bluuebunny/crossref_metadata_2025_split huggingface dataset:
Board of Certification Examination Achievement Gaps as a Barrier to Diversifying the Athletic Training Profession
Authors: Harris Nicolette A. , Eberman Lindsey E. 
Published: April 2022

Context
Achievement gaps have been well documented in the medical and health professions. Previous researchers have indicated that individuals from underrepresented minority groups consistently fall short of White candidates in performance on standardized credentialing examinations.

Objective
To determine the relative risk of failure by ethnicity and first-time and retake pass rates on the Board of Certification (BOC) examination.

Design
Descriptive study.

Setting
Professional master's degree athletic training programs.

Patients or Other Participants
A total of 3742 unique candidates with 4425 attempts between examination windows 1 of 2011–2012 (April) and 5 of the 2019–2020 (February) cycle of the BOC examination.

Main Outcome Measure(s)
Ethnicity as self-selected by the candidates, attempt number, result of each attempt, year, and testing window.

Results
Examination candidates self-identified as White (60.4%, n = 2261/3742), unknown (ie, withheld an ethnicity selection; 10.6%, n = 395/3742), Hispanic (8.6%, n = 320/3742), or African American (8.4%, n = 313/3742). On the first attempt, White candidates passed at a rate of 93.2% (2107/2261), African American candidates at 74.8% (234/313), and Hispanic candidates at 86.9% (278/320; overall first-time pass rate for this subsample = 90.5%, 2619/2894). The relative risk of first-attempt failure was higher for African Americans than for both White (relative risk = 3.706, 95% CI = 2.903, 4.730; P &lt; .001) and Hispanic (relative risk = 1.923, 95% CI = 1.368, 2.703; P &gt; .001) candidates. For Hispanic candidates, the relative risk of first-attempt failure was about 50% lower than for White candidates (relative risk = 0.519, 95% CI = 0.377, 0.715; P &lt; .001).

Conclusions
Achievement gaps existed between White candidates and those from ethnic minority groups in athletic training. Diversification of the athletic training workforce will require ensuring equity in preparation for and success on the BOC examination.
Neuroendocrine Tumors of Gastrointestinal Tract With Special Reference to Immunohistochemistry Markers at a Tertiary Care Hospital
Authors: Abdullah Hilal , Wani Zahid , Nabi Zarkah , Shah Parveen , Bhat Shuaeb 
Published: April 2022

Background:
Neuroendocrine tumors (NETs) are epithelial neoplasms that originate from the endocrine cells, contain cytoplasmic granules, and secrete a variety of biogenic amines, which are responsible for a variety of signs and symptoms produced by these tumors. Endocrine cells are interspersed within the mucosa of the gastrointestinal tract (GIT) and are also present in a variety of other viscera such as pancreas, adrenal gland, lung, and thyroid. The present study included forty cases of NETs of the GIT (excluding pancreas) reported in the Department of Pathology at Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, Kashmir. The objectives of this study were to study the histopathological spectrum of NETs of the GIT and to evaluate the immunohistochemical (IHC) expression of chromogranin, synaptophysin (SYP), neuron-specific enolase, and Ki-67 (MIB) in these tumors.

Materials and Methods:
The study was conducted at the SKIMS, Srinagar, Kashmir, in the Department of Pathology. It was a prospective study for a period of 1½ years starting from July 2015 to December 2016 and retrospective study for 3½ years from January 2012 to June 2015. The study included all cases of NETs of GIT with or without nodal metastasis.

Results:
Most of the tumors were well-differentiated NETs (45% G1 and 25% G2). Stomach was the most common site (27.5%) followed by duodenum (25%). Regional lymph node involvement was present in 25% of the cases. Liver was the most common site for distant metastasis. There was a slight female predominance (57.3%). On IHC, SYP, chromogranin-A, and neuron-specific enolase were positive in 100%, 77.5%, and 85% of cases, respectively. Ki-67/MIB-1 index was used to grade the neuroendocrine neoplasms and 45% were graded as G1 NETs, 25% as G2 NETs, and 30% as NEC.

Conclusion:
Lately, there has been a surge in the number of cases being diagnosed as NETs most probably due to advancement in various diagnostic modalities and increasing knowledge about these tumors which have helped in diagnosing more of these tumors early and correctly.
Varied Profile in Acute Coronary Syndrome
Authors: Shah Chetsi , Bhende Punam , Ghosh Labani M. , Mannari Jyoti G. 
Published: April 2022

Objective:
The objective was to study the clinical profiles of patients undergoing coronary angiography (CAG).

