bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Study of Fetal Umbilical Artery and Middle Cerebral Artery Doppler Velocimetry Before and after Treatment of Severe Maternal Iron Deficiency Anaemia
Authors: Rafiq Suhail , Posh Sheema , Wani Saima , Tang Shahnaz 
Published: October 2022

Background:
Despite maternal iron deficiency anemia being a worldwide medical complication, very few studies have been performed to evaluate the efficacy of iron supplementations for treating and preventing adverse pregnancy sequelae. This study attempts to show the impact of maternal iron deficiency anemia on the mother and the fetus and whether treatment can reverse the physiological and pathological effects of anemia on the mother as well as the fetus.

Objective:
To evaluate the effect of vascular adaptation and extent of compensatory changes in the fetus with the change in maternal hemoglobin (Hb) levels and to study maternal and perinatal outcomes after treatment of maternal iron deficiency anemia.

Methodology:
The present study was an observational prospective study conducted on 50 pregnant women in GMC, Srinagar from January 2016 to June 2017. The study population was divided into two groups-Group A-Patients with moderate anemia – Hb 7–9 g/dl and Group B-Patients with severe anemia – Hb <7 g/dl. Group A received parenteral iron preparation and Group B received blood transfusion or packed red blood cells until Hb exceeded 7 g/dL, then parenteral iron was used. Maternal Hb and color Doppler were performed before and after treatment of anemia.

Results:
There was a decrease in the umbilical artery resistivity index (RI) after treatment of maternal anemia in both the groups and the decrease was more in those who received blood transfusion. There was an improvement in middle cerebral artery RI in both the groups after treatment and the increase was statistically significant. The C/U ratio was normalized to >1.1 in both the study groups after treatment of anemia.

Conclusion:
Our data support the fact that maternal Hb content of <7 g/dl is strongly associated with marked fetal hemodynamic adaptation and must be treated with acute red cell transfusion. Moderate anemia (>7 g/dl) is not sufficient to trigger fetal blood flow redistribution and can be treated with parenteral iron. Close monitoring of the fetal umbilical and cerebral circulation by Doppler examination in anemic pregnancies allows the measurement of the amplitude of fetal vascular response, early assessment of fetal damage and helps in improving fetal outcome as well.
To Compare Creatinine Estimation by Jaffe and Enzymatic Method
Authors: Augustin Sahaya Merina , Deshpande Ravi Prakash , Shanthaveeranna Girish Konasagara 
Published: October 2022

Introduction:
Creatinine in urine and serum are used in the assessment of renal function. It is commonly estimated by Jaffe's and enzymatic method. In many institutions, serum creatinine is estimated by (POCT) Point of care testing device (Enzymatic method) and follow-up of the patients with creatinine results by other methods, analyzed in the Biochemistry laboratory. If the results of POCT do not correlate with the Jaffe method, it leads to differences in serum creatinine values and wrong treatment decisions during the follow-up of the patients. Hence, this study was done to know the difference between the two methods in a tertiary care hospital.

Aim and Objective:
To estimate creatinine by Jaffe's and enzymatic method and to compare the serum creatinine values between the two methods.

Materials and Methods:
It is an observational cross-sectional study, for a period of 17 months from November 2018 to March 2020. Seventy-five samples were analyzed for serum creatinine by Jaffe's method in the Biochemistry laboratory and by enzymatic method in the emergency department in POCT device.

Results:
Mean differences between Jaffe's and enzymatic method were −0.063 mg/dL, 0.070 mg/dL, 0.198 mg/dL, and 0.0685 in Group I, II, III, and all the groups together. The overall intraclass correlation coefficient including all the three groups (0.995) indicates a very good correlation between the two methods.

Conclusion:
Our study showed a good agreement and good correlation between the two methods, which is similar to other studies analyzed on same instrument.
A study on child sexual abuse reported by urban indian college students
Authors: Chacko Arman Z. , Paul Jackwin S. G. , Vishwanath Ranjith , Sreevathsan S. , Bennet Divya , Livingstone Pranuth D. , John Jacob 
Published: October 2022

Abstract

Background and Objectives:
The prevalence of child sexual abuse (CSA) in India is 18–50% depending on the population studied. To devise strategies for prevention of CSA at the primary care level, we studied the prevalence of CSA amongst college students aged 17–25 years.

