bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of the prescribing pattern of antidepressants and the side effects in depression patients
Authors: Ara Sepideh Khatib
Published: December 2022

ABSTRACT

Major depressive disorder (MDD) is a mental disorder characterized by impairment in mood regulation, loss of interest or pleasure, feelings of guilt, low self-worth, disturbed sleep and appetite, feelings of tiredness, and poor concentration. It is estimated to be the third leading cause of disability and about 350 million people suffer from depression worldwide. Treatment selection include consideration of the patient’s personal history of medication response, side effects, drug preference, coexisting psychiatric disorders, accessibility, cultural, social, and situational factors. The main objectives in this study are to analyze prescription pattern of antidepressants, to assess treatment outcomes and partial remission in depression, and to evaluate the side effects in patients receiving antidepressant medications. The investigators will obtain the patient demographic data, disease information, medical issues, and other relevant patient information by interviewing them and referring patient medical records in the hospital (both inpatients and outpatients) documented in a self-designed case report form along with assessment of Hamilton Depression Rating Scale (HMDR), Patient Health Questionnaire (PHQ-9), and Morisky Green Levine Medication Adherence questionnaire (MGLMAQ). Adherence to medications was assessed using Morisky Green Levine Scale in 70 previously diagnosed subjects. Most of the subjects (32.85%) were found to have low adherence to medications, whereas 20.00% were highly adherent. There was a high rate of antidepressant discontinuation without consultation with physician. A closer communication between patients and physicians should be encouraged to enhance persistence to medications and improve outcomes. Recognition of depression as a significant risk factor for noncompliance with medical treatment carries the potential to improve medical practice, reduce patient disability, enhance patient functioning, and improve healthcare outcomes.
Bacterial urinary tract infections and its relation with CD4+ T lymphocyte cell count among people living with HIV in Ajmer City, Center of Rajasthan
Authors: Chandwani Jyotsna , Meena Preeti , Mathur Surbhi , Parihar Geeta
Published: December 2022

ABSTRACT

Introduction:

Acquired immunodeficiency syndrome (AIDS) is a global health problem which weakens the immune system and makes it vulnerable to secondary opportunistic infections such as urinary tract infections (UTIs). In case of impaired immunity, asymptomatic UTIs may progress into symptomatic infection or even to sepsis and death. The current study was performed to determine the occurrence of UTI among HIV positive patients and its co-relation with CD4+ count.

Materials and Methods:

Sociodemographic data along with CD4+ cell count data of people living with HIV presented with signs and symptoms of UTIs were collected. Midstream urine samples were collected and sent to microbiology for culture and sensitivity testing.

Result:

Among the 101 participants, 79 had pathogen isolated from their urine specimens. Pseudomonas species was the most common isolate followed by CoNS, S. aureus, E. coli, Yeasts, Streptococcus species, and Enterobacter species. Pseudomonas species were found highly sensitive to Meropenem, Ampicillin-Sulbactan, Ciprofloxacin, and Norfloxacin. Nitrofurantoin was recorded as most effective antibiotic against both gram-positive as well as gram-negative bacteria (except Pseudomonas species). Among the 70 individuals having bacterial UTIs, 40 had CD4+ cell count <200 cells/mm3 followed by CD4+ cell count between 200 and 500 cells/mm3 in 22 individuals and only 08 person had CD4+ cell count >500 cells/mm3.

Conclusion:

Low CD4+ cell count acts as a risk factor for bacterial UTIs. Pseudomonas species becoming a common pathogen among people living with HIV which is intrinsically resistant to Nitrofurantoin, a broad spectrum antibiotic used commonly to treat UTIs.
Efficacy of atropine for myopia control in children: A meta-analysis of randomized controlled trials
Authors: Kumari Shalini , Anand Raj , Tripathi Shashank , Mishra Rajesh C. , Jha Simant Kumar
Published: December 2022

ABSTRACT

Objective:

To conduct a meta-analysis of randomized controlled trials (RCTs) on the effects of atropine eye drop in slowing myopia progression.

Methods:

A systematic search of relevant articles was done through a computerized search on PubMed, Medline, Cochrane Library, and Google Scholar on June 16, 2022. A supplementary search was done on ClinicalTrials.gov on the same date. After thorough search and analysis, seven relevant RCTs, double-masked with atropine eye drop as intervention arm and placebo as control arm, were selected for meta-analysis. Jadad scoring was used to evaluate the quality of RCTs. The outcome measurements included in the present meta-analysis are mean changes in the spherical equivalent (SE) of myopic error, and mean changes in axial length (AL) during the study period.

Result:

Pooled summary effect size, calculated by random effect model, for SE of myopia progression was 1.08 with 95% confidence interval (CI) (0.31–1.86) which was statistically significant (P-value = 0.006). Pooled summary effect size, calculated by random effect model, for axial length was − 0.89 with 95% CI (−1.48 to − 0.30) which was statistically significant (P-value = 0.003).

