bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence of middle mesial root canal in mandibular molars in an Iranian population: A micro-computed tomography study
Authors: Farhad Alireza , Hasheminia Mohsen , Hekmatian Ehsan , Mojiri Vahid
Published: January 2024

Background:

Knowledge about the anatomic variations of the root canal system and their prevalence is necessary for clinicians to ideally clean the root canal system. The anatomic complexity of the root canal system is one of the reasons for its inadequate debridement, resulting in residual microorganisms and root canal treatment failure. The present study aimed to evaluate the prevalence of middle mesial root canals in mandibular molars in an Iranian population.

Materials and Methods:

The samples in the present descriptive/cross-sectional study consisted of mandibular first and second molars (n = 100, with 50 first and 50 s molars). A convenient sampling method was used to collect samples. The teeth were mounted in gypsum and scanned using a micro-computed tomography unit. The images were reconstructed with software, and the relevant checklist was completed by the observers. The data were analyzed with SPSS v26 using the Chi-squared test at a significance level of P < 0.05.

Results:

The prevalence of the middle mesial root canal in the present study was 36% for mandibular first molars and 22% for mandibular second molars, with an overall prevalence of 29%. The prevalence of the middle mesial root canal was not significantly different between the first and second mandibular molars (P = 0.12). The mean distance between the mesiobuccal and mesiolingual root canal orifices in the teeth with a middle mesial root canal was significantly higher than in those without the middle mesial root canal (P < 0.001). In addition, there was no significant difference in the prevalence of the middle mesial root canal between the teeth with and without the second distal root canal (P = 0.89).

Conclusion:

The prevalence of the middle mesial root canal in the studied population was 29%, which is significant clinically. In addition, the mean distance between the mesiobuccal and mesiolingual root canal orifices in teeth with a middle mesial root canal was higher than that in teeth without this root canal.
Effect of photobiomodulation on postoperative endodontic pain: A systematic review of clinical trials
Authors: Seyyedi Seyyed Amir , Fini Maryam Baghizadeh , Fekrazad Reza , Abbasian Selda , Abdollahi Amir Ardalan
Published: January 2024

Background:

This review aims to perform a complete evaluation of the impact of photobiomodulation (PMB) on postoperative endodontic pain.

Materials and Methods:

The PRISMA checklist was used to perform this systematic review. The electronic databases were searched, including Google Scholar, PubMed, and Embase. Sixty-three papers were obtained through a main electronic search and a hand search. Nine trials met the criteria after screening the titles, abstracts, and/or full texts.

Results:

Seven out of nine studies showed that PMB has a significant impact on relieving postoperative endodontic pain, with no statistically significant difference in the severity of pain between the laser and control groups in the two remaining studies. In addition, eight studies showed no adverse effects, indicating that we can remove the adverse effects of drugs such as nonsteroidal anti-inflammatory drugs. However, one study showed evidence of the consequences of PMB application on teeth with symptomatic irreversible pulpitis. Therefore, it can be concluded that PMB should not be used in teeth with pain because of irreversible pulpitis.

Conclusion:

Although there is some understanding from a cellular viewpoint of the effects of PMB, there is still some uncertainty about whether these cell-level modifications impact reducing the postendodontic pain.
Effect of web-based asthma self-care program on school students’ quality of life in rural community
Authors: El-Moaty Sheha Eman Ali Abd , Mohammed Manar D. , Abdelrazic Marwa Ibrahim , Ahmed Soad
Published: January 2024

Background

Asthma is a pressing worldwide public health challenge and the foremost chronic disease observed in school-aged children. It constitutes a considerable social and economic burden and poses a substantial threat to the health-related quality of life of affected children. The attainment of sufficient knowledge and appropriate skills are fundamental requirements for effectively managing the potential hazards of asthma symptoms and administering optimal therapeutic interventions.

Aim

To appraise the effect of web-based asthma self-care program on high school students’ knowledge, the practice of inhaler technique, and the quality of life in Minia rural community.

Methods

A quasi-experimental design was utilized in this study.

Sample

The study was carried out on a purposive sample of 93 students suffering from bronchial asthma.

Setting

The study was conducted at governmental high school located in 4 rural sectors in Minia governorate.

Tools

Four tools were utilized for data gathering as follows: a structured interviewing questionnaire, including students’ demographic characteristics and past medical history; asthma knowledge questionnaire; the students’ reported practices checklist toward inhaler technique; and the Pediatric Asthma Quality of Life Questionnaire (PAQLQ).

Results

Reveals that 50.0% of participants who had insufficient knowledge had improper practice related to inhaler technique, compared to 88.3% of participants who had sufficient knowledge related to asthma disease had proper practices related to inhaler technique post-intervention, with a highly statistically significant difference between the students’ knowledge and practice postweb-based asthma self-care program, P≤0.001. And alsoshowed highly statistically significant improvements in students’knowledge, practices regarding using of powder inhaler, and metered dose inhaler, and overall quality of life after program implementation.

Conclusion

The web-based asthma self-care program successfully improved the student’s knowledge, the practice of inhaler technique, and quality of life postprogram implementation compared to pre-program as it has provided accessible methods for education and assistance for students with asthma, targeting their unique needs and empowering them to manage their condition, leading to better health outcomes.

