bluuebunny/crossref_metadata_2025 huggingface dataset:
Puberty signs and its relationship with lifestyle in 8-to-10-year-old girls: A descriptive-analytical study
Authors: Esfarjani Shahla Vaziri , Jamalzade Nadia Ghorban , Hakim Ashrafalsadat , Hesam Saeed
Published: September 2022

Introduction:

Declining the age of puberty causes many different physical, emotional and social changes that lead to negative consequences in adolescence and middle age. In the past 100 years, the average age of puberty has declined all over the world. External factors related to the lifestyle have effects on general sequences of puberty stages. The present study aimed to evaluate the puberty signs and their relationship with the lifestyle of 8-to-10-year-old girls in Ahvaz City.

Materials and Methods:

This descriptive-analytical study was conducted on 200 girls between 8 to 10 years of age from public schools of Ahvaz City from 2019 to 2020. Multi-stage cluster random sampling was used. The lifestyle questionnaire was distributed among the parents, and the children were examined physically for secondary sex characteristics. To analyze the data, SPSS 22 was used with the analyses and descriptive methods.

Results:

57.6% of the children experienced puberty, with an average onset age of 9.36 for girls. There was a significant relationship between the age of puberty onset and birth order (P = 0.007), body mass index (P = 0.001), nutrition of 8-year-old girls (P = 0.008) and alcohol abuse of 9-year-old girls’ families (P = 0.039). There was no significant relationship between the beginning age of puberty with environmental, social and psychological health.

Conclusion:

Results indicated a lower age of puberty onset compared to previous studies in the country. Therefore, these results can be a database for future analyses and comparisons.
Readiness to change among parents of overweight/obese children in Saudi Arabia and influencing factors
Authors: Arabi Hisham , Altaf Lina Z. , Khashoggi Alya A. , Alwazzan Shahad B. , Aldibasi Omar , Jamil Syed F.
Published: September 2022

Background:

Pediatric overweight/obesity is a major health problem worldwide. Accurate parental perception of children’s weight status is crucial in preventing and tackling this issue. Despite the consistent increase in prevalence of the childhood obesity in Saudi Arabia, the role of the parents is not well described. This study aims to explore Saudi parents’ readiness to change the lifestyle of their overweight/obese children and the barriers facing it.

Individuals and Methods:

Through a cross-sectional design, 362 parents of overweight/obese children attending King Abdulla Specialized Children’s Hospital were selected and requested to fill a predesigned questionnaire reflecting their perception about their children’s weight status and their preparedness to change their lifestyle. A Chi-square test was used to verify significance. A P value of <0.05 was considered an indication of significance.

Results:

Among all overweight/obese children (n = 362), obese children formed 39.5 and 22.7% had morbid obesity. Only one half of the parents (49.7%) had correct perception about their children’s weight. Correct perception increases significantly with an increase age of the child and in the presence of family history of diabetes, P < 0.05. Only 68.9% were worried about body weight of their children, the percentage was significantly higher in younger parents; parents with obese children and with a positive family history of hypertension P < 0.05. In total, 83.1% of the worried parents proceeded to preparation and action stages; the percentage was significantly higher among parents whom their children were free from identified comorbidities, P < 0.05.

Conclusion:

Misconception about real weight status of overweight/obese children is common in Saudi parents. Parents who have correct perception and worried about health status of their children are more likely to take actions. The first step in controlling children’s obesity is to educate parents about how to recognize the real weight status of their children and to be aware about the health-related problems of obesity.
Direct oral anticoagulant: Review article
Authors: Nasiri Abdulrahman , AlQahtani Ahmed , Rayes Nora H. , AlQahtani Rawan , Alkharras Reem , Alghethber Hamad
Published: September 2022

Venous thromboembolism (VTE) and atrial fibrillation (AF) is a major burden on the health care system. The average occurrence of venous thromboembolism annually is around 108 per 100,000 person-year. DOACs have transformed treatment of coagulation disorder, and now, it is the leading treatment for stroke prevention in AF and VTE prophylaxis and treatment. For more many years, oral vitamin K antagonists (VKAs) were the drug of choice in managing VTE. VKAs treatment is safe and effective if therapeutic international normalized ratio (INR) maintained on the target. However, achieving a stable, therapeutic international normalized ratio (INR) can be difficult and challenging in the context of drug and food interactions and liver disorder, resulting in undertreatment which increases the risk of thromboembolism or overtreatment which might cause bleeding. Herein, we provide an overview of DOACs indications, use in specific comorbidities, monitoring parameters, perioperative management, and reversal agents.
Hospice vs Palliative care: A comprehensive review for primary care physician
Authors: Sheikh Mona , Sekaran Sruthi , Kochhar Hansini , Khan Asma Tasnim , Gupta Ishita , Mago Arpit , Maskey Upasana , Marzban Sima
Published: September 2022

End-of-life medical services in the form of Hospice or Palliative care were initiated in the middle of 1900 in order to comfort the dying patients and support their families. There are a lot of similarities and differences between the two services. Many healthcare providers, including physicians, physician assistants, and nurses, are not fully trained or have comprehensive knowledge of these two types of end-of-life medical care. Through this paper, we aim to provide a thorough review of Hospice and Palliative care for internist and primary care physicians both in terms of indications or eligibility criteria; the similarities and differences between the two types of care; factors that disqualify an enrolled patient; and lastly, the role or use of Hospice and palliative care during COVID-19 pandemic.
Chronic abdominal pain due to entrapment of the anterior abdominal cutaneous nerve (ACNES): About a case
Authors: Galindo Blanca Sanchez
Published: September 2022

