bluuebunny/crossref_metadata_2025 huggingface dataset:
Challenges faced by small, medium and micro enterprises in Gauteng: A case for entrepreneurial leadership as an essential tool for success
Authors: Mhlongo Thabisile , Daya Preeya
Published: March 2023

Background: Traditional approaches to managing and leading in entrepreneurial systems, founded on traditional, reductionist and linear thinking, could have issues coping with the inherent uncertainties, complexity and dynamics of such circumstances. Entrepreneurial leadership is acknowledged as an important competency that entrepreneurs could adopt to enhance their leadership development and competitive and sustainable growth for their businesses.Aim: This research study sought to evaluate leadership challenges that affect the performance and the Gauteng province’s small, medium and micro enterprises (SMMEs) sustainability.Setting: This study focuses on SMMEs in the Gauteng province.Methods: In this qualitative study, a systems dynamics approach was used to explore the impact of the various leadership problems and dynamics influencing the SMME performance in the Gauteng province. Semi-structured interviews were conducted with 46 entrepreneurs, followed by creating causal loop diagrams to understand how system variables and components produce behaviours in interactive patterns within the entrepreneurial system.Results: Findings of the study revealed that SMMEs consistently suffer from relatively high levels of failures and lower performance levels caused by: (1) a lack of entrepreneurial leadership skills, (2) a lack of financial resources and/or finances, (3) a lack of financial education, (4) infrastructure constraints, (5) a lack of training, (6) a lack of technology and (7) crime and corruption.Conclusion: This study highlights that the entrepreneurial context in South Africa is dynamic and complex in nature and is limited by entrepreneurial leadership capabilities and a weak understanding of the business environment.Contribution: This study employs a system dynamics approach that entrepreneurs can use to understand and solve important, complex socio-economic and sustainability problems that they encounter.
Study of burnout and depressive symptoms in doctors at a central level, state hospital
Authors: Nazeema Ariefdien , Lowton Karishma , Tenea Zenaida , Anic Ani , Jayrajh Preethi
Published: March 2023

Background: Doctors are at high risk of burnout, which has far-reaching consequences on an individual and organisational level. Several studies have shown an association between burnout and depression.Aim: This study aimed to determine the rate of burnout and depressive symptoms among doctors, as well as factors associated with both conditions.Setting: Charlotte Maxeke Johannesburg Academic Hospital.Methods: Burnout was measured using the Maslach Burnout Inventory–Human Services Survey and defined as the total score of high emotional exhaustion (≥ 27 points) + high depersonalisation (≥ 13 points). Individual subscales were analysed separately. Depressive symptoms were screened using the Patient-Health Questionnaire-9 (PHQ-9) and a score of ≥ 8 was deemed indicative of depression.Results: Of the respondents (n = 327 for burnout and n = 335 for depression), 46.2% screened positive for burnout, whilst 53.73% screened positive for depression. Factors associated with increased burnout risk were younger age; Caucasian race; internship and/or registrarship; the discipline of emergency medicine; and having a prior psychiatric diagnosis of depressive and/or anxiety disorder. Factors associated with increased risk of depressive symptoms were females; younger age; being an intern, medical officer or registrar; disciplines of anaesthetics and obstetrics and gynaecology; having a prior psychiatric diagnosis of depressive and/or anxiety disorder; and family history of psychiatric disorder.Conclusion: A high rate of burnout and depressive symptoms was determined. Although there is an overlap between the two conditions in terms of both symptomatology and risk factors, specific risk factors were determined for each in this population.Contribution: This study highlighted the rate of burnout and depressive symptoms experienced by doctors at the state level hospital necessitating individual and institutional interventions to address this.
Lived experiences of adolescents admitted for first-episode psychosis in South Africa
Authors: Magula Luzuko , Lachman Anusha , Roomaney Rizwana
Published: March 2023

Background: First-episode psychosis is common in adolescents and can be distressful to the person experiencing it for the first time. However, there is limited research globally and specifically in Africa about the lived experiences of adolescents admitted into a psychiatric facility for first-episode psychosis.Aim: To understand the adolescents’ experiences of psychosis and receiving treatment in a psychiatric facility.Setting: Adolescent Inpatient Psychiatric Unit, Tygerberg Hospital, Cape Town, South Africa.Methods: This was a qualitative study that used purposive sampling to recruit 15 adolescents with first-episode psychosis and admitted to the Adolescent Inpatient Psychiatric Unit, Tygerberg Hospital in Cape Town, South Africa. Individual interviews were audio recorded, transcribed and analysed using thematic analysis consisting of both inductive and deductive coding.Results: The participants described negative experiences of their first episode psychosis, provided varying explanations for their first episode psychosis and had the insight that cannabis precipitated their episodes. They described both positive and negative interactions with both the other patients and staff. They did not wish to return to the hospital again following their discharge. Participants stated that they wanted to change their lives, return to school and try to prevent a second episode of psychosis.Conclusion: This study provides insights into the lived experiences of adolescents presenting with first-episode psychosis and calls for future research to delve deeper into factors that support or enable recovery among adolescents with psychosis.Contribution: The findings of this study call for improving the quality of care in the management of first-episode psychosis in adolescents.
Clinicopathological Profile of Primary Hyperparathyroidism with Special Reference to Ki-67 Labelling Index
Authors: Thanveer Azhar S. , Kamalanathan Sadishkumar , Badhe Bhawana A. , Palui Rajan , Rashmi Kengunte G. , Nadeem Naadia F.
Published: March 2023

Context:

Primary hyperparathyroidism (PHPT) can occur due to a neoplastic process or hyperplasia. While the disease presentation is predominantly asymptomatic in developed countries, this is not the case yet in India. Differentiation of the type of lesion can only be done based on histomorphology but has its own challenges. Immunohistochemical markers like Ki-67 have been studied to aid in diagnosis but data on this is sparse from India.

