bluuebunny/crossref_metadata_2025 huggingface dataset:
Análise espacial da desigualdade de gênero no mercado de trabalho na região Matopiba, Brasil
Authors: Saraiva Antonia Francisca da Silva , Oliveira Nilton Marques de , Lopes Walter Saraiva , Rodrigues Waldecy
Published: January 2024

O objetivo foi analisar a distribuição espacial da desigualdade de gênero no mercado de trabalho na região Matopiba, nos anos de 2013 e 2019. Os dados utilizados na pesquisa foram coletados da base de dados da Relação Anual de Informações Sociais (RAIS) referentes aos anos de 2013 e 2019, e organizados conforme por meio dos seguintes indicadores: número de empregos, faixa etária, remuneração, escolaridade e tempo de emprego. Foi realizada uma análise exploratória pela geoestatística espacial, empregando os indicadores de dependência espacial pelo software QGIS 3.16, para a análise dos dados e geração de mapas. Os resultados evidenciaram que os homens representaram 12,33% em 2013 e 10,87% em 2019, com maior representatividade nas ocupações de emprego do que as mulheres. Nesse período, a participação das mulheres teve um crescimento de 8,09%. Sobre a escolaridade, as mulheres se destacaram no ensino superior, com alta significância de 30,01%, de 2013 para 2019, enquanto os homens representaram 16,11%. Relativo à faixa etária, houve significância de 56,12% e 55,42% para os homens nos anos pesquisados, e à medida que a idade avança, essa diferença diminui gradativamente em relação às mulheres. Em relação à remuneração, foi observado que em 2013 uma taxa de 41,17% e em 2019 de 42,0% de mulheres empregadas que ganhavam menos de cinco salários-mínimos e superior a cinco salários-mínimos, 3,0% e 4,0% dos homens em ambos os anos. Quando ao tempo de emprego, os homens representaram 56,16% e 55,44% para 2013 e 2019, respectivamente, com maior significância, enquanto as mulheres tiveram um leve crescimento de 4,04% com mais de cinco anos no emprego, sendo inferior aos homens, que foram de 5,24%. Conclui-se, que a região Matopiba apresentou desigualdade de gênero, mas as análises espaciais evidenciaram a diminuição dessas desigualdades, ainda que de forma tímida.
Qualidade da água e definição de parâmetros preponderantes para monitoramento no Rio Puraquequara, Manaus, Amazonas, Brasil
Authors: Queiroz Neto João Carlos de , Albuquerque Carlossandro Carvalho de , Batista Ieda Hortêncio
Published: January 2024

A paisagem da bacia hidrográfica do Rio Puraquequara, antes formada por florestas, tornou-se área de solo exposto, casas, sítios, estaleiros, restaurantes flutuantes, indústrias, entre outros. Todos esses usuários consomem os recursos hídricos e a qualidade com a qual são devolvidos é de interesse público. Nesse sentido, o objetivo desta pesquisa foi analisar parâmetros físicos, químicos e biológicos do Rio Puraquequara e identificar os preponderantes, para monitoramento através da análise de componentes principais e fatorial visando contribuir também para a gestão dos recursos hídricos. Foram realizadas quatro campanhas de coleta e análise de água em seis pontos ao longo do baixo curso do Rio Puraquequara, entre 2021 e 2022. As águas apresentaram valores de oxigênio dissolvido oscilando entre 1,26 mg.L-1 e 6,26 mg.L-1 e altos valores de Demanda Bioquímica de Oxigênio (DBO) na enchente (até 20,1 mg.L-1). São águas ácidas (pH<6), com variação de temperatura registrada entre 26,52 °C e 31,3 °C. Na vazante, o menor volume da água ocasionou o aumento de partículas, influenciando na turbidez e nos sólidos totais. A maior condutividade no período das chuvas adveio da lixiviação do material das margens para dentro do corpo hídrico. O fósforo total não esteve em conformidade com a legislação ambiental em alguns pontos, e, junto com o nitrogênio total, os coliformes termotolerantes e demais parâmetros retrataram a influência antrópica na alteração destes. A turbidez, o oxigênio dissolvido, os coliformes termotolerantes, a DBO e os sólidos totais explicaram a maior variabilidade dos dados e foram os mais representativos na qualidade de água. Portanto, recomenda-se o fortalecimento dos instrumentos de gestão para manter ou melhorar a qualidade hídrica e continuar atendendo aos usos múltiplos.
The rise, spread and decline of Brazil’s participatory budgeting: the arc of a democratic innovation
Authors: Bogo Rodrigo Sartori
Published: January 2024

Resenha crítica que trata do livro "The rise, spread and decline of Brazil’s participatory budgeting: the arc of a democratic innovation", escrito por Brian Wampler e Benjamin Goldfrank e publicado pela Springer Nature em Janeiro de 2022. Na obra, os autores traçam um panorama e o histórico do orçamento participativo no Brasil, levantando análises e interpretações do porque o instrumento de gestão urbana teve um auge de prestígio e depois uma enorme decadência ao longo dos mais de 30 anos de sua existência no país. De maneira conclusiva, os autores apontam para um momento em que o OP atingiu uma policy bubble, ou seja, em que o lento grau de inovação e o pouco capital político resultante de sua implementação levaram à uma perca de prestígio. Ademais, mudanças no arcabouço institucional brasileiro e elementos do próprio desenho institucional do OP trouxeram limitações acerca da capacidade do Estado de manter a ferramenta na maioria das cidades brasileiras. O presente autor considera que o livro tem grande valor e contribuição para a Geografia urbana e estudos correlatos, trazendo elementos relevantes nos campos científico e político, trazendo fundamentos para uma discussão mais ampla do OP enquanto um dos muitos possíveis caminhos para a justiça espacial.
Resilience and mental toughness as predictors of anxiety, depression, and mental well-being
Authors: Naden Emma , Schepman Astrid , Bilton Gareth , Rodway Paul
Published: January 2024

