bluuebunny/crossref_metadata_2025 huggingface dataset:
EFEKTIVITAS VIDEO KESEHATAN TERHADAP PENGETAHUAN DAN SIKAP IBU TENTANG STUNTING DI WILAYAH KERJA PUSKESMAS BANGEKO KANAN
Authors: Armiyanti Armiyanti , Hanim Busyra
Published: August 2024

Stunting is a major threat to human quality, as well as a threat to the nation's competitive ability (Ministry of Health, 2018). Because stunting will result in children's intelligence levels not being optimal, making children more vulnerable to disease and in the future could be at risk of decreasing productivity levels. Efforts to prevent stunting should start from the beginning of pregnancy to reduce the risk of stunting in children. The aim of this research is to determine the effectiveness of health videos on mothers' knowledge and attitudes about stunting in the Bangko Kanan Community Health Center Work Area. This research method uses a quasi experimental design. The population used in this research was pregnant women with a sample size of 82 people. The researchers' results were based on the Wilcoxon test with asymp values. The knowledge sig is 0.00 and the attitude is 0.01 (<0.05), meaning that the health video has an impact on increasing mothers' knowledge and attitudes about stunting in the Bangko Kanan Community Health Center working area. It is hoped that the research can become a reference for health workers in providing health promotion to increase knowledge and attitudes of pregnant women about stunting
La relación entre la vacunación con COVID-19 y la irregularidad menstrual: ¿qué se ha descrito en la bibliografía?
Authors: Almeida Costa Tiago
Published: August 2024

En marzo de 2020, la Organización Mundial de la Salud decretó la pandemia de COVID-19 y para prevenir los casos de Síndrome Respiratorio Agudo Severo y otras complicaciones una de las medidas adoptadas fue la vacunación contra el COVID-19. El virus SARS-CoV-2, responsable del COVID-19, penetra en las células huésped a través de los receptores de la enzima convertidora de angiotensina II que se expresan en diversos órganos como el útero y los ovarios. Hasta el último trimestre de 2021, se han aprobado en todo el mundo unas doce vacunas, en seis categorías diferentes, contra el COVID-19, y entre los efectos adversos se han notificado irregularidades menstruales. En varios estudios se mencionan alteraciones del ciclo menstrual tales como alteración de la duración del ciclo, aumento del flujo menstrual, dismenorrea y amenorrea de 7 a 30 días después de la administración de la última dosis de COVID-19. También se observó en estos estudios que mujeres que no presentaban irregularidades después de la primera dosis de la vacuna, empezaron a tenerlas después de la segunda dosis. En general, las anormalidades del ciclo menstrual cesan dentro de los 3 meses después de la última dosis de la vacuna y no hay un impacto definitivo sobre la fertilidad de la mujer.
Sobre otras Revistas
Authors: Luis Aida
Published: August 2024

Fuente: JAMAAbsorción de nicotina de segunda mano a partir del vapor de los cigarrillos electrónicos versus al humo del tabaco en niños. Tattan-Birch H, Brown J, Jackson S, et al. Secondhand nicotine absorption from E-Cigarette vapor vs tobacco smoke in children. JAMA Netw Open. 2024;7(7):e2421246. doi:10.1001/jamanetworkopen.2024.21246
Resumen: Dado el aumento de la prevalencia del uso de cigarrillos electrónicos (vapeo) en todo el mundo, existe preocupación por la exposición de los niños al vapor de segunda mano.
Fuente: Current Opinion in PediatricsInfecciones ambulatorias por el virus respiratorio sincitial y las nuevas intervenciones preventivas. Hak S, Venekamp R, Wildenbeest J y Bont L. Outpatient respiratory syncytial virus infections and novel preventive interventions. Current Opinion in Pediatrics 36(2):p 171-181, April 2024. | DOI: 10.1097/MOP.0000000000001323
Resumen: Con las intervenciones para prevenir la infección por el Virus respiratorio sincitial (VRS) a nuestro alcance, esta revisión tiene como objetivo proporcionar a los profesionales de la salud la información más reciente necesaria para informar a los padres y evaluar el impacto potencial de la prevención del VRS en la práctica diaria. Abordamos las preguntas frecuentes para el asesoramiento de padres.
Fuente: Archivos Argentinos de PediatríaAsociación entre los marcadores lipídicos en la infancia/ adolescencia y los eventos cardiovasculares en la adultez: una revisión sistemática. Masson W, Barbagelata L, Corral P y Nogueira JP. Arch Argent Pediatr 2024;122(2):e202310094. doi (español): http://dx.doi.org/10.5546/aap.2023-10094
Resumen: La asociación entre los marcadores lipídicos en la infancia/adolescencia y la incidencia de eventos clínicos cardiovasculares en la adultez está poco explorada en la literatura. El objetivo de esta revisión sistemática fue analizar la evidencia disponible sobre este tema.
Optimized Selective Assembly using Hungarian Algorithm
Authors: P R Amal , K S Anjumol , S Unnikrishnan , V Dilip , Oommen George
Published: August 2024