Conclusion:

In summary, atropine was demonstrated to be effective in controlling myopia progression in children. Both outcome measures, mean SE changes and mean AL elongation responded to atropine intervention compared to placebo.
Urinary tract infection in children with Nephrotic syndrome: One of the hurdles for primary care physician and pediatrician towards timely diagnosis and optimum management of the disease
Authors: Indurkar Shubham K. , Mohan Kriti , Omar Balram Ji , Chacham Swathi , Kumar Manish
Published: December 2022

ABSTRACT

Background:

Urinary tract infection (UTI) is a common infection in children with nephrotic syndrome (NS). Clinical experience suggests that childhood nephrotic syndrome is frequently diagnosed incorrectly and managed inadequately on the top of this existing UTI in the episode becomes an additive obstacle for the primary care physicians or pediatricians towards optimum management, leading to poor outcome. So, we have conducted this clinico- microbiological study of UTI in NS in children to provide the exact picture of UTI with NS so that the primary care providers can be helped in having high index of suspicion of this infection and knowing prevalent organisms and their antimicrobial sensitivity pattern.

Aim:

The aim of the study was to study clinical features and identify the responsible organisms with its drug sensitivity pattern with response to treatment in various types and stages of NS with UTI in children.

Methods:

This cross-sectional hospital based study was conducted on 50 children of 2-18 years of age with NS attending nephrology clinic or admitted to the Paediatric ward of AIIMS, Rishikesh. Demographic, clinical, and microbiological data were recorded and details were entered in a predesigned proforma sheet.

Results:

Out of 50 cases, 8 (16%) had a positive urine culture. Six (75%) out of them had first episode and two (25%) were frequent relapsers of NS. Fever, decreased urine output, and generalized edema were the presenting features. The most common bacteria responsible for UTI was Pseudomonas aeruginosa (in around 25% isolates). Escherichia coli and Citrobacter koseri were the most resistant organisms. Patients were treated with antibiotics according to sensitivity pattern which resulted in resolution of symptoms and repeat urine culture became sterile subsequently.

Conclusion:

About one-sixth of children with Nephrotic Syndrome had UTI. UTI should be ruled out in every case of NS in active phase to prevent long-term morbidity and mortality.
Analysis of CD4, CD8, CD19, CD56-16, CD64, QuantiFERON biomarkers in exudative lymphocyte-dominant pleural effusion
Authors: Mehraban Zahra , Pourdowlat Guitti , Mortaz Esmaeil , Atefeh Abedini , Ghaforian Amin R. , MalAmir Mehrdad Dargahi , Bakhtiari Nima
Published: December 2022

ABSTRACT

Background:

There are two main causes of exudative effusion including malignancy-induced effusion and tuberculosis. Considering that in reactive ejections, such as tuberculosis-induced effusion, the role of B lymphocytes and in the malignant effusion, the role of T lymphocytes are more important, in this study we analyzed the frequency of CD4, CD8, CD19, CD56-16, CD64, QuantiFERON in the pleural and serum samples of patients with exudative lymphocytic-dominant effusion.

Methods:

In total, 73 patients were enrolled in the study by exudative lymphocyte effusion, and finally, 63 patients had definite diagnoses. The patients were sorted into three groups including malignant, tuberculosis, and none. The sample of blood plasma and pleural effusion were collected and CD markers were analyzed using flow cytometry.

Results:

The mean age in the malignancy and tuberculous (TB) groups was 63.16 ± 12 and 52.15 ± 22.62, respectively. There was no significant difference in the frequency of CD8, CD4, and CD16-56 cells in blood samples of patients with tuberculosis and malignancy. Compared to those with tuberculosis, the percentage of CD64 cells was significantly higher in patients with tuberculosis than in malignant subjects. Moreover, a comparison of the frequency of cells with CD8, CD4, CD19, CD64, CD16-56, and CD14 markers in pleural samples showed no significant difference between groups. Other inflammatory factors were also investigated. The erythrocyte sedimentation rate (ESR) value for tuberculosis patients was significantly higher than malignancy. Also, QuantiFERON was positive in 14.3% of malignant patients, and 62.5% of patients with TB, which had a significant difference.

Conclusion:

Considering that there are many confounding variables in the study, such as previous medications, subtypes of Mycobacterium, and race of patients conducting studies in different groups and performing data mining for using a set of parameters can be used to detect the exact diagnosis.
Nobel prize in physiology or medicine by the Indian medical education system: How far and how close?
Authors: Kumar Raman
Published: December 2022

ABSTRACT

Every year, Nobel prizes are announced, recognizing the unique contributions of individuals and organizations across the globe. Currently, India hosts the largest medical education system in the world with 650 medical colleges spread all over India and capacity to train 100,000 MBBS medical doctors a year. India is also a hub of cost-effective pharmaceutical industries and dubbed as the ‘pharmacy of the world’. However, the cost of care is still out of reach of a large section of the population. If India is to become a global economic power, such aspirations cannot be solely based on the consumer market-driven economy but on achieving supremacy in ‘new knowledge’ creation as well. The research capacity needs to be optimized and capable of translating research work into the domestic monopoly and control over newer knowledge, technologies, products, and services for global consumers. Cost of care for more than 1 billion people, even if it is through universal health coverage, can be significantly reduced by supporting research activities and creating domestic intellectual properties in the healthcare sector.
Public awareness of diabetes complications and its effect on treatment compliance in Asir region, Saudi Arabia
Authors: Alhammadi Nouf Ahmed , AL Qahtani Amar Abdullah , Hosiky Majed Fahad , AL Shahrani Faleh Saeed , AL Shehri Saeed Mofareh , AL Ghamdi Meshari Ata , AL Shehri Faisal Mofareh
Published: December 2022

ABSTRACT

Background:

Diabetes mellitus [DM] is the most prevalent disease that affects modern human life in Saudi Arabia. People with DM must have a comprehensive understanding of the nature, risk factors, complications, and treatment methods to mitigate complications.

