bluuebunny/crossref_metadata_2025 huggingface dataset:
Burnout Syndrome in Dermatology Residents
Authors: Shadid Asem M. , Aldosari Batal M. , Algarni Abdullah M. , Dahmash Abdulmajeed Bin , Altalhab Saad , Alharithy Ruaa
Published: June 2022

Background:

Burnout is defined by three dimensions: emotional exhaustion (EE), depersonalization (DP), and low personal feelings of achievement (PA). It is a prolonged response to chronic emotional and interpersonal stressors on the job. If unrecognized, the costs to the health-care system can be enormous.

Purpose:

The aim of this study is to investigate the prevalence of burnout levels and predictors among dermatology residents and the risk factors associated with it.

Methods:

Validated measure of burnout (Maslach Burnout Inventory–Human Services Survey), alongside the possible risk factors of burnout, was distributed to all dermatology board training residents in all affiliated centers in Riyadh, Saudi Arabia. The response rate was 96.2% with 51 residents completing the survey out of 53.

Results:

High EE was present in 41.2% of dermatology residents, a low sense of PA in 45.1%, while high DP was the least prevalent at 13.7%. Satisfaction with career was significantly associated with risk of high EE (odds ratios [OR] = 0.61, 95% Confidence interval [CI] = 0.15–22.3), risk of high DP (OR = 0.34, 95% CI = 0.08–0.316), and risk of low PA (OR = 0.86, 95% CI = 0.52–6.1). The average number of sleeping hours was also associated with risk of high EE (OR = 0.87, 95% CI = 0.54–3.88), risk of high DP (OR = 0.76, 95% CI = 0.5–1.41), and risk of low PA (OR = 0.86, 95% CI = 0.52–6.1). Our findings report high over all burnout in 7.8% of the respondents.

Conclusion:

EE and feelings of low PA were seen at a high rate among dermatology residents, while DP was the least prevalent across all burnout dimensions. Average daily sleeping hours alongside satisfaction with life/work balance, career, and salary showed a statistically significant association with DP, low PA, EE, and overall burnout. Protected time to pursue academic interests, for example, research and teaching, and a fair distribution of on-call hours per month, as well as a number of clinics per week may explain the rate of burnout in our study. These findings can be applied in the improvement of training programs to reduce the burnout rate among residents.
Skin Cleansing and Wound Care Practice in Patients with Epidermolysis Bullosa
Authors: Alheggi Ashjan , Alzakry Leena , Khunayn Rawan Bin , Alshareef Rahaf , Al-Khalid Yara
Published: June 2022

Background:

Epidermolysis bullosa (EB) is a group of genodermatoses characterized by fragile skin that may progress to erosions, blisters, and open nonhealing wounds. Understanding home skincare practices and topical products use among patients with EB is necessary to optimize management outcomes and quality of life.

Purpose:

The purpose of this study was to assess home bathing, skincare routines, and topical product used in patients with EB.

Methods:

Cross-sectional, observational study data were collected from patient-directed questionnaires in the Saudi EB registry. Data collection and statistical analyses were conducted using Microsoft Excel and SPSS-V.25.

Results:

Thirty-seven patients (62% males; mean age 14; [2 months–36] years) were enrolled. EB subtypes included EB simplex (n = 13), junctional EB (n = 6), and dystrophic EB (n = 13); five patients had unknown type. Twenty-one patients (57%) dislike multilayer wound dressings and/or find that they exacerbate the blistering during summer and in hot climates. Almost one-quarter of participants reported lancing a few of the intact blisters, and 5.4% did not lance any. Bath additives ranged from barely effective to potentially cytotoxic solutions of vinegar and sodium hypochlorite solution. Around 1/3rd of participants reported the use of topical antibiotics with no alternation or rotation on dirty wounds, and 8.1% of our cohort reported the use of antibiotics on intact skin.

Conclusion:

Education is needed for EB patients and their families on lancing of blisters and topical antibiotic use, especially in light of increasing antibiotic resistance. Dressing modification for EB patients living in the Gulf region countries, particularly during hot and humid months, may be helpful.
A descriptive study on child sexual abuse act in India
Authors: Singh Ranjana , Koushal Vipin , Bharti Bhavneet
Published: June 2022

ABSTRACT

Background:

Child sexual abuse (CSA) is a significant public health problem. Health care professionals can play an important role in the identification and reporting of such cases. This study was conducted to assess the awareness level among doctors working in a medical Institute about CSA.

Materials and Methods:

This is a cross-sectional descriptive study. Data was collected using a closed-ended structured questionnaire. Descriptive analysis was done to compute percentages and frequencies. Respondents’ educational qualification, as well as the relationship between their level of education and their awareness of child abuse, was also assessed.

Results:

Nearly 70% of respondents came across child abuse cases, wherein sexual abuse was found to be the commonest (58%), followed by physical abuse (28%). Nearly 40% of child abuse cases were reported in the hospital where they worked, while 15% of child abuse cases occurred in other hospital areas. The study also revealed that 81% of respondents had knowledge about child sexual abuse. However, only 34% were aware of the repercussions of non-reporting of a child abuse case. Nearly 64% of respondents had an idea about an online complaint system for child abuse, and 70% were aware of the availability of a one-stop centre at a respondent’s hospital. The majority (68%) were aware of the POCSO (Protection of Children from Sexual Offences) Act on sexual abuse. On seeking information regarding evidence of anal sexual abuse among children and adolescents, 36% were completely aware, and 13% were partly aware of it.

