Experiences and challenges of people living with multiple long-term conditions in managing their care in primary care settings in Kerala, India: A qualitative study.

Background: Multimorbidity or multiple long-term conditions (MLTCs), the coexistence of two or more chronic conditions within an individual, presents a growing concern for healthcare systems and individuals' well-being. However, we know little about the experiences of those living with MLTCs in low- and middle-income countries (LMICs) such as India. We explore how people living with MLTCs describe their illness, their engagements with healthcare services, and challenges they face within primary care settings in Kerala, India.

Thrombus histology does not predict stroke etiological subtype but influences recanalization.

Background: There is conflicting data on whether clot retrieved from mechanical thrombectomy can predict stroke etiology or the success of recanalization. We aimed to analyse the relation between thrombus histology and stroke aetiology as well as recanalization.

Methodology: Histopathological analysis of clots retrieved from patients with acute ischemic stroke and large vessel occlusion was done.

Awareness of risk factors, symptoms and screening of breast cancer: A cross-sectional survey among 35-65-year-old women in Alappuzha district, Kerala, India.

Background: Breast cancer awareness is vital to enhance early detection and treatment, thus improving women's quality of life and reducing the breast cancer burden in a country. This paper describes breast cancer awareness among women in the Alappuzha district, Kerala.

Methods: A community-based cross-sectional survey was conducted among 320 women aged 35-65 using a multi-stage cluster-sampling method.

Natural history of coronary stents: 14 year follow-up of drug eluting stents versus bare metal stents.

Background: Several randomized trials have shown the effectiveness of drug-eluting stents (DES) over bare metal stents (BMS) in terms of repeat revascularization at 1 year; however long term data in this context is conflicting.

Aim: To assess the long term clinical outcomes after coronary artery stenting with drug-eluting stents and bare metal stents.

Methods: This is a retrospective cohort study, including 100 consecutive patients with Coronary Artery Disease who underwent successful percutaneous intervention (PCI) with implantation of DES and contemporary 100 patients who underwent PCI with implantation of BMS in the years 2005 and 2006 at our center.

27-Hydroxycholesterol represses G9a expression via oestrogen receptor alpha in breast cancer.

27-hydroxycholesterol (27-HC) is a cholesterol metabolite and the first discovered endogenous selective estrogen receptor modulator (SERM) that has been shown to have proliferative and metastatic activity in breast cancer. However, whether 27-HC metabolite modulates the epigenetic signatures in breast cancer and its progression remains unclear. The current study, reports that 27-HC represses the expression of euchromatic histone lysine methyltransferase G9a, further reducing di-methylation at H3K9 in a subset of genes.

Quantitative susceptibility mapping from basal ganglia and related structures: correlation with disease severity in progressive supranuclear palsy.

Objective: We examined whether mean magnetic susceptibility values from deep gray matter structures in patients with progressive supranuclear palsy (PSP) differed from those in patients with Parkinson's disease (PD) and healthy volunteers, and correlated with the PSP rating scale.

Methods: Head of caudate nucleus, putamen, globus pallidus, substantia nigra and red nucleus were the regions of interest. Mean susceptibility values from these regions in PSP patients were estimated using quantitative susceptibility mapping.

Effectiveness and implementation of a lifestyle modification intervention for women with isolated impaired fasting glucose: Study protocol for a hybrid type 2 study in Kerala, India.

Isolated impaired fasting glucose (i-IFG) constitutes a major group in the prediabetic spectrum among Indians, and thus it is imperative to identify effective diabetes prevention strategies. This study aims to evaluate the effects of an intensive community-based lifestyle modification program on regression to normoglycemia among women with i-IFG, compared to a control group at 24 months. The study also aims to evaluate the implementation of the intervention, via both process and implementation outcomes.

Carotid Endarterectomy for Symptomatic Carotid Stenosis: Differences in Patient Profile in a Low-Middle-Income Country.

Introduction: Carotid endarterectomy (CEA) is the standard treatment for patients with symptomatic carotid stenosis. Data from low- and middle-income countries are sparse on CEA and its outcomes. We aimed to describe the profile of our patients and factors associated with periprocedural cerebral ischemic events in patients with symptomatic carotid stenosis who underwent CEA in our institute.

Association of 24 h Blood Pressure on Functional Outcome in Patients with Acute Ischemic Stroke Post Intravenous Thrombolysis.

Introduction: Elevated admission blood pressure (BP) and BP variability have been shown to be associated with poor outcomes in most studies, while few studies have not found such an association. We investigated the association of various BP parameters with 3-month functional outcomes, mortality, and symptomatic intracerebral hemorrhage (sICH) in patients with acute ischemic stroke (AIS) receiving intravenous thrombolysis (IVT).

Methods: Patients with AIS who received IVT between January 2012 and March 2020 were analyzed.

Does thrombus imaging characteristics predict the degree of recanalisation after endovascular thrombectomy in acute ischaemic stroke?

Background: Identification of computed tomography (CT) thrombus imaging characteristics can predict the degree of recanalization and outcome after endovascular thrombectomy (EVT) in patients with acute ischaemic stroke and large vessel occlusion.

Aim: We analyzed the thrombus imaging characteristics and procedural factors and correlated with the degree of recanalization and functional outcome after EVT.

