bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical Decision Support to Reduce Opioid Prescriptions for Dental Extractions using SMART on FHIR: Implementation Report (Preprint)
Authors: Rindal D Brad , Pasumarthi Dhavan Prasad , Thirumalai Vijayakumar , Truitt Anjali R , Asche Stephen E , Worley Donald C , Kane Sheryl M , Gryczynski Jan , Mitchell Shannon G
Published: January 2023

BACKGROUND

Clinical decision support (CDS) has the potential to improve clinical decision-making consistent with evidence-based care. CDS can be designed to save health care providers time and help them provide safe and personalized analgesic prescribing.

OBJECTIVE

The aim of this report is to describe the development of a CDS system designed to provide dentists with personalized pain management recommendations to reduce opioid prescribing following extractions. The use of CDS is also examined.

METHODS

This study was conducted in HealthPartners, which uses an electronic health record (EHR) system that integrates both medical and dental information upon which the CDS application was developed based on SMART (Substitutable Medical Applications and Reusable Technologies) on FHIR (Fast Healthcare Interoperability Resources). The various tools used to bring relevant medical conditions, medications, patient history, and other relevant data into the CDS interface are described. The CDS application runs a drug interaction algorithm developed by our organization and provides patient-specific recommendations. The CDS included access to the state Prescription Monitoring Program database.

RESULTS

The pain management CDS was implemented as part of a study examining opioid prescribing among patients undergoing dental extraction procedures from February 17, 2020, to May 14, 2021. Provider-level use of CDS at extraction encounters ranged from 0% to 87.4% with 12.1% of providers opening the CDS for no encounters, 39.4% opening the CDS for 1%-20% of encounters, 36.4% opening it for 21%-50% of encounters, and 12.1% opening it for 51%-87% of encounters.

CONCLUSIONS

The pain management CDS is an EHR-embedded, provider-facing tool to help dentists make personalized pain management recommendations following dental extractions. The SMART on FHIR–based pain management CDS adapted well to the point-of-care dental setting and led to the design of a scalable CDS tool that is EHR vendor agnostic.

CLINICALTRIAL

ClinicalTrials.gov NCT03584789; https://clinicaltrials.gov/study/NCT03584789
Prediction Models for Sleep Quality Among College Students During the COVID-19 Outbreak: Cross-sectional Study Based on the Internet New Media (Preprint)
Authors: Zheng Wanyu , Chen Qingquan , Yao Ling , Zhuang Jiajing , Huang Jiewei , Hu Yiming , Yu Shaoyang , Chen Tebin , Wei Nan , Zeng Yifu , Zhang Yixiang , Fan Chunmei , Wang Youjuan
Published: January 2023

BACKGROUND

COVID-19 has been reported to affect the sleep quality of Chinese residents; however, the epidemic’s effects on the sleep quality of college students during closed-loop management remain unclear, and a screening tool is lacking.

OBJECTIVE

This study aimed to understand the sleep quality of college students in Fujian Province during the epidemic and determine sensitive variables, in order to develop an efficient prediction model for the early screening of sleep problems in college students.

METHODS

From April 5 to 16, 2022, a cross-sectional internet-based survey was conducted. The Pittsburgh Sleep Quality Index (PSQI) scale, a self-designed general data questionnaire, and the sleep quality influencing factor questionnaire were used to understand the sleep quality of respondents in the previous month. A chi-square test and a multivariate unconditioned logistic regression analysis were performed, and influencing factors obtained were applied to develop prediction models. The data were divided into a training-testing set (n=14,451, 70%) and an independent validation set (n=6194, 30%) by stratified sampling. Four models using logistic regression, an artificial neural network, random forest, and naïve Bayes were developed and validated.

RESULTS

In total, 20,645 subjects were included in this survey, with a mean global PSQI score of 6.02 (SD 3.112). The sleep disturbance rate was 28.9% (n=5972, defined as a global PSQI score >7 points). A total of 11 variables related to sleep quality were taken as parameters of the prediction models, including age, gender, residence, specialty, respiratory history, coffee consumption, stay up, long hours on the internet, sudden changes, fears of infection, and impatient closed-loop management. Among the generated models, the artificial neural network model proved to be the best, with an area under curve, accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of 0.713, 73.52%, 25.51%, 92.58%, 57.71%, and 75.79%, respectively. It is noteworthy that the logistic regression, random forest, and naive Bayes models achieved high specificities of 94.41%, 94.77%, and 86.40%, respectively.

CONCLUSIONS

The COVID-19 containment measures affected the sleep quality of college students on multiple levels, indicating that it is desiderate to provide targeted university management and social support. The artificial neural network model has presented excellent predictive efficiency and is favorable for implementing measures earlier in order to improve present conditions.

CLINICALTRIAL
Memaknai TWK KPK Dalam Reproduksi Wacana Dengan Pemanfaatan Modal Sosial: Studi Kasus Data Percakapan TWK KPK di Media Sosial Twitter
Authors: Pradana Meirza Luthfi , Pratama Vincencius Alvian , Ramdhani Rika Aulia , Nugrahagung Panji Putranto
Published: January 2023

Kajian ini bertujuan untuk menganalisis pemetaan aktor dan pola sentimen yang terbentuk di media sosial Twitter dalam wacana isu “Tes Wawasan Kebangsaan Komisi Pemberantasan Korupsi (TWK KPK)”. Artikel  ini menggunakan pendekatan mix method, yakni kualitatif dan kuantitatif, dengan menggunakan pisau analisis Social Network Analysis (SNA) . Data dalam kajian ini diperoleh dari media sosial Twitter yang diolah dengan Big Data Analytics dari tanggal 16 Mei 2021 sampai dengan 13 September 2021. Tulisan ini mengungkap  terdapat tiga akun eks pejabat publik dan dua akun media nasional yang menjadi top engagement pada isu TWK KPK di Twitter. Adapun sentimen-sentimen mengenai isu TWK KPK yang terbentuk, meliputi isu positif, negatif, dan netral.
Jaringan Aktor dan Konflik Peran dalam Isu Rasisme Papua
Authors: Primaresti Felia , Rizky Murdiana  , Yasmin Pitaloka Ainun , Tiara Chaerani
Published: January 2023

