
Published: January 2025

Abstract

Background:
Glycated haemoglobin A1c (HbA1c) can serve as a diagnostic tool for predicting the development of diabetic foot ulcers (DFUs), a common chronic complication. There are inconsistent results about the association between baseline HbA1c and severity of DFUs. Objective: This study was to evaluate the relationship between levels of HbA1c and the severity of wound grades and bacteria isolates from infected ulcers.

Materials and Methods:
This study included 114 patients with lower extremity diabetic foot infection. The data included age, sex, and baseline glycated HbA1c. The severity of DFUs was evaluated using the Wagner classification. Bacterial infections were identified by VITEK 2 systems. SPSS software was used for statistical analysis.

Results:
The majority of DFUs were elderly (≥ 65 years) men. The HbA1c with mean value 9% ± 1.7 increases significantly with age. Most (43.8%) had a grade 4 (localized gangrene) wound classification. Grade 3 had levels of HbA1c (> 7), and decreased significantly (OR = 0.02*, 95% CI 0.001-0.62) in HbA1c ≤ 7 compared to grade 5 (gangrene involving the whole foot). Gram-negative bacteria; Esherichia coli was abundant, and increased in grade 4 compared to grade 5 (OR = 3.3*, 95% CI 1.04–10.6).

Conclusion:
HbA1c can be used as a predictive biomarker because the level of HbA1c (≥ 7) increased with age, severity of wound grades, and types of isolated bacteria, primarily with gram-negative. A lower HbA1c level (≤ 7) was observed in cases with extensive gangrene of wounds and may be attributed to systemic inflammation and anaemia.
Systematic Review of the Effectiveness of Common Probiotic Strains: Streptococcus faecalis, Clostridium butyricum, Bacillus mesentericus, and Lactobacillus sporogenes in the Management of Diabetes
Authors: Sooragonda Basavaraj G. , Thakur Preyander , Moganti Rajesh , Garg Arpit , Garg Umesh Kumar 
Published: January 2025

Abstract
Type 2 diabetes mellitus is often linked to changes in gut microbiota, and probiotics may play a significant role in the management. Four common probiotic strains: Streptococcus faecalis (Enterococcus faecalis), Clostridium butyricum, Bacillus mesentericus, and Lactobacillus sporogenes are commonly used in treating gut disorders. The current systematic review evaluates the efficacy of these strains in the management of diabetes. C. butyricum produces butyrate, which has been shown to regulate blood sugar levels, restore intestinal health, and mitigate inflammation. S. Faecalis has shown effectiveness in lowering postprandial glucose peaks, especially in research conducted on silkworm models and cell cultures. However, further research studies are necessary to determine the long-term efficacy of these strains in humans. The review shows the current evidence emphasizes the necessity for further investigation to identify and describe the active constituents, comprehend the processes by which they operate, and investigate the potential synergistic effects of combining various probiotics to achieve improved therapeutic results. Incorporating these probiotics into diabetes management may further enhance metabolic health.
Acute Kidney Injury Associated With Finerenone Use in Type 2 Diabetes Mellitus Patients: A Case Report
Authors: Srivastava Brijendra Kumar , Anjana Ranjit Mohan , Lavanya Rajendran , Mohan Viswanathan 
Published: January 2025

