bluuebunny/crossref_metadata_2025 huggingface dataset:
Foldscope: A smartphone based diagnostic tool for fungal keratitis
Authors: Parmar Dipali P , Rathod Jay S , Karkhanawala Minhaz M , Bhole Pradnya K , Rathod Darshana S
Published: October 2021

Purpose:

Smartphone-based microscopy tool like foldscope (FS) may serve the purpose of a low-cost diagnostic alternative to the compound light microscope especially in areas with limited resources. The purpose of this study was to detect fungal pathogens causing keratitis on direct smear by smartphone-mounted FS and to evaluate the efficacy of FS against routine compound light microscope (CLM).

Methods:

The prospective study was conducted at a tertiary eye care center from September 2019 to March 2020. The study included 60 smear examinations (Gram stain [GM] n = 30, Lactophenol Cotton Blue [LCB] n = 30) to detect fungal pathogens from corneal scraping material of clinically suspected fungal keratitis (FK) cases. The diagnostic utility of FS was compared with CLM for both GM and LCB wet mount. Data collected were used to quantify the agreement using Cohen’s kappa between CLM and FS imaging.

Results:

Forty-six samples out of 60 were positive for fungi using CLM. GM stain and LCB showed 22/30 (73.33%) and 24/30 (80%) positive results with CLM, respectively. Moderate agreement (0.49) was observed between CLM and FS with the smartphone method. LCB mount showed high specificity of 1.00 over 0.87 of GM stain for FS with the smartphone.

Conclusion:

Direct smear can be an early and sensitive measure to diagnose FK other than clinical suspicion. The smartphone-mounted FS has limited sensitivity as an alternative to CLM, but excellent specificity in the present study for FK. The FS as a smartphone-based diagnostic tool is simple, portable, and inexpensive in resource-constrained rural or remote clinical and public health settings in the absence of CLM and other higher diagnostic modalities.
Assessing the role of systemic inflammation in the etiopathogenesis of advanced stage keratoconus
Authors: Reyhan Ali H , Karadağ Ayşe Sevgi , Çınar Şerife Şule
Published: October 2021

Purpose:

It was aimed to compare the levels of inflammation-related parameters, such as neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR), in patients with advanced keratoconus (KC) and healthy controls. Also, we evaluated the relationships between these parameters and several corneal topography values used in the KC diagnostic index.

Methods:

Forty patients with advanced and 40 healthy volunteers were included in this study. In the KC group, 20 patients were nonprogressive KC and 20 patients were progressive KC. In all participating individuals, we evaluated detailed ophthalmologic examination findings and complete blood count data, while corneal topographic measurements were also recorded in patients with KC.

Results:

The mean NLR value was 2.3 ± 1.19 in the progressive KC group; nonprogressive KC values were 1.99 ± 1.69 and 1.81 ± 0.72 in the control group. Mean PLR value was 113.24 ± 48.44 in the progressive KC group, nonprogressive KC values were 96.47 ± 31.04 and 104.09 ± 35.14 in the control group. No statistically significant difference was found between patients with progressive KC, nonprogressive KC, and healthy volunteers in terms of mean NLR and PLR values (P > 0.05). NLR values were found to demonstrate significant positive correlations with the corneal topography parameters, Symmetry Index front (r = 0.278, P = 0.025), KC Vertex front (r = 0.247, P = 0.048), and Baiocchi Calossi Versaci front (r = 0.273, P = 0.028); there was no significant relationship between corneal topography parameters and PLR values.

Conclusion:

Although there was no significant difference between the progressive KC, nonprogressive KC, and control groups in inflammation parameters such as NLR and PLR, a positive correlation was observed between the NLR value and some corneal topography findings used in the diagnosis of KC. The role of inflammation in the etiology of KC can be better understood by clinical studies and laboratory tests conducted with prospective studies involving a higher number of patients.
A simple do-it-yourself model of phacoemulsification for resident training
Authors: Saluja Gunjan , Sujeeth M , Bhaskaran Karthika , Pujari Amar
Published: October 2021

COVID-19 has immensely affected the training of ophthalmology residents; wet-lab training thus becomes of utmost importance. A simple cost-effective model for cataract surgery training of residents becomes the need of this hour. Hence, we aim to describe a new ‘Do It Yourself’ model with easily available material for beginners.
Etiological spectrum of irreversible blindness in Kashmir in North India
Authors: Kaushik Madhurima , Nawaz Shah , Mufti Haniyaa , Qureshi Tariq Syed
Published: October 2021

Purpose:

To determine the etiological spectrum of irreversible blindness in Kashmir Valley in India.

Methods:

Patients presenting to a tertiary care hospital in Kashmir, India, with unilateral or bilateral blindness from April 2019 to March 2020 were included in this cross-sectional study. Blindness was defined using the World Health Organization (WHO) criteria. All subjects had a complete ophthalmologic examination and information was gathered regarding their demographic profile, nature of ocular disorder whether primary or secondary and laterality, if the ocular involvement was unilateral.

Results:

248 patients were enrolled in the study. The mean age of the patients was 57.17 years. The male: female ratio was 2.17:1. The commonest cause of unilateral or bilateral blindness was glaucoma (22.58%) followed by diabetic retinopathy (DR) (17.74%). Unilateral blindness was seen in 78.62% of the patients. Unilateral blindness occurred mainly due to glaucoma (16.41%), DR (14.87%), age-related macular degeneration (13.33%), and trauma (pellet injury: 10.76%, non-pellet injury: 10.25%). The major causes of bilateral blindness were glaucoma (45.28%), DR (28.30%), and hereditary/congenital retinal diseases (16.98%). Socioeconomic status and educational status were significantly associated (P < 0.05 each) while age, gender, place of residence, and occupation were not significantly associated (P > 0.05 each) with the number of eyes affected by blindness.

