bluuebunny/crossref_metadata_2025 huggingface dataset:
Predictors of maternal and fetal outcome in severely anemic pregnant mothers: A sequential mixed methods study
Authors: Saraswathy V. , Subashini M. , Jayavani R. L. , Vaithiyanathan Usha , Mohan Reenaa , Sindhuri R.
Published: November 2023

Introduction:

Severe anemia in pregnancy increases maternal and neonatal morbidity and mortality in the antenatal period.

Objective:

To find out the maternal and fetal outcomes in severely anemic pregnant women and explore the reason for the persistence of severe anemia in pregnant women.

Materials and Methods:

Sequential explanatory mixed method study (Quan-Qual) was conducted in the Government Women and Children Hospital for a period of 1 and half years. Most of the people were from rural backgrounds and belonging to low socioeconomic status have been registered. Quantitative data were collected from 125 severe anemic cases; a consecutive sampling technique was applied. In-depth interviews were conducted among purposively selected severe anemic patients (n = 15) who were vocal and willing to explore the reason for the persistence of anemia. The interviews were conducted till the point of saturation. Ethical principles were adhered throughout the study. Quantitative data were anlyzed using SPSS software. Manual content analysis was done for qualitative data.

Results:

Among 125 severe anemic patients, 12.8% patients had preterm labour, about 23.2% had inadequate lactation, and 13.6% had a puerperal febrile illness. It was found 41.6% of neonates had respiratory distress and 33.6% had the refusal of feeds. When compared to vaginal delivery, women undergoing cesarean section have 3.2 times (95% confidence interval 1.39-7.32) higher odds of developing maternal complications. Nagelkerke's R2 value for the model was 11.1%. Five broad categories namely Family centric nature, Lack of awareness, Pill burden, Food Fads, and Myths related to iron intake emerged from the study.

Conclusion:

Complications can occur in mothers and neonates if anemia is not corrected in early trimester.
Prevalence and determinants of adverse events following ChAdOx1 nCoV-19 vaccination (COVISHIELD) – A retrospective cohort study among healthcare workers in central Karnataka, India
Authors: Davalagi Shubha B. , Nayak Vaman P. , Ghose Anisha , Marakatti Siddarth S. , Kasturi Eshwar S. , Maganahalli Anurupa S.
Published: November 2023

Background:

India has launched COVID vaccination program on January 16, 2021 and precautionary dose (third dose) on January 10, 2022. Our study evaluated adverse events following immunization (AEFI) among healthcare workers (HCWs) following first, second, and precautionary dose of ChAdOx1 nCoV-19 (COVISHIELD) vaccine. We also evaluated the association of AEFI with the study participants' characteristics.

Objectives:

(1) To assess the adverse events among HCWs following first, second, and precautionary dose of COVISHIELD vaccine. (2) To determine the factors associated with adverse events of COVISHIELD vaccine.

Materials and Methods:

A retrospective cohort study was conducted among HCWs of a tertiary care teaching hospital in central Karnataka from January 2021 to June 2022. A semi-structured, pretested questionnaire was used to interview the HCW of tertiary care teaching hospital regarding adverse events following first, second, and precautionary dose of COVISHIELD vaccine; data collected was entered in MS Excel 2019 and analyzed using SPSS v24.0.

Results:

Among 454 participants majority of them were females (231, 50.88%) and in the age group 18-27 years (151, 33.25%), and the majority were nursing staff (147, 32.37%). Adverse events were reported among 204 (44.93%) following the first dose, 149 (32.81%) after the second dose, and 230 (50.66%) participants following the precautionary dose. Generalized weakness and fever were the common adverse effects reported by participants.

Conclusion:

Majority of the study population did not report any adverse events following vaccination. Among the study participants who reported adverse events, most events were reported on the same day. Symptoms were mild in severity and short-lived.
Bevacizumab combined with platinum-based chemotherapy in primary or relapsed ovarian cancer patients: Meta-analysis and literature to review
Authors: Tauseef Abubakar , Zafar Maryam , Abodunrin Faith , Siddiqui Sameed A. H. , Millner Paul , Khan Saber M. , Teplitsky Ella , Masih Durva , Mirza Muazzam , Mirza Mohsin
Published: November 2023

Introduction:

Earlier, patients with advanced ovarian cancer were treated with a combination of cytoreductive surgery and platinum-based chemotherapy, which had significant outcomes in the past until an increase in relapse and resistance to treatment, which led to the use or development of bevacizumab (a vascular endothelial growth factor inhibitor) in the treatment of primary or relapsed ovarian cancer.

Method and Methodology:

This study includes five-phase three randomized controlled clinical trials designed to study the impact of bevacizumab in combination with platinum-based chemotherapy compared with platinum-based chemotherapy alone.

Results:

This study demonstrated significant improvement in the progression-free span but no improvement in overall survival in the treatment group when compared with the control group. Also, adverse effects reported with combination therapy were tolerable and easily manageable by decreasing the infusion rate or by decreasing the frequency of infusion.
Patients' perceptions of telehealth video visits experience in primary healthcare setting, Saudi Arabia
Authors: Alotaibi Hanan F. , Ghazi Sultan S. , Asraf Nisreen O. , Al Asmari Zahra S.
Published: November 2023

Background:

The widespread utilization of telehealth recently in Saudi Arabia is unprepared and may have a remarkable adverse effect on healthcare delivery. The study aimed to investigate attitude, satisfaction, and barriers of telehealth application among patients.

