bluuebunny/crossref_metadata_2025 huggingface dataset:
Composition operators on Hardy-Sobolev spaces with bounded reproducing kernels
Authors: He Li
Published: November 2022

For any real $ \beta $ let $ H^2_\beta $ be the Hardy-Sobolev space on the unit disc $ {\mathbb D} $. $ H^2_\beta $ is a reproducing kernel Hilbert space and its reproducing kernel is bounded when $ \beta > 1/2 $. In this paper, we prove that $ C_{\varphi } $ has dense range in $ H_{\beta }^{2} $ if and only if the polynomials are dense in a certain Dirichlet space of the domain $ \varphi({\mathbb D}) $ for $ 1/2 < \beta < 1 $. It follows that if the range of $ C_{\varphi } $ is dense in $ H_{\beta }^{2} $, then $ \varphi $ is a weak-star generator of $ H^{\infty} $, although the conclusion is false for the classical Dirichlet space $ \mathfrak{D} $. Moreover, we study the relation between the density of the range of $ C_{\varphi } $ and the cyclic vector of the multiplier $ M_{\varphi}^{\beta}. $
Redaksionele beleid van die Hervormde Teologiese Studies
Authors: Van Aarde A. G.
Published: November 2022

No abstract available.
Truth and commitment in theology and science: An appraisal of Wolfhart Pannenberg’s perspective
Authors: Huyssteen Wentzel Van
Published: November 2022

The Leitmotiv of Wolfhart Pannenberg’s work has always been his conviction that the Christian faith, and especially theology as a reflection on this faith, has a universal credibility in our age. This essay approaches this issue and sets forth a thesis in terms of the rationality of theology and of science. The shaping of rationality in both theology and science eventually forms the framework for dealing with the philosophical problems of truth, objectivity and commitment in Pannenberg’s impressive and ever expanding body of thought.
Verslag van die drie en veertigste algemene jaarkonferensie van die Studiorum Novi Testamenti Societas gehou by Robinson College, Universiteit van Cambridge, 8-12 Augustus 1988
Authors: Pelser G. M.M.
Published: November 2022

No abstract available.
Boekbespreking
Authors: Office Editorial
Published: November 2022

Botha, PJ - Deist, FE Le Roux, JH 1987. Revolution and reinterpretation: Chapters from the history of Israel. (Bladsy 201)Geyser, PA - De Villiers, PGR 1987. Liberation theology and the Bible. (Bladsy 203)Naudé, RM - Kriel, JR 1988. Removing medicine’s cartesian mask: The problem of humanising medical education. (Bladsy 206)Stander, HF - Ferguson, E 1987. Backgrounds of early Christianity. (Bladsy 207)Stander, HF - Durst, M 1987. Die Eschatologie des Hilarius von Poitiers: Ein Beitrag zur Dogmengeschichte des vierten Jahrliunderts. (Bladsy 209)Storm, JMG - Loubser, JA 1987. The apartheid Bible. A critical review of racial theology in South Africa. (Bladsy 212)Van der Merwe, PJ - Krüger, JS 1988. Aandag, kalmte en insig. (Bladsy 215)Van der Merwe, JC - Van der Walt, BJ 1988. My roeping as Christenjongmens in die huidige Suid-Afrika. (Bladsy 217)Van der Westhuizen, HG - Van Houten, RL 1988. The Message of Harare. (Bladsy 222)Van der Westhuizen, HG - Du Preez, J 1988. Die aantrekkingskrag van die Marxisme vir die Derde Wereld. (Bladsy 225)Van Staden, AJ - Algemene Kommissie vir die Diens van Barmhartigheid van die Nederduitse Gereformeerde Kerk 1986. Die diakonaat en die alkohol- en dwelmaflianklike. (Bladsy 227)
Redaksioneel
Authors: Van Aarde A. G.
Published: November 2022

No abstract available.
Die invloed van meta-teorieë op basisteorieë in die beoefening van die Praktiese Teologie
Authors: Van den Berg H. P. , Dreyer T. F.J.
Published: November 2022