Anterior abdominal cutaneous nerve entrapment syndrome (ACNES) is a chronic neuropathic abdominal pain that can radiate dorsally and occurs as a result of entrapment of the thoracic intercostal nerves in the abdominal muscles. This pain increases with the contraction of the abdominal muscles and is not related to meals or bowel habits. Its diagnosis is based on history and physical examination without the need for additional tests. The treatment of this pathology consists of the infiltration of a local anesthetic together with corticosteroids at the point of greatest pain, which achieves an immediate resolution of the pain.
The effects of intrinsic foot muscles strengthening exercises on knee kinematic in pronated foot subjects during forward jump landing
Authors: Sadeghi Marzieh , Mohammadi Hosein Kouhzad , Mehravar Mohammad , Salehi Reza , Taheri Navid , Karimzadeh Atefeh
Published: September 2022

Introduction:

The foot and ankle are a complex set of multiple joints with multiple degrees of freedom that play an important role in static and dynamic activities. The intrinsic and extrinsic muscles of this complex play a role in controlling the deformity of the arch; thus, the aim of this study was to investigate the effect of the intrinsic foot muscle-strengthening exercises on knee kinematic parameters in pronated foot subjects during forward jump landing.

Methods:

This interventional study was performed on students aged 20–30-years old with foot pronation in the School of Rehabilitation. In this study, the kinematic changes of the knee in the frontal, sagittal and transverse plane before and after 6 weeks of strengthening exercises of the intrinsic foot muscles during the forward jump-landing task were examined using a motion analyser. All data analysis was performed offline using a special software program in the MATLAB software environment.

Results:

Knee angle variables have a normal distribution before and after exercise. The ICC coefficient of all variables was calculated as between 0.44 and 0.71; therefore, the reproducibility of the variables under study in this study was considered moderate to good. The knee angle on the frontal plate was 2.54 ± 2.4 before the exercises and 2.49 ± 2.14 after the exercises, and there was no significant difference between them (P = 0.21).

Conclusion:

Plantar intrinsic foot muscle-strengthening exercises alone have no effect on the kinematic changes of the knee in people with foot pronation, or the duration of strengthening exercises should be increased during the day to see the effect of strengthening the intrinsic muscles among pronated foot subjects.
Population control bill of Uttar Pradesh (two-child norm): An answer to population explosion or birth of a new social problem?
Authors: Mishra Chandra M. , Paul Sourabh
Published: September 2022

Recently, the Government of Uttar Pradesh (UP) unveiled a draft bill of the UP Population Policy (2021–2030) on World Population Day to bring down the gross fertility rate and stabilization of the population. The history of the two-child norm in India has shown that different state governments had tried to implement it at different timelines during the past 20 years. Global evidence suggests that Vietnam and Bangladesh have stabilized their population and control birth rate despite not having two-child policies. Moreover, sex-selective abortion, preference for male children, denying the paternity of female children, pre-natal sex determination, and violence against women for giving birth to girl children will be on rise. Female literacy, empowerment, and addressing unmet needs of contraceptives are the time-tested solutions for population control rather than raising a new social problem with a “two-child policy” bill/act.
Psychological aspects of COVID-19 vaccine in Indian population. Are we still hesitant?
Authors: Shaheed Raza , Acharya Sourya , Shukla Samarth , Kesarwani Monika , Acharya Neema
Published: September 2022

During the Coronavirus disease-19 (COVID-19) pandemic, with channelization of misinformation in several platforms that people can access, the world has witnessed a unique infodemic throughout the globe. Some knowledge helped people to alleviate not only the stigma and anxiety but also inclined them to take appropriate COVID-19 behavior; whereas, the some acted opposite and buildup an aura of negative thoughts in the community regarding the prevention and control and the efforts toward effective vaccine uptake contributing to psychological disbeliefs which in turn leading to vaccine hesitancy. In India, current vaccination program for COVID-19 needs to be communicated to not only promote vaccine acceptance but to also counter rumors related to COVID-19. The WHO has recommended all the individual governments to highlight the vaccine objection spots and that the governments, educate, and implement social awareness on the vaccination with the help of local organizations so that large proportion are covered with this safe immune program. With the emergence of new variants COVID-19 infection can be severe. “Earlier people get vaccinated the earlier people are protected”. Taking these concerns, our study will throw some light for primary care physicians on COVID-19 vaccine-related psychological attributes and hesitancy and will present pragmatic approaches to deal with scenarios related to it during the pandemic.
Early initiation of remdesivir and its effect on oxygen desaturation: A clinical review study among high-risk COVID-19 patients in Myanmar
Authors: Aye Than Than , Myat Kaung , Tun Hpone Pyae , Thiha Phyo , Han Tin Myo , Win Yin Yin , Han Aye Moh Moh
Published: September 2022

Background:

Although Remdesivir has been evaluated for the treatment of coronavirus disease 2019 (COVID-19), few study has yet shown effective mortality reduction. It might be because, in almost all those studies, remdesivir therapy was started beyond 7th days from the onset of symptoms when the active viral replications have already gone.