Materials and Methods:

A cross-sectional study was conducted at primary healthcare centers during the period of December 2021–January 2022. All Saudi patients (≥18 years) who were treated through telehealth programs in specialized polyclinic were eligible for study inclusion. A self-administered questionnaire was utilized and consists of four main parts: personal information, history of using telehealth, assessment of satisfaction with telehealth program, and attitude toward telemedicine.

Results:

A total of 641 participants were included. Females represented 57.3% of them. A majority (82.7%) of patients were satisfied with telemedicine services. Multivariate logistic regression analysis revealed that Bachelor/postgraduates were more likely to be satisfied with telemedicine services (P < 0.001), whereas patients reported no appointment slot in the clinic were less likely to be satisfied with telemedicine services (P = 0.042). A majority of patients (84.1%) expressed positive attitude toward telemedicine services. Multivariate logistic regression analysis revealed that older patients (P = 0.002) and widowed (P = 0.001) were less likely to have positive attitude toward utilization of telemedicine services, whereas Bachelor/postgraduates (P = 0.038) and patients with more than this time were more likely to have positive attitude toward telemedicine services (P = 0.001).

Conclusion:

Patients were overall satisfied and expressed positive attitude concerning the service of telemedicine consultation. However, more in-depth investigation is recommended to better understand the predictors of satisfaction with telemedicine and barriers for its proper application.
View of mucormycosis during the era of COVID-19 infection: A cross-sectional study
Authors: Zakaria Ossama M. , Alkuwaity Dana W.
Published: November 2023

Background:

During the coronavirus (COVID-19) global pandemic, the diagnosis of mucormycosis co-infection has become challenging as it is sometimes misdiagnosed or even undiagnosed. Many factors contribute to acquiring such infections. These factors vary but their main reason for getting such infections is being immunocompromised. Thus, it results in weak host immunity to fight and prevent such co-infection.

Objectives:

This study aims to assess the knowledge perception among the general population in Saudi Arabia regarding black fungus and its relationship with the global pandemic COVID-19.

Materials and Methods:

A prospective, qualitative, questionnaire-based cross-sectional study took place. The obtained data were statistically analyzed using SPSS version 21.

Results:

The study included 1138 participants, 31.5% from southern region, 27.8% from Eastern region, 22.2% from north region, 12.2% from Western region, and 6.3% from Central region. The participant's mean age was 27.1 ± 11.9 years old. A good knowledge level was detected among 35% of female respondents compared to 28.9% of males with reported statistical significance (P =0.036). All other factors including age, education, and work were insignificantly associated with public knowledge level.

Conclusions:

A considerable percentage of the current study population had poor knowledge level of perception and awareness regarding mucormycosis in relation to COVID-19.
Clinicoepidemiologic profile of leprosy in geriatric population in post-elimination era: A retrospective, hospital-based, cross-sectional study from Eastern India
Authors: Pradhan Swetalina , Shahid Rashid , Singh Suvesh
Published: November 2023

Background and Aim:

Geriatric populations are susceptible to leprosy infection with masked clinical signs due to lower immunity in them. Our aim was to analyze the clinicoepidemiologic profile of patients with geriatric leprosy and find out the reasons for delayed diagnosis and treatment.

Materials and Methods:

A retrospective, record-based study was conducted in a tertiary care center from May 2019 to May 2022. The clinicodemographic data of biopsy-confirmed leprosy cases aged ≥60 years were obtained from the leprosy clinic record. Various reasons for the delay in treatment were also recorded. Simple statistics was used for analysis.

Results:

Out of 605 leprosy cases, 50 (7.4%) cases belonged to the geriatric population. Males outnumbered females (M/F = 37/13). The mean age of the patients was 66.28 + 6.5 years. Maximum patients belonged to 60–69 years of age. The mean duration of illness was 35.22 months (range 1–240 months). Most of the patients were illiterate (33.6%), and 56% were farmers by occupation. The ulnar nerve was the most common nerve to be thickened in 90% (45/50) cases, followed by the common peroneal nerve in 54% (27/50) cases, radical cutaneous nerve in 52% (26/50) cases, and posterior tibial nerve in 24% (12/50) cases. Borderline tuberculoid was the most common type in 44% cases, followed by lepromatous leprosy in 22%, borderline lepromatous leprosy in 18% (9/50), and pure neuritic leprosy in 14%. Type 1 and type 2 lepra reactions were found in 18% and 14% cases, respectively. Also, 38% had grade 2 disability. Common reasons for the delay in treatment were financial constraints, lack of family support, and personal superstitious beliefs. The study was limited by its retrospective nature.

Conclusion:

Geriatric leprosy needs special attention as the elderly are more prone for deformities; also, because of low immunity, there is a high chance of developing multibacillary leprosy, and therefore, they are potential sources of infection to the community.
From designing minimum data set to developing kidney transplantation registry in Iran
Authors: Akhlaghi Ahmad , Langarizadeh Mostafa , Rahimzadeh Nahid , Rostami Zohreh
Published: November 2023

Objective:

Currently, population growth and increasing life expectancy are becoming one of the biggest public health challenges in the world, which has increased the prevalence of chronic diseases such as end-stage renal disease and the need for kidney transplantation. The use of a variety of registries has the potential to determine the effectiveness of clinical care and costs and improve the quality of patient care. The aim of this study is to design minimum data set to develop a kidney transplantation registry in Iran to improve the quality of care for people with end-stage renal disease.

