bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of pandemic on Quality of life in Diabetics (QOLID) assessment
Authors: Meher Dayanidhi , Kar Sonali
Published: November 2021

Background:

Quality of life in Diabetics (QOLID) questionnaire is a validated tool to assess the quality of life affected by diagnosed diabetic patients and has 8 sub domains, which are essential factors that have proven effect on the management. In a state of art Diabetic clinic in Bhubaneswar city, the tool was used to add more quality to diabetic management.

Methods:

The ongoing assessment through the months of 2020 (study period being from December 2019 to August 2020), offered an opportunity to assess the effect of the pandemic on QOLID scores and review some nascent or strong factors which may be affecting chronic disease management.

Results:

Complete data could be collected from 599 subjects, 343 from pre pandemic and 256 from pandemic period. The overall scores which were on 100, did not show any significant difference for pre covid and the Covid period, interestingly nearly 1.93 points better in Covid period (69.69±11.10 vs71.62±8.49; p=0.396). Mild difference in overall scores of 4.82 points is seen in females in Covid period; and as seen in age group data maximum gain in sub domains, more for females is seen in the emotional and mental health. Though women reporting to the clinic in both periods are usually in 1:2 ratios, as against men; but QOLID scores in both men and women in Covid period was 71 to 80 points. After the univariate analysis for significant factors, it was that Covid (1.50; 1.08 - 2.07); compliance to medications (2.27; 1.48 - 3.50) and reporting of all diabetic complications especially that of eye and depression are coming out to be strong associative factors to affect QOLID scores. Interestingly, rising education has a protective effect on QOLID scores that was significant as higher awareness and better job or earning opportunities may be a contributor for higher QOLID scores for the well educated.

Conclusion:

This brings out a strong emphasis on QOL assessments to be made an inbuilt part of Diabetic management at all centers to maximize treatment outcomes
The impact of critical thinking training using critical thinking cards on clinical decision-making of CCU nurses
Authors: Jalalpour Hamideh , Jahani Simin , Asadizaker Marziyeh , Sharhani Asaad , Heybar Habib
Published: November 2021

Introduction:

Due to the complexity of the situation and rapid changes in patients’ clinical status in intensive care units, it is necessary to teach decision-making skills to nurses, alongside critical thinking. The aim of this study was to evaluate critical thinking training by using critical thinking cards on clinical decision-making of nurses in cardiac care units (CCU).

Methods:

In this quasi-experimental study, 74 CCU nurses from the selected hospitals affiliated to Ahvaz and Dezful Universities of Medical Sciences were selected based on the inclusion criteria and were assigned to either the intervention or the control group by using permuted block randomization. The data were entered into SPSS V22 and analyzed.

Results:

There was no statistically significant difference between the demographic characteristics of the two groups (P < 0.05). The mean total score of nurses’ clinical decision-making before training sessions in the intervention group was calculated to be 141.59 ± 10.76, which was lower compared to a score of 148.56 ± 10.95 in the control group (P = 0.011). Therefore, covariance analysis was used to modify the results. The mean total score of nurses’ clinical decision-making after the training in the intervention group was calculated as 163.82 ± 8.83, indicating a significant increase compared to a score of 154.50 ± 11.25 in the control group (P < 0.001).

Conclusion:

The findings of the present study show that the education of critical thinking by using the critical card tool leads to improved clinical decision-making in CCU nurses.
A cross-sectional survey of knowledge, attitude, and practices toward dengue fever among health workers in a tertiary health institution in Sokoto state, Nigeria
Authors: Oche Oche Mansur , Yahaya Musa , Oladigbolu Remi Abiola , Ango Jessica Timane , Okafoagu Christina Nneka , Ezenwoko Zainab , Ijapa Adamu , Danmadami Abdulaziz Muhammad
Published: November 2021

Introduction:

Dengue fever (DF) has become a disease of public health concern. It is a mosquito-borne virus infection caused by one of the four serotypes of the dengue virus, and the disease is prevalent in the tropical and subtropical regions of the world, with a global burden in the Americas. Yearly, about 390 million cases of new infection are estimated to occur.

Aims of the Study:

This study was aimed atdetermining the knowledge, attitude and practices regarding dengue fever amongst health workers in a tertiary health institution in Sokoto state , Nigeria.

Methods:

A descriptive cross-sectional study was carried out at the Usmanu Danfodiyo University Teaching Hospital, Sokoto, among 367 health-care workers who had worked in the hospital for at least 1 year before the study were selected using a systematic sampling method. Data were collected by trained resident doctors using a standardized, pretested questionnaire and analyzed using SPSS version 20 with a significance set at P > 0.05.

Results:

There was high awareness (95.1%) among the respondents, with seminars and lectures in school as the most familiar information sources. A more significant proportion, 87.8%, 93.2%, and 76.6%, of the respondents had adequate knowledge, positive attitude, and appropriate DF practice, respectively. Nurses and laboratory scientists had higher practice scores compared to other health-care workers (P = 0.016).

