bluuebunny/crossref_metadata_2025 huggingface dataset:
Tailored therapy with turoctocog alfa pegol according to patient’s lifestyle and hemorrhagic phenotype: from clinical trial to real-life
Authors: Nichele Ilaria , Carli Giuseppe , Tosetto Alberto
Published: April 2024

Although the use of prophylaxis regimens with prolonged half-life factors is now widespread in the world of hemophilia A, there is a lack of real-life evidence on the impact of these products on joint health, adherence, and quality of life of patients. Turoctocog alfa pegol is a glycoPEGylated recombinant factor VIII (FVIII) with an extended half-life (EHL), developed for prophylaxis, treatment of bleeds, and perioperative management in patients with hemophilia A. We report here on three cases of three patients affected by severe hemophilia A, with variable bleeding phenotype and lifestyle, to describe our clinical practice on prophylaxis with turoctocog alfa pegol. As confirmed in our cases, FVIII trough levels remained coherent with those experienced in the registration trial after the switch to the commercial EHL drug. Moreover, the cases highlight how the current clinical management of hemophilia can personalize treatment in several specific conditions.
An unusual case of upper airways obstruction
Authors: Scaramozzino Marco Umberto , Nassisi Veronica , Sapone Giovanni
Published: April 2024

Tracheal stenosis poses a diagnostic challenge that can mimic other respiratory pathologies, particularly bronchial asthma. It is characterized by a narrowing of the tracheal caliber, leading to respiratory symptoms such as dyspnea, cough, and wheezing. However, these manifestations can overlap with those of bronchial asthma, making the differential diagnosis a challenging yet crucial task for an appropriate therapeutic approach. This study aims to underscore the importance of a comprehensive clinical approach, utilizing bronchoscopy and global spirometry with bronchodilator reversibility testing, to differentiate tracheal stenosis from bronchial asthma, thereby contributing to accurate and timely surgical treatment. Bronchoscopy stands as a cornerstone in investigating tracheal stenosis, allowing for a direct assessment of the site, extent, and nature of the stenosis. Endoscopic observation of the morphological characteristics of the stenosis, such as concentric narrowing or mucosal irregularities, can guide towards a more precise diagnosis. Asthma, characterized by a reversible bronchial obstruction, responds positively to bronchodilators, whereas tracheal stenosis shows a limited or absent response.
Pulmonary "cannonball" metastasis from endometrial cancer: a rare case report
Authors: Scaramozzino Marco Umberto , Nassisi Veronica , Sapone Giovanni
Published: April 2024

Endometrial cancer is the most common gynecological neoplasm in Italy and developed countries. Pulmonary metastases, though uncommon, signify advanced disease, with "cannonball" metastases being a distinctive pathological finding requiring careful management. Despite advancements in bronchoscopy technology, fundamental diagnostic procedures like Bronchoalveolar Lavage (BAL), Transbronchial Lung Biopsy (TBLB), and Transbronchial Needle Aspiration (TBNA) remain essential for evaluating bronchopulmonary diseases. These techniques enhance the diagnosis and staging of oncological diseases of the genitourinary system with pulmonary involvement. Traditional bronchoscopic procedures continue to play a vital role in managing lung disorders effectively.
Pathological changes of biochemical, hematological and coagulation analyses in patients with COVID-19 disease
Authors: Gashi Zafer , Kadrija Muhamet
Published: April 2024

The identification of patients with poor prognosis and early detection of COVID-19 disease complications are made possible by pathological analyses of routine hematological, coagulation, and biochemical tests. Interpreting analyses needs to be done within the framework of each patient’s unique clinical picture. It’s also critical to keep an eye on changes at the individual parameter level. From May 20th, 2021, to March 30th, 2024, a comprehensive search of literature was carried out using international databases, such as PubMed, Embase, Web of Science, Scopus, and the Cochrane Library, in compliance with the PRISMA guidelines. The research question was formulated using the PICO strategy. The following terms were used: biochemical parameters in COVID-19, hematological parameters in COVID-19, blood coagulation parameters in COVID-19, indicators of inflammation, and indicators of tissue damage in SARS-CoV-2. Routine hematological, coagulation, and biochemical tests are primarily used to monitor the progression of the disease and the effectiveness of treatment rather than being utilized for the established diagnosis of COVID-19 due to their low specificity. Molecular genetics and immunological techniques should be used to determine the COVID-19 disease diagnosis.
Movements of translocated Griffon Vultures (Gyps fulvus) from Sardinia to Corsica call for the transboundary management of an expanding vulture population
Authors: Cerri Jacopo , De Rosa Davide , Fozzi Ilaria , Terraube Julien , Tavares José , Lörcher Franziska , Secci Dionigi , Muzzeddu Marco , Seguin Jean-François , Berlinguer Fiammetta
Published: April 2024

The conservation of Griffon Vulture (Gyps fulvus), the most abundant and widespread vulture in Europe, has been the focus of two LIFE project in Sardinia, that foresaw, among other actions, the release of individuals to increase population size. Within the project LIFE Under Griffon Wings (2015-2020), out of 76 Griffon Vultures that have been released in North Western Sardinia, 43 have been fitted with GPS/GSM tags. On the 3rd of April 2023, one of these Griffon Vultures, named “Caniga”, crossed the Strait of Bonifacio and reached Corsica. It stayed on the island for 20 days, before returning to Sardinia on the 23rd of April. Despite Griffon Vultures have been occasionally reported in Corsica in the last decades, this was the first time that one of the individuals released within the LIFE “Under Griffon Wings” project was recorded there. This observation provides evidence that expanding Griffon Vultures in Sardinia could also include Corsica in their movements and calls for the transboundary management of vulture populations between the two islands, including both monitoring and conservation actions minimizing anthropogenic mortality.
Österreichischer Brutvogelatlas 2013-2018
Authors: Ferlini Flavio
Published: April 2024

