bluuebunny/crossref_metadata_2025 huggingface dataset:
Identification of High Death Risk Coronavirus Disease-19 Patients using Blood Tests
Authors: Zadeh Hosseingholi Elaheh , Maddahi Saeede , Jabbari Sajjad , Molavi Ghader
Published: August 2022

Background:

The coronavirus disease (COVID-19) pandemic has made a great impact on health-care services. The prognosis of the severity of the disease help reduces mortality by prioritizing the allocation of hospital resources. Early mortality prediction of this disease through paramount biomarkers is the main aim of this study.

Materials and Methods:

In this retrospective study, a total of 205 confirmed COVID-19 patients hospitalized from June 2020 to March 2021 were included. Demographic data, important blood biomarkers levels, and patient outcomes were investigated using the machine learning and statistical tools.

Results:

Random forests, as the best model of mortality prediction, (Matthews correlation coefficient = 0.514), were employed to find the most relevant dataset feature associated with mortality. Aspartate aminotransferase (AST) and blood urea nitrogen (BUN) were identified as important death-related features. The decision tree method was identified the cutoff value of BUN >47 mg/dL and AST >44 U/L as decision boundaries of mortality (sensitivity = 0.4). Data mining results were compared with those obtained through the statistical tests. Statistical analyses were also determined these two factors as the most significant ones with P values of 4.4 × 10−7 and 1.6 × 10−6, respectively. The demographic trait of age and some hematological (thrombocytopenia, increased white blood cell count, neutrophils [%], RDW-CV and RDW-SD), and blood serum changes (increased creatinine, potassium, and alanine aminotransferase) were also specified as mortality-related features (P < 0.05).

Conclusions:

These results could be useful to physicians for the timely detection of COVID-19 patients with a higher risk of mortality and better management of hospital resources.
Investigating the Effect of Zinc on the Prevention of Acute Peripheral Neuropathy in Cancer Patients Treated with Taxanes
Authors: Haji Gholami Ali , Ansari Hourieh , Fardani Farshad
Published: August 2022

Background:

Chemotherapy-induced peripheral neuropathy (CIPN) is a major complication of many chemotherapeutic agents, including taxanes. Here, we aimed to investigate the effect of zinc on CIPN.

Materials and Methods:

This is a double-blinded controlled clinical trial that was performed in 2020–2021 in Isfahan on 55 cancer patients. We collected the data regarding CIPN, its severity, presence of abnormal deep-tendon reflexes, paresthesia, restriction in daily activities, and restriction in self-care and pain. Patients were divided into two groups: Patients in the first group were treated with capsules of zinc sulfate 25 mg daily and the control group received placebo. The duration of treatments was 3 months. Patients were visited 6, 9, and 12 weeks after study initiation.

Results:

There was a statistically significant decrease in the frequency of CIPN in the intervention group (37.03% vs. 14.8%, P < 0.001). The evaluation of the severity of neuropathy and presence of abnormal deep-tendon reflexes also demonstrated significant decrease in the intervention group during the study (P < 0.001 for both), but no significant changes were observed in the placebo group (P > 0.05). The activity limitations and pain severity improved significantly both in the intervention and placebo groups (P < 0.001 for both groups and items). The intervention group, however, had significantly lower frequencies of activity limitation and lower pain severity within compared to the control group during the study (P < 0.001).

Conclusion:

Zinc supplement therapy resulted in reduced frequency and intensity of CIPN in patients undergoing chemotherapy with taxanes.
Evaluation of Growth Hormone Deficiency in Children with Cystic Fibrosis
Authors: Reisi Mohsen , Sharif Ahmadian Niloufar , Hashemipour Mahin , Mostofizadeh Neda , Keivanfar Majid , Hashemi Elham
Published: August 2022

Background:

Due to chronic respiratory and gastrointestinal problems, growth failure is a common issue in patients with cystic fibrosis (CF). The present study aimed to investigate the prevalence of growth hormone deficiency (GHD) in CF children with stable gastrointestinal and respiratory conditions.

Materials and Methods:

In this study, the growth indicators of all 4–16-year-old children referred to two CF clinics were monitored over 3 years. Children without severe gastrointestinal or pulmonary symptoms with weight <3% percentile or whose height increase were two standard deviations below their expected height growth over 6 months were selected for the growth hormone (GH) stimulation test by clonidine and L-dopa test. Some of the children without CF, who were also referred for height growth disorders and matched the CF group, were considered the control group. They underwent the GH stimulation test, and the results were compared.

Results:

From 150 patients with CF, growth failure was observed in 24 patients with stable gastrointestinal and respiratory conditions; in 10 of them, the GH stimulation test was deficient. The prevalence of GHD was 6.6% in CF patients. In the control group of 30 children without CF, but with growth failure, the GH was deficient in nine cases, implying no significant difference with the case group (P = 0.37).

Conclusion:

In our study, the prevalence of GHD was 6.6% in CF patients, whereas the prevalence GHD in the normal population of childhood is <1%. Therefore, further studies should be designed to investigate the cause of GHD in CF patients.
A combination of diosmin, hesperidin, and ruscogenin
Authors: Romano Lucia , Nervini Andrea , Stia Simone , Schietroma Mario , Giuliani Antonio
Published: August 2022

Background:

Phlebotonics are made of plant extracts and synthetic compounds. Although their mechanism of action is not completely clear, they are associated with an increase in venous tone and decreased capillary permeability. The aim of this paper was to assess the efficacy of Diosmin 500mg, Esperidine 90mg, Ruscogenin 100mg in improving symptoms of patients with hemorrhoidal disease.