Meta-theories, base-theories and theories of practice in Pratical Theology The problem of meta-theories and base-theories, their interaction and the influence of each on the scientific process, have widely been debated in practical theology. In South Africa two meta-theories namely the system- theory together with the theory that social science is busy with the study of actions, are having the greater deal of attention. The purpose of this article is to point out the fact that an early and absolute choice of particular meta-theories, restricts the work of practical theology because it will influence your base-theories, and can weaken the theological content of practical theology. An attempt is made to offer a model by which the interaction between, meta-theories, base-theories and theories of practice can he understood and which can also help the theologian, busy with practical theology, to steer clear of problems and understand the meta- influences in his own scientific work.
Menseregte en teologie: 'n Noodsaaklike debat
Authors: Vledder E. J.
Published: November 2022

Human rights and theology: An essential debate Human rights form an essential element of the new Constitution of South Africa. Can Christians take part in the debate on human rights? A model will be proposed called 'Analogy and difference’, which indeed makes it possible and desirable to do so. Although not founded essentially on Scripture or theology, analogies for the three basic principles of human rights — freedom, equality and participation — can be found in the Christian tradition. However, the difference between the Christian tradition and the tradition of the Enlightenment has to be taken into account. Thus, the Christian can critically enter the debate on human rights, not to fill the concepts with Christian meaning, but to achieve a new ethical consensus.
Perceived Impact of the COVID-19 Pandemic on Postgraduate Residents
Authors: Solanki Ajay , Solunke Hrishikesh , Rao T. S. Sathyanarayana , Kishor M.
Published: November 2022

Introduction:

COVID-19 has led to an increase in burden on health-care workers. Postgraduate residents are at the forefront of the pandemic. Understanding its impact and the perspectives of postgraduate residents could provide better solutions to their problems.

Objectives:

1. To assess the psychological impact of the COVID-19 pandemic on postgraduate doctors. 2. To assess the perception of postgraduate doctors regarding the medical profession and its association to the psychological impact of the COVID-19 pandemic.

Methodology:

This cross-sectional study recruited 65 postgraduate medical resident doctors working in teaching hospitals involved in the care of COVID-19 patients. They were requested to complete the questionnaire consisting of qualitative as well as quantitative questions. For an objective assessment of anxiety, the Generalized Anxiety Disorder-7 (GAD-7) scale was used. Relevant statistical methods were employed and statistical analysis was done using IBM SPSS software version 20.0.

Results:

The qualitative data showed themes of concern regarding social awareness about COVID-19 (hygiene, masks, and social distancing), working conditions of doctors, and increased stress and burnout. 47.54% (n = 29) of respondents said that they would reconsider their profession/specialty, out of which 21 said that they would switch to another profession. The resident doctors who would reconsider their choice of profession/specialty had significantly higher (P < 0.05) scores for anxiety (GAD-7).

Conclusion:

Owing to the significant association between anxiety and desire to change their profession altogether, greater psychological support for doctors appears to be a pressing need. It is important that the concerns of the postgraduate residents are addressed promptly and holistically.
Effect of Propranolol in Cutaneous and Intracavitary Hemangiomas
Authors: Akhtar Mohammad Sadik , Goel Agam , Guroo Sartaj Ahmad , Rabbani Syed Shamayal , Alim Sheikh Saif , Haseen Mohd Azam , Abbasi Areeb
Published: November 2022

Objectives:

The objective was to study the role of propranolol in decreasing the size and severity of hemangioma.

Materials and Methods:

This study was conducted in JNMC, AMU, Aligarh, India, on 100 patients who were divided according to their age group among infants (0–1 year), children (1–14 years), and adults (>14 years). Intracavitary hemangioma was diagnosed with ultrasonography/magnetic resonance imaging scan. Treatment with oral propranolol was started after ruling out any contraindication to therapy. The patients were assessed according to the Hemangioma Activity and Severity Index (HASI) at the start and at the end of treatment. The treatment outcome and side effects were recorded.