Throughout history there have been periods so exceptional that even today they are known by nicknames that immediately recall their memory...
Community Pharmacists’ Identifying and Counseling of Breastfeeding Women: A Study from Jordan
Authors: Harahsheh Mea’ad Mansour , Mukattash Tareq Lewis , Al-shatnawi Samah Fawzi , Abu-Farha Rana Kamal , D’Arcy Deirdre M. , Jarab Anan Sadeq , Abuhammad Sawsan Hammad
Published: April 2024

Background: This study explored the approaches of Jordanian community pharmacists to identifying and counseling breastfeeding mothers regarding medication usage.Methods: This cross-sectional study used self-administered questionnaires. A convenience sample (n=381) of Jordanian community pharmacists was recruited through social media. The responses were statistically analyzed using IBM SPSS ver. 25.0 (IBM Corp., USA).Results: The majority of recruited pharmacists were female (n=329, 86.4%). Asking every woman was Jordanian pharmacists’ preferred approach to identifying breastfeeding women (n=211, 55.4%). The study showed that around one-third of the pharmacists (n=128, 33.6%) reported that they currently experienced queries regarding medication use during breastfeeding on a daily basis. Additionally, the majority (n=325, 85.3%) of pharmacists reported feeling confident, and 67.2% of them (n=256) reported feeling comfortable while giving advice to breastfeeding women. The surveyed pharmacists relied on different resources during their course of practice to answer queries related to medicine usage by breastfeeding mothers.Conclusion: Community pharmacists have continuous interactions with breastfeeding women. Pharmacists require reliable and updated data access to answer queries related to medication use while breastfeeding.
Testing the reliability and validity of the Korean version of the Pittsburgh Sleep Quality Index using Fitbit devices: a cross-sectional analysis
Authors: Lee Si-Yeon , Choi Ja-Eun , Lee Ji-Won , Lee Yaeji , Park Jae-Min , Hong Kyung-Won
Published: April 2024

Background: Sleep disorders and insomnia are prevalent worldwide, with negative health outcomes. The Pittsburgh Sleep Quality Index (PSQI) is a widely used self-report assessment tool for evaluating sleep quality, comprising seven subdomains. The Korean version of the PSQI (PSQI-K) has been tested for reliability and validity in small sample sizes but lacks large-scale validation using objective measures.Methods: This study was conducted with 268 Korean adults attending health check programs. Participants completed the PSQI-K questionnaire and wore Fitbit devices (Fitbit Inc., USA) to ascertain sleep parameters. Reliability was analyzed using the Cronbach’s α coefficient, and construct validity was determined through factor analysis. Criteria validity was assessed by correlating their index scores with Fitbit sleep parameters. We identified the optimal cutoff for detecting sleep disorders.Results: The Cronbach’s α coefficient was 0.61, indicating adequate internal consistency. Factor analysis revealed three factors, explaining 48.2% of sleep quality variance. The index scores were negatively correlated with Fitbit sleep efficiency, total sleep time, and number of awakenings (P<0.05). The optimal cutoff point for identifying sleep disorder groups was ≥6.Conclusion: The PSQI-K demonstrated good reliability and validity when correlated with Fitbit sleep parameters, offering a practical screening tool for identifying sleep disorders among Korean adults. Cutoff scores can help identify patients for sleep interventions. However, further large-scale studies are required to validate these findings.
Prevalence and Factors Associated with Sickness Presenteeism among Thai and Foreign Teachers Following the End of COVID-19 Public Health Emergency of International Concern
Authors: Hongsa Thanawat , Polyong Chan Pattama
Published: April 2024

Background: Sickness presenteeism (SP) refers to the phenomenon where employees attend work while sick, a decision that impacts both their physical and mental well-being and can lead to burnout. This study aimed to determine the prevalence of and factors influencing SP among Thai and foreign teachers following the end of the coronavirus disease 2019 public health emergency of international concern (PHEIC).Methods: A sample of 400 individuals was analyzed using chi-square tests and logistic regression to obtain odds ratios (ORs) and 95% confidence intervals (CI).Results: Post-PHEIC, a significant proportion of teachers (51.9%) perceived an increase in their workload, and 62.1% reported having taken health-related leave of absence. The prevalence of SP was high (35.0%). Factors significantly associated with SP (P<0.05) included being younger than 37 years (OR, 1.825; 95% CI, 1.108–3.006), facing monthly financial challenges (OR, 1.627; 95% CI, 1.028–2.575), doing school-related work on holidays (OR, 1.920; 95% CI, 1.180–3.122), and experiencing sleep disturbances owing to work-related stress (OR, 1.910; 95% CI, 1.203– 3.033). No discernible difference existed in SP rates between Thai and foreign teachers.Conclusion: As a course of action, we recommend the provision of appropriate financial planning resources for teachers. Policywise, school events and activities should be scheduled on working days to ensure that teachers maintain a work-life balance. Additionally, task allocation that caters to individual strengths and limitations can mitigate the effects of SP.
Comparative evaluation of biomechanical changes and aberration profile following accelerated collagen cross-linking using hypo-osmolar and iso-osmolar riboflavin: A prospective study
Authors: Manumuraleekrishna  , Asif Mohamed Ibrahime , Maharana Prafulla Kumar , Nagpal Ritu , Agarwal Tushar , Sinha Rajesh , Titiyal Jeewan Singh , Sharma Namrata
Published: April 2024

Purpose:

To compare the changes encountered in corneal biomechanics and aberration profile following accelerated corneal collagen cross-linking (CXL) using hypo-osmolar and iso-osmolar riboflavin in corneal thicknesses of <400 and >400 microns, respectively.