Methods:

The present research is descriptive-applied. The minimum data set was reviewed and evaluated in expert panel meetings. The various elements of the minimum data set were discussed, and specialists in urology, nephrology, health information management, and medical informatics presented their views.

Results:

The characteristics of the kidney transplantation registry in the form of eight axes of purpose, structure, data sources, minimum data set, classification systems, data processing and reporting, distribution and access to information, and data quality were extracted and finally these characteristics were approved by experts. The relevant tables were validated and were within the acceptable range from the point of view of experts.

Conclusion:

In developing a kidney transplantation registry in Iran, the necessary requirements and features for designing a web-based registry have been considered. The prototype of this registry in the country will help to collect higher quality data. It is hoped that by developing this registry, a step will be taken to better manage the information on people with end-stage renal disease, provide better services to these patients, and facilitate related research.
Study of menstrual cycle synchrony in female medical students sharing common accommodation
Authors: Siddiqui Nazeem I. , Chinchole Sangeeta , Khan Sarfaraz A. , Bose Sukhwant , Mishra Piyush K.
Published: November 2023

Context:

Menstrual cycle synchronization is a phenomenon in which menstrual onset shifts progressively closer with time. It is an adoptive conditional phenomenon seen in the females who associate closely and share a common environment.

Aims:

To ascertain whether menstrual cycle synchrony exists in the roommates living in a closed space in a medical hostel.

Settings and Design:

This is a prospective observational study comprising 62 female medical students of a mean age of 22 years living in twin sharing accommodation with a history of regular menses (26–32 days).

Methods and Material:

These participants were followed on a monthly basis for 13 months. Menstrual cycle history was obtained using standardized Google forms. Menstrual cycle initial and final onset differences, expected cycle cut-off values, and absolute differences were calculated. The menstrual cycle synchrony score was obtained by subtracting the expected difference from the onset difference. Wilson's absolute difference method was used for determining menstrual synchrony between pairs.

Statistical Analysis Used:

The descriptive analysis was done using mean and standard deviation. One sample t-test was used to assess the synchrony between roommates. P value ≤0.05 was considered as statistically significant.

Results:

The initial onset difference of the menstrual cycle was 7.58 ± 4.25 days, whereas the final onset difference was 6.06 ± 3.92 days. The calculated synchrony score was -9.28 ± 5.05, which was statistically significant. Menstrual cycle synchrony was observed in 17 pairs (54.8%) and asynchrony in eight pairs (25.8%).

Conclusions:

Long-term association between roommates has potential to cause menstrual cycle synchrony. It has significant implications in reproductive medicine for reproductive scheduling and family planning.
Smoked tobacco dependence and its correlates among participants attending life skills training and counselling services programme across Karnataka (2017–2022)
Authors: Therat Sonia , Banandur Pradeep S. , Sukumar Gautham M. , Shenoy Anusha B. , Arvind Banavaram A. , Nagaraja Srividya Rudrapattana , Rai Veeksha , Medhi Upashana , Devyani Azad
Published: November 2023

Introduction:

Indian National Mental Health Survey reports an alarming prevalence of 20.9% for tobacco dependence in India. Dependence on smoked tobacco can be prevented by thorough knowledge of the risk factors associated with it.

Objectives:

To estimate the prevalence and identify the factors associated with smoked tobacco dependence among participants attending the life skills training and counselling services programme (LSTCSP) across Karnataka from 2017 to 2022.

Materials and Methods:

Pretraining data of 3104 participants from training programmes between 2017 and 2022 were utilised. Univariate and multivariable logistic regression analysis was performed based on a conceptual framework with various hypothesised exposure variables and smoked tobacco dependence as outcome.

Results:

The overall prevalence of smoked tobacco dependence among LSTCSP participants who used smoked tobacco products was 59.4%. Ever use of smokeless tobacco products (Adjusted odds ratio (AOR) =2.05, 95% CI: 1.11–3.78) and screening positive for symptoms of generalised anxiety (AOR = 2.53, 95% CI: 1.32–4.84) significantly increased the odds of smoked tobacco dependence, whereas making decisions collectively in the family (AOR = 0.35, 95% CI: 0.18–0.66) and individuals with increased score for neurotic personality traits (AOR = 0.64, 95% CI: 0.44–0.93) were the factors associated with reduced odds of smoked tobacco dependence.

Conclusion:

The identified risk factors associated with smoked tobacco dependence are important to develop tobacco control programmes as well as in preventing its onset. With the risk factors for smoked tobacco dependence identified, the results of this study have implications for health promotion and prevention programmes as well as cessation programmes related to smoked tobacco dependence, within India and similar countries.
Study of HbA1c levels in non-diabetic individuals recovered from Covid-19
Authors: Gandikota Sainithesh , Sudha Kothapalle Sowmya , Naramalli Madhavi Latha
Published: November 2023

Objectives:

To study the glycemic control by estimating HbA1c levels among previously non-diabetic individuals aged above 40 years, who recovered from coronavirus disease 2019 (Covid-19) infection.

Materials and Methods:

This is an analytical cross-sectional study of people affected with Covid-19 infection, who were home-isolated, hospitalized, and discharged. The simple random sampling technique was used for the study group. Tirupati City, Andhra Pradesh State, India. We assessed socio-demographic profiles, hba1c levels, RBS, and severity of infection. The obtained laboratory reports were analyzed by using means and proportions after entering data in MS Excel and converted to SPSS software new version.

