bluuebunny/crossref_metadata_2025 huggingface dataset:
Perception and Practices of COVID Appropriate Behavior
Authors: Bhattacharya Archita , Das Manisha , Ghosh Santanu , Samanta Amrita
Published: December 2022

Introduction:

Recent COVID-19 pandemic is an unprecedented public health problem worldwide. Knowledge about the disease and adoption of COVID Appropriate Behavior (CAB) are of utmost importance in combating the pandemic. The study was conducted to assess and compare the knowledge, attitude, and practice and to determine different misconceptions and wrong practices related to the disease among urban and rural populations.

Materials and Methods:

A community-based analytical study with cross-sectional design was conducted from January 2021 to March 2021 among 144 adult residents from urban and rural West Bengal. Multistage sampling was adopted and a predesigned, pretested, semistructured schedule was used for interviewing study subjects.

Results:

Urban people were significantly more knowledgeable and more appropriate in attitude and practice than rural people (P < 0.05). The mean knowledge and attitude scores of urban population were significantly higher than the rural population across age groups, gender, occupation, and education (P < 0.05), whereas mean practice score was significantly higher across gender and occupation in the urban population compared to the rural population (P < 0.05). Many cultural and indigenous practices such as drinking warm water, using mouth wash, using home remedies were more common in urban areas and consumption of homeopathy medicines, lighting candles, making sound with utensils, blowing conch shells, and worshipping corona were observed more in rural areas.

Conclusions:

Wide gap exists in knowledge, attitude, and practice between urban and rural population and there were many wrong perceptions and practices surrounding COVID-19 among both urban and rural population. Appropriate policy for improving knowledge, attitude, and CAB is the need of the hour.
Prognostic Factors in Lung Adenocarcinoma with Brain Metastasis
Authors: Karaman Elanur , Rakici Sema Yilmaz
Published: December 2022

Introduction:

Brain metastasis (BM) is significantly seen in lung adenocarcinoma and adversely affects survival. We aimed to evaluate the factors affecting the prognosis in patients with BM diagnosed with lung adenocarcinoma.

Materials and Methods:

Patients with BM between 2012 and 2022 were reviewed retrospectively. Demographic characteristics of the patients, primary tumor characteristics, presence of mutation, BM number, localization, size, development time, and treatment characteristics were evaluated. Inflammatory indices at the time of BM were examined. The overall survival time was calculated.

Results:

About 92.9% of 113 patients were male, the median age was 62 years (54.5–68.5), and follow-up was 8 months (3–18). BM was detected at the time of diagnosis in 62 (54.9%) of the patients, whereas BM developed later in 51 (45.1%) patients. Systemic treatment was applied to 72.5% of the patients. Survival was lower in patients with BM at diagnosis (4 vs. 14 months, P < 0.001). Primary tumor maximum standardized uptake value level was higher on fluorodeoxyglucose-positron emission tomography-computed tomography at diagnosis in patients with late BM (P = 0.004). The development time of BM was 9 months (4–16), and the median survival was 8 months (6.2–9.8). There was no difference between tumor localization or inflammatory indices and the development of BM and prognosis. The presence of BM at diagnosis and lack of systemic treatment were found to be factors that independently reduced survival (P < 0.001, P = 0.007).

Conclusion:

The presence of BM at diagnosis significantly reduces survival. It has been observed that systemic treatments applied in addition to local treatments have a positive effect on the prognosis.
Morphometric Analysis of Laminae of C3–C6 Vertebrae of Cervical Spine in the Population of North West India
Authors: Malik Vivek Singh , Sidhu Amanpreet Singh , Ghalawat Neeru , Garsa Vipin
Published: December 2022

Introduction:

The knowledge of morphometric parameters of laminae of cervical vertebrae is indispensable in surgical procedures and developing instrumentation for surgical processes. Literature reports ethnic and geographical variations reported in these dimensions.

Materials and Methods:

This cross-sectional study included analysis of laminae of 212 cervical vertebrae (C3–C6). The length of superior border of lamina and inferior border of lamina was measured on the right and left sides using vernier caliper. Descriptive and inferential statistical analysis was done with the help of Microsoft Excel version 2021.

Results:

The length of the superior border of lamina on both sides increases from C3 to C5. The length of the inferior border of the lamina on both sides decreases from C3 to C4, then on the right side, it increases from C4 to C5 and then decreases from C5 to C6, and on the left side, it increases from C4 to C6. At C4, the length of superior border of lamina on the right side differed statistically from the length of superior border of lamina on the left side (P = 0.042). A significant difference between lengths of the inferior border of laminae on the right and left sides was also found at the C5 vertebra (P = 0.001) and C6 vertebra (P = 0.012). No significant difference in thickness and height of lamina was observed between right and left sides.

Conclusion:

The present study indicates morphometric parameters of laminae of typical cervical vertebrae in the North West Indian population differ from the same parameters in Brazilian as well as South Indian populations. The length of superior border as well as inferior border of lamina has significant differences between right and left sides. However, there is no significant difference in height and thickness of laminae between right and left sides.
A Comparative Study on Comprehension of Informed Consent Before Emergency and Elective Surgical Operative Procedures
Authors: Mondal Soumitra , Bhattacharya Saikat , Jana Pulak Kumar , Mitra Kaushik
Published: December 2022

introduction:

A health-care beneficiary should comprehend different aspects of medical and surgical interventions before giving consent to perform those. There is no defined way to find out adequate patient comprehension as part of the decision-making procedure to give consent. This study was conducted to find out the disparity of comprehensiveness between emergency and elective surgical operative procedures both in terms of knowledge dissemination and knowledge comprehension.

