bluuebunny/crossref_metadata_2025 huggingface dataset:
Perceived Stress and Insomnia Among Medical Residents in South India
Authors: Anupama M , Kulkarni Harish , Nisarga Vinyas , Sushravya
Published: March 2022

Background:

The ever-expanding medical knowledge, longer work schedule and the work atmosphere ridden with litigations make the medical education a stressful phase. Stress in resident doctors goes unattended many a times. Residents also face difficulty in sleep owing to their heavy work and erratic routine. Insomnia is noted to be a common accompaniment of stress. In this background, the present study is aimed to estimate the prevalence of stress levels and the presence of insomnia among resident doctors and to assess the association between them along with their socio-demographic correlates.

Methodology

Resident doctors working in three different hospitals attached to a medical college were approached; consenting participants were administered Sociodemographic pro forma, Perceived Stress Scale, and Bergen's Insomnia scale. Statistical analysis was done using SPSS software.

Results

A total of 251 residents participated in the study, of which majority were females, Hindu, from an urban background, unmarried and used no psychoactive substance. Of all the residents 80% reported to be stressed and 62% had insomnia. Bergen's Insomnia scores had moderate correlation with Perceived stress scores (r = 0.453, P < 0.001). Female and sleep-deprived residents had higher stress. Residents in clinical branches and residents with long work hours had significant insomnia than their counterparts. On logistic regression analysis, duration of work hours and problem adjusting to the current place of residence significantly predicted insomnia.

Conclusion

Most residents reported to be having stress and the stressed individuals had associated insomnia. Given the serious health effects of stress, there is a need to detect it early. Insomnia could be viewed as an early and soft indicator of underlying stress.
Methamphetamine Abuse in the Form of Yaba Pills
Authors: Ghosh Soumi , Mukherjee Disha , Mondal Arijit
Published: March 2022

YABA, also known as “Nazi speed” is a relatively newer stimulant drug with abusive potential that contains methamphetamine and caffeine in various proportions and mostly available in Bangladesh and its subcontinent and relatively rare in Indian states. Here, we report a case of a 30-year-old male with history of Yaba abuse for the past 4 years currently complaining of withdrawal symptoms palpitation, dry mouth, irritability, and mood symptoms that managed symptomatically and with topiramate tablets to prevent future relapse.
Antimicrobial prophylaxis uses and incidence of surgical site infection in Jayanagar General Hospital, Bangalore, India
Authors: Allaf Navirian Hassan , Navyashree G.A.
Published: March 2022

Objective:

Wound infections are the commonest hospital-acquired infections in surgical patients. The aim of the present study was to evaluate the pattern of antimicrobial prophylaxis in general surgery in Jayanagar general hospital, Bangalore, India.

Method:

It is a prospective, observational study. The data were collected from 180 patients who satisfied inclusion and exclusion criteria in Jayanagar General Hospital. During the study, 180 prescriptions were studied and patient records were collected and analyzed using SPSS and Microsoft excel.

Result:

The patients were taken a crack at the investigation. More frequently used antibiotics are cefotaxime, ceftriaxone, and amikacin. About 98% of patients who undergo minor or major surgery received antibiotics. Among them, 27.22% received amikacin and cefotaxime, 12.22% received ceftriaxone and metronidazole, 12.22% received cefotaxime and metronidazole, and 10.55% received amikacin and ceftriaxone. About 20.5% received the triple combination. Among 180 patients, 37 patients were treated with one antibiotic, 120 patients were treated with two antibiotics, and the rest of 23 patients with three antibiotics and more; among them patients treated with single antibiotics had a high incidence of SSI.

Conclusion:

The study finished up about the abuse and inappropriate selections of antibiotics. Henceforth, our study likewise proposes following the guidelines for judicious utilization of antibiotics, and limiting inappropriate antibiotic use is the most ideal approach to minimize the odds of SSI. The clinic ought to set up prophylactic antibiotics guidelines which ought to be open and open by each individual from the careful group. The medical checklist ought to be polished viably. Incessant review of prophylactic antibiotic use is expected to improve legitimate practices (prophylactic antibiotics employments). Surgeons should adhere to prophylactic antibiotics guidelines.
Determinants of treatment interruption and outcome among smear-positive pulmonary tuberculosis patients in a tuberculosis unit of Purba Bardhaman district of West Bengal
Authors: Nandi Chinmay , Mitra Kaushik , Bhaumik Dipankar
Published: March 2022

Context:

The adoption of directly observed treatment short course (DOTS) in Revised National Tuberculosis Control Programme has given impressive results with higher treatment success. But interruption of treatment has been one of the major obstacles to treatment of tuberculosis.

Aims:

The aim of the study was to evaluate the determinants of treatment interruption and outcome. It also evaluated the impact of treatment interruption on treatment outcomes.

Settings and Design:

The study was carried out in the area covered under Bhatar tuberculosis unit (TU) of Burdwan district of West Bengal. The study was a descriptive cross-sectional study.

Methods and Material:

Smear-positive pulmonary tuberculosis patients were taken as study subjects in both the components of study. Complete enumeration technique, rather than sampling, was followed in this study. Data were collected in a predesigned and pretested schedule. Statistical Analysis Used: Data were analyzed by percentages and proportion. Chi-square test was used to find the association between variables.

