bluuebunny/crossref_metadata_2025 huggingface dataset:
Chronic umbilical abscess secondary to a patent urachus in a 30 years male: a case report
Authors: Nynasindhu Akula , Palavalasa Swetana
Published: August 2021

Urachus is epithelialized, fibromuscular remnant part connecting urinary bladder with umbilicus. Urachal anomalies present and progress differently in paediatric and adult population. They remain largely asymptomatic until infected. Clinical presentation may vary from simple discharge from umbilicus to intrabdominal abscess and peritonitis. We present a case of urachal sinus presenting as recurrent umbilical abscess. 30 years male presented with complaints of umbilical mass with pus discharge. He was evaluated clinically and radiologically. Ultrasound revealed a localized collection near umbilicus whereas CT scan revealed connection of that collection to a fibrous strand like structure approximately 10 cm extending from umbilicus to urinary bladder. An open exploration was done under regional anaesthesia and 20 ml of abscess drained with excision of tract by ligating near the bladder end. Local debridement was done near the umbilical area. Wound closed in layers. Post-op period was uneventful without any recurrence. urachal anamolies need a high index of suspicion in adults to intervene early and get better outcomes with less morbidity.
COVID-19 gastrointestinal manifestation presenting as acute surgical like abdomen
Authors: Ramavath Krishna , Rao Siddharth S. , Sindhu Nyna , Parmeshwar Tushar , Palle Pranay
Published: August 2021

COVID-19 disease is caused by severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) which can cause respiratory symptoms more. It can cause gastrointestinal symptoms also due to this RNA virus protein binding to the angiotensin converting enzyme 2 (ACE2) receptors which are abundantly present in stomach, small intestine, large intestine and liver. The gastrointestinal manifestations of COVID-19 disease can present as acute surgical abdomen which can create diagnostic dilemma. We presented a case of COVID-19 disease, admitted in our hospital. Later he had symptoms of acute surgical abdomen symptoms like sudden onset abdominal pain, nausea, vomiting and loose stool without blood. He was properly evaluated and conservatively managed. The gastrointestinal manifestations of COVID-19 disease can present as acute surgical abdomen. So, these patients properly evaluated and then only surgical plan will be made according pathology.
Extensive post-covid mucormycosis salvaged by old fashioned negative pressure wound therapy
Authors: Sanjay R. , Khan Farukh , Gupta Shalu , Chikkarangappa Rahul , Choudhary Komal
Published: August 2021

Mucormycosis represents a group of life threatenening infections caused by fungi of the order Mucorales. Mucorales are ubiquitous environmental fungi that grow well in moist and damp conditions. They can invade arteries to cause thrombosis and infarction. These fungi cause infection primarily in patients with diabetes, neutropenia, elevated levels of free iron and those who are on glucocorticoid therapy, which supports fungal growth in serum and tissues. Recently the incidence of mucormycosis was found to have increased in patients previously infected with coronavirus (COVID-19). Here we presented a 52 year old lady who was previously infected by coronavirus, was administered glucocorticoids as a part of empirical treatment for COVID-19 pnemonitis. She recovered uneventfully within a few days, but, around a month later presented with erythematous papule over the anterior chest wall. The papule developed into a large fungating ulcer over a period of 10 days. KOH mount and culture confirmed it to be mucormycosis. Cutaneous mucormycosis can be highly invasive, penetrating into muscle, fascia and even bone. These are molds that grow well in moist and damp conditions. But depriving them of moisture and oxygen can help control their spread. This could be achieved by thorough debridement and applying negative pressure to the wound. The results achieved are remarkable and satisfactory.
Effectiveness of tramadol compared to pentazocine in pain management during labour
Authors: Bano Bushra , Bai Kalavanti , Jumani Shaista , Bashir Noreen , Mohsin Humaira , Laghari Saima , Yasmeen Haleema
Published: August 2021

Background: Pain and agony during childbirth is quite often unbearable and at times beyond description. Pain relief can help in removing curb due to pain. To determine the efficacy of intramuscular tramadol hydrochloride as an analgesic during labor compared to those of pentazocine.Methods: This randomized controlled trial conducted at Jinnah post graduate medical center, ward 8 (Gynaecology and obstetrics) between 2nd December 2013 to 1st June 2014 after approval from the ethical committee of the hospital. Pregnant women aged 15 to 45 years, parity ≥1 with Gestational age between 37 to 42 weeks with a single fetus were included in this study. The subjects fulfilling inclusion criteria were enrolled after informed consent. Women were allocated randomly to pentazocine or tramadol. Labour pain was assessed immediately by 4-point visual rating scale before, at 30, and 60 minutes after injection of the trial drug and mean score was calculated. The data was analysed using SPSS version 20.Results: A total of 128 patients were randomized to ether tramadol or pentazocine. The mean age of enrolled participants is 30±7.01 years and 53.1% participants were below 30 years of age. Of 64 patients who received tramadol, 53 (82.8%) had pain relief compared to 39 (60.9%) in patient who received pentazocine (p=0.005).Conclusions: It is concluded from this study that tramadol is more effective in reducing labor pain
Determinants of healthcare quality in single-payer healthcare system countries
Authors: Al Saied Nouf S. , Al Ali Musaed S.
Published: August 2021

