One-year outcomes of a digital twin intervention for type 2 diabetes: a retrospective real-world study.

This retrospective observational study, building on prior research that demonstrated the efficacy of the Digital Twin (DT) Precision Treatment Program over shorter follow-up periods​​, aimed to examine glycemic control and reduced anti-diabetic medication use after one-year in a DT commercial program. T2D patients enrolled had adequate hepatic and renal function and no recent cardiovascular events. DT intervention powered by artificial intelligence utilizes precision nutrition, activity, sleep, and deep breathing exercises.

Polycystic Ovarian Syndrome among Young Women of a University in Central Gujarat - A Cross-sectional Study.

Background: Polycystic ovarian syndrome (PCOS) is one of the most common reproductive endocrinological disorders affecting 6%-8% of women in reproductive years. An early liberal PCOS screening appears to be a cost-effective strategy, benefiting earlier diagnosis and intervention.

Objectives: The objectives are to measure the prevalence of PCOS and factors associated with PCOS among young girl students of a University in Central Gujarat.

Prevalence of menopausal symptoms among women in Vadodara, Central Gujarat: The urban-rural divide.

Aim: The aim of this article is to estimate prevalence of menopausal symptoms among women in the menopausal age group and study the urban-rural differences.

Methods And Design: Analytical cross-sectional study conducted in rural and urban field practice areas of a tertiary care center affiliated to Medical College, where 290 women (145 each from urban and rural areas) were interviewed to measure prevalence of menopausal symptoms. Forty-one symptoms were divided into 'Psycho-somatic' (17 symptoms), 'genito-urinary (9 symptoms)' and musculo-skeletal (5 symptoms) domains.

Out-of-Pocket Expenditure and Opportunity Cost of Leptospirosis Patients at a Tertiary Care Hospital of Gujarat, India.

Introduction: The study investigates the cost incurred by leptospirosis patients as either out-of-pocket expenditure (OOPE) or opportunity cost (OC) and recommends accordingly for the national program on leptospirosis in India.

Objectives: The objective of this study is to determine leptospirosis-related OOPE and OC at a government tertiary care hospital and to disaggregate the total OOPE into contributing cost domains.

Materials And Methods: The OOPE data were collected by the personal interview of confirmed leptospirosis cases who took complete treatment at the hospital in year 2009 using a prestructured questionnaire.

Stigma, Discrimination, and Domestic Violence Experienced by Women Living with HIV: A Cross-sectional Study from Western India.

Background: In India, social issues such as stigma and discrimination are still experienced by many women living with HIV (WLHIV) at various levels such as family, community, or health care settings even after a decline trend in HIV prevalence.

Objectives: To assess stigma, discrimination, and domestic violence among WLHIV attending an antiretroviral therapy (ART) center and its association with unsafe sexual practices.

Materials And Methods: This cross-sectional study was carried out among WLHIV attending an ART center of a tertiary care hospital after obtaining approval from the institutional ethics committee.

Genital lichen sclerosus et atrophicus in females: An update.

Lichen sclerosus et atrophicus is an acquired chronic inflammatory dermatosis commonly affecting the vulvar and perianal regions. It is associated with an increased risk of vulvar cancer even though it is not a premalignant condition itself. The true precursor of cancer associated with lichen sclerosus (LS) is vulvar intraepithelial neoplasia (VIN), differentiated type.

Laparoscopic Hysterectomy Outcomes: Hospital vs Ambulatory Surgery Center.

Background And Objective: Compare operative outcomes of laparoscopic hysterectomy in an outpatient hospital setting versus freestanding ambulatory surgery center.

Methods: Retrospective cohort study of two groups in an outpatient hospital surgery department and freestanding ambulatory surgical center, both serving the Washington, DC area. Women, 18 years or older, who underwent laparoscopic hysterectomy for benign conditions in an outpatient hospital setting between 2011 and 2014 (n = 821), and at an ambulatory surgery center between 2013 and 2017 (n = 1210).

Value-based assessment of hysterectomy approaches.

Aim: By evaluating operative outcomes relative to cost, we compared the value of minimally invasive hysterectomy approaches, including a technique discussed less often in the literature, laparoscopic retroperitoneal hysterectomy (LRH), which incorporates retroperitoneal dissection and ligation of the uterine arteries at their vascular origin.

