bluuebunny/crossref_metadata_2025_split huggingface dataset:
Primary Cutaneous Gamma-Delta T-Cell Lymphoma
Authors: Hrin Matthew L. , Newsom Megan R. , Ghamrawi Rima I. , Niehaus Angela G. , Feldman Steven R. , Sigmon Justin R. , Strowd Lindsay C. 
Published: April 2022

Abstract

Background:
Primary cutaneous gamma delta T cell lymphoma (PCGD TCL) is a rare and rapidly progressive cutaneous malignancy that can be diagnostically challenging.

Purpose:
To improve characterization of the clinical and histologic features of PCGD-TCL.

Methods:
We present two patients with PCGD TCL and review an additional 97 PCGD TCL cases from the English literature.

Results:
A 51 year old male with biopsy proven psoriasis and a previously healthy 31 year old male with vitiligo developed PCGD-TCL. Initial biopsy specimens in both patients suggested tumor stage mycosis fungoides (MF), but subsequent histopathology confirmed PCGD TCL. Ninety-seven patients were identified in the literature, mostly males (53%) with a mean age of 55.2 years. Lesions most commonly involved the lower (60%) and upper (30%) extremities and existed a mean of 26 months before diagnosis. The most common immunohistochemical markers were EBV(-), CD3(+), CD4(-), CD5(-), CD7(-), CD8(-), CD30(-), CD56(+), granzyme-B(+), perforin(+), and βF1(-). Radiation and CHOP chemotherapy were the most common interventions and 52% of patients died.

Conclusion:
PCGD TCL is a devastating disease that can clinically and histologically mimic more common dermatologic conditions, such as psoriasis and MF, and its diagnosis may require multiple biopsies and review by a multi specialty pathology team.
Probiotic Supplementation (Vibact DS) in Patients with Type 2 Diabetes Mellitus
Authors: Gupta Sunil , Kamat Tejas , Chawla Rajeev , Abhyankar Mahesh V. , Revankar Santosh , Walia Silki 
Published: April 2022

Purpose:
The aim of this study was to evaluate the effect of probiotic supplementation (Vibact DS) on anthropometric, glycemia, and lipid parameters in Indian patients with type 2 diabetes mellitus (T2DM).

Materials and Methods:
In this multicentric, retrospective, observational study, adult patients with T2DM who had received Vibact DS probiotic supplement for 3 months were identified from the patient medical records at each center. We assessed the effect of probiotic use on weight, body mass index (BMI), glycemic parameters, lipid profile, and impact on gastrointestinal (GI) side effects.

Results:
From 50 centers across India, data of 308 patients were analyzed retrospectively. In this sample, the mean age was 54.15 years, 60.69% were males, and the mean weight was 70.97 ± 10.38 kg. After 3 months of Vibact DS, there was a significant reduction in body weight, BMI, fasting plasma glucose (FPG), and postprandial plasma glucose (PPG) (P < 0.0001 for each parameter). Mean reduction in HbA1c was statistically significant (mean change at 3 months: -0.8%; P < 0.0001). There were significant improvements in lipid parameters (P < 0.0001) excepting high-density lipoprotein. Control of GI side effects was reported in 12.66% of patients. Physicians rated excellent and very good clinical efficacy in 25.9% and 40.6% of patients, whereas excellent and very good tolerability was reported in 28.2% and 42.1% of patients, respectively.

Conclusion:
This real-world evidence from India shows that regular use of probiotics such as Vibact DS may significantly improve the glycemic and metabolic profile and aids in relieving GI problems in patients with T2DM.
Identification of Dietary Patterns Associated with Poor Glycemic Control among Free Living Adults with Type 2 Diabetes in Chennai (CURES-162)
Authors: Priya Nagarajan Lakshmi , Rajagopal Gayathri , Bhupathiraju Shilpa , Kavitha Vasudevan , Rajeswari Veeramarthandan , Kamala Krishnaswamy , Anjana Ranjit Mohan , Unnikrishnan Ranjit , Mohan Viswanathan , Vasudevan Sudha 
Published: April 2022

Aim:
Diabetes is a chronic progressive disease. A healthy eating pattern is essential to achieve good glycemic control (HbA1c 7%) which aids in delaying and preventing diabetes-related complications. The pivotal role of diet, a modifiable risk factor for type 2 diabetes has not been understood completely especially in India where carbohydrate consumption is high. This study, therefore, aims to identify major dietary patterns associated with uncontrolled diabetes by using data reduction methods.