Setting and Design:
It was a cross-sectional retrospective study of 207 patients who have undergone CAG at B and M Cardiac Centre, Shree Krishna Hospital, from study period of September 2018 to April 2019.

Materials and Methods:
The patients included were those undergoing CAG of more than 20 years of age. Those who underwent coronary artery bypass graft in the past or re-do CAG and those under 20 years of age were excluded. Data were entered and analyzed with Epi Info version 7.

Statistical Analysis:
Association between categorical variables was tested with Chi-square test.P<0.05 was considered statistically significant.

Observations and Results:
Males were higher in the age group of 50–59 years while females predominated in the higher age groups. Hypertension was the most common comorbidity (43.48%) followed by diabetes. Males presented predominantly with anterior and inferior wall myocardial infarction (MI) whereas non-ST-elevation MI, unstable angina, chronic cardiac failure, and atypical presentation were higher in females. Twenty-two percent had normal electrocardiogram whereas a CAG was normal in 22.7% of the patients. Left anterior descending (LAD) involvement was predominant in both males (78.81%) and females (78.57%). Single-vessel disease (SVD) was significantly higher in females (45%). Chest pain (87.4%) and dyspnea (23.2%) were the most common complaints. Smoking was the most significantly associated addiction (P < 0.05).

Conclusion:
The most common presentation is unstable angina followed by anterior wall MI (AWMI). SVDs are common in females, but when presented with AWMI, triple-vessel disease was found to be most commonly associated with AWMI in females than males. As age progresses, the number of vessels involved increases. Echo is best correlated with anterior and inferior wall MI. LAD is the most common culprit vessel in both males and females. Multiple vessel involvement was common in diabetics. SVD was most common in hypertensives.
Assessment of Knowledge and Practice Trends about COVID-19 Disease and Vaccination among Patients with Type 2 Diabetes Mellitus Attending an Outpatient Department of a Tertiary Care Hospital
Authors: Swain Jayshree , Manglunia Ankit , Mangaraj Swayamsidha , Singh Jaspreet , Sravya S. L. , Jadhao Pooja 
Published: April 2022

Background:
COVID-19 pandemic has been the most challenging health-care crisis of modern times which has severely impacted the health-care and economic infrastructure of all affected nations. Diabetic people are at an increased risk of morbidity as well as mortality from COVID-19 infection. Efforts to stop the spread of any pandemic depend upon the people's knowledge regarding the preventive measures as well as their attitudes and healthy practices. The purpose of this study is to assess the knowledge, attitude, and healthy practices of the diabetic population in our part of the country toward COVID-19 pandemic as well as toward ongoing vaccination drive in our country.

Materials and Methods:
This is an observational study, face-to-face interview with the type 2 diabetes patients attending our endocrine outpatient department regarding the knowledge, attitude, and practice questionnaire. The knowledge questionnaire took into account the current knowledge regarding COVID-19 and its relationship with diabetes mellitus as well as healthy practices to be followed during pandemic.

Results:
Among our study population, around 78% of the participants had an average knowledge while 10% still had below-par knowledge. There was significant discordance between knowledge and healthy practices among the studied subjects. Even when patients had knowledge about the precautions to be taken, they were not following it strictly. In our study, nearly 54% of the subjects expressed confidence over the efficacy of the vaccine. Similarly, 53% of the subjects knew that they are supposed to follow social distancing norms and wear masks even after vaccination to prevent the spread of COVID-19.

Conclusion:
The knowledge of our diabetic population related to COVID-19 pandemic is still average. Even with average knowledge, there is a wide gap between knowledge and health practices. The attitude of the diabetic population toward vaccination is still below par which could have implications regarding vaccine acceptability.
Red, Necrotic Papule and Lymphadenopathy in an Immunocompromised Patient
Authors: Clarke Emily L. , Willenbrink Tyler J. , Keeling Brett 
Published: April 2022

