bluuebunny/crossref_metadata_2025 huggingface dataset:
Investigating emergency rescue readiness on Indian national highways: A case study of Jaipur-Jodhpur Highways (India) using a geospatial approach
Authors: Dandabathula Giribabu , Roy Subham , Ghosh Koushik , Chadha Ishani , Rathore Sejal , Kumar Gaurav , Joshi Nitin K. , Bhardwaj Pankaj , Bera Apurba Kumar , Srivastav Sushil K. , Raikwar Madhu
Published: November 2024

ABSTRACT

Background:

Highways represent the most significant capital asset that any country’s public sector holds. A system of national highways with easy access to ambulance and trauma centers is termed emergency rescue ready and helps reduce the mortality due to road accidents. Given the rich impetus for road infrastructure development by the government of India, there is a need to consider emergency rescue readiness on highways. Previous research suggests that on typical Indian highways, an ambulance can reach the accident scene within 30 minutes; the remaining 30 minutes of golden hour is essential for saving the life of the injured by admitting to a healthcare facility with a trauma unit.

Objective:

To investigate the emergency rescue readiness for a stretch of highway between two cities in India. The main objective is to determine the possibility of transporting the injured due to the accident on the highway to the nearest available trauma center within 30 minutes.

Methods:

A Geographic Information System (GIS)-based network analysis method has been adopted to find the possibility of transporting the injured anywhere on the circuit of a national highway to the nearest healthcare unit within 30 minutes.

Results:

A map representing the status of emergency rescue readiness has been presented for the study area. For a circuit of national highway with a length of 805 km, in a stretch of 89.5% (718.5 km), the injured can be transported to the healthcare unit within 30 minutes. In the remaining 10.5% of the highway, the healthcare units are significantly far from the highways and may hamper the post-crash rescue operations.

Conclusion:

There exists a wide disparity in trauma care delivery in the study area. Currently, the healthcare units established to serve the areas with dense populations also serve as emergency rescues during accidents on the national highways. Using GIS techniques for highway stretches with difficulty reaching the trauma centers, a national-level assessment is highly recommended.
Determinants of malnutrition among adolescent females of age 15–19 years in an urban slum of Raipur city
Authors: Das Sakthi , Shukla Arvind Kumar , Galhotra Abhiruchi
Published: November 2024

ABSTRACT

Context:

Adolescent girls suffer the brunt of malnutrition due to increased nutritional needs to facilitate rapid growth spurt including menstruation and increased physical activity. This vulnerable group has low social power and is subjected to peer and social pressures related to body image and weight. All these factors along with the sociocultural milieu may lead to a spectrum of nutritional problems in them.

Aims:

To determine factors associated with malnourishment among adolescent females of age 15–19 years in an urban slum of Raipur City.

Settings and Design:

The study setting was the urban field practice area of the institute in Raipur. The study was an analytical cross-sectional study done from January 2022 to June 2023 among 401 adolescent girls of age 15–19 years.

Methods and Material:

The sampling was done using the consecutive sampling method. The study tools used were a semi-structured questionnaire on sociodemographic variables and details of the respondents, anthropometric measurements, dietary assessment using the 24-hour food recall method, and food consumption patterns using a food frequency questionnaire.

Statistical Analysis Used:

The Chi-square test of significance was applied to find the association between malnourishment with the input variables. For calculating the strength of the association, the odds ratio was estimated for those variables with P value < 0.2 in the Chi-square test, and later the odds ratio was adjusted for confounding with the same variables, using multivariable logistic regression.

Results:

According to BMI-for-age Z scores, 2% were severely thin (< −3 SD), 9.7% were thin (−3 to − 2 SD), 5% were overweight (1 to 2 SD), and 1.5% were obese (>2SD). While measuring the height-for-age Z scores, 5.5% had severe stunting and 21.9% had moderate stunting. Those respondents with educational status of high school or below [AOR 3.5 (1.8–6.8), P < 0.001] and those who did not consume a non-vegetarian diet [AOR 2.1 (1.1–4.1), P = 0.02] had significantly higher adjusted odds of being undernourished (severely thin or thin) as compared to those with educational status above high school and those who consumed a mixed diet, respectively. The respondents who are currently not going to school/college had significantly higher adjusted odds [AOR 2.2 (1.2–3.8), P = 0.007] of being stunted when compared to those who are attending school/college.

Conclusions:

The significant levels of malnutrition observed in this study among late adolescent girls aged 15–19 years—11.7% undernourishment, 6.5% overnourishment, and 27.4% stunting—highlight the concerning vulnerability of this population. The higher prevalence of stunting throws light onto the chronicity of malnutrition. As seen from the significant associations, proper education, and a mixed diet will help nurture a healthy female adolescent population.
Exploring sleep-related disorders in patients with multiple sclerosis: A questionnaire-based approach
Authors: Bamaga Ahmed K. , Aljohani Awatif , Muthaffar Osama Y. , Alyazidi Anas S. , Bahowarth Sarah Y. , Almasry Nouf A. , Bakhsh Danya Y.
Published: November 2024

ABSTRACT

Background:

Multiple sclerosis (MS) is considered the most prevalent neurological disorder in young adults with many patients manifesting sleep-related disorders (SRD) due to its pathomechanisms. This is subsequently reflected in patients’ quality of life and physical activities.

