bluuebunny/crossref_metadata_2025 huggingface dataset:
Quality of life of workers with disabilities in readymade garments factories in Bangladesh
Authors: Rahman Md. Habibur , Habibur Rahman Mohammad , Akter Kakuli Samena , Kabir Md. Feroz , Moniruzzaman Sk. , Hossain Md. Sazzad , Subahan Sanjida
Published: April 2023

Background: Bangladesh's readymade garment (RMG) sector has developed as a major employer for individuals with disabilities. The number of workers with disabilities in Bangladesh's RMG industry has grown over the past few years. In Bangladesh, there has no statistics about the quality of life of workers with disabilities after their employment, especially after training-based employment support. Therefore, the researcher is interested to find out the quality of life of workers with disabilities in readymade garments factories in Bangladesh that will determine satisfaction over their life in different aspects. The objectives of this paper were to find out the health-related quality of life and overall satisfaction with life among workers with disabilities in the readymade garment sector in Bangladesh.
Methods: This study used a cross-sectional design and recruited 102 participants with disabilities from various Bangladeshi garment factories who ranged up to 18 years by convenient sampling. The WHOQOL questionnaires were used for data collection through a combination of telephone and in-person interviews. Descriptive statistics were used for the data analysis.
Results: Among the total participants 63% of them were women and 37% were men. The results revealed that education and job status significantly impacted on QOL. The majority of participants did not need any assistive devices; most of the participants resided in semi-urban areas, and physical disabilities predominated among them. On the other hand, most of the participants reported their quality of life as neither poor nor good but they were satisfied with health-related QOL.
Conclusions: QOL is a vast aspect of every human being. This study finally concluded the overall QOL of maximum Workers with Disabilities in Readymade Garments Factories in Bangladesh was just average and most of them were satisfied with their health-related QOL.
COVID-19 infection and vaccine status in patients with chronic kidney diseases
Authors: Haider M. Shafiul , Arjumand Marina , Mahtab Ul Islam Syed , Abdul Aziz N. M. , Mahmud M. Hasan
Published: April 2023

Background: The COVID-19 virus has had a great effect globally, changing many commonalities. The incidence of COVID-19 had weakened the immune system, leading to more severe outcomes of various common diseases. Since its early development, the vaccination of COVID-19 has also had mixed responses. The aim of the study was to observe the incidence rate of COVID-19 infection and vaccination status among chronic kidney disease patients.
Methods: In this study 50 (27 male and 23 female) adult skulls were investigated to determine the type of asterion, its distance from important bony landmarks and also the nearby venous sinuses were measured.
Results: Majority (41.61%) of the participants had been between the ages of 41-55 years old, and 64.84% male prevalence was observed. 60.65% of the participants had been from rural areas. A large portion of the participants (38.06%) did not have any comorbidities, while multiple comorbidities were present among many of the remaining participants. Hypertension was the most common comorbidity, observed in 56.45% of the participants. 72.26% of the present study participants had been asymptomatic, while 13.23% had a fever as their symptom of COVID-19. COVID-19 test was done on 81 patients, among whom 64 had tested positive. Among the total 310 participants, 29.03% had not received any vaccinations, while 14.19% had received only 1st dose of vaccination, 47.2% had received up to their 2nd dose, and 9.35% had received their booster dose.
Conclusions: The present study observed a low incidence rate of COVID-19 positive patients among those affected by chronic kidney disease. However, the study also observed a significant positive relation between COVID-19 positive patients and the need for additional medical support, leading to the conclusion that COVID-19 can significantly affect the severity of CKD.
Application of the laboratory risk indicator for necrotizing fasciitis score for patients with hand infection in Mexican population
Authors: Pacheco López Ricardo C. , Morales Hecly L. Vázquez , Hernández Ordoñez Rubén , Mejorada Roberto Martínez , González Gabriel García , Rojas-Ortiz Jorge A.
Published: April 2023

Background: Necrotizing fasciitis (NF) is a severe form of soft tissue infection, early diagnosis, and surgical intervention are direct factors in mortality, it may arise from many infectious aetiologies, at our hospital in Mexico city, it is not uncommon that hand infection patients progress to NF, that in many cases its recognition and treatment may also be delayed, resulting in fatal outcomes. Wong et al in 2004 introduced a laboratory risk indicator for necrotizing fasciitis (LRINEC score) that utilizes common laboratory values of patients with clinical infection and stratifies them by their risk of developing NF, so the aim of our study was to validate this tool in Mexican population.
Methods: We reviewed all patients with an initial diagnosis of hand infection admitted at the emergency department of our hospital in Mexico City, from April 2020 to March 2022 and examined the LRINEC score at admission, post-debridement, and at the end of the hospitalization to evaluate its usefulness in our population.
Results: The LRINEC score at cut-off ≥6 reported sensitivity for the diagnosis of NF of 35.71% (95% CI 12.76-64.86%), specificity of 100% (95% CI 78.2-100%), positive predictive value of 100% (95% CI 71-100%), and negative predictive value of 62.5% (95% CI 53.01-71.12%).
Conclusions: The LRINEC score is a useful tool to distinguish NF from other soft tissue infections, but it is not helpful for early recognition of NF alone, LRINEC score could predict worse hospital outcomes in patients with NF and identify the high-risk patients.
Effects of Englerina drummondii Balle ex Polhill and Wiens leaves extract on selected female rat organs’ weights
Authors: Gbaranor Barinua K. , Kinako Sam E. , Mube Williams A. , Tamuno-Opubo Abiye , Kue David S. , Lebara Lewis B. , Sekiita Kianen , Famba D. Famba , Ile Vivian , Nwosu Gloria N. , Amadi Ijeoma N. , Ajumoke Onita O. , Edward Ucheawaji F. , Horsfall Faithwin , Nmehielle-Oluwadare Ihundah , Amadi-Ikpa Henry A. , Berepele Rehan O.
Published: April 2023

