bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence of internalized stigma in patients with psychiatric illness in Abha, Southern Region, Saudi Arabia
Authors: Zarbah Abdulmajeed A. , Al Alfard Hayfa A. , Alamri Hassan S. , Al Edrees Nada , Alshahrani Nouf S. , Alshehri Ali F.
Published: May 2023

BACKGROUND:

Mental stigma occurs when patients with various mental disorders are labeled by their disorders. Little is known about the burden of mental stigma on patients with mental disorders. The aim of this study was to evaluate the incidence of mental stigma on patients with psychiatric disorder in Saudi Arabia.

MATERIALS AND METHODS:

This cross-sectional study was conducted among previously diagnosed patients with any psychiatric disorder attending King Khalid Hospital, Abha, Saudi Arabia. The patients were interviewed with a sociodemographic questionnaire and a validated Arabic version of the Internalized Stigma of Mental Illness (ISMI-29) scale. Chi-square test and t-test were used to assess the association between various demographic characteristics and presence of stigma.

RESULTS:

The study included 489 patients with different psychiatric disorders. The mean age of the participants was 32.8 years and 54.6% were females. About 39% participants showed no to minimal internalized stigma, 37.4% of total sample had mild stigma, 20% had moderate stigma, and 3.7% had severe stigma. A signficantly higher proportion (71.4%) of widowed patients had stigma (P = 0.032).

CONCLUSION:

Self-stigma is prevalent among patients with psychiatric disorders in Abha, Saudi Arabia, but lower than the prevalence in developing countries. Marital status has a significant impact on the prevalence and severity of the self-stigma of patients. There is a need for awareness program to reduce self-stigma. Psychiatric institutions should also focus on promotion of patients’ social life and increase patient’s awareness of certain issues that could prevent stigma.
Attitude of family medicine residents toward team-based care in primary healthcare centers in Saudi Arabia
Authors: Haji Alhan M. A.
Published: May 2023

BACKGROUND:

Team-based care (TBC) is becoming the standard method of delivering primary care services in Saudi Arabia. Family medicine residents are considered the future leaders who will apply the Saudi Ministry of Health (MOH) strategic transformation plans in practice. The aim of this study was to assess the attitude of family medicine residents toward TBC and the factors associated with their current attitudes.

MATERIALS AND METHODS:

A cross-sectional study was conducted between February and April 2022. The study targeted all Family Medicine residents rotating in primary healthcare centers of the Saudi MOH. A web-based survey was built using a modified version of the Attitudes Toward Health-Care Teams Scale. Data was analyzed using SPSS. Mann-Whitney U test and analysis of variance (ANOVA) were performed to compare mean attitude scores between various study variables.

RESULTS:

The overall mean attitude score was 2.71; the mean scores for attitudes toward team value, team efficiency, and physicians shared role were 3.94, 2.47, and 1.71, respectively. The residents who had received TBC training had significantly higher mean scores for attitudes toward team value subscale compared to those who had no training (4.09 vs. 3.87, P = 0.038). Similarly, the mean score for same attitude subscale was significantly higher among those who practice TBC compared to those who do not (4.08 vs. 3.85, P = 0.038).

CONCLUSION:

The residents exhibited an overall positive attitude, especially toward team value; however, their understanding of physicians’ shared role in the team should be improved by training and practice with role models.
Atypical site of nasopharyngeal branchial cleft cyst: A case of an unusual age presentation
Authors: Alsharhan Salma S. , Alghuneem Aishah A. , Alrusayyis Danah F. , Aljahli Marwah S.
Published: May 2023

Nasopharyngeal branchial cleft cysts (NBC) are generally single, unilateral, and asymptomatic. They may get infected or produce obstructive symptoms as it enlarges. The definitive diagnosis is usually confirmed by Magnetic resonance imaging (MRI) and histopathology. A 54-year-old male patient presented with progressive bilateral nasal obstruction, more on the right side, associated with hyponasal voice and postnasal discharge of 2 years’ duration. A cystic mass was found by nasal endoscopy on the lateral right side of the nasopharynx, extending to the oropharynx, and was confirmed with MRI findings. Uneventful total surgical excision and marsupialization were done with follow up of nasopharyngeal endoscopic examination on each visit. The pathological features and the site of the cyst were compatible with a second branchial cleft cyst. Although rare, NBC should be considered one of the differential diagnoses of nasopharyngeal tumors. Surgical excision and marsupialization are the main treatment with low complication and recurrence rates.
Efficient and Reliable Data Extraction in Radiation Oncology using Python Programming Language
Authors: Chauhan Rohit Singh , Pradhan Anirudh , Munshi Anusheel , Mohanti Bidhu Kalyan
Published: May 2023

Background and Purpose:

In recent years, data science approaches have entered health-care systems such as radiology, pathology, and radiation oncology. In our pilot study, we developed an automated data mining approach to extract data from a treatment planning system (TPS) with high speed, maximum accuracy, and little human interaction. We compared the amount of time required for manual data extraction versus the automated data mining technique.

Materials and Methods:

A Python programming script was created to extract specified parameters and features pertaining to patients and treatment (a total of 25 features) from TPS. We successfully implemented automation in data mining, utilizing the application programming interface environment provided by the external beam radiation therapy equipment provider for the whole group of patients who were accepted for treatment.