Assembly of discrete parts guided by hardware design specification constitutes the final phase in product manufacturing. In the course of mass production of components, mating parts with geometric or dimensional deviation from their intended design can be made acceptable by the identification of suitable pairs after analysing design fit and tolerance limits. By transforming this application-specific problem into a unified mathematical model, an optimal solution can be achieved that minimizes the rejection of non-conforming fabricated parts. Regardless of the type and range of a design fit, the problem can be mapped into a matrix using a ranking function defined by the user. The ranking function is modifiable as per the user requirements and may vary based on the selection criteria for an assembly. Based on the type of ranking function used, the tabulated matrix is solved using the Hungarian minimization/maximization algorithm, which is a powerful combinatorial optimization algorithm that solves the classical assignment problem in mathematics. This approach ensures maximum number of suiting pairs as well as nominal suiting of parts with each other resulting in high-quality products and maximum utilization of fabricated resources.
A Research on Identifying Intertwined 4IR Technologies in the Supply Chain Context
Authors: Özkanlısoy Özden
Published: August 2024

The Fourth Industrial Revolution is the conversion of industries, economies, and so supply chains by a fusion related to technological, business, and social disruptive forces. The disruptive forces that cause the conversion discourse are the technologies it has enabled. This industrial revolution has a crucial impact on all industries, especially the manufacturing industry, and this effect sustains exponentially. The utilisation of The Fourth Industrial Revolution technologies and the digital transformation of supply chains is a pivotal step today towards enhancing their competitiveness and their supply chain performance and being able to follow the supply chains of the future. However, implementing them alone is not enough; new ways to get the most benefit from them must be inquired. The combined utilisation of certain industrial revolution technologies boosts their efficiency and their contributions to companies and supply chains. This study investigated the correlational relationships of the eight most used The Fourth Industrial Revolution technologies in the supply chain context and determined the technologies with the highest relationship with each other and called them intertwined technologies. The sample size consists of 393 companies. The study is a guide for companies and supply chains that will implement these technologies or invest in a novel one.
Macroeconomic Analysis of Vietnam: Challenges and Policy Recommendations
Authors: Siddhartha Sashya
Published: August 2024

Vietnam, a one-party socialist republic, has undergone significant economic transformation since the lifting of U.S. sanctions in 1986. Transitioning from a closed, agrarian economy to a market-oriented system, the country has achieved notable progress, advancing from one of the poorest nations to a lower-middle-income status. Despite this progress, Vietnam faces several macroeconomic challenges including high inflation, a depreciating currency, and a growing trade deficit. The COVID-19 pandemic has exacerbated these issues, leading to disruptions in business activity, supply chains, and economic instability. Additionally, severe air pollution presents a pressing concern for public health and economic productivity. This paper examines Vietnam's current macroeconomic challenges, evaluates the impact of recent economic disruptions, and proposes policy recommendations to address these issues. Recommendations include increased health spending, structural reforms to enhance green growth, and monetary policies aimed at controlling inflation and encouraging investment. The analysis highlights the need for a balanced approach to sustain economic progress while addressing critical challenges.
MPN/MDS overlap syndrome anticipated by a severe bleeding diathesis: hypothesis of a pre-existing platelet disorder
Authors: Ranalli Paola , Baldoni Stefano , Bruno Daniela , Di Ianni Mauro
Published: August 2024

We report the case of a patient with a conclusive diagnosis of “MDS/MPN” Overlap Syndrome preceded by platelet disorder and hemorrhagic phenotype. We want to induce a reflection about diagnosis of oncohematological disorders in patient with a documented personal history of bleeding and/or platelet disorder, considering all the possible differential diagnosis: 1) Bleeding as the epiphenomenon of a still undiagnosed Myeloid Neoplasm or 2) Myeloid Neoplasm with germline predisposition and pre-existing platelet disorder; 3) Inherited platelet disorder successively developing MPN/MDS Overlap Syndrome.
This case report underlines the importance of genetic testing in case of patient with documented platelet function disorder, including both mutations associated with inherited platelet disorders and germline mutations more strictly predisposing to Myeloid Neoplasms.
ANTIBIOTIC LOCK THERAPY FOR PORT CATHETER-RELATED INFECTIONS OF CHILDREN WITH ACUTE LEUKEMIA
Authors: Kurtipek Burçin , Koca Yozgat Ayça , Kanık yüksek Saliha , Kaçar Dilek , Bayhan Turan , Gürlek Gökçebay Dilek , Özkaya Parlak Aslınur , Yaralı Neşe
Published: August 2024

Background: Port catheters facilitate the administration of chemotherapy, antibiotics, blood products, fluid and parenteral nutritional support to pediatric patients with hematological malignancies. However, as its use has become widespread, local, and systemic catheter-related infections have emerged as important causes of morbidity and mortality. In our study, we aimed to evaluate the success of antibiotic lock therapy in port catheter- related infections of pediatric patients followed up with acute leukemia.
Methods: Port catheter cultures taken from a total of 182 pediatric patients with acute lymphoblastic/myeloblastic leukemia who were followed up at Ankara City Hospital Pediatric Hematology Clinic between August 2019 and August 2023 were evaluated retrospectively. Results: Bacterial growth was identified in 739 port catheter culture specimens of 182 patients. Closure or removal of the port was required in 91, and removal of the port catheters in 49 patients due to port catheter-related infections. Antibiotic lock therapy was started in 56 patients with bacterial growth in the port catheter. With antibiotic lock therapy, port catheter-related infections of 42 patients were eradicated, and their catheters began to be used again. As a result, the port catheter-related infections of 42 of 56 (75%) patients whose ports were closed and also received systemic antibiotherapy were eradicated, and no recurrence of infection was observed.
Conclusion: Adding antibiotic lock therapy to systemic antibiotics in pediatric patients may be beneficial in terms of catheter salvage.
Celebrating cultural heritage within national parks
Authors: Ndlovu Ndukuyakhe
Published: August 2024