Methods: Retrospective chart review of all women (N = 2689) aged greater than or equal to 18 years who underwent hysterectomy for benign conditions from 2011 to 2013 at a high-volume hospital in Maryland, USA. Procedures included: laparoscopic supracervical hysterectomy, robotic-assisted laparoscopic hysterectomy (RALH), total laparoscopic hysterectomy, laparoscopic-assisted vaginal hysterectomy, total vaginal hysterectomy (TVH), and LRH.

Epidemiological, clinical, and immunological profile of cases at the time of HIV testing (a clinic-based observational cross-sectional study).

Introduction: With the availability of free antiretroviral therapy (ART), HIV/AIDS has become a chronic manageable disease, but its transmission still continues. Early testing, though desirable, is still a far-fetched goal.

Materials And Methods: Forty-six newly detected HIV cases attending skin and sexually transmitted disease (STD) outpatient department (OPD) were studied.

Laparoscopic-Assisted Myomectomy with Bilateral Uterine Artery Occlusion/Ligation.

Study Objective: Conventional laparoscopic myomectomy (CLM) and robotic-assisted myomectomy (RAM) are limited in the number and size of myomas that can be removed, whereas abdominal myomectomy (AM) is associated with increased complications and morbidity. Here we evaluated the surgical outcomes of these myomectomy techniques compared with those of laparoscopic-assisted myomectomy (LAM), a hybrid approach that combines laparoscopy and minilaparotomy with bilateral uterine artery occlusion or ligation to control blood loss.

Design: Retrospective chart review (Canadian Task Force classification II-1).

Delay before drug susceptibility testing among patients with presumptive multidrug-resistant tuberculosis in Gujarat, India.

Background: Reducing delay in the diagnosis of multidrug-resistant tuberculosis (MDR-TB) by performing genotypic drug susceptibility testing (DST) among eligible patients as early as possible can improve clinical presentation and treatment outcomes and reduce transmission. We aimed to determine the delay from being eligible for DST to performing DST and factors associated with the delay.

Methods: This was a retrospective cohort study involving record review among presumptive MDR-TB patients who underwent genotypic DST from five selected districts in the state of Gujarat, India (2014).

Delay and attrition before treatment initiation among MDR-TB patients in five districts of Gujarat, India.

Gujarat, a state in west India. Although treatment initiation has been improving among patients diagnosed with multidrug-resistant tuberculosis (MDR-TB) in programme settings, it has still not reached 100%. To determine pre-treatment attrition (not initiated on treatment within 6 months of diagnosis), delay in treatment initiation (>7 days from diagnosis) and associated factors among MDR-TB patients diagnosed in 2014 in five selected districts served by two genotypic drug susceptibility testing (DST) facilities and a drug-resistant TB centre in Gujarat.

Family and carer smoking control programmes for reducing children's exposure to environmental tobacco smoke.

Background: Children's exposure to other people's tobacco smoke (environmental tobacco smoke, or ETS) is associated with a range of adverse health outcomes for children. Parental smoking is a common source of children's exposure to ETS. Older children in child care or educational settings are also at risk of exposure to ETS.

Pre- and post-sexual exposure prophylaxis of HIV: An update.

Pitfalls in current HIV prevention strategies include late HIV testing, vulnerability among youth and females; lack of emphasis on treatment, low acceptance of circumcision, and nonavailability of protective vaccines. Continuing high-risk sexual behavior, forceful sex, coercive and nonconsensual sex, rape, and unprotected sexual activities make women the most vulnerable to acquisition of sexually transmitted infection/HIV and necessitates a more radical approach of prevention in high-risk individuals who do not have HIV. Preexposure prophylaxis is defined as the administration of antiretroviral drugs to an uninfected person before potential HIV exposure to reduce the risk of infection and continued during risk.

Drug adherence rate and loss to follow-up among people living with HIV/AIDS attending an ART Centre in a Tertiary Government Hospital in Western India.

Introduction: National AIDS Control Organization (NACO) has expanded the reach of anti retroviral therapy (ART) to combat the epidemic of HIV/AIDS in India which has one of the largest populations of people living with HIV/AIDS (PLWHA) in the world. One of the major challenges related to ART is a lifelong commitment by patients to adhere diligently to daily medication dosing schedules and scheduled visits to the ART center. Hence, the current study is carried out to assess the drug adherence rate and loss to follow-up (LFU) among PLWHA attending ART centre of a tertiary care hospital in Western India.

Predictors of unsafe sexual behavior among people living with human immunodeficiency virus/AIDS attending antiretroviral therapy center in Western India.

