bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative study of intravaginal misoprostol versus dinoprostone gel for induction of labour in primigravida
Authors: Dulewad Shirish S. , Haritha Chitikala
Published: October 2021

Background: Labour is an inevitable consequence of pregnancy. The aim of the present research was to study the safety, efficacy and effect of intravaginal misoprostol and dinoprostone gel for induction of labour.Methods: 300 patients who required induction of labour in a tertiary care centre were included in this prospective randomized controlled study from August 2019 to August 2021 with a study duration of 12 months. 50% of cases received 25 µg of intravaginal misoprostol and repeated for a maximum of 6 doses every 4 hours as needed. 50% cases received 0.5 mg dinoprostone gel and repeated for maximum of 2 doses every 6 hours as needed. The patients selected were evaluated initially by modified Bishop’s score and admission test for fetal wellbeing. After drug insertion, patients were monitored for fetal heart rate, vital signs, progress of labour. A partogram was strictly maintained in all patients.Results: The highest number in both groups being below 40 weeks which were 74% and 76% in dinoprostone and misoprostol groups respectively. Rest were between 40.1-41.6 weeks. The mean induction delivery interval in dinoprostone was more (16.15±3.1) than in misoprostol (12.26±2.21). Requirement of oxytocin augmentation was less in misoprostol group than dinoprostone group. Caesarean section rate was less in misoprostol group. Maternal side effects were minimal in either groups and neonatal outcome was good in both the groups.Conclusions: Both misoprostol and dinoprostone gel are safe, effective for cervical ripening and induction but misoprostol is more cost effective and stable at room temperature.
Maternal and neonatal outcome in COVID-19 pregnancy: an ongoing review of first wave in a tertiary care center in North India
Authors: Kashyap Swati , Pandher Dilpreet K. , Sehgal Alka , Jain Suksham
Published: October 2021

Background: This study analyzed the clinical outcomes in the obstetric patients with COVID-19 and their neonates in first wave of COVID-19 pandemic in North India, 2020.Methods: This prospective study was conducted between 10 May 2020 to 31 December 2020 on 83 obstetric patients with COVID-19 and their 52 neonates.Results: 36.14% obstetric patients presented with COVID-19 like symptoms with most common symptom as fever in 60% and cough in 53.33%. 4.81% patients were admitted in HDU and 1/83 (1.20%) patient who required ICU had mortality due post-operative complications. 20.48% had pre-existing medical diseases. Amongst (78) antenatal patients, 21.79% had pregnancy related hypertensive disorders, 12.82% had deranged liver function tests without hypertension and 8.97% had gestational diabetes mellitus. More probability of pre-term labour pains 2.4 (95% CI, 1.37-4.18) and IUFD 2.18 (1.13-4.20) were observed in symptomatic patients as compared to asymptomatic patients. Neonates born to COVID-19 symptomatic mothers had 1.81 (95% CI, 0.73-4.49) times the risk of being symptomatic, 1.37 (95% CI, 0.54-3.41) times the risk of getting admitted to NICU and 1.57 (95% CI, 0.48-5.09) times the risk of getting infected by SARS-CoV-2 and increased morbidity in neonates. 8% neonates had perinatal and 1.5% had horizontal transmission of SARS-CoV-2.Conclusions: First wave of COVID-19 pandemic did not cause significant adverse outcome in pregnant patients and mother-newborn dyads in our tertiary care centre when active and intensive management of mothers and newborns were done but still there is possibility of severe morbidity and mortality due to COVID-19.
Pregnancy and perinatal outcomes in women with polycystic ovarian syndrome
Authors: Rizwana A. , Rajkumar Shery Angel , Anuradha C. R.
Published: October 2021

Background: To study the pregnancy and perinatal outcomes in women with PCOS with normal women and to study the incidence of complications like menstrual irregularities, mode of conception, gestational diabetes mellitus, pre eclampsia, preterm labour and NICU admissions in women with PCOS.Methods: It was prospective comparatives study done in 100 women to compare outcome in pregnancy with PCOS and normal women.  A  detailed history, general and obstetric examination, antenatal investigations, routine dating scan, glucose challenge test at 24 to 28 weeks in study and control groups, blood pressure recording and urine for proteinuria after 20 weeks to evaluate preeclampsia. After delivery, birth weight and APGAR score at 1 and 5 minutes were recorded. Body mass index was calculated and pregnancy outcome studied and compared.Results: Out of 50 women with PCOS 13 developed GDM, 10 developed pre eclampsia, 6 had abortion, 4 went into preterm labour. 15 babies required NICU admission.Conclusions: Pregnancy complications like GDM, pre eclampsia, preterm labour, abortions and neonatal complications like NICU admissions are higher in women with PCOS when compared with normal women. Hence PCOS needs to be diagnosed early and treated accordingly to prevent pregnancy complications.
A study to assess the occurrence and factors of maternal near-miss among women admitted in maternal unit in selected hospitals of Kolkata, India
Authors: Das Dipti , Mitra Sujata , Barui Saraswati
Published: October 2021