Conclusion:

There is a need for continued education and advancement of all health care professionals to improve the diagnosis and reporting of CSA.
The application of six-minute walk test to identify ‘pre-hypoxemia’ phase in asymptomatic/mild disease COVID-19 patients managed in home isolation or primary health care setting
Authors: Sood Vivek , Gupta Swatantra , Joshi Amit , Raina Sujeet
Published: June 2022

ABSTRACT

The clinical spectrum of COVID-19 infection patients extends from being asymptomatic to mild, moderate and severe disease. This classification is largely based on oxygen saturation and respiratory rate. Asymptomatic/mild disease patients are managed in home isolation or COVID care centers. A subgroup of these patients will deteriorate and develop moderate to severe disease. Six-minute walk test is useful in identifying this group of patients by inducing hypoxia in normoxemia patients. This stage of the disease is labelled as ‘pre-hypoxemia’ phase in asymptomatic/mild disease. Identifying this stage in the course of illness of patients will help in intercepting further deterioration at the earliest by timely intervention.
A cross-sectional study to assess the prevalence of anosmia and ageusia and its association with disease severity among COVID-19 affected patients in Salem, Tamil Nadu
Authors: Rajamani Shanmugasundaram , Ranganathan Rangabashyam S. , Kanaguraju Kirubhakaran , Shanmugaraja Karthick
Published: June 2022

ABSTRACT

Introduction:

An epidemic of the severe acute respiratory syndrome was started in 2019 in Wuhan city, China. Due to international trade and travel, this disease has become a pandemic across the world. The agent causing this disease was named Corona Virus Disease 2019 by (COVID-19) by the World Health Organization (WHO). The following study was done with the objective of estimating the prevalence of anosmia and ageusia and its association with disease severity among COVID-19 affected individuals.

Materials and Methods:

A cross-sectional analytical study was conducted among COVID-19 patients in a tertiary hospital in Salem, Tamil Nadu. The data were collected using a semi-structured questionnaire, which consisted of demographic details such as age, gender, and place, clinical symptoms, and signs such as fever, loss of taste, breathing difficulty, loss of smell, sore throat, and fatigability, vital signs, and co-morbidities.

Results:

In this study, we found that the severity of the disease (according to CT chest scores) among the study participants had a statistically significant association with breathlessness and headache.

Conclusion:

The symptoms of headache and breathlessness have statistically significant associations with disease severity that can be used in any setting to classify the COVID-19 case as who is eligible for home isolation, and who is eligible for admission or to be referred.
Poverty, undernutrition and morbidity: The untold story of tea-garden workers of Alipurduar district, West Bengal
Authors: Yasmin Shamima , Sau Manabendra , Patra Manas , Sinha Nirmalya , Baur Baijayanti
Published: June 2022

ABSTRACT

Background:

There is a paucity of information on health and nutritional status of tea-garden workers of West Bengal, which is crucial to meet their health needs by formulating appropriate public health interventions.

Objectives/Aims:

The objective of this study is to assess the morbidity pattern and nutritional status of tea-garden workers of West Bengal, India.

Materials and Methods:

The present cross-sectional study was conducted among 463 tea-garden workers of randomly selected three tea gardens of Alipurduar district of West Bengal, India, chosen by multi-stage sampling. Pre-designed and pre-tested questionnaire was used to collect information on socio-demographic and other variables by means of interview. Physical examination and anthropometric assessment were performed. The haemoglobin was estimated by the ‘filter paper cyanmethemoglobin method’. Morbidities were assessed on the basis of history, clinical examination, evaluation of medical records if any and relevant laboratory investigations and classified and coded as per the 10th revision of the international classification of the diseases. Morbidity profile and nutritional status were assessed through history taking, clinical examination, review of medical records if any, anthropometric assessment and laboratory investigations.

Statistical Analysis:

Simple proportion was used for interpretation of point prevalence. Chi-square test was applied as the test of significance wherever applicable.

Results:

Out of total 463 tea-garden workers, majorities (76%) were female and from backward social class (81.2%). More than half (55.9%) were illiterate and three-fourth (67.2%) belonged to lower income quartile. Anaemia was found widespread (87.9%) and more than one-third (36.1%) of the tea-garden workers were found undernourished. Also 43.8% of the workers had airway obstruction as measured by peak expiratory flow rate. Majority (69.8%) of the garden workers had any form of morbidity. Non-communicable diseases (24.2%), musculoskeletal disorders (17.9%), skin disorders (17.7%), respiratory morbidities (16.2%), febrile illness (12.3%), gastro-intestinal disorders (8.6%), ocular problems (8.4%), vitamin and micronutrients deficiencies were found the common morbidities among tea-garden workers. Scheduled tribe caste, undernutrition and anaemia were found independent determinants of any morbidity among the tea-garden workers.