Results:

Among the total patients studied, there were more number of adult patients in this study, most of them were male. There were more number of patients of extracutaneous hemangioma, most of which were intra-abdominal. The difference of location of hemangioma and age group was observed, with intra-abdominal hemangiomas being more common in adult patients and cutaneous hemangioma being more common in infant and pediatric age group. The propranolol therapy was effective in all age groups, with mean HASI being reduced significantly between start and end of treatment at 16 weeks (P = 0.001). There was regression in a good number of patients with partial regression in 55% of patients and complete regression in 32.5% of patients. Minor side effects of hypoglycemia, palpitation, and episodic bradycardia were observed in very few patients.

Conclusions:

Propranolol is effective in reducing the size and severity of hemangiomas among all age group of patients without causing any severe side effect.
COVID-19-Positive Ruptured Abdominal Aortic Aneurysm Successfully Managed by Open Surgical Repair and Review of Literature
Authors: Abuji Kishore , Savlania Ajay , Kumar Deepak , Kaman Lileshwar , Gorsi Ujjwal , Tandup Cherring
Published: November 2022

COVID-19 pandemic has affected everyone globally in every walk of life. A rise in the number of patients afflicted with thromboembolic complications of COVID-19 is being reported, both venous and arterial. Elective vascular surgery has been stopped entirely at our institute. However, both COVID-19-positive and negative patients continued to require emergent vascular surgery even during the pandemic. We are reporting a case of COVID-positive, ruptured abdominal aortic aneurysm (AAA) who was successfully managed at our hospital. The principles of open repair of ruptured AAA remained same, with a few special considerations. We did not find any report on open repair of ruptured AAA in COVID-19-positive patient. On search at Medline, we found two cases of ruptured AAA, which were successfully managed with endovascular aneurysm repair (EVAR).
A Wolf in Wolf's Clothing? The Complexities of Decision Involved with Acute Thoracic Endovascular Aortic Intervention for Penetrating Aortic Ulcer and Intramural Hematoma
Authors: Singla Animesh , Cook Victoria , Kotecha Krishna , Mohabbat Walid
Published: November 2022

This article provides a case and reviews the considerations involved in acute endovascular stent for penetrating aortic ulcers (PAU)/intramural hematoma (IMH). This case aims to highlight the decision-making and considerations in the acute endovascular management of a patient presenting with PAU and associated IMH. The literature was reviewed including Google Scholar, PubMed, and Embase. Acute aortic syndrome encompasses a spectrum of aortic disease ranging from aortic dissection to PAU and IMH. Whilst classical aortic dissection has been well studied, the PAU/IMH subset of this population is exceedingly rare. Only a handful of case reports have reported on technical considerations for repair. Despite limited natural history data, growing evidence suggests a more aggressive stance is warranted to prevent progression to rupture and late aortic-related mortality. This pathology poses unique challenges in anatomical and technical considerations of repair.
Analysis of spirometric variables with increasing body mass index in normal and overweight healthy individuals
Authors: Jaleel Ilham , Ahamed Haja Nazeer
Published: November 2022

Background:

The relationship between the parameters of body mass index (BMI) and lung function has been established by numerous studies done earlier. Those studies have been done mainly on obese individuals, but only a very few studies have been done in people with normal BMI or overweight group. Our aim is to analyze the various spirometric variables, namely forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), forced expiratory flow (FEF 25%–75%), and peak expiratory flow rate (PEFR), with respect to increase in the BMI in otherwise normal healthy subjects.

Methods:

The present study design is a randomized experimental parallel-group study. Sixty individuals who were otherwise healthy without any respiratory illness were selected for this study. Their anthropometric measurements were taken. Based on WHO classification, the subjects were grouped as follows: Group I with a BMI of 18.5–24.9 as a normal weight group and Group II with a BMI of 25–29.9 as the overweight group. Using Medispiror, the spirometric variables were determined. Analysis of spirometric variables, namely FEV1, FVC, FEF 25%–75%, and PEFR, were all done using the appropriate statistical method.