Results:

Gender, religion, and substance abuse were found to be statistically significant factors with interruption. It was also observed that treatment outcome was not statistically significant with age, gender, religion, and category of treatment. In the study, 84.6% of the study subjects with interruption less than 1 week had favorable outcome. But in study subjects with longer duration of interruption (≥2 weeks), only 12.5% had favorable outcome. Not only interruption, duration of interruption was found to be adversely affecting the treatment outcome.

Conclusions:

Interruption had an impact on the treatment outcome in the present study. Unfavorable outcomes were significantly more frequent among patients with interruption as compared to those without any interruption.
Socio-demographic features and quality of life post burn injury
Authors: Gautam Richa , Rajoura O. P. , Sharma A. K. , Rajpal  , Bhatia M. S.
Published: March 2022

Introduction:

Burn injury is a highly devastating injury accounting for the major cause of disability-adjusted life years (DALYs) lost mostly in developing countries. Physical trauma, body disfigurement, the social stigma associated with injury completely shatter an individual’s life.

Aim:

To study the quality of life among burn injury patients.

Methodology:

A cross-sectional hospital-based descriptive study was done on 150 burn injury patients. During the initial recruitment from Burns and Plastic Surgery Ward, socio-demographic profile and burn incident-related data were collected, whereas the WHO QoL-BREF tool was applied after 3 months of discharge during a follow-up visit in the outpatient department of Burns and Plastic Surgery to assess the quality of life among subjects. Data were compiled in MS Excel and statistical analysis was done using SPSS 20 version.

Results:

The study revealed poor quality of life among four domains of QoL; it was most inferior in the psychological domain followed by the physical health domain, environment domain, and social relationship domain.

Conclusion:

Advancement in the medical field has improved the survival rate in victims although the patients recover from the acute painful phase of physical trauma. However, the psychological and social impacts of injury remain unaddressed leading to a poor QoL. There is a need for an integrated approach for prevention and enhancement of the quality of care for the victims in all four domains of life. More emphasis is needed on rehabilitative care for long-term improvement in the QoL of the affected person.
Implications of β-thalassemia on oral health status in patients: A cross-sectional study
Authors: Nabi Aaysha T. , Muttu Jayalakshmi , Chhaparwal Amit , Mukhopadhyay Arka , Pattnaik Samarjeet J. , Choudhary Pallawee
Published: March 2022

Background:

β-Thalassemia is a chronic disease of autosomal recessive origin that is identified by the presence of a severe form of anemia. This hematological disease has been shown to directly influence a person’s physical as well as psychological well-being along with their families. Aim: This study aimed to find an association between dental health status and oral health-related quality of life (QoL) among children who have been diagnosed with β-thalassemia.

Materials and Methods:

This prospective cross-sectional study was carried out in the dental outpatient department; blood bank and pediatric outpatient departments that were associated with the primary institute. All study participants were age-ranged from 3 to 15 years. Informed written consent was obtained from caregivers or parents of all the study participants. This study was conducted for a total duration of 1 year (from June 2020 to June 2021). All study participants were categorized into two groups: (a) Group I (n = 150) comprised children who were diagnosed with β-thalassemia and (b) Group II (n = 150) comprised normal controls. Exclusion criteria in the study included children suffering from any systemic disease that predisposes them to dental caries or periodontal diseases. The intra-oral examination was performed using Decayed-Missing-Filled Teeth Index (DMFT/dmft Index) and Oral Hygiene Index-Simplified (OHI-S). Assessment of QoL was done by using the “Child Perceptions Questionnaire for children.” Collected data were recorded in Microsoft Excel workbook, 2007. Statistical comparison between both the groups was performed by using statistical tools such as the Chi-square test, Fisher’s exact test, independent t-test, and Mann–Whitney U test. The probability values lesser than 0.05 were considered to be statistically significant.

Results:

Maxillofacial findings—rodent facies, saddle nose, lip incompetence, pale oral mucosa, anterior open-bite, lower anterior teeth crowding, and maxillary anterior teeth spacing or crowding—were seen. Class II malocclusion was present in significant numbers of subjects. On comparing dmft/DMFT scores, no significance was observed while on comparing OHI-S index, statistical significance was seen. A statistically significant difference in the QoL was noted between thalassemic children and the control group.

Conclusion:

Thalassemic children showed a significant association between dental health and QoL.
Anterior cruciate ligament (ACL) injuries: A review on the newest reconstruction techniques
Authors: Gerami Mohamad Hadi , Haghi Farshid , Pelarak Ferdos , Mousavibaygei Seyed Rohallah
Published: March 2022

The anterior cruciate ligament (ACL) is considered very important for normal knee function, the disruption of which may result in malfunction, meniscal lesions, and the early onset of joint degeneration. The aim of this comprehensive review was to investigate the different techniques used in the reconstruction of damaged ACL. Current methods in reconstruction of ACL include different types of autograft and allograft to replace native ligaments. The ideal graft for reconstruction of ACL is one which is biomechanically similar to the native ligament, is easily harvested, has least harvest site morbidity, and gets well incorporated with the bone. Cross-fixing of hamstrings has been created for ACL reconstruction in the hopes of improving potential problems related to the interference screw and button fixation technique. Previous clinical results indicated that double-bundle ACL reconstruction is equivalent or even superior to single-bundle ACL reconstruction in regaining anterior and rotational stability.
Compliance to antibiotic therapy at paediatric out-patient clinic
Authors: Patel Dipen V. , Acharya Unnati K. , Shinde Mayur K. , Nimbalkar Somashekhar M.
Published: March 2022

Background:

Poor compliance to antibiotic therapy leads to ineffective treatment. Objective: The objective of this study is to assess compliance to oral antibiotic therapy in paediatric patients and factors affecting it.

