bluuebunny/crossref_metadata_2025 huggingface dataset:
An observational study on clinical profile of acute coronary syndrome among young adults attending a tertiary care institute in Maharashtra
Authors: Vyas Sunay G. , Shaikh Sohail , Vyas Sarita S.
Published: August 2021

Background: ACS is most common cause of hospital admissions even in middle income countries like India. ACS in an early age is one of the important causes of sudden death. Incidence of ACS is positively correlated with age. But in the recent years, there is increased incidence of ACS among younger adults. In depth studies have been conducted in older adults but profile among younger patients is rarely reported.Methods: An observational study was conducted among young adults with ACS admitted under department of medicine of Punjabrao Deshmukh memorial medical college. This study was conducted for one and half years (August 2019 to March 2021). All young patients of both sexes less than 35 years of age admitted with diagnosis of ACS were included in the present study. The questionnaire had demographic details like age, gender, address, occupation, etc. It also had detailed clinical history, physical examination findings, systemic examination findings and investigations in it.Results: The most common chief compliant was chest pain (73.05%) followed by epigastric pain (53.30%) and sweating (53.90%). The most common risk factors were overweight/obesity (58.66%), tobacco chewing (38.32%) and smoking (34.73%). About 48.5% of the cases were STEMI, 32.9% were NSTEMI and 18.6% were UA in the present study. Among 167 cases studied, 1.19% cases had ventricular septal rupture, 3% had arrhythmia, 7.78% were in cardiogenic shock and 3.60% was the mortality rate.Conclusions: Chest pain was present in more than 75% of the cases. The most common risk factors were overweight/obesity, tobacco chewing and smoking. Complications like cardiogenic shock, arrhythmia and ventricular septal rupture were noted. Minor patients suffered cardiac arrest. It is important to screen for ACS even in young adults. The time with a saying that ACS is a disease of older adults is gone
Efficacy of a polyherbal formulation in the management of benign prostatic hyperplasia: a randomized, controlled trial
Authors: Bhat Shabir Ahmad , Rather Shameem Ahmad , Islam Naquibul
Published: August 2021

Background: Benign prostatic hyperplasia (BPH) affects a significant number of men beyond the age of 40 years with its incidence reaching up to 90% in 80’s. Despite multiple treatment innovations, BPH still remains a nightmare for ageing men, mostly due to its distressing lower urinary tract symptoms (LUTS) and sexual dysfunction. The severity of LUTS is graded by international prostate symptom score or American urological association symptom index (AUA-SI) along with impact on quality of life (QOL). The objective of this study was to evaluate the efficacy of an Unani polyherbal formulation, Habb-i-muqil, in improving the AUA-SI and QOL in patients with BPH.Methods:In an open, standard controlled study, 76 men, diagnosed with clinical BPH, aged between 40 and 80 years were randomly allocated for treatment for duration of 90 days with Habb-i-muqil (test drug) or Tamsulosin (standard control) after ethical approval. AUA-SI and QOL were assessed at baseline (0 day) and days 15, 30, 45, 60, 75 and 90.Results: Analysis of 60 men showed that after 90 days of treatment the percentage changes in the AUA-SI from baseline were 59.4 and 49.4% by Habb-i-muqil and tamsulosin, respectively. The test drug produced statistically significant improvement (p<0.001) in overall AUA-SI and QOL compared with standard control.Conclusions:The Unani polyherbal formulation, Habb-i-muqil, was effective in improving AUA-SI and QOL in men with BPH in comparison to tamsulosin. Both the treatments were generally well tolerated.
Altered left atrial appendage function associated with cardioembolic stroke in patients with rheumatic heart disease
Authors: Mansuri Zeeshan H. , Brahmbhatt Jit H. , Singhal Roopesh R. , Natarajan Karthik
Published: August 2021

Background: Left atrial appendage (LAA) is usually the first site for thrombus formation in rheumatic heart disease (RHD). LAA function is altered in RHD which may predispose it to thrombus formation. The aim of this study was to determine an association between function of LAA and cardioembolic stroke.Methods:Total 132 patients with RHD were studied by means of transthoracic echocardiography and/or transesophageal echocardiography and left atrial (LA) size, LAA ejection fraction (EF) and peak flow velocities were measured. These patients were followed up for 18 months with reference to development of cardioembolic stroke.Results: Seventy nine patients had atrial fibrillation (AF), of which 34 had thrombus in LAA. Out of 53 patients with sinus rhythm, 5 had LAA thrombus. Mean LAA EF was significantly lower in patients with thrombus in LAA, so was the peak flow velocity (both variables p<0.0001). Saw tooth LAA outflow velocity pattern was visible in 30 (80%) patients with LAA thrombus versus 20 (28%) patients without LAA thrombus. Total 14 patients experienced cardioembolic stroke. Patients with cardioembolic stroke had lower mean LAA EF and peak flow velocity as compared to patients without cardioembolic stroke.Conclusions:Increased LAA size, reduced LAA EF and reduced peak flow velocity are associated with increased risk of cardioembolic stroke. LAA evaluation should be mandatory in deciding treatment strategies in patients with RHD and AF.
Association of risk stratification and mortality outcomes in patients of acute pulmonary embolism
Authors: Brahmbhatt Jit H. , Mansuri Zeeshan H. , Singhal Roopesh R.
Published: August 2021