Methods:
A group of medical students and their friends were sent, an anonymous questionnaire validated by experts via WhatsApp. The questionnaire assessed demography, occurrence of prior CSA and details of the sexual abuse.

Results:
About 574 students participated in the study. The majority of respondents were female (380, 66.2%). About 467 (81.2%) of participants were from South India. Of the 380 women and 194 men who consented to participate in the study, 218 (57.3%) and 65 (33.5%), respectively, said that they had been sexually abused in the past (p < 0.00001). The event commonly occurred at 12–14 years (22.6%), but about 53% of victims were <12 years of age. The perpetrator was usually male (93.2%), less than 30 years of age (54%) and a stranger (42.7%). The most common form of CSA from 348 instances in 283 respondents was some form of “bad touch or caresses” (56.6%). About 25.8% of those abused did not speak to anyone about the event. Only 249 respondents (43%) were counselled regarding CSA by their parents.

Conclusions:
The prevalence of CSA amongst South Indian college students is 49.3%. The victims were mainly girls <12 years of age and the perpetrators were mainly male (93.2%). Primary Care Physicians can play a greater role in the early detection and prevention of CSA.
Oral capillary hemangioma in a ten year old female child with hepatitis B treated with monopolar electrocautery
Authors: Kumar Vinod , Nanda Anisha , Kalele Ketki , Amrutha Rudraraju , Kuniyil Shakir Mekkalayil , Babu Aleena 
Published: October 2022

Abstract
Capillary hemangioma is a benign, vascular tumor characterized by proliferation of blood vessels that are primarily reported to be a developmental hamartomatous lesion of infancy and childhood. Till date, many cases of capillary hemangiomas have been reported in the literature, but juvenile hemangiomas with other systemic manifestations such as hepatitis B have not been studied well so far. The present paper reports a rare case of capillary hemangioma in a ten-year-old female with hepatitis B, which was treated under general anesthesia using electrocautery and followed up for one year and no recurrence was found.
Assessment of cardiovascular risk using WHO CVD risk prediction chart with respect to hypertension status among Indian population: A secondary analysis of National Family Health Survey (2015–16)
Authors: Jaiswal Abhishek , Selva Das P. Ananda , Singh Garima , Sathiyamoorthy Ramadass , Deori Trideep Jyoti , Dwarakanathan Vignesh , Malhotra Sumit , Verma Madhur , Goel Sonu 
Published: October 2022

Abstract

Background:
Hypertension, is a crucial risk factor for the development of cardiovascular disease (CVD). Studies assessing the risk of developing CVD among high-risk groups like hypertensives is limited.

Aim:
The purpose of this study was to find the distribution of CVD risk with respect to hypertension status among Indian adults.

Material and Methods:
This was a secondary data analysis of NFHS-4 survey data. The distribution of CVD risk among hypertensive participants using 2019 WHO CVD risk prediction charts was compared with normotensive participants among women aged 40–49 years and men in the age group of 40–54 years.

Results:
The proportion of hypertension was higher among women who consumed alcohol (31.5%) than those who did not (24.3%). The proportion of hypertensives increased with increasing BMI, with maximum proportion among obese women (37.3%). Among women, majority (95.7%) had low CVD risk (<5%) while 4.2% had 5% to <10% CVD risk, and only 0.1% had >10% risk. Among men, those with low CVD risk (<5%) was 65%, those with 5% to <10% CVD risk was 32.3%, 10% to <20% was 2.7%, and a meagre 0.03% had 20 to <30% risk.