Material and Methods:

This is a cross-sectional study at a tertiary care center. Patients diagnosed with MS were enrolled, and assessment of their sleep patterns and related disorders were measured using pre-validated scales. A questionnaire consisting of 38 items was used, and the obtained data were analyzed using RStudio software.

Results:

A total of 260 patients participated in the study. Most participants were aged 31–40 (n = 112) with a mean age of 36.49 ± 8.41 (age range: 18–56 years). The most used medications were rituximab (27%) and ocrelizumab (25%). Shapiro–Wilk Test was significant (P = 0.04) and just below the significance level of α = 0.05, suggesting potential significant deviation in the distribution of age. Logistic regression model was applied, and the female probability of sleeping more than six hours was 3.60 times the probability of sleeping six hours or less.

Conclusion:

Sleep quality is multifaceted and requires intensive investigation in patients with chronic disorders including MS. In this study, several novel data have been presented in a population that has very little literature data.
Gastrointestinal pathology in patients presenting with iron deficiency anaemia: A single-centre cross-sectional study
Authors: Tahaseen Shaik Mohammad , Kirti Ravi , Kumar Ramesh , Pandey Sanjay , Rao Rajath , Kumar Anjani , Arya Rahul , Maji Tanmoy , Biswas Ratnadeep
Published: November 2024

ABSTRACT

Background:

About a third of the world’s population is estimated to suffer from anaemia, and iron deficiency is expected to account for about half of all anaemia cases. This study was designed to get an estimate of the proportion of patients with iron deficiency anaemia (IDA) who have a significant gastrointestinal (GI) pathology, in particular a GI malignancy, and to identify any risk factors or predictors for the same.

Methods:

This cross-sectional study was conducted at a hospital in Eastern India. The study population comprised males above the age of 18 and postmenopausal females with IDA, excluding those haemodynamically unstable or with chronic diseases. Data collection included a detailed history, sociodemographic details, dietary habits, GI symptoms, and severity of anaemia. Faecal occult blood tests (OBTs) were conducted, and patients were referred for upper and lower GI endoscopy with biopsies.

Results:

Out of the 257 patients, 50.97% (n = 131) had a significant GI pathology, and 25.68% (n = 66) had a GI malignancy. Male gender (AOR: 5.203, 95% CI: 1.725–15.698) and a positive stool OBT (AOR: 6.516, 95% CI: 2.255–18.828) were found to be independent risk factors for any GI pathology. Age 40 years or above (AOR: 11.376, 95% CI: 1.199–107.946), loss of appetite (AOR: 15.548, 95% CI: 1.416–170.735), pain abdomen (AOR: 5.566, 95% CI: 1.149–26.953), dysphagia (AOR: 7.945, 95% CI: 1.036–60.915), family history of malignancy (AOR: 46.726, 95% CI: 4.076–535.645), and positive OBT (AOR: 22.430, 95% CI: 3.933–127.915) were found to be independent risk factors of GI malignancy.

Conclusions:

This study shows that a large proportion of adult males and postmenopausal females presenting with IDA in India have significant GI pathology. Furthermore, a significant proportion of them have GI malignancies. Thus, bidirectional endoscopy should be considered for these patients. Male patients, age >40, those with history of loss of appetite or weight, pain abdomen or dysphagia, positive family history, and positive OBT should be prioritised for the investigation.
Understanding the impact of delayed diagnosis and misdiagnosis of systemic lupus erythematosus (SLE)
Authors: Mitchell Jordan L.
Published: November 2024

ABSTRACT

Systemic lupus erythematosus (SLE) is a complex and multifaceted autoimmune disease that poses a significant diagnostic challenge for healthcare providers due to its diverse clinical manifestations, lack of specific testing, and potential to mimic other conditions. Delayed diagnosis and misdiagnosis of SLE can have serious consequences for patients, impacting their physical and psychological well-being. The physical consequences of delayed diagnosis and misdiagnosis of SLE are significant. Studies have shown that delays in diagnosis can lead to increased organ damage, poorer health outcomes, and increased morbidity and mortality. With a delayed diagnosis or misdiagnosis, patients may also experience increased psychological symptoms, such as depression, anxiety, and lack of trust in clinicians. The median delay from the first symptom to diagnosis in SLE is 47 months, highlighting the need for early recognition and management. Delayed diagnosis can lead to increased disease progression, which can result in irreversible organ damage and long-term complications. This paper investigates the multifaceted consequences of delayed diagnosis and misdiagnosis of SLE, encompassing both physical and psychological impacts. It delves into the underlying reasons behind diagnostic delays and offers comprehensive strategies for healthcare providers to enhance early recognition and management. Through a thorough analysis of medical literature and statistical data, this paper aims to provide physicians with actionable insights to improve diagnostic accuracy and patient outcomes in SLE.
Evaluation of biofilm formation and carbapenem resistance in Klebsiella pneumoniae isolated from clinical samples at a rural hospital in western Uttar Pradesh
Authors: Jaisal Shashikant , Singh Amit , Verma Rajesh K. , Ram Vidya Sagar , Verma Shesh Kumar , Yadav Himanshi , Prakash Vijay
Published: November 2024

ABSTRACT

Introduction:

Klebsiella pneumoniae commonly causes healthcare-associated infections and shows multidrug resistance. K. pneumoniae can produce biofilm. Carbapenem resistance in K. pneumoniae is due to the production of carbapenemases mainly. This study was done to evaluate the formation of biofilm and carbapenemase resistance in K. pneumoniae isolates.