Tulisan ini berusaha memetakan aktor dan relasinya dalam perkembangan sentimen dan isu SARA terhadap masyarakat Papua di Twitter. Selain itu, artikel ini juga berupaya melihat respons masyarakat Twitter terhadap sentimen SARA oleh aktor yang sudah dipetakan. Pendekatan yang digunakan dalam tulisan ini adalah pendekatan kualitatif, sementara metodenya adalah Social Network Analysis (SNA) dan metode analisis sentimen pada rentang waktu Agustus 2019 hingga Juni 2021 (Kasus Papua-Surabaya, Abu Janda-Natalius Pigai, Papua-Risma-ASN, dan Papua-TNI-Disabilitas). Persamaan yang dapat dilihat dari empat kasus rasisme yang hadir adalah adanya campur tangan multiaktor dalam setiap isu yang berkembang, seperti adanya keterlibatan negara, media, organisasi masyarakat sipil, dan aktor individu. Masing-masing aktor dapat menjadi representasi suatu lembaga yang memengaruhi pola pikir dan arah narasi yang diutarakan. Namun, sering kali aktor mewakili dirinya sendiri (alter) dan cuitan yang hadir tidak merepresentasikan golongan mana pun (anonim). Sentimen dalam temuan penelitian ini justru mendorong narasi rasisme terhadap masyarakat Papua yang harus dihentikan. Tingginya intensitas narasi rasisme yang muncul di Twitter membentuk komunitas yang sensitif terhadap konflik dan isu-isu rasial. Twitter sebagai platform yang memfasilitasi perkembangan isu sosial-politik membawa dampak yang cukup luas terhadap komposisi masyarakat yang semakin sensitif terhadap isu rasial di dunia nyata.
A QUESTIONNAIRE-BASED STUDY TO ASSESS THE AWARENESS OF HARMFUL EFFECTS ASSOCIATED WITH JUNK FOODS CONSUMPTION AMONG ADOLESCENT
Authors: RAJENDIRAN DEEPA , MG AKASH , M ARUNA
Published: January 2023

Objectives: The present study aimed to assess the awareness of the harmful effects associated with junk food consumption. The frequent consumption of Junk food causes our bodies to store more fat and sugar, which has detrimental impacts on our health. Assessing the awareness of side effects associated with junk food can help to improve the health status and alert people about the harmful effects of junk food.
Methods: A questionnaire-based study was conducted among adolescents and the questionnaire was administered to 100 people to assess their knowledge about awareness of harmful effects associated with junk foods. The completed questionnaire was collected and statistically analyzed.
Results: The result of the present study showed that among 100 people, 54% opted for junk food twice a day because of taste as the predominant factor which was responded to by 70%, the awareness of nutritional labels and chemicals present in the junk food was responded to by 53%, and 43%, respectively. The awareness of illness due to junk food consumption was responded to by 81%.
Conclusion: The present study showed that most people were aware of the negative effects of junk food, but half refused to change their eating habits. Frequent consumption of junk foods causes many health problems. Further educational programs are required to provide information on nutrition education and junk food. This will help people to reduce their junk food intake.
CLINICO PATHOLOGICAL STUDY OF NECK MASSES IN PATIENTS ATTENDING ENT DEPARTMENT OF MATA GUJRI MEMORIAL MEDICAL COLLEGE AND LIONS SEVA KENDRA HOSPITAL, KISHANGANJ, BIHAR
Authors: CHAKRAVARTY SABYASACHI , BHATTACHARYA BARUN KUMAR , PRASAD SACHIN
Published: January 2023

Objective: The aim of the study was to compare the accuracy of fine-needle aspiration cytology (FNAC) over open biopsy in the assessment of the cause of neck swellings.
Methods: The sample includes 100 patients with neck swellings who visited the nose and throat outpatient department at M.G.M. Medical College and Lions Seva Kendra Hospital in Kishanganj, Bihar. The period of study was 2 years, from October 2019 to October 2021 prospective study. All cases of neck enlargement were referred for radiological examinations. A ultrasound neck Doppler study was performed to determine the nature and vascularity of the swelling. Then, all the cases of neck swelling were sent to the department of pathology for FNAC.
Results: Lymph node aspiration was carried on in 25 cases, tubercular lymphadenitis, which was the commonest swelling in our study. Twenty-five of these lymph node cytology reports were similar to the histopathological examination (HPE) report. Of the 49 thyroid swelling aspirates, 24 cytological reports were similar to HPE reports, and 20 reports did not match with HPE reports. Two cases of colloid goiter were found to be papillary carcinoma of the thyroid. Out of eight salivary gland swelling were matched with the HPE reports. One more case of lateral neck swelling was noted in FNAC as adnexal mass. The patient underwent surgery histopathology concluded as schwannoma.
Conclusion: FNAC of neck masses with clinical correlation can provide the surgeon with the most helpful information to determine the different management modes. It is also essential to take into consideration clinical symptoms and biochemical tests. Hence, we conclude that FNAC is a safe, simple, and rapid method that can be done to diagnose a wide range of neck swellings.
EFFICACY OF MYCOPHENOLATE MOFETIL VERSUS CYCLOPHOSPHAMIDE IN THE TREATMENT OF LUPUS NEPHRITIS
Authors: MANTADA PRASANTHA KUMARI , PRIYANKA MATHEPRASANNA , BHARGAVI LINGATHOTI , BABU PAIDIPOGU LAKSHMAN , RASAGNA YALAVARTHI SAI , MALAMANTI SAI KRISHNA , JYOTHSNA SANKURI
Published: January 2023

