bluuebunny/crossref_metadata_2025 huggingface dataset:
A study of clinical, etiological and neurodevelopmental profile of epilepsy in children aged 0-5 years
Authors: Chanpura Vaishali R. , Mori Hardev T.
Published: June 2021

Background: Seizures constitute the most common neurological problem in children. Appropriate diagnosis and management of childhood epilepsy is essential to improve quality of life in them. Objectives of the study were to study the clinical and etiological profile of early childhood epilepsy and its effect on neurodevelopment.Methods: This was a time bound study; duration being one year from September, 2018 to September 2019. All new patients with acute seizures or status epilepticus admitted in paediatric emergency ward were evaluated and those meeting inclusion criteria were enrolled. On the basis of history, neurological and systemic examination and available investigations primary diagnosis of epilepsy was reached. Neurodevelopmental parameters like vision, hearing, and DQ were assessed. EEG was done in all patients. Other relevant investigations like neuroimaging were carried out when indicated. Collected data was analysed in form of frequency and percentage.Results: A total of 52 patients were enrolled. 60% patients were younger than 2 years. Maximum patients had generalised convulsions; generalised tonic-clonic being the most prevalent. 38% patients had significant perinatal complications like perinatal asphyxia, pyogenic meningitis and kernicterus. Fifty per cent patients had delayed milestones and half of those had severe delay. 67% had abnormal EEG and 20 patients had abnormal neuro-imaging findings. The most common etiologies for epilepsy were hypoxic ischaemic encephalopathy, idiopathic, epilepsy syndromes, metabolic disorders and CNS infections.Conclusions: Majority of early childhood epilepsy is a result of either genetic conditions or perinatal events. They have neurodevelopmental and behavioural associations. While treating epilepsy all these factors should be considered in order to ensure a near-normal life for these patients.
Pattern of congenital heart diseases among children attending a pediatric cardiology OPD of a tertiary level hospital in West Bengal, India: a retrospective study
Authors: Islam Nurul , Mandal Suprakash , Ahamed Farhad , Biswas Soumyadeep , Dey Chandrasekhar , Khan Krishnendu , Ghosh Tandra
Published: June 2021

Background: Congenital heart disease (CHD) is one of the most common congenital defects worldwide. The prevalence of CHD is low in India mostly due to under detection. The knowledge regarding socio-demographic factors, other congenital anomalies/syndromes and social impacts associated with CHDs in India is grossly lacking.Methods: This was a retrospective study. Details of all diagnosed pediatric (age 0-14 years) cases of CHD were recorded by a single cardiologist from the year 2013 to 2020. Duplicate entries were removed and CHDs were classified according to Q20-Q28 of tenth revision of international classification of diseases (ICD). For description purposes, the CHDs were divided into 10 sub-groups.Results: Total 9247 cases of CHDs were recorded during the study period. Ventricular septal defect was the most commonly identified CHD (32.1%). Most cases were acyanotic (69.8%) and presented first time at age of more than two years. Almost 1.5% cases were associated with other non-cardiac congenital defect or syndrome. In 1.0% of cases either mother or the child faced social or family problem due to the disease.Conclusions: CHD is an emerging public health problem. It is associated with other congenital anomalies/syndrome. Mandatory screening for birth defects needs to be initiated at all birth facilities. At birth counseling of the parents need to be implemented due to the associated social issues.
Cranial imaging in children with malnutrition aged 6 to 60 months
Authors: Tiwari Kavita , Goyal Suresh , Soni Ravi , Devaraj Sunilkumar , Goyal Saurabh , Gahlot Kushal
Published: June 2021

Background: India has 57 million or more than a third of the world's 146 million undernourished children. Protein energy malnutrition is associated with cerebral atrophy 2 which may be detrimental to intellectual development. The aim and objective of this stusy was to study the changes in the brain by cranial imaging in children with malnutrition aged 6 months to 5 years and to correlate these changes with severity of malnutrition.Methods: It was a hospital based prospective study done in Bal Chikitsalay, Maharana Bhupal government hospital, Udaipur during the study period July 2015 to July 2016. Total 120 children were enrolled, out of which 80 were severely malnourished, 20 were moderately malnourished and 20 normally nourished children undergoing neuroimaging for some other reason taken as controls. All the cases were subjected to CT scan and the following parameters were noted. Central atrophy was evaluated by bifrontal index (BFR) and bicaudate index (BCR). Cortical atrophy was evaluated by width of sylvian fissure (SFW) and widening of interhemispheric fissure (IHD). These parameters were then compared with the severity of malnutrition and among controls. Data was analysed with standard software of biostatics using parametric tests, Pearson’s correlation analysis, ANOVA test and student’s t test.Results: On an average 80% of SAM and 10% of MAM had various degree of cerebral atrophy while none of the controls showed significant degree of cerebral atrophy.Conclusions: Effect of malnutrition on brain can be objectively assessed by CT indices, BFR, BCR, SFW and IHD to define the degree of cerebral atrophy in the malnourished population.
A case report of Graves’ disease following SARS-CoV-2 infection
Authors: Rockett John , Nelson Colbert , Pierce Robert , Morlan Amie Van
Published: June 2021

