bluuebunny/crossref_metadata_2025 huggingface dataset:
Barriers and facilitators to COVID-19 screening at Jaipur International Airport, India
Authors: Mantri Neha , Joshi Nitin Kumar , Bhardwaj Pankaj , Goel Akhil Dhanesh , Gupta Manoj Kumar , Singh Kuldeep , Misra Sanjeev
Published: November 2022

ABSTRACT

Background:

Airports pose a possible threat in facilitating global disease transmission within the community which may be prevented by rigorous systematic entry-exit screening. This study captures the perception of stakeholders on barriers and facilitators of coronavirus disease 2019 (COVID-19) screening. Further, key outcomes viz. total passengers screened, suspected cases, and confirmed cases were assessed.

Methods:

An inductive-deductive mix-method thematic analysis was conducted to capture qualitative data of key stakeholders on COVID-19 disease screening at Jaipur International Airport. Additionally, secondary data retrieved from Rajasthan Medical & Health Department team deployed for COVID-19 airport screening were analyzed.

Results:

Jaipur International Airport screened 4565 passengers (Males = 4073 and Females = 492) with 23 suspected cases during an outlined period of declaration of Pandemic to Lockdown in India (11 to 24 March 2020). Total 65 passengers had travel history from China (3 from Wuhan). The mean average age of passengers was 40.95 ± 7.8 years. The average screening time per passenger was 2-3 min with a load of 25-90 passengers per team per flight. Fishbone analysis of screening challenges revealed poor cooperation of passengers, masking symptoms, apprehension, and stigma related to quarantine. Moreover, inadequate human resources and changing guidelines overburdened healthcare providers. But, perception of risk, and social responsibility of travelers together with supportive organization behavior act as facilitators. Overall, groundwork on airport screening was insightful to propose key action areas for screening.

Conclusions:

Globally, COVID-19 has an impact on health infrastructure and international travel. International coordination with streamlined screening will go an extended way in virus containment.
Clinical and laboratory profile of patients with presumptive clinical diagnosis of acute bacterial meningitis and its short-term complications
Authors: Garg Anubha , Fotedar Sanjay , Bharti  , Garg Dinesh , Sharma Anupama , Chawla Sumit
Published: November 2022

ABSTRACT

Background:

Worldwide, one million cases of bacterial meningitis are estimated to occur and 200,000 of them die annually. Case fatality rates vary with age at the time of illness and the species of bacterium causing infection. In view of variable clinical features and complication rates in various studies, the present study was planned to assess the clinical and laboratory profile of patients with acute bacterial meningitis and analyze the therapeutic response and short-term sequelae.

Materials:

This study was conducted in the department of pediatrics at Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences (PGIMS), Rohtak. A total of 50 pediatric patients with signs and symptoms of acute bacterial meningitis who satisfied the inclusion or selection criteria were enrolled in the study. Appropriate statistical tests were applied for analysis and trial registry was done with PGIMS.

Results:

In the present study, slightly more males (54%) were found than females (46%). The sequelae and mortality were 33.3%, 26.1% and 7.4%, 8.7% in males and females, respectively. There were higher chances of sequelae or mortality in males as compared to females (OR 1.289, 95% CI 0.073–6.11, P > 0.05). Predominant cells were polymorphonuclear (PMN) cells except in >120 months age group where both PMN (50%) and mononuclear (50%) cells were equally visualized. Mean CSF protein was slightly higher in 2–24 months age group.

Conclusion:

We compared the group with sequelae with the group with no sequelae and found neurological deficit (P < 0.01), and presence of complications (P < 0.01) were significantly associated with sequelae.
Effect of 0.5% povidone-iodine on the nasopharyngeal and oropharyngeal viral loads in patients with COVID-19: A double-blind placebo-controlled randomized clinical trial
Authors: Sharma Pranav , Singh Amit , Singh Naresh Pal , Takhelchangbam Nilima , Kumar Raj , Yadav Ramakant
Published: November 2022

ABSTRACT

Background and Objective:

The povidone-iodine (PvP-I) nasal antiseptic has been shown to completely inactivate the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in vitro at variable concentrations. This study was performed to investigate the effect of 0.5% PvP-I nasal drops and oral gargles on the nasopharyngeal and oropharyngeal viral loads in SARS-CoV-2-positive patients.

Methods:

This was a double-blind, placebo-controlled, randomized clinical trial among patients aged ≥18 years with reverse-transcriptase polymerase chain reaction confirmed in the mild to moderate category of SARS-CoV-2 infection. A total of 32 patients were randomly assigned to receive either freshly prepared 0.5% PvP-I solution or distilled water in the form of supervised self-administered 4–5 nasal drops, followed by 20 ml for gargling for at least 30 seconds. The main outcome measure was the mean change in viral titer and Ct values in the nasopharyngeal and oropharyngeal samples at baseline, 5 minutes, and 3 hours post intervention.

Results:

The mean change in viral titers across the time duration for the test group when compared with the control group was not statistically significant (P = 0.109). However, the mean change in Ct value was found to be borderline statistically significant (P = 0.042). Noticeable differences were noted among the mean viral titers and Ct values in the intervention group when plotted against the time of testing as compared to the control group. PvP-I solution at 0.5% dilution was well tolerated, and no evident side effects were reported.