Materials and Methods:

This was an observational trial performed at the Department of Universitary General Surgery of L'Aquila from March 2021 to September 2021. Symptoms have been evaluated using scoring system proposed by Giordano et al. Patients have been clinically evaluated by the same surgeon at the time of diagnosis and at the 30th day of treatment.

Results:

Seventy-one patients were included in the study. In Group A (study group) we reported a decrease in symptomatologic score of 50% with a 30-days follow-up, while we reported a decrease of 27% in Group B (control group). Among patients in Group A, 67% of those with grade IV hemorrhoidal disease have been re-stadiated to grade III after 30 days of treatment.

Conclusion:

Flavonoids mixture could be a safe and effective mean for conservative management of hemorrhoidal disease. The doses seemed to be satisfactory and the proposed duration of treatment can be considered adequate.
Cross sectional study to estimate the morbidity pattern in ascetics visited to a largest religious gathering in west central part of India
Authors: Bhujade Rashmi , Baghel Anil S. , Chourasiya Sanjay K.
Published: August 2022

Background:

Ascetics are otherworldly creatures that have thought of being ethereal. To be spiritual one has to be physically fit because a healthy body has an intimate connection with spiritual health.

Methods:

Cross sectional survey was accomplished in a festive gathering to estimate morbidity pattern among ascetics in central India.

Results:

The sample size was 960. 352 participants (36.6%) were either overweight or obese, 284 participants (29.6%) had hypertension, 236 (24.6%) were diagnosed with cataract and 194 (20.2%) had anemia, Diabetes was found in 58 participants (6%) and 28 (2.9%) had fever.

Conclusion:

Obesity (and overweight) and hypertension were the top two morbidities came across during study. Morbidities were found to be more associated with socio-demographical factors than spirituality.
A systematic review of four decades of prevalence of oral soft tissue infections and conditions among adult HIV patients in India
Authors: Satyalakshmi K , Sathyanath D , Muralidharan Shrikanth
Published: August 2022

Oral lesions are a cue for decreased immunity among Human Immunodeficiency Virus (HIV) positive patients. There is no cumulative data available related to the prevalence of oral soft tissue lesions among the HIV positive patients. Hence, the present review was carried out to assess the various oral lesions reported among adult HIV patients across India. Two search engines were used—Google Scholar and PubMed, with key words of HIV/Acquired Immune Deficiency Symdrome(AIDS), soft tissue, oral cavity, India, and adults for searching the articles from January 1990 to December 2020. After initial review, 21 articles that fulfilled the criteria were included in the review. We used 9 parameters to access the quality of the reports. Most common lesion reported was that of oral candidiasis. Not all articles reported about sample size determination or of sampling design and technique. Other lesions like hyperpigmentation, gingivitis, and periodontitis were also found to be highly prevalent. Most reports were from South India. Further epidemiological data are required from different regions for using it to develop planning and execution related to oral health care for the HIV positive patients in India.
Prevalence of preterm birth and perinatal outcome
Authors: Reddy Ke Manga , Ravula Shilpa Rani , Palakollu Shruthi , Betha Kalpana
Published: August 2022

Context:

Preterm birth is defined as births before 37 weeks of gestational age. Preterm birth is a major challenge in obstetric health care and leading cause of perinatal mortality and long-term morbidity. Complications arising from preterm births are the leading cause of deaths among children less than 5 years of age. Seventy-five percent of them could be saved with current, cost-effective interventions. The rate of preterm births worldwide is 5–18% with the developing countries accounting for the maximum deaths.

Aims:

This study was undertaken to evaluate the prevalence of preterm births and risk factors associated with it among women delivered at a rural tertiary teaching hospital in Telangana and further assess its impact on perinatal outcome.

Settings and design:

This was a retrospective case control study conducted at Mediciti Institute of Medical Sciences from January 2019 to December 2019.

Methods and material:

Of the 1243 deliveries during the study period, 135 births that occurred at <37 weeks were taken as cases and 248 term neonates were taken as control group. Data were collected retrospectively through review of prenatal and hospital delivery records.

Statistical analysis used:

Data were collected and tabulated as shown in the results. Statistical analysis was done using Microsoft Excel. Frequency and percentage of each parameter were calculated and analyzed. The risk estimates were analyzed between the cases and controls by calculating the odds ratio, 95% confidence interval, and P value. P Value of <0.05 was considered significant.

Results:

The prevalence rate of preterm birth was 10.86%. History of previous preterm birth (OR = 4.88, C.I: 1.50–15.87, P = 0.0084), previous LSCS (OR = 2.16, C.I: 1.36–3.44, P = 0.001), inter-pregnancy interval <12 months (OR = 2.78, C.I: 1.13–6.84, P = 0.026), hypertension (OR = 3.10, C.I: 1.78–5.42, P = 0.0001), PROM (OR =0.73, C.I: 2.36–9.49, P < 0.0001), Oligohydramnios (OR = 3.58, C.I: 1.29–9.9, P = 0.01), and multiple pregnancy (OR = 24.09, C.I: 3.09–187.46, P = 0.0024) were found to be significant risk factors for preterm birth. Though the NICU admission rate was high (52%), neonatal outcome was found to be satisfactory.