To examine how strongly the attributes of resilience and mental toughness predicted levels of anxiety, depression, and mental well-being, a quantitative online survey of 281 adults was employed. The survey was conducted in the United Kingdom (April to June 2021) using opportunity sampling. Resilience, mental toughness, and mental well-being were measured by the 10-item Connor-Davidson resilience scale, the 10-item mental toughness questionnaire, and the 14-item Warwick-Edinburgh mental well-being scale, respectively. In addition, the hospital anxiety and depression scale (HADS) measured anxiety and depression, and the patient health questionnaire-9 (PHQ-9) was used to measure depression. Hierarchical multiple regression was used to analyze which attribute was the strongest predictor of mental health. Mental toughness was found to be a significantly stronger predictor of well-being (β=0.54) than resilience (β=0.21), of anxiety (β=-0.70 versus 0.02, respectively), of HADS depression (β=-0.52 versus -0.15), and of PHQ-9 depression (β=-0.62 versus -0.09). We propose that mental toughness may predict well-being more strongly than resilience because it is a broader construct, incorporating proactive traits that enhance well-being. The findings suggest that training and interventions that enhance mental toughness in non-clinical populations may be more effective at promoting mental well-being and reducing anxiety and depression than those that enhance resilience. Further research is required to test these practical implications and to clarify why mental toughness is a stronger predictor than resilience for positive mental health.
Factors associated with disordered eating behaviors among schizophrenia patients
Authors: Khosravi Mohsen
Published: January 2024

Recent hypotheses suggest that patients with schizophrenia consume more unhealthy foods, an issue that raises the need for a more meticulous examination of disordered eating behaviors (DEBs) in such patients due to increasing rates of metabolic mortality and morbidity. Therefore, this study aimed to investigate predictors associated with DEBs in schizophrenia. This cross-sectional study was conducted from May 2018 to November 2019. A total of 131 patients with schizophrenia were recruited through convenience sampling among outpatients referring to the Baharan Psychiatric Clinic (Zahedan, Iran). Patients were evaluated using demographic information forms and the eating attitudes test-26 items. In this study, 120 patients (52 males and 68 females) with schizophrenia provided correct answers to the questionnaires. According to regression analysis results, the variables of marital status, employment, classes of medication, and duration of disease could significantly predict DEBs among schizophrenia patients. The results of this study demonstrate the need for a more meticulous examination of DEBs at earlier stages of schizophrenia. Besides, psychosocial interventions and antipsychotic medication switching seem to be associated with a decreased risk of DEBs among schizophrenia patients.
A Novel Method to Fix Paediatric Mandibular Fracture using 2-0 Polyglactin Suture
Authors: Marimallappa T. R. , Pal Supriyo , Rao Keerthana , Sreelakshmi M. S.
Published: January 2024

Aim:

This study aimed on a novel cost-effective technique of stabilising the paediatric mandibular fracture using 2-0 resorbable polyglactin 910 suture with minimal trauma to tooth buds and bone and adequate stability.

Background:

Reduction and stabilisation of fractures at the earliest is valuable in the paediatric age groups. This novel technique focuses on stabilisation of the fracture fragments using vicryl, which has an added advantage to conventional plating and wiring.

Technique:

After raising a full-thickness mucoperiosteal flap, the fracture segments are identified and reduced. 1.6mm drill bit is used to make holes through the buccal cortex on either side of the fractured segment in an anteroposterior direction. The patency of holes is checked by passing a long 26-gauge wire. The proximal end of the wire is bent into a loop, a 2-0 resorbable polyglactin suture (vicryl) is passed through this loop and the loop is pressed in place to lock the suture. The wire with the attached suture is pulled through the distal end. Once the suture is secure in place, the 26G wire is cut, and the two ends of sutures are knotted and stabilised. The mucoperiosteal flap is then closed.

Conclusion:

A novel method of stabilisation of paediatric fracture without hampering the tooth and jaw growth, especially in the financially unstable population.

Clinical Significance:

2–0 polyglactin 910 suture is cost-effective, $2 US, compared to resorbable plates costing about $150 US, and easily available. Polyglactin 910 takes 40–60 days for resorption, and half-life tensile strength is 2 weeks; thus, it gives adequate stability and time for callus formation and does not damage the tooth buds or bone by cutting through them.
Management of Complete Persistent Rectal Prolapse in Children
Authors: Gad Mostafa , Dessouky Mostafa Nabil , Abdullateef Khaled Salah , Abdelazim Osama , Fares Ahmed E. , Kaddah Sherif Nabhan , Ragab Moutaz
Published: January 2024

Context:

Rectal prolapse is a relatively common, usually self-limiting illness in children. Peak incidence is between 1 and 3 years. The primary treatment of rectal prolapse is non-operative. Surgical intervention is needed in long-standing intractable cases of rectal prolapse, rectal pain/bleeding/ulceration and prolapse that needs frequent manual or difficult reduction.

Aim of the Study:

The aim of this study was to compare the efficacy and outcome of laparoscopic ventral mesh rectopexy versus laparoscopic suture rectopexy in the management of persistent rectal prolapse in children not responding to conservative management and/or recurrent after sclerotherapy or anal encirclement.