Objective: Despite the prevalence of SLE, lupus nephritis (LN) is the primary cause of morbidity and mortality. This study objective was to assess the efficacy and safety of the induction treatment with mycophenolate mofetil (MMF) and cyclophosphamide (CYC).
Methods: This was a prospective observational study enrolled 100 LN patients who were treated with MMF and cyclophosphamide. In this study, 6 male and 44 female patients were treated with MMF and 3 male and 47 female patients were treated with cyclophosphamide. To estimate drug efficacy, patients were evaluated for 24-h urinary protein excretion estimation, serum creatinine, protein-creatinine ratio (PCR), Proteinuria, Serum complement C3, Serum complement C4, and Serum albumin. The primary end point was a prespecified decrease in urine PCR and stabilization of serum creatinine. Secondary end points were complete renal remission, systemic disease status and safety.
Results: The results indicated a potential small advantage of MMF over CYC although the results were not significant. Serum creatinine, 24-h urine protein, and serum albumin were also similar between the MMF and CYC groups after induction therapy. Leukopenia was significantly reduced in MMF treated patients. Both groups suffered from upper gastrointestinal symptoms, but the MMF group’s symptoms were mild and self-limited. MMF therapy was effective in reducing proteinuria and boosting serum complement levels.
Conclusion: MMF and CYC were not significantly different in remission induction therapies for LN. Clinical improvement was seen in most patients in both treatment groups.
PREVALENCE OF BURNOUT AMONG NURSING STAFF: AN EXPERIENCE FROM A TERTIARY CARE HOSPITAL IN INDIA
Authors: JOSHI NAVDEEP , YAKHMI SAURABH , SHARMA RAVI CHAND , SOOD ANKIT
Published: January 2023

Objective: The present study aimed to assess the prevalence of burnout in staff nurses at a tertiary care hospital and to examine the relationship of socio-demographic factors with burnout.
Methods: In this present cross-sectional study, data from 100 staff nurses were collected using the Maslach Burnout Inventory (MBI) and Modified Kuppuswamy Scale. It was analyzed to find out the burnout level.
Results: All the participants were females with mean age of 27.36±3.258 years. Most of participants (68%) belonged to the upper middle socioeconomic class. High level of burnout was reported in 33% participants in depersonalization and 28% in personal accomplishment domain, respectively. Medium level of burnout was found in 37%, 46%, and 25% of participants in emotional exhaustion, depersonalization, and personal accomplishment domains, respectively. About 63% of participants reported low level of burnout in emotional exhaustion domain.
Conclusion: The present study reported a medium and high level of burnout in depersonalization and personal accomplishment domains among significant number of participants which needs to be addressed for efficient human resource management at tertiary care hospital.
ASSESSMENT OF UTILIZATION OF ESSENTIAL IMMUNIZATION SERVICES AMONG CHILDREN UNDER 2 YEARS IN AN URBAN SLUM OF BHUBANESWAR, ODISHA
Authors: KUMAR AMIT , MOHAPATRA IPSA , MISHRA KRISHNA
Published: January 2023

Objectives: The study was planned with the objectives to assess the under-two immunization coverage and to identify determinants and reasons for non-utilization.
Methodology: It was a cross-sectional study which was undertaken in urban slums under field practice area of a medical college, over a span of 4 months among 100 mothers with children 12–23 months of age. Descriptive statistics was used and Fisher’s exact test as the test of association; taking p<0.05 as statistically significant.
Results: Mean age of the children was 17.63 months±3.43.72% were fully immunized, 28% partially, and none in unimmunized category. Mother’s literacy status (p=0.03) and father’s literacy status (p=0.0001) were found to be significantly associated with the immunization status of the child. The immunization coverage based on card and history was – BCG (93%), OPV1 (88%), OPV2 (86%), OPV3 (82%), pentavalent 1 (88%), pentavalent 2 (84%), pentavalent 3 (82%), and measles (84%). Waiting time (85.71%) and lack of adequate information (67.86%) were reasons cited for partial immunization.
Conclusion: The overall immunization coverage was good with none unimmunized. The literacy status of the parents played a major role in determining the immunization status of the children. Waiting time and lack of information were some of the identified barriers.
A CASE OF SWOLLEN HANDS AND FEET SYNDROME BUT NOT LEPROSY; A DIAGNOSTIC CHALLENGE
Authors: PUSHKAR PUSHPENDRA
Published: January 2023

Polyarthritis in leprosy mainly manifests itself in the form of swollen hands and feet syndrome during lepra reactions or insidious-onset chronic symmetrical polyarthritis mimicking rheumatoid arthritis (RA). However, hereby I’m reporting a case in which a patient has swollen hands and feet syndrome but neither he is suffering from leprosy nor RA and asking what’s wrong with me?
EFFICACY OF SURGICAL EXCISION COMBINED WITH INTRALESIONAL TRIAMCINOLONE ACETONIDE THERAPY IN EAR KELOID: CASE SERIES
Authors: JAIN SUMIT , BHATI TUSHAR , BHATTI DEEPAK J , KUMAR RAJ
Published: January 2023