Methods: We evaluated the thrombus imaging characteristics (hyperdense MCA sign, thrombus location, length and thrombus permeability) from thin slice CT and CT angiogram.

Hypertension control in Kerala, India: A prescription-based study at primary and secondary level health care institutions.

Objective: We undertook a prescription-based study to identify the provider and institution-level factors related to achieving guideline-recommended control of hypertension and diabetes mellitus in Kerala, India.

Methods: This cross-sectional study in primary and secondary care hospitals in Kerala included both public and private institutions. One practitioner was selected from each institution.

Contraception for married adolescents (15-19 years) in India: insights from the National Family Health Survey-4 (NFHS-4).

Purpose: Despite the fact that marriage below the age of 18 years is illegal in India, a considerable number of females get married and start childbearing during their adolescent years. There is low prevalence of contraceptive methods and high unmet need for family planning (FP). Realizing this, new government programs have been launched to increase the uptake of sexual and reproductive health services among adolescents.

A Comparative Study of Invasive Modalities for Evaluation of Pulmonary Arteriovenous Fistula after Bidirectional Glenn Shunt.

Development of pulmonary AV fistula (PAVF) after bidirectional glenn shunt (BDG) results in significant cyanosis, impaired exercise performance, and increased morbidity and mortality. We attempted to detect and quantify PAVF in post-BDG patients by saline contrast transesophageal echocardiography (TEE) and compare with pulmonary angiography and pulmonary vein oximetry. This was a prospective study done between 2017 and 2018.

Apraxia of Lid Opening in Subthalamic Nucleus Deep Brain Stimulation for Parkinson's Disease-Frequency, Risk Factors and Response to Treatment.

Background: New-onset apraxia of lid opening (ALO) is reported to occur in Parkinson's disease (PD) patients following Deep Brain Stimulation (DBS). There are only few systematic studies on this uncommon disorder of eyelid movements.

Objectives: We aimed to examine the frequency, temporal evolution, predisposing factors and response to treatment, of new-onset ALO in PD patients who underwent bilateral subthalamic nucleus (STN) DBS.

Challenges of health promotion and education strategies to prevent cervical cancer in India: A systematic review.

Background: Although there is a reduction in cervical cancer incidence over the years, it keeps the second position of the most common cancers among females in India. The aim of this review is to understand the challenges of health promotion and education strategies to prevent cervical cancer in India.

Materials And Methods: This review is based on 78 studies published during 1993-2017 on the topics of awareness, attitude, and acceptance toward cervical cancer, screening, and human papilloma virus vaccination among Indians.

Prevalence of risk factors of non-communicable diseases in Kerala, India: results of a cross-sectional study.

Objective: To estimate the prevalence of non-communicable disease (NCD) risk factors in Kerala.

Design: A community-based, cross-sectional survey.

Participants: In 2016-2017 a multistage, cluster sample of 12 012 (aged 18-69 years) participants from all 14 districts of Kerala were studied.

Asymptomatic Hearing Impairment Frequently Occurs in Early-Onset Parkinson's Disease.

Objective: Recent reports of hearing impairment in Parkinson's disease (PD) have suggested that auditory dysfunction could be a non-motor manifestation of PD. These reports were based on observations of elderly patients for whom presbycusis may, to some extent, have contributed to hearing dysfunction. Therefore, we aimed to explore the auditory functions in younger patients with PD.

Young women's attitude toward gender-equitable norms on domestic chores and violence domains in Trivandrum.

Background: Trivandrum is a place with better educational status for women. The aim of this study is to describe young women's attitude toward gender-equitable norms.

Methods: A cross-sectional survey was conducted in Trivandrum, using multistage cluster sampling method.

Contraceptive use and preferences of young married women in Kerala, India.

Background: As in other states of India, female sterilization is the most widely used contraceptive method in Kerala where women have higher levels of education compared to most other states in India. This paper describes the use and preferences of contraceptive methods among young married women in Trivandrum district, Kerala, India.

Subjects And Methods: A community-based cross-sectional survey was carried out among 203 young married women (18-28 years) during January-March 2015 using multistage cluster sampling method.

Enhanced P-selectin expression on platelet-a marker of platelet activation, in young patients with angiographically proven coronary artery disease.

P-selectin (CD62p) exposure is an established marker for platelet activation. P-selectin exposure can trigger variety of thrombotic and inflammatory reactions. In patients with coronary artery disease (CAD), platelets are activated, and hence, there is increased P-selectin exposure.

Effect of Screening on Variation in Cervical Cancer Survival by Socioeconomic Determinants--a Study from Rural South India.

Background: Socioeconomic factors are associated with screening in terms of reducing the risk of cervical cancer. This study aimed to clearly establish the effect of screening on variation in socio-economic factor-specific survival estimates.

Materials And Methods: Survival estimates were calculated using the life table method for 165 women from the routine care control arm and 67 from the visual inspection with acetic acid screening arm diagnosed with cervical cancer during 2000-2006 in rural south India.

Self-reported physical activity and its correlates among adult women in the expanded part of Thiruvananthapuram City, India.

Data on correlates of physical activity (PA) are limited in India. This study estimated the prevalence and correlates of PA among women. A cross-sectional survey was conducted among 1303 women (mean age 45 years) selected by multistage cluster sampling.