bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence of frailty and its association with lifestyle factors among elderly in rural Bengaluru
Authors: Shilpa K , Norman G
Published: May 2022

Background:

There are nearly 10.4 crores elderly in India, with 65% of them living in rural areas. Accessibility to healthcare is limited in rural areas. Primary care physicians deal with a fairly large number of patients from the geriatric age group. With the steady increase in the proportion of elderly, there is a corresponding increase in the prevalence of frailty. Frailty among the elderly leads to increased dependency, adverse health outcomes and mortality. Early identification and targeted interventions by primary care physicians could prevent these adverse outcomes and even reverse its occurrence. Knowledge about environmental and lifestyle influences on frailty would further assist primary care physicians to prevent and manage it optimally

Methods:

We interviewed 502 participants (>60 years of age) from four taluks of rural Bengaluru. Participants with frailty scores of 3 and above were considered frail, scores of 1-2 were considered prefrail. Association of frailty with lifestyle and environmental factors were tested using the Chi-square test. A value of P < 0.05 was considered significant

Results:

Prevalence of frailty was 24.70% and prefrailty was 62.75%. Elders in age group 60 to 74 years, those living alone or with others (other than the spouse), illiterate, working elders, elderly with less than two diagnosed comorbidities, elderly with low social score and low physical activity were associated with frailty

Conclusion:

The young old population seems vulnerable to frailty. Health programs aimed at prevention, early detection and treatment of morbidities and frailty will improve their health.
COVID-19 infection among health care workers
Authors: Jamil Md , Bhattacharya Prasanta K. , Barman Bhupen , Topno Noor , Narang Naku , Phukan Pranjal , Dey Biswajit , Saikia Bishwajeet , War Gwenette Andrea , Hynniewta Yasmeen
Published: May 2022

Background:

COVID-19 can infect any individual, but the group most susceptible is the Health Care Workers (HCWs) who are directly involved in COVID-19 patient care. Despite adhering to the recommended personal prospective equipment, a disproportionately large number of cases of COVID-19 were reported among the HCWs.

Aims and Objectives:

To study the burden of COVID-19 infection among the HCWs and to study the probable factors associated with increased risk of COVID-19 infection among HCWs.

Materials and Methods:

A hospital-based prospective cross-sectional study was conducted at a tertiary care teaching institute in the state of Meghalaya, India for the period between 1st May 2020 and 30th June 2021 and included only laboratory-confirmed COVID-19 cases. Data collected included: A) Demographic data – age, gender, category of HCW, B) History of exposure, place of posting, C) Clinical presentation and disease category.

Results and Observations:

A total of 144 cases were included in the study. The mean age of affected HCWs was 33.83 ± 1.408 years and male to female ratio was 0.47:1. The commonest age group affected was 18 to 30 years of age (45.14%). The majority of the HCWs were Nursing Officers (staff) (52.78%) followed by Resident Doctors (18.06%). Out of all cases, 135 (93.75%) were either asymptomatic or had mildly symptoms. In 96 (66.67%) HCWs, there was high-risk contact with a known case of COVID-19. High-risk contact outside the COVID-19 designated area of the hospital was noted in 53 (36.81%) cases; however, only 22 (15.27%) patients had a history of working in the COVID-19 designated area at the workplace.

Conclusion:

The most common group that got infected was the nursing staff followed by the resident doctors, with more than ninety percent of the cases having either mild symptoms or were asymptomatic. The risk of contracting COVID-19 infection was higher in non-COVID-19 as compared to COVID-19 designated areas of the hospital.
Comparison of nutritional status of HIV positive children with homecare and institutional care/ orphanage – An eye opener cross sectional study
Authors: Pushkar Kumar , Hiremath Ravishekar N. , Gupta Rajul K. , Ghodke Sandhya
Published: May 2022

Background:

Nutrition has an important bearing on the health of Human immunodeficiency virus (HIV) positive children. Ascertaining the nutritional demands correctly and provisioning the nutritional needs to HIV positive/ Acquired Immunodeficiency syndrome (AIDS) children will go a long way in maximizing the therapeutic benefits reaped through ever improving pharmaceutical initiatives, and thus, contribute to prolonging the longevity of these children who have a whole life ahead of them.

Objectives:

To study the nutritional status, including dietary assessment and anemia status of HIV-positive children, and compare the outcomes among children under homecare (staying with families) and orphanages/institutional care.

Methodology:

A cross sectional study was carried out among children between 2 and 15 years who were attending Pediatric Outpatient department (OPD) of a tertiary care hospital in western Maharashtra. Data were collected from 106 children by the interviewer himself using pretested validated questionnaire along with anthropometric measures and relevant blood tests. A 24-h recall method was used to collect the dietary intake. Institutional ethical clearance was taken, and data were collected through informed consent of the parent/guardian accompanying the children.