Results:

This in-house Python-based script extracted selected features for 427 patients in 0.28 ± 0.03 min with 100% accuracy at an astonishing rate of 0.04 s/plan. Comparatively, manual extraction of 25 parameters took an average of 4.5 ± 0.33 min/plan, along with associated transcriptional and transpositional errors and missing data information. This new approach turned out to be 6850 times faster than the conventional approach. Manual feature extraction time increased by a factor of nearly 2.5 if we doubled the number of features extracted, whereas for the Python script, it increased by a factor of just 1.15.

Conclusion:

We conclude that our in-house developed Python script can extract plan data from TPS at a far higher speed (>6000 times) and with the best possible accuracy compared to manual data extraction.
Simulation Analysis on the Performance of a Circular-Edge Technique in Measurements of the Modulation Transfer Function
Authors: Maruyama Sho
Published: May 2023

The modulation transfer function (MTF) plays an important role in characterizing medical imaging systems. For such characterization, the circular-edge technique has become a prevalent task-based methodology. When determining the MTF with complicated task-based measurements, error factors must be well understood to properly interpret the results. In this context, the aim of this work was to study the changes in measurement performance in the analysis of the MTF using a circular edge. To eliminate the systematic error related to the measurement and suitably manage the error factors, images were generated by Monte Carlo simulation. Further, a performance comparison with the conventional method was conducted; in addition, the influence of the edge size and contrast and the setting error of the center coordinates were investigated. The difference from the true value and the standard deviation relative to the average value were applied to the index as the accuracy and precision, respectively. The results demonstrated that the smaller the circular object used and the lower the contrast, the grater the deterioration in the measurement performance. Furthermore, this study clarified the underestimating of the MTF in proportion to the square of the distance with respect to the setting error of the center position, which is important for the synthesis of the edge profile. Evaluations in the backgrounds wherein there are multiple factors affecting the results are complex, and the system users must properly judge the validity of the characterization results. These findings provide meaningful insight in the context of MTF measurement techniques.
Rotational Set Up Uncertainly in Non-6D Couch and its Effects in Clinical Target Volume- Planning Target Volume Margin Calculation for Different Sites
Authors: Robert Ngangom , Sehgal Tinish , Singh Ranjit , Oinam Arun , Trivedi Gaurav , Singh Budhi , Bahl Amit , Madan Renu , Rai Bhavana
Published: May 2023

Purpose:

The purpose of this study was to estimate and incorporate rotational error to translational error for clinical target volume (CTV) to planning target volume (PTV) margin calculations for non-6D couch.

Materials and Methods:

The study involved cone-beam computed tomography (CBCT) images of the patients who already had treatment in Varian Trilogy Clinac. The different sites studied were brain (70 patients, 406 CBCT images), head and neck (72 patients, 356 CBCT images), pelvis (83 patients, 606 CBCT images), and breast (45 patients, 163 CBCT images). Rotational and translational patient shifts were measured with the help of Varian eclipse offline review. The rotational shift introduces translational shift as it resolved along craniocaudal and mediolateral directions. Both rotational and translational error follow normal distribution and their respective errors were used to calculate CTV-PTV margin using van Herk model.

Results:

Rotational effect on CTV-PTV margin contribution increases with increase in size of CTV. It also increases with increase in distance between center of mass of CTV and isocenter. These margins were more pronounce in single isocenter supraclavicular fossa-Tangential Breast plans.

Conclusions:

There is always rotational error in all sites and it causes shift and rotation of the target. Rotational contribution to the CTV-PTV margin depends upon geometric center of CTV and isocenter distance and also on size of CTV. CTV-PTV margins should incorporate rotational error along with transitional error.
Prediction Factors of Radiation Esophagitis in Breast Cancer Patients Undergoing Supraclavicular Radiotherapy
Authors: Amin Soma Saeed Mohammed , Faraj Kharman Akarm , Ali Jalil Salih , Rahim Hawzhin Abdalla Hama , Yarahmadi Mehran
Published: May 2023

Purpose:

The aim of this study was to investigate demographic and dosimetric parameters which may link with esophagitis in patients with breast cancer receiving three-dimensional conformal radiotherapy to the supraclavicular fossa.

Materials and Methods:

We examined 27 breast cancer patients with supraclavicular metastases. All patients were treated with radiotherapy (RT) with a prescribed dose of 40.5 Gy in 15 fractions for 3 weeks. Esophagitis was recorded weekly and esophagus toxicity was evaluated and graded according to the tadiation therapy oncology group. The following factors were examined regarding their correlation with grade 1 or worse esophagitis by univariate and multivariate analyses: age, chemotherapy, smoking history, maximum dose (Dmax), mean dose (Dmean), esophagus volume receiving 10 Gy (V10), esophagus volume receiving 20 Gy (V20), and length of esophagus in the treatment field.

