bluuebunny/crossref_metadata_2025 huggingface dataset:
Drotaverine to improve progression of labour among parturient women- a case control study
Authors: K. V. Samskruthi , Hebbar Shripad , Pandey Deeksha , Upadhyaya Rajani , Lobo Viwal
Published: August 2023

Background: Prolonged labour contributes to increased perinatal and maternal morbidity. Pharmacological interventions can hasten cervical dilation and help obstetrician to accomplish the delivery in the shortest possible time without compromising maternal and fetal safety. Aims and objectives were to evaluate the acceleration effect of drotaverine on the dilatation of the cervix in both primigravidae and multigravida and compare it with control group.
Methods: A total of 70 patients were studied (35 in drotaverine group and 35 in control group). The inclusion criteria were pregnancy with at least 37 weeks completed, cervical dilatation 3-4 cm, regular uterine contractions and cephalic presentation. The study group received 40 mg drotaverine hydrochloride i.m. in active phase of labour, control group received standard delivery care. Parameters such as duration of first and second stage of labour, mode of delivery, neonatal outcome and side effects to drug was recorded.
Results: 6 subjects from the study group and 4 from the control group developed complications in first stage of labour and were taken up for operative delivery and hence they were excluded from calculation of various labour parameters. The mean rate of cervical dilatation with drotaverine was 2.26 cm/hour, while it was 1.67 cm/hour without any intervention (p value <0.05). Mean duration of active phase of first stage of labor was 3.09 hours in drotaverine group against 4.98 hours in study group (p value <0.05). There were no significant untoward effects noted in either of the groups.
Conclusions: Drotaverine was found to be an effective and safe drug in shortening the duration of the first stage of labor without any significant detrimental effects on the mother and newborn. Drotaverine did not interfere with uterine contractility and there was no increased incidence of operative deliveries.
A comparative study of different treatment modalities of polycystic ovarian syndrome in women of reproductive age group at tertiary care centre
Authors: Arvindar  , Sen Sangeeta
Published: August 2023

Background: Polycystic ovarian syndrome is considered to be a multifaceted disease with a spectrum of manifestation affecting not only women of childbearing age group but also adolescent and post-menopausal women. Most prevalence studies in India prevalence of PCOS as 3.7%-22.5%. Rotterdam consensus conferences, revised diagnostics criteria used. Treatment depends on patient goals ranging from lifestyle modification to drug therapy. It includes: dietary and lifestyle modification, medical management with oral contraceptive pills, metformin, spironolactone, ovulation induction with letrozole, clomiphene.
Methods: Study was conducted in women of reproductive age group with PCOS attending gynaecological OPD at RNT medical college Udaipur. It is a prospective comparative study. Total 290 women included and were followed up for one year.
Results: One year follow up among letrozole group 9 women got conceived, among metformin with letrozole group 23 women got conceived which was statistically significant. Metformin group had significantly greater difference followed by OCP+Metformin group and lifestyle modification group. OCP group and OCP+Metformin group has significant reduction in incidence of hirsutism at one year follow-up. OCP group and OCP+Metformin group had significant reduction in acne at one year follow-up.
Conclusions: Weight reduction is better after metformin along with lifestyle modification than lifestyle modification alone or combine OCP with metformin treatment. Hyperandrogenic symptoms are better responded with OCP then other mode of treatment. Menstrual regularity is well attained by combination treatment of OCP and metformin then monotherapy. Combination of letrozole and metformin is superior as compared to letrozole alone for induction of pregnancy.
Comprehensive review of adnexal masses in a tertiary care hospital
Authors: Janice A. Betty , A. Padma
Published: August 2023

Background: Adnexal masses can be either be a physiological luteal cyst, a benign tubo-ovarian mass or a malignancy. The signs and symptoms along with tumour markers and imaging modalities are considered to differentiate between a benign and a malignant adnexal mass. Adnexal masses in pregnancy can be asymptomatic or can present with acute abdomen in cases of ectopic pregnancy and torsion. The aim was to study the prevalence of various histopathologic types of adnexal masses in different age groups.
Methods: This was a retrospective study carried out in the department of obstetrics and gynecology in a tertiary care hospital from May-2019 to April-2022. Women with sonographically diagnosed adnexal mass were evaluated. Data regarding ultrasound findings, tumour markers, RMI score and the management done were recorded from medical record charts. Descriptive statistics was applied and results shown in the form of frequencies and percentages.
Results: Among 31 study participants, the most common presentation was pain abdomen. Majority (93.5%) patients had benign adnexal pathology and 6.45% had malignant pathology. The most common ovarian pathology encountered was Benign surface epithelial tumours (48.4%). Early diagnosis of 2 tubal ectopic and 1 ovarian ectopic pregnancy was made and managed conservatively.
Conclusions: Early diagnosis and intervention is helpful in adolescent girls to conserve their ovarian function. Early diagnosis of ectopic pregnancy in stable patients can be managed conservatively. A high RMI should raise a suspicion of malignancy.
A study of perinatal outcome in patients with breech presentation at tertiary care centre
Authors: Jadhav Rajitha , Yadav Babli , Kumar Kranthi
Published: August 2023