Methods:

This study reviewed the effectiveness of early remdesivir therapy during viral phase of COVID-19 and safety of its administration at home or community care during the outbreak of COVID-19 from July to September 2021 in Myanmar. We retrospectively reviewed clinical records of 204 high risk COVID-19 patients who had received remdesivir therapy within 7 days from the onset of illness and before oxygen desaturation. Findings: All patients received remdesivir therapy according to standard five days course of 200 mg loading dose on day 1, followed by 100 mg daily for up to 4 additional days. Out of 204 patients, 60.75% (124/204) were aged 60 years and above with comorbidity; 21.1% (43/204) aged under 60 years with comorbidity and 18.1% (37/204) were aged more than 60 years old without comorbidity. The patients who received RDSV therapy within 1-4 days and within 5-7 days were 50.5% (103/204) and 49.5% (101/204) respectively. All patients survived to 21 days without ICU admission or mechanical ventilation. Eighty six percent of patients had no hypoxia and only five percent had moderate to severe hypoxia, requiring oxygen. Those who received RDSV therapy within 1 to 4 days from the onset of symptoms had significantly lower rate of hypoxia compared to those who received remdesivir therapy on 5 to 7 days. After RDSV therapy, increased lymphocyte count and decreased CPR were observed in 74.5% (152/204) and 52.9% (108/204) of the patients respectively. There was no report of major adverse events.

Conclusion:

Remdesivir, if given within first 4 days from the onset of symptoms, is the most effective strategy for prevention of oxygen desaturation, further progression of COVID-19 and death although it is still beneficial if given later, days 5 to 7. It is a safe drug to be prescribed in hospital at home care. It may be cost-benefit if high-risk group of patients with COVID-19 were selected for early remdesivir therapy in the community.
The autopsy practice and pathology in COVID-19
Authors: Kaur Jasmeen , Kaur Manmeet
Published: September 2022

The universal spread of novel virus named coronavirus disease 2019 (COVID-19) also known as 2019-nCoV, Middle East Respiratory Syndrome and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) declared by the world health organisation (WHO). This virus has dived in to multiorgan, with clinical manifestations of fever, sore throat, dry cough, dyspnoea, chest pain, nausea, vomiting, diarrhoea and muscle pain. As novel coronavirus been categorised as HG3 infection which has highest with inhalation and by skin surface contact. As previous pandemics have occurred like SARS and MERS special attention to autopsy had been given to prevent exposure to the healthcare workers. Similar attention should be given to the autopsy protocols and underlying pathology for COVID-19 infection so as to better understanding of the disease for further control and treatment guidelines. Thus, herein we bring and summarise review of literature for understanding.
The impact of chronic disease and accompanying bio-psycho-social factors on health-related quality of life
Authors: Bahall Mandreker , Bailey Henry
Published: September 2022

Background:

Most chronic illnesses lead to poor health outcomes. Bio-psycho-social sequelae and accompanying depression lead to further deterioration in health-related quality of life (HRQoL). This study explored the HRQoL of patients with major chronic diseases in a public tertiary health care institution in Trinidad and Tobago.

Methods:

This cross-sectional study was conducted on a convenience sample of adult patients with chronic illnesses in a public health institute in Trinidad. Data were collected using face-to-face interviews and consenting patients’ records. A 43-item questionnaire comprising demographic, medical, and lifestyle questions, the nine-item patient health questionnaire (PHQ-9) on depression, and the EQ-5D-5L HRQoL questionnaire were used. Psychological and social variables were divided into six groups: Group 1 (community attachment variables), Group 2 (family and friends), Group 3 (life satisfaction), Group 4 (depression symptoms), Group 5 (social support), and Group 6 (lifestyle variables). The impact of these variables on HRQoL was investigated using regression and canonical correlation analysis.

Results:

Patients were primarily female (70.3%), Indo-Trinidadian (63.9%), having diabetes mellitus (46.0%) or cancer (35.8%). The quality of life was lower than Trinidad and Tobago EQ-5D-5L population norms. Females and older patients had worse HRQoL than males and younger patients, respectively. Furthermore, kidney failure, all cancer patients, and middle-aged female cancer patients fared worse than other categories. Life satisfaction and exercise were significantly associated with better HRQoL. Depressive symptoms were consistently and significantly negatively associated with HRQoL.

Conclusions:

HRQoL was lower among participants with chronic disease than in the general population. Depressive symptoms led to worse HRQoL, whereas life satisfaction and exercise significantly improved HRQoL. The EQ-5D dimension most frequently affected was anxiety/depression.
A study on foetomaternal outcome of pregnancies complicated by cardiac diseases
Authors: Pillai Sheila Kamalasan , Monisha Subbaiya
Published: September 2022

Cardiac disease complicates around 1–4% of all pregnancies. This study has been conducted to know the incidence of cardiac diseases complicating pregnancy in our institution and to identify the spectrum of various cardiac diseases and their associated maternal and fetal complications.

Objectives of the Study:

1. To evaluate the maternal and fetal outcome in patients with cardiac disease in pregnancy. 2. To identify any significant association between the modified World Health Organisation (WHO) risk classification of maternal cardiovascular diseases and the maternal and fetal outcomes.