Results:

Of 27, 11 (40.7%) patients developed no esophageal irritation throughout therapy. Approximately half of the patients 13/27 (48.1%) had maximum grade 1 esophagitis. 2/27 (7.4%) patients had grade 2 esophagitis. The incidence of grade 3 esophagitis was (3.7%). Dmean, Dmax, V10, and V20 were 10.48 ± 5.10 Gy, 38.18 ± 5.12Gy, 29.83 ± 15.16, and 19.32 ± 10.01, respectively. Our results showed that Dmean, V10, and V20 were the significant factors for the development of esophagitis, whereas esophagitis was not significantly associated with the chemotherapy regimen, age, and smoking status.

Conclusions:

We found that Dmean, V10, and V20 correlated significantly with acute esophagitis. However, the chemotherapy regimen, age, and smoking status did not affect esophagitis development.
Validation of the Fabricated Cast Nylon Head Phantom for Stereotactic Radiosurgery End-to-End Test using Alanine Dosimeter
Authors: Intang Aungsumalin , Oonsiri Puntiwa , Kingkaew Sakda , Chatchumnan Nichakan , Oonsiri Sornjarod
Published: May 2023

Background:

Stereotactic radiosurgery (SRS) is an alternative to surgery as it precisely delivers single-large doses to small tumors. Cast nylon is used in phantom due to its computed tomography (CT) number of about 56–95 HU, which is close to that of the soft tissue. Moreover, cast nylon is also more budget-friendly than the commercial phantoms.

Aims:

The aim of this study is to design and validate the fabricated cast nylon head phantom for SRS end-to-end test using an alanine dosimeter.

Materials and Methods:

The phantom was designed using cast nylon. It was initially created by a computer numerical control three-axis vertical machining center. Then, the cast nylon phantom was scanned using a CT simulator. Finally, the validation of the fabricated phantom using alanine dosimeter proficiency with four Varian LINAC machines was performed.

Results:

The fabricated phantom presented a CT number of 85–90 HU. The outcomes of VMAT SRS plans showed percentage dose differences from 0.24 to 1.55, whereas the percentage dose differences in organ at risk (OAR) were 0.09–10.80 due to the low-dose region. The distance between the target (position 2) and the brainstem (position 3) was 0.88 cm.

Conclusions:

Variation in dose for OAR is higher, which might be due to a high-dose gradient in the area where measurement was being conducted. The fabricated cast nylon end-to-end test head phantom had been suitably designed to image and irradiate during an end-to-end test for SRS using an alanine dosimeter.
Two failed trials of repetitive transcranial magnetic stimulation (rTMS) in obsessive-compulsive disorder (OCD): Is this rTMS-resistant OCD?
Authors: Joseph Jithin T , Jammigumpula Ashok , Manibettu Vidyashree S , Purohith Abhiram Narasimhan , Shenoy Sonia , Praharaj Samir Kumar
Published: May 2023

Treatment options for obsessive-compulsive disorder (OCD) includes serotonergic medications and cognitive-behavioral therapy, however, many patients show poor response to treatment. Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive intervention which has shown some efficacy in OCD, and newer treatment protocols are being studied. We report a case of treatment-resistant OCD which did not improve with 20 sessions of high-frequency primed low frequency rTMS over supplementary motor area, and 15 sessions of accelerated continuous theta burst stimulation of the right frontal pole, raising the possibility of TMS-resistant OCD.
The day my Diya burnt out: The shadows that remain
Authors: Chandna Ateev Sudhir
Published: May 2023

This short story takes the form of a journal entry where the author reflects on their life as a doctor. Growing up in a family of doctors and undergoing the rigorous training and selection processes of medicine conditioned them to be ruthlessly competitive and self-centred. However, their perspective shifts when their younger sister, also a medical student, unexpectedly takes her own life. The author realizes that despite being surrounded by doctors, they failed to recognize the signs of their sister’s mental health struggles and how they could have supported her. This traumatic experience leads the author to question the culture of medicine and the lack of emphasis on empathy and emotional support for both patients and fellow medical professionals. The story serves as a poignant reminder of the consequences of neglecting mental health and the importance of cultivating a more compassionate and understanding medical culture.
Change in substance use patterns and behaviors due to COVID-19 and related restrictions among patients seeking treatment for substance use
Authors: Chatterjee Biswadip , Das Nileswar , Kattula Dheeraj , Kololichalil Anaf , Sarkar Siddharth
Published: May 2023

Background:

Coronavirus disease 2019 (COVID-19) and related restrictions have affected individuals with opioid use disorders who are on treatment by affecting the opioid agonist treatment services worldwide. The study aimed to assess the changes in substance use patterns and associated behaviors among the patients on buprenorphine maintenance treatment (BMT) due to the first wave of COVID-19 in India (March–September 2020).

Materials and Methods:

The cross-sectional observational study was conducted in a community-based drug treatment center situated in northern India serving a slum population. Male opioid-dependent patients (n = 94), maintained on BMT for at least a year before the start of the COVID-related restrictions in India, were assessed for use of illicit opioids, diverted opioid agonist medications and other psychoactive substances, lapses, compliance to BMT, high-risk behaviors, socio-occupational and mental health, and impact of COVID-19 by comparing it with the immediate pre-COVID period (September 2019–February 2020).