Recommendations

Conducting web-based asthma self-care program focusing on increase the awareness of students regard to trusted websites focusing on asthma, coupled with targeted efforts aimed at providing periodic supervision for school students to follow up on them to prevent complications; and replicating the developed program in a randomized clinical trial to confirm the findings.
Mothers’ knowledge and reported practices about their infants undergoing open-heart surgery
Authors: Kheder Mohammed E.A. , Mohamed Afkar R. , Ibrahim Marwa A.E. , Mohamed Hanem A.
Published: January 2024

Background

Congenital heart diseases emerge as the most frequently occurring congenital anomaly, signifying a significant global health concern. Infants experiencing severe congenital heart disease necessitate open-heart surgery during the neonatal phase for their survival. The effective delivery of postoperative and home care by mother careers is a crucial factor in determining a favorable health outcome for infants who have after a cardiac procedure involving an open-heart surgical intervention.

Aim

The study aimed to assess mothers’ knowledge and reported practices for their infants after open-heart surgery.

Study design

The present study utilized a descriptive-exploratory research design.

Setting

The research was carried out at the outpatient clinic for postoperative open-heart surgery.

Sample

A convenient sample of 60 infants and their mothers who had after open-heart surgeries was included in this study.

Tools

Three tools were used for data collection: the structured interview questionnaire; the mothers’ knowledge assessment sheet; and the mothers’ reported practices sheet.

Results

The results of the current study showed that: three-quarters of mothers live in rural areas; two-fifths of the mothers have only primary education; less than two-thirds of the studied infants’ age ranged between 9 and 12 months; the highest percentages of infants were diagnosed with ventricular septal defect; more than half of the mothers had an unsatisfactory total knowledge level, and the majority of the mothers had unsatisfactory total practices level.

Conclusion

The current study concluded that the studied mothers’ knowledge level was unsatisfactory and, in addition, their reported practice level regarding caring for their infants after open-heart surgery was unsatisfactory, as well.

Recommendations

An empowerment program directed to mothers to improve their knowledge and practices regarding caring for their infants after open-heart surgery should be encouraged. Nurses’ role in mothers’ and family education should be activated and intensified in perioperative open-heart surgery.
Medication safety climate: managing high-alert medication administration and errors among nurses in intensive and critical care units
Authors: El-Fattah Mohamed Aly Nagah Abd , El-Shanawany Safaa M. , Ghanem Maha , Elbiaa Maysa Abdalla , Mohamed Hana Abass Ahmed , Lotfy Wael M.
Published: January 2024

Background

High-alert medications are drugs that may lead to serious harm when they are wrongly administered to patients. Safe medication administration is the crucial role of nursing staff.

Aim

This study aims to investigate relationships of medication safety climate and nurses’ knowledge about high-alert medications with managing their administration and errors.

Design

A cross-sectional correlational study.

Sample

A convenience sample of 300 nurses.

Setting

Surgical intensive and critical care units.

Tools

Self-report questionnaires about medication safety climate, nurses’ knowledge and administration competency of high-alert medications and high-alert medication error experience as well as high-alert medication practice observational tool.

Results

The nurses’ knowledge, practice, and competencies about administering high-alert medications were below sufficient standards. They described medication safety climate at undesirable levels and reported encountering high-alert medication administration errors of about 25.3%. The medication safety climate and nurses’ knowledge of high-alert medication were associated with and affected nurses’ practice (r =.43; r =.31, respectively) and competencies (r=.32; r=.23, respectively), during administration of high-alert medications. Insufficient levels of medication safety climate and nurses’ knowledge and administration practice of high-medications were the predictive factors of incidence of high-alert medication administration errors among nurses (r =-.18; r =-.32; r = -.21, respectively).

Conclusion

Sufficient nurses’ knowledge and medication safety climate were deemed to be one of the most important measures to improve managing high-alert medication administration and reduce the occurrence of high-alert medication administration errors.

Recommendation

The hospital management should implement medication safety in its clinical standards and plan for promoting the safe administration of high-alert medications.
Effect of nursing teaching protocol on mastitis prognosis: quasi-experimental research design
Authors: Hashem Eman Mohammed , Ahmed Wafaa Ramadan , Elnga Ahmed Nagm Eldin Abu , Desouky Amna Abdullah
Published: January 2024

Background

Mastitis is a problematic issue because it may lead to many complications as early termination of breastfeeding, formation of breast abscess, deformity of breast tissue, and recurrence. Nursing management is conducted to deepen patients’ understanding of the diseases, enhancing self-care ability, and establishing healthy living habits.

Aim

The aim of this study is to evaluate the effect of a nursing teaching protocol on mastitis prognosis.

Design

A quasi-experimental research design was utilized.

Setting

The study was conducted in the breast unit in general surgery department at Main Assiut University Hospital.

Sample

A convenient sample of sixty adult female patients diagnosed with mastitis was included.

Toolss

Four tools used I: An interview questionnaire sheet, II: Mastitis self-care practices, III: Numeric Pain Rating Scale, and IV: Mastitis prognosis sheet.

Results

The mean age of both study and control groups was (37.57±9.01, 38.30±9.24 respectively). (60.0% and 50.0% respectively) of both groups had lactational mastitis. There was statistically significant improvement in study group’s level of knowledge and self-care practices at follow up. Moreover, (63.3%, 70.0% respectively) of both groups had severe pain at base line. However, at follow up (66.7%,) of study group didn’t have any pain and cured completely. while (40.0%) of control still having severe pain, (33.3%) discontinued breast feeding and (20.0%) converted into breast abscess.