SARS-CoV-2 pandemic has had significant impacts on the world. The longer the pandemic continues the more we learn about the virus behind it and the post-infection complications. SARS-CoV-2 infections have been associated with immune dysfunction and thyroid disease. The spectrum of thyroid disease reported spans from subacute thyroiditis to Hashimoto’s thyroiditis. We report a 16-years-old patient whose COVID-19 infection was followed by multiple complications including the appearance of symptomatic Graves’ disease. Laboratory analysis was significant for elevated TSH, low free thyroxine, and antibodies consistent with the diagnosis of Graves’ disease. This is the first case of Graves’ disease after COVID-19 infection to be reported and the first case of thyroid dysfunction secondary to COVID-19 infection reported in the pediatric population. The spectrum of thyroid and autoimmune disease following COVID-19 is discussed. Further research into the underlying pathology behind COVID-19 infection and immune dysfunction will lead to expediated diagnosis and improved patient outcomes.
The modified Nadeem’s technique for the treatment of H-type tracheoesophageal fistula
Authors: Zahra Fatima Al , Akhtar Nadeem , Khan Sana , Abdullah Saif Mohammed Abdulmomen , Butt Muhammad Umair , Syed Ramsha
Published: June 2021

An H-type fistula is an unusual category of the tracheoesophageal fistula to occur constituting only 5 % of all cases. The continuity of the esophagus leads to a delayed and vague presentation with a complaint of choking on feed and respiratory issues unlike the inability to feed and frothing soon after birth in other variants of tracheoesophageal fistula. We received a referred case of a 3-months-old male having recurrent respiratory tract infections and episodes of choking. After a thorough evaluation, a suspicion of H-type fistula was encountered that led to refined radiological evaluation. Contrast given per oral also delineated fistula and CT scan with intravenous and oral contrast revealed fistulous communication between two channels. Operated for H-type fistula through the modified Nadeem’s technique via a left cervical approach and discharged after uneventful recovery. The modified Nadeem’s technique via a left-sided cervical approach facilitates access, vision, and intervention easily as compared to the conventional right-sided approach given in the literature.
Malignant infantile osteopetrosis with rickets presenting with bicytopenia in septic shock: case report
Authors: Govindarajan Varun , Mohammed Thanzir , Jagadish Meghana , Kariyappa Mallesh
Published: June 2021

Malignant infantile osteopetrosis is a rare, fatal autosomal recessive disorder due to abnormal osteoclast activity. We report a 1-year-old infant, born to consanguineously married couple, who presented to our ER with acute respiratory distress and bicytopenia. He had tender hepatomegaly, splenomegaly, failure to thrive and features of rickets. He was evaluated previously for possible hydrocephalus secondary to his abnormal shape of head with proptosis, MRI revealed a subarachnoid cyst, but possibility of osteopetrosis was missed. Skeletal radiographs done later detected dense, sclerotic bone with sandwich vertebra, provided a delayed diagnosis of MIOP. Rickets, a paradoxical association, was also seen in our case, with low serum calcium and vitamin D3 levels. He succumbed due to severe bronchopneumonia with septic shock. Early diagnosis and timely hematopoietic stem cell transplant are the only curative approach for MIOP, which is otherwise fatal.
Measles like syndrome after measles and rubella vaccination
Authors: Prasad Tulsi
Published: June 2021

National vaccination program (NIS, IAP) provides vaccination for measles and rubella (MR vaccine) for all children below 15 years of age. After vaccination with live attenuated viruses, the virus replicates on a limited scale. Replication may lead to mild symptoms occurring 5-14 days after MR-vaccination including fever, conjunctivitis and rash but sometimes it leads to florid type of severe rashes which are indistinguishable from a wildtype measles infection. A measles like syndrome may occur following MR vaccination, although it seems to be a rare event and therefore as a pediatrician we must take out time to educate and reassurance the parents about this benign nature and so as to avoid unnecessary problems in future. A 14 year old female child was admitted in our hospital with an impressive (florid) rashes, 7 days after MR vaccination in our vaccination clinic. Diagnostic tests were negative for measles and other infections and was discharged after 7 days of nursing and supportive care. Within 14 days after MR vaccination, a child can present with symptoms very similar to a wildtype measles virus infection. The low incidence of wildtype measles infection after MR vaccination, strongly suggests that these symptoms will likely be a reaction to MR vaccination. To elaborate lots of diagnostic procedures may cause the parents a lot of stress and therefore offering nursing care, supportive care and reassurance to parents may be more appropriate and effective in such cases.
Epitheloid granuloma of bone marrow- not always tuberculosis, think beyond what you see
Authors: Sneha Latha M. , Thayammal Indhuumathy S. , Priyathersini Nagarajan , Vilvanathan Vairan
Published: June 2021