Result:

There was no significant increase in the use of illicit opioid use, spending on illicit opioids, and lapse rate. Though treatment break was seen in 39.4% of subjects at the start of the COVID-19 restrictions, the proportion of those abstinent from illicit opioids remained constant. No significant increase in the use of illegally diverted buprenorphine and other substance use was noted. More than half (56.4%) of the patients abstained from all substances (excluding tobacco). However, a significantly higher proportion of participants reported financial loss, unemployment, and frequent anxiety and depressive symptoms during the COVID period.

Conclusion:

The study demonstrated that despite the restrictions, continuing treatment service can help retain patients, keep them abstinent, prevent other high-risk behaviors, and help them tide over economic hardships.
Clozapine for management of bipolar disorder: A case series
Authors: Grover Sandeep , Redhu Promil
Published: May 2023

Clozapine is considered to be the treatment of choice in patients with treatment-resistant schizophrenia. However, there is little information on the use of clozapine in patients with bipolar disorder (BD), especially in India. The aim of this paper is to present four cases of BD who were having frequent relapses while on a combination of two mood stabilizers and an antipsychotic medication, whose frequency of episodes reduced significantly after starting clozapine. Four patients with treatment-resistant BD (i.e., lack of response to a combination of two mood stabilizers) with a history of frequent suicidal behavior (in two patients) and marked aggression (in two patients) were managed with a combination of a mood stabilizer and clozapine (three patients) or combination of antidepressant and clozapine. The addition of clozapine led to the remission of hypomanic/manic episodes in all the patients. Three of the four patients who were followed for 3.5–8 years had a marked reduction in the number of episodes of either polarity, suicidality, aggression, and medication load. One patient who was followed up for 3 months also reported remission of manic symptoms and reduction in aggression. This report suggest that clozapine can be a helpful treatment option in patients with BD, especially those with treatment-resistant BD who usually do not respond adequately to other medications. Additionally, the use of clozapine in patients with BD is also associated with reduced self-harm behavior, aggression, and medication load.
Comparative efficacy of amisulpride and risperidone in schizophrenia with predominantly negative symptoms: A randomized clinical trial
Authors: Alam Mohammad Tariqul , Ahmed Helal Uddin , Sarkar Mekhala , Khan Niaz Mohammad , Sarkar Ahsan Aziz
Published: May 2023

Introduction:

Negative symptoms are core components of schizophrenia and can cause significant long-term functional handicap, severely impair the quality of life of both the patient and the caregivers and place a substantial burden on society. There are only a handful of studies comparing the efficacy of amisulpride and risperidone in schizophrenia with predominantly negative symptoms.

Materials and Methods:

This single-center, single-blind, randomized 90-day long clinical trial enrolled 64 patients who received either amisulpride (150-300 mg/day) or risperidone (4–8 mg/day) for 90 days. The Scale for Assessment of Negative Symptoms (SANS), Positive and Negative Symptom Scale (PANSS), and Clinical Global Impression- Schizophrenia Scale (CHI-SCH) scales were used to assess patients.

Results:

There were significant declines in all three scale scores over the trial period of 90 days. There was no significant difference between the two groups in SANS, PANSS, and CGI-SCH scores at baseline, day 30, and day 90 of the trial. The higher proportion of patients on amisulpride showed a 30% and 50% score decline at day 30; but on day 90, both groups showed a similar proportion of declines.

Conclusion:

Amisulpride and risperidone showed similar efficacy at 90 days in schizophrenia patients with predominantly negative symptoms.
Folie a trois: In mother and her twin adolescent daughters: Case report
Authors: Pradhan Lopamudra , Sahu Pallabi , Swain Sarada Prasanna
Published: May 2023

Shared psychotic disorder is not uncommon and affects different sets of people with different profiles. Here we present a case of a mother and her two dizygotic daughters who showed suspiciousness and social withdrawal. The case is unique as even after hailing from a well-educated family, the social stigma and lack of awareness caused a surplus lapse in treatment. Close association, female gender, suggestibility, and untreated medical conditions in the primary can act as psychopathological factors. In such situations, separation along with concurrent pharmacotherapy and psychotherapy is advocated emphasizing individualized treatment.
Integrating Patient Safety in the Existing Undergraduate Medical Curriculum
Authors: Shrivastava Saurabh RamBihariLal , Shrivastava Prateek Saurabh
Published: May 2023

The field of medicine has made significant advancements owing to multiple scientific innovations, and the outcome is quite evident in terms of improvement in the health outcomes. The aim of the current review is to understand the magnitude of the problem, scope of patient safety in undergraduate medical education, and components of the same. An extensive search of all materials related to the topic was carried out in the PubMed search engine and World Health Organization website. Overall, 20 articles were selected based upon the suitability with the current review objectives and analyzed. Keywords used in the search include patient safety and medical education in the title alone only. If we really aim to minimize the errors on our part and thereby improve the patient safety, the ideal approach will be to train the undergraduate medical students about different aspects of patient safety during their training period. We must understand that mere knowledge about patient safety (Knows level in Miller's Pyramid) will not serve the desired purpose. Rather, the better approach will be to target knows how and even does level in Miller's Pyramid, as ensuring patient safety is predominantly a skill. To conclude, patient safety curriculum is an important component of the medical undergraduate training. The need of the hour is to acknowledge the importance of patient safety, plan for its integration within the existing curriculum, and implement the same with the help of faculty members.
Efficiency of Matrix Rhythm Therapy on Pain, Strength, and Quality of Life in Forward Neck Posture
Authors: Naik Varun C , Kerkar Mayuri , Mascarenhas Sazney
Published: May 2023

Objective:

To determine and compare the effects of the Dynamic Exercise Program (DEP) and matrix rhythm therapy (MaRhyThe©) along with conventional physiotherapy in asymptomatic subjects with forward head posture (FHP) on a craniovertebral angle (CVA), strength, pain, and quality of life (QoL) using CVA, pressure biofeedback unit, pain algometer, and short form (SF-36), respectively.