Methods:

This is a prospective, interventional, comparative study involving 100 eyes of 75 patients with progressive keratoconus. Eyes were divided into two groups based on corneal thickness: group 1 included eyes with a corneal thickness of <400 microns who underwent hypo-osmolar CXL, and group 2 included eyes with a corneal thickness of >400 microns who underwent iso-osmolar CXL. Corneal biomechanical and aberration profiles were evaluated and compared between groups.

Results:

In group 1, all higher-order aberrations (HOA) except secondary astigmatism significantly decreased from baseline; however, in group 2, only coma and trefoil decreased. The corneal resistance factor and corneal hysteresis significantly improved in both groups, which was significantly greater in group 2 than in group 1. The change in inverse radius, deformation amplitude, and tomographic biomechanical index was significantly improved in group 2 as compared to group 1.

Conclusion:

Improvement in corrected distance visual acuity and decrease in HOA were significantly better in the hypo-osmolar CXL group; however, the improvement in biomechanical strength of the cornea was significantly better in the iso-osmolar group.
Choroidal and central macular thickness before and after treatment in post fever retinitis
Authors: Sanjay Srinivasan , Acharya Isha , Kawali Ankush , Chitturi Sai Prashanti , Mahendradas Padmamalini
Published: April 2024

Purpose:

To study the choroidal thickness (CT) and central macular thickness (CMT) in post-fever retinitis (PFR) and their correlation with visual acuity and treatment.

Methods:

A retrospective, observational study of patients presenting with PFR from 2013 to 2021 and with spectral domain optical coherence tomography (SD-OCT) (Heidelberg®, SpectralisTM, Heidelberg, Germany) images were included. The CT and CMT were measured at presentation and at the final visit. The CT was measured subfoveally and at points 2000 µm superior, inferior, medial, and lateral from the fovea using the caliper tool.

Results:

Seventy-nine eyes of 65 patients were included for this study. The mean age was 39.03 (±16.00) years with female preponderance of 53.84% (n = 35). Mean follow-up duration was 30 days. Mean CT at presentation and at follow-up was 254.12 µm and 241.51 µm, respectively. CT was decreased in majority of the eyes 67.1% (n = 53) from their baseline value. Mean CMTs at presentation and final visit were 454.8 µm and 223.7 µm, respectively. Best corrected visual acuity had a positive correlation with CMT (r= 0.340;P= 0.002) and negligible correlation with CT. A significant decrease in the mean CT was noted in patients who received doxycycline either alone or in combination with a steroid as compared to those who did not receive any treatment (P< 0.001). The significance of which is unknown presently.

Conclusion:

CMT has a greater role in determining the final visual outcome than CT. CT can be reduced post-treatment with no effect on vision.
Multiple sclerosis-associated uveitis – A series from South India
Authors: Babu Kalpana , Janardhana Geethanjali C , Murthy Krishna R
Published: April 2024

Purpose:

To report clinical profiles of multiple sclerosis (MS)-associated uveitis in seven cases from a single tertiary eye care center in South India.

Methods:

Retrospective case series 2013–2023.

Results:

Seven cases of MS-associated uveitis were retrieved from our databases. There were five females and two males. The diagnosis of MS was made by the neurologist in all cases. Bilaterality was seen in all cases. Intermediate uveitis was the most common presentation (five cases). It was associated with peripheral retinal vasculitis (two cases) and disc pallor (two cases). Fuchs heterochromic iridocyclitis (one case) and incomplete Vogt–Koyanagi–Harada (VKH)-like presentation with a peripapillary choroidal neovascular membrane (one case) were the other presentations. In the case with incomplete VKH-like presentation, whole genome sequencing revealed a heterozygous non-synonymous variation (c.1228C>T) in exon 10 of TNFRSF1A, suggestive of susceptibility to multiple sclerosis 5 due to mutation in the TNFRS1A gene on chromosome 12p13.31. All cases received systemic steroids. Azathioprine (three cases) and rituximab (three cases) were the commonly used immunomodulatory drugs. The visual outcome was good in all cases at the last follow-up.