Background: To study the association of risk stratification and mortality outcomes of patients with high/intermediate risk acute pulmonary embolism who are given the guideline directed therapy after the diagnosis of pulmonary embolism.Methods: Prospective observational study of demographics, clinical profile, risk stratification, management and outcome of patients presenting with acute pulmonary embolism from October 2019to December 2020. Risk stratification was done as per ESC 2019 guidelines into high and intermediate categories, intermediate category patients were further stratified into intermediate-high and intermediate-low-risks.Results: 100 patients who were detected to have acute pulmonary thromboembolism with a mean age of 45.08 years with 60% being males were included in the study. There were 31 patients in high-risk group, 59 patients in intermediate-high subgroup, 10 patients in intermediate-low subgroup. Echocardiography was done in all patients. Outcome was relatively grave in these subgroups with overall mortality of 56 patients. 49 patients were thrombolysed with rTPA, 27patients with alteplase, 4 patients with streptokinase, 12patients who had contraindication to systemic thrombolysis were subjected to catheter directed thrombolysis and 8 patients were taken up for surgical embolectomy.Conclusions: Pulmonary embolism can present with unexplained dyspnea and atypical chest pain among other signs and symptoms. Early diagnosis, risk stratification and guideline directed prompt management can lead to favorable outcomes however; patients with high and intermediate risk at presentation are associated with higher mortality rate despite GDT.
Study of the correlation of oesophageal varices with portal vein diameter and ratio of platelet count to splenic diameter and their comparative evaluation in liver cirrhosis
Authors: Singh Harpreet , Sharma Sidharth , Singh Gurminder , Kaur Dania
Published: August 2021

Background: The aim of the study was to determine the correlation of oesophageal varices (OV) with portal vein diameter and the platelet count to splenic diameter ratio and their comparative evaluation in patients of liver cirrhosis.Methods:The present study consisted of 50 patients diagnosed with liver cirrhosis. Necessary investigations were performed in all the patients including Upper gastrointestinal (GI) endoscopy. Platelet count/spleen diameter ratio, spleen diameter and portal vein diameter were calculated for all patients and the presence and grading of OV was then comparatively evaluated. The results were systematically recorded and statistically analysed.Results: The mean age of patients was 49.82±10.23 years. 78% of patients presented with OV. The portal vein diameter, platelet count, spleen diameter and platelet count/spleen diameter ratio were significantly increased in patients with OV than those without OV (p<0.0001). Highly significant positive correlation between portal vein diameter, spleen diameter and grading of OV was seen. Platelet count/spleen diameter ratio and platelet count was significantly decreased as the grade of OV increased in the patients. There was statistically, a highly significant negative correlation between them.Conclusions: The non-invasive parameters used to detect presence of OV in liver cirrhosis were portal vein diameter and platelet count/spleen diameter ratio. Though, both seemed to be effective in predicting OV, platelet count/spleen diameter ratio proved to be slightly more significant when compared to the other.
The impact of COVID-19 on the postgraduate exit examination in a clinical subject
Authors: Diwan Arundhati , Singh V. P. , Karne Sampada , Barsode Supriya , Nadkarni Varad
Published: August 2021

The year 2020 world experienced the rise of a new pandemic COVID-19 beginning. It started in India in early March. Maharashtra state saw a lockdown from March 2020.  It has affected all the aspects of life in India including economy, patient care and medical education. The whole working system of hospitals had to be changed and most of the hospitals were divided into COVID and non-COVID parts. This article is an effort to study the perceptions of postgraduate medical students in the department of medicine on the exit examination at the end of three years of residency in a medical college in Pune. Along with the postgraduate student’s perceptions, views of examiners are also studied under four aspects protective measures during examination, assessment of knowledge using case scenarios, student’s experience of case presentation without physical presence of patients and overall satisfaction with the novel method of examination.
Oral candidiasis and the risk factors: a serial case reports
Authors: Tan Erlyne , Suryana Ketut
Published: August 2021

Oral candidiasis (OC) is also referred as ‘thrush’ is caused by the infections of the tongue and other oral mucosal sites and characterized by fungal overgrowth and invasion of superficial tissues. The main causative agent of 95% OC cases is Candida albicans. The prevalence of fungal oral infection was increased due to the increasing use of antibiotic and immunodeficiency condition. However, many factors have been suggested as risk factors for oral colonization. These predisposing factors are divided into local and systemic factors. We present two cases of patient with oral candidiasis that have admitted at Wangaya Regional Hospital, Denpasar, Bali, Indonesia with different precipitating factors in order to remind health provider that oral candidiasis does not only occur in people living with HIV/AIDS (PLWHA).
Kikuchi-Fujimoto disease
Authors: Alakkad Ashraf , Alakkad Mohamed
Published: August 2021