Methods:

Patients aged less than 18 years, coming to outpatient department, who were prescribed oral antibiotics in last 1 week, were eligible for participation in the study. Compliance to oral antibiotic therapy and factors affecting it were evaluated through verbal interview of their caretakers.

Results:

Out of total of 815 participants in the study, 241 (29.6%) were non-compliant either due to not completing the course [142 (17.4%)] or due to not complying with the frequency [99 (12.2%)]. Causes of incomplete course were adverse effects [28 (19.7%)], poor palatability [30 (21.1%)] and no improvement [84 (59.2%)]. Gender, religion, age, development of child and education or occupational status of caregiver did not affect the compliance. Multivariable logistic regression showed two or more drugs in addition to antibiotic therapy (odds ratio [OR] 1.73; 95% confidence interval [CI] 1.03–2.92); more frequency intake of antibiotic in a day, that is, either twice a day (OR 2.13; 95% CI 1.24–3.66) or thrice a day (OR 3.7; 95% CI 2.18–6.48), was significantly associated with non-compliance. Though syrup formulation and low cost of prescription were associated with better compliance on univariate analysis, they did not have any impact in multivariable logistic regression.

Conclusions:

Restricting use of unnecessary drugs with antibiotic therapy, preferring once-a-day frequency and carefully selecting antibiotic with minimal adverse effects and better palatability improve the compliance to oral antibiotic therapy in paediatric patients.
Awareness of the Unaizah populations in Al-Qassim province in Saudi Arabia regarding nasal decongestant use for allergic rhinitis and their side effect
Authors: Almutairi Abdulhakeem , Almutairi Homood , Althwiny Faisal A. , Almutairi Abdulrahman , Alwasil Saleh , Albadrani Naif , Aljeri Yazeed , Alawad Muath
Published: March 2022

Background:

Nasal decongestant drugs are widely used as potent vasoconstrictive agents to reduce congestion of nasal and ocular mucous membranes in disease such as allergic rhinitis. These drugs are easily accessible to the people over the counter without prescription. The ease in access may lead the population in believing that the drugs are risk free and free from side effects. The purpose of this study was to determine the level of awareness of the people in Unaizah Al-Qassim province in Saudi Arabia on the use of nasal decongestants ad their side effects.

Methodology:

After gaining the Institutional Review Board (IRB) approval, the study was a questionnaire-based cross-sectional study conducted on the people Unaizah Al-Qassim province in Saudi Arabia. It was explorative in nature as such a study has never been done in Unaizah before and hence descriptive statistics was mainly used to establish significance and reference. The questionnaires assessed the demographical characteristics of the population, participants’ history on the usage of nasal decongestants, health condition of the participants, and knowledge on nasal congestion and use nasal decongestants.

Results:

Out of 385 participants, 54% were male and 46% are female. With regards to age, majority of the participants were between the age of 20 and 40 years 56%, followed by 40--60 years old (33%). 79% of the participants had acquired a baccalaureus level in education. When assessed on the usage of nasal decongestants, 32.5% currently use the decongestants, 64.4% have ever used the drugs now and in the past. In terms of knowledge of the drugs, 16.6% of the participants are aware of the side effects, 25.2% are aware of the medically recommended period to use the drugs, 21.3% have heard of the nasal congestion addiction, and 21.6% are aware of the medication that may cause nasal congestion.

Conclusion:

The study established that the level of awareness on the use nasal decongestants and the side effects is not significant. There needs to be a sensitization campaign to educate the population on the use of nasal decongestants.
Household sanitation and menstrual hygiene management among women: Evidence from household survey under Swachh Bharat (Clean India) Mission in rural Odisha, India
Authors: Behera Manas Ranjan , Parida Subhashree , Pradhan Himanshu Sekhar , Priyabadini Sucheta , Dehury Ranjit Kumar , Mishra Biswajit
Published: March 2022

Introduction:

Discussion on women empowerment without addressing their basic needs would be meaningless. As such, the needs of women and girls have been prioritized in global sanitation efforts including menstrual hygiene. However, there is little research on existing approaches on menstrual management. India’s most ambitious sanitation campaign named Swachh Bharat Mission or “Clean India Mission” aimed to achieve universal sanitation coverage in every single household, targeted to end open defecation by October 02, 2019. This study aimed to assess the women’s perception of household sanitation facilities and menstrual hygiene management experience in Odisha under Swachh Bharat Mission.

Methods:

The study is a community-based survey having cross-sectional in nature conducted among 700 rural women and girls aged 15–45 years in the Balesore district of Odisha state in India from January to April 2021. A multi-stage sampling method was adopted to select the study participants. Data was collected using a pretested questionnaire based on the Performance Monitoring and Accountability 2020 survey questionnaire and analyzed by SPSS version 25. Descriptive statistics was used to assess the household sanitation and menstrual hygiene management experience among women.