Methods:

Twenty-four cases were randomised into two groups at the ratio of 1:1, Group 1 patients were managed by laparoscopic ventral mesh rectopexy, whereas Group 2 cases were managed by laparoscopic suture rectopexy. Patients with primary surgical conditions such as anorectal malformations, Hirschsprung’s disease, rectal polyps or masses and Ectopia Vesicae were excluded from the study. Inclusion criteria were complete rectal prolapse cases with failed medical treatment for at least 6 months and/or recurrent after injection sclerotherapy or anal encirclement.

Results:

In the mesh rectopexy group, one case had recurrence in the form of partial prolapse 3 weeks postoperatively which improved 2 months postoperatively with conservative management, one case had bleeding per rectum 2 months postoperatively, stool analysis was done revealing parasitic infestation which was treated medically. In the suture rectopexy group, one case had one attack of bleeding per rectum on the 2nd day postoperatively which resolved spontaneously and one case was readmitted on the 5th day postoperatively for non-bilious vomiting which improved by medical treatment. No recurrent cases of complete rectal prolapse were reported in both groups.

Conclusion:

Laparoscopic rectopexy can be an effective modality for the treatment of refractory complete rectal prolapse in children. It is effective, safe and easy. Although the current study has shown that laparoscopic suture rectopexy and mesh rectopexy have nearly the same results, a larger number of patients are needed to compare more deeply between the two groups.
Expert Consensus on Molecular Tumor Boards in Taiwan: Joint Position Paper by the Taiwan Oncology Society and the Taiwan Society of Pathology
Authors: Chen Ming-Huang , Li Wan-Shan , Liao Bin-Chi , Wu Chiao-En , Li Chien-Feng , Hsieh Chia-Hsun , Kuan Feng-Che , Tzeng Huey-En , Hang Jen-Fan , Chiang Nai-Jung , Chen Tse-Ching , Chen Tom Wei-Wu , Chang John Wen-Cheng , Hsieh Yao-Yu , Chen Yen-Lin , Yeh Yi-Chen , Liang Yi-Hsin , Su Yu-Li , Lai Chiung-Ru , Yang James Chih-Hsin
Published: January 2024

Background:

The Taiwan Oncology Society (TOS) and the Taiwan Society of Pathology (TSP) have collaborated to present a joint position paper on the molecular tumor boards (MTBs) within the medical institutions of Taiwan.

Materials and Methods:

To raise awareness of MTBs among health-care professionals, policymakers, and the public, a total of 20 experts from TOS and TSP formulated a joint consensus statement through a voting process.

Results:

The joint statement proposes key recommendations: (1) MTB discussions encompass diverse molecular analyses including next-generation sequencing (NGS), RNA sequencing, whole-exon sequencing, and whole-genomic sequencing addressing relevant genomic changes, tumor mutation burden, microsatellite instability, and specific biomarkers for certain cancers. (2) MTB meetings should involve multidisciplinary participants who receive regular updates on NGS-related clinical trials. (3) Prioritize discussing cases with unique clinical needs, gene alterations lacking treatments, untreatable neoplasms, or oncogenes unresponsive to targeted therapies. (4) Base MTB discussions on comprehensive patient data, including genetics, pathology, timing of specimen collection, and NGS outcomes. (5) MTBs offer treatment recommendations: standard therapies, off-label use, clinical trials, genetic counseling, and multidisciplinary reviews. (6) MTB effectiveness can be gauged by member composition, case reviews, treatment suggestions, and patient outcomes. Encourage government incentives for MTB engagement.

Conclusion:

The primary aim of this initiative is to promote the advancement of precision oncology in Taiwan.
Dose-dense neoadjuvant chemotherapy in triple-negative breast cancer: Real-world data from a developing country
Authors: Sharma Rakesh Kumar , Gogia Ajay , Deo SVS , Sharma Dayanand , Mathur Sandeep , Sagiraju Hari Krishna Raju
Published: January 2024

Background:

Dose-dense adjuvant chemotherapy has been shown to be associated with improved long-term survival outcomes in triple-negative breast cancer (TNBC). However, there is a lacuna of data on the benefits of dose-dense neoadjuvant chemotherapy (NACT) in TNBC.

Methods:

This retrospective study included 217 newly diagnosed cases of TNBC treated with a sequential anthracycline and taxane-based NACT, followed by definitive surgery. Study groups consisted of 137 patients who received 3-weekly conventional chemotherapy (cNACT group) and 80 patients with 2-weekly dose-dense NACT (ddNACT group). Pathological complete response (pCR) rates, relapse-free survival (RFS), overall survival (OS), and grade-3/4 chemotoxicities were compared across the groups.

Results:

No significant difference in the pCR rate (32.8% versus 31.3%; P = 0.808) was observed across the study groups. Relapse rate was lower in the ddNACT group compared to the cNACT group (odds ratio [OR]: 0.51, 95% confidence interval [CI]: 0.27–0.95). However, ddNACT had no RFS advantage over conventional chemotherapy (median RFS: not reached versus 56.1 months in cNACT; hazard ratio: 0.90, 95% CI: 0.52–1.53). OS was also comparable in both the groups with a 3-year survival rate of 78.8% (95% CI: 60.9–89.2) in the ddNACT group versus 84.3% (95% CI: 74.8–90.4) in the cNACT group. Younger age, menopause, the Eastern Cooperative Oncology Group ECOG status, and pCR were significantly associated with OS in our cohort. Grade-3 toxicities were comparable in both groups.

