bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spinal Anesthesia for Elective Cesarean Section – Comparison of Levobupivacaine and Ropivacaine with Hyperbaric Racemic Bupivacaine
Authors: George Melwin , Ipe Shalini Miriam , Ipe Shaloo , Abraham Saramma P. 
Published: November 2022

Background:
Spinal anesthesia is a popular technique for cesarean section, the commonly used drug being hyperbaric bupivacaine. Levobupivacaine and ropivacaine are newer local anesthetics in the Indian market with similar sensory block profile, lesser cardiotoxicity, but shorter duration of motor block.

Aim:
To determine the efficacy and safety of hypobaric levobupivacaine and ropivacaine and to compare it with hyperbaric bupivacaine all with fentanyl for spinal anesthesia in elective cesarean section.

Study Design:
This was a prospective, randomized controlled, double-blinded study.

Methodology:
Ninety pregnant patients were allocated to three groups of 30 each. Group A (control) received 0.5% hyperbaric bupivacaine 1.8 ml with 25 μg fentanyl, Group B (study) received 0.5% levobupivacaine 1.8 ml with 25 μg fentanyl, and Group C (study) received 0.75% ropivacaine 1.8 ml with 25 μg fentanyl. The efficacy and safety were assessed and analyzed using SPSS version 22.

Results:
Our study showed that ropivacaine is noninferior to hyperbaric bupivacaine, with a similar efficacy of 96.7%. Hyperbaric bupivacaine and ropivacaine are superior to levobupivacaine with a success rate of 96.7% versus 80%, with a P = 0.02 for superiority (one-sided). Duration of motor block was shorter in levobupivacaine (P < 0.001) and ropivacaine (P = 0.016) groups compared to bupivacaine group. Mean duration of analgesia was shorter in levobupivacaine (P = 0.001) and ropivacaine (P = 0.010) groups when compared to bupivacaine group. Although the percentage of patients having hypotension were similar among the groups, episodes of intraoperative hypotension and the amount of ephedrine consumed were higher in ropivacaine group compared to bupivacaine group (P = 0.039).

Conclusion:
Ropivacaine 0.75% appeared noninferior to hyperbaric bupivacaine 0.5% in terms of efficacy and safety. Levobupivacaine 0.5% was found to be inferior to bupivacaine and ropivacaine in terms of efficacy.
Effect of Dental Fluorosis on Oral Health-Related Quality of Life and Daily Performances Among 12- and 15-year-old School-going Children Residing in High- and Low-Fluoridated Areas of Meerut District
Authors: Varshney Shivangi , Menon Ipseeta , Gupta Ritu , Arora Vikram , Sharma Anubhav , Rohatgi Lavanya 
Published: November 2022

Introduction:
Dental fluorosis is a clinical situation that leads to changes in esthetic appearance in teeth. Oral health problems can cause problems in performing daily activities and social well-being, which may affect individual's quality of life (QOL).

Aim:
To assess the effect of dental fluorosis on oral health-related QOL and condition-specific oral impact on daily performance (CS-OIDP) among 12- and 15-year-old children residing in high and low fluoridated areas of Meerut district, UP.

Methodology:
A cross-sectional study was conducted among 200 12- and 15-year-old school-going children residing in high- and low--fluoridated areas of Meerut district. Dean's fluorosis index was used to evaluate dental fluorosis. A pretested questionnaire, CS-OIDP index, was used to assess the dental fluorosis effect on the oral health-related QOL and daily performances.

Results:
The mean CS-OIDP score among high-fluoridated area was 39.85 and a significant correlation was found between dental fluorosis, CS-OIDP, and oral health-related QOL (P < 0.005).

Conclusion:
The results of the present study can act as an alarm for dentists to carry out epidemiological investigation at village and district level to evaluate the risk factors and possible treatment and preventive measures.
Determination of Atogepant Using RP-HPLC in Bulk and Table ts
Authors: Kumar H. Mundarinti Sudheer , Chandrasekhar Kothapalli Bannoth 
Published: November 2022

Context:
Around one in seven individuals worldwide suffers from migraine, a highly prevalent and chronic neurological disease. In the prevention and treatment of migraines, 'gepants' are a class of receptor antagonist molecules that block calcitonin gene-related peptide (CGRP) receptors. Atogepant (ATO) is the first and only oral CGRP receptor antagonist (gepant) that was developed exclusively for the prevention and treatment of episodic migraines.

