bluuebunny/crossref_metadata_2025 huggingface dataset:
Transnasal Endoscopic Surgical Repair of Cerebrospinal Fluid(CSF) Rhinorrhea by Inferior Turbinate Grafts
Authors: Saleem Muhammad , Ur Rehman Naeem , Khan Raina , Alamgir Ashar , Bibi Sarwat , Ahmad Humaira
Published: February 2022

Objective: The study aims to evaluate the outcomes of transnasal endoscopic surgical repair of CSF rhinorrhoea.Materials and Methods: After approval from the institutional ethical committee (DME-396-18) and patient consent, a descriptive study of 27 patients with cerebrospinal fluid rhinorrhea was conducted at Aziz Fatimah Trust Hospital Faisalabad from August 21, 2018, to February 7, 2021. Transnasal endoscopic surgical repair of Cerebrospinal fluid leak was performed by using multilayer technique using a graft from the inferior turbinate. The data collected were analyzed using SPSS 20.Results: The most common site of the CSF leak was the left side of the cribriform plate (n=19,70%). The most common etiology was spontaneous (n=16,59%). At the same time, traumatic CSF leak (n=16,59%). was the second common etiological factor. The surgical procedure used in the study reported a 93%(n=25) success rate. The success rate was 97.5% on revision surgeries.Conclusion: Transnasal endoscopic surgical repair of CSF leak is one of the most effective and safe surgical interventions. Multilayer technique is not only safe but also has lesser complications. Moreover, this minimizes the risk for the development of secondary wounds as compared to other surgical processes.
Assessment of knowledge, preventive behaviours and risk perception related to Covid-19 among medical students of Rawalpindi
Authors: Din Mohi Ud , Mashhadi Syed Fawad , Maroof Saira , Fatima Syeda Gohar , Rehman Habib ur , Sarfraz Sana
Published: February 2022

Objectives: The study was conducted to determine the knowledge, preventive behaviours and perception of risk related to Covid-19 among the medical students who are the front line workers and are more susceptible to be infected.

Methodology: This analytical cross sectional study was conducted in medical students of 1st, 2nd and 3rd year MBBS of various medical institutions of Rawalpindi. Study duration was 5 months (March 2020 to July 2020). The sample size was 425. Age ranging from 18 to 21 and 273 (64.2%) comprised of females. The inclusion criteria were those students who gave consent and filled out the questionnaire and the exclusion criteria was who didn't concede. The data was analysed on SPSS. Confidence interval was set to be 95% with 5% margin of error.

Results: Most of the students were aware of the basic Covid-19 related knowledge like common symptoms, incubation period, transmission and the basic preventive measures which was on average higher than the previous studies conducted on medical students and on health care workers. Students were also having high level of performance in preventive behaviours in perspective of Covid-19 but risk perception is of moderate level.

Conclusion: Participants were found to have high levels of knowledge related to Covid-19 except use of N95 masks and use of anti-viral drugs for treatment. Among self-reported preventive behaviours section, lowest score is related to frequency of cleaning and disinfecting items that can be easily touched with hands (i.e. door handles and surfaces). Participants had moderate risk perception despite having high levels of knowledge and high performance in self-reported behaviours.

Keywords: Covid-19, medical students, risk perception
Analisis Perubahan PDRB Provinsi Bali Berdasarkan Dampak yang Dialami Industri Pariwisata
Authors: Hendru Hendru , Vincent Vincent , Candy Candy
Published: February 2022

The study at hand was made in the aims to investigate, and correlate between the Gross Regional Product (GRP) of Bali with the effects of Covid-19 on the tour and travel industry. The data used in the study is based on secondary data procured from notable and trustworthy websites such as the Government Statistics Department (BPS) and publishes only found in Google Scholar and Emerald. The data was collected with a quantitative approach in mind resulting in most of the data being analytical data and statistics. The state of the industry of tour and travel represented by the ratio and number of rooms occupied during a given year shows a significant drop from the then 59,56% to 15,61% and number of visitors dropped immensely, close to 83% from the year before. The effect it had on Bali’s GRP is a reversal in economic growth from 252.138.88 to 224.214.11 billion rupiah.
Optimalisasi BUMDES Berbasis OVOP (One Village One Product) Concept Di Kabupaten Pamekasan
Authors: Ardiansyah Firman , Firdaus Nabila Yuli , Muhtadi Ridan
Published: February 2022

This study aims to provide a conceptual model regarding the optimization of Village-Owned Enterprises (BUMDES) based on the OVOP (One Village One Product) concept as a flagship program, which is every BUMDES in Pamekasan Regency forms a community that leads to integrated community economic empowerment order to optimizing superior commodities in Pamekasan Regency each village. This study uses descriptive qualitative methods with secondary data collection methods obtained from literature and documentaries that have been processed. While the data analysis technique starts from editing, organizing and finding. The results showed that this program has the potential to be realized, seeing the superior commodities owned by each village in Pamekasan Regency are very many and varied, in addition to support from the government regarding the priority of using the 2021 Village Fund for BUMDES, this program is the right step in overcoming existing problems. This program can be an alternative that is able to create food self-sufficiency in Pamekasan Regency as well as become one of the exporters of domestic products spread to national and international regions.
Comparison of Leukocyte, Neutrophil, and Lymphocyte Levels in Child Patients that Experienced Breathlessness with COVID-19 and Non-COVID-19 (2020–2021) in Medan, Indonesia
Authors: Wijaya Hendri , Pitaloka Ayodhia , Lubis Ivnke , Amelia Rina
Published: February 2022

