bluuebunny/crossref_metadata_2025 huggingface dataset:
Duodenal and Pyloric Web in Children
Authors: Solanki Shailesh , Menon Prema , Dogra Shivani , Samujh Ram
Published: May 2024

Background:

Duodenal and pyloric web (DW/PW) can present at any age, symptoms depend upon the location of the web along with the presence and size of the opening in the web. The surgical management is not straightforward always. Here, in this study, we aim to assess clinical characteristics, management, and outcome of children with DW/PW.

Materials and Methodology:

This was a retrospective study from 2005 to 2019, and data were collected from record registers. All children of DW/PW presented between this duration were included in this study.

Results:

A total of 45 patients (age range = 1 day to 11 years) included in the study, 40 had DW while 5 had PW. Seven patients were diagnosed antenatally and 20 patients had associated congenital anomalies. Most patients presented with vomiting either bilious or nonbilious. Plain X-ray was sufficient for the diagnosis in 60% of patients, the rest diagnosed on contrast study. The web excision and pyloroplasty were done for PW. The web excision and Heineke-Mikulicz type enteroplasty was the preferred surgery for DW but some patients were required Kimura's duodeno-duodenostomy. For postoperative nutrition, enteral feeding was established through the placement of a feeding tube beyond anastomosis. Ten patients died due to septicemia and associated anomalies. Four patients had a minor leak which was managed by conservative means. Four patients required redo surgery, adhesive obstruction was the most common indication. During follow-up, all 35 patients were doing well with no major complaints.

Conclusion:

DW/PW has different presentations as compared to other intestinal atresia and can present at any age. A contrast study confirms the diagnosis when plain X-ray is inconclusive. Associated anomalies and septicemia are the poor prognostic indicators. Postoperative enteral feeding helps in maintaining adequate nutrition and improves the outcome even in children with a minor anastomotic leak.
An Unusual Case of Type A Posterior Cloaca Associated with 46XX Disorder of Sexual Differentiation with Y Duplication of Urethra
Authors: Gupta Rahul K. , Tiwari Pooja , Parelkar Sandesh V. , Sanghvi Beejal V. , Mudkhedkar Kedar P. , Mhaskar Satej S. , Shah Rujuta S.
Published: May 2024

We report an infant reared as a girl who presented with ambiguous genitalia and urine coming per rectum. On examination, she had minimal clitoromegaly with labial fusion and Y urethral duplication. On investigations, genetic, metabolic, and endocrine causes for disorder of sexual differentiation were ruled out. This girl was operated via a posterior sagittal approach. This case was unique in that the urogenital sinus was deviated posteriorly and opened in the anterior rectal wall and the accessory urethra opened in clitoris, along with ambiguity of external genitalia, thus making it a rare variant of the posterior cloaca. The diagnosis requires a high index of suspicion in clinician and a meticulous examination of the external genitalia. Very little literature is available for this rare anomaly. Few reports have classified them as female pseudohermaphroditism with cloacal and urogenital sinus defects. Hence, we hereby discuss and review the literature for previously reported cases.
Electronic Medical Record System-Based Teleconsultations in Pediatric Surgery
Authors: Anand Sachit , Dhua Anjan Kumar , Singh Apoorv , Subramonian Nellai Krishnan , Verma Ajay , Jain Vishesh , Yadav Devendra Kumar , Mitra Aparajita , Agarwala Sandeep , Goel Prabudh , Bajpai Minu
Published: May 2024

Background:

There has been a dramatic effect of the coronavirus disease 2019 pandemic on the daily health-care services. The era of physical consultations is slowly being replaced with teleconsultation, and this current pandemic has tipped the scales further. This study highlights the preliminary experience in providing teleconsultation to pediatric surgical patients at a tertiary care hospital in north India.

Materials and Methods:

A retrospective analysis of the electronic medical record system records of the patients undergoing teleconsultation at the authors’ department between the June 26, 2020 and the September 26, 2020 was performed. The data were categorized on the basis of the type of consultation (urgent, semi-urgent, or routine) and the type of intervention. A comparison with the data from the corresponding months of 2019 was also performed.

Results:

A total of 261 teleconsultations were conducted during the study period, with a success rate of 69% (181/261). Of these, 96% (171/178) were follow-up patients and 56% (99/178) presented with genitourinary complaints. After triaging, only 10% (18/178) of the patients required urgent medical/surgical attention.

Conclusion:

In the current as well as postpandemic phase, teleconsultation can act as a potent triaging tool and can help in better utilization of resources alongside helping in the maintenance of social distancing by decreasing the number of physical visits to the hospital.
Giant Feeding Artery from Abdominal Aorta in Intralobar Pulmonary Sequestration
Authors: Singh Anita , Mandelia Ankur , Verma Prabha , Naranje Kirti , Gupta Girish
Published: May 2024

Pulmonary sequestration (PS) is a rare congenital lung malformation. We present a case of newborn with antenatally diagnosed case of PS. The baby was delivered by cesarean section to primigravida mother at 38 + 3 weeks of gestation with birth weight of 2700 g. At 20 weeks of gestation, the antenatal ultrasound showed a triangular echogenic area in left lung supplied by feeding artery from descending aorta. The baby had respiratory distress soon after birth. Computerized tomographic pulmonary angiogram revealed abnormal blood supply of left lower lobe arising from descending aorta. The feeding vessel was abnormally large and was almost half of the diameter of the aorta. The baby underwent left lower lobectomy with double ligation of feeding artery at day 7 of life and was discharged on day 14 of life. Antenatal diagnosis of congenital lung malformation helps in careful planning of perinatal care and facilitates the early diagnosis and management.
Pediatric Neuroblastoma - Impact of Nutritional Status on Complications and Outcomes
Authors: Nandan Ruchira , Sharma Shilpa , Bajpai Minu , Jain Vishesh , Goel Prabudh , Yadav Devendra Kumar
Published: May 2024

Aim:

The aim is to study the impact of nutritional status on outcomes and treatment-related complications in patients of neuroblastoma.