Background: Herbal medicine are patronized by several people across the globe This herbal medicine is routinely use and are more accessible and available. This study aimed to investigate the effects of Englerina drummondii Balle ex Polhill and Wiens leaves on rat organs (thyroid gland, kidneys, ovary and fallopian tubes) weights in female rats.
Methods: 20 female rats were selected randomly into 4 groups with 5 rats per group. Group 1 received 5 ml/kg of water, group 2 received extract 100 mg/kg, group 3 received extract 200 mg/kg, and group 4 received extract 400 mg/kg. Administration of extract was done for 28 days.
Results: The study revealed significance decreased in the weight of the left ovary organ when extract of medium dose (200 mg/kg) and high dose (400 mg/kg) was administered, as compared to control. The result also shows decrease in the organs weight of the thyroid gland, left kidney, right and left fallopian tubes extract of low, medium and high dose were administered. The right kidney shows increase when low dose extract was given but decrease when both low and medium dose of extract was given. However, this decrease is not significance and could be due to dose or time dependent. Statistical analysis was done using statistical package for the social sciences (SPSS) version 23 and p<0.05 was significant.
Conclusions: There was significance decreased in the weight of the left ovary organ when extract of medium dose (200 mg/kg) and high dose (400 mg/kg) was administered. Also, there is decrease in other organs weight when low, medium and high dose was given but not significance.
Short term effects on liver and renal functions following chemotherapy treatment for breast cancer patients in oncology clinic, university hospital Kotelawala Defence University in Sri Lanka
Authors: Siriwardana E. P. E. D. Z. , Rathnayake R. M. U. M. , Himasha B. U. S. , Weerakoon D. C. R. , Malaviarachchi S. L. , Jayasekara J. M. K. B.
Published: April 2023

Background: Breast cancer tops the global cancer incidence rates, having the highest rate of death among women. The primary objective of this study was to assess the impact of standard chemotherapy treatment dose adjusted for the Sri Lankan population, on hepatic and kidney function of breast cancer patients.
Methods: The study conducted a cross-sectional, retrospective and prospective analysis of 75 breast cancer patients who received doxorubicin, cyclophosphamide, and paclitaxel chemotherapy regimen with normal liver and renal function at baseline at UHKDU oncology clinic. The study population had a mean age and BMI of 54.04±11.33 years and 26.7±3.89, respectively. Prior to starting the 16-cycle chemotherapy treatment, mean serum SGOT, SGPT, Creatinine, and eGFR values were 27.57 U/l, 31.32 U/l, 0.71 mg/dl, and 99.07 ml/minute/1.73 m2 respectively.
Results: During the treatment, there was a statistically significant increase in the mean values of SGOT and SGPT (p<0.05), whereas there was no significant variation in the mean values of creatinine and eGFR (p>0.05) compared to the baseline results. The study identified a significant positive correlation in SGOT (r=0.793) and SGPT (r=0.872) values, while there was a noteworthy negative correlation (r=-0.757) between eGFR and chemotherapy cycle. Furthermore, there was a positive significant correlation between serum creatinine levels and chemotherapy cycle (r=0.579).
Conclusions: The dosed adjusted chemotherapy regimen had a significant impact on hepatic function but had no statistically significant impact on renal function among the study population. Further research is recommended to evaluate the long-term effects of standard chemotherapy treatment on liver and kidney functions.
Pattern of bacterial infection in acute exacerbation of bronchiectasis according to the lobar distribution
Authors: Chandra Paul Shipan , Sarkar Gopal Chandra , Kumar Paul Susanta , Chakrabortty Rajashish , Ahmed Shamim , Rahman Mohammed Atiqur
Published: April 2023

Background: The pattern of bacterial infection in acute exacerbation of bronchiectasis is varied with geographical area and lobar distribution of bronchiectasis. The exact pattern of bacterial infection in acute exacerbation of bronchiectasis according to lobar distribution is not known in our country. This study aimed to investigate the pattern of bacterial infection in acute exacerbation of bronchiectasis according to lobar distribution.
Methods: A total of eighty-four patients diagnosed with acute exacerbation of bronchiectasis were included in this cross-sectional study in the department of respiratory medicine, Bangabandhu Sheikh Mujib Medical University. Sputum culture and real-time polymerase chain reaction were used to characterize the bacterial profile and high-resolution computed tomography scans for the location of the bronchiectasis. Before enrolment, informed written consent was obtained from the participants.
Results: The mean (SD) age of this study population was 47.89 (±14.95) years, 29.8% were female and 60.7% were a non-smoker. Bronchiectasis was more common in the right middle lobe (63.1%), followed by the right lower lobe (44%), and the left lower lobe (42%). Bacteria were isolated in 66% of patients and Gram-negative bacteria were predominant (78.6%). Pseudomonas aeruginosa (25%) and Klebsiella pneumoniae (17.9%) were the most common bacteria.
Conclusions: Pseudomonas aeruginosa was identified predominantly in the right upper lobe, right middle lobe, left upper lobe, and bilateral upper lobe and Klebsiella pneumoniae was in the right lower lobe, left lower lobe, and bilateral lower lobe.
Epidemiology of fractures of the humerus at the university college hospital Ibadan
Authors: Ogunrewo Tolulope O. , Balogun Mosi J. , Oyewole Olugboyega A. , Omoyeni Richard A. , Adekiunle Noroudeen
Published: April 2023