Extra pulmonary tuberculosis has varied presentations and hence fever of unknown origin, with malaise, weight loss and cytopenias is generally attributed to tuberculosis in endemic regions. Tuberculosis being the most frequent cause of bone marrow granulomas, there is a risk of labelling granulomatous lesions as of infectious etiology when underlying etiology has an atypical presentation. Progressive painless lymphadenopathy, most commonly involving the cervical or supraclavicular area is the commonest presentation of Hodgkin’s lymphomas (HL) in 80%. Primary extra nodal presentation of HL is rare. We describe a case of an adolescent girl who presented with fever of unknown origin, weight loss, malaise, hematological derangements and bone marrow showing granuloma, all features pointing towards an infectious etiology, but later proven to be a case of HL.
Case report of early biotinidase deficiency, a type of multiple carboxylase deficiency
Authors: Rajesh Cheruku , Babji N. Shivaramakrishna , Siddiq Mohammed Ashraf Mohiddin
Published: June 2021

Early biotinidase deficiency is an inherited form of multiple carboxylase deficiency leading to increased accumulation of biocytin and decreased biotin, predominantly effecting the central nervous system and skin. The symptoms can be reversed by early biotin supplementation.
Sustaining viability in a pre-gangrenous bowel with midgut volvulus
Authors: Zahra Fatima Al , Akhtar Nadeem , Khan Sana , Abdullah Saif Mohammed Abdulmomen , Butt Muhammad Umair , Syed Ramsha
Published: June 2021

Midgut volvulus is a condition peculiar to neonates having acute abdomen. The condition is anticipated in any neonate having bilious vomitus and inability to pass stools. This being a surgical emergency does not sanction any time-consuming radiological procedures, thus, history and the clinical picture are sufficient to warrant surgical exploration. A sick neonate in the 2nd week of life presented with all signs and symptoms of midgut volvulus for which he was explored. Exploration gave the outlook of a necrotic midgut along its entire length. No haste was made in resection as it had a fatal prognosis for survival, instead, watchful waiting opted after necessary measures were taken to allow for the resumption of perfusion. Not only the baby survived to undergo a relook laparotomy showing marked improvement but also showed improvement in lab values and started passing stool and tolerating orally after a wait of three weeks post 1st laparotomy. Midgut volvulus leading to seemingly necrotic intestine should be given due consideration by relook surgery. The alternative would be total resection followed by short bowel syndrome, need for an intestinal transplant while being on TPN. This approach gives an immense advantage by giving the gut a fair chance to restore its perfusion by gut rest after de-twisting.
Emergency atrial septostomy with nasogastric tube through umbilical venous route in neonates with critical congenital heart defects
Authors: Kariyappa Mallesh , Govindarajan Varun , Hanumanna Anil Kumar , Nagarasaiah Ashwini Harohalli , Jagadish Meghana
Published: June 2021

Neonates born with critical duct dependent congenital heart diseases acutely deteriorate in first few days after birth when physiological conduits which allow for mixing blood close. Balloon Atrial septostomy is performed on emergency basis in such neonates to create a right to left intracardiac shunt, until a definitive surgery is performed, but requires a cardiac intervention setup. In settings where advanced cardiac interventions are not available, we propose an alternative approach for atrial septostomy using nasogastric feeding tube through umbilical venous route, under echocardiographic guidance. Feeding tube gradually inserted into the umbilical vein, reaches the right atrium, following which it is thrust into the atrial septum at the location of foramen ovale, perforating it to create an emergency conduit between the atria. We performed the above procedure in a neonate with dTGA at our NICU setup, with partially successful outcome. We propose this method as an alternative, safe, simple and cost effective procedure, though not definitive, in resource limited settings for emergency stabilisation of neonates with critical duct dependent heart defects.
A rare case of acquired infantile Bell’s palsy
Authors: Mulinja Lakshmi , Mohammed Thanzir , Govindarajan Varun , Kariyappa Mallesh
Published: June 2021

Bell’s palsy, an acute onset, acquired, isolated peripheral facial palsy, usually follows a viral illness, is common disorder post infancy to adolescence. It has a favourable prognosis with spontaneous resolution, or with use of oral corticosteroids. Its presentation in early infancy is very unusual, as in our case report of 3 month old infant with an ovoid mass lesion in parotid, which disappeared after therapy with corticosteroids with no residual deficit.
COVID-19 associated mucormycosis in head and neck region of pediatric patients: a life-threatening disease in current pandemic
Authors: Swain Santosh Kumar
Published: June 2021