Materials and Methods:

A cross-sectional comparative study was conducted at the General Surgery Department of Medical College, Kolkata, during September and October 2021. An interviewer-administered questionnaire was used on patients undergoing emergency and elective surgical procedures. The comprehension level of informed consent (IC) form was scored as 1, 2, and 3 and compared between two groups using an unpaired t-test and Mann–Whitney U-test.

Result:

Data collection was done from 39 patients for emergency operative procedures and 52 for elective surgical procedures. A composite comprehension score was calculated after adjusting for questions not asked while taking IC. The mean comprehension score for emergency procedures was 18.86 and for planned surgery, it was 20.14. Unpaired t-test showed significantly high mean comprehension for planned procedures than the emergency procedures (P = 0.007). Comprehension is significantly poorer in emergency conditions even after controlling for age and literacy denoting difficulty in decision-making in emergency scenarios.

Conclusion:

It is suggested that the procedure of consent taking should be more structured and interactive so that even in stressful conditions participant understand better about the procedures and take their own decision instead of relying blindly on doctors.
Evaluation of Sagittal Inclination of Occlusal Plane and Horizontal Condylar Guidance Using Various Anterior Reference Points on Arcon and Nonarcon Articulators
Authors: Palaskar Jayant N. , Joshi Nikhil P. , Hindocha Amit D. , Gunjal Anuja P. , Balsaraf Ketaki D.
Published: December 2022

Aim:

The aim of the study was to determine the effect of different anterior reference points during facebow transfer, on sagittal inclination of occlusal plane (SIOP) and horizontal condylar guidance (HCG) values obtained on arcon and nonarcon articulators.

Materials and Methods:

Facebow records of 25 participants were made and transferred to Hanau Wide-Vue (WV) and Hanau H2 (H2) articulators using conventional indirect transfer (CIT), superior annular groove (SAG), and inferior annular groove (IAG) as anterior reference points. Maxillary casts were mounted on each articulator followed by mandibular mountings. Protrusive interocclusal record was used to determine HCG, and SIOP was measured as an angle between the occlusal plane of mounted maxillary cast and upper member of the articulator. Both, HCG and SIOP were measured on a digital lateral cephalogram and the values obtained were compared with previously determined values from both the articulators. Intergroup comparison was done by analysis of variance and pair-wise comparison by Tukey post hoc test.

Results:

Values of SIOP significantly (P = 0.00) changed on both the articulators when CIT, SAG, and IAG were the anterior reference points. The ratio of SIOP and HCG on both articulators was comparable to that of the cephalogram for CIT, IAG, but it was substantially low for SAG.

Conclusions:

The variation of anterior reference point changes the value of SIOP recorded on Hanau WV and H2 articulators; however, it had no effect on HCG values recorded on both the articulators. The angle between SIOP and HCG changed with variations in superior-inferior position of the mountings on both articulators.
Treatment of Fissure Caries of Children with Severe Rheumatic Diseases with Difficulty in Opening the Mouth
Authors: Skakodub Alla Anatolyevna , Mamedov Adil Askerovich , Admakin Oleg Ivanovich , Dudnik Olesya Viktorovna , Chertikhina Arina Sergeevna , Beznosik Aleksandra Romanovna
Published: December 2022

Background:

Pediatric dentists face difficulties in treating tooth decay of children with difficulty in opening the mouth. This is especially true, as the main disease is accompanied by such symptoms as arthritis, osteoarthritis, myositis, myalgia, sclerosis, and oral atrophy.

Aim:

The aim was to increase the level of treatment of fissure tooth decay for children with rheumatic diseases, using the silicone key method (SKM).

Materials and Methods:

A dental examination of 82 children was carried out, with diagnoses: systemic lupus erythematosus, juvenile systemic scleroderma, juvenile dermatomyositis, and juvenile rheumatoid arthritis. Evaluation of the intensity of caries using indices: decayed, missing, and filled teeth (DMFT)(average). Assessment and measurement of the degree of mouth opening (MMO) by Sh. M. Batashvili. The SKM was used to treat fissure tooth decay.

Results:

During the dental examination of the oral cavity of all children with RD, multiple caries lesions were found. In the first age group of index indicators (DMFT) (on average) - 4.88, in the second age group DMFT (on average) - 7.58 - these values corresponded to high scores for the degree of dental caries, which requires frequent appointment to the dentist. Oral hygiene of children with difficult opening of the mouth is unsatisfactory, which leads to a rapid increase of caries. Restriction of moth opening <4 mm was found in 57 children with RD (69, 51%) that made it difficult to treat caries.

