bluuebunny/crossref_metadata_2025 huggingface dataset:
Profile and telehealth usability of patients attending a telepsychiatry unit in south India during pandemic: a prospective observational study
Authors: Veeraraghavan Vishnupriya , Srinivasan Krishnan
Published: December 2024

Telepsychiatry, which refers to the delivery of mentalhealth services throughvideo-based conferencing, has immense potential to resolve the mental health disparities. Era of telepsychiatry came into full force during the COVID -19 pandemic in the year 2020 in India. The literature on profile of patients attending a telepsychiatry unit is limited as the official guidelines for Telemedicine was released by the government of India in March 2020. This article provides a state-of-art analysis on the profile, telehealth usability, diagnosis, drug treatments of patients attending a telepsychiatry unit in a Union Territory in south India. 1. To profile the telepsychiatry usability by using standard questionnaire. 2. To compare the telepsychiatry usage between 2020 and 2021 (during lockdown 1 & lockdown 2).  A retrospective analysis of the profile of patients attending a telepsychiatry unit in south India during the consecutive years of 2020 and 2021 was made. Demographic data regarding the age, sex, marital status, occupation, location, number of online consultations made were collected. Diagnosis was made in accordance with the International Classification of diseases tenth edition. Various groups of drugs used like antidepressants, antipsychotics, mood stabilisers, benzodiazepines. Comparison of data between the two years was made. In the year 2020, 147 teleconsultations were made and in the year 2021 46 consultations were done. Among the study participants, 62% were female. In the year 2020, psychosis was found to be the reported more(34%) and in 2021, adjustment disorder was higher (35%). Among the medications, antidepressants (35%) were the commonly prescribed group followed by antipsychotics(13%). Telepsychiatry is a budding  phenomenon in India and this study is the first of its kind to throw light on the profile, drug treatment of patients attending a telepsychiatry set up.
Child growth and development: representations, potentialities and weaknesses in the voice of community health agents
Authors: Silva Mateus Celio da , Flores Maria Isabel Quadros da Silveira , Benedett Franceliane Jobim , Silveira Andressa da , Soccol Keity Laís Siepmann , Range Rosiane Filipin
Published: December 2024

The activities developed by Community Health Agents are strategic for child growth and development due to the uniqueness and proximity with which these actors perform their interventions in the community. Such actions favor children's health, resulting in a reduction in child mortality, improvement in growth deficit and malnutrition, and an increase in vaccination coverage and breastfeeding. The objective of the study was to know the perception of community health agents about child growth and development. This is an exploratory descriptive, qualitative study, carried out with 30 Community Health Agents who worked in Primary Care and Family Health Strategy Teams in a municipality in the central region of Rio Grande do Sul, Brazil. Data were collected from April to July 2021, through an online questionnaire and analyzed according to Discursive Textual Analysis. Data analysis allowed the construction of four categories, namely: Growth as a process of physical evolution of children; Child development as a broad process of evolution; Elements that facilitate the work of Community Health Agents; and Elements that hinder the work of Community Health Agents. For the study participants, children growth is associated with the physical evolution of children, while child development is understood as a broader process that is influenced by the environment and the external conditions in which children live. The Community Health Agents have a strategic and unique professional role in the monitoring of these processes, as they are capable of identifying diseases that need specific attention and providing care in a timely manner.
El clamor de una revuelta en las lenguas: activismos traductológicos y la emergencia del género no binario en lengua italiana
Authors: Esposito Giorgia
Published: December 2024

El presente artículo analiza la emergencia de formas lingüísticas de género no binario en lengua italiana vinculándola con la traducción y recontextualización de prácticas discursivas que proceden, en su mayoría, de los feminismos contemporáneos latinoamericanos. Basándonos en los supuestos de la Traductología Feminista Transnacional (Castro & Ergun, 2017; Castro & Spoturno, 2020; Castro, Ergun, Flotow, & Spoturno, 2020), defendemos que la reciente circulación en Italia de instancias relativas a la desarticulación del orden sexogenérico androcéntrico y binario, así como de las prácticas lingüísticas que acompañan esas reivindicaciones, está profundamente anclada en la praxis traductora. Presentamos un breve estado de la cuestión y el marco teórico-metodológico de referencia para luego abordar el devenir de las formas del lenguaje inclusivo de género en italiano, mostrando las variantes no binarias que se emplean en entornos activistas transfeministas. Sucesivamente, nos detenemos en algunas intervenciones discursivas públicas que han propiciado la visibilización del género no binario para el público general. Finalmente, nos centramos en el papel crucial cumplido por la traducción editorial. En particular, sostenemos que los paratextos que acompañan dichas traducciones son empleados para contextualizar el reto traductor (acaso un ‘todes’ en el original) y justificar la decisión tomada; por tanto, son un espacio estratégico en los activismos traductológicos ya que permiten poner el tema sobre la mesa y generar conciencia acerca de la diversidad sexogenérica.
Sobre (não) generificação e binarização de gênero no Brasil: documentos históricos e modos de vida ancestrais
Authors: Pedrotti Alline de Souza , Severo Cristine Gorski
Published: December 2024

