bluuebunny/crossref_metadata_2025_split huggingface dataset:
Smoothened percentiles for height, weight and body mass index of urban school going adolescents aged 11-17 years in national capital territory region of Delhi, India
Authors: Mani Kalaivani , Malhotra Sumit , Sati Hem Chandra , Malhotra Jyoti 
Published: August 2022

Purpose:
The aim of the study was to estimate centiles by using improved statistical smoothing procedure, the Box–Cox power-exponential (BCPE) method, in urban northern Indian adolescents aged 11–17 years.

Materials and Methods:
Data were collected cross-sectionally by measuring specific anthropometric features such as height, weight, and mid-upper arm circumference in school-based adolescents aged 11–17 years including both boys (n = 838) and girls (n = 788) enrolled in government educational institutions in urban Delhi. We used a state-of-the-art statistical methodology (BCPE method) to establish centile curves.

Results:
The model fitted before smoothing revealed that weight, height, and BMI did not follow a normal distribution; both skewness and kurtosis were observed in all three variables. After correcting both skewness and kurtosis, estimated empirical percentile values showed a gradual increase in weight, height, and BMI in both boys and girls. Girls had higher weight and height than boys in initial ages and observed a steep increase in boys in both weight and height in later ages. BMI was higher in girls than boys and visibly higher during 14–16 years of age. The 50th percentile value of BMI was smaller in all the ages in our study than that in other studies.

Conclusions:
Smoothened percentile values derived for BMI by using the state-of-the-art statistical methodology may help policymakers to promote better growth in urban adolescents.
Analysis of Maternal and Infant Death Reporting System (MIDRS) in a North Indian State during 2013–2018
Authors: Verma Madhur , Tripathy Jaya Prasad , Arora Varun , Kaur Harmanjeet , Rashi  , Parija Pragyan Paramita , Gupta Madhu , Gupta Rakesh 
Published: August 2022

Background:
Haryana launched the Maternal and Infant Death Reporting System (MIDRS) in 2013 to report deaths and their causes. We evaluated the system in terms of its data quality, accuracy, and timing of reporting.

Methods:
Secondary data analysis of data about the maternal, infant, and child deaths from the state level MIDRS portal from 2013 to 2018. The portal combines infant and maternal deaths and stillbirths reported through passive and active surveillance. We used the descriptive measure of statistics (proportion) to describe the characteristics and causes of neonatal, post-neonatal, and maternal deaths.

Results:
Of 1,18, 028 neonatal deaths, 39% (46,140) neonates died at a government facility. Gender was not recorded in 7,093 (6.0%) deaths. “Others” was a predominant category (14,664, 53%) of death. Of 2,842 maternal deaths, the cause of death was unknown in 465 (16.4%) deaths and mentioned as “others” in 1,618 (56.9%) instances. Nearly 60% of maternal deaths occurred at a health facility. Stillbirth was published as a cause of death in 228 (7.8%) child deaths (1–5 years). Missing data were observed in critical variables such as the timing of maternal mortality (50, 1.8%) and sex of child (4884, 4.3%).

Conclusion:
Delay in reporting, inconsistencies in data, and missing information were some challenges. Ascertainment of the exact cause of death needs to be improved through better training.
Case series of unscarred uterine rupture in primigravida
Authors: Trivedi Kiran , Anand Shikha , Monalisa  
Published: August 2022

Objective:
To present a highly rare case series of uterine rupture in primigravida individuals with an unscarred uterus.

Case:
The unscarred uterus in primigravida patients is supposed to be impervious to rupture, yet we have four cases of ruptured uterus in primigravida patients in our institute over a three-year period (2018-2021). In this case series, the ruptured uterus was discovered in primigravida women with premature labour, obstructed labour, instrumental delivery, and abruptio placentae. In the absence of previous surgery or multiparity, uterine rupture may go unnoticed, resulting in late diagnosis and considerable mortality and morbidity. All four cases required immediate resuscitation and laparotomy; uterine repair was performed in three cases, although a peripartum hysterectomy was needed in one.

