bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Real Burden of Tuberculosis
Authors: Agarwal Swapnil , Chaurasia Zini , Malik Dishant Kumar , Gupta Renu , Singh Cheta , Jain Surbhi 
Published: April 2023

Introduction:
Developing nations have a huge burden of tuberculosis (TB), because of which many cases are undetected and diagnosed only on autopsies. The purpose of this study was to find these cases in a series of consecutive autopsies conducted at a tertiary care centers.

Materials and Methods:
This retrospective study of 7-year duration from 2014 to 2020 consisted of reviewing 767 autopsies. The records of cases where a diagnosis of TB were established on histopathology were noted and evaluated.

Results:
Of 767 autopsies, TB was the diagnosis on histopathology in 72 cases. Of the 72 cases, 53 cases were undiagnosed antemortem and incidentally detected on autopsy. The study showed a male predominance with a 1.52:1 male-to-female ratio. The most common age group involved was the second decade. The study constitutes 26 cases of isolated pulmonary TB, 23 cases of disseminated TB, three cases of solitary renal TB, and one case of hepatic TB. The liver was the most commonly involved organ along with the lung in cases of disseminated TB, followed by the spleen, kidney, pancreas, intestine, brain, and heart.

Discussion:
Epidemiology and research on TB may be affected by these hidden cases which are unraveled incidentally on autopsy. These cases must always be reported and brought to the attention of clinicians for nation's better public health.
Molecular Detection of Mycobacterium tuberculosis Complex Species in Triatomines Found in Urban Households and Peridomiciles in a City with High Prevalence of Tuberculosis in Northeastern Brazil
Authors: Silva Caroliny Soares , Gondim Costa Lima Luana Nepomuceno , Batista Lima Karla Valéria , Freitas de Almeida Rosa Livia , da Conceição Marília Lima , Parente Cynara Carvalho , Rocha Amanda Albuquerque , da Silva Thales Candido , de Oliveira Sancho Soraya , Frota Cristiane Cunha 
Published: April 2023

Background:
Triatomine insects, native to northeastern Brazil, have been found in the urban peridomicile. The city of Sobral has a high number of tuberculosis cases and several triatomine species. This study investigates the presence of mycobacteria, particularly Mycobacterium tuberculosis complex (MTBC) species, in triatomines captured in the urban perimeter of Sobral.

Methods:
We analyzed 167 triatomines captured in urban households and peridomiciles of Sobral. Mycobacteria were identified by the PRA-hsp65 method followed by partial sequencing of the hsp65 and rpoB genes. The sequences confirmed as MTBC were also typed by mycobacterial interspersed repetitive units-variable number tandem repeats (MIRU-VNTR) and spoligotyping.

Results:

Triatoma brasiliensis (38.6%), Triatoma pseudomaculata (32.9%), Panstrongylus lutzi (24.3%) were the most frequently identified. In 51.1% (70/167) of them, species of the Mycobacteriaceae family were detected by PRA-hsp65; of these, 31.4% (22/70) were identified as belonging to MTBC species. Nine (12.9%) of the triatomine samples were confirmed by sequencing as belonging to MTBC species. MIRU-VNTR genotyping suggests that the presence of different MTBC sublines in the triatomines should be investigated.

Conclusion:
This is the first report of MTBC lineages in triatomine insects. These results indicate the migration and adaptation of these insects in an urban setting.
Early Secreted Antigenic Target of 6 Kda-Like Proteins of Mycobacterium tuberculosis
Authors: Mustafa Abu Salim 
Published: April 2023

Background:
Early secreted antigenic target of 6 kDa (ESAT6) is low-molecular-weight and immunodominant protein of Mycobacterium tuberculosis with relevance to diagnosis and vaccine development. Analysis of the M. tuberculosis genome has shown the existence of 23 ESAT6-like genes. This study was aimed to determine M. tuberculosis-specificity vis-à-vis crossreactivity of ESAT6-like genes and encoded proteins and their potential in the diagnosis and vaccine development.

Methods:
All ESAT6-like proteins were characterized using the webserver Tuberculist. The sequence identities were determined using basic local alignment search tool.

Results:
The genes for six ESAT6-like proteins were located in M. tuberculosis-specific genomic regions of differences (RDs), i.e., EsxA and EsxB in RD1, EsxO and EsxP in RD7, and EsxV and EsxW in RD9. The genes for other ESAT6-like proteins were located in the genomic regions shared with other mycobacteria. Based on sequence identities, the ESA6-like proteins were divided into four subfamilies of 15 proteins and no subfamily of 8 proteins. The members of subfamilies 1-4 shared extensive sequence identities among the members of each subfamily. Each member of subfamily 1 (EsxI, EsxL, EsxN, EsxO, EsxV) and subfamily 2 (EsxJ, EsxK, EsxM, EsxP, EsxW) were homologs. Hence, the gene sequences identical to EsxO and EsxP located in RD7, and EsxV and EsxW located in RD9 were also present in the regions of M. tuberculosis genome shared with other mycobacteria.