Conclusion:

MS-associated uveitis is underreported in India. This series highlights the clinical profile of MS-associated uveitis in India.
India’s National Suicide Prevention Strategy, 2022: A Critical Appraisal
Authors: Bhatia Gayatri , Pal Arghya , Sharma Pawan , Parmar Arpit
Published: April 2024

India recently published its National Suicide Prevention Strategy aimed at reducing suicide mortality in the country by 10% by the year 2030. This strategy laid out time-bound objectives and action plans, targeting biological, psychosocial, and cultural risk factors for suicide, which are specific to the region. The strategy is to be implemented by utilizing existing national and regional mental health-care infrastructure and enlisting multisectoral cooperation. This discussion provides a critical appraisal of the National Suicide Prevention Strategy of India, 2022.
An appraisal of psychotherapy training during psychiatry residency program in India: A national survey
Authors: Kumar Ajay , Somani Aditya , Chandran Suhas , Kishor M , Isaac Mohan , Visweswariah Ashok M.
Published: April 2024

Background:

The need for psychotherapy training (PT) has been recognized worldwide and is considered an integral component of postgraduate psychiatry training. Our study aims to assess the quality of PT received by psychiatrists during their postgraduate studies and its impact on their current practice.

Aim:

To evaluate the quality of PT and its effect on the current psychiatry practice.

Methodology:

An anonymous web-based survey was conducted on registered psychiatrists practicing in India to evaluate the level and quality of PT received during their postgraduate studies.

Results:

The survey indicates that PT was included in the postgraduate psychiatry curriculum (73.8%). However, more than 50% of responders reported no separate posting, evaluation, logbook, or guidelines related to PT. Most (95.4%) psychiatrists think their PT could have been better. PT was satisfying in medical colleges in terms of inclusion in the curriculum (7.70, P = .021), psychotherapy rotations (16.48, P = <0.001), supervision of sessions (14.80, P = 0.001), lectures on psychotherapy (10.13, P = 0.006), periodic psychotherapy meet/forum (19.35, P = <0.001), maintenance of psychotherapy logbook/records (7.65, P = 0.022), institutional or departmental guideline related to PT (20.55, P = <0.001), and overall quality of PT (22.05, P = .005 and 31.81, P = <.001). Time constraint is the most common (49.9%) barrier in delivering psychotherapy.

Conclusion:

PT is not well organized, consistent, and uniform in psychiatry training; there is a prevailing sense of inadequacy and dissatisfaction among the country’s psychiatrists with a perceived need to improve and learn PT.
The elephant in the room: Is betrayal trauma associated with borderline personality disorder?
Authors: Sridhar Vindhya K. , Praharaj Samir Kumar
Published: April 2024

Background:

Borderline personality disorder (BPD) has been found to be closely linked to childhood trauma, particularly betrayal trauma.

Aim:

In our study, we aimed to investigate the association between betrayal trauma and anxiety among young adults.

Methods:

We assessed a total of 305 young adults using a Google form utilizing three assessment tools: the 10-item McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD), the 12-item Brief Betrayal Trauma Survey (BBTS), and the 7-item Generalized Anxiety Disorder (GAD-7) to evaluate borderline personality traits, betrayal trauma experiences, and anxiety level.

Results:

Our findings revealed that 22% [95% confidence interval (CI) 17.7 to 26.9] of the participants screened positive for BPD on MSI-BPD assessment; self-reported anxiety as reported by GAD-7 was observed in 27.9% (95% CI 23.1 to 33.2), while 82% (95% CI 77.3 to 85.9) reported experiencing betrayal trauma. A significantly higher proportion of individuals with BPD (97%) reported experiencing betrayal trauma compared to those without the disorder. High betrayal trauma [odds ratio (OR) 8.14, 95% CI 3.06 to 21.67] and medium betrayal trauma (OR 7.06, 95% CI 2.64 to 18.92) were significantly associated with the diagnosis of BPD. The associations held true across genders, although they were stronger in females.

Conclusions:

Our study highlights the strong relationship between betrayal trauma and BPD, with significant implications for the development of anxiety in young adults. These findings underscore the importance of recognizing and addressing childhood trauma, particularly betrayal trauma, in individuals at risk for BPD.
The impact of online health information source preference on intolerance to uncertainty and cyberchondria in a youthful generation
Authors: Bahadir Ozkan , Dundar Cihad
Published: April 2024

Background:

The increasing utilization of the Internet to access health-related information is believed to heighten anxiety and trigger cyberchondria due to the presence of conflicting and sometimes overly detailed information.

Aim:

To investigate the levels of cyberchondria and intolerance of uncertainty among university students and their relationship with different online health information sources.

Methods:

Between June and July 2022, 420 university students (mean age = 21.5 ± 2 years, 54% female) participated in this cross-sectional study. The socio-demographic form, Uncertainty Intolerance Scale (IUS), and Cyberchondria Severity Scale (CSS) were used in data collection. Pearson correlation test and binary logistic regression analysis were used to identify factors associated with cyberchondria.

Results:

Forums and private hospital/clinic websites were the most frequently utilized online health information sources, while governmental websites were the least. The mean scores for CSS and IUS were 81.5 and 41.0, respectively. There was no significant gender-based difference in CSS and IUS scores. Students who used newspapers/magazines and social media for health information had significantly higher scores on both scales. Cyberchondria had a negative association with age [odds ratio (OR) = 0.90], a positive significant relationship with newspaper/magazine website use (OR = 7.24), and IUS score (OR = 1.09). There was a positive and moderate correlation between CSS and IUS scores (r = 0.39, P < 0.001).