Aims:

The aim of this study is to assess the clinical, biochemical and pathological profile of PHPT and to analyse the differences in immunohistochemical marker Ki-67 among the various lesions.

Setting and Design:

A descriptive study was carried out on 38 PHPT patients who were treated at our institute from January 2011 to March 2021.

Materials and Methods:

Post-surgery, the causative lesions were categorised as adenoma (31), hyperplasia (5) and carcinoma (2). Clinical, biochemical, radiological and histopathological features of all lesions were collected and analysed. Ki-67 proliferation index was calculated. The various parameters were compared across the three groups of lesions and correlated with Ki-67 index.

Results:

Out of 38 patients, 37 were symptomatic with skeletal symptoms being the most common followed by renal symptoms. There was no difference in clinical or biochemical parameters among the three types of lesions. Significant negative correlation was seen between serum iPTH and serum 25-OH Vitamin D levels (P0.006) The median Ki-67 index was found to be 0.40% in hyperplasia, 0.49% in adenoma and 5.84% in carcinoma.

Conclusion:

PHPT still presents as an overtly symptomatic disease in India. Diagnosis of the nature of lesion depends on the accurate application of morphological criteria. A high Ki-67 index was not found to be an absolute marker of carcinoma, as it was also seen in a small proportion of atypical adenomas.
Prevalence and Predictors of Osteoporosis/BMD Below Expected Range for Age in Pheochromocytoma/Paraganglioma and BMD, TBS Change Post-Operatively: A Prospective Cohort Study
Authors: Khatiwada Saurav , Agarwal Shipra , Kandasamy Devasenathipathy , Kumar Rajeev , Jyotsna Viveka P , Tandon Nikhil
Published: March 2023

Context:

Pheochromocytomas/paragangliomas (PPGLs) have recently been shown to be associated with lower bone mineral density (BMD) and trabecular bone score as compared to healthy controls suggesting low bone mineral concentration and disrupted bone microarchitecture. There is paucity of data on prevalence and clinical predictors of low BMD/osteoporosis in PPGL from India and the extent of change in BMD post-operatively.

Aims:

This study aimed to find prevalence of low BMD/osteoporosis and trabecular bone score (TBS)-adjusted FRAX score in subjects with PPGL and to see the post-operative change in BMD and TBS at follow-up.

Material and Methods:

32 consecutively diagnosed adult cases with PPGL were enrolled. Although the provisional diagnosis of PPGL was made based on imaging consistent with PPGL supported by biochemical evidence of catecholamine excess, its confirmation was made histopathologically before final analysis.

Results:

We found significantly low average BMD T-score/Z-score at spine, hip or wrist. Osteoporosis was evident in 87.5% of subjects (nine of 11 post-menopausal women or men >50 years of age) and BMD below the expected range for age in 42.9% of subjects (nine of 21 pre-menopausal women or men <50 years of age) by International Society for Clinical Densitometry criteria.

Conclusions:

87% of older subjects with PPGL had osteoporosis while 43% of younger subjects had BMD below expected range for age (Z-score ≤-2.0), more at lumbar spine than at hip. Decreased body weight was associated with osteoporosis in older or Z-score ≤-2.0 in younger subjects. There was no significant change in BMD and TBS scores at a median of four months post-operatively.
Study of Non-Thyroidal Illness Syndrome and Its Recovery in Critically Ill Patients at a Tertiary Care Centre in South India
Authors: Praveen N S , Modi K D , Sethi Bipin K. , Murthy JMK , Reddy Pawan K. , Kandula Srinivas
Published: March 2023

Background and Objectives:

Transient thyroid hormone alterations are common during critical illness and are termed non-thyroidal illness syndrome (NTIS). We studied the prevalence of NTIS in the ICU setting and its impact on predicting mortality and other outcomes and compared it to the Acute Physiology and Chronic Health Evaluation II (APACHE II) score.

Materials and Methods:

The study included 119 consecutive patients admitted with a critical illness. APACHE II score was calculated. Total T3, total T4, TSH, free T3, and free T4 were measured at admission and after six weeks of discharge. NTIS and euthyroid groups were studied for ICU, hospital stays, mortality, readmission, and recovery. Predictors of mortality were compared between survivors and non-survivors.

Results:

The mean age was 60.15 ± 14.50 years with M:F = 84 (71%):35 (29%). NTIS was observed in 84 (71%), low T3 being the most common abnormality in 53 (63%). The occurrence of NTIS was significantly higher among non-survivors (28/30, 93%) versus survivors (56/89, 63%) (P = 0.002). Non-survivors showed significantly lower T3, TSH, and FT3/FT4 ratios and higher readmissions. NTIS group showed significantly greater ICU stay (P = 0.02) and had higher readmission rates (P = 0.032). Baseline T3 had the greatest power to predict mortality. APACHE II score also correlated significantly with mortality (19.60 ± 10.58 vs 11.99 ± 6.80, P < 0.001). The area under the curve (0.677) for the T3 level was lower than the APACHE II score (0.760). After six weeks, 61% had recovered from NTIS.