Materials and Methods:

Anthropometry (height, weight, weight for height [in <5 years], mid-arm circumference [MAC] [in <5 years], and body mass index [BMI]), hemoglobin level, and serum albumin level were recorded.

Results:

Twenty-four neuroblastoma patients, 16 males and 8 females, with a mean age of 42.7 months were treated and followed up over a period of 0.03–170 months. Of 24 patients, 16 survived (complete response - 9, partial response - 2, no response - 2, progressive disease - 3). Height <2 standard deviation [SD] was seen in 12.5% (3/24). Mortality and complications were found in 66.7% (2/3) and 100% (3/3), respectively. Weight <2SD was seen in 37.5% (9/24). Mortality and complications were found in 33.3% (3/9) and 67% (6/9), respectively. Weight for height <2 SD was seen in 35% (7/20). Mortality and complications were found in 42.9% (3/7) and 71.4% (5/7), respectively. MAC <2 SD was seen in 15.8% (3/19). Mortality and complications were found in 66.7% (2/3) and 66.7% (2/3). BMI <2SD was seen in 29.2% (7/24). Mortality and complications were found in 42.8% (3/7) and 28.6% (2/7). Anemia was seen in 62.5% (15/24), of which nine survived. Complications were seen in 58.3% (14/24) (P = 0.001). Hypoproteinemia was seen in 20.8% (5/24). Mortality and complications were 40% (2/5) and 80% (4/5).

Conclusion:

Neuroblastoma has poor outcome in Indian children, and there does not appear to be a major role played by nutrition in determining the response to treatment and survival.
Early Feeding versus Traditional Feeding in Children with Ileostomy Closure
Authors: Gil-Vargas Manuel , Saavedra-Pacheco Mary Sol , Coral-García Miguel Ángel
Published: May 2024

Context:

Elective intestinal anastomosis is a frequently used surgical procedure in pediatric surgery.

Aims:

This study aimed to compare postoperative complications and hospital stay in children who underwent ileostomy closure with early feeding in the 1st 24 h versus those in whom the oral route was initiated traditionally.

Settings and Design:

Observational, comparative, cross-sectional, ambispective, and single-center study that included pediatric patients who had undergone ileostomy closure from January 2017 to August 2019.

Materials and Methods:

Data were analyzed in SPSS. Statistical analysis was used: the variables were analyzed using the Chi-square test or Fisher's exact test when the former could not be applied.

Results:

They were divided into the following two groups: group 1 included patients who started the oral route early (n = 25) and Group 2 included patients who started the oral route late (n = 20). The average in-hospital stay for Group 1 was 5.48 days and that for Group 2 was 8.35 days. In Group 1, the oral route was started with a mean of 9.32 h and in Group 2 at 146.4 h. Those in Group 1 at 32.9 h presented their first evacuation and Group 2 at 131.45 h. Group 1 reached their normal diet on average at 79.96 h and Group 2 at 172.8 h.

Conclusions:

This comparison between early oral feeding and traditional oral feeding suggests that various benefits exist when enteral nutrition is initiated early after ileostomy closure in pediatric patients. The benefits and importance of initiating early oral feeding in adults have been reported, but there are few studies on pediatric populations
Mesenteric Injury in Blunt Abdominal Trauma in Children
Authors: Singh Amit Kumar , Bais Prateek Singh , Chand Karunesh , Dey Santosh
Published: May 2024

Objective:

There is an increasing trend of observational, nonsurgical management of abdominal injuries in children. We analyzed the feasibility and outcome of our management protocol in managing cases of the mesenteric injuries in blunt trauma abdomen in pediatric age group.

Methods:

Single-center retrospective analysis of pediatric trauma case records from July 2018 to March 2020 was performed.

Results:

Thirty-four cases of blunt abdominal trauma of whom 13 had mesenteric injuries were reviewed. The male-to-female ratio was 2.2:1, and the mean age was 9.11 ± 4.90 years. Mesentery of the small bowel was the most commonly injured segment and treatment consisted of repair of mesenteric tear, resection, and anastomosis with or without stoma formation.

Conclusions:

Isolated mesenteric injury of all grades should be managed either with diagnostic laparoscopy or laparotomy irrespective of hemodynamic status.
Biliary Cystadenoma in a Child
Authors: Ahmad Sohail , Sahoo Subrat Kumar , Manekar Aditya Arvind , Narahari Janjala , Tripathy Bikasha Bihary , Sable Mukund , Mohanty Manoj Kumar
Published: May 2024

Biliary cystadenoma, a rare potentially malignant hepatic cystic lesion, is characterized by multiloculations and septations. It is common in middle-aged females (about 5% of nonparasitic liver cysts); only 12 cases are described in children. We report a rare case of hepatic biliary cystadenoma in a 3-year-old girl, with a gradually increasing lump in the right upper abdomen. Complete excision with a healthy liver margin was done.
Unusual Presentation of Ileal Intussusception Due to Submucosal Lipoma in a Child and its Management
Authors: Girish Nisha , Thomas Naveen , Natraj Gayathri , Satish Kumar K. V. , John Neena
Published: May 2024