BACKGROUND: COVID-19 is a disease caused by severe acute respiratory syndrome coronavirus-2. Various risk factors affect the morbidity and mortality of COVID-19, such as age, gender, ethnicity, comorbid conditions, and laboratory parameters. Clinical manifestations of COVID-19 in children are asymptomatic mild degrees or with acute upper respiratory tract symptoms and moderate degrees with clinical pneumonia. In the course of the COVID-19 pandemic, several biomarkers are needed that can be useful in risk stratification to predict the severity and fatality of COVID-19. Several biomarkers are used as markers of disease progression to a critical degree, such as leukocytes, lymphocytes, platelets, interleukin-6, and serum ferritin. Increased leukocytes and neutrophils and decreased lymphocytes are associated with severity and mortality in COVID-19. Laboratory findings in children with COVID-19 include decreased lymphocytes, leukopenia, and increased procalcitonin. In severe COVID-19, children often have abnormal laboratory parameters that suggest a systemic inflammatory response.

AIM: This study aims to compare leukocytes, neutrophils, and lymphocytes levels in children with the complaints of shortness of breath with COVID-19 and non-COVID-19 pediatric patients.

MATERIALS AND METHODS: This study is an analytic study with a cross-sectional approach to pediatric patients treated in Haji Adam Malik General Hospital Medan with the complaints of shortness of breath. Patient data were assessed based on the characteristic values of hemoglobin, leukocytes, neutrophils, lymphocytes, and COVID-19 polymerase chain reaction results and then analyzed using SPSS for Windows software. The study samples were 276 patients, with 43 confirmed positive COVID-19 patients and 233 negative patients. The source of this research data is data from the patient’s medical record for 1 year (2020–2021).

RESULTS: The statistical analysis results found differences in the levels of leukocytes, neutrophils, and lymphocytes in children diagnosed with COVID-19 and non-COVID-19 (p < 0.05). However, there was no difference in hemoglobin levels in children who were congested with COVID-19 and non-COVID-19 (p > 0.05).

CONCLUSION: These results are consistent with several cases and previous studies where the levels of leukocytes, neutrophils, and lymphocytes can be used as a detection tool and a diagnostic and prognostic tool in COVID-19 patients.
Diversity and vertical distribution patterns of wildlife in Tianzhushan, Shaanxi Province, China
Authors: Sun Yuting , Hu Han , Gong Congran , Yang Dongdong , Su Lina , Li Peiwei , Li Yinhu , Liu Yan , Wu Xiaomin , Zhang Hongfeng
Published: February 2022

Biodiversity monitoring is an important means by which to evaluate management effectiveness and develop sound conservation plans. In this study, 52 cameras were installed in the study area of Tianzhushan to assess wildlife diversity and elevational patterns from 2018 to 2019. In total, 9 541 independent photos were collected within 26 565 camera-days. We analysed the relative abundance index (RAI), activity patterns and seasonal activity rhythms of the five most abundant species at 200-m elevational intervals throughout the study area (elevation range 1 400–2 000 m a.s.l.). Based on RAI results, the activity patterns of the five most abundant species (i.e. Sus scrofa, Naemorhedus griseus, Muntiacus reevesi, Arctonyx collaris and Capricornis milneedwardsii) were analysed. Amongst the detected wild mammals, Sus scrofa had the highest RAI value of 9.91, while the occurrence of Tamiops swinhoei had the lowest RAI at 0.004. In addition, there were significant differences in species activity during the daytime and night-time. RAI of the ungulate community peaked at the 1 600–1 800 m a.s.l. elevational range, thus showing a mid-elevational peak pattern. Differences in vertical distribution patterns were detected for the five most abundant species. Mainland serows and wild boars preferred mid-elevation habitats (1 600–1 800 m a.s.l.), long-tailed gorals preferred mid- and high altitudes (1 600–2 000 m a.s.l.) elevation habitats and Chinese muntjacs and hog badgers preferred low elevation habitats (1 400–1 600 m a.s.l.). Taken together, this is the first study to reveal the five dominant species activity patterns in Tianzhushan, which is of importance for wildlife conservation.
Multicellular model of angiogenesis
Authors: Nakazawa Takashi ,   Center for Mathematical Modelling and Data Science, Osaka University, 1-3, Machikaneyama-cho, Toyonaka-shi, Osaka 560-8531, Japan, Tasaki Sohei , Nakai Kiyohiko , Suzuki Takashi ,   Department of Mathematics, Faculty of Science, Hokkaido University, Kita-10, Nishi-8, Kita-ku, Sapporo 060-0810, Japan,   Chugai Pharmaceutical Co. Ltd., 2-1-1 Nihonbashi-Muromachi, Chuo-ku, Tokyo 103-8324, Japan
Published: February 2022

This paper presents a mathematical model governing the dynamics of a morphogenetic vascular endothelial cell (EC) during angiogenesis, and vascular growth formed by EC. Especially, we adopt a multiparticle system for modeling these cells. This model does not distinguish a tip cell from a stalk cell. A formed vessel is modeled using phase-field equation to prevent capillary expansion with time stepping in particular. Numerical simulation reveals that all cells are moving in the direction of high concentration of vascular endothelial growth factor (VEGF), and that they are mutually repellent in cases in which they are closer than some threshold.
Analysis of the paddy cultivation pattern in Galle and Matara districts in the Southern province of Sri Lanka
Authors: Silva K. N. N. , Gunasekara S. D. W.
Published: February 2022