Background: Assessment of the occurrence of maternal near-miss (an event in which a woman comes close to maternal death, but survive), identify the factors of maternal near-miss and to find out the association between determining factors and selected sample characteristics of maternal near-miss women.Methods: A descriptive survey is carried out among purposively selected women admitted in the maternity unit of two tertiary hospitals of Kolkata. Data are collected by face-to-face interview using valid and reliable semi-structured interview schedule to identify factors of maternal near-miss. WHO selected maternal near-miss proforma (2011) is used for assessment of occurrence of maternal near-miss by using record analysis.Results: The occurrence of maternal near-miss is identified as 100 out of 1669 women admitted in maternity unit. Eclampsia occurred maximum (27%) followed by severe pre-eclampsia (19%), severe PPH (6%) among potentially life-threatening conditions. Multigravida (65%), multipara (54%), non-booked cases (5%), duration of labour more than 18 hours (65%), caesarean section (78%), referred cases (79%), maternal type 1 delay (53%) and type 2 delay (67%) all are the factors mainly responsible for developing maternal near-miss. Significant association present between reproductive and obstetrical factors and maternal education, marital age (p<0.01). Significant association is also present between maternal delay factors and residence, maternal education, monthly family income, marital age (p<0.01).Conclusions: Exploring the factors of maternal near-miss may help to identify the factors early, which in turn will prevent the condition. Lesson can be learned from cases of near-miss which can serve as a useful tool in reducing maternal mortality ratio.
Comparison of caesarean section rate and maternal complications in elective induction versus spontaneous labor
Authors: Beigh Salma Kousar , Mukhtar Samar , Firdous Nighat , Amaan Fariha
Published: October 2021

Background: Elective induction of labor is defined as an initiation of labor, either by mechanical or pharmacological means at a time earlier than nature regardless of a medical or obstetric indication. Objectives were to estimate the proportion of caesarean sections and vaginal deliveries and magnitude of maternal complications following elective induction and spontaneous labor.Methods: The study entitled “comparison of caesarean section rate and maternal complications in elective induction versus spontaneous labor in LD Hospital, Kashmir” was a hospital based observational study, conducted in the Postgraduate Department of Obstetrics and Gynaecology, LallaDed Hospital of Government Medical College, Srinagar over a period of one and a half years.Results: Women in induced labor group had slightly increased risk of caesarean section than those in spontaneous group. Fetal distress was the most common indication for caesarean section in both the groups. There was no difference in both groups regarding maternal complications such as perineal lacerations; postpartum hemorrhage (PPH); need for blood transfusions and post partum hospital stay.Conclusions: Though induction of labor is associated with a slight increased risk of caesarean delivery, it is not related to other maternal complications. Therefore inductions are safe in hands of safe obstetricians.
A prospective observational to study sociodemographic profile, clinical profile and pattern of gynecological malignancies in a tertiary care center in Himachal Pradesh
Authors: Ravindran Ashritha , Sood Rajeev , Negi Kalpna
Published: October 2021

Background: Cancer is the second leading cause of death globally and is estimated to account for 9.6 million deaths in 2018. Due to the lack of cancer awareness, variable pathology, and dearth of proper screening facilities in developing countries such as India, most women report at advanced stages, adversely affecting the prognosis and clinical outcomes. The aim of the study was to study the sociodemographic profile, clinical profile, pattern of gynaecology malignancies and their histopathological findings of all gynaecological malignancy patients attending gynaecological OPD.Methods: A prospective observational study was conducted in the Department of OBG, KNH Shimla from June 2019 to May 2020 where 241 gynaecological malignancy patients were recruited. Detailed history, general physical examination, systemic, gynaecological examination and required investigation was done and the data was analysed.Results: The most commonly occurring gynaecological malignancy was cervical cancer. 82.2% of the patients belonged to the age group 40-69 years. Majority of the patients were multiparous, belonged to rural background, belonged to Hindu community. 69.3% were menopausal. Among the 132 women who gave history of age at first coitus as less than 18 years, 60.6% of them had cervical cancer. Most common presenting complaints was post-menopausal bleeding. In cervical cancer 43.6% of patients diagnosed at stage III and were managed by radiation therapy.Conclusions: According to this study, cervical cancer is the most common gynaecological malignancy followed by ovarian cancer. Most of these patients seeked medical attention in advanced stage.
A prospective observational study to analyse the relationship between fundus changes in pregnancy induced hypertension with visual impairment and its reversibility
Authors: Dharmalingam Vinitha , Kala R.
Published: October 2021