Conclusions:

This observational study focusing on ddNACT among TNBC patients demonstrated significant differences in the relapse rate with no survival benefits. Differential effects of ddNACT by tumor presentation (early vs. late), tumor size, tumor biology, and cost–benefits of granulocyte colony-stimulating factor support with such regimens need further exploration.
Bortezomib-based induction therapy followed by autologous hematopoietic cell transplantation in newly diagnosed multiple myeloma patients: A single-center experience and review of Indian literature
Authors: Kathrotiya Manthan , Radhakrishnan Vivek , Bhave Saurabh J. , Nag Arijit , Arora Neeraj , Roychoudhry Mita , Parihar Mayur , Mishra Deepak , Nair Reena , Chandy Mammen , Kumar Jeevan
Published: January 2024

Introduction:

High-dose chemotherapy with melphalan, followed by autologous hematopoietic stem cell transplantation (AHCT) remains the standard of care for consolidation therapy of fit patients with newly diagnosed multiple myeloma (NDMM), for more than 20 years now.

Material and Methods:

This is a retrospective study of NDMM patients who underwent AHCT at our center from 2011 to 2018. Data was undertaken using the hospital electronic medical records (EMR).

Results:

Among transplant eligible patients (which were 764), 78 patients (10.2%) underwent AHCT. The predominant stage in the study cohort was International Scoring System (ISS)-III (55%), and IgG-kappa (44%) was the commonest subtype of multiple myeloma (MM). Light chain myeloma was found in 23.5% of patients. Pretransplant, 42%, 48%, and 10% patients were in more than very good partial response (>VGPR), very good partial response (VGPR), and partial response (PR), respectively. The median duration of follow-up was 57.2 months (range: 12.1–120.2 months). The entire cohort’s 5-year overall survival (OS) and progression-free survival (PFS) were 89.1% and 41.8%, respectively.

Conclusion:

Bortezomib based triplet induction regimens were effective and well tolerated in this retrospective analysis of Indian patients. We observed that AHCT effectively achieves deep and durable remission in MM.
Spatial Patterns of Heaping in Age Data among Literates, Illiterates, and Numeracy–Literacy Correlates: A Cross-Sectional Analysis of Census 2011, of India
Authors: Datta Jayanta , Sinha Prasenjit
Published: January 2024

Background:

Accurate information on age is an essential prerequisite for demographic and epidemiological studies. This study analyzed the age data quality among the literate and illiterate (combined, rural, urban) population and examined the association between data quality and literacy.

Material and Method:

Secondary data on age statistics and literacy were obtained from census 2011. We measured age data quality for literates and illiterates (combined, rural, urban) by transforming Whipple’s index known as ABCC, abbreviated based on surnames of the developers A’Hearn, Baten, and Crayen (2009). Correlation tests between literacy and ABCC were performed. RStudio (Version 1.3.1073) was used.

Result:

Computed ABCC indices in majority states (union territories) for literates (data quality rough) were higher than illiterates (data quality very rough). Urban data among literates and rural data among illiterates were comparatively superior. Correlation between ABCC and literacy rates for (i) literate combined (R = 0.84, P = 3.5e-10), (ii) literate rural (R = 0.8, P = 1.1e-08), (iii) literate urban (R = 0.8, P = 1e-08), (iv) illiterate combined (R = 0.54, P = 9e-04), (v) illiterate rural (R = 0.48, P = 0.0034), and (vi) illiterate urban (R = 0.73, P = 6.4e-07) was significant. Age data quality for both literates and illiterates was poor. There was heaping at terminal digits “0” and “5” even among literates, which contradicts the theoretical expectation of quality data among literates.

Conclusion:

Correlations between data quality and literacy were significant, with comparatively lower magnitude among illiterates, which indicates the role of literacy in yielding quality data. Awareness, training, ADHAAR-based enumeration, and digitization may be suggested for better age data.
Strengthening of District/Taluk Level Hospitals Through Implementation of Post-graduate Medical Courses in Karnataka, India
Authors: Maroor Parimala S. , Pushpalatha B. S , Kodkani Sangeetha , Shruthi Lourdu , Ashwini Damaraju , Sharma Anjali , Negandhi Himanshu , Shapeti Suresh S. , Zodpey Sanjay P.
Published: January 2024

The World Health Organization (WHO) recommends the requirement of human resource for health (HRH) stands at 44.5 skilled health workers per 10,000 population. WHO recognizes India as one of the countries which has HRH crisis. Karnataka, a southern state in India, has the highest number of medical colleges yet faces the shortage of specialists in the public hospitals. We conducted desk review to understand the HRH crisis, particularly the medical specialists in India. Simultaneously, we conducted secondary research to explore the initiatives taken by the Government of Karnataka (GoK) to mitigate the shortage of medical specialists in the rural areas. GoK scaled up the National Board of Examination in Medical Sciences (NBEMS) postgraduate and super-speciality courses such as Diplomate of National Board (DNB), Diploma, and Doctorate of National Board (DrNB) in district hospitals (minimum 250–500 bedded) and taluk hospitals (minimum 100 bedded) by utilizing the existing resources. Karnataka is the first state in India to expand the NBEMS (DNB and Diploma) courses in taluk hospitals and to begin DrNB courses in district hospitals. The paper documents the process of implementation of the NBEMS courses at district and taluk hospitals of Karnataka, which has supported in strengthening these hospitals in the state.
“I Would Rather Die Drinking than take the Medicine”: Role of Alcohol Use Disorder in Loss-to-follow-up of Tuberculosis Treatment in a Rural Area of Ballabgarh, Haryana
Authors: Khaitan Anwita , Rai Sanjay K. , Krishnan Anand , Gupta Sanjeev K. , Kant Shashi , Khilnani Gopi C.
Published: January 2024

Introduction:

Alcohol use disorder (AUD) is a significant risk factor for tuberculosis (TB) treatment loss-to-follow-up (LTFU). This field-based study was undertaken to understand the role of AUD and TB treatment LTFU and the reasons behind this association in a rural area of Ballabgarh, Haryana.