Conclusions:

Some of the risk factors that contributed to preterm birth were modifiable. Preventive strategies addressing the risk factors such as hypertension, oligohydramnios, and also improving health care quality to pregnant women will reduce the prevalence of preterm births and outcomes.
Bronchial mucus plug mimicking fragmented Ascaris worm
Authors: Mehta Vibha , Loomba Poonam S. , Mishra Bibhabati , Sakhuja Puja
Published: August 2022

With increasing travel and immunosuppression, parasitic lung and pleural diseases are increasingly been reported. The diagnosis in certain cases is very challenging because of nonspecific clinical and radiological features. We hereby present a case of a 60-year-old immunocompetent female complaining of difficulty in breathing for 4–5 days for which sputum sample along with the coughed-up fragment of the parasite under investigation was sent to the laboratory. All the blood parameters along with blood and sputum culture were within normal limits. Direct microscopy for sputum and multiple fecal samples did not yield any significant information. Chest X-ray was normal, whereas contrast-enhanced computed tomography scan changes were suggestive of fibrotic changes and mucoid impaction. The histopathological examination showed thick mucus content and no evidence of a parasitic infestation, worm, larva, or ova. So the differential diagnosis of the right lower lobe obstruction probably due to mucus plug was made, and the patient was referred to a pulmonologist for further follow-up. This case highlights the importance of common respiratory disorders characterized by mucus plugs and that some may mimic parasitic segments. Specific clinical, radiological, and pathologic features, microscopic examination, or serological testing can help to narrow the differential diagnosis of infective or noninfective causes and help the patients in early and accurate diagnosis and treatment and save them from unnecessary expensive and invasive investigations.
Peripartum dilated cardiomyopathy complicated by miliary tuberculosis—a maternal near miss (MNM)
Authors: Mohammad Shazia , Acharya Neema , Acharya Sourya , Jajoo Shubhada , Joshi Ketav
Published: August 2022

The term ‘Maternal Near Miss’ (MNM) refers to women who have survived serious life-threatening complications during pregnancy, labour or within 6 weeks after termination of pregnancy, either by chance or due to good health care. The goal of this report is to emphasise the need for patients’ education, emergency transportation and availability of multidisciplinary tools at all levels of the health care system. Severe acute maternal morbidity (SAMM) is a measure of maternal mortality that may also be used to assess the quality of obstetric treatment in a certain facility. Also, the motive of this report is to give an idea to primary care physicians of all the preliminary risk factors to be taken into consideration while treating the patient on arrival.
Inculcating research methodology related skills and aptitude amongst medical undergraduates- An interventional study
Authors: Shukla Samarth , Acharya Sourya , Acharya Neema , Singh Satyam , Dolas Paridhi
Published: August 2022

Introduction:

The present project was carried out at Jawaharlal Nehru Medical College (JNMC), Datta Meghe Institute of Medical Sciences (DMIMS, deemed to be University), Wardha, Maharashtra, as part of the training programme as per the advanced course in medical educational research, the theme of the project was based on skill training. The project was titled “Inculcating research methodology related skill and aptitude amongst medical undergraduates”.

Aim:

The basic aim of the study was to make the medical undergraduates competent and apprised with certain basic research skills in research methodology and to develop aptitude amongst the undergraduates for research.

Material and Methods:

The present research project took Bachelor of Medicine and Bachelor of Surgery (MBBS) students from the 2016 batch, from the sixth and seventh term of their professionals and the project was conducted for 6 months duration from October 2018 to March 2019. From the batch of 200, a randomised selection of students was carried out and 57 students in total were selected. The study was carried out in three phases as follows: Phase one (assessment and sensitization); phase two (skill training/mentoring); phase three (research outcome/culmination).

Results:

In the primary endpoint, the assessment of pretest and posttest were tabulated as well as feedback was taken; in the secondary endpoint the research projects conducted were translated into publications and the student’s response were applied for funded research projects like the Indian Council of Medial Research (ICMR) that was evaluated. Pretest score of 1 out of 10 (average score of 57 responses), that is, 10% and a posttest score of 6.9 out of 10, that is, 69.1%, the absolute learning gain was 59.1% and relative learning gain was 59.1%, the classroom averaged learning gain was 0.59. In the present study, the learning gain score was 0.59 which is in medium range according to Hake’s learning gain criteria.

Conclusion:

The present study concluded that there was a lack of understanding amongst medical undergraduates pertaining to the basic nuances of the research and how to go about carrying out the same. An ideal environment, mentorship is necessary for inculcating interest for research.
Miller Fisher syndrome associated with COVID 19
Authors: Yaqoob Arjimand , Dar Waseem , Khuja Zubair , Bukhari Immia , Raina Adnan , Ganie Hilal , Chandra Amit , Wani Maqbool , Asimi Ravouf , Wani Faizan
Published: August 2022

Miller Fisher syndrome (MFS), is an acute peripheral neuropathy, a variant of Guillain-Barre syndrome, that develops following exposure to different viral, bacterial, and fungal pathogens. Patients usually present with a triad of ophthalmoplegia, ataxia, and areflexia. During Covid pandemic MFS has been described associated with novel coronavirus disease 2019 (COVID-19). Here we describe the clinical course, Cerebrospinal fluid (CSF) findings, nerve conduction studies, treatment and outcome of the patient having MFS concurrent with COVID 19.
Musculoskeletal disorders associated with depression and psychosocial risk factors among female teachers in riyadh region, Saudi Arabia
Authors: Alajmi Dhafer Mubarak , Abdulaziz Maha Saleh Bin , Saeed Nehal Saad Bin , Almutairi Abrar Sayer
Published: August 2022

Background:

Teachers have the highest musculoskeletal disorders (MSD) rates worldwide because of stressful working conditions. MSD is likely to be linked to psychosocial elements such as need for social help, loss of job control, performance concerns, repetitive work, and feeling burdened and stressed.