Conclusions:

This study shows that 0.5% PvP-I has an effect on reducing nasopharyngeal and oropharyngeal viral loads in COVID-19 patients. This can be of substantial aid for the primary care physicians, especially for the practitioners in remote and resource poor areas.
Household secondary attack rate in SARS-CoV-2 infection during the second wave of the COVID-19 pandemic in South India
Authors: Areekal Binu , Joseph Navya C. , Rajan Maneesha P. , Ravindran Reshmy K. , Vijayan Anagha S. , Vanlalhriatpuii Emmanuelle
Published: November 2022

ABSTRACT

Background:

Coronavirus disease 2019 (COVID-19) has become a major public health problem since its inception disrupting public life and crippling health systems. The mutated variant of the causative virus, Delta, has been notorious in causing rapid upsurge in cases compared to the Alpha variant. The current study tries to find out the household secondary attack rate (HSAR) of COVID-19 and factors associated with it during the second wave of cases in Kerala.

Methodology:

A retrospective cohort study was performed among 313 household contacts of 76 COVID-19 patients who had been admitted in Government Medical College, Thrissur, in the southern state of India, Kerala. Data from the participants were collected via phone using a semi-structured interview schedule, and analysis was performed with SPSS software.

Results:

The HSAR among household contacts was 59.1% (53.4–64.6%). The risk of acquiring COVID infection among household contacts was higher among contacts of symptomatic index cases with a P value of 0.001 and an odds ratio of 11 (3.7–32.4). index cases were having a home isolation P value of 0.001 and an odds ratio of 3.2 (2–5.1), with delay in COVID-19 testing for index cases with a P value of 0.006. Regarding characteristics of household contacts, higher age groups (p = 0.048), groups living in the same room with an index case P value of 0.021 and an odds ratio of [1.71 (1-2.8)], groups having physical contact with an index case P value of 0.001 and an odds ratio of [3.7 (2.1-7)], groups with touched or cleaned linen/articles with an index case P value of 0.02 and an odds ratio of [1.8 (1-3.1)], and groups having co-morbidities, especially diabetes mellitus (p = 0.0020), were significantly associated with chances of acquiring infection. However, the history of previous COVID positivity in household contacts was a protective factor against the infection P value of 0.009 with an odds ratio of [0.09 (0.01-0.78)].

Conclusion:

The study concludes that the second wave of COVID-19 in Kerala was primarily caused by a high SAR, especially among household contacts, and this could have been the reason for the difficulty in control measures during the wave.
Prescribing pattern of anti-diabetic drugs and adherence to the American Diabetes Association’s (ADA) 2021 treatment guidelines among patients of type 2 diabetes mellitus: A cross-sectional study
Authors: Tiwari Kalpana , Bisht Manisha , Kant Ravi , Handu Shailendra S.
Published: November 2022

ABSTRACT

Background:

Glycemic control is the major therapeutic objective in diabetes. Poor glycemic control in diabetes mellitus can be prevented by using rational use of anti-diabetic medication, which needs to be evaluated for effectiveness by prescription pattern studies. The objective of this study was to assess the prescribing pattern and adherence to the American Diabetic Association’s (ADA) treatment guidelines in type 2 diabetes mellitus patients in a tertiary care teaching hospital in Uttarakhand, India.

Methodology:

This cross-sectional study was conducted on 206 type 2 diabetic patients who were prescribed anti-diabetic therapy. Patient’s demographic details and drugs prescribed, with their dosage, were recorded to study the prescription pattern.

Results:

Oral anti-diabetic drugs were most commonly prescribed in 149 (72.33%) type 2 diabetic mellitus patients. Five of these patients (3.35%) were on metformin monotherapy, whereas majority of patients (81, 54.36%) were on a fixed dose combination of Glimepiride (SU) + Metformin (MET). Forty-five patients (30.20%) were on MET + Dipeptidyl peptidase 4 inhibitors (DPP4I) combination; 5 (3.35%) were on MET + SU + alpha-glucosidase inhibitors (AGI) combination; 7 (4.69%) were on MET + SU + Pioglitazone (PIO) (Thiazolidinediones) combination; 6 (4.02%) were on sodium/glucose cotransporter-2 inhibitors (SGLT2I) and 57 (27.66%) were on insulin therapy. Out of 206 patients, the prescriptions of 185 patients (89.8%) were adherent and of 21 patients (10.19%) were not adhering to ADA 2021 treatment guidelines.

Conclusion:

Oral anti-diabetic agents predominate the prescribing pattern practices for type 2 DM but there was a shift in trend towards the use of fixed-dose combinations (FDC) in the management of type 2 DM, and majority of prescriptions were adherent to ADA treatment guidelines.
Study of platelet indices and their role in evaluation of thrombocytopenia
Authors: Saran Khushboo , Vidya K , Seema Kumari , Prasad Anupa , Prakash Jay
Published: November 2022

ABSTRACT

Background:

Thrombocytopenia may result from mechanisms such as marrow hypoplasia, increased destruction of platelets, and splenic sequestration. The gold standard method for discriminating the causes of thrombocytopenia is bone marrow examination, but it is invasive and expensive. Therefore, an alternative method should be introduced as a first-line diagnostic procedure. Of late, the automated blood cell analyzer has made it possible to assess the cause of thrombocytopenia through various machine-derived parameters, known as platelet indices, which include the mean platelet volume (MPV), platelet distribution width (PDW), and plateletcrit (PCT), which are provided as a part of routine complete blood count.

Objectives:

The objectives of the present study are to study the variation and effectiveness of platelet indices in establishing the etiology of thrombocytopenia.