A lady from Sudan was referred to our medical clinic as a case of cervical lymphadenopathy with gradual enlargement. She had no complaint. The cervical lymphadenopathy was not associated with pain, fever, weight loss, cough, neither bleeding nor other associated swellings. There was no history of chronic medical problems including TB and underwent thorough investigations including LN biopsy. Lymphoma was initially suspected. Fine-needle aspiration and excision biopsy were undertaken. Histological analysis later suggested Kikuchi-Fujimoto disease, also known as histiocytic necrotizing lymphadenitis. Kikuchi-Fujimoto disease (KFD) was described in 1972 as lymphadenitis with focal proliferation of reticular cells accompanied by numerous histiocytes and extensive nuclear debris. KFD, frequently found in East Asian countries, is rare in the UK. No definite etiology of KFD is known despite autoimmune and infection factors being suggested. The diagnostic hallmark is histological findings from lymph nodes. Steroid therapy could be used in severe cases. KFD is relatively unknown and this case report aims to highlight its occurrence in our population.
Management of mandibular parasymphysis fracture: a case report
Authors: Wedayanti Desak P. K. , Dinatha Gusti N. K. , Partama Putu Gosen , Ardi Saputra Made Kurniawan
Published: August 2021

Mandibular fractures are among the most common injuries to the facial skeleton. Mandibular parasymphysis fractures lead to the loss of occlusion with step deformity formation. Treatment of mandibular fractures aims to restore occlusion and function and facilitate direct bone healing by adequate reduction and immobilization on the fractured site. We report a mandibular parasymphysis fracture of 17 years old male patient due to the road traffic accidents. Patient reported severe jaw pain during movement and abundant intraoral bleeding was observed. A clinically computed tomography scan of the face with axial, coronal, and 3-D reconstruction was performed, which showed parasymphysis fracture. The following treatment done was the application Arch bar and open reduction internal fixation (ORIF) mini plate under general anesthesia. After access, mandibulomaxillary fixation was performed to ensure satisfactory occlusion after adequate fragment reduction. The fractures were properly fixed with 6 hole and 3 hole, screw 8mm for the left mandibular, and for the right mandibular used 5 hole and 3 hole, screw 8 mm. Mandibular fractures are the most common fractures of facial region and treatment options depend upon the type of fracture of mandible according to the anatomic variations.
Scrub typhus associated acute kidney injury in a 33-year-old male
Authors: Konyak Nyamnyei , Kuotsu Medo M. , Mog Labresai , Chowdhury Sandipa Roy , Ering Prity , Majhi Prabin Kumar , Medhi Pranab Kumar
Published: August 2021

Scrub typhus or bush typhus is caused by Orientia tsutsugamushi. An eschar at the site of bite is evidentiary of scrub typhus. Increased mortality is seen in cases presenting with acute kidney injury (AKI), acute respiratory distress syndrome (ARDS), pneumonitis, meningitis, myocarditis and multi-organ dysfunction. Renal impairment in scrub typhus should be identified and management initiated early to prevent the progress of the damage. Scrub typhus if left undiagnosed and untreated results in high morbidity and mortality. Here we report a case of a 33-year-old male with AKI following scrub typhus fever. In our case early diagnosis and management led the patient to recovery.
Acute ischemic stroke in COVID-19: a case report
Authors: Ramalingaiah Mamatha Tittamegalapalya , Jogihalli Mood Jeetendra Kumar , Murthy Vinutha Bagalur Srinivas , Singh Virender
Published: August 2021

Corona virus disease (COVID-19) is an infectious disease caused by SARS-CoV-2 virus. It predominantly affects respiratory system causing fever, cough, and breathlessness. But it can also affect central nervous system. Clinicians must adopt methodical approach in investigating a patient with neurological manifestation. Early detection and treatment is required for neurological disease of COVID-19 to reduce post COVID neurological sequel.
Resistant hypertension: a review
Authors: Parasher Anant , Jhamb Rajat
Published: August 2021

Resistant hypertension is currently defined as uncontrolled blood pressure despite the use of optimal doses of three antihypertensive medications, of which one is a diuretic. Several factors have been identified as contributors to resistant hypertension such as poor patient adherence, physician inertia, inadequate doses or inappropriate combinations of antihypertensive drugs, excess alcohol intake, certain drugs and volume overload. Uncontrolled blood pressure is a considerable cardiovascular and neurological risk factor that can lead to possible end-organ consequences of untreated hypertension, including heart failure, stroke, ischemic heart disease and renal failure. A comprehensive history and physical examination are essential for pointing towards to an underlying diagnosis. A PubMed search was conducted for review articles and papers from 1955 to 2019 containing the keywords ‘resistant hypertension’, ‘secondary hypertension’, ‘refractory hypertension’, ‘heart failure’ and ‘stroke’, and the literature was compiled. Non-pharmacological measures chiefly include lifestyle modifications such as smoking cessation, reduction in alcohol intake, dietary sodium restriction, healthy eating plans, increased physical activity and weight loss. Among recommended drugs, spironolactone and beta blockers are the preferred fourth- and fifth-line drugs respectively, in patients unresponsive to ACE Inhibitors, calcium channel blockers as well as diuretics. Although most patients are well controlled on extended drug regimes, some develop refractory hypertension which does not even respond to the five-drug regimen. Interventional therapies such as renal denervation and carotid sinus stimulation have been developed for patients with refractory hypertension, but still require further research and follow up to ascertain their full potency and efficacy.
Prokinetics in the management of upper gastrointestinal motility disorders: an Indian expert opinion review
Authors: Rai Ramesh Roop , Prasad V. G. Mohan
Published: August 2021