Objective:
To study and compare the association of dietary patterns with elevated HbA1c among known diabetic adults using three data reduction methods (principal component analysis (PCA), reduced rank regression (RRR), and partial least-squares (PLS) regression).

Materials and Methods:
The Chennai Urban Rural Epidemiological followed up study (CURES) was completed in 2410 adults. Adults with diabetes (both genders, aged >20years), 573 were selected for the present analysis. Dietary intake was assessed using food frequency questionnaire.

Results:
The PCA derived the non-vegetarian and vegetarian pattern. Both showed positive association with the risk of high HbA1c. The first pattern of RRR and PLS showed a positive association with many foods especially those contributing to increased intakes of total calories. Whereas the 2nd pattern of RRR and PLS scores both showed an inverse association with HbA1c especially with the reduction in rice-based recipes and total calories.

Conclusions:
The low intake of certain foods, especially white rice, directly decreased the total calories, total carbohydrate, glycemic load, and glycemic index which has a beneficial effect on glycemic control among those with diabetes.
Prevalence and Impact of Stress Among Individuals with Type 2 Diabetes Attending a Tertiary Diabetes Center in South India
Authors: Vidyulatha Jayaram , Pramodkumar Thyparambil Aravindakshan , Pradeepa Rajendra , Deepa Mohan , Poongothai Subramani , Venkatesan Ulagamathesan , Aarthi Garudam Raveendiran , Thenmozhi Somasundaram , Anjana Ranjit Mohan , Mohan Viswanathan 
Published: April 2022

Aims and Objectives:
Diabetes is a chronic health condition proving to be a major health challenge globally. Being a lifestyle-related disorder, psychosocial and behavioral factors are critical for its management, among which stress plays a contributory role. Diabetes is associated with increased risk of depression, anxiety, and stress due to its debilitating nature and complications. Stress not only affects glycemic control through biological pathways but also leads to unhealthy behavior such as binge eating, smoking, and alcohol. This study attempts to fill the lacuna between clinical and psychosocial aspects of stress and thereby determines the prevalence and impact of stress among type 2 diabetes individuals in a clinic population.

Materials and Methods:
This is a cross-sectional, case–control study that includes individuals with type 2 diabetes mellitus (T2DM) as well as those with normal glucose tolerance. Assessment of stress was done using a validated tool, the Depression Anxiety Stress Scale-21 (stress component). Sociodemographic characteristics, anthropometry, blood pressure, and biochemical parameters were collected in all the participants. Data were analyzed using Statistical Package for Social Sciences statistical software.

Results:
The prevalence of stress was significantly higher in T2DM compared to normal glucose tolerance (NGT; 43% vs 13%, P < .001). Both among T2DM and NGT, stress levels were higher in younger individuals with higher education, higher income levels, and professionals. Stress scores decreased with age at diagnosis of T2DM (16.6 [≤25 years] vs 15.6 [≥26–40 years] vs 12.7 [≥41 years], P < .001). T2DM was significantly associated with stress after adjusting for confounding factors.

Conclusion:
Individuals with T2DM had significantly higher prevalence of stress. Regular screening of stress could lead to better glycemic control.
Antidiabetic Effect and Preference of Fenugreek with Dietary Modifications in Patients with Prediabetes
Authors: Addepalli Syama K. , Nigam Nilam , Kumar Shrawan 
Published: April 2022

Objective:
The prevalence of diabetes mellitus in India is increasing day by day. This study was conducted to assess the impact of fenugreek with controlled diet in prediabetic patients of with fasting blood glucose (FBG) and glycosylated hemoglobin (HbA1c).

Study Design:
Interventional parallel randomized control trial.