Background: The quality of healthcare system in any country is essential for the wellbeing of its population. Improving the quality of the healthcare sector would lead to a healthier population and thus more productive nation and stronger economy. The level of healthcare quality depends on both economic and non-economic factors. Addressing the level of effect these factors on healthcare quality would facilitate policy makers’ tasks in achieving that goal.Method: This study is based on the 2019 data of 29 countries that adapt single-payer healthcare system. Pearson correlation matrix is used to examine the relation of a number of variables with healthcare quality, measured by life expectancy, in these countries.Results: The results from this research showed that literacy rate, digital adaptation, pollution level, corruption level, healthcare expenditure (HE) per capita, GDP per capita, healthcare expenditure as a percentage of GDP all showed a strong relation at the 99% confidence level while the number of physicians per 1000 showed statistically significant relation with healthcare quality at the 95% confidence level. While all factors showed direct relation, pollution and corruption showed an inverse relation.Conclusions: Improving the quality of the healthcare sector is the goal of any government since it would lead to better and stronger economy. While economic factors play a role in achieving that goal, other non-economic factors can also have the same effect in achieving that goal.
Programmatic evaluation of a school-based typhoid vaccination campaign: findings of qualitative research
Authors: Tabassum Farhana , Nooruddin Shanila , Habib Atif , Ali Noshad , Hussain Imtiaz , Pach Alfred , Memon Zahid , Soofi Sajid , Bhutta Zulfiqar A.
Published: August 2021

Background: Globally, typhoid fever is a vaccine preventable infectious disease with significant morbidity and mortality. Apart from EPI center, other alternative and accessible venues were needed for this vaccine like schools. The purpose of this study was to identify the factors influencing acceptance and rejection of participation in school-based typhoid vaccination program in target communities in Karachi.Methods: A qualitative study was conducted, 46 in-depth interviews were conducted with parents, teachers and administrators in the schools where the typhoid vaccine was provided. NVivo was utilized for data coding and themes were derived along with WHO’s analytical framework, vaccine hesitancy, that is, confidence, convenience and complacency, in responses to the vaccination.Results: Participants described confidence as a key factor that largely rooted their perceptions and attitudes related to the vaccination program. Stakeholders showed their concerns about affordability, safety and effectiveness and convenience of the vaccine’s delivery to the students. Satisfied participants from the school-based program showed lack of trust in quality of vaccine and vaccination procedures.Conclusions: Our findings indicate the importance of providing adequate information on vaccination through multiple communication channels, sustained social mobilization programs including community engagement. Addressing concerns through dialogic interactions were crucial for motivation and acceptance of the vaccination program.
Impact of meteorological factors on number of new COVID-19 cases in Pune
Authors: Mahajan Saurabh , Devarakonda Ravi , Mukherjee Gautam , Verma Nisha , Pushkar Kumar
Published: August 2021

Background: Coronaviruses are a family of viruses that can result in different types of illnesses, most commonly, as Severe acute respiratory syndrome (SARS). Researches have shown that the atmospheric variables and the density of population have affected the transmission of the disease. Meteorological variables like temperature, humidity among others have found to affect the rise of pandemic in positive or negative ways.  Respiratory virus illnesses have shown seasonal variability since the time they have been discovered and managed. This study investigated the relationship between the meteorological variables of temperature, humidity and precipitation in the spread of COVID-19 disease in the city of Pune.Methods: This record based descriptive study is conducted after secondary data analysis of number of new cases of COVID-19 per day from the period 01 May to 24 December 2020 in Pune. Meteorological data of maximum (Tmax), minimum (Tmin) and daily average temperature (Tavg), humidity and precipitation were daily noted from Indian meteorological department website. Trend was identified plotting the daily number of clinically diagnosed cases over time period. Pearson’s correlation was used to estimate association between meteorological variables and daily detected fresh cases of COVID-19 disease.  Results: Analysis revealed significant negative correlation (r=-0.3563, p<0.005) between daily detected number of cases and maximum daily temperature. A strong positive correlation was seen between humidity and daily number of cases (r=0.5541, p<0.005).Conclusions: The findings of this study will aid in forecasting epidemics and in preparing for the impact of climate change on the COVID epidemiology through the implementation of public health preventive measures.
Multiple behavioral risk factors causing cancer in rural women of Mysuru
Authors: Khanum Rufia Shaistha , Kumar D. Sunil , Verma Satendra Kumar , Narayanmurthy M. R.
Published: August 2021