Results:

Out of the 106 subjects studied, 54 (50.9%) were living in orphanages and 52 (49.1) were living with the family. Out of the 52 subjects of children under caregivers, 48.1% of the caregivers were unskilled workers and more than half of the subjects had a monthly family income of less than Rs 3,000. About 46.1% of the subjects’ caregivers were illiterate. In the orphanage, 28 (51.8%) were males and 26 (48.2%) were females; 52 (49.1%) children were living with family of whom 30 (57.7%) were males and 22 (42.3%) were females. The prevalence of anemia (86.5%) and undernutrition (61.1%) was more among those living with family compared to the orphans living in orphanages and the same was statistically significant (P < 0.05). Among the children living in orphanages, the mean intake for most of the nutrients was more across all age groups. Within homecare, the mean nutrient intake of the females for all nutrients was more than the males across all age groups except 3–9 years, where it was more in males. Overall, all the children received less of water-soluble vitamins compared to recommended daily allowances (RDA), and the children of age group 5–15 years received less vitamin A and iron also.

Conclusion:

Adequate nutrition, which is best achieved through the consumption of a balanced healthy diet, is vital for health and survival for all HIV-infected children. Specific measures to be directed to children under homecare and measures directed to improve social factors need to be undertaken.
Poor sleep and the metabolic derangements associated with obesity in adult males
Authors: Ankita Annu , Mehta Bharati , Dutt Naveen , Nayak Prasunpriya , Sharma Praveen
Published: May 2022

Context:

Short sleep and obesity have a causal association with each other. Obesity is also associated with metabolic imbalances. However, a subset of 20%–30% of obese population have only few metabolic complications, known as metabolically healthy obese (MHO) and rest with worsened metabolic profile are known as metabolically abnormal obese (MAO)

Aims:

To find the association between sleep quality and metabolic health of adult obese males.

Settings and Design:

The study was a cross-sectional study conducted at medicine out-patient department of the institute.

Methods and Material:

In this study, hundred adult obese males of age group 25–60 years, with Body mass index (BMI) ≥ 25 Kg/m2, were divided into MHO and MAO, based on their metabolic health using Joint Interim criteria. Sleep quality was assessed using Pittsburgh sleep questionnaire index (PSQI).

Statistical analysis used:

The data obtained were analyzed using PAST statistical software

Results:

The two groups MHO and MAO presented with significant differences in their mean age and BMI (P = 0.0001). The global score of PSQI was significantly high for MAO than MHO with mean values of 8.24 ± 3.60 and 6.65 ± 3.58, respectively (P = 0.016). Sleep disturbances score was significantly high in MAO (P = 0.0001). Significant associations were observed for global score with age, BMI, waist circumference, fasting blood sugar, and triglycerides

Conclusions:

Poor sleep quality was significantly associated with detrimental metabolic profile and BMI. The metabolic health worsened with increasing age and obesity.
Physician’s knowledge, attitude and practice of fixed drug combinations
Authors: Singh Alok , Dhaneria Suryaprakash , Gupta Dhyuti
Published: May 2022

Objective:

The Indian pharmaceutical market is flooded with different fixed drug combinations (FDCs), many of which lack a rational justification. The study aimed to assess the knowledge, attitude, and practice (KAP) regarding FDCs among the physicians of a tertiary-care teaching center

Method:

The target sample size for this cross-sectional study was calculated as 75, and the study was conducted between February and August 2020 by using a content-validated questionnaire. Descriptive statistics had been utilized for data analysis, and Chi-square test had been applied for intergroup comparison (with P < 0.05 considered to be significant)

Results:

The mean age of the physicians who participated in this survey was 33.2 years. While 44% of them could identify all the potential advantages of using FDCs, only 09% could correctly recognize all the disadvantages associated with the same. Among the list of rational and irrational FDCs, only 49% could single out the irrational ones. And though the majority (83%) of the respondents do check for the rationality of FDCs before prescribing them, still out of 25 most commonly prescribed FDCs, 16 lacked any scientific justification for combination, and 09 (out of 16) had been banned by the Government of India

Conclusion:

The outcome of this cross-sectional questionnaire-based study reflects the deficit in the knowledge regarding FDCs, as well as incoherence among the knowledge, attitude, and prescription practice. Though the physicians have cultivated a healthy attitude towards prescribing FDCs, the same is not reflected in their practice. In order to rectify these disparities, the authors have proposed certain recommendations within this article.
Yamaguchi syndrome
Authors: Ruhela Manish , Ola Rakesh Kumar , Chaturvedi Neeraj , Bagarhatta Rajeev
Published: May 2022

Apical hypertrophic cardiomyopathy is a relatively rare subtype of hypertrophic cardiomyopathy with a wide range of clinical manifestation. The most frequent symptom is chest pain and thus it can mimic the acute coronary syndrome and due to unfamiliarity of this condition by some physicians, the diagnosis is frequently missed or delayed. In this case, report our purpose is to emphasize the importance of keeping apical hypertrophic cardiomyopathy as one of the differential diagnoses in a young patient presented with chest pain.
Evaluation of the effect of intrauterine injection of platelet-rich plasma on the pregnancy rate of patients with a history of implantation failure in the in vitro fertilization cycle
Authors: Ershadi Sara , Noori Narjes , Dashipoor Alireza , Ghasemi Marzieh , Shamsa Nahid
Published: May 2022

Objectives:

Implantation failure is a major problem in reproductive medicine, and despite the various methods described for treatment, there is little consensus on the most effective method. This study was conducted to investigate the effect of intrauterine injection of platelet-rich plasma (PRP) on the pregnancy rate of patients with a history of implantation failure in the in vitro fertilization (IVF) cycle.

