bluuebunny/crossref_metadata_2025_split huggingface dataset:
Community Assessment of Incidence of Quantitative Microalbuminuria at the Time of First Diagnosis of Type 2 Diabetes Mellitus – Kumbakonam Urban–Rural Epidemiological Study – Kures 9
Authors: Suchitra M. R. , Anand Monica , Saravanan Balachandar , Parthasarathy S. 
Published: December 2022

Background:
Diabetic nephropathy (DN) is a condition defined by persistent albuminuria and progressive loss of kidney function, with the term implying the occurrence of a typical described pattern of glomerular disorder. The early marker of the disease is detecting microalbuminuria in the urine.

Methods:
The patients who consented for the sampling was considered when they were diagnosed with diabetes mellitus (DM) for the first time. The first hundred adult patients who consented to participate were included. Established methods were used to estimate quantitative microalbumin in the urine from the first sample of the morning. All the positive reports were counter-checked. The initiation of drugs was left to the physician's choice. Any other events were recorded. On arrival, random blood sugar and blood pressures were recorded. Descriptive analyses and Pearson correlation analyses were used.

Results:
A total of 101 patients were analyzed. There were 58 males and 43 females. The microalbuminuria was positive in 44.6% of newly diagnosed cases. There was no relationship between the random sugar values, age, or sex with the incidence of microalbuminuria. The mean ages of both the positive and negative cases were similar.

Conclusion:
There was a high incidence of microalbuminuria in our study among newly diagnosed DM. With such a high incidence of early renal damage on diagnosis, we suggest that the initial management should switch from other drugs to inhibitors of the sodium-glucose cotransporter 2 (SGLT2). We theorize that the high incidence may be due to a delayed diagnosis of diabetes in our area and a poor control of the disease. With such a high incidence of early renal damage on diagnosis, we suggest that the initial management should switch from other drugs to inhibitors of the SGLT2. This is the first such study on the incidence of early nephropathy on first diagnosis of DM.
A Stability Indicating Novel Analytical Method for the Determination of Lamivudine and Dolutegravir in Bulk and its Tablets Using Reverse Phase High-Performance Liquid Chromatography
Authors: Lalitha K. V. , Reddy J. Raveendra , Nayakanti Devanna 
Published: December 2022

Aim:
A simple and sensitive analytical method was developed to simultaneously estimate lamivudine (LAM) and dolutegravir (DOL), anti-retroviral drug combination in bulk and dosage forms.

Materials and Methods:
Separation of analytes was done on a BEH Shield RP18 (2.1 mm × 100 mm × 1.7 mm, 5 μm Particle size) using sodium dihydrogen phosphate pH 4.9 adjusted with orthophosphoric acid: Methanol (60:40, %v/v) as mobile phase pumped at 1.0 ml/min. A photodiode array detector was used to find the detection wavelength at an isosbestic point of 292 nm while maintaining the column temperature at 30°C. With a total run period of 8 min, the mobile phase was utilized as a diluent. The International Council on Harmonization guidelines were followed in the method's validation. The method's capacity to indicate stability was confirmed by experiments on forced degradation.

Results:
LAM and DOL eluted at 2.88 and 3.83 min, respectively. Both the drugs exhibited excellent linearity between 105.00–315.00 and 17.50–52.50 μg/ml for LAM and DOL, respectively. The LOD and LOQ were found to be 4.51 and 15.03 μg/ml for LAM and 5.82 and 19.41 μg/ml for DOL, respectively, which are very minute concentrations.

Conclusion:
The method was therefore found to be quite sensitive. The proposed high-performance liquid chromatography technique was thereby sensitive, reproducible, accurate, and reliable for the measurement of LAM and DOL.
The Phenomenon of Giving Hypnotic Medications to Children without a Therapeutic Purpose
Authors: Osman Mhdia Elhadi , Khaloofi Heba Ali 
Published: December 2022

Background:
The antihistamines such as chlorpheniramine malate, triprolidine, and pseudoephedrine cause sedation and are prescribed for insomnia as a first-line drug. Some mothers in Saudi Arabia reported using these medications for their children to induce and regulate sleep without prescription. This unnecessary and dangerous practice can cause serious side effects.

Objective:
The research aimed to discover the prevalence of sedative medication use among children in Saudi Arabia and evaluation of the mother's awareness of the seriousness of these medications' effects. This research also aimed to provide natural alternatives.