Aim:

The aim of the study is to assess diabetic patient awareness of complications and their effect on treatment compliance in the Asir region of Saudi Arabia. A cross-sectional study was conducted targeting available diabetic patients in the Asir region, Saudi Arabia. Patients aged 18 years or more living in the Asir region with type 1 or type 2 diabetes were included. Data were collected from eligible patients using a pre-structured electronic questionnaire. The tool covered the following data: patients’ sociodemographic data, patients’ diabetes duration, patients’ compliance with medical care and treatment, patients’ awareness regarding diabetes-related complications, and patients’ experienced complications. The questionnaire was uploaded online using social media platforms by researchers.

Results:

A total of 466 diabetic patients fulfilling the inclusion criteria completed the study questionnaire. Patients’ age ranged from 18 to more than 50 years old, with a mean age of 38.9 ± 12.6 years old, Of the 279 patients, 59.9% were males. 143 [30.7%] patients reported measuring HbA1c every three months. 363 [77.9%] reported having a blood glucose meter at home, but only 205 [44%] reported having a good concern to measure their blood sugar and 211 [45.3%] had good diabetic control, while 124 [26.6%] reported excellent control. Of those, 218 [46.8%] patients had good awareness levels regarding diabetes-related complications, while 248 [53.2%] had poor awareness levels.

Conclusions:

Our study showed that diabetic patients living in Asir region had an average awareness level regarding diabetes-related complications, especially newly diagnosed, young people. Interestingly, diabetic patients showed good-to-excellent adherence to medical care and medications.
Thyrotoxic hypokalemic periodic paralysis and COVID-19 infection
Authors: Chinangkulpiwat Sitanun , Tantiprawan Jutamart , Amornvit Jakkrit , Bunchaya-Anant Patchaya , Snabboon Thiti
Published: December 2022

ABSTRACT

Various conditions causing weakness associated with coronavirus disease 2019 (COVID-19) infection have been described, including cerebrovascular diseases, acute myelitis, Guillain-Barré syndrome, myasthenia gravis, critical illness myopathy and neuropathy, myositis, and rhabdomyolysis. We report an adult man presenting with an unusual etiology of weakness after a COVID-19 infection. Thyrotoxic hypokalemic periodic paralysis (THPP) was diagnosed from the presence of Graves’ disease and hypokalemia because of intra-cellular potassium shifting. His weakness and hypokalemia responded well to potassium supplements and a non-selective b-blocker, whereas his thyrotoxicosis was initially controlled by an anti-thyroid medication and subsequently with radioactive iodine therapy. He was also treated as having mild COVID-19 based on his normal chest X-ray and oxygenation level. This is the first report showing an association between COVID-19 infection and a paralysis attack of THPP. Physicians should be alerted about this unusual cause of weakness, particularly in Asian patients.
Assessment of pulmonary function test in brick factory workers
Authors: Bansal Nandini , Lanjewar Ajay , Acharya Sourya , Shukla Samarth
Published: December 2022

ABSTRACT

Background:

Industrial workers are exposed to dust and pollutants and thus they get occupational disorders when exposed for a long duration. Occupational diseases mainly affect the respiratory system more than other systems. Some of the respiratory occupation disorders are asbestosis, silicosis, coal worker’s pneumoconiosis, work-related asthma, and so on, as the duration of exposure of pollutants increases the pulmonary function decreases.

Method:

A total of 100 subjects working in the Brick factories near Wardha district, Maharashtra were examined using a portable spirometer. Their pulmonary function test was assessed three times and the best out of three values was taken. A pretested questionnaire was filled out by the workers which consisted of their sociodemographic details. Consent was obtained from all the subjects for this in their native language. Similarly, a pretested questionnaire was filled by 50 subjects among the normal population, that is, those not working in brick factories, and consent was obtained from all. And then, their pulmonary function test was carried out using a portable spirometer and the best out of the three values was taken. Statistical analysis was done by using descriptive and inferential statistics using the software.

Results:

As analyzed by the pulmonary function test data values collected among the brick factory workers and the control group, there was a significant decrease seen in the values of the pulmonary function test of brick factory workers. And as analyzed by the pulmonary function test values of smokers and non-smokers among the brick factory workers, it was seen that there was a significant P value of 0.0001, thus a decrease in pulmonary function test among smokers.