Conclusion:
Rupture uterus can occur even in the unscarred uterus of primigravida patients and early diagnosis and timely management can prevent high maternal mortality and morbidity.
Effect of obesity on autonomic functions of Heart among healthy volunteers at a teaching Institute
Authors: Sharma Ramesh K. , Bhatt Ajay , Dwivedi Suresh K. 
Published: August 2022

Background:
Obesity usually results from an imbalance between energy intake and energy expenditure, that is, energy homeostasis, which is controlled by the autonomic nervous system. This imbalance results from multifaceted interactions of genetic, physiological, behavioral, environmental, endocrine, nervous, metabolic factors, which lead to hemodynamic and metabolic alteration.

Objective:
To study the effect of obesity on the autonomic functions of the heart.

Methods:
An observational analytical study was carried out among 100 subjects. All healthy volunteers of 30–50 years were included. The subjects were grouped into two categories of body mass index (BMI): 30–39.99 kg/m2 as Obese group and BMI: 18.50–24.99 kg/m2 as Non -Obese group. Out of 100 subjects, 50 were obese and 50 were non-obese. The interview was taken. General physical examination and anthropometric measurements were recorded. The assessment of various cardiac autonomic function tests was carried out.

Results:
Both groups were comparable for age and sex (P = 0.754). The resting heart rate, SBP, and DBP in the obese group were significantly higher compared to the non-obese group (P < 0.05). All values of autonomic function tests in the non-obese group were significantly higher compared to the obese group (P < 0.05) except for the Standing to lying ratio (P > 0.05). The values of SBP and DBP increased significantly in the non-obese people after the isometric handgrip test and cold press test compared to the obese people (P < 0.05).

Conclusion:
We conclude that the resting HR, SBP, and DBP were higher in obese people. However, after applying autonomic function tests, non-obese people respond better to these tests compared to obese people in the form of an increase in these parameters. Obesity is, thus, found to affect the autonomic function tests
An epidemiological study of domiciliary practices and health seeking behaviour among animal bite patients attending a hospital in Delhi
Authors: Panda Manasi , Kapoor Richa 
Published: August 2022

Background and Objectives:
Rabies, although a 100% fatal disease, is preventable with appropriate post-exposure prophylaxis. A hospital-based cross-sectional study was conducted among 360 animal bite patients in the anti-rabies clinic (ARC) of Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi (VMMC & SJH).

Methods:
A predesigned, pretested, structured questionnaire was administered by interview technique to assess the sociodemographic profile, health-seeking behavior, and the various domiciliary practices adopted by the animal bite patients.

Results:
Out of 360 study participants (348; 96.7%) visited a health facility (government/private) after an animal-bite incident. Of the 241 study participants who washed their wounds, 131 (54.4%) had washed the wound using soap and water and 216 (89.6%) had washed the wound for less than 5 min. Chili paste (128; 35.6%) was the most commonly used household remedy.

Interpretation and Conclusions:
It was observed that a considerable segment of the study population approached health care facilities for vaccination following animal bite but did not practice the correct wound-washing practices immediately after the incident, and a sizeable proportion of the study participants resorted to non-allopathic practices (e.g., chili paste) as a measure of first aid to manage animal bite wounds. No association was found between the sociodemographic determinants and domiciliary practices and health-seeking behavior (P > 0.05). As rabies is a preventable disease, increasing awareness pertaining to its prevention may prove to be beneficial in reducing the morbidity and mortality.
Routine hematology parameters in COVID-19
Authors: Awale Rupali B. , Singh Ashutosh , Mishra Prabhaker , Bais Prateek S. , Vansh Khare , Shamim Rafat , Ghatak Tanmoy , Hashim Zia , Gupta Devendra , Nath Alok , Singh Ratinder K. , Singh Chandrakanta , Pande Shantanu 
Published: August 2022

Background:
Our understanding of the pathophysiology of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is still evolving and is limited for prognostication. The study was performed to predict severity and mortality based on hematology parameters in coronavirus disease (COVID-19).

Material and Methods:
The study was a single-center retrospective analysis of 240 patients with COVID-19. The hematological parameters were compared between different grades of severity. The receiver operating characteristics (ROC) curve along with the Classification and Regression Trees (CART) methods were used for the analysis.