Conclusion:

Capacity building of health-care workers, especially the primary care physicians on surveillance, proper diagnosis, and treatment, is needed to avoid missing cases or misdiagnosis of cases, especially in developing and underdeveloped countries with limited health resources care service delivery.
Assessment of under nutrition among under 5 tribal children in a rural area in West Bengal
Authors: Chandra Archi , Chakrabarti Soma , Mallik Sarmila , Bhattacharyya Nabanita
Published: November 2021

Tribal population is socio economically disadvantaged group. Knowledge about nutritional status of various tribal populations is important because it impels to identify under nutrition which is a leading cause of morbidity and mortality. This study is conducted to assess under nutrition among under 5 tribal children. In this cross sectional study with a sample of 68 under 5 tribal children selected through complete enumeration fulfilling the inclusion criteria after obtaining ethical clearance from Institutional Ethics Committee. Anthropometric measurements were recorded to determine types of under nutrition prevailing among them using World Health Organization Anthro software. 24 h recall of dietary history of children was taken for 7 days to assess mean energy, protein, and fat intake per day and compared with recommended daily allowances. A total of 30.8% children were stunted, 30.8% were wasted, and 14.7% were both stunted and wasted. The consumption of energy, protein, and fat was much low. Chi square test showed a significant association of under nutrition with gender, education of father, type of family, socio economic status, and birth order but binary logistic regression showed significant association only with socioeconomic status. Under nutrition in form of stunting and wasting and low dietary intake of energy, protein, fat was found among these children. Multi sectoral approach is suggested.
Male systemic lupus erythematosus
Authors: Akhil Sugandhi , Sharma K. Sai Kanth , Kumar Dharmender
Published: November 2021

Systemic lupus erythematosus (SLE) multisystem autoimmune disease is characterised by a series of exacerbations and remissions. Tissues of multiple-organ systems are affected by autoantibodies. We report here two cases of SLE in male patients. Being rarer in males, diagnosis is often delayed and associated with poorer outcomes. An alert primary care physician can be instrumental in early diagnosis and ensuring better outcomes.
Newer variants of COVID-19, newer challenges of whole-genome strategy in India
Authors: Laskar Ananya Ray , Garg Suneela , Kumar Raman , Yadav Kartikey , Gopal K. Madan
Published: November 2021

The sudden upsurge in the newly emerging COVID-19 variants acted as a catalyst for India to scale up the viral Genomic surveillance in order to understand the nature and trends of the newer variants of concern and strengthen public health interventions across the country. The Government of India has proposed the Indian SARS-CoV-2 Genomics Consortium to expand the whole-genome sequencing (WGS) of this virus. However, in a vast country like India introduction and implementation of any new strategies amidst the already existing barriers due to COVID-19 will be a herculean task. This paper talks about how the primary care physicians can play a vital role in successful implementation of the above strategy in addition to the surveillance systems in India.
Parental perception of oral health-related quality of life in children with autism. An observational study
Authors: Prakash Jayant , Das Indrani , Bindal Ruchi , Shivu ME , Sidhu Sandeep , Kak Vasudha , Kumar Avanindra
Published: November 2021

Background:

Autism is reportedly the most severe neuropsychiatric disorder affecting children. Autistic subjects can be characterized by impairments in social interactive behavior along with restricted interests and quite frequently, are seen exhibiting repetitive behavior patterns in stereotyped manner. The inability to perform routine tasks can widely impact the oral health and also, the constant care and sense of helplessness might drastically affect quality of life.

Aim:

The aim of the study was to assess the oral health status and perceptions regarding an autistic child’s oral health among parents.

Materials and Methods:

Parental perception regarding the quality of life among the afflicted autistic children was done using a self-assessment questionnaire that included eight questions which were replied to in an affirmation or negative answer. 300 parents of autism affected children formed the study participants. Recorded responses were evaluated and percentage of each response was derived. Oral health status was measured by determination of dental caries prevalence and OHI-S index using chair light illumination, mouth mirror, diagnostic probe and a standard WHO periodontal probe. For statistical analysis, the calculations were performed by using the paired t test. Statistical significance, which was fixed at P < 0.05, which is statistically significant.

Results:

Approximately 18.33% of parents showed were aware that oral health can influence general health; 15% did have exhibit awareness. 15% of parents did not consider that primary teeth were important; 59.1% visited any dentist only when suffering from pain; 5% went for an annual dental examination; 15% and 24.6% parents visited dental practitioners at intervals of 3 and 6 months, respectively. 30%, 25% and 51.66% parents considered obtaining consultation and getting treatment from pediatric dentist; general dentist and general physician. 41.6% parents had taken their children for restorations. 52% reported constant stress whereas 48% reported with constant distressed emotions. No significant difference was determined between the parameters. 75% of autistic children suffered from dental caries whereas oral hygiene scores demonstrated high mean value of 4.

Conclusion:

Autism is a severely distressing condition wherein oral health along with general physical health is affected. Since parents are directly involved in upbringing of these individuals, they also subsequently show a reduction in quality of life.
Association of psychosocial factors with aggression among school going rural adolescents in Haryana
Authors: Verma Ramesh , Kumar Gopal , Yadav Rohtas Kanwar , Chayal Vinod , Kalhan Meenakshi , Bhalla Kapil , Dhaka Rohit , Agrawal Ginni , Sachdeva Aman , Satija Jitesh , Pankaj  , Sagar Vidya
Published: November 2021

Background:

Adolescents are being involved in aggressive activities nowadays. Sometimes, involvement in aggressive activities may be fatal for the victim as well as for the doer. It is a matter of great concern for all including parents, teachers, psychologists, social reformers, and others. A momentary expression of anger sometimes may spoil the future life of the adolescents.