Conclusion:

Glaucoma and DR are the foremost causes of irreversible blindness in Kashmir. Public health plans aimed at encouraging good health education of patients should be developed in this region. Moreover, patients should be screened effectively for glaucoma and diabetes at the level of primary health care facilities.
A comparative cross-sectional analysis on outcomes of Covid-19 patients requiring dialysis
Authors: Gokhale Chinmay N. , Chavhan Smita S. , Mahajan Harshal N. , Adsul Balkrishna B. , Kumbhar Maharudra A. , Ingale Aniket R.
Published: October 2021

Context:

Coronavirus Disease 2019 (COVID-19) was declared as a pandemic by the World Health Organization (WHO) on March 11, 2020. COVID-19 disproportionately affects patients with pre-existing comorbidities including those undergoing dialysis at intermittent intervals. These patients requiring renal replacement therapy like intermittent hemodialysis have a preponderance to go into severe clinical states. Hence, this study was planned to analyze the outcomes of such patients requiring dialysis and suffering from the COVID-19 disease.

Objectives:

This study was carried out to compare the outcomes of the COVID-19 patients requiring hemodialysis with those not requiring hemodialysis.

Materials and Methods:

This cross-sectional observational study was carried out between April 2020 and August 2020 at a dedicated COVID-19 hospital and included COVID-19 patients requiring hemodialysis at the time of admission and an equal number of controls matched for age and sex.

Results:

The study included 271 COVID-19-positive patients requiring dialysis and 271 COVID-19-positive controls without the requirement of a dialysis matched for age and sex; 10.3% cases needed intensive care. There were 18.8% deaths in cases as opposed to 8.9% among controls. Multivariate analysis showed that advancing age (OR 2.6 in cases and 1.06 in controls) need for intensive care (OR 27.9 in cases and 331 in controls), and diabetes alone and with other comorbidities were significant predictors of mortality.

Conclusions:

This study showed that the mortality proportions were more in cases as compared to controls; and advancing age, diabetes, and need for intensive care unit (ICU) were significant predictors. The study also highlighted the crisis faced by patients who require dialysis at regular intervals due to this COVID-19 pandemic.
National guidelines for sanitation services
Authors: Siddharth Vijaydeep , Singh Angel Rajan , Sharma D. K. , Satpathy Sidhartha , Kaushal Vipin Kumar , Lathwal Amit , Sain Anil , Misra Shweta , Kausar Mohammad , Garg Ruchi
Published: October 2021

Background:

Cleanliness is one of the main reasons for poor satisfaction among the patients and their attendants visiting healthcare facilities.

Objective:

To elevate and transform the sanitation in public sector facilities, a committee was constituted by Ministry of Health and Family Welfare, Government of India to study the existing system of Housekeeping in Central Government Hospitals and draft the Guidelines for house-keeping services, since no such literature is available in context of the healthcare facilities in India.

Methods:

The committee ascertained the housekeeping services in three tertiary care hospitals of Central Government and simultaneously conducted the literature review of the best practices in hospital sanitation and housekeeping.

Results:

Formulated national guidelines focus on various aspects of sanitation services in health facilities, i.e., hospital infrastructure; organization of sanitation services; human resource requirements; qualification, experience and training needs of sanitation staff; roles and responsibilities of different personnel; risk categorization of hospital areas; mechanized cleaning; cleaning agents; cleaning standards and standard operating procedures; effective supervision and monitoring; procurement of these services, etc.

Conclusion:

Formulated guidelines can be adopted by developing countries aiming for standardizing cleaning practices in public health facilities.
Gender determination and gender gap
Authors: Rawat Shalini , Yadav Ashwini , Bhate Kamaxi
Published: October 2021

Background:

Sex ratio is an important sociodemographic characteristic of the country reflecting the status of its women and underlying socioeconomic and cultural patterns. PC-PNDT law is in place since so many years still sex determination is prevalent. Here not only doctors but the parents are also equally responsible for propagating this social evil as most of them are unaware about the Act and its legal implications and consequences of the declining sex ratio.

Methods:

Study was conducted over a period of 24 months from December 2018 to November 2018 in Immunisation OPD of a tertiary health care centre and a primary health centre with a sample size of 117 in both areas. Simple Random sampling method was used and analysis was done using SPSS software.

Results:

Out of 234 mothers approximately 70% were aware that pre-natal sex determination can be done. About 40% were aware that it is illegal, 30% said that ultrasonography is used for doing it, 20% said that both doctor and parents are punished under this act. Only 5% were aware about the correct punishment under this Act. Awareness regarding the place, method, legality and punishment was more among mothers of urban area as compared to rural area. Education and socioeconomic status was associated with awareness.