As ideologias linguísticas inscrevem representações variadas sobre as práticas linguísticas, como as funções, as normas, os valores, as expectativas, as preferências e os papéis e sujeitos envolvidos nessas práticas. Este artigo versa sobre a ideologia binarizada de gênero, bem como os interesses e valores manifestados em seu percurso histórico, que se materializam através de recursos semióticos e linguísticos. Objetiva-se explorar as ideologias linguísticas relacionadas à (não) generificação e binarização de gênero, considerando suas manifestações em documentos históricos e modos de vida ancestrais. Para tanto, os seguintes procedimentos metodológicos e analíticos são adotados: levantamento e análise de registros documentais dos séculos XVI, XVIII, XIX e XXI, a fim de identificar práticas coloniais e neocoloniais racistas e de repressão às expressões de gênero não binárias; breve descrição da organização social e a cosmogonia yorubás, para destacar a presença de uma linguagem não sexista e não binarizada, que exerce influência no contexto dos terreiros de candomblé brasileiros e; investigação da figura de Exu como orixá da comunicação que apresenta uma epistemologia não binária e que contribui para a formação de categorias identitárias. Assim, são acionados documentos e análise/observação de contexto religioso. Por meio da abordagem comparada dos documentos, discursos e contextos mencionados, foi possível identificar a construção do gênero como marcador social; a construção binária e hierarquizante de gênero social (masculino vs. feminino) e a invisibilização de formas não binárias em gênero e não generificadas no Brasil.
Ni siquiera el silencio del hablante es neutral: lenguaje y género en la disputa política del binarismo
Authors: Batista João Paulo Santos , Araújo Gracineia dos Santos , Santos Jocenilson Ribeiro dos
Published: December 2024

Los debates sociales sobre el uso del lenguaje neutral son controversiales y polarizados, pero para el campo de los estudios lingüísticos es esencial que se investiguen y produzcan evidencias sobre el uso y comprensión social de este fenómeno. La lingüista Raquel Freitag lanzó el libro Não existe linguagem neutra! Gênero na sociedade e na gramática do português brasileiro (2024), publicado por Contexto. En una investigación competente la pesquisadora trata cuestiones como ¿qué es este lenguaje neutro y por qué ha suscitado tanto interés y debate en la sociedad brasileña?. El objetivo de esta resenha es presentar al lector una síntesis de las reflexiones, posiciones y respuestas que la autora aporta a tantas cuestiones que rodean la polarización y los acalorados debates sobre el género en la gramática y sus usos en el portugués brasileño. Pretendemos también promover cuestiones planteadas por el libro sobre la relación entre lengua, género, gramática y política, sin restringirse exclusivamente a las páginas del libro, teniendo promovido posibles reflexiones y diálogos entre la sociolingüística y la línea de los estudios discursivos.
Ordens indexicais mobilizadas em projetos de lei estaduais e distrital sobre linguagem não-binária no Brasil
Authors: Frank Hélvio , Coelho Marcus Vinícius Silva
Published: December 2024

Tendo em vista que discursos ocupam papel central em nossas práticas sociais, assumindo modos de fazer coisas no mundo (Derrida, 1988; Baumann & Briggs, 1990), este estudo, inspirado nos trabalhos de Barbosa Filho (2022), de Brevilheri, Lanza, e Sartorelli (2022) e de Vellasco (2024), investiga e problematiza ordens indexicais mobilizadas em Projetos de Lei em nível estadual e distrital no Brasil sobre linguagem não-binária. Para isso, foi implementada metodologicamente uma pesquisa qualitativa, com vistas à análise de ordens de indexicalidade (Blommaert, 2007), a partir de um corpus que abrigou o total de 53 propostas parlamentares em apreciação em casas legislativas do Brasil durante o período de 2019 a 2023 e que foi discutido com base em estudos críticos e transdisciplinares (Borba, 2019; Miskolci, 2021). Os resultados indicam que os textos de lei mobilizam ordens indexicais de proibição de linguagem não-binária pautadas em um conservadorismo linguístico ao proporem exclusividade no ensino gramatical escolar de norma culta da língua portuguesa. Nessa direção, alguns Projetos de Lei se assentam em justificativas de gênero, reverberando discursos atrelados à dinâmica de uma sociedade historicamente marcada por princípios moderno-coloniais e cristãos.
Climate Change: Time for Hospitals to Respond
Authors: Pate Mary Frances D.
Published: December 2024

Alarm bells are sounding internationally as climate change impacts planet Earth and its inhabitants. Health care organizations must consider the role they play in working toward environmental sustainability in terms of mitigation, resilience, leadership, and equity. Institutions need to address the effects of climate change on the physical health and mental well-being of patients and their families as well as employees. Awareness of the complexities of sustainability initiatives and disaster management related to inclement weather and weather-related events is critical for health care organizations to avoid precipitating the illnesses and diseases they endeavor to prevent and heal.
Developing a Green Nursing Practice in a Profession That Contributes to Climate Change: One Nurse’s Journey
Authors: Shelby Louisa A.
Published: December 2024