Background: Cancer has affected humans since pre-historic times, but in recent years its occurrence has sharply increased. The common causative factors are an individual’s diet, decreasing physical activity, consumption of tobacco and alcohol. Cancer deaths are increasingly popular as the world is ignorant of its harmful lifestyle habits. Interventions focusing on behavior change are key to curb diseases caused by behavioral risk factors. The aim of the study was to identify the association between multiple behavioral risk factors and cancer in rural women.Methods: A cross-sectional study was conducted in Bharat hospital and Institute of oncology for a period of 5 months (February 2021-June 2021). A total of 380 rural women diagnosed with cancer were included in the study. A structured proforma was used to collect data about behavioral risk factors. The data was coded and entered in MS Excel and analyzed using SPSS version 25. Descriptive statistical analysis was done. Crosstables were constructed, Chi square test was done to find the association of behavioral risk factors causing cancer.Results: Significant association was found between the frequency of dairy products intake/week, frequency of fruits intake/week, frequency of vegetable intake/week, frequency of sweets intake/week, the frequency of tea, coffee consumption/day, frequency of smoking/week, frequency of snuff, sun protection practices and various cancers.Conclusions: Multiple behavioral risk factors like diet, physical activity, tobacco consumption, alcohol use, sun exposure, etc., are can be modified and treated. Proper education and health promotion are the keys to decrease non-communicable diseases.
Prevelance of symptoms during menstruation and its management among adolescent girls
Authors: Saji Angitha , Sunil Krupa Ann , John Agatha Mary , B. Abhilash Kumar , Thomas Abel Abraham
Published: August 2021

Background: Menstruation is a natural phenomena of the female reproductive cycle in which discharge of blood from the uterus exits through the vagina every month, it is the spontaneous onset of puberty. 75% of girls confront some problems associated with menstruation including delayed, irregular, painful and heavy menstrual bleeding. Menstruation can be accompanied with premenstrual and postmenstrual symptoms which include both physiological symptoms and psychological symptoms. It is important to treat both physiological and psychological symptoms with pharmacological and nonpharmacological treatment approaches.Methods: The study was a prospective observational study done with a sample size of 650 subjects of 9 to 18 age group in whom menstruation already occurred were recruited from five different schools in regions of Pathanamthitta and Alappuzha. The study was conducted in 3 phases, where initially a predesigned well-structured questionnaire was provided to assess the attitude, awareness and practices.Results: Subjects experienced some or other type of symptoms and had better knowledge regarding menstrual symptoms and its importance of management when compared to subjects from other regions of India which was imparted from a developed and supporting society but still, they lacked some adequate and updated information on symptoms and management of symptoms during menstruation.Conclusions: So, this study laid the groundwork for discussion on menstrual symptoms, various approaches of treatment to the adolescent girls, providing them the information they lacked and better guidance.
Oral health assessment and associated lifestyle behaviors among adults in Mathura city: a cross-sectional study
Authors: Jaiswal Saumya , Kaur Navpreet , Bhalla Manish , Sharma Vivek , Gupta Roopali , Chaudhary Sunil Kumar
Published: August 2021

Background: Oral health is recognized as an important aspect of an individual’s general health and quality of life. Impairment of oral health diminishes the quality of life. The aim of the study was to assess the oral health (the number of natural teeth, pain or discomfort on teeth, having dentures), oral health behaviors (e.g., using toothbrush, dental flossing, and toothpaste containing fluoride) and lifestyle behaviors (e.g., sugar consumed, tobacco, alcohol) of people living in Mathura city, Uttar Pradesh.Methods: This study was cross-sectional study conducted at K. D. Dental College and Hospital, Mathura. Pre-validated WHO oral health questionnaire was used to assess oral health, lifestyle and oral health behaviors of the study participants. Face to face interview sessions were conducted with consenting individual participants to ensure transparency and consistency, to reduce interviewer and misclassification bias.  Results: Total 550 participants were participated, in which 272 (100%) participants of 18-35 years of age group had 20 teeth or more. Majority of the participants had reported average status of teeth and gums. More than half of the participants were unaware of fluoride containing tooth paste i.e.; 122 (89.1%) participants of 36-50 years age group and 107 (75.9%) participants of 51-65 years age group.Conclusions: Although majority of the Mathura adults considered their oral health status good, only a small population considered their oral health status poor. Use of oral hygiene aids such as toothpick, dental floss etc., was limited in participants.
A study on psychological morbidity of cancer patients and chronic kidney disease patients
Authors: Sharma Ved Prakash , Shankar Ravi
Published: August 2021

Background: Cancer disease is a dangerous illness that causes about12% of deaths throughout the world. Increasing to 54% of all deaths by the year 2025. Recent international data show that there were 10 million new cases, 6 million deaths, and 22 million people living with cancer in 2000. In addition to physiological problems, the patient faces at large too many inherent problems by the family and society. Methods: A Hospital-based cross-sectional study was carried out among the people aged 18 to 70 years from the selected study area. The sample size was determined based on a prior study of the mean score of these three psychological variables anxiety, depression, stress. data was collected by using hospital anxiety depression scale and presumptive stressful life event scale.Results: In our study, The percentage of mean depression and stress level before 1 year were higher (11.49±2.76) (64.12±85.28) in CKD patients than cancer patients (10.86±2.51) (39.57±56.60), and the difference was found to be statistically significant (t=2.119, p=0.035) (Z=2.327, p=0.020) but the mean percentage of anxiety (7.43±3.21) and stress during past 1 year (317.46±87.95) were higher in cancer patients than CKD patients (5.63±2.82) (266.01±87.26). Conclusions: Based on our findings we may conclude that cancer patients have inclined to various psychological problems particularly depression, anxiety, and stress as compared to CKD. The depression and stress level before 1 year in CKD patients were more than that of cancer patients but anxiety and stress level during past 1 year was found more in cancer patients than that of CKD patients. Cancer thoroughly breaks the patients psychologically as well as biologically.
Correlation of smartphone addiction with musculoskeletal discomfort and neck disability among college students
Authors: Chovatiya Nandani K. , Chaudhary Hardi S. , Kanabar Nisha S.
Published: August 2021