Study Design:

In this study, women attending the infertility clinic of Ali ibn Abi Taleb Hospital, who had a history of implantation failure and were candidates for frozen embryo transfer (FET), were examined in Zahedan (Iran) in 2019. The patients were divided into two groups of PRP recipients and the control group. IVF was performed routinely, and in the PRP-receiving group, an intrauterine injection was given 48 h before embryo transfer (ET). The number of gestational sacs, the rate of implantation, the frequency of chemical and clinical pregnancies as well as the frequency of abortion were compared in the two groups. The collected data were analyzed by the SPSS software version 21

Results:

Ninety patients with a history of implantation failure participated in the study, and finally, the information of 85 patients was studied. The frequency of chemical pregnancy was 40% in the experimental group, 27% in the control group, and regarding clinical pregnancy, 33% in the experimental group and 24% in the control group, but there was no significant difference between the two groups. The rate of implantation, the mean thickness of the endometrium, and the frequency of abortion did not differ significantly between the two groups

Conclusion:

In patients with endometrial thickness greater than 8 mm with a history of recurrent implantation failure, intrauterine injection of PRP had no effect on the fertility outcome.
Impact of self-efficacy and sense of coherence on tobacco cessation motivation and readiness among slum dwellers in Ajmer city during COVID-19 health emergency
Authors: Vyas Deepika , Patel Mamta , Sharma Ashish , Chhabra Kumar Gaurav , Gupta Aditi , Mundra Rohit
Published: May 2022

Background:

Tobacco cessation motivation majorly depends on self-efficacy and sense of coherence. Hence the aim and objective of the present study was to explore how self-efficacy (SE) in addition to sense of coherence (SOC) affected tobacco cessation motivation and readiness among slum dwellers during the COVID-19 health emergency.

Materials and Methods:

The ongoing research was a cross-sectional, descriptive questionnaire study. The research started in November and ended in December 2020. The research took place in primary health centres located in Ajmer’s urban slums. In this analysis, east, west, north and south directions of Ajmer were chosen at random from each direction, and each slum had an associated primary health centre (PHC). From these 16 PHCs, people coming from slum areas were interviewed. The questionnaire consisted of demographic details, tobacco motivation and readiness, SOC and SE.

Results:

The majority of study participants (178, 56.7%) were not seriously considering reducing their tobacco intake. The majority of study subjects had poor sense of coherence {137 (43.6%)}, self-efficacy {141 (44.9%)} and tobacco cessation motivation and readiness {156 (49.7%)}. Using the logistic regression model, it was discovered that study participants with high SE and a high SOC had a substantial impact on successful tobacco cessation motivation and readiness (P = 0.01*), (P = 0.00*).

Conclusion:

It was concluded that the study participants with high self-efficacy and high sense of coherence had a significant impact on good tobacco cessation motivation and readiness.
Estimate and determinants of SARS-CoV-2 RNA clearance time among non-severe COVID-19 patients
Authors: Aljunaid Mohammed A. , Albeshry Abdulrahman M. , Alshahrani Najim Z. , Barabie Samaher S.
Published: May 2022

Objectives:

To estimate SARS-CoV-2 RNA clearance time among non-severe COVID-19 patients and explore factors associated with delayed negative conversion.

Methods:

A retrospective cohort study was conducted at the COVID-19 unit of a tertiary care center in the Western region of Saudi Arabia. Reverse transcriptase-polymerase chain reaction (RT-PCR) confirmed COVID-19 patients diagnosed between April 1 and June 30, 2020, were considered. The primary outcome was the time (days) from disease onset to first negative RT-PCR, which was analyzed using Kaplan–Meier and Cox regression survival methods. Demographic data, clinical history, baseline clinical, radiological and laboratory findings and management, and outcome data were collected and analyzed as factors associated with the viral RNA clearance time.

Results:

One hundred and forty-four patients were included. The mean (standard deviation [SD]) age was 36.93 (14.41) years, 50.7% were females, and 45.1% were healthcare workers. COVID19 was asymptomatic, mild and moderate in 11.1%, 71.5% and 17.4% of the participants, respectively. Fever (59.4%) and cough (58.0%) were the dominant onset symptoms. The mean viral RNA clearance time was 22.9 days (SD = 8.6; 95% confidence interval [CI] = 21.5–24.3 days). Extended clearance time was associated with older age (mean = 24.0 vs. 22.0 days; log-rank = 0.037), married status (23.2 vs. 22.6 days; log-rank = 0.021), working in health sector (24.2 vs. 21.8 days; log-rank = 0.006), and having a chronic disease (24.8 vs. 21.9 days; log-rank = 0.028), compared to their counterparts, respectively. In the adjusted model, the job sector was the only factor that was independently associated with clearance time. Non-healthcare sector showed hazard ratio 1.8 (95% CI = 1.3–2.7; log-rank = 0.002) with reference to healthcare sector.