Idiopathic intussusception is the most common form of intussusception in infants and young children. In older children and adults, intussusception being rare, the lead point is usually an underlying bowel pathology (Meckel's diverticulum, hemangioma, carcinoids, polyps, submucous lipomas, etc.) and these are called pathological lead points (PLP's). The management of an obese child with recurrent abdominal pain for over 2 years, diagnosed with ileo-ileal intussusception due to submucosal lipoma is reported here.
Yolk Sac Tumor of the Cervix in an Infant
Authors: Narasimhan Swati , Arul Janani , Swaminathan Rajendran , Agarwal Prakash
Published: May 2024

A 5-month-old child presented with vaginal bleeding and found yolk sac tumor of the uterine cervix. She attained complete remission only with chemotherapy and on follow-up for more than a year. We report this for the unusual age and feasibility of avoiding surgery in selected cases.
A Novel Technique of SMA Massage with Systemic Fibrinolytic Therapy in Ischemic Midgut Volvulus
Authors: Giriradder Vandana Basappa , Jadhav Vinay , Anilkumar P. L. , Babu M. Narendra
Published: May 2024

Purpose:

Midgut volvulus is a surgical emergency requiring immediate intervention. Intestinal ischemia of the midgut as a consequence of volvulus from malrotation is a fateful event with high mortality and significant morbidity even in survivors. Derotation followed by correction of malrotation is the procedure of choice though has significant morbidity if intestinal reperfusion was not successful. A combined treatment to restore intestinal perfusion based on the digital massage of the superior mesenteric artery after derotation and systemic infusion of fibrinolytic has been previously reported with success but underused. Here, we report three such cases of midgut malrotation with severe intestinal ischemia due to volvulus.

Materials and Methods:

A retrospective analysis of three confirmed cases of midgut malrotation with volvulus managed with emergency laparotomy, derotation, and Superior Mesenteric Artery (SMA) massage with systemic fibrinolytic therapy, followed by correction of malrotation was evaluated.

Results:

There was dramatic improvement in intestinal perfusion noted in all three patients inspite of delayed presentation. 2 out of 3 patients on follow up are doing well with adequate weight gain while 1 patient succumbed due to sepsis.

Conclusion:

Critical intestinal ischemia due to mesenteric thrombosis can persist after derotation of midgut volvulus and can lead to devastating consequences. The use of digital massage of SMA to disrupt the thrombus along with fibrinolytic therapy though reported is underutilized. Hence, awareness of this management and usage needs to be re-emphasized.
Congenital Transmesenteric Hernia – A Rare Presentation
Authors: Lingegowda Anilkumar Pura , Amit B. , Pillai Pramod R. , Chandrayya Ramachandra
Published: May 2024

Congenital transmesenteric defect is a rare but serious condition which presents a diagnostic challenge as symptoms and investigations are nonspecific. Here, we present a case with fetal ascites and dilated bowel loops who underwent intervention within 6 h of birth. Laparotomy showed volvulus and gangrene of 45 cm of the distal ileum, which was herniating through mesenteric defect. Timely detection and intervention can help in preventing significant morbidity and mortality. Given the downside to delay of surgical intervention and lack of specific tests, open exploration continues to be the only way to establish a definitive diagnosis of a transmesenteric hernia.
Zinner Syndrome with Papillary Neoplasm
Authors: Randhawa Jaskiran S. , Shankaran R. , Nagamahendran R. , Upadhye Manoj Arun , Deepak H
Published: May 2024

One of the uncommon urogenital malformations in males, which presents late in the second or third decades of life, is the congenital malformation of the seminal vesicle. Zinner syndrome is a rare condition comprising a triad of unilateral renal agenesis, ipsilateral seminal vesicle obstruction, and ipsilateral ejaculatory duct obstruction. Very few cases in the literature describe the malignant change in seminal vesicle cyst in Zinner syndrome. To the best of our knowledge, this is the first report of a papillary neoplasm of the seminal vesicle cyst developed in a patient with Zinner syndrome.
Rapunzel Syndrome
Authors: Kumar Deepak , Pandey Vaibhav , Nandan Ruchira
Published: May 2024

The diagnosis of Rapunzel syndrome can sometimes be challenging. The silent features such as poor appetite, constipation, anemia, hypoalbuminemia, and hypoproteinemia were all overlooked in our patient initially. The Rapunzel tail leads to multiple intussusceptions and an unexpected perforation sealed by intussusceptions. Perforation sealed by intussusceptions in a clinically stable patient of Rapunzel syndrome has never been reported.
Hernia of Umbilical Cord
Authors: Tiwari Pooja , Shukla Ram Mohan , Joleya Maneesh Kumar , Jain Sarvagya , Ladda Ashok Kumar , Sharma Shashi Shankar , Raj Vinod , Lahoti Brijesh Kumar , Joshi Manoj
Published: May 2024

Introduction:

Hernia of the umbilical cord (HUC) is an uncommon problem which is often misdiagnosed, leading to inadequate treatment and various complications which cause increased morbidity and mortality in neonates. To address this issue, we took up this study.

Materials and Methods:

Patients diagnosed with HUC from January 1, 2017, to December 31, 2021, were retrospectively analyzed. The following data of all these patients were collected and retrospectively analyzed: demography, radiological investigations, echocardiography, contents of hernia, type of surgery performed, and outcome.