Conclusion:

Using SKM will improve the quality of caries treatment and provide a stable result of treatment in patients with difficulty opening the mouth in severe somatic pathologies.
Targeted Endodontic Microsurgery
Authors: Reddy Smitha , Gadhiraju Sravya , Quraishi Akram , Kamishetty Shekhar
Published: December 2022

Targeted endodontic microsurgery combines a precisely designed three-dimensional (3D)-printed surgical guide in which the osteotomy site and angulation is defined preoperatively to avoid damaging anatomically important structures. The current endodontic microsurgical procedures have been progressing in pace with technological advances as a predictable alternative to nonsurgical treatment of persistent and recurrent apical periodontitis. The 3D-printed template has been used earlier in the guided endodontic procedure (access openings). The endodontic microsurgery utilizes the surgical microscope and microsurgical instruments which help in enhanced magnification, illumination, and visualization compared to conventional endodontic surgery. Cone beam computed tomography (CBCT) plays an important role in surgical endodontics as it helps in measuring the distance between the cortical plate and the apex, position of the roots within the bone, and the proximity of vital structures can be assessed. The true size, location, and extent of the periapical lesion can also be appreciated preoperatively. In the present cases, the guide allowed the clinicians to precisely reach the targeted tissues in a faster and more accurate manner with a more conservative and less traumatic treatment procedure. A 1-year CBCT follow-up of both cases showed complete 3D healing of the surgical site.
mRNA Expression of Ezrin in Gingival Crevicular Fluid and Whole Blood of Gingivitis and Chronic Periodontitis Patients – A Polymerase Chain Reaction Study
Authors: Cecil Anju , Sambashivaiah Savita , Bilichodmath Shivaprasad , John Rubin S.
Published: December 2022

Background:

A comparative analysis of protein expression of gingival crevicular fluid (GCF) obtained from healthy individuals and individuals with periodontal diseases would help to identify proteins involved in periodontal disease progression. Among the identified proteins, Moesin which is a disease-associated protein belongs to the ezrin-radixin-moesin protein family and was proved to play an important role in the recognition of oral bacteria contributing to the consequent development of inflammatory immune responses involved in periodontal disease development.

Aim:

The aim of the study is to quantify and compare mRNA expression levels of ezrin in GCF and whole blood of gingivitis and chronic periodontitis patients.

Materials and Methods:

A total of 60 patients were selected for the study and were divided into three groups as follows: Group 1 (20 participants with healthy gingiva), Group 2 (20 participants with gingivitis), and Group 3 (20 participants with chronic periodontitis). Clinical parameters such as gingival index, periodontal index, probing pocket depth, and clinical attachment level were assessed. GCF and blood samples were taken from these patients and assessed for the mRNA expression of ezrin using real-time polymerase chain reaction.

Results:

The expression and mean relative quantification of mRNA expression of ezrin in GCF and blood were higher for periodontitis (18.32 ± 8.398, 19.34 ± 9.487) when compared to that of gingivitis (5.34 ± 3.609, 5.48 ± 4.428) and healthy individuals (2.33 ± 0.643, 3.47 ± 1.923) and they positively correlated with the clinical parameters.

Conclusion:

The increased expression of ezrin can be considered as a good indicator to assess the inflammatory activity in periodontitis and gingivitis.
Dentists' Knowledge, Practices, and Mishaps in Relation to Post Placement for Endodontically Treated Teeth
Authors: Singh Abhinav Kumar
Published: December 2022

Background:

When restoring teeth, the post and core method is often employed. Unfortunately, several reports of endodontically treated teeth failing after placement of this material exist.

Objective:

The purpose of this research is to determine whether or not dentists have a thorough understanding of the causes of post and core failure. The goal is to evaluate patient outcomes following post coronal restoration procedures, such as post space preparation, post placement, and post final coronal restoration.

Methodology:

The quantitative methodology has informed a cross-sectional study design. One hundred dentists were chosen at random to fill out the questionnaire, which was then examined statistically.

Results:

Sodium hypochlorite irrigation, rubber dams, mineral trioxide aggregate management, and follow-up were all mentioned in the findings. Further, it was demonstrated that factors such as tooth size, tooth type, repair time, and repair material all play a role in whether or not a restorative tooth fails.

Conclusion:

According to the results, the study population had varying degrees of understanding of the post- and core-restorative system. Guidelines should be established to improve restorative practices and expand understanding. Likewise, this aids in avoiding any accidents that could arise as a result of the same causes.
An Appraisal of Knowledge, Attitude and Practices of Anganwadi Workers under Integrated Child Development Services Scheme on Infection Prevention and Control in the Initial Months of COVID-19 Pandemic in District Lucknow, UP, India
Authors: Singh Manish Kumar , Maurya Mukesh , Yoosuf Ahmed Shammas , Nargotra Shikha , Pawar Priyanka J , Mukherjee Ritika , Mahapatro Archisman
Published: December 2022

Background:

During the COVID-19 pandemic, Anganwadi workers (AWWs) were repositioned for community support, community surveillance, community awareness on infection prevention and mitigating stigma/discrimination entailing infection, going door to door. The job entailed good knowledge, attitude and practices (KAP) with regard to infection prevention and control (IPC). Aims

:

To assess the KAP of AWW with regard to IPC in context of COVID-19 in Lucknow district.

Methods:

A cross-sectional survey was conducted using Google form between 30 June and 28 July 2020. AWWs were recruited from Lucknow district irrespective of their training status; data analysis was done on 137 participants. The mean KAP score was calculated and student t-test was applied. Chi-square test was performed between categorical variables and KAP. Univariate and multivariate logistic regression was applied between independent and dependent variables.