Mucormycosis is a severe form of fungal infection and often affect immunocompromised patients. It is associated with high morbidity and mortality and characterized by extensive angioinvasion and necrosis of the affected tissue. It is potentially fatal invasive fungal infection in the pediatric age group. It results in rapid spread of the disease with tissue destruction and its nature of angioinvasion can cause wide-spread dissemination. Currently this dreaded mucormycosis is rising among COVID-19 pediatric patients during their treatment period or after their discharge from hospital. It is also called COVID-19 associated mucormycosis (CAM) or black fungus. Classically, uncontrolled diabetes mellitus (DM) and other immunosuppressive conditions or corticosteroid therapy during COVID -19 treatment are known risk factors for causing mucormycosis in pediatric patients. Early identification and prompt treatment in pediatric patients with CAM are required. In the head and neck area, rhino-orbital-cerebral mucormycosis is a fatal clinical entity associated with COVID-19 infections result in higher morbidity and mortality of the pediatric patients. Aggressive endoscopic surgical debridement for local control and appropriate systemic antifungal treatment will help to improve the prognosis and survival of the patients. The aim of this review article is to discuss the detail of epidemiology, etiopathology, clinical profile, diagnosis and current treatment options of the CAM in children.
Chemical hazard and healthcare workers; findings from a tertiary health institution in south-western Nigeria
Authors: Akinyemi Patrick A. , Adeomi Adeleye A. , Ogundiran Abdulrahaman , Okoro Nnamdi , Madaki Kamil
Published: June 2021

Background: Improvement in diagnostic and therapeutic services has further increased the hazards in healthcare facilities, particularly the chemical hazard. Therefore, the need for more focus on chemical hazard exposure among healthcare workers. This study aimed to assess the perception of healthcare workers about chemical hazards associated with their job and the pattern of adopted preventive measures.Methods: A descriptive cross-sectional study was employed. One hundred and seven healthcare workers were enrolled in the study. The sample size was proportionally allocated to various departments that provide care directly to patients. Data on workers’ perceptions about chemical hazard exposure and utilization of preventive measures were obtained using self-administered questionnaire.Results: Majority of the respondents had high level of awareness (86.0%) and knowledge (81.3%) of chemical hazards. About one-fifth, 24 (22.4%), had experienced inadvertent exposure to chemical hazards. Gender, knowledge, and perception of chemical hazards had statistically significant associations with the use of personal protective equipment (PPE). Females are more likely to use PPE than male (odds ratio=5.1, p=0.008) and respondents with good perception of chemical hazard exposure are more likely to use PPE relative to respondents with poor perception (odds ratio=11.8, p=0.018). Standard operating procedures were available to less than half of the respondents, 52 (48.6%).Conclusions: There is a need for continuous strengthening of available safety measures to further reduce incidences of inadvertent chemical hazard exposure. The hospital management should ensure availability of standard operating procedures at all service locations.
Compliance and adherence to drug treatment on patients with chronic kidney disease in high prevalence areas of North Central Province, Sri Lanka
Authors: Chathuranga Dilan , Manathunga Harith S. , Gunasekara Sumali K. , Jayasekara Kithsiri B. , Sanjeewani Ashoka
Published: June 2021

Background: Chronic kidney disease that cannot be explained by traditional factors such as hypertension, diabetes mellitus is called chronic kidney disease unexplained etiology. With limited evidence on the success of interventions in enhancing medication adherence, this study was designed to test patient compliance and adherence on taking medication in North Central Province in Sri Lanka.Methods: A cross sectional study was conducted in a selected area of NCP to identify compliance, adherence. Data was collected using an interviewer administered questionnaire by visiting patients at their own residences.Results: A total of 200 people participated in this study. 92.5% of the population was involved in agriculture and 63% worked more than 1 acre of farmland. Among the selected population (74%) were not educated about the side effects of medication. 60.5% had missed taking their medicines during the prescribed time period. The entire population of the study was selected among patients having a monthly income of less than 15,000 Sri Lankan rupees. There was a statistically significant association in missing doses with land extent, patient’s income and stages of the disease.Conclusions: Non adherence and compliance to the medication is common in patients that worked in largely extended lands, were in late stages of the disease and had reduced income. Compliance and Adherence to the medication can be enhanced by proper counseling and improving patient’s knowledge about their medication.
Transferring performance-based financing practices in Burundi health system: the role of actors’ interactions
Authors: Ndayishimiye Richard , Niyondiko Dominique
Published: June 2021

Background: For the past twenty years, African countries have experienced a massive deployment of performance-based financing practices within health systems. These numerous transfers involved several actors of different profiles and who intervened at different levels. At a time when many actors in their diversity are playing key role in the success or failure of the transfer process, the role of actors’ interactions in the transfer process of performance-based financing practices remains however less explored in context and in depth. This paper aimed to explore the role of actors’ interactions in the deployment of this process within Burundi health system.Methods: We conducted a case study of the transfer of performance-based financing practices within Burundi health system. 32 semi-structured interviews were carried out in addition to documentary technique and observation. In a qualitative approach, our interpretive approach followed an abductive reasoning to interpret the data collected. Conceptualization using NVivo12 software allowed to perform thematic and content analysis.Results: We argued that the transfer setting, the organizational specifics, the nature of the transferred practices, the levels of operationalization and the actors’ perceptions are determining factors of the deployment of the transfer process of performance-based financing practices. Moreover, the actors’ interactions as well as their causes and their effects affect the deployment of the transfer process.Conclusions: The actors’ interactions are shown to play moderating and mediating roles in the process of transferring those practices. Future research could focus on verifying and validating this role with quantitative methods.
Factors associated with knowledge about the health effects of exposure to secondhand smoke among youth in Bangladesh
Authors: Sultana Rabeya
Published: June 2021

