bluuebunny/crossref_metadata_2025 huggingface dataset:
A community-based study on health seeking behaviour among NCD patients in rural and urban Tamil Nadu – A convergent mixed method study
Authors: Kirubakaran S , Sudhan Dharshnee , Kovur Hariharan , Appanabhotla Prasananjali , Murugan Arun
Published: September 2024

ABSTRACT

This study focusses on the health seeking behaviour of NCD patients which entails regularity of health care facility visitations and adherence to lifestyle modifications.

Aims:

To analyse the hospital visitations and lifestyle modifications of NCD patients. To do a comparative study about the health seeking behaviour among NCD patients in Rural and Urban areas. To explore the various difficulties that patients face with regards to Lifestyle modifications.

Settings and Design:

It is a convergent type mixed-methods design, undertaken in the field practicing areas of RHTCs and UPHCs of Government Medical College, Omandurar Government Estate.

Methods and Material:

The data was collected by means of Free listing, Focussed Group Discussions, Key Informant Interviews and Structured Questionnaires from patients diagnosed with one or more non-communicable diseases.

Statistical analysis used:

Smith’s S value Manual Content Analysis Bivariate analysis.

Results:

The health seeking behaviour of NCD patients is influenced by lesser crowding and shorter distance to travel, reduced waiting time, focused attention from and familiarity with the healthcare provider, community health, systematic dispensing of medications and regularised testing. Rural population have a higher positively inclined health seeking behaviour than urban population.

Conclusions:

The health seeking behaviour of patients with NCDs seem to be on the positive trend and is influenced by the locality of the respondents.
Awareness of first aid among adults in Al-Ahsa City, Saudi Arabia: A cross-sectional study
Authors: Alanazy Ahmed , Alruwaili Abdullah , Al-Hassan Hassan H. , Almulhim Abdullah , Altaher Nawaf A. , Alhomoud Abdulraouf S. , Alduhaish Mohammed , Alanazi Sultan N. , Alanazi Turki M.
Published: September 2024

ABSTRACT

Background:

First-aid knowledge among the general public is critical for saving lives in medical emergencies before expert care arrives. However, studies show persistent gaps in layperson first-aid capacity worldwide. This study assessed first-aid knowledge and awareness among adults in Al-Ahsa City, Saudi Arabia, to identify strengths and weaknesses to guide tailored interventions.

Materials and Methods:

A cross-sectional survey was conducted among 716 adults recruited through convenience sampling. A structured questionnaire collected sociodemographics and assessed knowledge across 12 first-aid scenarios involving bleeding control, burns, seizures, choking, and cardiopulmonary resuscitation (CPR).

Results:

Just 59.2% correctly identified direct pressure to stop bleeding, and 61.2% knew proper burn first aid. Only 52% recognized the pediatric CPR compression-to-ventilation ratio (15:2), and 36.2% identified the chest compression rate of 100/min. For choking, 73.9% endorsed abdominal thrusts for children, but only 60.9% knew backslaps for infants. Females scored higher on bleeding (94.5% vs 92.8% correct) and abdominal thrusts (83.6% vs 66.1%), while males were more knowledgeable on burns (70.4% vs 53.8%) and infant choking (81.1% vs 44.7%). Younger and more educated respondents had higher scores.

Conclusions:

Major gaps exist in implementing proper first-aid techniques, especially differentiation by age. Deficits in direct bleeding control, high-quality CPR, and tailored pediatric care represent high-risk knowledge weaknesses in this population. Targeted education programs focused on skill-building in these areas, particularly for higher-risk demographics like the elderly and less educated, are critically needed to strengthen public preparedness and save lives. Findings provide key insights to inform evidence-based interventions.
Bias in obtaining broad consent in a German general practice? – Preliminary results from a cross-sectional study
Authors: Moser Konstantin , Bauch Felix , Richter Manon , Brütting Christine , Bauer Alexander , Vinker Shlomo , Deutsch Tobias , Frese Thomas
Published: September 2024

ABSTRACT

Background:

The growing importance of collecting Broad Consent (BC) for research utilizing electronic health records in Germany has brought attention to the need for a deeper understanding of potential selection bias in the process. Since 2020, the BeoNet-Halle outpatient database has been collecting anonymous and pseudonymous patient data from primary care and specialty practices throughout Germany, with the practice being an integral part of this data collection effort. The primary objective of the pilot study is to explore potential socioeconomic discrepancies between patients who provided BC and the general practice population.

Method:

This is a single-center, cross-sectional study. The study was performed with patients from one Medical Care Center including eight GPs. We categorized patients with at least one interaction with a general practitioner from March 2021 to January 2023 into two sets: patients who approved BC versus a randomly chosen representative sample (RS) of non-BC inquirers. We mailed a sociodemographic survey to both groups.

Results:

A total of 561 patients were analyzed, with the BC group responding more actively (60.7%) than the RS group (29.7%). Age and gender were similar between the BC group and RS group. Being widowed, divorced, or unmarried and being neither open nor hostile toward research was associated with an increased likelihood of giving consent. Analysis of personality traits did not show any impact on giving consent.