Conclusion:

SARS-CoV-2 RNA clearance time is likely to be longer in non-severe COVID-19 patients, representing an additional risk for the virus dissemination among the community and calling for higher caution among the population.
Profile of comorbidity and multimorbidity among women attending antenatal clinics
Authors: Pati Sanghamitra , Puri Parul , Sinha Rajeshwari , Panda Meely , Pati Sandipana
Published: May 2022

Background:

Multimorbidity is being recognized as a crucial maternal health challenge in India. However, pregnancy remains an exclusion criterion in most multimorbidity estimation studies resulting in a deficient understanding of the problem in this population. The present study aims to estimate the prevalence of multimorbidity, identify its correlates, and assess healthcare utilization and expenditure outcomes among women availing of antenatal care clinics

Methods:

An exploratory cross-sectional study was conducted among 127 pregnant women attending three antenatal clinics of Bhubaneswar, Odisha, from February to July 2016. Data were collected using a “multimorbidity assessment questionnaire for primary care,” contextualized for antenatal settings. The prevalence and correlates were determined using descriptive analysis, and the outcomes were measured by the number of healthcare visits, medications, and healthcare expenditure. About 15% of antenatal women were multimorbid

Result:

Anemia (52.6%), hypertension (31.6%), acid-peptic diseases (26.3%), and thyroid (26.3%) were the leading chronic conditions. Statistically, significant association was found between multimorbidity and medical consultation, the medicines consumed, and functional limitation. The healthcare expenditure was significantly higher among the multimorbidity groups

Conclusion:

Our findings suggest the inclusion of comprehensive multimorbidity assessment in routine antenatal screening. Preconception care should establish linkages between maternal and reproductive health with chronic disease prevention, and identify ways to reduce healthcare utilization and expenditure. Longitudinal studies to assess the trajectory and impact of multimorbidity on maternal and infant health are warranted.
COVID-19 vaccination hesitancy and attitude post-initiation of vaccination drive, a cross-sectional study across Odisha
Authors: Kuchi Sravya , Parida Swayam P.
Published: May 2022

Objectives:

To find the prevalence of COVID vaccine hesitancy amongst people of Odisha and reasons for the same

Design:

Observational Study

Setting:

Outpatients, inpatients, and attenders in tertiary health centers in Khorda, Tangi, and Mendhasal, Odisha, India; online data via google forms from people across the state.

Duration of Study:

April to June 2021

Participants:

Convenience sampling of 450 adults aged between 18 and 60

Main Outcome Measure:

Willingness to get vaccinated against COVID-19

Results:

Hesitancy rate stands at 12.7%, with 5.7% in the urban setting and 20.9% in rural (CI 95%, P = 0.000), 3.1% amongst males and 25.4% females (CI 95% P = 0.000), and 42.6% amongst the homemakers. Main reasons for vaccine hesitancy include lack of knowledge about efficacy,fear of side effects, and testing positive despite taking the vaccine

Conclusions:

The near tripling of the hesitancy rates indicates a probable hindrance in stopping the spread of the infection. Family physicians have a significant role in alleviating the myths, counseling people, and managing adverse events.
Serum kallistatin as a marker of severity of liver fibrosis in cirrhosis
Authors: Kularaj Seetaram Singh , Verma Sudhir Kumar , Kumar Vivek , Patwa Ajay Kumar , Chaudhary Shyam Chand , Sonkar Satyendra Kumar , Gupta Kamlesh Kumar , Atam Virendra , Verma Sanjeev Kumar , Bhosale Vivek , Singh Shail
Published: May 2022

Background:

Liver cirrhosis is among the leading causes of morbidity and mortality worldwide. Although liver biopsy is the gold standard for the assessment of liver fibrosis in cirrhosis, it has its own limitations. Therefore, noninvasive methods to detect liver fibrosis are widely preferred. However, they also have their own limitations. Thus, there is always a need to extend the battery of serum-based assays. Kallistatin is a protein synthesized primarily in the liver. As it is a negative acute-phase protein, its blood level decreases with a decline in liver function. In our study, we explored the relationship between serum kallistatin and radiological evidence of liver fibrosis by transient elastography to determine if kallistatin levels can be used as a diagnostic marker of liver fibrosis.

Materials and Methods:

A cross-sectional study of 1-year duration was conducted at a leading tertiary care hospital in northern India. Patients between 15 and 75 years of age having evidence of chronic liver disease were enrolled. All enrolled patients were evaluated by detailed history, physical examination, and relevant investigations. Serum kallistatin levels were quantified using the ELISA method. Grading of liver fibrosis was done using transient elastography. A FibroScan scoring card was used to convert FibroScan results measured in kPa into the Metavir scale F1–F4

Results:

A total of 128 subjects, including 64 patients with cirrhosis and 64 healthy controls, were enrolled. Our study suggested that FibroScan values were significantly higher in cases as compared to controls. The kallistatin level of cases was significantly lower than that of controls. An inverse correlation was found between FibroScan value and kallistatin level among cases

Conclusion:

We conclude that serum kallistatin levels are low in patients with liver fibrosis and can be used as a potential marker of liver fibrosis.
Is it a challenging task to work with personal protective equipment in a COVID-19 ICU
Authors: Mahalingam Karthikeyan , Surbhi  , Balaji Akshaya , Ganesh Ragul , Daniel Roy Arokiam , Aggarwal Richa , Soni Kapil Dev , Singh Akhil Kant , Khanna Puneet , Gupta Viney , Trikha Anjan
Published: May 2022

Introduction:

Amidst the coronavirus disease 2019 (COVID-19) pandemic, the use of personal protective equipment (PPE) is mandatory for healthcare workers to remain protected against infection. The present study was undertaken to evaluate challenges faced by the healthcare workers while using level 3 PPE.