Methods:

This study was conducted in the Department of Obstetrics and Gynecology at Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil nadu.

Study Design:

Retrospective and Prospective observational study.

Study Period:

April 2017–April 2020. Sample Size 72 patients satisfying the inclusion criteria admitted from April 2017 to April 2020.

Inclusion Criteria:

Rheumatic heart disease, congenital heart disease, arrhythmias, and conduction disorders.

Exclusion Criteria:

Cardiomyopathy.

Results:

The incidence of heart disease complicating pregnancy in our study was 0.5%. The ratio of RHD: CHD in our study was 4:1. There was no statistically significant association between the modified WHO risk classification of heart disease and the mode of delivery. 36.1% patients of the study group developed complications related to their cardiac disease, of which 96.3% belonged to the rheumatic heart disease (RHD) group. There were no cases of maternal mortality or perinatal mortality in our study.

Conclusions:

According to our study, there was a statistically significant association between the maternal complications, namely. congestive cardiac failure and acute pulmonary edema and the modified WHO risk assessment class of maternal cardiovascular diseases in pregnancy. There was no statistically significant association between the perinatal morbidity and the modified WHO risk assessment class of maternal cardiovascular disease in pregnancy.
Diffuse large B-cell lymphoma and new insights into its pathobiology and implication in treatment
Authors: Mamgain Garima , Singh Praveen K. , Patra Priyanka , Naithani Manisha , Nath Uttam K.
Published: September 2022

The most common non-Hodgkin lymphoma (NHL) subtype is diffuse large B-cell lymphoma (DLBCL). It accounts for roughly 30% of all cases of NHL affecting both nodal and extra nodal sites. There are molecular subtypes of DLBCL, germinal centre subtype (GCB), and activated B-cell (ABC), based on gene expression profiling (GEP), in accumulation to distinct morphological and clinicopathological subtypes. To prognosticate patients, the International Prognostication Index (IPI) and its variants are used. In ABC type DLBCL, limited stage disease is treated with a combination of abbreviated systemic chemotherapy (three cycles) and field radiation therapy. Although advanced stage disease is treated with a full course of chemotherapy as well as novel agents (Bortezomib, Ibrutinib, Lenalidomide). In this review study, we looked at the role of multiple aspects of genetic and microenvironment changes which have effects in DLBCL tumours.
Nerve biopsies in patients with peripheral neuropathy: A prospective evaluation
Authors: Agrawal Abhishek , Garg Ravindra K. , Malhotra Kiranpreet , Malhotra Hardeep S. , Rizvi Imran , Kumar Neeraj , Suvirya Swastika , Sharma Praveen K. , Verma Rajesh , Uniyal Ravi , Pandey Shweta
Published: September 2022

Background:

In approximately 25% of peripheral neuropathy cases, diagnosis remains obscure. In India, leprosy continues to remain one of the most frequent causes of peripheral neuropathy. We, in this prospective evaluation, performed nerve biopsies in patients with peripheral neuropathy for early confirmation of the diagnosis.

Materials and Methods:

A total of 55 consecutive cases of peripheral neuropathy were included in this study. All patients were subjected to clinical and electrophysiological evaluation. Sural nerve biopsies were performed in all the patients.

Result:

After a nerve biopsy in 29 cases, we were able to identify the underlying cause of peripheral neuropathy. In 26 cases, the diagnosis remained obscure. The most frequent histopathological diagnosis was leprosy, which was seen in 20 cases. Other diagnoses were chronic demyelinating neuropathy (four cases), vasculitis (two cases), and amyloidosis in one case. In two biopsies, the findings were consistent with hereditary neuropathies. The demonstration of lepra bacilli was the most distinctive feature. In addition, foamy macrophages (100%) and granuloma (100%) formation, epineurial (83.3%) and endoneurial infiltration (69%) along with epineurial (87.5%) and perineurial thickening (77.3%) were also noted more frequently in leprosy-associated neuropathy.

Conclusion:

The nerve biopsies revealed that leprosy was the most common etiology in patients with peripheral neuropathy. In approximately 47% of the cases, even nerve biopsies failed to establish a confirmed diagnosis.
The pattern of tobacco use and the associated socio-demographic factors among Transgenders living in Chennai city of Tamil Nadu, India
Authors: Sucharitha Sree T. , Pradeep Rangasawmy , Vikram Ashokkumar , Sivagurunathan Chinnaian , Ezhilvanan Mani , Premkumar K.
Published: September 2022

Introduction:

The tobacco epidemic is one of the biggest public health threats the world has ever faced, which kills more than 8 million people a year around the world. Transgenders are prone to use and abuse substances including tobacco and alcohol as a coping mechanism to manage minority stress experienced due to high levels of discrimination and lack of acceptance by society.

Objectives:

Among transgenders living in Chennai city, Tamil Nadu, (1) we aimed to estimate the prevalence and describe the pattern of tobacco use and (2) identify the sociodemographic factors associated with tobacco use.

Methods:

A community-based cross-sectional analytical study was conducted among 734 transgender adults living in the Chennai city of Tamil Nadu. A pre-tested, semi-structured interview schedule was used. Descriptive statistics such as frequency and proportions were used for categorical variables. Chi-square test was applied to find the significance of the association between tobacco use and sociodemographic factors.