This study aims to determine the current trends of paddy cultivation in the Galle and Matara districts in the southern province of Sri Lanka. Moreover, constraining factors for paddy cultivation and the role of extension services to promote paddy farming are also analyzed. The required data was gathered from the field survey carried out using 400 farmers in Galle and Matara districts. The majority of paddy lands have single ownership in both districts while shallow and bog soil was dominant soil types in the paddy fields. Among the factors affecting paddy cultivation patterns, poor water drainage conditions and labor scarcity were the main reasons for the decreasing trend. Bog and shallow soil conditions of paddy lands have created the water drainage issue. The average cost of paddy farming in the Galle and Matara districts was Rs.39444 and Rs.39374 per acre respectively. The highest percentage of the cost is incurred for land preparation while the next highest cost is for paddy harvesting. The government farmer training programs were not sufficiently addressing the farmers' needs and did not contribute to increasing paddy farming in these districts. The frequency of farmer visits by advisory services was 2-3 visits per season, while farmers prefer to meet them at least once a week. Agrarian service centers and community-based organizations were the main farmer assistance services. Farmers expect government assistance mainly for the irrigation facilities to promote paddy farming in Galle and Matara districts.
Molecular docking analysis of seagrass (Enhalus acoroides) phytochemical compounds as an antidiabetic
Authors: Fatmawati Yayuk , Sandrina Sophi , Nur Aina Richca , Narulita Erlia
Published: February 2022

Enhalus acoroides have potential to inhibit the α-glucosidase enzyme and as an antidiabetic drug. Twenty-seven phytochemical compounds of seagrass (E. acoroides) were analyzed by molecular docking method. All possible candidate compounds predicted ADME pharmacokinetic properties using the swiss ADME website. A molecular docking analysis was carried out using the PyRx 0.8 Autodock Vina software. Furthermore, the interaction analysis between molecules was carried out using PyMOL software and the Discovery Studio Visualizer BIOVIA. There were 17 of the 27 compounds which had the best potency as oral antidiabetic drug candidates. The validation results showed that all ligands had aroot mean score deviation (RMSD) value <2Å with the best value of 0.0. The binding affinity with the strongest bond value was -9.2 (kcal/mol) on the NAMPT bond with tannin, while the weakest value was 40.01 at 3l4y (α-glucosidase) with 3-methyl. The 2h6d receptor can bind to all ligands, and the α-glucosidase receptor can bind to two test ligands. The docking method used in this study was valid, and the phytochemical compounds of seagrass have the potential to be an alternative to antidiabetic drugs.
La morte cerebrale nel neonato e nel neonato con anencefalia
Authors: Di Rocco Concezio
Published: February 2022

Lo studio, muovendo dall'accertamento - negli anni '50 - dell'insufficienza dei tradizionali criteri di accertamento della morte clinica (cessazione dell'attività respiratoria e cardiaca), si sofferrna sul lavoro svolto - ed ampiamente accettato seppure sottoposto a continui affinamenti - dal Comitato "ad hoc" costituito negli anni '60 dalla Facoltà medica di Harvard in ordine a precisi criteri di accertamento della morte cerebrale. Tuttavia nessuna indicazione veniva data per la morte in età pediatrica. Allo scopo sono state successivamente elaborate specifiche linee-guida come, per esempio, dal "Children's Hospital" di Boston e dalla "Task Force" per la determinazione della morte cerebrale nel bambino (USA). L'Autore conclude lo studio argomentando sul problema del bambino come fonte d'organi, in riferimento soprattutto al bambino anencefalico.
Use of flow volume curve to evaluate large airway obstruction
Authors: Sarkar Malay , Madabhavi Irappa V. , Mehta Shailee , Mohanty Swadeshkumar
Published: February 2022

The flow volume loop (FVL) is a graphic display of airflow against lung volumes at different levels obtained during the maximum inspiratory and expiratory maneuver. It is a simple and reproducible method of lung function assessment. A narrative review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. PubMed, EMBASE, Ovid MEDLINE and CINAHL databases were queried and reviewed for studies pertinent to the various FVLs abnormalities and their mechanisms from January 2020 to December 2020. We used the following search terms; flow-volume loop, upper airway obstruction, Obstructive airway disease, and spirometry.  Assessing the shape of the flow-volume loop is particularly helpful in diagnosing and localizing upper airway obstruction. They are also helpful in identifying bronchodilator response to treatment. Characteristic FVLs is also seen in patients with obstructive or restrictive lung disorders. Spirometry should be interpreted using the absolute values for flows and volumes as well as the flow volume and volume time curves.
Assessment of peripheral artery disease risk in building construction workers by Ankle-Brachial index measurement with automated oscillometric and hand-held Doppler device
Authors: Verma Manish K. , Gangwar Vibha , Jasrotia Rajani B. , John Nitin A.
Published: February 2022

Background:

Peripheral arterial disease (PAD) remains underdiagnosed, partly because of the limitations of the Doppler ankle-brachial index (ABI) with regards to equipment, training, and time constraints.

Aims:

To compare the accuracy and validity of automated oscillometric ABI measurement in detecting PAD in primary care settings against a gold standard Doppler device.

Settings and Design:

A cross-sectional observational study was conducted at the physiology department, Dr. Ram Manohar Lohia Institute of Medical Sciences (DrRMLIMS), Lucknow.

