bluuebunny/crossref_metadata_2025 huggingface dataset:
Establishing a Regional Rare Blood Donor Registry in Uttarakhand, India
Authors: Raturi Manish , Adhikari Bhawana , Dhiman Yashaswi , Gaur Dushyant Singh , Kusum Anuradha
Published: November 2023

Background and Objectives:

Uttarakhand, a state in northern India, is home to various local communities, including the Garhwali, Kumaoni, and Jaunsari. In addition, individuals from neighboring countries such as Nepal and Tibet reside in Uttarakhand for many years, resulting in a diverse population. However, currently, there is no regional registry for rare blood donors in this state. The aim of this study was to develop a rare donor registry in Uttarakhand which could in future become a part of the national rare blood donor registry.

Methods:

During the routine donation process, samples were taken from randomly selected O-typed blood donors who are residents of Uttarakhand. Seventeen monoclonal antisera included Rh (anti-D, anti-C, anti-c, anti-E, and anti-e), Duffy (anti-Fya and anti-Fyb), Kell (anti-K and anti-k), Kidd (anti-Jka and anti-Jkb), Lewis (anti-Lea and anti-Leb), M, N, S, and s (Ortho Diagnostics Pvt Ltd, Mumbai, India). Furthermore, four polyclonal antisera from our serum repository, Diego (anti-Dia), Indian (anti-Ina), Rh (anti-Cw), and anti-Gp-Mur were used for phenotyping. The study was financially aided by the Uttarakhand State Council of Science and Technology (UCOST), Dehradun, Uttarakhand, Government of India.

Results:

Over a period of 16 months (November 2021–February 2023), out of a total of 17,004 blood donations, O blood type donors accounted for 29.9% (5085/17,004) of the donors screened. Among these, 7.3% (374/5085) of the donors were from the interior and plain areas of Uttarakhand. Our study revealed a high prevalence of k and e antigens, with 96.7% and 92.5%, respectively. The least prevalent antigen was Rh (Cw), observed in only 0.5% of cases. We also identified rare blood antigens such as Diego, Indian, and Gp-Mur and compared our findings with other studies. Furthermore, we identified a donor with an H-deficient phenotype, specifically the Bombay blood group (Oho).

Conclusion:

We have successfully established a regional registry for rare blood donors in Uttarakhand, which will be valuable for managing complex transfusion scenarios in the future. Further, given Uttarakhand's proximity to China and Nepal, the presence of individuals from these countries aptly connects the fields of anthropology and transfusion medicine.
Blood Transfusion-Related Change in Circulating Plasma-Free Hemoglobin Levels and its Impact on Microvascular Oxygenation: A Prospective, Observational Study
Authors: Tomar Akshaya , Kushwaha Neerja , Asthana Bhushan , Kumar Sudeep , Sharma Sanjeevan
Published: November 2023

Background and Objectives:

Transfusion of stored, packed red blood cells (PRBCs) is a common therapeutic intervention; however, development of hemolysis during storage might contributes to some negative consequences due to the release of free hemoglobin (fHb), a potent nitric oxide scavenger, which may impair vasodilation and microcirculatory perfusion after transfusion. We undertook this study to find out the change in fHb levels in recipients, whether this affects microvascular oxygenation posttransfusion.

Methods:

Eighty stable transfusion recipients were selected for this prospective observational study and were divided into three groups as per the age of blood transfused (<7 days, 7–14 days, and >14 days). Blood samples were collected to analyze the plasma levels of fHb in the bag. The patient's circulating plasma Hb (FHb) and pO2 by venous blood gas analysis were studied before and after 1 h of transfusion. Data were analyzed through paired t-test, ANOVA, and Pearson's correlation coefficient using the SPSS version 23.

Results:

Overall, there was a significant difference between the three groups in terms of change in plasma fHb (g/dL) from pretransfusion to the 1 h posttransfusion time points (P < 0.05). Significant increase in pO2 Levels was noticed from the pretransfusion to 1 h posttransfusion time points in bags <7 days old (t = −4.6, P < 0.001). Furthermore, a strong negative correlation was obtained between FHb and pO2 using Pearson's correlation coefficient (r = −0.738; P < 0.001).

Conclusion:

This study concludes that red blood cell transfusion can significantly increase posttransfusion plasma Hb levels depending upon the age of PRBC units and has an implication on microvascular oxygenation. However, the effect on the clinical outcome of the patient was not studied, and it would be worthwhile to investigate whether the age of the blood transfused affects the patient morbidity or mortality.
Prestorage Inline Leukodepletion of Buffy Coat-depleted Packed Red Blood Cells: Comparative Analysis of White Blood Cell Count and Interleukin-8 between Leukodepleted and Nonleukodepleted Packed Red Blood Cells
Authors: Qanoon Hakim Ali , Makhdoomi Rumana Hamid , Shah Zaffar Amin , Eachkoti Rafiqa , Roshan Reshma
Published: November 2023

Background and Objectives:

We aimed to analyze the impact of prestorage Inline leukodepletion and storage time on interleukin 8 (IL-8) levels in stored buffy coat-depleted packed red blood cell (PRBC) units in the Kashmiri population setting.