Background: The humerus is one of the long bones of the upper limb. It may be fractured following traumatic or non-traumatic injury. Humeral shaft fractures account for 1-3% of all fractures. However supracondylar fracture of the humerus is more common amongst children accounting for about 16% of all pediatric fractures. Trauma especially from falls especially in both children and geriatric populations has been known to cause humeral fractures. Other causes had been documented also. This study was aimed at determining the incidence, cause and pattern of humeral fracture in patients who presented to the accident and emergency department of the University College Hospital, Ibadan, Oyo state, Nigeria.
Methods: Patients with radiologically confirmed humeral fractures who presented to the accident and emergency department of the hospital between January 2015 and December 2019 were included in the study. Data was obtained from the electronically stored data at the department of orthopedic surgery and trauma university college hospital Ibadan using a proforma and the data generated was analyzed using Statistical Package for the Social Sciences version 16.
Results: A total of 167 patients with humeral fractures were seen during the study period. Most of these patients are within the age range of 0-15 years. Male to female ratio was 1.7:1. Most humeral fractures were due to fall and the distal humerus was most commonly affected.
Conclusions: Humeral fractures occur in younger people and efforts should be geared towards preventing this trend in younger population.
Clinical profile and outcome of diabetic foot ulcers
Authors: Boopathy D. , Asokan P. K. , Yeshwanth T. R.
Published: April 2023

Background: Diabetes mellitus is a common metabolic endocrine disorder, once prevalent in developed countries has become the leading ‘global epidemic’. WHO estimated that in the year 2000. Roughly 3% of the total world population had Diabetes. In India around 61million of general population affected in 2011 which may rise to 101 million by 2030. The aim of the study was to study the clinical profile and outcome of diabetic foot ulcers. The clinical profile of 120 patients with diabetic foot ulcer was studied.  
Methods: Patients with diabetic foot ulcer of both genders with age above 30 years willing to participate were included in the study. All patients were subjected to routine diabetic work up with Doppler study and X-ray foot to rule out bone involvement.
Results: The majority of patients with diabetic foot ulcers were of age group 51 to 60 years, male predominant, 84 patients out of 120 isolated included for study, 24 (28.6%) isolates had Klebsiella, 46(54.8%) isolates Pseudomonas, 14 (16.7%) isolates has E.coli.
Conclusions: Our study gives important information that diabetic foot ulcer is more common among middle-aged people with male predominance which gives the importance of screening diabetic patients for neuropathy and peripheral vascular disease.
Association of plasma fibrinogen and development of complications in type 2 diabetes mellitus
Authors: Patel Het V. , Sumple Rajesh S. , Harshitha K. Pooja , R. Sumple Kshitij
Published: April 2023

Background: Fibrinogen is a glycoprotein produced by the liver that plays a crucial role in blood clotting. Elevated levels of fibrinogen have been associated with an increased risk of cardio vascular disease, stroke and other chronic conditions. Several studies have investigated the relationship between fibrinogen and diabetes mellitus. Furthermore, fibrinogen has been suggested to play a role in pathogenesis of diabetes and its complications by promoting inflammation and endothelial dysfunction. The aim of the study was done to study association of fibrinogen levels and development of complications of diabetes mellitus.
Methods: A cross sectional observational study was conducted at medicine department of Dhiraj Hospital, Vadodara. Total of 114 diabetes mellitus patients were studied. The level of fibrinogen as well as presence of various risk factors like smoking, hypertension, obesity, dyslipidemia and different microvascular and macro-vascular complications were assessed. There were no conflict of interest.
Results: Of 114 patients smoking, overweight, hypertension, uncontrolled diabetes and dyslipidemia was reported in 54.4%, 30.7%, 41.2%, 28.1% and 60.5% respectively. Microvascular complication like retinopathy, nephropathy and neuropathy was reported in 34.2%, 40.4% and 21.1% patients respectively. Macrovascular complications like coronary artery disease and stroke was reported in 20.2% and 16.7% patients respectively. Average level of fibrinogen was found higher amongst diabetic patients with microvascular as well as macrovascular complications.
Conclusions: Serum fibrinogen level was found to be higher among patients with poor glycemic control, dyslipidemia, hypertension and higher BMI. A positive correlation was found between the level of fibrinogen and various complications of diabetes mellitus.
Respiratory index of severity in children score for assessment of severity in pediatric pneumonia- a hospital-based study
Authors: Verma Ekta , Das Indira , Das Anupam
Published: April 2023