Methods and Material:

A total of 200 male building construction workers of all types of age groups between 20 and 40 years were recruited. The ABI measurement was performed using the Watch BP Office and hand-held HI.dop, BT-200 Vascular Doppler device.

Statistical Analysis Used:

The Bland-Altman plot and receiver operator characteristics (ROC) curve were determined to analyze the agreement between the two methods. For the reliability of the test, Pearson’s correlation with linear regression was done and the intraclass correlation (ICC) coefficient was calculated.

Results:

The mean ABI (Osc) and ABI (Dop) were 1.13 ± 0.09 and 1.06 ± 0.08, respectively. The ABI (Dop) and ABI (Osc) methods were highly correlated Pearson’s correlation coefficient of 0.96 with 95% confidence interval (CI) ranges between 0.985 and 1.066 (P < 0.001). On linear regression analysis, the ABI (Dop) predicted ABI (Osc) 92.6% correctly. The paired mean difference between the two measuring devices was 0.07 (95% CI = −0.03 to −0.12). At 0.90 cut-off value of diagnosing PAD, the sensitivity is 50%, specificity 100%, positive predictive value 100%, and negative predictive value 97% by an oscillometric automated device.

Conclusion:

Our finding suggested that ABI measurement by the automated oscillometric device is reliable, free of examiner bias, and less time-consuming.
Hyperglycaemic and hypoglycaemic emergencies among patients with diabetes mellitus who participated in pilgrims of the 2019/1440H Hajj season
Authors: Alfadhly Abdulaziz , Darraj Hussain , Alamlki Basim , Alfaez Saad , Alzahrani Mohammed , Mubarak Ali , Albogami Safar , Almalki Daifallah , Alshehri khalid , Alqarni Ali , Alzahrani Ali , khalid Hamzah , Altwairiqi Rami , Alselmi Adhari , Almajnouni Afnan , Kamal Turki , Kamal Mohammed , Almatrfi Fahad , Osman Mugtaba , Alotaibi Abdulkareem
Published: February 2022

Background:

Diabetic emergencies are serious acute life-threatening complications of diabetes mellitus (DM). The Hajj season requires the health system in Saudi Arabia to prepare efficiently for the healthcare of millions of pilgrims, particularly for diabetic emergencies. Thus, diabetic emergencies need rapid recognition, diagnosis and treatment. This study aimed to explore the frequency and associated factors of diabetic emergencies among the pilgrim's patients with DM during Hajj, Mecca 2019.

Methods:

This is a prospective study which was conducted on 153 patients with DM. They were selected from three major healthcare-providing facilities during Hajj, which are Arafat, Muzdelefah and Muna healthcare centres. The study was conducted from Aug 5 to 12, 2019. All the patients who presented with any of the hypoglycaemic or hyperglycaemic emergencies had their demographic and clinical characteristics recorded to estimate the prevalence of each emergency and identify its significant associated factors.

Result:

More than 90% of the study participants were patients with type 2 diabetes mellitus (T2DM), while around 7% had type 1 diabetes mellitus (T1DM). Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycaemic state (HHS) and hypoglycaemia were presented in (n = 11, 7.2%), (n = 19, 12.4%) and (n = 28, 18%), respectively, of the participants. Moreover, the study found that “younger age” (odds = 30.4, P = 0.0115) and “type of medication” are significantly associated with DKA. Furthermore, “older age”, “type of medication”, “having Cardiovascular Disease (CVD)” and “diabetes duration” were found to have a significant association with HHS. Moreover, hypoglycaemia was associated with neuropathy complication (odds = 3.54948, P = 0.0187).

Conclusions:

Among the pilgrims with diabetes participating in Hajj, a considerable proportion with a range of diabetic emergencies present to the onsite medical facilities. Preparation is required in terms of logistics and health education about diabetic emergencies to meet the needs of pilgrims with DM, especially those who use insulin and have longstanding diabetes. Further research on DM and the creation of guidelines for health providers and patients with DM during Hajj are important focuses for the future.
Prevalence of neck and shoulder pain among Saudi universities’ students who are using smartphones and computers
Authors: Elsiddig Amal I. , Altalhi Ibtisam A. , Althobaiti Manal E. , Alwethainani Manal T. , Alzahrani Amjad M.
Published: February 2022

Aim:

This study aimed to identify the prevalence and associated factors of neck and shoulder pain that result from using smartphones and computers among Saudi university students.

Methods:

A cross-sectional study was conducted on 516 students. An online questionnaire containing data about participants’ characters, type of device used, reason and duration of use and position when using smartphones, suffering neck or shoulder pain, severity, pain relief medicines, exercises for the neck and shoulder after use, and effect of pain on daily routine was distributed on Google Form.

Results:

45% of participants were using smartphones; 35.1% spent 6–9 hours on average. Further, 40.5% used mobiles with one hand with a slight neck tilt below the horizon line; 59.1% complained of neck or shoulder pain while using devices, and only 2.7% of those suffering from pain were using pain relief medicines. Moreover, 34.3% were doing exercises after using devices, and 20.3% experienced pain in their daily routines. Participants using both iPads or tablets and computers had a significantly higher percentage of neck or shoulder pain compared to other user devices. Participants using devices for studying accounted for a significantly higher percentage of suffering from neck or shoulder pain compared to those using it for other purposes. Participants using mobile with one hand with a large neck tilt below the horizon line had a significantly higher percentage of suffering from neck or shoulder pain.