Background: Despite the high prevalence of secondhand smoke exposure among Bangladeshi adults, little is known about the knowledge regarding the health effects of exposure to secondhand smoke among the youth aged 15-24 years in Bangladesh. Against this background, the present study was conducted among the youth in Bangladesh to ascertain their levels of knowledge regarding health effects of secondhand smoke and its associated factors.Methods: This was a cross-sectional study of 656 respondents between the age of 15-24 years old selected by multistage cluster sampling. This study was conducted in Dhaka Division, Bangladesh. Data was analyzed using Chi square testing and multivariate logistic regression.Results: The proportion of good, average and poor knowledge scores among respondents were 30.5%, 50.0% and 19.5% respectively. Age and education were significant independent predictors of good knowledge. Furthermore, education and gender were tended as independent predictor of average knowledge. OR for age: 1.12 (95% CI: 1.01 to 1.25); OR for education: 1.27 (95% CI: 1.15 to 1.40).Conclusions: Overall, the results of this study found that less than one-third of the youth had a good level of knowledge on secondhand smoke health effects. The government needs to focus more on less-educated individuals and adolescents if a successful policy is to be implemented.
Study of self-drug administration among 3rd professional medical students
Authors: Bhushan Rabi , Chandra Akash , Verma Raj Kishore
Published: June 2021

Background: Self-medication is very common in our day-to-day life which is an unhealthy and risky practice. Present study was done to determine the knowledge, attitude and practice among 3rd professional medical students of Shaheed Nirmal Mahto Medical College and Hospital, Dhanbad.Methods: A questionnaire related to self-medication with consent was prepared and distributed among the students of 3rd professional. Data was collected and analysed the results expressed as counts and percentages.Results: Total 50 students participated in the study for taking self-medication and was no need to visit the doctor for minor illness. In maximum students, source of information of the drugs used for self-medication pharmacological based and learning process in the college. The source of drug was medical store. Most of the students took self-medication for loose motion and headache followed by cough, cold and fever. Out of total 50 students, most of the students took paracetamol tablet as self-medication.Conclusions: This study showed that third professional medical students after they studied pharmacological books, they do not use any wrong medicine as self-medication. High level of awareness of 3rd professional students has minimized self-medication.
Menstrual hygiene management practice among adolescent girls: a cross sectional study in Nepal
Authors: Gautam Koshish Raj , Dahal Harsha Raj , Karki Kshitij , Acharya Shradha , Subedi Suraksha , Upadhyay Abinash , Shah Sanjeev Kumar
Published: June 2021

Background: Good menstrual hygiene is fundamental to health, hygiene and well-being of women and girls. As menstruation itself considered as taboo in Nepalese society, it has direct impacts on the health of the women and adolescent. The objective of the study is to assess the knowledge and practices regarding menstrual hygiene management among adolescent girls.Methods: A cross- sectional study design was conducted among 398 samples. Simple random sampling was done to select the resource center schools and probability proportionate sampling (PPS) technique used to get sample size. Structured interview schedule is used to collect data and analysed from SPSS software after validation.Results: Knowledge on menstrual hygiene management was good in urban adolescent girls (93.69%) as compared to rural (6.31%). Similarly, level of practice was good regarding menstrual hygiene management was good in urban adolescent girls (91.29%) as compared to rural (8.71%). Place of the residence and knowledge level of the adolescent girls was highly significant (p<0.001).Conclusions: The findings showed that rural adolescent girls had poor knowledge, various misconceptions and inadequate practices regarding menstrual hygiene management.
An account of alternative and complementary medicine and its scope in a clinical scale
Authors: Maduskar Saumil
Published: June 2021

Background: Alternative medicine is the practice of using alternative therapies as treatment modalities and complementary medicine is their inculcation with conventional medical practices. The purpose of this article was to judge people’s perception of these practices and assess societal attitude towards alternative and complementary medical practices.Methods: A survey was conducted among non-medical professionals to assess their attitude towards alternative medicine. They were asked questions with multiple choices to choose from in order to grade their attitude towards and comprehension of alternative and complementary medicine. The questions were designed in a way so as to demand responses ranging from their last visit to an alternative medical therapist to their reason for their visit and their experience.Results: It was observed that most people surveyed were aware of the difference between conventional and complementary medicine but usually visited an alternative therapist without consulting their physician. It was documented that most people were misguided about the actual benefits of complementary medical practices and a majority of the surveyed population chose either alternative medicine or conventional medicine but very few were willing to integrate the two.Conclusions: Alternative medicine is extremely beneficial when used in tandem with conventional medicine and provides numerous benefits. Its use and propagation however must be strictly monitored in order to prevent quackery and the spread of misconceptions regarding its effects.
A hospital based case control study to explore the association between Bruxism and Cardiovascular diseases in Kangra region of Himachal Pradesh
Authors: Bhatia Ragini , H. Divya Nair , Bhatnagar Mukul Kumar , Sood Saloni , Kumar Praveen , Chaudhary Rajesh
Published: June 2021