Results:

Eighteen out of 19 patients included in the study were taken up for surgery after baseline investigations and echocardiography. Out of 19 patients, 15 were discharged successfully and are on regular follow-up. Of the remaining four patients, an anastomotic leak occurred in two and they went into sepsis and succumbed. One of the patients died before any intervention and one succumbed on 3rd postoperative day due to sepsis.

Conclusion:

Timely referral and intervention can save precious lives. We need to educate doctors and health-care providers so that proper diagnosis and timely management can be done for this anomaly which is associated with less morbidity and a lower rate of associated anomalies.
Recurrent Hemangioma of the Penile Urethra – An Unusual Etiology of Gross Hematuria Managed Successfully with Holmium Laser Coagulation
Authors: Pal Atanu Kumar , Naredi Bikash Kumar , Manikandan Ramanitharan , Kalra Sidhartha , Jindal Bibekanand , Koya Naseera
Published: May 2024

Urethral hemangioma is a benign uncommon vascular tumor. It presents with hematuria and macroscopic urethrorrhagia. Urethrocystoscopy is the main diagnostic modality. We share the case of a 14-year-old male child who presented with recurrent massive hematuria and was treated with urethra-cystoscopic holmium laser coagulation.
Double Whammy due to Coronavirus Disease-2019
Authors: Zulpi Prashant K. , Kulkarni Vijay K. , Rani Hephzibah , Halgeri Anil , Agnihotri Aditya
Published: May 2024

Mucormycosis is a fatal fungal infection occurring in immunocompromised patients. Small bowel mucormycosis is extremely rare with a high mortality rate. We report the case of a 12-year-old girl with postcoronavirus disease (COVID) recent-onset diabetic ketoacidosis, who presented with acute abdomen with fecal peritonitis. She was diagnosed with intestinal mucormycosis (post-COVID) and was treated successfully with surgical and antifungal management.
Epidemiological Survey to Identify Depressive Symptoms in School-going Rural Adolescents of Chandigarh, India
Authors: Goel Naveen Krishan , Singh Gurvinder Pal , Thakare Meenal Madhukar , Walia Dinesh Kumar , Sharma Deepak
Published: May 2024

Background:

The prevalence of mental health problems in the adolescent population is higher than in the general population.

Aims and Objectives:

To assess the mental health and to identify depressive symptoms in the adolescent population in the schools in northern India and to study the association of sociodemographic and socioeconomic variables with depressive symptoms and screening instrument scores.

Materials and Methods:

A cross-sectional survey was conducted on 350 adolescents studying in the 5th standard to 12th standard in two schools in village Palsora, Chandigarh, India. The socioeconomic status was assessed using Modified Kuppuswamy Classification. Short Mood and Feelings Questionnaire (SMQ) was used to measure mental health and screen for depressive symptoms among rural adolescents. Sociodemographic and socioeconomic variables, mental health, and depressive symptoms among adolescents were evaluated. The participants were interviewed by trained mental health professionals.

Results:

62% of the study participants had a high SMQ score on the assessment instrument which measured depressive feelings felt in the last 2 weeks. Female adolescents had significantly higher SMQ scores than male adolescents. The younger adolescents in the age group 10–14 years and overcrowding in the family were associated with significantly high SMQ scores.

Conclusions:

The survey concluded that there was a high prevalence of depressive symptoms in adolescents studying in rural schools in northern India. 62% of the study participants had a high SMQ score and were at risk for depression and predicted future depression in adolescents. The female and younger adolescents had significantly higher SMQ scores than male and older adolescents.
Psychosocial Intervention for Harm Reduction of Alcohol Use among School-going Adolescents from North India
Authors: Singh Gurvinder Pal , Gehlot Suman , Kaur Manpreet
Published: May 2024

Aims and Objectives:

It was to evaluate the usefulness of psychosocial intervention in promoting knowledge and awareness about the harmful effects of alcohol use in a sample of adolescents.

Materials and Methods:

The research design was a prospective, interventional nonrandomized control group design with two groups, one experimental group (interventional) and another control group. Ethical clearance was obtained from the institutional ethical committee. Samples were selected using the nonprobability convenience sampling technique in two schools district of Patiala, Punjab. The assessment instruments were as follows: (a) semi-structured sociodemographic pro forma, (b) alcohol use pro forma, (c) semi-structured interventional knowledge questionnaire, and (d) psychosocial intervention package. A psychosocial intervention package for the prevention of alcohol use among adolescents was provided to the experimental group.

Results:

The target intervention population consisted of adolescents in the age group (14–18) years. Nearly half of the subjects (47.5%) in the experimental and more than half of the subjects (57.5%) in the control group had a trend of alcohol use during family functions and social gatherings. The study’s results revealed that in the preintervention baseline assessment, the adolescents had an average level of knowledge regarding the ill effects of alcohol use, and the mean score (±standard deviation [SD]) was 12.43 ± 2.645. After postintervention, an average level of knowledge was found to be improved regarding the ill effect of alcohol use, and the mean (±SD) knowledge level score was 19.60 ± 2.599.

Discussion:

The findings of this study showed that after psychosocial intervention among the experimental group, the knowledge level for minimizing alcohol consumption increased significantly. The participants reported abstinence from alcohol consumption in the experimental group after intervention.