Background: Regardless of the delivery method, breech presentation causes a 2–4 times increase in perinatal death and morbidity. Any change toward the method or technique of breech birth should attempt to enhance the perinatal result as well as maintain low rates of maternal morbidity and mortality. The success of a particular strategy for the management of labour with breech presentation is determined by the fetal outcome.
Methods: This prospective observational study was conducted in 320 consecutive patients with breech presentation at tertiary care centre from 1 January 2021 to 31 August 2022. This study was approved from Institutional ethical committee.
Results: In 206 primi gravida females, 4 underwent vaginal breech delivery and 202 had LSCS. Among 114 multigravida females, 66 had LSCS and 48 had vaginal breech delivery. Majority (213 cases, 66.6%) were term deliveries and 33.4% (107 cases) had preterm deliveries. 83.38% (268 cases) had LSCS and 16.3% (52 cases) had vaginal delivery. Of all vaginal deliveries 46 were assisted vaginal deliveries and 6 were spontaneous vaginal delivery. It was found that out of all 52 vaginal deliveries, 15 (28.8%) patients had complications. And out of all 268 LSCS, 32 (11.9%) patients had complications. Maternal complications were found to be statistically significant associated with vaginal breech delivery (p=0.02*). Total 5 perinatal mortalities were observed with emergency LSCS and no perinatal mortality was found with elective LSCS.
Conclusions: Multiparous women has better maternal and perinatal outcome compared to Primigravida with breech presentation. Zero perinatal mortality in elective caesarean section. Perinatal outcome is good in elective LSCS than in an emergency LSCS.
Case series of scar endometriosis at three different scar locations
Authors: Bulusu Ratna , Aswath Reddy Swathi
Published: August 2023

Endometriosis is a common clinical condition which often present to the gynaecologist with a typical history of cyclical abdominal pain, discharge and swelling. It can be present in pelvic and extra pelvic sites. Here we present a series of different case of endometriosis at three different scars.
A case report: incidental diagnosis of endometrial tuberculosis in cases of abnormal uterine bleeding
Authors: B. V. Induja , Sawant Vasudha , Potdar Mohan , Dalvi Rupali Mahesh
Published: August 2023

Abnormal uterine bleeding (AUB), including heavy menstrual bleeding (HMB), levy a massive burden on society. Here, we discuss about two patients who came to OPD with AUB symptoms for evaluation, but incidentally diagnosed with endometrial tuberculosis. In Case 1, 45-year-old female came with complains of heavy menstrual bleeding for 6 months for 6 months. USG showed adenomyosis. Patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy. But on day 7 she developed serous blood-tinged discharge per vaginum. Incidentally, patient endometrial CBNAAT report came positive for MTB, with no resistance to rifampicin. Patient was started on anti-tubercular treatment for 6 months. In Case 2, 43-year-old female came with complaints of HMB with pain abdomen and irregular menses for 3 years. USG shows early changes of Adenomyosis. Patient underwent therapeutic curettage with MIRENA insertion. Endometrial CBNAAT was negative and liquid culture (LJ) was MDR positive. Sensitivity report s/o of isoniazid and rifampicin resistant. Patient was advised monthly close follow up as symptoms were under control. When a routine screening for FGTB by CBNAAT is done for cases of AUB, there are high chances of reporting more cases in a developing nation like India. Hence sending endometrial samples for TB screening in AUB cases can be useful in finding out more cases of genital TB, where their symptoms can be related to TB infection rather than searching for a structural cause that may be is not the cause for the severe symptoms. Due to which mismanagement or unnecessary surgical interventions can be avoided.
A rare case of Guillain-Barré syndrome in pregnancy and its implications: a case report
Authors: Mohanty Girija S. , Kumar Abhay
Published: August 2023

Guillain barre syndrome (GBS) is a rare neurological disease in pregnancy. Incidence varies from 1.2 and 1.9 cases per 100,000 people annually. It carries high maternal risk and may complicate pregnancy. It usually presents as an acute ascending symmetrical polyneuropathy. It requires early diagnosis and multidisciplinary supportive care for its management.
Chronic abscess in isthmocele: a rare entity
Authors: Jacob Sujamol , B. S. Lakshmi , S. Sujin
Published: August 2023

Uterine isthmocele, also known as caesarean scar defect or uterine niche is a triangular defect   in the anterior uterine wall at the site of the previous caesarean scar, with its base communicating with the uterine cavity. It represents an inadequate healing of the myometrium following caesarean section. Transvaginal ultrasound (TVS), saline infusion sonohysterogram (SIS), hysterosalpingogram, hysteroscopy, and MRI are various modalities to make a confirmatory diagnosis. Medical or surgical management is undertaken depending on the size and type of defect.  The aim is to manage symptomatic patients. But chronic presentation of isthmocele is very rare and hence difficult to diagnose. Hereby presenting this case report, where the isthmocele was presented as a chronic abscess. Hence reporting this case for early suspicion of isthmocele and prompt management.
Lifestyle, nutrition knowledge, body dissatisfaction, and nutritional status of IPB university students in Indonesia
Authors: Farisa Dian Tiara , Khomsan Ali
Published: August 2023