Functional gastrointestinal disorders (FGIDs) are disorders of gut-brain interaction. Nearly 40% of individuals globally suffer from FGIDs and have chronic fluctuating symptoms. Of all GI conditions, 30-45% are referable to intestinal motility disorders. Prokinetics act by different mechanisms and are effective in FGIDs with delayed gastric emptying or postprandial distress. When choosing a prokinetic, safety is the primary concern, particularly with regard to the central nervous system and cardiovascular risk. Here, we review the efficacy and safety of prokinetics in functional GI motility disorders and provide expert opinions for the use of prokinetics to manage upper GI motility disorders in the Indian context.
Indications and timing to perform tracheostomy in COVID-19 patients in intensive care unit: a review
Authors: Swain Santosh Kumar
Published: August 2021

Coronavirus disease 2019 (COVID-19) is a fatal and evolving disease   and associated with more complication such as respiratory failure and requirement of mechanical ventilation in intensive care unit (ICU). Tracheostomy is a commonly performed surgical procedure done at ICU for prolonged ventilation of the COVID-19 patients. The indications and timing to do tracheostomy on COVID-19 patients are controversial. The requirement of prolonged invasive mechanical ventilation in COVID-19 patients is placing to increased request to perform tracheostomy. The role of performing tracheostomy in COVID-19 patients is exactly not known. Currently, there is no clear-cut evidence for improvement of the clinical course of COVID-19 patients. However, it is confirmed that tracheostomy decreases the ICU stay. Tracheostomy is usually suggested for avoiding potential tracheal injury within 7 to 14 days. Currently, there is uncertainty for timing of tracheotomy, prognosis of the patients and safety of health care professionals. Enhanced personal protective equipment and optimized tracheostomy can make the procedure safe and beneficial in COVID-19 patients. The need of tracheostomy is increasing in current COVID-19 pandemic. We have to perform this surgical procedure in proper time with safe manner for benefit of the patients and health care professionals. This review article focuses on the indications and optimum timing for performing tracheostomy on COVID-19 patients in ICU.
The dilemma of prioritizing: are we ignoring the elderly
Authors: Behera Ashish
Published: August 2021

Thie COVID-19 pandemic has brought about a lot of changes in the perspectives towards the aging persons of the community. It has also brought out the flaws of medical care to the table of discussions and the rational utilization of the limited resources available. Through this article, I want to raise the issue of prioritization of young over the old in limited-resource settings, especially in   the developing countries
Study of an epidemiological profile of confirmed COVID-19 positive persons in district Kathua, Jammu and Kashmir
Authors: Kaur Gurmeet , Bala Kiran , . Shalli
Published: August 2021

Background: India recorded its first COVID-19 case on 30 January 2020. Though the early, extended nationwide lockdown of the country was implemented effectively, this alone was not sufficient to defeat the COVID-19 disease. Realizing the importance of the need to generate local epidemiological data through robust studies, this study was undertaken in a district Kathua of Jammu and Kashmir. The aim was to study the epidemiological profile of patients tested positive in district Kathua.Methods: Retrospective observational study was done to find the spatial distribution of corona virus infection in the five blocks in district Kathua of Jammu and Kashmir. Data from the integrated disease surveillance project (IDSP) unit of district Kathua was screened and the epidemiological information from all the positive reports which included the total number of COVID-19 positive cases, address, travel history, contact history were extracted for the period of five months April 2020 to August 2020.Results: 929 patients were found positive for COVID-19. Male outnumbered the females.  More than 58.8% of males were of age group 21-40 years and the least number of positive male cases were seen in the age group >80 years. In our study 627 (67%) had a history of travel, 202 (21%) had a history of contact with a positive patient, 100 (10%) were positive with no history of travel or contact.Conclusions: Kathua block of the district was maximally affected having the 58.7% largest number of COVID-19 positive cases with cure rate of 92.46% and case fatality rate of 0.5% was observed.
Epidemiological and etiological factors related to suicide in the Middle East
Authors: Aloufi Khalid Kulaib , Alafghani Lina Abdel , Ismail Rawaa Ismail , Alzaid Ban Abdullah , Alkhidhr Mohammed Tariq , Alsubaie Shoug Sultan , Alzaidi Ahmed Ali , Alrubeh Tuqa Mohammed , Abu Suliman Talal Adnan , Alessa Mutaz Hamad , Alzahrani Amro Saad
Published: August 2021

Estimates show that suicide is relatively common among Middle Eastern countries as a total of 26,000 fatalities in 2016 were attributable to suicide in them. However, the quality of care of mental illness in these countries is not adequate as compared to the international levels. The aim of the study was to discuss the different epidemiological and etiological factors that were linked with suicide in the Middle East, according to evidence obtained from studies in the literature. The impact of cultures and religions on dealing with mental illnesses and suicide as well as the roots of these conditions will be explored to find the appropriate solutions. Suicide in the Middle East is common but unique from other countries in the world. Religion, socio-economic status, war and conflict in many regions play a big role in the rate of suicide. Religion reduces the prevalence rates of suicide but other factors might be more dominant as many regions are in conflict and have low socio-economic status. Furthermore, gender, family conflicts and mental illnesses were identifiable risk factors in the literature. More efforts on a national level is warranted as well as among communities to reduce the rates of suicide. The initiation of support groups among those with mental illnesses and low socio-economic state will prove extremely beneficial in reducing the rate of suicide as they are almost non-existent in Middle East.
Factors that influence healthcare service utilization during COVID-19 pandemic among pregnant women and caregivers with children under two years in Rongo sub-county, Migori County, Kenya
Authors: Awino Doreen Baraza , Mwaura-Tenambergen Wanja , Oluoch Musa
Published: August 2021

