bluuebunny/crossref_metadata_2025 huggingface dataset:
Tennis elbow: a prospective comparative clinical study comparing the outcome of conservative of management local infiltrations of leucocyte enriched platelet-rich plasma and glucocorticoid
Authors: Arora Kamal Kumar , Chaudhary Priti , Kapila Rajesh , Singh Raminder
Published: October 2022

Background: Lateral epicondylitis is a painful condition of the elbow, characterised by pain and tenderness with resisted wrist extension. This study was carried out to evaluate the comparative efficacy of the local infiltration of leucocyte enriched platelet rich plasma (L-PRP) and methylprednisolone in patients with lateral epicondylitis.Methods: Sixty adult patients, between the ages 30 to 50 years, diagnosed with lateral epicondylitis of more than 12 weeks, were enrolled in the prospective randomised study. Their medical history and previous conservative treatment were recorded; the clinical evaluation of the tendinitis was made with the visual analogue scale (VAS), the disabilities of the arm, shoulder, and hand (DASH) outcome scores, the modified elbow performance index (MEPS), the functional assessment by patient-rated tennis elbow evaluation (PRTEE), together with the laboratory investigations. The patients were randomised using the computer-generated alphabets into two groups of 30: group A received PRP, and group B received corticosteroid.Results: Patients were seen at 4, 8 and 12 weeks to evaluate the post-injection status. VAS, DASH, and PRTEE scores were significantly reduced, and MEPS was significantly improved in group A compared to group B.Conclusions: PRP leads to superior healing with long-term therapeutic advantages compared to corticosteroids though it takes a little longer to have its effect.
Clinical study of various forms of acute pancreatitis in a tertiary care centre
Authors: Patel Kautilya , Jivani Sachin , Zala Jahnavi , Shukla Shashank , Gupta Rohan , Pancholi Mukesh
Published: October 2022

Background: Acute pancreatitis is an acute inflammatory process of the pancreas with variable involvement of regional tissues and remote organ system. Severe acute pancreatitis (SAP) is characterized by a short course of progressive multi organ dysfunction syndrome (MODS), early hypoxemia and increased incidence of necrosis, infection, and abdominal compartment syndrome (ACS). The average mortality rate in severe acute pancreatitis approaches 2-10%. This study was conducted to observe etiological factors, the clinical presentations and outcome of various form of acute pancreatitis.Methods: A hospital record based retrospective study on one hundred (100) cases of various forms of acute pancreatitis in the department of surgery at tertiary care teaching hospital of South Gujarat from January 2019 to December 2019 to know the clinical presentation of acute pancreatitis patients.Results: The maximum patients were belonged to age group between 31-40 years. There was a high incidence of alcoholic pancreatitis as compared to the gallstone pancreatitis. In both males and females, alcohol was the main etiological factor. Few patients needed ICU admission and oxygenation. Surgery was the modality for some patients. Out of total, 89 cases were recovered.Conclusions: Early identification of sever and complicated acute pancreatitis prompts the highly dependent intensive care and early intervention. Gall stones are considered most common etiological factor for acute pancreatitis in India but alcoholism crosses this limit suggests changing life style of our people. Outcome is favourable in expectant conservative management of any form of acute pancreatitis.
Validation of intra-operative scoring system for difficult laparoscopic cholecystectomy
Authors: Gupta Saumya , Anand Krishnanand , Paliwal Palak , Baghel Aditya S.
Published: October 2022

Background: Laparoscopic cholecystectomy is the procedure of choice for most patients with gallbladder disease. The key, as in open surgery, is the identification and safe dissection of Calot’s triangle. Surgeons performing laparoscopic cholecystectomy should not think of conversion to open operation as a complication, but rather a sound clinical judgment.Methods: This is an observational, single center study. The scoring system included five aspects; appearance and adhesion of gall bladder (GB), distension or contracture degree of GB, ease in access, local or septic complications, and time required for cystic artery and duct identification. A score of <2 would imply mild difficulty, 2–4 moderate, 5–7 severe and 8–10 extreme. The scores were compared in each patient to conclude the practicality of intra operative predictive score.Results: The most common reason for conversion to open surgery was found to be difficulties in dissection of cystic duct and artery in Calot’s triangle. The moderate and severe category was found to be statistically insignificant to predict the conversion, therefore, one can consider to merge these 2 categories into a single category to forfeit the prediction for conversion.Conclusions: The extreme category was found to be statistically significant for prediction of conversion, therefore, the patients falling into this category forfeits the chances of increased risk of injury and therefore, should be converted early.
Efficacy and endurability of tricortical syndesmotic screw fixation in ankle fractures: a clinical prospective study
Authors: Arora Kamal Kumar , Chaudhary Priti , Kapila Rajesh , Singh Raminder
Published: October 2022