Method:

An observational, prospective, and comparative study was conducted on 134 patients with thrombocytopenia, and 67 cases were taken as the normal group. The study group was classified into two groups: hypo-productive and hyper-destructive. Platelet indices were recorded and compared in the two groups along with the normal group.

Results:

The mean platelet count (10^3 μL) in the normal, hypo-productive, and hyper-destructive groups was 232.03 ± 74.84, 73.00 ± 36.52, and 68.28 ± 38.24, respectively. The MPV and mean PCT in the normal, hypo-productive, and hyper-destructive groups were 9.46 ± 1.68fL, 8.99 ± 1.49fL, and 11.35 ± 1.35fL and 0.22 ± 0.06%, 0.07 ± 0.04%, and 0.08 ± 0.05%, respectively. The mean PDW in the normal, hypo-productive, and hyper-destructive groups was 15.66 ± 1.76fL, 17.63 ± 1.01fL, and 18.32 ± 1.10fL, respectively.

Conclusion:

In the present study, platelet indices such as MPV, PCT, and PDW are higher in the hyper-destructive group and may discriminate hyper-destructive from hypo-productive causes of thrombocytopenia.
A case of ischemic stroke and transient thrombocytopenia in a young female following adenoviral vector-based COVID-19 vaccination: Was the association incidental or causal?
Authors: Pandey Shweta , Garg Ravindra Kumar , Tripathi Pooja , Malhotra Hardeep S. , Kumar Neeraj
Published: November 2022

ABSTRACT

Since March 2021, cases with unusual clots, particularly cerebral venous sinus thrombosis and splanchnic vein thrombosis, have been reported worldwide following adenoviral vector-based coronavirus disease 2019 (COVID-19) vaccination. This entity has been termed vaccine-induced thrombotic thrombocytopenia (VITT). We report a 23-year-old healthy female who developed seizures, altered sensorium, and left hemiparesis, 20 days after receiving the first dose of adenoviral vector-based COVID-19 vaccine “Covishield™.” The patient had transient thrombocytopenia. The D-dimer level was 2460 ng/mL. Magnetic resonance imaging (MRI) demonstrated occlusion of M2 segment of the middle cerebral artery and cerebral infarction. Platelet factor-4 antibodies level was normal. Treatment with aspirin and antiepileptic drugs resulted in a remarkable recovery. This is the first Indian case report of ischemic stroke and transient thrombocytopenia following SARS-CoV-2 ChAdOx1 nCoV-19 vaccination. Our case had clinical features consistent with the diagnosis of probable VITT. Familiarity with VITT is crucial because timely treatment with non-heparin anticoagulants and intravenous immunoglobulin improves the outcome.
Compliance to post-exposure prophylaxis among animal bite patients – A hospital-based epidemiological study
Authors: Panda Manasi , Kapoor Richa
Published: November 2022

ABSTRACT

Background and Objectives:

Although rabies is a 100% fatal disease, it is preventable with appropriate and timely post-exposure prophylaxis (PEP). A hospital-based study was conducted among 360 animal bite patients in the Anti-Rabies Clinic (ARC) of Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi (VMMC and SJH).

Materials and Methods:

A predesigned, pretested, structured questionnaire was administered by the interview technique to assess the compliance to PEP among the animal bite patients attending the ARC, which comprised assessment of wound washing practices adopted by the animal bite patients, administration of rabies immunoglobulin (RIG), and compliance to full course of anti-rabies vaccination (ARV).

Results:

Out of 360 study participants, 131 (54.4%) had washed the wound using soap and water and 216 (89.6%) had washed the wound for less than 5 min. The compliance to the full course of ARV was seen among 172 (47.8%) study participants, whereas 164 (45.5%) were found to be non-compliant and 24 (6.7%) were found to be delayed compliant.

Conclusions:

It was observed that a considerable segment of the study population did not practice the correct wound washing practices, and only about half of the total study participants (172; 47.8%) were found to be compliant to the full course of ARV. As rabies is a 100% preventable disease, increasing awareness pertaining to appropriate PEP may prove to be beneficial in improving the compliance to PEP and reducing the burden of mortality.
Effects of social networking services on academic performance and self-esteem: A cross-sectional study among medical students
Authors: Takieddin Siba Ziad , Alghamdi Faris Saeed , Fida Hamza Loai , Alghamdi Maha Khider , Kamfar Renad Ahmed , Alsaidlani Rawan Hamed , Khojah Imad Mohammed
Published: November 2022

ABSTRACT

Background:

Social networking services (SNS) are a subcategory of social media that provide a useful tool for an individual’s practical life and social relations. Since the impact of SNS on students’ lives is a relatively neglected topic, we aimed to investigate the effect of social media on academic performance and self-esteem.

Methods:

A cross-sectional study was conducted with 373 medical students distributed across different academic years. Data was collected and analyzed using measures of central tendency to describe numerical variables, while frequencies and percentages were used for categorical variables. Pearson’s chisquared test, Pearson’s correlation coefficient, independent sample t-test, and the one-way analysis of variance (ANOVA) were used to identify relationships between the variables. All P values < 0.05 were considered significant using a 95% confidence interval and a 5% margin of error.

Results:

The majority of our sample believed that SNSs were useful, and 37.5% believed that social media positively affected their academic performance. However, no significant relationship was found between the time spent on social media and the students’ grade point average (GPA). Conversely, there was a significant relationship between students’ perceived addiction to social media and their self-worth, along with a positive correlation between GPA and self-esteem.