Material and Methods:

A total of 110 K. pneumoniae isolated from various clinical samples were taken, the antibiotic susceptibility test was done by the Kirby disk diffusion method, and biofilm detection was done by the tissue culture plate method. All the carbapenem-resistant isolates were confirmed by multiplex real-time PCR (mPCR). Those found positive for any of the carbapenemase genes were tested by the modified Hodge test (MHT), modified carbapenem inactivation method (mCIM), and ethylenediamine tetraacetic acid (EDTA)-modified carbapenem inactivation method (eCIM).

Results:

Out of 110 isolates, 66% (72/110) were carbapenem-resistant (suggestive of carbapenemase producers) by Kirby-Bauer disk diffusion but 58% (42/72) of Klebsiella isolates were confirmed for carbapenemase production by mPCR. Maximum number of carbapenemase gene were New Delhi metallo-β-lactamase (NDM) 52% (N = 22), 29% (N = 12) coproducers (NDM+OXA-48), and lowest in oxacillinase (OXA-48), 19% (N = 8). The overall sensitivity of MHT and mCIM+eCIM was 62% and 93%, and specificity was 88% and 97%, respectively. Our study showed that moderate biofilm producers were 51% (N = 56) K. pneumoniae isolates, strong biofilm producers 27% (N = 30), and 22% (N = 30) were weak/non-biofilm producers. We also found the correlation between biofilm formation and carbapenem-resistant K. pneumoniae (CR-KP) genes was statistically significant with a P value of 0.01*<0.05.

Conclusion:

Most isolates of K. pneumoniae demonstrated a wide range of antibiotic resistance and were biofilm producers. Our results indicated that the combination of mCIM with eCIM showed high sensitivity and specificity to detect CR-KP compared with MHT.
Overzealous over-the-counter cough syrup ingestion leading to serious manifestation in a child – A case report
Authors: Yadav Dinkar , Verma Hunny , Yadav Neha , Bhalla Kapil
Published: November 2024

ABSTRACT

Cough is a protective reflex that allows clearance of secretions from upper respiratory tract. It is not a disease by itself but a symptom of underlying disease. In a majority of cases, it is self-limiting and requires only supportive care. But over-the-counter cough syrups are inadvertently used to relieve cough in Indian settings. We hereby report a case of a 6-year-old girl child who presented to pediatrics emergency services with complaints of loss of consciousness and abnormal body movement after ingestion of dextromethorphan and chlorpheniramine containing cough syrup. All investigations including cerebrospinal fluid examination, neuroimaging, and electroencephalogram revealed no significant abnormality. The child was admitted for 5 days and discharged after that in stable conditions.
Diagnostic accuracy of Gorelick 10 point scale in comparison to IMCI scale in identifying significant dehydration in South Indian children? - A prospective observational study
Authors: Sathyakiran Mudiganti , Chandramohan Anandhi , Palanisamy Soundararjan
Published: November 2024

ABSTRACT

Background:

Unavoidable cause of mortality among under 5 children in India is dehydration resulting from acute diarrhoeal diseases. In spite of various dehydration scales available across the world, the most commonly used dehydration scale in India is IMCI.Gorelick 10 point scale having more clinical indicators could also be considered using if the diagnostic accuracy of the scale in identifying the significant dehydration is in par with that of IMCI scale. Our Objective was to classify the 1month - 60 month aged children admitted with diarrhoeal disease based on dehydration assessment using Body weight, Gorelick 10 point scale, IMCI scale and to compare the diagnostic accuracy of Gorelick 10 point scale vs IMCI scale in identifying significant dehydration.

Methods:

The prospective observational study was done among 224 , 1 month to 60 month aged children admitted with acute watery diarrhea. The children were assessed for severity of dehydration using Body weight, Gorelick 10 point scale, IMCI scale. The diagnostic accuracy of Gorelick 10 point scale vs IMCI scale in identifying significant dehydration was assessed using statistical methods like, Sensitivity, Specificity, Positive Predictive Value PPV,NPV,LR+, LR-, Youden index and accuracy and Kappa statistic to detect inter-rater reliability.

Results:

The proportion of participants classified as to have no dehydration, some dehydration and severe dehydration according to Gorelick 10 point scale, IMCI and percentage of weight loss was 79.9%, 18.8%, 1.3% vs 77.7%,21%,1.3% vs 79.9%,18.8%,1.3% respectively The diagnostic accuracy of IMCI scale in identifying Significant dehydration was higher than Gorelick 10 point scale, as noted by having Sensitivity, Specificity,PPV,NPV,LR+,LR-,Youden index and accuracy as 100%,97.2%,0%,100%35.8,0,0.97,97.7% vs 88.9%,97.2%,88.2%,97.2%,31.8,0.11,0.85,95.5% respectively and k value was 0.9.

Conclusion:

Though the diagnostic accuracy of IMCI was little higher than Gorelick 10 point scale in identifying significant dehydration, having obtained k value of 0.9, indicates posing an excellent agreement Gorelick 10 point scale can be used in place of IMCI to identify Significant dehydration.
Prevalence of anxiety disorders among visitors at a military primary health center in UAE
Authors: Alameri Fayeza , Yaslam Manea , Alraeesi Nahed , Alshereif Sojoud , Darwish Ebtihal , Heena Humariya
Published: November 2024

ABSTRACT

Background:

Anxiety disorders are common. However, individuals suffering from anxiety disorders often do not seek treatment. These disorders impose a high individual and societal burden, especially on military personnel and their families, and place a significant burden on healthcare systems as care is often sought from primary care physicians rather than specialized professionals. This study was undertaken to determine the prevalence and correlates of anxiety among visitors at a Military Primary Health Center.