Materials and Methods:
A cross-sectional study has been conducted using a structured online questionnaire. The survey has been performed to identify the views of mothers on the subject and the reasons for their use of medicines and the most widely used drugs, dosage, and side effects. Fifty responses were collected from mothers and evaluated using Statistical Package for the Social Sciences (SPSS) software.

Results:
Most participants use sedative drugs to keep their children calm and in a deep sleep with ignorance and a lack of awareness of their serious side effects. We strongly encourage the initiation of awareness campaigns using pamphlets and other platforms including messages.

Conclusion:
Mothers, mainly working women, tend to use hypnotic medication for their children without a therapeutic indication. This practice needs to be stopped by awareness campaigns using both traditional and electronic formats.
Satisfaction of the Clients Attending Integrated Counseling and Testing Center in a Teaching Hospital of North-Eastern India
Authors: Debnath Arpita , Roy Tarun Kumar , Bhattacharjya Himadri 
Published: December 2022

Background:
Integrated Counseling and Testing Centers (ICTC) provide counseling and testing for HIV to the clients. Satisfaction of the clients attending an ICTC determines its acceptance among people, and it is crucial for preventing this disease.

Objectives:
To estimate the level of satisfaction and to determine its association with sociodemographic parameters of the clients attending ICTC in a teaching hospital.

Methodology:
This hospital-based cross-sectional study was conducted in October 2019 among 213 clients attending ICTC of Agartala Government Medical College, chosen by census technique. An interview schedule containing information regarding age, sex, marital status, education, socioeconomic class, along with a component for evaluating HIV counseling and testing services initially used by UNAIDS, was used for data collection.

Results:
Among the clients, 54.5% (116) were male, 45.5% were aged between 35 and 80 years, 79.3% were from rural areas, 87.8% were Hindu by religion, 33.8% belonged to scheduled caste community, 63.4% were primary educated, 35.2% belonged to BG Prasad's Class II socioeconomic status, 83.6% were married, and 10.3% attended ICTC by self-initiated approach. Only 39% of the clients were found to be satisfied with the services of this ICTC. Waiting time in queue was found to be significantly associated with client's satisfaction.

Conclusion:
The client's satisfaction level was found to be low. Reduction in queuing time, caring attitude, and use of the client's own language might improve the scenario.
Surgical Management of Complicated Duplex Kidney
Authors: Paraboschi Irene , Farneti Federica , Mantica Guglielmo , Kalpana Patil , Tagizadeh Arash , Anu Paul , Pankaj Mishra , Garriboli Massimo 
Published: December 2022

Aim:
The management of a complicated duplex kidney remains a challenge for paediatric urologists. The aim of this study is to report a 10-year experience of the surgical management of complicated duplex kidney in a single tertiary care paediatric referring hospital.

Materials and Methods:
Clinical records of all children who undergone a surgical procedure for complicated duplex systems between January 2009 and March 2019 at our institution were retrospectively reviewed. Clinical manifestations, surgical procedures, complications and follow-up were collected and analysed. Logistic regression was performed to explore if any patient's characteristic or underlying associated comorbidity (ureterocoele, ectopic ureter, obstruction, etc.,) could be positively linked to the chance to develop recurrent urinary tract infections (UTIs).

Results:
We have identified 95 children who received a surgical treatment for 102 complicated duplex kidneys. The presence of an ureterocoele was recorded in 41 (43.2%) patients, an ectopic ureter in 25 (26.3%), a vesicoureteral reflux (VUR) in 40 (42.1%), a vesicoureteric junction obstruction in 24 (25.3%) and an ureteropelvic junction obstruction in 3 (3.2%). An invasive approach such as an heminephrectomy (71.6%) was required in the majority of cases. Higher risk of developing a UTI has been demonstrated in children diagnosed postnatally (P < 0.001) and in those with an associated obstruction (P < 0.05).

