bluuebunny/crossref_metadata_2025 huggingface dataset:
Outcome Analysis of Surgeries Around Craniovertebral Junction
Authors: Ostagar Abdul Naim , Kumar Rajan , Akhtar Nasim , Das Sisir , Kar Arkadeb
Published: May 2022

Background:

The craniovertebral junction (CVJ) is mainly affected by various bony developmental anomalies. Other causes of compression include trauma, tumors, atlantoaxial instability, and infection (tubercular/pyogenic). We have surgically treated 38 patients of CVJ utilizing different procedures over a span of 4 years and done retrospective study. The purpose of this paper is to analyze the outcome of surgeries around CVJ.

Materials and Methods:

In our institution, from September 2015 to August 2019, 38 patients underwent surgeries by different methods around CVJ and a retrospective analysis was done. Clinico-radiological evaluation was done to assess the results. The neurologic recovery rate was calculated by Japanese Orthopaedic Association (JOA) score.

Results:

There were 31 male and 7 female patients in our study with a mean age of 49.8 years (2–86 years). Three (3) anterior surgeries, one (1) combined anterior-posterior 360º fusion, and 34 posterior surgeries including 22 atlantoaxial fixations were done. Average JOA pre-op was 11.6 (range 4–16), at last follow-up average JOA is 14.1 (range 6–16). Radiologically, fusion was achieved in all except two cases.

Conclusion:

We conclude that CVJ procedures are safe and effective, posterior-only surgery gives promising results with high fusion rate and neurological improvement in most of the patients.
Anterior Cruciate Ligament Reconstruction Using Bone-Patellar Tendon-Bone Graft Through Transtibial Tunnel
Authors: Barman Riddhideb , Pijush Sarkar Pushpal , Kisku Lawrence , Akhtar Mohammad Nasim , Keshkar Sanjay
Published: May 2022

Background:

The anterior cruciate ligament (ACL) reconstruction is conducted to improve the stability and function of the knee. Bone-patellar tendon-bone (BPTB) graft is still considered as one of the best grafts for ACL reconstruction. The purpose of this paper was to assess outcomes of BPTB ACL reconstruction at 7 years of follow-up.

Materials and Methods:

This was a retrospective study in which records of 26 patients, who had ACL reconstruction using BPTB graft from 2013 to 2015, were done and the outcomes of results were analyzed by clinical Tegner activity levels and Lysholm score at 6–8 years of follow-up.

Results:

The follow-up study has revealed excellent long-term results. Approximately 87% of 26 patients had negative pivot shift examination with the remaining 13% having grade 1 ligament laxity. Tegner activity levels were similar to preinjury levels and Lysholm score was 91. All patients were satisfied with the procedure.

Conclusion:

BPTB ACL reconstruction using transtibial tunnel provides a satisfactory mid-term follow-up outcome.
Effective Editorial Review System for Improving Impact Factor of Orthopedic Journals
Authors: Debnath Ujjwal K. , Keshkar Sanjay
Published: May 2022

The impact factor (IF) for peer-reviewed orthopaedic journals has increased in the recent years, so has the number of journals. The publication of high-level research in orthopaedics has considerable importance of citing good quality evidence for impact on day-to-day practice. Transparency and rigorous engagement of reviewers and authors in the peer review process may improve the quality of publication which may help developing practice guidelines. This article seeks to suggest simple ways to have effective peer review process which can maximize publication success and improve the IF.
Comparison of Doubled Semitendinosus and Gracilis Autograft Versus Bone-Patellar Tendon-Bone Autograft for Reconstruction of the Anterior Cruciate Ligament
Authors: Karn Navin Kumar , Mishra Bibhuti Nath , Jha Ranjib Kumar
Published: May 2022

Background:

The choice of graft for anterior cruciate ligament (ACL) reconstruction is a matter of debate with hamstring and bone-patellar tendon-bone being the most popular autologous graft options. Objective: The objective of this study was to conduct a prospective randomized control trial comparing doubled semitendinosus and gracilis graft versus bone-patellar tendon-bone graft.

Materials and Methods:

Sixty patients with chronic unilateral rupture of ACL underwent arthroscopically assisted ACL reconstruction using quadrupled hamstring and bone-tendon-bone graft after randomization. Both groups were comparable with demographic data, preoperative activity level, mechanism of injury, the interval between injury and operation, and preoperative laxity of the knee. The same well-proved surgical technique and aggressive rehabilitation were used in all cases. The outcome assessment was done using the visual analog scale, Lysholm score, Tegner activity level, and International Knee Documentation Committee (IKDC) evaluation system.

Results:

At 2-year follow-up, we found that results within the same groups showed statistically significant improvement as assessed by IKDC, Tegner’s, and Lysholm operative scores. There was also a significant correlation between the manual Lachman test and stress laxometry findings. There was no statistically significant difference between the scores of the two groups (hamstring and bone patella tendon). In the hamstring group, we recorded a higher incidence of femoral tunnel widening, and in the bone-patellar tendon-bone group the higher incidence of kneeling discomfort and increased area of decreased sensation in the skin.