Materials and Methods:
A total of 280 prediabetics were included in the study. Patients were randomized and one group of patients received 10 g of fenugreek powder in hot water every day, whereas the second group did not receive it. Strict dietary controls were followed as per the guidelines of American Diabetic Association (ADA) protocols. The parameters were assessed on the first visit and every 3 months for 24 months.

Results:
Dietary addition of fenugreek leads to a reduction in blood glucose levels. Statistical analysis shows that there was a significant reduction in FBGlevels in the 24 months in the study group (P < 0.001), whereas a significant reduction in HbA1c in the 24th month (P = 0.001). Half of the study participants (52.9%, 59.2%, and 57.1% at 6, 12, and 24 months, respectively) reported acceptable compliance about fenugreek treatment.

Conclusion:
Dietary addition of fenugreek can have a synergistic effect along with diet control on FBG and HbA1c.
Diet and Insulin Dose as Mediators of Insulin-Associated Weight Gain Among People in Pakistan with Type 2 Diabetes
Authors: Rubina Hakeem , Basit Abdul , Fawwad Asher , Abdeali Mariam 
Published: April 2022

Objective:
This paper aims to explore the role of diet in determining insulin-associated weight gain (IAWG) in Pakistani people.

Materials and Methods:
This observational study was conducted in the Diet and Education Department of Baqai Institute of Diabetology and Endocrinology. The data are obtained from Electronic Health Records from the Health Management System, and it included demographical, anthropometric, clinical, biochemical, and dietary information of the subjects. A total of 917 cases were included in this study, on the basis of inclusion criteria, which were subjects to be of age 18 years and above, diagnosis of type 2 diabetes, and availability of clinical, medical, and dietary data for at least two visits, for subsequent years. Dietary data include energy and macronutrient intake, which is calculated by the system on the basis of food intake data collected and entered by registered dietitians at each visit. Ethical approval for the study was taken from BIDE Institutional Review Board.

Results:
Differences in the rate of weight gain between insulin-treated and oral antihyperglycemic agents-only-treated groups could not be attributed to differences in dietary changes. Higher intake of insulin in relation to carbohydrate intake was found to be associated with higher weight gain among insulin-treated groups. The rate of weight gain with HbA1c (glycated hemoglobin) increase was lowest among those who had a “decreased” energy intake, with moderate insulin doses, whereas it was highest among those who had high insulin doses with “increased” energy intake.

Conclusion:
Weight gain was observed following deviation in the macronutrient composition among the insulin users in this study. Dietary intake in relation to body needs for healthy weight and economical doses of insulin appears to have a good potential for inducing normoglycemia without promoting IAWG.
Putting Knowledge into Practice
Authors: Suri Monika , Kapur Deeksha 
Published: April 2022

Background:
Diabetes mellitus is a chronic condition that remains a matter of concern for the medical fraternity because of its alarming pace of growth worldwide. Its progression is higher in India and other Asian countries as compared with the other countries in the world. Its continuance can only be halted by better management of it. Assessment of knowledge, attitude, and practices (KAP) is essentially the significant and fundamental necessity for secondary prevention of disease progression. The effective planning and implementation of the strategy need the evaluation of knowledge, attitude, and if any gap in the transcription of it into practice.

Aim and Objectives:
The given study was carried out with the purpose to evaluate the KAP among patients with diabetes from the urban locale of city Gurugram, North India.

Materials and Methods:
A cross-sectional, observational study was performed on 138 patients with no subjection to any formal education program on type 2 diabetes management. Patients were recruited from the out-patient department of tertiary care hospitals and random purposive sampling were used to put together data by administering a structured survey form executed through personal interview technique. Data related to demographics, span of the disease, hypertension, fasting and post-prandial blood glucose levels, anthropometry, and KAP of type 2 diabetes mellitus patients were recorded.

Results:
The study population confirmed a fair amount of knowledge about type 2 diabetes and its related aspects. Despite a positive attitude and adequate knowledge about the disease and its related aspects, the population scores with regard to practices were not inspiring.