Conclusion

Implementation of a nursing teaching protocol had a positive outcome on mastitis prognosis.

Recommendation

Distribution of a mastitis teaching protocol for patients with mastitis to improve prognosis.
Intrafamilial transmission risk factors and preventive measures followed by household contacts of hepatitis C patients
Authors: Ahmed Amala Abdulla Saad , Rizk Saneya Mohamed , Abdeldaiem Nabila Abdel-Kader
Published: January 2024

Background

Hepatitis C virus (HCV) infection is the most challenging public health problem in Egypt where the prevalence is the highest in the world. Intrafamilial transmission of hepatitis C occurring between patients infected with HCV and their household members sharing the same house and living conditions. Preventive measures of hepatitis C are considered the first line of defense against HCV infection.

Aim

assess the intrafamilial transmission risk factors and preventive measures followed by household contacts of hepatitis C patients.

Design

A descriptive cross sectional research design was utilized.

Setting

The study was conducted at outpatient clinics of Liver Institute at Kafer-Elsheikh Governorate.

Sample

A simple random sample of 365 household contacts of hepatitis C patients was recruited for the current study.

Tool

Data was collected through one tool: A structured Interviewing Questionnaire for household contacts of hepatitis C patients which included three parts; part I-(a) Demographic data, (b) Medical history of household contacts, Part II (a) Household contacts knowledge about HCV (b) Hepatitis C risk factors, Part III: Preventive measures followed by household contact of hepatitis C patient: This part is self-reported practices.

Results

The study revealed that;56.7% of household contacts were males, 72.1% of them were living in rural areas, 75.60% were married, with a mean age ±SD 36.73±9.18 years old.44.1% obtained secondary education, 30.7% were employees, among this group hypertension and diabetes were the main chronic illness. 49.90% had moderate level of general knowledge about HCV infection, 71.50% had low level of knowledge about hepatitis C risk factors and 90.00% had a low level of preventive measures (self-reported practices) regarding HCV. There was no correlation between household contacts knowledge about HCV risk factors and their preventive measures(r=0.031 andP=0.549).

Conclusion

Almost half of household contacts mentioned that they knew intrafamilial risk factors while about half of this group have a misconception about intrafamilial risk factors, while majority of them stated that they knew sharing scissors and clippers as the main intrafamilial risk factors and less than one-fourth of them knew direct contact with infected blood and sharing of special equitoothbrushesth brushes. Household contacts applied some preventive measures such as; Cover the wound with a piece of cloth or gauze, disinfect the site with alcohol or antiseptic solution and frequent and proper hand washing.

Recommendations

Routine health assessment of household contacts knowledge regarding intrafamilial risk factors and preventive measures therefore health education sessions should be conducted to raise their awareness regarding HCV infection and further research should be conducted on larger samples of contacts.
Biopsychosocial needs and problems among preschool children with speech impairment
Authors: Mourad Narges Abdelwahab , Elkaramalawy Effat , Hegazy Mona
Published: January 2024

Background

Speech impairment means a communication disorder, such as stuttering, impaired articulation, language impairment, or a voice impairment, that adversely affects a child’s educational performance.

Aim

The current study aimed to assess the biopsychosocial needs and problems of preschool children with speech impairment.

Design

A descriptive research design was utilized in the current study.

Setting

The current study was done in outpatient phonetic clinic at El-Menofeya University Hospital.

Sample

A purposive sample of 200 preschool children with determined inclusion criteria.

Tools

for data collection Demographic and medical history questionnaire for children with speech impairment, biopsychosocial needs scale for preschool children with speech impairment and biopsychosocial problems scale for preschool children with speech impairment.

Results

The current study showed that 69% of the selected children with speech impairment were aged from 4 to 5 years with a mean of 4.2±1.0. Regarding Sex, 54% of selected children were males. While 47% and 46% of their fathers and mothers had diploma levels respectively. Regarding physical needs, 58% of them usually ate healthy and preferable foods. Regarding psychological needs, 71% of the selected children were sometimes satisfied with love and compassion and had family support to overcome fear. Related to social needs, 66% of the selected children were encouraged to participate in group activities. Concerning biopsychosocial problems, 63% of them sometimes had a lack of appetite. Similarly, 48% and 70% had aggressive reactions and fears from others, except for family members, and did not interact with peers easily.

Conclusion

The study concluded that 86%, 82% and 86% of selected children were satisfied with their physical, psychological, and social needs, respectively, while 92.5% of the selected children needed medical and nursing intervention related to biopsychosocial problems and 7.5% of them needed to modify the unacceptable behaviors related to biopsychosocial problems.

Recommendation

The study recommended the need for further researches on a large scale to assess biopsychosocial needs and early detection of biopsychosocial problems among preschool-aged children with speech impairment in different community settings. Furthermore, applying biopsychosocial assessment for needs among preschool age children with speech impairment in all phonetics outpatients’ clinics and speech centers.
Polymorphism of Toll-like Receptor 4 is Correlated with an Increased Risk of Mortality of Hemodialysis Patients: A Retrospective Cohort Study in Taiwanese
Authors: Lee Meng-Chang , Chen Nai-Hua , Liu Nien-Tzu , Su Wen , Liao Chun-Cheng , Su Sui-Lung
Published: January 2024

Background:

Hemodialysis (HD) is a public health issue, and HD-induced infection is a major risk factor for mortality. Toll-like receptor 4 (TLR4) plays a key role in the pathogenesis of infection. However, polymorphisms of TLR4 contribute to infection are still unknown.