Material and Methods:

TB patients who had completed their treatment and who had been LTFU were included in the study, along with the National TB Elimination Program (NTEP) staff, healthcare providers, family, and community members from Ballabgarh block of the north Indian state of Haryana. In-depth interviews (IDIs) and focused group discussions (FGDs) were conducted to gauge the perceptions of stakeholders regarding reasons for LTFU, especially in the context of alcohol use. Inductive analysis of the transcripts was done in keeping with the grounded theory, and themes with their sub-themes were identified. A conceptual framework of TB-AUD was constructed, and potential areas for intervention were determined.

Results:

Fifty-eight IDIs and four FGDs were conducted in mid-2018. Almost all key informants and many patient participants believed that alcohol use makes TB patients highly susceptible to treatment LTFU. Key themes identified were shared personality traits and attitudes, combined side effects of anti-tubercular drugs and alcohol use, lack of family support, and an adverse financial situation.

Conclusion:

These findings call for a change in NTEP’s approach to AUD-TB. Interventions may include collecting alcohol use information at patient enrolment and closure, integrating brief interventions for alcohol cessation in NTEP, and linking patients to deaddiction centers with the provision of appropriate dietary and financial support.
Development and Validation of a Questionnaire to Measure a Medical Student’s Interest in the Subject of Community Medicine
Authors: Ali Syed I. , Begum Jarina , Kumar Abhishek , Shikha Swati , Patil Sachin K. , Sinha Ratnesh
Published: January 2024

Background:

Lack of interest has been cited by many studies as the predominant cause for students undervaluing the subject of Community Medicine. However, there are few valid and reliable tools that could measure this interest. To develop and validate a questionnaire to measure a medical student’s interest in the subject of Community Medicine.

Material and Methods:

Cross-sectional study conducted at MTMC Jamshedpur. The Community Medicine Interest Questionnaire (CMIQ) was developed in two phases: item generation and item reduction. Items were generated through a review of the literature, focused group discussions, and in-depth interviews. In the item reduction phase, the content and construct validity of the questionnaire were ascertained. Content validity was carried out by a group of experts based on three parameters: the interrater agreement on the representativeness of the item, the interrater agreement on the clarity of the items, and the content validity index. The construct validity was ascertained through pilot testing of 480 responses from undergraduate medical students. Exploratory factor analysis through principal axis factoring and Promax rotation.

Results:

Twenty-five items were generated. Three of these items were removed following expert validation. Furthermore, three items were removed after pilot testing. The resulting CMIQ consisted of 19 items distributed over three dimensions: feeling, value, and predisposition to reengage toward the subject. The internal consistency of each of the subscales was ascertained.

Conclusions:

CMIQ is a valid and reliable tool that can be used to measure such interest for providing educational interventions.
Factors Influencing Social and Community Participation of People with Spinal Cord Injury in Karnataka, India
Authors: Babu Heavenna , Sriraman Sheetal , Karthikbabu Suruliraj , Sophia P. , Kumar Senthil N. S.
Published: January 2024

Background:

Social and community participation are major indicators to assess the adequacy of treatment and rehabilitation in patients with spinal cord injury (SCI). This study examined the relationship between functional independence, level of disability, and social and community participation among people with SCI in India.

Materials and Method:

In this cross sectional study, 110 persons with SCI, aged 18 years and above participated in a community setting, in Karnataka, India. Spinal Cord Independence Measure Version III-self-reporting (SCIM III-SR), Craig Handicap Assessment and Reporting Technique (CHART), and WHO Disability Assessment Schedule 2.0 (WHODAS) were the clinical outcome measures. Spearman’s correlation and stepwise multiple linear regression were done to determine association and identify the factors determining the community participation of people with SCI.

Results:

CHART physical independence had a positive correlation with SCIM self-care (R = 0.446) and SCIM mobility (r = 0.434). CHART cognitive independence (R = -0.38) and CHART mobility (R = -0.396) had a weak correlation with WHODAS. SCIM self-care and SCIM mobility (R2 = 0.34) were determinants of CHART cognitive independence. SCIM respiratory and sphincter management and SCIM self-care (R2 = 0.327) were determinants of CHART mobility.

Conclusion:

Self-care and mobility of people with SCI determine their ability to successfully reintegrate into the community, warranting a comprehensive community rehabilitation program.
Assessing the Burden of COVID-19 among Children Aged 6-14 Years in Karnataka, India: A Cross-sectional Survey
Authors: Rajagopal Padma M , Sil Satyam , Dinesh Prameela , Shiju Shilpa , Arunkumar D P , Ramaiah Srinivas S , Lalitha Hande R , Mamatha T , Kantinath P Ainapure , Pujari Lokesh , Pradeep BS , Shenoy Anusha B , Desai Anita , Munivenkatappa Ashok , Gudi Chetan S , Babu Giridhara R , Sudarshan M K
Published: January 2024

Background:

India experienced three coronavirus disease (COVID-19) waves, with the third attributed to the highly contagious Omicron variant. Before the national vaccination rollout for children above 6, understanding severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunoglobulin G (IgG) positivity in the pediatric population was essential. This study aims to assess the burden of Covid-19 infection and to estimate the seroprevalence in children aged 6 to 14 years in the state of Karnataka.