Conclusions:

Morbidities, anaemia and under-nutrition were found very much prevalent among tea-garden workers of West Bengal, which necessitates urgent public health interventions through multi-disciplinary approach in a focussed manner with an aim to improve the overall quality of life of the tea-garden workers.
Erythema annulare centrifugum in a case of chronic myeloid leukemia
Authors: Agrawal Prabhat , Kumar Amit , Pursnani Nikhil , Agarwal Geetika , Sathi Satyanand
Published: June 2022

ABSTRACT

Chronic myeloid leukemia (CML), BCR-ABL1-positive, is classified as a myeloproliferative neoplasm predominantly composed of proliferating granulocytes and determined to have the Philadelphia chromosome/translocation t (9;22)(q34;q11.2). Skin is said to be the mirror to systemic diseases, with skin manifestations ranging from nonspecific cutaneous lesions to specific lesions. The cutaneous manifestations of CML are generally reddish-brown to violaceous papules and nodules, indurated or hemorrhagic plaques, perifollicular acneiform papules, bullae, and palpable purpura. Other unusual manifestations could be erythema nodosum, pyoderma gangrenosum, erythema annulare centrifugum, and so on. Here we present a case of a 50-year-old woman with a history of recurrent pruritic skin lesions and erythema annulare centrifugum as the presenting complaint of CML.
Mucormycosis in post-covid patients: An epidemic in pandemic
Authors: Kesarwani Vasudha , Kumar Amit , Kesarwaani Shivaam , Kesarwani Divya
Published: June 2022

ABSTRACT

Rhino-orbitol-cerebral mucormycosis (ROCM) is seen as a common post-coronavirus disease (COVID-19) fungal infection in India. It is a lethal, opportunistic infection of the paranasal sinuses and brain caused by fungi of the Mucorales, most commonly with Rhizopus spp. Early diagnosis and timely management are essential. Other studies have shown high mortality up to 25–60%. However, in this study, the recovery rate is very high. We aimed to present six post-COVID mucor cases and to review the literature in terms of prevention, diagnosis, and management of this fatal infection. We carried out a retrospective case series of six patients with a confirmed diagnosis of ROCM presenting to a single tertiary-level hospital during the second wave of covid 19 pandemic. Clinical details for each case was obtained from the hospital information system. A total of six patients (five males and one female) were diagnosed with ROCM during this period. Out of six patients, four had diabetes mellitus and all were on steroid treatment during COVID-19 infection. The most common presenting features were headache (100%), facial pain (80%), orbital swelling (80%), and earache (20%). Most of the patients had sinusitis as a predominant finding in preop magnetic resonance imaging (MRI) at presentation. All patients received liposomal amphotericin B (LAmB) as the first line of treatment and subsequently shifted to posaconazole. The overall recovery rate was 100% and patients were discharged. ROCM infection is very hard to treat. The studies have shown cases with late presentation spreading beyond paranasal sinuses. Early intervention and treatment with antifungals and extensive surgical debridement resulted in the full recovery of all six cases.
Tuberous xanthoma with cardiac failure in a child
Authors: Narasimhan Murali , Muthu Preethi , Ramakrishnan Ramachandran , Sriram V
Published: June 2022

ABSTRACT

A 14-year-old girl presented with gradually progressive breathlessness for 3 weeks. On evaluation, it was found that she had left ventricular hypertrophy and nonprogressive R wave in ECG. An echocardiogram revealed aortic stenosis and severe left ventricular dysfunction.Computed Tomography (CT) imaging showed aortic annulus calcifications causing aortic stenosis. Over three years she had gradually developed asymptomatic cutaneous swellings over the small and large joints of the extremities suggestive of tuberous xanthomas. Skin biopsy revealed scattered foamy macrophages in the upper dermis and cholesterol clefts. Her lipid profile showed raised total cholesterol and low-density lipoprotein levels. With the above clinical, histological, and laboratory findings she was diagnosed as a case of familial homozygous hypercholesterolemia with tuberous xanthomas and cardiac failure. She was started on statins, ezetimibe, and other anti-failure measures. We present this case for its rarity. Early diagnosis of this condition based on skin findings, could have prevented cardiac failure by initiating early appropriate treatment.
Molecular pathways in glioblastoma-derived stem cells to identify effective drug agents: A bioinformatics study
Authors: Mirzaei Tahereh , Sheikholeslami Seyed Amir , Bereimipour Ahmad , Jalili Arsalan , Zali Alireza , Sharbati Sheida , Kaveh Vahid , Salari Sina
Published: June 2022

ABSTRACT

Background and Aim:

Glioblastoma multiform (GBM) is considered as one of the malignant brain tumors that affect a wide range of people every year. Cancer stem cells, as essential factors, are resistant to chemotherapy drugs and complicate treatments. Therefore, finding critical molecular pathways in GBM-derived stem cells, and selecting the appropriate drug agents can prove more effective treatment approaches for GBM.

Method:

In this study, using RNA-Seq data, we performed continuous bioinformatics analyses and examined the up-and down-regulated genes from GBM-derived stem cells samples. Afterward, we separated the signaling pathways using the KEGG database and measured the protein interactions with the STRING database. Then, using the Drug matrix database, we nominated drugs that could affect these genes.

Results:

The first 20 pathways on tumorigenesis and 41 up-regulated and 73 down-regulated genes were selected. These genes were most active in the pathways involved in cell division, metabolism, cytoskeleton, cell adhesion molecules, and extracellular space. We then examined the candidate genes and the approach of the drugs that target these genes. Chlorambucil, cyclosporine A, doxorubicin, and etoposide were selected as the drug agents.