Aim:

This study aimed to examine the correlation between polymorphisms of TLR4 and mortality among HD patients.

Methods:

This retrospective cohort study included 585 participants from Tri-Service General Hospital in Taipei from 2011 to 2015. All participants were genotyped for TLR4 rs10116253T/C and rs7873784G/C by the iPLEX Gold single-nucleotide polymorphisms assay. Analysis of the conditional Cox proportional hazard model was used to test the association between TLR4 polymorphisms and mortality.

Results:

Our results show that adjustment with age and gender, TLR4 rs10116253T/C demonstrates an association with mortality (hazard ratio [HR] =1.38, 95% confidence interval [CI] =1.00–1.89) in a dominant model, especially in infection-related mortality (HR = 2.14, 95% CI = 1.04–4.43) of HD patients.

Conclusion:

The results demonstrate that TLR4 rs10116253T/C may play a role in the etiology of infection among HD patients.
Characterization Integrons and Gene Cassettes in Trimethoprim/Sulfamethoxazole-resistant Stenotrophomonas maltophilia
Authors: Lai Jiun-Ji , Chuang Yi-Ping , Wu Rui-Xin , Yu Ching-Mei , Shang Hung-Sheng , Wang Ching-Hsun
Published: January 2024

Background:

Integrons in Stenotrophomonas maltophilia are the major mechanism for trimethoprim/sulfamethoxazole (TMP/SMX) resistance. Molecular epidemiology of S. maltophilia with integrons has not been studied till now, and gene cassettes of the integron in S. maltophilia may change with time.

Aim:

Molecular typing and interrelatedness between TMP/SMX-resistant S. maltophilia (TSRSM) isolates in a hospital in 2017 were analyzed and gene context of cassettes in integrons was studied.

Methods:

Molecular typing was determined through a multilocus sequence typing (MLST) scheme, while pulsed-field gel electrophoresis (PFGE) was used for relatedness analysis of TSRSM with integrons. Mapping of gene cassettes in the integron was also performed through sequencing.

Results:

From 214 S. maltophilia isolates collected in 2017, 34 of them (15.9%) were TSRSM. A total of 20 (58.8%) from 34 TSRSM isolates harboring the class 1 integron were analyzed. The MLST analysis revealed 11 different sequence types, 5 out of which were novel STs (ST 830, ST 833, ST 836, ST 837, and ST 839), suggesting a wide genetic diversity. There were two clones with intrahospital dissemination between different hospital settings, according to PFGE. Mapping of gene cassettes of the integron revealed four novel combinations of multiresistance genes (aacA4-aadA5, aacA7-catB, cmlA10-aadA2, and aacA4-aphA15-catB3), indicating the continued evolutionary change of the gene cassettes.

Conclusion:

Evidence of clonal transmission within the hospital and continuous change of multiresistant gene combinations in the cassettes of the integron showed that S. maltophilia with resistance integrons may play a role in the spread of antimicrobial resistance.
Novel Genetics and Humoral Prognostic Markers of Left Ventricle Hypertrophy in Hypertensive Patients
Authors: Voroniuk Kseniia , Sydorchuk Larysa , Repchuk Yuliya , Sydorchuk Andrii , Sydorchuk Ruslan , Iftoda Oksana
Published: January 2024

Background:

Left ventricular hypertrophy (LVH) is not only complications or the damaged appearance of the target organ of patients with essential arterial hypertension (EAH), but at the same time, it is also a prognostic factor.

Aim:

The aim is to evaluate the echocardiographic (Echo-CG) changes in patients with EAH depending on genes AGT (rs4762), GNB3 (rs5443), and some humoral markers.

Methods:

A total of 100 EAH patients were recruited for this study. AGT (rs4762) and GNB3 (rs5443) genotyping were performed by Real-Time PCR. All recruited individuals were tested for serum levels of ionized calcium, parathyroid hormone, and 25-hydroxyvitamin D. LVH was assessed using Echo-CG.

Results:

T-allele of the AGT (rs4762) and GNB3 (rs5443) genes are associated with myocardial structure changes in hypertensive patients: thicker relative wall thickness (RWT), interventricular septum in diastole and higher left ventricular (LV) mass index (LVMI) in women for GNB3 (rs5443) gene. Hypovitaminosis D in EAH patients is accompanied by LV remodeling: larger left atrium size, LV mass (LVM), and LVMI in women, with lower ejection fraction. Hypocalcemia links to the smaller wall thickness of hypertrophied LV myocardium in EAH individuals than in the case of its normal concentration, as well as a lower LVMI and better LV contractile function, which confirms the hypothesis of active involvement of calcium in the process of myocardial remodeling and hypertrophy.