Results:

The study participants comprised mostly middle age group males and females (mostly 40–60 years, with 60% of them being females). Most of the study subjects were healthy, and 58% of them have normal hba1c levels. 32% of them are in border line diabetic. The prevalence of diabetes post Covid-19 infection is 10%. The majority of participants have normal random blood sugar levels (around 92%), and very less individuals have abnormal random blood sugar levels (2% of the subjects). There is no significant association between hypertension and raised blood sugar levels post Covid-19 infection.

Conclusions:

Based on the study, Covid-19 infection has an impact on blood sugar levels and altered glycemic control, switching a few individuals into diabetic and a significant number of individuals into the pre-diabetic state, who are non-diabetic individuals before Covid-19 infection.
Effect of preterm birth on blood pressure in later life: A systematic review and meta-analysis
Authors: Alsubai Abdulla K. , Ahmad Mushtaq , Chang Rabia , Asghar Mustafa A. , Siddiqui Amna , Khan Hamza N. , Ashraf Muhammad H. , Javaid Muhammad D. , Kalwar Asifa , Asad Mahnoor , Memon Kainat , Khan Laibah A. , Noorani Amber , Siddiqi Ahmed K.
Published: November 2023

Introduction:

Preterm birth is linked to various complications in both infancy and adulthood. We assessed the association between preterm birth and hypertension in adulthood.

Materials and Methods:

PubMed, EMBASE, and Cochrane CENTRAL Register were searched for randomized controlled trials (RCT) comparing systolic and diastolic blood pressures in individuals born preterm and those born full-term, from inception till April 11th, 2022. Data were extracted, pooled, and analyzed. Forest plots were created for a visual demonstration.

Results:

Twenty-eight studies were included in our meta-analysis. SBP and DBP across all categories (Mean, Ambulatory, Daytime, and Nighttime) were higher in the preterm group compared to the term group. Mean SBP, mean ambulatory SBP, mean daytime SBP and mean nighttime SBP were 4.26 mmHg [95% CI: 3.09–5.43;P< 0.00001], 4.53 mmHg [95% CI: 1.82–7.24;P= 0.001], 4.51 mmHg [95% CI: 2.56–6.74;P< 0.00001], and 3.06 mmHg [95% CI: 1.32–4.80;P= 0.0006] higher in the preterm group, respectively. Mean DBP, mean ambulatory DBP, mean daytime DBP, and mean nighttime DBP were 2.32 mmHg [95% CI: 1.35–3.29;P< 0.00001], 1.54 mmHg [95% CI 0.68–2.39;P= 0.0004], 1.74 mmHg [95% CI: 0.92–2.56;P< 0.0001], and 1.58 mmHg [95% CI: 0.34–2.81;P= 0.01] higher in the preterm group, respectively.

Conclusion:

Our observations suggest that individuals who were born preterm may have higher blood pressures as compared to those who were born full-term.
Perception of beneficiaries on motivating factors and challenges of COVID-19 vaccination: An institute-based study
Authors: Karmakar Tanushree , Sain Sonali , Dey Surya Prakash , Sarkar Aditya P. , Biswas Atanu
Published: November 2023

Background:

The novel coronavirus disease 2019 (COVID-19) caused by a newly discovered SARS-CoV-2, led to COVID-19 pandemic across the world. Vaccination played an important role in reduction in morbidity and mortality concerning the current pandemic, but there was a lack of awareness and motivation to get vaccinated during the pandemic.

Objective:

This study was aimed at assessing the motivating factors and finding out the challenges perceived among the beneficiaries receiving the vaccine at the COVID-19 immunization center of Bankura Sammilani Medical College and Hospital (BSMCH).

Materials and Methods:

This institution-based descriptive cross-sectional study was conducted from June 2021 to October 2021 at the COVID-19 Vaccination Centre of Bankura Sammilani Medical College, West Bengal, among 158 beneficiaries. The study population was selected through a systematic random sampling method, and data were collected by interview with a predesigned, pretested structured questionnaire. To identify the predictor (s), variables that were found statistically significant in binary logistic regression analysis were considered for multiple logistic regression.

Results:

Motivation for vaccination was significantly (P < 0.05) higher among participants who were educated up to the secondary level. Challenges perceived were significantly (P < 0.05) higher among participants aged less than 60 years and the participants who were coming from a distance of more than or equal to three kilometers.

Conclusion:

Awareness generation program, frequent Information, education and communication (IEC) activities, etc., may alleviate these challenges and can improve vaccination coverage in the future.
Six-month outcome of multisystem inflammatory syndrome with persistent neutropenia in neonate: A case report and review of literature
Authors: Jhajra Sandeep D. , Tanti Sanjay K. , Sauparna Chhavi , Kumari Sarita , Uddin MD W. , Diwakar Kumar
Published: November 2023