Background: Health systems have failed in past epidemics to maintain delivery of routine health essential services. Most resources including human and essential supplies are all diverted to address health emergency, sometimes resulting in lack of important basic and routine health services.Methods: This was a retrospective cross-sectional study with mixed data collection methods, where respondents were asked questions on how COVID-19 affected them with regard to utilization of MCH healthcare during the first peak of the COVID-19 in Kenya. Two high volume facilities were selected purposively based on volume and capacity of services offered. A random sample was drawn from the stratum using a list generated by community health workers (CHWs) attached to the health facilities. Key informant interviews were used to collect data among health care providers and structured questionnaire was used for pregnant women and caregivers. Independent variables, social distancing, social stigma, communication and human mobility restriction were associated with health care service utilization and significant at 0.05 p value.Results: Correlation analysis indicated social stigma (r-0.407, p<0.512), social distancing (r-0.324, p<0.001) and human mobility restrictions (r-0.606, p<0.001) negatively influenced service utilization. Whereas COVID-19 related communication (0.631, p<0.001) was protective and thus promoted service utilization. The hierarchical linear regression model explained 67.73% of the total variations in the health care service utilization, which was r=0.6773.Conclusions: From the findings social stigma, communication, social distancing and human mobility restrictions influence health care service utilization. Ministry of health should strengthen targeted community outreaches for pregnant women and caregivers with children under two years.
Elastography ultrasound for screening and early detection of esophageal varices
Authors: Abdou Abdelhamid Mohamed , Alsafwani Doha Jawad , Alamrousi Kamal Jamal , Muri Alaa Ali , Almagrabi Aseel Hassan , Alenazi Faisal Thiab , Alabdullatif Almaha Abdulaziz , Khabt Al-Khansa'a Ahmed , Alhussain Alhareth Khalid , Kadomi Nawaf Nhari , Altaroubi Noor Munir
Published: August 2021

Despite that esophageal varices can be effectively detected by using upper gastrointestinal tract endoscopy, the procedure is invasive and requires the integration of adequate experience and training, and it is not suitable for many patients. Accordingly, ultrasound elastography has been developed and validated by many studies in the recent literature as effective and non-invasive modalities for the early observation and diagnosis of esophageal varices and the relevant hepatic diseases. In this study, we aim to conduct a literature review to furtherly elaborate on the role and validity of elastography ultrasound to screen and early detect esophageal varices. We have discussed the diagnostic efficacy of three different types of ultrasound elastography including two-dimensional shear wave elastography, point shear wave elastography, and transient elastography in detecting and early diagnosis of esophageal varies. Transient elastography (TE) has been reported to be efficacious and the simplest technique. However, it was reported with some limitations. These limitations could be compensated by the two-dimensional shear wave elastography and the point shear wave, Nevertheless, these two modalities need high levels of experience and are not widely available. Besides, there are a few investigations that have validated the efficacy of the latter in detecting esophageal varices. Accordingly, we encourage further investigation for a future relevance.
Halitosis as a key diagnostic factor to systemic diseases in the primary care
Authors: Abdullah Marwah Yakoop , Mansour Anhar Abdullah , Abusallama Abdulrahman Ahmed , Alenazi Faisal Thaib , Almumtin Hussain Ali , Althubyani Hamdan Ahmed , Alwimny Alhnoof Abdullah , Aldamanhori Haya Baher , Alsuwailem Norah Abdulmohsen , Aloufi Abeer Ali , Alruwaili Gharam Moghdeb
Published: August 2021

Halitosis might be associated with reduced quality of life for the affected patients as a result of the personal and social embarrassments it might cause. The adequate identification and diagnosis of the underlying condition causing halitosis are important to achieve adequate treatment and prevention of many systemic diseases or even neoplasms. In this literature review study, we have discussed the potential role of halitosis in the diagnosis and identification of systemic diseases. We have discussed many diseases as diseases related to the gastrointestinal tract and liver, others related to metabolic and endocrinal disorders. Furthermore, psychological factors might attribute to pseudo-halitosis, while true halitosis comes secondary to oral and extraoral factors and physiological conditions. Poor oral hygiene might be the only reason for oral malodor, while many oral conditions might also contribute to the development of halitosis. Additionally, some conditions might have a characteristic bad smell, which might significantly enhance the diagnostic value and help clinicians. However, further examination and evaluation should also be conducted to prevent a potential overlap between the different conditions. On the other hand, some extra-oral disorders do not have a characteristic oral smell, which indicates that halitosis alone cannot adequately establish a proper diagnosis. Therefore, raising awareness about seeking medical attention when suffering from halitosis is recommended to achieve better outcomes and help clinicians draw efficacious prevention programs.
Women’s autonomy and maternal health service utilization among the women’s having less than two years age children in Rautahat district, Nepal
Authors: Shah Sanjaya Kumar , Yadav Neelima , Shah Richa , Bhatta Ramesh , Karki Rajesh , Chaudhary Anil , Khanal Josana , Gupta Rajesh Kumar
Published: August 2021

Background: Maternal health refers to the health of women during pregnancy, childbirth and the postpartum period. Despite various attempts and schemes made by government. maternal mortality remains as one of the biggest public health challenges in Nepal. The aim of the study was to assess the association of women autonomy with maternal health service utilization among the women having 2 years children in Paroha municipality ward no. 3 and 4, Rautahat, Nepal.

