bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reasons for Hospitalisation among Patients with Diabetes in a Secondary Care Hospital in South India
Authors: Rani Santhosh , Rahman Sajitha MF , Pricilla Ruby A. , David Kirubah V. 
Published: June 2022

Background:
Type 2 diabetes mellitus is a rapidly emerging non-communicable disease in India. It is associated with many life-long complications and higher rates of hospitalisations. The characteristics and reasons for hospitalisation among individuals with diabetes have not been documented in India. Such a study would direct policy makers in implementing prevention and education strategies and economic changes as needed.

Aim and Objectives:
The study aimed to study the characteristics and causes of admission of patients with diabetes admitted to a secondary care unit in South India.

Methods:
Aretrospective observation study of inpatient records of patients with diabetes aged 18 years and above admitted between January to December 2019 in a secondary care unit was done. The details of patient demographics, reason and outcome of admission were retrieved manually from paper-based patient records. Descriptive analysis was done using SPSS version 23. The study was approved by the Institutional Review Board of the institution.

Results:
Among the 479 admissions of patients with diabetes during 2019, the mean age of the admitted patients was 57.75 years. The majority of them had only one admission, 15% had re-admissions in the same time period. Approximately 78% of the admitted patients had one or more co-morbidities, 44.6% had hypertension as a co-morbidity. The principal cause of admission was infections (45%), followed by metabolic and endocrine causes (13.5%), cardiovascular disease (10.9%) and renal disease (7.96%). More than 80% of the admissions had a favourable outcome and were discharged.

Conclusion:
This retrospective study demonstrated that the most common reason for admission among patients with diabetes to a secondary care unit in South India was infection. Many infections are preventable with effective treatment for diabetes and health education. Patients bear the costs of routine treatment for diabetes which is a fraction of the direct cost of hospitalisation and can drive them to huge economic losses. Therefore, interventions to promote standard treatment by primary and secondary care health professionals and self-awareness among patients need to be done to prevent hospitalisations.
Efficacy and Safety of Low Dose Insulin Infusion against Standard Dose Insulin Infusion in Children with Diabetic Ketoacidosis- An Open Labelled Randomized Controlled Trial
Authors: Saikia Diganta , Mittal Medha , Kanakaraju Chapala , Dhingra Dhulika , Kumar Manish 
Published: June 2022

Objective:
To compare the efficacy and safety of low dose insulin infusion (0.05 U/kg/h) against the standard dose insulin infusion (0.1 U/kg/h) in children with diabetic ketoacidosis.

Method:
Children (age <12 years, n = 30) presenting with diabetic ketoacidosis were enrolled and randomised to receive insulin infusion either as 0.05 U/kg/h (low dose) or 0.1 U/kg/h (standard dose) as an open labelled randomised controlled trial. The rest of the management was identical in both groups. The time taken for resolution of acidosis (pH ≥7.3 and HCO3 ≥15) was the primary outcome variable. The secondary outcome variables included the time taken until a decline in blood glucose to 250 mg/dl, the proportion of children developing hypoglycemia and hypokalemia, and any treatment failure.

Results:
The two groups were similar with respect to mean age, weight and gender distribution. New-onset diabetes was diagnosed on 24/30. The mean ± SD time for resolution of acidosis was similar between the groups; 27.0 ± 6.1 hours in the low dose group vs 23.4 ± 7.3 hours in standard dose group, P = 0.16. The mean time for the decline in blood glucose to 250 mg/dl was 13.0 ± 5.9 hours in low dose vs 11.6 ± 6.0 hours in standard dose group, P = 0.52. A lesser proportion of participants developed hypoglycemia and hypokalemia in the low dose group, though not statistically significant. There was no incidence of treatment failure in either group.

Conclusion:
Low dose insulin infusion is equally effective and safe as standard dose insulin infusion in children with diabetic ketoacidosis.
A novel reassortant avian influenza H4N6 virus isolated from an environmental sample during a surveillance in Maharashtra, India
Authors: Pawar Shailesh D. , Keng Sachin S. , Kode Sadhana S. , Tare Deeksha S. , Singh Dinesh K. , Mullick Jayati 
Published: June 2022

Background & objectives:
Low pathogenic avian influenza (LPAI) viruses cause mild clinical illness in domestic birds. Migratory birds are a known reservoir for all subtypes of avian influenza (AI) viruses. The objective of the study was to characterize AI H4N6 virus isolated from an environmental sample during surveillance in Maharashtra, India.