No abstract available.
Platelet-Rich Fibrin for Root Coverage
Authors: Parihar Anuj Singh , Narang Sumit , Dwivedi Shivani , Narang Anu , Soni Sweta
Published: August 2024

Predictable esthetic root coverage has evolved into conventional treatment modalities making cosmetic procedures an integral part of periodontal treatment. The advent of second-generation platelet concentrates, i.e., platelet-rich fibrin (PRF), has broad clinical application in medical as well as dental field with its recent use for recession defects. The simplicity of PRF procurement and its low cost makes it most suitable for use in daily clinical practice. This particular case report foregrounds the benefit of PRF membrane along with coronally repositioned flap for mucogingival surgery on the labial surface of an upper anterior tooth.
Diabetes-related Knowledge, Attitude, and Practice among Outpatients of a Tertiary Hospital in North-western Nigeria
Authors: Muhammad Fakhraddeen Yahya , Iliyasu Garba , Uloko Andrew E. , Gezawa Ibrahim D. , Christiana Enikuomehin Adenike
Published: August 2024

Introduction:

One of the challenges facing the management of diabetes is the misconception and inadequate knowledge about the disease. We assessed the level of diabetes-related knowledge, attitude, and practice (KAP) among patients with diabetes in North-western Nigeria.

Materials and Methods:

This was a hospital-based cross-sectional study. A total of 400 participants were recruited. A KAP questionnaire was used to assess the KAP of the patients. Glycated hemoglobin was used to measure the level of glucose control of the study participants.

Results:

The mean age of the patients was 51 years, majority being females 233 (58.3%). The mean knowledge score was 6.2 ± 3.1 points (out of 15), average attitude score was 2.5 ± 1.5 points (out of 5), and the mean practice score was 2.1 ± 1.3 points (out of 6). The level of KAP was found to be directly related to glycemic control (P < 0.01). The level of education (odds ratio [OR]: 5.0 and 95% confidence interval [CI]: 0.196–0.452) and monthly income (OR: 4.4 and 95% CI: 0.123–0.326) were found to be independent predictors of diabetes-related KAP.

Conclusion:

The study has demonstrated poor diabetes-related KAP. The patient's level of education and income plays a major role in the management of diabetes.
Public Health Ethics and the COVID-19 Pandemic
Authors: Aliyu Alhaji A.
Published: August 2024

Health is a human right anchored in values as a basic necessity of life. It promotes the well-being of persons, communities, economic prosperity, and national development. The coronavirus disease-2019 (COVID-19) pandemic caught the world unaware and unprepared. It presented a huge challenge to the health and economic systems of every country. Across the spectrum of human endeavor and liberty, several ethical questions have been raised with regard to its management, particularly the public health control measures. Decisions for pandemic control measures are made under difficult circumstances driven by urgency and panic, with uncertainties and complexities for public goods over individual rights. Global solidarity in controlling the pandemic is being tested. National governments have the responsibility to protect public health on the grounds of common good. Political considerations should not be the basis for decision-making against the best available epidemiological data from pandemic disease dynamics. Hence, the need to adhere to the values of honesty, trust, human dignity, solidarity, reciprocity, accountability, transparency, and justice are major considerations. A literature search was conducted for the publications from academic databases and websites of health-relevant organizations. I discuss the ethical questions and challenges of the COVID-19 pandemic in the context of public health control measures using the standard ethical principles of respect for autonomy, beneficence, nonmaleficence, and social (distributive) justice. It is observed that, at the country level, the World Health Organization (WHO) guidelines are used to control the pandemic. As WHO through the COVAX strategy distributes the vaccines to less developed countries, a lot still needs to be done to address the complex bottlenecks of allocation and distribution. There is a need to ensure acceptable and transparent system that promotes cooperation, equitable access, and fair distribution of vaccines on a global scale.
Approach to Renovascular Hypertension
Authors: Sreelatha Melemadathil , Chandra M. Bharath
Published: August 2024

ABSTRACT

The article describes the case of a 68-year-old man with poorly controlled hypertension, diabetes, and coronary artery disease, highlighting potential underlying causes of his condition, particularly secondary hypertension due to renal artery stenosis. His clinical evaluation reveals risk factors such as prolonged smoking, obesity, and peripheral vascular disease. Clinical examinations indicate significant blood pressure discrepancies between limbs and the presence of renal bruits, leading to the suspicion of renovascular hypertension. Resistant hypertension can often stem from renal causes, specifically atherosclerotic renal artery disease. Diagnostic approaches are detailed, including various imaging techniques and criteria for assessing renal artery stenosis. Management options are discussed, exploring both medical and interventional therapies. Although recent trials like ASTRAL, CORAL, and STAR showed limited benefits of revascularisation over medical management, selected patients may still benefit from intervention. The case underscores the importance of individualised patient evaluation for managing secondary hypertension and renovascular disease, considering both clinical presentation and renal parenchymal viability.
Correlation of Malnutrition Inflammation Score and Highly Sensitive C-reactive Protein with Mortality and Morbidity in Patients on Maintenance Hemodialysis in a Tertiary Care Center from South India – A Prospective Study
Authors: Prabhu Pooja Prakash , Siddini Vishwanath , Bonu Ravishankar , Prakash G. K. , Sundar Sankaran , Ballal Sudarshan
Published: August 2024