Background: Cardiovascular diseases (CVDs) have a huge social and economic impact all over the world. Therefore research needs to analyse emerging risk factors for CVDs. Bruxism is a health problem that has low prevalence in the community but may be associated with CVDs. It leads to poor oral health and significantly impacts the quality of life. Studies showing association of CVDs and Bruxism are sparse and, none in Indian context.Methods: This study was conducted in two hospitals of Kangra region of Himachal Pradesh between the months of April 2020 to June 2020. Due to rising infection rates of COVID-19 cases, 160 patients were enrolled in the study and divided into two groups. 80 patients with a positive history for CVD were included as cases while another 80 patients without any known history for CVD were included in the control group. Self-reporting questionnaire and tooth wear index (TWI) were used as research instruments.Results: An unadjusted odd’s ratio of 2.43 (95% CI, 1.28-4.68) and p value of 0.0069, was found when only self-reported bruxism was taken into account. But when self-reporting of bruxism was combined with TWI, an unadjusted odd’s ratio (logit OR) of 3.16 (95% CI, 1.66-6.21) and p value of 0.000529 was found, explaining that the odds of having CVD are 3.16 times higher in patients with bruxism than in those without bruxism.Conclusions: Bruxism is significantly associated with cardiovascular diseases. More studies, with larger sample size are required to firmly establish the causative relationship between bruxism and CVDs.
Problematic internet use, depression, stress and anxiety amongadolescents in an urban area in South India: a cross sectional study
Authors: Rajanna Kavya , Sathyanath Shreyaswi M.
Published: June 2021

Background: Internet usage is ubiquitous, especially among young population in urban India. The present study aims to assess the burden of problematic internet use and to determine its association with depression, anxiety and stress among adolescents in urban South India. We have also assessed the role of parental/care giver factors in internet usage among the adolescents.Methods: This was a school based cross sectional study among two high schools in urban field practice area. The students were administered validated questionnaire on sociodemographic details, parental/care giver factors, pattern of internet usage, problematic and risky internet use screening scale as well as depression, anxiety and stress scale-21.The descriptive data was analysed as proportions and associations were determined using Chi square tests.Results: 24% of students had PIU and this was significantly associated with stress, depression and anxiety. 33% had stress and class of studying was found to be the only significant determinant. Almost half (48%) had depression and class of studying, type of family as well as mother’s occupation were the significant determinants. Half (50%) had anxiety with the significant determinants being age, class of studying, type of family, type of school, religion and father’s education. The only common factor found to significantly affect internet usage was parental rule setting and supervision.Conclusions: Depression, stress and anxiety were associated with PIU. Setting and enforcing reasonable rules while maintaining trust and emotional support is essential to protect adolescents from the harmful effects of problematic internet usage.
Anxiety and panic buying of population of India during COVID-19: the mediating role of adjustment
Authors: Modi Ritu , Tipandjan Arun , Mishra Laxmi D. , Gupta Chhavi , Nithiya Devi R.
Published: June 2021

Background: The aim of the study was to study the relationship between coronavirus anxiety, panic buying, work and social adjustment. It also examines how adjustment mediates the relationship between coronavirus anxiety and panic buying.  Methods: The study's total sample size was 450 participants aged 21-76 years. Both genders were equally represented in the sample, with 225 males and 225 females. An incidental sampling technique was adopted for data collection. Data was collected using a Google form survey from participants who consented to participate in the research from various Uttar Pradesh, India cities. The socio-demographic details and corona anxiety, panic buying and work and social adjustment related responses were recorded.Results: The results indicated that coronavirus anxiety, work and social adjustment, and panic buying are significantly correlated with each other. Results showed that coronavirus anxiety and work and social adjustment would significantly variance in panic buying scores. It was also found that work and social adjustment mediated the relationship between coronavirus anxiety and panic buying.Conclusions: It was evident from the results that panic buying results from fear and negative emotions. This demonstrates the importance of adjustment training to cope with sudden or future uncertainties in a better manner. This could help alleviate the wave of anxiety and panic, leading to better emotional well-being and adjustment to unexpected and adverse circumstances.
Prevalence of mental health morbidity among the inmates of childcare homes under Social Justice Department, Government of Kerala
Authors: Mohan Minu , Anilkumar Thekkethayyil Viswanathan , Mathew Thomas
Published: June 2021