Conclusion:

Creating awareness in the general public and specifically mothers regarding the Act and consequences of its violation. Comprehensive behavioural change communication activities can be done through mass media for educating the people regarding the effect of declining sex ratio.
REAL-world evidence of risk factors and comorbidities in YOUNG Indian adults with type 2 diabetes mellitus
Authors: Saboo Banshi , Agarwal Sanjay , Gupta Sunil , Makkar Brij , Panneerselvam A , Sahoo Abhay Kumar , Ramchandani G. D. , Das Sambit , Erande Suhas , Kadam Yogesh , Abhyankar Mahesh V. , Revankar Santosh
Published: October 2021

Objective:

To assess the clinical characteristics, risk factors, and comorbidities associated with type 2 diabetes mellitus (T2DM) in young adult patients.

Methods:

This is a retrospective, multicentric real-world study that included young adults (18–45 years) with T2DM. Primary information including demographics, medical and family history, biochemical measures (pre-and post-prandial blood glucose levels, glycosylated hemoglobin [HbA1c] and blood pressure, and lipid parameters) smoking and drinking habits were collected retrospectively from the medical records of the respective hospitals/clinics. Data were analyzed using descriptive and appropriate comparative statistics.

Results:

A total of 22,921 patients from 623 sites were included. The median age was 37.0 years and the majority were men (61.6%). The proportion of patients from the age group >35–≤45 years was 62.7%. Among all patients, 46.9% had only T2DM; however, 53.1% of patients had T2DM with other comorbidities (T2DM with hypertension, dyslipidemia, and both). The majority of patients had elevated body mass index (BMI) (overweight, 46.6%; and obese, 22.9%). Family history of T2DM (68.1%) was most common in overall population. Sedentary lifestyle (63.1%), alcohol consumption (38.9%), and regular smoking (23.1%) were the most common associations in patients with T2DM with dyslipidemia and hypertension. Uncontrolled HbA1c level (≥7%) were observed in 79.2% of patients. The level of HbA1c was significantly increased with the duration of T2DM and sedentary lifestyle (p < 0.001).

Conclusion:

Higher BMI, family history of T2DM, sedentary lifestyle, alcohol consumption, and smoking were the most common risk facors, while hypertension and dyslipidemia were the most prevalent comorbidities associated with T2DM in young Indian adults.
Knowledge, attitude, and practices regarding dietary habits among medical and non-medical university students
Authors: Alghamdi Saeed Ali , Alqarni Abdulaziz Abdullah , Alghamdi Abdullah Fuad , Alghamdi Tariq Khalid , Hasosah Naif Mohammed , Aga Syed Sameer , Khan Muhammad Anwar
Published: October 2021

Background:

Medical students even though being aware of the importance of well-balanced nutrition do tend to have laxity in practicing it themselves leading to poor nutrition. The aim of this study was to compare the awareness and knowledge of dietary habits among medical and non-medical students.

Methods:

This cross-sectional study was carried out in two universities in the Jeddah province, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) and King Abdulaziz University (KAU), Jeddah over 6 months. A self-administered online questionnaire was employed to assess the knowledge and attitude of the dietary habits among the students.

Results:

The number of students who responded positively to the survey was 386, the mean age was 21.5 ± 2.10. 310 (80.3%) of which were males while 76 (19.7%) were females by a ratio of 4.07:1. Most of the participants were single (95.9%); 238 (87.6%) participants lived with their family and 272 (70.5%) participants were in the college of medicine. Among the medical students, 41.9% did exercise “sometimes,” 57.4% identified breakfast as an important meal of the day, and 14.7% were smokers.

Conclusion:

In our study, we found that the medical students were having a higher level of awareness about the dietary and lifestyle habits but it was not reflected in their practice which needed to be taken care of.
Sexual behavior and contraceptive practices
Authors: Beri Lakshay V. , Shelke Pallavi S. , Acharya Shrikala M.
Published: October 2021

Background:

As many as half of people with HIV who are in a long-term sexual relationship have an HIV-negative partner. Data on sexual behavior and contraceptive needs of heterosexual serodiscordant couples are scarce in India. Keeping these facts in mind, it was considered imperative to conduct a study on sexual behavior, contraceptive practices and associated high risk factors among heterosexual serodiscordant couples.

Objectives:

The objective of the study was to assess the sexual behavior, current contraceptive practices and various risk factors of HIV transmission among married heterosexual HIV serodiscordant couples.

Materials and Methods:

Descriptive study conducted at antiretroviral therapy (ART) centre from where 100 discordant couples were included, data were collected related to their sexual practices, knowledge about different contraception methods and high risk factors related to infection transmission were recorded.

Results:

All couples had knowledge of use of condoms (100%) while consistent usage was seen only in 18%. The high risk of HIV transmission was seen among recently married serodiscordant couples. Couples engaged in daily intercourse were more likely to have high risk of transmission (P value < 0.05).

Conclusion:

This study showed various risk factors for infection transmission to the seronegative partner among serodiscordant couples. Henceforth, given conception that prevention of these factors could reduce overall seroconversion rate among such couples.
Treatment outcome among Post TB obstructive airways diseases and COPD
Authors: Swain Smrutirekha , Pothal Sudarsan , Behera Aurobindo , Manjhi Rekha , Dutta Pravati , Pradhan Gourahari
Published: October 2021

Context:

Post Tubercular Obstructive Airways Diseases (Post-TB OAD) is a sequela of Pulmonary TB but diseases progression may not same like Chronic Obstructive Pulmonary Diseases (COPD).

Aim:

To compare the frequency and severity of exacerbations, change of FEV1, frequency of hospitalization and mortality among COPD and post TB OAD patients.

Setting and Design:

Hospital-based prospective cohort study.