Results:

Anxiety disorders were high in our study population. Generalized Anxiety Disorder (GAD) was the most common, while social phobia was less prevalent. 72.5% were 18-40 years old and 63.5% were males. 68% were military personnel, 23% were military personnel family, and the rest were retired. The most common symptoms were sleep disturbances (60.4%), irritability (55%), and restlessness (51.4%). GAD, specific phobia, and panic disorder were more likely in divorced people, and chronic diseases were more likely in people suffering from GAD.

Conclusions:

The prevalence of anxiety disorders was considerably higher among visitors at a Military Primary Health Center due to the high stress levels and occupational difficulties associated with an unstable social and family life. Counseling services and follow-up of diagnosed cases should be available at the primary health care level for improved healthcare delivery by the primary care or family health physicians.
Maternal and child health services during COVID-19 in India: Highlighting the role of primary care physicians in maintaining continuum of care
Authors: Sharma Saurabh , Aggarwal Sumit , Singh Kh. Jiten Kumar , Singh Lucky , Gaym Asheber , Sahu Damodar , Adhikari Tulsi , Nair Saritha , Kumar Anil , Juneja Atul , Rao Mendu Vishnu Vardhana
Published: November 2024

ABSTRACT

Background:

This study aims to address the lack of substantial evidence regarding the effect of COVID-19 on maternal and child health (MCH) services in India and also highlight the role of primary care physicians in maintaining essential services during a pandemic. While studies conducted worldwide and in India have examined the effects of COVID-19 on these services, a significant gap in robust evidence remains.

Methods:

Forty-two districts were selected randomly from seven regional states of India. Data on five selected MCH indicators were extracted from HMIS for the months from March to June 2019 and 2020. Relative changes in service utilization for each month from March to June over the two years were compared. Comparisons were also made between the selected districts based on the COVID-19 categorization into red and green zones.

Results:

COVID-19 and its associated restrictive measures created significant disruption to essential MCH service utilization in India across all states reviewed. Both institutional, and outreach services were impacted; however, hospital-based services were more impacted. Institutional deliveries and emergency obstetric services saw a decline in March and April 2020 which gradually improved between May and June in some states. Immunization sessions held in 2020 observed a decrease in April.

Conclusions:

The analysis indicates a disruption in service delivery during the initial phase of the lockdown. However, the services resumed gradually as national and state-specific operational guidelines were implemented to maintain a continuum of care.
SWOT analysis of Janani Suraksha Yojana among women of Western Uttar Pradesh, India
Authors: Mattas Shalki , Pant Bhawna , Sharma Saurabh , Dobhal Priyanka
Published: November 2024

ABSTRACT

Introduction:

In April 2005, under the umbrella of National Rural Health Mission (NRM) in response to the slow and varied progress in improvement of maternal and neonatal health, the Government of India launched a scheme known as Janani Suraksha Yojana (ISY)

Objectives:

With the help of this study, we intend to understand the knowledge, source of information, awareness, and barriers to acceptance of JSY among women in Western Uttar Pradesh and conduct a SWOT analysis for the same.

Material and Methods:

The sample size was 300 and calculated using the prevalence of institutional delivery taken from National Family Health 2015-16 Survey (NFHS-4) in Uttar Pradesh, India, which was 67.8%. Data were analysed using appropriate statistical tests by Statistical Package for Social Sciences (SPSS) software and Microsoft excel.

Results:

Grassroot-level workers, namely, ASHA, ANM, AWW, and Dai, were an important source of information regarding JSY in the rural area with 68% beneficiaries saying that they got their information about JSY from them compared to only 22% in the urban area. Out of the 105 beneficiaries who delivered at home, the two most common reasons for noninstitutional delivery were the cost of the institutional delivery (51.4%) and home is convenient (47.696).

Conclusion:

Cash incentives help in the use of health services such as antenatal care, postnatal care, and counselling services. Less focus and ASHA coverage in urban areas as compared to rural areas.
The Impact of HPV Vaccination on Cervical Cancer in adolescent females: A narrative review
Authors: Bhalerao Vijay , Gotarkar Shashank , Muneshwar Komal
Published: November 2024

ABSTRACT

To effectively prevent cervical cancer, a leading cause of global morbidity and mortality among women, widespread adoption of the HPV vaccine has a well-established link to human papillomavirus (HPV) infection. HPV vaccine must be the vaccine’s effectiveness in reducing HPV infections, and subsequent cervical lesions have been extensively demonstrated, marking a pivotal milestone in public health. Important research highlights the vaccine’s safety profile, allaying worries and promoting trust in its application. By targeting HPV strains responsible for a majority of cervical cancer cases, vaccination emerges as a strategic intervention to curb the burden of this malignancy. The strategy is used to search PubMed and Google Scholar, with only free full-text and English language study included. However, addressing existing misconceptions and ensuring equitable vaccine access remains imperative. Informed decision making is pivotal, necessitating comprehensive public health initiatives that educate communities about the vaccine’s benefits. Encouragingly, successful vaccination programs in various regions have demonstrated tangible reductions in HPV prevalence and cervical cancer incidence. This review concludes by emphasizing the urgent need for global collaboration to integrate HPV vaccination into routine immunization schedules, thereby fortifying the collective effort to mitigate cervical cancer’s impact. As a cost-effective, evidence-based strategy, widespread HPV vaccination stands as a linchpin in the ongoing battle against cervical cancer, promising a healthier future for women worldwide.
Health care providers’ comfort caring for trauma-exposed patients in the primary care setting: A mixed methods approach
Authors: Lathan Emma C. , Langhinrichsen-Rohling Ryan , McAfee Elizabeth , Sonu Stan C. , Haynes Tamara , Powers Abigail
Published: November 2024