Result:
The total leukocyte count, absolute neutrophil count, neutrophil-lymphocyte ratio (NLR), and neutrophil-monocyte ratio (NMR) were increasing along with an increase in severity; while the absolute lymphocyte count and lymphocyte-monocyte ratio (LMR) were decreasing (P < 0.001). For prediction of severity and mortality on admission, the NLR, NMR, and LMR were significant (P < 0.001). The NLR, NMR, and LMR had an area under the receiver operating characteristics curve (AUROC) of 0.86 (95% CI of 0.80–0.91), 0.822 (95% CI of 0.76–0.88), and 0.69 (95% CI of 0.60–0.79), respectively, for severity. While the NLR, NMR, and LMR had an AUROC value of 0.85 (95% CI of 0.79–0.92), 0.83 (95% CI of 0.77–0.89), and 0.67 (95% CI of 0.57–0.78), respectively, for mortality.

Conclusion:
With the increase in severity there was an increase in the total leukocyte count and absolute neutrophil count while the absolute lymphocyte count decreased. On admission, the cut-off value of NLR >5.2, NMR >12.1, while LMR <2.4 may predict severity and mortality in COVID-19.
A randomized controlled trial comparing Macintosh laryngoscope and Airtraq video laryngoscope for endotracheal intubation in patients with thyroid swelling
Authors: Singh Pratibha , Srivastava Vinod , Gautam Shefali , Malik Anita , Kohli Monica , Agarwal Jyotsna 
Published: August 2022

Background:
Patients with thyroid swelling are anticipated difficult airway due to the anatomical complications associated with it leading to restricted neck movements and distorted laryngeal anatomy. The aim of this randomized prospective study was to compare Macintosh laryngoscope and Airtraq video laryngoscope for endotracheal intubation in patients with thyroid swelling.

Methods:
Eighty adult American Society of Anesthesiologist (ASA) grades I-II patients were taken and randomly divided into two groups of 40 patients in each. After induction of general anesthesia, tracheal intubation was done with either of the technique using a flexometallic tube. Time taken for intubation, hemodynamic variations during and after intubation, any optimization maneuver used during intubation, Cormack-Lehane score, Percentage of Glottic Opening (POGO score), Intubation Difficulty Score (IDS), and postoperative airway symptoms were noted.

Results:
Mean time required for intubation with Airtraq was more than Macintosh; P = 0.003. But Cormack-Lehane score, IDS score, and POGO score were better in the Airtraq group. Hemodynamic variations in both groups were comparable. Optimization maneuver required and postoperative airway symptoms were more in the Macintosh group.

Conclusion:
In patients with thyroid swelling, Airtraq video laryngoscope provides better visualization of the glottis, requires less manipulation during intubation, and less post-operative complications than Macintosh laryngoscope but requires significantly more time for intubation.
Adverse events following remdesivir administration in moderately ill COVID-19 patients - A retrospective analysis
Authors: Gandham Ravi , Eerike Madhavi , Raj Gerard M. , Bisoi Debasis , Priyadarshini Rekha , Agarwal Neeraj 
Published: August 2022

Introduction:
Remdesivir, an antiviral drug, received an emergency use authorization for treating coronavirus disease 2019 (COVID-19) patients. Though many studies have reported the safety aspects of this antiviral agent, most of them were observed in severely ill COVID-19 patients, making very less data available in the moderately ill patients. The present study was conducted with an objective of finding the adverse events (AEs) associated with remdesivir in moderately ill COVID-19 patients.

Methodology:
A retrospective observational study was conducted by collecting data of demographic details and details of remdesivir, laboratory investigations, and AEs from the patient medical records from May to July 2021 and analyzed by using the appropriate statistics.

Results:
Out of the 160 COVID-19 patients, 32 were moderately ill (males: 29, females: 03) and were treated with remdesivir along with steroids and low molecular weight heparin (LMW) heparin. The average number of administered remdesivir doses was 4, with a loading dose of 200 mg and a maintenance dose of 100 mg. A total of 41 AEs were observed out of which 17 were adverse drug reactions (ADRs) (a significant increase in the alanine transaminase (ALT) [P < 0.001]) and 23 AEs (a significant rise in random blood sugars, RBS [one of the AEs] [P = 0.007]). The AEs were more commonly seen in the hypertensive patients. An increased oxygen requirement was a major serious AE observed in four patients.