Aim and Objectives:

To determine the prevalence of aggression and to identify the psychosocial risk factors associated with aggression among school-going adolescents

Methodology:

The study recruited 480 school-going rural adolescents from eight government senior secondary schools in the rural block of Beri, district Jhajjar (Haryana).

Observations:

The mean age of the adolescents was 14.11 ± 1.12 years; 49.4% of the adolescents were found to be aggressive. After applying binary logistic regression, there was a statistically significant relation between aggression and determinants like class, gender, occupation of the father.

Conclusion and Recommendations:

The study concluded that determinants like age, class of students, gender of the subject, occupation of father found a significant association with aggression. To solve this current situation, parents must give love, attention to their children and must act in an appropriate way in front of them and be role models.
Public awareness of early symptoms of acute myocardial infarction among Saudi population
Authors: Basham Karam , Aldubaikhi Ahmed , Sulaiman Ihab , Alhaider Abdullah , Alrasheed Ahmed , Bahanan Fahad , Masuadi Emad , Alsaif Abdulmalik
Published: November 2021

Introduction:

Globally speaking, cardiovascular disease is the leading cause of mortality, with coronary artery disease (CAD) contributing to half of the cases. A major complication of CAD is myocardial infarction (MI). The clinical outcomes of MI are predominantly time-dependent; therefore, it is paramount that the general public is familiar with the early symptoms of MI.

Aim:

The main objective is to gauge the local public awareness of the early symptoms of MI, and their knowledge of the best course of action to be taken from the onset of symptoms.

Method:

A cross-sectional study was conducted using google forms. Participants were randomly selected through multiple social media platforms. The study included Saudi citizens who were 18 years or older, with no current or prior experience in the health care field. The questionnaire assessed the participants’ awareness of 14 risk factors for CAD. The variables investigated were participants’ knowledge of the symptoms, causes, appropriate course of action to be taken, and the risk factors of CAD.

Results:

A total of 1689 participants were involved in this study. Sixty percent were females, and 29.2% were in the age group of 18–24 years. Seventy-three percent of the participants knew the definition of heart attack, and 90% knew that chest pain is a symptom of a heart attack. Approximately, 75% of the participants recognized that hypertension, cigarette smoking, and high cholesterol are the risk factors of MI. In terms of knowledge, Al Madinah province obtained the highest score when compared with other regions.

Conclusion:

This study showed the overall knowledge and awareness of CAD was suboptimal, indicating that awareness initiatives and patient education of CAD need more work in Saudi Arabia, especially in high-risk groups and lower education groups. More studies are needed to identify the efficiency and population access of different approaches for CAD awareness.
Systems E-approach for women at risk (SEWA)—A digital health solution for detection of high-risk pregnancies
Authors: Gupta Anil , Agrawal Ritu , Gupt Anadi , Guleri Rajesh , Bajpayee Devina , Joshi Naresh , Sarin Enisha , Gupta Sachin , Kumar Harish
Published: November 2021

Background:

High-risk pregnancy (HRP) puts current pregnancy at an increased risk of complications. In the absence of pre-existing HRP implementation model of the country, in collaboration with the Government of Himachal Pradesh, a new digital HRP model called the ‘SEWA—A System E-approach for Women at risk’ was developed. The current article demonstrates a model for the early identification and line listing of high-risk pregnant women (PW) with appropriate referrals and increased engagement with the healthcare workers using a digital tool in the form of the Android App.

Methods:

SEWA was implemented as a pilot intervention in two community development blocks of the Chamba district. The key implementation steps included finalizing protocols for the identification of HRPs, defining processes and roles, mapping health facilities, setting up the communication loop, and developing of digital solutions. The digital app, used by the auxiliary nurse midwife (ANM) and program officers, tracked PW for a year from October 19 to October 20 and recorded the ANC visits, referrals, and birth outcomes. A qualitative assessment was conducted among the health workers to find out their level of acceptance.

Results:

A total of 1,340 high-risk PW were identified. The intervention year saw a rise in the identification of HRP to 27.9% from 3.5% in the previous year. A total of 2,559 conditions were tagged to the identified 1,340 women categorized into current pregnancy (81%), previous pregnancy (16%), and any existing chronic illness (3%). A majority of the women who required urgent referrals were provided referrals. The application recorded 53% of the delivered HRP with a digital birth preparedness plan, prepared and shared with the PW and Accredited Social Health Activists (ASHA), by text message for compliance.

Conclusion:

The SEWA application is a feasible and sustainable solution to complement the competency of the care providers for early identification of the high-risk conditions and reduce the burden of preventable unprecedented deaths around the time of birth.
A study on knowledge, attitude and practices towards the COVID-19 pandemic among the non-COVID-19 patients at Outpatient Department in a Teaching Hospital, Northern Sri Lanka
Authors: P. W. Hathurusinghe H. M. , Suganthan Navaneethakrishnan , Sujanitha Vathulan , Rajeshkannan Nadarajah
Published: November 2021

Background:

Severe Acute Respiratory Syndrome Coronavirus -2 (SARS-CoV-2) has infected millions of people all over the world and Sri Lanka is not an exception for the impact of Coronavirus Disease (COVID-19). As there are no effective therapeutic agents at present and newly developed vaccines are not freely available for many countries, preventive measures such as handwashing, social distancing, and respiratory etiquette are key to control of spread. The effective implementation of these measures depends on public knowledge and attitude towards COVID-19 and adherence to key practices.