Conclusion:

Almost half of our participants agreed that social media is a helpful method for finding useful information. Nevertheless, excessive usage has been found to have a harmful effect on the students’ health and self-esteem.
Patient satisfaction with hospital services in COVID-19 era: A cross-sectional study from outpatient department of a tertiary care hospital in Jammu, UT of J&K, India
Authors: Sultan Nida , Mahajan Richa , Kumari Rashmi , Langer Bhavna , Gupta Rajiv K. , Mir Mehak T. , Chowdhary Nahida , Sultan Asheeb
Published: November 2022

ABSTRACT

Background:

In the coronavirus disease (COVID-19) era, healthcare delivery toward patient-centered orientation has gone a paradigm shift. High levels of adherence to treatment and recommended prevention are usually the outcome of perceived patient satisfaction.

Aims:

The present study aimed to assess patient satisfaction levels in the COVID-19 era and explore its determinants.

Settings and Design:

A cross-sectional study from outpatient department of a tertiary care hospital in Jammu, UT of J&K, India.

Materials and Methods:

The present cross-sectional study was carried out in outpatient department of a tertiary care hospital in the Jammu district. A total of 220 patients were interviewed using consecutive sampling. The tool used to assess patient satisfaction was the patient satisfaction questionnaire-18 (PSQ-18).

Statistical Analysis:

Data were analyzed using Statistical Package for Social Sciences (SPSS) version 20.0. Tests of significance used were ANOVA and t-test.

Results:

The overall mean satisfaction score was found to be 2.91 ± 0.17 and it was highest in the communication domain (3.12 ± 1.50), whereas it was lowest in the accessibility and convenience domain (2.73 ± 1.17). Except for religion, which was found to be statistically significant (P < 0.05) with overall mean satisfaction score, other sociodemographic variables (occupation, marital status, and monthly family income) were found to be statistically insignificant (P > 0.05).

Conclusions:

Out of the seven subscales of patient satisfaction, results revealed high scores for communication and financial aspects. Only religion as a demographic variable was found to be significantly associated with patient satisfaction scores. There is a need to improvise the healthcare services in this COVID-19 era in such a manner so that we can contribute to better patient trust leading to a positive influence on health outcomes.
Case series on successful anesthetic management of COVID-19–positive obstetric patients undergoing emergency cesarean section
Authors: Kaur Bhanupreet , Kanwat Jyoti , Jalwal Gopal , Singh Inderpreet
Published: November 2022

ABSTRACT

Coronavirus disease 2019 (COVID-19) outbreak was first reported in Wuhan, and its manifestations in pregnancy can be variable ranging from mild illness to severe acute respiratory syndrome. Management of such patients depends on severity of illness and gestational age. Case 1: A 67-year-old elderly primigravida with multiple comorbidities (type 2 diabetes, hypothyroidism, and intrahepatic cholestasis of pregnancy) and mild COVID-19 infection presented for emergency cesarean. Cesarean was conducted under spinal anesthesia after taking due personal protective equipment (PPE) precautions. Both mother and baby were discharged successfully. Case 2: A 24-year-old lady with severe COVID-19 illness who presented for emergency cesarean section was taken up under regional anesthesia with continuous positive airway pressure (CPAP) support. Intraoperative course went uneventful, and the patient was discharged after 12 days of intensive care unit (ICU) admission. Choice of anesthesia for a cesarean section is preferably regional anesthesia, whether the patient is COVID-19 positive or negative. Symptom management and optimisation is necessary in preoperative period the patient for surgery. Involvement of a multidisciplinary team approach with ICU care is helpful in successful management of the patient.
Preparedness of Primary Care Centers for COVID-19 epidemic in Aseer region, KSA
Authors: Al-Khaldi Yahia M. , AlAsmari Bandar Abdullah , Al-Mosa Khalid Mohammed , Falqi Tariq A. , Aldawood Kasim Mohammed , AlAseeri Khaled Abdulatef Zayed , Asiri Mohammed Yahya
Published: November 2022

ABSTRACT

Objective:

The objective of this study is to assesses the preparedness of primary care centers (PHCs) in Aseer region, KSA, for the coronavirus disease 2019 (COVID-19) pandemic.

Methods:

This survey was conducted during April 2020 in PHCs. The questionnaire was developed by the investigators and sent via e-mail to health care providers of primary health care centers (PHCCs). The questionnaire consisted of five parts to assesses readiness of PHCs, knowledge, attitude, and practice of health care providers (HCPs) concerning the COVID-19 pandemic. Data entry and analysis were managed by SPSS version 20.

Results:

Three hundred and seventy-one HCPs participated in this study. Most of them were males (58%), doctors or nurses (81%). Almost all PHCCs have adequate infection control resources, with some shortage in sterilization rooms. Most of participants received on-job training (85%) and had good knowledge about COVID-19. Attitudes of participants showed variation toward COVID-19; 74% were afraid to be infected, 54% were afraid to care for infected patients, 58% were ready for vaccination, and 80% thought that COVID-19 has a huge negative impact on the health care system. Compliance with preventive measures ranged from 66% for keeping social distance to 90% for using personal protective equipment. Most of the participants had positive contributions regarding health education of individuals and communities using different methods including the new social media (80%).