Conclusions:

Arthroscopic ACL reconstruction by either hamstring tendon graft or bone-patellar tendon-bone graft gives equally satisfactory results.
Demography and Impact of Initiation of Definitive Treatment in Osteoarticular Infections of Infants and Neonates
Authors: Makur Sayantan , Karmakar Arnab , Das Nilay K.
Published: May 2022

Background:

Osteoarticular infections in infants, such as osteomyelitis and septic arthritis, are a growing problem with a potential for not only systemic after-effects but also irreversible joint damage and limb deformity. Therefore, early treatment is necessary to reduce permanent damage/deformity. The purpose of this study is to find out the demography and impact of early initiation of definitive institutional management in osteoarticular infections.

Materials and Methods:

This study was conducted after approval by the institutional review board. All neonates and infants admitted between June 2019 and May 2021 with a clinical and laboratory diagnosis of osteoarticular infection were included in this study. Data for each patient were collected using the Hosp Gestor program. Patients having a history of pain, redness, swelling in joints associated with fever, and discharging sinus from bone were studied for unknown risk factors and atypical presentations. The impact of definitive management and sequelae were noted in all patients.

Results:

In this study, males were affected more than females. Osteoarticular infection of septic arthritis (53%) is the most common followed by osteomyelitis (43%) affecting predominantly the hip joint. In the majority of the cases, atypical risk factors like congenital talipes equinovarus and preterm delivery were noted. The most common organism isolated was Staphylococcus aureus (35%); however, atypical organism was Acinetobacter haemolyticus (2.5%). Among treatment methods, surgical cleaning, arthrotomy, and drainage was the most common procedure. The greater the delay in institutional visit, the more severe was the complications. Worst outcomes and sequelae are seen when the delay is >3 months, namely epiphyseal growth arrest, varus deformity, and destroyed head of the femur; good outcomes are seen when a delay is for a few days.

Conclusion:

Early detection and institutional visit resulted in good outcomes. This study proves the truth behind the fact that delay in diagnosis and initiation of definitive treatment causes more complications and sequelae. This study also serves as a clinical guide to identify risk factors, awareness about early detection, and effective institutional treatment of osteoarticular infections in infants and neonates.
Evidence-Based Orthopedic
Authors: Keshkar Sanjay , Dey Nirmal
Published: May 2022

We are talking about evidence-based medicine (EBM) for decades. Now each and every field of medicine has adapted evidence-based practices and the same is true for orthopedics also. There are thousands of reasons to support an evidence-based approach in the teaching and practice of orthopedics but hurdles and challenges are also there. So it’s time to revisit the challenges of EBM in orthopedic teaching and practice.
Bilateral Floating Knee Treated by Intramedullary Nailing on Orthopedic Table
Authors: Lazrek Omar , Sabri El Mehdi , Boufettal Moncef , Rida Allah Bassir , Lamrani Moulay Omar , Kharmaz Mohammed , Mahfoud Mustapha , Bardouni Ahmed , Berrada Mohamed Salah
Published: May 2022

Floating knee is a lesion entity first described in 1975 by Blake and McBride. Bilateral involvement is exceptional. It occurs for high-energy trauma and is usually accompanied by other potentially life-threatening lesions. Our patient presented a trauma of lower limbs following a motorcycle accident. The clinically evoked diagnosis was confirmed after standard radiological assessment.
Role of renal replacement therapy in pregnancy related acute kidney injury and its outcome
Authors: Sachan Rekha , Shukla Savita , Shyam Radhey , Patel Munna Lal , Verma Manju Lata
Published: May 2022

Background:

Pregnancy-related acute kidney injury (PRAKI) has bimodal distribution. The rates of maternal mortality and perinatal mortality in patients with PRAKI have increased. The aim of this study was to evaluate magnitude of PRAKI in North Indian women and to assess morbidity, mortality, and outcomes in patients who received renal replacement therapy.

Materials and Methods:

This prospective observational study was carried out in the Department of Obstetrics and Gynaecology, in collaboration with nephrology. A total of 150 women suffering from PRAKI were recruited and total 98 obstetrics AKI, requiring renal replacement therapy, classified as per KDIGO guidelines 2012 were enrolled for dialysis. Six patients were lost to follow up before final analysis. Haemodialysis was carried out by B. Brawn machine

Results:

Approximately 82% cases of PRAKI diagnosed in postpartum period. Mean cycles of dialysis was 9.06 ± 7.75 approximately half of the females required 1–5 cycles of dialysis. Higher percentages of maternal deaths were observed within 1–5 cycles of dialysis. Women received dialysis after 72 h showed increased chances of partial recovery. After 3 months of follow-up, rate of complete recovery was significantly higher in Stage I (100%) and Stage II (84.6%) PRAKI while rate of partial recovery and deaths were significantly higher in Stage III PRAKI (37.3%). Stage of AKI, baseline K+ levels, treatment modality, duration of ICU stay and use of Vasopressure showed significant association with adverse outcome

Conclusion:

Higher percentages of deaths were observed in those who referred late and delay in initiation of dialysis and it was observed within 1–5 cycles of dialysis.
Derivation of a Modified Friedewald’s equation for LDL cholesterol estimation in Sub-Himalayan population
Authors: Dudi Parmila , Vishwajeet  , Yadav Shashi Ranjan Mani , Sharma Poonam , Kumar Prashant , Mirza Anissa A. , Naithani Manisha , Rana Satyavati , Goyal Bela
Published: May 2022

Background:

Despite the availability of alternative homogenous assays for LDL-C measurement, most of the laboratories still use Friedewald Equation (FE). However, various novel equations have shown better performance than FE specific to a particular population. Besides, no equation has been devised for use in Sub-Himalayan population.