Results:

The results showed that there was a significant decrease in all spirometric variables except PEFR with an increase in BMI. However, the decrease in FVC was relatively more than the decrease in FEV1.

Conclusion:

This study can be concluded that there is a significant decrease in spirometric variables, namely FEV1, FVC, and FEF 25%–75%, as the BMI increases even in normal individuals who are not obese.
Rhabdomyolysis
Authors: Oleolo-Ayodeji Khadijah Omobusola , Salako Helen Olubunmi , Moronkola Olaolu Aziza , Oyenusi Elizabeth Eberechi , Oduwole Abiola Olufunmilayo
Published: November 2022

A 19-year-old male with type 1 diabetes mellitus (diagnosed at 12 years of age) was brought to the emergency room with fever and altered sensorium. His compliance with his insulin regimen was questionable. Examination revealed a Glasgow Coma Scale of 5/15, sluggishly-reacting pupils, severe dehydration, and fever (temperature 38.8°C). Vital signs at the upper limit of normal, urethral catheter drained dark red urine with output of 1–2 ml/kg/hr. Laboratory investigations showed hyperglycemia (250 mg/dL), ketonuria (+) hematuria (+++) and proteinuria (++), and glycated hemoglobin (HbA1C) – 9.6%. Full blood count showed leukopenia, neutrophilia, and thrombocytopenia. Deranged electrolytes included hypernatremia, metabolic acidosis, and hypophosphatemia with elevated urea and blood urea nitrogen. Serum creatinine kinase (CK) was elevated. A diagnosis of diabetic ketoacidosis (DKA) with rhabdomyolysis (RM) and raised intracranial pressure was made and he was managed with adequate fluid resuscitation, osmotic diuresis, glycemic control, platelet transfusion, and antibiotics with clinical improvement. Normal CK levels were documented 3 months later. RM is a rare complication of DKA. High index of suspicion should be maintained for prompt detection and management to prevent potential complications, especially acute kidney injury.
Correlation between Lund-Mackay CT scan score and Sinonasal Outcome Test-20 symptoms score in the evaluation of chronic rhinosinusitis
Authors: Shirama Yakubu Bababa , Adamu Auwal , Iseh Kufre Robert , Ahmed Sa'idu Sule , Baba Sule Muhammad , Ma'aji Sadisu Muhammad
Published: November 2022

Background:

Computed tomographic (CT) scan is important in the evaluation of chronic rhinosinusitis (CRS). The usefulness of CT scan in predicting the severity of symptoms is still debatable. The aim of this study is to determine the correlation between a CT scan scoring and the severity of clinical symptoms in patients with CRS.

Methods:

A cross-sectional study of patients with clinically diagnosed CRS. Their symptoms severity was assessed using the Sinonasal Outcome Test-20 (SNOT-20) scoring system. All eligible patients had CT scans using BrightSpeed (GE) computed tomographic scanner. The CT scan findings of each subject were scored according to the Lund-Mackay scoring system. The correlation between the CT score and the SNOT-20 symptom score was determined.

Results:

There were 120 participants comprised 70 (58.3%) males and 50 (41.7%) females with male: female ratio of 1.4:1. The mean and standard deviation of SNOT-20 were 38.9 ± 17.5 (range: 6–81) and that of Lund-Mackay score were 9.8 ± 5.5 (range: 0–24). There was statistical significant correlation between Lund-Mackay score and SNOT-20 score (r = 0.653 P = 0.000). The correlation was strongest in relation to nasal symptom domain (r = 0.746, P = 0.000), but it was weak with the facial symptom domain (r = 0.225, P = 0.013).