Methods and Material:

COPD cohort was diagnosed based on symptoms, history of exposure to risk factors and post bronchodilator FEV1/FVC ratio <70%. Post TB OAD cohort was diagnosed like COPD along with past history of Pulmonary TB. Both cohorts were followed up every 3-monthly intervals for up to 12 months.

Statistical Analysis:

Comparison of categorical variable was done by Chi-square test and continuous variable by unpaired t test. Longitudinal data of FEV1% were analyzed by repeated measure ANOVA test.

Results:

Totally, 68 patients with Post TB OAD and 66 COPD patients were taken into this study. The frequency of exacerbation (3.52 ± 1.84 verses 2.70 ± 1.37), number of severe exacerbation (56 verses 24) and frequency of hospitalization (1.37 ± 0.81 verses 0.97 ± 0.94) more seen in post-TB OAD cohort in compared to COPD cohort which is statistically significant. Mortality more seen in post-TB OAD group (14 verses 6). Rate of decline FEV1 per year more seen in Post-TB OAD (0.27 ± 0.28 lit verses 0.17 ± 0.26 liter) as compared to COPD. There was overall decreasing trend of FEV1% over period of 12 month but without any difference among two cohort.

Conclusion:

There was more in frequency of exacerbations, number of severe exacerbations, frequency of hospitalization and number of mortalities among post TB OAD compared to COPD.
Knowledge, attitude, and practice regarding child maltreatment among health care providers working in primary care centers in Riyadh, Saudi Arabia
Authors: Alkathiri Moath Abdulmohsen , Baraja Muneera Abdullah , Alaqeel Suliaman Mohammed
Published: October 2021

Objective:

The aim of the study was to assess the level of knowledge, attitudes, and current practice of primary healthcare physicians and nurses employed at the National Guard affiliated Primary Care Centers related to child abuse and neglect.

Method:

A cross-sectional study was conducted at four National Guard affiliated Primary Care Centers, Riyadh, Kingdom of Saudi Arabia, from May to September 2019. A total of 308 physicians and nurses participated in the study, using a convenience sampling technique. After obtaining informed consent, data was collected with a self-administered questionnaire.

Results:

The overall attitude score was excellent in 64.2% of the sample. The majority (90.3%) had an excellent knowledge score. The study indicated that the married group and participants with more than 10 years of experience were more aware of child maltreatment reporting procedures compared to the non-married group and less experienced participants. Almost two-thirds of the sample (67.2%) agreed that child abuse and neglect are underreported in Saudi Arabia. Lack of knowledge was the most frequent reason for underreporting.

Conclusion:

Our study highlighted that most of the primary care physicians and nurses at King Abdulaziz Medical City had excellent knowledge and positive attitudes related to child maltreatment. However, a major knowledge deficit exists in terms of the reporting procedures of suspected child maltreatment cases.
Cataract and Associated Factors Among OPD Attendees in a Teaching Institute of North East India
Authors: Das Rathindra , Sengupta Bitan , Debnath Arpita , Bhattacharjya Himadri
Published: October 2021

Background:

In India 66% of blindness among individuals aged 50 yrs and above is attributable to cataract. Cataract has multiple etiologies and many of them are modifiable. But data regarding burden and correlates of cataract among OPD attendees in Northeast India are insufficient.

Objectives:

To estimate the proportion of cataract among the attendees of ophthalmology OPD of a teaching hospital of Northeast India and to study the factors associated with it.

Methods:

This hospital based cross-sectional study was conducted during 7th February to 6th March 2020, using a pre-tested structured interview schedule, among 330 adults attending ophthalmology OPD of Agartala Government Medical College, chosen by consecutive sampling.

Result:

Proportion of cataract among the attendees was 36.7% and it was 51.5% among the subjects aged ≥50 years. Age, family type, literacy, diabetes mellitus and hypertension had significant associations with cataract (P < 0.05). Logistic regression model has identified age ≥ 50 yrs (OR: 5.57, 95% CI: 2.98-10.43) and illiteracy (OR: 2.67, 95% CI: 1.55-4.59) as the significant predictors for developing cataract (P < 0.05) in the study population.

Conclusion:

Proportion of cataract among OPD attendees is 36.7%, which is higher than the community prevalence of cataract in Tripura. Promoting literacy, reducing family size, blood sugar and blood pressure may bring down the proportion of cataract in this population.
Assessment of factors influencing the contribution of primary healthcare physicians in prevention of type 2 diabetes in South of Saudi Arabia
Authors: Gosadi Ibrahim M. , Daghriri Khaled A. , Majrashi Ali A. , Ghafiry Hassan S. , Moafa Ramiz J. , Ghazwani Majed A. , Bahari Alanoud Y. , Ajeebi Reham E. , Zurayyir Atyaf J. , Jarab Fahad K. , Bahri Ahmed A. , Ryani Majed A. , Salim Abdulrhman M.
Published: October 2021

Background:

This study was aiming to assess factors influencing the contribution of primary healthcare physicians concerning prevention of type 2 diabetes in the Jazan region, south of Saudi Arabia.

Materials and Methods:

A cross-sectional study was conducted to assess physicians' knowledge about evidence-based guidelines concerning diabetes prevention, their attitude towards lifestyle interventions and their practice concerning screening and provision of lifestyle interventions in their clinics. Interviews were conducted to complete a semi-structured questionnaire. Data analysis involved reviewing open-ended responses of physicians followed by quantitative analysis to assess level of knowledge, attitudes, and practice adherence.