Methodology:

Sixty-five people were screened for the study, of which 30 were included (18 females and 12 males) who participated in the study. The study participants were randomly allocated to Group A (DEP) or Group B (MaRhyThe©). Preintervention outcome measures used were CVA for the neck position, a craniocervical flexion endurance test for strength, a pain algometer for pain pressure threshold, and SF-36 for QoL. Postintervention outcome measures were recorded on the 6th day after intervention.

Results:

Data were analyzed descriptively with a priori establishment of success criteria of P < 0.05. Within-group analysis of both groups demonstrated statistically significant parameters of CVA, strength, and pain as P < 0.05. Between groups analysis demonstrated Group B to be statistically significant in all the outcome measures CVA (P < 0.0001), strength (P < 0.0001), and pain (P < 0.0001). SF-36 showed a positive effect on some subdomains as to emotional well-being (0.0320) and pain (0.0047*).

Conclusion:

It was determined that both deep exercise programs and MaRhyThe© when combined with conventional physiotherapy are effective in treating FHP. However, MaRhyThe© with conventional physiotherapy was found to be superior in reducing pain and improving range of motion, strength, and QoL.
Mania with Malignant Catatonia Due to Nonpara Neoplastic Anti-N-Methyl-D-aspartate-Receptor Encephalitis in a 29-year-old Female – A Rare Entity
Authors: Garg Sunny , Chauhan Alka
Published: May 2023

Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is a rare neurological autoimmune encephalitis. Its symptoms may mimic psychosis as this disease is neurological disorder in psychiatric costume. Disparity in clinical symptoms and nonsupportive laboratory investigations except the cerebrospinal fluid (CSF) analysis delays the diagnosis. We presented a case of 29-year-old female with psychiatric symptoms such as suspiciousness, decreased sleep, and boastfulness. Within few days, the patient developed neurological symptoms like seizures, disorientation, while the patient was on antipsychotic and benzodiazepines. Her symptoms worsened and the patient entered into the catatonic phase of the illness along with autonomic instability. We reached a positive diagnosis of Anti-NMDA encephalitis through CSF analysis. The patient recovered completely with the help of immunotherapy and intensive cognitive rehabilitation. This case emphasizes the need of a multidisciplinary approach in the management, early detection, and adequate treatment of this challenging illness for the better outcome of the patient.
Psychosocial Burdens of Women in India
Authors: Ram Dushad , Mathew Akash
Published: May 2023

Various psychosocial factors play a vital role in mental health. India's rich cultural, traditional, and social value system is well-known throughout the world. However, a considerable proportion of women are disadvantaged in these systems, and as a result, they are more likely to experience a significant psychosocial burden that affects their physical, mental, social, and spiritual well-being. These psychosocial burden also have an impact on their quality of life, personal well-being, and some fundamental human rights. In the light of the current Indian situation, this narrative review depicts the psychosocial burden that a significant proportion of Indian women are likely to face.
Implementation of a Student Support System in Medical Institutions
Authors: Shrivastava Saurabh RamBihariLal , Shrivastava Prateek Saurabh
Published: May 2023

The training period in the delivery of medical education has to be utilized for the comprehensive development of the student. Acknowledging the presence of multiple problems in the life of a medical student is inevitable to plan and implement a student support system within each of the medical institutions. In fact, specific standards have been laid down by the national and international regulatory bodies to minimize stress, resolve problems, and holistically address all the issues which can together influence the academic performance of a student. The need of the hour is to adopt a student-centered approach that enables the students to understand their thoughts and feelings better and this can be streamlined with the help of a mentor or teacher in a confidential and nonjudgmental manner. In conclusion, the life of a medical student is full of ups and downs, and thus, there is an indispensable need to develop a student support system, which ensures the comprehensive development of them. Moreover, the success of such a system will be determined by the institutional culture, wherein all the stakeholders work together for the betterment of the students.
Knowledge and attitude toward dental stem cells among dental professionals
Authors: Sai Lakshmi L. J. , Jeddy Nadeem , Radhika T. , Amutha S. , Gnanasagar W. R.
Published: May 2023

Introduction:

Dental stem cells (DSCs) derived from tooth structures refer to adult stem cells. DSCs can be used to regenerate both dental tissues and nondental organs. DSC research is progressing at a rapid pace and hence it is imperative for dental professionals to possess adequate knowledge and a favorable attitude toward the same. The aim of this study was to assess the knowledge and attitude of dental professionals toward DSCs.