Methods:
AI surveillance in wild migratory birds was conducted during the winter migratory bird season (2016-2017) in Pune, India. AI H4N6 virus was isolated from the faecal droppings of a wild migratory waterbird. Virological and molecular characterization of the isolated virus was carried out. Virus titration, haemagglutination inhibition assay, receptor specificity assay, intravenous pathogenicity index and neuraminidase inhibition assays were performed. Full genome sequencing, molecular and phylogenetic analyses were also conducted.

Results:
The virus was found to be of low pathogenicity, with avian type receptor specificity, and was susceptible to neuraminidase inhibitors. Phylogenetic and molecular analysis revealed that the present virus is a result of extensive reassortment with AI H8N4, H6N2, H4N3 and H3N6, predominantly as donor viruses among others.

Interpretation & conclusions:
This is the first report of the isolation and characterization of an LPAI H4N6 virus from an environmental sample from India. The present study showed that the H4N6 virus is a novel reassortant and divergent as compared with the reported H4N6 viruses from poultry in India, indicating independent introduction. This highlights the role of wild and migratory birds in the transmission of AI viruses and necessity of such studies at the human-animal interface.
Clinico-microbiological profile of Bacteroides fragilis with focus on molecular detection of emerging resistance
Authors: Gupta Akshita , Shenoy Padmaja A. , Kumar Ajay , Chawla Kiran 
Published: June 2022

Background & objective:

Bacteroides fragilis is a Gram-negative anaerobic opportunistic pathogen which is managed by empirical anaerobic coverage as a hospital norm. However, with rising reports of resistance among
B. fragilis
strains, antibiotic susceptibility testing for this pathogen may be the only way to understand the magnitude of the problem. This study aimed to characterize resistance patterns among clinical isolates and identify resistance genes.

Methods:
A prospective observational study was conducted which included all samples requesting anaerobic cultures within the study period. Minimum inhibitory concentration (MIC) was detected for metronidazole, clindamycin and chloramphenicol by agar dilution. E-test strips were used for imipenem and piperacillin, followed by polymerase chain reaction to detect nim and cfiA genes.

Results:
Among a total of 50 isolates, 94 per cent (47/50) were susceptible and six per cent (3/50) showed intermediate resistance to metronidazole. Susceptibility to clindamycin and piperacillin was noted in 70 and 50 per cent of strains; intermediate resistance in 14 and 2 per cent and resistance in 16 and 48 per cent, respectively. No resistance was observed for chloramphenicol and imipenem. Nim gene was found in 26 per cent (13/50) and cfiA gene was found in 52 per cent (26/50) of isolates. Isolates with high metronidazole MIC of 8-16 µg/ml were found to carry nim gene (χ
2 test, P<0.001).

Interpretation & conclusions:
Rising resistance among B. fragilis is evident and there is a significant association between nim gene and metronidazole resistance. Improving awareness among clinicians is paramount in tackling AMR among these pathogens, as empirical anaerobic coverage may not be effective in all cases.
Growth pattern of skinfold thicknesses in term symmetric & asymmetric small for gestational age infants
Authors: Kaur Harvinder , Bhalla Anil Kumar , Kumar Praveen 
Published: June 2022

Background & objectives:
A etiologically symmetric and asymmetric small for gestational age (SGA) infants are two distinct entities. In view of absence of longitudinal information on growth pattern of skinfold thicknesses (SFTs) among Indian infants, this study was conducted to assess the auxological dynamics of SFTs (sub-cutaneous fat) of symmetric and asymmetric SGA infants.

Methods:
Triceps, sub-scapular, biceps, mid-axillary and anterior thigh SFTs among full-term, 100 symmetric SGA, 100 asymmetric SGA and 100 appropriate for gestational age (AGA) infants were measured at one, three, six, nine and 12 months. Ponderal Index (PI) was used to categorize infants into symmetric SGA (PI ≥2.2 g/cm3) and asymmetric SGA (PI <2.2 g/cm3). Intra-group (symmetric vs. asymmetric), inter-group (SGA vs. AGA) and gender differences were quantified.