Conclusion:

In this study, we evaluate the respiratory function test among the brick factory workers and the control group and make the workers aware of the damage their habits have on their lung capacity and function based on the evaluation of the predicted and the actual value and thus helps them lead a better life. In this study, we also compare the values of pulmonary function tests among the brick factory workers and control groups.
Orbital rehabilitation of a COVID-19-induced mucormycotic defect – A case report
Authors: Dahihandekar Chinmayee A. , Pisulkar Sweta Kale , Patra Madhumaitri , Bansod Akansha V.
Published: December 2022

ABSTRACT

The surgical removal of the maxilla and the orbit and its content, which leads to degraded esthetics, weakened functioning, and arrested psyche, has caused widespread fury among coronavirus disease (COVID-19)-produced mucormycosis patients. It has been stated that a patient with an ocular deformity due to surgical excision of a mucormycosis infection can be rehabilitated. Obtaining a healthy location for prosthesis acceptance is critical for the success of many resected patients. The advantages of anatomical and mechanical retention were fully exploited. The report includes an appropriate treatment plan for the rehabilitation of such faults, as well as a follow-up period and maintenance. Such rehabilitation not only improves the cosmetic outcome but also helps to elevate the patients’ spirits mentally. The following case report defines the treatment guidelines for rehabilitation of a patient with orbital and intra-oral defect owing to COVID-19-induced mucormycosis. It also establishes the steps required for the fabrication along with materials required and suitable pertaining to the above-mentioned scenario. The text is duly supported by images wherever necessary.
Saving oxygen when it was most needed
Authors: Bhaskar Vikram , Panwar Neha , Saryan Smriti , Masih Sarita
Published: December 2022

ABSTRACT

Background:

Oxygen is one of the most commonly prescribed drugs across the globe. The ongoing Covid-19 pandemic has put enormous burden on hospital infrastructure and oxygen demand. There is lack of knowledge among healthcare workers regarding optimal utilization of oxygen delivery devices, target oxygen saturations and adequate oxygen prescription. A quality improvement project was designed to optimize the oxygen usage in wards.

Methods:

A core team comprising one each of consultant, senior resident, junior resident and nursing officer was formed. Fish bone analysis was done to find deficiencies in the existing system and strategy was planned to overcome these deficiencies. The key intervention included education and training of staff, Formulation of Standard Operating Procedures, use of lower target oxygen saturation and use of oxygen concentrators.

Results:

The project was carried out for a very short period of 5 days, and a total of 180,000 liters of oxygen was saved. The use of oxygen concentrators increased from zero to 9.5% and thus reducing the load on central oxygen supply.

Conclusion:

The proper training and sensitization of health care workers can help in saving oxygen, which further helps in saving precious human life.
Usefulness of STOPP/START criteria and Beers criteria for prescribing in geriatric patients in a tertiary health care center, Raipur, Central India
Authors: Keche Yogendra Narayanrao , Gaikwad Nitin R. , Wasnik Preetam N. , Siddiqui Sabah , Nagpure Keshao , Dhaneria Suryaprakash
Published: December 2022

ABSTRACT

Background:

Polypharmacy and inappropriate prescribing are risk factors for adverse clinical outcomes in older people. Screening tools can identify potential medicine-related patient safety incidents for the elderly on multiple medicines and with chronic diseases.

Methods:

In this prospective observational study, details of demography, diagnosis, history of constipation/peptic ulcer disease, over-the-counter medications, and clinical and laboratory findings were noted. Information obtained was reviewed and analyzed with the help of STOPP/START and Beers 2019 criteria. At 1 month follow-up, improvement was assessed with the help of a structured questionnaire.

Results:

As per the criteria, modification in drugs was recommended for 213 drugs; it was actually performed for 27.73% and 48.71% drugs as per Beers and STOPP/START criteria, respectively. Glimepiride was replaced with short-acting sulfonylureas because of hypoglycemia, and angiotensin receptor blockers were stopped because of hyperkalemia as per Beers criteria. Statins were started in 19 patients by START criteria. Overall general health improvement was observed at 1 month, but an increase in anxiety, tension, worry, depressed feel, and insomnia was observed in initial days of the coronavirus disease 2019 pandemic.

Conclusions:

In view of polypharmacy in the prescriptions, the combination of prescribing criteria need to be considered while prescribing medications to the elderly to get optimum therapeutic benefits and improvement in the quality of life. The quality of primary care of the elderly can also be improved by use of screening tools such as STOPP/START and Beers criteria by a primary/family physician. Prescription evaluation by a trained pharmacologist/physician for possible drug/food/disease interactions and for therapy modification can be incorporated for routine geriatric care at a tertiary care center.

Clinical trial registry of India registration number: CTRI/2020/01/022852
Compulsive buying disorder (CBD) among medical students in colleges of medicine, dentistry and pharmacy at King Saud University in Riyadh
Authors: Amin Hussain S. , Binobaid Alkaseem A. , Nagshabandi Khalid N. , Alammari Omar B. , Alshunaybir Omar H. , Alhammad Sultan A. , Almezaini Abdulrahman I.
Published: December 2022

ABSTRACT

Background:

Compulsive buying disorder (CBD) is a dysfunctional chronic and extreme consumer attitude that attributes to negative overall impact on psychological and mental wellbeing.

Objective:

This study was aimed to examine the prevalence of compulsive buying disorder (CBD) among medical college students, particularly from colleges of medicine, dentistry and pharmacy. Secondary to this, we also examined (i) the association between sociodemographic factors and CBD; and (ii) the association between the five factors of CBD as per (II) Edward’s Compulsive Buying Scale (ECBS) and participants’ gender.

Method:

This cross-sectional survey was conducted among 263 college students from the colleges of medicine, dentistry and pharmacy of King Saud University from February till March 2021.