Multisystem inflammatory syndrome in Children (MIS-C) is a postinfectious immune mediated complications seen in children and develop after 4-6 weeks of severe acute respiratory syndrome coronavirus -2 (SARS-CoV-2) infection, however, it is rare in neonates. The index case was admitted at day 19 of life with complaints of fever, loose stools and rash. Baby was discharged after 1 weeks with diagnosis of Multisystem inflammatory syndrome with persistent neutropenia. We follow up the case at 6 weeks, 12 weeks and 6 months of life. Growth, neurodevelopment and hematological parameters were monitored over time. We are reporting this follow up of MIS-N with persistent neutropenia because it is very rare, organ specific manifestations, effect on growth & development is unknown and needs to be reported. Improvement in hematological parameters and markers of coagulopathy & systemic inflammation required months before they return to baseline. There are no long-term sequelae on growth and neurodevelopment.
Health-seeking behaviour and its determinants of health of Under–5 Children living in urban slums of Chennai, India 2018
Authors: Ganeshkumar Parasuraman , Kamaraj Pattabi , Mageswari S , Gayathri K , Gajendran Srilekha , Selvi S Karthigai , Rajan H Magesh , Balusamy M , Vijayaprabha R
Published: November 2023

Background:

Appropriate health-seeking behaviour could help in reducing child mortality and morbidity. Information on social factors of mortality and health-seeking behaviours of caregivers of under-5 children from slums of Indian cities is minimal in literature.

Objectives:

We estimated the prevalence of health-seeking behaviour for morbidity ofunder-5 children and its determinants in urban slums in Chennai city, India.

Methods:

A cross-sectional study was conducted using a mixed-method design among primary caregivers of under-5 children living in Chennai slums, India. Two-stage cluster sampling was adopted to select 40 slums. A total of 233 primary caregivers were interviewed. Nine focus group discussions and 18 in-depth interviews were conducted among the primary caregivers. Prevalence of inappropriate health-seeking behaviour was estimated, and determinants were identified by multivariate binary logistic regression analysis. Thematic analysis was done on qualitative data.

Results:

We interviewed 233 primary caregivers. The weighted prevalence of inappropriate health-seeking behaviour for under-five children in urban slums of Chennai was 53.9% (95% CI: 46.9 – 60.8). Primary caregivers educated above secondary school were more likely (AOR of 2.3, 95% CI: 1.3–4.1) to follow inappropriate health-seeking behaviour compared to those educated below. Similarly, caregivers who were unaware of young child feeding practices (AOR of 3.6, 95% CI: 1.9–6.5) and early care-seeking and health practices (AOR of 2.5, 95% CI: 1.3–4.9) were more likely to engage in inappropriate health-seeking behaviour compared to those who were aware and we found that illness symptoms influenced health-seeking behaviour and that early disease detection might prevent severe illness.

Conclusion:

Health-seeking behaviour was found to be suboptimal among under-5 children in Chennai's urban slums. We suggest policymakers improve interventions on early care-seeking of common childhood illnesses in the urban health programme.
Effectiveness of interventional package on body image perception and self-esteem among adolescents – A pilot study
Authors: Kaur Navjot , Jiwan Triza , Pooni Puneet A.
Published: November 2023

Background of the Study:

In adolescence various physical and psychological changes, impact their overall perception that leads to either satisfaction or dissatisfaction with body image. Adolescents can suffer from body image dissatisfaction. Counselling sessions, video and documentaries can be used to improve the body image concerns. So, this study aims to evaluate the impact of interventional package on the body image perception and self-esteem among adolescents.

Materials and Methods:

The sampling technique used to enrol 65 adolescents was simple random. Body image was assessed in the form of affective and behavioural body image perception. Two different structured scales were used to assess affective and behavioural body image perception. Pre-test was conducted to assess the body image perception among adolescents; then, documentary was shown in the form of intervention 1 and the post-test 1 was taken, again booklet was distributed as intervention 2 and post-test -2 was taken.

Results:

A statistically significant improvement in the satisfaction with weight, height, complexion, hair, teeth, buttocks, thigh and moustache, after the use of interventional package. In behavioural perception of body image, no significant association was found in pre-test, post-test 1 and 2, there is statistically significant improvement in self-esteem of adolescents, as P = 0.03.

Conclusion:

Interventional package in the form of documentary and booklet is useful in improving body image perception among adolescents. Significant improvement was seen in perception related to certain body parts.
Three years versus four years Saudi Board Family Medicine program: Graduates' academic performance, perceptions, burnout, and satisfaction with professional life
Authors: Almutairi Abdulaziz , Alrebdi Muath , Kalevaru Chandra Sekhar , Jahan Saulat
Published: November 2023

Background:

The specialty of family medicine, established in Saudi Arabia in the 1980s, has rapidly progressed in healthcare settings and is increasingly utilized by the population as well as recent MBBS graduates. Universally, there is ambiguity in the duration, curriculum, and assessment methods used in family medicine specialization programs.

Methodology:

A cross-sectional study was conducted among 183 fresh graduates from a 3-year and 4-year residency program. Data were collected using electronic forms, which were subsequently transferred to Microsoft Excel. Following appropriate coding, the data were transferred to SPSS for analysis. The dataset was then cleaned, and statistical tests, such as Chi-square and independent t-tests, were used to draw inferences.

Results:

Males (50.3%) and females (49.7%) had almost equal distribution in the study. Overall, 67.6% of respondents had passed the final exam; the pass percentage was 69.3% for the 3-year residency program and 66.4% for the 4-year program. The overall mean score for perceived achievement of SaudiMED-FM 2020 competencies was 23.06 ± 5.52 out of a total score of 30. On comparing the 3-year versus 4-year residency program, there was no statistically significant difference between perceived competency scores and professional satisfaction scores. Among the study participants, 19 (10.4%) had ‘serious burnout’, and 22 (12%) had ‘extremely serious burnout’. Professional satisfaction was significantly associated with burnout (P = 0.006).

