A New Paradigm in Foot and Ankle Outcomes?: Away From Radiographs and Toward Patient-Centered Outcomes.

Having reasonable outcome measures is essential to unbiased research. For years, provider-measured outcomes have been valued as they are more objective and convenient for investigators. However, with the popularity of patient-centered medical care delivery, patient-reported outcome measures are appropriately becoming more popular in foot and ankle research.

Humoral and cellular immune response in patients of liver cirrhosis and immunocompetent recipient of ChAdOx1nCoV-19 Vaccine (Covishield).

Despite the effectiveness of COVID-19 vaccination in reducing the severity of the disease, the demand for booster is increasing in vulnerable populations like elderly and immunocompromised individuals especially with each new wave of COVID-19 in different countries. There is limited data on the sustained immunity against COVID-19 in patients with liver cirrhosis. The study was aimed to compare the T cell and humoral immune response after 1 year of ChAdOx1nCoV-19 Vaccine in patients with liver cirrhosis and healthy health care workers (HCW).

American Association of Clinical Endocrinology Consensus Statement: Addressing Stigma and Bias in the Diagnosis and Management of Patients with Obesity/Adiposity-Based Chronic Disease and Assessing Bias and Stigmatization as Determinants of Disease Severity.

Objective: To focus on the intersection of perception, diagnosis, stigma, and weight bias in the management of obesity and obtain consensus on actionable steps to improve care provided for persons with obesity.

Methods: The American Association of Clinical Endocrinology (AACE) convened a consensus conference of interdisciplinary health care professionals to discuss the interplay between the diagnosis of obesity using adiposity-based chronic disease (ABCD) nomenclature and staging, weight stigma, and internalized weight bias (IWB) with development of actionable guidance to aid clinicians in mitigating IWB and stigma in that context.

Results: The following affirmed and emergent concepts were proposed: (1) obesity is ABCD, and these terms can be used in differing ways to communicate; (2) classification categories of obesity should have improved nomenclature across the spectrum of body mass index (BMI) using ethnic-specific BMI ranges and waist circumference (WC); (3) staging the clinical severity of obesity based on the presence and severity of ABCD complications may reduce weight-centric contribution to weight stigma and IWB; (4) weight stigma and internalized bias are both drivers and complications of ABCD and can impair quality of life, predispose to psychological disorders, and compromise the effectiveness of therapeutic interventions; (5) the presence and of stigmatization and IWB should be assessed in all patients and be incorporated into the staging of ABCD severity; and (6) optimal care will necessitate increased awareness and the development of educational and interventional tools for health care professionals that address IWB and stigma.

Exploring the challenges in the management of childhood pneumonia-qualitative findings from health care providers from two high prevalence states in India.

India ranks among the top five countries in the world in child deaths due to pneumonia. Apart from poor public awareness, inadequate health infrastructure and treatment services have compromised effective management. This qualitative study guided by components of the Andersen-Newman's health care utilization framework explored contextual and community challenges faced by health care providers (HCPs) in the delivery of care services for children with pneumonia in select districts of Uttar Pradesh (UP) and Madhya Pradesh (MP).

Hypercholesterolemia After COVID-19: Time to Include Lipoprotein X Among the Differential Diagnoses.

Background: Lipoprotein X (LpX) is an abnormal lipoprotein composed of phospholipids, free cholesterol, and albumin. Its overaccumulation is an infrequent cause of hyperlipidemia, which oftentimes presents in patients with cholestatic liver disease. The aim is to present the first 2 cases of patients with post-COVID cholangiopathy and LpX overaccumulation.

Anemia in Pregnancy: A knowledge, Attitude and Practice Survey Amongst Obstetricians and Gynaecologists in India.

Background: Anemia continues to affect one-third of the global population and is one of the most common reasons for large-scale morbidity and mortality especially among women. The importance of iron-rich diet has always been the backbone of preventing iron deficiency anemia (IDA) in vulnerable age groups followed by oral iron therapy and parenteral iron therapy as the next options in management of iron deficiency.

Objective: Objective of this survey was to assess the knowledge, attitude and practices of obstetricians and gynaecologists relevant to anemia in pregnancy and identify the practice gaps in management of anemia in pregnancy.