ABSTRACT

Background:

Patients undergoing maintenance hemodialysis have a high prevalence of protein energy malnutrition and inflammation. There are very few Indian studies which have looked into the utility of malnutrition inflammation score (MIS) in assessing the prognosis in dialysis patients. The objectives of this study were to assess the correlation of MIS with mortality and morbidity among hemodialysis patients and to compare it with highly sensitive C-reactive protein (hs-CRP).

Methodology:

MIS and hs-CRP were calculated for each patient at the beginning of the study and at the end of 12 months. Patients were followed up for 1 year and assessed for hospitalization rates, infection rates, erythropoietin requirements, cardiovascular events, cerebrovascular events, and mortality.

Results:

A very high mortality of 50% was noted with those who had MIS ≥10. MIS score of >7 was a strong predictor of 1-year mortality. There was an increased rate of hospitalization and infections noted in patients with higher MIS scores. There was a good correlation between MIS scores and hs-CRP among dialysis patients. Upon follow-up, there was a statistically significant difference in terms of serum albumin, hs-CRP, and hospitalization rates among those patients who continued to be in the low-risk group MIS (1–4) when compared to those who had worsening of their MIS scores at the end of 1 year.

Conclusion:

MIS is a good indicator of mortality and morbidity among dialysis patients. Periodic assessment of MIS score in the dialysis unit will enable us to risk stratify the patients and take necessary measures to improve their quality of life. By providing adequate dialysis, vascular access care, and nutritional support, it is possible to reduce the MIS and decrease the mortality and morbidity among hemodialysis patients.
A randomized, open-label, multicentered parallel-group clinical study to evaluate the efficacy and safety of Joint Core™ compared to Jointace DN™ in osteoarthritis patients
Authors: Kannan Ramesh , Bakthavatchalam Sriram , Murugesan Sakthibalan , Kumar B. Aravinda , Deb Bijoy , Marimuthu Chandramohan , Rajendran Priya
Published: August 2024

Background:

Osteoarthritis (OA) is one of the most common musculoskeletal diseases worldwide, with pain, joint stiffness, fatigue associated with disability, and loss of physical activity. There is a need for an effective and safer alternative medication for the management of OA knee in elderly patients as the current medications possess severe risks to the patient compromising the quality of life.

Methodology:

The study design and setting were phase 3, randomized, open-label, multicentered, active-controlled parallel-group interventional trial conducted at secondary care centers in Puducherry. Fifty patients (50) patients with OA knee were enrolled as per study criteria and randomized to receive Joint Core™ and Jointace DN™ for 12 weeks. The outcomes were assessed using various pain scales and subscales, Short-Form Health-12 (SF-12) questionnaire, and inflammatory markers. The data obtained at baseline and weeks 4, 8, and 12 were compared and statistically analyzed.

Results:

Joint Core™ showed continuous reduction in the Visual Analog Scale pain scores at 4, 8, and 12 weeks and improvement in Western Ontario and McMaster Universities OA Index subscale and pain global assessment scales and good response rate in the Outcome Measures for Rheumatology Committee and OA Research Society International Standing Committee for Clinical Trials Response Criteria Initiative scores proving it to be efficacious in the treatment of OA knee compared to Jointace DN™. The safety assessed showed that Joint Core™ produces minimal gastrointestinal side effects and does not affect any organs as assessed by the laboratory parameters.

Conclusion:

Joint Core™ is effective and safe in the treatment of OA knee when compared to its comparator Jointace DN™. Joint Core™ can be an alternative treatment option in the patients with OA knee who are intolerant to diacerein-based combinations available to treat OA.
The role of cascade reporting integrated with breakpoint to minimum inhibitory concentration quotient (minimum inhibitory concentration therapeutic index) and minimum inhibitory concentration guiding table on clinical microbiology reporting of culture-proven bloodstream infections
Authors: Dhandapani Sarumathi , Priyadarshi Ketan , Rajshekar Deepashree , Sivaradjy Monika , Madigubba Haritha , Sastry Apurba Sankar
Published: August 2024

Background:

The breakpoint to minimum inhibitory concentration (MIC) quotient (BMQ) of an antimicrobial agent is the ratio of susceptible breakpoint divided by MIC of the test isolate. The higher the BMQ, the better is the therapeutic efficacy. The reporting of BMQ and MIC guiding table (MGT) when integrated with cascade reporting is more useful, especially in bloodstream infections.