Conclusion:
In the current study, prevalence of hypertension was seen to be increasing with age and was higher in urban residents than rural among both men and women. Both high blood pressure reading during the survey and self-reported hypertension was found to be higher among richest wealth index category. Although risk was higher among hypertensives, self-reported hypertensives who had their blood pressure controlled, had risk similar to normotensives indicating the importance of management of hypertension.
Establishing nomogram of blood pressure for late adolescents in India: Secondary analysis of NFHS-4 data
Authors: Jaiswal Abhishek , Dwarakanathan Vignesh , Selva Das P. Ananda , Singh Garima , Sathiyamoorthy Ramadass , Deori Trideep Jyoti , Malhotra Sumit , Jaswal Nidhi , Goel Sonu 
Published: October 2022

Abstract

Background:
Hypertension among adolescents is a public health problem, which is going to become more severe given the current obesity epidemic. There is a scarcity of information on the reference range value for blood pressure (BP) cut-off for adolescents.

Aim:
We aimed to establish BP distribution in adolescents aged 15–19 years by using the nationally representative National Family Health Survey-4 (NFHS-4) data.

Materials and Methods:
We analyzed the data of 15,936 boys and 1,04,132 girls aged 15–19 years in the NFHS-4 survey. We took the mean of systolic and diastolic BPs. Height for age z scores for each individual was calculated using the WHO Anthro plus. The sampling weight was taken as provided by the demographic and health surveys (DHS) website. Nomograms of systolic and diastolic BPs were made by calculating their 50th, 90th, and 95th percentiles for each age (in months), gender, and height percentile for age categories.

Results:
Both systolic and diastolic BPs increased with age and height centiles. The BP was higher in boys than girls. The average annual increase in systolic and diastolic BPs was 2.52 and 1.20 mmHg in boys and 0.50 and 0.46 mmHg in girls, respectively, when adjusted for height centiles.

Conclusion:
This study provides a BP nomogram that can be generalized to all the Indian population. Research is required for the diagnostic performance of this nomogram for the diagnosis of adolescent hypertension.
Utility of modified Mann assessment of swallowing ability (MMASA) in predicting aspiration risk and safe swallow in stroke patients
Authors: Panjikaran Nittu Devassy , Iyer Rajalakshmi , Sudevan Remya , Bhaskaran Renjitha 
Published: October 2022

Abstract

Introduction:
Aspiration pneumonia is one of the commonest causes of post-stroke mortality. We may be able to reduce this morbidity and mortality by assessing the risk of aspiration in stroke patients. Assessment of this risk can be done using a physician-administered screening protocol to assess dysphagia. A score of ≥95 is a good cut off to detect patients who can take oral feeds safely.

Objectives:
The primary objective was to predict aspiration risk using the Modified Mann Assessment Swallowing Ability (mMASA) scale. The secondary objective was to predict the safety of oral feeds using the same scale.

Materials and Methods:
An analytical cross-sectional study was conducted at a tertiary care rehabilitation centre in South India. A total of 100 stroke patients who underwent stroke rehabilitation in the study institution were divided into patients who were able to eat orally or not based on the mMASA scale. Demographic and stroke characteristics were recorded. The mMASA score was calculated and those with a score of ≥95 were given oral feeds. Those who scored <95 were given swallow therapy and re-evaluated in 2 weeks. Also, the mMASA score below which the patient was likely to develop aspiration pneumonia was detected using the receiver operating characteristic curve (ROC).

Results:
Out of the 100 patients, 37 patients had a score of ≥95 and were started on oral feeds and had no complications; the rest were started on 2 weeks of swallow therapy. On re-evaluation after swallow therapy, 12 more were started on oral feeds. The remaining 51 patients did not reach the cut-off score of ≥95 and were continued on nasogastric tube feeding. A total of 11 patients developed features of aspiration pneumonia; all of them belonged to the group of 51 patients who consistently had a mMASA score <95. The ROC curve determined that a score of <89 was a good cut off to predict patients who are at high risk of aspiration.

Conclusion:
The scale can be used to predict the likelihood of aspiration and readiness to start oral feeds in sub-acute stroke patients.
Tobacco use and uncontrolled hypertension among Indian men: Insights from the National Family Health Survey (NFHS-4), 2015-2016
Authors: Singh Harshvardhan , Sharma Shailja , Kathiresan Jeyashree , Bhatt Garima , Goel Sonu 
Published: October 2022

Abstract

Background:
Tobacco use is a modifiable risk factor for developing cardiovascular diseases, of which hypertension is a major killer. Uncontrolled hypertension (UHT) is a major public health concern that exerts a financial and service burden on the health system.