Conclusion:
Remdesivir caused a significant increase in the liver enzymes. Increased blood sugar levels were the most common AE and increased oxygen requirement was the major serious AE observed.
Awareness of gestational diabetes mellitus among females in Jeddah, Saudi Arabia – A cross-sectional study
Authors: Abualsaud Renad M. , Baghdadi Ebtihal S. , Bukhari Ayman A. , Katib Hadeel A. 
Published: August 2022

Aim:
This study aimed to assess the awareness about gestational diabetes mellitus (GDM) among married females in Jeddah, Saudi Arabia.

Methods:
A cross-sectional study was done on all women in reproductive age and an electronic questionnaire was used. Data about participants’ demographics, parity, BMI, pregnancy, family and personal history of chronic diseases, gestational diabetes were collected. Their knowledge about effect of gestational diabetes on mother and on neonatal outcomes and their source of information about GDM were assessed.

Results:
The mean age of the participants was 37.99 ± 9.44 years and 77.8% of them had poor knowledge about GDM and 6.1% had good knowledge. Multipara women with a university education had a significantly higher mean knowledge level and the most common source of participants’ knowledge about GDM was social media.

Conclusion:
Females’ knowledge about GDM was significantly low in Jeddah. Health education campaigns and mass media education are urgent to increase their awareness about GDM. Health care practitioners should focus on popularizing GDM and raising awareness of its consequences.
Development and pilot-testing of a skill-based intervention to prevent psychoactive substance use among college students
Authors: Doraiswamy Padmavathy , Nattala Prasanthi , Murthy Pratima 
Published: August 2022

Background:
Psychoactive substance use among college youth is increasing in low- and middle-income countries like India. However, there are few systematically developed interventions for this vulnerable group. Aim: The aim of this study was to develop a skill-based intervention to prevent substance use among college students (or enable them to quit, if already initiated use).

Method:
The skill-based intervention was informed by focus group discussions with college students regarding the kind of help they perceived would be useful. The intervention was pilot-tested for its appropriateness and acceptability in this population, and revised based on their inputs.

Results:
The feedback received from the students was incorporated and the intervention was suitably revised. The final intervention adopted a disease prevention and health promotion approach, by addressing psychoactive substance use as a risk factor for several major illnesses, and providing practical guidance on how to overcome use. The intervention consisted of four sections: (i)
Health effects of substances, with realistic depictions through computer graphics (e.g., to illustrate arterial blockage, brain shrinkage, lung damage, erosion of gastric mucosa, impaired sexual performance, premature aging); Clarification of Myths, Providing Medical Facts, (ii) How to Overcome Substance Use, with practical strategies for quitting, (iii)
Quitting Substance Use as part of a Healthy Lifestyle, (iv) Conclusion, portraying life after quitting substances, with motivational messages.

Conclusion:
The skill-based intervention received positive feedback regarding its applicability and acceptance among college students. An experimental trial can be planned to examine the efficacy of the intervention in bringing about improvement in specific outcomes.
Percutaneous Pedicle Screw Fixation in Lumbosacral Degenerative Disorder: Is Two-Dimensional Fluoroscopy Guide Reliable in Accuracy?
Authors: Yudoyono Farid , Setiahandoko Arief , Adhipratama Hadian 
Published: August 2022

Background:
Percutaneous pedicle screw fixation (PPSF), which is a minimally invasive procedure, has now become popular in treating disorders of the lumbosacral. This study aimed to evaluate whether two-dimensional (2D) fluoroscopy is effective for PPSF insertion in patients with degenerative lumbar spine disorder.

Methods:
This study is a retrospective study covering degenerative lumbosacral spine disorders that underwent surgery. PPSF was performed in all patients. Several parameters were evaluated for pedicle screw breach, complications, Visual Analog Scale, and Oswestry Disability Index during 6 months of follow-up.

Results:
A total of 12 screws were percutaneously installed in 2-dimensions anteroposterior and lateral view. Ten screws were installed in the ideal position. One screw indicated sideways penetration of the pedicle, whereas 1 screw indicated upward penetration of the pedicle. No screws were attached medially. At the end of the follow-up, there was a significant improvement in pain and disability scales in patients undergoing PPSF. There were no postoperative complications.