Material and Methods:

We surveyed 5,358 children aged 6-14 across Karnataka using 232 health facilities, from June 6 to 14, 2022. We determined the sample size using the PPS (Population Proportional to Size) technique and employed cluster sampling. We tested all participants for SARS-CoV-2 IgG with an enzyme-linked immunosorbent assay (ELISA) kit and SARS-CoV-2 RNA with reverse transcription-polymerase chain reaction (RT-PCR). We sequenced samples with a cycle threshold (CT) value below 25 using whole genomic sequencing (WGS).

Result:

We found an adjusted seroprevalence of IgG at 75.38% statewide, and we found 0.04% of children RT-PCR positive for COVID-19. We determined a case-to-infection ratio of 1:37 and identified the SARS-CoV-2 strains as Omicron, BA.5, and BA.2.10.

Conclusion:

The study showed a high seroprevalence of IgG among children with low active infection. Omicron, BA. 5, and BA. 2.10 variants were detected through WGS.
Prevalence and Severity of Periodontal Disease and its Association with Type-II Diabetes Mellitus and Smoking by Using Periodontal Screening and Recording: A Retrospective Study
Authors: Devi Oinam Monica , Sood Shaveta , Gupta Jyoti , Jain Ashish
Published: January 2024

Background:

Periodontal screening recording (PSR) is considered a quick, reliable, reproducible valuable screening tool for periodontal disease. This study aims to find the prevalence and severity of periodontal disease and its association with self-reported diabetic status and smoking history of the patients by using PSR codes over a period of 2 years.

Material and Methods:

This was a cross-sectional retrospective study in a dental hospital in Chandigarh. Data of 10,882 patients comprising self-reported history of smoking (893) and diabetes (725) patients were assessed for the prevalence of periodontal disease by using PSR codes. Pearson Chi-Square test was used for statistical evaluation of PSR codes data.

Results:

Out of a total of 65,292 sextants assessed, the maximum and minimum reported PSR codes were 2 and 4, respectively. Gingivitis was found to be the most prevalent, followed by periodontitis and periodontal health in the total assessed population (P < 0.001). Mucogingival problems and complete edentulism were found to be more prevalent in posterior sextants in comparison to anterior sextants. Both self-reported smokers and type-II diabetes mellitus patients presented gingivitis as the most common clinical presentation, with the highest prevalence seen in the 55–74-year age group, which also comprised the group with maximum mucogingival problems and edentulism.

Conclusion:

This study gives an overview of patients’ general oral health status and reflects the burden of periodontal disease in the Chandigarh region, thus contributing to the national oral health data.
Musculoskeletal Comorbidities among known Diabetes Patients, their Quality of Life, and Healthcare Costs: A Comparative Study From a Tertiary Care Hospital in Uttarakhand
Authors: Lekhwani Seema , Nath Bhola , Gupta Shiv Dutt , Kumari Ranjeeta , Vaswani Narain Das , Pawar Neeraj
Published: January 2024

Introduction:

Diabetes is a chronic disorder with long-term sequelae and multisystem manifestation. Burden of diabetes in on the rise. Presence of other morbidities can not only have a detrimental effect on the disease treatment and recovery course, but also on the financial burden and quality of life. Present study aims to investigate how musculoskeletal conditions affect individuals with diabetes compared to those without the condition.

Material and Methods:

A comparative study was conducted among patients attending the outpatient department of a tertiary care hospital in North India to assess the burden of musculoskeletal disorders in people with and without diabetes. A total of 195 diabetes patients and an equal number of individuals without diabetes were sequentially enrolled from the outpatient department (OPD).

Results:

Burden of musculoskeletal comorbidities was significantly higher (46.2%) among people with diabetes than the comparison group (25.1%). The overall odds ratio (OR) for comorbidities of musculoskeletal system was 2.5 times higher in diabetes cases as compared to individuals without diabetes. The OR for rheumatoid arthritis, chronic backache, and osteoarthritis was found to be 3.6, 2.9, and 1.7 respectively. Poor quality of life and higher direct cost of treatment were found among diabetes cases with musculoskeletal comorbidities as against those without these comorbidities.

Conclusion:

Presence of musculoskeletal comorbidity is high among diabetes patients, and it has an impact on the quality of life and treatment cost. Screening for musculoskeletal comorbidities should be included as part of the diabetes complication assessment to allow for early detection and treatment.
Family Adoption Program for Undergraduate Medical Students at a New Medical School of Jharkhand: An Experience and SWOC Analysis
Authors: Shikha Swati , Kumar Abhishek , Begum Jarina , Ali Syed Irfan , Tripathy Sunita
Published: January 2024

Introduction:

Family adoption program (FAP) incorporated into the undergraduate medical education curriculum is beneficial to all stakeholders involved. Many medical colleges have started FAP at different times and various levels based on resources availability, feasibility, and accessibility. This article is intended to cover the process of FAP implementation, the strength, weakness, opportunities, and challenges at various levels, and its scope in future.

Methodology:

FAP was launched by adopting a hamlet 17 km away from the college. During the foundation course, orientation lessons and logbook discussions were conducted online before the actual field visit. During the initial visit, families were assigned, which was followed by collecting sociodemographic information, a plantation drive, and organizing medical camp/ door to door screening in the last visits for phase one students.