ABSTRACT

Introduction:

Patients seeking primary care often present with health concerns related to psychological trauma, highlighting the importance of health care providers’ (HCPs) comfort discussing trauma in the primary care setting. This study used mixed methods, including qualitative content analysis, to (1) document HCPs’ trauma-related comfort levels and factors contributing to discomfort and (2) examine the associations between provider-level factors and comfort.

Materials and Methods:

Direct patient care providers (74.6% physicians/residents; 68.7% women; 44.8% White; Mage
= 36.7 years, SDage
= 9.8) were recruited from primary care clinics in an urban public hospital system in the United States to complete a survey assessing trauma-related comfort; responses to open-ended prompts were coded by independent raters.

Results:

Few HCPs endorsed comfort providing care to patients with known trauma histories (29.8%), most often citing limited knowledge and fear of exacerbating symptoms as contributors to discomfort. HCPs most often endorsed formal education and integrated behavioral health teams as having enhanced their comfort providing trauma-informed care; 59.2% indicated that receiving formal education would further increase comfort. HCPs’ comfort was unrelated provider-level factors other than department, F (2,53) =6.56, P = 0.003, and race, F (2,52) =5.69, P = 0.006.

Discussion:

Findings provide critical context to HCPs’ trauma-related discomfort as well as actionable next steps to increase trauma-related comfort during primary care encounters.
Postpartum morbidity and its determinants with special reference to anemia among urban vulnerable population in Uttar Pradesh: A cross-sectional study
Authors: Shree Tuhina , Agrawal Deepika , Kaswan Pradeep , Manna Souvik
Published: November 2024

ABSTRACT

Background:

The postpartum period is critically important for comprehensive obstetric care; however, most women are neglected during this important period.

Objective:

This study was carried out to determine the burden of postpartum morbidities and associated factors among the urban vulnerable population in Gautam Buddha district, Uttar Pradesh.

Methods:

A cross-sectional study was conducted among 150 postpartum women in urban slums of Gautam Buddha district. A semi-structured questionnaire was used along with a physical examination and assessment of anemia by Sahli’s hemoglobinometer.

Results:

A total of 106 (70.7%) mothers reported at least one of the postpartum morbidities (PPMs). The most frequently reported morbidity was anemia (55.3%) followed by backache (29.3%). Almost a third (39, 36.8%) of all women, who suffered from PPM, did not seek any treatment for the same. Univariate analysis revealed that morbidities were higher among women with low literacy (Odds Ratio, OR: 5.63, 95% CI: 2.508–13.54, p = 0.000), low socioeconomic status (OR: 0.317, 95% CI: 0.151–0.657, p = 0.002), and inadequate antenatal care (OR: 0.108, 95% CI: 0.044–0.246, p = 0.0001). Similarly, young mothers (OR: 2.599, 95% CI: 1.332–5.14), less educated (OR = 3.603, 95% CI: 1.838–7.203, p = 0.000), those from lower economic status (OR: 0.247, 95% CI: 0.119–0.497, p = 0.001), with inadequate antenatal care (OR: 0.112, 95% CI: 0.052–0.232, p = 0.005), and low iron folic acid intake (OR: 0.371, 95% CI: 0.184–0.732, p = 0.004) showed higher prevalence of anemia.

Conclusion:

The role of education and adequate antenatal care are highlighted in the study. Antenatal visits should be utilized as opportunities to increase awareness regarding various aspects of care during the postnatal period. Maintaining more comprehensive support and involvement between health care providers and the mothers is needed to prevent many of these postpartum morbidities.
The investigation of the relationship between vitamin D level and severity of diabetic ketoacidosis in new cases of type 1 diabetes in children referred to Hazrat-E- Ali-Asghar Hospital in 2021
Authors: Nabavi Seyed Salaheddin , Soheilipour Fahimeh , Delavar Motahare Aghajani , Javaherchian Mahsa , Karimian Pegah , Jafarnejad Shabahang , Ebrahimi Hamidreza Khoshnezhad , Mostafavi Atoosa , Dezfouli Seyedeh Mahsa Mahmoudinezhad , Esmaeilian Somayeh , Iranmanesh Saeideh
Published: November 2024

ABSTRACT

Background and Purpose:

According to the role of 25-hydroxyvitamin D (25OHD) in glucose homeostasis and immune modulation, vitamin D deficiency may be associated with type 1 diabetes and diabetic ketoacidosis (DKA). Therefore, this study was conducted with the aim of investigation of the relationship between the vitamin D level and severity of diabetic ketoacidosis in new cases of type 1 diabetes in children referred to Hazrat-E-Ali-Asghar Hospital in 2021.

Methods:

The present study is based on a cross-sectional study. The population studied in this research includes new cases of children with type 1 diabetes referred to Ali Asghar Children’s Hospital in Tehran in 2021. The data analysis was performed using SPSS version 23 software and a significance level of less than 0.05 was considered.