Background: Adolescents experience changes as a response to concerned behaviour about body shape, leading to a restricted diet in their food consumption. It is stated that 76.56% of male students and 82.87% of female students experienced body dissatisfaction. As a result, the students are developing negative eating behaviour despite having a normal nutritional status.
Methods: This comparative cross-sectional study was conducted at IPB University dormitories. The study involved selecting samples using a systematic random sampling method. Total samples were 80 students.
Results: A significant difference was found in the diversity of food consumption between male and female subject groups (p=0.038). This research also showed other significant differences found in consumption of green leafy vegetable group (p=0.013), fruits and vegetables source of vitamin A group (p=0.000), and meat and fish group (p=0.033) within the male and female subjects. The other significant differences were also found in the frequency of exercise (p=0.000) and in the level of physical activity (p=0.027) between male and female subject groups.  There was a significant correlation between nutritional knowledge and nutritional status of male (r=0.784, p=0.045) subjects, and correlation between body dissatisfaction and nutritional status of male (r=0.349, p=0.027) and of female (r=0.383, p=0.015) subjects.    
Conclusions: There was a significant relationship between nutritional knowledge and nutritional status in male subjects. Furthermore, there is a relationship between body dissatisfaction and the nutritional status of the subject, where subjects with more nutritional status tend to have higher body dissatisfaction scores.
Knowledge, perception and safety practices of monkeypox infection among healthcare workers in a tertiary health facility in southwest Nigeria
Authors: AbdulMumin Ahmed K. , Adeniyi Makinde A. , Temitayo-Oboh Abiola O. , Abdullah Ahmed , Ojo Omobola Y.
Published: August 2023

Background: Monkeypox is a self-limiting disease first reported in 1970 in Zaire. It is characterised with small pox like eruptions and presently there is no approved anti–viral drug yet, clinical management of human monkey pox cases is mainly by supportive treatment and symptomatic treatment. This study assessed the knowledge, perception and safety practices of monkey pox disease among healthcare workers in a tertiary facility in Southwest state, Nigeria.
Methods: The study was a descriptive cross-sectional study, web-based conducted among 402 healthcare workers in a tertiary health centre in Southwestern Nigeria. The 38-item survey instrument for the quantitative study was adapted from a similar study on COVID-19 among healthcare workers. Data was analysed using SPSS software version 20.0. Level of significance was pre-determined at p value <0.05 at a confidence level of 95%.
Results: Female respondents constituted 241 (60%) while 161 (40%) were males. Mean age was 35.4±6.5 years with age group 26-35 years (49.0%) being the majority. Majority, 311 (77.4%) had poor knowledge of monkeypox while 69.9% had good perception. There was statistically significant association between age (α- 0.001), work experience (α- 0.001), tribe (α- 0.001), and average monthly income (α- 0.001) with perception about monkey pox infection among the respondents.
Conclusions: Monkeypox is endemic in Nigeria and the knowledge and perceptions of healthcare workers towards the disease is a critical epidemiological determinant of its transmission rate, it is therefore imperative that intensive training be targeted among all cadres of healthcare professional including non-medical workers in healthcare setting.
Awareness, prevalence and risk burden of cataract among adults in IDO/OSI local government area, a rural community of Ekiti state, southwest Nigeria
Authors: Adeniyi Makinde A. , Adewoye RaRasaq K. , Popoola Gbenga O. , Aderukuola Babatunde , Ibrahim Azeez O. , Azees Ayotunde S.
Published: August 2023

Background: Cataract is characterized by lens opacity, making images look blurred and hazy. It causes increased light sensitivity, decreased vision at night, and seeing double images, leading to total blindness. The WHO also estimates that cataract blindness will reach 40 million by 2025 due to ageing population and longer life expectancy. Developing countries, including Sub-Saharan Africa have the highest number of people who are blind due to cataract. This study aims to determine the awareness, prevalence and risk burden of cataract among adults in Ido/Osi LGA, a rural community of Ekiti State.
Methods: This is a descriptive cross-sectional study. The estimated sample size is 361 and a multi stage sampling technique was used. Data collection was through ophthalmic examinations and questionnaires which were analyzed using SPSS version 25.0.
Results: The mean age of respondents was 54.94±11.17. Most respondents, 287 (79.5%), had a good awareness of cataracts. The prevalence of cataract in this study is 3.9%. Cataract significant Visual Acuity was found in 49 (13.5%) of the respondents. Age (<0.001), visual impairment (<0.001), hypertension (<0.001) and diabetes mellitus (0.003) were the factors associated with having cataracts.
Conclusions: Intersectorial collaboration, health education through the mass media, evidenced based policies and research will help reduce the prevalence of cataract.
Beneficiaries perceptions on motivation to family planning intervention in a community of Karachi Pakistan
Authors: Chand Zaheer , Bhamani Shelina , Syed Areeba , Abbas Maliha , Karim Zaibunissa , Sheikh Lumaan
Published: August 2023

