bluuebunny/crossref_metadata_2025 huggingface dataset:
Measurement of spectacle-induced aniseikonia in axial anisometropia using the New Aniseikonia Test
Authors: El-Abedin Rajab Ghada Z. , Elaziz Mohamed S.A. , Soliman Shiamaa S. , Basiony Ahmed I.
Published: December 2022

Aim

To determine whether spectacle correction in axial anisometropes can cause significant aniseikonia.

Patients and methods

A cross-sectional study was conducted on eight patients who had axial anisometropia with a spherical equivalent difference between both eyes equal or more than 4 D. Aniseikonia was measured using the New Aniseikonia Test ‘Awaya.’ Aniseikonia of 3% or more was considered clinically significant. Spearman correlation between the amount of aniseikonia and anisometropia was calculated.

Results

The mean±SD age of the patients was 13±4.64 years (range, 7–24 years). Anisometropia ranging from −14.5 to +5.25 DS with a mean±SD of −6.70±5.18. The overall mean±SD of aniseikonia was −1.45±0.52. Five patients had no aniseikonia, three patients had −1% aniseikonia, and three patients had −2% aniseikonia. Spearman correlation showed an insignificant positive correlation between the amount of anisometropia and aniseikonia (r=0.05, P=0.86).

Conclusion

Among our cases, spectacle correction in axial anisometropia did not lead to significant aniseikonia using the New Aniseikonia Test. Aniseikonia should be assessed in patients with anisometropia as 1% of aniseikonia per diopter of anisometropia does not apply in every case.
The use of chloral hydrate sedation in pediatric strabismus outpatient clinic
Authors: Rajab Ghada Zein El- Abedin , Sultan Amany Aly , Soliman Shaimaa Sherif
Published: December 2022

Purpose

To assess the use of oral chloral hydrate (CH) sedation in uncooperative children to perform a precise cycloplegic retinoscopy and a thorough dilated fundus examination in an outpatient strabismus and nystagmus clinic.

Patients and methods

A prospective study was conducted on 114 uncooperative children (119 sedation episodes) who were attending the strabismus and nystagmus outpatient clinic at Menoufia University Hospital. Children were sedated by the first dose of CH (50 mg/kg). A second dose, half-strength of the first dose, was given if no adequate sedation occurred after 30 min. The degree of sedation was graded into five categories: excellent, good, fair, poor, and failure. All demographic characteristics, sedation success, failure, and adverse events were reported and statistically analyzed.

Results

The mean age of children was 23.38 months (range: 5.16–62.06), and their weight ranged from 6.5 to 22 kg. The total CH dose ranged from 325 to 1500 mg. A total of 78 sedation episodes were reported by a single dose, and 41 by two doses. The percentage of the grade of sedation in our 119 episodes was as follows: excellent (56.3%), good (9.2%), fair (28.6%), poor (2.5%), and failure (3.4%). The overall success of one dose was 65.5%, which increased to 96.6% by a second supplemental dose. The most common complication was vomiting (13.4%). Other complications included prolonged drowsiness (one case) and paradoxical agitation (two cases). Spearman correlation showed a significant positive correlation between the degree of sedation and the total dose of CH (r=0.603, P<0.001).

Conclusion

According to our study, the use of CH was found to have a high success rate with two doses, without major adverse events.
Prediction of Low Birth Weight by Quadruple Parameters in High-Risk Pregnancies
Authors: Pradhan Avani , Mishra Prabhakar , Tiwari Swasti , Choure Kamlesh , Gupta Amrit
Published: December 2022

Context:

Aneuploidy screening is done in the early second trimester of pregnancy among all pregnant women as compulsory, with a special focus on those who had abnormal ultrasound parameters, higher dual marker risk, or other comorbidities. Recently, all individual quad markers of conventional trisomy screening have been suggested as useful in predicting adverse pregnancy outcomes (APO) such as preeclampsia, preterm labor, small for gestational age, and placental abruptions. However, similar studies on Indian pregnant women are limited. Hence, this study was intended to find the relation of quadruple markers with any other APO than aneuploidy.

Materials and Methods:

A retrospective study was conducted in a Tertiary Care multi-specialty hospital in North India. Data from 252 pregnant women’s quadruple test was analyzed. The association of abnormal value of quadruple markers (human chorionic gonadotropin [HCG]/alpha-fetoprotein/uE3/Inhibin A) with adverse outcomes was evaluated. Multiple logistic regression analysis and classification and regression tree were used to predict the significant risk factor in high-risk pregnancies.

Results:

In the study, a total (n = 252) of pregnant women, 190 were screened as high-risk pregnancies, whereas the remaining 62 were reported as low-risk using trisomy screening in the quadruple test. Baby birth weight was observed to be significantly associated with Inhibin-A, and HCG (P < 0.001), whereas Corrected (Corr)-multiple of median (MoM)-HCG (>1.415) and Inhibin-A Corr-MoM (>364.175) were the suitable predictor for the LBW. Both parameters were significantly higher in the high-risk group as compared to the low-risk group (each P < 0.05).