Methodology:

A cross-sectional, descriptive, questionnaire-based survey was conducted on a sample of 200 dental professionals from various dental colleges in Chennai. The questionnaire included a total of 15 questions to assess the knowledge and attitude toward DSCs. The Pearson's Chi-square test and percentages of the total were used for statistical analysis.

Results:

A total of 200 dental professionals completed the questionnaire survey; of which 42 (21%) were male and 158 (78%) were female. Maximum respondents were intern (n = 92, 46%), followed by dental practitioners (DP) (n = 58, 29%) and postgraduates (n = 50, 25%). Around 182 (91%) dental professionals are aware of the term stem cells. Overall, 66% of dental participants were not aware of ethical considerations and guidelines related to DSCs given by the Indian Council of Medical Research. The majority of dental participants (83%) were interested in attending workshop/conference/Continuing Dental Education (CDE) program on applications of stem cells.

Conclusion:

This study revealed that there was a generalized awareness of the term “DSCs” among the study participants. However, there was a huge lacuna in the knowledge of its types, ethical considerations, and the concept of stem cell banking and DSC banks in India. The results of the current study emphasize the need for improvement in knowledge of DSCs for dental professionals by promoting more CDE programs focusing on this subject.
Real-World Effectiveness of Generic Antihypertensive Drugs of Pradhan Mantri Bhartiya Janaushadhi Kendra
Authors: Sheikh Chandani , Donage Nikita , Donga Bhavana , Benny Stephen , Majjigeri Kiran , Spoorthi Sowmya , Bhandari Ramesh , Ganachari M. S.
Published: May 2023

Background:

The Government of India started the Janaushadhi Scheme in 2008 to control individuals' expenditure by providing low-cost generic medicines for health benefits. Hence, this study aims to study the real-world effectiveness of Jan Aushadhi generic antihypertensive medicines at a Pradhan Mantri Bhartiya Janaushadhi Kendra and also to assess knowledge and attitude toward generic drugs.

Methods:

This study was done in Pradhan Mantri Bhartiya Janaushadhi Kendra. Participants who were hypertensive and on at least one antihypertensive drug from Pradhan Mantri Bhartiya Janaushadhi Kendra were enrolled in the study. All the participants received three blood pressure (BP) measurements, i.e., two manual readings and an average of two taken. One digital reading is followed by questionnaires, which help assess patients' knowledge and attitude using Pradhan Mantri Bhartiya Janaushadhi Kendra medicines. All the participants were evaluated for baseline, 1st-month, 2nd-month, and 3rd-month follow-up visits. The baseline, 1st-month, 2nd-month, and 3rd-month data were compared using paired t-test and Cochran's q-test.

Results:

The important findings were a considerable reduction in BP compared to the baseline, 1st-month, 2nd-month, and 3rd-month follow-up. Approximately half of the patients (53.36%) know the difference between generic and brand medicines. A significant proportion of the participants believe that taking Janaushadhi medication reduces the cost. Hence, considerable improvement was evidenced in all outcome measures.

Conclusion:

A significant reduction in systolic and diastolic BP was achieved for all the hypertension stages, providing the authentication that most hypertensive patients may benefit from low-cost generic Jan Aushadhi medicines.
Training Medical Students to Develop the Skills for Establishing Clinical Diagnosis
Authors: Shrivastava Saurabh RamBihariLal , Shrivastava Prateek Saurabh
Published: May 2023

In the field of medicine, it is extremely important to establish a correct and timely diagnosis to ensure delivery of appropriate quality assured care, maintain patient safety, and minimize hospital-induced errors. An extensive search of all materials related to the topic was carried out in the PubMed search engine and a total of 6 articles were selected based on the suitability with the current review objectives and analyzed. There are no doubts that the process of making a precise clinical diagnosis is a complex one and is error prone. Amid these facts, it is a real challenge for the medical teachers to teach and train the medical students with an aim to accomplish the core competency of reaching a correct clinical diagnosis in authentic settings. One of the approaches adopted by the teachers is to provide learning opportunities to the students so that they can develop critical thinking and clinical reasoning skills. In conclusion, medical teachers have to adopt a systematic approach for teaching students the skill of establishing a clinical diagnosis in authentic settings. It is essential that the training should start from the early years and should be implemented in such a way that students get a number of learning opportunities in real settings to be more useful.
A Cross-Sectional Study
Authors: Saini Jitndra Kumar , Suthar Hansaram
Published: May 2023

Background:

Alcoholism is gradually tearing down college students worldwide. This is turning out to be a major social predicament. Alcohol misuse was reported as a strong predictor of students' mental health.

Objectives:

This study aimed to assess the prevalence of alcohol consumption, factors associated with it, and its effects among undergraduate students.

Materials and Methods:

A cross-sectional survey was applied on 180 undergraduates at Shekhawati PG College, Rajasthan, India, using stratified random sampling. Structured questionnaire and rating scale were used to collect the data.

Results:

The finding showed 25.55% prevalence of alcohol consumption with majority of being males (63.04%). Maximum number (47.8%) of the students started alcohol consumption at 18–19 years of age, with reasons being social gathering or marriage party (69.56%), peer pressure and curiosity about the effects of alcohol (13.04%), and drinking habit of the parents (6.52%). Majority of the student (65.21%) drink outside the home and at night time (91.30%). Maximum urge (86.95%) was felt for pleasure (93.47%) on special occasions or party functions. Early onset of consumption made students (28.26%) addicted. Maximum students (78.3%) showed mild effects of alcohol consumption, whereas 21.7% experienced moderate effects of alcohol consumption.