Conclusions:

Overall, this study outlines that there is some bias between BC and RS. Possible associations in BC decisions that offer insights into complex decisions to participate in medical research are marital status, immigrant background, income, and age. Findings emphasize the potential of BC for outpatient research, warranting further investigation to optimize its application in the general practice setting.
Role of FIRE-MADE FI for diagnosing frailty in central rural India and its comparison with LASA FI
Authors: Khan Khalid I. , Quazi Sabiha , Bawankule Shilpa , Acharya Sourya
Published: September 2024

ABSTRACT

Background:

An aging population ultimately has deprived physiological stores making them vulnerable for development of a syndrome called frailty, which presents with a cumulative decrease in tolerance, immunity, vision, balance, organ functions, health, and independent living. All these result in rising prevalence of frailty and its components, along with burden of disease, dependence, and health care cost. Thus, early estimation and assessment and interventions to correct it mark the mile stone in geriatric medicine. The present study was conducted with an aim to compare and correlate FIRE-MADE (Frailty Index in Rural Elderly – Mental status, Activities of daily living, Depression, and Events) FI (frailty index) with LASA (Longitudinal Aging Study Amsterdam) FI in central rural India’s geriatric population.

Methodology:

A cross-sectional study for assessment of frailty in the geriatric population of central rural India, reporting to the medicine department of a tertiary hospital, situated at Wardha district, by using FIRE-MADE and LASA FI was undertaken. Their scores were compared. The efficiency of FIRE-MADE FI in comparison with LASA FI was calculated. A frailty threshold of ≥ 0.25 is considered for diagnosing frailty. Standard descriptive and inferential statistics were used to evaluate all parametric and non-parametric data.

Results:

Out of 250 geriatric people, 224 (89.6%) were frail according to LASA FI and 204 (81.6%) were frail according to FIRE-MADE FI. As compared to LASA FI, FIRE-MADE FI was 91.07% sensitive and 73.08% specific, with a positive predictive value of 96.68% and a diagnostic accuracy of 89.20%.

Conclusion:

The Indian rural population of central India has high prevalence of frailty. FIRE-MADE FI can be used as a potential, effective, and validated tool for early diagnosing and management of frailty. Among the parameters of FIRE-MADE FI, IHD was the most important contributing factor for development of frailty, followed by cognitive impairment, polypharmacy, and remaining factors mentioned in FIRE-MADE FI.
Bacteriological profile and antibiotic sensitivity pattern of bloodstream infections from a teaching institution in Eastern Uttar Pradesh, North India
Authors: Gupta Shefali , Shukla Mukesh , Meena Mahendra , Nag Soumyabrata , Islahi Sana , Singh Sweta , Srivastav Akshat , Mukherjee Anirudh
Published: September 2024

ABSTRACT

Introduction:

Bloodstream infections (BSIs), encompassing both self-limiting bacteremia and potentially fatal septicaemia, make up the majority of healthcare-associated ailments worldwide. The organisms encountered are mostly multidrug-resistant (MDROs), leading to increased hospital stays. Our study aims to collect data about blood culture isolates from a medical college in eastern Uttar Pradesh, India.

Materials and Methods:

A retrospective analysis of blood culture isolates obtained at our laboratory for ten months from patients with clinical suspicion of sepsis or infection with the possibility of haematogenous spread was done. We only considered consecutive and patient-specific, non-duplicate isolates. Blood samples were initially incubated in BacT/ALERT® and then manually processed once they flagged positive.

Results:

A total of 1,033 blood samples were received, of which 217 (21%) showed the growth of a pathogenic organism. The positivity rate varied significantly across different age groups, locations, and departments (P value < 0.001). It was higher among in-patients, those with central venous access, and patients with diabetes mellitus (DM). Staphylococcus aureus [n = 105, 48.38%] was isolated most commonly, with a high prevalence of methicillin resistance (83%). Enterococcus demonstrated a high degree of resistance. MDROs accounted for 68% of the detected Gram-negatives.

Discussion:

This study comprehensively analyses blood culture results from a diverse group of patients and emphasizes the association between risk factors and positive blood cultures. Gram-positive and Gram-negative isolates demonstrated low sensitivity to common antibiotics, urging vigilant monitoring and specific therapy.

Conclusion:

Our study reveals important insights guiding clinical practices, antimicrobial stewardship, and infection control strategies.
Low back pain among college students in a public Saudi university: A cross-sectional study
Authors: Bin Abdulrahman Khalid A. , Al Askar Abdullah Talae S. , Alhamidi Abdulrhman Khalid A. , Al Sharani Abdullah Hezam A. , Alanazi Ali Abdulelah S. , Alkatheeri Abdullah Nasser H. , Alhazmi Maan Talal A. , Alharbi Abdulrahman Jahz
Published: September 2024

ABSTRACT

Background:

Low back pain (LBP) is the most prevalent orthopedic condition worldwide. University students are more likely to have this issue due to their demanding and time-consuming course load. This study aimed to investigate the prevalence of LBP and the factors that lead to it among students at the Imam Mohammad Ibn Saud Islamic University (IMSIU).

