bluuebunny/crossref_metadata_2025_split huggingface dataset:
A study of electrocardiographic and 2D echocardiographic changes in type 2 diabetes mellitus patients without cardiovascular symptoms
Authors: Sardesai Vasudha V. , Kokane Hemant T. , Mukherjee Souradip , Sangle Shashikala A. 
Published: March 2022

Context:
Cardiovascular diseases in diabetic patients are mostly asymptomatic due to autonomic neuropathy. Many patients with left ventricular dysfunction remain undiagnosed and untreated until advance disease causes disability. This delay could be avoided if screening techniques are used to identify left ventricular dysfunction in its preclinical phase.

Aims:
This study was undertaken to find out the incidence of electrocardiographic (ECG) and 2D echocardiographic (2 D Echo) abnormalities in diabetic patients without cardiovascular symptoms. The correlation of control of diabetes with these abnormalities was also studied. Settings and Design: A hospital-based, cross-sectional observational study.

Methods and Material:
Type 2 diabetic patients (outpatient and indoor) without cardiovascular symptoms like palpitations, chest pain, syncope, and breathlessness were included in the study. Their ECG and 2D Echo findings were noted and correlated with their blood sugar levels. Statistical Analysis Used: Chi-square test. Results: Type 2 diabetic patients without cardiovascular symptoms had significant abnormal findings on ECG and 2D Echo. Control of postprandial blood sugar level was of primary importance to prevent cardiovascular abnormalities.

Conclusions:
Type 2 diabetics without cardiovascular symptoms must be screened for cardiovascular abnormalities so that early interventions can be done to prevent further progression to symptomatic cardiovascular abnormalities. There is a significant number of people having normal ECG but abnormal 2D Echo and vice versa, so not only ECG but also 2D Echo should be done to predict cardiovascular risk in type 2 diabetic patients without cardiovascular symptoms.
Impact of lockdown and unlocking on symptomatology and emergency department visits during the first wave of the COVID-19 pandemic
Authors: D’Silva Rachel E. , Kola Ashwin K. , Vijay Joshua , Jacob Mariam , Selvaraj Bagyalakshmi , Joseph Jeremiah N. , Abhilash Kundavaram Paul Prabhakar 
Published: March 2022

Background:
The COVID-19 pandemic resulted in a complete nationwide lockdown on March 24, 2020. The months of April and May had stringent lockdown measures followed by a gradual loosening of restrictions in a graded manner.

Methods:
This observational study was performed in the emergency department (ED) of a tertiary hospital in south India triage Priority 1 and Priority 2 patients presented during the COVID-19 lockdown and unlock periods spanning from April 2020 to August 2020. The three different lockdown periods and the subsequent unlock periods were categorized as lockdown 1 (LD1), lockdown 2 (LD2), lockdown 3 (LD3), and unlock phase (UL), and a 7-day time period in each were taken for 7-day incidence analysis.

Results:
During the 5-month study period, a total of 1,954 patients were analyzed for the study that included 405, 440, 492, and 617 patients during the 7-day time periods in the LD1, LD2, LD3, and UL periods, respectively. The 7-day incidence of COVID-19 suspects increased significantly by 101.9% from LD1 to UL phases, whereas trauma cases increased by 52.9% in the same two time periods. Compared with LD1, in the UL phase, the 7-day ED admission and in-hospital mortality rates increased by 50.3% and 66.7%, respectively.

Conclusion:
The number of COVID-19 suspects saw a near-constant increase through the different phases of lockdown, culminating in the UL phase. The stringent lockdown measures resulted in a significant reduction in the incidence of trauma with a rebound increase in the UL phase.
A community-based cervical cancer screening program in Alappuzha district of Kerala using camp approach
Authors: Mohan Lakshmi , Karthika M 
Published: March 2022

Background:
Cervical cancer is a major cause of preventable cancer related death in women, particularly in middle-income developing countries. Screening of cervical pre-cancer by cytology remains an effective strategy for prevention of mortality. However, there is paucity of community-based studies in Kerala. The aim of this study was to determine the prevalence of cervical precancerous lesions and to study the associated epidemiological factors through camp approach.

Materials and Methods:
A cross–sectional study was carried out among women in Alappuzha district, Kerala, by conducting community-based screening camps covering all the panchayaths from February 2017 to January 2019.