Methods:

A cross-sectional laboratory data-based study was conducted by recruiting lipid profiles of 1851 samples to validate 10 different equations for calculating LDL and to devise a novel Modified Friedewald Equation (MFE) specific for Sub-Himalayan population.

Results:

The novel MFE is presented as: LDL-C = -2.421 + (0.752 × TC) - (0.047 × TG) - (0.350 × HDL). A significant difference was observed between direct LDL-C (118.84 ± 40.39 mg/dL) and all other equations except MFE (118.84 ± 37.96 mg/dl, P > 0.999) and Puavilai Equation (117.99 ± 49.05 mg/dL, P = 0.138). Additionally, MFE showed lowest mean percentage bias of 0.14% with 95% limits of agreement within ± 2SD on Bland-Altman analysis. On ROC analysis at cut-offs of clinical decision limits of 100 mg/dl, 130 mg/dl, 160 mg/dl, and 190 mg/dl, MFE outperformed all other equations with highest AUC (0.974, 0.978, 0.982, and 0.995) respectively with specificity >95% at higher levels. MFE also showed highest correlation (r = 0.954, P < 0.001) and least rMSE (13.8) with direct LDL although all the equations showed significant positive correlation with direct LDL (p < 0.001).

Conclusion:

MFE derived in this study showed a better diagnostic performance as compared to other 10 equations taking Direct LDL-C as gold standard for Sub-Himalayan Population and may be used as a substitute for FE in the study population.
Tuberculosis among resident doctors and nurses in a tertiary care hospital
Authors: Chavan Yuvaraj B. , Shenoy Priyanka S.
Published: May 2022

Background:

Tuberculosis (TB) is one of the widely rampant infectious diseases worldwide. Healthcare workers (HCWs) such as Medical students and nurses are continuously exposed to this air-borne infection in hospitals and are vulnerable to the infection. Overcrowding at workplace, inadequate ventilation, lack of personal protective measures, improper eating habits, etc., further make the HCWs more susceptible to TB.

Objectives:

Study of sociodemographic profile of resident doctors and nurses; study of factors for occurrence of TB among HCWs in a tertiary care hospital.

Materials and Methods:

Case-control study conducted. Questionnaire used to collect data. Comparison was made between the TB cases and controls among HCWs to identify the epidemiological determinants of TB and derive preventive measures for the same.

Results:

By Chi-Square test, regularity of breakfast P < 0.001; BMI P – 0.001; total duration of exposure to TB patients P – 0.013; screening for TB P – 0.014; adequacy of sleep P – 0.029; adequacy of protein intake P – 0.035 were found to have a significant association with the occurrence of TB.

Conclusion:

Having regular meals at appropriate times, nutritional status, duration of exposure to TB patients, history of screening being done or not were found to have a significant association with the occurrence of TB.
Status of socio-demographic and behavioral profile of younger and older HIV high risk groups in Chhattisgarh
Authors: Sinha Ashish K. , Samantaray Aurobindo , Panda Prem S. , Shinkar Swapnil V.
Published: May 2022

Background:

The prevention of new infections in high-risk groups is a major thrust in National AIDS Control Program. There is enough evidence that many epidemiological and behavioral determinants which make High Risk Group vulnerable to HIV transmission. The most effective means of controlling the spread of HIV is through the implementation of Targeted Interventions (TIs) efforts by which services are catered to them. Furthermore, stigma and marginalization are often linked to this population, which may lead to difficulties while accessing social and health services (SHS) due to behavioral, cultural and language barriers or lack of knowledge of the system. So, finding the sociodemographic & behavioral profile can give a breakthrough in improving the quality of life of HIV high risk groups.

Material and Methods:

A cross sectional study was conducted during September to December 2019 in two districts (i.e., Raipur & Durg) among HRGs of Chhattisgarh. Training cum sensitization of survey team e.g., peer educators, outreach workers, counselors, project managers prior to the survey was done for data collection.

Results:

A Total of 3963 HRGs were registered with TI NGOs, 3418 (86.2%) were screened. The mean age of study participants was 27.69 ± 6.1. Compliance of participation was 86.2%. HRGs were observed to have malnutrition (BMI <18.5 &> 25.0). 7 cases of Pulmonary TB were found among IDUs. Prevalence of diabetes and Hypertension was 1.2% and 1.1% respectively. Substance abuse (i.e., for Alcohol and Tobacco) was significantly higher among IDUs and FSWs.

Conclusion:

This study reinforces the fact that for accessing High Risk Groups and retrieval of relevant information can best be obtained by their care givers i.e., TI NGOs personnel. Also understanding the sociodemographic and behavioral profiles are central to designing targeted HIV prevention interventions for them.
Gestational Diabetes Mellitus with autoimmune subclinical hypothyroidism in pregnancy in relation to gravida
Authors: Dash Prakruti , Tiwari Rajlaxmi , Nayak Saurav , Jena Saubhagya K. , Mangaraj Manaswini
Published: May 2022

Introduction:

Gestational diabetes mellitus (GDM) and hypothyroidism are the most common endocrinological abnormalities associated with pregnancy. The association of gravida with incidence of autoimmune subclinical hypothyroidism (SCH) and GDM in pregnancy has not been studied extensively with availability of very limited data in this context. So, this study was done to find out the association between GDM and autoimmune SCH in pregnancy as per gravida status of the study population.