Results:

The mean score of knowledge was 7.22 ± 2.64, attitude was 4.34 ± 1.14 and practice was 4.44 ± 1.11. There was a significant difference between good and poor score for KAP. Participants with older age, good knowledge and attitude scores were more likely to have good practices.

Conclusion:

AWWs had good attitude and practices, but lacked adequate knowledge on IPC measures. Ensuring training for AWW on IPC is important.
Prevalence of Iodine Deficiency and Urinary Iodine Excretion among School-Going Children in a Southern District of Karnataka – A Cross-Sectional Study
Authors: Kamath Ramachandra , Kotabal Rajashree , Kruthika K , Udayar Sharvanan E. , Gangani Jagadish
Published: December 2022

Background:

Iodine deficiency is a major public health problem, which leads to impaired neurodevelopment, particularly in early life and is the single most preventable cause of mental retardation and brain damage in children and fortunately, it is preventable.

Aims:

To estimate the prevalence of goitre among school children in Kodagu District and to estimate the urine iodine excretion and salt iodine content in a subsample.

Patients and Methods:

A cross-sectional study was conducted among school children of 6-12 years in the Kodagu district. Sampling was done by population proportionate to size cluster sampling method with 2700 study participants, 540 salt samples and 270 urine samples.

Results:

Out of 2700 study participants, the prevalence of goitre was 15.50%. Students of Madikeri Taluk, rural area students, 11-year-old students, Consumption of Goitrogens among students show significant association with goitre after multivariate logistic regression analysis. Urinary iodine excretion test shows 0.36%, 1.80% and 12.99% of the participants had severe, moderate and mild iodine deficiency, respectively.

Conclusion:

The prevalence of goitre was high indicating that it is an endemic area. Activities such as periodic surveys, provision of iodised salt and intensified monitoring and further evaluation of the IDD programme is obligatory to reduce the goitre rate.
Present Status of Department of Health Research Registered Ethics Committees in India after Implementation of New Drugs and Clinical Trials Rules 2019
Authors: Agrawal Neeraj Kumar , Gupta Uma
Published: December 2022

Background:

Under the New Drugs and Clinical Trials Rules -2019 that came into force on 14th September 2019, all Ethics Committees (ECs) reviewing biomedical and health research should register with the authority designated by the Central Government of India.

Study Objective:

We investigated the status of registration of ECs in the Department of Health Research (DHR) to date.

Materials and Methods:

The data collection was started on 1 April, 2021 and was last updated on 10 April, 2022. The ECs registered with DHR were extracted from NAITIK online portal. The ECs were segregated according to the state and Union territories, medical colleges, dental colleges, and hospital and research institutes.

Results:

Total of 836 registered ECs were uploaded on the DHR website to date. Out of which, 822 (98.32%) were Institutional and 14 (1.67%) were independent. Among total ECs, 518 (61.96%) were in hospitals and research institutes, 231 (27.63%) in medical colleges, and 73 (8.73%) in dental colleges. 76 (9.09%) got the final certificate after completion of a provisional period of two years. Among 606 medical colleges and 316 dental colleges, 38.11% and 23.10% of colleges had registered ECs respectively. Maharashtra has the highest number with 129 (15.43%) registered ECs whereas Gujarat is number one (53.33%) in terms of percent registered ECs in medical colleges of particular states.

Conclusions:

Timely registration of ECs should be encouraged by the concerned stakeholders and try to make a robust mechanism for bringing transparency, uniformity, and accountability to the ECs across the states.
Patient-Generated Health Data
Authors: Shafqat Naseema , Verma Ranjana , Bali Surya , George T J
Published: December 2022

Patient-generated health data are a promising arena that can create a revolutionary change in the field of healthcare. Although a lot has been done globally to incorporate the information and data directly from the patient for their benefit, patient-generated health data (PGHD) remains a nascent area for the stakeholders including the clients themselves as well as the healthcare professionals and the system itself. This narrative review aims to familiarise the readers with the concept of PGHD, the strategies utilised by key organisations across the globe and to make them cognizant of the challenges and potential hurdles in the implementation and amalgamation of PGHD into the healthcare system. With the advancement in information technologies, artificial intelligence and remarkably evolving software, it has become easy to access health-related data such as heart rate, blood pressure, pulse oximetry and even electrocardiograms at the comfort of our homes with the touch of a button. The easy availability and affordability of smartphones for most of the population have led to the blooming of the wearable device industry, and there is a surge of primary health-related data overflowing around us everywhere. Proper utilisation of this deluge of data in the form of PGHD can reduce the healthcare cost and burden of care, especially in developing countries by improving the patient–provider interactions and bridging the existing information gaps. PGHD plays a significant role in health promotion also by supporting self-management activities such as healthy eating and exercise. In this modern era of precision health with comprehensive veracity, it becomes essential that researchers and healthcare professionals should lead from the front in the amalgamation of PGHD into healthcare.
Effectiveness of ultrasonography-guided cardiac sympathetic denervation in acute control of electrical storm: A retrospective case series
Authors: Dhanse Suheil , Rao Mugula Sudhakar , Ramachandran Padmakumar , Devasia Tom , Ashwal A J , Paramasivam Ganesh , Prabhu Manjunath
Published: December 2022

Background and Aims:

Ultrasonography-guided left cardiac sympathetic denervation (LCSD) or bilateral cardiac sympathetic denervation (BCSD) may be a useful intervention in the electrical storm (ES) that persists despite pharmacological therapy. The aim of our study was to evaluate the effectiveness of ultrasonography-guided LCSD or BCSD in the acute control of ES. We conducted a retrospective case series of patients who underwent ultrasonography-guided CSD for control of ES at a tertiary care hospital.