Conclusion:

Abnormal deviation of biochemical markers from aneuploidy screening assessment could help predict other perinatal adverse outcomes such as low birth weight babies.
Association of Serum Pentraxin 3 and High-Sensitivity C-Reactive Protein with Severity of Coronary Stenosis
Authors: Premnath Sujatha Mahadevarao , Nanda Sunil Kumar , Ray Lopamudra , Arokiaraj Mark Christopher , Ravichandran Kandasamy
Published: December 2022

Background:

Atherosclerosis being the keystone in the pathology of coronary artery disease (CAD) is a chronic inflammation of arterial intima mediated by various inflammatory markers. Pentraxin 3 (PTX3) and high-sensitivity C-reactive protein (hs-CRP) are the two important biomarkers of chronic inflammation that causes atherosclerosis.

Aims:

This study aims to investigate the association of serum PTX3 and hs-CRP with the severity of coronary stenosis in patients undergoing coronary angiogram.

Subjects and Methods:

A total of 80 patients who underwent elective coronary angiogram were included. Their blood sample was collected for PTX3 and hs-CRP estimation prior to angiogram. Based on the angiogram, the participants were divided into four groups based on the number of arteries affected. PTX3 was estimated using enzyme-linked immunosorbent assay and hs-CRP was assayed using latex-enhanced immunosorbent assay.

Statistical Analysis Used:

Kruskal–Wallis test was used to find the association of PTX3 and hs-CRP in each group and Pearson’s correlation was used to correlate PTX3 and hs-CRP with the extent of stenosis.

Results:

The mean PTX3 and hs-CRP levels in patients with some lesions in the coronary artery were 231.5 ± 129.9 pg/mL and 2.4 ± 0.4 mg/mL, respectively. The PTX3 levels elevate gradually with the severity of stenosis with P = 0.000 which is highly significant. A strong positive correlation was observed (R = 0.7929, P < 0.00001) with PTX3 and severity of stenosis. Whereas, for hs-CRP, the correlation was weaker (R = 0.3011, P = 0.006).

Conclusions:

PTX3 and hs-CRP can not only predict the number of arteries affected but also can differentiate between normal coronaries and CAD which can minimize the use of angiography.
Liver abscess in children – Clinical profile and outcome in a resource-limited setting
Authors: Rakholia Ritu , Rawat Vinita , Maroof Mohd
Published: December 2022

ABSTRACT

Background:

Liver abscess continues to be a major cause of morbidity in developing countries. There is no gold standard for management; it has to be tailor made for each child depending on availability of resources. We aimed to study clinical features, laboratory parameters, treatment, and outcome of children with liver abscess in resource-limited settings.

Materials and Methods:

This is a retrospective observational cohort study of children less than 16 years admitted in pediatric ward with diagnosis of liver abscess during 4 years duration (2016–2019). Demographic data, clinical features, laboratory, ultrasonographic (USG) and microbiological findings, management, and outcome were documented. For descriptive analysis, mean ± standard deviation/median with interquartile range, percentages were used and for testing association, Chi-square test and independent t-test were used. P value <0.05 was considered significant.

Results:

The mean age of children was 8.4 ± 4.4 years (19– 7 male and 11 female). Fever with chills was the most common symptom (19, 100%), followed by right upper quadrant pain (18, 89.5%), vomiting (7, 36.8%), and pleural effusion (6, 31.6%). Of the 19 children, 26.3% (5) were moderately undernourished and 63.2% (12) severely undernourished. Among the laboratory parameters, leukocytosis (16, 84.2%), anemia (19, 100%), and raised C Reactive protein (CRP) (19, 100%) were seen. Liver abscess on USG was solitary in 14 (73.7%), multiple in five (26.3%), in the right lobe in 14 (73.7%), and left in five (26.3%) with average volume of 104.5 ± 79.2 cc. Blood culture was positive in 22.2% (4/19) with growth of Staphylococcus in 10.4% (2), Pseudomonas in 5.2% (1), and Escherichia coli in 5.2% (1). Pus culture was positive in one (1/8, 12.5%) showing Pseudomonas. Half (9/19) of children were managed on only antibiotics and the other half (10/19) were managed by USG-guided aspiration on two to three occasions along with antibiotics successfully with no mortality.

Conclusion:

High index of suspicion in children with fever, right upper abdomen pain, positive CRP, and anemia should prompt an urgent USG. Liver abscess can be successfully managed by intravenous antibiotics and USG-guided aspiration in larger abscess, with no mortality. However, in case of signs of impending perforation, surgical management should be considered.
Adverse drug reactions reporting: Five years analysis from a teaching hospital
Authors: Thakare Vaishali , Patil Anant , Jain Mukta , Rai Vivek , Langade Deepak
Published: December 2022

ABSTRACT

Background:

Adverse drug reactions (ADRs) are important cause of morbidity and mortality. Despite its known importance, rate and quality (completeness score) of ADR reporting is not satisfactory. The objective of this study was to analyze pattern and completeness score of ADRs during past five-years.

Material and Methods:

In this retrospective study, ADRs reported between 2017 to 2021 were analyzed according to year, gender, age-group, pharmacological class and department. The completeness score of ADRs was calculated. The number of sensitization programs conducted over 5 years and its impact on the completeness score was also evaluated.