Results:

More than two-thirds (68.4%) of rural households use improved sanitation facilities. Around 30% of families have inadequate sanitation infrastructure, which means at least one household member defecates in the open space. Nearly 64.6% disposed of their menstrual absorbents in the bush or field, while 29.1% disposed in the river and 24.1% in the waste bin. Still, 40.6% of women were using clothes as menstrual absorbents, and 54.9% of the respondents reported washing their menstrual materials for re-use. Of those who washed and re-used, 99.2% said their re-use material was completely dry before re-use. About 69.7% of the respondents mentioned that they change their menstrual absorbents in sleeping areas at home. About 91% of the respondents reported that the place where they changed their menstrual absorbents was safe, clean, and private. Only 22.5% of women responded to having water and soap at their menstruation management area.

Conclusion:

The effort for improvements in sanitary techniques during menstruation is partly effective in creating healthy behavior. The current strategy for developing programs to adopt menstrual hygiene measures needs a bottom-up approach with women at the center. Components associated with menstrual hygiene management, such as women’s cleanliness, water supply, and the availability and accessibility of disposable sanitary napkins, should be given specific attention. It is essential to acknowledge the issues like toilet construction and behavior change communication to consolidate the gains in an era of “Clean India Mission.”
Pediatric orthopedic injury prevention for team sports post COVID-19
Authors: Kong Heather , Feng Jing , McClellan Catherine , Raney Ellen , Foss Michelle , Cowley Joel , Wick Jane M.
Published: March 2022

Queries of youth orthopedic sports injuries from the U.S. National Electronic Surveillance System, a database from the Consumer Product Safety Commission, demonstrate decreased orthopedic injuries related to team sports during the COVID-19 pandemic, indicative of reduced sports participation. Multiple articles have shown that COVID-19 had a marked effect on the physical and psychological wellbeing of the youth. The lockdown resulted in a cessation in school attendance and sports activities, especially team sports. Though increased emphasis has been placed on children infected by COVID-19, less attention has been given to healthy children. Numerous articles discussed the physical and psychological benefits for the youth returning to physical activity and sports; however, few have addressed detraining and deconditioning concerns postpandemic. This article discusses a safe return to team sports for the youth experiencing physical and psychological changes related to the pandemic. Orthopedic injuries are anticipated to increase as restrictions are relaxed. A multidisciplinary team presents a review of common youth sports orthopedic injuries, a discussion of psychological issues youths have experienced during COVID and why sports participation is beneficial for youth, and a risk assessment for pain and limited range of motion for youth returning to sports. The intent of this article is to increase awareness of the physical and psychological changes experienced by youth due to their inability to participate in team sports during the pandemic. Family medicine and primary care providers need to recognize the increased risks for injury and proactively encourage the youth to return to sports in a safe manner.
Clinical and radiographic assessment of post-treatment endodontic disease by primary healthcare professionals: A hospital-based 1-year follow-up
Authors: Kalyani Prashant , Patwa Neha , Gupta Neel , Bhatt Akash , Saha Saheli , Kanjani Varsha
Published: March 2022

Background:

The comprehensive healthcare approach including prophylactic guidance and motivation by the primary healthcare professionals towards oral and maxillofacial diseases such as post-treatment endodontic disease (PTED) plays a significant role in diagnosing and managing the condition. Especially in the developing countries like India where the hygiene practices are severely compromised, the primary healthcare professional plays an upfront role.

Objectives:

The present study was conducted to assess the clinical and radiographic characteristics of PTED by primary healthcare professional.

Materials and Methods:

The cross-sectional study was conducted in a dental hospital in Kutch, Gujarat, India. In the present study, out of a total of 755, 96 patients were diagnosed with PTED, met the inclusion criteria, and were enrolled for the study. After performing intraoral and extraoral examination, intraoral periapical radiographs were taken of the concerned teeth. Under dark room conditions, radiographs were examined using dentsply light box and magnifying glass by healthcare professionals.

Results:

Out of 755 patients, 96 (12.71%) patients were enrolled in the study with 98 concerned teeth. The most common teeth diagnosed with PTED were maxillary molars with 25.51% (21) individuals. Well-defined radiolucent lesions were seen in 62.24% (61) individuals. Voids in both coronal and apical region were seen in majority (38.77%) of patients. The length of root-end fillings with respect to the radiographic apex was satisfactory in 44.89% (44) individuals. The present study showed strong correlation between sinus formation and presence of periapical lesion with P value of 0.0219*.

Conclusion:

The proper guidance and preventive care by primary healthcare professionals leads to the relatively less prevalence of post-treatment endodontic disease in Indian population. The present study further suggests the higher substandard quality of root-end fillings of endodontically treated teeth.
Is typifying systematic reviews and meta-analysis as the top on the ladder justified?
Authors: Raina Sunil K. , Kumar Raman
Published: March 2022

A large number—possibly the large majority—of systematic reviews and meta-analyses produced to date may not be useful for various reasons. This article though not ruling out the usefulness of these, is raising concerns on the way these are conducted or intended for in terms of outcomes.
Effects of vitamin D on bone density in healthy children: A systematic review
Authors: Karimian Pegah , Ebrahimi Hamidreza Khoshnezhad , Jafarnejad Shabahang , Delavar Motahare Aghajani
Published: March 2022