Abstract
Individuals with diabetes are at an increased risk of cardiovascular (CV) disease. The risk further increases in the presence of kidney involvement. Nonsteroidal mineralocorticoid receptor antagonist finerenone has shown beneficial effects on cardiorenal outcomes in type 2 diabetes mellitus (T2DM) and has been recommended by various guidelines for the reduction of chronic kidney disease progression and CV events. Here, we present an individual with T2DM and early renal insufficiency, who had acute worsening of renal parameters after finerenone therapy, which reverted back to baseline levels after the therapy was discontinued. A 58-year-old male with T2DM of 13 years duration presented with loss of appetite, weight loss of 4 kg during the last 6 months, cough for 1 week, fever with chills on and off for the last 1 month, and fluctuating blood sugars. Investigations revealed elevated renal parameters, uncontrolled blood sugars, hyperuricemia, anemia, eosinophilia, and hyperlipidemia. A nephrologist’s opinion was taken and, on his advice, conservative renal care was continued. Finerenone (10 mg) was initiated as a cardiorenal protective measure along with other supportive measures. After three doses of finerenone, there was a sudden worsening of the renal parameters. Blood urea increased from 73 to 100 mg/dL, serum creatinine increased from 1.7 to 4.7 mg/dL, and serum potassium from 4.3 to 5.4 mEq/L. After finerenone was stopped, along with good hydration and renal supportive measures, the renal parameters and serum potassium levels reverted back to baseline levels. Occasionally, finerenone may induce acute worsening of renal parameters. When initiating treatment with this drug, apart from repeating serum potassium, renal parameters may also need to be reassessed.
Examining Nailfold Capillary Alterations and Their Link to Diabetic Neuropathy in Diabetes Mellitus
Authors: Kumar Sudhir , Garg Uma Shankar , Kapoor Suraj 
Published: January 2025

Abstract

Introduction:
Diabetes mellitus (DM) is a chronic metabolic disorder characterized by hyperglycemia and microvascular alterations. The current study aimed to identify microvascular changes in DM patients using nailfold capillaroscopy (NFC) and determine their relationship with diabetic neuropathy.

Materials and Methods:
The study included 100 subjects aged 20–50 years, divided into DM patients and healthy controls. NFC was performed on eight fingers, focusing on the fourth and fifth digits, at 200× magnification. Capillary density (CD), loop diameter (LD), arterial limb diameter (ALD), venous limb diameter (VLD), intra-capillary distance (ICD), and abnormal morphology (AM) were assessed. Sensory neuropathy was evaluated clinically and through nerve conduction studies. Statistical analysis was performed using Statistical Package for Social Sciences version 23.

Results:
The results showed significant differences in NFC parameters between DM patients and controls. DM patients had lower CD, higher LD, ALD, VLD, and ICD, and more frequent AM compared to controls. Patients with poor glycemic control (HbA1c ≥7%) exhibited more pronounced microvascular changes. Sensory neuropathy was significantly associated with abnormal NFC findings.

Conclusion:
NFC is a valuable tool for detecting microvascular alterations in DM patients, which correlate with the presence of diabetic neuropathy. Early recognition of these changes using NFC may aid in the timely management of diabetic complications and improve patient outcomes.
Fixed-dose Combination of Dapagliflozin and Linagliptin in Individuals with Type 2 Diabetes Mellitus Inadequately Controlled on Metformin: A Randomized Double-blind Multicenter Trial
Authors: Kumthekar Prashant , Upadhyay Mihir R. , Tamma Rajasekhara Reddy , Kranti Vijay , Bhattacharya Raja , Sharma Prabhat Kumar , Barge Vijaykumar Bhagwan , Revankar Santosh , Ghatge Shweta 
Published: January 2025

Abstract

Context:
Combining dipeptidyl peptidase 4 inhibitors and sodium-glucose cotransporter-2 inhibitors in therapy could be beneficial for those with metformin intolerance or not achieving adequate control.

Aims:
To evaluate the efficacy, safety, and tolerability of a fixed-dose combination (FDC) of dapagliflozin plus linagliptin in patients with type 2 diabetes mellitus (T2DM) inadequately controlled on metformin.

Settings and Design:
It is a phase III, prospective, randomized, double-blind, multicenter study.

Materials and Methods:
Patients with T2DM, with a stable dose of metformin ≥1000 mg/day as monotherapy for at least 3 months before screening, with inadequate glycemic control at screening were randomly assigned to either arm A (dapagliflozin 10 mg + linagliptin 5 mg) or arm B (linagliptin 5 mg) in a 1:1 ratio.

Statistical Analysis Used:
The primary and secondary efficacy endpoint analyses were done using repeated measures analysis of covariance or a two-sample t test. All safety parameters were analyzed using a two-sample t test and descriptive statistics.