Background: This hospital-based study aimed to evaluate the respiratory index of severity in children (RISC) score’s performance in predicting severity and mortality risk in pediatric pneumonia patients in a developing nation.
Methods: The study included 200 children under 5 years of age who were admitted to the ward and pediatric intensive care unit (PICU) and did not have documented congenital heart disease, chronic respiratory illness, congenital lung problems, immunosuppressive conditions, or known neuromuscular disorder with respiratory system involvement. The RISC score was determined, and its correlation with chest x-ray score, mortality, and PICU admission was calculated for assessing the severity of pneumonia.
Results: The study found that the RISC score is a potentially useful tool for predicting severity and mortality risk in pediatric pneumonia patients.
Conclusions: The findings may contribute to the development of more accurate and reliable scoring systems to guide appropriate treatment and improve outcomes in pediatric pneumonia patients.
Evaluation of appropriateness of packed red blood cell and fresh frozen plasma transfusion in post-surgical adult patients admitted in ICU and its outcome: a retrospective study in a tertiary care hospital
Authors: Sahai Ankit , Verma Anil Kumar , Sheikh Firoz , Krishnani Chandni
Published: April 2023

Background: The objective of this study was to evaluate appropriateness of packed red blood cell (PRBC) and fresh frozen plasma transfusion (FFP) in post-surgical adult patients admitted in ICU and its outcome.
Methods: A total number of 800 ICU adult patients were enrolled. Out of these 600 patients received PRBC transfusion and 200 received FFP transfusions. Transfusion pattern was analyzed with respect to the number of units transfused, pre and post transfusion hemoglobin levels and coagulation profile. The outcome was measured in terms of mortality, morbidity and length of ICU stay. Transfusions were categorized into appropriate and inappropriate based on transfusion triggers used as per BSH guidelines (British Society for Hematology). The SPSS software was used for analyses.
Results: Out of six hundred, 384 were those with appropriate red cell transfusion. In the appropriate transfusion group, majority i.e. 167 (43.49%) underwent more units of PRBC transfusion. The mean duration of mechanical ventilation in appropriate group was 7.43±4.1 days and in inappropriate group was 5.95±3.34 days. (p<0.05). There was significant association found between the high mortality and appropriateness of blood transfusion. Out of 200, One hundred and thirty-seven (137) were those with appropriate FFP transfusion. Majority of the patients underwent two units of FFP transfusion (47%). The mean change in aPTT and INR was comparable in both the groups (p>0.05).
Conclusions: Analysis of appropriateness of transfusion according to BSH guidelines shows a high rate of irrational transfusions in Indian subjects. Further studies including large sample size are needed in this context.
Morphometric study of mandibular foramen and its clinical significance in inferior alveolar nerve block
Authors: Insha Syed Insha , Fatima Kaneez , Shahdad Shaheen , Bhat G. M.
Published: April 2023

Background: This study was done to determine the precise location of the mandibular foramen so as to lower down the percentage of the failure of the attainment of the anaesthesia of the inferior alveolar nerve during dental procedures.
Methods: In this cross sectional study a total of 50 dry human mandibles were examined. The measurements were taken from the anterior border of the ramus (coronoid notch) to the midportion of the MF (mandibular foramen) and from the midportion of the mandibular foramen to other landmarks such as posterior border of ramus, from inferior limit of MF to inferior border of ramus and the midpoint on symphysis menti.
Results: The comparison of data was done using student’s t-test. The mandibular foramen was positioned at a mean distance of 18.26 mm (with a standard deviation of 1.77) from the anterior border of the ramus. The mean distance from posterior border of the ramus to the mid point of mandibular foramen was 13.5 mm with a SD of 2.16.
Conclusions: The present study gives a fair knowledge of the position of mandibular foramen and provides information for successful local anesthesia of inferior nerve block to maxillofacial surgeons, ENT surgeons and onco-surgeons.
Morphologic patterns of nodal reactive hyperplasia in primary organ malignancy-architectural changes and evaluation by comparison with other morphological parameters
Authors: Singh Preeti , Singh Neha , Jaiswal Vijay Kumar , Verma Nidhi
Published: April 2023

Background: Reactive lymph node hyperplasia can exhibit morphological patterns I to VI. This study was done to evaluate lymph node hyperplasia, lymph node reactive patterns, lymph node metastasis and correlation with tumour stage, lymph node patterns and lymph node size.
Methods: Total 454 lymph nodes were reviewed for metastases and reactivity patterns I to VI as per the World Health Organization (WHO) protocol. Association between qualitative variables was assessed by the chi-square test and Fisher’s exact test, those between quantitative variables using unpaired t-test.
Results: Lymph node hyperplasia was highest in breast and commonest lymph node reactive patterns were lymphocyte predominance, germinal centre predominance, sinus histiocytosis and mixed patterns.
Conclusions: Lymph node hyperplasia and lymph node reactive patterns show organ-wise variation and need standardisation. Most common lymph node reactive patterns included lymphocyte predominance and germinal centre predominance hyperplasia. Studying lymph node reactivity may help to understand host immune reaction against the tumour and thus influence prognosis.
Vitamin D and sleep duration: a possible link
Authors: Singh Sonia
Published: April 2023