Results:

In total, 112 people were included in the study. The difference between the three groups of severity of ketoacidosis in blood pH and bicarbonate level was significant (P < 0.001). The comparison of serum vitamin D levels in different severity of ketoacidosis showed a significant difference between the three groups (P = 0.013), which seems to be caused by the significant difference between the severe and mild ketoacidosis groups. There was observed no significant difference between the gender subgroups and different serum vitamin D levels and also different severity of ketoacidosis (P = 0.801) and (P = 0.25).

Conclusion:

Based on the findings of our study, there is a significant relationship between vitamin D and the severity of diabetic ketoacidosis in children with type 2 diabetes. We suggest that routine evaluation of vitamin D levels in diabetic patients and prescribing vitamin D supplements to patients with vitamin D deficiency to prevent the risk of diabetic ketoacidosis.
Sociodemographic factors affecting knowledge levels of tuberculosis patients in New Delhi
Authors: Zaidi Ilham , Sarma P. S. , Khayyam Khalid Umer , Toufique Ahmad Quazi , Ramankutty V. , Singh Gurpreet
Published: November 2024

ABSTRACT

Background:

Sociodemographic factors can significantly influence the knowledge level of tuberculosis (TB) patients, affecting the overall health outcomes. Due to lack of awareness and the stigma associated with TB, Indian TB elimination efforts are facing challenges. Patients with less information are more likely to experience delays in diagnosis and proper care.

Method:

A cross-sectional study was conducted in New Delhi across 26 operational National TB Elimination Program districts, involving 200 adult pulmonary TB patients receiving treatment from April to August 2020. A structured questionnaire guided the interviews, followed with bivariate analysis and descriptive statistics used for analysis.

Results:

Predominantly, residents of semiurban regions accounted for the highest proportion (70.5%), followed by urban areas (20.5%), with rural areas/slums comprising a minority (9%). Notably, a significant majority (94.5%) reported residing in individually owned dwellings, with shared accommodations limited to a minority (5.5%). Sanitary facilities varied, with 77% possessing personal toilets, 18.5% utilizing private facilities, and only 4.5% relying on public toilets. Awareness levels about TB reflected moderate awareness among 56% of participants, good knowledge among 41%, and minimal awareness (poor knowledge) among only 3% of respondents.

Conclusion:

Age, sex, socioeconomic level, kind of lodgings, malnutrition, and personal cleanliness should all be taken into account for TB treatment adherence. A new set of frameworks should be developed to enhance the living circumstances of high-risk populations and patients who are living in crowded locations since sharing a room or a house in a populated region increases the risk of TB transmission.
Impact of COVID-19 pandemic on tuberculosis notification and outcome in a district of South Gujarat
Authors: Maniya Meera , Patel Shashank , Damor Rahul , Patel Monank
Published: November 2024

ABSTRACT

Context/Background:

The COVID-19 pandemic affected the health care services worldwide, with the target of END TB 2025; it was important to make sure that the TB notification and linkage services were not hampered. The current study aims to document the overall impact of COVID-19 on TB notification and treatment services.

Aims/Objectives:

To document the impact of COVID-19 on notification and comparison of their outcome between pre-COVID-19 and COVID-19 era.

Methodology:

Programmatic data of 9893 notified TB cases reported from Surat rural between 2019 and 2021 were collected from Nikshay portal through DTO Surat. Detailed comparison of pre- and COVID-19 era was performed using stratified analysis.

Results:

There was a significant (P = 0.02) 29% decline in cases reported in 2020 as compared to the cases reported in the previous year. The impact of COVID-19 was also seen on mortality of the reported cases (18% increase). The overall proportion of treatment failure was increased (28%), whereas difference of 20% was seen in cases where treatment regimen was required to be changed.

Conclusions:

Despite the overall impact of COVID-19 on TB services (2020), the health department has proactively countered and bounce back in 2021 with an overall increase in notification and treatment services.
Effectiveness of introducing fresh fruits in Anganwadi menu among children between 3–6 years in Mysuru city
Authors: Hegde Saurish , Gohri Jay , Kulkarni Praveen , Pragadesh R , Siddiqua Aisha , Kashyap Shreyaswini , Sahana K S , Kurien David Ninan
Published: November 2024

ABSTRACT

Introduction:

Micronutrient malnutrition remains a huge public health problem, with the main issues lying with the lack of diet diversity, either lack or less of animal products, sparse amount of fruits and vegetables. Fruits are a very good source of vitamins and minerals to help in the growth and development of the child. There are a lot of implementation hurdles at the ground level. Hence there is a need for further exploration of the role of fruits and dietary diversity on the growth and development of the children.

Methodology:

The study is an interventional study, conducted over 3 months. There was a systematic random sampling performed. A total of 60 participants, were taken out of which 30 were given the intervention. The assessment was conducted through anthropometry and semi-structured questionnaire.

Results:

When asked about their reluctance to include fruits in their diet, 58.3% did not prioritise it in their daily diet, while the rest found it expensive to buy it. There was a significant difference in the height and MUAC between the groups and that had no influence on the intervention. There was a slight increase in height over the three months in the interventional groups.