Conclusions:

NTIS was common amongst critically ill patients (71.5%), which reversed in 61% at six weeks. Low T3 was the most common abnormality and independently predicted mortality. Free T3/free T4 also significantly predicted mortality. The correlation between thyroid dysfunction and the severity of primary illness makes it an additional attractive low-cost marker of mortality.
Iodine Status, Thyroid Disorder and Feto-Maternal Outcome among the Tribal Pregnant Women of Eastern Himalayas
Authors: Sonowal Trisha , Sarmah Jatin , Sarma Paresh K. , Deka Manab
Published: March 2023

Introduction:

Iodine deficiency and thyroid disorder during pregnancy have adverse effects on fetal and neonatal outcomes.

Objective:

To assess iodine status and thyroid functioning during pregnancy and to evaluate the feto-maternal outcome.

Methods:

Urinary iodine content (UIC) is determined by arsenic cerium catalytic spectrophotometry method and thyroid hormone analysis was carried out by chemiluminescence assay. Fetal and neonatal outcomes were obtained from hospital records.

Results:

Among the considered tribal pregnant women 56.75% had insufficient urinary iodine and 24.5% had a thyroid disorder. Thyroid disorder was more common in pregnant women with urinary iodine concentration (UIC) <99 μg/L than UIC >150 μg/L (56.75% vs 41.5%). Pregnant women with UIC<99 μg/L had a higher incidence of anemia (86.36%), gestational diabetes mellitus (GDM) (3.33%), and preeclampsia (5.71%) than UIC >150 μg/L. The fetal outcome with UIC <99 μg/L had a higher incidence of low birth weight (9.09%) and preterm births (1.9%). Stillbirths were distributed equally among different UIC groups. The neonatal outcomes with UIC <99 μg/L between 150-249 μg/L had a higher incidence of respiratory distress (5.23%). Hypothermia was equally distributed among different UIC groups. Subclinical hypothyroid had a high prevalence of anemia (62.96%), preeclampsia (3.7%), and GDM (6.17%) respectively than the euthyroid group. The fetal outcome with low birth weight (LBW) (9.87%), stillbirths (3.7%), and preterm birth (8.64%) was more common in the subclinical hypothyroid than in the euthyroid group. Among the neonatal outcomes respiratory distress (6.17%) and hypothermia (4.93%) were more common in subclinical hypothyroid than euthyroid pregnant women.

Conclusion:

Insufficient maternal iodine and thyroid disorders during pregnancy were associated with adverse pregnancy outcomes.
Thyroid Autoimmunity and Subclinical Hypothyroidism in Prolactinoma: A Case Control Study
Authors: Laway Bashir A. , Sahu Danendra , Bhat Moomin H. , Baba Mohammad S. , Viswanath S Arun , Misgar Raiz A. , Wani Arshad Iqbal , Bashir Mir Iftikhar , Shah Zaffar Amin , Mudassar Syed
Published: March 2023

Background:

This study was aimed at determining the frequency of thyroid autoimmunity and subclinical hypothyroidism in patients with hyperprolactinemia due to prolactinoma compared to well-matched healthy controls.

Methods:

This was a cross-sectional study wherein 78 treatment naïve prolactinoma patients and ninety-two healthy control subjects were recruited. Serum prolactin (PRL), thyroid-stimulating hormone (TSH), total thyroxine (T4), circulating anti-thyroid peroxidase (anti-TPO), and anti-thyroglobulin (anti-Tg) antibody levels were measured in all study subjects. Progression of the antibody-positive population to subclinical hypothyroidism was determined.

Results:

The median PRL level among patients was 166 ng/ml (IQR 85-467) compared to 11.4 ng/ml (IQR 8.5-15.9) in controls (P < 0.001). There was no significant difference in levels of T4 (P = 0.83) and TSH (P = 0.82) between the cases and controls. Overall, 25% of patients had the presence of anti-thyroid antibodies as compared to 20% of controls (P = 0.56). SCH was more common in antibody-positive hyperprolactinemia subjects compared with antibody-positive controls.

Conclusion:

We did not find an increased prevalence of thyroid autoimmunity among untreated prolactinoma patients compared to healthy controls. At the same time, subclinical hypothyroidism was more common in thyroid antibody-positive patients with hyperprolactinemia than positive controls.
Clinicomicrobiological profile of mycotic keratitis patients presenting at a tertiary care hospital of rural North India
Authors: Sangwan Jyoti , Lohan Kirti , Kaur Manpreet , Kumar Yogesh , Saini Nishtha , Mane Pratibha , Singla Pooja , Khan Sameena
Published: March 2023

Background:

Mycotic keratitis (MK) or keratomycosis is an infection of corneal stroma caused by a variety of fungal species. It is a condition resulting in blindness if untreated seen, especially in tropical and subtropical countries. The identification of causative fungus is key to starting appropriate treatment. This study aimed to describe clinicomicrobiological profile along with associated demographic factors of MK patients presenting at a tertiary care hospital situated in rural North West India.