Background: Normal-range sleep duration is an important factor for general health and metabolism. Insufficient or excessive sleep duration is associated with various chronic physical or mental illness, such as obesity, hypertension, diabetes, metabolic syndrome, depression, and other psychiatric diseases. Sleep duration is mainly affected by circadian rhythm, and circadian rhythm is affected by the melatonin level controlled by the light exposure. Therefore, sun exposure has an important role for determining sleep time. Aim and objective was to find an association between self-reported sleep duration with serum vitamin D levels in healthy adults.
Methods: A cross sectional study was carried out on 150 first professional MBBS students. They were asked about their sleep duration via a questionnaire and their morning samples of serum vitamin D was taken. All the data was put in SPSS software and analyzed.
Results: There was a definite positive correlation between sleep duration and the concentration of 25(OH)D in this study (r=0.11, p<0.05).
Conclusions: The present study revealed that vitamin D [25(OH)D] deficiency was an independent predictor of insufficient sleep among healthy adults.
Association of serum estrogen and melatonin levels with bone mineral density of post-menopausal women- a case-control study
Authors: Sadadiwala Mehul Hitesh , Sadadiwala Ashna
Published: April 2023

Background: A skeleton is a metabolically active organ that constantly undergoes remodelling throughout life. Various factors influence the process of bone formation and resorption. Menopause is a crucial stage in a woman’s life and a female’s body undergoes many significant changes during this stage. Hormone-related changes occur not only due to menopause but also due to aging; the two crucial hormones we emphasized in our study are- estrogen and melatonin; and their manifestation in the skeletal system of a postmenopausal population.
Methods: Our study consisted of 48 post-menopausal females, 24 subjects in the case group, and 24 in the control groups, to study the differences in certain parameters existing between the two. Serum estrogen and melatonin were calculated using the ELISA test; bone mineral density (BMD) was evaluated using a portable ultrasound bone densitometer testing machine.
Results: The factors (estrogen and melatonin) have a direct strong linear relation with BMD. Pearson correlation coefficient was found to be positive (r) 0.92, indicating a strong correlation. The ‘goodness of fit’ (r2) of multiple linear regression was found to be 0.8485 (roundabout 85%), indicating strong positive results.
Conclusions: The results of our study exhibited strong interdependence of BMD on serum estrogen and melatonin. Osteopenic subjects who had a lower BMD were also found to have relatively lesser levels of serum estrogen and melatonin. Aligning with the results, similarly, the control group with normal BMD was found to have relatively higher serum levels of both hormones.
Extended sick neonatal score in prediction of mortality of out born neonates: a hospital-based study
Authors: Jamoh Yabom , Begum Rukeya
Published: April 2023

Background: A prospective observational study was conducted in Barpeta, India to evaluate the utility of the Extended Sick Neonatal Score (ESNS) in predicting in-hospital mortality of outborn neonates.
Methods: Purposive sampling was used to select a sample size of 200 neonates who were assessed upon arrival at the neonatal unit emergency. The babies were followed up till discharge or death and given scores based on ESNS. A score of ≤11 for all term babies and a score of ≤12 for preterm neonates were found to best predict mortality.
Results: Among the 16 total deaths, 12 occurred among full-term neonates, while 4 occurred among preterm neonates. Birth asphyxia was the leading indication of neonatal mortality. ESNS can predict ‘in-hospital mortality’ outcome with satisfactory sensitivity and specificity. For term babies, ESNS of ≤11 had the best sensitivity (93.48%) and specificity (80.92%), AUC (95% CI) was 0.845 (0.772 to 0.902) and for preterms, ESNS ≤12 had the best sensitivity (92.57%) and specificity (79.48%), AUC (95% CI) was 0.729 (0.609 to 0.829).
Conclusions: ESNS can predict ‘in-hospital mortality’ outcome with satisfactory sensitivity and specificity. It has the advantage of being easy to score with minimal resources in both term and preterm neonates when applied early during the course of hospitalization. It could also be a tool to compare performance of SNCUs.
Study of relationship between serum magnesium and carotid atherosclerosis in hemodialysis versus non-hemodialysis dependent CKD patients
Authors: Gulati Yuvraj , Rastogi Ishita , Giri Richa
Published: April 2023

Background: Cardiovascular diseases are the most important causes of morbidity and mortality in CKD mainly due to accelerated atherosclerosis. Mg2+ possesses an anti-atherosclerotic effect, because of its anti-inflammatory and antioxidant properties. Mg2+ deficiency promotes hydroxyapatite formation and calcification of VSMC thus leading to accelerated plaque formation. To evaluate relationship between serum Mg2+ level and atherosclerotic changes in CKD patients who are hemodialysis dependent versus who have not undergone hemodialysis.
Methods: This hospital based observational cross-sectional study has been carried out in Department of K.P.S Institute of Medicine, GSVM Medical College, Kanpur.58 subjects (29 being dialysis dependent and other 29 who have not undergone dialysis sessions yet. All the subjects underwent routine tests and intima media thickness (IMT) of carotid artery was measured via Doppler study.
Results: In our study the mean value of Mg was 2.25 mg/dl + 0.81 with 17 patients had hypomagnesemia. IMT of carotid artery with a mean value of 0.91mm + 0.24, was found to be increased in 16 patients, these were the patients who were on hemodialysis and had lower magnesium levels. Serum Mg2+ was negatively correlated (Pearson correlation coefficient was -0.677 and -0.704) with CIMT with statistical significance as (P<0.001) , only in patients who have underwent series of hemodialysis sessions.
Conclusions: We concluded that serum Mg might be considered as a modifiable risk factor of atherosclerosis (and thus, cardiovascular mortality) in Hemodialysis dependent CKD patients.
Outcomes of usage of polypropylene mesh in TAPP hernia repair
Authors: Kumar Amit , Malik Adeel Ahmed , Singh Gurbir , Bhat Agnishikha
Published: April 2023