Background: Irreversible visual impairment and morbidity are associated with pregnancy induced hypertension. It causes pathological changes in vascularity of placenta, kidney and brain along with two major pathological types of changes in fundus namely arteriolar vasospasm and permeability changes in vascular endothelium. The aim of our study was to analyse the relationship between fundus changes in pregnancy induced hypertension with visual impairment and its reversibility.Methods: A prospective observational study done on pregnant women with any grade of pregnancy induced hypertension with recent visual impairment from 24 completed weeks of pregnancy.Results: Out of 75 patients with PIH, all the patients had varying degree of fundus changes in one or both eyes. In 150 eyes of the 75 patients, 86 (57.30%) eyes had isolated arteriolar vasospasm, 14 (9.33%) had grade III hypertensive retinopathy, 4 (2.66%) had grade IV hypertensive retinopathy, 30 (20%) had macular oedema, 4 (2.66%) had central serous chorioretinopathy, 2 (1.33%) had vascular occlusion, 2 (2.66%) eyes had normal fundus with cortical blindness, 2 (2.66%) had exudative retinal detachment, 6 (4%) eyes had normal fundus with changes in the other eye.Conclusions: Out of 75 patients, 7 (9.3%) patients had irreversible loss of vision, 3 (42.85%) due to arteriolar vasospasm, and 4 (57.15%) due to choroidal ischemia. Among the 4 patients with choroidal ischemia, 3 (75%) were in the group of eclampsia and 1 (25%) in gestational hypertension.
Knowledge and attitude towards contraceptive use among adolescents in Africa: a systematic review
Authors: Atuhaire Shallon , Ngendakumana Jonas , Galadima Ali , Adam Ayoub , Muderhwa Rodrigue B.
Published: October 2021

A 46% rate of unintended pregnancies among adolescents in Africa is a glaring notification of the barriers to contraception. There is little documentation of the knowledge and attitude towards contraceptive use among adolescents in Africa especially from systematic review perspective, which purposed this study. An E-literature search of the studies on the topic was conducted through PubMed, and Google Scholar, considering a period between January 2015 to August 2021. The search strategy used; “knowledge and attitude towards contraceptive use among adolescents in Africa”, which was sorted by date. The search resulted in 14,468 journal articles: 14,300 from Google Scholar, and 168 from PubMed but only 27 studies qualified for inclusion. Results indicate inadequate knowledge of contraception but this varies by age, level of education, marital status and geographical distribution. The majority of adolescents are aware of emergency contraception and traditional methods such as abstinence, lactational amenorrhea, and coïtus interruptus. Even with this knowledge, a larger proportion of adolescents do not use contraception due to limited access, misinformation on side effects and the negative attitude shaped by religious and socio-cultural beliefs and attitude of health care providers to them. Adolescent boys have more knowledge of contraception than the adolescent girls do but their use of contraceptives is not well documented. The low level of knowledge and negative attitude limits the use of these services and could be addressed by a well-informed approach on sexuality literacy and contraception that involves not only adolescents but also parents, the community and health care providers.
Remdesivir use in pregnant women with severe COVID-19
Authors: Mamilla Sarada , Boorugu Harikishan , B. P. L. Ramya Bharghavi , Kodam Bhavana Priya , Adapa Sandhya Rani , Kamani Gayathri , Vuta Tejaswi
Published: October 2021

Numerous therapeutic strategies are proposed and tested for SARS CO-V2 infection. Remdesivir is researched and proposed by various societies. Studies about efficacy and safety in pregnancy are limited. A case series of 22 pregnant women effected with severe COVID disease and who received remdesivir, over a period of 1 year from May 2020 to May 2021 is presented. The 12 antenatal and 10 post-partum women were included. Demographic factors, baseline, day 3 and day 7 blood values of haemoglobin, total leukocyte count, platelets, liver enzymes, serum creatinine and D-dimers were collected. Adverse events were reported. Pregnancy complications and foetal and neonatal complications were studied. Pre-eclampsia was the most common comorbidity. The 99% of pregnant women and 100% of postpartum women recovered from COVID disease after remdesivir use. Lab investigations did not change considerably during the week of remdesivir use, suggesting its safety. Incidence of adverse events reported is 36.3%, of these 9% are serious adverse events. There are no antenatal or post-natal complications. No incidence of teratogenicity, foetal or neonatal complications. Incidence of feto-maternal transmission was 9%. Remdesivir is effective in treating severe SARS-CoV2 infection and has safety profile in pregnancy with regard to maternal and foetal effects.
Isolated psoas hydatidosis mimicking ovarian neoplasm
Authors: Baruah Upasana , Barmon Debabrata , Tak Apoorva , Begum Dimpy
Published: October 2021

We report a unique case of hydatid cyst in iliopsoas muscle in a 65-year-old postmenopausal female. She presented with lump abdomen. On performing exploratory laparotomy, we discovered iliopsoas hydatidosis. This case reports the diagnostic dilemmas that a hydatid cyst can pose and the implications it has on management.
MRI findings in ruptured ovarian ectopic pregnancy: an unexplored avenue
Authors: Singhal Annu , Kottiyath Vivek C. , Gupta Tej Prakash , Arora Prachi
Published: October 2021

Ovarian ectopic pregnancy (OEP) is a rare form of ectopic pregnancy (EP) and constitutes approximately 0.5-3% of all ectopic cases. Its presentation mimics the symptoms of tubal ectopic pregnancy, hemorrhagic ovarian cyst/follicle, tubo-ovarian abscess, urinary tract calculi, appendicitis or ovarian torsion. Occasionally determining the anatomic location of an extra-tubal ectopic pregnancy based on ultrasound imaging and presentation alone can be challenging, particularly when it is adherent to the fallopian tube. Although transvaginal ultrasound (TVS) is the primary modality used in the diagnosis, various forms of OEP and its complications may be incidentally detected and further evaluated on computed tomography (CT) or magnetic resonance imaging (MRI) when an alternative diagnosis is suspected. We reported a case of a second gravid para zero, 25 years old lady, who came with pain in the left lower abdomen. Her urine pregnancy test was positive. TVS showed empty uterine cavity, an extremely tender, heterogenous hyperechoic right adnexal mass, but no obvious gestation sac (GS). A large hematoma was detected adjacent to it in the pouch of Douglas (POD). Keeping a high suspicion of ectopic pregnancy, MRI was performed to evaluate the lesion better which revealed a natural, non-assisted, ruptured right ovarian ectopic pregnancy and was subsequently confirmed at laparotomy and proven on histopathology. Patient underwent left oophorectomy and discharged on 4th day with uneventful follow up.
Large ovarian dermoid, a cause for fetal growth restriction and oligohydramnios: rare instance in literature
Authors: . Anupma , Sarkar Avir , Yadav Deepak , Sharma Jagadish C.
Published: October 2021