Methods:

A total of 50 donors of Kashmiri origin from North India equally and randomly distributed between Leukodepleted (LD) and non-LD (NLD) arms were recruited in this study. Leukodepletion of PRBCs units was performed using 3rd Generation integrated LD filters and the residual white blood cell (WBC) count was enumerated by FACS using fluorochrome-tagged CD45+ antibodies and IL-8 levels measured by ELISA.

Results:

In contrast to NLD arm, leukodepletion in the LD arm significantly reduced total leukocyte count (TLC) from pre-LD TLC of 2.25 ± 0.47 × 109/PRBC unit to post LD cell count of 2.40 ± 0.65 × 106/PRBC unit, P = 0.001, i.e., 3 log reduction, P = 0.0001. Contrary to the LD arm, a significant difference in IL-8 levels in NLD arm was observed with 27.15 ± 30.32 pg/mL on day 0, 45.15 ± 36.15 pg/mL on day 14, and on day 28, 37.98 ± 33.05 pg/mL. Furthermore, significant variance (LD vs. NLD) in IL-8 levels was observed at day 0, 14th, and 28th day of storage, with maximum variance observed on day 14th Fstat = 21.46, P = 0.00, depicting prestorage LD have a significant role in suppressing the IL-8 levels in LD stored PRBC units while as in NLD PRBC units with time IL-8 accumulated as its cell source (WBCs) was intact.

Conclusion:

Inline prestorage leukodepletion by 3rd generation LD filters was uniformly effective in reducing the residual WBC count to desired levels of <5 × 106/unit of PRBC. The significant decrease in TLC and resultant far less accumulation of cytokine (IL-8) in prestorage LD PRBC units of Kashmiri origin, as observed in this study, would be translated into clinical benefits associated with transfusion of LD-PRBC units.
Comparison of gum elastic bougie-guided insertion of LMA ProtectorTM versus the conventional method in achieving oesophagal patency - A randomised comparative study
Authors: Kerai Sukhyanti , Prathap T. H. , Bhatt Garima , Gaba Prachi , Gupta Lalit , Saxena Kirti N.
Published: November 2023

Background and Aims:

The passage of a Ryle’s tube through the drain port on the laryngeal mask airway (LMA) ProtectorTM has been reported to be arduous despite the larger gastric channel. There are no studies on the evaluation of the guided insertion of LMA ProtectorTM to achieve adequate gastrointestinal drainage function.

Methods:

This randomised study included 132 patients who underwent surgery under general anaesthesia. The gum elastic bougie (GEB)-guided insertion of LMA ProtectorTM (group I) was compared with the conventional method (group II), and the alignment of the tip of the drain tube with the oesophagus was assessed. The insertion characteristics of the device, accuracy of LMA ProtectorTM placement, haemodynamic parameters, and post-operative airway morbidity following the insertion of the device were also compared between the two groups.

Results:

The first-attempt success rate for the placement of LMA ProtectorTM and the patency of oesophagus was higher in group I patients than in group II (100% vs 84.8%; P < 0.001). However, the time taken for device insertion and associated haemodynamic changes were significantly longer in group I. The patients in group I had better visualisation of laryngeal structures. The GEB-assisted insertion of LMA ProtectorTM resulted in less incidence of blood staining at the cuff of the device.

Conclusion:

GEB-guided insertion of LMA ProtectorTM achieved better oesophageal patency than the conventional insertion method. This method also had higher first-attempt success at the placement of the device and was observed to be less traumatic.
Carle’s obstetric early warning score as a screening tool for critical care admission
Authors: Gupta Chhavi , Suri Jyotsna , Bachani Sumitra , Bharti Rekha , Pandey Divya , Mittal Pratima
Published: November 2023

Background & objectives:

Early warning systems (EWS) involve serial observations (track) with criteria (trigger) to timely identify patients at risk of complications. Carle designed a statistically based clinically modified obstetric early warning score (Carle’s OEWS). This study evaluated Carle’s OEWS and its individual components for predicting admission to the obstetric critical care unit (OCCU). Maternal near-miss and maternal mortality were the secondary outcomes.

Methods:

A prospective observational study was conducted among 1250 pregnant women with a period of gestation ≥28 week admitted in the labour wards of a tertiary centre over 18 months. The physiological parameters of OEWS were recorded and aggregate score was calculated at admission and at regular intervals thereafter, till discharge or OCCU admission.

Results:

The area under receiver operating characteristic (ROC) curve of OEWS was 0.975 for predicting OCCU admission, 0.971 for near-miss, and 0.996 for predicting maternal mortality and was significant for all outcomes. All individual parameters, except diastolic blood pressure, had a significant relative risk for predicting OCCU requirement.

Interpretation & conclusions:

Carle’s OEWS is a useful screening tool for predicting obstetric OCCU admission and can be routinely used in labour wards to ensure timely intervention.
Iris depigmentation and cytomegalovirus in aqueous humor as predictors of uveitic activity and recurrence in chronic and recurrent anterior uveitis
Authors: Kam Ka Wai , Mok Eugenie , Ho Mary , Wong Chung Hei , Sze Ryan Kin Ho , Chan Paul KS , Young Alvin L
Published: November 2023

Purpose:

To examine the clinical outcomes in chronic or recurrent anterior uveitis in the presence or absence of cytomegalovirus (CMV) and investigate the predictive factors for uveitic activity and recurrence.