Background: Pakistan is facing a great challenge in planning, implementing, and sustaining family planning and birth control policies. Considering this, one of the community health programs in the outskirts of a community health worked led family planning counselling. The purpose of this research study is to highlight perceptions of the beneficiaries regarding the benefits of the same.
Methods: A qualitative descriptive study was undertaken for this investigation using a non-random sampling technique. The sample was chosen from the community population who were part of this intervention, with an inclusion criterion. The data was collected using in-depth interviews from 13 participants in total.
Results: The key themes emerged across the interviews: Unfolding myths: Participants’ recognized that using family planning mediums does not mean that there is a medical deficiency outcome to it but a way to prevent large families, societal pressure: Participants shared the issues and cultural taboos attached to the family planning and how it is conceived in their societies, program support: participants shared that having a female lady health worker coming to the home brings in more access to the family planning and benefits: they found that effective and structured family planning is contributing to their enhanced personal life relations, economic gains and social comfort.
Conclusions: A community health program model can be one of the outlets the government can collaborate to offer door to door provision, service quality and access to family planning to such communities in need.
Practice of environmental modifications and identification of its barriers in homes of community-dwelling elderly with moderate to high risk of falls
Authors: Joshi Disha S. , Bhattad Radha R. , Dabadghav Rachana P. , Shyam Ashok K. , Sancheti Parag
Published: August 2023

Background: Age is one of the key risk factors for falls. The prevalence of falls in Indian older adults is seen to be 14 to 53%. The economic consequences of falls are critical to family, community and society. The main risk factors for falls are divided into four dimensions-biological, behavioural, environmental and socioeconomic factors. The risk of falling is increased by the interaction of biological with behavioural and environmental factors.
Methods: A cross-sectional study was conducted on 60 community-dwelling elderly with moderate to high risk of falls (0-40/56 on Berg Balance scale) and no history of upper or lower limb injury. Convenience sampling method was used. After taking their consent, elderly were assessed for their risk of falls on Berg Balance Scale. Participants fulfilling the criteria were presented with a self-made questionnaire about practice of environmental modifications and identification of its barriers.
Results: 31% of the elderly individuals experienced falls in the past one year with four being the average number of falls experienced. The study showed that the elderly are practising at least a few modifications in each domain. Lack of available information (95%) was the most perceived barrier.
Conclusions: The study showed that all the elderly are practising at least a few modifications in every domain. The barriers identified in the study need to be worked upon for an efficient practice of modifications thereby contributing to fall prevention.
Evaluation of awareness and factors determining satisfaction among tuberculosis patients regarding RNTCP services in a western district of Uttar Pradesh: a cross sectional study
Authors: Kumar Deepak , Sachan Divyata , K. Verma Manoj , Gangwar Abhinav , K. Jain Pankaj , K. Srivastava Dhiraj , K. Bajpai Prashant
Published: August 2023

Background: With the help of ‘Revised National Tuberculosis Control Program’ (RNTCP), India has envisioned to end Tuberculosis (TB) five years ahead of the targets set by SDG which was by 2030. Regular evaluation is necessary for every programme to keep the programme in track and to identify the existing lacunae. Therefore, this study was planned to assess the awareness of TB patients regarding RNTCP along with identifying the factors which determine satisfaction of TB patients.
Methods: A community-based cross sectional study was conducted on patients seeking treatment at district tuberculosis centre and DOTs centres of district. The data were collected using a close-ended, pretested and pre-validated questionnaire.
Results: The mean score for awareness regarding TB among 205 study participants was 5.76±1.88 with level of awareness being poor, average and good in 41%, 31% and 28% of the study participants respectively. The mean satisfaction score was 9.47±1.02 and the services were perceived as good, average and poor by 56%, 39% and 5% of the study population respectively. Majority of the participants were unsatisfied due to the untimely distribution of the money provided under Nikshay Poshan Yojna (31.7%). The reasons for satisfaction among majority of the participants was the availability of staff at DOTS Centre (87.3%). A significant correlation was observed between satisfaction score and awareness score (r2=0.033, p=0.01).
Conclusions: The overall awareness and satisfaction about RNTCP services was good among TB patients with a greater satisfaction among people with high awareness.
Assessment of effect of menopause on oral health and its awareness in population visiting dental OPD: a hospital-based study
Authors: Chand Pooran , Dutt Pranjali , Jurel Sunit Kumar , Dasgupta Santanu , Gautham Harshika , Shetye Akanksha Gopal
Published: August 2023

Background: Menopause is a normal mechanism which takes part in every woman’s life. However, the awareness regarding menopause has to be highlighted effectively. Aim of this study was to assess the incidence and frequency of oral symptoms in postmenopausal women as well as to assess the level of awareness of menopause in women.
Methods: A hospital-based study using a 60-item questionnaire was conducted on postmenopausal women with age range of 35-70 years for a period of three months. Statistical analyses were performed. Results on continuous measurements were presented on Mean±SD. Descriptive statistics with frequency and percentage were computed.
Results: A total of 650 responses were received. In the present study, the mean age of menopause was 54 years. The most prevalent general symptoms reported were tiredness (89.8%), joint pains (89.7%) and irritability (76.5%). The most common oral manifestations of menopause were dryness of mouth (57.1%), altered taste (26.3%) and cracked corners of mouth (25.8%). About 39.8% of postmenopausal women had poor KAP score followed by 34.6% who had an average score while 18.3% had a good score and only 7.2% had scored excellent.
Conclusions: Our study showed that the occurrence of classical menopausal symptoms of sweating and hot flushes was lesser in comparison to previous studies on Asian women. The increased incidence of dry mouth could lead to a rise in oral diseases. Moreover, a majority of postmenopausal women had a poor KAP score which showed that the awareness towards menopause needs to be increased.
Readiness of the Interns to work at rural area: a cross-sectional survey in a backward district of West Bengal
Authors: Samanta Sumana , Maji Baisakhi , Narayan Ravi Kant
Published: August 2023