Results:

The prevalence of the current use of any form of tobacco products among transgenders was 64.4%. About 27% had tried to stop using tobacco during the past 1 year. Education status, socioeconomic class, and occupation were significantly associated with the current use of any form of tobacco and trying to quit tobacco use.

Conclusion:

The prevalence of tobacco use among transgenders is alarming. The present study findings highlight the need to increase awareness activities by health authorities and non-government organizations (NGOs)/community-based organizations (CBOs) to generate awareness about the health hazards of tobacco use among transgenders. Tobacco control programs focussing on transgenders are essential.
Older people’s perceptions of intergenerational relationships in nursing homes: A qualitative content analysis
Authors: Harouni Mahboubeh D. , Tabrizi Kian N. , Fallahi-Khoshknab Masoud , Fadayevatan Reza , Maddah Sadat S.
Published: September 2022

Introduction:

Intergenerational conflict is one of the components which helps to inappropriate communication patterns and ineffective interactions. Intergenerational research aims to promote deeper understanding and respect between generations and helps to create more cohesive communities, suggesting that it can have numerous health and social benefits. Despite the importance of intergenerational relationships in the elderly, the older people’s perceptions of intergenerational relationships in nursing homes are not well understood. The purpose of this study was to explore the older people’s perceptions of intergenerational relationships in nursing homes in relation to nurses.

Methods:

This was a qualitative content analysis in which 12 elderly residents and 6 employees (3 nurses, 1 supervisor, 1 psychologist and 1 nursing home manager) in the nursing home were recruited purposively from three nursing homes located in Tehran, Iran. Semi-structured interviews were used to collect information. Data were analyzed via qualitative content analysis and continuous comparison and were based on self-interactional group theory (SIGT).

Results:

During data analysis, “Struggle for existence” was extracted from three subthemes as the main theme. Subthemes such as “prejudicious tendencies”, “Communication nodes” resulting from intra-group and inter-group analysis, respectively, and the “umbrella of society,” which influences both concepts, formed the intergenerational relationships in the nursing homes.

Conclusion:

Generational differences between nursing home residents and nurses make establishing effective communication between them difficult and lead to lack of quality care. The study findings can help nursing home managers apply strategies to remove barriers to intergenerational relationships, improve these relationships and increase cohesion between generations to lead to better care and subsequent improvement in their quality of life.
When time is short, and we are late!: A story of chronic meningitis
Authors: Chakraborty Debabrata , Bhaumik Sanjay , Agarwal Sushil , Sen Sagar , Majumder Saptarshi
Published: September 2022

We often face situations when the exact etiological diagnosis of meningitis is difficult. The reason behind this is that many pathogens have similar clinical, radiological, and laboratory pictures. The low yield of the pathogen in cerebrospinal fluid (CSF), non-availability of detail tests in all corners of the world, delay in availability of reliable results (like cultures), and difficulty in performing confirmatory tests like brain biopsy (in inconclusive cases) make the job of a clinician challenging. We report here a case where a late diagnosis of a disease owing to inconclusive results leads to dissemination. The complications following the introduction of the treatment based on presumption lead to further difficulty. We remained inclined to our diagnosis based on clinical judgement, acknowledged and managed the inflammatory changes secondary to the infection, and finally won the long battle. So, sometimes we need to make decisions based on clinical grounds. We need to depend on the fact that uncommon presentations of common diseases are commoner than a common presentation of uncommon diseases.
Knowledge, attitude, and hesitance toward COVID-19 vaccination – a cross-sectional study from Jharkhand
Authors: Kumari Anita , Rani Sudha , Kumar Chandramani , Kumari Vinita
Published: September 2022

Introduction:

In order to enhance public acceptability and reduce vaccine hesitancy in the face of the disease, it is necessary to examine the general public’s awareness of the coronavirus vaccination. Vaccination resistance to the coronavirus disease 19 (COVID-19) vaccination continues to be a problem throughout the world. Some of the greatest hurdles to dedication to hygienic standards are a lack of scientific testing for the vaccination, the fear of vaccine side effects, and reports of active viruses in immunizations. National and international health groups are launching initiatives to promote public knowledge about the COVID-19 vaccinations. This study aimed to understand the knowledge, attitude, and hesitancy toward the COVID-19 vaccine among the people of the Hazaribag district from Jharkhand.

Methodology:

The present study was conducted in Sheikh Bhikhari Medical College and Hospital, a tertiary care hospital of Jharkhand. It was a cross-sectional study. The research was conducted from June 2021 to December 2021.

Result:

The majority of respondents (83.3%) were confident in taking the COVID-19 vaccine, and 76% respondents agreed that the COVID-19 vaccinations now in use were safe; nevertheless, concern was expressed by 8% of respondents, whereas neutrality was expressed by 15.1%.