Skeletal growth and bone health are very important in children. The effective role of vitamin D in bone mineral density has been observed in children and adolescents. This systematic review study evaluated the effects of vitamin D on bone density in healthy children with the help of valid databases and the website of clinical trials. The results of experimental, clinical, retrospective, prospective, double-blind, and randomized studies were used. Articles that appropriately covered the topic and had the proper content structure were selected for this review. Out of a total of 132 articles, finally, 13 articles were selected based on inclusion and exclusion criteria for further study, the results of which show the association between serum levels of vitamin D and bone mineral density and health. However, in some articles, the relationship between other influential variables such as age and nutrition on bone density in children was identified. In general, the current systematic review demonstrates the role of vitamin D on bone density in healthy children, so that in children studied, vitamin D is at different levels and complications related to bone density are observed in many children. It is recommended that more clinical and longitudinal studies be performed to further understand the role of vitamin D levels in bone health in children.
Socioemotional behaviour of toddlers influenced by the sleep patterns: Prevalence study
Authors: Sam Gigi , Naif Maha , Zinaf Sarah , Hamoud Maha , Inad Noora
Published: March 2022

Background:

This study investigates the influence of sleep duration and sleep patterns on the social-emotional behaviour of 3–70-month-old children.

Methods:

A Brief Infant Sleep Questionnaire (BISQ) and Ages, Stages Questionnaire: Social-Emotional (ASQ:SE) were filled by the participants through a web link. The internal consistency of the items used in the questionnaire was analysed using Cronbach’s alpha and the effects of sleeping disorders on the likelihood of children having social-emotional problems were performed by binary logistic regressions.

Results:

The highest level of bedtime resistance and nocturnal awakening was observed in children of 27–32 months of age, while sleep anxiety was maximum in 42–53-month-old children. The logistic regression models were found to be statistically significant with Χ2 (3) =19.556 for 3–8-month-old children, Χ2 (3) =11.874 for 9–14-month-old children, Χ2 (3) =8.928 for 15–20-month-old children, Χ2 (3) =10.061 for 21–26-month-old children and Χ2 (3) =38.358 for 54–70-month-old children, P < 0.0005.

Conclusion:

Our findings imply that no statistically significant association was observed between sleep duration and social-emotional problems, however, sleep disorders significantly impacted social-emotional behaviour and also night-waking caused social-emotional behavioural issues in preschoolers.
Determinants of physical activity in women with multiple sclerosis based on theory of planned behavior
Authors: Goldoust Faride , Garmaroudi Gholamreza , Abolhasani Maryam , Shakibazadeh Elham , Yaseri Mehdi
Published: March 2022

Background:

In recent decades, the scientific evidence has demonstrated that regular physical activity (PA) provides abundant physiological and psychological benefits in people with multiple sclerosis (MS). However, most persons with MS are physically inactive. This study examined determinants of PA based on the theory of planned behavior (TPB) among women with MS.

Method:

Participants (178)-completed measures included Godin Leisure-Time Exercise and TPB questionnaires. Descriptive statistics and hierarchical linear regression were analyzed using IBM SPSS.

Result:

Most participants were homemaker and the mean age was 34.2 years. The mean of PA was 11.6 ± 7.9 and only 10% of participants had sufficient amount of PA. The result of hierarchical linear regression indicated that attitude (β = 0.27; P < 0.05), subjective norm (β = 0.18; P < 0.05), and perceived behavioral control (β = 0.44; P < 0.05) explained 58% variance in exercise intention. Intention (β = 0.20; P < 0.05) and other variables explained 18% variance in PA.

Conclusion:

Our findings indicate that constructs of TPB could be used in behavioral interventions by health-care providers for increasing PA among women with MS.
A cross-sectional study on knowledge of registered medical practitioners, regarding management of medico-legal cases in Meghalaya
Authors: Nath Anamika , Ropmay Amarantha D. , Slong Daunipaia , Patowary Amar Jyoti , Rao Ankith J.
Published: March 2022

Introduction:

Medico-legal issues are handled by every registered medical practitioner in their day-to-day medical practice but if they are not well versed with rules of managing such cases and laws behind them, they often land into criticism and are distressed at the courts while disposing of the cases. Objective: To assess the knowledge of registered medical practitioners in Meghalaya regarding the management of medico-legal cases in day-to-day medical practices.

Materials and Methods:

This was a cross-sectional study, conducted at the Department of Forensic Medicine, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS) for 6 months. The study group included registered medical practitioners working in the government sector who were approached through the Director of Health Services (DHS), Meghalaya. Study tools included one preformed and pretested questionnaire. Knowledge was assessed along with designation and years of experience. A P value of < 0.05 was considered statistically significant.

Results:

From 94 subjects analyzed for their answers, 56% had adequate knowledge. Amongst nonspecialist doctors (n = 53), 52.8% had adequate knowledge and amongst specialist doctors (n = 34), 67.6% had adequate knowledge in various aspects of management of medico-legal cases, and it was found that 6.4% had adequate knowledge in documentation, 21.2% in consent, 3.2% in the Protection of Children from Sexual Offences (POCSO) Act, 71.2% in autopsy, 88.2% in legal duties in emergency care. A total of 68.7% of those having 16–20 years of experience had adequate knowledge. Chi-square test of designation and years of experience on knowledge was found to be 0.33 and 0.75, respectively.