Observations:

The strengths perceived were early community exposure of students and leadership skills, and the weaknesses were allocating adequate number of slots in the curriculum, adopting families far away, etc., Similarly, FAP has an opportunity to achieve the larger goal of Heath for All in terms of identifying, following up, and managing various socio clinical cases in the adopted families. However, few challenges can pose as it progresses across other phases, such as language problem, allotment of problem families, existing social pathology in family, cultural taboos, etc.,

Conclusion:

The article suggests that once a student leaves, another student should continue the cycle of adoption and provide continuum care of services to prevent the family from being orphaned.
Percutaneous Placement and Management of High-flow Catheter for Hemodialysis: The Case for DualCath, Two-tunneled, Single-lumen Silicone Catheters
Authors: Canaud Bernard , Leray-Moragues Hélène , Klouche Kada , Morena Marion , Chenine Leila , Miller George , Cristol Jean-Paul , Canaud Ludovic
Published: January 2024

Introduction:

Tunneled central venous catheters (CVCs) are often regarded as the final choice for vascular access in patients needing extracorporeal renal replacement therapy due to their higher morbidity, lower performance, and increased cost. The inherent limitations of tunneled CVCs have been recognized and extensively analyzed in numerous studies.

Materials and Methods:

The objective is to offer a comprehensive technical note on the percutaneous placement and management of high-flow DualCath (DC) for hemodialysis, involving the simultaneous insertion of two tunneled single-lumen silicone catheters through a single skin incision and vein puncture. In addition, we aim to summarize the results derived from our extensive clinical experience.

Results:

This 20-year study involved the placement of 1035 DC devices. The main indications were end-stage kidney disease in 859 cases, acute kidney injury in 50 cases, and miscellaneous purposes in 30 cases. Most of the insertions were in the internal jugular vein, with varying dwell times averaging 213 ± 335 days. In total, the DC devices were used for 594 patient-years.

Conclusion:

DC can be placed using a minimally invasive percutaneous method in both chronic and acute settings, showcasing its exceptional versatility. The design and geometry of the two silicone cannulas are precisely tailored to meet the needs of clinicians, focusing on achieving optimal flow performance, and ensuring adequate dialysis.
Impact of COVID-19 on medical students well-being and psychological distress
Authors: Tyagi Kashish , Chaudhari Bhushan , Ali Tahoora , Chaudhury Suprakash
Published: January 2024

Background:

Mental well-being is important for medical students to perform effectively. The COVID-19 pandemic posed different stressors to medical students increasing their vulnerability to distress and impaired well-being.

Aim:

To assess the effect of the COVID-19 pandemic on the well-being of medical students and its relation with COVID-related psychological distress and fear as well as sleep quality.

Materials and Methods:

We planned a cross-sectional study on medical students with the help of an online Google Form including sociodemographic data, medical students well-being index (MSWBI), Psychological Distress Scale, fear of COVID-19 Scale (FCV-19S), and Pittsburgh Sleep Quality Index (PSQI).

Results:

48.13% of students reported higher distress and impaired mental well-being. Impaired well-being is correlated with COVID-related psychological distress, fear of COVID-19, and disturbed sleep quality. Regression analysis showed that joint family and sleep disturbances significantly predicted distress or poor well-being in medical students.

Conclusion:

Almost half of the medical students revealed impaired mental well-being underlining the role of COVID-related stressors in worsening the psychological health of students. In this situation, it is important to take prompt measures to identify vulnerable students and help them.
Anxiety, stress, and quality of life in patients with tuberculosis: A systematic review and meta-analysis
Authors: Sutar Roshan , Majumdar Anindo , Yadav Vikas , Basera Devendra Singh , Gupta Himank
Published: January 2024

Anxiety symptoms when coexisting with tuberculosis (TB), can have deleterious effects on treatment continuation that could contribute to the development of treatment resistance in TB. It is essential to understand the prevalence of anxiety in TB to develop clinical recommendations for its management. The primary objective of our review was to estimate the pooled prevalence of anxiety in TB patients along with the estimation of stress and quality of life in such patients. The relevant literature search on observational studies published in the English language till the year 2020 was carried out. A total of 8086 participants from 29 studies were included, of which 24 were cross-sectional studies and the remaining were case–control, and cohort studies. The estimated pooled prevalence of anxiety, comorbid depression, stress, and poor quality of life in TB patients was 32.54% [24.95, 41.18], 32.87% [25.79, 40.82], 52.68% [48.60, 56.72], and 79.51% [45.67, 94.72] respectively. When comparing the prevalence of anxiety across World Health Organization (WHO) regions, there was a statistically significant difference, with the African Region (AFR) having the highest prevalence i.e. 37.87% [29.59, 46.92], and the Western Pacific Region (WPR) having the lowest prevalence i.e. 15.83 % [12.72, 19.53]. The higher prevalence of anxiety in TB in the AFR and South-East Asian Region (SEAR) suggests a strong correlation with the developing status of these regions which calls for efforts to identify and treat the risk factors common to both anxiety and TB.
The correlation between pre-treatment CEA levels and the EGFR mutation status in advanced lung adenocarcinoma
Authors: Uysal Mukremin , Beypinar Ismail , Araz Murat
Published: January 2024

Background:

The discovery of the epidermal growth factor receptor (EGFR) mutation, especially in adenocarcinoma, has led to a major change in the treatment of non-small-cell lung cancer (NSCLC). This study investigated the relationship between the EGFR mutation status and the carcinoembryonic antigen (CEA) levels at the time of diagnosis.

Materials and Methods:

A total of 102 patients with EGFR mutation and tested CEA levels were recruited for this study. Of the patients, 24 were EGFR mutants (23.5%), while 78 patients (76.5%) did not harbor any EGFR mutations.