The health care industry accounts for 5% of global greenhouse gas emissions, with hospitals being the largest contributor. Critical care units create 3 times the greenhouse emissions of other hospital patient care units. Health care contributions to environmental harm include medical waste disposal, toxicant exposure, and pollutants. Integrating green practices into hospitals, especially in intensive care units, can seem overwhelming, with barriers including time constraints, lack of leadership and organizational support, and ignorance of green practices. Nursing is a socially responsible discipline committed to improving the health of individuals and communities; values of environmental stewardship and the desire to minimize poor health outcomes caused by climate change do not always align with hospital policies or clinician practices. This article addresses how nurses can confront the complex environmental problems in the workplace, apply sustainability principles to develop a green nursing practice, and collectively influence the future of national and global health.
A randomized trial on transphyseal vs. physeal-sparing reconstruction in skeletally immature patients: functional outcomes and safety considerations
Authors: Stefanov Vladimir , Tzachev Nedelcho , Simeonov Marian , Milanova Hristina , Obretenov Vasil , Panayotov Kiril , Angelova Anna , Papathanasiou Jannis
Published: December 2024

Reconstruction of the Anterior Cruciate Ligament (ACL) in Skeletally Immature Patients (SIP) poses challenges due to anatomical and developmental factors. This randomized controlled trial evaluated the Functional Recovery (FR) of pediatric patients undergoing ACL Reconstruction (ACLR), comparing Transphyseal Reconstruction (TPR) and physeal-sparing reconstruction (PSR). Forty-three young athletes (mean age 14.1 ± 2.3 years), including 29 boys and 14 girls, were randomized to TPR (n=23) or PSR (n=20). FR was assessed by using the Pediatric International Knee Documentation Committee (Pedi-IKDC) questionnaire at baseline, 8 months, and 12 months post-surgery. At the 12-month follow-up, the TPR group demonstrated a significantly greater improvement in Pedi-IKDC scores, with a 66.95% increase compared to 56.73% in the PSR group, reflecting notable differences in knee function between the groups at both 8 and 12 months (p < 0.001). Additionally, 80% of participants in the TPR group returned to sports, with 56% resuming limited activities, while the PSR group exhibited a slower recovery trajectory. These preliminary findings indicate that TPR provides superior FR and a faster return to sports compared to PSR, underscoring the importance of tailored rehabilitation protocols and long-term follow-up to optimize outcomes in SIP.
Diagnostic accuracy of cancer ratio and other new parameters in differentiating malignant from benign pleural effusions
Authors: Narahari Narendra Kumar , Ravula Nandini , Kodati Rakesh , Uppin Shantveer G , KSS Saibaba , Kakarla Bhaskar , Gongati Paramjyothi
Published: December 2024

Differentiation of malignant from benign pleural effusions is challenging in clinical practice due to limitations in the cytologic analysis. The combination of pleural fluid biomarkers has previously been used to predict malignant pleural effusion (MPE). We have conducted a prospective observational study to assess the diagnostic potential of cancer ratio [(CR) serum lactate dehydrogenase (sLDH): pleural fluid adenosine deaminase (pADA)], CR plus (CR: pleural lymphocyte count), sLDH: pleural lymphocyte count, and age: pADA in differentiating malignant effusions from benign ones. Prospective data from patients evaluated for exudative pleural effusions in the pulmonary medicine department at our institute over 12 months were collected. All subjects underwent thoracentesis, and if the results were inconclusive, they underwent invasive diagnostic testing for confirmation. They were divided into MPE and non-MPE groups for analysis. Pleural fluid biomarker ratios were calculated and compared between both groups, and receiver operating characteristic curves were generated. We included 120 subjects: 59 were diagnosed with MPE, and 61 had benign effusion (46 tubercular and 15 parapneumonic). The mean (standard deviation) age of the study population [64 (53.3%) males] was 52.4 (14.5) years. CR, CR plus, and age: pADA were significantly higher in the MPE group compared to the benign group. The sLDH: lymphocyte count was similar between both groups. Age: pADA ratio and CR performed best, with areas under the curve of 0.99 [95% confidence interval (CI), 0.97-1.0] and 0.97 (95% CI, 0.94-1.0) respectively. A higher age: pADA level was associated with a malignant etiology of effusion (adjusted odds ratio 12.27, 95% CI 2.37-63.54) on multivariate analysis. At a cut-off of 2, age: pADA ratio provided 96.6% sensitivity, 93.4% specificity, with a positive likelihood ratio of 14.7. Age: pADA and CR are promising diagnostic indices for differentiating MPE and non-MPE with high sensitivity and specificity. The diagnostic accuracy of CR plus and sLDH: lymphocyte ratio is inferior to that of CR and age: pADA.
Inclusive education pandemic: Learning barriers for children with disabilities in South Africa
Authors: Chirowamhangu Raymond
Published: December 2024

Background: Children with disabilities encounter obstacles attaining basic education. Significantly, previous studies on South Africa have shown that up to 70% of the children with disabilities are out of school. Despite efforts to support inclusive education through White Paper 6 policy, the deployment of resources and transformation of the education sector has been a slower process.Objectives: The main objective of the article is to explore the challenges of basic education faced by children with disabilities in South Africa.Method: The study was conducted during the COVID-19 pandemic using a qualitative research methodology. The data were collected using key informant interviews through online media platforms. The data analysis was conducted using computer-aided software in the form of ATLAS.ti 8.Results: This study established several challenges faced by special needs schools, especially in the rural areas. These include a limited number of special needs schools, scholar transport, enrolment, lack of psychosocial and expert support, sanitation and infrastructure and the impact of COVID-19 pandemic on children with disabilities.Conclusion: The article concludes that even though White Paper 6 focusses on Special Needs Education in South Africa, there remains poor policy implementation to ensure inclusivity for learners with disabilities.Contribution: The research provides an understanding of the challenges faced by children with disabilities to assist policy makers with recommendations and areas of concern to improve policy implementation of the White Paper 6 in South Africa.
Biblical discourses and compulsory monogamy among the Vatsonga people in South Africa
Authors: Shingange Themba
Published: December 2024