Conclusion:

This study revealed that PHCCs in Aseer region were well equipped and HCPs were well prepared to deal with the COVID-19 pandemic. There are some shortage in a few items of infection control at PHCCs and gaps in knowledge and practice among HCPs which need continuous assessment and monitoring to overcome such barriers.
Assessment of knowledge of obstetric danger signs and its associated factors among pregnant women attending antenatal clinic of rural health training centre of a medical college: A cross-sectional study from Rajasthan
Authors: Kumar Abhishek , Raj Dilip , Gupta Ajay , Kumar Amit
Published: November 2022

ABSTRACT

Background and Objectives:

Women and newborns are most vulnerable during and immediately after childbirth. The majority of maternal and newborn deaths occurring in developing countries can be attributed to inabilities to access health services, illiteracy, social stigmas, and gender inequalities. Women should be made aware of the danger signs so that health care services can be assessed on time, thus reducing maternal mortality. The objectives of this study were to assess the knowledge about obstetric danger signs and to find out various factors associated with them among pregnant women attending antenatal care (ANC) clinic at the Rural Health Training Centre (RHTC) attached to a Medical College.

Methodology:

This cross-sectional study was conducted at the ANC clinic of the RHTC attached to a medical college of Rajasthan for a period of 4 months and included 353 pregnant women. A pre-designed and pre-tested schedule was used. Mean knowledge scores were computed and knowledge was classified into adequate and inadequate. Descriptive statistics were used and the Pearson Chi-square test was used as a test of significance, taking a P value of < 0.05 as statistically significant.

Results:

Educational status of pregnant women, antenatal check-up status and gravid status had significant associations with the knowledge of obstetric danger signs.

Conclusions:

About half of the respondents had adequate knowledge about the obstetrics danger signs. Therefore, there is a strong need of creating awareness in the community by improving access to health care.
Old versus new antihistamines: Effects on cognition and psychomotor functions
Authors: Shamil K Sheth , Prakruti P Patel , Anuradha M Gandhi , Bela J Shah , Chetna K Desai
Published: November 2022

ABSTRACT

Context:

Antihistamines (AHs) are the most widely long-term therapeutic option to manage allergic diseases. This research aimed to study the effects of long-term administration of AHs: on cognitive (memory, mood, attention, sleep and executive function) and psychomotor performance.

Materials and Methods:

This prospective, observational study for a total duration of 30 months was carried out at the Dermatology OPD in adult patients with dermatological condition who were newly prescribed either chlorpheniramine (4 mg, BD), levocetirizine (10 mg, OD), fexofenadine (180 mg, OD) or bepotastine (10 mg, BD) for at least 28 days as per inclusion and exclusion criteria after taking written informed consent. A detailed history of the patients, memory (using PGI memory scale) and psychomotor functions, Brief Mood Introspection Scale and Epworth Sleepiness Scale were assessed at baseline, 1 week and 4 weeks. Data obtained were analysed using paired sample t-test and one-way ANOVA followed by post hoc analysis (P-value <0.05 statistically significant).

Results:

A total of 22 in chlorpheniramine group, 23 in levocetirizine group, 20 in fexofenadine group and 18 in bepotastine group were analysed. Chlorpheniramine and levocetirizine had deteriorating effects on cognitive and psychomotor performance, whereas fexofenadine and bepotastine showed positive effect on various cognitive and psychometric tasks. The study results showed chlorpheniramine and levocetirizine to be having sedative effects, whereas fexofenadine was nonsedating. In bepotastine group, no effect on sleep was observed. No significant difference in mood scores was observed in between chlorpheniramine, levocetirizine and fexofenadine groups. In bepotastine group, arousal calm and positive tired scores increased at 4 week as compared to baseline.

Conclusion:

Patients with dermatological illnesses can be prescribed fexofenedine and bepotastine, as compared to chlorpheniramine and levocetirizine, and their cognitive and psychological functions should be evaluated periodically with suitable tests.
Blood pressure-lowering effect of telmisartan compared to losartan among mild to moderate essential hypertensive adult subjects: A meta-analysis
Authors: Kumari Kusum , Toppo Mary Sunita , Majhi Lakhan , Kumar Amit
Published: November 2022

ABSTRACT

Objective:

We conducted a meta-analysis in which the blood pressure (BP)-reducing effect of telmisartan was compared to losartan among hypertensive subjects and its association with ethnicity, age, and gender was investigated.

Materials and Methods:

PubMed, Google Scholar, and the Cochrane library were searched from inception to April 2021 to obtain relevant articles. Cochrane risk of bias assessment tool was used for assessment of bias risk. GRADE analysis was done for determining the certainty of evidence. Data was analyzed using Revman 5.4.2 software. The pooled mean difference with 95% confidence interval (CI) was computed using random-effects model. Heterogeneity was also assessed using meta-regression and subgroup analysis. This study has been registered in PROSPERO with registration no. CRD42021245122.

Results:

Fifteen randomized controlled trials (RCTs) with 1926 subjects were selected from various countries. Both systolic BP (SBP) and diastolic BP (DBP) were found to be significantly reduced among telmisartan-treated groups (weighted mean difference [WMD] = 2.69, 95% CI: 1.38–4.00 and WMD = 1.26, 95% CI: 0.45–2.08 respectively). One subgroup analysis noted better reduction in both SBP and DBP among Asian population compared to Caucasians.