Background: The nearly universal availability of smartphones in present cultures has resulted in smartphone addiction. The main purpose of the study was to assess risk of musculoskeletal discomfort and neck disability among college students who are smartphone addicted and assumes faulty posture with prolong smartphone use.Methods: The study examined 100 healthy students of a college in Ahmedabad and Gandhinagar by random sampling based on self-administered questionnaires that consist of Smartphone addiction scale (SAS), Cornell musculoskeletal discomfort questionnaire (CMDQ), Neck disability index (NDI) in the age group of 18-25 years. Pearson correlation coefficient was used to correlate between SAS and CMDQ, and SAS and NDI.Results: There was a predominance of females over males (females- 78, males- 22). Mean±SD of SAS, NDI and CMDQ was 92.74±21.33. 8.6±9.56 and 88±14.84 (CMDQ frequency), 30.5±7.77 (CMDQ discomfort), 27±4.24 (CMDQ interference) respectively. Pearson correlation coefficient showed a significant moderate positive correlation between SAS and NDI (r=0.44) and it showed a significant moderate positive correlation between both SAS and CMDQ (frequency) (r=0.50) and SAS and CMDQ (discomfort) (r=0.40), while it showed weak correlation between SAS and CMDQ (interference) (r=0.38).  Conclusions: The study indicated that there was a moderate positive correlation between neck disability and Smartphone addiction, while there was mild to moderate correlation between musculoskeletal disorders and smartphone addiction.
Belief about birth order and their reflection in academic performance: a cross sectional study
Authors: Premnath Parvathy , Aljesira Syed , . Suthesha , Nowfiya Syed , Abdullah Zoha
Published: August 2021

Background: Alfred Adler in 1964 stated that different position in a family, birth order may be correlated to both positive and negative life outcomes. Children in the same family are different from each other in academic achievement and the effects of birth order one child/s educational achievement has been studied. The objective was to evaluate the relationship between birth order and their reflection in academic performance.Methods: The study design was a cross-sectional survey where data collected by a self-administered online questionnaire to gather information about students bio data, birth order, gender, age, siblings size, parents education and income. A total of 92 online questionnaire were distributed to the participants (34 male and 53 female). Out of which 88 participants were submitted the response. All answered data were anonymous and recommended. Data were entered in excel and descriptive statistics were performed using SPSS software version 25.Results: The result showed that the birth order in family was more than 44.85% were first born, 11.96% participants were middle born, 31.03% of the participants had effect on child behaviour with birth order on educational settings. 28.57% of the participants showed that sibling role is related to academic success in life.Conclusions: There was a little significance gained from the response rate of the participants which showed that there was a relationship between birth order and academic performance. The controversy of birth order effect on academics may vary among countries, family size and different cultures.
Adverse effects of prolonged use of personal protective equipment among health care workers during COVID-19 pandemic
Authors: Chand Subhash , Sharma Neeraj , Kumar Sanjay
Published: August 2021

Background: To know adverse effects of prolonged use of (PPE) personal protective equipment among various categories of health care providers while taking care of COVID-19 patients.Methods: This study include health care workers involved in care of covid-19 positive patients admitted in COVID dedicated hospital. A preformed questionnaire based performa was distributed among health care providers. Questions were framed about various possible adverse effects of use of PPE. Duration of study was six month from first July 2020 to 31 December 2020. The data was obtained from questionnaire and thereafter analysed to determine the adverse effects of different parts of PPE among various categories of HCPs depending on their age, sex and duration of exposure.Results: A total of 150 health care workers of various categories were surveyed. Maximum numbers of health care workers were in the age group of 31-40 years. Most common side effects were itching, rash, suffocation and impaired cognition. N-95 masks, gloves and face shield when used caused maximum discomfort.Conclusions: COVID-19 is ongoing pandemic with uncertinity about its end. Health care workers are continuously exposed to COVID-19 positive patients and almost all the healthcare providers experienced discomfort while using PPE causing reduced work efficiency.
Assessment of beneficiary satisfaction at district early intervention centre, Mysuru district, Karnataka
Authors: Shruthi H. , Doddaiah Sunil Kumar , . Chandan , Gopi Arun , Narayan Murthy M. R. , Bilimale Anil S.
Published: August 2021