Conclusions:

Based on the study results, there was no significant difference regarding academic performance, perceived competencies, and professional satisfaction among the graduates of the 3-year versus 4-year residency program. Approximately more than half of the graduates had suffered from burnout which was reported more by the females and those with financial issues. The majority of the respondents suggested improvements in clinical rotation and assessment methods.
To assess the impact of training about hospital infection control measures related to hemodialysis services on the knowledge of healthcare providers (HCPs) at the teaching institution of Haryana
Authors: Singh Sukhbir , Aggarwal Hari Kishan , Pal Shekhar , Chandra Hem
Published: November 2023

Background:

Adequate knowledge among nursing professionals toward hospital infection control measures related to hemodialysis (HD) services is essential to decrease infection among patients.

Objective:

This study assessed nursing professionals' knowledge about hospital infection control measures related to HD services and the effect of training interventions.

Settings and Designs:

It was a single group, a pre–post-interventional study conducted on nursing professionals of a single apex medical college of Haryana.

Materials and Methods:

A pretested questionnaire consisting of two parts was used as a study tool.

Statistical Analysis:

Various statistical tests such as paired t-test and Pearson's correlation were used.

Results:

The pre-intervention group had a lower mean knowledge score (mean knowledge = 90.2786, strongly disagree [SD] = 15.52682, standard error [SE] = 1.09518) and then the post-intervention mean knowledge score (mean knowledge = 137.5622, SD = 9.72252, SE = 0.68577).

Conclusions:

The training program or educational intervention proved very useful for enhancing nursing professional's knowledge about hospital infection control measures related to HD services.
To Study the Efficacy of Intraamniotic Prostaglandin F2 Alpha versus Mifepristone and Misoprostol Combination for Mid-trimester Medical Termination of Pregnancy
Authors: Kapur NM Anupam , Rao V. Saujanya J. , Tangri M. K. , Bhatt Reema Kumar , Magdum Hrishikesh
Published: November 2023

Context:

Aims: This study aims to compare the effectiveness, induction to abortion interval, blood loss, and side effect profile between administration of intraamniotic prostaglandin F2 alpha (PGF2α) with a combination of mifepristone and misoprostol for medical termination of pregnancy in mid-trimester. Prospective observational study.

Subjects and Methods:

The study was conducted by dividing the women with indicated mid-trimester abortions into two groups of 20 women each. Group-I received Tablet Mifepristone 200 mg orally on day 1 and then after 48 h, Tablet Misoprostol 400 μg given per vaginally every 4 h till abortion was completed or a maximum of 5 doses whichever was earlier. Group-II received a single injection of PGF2α (250 μg) intra-amniotically under ultrasonography guidance. Group comparisons were made using t-test/Mann–Whitney U-test for normally/nonnormally distributed continuous data, respectively, and Chi-square test for categorical variables. SPSS version 23 was used for analysis. P < 0.05 was taken as the cut-off for statistical significance.

Results:

The success rate was 100% in both the groups. There was a significant difference in the mean induction to abortion interval between Group-I, the mean being 12.92 ± 2.68 h compared to Group-II being 33.08 ± 6.35 h (P < 0.001). Group-I had a mean blood loss of 221 ± 55.15 mL, significantly more than Group-II 160 ± 25.13 mL (P < 0.001). Twenty-five percent of the Group-I woman had retained products of conception with none in Group-II (P = 0.029). The pain score was better in Group II (pain score 4.4 vs. 5.7, P < 0.001). Fewer women developed chills in Group II compared to Group I (0% vs. 50%, P < 0.001).

Conclusions:

PGF2α is equally effective as a combination of Mifepristone and Misoprostol in mid-trimester abortion. Although it has a longer induction to abortion interval, it appears to be better with respect to the completeness of evacuation, lesser blood loss, and better patient tolerance.
Transition toward Technological Transformation: Challenges of Implementing Virtual Reality and Augmented Reality in the Health Sector
Authors: Ray Sougat , Tawar Shabeena , Singh Neha , Singh Gurpreet
Published: November 2023

Background:

Metaverse, the disruptive digital technology, has demonstrated significant effectiveness in the fields of preventive and cognitive therapy, diagnostics, surgical interventions and rehabilitation. Virtual Reality (VR), a part of Metaverse, integrates imaging data and input from users and deliver a 3D graphical output which can be visualised through a wearable headset. Augmented reality (AR) on the other hand, can control the presence of the user in the real world.

Methodology:

A review was undertaken of peer-reviewed literature on the emerging evidence on the applications of AR and VR in healthcare. Research studies carried out to identify effectiveness of AR and VR technologies were included.

Result:

AR & VR have been effective in rehabilitation of patients of Autism Spectrum Disorders and Mild Cognitive Impairment by improving motor skills, social skills and various cognitive indices like task learning and attention. In the surgical field, AR head mounted device (HMD) can provide three-dimensional, patient specific anatomic information during surgery. It minimises surgical complications and improves patient satisfaction. AR is of particular interest in complicated spinal surgeries and orthopaedic manoeuvres which require high level of surgical skill. AR has also been used successfully in different types of robotic surgeries as well. In several countries AR technology have been used in basic medical and advanced surgical training. Major challenges in implementing AR and VR in the field of health care persist in the domains of cyber security, ethical issues and cost effectiveness.