Material and Methods:

Data of all patients who underwent unilateral or bilateral CSD were collected from January 2017 to December 2019. Eleven patients with ES refractory to standard antiarrhythmic therapy underwent ultrasonography-guided pharmacological CSD (eight underwent LCSD and three underwent BCSD). Quantitative data was expressed as mean and median with interquartile range (IQR). Non-quantitative data was expressed in proportions.

Results:

Eleven patients underwent ultrasonography-guided pharmacological CSD (eight underwent LCSD and three underwent BCSD). Six of the eleven patients were female (54.5%). Ischemia was the underlying substrate in nine patients (81.8%). Five patients (46%) had complete resolution of ventricular tachycardia (VT) after CSD and one had 90% reduction in episodes of VT. The median follow-up duration was 8 months inter-quartile range IQR (7–18). One patient succumbed to heart failure and one patient was lost to follow up. The other patients had no further events and were well at last follow up.

Conclusion:

Ultrasonography-guided pharmacological CSD is effective in the acute control of ES. It is easily performed with equipment that is readily available and relatively safe in terms of immediate complications and is an ideal second-line intervention when ES persists despite drug therapy.
Perfusion index as a predictor of working pediatric caudal block under general anesthesia- A prospective observational study
Authors: Rajan Karthika , Dave Nandini , Dias Raylene , Muneshwar Priyanka , Kesarkar Nikhil , Saxena Vishal
Published: December 2022

Background and Aims:

Advances in pulse oximeter technology have enabled us to measure parameters such as perfusion index (PI). We aimed to ascertain the utility of PI in the lower limb for evaluating the onset and adequacy of the pediatric caudal block under general anesthesia. The primary objective was to monitor PI trends after caudal block. The secondary objective was to compare the role of PI, heart rate (HR), and mean arterial pressure (MAP) in detecting onset and adequacy of caudal block and to ascertain whether PI was an earlier indicator in detecting adequate block.

Material and Methods:

Twenty-five children between 1 and 6 years, who underwent general anesthesia (GA) with caudal block were included. Baseline PI, HR, and MAP were recorded prior to and post caudal block at 5, 10, 15, 20 min and on skin incision. The onset of adequate block was defined as 100% increase of PI from baseline, 15% decrease of MAP or HR from baseline. T-test was used to compare trends of PI with baseline and the number of patients who met or failed these criteria for each of these three parameters at various time intervals wasnoted.

Results:

PI increased at all time intervals in 23 of 25 patients with working caudal block (P < 0.0001). By 10 min all those with a working caudal showed a 100% increase in PI. In contrast, 15% decrease in HR was not attained until 15 min where only 8 out of 23 achieved the above criteria, reaching a maximum of 20 patients at the time of incision; a 15% decrease in MAP was observed only in one patient at 5 min, reaching a maximum of eight patients at the time of incision.

Conclusion:

PI is an earlier and more sensitive indicator of the onset of the caudal block under general anesthesia (GA) than HR and MAP.
Prospective analysis of intraoperative critical incidents relevant to anaesthesia in a tertiary care teaching hospital in India
Authors: Shah Saloni K. , Kulkarni Aarti D.
Published: December 2022

Background and Aims:

Critical incidents associated with anesthesia can affect the patient’s outcome, may cause transient damage, and contribute to mortality. We aimed at recording anesthesia-related critical incidents in patients undergoing general surgical, ear, nose, and throat (ENT) and orthopedic surgical procedures in our institution. The critical incidents data were analyzed regarding the cause to establish protocols to prevent recurrences.

Material and Methods:

We conducted a prospective analysis of voluntarily reported perioperative critical incidents occurring in patients subjected to anesthesia over 1 year. Critical incidents were noted in terms of time (while inducing/intraoperative/while extubating), location (operating theater/recovery room) of the incident, anesthesia-related or surgery-related complications. Data collected were expressed as numbers and proportions to calculate incidence.

Results:

Anesthesia was administered to 5,645 patients of which 131 (2.32%) patients had critical incidents. Of these 131, 46 (35.11%) patients had more than one critical incident. A total of 216 (3.82%) critical incidents were noted. A majority of the patients were in the age range of 51–60 years. The maximum incidents occurred during the intraoperative period (35.11%) and in the operating theater (86.25%). Of the 216 incidents, 154 (71.30%) were anesthesia-related, 18 (8.33%) were surgery-related, 1 (0.46%) was patient-related and 43 (19.91%) were recovery-related. Of the 216 incidents, cardiovascular-related incidents accounted for the maximum incidents (18.05%, n = 39). Most of the events were preventable.