Background: As more and more people with human immunodeficiency virus (HIV) live longer and healthier lives because of antiretroviral therapy (ART), an increasing number of sexual transmissions of HIV may arise from these people living with HIV/AIDS (PLWHA). Hence, this study is conducted to assess the predictors of unsafe sexual behavior among PLWHA on ART in Western India.

Materials And Methods: The current cross-sectional study was carried out among 175 PLWHAs attending ART center of a Tertiary Care Hospital in Western India.

A Case-Study of the Resources and Functioning of Two Research Ethics Committees in Western India.

Assessing the resources and functioning of research ethics committees (RECs) in low-resource settings poses many challenges. We conducted a case study of two medical college RECs (A and B) in Western India utilizing the Research Ethics Committee Quality Assurance Self-Assessment Tool (RECQASAT) as well as in-depth interviews with representative members to evaluate REC effectiveness. REC A and B obtained 62% and 67% of allowable points on the RECQASAT.

"When Treatment Is More Challenging than the Disease": A Qualitative Study of MDR-TB Patient Retention.

Background: One-fifth of the patients on multidrug-resistant tuberculosis treatment at the Drug-Resistant-TB (DR-TB) Site in Gujarat are lost-to-follow-up(LFU).

Objective: To understand patients' and providers' perspectives on reasons for LFU and their suggestions to improve retention-in-care.

Design: Qualitative study conducted between December 2013-March 2014, including in-depth interviews with LFU patients and DOT-providers, and a focus group discussion with DR-TB site supervisors.

Predictors of overweight and obesity among school going adolescents of Vadodara city in Western India.

Background: Obesity among adolescents is escalating as a global epidemic which is associated with various lifestyle disorders in later life.

Objective: To assess the factors influencing overweight and obesity among school going adolescents of Vadodara city in Western India.

Methods: The study was carried out among 1050 school going adolescents from 15 schools selected by systematic random sampling after taking written informed consent from the participants.

Loss-To-Follow-Up on Multidrug Resistant Tuberculosis Treatment in Gujarat, India: The WHEN and WHO of It.

Background: Multidrug-resistant Tuberculosis (MDR-TB) is a rising global threat to public health and concerted efforts for its treatment are diluted if the outcomes are not successful, loss to follow up (LFU) being one of them. It is therefore necessary to know the proportion and the associated reasons for LFU and devise effective patient-centered strategies to improve retention in care.

Methods: A retrospective cohort study was conducted at the MDR-TB treatment site (DR-TB Site)in Central Gujarat among all patients registered from February 2010 to June 2013.

Parental determinants of metabolic syndrome among adolescent Asian Indians: A cross-sectional analysis of parent-offspring trios.

Background: The aim of the present study was to investigate the relationship between parental metabolic syndrome (MS) and the risk of MS and associated abnormalities in adolescent offspring.

Methods: This cross-sectional study was performed on 304 adolescents (12-16 years; 236 children with at least one parent and 124 father-mother-child trios) recruited from four schools representing different socioeconomic strata from Vellore, India. Anthropometric data was collected and blood pressure, blood glucose, and lipids were measured.

Evaluation of the effect of Block Level Awareness Campaign on performance indicators of National Leprosy Elimination Program in Vadodara district, Gujarat, India.

Background: Leprosy is probably the oldest disease afflicting mankind and a public health problem for centuries. Many cases are hidden or undiagnosed, especially due to social stigma, and neglect of painless patches. Between years 2001 and 2005, during which time active surveillance for detection of leprosy was in practice, a steep fall in the prevalence rate (PR) of leprosy was observed.

Assessing Institutional Ethics Committees in India Using the IRB-RAT.

Institutional ethics committees (IECs) are currently still in their infancy in low- to middle-income countries (LMICs), which may have important implications with regard to the oversight of the protection of human participants. Understanding how these IECs currently function is a critical first step in helping LMICs build infrastructures that support the protection of research participants and improve the scientific quality of health research worldwide. We assessed the functioning of the IECs at two medical colleges in Gujarat, India, by administering the Institutional Review Board Researcher's Assessment Tool (IRB-RAT) to 42 IEC and faculty members.

Family and carer smoking control programmes for reducing children's exposure to environmental tobacco smoke.

Background: Children's exposure to other people's cigarette smoke (environmental tobacco smoke, or ETS) is associated with a range of adverse health outcomes for children. Parental smoking is a common source of children's exposure to ETS. Older children are also at risk of exposure to ETS in child care or educational settings.