Conclusions:
No standardised management could be recommended for the surgical treatment of complicated duplex kidney. Children without antenatal diagnosis and with either an upper tract obstruction or VUR are at greater risk to develop UTI and need to be looked after more closely.
Evaluation of the Result of Total Knee Replacement in Various Arthritic Condition of Knee
Authors: Patel Jaydeep , Kapoor Rajat , Verma Ashutosh , Chauhan Randheer , Saini Sushil , Pal Chandra Prakash 
Published: December 2022

Introduction:
Osteoarthritis is the most common form of the arthritis and is a leading cause of disability in older adults. The management of knee arthritis depends upon severity of arthritis. It starts from conservative management in earlier stage and goes upto the total knee replacement (TKR) in severely advance stage. TKR is an operation to restore pain-free motion to a joint, muscle, ligament, and other soft tissue structures that control joint. The goal of total knee arthroplasty is as simple as to relieve pain, provide motion, maintain stability, and simultaneously correcting deformity. The purpose of this study is to evaluate pain, mobility, stability after TKR in arthritis and to evaluate functional outcome.

Materials and Methods:
The case material for present study was selected from the out patient Department of Orthopaedics, S.N. Medical College and Hospital, Agra. Each patient would be subjected to detailed clinical history and examination and necessary radiological and pathological investigation. Data was collected by interviews, observation of clinical and radiological findings and assessment of function done using knee society knee score (having 100 points).

Results:
In this study, evaluation of 10 total knee arthroplasty was performed in S.N. Medical College and Hospital, Agra. In our study most of cases (70%) have age ≥60 years and most of (70%) cases are female in whom TKR was performed. The pre-operative ROM at knee were between 51° and 80° in all the cases (100%). But post-operative after 6 months all the cases have their range of motion between 91° and 110°. Maximum number of the cases (80%) have moderate continuous pain at knee before the operation and rest 20% have moderate occasional pain at their knee preoperatively. After the operation, maximum number of cases (90%) have no pain or mild occasional pain after the operation. Maximum number of cases (90%) have ≥30° increase in their range of motion, after operation. Similarly after TKR, there is an increase in post-operative functional knee scores at 6 months (86.5%) as compared preoperative scores (21%). Though there is an initial fall (16.5%) in the functional score in initial 15 days after operation, it then starts increasing at 1 month and ultimately at 6 month.

Conclusions:
Total knee arthroplasty should definitely be performed over 60 years of age having pain at knee not responding to analgesics with or without any significant deformity at knee. As we found that is no or occasional pain with good range of movement after 6 month of operation so that patient satisfaction level is very high. But large number of patient and ling follow-up is required for long-term result.
Comparison of Dual Plating with Single Lateral Locking Plate Supplemented with Two Medial Cannulated Cancellous Screws for AO Type C Tibial Plateau Fractures—An Experience from Central India
Authors: Jain Nikhil , Agarwal Saurabh , Nagaich Abhishek 
Published: December 2022

Background:
Type C tibial plateau fractures are complex injuries, and an ideal method for their treatment is still controversial. In the present study, we discuss the outcomes of Arbeitsgemeinschaft für Osteosynthesefragen (AO) type C tibial plateau fractures treated with dual locking plating and single lateral locking plate supplemented with two medial cannulated cancellous (CC) screws.

Materials and Methods:
This prospective study included 34 patients of AO type C tibial plateau fractures divided into two groups. Dual locking plating and single lateral locking plate supplemented with two medial CC screws were the treatment methods in group 1 and groups II, respectively. The patients were evaluated using the Rasmussen clinical grading system at 1 and 2 years postoperatively.

Results:
The range of motion (ROM) was observed as 121.0° ± 1.9° and 126.3° ± 2.6° in group II, whereas in group I, ROM was 112.5° ± 3.1° and 120° ± 1.5° at 1 and 2 years, respectively. Pain, walking capacity, and final outcome were significantly better in group II at 1 and 2 years postoperatively. No significant difference was observed in two groups in terms of radiological results.

Conclusion:
Lateral locking plate supplemented with two medial CC screws proves to be a better method to treat AO type C tibial plateau fractures in adults, with minimal complications.
Volar Plating vs. External Fixator with Cross K-wire for Distal Radius Fracture
Authors: Agarwal Saurabh , Nagaich Abhishek , Jain Nikhil , Shah Arvind 
Published: December 2022

Background:
Now a days there is increased utilization of volar locking plates fixation over external fixation. However, the comparative complications and outcomes of both surgical methods are still unclear.

Purpose:
The purpose is to compare if volar locking plate is superior to external fixation for distal radius fractures with comparison of complications associated with both surgical methods.