Conclusions:
2D fluoroscopy-guided percutaneous pedicle screws placement with the appropriate technique is an acceptable and reliable procedure with low rates of screw-related complications and revisions. However, this technique is associated with an initial learning curve and technical skills that can be gained by enough experience.
Role of cancer-associated mesenchymal stem cells in the tumor microenvironment: A review
Authors: Wang Kai-Hung , Ding Dah-Ching 
Published: August 2022

Abstract
Mesenchymal stem cells (MSCs) were applied to the therapy for degenerative diseases, immune, and inflammation. In tumor microenvironments (TME), different sources of MSCs showed that tumor-promoting and -inhibiting effects were mediated by different signaling pathways. Cancer-associated MSCs (CaMSCs) could be recruited from bone marrow or local tissues and mainly showed tumor-promoting and immunosuppressive effects. The transformed CaMSCs preserve the characteristics of stem cells, but the properties of regulating TME are different. Hence, we specifically focus on CaMSCs and discuss the detailed mechanisms of regulating the development of cancer cells and immune cells. CaMSCs could be a potential therapeutic target in various types of cancer. However, the detailed mechanisms of CaMSCs in the TME are relatively less known and need further study.
Effect of teprotumumab on intraocular pressure in thyroid-associated ophthalmopathy
Authors: Adetunji Modupe O. , Nguyen Brian J. , McGeehan Brendan , Tamhankar Madhura A. , Briceño César A. 
Published: August 2022

PURPOSE:
To examine changes in intraocular pressure (IOP) in patients with thyroid eye disease (TED) following teprotumumab.

MATERIALS AND METHODS:
A retrospective review of 17 patients with TED who received teprotumumab between January 2020 and September 2021 was conducted. IOP, extent of proptosis, and clinical activity score were reviewed at baseline and at 6 weeks, 12 weeks, and 24 weeks for patients undergoing teprotumumab treatment. The primary outcome measure was change in IOP, while secondary outcome measures included changes in proptosis and clinical activity score.

RESULTS:
Of the 17 patients (34 eyes) with TED who were treated with teprotumumab, the mean age was 50.5 years, and 15 (88%) were female. The mean baseline IOP was 20 mm Hg (range 13–28), and the mean baseline clinical activity score was 3.8 (range 0–6). Of the 34 eyes examined at baseline, examinations were repeated in 16 at 6 weeks, 26 at 12 weeks, and 8 at 24 weeks. At week 6 of treatment, mean IOP decreased by 4.9 mm Hg (P < 0.0001). At week 12 of treatment, mean IOP decreased by 4.6 mm Hg (P < 0.0001). Mean IOP was decreased at last record of follow-up by 4.9 mm Hg (P < 0.0001).

CONCLUSION:
Among patients with TED, teprotumumab treatment was associated with a reduction in IOP.
Case Report: Pharyngeal Diphtheria in a Pregnant Woman from South India
Authors: Pattar Suhas S. , Deepashree R. , Sumana M. N. , Sujatha S. R. , Tejashree A. , Rao Raghavendra , Murthy Neetha 
Published: August 2022

ABSTRACT.
Diphtheria is a vaccine-preventable disease and is caused by toxigenic strains of Corynebacterium diphtheriae. Several case reports have been published in the recent years, and this resurgence of cases has occurred mainly in adolescent and adult populations. Also, several research articles have reported waning immunity against diphtheria in adults who have completed childhood immunization. Thus, it is an important need to conduct larger sero-surveillance studies to understand the cause of rising diphtheria cases. Here, we report a case of a 23-year-old pregnant women of 8 weeks’ gestation who presented to the outpatient department with fever, severe throat pain, odynophagia, dysphagia, neck pain, and neck swelling of 3 days’ duration. On clinical examination, a gray, leathery membrane was noted on the soft palate. An Albert’s stain from the membrane revealed organisms resembling Corynebacterium diphtheriae. Appropriate treatment was initiated immediately, and follow-up examination at 2 weeks from date of discharge was uneventful. The gray membrane had completely resolved. Contact tracing was done and the appropriate antimicrobial agent was administered. This case study indicates the importance of timely clinical and microbiological diagnosis and reinforces the previously reported resurgence of diphtheria infection.