Aim:
The current analysis aimed to determine the association between tobacco use and UHT among Indian males.

Material and Methods:
Data from the 4th National Family Health Survey (NFHS) of 1,04,120 men aged 15–54 years were used. We estimated the adjusted prevalence ratio for having UHT among reported tobacco users and non-users.

Results:
The prevalence of UHT was the lowest (41.02%) among those who did not consume tobacco in any form. Among tobacco users, those smoking tobacco had the highest prevalence (53.53%) of UHT followed by those using both smoked and smokeless forms of tobacco (43.84%) and those using only smokeless forms of tobacco (42.26%). Factors significantly associated with UHT were alcohol consumption (aPR: 1.30; 95% CI: 1.19–1.43), belonging to the richer wealth quintile (richest quintile- aPR: 1.27; 95% CI: 1.05–1.38), being overweight (aPR: 3.14, 95% CI: 2.35–4.21), and being obese (aPR: 2.89, 95% CI: 2.12–.94). Higher educational status was significantly protective against UHT (aPR: 0.75; 95% CI: 0.63–0.88).

Conclusions:
Tobacco use is significantly associated with hypertension in Indian men. Addressing tobacco control and prevention of UHT remain the cornerstones for achieving the SDG target 3.4 by 2030, which aims to reduce premature mortality from NCDs by a third by 2030 relative to 2015 levels.
Prevalence and determinants of isolated systolic and isolated diastolic hypertension in India: Insights from the national family health survey (NFHS)- 4
Authors: Gupta Puneet , Sarkar Prattay G. , Verma Vivek , Kumar Amit , Arora Sameer , Kotwal Atul , Raj Sonika , Goel Sonu , Malhotra Sumit 
Published: October 2022

Abstract

Background:
Isolated Systolic Hypertension (ISH) and Isolated Diastolic Hypertension (IDH) are often the ignored forms of hypertension and are determinants of future cardiac and neurological events and contribute to mortality. However, the nationally representative estimates of both these forms of hypertension remain unknown from India.

Aim:
To estimate the ISH and IDH from a nationally representative survey of India.

Material and Methods:
The present study used data from 7,23,181 people (15–54 years), recorded during the fourth round (2015–2016) of the National Family Health Survey (NFHS), India. The prevalence of ISH and IDH was calculated for state comparison, while multilevel logistic regression analysis was done to assess the correlates of both types of hypertension.

Results:
The prevalence of ISH and IDH was found to be 1.2% (95% CI 1.0–1.4) and 5.7% (95% CI 5.2–6.2), respectively. The prevalence of both ISH and IDH increased with age, with a more significant increase in systolic pressure towards the higher age. Northeastern states of India (Assam, Meghalaya, and Arunachal Pradesh) had the highest prevalence of both forms of hypertension. On multilevel logistic regression, male gender, increasing age groups (highest odds ratio (OR) being in 45–49 year age group), alcohol, and diabetes positively predicted both ISH and IDH. Urban residence, literacy, and tobacco were positive predictors of IDH, whereas urban residence, smoking, and literacy negatively predicted ISH.

Conclusion:
ISH and IDH have a significant presence among the population of India. This data provides insights to formulate strategies at the primary and primordial prevention levels.
Therapeutic response to ramucirumab + folfiri in patients with metastatic gastric cancer
Authors: Rezvani Hamid , Haghighi Shirin , Ghobakhlou Mehdi , Ataei Elnaz 
Published: October 2022

Abstract

Background:
Gastric tumors are important gastrointestinal malignancies, and the prediction of therapeutic responses and related factors are important to improve the prognosis. Hence the aim of this study was to determine the therapeutic response to ramucirumab + folfiri in patients with metastatic gastric cancer.

Methods and Materials:
In this prospective cohort, 13 consecutive patients with metastatic gastric cancer attending Taleghani Hospital that underwent ramucirumab + folfiri therapy were enrolled, and the therapeutic response among them was determined.