Ovarian dermoids mostly remain asymptomatic during pregnancy. Large dermoids may present with torsion, hemorrhage or rupture. However, a dermoid cyst causing fetal growth restriction (FGR) and oligohydramnios is a very rare entity. We report a case of a large ovarian dernoid (15×12 cm) hampering intrauterine fetal growth. Due to the COVID-19 lockdown, patient was unable to get ultrasound examinations in early gestation, and thereby surgical intervention was not possible during the second trimester. As a result, this growing teratoma finally led to FGR by either exerting a pressure effect upon the uterus or by dwindling its blood supply.
Adaptation, validation and reliability of the Spanish version of eating pattern inventory for children EPIC-C in a sample of Mexican adolescents
Authors: Trujano Patricia , Gracia Manuel De , Nava Carlos , Thomas Mónica
Published: October 2021

Background: Eating behavior represents an important public health issue. This study shows the results of the adaptation and validation of the questionnaire eating pattern inventory for children (EPI-C) in the Spanish version, what can be very useful in Spanish-speaking contexts.Methods: The adaptation and validation of the questionnaire was carried out with a statistically representative sample of 417 adolescents of Mexico City. Different statistical analysis were applied.Results: The analysis of the adapted version reproduced the same factorial structure and psychometric properties as the original questionnaire. The adapted inventory consisted of 20 items, formed by 4 subscales dietary restraint (8 items), external eating (6 items), parental pressure to eat (3 items), and emotional eating (3 items) which explained the 68,8% of the total variable.Conclusions: The scores of the subscales were associated with the body weight of the adolescents with normal weight and overweight-obesity, with the level of the anxiety state, with the emotional eating and with the dietary restraints which suggests initial evidence of its validity and utility in Spanish speaking countries.
Knowledge and practice of standard precautions among healthcare workers in primary and tertiary health facilities in Enugu state, Nigeria; a qualitative study
Authors: Nwoga Hope O. , Ajuba Miriam O. , Omotowo Babatunde
Published: October 2021

Background: Standard precautions (SP) is a broad concept involving measures that should be applied in hospital setting to reduce infection transmission. Most hospital acquired infections occur due to breach in SP practices. The objective was to determine the knowledge and practice of SP among HCWs in primary and tertiary health facilities in Enugu State Nigeria.Methods: The study used a qualitative design with case study in primary and tertiary health care workers (HCWs) in Enugu Metropolis, Enugu State Nigeria. A total of 74 HCWs; 24 from the primary and 50 from the tertiary health facilities were observed while 37; 12 from primary and 25 from the tertiary health facility were interviewed. The qualitative study used in-depth interview and triangulation with observational checklist.Results: The HCWs had good knowledge but poor practice of SP. Higher proportion of the tertiary HCWs had better practice of hand hygiene than those in the primary health facilities (OR=17.637, p<0.001). Also, the tertiary HCWs used personal protective equipment (PPE) more adequately (OR=11.417, p=0.001) and practiced injection safety better than the primary HCWs (OR=22.369, p<0.001) except in detaching of needles from syringes where higher proportion of the tertiary HCWs were involved in such practice (tertiary =40.0%, primary =29.2%).Conclusions: There was good knowledge of SP among the HCWs but their practice was poor.
Trends of oesophageal carcinoma and increasing number of young patients with oesophageal carcinoma in Southern Punjab, Pakistan
Authors: Samad Afra , Sartaj Safia , Sartaj Rafia , Naeem Namra
Published: October 2021

Background: Oesophageal cancer (OC) is a cancer that develops in the gastrointestinal tract and is caused by a variety of circumstances. It has quite an uneven geographic distribution with male predominance and squamous cell carcinoma being most frequent type of oesophageal carcinoma in developing countries. As Pakistan lacks any proper cancer registry this study was needed to have an idea of the OC statistics in South Punjab region. Objective was to determine the prevalence of OC in the general population and in young people of South Punjab, PakistanMethods: Retrospective cross-sectional study. Two hundred and twenty-three patients who presented to Multitest lab from 2014 to 2018 were included in the study.Results: The 186 patients were positive for OC. Sixty patients were below 40 years of age. Male to female ratio was 1.24:1. Most frequent symptom was dysphagia and squamous cell carcinoma was histological subtype.Conclusions: In our study based on South Punjab region, oesophageal carcinoma has become a common condition and is more prevalent in males. It commonly involves upper oesophagus and squamous cell carcinoma is the most frequent type. It can also be concluded that it is in increasing in young population of South Punjab.
Acute appendicitis: is it a seasonal disease?
Authors: Elshambaty Yasir Babiker , Alzahrani Saleh A. , AlOmari Talal A. , Shahwan Waleed S. , Alzahrani Abdullah A. , Alghamdi Osama A.
Published: October 2021