Conclusion:

Nearly half of the registered medical practitioners of Meghalaya have adequate knowledge. However, years of experience and designation have no significance with the knowledge of registered medical practitioners regarding the management of medico-legal issues.
Knowledge and attitude of children safety at home among population in Saudi Arabia
Authors: Filemban Athal , Hijan Bushra , Alaydarous Shahad , Alharbi Amani , Ghanem Amjad Bin , Alghamdi Rawan , Bawadood Manar , Alghamdi Sarah , Saleh Sohaila , Aaidarous Ghayda , Kadi Mohammed , Saif Shimaa Abu , Safdar Osama
Published: March 2022

Background:

Unintentional injury to children at home is a public health problem and it is a significant cause of death and disabilities. It accounts for 40% of all child deaths. To our knowledge, there have been no similar studies done on Arabic countries that show the prevalence of home injuries among children.

Aim:

We aimed to assess the adults’ knowledge and attitude toward child safety at home in Saudi Arabia. Methods: A cross-sectional study was conducted among 1,301 participants, during August 2017, who are older than 18 years old and have at least one child in the family. Data were collected by an online questionnaire assessing the believes, knowledge, and behavior of the participants. Analysis was carried out using IBM SPSS Software version 21, using descriptive analysis, t-test, and one-way ANOVA.

Results:

It was found that gender, age, marital status, employment status, and the type of accommodation played key roles in the awareness of children safety at home, the study showed that females and age group above 25, married, employees, and those who lived in flats had more awareness than the other groups, respectively.

Conclusion:

The majority of the population had good awareness about children’s safety at home. Despite the good level of awareness, more public health education is recommended to improve the awareness and the prevention methods of these injuries.
A study on maternal and foetal prognosis and predictive factors for adverse outcome in pregnant patients with dengue in an endemic state of India
Authors: Sinha Ruchita , Datta Mamta Rath , Singh Vinita
Published: March 2022

Aims:

Dengue fever is a major health problem with high morbidity and mortality especially during epidemic season; pregnant females being no exception. But, there is paucity of published data on dengue fever during pregnancy. Hence, this study was planned to study the clinical profile, maternal outcome and predictors of poor outcome in pregnant dengue patients.

Materials and Methods:

All pregnant females attending labour room of Tata Main Hospital, Jamshedpur from April 2016 to October2020 with acute febrile illness caused by dengue virus at any gestational age were included in the study. Diagnosis of dengue was made by detection of NS1 antigen or dengue serology. A predesigned proforma was used to record materno-foetal outcomes and were analysed.

Results:

Dengue was the cause of fever in 7.1% febrile patients. Maternal complications included abortions (26%), abruptio (1.9%), postpartum haemorrhage (11.9%) . Of all the pregnant dengue patients, five had severe dengue(SD) with high mortality (3/5; 60%). Fetal complications were intrauterine death(7.7%),preterm(42.3%). Thrombocytopenia and elevated transaminases were associated with adverse outcome.

Conclusions:

Dengue fever in pregnancy is associated with poor outcomes more in cases of SD rather than dengue fever . Pregnant females with high risk predictors should be identified and managed aggressively in intensive care units to improve outcomes.
Is it atopic asthma, chronic eosinophilic pneumonia, or eosinophilic granulomatosis with polyangiitis?
Authors: Vidhale Tushar , Pustake Manas , Parab Aakash , Roy Tanmoy , Sasane Sanjay , More Sneha , Gandhi Charmi , Mishra Tuhina
Published: March 2022

A 45-year-old man, used to work in a cement factory, presented to us with a history of adult-onset sub-optimally controlled asthma and was initially managed as a case of acute exacerbation of allergic asthma. However, his repeated evaluation revealed raised eosinophil count, raised serum total IgE and persistent chest infiltrates on imaging. He was provisionally managed empirically with a short course of oral steroids and advised follow-up on an out-patient basis to rule out the possibility of idiopathic eosinophilic pulmonary syndromes. The patient was then lost to follow-up, and after four years, he presented with a vasculitic presentation and was diagnosed with Eosinophilic Granulomatosis with Polyangiitis (EGPA). He improved with corticosteroids and cyclophosphamide pulse therapy. This case depicts the importance of evolving nature of EGPA wherein the eosinophilic phase of the disease can mimic other pulmonary eosinophilic diseases and vasculitic symptoms can be delayed as much as by four years.
Evaluating diagnostic utility of PAS stained skin scrape cytology smear in clinically suspected superficial cutaneous mycoses: A simple yet unpracticed technique
Authors: Khurana Ujjawal , Marwah Annika , Dey Vivek , Uniya Upasana , Hazari Rakesh
Published: March 2022

Background and Objectives:

For fungal dermatitis, a wet Potassium Hydroxide (KOH) preparation of the skin scrapings forms the routine practice for diagnosis. This study was carried out to determine the diagnostic accuracy and to evaluate the value-added information of PAS-stained scrape cytology smear in evaluating the presence of fungal elements.

Methods:

This prospective study was carried out on the patients clinically diagnosed with superficial cutaneous mycoses. For each patient, a wet KOH preparation and one PAS-stained skin scrape cytology (SSC) smear was prepared.