Conclusion:

VR and AR technology can maximise patient outcomes and rapidly develop satisfactory patient management in fields of cognitive research and surgical interventions. More clinical trials with immersive digital technologies are required. Ethical and cyber security challenges are present but there are ways to overcome them. It is our duty as physicians to participate in the development of these innovations to ensure virtual health reality benefits for our patients in real-world setting.
Evaluation of Corneal Sensitivity and Quadrature Variability in Patients with Diabetic Neuropathy
Authors: Kiyat Pelin , Kose Timur , Gümüstas Banu , Selver Ozlem Barut
Published: November 2023

PURPOSE:

The purpose of the study was to evaluate the corneal sensitivity and its quadrature variability in patients with diabetic neuropathy (DN) diagnosed with electromyography and to compare these results with age- and sex-matched healthy individuals.

METHODS:

The left eyes of 32 patients who applied for refraction or fundus examination and had a diagnosis of DN by electromyography in their medical history were included in this study. Corneal sensitivity was evaluated using the Cochet–Bonnet esthesiometer (Luneau, Paris) in five zones: central, nasal, superior, temporal, and inferior. The measurements of the patients were compared with the measurements of 32 age- and sex-matched healthy volunteers. Furthermore, the measurements of five corneal zones were compared with each other, and the level of correlation was investigated in each group.

RESULTS:

The central corneal sensitivity values were measured as 4.12 ± 1.04 (mm) and 5.92 ± 0.14 (mm) (P < 0.001). While the sensitivity values at the superior, inferior, nasal, and temporal quadrants were detected as 5.85 ± 0.21, 5.85 ± 0.26, 5.94 ± 0.13, 5.93 ± 0.13, and 5.92 ± 0.14 (mm) in the control group, it was measured as 3.67 ± 0.66, 3.67 ± 0.62, 3.67 ± 0.62, and 3.89 ± 0.73 (mm) in the DN group, respectively. The corneal sensitivity values were all found to be significantly lower in the DN group (P < 0.001 for all parameters) at all quadrants as well as the central cornea. Furthermore, a moderate positive correlation between all five zones in the control group and a very strong positive correlation in the DN group were found in terms of the corneal quadrature sensitivity.

CONCLUSION:

The current study revealed a significant reduction in corneal sensitivity in patients with DN. In both the control group and DN group, all corneal zones showed positive correlations which show the consistency of the measurement in different quadratures. Evaluating corneal sensitivity with a Cochet–Bonnet esthesiometer might serve as a useful screening tool in detecting neuropathy development. By taking the necessary precautions, further damage can be prevented.
Comparison of Continuous versus Pulsed Mode in Accelerated Corneal Collagen Cross-linking for Keratoconus
Authors: Karotkar Kirti S. , Karotkar Sagar A. , Bhirud Kiran M. , Lakra Mahaveer S.
Published: November 2023

PURPOSE:

To compare efficacy and safety between the two modes of energy delivery-pulsed and continuous, in accelerated corneal collagen cross-linking (KXL) to stop the keratoconus advancement through topographical, visual, and refractive endpoints.

METHODS:

It was a prospective, comparative, randomized, interventional trial. Patients with bilateral progressive keratoconus were subjected to pulsed mode KXL (P-KXL) in the right and continuous mode KXL (C-KXL) treatment in the left eye. In both methods, additional supplemental oxygen was delivered to corneal surface using a nasal cannula connected to an oxygen supply. Uncorrected distance visual acuity (UDVA) and corrected distance visual acuity, posttreatment manifest spherical equivalent and astigmatism, and corneal topography were studied. The deformation amplitude index (DAI) was measured by Corvis-ST. Postoperative follow-up was done.

RESULTS:

One hundred eyes of 50 patients underwent P-KXL in the right eye and C-KXL in the left eye. The average follow-up was 12.1 ± 1.2 months. At 1 year posttreatment, the UDVA had a mean change of 0.11 ± 0.14 logMAR in P-KXL and 0.18 ± 0.14 logMAR in C-KXL groups. The line of demarcation was observed at 251.13 ± 18.28 μ and 245.28 ± 28.26 μ deep, respectively, in P-KXL- and C-KXL-treated eyes at 6 months’ follow-up. The DAI as measured by Corvis-ST showed a significant decrease from pretreatment values of 1.12 ± 0.13 mm to 0.84 ± 0.14 mm (P < 0.01) in P-KXL eyes and from 1.04 ± 0.14 mm to 0.85 ± 0.15 mm (P = 0.03) in C-KXL eyes. Both the groups did not show any statistically significant endothelial cell loss posttreatment.