Conclusion:

The polymorphic variants of the AGT (521 C>T) and GNB3 (825 C>T) genes are associated with myocardial structure changes in EAH patients. Hypovitaminosis D in hypertensive individuals is accompanied by LVM and LVMI increase but reliably only in women.
Association of Premenstrual Symptoms with Premenstrual Syndrome
Authors: Badkur Deepika , Wanjpe Arun R
Published: January 2024

Background:

Premenstrual syndrome (PMS) occurs 7–14 days before the onset of menstruation and subsides with the commencement of menstrual flow, it affects women during their reproductive age, and is associated with physical, psychological, and behavioral changes of varying severity and can interfere with the lives of the affected, as well as their interpersonal relationships. Study to follow the menstrual cycle of females and study the association between self-reported symptoms and Premenstrual Syndrome and find sensitivity and specificity of premenstrual symptoms.

Materials and Methods:

An observational follow-up study was conducted from December 2014 to June 2015 in 250 college-going females (18–25 years) using a self-reporting Modified Daily Record of Severity of Problems questionnaire. Data were analyzed using IBM, SPSS statistics software version 16.0.

Results:

PMS was associated with some psychological and physical premenstrual symptoms. Multiple logistic regression showed that symptoms made no significant contribution to PMS. The highest sensitivity and lowest sensitivity were 29.8% (general body discomfort) and 2.4% (diarrhea/constipation), respectively. Whereas the highest and lowest specificity was 96.8% (diarrhea/constipation) and 82.4% (swollen extremity), respectively.

Conclusion:

PMS was found to be associated with some psychological and physical premenstrual symptoms. None of the symptoms in the present study were highly sensitive and specific at the same time. However, a few symptoms that have high specificity but low sensitivity could be better used in ruling the diagnosis of PMS in the study participants rather than detecting likely PMS. So, more systematic research is required to assess the sensitivity and specificity of these symptoms in order to improve the screening instrument.
From Alpha to Omicron Genetic Variants: The Evolution of Severe Acute Respiratory Syndrome Coronavirus 2 and Other Beta Coronaviruses – A Narrative Overview from Public Health Point of View
Authors: Harisingani Avi , Gupta Nikita , Pustake Manas , Ganiyani Mohammad Arfat , Shahnaz Fathima , Shah Aditya , Shah Priyanshi , Mukherjee Sayan , Deshmukh Krishna
Published: January 2024

Acute respiratory syndrome coronavirus disease-2019, caused by a new coronavirus (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) with a high morbidity and death rate, has emerged as one of humanity’s most serious dangers in recent decades. Because of the virus’s ongoing development, with its single-nucleotide polymorphism variations and many lineages, determining SARS-CoV-2 infectivity is very challenging. However, it is critical to do in-depth research on the virus to understand the mechanisms of its pathogenicity and virulence and to create efficient treatment methods. The current contribution compiles existing information on the virus’s evolutionary and structural characteristics to explain its mutational pattern and potential involvement in the ongoing epidemic.
Role of Nasal Endoscopy in Early Clinical Diagnosis of Mucormycosis during COVID-19 Pandemic
Authors: Bajoliya Sunil , Agrawal Sanjay , Verma Abhilasha , Agrawal Ramesh , Verma Pramila
Published: January 2024

Background:

Sinonasal mucormycosis is an uncommon entity and extremely challenging to treat by ENT surgeons. It occurs mainly in immunocompromised patients. Nasal endoscopy in the early stage could help in the diagnosis and treatment of sinonasal mucormycosis.

Objective:

The aim is to evaluate the role of nasal endoscopy in the early clinical diagnosis of mucormycosis in COVID-19 pandemic.

Materials and Methods:

This prospective study was conducted in the Department of Otorhinolaryngology, Tertiary Care Hospital, Central India, for 1 month. Nasal endoscopy was done on all the patients, and biopsy was sent to histopathological examination.

Results:

A total of 40 patients in the age group of 18–78 years, with the suspected signs and symptoms of mucormycosis, enrolled in the present study. Out of 40 patients, 18 cases had a history of COVID-19 and 22 cases had a history of hospitalization for breathlessness in the past 1–4 months. Mucormycosis was diagnosed by direct microscopic examination of aspirate/crusts from the nasal/sinus mucosae seen in 10 (25%), diagnosed by histopathology in 24 (60%), and both microscopy and histopathology in 16 (40%) cases.

Conclusion:

We have concluded that the early endoscopic diagnosis and prompt treatment of mucormycosis definitely reduce the morbidity and mortality of the patients.
Invasive Group B Streptococcus Epidemic among the COVID-19 Pandemic in Hong Kong: A Silent Endemic
Authors: Tambolkar Isha , Pustake Manas , Ahmad Shahzaib , Nansubuga Esther Patience , Chandra Ayush , Agbendeh Lubem Nathaniel
Published: January 2024

This scholarly piece investigates the impact of COVID-19 efforts on the Group B Streptococcus (GBS) epidemic. Efforts in Hong Kong shifted to battling the COVID-19 pandemic, which has allowed for the influx of GBS cases. This article looks at how several factors have impacted the wave of GBS cases, including medical professionals not detecting GBS if it is co-infection with COVID-19 pandemic. Other factors influencing the rise of GBS are the primary economic source to Hong Kong, the fishing industry. Due to the negative impact that GBS has on younger individuals, this manuscript focuses on public health interventions, including testing, protocols in place for early detection, and vaccinations for GBS.
Clinical Outcome in Post-ST Segment Elevation Myocardial Infarction Patients Receiving β-Blocker and Angiotensin-converting Enzyme Inhibitor/Angiotensin Receptor Blocker versus Receiving Either Therapy Alone: A Prospective Observational Study
Authors: Kanuga Kshitij H. , Mistry Ankit R. , Patel Aman T. , Malhotra Supriya D. , Patel Tejas M.
Published: January 2024

Background:

Cardiovascular disease (CVD) has now become the leading cause of mortality in India. A quarter of all mortality is attributable to CVD. The study is aimed to compare the use of secondary preventive therapies after percutaneous coronary intervention (PCI) in ST segment elevation myocardial infarction (STEMI) patients.