Methods:

This is a cross-sectional study conducted among 500 non-COVID-19 patients who attended the Outpatient Department (OPD) of the Teaching Hospital Jaffna, Sri Lanka. Knowledge, attitude and practices (KAP) was assessed through a self-administered questionnaire and analysis was performed by using SPSS 26.

Results:

The majority were females (67.8%) and the mean age of the participants was 36.9 (range: 15–85). Most of the participants were homemakers. Two hundred and twenty-two patients (44.4%: 40.1–48.8) showed a suboptimal knowledge score regarding COVID-19. The males, age above 65, were significantly associated with low knowledge score (P < 0.05). Similarly, a significant proportion (36.4%: 32.3–40.7) showed a suboptimal attitude score but the majority of the participants have adopted positive behaviours such as frequently washing hands (88.4%) and wearing masks in appropriate places (91.6%). The major sources for information regarding COVID-19 among the participants were the news media (54.0%) followed by social media (23.2%).

Conclusion:

As a significant proportion of the participants showed a poor knowledge score and gaps in specific aspects related to COVID-19, the primary care physicians have a significant role to play to improve community knowledge by educating specific groups such as the males and elderly by using appropriate news media and social media platforms.
Childhood obesity and its relation with dietary habits among children in Aseer region, Southern Saudi Arabia
Authors: M. Mustafa Alam Eldin , A. Assery Abeer Ayed , A. Asiri Fatimah Mohammed , Alfarhan Nojoud M. , Alqarni Afnan M. , S. Alqahtani Fatimah Muslih
Published: November 2021

Background:

The rate of obesity in children is rising and it has become a growing epidemic worldwide; Childhood obesity is related to the high risk of obesity later in adult life. In the last 30 years the prevalence childhood obesity more than tripled. Overweight in paediatric population is suggested to be related to many cardio-metabolic risk factors such as metabolic syndrome, type 2 diabetes, hypertension, insulin resistance. Metabolic syndrome and dyslipidaemia and 70% obese children had first cardiovascular disease risk factor and 30% had second or more.

Aim:

To estimate the prevalence and correlates of obesity among children in Aseer region.

Methodology:

A descriptive cross-sectional survey was conducted in the schools of Abha and Khamis Mushayet Cities; Aseer region during the period from January to December 2019. The respondents were any of the parents of the child. After having permission from the school authority, self-administered questionnaires were distributed to a total of 300 children, with explanations about the questionnaire by the principal investigator and class teacher.

Results:

The study included 300 students with ages that ranged from 1 year up to 17 years and mean age was 8.6 years old. Exact of 55.3% of the students were males and 32% were at preschool age while 43.7% were at the primary level of education. Students’ body mass index (BMI) distribution demonstrated that more than half of the children had overweight or obesity and 16.7% were with underweight. There was a significant relation between obesity among the children and some of their dietary habits including sweets, chocolate and fast food.

Conclusions and Recommendations:

In conclusion, the study revealed that nearly one-third of the children in the study group were overweight or obese with obesity more prevalent. Obesity was more recorded among old-aged children who frequently had unhealthy food. Improving the children lifestyle and dietary habits is mandatory to work against weight gain.
The outlook of doctors toward telemedicine
Authors: Singh Alok , Sahoo Ajaya K. , Dhaneria Suryaprakash , Gupta Dhyuti
Published: November 2021

Background:

In an underdeveloped country like India where there are varied constraints in accessing healthcare, telemedicine can prove to be instrumental in providing access to the scant medical resources and infrastructures. The irony lies in its underutilization, which is multifactorial.

Objective:

The present research was planned to evaluate the level of awareness, knowledge, and attitude toward telemedicine among the faculty members of tertiary-care teaching centers in Chhattisgarh, India.

Methods:

A questionnaire-based survey was conducted to collect appropriate data, which were utilized for analysis as well as various intergroup analyses (among different designations, age groups, sex, and worksite). The data have been presented as median and percentage, while for intergroup comparison Mann-Whitney Test was performed.

Results:

Among the 115 respondents, only 34% were females. The mean age was around 40.7 years, and 58% were <40 years of age. Their median scores of awareness, knowledge, and attitude were estimated to be 06, 14, and +9, respectively. No statistically significant difference was observed in the awareness, knowledge, and attitude among the faculty members belonging to different designations, age groups, and worksites.

Conclusions:

Though, in general, the faculty members have demonstrated a favorable attitude toward the use of telemedicine yet most of them scored below the median mark. Furthermore, the estimated level of knowledge and awareness was also mediocre.
Prevalence and knowledge of hepatitis B infection in pregnant women in a primary health center of Patna district, Bihar
Authors: Pandey Sanjay , Lohani Pallavi , Roy Ria , Bhar Ditipriya , Ranjan Alok , Kumar Pragya , Singh C. M.
Published: November 2021

Introduction:

There is a risk of chronic hepatitis B virus (HBV) infection to the newborn through perinatal transmission from a hepatitis B surface antigen (HBsAg) positive mother that can later cause liver cirrhosis or hepatocellular carcinoma. This study was undertaken in a primary health center (PHC) in the Patna district to determine the prevalence of HBV among pregnant women and assess their knowledge across different characteristics.

Methodology:

A cross-sectional study was done among 275 pregnant women attending the PHC for the first time, using consecutive sampling. The study duration was 12 months. Socioeconomic, obstetric, risk history, and levels of knowledge about hepatitis B were collected followed by rapid diagnostic test (RDT) for serum HBsAg. Univariate analysis was used to compare the knowledge levels across different background characteristics. The significance was set at P < 0.05.