The 19th-century missionary-biblical discourses that marked the missionary-colonial project promulgated under the guise of Christianisation and civilisation of the heathens in Africa rendered the recipients as slaves. In Africa, the perpetual legacy of this project still manifests among others by the continued demonisation of African cultural practices. Among the vast South African conventional practices that were frowned upon by the missionaries and continue to be demonised through biblical rhetoric is polygamy. This article investigated how the 19th-century missionaries’ biblical discourses promulgated compulsory monogamy among the Vatsonga people in South Africa. It further looked at how the narrative continues to be spread by Christians using biblical discourses in contemporary South Africa. The article argued that this narrative is tantamount to what Wa Thiong’o calls a ‘cultural bomb’, which uses biblical discourses to eradicate African cultural practices. It further contended that the hegemonic superiority complex of Western epistemologies and cultural practices needs to be problematised. Thus, the article used the desktop research methodology to collect and analyse data. The findings revealed that 19th-century biblical discourses are still used as a colonial tool to disregard the Vatsonga cultural marital practices.Contribution: This article aims to contribute to the body of knowledge and discourses that address the legacies of colonialism around the coming of missionaries in Africa. Therefore, this task was sought to be completed by the decolonial call to change the narrative.
Navigating the complex landscape of African thought
Authors: Shokane Allucia L. , Masoga Mogomme A.
Published: December 2024

No abstract available.
Humanitarian strategies for tackling public health crises in conflict zones in Africa
Authors: Nasreldin Mehad , Shaweno Tamrat , Dereje Nebiyu , Ndembi Nicaise
Published: December 2024

No abstract available
Educators’ perspective on parental involvement in homework at a rural primary school in Palala
Authors: Seleka Hlongolane A. , Masoabi Charles S.
Published: December 2024

Background: Educators have a very important job of moulding learners’ lives. However, they cannot do it alone, they need assistance from parents. Every child is different and learns differently and most of the information a child receives comes from their parents.Aim: The article seeks to find ways to help educators to work closely with parents to support their children in their academics for better achievement. This study forms part of a master’s project; however, this article focuses on educators’ perceptions of parental involvement towards learners’ academic work at a rural primary school.Setting: The research was conducted at a rural primary school in the Palala circuit located in Limpopo.Methods: This study was approached by means of a phenomenological research design. Phenomenology seeks to comprehend the phenomena from those who live in the setting under study. The article used questionnaires to collect the data, and convenient sampling was employed. For this research we interviewed Grade 6 and 7 educators.Results: It was found that most educators are concerned with the lack of parental involvement in learners’ academic work.Conclusion: The article recommends that illiterate parents be brought closer to the teachers and be assisted on how they could be actively involved in their children’s schoolwork. The school staff, including educators, need to be workshopped on how to address parents equally and with respect, to feel welcome.Contribution: This article therefore seeks to promote awareness and devise ways to enhance rural parental involvement in children’s schoolwork and school life.
A Case Series: Refractive Outcome of Implantable Phakic Copolymer Lens with Central Hole among Adults with High Myopia and Compound Myopic Astigmatism
Authors: Ganguly Santanu , Chakraborty S.
Published: December 2024

ABSTRACT

Purpose:

To assess the effectiveness and safety profile of implantable phakic copolymer lenses (IPCLs) with central and peripheral optic holes in adults with moderate-to-high myopia and myopia with astigmatism.

Materials and Methods:

Twelve eyes of seven adults who underwent IPCL implantation were followed up for 6 months after surgery, and data were analyzed. Preoperative parameters, such as subjective refraction, anterior chamber depth, and white-to-white diameter, were measured. A custom-made IPCL was then implanted in the posterior chamber through verion-guided temporal incision to correct moderate-to-high myopia/myopia with astigmatism.

Results:

Clinical outcome data were analyzed. The mean age was 24.08 years (standard deviation [SD] 1.72 years), and 75% of the patients were female. The mean preoperative best-corrected visual acuity was 0.3 logMAR unit (SD: 0.154 range 0.176–0.447, median 0.176). The post-IPCL implantation mean uncorrected visual acuity was 0.329 logMAR units (SD: 0.456 range 0.176–1.77, median 0.176); complications were seen in 2 (16.6%) cases. Spectacle independence was achieved in 91.3% of cases.