Results:

A total of 104 ADRs were reported among 61 (58.6%) female and 43 (41.4%) male patients. Adults (18-65 years) comprised the most affected age group, accounting for 82 (79%) patients. Out of all, 35.5% ADRs were reported in 2018, whereas 27% were reported during 2021. Except during 2017, percentage of females with ADRs was more. Department of pulmonary medicine and dermatology contributed to maximum extent in ADR reporting. Antibiotics [23 (22.11%)], antitubercular drugs (AKT) [21 (20.19%)], and vaccines [13 (12.4%)] represented the most common agents with which ADRs were reported. ADR reporting was very low in 2017 (4/104). Percentage improvement in completeness score in 2021 vs. 2018 was 11.95% (P < 0.05). Positive trend in the improvement of average completeness score with number of sensitization programs was observed.

Conclusion:

Incidence of ADRs was more common in females. AKT and antimicrobials are commonly implicated in ADRs. Increase in awareness of ADR reporting through sensitization programs can help to improve rate and quality of reporting.
Knowledge and attitudes of nurses toward sickle cell disease patients in Jazan
Authors: Abdeldafie Selwa Y. , Alaajmi Sameera O.
Published: December 2022

ABSTRACT

Background:

In this study, we look at the role of nurses in dealing with sickle cell disease (SCD) patients in Jazan city.

Objectives:

The aim of this study was to determine the knowledge of nurses and their attitudes toward SCD patients in Jazan hospitals, Saudi Arabia.

Materials and Methods:

In this cross-sectional, hospital-based study, based on the inclusion and exclusion criteria, we recruited 240 nurses from Prince Mohammed bin Nasser and Jazan general hospitals in Jazan city, Saudi Arabia. We depend on the validity and reliability of the instrument that were done by the author who prepared the tool of the primary research, and data management processing was incorporated. Statistical analysis was performed with the obtained data.

Results:

In this study, 24.2% of males and 75.8% of females were included. Of these, 40.4% of nurses between 35 and 40 years of age. About 50.4% has 10–15 years of working experience. 5% of the study participants’ salary is equal to 5000 SR which is the lower salary in the group of the participants. Also, 54.6% of nurses had a bachelor’s degree, 32.9% had a diploma, and only 12.5% had a master’s degree. Approximately 65% of nurses were married. Around 52% of nurses knew that SCD patients should have daily intake of 3 l of liquid and 44% of them recommended pop, juice, and broth. Among the sociodemographic variables, gender and income source were associated with attitude and knowledge scales, whereas among nurses’ groups, only marital status was associated (P < 0.05). Also, among the sociodemographic variables of nurses, There is statistically significant relation between the nurses’ knowledge and attitude and the demographic characteristics such as income levels, marital status and experiences as revealed by P.vale <0.05. In this study, 72.5% of nurses had poor knowledge score levels and 27.5% had good knowledge.

Conclusion:

This study concludes that the average total knowledge score was 8.41 and only 27.5% of nurses had good knowledge about SCD in Jazan region. This study also suggests increasing educational interventions, which could aid in improving nurses’ knowledge and attitudes toward SCD. It is recommended to conduct a similar study with a large number of professionals in order to generalize the findings.
COVID-19 exposure during pregnancy and low birth weight in community development blocks, Purba Bardhaman: A retrospective cohort study
Authors: De Arindam , Biswas Puspendu , Ray Soumalya , Hosen Sekh Faruk , Ghosh Harsha , Bhowmik Sanghamitra
Published: December 2022

ABSTRACT

Introduction:

COVID-19 exposure during pregnancy is hypothesized to affect the birth weight of the children. Community based findings on such hypothesis are scarce in West Bengal. This study was conducted with the objective to determine the relationship between low birth weight (LBW) and maternal exposure to COVID-19.

Materials and Methods:

In this retrospective cohort study, mothers of children, who were born between February 2020 and October 2021 and who were registered in the subcenters of Purba Barddhaman district, West Bengal, were selected as study population. Mothers who were diagnosed as COVID-19 positive during the antenatal period were considered as ‘Pregnancy with COVID’ and others were considered as ‘Pregnancy without COVID’. The minimum required sample size using Fleiss formula were 119 and 476, respectively, whose were selected through multi-stage random sampling. A schedule was used to collect data through review of relevant records of antenatal registers of sub-centers of selected individuals. The association was checked through multivariate logistic regression model where P < 0.05 was considered statistically significant.

Results:

Incidence of LBW in COVID pregnancy, Non-COVID Pregnancy group were 30.3% and 18.7%, respectively. COVID positivity during pregnancy shows relative risk of 1.62 and attributable risk of 38.28% for LBW baby as pregnancy outcome. Multivariate analysis reveals that LBW babies are significantly associated with COVID status during pregnancy (AOR 2.18, 1.3–3.63) after adjusting for anemia in pregnancy, incomplete antenatal visits, mothers age ≥30 years, parity and periods of gestation.