Results:

The results showed that the majority of participants were male (144, 54.8%) with mean age 20.1 ± 3.1 (range: 17–23); statistically significant difference was observed in compulsive buying disorder with respect to gender (P-value = 0.02), field of study (P < 0.0001) and educational year (P = 0.03).

Conclusion:

The study concluded that the prevalence of compulsive buying among university students was more frequent among female students in comparison to male students in Riyadh city. This study provided baseline data for the estimation of CBD prevalence among adolescent and youth in KSA, particularly Riyadh city.
Safer citalopram use in primary care: Can staff education and prescribing prompts improve adherence to national guidance? A closed loop clinical audit, service evaluation and quality improvement study
Authors: Waller Mark
Published: December 2022

ABSTRACT

Background:

Citalopram is a drug with many important safety considerations in prescribing including dosage adjustments, pre-prescription testing and multiple interactions. Because of this, the UK government issued advice regarding the prescription of citalopram and escitalopram in its Drug Safety Update Vol 5 Issue 5, Dec 2011,[1] and the expectation is that all prescribers adhere to this.

Purpose/Aim:

To establish the adherence to prescribing guidance of citalopram at the practice level, implement change to address the lack of adherence and then evaluate the effectiveness of the change using re-audit techniques.

Methods:

Patients were identified using data searching techniques on EMIS for February–April 2020. Parameters searched for included age, hepatic impairment, cardiac disease, known QT prolongation and concomitant use with other QT-prolonging medication. Following the first cycle teaching on the safer use of citalopram was delivered to all prescribers and an EMIS prompt was also set up. A second audit cycle was then carried out. Data was analysed using Statistical Package for Social Sciences software to assess the significance of the results.

Results:

Following the presentation of the first cycle findings and the introduction of the EMIS safety prompt, there was a statistically significant reduction in incorrect citalopram dose prescription in the over 65s (8 vs 1), a statistically significant reduction in the incidence of dangerous drug interactions involving citalopram (44 vs 8) and a significant reduction in the incidence of unsafe prescribing of citalopram overall (47 vs 9).

Conclusion:

The introduction of an EMIS prompt and one-off prescriber teaching resulted in a statistically significant reduction in incorrect prescriptions of citalopram when re-audited a year later. These interventions resulted in improved patient safety and more effective use of resources and could easily be replicated at other practices throughout the country both for citalopram and other drugs with multiple safety considerations.
Beneficial esthetic lightening effects of Cuscuta extract on skin darkness in healthy individuals: A clinical trial study
Authors: Roohaninasab Masoumeh , Mojtabaee Mahdis , Livani Fatemeh , Heidari Nazila , Alizadeh Nilufar , Khosravi Sepehr , Goodarzi Azadeh
Published: December 2022

ABSTRACT

Background and Objective:

Many biological activities and pharmacological usages have been revealed for the Cuscuta species. The present study aimed to assess the beneficial effects of Cuscuta on removing skin dark spots in healthy individuals, which is an important cosmetic concern, especially in women.

Materials and Methods:

This prospective, interventional before–after trial was conducted in 70 healthy individuals without any evidence of skin or systemic disorders who presented for consultation on removing skin darkening. The Cuscuta extract was prepared and then assessed for plant quality control and lack of microbial contamination. The content of melanin at baseline and at 1 and 3 months after intervention was assessed using Dermacatch, an accurate skin colorimetric measurement tool.

Results:

Comparison of the melanin content of the lesions and treated area to the surrounding normal area at baseline and at 1 month after treatment showed a significant reduction in melanin content from 519.61 ± 45.09 to 498.50 ± 39.35 (P < 0.001). This reducing trend remained significant from the first month to the third month after treatment (from 498.50 ± 39.35 to 483.53 ± 40.99, P < 0.001). This decreasing trend was persistent even after adjusting baseline characteristics including gender, age, and duration of skin lesions. Both patients and investigators had high satisfaction level with the anti-melanogenesis effect of Cuscuta extract.

Conclusion:

Cuscuta extract is useful for removing hyperpigmented lesions and for skin lightening in healthy individuals.
Knowledge and attitude of physicians toward child abuse and reporting in a tertiary hospital in Riyadh
Authors: Alaraik Enas Fahad , Saad Hussain , Al Lafi Abrar Humoud Fahad , Alshuniefi Abeer Suliman Abdulaziz , Alruwayshid Mashael Suwailem Mohammed , Alaraik Ayman Fahad , Alsaad Samaher Z.
Published: December 2022

ABSTRACT

Background:

Child abuse is a common global devastating issue for the patient and physician. It can lead to much unpleasant and danger and even death. One of the most essential parts of a doctor’s job is to help people in need and a child should be top priority as they are dependent for protection and care.

Objectives:

To analyze the experience and knowledge of Saudi residents from both specialty family medicine and pediatrics working in Riyadh city toward the recognition and diagnosis of child abuse and neglect and spot the light on the barriers that prevent its reporting and to assess the need for further training.

Method:

A cross-sectional study was conducted in four major tertiary hospitals in Riyadh (KKUH, National Guard Hospital, King Fahad Medical City, Prince Sultan Medical City) from March 2019 to January 2020.