Results:
SFTs among symmetric, asymmetric SGA infants increased to attain peak by six months. Maximum fat deposition in SGA infants was noticed for triceps, minimum for mid-axillary SFT. Mean triceps and sub-scapular skinfolds were measured higher in symmetric SGA than in asymmetric infants. SGA infants had significantly (P≤0.05) thinner SFTs than AGA. Growth velocity for SFTs, among symmetric and asymmetric SGA, was measured maximum between one and three months, threreafter it declined and relatively, steepness of fall was maximum for mid-axillary SFT followed by sub-scapular SFT.

Interpretation & conclusions:
Thinner SFTs obtained for symmetric and asymmetric SGA as compared to AGA infants reveal their compromised adiposity and nutritional status. Comparatively, higher SFTs in symmetric than in asymmetric SGA infants appear to suggest that the former have a tendency to accumulate more fat, than the latter during infancy.
Quality of life assessment & out-of-pocket expenditure in multiple myeloma
Authors: Mathew Anisha , Farooqui Habib Hasan , Kumar Lalit 
Published: June 2022

Background & objectives:
Prognosis of patients with multiple myeloma (MM) has improved significantly in the past two decades. However, the symptoms burden is high at onset and treatment is generally prolonged with significant financial burden. This study was undertaken to assess the quality of life (QoL) and to analyse out-of-pocket expenditure (OOPE) incurred on MM patients being treated at a tertiary care cancer centre in north India.

Methods:
This observational, cross-sectional study included 116 patients (aged >18 yr) of MM (both newly diagnosed and those with recurrent disease). For QoL assessment, European Organisation for Research and Treatment of Cancer (EORTC)-validated questionnaire (EORTC QLQ C 30 version 3.0) and disease-specific QLQ MY20 were used. For assessing OOPE incurred on treatment, the National Sample Survey Organisation (NSSO) questionnaire was used.

Results:
Bone pains (68.1%), fatigue (59.7%) and dyspnoea (54.6%) were common symptoms. The mean global health status/QoL score was 59.62±19.21. International Staging System (ISS) score correlated with global health status score, and gastritis was the main adverse effect. QoL score showed negative correlation to side effects of treatment (−0.53) of MY20 domain. On multivariate analysis, ISS stage (P<0.001) and adverse effects of treatment (P=0.02) were predictive factors. The median OOPE was

JOURNAL/ijmer/04.03/02223309-202112000-00010/math_10MM1/v/2022-09-30T185922Z/r/image-tiff

7900 (IQR,

JOURNAL/ijmer/04.03/02223309-202112000-00010/math_10MM2/v/2022-09-30T185922Z/r/image-tiff

4950-13,550) towards medical and

JOURNAL/ijmer/04.03/02223309-202112000-00010/math_10MM3/v/2022-09-30T185922Z/r/image-tiff

1150 (IQR,

JOURNAL/ijmer/04.03/02223309-202112000-00010/math_10MM4/v/2022-09-30T185922Z/r/image-tiff

500-3100) for non-medical expenses for the past one month.

Interpretation & conclusions:
Regular assessment of QoL in the clinical management of multiple myeloma patients has the potential of improving treatment outcomes. Measures to reduce out-of-pocket expenditure may improve treatment compliance.
Coronin-1 levels in patients with tuberculosis
Authors: Sinha Sanjeev , Gupta Gaurav , Biswas Sagnik , Gupta Kartik , Singh P.P. , Jain Rahul , Sharma S.K. , Das Bimal K. 
Published: June 2022

Background & objectives:
Despite advances in diagnostics and therapeutics, tuberculosis (TB) is widely prevalent and contributes to a significant burden of illness in both developing and developed nations. The present study was aimed to assess the role of coronin in TB patients and healthy controls. Coronin is a leucocyte-specific protein that is actively recruited in mycobacterial phagolysosomes, where it inhibits lysosomal delivery of Mycobacterium by activating a calcium-dependent phosphatase-calcineurin.