Keloids occur due to abnormal wound healing resulting in extension of raised scar tissue beyond its original margins and rarely they regresses spontaneously. The etiology of keloid is still not clear. Cosmetic concerns, pain, erythema, pruritus, paresthesia, and impairment of function are all keloid related symptoms. There is no single effective treatment for keloids. Keloid’s surgical excision in absence of any adjuvant therapy is considered obsolete due to the high recurrence rate. Corticosteroids are also used as adjuncts to surgical excision to prevent a recurrence. In this prospective, interventional, and case series, six subjects with ear keloid were treated for pre-operative three doses of intralesional Triamcinolone acetonide (TA) injection followed by surgical excision and post-operative two doses of Triamcinolone acetonide injection at the scar site. No signs of recurrence were shown in any lesion.
CAUSES OF BLINDNESS AND VISUAL IMPAIRMENT AMONG STUDENTS IN INTEGRATED SCHOOL FOR THE BLIND IN BIKANER
Authors: POONIA RAUNAQ , MEENA SAJJAN SINGH , BHARGAVA POONAM , BHAKHAR SATA RAM
Published: January 2023

Objective: The study was undertaken to find out the causes of blindness and visual impairment among students in integrated schools for the blind in Bikaner city of Rajasthan.
Methods: A observational study was conducted in the only blind school of Bikaner city. The understudies in the visually impaired school visited were remembered for the review and informed assents from guardians were gotten. Pertinent visual history and essential visual assessments were completed on the understudies of the visually impaired school.
Results: A total of 81 students were examined in school of the blind in Bikaner. The main causes of severe visual impairment and blindness in the better eye of students were microphthalmos (25.92%), corneal scar (20.98%), phthisis bulbi (16.04%), retinal dystrophy (8.64%), optic nerve atrophy (8.64%), buphthalmos/glaucoma (6.17%), amblyopia (3.7%), staphyloma (3.7%), cataract (1.23%), anophthalmos (1.23%), aphakia (1.23%), coloboma (1.23%), retinal detachment (1.23%), etc. Of these, 11 (13.58%) students had preventable causes of blindness.
Conclusion: It was observed that inherited infections, corneal scar, glaucoma, and waterfall were the conspicuous reasons for visual impairment among the understudies of visually impaired school. Practically, 13.58% of the students had preventable causes, demonstrating the need of genetical directing and centered intercession.
A RETROSPECTIVE STUDY OF FINDINGS AND CHALLENGES IN CONDUCTION OF COVID-19-POSITIVE AUTOPSIES
Authors: KAUL MANPREET , SINGH JASPINDER PRATAP , KUMAR KULDIP , BASRA SUNNY
Published: January 2023

Objectives: In this article, we report our observations as well as the innovations which were adapted in the resource-limited settings which are present in most parts of the country. The standard protocols were adopted for complete COVID-19 autopsies that were conducted.
Methods: The present retrospective study was conducted in the Department of Forensic Medicine and Toxicology, Government Medical College, Amritsar. The medicolegal autopsies were conducted completely in confirmed positive COVID-19 cases. In the medicolegal cases, complete autopsies were conducted, where the investigating officers did not forgo the autopsy. A total of ten COVID-positive autopsies were conducted from July 2020 to August 2021.
Results: Gross findings of various organs during autopsy include that of lungs showing relatively unremarkable lungs with mild edema and consolidation, brain showing edema, and subarachnoid hemorrhage, pancreas showing necrotic and hemorrhagic changes, and kidneys flea-bitten and were contracted.
Conclusion: Although a complete autopsy is desired to provide the best possible understanding of the disease process, its variants, such as core biopsies and echopsies, can be taken up as safer alternatives, especially in resource-limited centres. Experience, preparation, and experience are the significant vital aspects which help in managing the COVID-19-positive autopsy. The institution needs to develop guidelines as well as standard operating procedures for the smooth and safe conduct of autopsies in COVID-19 dead bodies.
ASSESSMENT OF PATIENTS’ KNOWLEDGE, ATTITUDE AND PRACTICE REGARDING DIABETES MELLITUS IN A TERTIARY CARE HOSPITAL IN EASTERN INDIA
Authors: DAS ALAK KUMAR , GHOSH DEBADRITA , GHOSH JINIA
Published: January 2023

Objectives: Proper assessment and understanding of knowledge, attitude, and practice (KAP) among diabetic population towards this disease are important as diabetes needs lifelong adoption of healthy lifestyles for prevention and control. We aimed to evaluate the knowledge, attitude, and practice of diabetic patients regarding their disease in a tertiary care center.
Methods: This was a questionnaire-based, cross-sectional study conducted on diabetic patients attending the diabetic clinic over 2 months. Administration of a pre designed, validated, and structured questionnaire consisting of 24 items was done by face-to-face interview.
Results: Responses from 129 subjects were analyzed. Most of the subjects could not define diabetes (60.45%). However they identified the symptoms of diabetes (polyurea 62.79% and polyphagia 55.81%), and knew that lifestyle modification was necessary to control diabetes (exercise 66.66%, and dietary modification 62.79%). Majority had the notion that bitter substances could cure diabetes (51.93%) and insulin should be avoided (28.68%). Most of the subjects did not monitor blood glucose at home (81.4%) and did not take care of their feet (59.69%). Positive associations were found between patients’ knowledge and their family history, educational level, and duration of diabetes. Duration of diabetes and educational level were positively associated with practice of the patients.
Conclusion: Present study reflects that diabetic patients require support and guidance for practicing better disease management. The role of a clinical pharmacist, as well as clinical activities such as patient counseling and pharmaceutical care program may aid in improving patients’ KAP of diabetes management.
EVALUATION OF A DRUG UTILIZATION PATTERN AND USE OF POTENTIALLY INAPPROPRIATE MEDICATIONS AMONG GERIATRIC PATIENTS ADMITTED TO A MEDICAL INTENSIVE CARE UNIT OF A TERTIARY CARE TEACHING HOSPITAL
Authors: PANCHAL YASH N , VYAS BHAVESH M , PARMAR CHETAN G , H DUMRA GURUSHARAN
Published: January 2023