Conclusion:
In the face of a positive attitude, the average application of adequate knowledge is clearly evident in the millennium city's subject population. This highlights the need for effective diabetes management programs for educating the populace.
Comparison of Efficacy of Detemir and Degludec Insulin in the Management of Children and Adolescents with Type 1 Diabetes
Authors: Zabeen Bedowra , Ahmed Bulbul , Islam Nasreen , Tayyeb Samin , Nahar Jebun , Azad Kishwar 
Published: April 2022

Aims and Objectives:
Despite the advantages offered by current basal analogs, the management of type 1 diabetes (T1D) in children and adolescents is a great challenge till now. Insulin degludec (IDeg) is alternative basal insulin to be used in persons not responding to other basal insulins. The aim of the study was to compare the efficacy of IDeg (once daily) and insulin detemir (IDet) in children and adolescents with T1D in Bangladesh.

Materials and Methods:
In this retrospective analysis, we included T1D patients who were treated with IDet or IDeg in CDiC Diabetes Center, BIRDEM Hospital from January to June 2018. Thirty patients with IDeg were compared with 30 patients who were taking IDet; patients were randomly selected from the data set. Insulin dose requirement, weight, body mass index, fasting plasma glucose (FPG), and HbA1c were compared at the base level and at three and six months after treatment.

Results:
While comparing between two groups, the median FPG was high, 15.0 (13.6–18.3) vs. 14.4 (10.5–16.9), in both groups at the base level. Over the six months, FPG was gradually reduced in both groups but significantly reduced in IDeg patients (P = 0.03), although median HbA1c was higher, 9.9 (8.4–12.0), in IDeg patients than in IDet patients, 9.3 (8.1–10.4), at the base level but reduced significantly in IDeg patients, 8.4 (7.6–9.0), compared with IDet patients, 9.0 (8.1–9.7), after six months (P = 0.042). Though mild hypoglycemia was documented, there was no incidence of severe hypoglycemia in IDet or IDeg groups.

Conclusion:
In conclusion, in our study population, the IDeg group had more improvement in glycemic control, reducing FPG, than the IDet group. Moreover, there was more reduction of basal insulin dose in IDeg than in IDet after six months of starting the therapy.
Remission of Tuberculosis Following Control of Glycemic Excursions in a Patient with Type 2 Diabetes Mellitus
Authors: Hinduja Anand 
Published: April 2022

Rationale:
Tuberculosis (TB) and diabetes mellitus (DM) are converging epidemics, each worsening the morbidity of the other. Chronic hyperglycemia is associated with dysfunctional immunity to Mycobacterium in patients with DM and, therefore, is likely to decrease the efficiency of anti-mycobacterial treatment. Early aggressive management of TB and timely initiation of insulin therapy helps in controlling the glycemic excursions that are otherwise not controlled by multiple oral antidiabetic agents.

Patient Concerns:
A 42-year-old female with type 2 diabetes for six years presented with complaints of persistent cough, pain in the chest, weight loss, and loss of appetite for two months in November 2018.

Diagnosis:
The patient was diagnosed with multidrug-resistant TB (MDR-TB), which further progressed to extensively drug-resistant TB (XDR-TB) in February 2019. Her hemoglobin A1c (HbA1c), which was 8.3% prior to TB diagnosis, increased to 13.8%.

Interventions:
The patient was initiated on anti-TB medications as per the Revised National TB Control Programme (RNTCP) guidelines. The antidiabetic regimen consisted of glimepiride 2 mg b.i.d, metformin 500 mg b.i.d, and voglibose 0.2 mg b.i.d. On confirmation of XDR-TB and persistently high HbA1c, insulin glargine was initiated in July 2019. Due to continued uncontrolled blood glucose levels, insulin IDegAsp (30% Aspart and 70% Degludec) was initiated in February 2020.

Results:
After the initiation of IdegAsp, HbA1c levels reduced significantly and there was improvement in the measures of daily blood glucose level indices such as time in target range (TIR), time below target range (TBR), and time above target range (TAR). Optimal blood glucose was achieved in a significant amount of time in a day. Sputum was negative for XDR-TB in February 2021, and the patient recovered from TB. Her HbA1c was reported to be 7.5% in February 2021.