Methods:

Polymerase chain reaction (PCR) was performed in a prospective cohort of immunocompetent adults with recurrent or chronic anterior uveitis to detect CMV in aqueous humor. The clinical outcomes were compared between eyes with and without CMV DNA. Logistic regression was performed to evaluate associations between iris depigmentation, CMV-PCR status, uveitic activity, and recurrence.

Results:

Thirty-eight eyes of 38 subjects with a mean age of 61.1 ± 11.2 years old were analyzed. Fifteen eyes were positive for CMV. More eyes with CMV developed recurrences and remained actively inflamed at 6, 12, and 24 weeks though the differences were insignificant. The presence of iris depigmentation was predictive of a greater odd of uveitic recurrences by 12 and 24 weeks (Odds ratio (OR) = 9.17 and 5.72, P = 0.007 and 0.034 respectively), whereas positive CMV-PCR predicts a greater odd of uveitic activity at postoperative 12 and 24 weeks (OR = 13.08, 34.30; P = 0.027, 0.007).

Conclusion:

Eye with and without detectable CMV behaved similarly in their clinical course. Our findings suggested that iris depigmentation was predictive of more frequent uveitic recurrence, regardless of the PCR status, whereas the presence of CMV in aqueous humor was associated with persistent uveitic activity. Iris changes may be present during the earlier phase of the disease and precede the detection of virus from the aqueous humor at a later stage of CMV infection.
Clinical profile of childhood exotropia in a tertiary eye care center in North India
Authors: Gore Jinal , Rath Soveeta , Ganesh Suma
Published: November 2023

Purpose:

To identify different types of exotropia in children less than 16 years and their clinical presentation. The secondary objective is to identify the age of onset, age of presentation, birth history, and ocular and systemic associations as well as to evaluate their motor and sensory status.

Methods:

This hospital-based descriptive observational study was conducted from September 2018 to December 2019. Patients with a clinical diagnosis of exotropia of age less than 16 years, and exotropia of ≥ 10 PD were included in the study. Data were collected using a structured proforma. All statistical calculations were performed using Microsoft Excel Office version 2016 and R version 4.0.2.

Results:

Two hundred eighty-six (286) consecutive children with exotropia were analyzed. Intermittent exotropia (72%) was the most common form of exotropia, followed by exotropia with a neurological association (11%), infantile (8%), sensory (6%), restrictive (2%), and paralytic (1%) types. Exotropia with neurological association had a significantly earlier age of presentation (median = 42months) as compared to other types (P = 0.039).

Conclusion:

We recorded a huge amount of cases of exotropia associated with neurological abnormalities and this group of patients had significantly more number of preterm and low birth weight children. This study has its limitations as it is not a population-based study and prevalence rates could not be calculated.
Central retinal artery occlusion following pediatric blunt ocular trauma
Authors: Ramachandran Sivaranjan , Chavan Kasturi , Padhi Tapas R , Takkar Brijesh , Karande Sayali , Kelgaonkar Anup , Panda Krushna G , Padhy Srikanta K
Published: November 2023

Background:

To analyze the clinical profile, presentation, possible pathophysiology, and outcomes of central retinal artery occlusion (CRAO) following blunt trauma in pediatric subjects.

Methodology:

The medical charts of subjects aged 18 years or less with a diagnosis of CRAO following blunt ocular trauma were analyzed retrospectively for demography, details of the trauma, ocular findings, additional imaging reports if any, and final outcome. A Medline search was done (key words like central retinal artery occlusion, blunt trauma, children, pediatric subjects, and adolescents) to gather information available in the literature on the subject.

Results:

A total of 11 patients (11 eyes), mean age of 14.3 ± 3.4 years, and 100% male preponderance, with an average time duration from trauma to presentation to the hospital of 8.1 days were included. Visual acuity ranged from no light perception (four eyes) to finger count at a 1 m distance. Intraocular pressure was raised in three patients, of which two were suffering from sickle cell disease. In two eyes, the CRAO coexisted with optic nerve avulsion and the cilioretinal artery was spared. Disk pallor was seen in six eyes as early as 12 days from the trauma. None of the cases revealed any bony fracture in the CT scan.

Conclusion:

CRAO was observed to be an important primary or contributory cause of visual loss in children following blunt trauma, reflex vasospasm being the most common etiology. Early onset disk pallor could suggest an underlying vascular compromise of both retinal and optic disk circulation in addition to direct disk damage.
A randomized controlled trial to assess safety and efficacy between terminal chop, stop and chop, and direct chop
Authors: Sinha Aprajita , Morya Arvind Kumar , Gupta Vinita , Prasad Ripunjay
Published: November 2023

Purpose:

The goal in developing new techniques of cataract surgery is to provide a safer, more efficient surgical experience with the lowest complication rate and endothelial cell loss. We compared the efficiency and safety of stop-and-chop, direct chop, and the novel terminal chop techniques of nuclear fragmentation for cataracts grade II-V.

Methods:

We conducted a prospective randomized clinical trial comparing three different techniques of phacoemulsification, namely, stop-and-chop, direct chop, and terminal chop to assess any differences between them and to establish whether any one method was superior to the others. The pre- and postoperative parameters studied, included central corneal thickness (CCT), ultrasonic time (UST), endothelial cell density (CD), cell loss and effective phacoemulsification time (EPT), average cumulative dissipative energy (CDE), and best-corrected visual acuity, among others.