Conclusion:

The critical incident reporting system should be encouraged and protocols established to reduce the frequency and severity of these occurrences.
Evaluation of the HemoCue® for blood loss estimation in suction fluid in patients undergoing neurosurgical procedures: A prospective observational study
Authors: Ranjitha Y. S. , Shetty Anita N. , Hemantkumar Indrani , Gangakhedkar Gauri R , Choudhari Ashwini
Published: December 2022

Background and Aims:

Blood loss in neurosurgical procedures can be rapid and tremendous leading to consequential hemodynamic instability. HemoCue is a portable photometer used for the measurement of blood hemoglobin concentration. Using this point of care device, we contemplated this study to assess the reliability of HemoCue for suction hemoglobin determination and calculation of surgical blood loss by comparing with the gold standard laboratory Coulter Counter method in patients undergoing neurosurgical procedures.

Material and Methods:

This prospective observational study was conducted in 233 patients undergoing elective neurosurgical procedures in the age group of 18 to 60 years and having preoperative hemoglobin (Hb) values above 9 g/dL. Values of preoperative hemoglobin, suction hemoglobin, and volume in the suction container were used to obtain the estimated blood loss. The normality of the data was tested using the Kolmogorov Smirnov test. Bland Altman analysis was used to test the reliability of HemoCue in estimating hemoglobin and blood loss with reference to the gold standard laboratory Coulter Counter automated hematology analyzer.

Results:

Median blood loss calculated in our study using HemoCue was 554.65 mL with an interquartile range of 336.81 mL to 982.39 mL. Laboratory counter method estimated median blood loss was 533.37 mL with an interquartile range of 335.21 mL to 994.73 mL. The majority of the data obtained and analyzed using the Bland and Altman analysis method were within a 95% confidence interval.

Conclusion:

The HemoCue method is a reliable method and henceforth can be used to estimate blood loss in suction fluid in patients undergoing neurosurgical procedures.
Intraocular Complications after Caudal Epidural Steroid Injection for Discogenic Lumbar Pain with Radiculopathy
Authors: Nazm Nazneen , Keshkar Lata , Agrawal Manju , Akhtar Mohammad Nasim , Keshkar Sanjay , Agrawal Alok C.
Published: December 2022

Background:

Epidural steroid injection is a common intervention for symptomatic lumbar disc herniation. It is safe, but not absolutely free from complications. Visual complications and adverse intraocular events are sparse in the literature. This study is done to determine any intraocular complication after caudal epidural steroid injection for discogenic low back pain and radiculopathy.

Materials and Methods:

It was a prospective study, conducted from April 2018 to December 2019 by the orthopedics and ophthalmology departments of our institute. A total of 31 patients were recruited based on inclusion/exclusion criteria. All the patients presented to this institute with complaints of low back pain and sciatica were investigated. After proper diagnosis, the decision was made for caudal epidural steroid injection as per the standard principles of orthopedic surgery. Eye evaluations (intraocular pressure [IOP], visual acuity, and ocular examination) were done 1 day before, and 2–4 h, 1 week, and 2 weeks after epidural injection. The differences in eye evaluation values between time points were determined and discussed.

Results:

A total of 31 patients were recruited for this study, out of which the majority of the patients (27 patients) were between 41 and 60 years of age, and males (22 patients) outnumbered females (nine patients). Most of the patients (17 patients) had prolapsed IV disc of L5-S1. IOP was found to be raised after the intervention of epidural steroid injection which gradually came down to a preinjection level within 2 weeks. There was no change in visual acuity and no other intraocular complications, like hemorrhages.

Conclusion:

Epidural steroid injection for discogenic low backache (LBA) with radiculopathy did not adversely affect IOP, and neither had any ocular complication (in an ophthalmologically normal set of patients). A prudent approach should always be implemented.
Association between sleep quality and stress among medical students of a rural indian tertiary care setting
Authors: Periasamy Panneerselvam , Vajiravelu Suganthi , Gunasekaran Sasikala , Balakrishnan Ragavendrasamy , Manivannan Janani
Published: December 2022

Background:

Due to the rigorous academic standards and demanding professionals, the medical field is thought to be a stressful subject of study. This has a negative impact on the student’s mental and physical health. The long-term effects of this study will have an impact on identifying major issues that our students are facing, which will ultimately improve the level of medical treatment offered by future doctors.

Materials and Methods:

This cross-sectional study was conducted from October to December 2020 at a tertiary care institution in Tamil Nadu, India for three months. After getting the necessary ethical permissions from the institution with reference number GEMC/2020/002, the undergraduate students from the first year to the internship were included in the study.

Results:

The educational status of the students indicated that around 147 (31.1%) of respondents belonged in the first year. The mean + Pittsburgh Sleep Quality Index (PSQI) was observed to be 6.33 + 2.13, where undesirable sleep quality was predominant among 370 (78.3%) of the respondents with a p-value of less than 0.0001. The majority of the students (70.1%) have normal levels of stress which were significant with a p-value of 0.0027.

Conclusion:

Medical students experience poor sleep and ongoing stress, which can result in harmful behaviors like overindulging in junk food and a reduced likelihood of exercising. They are undeniably more prone to developing chronic illnesses. If these issues are not addressed, they will affect the medical care that is given to their incoming patients.
Pattern of comorbidities and clinical profile of young adults who died due to severe coronavirus disease
Authors: Mary Grace N. C. , Babu Shinas , Joseph Anoop , Jacob Dayan , Benjamin Allen S. , Anaghajyothi V. , Pulpandi Sanjay , Jacob Crisanta
Published: December 2022

Introduction:

Mortality due to coronavirus disease (COVID-19) is a significant problem among the non-elderly population.