Aims:

To evaluate the usage of drugs, to compare the use of Beta blockers (BB) or angiotensin-converting enzyme (ACE)/angiotensin receptor blockers (ARBs) alone versus combination of beta blockers and ACE/ARBS inhibitors following PCI, and to determine the outcome after angioplasty in STEMI patients on follow-up.

Methodology:

This was a prospective observational study of 9-month duration from September 2021 to April 2022 involving diagnosed STEMI patients who underwent percutaneous transluminal coronary angioplasty. The study began after the approval of the study protocol by the institutional review board. The demographic details and comorbid illness were noted. Drug use pattern and clinical outcomes were recorded at the time of discharge and followed up. Statistical analysis was done using Microsoft Excel Office 2019 and rechecked with SPSS (version 25.0). P < 0.05 was considered statistically significant.

Results:

A total of 94 patients of either gender were enrolled in the study (mean age: 53.46 ± 11.03 years). The most common comorbidities were hypertension with diabetes mellitus in 30 patients (41.34%). A total of 85 patients underwent PCI after coronary angiography. Patients were categorized into three groups (Group 1 = BB, Group 2 = ACE inhibitor [ACE-I]/ARB, and Group 3 = BB + ACE-I/ARB). Among 81 patients, BB (70; 15.08%) were the most commonly prescribed medication, followed by ARB (66; 14.22%) and ACE-I (4; 0.86%), respectively. Ejection fraction (EF) was increased from 40.16 ± 12.112 (at baseline) to 50.94 ± 11.085 (at 4th month) in Group 3. EF was statistically improved in patients who were in Group 3 (P < 0.05).

Conclusion:

Our conclusions support the current American College of Cardiology/American Heart Association guidelines recommending beta-blocker therapy along with ACE-I/ARB for secondary prevention. Therefore, in this study, we suggest that the combination of BB with ACE-I/ARB may improve clinical outcomes. It also shows that patients receiving only one group were at a loss. The search for alternative drugs in such patients should be an area of extensive scientific investigation.
Chronic diarrhea - The poetic masquerade
Authors: Bhattacharjee S , Siyad I , Maramattom BV
Published: January 2024

Chronic diarrhea, by definition, is the passage of loose/liquid stools, with increased frequency (more than three times/day), or an output of over 200 g/day, lasting for a duration of four or more weeks. The clinical approach to identify the cause of chronic diarrhea generally depends on the local socioeconomic status. In high-income countries, systemic causes such as irritable bowel syndrome (IBS), inflammatory bowel disease, malabsorption syndromes (lactose intolerance/coeliac disease) are primarily considered. In mid- to low-income countries, infective causes like chronic bacterial, mycobacterial, fungal infections, HIV, bowel cancer are considered before systemic causes/malabsorption syndromes. Amyloidosis, more accurately, reactive amyloidosis is one of the rarer causes of chronic/persistent diarrhea. Inflammatory colitis secondary to POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes) as a cause for chronic diarrhea has been reported only in a handful of cases and is often missed. We present such a case of chronic diarrhea in a middle-aged man, who was eventually diagnosed to have POEMS syndrome.
The development of QERM scoring system for comprehensive assessment of the Quality of Empirical Research in Medicine - Part 1
Authors:   Research Quality Improvement Group, Indrayan A , Vishwakarma G , Malhotra RK , Gupta P , Sachdev HPS , Karande S , Asthana S , Labani S
Published: January 2024

Purpose:

Whereas a large number of features are mentioned to connote the quality of medical research, no tool is available to comprehensively measure it objectively across different types of studies. Also, all the available tools are for reporting, and none includes quality of the inputs and the process of research. The present paper is aimed to initiate a discussion on the need to develop such a comprehensive scoring system (in the first place), to show that it is feasible, and to describe the process of developing a credible system.

Method:

An expert group comprising researchers, reviewers, and editors of medical journals extensively reviewed the literature on the quality of medical research and held detailed discussions to parse quality at all stages of medical research into specific domains and items that can be assigned scores on the pattern of quality-of-life score.

Results:

Besides identifying the domains of the quality of medical research, a comprehensive tool for scoring emerged that can be possibly used to objectively measure the quality of empirical research comprising surveys, trials, and observational studies. Thus, this can be used as a tool to assess Quality of Empirical Research in Medicine (QERM). The expert group confirmed its face and content validity. The tool can be used by the researchers for self-assessment and improvement before submission of a paper for publication, and the reviewers and editors can use this for assessing the submissions. Published papers can also be rated such as those included in a meta-analysis.