Objectives:

To determine the prevalence and anatomical distribution of MSDs and the associated psychosocial risk factors, primarily depression, among female teachers in the Riyadh region of Saudi Arabia.

Settings and Design:

An observational, quantitative, cross-sectional study was done.

Material and Methods:

Data was collected from female teachers in Riyadh region, Saudi Arabia, via a questionnaire. All the participants completed the Patient Health Questionnaire (PHQ-9) and Nordic Musculoskeletal Questionnaire (NMQ). The data was analyzed using Statistical Package for the Social Sciences software.

Results:

Of the 372 questionnaire responses obtained from the teachers, the prevalence of depression was 65.6% and of MSD was 86%. The main site of pain was the neck (62.9%), followed by the lower back (53.8%). There was a significant relationship between the prevalence of MSD and the prevalence of depression. MSD occurred in 64.1% of participants without depression, in 95.9% of those with mild depression, and in 100% of those with more severe depression (P ≤ 0.001).

Conclusions:

A high prevalence of MSD pain was found among the female teachers, especially among older women, those teaching at elementary schools, and those with a higher number of pregnancies. The coexistence of MSD and depression affects the work ability of the teachers and reduces their efficiency.
Acalculous cholecystitis presentation in a young patient
Authors: Biggs Megan , Abutalib Jabeen , Roach Paul
Published: August 2022

Acute acalculous cholecystitis accounts for only 5-10% of cholecystitis cases and is often associated with severe trauma, critical illness, or chronic disease. Our case describes an otherwise healthy 25-year-old female presenting with acute abdominal pain. After undergoing a magnetic resonance cholangiopancreatography and cholescintigraphy she was diagnosed with acute acalculous cholecystitis. Her symptoms resolved following laparoscopic cholecystectomy which highlights the importance of prompt diagnosis and treatment of acalculous cholecystitis even in the absence of trauma or critical illness.
Management of COVID - 19 with Siddha and Western Medicine – An Integrative Case Report
Authors: Priya B K , Aishwarya A , Manickavasagam R , Susila R
Published: August 2022

Renaissance in acceptance of the Siddha system of medicine in all over India happened during the current scenario of coronavirus disease-2019 (COVID–19) pandemic. The classical texts of Siddha medicine contain descriptions of the symptoms of COVID–19 as a syndrome like definition that may be correlated with KabaSuram. A 49-year-old female residing at New Delhi who got COVID-19 positive with comorbidity of hypothyroidism treated successfully using an integrative treatment plan (Siddha and Allopathic) as per Government-mandated COVID–19 treatment guidelines. The patient developed symptoms such as fever, sore throat, cold, cough with expectoration, difficulty in breathing, chest congestion, and body ache. Initially the patient took Western Medicine (WM) for five days but the symptoms did not subside. After five days an integrated treatment including Siddha medicine (Internal and external medicines) initiated at In Patient ward, Safdarjung Hospital. The health of the patient improved within 3 days and all her symptoms got relieved within 10 days. After completion of treatment, she tested reverse transcription - polymerase chain reaction (RT-PCR) and it was negative on 14th day. Another patient who was admitted with her got COVID–19 positive turned negative only after 30 days as she missed the integrative medicine by probability. The reported case had a prospective follow-up for six months and found to be free of post-COVID complications. Since, this case report based on a single case which shows a positive outcome is incapable of generalizing the conclusion. Further suitable clinical trials need to be conducted to assess its efficacy. The status of the summary is reported as per CAse REport (CARE) guidelines.
Trichotillomania Prevalence in an Arab Middle Eastern Population
Authors: Subki Ahmed H. , Khatib Hazim A. , Butt Nadeem S. , Jamjoom Mohammed A. , Alharbi Rame S. , Shaikhoon Bahaa M. , Alharbi Mamdouh W. , Shaikhoon Sarah M. , Al-Zaben Faten , Alghamdi Waleed A. , Koenig Harold G.
Published: August 2022

Aim:

Trichotillomania (TTM) (hair-pulling disorder) is a relatively rare psychiatric condition. We are aware of no studies of this disorder in Arab Middle Eastern populations. We examine the prevalence and correlates of TTM in a community sample of individuals living in a large port city in western Saudi Arabia.

Methods:

An observational cross-sectional study of 511 adults aged 18 years or over living in Jeddah, Saudi Arabia, was conducted. After inquiring about demographic information and self-reported psychiatric disorders, the Massachusetts General Hospital Hair-Pulling Scale (MGH-HPS) was administered to assess symptoms of TMM.