Methods:

This hospital-based study was conducted among resident doctors selected by convenience sampling method using a pretested, semi-structured, self-administered questionnaire after getting informed consent from the participants to collect data on the somatic, psychological, and technical problems faced while working in PPE. Bivariate and multivariable logistic regression was done between outcome variables and other independent variables to check for the association.

Results:

Of the total, 252 resident doctors completed the survey, their age ranged from 22 to 36 years with 140 (55.6%) males and 112 (44.4%) females. One-twenty-nine (51.2%) residents were trained to work in ICU, 73 (29%) participants used PPE ≤10 times and the rest 179 (71%) used PPE more than 10 times. The difficulties faced were as follows: visual impairment (n = 244, 96.8%), headache (n = 226, 89.6%), breathing difficulty (n = 216, 85.7%), hearing impairment (n = 201, 79.8%), sweating (n = 242, 96%), and fear of being infected (n = 156,61.9%). Two-thirty-six (93.6%) participants felt that overall work quality reduced due to PPE. Headache, hunger, urge to micturate, anxiety, sleep disturbances, and need to change the timing of medication or diet were higher with increased duration of work with PPE.

Conclusion:

A longer duration of work is associated with headache, hunger, anxiety, and sleep disturbances. More research has to be done to improve the PPE to reduce problems like visual impairment, skin irritation, sweating, and breathing difficulty.
Epidemiological correlates of hepatitis C infection- A case control analysis from a tertiary care hospital
Authors: Sharma Pranjl , Satija Mahesh , Chaudhary Anurag , Singh Surinderpal , Sharma Sarit , Girdhar Sangeeta , Gupta Vikram Kumar , Bansal Priya
Published: May 2022

Background:

Hepatitis C virus (HCV) infection is considered one of the growing public health problems. Identification of HCV-associated risk factors is pivotal for developing appropriate prevention strategies

Objectives:

To determine the epidemiological variables of HCV infection in a tertiary care hospital

Methods:

This hospital-based case-control study was conducted in a tertiary care hospital in Punjab on 320 subjects, including 160 cases and controls each. Cases and controls were matched by age (±5 years), gender, and residence. A patient ≥18 years of age fulfilling the biomarker criteria with or without clinical criteria diagnosed in the last 1 month was considered as a case. The information on socio-demographic characteristics and previous exposures to selected risk factors was collected through detailed interviews of the subjects. Analysis was performed using SPSS 20 statistical software. Odds ratio (OR) with 95% confidence interval (CI) was calculated to measure the strength of association between cases and controls for each risk factor

Results:

Odds of having HCV infection was significantly higher among those with a history of blood transfusion (OR: 2.30, 95%CI: 1.14–4.63), dental procedure (OR: 4.82, 95%CI: 2.38–9.77) and intravenous injection/infusion from quacks (OR: 3.26, 95%CI: 1.47–7.19), injectable drug use (OR: 26.69, 95%CI: 3.55–200.24), non-injectable drug use (OR: 2.37, 95%CI: 1.44–3.90), tattooing (OR: 7.91, 95%CI: 2.31–27.08), and piercing from street hawkers (OR: 2.25, 95%CI: 1.18–4.29). Multivariate analysis identified history of blood transfusion, dental procedure, intravenous injection/infusion from quacks, injecting drug use, and piercing as independent risk factors for HCV infection

Conclusion:

The study identified multiple risk factors for acquiring HCV infection and suggest appropriate interventions targeting high-risk populations.
Development and validation of a questionnaire to evaluate satisfaction of the patient with diabetes at the primary care level
Authors: Maldonado-Paredes Sarahi Estrella , Juárez-Cedillo Teresa , de la Peña Jorge Escobedo , Vaca-Marín Miguel Angel , Quiñones-Villalobos Carolina , Garrido-Acosta Osvaldo , González-Meléndez Roberto C.
Published: May 2022

Aims:

To develop and validate a new instrument to measure satisfaction with integral care (doctor–nurse) of the patient with type 2 diabetes mellitus, considering expectations-experiences together for the primary level of care

Methods:

The instrument was constructed with questions regarding integral care to measure the satisfaction of the diabetes patient and was classified into four domains. The validity of the content was done through a panel of experts, apparent validity through a focus group, the validity of the construct through analysis of the main components and confirmatory factorial analysis, instrument reliability with internal consistency, determined by Cronbach alpha and temporal stability (test-retest)

Results:

The reliability of the questionnaire was 0.942. The intraclass correlation coefficient was 0.849. Validity of the construct showed acceptable goodness-of-fit and factorial structure with four factors: communication, empathy, technical care, care continuity, and 24 items for each domain, giving a Kayser–Meyer–Olkin index above 0.80 and a total variance above 73%

Conclusions:

The instrument is reliable and is also valid in terms of up into construct and content to evaluate satisfaction.