Conclusion:

Overall, the participants in the study had a good understanding of the coronavirus vaccine and agreed to take it. The development of mild or major side effects following immunization is the most important determinant for vaccine reluctance. Vaccine acceptability may improve whenever more information about vaccine safety and efficacy becomes available in the public domain, preferably from a centralized, trustworthy source. To promote public vaccination acceptance and reduce vaccine hesitancy, ongoing training and health education programs are required.
Dog tick (Rhipecephalus) causing Lyme disease in an adult human
Authors: Grover Ashok Kumar , Singh Purneetha , Puri Saurabh , Jindal Saurabh , Choudhary Pankaj Nand
Published: September 2022

Lyme disease is a tick-borne multisystem disorder transmitted by the family of Ixodes and caused by a spirochete, Borrelia. An early manifestation of the disease presents with skin lesions typically called Erythema chronicum migrans (ECM). Doxycycline should be the antibiotic of choice used for its treatment. However, we present the case of Lyme’s disease in an adult male with dog tick, Rhipecephalus as a vector.
Efficacy of phenytoin for 7 days versus 21 days as prophylactic anticonvulsant in traumatic brain injury patients – A comparative study
Authors: Kumar Santosh , Bharti Alok Kumar , Prasad Ravi Shankar , Kumari Sarita , Singh Anup , Yadav Ghanshyam
Published: September 2022

Background:

Post traumatic seizures (PTS) are very common after traumatic brain injury and occur more common in severe form of injury. Prophylactic treatment with phenytoin has been found to be effective however till now no uniform internationally agreed guideline is available for the duration of anticonvulsant prophylaxis for traumatic brain injury patients.

Methods:

100 patients of either sex between age group of 18–65 years who have suffered intracranial injury identified by CT scan, admitted in Trauma ICU were enrolled in this prospective randomized single blinded clinical study. Group 1 (n = 50) received 7 days prophylactic anticonvulsant therapy with phenytoin and Group 2 (n = 50) received for 21 days. The primary end point was the occurrence of seizures, which were classified as early (occurring from time of drug loading to day 7) or late (occurring on day 8 or later after loading of drug). Patients were also assessed for the possible adverse side effects of phenytoin.

Result:

Out of 100 patients, 90 completed the study successfully as 5 patients from each group expired during the duration of the study. On comparing the frequency of seizure from 1st to 7th day after loading dose of phenytoin between two groups, out of 45 patient, 2 (4.4%) developed seizure in group 1 and 3 (6.7%) developed seizure in group 2 and found to be statistically insignificant (P = 0.645). On comparing the frequency of seizure from 1st to 21st day after loading dose of phenytoin between two groups, out of 45 patient, 4 (8.9%) developed seizure in groups 1 and 3 (11.1%) developed seizure in group 2 and found to be statistically insignificant (P = 0.725).

Conclusion:

A 21-day prophylactic anticonvulsant therapy with phenytoin was not more effective than a 7-day prophylactic therapy with phenytoin to reduce the frequency of seizure in a TBI patient in trauma ICU and was also associated with more adverse side effects that were insignificant.
Health-related quality of life of intellectually disabled children attending a special school in Puducherry-A cross-sectional study
Authors: Sasinthar Karthikayini , Sugumaran Arun , Boratne Abhijit V. , Patil Raj K.
Published: September 2022

Introduction:

Health-related quality of life (HRQOL) is a measure of an individual’s psychosocial, emotional, and physical well-being. Around 1 in 20 children are less than 15 years of age and are living with a moderate-to-severe form of disability. Thus, our study aims to determine the HRQOL of intellectual disabled (ID) children attending a special school in Puducherry and to determine the socio-demographic factors influencing the level of HRQOL.

Methodology:

A cross-sectional analytical study was conducted among 350 ID children attending a selected special school in Puducherry over 1 year. By the universal sampling method, all the caregivers of ID children were recruited and the parent proxy form of Pediatric Quality of life Inventory scale version 4.0 (PedsQL ver 4.0) was used to assess the level of HRQOL of ID children. The data were analyzed using the Statistical Package for Social Science version 16.0 (SPSS ver. 16.0) and the statistical significance was set at P value <0.05.

Results:

Among the 350 respondents, a majority of the caregivers were mothers (78.9%) and 65.7% were homemakers by occupation. Most of the respondents were from the nuclear family (77.7%) and 55.1% were from urban areas. The mean age of ID children was 12 (±3.8) years; 61.2% were males and 40.8% of the children had a moderate form of ID.

Conclusion:

The HRQOL of ID children is found to be lower. The factors influencing the lower HRQOL were age, the intelligent quotient (IQ) of ID children, and type of marriage of the caregivers.
A study of clinical, radiological features and HLA-B27 serology of axial spondyloarthropathy with comparison of radiographic and non-radiographic disease
Authors: Edara Manaswini , Bhatt Varsha , Zanwar Abhishek , Koneru Kavya , Patel Aditi M. , Jawade Pranav
Published: September 2022

Background:

Axial spondyloarthropathy is a type of disease which affects the axial skeleton affecting productive years.

Methods:

This was a cross-sectional, observational study in which 28 consecutive patients more than 16 years of age, fulfilling the Assessment of SpondyloArthritis International Society (ASAS) criteria for axial spondyloarthropathy were included. They were further sub-grouped into radiographic and non-radiographic axial spondyloarthropathy. Clinical features, joint involvement, measurements, HLA-B27 serology, and disease activity were evaluated. Data was entered into Microsoft Excel, and SPSS (Statistical Package for Social Sciences) software 2.0 was used for analyzing the data.