Aims:

The primary objective was to estimate the prevalence of comorbidities among the deceased in the age group of 18–64 years and the secondary objective, was to describe their clinical profile.

Settings and Design:

The study setting was a tertiary care center catering to COVID-19 patients. This was a record-based descriptive study.

Materials and Methods:

Sampling strategy and Sample size: The formula used for sample size calculation is Z2 * P(1 – P) / d2. The sample size required was 97. The study period was from July 1 to November 30, 2021. Data collection: Demographic data including comorbidities, and clinical and laboratory features were studied. The laboratory investigations were done on the day of admission, and either on the last day or one day before death were taken for analysis. Statistical analysis used: Statistical analysis was carried out in IBM SPSS Version 26. Chi-square and Fisher’s exact tests, Mann–Whitney U and Kruskal–Wallis tests, Wilcoxon signed rank test, and Correlation tests were used for analysis.

Results:

The majority of the patients had more than one comorbid condition. The parameters which showed significant variation as the illness progressed were lymphocyte count, total protein, and albumin.

Conclusion:

Special vigilance should be kept while managing young patients with comorbidities. Lymphocyte count and serum albumin can be helpful in prognostication.
Comparative, observational study of the use of artesunate injections along with standard-of-care treatment versus only standard-of-care treatment in moderate and severe acute respiratory distress syndrome cases of COVID-19-positive infections
Authors: Ghodke Babita A. , Ghodke Ashok , Mali Kiran , Thorat Pooja
Published: December 2022

Introduction:

COVID-19 is a type of coronavirus disease belonging to the family Coronaviridae. In late December 2019, this virus emerged from Wuhan, Hubei province, China, and resulted in an outbreak in China and expanded globally. In India, the mortality rate today was 521,691 till the date-time of writing this article. Several therapeutic agents have been evaluated for the treatment of COVID-19.

Materials and Methods:

This was a hospital-based comparative, observational study of the use of artesunate injections with standard-of-care (SOC) treatment (group A) versus only SOC (group B) treatment in moderate-to-severe cases of COVID-19 acute respiratory distress syndrome (ARDS) patients, on a total of 130 patients (comparative group of 65 patients each). The study was done on hospitalized COVID-19-positive moderate and severe cases of ARDS from October 2020 to June 2021 at MGM Hospital and Research Centre, CBD Belapur, Navi Mumbai, Maharashtra, India.

Results:

One hundred and thirty patients were divided into two groups of 65 each; group A was compared with group B; group A received SOC with artesunate injections and group B received only SOC treatment. The mean age of patients in group A was 57.3 ± 12.5 years (standard deviation [SD]: 54.2–60.3) and in group B was 55.8 ± 12.5 years (SD: 52.8–58.9). Diabetes mellitus was the most comorbid condition. The inflammatory markers, respiratory rate, and SpO2 improved in group A as compared to group B. The proportion of patients progressing to noninvasive and invasive ventilation was more in group B as compared to group A (P < 0.05). About 93.8% of patients (61 patients) recovered in group A compared with 72.3% of patients (47 patients) who recovered in group B. The overall death in group A was 6.2% (four patients) and 27.7% (18 patients) in group B (P < 0.05), indicating the proportion of dead patients is significantly more where only SOC treatment was given.

Conclusions:

Artesunate injection administration accelerated recovery in our patients with moderate and severe COVID-19 disease by controlling hyperimmune response. The clinical improvement was seen by decreased levels of inflammatory markers, reduced respiratory rate, and improved oxygen saturation and showed significant survival in group A compared with group B. Artesunate injections were given 2 mg/kg body weight diluted in 1 mL 5% sodium bicarbonate solution as a bolus followed by 1 mg/kg body weight after 6 h and 2 mg/kg body weight with 1 mL sodium bicarbonate solution for next 2 days at an interval of 24 h. Patients tolerated the injections well and recovery improved, so artesunate can be considered a therapeutic option in moderate and severe cases of COVID-19 ARDS.
Infectious human diseases
Authors: Khandekar Pramod , Ghosh Prasanta K.
Published: December 2022

Infectious diseases are a significant burden on the global economy and public health. The major factors attributed to the rise in infectious diseases are thought to be the unstructured rise in the human population with expanding poverty, unplanned urbanization, fast urban migration, unplanned human habitats in thickly populated urban pockets that are the residence of poor people, insufficient healthcare infrastructure, inadequate vaccination, and neglect in effectively containing the zoonotic diseases, among others. Certain global regions such as China, India, Bangladesh, Pakistan, and Indonesia among the other Asian countries, sections of South America, and vast parts of Sub-Saharan Africa harbor more infectious human diseases. To contain the infectious disease burden, the health infrastructure especially in poor countries needs to be improved. With the assistance of rich countries monetarily as well as technologically, the situation can be improved. International institutions and large philanthropic organizations are working to improve human health globally. More monetary assistance to these organizations would positively contribute to the cause and would go a long way in diffusing the infectious agents.
A morphometric study of spinoglenoid notch, subcoracoacromial arch, and spinous process of the scapula on shoulder impingement
Authors: Kannappan Senthil Ganesh P. , Bagoji Ishwar B. , Kumar Senthil
Published: December 2022

Introduction:

Morphometric study of spinoglenoid notch, coracoacromial arch, and another measurement of the scapulae are required to understand the reason for spasms of common muscle due to supraspinatus tendinitis, nerve compression over the spinoglenoid notch. Therefore, the aim of this study was to discuss the subcoracoacromial arch, deviation of the spinous process, and measurement of the spinoglenoid notch.