Results:

307 eyes were recruited to the study, 102 were recruited to the stop-and-chop group, 103 to the direct chop group, and 102 to the terminal chop group. Statistical differences were found between the techniques with regard to postoperative CCT among NS II (P. 0001) and NS IV cataracts (P = .005) with the lowest values in the terminal chop group among NS II, NS III, and NS IV cataracts. Endothelial cell loss was minimum with a terminal chop in NS II (P = .018) and NS IV cataracts (P = .245). CDE was minimum in terminal chop across different cataract densities.

Conclusion:

Terminal chop showed improvement over the other two techniques in terms of CDE and was comparable to them with regard to other parameters.
The effect of blue light filter on visual and task performance
Authors: Usgaonkar Ugam P S , Dessai Sailee P , Shetty Aksha
Published: November 2023

Purpose:

This study aimed to determine the effect of the blue light (BL) filter on the different tasks performed on a laptop on a daily basis.

Methods:

Forty subjects were required to perform a 45-minute task on the laptop screen with or without the BL filter on two different days. In the first task, subjects were made to watch a video. In the second task, subjects were made to read a passage from the laptop for 3 minutes, and reading speed was calculated. In the third task, subjects were made to enter the data on the laptop. The time taken to fill in the data was recorded. After the completion of the task, questionnaires were administered. Pre- and post-task accommodative tests were performed.

Results:

Forty emmetropes with a mean age of 21 ± 2 were recruited. In visual performance, the subjective response showed a significant difference in visual fatigue level with and without the filter. A statistically significant difference was seen in reading speed and data entry during task performance with and without the filter. Pre- and post-task accommodative parameters showed variable responses.

Conclusion:

This study showed that the use of a BL filter improves task performance, but subjectively, people experienced more visual fatigue while using the filter.
Combat ocular trauma in counterinsurgency operations
Authors: Rana Vipin , Patra Vinod K , Bandopadhayay Sandepan , Raj Biresh , Sharma Vijay K , Gupta Atul , Mishra Sanjay K , Kumar Pradeep
Published: November 2023

Purpose:

To identify the pattern, distribution, and causes of ocular injuries among the security personnel participating in counterinsurgency operations (CIOps).

Methods:

This was a multicentric, retrospective review of chart records of patients reporting to three hospitals located in the geographic region affected by CIOps. The hospital registry was examined for all patients diagnosed with any type of ocular trauma between January 1, 2016, and December 31, 2019. A standardized proforma was filled out using the case records, and entries were validated.

Results:

A total of 131 ocular injuries fulfilled the criteria of the study. The mean age of the patients was 32.46 ± 10.2 years. All the patients were males. The causes of the injuries were explosive blasts in 60 eyes (45.80%), gunshot wounds in 15 eyes (11.42%), stone pelting in 16 eyes (12.21%), training-related causes in 26 eyes (29.84%), vehicular accidents in 13 eyes (9.92%), and battery blast in one eye (0.76%). Among the type of injuries, open globe injuries included 66 eyes (50.38%), closed globe injuries included 35 eyes (26.72%), isolated lid lacerations included 14 eyes (10.68%), and isolated chemical injury was seen in two eyes (1.52%). Optic nerve head avulsion was seen in two eyes (1.52%).

Conclusion:

The study revealed a considerable number of ocular injuries related to combat, with explosive bursts being the leading cause. The incidence of ocular injuries was found to be highest in zone 1. This study emphasizes the importance of the need for soldiers deployed in active CIOps regions to wear protective eyewear, such as ballistic goggles or military combat eye protection, to reduce the risk of ocular injuries.
EYESPIRATOR- A novel do-it-yourself suction device
Authors: Shafeena P , Venkataramanan Padmapriya , Murugesan Sindhuja , Gosalia Hirika , Chandrakanth Prithvi , Venkatapathy Narendran
Published: November 2023

Surgery, by nature, involves blood loss. Thus, suction plays an important role in ensuring a clean operating view and ease of access. In ophthalmology, there is a void for an efficient and flexible suction apparatus that is yet to be filled. Our innovation, the Eyespirator, is made using recycled or inexpensive parts, is easy to assemble, and can serve as a cost-effective alternative to the current apparatus under use. It helps to overcome the difficulties caused by large instruments and non-pliable suction tips, unregulated generation of vacuum, and high pressures generated causing trauma to the delicate structures, and can prove to be of immense use in fields such as ophthalmology where the small surgical field is a big challenge. It creates a vacuum by using a simple water pump and is regulated by a foot pedal. This can be deployed even in rural settings, and small modifications can allow its usage in a wide variety of surgical fields.
COVID and COVID vaccine–related corneal morbidity: A review
Authors: Sidhu Navneet , Vanathi Murugesan , Gupta Noopur , Tandon Radhika
Published: November 2023

Systemic coronavirus disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus has had several ocular consequences. Many vaccines have been developed against the disease, with adverse events being reported as well. Various ocular adverse events secondary to coronavirus disease 2019 (COVID-19) vaccines have also featured in literature in recent times. This review features the reported corneal-related effects of COVID infection and vaccination. These include direct effects on corneal grafts and unilateral or bilateral corneal melts. The compilation of reported experiences from across the world in this systematic review will help clinicians recognize the possible presentations, pathogenesis, and management of the same.
Did healthy life awareness affect the behavioral or cognitive avoidance attitude from COVID-19? An observational study
Authors: Şen Ayşegül , Başpınar Melike Mercan , Basat Okcan
Published: November 2023

Aim:

This study purposed to evaluate the healthy life awareness (HLA) level versus the COVID-19 avoidance attitudes.