Materials and Methods:

382 antenatal cases, both primi and multigravida, were screened for thyroid dysfunction and GDM in their first ANC coming to a tertiary level health care institution. 75 gm GCT was used for diagnosis of GDM and serum TSH, fT4, and anti-TPO antibody were measured for assessment of thyroid dysfunction. Prevalence of SCH was evaluated taking the ATA 2011 guidelines. Data obtained was also compared with ATA 2017 recommendations. Anti-TPO antibody level more than 60 U/L was considered to be raised value.

Observation:

The percentage of GDM was higher in autoimmune SCH participants compared to euthyroid cases with raised anti-TPO Ab Titer. GDM, SCH, and raised anti-TPO Ab titer were overall more prevalent in multigravida cases compared to primigravida participants.

Conclusion:

GDM and SCH with high anti-TPO Ab titer were more prevalent in multigravida participants compared to primigravida cases though not statistically significant. As occurrence of SCH varies with nutritional and geographical factors, hence internal trimester specific range should be calculated and used in practice as recommended by ATA 2017 guidelines.
Correlates of depression among school going adolescents in the urban area of Patna in eastern India
Authors: Bharati Dharmvir R. , Kumari Seema , Prasad Nidhi , Choudhary Sanjay K. , Kumar Sanjay , Pal Ranabir
Published: May 2022

Background:

Depression is a hidden pandemic among adolescents with multi-factorial causal risk and risk correlates.

Objectives:

To find the prevalence of depression and risk factors among school-going adolescents.

Methods:

A cross-sectional study was conducted among 838 adolescents enrolled in 6th–11th standards (age: 11–19 years) in 15 urban schools in Patna city by using the modified Patient Health Questionnaire-9 (PHQ-9); binary logistic regression was applied to find significant risk correlates.

Results:

Depression was noted among 51.2% adolescents of our study participants: mild 32.3%, moderate 14.3%, moderately severe 3.9%, severe depression 0.6%; among early adolescents (46.2%; boys-21.2%, girls-78.8%) and among late adolescents (55.3%, boys-34.7%, girls-65.3%). Adolescent depression was significantly associated in our study with female gender, late adolescence, higher classes (9th–11th), vegetarian diet, soft drink consumption, fast foods, screen time, domestic harassment, academic dissatisfaction, parental discord as well as mental illness. Girls had higher risk who were in higher classes, on a vegetarian diet, habitually on soft drink, more screen time (>3 h), face more family nuisance, parents brawling frequently, and suffering from known mental diseases.

Conclusion:

Depression was noted in more than half of the adolescents, with a higher prevalence in girls, scholastic failure, higher grades, vegetarian diet, more screen time, familial disease, and conflict.
Prevalence of hepatitis B and C virus infections and immunity among hemodialysis patients in the Mazandaran province, Northern Iran
Authors: Darrudi Amin , Nava Melody Omrani , Ebrahimi Ata , Ghaffari Kosar , Moghaddam Kasra Ahmadi , Roozbeh Fatemeh
Published: May 2022

Background:

Hemodialysis (HD) is one of the most common causes of blood-borne infections. In order to prevent viral hepatitis and confront with the virus on the next step, health providers specify infected patients by screening and vaccination. This study is designed to investigate the prevalence of Hepatitis B virus (HBV) and Hepatitis C virus (HCV) infections in HD patients in Mazandaran, Iran.

Methods:

The medical records of 216 patients referred to the hemodialysis centers were evaluated in this cross-sectional study between 2019 and 2020. The collected data was analyzed using t-test and Chi-square.

Results:

Among 216 patients, 106 cases were female (49.07%) and 110 subjects were male (50.9%). The mean age was 40.1 y/o in females and 50.9 y/o in the male patients. The study recorded nine HBs-Ag positive (prevalence: 0.06%) and 15 HCV-Ab positive (prevalence: 6.94%) patients. Also, the most common co-morbidities were diabetes and hypertension. It was observed that 13 patients from 34 patients with negative HBs-Ag (who had 10–100 U HBs-Ab in the first stage) experienced sudden drop in the antibody titration to less than 10 U (P < 0.05). From 50 HBs-Ag negative patients with HBs-Ab more than 100 U in the first stage, antibody titration of five patients was decreased to less than 10 U in the second stage (P < 0.05).

Conclusions:

The prevalence of HCV and HBV was low in HD patients in Mazandaran province. However, due to the large number of patients with non-protective HBs-Ab levels, there is a risk of an increased prevalence of the disease.
Platelet parameters as a diagnostic marker in early diagnosis of neonatal sepsis- Seeking newer answers for older problems
Authors: Panda Santosh Kumar , Nayak Manas Kumar , Thangaraj Jenith , Das Palash , Pugalia Rishabh
Published: May 2022

Background:

Early identification and intervention of neonatal sepsis can improve the clinical outcome. Blood cultures remain the gold standard for diagnosis but are not easily available and require time. There is a need to identify and validate newer easily available cost-effective investigations, which would help in the diagnosis of neonatal sepsis.

Aim:

To test the hypothesis that whether platelet parameters, i.e., total platelet count (TPC), mean platelet volume (MPV), and the ratio of MPV/TPC can serve as diagnostic markers in neonatal sepsis.