Conclusion:

Using integrated bioinformatics analyses, it was found that prominent genes in the cell cycle and cytoskeletal pathways are more expressed in cancer stem cells and that Chlorambucil, cyclosporine A, doxorubicin, and etoposide can be effective compounds to attenuate these cells.
Is the unrealistic expectation of getting cured related to poor treatment adherence among Indian Asthma patients? A hospital based mixed methods study from central India
Authors: Lahri Madhvi , Kumar Sanjeev , Mitra Arun , Singh Gyanendra
Published: June 2022

ABSTRACT

Background:

Prevention of premature deaths due to asthma requires continued disease control through efforts of both patients and healthcare providers. The expectations of patients have been shown to influence treatment adherence and disease control.

Methodology:

We conducted a hospital-based sequential exploratory mixed methods study and used definitions of the Global Initiative for Prevention of Asthma (GINA). We recruited 80 asthma patients in a tertiary public health facility of central India. We assessed treatment expectations, health literacy, awareness, behavioural risk factors, self-care, treatment adherence, and disease control. We conducted a thematic analysis of qualitative data through manual inductive coding and used statistical software R version-3.6.1 for quantitative analysis.

Results:

Sixty-seven (83.75%) patients expected that the current doctor would help them achieve ‘cure’, while 28 (35%) expected to obtain information about asthma. 81.2% and 77.5% of participants had inadequate health literacy and inadequate awareness, respectively. 73.8% were using inhalers and 21.2% were not using any treatment. Forced expiratory volume in 1 (FEV1) and Forced vital capacity (FVC) values were available for only 46.25%, while a meagre 6.25% were using peak-flow meter for self-monitoring. Though 21.2% reported optimal treatment adherence, 27.5% had good control. We found the expectation of cure and poor health literacy being significantly related to sub-optimal treatment adherence. We didn’t find any association between the expectations of patients and their disease control.

Conclusion:

Asthma patients in our setting mostly expected to get cured. The unrealistic expectation of ‘cure’ is related to poor treatment adherence and possibly poor disease control.
Scrub Typhus in Paediatric Age Group at a Tertiary Care Centre of Eastern India: Clinical, Biochemical Profile and Complications
Authors: Agrawal Aman , Parida Preetinanda , Rup Amit Ranjan , Patnaik Sibabratta , Biswal Sebaranjan
Published: June 2022

ABSTRACT

Background:

Scrub typhus is a reemerging zoonosis, which presents as acute febrile illness. Very few paediatric prospective studies on this disease are reported from Eastern India. This prospective observational study was carried out to study the clinical presentation, diagnosis, complications and immediate outcome of Scrub typhus in paediatric population in a tertiary care hospital from Eastern India.

Material and Methods:

Totally 209 cases between 1 month and 18 years of age were included. Clinical manifestations, laboratory parameters and immediate outcome of all patients were recorded. All the data were collected and plotted in Microsoft Excel master chart. Continuous data were presented as mean ± standard deviation (SD) and categorical data as frequency and percentage. All the data analysis was performed using statistical software IBM Statistical Package for the Social Sciences (SPSS) version 20.0.

Results:

Highest number of cases (41.1%) were found between 1 year and 5 years age group. Fever was the presenting complaint in all cases. Other common symptoms were cough (34%), pain abdomen (23.4%), vomiting (23%), seizure (11.5%) and altered sensorium (9.6%). Hepatomegaly was found in 56.5% and splenomegaly in 39.7% cases. Eschar was found in 27.3% cases. C-reactive protein was elevated (>10 mg/L) in 93.3% children. Other complications were pneumonitis (20.6%), meningoencephalitis (12.4%), septic shock (8.6%), acute respiratory distress syndrome (5.7%), myocarditis (4.8%) and acute kidney injury (4.3%). Mortality was low (1%).

Conclusion:

Scrub typhus is not uncommon in paediatric population and it must be considered as a close differential diagnosis of any acute febrile illness even when classical clinical presentations are not found. Early treatment results in favourable outcome.
Prevalence of anemia among toddlers (12–36 months) in urban area of district Rohtak, Haryana
Authors: Kalhan Meenakshi , Kaushal Pankaj , Chayal Vinod , Verma Ramesh , Singh Tarun , Yadav Garima , Kumar Mukesh , Kumar Arun
Published: June 2022

ABSTRACT

Background:

Children are considered as an important asset for any country and their health as one of the important indicators of a healthy country. There are several factors affecting children’s health and anemia is one of them. Globally around 1.62 billion people are affected by it, which corresponds to 24.8% of the population, with the highest prevalence of anemia (47.4%) among preschool-aged children.

Aim:

The present study was conducted to estimate the prevalence of anemia among toddlers (12–36 months) and to determine the associated factors.

Materials and Methods:

A cross-sectional study was carried out among toddlers (12–36 months) in the urban field practice area of Pt. B.D. Sharma PGIMS, Rohtak. A total of 170 toddlers were enrolled in the study and their mothers were interviewed using a semi-structured pretested questionnaire. Hb was estimated by Sahli’s acid hematin method. The data were analyzed using SPSS software version 20.

Results:

In the present study, more than half (55.9%) participants were girls and 44.1% were boys. The overall prevalence of anemia was found to be 62.4%, with mild, moderate, and severe anemia being 41.8%, 17.7%, and 2.9%, respectively. The children with regular intake of iron supplementation were found to be 6.625 times likely to be nonanemic as compared to those with no supplementation.