Methodology:

A cross-sectional study was conducted for 3 years from June 2018 to June 2021 at a tertiary care hospital situated in rural North India after obtaining ethics committee approval. After obtaining informed consent, a detailed history was taken from suspected MK patients. Then, corneal scrapings were taken under the slit lamp and processed in the microbiology laboratory for isolation and identification of causative agents. The results obtained were analyzed.

Results:

A total of 114 nonrepetitive samples were collected from patients suspected of keratomycosis during the study period. Eighty-one (71.1%) samples were found to be positive for fungal growth. Males were affected more than females (1.53:1). Individuals belonging to the age group of 21–40 years were involved the most. Farmers (48.1%) were affected most of all. The predominant fungal species isolated was Candida followed by Aspergillus and Fusarium.

Conclusion:

The present study highlights the different etiology of MK across different geographical regions. Candida spp. was the most common etiological agent observed in the study followed by Aspergillus and Fusarium spp. Its prevalence, risk factors, and causative agents involved vary with geographic variation, occupation, and local prevailing practices. Timely diagnosis can get an individual the right treatment and can save the vision.
A study on the understanding of sterilisation in the central sterile services department by the healthcare personnel in a tertiary care hospital in Sikkim
Authors: Subba Sunu Hangma
Published: March 2023

Background:

Globally, hundreds of millions of people are affected every year by avoidable infections in healthcare (healthcare-associated infections, [HAIs]). Through knowledge, best practices and infection prevention and control (IPC), we can prevent HAI to patients and health workers. Following recent threats caused by widespread epidemics and increasing awareness about the spread of antimicrobial resistance, several countries are paying more attention and investing resources to strengthening IPC infrastructures and improving practices.

Objective:

The objective was to assess the practices by the healthcare staff regarding the sterilisation process in the central sterilisation service department (CSSD) and to bring about improvements in the practices in the hospital.

Materials and Methods:

A cross-sectional study was conducted where the healthcare staff were given a set of questionnaires on sterilisation in the CSSD. The staff who participated in the study included doctors, intensive care unit nursing staff, infection control nurses, operation theatre nursing staff, CSSD staff and outpatient department nursing staff.

Results:

The questionnaire was administered to 120 health staff. All the staff agreed that instruments should be cleaned at the source. The majority of the participants (82%) believed that medical devices should be reprocessed centrally in CSSD; however, very few of them (18%) have felt otherwise. Almost 70% of staff did not know about the indicators used in CSSD and the zones in CSSD. The expiry date of the items once received from CSSD, 60% said it is not mentioned on the pack and 40% of participants agreed that it is mentioned on the pack.

Conclusion:

The processes of sterilisation and decontamination are complex, require specific infrastructure and equipment and involve several steps that need to be correct, from device collection, receipt by the unit, processing, storage and distribution them throughout the facility. Quality control measures to evaluate the proper functioning of the equipment are of the utmost importance.
Staphylococcal nasal colonisation amongst medical students
Authors: Gupta Munesh Kumar , Sinha Gargi , Singh Ashish Kumar , Prakash Pradyot
Published: March 2023

Background:

Staphylococcus aureus is a common cause of hospital-acquired infections. Medical undergraduates are frequently exposed to hospital-adapted bacterial strains especially S. aureus and therefore are always at risk of colonisation.

Materials and Methods:

A prospective study was conducted on 150 undergraduate students, of different semesters, to detect S. aureus nasal colonisation. A detailed history regarding attending the hospital ward teaching, hospitalisation, frequency of nose touching and immunocompromised condition was unequivocally obtained from all the participants. Anterior nares were swabbed and inoculated on mannitol salt and blood agar plates. S. aureus isolates were subsequently verified by conventional microbiological techniques. The antibiotic susceptibility testing was done by the modified Kirby–Bauer disc diffusion method. In addition, PCR-based detection of mecA gene and pvl gene was performed.

Results:

Out of 150 students, we found 18 students (3 of 1st, 10 of 5th and 5 of 9th semester, respectively) to be colonised by S. aureus. Of these 18 isolates, 8 were found to be methicillin-resistant. We observed a significant association (P < 0.05) of hospital exposure, ward teaching/hospitalisation with S. aureus colonisation. These S. aureus isolates exhibited varying susceptibility towards different antibiotics with multiple antibiotic resistance indexes ranging from 0.08 to 0.58. Interestingly, all eight methicillin-resistant S. aureus isolates displayed mecA positivity while all were found to be pvl negative.

Conclusion:

The results indicate the importance of imparting knowledge about infection control practices during the initial years of undergraduate training in medical schools, which may increase awareness amongst students before getting outpatient or ward postings.
Sociodemographic profile, work practices, and disease awareness among stone mine workers having silicosis from Central Rajasthan
Authors: Dixit Ramakant , Kuldeep Rajveer , Goyal Mukesh , Agarwal Deepesh , Jalutharia Jitendra
Published: March 2023

Background and Objectives:

Silicosis continues to pose an important health hazard among workers having occupational exposure to stone dust. Several studies have addressed clinical presentation, radiographic and pulmonary function abnormalities in workers with silicosis. This study was planned to analyze sociodemographic profile and awareness about several aspects of silicosis among the stone mine workers visiting our centre.