Results:

Mean age was 28.5 ± 6.3 years. 85.7% were males. Inflammatory low back pain was the most common clinical feature at presentation (89.2%). Enthesitis was the most common extra-articular feature seen in 35.7% of patients. 42.8% were non-radiographic axial spondyloarthritis. 85.7% of patients were HLA-B27 positive. 50% of patients had bone marrow edema on MRI, and only one patient had ankylosis indicating predominantly early disease. 50%–70% of our patients had high disease activity and 89.3% were responding well to non-steroidal anti-inflammatory drugs (NSAIDs). There was no significant difference between the radiographic axial spondyloarthritis group and the non-radiographic group except for elevated C-reactive protein (CRP).

Conclusion:

Ankylosing spondylitis in western India occurs mostly in the age group of 20–30 years, suggesting affection of productive age group. There was a delay of diagnosis for approximately three years from the onset of symptoms. There was a positive association with HLA-B27 in majority of the patients. Most of our patients had early disease based on radiological findings, suggesting that there was room for therapeutic intervention before irreversible ankylosis had set in.
Comparative pulmonary function test parameters in non-tribal and tribal women in singleton first, second, and the third trimester of pregnancy
Authors: Manjulata  , Kumar Sandeep , Behera Joshil Kumar , Mondal Himel , Singh Poonam
Published: September 2022

Background:

During pregnancy, women undergo adaptive changes in different organ systems including the respiratory system by hormonal changes and mechanical pressures. Several previous studies reported the change in pulmonary functions in pregnancy and tribal populations. However, trimester-wise, pulmonary functions in tribal women residing in Jharkhand, India, are not available.

Aim:

This study aimed to find and compare the pulmonary function test parameters in tribal and non-tribal women in singleton first, second, and third trimesters of pregnancy.

Methods:

We conducted this cross-sectional observational study in a tertiary care hospital in Jharkhand, India, with 58 tribal women and 116 age-matched controls. The pulmonary function tests, namely forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), peak expiratory flow rate (PEFR), maximal mid expiratory flow (MMEF) were measured with a computerized spirometer (Spiro Excel, Medicaid, Punjab, India) and FEV1/FVC was calculated.

Results:

A total of 58 tribal women with median age 22 (Q1–Q3: 21–25) years and 116 non-tribal women with median age 22 (20–25) (P=0.33) participated in the study. The tribal women showed higher respiratory rate (20 [18–24.5] vs. 16 [15–18] per minute, P<.0001), higher MMEF in the first trimester (1.46 [1.12–1.79] vs. 1.24 [1.04–1.5] L/s, P=0.047) and higher PEFR (4.02 [2.78–4.11] vs. 3.15 [2.58–3.87] L/s, P=.047) in the second trimester. There was no difference in the third trimester of pregnancy. In the overall sample, the tribal women showed higher PEFR (3.82 [2.96–4.33] vs. 3.3 [2.73–4.05] L/s, P=.02) and MMEF (1.43 [0.99–1.7] vs. 1.21 [1–1.47] L/s, P=.04).

Conclusion:

The respiratory rate was higher in the tribal women in the three trimesters of singleton pregnancy compared to the non-tribal women. There was a higher MMEF in the first trimester and PEFR in the second-trimester pregnancy in the tribal women. The finding of this pilot study should be enhanced by further study with a large number of tribal women from this region.
Percutaneous pedicle screw fixation in caries spine – Does early MIS fixation has advantage over conservative?
Authors: Nishant  , Agarwal Varun Kumar
Published: September 2022

Objective:

We performed this study to investigate the role of fixation by percutaneous pedicle screw fixation (PPSF) in spondylodiscitis secondary to TB origin for pain relief and rapid early mobilization of the patient.

Material and Methods:

Thirty-two cases of tuberculous spondylodiscitis were managed from March 2017 to 2019. Clinical assessment, radiological evaluation, and laboratory studies with over a year follow-up after PPSF without decompression. Visual analog scale (VAS score) and Oswestry disability indices (ODI scale, Hindi version) were used for outcome measure.

Results:

Female-to-male ratio was 19:13. The average follow-up was 14 months ± 6 days and the duration for fusion was around 6 months. The mean duration of hospital stay was 4.006 ± 1.17 days. The average blood loss was 27.18 ml ± 17.71. The mean surgical time was 121.25 ± 14.59 min. ATT was continued for 12–18 months. C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) pain scores (visual analog scale), and ODI were lower at 3 months and at final follow up. No failure of instrumentation or decline in neurological condition was reported after operative intervention.

Conclusion:

Primary treatment of TB spine has been chemotherapy with limited indications for surgery. Severe pain in the presence of spondylodiscitis without neurological deficit or deformity projects as an unclear situation and a temporary surgical fixation gives stability to prevent unexpected neurological injury and promote early healing with faster rehabilitation in contrast to strict bed rest and external bracing.
Recurrent lumbar disk herniation – Fusion is the answer
Authors: Borkar Sachin A , Bansal Tungish
Published: September 2022