Conclusions:

The study showed that the most common age to start consuming alcohol was between 18 and 19 years, and common reasons to start included “social activities” and “peer pressure” for majority and for a few “curiosity” and “family influence.” It becomes incumbent on the government, health-care practitioners, and other stakeholders to promote responsible drinking and discourage premature drinking.
Omicron
Authors: Taywade Manish , Pal Debkumar , Kalra Ranjana , Maji Shampa
Published: May 2023

With the detection of Omicron, a new variant of severe acute respiratory syndrome coronavirus-2 in South Africa, a question arises regarding its implication in public health. The infectivity, ability of getting detected by available testing method and effectiveness of existing vaccine against this strain are not known properly. This Omicron variant can impact public health similarly or more than the Delta variant. The research is going on in many countries to get conclusion regarding the impact of the Omicron variant in public health.
Placenta Increta Manifesting as Unusual Cervical Mass after First Trimester Dilatation and Curettage, Managed by Laparoscopy
Authors: Metgud Mrityunjay , Alimilla Sindhu , Patil Kamal Prakash , Savanur Mahadevi , Malli Rajashekhar , Sanikop Adarsh , Kenawadekar Rahul
Published: May 2023

Placenta accreta spectrum, is characterized by abnormal placental adherence to the myometrium. Depending on the depth of trophoblastic growth, it is classified into placenta accreta, placenta increta, and placenta percreta. This condition is associated with life-threatening hemorrhage, resulting in high maternal and neonatal morbidity and mortality. Placenta accreta usually presents with vaginal bleeding during difficult placental removal in the third trimester. Placenta accreta spectrum is very rarely present in the first trimester. Severe forms may complicate first-trimester pregnancy losses, causing profuse postcurettage hemorrhage. A 28-year-old lady with one living issue by cesarean section who had undergone a dilatation and curettage (D&C) 2 months ago for missed abortion, came with the complaints of prolonged vaginal bleeding following the procedure. On pelvic examination, the uterus was bulky, partly firm on one side, and soft on the other. Ultrasound examination revealed it to be a bicornuate uterus with retained products in one of the horns. Magnetic resonance imagining was suggestive of lateral cervical fibroid. Diagnostic laparoscopy revealed it to be a left lateral cervical mass. Total laparoscopic hysterectomy was performed. On histopathological examination, specimen revealed necrotic placenta infiltrating the endocervix and isthmus. Placenta accreta is a rare problem and difficult to diagnose in the first trimester. It can occur when there are risk factors or if there are ultrasound markers of the first trimester suspicious of the adherent placenta. A diagnosis of placenta accreta spectrum needs to be considered when there is post-D&C prolonged or heavy vaginal bleeding.
Laparoscopic Removal of Congenital Seminal Vesicle Cyst in a Preadolescent Male
Authors: Kumar G Ajay , Reddy M N , Babu B S R Prasad , Kumar A Lava , Sindhuri A
Published: May 2023

Zinner syndrome refers to the triad of ipsilateral renal agenesis, seminal vesicle cysts, and ejaculatory duct obstruction. Ipsilateral renal agenesis may be associated with seminal vesicle cysts in 70% of cases, but a remnant ureteral bud has been shown to coexist in only 27% of these cases. While some patients may remain asymptomatic and are discovered incidentally, others present with symptoms related to seminal vesicle cysts or ejaculatory duct obstruction, voiding, or ejaculatory difficulty, or pain. Symptomatic cases are very rare in the preadolescent age group. The uniqueness of our case report is that the patient is a 16-year-old male with suprapubic discomfort who was diagnosed with left seminal vesicle cyst (Zinner syndrome) and was successfully managed by laparoscopic resection. To our knowledge, none of the case reports were published in such age group.
Clinicopathological Features and Outcome of COVID-19 – Early Experiences from Three COVID Hospitals, Chittagong, Bangladesh
Authors: Biswas Rajat Sanker Roy , Nath Jishu Deb , Barua Pranab Kumar , Karim Md. Rejaul , Jahan Safatuj , Islam Mohammad Saiful , Ahmed Kazi Farhad , Kanti Kajal
Published: May 2023

Introduction:

COVID 19 is an unknown virus affecting mankind creating a deadly experience to all. It is true for Bangladesh also. So the objectives of the present study are to find the clinicopathological features and outcome of COVID patients admitted to three COVID dedicated hospitals of Chittagong, Bangladesh.

Methods:

This was an observational study where a total of 209 patients admitted to three COVID dedicated hospital were recruited. Clinicopathological data were recorded and patients were under observation till discharge and thus outcome were recorded. Prior consent was taken from the patients and ethical clearance was also taken. Data were compiled and analyzed by Statistical Package for Social Sciences-20.