Conclusion:

Every endeavor should be made to combat the anemia in children through multisectoral and multipronged approach such as nutritional education of mothers, growth monitoring, nutritional supplementation, etc.
Safe Delivery application with facilitation increases knowledge and confidence of obstetric and neonatal care among frontline health workers in India
Authors: Sarin Enisha , Dastidar Sourav Ghosh , Bisht Nitin , Bajpayee Devina , Patel Rachana , Sodha Tarun Singh , Bhandari Aditya , Mohanty Jaya Swarup , Dey Surajit , Chandra Subodh , Agrawal Ritu , Saboth Prasant , Kumar Harish
Published: June 2022

ABSTRACT

Background:

Digital learning tools have proliferated among healthcare workers in India. Evidence of their effectiveness is however minimal. We sought to examine the impact of the Safe Delivery App (SDA) on knowledge and confidence among frontline health workers (HW) in India. We also studied whether facilitation to address technical challenges enhanced self-learning.

Methods:

Staff nurses and nurse-midwives from 30 facilities in two states were divided into control and intervention groups through randomization. Knowledge and confidence were assessed at baseline and after 6 months. Three rounds of facilitation addressing technical challenges in downloading and usage along with reminders about the next phase of learning were conducted in the intervention group. A user satisfaction scale along with qualitative interviews was conducted in the intervention group at the endline along with qualitative interviews on facilitation.

Results:

The knowledge and confidence of the healthcare workers significantly increased from the baseline to endline by 4 percentage points (P < 0.001). The participants who received facilitation had a higher mean score difference in knowledge and confidence compared to those who did not receive facilitation (P < 0.001). The participants were highly satisfied with the app and video was the most-watched feature. They reported a positive experience of the facilitation process.

Conclusion:

The effectiveness and acceptability of the SDA indicate the applicability of mHealth learning tools at the primary healthcare level. In a time of rapid digitalization of training, facilitation or supportive supervision needs further focus while on-ground digital training could be invested in to overcome digital illiteracy among healthcare workers.
Saliva as a propitious diagnostic biofluid, biomarker, and bodies first line of defense against COVID-19: A review
Authors: Langalia Akshay , Sinha Nidhi , Thakker Viral , Shah Aarshvi , Shah Jinali , Singh Bijay
Published: June 2022

ABSTRACT

This review aims to recognize the role of saliva not just as a transmitting agent of COVID 19, but also comprehend its role in the diagnosis, and as a biomarker. A systematic literature search was performed in the PubMed database and eligible studies were included if they addressed the key issues i.e saliva as a diagnostic aid. As of January 10, 2021, a total of 309 articles across the PubMed database were identified of which 28 studies met the inclusion criteria. They were carefully examined for the type of study, sample size, parameters used, sample collection technique, and conclusions drawn. Diagnostic properties of saliva, the role of ACE 2 receptors, antibody formation ability, and antiviral characteristics were also explored. Comparisons among methods of sample collection like nasopharyngeal swabs and oropharyngeal swabs to saliva were also investigated. The observations and important deductions among the different studies were compared. Results indicated that saliva could be a reliable and financially viable option in both testing viral titers as well as marking for bio analytes due to its propitious specificity and sensitivity results reported in most of the studies. However, the inferences drawn from many of these studies should be interpreted with caution due to small sample sizes, inadequate detailing on the sample handling, laboratory processing, and rush in Corona-related publication. Scientific research with larger sample sizes, in diverse populations and age groups, at different phases of disease progression of COVID-19 are essential to reach any conclusion regarding its multi-facet use in the future.
COVID-19 pandemic: Hospital preparedness in a tertiary care hospital in North East India
Authors: Pandita Kawal Krishan , Noor Topno , Sahoo Sambit Kumar
Published: June 2022

ABSTRACT

Background:

The first case of Coronavirus was reported by World Health Organisation (WHO) on 31 December 2019. Due to its high infectivity and increasing mortality, WHO on 30 January 2020 declared the infection as public health emergency of international concern. Various measures were initiated and carried out by health care facilities to tackle the pandemic. Our experiences of hospital preparedness may help future health policies to tackle the pandemics.

Method:

Various guidelines given by Ministry of Health and Family Welfare, Centre for Disease Control, Indian Council of Medical Research were studied and analysed. The hospital lay out plan was studied, modifications in the physical structure of the hospital as planned by the hospital authorities were observed and recorded. The impact of the new planning on patient management was recorded by the investigators.

Results:

It was observed that proper planning on the basis of laid down guidelines and the modifiable initial layout is very effective in the prevention and management of the pandemic. A total of 130 beds of the hospital under study could be separated from the main building with little modifications. Another important observation was dedicated leadership and coordination among different specialities ensuring successful planning. The investigators concluded that the new hospitals should be planned and constructed in such a way so that a major part of the hospital building can be converted to an isolation area with little modifications in the physical structure of the hospital at the time of pandemics.
Home-based telemental health services for Indian patients during the COVID-19 pandemic: A comparison with the pre-COVID phase
Authors: Chakravarty Rahul , Chakrabarti Subho , Shah Ruchita
Published: June 2022

ABSTRACT

Background:

Many developed countries have switched from conventional outpatient psychiatric services to tele mental health-based alternatives because of the COVID-19 pandemic. However, similar transitions might be difficult for countries like India because of a shortage of necessary resources. Therefore, the feasibility and acceptability of converting to a home-based tele mental health (HB-TMH) service during the pandemic were examined in an Indian hospital.

Materials and Methods:

A new and expanded version of an HB-TMH service was operated for all outpatients following the onset of the pandemic. Feasibility outcomes included operational viability, service utilization, service engagement, the need for additional in-person services, and the frequency of adverse events. Patients’ and clinicians’ satisfaction with different aspects of the service were evaluated using Likert-style questionnaires to ascertain acceptability. The outcomes during the prepandemic and pandemic phases were also compared.