Background: Ankle fractures represent 10% of all fractures with an incidence of around 137/105 population per year. These fractures are most of the times associated with syndesmotic injuries due to rotation of the limb with foot fixed/axial loading as a result of high velocity injuries. The syndesmosis is ruptured as a result of a torsional movement of the talus or as a result of a severe abduction force. Diastasis requires the rupture of three strong ligaments and the interosseous membrane and therefore represents a very substantial insult to the ankle at tibio-fibular joint and requires fixation. A syndesmosis screw through fibular plate prevents normal movement between the distal tibia and the fibula to allow healing and stability. Tricortical fixation provides more endurability during axial loading and ankle movements while walking. The present clinical prospective study was carried out with an aim to evaluate the efficacy and endurability of tricortical fixation of syndesmotic injuries, by one 3.5 mm screw through fibular plate.Methods: The present clinical prospective study was carried out at a tertiary institute of Punjab on 50 IPD patients admitted through emergency/outdoor patient department.Results: The 70% of the cases with surgical fixation of diastasis of syndesmosis gained normal range of motion at ankle joint after six weeks of immobilization in plaster of Paris (POP) back slab.Conclusions: Tricortical fixation of syndesmotic injuries, by one 3.5 mm screw through fibular plate is a must as it provides stability and endurability during axial loading and ankle movements while walking.
Diagnostic and therapeutic challenges in the management of silent and functional giant pheochromocytoma
Authors: Deivasigamani Sriram , Ansari Azharuddin , Irrinki Santhosh , Khare Siddhant , Kurdia Kailash Chand , Chatterjee Debjyoti , Sakaray Yashwant Raj
Published: October 2022

Giant pheochromocytoma is a rare retroperitoneal tumor that is "clinically and biochemically quiet" most of the time, posing diagnostic and treatment hurdles in ordinary surgical practice. This case study includes four participants. The average age of the patients was 56.5 years. Two patients exhibited symptoms and biochemical diagnostic characteristics, but the other two were clinically and biochemically silent. Preoperative imaging revealed the diagnosis in two individuals. In two patients with an initial diagnosis, all patients underwent laparotomy after preoperative preparation and stabilization. The diagnosis of giant pheochromocytoma was confirmed histo-pathologically in all four individuals with a PASS score of less than 3. All patients were disease-free and were being followed on a routine basis. Even though it is uncommon, "clinically and biochemically silent" Giant pheochromocytoma should be considered as a differential diagnosis of retroperitoneal tumor, where preoperative diagnosis by imaging and biopsy, alongside patient preparation and stabilization, reduces adverse intraoperative and postoperative events.
Enlarging phytobezoar: a rare cause of small bowel obstruction seen in an elderly patient
Authors: Tang Hannah N. , Green Ryan
Published: October 2022

Phytobezoars are a rare cause of small bowel obstruction (SBO) but must be a consideration especially in patients with previous gastric surgeriesand the elderly population. Preoperative computed tomography (CT) should be done to differentiate between bezoars and other causes of SBO. If non operative management fails, surgical removal is the recommended treatment.
Trichobezoar with duodenal perforation: a rare occurrence
Authors: Ooi Juin Yeen , Koay Kean Leong , Tang Lilius Li Hui , Velayutham Ramamoorthy
Published: October 2022

Trichobezoar is an intraluminal mass formed from the accumulation of undigested hair. It is a rare condition that is typically seen in young females with trichophagia and trichotillomania. When not recognized, it may present with complications such as obstruction, ulceration and in some rare cases, perforation. While most trichobezoar perforations are located in the stomach, however, duodenal perforation has not been reported before. We report a case of a 13-year-old girl who presented to the emergency with signs and symptoms of peritonitis and perforated viscus. Radiological investigation revealed a large heterogenous intraluminal mass with mottled gas pattern suspicious of bezoar. Oral contrast was seen tracking from the gastric pylorus into the peritoneum suggestive of a perforation. The girl was brought to theatre for emergency laparotomy and a trichobezoar was found extending from the stomach down to the level of D1. There is a perforation in D1 on its antero-superior surface measuring 1×1 cm. The bezoar was removed via a gastrostomy and the perforation was primarily repaired and patched with omentum. Post operatively, her recovery was complicated with wound breakdown and was subsequently discharged after 1.5 months of hospitalization with outpatient referral for psychiatry consults.
Appendiceal neuroendocrine tumour association in a patient with a large sarcomatoid renal cell carcinoma
Authors: Silva Munasinghe , Shanmuga Anandan Aathavan
Published: October 2022

Renal cell carcinoma (RCC) can develop into sarcomatoid differentiation which demonstrates aggressive biological behavior evident by the rapid progression of the tumour with multiple metastases. Though the appendiceal neuroendocrine tumour (NET) has a good prognosis, the prognosis can be worse when associated with the sarcomatoid RCC (sRCC). A 45-year-old female patient presented to the emergency department with a 2-month history of worsening right upper abdominal pain, nausea, vomiting, and significant weight loss. Computed tomography (CT) revealed heterogeneously enhancing solid cystic mass lesions arising from a lower pole of the right kidney with a tumour thrombus involving the entire right renal vein and extending into the inferior vena cava (IVC). The patient underwent radical nephrectomy and appendectomy and was managed conservatively due to the poor prognosis. After four weeks, she presented with severe right upper abdominal pain, and Magnetic resonance imaging (MRI) indicated a possible liver metastasis and tumour necrosis. In three weeks, the patient died of respiratory failure following multiple organ dysfunction syndrome (MODS). This case report outlines a presentation of sRCC with biologically aggressive disease progression and a rare association with appendiceal NET. CT, MRI, and PET scans can be helpful in the diagnosis and monitoring of disease progression. Early identification of the sRCC and appendiceal NET will contribute to better outcomes of the disease and complications. The prognostic elements and similar genetic patterns of sRCC and appendiceal NET would be of great clinical interest.
Subhepatic perforated subhepatic appendicitis versus acute cholecystitis: a diagnostic dilemma
Authors: Koay Kean L. , Ong Mang Ning , Tok Zhen Yu , Ahmad Jafri Norjazliney Binti , Thangaratnam Ramesh R.
Published: October 2022