Methods:

This cross-sectional study targeted undergraduate students using an online self-administered questionnaire. A descriptive analysis method was conducted.

Results:

Of the 830 students who completed the survey, 71.4% were females. About two-thirds were aged between 18 and 22 years. Our study shows that 68.2% had complained of recent LBP. The most significant prevalent factor associated with LBP among IMAMU students, 94.2%, was prolonged sitting. Heavy object lifting is 93.2%, and unhealthy seating/body position is 90.2%, which comes in second and third place. Those who complained about the discomfort of their lecture hall seats were shown to be dramatically more likely (5.549 times more) to develop LBP than students who did not. Students with a positive history of depression were significantly more prone (2.565-fold) to LBP. A positive family history of LBP and smoking cigarettes were found to increase the chance of developing LBP.

Conclusion:

LBP among IMSIU students is high, mainly because of prolonged sitting, heavy object lifting, and unhealthy sitting and/or body position. There is a strong association between LBP and a positive family history of LBP, smoking, and uncomfortable seats. Prevenive measures, such as an intervention program for university students, are required.
Determination of SRPA and adiposity measures and its association with glycemic status in type 2 diabetics having high mean HbA1c in a private clinic of a city in west India
Authors: Solanki Jayesh D. , Vaghasiya Rahul , Sharma Isha , Patel Jagdish B.
Published: September 2024

ABSTRACT

Introduction:

Indian type 2 diabetics (T2D) is known for poor disease control on which self-reported physical activity (SRPA) and optimum body composition have positive impact. We determined prevalence of SRPA and general/visceral obesity and its impact on HbA1c-based glycemia.

Methodology:

By a cross-sectional study conducted on 200 T2Ds in a private clinic, HbA1c-based glycemic status, WHO questionnaire-based SRPA, BMI-based general obesity, and bipolar bioelectrical impedance-based visceral obesity were evaluated. SRPA and obesity were compared and associated with glycaemic status keeping mean HbA1c as cutoff.

Result:

Mean age, male%, mean duration of T2D, mean BMI, mean HbA1c, and SRPA prevalence were 54 years, 42.5%, 4.82 years, 25.49, 8.69%, and 61.5%, respectively. Comparison of groups based on either SRPA or BMI (cutoff 25) showed better HbA1c with the presence of SRPA and BMI <25. Physical inactivity imposed odds risk of 3.44 for visceral fat (VF) ≥10% and odds risk of 2.6 for more than mean HbA1c with statistical significances. VF ≥10% imposed odds risk of 4 for higher than mean HbA1c. Physical inactivity and visceral obesity together imposed ⅓rd prevalence of better glycaemic value, while physical activity and controlled visceral obesity yielded ¾th prevalence of good glycaemic value.

Conclusion:

In T2D with poor glycaemic status and moderately prevalent physical activity, we found strongly significant association of SRPA and controlled body adiposity with HbA1c-based glycaemic status. It reaffirms physical activity and control of central obesity as forerunners of better glycaemic status and calls for further studies having vertical follow-up.
A study of parental knowledge and intended behaviour regarding introduction of juices and sugar-sweetened beverages in early childhood
Authors: Mori Sandip R. , Kumar Amit , Shah Sneh U. , Shah Deepali M. , Dhedhi Naresh D. , Tandon Krutika R.
Published: September 2024

ABSTRACT

Background:

Parents and families have a role to play in helping children develop healthy behaviours that will carry over into adulthood. The sugary drink and fruit juice consumption is significantly related to unhealthy weight gain in childhood. Hence, this study was planned to assess parental knowledge, attitudes, and practices about juice and sugar-sweetened beverages (SSBs) among parents of children (2–24 months) and identify factors that contribute to their early introduction.

Methods and Material:

A cross-sectional study was conducted on 400 children-parent dyads (2–24 months). A questionnaire regarding the knowledge and attitudes about initiating fruit juice and SSB among children was prepared with 6 statements that were validated for contents by two subject experts. Each of the questions was designed to be answered on a Five-point Likert-type scale. STATA 14.2 version was used to analyse data.

Results:

Out of 400, 14 (26.9%) and 125 (68%) parents planned to introduce SSBs and juices respectively in the first year life of their child. None of the parents had an excellent knowledge score. There was no significant difference reported between parents with less than high school and those with high school/graduation educated in their intention to introduce juice and SSBs (P = 0.68) to their babies in the first year of life and about its knowledge (P = 0.82). Most parents with lower socio-economic status (58.6%) showed less likeliness to introduce juices and SSBs to their child’s diet as reflected by a statistically significant (P = 0.01) knowledge score.

Conclusion:

There was a knowledge gap among parent’s of children irrespective of their education level and socio-economic status.
Patient-centered approaches to communicating ear, nose, and throat advancements: Bridging the knowledge gap
Authors: Salunkhe Rahul M. , Salunkhe Shradha R. , Prashant Rashmi , Ingale Mayur H. , Tayade Motilal C.
Published: September 2024

ABSTRACT

Background:

Effective communication between patients and healthcare providers is essential for optimal care outcomes, particularly in the field of ear, nose, and throat (ENT) medicine. Our study aimed to explore patient-centered communication approaches in the context of ENT advancements to bridge the knowledge gap between healthcare providers and patients.