Background: The scarcity of qualified doctors in rural areas remains a critical challenge for the health sector in India Aim was to analyze the perception of medical students regarding upcoming compulsory rural posting for 1 year as a part of their rotatory internship
Methods: A cross-sectional survey was conducted in a medical college of West Bengal among the interns during March 2019 to February 2020. By doing complete enumeration of the interns present at the end of their Community Medicine posting, the sample size became 125. Predesigned, semi structured questionnaire was used for data collection. At the end of community medicine posting, when the interns came to department for completion, the printed questionnaire were given to them for filled up by their own. Collected data were entered in MS excel spreadsheet and analyzed with the help of SPSS 22.0 version.
Results: About 74% interns thought it was difficult to serve the rural areas however 52% felt it will enrich their professional skills and about 65% thought it would be beneficial to the rural community. Only 22.4% were in favour of rural posting during their internship and 46% thought paying bond money is a good way out. Lengthening of MBBS course, inadequate clinical exposure, poor connectivity, no job satisfaction, obstructed career growth, no quality of life, insecure working environment for women, excessive workload, inadequate monetary compensation were the major reasons identified by interns for noncompliance of compulsory rural service during internship.
Conclusions: The policymakers and medical educators need to design newer strategies for the improvement of rural healthcare facility keeping in mind the perception of students regarding rural service in the present scenario.
Effect of COVID-19 pandemic on maternal and child health care in a medical teaching hospital, Bengaluru, India
Authors: Sakranaik Saraswathi , Chinnappa Gayathri Devi , Hegde Vinaykumar Ganesh , Vuttanur Anjali V. , Jois Abhiram
Published: August 2023

Background: Maternal and child health (MCH) care is a fundamental service of the public health delivery system of a nation, especially in low and middle-income countries like India. As the Covid-19 pandemic continued throughout the world, the health services such as maternal and child health (MCH) remained in inertia. Stringent lockdown measures and fear of contracting Covid-19 infection made accessing these services extremely hard.
Methods: A cross sectional study was conducted in a tertiary care maternity hospital in Bengaluru from July to September 2021 among the post-natal mothers using a semi-structured questionnaire about the utilization of MCH services.
Results: A total of 316 mothers were interviewed. Among them, 72.8% mothers had completed 4 or more antenatal visits. Among high-risk pregnancies, only 66.3% had completed adequate antenatal visits. 63% of infants had low birth weight and 83.4% of children were immunized up to date.
Conclusions: This study revealed that, more than 1/4th of mothers had not completed 4 or more antenatal visits and about 1/3rd of the high-risk mothers had not completed adequate antenatal visits. More than 2/3rd of infants had low birth weight. This shows that there was a marked reduction in the utilization of MCH services during the Covid-19 pandemic.
Adequacy of sanitation and handwashing facilities in public primary schools: case of Tharaka Nithi County, Kenya
Authors: Mureithi Njeru Amos , Juma Joseph , Mugo Judy , Odongo Alfred Owino
Published: August 2023

Background: Hygiene as practices and conditions contribute to the upholding of population health or prevention of disease outbreak. The implication of sanitation needs to the population tends to weigh heavily on the children population due to their vulnerability to pathogens.
Methods: Analytical cross-sectional study design was used and 219 participants in the selected public primary schools participated in the study. Data was collected using administered structured questionnaire, observation and Key Informant Interview. Quantitative data analysis was conducted using SPSS version 26.0 and involved univariate and bivariate analysis. Bivariate analysis was done through logistic regression was used to test the significance of the association between the dependent and independent variables (p<0.05). Qualitative data was analyzed by thematic content analysis.
Results: More than three quarter 171 (78.1%) were day school with 40 (18.3%) and 54 (24.7%) of school having between 150-179 boys and 180-209 girls respectively. Slightly less than half 104 (47.5%) of schools had less than 5 toilets for boys and 90 (41.1%) of schools had between 5-10 toilets for girls, 112 (51.1%) of schools had water available for hand washing outside the latrines/toilets. Schools with 120-149 boys and 210-239 girls were more likely to avail water for handwashing outside the toilets.
Conclusions: Schools lack sanitary facilities, water, soap and protective clothing, leading to poor sanitation levels, further, schools with scarcity of water and soap for hand washing are at risk of contamination, leading to the spread of diseases like cholera.
Impact of human immunodeficiency virus on category I pulmonary tuberculosis cases in a tertiary care hospital: a case control study
Authors: Kadam Monali
Published: August 2023