Practice Implications:

In addition, these results allow to have elements for the design of strategies aimed at improving the relationship of health personnel with the patient.
An interesting case of nevus flammeus with loss of vision and hemiparesis
Authors: Narasimhan Murali , Valarmathi S. , Ramakrishnan Ramachandran , Durai Priya Cinna. T. , Guhan Sivathangavel T.
Published: May 2022

Nevus flammeus is the most common benign congenital capillary malformation, often known as a port-wine stain. Sturge–Weber syndrome (SWS) is a congenital, sporadic, nonfamilial disease characterized by intracranial and ophthalmic vascular anomalies and nevus flammeus. It usually manifests as developmental delay, learning problems, paralysis, seizures, glaucoma and attention deficit, and hyperactivity disorder. A 29-year-old male patient presented with a reddish patch over the face since birth. He was found to have hemihypertrophy of face, hemiparesis of right limbs, and low intelligence quotient. On ophthalmic examination, the patient was found to have glaucoma and only perception of light in the left eye. Computed tomography brain showed atrophy of the left cerebral hemisphere and calcifications in the left frontal, parietal and occipital regions. With these findings, he was diagnosed as SWS type I. A multidisciplinary approach was followed for patient evaluation and management. This case also highlights the irreversible sequelae of this rare phacomatosis.
Fulminant dengue hepatitis in sickle cell disease
Authors: Shah Divit , Talwar Dhruv , Kumar Sunil , Acharya Sourya , Hulkoti Vidyashree
Published: May 2022

Fulminant hepatitis is a potentially life-threatening disease that is evident through the findings of organ dysfunction, jaundice, and hepatomegaly, which is painful. Dysfunction of the endothelial cells and thus the damage of the endothelium is the probable mechanism, which is responsible for causing complications of hepatobiliary system in patients with sickle cell disease. Various acute as well as chronic manifestations of the hepatobiliary system, having varied severity and pathophysiology are associated with sickle cell disease. Dengue fever may also affect the liver starting from asymptomatic liver enzyme derangement to fulminant hepatic failure. This case series describes the first ever association of fulminant hepatic failure resulting from the synergistic effect of dengue fever with sickle cell disease and thus highlights the importance of prevention of dengue fever in sickle cell patients, thereby preventing potentially lethal fulminant hepatic failure.
Vaccine hesitancy after taking the first dose of COVID-19 vaccine
Authors: Bansal Yashik , Chand Pragya , Bansal Naveen , Singh Pushpendra
Published: May 2022

Background:

Coronavirus disease 2019 (COVID-19) vaccination campaigns are trying to curb the pandemic by vaccinating as many individuals and as quickly as possible. The speed of immunization depends upon the availability of the vaccine and vaccine uptake by the communities, which in turn is related to vaccine hesitancy, the safety/efficacy profile of the vaccines, and adverse events following immunization (AEFI)

Objectives:

(i) To study the AEFI experienced by vaccine recipients and (ii) to assess the subjective effect of these AEFI on the vaccine recipients, that is, perceived disability and opinion regarding taking the vaccine’s second dose

Methods:

This was a cross-sectional study conducted at a tertiary care hospital where a questionnaire was distributed to the medical students who had taken at least one dose of a COVID-19 vaccine

Results:

Out of 208 participants, more than three-quarters (n = 169, 81.2%) experienced AEFI symptoms within 12 hours of vaccination. The commonest symptoms were pain at the injection site (n = 173, 83.2%), body aches (n = 91, 43.8%), fever (n = 88, 42.3%), weakness (n = 86, 41.3%), and headache (n = 72, 34.6%). A majority of the participants reported complete recovery within 13–24 hours. Complete recovery was seen in all the study participants, and no serious event was seen. Twenty (10%) participants reported that they were not confident in taking the second dose of the vaccine

Conclusions:

The disability perceived by the vaccine recipients should be taken into consideration in a vaccine with a multi-dose schedule. Pitfalls in alleviating the immunization-related anxiety should be identified and addressed.
Yoga, immunity and COVID-19
Authors: Shah Komal , Adhikari Chiranjivi , Saha Somen , Saxena Deepak
Published: May 2022

Yoga is recognized and practiced for different levels of prevention since antiquity. The current scoping review aimed to identify and document the evidence reporting the effect of yoga interventions on immunity against COVID-19 infection. Three databases––PubMed, Cochrane, and Google Scholar, were searched to identify eligible studies. Articles published in English after 2010 and assessing the impact of any form of yoga (such as yogasanas, meditations, or pranayamas) on immunological markers were included in the review. The studies without information of the intervention on immunity markers, and experience sharing reviews were excluded. The search yielded 45 eligible articles with majority of the studies being published from the USA and India. Most of the studies were randomized controlled trials, enrolling the adult population with a specific focus on diseases like HIV, cancer, and heart failure. It was observed that a variety of yoga interventions along with meditation and pranayama, in different combinations were used by the authors. However, all these studies unanimously reported improvement in immunological profile (indicated by improved biochemical markers) of an individual (irrespective of disease state and type) with yoga. Moreover, the beneficial effects of these traditional Indian interventions were also found to have a positive impact on overall physical and physiological wellbeing and quality of life. Findings from the existing literature indicate that the practice of yoga has the potential to strengthen cell-mediated immunity and hence could be used as an effective preventive measure against COVID-19 where immunity plays a critical role.
Clinicoepidemiological profile of COVID-19 patients admitted at a teaching institute in a hilly area of India during the second wave—A retrospective observational study
Authors: Udayar Sharvanan E. , Marella Krishnaveni , Naidu Shwetha , Sinha Shwetha
Published: May 2022

Introduction:

COVID-19 ongoing pandemic has resulted in millions of deaths globally, and India has recorded the second highest number of confirmed cases till now. In the absence of effective treatment, it becomes crucial to know about the course of the disease in hospital settings for effective patient care. The present study discusses the clinicoepidemiological, haematological and biochemical determinants among survivors and non-survivors of COVID-19 patients admitted to a tertiary care hospital in a hilly area