Results:

A total of 234 physicians from 127 primary healthcare centres (PHCs) in the region were recruited. Knowledge of evidence-based clinical indicators for the prevention of diabetes was limited (mean level of knowledge 3.14/8 [SD: 1.2)]. Recruited physicians did have a positive overall attitude to the influence of lifestyle/behavioural therapy on the prevention of type 2 diabetes. The physicians narrated a variety of factors that might influence the effectiveness of this approach, which were related to the community, the patients and the physicians themselves. Only the association between gender of physicians and their levels of knowledge was statistically significant where odds of greater knowledge were higher among female physicians in comparison to males (odds ratio : 1.8, P value = 0.025).

Conclusion:

Most of the physicians in our sample were misinformed about the components of lifestyle/behavioural interventions for diabetes prevention, which mandates designing and implementing lifestyle medicine programmes for the PHC physicians in Jazan region.
Unilateral primary ovarian leiomyoma masqueraded as ovarian fibroma
Authors: Bharti Sushma , Khera Sudeep , Sharma Charu , Balakrishnan Arsha
Published: October 2021

Leiomyoma is the commonest benign mesenchymal tumor of the uterus, which can be developed at any site where smooth muscle cells are found. The broad ligament is the most common and ovary is one of the rarest extrauterine sites, accounting for 0.5–1% of all benign ovarian tumors. Herein, we report a case of ovarian leiomyoma in a perimenopausal female, clinically presented with heavy menstrual bleed, radiologically diagnosed as subserosal uterine fibroid. Intraoperatively, it was considered as ovarian fibroma but finally diagnosed as ovarian leiomyoma on histomorphology, which was confirmed on special stains and immunohistochemistry. A review of literature showed that less than 100 cases of primary ovarian leiomyomata have been reported until now. Ovarian leiomyoma is usually small, asymptomatic, and an incidental finding mostly, usually synchronously seen with uterine leiomyoma. Ovarian leiomyoma is a rare tumor, often misdiagnosed prior to surgical removal and it should be differentiated from other spindle cell neoplasm and solid tumors of the ovary.
Pediatric hypereosinophilia and toxoplasma
Authors: Banday Aaqib Z. , Bhattarai Dharmagat , Bhagat Naveen , Sreedharanunni Sreejesh , Khurana Sumeeta , Suri Deepti
Published: October 2021

Evaluation of pediatric hypereosinophilia (HE) is challenging, especially in the tropical developing countries, as appropriate diagnostic facilities may be lacking, parasitic/helminthic infections are common, and existing data on the etiology of severe eosinophilia are sparse. Second, data on long-term follow-up of these children including the temporal course of eosinophilia are also scarce. Besides, questions regarding the coexistence of multiple etiologies and their association with the severity of HE are largely unexplored. These challenges and questions often lead to diagnostic and therapeutic dilemmas. We highlight these difficulties utilizing a real-life clinical description. We emphasize the need for long-term follow-up of such children as HE may be the combinatorial effect of multiple etiologies, rather than a single cause. We also describe an unusual association of severe eosinophilia in a child with toxoplasmosis that was treated successfully with 8-week combination therapy with azithromycin and cotrimoxazole (sulfadiazine and pyrimethamine were not available).
Strategy to prevent infection from Covid-19 among security officers of tertiary care centre
Authors: Sharma Rakesh , Rohilla Kusum K. , Chadha Lisa , Malhotra Priyanka , Sharmila S , Jelly Prasuna
Published: October 2021

Background:

The extensive spread of Covid-19 pandemic globally became the main cause of concern for everyone, including security officers working in a health care setting.

Objective:

To assess the effectiveness of instructional module for Covid-19 prevention among hospital security officers.

Methods and Materials:

A preexperimental study was conducted at a tertiary care hospital from North India. A total of 344 security officers were selected by the convenient sampling technique. A self-structured knowledge and practice questionnaires and instructional module were developed based on the guidelines released by World Health Organization, Centre for Disease Control and Prevention and Ministry of Health and Family Welfare. Knowledge and practice were pretested, followed by the implementation of a video cum discussion instructional module for Covid-19 prevention. A posttest of knowledge and practice assessment was done after 7 days by using the same questionnaire. Descriptive and inferential statistics were used to compute and analyse the data.

Results:

The mean age of participants was 29.5 ± 2.25; mos participants (75%) were male security officers. Knowledge and practice scores improved after the implementation of instructional module as mean scores of pretest to mean posttest scores had shown a significant difference (P = 0.00). In practice, instructional module was significantly effective, except for touching hair again and again, as it could be a source of covid-19 infection.

Conclusion:

This study finding highlights the significance of training security officers about the prevention of Covid-19.
Cardiovascular complications in patients with interstitial lung disease and their correlation with 6-minute walk test and spirometry
Authors: Gupta Saurabh , Padhan Prasanta , Subhankar Saswat , Singh Pratima
Published: October 2021

Introduction:

Pulmonary hypertension and other cardiac complications occur frequently due to chronic hypoxia induced by interstitial lung diseases (ILD) or due to connective tissue disorder itself. Two-dimensional (2D) echocardiography is ideal for identifying abnormalities at a given time. In this study, we tried to detect cardiovascular complications in patients with ILD using 2D echocardiography and correlate them with a 6-minute walk test (6 MWT) and spirometry.