Conclusion:
Because of their specificity to M. tuberculosis, only EsxA (ESAT6) and EsxB (CFP10) will be useful in the specific diagnosis. However, other ESAT6-like proteins may be useful for vaccine development against tuberculosis.
Predictors of Treatment Outcomes in Drug Resistant Tuberculosis-Observational Retrospective Study
Authors: Johnson July Mary , Mohapatra Aswini Kumar , Velladath Saleena Ummer , Shettigar Kavitha S 
Published: April 2023

Background:
In this study, we evaluate the predictors of treatment outcomes in drug resistant tuberculosis.

Methods:
An observational retrospective study was conducted by using the medical records of patients confirmed for TB at Kasturba Medical College from January 2015 to December 2018.

Results:
Four hundred and sixty-two TB patients were included in this study. Of the total TB-confirmed patients, about 85.1% are diagnosed with pulmonary TB (PTB) (n = 393), 11.7% were extrapulmonary tuberculosis (EPTB) (n = 54), and 3.2% (n = 15) cases had both PTB and EPTB. Among the 462 cases, the frequency of multidrug-resistant TB (MDR-TB) was 25% (n = 117), extensively drug-resistant TB was 1% (n = 3), and non-MDR cases were 74% (n = 342). The frequency of unsuccessful treatment outcome was 92.9% (n = 429) and successful outcome was 7.1% (n = 33). There were 68.2% of new and 31.8% retreatment cases of TB. HIV co-infection was found in 2.3% (n = 14) of TB cases, and among them, 64.3% (n = 9) were found in PTB cases. The major comorbidities found were diabetes (21.2%), weight loss (12.6%), and anemia (12.6%). There was a difference in rate of PTB cases across years decreasing in the year 2017, whereas ETB cases were increasing in the year 2017. The TB treatment success rate was increased from 2015 (4.8%) to 2018 (8.3%).

Conclusion:
The higher rate of poor treatment outcome emphasizes the need of improvement in TB surveillance, treatment, more stringent follow-up, monitoring, and patient education to ensure complete and successful treatment.
Changes of Th1 and Th2 Cytokines Levels among Sudanese Tuberculosis Patients during Treatment
Authors: Abdul-Aziz Ahmed A. , Elhassan Mogahid M. , Yousuf Amjad M. , Hamid Mohamed E. , Abdulsalam Salma A. , Gafar Rana A. , Elmekki Miskelyemen A. 
Published: April 2023

Background:
The interaction of T cells with infected macrophages depends on the interplay of cytokines produced in each cell, and this mechanism is a key to protective immunity against Mycobacterium tuberculosis. Extensive research has been devoted to studying the changes in systemic cytokine levels in patients with tuberculosis (TB), but the results are inconclusive. Determine Th1 and Th2 cytokine immune response levels among new TB patients compared to follow-up and healthy control

. Design:
Cross-sectional laboratory-based study.

Setting:
Immunology Laboratory, National Center for Research.

Methods:
Blood samples (n = 145) were collected from confirmed new TB cases, follow-up TB cases, and from healthy controls. Participants were initially diagnosed by microcopy using Ziehl–Neelsen smear method and confirmed by polymerase chain reaction using IS6110. Cytokine levels (interleukin-10 [IL-10], tumor necrosis factor alpha [TNF-α], and Interferon-gamma [IFN-γ]) were measured directly from plasma using sandwich enzyme-linked immunosorbent assay.

Main Outcome Measures:
Measuring Th1 cytokines (IFN-γ and TNF-α) and Th2 cytokine (IL-10). One hundred and forty-five cases (new TB cases, 85; follow-up, 25; and healthy control, 35) were included in this study.

Results:
The study population were mainly males (70.3%) compared to females (29.7%) and 87.5% aged between 21 to 60 year. The plasma IFN-γ levels were found significantly higher in new TB cases (mean 35.38 pg/m; confidence interval: 29.32–41.43) than in the follow-up patients and the healthy control (P = 0.000). There were no significant differences in TNF-α and IL-10 levels among the new TB cases and the follow-up and healthy control (P = 0.852 and P = 0.340, respectively).