Conclusion:

Implantation of the IPCL with central and peripheral holes in the intraocular posterior chamber resulted in a clinically significant improvement in unaided visual acuity and quality of vision among the most in the study group, which makes it a suitable surgery for such cases though serious complications like retinal detachment also should be kept in mind.
Innovative Keratoconus Surgical Algorithm: A Refractive Approach to Restoring Vision
Authors: Gulani Arun C. , Pandya Radha P. , Gulani Aaishwariya A. , Gulani Yash A.
Published: December 2024

ABSTRACT

Keratoconus is a progressive disease characterized by corneal protrusion and significant visual impairment. Influenced by genetic and environmental factors, the pathophysiology involves the abnormal apoptosis and overwork of keratocytes, resulting in corneal stromal thinning. Historically, keratoconus has had a dreary prognosis with traditional treatment options ranging from contact lenses to corneal cross-linking to corneal transplantation with patients rarely regaining adequate visual acuity. This manuscript outlines a paradigm shift with a novel keratoconus treatment algorithm that advocates for corneal transplants as a last resort, aiming for optimal visual outcomes regardless of the disease severity. This treatment algorithm introduces concepts such as the “think outside the cone” approach and the “LEGO Concept,” which deconstructs keratoconus into a series of individual abnormalities. Cases are discussed demonstrating the successful application of specific surgical techniques, including LaZrPlastique®, INTACS®, and corneal cross-linking that have allowed patients to regain vision. By shifting the focus of keratoconus treatment from disease management to achieving the best vision potential, this innovative algorithm offers a comprehensive and patient-centered strategy with the goal of achieving emmetropia and reducing the need for invasive interventions.
Primary pleural serous carcinoma of mullerian origin—Report of a rare case
Authors: Modi Shilpi , Goel Deepa
Published: December 2024

Mullerian tumor arising from pleura is a rare occurrence and under-reported in medical literature. We hereby present such a case in a 47 years old female who presented with pleural effusion. Pleural biopsy revealed a papillary tumor with mild-to-moderate nuclear atypia. Immunohistochemistry profile with positivity for WT1, Pax8, ER, and PR together with negative mesothelial markers and ruling out primary in female genitalia led us to a diagnosis of primary pleural serous carcinoma of mullerian origin. The patient received paclitaxel and carboplatin chemotherapy and is disease-free till now after 2 years of follow-up.
An incidental diagnosis of an unusually located echinococcus alveolaris
Authors: Çoban Ganime , Abdallah Anas , Gücin Zuhal , Alkan Alpay
Published: December 2024

Hydatid cyst disease is a zoonotic infection caused by the genus Echinococcus. Hydatid cysts are usually located in the liver or lungs whereas the brain is an unusual location. A 45-year-old male patient was diagnosed with an intracranial mass suggesting a metastasis in the frontal region shown in the cranial computed tomography (CT) scan following a cranial trauma. The histological evaluation revealed an acellular laminated lesion surrounded with reactive changes, compatible with a cuticle. These findings were evaluated in favour of a hydatid cyst caused by Echinococcus multilocularis. Alveolar echinococcosis is a zoonotic disease caused by the genus Echinococcus multilocularis. Hydatid cyst is a common public health issue in the countries where livestock farming is common. Primary or metastatic tumours and abscesses should be considered in the differential diagnosis of hydatid cysts regardless of their location.
Primary subglottic inverted papilloma: An exceptional localization
Authors: Saraydaroglu Özlem , İnan Hakkı Caner , Yirmibes Selin
Published: December 2024

Inverted papillomas are predominantly seen in the sinonasal region. Extra-sinonasal lesions are considered to be heterotopic. We present a case of primary laryngeal inverted papilloma with an unusual subglottic localization. An 84-year-old female patient presented with dyspnea on exertion. In the endoscopic examination, a subglottic vegetative lesion was observed. Radiological examination revealed a well-circumscribed, solid mass involving the anterior commissure and extending to the subglottic region. Total excision of the mass was performed with the CO2 laser surgery. Histopathologic examination revealed endophytic growth of round-oval nests of transitional hyperplastic epithelium. The patient was diagnosed with primary laryngeal inverted papilloma. Primary laryngeal inverted papillomas are extremely rare. This is the fifth case and the only the second with a subglottic localization. Due to its rarity, it is difficult to predict the underlying cause and clinical course. However, cases with an atypical localization must be followed up like those in the sinonasal region.
Liposarcoma of tongue: A case report
Authors: Kaur Amarjot , Singh Aminder , Narang Vikram , Kakkar Chandan
Published: December 2024

Liposarcoma (LS) is one of the most common malignant tumors. However, oral LS is an extremely rare lesion that is often clinically misdiagnosed as a benign lesion because of its asymptomatic and indolent clinical course. In oral cavity, the tongue is the most frequent site for its occurrence.
Clinico-Radiological Outcomes of Conservative versus Operative Treatment of Physeal Injuries
Authors: Anwer Adnan , Siddiqui Yasir Salam , Abbas Mazhar , Jain Shrey , Aziz Mohd Hadi , Adnan Mohd. , Harun Faisal , Adil Mohd
Published: December 2024

Introduction:

Physeal injuries are common in our day-to-day practice, with the utmost importance on early recognition so as to avoid complications such as premature physeal closure or limb length discrepancy. Physeal injuries are often missed, leading to poor outcomes. This study aims to evaluate the operative and nonoperative methods of treating physeal injuries.

Materials and Methods:

All pediatric patients who presented to the casualty ward with physeal injuries were enrolled, and regional distribution was done. Salter–Harris classification was used to classify the type of physeal injuries. Additional investigations such as computed tomography or magnetic resonance imaging were done where needed.

Results:

A total of 117 patients were included in the study, out of which 73 were male and 44 were females. Type II Salter–Harris injuries were found to be the most common. Left-sided injuries were common as compared to right-side ones, out of which road traffic accidents was the most common mechanism of injury, followed by slips and falls. About 94.1% were closed injuries, while 5.98% were compounding injuries. Out of 117 patients, 73 were treated conservatively, while 44 were managed operatively.