Conclusion:

The study concludes that COVID positivity during pregnancy significantly increases the risk of LBW as pregnancy outcome.
5G Technology for healthcare and its health effects: Wonders, dangers, and diligence
Authors: Jain Sunil , Jain Prem K.
Published: December 2022

ABSTRACT

“Radiation uses and ubiquitousness: The good, bad, and limits” an earlier review was published before launch of 5th Generation (5G) mobile networks technology. Now with 5G technology’s upcoming use, its advantages need to be used for advancing healthcare. All this for best applications possible and as safely as possible. The review update aims at reviewing the 5G technology benefits, risks, and its reduction. All this is important for rationale use. We searched the MedLine database and relevant statutory government recommendations. Results are discussed and put in proper perspective. Advantages are higher data transmission rates, lower latency and better quality of service. 5G technology will be beneficial for health services with shortened time and space. It will aid overcoming some of the current challenges to healthcare. The advantageous applications are elaborated for (1) proper assessment, (2) pertinent treatment, (3) progress monitoring, (4) prevention applications, and (5) professional standards. The concerns about possible adverse effects to human health needs to be addressed. The health effects of frequencies in the range 450 to 6,000 MHz are cautioned. There is a need of studies on nonthermal effects of the higher frequencies. In our present state of understanding and evidence, the useful strategies suggested are the “3Rs”: (1) risk-reducing devices, (2) risk-reduction necessarily, and (3) risk-reduction engineering and environment. Balancing risks and rewards are the best strategy forward. Robust communication will make excellent healthcare reach all, always and especially in times of need.
Aspergillosis-induced osteomyelitis involving the maxillary sinus with multiple extraoral sinus - A rare case report
Authors: Subramanian Mohithan , Mohan Karthik Rajaram , Fenn Saramma Mathew , Thangavelu Ravikumar Pethagounder
Published: December 2022

ABSTRACT

Aspergillosis is a deep-seated fungal infection caused by the fungus Aspergillus fumigatus. It is commonly seen among farmers, who frequently handle moist hay, which harbors the spores of the Aspergillus fungus. The infection is acquired by the inhalation of fungal spores and clinically manifests in immunocompromised patients. Such a case of Aspergillosis reported in a 50-year-old male patient with periorbital swelling and multiple sinuses near the lower left eyelid with a complaint of a non-healing socket after dental extraction and treated by coblation turbinoplasty under general anesthesia by endoscopic sinus surgery is described here.
Challenges and solutions adopted by frontline health managers in the management of routine health services during the COVID-19 pandemic at the grassroots level in India: A qualitative quest
Authors: Kundapur Rashmi , Aggarwal Sumit , Velamala Sunhitha , Rashmi Anusha , Gaitonde Rakhal , Masthi N R , Garg Suneela
Published: December 2022

ABSTRACT

Background:

The public health emergency due to COVID-19 has placed an immense burden on the health care system. The strain for provision of health care services has also extended to routine services. The future impact of this decline in facility provision can be seen in morbidity and mortality indicators of the country. In a time when the country is working toward meeting the sustainable development goals (SDGs), COVID-19 has become a setback.

Objective:

This study tries to find the very challenges faced by frontline workers and the measures adopted to overcome the same.

Materials and Methods:

This was a mixed methods study conducted at various selected states across the country based on their vulnerability index. Data was collected via in-depth interviews among 120 frontline managers. Transcribed responses were coded. Framework analysis with preformed codes were done. Quantitative data are represented as frequencies and percentages.

Results:

Analysis showed increased work pressure, innovative approach adopted locally, and allaying fear by reinstating services helped as coping mechanisms to take care of routine health care services at the grassroots level.

Conclusions:

The conscious effort of all involved with the use of local solutions and innovations, along with intersectoral coordination and efficient use of resources paved the way for a good deliverance of health care to the society. The frontline managers minimized the damage by using available resources consciously and wisely.
Assessment of knowledge, attitude, practice (KAP) regarding directly observed therapy (DOT) in tuberculosis among ASHA workers from tribal subpopulation zone of Rajasthan
Authors: Dwivedi Rakhi , Goswami Divya , Singh Pratibha , Singh Kuldeep
Published: December 2022

ABSTRACT

Introduction:

A high level of community awareness and positive perception towards tuberculosis and its management is crucial for the successful outcome of any control measure. In India the Accredited Social Health Activist (ASHA) plays a key role in providing awareness and counselling on healthcare issues and management, particularly in remote areas. The tribal population is vulnerable to such infectious diseases due to resource limitations and remote locations. We assessed the knowledge, attitude, and practice (KAP) regarding directly observed therapy (DOT) among ASHA workers in the tribal belt of the Sirohi district of Rajasthan state.

Material and Methods:

This cross-sectional study was conducted among ASHA workers of Sirohi district from January 2021 to June 2021. A predesigned and structured questionnaire was used to gather information on knowledge, attitude, and practices regarding the management of tuberculosis and DOT.

Results:

A total of 95 ASHAs participated in the study with a mean age of 35.82 years. Good knowledge (Mean score = 6.2947 ± 1.08052) was observed regarding tuberculosis and DOT. 81% (n = 74) have good knowledge regarding DOT whereas most have a poor attitude and only 47% have adequate practice. A 55% of ASHAs did not adhere even a single TB patient in the last three years.

Conclusion:

In our study, knowledge gaps were identified which may result in substandard patient care. The structured refresher training towards DOT and also training to work in tribal areas will further improve the KAP of ASHAs. It might be needed to provide a module or curriculum regarding awareness among ASHAs for strengthening follow-up system for tuberculosis patients among the tribal population.
Effect of lock down due to COVID-19 pandemic on the alcohol use and abuse among a tribal community in South India
Authors: Mathew Asha E. , Minz Shantidani , Vinodh Amala , Prasad Jasmin Helan , Paul John , Jebaraj Paul , Rose Anuradha
Published: December 2022

ABSTRACT

Background:

Alcohol consumption in the tribal communities is found to be rising, as Indian-made foreign liquor (IMFL) is easily accessible through state-run outlets. During the first coronavirus disease (COVID-19) lockdown, despite IMFL being non-available, there were not any reports of alcohol withdrawal among the tribal men who were enrolled in our substance abuse clinic.