Background: Repair of hernia has seen a paradigm shift from open technique to laparoscopic technique. Laparoscopic transabdominal preperitoneal mesh hernioplasty is the latest technique with several advantages over open repair. Polypropylene (PP) mesh is the most frequently preferred product, as are easily and cheaply available, provide enough strength for the technique with good biocompatibility and less tissue reaction. Objective was to study the outcome of usage of polypropylene mesh in TAPP hernia repair.
Methods: It was a prospective study on patients with diagnosis of inguinal hernia and underwent TAPP hernia repair with polypropylene mesh.
Results: Total of 60 patients were included. Majority of the patients (18; 30%) were in age groups of 46-55 years and 56-65 years. 67% cases of inguinal hernia were of indirect type, 30% direct type and 3% both direct and indirect. Right-sided inguinal hernia (57%) was more frequent, followed by left sided (23%) and bilateral (20%). Average time taken was 72 to 98 minutes with a mean of 81.33 minutes in the surgery for unilateral repair and 90 to 103 minutes with a mean of 97.66 minutes for bilateral repair. 40 (67%) patients returned to work within 2 weeks of surgery.
Conclusions: Inguinal hernia repair is a common surgical procedure performed on daily basis around the world. Delay in treatment can lead to complications. Laparoscopic approach has shown clear advantages regarding less postoperative pain, numbness, fast return to normal activities and decrease in the incidence of wound infection and hematoma. Polypropylene has proven physical, chemical and biological properties and is currently the most widely used allograft in laparoscopic inguinal hernias.
COVID-19 associated mucormycosis and COVID-19 vaccination status
Authors: Godse Ashwini , Raj Shivalingaiah Pruthvi , Mujahid Zaaraasmat Ahesannawaz , Kalyanapura Gurumurthy Manjula , Elachola Yumna Beegum , Johnson Jewel Christy
Published: April 2023

Background: Mucormycosis is lethal angio invasive fungal infection affecting mainly the immunocompromised individuals. During second wave of COVID-19 pandemic there was rise in number of rhino-orbito-cerebral (ROCM) cases in both COVID-19 affected patients and patients who recovered from COVID-19 infection. This study was conducted to know the anatomical site and extent of involvement in head and neck region in both COVID-19 vaccinated and unvaccinated individuals.
Methods: A retrospective descriptive study was conducted between May 2021 and November 2021 at Bowring and lady Curzon hospital, Shri Atal Bihari Vajpayee medical college and research institute, Bangalore, Karnataka, India. 358 patients with post-covid RTPCR negative rhino-orbital mucormycosis were included in the study. The demographic data, COVID-19 vaccination status and anatomical sites of involvement in the patients was collected and analysed.
Results: 4 (1.11%) patients were fully vaccinated with 2 doses of covid vaccine, 18 (5.02%) patients were partially vaccinated, 336 (93.85%) were unvaccinated.  Majority of the patients were in the age group of 41-60 years in all the groups. In unvaccinated group, majority of the patients presented with stage II/III disease (48.51%; 39.88% respectively) and 39 (11.60%) patients with stage IV ROCM.
Conclusions: The extent and severity of ROCM was higher in COVID-19 unvaccinated patients as compared to vaccinated group. Further studies are required to determine the role of COVID-19 vaccine in reducing the severity of the of ROCM.
Efficacy of nasal irrigation of normal saline as compared to budesonide following functional endoscopic sinus surgery
Authors: Anjum Areena , Majeed Farkhanda , Mir Shahid A. , Kalsotra Parmod , Showket Zuha
Published: April 2023

Background: Nasal irrigation following Functional endoscopic sinus surgery (FESS) appears to be a nearly universal recommendation. FESS significantly improves the symptoms of the CRS (Chronic rhino sinusitis) and the postoperative endoscopy scores. The primarily objective of our study was to study the efficacy of nasal irrigation of normal saline as compared to budesonide following functional endoscopic sinus surgery.
Methods: A total of 100 patients who underwent functional endoscopic sinus surgery were randomly divided into two groups on the basis of computerized generated random table with 50 patients in each group. In group 1 normal saline was used where as in group 2 budesonide solution was used for nasal douching. Post-operative evaluation was done using Lund Kennedy Endoscopic scoring (LKES) at the 7th and 30th postoperative day.
Results: On 7th postoperative day, we found that none of our patient in the study groups had polypoidal change. There was decrease in scores of polyposis, discharge mucosal edema, scaring and crusting in both the groups. However, the reduction of discharge in the budesonide group was more significantly decreased than normal saline group (p value<0.05). We also noted that  on 30th postoperative edema, scarring and crusting was significantly decreased in budesonide group as compared to normal saline group (p value <0.05).
Conclusions: We concluded that the addition of budesonide in nasal irrigation resulted in improved scores of polyposis, discharge, mucosal edema, crusting and scarring and total score of LKES than normal saline alone.
The prevalence of pruritus gravidarum and its relation with intrahepatic cholestasis of pregnancy
Authors: Choudhary Leena , Kaur Amrit Pal , Kaur Tejinder , Kaur Kiranjeet
Published: April 2023