Abstract
Immunocompromised patients, including those with acquired immunodeficiency syndrome (AIDS), are susceptible to a variety of opportunistic infections, cutaneous malignancies, and other skin lesions, which can present with nonspecific cutaneous findings. Herein, we present the case of a 28-year-old male with AIDS who presented with fatigue, left axillary lymphadenopathy, and a necrotic, red papule on the left upper arm. This case reviews the differential diagnosis of this presentation in an immunosuppressed patient including the key pathological findings.
Observational Study on Saveng Protocol of Glucose Control in Intensive Care Unit
Authors: Saseedharan Sanjith , Udhoji Prasad , Kadam Vaijyanti , Chiluka Annapurna , Mathew Elizabeth J. , Talwalkar Pradeep G. , Argikar Arvind , Boraskar Anil , Phatak Ragunath , Kulkarni Nikhil , Baghel Paritosh , Patil Adwait , Gadgil Yatin , Patil Kiran , Jain Shailesh Kumar 
Published: April 2022

Background:
Hyperglycemia (>180 mg/dL or >10.0 mmol/L) has serious health implications in intensive care unit (ICU) patients. The aim of the present study was to explore the effectiveness of SavenG (Sanjith's Very Easy Nurse managed glucose control) protocol in the maintenance of glucose concentration in ICU patients.

Materials and Methods:
In this observational study, a total of 108 patients admitted to the ICU unit of SL Raheja hospital, a tertiary care institute in Mumbai, were enrolled. The patients received insulin therapy as proposed in SavenG protocol. The glucose in serum was measured using a glucometer and was categorized into three levels: <150 mg/dL, 150–200 mg/dL, and >200 mg/dL. The collected data were statistically analyzed by using SPSS version 24.0.

Results:
Patients were primarily male (69%), with an average age of 63.96 ± 13.14 years, reporting at least two complications (1.49 ± 1.03), and with a greater risk of hypertension (60%). Higher doses of insulin (~59.9 units) were administered on the first two days of protocol. By day 5, the requirement of insulin dose was gradually decreased to 36.8 units. The insulin was administered for totally seven days. The insulin dosing that was administered was sufficient to maintain the glucose level of 150–200 mg/dL for 12 h (F = 79.35, P < 0.01) and this sugar level showed a comparatively lower level of variation within a day (F = 13.123, P < 0.01). Further, the sugar level was not influenced by demographic characteristics such as age, gender and concomitant complications such as hypertension, ischemic heart disease, coronary artery bypass grafting, and kidney disease.

Conclusion:
The proposed SavenG protocol validates the effectiveness of insulin doses to regulate and maintain the glucose level at 150–200 mg/dL for 12 h within a day in ICU patients.
Evaluation of Serum 1,5-Anhydroglucitol Levels as Hyperglycemic Indicator in Patients with Newly Diagnosed Type 2 Diabetes Mellitus
Authors: Vanagamudi Ashok , Padmini Jeyarajan 
Published: April 2022

Background and Objectives:
1,5-Anhydroglucitol (1,5-AG) is an emerging marker in the acute assessment of glycemia. 1,5-AG has been shown to be associated with glycemic excursions and also been found to have association with microvascular complications of diabetes and atherosclerosis. This study aimed to evaluate serum 1,5-AG concentration in newly diagnosed type 2 diabetes patients and find the correlation between serum 1,5-AG concentration and blood glucose concentration.

Materials and Methods:
The study group consisted of 60 type 2 diabetes patients aged 35–55 years and 60 age- and sex-matched controls. 1,5-AG plasma level, HbA1c, fructosamine, and blood glucose were measured in all subjects. Data analysis was done using SPSS software.

Results and Discussion:
1,5-AG levels were significantly lower in patients with diabetes mellitus when compared with the control group. 1,5-AG serum level negatively correlated with postprandial blood glucose. The linear regression analysis revealed that 1,5-AG had a linear association with postprandial blood glucose.

Conclusion:
Serum 1,5-AG levels significantly decreased with an increase in plasma glucose concentrations in patients with diabetes mellitus. Thus monitoring of serum 1,5-AG level may be useful for evaluating glycemic control in patients with newly diagnosed diabetes mellitus.
Територіальна оборона та її медичне забезпечення – веління сьогодення
Authors: Pechyborsch V. P. , Yakimets V. M. , Ogorodniychuk I. V. , Yakimets V. V. , Pechyborsch O. V. 
Published: April 2022