Statistical Analysis Used:
Descriptive statistics including mean for continuous variables and frequency along with their percentage for categorical variables were determined. Pearson’s Chi-square test was used to determine the strength of the association between variables. Statistical significance was set at P value less than 0.05.

Results:
Out of 5241 women screened, majority (62.9%) were in the reproductive age group (31–50 years) with mean age of 47.1 ± 10.3 years. The prevalence of precancerous lesions of cervix was 6.37%, which consisted of low-grade squamous intraepithelial lesion (LSIL) in 2.2%, high-grade squamous intraepithelial lesion (HSIL) in 0.5% and Carcinoma-in-situ in 0.2%. Risk factors that had significant association with cervical precancerous lesions were lower education status, genital infections, early marriage age and high parity.

Conclusion:
Well planned community-based screening programs can help to identify the exact prevalence of cervical pre-cancer in a region and the associated epidemiological factors leading to formulation of effective elimination strategies.
Oral manifestations in COVID-19 patients: An observational study
Authors: Muthyam Alka Kumari , Reddy M. Padma , Kulkarni Suhas , Srilatha Adepu , Sahithi Kommuri , Satyanarayana Dantala 
Published: March 2022

Background:
Viral diseases continue to emerge as a threat to mankind and are a serious concern to public health. The latest lethal SARS-CoV-2 or COVID-19 is a highly contagious disease, which propagated quickly across the globe. Similar to other influenza-like viral infections, symptoms such as fever, dry cough, myalgia, arthralgia, headache, diarrhea, dyspnea, and fatigue were reported among COVID-19 patients. Evidence suggests that the oral cavity is affected by this virus either directly or indirectly. Aim: The aim of this observational study was to determine the oral manifestations among COVID-19 patients.

Materials and Methods:
A cross-sectional, questionnaire-based study was carried out among COVID-19 recovered patients. A sample of 100 subjects, diagnosed as mild and moderate cases of COVID-19 disease were selected based on inclusion and exclusion criteria.

Results:
The study comprised an almost equal number of male (51%) and female (49%) participants and among them, 48% belong to the health professional group. A total of 54% of subjects were aged above 35 years and 46% below 35 years. Oral manifestations among study subjects during and after the disease illness included xerostomia being the commonest symptom (44%), followed by swallowing difficulty (16%), mouth ulcerations (10%), chewing problem (7%), gum bleeding (6%), and burning sensation (4%).

Conclusion:
Xerostomia, frequent aphthous ulcers, swallowing difficulty, and burning mouth were the most frequently encountered symptoms in study subjects during the disease and post recovery. Early identification of oral symptoms in COVID-19 recovered or suspected cases can help a dentist or a general physician to diagnose high-risk groups, mitigate transmission, and promote overall health.
A study to correlate effect of dietary modification on biochemical and cardiovascular parameters among prediabetics
Authors: Saboo Neha , Kacker Sudhanshu 
Published: March 2022

Objectives:
Dietary factors are important in the prevention and treatment of prediabetes and diabetes mellitus (DM). This study was designed to evaluate the prevalence, associated risk factors, dietary modification, and calories consumption calculated by the food frequency questionnaire and correlate them with the metabolic parameters, namely blood glucose, HbA1c, lipid profile, and cardiovascular parameters as heart rate variability and carotid intima media thickness (CIMT) among the prediabetics.

Methods:
An experimental interventional study was carried out in the Department of Physiology and Medicine at the RUHS College of Medical Sciences and Associated Group of Hospitals. The assessments were done at baseline and after 6 months of post-dietary modification. The total duration of the study was 6 months. A total of 250 prediabetic subjects were enrolled. Study Group A (n = 125) was engaged in dietary modification, whereas Group B (n = 125) was considered as control. The dietary assessment was done by a food frequency questionnaire.

Result:
After dietary modification, a decrease in the body mass index (1.3%), systolic blood pressure (3.1%), diastolic blood pressure (3.1%), blood glucose (2.8%), triglyceride (2.8%), high density lipoprotein (0.9%), HbA1c (2%), cholesterol (1.4%), and low-frequency/high-frequency ratios (1%), carotid intima media thickness (1.6%), as compared to control, was noticed after 6 months of dietary modification.