Background: Pruritus is a common complaint amongst pregnant woman, affecting 20% of them. This can be physiological or due to some specific dermatological conditions. Among them Intrahepatic cholestasis of pregnancy is most common cause and is characterized by pruritus with derranged liver enzymes and raised serum bile acid levels in the absence of any other liver pathology. It is associated with increased fetomaternal morbidity.
Methods: This was a prospective study, conducted at Bebe Nanki Mother and Child Care Centre, Government Medical College, Amritsar in the Department of Obstetrics and Gynaecology with collaboration of Dermatology Department, from March 2021 to Aug 2022. After taking ethical approval, informed consent, detailed history, clinical and biochemical assessment was done and fetomaternal outcome was recorded.
Results: Prevalance of pruritus was 20.8% amongst pregnant women, of which 24% patients were diagnosed having intrahepatic cholestasis of pregnancy (ICP) and 76% were labelled as NON ICP patients. Among NON ICP patients prevalence of pruritic urticarial papules and plaques of pregnancy was 32.10%. Majority intrahepatic cholestasis of pregnancy patients had moderately affected quality of life. Majority of pruritic patients had normal bilirubin levels and all intrahepatic cholestasis of pregnancy patients had raised serum Alanine transaminase, Aspartate transaminase, bile acids values. Meconium stained liquor, preterm delivery, Low birth weight, cesarean rates, NICU admissions rates were higher in intrahepatic cholestasis of pregnancy patients.
Conclusions: Pruritus in pregnancy is a common condition. Dermatological opinion along with liver function tests should be done to know about the cause and severity of pruritus. Intrahepatic cholestasis of pregnancy (ICP) affects perinatal outcomes. So patients should be closely monitored to improve the fetomaternal outcome.
Study and analysis of maternal serum alpha-fetoprotein levels as a biomarker of placental adherence in low lying placenta
Authors: Kaur Jashanjot , Kaur Amrit Pal , Kaur Sukhraj , Sidhu Harjot Kaur
Published: April 2023

Background: The objective was to study and analyze maternal serum alpha-fetoprotein levels as a biomarker of placental adherence in low lying placenta.
Methods: This was a prospective observational study analysing the conditions and the data of 80 cases with low lying placenta in a tertiary care hospital. The analysis was done for the association of MSAFP with MRI, perinatal and maternal outcome.
Results: The level of MSAFP was found higher in 12 out of 13 cases (93.3%) of placenta previa with placental adherence. There was significant surgical intervention (80%) and increased maternal morbidity (68.8%) in the study group with placental adherence and raised MSAFP respectively.
Conclusions: MSAFP is an important biomarker for prognostication of placental adherence in low lying placenta.
Incidence of steroid-induced diabetes mellitus among in-patients treated for COVID-19 infection in tertiary care centre
Authors: R. M. Suresh , T. M. Abhishek , P. Girish , V. Anjali , K. Venugopal
Published: April 2023

Background: Glucocorticoids are one of the most effective lifesaving treatments for severe COVID-19 infection. The aim of this study was to review the incidence of glucocorticoid-induced diabetes and its associated risk factors in COVID-19 patients.
Methods: This was a retrospective cohort study, Hassan institute of medical sciences, Hassan, Karnataka, from 1st July 2020 to 31st December 2021. Data were collected from the medical record department of all RTPCR/RAT-positive cases of COVID-19 patients admitted and treated for COVID-19, with a sample size of 521 patients.
Results: In the present study of 521 patients with COVID-19 who received glucocorticoid therapy, 72 (13.8%) of the patients experienced GI-DM. In our series of 521 patients treated with steroid for respiratory diseases, old age and chronic smoking was an independent risk factor for GI-DM. Glucose tolerance declines progressively with age, resulting in a high incidence of type 2 diabetes and impaired glucose tolerance in the old population.
Conclusions: In conclusion, this study found that 13.8% of in-patients treated for COVID-19 infection in a tertiary care centre developed GI-DM. The incidence of GI-DM was higher among patients who were older, had a history of smoking, and had hyperlipidaemia or malignancy. The study highlights the importance of monitoring blood glucose levels in patients receiving steroids for the treatment of COVID-19. Additionally, the results suggest that patients with certain risk factors may benefit from closer monitoring of blood glucose levels.
Comparison of diagnostic accuracy of APRI and Transient Elastography for prediction of esophageal variceal bleed in liver cirrhosis
Authors: Kumar Shailesh , Kumar Vinay , Giri Richa , Gautam S. K.
Published: April 2023

Background: Liver Cirrhosis is the end-stage for chronic liver disease. Repeated course of endoscopy is recommended, as this intervention is expensive and often poorly accepted by patients, there is a need for non-invasive methods to predicts the progression of portal hypertension as well as the presence and size of esophageal varices. This study was aimed to assess the APRI and Transient Elastography for predicting esophageal variceal bleed in cirrhotic patients. Objectives of the study were to study Diagnostic accuracy of APRI for Prediction of esophageal variceal bleed in liver cirrhosis, diagnostic accuracy of Transient Elastography for Prediction of esophageal variceal bleed in liver cirrhosis, comparison of diagnostic accuracy of APRI and Transient Elastography for Prediction of esophageal variceal bleed in liver cirrhosis.
Methods: It was a Single centre, observational study in 35 patients of chronic liver disease. Patients were included in the study after fulfilling inclusion and exclusion criteria. CBC, LFT, KFT, SE, viral marker, USG whole abdomen, UGIE, Transient Elastography was done. APRI was calculated for every patient.
Results: The APRI and Transient Elastography showed moderate diagnostic accuracy in predicting the presence of esophageal variceal bleed. Transient Elastography performed better for prediction of esophageal variceal bleed.
Conclusions: The APRI and Transient Elastography showed moderate diagnostic accuracy in predicting the presence of esophageal variceal bleed. They help in starting prophylactic therapy earlier to prevent the bleeding and other complications of varices. These non-invasive parameters can also play an effective role in conjunction with endoscopy in predicting the presence of esophageal varices.
Comparison of exponential smoothing and ARIMA time series models for forecasting COVID-19 cases: a secondary data analysis
Authors: Abhinav Bahuguna  , Uniyal Akanksha , Sharma Neha , Semwal Jayanti
Published: April 2023