Methods:

A mixed-methods approach was employed, including quantitative surveys, qualitative interviews, and medical record reviews for this cross-sectional observational study. A total of 120 patients and 40 ENT clinicians were included in the study, with data collected over a 1-year period. Demographic characteristics, patient understanding, satisfaction with communication, preferences for receiving information, and themes identified from qualitative interviews were analyzed.

Results:

The study revealed high levels of patient understanding and satisfaction with communication from ENT providers. Verbal communication was the most preferred method for receiving information, followed by written materials and online resources. Qualitative interviews identified themes emphasizing the importance of clear communication, desire for shared decision-making, and the need for accessible information. The survey among 40 ENT practitioners reveals that 25% utilize multimedia platforms frequently, 50% occasionally, 20% rarely, and 5% never.

Conclusion:

In conclusion, the findings of this study highlight the importance of patient-centered communication in enhancing patient understanding, satisfaction, and engagement in ENT healthcare speciality. By prioritizing clear communication, shared decision-making, and accessible information, healthcare providers can influence patients to play an active role in their care and improve healthcare outcomes.
Knowledge, attitude, and practice of primary health physicians in Saudi Arabia in prescribing vitamins and minerals as treatment for hair loss
Authors: Aljulifi Mohammed Zaid , Mubki Thamer , Alaboody Ziyad Mohammed , Alamri Ammar Nasser , Altariqi Waleed Mohammed , Alharbi Bader Salem , Almohaimeed Abdulaziz Fahad
Published: September 2024

ABSTRACT

Purpose/Background:

Hair loss is a common presentation in primary care. This condition is caused by telogen effluvium and alopecia, among others. Several factors such as drugs, trauma, and emotional and physiological stress can lead to the development of hair loss in addition to vitamin and mineral deficiency. This study aimed to assess the knowledge and practice of primary health physicians in Saudi Arabia on the use of vitamins and minerals for the treatment of hair loss with the research question of what is the knowledge and practice level among primary physicians in Kingdom of Saudi Arabia regarding hair loss.

Methods:

This cross-sectional study was carried out in primary health care centers in Saudi Arabia. Data were collected by a self-administered online questionnaire. The questionnaire included two parts; the first one is the personal information such as age, sex, year of experience, and current medical ranking. The second part included questions assessing the knowledge and practice of using vitamins and minerals for treatment of hair loss. Data were analyzed by using Statistical Package for Social Sciences (SPSS).

Results:

A total of 146 physicians were included in the final analysis with a mean age of 41.65 (SD = 12.71). Slightly over half (54.1%) were juniors being general practitioners or residents. The mean knowledge score was 12.6 (SD = 2.83), and the mean practice score was 8 (SD = 3.43), with no difference between the total score between the senior and junior physicians, while some significant differences were noted in some items of both scores. No significant association was noted between knowledge and practice scores.

Conclusion:

The findings show the low scores of knowledge and practice among doctors about the causes and treatment of hair loss. Guidelines should guide practice regardless of seniority. Future studies should address each group separately.
Parents’ views on pediatric COVID-19 vaccine in Saudi Arabia
Authors: Alhusayn Khalid , Basudan Loay , Jnaid Hussam , Alkhunizan Muath , Abdulkarim Ahmed , Alodhaibi Khitam , Sultana Habiba , Alsulaiman Thamer , Alendijani Yaser , Khan Abdul Rahman , Alkhenizan Abdullah
Published: September 2024

ABSTRACT

Background:

To end the COVID-19 pandemic, we need to reach herd immunity. A successful pediatric COVID-19 immunization program is the only way to achieve this goal. The objective of this study was to determine the views of parents in Saudi Arabia on the COVID-19 vaccine in children.

Materials and Methods:

This cross-sectional study took place within the Family Medicine Pediatric clinics at the King Faisal Specialist Hospital and Research Center (KFSH and RC). All parents of patients of Family Medicine Pediatric Clinics at KFSH and RC, Riyadh, were invited to participate in this study between January 2022 and June 2022. A culturally sensitive and specially designed questionnaire was administered using an interview-based model.

Results:

Safety concerns were the primary reason for vaccine hesitancy among parents, with 29.7% of parents expressing concerns about side effects and 25.1% not knowing where to get reliable information about vaccines. Negative information and lack of perceived need were also important factors, with 17.1% and 18.3% of parents citing these reasons, respectively. Poor knowledge about vaccines was a significant predictor of parental vaccine hesitancy. Mothers had more concerns about the efficacy and safety of vaccines than fathers.