Background: District early intervention centres (DEIC) are established under Rashtriya Bal Swasthya Karyakram (RBSK), aimed at providing early intervention and screening of the children identified with 4Ds. Aimed to assess the beneficiary satisfaction visiting DEIC. Patient satisfaction was an important and commonly used indicator for measuring the quality of health care.Methods: A cross-sectional study was conducted at DEIC, Mysuru to assess client satisfaction. 276 study participants who visited the DEIC (from January 2021 to June 2021) were selected through the convenience sampling method. A semi-structured questionnaire was administered about the services provided across various departments at DEIC. Data were analyzed by using IBM version 23 SPSS.Results: Among 276 beneficiaries who reached DEIC, about overall client satisfaction, 250 (90.5%) were satisfied and 26 (9.42%) were dissatisfied with the functioning and services provided across various departments at DEIC. 272 (98%) were satisfied more with the information provided about the medications by the pediatric department and 11 (18.0%) were more dissatisfied with the room infrastructure, information provided about treatment adopted and instructions to parents/guardians for regular follow up by the counseling department.Conclusions: Overall, the clients were more satisfied with the services provided by the pediatric department and less dissatisfied with the counseling and psychology department. The findings of this present study will be useful input for the early intervention centers to improve their services and can also give an overview to the healthcare managers and policymakers in developing programs and policies. Improvement in the psychology, counseling, and ophthalmology departments will provide better beneficiary satisfaction.
Oral hygiene behaviour and practices of urban slum population: a cross-sectional study
Authors: Alure Shriprasad B. , Dodamani Arun S. , Vishwakarma Prashanthkumar , Jain Vardhaman M. , Mali Gaurav V. , Kulkarni Gunderao P.
Published: August 2021

Background: Poor oral hygiene is a major etiological factor for oral diseases. Urban slums are identified as a risk group population as the burden of oral diseases is high among them. So, the aim of the study was to evaluate oral hygiene status among the urban slum population.Methods: A cross-sectional study was carried out on 480 urban slum people aged between 18 to 75 years. A cluster random sampling method was adopted. Data were collected by structured questionnaire. The questionnaire included information related to patient’s knowledge, attitude, and practices related to their oral hygiene. Descriptive statistics were used to analyse the data.Results: The majority of people brushed their teeth once a daily (58.3%) by using a toothbrush and toothpaste (65%) followed by mishri and charcoal. 81.7% of people did not use any other oral hygiene aid. The majority of people did not use interdental aids, tongue cleaner, mouthwash. The majority of people (72%) know the harmful effect of tobacco still they consume various forms of tobacco. The results showed an acute lack of oral hygiene awareness and practices as well as the effect of poor oral hygiene on systemic health.Conclusions: There is a need to educate the urban slum population regarding proper dental care, oral hygiene methods, and prevention of dental diseases through dentists, outreach programs, effective oral health education, and promotion programs to make healthy individuals and healthy society.
Prevalence of type-II diabetes mellitus in relation to dietary habits and anthropometric status among adults
Authors: Kanaujia Anglica , Kumar Arun , Jain Seema , Singh Ganesh , Mittal Chhaya
Published: August 2021

Background: Type 2 diabetes is a metabolic-cum-vascular syndrome characterized by predominant insulin resistance with varying degrees of insulin secretory defect. It is more common in overweight and obese individuals of middle to late age but is increasingly being seen in younger age groups and in those with lower BMI as well. To determine the prevalence of type-II diabetes mellitus (DM) in relation to dietary habits among adult population of urban Meerut and to study anthropometric status associated with type-II diabetes mellitus.Methods: The present study was conducted in the field practice area of urban health training centre, LLRM medical college, Meerut by house-to-house survey among adults 30 years and above.Results: Prevalence of diabetes mellitus in the present study was found to be 13.1%. When prevalence of DM in relation to the type of diet was observed, it was more among those who were non vegetarians (17.8%) while it was only 7.2% among those who were vegetarians. The prevalence of diabetes in relation to the body mass index, waist-hip ratio shows statistically significant association.Conclusions: Inappropriate and unhealthy dietary patterns, obesity and increased waist hip ratio (WHR) were the major risk factors to cause diabetes mellitus.
A study on prevalence of anemia among late adolescent girls in JSS Schools and Colleges of rural and urban Mysuru district, Karnataka, India
Authors: Verma Satendra Kumar , D. Sunil Kumar , Khanum Rufia Shaistha , R. Narayanmurthy M.
Published: August 2021