Conclusion:

This study found a strong positive correlation between the Lund-Mackay score and SNOT-20 symptoms score among patients with CRS.
The impact of dental fear on the dental attendance behaviors: A retrospective study
Authors: Alenezi Ali A , Aldokhayel Hamad S.
Published: November 2022

ABSTRACT

Objective:

The aim is to investigate the causes of dental fear and its impact on dental attendance behaviors.

Materials and Methods:

A short questionnaire was distributed to participants at different dental clinics and by emails to evaluate their perceptions of dental fear. The questionnaire contained questions related to gender and age group. The remaining part of the questionnaire investigated the causes of dental fear and its impact on dental visits.

Results:

A total of 2264 participants aged 18 years and above agreed to complete the questionnaire. There were 1177 (52%) male participants and 1095 (48%) female participants. There was a response rate of approximately 60%. Drilling tooth devices and their sounds was the option that caused the highest dental fear among the participants who had it (n = 248; 37.7%). Pain was the second most frequently chosen option to cause dental fear (n = 165; 25%). Around 70% (n = 1257) of the participants who had dental fear overcame their fear and decided to seek treatment when they experienced annoying pain. At the same time, 18% (n = 323) of them sought the treatment when they experienced slight pain and 10% (n = 180) sought the treatment once they noticed a large carious lesion.

Conclusion:

People from both genders responded similarly to dental fear, and age was not found to be a significant factor in individuals’ reactions to dental treatment. The sounds of teeth-drilling devices and related sounds may be responsible for the dental fear, as reported by many people. People with dental fear are more likely to avoid regular dental visits.
Minimal change disease (MCD) following vaccination with ChAdOx1 nCoV-19 vaccine in a young Indian male: A case report
Authors: Krishna Amresh , Singh Prit Pal , Mazumdar Prajit , Sharma Alok
Published: November 2022

ABSTRACT

Various vaccines against coronavirus disease 2019 (COVID-19) have been developed amidst the ongoing pandemic. Few cases of glomerulonephritis after COVID-19 vaccination have been reported globally. We present a case of nephrotic syndrome due to minimal change disease (MCD) most likely associated with the ChAdOx1 nCoV-19 vaccine. A 24-year-old male presented with anasarca and frothy urine after receiving the first dose of the COVID-19 vaccine. On admission, the patient had normal serum creatinine with 24-h urinary protein excretion of 4.1 g/day and severe hypoalbuminemia. Kidney biopsy revealed nonproliferative glomerular morphology with relatively unremarkable-appearing glomeruli on light microscopy and diffuse effacement of the odocyte foot processes on electron microscopy, consistent with diagnosis of MCD. This case highlights the risk of new-onset nephrotic syndrome due to MCD after COVID-19 vaccination.
Prevalence of Helicobacter pylori infection among patients with dyspepsia and other gastrointestinal diseases in King Abdulaziz Specialized Hospital in Taif
Authors: Oraijah Abrar A. , Shaqhan Mohammed H. , Alhebshi Fatimah A. , Alsuwat Rawan W. , Algethami Abdullah H. , Alsofyani Afnan H. , Ozayzan Angham , Altowairqi Sameer A. , Alqurashi Hesham H.
Published: November 2022

ABSTRACT

Introduction:

To estimate the prevalence of H. pylori in patients with dyspepsia as well as the prevalence of cancerous and precancerous nonmalignant lesions in patients with H. pylori.

Methods:

A retrospective cohort study has been conducted at King Abdulaziz Specialist Hospital (KAASH), Ministry of Health (MOH) in Taif city in the Western province of Saudi Arabia among patients who underwent endoscopy between July 2019 and July 2021. Data were collected from the endoscopy log book and consisted of four sections; demographic data (age and gender), presenting symptoms and indications of endoscopy, endoscopic findings, and histopathological findings in endoscopic biopsies.