Materials and Methods:
An observational study was done from 2020 to 2022 among patients presented with displaced distal end radius of 30 patients in which 15 were treated with external fixator with cross k – wire and 15 were treated with volar locking plate with an average of 12 month or longer follow up.

Results:
Acceptable functional outcomes were observed with DASH scoring in 70% of study population. The functional outcome score was higher in younger population with an overall complication rate of 17% including pin track infection, hardware related issues, tendon injury, nerve dysfunction.

Conclusions:
In the volar plating patients outcomes (DASH SCORE), In the first 3 and 6 months is better than External fixation, However after 1 year the outcomes of both techniques found equal with little difference in terms of range of motion, grip strength, osteoarthritis.
Role of Teriparatide (rh PTH) in Fracture Healing of Osteoporotic Patient
Authors: Kumar Vinod , Patel Jaydeep , Verma Ashutosh , Yadav Rohit , Pal Chandra Prakash 
Published: December 2022

Introduction:
Osteoporosis a disease where decreased bone strength increases the risk of a fracture. It is the most common reason for fracture among the elderly. Osteoporosis, an imbalance between bone resorption and bone formation. The diagnosis of osteoporosis can be made using conventional radiography and by measuring the bone mineral density. Osteoporosis is diagnosed when the bone mineral density is less than or equal to 2.5 standard deviations below that of a young reference. Teriparatide, a recombinant form of parathyroid hormone (identical to a portion of human parathyroid hormone (PTH)), intermittent use activates osteoblasts more than osteoclasts, which leads to an overall increase in bone turnover. Teriparatide is the only anabolic agent (i.e., bone growing) indicated for use in postmenopausal women with osteoporosis at a high risk for fracture or with a history of osteoporotic fracture, patients with multiple risk factors for fracture. It has been FDA-approved since 2002.

Materials and Methods:
Over duration of october 2016 to march 2018, 60 patients who have fracture with osteoporosis admitted in S.N. Medical College, Agra. Patient suspected to have osteoporosis based on conventional radiography. Selected patients in the study undergone confirmation of osteoporosis by dual energy absorptiometry and those who are below 2.5 standard deviation are kept in study. Patients fitting into inclusion criteria would form the study group. Data collected by interviews, observation of clinical and radiological findings. 60 patients divided in two groups as cases and controls. Cases are subjected to teriparatide therapy and controls given placebo.

Results:
Bone formation marker alkaline phosphatase were 150% above baseline after 8 weeks in the teriparatide-treated patient. At 8 weeks, approximately 91.037% in the teriparatide group showed improved healing of osteoporotic fracture compared to 57.14% in the placebo group.

Conclusion:
Our findings suggest that teriparatide provide selective advantages to fracture healing or functional recovery in the management of osteoporotic fractures. Teriparatide effective in accelerating and increasing the rate of fracture healing. However, more randomized controlled trials are needed to evaluate with certainty the impacts of Teriparatideosteoanabolic role in fracture healing to decide on incorporate this drug as a standard option for conservative management of osteoporotic fracture.
Functional and Radiological Outcome of Isolated Shaft of Humerus Fracture Managed with Functional Cast Brace
Authors: Naresh G. , Jaiswal Sankalpa , Yadav Ajay Kumar , Pandey Sarvesh Kumar , Kamboj Naman , Rajan Ravi , Khare Rahul 
Published: December 2022

Purpose:
Functional Cast Bracing is a most common, universally following method of conservative management of shaft of humerus fracture. The objective of this study were to assess union rate, complications and risk factors associated with non-union of shaft of humerus fracture and same were evaluated with functional cast brace.

Materials and Methods:
The study was designed as a Descriptive observational study. Patients who presented with closed isolated shaft of humerus fracture as diagnosed by clinical and radiological were included in the study (n = 83). Patients were managed with closed reduction and “U” slab application for about 2nd weeks. On 3rd week of post injury “U” slabs were removed and functional cast braces were applied. Functional (Constant-Murley score) and radiological outcome were assessed on 4th, 6th and 12th weeks of post injury.

Results:
Total 83 patients were included in this study. Union rate was 84.4% (n = 70), non-union rate was 15.6%(n = 13) and the risk factors which associated with non-union were occupation (more in laboured, n = 9(37.5%)), socioeconomic status (more in lower socioeconomic status, n = 9(50%)), smoking (more in smoker, n = 9(60%)) and type of fracture (more in spiral fracture, n = 7(50%)).