Conclusion:
This study suggested that prediabetics required health education including nutritional education as diet modification can play an important role to encourage diabetes-onset prevention and its related complications. The health-care providers and workers should increase the awareness about the importance of diet and encourage the prediabetics toward a healthy lifestyle, which may help in the quality of life and appropriate self-care, primary prevention of diabetes and its complications. CTRI Registration: CTRI/2017/06/008825.
Managing COPD exacerbation at home- Teleconsultations amid COVID-19
Authors: Shahnawaz Mir , Dar Mohd Yousoof , Nabi Shabnam , Mustafa Hena , Samreen Sheema , Shah Naveed Nazir 
Published: March 2022

Background:
Due to an enormous health care crisis arising out of COVID-19 pandemic, alternate methods of seeking treatment like tele-consultation proved useful to patients. We assessed the role of teleconsultation in managing COPD exacerbations at home in the times of COVID-19 crisis.

Materials and Methods:
A prospective study of 527 diagnosed cases of COPD seeking treatment for exacerbation of their illness telephonically because of difficulty in visiting the hospitals created by the COVID-19 lockdown. Data were collected telephonically and via social media platforms from April 7,2020 to October 29, 2020.The patients were treated for exacerbation and followed telephonically at day 3,5,7, 14 and day 30. Patients who turned to be COVID-19 positive were referred to COVID health facility centers.

Results:
509 patients out of 527 patients were treated for exacerbation of COPD, 18 patients tested positive for COVID-19. Out of 509, 13 patients did not improve and had to be referred to hospital. All of them had acute respiratory failure (Type 2) as documented by their arterial blood gas analysis. 2 out of them did not survive. 496 out of 509 (97.4%) patients of COPD exacerbation were successfully treated via teleconsultations and with a follow-up of 4 weeks period minimum for all the patients.

Conclusion:
Teleconsultation provided excellent means to manage COPD exacerbation remotely with equally effective outcome as seen in hospital care in the times of health care crises due to COVID-19 pandemic.
A cross-sectional study on determinants of indoor air pollution and its perceived impact among the residents of urban field practice area of AMCH, Salem, Tamil Nadu
Authors: Priyadarsini S. P. , Ibrahim R. Mohammed , Somasundaram V. M. , Nayeem R. Abdul , Balasubramanian R. 
Published: March 2022

Background:
Over the past 20 years, indoor air pollution (IAP) has received much attention as the quality of the indoor air is affected a lot. IAP means the presence of substances which are redundant in the indoor air at concentrations toxic to health. Very few studies have addressed the determinants of indoor air pollutants in places like urban slum areas in Tamil Nadu. To reduce this research gap, this study has been undertaken. Aim: To study the determinants of IAP and its perceived impact on health.

Settings and Design:
This was a community-based cross-sectional study. Complete information from 440 households consisting of 1606 individuals was collected through a semi-structured questionnaire.

Materials and Methods:
Residents of an urban field practice area of Annapoorana Medical College and Hospitals (AMCH) were the study participants. The study period was from April 19 to March 2020. The study area was an urban field practice area around Department of Community Medicine, Karungalpatty, AMCH. Frequency, proportions, and Spearman test were used to find out the significance between various household environmental conditions and the respiratory diseases using Epi Info software.

Results:
Results showed that 52.3% of the participants were using incense sticks at home in the evening during pooja and 17.7% of the houses were using mosquito coil in the evening and at night. Also, 29.5% houses reported overcrowding and 66.4% of the houses were not having chimney or exhaust. Results also showed that 71.4% households were practicing opening their windows while cooking. One hundred and fifty-two (34.5%) female respondents had perceived the symptoms like dizziness (12.3%), eye irritation (10.2%), difficulty in breathing (4.5%), dry cough (3.06%), running nose (1.4%), and nasal congestion (1.1%) due to IAP. Among under-five respondents, 1.6% reported having acute respiratory infections in the last 15 days and 10.5% reported the same in the last 1 year 10.5%.
A Rare Case of Fetal Gas Gangrene Following Premature Rupture of Membranes in the Second Trimester Diagnosed with the Aid of Computed Tomography
Authors: Venkatesha Gupta K. V , Ajith Kumar A. K , Bhattacharya Modhulika , Murthy Pooja R. , Sarath K 
Published: March 2022

Introduction:
To report a rare case of foetal gas gangrene following premature rupture of membranes in the second trimester diagnosed with the aid of computed tomography.