Results:

The study included 680 patients. Their age ranged between 12 and 97 years with an arithmetic mean of 40.9 years and a standard deviation of 16.4 years. The prevalence of dyspepsia was 45.9% while that of H. pylori was 32.5%. The prevalence of H. pylori among patients with dyspepsia was 30.1% compared with 34.5% among those without dyspepsia, P > 0.05. The prevalence rates of H. pylori among male and female patients were 32.3% and 32.7%, respectively, P > 0.05. The prevalence rate of H. pylori was highest among patients aged between 41 and 60 years (38.7%) and lowest among those aged over 60 years (19.5%), P = 0.005. Active chronic gastritis was reported among almost two-thirds (65.6%) of patients with H. pylori compared with only 9.8% of those without H. pylori, P < 0.001.

Conclusion:

The H. pylori was a common health problem among patients suffering from dyspepsia, however, its prevalence was relatively lower than other rates reported from other developing countries.
Clinical features and haematological parameters associated with COVID-19 severity among hospitalized patients: A retrospective observational study from Tribal Central India
Authors: Kabirpanthi Vikrant , Gupta Vikas , Singh Ajit
Published: November 2022

ABSTRACT

Background:

Reports describing demographics, clinical characteristics, hospital course, morbidity, and mortality in patients in the Indian setting have been published, but they are based on limited numbers of cases. The present study among the patients with known outcomes enabled us to better understand the disease process and progression of COVID-19 cases and to correlate the factors affecting the outcome.

Methods:

This was a record-based, retrospective observational study of patients admitted to COVID-19 Hospital. We have retrieved medical records for all the hospitalized patients with a laboratory confirmed COVID-19 diagnosis with a known outcome (discharged or died) between April 1, 2020 and February 28, 2021. The extracted data included basic demographics, signs and symptoms, duration of hospitalization, and laboratory parameters. Categorical variables were analysed using either the chisquare test or Fisher’s exact test. The level of significance was set at P < 0.05.

Results:

The mean age of severe and moderate patients was 38.71 years, compared to 34.95 years for mild patients. No gender difference was observed for the severe/moderate, and mild cases. The mortality rate among severe/moderate cases was 11.6%, whereas it was 3.9% in mild patients. Laboratory parameters which were significantly (p < 0.05) raised among the dead compared to discharged patients included CT score, D-dimer, CRP, ALT, AST, and alkaline phosphatase.

Conclusion:

Clinical and laboratory characteristics reflect the pathophysiology of disease and thus help clinicians recognise the severity of medical illness. They also facilitate the creation of management protocols for clinical care that results in improvement in patient related outcomes.
Are we expecting too much for too long from the vaccinators? A qualitative study on perceived challenges of COVID-19 vaccinators of district Shahdol, India
Authors: Singh Akash Ranjan , Kabirpanthi Vikrant , Sonare Anshuman , Chavan Pragati V. , Ashraf Mohd. , Shewade Hemant D.
Published: November 2022

ABSTRACT

Background:

There is a paucity of knowledge regarding challenges faced by the coronavirus disease 2019 (COVID-19) vaccinators in resource constraint settings like district Shahdol, Central India. Hence, the present study was planned to explore the perceived challenges of vaccinators regarding COVID-19 vaccination.

Methods:

In October 2021, district health authorities conducted a one-day workshop with the auxiliary nurse midwives, staff nurses, and lady health visitors who work as vaccinators. It had three distinct but mutually connected phases. In the first phase, a free listing exercise was performed to list out their perceived challenges that are prominent and representative of their cultural domain. In the second phase, the pile-sorting exercise with the challenges mentioned in the above step was performed to produce similar data in the form of a matrix, based on a perceived similarity between them by multi-dimensional scaling analysis. In the final phase, the transcripts generated during the discussion on the free listing and pile sorting exercises was used for the thematic analysis to find plausible explanations for the findings.