Results:

A total of 9 of 511 participants (1.8%) scored above the cutoff for suspected TTM on the MGH-HPS, whereas 203 (39.7%) had a history of hair-pulling. Those with suspected TTM were more likely to be female (2.8% vs 0.4% in males, P = 0.047) and somewhat more likely to have a history of obsessive-compulsive disorder (OCD) (6.7% vs 1.5%, P = 0.093). Hair pulling was also more common in unmarried, not living with family, and unemployed. Among those with a history of hair-pulling, the most frequent locations were from the face (62.7%), head (55.7%), and legs (15.3%).

Conclusions:

While a history of hair-pulling is common in this community sample (40%), suspected TTM is much less prevalent (<2%), although not rare by any means. When present, the condition is more common in women and possibly in those with OCD.
General practitioners’ knowledge, attitude, and practices regarding optional immunization in urban area of Sangli District
Authors: Dhobale Randhir V. , Waghachavare Vivek B. , Gore Alka D. , Dhumale Girish B.
Published: August 2022

Introduction:

Immunization is one of the most effective, safest, and efficient public health interventions. Thousands of children are still dying from vaccine-preventable diseases every year. Administration of optional vaccines such as Hib, Inactivated polio vaccine (IPV), typhoid, hepatitis A, chickenpox, and rotavirus at appropriate age helps them in protecting from various diseases in under 18 population. Also, the attitude and practices of general practitioners have an important role in preventing modern diseases in children.

Objective:

This study was undertaken to assess the level of knowledge, attitude, and practices regarding optional vaccines among the general practitioners.

Material and Methods:

Study type: Cross-sectional. Study setting: Sangli–Miraj–Kupwad corporation area. Study subject: Practicing General Practitioners willing to participate. Study period: July 2018–Sep 2019. Study tools: predesigned, pretested questionnaire. Statistical analysis: by using Microsoft Excel and SPSS 22.0 version software.

Results:

Out of 162 general practitioners, 105 were males and 57 were females. A total of 83 (51.23%) general practitioners had good knowledge about optional vaccines in their practice. Good knowledge was found to be highest among MBBS practitioners 38 (55.9%). A total of 118 (72.84%) general practitioners were counseling the parents regarding optional vaccines.

Conclusion:

There is a need to create training programs and continuing medical education (CMEs) for general practitioners (GPs) on optional vaccination practices to improve knowledge.
Effect of long-term yoga training on autonomic function among the healthy adults
Authors: Shobana R , Maheshkumar K , Venkateswaran S.T. , Geetha M Bagavad , Padmavathi R
Published: August 2022

Background:

Autonomic dysfunction is one of the major complications in noncommunicable diseases, and there are studies to prove yoga practice improves cardiac autonomic function. So, this present study was done to compare the autonomic functions among yoga practitioners and nonyoga practitioners.

Methods:

This cross-sectional comparative study was initiated among 68 healthy volunteers of both sexes, after recruiting them based on inclusion and exclusion criteria in the age group of 17–30 yrs. The autonomic reactivity tests like resting heart rate, response of heart rate to standing, Valsalva maneuver, and response of heart rate to deep breathing, response of BP to standing, and sustained hand-grip were done.

Results:

In the autonomic reactivity test, resting heart rate (80.92 ± 11.76 vs 69.24 ± 10.64) and sustained handgrip (16.30 ± 4.53 vs 10.20 ± 3.67) significantly decreased (P < 0.05) in the participants of the yoga group compared to control group. Deep breathing test, Valsalva maneuver, 30:15 ratio in lying to standing, and BP response to standing test did not show any significant difference between the groups (P > 0.05).

Conclusion:

The present study revealed diminished sympathetic activity and improved parasympathetic activity among the regular yoga practicing participants. It can be practiced regularly to reduce stress and prevent lifestyle-associated disorders in the future.
Amoxicillin-clavulanate induced DRESS syndrome masquerading as red man syndrome
Authors: Jafry Ali H. , Nimri Jena , Akhtar Khawaja H. , Qureshi Saleem , Bray-Hall Susan
Published: August 2022

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a severe drug-induced hypersensitivity reaction carrying a mortality rate of up to 10%. We present a rare case of DRESS syndrome induced by amoxicillin-clavulanate, initially masquerading as red man syndrome. A 32-year-old male was admitted with flu-like symptoms and a maculopapular rash on the trunk and face that was exacerbated with vancomycin infusion, concerning for red man syndrome. He was receiving systemic antibiotics (vancomycin, ceftriaxone, and metronidazole) for infective endocarditis and previously took amoxicillin-clavulanate for a dental abscess. Despite the discontinuation of vancomycin, the exanthem continued to worsen, extending to involve >50% of his body surface area. Eosinophilia, hepatosplenomegaly, and acute kidney and liver injuries prompted consideration of DRESS syndrome. All antibiotics were discontinued, and systemic glucocorticoids were initiated. Punch biopsy revealed interface dermatitis with eosinophilic infiltrates; a high RegiSCAR score confirmed the diagnosis of DRESS. Amoxicillin-clavulanate was flagged as a severe allergy and deemed the culprit owing to the timing of exposure and personal/family history of hypersensitivity.
Depression among higher secondary students of science stream of private schools of Rajkot
Authors: Chauhan Dixit , Patel Umed , Rahul Kirtikumar , Patel Mehul
Published: August 2022

Background:

Depression with the magnitude of 8 − 20% emerged as major mental health morbidity among adolescents due to its devastating consequences of suicidal tendencies, academic failure, poor social relationships, and substance abuse. The current study was carried out to estimate the magnitude of depression among the students of private higher secondary schools of science stream in Rajkot city, Gujarat.