Мета роботи полягає в дослідженні позитивного досвіду АТО/ООС та шляхів оптимізації діяльності медичних сил ЗС України з метою створення оптимізованої моделі організації медичного забезпечення Сил територіальної оборони в умовах національного спротиву - територіальної оборони, руху опору та підготовки громадян України до національного спротиву.
Матеріали та методи. Вивчали стан організації медичного забезпечення Сил територіальної оборони, проблемні питання та шляхи їх вирішення на предмет позитивного досвіду організації медичного забезпечення Сил оборони в АТО/ООС та екстреної медичної допомоги (далі ЕМД) в надзвичайних ситуаціях (далі НС) в системі охорони здоров’я України та Єдиній державній системі цивільного захисту. Матеріалами слугували нормативно-правові акти, що регламентують діяльність медичних сил ЗС України, та ЕМД в НС, публікації у відкритих джерелах інформації. Методи досліджень: бібліографічний, аналітичний, системного підходу
Результати. В результаті проведеного аналізу визначено, що медичні сили ЗС України в цілому готові до виконання завдань за призначенням, але повна готовність медичної служби командування Сил територіальної оборони як органу управління медичним забезпеченням, медичної служби бригад та батальйонів Сил територіальної оборони у такий короткий термін не можлива, але є альтернативні варіанти вирішення цієї важливої державної проблеми.
Висновки. Медична служба Сил територіальної оборони зможе виконати завдання з надання медичної допомоги особовому складу підрозділів Сил територіальної оборони та населенню у повному обсязі при умові використання територіального принципу в єдиному медичному просторі із залученням сил і засобів територіальних підрозділів Центрів ЕМД та медицини катастроф областей та наявних закладів охорони здоров’я, підсистеми медичного захисту в Єдиній державній системі цивільного захисту.
Research on the composition development of suppositories with echinacea and study of their stability
Authors: Herasymova I. V. , Yurieva H. B. , Yarnykh T. H. , Voronenko D. V. 
Published: April 2022

The purpose of the work was to experimentally substantiate the composition and study the stability of extemporal suppositories with Echinacea, intended for use in complex therapy and prevention of genitourinary diseases.
Materials and methods. The object of the study was samples of suppositories made by pouring using liquid Echinacea extract as an active pharmaceutical ingredient. Cocoa butter, Witepsol H15 and Witepsol W35 were used as suppository bases. The study was carried out using modern physicochemical, pharmaco-technological and microbiological methods.
Results. On the basis of the carried out physicochemical and pharmaco-technological studies, it was found that in the manufacture of suppositories using liquid Echinacea extract, Cocoa butter or Witepsol can be used as a suppository bases. The main indicators of the quality of suppository samples were also studied: organoleptic characteristics, average weight, melting point, time of complete deformation, microbiological purity, meeting the requirements of the State Pharmacopoeia.
Conclusions. As a result of the carried out physicochemical, pharmaco-technological and microbiological studies, a suppository base was selected for the creation of extemporal suppositories for the treatment and prevention of genitourinary diseases, the main quality indicators were established that meet the requirements of the State Pharmacopoeia of Ukraine, and the shelf life of the suppositories is 10 days.
Four decades of urolithiasis: What has changed in our practice?
Authors: Manzoor Hussain  , Saeed Abidi  
Published: April 2022

Urolithiasis is the most common urologic disease in Pakistan, which is treated and managed by urologists throughout their careers.1 Its exact prevalence and incidence has never been investigated in the country, but a few rough estimates show the disease prevalence to be 9-15%.2 The oldest study on urolithiasis on 400 patients, was published in 1975, which showed predominantly bladder stone disease accounting for 60% of all cases.3 After the first publication, about 35 papers have been published on this subject from Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan. SIUT is a major tertiary care urology and nephrology center with a catchment area extending to almost the entire country.
In this resume the subject of stone disease from 1971 onwards will be presented to note the changes in its epidemiology and management. Collectively, 83,107 adult stone patients were treated during the above period. The number of stone patients has increased enormously from 2,345 between 1971-1982 to 8,905 during 1983-1993, and 27,541 during 1994-2004 period. Finally, during the years, 2005-2014, 45,318 patients were managed.4 This tremendous increase in the number of patients could be attributed to increasing free facilities of minimally invasive surgery including Extracorporeal shock wave lithotripsy (ESWL), Percutaneous Nephrolithonomy (PCNL) and Ureteroscopy (URS) at this institute, availability of ultrasound at tehsil and district level hospitals, or due to increasing incidence and prevalence of stone disease in the country.
Similarly, if the peak age and gender differences at different periods in the four decades are studied, then it can be seen that from 1972-1974, the peak age was 21-40 years with M:F ratio of 4.5:1.3, in 1987-1990, it was 31-40 years with M:F ratio 4.1:1, in 1991-1993, it was 21-30 years with M:F ratio of 4.8:1, in 2001-2004, it was 31-40 years with M:F ratio of 1.7:1.4
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Prediabetes: A Pragmatic approach to counselling and coaching
Authors: Sanjay Kalra  , Arbinder Singal  , Nitin Kapoor  
Published: April 2022