Methodology:

The study period was of 2 years (June 2019–May 2021). The blood culture (BC) isolates were subjected to susceptibility testing by VITEK® 2 automated antimicrobial susceptibility test (AST) system for all the antimicrobials at a time but reported only selectively (cascade reporting). The BMQ of the susceptible antibiotics was calculated and the MGT was developed by using a specialized “clinical microbiology reporting software.” Both the BMQ and MGT were included in the clinical microbiology report along with the suggested “drug of choice” (DOC) based on the highest BMQ.

Results:

A total of 2644 out of 56,663 BC episodes were included. Of all the AST results, 57.0% (1, 508) were found to be susceptible to ≥1 first-line antimicrobials tested and 8.7% (230) were found to be resistant to all antimicrobials tested. Overall in about 16.7% of episodes, BMQ-DOC reported was found to be different compared to the raw MIC-DOC, and the difference was found to be maximum for Pseudomonas aeruginosa (50.3%).

Conclusion:

Reporting of BMQ and MGT is impactful only when it is integrated with cascade reporting as BMQ can only be taken into consideration while comparing the agents of similar spectrum.
COVID-19-associated pulmonary aspergillosis
Authors: Singh Priyanka , Kakkar Aanchal
Published: August 2024

Invasive pulmonary aspergillosis (IPA) is now been recognized as a possible secondary infection affecting COVID-19 recovery and increasing mortality. It can be explained due to factors such as direct epithelial injury, hypercoagulable and hyperinflammatory states, and the use of immunosuppressive treatment. We managed five such cases in a post-COVID intensive care unit facility at a tertiary care institute in North India. All patients had high oxygen demand, positive serum galactomannan (GM) index, and significant chest X-ray changes. All patients showed an initial improvement after receiving intravenous antifungal treatment with voriconazole. Systemic markers were suboptimal for the diagnosis of COVID-19-associated pulmonary aspergillosis (CAPA) with a sensitivity of less than 50%. GM assay has been validated in BAL and serum in numerous studies. Serum GM is a sensitive marker for IPA in patients with neutropenia; however, in nonneutropenic critically ill patients, serum GM exhibited a sensitivity of 25%, although a negative serum result cannot exclude the diagnosis of CAPA. The diagnosis of CAPA is challenging, and in patients with severe COVID-19 pneumonia may be associated with a worse prognosis. GM levels can be used for the diagnostic purpose of probable CAPA cases and administration of prophylactic treatment with voriconazole is still under debate.
Gender dysphoria in adults
Authors: Faheem Abdul , Balasubramanian Ilambaridhi , Menon Vikas
Published: August 2024

Gender dysphoria (GD) is a condition where one feels distressed about one's assigned gender at birth. The construct has undergone successive revisions in understanding and terminology in contemporary classificatory systems. Currently, the terms “GD” and “gender incongruence” are used in the Diagnostic and Statistical Manual of Mental Disorders-5 and International Classification of Diseases-11, respectively. However, there continues to be a lack of clarity on terminologies used in describing related concepts. Sex is an inflexible categorical concept, whereas gender is a social construct. It is vital to understand and distinguish between sexual orientation and gender identity. Clarity in understanding and usage of these and other related terms in the field is central to addressing the issue of stigma faced by the members of the lesbian, gay, bisexual, transgender, queer, intersex, asexual+ (LGBTQIA+) community, an umbrella term used to denote individuals with nonconformative gender identity and orientation. Several clinical and ethical issues exist with diagnosing and managing GD such as optimal treatment of minors, fertility after gender affirming treatments, and dissatisfaction following gender reassignment. To clarify these issues and facilitate access to care for LGBTQIA+ individuals, the GD category has been retained in the classificatory systems despite activists calling for dropping the term from diagnostic manuals to minimize associated stigma. Other controversies in the area include inclusion of childhood GD diagnosis on the grounds of uncertainty of longitudinal trajectory of the clinical phenomenon and use of nonevidence-based, potentially harmful, treatments such as “conversion therapies.” There is a need to sensitize clinicians about these issues and mainstream them in the assessment and management of GD. Such an approach would aid development of culturally sensitive and evidence-based treatments for gender variance.
Copious white leathery tenacious froth in a case of hanging – An arcane presentation
Authors: Narayan Gaurang , Bharathi O. Murugesa , Rathinam Rajesh Duraisamy , Ravitchandrane Revanth , Suvvari Tarun Kumar
Published: August 2024

The presence of froth during autopsy in cases of asphyxial death has been widely studied and attributed to drowning. Although hanging is the most common cause of mechanical asphyxia in comparison to drowning, frothing observed in cases of hanging has not been reported. Herein, we describe a case of an 18-year-old married pregnant woman who attempted suicide by hanging. During the postmortem examination, the presence of copious, white, tenacious, leathery froth forming a mushroom-like mass was observed. Furthermore, internal examination and histopathological evaluation revealed noncardiogenic pulmonary edema to be the likely cause of death. Although the development of postobstructive pulmonary edema has been effectively studied in sublethal cases of hanging, with appropriate ventilation management, mortality associated with such cases has drastically reduced. Thus, the incidence of frothing noted in such cases of hanging has not been described. Pulmonary edema, which subsequently develops in patients with hanging, is an unfamiliar and unusual cause of death. Hence, we conclude that autopsy surgeons must watch out for other causes of frothing and must investigate for evidence of its differentials, not limited to only cases of drowning. This finding also becomes important for emergency physicians to consider the development of interstitial edema in the setting of nonlethal hanging.
Knowledge and practice of hand hygiene among health-care workers in a tertiary care hospital
Authors: Joseph Sharon , Kuruvilla Thomas S. , D’Souza Rose Meroline
Published: August 2024

Background:

A good awareness and application of hand hygiene (HH) among health-care personnel form a solid foundation for any health-care center to prevent nosocomial infections. The objective of this study was to gauge the expertise and execution of HH among various health-care professionals in a tertiary care teaching hospital.