Materials and Methods:

A single-centered observational study was conducted in the Family Medicine Clinics of a tertiary hospital between April 30, 2021 and July 30, 2021. The HLA scale was used to determine the participants' HLA levels. In addition, the avoidance attitudes from the COVID-19 scale score assessed attitudes toward avoiding COVID-19. Data were analyzed with E-Picos (MediCRES) Statistical Programme.

Results:

Of the 311 participants aged 30.79 ± 8.37 years, 58.52% (n = 182) were female and 41.48% (n = 129) were male. A negative relationship between the HLA and cognitive avoidance scores (r = −0.255, P < 0.001) and a positive relationship between HLA and behavioral avoidance scores (r = 0.119, P = 0.036) have been indicated. The results of a binary logistic regression, taking the presence of a higher HLA score as the dependent variable, have shown that high awareness was observed in women, approximately 1.7 times more than in men [odds ratio (OR): 1.684, 95% confidence interval (CI) = 1.058–2.696; P = 0.030]. Participants with high HLA had 1.06 times higher behavioral avoidance scores than others (OR: 1.066, 95% CI = 1.012–1.455; P = 0.049). As the cognitive avoidance score increased, the presence of high HLA decreased by nearly 33%. (OR: 0.666, 95% CI = 0.512–0.867; P = 0.002).

Conclusion:

This study emphasized that a higher HLA was associated with increased behavioral avoidance and decreased cognitive avoidance from COVID-19. HLA has led to doing what needed to be done without being affected by negative discourses.
Comparative study of ‘the clinical profile of COVID-19-positive patients with and without vaccination profile’
Authors: Kullolli Dhruv Vijay , Kullolli Monika , Gore Alka Dilip
Published: November 2023

Background:

More than 4.5 million people have perished from the COVID-19 virus, which has so far been linked to more than 200 million reported cases. Vaccination is an ultimatum for survival from this disease. Hence, this research was designed to study the course of disease in vaccinated and unvaccinated group and to understand the significance of blood markers, to study lung involvement (HRCT), number of hospitalised days, number of O2 days, and number of days of ventilator support in both the groups in hospitalised patients.

Material and Methods:

A cohort study was conducted among COVID-19-positive patients tested either with rapid antigen test or RT-PCR test hospitalised in Kullolli Institute of Health Services. Patients who had received at least one dose of vaccination were included in the analysis. Data were analysed by using unpaired t-test, between the two groups of survived and non-survived patients. Chi-square test and/or Fisher's exact tests were used to check the association.

Results:

In the study, only 71 (18.6%) patients were vaccinated. There were 49 (69.01%) patients out of 71, representing a massive number of vaccinations for people over the age of 50. There were 40 patients with co-morbid conditions, 31 (77.50%) of whom were vaccinated. CRP levels were significantly severe in non-survived patients of non-vaccinated group (Fisher's exact = 8.938, P = 0.024). d-Dimer levels, serum ferritin levels, and HRCT scores were significantly related to the outcome (survival/non-survival). Patients who did not survive have higher levels of these parameters. In the vaccinated group, these associations were not significantly associated. Vaccination did not show statistically significant benefits in patients with co-morbid conditions.

Conclusion:

Vaccination has enormous life-saving potential. Regardless of the type of vaccine used, the immunisation provides life-saving protection against a disease that has killed millions.
Perception and attitude of type 2 diabetic patients toward insulin therapy in the primary care of National Guard for Health Affairs (NGHA) in Jeddah, Saudi Arabia
Authors: Alzahrani Abdullah M. , Alshareef Reem J. , Balubaid Marwan M. , Alzahrani Mohammed , Alsoubhi Mohammed , Shaheen Mostafa
Published: November 2023

Purpose/Background:

Our study explores and determines the perception toward insulin among patients with diabetes in the National Guard for Health Affairs (NGHA), Jeddah, the Kingdom of Saudi Arabia (KSA), and aims to gain insight into the causes of refusal. Patients with type 2 diabetes (T2D) are likely to need the use of insulin to keep blood glucose levels within normal range and delay the onset of diabetes-related problems. Individuals with diabetes may be hesitant to begin insulin therapy if they have a negative attitude toward it, which might add to the delay in beginning treatment.

Materials and Methods:

A cross-sectional study was conducted in the primary healthcare centers of the NGHA in Jeddah, Saudi Arabia. Data were collected through a validated self-administered questionnaire that was divided into three sections, with a total of 32 questions. The first section concerned demographic data, the second part was directed toward insulin users, and the last section was directed toward non-insulin patients.