Materials and Methods:

This study was conducted at the Department of Anatomy, Sri Venkateshwaraa Medical College Hospital & Research Centre, Chennai, Tamil Nadu, India on 70 scapulae that include 58 non-articulated scapulae and 12 articulated scapulae. All the measurements were performed with a vernier caliper and the alignment of the spinous process of the scapula was measured with a goniometer. All the measurements are compared on both sides.

Results:

All the measurements were performed and presented as mean with standard deviation. We found the variation of diameter between the left and right sides. Spinoglenoid notch diameters were noted as anterior to posterior right 2.97 ± 0.37 cm, left 3.06 ± 0.56 cm and medial to lateral right 1.36 ± 0.14 cm, left 1.4 ± 0.08 cm. Subcoracoacromial arch was observed as right 1.85 ± 0.23 cm and left 1.92 ± 0.4 cm. The direction of the spinous process of the scapula was noted as right 21.50º ± 8.50 and left 18.8º ± 7.89.

Conclusion:

The present morphometric study findings may give a different approach to supraspinatous tendinits, shoulder instability, and dislocation cases due to morphometric changes present in the spinous process, acromion process, glenoid cavity, and spinoglenoid notch of the scapula. These morphometric studies on scapula can help radiologists, orthopedicians, and physiotherapists to plan patient management.
Micro- and macro-level economic implications of digital addictions
Authors: Shetty Kannappa V. , Tewathia Nidhi , Bamney Urmila , Rawat Vikram Singh
Published: December 2022

Introduction:

Technology has significantly transformed how we live our lives. The Internet has made life easier by making knowledge more accessible to all and connecting individuals all over the world. However, it has also caused many people to spend far too much time in front of the computer, to the point that it has become the center of their existence.

Materials and Methods:

A case of a 20-year-old male student of Bachelor of Engineering, who belongs to the middle socio-economic status of a rural area, is digitally addicted, and getting treated in a tertiary hospital in Karnataka, India.

Discussion and conclusion:

Digital addiction can cause various psychological issues, particularly anxiety, depression, insomnia, and behavioral issues. It further creates an economic crisis in the family of a digital addict as well as for the nation. Therefore, to address the implications of digital addiction, the country must devote resources towards awareness, prevention, and intervention in the area of digital addiction.
Motherhood after hysterectomy
Authors: Gopinath Pondicherry M.
Published: December 2022

Uterine rupture in pregnancy is rare and life-threatening. Myomectomy is one of the common procedures done to enhance success rates in the treatment of subfertile patients. The risk of scar rupture is very high during the third trimester. The rate of total uterine rupture has been reported about 0.07%. This patient was a 33-years-old, seeking motherhood after hysterectomy following a ruptured uterus in the third trimester. Invitro fertilisation stimulation was done, and the embryo transferred to a surrogate mother.
Therapeutic ART for borderline ovarian tumor
Authors: Gopinath Pondicherry M. , Raaj Anusha , Manoharan Sahityalakshmi
Published: December 2022

Borderline ovarian tumors occur in about 10–16% of all epithelial ovarian tumors. However, it has a good prognosis when compared with other epithelial malignant tumors. Out of all the types, serous borderline tumor is the most common type, found bilateral in 30% of the cases. Management is tailored based on physical examination, radiological findings, and histopathology report. Even though the diagnosis is based on histopathological findings, pre-operative evaluation, especially in younger women, plays an important role in selecting less radical treatment. Here is a case of a borderline ovarian tumor, which was managed considering her age, marital, and fertility status.
YEREL YÖNETİMLER İÇİN ENTEGRE FAALİYET RAPORLAMA MODELİ ÖNERİSİ
Authors: ALKAN Gönül , KAPLANOĞLU Emre
Published: December 2022

Yerel yönetimler mevzuat gereği, zorunlu olarak ve kamuyu aydınlatmak için mali ve sosyal verileri içeren çeşitli raporlar sunmaktadır. Bu raporlar yerel yönetimlerin çevresel, yönetsel, sosyal ve finansal performanslarını kamuoyu ile paylaşmaları açısından çok değerlidir. Ancak bu raporların ayrı ayrı sunumu, yönetsel stratejilerin oluşturulmasında ve kamuoyunun bütün bilgilere bir arada ve standart bir sunumla erişiminde sınırlı kalmaktadır. Bu çalışmada işletmelerin finansal ve finansal olmayan performans bilgilerinin verildiği ve açıklandığı entegre raporların yerel yönetimlerde uygulanabilirliğine ilişkin GRI göstergelerine göre hazırlanan örnek bir entegre faaliyet raporu sunulmaktadır. Çalışmanın kapsamına İzmir Büyük Şehir Belediyesi’nin faaliyet raporları alınmıştır. Belediyenin faaliyet raporunda yer alan bilgiler incelenmiş ve GRI göstergeleriyle uyumlu olanlar alınarak bir entegre faaliyet raporu örneği oluşturulmuş ve öneriler paylaşılmıştır.