Aim
A stability-indicating reverse phase high performance liquid chromatography (RP-HPLC) method for the determination of ATO has been developed and validated in bulk and tablet dosage forms.

Materials and Methods
The chromatographic analysis was carried out on a Waters C18 Column with 250 mm × 4.6 mm and a particle size of 5 μm, using an isocratic mobile phase of Phosphate Buffer pH 3.6: Methanol: 0.5% Formic acid 60:38:2 v/v at a flow rate of 0.8 mL/min, and the eluents were monitored at an isosbestic point of 217 nm.

Results
The specificity, precision, accuracy, linearity, and robustness of the proposed method were all validated according to the ICH standards. Forced degradation studies confirmed the method's stability-indicating nature. ATO had retention time of 3.58 min. The current method was found to be accurate, precise, and sensitive. ATO linearity was achieved between 105 and 315 μg/mL, while LOD and LOQ were found to be 4.33 and 14.44 μg/mL, respectively.

Conclusion
As a result, the suggested RP-HPLC method for the quantification of ATO was reliable, reproducible, accurate, and sensitive.
Prior Experience of Physiotherapy Treatment Among the General Public
Authors: Gayathri K. , Hariharan S. , Anbupriya M. 
Published: November 2022

Background:
Physiotherapy services continue to be an essential component in patient recovery throughout hospital care, from acute to subacute, palliative extended care and outpatient services. Physiotherapists are also concerned as their role in working with a physical or mental condition that limits a person's movement as they deal through active rehabilitation and health promotions. The physiotherapists gain experience through volunteer work with local senior care centre or local clinic. This study aims to find out the Prior experience of Physiotherapy treatment among General public.

Methodology
A qualitative study conducted with 105 willing participants aged more than 40 years, of both sexes who had a prior experience of physiotherapy treatment at least once in recent 2 years. A self-reported questionnaire was given and the responses recorded.

Results
It shows that Domain (D1-45, D2 -59, D4-53, D5-59, D6-61, D7-60, D8-57, D9-55) participants reported maximum responses towards agreeing, whereas Domain D3 received maximum responses of 46 participants towards disagreeing.

Conclusion
The study concluded that the Prior experience of Physiotherapy treatment among General public using a self-administered questionnaire showed more positive responses towards the Physiotherapy treatment and Physiotherapists.
Prospective clinical study to evaluate role of centchroman in regression of mastalgia in rural population
Authors: Mishra Shashi Prakash , Singh Somendra Pal , Singh Shailendra Pal , Gupta Vipin , Gupta Prashant , Sharma Anil Kumar , Kumar Shesh , Agarwal Manish 
Published: November 2022

Background:
Mastalgia in the reproductive age group is common among women. Treatment is not yet standardized for these conditions. The majority of treatments used for mastalgia is costly and have side effects. The aim of our study was to find the efficacy of centchroman for regression of mastalgia in a predominantly rural population, measured by the visual analog scale (VAS).

Materials and Methods:
A total of 140 patients were randomized into two groups: Group 1 (n = 70) patients treated with centchroman and Group 2 (n = 70) patients treated with placebo for 12 weeks. The main outcomes are evaluated after one week to look for any intolerance, followed by repeated follow-ups at four, twelve, and twenty-four weeks to evaluate the treatment response using the VAS score and the side effects.

Results:
The mean age of patients in Group 1 was 29.63 ± 9.67 years and 32.32 ± 9.74 years in Group 2. The baseline mean VAS score was 6.40 ± 1.65 and 5.83 ± 1.69, respectively. After 2, 4, 8, 12, and 24 weeks of follow-up, the mean VAS score was significantly decreased in patients treated with centchroman. On intragroup comparison, the mean VAS score was significantly decreased at baseline to 2, 4, 8, 12, and 24 weeks of follow-ups. In both the groups, gastritis and headache were comparable, and delayed menstruation was significantly more in patients treated with centchroman.

Conclusion:
Centchroman has substantial efficacy, with a marginal effect on regression, of mastalgia in women of the reproductive age group, and it can be used as the first line of treatment.
Effect of COVID-19 on sleep pattern, mobile usage, and serum melatonin level among 1st -year medical students
Authors: Hnamte Lalmalsawma , Phurailatpam Jayshree , Laishram Memeeka 
Published: November 2022

Background:
The COVID-19 pandemic has enforced a new norm in the world with maximum dependence on technology in day-to-day living as well as the academic atmosphere. Globally, students are profoundly affected but more specifically medical students are subjected to immense stress, which is bound to affect their sleep and thus the sleep-regulating hormone, melatonin. Young medical students right at the entry to their professional career have, therefore, been hit by the changing scenario with most classes becoming online and increasing dependence on technological gadgets such as smartphones and laptops.