Background: Anemia is the commonest micronutrient deficiency across the world. The burden of disease is high in underdeveloped and developing countries. Anemia itself is not a disease but a symptom of underlying deficiency. A large portion of iron deficiency is preventable with appropriate and timely intervention. Adolescence is a crucial phase for growth and development. Increased physiological demands, poor attitude of young children towards nutrition, lack of awareness amongst parents about healthy diet etc., are some of the reasons that makes anemia common among adolescents.Methods: A cross-sectional study was conducted in JSS schools and pre-university during February 2021. Sample size is 292 and a total of 300 girls in late adolescent age group were included in the study. Haemoglobin estimation was done by finger prick method using a digital haemoglobinometer. A structured proforma was used to collect data regarding socio-demographic characteristics and factors associated with anemia.Results: In our study 49% of the girls were anemic. Mean haemoglobin levels of the girls were 14±4 mg/dl. In this study there was significant association between menarche status (p=0.0041) and history of taking iron supplements (p=0.04). Significant association was noted between the mother’s education and the study participants’ anemia status (p=0.00). Significant association was noticed between BMI category of the study participants and their anemia status (p<2.2e-16).Conclusions: Anemia is huge problem among adolescent girls. The awareness is poor regarding the disease and its effects. The community is ignorant about the detrimental effects of anemia. Hence appropriate health interventions targeting women and children are needed to see any positive changes in their status.
Care seeking behaviour of infertile couples attending a government infertility clinic in Delhi
Authors: Negi Janender S. , Shahrawat Renu
Published: August 2021

Background: Childbearing is the reproductive right of every infertile couple. Infertility brings with it, multi-dimensional implications like social, economic and psychological. Care seeking by infertile couples is poorly understood as infertility services are deficient at grass-root level. We aimed to examine treatment seeking behaviour among infertile couples.Methods: A descriptive study was carried from 15 October 2019 to 15 March 2020. Primary data was collected by interviewing 196 married couples seeking care from an infertility clinic in Delhi. Data was tabulated and analyzed using statistical package for the social sciences (SPSS) version 23.Results: Majority of the couples had primary infertility (73%). In 47% of the couples, care seeking was advised by the household members. Most of the couples (82%) took decision to seek care themselves. Treatment was initiated within 3 years of marriage in 45% of couples. For first consultation, infertility treatment was sought from private sector (73%), public sector (16%) and informal sector (11%). Among public sector consultations, Government Medical College was preferred by 44% of couples while in private sector, 80% of them preferred private clinics. Infertility care was sought in 79% of couples from allopathic specialists. Mean duration of treatment and visits per consultation was 5 months and 10 visits respectively. Main source of information for treatment were friends and close relatives. Females (98%) faced more pressure from family to seek treatment than the males (72%).Conclusions: Main source of infertility care was from private sector. Females faced more pressure to seek treatment. Services in the public sector needs to be developed and strengthened to make infertility care accessible, equitable and affordable.
An observational study to evaluate psychological experience and social stigmas in COVID-19 patients: a prospective study on home isolated patients
Authors: Mistry Ankit R. , Gupta Parth , Bhimani Sagar R. , Patel Kamlesh P. , Malhotra Supriya D. , Patel Pratik R.
Published: August 2021

Background: Coronavirus disease 2019 (COVID-19) has caused significant distress. Apart from evident physical symptoms in infected cases, it has caused serious damage to public mental health. The present study was carried out to assess disease burden, fear and stigma associated in home isolated patients.Methods: A Prospective, observational study of 8 weeks began after IEC approval in diagnosed COVID 19 patients who were home isolated and visited by the researcher as part of Sanjeevni home care service launched by the municipal corporation. Number of patients turning symptomatic from asymptomatic was recorded. Frequency for transmission was also noted. Fear and social stigma by Fear of COVID 19 scale (FCV-19S) and Stigma scale was measured respectively.Results: A total of 746 patients were included in the study (mean age: 40.2±16.2 years). About 105 patients (14.07%) suffered from co-morbidities like Hypertension, Diabetes, Obesity. About 38.47% were asymptomatic while 61.53% were symptomatic during their home isolation period. Among asymptomatic patients, 48.78% became symptomatic during their period of home isolation and follow up. A family member being found positive was 35.19% from asymptomatic patients while 34.85% from symptomatic patients. The mean score of the patients for fear and stigma in our study was 14.74±5.13 and 35.13±8.48 respectively.Conclusions: Both symptomatic as well as asymptomatic patients can transmit the disease with equal frequency. Asymptomatic at diagnosis also converts to symptomatic in almost half of the population. This further highlights the importance of home isolation. This was the first time we have used a Stigma and Fear scale in patients affected by COVID 19 who were home isolated. Higher score of Fear scale was seen in >50 years of age.
Prevalence and associated factors of Internet addiction among college students using smartphone in Tamil Nadu -A Cross-Sectional Study
Authors: X. Mariavinifa , K. Govindarajan P. , Felix John William A.
Published: August 2021