Results:

Hepatitis B-positive pregnant women were 0.4%. Out of the 275 participants, only 43 had heard about hepatitis B. The mean knowledge score was 0.65 (±1.73) with 1.45% having adequate knowledge. The knowledge score was significant across education (P 0.040), category (P 0.022), hepatitis B immunization status (P 0.003), and risk factor (P 0.039).

Conclusion:

Knowledge was higher in the literate women belonging to the general category and higher social class, who received hepatitis B vaccination. However, the overall level of knowledge among the pregnant women was very poor, so they should be targeted for quality health education. Additionally, identifying the afflicted pregnant women through point-of-contact diagnosis will aid in community prevention of chronic hepatitis B.
Clinical features and outcome of COVID-19 among PLHIV in Gujarat, India
Authors: Patel Parimal , Amin Bipin , Mehta Kedar G. , Gopal Rajesh , Raval Devang A. , Kadri A.M. , Makadia Khushbu
Published: November 2021

Information on people living with HIV (PLHIV) and current COVID-19 pandemic is still scarce in Indian setting. This case series of PLHIV with COVID-19 describes clinical characteristics and outcome in this special group of patients. This case series included 11 confirmed cases of COVID-19 among PLHIV admitted at a tertiary care hospital in Gujarat, India during April–December 2020. This retrospective study was conducted by doing secondary data analysis from case records of patients for various variables including demographic, clinical characteristics, HIV-related parameters, and outcome (discharged/death). The mean age of patients was 39.2 years ranging from 20 to 55 years. Nearly, 18% (2/11) of patients had major comorbidities like diabetes and hypertension. All were taking antiretroviral therapy drugs with >95% drug adherence and had CD4 count ranging from 79/cu.mm. to 1189/cu.mm. Majority (91%) of patients recovered and were discharged while only one patient (9%) died during course of COVID-19 treatment. COVID-19 showed a similar clinical and epidemiological profile among PLHIV like other group of people. Further studies with large-sample size are recommended to find risks of COVID-19 among PLHIV and its impact on treatment outcomes.
Clinical and epidemiological characteristics of road traffic accidents patients received at 2 intensive care units in Saudi Arabia—A cross-sectional study
Authors: AbdelRazik Mohamed , Alquwaiz Ibrahim Abdulrahman , Khojah Abdulaziz Abdulrahman , Alshahrani Abdullah Yahya , Aldakkan Osamah Zeid , Alhumaydani Naif Khalid , Alqahtani Faisal Turki
Published: November 2021

Background:

Road traffic accidents (RTAs) lead to major trauma, which is the greatest cause of morbidity and mortality worldwide. The purpose of the study was to determine the clinical epidemiological profiles of the patients received in intensive care units (ICU) with road traffic injuries (RTIs).

Methods:

The study, which included 300 patients, was conducted at emergency departments and two reference ICUs in Saudi Arabia. The patients were of varying ages and genders from different demographic backgrounds with different modes of injuries, varying degrees of shock, and multiple types of injury. Study variables included demographics, clinical presentations, and the types of fractures and lacerations.

Results:

Most of our study population was male (n = 273; 91%). Car accidents were found to be the prevalent cause of injury (n = 267; 89.0% cases). Only 21.7% of the study population (n = 65) needed ICU admission compared to non-ICU patients (n = 235; 78.3%). Injuries to the chest (P = 0.0001), abdomen (P = 0.0001), upper limbs (P = 0.022), and spine (P = 0.001) significantly contributed to ICU admissions.

Conclusion:

The burden on ICUs due to RTIs can be reduced in Saudi Arabia by adopting strict preventive measures against RTAs.
Comparative Evaluation of Clinical, Cytological and Microbiological Profile in Abdominal vs. Cervical Lymph Nodal Tuberculosis with Special Emphasis on Utility of Auramine-O Staining
Authors: Gulati Harveen K. , Mawlong Michael , Agarwal Arushi , Ranee Karen R.
Published: November 2021

Context:

Extrapulmonary tuberculosis (EPTB) especially abdominal lymph nodal tuberculosis (LNTB) poses a unique diagnostic challenge. The clinical, cytological, and microbiological profiles, especially with respect to the use and role of Auramine –O (AO) stain, are not as well characterized in abdominal LNTB as cervical LNTB and were evaluated in the present comparative study.

Subjects and Methods:

This study was conducted in the Department of Pathology of a tertiary care hospital in Shillong, Meghalaya in 540 clinical suspected cases of tuberculosis who underwent FNAC. The smears were submitted for Leishman's stain for cytological analysis, along with ZN and Auramine O stain for demonstration of the organism, analyzed, and scored and the results were compared with culture wherever available. The results from abdominal and cervical lymph nodal tuberculosis were compared using Microsoft Excel and SPSS software.

Results:

Out of 540 cases, most were tuberculosis (266) followed by reactive lymphadenitis (162), malignancy, and acute necrotizing lesion. On comparing, abdominal lymph nodes (n = 163) were more likely to reveal cheesy/purulent material macroscopically, necrotizing lymphadenitis along with ZN stain and Auramine positivity (P < 0.05) while cervical lymph nodes (n = 66) revealed a higher proportion of granulomatous lymphadenitis and culture positivity (P < 0.05). The sensitivity, NPV, and diagnostic accuracy of AO stain (85.9%, 48.0%, and 62.3%) were higher as compared to ZN stain (47.4%, 39.3%, and 51.9%) with culture as the gold standard. The combined sensitivity of Ziehl Neelsen stain and Auramine stain was 92.05%.