Appendicitis, being one of the most common surgical problems, is often diagnosed clinically. The typical clinical sign elicited from a patient suffering from acute or perforated appendicitis includes: Rebound tenderness, Rovsing sign, Obturator sign, Psoas sign, and tenderness over the right iliac fossa. Cholecystitis, another common surgical problem, typically presents with tenderness over the right hypochondrium, and the typical sign associated with this condition is positive Murphy’s sign. In this report, we describe how a subhepatic perforated appendicitis can mimic acute cholecytstitis, both clinically and radiologically in an adult patient.
Perforated diverticulitis leading to Fournier’s gangrene
Authors: Watter Henry K. , Choi Ho Nam , Munugani Suresh
Published: October 2022

Perforated diverticulitis is a rare cause of Fournier’s gangrene. Management for these conditions separately is well established, however no clear guidelines exist for operative management when they present in combination. This case provides a suggested management approach for managing the two conditions concurrently, in a peripheral hospital.
Dorsal agenesis of the pancreas associated with mixed carcinoma: a rare case report and review of literature
Authors: Kumar Sharath V. , Sangu Prashanth , Jose Livin , Harwal Rahul , Dubey Alok , Raju Prabhakaran , Chidambaranathan Sugumar , Obla Lakshmanamoorthy Naganath Babu
Published: October 2022

Dorsal agenesis of the pancreas is a very rare congenital anomaly with less than 100 cases reported in the world literature till 2020. Dorsal agenesis associated with pancreatic tumors is extremely rare; only 17 cases have been reported to date. Here we reported a rare case of dorsal agenesis of the pancreas associated with mixed carcinoma of the pancreas.
A rare case of acute presentation of a chronic massive extraperitoneal abscess: a case report
Authors: Sekaran Praveen G. , Krishnan Gokul Manu
Published: October 2022

Extra-peritoneal abscesses are uncommon entities encountered during general surgical practice. They occur in a plane present between the peritoneum and the deep fascia anteriorly, posteriorly or in the pelvis. These abscesses commonly occur as a result of supra-levator and pre-peritoneal extension of an ischiorectal abscess. Treatment includes antibiotics and drainage. Here we have described a case of an abscess in the anterior extra-peritoneal plane extending from perirectal and pararectal space, drained surgically through a midline incision.
Aggressive angiomyxoma of vulva: a rare and interesting entity
Authors: Kharkwal Suman , Sarkar Sushanta , G. Keerthana
Published: October 2022

We report a case of a 44-year-old female with aggressive angiomyxoma arising from right labia majora. The patient presented with a gradually enlarging vulvar mass and was treatment included wide local excision of the mass with R0 resection. Pre operative and final histopathology was consistent with features of aggressive angiomyxoma. Angiomyxoma is a rare, benign, locally infiltrative mesenchymal tumor that occurs in females at reproductive age. Repeated recurrence and locally invasive characteristics of the tumor makes it important to be considered as a part of the differential diagnosis especially in cases of pelvic mass in females.
An intriguing case of a complete 2nd arch branchial fistula: a portal to the infectious world
Authors: Reddy Komatreddy G. , Venkat Poojitha R. G. , Teja Katra S.
Published: October 2022

Complete 2nd arch branchial fistulae are very rare congenital anomalies of head and neck. They arise due to the incomplete obliteration of the branchial clefts during embryonic period. In this article we report a case of type IV 2nd branchial cleft anomaly in a 15-year-old female. Explicit knowledge regarding its development, anatomy and accurate diagnosis, skillful complete excision of the tract is paramount in its management and to prevent recurrence.
Appendicular mass with pseudomyxoma peritonei: a case report
Authors: Kang Brahampreet S. , Arora Anshika , Harsh Meena
Published: October 2022