Results and Conclusion:

Our study collected 314 responses. Males constituted 54.8% of participants and insulin users resembled 45.7%. According to our study, important deterrents to starting insulin therapy among non-insulin users included the following: the cost of insulin, the pain associated with injections, the difficulty in maintaining food control while on insulin treatment, scarring at the injection site, and the weight gain impact. Factors that were found to influence compliance to insulin therapy among insulin users included fear of weight gain and self-administration of insulin.
Description of HIV risk behavior among adolescent female sex workers: Findings from the nationwide cross-sectional integrated biological and behavioral surveillance (IBBS) 2014–15 survey for HIV in India
Authors: Rai Sanjay K. , Thakur Nishakar , Jha Shreya , Kumar Pradeep , Haldar Partha , Kant Shashi , Misra Puneet , Venkatesh Srinivas
Published: November 2023

Introduction:

Adolescent female sex workers are at high risk of acquiring human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) infection. There was paucity of information regarding their sexual practices. The main objective of this study was to study the sexual behavior, condom use practices, and physical and sexual violence experienced by adolescent female sex workers (FSWs).

Materials and Methods:

This study was a secondary data analysis of the data collected during the nationwide IBBS 2014–15 survey. All adolescent FSWs aged 15 to 19 years were included in the analysis. The primary outcome variable was HIV serostatus, and independent variables included sexual behavior and condom use practices and socio-demographic variables. Descriptive analyses were performed to estimate the prevalence of independent variables. Ethical approval of the original IBBS study was obtained by the Ethics Committee of National AIDS Control Organization.

Results:

A total of 948 adolescent FSWs were included in the final analysis. The prevalence of HIV in adolescent FSWs was 1.2% [95% confidence interval, 0.1–1.9%]. The mean age [standard deviation (SD)] of FSWs was 18.2 (0.9) years. The mean (SD) age at first sexual intercourse was 15.6 (1.7) years, and the mean (SD) age of starting sex work was 16.6 (1.5) years. The majority of the FSWs (94%) had used condom during the last sexual intercourse with a commercial partner, and about one-thirds (66%) had consistently used condom with a commercial partner. About a quarter (26%) of the FSWs had anal intercourse with a commercial partner in the last 1 month. About one in five FSWs (21%) had experienced physical violence in the last 1 year.

Conclusion:

Almost one-third of FSWs had high-risk sexual behavior like multiple clients, anal intercourse, inconsistent condom use, and so on. These behaviors in turn increase their vulnerability to HIV infection.
Oral rehabilitation of a 14-year-old quadriplegic child with cerebral palsy under general anesthesia: A case report
Authors: Baviskar Mansi , Mudaliar Akshaya , Kodical Sanjana Ratnakar , Chaudhary Chinmaya , Valke Parnaja
Published: November 2023

Cerebral palsy is a neuromuscular disorder in which patients deal with dysfunction in motor coordination in addition to other problems like epilepsy. Due to disrupted motor functions, the oromotor coordination is also affected, leading to higher incidence of dental caries, which is also due to increased consumption of medications. This case report deals with the oral rehabilitation of a quadriplegic 14-year-old child with cerebral palsy, suffering from severe dental pain and who was treated under general anesthesia.
NAT yield in blood donors: An observational study
Authors: Sharma Ankit , Bundas Sunita , Parashar Rashmi
Published: November 2023

Introduction:

Individual donation nucleic acid testing (ID-NAT) is considered as highly sensitive technology for viral transfusion-transmissible infections (TTIs) in blood donors. The present study was aimed to analyze the results of ID-NAT with special reference to different types of donors, their age, gender, blood group ranges in a tertiary care center in north India.

Methodology:

The present study was done from 24th June 2019 to 31st December 2021 in Blood Center, Department of Immunohematology and Blood Transfusion, SMS Hospital, Jaipur. A total of 18313 apparently healthy adult donors were included in present study.

Result:

In 2019 Combined NAT yield was 1 in 754, in 2020 it was 1 in 2368 and in 2021 it was 1 in 741. With Total NAT yield was 1 in 1017 (0.09 %) over a period of study. NAT yield in HBV is 1 in 1077, in HCV 1 in 18313 and no NAT Yield in HIV.

Conclusion:

NAT testing for hepatitis B provides additional safety because ELISA does not pick up occult hepatitis. The non-seroconverting or delayed seroconverting disease is missed by ELISA alone and can be picked up by NAT.
Applications of artificial intelligence in the management of childhood obesity
Authors: Alghalyini Baraa
Published: November 2023

Background:

Childhood obesity has emerged as a significant public health challenge, with long-term implications that often extend into adulthood, increasing the susceptibility to chronic health conditions.

Objective:

The objective of this review is to elucidate the applications of artificial intelligence (AI) in the prevention and treatment of pediatric obesity, emphasizing its potential to complement and enhance traditional management methods.

Methods:

We undertook a comprehensive examination of existing literature to understand the integration of machine learning and other AI techniques in childhood obesity management strategies.

Results:

The findings from numerous studies suggest a strong endorsement for AI's role in addressing childhood obesity. Particularly, machine learning techniques have shown considerable efficacy in augmenting current therapeutic and preventive approaches.