Methods:

A cross-sectional study was conducted among the 1219 students of 11th and 12th standards of private schools of science stream in Rajkot city using a multistage sampling method. Students were screened using Patient Health Questionnaire-9 for Depression and categorized into no depression, mild, moderately severe and severe depression. Epi Info software version 7.1.5.2. from CDC, Atlanta, USA was used to analyze the data.

Results:

One-third (31.99%) of students had depression followed by Dysthymia (20.59%) and Suicidal risk in 1.64% of students. The prevalence of depression was higher in female students (37.28%) than males. Students of 12th standard (38.06%) were more depressed than 11th standard (25.98). The suicidal risk was found more among the students of 12th standard (2.47%) compared to 11th standard (0.82). The prevalence of Depression, Dysthymia and Suicidal risk were more in Muslim students than Hindus. According to severity, female students (13.98%), 12th standard students (11.53%), Muslim (19.73%) and students residing at a hostel (12.12%) were more depressed (moderate to severe) than their counterparts.

Conclusion:

In the present study, a significant proportion of students were found suffering from depression.
Prevalence of usage of Tobacco and its various correlates in District Gautam-Budh Nagar, Uttar Pradesh
Authors: Srivastava Shalini , Mahajan Harsh , Jindal Manisha , Dohare Sunil , Khurana Shweta
Published: August 2022

Context:

Tobacco use is the leading single preventable cause of deaths worldwide. India is the second largest consumer of tobacco in the world.

Aims:

To study the prevalence of tobacco use among the adult population >15 years age of District Gautam-Budh Nagar and find the association of various socio-demographic factors with the tobacco usage.

Settings and Design:

Cross-sectional community-based study conducted in urban and rural areas of District Gautam-Budh Nagar, Uttar-Pradesh.

Subjects and Methods:

The study was conducted among 1461 adults aged 15 years and above in the District Gautam-Budh Nagar. Multistage sampling was used to select the study subjects. The questionnaire used for the interview consisted of questions related to socio-demographic profile, smoking habits and smokeless tobacco use, intention to quit and exposure to second-hand smoke.

Statistical Analysis:

The data were entered and analyzed in SPSS Software version 20.0. The prevalence of tobacco use was expressed in percentages. The association between various socio-demographic factors and tobacco use was assessed by Chi-square test. P value < 0.05 was taken as significant.

Results:

Prevalence of tobacco usage in this study was found to be 50.4% (65% among males and 28.8% among females). The prevalence of smoking and smokeless tobacco use in our study was 37.2% and 21.3%, respectively. Increasing age, male gender, and lower educational status were found to be significant risk factors for tobacco use in our study.

Conclusions:

India needs to gear up the efforts more and can still do more to make the proven tobacco control tools work for its citizens’ well-being.
Predictors for mucormycosis in COVID era
Authors: Trivedi Poonam , Memon Farjana , Shah Komal , Shah Hemal , Yasobant Sandul , Saxena Deepak
Published: August 2022

Context:

Mucormycosis has been increasingly described in the coronavirus disease (COVID-19) era, however, there is a lack of robust epidemiological studies to understand the predictors for the development of mucormycosis from India.

Aims:

To document the risk factors of mucormycosis with or without COVID-19 and estimate the strength of association of various risk factors. Settings and Design: A case-control study was conducted in the Ahmedabad districts of Gujarat from June to August 2021.

Methods and Material:

One hundred participants (25 cases with mucor, 75 without mucor) were enrolled in the study. The cases and controls were then matched based on age and gender. Ethical approval was sought from the Institutional Ethics Committee of the Indian Institute of Public Health Gandhinagar, Gujrat, India.

Statistical Analysis Used:

Data were collected using the Epi Collect 5 application, and the descriptive, inferential analysis was done using the SPSS version 21 statistical software.

Results:

About 68% of the cases were from a rural area and had past comorbidity conditions. About 80% of the cases reported a previous history of COVID-19, whereas 67% of the controls reported the same. The factors which remained significant after applying the hierarchical model were rural residents (OR = 3.2 [95% CI: 1.05–10.3]) and history of oxygen therapy (OR = 5.42 [95% CI: 1.24–23.8]).

Conclusions:

This study concludes that mucormycosis is independent of the COVID-19 status. Rural residents and oxygen therapy were found to be the most significant risk factors for mucormycosis. The findings of this study are also not conclusive to establish an association; thus, further exploration and in-depth research with larger samples are recommended.
Spectrum of infections occurring in patients of autoimmune rheumatic diseases on treatment with biological versus conventional disease-modifying antirheumatic drugs
Authors: Gupta Partisha , Padhan Prasanta , Bhargava Nishant , Behera Pradip Kumar , Tripathy Krishna Padarabinda , Panda Sudhansu Sekhar
Published: August 2022

Background:

The era of biological therapy has revolutionized in the management of autoimmune rheumatic diseases. There have been conflicting results about the incidence of infections related to these drugs. The purpose of this study was to compare the spectrum and severity of infection between patients on biological disease-modifying antirheumatic drugs (bDMARDs) versus conventional disease-modifying antirheumatic drugs (cDMARDs).