Background: The aim of this study was to review the management of acute appendicitis in a rural hospital. It was generally reported to be more common in men. Appendicitis is the most common surgical cause of abdominal pain worldwide. Appendectomy is the lonely curative treatment of appendicitis.Methods: This was a retrospective study in which we reviewed the records of the patients who had been diagnosed and operated on for appendicectomy from January to December 2017 in a rural hospital. The data were analyzed with SPSS version 25.Results: The total number of the patients was 114. About 69.3% are males. The mean age was 25.11 years. About (39.5%) were above 20 years old. Most of the cases presented in the period between January and March (27.3%). Right lower quadrant pain was the most common presenting symptom (93.9%). Nausea and vomiting mentioned by 57 (50%) and 74 (64.9%) of the participants respectively, fever in 42 (36.8%), muscle guarding in 0.9%, tenderness in 44 (38.6%), abdominal ultrasound was requested in 96 (84%). The most common histological diagnosis was acute suppurative appendicitis with peri-appendicitis in 15 (13.2%). All the cases were treated with open appendicectomy.Conclusions: We concluded that male are more affected with acute appendicitis. The most common presenting symptom was right lower quadrant pain. The vast majority of the cases were in the winter. Ultrasound has been used in the most cases particularly in male more than in females. The most common histological diagnosis was acute suppurative appendicitis. Open appendicectomy is the main operative management in our pts.
Risk factors of visceral leishmaniasis among residents of Baringo County, Kenya
Authors: Kiptui Emily G. , Kiprono Sabella J. , Mengich Gladys J.
Published: October 2021

Background: Leishmaniasis is protozoan disease, transmitted by Sandflies. The annual incidence of visceral leishmaniasis in East Africa is between 29,400 and 56,700 cases, accounting for approximately 15% of the global cases. Visceral leishmaniasis is endemic in Baringo County yet the current report on risk factor burden of the disease has not been documented. Objective was to assess risk factors associated with visceral leishmaniasis among residents of Baringo County, Kenya.Methods: Analytical cross sectional study design was conducted in Tiaty and Baringo south sub counties, Baringo County. The study population was 422 households selected through simple random sampling. The data collection tool were questionnaires. Data was analyzed using descriptive statistics, cross tabulations and chi square test of independence. Logistic regression was used to compute odds ratio. Variables with p value of less than 0.05 was considered statistically significant.Results: Findings showed that uneducated were majority (68%), higher number of the population had more than 6 persons per household (70.6%). On occupation, pastoralists were more affected (62.2%), those living in mud and cracked house were more (61.8%) (63.0 %) respectively p<0.01. Daily activity 35.24, p<0.01), sleeping under acacia tree 53.42, p<0.01), sleeping outside the house 112.7, p<0.01), and presence of ant hills nearby homestead 32.42, p<0.01) were individual risk factors significantly associated visceral leishmaniasis.Conclusions: The risk factors increased the exposure of the community to visceral leishmaniasis infection which needs to be addressed through control and prevention measures.
Prevalence of Dunning Kruger effect in first year medical students in a tertiary care hospital
Authors: Deb Novonil , Roy Poulami
Published: October 2021

Background: Dunning Kruger (DK) effect refers to overestimation of one’s ability which is attributed to their inadequacy of metacognitive skills i.e., the low-performing individuals are often nescient of their incompetence which leads them to reach fallacious conclusions and make regrettable choices. Objectives of the study were to assess the degree of DK effect among the first-year medical students and to compare the associated socio-economic variables.Methods:  A descriptive cross-sectional study was conducted among the interested first-year medical students of North Bengal medical college and hospital from March 2021 to April 2021 using a questionnaire. Responses were recorded in Microsoft excel 2017, analysed, and presented in form of tables and charts following principles of descriptive statistics.Results: The overall prevalence of DK effect was found to be 78.38% among the first-year medical students. Higher prevalence was observed among females (80.28%) as compared to males (75%). Students having low study hours (79.13%), no academic achievements (77.5%), and greater hours of sleep (79.74%) manifested more predisposition to DK effect.Conclusions: In our research, we have noticed a higher DK effect among the first-year medical students, which might hamper the quality of treatment and patient care in the future. Proper orientation and counselling methods are required to overcome this phenomenon.
Prevalence and risk for overweight among employees in a leading auto-mobile industry in India
Authors: Roy Runalika , Sukumar Gautham Melur , Kupatira Kowshik
Published: October 2021