Methodology:

This is a community-based, mixed-method study to document the changes during the lockdown in the drinking pattern and behavior of families and communities of men who consume alcohol. The quantitative part of the study was done by interviewing 45 alcohol-dependent men and documenting their alcohol use disorders identification test (AUDIT) scores during the lockdown. The qualitative part captured the changes in familial and social behavior. Focused group discussions (FGDs) were conducted among community members and leaders. In-depth interviews (IDs) were done among men with harmful drinking patterns and their spouses.

Results:

There was a significant reduction in the consumption of IMFL among the men interviewed as depicted by the low mean AUDIT score (16.42, P < 0.001). Trivial withdrawal symptoms were found among them (67%). Around 73.3% could access arrack. The community perceived that arrack was brewed and sold at a higher cost within days of lockdown. Familial conflicts reduced. Certain community leaders and members could proactively curb the brewing and selling of arrack.

Conclusion:

The study uniquely brought out in depth the information at the individual, familial, and community contexts. It is imperative to develop policies to protect indigenous populations by different rules governing the sales of alcohol.
The effect of different doses of vitamin D on the prognosis of patients undergoing carpal tunnel syndrome surgery
Authors: Noorizadeh Karim , Mohammadi Seyed Mohammad , Seifi Mozhgan , Moradi Mohammad Saeed , Sadoni Hanoon
Published: December 2022

ABSTRACT

Background and Objective:

Vitamin D accelerates myelin repair and recovery after nerve damage. This study aimed to evaluate the effect of vitamin D on the prognosis of patients with carpal tunnel syndrome (CTS).

Methods:

A randomized clinical trial was conducted in the orthopedic ward of Golestan and Imam Khomeini hospitals in Ahvaz for 2 years (from October 2018 to October 2020). Patients were divided into three groups: the first group received 1,000 units of vitamin D daily, the second group received 4,000 units of vitamin D per week for the first 4–6 weeks and then 2,000 units per month, and the third group received no vitamin D supplementation. The results were compared before and after 6 months between the study groups.

Results:

A total of 105 patients were included in the study, who were divided into three groups. The mean age of the patients was 39.24 ± 7.01 years (25–52 years). The mean level of the vitamin D in the control group was 25.40 ± 8.37 ng/mL, the group receiving 1,000 units/day was 26.71 ± 8.70 ng/mL, and the group receiving 50,000 units per week was 26.17 ± 8.63 ng/mL. The mean values of preoperative pain intensity, symptom severity, and functional status were almost the same in the three groups. These values were reduced after surgery in the two groups receiving the drug compared to the control group.

Conclusions:

The findings of the study showed that the administration of vitamin D supplementation in patients with CTS can significantly improve the postoperative symptoms of patients who underwent tendon release surgery and further improve the severity of symptoms and dysfunction of patients.
Patients’ sexual quality of life – Is enough weightage being given to it in onco-clinical practice?
Authors: Kumar Divyesh , Kiran Nali M.
Published: December 2022

ABSTRACT

Although quality of life (QOL) is an important endpoint of interest in most oncological treatments, sexual QOL of cancer patients is less emphasized upon. With an increase in the survival rates of cancer patients with time, besides other QOL-defining parameters, sexual QOL should also be taken into consideration. The article throws light upon this less talked about area in oncology, various reasons for its non-implementation, its need in routine practice, steps for improvement, and a multidisciplinary approach to provide better sexual QOL to our patients.
A cross-sectional study on the frequency and risk factors for neonatal hypoglycemia in babies born in rural Kerala
Authors: Pillai Swapna K. , Fhausiya V.K
Published: December 2022

ABSTRACT

Introduction:

Glucose is the main source of energy for the developing brain. Hypoglycemia is a commonly encountered and treatable problem in the neonatal period. The newborn baby should be breastfed soon after delivery and continued on demand breastfeeding. As families become nuclear, mothers may not have the necessary skills and knowledge about the importance of exclusive breastfeeding. Health care workers play an important role in preparing the mothers for exclusive breastfeeding and ensuring that the newborn remains euglycemic. Problems encountered during breastfeeding should be corrected on an individual basis, and uninterrupted feeding should be ensured as per BFHI guidelines.

Aim:

To find out the frequency and risk factors of hypoglycemia and its relation to feeding in babies of GDM mothers, large for gestational age, and small for gestational age babies in a baby-friendly hospital adhering to the BFHI guidelines.

Materials and Methods:

A single-center, observational study was carried out among 160 consecutively born babies born to mothers with gestational diabetes, large for gestational age and small for gestational age for a period of one year from October 2018 to September 2019. Data was collected using an interviewer administered proforma and from antenatal and postnatal records. Glucose monitoring was done and values were recorded. Data was analysed using SPSS software. Qualitative data was expressed as percentage. and quantitative data was expressed as mean and standard deviation. Association with risk factors was studied using the Chi-squared test.