Methodology:

This analytical cross-sectional study was conducted over 2 months. A self-administered online questionnaire adapted from the WHO’s “Hand Hygiene Knowledge Questionnaire for Healthcare Workers” was sent to 217 participants. Their answers were scored based on the level of knowledge and practice of HH among them.

Results:

All age groups practiced HH to a fair extent, although respondents over the age of 31 (94.1%) showed significantly higher levels of understanding of HH in comparison to younger adults. There was no statistical difference in the knowledge level between male and female gender; however, females (91.2%) showed a better practice of HH than males. Although doctors (87.8%) had a higher degree of knowledge than nurses (70%), nurses (98%) had better HH practice than doctors. Overall, knowledge of HH was adequate with good practice.

Conclusion:

The adoption of excellent HH habits is thought to be predicted by greater knowledge about HH. However, to foster better HH habits that can significantly contribute to maintaining compliance with good practices, it is crucial to convey lacunae in knowledge during routine training sessions.
Let’s pause and think… Do we follow the right steps in developing a research questionnaire – Is it an art or a science? Insights gained from a study investigating an outbreak of hepatitis B in Central Kerala, India
Authors: Varghese Sangeetha Merrin , Abraham Jithin Mathew , Chacko Thomas Vengail , Benjamin Anoop Ivan , Chandy George Mateethra
Published: August 2024

Background:

Medical research utilizes a lot of questionnaires, but their quality is highly variable and lacks consistent, rigorous standards such as the use of conceptual framework or any other systematic process for its development. Our aim was to apply an insight obtained from medical education to describe the process of designing and developing a questionnaire, through an exploratory process to capture various risk factors and determinants that are valid and relevant in construct, to improve the health of the community.

Methodology:

We followed a seven-step systematic process of questionnaire development following the Association of Medical Education of Europe Guidelines (Guide 87) with a few modifications, to explore the factors responsible for an outbreak of hepatitis B in the Pathanamthitta district, Kerala.

Results:

About half of the questions (51.1% [23/45 questions]) were obtained via literature review, 37.7% (17/45 questions) were obtained via focus group discussions, 11.1% (5/45 questions) were included, and 6.6% (3/45) questions were also omitted based on expert advice. Cognitive interviewing helped in clarifying questions related to electromyography, the appearance and bite – characteristic of a deerfly, and also the explanation of contact sports, in the transmission of hepatitis B.

Conclusion:

A well-designed questionnaire developed following a systematic process helps to achieve the research objectives, is easy for both interviewers and respondents to complete, provides complete and accurate information, and is designed with the very purpose of making sound analysis and interpretation possible. This project helped in dispelling the myths and bringing forth the facts associated with the hepatitis B outbreak.
Active tuberculosis cases in the community, lessons learned
Authors: Mohankumar R. , Rajakarthika G. R. , Nandhinikumari N. R. , Sri R. N. , Mruganayani G. , Julieanne J. M. , Shereen A. S. , Newtonraj Ariarathinam , Konduru Rajesh Kumar
Published: August 2024

India is working hard to eliminate tuberculosis (TB) by 2025 and one of the key strategy is active case finding (ACF) of TB by house to house visit in the community. Through this ACF, which was carried out in a rural area of Pondicherry, three active cases of TB were identified. Active cases found through ACF differs from passive cases finding mainly in health care-seeking behavior and act as a source for spreading of the disease in the community and it is imperative to discuss about them. All the three cases that were detected were having diabetes and two of them were from a scheduled community area. One among them is a “newly diagnosed” case, while the other two cases belonged to “loss to follow up” and “failure of treatment” criteria. There was a lack of motivation among these patients to seek health care and adherence to treatment; and the health system also needs to gear up to tackle these active cases in the community, so that elimination of TB can be achieved by 2025. All the cases were notified with the health system and appropriate intervention was started.
Knowledge, attitude, and Practices of telemedicine among the health-care practitioners during COVID pandemic
Authors: Petimani Mahalaxmi S. , Bhat Nagapati P. , Preethishree P. , Adake Prabhakar
Published: August 2024

Introduction:

COVID pandemic created a difficult situation for the medical fraternity. Many health-care practitioners achieved their work through telemedicine. For delivering better patient care, especially during the pandemic, the present study was conducted to assess the Knowledge, Attitude, and Practices (KAP) of telemedicine among healthcare practitioners of our institution.

Materials and Methods:

A prevalidated questionnaire form containing 13 questions on KAP of telemedicine was circulated to health-care practitioners through Google Form by snowball technique. A total of 96 responses were collected. Descriptive statistical method was applied and results are expressed in percentages.