Conclusion:

Malnutrition is not a single-factor disease but happens because of many factors which include, education, income, environment and nutritional awareness among mothers and families. Fruits are a major component in the diet and have to be included by the family for the children to improve their basic anthropometry and also more functions.
Exploring frailty prevalence among adults in Indian healthcare settings: A systematic review and meta-analysis
Authors: Debnath Aninda , Gupta Sunanda , Yadav Ankit , Charag Shweta , Mondal Anubhav , Kishore Jugal
Published: November 2024

ABSTRACT

Frailty is an age-associated state of increased vulnerability due to declines in physiologic systems, leading to compromised ability to withstand stressors. Given India’s rapidly aging population, our study aims to estimate the pooled prevalence of frailty and its associated factors in hospital settings. An extensive search was conducted across four databases, up to January 2024. A random-effects model was utilized. To quantify heterogeneity, the I² statistic, prediction interval, and the Chi-square-based Q test were employed. Outliers were identified using a Baujat plot and influence analysis. Doi plot, luis furuya kanamori (LFK) index and funnel plot were used to assess publication bias. The current meta-analysis determined a pooled frailty prevalence of 42.3% (95%CI: 34.8%−50.1%) and prefrailty prevalence of 39.8% (95%CI: 30.4%−49.8%), both exhibiting high heterogeneity (I² values of 96.9% and 95.3%, respectively). A high degree of variability was indicated by a prediction interval ranging from 9% to 76%, while Egger’s test suggested no evidence of publication bias. Our systematic review and meta-analysis, encompassing 6,856 individuals, revealed a considerable prevalence of frailty at 42.3%, underscoring its ubiquity across health spectra and demographics in India.
A study of autoimmune thyroid disease in pregnant women and its effect on fetal and maternal outcome
Authors: Ekka Shreyasi C. , Sinha Mani Bhushan K. , Kumari Anita
Published: November 2024

ABSTRACT

Introduction:

Anti-thyroid antibodies not only cause thyroid dysfunction but have independent adverse outcomes in the fetus and mother during pregnancy and after birth. Chronic lymphocytic thyroiditis as a presentation of immune system deregulation may be associated with a generalized activation of the immune system at the fetus–maternal unit, the placenta. This interference could be associated with pregnancy morbidities in m o t h e r a n d fetus. This study was done to find out the frequency of autoimmune thyroid disease and its effect on maternal and fetal outcomes in a tertiary care facility in Jharkhand.

Method:

This is an Observational Prospective Study done during an 18-month period on 254 pregnant women in their second trimester who came to the antenatal clinic (ANC) clinic with singleton pregnancy at RIMS Ranchi.

Result:

222 (87.4%) out of the 254 pregnant women had anti- TPO antibodies less than 35 IU/ml. Anti-thyroid peroxidase (anti-TPO) antibody positivity with values greater than 35 IU/ml was found in 32 patients (12.6%). Anti-TPO antibody mean value was 22.54 ± 19.67 IU/ml. Among the 222 individuals who tested negative for the anti-TPO antibody, 7 (3.3%) had miscarriages, 182 (88.3%) gave birth vaginally, and 33 (14.9%) underwent a cesarean section. Of the 32 individuals who tested positive for the anti-TPO antibody, 2 (6.3%) had miscarriages, 24 (75.0%) had vaginal deliveries, and 6 (18.8%) had cesarean sections. Using the Chi-square test, a P value of 0.549 was calculated, indicating statistical insignificance (Pearson Chi-square test value = 0.200a).

Conclusion:

Anti-TPO antibody positivity was significantly related to miscarriage and anemia. Other complications like preterm delivery, pre-eclampsia, and low birth weight were higher in anti-TPO antibody-positive patients as compared to anti-TPO antibody-negative patients. However, these findings were not statistically significant.
Salmon colored fluorescence on Wood’s lamp in a pediatric patient with vitiligo: A case report
Authors: Nagshabandi Khalid Nabil , Shadid Asem , Alakresh Lamia
Published: November 2024

ABSTRACT

Vitiligo, a prevalent cutaneous depigmentation disorder, often leads individuals to seek cosmetic remedies such as dihydroxyacetone (DHA)-infused camouflage makeup. Wood’s lamp, a common diagnostic tool in dermatology, is typically employed to assess vitiligo lesions, revealing DHA-induced fluorescence in a distinct salmon color, contrasting with the bright blue-white fluorescence exhibited by vitiligo lesions. Erythrasma, a bacterial infection of the epidermis, is known for its unique bright coral-pink or coral-red fluorescence under Wood’s lamp. We present a case involving a 9-year-old girl who was initially diagnosed with erythrasma upon Wood’s lamp examination. Subsequent investigation revealed the use of vitiligo camouflage makeup infused with DHA, resulting in a fluorescence pattern similar to erythrasma under Wood’s lamp scrutiny. The awareness of mimicking agents like DHA is crucial for accurate diagnoses and optimal patient outcomes. Clinicians, especially family physicians and dermatologists, are urged to exercise heightened scrutiny and maintain a keen awareness of such nuances in order to navigate through the intricacies posed by substances like dihydroxyacetone during diagnostic processes, as some may reveal similar appearances in mechanical diagnostic tools, such as Wood’s lamp.
Community awareness regarding smokeless tobacco (Shamma) as a cause of oral cancer in Jazan region, Saudi Arabia: A cross-sectional study
Authors: Dallak Fatimah H. , Alharbi Fahd A. , Alhazmi Abdulaziz H. , Abusageah Faisal , Durayb Amjad A. , Almalki Norah M. , Tayrah Faisal A. Abu , El-Setouhy Maged , Dallak Rawan H. , Shami Ruqayyah M.
Published: November 2024

ABSTRACT

Introduction:

Oral cancer has emerged as a significant public health issue, with 90% of instances because of avoidable causes. Smokeless tobacco usage is thought to be a substantial source of cytological alterations in the oral mucosa, and snuff (Shamma) is often used in Saudi Arabia. In this study, we investigated community awareness of Shamma as a cause of oral cancer in the Jazan region’s general population.