Results:

Among 209 patients most of them were male 139 (66.5%) and male to female ratio was 1.98:1. Age group distribution revealed more were aggregated in the age group of 41–50 years 36 (17.2%), 51–60 years 54 (25.8%), and 61–70 years 57 (27.3%). Among all 92 (44%) patients were reverse transcription-polymerase chain reaction (RT-PCR) positive and 117 (56%) were probable cases. Fever was present in 195 (93.3%) cases, cough in 180 (86.1%), respiratory distress in 105 (50.2%) anosmia in 123 (58.8%), aguesea in 112 (53.58%) and lethargy was present in 143 (68.42%). Chest X-ray findings revealed 73 (34.9%) had bilateral patchy opacities, 20 (9.6%) had unilateral opacities 65 (31.1%) had consolidations, 6 (2.9%) had ground glass opacities, and 2 (1.0%) had pleural effusion. Supplemental O2 was given in 173 (82.8%) patients, Favipiravir in 59 (28.2%), Remdesivir in 111 (53.1%), Methylprednisolone in 87 (41.6%), Dexamethasone in 93 (44.5%), Antibiotics in 204 (97.60%), Toccilizumab in 34 (16.3%), plasma in 18 (8.6%), and low molecular weight heparin (LMWH) in 200 (95.7%) patients. Regarding outcome of the COVID patients admitted, 85 (92.4%) patients improved, 6 (6.5%) died who were RT-PCR positive and 107 (91.15%) improved, 9 (7.7%) died who were probable cases. Total death rate was 7.1%.

Conclusion:

The present study findings were some early activities among COVID patients in the years 2020. Male were more affected and middle age group people were the most victims.
Employment of Objective Structured Clinical Examination Tool in the Undergraduate Medical Training
Authors: Shrivastava Saurabh RamBihariLal , Shrivastava Prateek Saurabh
Published: May 2023

The delivery of medical education has shown a significant shift from the conventional mode of training to the competency-based training. Assessments have been identified as the most significant difference between the two approaches of training. The purpose of the current review was to explore the employment of objective structured clinical examination (OSCE) tool in the delivery of medical education. An extensive search of all materials related to the topic was carried out in the PubMed search engine, and a total of 30 articles were selected based upon the suitability with the current review objectives. It is quite obvious that during assessments, we plan to assess knowledge, skill, and affective domains, which actually gives inference about the overall learning progression. OSCE is an assessment tool that is being employed in medical training owing to its objectivity and structured nature. With the passage of time, OSCEs have been widely used in both undergraduate and postgraduate examinations. Acknowledging the fact that the OSCE can be of immense significance in monitoring the learning and its progression, it becomes quite essential to ensure its quality. In conclusion, the scope of OSCE as an assessment tool in medical education training is immense. It is the need of the hour to use the tool in an objective and structured manner to assess the level of learning in students and even monitor the progression in learning.
Morphometric Scrutiny of the Radial Head
Authors: Shrivastava Shilpi , Bhimalli Shilpa M , Pattanshetti Sheetal Vishwanath
Published: May 2023

Background:

Radius is one of the two constituent bones of the forearm. It is frequently fractured or dislocated due to trauma, pathology, etc. Prosthetic radial head may be indicated in the management of comminuted fractures of the radial head.

Aims and Objectives:

This study was undertaken with the aim to measure various dimensions of the head of the radius bone and to collate these dimensions between right-sided and left-sided bones.

Materials and Methods:

Three hundred bones, collected from the Department of Anatomy of Jawaharlal Nehru Medical College, Belagavi, Karnataka, were systematically investigated using digital Vernier caliper, normal ruler, and inelastic thread. The data recorded were then analyzed to obtain the results.

Results:

The mean length, diameter, and circumference of the head of the radius bones were 9.47 ± 1.49 mm, 19.92 ± 2.03 mm, and 6.42 ± 0.63 cm, respectively (irrespective of the side). For only one aspect, the length of the radial head, a statistically significant difference was obtained between the values of bones of both sides.

Conclusion:

Numerous studies have shown an extensively varied range of values for several parameters. Utmost care and precision are required by the orthopedic surgeons, prosthetists, etc. while treating patients or prosthesis making, to avoid untoward outcomes like soreness, etc. This study strives to underline this need for precision by highlighting the varied range of parameters in the regional population.
Justifying the Need of Developing Research Skills among Medical Students to Strengthen the Practice of Evidence-Based Medicine
Authors: Shrivastava Saurabh RamBihariLal , Shrivastava Prateek Saurabh
Published: May 2023

Encouragement of research has been recognized as one of the most important reasons for the advancement in the field of medicine and the same stands true for the adoption of curricular innovations in the delivery of medical education. However, there have been significant concerns about the fact that many of the medical doctors are not participating in clinical research or basic research. An extensive search of all materials related to the topic was carried out in the PubMed search engine and a total of eight articles were selected based upon the suitability with the current review objectives. These are ominous signs for the field of medical education and research in medicine and call for an urgent need to expose medical students to the basic skills of performing research at an early stage in their training period. The idea is that students should be informed about the set of research skills which they should develop during their graduation period and the ways in which these research skills will help them in their academic career and professional practice. In conclusion, a medical student has to master multiple research skills during their undergraduation period to ensure effective patient care as well as enhance their contribution in the field of medical research. However, considering the already packed curriculum, it is a must that the research should be integrated within the curriculum in a longitudinal manner throughout the duration of medical training.