Objectives: The aim of the study was to evaluate a drug utilization pattern and use of potentially inappropriate medications (PIMs) among geriatric patients admitted to a medical intensive care unit (MICU) of a tertiary care teaching hospital.
Methods: A prospective and observational study was conducted among geriatric patients admitted to a MICU of a tertiary care teaching hospital. The data relevant to study variables were collected in a pre-designed case record form. Evaluation of a drug utilization pattern was carried out using WHO core drug prescribing indicators, and the use of PIMs among patients was evaluated using the Beers criteria 2019.
Results: The average duration of stay in MICU per patient was 6.98±1.82 days. Hypertension and diabetes mellitus were the two most common comorbidities found in the geriatric patients. Average 10.29±3.46 drugs were prescribed per patient. Average 0.77±0.08 antibiotics were prescribed per patient. Nearly half of the drugs were prescribed in the form of parenteral formulations. About 14.6% of the prescribed drugs were found to be potentially inappropriate according to Beer’s criteria 2019.
Conclusion: The majority of the drug classes were prescribed to geriatric patients for the appropriate indications. Prescribing PIMs to geriatric patients was common. The Beers criteria have not yet found their way into mainstream clinical practice.
RAPID APPRAISAL OF JUNIOR AND SENIOR RESIDENTS WITH RESPECT TO UTILITY OF CBNAAT IN SETTING TO TUBERCULOSIS ILLNESS
Authors: SINGH YADUVIR , SURANA AVINASH , KANNADASAN BHARATHI , KUMAR SUNIL , SINGH ABHISHEK
Published: January 2023

Objective: This study was rolled out to survey the understanding of junior and senior residents regarding utility of cartridge-based nucleic corrosive enhancement test (CBNAAT) in setting to tuberculosis (TB) ailment.
Method: The review was led among junior and senior resident specialists right now working at a medical college. Concentrate on subjects was evaluated utilizing a semi-organized poll. Information level of the subjects was arranged into three classes based on their insight score. Disposition was surveyed on a five-point Likert Scale.
Results: About 58.4% (n=70) occupants had acceptable information level. Members having postgraduate certification would be advised to information level (agreeable/great) when contrasted with those having MBBS degree. Positive affiliation was seen between information level with capability and long periods of involvement. About 64.16% (n=77) inhabitants rehearsed CBNAAT testing for TB location. About 38.33% (n=46) did not answer when gotten some information about number of tests being sent for CBNAAT testing consistently. Most normal sent example was sputum, trailed by discharge, and body liquids.
Conclusion: Practices for CBNAAT utilization stays low as reflected in the current review notwithstanding having great information scores. This brings up toward information practice gap. Measures should be taken with the goal that they set information up as a regular occurrence and fill the current information practice gap.
CORRELATION BETWEEN REPORTED LEVELS OF THERAPEUTIC COMPLIANCE AND GEOGRAPHIC LOCATION OF PATIENT RESIDENCE
Authors: MIR SHAKEEL AHMAD
Published: January 2023

Objectives: Globally, healthcare suffers from the urban-rural and rich-poor divide. Our objective is to assess differences in therapeutic compliance between rural and urban adults.
Methods: In a questionnaire-based study of outpatients, we assessed 400 adult outpatients selected by simple randomization.
Results: The patients belonging to urban areas had better therapeutic compliance as compared to those belonging to rural areas. About 53.1% of patients from urban areas had good compliance as compared to 22.9% of patients from rural areas (p<0.001).
Conclusion: Our findings reveal statistically significant differences in therapeutic compliance between rural and urban population.
EVALUATION OF THYROID HORMONE CHANGES DURING PREGNANCY
Authors: MALHOTRA PREETI , TANWAR KAVITA , CHITTARA DIKSHA KUMARI , SOGANI SONAL
Published: January 2023

Objective: Knowing the ideal levels of triiodothyronine (T3), thyroxine (T4), FT3, FT4, and thyrotropin-stimulating hormone (TSH) for each pregnancy trimester are the goal.
Methods: The Department of Obstetrics and Gynecology at the Pacific Institute of Medical Sciences in Udaipur treated 150 patients (obstetric cases) for the current longitudinal research. The following parameters were examined for in a fasting blood sample: T3, T4, FT3, FT4, and TSH.
Results: As a result, thyroid profile readings in every group (I, II, and III trimester) were increased and were maximum in second group or second trimester followed by third. The levels above the normal range were in 39 (12+12+15) women of all the groups.
Conclusion: The second trimester of pregnancy saw the greatest increase in thyroid hormones readings. Thyroid profile was lower during the first trimester, particularly at par during the second, and decreased in third trimester.
ANALYZING THE CHANGES IN THYROID HORMONES AND THE SERUM LIPID PROFILE IN NON-PREGNANT, PREGNANT, AND PREECLAMPTIC WOMEN
Authors: TANWAR KAVITA , MALHOTRA PREETI , YADAV HEMENDRA , JAIN SUMAN
Published: January 2023

Objective: The objective of the study was to investigate lipids and thyroid profile status among women with (100 pregnant women) or without pregnancy (100 normal) and with preeclampsia (100 pre-eclamptic women). Methods: The Department of Obstetrics and Gynecology at the Pacific Institute of Medical Sciences in Udaipur treated 300 patients (obstetric cases) for the current case control comparative study. The total lipid and thyroid profile were examined for in a fasting blood sample. Results: The study showed increased level of triiodothyronine, thyroxine in pre-eclampsia than normal pregnant but non-significant. Lipid profile (TC, TG, LDL, and VLDL), TSH were significantly higher in pre-eclampsia than in normal pregnant and non- pregnant women. Conclusion: Thyroid disorder is one of the predisposing causes for pre-eclampsia. Hence, thyroid hormonal assay can be considered as a screening test for early diagnosis and treatment of pre-eclampsia to prevent further complications of it.
LEVELS OF PHYSICAL ACTIVITY AMONG MEDICAL STUDENTS IN KALABURAGI, NORTH KARNATAKA: A CROSS-SECTIONAL SURVEY
Authors: VADIVEL KAMALAKANNAN , PRASHANTH TALIKOTI  , SHILPA MANOHAR KAMBLE  , NILESH N KATE
Published: January 2023