Conclusion:

The intersection of AI with conventional obesity management practices presents a novel and promising approach to fortify interventions targeting pediatric obesity. This review accentuates the transformative capacity of AI, thereby advocating for continued research and innovation in this rapidly evolving domain.
Recurrent abdominal laparotomy wound infection and dehiscence in a patient with zinc and selenium deficiency associated with Roux-en-Y gastric bypass: Case report and literature review
Authors: Chizooma Eugine , Fabyan Sarah , Panda Akhila , Ahmed Mohamed Hassan , Panourgia Maria , Owles Henry , Webber Jane
Published: November 2023

We report a case of a 72-year-old woman who developed recurrent abdominal laparotomy wound dehiscence and infection following a hepatico-jejunostomy. Her surgical history included a Roux-en-Y gastric bypass (RYGB) that was carried out 11 years ago. Upon further assessment in the current admission, she was found to be deficient in both selenium and zinc. Daily multivitamin and mineral tablets and a nutritional supplement drink were prescribed to address her deficiencies. After 2 months of supplementation, the laparotomy wound had made significant healing progress and no further surgical input was required. This case illustrates the importance of assessing micronutrient levels in patients with a history of bariatric surgery who present with poor wound healing and infection. Bariatric patients should also be educated about the risks of nutritional deficiencies and encouraged to adhere to prescribed dietary and lifestyle changes. Importantly, family medicine and primary care physicians need to consider an adequate level of supplementation of micronutrients in all patients with RYGB surgery.
Subcutaneous pseudomycetoma of the knee caused by Acremonium species in a diabetic male: A case report
Authors: Vaidya Viplov V. , Chandrakar Sagar , Kumbhar Nitin S. , Jorule Kailash M. , Raushan Kumar , Sane Nikhil S. , Arora Sohini
Published: November 2023

A subcutaneous infection in the form of pseudomycetoma is rare. Acremonium species are rarely considered to be pathogenic in subcutaneous infections due to their ubiquitous nature. We report a case of subcutaneous pseudomycetoma over the dorsolateral aspect of the left knee caused by Acremonium species in a 55-year-old diabetic male who was treated successfully with oral itraconazole.
Association of medication adherence quality measures for diabetes, hypertension, and hyperlipidemia with cognitive decline
Authors: Racsa Patrick N. , Booth Tori A. , Chung Linda N. , Dixon Suzanne W. , Poonawalla Insiya B.
Published: November 2023

Background:

While diabetes, hypertension, and hyperlipidemia each are associated with increased risk of cognitive decline, little is known regarding how nonadherence to medications for these conditions is associated with cognitive decline risk.

Methods:

We identified patients enrolled in a Medicare Advantage Prescription Drug plan who were eligible for inclusion in the CMS Star Medication Adherence quality measures for diabetes, hypertension, and hyperlipidemia in 2018, 2019, and 2020. To achieve an adherence quality measure, patients had to meet 80% of the proportion of days for the medication. We used propensity score with inverse probability of treatment weighting to balance outcomes for baseline characteristics and logistic regression models to compare odds of cognitive decline outcomes across patient groups.

Results:

The study population of 99,774 individuals had a mean age of 71.0 years and was 49.1% female, 73.9% White, and 17.8% Black, with 62.0% living in an urban setting. Compared with patients who missed zero adherence measures, those who missed one measure had 23%–33% increased odds of cognitive decline (any decline OR = 1.23; dementia OR = 1.33; Alzheimer's disease OR = 1.27; all P values <0.01). Patients who missed 2–3 measures had 37%–96% increased odds of cognitive decline (any decline OR = 1.37; dementia OR = 1.58; Alzheimer's disease OR = 1.96; all P values <0.01). Patients who missed ≥4 adherence measures had the greatest odds of cognitive decline (any decline OR = 1.64; dementia OR = 2.05; Alzheimer's disease OR = 2.48; all P values <0.01).

Conclusion:

Not achieving CMS Star Medication Adherence quality measures for diabetes, hypertension, and hyperlipidemia therapies was associated with increased risk of cognitive decline outcomes.
Barriers in exclusive breastfeeding encountered by mothers in urban slum area of a metropolitan city
Authors: Gala Zil , Shetye Sonal , Sadawarte Deepika M. , Autade Mrunali
Published: November 2023

Background:

Breastfeeding is considered the most important source of nutrients for the baby. But owing to ignorance, lack of education, and cultural norms, exclusive breastfeeding (EBF) is not done by majority of the mothers. Hence, this study is carried out to determine various barriers faced by the mothers that influenced their decision on EBF.

Methods:

A descriptive qualitative study was conducted among the mothers whose children were less than 1 year of age visiting a well-baby clinic and Immunisation OPD of Urban Health Centre catering to the Urban Slum of Malvani in the Metropolitan city of Mumbai. In-depth interviews (IDIs) were done with 17 participants from August to November 2022. Thematic analysis was conducted on the qualitative data obtained.

Results:

Four major themes were generated from the transcripts. They are –barriers and concerns faced by mothers to exclusively breastfeed, enablers/motivators, sources of knowledge regarding EBF, and breastfeeding practices. Various barriers faced by mothers were gaps in knowledge, maternal Illness, religious reasons, inadequate milk production, bias toward top feeds, lack of autonomy to take decisions, and cultural norms, while positive family support, good knowledge about breastfeeding, and a supportive home environment motivated mothers to exclusively breastfeed their infants. Sources of knowledge were identified to be doctors and health care workers, mothers/mothers-in-law, sisters, friends, and social media.