Conclusion:

It is feasible to devise a comprehensive scoring system comprising domains and items for assessing the quality of medical research end-to-end from choosing a problem to publication. The proposed scoring system needs to be reviewed by the researchers and needs to be validated.
Time to implement tailored interventions in Chhattisgarh, east-central India to reach malaria elimination
Authors: Ranjha Ritesh , Sontee  , Yadav Chander Prakash , Mohan Mradul , Singh Kuldeep , Kumar Jitendra , Bharti Praveen Kumar , Anvikar Anup R.
Published: January 2024

Background & objectives:

Despite significant progress in malaria control throughout India, Chhattisgarh state continues to be a significant contributor to both malaria morbidity and mortality. This study aims to identify key factors associated with malaria endemicity, with a goal of focusing on these factors for malaria elimination by 2030.

Methods:

We employed an analysis and narrative review methodology to summarize the existing evidence on malaria epidemiology in Chhattisgarh. Data encompassing environmental conditions, dominant malaria vectors and their distribution, and the impact of previous interventions on malaria control, were extracted from published literature using PubMed and Google Scholar. This information was subsequently correlated with malaria incidence data using appropriate statistical and geographical methods.

Results:

Much of the malaria burden in Chhattisgarh state is concentrated in a few specific districts. The primary malaria vectors in these regions are Anopheles culicifacies and An. fluviatilis. High transmission areas are found in tribal belts which are challenging to access and are characterized by densely forested areas that provide a conducive habitat for malaria vectors.

Interpretation & conclusion:

Conducive environmental conditions characterized by high forest cover, community behavior, and insurgency, contribute to high malaria endemicity in the area. Challenges include insecticide resistance in malaria vectors and asymptomatic malaria. Allocating additional resources to high-endemic districts is crucial. Innovative and focused malaria control programs of the country, such as DAMAN and Malaria Mukt Abhiyan, hold immense importance.
Structural exploration of the PfBLM Helicase-ATP Binding Domain and implications in the quest for antimalarial therapies
Authors: Gattan Hattan S , Al-ahmadi Bassam M , Shater Abdullah F , Saeedi Nizar H , Alruhaili Mohammed H
Published: January 2024

Background & objectives:

The battle against malaria has witnessed remarkable progress in recent years, characterized by increased funding, development of life-saving tools, and a significant reduction in disease prevalence. Yet, the formidable challenge of drug resistance persists, threatening to undo these gains.

Methods:

To tackle this issue, it is imperative to identify new effective drug candidates against the malaria parasite that exhibit minimal toxicity. This study focuses on discovering such candidates by targeting PfRecQ1, also known as PfBLM, a vital protein within the malaria parasite Plasmodium falciparum. PfRecQ1 plays a crucial role in the parasite’s life cycle and DNA repair processes, making it an attractive drug development target. The study employs advanced computational techniques, including molecular modeling, structure-based virtual screening (SBVS), ADMET profiling, molecular docking, and dynamic simulations.

Results:

The study sources ligand molecules from the extensive MCULE database and utilizes strict filters to ensure that the compounds meet essential criteria. Through these techniques, the research identifies MCULE-3763806507-0-9 as a promising antimalarial drug candidate, surpassing the binding affinity of potential antimalarial drugs. However, it is essential to underscore that drug-like properties are primarily based on in silico experiments, and wet lab experiments are necessary to validate these candidates’ therapeutic potential.

Interpretation & conclusion:

This study represents a critical step in addressing the challenge of drug resistance in the fight against malaria.
The correspondence between the physiological cold tolerance and the distribution border of Mediterranean sandflies in Southeast Europe
Authors: Trájer A J
Published: January 2024

Background & objectives:

The distribution of sandflies is influenced by several climatic factors, like winter temperature limits, summer humidity, and drought. Only a few studies were performed to search for the connection between the physiological tolerance of sandflies and the result of the Climate Envelope Models projected distribution borders.

Methods:

It was studied how the depth of rodent burrows could determine the occurrence of five European Phlebotomus species based on their known physiological cold tolerances.

Results:

The modelled distributions based on the monthly minimum temperatures showed notable differences by soil depth and species. The observed and modelled European distribution areas of sandflies according to - 20 cm soil depth showed good coincidence with the observed occurrences of Phlebotomus neglectus, Ph. papatasi, and Ph. perfiliewi in East-Central, Southeast, and East Europe. Also, a good coincidence was found in the case of the modelled and observed occurrences of Phlebotomus perniciosus in Western Europe.

Interpretation & conclusion:

It can be concluded that in their north-eastern distribution borders, sandflies can overwinter in rabbit and rodent burrows at depths of - 20 cm below the surface. The physical cold tolerance of Ph. ariasi could be underestimated. In more than - 50 cm of depth, the stable and continuously cold environment of the shelters (mean temperature less than 10°C) could inhibit the post-winter diapause activation of sandflies in the northern regions.
A Rare Case of Congenital Cystic Adenomatous Malformation of Lung
Authors: Kambale Tushar , Ghule Vijay , Ingale Yaminy Pradeep , Gore Charusheela
Published: January 2024