Methods:

It is was a prospective study conducted in a tertiary care neonatal intensive care unit (NICU). The platelet parameters, i.e., TPC, MPV, and MPV/TPC of blood culture-positive septic neonates were compared with those of non-septic neonates admitted to the NICU. The diagnostic accuracy of the platelet indices was assessed by receiver operating characteristics (ROC) curves and sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).

Result:

During the study period, 43 blood culture-positive sepsis neonates were compared with 54 cases of non-septic neonates. There was a significant difference in the mean of TPC, MPV, and MPV/TPC ratio between septic groups and non-septic groups. The sensitivity, specificity, PPV, NPV values of MPV (cut-off >9 fL) were 63.40%, 53.8%, 52.0%, and 65.11% respectively. The sensitivity, specificity, PPV, NPV of MPV/TPC ratio (>7.2) were 48.8%, 96.22%, 90.9%, and 70.42% respectively. The area under the curve (AUC) values for TPC, MPV, and MPV/TPC in the ROC analysis were 0.797, 0.641, and 0.809, respectively.

Conclusion:

Platelet indices MPV and MPV/TPC ratio can be useful in the early diagnosis of neonatal sepsis.
Hail the healers in the hell of Covid 19 pandemic
Authors: Arora Devamsh , Sharma Muskan , Shukla Rushikesh , Singh Nihaal , Acharya Sourya , Shukla Samarth
Published: May 2022

The condition of the world is different in the year 2021. People who were busy with their daily life and all the social activity have realized that tables can turn over at any moment of time. It’s the COVID-19 pandemic this year. The world has seen the importance of health care workers all around the globe. All the countries have realized the importance of the health care sector along with the need to expand it further. The importance of spending more financially on a country’s health care sector has become utmost important right now. At this time of emergency when humanity is foaling in a way which was never witnessed in the acts of violence against frontline workers, doctors are still not ready to give up on humanity. The human era has witnessed times when people used to laugh out loud about water being sold and now have come to witness such times when even a liter of oxygen is worth millions of Rupees, the conclusion being basic human amenities have started to fade away. Even after witnessing such crises around the globe, and the sacrifices of health care workers, people are still busy creating chaos for them or I would like to say “create a hell-like environment” for them to work in. Even after such a chaotic condition, health care workers are giving their best to control this health care emergency and since time immemorial, they are putting their life at risk for this society which are dwelling devils inside for them.
Comparison of neonatal and maternal outcomes of anti-diabetic drugs in the treatment of gestational diabetes mellitus
Authors: Shah Mandar K. , Shah Mihika A. , Shah Sharan D. , Shah Parshwa K. , Patel Kaushal , Gupta Mamta
Published: May 2022

The safety and efficacy of different anti-diabetic drugs are not clear because of the lack of sufficiently powered clinical trials. This network meta-analysis was conducted to compare the efficacy and safety of three anti-diabetic drugs (insulin, glyburide, and metformin), and rank them as per their efficiency to control glucose levels, pregnancy, and neonatal outcomes. The study design is a systematic review, meta-analysis, and network meta-analysis. After a systematic search of existing databases, 34 randomized controlled trials were selected for inclusion in the analysis. We did pairwise network meta-analysis to calculate standardized mean difference and odds ratio (OR) as the summary measures for numerical and dichotomous variables, respectively, by using random-effects model. Our key outcomes were incidence of neonatal hypoglycemia, respiratory distress syndrome, macrosomia, C-section, admission to neonatal intensive care unit (NICU) and mean differences in the birth weight of neonates, gestational age at birth, HbA1C levels, fasting blood sugar, large at gestational age, and post-prandial glucose. It was found that metformin significantly lowered the post-prandial levels of glucose as compared with both glyburide and insulin in pairwise analysis (SMD = 14.11 [23–4.8]; SMD = 22.45 [30–14]), respectively. There was a significant reduction in birth weights of babies whose mothers were administered metformin as compared with either glyburide or insulin. The proportion of neonates admission to NICU was significantly lower for metformin when compared with insulin [Log OR = 0.334 (0.0184, 0.6814))]. Large at gestational age was significantly lower for metformin as compared with both glyburide and insulin [log OR = 0.6882 (0.171, 1.329), log OR = 0.393 (0.00179, 0.8218)], respectively. Oral anti-diabetic drugs especially metformin performed better than both glyburide and insulin for all neonatal and maternal outcomes except that it significantly lowered the neonatal birth weight.
Effectiveness of introduction of JEV vaccination into routine immunization program in a tribal district of Odisha
Authors: Kshatri Jaya S. , Pattnaik Matrujyoti , Badaik Goldi , Choudhary Hari R. , Mansingh Asit , Pati Sanghamitra , Bhattacharya Debdutta
Published: May 2022

Background:

A severe outbreak of Japanese encephalitis (JE) and acute encephalitis syndrome (AES) with high case fatality among tribal children was reported from Malkangiri district of Odisha, during September to November 2016 affecting 336 children with 103 deaths. Following the outbreak, a mass vaccination campaign was introduced in Malkangiri district in2017. In 2018, the JE vaccine was introduced into the routine immunization program as per National Immunization Schedule. Our study surveys the JE vaccination coverage among children of Malkangiri and the incidence of JE cases for a period of three years.

Methodology:

The current study was conducted by establishing prospective and retrospective AES surveillance system and household vaccine coverage surveys in Malkangiri district. In the target population, the vaccination coverage survey was undertaken and also additional immunization coverage data from sub-centers was collected.