Conclusions:

Our results underline the susceptibility to cyberchondria and intolerance of uncertainty among young adults who used less reliable online health information sources and highlight promoting online health literacy to reduce vulnerabilities and the need for further research on socio-demographic determinants in both mental problems.
Anaemia of chronic disease among pulmonary tuberculosis patients is associated with inflammatory marker at the start of intensive phase
Authors: Leon Jovita , Sarkar Sonali , Basu Debdatta , Nanda Nivedita , Joseph Noyal Mariya
Published: April 2024

ABSTRACT

Background:

Tuberculosis (TB) disrupts iron balance through systemic inflammation. Pulmonary tuberculosis (PTB) is linked to diverse anaemia types, necessitating intricate haematological and biochemical assessments for diagnosis. This study aims to describe the prevalence of anaemia of chronic disease (ACD), iron deficiency anaemia (IDA) among PTB patients and factors associated with these types of anaemia.

Methods:

A cross-sectional analysis was conducted from community-based cohort study involving sputum-positive PTB patients from 2018 to 2020 in urban Puducherry. Participants were enrolled from 10 primary health centres within 2 weeks of initiating anti-tubercular treatment (ATT). Blood samples were collected for assessing haematological and biochemical parameters. The sTfR/log ferritin ratio was used to distinguish between ACD and IDA. Data were captured using Epicollect5 and analysed using STATA V14.

Result:

Of the 176 PTB patients included, 63.07% (111/176) had anaemia, with ACD being the predominant type (84.6%, 94/111). The C-reactive protein (CRP) levels were higher among the anaemic group [40.77 (16.66-58.51) mg/dl vs 24.65 (14.23-47.26) mg/dl] and higher among the ACD as compared to IDA [46.9 (22.3-61.2) vs 20.8 (13.0-39.1) mg/dl]. Undernourished [adjusted prevalence ratio (APR) =3.43; confidence interval (CI): 1.21-9.69] and patients having low risk of dependence on tobacco [APR = 1.52; CI: 1.10-2.11] had higher risk of ACD. Female patients had higher risk of IDA [APR = 4.95, P < 0.01].

Conclusion:

The largest proportion of the PTB participants with anaemia had ACD. Acute-phase reactant and inflammatory marker are increased among newly diagnosed new sputum smear-positive (NSP) PTB participants at the start of ATT. Addressing inflammation is needed for combating anaemia in PTB patients.
Vitamin D and cardiovascular diseases: A narrative review
Authors: Alissa Eman Mokbel
Published: April 2024

ABSTRACT

Cardiovascular diseases (CVD) and vitamin D deficiency are becoming highly prevalent among general populations. Despite plausible biological mechanisms for the role of vitamin D in cardio-protection, a cause-and-effect relationship has not yet been established. The interest in vitamin D as a potential therapeutic target to attenuate cardiovascular risk has been raised. The question about the benefit of vitamin D supplementation for cardiovascular outcomes cannot be answered certainly for the moment. The association between hypovitaminosis D and CVD has been proven by some studies while other studies deny any such link. The present narrative review gives a comprehensive overview of studies on the potential impact of hypovitaminosis D on CVD. The potential role of vitamin D supplementation in the management of CVD is also evaluated. Particular emphasis is paid to those studies that achieve a high level of scientific evidence.
Diabetes Mellitus and Other Comorbidities: Outcome among Covid-19 Patients in Kerala: A Retrospective Observational Study
Authors: Abraham Rahael , Biju Asha , Ittyachen Abraham M.
Published: April 2024

ABSTRACT

Background:

Covid-19 was declared by the WHO as a pandemic in 2020; India was also severely affected. Diabetes, a major lifestyle disorder, has seen its prevalence rate rising in developing countries. India is home to the world’s second-largest population of diabetes. Several studies have reported greater severity and mortality of Covid-19 in diabetic patients.

Methodology:

This was a hospital-based retrospective study done in a rural-based medical college in Kerala State. Data was collected using a semi-structured proforma and analysis was performed using Statistical Package for Social Sciences software version 25. The study was part of the STS research program of the Indian Council of Medical Research (ICMR).

Results:

There were 567 patients in the study. Those with pre-existing diabetes had a worse outcome compared to those with newly detected diabetes. The presence of CKD was associated with a poor outcome. Patients admitted to the ICU, and those on assisted ventilation also had a lower survival rate; within the subgroup, those on non-invasive ventilation had a better outcome.

Conclusion:

Mortality in Covid-19 is multifactorial. Those with diabetes have a poor outcome. Comorbidities have been reported to confer a high mortality rate in Covid-19 but this was not so in our study (except for CKD). Variability in outcome with respect to comorbidities and better outcomes in those who were non-invasively ventilated calls for more research to establish the relationship between pre-existing conditions and severity of disease. The use of non-invasive ventilation could also provide succor to resource-limited communities.
Depression and its role in adherence to anti-retroviral treatment in people living with HIV and AIDS in Chennai
Authors: Kanakaraj Ranjani , Umamaheswari R , Subramaniam Sudharshini
Published: April 2024

ABSTRACT

Context:

The AIDS epidemic has drastically reduced in India since it was first identified in 1986, largely due to the widespread availability of anti-retroviral treatment (ART). Management of HIV is currently more focussed on long term morbidities, including mental health. Depression is the most common co-morbidity seen in people living with HIV. Depression is found to negatively affect patient adherence to ART. Poor adherence to ART leads to drug resistance and susceptibility to opportunistic infections.

Aims:

The purpose of this study is to find the prevalence of depression among people living with HIV and to study the correlation between depression and adherence to ART.

Setting and Design:

The study was conducted in the ART centre at Rajiv Gandhi Government General Hospital in Chennai, between August and October 2022.