Results:

Out of the 52 suspected cases of superficial cutaneous mycoses, 50 showed fungal elements on either or both the techniques. The presentation was Tinea cruris together with Tinea corporis in 21 cases (42%), isolated tinea cruris in 19 cases (38%), tinea corporis in 8 cases (16%), and tinea corporis with tinea manuum and onychomycosis in 2 cases (4%). KOH preparation was positive in 45 out of 50 cases (90%) and SSC was positive in 49 out of 50 cases (98%). The sensitivity, specificity, positive predictive value, and negative predictive value for PAS-stained SSC smear was 98%, 100%, 100%, and 66% and that for KOH preparation was 90%, 100%, 100%, and 28%, respectively. Fungal elements quantity was graded on SSC smear as 1+(5), 2+(19), 3+(19), 4+(6), and in one case, it was negative.

Conclusion:

Incorporation of the PAS-stained SSC smear for fungal dermatitis ensures more efficient and confident diagnosis and the slides are available for archivable studies.
Prevalence and predictors of hypertension: Evidence from a study of rural India
Authors: Vijna  , Mishra Chandra Pati
Published: March 2022

Background:

Raised blood pressure (BP) is the leading global risk factor for cardiovascular diseases and a major cause of premature death. Worldwide, one in four men and one in five women are hypertensive. For effective preventive strategy, understanding of predictors of hypertension is necessary. Objective: To assess prevalence and predictors of hypertension in the rural adult Indian population.

Material and Methods:

This cross-sectional study was carried out on 425 rural subjects (25–64 years) of the Varanasi district in India selected through multistage sampling. Blood pressure of each subject was measured using a standard technique. Sociodemographic data and predictors of hypertension were assessed by interviewing subjects with help of a predesigned and pretested proforma.

Results:

Prevalence of hypertension was 31.5% (95% CI: 27.1–35.9). There existed a significant (P < 0.05) association of BP with age, educational status, occupation, socioeconomic class, tobacco consumption, waist circumference, waist-hip ratio, and nutritional status. No significant association was found with gender, religion, caste, marital status, type and size of family, family without NCDs, awareness of screening camps for NCDs and national program for prevention and control of cancer, diabetes, cardiovascular diseases and stroke, and alcohol consumption. Significant association of education, nutritional, and occupational status obtained in univariate analysis got eliminated in the logistic model. Risk of hypertension was higher in the 45–64 years age group (AOR: 3.06; 95% CI: 1.75–5.35) and in socioeconomic class IV and V (AOR: 2.24; 95% CI: 1.17–4.31).

Conclusion:

Prevalence of hypertension in the rural population was high and most of the observed predictors were modifiable.
Identifying a minimum data set as a necessity to design a web-based personal health record for patients under chronic dialysis
Authors: Jeddi Fatemeh R. , Nabovati Ehsan , Rezayi Sorayya , Saeedi Soheila , Amirazodi Shahrzad
Published: March 2022

Objective:

Many people suffer from kidney disease, and self-management is essential in these patients. Personal health record (PHR) can be used as a tool to improve self-management in these patients. This study aimed to identify a minimum data set (MDS) of PHR in dialysis patients.

Methods:

This descriptive and cross-sectional study was conducted in 2019, and national and international scientific literature entitled “Personal Health Record,” “Electronic Personal Health Record,” “Dialysis Patient Portal,” “Dialysis Health Record,” and “Dialysis Information Needs” by content analysis method was reviewed. A questionnaire with 14 items was designed to examine patients’ problems and data needs based on the review of scientific literature and web-based PHRs. Based on the patients’ survey and the review of scientific literature, a questionnaire with 114 questions was designed. Finally, with experts’ opinions, data elements were determined.

Results:

An MDS for developing web-based PHR for patients under chronic dialysis was created with 17 data classes including demographic information, insurance information, contact information in case of emergency, information on dialysis sessions, physicians information, dialysis center information, information on individual measured values (blood pressure, blood sugar, and weight), disease history information, information on surgical procedures and operations, history of visits, allergies, vaccinations, family history, drugs, laboratory tests, diet, and education materials for the patient.

Conclusion:

In this study, an MDS was developed for a web-based PHR for dialysis patients. The use of standard data can help collect the data that is essential to improve the patient’s health and track his medical condition.
The socioeconomic apprehensions of a pregnant woman around COVID-19 – Do we need to be worried?
Authors: Yadav Anita , Baghel Jyoti , Kamath Anusha , Mundle Shuchita , Sharma Charu , Prakash Avinash , Rawat Rajneesh
Published: March 2022

Introduction:

Coronavirus 2019 (COVID-19) pandemic has become the most severe intercontinental health challenge and pregnant women are deemed to be a special population group. The COVID-19-related restrictions on visiting the hospital for antenatal check-up and procedures may be distressing for them. The present study aims at assessing the level of anxiety and risk perception of pregnant women during the pandemic.

Materials and Methods:

This cross-sectional observational study included all pregnant women who were above 18 years of age, irrespective of their gestational age. They were administered the pre-designed, pre-tested questionnaire via face-to-face interview. The effect of the COVID-19 pandemic and its influence on women’s experience including her worries were collected. Data analysis was done using SPSS software version 22.