Background: Mental disorders are common, affecting more than 25% of all people at some time during their lives. Worldwide literature has shown that onset of common mental disorders occurs in childhood and adolescence. Children with mental health problems are often first seen and first treated in the education, social justice, or juvenile justice systems. In India, according to Juvenile Justice Act, 2000, such children are institutionalized in children’s and observation homes under Social Justice Department. This study aims at assessing the mental health status and estimating the prevalence of mental health morbidity among these children and adolescents.Methods: This is a cross sectional study conducted among the inmates of childcare homes under the Social Justice Department, Government of Kerala. Each individual district in the state was fixed as clusters. Out of the 14 districts, five districts were randomly selected. The childcare homes in each cluster were included. All the eligible children in the cluster during the visit were studied.Results: The median SDQ total score of the study participants was 15 (11, 21). The prevalence of mental health morbidity was estimated as 33.3% (95% CI: 26.86% - 40.31%) in the study population. There were 32 (15.9%) study participants with borderline SDQ score.Conclusions: The prevalence in the current study was more than that found in the general child population children across the world as well as in India, which in turn suggests the need of special care needed for these children and adolescents, especially in mental health.
Depression, anxiety and stress amongst students in science verses non-science stream: a comparative study
Authors: Chokshi Anushka S. , Rangwala Pooja P. , Dumra Gurusharan H. , Thakrar Manan R. , Singh A. J. , Lakdawala Bhaveshkumar M.
Published: June 2021

Background: Depression (D), anxiety (A) and stress (S) are common issues among students nowadays. The occurrence of D, A, and S was primarily considered to be associated with the students’ academics, especially in twelfth standard because these groups are highly vulnerable to immense pressure, rising competition for undergraduate courses and constant changes in the education system. The objective of this study was to find the comparative magnitude of occurrence and severity of D, A, and S in the science and non-science stream among twelfth standard students.  Methods: This cross-sectional study was carried out across 460 students of twelfth standard from all streams. A socio-demographic questionnaire along with DASS-42 was distributed. The scores were calculated and percentage, mean scores, standard deviation, p values, odds ratio were obtained.Results: A statistically significant difference was seen in the mean scores of depression and anxiety among science and non-science students (p<0.005).  Students belonging to science stream showed more depression and anxiety overall as well as when compared on basis of age groups. Similar results were also observed among science students who said it was not their own decision to choose their stream. Anxiety was found to be higher in science students from nuclear families where as depression was higher in those from joint family. On the contrary, occurrence of all states was found to be more in females of non-science field as compared to science field.Conclusions: Along with academic pressure, various other factors like gender, voluntary choice of stream, type of student’s family etc. contributed to D, A, and S in students.
Perceived academic concerns of under graduate medical students: a study of student’s perspective
Authors: . Priyanka , Goel Manish Kumar , Rasania Sanjeev Kumar
Published: June 2021

Background: With the drastic increase in the number of under graduate medical seats in India, the quality of medical education is facing challenges. To address these issues, curricular reforms have been advocated. Medical students are one of the stakeholders and their perceptions regarding medical education system hold a lot of importance.Methods: This study was conducted by the department of community medicine of a premier medical institute of Delhi and involved analysis of 457 feedback forms filled by medical students about their academic concerns and their perceptions about ways to address these concerns. The responses were kept anonymous. They were read several times and were grouped to deduce meaningful information in order to reach an overall understanding.Results: The medical students were concerned about the lengthy curriculum, long duration of lectures, language barrier and inappropriate assessment methods used. Lack of proper time management and recreational facilities were also pointed out. To address these concerns, they suggested some modifications in teaching and assessment methods like shorter and more interactive lectures, more focus on small group interactive teaching, healthier and friendlier teacher-student relationship and less frequent and skill-based assessment.Conclusions: The concerns and suggestions made by students are important and valid. Most of these issues have already been taken up in latest modifications in medical education by Medical Council of India. The competency based medical education program which has been implemented recently has called for major reforms, which are also the felt needs of medical students.
Initial approach to a patient presenting with breathlessness in a resource limited centre in the context of the COVID-19 pandemic: standard operating procedure
Authors: Pasangha Elaina Terese Antonette
Published: June 2021

Background: The community health and training centre at Mugalur village is a primary level healthcare centre. Resident medical officers found an increased number of patients presenting in the winter months with complaints of acute breathlessness as a result of exxcerbations of COPD and asthma. Prior management at the centre included testing for COVID-19 as initial management resulting in delayed treatment of other diseases. To ensure proper management in the context of the COVID-19 pandemic an SOP was designed.Methods: A quality improvement project which is a cross sectional analysis using plan-do-study-act cycles was conducted. Response and effectiveness was later recorded qualitatively from the staff and quantitatively by comparing with baseline data from prior records periodically at the end of each cycle.Results: Out of the 87 patients seen in the PDSA1, the mean age was 56.0 (SD=11.052) years. About 59.3% of patients were male. 27.6% patients belonged to lower socioeconomic status. Understanding was seen by 100% and 78% of doctors and healthcare workers during PDSA1 and by 100% by both groups in PDSA2. 84% followed the SOP in PDSA1 and 93% in PDSA2. Everyone followed SOP in PDSA3. Number of hospital admissions was found to significantly reduce to 25.5% from 30% at baseline and during PDSA1 following implementation of the SOP.Conclusions: A standardized guideline based on local epidemiology of the disease not only eases management for praticising physicians but also results in improved patient outcomes. This novel protocol can be used to manage patients presenting with acute onset breathlessness in similar resource limited centres.
Effects of mobile phone radiation on buccal mucosal cells based on specific absorption rate: a cross sectional study
Authors: Revanth M. P. , Aparna S. , Madankumar Parangimalai Diwakar , Ranganathan K.
Published: June 2021