Background: Tuberculosis (TB) is an opportunistic infection (OI). OIs are infections that occur more often or are more severe in people with weakened immune systems than in people with healthy immune systems. Human immunodeficiency virus (HIV) weakens the immune system, increasing the risk of TB in people with HIV. This case control study was done to assess the impact of HIV on clinical aspects and treatment outcome of newly diagnosed bacteriologically positive pulmonary tuberculosis.
Methods: This study was done among unmatched 75 cases and 75 controls who were pulmonary TB and TBHIV co-infected patients. Data were collected using a pretested, structured, interviewer-administered questionnaire and was analyzed using descriptive and analytical statistics.
Results: Total 150 patients were enrolled in the study out of which 75 patients had HIV-TB co-infection while remaining 75 patients were diagnosed as pulmonary TB. Treatment success rates are 74.7 % (56/75) for TB-HIV co-infected patients and 82.7% (62/75) for pulmonary TB patients. TB-HIV co-infected patients had a higher risk of an unsuccessful treatment outcome [(p = 0.232) with OR and 95% CI of 0.68 (0.28-1.36)]. The risk of unsuccessful treatment outcome was associated with family history of TB, Tobacco use, low BMI.
Conclusions: TB treatment success rate is good as compared to the WHO minimum requirement. Successful treatment outcome is lower among patients with HIV infection, tobacco use, low BMI, <200 /mm3 CD4 count patients. Therefore, due emphasis should be given to these high-risk groups.
Knowledge-practice gap in breastfeeding and the factors influencing it among the urban mothers attending the immunization clinic under a tertiary care hospital in eastern India
Authors: Kar Sonali , Singh Snigdha , Kar Ansuman
Published: August 2023

Background: Breast milk is a complete food for the newborn. Timely introduction of breast milk and exclusive breast feeding till 6 months of age of a newborn, with proper positioning and adequate attachment to mother’s breast is encouraged as Initiation of breast feeding within the first hour after birth, prevents the newborn from the risk of morbidity and mortality. An effective improvement in mother’s self efficacy and understanding on breast feeding will be useful in meeting the nutritional goals of the child. Aim of study was to assess the knowledge, perception and practice among the mothers on breast feeding and the factors influencing their practice and to determine probable association of ideal infant weight with exclusive breast feeding.
Methods: Descriptive cross-sectional study among 390 mothers attending the Immunization Clinic of Kalinga Institute of Medical Sciences, Bhubaneswar. They were assessed if they breast fed infant by following the ideal positioning and proper attachment to breast and for their knowledge, perception and practices of breast feeding. Analysis was done using STATA-17.
Results: Good knowledge, perception and practice of breast feeding was present among 88.2%, 83.5% and 69.8% mothers, respectively. Association between ideal weight of baby and proper breast feeding technique was found. Knowledge was more positively related to practice, than to perception.
Conclusions: Children who have been exclusively breast fed, had the right weight for age. Mother and other family members must be aware of proper technique, adequacy and frequency of breast feeding for the best nourishment of the newborn.
Prevalence of dental caries and other oral health problems among municipal secondary school children in Mumbai metropolitan region
Authors: Sharma Sahil , Raut Prasheel , Gurav Ravindra Balaram
Published: August 2023

Background: Dental caries and other oral health issues are major public health problems among school going children. This study is conducted to assess the prevalence of dental caries, other oral health problems and some oral hygiene practices among municipal secondary school children in an urban area.
Methods: The present study was conducted among randomly selected 152 students studying in a Municipal Secondary School in an urban area. They were examined for dental caries and other oral health problems. Also, they were asked about the oral hygiene practices. Data was entered in Google form. Obtained data was entered in a MS-Excel spreadsheet and statistical analysis was done using Chi-square test.
Results: Of the 152 subjects examined, 137 (90.13%) were having one or more oral health problems. 74 (48.68%) subjects were having dental caries. Of the 137 subjects having oral health problems, 132 (86.84%) subjects’ fathers’ education and 135 (88.82%) subjects’ mothers’ education was ≤12th standard (p<0.05). Of the 77 subjects studying in 5th to 7th standard, 45 (29.61%) were suffering from dental caries (p<0.05). Of the 140 subjects whose fathers’ education was ≤12th standard, 73 (48.03%) were suffering from dental caries (p<0.05). Of the 74 (48.68%) subjects who were suffering from dental caries 24 (15.79%) and of the 78 (51.32%) who were not suffering from dental caries 35 (23.03%) were brushing their teeth for more than 2 minutes.
Conclusions: School health services should be strengthened to detect and treat oral health problems in time as well as to increase general oral health awareness among school children.
Role of prebiotics and probiotics in the prevention of the gastrointestinal side effects of metformin among the type 2 diabetic patients
Authors: Khan Sundus , Yousaf Hira , Rafiq Hina , Zamir Zarish , Muhammad Deen Ayesha , Khan Tayyab Mumtaz , Nauman Hina , Nauman Sheema , Khan Shahrukh
Published: August 2023

Background: Diabetes mellitus (DM) is most common endocrine disorder all over the world. Metformin has been used as a first line drug, however, it has several gastrointestinal side effects. This study aims to determine the frequency of metformin induced gastrointestinal side effects among type 2 diabetic patients and role of prebiotics and probiotics in the prevention of the metformin-induced GI side effects.
Methods: This cross-sectional study was performed in a tertiary care hospital, Rawalpindi, among 130 for one year from January 2021 to December 2022. Data was collected by applying a self-structured questionnaire. Descriptive statistics were used for the data analysis. Data analysis was performed via statistical package for the social sciences (SPSS) version 25.0.
Results: The means for study variables like age, dose, and duration of therapy were 54.09 years, 1000 mg and 3.6 years respectively. Female patients had more GI side effects than male patients. Similarly, GI side effects frequency was also higher among the patients who were on metformin alone than the patients who were using metformin and combination of prebiotics and probiotics. Patients with higher dose of metformin and shorter duration of metformin therapy had higher frequency of GI symptoms. The most common GI symptom was constipation followed by diarrhea, bloating, abdominal pain, vomiting/nausea, dyspepsia, loss of appetite and flatulence.
Conclusions: Metformin induced GI symptoms were common among study population. Use of prebiotics and probiotics combination with metformin, low dose of metformin, and longer duration of metformin use were found protective against the metformin-induced GI side effects.
Impact of patient provider support agency on private sector engagement in Tuberculosis care in Eastern India
Authors: Narain Smiti , Sagar Vidya , Thankamma Anupama , Mitra Anindya
Published: August 2023