Methods: Cross sectional study was conducted. Simple random sampling was used to select respondents. Data were collected through face to face interview. Data were entered in Epi data and analyzed using SPSS. Chi square test was applied to test the significance of association at 95% confidence interval.  

Results: Majority (76.8%) of the respondents had antenatal care visit and more than half of them had four or more antenatal care visits. similarly, overwhelming majority (88.4%) of the birth were institutional delivery. Almost (91%) of the women had postnatal care visit for their last child. The study indicates that almost (95.5%) of the decisions were made without the involvement of the women. Most of women had medium level autonomy in all aspect (score= 17-32). Autonomy was positively associated with use of maternal health services i.e.; ANC visit (p=0.000), place of delivery (p=0.036), PNC visit (p=0.045).

Conclusions: Findings of the study show that if women autonomy will be higher, there will be increase in maternal service utilization. Whereas autonomy has link with better education and employment opportunity of the women.
Effect of lockdown due to COVID-19 pandemic on lipid profile of Indian male population
Authors: Tripathy Subrat K. , Ray Subhashree
Published: August 2021

Background: SARS-COV-2 pandemic is one of the biggest health challenges for modern era and this type of pandemic was never witnessed in recent past. To control the pandemic various measures were taken by various authorities like lockdown and shutdown. This study was meant to find the effect of this new way of social isolation during lockdown on Indian male population.

Methods: The study was conducted in IMS and SUM hospital, Bhubaneswar, Odisha. Those having routine blood check-up before lockdown in the hospital were again re-evaluated for their lipid profile after lockdown. Only male between age group of 20 to 59 included in the study who were mostly confined to home during lockdown.  Female, front line workers and people already having deranged lipid profile were excluded from the study.

Results: It was found that there are significant variations in the triglyceride and cholesterol level in men before and after lockdown whereas the level of HDL did not show any significant variation.

Conclusions: From above study it may be concluded that though lockdown is somehow able to control the rapid spread of the virus but it has negative effect on the lipid profile and indirectly cardiovascular health of a man.
Prevalence of intestinal parasites and its association factors, knowledge, attitude and practice about intestinal parasite Saint Peter TB specialized hospital Addis Ababa, Ethiopia
Authors: Muleta Birhanu K. , Wube Asmare M. , Teka Yeabkal D. , Gebre Mistre W. , Zerfu Biruk Z.
Published: August 2021

Background: Intestinal parasitic infections and HIV/AIDS have been the leading and persisting public health problems in the world. There vital causes of morbidity and mortality are remarkably high in Sub-Saharan Africa.

Methods: A cross-sectional study was conducted among patients attending Saint Peter hospital from December 2019 to May 2020. A total of 328 participants were select by using convenient sampling method. Socio-demographic data and knowledge, attitude and practice were collected using a structured questioner. Stool specimen was collected using clean container and processed and analyzed for parasitological examination using direct wet mount, formal-ether sedimentation and modified Ziehl-Neelsen (ZN) staining techniques. Venous blood was collected and the CD4+ T-lymphocyte and hemoglobin analyzed by Presto instrument. The data were analyzed by using SPSS version 23 and p values less than 0.05 were considered statistically significant.

Results: A total of 328 HIV-positive individuals (59.8% female) of age ranging from 13-72 years (mean=41.8, SD=10.8) participated in this study. The overall prevalence of intestinal parasites among the study participants was 26.2% (86/328), from this 88.4% (76/86) was infected by single parasite. IP was significantly associated with CD4 count <200 AOR (4.736 CI: 2.338-9.594; p<0.001) and also anemia AOR (3.271 CI: 1.069-10.010).

Conclusions: Intestinal parasitic infections are still common health problems among HIV/ADIS patients in the study area, so the health professionals need to give attention to parasitological examinations in the routine treatment of HIV/AIDS patients and also give education on these three parts knowledge, attitude and practice, but more focus and follow up on the practice of HIV/AIDS patients on transmission, prevention and control mechanisms of intestinal parasitosis.
Prevalence of musculoskeletal problems in caregivers handling non-ambulatory spinal cord injury patients
Authors: Kulkarni Pranjali , Ray Manish , Shyam Ashok , Sancheti Parag
Published: August 2021

Background: Spinal cord injury (SCI) is a distressing disorder that can cause of loss of physical, psychological and social functioning, that can cause high level of disability in patients. Due to disability, they are dependent on caregivers for their daily activities. Caregivers of SCI can be family or professional caregivers. Due to lack of training and awkward posture, caring for SCI patients may be burdensome which results in musculoskeletal problems in caregivers so it is important to find out the prevalence of musculoskeletal problems. The objectives were to find out the prevalence of musculoskeletal problems in caregivers handling non-ambulatory SCI patients and most common site of injury.