Conclusion:

Our study demonstrated a negative attitude toward the pediatric COVID-19 vaccine among parents in Saudi Arabia. A higher level of awareness about the vaccine was significantly associated with planning on having the vaccine. There is a need for effective awareness programs for better pediatric COVID-19 vaccine-related education to increase the acceptance of the vaccine among parents in Saudi Arabia.
Seroprevalent study of cytomegalovirus infection in the regions of Jharkhand
Authors: Sundi Anita , Roopa Nilamber , Gupta Piyalee , Irfan Sana , Kar Tarun Kumar
Published: September 2024

ABSTRACT

Background:

The Human Cytomegalovirus (HCMV) is a type of beta herpesvirus widespread in all human populations. It is estimated that up to 80-100% of adults worldwide and most infections are harmless and can cause severe health complications in infants, like hearing loss and developmental issues. Still, immunocompromised individuals can experience serious complications from the virus. Unfortunately, there is limited information on the prevalence of this virus in our country, and no studies have been reported on the rate of CMV transmission yet.

Objectives:

This study aims to evaluate the levels of IgM antibodies against Cytomegalovirus (CMV) in East Singhbhum, West Singhbhum, and Seraikela Kharsawan using an ELISA test.

Methods:

An indirect ELISA test was performed to detect anti-CMV IgM and the period of study was from January’2021 to June’2023.

Results:

The examination tested 55 people for the TORCH profile of CMV parameters from regions of East Singhbhum, West Singhbhum, and Seraikela Kharsawan. Here, 17 people (30.09%) were IgM positive by ELISA.

Conclusions:

The serological data confirms that CMV is not being monitored and recognized in the general population, which limits our study between CMV infection, disease, and clinically diagnosed outcomes. This understanding is crucial for the healthcare and policy sectors. Thus, we recommend implementing a surveillance and mindfulness program for at least one-fourth of the population in Jharkhand and continuing to explore and develop effective vaccines to control CMV infections.
Feedback to national medical commission regarding aadhar-enabled biometric attendance system at medical colleges in India
Authors: Gupta Harish
Published: September 2024

ABSTRACT

Teachers are the backbone of any country, the pillars upon which all aspirations and dreams converge, if we paraphrase 11th President of India, Dr A P J Abdul Kalam,. A teacher of a Medical college has immense potential to shape the foundation and basic wisdom/ technical skills of a young student and resident. So, teachers’ absence makes the learners bereft of these gifts- making them vulnerable to construct poor reasoning and judging clinical scenarios inappropriately: deriving incorrect or false interpretation from a given case presentation. For this reason, when the National Medical Commission (NMC) comes up and pushes for an idea ensuring physical presence of workforce at their respective workplaces, everyone should welcome the move. Nevertheless, like every fixture the virtual solution has its unique challenges, requiring nuances for proper assessment, demands reasoned and detailed dissection of actual ground -level situation; hence, I want the regulatory body to tweak the attendance -system to make it suitable for diverse atmosphere, varying working -conditions and rapidly -changing environment. Such formulation should have two- way communication channels between man (and woman) power as well as their regulators. Only then fine -tuning may be expected to be achieved to derive the maximum benefit while reducing chances of error/ omission/ glitch/ incompleteness and fault.
Self-medication practices among university students at a public university in Riyadh, Saudi Arabia
Authors: Bin Abdulrahman Khalid , Alharbi Abdulaziz Khalid , Alhaddad Abdulrahman Mohammed , Alshaya Abdulaziz Mohammed , Aldayel Abdullah Sultan , Aljumaiah Muath Abdullah
Published: September 2024

ABSTRACT

Background:

Self-medication is a concern at the global level. It comes with complications and different health issues. This study measures the prevalence, influential factors, and reasons behind self-medication.

Methods:

A descriptive cross-sectional study was conducted at Imam Mohammad Ibn Saud Islamic University. The prevalence and influential factors were measured between September and November 2023. Statistical analysis was performed using RStudio (R version 4.3.1). We used frequencies and percentages to present categorical variables. Using a convenient sampling technique. Factors associated with using self-medication and the differences between students of the medical college and their non-medical counterparts were assessed using Pearson’s Chi-squared test or Fisher’s exact test. Statistical significance was considered at P < 0.05.

Result:

We initially received 410 responses on the online platform. However, we excluded seven responses from those who disagreed to participate and 12 from participants outside Riyadh. The majority of the participants were female (67.5%). Three hundred nineteen (319) participants indicated that they had ever used self-medications, accounting for a prevalence of 81.6%. Regarding the reasons for self-medication, the most frequently cited factors were ‘previous experience’ (66.5%) and ‘time-saving’ (50.2%). Additionally, the primary source of drug information utilized for self-medication practices was predominantly from ‘relatives/friends’ (62.4%) and ‘pharmacologists’ (48.0%). Medications were primarily used for headache (76.8%), fever (48.6%), and pain (47.3%). The most commonly used classes of drugs used for self-medication were painkillers (84.0%), vitamins (42.0%), and eye drops (32.9%).

Conclusion:

The results showed that the prevalence of self-medication is high in the surveyed population. There has been an association between monthly income and the prevalence of self-medication. As pharmacists are the second most common source of drug information, it is essential to increase responsibility and avoid marketing and personal benefiting behavior as they are considered a reliable source of information in the population. Healthcare organizers can utilize our study to educate people about the adverse effects of self-medication.
Impact of yoga-based interventions on cognitive and autonomic functions in major depressive disorder population
Authors: Sharma Sunidhi , Kacker Sudhanshu , Saboo Neha
Published: September 2024

ABSTRACT

Background:

Cognitive and autonomic dysfunction is increasingly being recognized as an important clinical dimension in major depressive disorder.