Methods:

A questionnaire was administered in a convenient sample of eligible subjects over six years period. The questionnaire was aimed to collect sociodemographic variables, like age, gender, educational status, residential background, smoking status etc., apart from information on work-related profile including protective measures taken. Also knowledge and attitude regarding silicosis was assessed. Silicosis awareness index was also calculated as per the response received.

Results:

Majority of the study subjects were male (96.6%) with rural background (98.5%). 54.1% subjects were in the age group of 30 to 50 years. 81.9% mine workers were illiterate. The common addictions observed among them included smoking (60%), tobacco chewing (34%), alcohol (20%) etc., Varying duration of work exposure was observed with more than 10 years in 63.4% and more than 20 years in 32.2% workers. The commonest work exposing them to stone dust was breaking stones by chisel and hammer (51%) followed by separation of stone slab (20%) and stone drilling (15%). 80.9% subjects were not aware of the term silicosis, more than 80% were not aware of the symptoms and causes of silicosis. Only one fifth subjects were having awareness of using protection against the disease. Overall awareness about silicosis was better among literate and youngers participants.

Conclusions:

Stone mining industry reflects male dominance, poor literacy, long working hours for many years, financial compulsion to start and continue the job and very poor awareness regarding the disease silicosis and importance of personal protection at workplace.
Large mediastinal/thoracic benign teratoma presenting with haemoptysis: Report of a case and review of the literature
Authors: Goyal Vikas Deep , Pahade Akhilesh , Misra Gaurav , Kaira Vaanika , Prajapati Neeraj
Published: March 2023

The mediastinal teratomas can grow to a large size before becoming symptomatic. The symptoms are usually due to the compression of adjacent structures. A computed tomographic scan of the chest is the investigation of choice for making a provisional diagnosis and planning for further management. Removal of large mediastinal/thoracic teratoma can be associated with various intraoperative and postoperative complications, which can be life-threatening sometimes. We operated on a patient with a large mediastinal mass extending into the right thoracic cavity up to the costo-phrenic angle. The postoperative period was eventful and required judicious intensive care. The patient eventually recovered with conservative treatment. A literature search was done on PubMed using the keywords benign mediastinal teratoma. Case series/original articles published in the last two decades, that is, after the year 2000, were evaluated. As per the review of the literature, the prevalence of benign mediastinal teratoma may be higher in eastern countries. Thoracoscopic surgery is the preferred modality except for cases with adhesions or infiltration into surrounding structures.
Reinfection of COVID-19 among doctors at a tertiary care centre in Northern India: A report from a resource-limited setting
Authors: Reddy D. Himanshu , Kapoor Rohan , Rai Priyanka , Atam Virendra , Khan Farman , Pandey Saurabh , Malhotra Hardeep S. , Gautam Medhavi , Bharadwaj Nitin
Published: March 2023

Background and Aims:

There is an increasing recognition of reinfection in coronavirus disease 2019 (COVID-19). We studied the reinfection of COVID-19 disease among doctors at a tertiary care centre in Northern India.

Methods:

All COVID-19 patients readmitted for COVID-19 disease after any duration with at least a positive Real time- polymerase chain reaction (RT-PCR) for severe acute respiratory syndrome coronavirus 2 were included. Their clinical profile, vaccination status, outcome and Centre for disease control (CDC), Atlanta, USA reinfection criteria screening were recorded.

Results:

A total of 57 (0.53%) doctors were identified and 56 of them satisfied the CDC criteria. It included 13 (20.3%) females and 89.3% of cases were from clinical specialities; 98.2% of individuals had the first infection in 2020 and mean duration between 2 infections was 156.29 ± 76.02 (35–298) days. Duration between two episodes of the disease with more than 90 days apart was in 80.3% cases. One (1.8%) patient developed severe disease and two (3.6%) cases were of moderate severity. Symptoms were similar in both infections except significantly higher number of extra-respiratory complaints (2.2% vs. 9.1%). There were 37.5% cases who had received first dose of vaccination of any duration at the time of second infection. Nine (16.1%) and four (7.1%) patients with more than 4 weeks after the first and second dose of vaccination developed the second infection, respectively.

Conclusion:

Majority of reinfection were symptomatic and developed after 90 days and so majority followed CDC criteria. Breakthrough infections among vaccinated healthcare worker are real, and with sustained exposure to the virus, they should continue to use precaution including hand hygiene and mask in order to prevent reinfection.
The impact of lockdown on symptoms and health status of patients with chronic airway diseases: An appraisal of patient perceived impressions
Authors: Bhattacharyya Parthasarathi , Mukherjee Sikta , Chatterjee Moumita , Saha Dipanjan , Sengupta Sayoni , Dey Debkanya
Published: March 2023

Background:

The pandemic-specific lockdown may influence the health status of patients with chronic airflow obstruction (CAO) as COPD, COPD-PH, and chronic asthma.

Objectives:

To find the impact of the lockdown on symptoms, and the degree of perceived change in physical activity and emotional health with possible reasons including the indicators of ambient air pollution.

Methods:

A cohort of CAO patients was telephonically enquired regarding their perceived well-being in symptom status, physical activity, and emotional health with the perceived contribution from plausible reasons (regular medication, simple food, no pollution, and family attention) for the change; all being expressed in percentages. The change in symptom scores as 0-39, 40-79, and 80-100 were regarded as ‘low’, ‘medium’, and ‘high’ respectively. The impact of the individual contributing factor was calculated statistically. The assessment of the CAT (COPD assessment test) score and the ambient air pollution (PM2.5 and PM10) was also done for their association with well-being.