Dietary Interventions to Treat Type 2 Diabetes in Adults with a Goal of Remission: An Expert Consensus Statement from the American College of Lifestyle Medicine.

Objective: The objective of this Expert Consensus Statement is to assist clinicians in achieving remission of type 2 diabetes (T2D) in adults using diet as a primary intervention. Evidence-informed statements agreed upon by a multi-disciplinary panel of expert healthcare professionals were used.

Methods: Panel members with expertise in diabetes treatment, research, and remission followed an established methodology for developing consensus statements using a modified Delphi process.

Leveraging Technology and Gamification to Engage Learners in a Microbiology Curriculum in Undergraduate Medical Education.

Background: Microbiology is a critical and expansive topic that many medical schools' curriculum must teach in a constrained time frame. We implemented a microbiology question bank smart phone app enhanced with game elements and clinical pearls during a microbiology course for first-year medical students. We hypothesized that these enhancements and clinical pearls would engage the students meaningfully and increase their knowledge base.

Diversity, Equity, and Inclusion in Endocrinology: A Survey and Vision for the Future.

Objective: The Diversity, Equity, and Inclusion (DEI) committee of the American Association of Clinical Endocrinology (AACE) performed a survey whose aim was to explore characteristics of our membership, members' definitions, perceptions, and experiences with DEI in the endocrinology community, and future directions for the organization in this arena.

Methods: A cross-sectional study was conducted consisting of an anonymous, self-administered online questionnaire that captured members' demographic and professional data and assessed their responses to questions about DEI in the endocrinology community. The questionnaire was sent to all AACE members (n=4,079) during May and June 2021.

Attitudes, Perceptions, and Practices Among Endocrinologists Managing Obesity.

Objective: Obesity has been globally recognized as a critically important disease by professional medical organizations, in addition to the World Health Organization and American Medical Association, but health care systems, medical teams, and the public have been slow to embrace this concept.

Methods: The American Association of Clinical Endocrinology staff drafted a survey, and 2 endocrinologists independently reviewed the survey's questions and modified the survey instrument. The survey included questions related to practice and patient demographics, awareness about obesity, treatment of obesity, barriers to improving obesity outcomes, digital health, cognitive behavioral therapy, lifestyle medicine, antiobesity medications, weight stigma, and social determinants of health.

Dehydroepiandrostenedione sulphate (DHEAS) levels predict high risk of rheumatoid arthritis (RA) in subclinical hypothyroidism.

Introduction: The presence of rheumatism is well recognized in primary hypothyroidism. Dehydroepiandrstenedione sulphate (DHEAS) is associated with rheumatological diseases like rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). This study aims to explore relationship between joint pains and DHEAS levels in primary hypothyroidism.

Beta-HCG Concentration in Vaginal Fluid: Used as a Diagnostic Biochemical Marker for Preterm Premature Rupture of Membrane in Suspected Cases and Its Correlation with Onset of Labour.

Objectives: To evaluate β-hCG concentration in vaginal fluid as a biochemical marker for PPROM in suspected cases and its correlation with onset of labour.

Materials And Methods: This is a prospective case-control study carried out in tertiary care centre in 1 year. Total 150 pregnant women of gestational age 28-36 week + 6 days were included and were divided into two groups: control (Group 1) ( = 50) normal antenatal patients.

Where do mothers take their children for pneumonia care? Findings from three Indian states.

Childhood pneumonia accounts for 17% of IMR in India, posing a major health burden. With cultural beliefs influencing care seeking behaviour and disparities existing in health infrastructure across the country, an understanding of the underlying issues merits exploration. Study assessed prevalence of probable pneumonia and examined care seeking behaviour of mothers in three states, Madhya Pradesh (MP), Uttar Pradesh (UP) and Tamil Nadu (TN).

The role of diffusion weighted imaging as supplement to dynamic contrast enhanced breast MRI: Can it help predict malignancy, histologic grade and recurrence?

Rationale And Objectives: To evaluate the value of adding Diffusion Weighted Imaging (DWI) with Apparent Diffusion Coefficient (ADC) mapping to dynamic contrast enhanced (DCE-MRI) to distinguish benign from malignant pathology subtypes and tumor recurrence.