Conclusion:

University students should be given top attention when it comes to raising awareness about health and safety risks associated with computer use.
Deliberate self-poisoning and harm
Authors: Abhilash Kundavaram Paul Prabhakar , Murugan Sanjay , Rabbi N Abel S. , Pradeeptha Sharon , Kumar Sathish , Selvaraj Bagyalakshmi , Gunasekaran Karthik
Published: February 2022

Background:

Deliberate self-poisoning and harm (DSPH) is an unabating problem with a wide variation in the methods used across the world. Hence, this study was conducted to understand the current spectrum of methods used for DSPH by patients in our geographic locality and catchment area with special emphasis on newer compounds and drugs used.

Methods:

This retrospective study included patients presenting with DSPH to the emergency department (ED) between January 2017 and December 2018.

Results:

This study included 1802 patients, with a mean age of 32 ± 12.7 years. Of the patients, 85% were in the young to middle age group (16–45 years). Agrochemicals (n = 604, 33.5%), drugs (n = 498, 27.6%), plant toxins (n = 150, 8.3%) and rodenticides (n = 145, 8%) were the predominantly used compounds. The major emergency resuscitation procedures required in the ED were intubation (n = 321, 18%), vasopressor support (n = 73, 4%) and cardiopulmonary resuscitation (n = 27, 1.4%). A quarter (23.2%) was discharged stable from the ED, whereas a further 56.5% were discharged stable after hospital admission. The in-hospital mortality rate was 3% (n = 47). Multivariate logistic regression analysis showed rodenticides (odds ratio (OR): 22.32; 95% confidence interval (CI): 8.05–61.88; P = 0.005) and plant poisons (OR: 23.92; 95% CI: 8.95–63.94; P = 0.005) to be the independent predictors of mortality.

Conclusion:

DSPH is prevalent in the highly productive young age group. Agrochemical ingestion and drug overdose are the most common methods used, whereas rodenticide and plant poisoning are associated with significant mortality.
Post surgical immediate prosthetic reconstruction in patients with rhinocerebral mucormycosis
Authors: Mahajan Kamya , Das Monalisha , Kumar G. Ajay
Published: February 2022

Coronavirus disease has taken a toll on everyone's lives either physically or emotionally throughout the world. One of the most serious complications occurring currently in covid-positive and recovered patients is the deadly invasive mucormycosis. There are five clinical types of mucormycosis, out of which rhino-orbito-cerebral is the most common form (44%–49%). Management includes early diagnosis, control of the underlying diseases, and aggressive medical and surgical intervention. In patients undergoing maxillectomies, the use of immediate surgical obturators has become the gold standard. The rationale for its use is threefold—functional (matrix for the surgical dressing; allows the patient to speak and swallow), hygienic (separates the maxillary surgical site from contents of the oral cavity), and psychological (restores patient's self-image by reproducing lost oral structure). This article includes two case reports of patients diagnosed with rhinocerebral mucormycosis. The surgical debridement, medical management, and immediate reconstruction using palatal obturators have been explained.
Anthropometric indices and its association with hypertension among young medical students
Authors: Lahole Swapnil , Rawekar Rajendra , Kumar Sunil , Acharya Sourya , Wanjari Anil , Gaidhane Shilpa , Agrawal Sachin
Published: February 2022

Introduction:

Obesity, defined on the basis of anthropometric measures is a global epidemic and threatening to healthy population worldwide. A research from China among young adults (20--44 years) recorded six and two times the risk of hypertension (HTN) in individuals who were obese and overweight, respectively, relative to normal weight individuals. This study highlights about anthropometric indices and its association with HTN among young medical students at rural medical college.

Methods:

In this cross-sectional study, 1,000 medical students had been enrolled. Anthropometric indices like body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR), neck circumference (NC) as per South East Asian guidelines were measured in all students.

Results:

Among young medical students, the prevalence of obesity defined by BMI, WC, WHR, and NC was 46.5%, 32.4%, 57.3%, and 8.4%. Among males, there was significant positive correlation of BMI with SBP (P < 0.0001) and DBP (P < 0.0001), whereas WC (P < 0.0001) and WHR (P = 0.012) had positive and significant correlation with SBP but not with DBP. Correlation of NC with SBP and DBP was negative but did not reach statistical significance (P = 0.266 and P = 0.670, respectively). Among females, there was significant positive correlation of BMI with SBP (P < 0.0001) and DBP (P < 0.0001), WC had significant positive correlation with SBP (P < 0.0001,) and DBP (P < 0.0001). Correlation of WHR was significant with DBP (P = 0.002) but not with SBP (P = 0.055).

Conclusion:

The prevalence of HTN in this study was 9.8% in young medical students overall and varies according to anthropometric indices. The prevalence rate varies in males and females depending on the anthropometric measures.
Clinical profile of obsessive-compulsive disorder in children
Authors: Rajith Ravindren K. , Krishnakumar Padinharath
Published: February 2022

Introduction:

Most studies on obsessive-compulsive disorder (OCD) among children and adolescents pertain to adolescents and Indian data on childhood-onset OCD are scant.

Objective:

To evaluate the clinical profile of OCD among children and adolescents with onset before the age of 12 years.

Methods:

Children and adolescents who attended the outpatient clinic with a clinical diagnosis of OCD were included in the study. Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) was used to assess the phenomenology and severity of OCD. The diagnoses of OCD and comorbid disorders were based on DSM5 diagnostic criteria. Children with the onset of symptoms before the age of 12 years were analyzed.