Results:

The overall incidence of hypoglycemia was 15.3% in our study. The main risk factors identified were prematurity and small for gestational age. Maximum incidence of hypoglycemia was noted in the first 24 hours after birth. Incidence of hypoglycemia in exclusively breastfed babies was only 10.5% compared to those on formula feeds where breastfeeding was contraindicated due to medical reasons and where the incidence was found to be 33.3%. Incidence of hypoglycemia was 50%. The most common symptoms of hypoglycemia were jitteriness and poor feeding. Eleven per cent of babies had asymptomatic hypoglycemia. In babies detected to have hypoglycemia, prompt treatment with oral feeds or intravenous (IV) dextrose was started. There was no mortality in the study population.

Conclusion:

Incidence of hypoglycemia was maximum in the first hour of life, highlighting the need to start early feeds and to do meticulous monitoring in high-risk babies like pre-term babies, small for gestational age, large for gestational age and babies of diabetic mothers. The incidence of hypoglycemia in exclusively the breastfed group was 10.5%. This showed that confident and successful breastfeeding with the support of health care staff should be the norm to prevent hypoglycemia, and preparation for breastfeeding should begin right from the antenatal period.
Awareness about reproductive tract infection, its relation with menstrual hygiene management and health seeking behaviour: A cross-sectional study among adolescent girls of Lucknow
Authors: Singh Ankita , Kushwaha Sonam
Published: December 2022

ABSTRACT

Background:

The reproductive tract infection (RTI) is one of the major health issues associated with menstrual hygiene management which often goes unnoticed and hence remains underdiagnosed and untreated, resulting in devastating health effects on women. It gives way to some common complications like pelvic inflammatory disease (PID), ectopic pregnancy, infertility, adverse outcomes of pregnancy, neonatal morbidity and death (in case of a coexisting grievous disease like Human immune deficiency virus (HIV)).

Method:

A cross-sectional study was conducted in the rural and urban government schools of Lucknow, using two-stage cluster sampling separately for both urban and rural areas. Two schools (one co-education and one all girls) were chosen from each area. A total of 629 participants were taken for the study, 389 from urban and 240 from rural schools. The study subjects were taken proportionately from each school for an interview-based session using a pre-designed and pretested questionnaire. Descriptive analysis and Chi-square tests were used to analyse the quantitative data.

Result:

A total of 629 participants were taken for the study, from rural (240) and urban schools (389) of Lucknow. From urban, 50.9% had fair knowledge about RTI. Whereas 71.3% from urban had fair knowledge about RTI. Lower abdominal pain (54.8%) and vaginal discharge (32.6%) were the most common complaint reported by the participants related to RTI. Only 58.1% from urban and 32.6% from rural used sanitary pads as menstrual absorbents. The presence of vaginal discharge showed a significant relation (P value < 0.001) with the type of menstrual absorbent used.

Conclusion:

The knowledge related to RTI and menstrual hygiene practices has not changed significantly with time. Which is amongst the primary prevention that could be employed to prevent RTI and the consequences arising from a physiological cause.
Stake holder perspectives on the role of accredited social health activists (ASHAs) in Indian public mental healthcare space: A qualitative study
Authors: Varshney Prateek , Malathesh Barikar C. , Nirisha P.L. , Harshitha Nisha R. , Kulal Nithesh , Kumar Channaveerachari N. , Gajera Gopi , Suhas Satish , Rahul Patley , Harshitha H.A , Manjunatha Narayana , Manjappa Adarsha A. , Math Suresh B. , Thirthalli Jagadisha
Published: December 2022

ABSTRACT

Background:

Community health workers such as Accredited Social Health Activists (ASHAs) are existing resources who can facilitate the bridging of the mental health treatment gap. Knowing about the perspectives of ASHAs in delivering mental health care and other professionals with experience working in the area of community mental health is imperative.

Method:

As part of an implementation research project aimed at comparing the effectiveness of two training methods for community health workers (ASHAs), we conducted five focussed group discussions including four with ASHAs (n = 34) and one with other stakeholders (n = 10). Focussed Group Discussion (FGD) was conducted under the following themes: acceptance and feasibility of provision of mental health services from ASHA’s point of view and understanding the supply and demand side opportunities and challenges. The discussion began with open-ended questions, allowing for new themes to emerge until saturation was reached.

Results:

ASHAs were willing to incorporate mental health identification (and referral) in their regular activities without additional perceived burden. ASHAs were easily able to identify severe mental disorders (SMDs). For substance use disorders (SUDs), due to factors such as normalization of substance consumption and stigma, there was a felt difficulty in the recognition by ASHAs. ASHAs’ difficulty in identifying the CMDs was because of poor awareness in both those with mental illness and ASHAs. Incentivizing the work of ASHAs was thought to yield more returns.

Conclusions:

ASHAs have the potential to be excellent resources for easy screening, identification, and follow-up of those with mental health concerns in the community. Policies to involve them need to evolve.
A cross-sectional study of various clinical and laboratory parameters in snakebite and their association with mortality at a tertiary care centre in Jharkhand
Authors: Kumar Awanish , Dungdung Ajit , Kumar Abhinav , Shashank  , Kumar Ravi , Pandey Vikas , Priya Shimpy
Published: December 2022

ABSTRACT

Background:

Snakebite is a common occupational hazard in tropical countries such as India. India has the highest number of snakebites and accounts for nearly 50% of global snakebite deaths. Jharkhand is a state with abundant flora and fauna, with a large rural population, prone to snakebite deaths. We aimed to study various clinical and laboratory parameters in snakebite patients and their association with mortality.