Aim:

The aim of this study is to evaluate the effect of a combined approach of yoga and diet intervention on cognitive and autonomic functions in individuals with major depressive disorders.

Methods:

This experimental observational study was conducted at RUHS College of Medical Sciences and Associated Hospitals, Jaipur, on the major depressive disorder population of either sex cognitive function (mini-mental score, Montreal cognitive protocol A and B, P300 latency and amplitude) and autonomic function parameters (frequency and time domain) were recorded at baseline and after three months of a combined approach of yoga and diet intervention.

Results:

This study compared cognitive and autonomic function parameters at baseline and after three months of yoga and diet intervention in a major depressive disorder population. Analysis revealed a significant decrease in body mass index (<0.05), systolic blood pressure (<0.001), Hamilton rating scale for depression (<0.001), P300 latency (<0.001), standard deviation of NN interval (SDNN) (<0.001), and mean heart rate (<0.001), whereas there was a significant increase in mini-mental score (<0.001), Montreal cognitive protocol A and B (<0.001), high frequency (HF) (<0.001), root mean square standard deviation (RMSSD) (<0.001), and PNN50 (<0.001) after a combined approach of yoga and diet in the study group as compared to control group participants.

Conclusions:

Yoga and diet combined may be an effective adjunct therapy for improving brain health and mental performance, lowering the risk of depression by affecting the neurotransmitter system and raising vagal tone which contributes to learning and memory.
Central diabetes insipidus: A rare primary manifestation of small-cell lung carcinoma
Authors: Kavya S , Rajanna Avinash H. , Kishore Naval , Chandrashekar Aditya
Published: September 2024

ABSTRACT

Diabetes insipidus (DI) is a disorder of water hemostasis that is associated with polyuria-polydipsia syndrome. Central DI (CDI) primarily results from autoimmune destruction, traumatic injury, or anatomical damage caused by neoplasms. Craniopharyngioma, germinoma, and distant metastases are the main neoplastic causes, with pituitary adenomas rarely manifesting as CDI. Pituitary gland metastasis is rare, with the vast majority of cases being asymptomatic. We present a rare case of pituitary metastasis originating from small-cell carcinoma of the lung with CDI and skin swellings as the primary manifestation, without any evidence of the primary malignancy upon initial presentation. A 56-year-old chronic smoker with newly diagnosed type-2 diabetes mellitus presented with a history of polydipsia and polyuria along with soft tissue swellings in the axilla and the chest for the last 3 months. A water deprivation test and a desmopressin challenge test were performed, revealing the presence of CDI. In light of the CDI, a contrast-enhanced magnetic resonance imaging brain was performed, which displayed a loss of pituitary bright spot and four T2 isointense lesions with post-contrast enhancement in the left frontal, parietal, occipital, and right temporal lobes, suggestive of metastatic lesions. Fine needle aspiration cytology of the swelling revealed cytomorphological characteristics indicating the presence of malignancy, specifically favoring carcinoma. Contrast-enhanced computed tomography thorax revealed a right hilar lung mass infiltrating the surrounding structures with multiple regional and distant metastases. A lung biopsy confirmed the presence of small-cell lung carcinoma (SCLC). The final diagnosis was advanced SCLC with multiple distant metastases associated with CDI, and the patient is currently receiving palliative care and inhalational desmopressin. In conclusion, metastatic lesions and lung cancer must be considered early when patients present with polydipsia and polyuria symptoms.
Needs assessment of military medicine education curriculum in medical students and upcoming challenges
Authors: Khoshi Abolfazl , Raeeszadeh Mohammad , Moghaddam Jamal Akhavan , Goodarzi Hassan
Published: September 2024

ABSTRACT

Introduction:

The curriculum of military medicine for medical students of universities of military medical sciences is a priority and a practical goal. Paying attention to the educational needs of students creates vitality and motivation among students for better learning and improving the learning environment. Frequent monitoring and updating of the content of military courses and modern teaching improve the quality and quantity of the military medicine curriculum.

Materials and Methods:

This applied, inductive, and exploratory descriptive was conducted in a single cross-sectional and qualitative method. The data were collected using the brainstorming method and individual and collective Delphi techniques. The population included the medical students of Baqiyatallah University of Medical Sciences in Tehran, Iran, who completed the course in military medicine. The data were collected by purposive sampling and classified until the saturation limit was reached. EXCEL 2019 and MAXQDA2020 software were used for data analysis.

Findings:

This research was carried out in collaboration with the military medicine department of the university to identify the needs of students in the military medicine curriculum. First, the findings were collected in 22 axes. In the next step, the needs were prioritized in the four main components of the combat medicine curriculum (1 goal, 2 content, 3 teaching strategy, 4 evaluation), and the results were extracted.