Results:

Among the 46 children with OCD, 31 (16 boys and 15 girls) had onset before the age of 12 years. The youngest child was 6 years old and in 29% of children, OCD symptoms began before the age of 8 years. Family history of OCD, other mental illnesses, and tics disorder was present in 48.4%, 29%, and 12.9% of children, respectively. Comorbid tics disorder was present in 12 (38.6%) children and 1 (3%) child each had depression and conduct disorder. Common obsessions and compulsions were obsessions of contamination (77.4%) and washing and cleaning compulsions (87.1%). Miscellaneous obsessions and compulsions occurred in 25.8% and 77.4% of children, respectively.

Conclusion:

OCD is not uncommon in young children. The present study provides preliminary data on childhood-onset OCD among children and adolescents and points to the need for larger community-based studies.
Reinfection with SARS-CoV-2
Authors: Sonié Pedro , Manuel-Silva Jorge , Rafael Alexandra , Amorim-Alves Luís
Published: February 2022

Data show that antibody-related immunity against SARS-CoV-2 may not be long-lasting. We report two cases regarded as cured from COVID-19, which presented again with symptoms and a positive SARS-CoV-2 RT-PCR test. Case one, a 60-year-old male, had a biphasic presentation of symptoms compatible with COVID-19 infection, associated with a positive RT-PCR test. Case two, a 25-year-old female, had a first positive RT-PCR test during hospital screening, and months later a symptomatic presentation of COVID-19, associated with a positive RT-PCR test. All cases were immunocompetent. Anti-IgG-SARS-CoV-2 blood samples were negative in both. Elevation of analytical inflammatory markers suggested new infection in both cases. COVID-19 reinfection may be a differential diagnosis and primary care physicians should acknowledge it. Previously cured patients should be encouraged to comply with health public preventive measures.
Dramatic neuromuscular paralysis following occult snakebites
Authors: Mehta Vishal , Kumar Ritesh , Prabhakar Rathod , Sharma Chandra B. , Thomas Aneesha
Published: February 2022

Neurotoxic snakebites are a common emergency in tropical countries and account for significant morbidity and mortality worldwide. Manifestations vary from mild ptosis and ophthalmoplegia to severe flaccid paralysis with ventilatory failure. At times, the neuromuscular paralysis may be severe enough for patients to be misdiagnosed as a locked-in syndrome or brain dead. Occult snakebites, wherein patients are unaware of the bite and fang marks are absent, have been reported in kraits, an endemic neurotoxic snake belonging to the Elapidae family. We report a series of three cases in which young males presented with dramatic neuromuscular paralysis and were likely suffering from elapid snake bites. Each of these patients presented an intriguing clinical challenge and had different in-hospital outcomes. Primary care physicians in the emergency department are usually the first respondents to such patients. Owing to a lack of snake bite history and unavailability of specific diagnostic tests, severe envenomation presents a challenge for physicians, unless they are aware of it and a high level of suspicion is maintained.
Job satisfaction among medical officers working in Delhi
Authors: Anand Tanu , Kaur Gurmeet , Gupta Kalika , Thapliyal Sunil , Lal Panna
Published: February 2022

Background:

Satisfied human resource is an essential asset for high productivity, efficiency, and quality of care in a healthcare organization. Job satisfaction among healthcare professionals assumes further significance for the purpose of maximization of human resource potential in the context of the shortage of manpower in the health sector in India. Objectives: The objective of the study was to assess the job satisfaction among medical officers (MOs) working in Delhi and to study the factors influencing the satisfaction level amongst them.

Material and Methods:

It was a cross-sectional study conducted amongst selected MOs (by convenience) in all the districts of Delhi. A structured, self-administered questionnaire was used to collect data from the participants.

Results:

A total of 115 MOs completed the questionnaire. There were 61 (53%) female doctors and 54 (47%) male doctors. The mean age of the study participants was 38.28 ± 7.37 years. The experience of the study group ranged between 1 and 28 years (9.59 ± 6.47 years). Of the total, 59.1% of participants were found to be satisfied with their job. The most common reason given for satisfaction with job was the timing of their job that suits them. The reason given for not being satisfied with job was salary not at par with work pressure. A significantly higher proportion of male participants considered “lack of accommodation” (P < 0.03) and “frequent detailment” (P < 0.031) are big problems faced in their jobs as compared with the female participants. Only 37 (32.2%) participants felt that the MO is able to give enough time to patients for clinical assessment in Out Patient Department.

Conclusions:

Although majority (59%) of the study group was satisfied with their job, there were numerous problems faced by the doctors at their workplace. Low pay was one of the important reasons cited for being dissatisfied. There is an urgent need to address all the factors affecting job satisfaction through proper planning and implementing relevant human resource policies for improvement in the work environment at public health institutions.
Can proactive roles played by Community Medicine professionals in times of COVID-19 Pandemic bring the leadership of public health in India in the right hands?
Authors: Satpathy Parmeshwar , Singh Arvind K. , Agarwal Neeraj , Majumdar Anindo , Goel Akhil D. , Yadav Kapil
Published: February 2022