Methods:
In the study, 100 newly diagnosed cases of TB (pulmonary and extra-pulmonary) and healthy controls were prospectively enrolled over one year and the levels of coronin-1a in these patients and controls were measured by quantitative PCR (qPCR).

Results:
A total of 100 TB patients and 100 healthy individuals as controls were assessed. There were 59 patients with extra-pulmonary TB (EPTB) and 41 of pulmonary TB (PTB). In 47 per cent of patients, corroborative histopathological evidence of TB was also available. Significantly higher values of coronin-1a were observed in TB patients (19.94±2.61) than in healthy controls (16.09±1.91) (P<0.001).

Interpretation & conclusions:
Coronin 1a appears to play an important role in the TB disease pathophysiology and agents developed against coronin may have a role in the treatment of TB. Further studies are required to assess if coronin-1a levels are elevated in non-tubercular infective a etiologies and whether these can be a potential drug target in patients with TB.
Comparing the chondrogenic potential of rabbit mesenchymal stem cells derived from the infrapatellar fat pad, periosteum & bone marrow
Authors: Rajagopal Karthikeyan , Madhuri Vrisha 
Published: June 2022

Background & objectives:
Rabbit model is commonly used to demonstrate the proof of concept in cartilage tissue engineering. However, limited studies have attempted to find an ideal source of rabbit mesenchymal stem cells (MSCs) for cartilage repair. This study aimed to compare the in vitro chondrogenic potential of rabbit MSCs isolated from three sources namely infrapatellar fat pad (IFP), periosteum (P) and bone marrow (BM).

Methods:
Rabbit MSCs from three sources were isolated and characterized using flow cytometry and multi-lineage differentiation assay. Cell proliferation was assessed using trypan blue dye exclusion test; in vitro chondrogenic potential was evaluated by histology and gene expression and the outcomes were compared amongst the three MSC sources.

Results:
MSCs from three sources shared similar morphology and expressed >99 per cent positive for CD44 and CD81 and <3 per cent positive for negative markers CD34, CD90 and human leukocyte antigen – DR isotype (HLA-DR). The BM-MSCs and IFP-MSCs showed significantly higher cell proliferation (P<0.001) than the P-MSCs from passage 4. Histologically, BM-MSCs formed a thicker cartilage pellet (P<0.01) with abundant matrix deposition than IFP and P-MSCs during chondrogenic differentiation. The collagen type 2 staining was significantly (P<0.05) higher in BM-MSCs than the other two sources. These outcomes were further confirmed by gene expression, where the BM-MSCs demonstrated significantly higher expression (P<0.01) of cartilage-specific markers (COL2A1, SOX9 and ACAN) with less hypertrophy.

Interpretation & conclusions:
This study demonstrated that BM-MSCs had superior chondrogenic potential and generated better cartilage than IFP and P-MSCs in rabbits. Thus, BM-MSCs remain a promising candidate for rabbit articular cartilage regeneration.
Motivations of Drinking or Abstaining from Alcohol
Authors: Datar Manjiri Chaitanya , Shetty Jyoti Vittaldas , Mali Bharat Kumar Manchharam 
Published: June 2022

Background:
Alcohol consumption at young age can lead to various negative medical and social consequences for college students. There are various motivations for students to consume alcohol. Few studies have been done to find out the motivations of students who prefer to stay abstinent from alcohol. Understanding the motivations of drinking and abstinence would help designing various preventive therapeutic programs for alcohol abstinence.

Objectives:
The objectives of the study were as follows: (1) to find the most prominent motivations for alcohol consumption and abstinence in students, (2) to compare the motivations for alcohol consumption and abstinence according to gender, and (3) to compare the motivations of students who did not ever consume alcohol with students who are abstinent for 6 months.

Methodology:
This was a cross-sectional study. Second-year undergraduate students of medical, engineering, and fine arts colleges who consented for the study were asked to fill pro forma about the pattern of alcohol consumption revealing the details of only age and gender. Depending on response about the last consumption of alcohol, the students were asked to fill either four-factor motivational model questionnaire for those who had consumed alcohol in the past 6 months or motivation for abstaining from alcohol questionnaire for students who had never consumed alcohol or were completely abstinent for the past 6 months. Descriptive and inferential statistical analysis using two independent sample tests was used.