Conclusion:

This study illustrated an overall similar success between the surgical and the conservative treatments for pediatric physeal injuries. Due to the higher complication rate reported in the conservative management group, the conservative treatment cannot be considered safer than the surgical treatment. With early recognition and effective treatment of physeal injuries, good results are expected even in intra-articular physeal injuries. Long-term follow-up is important to identify the development of physeal growth disturbances.
Painless Juvenile Rheumatoid Arthritis in Two Siblings
Authors: Kumar Aditya , Kushwaha Sudhir Shyam , Varshney Shalabh
Published: December 2024

Juvenile rheumatoid arthritis (JRA), also known as juvenile idiopathic arthritis or Still’s disease, is a chronic inflammatory autoimmune disorder primarily affecting children under 16 years of age. Rarely, do cases present without pain contrary to typical symptoms of pain, swelling, and stiffness. This report details two siblings with painless JRA, highlighting the importance of early recognition of atypical presentations and the potential genetic or environmental factors contributing to familial occurrence.
Prevalence and associated risk factors of insomnia among adults attending primary health care settings in the Kingdom of Bahrain
Authors: Juma Noor A. , Alshehabi Diana S. , Ali Fatema S. , Baqer Tahera H. , Alherz Zahra A. , Budhaish Naeema , Alsaffar Basma
Published: December 2024

ABSTRACT

Background:

Insomnia patients often visit their primary care physician, but their sleep disorders go undiagnosed and many sufferers do not receive adequate care. This study aims to detect insomnia among adults in Bahrain and its associated risk factors in order to provide a better quality of sleep for these individuals.

Methods:

A cross-sectional study was conducted in a primary health care center with 400 adult participants in Bahrain. The study participants completed a self-administered questionnaire containing two parts: a structured part for sociodemographic and lifestyle factors, and the AIS.

Results:

Among the participants, 59% had insomnia. The highest prevalence was among students (80%) (P < 0.001). Regarding risk factors, insomnia was more prevalent in females (64.5%) (P = 0.017), unmarried (66.9%) (P = 0.037), and those who practiced physical activity less than 30 minutes per day (53.9%) (P = 0.032).

Conclusion:

Insomnia is a prevalent problem among primary healthcare attendees that needs special attention. It is mostly associated, according to this study, with young age < 30 years, female sex, being a student, and physical inactivity.
Results from a UK consensus about the optimal prescribing of medium strength triple therapy in uncontrolled adult asthma patients in the NHS
Authors: Russell Richard E. K. , Attar-Zadeh Darush , Harper Natalie , Mosgrove Fiona , Rush Laura , Singh Dave
Published: December 2024

ABSTRACT

Context:

An inhaled corticosteroid (ICS) in combination with a long-acting β2-agonist (LABA) is a common treatment approach for asthma patients not controlled on ICS alone, but a significant proportion of patients remain uncontrolled on this combination and treatment adherence can also be a challenge. One of the options for adults whose asthma is uncontrolled in an ICS/LABA is the addition of a long-acting muscarinic receptor antagonist (LAMA), an approach commonly referred to as ‘triple therapy’. The use of medium-strength ICS/LABA/LAMA is established in treating chronic obstructive pulmonary disease but is less well-established in asthma. Lack of clarity exists regarding who should prescribe ICS/LABA/LAMA and in which patients, and this is compounded by a lack of consistency among guidelines.

Aims:

To define the optimal prescribing of medium-strength ICS/LABA/LAMA triple therapy in adult asthma patients uncontrolled on ICS/LABA.

Methods and Material:

Using a modified Delphi method, a panel of experts developed 39 Likert scale statements across six key domains. These statements were used to develop an online survey that was distributed to healthcare providers (HCPs) working with adult asthma throughout the UK. The threshold for consensus was set at 75%.

Results:

In total, 314 responses were received from primary and secondary care stakeholders involved in the management of asthma. On analysis, 22/39 statements reached a very strong agreement (≥90%) and 16/39 attained strong agreement (≥75% and < 90). From these results, the panellists developed a set of twelve recommendations to help define how an optimal approach for prescribing triple therapy in patients who are uncontrolled on an ICS/LABA can be achieved.

Conclusions:

The strength of agreement shows that HCPs support the use of medium-strength ICS/LABA/LAMA triple therapy in appropriate asthma patients, and that clarity is needed regarding how best this can be achieved. The proposed set of recommendations provides such guidance to support the prescribing of triple therapy in primary care.
How the development of chronic morbidity and multimorbidity depends on natural age of menopause: Results from nationally representative cross-sectional Indian study
Authors: Halder Pritam , Kansal Shubham , Chadhar Kartik , Seth Aswani , Das Semanti , Pal Saumyarup , Das Anamika , Vijayakumar Dheenadhayalan
Published: December 2024

ABSTRACT

Background:

Multimorbidity development is linked with the age at menopause. Fewer studies are available to support the findings. This study was conducted to find, how multimorbidity is associated with the natural age of menopause.

Methodology:

LASI-1, a longitudinal study, collected detailed information on the psychological, social, economic, and health aspects of aging in India. Wave-1 data collection was done in all 35 states and union territories in India. Baseline data was collected from year 2017–2019. As the current study was a secondary data analysis to find the association between multimorbidity and age of menopause, only eligible women’s relevant data was analyzed.