Since the onset of the COVID-19 Pandemic, various public health measures have been in focus, viz. social distancing, hand hygiene, use of masks, screening of patients for COVID-19 symptoms, development of quarantine and isolation facilities, and public health surveillance. Most of these relate to the principles of prevention, early case detection, and primary care. In the ongoing fight against COVID-19, community medicine (CM) professionals are involved at various positions and have been leading from the front in a variety of activities, be it screening, patient care, surveillance, orientation and training of front line workers, community engagement, evidence generation through research, and development of guidelines. However, their engagement in policymaking has still been limited. The government should work more closely with CM professionals in order to stem the tide of COVID-19 or any such public health emergencies in the future by shifting the focus to preventive and promotive interventions. CM professionals should take a more proactive approach in getting involved in policymaking and demonstrate leadership through their actions to lead the national, state, and district-level public health teams through collaboration across disciplines and sectors. This will help bring the leadership of public health in India in the right hands for optimum population health and appropriate and timely health emergency response.
Antibiotic-prescribing pattern in the outpatient departments using the WHO prescribing indicators and AWaRe assessment tool in a tertiary-care hospital in South India
Authors: Priyadharsini R. P. , Ramasamy Kesavan , Amarendar Sura
Published: February 2022

Context:

Rational drug use has a great role of influence in health care. The fact sheet given by the World Health Organization (WHO) shows that around 50% of the drugs are prescribed, dispensed, and sold inappropriately. One of the major consequences of irrational drug use in infections is antibiotic resistance.

Aim:

The present study aims to assess the antibiotic-prescribing pattern by auditing the prescriptions in a teaching hospital.

Settings and Design:

A prospective cross-sectional study was conducted in the pharmacy of a teaching hospital to evaluate the prescriptions of the outpatient department.

Materials and Methods:

The prescriptions used to treat symptoms suggestive of infections were taken into consideration. A total of 1,000 prescriptions were analyzed.

Data Analysis:

The data was analysed using Microsoft Excel.

Results:

A total of 2,536 drugs were prescribed. The average number of drugs per prescription was 2.5. The percentage of encounters with antibiotics prescribed was 17.5%. The percentage of encounters prescribed with a generic name and with drugs from the essential drug list was 87.5% and 65%, respectively. There were no injections prescribed. Amoxicillin and ciprofloxacin were the most common antibiotics prescribed. The duration of the treatment was mentioned in all the prescriptions.

Conclusions:

Our study shows that the percentage of antibiotic usage is within the WHO standard value. The average number of drugs per prescription was slightly higher than the WHO value. Steps should be taken to improve the generic prescribing by the physicians.
Socio demographic determinants of violence among school-going adolescent girls in a rural area of North India
Authors: Vinay  , Kumar Neelam , Malik J.S. , Sachdeva Aman , Kumar Mukesh , Kumar Hement , Rathee Manjeet
Published: February 2022

Background:

The United Nations defines violence against women as “any act of gender-based violence that results in, or is likely to result in, physical, sexual or mental harm or suffering to women, including threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or in private life”.[1] Violence can take many forms, including physical, sexual or emotional and varies in its severity. Gender discrimination, norms and practices mean that adolescent girls are likely to experience certain forms of violence, such as sexual violence, at much higher rates than boys.

Methods:

This cross-sectional study was conducted in a rural block of North India. A total of 500 adolescent girls in the age group of 13–19 years studying in class VIII to class XII in 10 government and private senior secondary schools of the Lakhanmajra block were included in the study. A pre-designed pre-tested semi-structured interview schedule was used.

Results:

In this study, we found the prevalence of physical, sexual and emotional violence among adolescent girls as 6.6, 5.4 and 5.2%, respectively. The most frequent perpetrator of physical violence was the parent and of sexual violence was the neighbour followed by friends or relatives. Higher emotional violence was experienced by adolescent girls from middle-class families (P < 0.05). The prevalence of physical violence among adolescent girls was maximum in the younger age group 13–14 years (10.2%), followed by 15–17 years (4.0%). This association was found statistically significant (P < 0.05).

Conclusions:

There are several restrictions on free communication about violence-related topics in our highly conservative society. Blaming the victim is the rule rather than the exception and sexual abuse is usually linked to a loss of virginity and family honour in our patriarchal society. Hence, girls may be more reluctant to disclose their experience of violence.
The hidden patient
Authors: Holliday Alison M. , Quinlan Claire M. , Schwartz Andrea Wershof
Published: February 2022

Caregivers, or persons who provide unpaid support to a loved one who could not manage to live independently or whose health or well-being would deteriorate without this help, are increasingly common. These rates have only increased with the COVID-19 pandemic forcing many to care for sick family members in the short or long term. Unfortunately, caregiving is associated with significant burden and health risks, not only for caregivers themselves but also for the care recipients of overwhelmed caregivers. These risks have also been exacerbated by the social isolation of the COVID-19 pandemic. Although interventions exist which have been proven to reduce caregiver burden, education on these interventions is lacking, partly because there has not been a memorable framework on how to care for caregivers. In this paper, an innovative framework to teach clinicians about caring for caregivers is introduced, the C.A.R.E. framework: Caregiver well-being, Advanced care planning, Respite, and Education. This simple framework will help providers become aware of caregiver needs, comfortable in addressing their needs, and able to suggest interventions proven to reduce caregiver burden. Knowledge of this framework should start with medical students so that they can incorporate this critical aspect of primary care into their clinical practice early on in their careers. If providers can simply remember to perform these four interventions, to C.A.R.E. for our caregivers, then they will make a significant impact on the lives of both our patients and their loved ones, during the present COVID-19 pandemic and thereafter.
Clinical experience of tocilizumab treatment among a cohort of patients with COVID-19 infection from Western India
Authors: Surana Prince D. , Nayak Rupesh , Sheikh Arif , Haldankar Pradnya , Kale Jyoti
Published: February 2022

Background:

Initiation of tocilizumab (TCZ) treatment in patients with coronavirus disease 2019 (COVID-19) during the early phases of cytokine storm is crucial. This study evaluated the clinical experience of TCZ use in the treatment of patients with COVID-19.