Methods: A cross sectional study was carried out on 80 caregivers including both professional and family caregivers. Self-structured validated questionnaire used to interview the caregivers based on convenient sampling. The data was analysed by descriptive statistics.

Results: The prevalence of musculoskeletal problems is 95% in caregivers including both family and professional caregivers. Low back pain was the commonest site of symptoms (53%) followed by 15% neck, 12% upper back pain, right shoulder (10%), right wrist (5%) and no pain (5%).

Conclusions: The prevalence of musculoskeletal problems in caregivers handling non ambulatory SCI is high. Most affected area is low back pain and neck pain. The findings of the study indicated that proper training and exercise are required, on means of preventing musculoskeletal problems.

 
Factors affecting the uptake of community-based health insurance in Ethiopia: a systematic review
Authors: Bayked Ewunetie M. , Kahissay Mesfin H. , Workneh Birhanu D.
Published: August 2021

The goal of health care financing in Ethiopia is achieving universal health care coverage by community-based health insurance which was expected to cover more than eighty percent of the population. The aim was to minimize catastrophic out-of-pocket health service expenditure. We systematically reviewed factors affecting the uptake of community-based health insurance in Ethiopia. We searched various databases by 09 to 10 March 2019. We included articles regardless of their publication status with both quantitative and qualitative approaches.  The factors determining the uptake of community-based health insurance in Ethiopia were found to be demographic and socio-economic, and health status, and health service-related issues. Among demographic and socio-economic factors, the report of the studies regarding gender and age was not consistent. However, income, education, community participation, marriage, occupation, and family size were found to be significant predictors and were positively related to the uptake of the scheme. Concerning health status and health service-related factors; illness experience, benefit package, awareness level, previous out of pocket expenditure for health care service, and health service status (quality, adequacy, efficiency, and coverage) were significantly and positively related but the premium amount, self-rated health status and bureaucratic complexity were found to be negative predictors. To achieve universal health care coverage through community-based health insurance, special attention should be given to community-based intervention.
Study proposal of the impact of gas flaring on health of communities in Delta state Nigeria
Authors: Obi Nkemdilim , Bwititi Phillip , Nwose Ezekiel
Published: August 2021

Gas flaring is the continuous discharge of gaseous fuel into the atmosphere during oil and gas operations. Over the past years, there has been an increased concern of the impact of gas flaring on the environment and recently on human health. The impact of gas flaring in Niger Delta, Nigeria is of local and global environmental concern. The uncontrolled and wasteful flaring of gas has caused negative impacts on the flora, fauna and human health and livelihood in the region. Reports indicate that gas flaring in Nigeria contributed more greenhouse gases (GHGs) such as carbon dioxide, methane, nitrous oxide, chlorofluorocarbons to the atmosphere than the combined contribution of gas flaring on GHGs in the Sub-Saharan African countries. The GHGs emitted during gas flaring contribute significantly to global warming which may result in sea level rise and hasten the effects of climate change. Gas flaring, commonly carried out by oil exploration companies in Nigeria poses a hazard to the health of populations and environment by pollution, warming and release of GHGs. This study seeked to identify the risks associated with gas flaring in relation to human health in Delta region of  Nigeria.
Advanced stage cervical carcinoma diagnosed one year after pregnancy: the importance of cervical cancer screening
Authors: Çelik Gayem Inayet , Akpak Yasam Kemal , Kantarci Sercan , Karabulut Alaattin , Oral Serkan
Published: August 2021

Cervical cancer is the most common gynecological malignancy during pregnancy. The incidence of cervical cancer during pregnancy is 0.004-0.1%. Cervical cancer accompanied by pregnancy may have severe maternal and fetal consequences. In our case, our patient died approximately 1 year after giving birth and 2 months after being diagnosed with cervical cancer. Among the treatment options, chemotherapy, radiotherapy and surgical treatment options were available alone or in combination. Type of treatment needed to be individualized and depended on stage, type of histology and gestational age. The aim of our study was to emphasize the importance of vaginal examination and its method during pregnancy in the diagnosis of cervical cancer, which was among the preventable cancers in pregnancy.
Prospects and Challenges of Crowdfunding as an Alternative Funding Option in Nigeria
Authors: Aderemi Abdulmajeed M.R. , Maulida Sri , Maikabara Abdullateef Abdulqadir
Published: August 2021

This study aims to review the concept, prospects, and challenges of crowdfunding in Nigeria. Furthermore, it adopts a library-based concept in which secondary sources are relied on data collection using descriptive and deductive approaches of analysis. The results showed that Nigeria has the potential of becoming the hub center of crowdfunding in Africa. However, various challenges are facing the growth of this platform as a means of ﬁnancing. These include the issues of regulation, lack of adequate awareness, as well as fraud and corruption. Furthermore, this study recommends the need for adequate awareness about crowdfunding and the regulation to ensure its functionality. It also oﬀers additional literature as a means of ﬁnancing, especially from the Nigerian context.
Secondary Use of Sewage Sludge, Research on Its Morphology and Physical and Chemical Properties
Authors: Mezhevova A.S. , Berestneva Yu.V. , Pugacheva A.M.
Published: August 2021