Material and Methods:

This study was an analytical cross-sectional study conducted from October 2019 to April 2021. Snake-bitten individuals admitted in the in-patient department (General Medicine) of a tertiary care centre of Jharkhand state were included in this study. Information regarding gender, species of the snake, site of bite, symptoms (neurological and haematological), signs, reaction to ASVS, procedures performed (haemodialysis), general examinations, systemic examinations, and investigations were collected and analysed to predict mortality.

Results:

Out of 60 snakebite patients, 39 (65%) were males and 21 (35%) were females. Snakebite in 41.67% patients was because of unknown species, snakebite in 26.67% patients was because of Russell’s viper, snakebite in 21.67% was because of krait, and snakebite in 10% was because of cobra. 41.67% of individuals sustained bites over the right leg, 23.33% over the left leg, 18.33% over the right arm, and 15% over the left arm. Mortality was seen in 8 (13.33%) patients. Haemorrhagic manifestations including haematuria and haemoptysis were seen in 10 (16.66%) and 3 (5%) patients, respectively. Neurological symptoms were present in 27 (45%) patients. In laboratory examination, the total leucocyte count, international normalised ratio, d-dimer, urea, creatinine, and amylase were significantly high in the non-survivor group (all P values < 0.05). In this study, mortality was significantly associated with increased requirement of haemodialysis because of renal failure and an increase in duration of hospital stay (P value < 0.05). The duration of hospital stay independently predicts mortality with an odds ratio of 0.514 (95% confidence interval 0.328 to 0.805; P = 0.004).

Conclusion:

Early evaluation of clinical and laboratory parameters is needed to identify various complications (haematological and neurological) as they may prolong the hospital stay, leading to an increase in mortality.
Quality of life among those with diabetes mellitus type II attending a secondary outpatient facility in South India
Authors: Thomas Zachariah , Mathew Anna , Jowil Gabrin , Sriram M Karthick , Ranjan Manogya , Dhinagar Manoj J. , Abraham Vinod J.
Published: December 2022

ABSTRACT

Context and Aim:

Diabetes mellitus (DM) can affect one’s quality of life (QoL). Literature on the association of QoL among type II diabetics with drug compliance and diet quality among rural communities is poor. This study aimed to determine the QoL among those with type II DM attending an outpatient clinic at a secondary hospital in Tamil Nadu.

Settings and Design:

A cross-sectional, interview-based study was carried out among those with type II DM. A questionnaire comprising the WHO-BREF tool, Diabetes Healthy Eating Index, Hill-Bone Medication Adherence Scale was administered to participants selected via systematic random sampling.

Results:

The prevalence of good QoL was estimated to be 51.7% (n = 45, 95% CI: 41.20–62.20). There was no association between good QoL and medication compliance. None of the patients had a good diet quality. Bivariate analysis revealed significant association (p < 0.05) between good QoL and higher education (OR-2.70), those not on medication for complications (OR-2.81) and decreased frequency of general random blood sugar (GRBS) monitoring (OR-2.44). Multivariable analysis adjusting for gender, education, treatment/medication for complications, hospitalisation for DM and GRBS frequency demonstrated significant association between good QoL, lack of medication for complications/co-morbidities and decreased GRBS monitoring frequency with likelihood ratios of 3.25 and 3.44, respectively.

Conclusions:

The drop in QoL observed could be due to the aftermath of the COVID pandemic. Keeping in mind the impact of healthcare interventions on the QoL of type II DM patients, primary physicians must consider dietary and treatment plans suited to their socio-economic status.
Is the National Institute of Health Stroke Scale a valid prognosticator of the aftermath in patients with ischemic stroke?
Authors: Ramachandran Kavitha , Radha Devarajan , Gaur Archana , Kaliappan Ariyanachi , Sakthivadivel Varatharajan
Published: December 2022

ABSTRACT

Background:

Cerebrovascular disease is the second most common cause of death in people more than 60 years of age. Predicting the outcome of the stroke is a great challenge for physicians. Various risk factors such as age, sex, co-morbidities, smoking and alcohol habits, type of stroke, National Institute of Health Stroke Scale (NIHSS) score, modified Rankin Scale (mRS), and others play the role in the outcome of stoke.

Aim:

To assess the degree of impact of NIHSS score in comparison to the other traditional risk factors on the functional outcome and 30-day mortality by mRS in the patients with acute ischemic stroke.

Materials and Methods:

Patients with acute ischemic stroke and age more than 18 years were included. Their admission NIHSS score and the 30-day mRS were analyzed. Patients were divided into two groups as survivors and non-survivors.

Results:

The mean age of survivors and non-survivors was 59.77 ± 10.99 and 65.58 ± 6.67 years, respectively. The NIHSS score on day 1 for non-survivors was 21.21 ± 8.21, and almost half of this score was seen in survivors. The NIHSS score on day 1 had a significant association with mortality with a relative risk of 0.79 (95% CI = 0.70–0.89). The NIHSS score has 73.7% sensitivity and 74.1% specificity with cutoff value of 15.5 for discriminating the outcome of ischemic stroke.