Results:

After 2016 JE outbreak, a mass vaccination campaign was carried out in children up to 15 years of age, where 96% of children were covered in the district in 2017 and only four AES cases were detected. Under routine immunization program, the vaccine coverage for the year 2018 was 68% for JE-1 dose and 37% for JE-2 dose. There were 8 AES cases detected in 2018 out of which four children died. Vaccination coverage for 2019 was 97% for JE-1 dose and 84% for JE-2 dose. The AES cases detected in 2019 was nil.

Conclusion:

Vaccination against JEV and AES surveillance systems has an important role in prevention and control of AES outbreaks.
Monomelic amyotrophy with clinico-radiological and electrophysiological evaluation
Authors: Samanta Maheswar , Mishra Manasi , Mallick Ashok Kumar , Swain Kali Prasanna , Mishra Subhankar
Published: May 2022

Background:

Monomelic amyotrophy (MMA) is a benign, rare, sporadic disorder of adolescent and young adults with male predominance, where neurogenic amyotrophy is restricted to an upper or lower limb. It is a variant of lower motor neuron disorder with insidious onset and slow progression for 2-4 years. Paucity of cohort studies as well as relative unawareness among physicians in eastern India stimulated us to do this work.

Material and Methods:

Prospective observational study involving 140 cases of MMA from 2012 to 2016, conducted at S.C.B.Medical College, cuttack, Odisha to evaluate clinical profile, electrophysiology and radiological features. All the data were analysed & subjected to statistical analysis through SPSS software version 24.

Results:

Mean age at onset and presentation were 19.6yrs and 21.7yrs respectively and the average duration 3.2yrs. Upper limb involvement was more common (91.4%) with distal affection (83%) more than proximal (7%). Isolated Leg amyotrophy found in 12 cases (~9%) and 10 cases were having thigh weakness & atrophy. B/L Upper Limb distal involvement was present in 18.5% cases asymmetrically. Family history found in~2.8%. Autonomic symptoms were present in affected and bilateral homologous Limb in 21%, 5.8%(~6%) patients. Changes in electromyography (EMG) were present in affected limb (100%) and clinically unaffected limb (15%).

Conclusion:

MMA is a benign disease of young males with weakness and atrophy confined to unilateral limb or asymmetrical homologous limb and areflexia without sensory loss. It progresses variably for 2-3 years followed by stabilization without progression to Motor neuron disease.
Comparison of the incidence of contrast-induced nephropathy after primary PCI in patients receiving high-dose rosuvastatin and atorvastatin
Authors: Golshani Samad , Tavasoli Parastoo , Farsavian Ali Asghar , Farsavian Hossein , Charati Jamshid Yazdani
Published: May 2022

Introduction:

Contrast-induced nephropathy (CIN) is associated with increased disability and death. Randomized clinical trial studies have shown that short-term treatment with statins prior to cardiac intervention was capable of reducing the incidence of CIN. Therefore, the aim of this study was to compare the incidence of CIN after primary PCI in patients receiving high-dose rosuvastatin and atorvastatin.

Methods:

This clinical trial was performed in Mazandaran Heart Center Hospital on patients referred to the emergency department who underwent primary PCI with a diagnosis of STEMI. Patients received 1 cc/kg/h normal saline from PCI for up to 12 hours. Patients with EF less than or equal to 35% received intravenous normal saline at half the usual dose. SPSS software version 24 was used for data analysis. P value less than 0.05 was considered to be statistically significant.

Results:

206 patients were included in the study that the most underlying diseases of patients (79, 38.3%) were hypertension, followed by anemia (76, 36.9%) and diabetes mellitus (52, 25.2%). Among these, in the first criterion, 10 (8.1%) and 4 patients (4.8%) were in the atorvastatin and rosuvastatin groups, respectively, which did not have a statistically significant difference (P = 0.264). Examination of GFR subgroups also showed that GFR above 30 had significant differences between the two groups.

Conclusion:

The use of different statins has had similar results in the prevention of CIN in patients undergoing primary PCI. Rosuvastatin has no special advantage over atorvastatin, showing that the use of any of these drugs can be useful in patients requiring angiography.
Clinical characteristics of 200 COVID-19 patients in Mashhad, Iran, February and March 2020
Authors: AkbariRad Mina , Allahyari Abolghasem , Ravanshad Sahar , Mahali Shima Nabavi , Ebrahimzadeh Farnoosh , Mozdourian Mahnaz , Javidarabshahi Zahra , Seddigh-Shamsi Mohsen , Emadzade Maryam , Ghalibaf AmirAli Moodi
Published: May 2022

Introduction:

Coronavirus disease 2019 (COVID-19) is a pulmonary involvement which was reported for the first time in December 2019 in the city of Wuhan, Hubei province, China. The aim of the study was to describe the demographic, clinical, laboratory, and radiological characteristics of 204 definitive laboratory-confirmed COVID-19 patients hospitalized in Mashhad, Khorasan Razavi province, Iran.

Patients and Methods:

This study was performed on 204 laboratory-confirmed COVID-19 patients. A set of laboratory tests combined with various patient information and results from lung high-resolution computed tomography (HRCT) were gathered in a checklist and analyzed to give us a better view of patients who are hospitalized due to the complications caused by this disease.