Results:

There was a universal improvement (p < 0.5) in COPD (n = 113), COPD-PH, (n = 40), and chronic asthma, (n = 19) as regards symptoms, physical activity, and emotional health that tallies to overall and individual change in CAT score. There were concomitant reductions in PM10 and PM2.5 levels during the lockdown compared to the same period of the previous year. All the four listed factors contributed with the ‘no/low pollution’ and ‘simple food being the most important; on acting together, they reduced the moderate and severe symptoms impressively.

Conclusion:

Reduced air pollution and simple food appear most important for the improvement of CAO patients during the lockdown period.
Combining four screening tools for cost effective screening of OSA in train drivers: A UK experience
Authors: Ogunyemi Lanre , Nafisa Syeda , Stacey Tanya , Sovani Milind
Published: March 2023

Background:

Obstructive sleep apnoea (OSA) in drivers/workers has been implicated in railway and road traffic safety incidents; however, there are insufficient data on its prevalence and cost-effective screening methods.

Aim:

This pragmatic study examines four OSA screening tools: the Epworth sleepiness scale (ESS), the STOP-Bang (SB), the adjusted neck circumference (ANC) and the body mass index (BMI), exploring their suitability and effectiveness separately and in combination.

Method:

Using all four tools, 292 train drivers were opportunistically screened between 2016 and 2017. A polygraph (PG) test was carried out when OSA was suspected. Patients with an apnoea–hypopnea index (AHI) ≥5 were referred to a clinical specialist and reviewed annually. Those who had continuous positive airway pressure (CPAP) treatment were evaluated for compliance and control.

Results:

Of the 40 patients who had PG testing, 3 and 23 participants met the ESS >10 and SB >4, criteria, respectively, whereas 25 participants each had an ANC >48 and a BMI >35 with a risk factor or ≥40 with none. OSA was detected in 3, 18 and 16 of them who met the ESS, SB and ANC criteria, respectively, and was positive for OSA in addition to 16 others who met the BMI criteria. A total of 28 (72%) were diagnosed with OSA.

Conclusion:

Although when used individually, these screening methods are less effective/inadequate, combining them is easy, feasible and offers the maximum chance of OSA detection in train drivers.
Endovascular stenting for malignant superior vena cava syndrome - Case series and review of literature
Authors: Arshad Abdul Majeed , Pandiyan Arun Pandiyan Somasundara , Ayub Irfan Ismail , Chockalingam Chandrasekar , Thangaswamy Dhanasekar
Published: March 2023

The treatment of malignant superior vena cava syndrome (SVCS) revolves around radiotherapy and chemotherapy to relieve symptoms with surgery being ruled out due to the advanced stage of malignancy. Primary placement of endovascular stent for palliation of malignant SVCS is not commonly reported in the literature. Here, we present two cases of malignant superior vena cava syndrome with successful relief of symptoms after the placement of endo vascular stent.
Impact of Resilience and Environmental Stress on Burnout of Students in Public and Private Dental Schools in Western Saudi Arabia
Authors: Alsharif M , Almadani N , Mahmoud RY , Alsharif A , Al-Maweri SA , Kassim S
Published: March 2023

ABSTRACT

Background:

Dental students’ burnout has been repeatedly reported in the literature; however, there is little information about the contributing factors in different contexts and settings.

Aims:

This study aimed to investigate the correlation between burnout among undergraduate dental students and sociodemographic (specifically gender), psychological (resilience), and structural factors (dental environment stress).

Subjects and Methods:

An online cross-sectional survey questionnaire was distributed among a convenience sample of 500 undergraduate Saudi dental students. The survey included questions about sociodemographic factors (gender, level of education, academic achievement, type of school [public or private], and living arrangements). The study also included items that allowed assessment of students’ burnout using the Maslach Burnout Inventory (MBI) and assessment of student environmental stress and resilience using the Dental Environment Stress Scale (DESS) and the Brief Resilience Scale (BRS). Descriptive statistics, univariate, and linear regression analyses were performed.

Results:

The response rate was 67% (male = 119, female = 216). Univariable analysis showed that gender, level of education, and DESS and BRS scores correlated significantly (P <.05) with MBI scores. Adjusted multiple linear regression lends further support to that the MBI scores negatively correlated with the BRS score but positively correlated with the DESS score (β = -0.29, P <.001; β = 0.44, P <.001, respectively).

Conclusions:

Within the limitations of this study, the findings demonstrated that increases in resilience correlated significantly with decreases in burnout and increases in environmental stress correlated significantly with increases in burnout among dental students. However, gender had no influence on burnout.
Quantitative and Qualitative Assessment on Individual Perception and Self-Care Practice of Refractive Error in a Rural Community in Enugu, South East Nigeria
Authors: Nwachukwu NZ , Adeniyi DB , Amu NB , Nwachukwu DC , Chuka-Okosa CM
Published: March 2023

ABSTRACT

Background:

Globally, uncorrected refractive errors have been identified as the most common cause of visual impairment and the second leading cause of treatable blindness.

Aim:

This study quantitatively and qualitatively assessed individual perception and self-care practice of refractive error (RE) in a rural community in Enugu State.