Results:

The switch to HB-TMH services took 6 weeks during the pandemic. Patient numbers increased greatly following this transition. Attendance improved, the requirement for in-person services was low, and no serious adverse events were reported. However, patients’ satisfaction levels were relatively low during the pandemic. Clinicians were more satisfied than the patients with HB-TMH treatment during the pandemic. Differences between them were less marked but still present before the pandemic. Pre- and postpandemic comparisons revealed that both patients and clinicians were more satisfied with all aspects of HB-TMH care before the pandemic than during it.

Conclusions:

Though conversion to HB-TMH services was feasible during the pandemic, such services need to be improved to enhance patient acceptability.
Application of machine learning and medical imaging in the detection of COVID-19 patients: A review article
Authors: Yadollahi Sepideh , Yadollahi Setareh , Zanjani Elmira , Khaleghi Fatemeh
Published: June 2022

ABSTRACT

In the present study, a particular technique of artificial intelligence (AI) is applied for diagnosis and classifying medical images of patients with coronavirus disease (COVID-19). Chest radiography and laboratory-based tests are two of the most important diagnostic approaches for the detection of people with the coronavirus. Recently, a lot of studies have been carried out on using AI techniques for achieving appropriate diagnosis of COVID-19 patients using computed tomography (CT) of the chest. The present study is reviewing all available literature that have investigated the role of chest CT toward AI in the detection of COVID-19. As a novel field of computer science, AI focuses on teaching computers to be capable of learning complex tasks and decide about their solution methods. In this study, we used Matlab, Payton, and Fortran software as well as other software which are suitable for this research. In this regard, the present review study is aimed to collect the information from all the studies conducted on the role of AI as a decisive and comprehensive technology for the detection of coronavirus in patients to have a more accurate diagnosis and investigate its epidemiology.
Perception, burden and satisfaction of parents of children attending online classes during COVID-19 lockdown: A cross-sectional survey
Authors: Rathaliya Aarti , Malarkodi S , Deol Rupinder , Kuppuswamy Rajarajeswari
Published: June 2022

ABSTRACT

Introduction:

Coronavirus has spread havoc globally, resulting in the closure of all sectors including education. Therefore, to continue a child’s learning, the government started online classes from home by involving parents. This new learning method might be hectic and challenging for parents; therefore, this study aimed to assess the perception, burden, and satisfaction of parents of children attending online classes.

Methods:

A cross-sectional online survey was conducted in three schools of Rishikesh, Uttarakhand. A total of 220 parents of children attending online classes and studying between first and fifth standard responded voluntarily. Google Form was used to assess perception, burden, and satisfaction regarding online classes and analyzed using descriptive and inferential statistics.

Results:

The mean age of parents was 34.1 ± 5 years, and most of the respondents were mothers. Out of 220 parents, 52% showed negative perception, 42% experienced moderate to severe burden, and 51% were highly satisfied with the online classes during COVID-19 lockdown. Pearson’s correlation coefficient showed a positive correlation between perception andsatisfaction of parents (P = 0.000, r = 0.616 *). Parental role and preferred teaching method had a significant association with parental perception (P < 0.01, P < 0.05). The app used and preferred teaching method during the pandemic had a significant association with parental satisfaction regarding online classes (p < 0.01, P < 0.05).

Conclusion:

Parents had negative perception and experienced moderate to severe burden concerning online classes. At the same time, they were highly satisfied with achieving educational objectives to some extent during the COVID-19 pandemic.
Awareness of Indian government initiated social security schemes utilization among villagers of Kanpur rural region: An evaluative cross sectional study
Authors: Sachdev Rohan , Garg Kriti , Shwetam Samiksha , Srivastava Aaryan R. , Srivastava Akash
Published: June 2022

ABSTRACT

Context:

In India, the use of social security schemes by the rural population has not been evaluated with much consideration. The awareness of these social security programs plays a vital role in their use.

Aims:

This research was conducted to evaluate the awareness among the rural population regarding government-initiated social security schemes and to provide recommendations based on the results of the study.

Settings and Design:

A community-based cross-sectional study was conducted in a rural health care center.

Methods and Material:

A sample of 250 individuals in the rural health care center of a dental college was subjected to a questionnaire regarding the awareness of the government-launched social security schemes—Sukanya Samridhi Yojana, Pradhan Mantri Suraksha Bima Yojana, Atal Pension Yojana, Pradhan Mantri Jeevan Jyoti Bima Yojana, Ayushman Bharat Yojana, and Pradhan Mantri Kisan Samman Nidhi Yojana.

Statistical Analysis Used:

The study data were analyzed by Epi Info™ 7 software package. Descriptive statistics were assessed and differences between the two groups were compared using the Chi-square test and the P value of < 0.05 was considered to be significant.

Results:

In the present study, 212 rural people were aware of any one of the recently initiated social security schemes, and the awareness level of these social security schemes was higher in those with age more than 30 years, males, literates, and classes 3 and 4 economic groups of population.