Methods and Materials:

Patient health questionnaire-9 (PHQ-9) was used to identify depression, and the Adult AIDS clinical trials group (AACTG) questionnaire was used to identify adherence.

Statistical Analysis Used:

Data were entered in MS Excel and were analysed using Statistical Package for Social Science (SPSS) Version 16. The association between categorical data were analysed using Chi-square and Fisher exact test. The correlation between adherence and depression was done using the Spearman correlation.

Results:

The prevalence of depression was found to be 20.2%. A mild negative correlation was found between depression and adherence. Depression was found to have a significant correlation with women, unemployed, widowed, divorced individuals, and those with diabetes mellitus and tuberculosis.

Conclusion:

Depression is an important risk factor for adherence to ART. Though severe depression was not found in this study, mild and moderate depression was associated with reduced adherence to ART. Treating depression is likely to improve adherence and the overall wellbeing of patients with HIV and AIDS.
Correlation of Serum Calcium with Severity and Outcomes in Patients of COVID-19 Pneumonia
Authors: Fatima Jalees , Shukla Vaibhav , Siddiqi Zeba , Kumar Devendra , Mateen Saboor , Gupta Akhilesh Bandhu
Published: April 2024

ABSTRACT

Background:

Calcium is an essential electrolyte with critical physiological functions. Recently, it has been implicated in the pathogenesis and outcomes of COVID-19. This retrospective study was conducted to estimate serum ionic calcium and its correlation with clinical severity, inflammatory markers, and in-hospital outcomes in moderate to severe COVID-19 patients.

Methods:

We retrospectively analyzed data from 377 COVID-19 patients, aged between 23 and 79 years, with a mean age of 54.17±11.53 years. Severity of the disease was determined using ICMR criteria. Parameters including age, gender, inflammatory markers, calcium levels, and clinical outcomes were assessed.

Results:

The study showed a prevalence of moderate and severe COVID-19 in 58.1% and 41.9% patients, respectively. Severity was significantly associated with younger age, higher mean inflammatory markers, notably IL-6, procalcitonin, D-Dimer, and lower ionic and total calcium levels, as well as vitamin D levels. Mortality and referral rate were significantly higher in the severe group. Hypocalcemia was prevalent in 39% of the patients and was significantly associated with disease severity, ARDS, and mortality. On multivariate assessment, only age and ionic calcium were significantly associated with COVID-19 severity.

Conclusion:

Lower serum ionic calcium levels are associated with increased severity and poor outcomes, including higher mortality in COVID-19 patients, underscoring the potential role of calcium as a diagnostic and prognostic marker in COVID-19 pneumonia and may be an important factor in various other forms of pneumonia.
An uncommon presentation of segmental Becker’s nevus involving the T4 dermatome
Authors: Arvind M N , Rajanna Avinash H. , Kanth Mahesh S. , Chandrashekar Aditya
Published: April 2024

ABSTRACT

This case report explores a rare manifestation of Becker’s nevus, where the patient exhibited an unusual dermatomal distribution featuring a hyperpigmented, irregular patch with associated hypertrichosis on the T4 segment. While Becker’s nevus is a well-known dermatological condition typically observed in the upper back region, instances of dermatomal distribution are exceptionally uncommon. This case presents a unique occurrence of segmental Becker’s nevus, highlighting the atypical presentation of this condition.
Perception, practices and understanding of teenage pregnancy among the adolescent girls in India: A scoping review protocol
Authors: Panda Arpita , Parida Jayashree , Jena Susangita , Pradhan Abinash , Pati Sanghamitra , Kaur Harpreet , Acharya Subhendu Kumar
Published: April 2024

ABSTRACT

Introduction:

Teenage pregnancy is a subject of concern among adolescents. Inadequate knowledge and misperceptions about pregnancy are major contributing factors to teenage pregnancy. Without a proper understanding, adolescents are involved in unsafe sexual practices, which results in pregnancy. So, perception and understanding are important aspects to explore among adolescents. In this planned scope review, all eligible studies will be identified around the perception, practices, and understanding of teenage pregnancy among married and unmarried adolescent girls.

Methods:

The Arksey and O’Malley (2005) scoping review framework and the Joanna Briggs Institute Reviewers’ Manual (2015) will be used for the planned scoping review. The population, concept, and context strategy (PCC) will be used to develop the research question, search strategy, and eligibility criteria. Preferred Reporting Items for Systematic Review and Meta-Analysis Extension for Scoping Reviews (PRISMA ScR) will be used for the findings of the study. For the literature search, authors will use Google Scholar, PubMed, and ResearchGate electronic databases with specific words such as “teenage”, “adolescence”, “pregnancy”, “perception”, “knowledge”, “awareness” and “abortion”.

Result:

The planned scoping review will be helpful in addressing the lack of adolescent misperception, malpractices, and misunderstandings regarding teenage pregnancy. It can provide detailed information about teenage pregnancy in the Indian context.

Conclusion:

The evidence synthesis and gap analysis will be helpful in suggesting insights into the issue of teenage pregnancy, which will be helpful in future policies and programs.
Genital ulcer disease: Study of factors associated and utility of rapid diagnostic methods in current pandemic
Authors: Inamdar Dhanashree P. , Kulkarni Arun , Basavaraju Anuradha
Published: April 2024

ABSTRACT

Background:

Genital ulcer disease (GUD) is regarded as the most difficult conundrum for clinicians, as valid and rapid methods to diagnose them are limited, especially in India. The sexual behavior of an individual plays a role in the causation of GUD, and it depends on psychological, behavioral, and social well-being, which was significantly affected during the COVID-19 pandemic. Hence, the present study was undertaken to determine the etiology of genital ulcers by using simple, rapid microbiological methods and to study various factors associated with them.