Conclusion:

The NIHSS and mRS scales are simple, validated, easily applicable, and reliable tools for assessing the mortality and the functional outcome of ischemic stroke patients.
Cutaneous granular cell tumor: A case series, review, and update
Authors: Fahim Shabnam , Aryanian Zeinab , Ebrahimi Zahra , Kamyab-Hesari Kambiz , Mahmoudi Hamidreza , Alizadeh Nilufar , Heidari Nazila , Livani Fatemeh , Ghanadan Alireza , Goodarzi Azadeh
Published: December 2022

ABSTRACT

Background:

Granular cell tumor (GCT) or Abrikossoff’s tumor is an uncommon neuro-derived tumor in which Schwann cells are found and express S-100 protein. Often, it is a benign lesion. Histopathologically, there are granular cell infiltrations through the entire dermis without necrosis which are periodic acid Schiff (PAS) stain positive and reactive with S-100. The aim of this study is the clinicopathological evaluation of GCT.

Material and Methods:

In this paper, we described the experience of 6 patients with a GCT in different locations (4 cases in the skin and 2 cases in the mucosa), for example, a case with a tumor in the abdomen and a keloidal-like presentation with a highly sclerotic pattern (an uncommon pathological feature). Another case developed a lesion secondary to physical trauma.

Result:

In one case, the presence of a lesion in the lower lip associated with actinic damage secondary to chronic sun exposure resulted in misdiagnosis with actinic cheilitis and squamous cell carcinoma.

Conclusion:

Histopathologically, there were granular cell infiltrations through the entire dermis without necrosis which are PAS-positive and reactive with S-100.
Propranolol-induced hyperkalemia in infantile hemangioma patients: How serious is it?
Authors: Alakeel Abduallah , Alsalman Hanan , Alotaibi Ghadah , Somily Haneen , Alsohime Fahad
Published: December 2022

ABSTRACT

Background:

Infantile hemangioma is the most frequent benign vascular tumor of infancy, which has a specific clinical history of early growth, followed by spontaneous remission. Since the fortuitous discovery of propranolol’s efficacy in 2008, the management of infantile hemangioma has been quickly developing.

Methods:

This study is a retrospective cohort study. Electronic search in the patient’s registry of King Khalid University Hospital, Riyadh, Saudi Arabia, was performed using the keywords hemangioma, haemangioma, infantile hemangioma, and vascular tumors. The search revealed a total of 101 subjects for which 56 were included and 45 were excluded.

Results:

A total of 56 patients with infantile hemangioma were evaluated in this study. The majority were females. The F: M ratio is 3.4:1. The highest percentage of the patients was delivered by the elective cesarian section, that is, 23 (41.1%), followed by spontaneous vaginal delivery, that is, 19 (33.9%). Full-term patients were 27 (48%), whereas the pre-term patients were 21 (37%). The total number of patients who developed hyperkalemia while on propranolol was 12 (31%). There was no statistically significant difference (P > 0.05) between patients who developed hyperkalemia and patients who did not develop hyperkalemia in terms of gender, gestational age, mode of delivery, size and location of hemangioma, or concomitant topical timolol use.

Conclusion:

Hyperkalemia is benign and transient, although solid conclusive opinions cannot be drawn because of the small sample size and the retrospective nature of the study.
Delayed lung function testing after COVID-19 to detect persistent lung function abnormalities – The DELTA – COVID-19 lung function study
Authors: Nirmal Aparna S. , Venkitakrishnan Rajesh , Augustine Jolsana , R Divya , Cleetus Melcy , Vijay Anand , John Susan
Published: December 2022

ABSTRACT

Background:

Coronavirus disease 2019 (COVID-19) has made its presence felt as the worst pandemic witnessed till date in the 21st century. The mortality and morbidity associated with COVID-19 does not end with the acute pneumonia and respiratory failure and consequences extend well into the subsequent weeks to months in a minority. After recovery from severe disease, symptoms, lung function abnormalities and radiological changes are known to persist for varying length of time in a small proportion of patients. Various studies report different incidences of lung function abnormalities post-COVID-19. The present study describes the occurrence, severity, pattern and risk factors for persistent lung function abnormalities post-COVID-19 patients.

Aim:

The present study was aimed to find out the occurrence of persistent lung function abnormalities in patients hospitalised with COVID-19 at three months of discharge who had normal previous lung function prior to COVID-19. In those with persisting abnormal lung function, the severity, pattern and risk factors for persistent lung function abnormalities were also studied.

Methods:

The present study was a retrospective study in patients hospitalised with COVID-19 who had radiological evidence of pneumonia at admission. Patients with prior abnormal lung function were excluded from the study. Lung function was analysed with spirometry, 6-min walk test and diffusion capacity between day 85 and 95 of hospital discharge and the occurrence, severity and pattern of impairment was described. Lung function impairment was correlated with baseline characteristics and univariate regression analysis was done to identify risk factors for persisting functional impairment.

Results:

39 patients were included in the study. Spirometry at follow up showed a restrictive ventilatory defect in 26 out of 39 patients (64%) and a normal study was noted in 12 patients. One patient had an obstructive ventilatory defect. Diffusion impairment was present in 27 patients and normal transfer factor was seen in 12 patients. The degree of diffusion impairment was mild in 16 patients and moderate in 11 patients. Univariate regression analysis revealed that age, history of systemic hypertension, severe hypoxia at presentation, and extent of lung involvement by CT chest were associated with lung function impairment.

Conclusion:

Almost two-thirds of patients hospitalised with COVID-19 pneumonia have persistent lung function abnormalities at three months post-discharge. Advanced age, severe disease and medical comorbidities increase the risk of persistent functional abnormalities.