Aims and Objectives:
The purpose of the study was to determine the sleep pattern of 1st-year medical students, survey their mobile phone use, and to estimate their serum melatonin levels during the COVID-19 pandemic.

Materials and Methods:
This cross-sectional study was done in a Northeast India Medical Institute using standard questionnaires, Pittsburgh's Sleep Quality Index (PSQI) and Problematic Mobile Phone Usage Questionnaire among medical students and estimating their early morning serum melatonin level by ELISA assay.

Statistical Analysis:
Data collected were entered in SSPS version 21 and analyzed using descriptive measures, and statistical significances were set at P < 0.05.

Results:
One hundred and one students (Male: 49 and Female: 52) in the age range of 18–23 years responded to the study which recorded poor sleep quality in 53.5% and good sleep in 46.5%. Poor sleep quality as indicated by PSQI score >5 was reported in 63.5% of females and 42.9% of males which was statistically significant (P = 0.04). Out of these poor sleepers, 66.7% of males and 54.5% of females reported mobile phone usage for more than 2 up to 6 h. Comparatively, poor sleep quality was reported in only 19% of male students as compared to 27% of females among those using mobiles beyond 6 h. Besides, 14% of males and 18% of females among poor sleepers reported using mobiles <2 h. Further, in 80 respondents (Male: 40 and Female: 40) randomly selected for estimation of their early morning sample, serum melatonin level was estimated as 99.25 ± 72.07 pg/ml in males and 109.76 ± 84.54 pg/ml in females.

Conclusion:
Nearly 2/3rd of poor sleeper, 1st-year medical male students use mobiles for 2–6 h daily during the pandemic while Only ½ of the females do. However, among those poor sleepers using mobiles beyond 6 h daily, females outnumbered males. Estimated Serum smelatonin levels were also relatively higher than those reported in nonpandemic studies.
Epidemiological survey of fatal road traffic accident in Imphal, Manipur
Authors: Nandeibam Pabitramala , Pradipkumar Khangembam , Keisham Supriya , Nabachandra Huidrom 
Published: November 2022

Background:
Approximately 1.3 million people die each year as a result of road traffic accidents (RTAs). According to the National Crime Record Bureau, a total of 368,828 traffic accidents were reported in the country in 2020, and out of these, 96% of the cases were due to RTAs with 354,796 cases and 37% fatality.

Objectives:
The objective is to study the demographic profile of victims of fatal road accidents.

Materials and Methods:
A cross-sectional study was carried out in the department of forensic medicine of a tertiary care teaching hospital in Imphal on all cases of fatal RTA brought in between October 2015 and September 2018. All data including the postmortem findings were analyzed and presented.

Results:
Out of 478 medicolegal autopsies conducted during the study period, 159 (33.3%) were vehicular accident fatalities. The majority of the victims were males in the age group of >20–30 years (22.64%) and pedestrians (30.82%). Most of the accidents (40.88%) occurred during the afternoon period between 12 Noon and 6 PM and in the winter months (50.9%), with maximum cases occurring on national highways (55.3%). The cause of death of the victims was due to head injuries in 42.14%.

Conclusions:
Several factors are responsible for RTAs. There is clearly a need for road safety education among road users. The licensing authorities should adopt stricter, more comprehensive, and scientifically based test.
A retrospective analysis of drowning deaths in Imphal
Authors: Supriya K. , Pabitramala N. , Singh Khangembam Pradipkumar , James D. W. S. , Deepen C. 
Published: November 2022

Background:
Drowning is a major cause of death worldwide and it is the third leading cause of unintentional injury deaths accounting for 7% of all injury-related deaths. Different factors are responsible for causing death due to drowning.

Objectives:
The objective of this study was to find out the prevalence of death due to drowning in relation to epidemiological factors and to find out postmortem examination findings and manner of death of such cases.

Materials and Methods:
A retrospective study of drowning deaths brought to the Department of Forensic Medicine and Toxicology of a tertiary care teaching hospital in Imphal was conducted for 10 years. Data obtained were entered in a pro forma and later analyzed statistically.