Background: There has been rapid growth on the internet not only in India, but also in worldwide. It is a major public health problem affecting an enormous number of individuals. The objective of the present study was to determine the prevalence of Internet addiction and its associated factors among college students using smartphone in Tamil Nadu.Methods: A cross sectional study was conducted in Annamalai University from October 2019 to October 2020.A total of five hundred students from various streams (medicine, dental, bachelor of physiotherapy, engineering, arts and science) were selected conveniently and a self-administered questionnaire was used to collect data. A questionnaire consisting of socio-demographic data, questions on internet usage and Young's internet addiction test were used to gather data. Descriptive Statistics was defined in terms of percentage and frequency. Inferential statistics was analysed with Chi-Square test.Results: Out of the five hundred students, 45.4% were males, 54.6 % were females .The users were divided into groups, 38.8 % as normal users, 37% as mild addicts, 21% as moderate addicts, 3.2% as severe addicts. Thus overall prevalence of internet addiction was 61.2%. Degree of internet addiction was significantly associated with age, time spent daily on the internet and using internet for social media, online communications and playing online games.Conclusions: The present study showed a prevalence of internet addiction is high among college students. Therefore, it’s essential to make awareness among the students to enhance their quality of life through the prevention of addictive usage of the internet.
Evaluating metered dose inhaler and dry powder inhaler use technique among bronchial asthma and COPD patients attending tertiary health care centre in South India
Authors: Padmini Anaswara K. , Basheer Shabna
Published: August 2021

Background: Inhaler is a device used by patients who have chronic respiratory illness. Inhaled medication is directly deposited in the lungs, which is its site of action. Improper use of inhalers can lead to worsening of disease, over medication and side effects including oral candidiasis. This study aims to evaluate the inhaler use technique.Methods: A hospital based cross sectional study was conducted among patients who were using inhalers for one year or more attending respiratory medicine OPD using pretested semi-structured questionnaire.Results: The majority of 81 patients were MDI users. Only 8.64% of them performed all the steps according to NIH guidelines regarding proper technique of inhaler use properly. Among the 39 patients who used dry powder Inhaler, 33% correctly performed all the steps according to the guidelines.Conclusions: Only a low proportion of patients properly performed the steps in the technique of using inhalers. Improper use of inhalers leads to poor efficacy of the treatment. So health care providers should take measures to ensure that the patients on inhalers are aware of the proper technique and are following the steps in using inhalers correctly.
Visibility of gastric cancer awareness programs
Authors: Hange Namrata , Somagutta Manoj Reddy , Bobba Sai Harsha , Bathula Narayana Reddy , Batti Erkan , Iloeje Obumneme Jude , Ghazarian Klodin , Sajjanagandla Gouthami , Vasave Ulhas , Emuze Bernard
Published: August 2021

Gastric cancer is one of the most common and deadliest cancers known globally. Due to historically low survival rates and available few treatment modalities, especially in developing nations with high burden incidence of gastric cancers, reducing incidence seems to be the key to reducing mortality. This article has emphasized the planning and visibility of the gastric cancer awareness program. The gastric cancer awareness programs shall help people approach health care facilities if reported to be symptomatic and help to reduce the mortality burden through early detection and access to treatment. Stomach cancer awareness programs involve sensitization of the population regarding symptom recognition, screening, identification of vulnerable people, and preventive measures focused on disease control. Recognition of people at risk, symptom screening protocol along with prevention, and management of gastric cancer is meant to achieve this Gastric cancer control strategy. Gastric cancer awareness campaign, along with identification of risk factors, shall include prevention, early detection, and potential gastric cancer treatments through appropriate programs and activities. Targeting high-risk populations including males, aged more than 40 years, smokers, obese, alcoholic, red-meat eaters, population with low socioeconomic status, and people with a positive family history of gastric cancer along for health education shall be directed towards the annual gastric cancer screening programme either free or subsidized rate. Holistic gastric cancer awareness programs encompass the integrated lifestyle modification approach-addressing a healthy balanced diet; de-addiction for smoking and alcohol and stress-free life. Specific local, country-specific strategies tailored to each country's risk factor profile shall be considered while planning a gastric cancer awareness program.
Favorable and unfavorable maxillofacial comminuted fractures
Authors: Hifny Sara Ahmed , Almuzaini Abdullah Mohammed , Alharbi Shaika Meshal , AlJelayel Abdullah Abdulaziz , Kehaili Ohud Awwadh , Alhuwaymil Mohammed Abdullah , Khalil7 Eman Abdulsalam , Alrifaie Hamid Yaseen , Bakhadlg Haneen Abdulrhman , Al Mutarid Hassan Hadi
Published: August 2021

Many maxillofacial injuries were reported with the most common ones being nasal bone injuries. In another context, injuries occurring to the mandible followed by the malar bone and axilla are the most common injuries that require surgical interventions. However, favorable outcomes regarding the management of these injuries are associated with many factors. Such factors include the severity of the fracture and the presence of associated morbidities and other fractures, which might lead to unwanted complications and complex management plans. In this study, we aim to discuss the most reported maxillofacial fractures, elaborating when favorable and unfavorable events can be detected. Moreover, this literature review discusses some challenges that might be present in some cases, requiring the integration of certain management skills and techniques. Providing adequate examination is essential to conduct better management. Caring for the associated fractures with the main event is also important, and should be considered to intervene against the development of any adverse events.
Decoding the ergonomics in the new normal for dentistry: A narrative review
Authors: Munjal Sumit , Munjal Seema
Published: August 2021

Focus and precision are the sine qua non of dentistry, wherein the routine tasks require a peak pinch force and results in finger fatigue and cumulative trauma disorders combined with impaired vision. Dentists’ posture is treated with great care and oft repeated in Ergonomics, studied in undergraduate courses and the continuing education courses, though many still do not know the subject well enough. The study selection was done upon selecting the dental surgeons, hygienists, assistant working on their patients and included the findings relating to practice environment. The electronically searched sources until 2021 were the MEDLINE Pub med, EMBASE, Wiley Online Library, Science direct, American Dental Association (ADA) website and Google Scholar. An additional manual search and queries with cross-reference yielded around fifty studies ultimately. The International Ergonomic Association (IEA) recognized certain domains long ago and its noteworthy application for dental office is set forth in the present review. Ergo-dentistry may come to be realized as a new essential in the new normal for our profession.