Materials and Methods:

This study was carried out for 18 months including 100 consecutive cases of ILD. The diagnosis was made using the latest criteria as per the disease and high-resolution computed tomography (HRCT) thorax. All patients were evaluated with 2D echocardiography, 6 MWT, and spirometry along with routine investigations. Their results were analyzed using STATA 15.1 software.

Result:

Cardiovascular involvement was detected in 68% of cases. Pulmonary hypertension predominated with a prevalence of 50%. In spirometry, mean Forced expiratory volume in first second (FEV1)and Forced vital capacity (FVC) were found to be 54.96 (L) and 53.49 (L), respectively, with a predominant restrictive pattern (89%). There was a significant correlation between baseline saturation of oxygen (SpO2) and pulmonary arterial systolic pressure (PASP) with a P value of <0.05. Baseline SpO2 and distance covered in 6 MWT had a significant correlation (P = 0.014).

Conclusion:

A baseline or nighttime hypoxia is responsible for developing PAH. Pulmonary arterial hypertension should be suspected in patients unable to perform 6 MWT or having low baseline SpO2. A routine follow-up with a 6 MWT and baseline SpO2 should be performed in each visit to identify early deterioration of the disease.
Geo-Mapping of Early Childhood Caries Risk
Authors: Pandey Pragya , Singh Manish K. , Singh Diksha , Gupta Sarika
Published: October 2021

Context:

Given the uneven distribution of dental caries, there is an exigent need for a database of dental caries and its spatial distribution for better planning and efficient delivery of health promotional and preventive programs. Geo-mapping is a helpful tool for policy makers/administrators for efficient allocation of limited resources.

Aims:

To geo-map spatial distribution of caries risk in preschoolers of Lucknow and to identify associated predisposing factors.

Settings and design:

A cross-sectional study was done among 1000 preschool children (3-5 years of age) attending pediatrics, outpatient department at a medical college in Lucknow, Uttar Pradesh.

Methods and Material:

Children were enrolled using the systematic random sampling. Each child was geo-coded with respect to his/her residence, clinically examined for dental caries and given a Decayed Missing Filled Tooth (DMFT) index score. A pre-tested questionnaire was used to collect socio-demographic data. Caries prevalence was geo-mapped using color codes.

Statistical Analysis Used:

Median DMFT scores were compared using Mann-Whitney and Kruskal-Wallis test. QQ plot/Shapiro-Wilk's test was used to check the normality of data.

Results:

Prevalence of caries was found to be 76%. 10% children had DMFT score of 4 and more. A significant difference in distribution of DMFT score was observed for gender, income levels and between wards. Wards closer to the center of Lucknow district had a higher prevalence of caries.

Conclusions:

Geo-mapping of caries prevalence gives a quick visual glance of specific areas vulnerable to caries and help deliver specific tailor-made services.
Cervicogenic dysphagia associated with cervical spondylosis
Authors: Chu Eric C. P. , Lee Linda Y. K.
Published: October 2021

Dysphagia (swallowing difficulty) is most often related to another health problems, including brain or spinal cord injury, neurological damage, neuromuscular disorders, and anatomical conditions. Dysphagia can have detrimental effects on pulmonary health and also impact nutritional intake. The right treatment depends on the cause established. Cervicogenic dysphagia is a cervical cause of difficulty in swallowing. This report describes a 53-year-old female patient with sore throat, swallowing difficulty for solids, and acid reflux for 2 years. Radiographs revealed anterior osteophytic lipping and kyphosis of the cervical spine and thoracolumbar (right convex) scoliosis. After 6 months of chiropractic treatment, her complaints and spinal deformity were obviously resolved. Our case report is unique in that the patient had an unusual presentation, i.e. cervical osteophytes, cervical kyphosis, and thoracolumbar scoliosis, which are all contributable causes of dysphagia. Correction of spinal deformity could result in positive treatment outcomes in selected patients with symptoms of cervicogenic dysphagia.
Students' Anxiety during the COVID-19 Pandemic in Saudi Arabia
Authors: AL-Shahrani Abdullah M.
Published: October 2021

The sudden outbreak of the COVID-19 pandemic prompted educational institutions to close down worldwide. This unprecedented step led to a feeling of anxiety in the student community that encountered obstacles in shifting to an online education mode. Saudi Arabia also followed these steps to minimize the loss of life, but simultaneously, the administration also assured people that they had nothing to fear as the country was prepared to support them in every way. The current study was accordingly commissioned between April 21, 2020, and May 20, 2020, to assess the impact of the new developments on the anxiety of 119 students from the College of Medicine, University of Bisha, Saudi Arabia, using an adapted Generalized Anxiety Disorder Scale - 7 (GAD-7). The findings showed that 46.22% of respondents had minimal anxiety, 26.89% had mild anxiety, 12.60% had moderate anxiety, and 14.29% had severe anxiety. The findings indicate that Saudi University students had minimal anxiety issues concomitant to the pandemic. The results also significantly show that students' anxiety or its absence was a factor of gender and the students' current level of education in the university.

Context:

The sudden outbreak of the COVID-19 pandemic prompted educational institutions to close down worldwide. This unprecedented step led to a feeling of anxiety in the student community that encountered obstacles in shifting to an online education mode. Saudi Arabia also followed these steps to minimize the loss of life, but simultaneously, the administration also assured people that they had nothing to fear as the country was prepared to support them in every way.