Background: Overweight is a major risk factor for the non-communicable diseases. India is home to nearly 164 million industrial workers (2017) and yet information about prevalence and risk of overweight among them is limited. Being overweight can adversely affect a person's productivity in his workplace and increase the risk of non-communicable diseases. The objective was to assess the prevalence of overweight and association between overweight and employee age, type of work and native origin.Methods: The longitudinal analysis was conducted using periodical medical examination (PME) data of employees from 2010-2018. Relevant data were collected. Year-wise prevalence of overweight was estimated along with specific prevalence by age, type of work and region.Results: The mean weight of employees increased from 68.1 kgs to 72.6 kgs (2010-2018). Overweight proportion was significantly higher in non-production departments. Overweight prevalence ranged between 15-29.8% among Karnataka regions in 2010 in production employees but reached 35-55.6% by 2018. Significant association was found between overweight with type of work and region.Conclusions: The increase in weight over time indicates the trend of overweight and weight reduction interventions are needed in workplaces to prevent the risk of NCDs.
Prevalence of cataract, its risk factors and the barriers to cataract surgery among older women in a rural population of Cuddalore
Authors: Doss Merlin S. J. , Kalyani P. , Felix A. John William
Published: October 2021

Background: Cataract is the leading causes of vision impairment and preventable blindness in populations aged 50 and older. Advancing age, diabetes, hypertension, tobacco use and sunlight exposure are proven risk factors for cataract development. The prevalence of cataract is higher in low-income settings compared to high-income regions and also higher among females, compared to males. Hence this study has been conducted among a rural female population, aged 50 and above.Methods: The data collection for this descriptive cross-sectional study was conducted over a period of 4 months (December 2019 to March 2020), in a rural area of Chidambaram, Cuddalore. 397 study participants (202 females and 195 males) were interviewed using a semi-structured proforma, and examined accordingly. Of this, only the 202 females were included in this study, for estimating the prevalence of cataract among female population aged 50 and above. Data was analysed using SPSS statistical software presented as frequencies. Chi square test was used for finding association.Results: The overall prevalence of cataract in the present study is 64.9% (54.5% unilateral and 10.4% bilateral). Risk factors such as age, hypertension, diabetes, tobacco usage and sunlight exposure were significantly associated with the prevalence of cataract (p<0.05, 95% CI). Personal attitudinal reasons like neglect, no felt need and nobody to accompany were the most commonly encountered barriers to cataract surgery.Conclusions: Targeted camps, health education and screening programs can help overcome the unique barriers to surgery faced by females.
Knowledge and practice of nurses regarding standard precautions in a tertiary care public hospital, North India
Authors: Sharma Rakesh , Kumar Rajesh , Sharma Priya , Verma Divya , Sharma Mahesh Kumar , Sharma Anita , Sharma Maneesh , Jelly Prasuna
Published: October 2021

Background: Hospital-acquired infections could occur as a result of lapses in accepted standards of practice on the part of health care personnel (HCP). All individuals, particularly HCPs, are potentially at high risk of infection due to their frequent exposure. This study aimed to assess the knowledge and practices of nurses regarding standard precautions at a tertiary care hospital, North India.Methods: A cross-sectional study was conducted in a tertiary care hospital, Uttarakhand enrolling 134 nurses purposively from different units of the institute. Data was collected using a pre-structured self-administered questionnaire to seek information on participants’ knowledge and practices regarding standard precautions. SPSS version-23 was used to analyse the findings. Descriptive statistics were applied for the analysis of the results.Results: The mean age of the participants was 27.52±2.93 years, with more than half of the respondents were males (58.21%), and (41.79%) were females. Almost 60.45% had three or fewer years of work experience. Most respondents preferred hand hygiene (97.01%) and the use of PPE (88.06%). Almost 94.03% of participants favored disinfection of frequently touched surfaces. Regarding the practices, 95.52% answered that the right hand-washing is before wearing gloves, after removing the gloves, and after leaving the patient’s care area. About 98.51% of them answered that bio-medical waste should be discarded in the right type of color-coded bins.Conclusions: Findings suggested adequate knowledge and compliance among nurses regarding standard precautions. However, specific training programs may be conducted to attain full adherence to standard precautions. These programs can enhance their awareness and can work as a vital tool to achieve the desired improvement in knowledge and practices of standard precautions.
COVID-19 vaccination and breakthrough infections among healthcare workers: an online survey
Authors: Masthi Ramesh , Hebbar Gowri
Published: October 2021

Background: COVID-19 vaccinations were started in India among health care workers in January, 2021. These vaccinations provide protective immunity against the infection but may not completely exclude the possibility of contracting the infection. The objective was to assess the risk of contracting COVID-19 disease following vaccination; to describe the adherence to COVID appropriate behavior by vaccinated individuals.Methods: A cross-sectional study was conducted using an online questionnaire. The subjects selected were health care workers, medical students and other frontline workers. The sample size was 393. The risk of COVID-19 following vaccination was assessed against various factors like age, type of vaccination, status of vaccination, pre-existing comorbidities etc.Results: Out of the 393 vaccinated subjects, 57 (14.5%) acquired COVID-19 breakthrough infection. Majority of these individuals (75.4%) experienced mild symptoms. All vaccinated individuals were protected from severe COVID-19 disease. Most vaccinated individuals continued to strictly adhere to COVID appropriate behavior i.e., masks (97.0% and 98.0%), sanitized hands (93.0% and 98.0%) and maintain social distanced (91.6% and 86%) in both fully and partially vaccinated groups following vaccination.Conclusions: One tenth of the subjects were infected with COVID-19 following vaccination. Most experienced mild symptoms and risk of severe disease was significantly reduced.  There was no significant association between the type of vaccine administered and risk of infection.
Evaluation of a hospital-based surveillance system for birth defects in Chennai, India
Authors: Velayudhan Anoop , Seshadri Suresh , Jagadeesan Sujatha , Saravanan Jayanti , Yadav Rajesh , Yeung Lorraine F.
Published: October 2021