Conclusions:

There are various challenges as well as motivators identified for EBF. Barriers, such as gaps in knowledge, and the negative influence of social media can be improved upon by health education. Therefore, it is crucial to teach expectant mothers as well as families about breastfeeding. Additionally, we advise stepping up public health education initiatives to support breastfeeding.
Impact of telemedicine on antenatal care at a teaching institution in Eastern India: An insight into the future of better India
Authors: Mohapatra Ipsita , Rai Vikash K. , Samantaray Subha Ranjan
Published: November 2023

Objectives:

Telemedicine (TM) emergence has been profound in using technology to address the problems of obstetrics in remote and rural places, especially in low-risk pregnancy. Through this study, we made an effort to assess the satisfaction level and concerns of antenatal and postnatal patients who availed the telemedicine facility during the study period. We also made an effort to facilitate improved access to antenatal and postnatal care, especially the low-risk pregnancies through telemedicine for patients from remote areas of eastern India that do not have the availability of specialists.

Materials and Methods:

Primary data were collected by means of a telephonic survey of all the antenatal patients who used telemedicine services of AIIMS, Kalyani, based on a preformed questionnaire.

Results:

A total of 80 antenatal patients gave consent to participate in the study. Most of the patients were from the upper lower class [43.75%] followed by the lower middle class [35%]. The average gestational age of respondents was 23.95 weeks. Seventy-one out of 80 patients felt that the appointment was made within a reasonable time. Only 12 patients [15.3%] had waiting time greater than 10 min. The average waiting time was 6.93 min. 56.3% of respondents felt that the person who attended their call was very cooperative. 86.3% of respondents strongly agreed that the consultant was able to understand their health issues completely. Eighty percent of the respondents said that they would like to continue using telemedicine in the future. There is a significant difference between those preferring to use telemedicine in the future and those who do not prefer telemedicine in the future. Poor internet facility and privacy were prominent reasons for not opting for telemedicine in the future by some respondents.

Conclusion:

From this study, it was concluded that TM certainly has great potential to make health care accessible to people residing in rural and far-off places.
Oral health status, treatment needs, and patterns of utilization of dental services among village volunteers in Andhra Pradesh: A cross-sectional multi-stage cluster survey
Authors: Praveen Gadde , Sravani Manchikatla , Kadiyala Chaitanya Ram , Indukuri Sai Lakshmi Durga , Poornima ULS , Pampana Sravani
Published: November 2023

Background:

Community health depends on the leadership duties of a diverse population, such as village volunteers. Hence, a study was conducted to assess oral health status, treatment needs, and patterns of utilization of dental services among village volunteers in Andhra Pradesh state.

Methodology:

A cross-sectional study was conducted among 400 village volunteers in Andhra Pradesh state, India. A multi-stage cluster sampling procedure was employed in sample selection. A questionnaire was used to review the pattern of utilization of dental services. World Health Organization Oral Health assessment form 1997 was used to evaluate oral health status and treatment needs. Data collected were analyzed using IBM SPSS Statistics for Windows, Version 25.0. Descriptive statistics were done.

Results:

Out of 400, 18% had never visited the dental clinic in their lifetime. The majority (33.5%) considered that dental problems were not a serious concern. Dental caries was seen in 69.5%, and 78.5% were presented with periodontal conditions. About 19.8% and 24.3% had crowding and spacing in incisal segments, respectively. The prevalence of oral mucosal disorders and dental fluorosis was 4.25% and 8.75%, respectively. Overall, 94% of the study participants needed dental treatment for various reasons.

Conclusion:

This study provides sufficient evidence to conclude that this population's oral health was poor, with increasing unmet dental treatment needs. Selected interventions and strategies should focus on these factors to decrease the burden of oral diseases among village volunteers.
Management of Vitamin B12 Deficiency: A Comparative Analysis of Intramuscular Injections versus Oral Medications
Authors: Panda Prasenjit , Kumar Anupam , Shivaram G. , Singh Rohit
Published: November 2023

Introduction:

Regular monitoring of Vitamin B12 (VB12) levels and intake of supplements is crucial since their deficiency may cause serious health conditions including neurological and cardiovascular complications. Medical professionals recommend supplements in the form of oral tablets and parenteral replacement for patients who cannot obtain these nutrients through diet or who are deficient due to other health conditions. This study aimed to compare the efficacy of oral medications and parenteral administrations, especially intramuscular (IM) injections for managing VB12 deficiency.

Methods:

The patients diagnosed with confirmed VB12 deficiency (<211 pg/mL) were divided into two groups. One group received oral tablet (Mecobal 1000 mg); the other received VB12 injection (1000 mg) IM. The blood levels of both the groups were assessed after 6 months. The data were statistically analyzed to compare the efficacy of both routes.

Results:

The mean age of oral and IM groups was 57 ± 10 years and 53 ± 11 years, respectively. The baseline serum VB12 values for the oral and IM groups were 158 pg/mL and 139 pg/mL, respectively (P = 0.01), and the mean VB12 values after treatment for the oral and IM groups were 301 pg/ml and 1416 pg/ml, respectively (P < 0.0001). The oral group observed a mean change of 143, while the IM group experienced a change of 1277 pg/ml (P < 0.0001).

Conclusion:

Our findings support the use of parenteral replacement over oral medications for the management of VB12.