Aim:

To assess the impact of the new developments on the anxiety.

Settings and Design:

An exploratory cross-sectional study was conducted between April 21, 2020, and May 20, 2020 at the College of Medicine, University of Bisha, Saudi Arabia.

Methods and Material:

The students were asked to complete a self-administered questionnaire form, using an adapted GAD-7.

Results:

The findings showed that 46.22% of respondents had minimal anxiety, 26.89% had mild anxiety, 12.60% had moderate anxiety, and 14.29% had severe anxiety. The findings indicate that Saudi University students had minimal anxiety issues concomitant to the pandemic.
Assessment of diabetes-related distress among type 2 diabetic patients, Riyadh, Saudi Arabia
Authors: AlOtaibi Abdullah Aedh , Almesned Mohammed , Alahaideb Turki Mohammed , Almasari Saad Mohammed , Alsuwayt Saleh Saad
Published: October 2021

Objectives:

To assess the prevalence of diabetes-related distress (DRD) among Type 2 diabetics in the diabetic center of King Salman Hospital, Riyadh, Saudi Arabia.

Methods:

This was an observational descriptive study conducted between December 2019 and January 2020 among T2DM patients followed up at the diabetic clinics of the Diabetic Center of King Salman Hospital in Riyadh, Saudi Arabia. We used the 17-items Diabetes Distress Scale (DDS17) to measure DRD.

Results:

A total of 399 T2DM patients were included in the study, 58.4% were males. High distress was seen in 40 patients. Multivariate analysis showed that longer duration of diabetes (>15 years), female gender, longer intervals in-between visits (>6 months), and experience of episodes of severe hypoglycemia as the most significant factors related to higher levels of distress. The patients who were diabetics longer than 15 years had an increased risk for high distress by 3.6 times, infrequent clinic visits (longer than 6 months) increased the risk for high distress by 5.3 times×, and patients who experienced severe hypoglycemia had an increased risk for high distress by 5.8 times.

Conclusion:

This study showed a high (35.6%) prevalence of moderate to severe DRD. Long-standing diabetes, a longer interval of a clinic visit, and severe hypoglycemia increase the risk for DRD by 3.6, 5.3, and 5.8 folds. Health care providers should focus on reducing DRD and devise ways to increase self-care practices and coping skills.
Congenital heart disease
Authors: Jain Sunil
Published: October 2021

Pertinent perspectives for practical applications is advantageous professionalism. Congenital heart diseases (CHDs) are of varied types, severity, and complexity. Simple scientific approach along with sophistication is required for successful management at all levels. We gleaned important information from published evidence and authoritative resources and have put things in practical perspective. These include current prevention, care, correction, cure, and rehabilitation strategies for robust practices. Prospective prevention is with preconception counseling and addressing environmental factors. Fetal echocardiography and nondirective genetic counseling are important. Early detection and expert diligence is desirable. The suspicion is clinical. A number of clinical and investigative diagnostic modalities are available and should be utilized as guided by the clinical cues. Medical management includes general health maintenance, immunizations, monitoring, and complications treatment. Pediatric interventional cardiology is making rapid strides and treating many types of lesions. Understanding of procedure done is a prerequisite of follow-up care. Surgery is of curative, reparative, or palliative types. After surgical correction in early childhood long-term sequelae are rare. After reparative surgery some have life-long sequelae and some have significant late impairment. The number of postintervention/surgery survivors into adulthood is increasing. Microsurgical techniques are leading the way for precision and fewer complications. Follow-up care with “Ten Points Information and Action Plan (TP-IAP)” is suggested. The Armed Forces scenario involves frequent movements to difficult and harsh conditions. Special precautions for affected children needed. Cardiovascular health is enhanced by avoiding a sedentary lifestyle and obesity. Various intrinsic and extrinsic factors limiting functioning need to be suitably addressed.
Association of haematological biomarkers with severity of COVID-19 pneumonia
Authors: Kaeley Nidhi , Mahala Prakash , Walia Rohit , Subramanyam V. , Choudhary Suman , Shankar Takshak
Published: October 2021

Background:

Coronavirus disease 2019 (COVID-19) was first reported in Wuhan, China in December 2019. It is caused by SARS-CoV-2, a beta coronavirus. In this study, we assessed the association of biomarkers such as neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and lymphocyte monocyte ratio (LMR) with the severity of COVID-19 in patients.

Methods:

This retrospective observational study was carried out at a tertiary care hospital of the sub-Himalayan region of Uttarakhand over a period of six months from May to October 2020. A total of 350 patients with confirmed RT-PCR COVID-19 infection were included in the study. Detailed clinical, demographic and biochemical data of each patient was obtained from the hospital record section after permission from the Institute Ethical Committee. NLR, PLR and LMR ratios were calculated and compared with the outcomes in each patient. The patients were subdivided into two sub-groups: those with saturation less than 94% and those with saturation more than 94%. The patients were categorised as mild (with SpO2 of > 94%) and moderate-severe (with SpO2 of ≤94%) based on oxygen saturation.

Results:

A total of 350 patients with Covid-19 pneumonia were enrolled in the study. The mean age of the patients with oxygen saturation of ≤94% was 54.91 ± 13.29 years, which was comparable to the other group. Absolute neutrophil count (ANC) and NLR were significantly higher in patients with a saturation of < 94%. However, LMR and PLR were significantly lower in the group with saturation of <94%. Thus, a significant association was found between haematological inflammatory ratios and the severity of COVID-19 infection.