Conclusion:

Identifying the needs of students; improving the current military medicine curriculum; paying attention to individual differences, interests, and talents of students; and enhancing the motivation and level of satisfaction of students are the study results.
Clozapine-induced acute akathisia: A case report
Authors: Abhilasha Pallavi , Bhatti Neena , Joseph Girish , Injety Ranjit J.
Published: September 2024

ABSTRACT

Existing data suggest that clozapine has lesser propensity of developing akathisia as compared to first general antipsychotics. Clozapine is mostly used in patients with treatment-resistant schizophrenia, which is a second-generation antipsychotic. Akathisia is one of the rare side effects of clozapine. A 34-year-old woman with a 7-year history of schizophrenia exhibited positive and negative symptoms, initially treated with haloperidol and clonazepam. Despite relief in positive symptoms, she experienced recurring cycles of symptom exacerbation upon discontinuing medication. Because of poor compliance, she was admitted and started on clozapine, reaching 150 mg/day. Although showing symptom improvement, she developed clozapine-induced akathisia, characterized by restlessness and limb movements. Propranolol and a gradual reduction in clozapine alleviated akathisia, supplemented by lorazepam. The Barnes Akathisia Rating Scale dropped to 0 after three weeks. This case highlights the challenges of managing schizophrenia and the importance of tailored medication strategies. The use of clozapine should be customized based on each patient’s needs to prevent clozapine-induced akathisia.
The challenge of identifying family carers in general practice at an early stage and measuring their burden: A scoping review of possible tools and their actual use
Authors: Marx Yvonne , Bauer Alexander , Frese Thomas , Unverzagt Susanne
Published: September 2024

ABSTRACT

Informal care, provided unpaid by family members or friends is a crucial source for providing care at home due to chronic illnesses, disability, or long-lasting health issues. An increasing burden on informal carers largely determines the already proven negative mental and physical health effects. General practitioners are usually responsible for recognizing the effects of persistent burdens on informal carers at an early stage to maintain a functional caring relationship by providing individual support. A scoping review was conducted in four databases (PubMed, LIVIVO, Cochrane Library, and Cumulative Index to Nursing and Allied Health Literature [CINAHL]) until July 31, 2023, to identify studies describing the actual use of tools to identify informal care and measure the burden due to informal care. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines were followed to select studies. A total of 5.686 references were identified, and 59 potentially eligible articles were assessed for inclusion, resulting in the inclusion of five studies published between 2009 and 2019. Instruments were primarily used to measure burden after an intervention; only one study focused on instruments to identify carers in general practice. This review highlights the need for a tool to identify informal carers in general practice, but it is important to consider practice-specific processes and settings. Future research should take a proactive approach to testing, modifying, and implementing an assessment and optimizing framework conditions. A follow-up project should be initiated to evaluate the effectiveness of an adapted identification tool on the burden and health of family carers.
Utilization of telemedicine services of institute of national importance in the western region of INDIA: A mixed-method study
Authors: Joshi Krupal , Modi Bhautik , Katoch CDS
Published: September 2024

ABSTRACT

Introduction:

Telemedicine has emerged as a crucial healthcare tool, especially during the COVID-19 pandemic, offering risk-free contactless communication between physicians and patients. In India, the introduction of official guidelines in 2019 and initiatives like the “e-Sanjeevani” national teleconsultation portal have accelerated telemedicine’s adoption. However, the utilization and satisfaction levels of telemedicine services in Institutes of National Importance (INI) remain underexplored.

Objective:

This mixed-method study aims to describe the utilization of telemedicine services at the All India Institute of Medical Sciences (AIIMS), Rajkot, an INI in western India, and assess patients’ satisfaction with these services.

Methods:

Data was collected from patients availing telemedicine services through the e-Sanjeevani portal at AIIMS Rajkot between February and December 2022. Quantitative analysis included patient demographics, specialty attended, location, call duration, and wrong call rates. Qualitative analysis involved interviews with patients to assess their experiences and satisfaction levels. Statistical analyses were performed using SPSS for quantitative data and Atlas Ti for qualitative data.

Results:

A total of 12,442 doctor-to-doctor and 7,876 patient-to-doctor consultations were recorded, with a diverse age distribution (21-40 years, 45.4%). Most patients were from medical specialties, with general medicine, Pulmonary Medicine, and Dermatology being the highest. The data revealed a wide geographic distribution, with over 70% of cases from more than 200 kilometers away. Despite some challenges, including a 38.2% wrong call rate, the telemedicine services were well-received, with 96% of respondents reporting overall satisfaction.

Conclusion:

Telemedicine services at AIIMS Rajkot have shown high user satisfaction and accessibility, highlighting their potential in improving healthcare delivery and access, particularly in remote areas. However, efforts to enhance digital literacy and address challenges are necessary for further optimization of telemedicine services.
Assessment of the pattern of antibiotic resistance among microorganisms isolated from the culture medium prepared from hospitalized patients: A retrospective study
Authors: Davarpanah Mohammad Ali , Vares Vazirian Sara
Published: September 2024

ABSTRACT

Background:

Antibiotic resistance has become quite a challenge in the treatment of bacterial infections in the world. Therefore, the present study was conducted with the aim of investigating the pattern of antibiotic resistance among microorganisms isolated from the culture medium prepared from hospitalized patients.