The Birth Defects Registry of India-Chennai (BDRI-C) was created in 2001 to monitor birth defects and provide timely referrals. Using established guidelines to evaluate surveillance systems, we examined the following attributes of BDRI-C to help strengthen the registry: simplicity, flexibility, data quality, representativeness, acceptability, timeliness, and stability. We reviewed BDRI-C documents, including reporting forms; interviewed key informants; and calculated data completeness, coverage, and reporting time. BDRI-C captured 14% of the births in Chennai April 2013 - March 2014. About 7% of institutions in Chennai registered in BDRI-C, and of those registered, 37% provided data in 2013. Median reporting time was 44 days after birth in 2013. BDRI-C is a useful, simple, flexible, and timely passive birth defects surveillance system; however, improvements can be made to ensure BDRI-C is representative of Chennai, data processing and quality checks are on-going, and the system is acceptable for member institutions and stable.
Types and causes of chronic pain after laparoscopic operations
Authors: Siddiqui Mohammad Saqib , Albasri Natheer Ibrahim , Hemaid Nour Abdullah Al , Alamoodi Ahmed Talal , Alghazal Shooq Abdulaziz , Mahmood Zeyad Khaled , Alsaiari Abdulhakim Abdullah , Albogami Yazed Abdullah , Alhebshi Mohammad Khalid , Hezam Essam Abdullatif , AlDrea Amna Ahmed , Siddiqui Malaz Mohammad Saqib
Published: October 2021

Laparoscopy has been introduced as a minimally invasive approach that has been developed to achieve the intended outcomes by open surgeries but with less frequent body injuries and complications. However, evidence indicates that the reported favourable outcomes are mainly based on retrospective data and using historical controls and only a few prospective investigations and clinical trials were published. Furthermore, studies have also demonstrated that following laparoscopy, severe pain can develop similar to or equal to the pain reported during open surgeries that develop within the earliest hours due to the significant tissue trauma introduced by laparoscopy. The present literature review discussed the different causes and types of chronic pain following laparoscopy. We also shed more light on the potential mechanisms and pathophysiology that attributes to the development of pain following laparoscopy. Many studies have indicated the development of chronic pain after 3, 6 and 12 months after hysterectomy, cholecystectomy, nephrectomy, colorectal surgeries and other abdominal surgeries. The development of postoperative main might be attributed to the tissue or nerve injury and associated inflammatory status that can also aid to the development of pain in such settings. Evidence also shows that the incidental pain following laparoscopy is similar or superior to that following open surgeries. Therefore, further interventional approaches are needed to enhance the outcomes.
Change in profile of cutaneous manifestations of HIV after the advent of antiretroviral therapy: a retrospective analysis
Authors: Bwalya Ireen C. , Lakhani Som , Aldridge Christian
Published: October 2021

Background: To date, there has been no study conducted in Zambia to determine the prevalence of mucocutaneous conditions among HIV positive patients on antiretroviral therapy.

Methods: The aim of the study was to determine the differences in cutaneous manifestations of HIV between HIV positive adult patients on antiretroviral therapy and antiretroviral naïve patients.

Results: A total of 143 adult HIV/AIDS patients with dermatological manifestations, and fulfilling inclusion criteria, were included. Among the 58 patients on antiretroviral therapy, the most common dermatoses were hyper-pigmentation (18.97%), fungal dermatitis (17.24%) genital herpes (8.62%), papular pruritic eruption (8.62%), oral candidiasis (8.62%) and Kaposi’s sarcoma (6.9%). The most common dermatoses among the 85 antiretroviral naive patients were oral candidiasis (34.12%), herpes Zoster (17.65%), hyper pigmentation (8.24%), eosinophillic folliculitis (7.06%), abscesses (5.88%), herpes labialis (4.71%) and Kaposi's sarcoma (4.71%). Among patients in Stage III of HIV infection, the proportion of patients with infectious dermatoses was significantly greater than the proportion of patients with non-infectious dermatoses (47.5% versus 28.6%; p=0.036).The odds of having an infectious dermatosis were 28% lower for patients on antiretroviral therapy as compared to antiretroviral naive patients (p=0.001).

Conclusions: There is a changing profile of muco-cutaneous conditions in HIV infected patients. Infectious dermatoses such as oral candidiasis and Herpes Zoster infections occur more frequently in antiretroviral naïve patients, as compared to patients on ART. Prevention of infectious dermatological conditions occurs with the use of ART.
Study of the therapeutic efficacy and safety of intralesional tranexamic acid (25 mg/ml) for the treatment of melasma in male patients: A single centered “before-after” observational study
Authors: Verma Yog R. , Mehta Karaninder S. , Chauhan Pushpinder S. , Mahajan Vikram K. , Chandel Monika , Sharma Hitender K. , Sharma Anuj K. , Sharma Reena K. , Chauhan Amit
Published: October 2021

Background: Melasma is a common and difficult to treat hypermelanosis of poorly understood etiopathogenesis with great tendency to relapse. Tranexamic acid (TA) has been used in various formulations for its treatment, but there is paucity of studies/data and no consensus on the optimum dosage of intradermal TA, especially among the male patients. To study the efficacy and safety of intralesional TA 25 mg/ml for the treatment of melasma in male patients.