Results:

A total of 25,256 women were analyzed, 67.8% of participants had at least one comorbidity. The mean age was 58.5 ± 10.17 years. 57.04% and 13.45% women had optimal or suboptimal menopause, while 7.4%, 17.5%, and 4.4% had premature, early, and delayed menopause. A significant association was found for the presence of multimorbidity and premature (AOR 1.19 (1.07–1.32)), early menopause (AOR 1.18 (1.10–1.27)), and optimal age of menopause (AOR 0.83 (0.78–0.88)).

Conclusion:

There is a high burden of multimorbidity and it is associated with the natural age of menopause. This study would be helpful for effective policymaking and a better primary healthcare approach to deal with the condition.
Analysis and trends of caesarean sections using Robson’s classification over 7-year period at a rural teaching hospital
Authors: Nadella Mahathi , Maila Shyam S. , Nagelli Indira , Basany Kalpana
Published: December 2024

ABSTRACT

Background:

A ten-group classification system of caesarean section was proposed by Michael Robson in 2001. It is helpful in comparing the rates of caesarean section between hospitals. The objective of this study was to determine the caesarean section rates to analyse trends of caesarean section and classify according to Robson’s categories.

Methods:

This cross-sectional study was conducted from 2016 to 2022. A total of 3176 women who underwent caesarean section were grouped under Robson’s ten-group classification system.

Results:

The most common group was Group 5 (All multiparous women with at least one previous uterine scar, with single cephalic pregnancy, ≥37 weeks gestation) followed by Group 2 (Nulliparous women, with single cephalic pregnancy, >37 weeks gestation who either had labour induced or were delivered by caesarean section before labour). Results were obtained for the specified period (from 2016 to 2022), and Group 5 contributes more to the total CS rates (45% in 2016, 46% in 2017, 46% in 2018, 57% in 2019, 49% in 2020, 52% in 2021, 54% in 2022), followed by Group 2 (20% in 2016, 17% in 2017, 18% in 2018, 19% in 2019, 26% in 2020, 24% in 2021, 24% in 2022).

Conclusion:

Pregnant women with prior uterine scars contribute more to caesarean section rates according to Robson’s categories. Hence, strategies must be implemented to lower the primary caesarean section rates.
Evaluation of medicine use behaviors of adult patients in a rural area: A cross-sectional study from Turkey
Authors: Alan Hakan , Cubukcu Mahcube , Guzel Eda C. , Yildiz Latife M.
Published: December 2024

ABSTRACT

Background/Purpose:

This study aimed to determine the medicine usage behaviors of patients (>65 years) registered to the family health care center (FHCC) in a rural area.

Methods:

This cross-sectional and descriptive study was performed on 224 geriatric patients admitted to the FHCC in Terme town of Samsun between January 2018 and March 2018. The questionnaire consisting of 29 questions about sociodemographic characteristics, knowledge of drugs, and usage habits was applied to the participants by using the face-to-face interview technique. SPSS (version 23.0. SPSS Inc. Chicago. IL. USA) program was used in the analysis. P values of less than 0.05 were considered significant.

Results:

The mean age was 73.01± 0.3.14 years, 53.19% were male, 87.4% were married, and 52.9% had chronic diseases. Of all participants, 56% stated that they visited physicians when they got ill; 22% used drugs at home without consulting a physician. The presence of chronic disease appears to be associated with keeping drugs at home (P = 0.023). The most common medicines consumed without a prescription were painkillers; 67.6%. 20.9% of the participants stated recommending medication to their surroundings related to their level of education (P = 0.011). Furthermore, 24.9% stated that they had stopped their medications before the recommended time. Moreover, 82.9% of the group read the instructions before use. Those signs were more significant in males and in those >75 years old (P = 0.001 and P = 0.024, respectively).

Conclusion:

Rational use of medicine was associated with gender, chronic disease, and educational level in geriatric patients. The importance of rational drug use in society should be explained by individual characteristics.
Navigating herpes simplex encephalitis: Family medicine perspectives from Jharkhand, India
Authors: Patel Amit Kumar , Sharma Ashok Kumar , Seema Kumari , Kumar Abhay , Boipai Manju , Guria Rishi Tuhin , Sahu Upendra Prasad , Kumar Manoj
Published: December 2024

ABSTRACT

Background:

Herpes simplex encephalitis (HSE), caused by herpes simplex virus (HSV) is the most common cause of sporadic encephalitis that often presents as an emergency case of acute or sub-acute nature associated with poor prognosis. Early suspicion and prompt diagnostic testing with adequate antiviral therapy can only reduce morbidity and mortality associated with the disease. This study aims to evaluate the role of serological and molecular diagnosis of encephalitis caused by HSV 1 and 2 for timely detection of the disease.

Methods:

This cross-sectional study was conducted at the Department of Microbiology, Rajendra Institute of Medical Science, Ranchi, from April 2021 to September 2022. Cerebrospinal fluid (CSF) samples were collected and processed for the detection of HSV DNA by polymerase chain reaction (PCR) as well as serum samples were collected from those patients and were processed for the detection of IgM by ELISA.

Results:

A total of 188 CSF samples were collected, out of which 4 HSV-1 and 1 HSV-2 samples were found to be positive by conventional PCR. 36 samples were positive for HSV-1 and 2 IgM ELISA. 26.06% of cases belonged to patients between 0 and 10 years of age followed by 17.06% in 51-60 years age groups.