Results:

Most participants did not have sufficient knowledge regarding the physical assessment of suspected child abuse and neglect. The result showed no significant difference in terms of knowledge and attitude between family physicians and pediatrics working in tertiary centers in Riyadh.

Conclusion:

The study concluded that the Saudi residents from both specialties, that is, family medicine and pediatrics, had insufficient knowledge regarding child abuse. In addition, the residents had positive attitudes toward child abuse prevention. Finally, the study recommends conducting awareness campaigns to increase the knowledge of physicians about child abuse and the predictive factors.
Adverse effects after first and second dose of covishield and covaxin: A longitudinal study
Authors: Mittal Amit , Jain Bhavna , Varshney Amit Mohan , Garg Gagan , Sachan Divyata , Singh Ram Bali
Published: December 2022

ABSTRACT

Background:

COVID-19 vaccines have been rolled out recently in several parts of the world. Although the protective efficacy is frequently discussed, little is known about the factors associated with COVID-19 vaccine adverse effects. The study was conducted with the aim to evaluate the occurrence of adverse events following immunization (AEFI) with two doses of covishield and covaxin and to assess factors associated with these adverse effects.

Methods:

A longitudinal study was conducted for a period of three months in the adults above 18 years of age attending rural health training center (RHTC) either to receive their first or second dose of covishield or covaxin. After vaccination, the participants were observed at the health facility for 30 min for any AEFI and also followed up telephonically on seventh day from vaccination. Data was collected on predesigned and pretested questionnaire and appropriate statistical tests were applied.

Results:

Out of 532 participants, 250 (47%) came for their first dose while 282 (53%) came for second dose. In both the groups maximum participation was seen by males and those belonging to age group 18–30 years. Majority of the participants reported local tenderness (39.3%) after first dose of covaxin and fever (30.5%) after first dose of covishield. Mainly significant association was observed after vaccination in participants with comorbidities.

Conclusion:

The short-term adverse events with both the vaccines were observed, but these were mild and short lived. In this context, our study becomes more relevant in disseminating short-term safety data post vaccination. This will help individuals in their decision to accept vaccination.
Kounis syndrome and atrial fibrillation after bee sting: A case report
Authors: Gopinath Bharath , Kumar Gaurav , Nayaka Rakesh , Ekka Meera
Published: December 2022

ABSTRACT

Bee sting can lead to allergic reactions which can present as life-threatening emergencies. Kounis syndrome is an acute coronary syndrome caused by mast cell activation after exposure to an allergen. Atrial fibrillation (AF) along with Kounis syndrome after allergen exposure is a rare presentation. A 40-year-old male patient presented to the emergency department (ED) with multiple bee stings to the face and neck. He complained of retrosternal chest pain along with facial pain and swelling. An electrocardiogram (ECG) showed AF with ST elevation in aVR and generalized ST segment depression. Troponin levels were elevated. He was diagnosed with Kounis syndrome along with AF secondary to a bee sting. The patient improved symptomatically with removal of stings and conservative management (steroids, antihistamines, antiplatelet drugs). ECG reverted to sinus rhythm and resolution of ST-T changes. He was discharged from the ED in stable condition. The bee sting may lead to significant cardiovascular events such as AF and Kounis syndrome, which require a high index of suspicion and prompt treatment. Kounis syndrome should be suspected in the ED in young patients with no cardiovascular risk factors after exposure to an allergen.
Prevalence and sociodemographic predictors of perceived family functionality, marital satisfaction and intimate partner violence during the COVID-19 lockdown among married primary healthcare users
Authors: Michael Godpower Chinedu , Suleiman Abdullahi Kabir , Abdulkadir Zainab , Umar Zainab Abdulazeez , Olawumi Abdulgafar Lekan
Published: December 2022

ABSTRACT

Background:

The impact of COVID-19 lockdown on family experiences has not been thoroughly evaluated, given the consequent stressful home environment it reportedly caused that can adversely affect family dynamics. This study examined the prevalence and sociodemographic predictors of perceived family functionality, marital satisfaction and intimate partner violence (IPV) during the lockdown among married healthcare users in a Nigerian primary care setting.

Materials and Methods:

The study was cross sectional. Data were collected randomly from 432 eligible attendees of a primary care clinic in Kano, Nigeria. Information regarding participants’ sociodemographic characteristics, family functioning, marital satisfaction and IPV were measured using a sociodemographic questionnaire, APGAR-, Kansas marital satisfaction- and verbal HITS-scales.

Results:

Respondents’ mean (range) age was 30 (15–70) years; 293 (67.8%) were females. Family dysfunction, marital dissatisfaction and probable IPV were found in 44.2, 56.5 and 50.5% of respondents, respectively. The odds of a functional family were higher among caregiver and female respondents but lower among those aged ≥50 years, students, non-Hausa/Fulani, those with low education and residing outside the Kano metropolis during the lockdown. Marital satisfaction was higher among caregivers and respondents from polygamous families and lower among respondents aged ≥50 years. No studied sociodemographic variable predicted probable IPV.