Pseudomyxoma peritonei is an infrequently occurring clinical entity having an annual incidence of less than two per million. It is originated from the rupture of a tumour filled with mucinous substance. The intra-abdominal viscera are usually covered with a jelly-like substance. This syndrome originates most frequently from tumours of the appendix or ovaries. Genetic history is expected to play a role in the appendicular mucocele. The disease advances due to the presence of microbial agents expressed in carcinomas associated with gelatinous ascites. It typically has an insidious onset with a non-exclusive presentation like an increase in abdominal girth and associated abdominal pain with locoregional dissemination initially and dissemination to multiple sites later. The main sign is pelvic ascites. Diagnosis is made by combining radiological imaging with histopathology. Ultrasound aids in identifying the pelvic mass, peritoneal implants, calcifications, effusion, septa, the associated tumours (e.g., ovaries), the involvement of mesentery, and finalizing the surgical strategy. Usually, this condition is adequately treated by combining surgical excision and/or hyperthermic intra-peritoneal chemotherapy (HIPEC), which may be omitted by selecting the patient carefully.
Conservative management of Boerhaave’s syndrome: a case report
Authors: P. Silambarasan , Prasad Gaurav , Ram Vishnu , Kumar Nirmal
Published: October 2022

The management of esophageal perforation has evolved. The underlying principles of drainage of sepsis, adequate nutrition and repair, or defunctioning of the esophagus remain. We are presenting a case of Boerhaave syndrome, where we have successfully managed conservatively with endoscopic stenting. Endoscopic therapy and VATS are used with increasing frequency and in appropriately selected patients with good results. Careful selection of patients for such procedures are important. Implantation of self-expanding metallic stent in patients with esophageal leak or perforation is a safe and feasible alternative to operative treatment and can lower the interventional morbidity rate.
Knowledge level of health workers on hand hygiene, aseptic techniques, isolation and quarantine services in selected health facilities in Kiambu County, Kenya
Authors: Njuguna Judy Wanjiku , Kimani Harun , King’ori Isabell
Published: October 2022

Background: The objective of this article was to ascertain the knowledge level of health workers on hand hygiene, aseptic techniques, isolation and quarantine services in selected health facilities in Kiambu County.Methods: A descriptive cross-sectional research design was adopted in Kiambu County and Thika Sub-County was purposively selected. Stratified random sampling was used to draw a sample size of 261 study respondents. Both descriptive and inferential statistics were used to analyze the data.Results: Out of the 261 questionnaires administered, only 178 were accurately, appropriately filled and returned. Chi square was used to test the association between independent and dependent variables at 95% confidence interval. A p value of less than 0.05 (p<0.05) was considered statistically significant. The general knowledge of health workers on IPC was satisfactory with 135 (75.8%) having good knowledge. Knowledge was established to have statistically significant association with nosocomial prevalence (χ2 =49.45, df =2, p<0.001).Conclusions: It was concluded that majority of health workers had good knowledge on hand hygiene and aseptic techniques but in the contrary this was not the case with isolation and quarantine services. This could have been attributed to the fact that there were almost no trainings carried out on isolation and quarantine services and furthermore not all health facilities had the infrastructure for isolation and quarantine required to enforce those services.
An online questionnaire study about factors affecting first aid knowledge of citizens in Hong Kong
Authors: Leung Shek Ming , Eagle Li Kin Chun , Leung Pui Yan , Lo Hau Wan , Li Sin Man , Lui Yuen Ching , Leung Shuk Yi , Leung Ka Wing
Published: October 2022

Background: The study aimed to identify the factors associated with first aid knowledge among Hong Kong citizens.Methods: This was a questionnaire study that collected demographic data and assessed first aid knowledge. Multiple regressions were used to identify factors associated with first aid knowledge and participation in first aid course.Results: Better knowledge was associated with participation in first aid course (beta=1.53, 95% confidence interval: 0.98 to 2.08), experience of performing first aid (beta=0.88, 95%CI: 0.19 to 1.57), medical-related course (beta=0.89, 95%CI: 0.21 to 1.58), males (beta=0.67, 95%CI: 0.17 to 1.17) and less years past after first aid course completion (beta=-0.08, 95%CI: -0.15 to 0) (n=230). Respondents with medical-related education background (OR=2.33, 95%CI: 1.03 to 5.27) had more participation in first aid course.Conclusions: First aid course participation was the most important factor associated with knowledge. Regular refresher courses and promotion towards citizens without medical-related education background were recommended.
Determinants of effective staff performance in improving data management in healthcare: a case study of Mombasa county, Kenya
Authors: Ndishaa Kayanda Sarah , Nyamai Juma Joseph , Odongo Alfred Owino , Kariuki Peterson
Published: October 2022

Background: Previous research in developing countries has revealed a variety of issues that may jeopardize data quality in HIS. According to research, many developing countries health information systems are unable to provide the necessary support information. The information produced is of low quality and the information processed is not made good use of to inform decisions. The lack of promotion of information culture harms the performance of HIS. The general objective of the study was to assess factors influencing effective staff performance in improving data management in selected facilities in Mombasa County, Kenya.Methods: The study adopted a cross-sectional research design with a mixed methods approach. Quantitative data were analyzed using frequencies, proportions, mean, standard deviation, coefficient of variation, cross-tabulations, Phi correlation coefficient, and binary logistic regression (at a significance level of 0.05). Qualitative data were analyzed using content analysis.Results: The results indicated that organizational factors (ϕ=0.268, p>0.05), staff effectiveness (ϕ=0.408, OR=0.056, p>0.05) and individual attributes (ϕ=0.141, p>0.05) did not have significant influence on staff performance in improving data management, while knowledge and skills (ϕ=0.535, OR=0.031, p<0.05) was found to have a significant influence on staff performance in improving data management.Conclusions: The study concludes that the knowledge and skills of health care workers are a significant predictor of improvement in data management at the health facilities in Mombasa County.
Cost effectiveness analysis of typhoid fever vaccination in an endemic district of Kabale, Uganda
Authors: Odulusi Daniel
Published: October 2022