Case Report:
A 33-year-old lady, with G4A2L1, booked and vaccinated, developed premature rupture of membranes at 25 weeks of gestation. She developed severe abdominal pain with high-grade fever on the fourth night after expectant management with intravenous antibiotics and close monitoring. As there was a new-onset shock, she was referred to the higher centre from the obstetric care unit. The ultrasound of the abdomen and pelvis in the emergency room ruled out other causes of shock but confirmed intrauterine death. After planning for vaginal delivery, she had further deterioration requiring intubation and vasopressors. Contrast-enhanced computed tomography (CECT) of the abdomen and pelvis was performed which showed foetal gas gangrene and bilateral acute cortical necrosis. Emergency hysterotomy, performed under high-risk consent delivered macerated foetus. She had atonic uterus and required obstetric hysterectomy under general anaesthesia (GA). Her post-partum course was complicated by disseminated intravascular coagulopathy (DIC), acute respiratory distress syndrome (ARDS) and multiorgan dysfunction syndrome requiring multiple transfusions, prone ventilation and multiorgan support. However, she could not be salvaged and died on the 2nd day of surgery.

Conclusion:
We describe a rare fatal case of foetal gas gangrene in the second trimester following premature rupture of membranes which was diagnosed by a computed tomography (CT) scan of the abdomen and pelvis. The CT scan reliably identifies emphysematous changes in the amniotic cavity and foetal parts which helps in decision-making from the induction of labour to early surgical approach to prevent peritonitis and multiorgan failure. We recommend early CT scan in pregnancies complicated by intrauterine infections with shock which can change the line of management.
Sur la lissité du schéma Quot ponctuel emboîté
Authors: Monavari Sergej , Ricolfi Andrea T. 
Published: March 2022

AbstractDans cet article on caractérise la lissité du schéma Quot ponctuel emboîté d’une variété lisse—c’est-à-dire l’espace de modules paramétrant les drapeaux de quotients de dimension
$0$
d’un faisceau localement libre fixé. Nos résultats étendent la classification de Cheah dans le cadre des schémas de Hilbert ponctuels emboîtés.
Statistical Modeling of Deaths from COVID-19 Influenced by Social Isolation in Latin American Countries
Authors: da Silva Rafael André , de Souza Ferreira Luiz Philipe , Leite Jean Michel Rocha Sampaio , Tiraboschi Fernanda Assunção , Valente Thiago Maciel , de Paiva Roda Vinicius Moraes , Duarte Sanchez Jeniffer Johana 
Published: March 2022

ABSTRACT.
Social isolation is extremely important to minimize the effects of a pandemic. Latin American countries have similar socioeconomic characteristics and health system infrastructures. These countries face difficulties in dealing with the COVID-19 pandemic, and some of them have very high death rates. The government stringency index (GSI) of 12 Latin American countries was gathered from the Oxford COVID-19 Government Response Tracker project. The GSI is calculated by considering nine social distancing and isolation measures. Population data from the United Nations Population Fund and number-of-deaths data were collected from the dashboard of the WHO. We performed an analysis of the data collected from March through December 2020 using a mixed linear model. Peru, Brazil, Chile, Bolivia, Colombia, Argentina, and Ecuador had the highest death rates, with an increasing trend over time. Suriname, Venezuela, Uruguay, Paraguay, and Guyana had the lowest death rates, and these rates remained steady. The GSI in most countries followed the same pattern during the months analyzed. In other words, high indices at the beginning of the pandemic and lower indices in the latter months, whereas the number of deaths increased during the entire period. Almost no country kept its GSI high for a long time, especially from October to December. Time and GSI, as well as their interaction, were highly significant. As their interaction increases, the death rate decreases. In conclusion, a greater GSI at the start of the COVID-19 pandemic was associated with a decrease in the number of deaths over time in Latin American countries.
Prevalence of Epilepsy, Human Cysticercosis, and Porcine Cysticercosis in Western Kenya
Authors: Diaz Monica M. , Sokhi Dilraj , Noh John , Ngugi Anthony K. , Minja Frank J. , Reddi Prabhakhar , Fèvre Eric M. , Meyer Ana-Claire L. 
Published: March 2022