Result:

A total of 15 vaccinators took part in the workshop. In the free listing exercise, a total of 14 items were identified as perceived challenges for COVID-19 vaccinators. The three items with the highest Smith’s S value were overtime duty, no holidays, and lack of monetary incentive. The analysis of pile-sorting suggested that participants clustered their 14 perceived challenges into five groups; 1) beneficiaries related, 2) vaccination schedule related, 3) lack of facilities at vaccination site, 4) lack of monetary incentive, and 5) issues related to digital data handling. Thematic analysis suggested that their main challenges were overtime duty, no monetary incentive, and lack of toilet, food, and transport facility at the session site.

Conclusion:

Vaccinators perceive overtime duty and lack of holidays as their top two challenges and expect monetary incentives for this. The study recommends better basic amenities like toilet facility, sustained and effective community engagement, a monetary incentive, and a better ecosystem for digital data handling for the vaccinators.
Effectiveness of Semmes Weinstein 10 gm monofilament in diabetic peripheral neuropathy taking nerve conduction and autonomic function study as reference tests
Authors: Dube Suchitra , Hulke Sandip M. , Wakode Santosh L. , Khadanga Sagar , Thakare Avinash E. , Bharshankar Rajay N. , Pakhare Abhijit
Published: November 2022

ABSTRACT

Context:

Diabetic peripheral neuropathy (DPN) if detected early can reduce the burden on the health system and prevent the development of diabetic foot ulcers and amputation.

Aim:

To study the effectiveness of Semmes Weinstein 10 gm monofilament in detecting DPN taking nerve conduction studies (NCS) and autonomic function testing (AFT) as reference tests.

Settings and Design:

Observational and comparative cross-sectional study conducted in the Physiology department AIIMS, Bhopal in collaboration with the Medicine department of the institute.

Methods and Material:

A total of 72 diagnosed type-2 diabetes mellitus patients were examined using Semmes Weinstein 10 gm monofilament, DPN was confirmed using NCS (Nihon Kohden Neuropack XI machine) and autonomic neuropathy was confirmed using AFT (Ewing’s battery and Power lab) with heart rate variability (HRV). Diagnostic value of Semmes Weinstein 10 gm monofilament taking NCS and AFT as reference test was calculated.

Statistical Analysis Used:

Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) were calculated using the standard formula.

Results:

Sensitivity, specificity, PPV, and NPV using monofilament are 69.23%, 20%, 69.23% and 20% respectively taking NCS as reference test and 70.59%, 0, 92.30%, and 0 respectively taking AFT as reference test.

Conclusions:

Semmes Weinstein 10 gm monofilament is not the ideal screening test for the diagnosis of DPN. Sole clinical use of monofilament should be discouraged.
Awareness and preparedness of first responders regarding chemical, biological, radiological, nuclear and explosive (CBRNE) disaster management of a tertiary medical institute in South India: A mixed methods study
Authors: Suryawanshi Deodatt M. , Surekha A , Divya R , Gunasekaran Kalaipriya , Malini Indhu
Published: November 2022

ABSTRACT

Background:

In case of a CBRNE catastrophe, junior doctors (first responders) will be the first to respond to the CBRNE disaster, so they should be fully equipped with the knowledge and skills of managing CBRNE casualties and preventing the endangerment of lives.

Objectives:

To assess the awareness and preparedness of first responders in medical institutions regarding CBRNE casualties’ management and to explore the perceptions of first responders towards CBRNE disaster management.

Materials and Methods:

The present study was a mixed methods study which was conducted during the months of January to March 2020 among 153 study participants. Focus group discussions (FGDs) were conducted along with free listing and pile sorting till data saturation. Data entry was done in an Excel sheet and data analysis was be done using SPSS software v. 21.

Results:

Out of the 153 participants only 37 participants (24.1%) had ever heard about the term “CBRNE” (chemical, biological, radiological and nuclear disasters) or “hazmat” (hazardous material). At the end of FGDs, participants could answer affirmatively that they had heard the term “decontamination” of CBRNE casualties. Very few participants could ambiguously explain the meaning of the term “decontamination” in the context of CBRNE casualty.