Results:
A total of 232 patients were randomized in arm A (n = 112) and arm B (n = 110). At week 16, arm A showed a significant mean reduction in glycated hemoglobin (HbA1c) than arm B (−1.35% vs. −0.92%; P≤0.0001). Similarly, the mean reductions in fasting plasma glucose (−26.13 mg/dL vs. −22.59 mg/dL; P = 0.0492), 2-h postprandial plasma glucose (−52.29 mg/dL vs. −30.35 mg/dL; P≤0.0001), and body weight (−1.32 kg vs. −0.42 kg; P≤0.0001) were significantly higher in arm A than in arm B. Arm A had a higher proportion of patients achieving HbA1c <7.0% (42.24% vs. 22.41%; P = 0.0012). Adverse events were comparable between study arms.

Conclusions:
The FDC of dapagliflozin and linagliptin was superior in terms of improvement in glycemic control and a higher proportion of patients achieving target HbA1c level, with both treatment arms being well-tolerated.
Cost Analysis for Diabetic Outpatients in a Tertiary Care Hospital in Pune City, India
Authors: Deshpande Prasanna R. , Sonawane Suchita , Jadhav Pratik , Nair Shruthi , Gawali Darshan , Kanitkar Shubhangi , Jadhav Sammita 
Published: January 2025

Abstract

Background:
Globally, type 2 diabetes mellitus (T2DM) is a rapidly growing health concern with India experiencing a significant increase in cases. While this disease often imposes a substantial financial burden on patients, particularly in outpatient settings, limited research exists within the Indian context. Our study aimed to address this gap by analyzing the costs associated with outpatient management of T2DM in a tertiary care hospital located in Pune, India.

Materials and Methods:
This prospective observational study employed a self-designed questionnaire to collect data from outpatients in the hospital’s department.

Results:
We collected data from 201 outpatients with T2DM. The sample was skewed slightly male (53.23%). Our analysis revealed the annual average costs incurred by outpatients for various aspects of diabetes management: consultations: ₹3,383.45, investigations: ₹4,838.79, medications: ₹7,321.35, travel: ₹5,286.54, lost wages: ₹7,701.87, and total cost: ₹28,532. Furthermore, outpatients reported devoting an average of 11.79% of their annual income to managing their diabetes on an outpatient basis.

Conclusions:
This study highlights the significant financial burden borne by outpatients managing T2DM in India. Our findings underscore the need for implementing effective cost-minimization strategies within the Indian healthcare system.
A Study to Quantify the Exercise Stress in Terms of Oxygen Consumption and Anaerobic Threshold in Patients of Suspected Coronary Artery Disease during Conventional Treadmill Testing
Authors: Waghmare Lalitbhushan S. , Waghmare Tripti L. , Ambad Ranjit 
Published: January 2025

ABSTRACT

Background:
Coronary artery disease (CAD) is one of the leading causes of mortality worldwide, and early detection is crucial for effective management. Exercise stress testing, particularly treadmill testing, is widely used to assess cardiovascular function, with oxygen consumption (VO2) and anaerobic threshold (AT) serving as key indicators of cardiovascular fitness and exertional capacity. The aim of this study is to quantify exercise stress using VO2 and AT in patients with suspected CAD during conventional treadmill testing. These parameters may provide additional insight into the severity of coronary artery blockages and help in predicting cardiovascular events.

Objective:
The objective of this study is to quantify the exercise stress in terms of oxygen consumption (VO2) and AT in patients with suspected CAD using conventional treadmill testing.

Material and Method:
The present study was conducted in the Department of Physiology at Jawaharlal Nehru Medical College Sawangi Meghe Wardha Maharashtra. The study included 100 patients with suspected CAD, aged 40 to 70 years. These patients presented with symptoms such as chest pain, breathlessness, or a family history of cardiovascular disease, prompting the need for exercise stress testing. A control group of 50 healthy individuals matched by age and sex was also included for comparison.

Result:
The study demonstrated that VO2 and AT levels significantly correlated with the presence and severity of CAD in patients. Patients with CAD exhibited lower VO2 levels and earlier onset of anaerobic threshold compared to the healthy control group. The results suggest that these parameters could be used as effective indicators in the early detection of CAD.