Background: Typhoid fever is a preventable disease that affects the livelihood security of households and communities, accounting for a significant portion of the disease burden in Kabale district. Various preventive programs to control this burden such as curative services and vaccination are being implemented without empirical evidence of the effectiveness of either program in terms of costs and outcomes.Methodology: The study design is a mixed methods design in which for specific research objectives a cross-sectional survey was carried out in addition to a retrospective costing analysis. The outcome being a cost effectiveness evaluation of vaccination against typhoid with the comparator being no vaccination, expressed as the incremental cost effectiveness ratio. Results: Incidence rate of 39.8 per 1000, a case fatality rate of 0.061, and cost of illness of $75.62 for inpatient care and $33.85 for an outpatient case, with an average cost of illness of typhoid fever in Kabale district to be $54.74. In addition, typhoid fever costs Kabale district $217,158.8, of which $119,814.92 could be saved if a typhoid fever vaccination program is carried out, that will avert 2,189 cases of typhoid every year for three years. Vaccination results in 28,428.32 DALYs avoided. The resulting ICER of -6.348 reveals that the vaccination program against typhoid fever is both extremely cheaper and very effective in averting both typhoid cases and costs.Conclusions: a one-time fixed-post typhoid vaccination campaign in Kabale District, Uganda, was estimated to be a very highly cost-effective intervention from the public sector health care delivery perspective.
Sex education, awareness and perception among adolescents: a cross sectional study from Central Kerala
Authors: Anilkumar Angitha , Varghese Ann Mary , Mathews Chris Joseph , Paul Sandra , Sajan Manasa Maria , Joseph Sruthi Ann , Jose Betsy A.
Published: October 2022

Background: Teenagers exhibit little awareness of, or interest in, the normal processes of puberty, sexual health, pregnancy, or reproduction. They also have limited knowledge of sexual and reproductive fitness. Because sexual education is a lifelong process, it should be a fundamental component of development and understanding beginning in adolescence and continuing into adulthood.Methods: A cross-sectional study was undertaken among Central Kerala school students in the adolescent age group (13-18 years) with both genders. The students were provided with a pre-tested questionnaire on their knowledge, attitudes, and perceptions of sex education as well as a proforma on the socio demographic details.Results: The majority of research participants 30.1% were 17 years old, although the average age was 16 (±1.43 years). 67.9% of the participants were girls, and 32.1% were boys. Sex of the participant has association with knowledge, attitude and perception on sex education. Socio demographic factors tend to affect the knowledge. In the present study, attitude towards sex education has association with the sex of the participant and the syllabus they are studying.Conclusions: Just over half of the pupils have adequate understanding about sexual education. This demonstrates the importance of delivering sex education classes for adolescent kids on a regular basis. School based educational classes can be promoted wherein, a more familiar and comfortable person like the teachers, who are trained by medical professionals, can impart the adequate knowledge to the students.
Characteristics of neonatal sepsis at a tertiary care centre in Western Uttar Pradesh, India: a hospital based retrospective study
Authors: Sachan Divyata , Kharya Pradip , Bajpai Prashant K.
Published: October 2022

Background: Due to the constantly changing genome of the organisms causing disease it is important to be updated regarding the pattern of distribution of microbes and their antibiotic susceptibility. The study was conducted with the aim to determine the risk factors, microbial profile, antimicrobial susceptibility and the outcome of neonates diagnosed with neonatal sepsis.Methods: A retrospective study was done using the data collected from medical records department of a tertiary care hospital. All the neonates diagnosed with clinical sepsis between 1to 31 January, 2019 were included in the present study. The data were analyzed using SPSS software version 24, IBM, corp., Chicago, U.S.A. Association between the outcome and independent variable were assessed using Chi square or Fischer exact test, while the level of association was assessed by univariate and multivariate analysis.Results: During the study period, 332 neonates were registered in the hospital out of which 89 were diagnosed with clinical sepsis. Most of the neonates (64.9%) presented with early onset sepsis and were term neonates (68.5%) with birth weight less than 2.5 kg (53.4%). Parameters like mode of delivery (OR:6.18; CI:1.30-29.32), birth weight (OR:9.14; CI:2.38-35.10) and gestational age (OR:7.33; CI:2.32-23.12) were statistically associated with neonatal outcome. All gram-positive organisms were sensitive to vancomycin and linezolid. Gram negative organisms were resistant to cephalosporins, amoxicillin- clavulanic acid and piperacillin-tazobactam.Conclusions: A high antibiotic resistance was observed among the isolated organism. The Gram positive and gram negative organisms were equally responsible for neonatal sepsis.
Factors influencing, SWOT analysis and emerged strategies for improving the use of digital data platforms in immunisation program by frontline health care providers: a study from rural Eastern India
Authors: Patel Kripalini , Nayak Bhagyashree , Behera Tapas Ranjan , Mandal Nityananda , Rana Salaj , Gupta Nivedita , Malik Akash , Patil Sanghamitra , Palo Subrata Kumar
Published: October 2022