Conclusions:
Direct plasma IFN-γ level can be used in TB patient follow-up as a recovery marker as it correlated well with the appearance of the disease and treatment response.
A Multidrug-Resistant Tuberculosis Outbreak in a Language School
Authors: Itaki Mariya , Endo Masayuki , Ikedo Keiko , Kayebeta Aya , Takahashi Ikumi , Ota Masaki , Hirao Susumu , Nagata Yoko 
Published: April 2023

Background:
Japan has successfully reduced the burden of tuberculosis (TB) in the past seven decades; however, there are still some issues in eliminating TB. Its presence in immigrants, particularly multidrug-resistant (MDR) TB, is one of them. In mid-September 2019, a teenage Chinese male student in a morning class of a Japanese language school in Tokyo, Japan, was diagnosed with sputum smear-positive pulmonary MDR-TB.

Method:
The outbreak cases were analyzed in a cohort study.

Results:
We investigated 138 students and 18 teachers, of whom 81 (51.9%) were male, 115 (73.7%) were aged from 20 to 29 years, and 124 (76.9%) were from China. Four other students in the same classroom and another in a different classroom from the index patient in the morning classes were also diagnosed with MDR-TB disease by the end of November 2020. In addition, 31 cases of latent TB infection (LTBI) were detected among the students and teachers. Students in the same classroom had the highest risk of TB infection (78.9%, 95% confidence interval [CI]: 54.4%–93.9%) with a relative risk of 8.6 (95% CI: 3.9–19.0), followed by students in the other classrooms of the morning classes (25.9%, 95% CI: 15.0%–39.7%) with a relative risk of 2.8 (95% CI: 1.2–6.8), compared with the afternoon class students (9.2%, 95% CI: 3.5–19.0) who had minimal contact with the index patient.

Conclusion:
National TB programs should adopt prophylaxis regimens for MDR-TB LTBI cases and provide prophylaxis to them, particularly if related to an outbreak. The Japanese government should screen immigrants for TB, particularly those from TB-endemic areas.
Spoligotyping and Polymerase Chain Reaction Based Mycobacterium Bovis Strains Typing with Methods (Enterobacterial Repetitive Intergenic Consensus-Polymerase Chain Reaction, Randomly Amplified Polymorphic Dnas-Polymerase Chain Reaction and Out Polymerase Chain Reaction)
Authors: Sahin Funda , Tarhan Gülnur , Cinoglu Halil , Kayar Mediha Begüm , Yakici Gülfer 
Published: April 2023

Background:
In this study, it was aimed to investigate Mycobacterium bovis strains isolated from lungs and lymph nodes of slaughtered animals on clonal level by using different methods such as spoligotyping, enterobacterial repetitive intergenic consensus-polymerase chain reaction (ERIC-PCR), randomly amplified polymorphic DNAs (RAPD-PCR) and OUT-PCR. Comparative evaluation of these methods was further conducted.

Methods:
A total of 38 M. bovis isolates were evaluated in the study. DNA isolation of all M. bovis strains isolated from pruvat free Löwenstein Jensen medium was done by boiling method for ERIC-PCR, RAPD-PCR, and OUT PCR. Mickle device was used for DNA isolation for spoligotyping method.

Results:
In 38 M. bovis isolates examined in our study, 4 different groups were determined by spoligotyping and RAPD-PCR test methods, and 5 different groups were detected in ERIC-PCR tests. In the OUT-PCR tests, the band which provides sufficient type separation was not observed.

Conclusion:
ERIC-PCR, RAPD-PCR, and OUT-PCR methods are easily applicable, simple, and relatively inexpensive methods for evaluating the differences between origins in the typing of M. bovis. The tests need to be evaluated in more detail with extensive studies.
Practices toward Presumptive Tuberculosis Clients among Patent Medicine Vendors in Ebonyi State Nigeria
Authors: Onah Cosmas Kenan , Azuogu Benedict Ndubueze , Ossai Edmund Ndudi , Agu Adaoha Pearl , Ogbonnaya Lawrence Ulu , Onwasigwe Chika 
Published: April 2023

Background:
Tuberculosis (TB) is a major cause of ill-health and death globally but a serious challenge to its control is low case notification. In low- and middle-income countries, most patients with symptoms of the disease first seek care from patent medicine vendors (PMVs) who are not formerly trained to manage TB. The practices of PMVs toward presumptive TB are pivotal to control of TB.

Aim:
The aim of this study was to describe the pattern of practices toward presumptive TB and assess their determinants among PMVs.