Conclusion:
The study highlights that measuring oxygen consumption and AT during treadmill testing can enhance the assessment of cardiovascular stress and provide valuable prognostic information in patients with suspected CAD.
Variations in the branching pattern of the popliteal artery in the north Karnataka region: A cadaveric study
Authors: Noveltony Supriya , Kokati Drakshayini B. , Chaitra B. R. 
Published: January 2025

INTRODUCTION:
The clinically most important artery of the lower extremities is the popliteal artery. The normal branching pattern of the popliteal artery ranges between 92% and 96%. The branching pattern of the popliteal artery and its variations plays an important role for surgeons, radiologists, and anatomists during vascular grafting, surgical repair, embolectomy, knee replacements, diagnostic angiography, transluminal stent implementation, and transluminal angioplasty.

AIMS AND OBJECTIVES:
To study the variations in the branching pattern of the popliteal artery in the north Karnataka region and discuss its clinical application.

MATERIAL AND METHODS:
The present observational study was conducted on the formalin-fixed 15 cadavers, from the Department of Anatomy, JGM Medical College, Hubballi. The popliteal artery and its branches were studied in 30 limbs of 5 male and 10 female cadavers. Detailed dissection was carried out according to Cunningham’s manual, the popliteal fossa was exposed, and the popliteal artery, its terminal branches, the level of termination, and its mode of termination were studied.

RESULTS:
In the present study, the largest and shortest lengths of the popliteal artery measured were 60.7 mm and 10.4 mm, respectively. The mean length of the popliteal artery on the right and left sides was 35.76 mm and 33.687 mm, respectively with P = 0.580. Level of termination of the popliteal artery was observed and noted. Normally, the popliteal artery terminates at the lower border of the popliteus muscle. The artery terminating at the upper border of the popliteus was defined as high termination and artery terminating far below the lower border of the popliteus was defined as low termination. In the present study, out of 30 dissected limb specimens, two limbs showed high termination and 28 limbs showed normal termination of the popliteal artery.

CONCLUSION:
Knowledge of the variations of the branching pattern of the popliteal artery is important in planning surgeries and image-based interventions. Hence, the present study can be of help in selecting the treatment options at surgery and avoidance of iatrogenic injury.
Parathyroid adenoma in children: A rare cause of primary hyperparathyroidism
Authors: Roy Srotaswini , Agrawal Poorvi Chandraprakash , Wade Poonam , Bhagwat Nikhil M. 
Published: January 2025

Abstract:
Primary hyperparathyroidism (PHPT) is rare in children. The most common cause of PHPT is parathyroid adenoma, which occurs either sporadically or as part of the syndrome (the most common being multiple endocrine neoplasia syndrome). The clinical presentation is often vague with nonspecific symptoms involving the gastrointestinal, renal, musculoskeletal, and central nervous systems making the diagnosis challenging. Biochemical profiles and modern imaging techniques are the mainstay for diagnosing the condition, planning the right treatment, and for perioperative management. Herein, we present a case of PHPT who presented to us with all the classical symptoms of hypercalcemia described as “Bones, Stones, Groans, and Moans.”
Impact of social media influence on eating behavior in mid and late adolescent children a cross-sectional study
Authors: Patil Aishwarya , Salimath Gavishiddhayya , Angolkar Mubashir 
Published: January 2025

BACKGROUND:
Adolescence is an important period of life when healthy behaviors are learned and cultivated to improve quality of life and physical function. During this time, it is important to eat well, exercise, and feel good about yourself. Social media is a part of adolescent life having many advantages, however, wrong information can have an adverse health effect. Adolescents are influenced by the content posted on social media, which frequently features a lot of fast-junk food marketing advertisements. In turn, these posts affect their eating preferences and choices and may change their perception of what constitutes a healthy eating behavior.

OBJECTIVE:
The objective of this study was to assess the influence of social media on adolescent children and to determine its impact on their eating behaviors.

MATERIAL AND METHODS:
Two higher secondary schools were selected using a simple random sampling technique. Both schools’ principals were notified about the study and received signed informed consent. One hundred and forty-four teenagers (15–19 years old) who fit the inclusion criteria were recruited using the simple random sampling method. After explaining the study and obtaining consent/assent. A self-administered predesigned, semi-structured, validated questionnaire was used to collect data.