Conclusions:

The salient findings from this study can be utilized to develop and implement effective psychosocial prevention strategies to tackle alcohol use in various parts of India. Further research is warranted to replicate the findings of the present study.
Development and Validation of a Treatment Compliance Assessment Scale for Clients with Mental Illnesses
Authors: Mann Sucheta , Joseph Jaison , Malik Yogender Kumar , Devi Rajeshwari
Published: May 2024

Background:

Treatment compliance improves mental health and facilitates the resolution of the underlying illness. An accurate assessment of treatment compliance is necessary for effective and efficient treatment planning and for ensuring that changes in health outcomes can be attributed to the recommended regimen.

Aim:

This study aimed to develop a treatment compliance assessment scale for clients with mental illnesses and to evaluate its psychometric properties.

Methodology:

The initial questionnaire was developed through the Delphi expert consultation, pilot study, and semistructured interview. The instrument was applied to 130 clients attending the outpatient services of a tertiary care hospital in North India.

Results:

A seven-item clinician-rated questionnaire was formed in which exploratory factor analyses yielded two factors, including medication compliance and attitude toward current treatment. The instrument was found to have a good internal consistency (Chronbach’s alpha was 0.932), split-half reliability (Guttman’s split-half coefficient − 0.838), and test–retest reliability (0.882). The concurrent validity of demonstrated a significant correlation with the 12-item Medication Adherence Rating Scale at P ≤ 0.01.

Conclusion:

The clinician-rated treatment compliance assessment scale was found to be a valid instrument for assessing treatment compliance among patients with mental illnesses with adequate psychometric properties.
Comprehensive Mental Health Facets and their Correlates Amid “The New Normal” Pandemic
Authors: Singh Shweta , Gupta Pawan Kumar , Tripathi Rakesh Kumar , Datta Manjistha , Pandey Nisha Mani , Batra Saakshi , Mahour Pooja , Arya Amit , Tripathi Adarsh , Gupta Bandna , Agarwal Manu , Nischal Anil , Agarwal Vivek , Dalal P. K.
Published: May 2024

Objective:

The present study aimed to compare the comprehensive mental health facets of adolescents with the adults.

Materials and Methods:

A cross-sectional design with 1,027 participants (456 adolescents; 347 young and 224 middle age adults). The Comprehensive Diagnostic and Statistical Manual-5 self-rated Level 1 cross-cutting symptom measure, perceived stress scale, and brief COPE were used. Chi-square test of independence and spearman rank correlational analysis was performed.

Results:

33.77% of adolescents, 25.65% of young adults, and 17.41% of middle-aged adults reported that their symptoms started during the pandemic. Adolescents reported higher depression, anxiety, suicidal ideations, anger, and somatic complaints. Significantly higher adolescent females (39.9%) were found to have sleep disturbances than their male counterparts (25.5%). The correlational analysis showed that most mental health domains, except substance use, showed moderate-to-low correlations with the “impact of COVID-19.”

Conclusion:

This study observed that adolescents to be more clinically vulnerable in the domains of depression, anxiety, suicidal ideations, anger, and somatic complaints. Middle-aged adults should further be seen as a clinically vulnerable population for substance use during the new normal. This research indicates the need for further extensive research on assessment and management. Also, it provides a comprehensive analysis for clinical decision-making and policy development to combat the mental health problems in the backdrop of the COVID-19 pandemic.
Perceived Stress and Coping Skills in the Newly Joined Medical Undergraduate Students
Authors: Sahoo Swapnajeet , Mishra Pravash Ranjan , Mishra Shree , Kar Manisha , Padhy Susanta Kumar
Published: May 2024

Objectives:

To assess the perceived stress and to evaluate the sources of stress, the prevalence of psychological morbidity (if any) and different coping strategies among the newly joined 1st-semester medical undergraduate students.

Methodology:

A cross-sectional exploratory study was conducted on all the newly joined 1st-year medical students (who had entered 3 months back) at a tertiary care medical college and teaching hospital in Eastern India. Perceived stress and depressive symptoms were assessed on the Perceived Stress Scale-10 (PSS-10) and Patient Health Questionnaire-9 (PHQ-9). A self-designed questionnaire was used to evaluate different premedical entry-level preparation issues and ongoing psychosocial and academic-related stressors. Coping was evaluated on the Ways of Coping Checklist.

Results:

Ninety-five first-semester medical undergraduate students (mean age − 18.34 ± 0.95 years) who had joined the Institute 3 months back participated in the study. The mean PSS score was 21.56 ± 3.97 and about 85.3% and 11.6% of the students reported moderate and high degrees of stress. Depressive symptoms were reported by 36.8% (PHQ-9 cut-off ≥10). During medical preparation (as rated on a Likert scale of 0–10), the mean rated stress level was 6.84 ± 2.05. Almost half of the students reported facing problems adjusting to the new place and environment (48.4%), facing language problems (11.6%), and unfavorable hostel facilities (10.5%). Under academic stressors – more than half of the students perceived the vastness of academic curriculum as a major stressor as “often” (53.7%) followed by fear of failure in exams (35.8%). Students followed both negative coping strategies (such as escape avoidance coping, distancing, and confrontive coping) and positive coping strategies (self-controlling, seeking social support, planful problem-solving, and positive appraisal). Significant association of depressive symptom score was found with self-controlling (P - 0.012) and seeking social support (P = 0.015) type of coping.