Methods:

A cross-sectional A self-administered questionnaire was used in analytical research of people in the Jazan region to determine their awareness of Shamma consumption and its association with oral cancer. The collected data were analysed with SPSS software.

Results:

About 1380 participants were included in the study. 730 (52.9%) were females and most of the participants (63%) were between eighteen and thirty years old. About three-quarters 1022 (74.1%) of the participants had previously heard about oral cancer, 457 (44.7%) stated that it is possible to avoid oral cancer and 593 (58%) mentioned that oral cancer is treatable. About 45.1% of the participants believe that older ages are risk factor of oral cancer. Concerning awareness of the warning oral cancer’s symptoms and signs; more than half (76.9%) mentioned oral ulcers. Regarding knowledge about risk factors for oral cancer; the most often mentioned ones were smokeless tobacco (87%), smoking (86%), followed by khat chewing (62.1%), and alcohol (58.9%). About 66.2% of the participants have tried to stop Shamma in the past 12 months. We found that gender and age are a risk factor for oral cancer, where they are correlated significantly with knowledge and awareness of smokeless tobacco (P value < 0.001 and 0.049, respectively.

Conclusion:

Good overall awareness and knowledge about Shamma and smokeless tobacco. More than half of the individuals recognized Shamma as an oral cancer risk factor with accuracy. Oral ulcers were revealed to be the most well-known sign of oral cancer among survey participants. It was shown that there was a significant correlation between gender awareness and knowledge levels. In addition interventional research is necessary.
Correlating symptom severity index, clinical diagnostic criteria of CTS-6 and timed Phalen’s test in clinical evaluation of carpal tunnel syndrome
Authors: Priya Ankita , Bansal Charu , Mangla Harshita , Shinde Manjusha , Ghosh Tandra
Published: November 2024

ABSTRACT

Background:

Carpal Tunnel Syndrome (CTS) poses significant diagnostic challenges, especially in resource-limited settings. Reliable tools such as the 6-item Symptom Severity Index, Timed Phalen’s Test (TPT) and CTS-6 are promising but under investigated. Correlation between these tools and symptom severity remains underexplored.

Aim:

To correlate the 6-item Symptom Severity Index and CTS-6 diagnostic tool with TPT in clinically diagnosed CTS cases, evaluating their diagnostic performance.

Methods:

Prospective cross-sectional study, conducted in a tertiary care hospital in eastern India. 105 patients were enrolled after fulfilling inclusion criteria, assessing them with the 6-item Symptom Severity Index, CTS-6 diagnostic tool and TPT. Pearson’s and Spearman’s correlation coefficients were used, and statistical significance was set at P < 0.05.

Results:

Of 188 evaluated hands, TPT showed a significant negative correlation with CTS-6 scores (r = -0.59, P < 0.0001), indicating lower scores with higher TPT values. CTS-6 scores positively correlated with symptom severity (r = 0.34, P < 0.0001), indicating higher Symptom Severity Indices associated with increased diagnostic probability. Positive predictive value for TPT was 70.1%, with sensitivity of 83.7% and specificity of 61.1%. Symptom Severity Indexing demonstrated higher sensitivity (100%) but lower specificity (3.3%).

Conclusions:

This study highlights the utility of integrating subjective and objective assessment tools in CTS diagnosis. The findings underscore the importance of comprehensive evaluation and suggest the potential value of TPT as an adjunctive diagnostic tool. Further research is warranted to validate these findings and refine diagnostic algorithms for CTS management.
Effectiveness of health education on insulin injection technique in patients with type 2 diabetes mellitus: A quasi-experimental Pre-test post-test research
Authors: Mehta Preethi , Kiruthika Sivagourounadin , Laksham Karthik Balajee
Published: November 2024

ABSTRACT

Introduction:

Type 2 Diabetes Mellitus (T2DM) patients often exhibit gaps in knowledge and improper practices regarding insulin injection techniques. This quasi-experimental study aimed to assess the effectiveness of tailored health education in bridging these gaps and improving insulin injection practices among T2DM patients.

Objectives:

The study aimed to evaluate baseline knowledge and practices related to insulin injection techniques among T2DM patients, implement a tailored health education intervention, and assess the impact of this intervention on knowledge and practices.

Methodology:

Participants included T2DM patients attending rural health centers. A structured questionnaire was utilized to assess baseline knowledge and practices. Tailored health education sessions were then conducted, incorporating video-based teaching, mock demonstrations, and handouts in the local language. Post-intervention assessments were performed using the same questionnaire. Data were analyzed using appropriate statistical methods.

Results:

At baseline, a significant knowledge gap and improper insulin injection practices were identified among participants. Following the tailored health education intervention, a substantial improvement in participants’ knowledge of insulin storage, handling, and administration was observed. The intervention also positively impacted insulin injection practices, emphasizing key areas such as handwashing, site cleansing, and needle disposal.

Conclusion:

This quasi-experimental study highlights the effectiveness of tailored health education in enhancing insulin injection practices among T2DM patients. The findings emphasize the potential for structured health education programs to address knowledge gaps, improve healthcare standards, and enhance the overall quality of life for individuals with T2DM. The study underscores the importance of individualized educational approaches to meet patient needs better.