Subjects and Methods:

A descriptive, cross-sectional, population-based survey was done in Amorji community, Enugu State. A pretested, researcher-administered questionnaire was used to interview the respondents on knowledge of causes, features and treatment of RE, their self-care practices, and attitudes toward RE. Focus group discussions (FGDs) and in-depth interviews (IDIs) were also carried out to qualitatively assess these parameters. Data was analyzed using SPSS version 20.

Results:

A total of 522 adults, 307 (58.8%) males, and 215 (41.2%) females aged 43 ± 31.6 (range 18–83) years participated in the study. Of the participants, 235 (45.0%) had good knowledge of RE; 272 (52.1%) had positive attitude toward RE, while only 51 (9.8%) had good self-care practice. Educational status was significantly (p = 0.02) associated with participants’ knowledge, attitude, and self-care practices. Good knowledge significantly (p = 0.001) influenced attitude and self-care practices among the participants. Results from FGDs and IDIs were in agreement with those obtained from the questionnaire-based part of the study.

Conclusion:

The participants from Amorji community had good knowledge of the features of RE but poor knowledge of its causes and treatment. They also exhibited positive attitude, but poor self-care practices toward refractive errors.
Functional and Morphological Study of the Effects of Carvacrol on Smooth Muscle of the Thoracic Aorta in the Rat
Authors: Shatarat AT , Halaiqah SH , Altarawneh IA , Smadi ZS , Badran DH , Al-Essa Mohamed K. , Mohammed FI
Published: March 2023

ABSTRACT

Background:

The leaves of Origanum are widely used in herbal medicine hence of having many beneficial ingredients, one of these important compounds is Carvacrol. The inhibitory effect of Carvacrol was the core of this study by applying different kinds of stimulants to smooth muscles in the wall of thoracic aorta in rats.

Aim:

To investigate the pharmacological effects of Carvacrol, the main active ingredient present in the medicinal plant Origanum, on the contractile activity and morphology of the smooth muscle of the rat thoracic aorta.

Materials and Methods:

After the thoracic aorta arteries were isolated and prepared for the experiments, each thoracic aorta was cut into 5-mm ring segments; different stimulants were used (Potassium Chloride, Norepinephrine, U46619, and α,β-methylene ATP) in the presence and absence of Carvacrol on four groups of rats. The isolated rings were placed and connected to a force transducer which in turn linked to a data acquisition system via an amplifier to record the effect of each stimulant. GraphPad Prism version 5.02 for Windows, one-way analysis of variance followed by Dunnett’s multiple comparison test.

Results:

It was found out that Carvacrol obstructs the contractile responses elicited by exogenous NA, KCl, U46619, and α,β-methylene ATP in a concentration dependent manner.

Conclusion:

The addition of Carvacrol in the experimental rats showed an increase in the thickness of tunica media as evident by the number of smooth muscle layers and laminae of elastic fibers. It was found that Carvacrol reduced the vascular smooth muscle contractility in the rat thoracic aorta. The mechanism of action is presumed to be achieved through interfering with the mobilization of both intracellular and extracellular Ca2+ through different receptors. Furthermore, it might be suggested that Carvacrol in high doses stimulates smooth muscles in the wall of aorta leading to an increase in the thickness of tunica media layer.
Assessment of Left Ventricular Geometry in Normotensive Type II Diabetic Patients
Authors: Udora NC , Ejim EC , Young EE , Onwubere BJC
Published: March 2023

ABSTRACT

Background:

Abnormalities of glucose metabolism are associated with abnormal left ventricular geometry (LV) independent of atherosclerosis. Abnormal LV geometry, a predictor of premature cardiovascular events, indicates presence of subclinical target organ damages. Screening for abnormal LV geometry in diseases of abnormal glucose metabolism is desirable as part of their management protocol.

Aim:

To assess the left ventricular geometry in normotensive type II diabetic patients. Cross-sectional, descriptive, hospital-based study. One hundred normotensive type II diabetic patients drawn from the Endocrinology and Family Medicine Clinics of a tertiary hospital were age- and gender-matched with 100 apparently healthy controls. Participants meeting the criteria and informed consent proceeded for clinical evaluation, biochemical assessment, electrocardiography, and echocardiography using the American Society of Echocardiography guideline.

Materials and Methods:

Data were analyzed using the Statistical Package for Social Sciences [SPSS] version 25.0 (Chicago Illinois, USA).

Results:

Mean age of study and control groups was (55.56 ± 9.89 versus 55.47 ± 10.7) years (χ2 = 0.062, P = 0.951). The mean duration of diabetes illness was 6.57 ± 6.26 years. Prevalence of abnormal LV geometry was 51% (study) versus 18% (control) FT, P < 0.001). Concentric remodeling was the predominant geometry in 36% of study versus 11% of controls, followed by eccentric hypertrophy in 11% (study) versus 4% (control) and concentric hypertrophy in 4% (study) versus 3% (control). Geometry was normal in 49% of study against 82% in the controls (FT, P < 0.001). Significant association existed between LV geometry and duration of diabetes (χ2 = 10.793, P = 0.005).

Conclusion:

Abnormal LV geometry is highly prevalent in normotensive diabetic patients.
Knowledge, Attitude, and Practices Regarding Proton Pump Inhibitors among Community Pharmacists and Pharmacy Students
Authors: Hamurtekin E , Boşnak AS , Azarbad A , Moghaddamshahabi R , Hamurtekin Y , Naser RB
Published: March 2023

ABSTRACT

Background:

There are concerns about inappropriate use and insufficient knowledge of proton pump inhibitors (PPIs) use among medical staff.