ABSTRACT

Congenital pulmonary airway malformation (CPAM) is because of excessive and disordered proliferation of bronchial tubular structures of the lung. CPAM is slightly infrequent with the unknown etiology and incidence. The diagnosis of these cases is most of the time performed prenatally by routine ultrasonography scanning. Examination of the resection specimen is mandatory for determining occult malignancy. Complication of untreated congenital cystic adenomatous malformation of lung includes pulmonary hypertension; pulmonary hypoplasia; respiratory distress because of hydrops, pneumothorax, or prematurity; recurrent respiratory tract infection; recurrent pneumonia; hemothorax; pleural effusion; and pneumatocoele. A correct prenatal diagnosis and a clinical assessment of the congenital cystic lung diseases authorize an advanced and successful surgical timing. Surgery is the only definitive treatment and should be undertaken as early as possible to prevent infection and other complications.
Insufficient Physical Activity among School Going Adolescents: A Cross-Sectional Study in Government High Schools of Kolkata
Authors: Maurya Neelam , Dasgupta Aparajita , Paul Bobby , Shree Nidhi , Pyrbot Foulisa , Ghosh Pritam , Roy Soumit
Published: January 2024

ABSTRACT

Background:

Regular physical activity is an important behavior for promoting health or preventing diseases. Poor participation in physical activity, especially in school-going children, has a multifactorial causation. Present study aimed to find out the proportion and determinants of insufficient physical activity among school-going adolescents at selected government high schools of Dumdum.

Methodology:

A cross-sectional observational study was conducted among school-going adolescent students of class VIII, IX, X, XI, XII in two selected government high schools of Dumdum municipality of North 24 Parganas. Complete enumeration method was used to select 199 participants. Students, who were absent during the day of the survey or were not willing to participate were excluded. A pre-designed pretested structured schedule was used to collect data. Data was analyzed using statistical software SPSS version 16.

Results:

Out of 199 students, 62.9% were aged 13--14 years with mean age 14.4 (±1.37). 54.3% were females. Only 22.1% do adequate physical activity, 59.8% participants have satisfactory attitude towards adequate physical activity practices. 42.2% participants were addicted to smartphone according to smartphone addiction scale (SAS). Physical activity was significantly associated with female gender (OR = 2.56. 95% CI = 1.28--5.11), unsatisfactory attitude (OR = 2.41, 95% CI = 1.13--5.10) towards PA practices, high smartphone addiction (OR = 2.57. 95% CI = 1.23--5.35), and more screen time (OR = 2.20, 95% CI = 1.11--4.37).

Conclusions:

Physical activities in the school environment have short-term as well as long-term benefits over health. Various factors act as a barrier to physical activity. PA promotion programs in the school setting is needed for disease-free and healthy life.
A Comparative Study of Corneal Endothelial Morphology and Central Corneal Thickness in Type II Diabetes Mellitus Patients
Authors: Gotekar Rajesh B. , Mandlik Hanumant R. , Dongare Sumit D. , Joshi Ajit K.
Published: January 2024

ABSTRACT

Introduction:

Type II diabetes mellitus is a major public health problem nowadays and it affects almost all structures of the eye including the corneal endothelium. Corneal manifestations seen in diabetic patients are recurrent corneal erosions, punctuate epithelial keratopathy, persistent epithelial defects, impaired corneal sensitivity, ulcers, delayed wound repair, superficial keratitis, and corneal endothelial damage.

Materials and Methods:

A cross-sectional prospective analytical study with 100 patients including 50 type II diabetics (Group A) and 50 non-diabetics (Group B) was conducted in our tertiary care hospital from November 2020 to April 2021. Along with complete routine ophthalmic examination, endothelial morphology and central corneal thickness (CCT) assessment were performed by non-contact specular microscopy.

Results:

Mean CCT in Group A (535.44 ± 10.67 μm2) was higher than in Group B (526.86 ± 10.15 μm2) which was statistically significant (P-value < 0.001). Also mean endothelial cell density (ECD) and mean hexagonality were significantly lower in the diabetic group (2449.48 ± 210.52 cells/mm2 and 51.24 ± 4.83%) than in Group B (2581.56 ± 233.03 cells/mm2 and 54.12 ± 5.28%). The mean coefficient of variation (CV) was 38.32 ± 2.43% in Group A and in Group B it was 35.48 ± 2.55%, which shows that there was a statistically significant higher CV count in the diabetic group.

Conclusion:

The present study shows that CCT and CV are more, while ECD and hexagonality are less in diabetics in comparison with non-diabetics. Routine assessment of corneal endothelial morphology will help to take necessary measures to prevent further endothelial cell loss during intraocular surgery, so as to avoid post-surgery endothelial decompensation.
Cutaneous Metastasis from Solid Malignancies Heralding Underlying Dissemination: A Case Series of Rare Presentations
Authors: Bisht Niharika , Murthy Harish S. , Vashisth Rekha , Singh Sankalp , Joshi Richa , Manoj MG , Borde-Bisht Priyanka , Lohia Nishant , Trivedi Gaurav , Vadlamani Suryaprakash
Published: January 2024

ABSTRACT

Metastasis to the skin remains a rare site of disease involvement in visceral malignancies. It is also a poor prognostic marker for survival. We present a case series of four cases that presented with cutaneous metastasis in a background of solid tumors of the esophagus, gall bladder, kidneys, and lungs, respectively. In all cases, the appearance of the skin lesion acted as a herald that led to the discovery of recurrence or widespread dissemination of the malignancy. Three of the patients passed away within 6 months of the appearance of skin metastases. The use of targeted therapy showed a good response in the patient with renal cell carcinoma with significant regression of disease.