Methods: Total 58 males were enrolled for study from July 2019 to June 2020. TA in 25 mg/ml strength injection and about 0.05 ml was injected intradermally at 1 cm apart on the entire melasma lesion, not exceeding 50 mg per visit and repeated every 4 weekly for 12 weeks. The percentage reduction in MASI was the primary outcome measure. It was determined every 4th week till 12 weeks and finally at 24 weeks for recurrence.

Results: Mean MASI decreased from baseline score of 8.42±5.63 to 6.71±4.65, 5.09±3.59 and 3.41±3.06 at the follow up week 4, 8 and 12 respectively with a significant decrease from 8th week onwards. Majority of the patients were satisfied with their improvement after treatment (67.2%) without any significant adverse effects.

Conclusions: However, the TA was found to effective in all the three histopathological types of melasma but the dermal melasma was least responsive as well as earliest to relapse. We recommend monthly therapy at 25 mg/ml as more efficacious, time saving and cost effective to all the three types of melasma.

 
A real-world, non-interventional Indian study on clinical assessment of intense moisturizing formulation in dry skin disorders
Authors: Dhoot Dhiraj S. , Mahadkar Namrata , Barkate Hanmant
Published: October 2021

Introduction: Moisturizers account for the largest and important skin care product categories and are the backbone in the management of dry skin conditions associated with atopic dermatitis (AD), psoriasis and ichthyosis. 

Methods: A multicentre, retrospective data analysis was done at 145 dermatology clinics across India in patients who were prescribed MaxRich®. Patients with history of xerosis with an identifiable causes like atopic dermatitis, psoriasis and ichthyosis were included in study. Effectiveness data in terms of improvement in Dry Skin Area and Severity Index (DASI) Score compared to baseline and physician global assessment at the end of treatment for improvement in xerosis were captured.

Results: There was significant reduction in mean DASI score as compared to baseline at week 2 & 4 (p<0.01). As compared to baseline, a significant decrease in DASI score was observed by 47.7% and 82.4% at the end of week 2 and 4 respectively. As per physician global assessment, 458 patients (83.4%) noticed very good improvement in xerosis at the end of 4 weeks whereas 82 patients (14.9%) recorded moderate improvement. Similar results were also obtained for patient global assessment where 478 patients (87%) recorded very good improvement; 67 patients (12.2%) and 6 patients (1.1%) recorded moderate and mild improvement respectively. There were no adverse events reported with MaxRich®.

Conclusion: MaxRich®, an intense moisturizer was effective in improvement of DASI score associated with atopic dermatitis, psoriasis and ichthyosis and can be considered as an adjunct therapy in the management of these skin disorders for better results.
Successional occurrence of two papulosquamous disorders in HIV positive patient: a rare case report
Authors: Deshmukh Nitika Sanjay , Chavan Ravindranath Brahmadeo , Gosavi Anil Prakash , Kachare Supriya Ashok
Published: October 2021

Presentation of two papulosquamous disorders in a same individual is rare condition till date. Independently, psoriasis and Lichen planus (LP) are common inflammatory skin conditions affecting around 2-3% and 1% of HIV (Human immune deficiency) positive population respectively. As reviewed in the literature, psoriasis may be independently associated with other autoimmune conditions like vitiligo, alopecia areata, lichen planus, and discoid lupus erythematosus. In this article, we presented a case report of a HIV seropositive patient who suffered from psoriasis and lichen planus. The coexistence of psoriasis and lichen planus in one individual is rare and underreported in literature. Psoriasis or lichen planus may be the presenting feature of HIV infection and tends to be more severe, to have atypical presentations. Psoriasis and lichen planus can be coexistent or successionally appear one after other in one individual though rare presentation. High index of suspicion is always required while dealing with papulosquamous lesions in PLHIV.

 
Alzheimer’s disease: Causes, treatment & basic science review
Authors: Sharma Shivani
Published: October 2021

Alzheimer’s disease is that the most common cause of dementia in older, individuals and a major public health concern. The goal of this critical evaluation is to provide a short overview of Alzheimer’s disease. The study concentrates on the biochemical aspects of AD and MCI. It is the fourth most common cause of mortality in the United States, and it is spreading to other nations. With Alzheimer's disease, the total size of the brain decreases as the tissue loses nerve cells and connections. The loss of brain cells that occurs as a result of insanity cannot be stopped or reversed. The set up's aims include measurements for gift interventions in addition to an aim to improve research on interference and therapy. Although there are no disease-modifying medications available for Alzheimer's disease, certain options may help to reduce symptoms and enhance quality of life, therefore assisting patients to some extent. In addition, the paper discusses current attempts to create innovative treatments and improvements in the use of biomarkers for diagnosing SD.