Aims:

This study was designed to examine pharmacy students’ and community pharmacists’ knowledge, attitude, and practices toward PPIs and their relationship with specific sociodemographic characteristics.

Subjects and Methods:

This descriptive study was conducted on the pharmacy students (first and last year) at Eastern Mediterranean University and community pharmacists in North Cyprus Data were collected by a validated questionnaire, which assessed knowledge, attitude, and practices regarding PPI use. Students were included without sampling in a volunteer-based manner. Registered community pharmacists were selected randomly.

Results:

First-year pharmacy students (n = 77) showed significantly lower knowledge levels than last-year students (12.00 vs. 13.65; P < 0.001); however, there was no significant difference between last-year students (n = 111) and community pharmacists (n = 59). First-year pharmacy students were significantly less aware of PPIs’ “dosage and administration” than the other two groups. Last-year students and community pharmacists exhibited significantly higher attitude scores regarding PPI use (24.7 and 24.6 vs. 22.7; P < 0.001). Omeprazole was found to be the most preferred PPI among the three studied populations. Community pharmacists used PPIs mainly to treat acid reflux. Gender, nationality, and pharmacy education program type did not influence pharmacy students’ knowledge, attitude, or practices.

Conclusions:

There was not a significant difference regarding knowledge and attitude between the last-year pharmacy students and community pharmacists. The practices of community pharmacists were significantly different from the pharmacy students. It was concluded that certain essential topics regarding PPI use should be emphasized in pharmacy education and during pharmacy practice. Further, it is essentially important for community pharmacists to continue their education through training programs after graduation to enhance their knowledge of PPI use.
Current treatment landscape for obesity in Singapore
Authors: Lee Phong Ching , Lim Chin Hong , Asokkumar Ravishankar , Chua Marvin Wei Jie
Published: March 2023

The rising prevalence of obesity in Singapore is a harbinger for a corresponding increase in obesity-related complications such as type 2 diabetes mellitus (T2DM) and coronary heart disease. Obesity is a complex disease driven by multiple factors, and hence, treatment cannot follow a ‘one-size-fits-all’ approach. Lifestyle modifications involving dietary interventions, physical activity and behavioural changes remain the cornerstone of obesity management. However, similar to other chronic diseases such as T2DM and hypertension, lifestyle modifications are often insufficient on their own, hence the importance of other treatment modalities including pharmacotherapy, endoscopic bariatric therapy and metabolic–bariatric surgery. Weight loss medications currently approved in Singapore include phentermine, orlistat, liraglutide and naltrexone–bupropion. In recent years, endoscopic bariatric therapies have evolved as an effective, minimally invasive and durable therapeutic option for obesity. Metabolic–bariatric surgery remains the most effective and durable treatment for patients with severe obesity, with an average weight loss of 25%–30% after one year.
The impact of obesity: a narrative review
Authors: Lam Benjamin Chih Chiang , Lim Amanda Yuan Ling , Chan Soo Ling , Yum Mabel Po Shan , Koh Natalie Si Ya , Finkelstein Eric Andrew
Published: March 2023

Obesity is a disease with a major negative impact on human health. However, people with obesity may not perceive their weight to be a significant problem and less than half of patients with obesity are advised by their physicians to lose weight. The purpose of this review is to highlight the importance of managing overweight and obesity by discussing the adverse consequences and impact of obesity. In summary, obesity is strongly related to >50 medical conditions, with many of them having evidence from Mendelian randomisation studies to support causality. The clinical, social and economic burdens of obesity are considerable, with these burdens potentially impacting future generations as well. This review highlights the adverse health and economic consequences of obesity and the importance of an urgent and concerted effort towards the prevention and management of obesity to reduce the burden of obesity.
Применение уравнения Сильвестра к решеточной системе Кадомцева-Петвиашвили типа В
Authors: Sun Ying Ying , Wu Chen Chen , Zhao Songlin
Published: March 2023

С помощью метода обобщенной матрицы Коши показано, что частный случай уравнений Сильвестра связан с решеточной системой Кадомцева-Петвиашвили типа B. Переменные в уравнении Сильвестра применяются для определения функции $\tau$ и некоторых скалярных функций, которые тесно связаны с решеточным уравнением Кадомцева-Петвиашвили типа В. Если использовать эту связь, то становится ясно, что, кроме стандартных многосолитонных решений решеточного уравнения Кадомцева-Петвиашвили типа В, существуют и другие типы точных решений. Кроме того, для этого уравнения различными способами получены пары Лакса.
Toxoplasmosis congénita en España, presente y futuro
Authors: de Fuentes Corripio Isabel
Published: March 2023

La toxoplasmosis es una enfermedad de alta prevalencia y distribución mundial que puede cursar de forma asintomática, aunque también puede ocasionar clínica grave en personas inmunocomprometidas e incluso ser mortal. Este libro compila información desde la perspectiva “Una salud” contando con la visión de diferentes profesionales implicados en el área: clínicos, epidemiólogos y microbiólogos, lo que proporciona una perspectiva altamente enriquecedora y de gran utilidad para todos aquellos profesionales interesados en esta temática.