Conclusion:

Cytological and microbiologic features of abdominal LNTB differ from cervical LNTB. Moreover, AO stain increases the smear positivity, is almost twice as sensitive as ZN stain and should be used as an adjunct in cytological material wherever available.
Fulminant myocarditis, severe pediatric acute respiratory distress syndrome associated with H1N1 influenza and enteric fever rescued by prone ventilation
Authors: Goswami Goutam , Sharma Pradeep Kumar , Vinayak Nikhil
Published: November 2021

H1N1 influenza-associated fulminant myocarditis with pediatric acute respiratory distress syndrome (PARDS) is rare. We report a child of fulminant myocarditis, severe PARDS associated with H1N1 and enteric fever. She rapidly developed severe PARDS and refractory hypoxemia. She was successfully rescued with prone ventilation. Fulminant myocarditis with PARDS can be a manifestation of H1N1 infection. These scenarios pose a tough challenge, especially in resource-limited settings. Although we successfully managed our patient with prone ventilation, success in one case cannot be generalized until more evidence is generated.
Stevens–Johnson syndrome complicated by pneumomediastinum and cerebral venous sinus thrombosis in a 10-year-old girl
Authors: Jain Pawan , Singh Rakesh , Jain Shriyanka , Saxena Ankur , Verma Ujjwala , Bhojasiya Vikash K
Published: November 2021

Stevens–Johnson syndrome (SJS) is a life-threatening condition with severe mucocutaneous reaction in response to an offending medication. We report a case of SJS complicated with pneumomediastinum and cerebral sinus venous thrombosis in a girl. These two complications occurring simultaneously in a pediatric patient with SJS are hitherto unreported. Laboratory workup pointed underlying connective tissue disease in her. She received supportive care along with steroids, antimicrobials, and anticoagulant under supervision of a multidisciplinary team. She recovered well at discharge and is on follow-up. Clinical vigilance identifies rare but important complications of SJS early, mitigating severe morbidity and mortality.
Multiple opportunistic infection-associated hemophagocytic lymphohistiocytosis in nephrotic syndrome
Authors: Varadaraju Sireesh , Khandelwal Priyanka , Sankar Jhuma , Hari Pankaj
Published: November 2021

Multiple opportunistic coinfections during corticosteroid therapy for the nephrotic syndrome are uncommon. Infection-associated hemophagocytic lymphohistiocytosis (HLH) is a rare and potentially fatal multisystem disorder, manifesting as a state of hypercytokinemia in response to an infectious trigger. We describe a 4½-year-old boy with steroid-dependent nephrotic syndrome receiving high-dose steroids, who developed respiratory failure due to pulmonary tuberculosis, Cytomegalovirus, and Pneumocystis jirovecii coinfections; HLH complicated the course. Aggressive management of the underlying infections with antitubercular, antiviral, and antifungal therapy, prompt recognition of HLH, and immunomodulation with intravenous (IV) immunoglobulin and IV methylprednisolone enabled convalescence. This report emphasizes the serious risks of immunosuppression and the need for strict vigilance for rare opportunistic infections with multiple pathogens in patients receiving oral steroids for nephrotic syndrome. Clinical distinctions between severe sepsis and HLH may be ambiguous; a high level of suspicion is required for timely recognition and management.
Acute carbamazepine toxicity in a child
Authors: Randhawa Manjinder S , Sharma Prateek , Angurana Suresh Kumar , Bansal Arun
Published: November 2021

Carbamazepine is a commonly prescribed antiepileptic drug with a potential to cause fatal toxicity in acute overdose in children. Symptoms of acute toxicity include central nervous system depression, seizures, anticholinergic toxidrome, and arrhythmias. We report a 5 year old male child with accidental carbamazepine toxicity treated sussessfully with good suppotrive management. Intestinal decontamination therapies may be beneficial if used at the appropriate time. Multidose activated charcoal may be used if multiple controlled release tablets are ingested. Extracorporeal therapies for drug removal may be required in life-threatening toxicity to reduce plasma drug levels and hasten recovery. Appropriate and timely management leads to excellent neurological outcome.
The Value of the Illness-Death Model for Predicting Outcomes in Patients with Non–Small Cell Lung Cancer
Authors: Chae Kum Ju , Choi Hyemi , Jeong Won Gi , Kim Jinheum
Published: November 2021

Purpose The illness-death model (IDM) is a comprehensive approach to evaluate the relationship between relapse and death. This study aimed to illustrate the value of the IDM for identifying risk factors and evaluating predictive probabilities for relapse and death in patients with non–small cell lung cancer (NSCLC) in comparison with the disease-free survival (DFS) model.Materials and Methods We retrospectively analyzed 612 NSCLC patients who underwent a curative operation. Using the IDM, the risk factors and predictive probabilities for relapse, death without relapse, and death after relapse were simultaneously evaluated and compared to those obtained from a DFS model.Results The IDM provided more detailed risk factors according to the patient’s disease course, including relapse, death without relapse, and death after relapse, in patients with resected lung cancer. In the IDM, history of malignancy (other than lung cancer) was related to relapse and smoking history was associated with death without relapse; both were indistinguishable in the DFS model. In addition, the IDM was able to evaluate the predictive probability and risk factors for death after relapse; this information could not be obtained from the DFS model.Conclusion Compared to the DFS model, we found that the IDM provides more comprehensive information on transitions between states and disease stages and provides deeper insights with respect to understanding the disease process among lung cancer patients.
The coarse geometric $\ell^p$-Novikov conjecture for subspaces of nonpositively curved manifolds
Authors: Shan Lin , Wang Qin
Published: November 2021