Conclusion:

A substantial proportion of undergraduate medical students have moderate to high stress at the entry level (just within the months of joining medical curriculum) and about one-third (36.8%) had depressive symptoms. Most of the students reported of using escape–avoidant type of coping while dealing with the ongoing stressors. More focus on improving resilience and positive adaptive coping skills in the initial formative years of medical education to prevent psychological morbidities and burnout in future years of medical education.
Gender-Based Shame-Focused Attitude of General Public toward Mental Illness
Authors: Kumar Ravi Shankar , Pathak Abhijit
Published: May 2024

Objective:

The present study aimed to examine the attitude of the general public toward the mental illness in Jharkhand.

Material and Methods:

A community-based cross-sectional study with a sample size of 240 consisting of a male (163) and female (77) of the general population was done. The study was conducted in the urban and rural areas of Hazaribagh district based on a simple random sample technique. To collect data, Attitude Toward Mental Health Problem (ATMHP) was used. The sociodemographic profile has been calculated with descriptive statistics, and Mann–Whitney U-test has been used to find the significant differences in attitude score.

Results:

Males and females are both having positive attitude attitudes toward mental illness. Females are having a more positive attitude than males since the mean score is lower in all the four domains of ATMHP (9.39 ± 7.03 > 7.51 ± 5.87, 13.36 ± 9.87 > 9.67 ± 9.30, 5.52 ± 4.97 > 4.35 ± 4.59, 7.82 ± 6.34 > 5.53 ± 4.83, 6.41 ± 4.96 > 4.57 ± 4.46). However, a significant difference has not been found in two domains of ATMHP at 0.05 significant statistical levels. After controlling the co-variates through multinomial logistic regression, males showed 3.7 times odds of developing shame than female toward family member and statistically significant differences were found at less than P value 0.05 levels.

Conclusions:

People have started to comprehend and empathize with the patient and the family of the mentally ill, and they do not feel shame in admitting, seeking help, and reaching family to help.
Depression, Anxiety, and Stress among Indian Youth during the COVID-19 Lockdown - A Cross-Sectional Survey
Authors: Vaidya Ruchi , Kaza Santhosh Kumar , Gupta Pallavi , Weine Stevan M. , Nooyi Shalini Chandrashekar , Chaudhury Nayanjeet
Published: May 2024

Purpose:

The psychological effects of the unprecedented global emergency due to COVID-19 are a significant concern worldwide. The present study aims to investigate the prevalence of stress, anxiety, and depression among Indian youth during the COVID-19 lockdown.

Methods:

A cross-sectional survey was conducted online across India during the COVID-19 lockdown. A total of 1641 Indian youth between the ages of 15–24 years across 23 states and 3 union territories were analyzed for their mental health status. Depression, anxiety, and stress (DAS) levels of the Indian youth were measured using DAS scale 21. The study was approved by the Institutional Review Board (IRB Reference number: DRP/EFP 530/2020: 08/06/2020).

Results:

Moderate to higher levels of depression and anxiety were observed among 45% and 49% of Indian youth, respectively, during the COVID-19 lockdown. DAS was significantly higher among youth preparing for competitive examinations, those who had an acquaintance infected with COVID-19 and those who perceived COVID-19 as a risky infection (P < 0.01). School-going students showed significantly lower levels of depression and stress compared to college-going students (P < 0.01).

Conclusion:

The high levels of DAS during the COVID-19 pandemic indicate a significant mental health burden among Indian youth. These findings indicate the need for a multisectoral approach to cope with stresses and to improve psychological well-being among youth during the pandemic.
Interplay between Traditional Healing and Modern Psychiatry Resulting in Timely Diagnosis of Autoimmune Encephalitis
Authors: Imtiyaz Bushra S. , Jamwal Chahat , Margoob Mushtaq Ahmad , Maryam Hadiqa , Grover Sandeep
Published: May 2024

There is poor coordination between mental health professionals and traditional healers. This often leads to mismanagement of patients with various mental disorders, which can sometimes result in a fatal outcome. It is often suggested that there is a need to improve the coordination between mental health professionals and traditional healers. In this report, we present the case of a young girl whose family initially consulted a traditional healer for her condition and was then referred to appropriate mental health facilities. This coordination resulted in the timely diagnosis of autoimmune encephalitis.
Attitude and Knowledge of Physiotherapy Students toward Mental Health and Patients with Psychiatric Illnesses
Authors: Rathi Manisha Ashish , Joshi Ganesh , Naik Rujuta , Naikwad Samruddhi , Nair Veena , Metkari Sana , Mehta Karan
Published: May 2024

Background:

Stigma and violations of human rights directed toward people with psychiatric disorders hinder their care and rehabilitation. The role of physiotherapists in mental illness is to facilitate motivation, emphasize strengths, and offer positive feedback through cognitive therapy, guided imagery, body and movement awareness, relaxation and breathing techniques, yoga therapy, and aerobic exercises. It is important to understand the beliefs, knowledge, and attitude of physiotherapists toward psychiatric illness which in turn helps in better rehabilitation of such patients. Hence, the purpose of this study is to assess the attitude and knowledge of physiotherapy students toward mental health and patients with psychiatric illnesses and also to identify the barrier faced by them.

Methods:

Overall 191 physiotherapy students participated in this observational study, where students were assessed for their attitude toward patients having psychiatric disorders and knowledge regarding the same. The attitude was assessed using the Mental Illness Clinicians’ Attitude version 4 whereas knowledge was assessed using a prevalidated questionnaire. Both self-reported questionnaires were filled online by physiotherapy students. Data were analyzed using the SPSS software version 20. The correlation between attitude and knowledge was done using Spearman’s coefficient of rank correlation.