Methods:

This retrospective observational study included patients (>18 years) with confirmed COVID19 treated with TCZ alone/in combination with other drugs. Data related to demographics, clinical characteristics, radiological parameters, oxygen/ventilator/vasopressor support, treatment parameters, laboratory investigations pre- and post-TCZ treatment, and clinical outcomes were retrieved from medical records.

Results:

Out of 95 patients (mean age, 55 years), 68.4% and 31.6% of patients had moderate and severe COVID-19 disease, respectively. The mean time to TCZ administration from symptom onset was 8.7 days. At the time of admission, the mean oxygen saturation (SpO2) was 90.4% and mean concentration of fraction of inspired oxygen (FiO2) was 80.6%. The most commonly received dose of TCZ was 400 mg (84.2%) intravenously. The mean concentration of FiO2 and SpO2 improved significantly during the treatment (P < 0.001) compared to before TCZ initiation. The change in median levels of C-reactive protein (CRP) from baseline to post-treatment (63.0 vs. 4.5 mg/dL; P < 0.001) was significant. Post TCZ treatment, 73.6% of patients improved; whereas 26.4% of patients died. Acute respiratory distress syndrome (23.2%) and elevated transaminases (12.6%) were the most commonly reported adverse events.

Conclusion:

Tocilizumab administration during earlier phase of cytokine storm syndrome leads to reversal of abnormal SpO2 and FiO2 concentrations to normal levels and rapid decline of elevated CRP levels in patients with COVID-19.
Paradigm shift in pattern and prevalence of poisoning during COVID-19 pandemic
Authors: Behera Ashish , Singla Neeraj , Sharma Nalin , Sharma Navneet
Published: February 2022

Objective:

To assess the pattern, prevalence and outcome of poisoning cases reporting to hospital in North India during COVID-19 pandemic.

Material and Methods:

An observational, prospective study was conducted for 100 patients reporting to medical emergency with history of poisoning intake from April 2020 to January 2021. Age range was 14-85 years. Obtained data were analysed using descriptive statistics and results were expressed as percentage and mean.

Results:

Out of 100 patients (77M, 33F), mean age of 32.6 years, most cases belong to age group of 20-30 years and 50% were matriculates and majority of the patients belonged to Punjab and Himachal Pradesh. The most common poisoning agents consumed were corrosives (34%) followed by Aluminium Phosphide (24%). Respiratory distress (53%), loss of consciousness (43%), acute kidney injury (36%) were the common clinical presentations. PSS (Poisoning Severity Score) was moderate in 52% of patients, severe in 14%, fatal in 16% and minor PSS in 18% of patients. 16 patients with fatal PSS and 16 patients with moderate to severe PSS got expired. High mortality of 33% was seen in our study.

Conclusions:

The most vulnerable group in our study was of young males in age group of 21-30 years and less educated, who had lost their jobs due to COVID-19 pandemic lockdown. Corrosives were the most commonly consumed poison during lockdown. Our study found that scoring systems PSS and GCS were good assessment tools for degree of severity of poisoning at an early stage.
The general public’s perspectives on telemedicine during the COVID-19 pandemic in Korea: analysis of a nationwide survey
Authors: Kang EunKyo , Lee Hyejin , Hong Ki Jeong , Yun Jieun , Lee Jin Yong , Hong Yun-Chul
Published: February 2022

OBJECTIVES: We investigated the awareness, experience, approval, intention to use, and the desired type of telemedicine among Korean general public.METHODS: From November to December 2020, we conducted an online self-reported survey on awareness, experience, approval, and intent to use telemedicine services among Korean residents aged 20 years or older. A total of 2,097 participants completed the survey.RESULTS: Of the 2,097 participants, 1,558 (74.3%) were aware of, 1,198 (57.1%) approved of, and 1,474 (70.3%) had the intention to use telemedicine. Participants from regions other than the Seoul metropolitan area and Daegu–Gyeongbuk Province (adjusted odds ratio [aOR], 1.29; 95% confidence interval [CI], 1.02 to 1.63), households with a monthly household income of US$6,000 or more (aOR, 1.44; 95% CI, 1.01 to 2.08), participants who had a college/university or associate’s degree (aOR, 1.35. 95% CI, 1.04 to 1.75) or a master’s degree or above (aOR, 1.73; 95% CI, 1.20 to 2.50), and housewives (aOR, 1.30; 95% CI, 1.03 to 1.64) had higher odds of approval. Elderly participants, those with a chronic disease (aOR, 1.26; 95% CI, 1.04 to 1.54), those who had experienced delays of healthcare services (aOR, 1.94; 95% CI, 1.27 to 2.96), and those who had experience with telemedicine (aOR, 4.28; 95% CI, 1.69 to 10.82) were more likely to intend to use telemedicine services. Regarding types of telemedicine, teleconsultation between doctors showed the highest approval rate (73.1%).CONCLUSIONS: In the context of the coronavirus disease 2019 pandemic, more than 70% of participants had already used or intended to use telemedicine at some point. Groups with a substantial need for telemedicine were more in favor of telemedicine.