Method:
The study was carried out in Ebonyi State Nigeria using descriptive cross-sectional design. Through a multistage sampling, 250 PMVs were selected and interviewed. Data were collected using pretested interviewer-administered questionnaire and analyzed with IBM SPSS Statistics for Windows, version 22 (IBM Corp., Armonk, N.Y., USA). Chi-square test and binary logistic regression were used to determine factors associated with practices toward presumptive TB with P value set at 0.05 for statistical significance.

Results:
Almost half (48.8%) of the respondents engaged in poor practices by inadequate referral of clients (45.2%), delayed referral (69.6%), and unstandardized treatment with antibiotics (56.4%). There was no statistically significant association between independent variables and practice and none of the variables significantly predicted practice.

Conclusions:
There were poor practices toward presumptive TB shown in inadequate referral, delayed referral, and unstandardized treatment of clients. We recommend that PMVs should be trained and regularly sensitized about TB to improve their practices and that regulatory authorities should enforce policies on antibiotics distribution and sale.
Yoga Module for Somatoform Pain Disorders
Authors: Jha Monika , Dumbala Sowjanya , Gulati Kankan , Bhargav Hemant , Arasappa Rashmi , Varambally Shivarama , Gangadhar BN , Desai Geetha 
Published: April 2023

Background:
Yoga practices have been found to be useful in chronic pain conditions but studies focussing specifically on somatoform pain disorders (SPDs) are limited.

Aims:
Current study aims to develop and test the feasibility of a yoga program for patients with SPDs.

Materials and Methodology:
Athorough search of traditional and contemporary literature was performed with the objective of formulating a yoga program for reducing chronic non-specific pain and associated psychological distress. Content validity of the program was then determined by taking the opinion of 18 yoga experts (who had >5 years of experience in treating mental health disorders) using content validation ratio (CVR) through Lawshe's formula. The feasibility of the module was tested on 10 subjects diagnosed with SPDs as per the International Classification of Diseases (ICD) -10 criteria using standard scales.

Results:
In the finalized module, 70.83% (34 out of 48 items) of the practices were retained along with the modifications as suggested by the experts. Two practices were not found to be feasible (Trikonasana and Shalabhasana) and hence were removed from the final module. A significant reduction in pain severity was observed in the subjects after practising the yoga module for 2 weeks. The content validity index for the whole module (average of all CVRs) was 0.55.

Conclusions:
Ayoga module was developed for SPD. The content validity of the module was found to be good. The module was found safe and potentially useful for reducing pain severity in patients with SPD. Future studies should test the efficacy of the developed program through a randomized controlled clinical trial.
Effect of Community-Based Structured Yoga Program on Hba1c Level among Type 2 Diabetes Mellitus Patients
Authors: Misra Puneet , Sharma Gautam , Tandon Nikhil , Kant Shashi , Sangral Meenu , Rai Sanjay K , Yadav Kapil , Vishnubhatla Sreenivas , Mandal Suprakash , Kardam Priyanka , Thakur Nishakar 
Published: April 2023

Context:
In view of the rising burden of type 2 diabetes mellitus (DM) cases in India, there is an urgent need for an effective, low-cost, sustainable intervention controlling diabetes thus preventing complications.

Aims:
This study aimed to assess the effect of structured yoga programs on diabetes.

Subjects and Methods:
This was a community-based interventional study that was conducted in an urban resettlement colony of Delhi, India. Known diabetes patients with glycated hemoglobin (Hb1Ac) ≥6.5% were enrolled from 12 randomly selected blocks of the community with a sample size of 192 in each intervention and wait-listed control arm. The intervention was structured yoga of 50 min daily, 2 consecutive weeks in a nearby park and health center followed by twice a week home practice up to the 3rd month. The primary outcome measure was HbA1c% and secondary outcome measures were lipid profile and fasting blood glucose.

Statistical Analysis Used:
Aper-protocol analysis was done. Mean, standard deviation (SD), and 95% confidence interval were estimated. The level of significance was considered for 0.05.

Results:
There was a significant decrease of Hb1Ac (0.5%, SD = 1.5, P = 0.02), total cholesterol (11.7 mg/dl, SD = 40.5, P < 0.01), and low-density lipoprotein (3.2 mg/dl, SD = 37.4, P < 0.01) from baseline to end line in the intervention group. These changes in intervention group were also significantly different from the change in the wait-listed control group. The other variables did not change significantly.