Results:

The majority of students had a moderately positive attitude with little room for improvement (57.07%) followed by 40.31% having a negative attitude. Good knowledge was found in 59.69% of students followed by 22.51% of students having moderate and 14.14% excellent knowledge. It was observed a negative significant correlation between attitude and knowledge (r = −0.369, P < 0.001). Gender, year of study, and age have a considerable impact on one’s knowledge and attitude.

Conclusion:

This study concludes that knowledge and attitude are negatively correlated indicating the need to change the attitude of physiotherapy students and to make them understand their role in the rehabilitation of patients with psychiatric disorders.
Role of neutrophil–lymphocyte ratio in the management of children with snake bite envenomation: A single-center prospective observational study
Authors: Vijayaragavan Kutty , Balasubramanian Jeyaraman , Venkataramanan Raghavendran , Manigandan Velusamy
Published: May 2024

Background:

Neutrophil–lymphocyte ratio (NLR) has recently gained popularity as a simple, inexpensive, and highly accurate inflammatory marker. When the differential count of leukocytes is checked following it is characterized by leukocytosis with an increase in neutrophil count and a decline in lymphocyte counts. This study was conducted to assess whether alteration in the differential count of leukocytes following envenomation has the ability to diagnose and predict the severity and prognosis in children and to derive a cutoff value for the same.

Subjects and Methods:

This prospective observational study was done in the pediatric intensive care unit (ICU) of a tertiary care hospital from July 2019 to June 2020. From the complete blood count of patients done at admission, NLR1 was calculated. All patients were treated as per the national snake bite treatment protocol. The amount of antisnake venom (ASV) given, duration of hospital stay, and ICU stay were correlated with NLR1 values.

Results:

An NLR value of 3.35 can predict envenomation with 95% sensitivity and 100% specificity. Similarly, an NLR value of 6.72 can predict the need for more than 10 ASV vials with a sensitivity of 93% and specificity of 97%, and an NLR value of 6.72 can predict the occurrence of major complications with a sensitivity of 89.3% and specificity of 94%.

Conclusions:

NLR can differentiate poisonous snake bites from nonpoisonous bites and can also predict the severity of the envenomation.
Role of electrocardiometry in hemodynamic assessment of children with shock in multisystem inflammatory syndrome following COVID-19: A single-center prospective observational study
Authors: Lalitha A. V. , Moharana Suman Sudha , Ghosh Santu
Published: May 2024

Background:

The hemodynamic profile in multisystem inflammatory syndrome in children (MIS-C) has not been well described. Therefore, we conducted the study utilizing electrocardiometry (EC) to assess the hemodynamic characteristics in MIS-C patients presenting with shock.

Subjects

and
Methods: This pilot prospective observational study was conducted in the pediatric intensive care unit of a tertiary care hospital. Children between 2 months and 18 years meeting the WHO criteria for MIS-C presenting with shock during second COVID-19 pandemic were included in the study. All patients underwent measurement of hemodynamic profile with EC for the initial 48 h of enrollment. Based on EC assessment at enrolment, the systemic vascular resistance index (SVRi) of 1000–1600 dyn s/cm5/m2 was regarded as normal. The hemodynamic categorization was defined as vasodilatory shock in EC (VDEC) (SVRi <1000 dyn s/[cm5/m2]) and vasoconstrictive shock in EC (VCEC) (SVRi > 1600 dyn s/[cm5/m2]).

Results:

Thirty-one children met the WHO case definition of MIS-C during the study period. Sixteen children with shock were enrolled and studied. Clinically, 7 (43.75%) children had cold shock, whereas 9 (56.25%) had warm shock. The measured baseline (mean [standard deviation]) hemodynamic variables were cardiac index (CI) of 6 ± 1.41 L/min/m2, stroke volume variation of 23% ±9.6%, SVRi of 954.75 ± 263.35 dyn s/(cm5/m2), and thoracic fluid content of 51.18 ± 17.26 ml. VDEC was the predominant manifestation (87.5%) based on EC.

Conclusions:

Vasodilatory shock was the predominant phenotype observed in critically ill children with MIS-C with shock by EC assessment.
Scope of Twitter application in facilitating the delivery of medical education: A systematic review
Authors: Shrivastava Saurabh RamBihariLal , Shrivastava Prateek Saurabh
Published: May 2024

The process of delivery of medical education has always been a complex one, considering the amount of knowledge, skills, and other essential attributes that need to be developed during the training period. The purpose of the current review was to explore the role of Twitter in medical education and the areas in which it can help to augment the learning process. An extensive search of all materials related to the topic was carried out on the PubMed and Google Scholar search engines, and a total of 39 articles were selected based on their suitability with the current review objectives and analyzed. The review of literature was done by a single investigator and thus there were no duplicate articles. Keywords used in the search include social media, Twitter, and medical education in the title alone only. Twitter plays a crucial role in ensuring the active engagement of students by promoting academic conversations. To conclude, Twitter provides a platform for rapid and easy sharing of information on a global scale and thus encourages collaborative learning. Amid the emergence of the COVID-19 pandemic and in order to satisfy the learning needs of medical students and practicing physicians, Twitter is an innovative option. The need of the hour is to encourage and explore the utility of Twitter in different settings and use the same as an added tool for the attainment of learning outcomes.
Association between XRCC-1 Arg194Trp polymorphism with lung cancer in Iraqi patients
Authors: Al-Rawi Susan Saab Manfi , Khalaf Aysar Ashour , Al-Jbouri Ashwaq M S , Jasim Saade Abdalkareem , Mutar Ayad Abdulrazzaq
Published: May 2024

Background:

Preface, DNA repair is the most efficient protective approach against DNA damage. Because the integrity of the genome is vital and crucial, the process of repairing DNA induced by carcinogens is critical. The ability to repair DNA damage may be impacted by specific genetic variants in DNA-repair genes, which may also be a risk factor for the development of cancer. The X-ray repair cross complementing-1 (XRCC-1) gene product has been linked to base-excision and single-strand repair mechanisms.