Conclusion:

PCR is the optimal diagnostic test, but the sample must be collected in the early stages of the disease. Diagnosis by PCR assay of CSF samples targeting HSV DNA is the best confirmatory test at hand for early detection and also helps in estimating the incidence of herpes simplex virus encephalitis.
Factors influencing adherence to dietary recommendations for type 2 diabetes mellitus and their impact on disease control: A cross-sectional study
Authors: Patel Harsh K. , Unadkat Sumit V. , Patel Bela A. , Parmar Dipesh V.
Published: December 2024

ABSTRACT

Background and Objectives:

Diabetes is a chronic metabolic disease, with current estimates by the IDF (International Diabetes Federation) suggesting nationwide prevalence rates of 9.2% among Indians aged 20–79 years. An appropriate dietary pattern is widely accepted as a cornerstone of treatment among diabetes patients. However, motivating patients to achieve dietary self-care behaviors is challenging and requires ongoing efforts between patients and multidisciplinary teams. Therefore, the objectives of this study were to assess the level of adherence to the diet, to find out the association between dietary practices and disease profile, and to explore the reasons behind not adhering to the recommended diet.

Methodology:

The present cross-sectional study was conducted among type 2 diabetic patients visiting the NCD clinic in a tertiary care hospital and three CHCs in Jamnagar district. The final sample size was 450. A structured interview schedule containing sociodemographic profiles, details regarding diabetes mellitus, and dietary details was developed. Dietary assessment was done using the UKDDQ.

Result:

In a study of 450 participants, 44.88% were aged 61–70 years. The majority were Hindu (88%), with 69.3% residing in urban areas and 30.7% in rural areas. Using the UKDDQ dietary score, 71.55% had a healthy diet. This score was negatively correlated with BMI, HbA1c, and RBS. Factors such as family type, area of residence, family history of diabetes mellitus, duration of diabetes, mode of treatment, HbA1c, and complications of diabetes were significantly associated with the dietary score.

Conclusion:

The study found that poor dietary scores were linked to worse disease outcomes in type 2 diabetes. Identifying and addressing barriers to dietary adherence is crucial for improving outcomes and modifying recommendations accordingly.
Postpartum depression in Gujarat, India: Associations with social support, breastfeeding attitudes, and self-efficacy
Authors: Surati Bhumika , Yogesh M , Munshi Raza , Vamja Roshni
Published: December 2024

ABSTRACT

Background:

Postpartum depression (PPD) is a significant public health concern with detrimental effects on maternal and child well-being. Social support, breastfeeding attitudes, and self-efficacy have been identified as potential protective or risk factors for PPD. This study aimed to investigate the associations between PPD, social support, breastfeeding attitudes, and self-efficacy among postpartum women in Gujarat, India.

Methods:

A cross-sectional study was conducted among 403 postpartum women in Gujarat, India. Data on sociodemographic characteristics, obstetric factors, PPD (assessed using the Edinburgh Postnatal Depression Scale), social support, breastfeeding attitudes, and self-efficacy were collected through structured interviews. Bivariate and multivariate logistic regression analyses were performed to examine the associations between PPD and the independent variables.

Results:

The prevalence of PPD in the study population was 50.1% (n = 202), with 28.8% (n = 116) experiencing mild depression, 16.6% (n = 67) moderate depression, and 4.7% (n = 19) severe depression. Lower educational level (n = 120, 29.8%; AOR: 1.72, 95% CI: 1.04–2.85), lower socioeconomic status (n = 242, 60%; AOR: 1.84, 95% CI: 1.12–3.02), non-exclusive breastfeeding (n = 167, 41.4%; AOR: 1.68, 95% CI: 1.11–2.54), low social support (n = 101, 25.1%; AOR: 2.51, 95% CI: 1.57–4.02), and a history of depression (n = 93, 23.1%; AOR: 2.94, 95% CI: 1.82–4.75) were significantly associated with higher odds of PPD in the multivariate analysis. In addition, negative breastfeeding attitudes and low self-efficacy levels were associated with increased odds of PPD.

Conclusions:

The findings highlight the significant associations between PPD and various sociodemographic, obstetric, and psychosocial factors among postpartum women in Gujarat, India. Interventions targeting social support, breastfeeding attitudes, and self-efficacy, as well as targeted support for women with identified risk factors, may help mitigate the burden of PPD and promote maternal well-being.
Medical termination of pregnancy (Amendment) Act 2021: From the lenses of LGBTQIA+ community in India
Authors: Shendge Atul , Royal Abhishek , Dange Alpana , Kumar Vaibhav
Published: December 2024

ABSTRACT

The article presents the LGBTQIA + inclusivity analysis of the Medical Termination of Pregnancy (Amendment) Act 2021, which aims to provide safe abortion services across India. The analysis reports the use of cisgender-heteronormative language, instead of gender-neutral terms and pronouns in the legislation. Sexual assault/rape as an eligibility criterion for permitting abortion under this act does not apply to non-binary, trans- and queer individuals due to non-inclusivity in Rape Laws (Indian Penal Code 375 and 376). The analysis highlights the necessity for critical amendments to expand its scope to ensure LGBTQIA+ inclusive abortion services.