Results:

A total of 130 pregnant women with a mean maternal age of 26.1 ± 6.5 years were enrolled in the study. The mean gestational age of the women was 19 ± 4.7 weeks and most of them were in the second trimester (48.5%). Most of the pregnant women encountered the adverse socioeconomic influence of COVID-19 on their daily life (55.6% somewhat, 9.1% moderately so, 1.1% very much). Majority of them reported that they had limited their social activities (78.5%) and amorous relationship with their partner (30.8%). Also, around 59.2% of antenatal women experienced a moderate level and 40.7% had a mild level of anxiety.

Conclusion:

It is essential for obstetric providers to do prompt identification of mental health concerns in perinatal women and to liaise with mental health professionals to provide relevant interference.
Orbital prosthesis- An innovative approach
Authors: Saroya Komal K. , Singh Kavipal , Sethi Nimish , Suman Neelam , Kaur Simrat , Bawa Ramninder
Published: March 2022

An orbital prosthesis is a good alternative to surgical reconstruction for cosmetic and psychological rehabilitation of the patient. It should be aesthetic, durable, light weight, economical, and most importantly retentive. A clinical report explaining the prosthetic rehabilitation of post surgical case of orbital trauma that was followed by orbital exenteration has been described. The aim of the orbital prosthesis was to reinstate the esthetics and boost the psychological and mental state of the patient. The techniques employed along with incorporation of the patient’s own hair in eyelashes greatly improved the esthetics.
Out-of-pocket spending on hypertension and diabetes among patients reporting in a health -care teaching institute of the Western Rajasthan
Authors: Mehta Rishabh , Mantri Neha , Goel Akhil D. , Gupta Manoj K. , Joshi Nitin K. , Bhardwaj Pankaj
Published: March 2022

Background:

Across the globe, morbidity and mortality due to non-communicable diseases (NCDs) are major public health issues. The resulting concern is not just epidemiological but also about the economic consequences at the household level. Objective: To assess the various facets of out-of-pocket spending (OOPs) incurring on NCDs, namely hypertension and diabetes on patients attending a healthcare teaching institute in Rajasthan.

Methodology:

This cross-sectional study involves patients older than 18 years attending either out-patient clinics or who were admitted in the wards in a healthcare teaching institute for seeking care for diabetes or hypertension. Four hundred patients were chosen purposively and a pretested questionnaire was used to elicit information on incurring OOPs for NCDs. Descriptive statistics (like percentage, mean, median, and standard deviation) were calculated.

Results:

The study shows a significant expenditure other than out-patient, in-patient admissions, in the form of personal expenditure and loss of employment, amounting to 31.86 and 34.07%, respectively, of the mean total expenditure. In a quarter (3 months), the mean total expenditure is

JOURNAL/jfmpc/04.03/01697686-202203000-00043/1083FF01/v/2022-11-21T155320Z/r/image-tiff

9014.37 ± 6452.37. On average, the OOP expenditure per visit for an out-patient visit was

JOURNAL/jfmpc/04.03/01697686-202203000-00043/1083FF01/v/2022-11-21T155320Z/r/image-tiff

370.54 ± 237, while for the patients admitted to the hospital, the average OOPs was

JOURNAL/jfmpc/04.03/01697686-202203000-00043/1083FF01/v/2022-11-21T155320Z/r/image-tiff

1564.72 ± 1310.5.

Conclusions:

Health expenditures can contribute toward the impoverishment of many segments of the community. Undoubtedly, numerous people may tend to neglect the needed care for NCDs due to financial hurdles. Thus, there is a need to develop NCD care management centers with health insurance packages and make them accessible for all.
Enhanced Recovery After Cesarean Protocol Versus Traditional Protocol in Elective Cesarean Section
Authors: Gupta Sunanda , Gupta Apoorva , Baghel Aditi S. , Sharma Karuna , Choudhary Savita , Choudhary Vidhu
Published: March 2022

Background:

Enhanced recovery programs result in reduced morbidity in terms of effective pain control, reduced length of stay (LOS), and an earlier return to normal activities. This study has been conducted to compare Enhanced recovery after caesarean (ERAC) protocol to traditional care of cesarean section (CS) in our institute.

Materials and Methods:

Patients undergoing elective CS were subjected to ERAC protocol (Group A; n = 100) for first six months and traditional protocol (Group B; n = 100) for next six months. Primary outcome was comparison of total duration of stay (readiness to discharge) in the hospital, whereas secondary objectives were intraoperative hemodynamic control and requirement of vasopressor, comparison of Visual Analogue Scale (VAS) scores and requirement of analgesics in 24 hrs, barriers to implementation of ERAC components, urinary retention and need of recatheterization and any adverse events perioperatively.

Results:

Significant reduction in LOS or readiness for discharge was found in Group A; 2.85 ± 0.5 vs 5.25 ± 0.61 hrs in Group B (p < 0.0001). Episodes of hypotension and requirement of phenylephrine was significantly more in Group B. (p < 0.0001) VAS scores in Group A were significantly less postoperatively with significant reduction in consumption of rescue analgesic in 24 hrs. (p < 0.001) Components of ERAC protocol were implemented successfully with significant difference in time of ambulation, decatheterization, and resumption of oral feed postoperatively.

Conclusion:

Implementation of ERAC results in significant reduction in LOS in hospital with better pain relief and reduced postoperative opioid requirement following cesarean delivery.