Results:

The CEA levels did not differ across groups. Additionally, the CEA levels were analyzed between female and male patients separately due to EGFR mutations; no difference was observed. When the CEA levels were categorized as positive or negative based on different cut-off values, such as 5 and 10 ng/ml, no statistical difference was found between groups.

Conclusion:

In this study, no relationship between EGFR mutation and pre-treatment CEA levels was observed. Despite positive trials having shown a predictive value of CEA levels for EGFR mutation, more clinical trials are needed to elucidate the racial, clinical, and pathological differences of the study populations. Most studies have been located in the Far East, but new trials in Caucasian, African, and Hispanic populations are still lacking.
Volumetric and geometric changes in the parotid glands and target volume during image-guided radiotherapy for locally advanced oropharyngeal cancers
Authors: Gayakwad Sagar , Budrukkar Ashwini , Murthy Vedang , Laskar Sarbani G. , Upreti Ritu Raj , Upreti Udita , Gupta Tejpal , Agarwal Jai Prakash
Published: January 2024

Purpose:

This study aimed to evaluate the volumetric and geometric changes in the parotid glands and target volume during image-guided radiotherapy (IGRT) for locally advanced oropharyngeal cancers.

Materials and Methods:

Twenty patients receiving radiotherapy using IGRT at a dose of 70 Gy/35 fractions/7 weeks for locally advanced oropharyngeal cancers were accrued. Radiotherapy planning computed tomography (CT) scans were performed at pre-radiotherapy (RT), 20, 40, and 60 Gy for each patient. Volume changes in target and parotids along with shifts of parotids were assessed with respect to pre-RT scan after co-registration. In study scans, GTVp and GTVn were recontoured as per particular CT. CTV and PTV were copied from planning CT to study CT. CTV was edited from anatomical barriers, and PTV was edited only from the skin in the study CT. The parotids were recontoured on each study scan. The center of mass (COM) of C2 vertebral body was considered as the reference to evaluate its shifts.

Results:

There was a statistically significant percentage regression of ipsilateral and contralateral parotid mean volumes at the rate of 0.85%/0.207 cc and 0.98%/0.26 cc per day, respectively. We observed the mean medial shift of center of mass of ipsilateral parotid of 2.23 mm (p = 0.011) and contralateral parotid of 2.67 mm (p = 0.069) at the end of 60 Gy. GTVp (mean) reduced from 41.87 cc at 0 Gy to 31.13 cc (25.65%) at 60 Gy (p = 0.003), while GTVn (mean) reduced from 19.98 cc at 0 Gy to 10.79 cc (45.99%) at 60 Gy (p = 0.003). There was a statistically significant reduction in CTV and PTV volumes at 60 Gy.

Conclusion:

Statistically significant volumetric and geometric changes occurred during intensity-modulated radiation (IMRT), which were most prominent after 40 Gy and were maximum at 60 Gy. There was a medial shift of parotid glands toward the high-dose region. This study can be useful to devise an adaptive radiotherapy strategy.
Utility of guided FNAC and cell block preparation from liver and gall bladder masses: Learning experience from a tertiary care center
Authors: Bohara Sangita , Shukla Prakriti , Shah Saman , Chaturvedi Rashmi , Singh Kushal
Published: January 2024

Introduction:

Ultrasound- and CT-guided fine needle aspiration cytology (FNAC) increases the accessibility of intra-abdominal masses to the liver and gall bladder with the advantages of low cost and high diagnostic yield. Cell block technique has been known for further increasing the diagnostic accuracy.

Aims and Objectives:

We aimed to study the effectiveness of FNAC and the cell block method in cytological diagnosis of liver and gall bladder masses. We also followed a step-wise approach to increase the success rate.

Materials and Methods:

A 2-year observational study was done from July 2020 to June 2022. Total 80 guided (CT and ultrasound) aspirations were done from space occupying/mass lesions in the liver [74 (92.5%)] and gall bladder [6 (7.5%)], out of which cell blocks by the plasma thrombin method were prepared in 12 cases (15%). The on-site radiological details were noted, and rapid on-site evaluation was done in 65 cases (81.25%). The prepared cytology slides were stained with Papanicolaou, H and E and May-Grunwald Giemsa (MGG) stain. The cytological diagnosis was noted, and the uses and limitations (if any) were observed in each case. A step-wise structured questionnaire format was developed to assist the reporting pathologist so as not to miss out on important diagnostic observations, if present.

Results:

FNAC in 71 cases (88.7%) gave a conclusive diagnosis. The maximum number of cases were of adenocarcinoma [38 (51.3%)] from the liver followed by hepatocellular carcinoma in 10 cases (13.5%). In gall bladder masses, all 6 cases (100%) were positive for malignancy, out of which 4 cases (66.7%) could be characterized as adenocarcinoma. The cell block preparation was helpful in reaching the diagnosis as well as typing the malignancy in 10 cases (83.3%). The chief limitation observed on conventional cytology smears was inadequate cellularity, which caused inconclusive diagnosis in 9 cases (11.25%). The reporting questionnaire was helpful chiefly in terms of time-efficient reporting in 34 cases (42.5%), increasing the ease and confidence in 69 cases (86.25%) and the advantage of reproducibility of data in all cases (100%) according to the case-by-case evaluation by the reporting pathologists.

Conclusion:

Guided FNAC in conjunction with the cell block technique is extremely helpful in the evaluation of mass lesions of the liver and gall bladder for cytological diagnosis. A proper step-wise approach may be useful to reach a quick and effective diagnosis.