Results:

Out of 96 responses, 61 (63.5%) were from men and 35 (36.5%) from women. About 63.5% of health-care practitioners were aware of the term telemedicine, 22.9% were aware but not practising, and 13.5% were aware and currently practising telemedicine. Regarding the mode of telemedicine, 42.7% preferred video calling (Skype/hangout/WhatsApp), followed by 27.1% personalized website (HODO/Healzapp), 17.7% by text message (SMS/Email/Fax), and 12.5% for an audio phone call. With respect to taking consent, 59.4% expressed that consent is required and 40.6% expressed that consent is implied when the patient initiates the call. Regarding challenges in telemedicine, 83.3% expressed that clinical examinations cannot be done, 76% for connectivity issues, 55.2% worried about patient safety, and 54.2% for medico-legal issues. 53.1% of health-care practitioners would like to charge the same fees for telemedicine, followed by 27.1% lower fees, 12.5% no fees, and 7.3% would like to charge higher fees than routine.

Conclusion:

Telemedicine is essential for patient care, especially during a pandemic. Hence, National Medical Commission should incorporate telemedicine modules in the undergraduate curriculum for better patient care.
Impact of COVID-19 lockdown on characteristics of unnatural deaths autopsied at a tertiary care center in Pondicherry
Authors: Subramanyam Sunil , Janardhanan Joshima , Das Udit B. , Ravichandran Kandasamy
Published: August 2024

Background:

The number of reported unnatural deaths showed an observable decline during the lockdown imposed to curb COVID-19. In this study, we aimed to analyze the characteristics of unnatural deaths autopsied at our center during this 3-month period of lockdown and compared it with statistics of the same 3-month period in the 3 years before 2020.

Methodology:

The statistics of unnatural cases autopsied during the lockdown period were analyzed and compared with the statistics of cases autopsied in the same period of the previous 3 years (2017–2019). The data for this study were obtained from autopsy reports and police inquest reports of the cases autopsied at a tertiary care center in Pondicherry.

Results:

There was a reduction in homicidal and accidental deaths during lockdown when compared to previous years while suicides had doubled during the lockdown period. Unnatural deaths, where the presence of alcohol was either the instigator or a major contributor to the fatality, were also reduced.

Conclusion:

This study reveals the indirect and unexpected consequences of lockdown in relation to unnatural deaths and the findings can help in the implementation of social reform policies.
The commonly used adult generic quality of life instruments for chronic diseases with merits and demerits
Authors: Ravindra B. N. , Chonari Thanveer Ahammed , Kumar B. P. Satish , Dahim Muhammed , Mohan Akshay
Published: August 2024

A chronic condition is a physical or emotional wellness condition that endures over a year, causes utilitarian limitations, or requires progressing checking or treatment. The aging of the population has caused a high prevalence of chronic illnesses, such as diabetes, cardiovascular diseases, and cancer. Even though individuals live longer, they often live with disabilities and constant illnesses. Quality of life (QOL) has become a critical idea and focus for examination and practice in the fields of well-being and medication. During the previous years, more examination has focused on patients’ QOL, and the utilization of QOL evaluations has expanded. Health-related QOL (HRQOL) is now mandatory in assessing health outcomes. Searches were conducted using PUBMED, Google Scholar, Web of Science, and Google to find the studies published in peer-reviewed journals. Key search terms included HRQOL, QOL, SF-36, MQOL, COOP chart, SIP, NHP, QWB, EQ-5D, and EuroQol Instrument. Relevant articles were chosen from the search results. This review provides researchers and clinicians with up-to-date practical and comparative information on adult generic QOL instruments to help them decide which the instrument is best suited for their study. It examines the Medical Outcomes Study 36-Item Short Form (SF-36) Health Survey, the McGill QoL Questionnaire – Original (MQOL – Original), the Dartmouth Primary Care Cooperative Information Project (COOP) Charts, Sickness Impact Profile (SIP), Nottingham Health Profile (NHP), Quality of Well-Being (QWB) scale, and the EuroQOL 5-Dimension Instrument (EQ 5-D). This paper looks at 7 HR-QOL instruments and finds that there are no consistently “best” or “worst” instruments. The choice to use the generic QOL measure is driven by the reason for the assessment.
Meta-analysis of differential expression of sex-biased and common drug metabolism enzymes and transporters genes in blood transcriptomics of mental disorders
Authors: Mohandoss Anusa Arunachalam , Kumar S. Ananda Krishna
Published: August 2024

Background:

There are reports that pharmacogenomics, pharmacodynamics, and pharmacotherapeutics of psychiatric drugs differ significantly with sex. There is a dearth of literature on this aspect. The aim of this study is to identify sex-biased genes among common mental disorders and the influence of sex on the common drug metabolism enzymes and transporters (DMET) genes in blood transcriptomics data.

Methodology:

Data for this meta-analytic, in silico study, are from Gene Expression Omnibus repository with restrictions of human blood samples that measured the mRNA expression of genes of any mental disorder patients without any date limitations. The identified datasets were then entered into the online Exatlas software. Quality check of the dataset was performed and only those datasets that fulfilled were used further in this meta-analysis. DMET genes were identified from literature, and the differential expression (DE) was identified and presented.