Background: Digital health is a multidisciplinary concept that intermingles technology and healthcare for better service provision. Recently, these platforms are getting better utilised during the COVID-19 pandemic. We attempted to understand the factors influencing the use of digital data platforms by the frontline health workers and do a situational analysis using SWOT (strength, weakness, opportunity and threats) framework. Methods: We adopted a qualitative research method to explore both internal and external factors in a rural block of Odisha, India. 15 In-depth interviews (IDI) were conducted among the FHWs telephonically. Analysis was done using MAXQDA software. Based on findings and extensive literature review, a conceptual framework was developed.Results: The study explored that elder age, low education, less interest, fear of health problems, less experience in using applications, married, and work duplication were the internal factors causing reluctance and, user-friendliness, the language for operating, training on application use, handholding support, including troubleshooting, availability of internet, network and electric power supply were the external factors that influence the use. Further, opportunities such as the availability of IT platforms for data storage and troubleshooting, technological advancement, Government promotional initiatives and availability of resources through other programs could be strategically leveraged. Also, our study proposes strategies such as making the applications simple, informative, and user-friendly using advanced technology, better development of applications that are leveraging the "digital India" initiative. Conclusions: Exploring and understanding the situational factors and based on that, adopting context-appropriate strategies will help to achieve better and wider use of the digital platforms.
A descriptive study to assess the knowledge and expressed practices of primigravida mother’s regarding antenatal care and antenatal check-ups at selected government hospitals, Jodhpur, Rajasthan, India
Authors: Rai Neha , Rathore Jyoti
Published: October 2022

Background: Pregnancy associated death remain high in developing countries. According to WHO, giving quality antenatal care will reduce pregnancy related diseases and deaths and thus protecting both antenatal mother and the baby. The world health organization reported that in 2015 around 830 women died every day from problems in pregnancy and childbirth. Only 5 lived in high-income countries. The rest lived in low-income countries. The WHO recommends that pregnant women should all receive four antenatal visits to spot and treat problems and give immunizations. Although antenatal care is important to improve the health of mother and baby, many women do not receive four visits.Methods: A quantitative approach, descriptive research design was used among 200 primigravida mothers coming to selected government hospitals, Jodhpur, Rajasthan, India by non-probability technique. Structured Questionnaire tools used to assess knowledge and expressed practices to assess antenatal care and antenatal check-ups. Data analysis was performed using Statistical Package for the Social Sciences version 20.Results: The study findings revealed that knowledge level of the primigravida mothers regarding antenatal care and antenatal check-ups out of 25 maximum score the mean knowledge score is 16.23. The expressed practices of the primigravida mothers regarding antenatal care and antenatal check-ups out of 17 maximum score the mean expressed practice score is 10.97. The study findings also revealed that significant association is present between sample characteristics and knowledge level. There is positive correlation (0.8121) found between knowledge and expressed practices.Conclusions: Knowledge and expressed practice regarding antenatal care and antenatal check-ups was average among primigravida mothers Umaid and MDM hospital, Jodhpur, Rajasthan.
A study of the functioning of the adolescent friendly health clinics as well as the awareness and health seeking behaviour of adolescents attending the adolescent friendly health clinics in the Rampurhat health district, West Bengal, India
Authors: Biswas Tanima , Majumdar Kunal Kanti
Published: October 2022

Background: Adolescents constitute more than half of the country's population and one-sixth of the global population. Many of them drop out of school, marry young, work in dangerous jobs and engage in sexual activity. Many of the SDGs are heavily reliant on adolescent health and well-being so services should be accessible, acceptable, equitable, appropriate, effective, and comprehensive. Objective of current study was to study the awareness and health seeking behaviour among the Adolescents girls and boys attending AFHCs as well as functioning of adolescent friendly health clinic services in Rampurhat health district.Methods: This is a Cross-sectional study among the adolescents belonging to the age group of 15-19 years attending AFHCs and are residents of Rampurhat health district, West Bengal.Results: 40% of adolescent friendly health clinics (AFHCs) are located away from the OPD/Labour Room or other congested areas. Except for sanitary napkins, which were available at 40% of clinics, 80% of AFHCs had 100% supplies of the equipment and commodities. Most adolescent girls (44.5%) experienced menstrual problems and most adolescent boys (27.1%) reported genital itching and urinary problems. 48.5% of clients stated that they did not feel compelled to visit AFHCs. Clinical services were provided to 60% of AFHCs, with the remaining 40% receiving only partial clinical services.Conclusions: One of the primary reasons for low utilisation of available Sexual and Reproductive Health (SRH) related services is a lack of awareness. Preventing adolescent well-being issues requires a multifaceted approach involving many partners, including adolescents, schools, parents, society, the government, and health care providers.
Perception and awareness of first year MBBS students about the subject community medicine
Authors: Gupta Sunanda , Kishore Jugal
Published: October 2022