Conclusions:
It revealed that structured yoga program improved glycemic outcome and lipid profile of individuals in a community-based setting. Yoga can be a feasible strategy to control hyperglycemia, lipid levels, and can help better control type 2 DM.
A Correlation Study between Tri-Guna and Emotional Style
Authors: Ravindra P. N. , Babu Prashanth 
Published: April 2023

Background:Science of well-being is getting focused across all walks of life from health care to organizational behavior. Indian psychological principles of Tri-Guna offer a universal theoretical framework to understand the behavioral aspects of emotions and well-being, whereas affective neurosciences have explored neural circuits underlying few universal emotional styles. Both Tri-Guna and emotional styles are dynamic and vulnerable for modifications with training. Hence, establishing a relation between Tri-Guna and emotional style offers a novel insight to explore neural basis of Tri-Guna and its application in health and behavioral sciences.Aims:To establish the correlation between Tri-Guna and emotional styles in healthy adult subjects.Materials and Methods:Healthy adults (n= 121, 18–21 years) of both genders were individually administered with questionnaires to assess Tri-Guna (Vedic personality inventory) and emotional style (emotional style questionnaire). The relationship between Tri Guna (Sattva, Rajas and Tamas) and Six dimensions of emotional styles (attention, self awareness, outlook, resilience, social intuition and sensitivity to context) were assessed using Pearson's correlation coefficient.Results:All the emotional styles showed a positive correlation with Sattva and negative with Rajas and Tamas, except resilience. Resilience showed a negative correlation with Sattva and positive with Rajas and Tamas. Further, between Rajas and Tamas, emotional styles showed a stronger correlation with Tamas.Conclusions:Sattva guna showed an association with emotional styles that favors to develop a positive emotional pattern. Having fairly understood neural circuitry of emotional styles, this first preliminary correlation data will provide a theoretical framework to explore neural circuitry involved in understanding emotional aspects of Tri-Guna.
Correlation of Heart Rate Variability with Carotid Intima Media Thickness after 6 Month of Yoga Intervention in Prediabetics
Authors: Saboo Neha , Kacker Sudhanshu , Rathore Jeevraj 
Published: April 2023

Introduction:
Atherosclerotic carotid intimamedia thickness (CIMT) may be associated with alterations in the autonomic functions. The aim of this study was to investigate the effect of 6-month yoga intervention on heart rate variability (HRV) and CIMT in elderly subjects and the correlation between HRV and CIMT.

Methodology:
This was a randomized controlled study, in which a total of 250 subjects were enrolled. Randomization and allocation in yoga and control groups were performed using computer-generated random numbers. The CIMT was determined by B-mode ultrasonography, and cardiac autonomic function was determined through frequency domain parameter of HRV measures at baseline and after 6 months of yoga intervention.

Results:
Participants had a mean age of 45.4 ± 6.4 years, and a mean CIMT in control (0.70 ± 0.05) and study group (0.69 ± 0.073), and low frequency/high frequency (LF/HF) ratio in control (2.20 ± 1.05) and study group (0.57 ± 0.54). Yoga group had evidence of increased vagal activity in the frequency domain (HF and LF/HF ratio, P < 0.001) with respect to control group. Moreover, a study group showed lower intimamedia thickness (IMT) than control subjects (P < 0.01). In the whole population, LF/HF ratio positively and significantly correlated (r = 0.665, P < 0.01) to IMT.

Conclusion:
This study demonstrated that, after yoga intervention, LF/HF ratio is positively correlated with CIMT, a putative index of atherosclerosis, confirming cardiac autonomic neuropathy as a part of the pathophysiological pathway for atherosclerosis. It confirms that the regular yoga represents a valuable strategy to counter impairments of cardiac autonomic activity and artery structural changes.
Yoga for Caregiving Dyads Experiencing Chronic Pain
Authors: Gibson Barbara Ann , Puymbroeck Marieke Van , Fruhauf Christine A. , Schmid Arlene A. , Portz Jennifer D. 
Published: April 2023

Context:
Caregivers often provide unpaid care for family members and friends with physical disabilities, often to the detriment of their health and well-being. Caregivers often experience pain, and individuals with physical disabilities also are likely to experience pain. Merging yoga and self-management to Develop Skills Study (MY-Skills) is an intervention that merges self-management education with yoga for dyads experiencing chronic pain.

Aim:
This article presents the yoga protocol for the MY-Skills intervention.

Methods:
The yoga protocol was revised based on feedback from six caregiving dyads. The protocol focuses on reducing pain interference and supporting the caregiving dyad.

Results:
The final yoga protocol incorporated the following elements: Centering and mantra, prana vidya and pranayama, asanas, mudra, and guided savasana/dhyana.

Conclusion:
The MY-Skills yoga protocol was modified by a yoga therapist with feedback from study participants. Revisions focused on the caregiving dyad, with specific attention to reducing pain interference.