Conclusion:

Telmisartan was found to be a better hypertensive drug compared to losartan in patients with mild to moderate hypertension. Its efficacy was higher in Asian population compared to Caucasian population.
Barriers and facilitators of providing standard of care diabetes management at primary care level in geriatric population
Authors: Kumar Pratyush , Sinha Abhay Kumar , Kumar Ashok , Alam Md Ejaz
Published: November 2022

ABSTRACT

Background:

Geriatric population is gradually increasing and is expected to grow till 20% by 2050 from the current 8.6%, and so is diabetes prevalence and other comorbidities. To improve diabetes control, better coordination of provider, patient and health system is needed. It has been found that almost half of the diabetes patients do not achieve treatment targets. So, it is essential to assess the perceived barriers as well as facilitators from patients’ and physicians’ perspectives. The aim of the study was assessment of needs, care, barriers and facilitators to achieve treatment goals for patients and physicians.

Materials and Methods:

This observational, cross-sectional study was conducted by the Department of Geriatrics among 100 elderly diabetes patients and 50 physicians after obtaining ethical approval. All participants were interviewed based on a predefined, structured questionnaire with multiple options to grade or choose from.

Results:

Polypharmacy, mobility issues and dementia were the most common geriatric issues. Hypertension (HTN), arthritis and coronary artery disease (CAD) were the commonest comorbidities. Also, 73% reported that they followed dietary advice, but only 22% accepted that they were doing exercise regularly. Moreover, 5% mentioned that they were taking alcohol, and 15% confirmed of smoking. Also, 47% of patients felt that diabetes was well controlled. Remaining 53% patients gave reasons for poor diabetes control; the most common reason was not following a proper diabetic diet plan in 42% of patients and lack of exercise as instructed was reported by 22% as the reason for their poor diabetic control. Nineteen percent of patients accepted of not measuring their blood glucose as instructed. Among urban doctors, the three most common factors were not being consistent with lifestyle interventions, followed by no regular self-monitoring of blood glucose and no regular follow-up. Top three interventions suggested were to engage or encourage the family members of patients to become involved in diabetes care, provide more convenient diabetes brochures or education materials to patients and improve multidisciplinary and multispeciality collaboration in diabetes control.

Conclusion:

Diabetes in elderly needs proactive health system and coordinated care. Doctor–patient relationship with good communication skills, family support and multidisciplinary care is needed to improve diabetes care. Health education with a focus on diet control, exercise and other lifestyle modifications are essential factors in improving diabetes care.
Prognostication of COVID-19 patients using ROX index and CURB-65 score - A retrospective observational study
Authors: Arora Poonam , Shankar Takshak , Joshi Shrirang , Pillai Aadya , Kabi Ankita , Arora Rajnish K. , Khapre Meenakshi , Chowdhury Nilotpal
Published: November 2022

ABSTRACT

Objectives:

Coronavirus disease-2019 (COVID-19) disease has overwhelmed the healthcare infrastructure worldwide. The shortage of intensive care unit (ICU) beds leads to longer waiting times and higher mortality for patients. High crowding leads to an increase in mortality, length of hospital stays, and hospital costs for patients. Through an appropriate stratification of patients, rational allocation of the available hospital resources can be accomplished. Various scores for risk stratification of patients have been tried, but for a score to be useful at primary care level, it should be readily available at the bedside and be reproducible. ROX index and CURB-65 are simple bedside scores, requiring minimum equipment, and investigations to calculate.

Methods:

This retrospective, record-based study included adult patients who presented to the ED from May 1, 2020 to November 30, 2020 with confirmed COVID-19 infection. The patient’s clinical and demographic details were obtained from the electronic medical records of the hospital. ROX index and CURB-65 score on ED arrival were calculated and correlated with the need for hospitalization and early (14-day) and late (28-day) mortality.

Results:

842 patients were included in the study. The proportion of patients with mild, moderate and severe disease was 46.3%, 14.9%, and 38.8%, respectively. 55% patients required hospitalization. The 14-day mortality was 8.8% and the 28-day mortality was 20.7%. The AUROC of ROX index for predicting hospitalization was 0.924 (p < 0.001), for 14-day mortality was 0.909 (p < 0.001) and for 28-day mortality was 0.933 (p < 0.001). The AUROC of CURB-65 score for predicting hospitalization was 0.845 (p < 0.001), for 14-day mortality was 0.905 (p < 0.001) and for 28-day mortality was 0.902 (p < 0.001). The cut-off of ROX index for predicting hospitalization was ≤18.634 and for 14-day mortality was ≤14.122. Similar cut-off values for the CURB-65 score were ≥1 and ≥2, respectively.

Conclusion:

ROX index and CURB-65 scores are simple and inexpensive scores that can be efficiently utilised by primary care physicians for appropriate risk stratification of patients with COVID-19 infection.
Perceptions toward childhood vaccinations (side effects vs. benefits) among the parents living in Hail, Saudi Arabia
Authors: Alnumair Abdulaziz , Almulifi Abdullah
Published: November 2022

ABSTRACT

Objectives:

The objective of the study was to assess the knowledge, attitude, and behavior of parents living in Hail, Saudi Arabia, toward childhood vaccination program.

Materials And Methods:

This descriptive, cross-sectional study was carried out between November and December 2021. Parents who visited Hail’s primary health-care clinics were invited to participate in the study. Data was collected using a self-administered questionnaire, and data analysis was performed after data collection was completed.

Results:

Out of 200 parents who took part in the study, the majority were aged between 20 and 30 years (37%, n = 74), with females outnumbering males (67%, n = 134). It was discovered that younger parents (those under the age of 40) were less hesitant (P = 0.034), agreed to have their children vaccinated (P = 0.021), and felt it was effective (P = 0.038), when compared to parents over the age of 40. Furthermore, parents with a bachelor’s degree or higher felt more informed about vaccination (P = 0.011) and that vaccination for immunization is safe (P = 0.013).