Background: The usage of mobile phone had been increased drastically which created a major health concern among the people about the radiation emitted from mobile phones. Hence this study was aimed to evaluate the Micronuclei (MN) frequency in exfoliated oral mucosal cells in high and low mobile users based on Specific absorption rate (SAR) value.Methods: The total of 60 subjects were divided into two major groups: low SAR mobile phone users and high SAR mobile phone users. Further, Subjects who use mobile phone for more than 3 hours a week was considered as high talk time users and less than 3 hours a week was low talk time users. The buccal mucosa cells extracted by slightly scraping the oral cavity with a wooden spatula. For staining, Giemsa stain was used. Micronuclei were evaluated in 1000 cells per individual at the microscope.Results: The result show prolonged talk time may interfere with the development of micronuclei in individuals who use mobile phone for more than 3 hours per week rather than high SAR value showing a significant increase in frequency of micronuclei formation.Conclusions: The study showed mobile phone radiation had adverse effects on buccal mucosal cells.
Fear of COVID-19 pandemic (coronaphobia) amongst young adults in India
Authors: Verma Aditi , Biradar Ashwini
Published: June 2021

Background: The Novel Coronavirus disease has inherently brought a fear of uncertainty and continuity resulting in broad psychological effects on the mental health of the present generation. Although, few studies have tried to evaluate the degree of fear of COVID-19 but none has been done on young adults especially dental undergraduate healthcare providers so far. Hence, the present study aims to assess the fear of COVID-19 among young adults in India.Methods: A web based study was conducted on a sample of 309 dental undergraduate students of age group 18-25 years (young adults). The participants were asked for responding to a standardized online questionnaire prepared on google form that included the recently developed 7-item Fear of COVID-19 Scale (FCV-19S) to assess emotional fear reactions.Results: Overall mean fear score for the study population was 18.09+6.79. A significantly higher number of the study population reported low fear (56.6%). Age, place of residence, academic year, steady source of income and the students whose relative/friend got covid-19 depicted a significant difference based on the level of fear (p<0.05). Females and the students staying alone displayed higher levels of fear compared to their respective counterparts.Conclusions: Fear is a common psychological outcome during pandemics especially amongst healthcare providers as COVID-19 pandemic is a continuously evolving disease outbreak related to stress, disease contraction and dying. Thus, managing this fear in the young minds is imperative in order to reduce the psychological implications affecting their mental health due to the current COVID crisis.
Emerging risk factors and the disease pattern in Turkey: an analysis based on burden of diseases
Authors: Akgun Seval H. , Nayar Rajasekharan K.
Published: June 2021

Knowledge about the burden of disease and injury alone is not sufficient for health improvement and for defining and evolving policies and strategies. In many low and middle income countries, the impacts of chronic diseases are increasing gradually each year. Anticipating, understanding and reducing the impact of chronic diseases on human health is of great importance. The aim of this paper was to assess the main risk factors in chronic diseases in a developing country and to identify the effects of individual risk factors on burden of disease by using comparative risk assessment methodology. The first BoD study in 2003 revealed that the high systolic blood pressure was ranked first and the prevention of high systolic blood pressure would prevent 108.468 of 430.459 deaths in Turkey. Smoking was at the second rank and prevention of smoking would prevent 54.699 deaths while control of cholesterol level within the normal limits would prevent 49.029 deaths. It is also indicated that adequate levels of physical activity would prevent 45.120 deaths and that consumption of the recommended amount of fruits and vegetables would prevent 38.734 deaths. In the 2013 study, smoking ranked first, followed by nutritional risks at the second rank followed by high BMI, high blood pressure and high sugar level respectively. Smoking, high blood pressure, obesity and tobacco use are the most important problems among the preventable deaths and disability in Turkey. It can be concluded that Turkey now resembles the pattern seen in developed countries and some developing countries with low mortality.
Mental health in children: a view on social attribute
Authors: Sundaram Ramkumar , A. M. Shagirunisha Rizvana , T. Aishwarya , V. Anbarasan , S. M. Ganesh Babu
Published: June 2021

Child and adolescence are crucial periods to promote emotional well-being as the greater part of psychological issues start at these stages, and a large number of these continue for the rest of the life. Right now, this has become a need as overall information shows an increase in the pervasiveness of emotional well-being issues in childhood and adolescence and the level of those coming to almost 20%. Factors affecting mental health are familial factors, social and environment, media, physical activity, chronic illness in child, abuse, and bereavement. These factors affect the child’s mental health from their early stages of life. Thus remembering the effect from these factors the child’s mental health to be improved. Large numbers of the psychological wellness programs carried out in schools advance the improvement of social abilities, socio-enthusiastic capabilities, and learning results while simultaneously diminishing problematic behaviour.