Materials and Methods:

Various rapid tests like staining (Giemsa, Gram, and Diff Quick) and serology for antibody detection were used to diagnose agents causing genital ulcers among 71 suspected patients during the study period of 1 year. After due informed consent, sociodemographic and behavioral factors were recorded in proforma and analyzed.

Results:

Rapid tests could aid in diagnosing 47.9% of cases of GUD. Turnaround time was less than 60 minutes for all tests carried out. Genital herpes was the most common GUD followed by syphilis. Male gender (74.6%), age group of more than 34 years old (62%), literate (71.8%), and earning (70.4%) constituted most of the population presenting with GUD. Behavioral factors like promiscuity with a known person (83.1%) had a significant association (P 0.04) with GUD.

Conclusion:

Rapid diagnostic tests could assist in the early treatment of GUD cases. Factors like literacy, financial independence, and promiscuity with known individuals were associated with GUD in our study during the COVID-19 pandemic.
Care seeking behavior of the victims of unintentional injuries: A community-based study in a community development block of Purba Bardhaman District, West Bengal
Authors: Jha Sankar Nath , Das Soumyaneel , Chandra Archi , Dey Anwesha , Roy Ramaprasad
Published: April 2024

ABSTRACT

Background:

Care-seeking after injury episodes is generally associated with major uncertainties concerning its incidence, care, and cure/disappearance, and the price of care. Though the utilization pattern of the population is shaped by social, economic, cultural and political factors, it varies widely for the rich and the poor. With this background, a community-based epidemiological study was conducted to determine the care-seeking behavior of victims of unintentional injuries.

Methods:

A cross-sectional study was conducted from May 2023–September 2023 in the Bhatar block of Purba Bardhaman district, West Bengal. Cluster random sampling was applied to select a required sample of 555 individuals from 24 villages. Study tools used were predesigned and pretested schedules developed by the researchers with the help of guidelines for conducting community surveys on injuries provided by the World Health Organization (WHO). The study had approval from the Institutional Ethics Committee. Descriptive statistics were performed using SPSS V16.

Results:

Out of 49 injury episodes, 51.0% had received first aid. Out of 39 injury episodes seeking medical attention, a traditional practitioner, healer or bone setter was the type of first medical contact in the case of the majority of injury episodes (38.5%), followed by a hospital (35.9%).

Conclusion:

Low utilization of government healthcare facilities is a cause for concern. Reliance on unqualified informal healthcare providers is also a cause for concern. Our findings will help design community interventions to increase the provision of appropriate first aid in unintentional injuries.
Dr. Prakash Chand (PC) Bhatla: Father of Family Medicine
Authors: Kumar Raman
Published: April 2024

ABSTRACT

Dr. Prakash Chand (PC) Bhatla MBBS was one of the illustrious past presidents (1975–76) of Indian Medical Association (IMA). He was a General Practitioner by vocation and a towering professional leader. He made an immense contribution to the discipline of Family Medicine – the academic discipline, medical specialty, and the knowledge domain of Family Physicians/Family Doctors within India as well as the global level. He was a brilliant human being and professional par excellence. He was probably one of the greatest leaders of the medical profession in India and a rightful successor to Dr BC Roy’s legacy. As a rare achievement, he received the Dr BC Roy National Award from the President of India twice. He received this prestigious recognition award in 1977 for socio-medical relief in India and again in 1982 for the promotion of Specialty of General Practice. He founded IMA CGP (Indian Medical College of General Practitioners), and his foundational work led to the recognition of Family Medicine as a specialty in India. Due to his efforts, Family Medicine was included in the list of recognized specialties by the National Board of Examinations (NBE) as well by the Medical Council of India (MCI). His contribution to medicine at a global level is also remarkable. He is also considered one of the founding forefathers of WONCA – World Organization of Family Doctors. He was associated with the foundation process of WONCA from the beginning (1964). The International Liaison Committee organized the first World meeting of General Practice in Montreal (Canada) in 1964 and the second meeting in Salsburg in 1966. Dr Bhatla was the convenor of the Third World Conference on General Practice in New Delhi, India, in 1968. A global representative body of Family Medicine/General Practice was launched in 1972 in Melbourne, Australia. Due to contribution to WONCA, he was elected for the first ever WONCA fellowship, the most prestigious global Family Medicine award. He was contemporary to other world leaders of Family Medicine and Primary Care such as Ian McWhinney and Barbara Starfeild. He is rightfully recognized and remembered as Father of Family Medicine. Dr Bhatla’s intellectual, professional, and administrative contribution laid down the sound background for the foundation of a Specialty body of Family Medicine in India called the Academy of Family Physicians of India. Life and work of Dr PC Bhatla continues to inspire family doctors, family physicians, general practitioners, and Family Medicine specialists across India, South Asia, and the World in the 21st century.
Bridging the gap: Differences in hand hygiene compliance between parents and observers
Authors: Gilman Margaret , March Peter B.
Published: April 2024