Objective:

The goal of this study was to examine the relation of the XRCC-1 gene with lung cancer patients.

Materials and Methods:

polymarease chain reaction- restriction fragment length polymorphism (PCR-RFLP) analysis was used to compare 40 lung cancer patients along with 40 sample controls. Samples were collected at Al-Amal National Hospital for cancer management, ages ranging from 40 to 70 years. Statistics were carried out by using the SPSS Software program Version 20.0.

Results:

The results show that the XRCC-1 (Arg194Trp) gene carried seven exons, which were shown to have different frequencies in patients and controls based on three genotypes (Arg/Trp, Arg/Arg, and Trp/Trp). Hardy–Weinberg equilibrium with chi-square for the patient (7.949) and control group (8.236). Also, the Arg/Trp genotype was present at a significantly high frequency in patients (77.5%), and the odds ratio was (14.94, confidence interval [CI] = 4.99–44.76 to CI = 0.642), whereas the Trp/Trp genotype frequency increased in the control group (72.5%). And the odds ratio for this relationship was (0.3, P = 0.001, and CI = 0.01–0.11).

Conclusion:

This study’s findings also suggest that the Arg/Trp genotype may be linked to lung cancer in this particular group.
Review on Therapeutic Trials for Coronavirus Disease-19
Authors: Salih Ayam M. , Al-Kelaby Khalida K. Abbas , Al-Zaidi Jawad R.
Published: May 2024

Our world was gripped by the coronavirus disease-19 (COVID-19) pandemic during the first months of the year 2020. It has been characterized as a new coronavirus (i.e., severe acute respiratory syndrome-CoV-2, which is an acute severe respiratory syndrome coronavirus, and later, it has been referred to as the coronavirus disease-19 or COVID-19. Whereas this disease has been originated in Wuhan city in the Chinese province of Hubei, it was capable of rapidly spreading all over the world, which has resulted in a human disaster as well as massive economic damages. By the middle of June 2020, there were more than 8 million COVID-19 cases all over the world, with more than 436,000 death cases. The aim of this review study was to investigate the most effective therapeutic trials for COVID-19.
Prevalence of Text Neck Syndrome in Children and Adolescents Using Smartphones in Erbil City
Authors: Aziz Areen Nimat , Bakir Lana Adil
Published: May 2024

Background:

Neck and shoulder pain is a common health issue among children and teenagers in developing countries.

Objective:

This study aimed to identify the prevalence of text neck syndrome and its associated factors in children and adolescents.

Materials and Methods:

In this cross-sectional study, children and adolescents who attended primary health centers (PHCs) along with their parents were included. Four main PHCs in Erbil city in Iraqi Kurdistan in 2022 were selected for this study.

Results:

The prevalence of text neck pain was 69.0% among children. The level of neck disability score was 17.15 out of 21 among children. Adolescents (96.05%) those who used smartphones >3 h (83.56%), those studying secondary level (94.24%), and those with psychological, social, and physical functions and children who slept less, played fewer sports, used more computers, watched more TV, and played the game more than 3 h were more likely to have text neck syndrome. The study showed that children who spent more time on smartphones, watching TV, playing games, and those with physical and social functions had a high level of neck disability.

Conclusion:

This study found a high prevalence of text neck syndrome among schoolchildren in this region. The high prevalence of text neck syndrome was associated with more using smartphones and watching TV and a high prevalence of physical, psychological, and social issues.
Humoral immunity role in diagnosis of COVID-19 among people visited to a tertiary care hospital in Hilla City
Authors: Al-Asady Furqan Mohammed , Omran Tuqa Zuhair , Abood Fatima Malik
Published: May 2024

Background:

Rapid diagnosis of coronavirus disease 2019 (COVID-19) infection is an important tool to control its outbreak.

Objectives:

The study aimed to evaluate the spreading of COVID-19 and the immunological responses toward COVID-19 infection with qualitative determination of both IgM and IgG.

Materials and Methods:

The current work involved a total of 803 individuals. The study involved the use of Biozek COVID-19 antigen fast kit.

Results:

In this study, 487 (60.6%) were male, and 316 (39.4%) were female. Patients aged from 3 to 75 years. The majority of patients were located within the age group of 11–20 years. Significant correlation was obtained between chronic diseases and age of patients. In spite of that the majority of patients without chronic diseases, the patients that had those chronic diseases were exceeded 40 years old. A highly significant correlation between the presence of symptoms and the IgM level in the serum of patients. IgG level was found to be in a significant correlation with the previous COVID-19 infection (109 patients). Moreover, a significant correlation was reported between the level of IgG and chronic diseases (101 patients).

Conclusion:

Serological method is beneficial in detecting IgM and IgG for COVID-19 and has a crucial role in diagnosing symptomatic and even asymptomatic patients, encouraging the early treatment protocols in case of severely ill patients. It can assist in assessing the immunological behavior of patients.