Objective: Physical activity (PA) is associated with several health benefits. Level of PA among undergraduate medical students is less studied. The objective of the study is to assess the level of PA among medical students in a medical college in North Karnataka, Kalburgi district.
Methods: A cross-sectional survey using Global Physical Activity Questionnaire version 2 developed by the WHO was done among 167 study participants. The ration of male to female were 69:98. The total level of PA in three domains, namely, work-related PA, travel to and from places-related PA and leisure time PA were calculated and were expressed as MET-min per week.
Results: About 90% of the students have PA levels over 600 MET-min per week. 10% of students showed inactive PA levels (<600 MET-min per week). The level of PA during work was more than the travel to and from places-related PA and leisure time PA. Male participants were found to be significantly more active than female participants in work-related PA and leisure time vigorous PA. Travel-related PA was similar in both male and female participants.
Conclusion: The study provides MET-min per week score in undergraduate medical student which could provide baseline values for students of a medical college in North Karnataka. The data collected could be compared with the values obtained from other part of the state and our country.
COMPETITIVE ENVIRONMENT AND MYOPIA PROGRESSION IN YOUNG PEOPLE: A PROSPECTIVE STUDY
Authors: SINGH POOJA , CHOUDHARY PANKAJ , LAKHTAKIA SUJATA
Published: January 2023

Purpose: The aim of the study was to determine the effect of duration and distance of reading and writing over myopia progression in young people.
Methods: This prospective, observational, and single-centered study was conducted on 400 eyes of 200 myopic patients. Eyes were categorized into three groups based on degree of myopia (low, moderate, and high) at the time of presentation. Cycloplegic autorefraction followed by subjective refinement of refraction was done and spherical equivalent (SE) was calculated at baseline (Time 1), and then after 6 months (Time 2), and at 1 year (Time 3). Progression of myopia was calculated as increase in SE of subject’s eye between Time 1 and Time 3. Questionnaire survey about the amount of time spent on reading and writing and their preferred working distance in centimeters for each task was filled. Task specific diopter hours per day was calculated. Multivariate analysis was done to estimate the adjusted odds ratio for time spent on reading and writing and their preferred working distance in centimeters for each task and task specific diopter hours per day for reading and writing associated with myopia progression was calculated.
Results: Mean task specific reading and writing diopter hours per day in eyes with progression was 40±12 whereas that in eyes with no progression was 30±10. The observed difference was statistically highly significant (p<0.01). Task specific reading and writing diopter hours per day was significantly higher in eyes with progression as compared to no progression in low and moderate as well as in high myopes (p<0.01).
Conclusion: Risk of progression of myopia was significantly (<0.05) higher in patients engaged in longer duration of reading and writing (>6 h) and at near distance (<25 cm).
DISCRIMINATION OF EYES WITH PRIMARY OPEN-ANGLE GLAUCOMA FROM NORMAL USING MACULAR GC-IPL THICKNESS
Authors: VIRANI ANJALI , KHARE PRAVEEN , PATEL UMESH KUMAR , SINGH PUJA
Published: January 2023

Objective: Primary open-angle glaucoma (POAG), a neuro-ophthalmological disease, is a condition of slowly progressive loss of retinal ganglion cells which are evident as characteristic optic nerve head vicissitudes and visual field defects, only after death of more than 40% of cells. This huge loss when witnessed is started to treat only if the patient approaches an ophthalmologist with a significant complaint, leading to optic nerve head examination, which means being an asymptomatic disease, it is usually left undiagnosed until advanced. An additional system of diagnosis of the disease earlier in the stage can aid reduce the burden of the blindness of POAG.
Methods: Among a total of 62 eyes of 31 subjects, 40 eyes of 20 POAG subjects, and 22 eyes of 11 age-matched healthy subjects were recruited. All of them underwent Spectral Domain Optical Coherence Tomography macular and optic disk scans to note macular ganglion cell–inner plexiform layer (mGCIPL) and retinal nerve fiber layer (RNFL) thicknesses. Statistical analysis was did using an unpaired t-test and calculating a two-tailed p value, in which the significance was indicated by p<0.05.
Results: Similar to peripapillary RNFL thickness, the mGCIPL parameters, that is, minimum GCIPL thickness and GCIPL thickness in all sectors decreased significantly in POAG eyes to be able to discriminate them from normal. mGCIPL and RNFL thickness decreased as the severity of glaucoma increased.
Conclusion: The minimum GCIPL thickness and that in all sectors can discriminate POAG eyes from healthy eyes significantly and has comparable performance to that of peripapillary RNFL thickness.
COMPARATIVE STUDY OF PARACENTESIS, DIAGNOSTIC PERITONEAL LAVAGE, AND ULTRASONOGRAPHY IN THE MANAGEMENT OF PATIENTS OF BLUNT INJURY ABDOMEN – A STUDY FROM CENTRAL INDIA
Authors: CHANCHLANI ROSHAN , CHANCHLANI MADHU
Published: January 2023