Results:
The results in this study demonstrated that initial therapeutic response was 92.3% and the Progression-free Survival (PFS) was 16.2 months (84.6%) (CI95%:13.2-19.3). The nine-month PFS was 69.2%. Total survival was 16.7 months (CI95%:13.5-19.9).

Conclusion:
Ultimately, according to the obtained results, it may be concluded that the therapeutic response to ramucirumab + folfiri in a patient with metastatic gastric cancer is good, and the use of this regimen is recommended.
Prophylactic treatment abandonment in people bitten by suspected rabid animals, El Salvador, 2013-2017
Authors: Chavarría Larisa , Quinteros Edgar , Sánchez Mario , Domínguez Rhina 
Published: October 2022

Abstract

Introduction:
Around the world 60,000 people die from rabies each year. The main form of exposure to rabies is by the bite of animals infected with the virus. More than 20,000 cases of rabies-transmitting animal bites are reported each year, in El Salvador, a country located in Central America. People exposed should be managed with rabies prophylaxis.

Objective:
To determine the abandonment of post-exposure prophylaxis (PEP) cumulative incidence (CI) in humans bitten by suspected rabid animals in El Salvador from 2013 to 2017.

Methodology:
This is an ecological study based on the cases of bites by suspected rabid animals reported between 2013 and 2017 in the public health system of El Salvador. Descriptive and correlation analysis was performed using Statistical Package for the Social Sciences (SPSS) version 24. The municipality CI, expressed per 100,000 inhabitants.

Results:
The national CI of abandonment PEP in humans bitten by suspected rabid animals was 25.6 × 100,000 inhabitants. Simple bivariate correlation analysis shows that the departments with the highest CI of bites caused by cats, wild animals, and bites on the neck (R
2 = 0.99 P < 0.05) are mostly associated with dropping out of the PEP.

Conclusion:
In El Salvador, the abandonment CI of PEP is lower than other countries, however, bites by rabid suspected animal are frequent, this represents a public health problem due to the presence of the rabies virus in wild animals and the high lethality of the disease. Municipalities where head bites are common are the most related to the abandonment of PEP.
Hypertension as a silent epidemic among late adolescent girls, its associated demographic factors, and pregnancy outcome: A report from national family health survey (NFHS) IV data
Authors: Chandrashekarappa Smitha , Malhotra Sumit , Nagendraswamy Chandan , Gopi Arun , Murthy MR Narayana , Upadhyay Kritika , Goel Sonu 
Published: October 2022

Abstract

Background:
Hypertension is predominantly considered to be a disease frequently occurring after the fifth decade of life, its occurrence among adolescents has not received much public health attention. Pathophysiological and epidemiological evidence suggests that essential hypertension initiate in childhood and often goes unnoticed unless explicitly observed for this age group.

Aim:
The current study estimates the prevalence of hypertension, its predictors, and pregnancy outcome among late adolescent girls (15–19 years).

Material and Methods:
The study used secondary data from the NFHS 4 from January 2015 to December 2016. The sample of 1,24,878 adolescent girls out of 6,99,686, national women’s data was obtained through a stratified two-stage sample using a population proportionate to size sampling methodology. Descriptive statistical tests and inferential statistics were performed to find the relation of hypertension with the independent variables and Chi-square analysis to study association of hypertension during pregnancy and its adverse pregnancy outcomes.

Results:
The prevalence of hypertension among the late adolescents was 16.4% [CI: 16.2-16.6] (n=20,532). On multivariable logistic regression (after adjusting for all the variables) only age [AOR: 1.09 (1.08-1.11)]; education [AOR: 1.09 (1.006 – 1.2)], and wealth index [AOR: 1.17 (1.11 – 1.24)] retained the significance with hypertension. A significant association was seen between hypertension status of the adolescents and adverse pregnancy outcomes (c2 = 4.550, P = 0.033).

Conclusion:
Nearly 1/6th of late adolescents found to be hypertensive, significantly contribution to disease burden. Also, a significant association is seen between hypertension status of adolescents and adverse pregnancy outcomes. Hence, it is imperative to make the National Programme inclusive for adolescents and have a focused approach to health promotion, prevention, and management of non-communicable diseases.