Results:
In this study period, there were 110 cases of drowning cases. Male: female ratio was 10:1. The highest number of victims was observed in the age group of 21-30 years and the maximum number occurred in rivers, i.e., 54.54%. In 67.27% of the cases, there were signs of asphyxia and in 40% of the cases, froth was present around the mouth and nostrils. Cadaveric spasm which was considered the surest sign of antemortem drowning was observed in only 2.72%. Lungs were found to be voluminous in 77.27% of the cases. Maximum occurred in the rainy season.

Conclusion:
The manner of death could not be ascertained in the present study however from history, most of the cases seem to be accidental. Public awareness and water safety measures need to be improved to prevent drowning deaths.
Prevalence of nonadherence to iron and folic acid supplementation among pregnant women in Bishnupur district of Manipur
Authors: Debbarma Bikash , Konjengbam Shantibala , Elangbam Vijaya , Christina Soubam , Akoijam Brogen Singh 
Published: November 2022

Context:
Iron and folic acid (IFA) supplementation is an important strategy to reduce the prevalence of iron-deficiency anemia (IDA) during pregnancy. Consequently, it reduces risk of maternal mortality, neonatal mortality, and poor birth outcomes. Nonadherence to IFA supplementation is a challenging factor in combating IDA.

Aims:
The aim of this study was to determine the prevalence of nonadherence to IFA supplementation among pregnant women and identify the factors associated with it.

Subjects and Methods:
A cross-sectional study was conducted among pregnant women attending public health facilities of Bishnupur district, Manipur. Pregnant women with ≥20 weeks of period of gestation were recruited consecutively from the antenatal care clinics of the selected public health facilities. Face-to-face interviews were conducted using a pretested semi-structured interview schedule. Association between nonadherence to IFA supplementation and background characteristics and antenatal profile was analyzed using Chi-square test.

Results:
The mean age of the participants was 28 ± 5.7 years, and 69% were multigravida. Among 396 women who were currently consuming IFA tablets, 25% were nonadherent. Bad taste, side effects, and inadequate supply were cited as the main reasons for irregular intake. The presence of comorbidities (P < 0.001), government supply as source of IFA tablets (P = 0.001), and adequate knowledge about IFA tablets (P = 0.04) were found to be significantly associated with nonadherence. Other associated factors were religion, education, socioeconomic status, and period of gestation.

Conclusions:
The prevalence of nonadherence was high among pregnant women in Bishnupur district. The importance of IFA supplementation and its adherence should be emphasized to pregnant women.
On minimal ideals in pseudo-finite semigroups
Authors: Gould Victoria , Miller Craig , Quinn-Gregson Thomas , Ruškuc Nik 
Published: November 2022

AbstractA semigroupSis said to be right pseudo-finite if the universal right congruence can be generated by a finite set$U\subseteq S\times S$, and there is a bound on the length of derivations for an arbitrary pair$(s,t)\in S\times S$as a consequence of those inU. This article explores the existence and nature of a minimal ideal in a right pseudo-finite semigroup. Continuing the theme started in an earlier work by Dandan et al., we show that in several natural classes of monoids, right pseudo-finiteness implies the existence of a completely simple minimal ideal. This is the case for orthodox monoids, completely regular monoids, and right reversible monoids, which include all commutative monoids. We also show that certain other conditions imply the existence of a minimal ideal, which need not be completely simple; notably, this is the case for semigroups in which one of the Green’s preorders${\leq _{\mathcal {L}}}$or${\leq _{\mathcal {J}}}$is left compatible with multiplication. Finally, we establish a number of examples of pseudo-finite monoids without a minimal ideal. We develop an explicit construction that yields such examples with additional desired properties, for instance, regularity or${\mathcal {J}}$-triviality.
Early Treatment with Fluvoxamine among Patients with COVID-19: A Cost-Consequence Model
Authors: Mills Fergal P. , Reis Gilmar , Wilson Lindsay A. , Thorlund Kristian , Forrest Jamie I. , Guo Christina M. , Boulware David R. , Mills Edward J. , _ _ 
Published: November 2022