Conclusion:

According to the study findings, residents of Hail, Saudi Arabia, particularly those over the age of 40 and those with only a secondary education, have poor knowledge, beliefs, and behavior regarding the childhood immunization program. As a result, it is necessary to increase knowledge and dispel myths about childhood immunization. Various social media channels and awareness campaigns could be used in this regard.
To study thyroid hormone levels (FT3, FT4, and TSH levels) in critically ill children and their correlation with disease severity and clinical outcome in Rajendra Institute of Medical Sciences, Ranchi, Jharkhand
Authors: Sahu Upendra Prasad , Jha Sunanda , Mitra Olie , Pathak Apeksha , Prasad Kamal Narayan
Published: November 2022

ABSTRACT

Introduction:

There are manifold effects on neuro-endocrine and metabolic systems due to critical illness. Abnormalities in thyroid hormone levels in a critically-ill patient with no pre-existing hypothalamo-pituitary-thyroid dysfunction is seen in Euthyroid sick syndrome or Non thyroidal illness syndrome.The understanding of different endocrinal changes in acute phase of critical illness may help us to intervene early and improve by pharmacological intervention.

Materials and Methods:

Critically ill children admitted in PICU, RIMS,Ranchi, aged 29 days to 17 years.

Results:

In our study, it was seen that FT3 and FT4 were low at admission at admission in critically ill children. And among them, the non-survivors had significantly lower values compared to survivors.

Discussion:

Among this critically ill patient, more than 70% of patients have shown low free T3 (Type I NTIS) and around 50% of low free T4 levels and free T3 levels (Type II NTIS).We have done this study to assess the thyroid dysfunction in critically ill children admitted in our PICU and its correlation with disease severity and clinical outcome.
Knowledge and attitudes of cervical cancer screening among female high school teachers in Hail city: A cross-sectional study
Authors: Alshammiri Salma Merdhi
Published: November 2022

ABSTRACT

Background:

Cervical cancer is a primary preventable cancer. The current study aims to assess relevant knowledge and attitude of cervical cancer screening among female high school teachers in Hail city, Saudi Arabia.

Materials and Methods:

This cross-sectional study was conducted among female high school teachers in the Hail Province of Saudi Arabia. It is worth mentioning that Pap smear screening every 3–5 years with appropriate follow-up can reduce cervical cancer incidence by up to 80%, and abnormal results may suggest the presence of precancerous changes, allowing examination and possible preventive treatment.

Results:

Data from 387 participants were included in the final analysis. The study participants were female high school teachers. Mean age of the participants was 41.4 ± 5.3 years. Only 42% participants appeared to have good level of knowledge about cervical cancer. Fifty-eight percentage of females had not heard of it before. Only 22 (5.7%) participants had undergone Pap smear testing. A total of 182 (47.0%) participants believed that Pap smear test is a useful test and would undergo the test. Around 139 females (35.9%) will be allowing their daughters to get the human papilloma virus (HPV) vaccine.

Conclusions:

Interventions to increase cervical cancer knowledge are needed in Hail city in Saudi Arabia. In addition, further research is needed to understand and assess the effectiveness of different strategies to improve attitudes regarding cervical cancer, in order to increase the uptake of screening services.
Clinical and epidemiological aspects of herpes zoster disease in a primary care setting in Riyadh, Saudi Arabia: A retrospective cohort study
Authors: Binsaeedu Abdullah S. , Bajaber Abubakr O. , Muqrad Aiman G. , Alendijani Yaser A. , Alkhenizan Hamad A. , Alsulaiman Thamer A. , Alkhenizan Abdullah H.
Published: November 2022

ABSTRACT

Context:

Herpes zoster (HZ), or shingles, is one of the most common infectious diseases. HZ can be associated with other diseases, such as cancer and immunocompromised conditions. Thus, early recognition of the disease characteristics and clinical manifestations is critical to decrease the disease burden and to avoid further complications.

Aim:

To assess the epidemiology of HZ disease, its clinical manifestations, coexisting and post-existing conditions, complications, and management among patients in a primary care setting.

Subjects and Methods:

This was a retrospective, single-armed, cohort study. Data of all patients diagnosed with HZ, aged 18 years and older, who visited the Family Medicine Department at King Faisal Specialist Hospital and Research Center from January 2014 to August 2021 were reviewed from their medical records. All data analyses were performed using IBM Statistical Package for the Social Sciences (SPSS) statistical software, version 20.0.

Results:

A total of 330 cases were included over the study period. The male-to-female ratio was 1:2, with a higher occurrence of HZ (44.5%) in those aged ≥ 50 years. Only 4.5% of the patients were recipients of zoster vaccines. Thoracic dermatome was the most affected dermatome (38%). The most common coexisting disease was diabetes (21.5%). The most common post-existing disease was cardiovascular disease (3%), and the most common complication was postherpetic neuralgia (15.2%). Suboptimal dosage of acyclovir was the most commonly used treatment for HZ infections (69.7%).