The findings of comprehensive studies on morphology, physico-chemical properties of sewage sludge, as well as practicalities of its application have been introduced. The sewage sludge used for the research came from the purification facilities of Volzhsky after the preliminary treated by the enzymatic-cavitation method. The morphology and structure of the processed sewage sludge have been determined by scanning electron microscope investigation and X-ray phase analysis. The chemical composition of the processed wastewater sludge have been and tested as an organic fertilizer in the cultivation of the false saffron.
New Ash and Sulfur Dioxide Emission Limit Levels for Large Combustion Plants and Best Available Techniques of Stack Gases Treatment
Authors: Meshalkin V.P. , Roslyakov P.V. , Guseva T.V. , Dovi V.G.
Published: August 2021

In order to determine new technological parameters for reviewing ITS 38-2017, the authors analyse coal properties and techniques for sulphur and ash removal from the stack gases. The technologies of ash purification and desulphurization of gases are analyzed and recommendations for their effective use are given. New technological emission parameters for ITS 38-2017 review proposed and recommendations provided for expanding the list of the Best Available Techniques to be implemented at Russian large combustion plants.
Foundations of the Theory of Emergency Situations
Authors: Dokukin P.A. , Kharchenko S.G.
Published: August 2021

The basic terms underlying the theory of emergency management are analyzed. The advantages and disadvantages of official definitions are considered, in particular, the data in the law of 21.12.1994 No. 68-FZ (Federal Law), in GOST (State Standard) R 22.0.02-2016, as well as in the number of authoritative foreign sources (Webster's dictionary, encyclopedia Britannica, Cambridge dictionary, Oxford dictionary, documents of the European Commission, etc.). The consequences of the legislative definition of an emergency in No. 68-FZ are investigated. The etymological, epistemological and gnoseological basis of the concepts of emergency, safety and danger, risk and uncertainty are analyzed. There is a great deal of variation in the interpretation of the concepts of safety and danger in sources of different origin and the illegality of mixing or substituting these concepts.
Simulation of a Production Workplace Using Virtual Reality
Authors: Töröková Monika , Török Jozef
Published: August 2021

Innovations in the production process are one of the basic conditions for guaranteeing the company's long-term sustainable growth and increasing its competitiveness. The introduction and use of innovative systems and technologies is a way that will significantly influence and help achieve these goals. This paper describes a simulation of a production workplace using virtual reality. The simulation was performed in Visual Components software with HTC Vive Pro hardware.
The Impact of Integrated Mobile System on Students' Academic Achievement, Interaction and Satisfaction
Authors: Musa Al-Momani Mohammad , PILLI Olga
Published: August 2021

This study explored the effectiveness of Blended Learning, hereafter (BL) on students’ academic achievement, interaction and satisfaction in higher education. The Integrated M-Learning and ELearning system, (IMELS) was utilized on a sample of students (n = 52) who attended Artificial Intelligent course at a large urban college in Jordan. The pretest/ post-test design was used to investigate the students’ academic achievement, interaction and satisfaction. ANOVA test was conducted to compare the achievement scores between the BL with IMELS group and face-to-face learning group. The post-test revealed a significant difference between the two groups in favour of the treatment group. Findings also showed that interaction types were positively associated with satisfaction of the students exposed to the IMELS in favour of learner-instructor interaction. This study has contributed to a better understanding of new technologies like IMELS in BL environment, which can affect positively the students' academic achievement, interactions and their satisfaction.
Be Pouya! (Metaphor for Iranian Clients During Pandemic COVID-19)
Authors: Bozorg Bonnie
Published: August 2021

The article's abstract is not available.
The Effectiveness of Buckroyd’s Group-Based Therapeutic Approach on Increasing Efficiency Life Style and Improving Body Self-Image
Authors: Hosseini Fariba , Gorgi Yousef , Javadzadeh Afsaneh
Published: August 2021

Background: Group teaching can create empathy in teaching sessions. Therefore the objective of the present study was to investigate the effectiveness of team teaching based on Buckroyd’s Method on lifestyle, self-efficacy and body image structure of the women with obesity in the city of Isfahan.
Methods: This study was quasi-experimental with pretest, posttest and control group and follow-up. The statistical population of the study included all people with obesity referring to clinics in the city of Isfahan from whom 30 women with obesity were selected through purposive sampling from Sepahan Health clinic in 2014 and then they were put into two groups of fifteen (experimental and control). A therapeutic intervention based on Buckroyd Method was administered on the experimental group during 16 two-hour sessions twice a week. The measurement instruments in this study were BMI scale, demographic information form, life style self-efficacy questionnaire and body image questionnaire. Descriptive statistics (mean and standard deviation) and inferential statistics (repeated measures variance) were used to test the hypotheses using SPSS software (version 23) at 0.05 level of error.
Results: The results showed that team teaching based on Buckroyd Method has been effective on the increase of life style self-efficacy (p < 0.001) and the improvement of body image (p < 0.001) as the mean score of life style self-efficacy and body image structure have increased after team teaching at the post-test stage and it could maintain this increase in time (follow-up stage).
Conclusion: Buckroyd Method can be employed in the increase of life style self-efficacy and body image structure in the obese women.