Results:
Out of total sample of 224 students from the 3 colleges, 80 students who reported to have consumed alcohol in the past 6 months filled the four-factor motivational model questionnaire. One hundred and forty-four students who did not ever consume alcohol or were abstinent from the past 6 months filled the motivation for abstaining from alcohol questionnaire. Social and enhancement motives were most common in students consuming alcohol. Male students had more enhancement motivation than females. Among motivations to stay abstinent, fear of negative consequences of alcohol, indifference, and family constraints were the most common motives. Male students had significant fear of negative consequences and family constraints than female students. Fear of negative consequences, dispositional risk, and family constraints were significant motivations in students having alcohol abstinence for 6 months than those students who had never consumed alcohol.

Conclusion:
Positive motivations for alcohol consumption are predominant in college students. Knowledge of adverse consequences and family constraints play an important role in deterring students from alcohol consumption.
Comparison of Amsel’s criteria with low and high Nugent’s scores for the diagnosis of bacterial vaginosis
Authors: Mala Rajni , Sood Seema , Kapil Arti , Gupta Somesh , Singh Neeta 
Published: June 2022

Background:
Bacterial vaginosis (BV) is the most common cause of vaginal discharge (VD) in women of reproductive age group. It is marked by displacement of beneficial Lactobacillus sp. by polymicrobial flora. BV is becoming a major public health concern as it is associated with adverse birth outcomes and increased susceptibility to sexually transmitted infections (STIs). Diagnosis of BV is currently done using clinical criteria (Amsel's) and the microbiological criteria (Nugent's scoring), the latter being the gold standard. Many out patient settings lack in microscopy facility and also skilled microbiologists, so reliance is placed on findings of clinical examination.

Aims and Objectives:
The aim of the study was to correlate Amsel's criteria with low (7–8) versus high (9–10) positive Nugent's scores for better understanding on utility of clinical criteria.

Material and Methods:
Patients with self-reported symptoms of vaginal discharge, genital itching were included and their pelvic examination was performed. Two swab samples were collected from lateral wall of vagina and posterior fornix and tested for BV infection using both Amsel's criteria and Nugent's score.

Results:
Of the total 125 women, 29 (23.2%) were positive for BV by Amsel's criteria, whereas 34 (27.2%) were positive by Nugent's scoring. Amsel's criteria showed a sensitivity of 100% with high Nugent's scores and 81% with low scores, thereby implying very few cases of diseased individuals being missed.

Conclusion:
This study demonstrates the continued utility of the Clinical criteria in outpatient setting as a screening test.
Snap-shot of Microteaching as a Teaching–learning Method among Health Professionals in University of Health Sciences, Navi Mumbai
Authors: Mankar Madhavi Jogesh , Pimparkar Mrunal , Dubhashi Siddharth 
Published: June 2022

Introduction:
Microteaching (MT) is innovative teaching–learning method to honed and refined teaching skills in teachers. The training of medical teachers in India in pedagogical technique is not mandatory. Hence, the quality of teaching imparted in medical school is heterogenous. In today's era of Competency Based Medical Education and society's increasing high expectation on health professionals, it is essential to make competent medical teachers with improved pedagogical skills. Hence, the study was conducted to assess the baseline knowledge, practice, and attitude about MT among health professionals.

Methods:
A cross-sectional study was conducted during the period September 18–19 among all postgraduate (PG) students and teachers who have < 5 years of teaching experience after taking written consent in all constituent colleges under an university of Health science in Navi Mumbai.

Results:
Nearly 76.6% of health professionals were aware about concept of MT and 56.3% of health professionals could defined correctly MT. Only 12.6% of health professionals had correctly enumerated phases of MT. Nearly 65.1% of health professionals reported that MT as a teaching training tool should be included in PG training. Overall, 20–40% of health professionals were strongly agree to agree on various merits of MT. 57.8% health professionals suggested that experts should demonstrate teaching skills, whereas 50.6% of health professionals said that it should be made as mandatory exercise so that PG students and novice medical teachers would improve their teaching Skills.

Conclusion:
These observations suggest that microteaching exercise should be mainstreamed in health professional's curriculum in phase wise manner in future.