Evidence echoes that dentists are at risk for developing health problems, particularly the musculoskeletal disorders and impaired vision. Beyond doubt, a healthy dentist is a pre-requisite for a successful dental practice. Ergodontics is the key to keep check on the same and following its core principles is essential.
Student-led seminar as a teaching learning technique to introduce first year medical undergraduate students to self-directed learning
Authors: Verma Niket , Aggarwal Navita , Singh Harsimranjit
Published: August 2021

: Student-led seminar (SLS) is an interactive peer-led teaching learning method which offers several advantages for both the student learners and the student tutors including helping the learners to develop self-directed learning (SDL) skills. The aim of this study was to analyze the perception of first year medical undergraduate students towards a recently conducted SDL module in Anatomy utilizing student-led seminars as the teaching learning technique.

 Participation in the study was voluntary and all 100 first year students consented to participate in the study. Informed consent was taken from the participants. The module was implemented across 2 sessions. In session 1, a clinical case scenario on Shoulder Joint was discussed. Students were then asked to identify knowledge gaps and brainstorm in small groups to formulate the learning objectives. Session 2 was conducted as a student-led seminar after a 6-day gap. Student perception was then obtained using a Google Forms based questionnaire.

: Thematic analysis was conducted for the responses. Major themes that emerged were that the participants learnt, enjoyed and felt motivated. Students appreciated the role played by the facilitators in guiding them and some of the respondents wanted to take up leadership roles for their teams in future sessions.

 As medical educators, we should not only encourage the acquisition of SDL skills by the learners but also provide a conducive environment for self-directed learning. To our experience the student-led seminar can be an excellent teaching-learning method for incorporating SDL skills among undergraduate medical learners.
Safe Return to Exercise after COVID-19 Infection
Authors: Vasiliadis Angelo V , Boka Vasiliki
Published: August 2021

COVID-19 has been posing a significant challenge to the athletic community. A wide spectrum of clinical features was reported in athletes with confirmed COVID-19 infection having mild to severe symptoms requiring hospitalisation and intensive medical care. Possibly, a lack of exercise may negatively impact the immune system, leading to an increased susceptibility to infection and comorbidities. Determining safe return to exercise after COVID-19 infection is a challenge for sports physicians. A gradual return to exercise under the guidance of a specialised medical team to achieve the pre-infection fitness level is of utmost importance. Individualised exercise programmes must be initiated at low intensity which could be gradually made more rigorous based on the pertinent metabolic equivalent. Thus, there is a clear need for clinical recommendations before athletes may return to exercise after COVID-19 infection.

Keywords: COVID-19; Coronavirus; Exercise; Athletes; Return to Sports.
Benchmarking of Bosnia and Herzegovina to Croatia Manufacturing Industry and Industry 4.0
Authors: Bajric Hadis , Vučijak Branko , Kadrić Edin , Anđelić Andrej
Published: August 2021

The paper presents the results of the current state of Bosnia and Herzegovina (B&H) production companies benchmarked to the Croatian production companies and to the concept of Industry 4.0, using the same methodology formerly used in Croatia related to implementation of Industry 4.0. Assessment was made on a sample of 47 manufacturing companies from different industries. Responses were collected through online questionnaires and interviews. The assessment was made using structured questionnaire with questions related to the business processes of a company from product development, production and to the quality assurance and logistics. According to the collected responses and the methodology used, the level of development of B&H production companies is 2,19, which is very close to the Croatian companies, in which the level of development was at 2.15, but in a survey conducted three years earlier. This research confirmed that the level of development of B&H manufacturing companies is actually the same as with the Croatian companies.
An Empirical Relationship between Agriculture Investment and Economic Growth in North Macedonia: An ARDL Analysis
Authors: Jankulovski Nikolche , Angelova Biljana , Boshkoska Meri
Published: August 2021

The main aim of this paper is to find the
relationship between agriculture investment and the
growth of the gross domestic product in North
Macedonia. We collected the yearly secondary time
series data between the periods 1991 to 2020. We run
the ARDL co-integration test to check the long-run as
well as the short-run relationship between dependent
and independent variables. We found a positive and
significant relationship between agriculture valueadded
and the growth of the GDP in the long run. The
agricultural land has a positive relationship with the
growth of the GDP in the long run but negatively
correlated in the short run. Last, both variables
agricultural methane emissions and inflation are
negatively correlated with the growth of the gross
domestic product in both the long and the short run.