RESULTS:
Celebrities had a roughly similar influence on both male and female adolescents on diet and exercise routines. Among females, 16.25% were generally affected compared to 12.50% of males, whereas 37.50% were occasionally influenced compared to 35.94% of males. An analysis of the impact of advertisements on meals and beverages revealed that males were often more tempted than females. The influence of social networking sites on female eating habits revealed that 43.04% preferred to visit cafes and restaurants more frequently than 29.69% of males, whereas 15.19% of females ordered meals online compared to 25% of males. Females (57.50%) had a greater desire for an idle body type and attempted to lose or gain weight as influenced by media than males (46.88%). Interestingly, males (45.31%) were more body-conscious and concerned about their nutrition than women (39.24%).

CONCLUSION:
The present study concluded that females were more influenced by social media on eating behavior; however, males in the study were body conscious and desired an ideal body.
Prevalence of unmet need for contraception among married women aged 15–49 years in urban and rural areas of Telangana
Authors: Sundaran Stefi , Darivemula Surendra Babu , Bala Sudha , Tondare Devidas Prabhakarrao , Kumar S. Ajith , Molagara Sruthi 
Published: January 2025

BACKGROUND:
As reported by the National Family Health Survey-5, over 70% of currently married women aged 15–49 years have a demand for family planning. Women encounter a multitude of obstacles when it comes to accessing and adopting contraception, including limited knowledge, social disapproval, and inadequate availability of family planning resources.

OBJECTIVE:
The aim of this study is to estimate the prevalence of unmet need for contraception and factors affecting contraceptive behavior among reproductive age group women aged 15–49 years living in urban and rural areas of Telangana.

METHODOLOGY:
A cross-sectional study was conducted in urban and rural areas of Telangana among 306 reproductive age group women aged 15–49 years. Data were collected using a structured questionnaire, and the Chi-square test was used to assess the significance.

RESULTS:
The unmet need for contraception was found to be 18.6%, and it was significantly higher in urban than in rural (24.2% and 13.1%, respectively). Spacing need was 6.2% and limiting need was 12.4%, significantly higher among urban (17%) than in rural (7.8%). The occupation of the correspondent was found to be significantly associated with an unmet need for contraception.

CONCLUSION:
A high unmet need for contraception was observed among women in Telangana, highlighting the existence of a knowledge–action gap in promoting positive attitudes and behaviors toward contraception. Further research is necessary to explore the underlying factors contributing to the rising unmet need and training of frontline health-care workers to raise awareness about family planning methods and address associated stigmas.
Occult Breast Cancer Masquerading as Bicytopenia
Authors: Bhalla Ravi Vir Singh , Mohamed Ismail Ibrahim 
Published: January 2025

Abstract
Occult breast cancer (OBC) is a rare type of breast cancer without a detectable primary lesion in the breast on a physical examination or imaging such as an ultrasound or mammogram. Occult breast cancer may present as axillary lymphadenopathy, nipple discharge, nipple dermatitis, papillary dermal edema, eczema, skin retraction, etc. However, anemia and thrombocytopenia as the initial presentation of OBC are rare. We report the rare case of a patient with OBC who presented with significant thrombocytopenia and anemia due to bone marrow metastasis.
Addressing Neurological Inequities in Developing Countries: Challenges and Strategic Solutions
Authors: Kandel Amit 
Published: January 2025

Abstract
Neurological disorders pose one of the most urgent healthcare challenges globally, with a particularly severe impact on low-resource settings. Effective responses to this crisis require timely, intersectoral strategies, and coordinated actions to drive substantial positive changes. Political determinants of health play a crucial role in advancing initiatives in surveillance, prevention, acute care, and rehabilitation for neurological conditions. An essential life-course approach to brain health focuses on early intervention and sustained care throughout an individual’s lifespan. Building a comprehensive system of care, underpinned by robust policies and financial investments, is critical for progress in low-resource countries. In addition, urgent reforms in education are needed to cultivate a skilled neurological workforce that is equipped to meet the demands of these regions. Intersectoral strategies, including telemedicine, mobile health, organized systems of care, helicopter ambulance services, and widespread public awareness campaigns, are vital components for creating an equitable and responsive neurological healthcare framework.