ABSTRACT.
Cysticercosis is the leading cause of acquired epilepsy worldwide and has been shown to be highly prevalent in pig populations in western Kenya. We conducted a community-based door-to-door survey in a region of western Kenya with a high proportion of pig-keeping households. Persons with epilepsy (PWE) were determined using a screening questionnaire followed by a neurologist evaluation. Cysticercosis serum apDia antigen ELISAs and Western blot for LLGP and rT24h antigen were performed on all PWE and 2% of screen-negative patients. All PWE or people with positive apDia underwent contrast-enhanced brain computed tomography (CT). Of a sample of 810 village residents, 660 (81%) were present in the homestead, of whom 648 (98%) participated. Of these, 17 were confirmed to have lifetime epilepsy, an estimated crude prevalence of 2.6%. No humans with (N = 17) or without (N = 12) epilepsy had serological evidence of cysticercosis infection. Fourteen PWE and one individual with borderline positive apDia antigen ELISA underwent brain CT; none had radiographic findings consistent with neurocysticercosis. Nearly 30% of households kept pigs, with 69% always tethered in both wet and dry seasons. More than 8% (6/72) of pigs had palpable lingual cysts; these pigs all originated from homesteads with latrines, one-third of which were free-ranging at least some of the time. Epilepsy prevalence in our study was greater than the national prevalence, but we found no individuals with epilepsy attributable to cysticercosis. Additional studies are required to identify causes of epilepsy, human and porcine cysticercosis, the role of spatial clustering, and protective factors like host-pathogen immunity.
Analytically Sensitive Rickettsia Species Detection for Laboratory Diagnosis
Authors: Chung Ida H. , Robinson Lauren K. , Stewart-Juba Jeri J. , Dasch Gregory A. , Kato Cecilia Y. 
Published: March 2022

ABSTRACT.
Clinical and laboratory diagnosis of rickettsial diseases is challenging because of the undifferentiated symptoms (commonly fever, headache, and malaise) and low bacteremia (< 100 genomic copies [gc]/mL) during the early acute stage of illness. Early treatment with doxycycline is critical for a positive outcome, especially in Rickettsia rickettsii (Rocky Mountain spotted fever) infections where cases may be fatal within 5 to 10 days from symptom onset, emphasizing the need for more sensitive diagnostics. A real-time reverse transcriptase polymerase chain reaction (PCR) assay, RCKr, was developed and validated for Rickettsia spp. nucleic acid detection in human clinical samples. The limit of detection for RCKr was determined to be 20 gc/mL, compared with our 2013 (Kato et al.) laboratory developed test, PanR8 at 1,800 to 2,000 gc/mL. Inclusivity, exclusivity, accuracy, and precision results correlated as expected. From an evaluation of 49 banked clinical samples, RCKr detected 35 previously positive samples, as well as two specimens that were PanR8 real-time PCR negative yet clinically diagnosed as possible rickettsiosis. Ct values from RCKr clinical sample testing show a 100-fold increase relative to PanR8. Additional testing is needed to understand the clinical sensitivity of RCKr; however, this study demonstrates RCKr to have high analytical specificity and sensitivity for Rickettsia detection.
India Needs to Consider Planning a Change to Artemether–Lumefantrine to Treat Plasmodium falciparum Malaria
Authors: Rahi Manju , Chaturvedi Rini , Goswami Ritu , Sharma Amit 
Published: March 2022

ABSTRACT.
As the malaria elimination target draws closer for India, it must be ensured that the country’s policies, strategies, and tools remain effective. Artemisinin-based combination therapies are the mainstay of Plasmodium falciparum malaria management. India has a differential standard therapy for uncomplicated falciparum malaria in the form of artemether–lumefantrine in its northeastern states and artesunate + sulfadoxine–pyrimethamine in the rest of the country. The clinical failure of artesunate + sulfadoxine–pyrimethamine in the northeast regions was attributed primarily to parasite resistance resulting from mutations in the enzymes dihydropteroate synthase and dihydrofolate reductase. Artemether–lumefantrine was therefore substituted for artesunate + sulfadoxine–pyrimethamine in the region. The change has been a success, as evidenced by the therapeutic efficacy studies conducted at regular intervals in India. However, studies suggest that resistance may be emerging toward sulfadoxine–pyrimethamine in multiple parts of the nation. Hence, there is a possibility that the artesunate + sulfadoxine–pyrimethamine combination may be acting in part as a monotherapy, and this makes the longevity of the artesunate + sulfadoxine–pyrimethamine drug combination therapy uncertain. The increasing presence of drug-resistant mutants in P. falciparum dhps and dhfr genes suggests the need for a policy switch for uncomplicated P. falciparum malaria from artesunate + sulfadoxine–pyrimethamine to artemether–lumefantrine.