Conclusions:

The rural population’s knowledge of the government’s social security schemes is strong, and it is affected by people’s age, gender, literacy level, and socioeconomic status.
Prevalence and Risk Factors of Intestinal Parasitic Infection in Under-Five Children With Malnutrition: A Hospital Based Cross-Sectional Study
Authors: Deka Sangeeta , Kalita Deepjyoti , Hazarika Naba Kumar
Published: June 2022

ABSTRACT

Background:

Intestinal parasitic infections (IPIs) and malnutrition in under-five children contribute substantially to developing countries’ childhood morbidity and mortality. This study assessed the prevalence and profile of IPI in under-five children and compared them with nutritional status and other socioeconomic factors.

Methods:

Anthropometric indices were used for checking the nutritional status of under-five children. Malnutrition was graded into four grades (I–IV) based on the Indian Academy of Pediatrics advocated Weight-for-Age criteria. Children whose Height-for-Age and Weight-for-Height were <−2, standard deviations were regarded as stunted and wasted, respectively. Stool samples were examined by direct wet mount (normal saline and iodine) and formol-ethyl acetate concentration technique to detect parasitic cyst and ova. Stool smears were made directly from the specimen and after concentration and stained by kinyoun’s stain. Subsequently, the association of undernutrition was assessed with intestinal IPI using the Chi-square test.

Results:

The overall prevalence of Grade I, II, III, and IV malnutrition was 52%, 31.7%, 12.2%, and 4.1% while stunting and wasting IPIs were present in 60.2% and 36.6%, respectively. IPIs were present in 47.2%, and 11.4% showed polyparasitism. Soil-transmitted helminths were found to be the commonest (Ascaris lumbricoides: 21.1%; Trichuris trichiura: 13.0%; and hookworms: 8.1%) followed by the intestinal protozoa (Enterobius vermicularis: 7.3, Giardia lamblia: 6.5, and Cryptosporidium spp.: 2.4%). Increasing age upto 5 years, improper excreta disposal, low level of maternal education, and a higher number of childrenin the family were predictors of IPIs. The prevalence of IPI was significantly associated with Grade II and III undernutrition, stunting, and wasting. Individually, Ascaris and hookworms contributed significantly to stunting and cryptosporidium spp. to wasting.

Conclusion:

Prevalence of IPI in malnourished under-five children is high. Joint nutritional interventional strategies, early diagnosis/treatment of under-five children, and increased awareness among masses are imperative to break the vicious cycle of malnutrition and parasitic diseases.
Clinical profile of hemophilia B patients from Karnataka
Authors: Kulkarni Sujayendra , Hegde Rajat , Hegde Smita , Kulkarni Suyamindra S. , Hanagvadi Suresh , Das Kusal K. , Kolagi Sanjeev , Gai Pramod B. , Bulagouda Rudragouda S.
Published: June 2022

ABSTRACT

Background:

The most prevalent severe inherited hemorrhagic condition is hemophilia, which means “love of blood.” Hemophilia A and B are caused by a lack or malfunction of the factor VIII and factor IX proteins.

Objective:

The present study is to determine the prevalence and clinical profile of hereditary coagulation disorder, particularly hemophilia B, in Karnataka.

Methods:

The study comprised 150 HB patients with a mean age of 25, nmale = 148 and nfemale = 2. The samples were collected from hemophilia societies across Karnataka. The detailed history of HB patients was recorded in a predesigned Performa regarding family history, age, time of first bleed, site of the bleed, and bleeding history.

Result:

In our study cohort, the majority of the 58 (38.7%) cases belong to 21–30 years of age. The mean age of onset was 2.0 ± 1.0 years in severe, 7.5 ± 2.8 0 years in moderate, and 10.0 ± 3.5 years in mild HB patients. Out of 150 HB cases, 102 (68%) cases were diagnosed as severe, 30 (20%) as moderate, and 18 (12%) as mild. Mean factor IX levels were 0.6 ± 0.2, 2.5 ± 1.3, and 8.0 ± 2.6 in the severe, moderate, and mild group, respectively. A family history of bleeding was observed in 97 [64.7%] HB patients. Forty-seven (32.3%) HB patients had a history of consanguinity. The most common initial site of bleed was in joints in 86 [57.3%].

Conclusion:

The present study is one of the fewer studies from Karnataka studying the demographic and clinicopathological features of hemophilia B. Early diagnosis can be only helpful with knowledge of spectral presentation of hemophilia B in a local population.
Renal manifestations of COVID 19 in children
Authors: Mittal Aliza , Nadig Pallavi , Singh Kuldeep
Published: June 2022

ABSTRACT

Acute kidney injury (AKI) is an important factor affecting the outcome of hospitalized patients under any disease condition. While a lot has been said and studied about pulmonary manifestations of COVID-19 and multisystem inflammatory syndrome in children, this review focuses on its renal manifestations in children with and its complications. For the collection of data, the patient intervention control outcome model was applied to determine all eligible studies. The data was extracted using PubMed/Medline, Embase, and Google Scholar databases using a combination of keywords (AKI, renal failure, kidney disease, children, pediatric, covid-19, SARS COv2). Studies were reviewed after the exclusion of duplicates. The incidence of renal involvement in COVID 19 is up to 10–15%, which is higher than SARS. Both direct and indirect pathogenic mechanisms operate in patients with COVID 19 leading to varied manifestations. While AKI remains the most common manifestation in children admitted to intensive care units, other manifestations like, proteinuria, hematuria, rhabdomyolysis, and thrombotic microangiopathy have also been described in the literature. The children already on immunosuppression due to transplant or immune-mediated renal disorders do not seem to have more severe illness than those without it. The principles of management of AKI in COVID have not been different than other patient groups.
COVID-19 vaccination: Is it a matter of concern?
Authors: Kushwaha Poonam , Pundhir Ashish , Gahlot Anju
Published: June 2022

ABSTRACT

Background:

COVID-19 vaccination is still a matter of concern among the public since its inception. Primary care physicians being in prime position can share accurate and ample information about COVID-19 vaccination so we estimated proportion and determinants of adverse events following immunization (AEFI) with Covishield vaccine, vaccination and reasons of non-vaccination.