Results:

In all, 239 patient samples with five common mental disorders formed the study group. Of them, there were 21139 genes, of which the number of significant genes (FDR <0.05) was 16989. In this meta-analysis of mental illness among either sex, 32 genes were identified as DE. Of these 32 genes, 23 (72%) belonged to sex chromosomes and the remaining mapped to autosomes. We identified 48 DEMT genes from literature and their DE reported.

Conclusion:

Within the limitation of this study, it is established that among the mentally ill, there is a measurable difference between males and females, in terms of gene expression, particularly of DMET genes. Such DE of genes can potentially alter the pharmacogenomics, pharmacodynamics, and pharmacotherapeutics of psychiatric drugs.
Case series on the effectiveness of preoperative radiological templating on acetabular cup orientation in total hip arthroplasty of developmental dysplasia of the hip
Authors: Mahajan Neetin P. , Chandanwale Ajay S. , Gawhale Sangeet K. , Prasanna Kumar G S , Gadod Lalkar
Published: August 2024

Total hip arthroplasty becomes the challenging treatment in cases of neglected developmental dysplasia of the hip but requires elaborate preoperative planning, especially for the restoration of the normal hip center, correction of shortening, and achieve normal biomechanics to avoid limb and early failures. To determine the morphological changes resulting from the dysplasia, the anatomic acetabular position, the height of the femur head dislocation and the combined anteversion must all be established. Preoperative planning was done using 100% zoom digital X-rays of the pelvis with both hips in 15° of internal rotation. This included identification of true acetabulum and centre of hip rotation using Ranawat's triangle. Templating was done to determine the position of acetabulum and size of the cup and required length of subtrochanteric osteotomy. The length of subtrochantric osteotomy was determined so that it would not lengthen the leg more than 3 cm to prevent sciatic nerve stretching. The postoperative X-rays were compared with the template of X-rays for the effectiveness of preoperative planning in restoring the near-normal biomechanics of the hip joint.
Utility of biomarkers in predicting the severity and mortality of coronavirus disease 2019 infection
Authors: Deshpande Sapna S. , Mestri Namrata , Halgale Mohasin J. , Chimankar Pradnya M.
Published: August 2024

Context:

The clinical course of Coronavirus Disease 2019 (COVID-19) infection is variable and subjective. Hence, there is a dire need for objective interpretation of severity. The utilization of biomarkers categorizes these patients into nonsevere, severe, or critical categories.

Aim:

This study aims to assess the role of different biomarkers in predicting the severity and mortality of COVID 19.

Materials and Methods:

Case records of 247 patients of a designated COVID center in Kolhapur, Maharashtra, India, were included in this observational study. Biomarkers such as total leukocyte count, C-reactive protein, lactate dehydrogenase, D-Dimer, interleukin-6 (IL-6), procalcitonin, and serum ferritin were studied in different categories of severity of the disease.

Results:

The median serum ferritin levels among nonsevere cases, severe, and critical cases were 187.95 ng/mL (interquartile range [IQR] = 93.05 ng/mL to 382.50 ng/mL), 230 ng/mL (156 ng/mL to 670 ng/mL), and 412.33 ng/mL (234 ng/mL to 689 ng/mL), respectively and this difference was statistically significant (P < 0.001). The average values of IL-6 were significantly higher (P < 0.001) among the patients who died (19.12 pg/mL) when compared to those which were alive (3.74 pg/mL). Based on the receiver operating characteristic analysis, the interpretation of the severity of the disease was excellent through the evaluation of levels of serum ferritin (Area under curve = 0.755 [95% confidence interval = 0.635–0.875; P = 0.001]).

Conclusions:

Serum ferritin among the biomarker panel studied was the best test that predicted the severity of COVID-19 infection. The IL-6 levels were significantly higher among the patient who succumbed when compared to those who survived the disease.
Assessment of risk-taking behavior, leadership effectiveness, intelligence, ability to handle stress in college-going students, and effect of self-control on these parameters
Authors: Singh Mohita , Sachdev Sunil , Singh Amrita
Published: August 2024

Background:

Human intelligence is the intellectual prowess of humans, which is marked by high cognition, motivation, and self-awareness. Leadership is the art of motivating a group of people to achieve common goals. Risk-taking is conscious or nonconscious controlled behavior with perceived uncertainty about its outcome. The present study was designed to assess the risk-taking ability of an individual that is required to be a good leader along with intelligence, ability to handle stress, and the effect of self-control on these parameters.

Materials and Methods:

The study was performed in two phases. In the first phase, the subjects were asked to fill risk-taking questionnaire, and their leadership effectiveness and intelligence levels were assessed. Their basal level of stress parameters and Stroop test were assessed. A stressor was introduced and stress parameters, Stroop test were again assessed. In the second phase of the study, the subjects were asked to practice moderate-intensity physical activity for 15 days and its effect was seen on all the above parameters.

Results:

Statistically significant and nonsignificant differences were obtained on comparison between baseline and poststress values; and also between baseline and postexercise values in all the three groups namely high-risk takers, moderate risk-takers and nonrisk takers at different level of significance. Comparison between first phase and second phase of the study yielded significant and non-significant results.

Conclusion:

Self-control improves leadership effectiveness. Exercise helps reduce stress response that aids in better decision-making quality required for being a leader.