Method And Materials: In this retrospective IRB approved study, 956 consecutive patients underwent bilateral breast MRI between 1/2015 and 12/2015, with 156 BIRADS 4, 5, or 6 lesions detected in 111 patients. DWI imaging at B0, B100, B600, B1000 was performed with DCE-MRI.

To assess the effectiveness of various communication strategies for improving childhood pneumonia case management: study protocol of a community based behavioral open labeled trial in rural Lucknow, Uttar Pradesh, India.

Background: Community Acquired Pneumonia (CAP) is the leading cause of childhood morbidity and mortality worldwide including India. Many of these deaths can be averted by creating awareness in community about early symptoms of CAP and by ensuring availability of round the clock, quality health care. The objective was to assess the effectiveness of an innovative package of orienting doctors and community health workers about community perceptions on CAP barriers to qualified health care seeking, plus infrastructural strengthening by (i) providing "Pneumonia Drug Kit" (PDK) (ii) establishing "Pneumonia Management Corner" (PMC) at additional primary health center (PHCs) and (iii) "Pneumonia Management Unit" (PMU) at Community health center (CHCs) along with one of 4 different behavior change communication interventions: 1.

MR Imaging of the Female Perineum: Clitoris, Labia, and Introitus.

The female perineum has a complex anatomy and can be involved by a wide range of pathologies. In this article, we specifically focus on the clitoris, labia, and introitus. We discuss the normal anatomy of these structures, the MR imaging techniques to optimize their evaluation, and several common and uncommon entities that may affect them, including benign and malignant tumors, as well as infectious and inflammatory, vascular, iatrogenic, and developmental entities.

High-risk sexual behavior among people living with HIV/AIDS attending tertiary care hospitals in district of Northern India.

Context: Prevention with a positive approach has been advocated as one of the main strategies to diminish the new instances of HIV and the target are those who are engaged in high-risk sexual behavior. Therefore, understanding the risky behaviors of the HIV-infected individual is important.

Aims: This study aimed to assess the prevalence and the predictors of high-risk sexual behavior among people living with HIV/AIDS (PLHA).

Mono-(2-Ethylhexyl) Phthalate Promotes Pro-Labor Gene Expression in the Human Placenta.

Women exposed to phthalates during pregnancy are at increased risk for delivering preterm, but the mechanism behind this relationship is unknown. Placental corticotropin-releasing hormone (CRH) and cyclooxygenase-2 (COX-2) are key mediators of parturition and are regulated by the non-canonical NF-kB (RelB/p52) signaling pathway. In this study, we demonstrate that one of the major phthalate metabolites, mono-(2-ethylhexyl)-phthalate (MEHP), increased CRH and COX-2 mRNA and protein abundance in a dose-dependent manner in primary cultures of cytotrophoblast.

Whispering Gallery Mode Dip Sensor for Aqueous Sensing.

We report fabrication of a 4 mm thick, preassembled whispering gallery mode (WGM) sensor that can be repeatedly dipped into aqueous solutions and lifted. We built the viable photonic sensor assembly by bending an optical fiber by 90° and molding its tip into a sphere, thus, a long stem holding a submillimeter sensor at the end of a short arm of fiber, and positioning a pair of parallel cone-tipped tapers along the long stem so that the tips touch the sensor. Our sensor head is an optical fiber device just a few millimeters thick and yet has a sensitivity of the resonance wavelength shift comparable to the one obtained with conventional WGM sensors in a planar arrangement.

Efficacy and Safety of Split Peroneal Tendon Lateral Ankle Stabilization.

Chronic lateral ankle instability is a common condition. Split peroneal tendon lateral ankle stabilization, a modification of the Chrisman-Snook procedure, is biomechanically stable and often used for severe and/or recurrent chronic lateral ankle instability. The purpose of the present study was to evaluate the efficacy and safety of this technique.

Revisiting community case management of childhood pneumonia: perceptions of caregivers and grass root health providers in Uttar Pradesh and Bihar, northern India.

Background: Community-acquired pneumonia (CAP) is the leading cause of under-five mortality globally with almost one-quarter of deaths occurring in India.

Objectives: To identify predisposing, enabling and service-related factors influencing treatment delay for CAP in rural communities of two states in India. Factors investigated included recognition of danger signs of CAP, health care decision making, self-medication, treatment and referral by local practitioners, and perceptions about quality of care.