Conclusion:
Union rate was (84.4%) more and non-union rate was less (15.6%) of shaft of humerus fracture managed with functional cast brace. Occupation, socioeconomic status, smoking and spiral type of fracture were associated with non-union.
A study of microalbuminuria in sepsis with reference to acute physiology and chronic health evaluation II score in patients admitted to a medical intensive care unit
Authors: Katyarmal D. T. , Bhargav K. M. , Ganesh M. , Manolasya Venkat , Nimmanapalli Harinidevi , Sarma K. V. S. 
Published: December 2022

Background:
Prediction of outcome of critically ill patients helps in early aggressive therapy, optimum resource allocation and counselling of the family. This study was conceived to assess the predictive value of microalbuminuria, which is an underutilised biomarker.

Methods:
This was a longitudinal observational study conducted between March 2018 and June 2019 to assess microalbuminuria in patients with and without sepsis and to evaluate whether the degree of microalbuminuria could predict mortality in sepsis, and its association with to the acute physiology and chronic health evaluation II (APACHE II) score and the sequential organ failure assessment (SOFA) scores.

Results:
Among the 105 patients studied, 56 (53.3%) were male. This included patients with sepsis (n = 51) and without-sepsis (n = 54). The mean APACHE II score in sepsis group was 11.5 ± 3.5, in non-sepsis group was 8.2 ± 3.7 and overall was 9.8 ± 4.0. SOFA score in sepsis group was 3.0 ± 1.5, in non-sepsis group was 1.19 ± 1.15 and overall was 2.0 ± 1.6. The mean albumin/creatinine ratio (ACR) 1 and ACR2 among survivors were 150.5 ± 95.2 and 152.2 ± 87.2 and among non-survivors were 230.9 ± 43.9 and 287.8 ± 8.70, respectively. ACR2 performed similar to APACHE II in predicting mortality (difference between areas = 0.239; standard error = 0.0593 [95% confidence intervals: 0.123–0.355]; P = 0.0001).

Conclusions:
ACR2 had the highest value among ACR1, ACR2 and APACHE II for predicting mortality.
Magnitude and Holmes–Thompson intrinsic volumes of convex bodies
Authors: Meckes Mark W. 
Published: December 2022

AbstractMagnitude is a numerical invariant of compact metric spaces, originally inspired by category theory and now known to be related to myriad other geometric quantities. Generalizing earlier results in
$\ell _1^n$
and Euclidean space, we prove an upper bound for the magnitude of a convex body in a hypermetric normed space in terms of its Holmes–Thompson intrinsic volumes. As applications of this bound, we give short new proofs of Mahler’s conjecture in the case of a zonoid and Sudakov’s minoration inequality.
Residency and Fellowship Program Leaders' Perceptions of Virtual Recruitment and Interviewing
Authors: Das Anjali J. , Augustin Ryan C. , Corbelli Jennifer A. , Bump Gregory M. 
Published: December 2022

ABSTRACT

Background
Virtual recruitment is a new and more cost-effective alternative to traditional in-person recruitment in academic medicine. However, little is known about the perceived repercussions of the switch across a variety of training settings.

Objective
To describe the perceptions of graduate medical education program leaders about virtual matching and preferred format for future recruitment within an integrated health care delivery system sponsoring residency and fellowship programs at both university- and community-based primary teaching sites.

Methods
We surveyed program leadership of 136 Accreditation Council for Graduate Medical Education programs at a single sponsoring institution in April 2021, following residency match results but before matched applicants began programs. The 40-item survey pertained to various aspects of recruitment. Select questions were assessed using a 5-point Likert scale. Descriptive statistics, Student's t test, and ordinal linear regression models were used for analysis.

Results
Out of 136 programs, 129 (94.8%) responded. Overall, preferred format for recruitment was neutral, although there was wide heterogeneity of responses. Programs felt that virtual recruitment marginally decreased their ability to describe strengths but did not affect the strength or diversity of their matched class. Community sites preferred in-person recruitment.

Conclusions
Programs did not perceive that virtual recruitment affected the strength or diversity of their 2021 matched class, although community programs were more likely to prefer in-person formats.