Conclusion:

There was a high prevalence of family dysfunction, marital dissatisfaction and probable IPV among the respondents during the lockdown. These findings suggest screening married patients for family dysfunction, marital dissatisfaction and IPV during similar lockdowns for appropriate interventions. The predictor variables could form essential considerations for the screening.
Effect of physical health, dietary behaviour and personal hygiene on body mass index of school-going adolescents near Patna, Bihar: A cross-sectional study
Authors: Roy Ria , Pandey Sanjay , Ranjan Alok , Kumar Pankaj , Kumar Pragya , Singh CM
Published: December 2022

ABSTRACT

Background:

Body mass index (BMI) is the most frequently used method to determine the nutritional status in adolescents. School-going population in developing countries like India are susceptible to undernutrition due to several socioeconomic, demographic, and nutritional factors. Poor dietary habits, sedentary lifestyles and improper hygiene can have a deleterious effect on their BMI.

Methods:

The aim of the study was to determine any association of BMI with physical health, nutrition, and personal hygiene among the school-going adolescents near Patna, Bihar. Analytical cross-sectional study was conducted among 160 school-going adolescents, chosen by stratified random sampling. They were given Indian Adolescent Health Questionnaire which had close-ended questions about physical activity, nutritional, and hygienic practices. BMI was calculated from self-reported height and weight. Pearson’s correlation, independent t test, ANOVA, and Chi-Square test of proportions were done. Significance level was set at P < 0.05.

Results:

Only 39.4% adolescents had normal BMI, and almost half were underweight. Pearson’s correlation of BMI with age showed a weak positive correlation (r = 0.124, P = 0.118). Participants perceiving themselves overweight, did physical exercise to lose weight (P < 0.001), whereas who stated that they rarely consumed cooked vegetables, had the self-perception of being underweight (P = 0.009). This self-perception of their weight, physical activity, handwashing after using toilet/latrine and weekly frequency of brushing teeth significantly predicted the BMI in these adolescents (F = 10.895, df (4,155), P < 0.001, R
2 = 21.9%, Adj. R
2 = 19.9%).

Conclusion:

Malnutrition can lead to infection, impaired reproductive health, anaemia and other long-term morbidities into adulthood. Hence there is need of more objective nutritional assessment in adolescence for prevention of disease burden in the community.
Participatory cooking demonstrations: A distinctive learning approach towards positive health
Authors: Ali Syed Irfan , Begum Jarina , Badusha Mohammad , Reddy E. Srikaanth , Rali Padmavathi , Lalitha D. Lakshmi
Published: December 2022

ABSTRACT

Background:

Participatory cooking demonstration is a unique and effective way to teach nutritional concepts and basic cooking skills in a community setting. The present study attempted to develop the same in 4th-year nursing students through the intervention for a better nutritional health outcome. The objectives are to introduce and train nursing students on participatory cooking demonstrations in community households, evaluate the improvement of knowledge and self-efficacy of the participants, and assess the feedback of the study participants towards the intervention.

Methodology:

An educational intervention was carried out among BSc Nursing students in a tertiary healthcare institute from April to June 2019. A sample of 66 students were subjected to pre- and post-tests along with a self-efficacy evaluation and feedback survey.

Results:

Out of all, 91.1% were between 21 and 30 years, 77.8% belonged to rural areas, and 82% were in the lower–middle socioeconomic class. The knowledge was improved, and it was found to be statistically significant (P < 0.0001). The self-efficacy evaluation showed an enhancement of knowledge and awareness. The majority either strongly agreed or agreed that participatory cooking demonstrations helped them learn healthy cooking practices (80%), analyze specific nutritional problems (95.6%), and get hands-on experience in nutritional care (86.4%). The themes that emerged from qualitative data were discussed under liked, disliked aspects, challenges faced, and solutions offered.

Conclusion:

The hands-on sessions on participatory cooking demonstrations were successfully introduced and the knowledge and self-efficacy of the participants was improved. All participants were satisfied with the intervention as perceived by the participants.
Integrated community health service model (ICHSM): A new hope for primary care in hilly outreach areas of Uttarakhand, India
Authors: Kumar Santosh , Negi Sapna
Published: December 2022

ABSTRACT

Comprehensive primary health care has been a subject of concern for millennia, and the Indian government has undertaken a variety of initiatives, including the National Health Mission, Ayushman Bharat, and Health and Wellness Centers, to mention a few. Despite this, there are significant challenges in providing equitable access to primary health care, particularly for persons who live in rural and hilly areas. The major goal of this model is to develop a comprehensive community-based participatory strategy for galvanizing the community toward improved health-care access and realizing the impact of community empowerment. A thorough literature search was conducted to identify the articles that provide a snapshot of primary hea lth-care services situation in mountainous regions of India. Based on the gaps identified in health-care delivery, we proposed a unique approach built on the principle of “to the community, for the community, and by the community.” This paper provides the description of the model, its importance, as well as effectiveness of its implementation in a hard-to-reach region. The model recommends developing a community taskforce within the community to educate the masses about their primary health-care needs, thus reducing emergency department visits and hospital admissions, and also assist the primary care or family physician in preparing a collaborative treatment plan for their patients in early stages of diseases.
Unreported protocol deviations – The tip of the research-berg
Authors: Kulkarni Uma , Vaswani Ravi , Guthigar Mohammed , Bhat Nagapati , Sonde Laxminarayan
Published: December 2022

Introduction:

Failure to stay within an ethics committee (EC)-approved protocol limits is termed protocol deviation or violation (PD/PV), depending on the seriousness of the transgression and its attendant risks and/or harms. PD/PVs arise in the post-approval phase of the research and are often missed. Current guidelines expect ECs to detect, report and recommend suitable actions such that research participants’ risks and harms are mitigated, to the extent possible.