Methods:

A cross-sectional study was conducted from January to April 2021. Data collection was done by using data capture tool Epicollect-5. Regression analysis was performed to evaluate the association of AEFI and vaccine acceptance with various demographic variables.

Results:

Of 520 subjects, 408 got vaccinated, and of these 125 (30.6%) developed AEFI. Females without AEFI had lower median age than females having AEFI. Only religion (aOR = 5.311; 95% CI: 1. 216–23.1) was significantly associated with AEFI. Education (aOR = 0.399; 95% CI: 0. 199–0.799), marital status (aOR = 0.459; 95% CI: 0. 245–0.858), and religion (aOR = 3.874; 95% CI: 1. 96–7.648) were significantly associated with vaccination. Most common local AEFIs were inflammation (46; 36.8%) followed by lump (10; 8%) at the site of injection. Most common systemic AEFI were fever (87; 69.6%), feeling unwell (65; 52%), generalized weakness/fatigue (30; 20%), tiredness (26; 20.8%), flu-like symptoms (12; 9.6%), dizziness (10; 8%), headache (8; 6.4%) and gastrointestinal events (7; 5.6%).

Conclusion:

Most of the AEFI were mild and transient, resolved without any medical management. This study warrants active reporting of AEFI, public release of safety, and efficacy data. Primary care physicians can play a pivotal role by targeted awareness campaigns and trust-building activities to alleviate fear and anxiety related to vaccine.
The knowledge and attitude towards prostate cancer and screening practices among males in Saudi Arabia
Authors: Alothman Abdulrahman Musaad , Altamimi Alhanouf Fahad , Alhenaki Alanoud Waleed , Almansour Nouf Mohammed , Alhusaini Abdulrhman Khalid , Alateeq Fahad
Published: June 2022

ABSTRACT

Background:

Early-stage prostate cancer can be asymptomatic. The digital rectal exam (DRE) and the prostate specific antigen (PSA) test are usually used for prostate cancer screening. This study aims to assess knowledge and attitudes towards prostate cancer screening among males in Saudi Arabia.

Materials and Methods:

A cross-sectional study was conducted on Saudi males above the age of 40. A self-reported questionnaire was distributed online.

Results:

A total of 368 males completed the questionnaire. In the studied group, 64.5% had heard about prostate cancer through social media (46.7%), the internet (40.1%), or healthcare providers (18.6%). In addition, around 20.3% of the participants had heard about the PSA screening test. Moreover, 55.2% of participants had an inadequate level of knowledge about prostate cancer and the PSA test, while 53.1% had a negative attitude.

Conclusion:

There was a poor level of knowledge and attitude towards screening for prostate cancer among males in Saudi Arabia. This could be due to the lack of education on the risks of prostate cancer by healthcare providers.
Risk stratification and in-hospital outcome in patients with acute coronary syndrome
Authors: Bhalerao Amitkumar V. , Tahir Sheikh Mohamad , Agarwal Rajiv
Published: June 2022

ABSTRACT

Background:

Death and morbidity are caused by coronary artery disease (CAD) and acute coronary syndrome (ACS), which include ST-elevation myocardial infarction (STEMI) and unstable angina (UA), are the most common causes of death among those with CAD. The aim of the study was to define the demographic profile of patients with ACS in a tertiary care center, to identify risk factors in the profile of patients with ACS, to learn about the management of ACS in tertiary health care centers, and to estimate in-hospital outcomes in ACS patients at a tertiary health care center.

Methods:

The study was carried out in the Cardiology Department of Batra hospital and Medical Research Center, New Delhi, India. The Research Ethics Committee of the Hospital reviewed and approved the study protocol.

Data Collected Included:

Sociodemographic data, anthropometric data, clinical history, significant past medical history, medications, current clinical status of the patient, and investigations including electrocardiogram (ECG), electrocardiogram (ECHO), and coronary artery graft.

Results:

Age groups and type of ACS were having a statistically significant association (p = 0.04). A majority of patients with ACS were seen in the 55–74 years age group. Tobacco abuse was more common in STEMI patients as compared to other types of ACS. There was significant variation between risk stratification of ACS patients by Thrombolysis in Myocardial Infarction and Global Registry of Acute Cardiac Events scores. Single vessel disease (SVD) patients dominated both the STEMI [26 (50.9%)] and UA [13 (52%)] groups. There was a highly significant association between a specific line of treatment and type of ACS (p < 0.0001). A majority of patients underwent percutaneous intervention (69% of 100). Coronary artery bypass graft (CABG) was done in five (5/100) patients only. Thrombolysis was advocated in three (5.7%) patients with Streptokinase (SK) and two patients with Tenecteplase (TNK).

Conclusion:

There was a marked preponderance of STEMI in younger patients but it was less marked in older patients, according to the study. All conventional risk factors were represented in all types of ACS but hypertension and tobacco abuse were more consistent risk factors associated with STEMI.