CONCLUSION:

C-KXL can give similar functional outcomes as P-KXL with the help of supplemental oxygen delivery with the added advantage of a shortened procedure time in comparison to pulsed mode.
Limbal Autograft Stem Cell Transplantation: More Than 20-Year Follow-up
Authors: Al-Motowa Saeed A. , Al-Osaily Abdullah M. , Al-Motowa Sarah , Alfarhan Abdulrahman
Published: November 2023

Limbal stem cell deficiency (LSCD) is a very challenging situation and difficult to manage. A great works and ideas were conducted over the past 50 years. Numerous surgical techniques were proposed. We are reporting more than a 20-year follow-up of a case of limbal autograft stem cell transplantation due to LSCD secondary to chemical injury.
Online Faculty Development on Curriculum Design in Simulation-based Education by International Collaboration – An Example from the Democratic Republic of the Congo
Authors: Filipe Helena P. , Golnik Karl , Geary Amelia C. , Kilangalanga Janvier , Mack Heather G.
Published: November 2023

PURPOSE:

Faculty development for procedural specialists is intended to improve clinical education and surgical/procedural skills. Despite challenging in under-resourced settings, this may be enhanced by developing international collaboration agreements and supported by online learning experiences. The Congolese Society of Ophthalmology and the International Council of Ophthalmology agreed to collaborate on implementing an online educational program to form a community of practice (CoP) of ophthalmologists educators and enhance competence in curriculum design and simulation-based education (SBE) on cataract surgery.

METHODS:

Ten Congolese ophthalmologists, faculty for the “Centre de Formation Ophthalmologique pour l’Afrique Centrale” (CFOACF), participated in a group-mentored 12-webinar modular program on curriculum design, in 2019. Considering the geo-social–cultural learning environment, we developed a curriculum framework incorporating social constructivism and experiential learning principles to facilitate the implementation of learning. Educational strategies included flipped, practice-based and social learning, group mentoring, and individual and collective reflection opportunities. A CoP was virtually nurtured using WhatsApp. Program evaluation relied on (a) feedback survey per module and 3 months upon conclusion, (b) individual declarative knowledge assessment, and (c) group assignment to test competence improvement.

RESULTS:

The CFOACF formed a virtual CoP, commented on an enjoyable opportunity to develop scholar teaching competence, expressed intention in systematically building educational curricula design that includes active learning strategies and effective feedback and showed individual learning and team-competence improvement.

CONCLUSION:

This first iteration of our online faculty development program nurtured the formation of a CoP of ophthalmologists’ educators and enabled to practice a scholar teaching approach, especially applied to SBE.
Expanding Understanding of Thyroid Eye Disease Manifestations to Include Hispanic and Black Patients
Authors: Goldstein Tova , Mostowy Marilyn , Tingley Jennifer , Rand Gabriel , Moon Jee-Young , Barmettler Anne
Published: November 2023

PURPOSE:

Knowledge of thyroid eye disease (TED) is based on predominantly Caucasian populations. To date, no studies in the United States examine the presentation in Black and Hispanic patients. The purpose of this study is to introduce the presentation of TED in two previously undescribed populations.

METHODS:

This is a retrospective, cross-sectional, chart review study of patients with TED at a tertiary center using the Strengthening the Reporting of Observational Studies in Epidemiology checklist. The main outcome measure for severity was the European Group on Graves’ Orbitopathy 2016 Severity Scale.

RESULTS:

Of the 2905 charts reviewed, 99 met the inclusion criteria. The mean age was 51 (standard deviation 16) years with 78% women. Race was 49.4% Black, 39.1% Hispanic, 9.2% Caucasian, and 2.3% Asian. Smoking rates were 25% current smokers and 14% former smokers. Manifestations were proptosis (94% Hispanic and 91% Black), eyelid retraction (85% Hispanic and 79% Black), extraocular muscle (EOM) restriction (79% Hispanic and 63% Black), eyelid edema (41% Hispanic and 30% Black), chemosis (24% Hispanic and 14% Black), and optic neuropathy (18% Hispanic and 9% Black). Overall, disease severity was 22% mild, 65% moderate to severe, and 13% sight-threatening. Older patients had increased rates of optic neuropathy (P = 0.04). Younger patients had increased rates of proptosis (P = 0.02). Socioeconomic status was not associated with disease severity (P = 0.67).

CONCLUSION:

Hispanic and Black patients with TED presented with higher than previously established rates of proptosis, EOM restriction, and optic neuropathy. Including research of different races broadens understanding of presentation and management, improving patient outcomes.
Ocular Manifestations of Antiphospholipid Syndrome in Jordan
Authors: Al-Zubi Khalid , Sarayrah Fawaz
Published: November 2023

PURPOSE:

The purpose of the study was to evaluate the prevalence of various ocular manifestations in diagnosed cases of antiphospholipid syndrome (APS) in Jordan. It will also find the association of these manifestations with primary and secondary APS.

METHODS:

It was a retrospective cross-sectional study to analyze the ocular manifestations of APS in Jordan. Data of 90 cases were obtained from public hospitals from January 2018 to January 2021. There should have been at least two positive tests with a minimum of 12-week gap between them. The electronic data regarding Schirmer tests, examination of visual acuity (Snellen acuity), neuro-ophthalmic manifestations, dilated fundus examination for posterior eye segment manifestations, and slit-lamp examination for anterior eye segment were also recorded and analyzed. Using SPSS version 25, the frequency and percentages of the categorical data were computed. Pearson’s Chi-square test was conducted to find the associations.

RESULTS:

Among 90 APS cases, 52 (58%) patients had primary APS and 38 (42%) had secondary APS. At the same time, systemic lupus erythematosus was diagnosed in 31 (34%) patients. Keratoconjunctivitis sicca (dry eyes), decreased vision, and retinal vasculitis were the most common manifestations observed.

CONCLUSION:

The high prevalence of ocular manifestations warrants ophthalmologists to look for APS, as ocular manifestations could be the initial symptoms and/or signs of APS.