Background: In order to manage outbreaks and plan resources, health systems must be capable of accurately projecting COVID-19 case patterns. Health systems can effectively predict future illness patterns by using mathematical and statistical modelling of infectious diseases. Different methods have been used with comparatively good accuracy for various prediction goals in medical sciences. Some illustrations are provided by statistical techniques intended to forecast epidemic cases. In order to increase healthcare systems readiness, this study aimed to identify the most accurate models for COVID-19 with a high global prevalence of positive cases.
Methods: Exponential smoothing model and ARIMA were employed on time series datasets to forecast confirmed cases in upcoming months and hence the effectiveness of these predictive models were compared on the basis of performance measures.
Results: It was seen that the ARIMA (0,0,2) model is best fitted with smaller values of performance measures (RMSE=4.46 and MAE=2.86) while employed on the recent dataset for short duration. Holt-Winters Exponential smoothing model was found to be more accurate to deal with a longer period of time series based data.
Conclusions: The study revealed that working with recent dataset is more accurate to forecast the number of confirmed cases as compared to the data collected for longer period. The early-stage warnings through these predictive models would be beneficial for governments and health professionals to be prepared with the strategies at different levels for public health prevention.
Effect of alcohol on Glasgow Coma score in traumatic brain injury: a single, center, cross-sectional study
Authors: Thomas Minnu , Suseel Appu , David Suresh Samuel
Published: April 2023

Background: To study the effect of blood alcohol levels on GCS in Traumatic brain injury patients (TBI) and relate the findings to brain injury severity based on the admission CT scan.
Methods: This cross-sectional study with a comparison group is conducted in Emergency Department (ED) of Pushpagiri Institute of Medical Sciences and Research Centre, Central Travancore, Kerala, India from April 2016 to September 2017 including all patients of 18 - 70 years of age presenting with head injury. 200 participants, 100 each of alcohol intoxicated and non- intoxicated were selected by consecutive sampling. GCS, Blood alcohol concentration-BAC (derived from the reading of alcohol breath analyzer) and admission CT Rotterdam Score are collected and analyzed at the end of study.
Results: When CT Rotterdam Score is 1-3, GCS was found to decrease with increase in BAC (Chi-square test p value=0.011; Spearman’s Rank Correlation coefficient rs=-0.326). Independent t –test showed that at BAC 1-100 mg/dl, mean GCS decrease by 1.6 while only same decrease is found when the BAC levels ranges from 100-400 mg/dl. When the CT Rotterdam score is 4-6, no significant correlation was found between GCS and BAC (p value=0.092; rs=0.214). In the presence of alcohol, GCS had sensitivity 87.5% and specificity 70% in comparison to alcohol absent TBI patients (sensitivity 98.5%, specificity 69.7%). When features of hypoxia and shock are present, GCS have good agreement with actual CT findings of TBI. (Kappa coefficient: K 0.659, sensitivity 76%, specificity 100% in alcoholics and K 0.756, sensitivity 100%, specificity 80.6% in nonalcoholic).
Conclusions: Even in the setting of alcohol intoxicated TBI patient, Glasgow coma score is a useful tool for quick decision making in emergency department.
A study of self-medication practices among medical students
Authors: Rasania Shreya , Dambhare Dharampal , Priyanka  , Srivastava Akshit , Rasania Prasann
Published: April 2023

Background: Self-medication is widely prevalent in India, more so among medical students as they have easy access to information from drug indices, literature and physician samples.
Methods: This was a descriptive cross-sectional type of study conducted among undergraduate students of a medical college in Maharashtra. Minimum sample size came out to be 259 by taking prevalence of self-medication as 78.6% from a previous study conducted on similar population. 75 students each were randomly selected from all four batches of MBBS. Data collection was done by using pretested questionnaire and it was analysed using SPSS version 22. Qualitative data was expressed in proportions and quantitative data was expressed in mean and standard deviation. Chi square test was used to check the association of various factors and self-medication practice.
Results: The prevalence of self-medication was found to be 72.1%. The practice was significantly more common in females, those belonging to urban areas and those from senior batches of MBBS (p<0.05). Headache (34.2%), acidity (25.7%) and fever (24.3%) were most common indications and antipyretics (28.2%), antihistamincs (17.3%) and analgesics (11.4%) were commonly used drugs for self-medication. In spite of being aware about the side effects of self-medication and importance of completing antibiotic course, their practices were largely unfavourable. Previous prescriptions (45.5%), family members (23.8%), pharmacist (21.8%) and medical textbooks (18.3%) were sources of information about self-medication.
Conclusions: Self-medication was highly prevalent among medical students with more prevalence among females, students from urban areas and senior students. The practices of students were also unfavourable.