Materials and Methods:

This hospital-based prospective observational study was conducted in a tertiary care hospital, and a total 200 patients were enrolled in this study. Patients on either bDMARDs or cDMARDs for at least six weeks presenting with evidence of infection were included. Patients with known immunodeficiency states, multiple comorbidities, and patients on prednisolone >7.5 mg were excluded. Data was expressed as percentage and mean ± SD. Kolmogorov–Smirnov analysis was performed for checking linearity of the data, and analysis of variance (ANOVA) followed by Tukey’s HSD test were used to test the significance of difference between more than two parameters in parametric data.

Results:

Rheumatoid arthritis in 58 patients (29%) were the commonest ones presenting with infections, followed by systemic lupus erythematosus in 37 patients (18.5%). 135 patients (67.5%) were on cDMARDs and 65 patients (32.5%) on bDMARDs. Respiratory tract infection in 47 (34.8%) patients was found to be the commonest infection due to cDMARDs. Incidence of infection was higher with biologics, and types of infection in patients receiving infliximab and etanercept were significantly different from that of cDMARDs. Patients receiving etanercept had higher risk of infections and re-infections, but they were milder compared to cDMARDs. A significantly higher frequency of re-infection was found in patients who had not received vaccination.

Conclusion:

This study emphasizes that TNF-α inhibitors are significantly associated with higher risk of infections. Patients on etanercept have significantly higher but milder infections as compared to cDMARDs. Vaccination plays a pivotal role in prevention of re-infections.
Bitter bottle gourd poisoning
Authors: Chavda Dhruvrajsinh M. , Parikh Charmy , Patel Vishwa V. , Pandya Pankti S.
Published: August 2022

Bottle gourd juice is considered a panacea in traditional Indian medicine and used in various chronic diseases. Increased levels of Cucurbitacin can turn it bitter causing toxic effects in gastrointestinal system. We report the case of an elderly female who presented with shock in few hours after consumption of bitter bottle gourd juice. After proper evaluation we considered the possibility of bottle gourd poisoning as a probable diagnosis due to the Naranjo adverse drug reactions probability scale. Since there is no specific antidote available, management is mostly supportive with intravenous fluids, control of bleeding and management of shock.
Indian medical student perspectives on online mode of education
Authors: Singh Amandeep , Jadon Ranveer S. , Baitha Upendra , Sethi Prayas , Kaur Harleen , Kumar Arvind , Ranjan Piyush , Wig Naveet
Published: August 2022

Purpose:

The coronavirus pandemic has led to drastic changes in the education system globally. The medical education curriculum has also undergone a significant drift from traditional or physical classes to online classes. The study aims to explore the viewpoints of the Indian medical students toward online classes, their ramifications, and suggestions for improvement.

Methods:

The self-administered online questionnaire using the Google form was developed, validated, and circulated among students of All India Institute of Medical Sciences (AIIMS), New Delhi. The data of the survey were systematically analyzed by descriptive statistics.

Results:

A total of 223 students filled the Google form. After applying the inclusion and exclusion criteria, 171 students were finalized, and the analysis was done. The data suggested that 49.7% of the participants were facing technical glitches, poor Internet connectivity being the commonest. Eye straining (56.7%) was the major physical health hazard, whereas lack of concentration (53.8%) was the major psychological issue reported by the students. The major advantage of online classes reported was its accessibility (93%) at any time and place, whereas students also reported that the traditional learning method is more interactive and motivating (72.5%). Overall, 72.5% of the students wanted to continue both modes of education after the coronavirus disease (COVID-19) pandemic.

Conclusion:

As per the analysis of the results, it is concluded that, since both online and offline modes of education have advantages and disadvantages, henceforth, mixed or blended method of learning is the best form of learning medical science.
Clinical spectrum and treatment response in patient of chronic myeloid leukemia in correlation with ABO blood group
Authors: Meher Mukti P. , Gupta Saumya , Singh Arun Kumar , Kumar Prabhat , Kumar Sandeep , Amrit Amar Kumar , Arora Disha , Bharti Anju , Kumar Sandip , Meena Lalit Prashant
Published: August 2022

Background:

Several studies have been conducted to evaluate and investigate the molecular mechanisms underlying alterations in ABO blood group antigens in oncogenesis. We observed that no study has been reported yet that correlate cytological, molecular and haematological responses of Imatinib therapy in chronic myeloid leukemia (CML) patients with different types of blood groups.

Objective:

To determine the distribution of CML in the ABO blood group, clinical spectrum of CML in different blood groups, and treatment response of CML patients in correlation with ABO and Rh blood groups.

Material and Methods:

All the patients included in the study were diagnosed on the basis of clinical features, peripheral smears and bone marrow aspiration findings. Real-time reverse transcriptase polymerase chain reaction (PCR) and cytogenetic analysis were done in all patients at the time of initiation of therapy. Blood grouping and Rh typing of each patient were done at the initiation of therapy.

Results:

Out of 100 included patients, 58 were male and 42 were female patients. It was observed that 45 (45%) patients were having a B+ blood group; 33% patients were having O+ blood group, followed by A+ (10%), AB+ (8%), A− (2%), B− (1%) and AB− (1%). Around 43.64% study subjects with O + blood groups showed complete cytogenetic response, followed by B+ (41.82%), A+ (10.91), A− (1.82) and AB+ (1.82). An equal number of patients (40% each) with O+ and B+ blood groups, followed by A+ (20%) showed undetectable Abelson-breakpoint cluster region (BCR-ABL)/ratio (%). About 75% of patients showed complete haematological response (CHR) and 25% showed PHR. Patients with B+ and O+ blood groups (41.33%) showed a CHR. It was observed that a maximum number of patients were suffering from symptoms of an abdominal mass (37%), 43.24% of patients with B+ blood group showed an abdominal mass, followed by O+ (35.13%), A+ and AB+ (8.11% each), B − and AB− (2.70% each).