Conclusion:
In patients with type 2 diabetes and TB, maintaining optimal blood glucose level for a longer duration of time can have a positive impact on host immunity and also enhance the effect of ATT and better outcomes of TB infection. This case study highlights the importance of good glycemic control in patients with type 2 diabetes who acquire TB infection.
Impact of Diabetes Mellitus on Treatment Outcome of Newly Diagnosed Smear-Positive Pulmonary Tuberculosis Patients: A Case–Control Study
Authors: Rout Pragyan , Jagaty Suman Kumar , Behera Debasis , Subhankar Saswat , Mohapatra Sangram Keshari , Panda Gitanjali 
Published: April 2022

ABSTRACT

Background:
Tuberculosis (TB) and diabetes mellitus (DM) are major public health problems in developing countries such as India. The link of DM and TB is more prominent in these countries where TB is endemic, and the burden of DM is increasing. Studies regarding the effect of DM on smear conversion and treatment outcome of pulmonary TB (PTB) in India are limited.

Aims:
The study aimed to compare the conversion and treatment success among new smear-positive PTB patients with and without DM.

Materials and Methods:
A case–control study was conducted in the department of pulmonary medicine of a tertiary care hospital in eastern India between October 2019 and September 2020. All newly diagnosed smear-positive drug-sensitive PTB patients visiting the outdoor or being admitted were identified, and their initial smear status, history of diabetes, and glycemic status were recorded. All the patients were treated with category I regimen of the Revised National TB Control Program. Sputum smear was followed up at the end of intensive phase and at the end of treatment and compared between diabetic and nondiabetic patients. The software SPSS version 16 was used to analyze all the data.

Results:
Sixty newly diagnosed smear-positive PTB patients with DM and sixty smear-positive PTB without DM were included in this study. Smear conversion was seen in 24 (40%) out of 60 diabetic TB patients and 55 (91.7%) out of 60 nondiabetic TB patients. Treatment success was seen in 40 (66.7%) out of 60 diabetic TB patients and 56 (93.3%) out of the 60 nondiabetic TB patients.

Conclusion:
Smear conversion and treatment success rate are lower in diabetic TB patients as compared to nondiabetic TB patients.
Impact of educational interventions on utilization patterns of anticancer agents in patients with breast cancer at the specialty oncology care setting in South India
Authors: Sharma Aakanksha , Patel Himanshu , Parthasarathi Gurumurthy 
Published: April 2022

Aims/Objectives:
This study was conducted to assess the utilization patterns of anticancer agents in patients with breast cancer and to provide practice recommendations/educational interventions to optimize medication use in patients with breast cancer.

Materials and Methods:
This was an ambispective study conducted for a period of 3 years at a private, specialty oncology care hospital in South India. In the initial phase, the selection of anticancer agents, dosage of anticancer agents, and management of chemotherapy-induced nausea and vomiting (CINV) were reviewed retrospectively (using paper medical records) with respect to the National Cancer Comprehensive Network guidelines. The administration of anticancer agents and anti-emetics were reviewed with respect to the hospital drug administration policies. The deviations from the standards were reported, and practice recommendations/educational interventions were developed. Treatment patterns were reevaluated prospectively after providing educational interventions. Descriptive statistics were used to report and compare the results from both phases.

Results:
During retrospective phase, we observed 80% compliance in the selection of anticancer drugs, 74% compliance in drug dosing, and 63.5% compliance in the administration of anti-cancer agents. After the implementation of educational interventions, we observed 85% compliance in the selection of anticancer agents, 82.3% in their dosing, and 86.9% compliance in the administration of anticancer agents. For the management of CINV, we observed 75% compliance in the selection of drugs (vs. 53% during preintervention), 92% compliance in their dosing (vs. 90% during preintervention), 85.1% compliance in the administration of anti-emetics (vs. 50% during preintervention), and 80% compliance in the management of delayed CINV (vs. 60% during preintervention).

Conclusions:
Treatment patterns of breast cancer were improved with respect to treatment standards after educational interventions to oncology care team.