Results:

The average age of our patients was 58.83 ± 15.93 years. There were 122 (59.8%) male and 82 (40.2%) female patients, and almost all of our patients had at least one underlying disease. Nine (4.4%) of our patients reported having gone for a trip to COVID-19-epidemic areas in the last 2 weeks. The most common signs shared among all our patients were cough, fever, and decreased O2 saturation; the average respiratory rate was 25.50 ± 6.74/min, average axillary body temperature was 37.69°C ± 0.69°C, and average O2 saturation was 88.34% ± 7.34%.

Conclusion:

Based on our results, the most common signs of this disease are fever, cough, and shortness of breath, similar to seasonal influenza. Our data on disease severity showed that 33 (16.2%) patients had moderate disease, 139 (68.1%) had severe disease, and 28 (13.7%) were critical; 22 (10.8%) of our hospitalized patients died due to the complications of this disease.
Post-traumatic stress disorder among COVID-19 survivors in Manipur
Authors: Rajkumari Bishwalata , Akham Ngamba , Konjengbam Ojit Khaba , Pangambam Amrita Devi , Ningthoujam Suchitra Devi
Published: May 2022

Background:

Post-traumatic stress disorder (PTSD) is a condition which can develop among those experiencing psychological trauma and can cause substantial distress and disruption in one’s life during a pandemic. This study aims to assess the prevalence of PTSD among the COVID-19 survivors in Manipur and its predictors.

Materials and Methods:

This cross-sectional study was conducted among the COVID-19 survivors aged 18 years and above from July to September 2020 in Manipur using a validated instrument—the Post-Traumatic Stress Disorder Checklist-5 (PCL-5) based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) for screening PTSD which was administered through phone-based Google Form questionnaire. Descriptive statistics like mean and percentages were used and bivariate and multivariate logistic regression were used for predicting PTSD, taking P < 0.2 and P < 0.05, respectively

Results:

Out of the 228 participants screened, 67.5% were identified for PTSD symptoms. Increasing age of the participants (Adjusted Odds Ratio (AOR): 1.1; 95% CI: 1.19–1.13), being employed in the private sector (AOR: 14.55; 95% CI: 1.50–13.73), urban residence (AOR: 2.07; 95% CI: 1.01–4.25), and those referred by a doctor for testing Coronavirus Disease (COVID 19) (AOR: 7.90; 95% CI: 2.82–22.1) were found significantly more likely to have the PTSD symptoms

Conclusion:

Nearly three-fourths of the COVID-19 survivors were found to have PTSD symptoms. The active involvement of mental health professionals for psychosocial support and timely counseling along with support from the family and community is needed to avert the deleterious effect of the pandemic on mental health.
A cost analysis and availability scenario of drugs and oral care products prescribed for common oral conditions with reference to the current Indian market prices, Jan Aushadhi, and the state medical commissions
Authors: Gauthaman Jeevitha
Published: May 2022

Context:

The prevalence of oral mucosal lesions across various countries varies from 4.9% to 64.7%. The cost barrier is an important factor that prevents people in low-middle income countries from seeking professional help for dental problems

Aims:

The present study aims to analyze the costs of medicines and oral care products prescribed for common oral lesions and to find the most expensive and the most economic brands.

Methods and Material:

The list of medicines and oral care products prescribed for the management of four oral conditions namely, recurrent aphthous stomatitis, oral candidiasis, oral herpes, and gingivitis were taken and their median retail prices, cost variation percentages were calculated from the current Indian market brands. The median retail prices were compared with their corresponding Jan Aushadhi prices. Also, the availability of the drugs and oral care products were evaluated across the state drug procurement lists of Tamil Nadu, Rajasthan, Uttar Pradesh, Telangana, and Bihar

Results:

Wide cost variations were seen in most of the drugs and oral care products. The Jan Aushadhi prices of included drugs were very economical compared to the median market prices. However, the availability of the drugs was less in the Jan Aushadhi list and also in the state medical commission lists

Conclusions:

The availability of such commonly used drugs in oral conditions has to be ensured in state and central departments by the policy makers. Price regulations of drugs routinely prescribed by dentists will help reduce the overall treatment costs for dental care.
Evaluation of requirement of taking panoramic radiographs in children less than 6 years of age - A retrospective study
Authors: Gandhi Janvi M. , Govindaraju Lavanya
Published: May 2022

Aim:

To evaluate the prevalence of prescribing panoramic radiographs in children less than 6 years of age.

Materials and Methods:

The retrospective study was conducted in a dental institution in Chennai between December 2019 and January 2021. Details of all the children less than 6 years subjected to panoramic radiographs were collected. The reason for taking panoramic radiographs was also recorded. Chi-square tests were done to statistically analyze the data, and the significance level was set at 0.05

Results:

Out of 2,847 children less than 6 years of age visiting the dental institution, 1.08% (31 children) were advised to take an orthopantomagram (OPG) during the study period. Early childhood caries (75% in males and 66.7% in females) was found to be the most common reason for taking panoramic radiographs followed by developmental disturbances (12.5% in males and 13.3% in females). Chi-square test showed statistical significance between males and females (P- value = 0.003 and 0.002) for the reasons for taking panoramic radiographs in children

Conclusion:

Usage of radiographic techniques, especially panoramic radiographs should be limited for children under 6 years of age unless absolutely necessary.
Oral Mucormycosis
Authors: Kulkarni Madhura Dattatraya , Gulati Saakshi , Gupta Shivangi , Sabharwal Robin , Rajguru Jagadish P. , Baneerjee Abishek
Published: May 2022