Conclusion:

NLR, LMR and PLR ratios can be utilised as point of care markers to assess severity in patients with COVID-19 pneumonia.
The association between social media use and depressive symptoms among adults in Riyadh, Saudi Arabia
Authors: AlHamad Noura Saud , AlAmri Khaled
Published: October 2021

Background:

Excessive use of social media sites and applications was reported to be associated with depressive symptoms. We determined the association between social media use and depressive symptoms among adults in Riyadh and correlated the results with other studies.

Methods:

A cross-sectional study was performed using a self-administered survey questionnaire distributed to participants aged 13 years old and above. The Patient Health Questionnaire 9 (PHQ-9) was used as a screening tool to measure depression. Positive and negative affective experiences were also assessed.

Results:

A total of 467 participants with a mean age of 27.0 ± 10.9 years were surveyed; 269 (57.6%) were males, and 198 (42.4%) were females. The mean of the total PHQ-9 score was 8.7 ± 5.8. There were 17 patients (3.6%) with no depression, 103 (22.1%) with minimal depression, 160 (34.3%) with mild depression, 113 (24.2%) with moderate depression, 47 (10.1%) with moderately severe depression, and 27 (5.8%) with severe depression. Females significantly had experienced moderate to severe depression compared to males (P = 0.040, OR = 1.48). One hundred eighty-seven respondents (40.0%) had moderate to severe depression on the three dimensions of social networking sites (SNSs) usage. The PHQ-9 score was positively significantly correlated with all three dimensions of the use of SNSs. The negative affective experiences ranked high among other affective experiences with depression, the highest mean of all the scales (5.8 ± 1.4). The positive affective experiences scored low, with contentment scoring the lowest (3.7 ± 1.9).

Conclusion:

A high percentage of moderate to severe depression and negative affective experiences, including anger and happiness, exists among individuals who excessively use and spend a lot more time using SNSs. A greater tendency toward depression occurs among females. Although the data from this study are self-reported, there is a need for health practitioners and family physicians to identify early signs of depression that warrants early intervention to address to mitigate and prevent the potentially harmful consequences that might happen in the future.
Response of the health system in Nipah outbreak in Ernakulam district
Authors: Menon Vishnu B. , George Leyanna Susan
Published: October 2021

Background:

Nipah is an emerging zoonotic disease that is transmitted through contaminated food or directly between people. Recently, Nipah virus infection was confirmed in Kochi, Kerala, making it the fourth outbreak reported in India. However, due to its good epidemic response, the health system of Kerala was able to control it in a timely manner.

Objective:

To qualitatively analyse the response of the health system of Kerala in controlling the Nipah outbreak (2019) by identifying the enabling factors and the challenges faced by it.

Methods:

A qualitative study was conducted using grounded theory approach. Key informant interviews were conducted till data saturation was reached. The audio recorded data was translated, transcribed and was manually coded and thematically analysed.

Results:

The major enablers for its apt response were identified to be effective communication, good line of control, effective division of work, intersectorial coordination, strong leadership, political commitment, resilient public private partnership and support groups, past experiences in disaster management, quick procurement of medicines and availability of lab facilities. On the other hand, the challenges identified were initial confusions, lack of standard operating procedures/guidelines for epidemic management, complacency, lack of effective zoonotic surveillance, media management and community participation.

Conclusion:

This study attributes the success of the outbreak response to the strong leadership and political commitment. In order to prevent recurrences in the future, there is a need to build a resilient health system through capacity building and further strengthening of the surveillance system.
Comparison of demographic, clinical, spirometry, and radiological parameters between smoking and non-smoking COPD patients in rural Gujarat, India
Authors: Shah Dhruv M. , Kshatriya Ravish M. , Paliwal Rajiv
Published: October 2021

Context:

A total of 20% of Chronic Obstructive Pulmonary Disease(COPD) patients are non-smokers due to preventable causes, such as biomass fuel exposure, post tuberculous sequelae, occupational exposure, air pollution, persistent chronic asthma, and genetic predisposition.

Aims:

To compare smokers and non-smokers with COPD.

Settings and Design:

An observational study was conducted at a tertiary care hospital on 60 patients diagnosed with COPD, (GOLD criteria), who were divided into smoker and non-smoker groups.

Subjects and Methods:

Demographic data, clinical profile, smoking history, and radiological data were collected and compared. Exclusion criteria were individuals having active pulmonary tuberculosis and reversible air flow limitations.

Statistical Analysis Used:

Using STATA 14.2, quantitative and qualitative data were presented using descriptive statistics.

Results:

A total of 100% of smokers were male, whereas 70% of non-smokers were female. Compared to non-smokers (16.67%), smokers (26.6%) presented with higher grade of dyspnea. A statistically significant difference was seen with more smokers diagnosed as severe (40%) and very severe (30%) COPD compared to non-smokers with mild (16.67%) and moderate (46.67%) COPD (P < 0.012), Post bronchodilator FEV1 among smokers (42.63) compared to non-smokers (56.63) (P < 0.01) and decrease in FEV1 as the grade of dyspnea increased (P < 0.002). Compared to 36.67% in non-smokers, 70% smokers showed emphysematous x-rays.

Conclusions:

In our study we found majority of non-smokers to be female, and smokers had a higher grade of dyspnea, more severe COPD, lower post bronchodilator FEV1, and more emphysematous changes on x-rays.