Background: In India, departments of the medical discipline community medicine or preventive and social medicine began to be established in the year 1955. It plays important role in medical curriculum for imparting training as comprehensive healthcare giver at various levels of health system. This study aimed at assessing perception and awareness of first year MBBS students about the subject community medicine, before formal introduction of the discipline as a part of their medical curriculum.Methods: The cross-sectional study was conducted in a class of seventy-four students of first year MBBS, at Vardhman Mahavir Medical College and Safdarjung Hospital, Delhi, in May 2022.Results: One-third of students had either parent/sibling/close relative as doctor. One-third of students knew at least one person who had pursued the discipline ‘community medicine’. Most of the students (85%) expected to learn healthcare management at primary healthcare level from the medical discipline. Only one-third of the students were aware of the subject before joining MBBS. Students whose parent/sibling/close relative is doctor, differed significantly about having the knowledge about the discipline before admission to MBBS (p value <0.001). Also, students who knew any person who had pursued community medicine as specialization, had significantly more chance of knowing about the subject before admission to MBBS.Conclusions: The medical discipline of community medicine is yet to gain familiarity among students. Community medicine specialists should come forward to address the issue and popularize the discipline as a component of medical curriculum and highlight their role in front of general population as well.
Influence of literacy on abnormal white discharge in women of reproductive age group in a metropolitan city
Authors: Kasbe Abhiram M. , Rajadhyaksha Nikita G.
Published: October 2022

Background: White vaginal discharge is a physiological process in women, depicting various stages of the menstrual cycle, but when accompanied with an infection of the vagina or cervix, it can present as an abnormal, excessive discharge accompanied with odour, irritation, and a variation in colour. Certain perceptions in women and lack of their knowledge pertaining to genital hygiene play a role on their reproductive health. This study was taken up to find the influence of education (literacy) on the abnormal white discharge.Methods: Total 350 women staying in a slum of a metropolitan city were interviewed for the study. A predesigned semi structured questionnaire was prepared for all the study subjects. Voluntary consent was taken for the study in the language understood by the subjects.Results: The association between literacy (education) and abnormal white discharge was not found to be statistically significant with the p value of 0.819.Conclusions: Literacy was not found to have an influence on the abnormal white discharge in the married women of reproductive age group.
Functional status and mental health among the elderly in rural South India: a cross sectional study
Authors: Thomas Zachariah , Godfred Adithya C. , Sriram Karthick M. , Rout Gaurav , Eldho Anna , George Jason J. , Koshy Reshma N. , Abraham Anna K. , Balasubramanian Srividhya , Lyngdoh Eman C. , Jachuck Simran , Chawngthu Lalremruati , Gautam Priyanka , B. Pavithra , Viswanath Ranjith , Balasubramanya Bhavya , Oommen Anu M. , Rose Anuradha
Published: October 2022

Background: Functional status assessment in the elderly helps to improve quality of life and prognosticate chronic disease. Literature on the status of functional ability of the elderly in rural India is limited.Methods: A cross-sectional study was done among 164 rural elderly persons in eight villages from Vellore, Tamil Nadu, to assess the prevalence of poor functional status, mental and physical health.Elderly aged 60 and above were selected by systematic random sampling, from eight villages which were selected by simple random sampling from a single rural block. A semi structured questionnaire on disability, health status, activities of daily living and functional assessment (Katz Index), depression (Geriatric Depression Scale-5) and cognition (Dementia Assessment by Rapid Test) was administered.Results: Out of 164 participants, 6.7% (11, 95% CI: 2.8%-10.6%) had a dependent functional status. While 68.9% (n=113) reported a chronic condition, 21.9% (n=36) reported multiple comorbidities and 37.2% (n=61) screened positive for depression. All those with a dependent functional status had a chronic condition. Female gender (OR: 8.33, 95% CI: 1.04-100.00), living alone (OR: 11.60, 95% CI: 1.58-85.34) and depression (OR: 11.29, 95% CI: 2.00-63.70) were found to be significantly associated with dependent functional status.Conclusions: Although majority of the community dwelling rural elderly had normal functional status, given the high burden of chronic diseases, it is important to routinely assess functional status to identify elderly at risk of disabilities.
A cross-sectional study to assess menstrual hygiene and school absenteeism related to menstruation among school going adolescent girls of Jalandhar district
Authors: Sangha Navpreet Kaur , Kaur Prabhjot , Sangha Faazal Singh , Kaur Navjot , Singh Sohrab
Published: October 2022