Methods:

The type of study was cross-sectional descriptive. The antibiotic resistance pattern of positive samples collected from patients who got hospitalized in Shahid Faghihi hospital of Shiraz University of Medical Sciences between 2020 and 2021 using the disc diffusion method according to CLSI standards was measured. Then the data were entered into SPSS version 22 software and analyzed with appropriate statistical tests.

Results:

Of all positive samples, 69.7% were Gram-negative and the rest were Gram-positive. The most frequent Gram-negative bacteria were Acinetobacter baumannii (31.4%), Escherichia coli (25.3), and Klebsiella pneumonia (21.2%), and the most frequent Gram-positive bacteria were Staphylococcus aureus (79%), Coagulase-negative staphylococci (15.4%), and Enterococcus (3.6%). The resistance rate of Acinetobacter baumannii, Klebsiella pneumonia, and Pseudomonas aeroginosa against ciprofloxacin was 91.4%, 74.3%, and 52.3%; the resistance rate against gentamicin was 90.5%, 54.3%, and 43.9%; the resistance rate against Piperacillin-Tazobactam was 85.6%, 65%, and 43.1%; the resistance rate against imipenem was 97.1%, 57.9%, and 65.4%; and the resistance rate against colostin was 1.9%, 0%, and 3.4%, respectively. The resistance rate of Staphylococcus aureus against cefoxotin and vancomycin was 42.7% and 2.8%, respectively.

Conclusion:

Finally, we concluded from this study that microorganisms isolated from patients have developed resistance to many commonly used antibiotics.
Accessory breast tissue—A matter for exigence!
Authors: Tomey Vandana S. , Shivsharan Pradeep S. , Kalbande Shubham S. , Joshi Madhulika S.
Published: September 2024

ABSTRACT

Background:

The accessory breast tissue is found in 6%. It is seen commonly in the axilla. It is asymptomatic or causes pain, restricts arm movement, causes cosmetic problems, or causes anxiety. We evaluated symptoms, signs, investigations, treatment, and postoperative complications of women with accessory breast tissue.

Methods:

Our cross-sectional study was conducted in the Surgery OPD, Nagpur, on 52 women who presented with accessory breast tissue in the period from January 2019 to October 2023.

Results:

In this study, of 52 patients, the majority, that is, 38 (73.07%) patients, presented with uneasiness due to the position of mass followed by 25 (48.07%) with swelling in the axilla. Twelve (23.07%) patients presented with pain in mass in premenstrual and menstrual periods, and seven (13.46%) patients with accessory nipples. Fifty (96.15%) patients had axillary swelling. One (1.92%) patient each had swelling in groin and thigh. Thirty-six (69.2%) patients had sonography findings consistent with breast-like tissue. In nine (17.30%) patients, findings suggested lipoma. Surgical excision was conducted in 52 (100%) patients. In 43 (82.69%) patients, histopathology was consistent with simple breast tissue. In six (11.53%) patients, it was fibroadenoma, and in three (6.76%) patients, histopathology was suggestive of carcinoma. Twenty-eight (53.84%) patients had no complications. Thirteen (25%) patients had an allergy to sticking, six (11.53%) patients had uneven scar, and four (7.69%) patients had hypertrophy of scar.

Conclusion:

In our study, in the majority of patients, the site of accessory breast tissue was axilla. It caused uneasiness. Surgical excision was conducted in all patients. Postoperative complications were the least.
A cross-sectional survey of ocular problems after COVID-19 infection among healthcare workers at a teaching hospital
Authors: Mishra Santosh Kumar , Kumar Naveen , Kumari Arti , Verma Anant Kumar
Published: September 2024

ABSTRACT

Purpose:

The COVID-19 pandemic was caused by severe acute respiratory syndrome coronavirus-2 (SARS-COV2). The impact of the pandemic is becoming more apparent now on various tissues and body organs. Limited knowledge is present about the characteristics, duration, and long-term sequelae of ocular problems post-COVID-19 infection. The purpose of the present study was to evaluate and analyze the ocular problems occurring in healthcare workers after COVID-19 infection.

Material and Method:

This was a cross-sectional survey study conducted in the Department of Ophthalmology, Patna Medical College and Hospital, Patna. The participants were healthcare workers who were exposed to COVID-19 infection ≥6 months back. A questionnaire was prepared. Responses were evaluated and analyzed. Patient consent and institutional committee permission were taken as per norms.

Result:

A total of 210 healthcare workers who were infected with COVID-19 >6 months back responded with complete answers. The maximum number of respondents was between the ages of 31 and 60 (73.3%). The pre-covid ocular problems were present in 25% of the participants, especially in those having chronic diseases (such as diabetes, hypertension, or both). Post-ocular problems were faced by 60% of the participants, which was significant (P < 0.01). Dry eye, itching, and foreign body sensations were present in 60% of those facing ocular problems (P < 0.01). Ocular surface manifestations were more common.

Conclusion:

A knowledge, understanding, and awareness about ocular problems and their long-term sequelae in post-COVID-19-infected patients will help in early diagnosis and better management of such patients.