Recurrent lumbar disk herniations (rLDHs) are becoming a common occurrence in present times. However, the optimal surgical strategy for their management is a not clear with discectomy alone and discectomy followed by fusion emerging as the main surgical options. In this editorial debate, we discuss why discectomy and fusion is better option for the management of such cases. The complication rates, treatment satisfaction rates, visual analog scale (VAS) leg pain scores, and rates of adjacent segment disease (ASD) requiring surgery are similar in both the groups. However, the back pain score and reoperation rates are better in fusion surgeries. Moreover, the problems needing reoperations (hardware problems and ASD) in fusion group are easier to treat. Fusion surgery is already indicated in rLDH cases with deformity, instability, and significant axial low back pain. We believe it should be considered in all cases due to negligible risk of recurrence, addressing the iatrogenic spinal instability caused due to extensive bony work, ease of surgery due to more working space, and better restoration of disk height and sagittal balance.
Special AT-rich sequence-binding protein 2 (SATB2) in the differential diagnosis of osteogenic and non-osteogenic bone and soft tissue tumors
Authors: Milton Sharon , Prabhu Anne Jennifer , Titus V. T. K. , John Rikki , Backianathan Selvamani , Madhuri Vrisha
Published: September 2022

Background: The diagnosis of osteosarcoma (OSA) depends on clinicopathological and radiological correlation. A biopsy is considered the gold standard for OSA diagnosis. However, since OSA is a great histological mimicker, diagnostic challenges exist. Immunohistochemistry (IHC) can serve as an adjunct for the histological diagnosis of OSA. Special AT-rich sequence-binding protein 2 (SATB2) was recently described as a reliable adjunct immunohistochemical marker for the diagnosis of OSA.Methods: We investigated the IHC expression of SATB2 in 95 OSA and 100 non-osteogenic bone and soft tissue tumors using a monoclonal antibody (clone EPNCIR30A). The diagnostic utility of SATB2 and correlation with clinicopathological parameters were analyzed.Results: SATB2 IHC was positive in 88 out of 95 cases (92.6%) of OSA and 50 out of 100 cases (50.0%) of primary non-osteogenic bone and soft tissue tumors. Of the 59 bone tumors, 37 cases (62.7%) were positive for SATB2, and of the 41 soft tissue tumors, 13 cases (31.7%) were positive for SATB2. The sensitivity of SATB2 as a diagnostic test was 92.6%, specificity 50%, positive predictive value 63.8%, and negative predictive value 87.7%.Conclusions: Although SATB2 is a useful diagnostic marker for OSA, other clinical, histological and immunohistochemical features should be considered for the interpretation of SATB2.
Blind signal separation for coprime planar arrays: An improved coupled trilinear decomposition method
Authors: Que Zhongyuan , Zhang Xiaofei , Jin Benzhou
Published: September 2022

In this study, the problem of blind signal separation for coprime planar arrays is investigated. For coprime planar arrays comprising two uniform rectangular subarrays, we link the signal separation to the tensor‐based model called coupled canonical polyadic decomposition (CPD) and propose an improved coupled trilinear decomposition approach. The output data of coprime planar arrays are modeled as a coupled tensor set that can be further interpreted as a coupled CPD model, allowing a signal separation to be achieved using coupled trilinear alternating least squares (TALS). Furthermore, in the procedure of the coupled TALS, a Vandermonde structure enforcing approach is explicitly applied, which is shown to ensure fast convergence. The results of Monto Carlo simulations show that our proposed algorithm has the same separation accuracy as the basic coupled TALS but with a faster convergence speed.
Regenerarea naturală într-un șleau de luncă din Ocolul silvic București
Authors: Ghinescu Mugurel-Nicolae , Nicolescu Valeriu-Norocel , Stăncioiu Petru-Tudor
Published: September 2022

Lucrarea prezintă cele mai importante caracteristici ale regenerării naturale din sămânță într-un șleau de luncă din Ocolul silvic București (45°16’45,12” lat. N; 26°06’54,66” long. E, alt. 65 m). Arboretul a fost parcurs cu trei tăieri progresive în anii 2012, 2014 și 2016, iar ochiurile deschise în anul 2012 au fost integral regenerate. Cercetările s-au desfășurat în opt ochiuri, care au inclus câte două transecte pe direcțiile E-V și N-S, fiecare cu câte șase suprafețe de probă de câte 9 m2, situate la o distanță de 10 m între ele. În anul 2017, regenerarea naturală instalată a fost foarte bogată (de la 71.111 la 126.019 puieți la ha) în toate ochiurile, mult peste nivelul considerat „bun” prin normele tehnice în vigoare la vârsta respectivă, de 10-15.000 puieți la ha. Numărul de puieți de stejar pedunculat la hectar a variat de la 15.278 la 45.278. Compoziția arboretului este dominată de teiul argintiu, urmat de stejarul pedunculat și de carpen, iar ponderea stejarului în amestecuri a variat de la 12% la 43%. După cinci sezoane de creștere, diametrul mediu la colet al puieților, la nivel de ochi, a variat de la 9,6 mm la 11,8 mm. Stejarul a prezentat diametre medii la colet de la 7,1 mm la 9,9 mm. Înălțimea puieților, la nivel de ochi, a variat de la 62 la 83 cm, în timp ce la stejar aceasta a fost de 61-93 cm. În general, atât diametrul la colet, cât și înălțimea puieților au crescut de la est la vest și de la nord spre sud.

Întrucât puieții de stejar și din alte specii de bază au atins deja (la doar cinci ani de la începerea tăierilor de regenerare) dimensiuni mult peste cele recomandate de normele tehnice silvice pentru aplicarea tăierilor de racordare, rezultă că perioada de regenerare poate fi mai scurtă decât cea prevăzută în amenajament.