Methods:

A record-based cross-sectional study was carried out at the government hospital from March 2021 to June 2021, which included all confirmed cases of 18 years and above. Demographic details, delayed admission, co-morbidities and laboratory parameters were collected

Results:

Out of a total of 1267 COVID-19 patients, the mean age of survived and succumbed was 50.77 ± 16.1 and 60.50 ± 14.2 years, respectively (P < 0.001). The mean survival time in males (17.7 days) was lesser compared to that in females (20.3 days). Two hundred and twelve of them practised self-medication. The mean duration of delayed testing (2.95 ± 2.3 vs 3.36 ± 2.2 days), mean values of haemoglobin (11.39 ± 2.1 vs 12.5 ± 1.7), platelet count (193.8 ± 94.6 vs 253.1 ± 105.9), leucocyte count (11.53 ± 5.72 vs 9.11 ± 5.21), neutrophil–lymphocyte ratio (10.0 ± 2.9 vs 7.3 ± 3.5), urea (61.16 ± 51.8 vs 30.2 ± 21.2) and creatinine (2.13 ± 2.9 vs. 1.1 ± 0.3) among the two groups were statistically significant (P < 0.001). Increasing age, contact history, hypertension [OR 3.2 (95% CI, 1.40–7.39)], diabetes [OR 1.9 (95% CI, 0.81–4.40)] and chronic kidney disease [OR 15.4 (95% CI, 5.23–45.71)] were found to be associated with increased risk of mortality (P < 0.005)

Conclusions:

Public health interventions like contact tracing, testing and early identification of laboratory parameters and treatment on priority would help in providing effective care so that the mortality can be reduced.
Vaccine-induced thrombosis and thrombocytopenia (VITT); Exploring the unknown
Authors: Sunder Ashok , Saha Sudip , Kamath Sangita , Kumar Manish
Published: May 2022

Vaccination is supposed to be the most reliable means to end the COVID 19 pandemic, but recently there have been reports of thrombosis and thrombocytopenia in patients receiving the vaccine especially ChAdOx1 nCoV-19 (AstraZeneca University of Oxford and Serum Institute of India). This has been termed as vaccine-induced immune thrombotic thrombocytopenia (VITT), thrombosis with thrombocytopenia syndrome (TTS) and vaccine-induced prothrombotic immune thrombocytopenia (VIPIT). This is a challenging situation and patients are treated with Fondaparinaux and Rivaroxaban after thrombocytopenia is corrected. Herewith, we report a case of VITT who presented to our hospital and was successfully treated over a weeks’ time.
Concurrent evaluation of acute flaccid paralysis surveillance in Kashmir
Authors: Bashir Khalid , Qurieshi Mariya Amin , Kausar Zeenat , Khan Shahzada Muhammad Salim
Published: May 2022

Background:

Active acute flaccid paralysis (AFP) cases surveillance in children under 15 years is ongoing till reaching eradication of poliomyelitis in the globe. As there is always a high risk of importation of wild poliovirus (WPV) from the endemic countries, accurate surveillance for AFP cases to detect WPV circulation and to maintain our achievement is thoroughly essential.

Objectives:

To evaluate the performance of the AFP surveillance system in Kashmir Valley. To identify gaps, if any, in AFP surveillance.

Materials and Methods:

The Mixed Methods study was conducted in the Kashmir valley from March 2018 to March 2019. An explorative qualitative design using individual, face-to-face interviews with thirty-two (32) different stakeholders from the State, District, Medical Block, and PHC levels. To complement the qualitative study, a quantitative door-to-door survey was done in two Districts, Srinagar and Ganderbal, which consist of five and four Medical Blocks respectively.

Results:

The thematic qualitative analysis approach was used, and the analysis process resulted in five themes. 1. Stakeholders’ description of AFP surveillance. 2. Perception and awareness, appraisal of AFP Surveillance among stakeholders 3. Barriers in reporting AFP cases 4. Forging stronger linkages, improved planning in the health system to address gaps in AFP surveillance. 5. Enhancement of activities for sensitive AFP surveillance. In door to door survey of households in different sub-centre areas, a total of n = 1304 families were visited in which maximum (n = 647) families had two <15 years’ children. In the survey, only one AFP case was recorded from Sub-Centre Kurag.

Conclusion:

There is a need for sensitive AFP surveillance by working on various factors, including training, behavioural change of health workers, improving reporting of cases, especially efforts are needed for the formation of effective AFP surveillance system by forging cooperation with different segments of the health system.
An epidemiological study on morbidity profile and predictors of health seeking behaviour among elderly population in a tribal dominant state of India
Authors: Soren Santosh Kumar , Sunderam Shalini , Deo Manish , Kujur Anit , Singh Shashi Bhushan , Kachhap Atul
Published: May 2022

Background:

Ageing is defined as a process of deterioration in the functional capacity of an individual that results from structural changes, with the advancement of age. Globally the geriatric population has increased from 8% in 2012 to 8.5% in 2015 and expected to rise by 22% in 2050. Hence we planned to study morbidity profiles and predictors of health-seeking behaviour among the elderly population in Ormanjhi, Ranchi

Methodology:

A community based cross sectional study was conducted in Ormanjhi, Ranchi, Jharkhand for a period of six months (March-August 2018). The study was done among 206 geriatric populations fulfilling the eligibility criteria, selected by cluster sampling and those not giving their consent were excluded from the study. Data collected were entered in Microsoft Excel and analysis was done on Statistical Package for Social Sciences (SPSS) version 20.0

Results:

A total of 206 geriatric populations fulfilling the study criteria, were enrolled during the study. The majority of the age group was found between 60-69 years (71.8%). Around 202 (98.1%) of which resided in rural areas, nearly half 102 (49.5%) depended on pension for livelihood and 108 (52.4%) were illiterate. Two-fifth of the study subjects (40.3%) consulted a government doctor if any health problems occurred followed by 30.5% preferred a private doctor and 20.1% consulted unqualified practitioners. Most of the study participants (64.5%) did not seek medical care due to financial reasons followed by 14.5% considered it a minor illness than 13% complained that health facility far away and 8.1% considered that old age itself as a disease. Non tribal ethnicity, participants who had their own source of income and co-morbidity were significantly associated with health seeking behaviour

Conclusion:

Most participants in this study suffered from morbidities which also affect their quality of life. It was also observed that most of them were not dependent on others for their daily activities. Health seeking behaviour was found to be appropriate in nearly two third (70%) of elderly subjects in Ranchi, Jharkhand.
To determine the role of ultrasonography as a primary imaging modality as compared to MRI in patients with shoulder pain
Authors: Barad Hardev V. , Patel Viral , Patel Shreya , Patel Mamta
Published: May 2022

Context:

Prevalence of shoulder pain in general population worldwide ranges from 16 -26%. It is necessary to evaluate different causative factors in shoulder pain and explore the utility of ultrasonography in rotator cuff and non-rotator cuff diseases as a primary imaging modality and reserve MRI for unequivocal cases

Aims:

To evaluate patients with shoulder pain using ultrasound as first line of imaging modality compared to MRI.

Methods and Material:

A Prospective Cross-sectional Descriptive and Analytical study was done in patients with shoulder pain referred to radiology department for USG and MRI.

Statistical Analysis Used:

Analysis was performed using STATA (14.2). Descriptive statistics was used to portray baseline profile of study population. Sensitivity, specificity, PPV, NPV and Kappa value used

Results:

In the resent study the maximum patients were between 40-59 years with Male: Female ratio of 3.5:1. Trauma was the most common etiological factor and restricted range of motion was seen in 47 (94%). Supraspinatus tendon was the most common tendon to show abnormality followed by Subscapularis. For Supraspinatus tendon and Subscapularis tendon partial thickness tear- USG had a sensitivity of 90.62% and 100%, specificity of 88.88% and 95.74%, PPV of 93.5% and 60.00% and NPV of 84.21% and 100% respectively

Conclusion:

Ultrasound although being operator dependent and not as accurate as MRI, provides rapid real time non-invasive cross-sectional imaging of joint and thus can be considered as primary modality for imaging rotator cuff pathologies, as it is readily available and cost effective.
The intricate association of COVID-19 pandemic with ecological issues
Authors: Deka Sangeeta , Rani Diksha , Mahanta Putul , Kalita Deepjyoti
Published: May 2022

This critical narrative review is intended to emphasize the comprehensive ecological issues related to the evolution of the novel coronavirus, the environmental factors associated with the disease progress, and the impact the pandemic is having on the environment. Approximately 60% of the emerging infectious disease of the last century (including deadly viruses like HIV, Ebola, Influenza, coronavirus strains like SARS, MERS) are linked to zoonotic spillover. Therefore, to escape the emergence of newer cross-species infections, proper precautionary measures should be taken. Every country has specific rules to deal with the biomedical waste produced in hospitals. But the COVID-19 pandemic has posed a unique global challenge due to the overwhelming amount of biomedical waste generated from dedicated COVID hospitals, diagnostic facilities, quarantine centers, and home quarantine facilities. Moreover, inappropriate disposal of masks by the general public may contaminate the environment turning it into a potential health hazard. Therefore, strict adherence to Biomedical Waste Management Guidelines for proper disposal of masks and other medical waste by all concerned is a must. Lockdown has brought about tremendous improvement in conditions of the world’s atmosphere, hydrosphere, and biosphere. Dramatic improvement in air quality index, decrease in water, and noise pollution are some of the positive aspects of lockdown. However, these effects are temporary. But these teach an important lesson to the world to take some permanent measures to bring down greenhouse gases and other toxic emissions. Some harmful effects of lockdown are illegal deforestation, wildlife trafficking, encroachment of reserved areas etc.
Bilateral mucinous ovarian carcinoma in a young female with tumor weighing 41.1 kg
Authors: Khoiwal Kavita , Kumari Payal , Dhundi Deepika , Kumari Om , Gupta Anshu , Gupta Priyanka , Sama Sonu , Sharma Pankaj , Anthony Michael , Gaurav Amrita , Chaturvedi Jaya
Published: May 2022

Mucinous ovarian carcinoma is a less-prevalent subtype of epithelial tumors. We present a case of giant mucinous ovarian carcinoma weighing 41.1 kg in a 24-year-old Indian girl. Benign mucinous tumors have the potential to reach an enormous size but such a huge malignant mucinous tumor is very rare in literature and its occurrence in a young female is even rarer.