Background: In India, lack of awareness of safe menstrual hygiene practices is an important issue of adolescent health and is related to various adverse health outcomes. In addition, lack of proper washing facilities is a key factor leading to many adolescent girls missing school due to menstruation. Objectives of current study were to assess the knowledge of menstrual hygiene and its practices among school going adolescent females, associated socio- demographic factors and the prevalence of school absenteeism due to menstruation.Methods: A community based cross sectional study was conducted in the school going adolescent girls of 16 to 19 years age to assess the menstrual hygiene practices and related school absenteeism. A total of 180 participants were evaluated using a self-designed, self-reported and pre-tested questionnaire.Results: Less than half of the participants had prior knowledge of menstruation. Association of education of mother and prior knowledge was statistically significant. Most of the participants missed school due to menstruation. The association between excessive bleeding and absenteeism also showed statistically significant results.Conclusions: The study displayed good results regarding menstrual hygiene practices. Majority of participants had access to sanitary pads and maximum of them followed proper methods of disposal. School absenteeism due to menstruation was seen in more than half of the study population and menstruation had a huge impact on their daily lives.
A community based prospective study on thyroid dysfunction among pregnant females and its effect on maternal and neonatal outcome
Authors: Kukreja Srishti , Mulla Shakila , Das Subhashree , Singh Lakhan
Published: October 2022

Background: Thyroid disorders are often overlooked in pregnancy because of their non-specific symptoms and the hypermetabolic state of pregnancy. The laboratory measurements of thyroid function play an important role in the assessment of maternal thyroid health. Thyroid disorders can have grievous effect on mother and new-borne which can be prevented. The study was aimed to find the prevalence of thyroid dysfunction among pregnant females and its effect on maternal and neonatal outcome.Methods: A prospective study was conducted from August 2019 to October 2020 among 360 pregnant females in the rural fields practice area of a medical college. Thyroid function test was done in all pregnant females and the maternal and neonatal outcome was noted.Results: 20.31% of the pregnant females were found to be suffering from thyroid dysfunction which is approximately 1/5th of the total sample. Out the total females with thyroid dysfunction maximum females suffered from subclinical hypothyroidism that is 10.94% while 1.56% had overt hypothyroidism. 1.88% and 5.94% had subclinical and overt hyperthyroidism respectively. Postpartum haemorrhage, pre term delivery, abortion and neonatal deaths were more common in females with thyroid dysfunction as compared to euthyroid females although not statistically significant.Conclusions: Though pregnancy outcome was not found to be significantly adverse among females with thyroid dysfunction, very high prevalence of thyroid dysfunction among pregnant warrants its detection during antenatal care to be uniformly included in peripheral health care centres.
A cross sectional study on menstrual hygiene and associated factors among high school girls in rural Mysuru
Authors: Nimithamohan K. , Murthy M. R. Narayana , L. Divya K. , . Amoghashree
Published: October 2022

Background: Menstruation marks the start of a girl's reproductive life and is a significant process in her life. Women’s menstrual cycle is directly or indirectly impacted by diet and physical activity. Menstruating women's health and social lives are negatively impacted by a lack of understanding of physiology, an unscientific attitude, myths, and misconceptions. Despite the array of initiatives put up so far, a myriad of challenges remains to be addressed. The study aims to estimate the menstrual hygiene practices, and associated factors among rural high school girls in mysuru.Methods: A cross sectional study was conducted among 200 rural high school girls from January to March 2022 in rural Mysuru. A pretested and semi structured questionnaire was used for collecting data and analysed using SPSS software version 25.Results: The mean age of the study participants was 13.8±0.9 years. Out of 200 adolescent girls, 107 (59.4%) had attained menarche at 10-12 years of age. 61.7% of them reported having abdominal pain during menstruation. 71.1% of the girls reported that their diet was altered during menstruation. Only 37.5% of the study participants do regular exercise.Conclusions: The present study showed that the majority of the girls’ diet and physical activity altered after menarche and during menstruation. A focused intervention like behavioural change communication involving the high importance of consumption of fruits and vegetables, iron and calcium rich foods, avoidance of skipping meals, and taking healthy foods should be encouraged.
Sexual behaviours of HIV sero-discordant couples in the context of art: a systematic review of studies from Sub-Saharan Africa
Authors: Hassan Judith , Mitchell Kate , Basil Uguge , Shuaib Babatunde , Oti Victor B.
Published: October 2022

The impact of the use of antiretroviral therapy (ART) on the sexual behaviours of serodiscordant couples (SDC) is not well documented. This systematic review attempts to examine the strength of evidence from primary studies on the impact of ART on the sexual behaviours of serodiscordant couples in SSA. In this study, 16 studies that fit the inclusion criteria were identified. Nine were cohort studies, six cross-sectional and one randomised controlled trial. Risky sexual behaviours generally declined on several indicators used to assess them. Five within individual studies reported a decrease in unprotected sex from baseline to follow-up, while of the four that said consistent condom use, they observed a significant increase in condom use from baseline to follow-up. For the between-individual studies, one study posited that ART is significantly associated with inconsistent condom use, whereas reporting multiple and concurrent partners and self-reported symptoms of sexually transmitted infections (STIs) were associated with not being on ART. Overall, there was evidence of lower-risk sexual behaviours with ART among SDC in sub-Saharan Africa. However, this relationship was not established to be causal. Further research is required to fully explore and validate the impact of ART on the sexual practices of these couples. Behavioural programmes should be strengthened and targeted towards couple-based counselling and testing with disclosure of status and continue encouraging consistent condom use among steady couples.