ABSTRACT.
To date, two published randomized trials have indicated a clinical benefit of early treatment with fluvoxamine versus placebo for adults with symptomatic COVID-19. Using the results of the largest of these trials, the TOGETHER trial, we conducted a cost–consequence analysis to assess the health system benefits of preventing progression to severe COVID-19 in outpatient populations in the United States. A decision-analytic model in the form of a decision tree was constructed to evaluate two treatment strategies for high-risk patients with confirmed, symptomatic COVID-19 in the primary analysis: treatment with a 10-day course of fluvoxamine (100 mg twice daily) and current standard-of-care. A secondary analysis comparing a 5-day course of nirmatrelvir–ritonavir was also conducted. We used a time horizon of 28 days. Reported outcomes included cost-savings and hospitalization days avoided. The results of our analysis indicated that administration of fluvoxamine to symptomatic outpatients at high risk of progressing to severe COVID-19 was substantially cost-saving, in the amount of $232 per eligible patient and prevented an average of 0.15 hospital days per patient treated, compared with standard of care. Nirmatrelvir–ritonavir was also shown to be cost-saving despite its higher acquisition cost and provided savings to the healthcare system of $625 per patient treated. These findings suggest that fluvoxamine is likely to be a cost-effective addition to frontline COVID-19 mitigation strategies in many settings, particularly where access to nirmaltrevir–ritonavir or monoclonal antibodies is limited.
The effect of liraglutide on renal function in type 2 diabetes: a meta-analysis of randomized controlled studies
Authors: Luo Cheng , He Dongjuan , Yang HongBin , Zhu Chunyan , Zhu Jiajun , Hu Zhaohui 
Published: November 2022

Introduction: The efficacy of liraglutide on renal function in type 2 diabetes remains controversial. We conduct a systematic review and meta-analysis to explore the influence of liraglutide versus placebo on renal function in type 2 diabetes.
Methods: We search PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through March 2020 for randomized controlled trials (RCTs) assessing the effect of liraglutide versus placebo on renal function in type 2 diabetes. This meta-analysis is performed using the random-effect model.
Results: Seven RCTs are included in the meta-analysis. Overall, compared with control group in type 2 diabetes, liraglutide treatment shows no obvious effect on GFR (SMD=0.02; 95% CI=-0.43 to 0.47; P=0.94), RBF (SMD=-0.28; 95% CI=-0.80 to 0.24; P=0.29) or death (RR=1.93; 95% CI=0.71 to 5.21; P=0.20), but is associated with significantly decreased ACR (SMD=-0.82; 95% CI=-1.39 to -0.26; P=0.004) and systolic blood pressure (MD=-9.60; 95% CI=-17.46 to -1.73; P=0.02), as well as increased heart rate (MD=5.39; 95% CI=3.26 to 7.52; P<0.00001).
Conclusions: Liraglutide treatment may provide some benefits for protecting renal function in type 2 diabetes.
Keywords: Liraglutide; renal function; type 2 diabetes; randomized controlled trials.
Assessment of electrolytes, markers of glycaemic control and renal dysfunction among adult Nigerians recently diagnosed with type 2 diabetes mellitus
Authors: A Ekun Oloruntoba , F Fagbemi Oloruntoba , N Adejumo Esther , O Ekun Oyeronke , S Wojuade Kehinde , M Oshundun Folu , O Adefolaju Florence , R Oyegbami Sade 
Published: November 2022

Background: Diabetes mellitus is a chronic and progressive endocrine disorder that may result in macro and microvascular complications.
Objective: This study assessed some biochemical analytes in Nigerians who were recently (≤ 6 months) diagnosed with Type 2 diabetes mellitus (T2DM).
Methods: 160 T2DM and 90 non-diabetic control participated in this study. Blood samples were collected and analyzed for Heart-type fatty acid-binding protein (HFABP), high sensitivity C-reactive protein (hs-CRP), electrolytes, lipid and renal profile parameters, glycated haemoglobin (HBA1C) and fasting blood glucose (FBG), using standard guidelines.
Result: The body mass index (BMI) of the T2DM volunteers was higher than control (P <0.001). The lipid profile, potassium, glucose, HBA1C, urea and creatinine values were elevated (P <0.001) while estimated glomerular filtration rate (eGFR) was lower (P<0.05) in diabetes. The median HFABP and hs-CRP were raised (P <0.05) in T2DM. Positive associations existed between FBG and urea (P <0.001), Creatinine and HBAIC (P <0.001). A logistic regression analysis, shows that an increased BMI, HBA1C, FBG, Cholesterol, urea and creatinine were associated with higher odds (p<0.001) of cardiovascular and renal complications.
Conclusion: Elevated hs-CRP, glycated haemoglobin, urea and creatinine among T2DM increase the odds of cardiovascular and renal insults in this population.
Keywords: Type 2 diabetes mellitus; renal disease; glycated haemoglobin; high sensitivity C-reactive protein.