Conclusion:

This study revealed that study subjects with B+ and O+ blood groups showed better cytogenetic, molecular and haematological responses as compared with patients with other blood groups at 6 and 12 months of treatment with Imatinib.
Cervical cancer knowledge and attitude among a cohort of female schoolteachers in Salem city – A cross-sectional survey
Authors: Venkata Lakshmi S. , Deepa Lakshmi K. Priya , Bharath C. , Saravanan N. , Shaik Sabiha Shaheen , Nagilla Jithender
Published: August 2022

The present study aimed to assess the knowledge and attitude of female schoolteachers toward cervical cancer.

Materials and Method:

A cross-sectional study was conducted among 256 Government female schoolteachers aged 22–60 years in Salem city, Tamil Nadu. A self-administered questionnaire which assessed the levels of knowledge (6 items) and attitude (4 items) regarding cervical cancer was employed and responses were recorded on a three-point Likert scale. Data were analysed using Statistical Package for Social Sciences (SPSS) software version 20.0.

Results:

Overall adequate knowledge and good attitude regards to cervical cancer was observed among 60% and 66.8% of schoolteachers, respectively. Participants in the age range of 31–45 years (p = 0.007), primary schoolteachers (p = 0.004) and Hindus (p = 0.001) displayed significantly adequate levels of knowledge compared to their respective counterpart. Likewise, based on attitude subjects possessing postgraduation (p = 0.001) and middle schoolteachers (p = 0.009) had significant good attitude scores. Significant linear correlation was observed knowledge with class teacher (r = 0.136, P = 0.03) and religion (r = 0.208, P = 0.001) whereas attitude with qualification (r = 0.165, P = 0.008) and class teacher (r = 0.206, P = 0.001) which are positive predictors. Moreover, knowledge had a significant positive correlation with attitude (r = 1.000, P = 0.000).

Conclusion:

Primary care physicians partnering network with schoolteachers having adequate knowledge and good attitude acts as a workforce to support cervical cancer screening and human papillomavirus vaccination.
Plethora of adverse drug reactions in geriatric population receiving statin therapy for dyslipidaemia
Authors: Padhye Mugdha R. , Yadav Nikhil S.
Published: August 2022

Background:

Hyperlipidemia plays a major role in the pathogenesis of cardiovascular diseases (CVD). Statins are considered to be the most efficacious drugs in the management of hyperlipidemia and this class of drugs is most commonly prescribed for the treatment of hyperlipidemias. Although statin therapy has transformed the management of hyperlipidemia, it is associated with the skeletal muscle, neurological, and metabolic adverse effects. This study was conducted to evaluate the adverse effects of statin therapy in a geriatric population which may help in understanding whether these effects are dose-dependent.

Methods:

The study was conducted on 200 patients receiving statin therapy (atorvastatin and rosuvastatin) for hyperlipidemias. They were divided into four groups depending on the prescribed dose of atorvastatin and rosuvastatin. All study subjects were followed up for 6 months. The adverse effects reported by them during the statin therapy were documented and analyzed.

Results:

All patients reported adverse effects after the initiation of statin therapy. Headache and muscle symptoms were among the most commonly reported adverse effects. There was no serious adverse effect (SAE). None of the adverse effects led to the discontinuation of the statin therapy.

Conclusion:

The results of this study suggest that all patients receiving statin therapy experience one or more adverse effects during the therapy. The adverse effects were not found to be severe in the geriatric age group.
Effect of increased screen time on eyes during COVID-19 pandemic
Authors: Agarwal Richa , Tripathi Alka , Khan Imran Ahmed , Agarwal Mohit
Published: August 2022

Purpose:

The objective of the study was to assess the effect of increased screen time on ocular health during the coronavirus disease (COVID-19) crisis.

Materials and Method:

An online pretested, self-reported questionnaire with relevant details was generated through Google form and sent to participants. Chi-square or Fisher’s exact test was used to investigate the associations between the qualitative variables. The associated risk factors of number and frequency of ocular health problems were analysed by univariate and multivariate logistic regression.

Result:

A total of 435 responses were considered where 48.5% (N = 211) were female participants and 51.5% (N = 224) were male. Average age of the participants was 35 years. 89% of the participants reported an increase in the screen time during the during the lockdown period. Younger age group reported to have greater screen time than the older participants (p = 0.001) and hence experienced more symptoms of digital eye strain (DES) (p = 0.003). The most common symptoms associated with digital eye strain in our study were eyestrain 52.8% (N = 230) and headache 31.3% (N = 136). In total, 81.37% (354/435) of participants had experienced at least one symptom related to digital screen usage.

Conclusion:

DES is non-vision-threatening but discomfort caused due to it can have implications on overall physical, mental, and social well-being. The study highlights the increase in digital screen time during the pandemic and the resultant eye strain. There is need of spreading awareness regarding the adverse effects of digital device use and the preventive measures to safeguard our ocular health.