Individuals who have shown recovery from coronavirus disease (COVID-19) are increasingly getting diagnosed with Mucormycosis or “Black fungus.” It is a difficult condition to diagnose as it has symptoms that are common among a variety of diseases. Hence, it is important to identify the presenting signs and understand the underlying pathogenesis of COVID-19 associated Mucormycosis. The incidence of these mycotic infections has shown a substantial increase in current times owing to an increase in the prevalence of immunocompromised subjects, human immunodeficiency virus (HIV) infection, and acquired immunodeficiency syndrome (AIDS). Any suspected case of mucormycosis requires rapid diagnosis and management due to its rapid progression as well as the destructive course of infection. This article reviews the taxonomy, pathogenesis, and clinical signs along with laboratory investigations that may play a vital role in the timely diagnosis of this condition as it is mostly fatal.
Comparison of public health measures taken during Spanish flu and COVID-19 pandemics
Authors: Tambolkar Sampada , Pustake Manas , Giri Purushottam , Tambolkar Isha
Published: May 2022

The similarity of the consequences of COVID-19 reminded us of the destruction caused by the Spanish flu over a century ago and led us to find similarities in the way the two pandemics were handled. PRISMA Guideline was followed for a systematic search to identify eligible published articles. Information about the public health measures adopted during both the pandemics was taken from literature. It was found that there are parallels between the two pandemics in terms of general unpreparedness, attitudes of the community and government, and various policy issues. All the measures implemented in 2020 were the same as those implemented in 1918–1919, with the same trend, uncertainty, early relaxing, and rapid reversals. Even from a scientific standpoint, all the elements were already known. All the issues such as social isolation, intra-family spread, personal protective equipment, medicine types (quinine, aspirin, anti-inflammatories, etc.), immunization requirements, and so on had already been addressed. No doubt, we do have technology today at our disposal for managing the spread of the disease and even spread awareness among people much easily. We also have taken many steps forward in the world of globalization, which make the progression and spread of the pandemic very fast as well. Both factors tend to counter each other and hence make timely public health intervention as important (if not more) today as it was yesterday. When possible, approaches and goals should be found on scientific facts and include ethical input. Finally, we must take careful notice of past local and national lessons to avoid repeating the mistakes done in the past. The development of a strategy ahead of time that includes all levels of government health infrastructure and outlines clear lines of duties and functions is critical. The main objective of this article was to compare the public health measures undertaken during the pandemic of Spanish Flu and the pandemic of COVID-19, and assess the similarities and differences in the public health measures taken during these pandemics. The correlation of the public health measures and the outcomes was assessed and the implication of this article was to be pandemic-ready in the future.
Ensconcing a biostatistics clinic in tertiary care research institute of India
Authors: Kamal Kishore , Sharma Meenakshi , Rahul Mahajan , Rakesh Kapoor , Koushal Vipin
Published: May 2022

Context:

Data collection and statistical analysis are integral components of research. The beauty of statistics lies in its ability to evaluate evidence in the face of uncertainty. However, lack of dedicated biostatistical consultation units, rote academic teaching and training lead to poor statistical analysis. Thus, we aim to explore and understand the challenges of establishing a Biostatistics Clinic (BC) in a tertiary care research institute. A secondary aim is to identify the stage of research at which participants approach biostatisticians.

Material and Methods:

The data for the current study came from a consultancy unit named as “Biostatistics Clinic” in the department of biostatistics from Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India. The residents and students who approached the department of biostatistics for consultancy regarding study design, sample size, statistical analysis and other analytical work were the sampling units

Results:

A total of 208 residents and students made 404 visits to biostatistics clinic. The male and female visits were 118 (56.7%) and 90 (43.5%), respectively. Majority of visitors approached for data analysis (171; 75%) followed by study design and sample size calculation for protocol preparation (43; 18.9%). Leading reference to approach the biostatistics clinic was through a faculty (91; 43.8%) followed by self (54; 26%)

Conclusion:

Despite the thrust and apparent advantages of contacting statistician at the beginning of the study, majority approached only at the data analysis stage. Therefore, repeated and improved efforts are required to spread the message of approaching statistician early.
COVID myocardial involvement presenting as left ventricular aneurysm and clot associated with normal coronary anatomy, deep vein thrombosis, and abnormal brachial artery flow-mediated dilatation
Authors: Tayal Mohit , Dhingra Vandana , Sharma Pankaj , Walia Rohit
Published: May 2022

A 40-year-old non-diabetic, non-hypertensive male patient presented with complaints of dyspnea of a few days duration and coronavirus -19 disease (COVID) pneumonia. The electrocardiography (ECG) revealed sinus tachycardia with T inversion in V1 only. The ECG revealed a left ventricular aneurysm with a clot and severe left ventricular dysfunction. He had deep vein thrombosis involving the left lower leg. The cardiac magnetic resonance imaging revealed a left ventricular posterodorsal aneurysm with a large clot. Computed tomography angiography revealed normal coronaries and no evidence of pulmonary embolism or aortitis. The d-dimer was raised. A brachial artery Doppler revealed severe impairment of flow-mediated dilatation, suggesting endothelial dysfunction. He was stabilized with anti-platelets and anticoagulants, and diuretics.