Introduction: Blunt abdominal trauma comprises 1–1.5% of total admissions for trauma. In India every year more than a lakh persons die due to accidents. It is in fact the automobiles traveling at a greater speed than ever before that account for an amazing frequency of admissions in civilian hospitals. These injuries present a challenge to the most astute diagnostician, mainly because of the many organs involved, complexity of the hidden and vital structures involved and also because other frequently overshadow the early symptoms associated injuries to the head and chest. The figure is increasing every year, for example, from 1965 to 1966 and an increase by 8.4% was recorded.
Methods: The present study consists of 70 cases of blunt abdominal trauma treated in surgical indoors of Hamidia Hospital and associated Gandhi Medical College, Bhopal within the period of 3 years. Abdominal paracentesis was done in all cases and diagnostic peritoneal lavage (DPL) done in those cases, where paracentesis was negative or doubtful. Ultrasonography was also done in almost all the cases admitted.
Results: In our study, the accuracy and sensitivity of DPL marginally exceeds that of ultrasonography and accuracy and sensitivity of paracentesis is relatively less.
Conclusion: Our study establishes that safety and accuracy of peritoneal tapping as a diagnostic aid in acute abdomen. It is particularly useful in several centers, where radiological facilities do not exist. Comparing all the above diagnostic tools, ultrasonography and DPL were considered are the most accurate, sensitive, and specific diagnostic modalities in cases of blunt injury abdomen.
ROLE OF ORAL PANCREATIC ENZYME SUPPLEMENTATION IN PANCREATIC EXOCRINE DEFICIENCY
Authors: DESAI HITENDRA , PATEL ALPESH
Published: January 2023

Objectives: The present study was carried out to study the role of oral pancreatic enzyme supplementation in pancreatic exocrine deficiency.
Methods: This study included 50 consecutive cases of pancreatic exocrine deficiency. Diagnosis of pancreatic exocrine deficiency was made based on history, clinical examination, and contrast-enhanced computed tomography findings. Each patient was supplied with oral pancreatic enzyme supplements. Each patient was followed up for 1 year with three visits (3 months, 6 months, and 12 months) to assess changes in clinical features of pancreatic exocrine deficiency, change in nutritional status of the patient, and compliance with therapy.
Results: At first follow-up visit (3 months), abdominal discomfort reduced in 17 previously symptomatic patients. Mean stool frequency reduced from 3.18 per day to 2.34 per day. Stool consistency improved with only 18 patients (36%) having liquid consistency stool in comparison to 76% at the time of initial presentation. Average body mass index (BMI) improved from baseline value of 20.648 kg/sqm to 20.674 kg/sqm. Average hemoglobin improved from 10.40 g/dL to 10.52 g/dL and average serum albumin remained static at 3.0 g/dL. At second follow-up visit (6 months), abdominal discomfort reduced in 20 previously symptomatic patients. Mean stool frequency reduced from 3.18 per day (primary survey) to 1.7 per day. Stool consistency improved with only 12 patients (24%) having liquid consistency stool in comparison to 76% at the time of initial presentation. Average BMI improved from baseline value of 20.648 kg/sqm to 21.062 kg/sqm. Average hemoglobin improved from 10.40 g/dL to 10.69 g/dL and average serum albumin improved from 3.0 g/dL at primary survey to 3.1 g/dL. At third follow-up visit (12 months), abdominal discomfort reduced in 30 previously symptomatic patients. Mean stool frequency reduced from 3.18 per day (primary survey) to 1.6 per day. Stool consistency improved with only 9 patients (18%) having liquid consistency stool in comparison to 76% at the time of initial presentation. Average BMI improved from baseline value of 20.648 kg/sqm to 21.402 kg/sqm. Average hemoglobin improved from 10.40 g/dL to 10.76 g/dL and average serum albumin improved from 3.0 g/dL at primary survey to 3.3 g/dL.
Conclusion: In follow-up visits, there was an improvement in symptoms over 12 months. Abdominal discomfort and stool frequency reduced. Stool consistency improved. Nutritional parameters showed statistically significant improvement. Mean BMI of the study sample, mean hemoglobin, and serum albumin increased. The study provides rationale for using these clinical symptoms as surrogate markers for the efficacy of Pancreatic Enzyme Replacement Therapy in patients with pancreatic exocrine insufficiency.
Factors of Affecting the Development of Tourism in Uzbekistan in the Example of China and the USA
Authors: Qaumy Freshta , Bobur Sobirov
Published: January 2023

Uzbekistan has great potential for Zhe development of the tourism industry. Over the past three years, tourism in the country, as one of the main areas of reform and economic growth, has increased fivefold. While about 1 million tourists visited Uzbekistan in 2016, this figure rose to 2.7 million in 2017 and over 5.3 million in 2019. By 2025, the number of foreign tourists is expected to rise to 7 million, and annual foreign exchange receipts from foreign visitors will reach $2 billion. In adittion, the article discusses the factors influencing the development of tourism in Uzbekistan. Tourism is a significant source of income, employment, contributes to the diversification of the economy, creating industries that serve this area. In addition, tourism is an essential factor in the implementation of the foreign policy of the state.
Zinacantán y los conflictos por la tierra: una problemática de largo aliento
Authors: Annereau Fulbert Marie , Flores Hernández A. Rafael
Published: January 2023

Una carta de 1848 del párroco de Zinacantán, Patricio Correa, conservada en el Archivo Histórico Diocesano de San Cristóbal de Las Casas, remite a un conflicto agrario de largo aliento entre Chiapa y Zinacantán que se remonta al siglo xvi y que todavía en el siglo xix tenía relevancia para los pueblos de Chiapas. En este artículo analizaremos la configuración territorial de Zinacantán y su relación con la legislación agraria: la misiva expone una larga experiencia histórica de negociación de los indígenas de Chiapas con fuerzas políticas de mayor amplitud en el campo legal, lo que les permitió defender sus intereses y apuntalar sus estrategias territoriales, al tiempo que ilustra la profundidad de la memoria histórica de los pueblos en relación con la tierra.
Del rechazo a la aceptación: la nacionalidad como rasgo de diferenciación de los inmigrantes en el discurso de opinión en Chile (2017-2019)
Authors: Bello Arellano Daniel
Published: January 2023