Conclusions:

Zoster vaccination uptake was low. A national program for adult vaccination, including zoster vaccination, should be developed, and a guideline to direct primary health-care professionals in the management of HZ infections should be implemented.
Resonance frequency analysis mapping during implant healing using a nanostructured hydroxyapatite surface
Authors: Rosas-Díaz José Carlos , Malpartida-Carrillo Violeta , Córdova-Limaylla Nancy Edith , Guerrero Maria Eugenia , Palomino-Zorrilla Jerson Jimmy , Cervantes-Ganoza Luis Adolfo , Cayo-Rojas César Félix
Published: November 2022

Abstract

Aim:

Stability measured by resonance frequency analysis (RFA) is an important factor to be considered in the success of dental implant treatments, which can be evaluated from the implant stability quotient (ISQ). The aim of the present case series was to map the RFA during healing of implants with nanostructured hydroxyapatite surface to describe the behavior of ISQ values related to individual factors.

Materials and Methods:

Twenty-three implants were placed in eight patients by conventional surgical protocol, and ISQ values were monitored from the day of implant placement until week 20. To obtain the ISQ values, an Osstell device was used and the placed implants were grouped in proportional amounts to describe the ISQ behavior considering the length (≤10 or >10 mm), the diameter (3.5 or 4.3 mm), the insertion torque (<40 N-cm or ≥40 N-cm), and the placement area (maxilla or mandible).

Results:

All the implants assessed decreased their values in the first 3 weeks after placement. Subsequently, the ISQ values increased by amounts similar to those obtained at the time of the placement and even more. Implants with length >10 mm, diameter 4.3 mm, and insertion torque ≥40 N-cm showed the highest ISQ values.

Conclusions:

A decrease in the ISQ values of dental implants with nanostructured hydroxyapatite surface was evidenced between weeks 2 and 3 considering length, diameter, insertion torque, and maxillary or mandibular placement site.
Comparative evaluation of microtensile bond strength in three different dentin luting agents: An in vitro study
Authors: Castro-Ramirez Leonor Cristina , Ladera-Castañeda Marysela Irene , Cachay-Criado Hernán Rafael , Alvino-Vales María Isabel , López-Gurreonero Carlos , Cervantes-Ganoza Luis Adolfo , Cayo-Rojas César Félix
Published: November 2022

Abstract

Aim:

Long-term clinical success on indirect restorations is largely determined by bonding efficiency of the luting agent, with adhesion to dentin being the main challenge. Therefore, aim of this study was to assess the microtensile bond strength when using flowable resin composite, preheated resin composite and dual self-adhesive resin cement as dentin luting agents.

Materials and Methods:

Occlusal thirds of molar teeth were cut and randomly divided into 3 groups to be cemented: RelyX™U200, Filtek™ Z250 XT- preheated to 70° and Filtek Flow™ Z350XT. They were then thermocycled 5000 times between 5+/-2°C and 55+/-2°C. Subsequently, 10 microbars per group were prepared. The 30 samples were placed in saline solution for 24 hours at room temperature prior to microtensile test. This was performed with a digital universal testing machine at a crosshead speed of 0.5 mm/min. The bond strength values obtained were analyzed in Megapascals (MPa). Measures of central tendency such mean and measures of dispersion such standard deviation were used. In addition, the Kruskall Wallis non-parametric test with Bonferroni post hoc test was applied, considering a significance value of 5% (P< 0.05), with type I error.

Results:

The dentin microtensile bond strengths of preheated resin composite, flowable resin composite and dual self-adhesive cement were 6.08 ± 0.66 Mpa, 5.25 ± 2.60Mpa and 2.82 ± 1.26Mpa, respectively. In addition, the preheated resin composite exhibited significantly higher microtensile bond strength compared to the dual self-adhesive cement (P< 0.001). While the flowable resin composite showed no significant difference with the dual self-adhesive cement (P= 0.054) and the preheated resin composite (P= 0.329).

Conclusions:

The microtensile bond strength in dentin was significantly higher when using a preheated resin composite at 70°C as a luting agent compared to dual self-adhesive cement. However, the preheated resin composite showed similar microtensile bond strength compared to the flowable resin composite.
Bilateral Peritonsillar Abscess-Developed Ruptured Meckel's Diverticulum
Authors: Alenazi Abdulaziz S. , AlBahlal Jarallah M. , AlObaid Fahad A. , AlMahdi Mohammed J. , AlMarri Abdullah K.
Published: November 2022

Peritonsillar abscess (PTA) is an accumulation of pus between the fibrous capsule of the palatine tonsils and the superior pharyngeal constrictor muscle. Bilateral PTA (BPTA) is a rare disease. Meckel's diverticulum (MD) is a congenital abnormality of the distal ileum associated with failed vitelline duct closure. Spontaneous MD rupture during the management of PTA never happened before. In this article, the authors present a case of BPTA-developed MD rupture. We present a case involving an 18-year-old male who presented to the emergency department (ED) for a 2-day history of worsening sore throat, trismus, fever, and odynophagia; a diagnosis of bilateral severe PTA was made. During the management of the BPTA, the patient developed severe acute abdominal pain which was diagnosed later as a case of MD rupture. In ED, the patient underwent computerized tomography (CT) scan of the neck that showed bilateral hypodense masses, consistent with BPTA. Conservative management was started on IV antibiotics, IV fluids, and IV analgesia at the time of diagnosis in the ED. The patient then underwent two attempts of needle aspiration using 18-gauge needles that showed evidence of aspirated pus. Later on, the patient developed severe abdominal pain, which is evaluated by the general surgery department (GS), and underwent ultrasonography (US) and CT scan; then, the diagnosis of rupture MD was made. The patient underwent diagnostic laparoscopy performed by the GS team and improved thereafter. In this article, the authors present a case of BPTA-developed MD rupture.