In this paper, we prove the coarse geometric

\ell^p

-Novikov conjecture for metric spaces with bounded geometry which admit a coarse embedding into a simply connected complete Riemannian manifold of nonpositive sectional curvature.
HUBUNGAN PANJANG BERAT DAN FAKTOR KONDISI IKAN SEMBILANG (Plotosus canius) DI SUNGAI BELAWAN
Authors: Hasan Uswatul , Afriani Dwi Tika
Published: November 2021

Tujuan peneitian ini adalah untuk mengetahui pola pertumbuhan dan hubungan panjang berat ikan sembilang di Sungai Belawan. Pengambilan sampel ikan dimulai pada bulan Mei–Juli 2019. Penangkapan ikan menggunakan bubu dan pancing. Penentuan stasiun pengamatan menggunakan teknik purposive random sampling menggunakan Global Positioning System (GPS). Ikan diambil pada 3 titik stasiun pengamatan yang ditentukan berdasarkan luas badan perairan. Ikan yang tertangkap dilakukan pengukuran panjang total (total lenght) dan bobotnya. Analisis data menggunakan aplikasi Microsoft Excel 2010. Berdasarkan hasil analisis pola pertumbuhan ikan menunjukan nilai a = 0,0276 dan nilai b = 2,4701 serta nilai R2 = 0,849. Pola pertumbuhan ataupun hubungan panjang dan berat ikan sembilang di Sungai Belawan bersifat alometrik negatif. Kondisi faktor lingkungan berdasarkan hasil pengamatan menunjukan suhu air (29-31oC), Kecerahan air (46-141 cm), pH air (6,8-7,1), salinitas (15-20‰), DO (5,5-5,8 mg/L), BOD (2,900-3,400 mg/L), Nitrit (0,369-0,388 mg/L), Nitrat (2,0-4,9 mg/L), dan Posfat (0,30-0,80 mg/L)
PENGARUH LEVEL RATIO C:N TERHADAP NITROGEN TAK ORGANIK DALAM AIR YANG MENGGUNAKAN MOLASES SEBAGAI SUMBER KARBON
Authors: Panjaitan Pohan , Manullang Helentina Mariance
Published: November 2021

Tujuan dari penelitian ini adalah untuk melihat bagaimana rasio C:N mempengaruhi nitrogen anorganik dalam air dengan memanfaatkan molase sebagai sumber karbon organik. Dalam percobaan, larutan stok pekat NH4Cl digunakan untuk membuat konsentrasi yang sesuai dari larutan uji amonia (5 mgL-1 atau 4,117 mgL-1 nitrogen). Dua liter 5 mgL-1 amonia ditambahkan ke setiap wadah pengujian. Perlakuan dalam percobaan ini menggunakan rancangan acak lengkap (RAL) dengan tiga ulangan, yaitu: (1) tanpa molase; (2) tetes tebu dengan perbandingan C:N = 7,5; (3) tetes tebu dengan perbandingan C:N = 15,0; (4) tetes tebu dengan perbandingan C:N = 17,5; (5) tetes tebu dengan perbandingan C:N = 20,0; dan (6) tetes tebu dengan perbandingan C:N = 22,5. Data dianalisa menggunakan analisis varians dan regresi, Uji Duncan digunakan untuk membandingkan nilai rata-rata setiap percobaan. Ada penurunan substansial dalam konsentrasi amonia sebagai respons terhadap peningkatan kadar rasio C:N terhadap perlakuan molase. Perlu dicatat bahwa konsentrasi amonia pada perlakuan tanpa molase lebih rendah dibandingkan dengan perlakuan dengan molase dengan rasio C:N kurang dari 22,5.
Quantum Period Finding against Symmetric Primitives in Practice
Authors: Bonnetain Xavier , Jaques Samuel
Published: November 2021

We present the first complete descriptions of quantum circuits for the offline Simon’s algorithm, and estimate their cost to attack the MAC Chaskey, the block cipher PRINCE and the NIST lightweight finalist AEAD scheme Elephant. These attacks require a reasonable amount of qubits, comparable to the number of qubits required to break RSA-2048. They are faster than other collision algorithms, and the attacks against PRINCE and Chaskey are the most efficient known to date. As Elephant has a key smaller than its state size, the algorithm is less efficient and its cost ends up very close to or above the cost of exhaustive search.We also propose an optimized quantum circuit for boolean linear algebra as well as complete reversible implementations of PRINCE, Chaskey, spongent and Keccak which are of independent interest for quantum cryptanalysis. We stress that our attacks could be applied in the future against today’s communications, and recommend caution when choosing symmetric constructions for cases where long-term security is expected.
Semi-Automatic Locating of Cryptographic Operations in Side-Channel Traces
Authors: Trautmann Jens , Beckers Arthur , Wouters Lennert , Wildermann Stefan , Verbauwhede Ingrid , Teich Jürgen
Published: November 2021