Hand hygiene is critical in preventing health-care-acquired infections and is an element in patient satisfaction surveys. Programme managers identified discrepancies between compliance documented by hospital observers and parent satisfaction surveys. In 2021, programme managers set out to close the gap. The hand hygiene survey question was too specific. This question was changed to include all staff and methods of performing hand hygiene. Associate education was performed. Within 4 months, the gap between patient survey and observer-reported compliance was approximately 12%. This 12% discrepancy remained steady through 2022. The hand hygiene family engagement educational campaign was minimally successful.
Correlation between recurrent epistaxis and atherosclerotic retinal changes in hypertensive patients
Authors: Aboelazm Emadeldin I , Behery Abobakr M , El-Bradey Mohamed H , Saafan Magdy E
Published: April 2024

Background

Hypertension has long been considered as the most common factor associated with epistaxis. However, the relation between epistaxis and hypertension is a matter of longstanding controversy.

Aim

This study investigated atherosclerosis as a potential risk factor in hypertensive patients presented with recurrent attacks of epistaxis, through fundoscopic examination and identification of the degree of hypertensive retinopathy in these patients.

Patients and methods

Observational cross-sectional study of 100 patients presented with epistaxis was conducted. These patients were divided into two groups; Group A with 50 known hypertensive patients with recurrent attacks of epistaxis and group B (the control group) with other 50 patients presented with epistaxis due to causes other than hypertension. All patients underwent monitoring of blood pressure, and rhinoscopic and fundoscopic examination.

Results

There was no correlation between the number of previous episodes of epistaxis the patients had and the finding of their fundoscopic examination, despite being a correlation between the elevated blood pressure and the frequency of epistaxis they had.

Conclusion

This study showed that the relation between recurrent hypertensive epistaxis and hypertensive atherosclerotic retinal changes was insignificant.
A comparative histopathological study of benign laryngeal lesions in smoker versus nonsmoker patients
Authors: Abdalla Mostafa M A , El Naggar Ahmed A , Shareef Mohamed M , Hegazy Hassan M
Published: April 2024

Background

Benign vocal fold lesions are nonmalignant growths of abnormal tissue on the vocal folds. The most prevalent benign lesions are polyps, Singer’s nodules, papilloma, and cysts.

Aim

The aim of this study was to compare the histopathological changes in benign vocal fold lesions in smoker versus nonsmoker patients.

Patients and methods

This study was performed at the Department of Otorhinolaryngology, Tanta University Hospital. It was carried out from July 2020 to July 2021 on 40 patients, who were divided into two main groups: group 1, nonsmoker patients, and group 2, smoker patients.

Results

This is a cross-sectional study that was carried out on 40 patients in the 20–70-year age range, of either sex. Using clinical diagnosis and indirect laryngoscopy, all patients were chosen if they had benign vocal fold lesions done at the Department of Otorhinolaryngology, Tanta University Hospital.

Conclusion

A comparative analysis of the vocal fold polyps in smokers and nonsmokers was done in the current study. In comparison with nonsmokers, smokers’ polyps had a higher incidence of keratinization and edema, according to histopathological analysis. Additionally, smokers’ polyps had more hyaline degeneration than nonsmokers’ polyps fold. These changes most likely reflect the damage that cigarette smoke did to the vocal polyps’ epithelium and lamina propria.
Intraoperative dexmedetomidine infusion might preserve cognitive functions of elderly patients undergoing spinal surgeries under general anesthesia
Authors: Khashaba Mohamed A , Salman Samar A
Published: April 2024

Background

Elderly patients are more vulnerable to anesthesia-related cognitive dysfunction. Spinal surgery consumes long theater time that may affect patients’ outcome especially the elderly ones. Anesthetic manipulations were supposed to modulate cognitive outcomes of patients.

Aims

Evaluation of the effect of intraoperative (IO) dexmedetomidine (DEX) infusion during spinal surgery on the incidence and severity of postoperative cognitive disorders (POCD).

Patients and methods

152 patients were divided into Group P received a placebo infusion and Group D DEX infusion (0.5 µg/kg/h) with induction of anesthesia until wound closure. Cognitive function (CF) was assessed using Mini-Mental State Examination (MMSE) pre- and postoperatively. The median value of CF deficit in 4-week PO was calculated, and its correlation to the type of IO infusions and patients’ data were evaluated. The effect of DEX infusion on the incidence and severity of POCD is the study outcome.

Results

DEX infusion significantly decreased the incidence and severity of POCD with a significantly lower deficit in the MMSE score of patients of group D. The MMES deficit was positively correlated to age, body mass index (BMI), presence of systemic diseases, and infusion type. The use of DEX, young age, and low BMI are significant predictors for normal CF.

Conclusion

DEX infusion for elderly patients undergoing major surgeries of long operative time and predicted blood loss significantly reduced the incidence and severity of POCD. The used dose of DEX was appropriate for preserving CF without hemodynamic effects.
Pacemaker post transcatheter aortic valve replacement: A multifactorial risk?
Authors: Noble Stephane , Bendjelid Karim
Published: April 2024

Pacemaker post-transcatheter aortic valve replacement is related to multifactorial risk. Nwaedozie et al brought to the body of evidence electrocardiogram and clinical findings. However, procedural characteristics have at least as much impact on the final need for a permanent pacemaker and potentially on the pacing rate. In this regard, long-term follow-up and understanding of the impact of long-term stimulation is of utmost importance.