Background: India is the country with the world’s largest burden of tuberculosis, with a large proportion of patients seeking care from the private healthcare sector, which is fragmented and unregulated. There are significant gaps across the patient care cascade in the private sector on account of underreporting, diagnostic delays, irrational and non-standardized regimens, and catastrophic health expenditures to patients. Considering the gaps, Jharkhand state of India had implemented patient provider support agency scheme under National TB elimination programme to improve private sector engagement, operational since 27 September 2019. PPSA is giving end-to-end NTEP TB service packages to patients seeking care in the private sector.
Methods: This is a retrospective cross-sectional descriptive study using secondary data attained from the Nikshay web portal for Jharkhand and analyzed using Excel.
Results: After the introduction of PPSA, the proportion of private sector notifications in Jharkhand increased from 22.9 percent in 2019 to 33.5 percent in 2020. The Private sector notification rate in the state showed an increase from 34 per lakh population to 39 per lakh population.
Conclusions: Private sector engagement through PPSA has improved TB notification in Jharkhand. PPSA could sustain the provision of TB care in the private sector even during the COVID-19 pandemic. The access to quality data on patients seeking TB care in the private sector in the Nikshay web portal has improved since the implementation of the scheme resulting in better patient support and program monitoring.
Assessment of psychological distress and its association with socio-demographic variables among cancer patients in a tertiary care hospital in Bengaluru, Karnataka: a cross sectional study
Authors: S. Pooja , Savatagi Shivanand , Sengupta Angan , Jayanna Krishnamurthy
Published: August 2023

Background: Cancer diagnosis is known to cause significant mental distress and anxiety. Psychologically distressed patients are less compliant to treatments and endure longer hospitalization. Assessment of distress is critical to develop necessary interventions. Our research aims to assess the severity, contributing factors, and relationships between socio-demographic characteristics and psychological distress in cancer patients.
Methods: A cross sectional study with random sample of 188 cancer patients were assessed for distress with NCCN distress thermometer (DT) from a tertiary care facility. Descriptive analysis and Chi-square test performed using SPSS-28. 
Results: 75% reported "moderate and above" distress levels, with a mean distress of 5.5±2.99. Respondents below 40 years, females, currently unmarried, nuclear families, highly educated, and financially dependent were more likely to experience severe distress (score 8-10). Significant emotional concerns were associated with severe distress, followed by practical problems.
Conclusions: Distress can be routinely screened with a simple visual analogue scale like DT. A severely distress patient had 3 or more physical, practical, emotional and 2 or more social and spiritual concerns and a person with mild distress had just one emotional concern and spiritual concern and none of the other three. Early identification, routine screening and psychosocial support can reduce distress with optimal efficacy.
The contribution of nursing expertise to the management of complex comorbidities in internal medicine setting: a systematic review
Authors: Alresheedi Hend A. , Alanazi Norah A. , Alshammari Mariam H. , Alotaibi Khulud M. , Al Wagdani Abeer O. , Alotaibi Najla H. , Alotibi Amal M. , Al Rashidi Hind M. , Eid Nourah K. , Alshahrani Shuruq N.
Published: August 2023

The burden of comorbidities is on the rise, and nursing has long been recognized as having a crucial role in assisting individuals to manage long-term conditions. Over the past ten years, a growing number of chronic disease delivery models have given nurses great opportunities to develop roles and abilities focused on effective chronic disease management. We have conducted both electronic and manual searches within the potential databases to find relevant studies. Studies from the years 2010-2023 were included. Case reports with limited sample sizes, no descriptive statistics, review papers, and meta-analyses were excluded from this review. A quality assessment for all included studies was performed. Final inclusion resulted in a total of eight studies. Cardiovascular diseases, hypertension, and diabetes were the comorbidities reported by the majority of the studies, while chronic obstructive pulmonary disease, end-stage renal disease, and metastatic cancer were reported by each study. Overall, the findings suggest that nurses play a significant role in the management of comorbidities among patients, further improving patient outcomes, reducing readmissions and hospital costs, and preventing complications. The care of patients with complicated medical and social needs is coordinated through the employment of a wide range of interventions in an internal medicine setting. Nurse-led interventions /programs can play a vital part in reducing the burden of rising comorbidities among patients. However, the role of nurses in the internal medicine setting needs to be highlighted further by evidence-based research.
Bilateral Ischemic Lumbosacral Plexopathy after Proximal Aortic Surgery
Authors: Kim Min Gi , Lee Seung Hak
Published: August 2023