Prediabetes is often considered as the link between normoglycaemia and diabetes. Though a lot of emphasis is given to an individual after the development of diabetes, pre-diabetes is often not adequately addressed in clinical practice. Given a distinct diagnostic criterion, its association with metabolic complications, an opportunity to prevent further progression to diabetes and the large number of people affected with it, makes it a subject of great importance and opportunity. In this brief manuscript we compare and contrast prediabetes with diabetes mellitus. We also describe a pragmatic approach to address a patient with prediabetes.
Keywords: Prediabetes, Diabetes, Diabetes Education, Counselling, Diabetes coach, Lifestyle therapy, Behavior change.
Correlation of insulin resistance with neutrophil to lymphocyte ratio and serum ferritin in male patients of metabolic syndrome
Authors: Uzma Zafar  , Ali Zaima , Khaliq Saba , Lone Khalid Pervaiz 
Published: April 2022

Objective: To determine the correlation of insulin resistance with neutrophil-to-lymphocyte ratio and serum ferritin, and to evaluate whether NLR and serum ferritin can predict insulin resistance in metabolic syndrome.
Method: The cross-sectional analytical study was conducted at the University of Health Sciences, Lahore, Pakistan, from July 2016 to 2019, and comprised male patients of metabolic syndrome and healthy controls. The correlation involving insulin resistance, serum ferritin and neutrophil-to-lymphocyte ratio was determined. Data was analysed using SPSS 22.
Results: Of the 210 subjects, 160(76.2%) were cases with a median age of 45 years (interquartile range: 39-50 years), and 50(23.8%) were controls with a median age of 41 years (interquartile range: 35-50 years). Serum ferritin, alanine aminotransferase, total neutrophil count, lymphocyte count and neutrophil-to-lymphocyte ratio were significantly higher among the cases than the controls (p<0.05). Significant positive correlation of insulin resistance was observed with serum ferritin and neutrophil-to-lymphocyte ratio (p<0.05)) among the cases. Neutrophil-to-lymphocyte ratio significantly predicted insulin resistance among the cases (p<0.05).
Conclusion: Neutrophil-to-lymphocyte ratio was fund to be a significant predictor of insulin resistance in metabolic syndrome.
Key Words: Neutrophil to lymphocyte ratio, Ferritin, Type 2 diabetes. Insulin resistance.
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Psychological correlates of sexual self-esteem in young women
with Mayer-Rokitansky-Küster-Hauser syndrome
Authors: Beisert Maria , Chodecka Aleksandra , Walczyk-Matyja Katarzyna , Szymańska-Pytlińska Marta , Kędzia Witold , Kapczuk Karina 
Published: April 2022

IntroductionMayer-Rokitansky-Küster-Hauser syndrome (MRKHS) is a difference (disorder) of sex development that results from Müllerian duct aplasia in 46,XX females. The diagnosis of MRKHS is usually established in late adolescence. The purpose of the study was to assess the impact of congenital absence of uterus and vagina (CAUV) on a patient’s psychosexual functioning.Participants and procedureThirty-two women with MRKHS (mean age 22.9 years) and 32 matched healthy controls (mean age 24.75 years) completed three study questionnaires: the Sexual Self-Esteem Inventory for Women, the Rosenberg Self-Esteem Scale, and Minnesota Multiphasic Personality Inventory-2 (MMPI-2). Statistical analysis was performed by IBM SPSS Statistics 22.ResultsThere was no difference in global self-esteem between the two study groups. MRKHS females had lower sexual self-esteem and experienced higher intensity of some psychological functioning characteristics (paranoia, psychasthenia, schizophrenia) than their peers. Correlations between sexual self-esteem and results on depression, psychopathic deviate, schizophrenia, social introversion and anxiety scales were observed in patients with MRKHS. Global self-esteem and schizophrenia results were significant predictors of sexual self-esteem in the clinical group. Higher global self-esteem and lower results in the schizophrenia scale were associated with higher sexual self-esteem in patients with MRKHS.ConclusionsPsychological and medical counseling of women with MRKHS should address their impaired sexual self-esteem, especially sexual skills and experiences. While the number of diagnostic responses indicating the presence of specific symptoms in MRKHS females is statistically significantly different, the level of scores obtained does not exceed the threshold of clinical pathology.