Locating a cryptographic operation in a side-channel trace, i.e. finding out where it is in the time domain, without having a template, can be a tedious task even for unprotected implementations. The sheer amount of data can be overwhelming. In a simple call to OpenSSL for AES-128 ECB encryption of a single data block, only 0.00028% of the trace relate to the actual AES-128 encryption. The rest is overhead. We introduce the (to our best knowledge) first method to locate a cryptographic operation in a side-channel trace in a largely automated fashion. The method exploits meta information about the cryptographic operation and requires an estimate of its implementation’s execution time.The method lends itself to parallelization and our implementation in a tool greatly benefits from GPU acceleration. The tool can be used offline for trace segmentation and for generating a template which can then be used online in real-time waveformmatching based triggering systems for trace acquisition or fault injection. We evaluate it in six scenarios involving hardware and software implementations of different cryptographic operations executed on diverse platforms. Two of these scenarios cover realistic protocol level use-cases and demonstrate the real-world applicability of our tool in scenarios where classical leakage-detection techniques would not work. The results highlight the usefulness of the tool because it reliably and efficiently automates the task and therefore frees up time of the analyst.The method does not work on traces of implementations protected by effective time randomization countermeasures, e.g. random delays and unstable clock frequency, but is not affected by masking, shuffling and similar countermeasures.
Practical Multiple Persistent Faults Analysis
Authors: Soleimany Hadi , Bagheri Nasour , Hadipour Hosein , Ravi Prasanna , Bhasin Shivam , Mansouri Sara
Published: November 2021

We focus on the multiple persistent faults analysis in this paper to fill existing gaps in its application in a variety of scenarios. Our major contributions are twofold. First, we propose a novel technique to apply persistent fault apply in the multiple persistent faults setting that decreases the number of survived keys and the required data. We demonstrate that by utilizing 1509 and 1448 ciphertexts, the number of survived keys after performing persistent fault analysis on AES in the presence of eight and sixteen faults can be reduced to only 29 candidates, whereas the best known attacks need 2008 and 1643 ciphertexts, respectively, with a time complexity of 250. Second, we develop generalized frameworks for retrieving the key in the ciphertext-only model. Our methods for both performing persistent fault attacks and key-recovery processes are highly flexible and provide a general trade-off between the number of required ciphertexts and the time complexity. To break AES with 16 persistent faults in the Sbox, our experiments show that the number of required ciphertexts can be decreased to 477 while the attack is still practical with respect to the time complexity. To confirm the accuracy of our methods, we performed several simulations as well as experimental validations on the ARM Cortex-M4 microcontroller with electromagnetic fault injection on AES and LED, which are two well-known block ciphers to validate the types of faults and the distribution of the number of faults in practice.
Composite Enclaves: Towards Disaggregated Trusted Execution
Authors: Schneider Moritz , Dhar Aritra , Puddu Ivan , Kostiainen Kari , Čapkun Srdjan
Published: November 2021

The ever-rising computation demand is forcing the move from the CPU to heterogeneous specialized hardware, which is readily available across modern datacenters through disaggregated infrastructure. On the other hand, trusted execution environments (TEEs), one of the most promising recent developments in hardware security, can only protect code confined in the CPU, limiting TEEs’ potential and applicability to a handful of applications. We observe that the TEEs’ hardware trusted computing base (TCB) is fixed at design time, which in practice leads to using untrusted software to employ peripherals in TEEs. Based on this observation, we propose composite enclaves with a configurable hardware and software TCB, allowing enclaves access to multiple computing and IO resources. Finally, we present two case studies of composite enclaves: i) an FPGA platform based on RISC-V Keystone connected to emulated peripherals and sensors, and ii) a large-scale accelerator. These case studies showcase a flexible but small TCB (2.5 KLoC for IO peripherals and drivers), with a low-performance overhead (only around 220 additional cycles for a context switch), thus demonstrating the feasibility of our approach and showing that it can work with a wide range of specialized hardware.
Actions For Immediate Response To Antimicrobial Resistant Gonorrhoea
Authors: Tabuena Almighty C.
Published: November 2021

Antimicrobial resistance (AMR) is a growing global issue that causes significant morbidity. AMR causes more serious infections and consequences, increasing hospital stays and death. AMR threatens to undermine our capacity to cure common infectious infections. In this case, a clinician at a local sexual health clinic has recently alerted a 35-year-old male who has been seen in the clinic with probable AMR gonorrhoea. Consider the case's immediate consequences and select three measures to be addressed within the first several weeks. This article used the DEPESTEL (demographic structures, epidemiological patterns, political factors, economic influences, sociological trends, technological innovations, educational factors, and legislative requirements) framework to construct the response. In conclusion, AMR gonorrhoea infections stay in the body, increasing infection risk. Rapid gonorrhoea patient diagnosis is crucial for public health and clinical care of infected patients and sexual partners. Patients must be treated to cease transmission. AMR surveillance must include seasonal and epidemiological data. Keep track of treatment failures, warn partners, and prioritize clinical care. To appropriately analyze and handle treatment failure scenarios, cross-border collaboration is essential. Traveling overseas increases AMR gonorrhoea risk. Fear of AMR in the population may cause over-reaction to STIs. The media might assist in disseminating this vital health prevention, management, and security messages. People at risk need to be informed about the possibility of resistant gonorrhoea. Age, sex, sexual orientation, specimen location, prior infections, and concurrent STIs are also needed to be better reported.