Objective:

Yenepoya Ethics Committee-1 conducted an internal audit of ongoing postgraduate dissertations involving human participants to assess the occurrence of PD/PVs.

Materials and Methods:

54 out of 80 postgraduates responded to our request for filling out a self-reported checklist. These responses were followed up with physical verification of the protocol-related documents.

Results:

Protocol transgressions were classified as non-compliance (administrative issues), protocol deviations (minor transgressions with minimal or less than minimal increase in attendant risk to participants) and protocol violations (serious transgressions with more than minimal increase in attendant risk to participants). The non-compliances included non-reporting for audit and non-reporting of PDs. Protocol deviations included non-conformance to EC validity, sample size, approved methodology, informed consent process and documentation and suboptimal data storage. No protocol violations were observed.

Conclusion:

We report PD/PVs from these 54 protocols – with our assessment on the negative impact it may have on scientific validity, harm to participants, EC functioning and credibility of the institution – in the hope that our readers appreciate this important aspect of the post-approval process in the functioning of an EC.
Electroconvulsive Therapy Without General Anesthesia and the Human Rights of Mental Health Patients
Authors: Barrera Alvaro , Molodynski Andrew , Penzenstadler Louise , Khazaal Yasser
Published: December 2022

The use of unmodified electroconvulsive therapy (ECT), i.e., ECT without general anesthesia, vis-a-vis human rights of mental health patients and standards of care, is discussed. An overview of unmodified ECT is provided, followed by an account of recent events in Chile, where the Minister of Health referred the administration of unmodified ECT to the judicial system. The article concludes with a proposal to launch a voluntary system of accreditation, by which countries willing to have their mental health services accredited by the World Health Organization (WHO) would commit themselves to give unrestricted, unannounced, and at short-notice access to independently appointed the WHO representatives to their community and inpatient mental health facilities.
The smoothed complexity of Frank–Wolfe methods via conditioning of random matrices and polytopes
Authors: Rademacher Luis , Shu Chang
Published: December 2022

Frank–Wolfe methods are popular for optimization over a polytope. One of the reasons is because they do not need projection onto the polytope but only linear optimization over it. To understand its complexity, a fruitful approach in many works has been the use of condition measures of polytopes. Lacoste-Julien and Jaggi introduced a condition number for polytopes and showed linear convergence for several variations of the method. The actual running time can still be exponential in the worst case (when the condition number is exponential). We study the smoothed complexity of the condition number, namely the condition number of small random perturbations of the input polytope and show that it is polynomial for any simplex and exponential for general polytopes. Our results also apply to other condition measures of polytopes that have been proposed for the analysis of Frank–Wolfe methods: vertex-facet distance (Beck and Shtern) and facial distance (Peña and Rodríguez).

Our argument for polytopes is a refinement of an argument that we develop to study the conditioning of random matrices. The basic argument shows that for

c>1

a

d

-by-

n

random Gaussian matrix with

n \geq cd

has a

d

-by-

d

submatrix with minimum singular value that is exponentially small with high probability. This also has consequences on known results about the robust uniqueness of tensor decompositions, the complexity of the simplex method and the diameter of polytopes.
Establishment of quality parameters of Quisqualis indica leaves through sophisticated analytical techniques
Authors: Anjali Patadiya , Vivek Joshi , Jigar Pansara , Keyuri Bhagat , Vaibhavi Savalia , Jayesh Dhalani , Mayank Pandya , Devang Pandya
Published: December 2022

ABSTRACT. Quisqualis indica (Q. indica; Rangoon creeper) is found in Asia and finds its place in Ayurvedic texts, ethno-medicine as well as modern research. Its leaves contain important constituents like rutin, quisqualis acid, trigonelline, L-proline and L-asparagine. Traditionally, the leaves are used as antipyretic, anti-flatulent, anti-inflammatory, anti-septic, and anti-diarrhoeal. Modern pharmacological research also supports these claims. However, this plant remains unexplored phytochemically, which restricts any means for standardization of its formulations. The present research focuses on analysis of leaves of Q. indica using sophisticated chromatographic and spectral techniques. Thin layer chromatography (TLC), high performance thin layer chromatography (HPTLC), gas chromatography-mass spectrometry (GC-MS) techniques were used. After several pilots, TLC analyses, an HPTLC fingerprint of methanolic extract of the leaves was performed using chloroform: methanol: ethyl acetate (7: 3: 3) solvent system, which showed 12 peaks at 254 nm and 9 peaks at 366 nm. GC-MS analysis of the methanolic extract detected 7 known phytochemicals, some of them having pharmacological importance. This research may serve the parameters for quality control of Q. indica leaves in herbal industries, in the detection of adulteration of its formulations as well as open new avenues for phytochemical research, including isolation of a marker compound.

 

KEY WORDS: Quisqualis indica, Adulteration, Fingerprinting, GC-MS, HPTLC, Standardization

Bull. Chem. Soc. Ethiop. 2023, 37(2), 289-298.                                                           

DOI: https://dx.doi.org/10.4314/bcse.v37i2.4