En este artículo se examinan, dentro de un corpus constituido por 175 editoriales y columnas de opinión publicadas en Chile entre 2017 y 2019, las estrategias empleadas para construir discursivamente a la persona inmigrante a partir de ciertos rasgos identitarios vinculados con su nacionalidad. El análisis de discurso desarrollado permitió identificar las principales nacionalidades citadas en el corpus (haitiana, venezolana, peruana y colombiana), y observar cómo las nacionalidades mencionadas con mayor frecuencia se caracterizan en el texto y son utilizadas argumentativamente. El análisis evidenció el uso diferenciado de la nacionalidad como signo de una alteridad más o menos «radical». Asimismo, mostró un uso frecuente de la nacionalidad del migrante en los despliegues argumentativos de posiciones desfavorables a la migración, y un vínculo recurrente —en estas mismas posiciones— entre la nacionalidad haitiana y situaciones problemáticas o amenazantes.
Desde y para otras ontologías: experiencias durante el confinamiento en San Cristóbal de Las Casas, Chiapas
Authors: Rosas Fonseca Mónica Denisse
Published: January 2023

Mediante una autoetnografía situada en la ciudad de San Cristóbal de Las Casas, Chiapas, la autora del libro Los reptilianos y otras creencias en tiempos de covid-19 da cuenta y contribuye al conocimiento de lo humano en uno de los hechos históricos más desafiantes de los últimos años: la pandemia por sars-CoV-2. Es un texto que comenzó a la par del encierro y narra las dinámicas domésticas de la familia de la autora y de sus vecinos, con los que compartió, durante el confinamiento, espacios, palabras de aliento y teorías conspirativas.
Exploring the Motivation, Benefits, and Issues for Adopting Online Food and Ordering Food
Authors: Rajvanshi Sushant
Published: January 2023

Abstract: Online food delivering system is the process where various restaurants and food outlets deliver their foods and drinks according to the demand of the customer and give the maximum customer satisfaction and quality service. Although, there are various factors that depends on demand and supply and what goes in the customer’s mind. What motivates the customers, what benefits they will be having by ordering food online and what are the issues they face while adoption online food and ordering it. This paper will provide information of such factors. It is discussed what are the biggest reasons for same, how people achieve the benefits. How and where people face the issues and how can we solve it. In times of outbreak of Covid-19, technology helped in different ways. One of them was to deliver food to people in those tough times when people were sick, could not go out of their houses and protecting themselves and others as well. Hassle-free online payment made the things easier and still doing the same.
Effect of Stress Levels and Temperatures on Creep Compliance of Asphalt Binders
Authors: Raza Muhammad Maad
Published: January 2023

Abstract: Mostly, the laboratories in Pakistan use DSR (Dynamic Shear Rheometer) Test AASHTO T 315 for quality control purposes but it was designed for unmodified asphalt binders, and it gives inadequate results of modified binders. On the other hand, AASHTO T 350 called as multiple stress creep recovery (MSCR) test gives better result for modified binders. MSCR grades of mostly modified binders with additives, nano composites, viscous fluids is determined in this research paper. The effect of these modified as well as unmodified binders on the Creep Compliance factor is also evaluated. To characterize Creep Compliance factor along with Stress Sensitivity and Traffic Loading this test is now used. For evaluating the Stress Sensitivity of modified binders there is development of new factor called as JNR Slope instead of JNR Difference. Jnr Slope gives vast representation of asphalt binders and there is no congestion left between them. The binders which fail in JNR Difference might get satisfactory results from JNR Slope Which gives better results than the conventional way of testing. For determining the rutting behavior of modified as well as unmodified asphalt binders there is usage of peak strain factor at stress level of 100 Pascal, and 3200Pascal relatively. The values of JNR at the stress levels 25 Pascal to 25600 Pascal gives almost linear variation between modified as well as unmodified binders. This research paper is developed to determine Peak strain values, Creep Compliance factors, Stress Sensitivity Factors, And MSCR grading according to the Traffic Loading.
A study on the reduction of antibiotic use by introducing organic acids in broiler chicken feed in the district of Abidjan - Ivory Coast
Authors: SOROMOU Lanan Wassy , KESSE Fanh Serge , KONATE Yacouba , CAMARA Mamadou Fodé
Published: January 2023

The use of organic acids in the diet of animals is potentially beneficial for maintaining intestinal hemostasis and controlling the growth of pathogenic bacteria. The objective of this study was to experiment with organic acids as additives to antibiotics used by farmers. A total of 490 broilers were studied in this study and were divided into 5 lots of 98 subjects. The experimental core consisted of Fysal, Fysal-Selko, Selko, Patheryl (reference antibiotic) and Control. The experimental products were introduced in the drinking water (Selko pH) and in the feed (Fysal MP). A high feed consumption was noticed in the Fysal lot with 80.44±44g/chicken followed respectively by the Pteryl lots with 79.48 ± 42.25g/chicken, Fysal-Selko with 79.34 ± 43.62g/chicken, Selko with 77.27 ± 41.39g/chicken and finally Control with 76.01 ± 39.41g/chicken. The weight gain was high in the Fysal lot with 1770 ± 623.38g followed respectively by the Fysal-Selko lots with 1709 ± 606.05g, Pteryl with 1619 ± 577.70g, Selko with 1607 ± 567.90g against the Control lot with 1550 ± 544.41g. A mortality rate of 3.06% was recorded only in the Selko lot. Economically, the lots (Fysal, Fysal-Selko and Selko) that consumed the feed and water containing organic acids recorded higher profits compared to the Control and Pteryl batches. The organic acids such as Fysal MP and Selko pH could be used as alternatives to antibiotics in poultry farming.

Keywords: Broiler, growth performance, organic acids, antibiotics