In paraplegia after proximal aortic surgery, in addition to spinal cord ischemia, injuries to the plexuses and other peripheral nerves should be considered. Spinal cord ischemia—the most common etiology of paraplegia—can be caused by the occlusion of several radicular arteries resulting from aortic clamping. We report a case of bilateral ischemic lumbosacral plexopathy with a spared spinal cord occurring after proximal aortic surgery. A 76-year-old woman underwent aortic valve replacement with ascending aorta and total arch replacement, along with multiple hematoma evacuations. Postoperatively, she developed paraplegia with sensory deficits in the bilateral lower limbs. Spinal magnetic resonance imaging revealed no remarkable findings at any level of the spinal cord. In electrophysiological studies, the compound motor action potential and sensory nerve action potential of the bilateral lower extremities did not respond to stimuli; all examined muscles displayed abnormal spontaneous activities without motor unit action potentials. Based on these findings, a diagnosis of bilateral lumbosacral plexopathy was ultimately made.
The Hmax/Mmax Ratio as a Diagnostic Tool in Assessing Spasticity in a Patient with Hereditary Spastic Paraplegia
Authors: Kim Tae Yong , Kim Kyung Min , Cho Sung-Rae
Published: August 2023

Hereditary spastic paraplegia (HSP) refers to a group of inherited diseases caused by progressive degeneration of the corticospinal tracts. We report a case of an HSP patient with ankle spasticity treated with an intrathecal baclofen (ITB) pump, for whom the Hmax/Mmax ratio was used as a diagnostic tool for spasticity. A man in his early 30s who was born without any complications and developed normally in childhood was diagnosed with HSP when he was 29 years old. Equinus gait pattern and bilateral genu recurvatum improved after manual therapy and botulinum toxin injections in both gastrocnemius muscles; however, after a few months, his gait disturbance became more severe as a natural course of the disease. To treat ankle spasticity and clonus, he was considered a suitable candidate for an ITB therapy. However, as spasticity is a finding that is easy to recognize but difficult to evaluate, we conducted electrophysiological testing, including H-reflex and the ratio of H-reflex amplitude to compound muscle action potential amplitude. The Hmax/Mmax ratio was 75.2% on the right side and 65.2% on the left side before an ITB pump, and 37.6% on the right side and 47.0% on the left side after an ITB pump. This case illustrates the usefulness of testing electrophysiological parameters such as the Hmax/Mmax ratio to measure spasticity objectively in late-onset HSP patients. The Hmax/Mmax ratio is also a good tool for measuring the degree of improvement in spasticity after ITB or additional treatment in these patients.
Granular Cell Tumor: An Unusual Cause of Common Peroneal Neuropathy
Authors: Lee Juwon , Park Jintae , Jeong Seungsu , Noh Jung Ho , Kang Gu , Baek Sora
Published: August 2023

Granular cell tumors, also known as Abrikossoff’s tumors, are rare soft-tissue tumors, and their occurrence in the peripheral nerves has been very rarely reported. We present the case of a 35-year-old woman with common peroneal neuropathy due to a granular cell tumor, who complained of foot dragging. Common peroneal neuropathy was confirmed by electrophysiology. The tumor mass was observed using ultrasonography and magnetic resonance imaging. The tumor was surgically excised, the tumor cells stained positive for S-100, and eosinophilic granular cytoplasm was observed using microscopy. To the best of our knowledge, this is the first report of a granular cell tumor involving the common peroneal nerve.
Imperial Brazilian Mining Association (IBMA): a City de Londres na economia escravista brasileira no início do século XIX
Authors: Soares José Alex Rego , Saes Alexandre Macchione
Published: August 2023

O artigo analisa as práticas de uma companhia tipicamente capitalista no interior de uma sociedade escravocrata, acompanhando a atuação da Imperial Brazilian Mining Association (IBMA), empresa inglesa de mineração instalada no Brasil durante a primeira metade do século xix. Para tanto, alicerçamos nossos argumentos a partir das contribuições de estudos que apontam como a acumulação gerada a partir do trabalho escravo cumpriu um relevante papel para o desenvolvimento do capitalismo.
Caribbean Economics Quarterly: Volume 12, Issue 2: Global and Regional Economies at a Crossroads
Authors: Rosenblatt David , Mooney Henry , Clayton Khamal , Saboin José Luis , Ortiz de Mendívil Cloe , Gauto Victor , Teixeira Gisele , Graham Monique , Satnarine-Singh Nirvana
Published: August 2023

The global economy and Caribbean regional economies are at a crossroads. In general terms, tourism-oriented economies have recovered more rapidly than expected from the sharp pandemic-induced contraction of 2020. Commodity prices have subsided; however, they remain above pre-pandemic levels, with persistent negative effects on households across the region, while at the same time buoying macroeconomic prospects for commodity exporters. Regional economies have grown faster than the global economy, recovering from a deeper shock, but growth rates are likely to converge to pre-pandemic levels unless there are significant structural changes to enhance productivity, country circumstances vary substantially, as noted in the country sections of this report. Some countries (e.g., The Bahamas and Jamaica) tourism sectors have recovered more rapidly than others (e.g., Barbados), and there is the hydrocarbon-fueled extraordinary growth of Guyana that dwarfs the economic growth of all countries in the Western Hemisphere. Key risks and opportunities also vary across countries, and these are analyzed in the country sections of the report.