Conclusion:

There is an imperative need for enhancing not only knowledge and awareness, but also proper training for first responders to utilizing simulation sessions. This is particularly important as health care professionals are the first line of defence when it comes to identifying and treating patients that have come into contact with CBRNE hazards.
Non-COVID infections causing MIS-C in COVID recovered children: An association or co-illness – A case series
Authors: Bedi Nidhi , Richa  , Kaur Jasleen , Sadadiwala Shikha , Gupta Neha , Abrol Pankaj
Published: November 2022

ABSTRACT

With the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, multi-system inflammatory syndrome (MIS-C) is being reported all across the world. Why some children develop it whereas others do not and the various implicating agents for the same are not clear. It has been seen that various infections are associated with immune mediated diseases. Whether new infections, in COVID recovered children, can lead to the cascade of MIS-C is still a matter of debate. We report a case series of four cases of MIS-C all subsequent after bacterial or viral infection in COVID recovered children. All children had a documented evidence of past SARS-CoV-2 infection and present bacterial or viral infection. They were given the required management as per the concerned infection but none improved after standard therapy. All children showed drastic improvement after initiation of specific therapy for MIS-C. It is important to understand increased risk of MIS-C with new onset viral and bacterial infections in COVID recovered children.
A case series of malignant pericardial effusion
Authors: Babu Reshma S. , Lanjewar Ajay , Jadhav Ulhas , Wagh Pankaj , Aurangabadkar Gaurang , Upadhyay Puja
Published: November 2022

ABSTRACT

The most common primary malignancies that affect the pericardium are lung cancers. Typically, pericardial involvement stays undiagnosed, with almost 1-20% of all tumor-related autopsies revealing invasion of the pericardium. Pericardial effusions are seldom the first location of metastasis and presentation of a primary malignancy. Malignant pericardial effusions are usually silent, although they cause dyspnea, chest discomfort, arrhythmias, cough, and, in rare cases, pericardial tamponade. In a patient with tamponade, a high index of tumor-related suspicion is crucial to rule out cancer. Emergency pericardiocentesis is indicated based on the clinical presentation, however, the patient frequently has a bad prognosis regardless of whether treatment is administered or not. In this case series, we report five cases of non-small cell lung cancer (NSCLC) with pericardial effusion as an initial presentation.
Screening for mental illness using GMHAT App of patients with Type 2 diabetes mellitus at a teaching institute hospital in India – A cross sectional study
Authors: Majgi Sumanth M. , Mal Nihar Mal , Krishna Murali , Suresh Harshini , Ebuenyi Ikenna D. , Jones Steven
Published: November 2022

ABSTRACT

People with diabetes will have some coexisting mental illness most of the time and its evaluation and management are essential for the well-being of the person. With this background, the Global Mental Health Assessment Tool (GMHAT) app was used to screen for mental illness among type 2 diabetes mellitus patients attending a tertiary care hospital in Mysore, India.

Methods:

A cross-sectional study was conducted on 100 patients who were on treatment for type 2 diabetes for at least 6 months from the Out-Patient Department of KR Hospital, Mysore. Interviews were conducted using a structured GMHAT. Data were entered in MS Excel and analysed using SPSS version 21.0. Chi-square, Independent T-test/Mann–Whitney tests were used to investigate associations between the variables.

Results:

The mean age of the study participants was 48.8 ± 11.6 years. Among the 100 diabetic patients, 39% (n = 39) had mental illness and among the 39 subjects, 21% had depression, 14% had anxiety disorder and 4% suffered from organic disorder. Apart from diabetes, 29, 17, 13, 27, 23 and 20% had hypertension, chronic kidney disease, liver disease, retinopathy, neuropathy and nephropathy, respectively, as comorbid conditions.

Conclusion:

There is a higher prevalence of mental illness in patients with diabetes mellitus. The prevalence rate increases with an increase in the chronicity of diabetes. The use of the GMHAT app could help in rapid assessment and accurate diagnoses.
Description and outcomes of patients with eclampsia and severe pre-eclampsia in a rural hospital in North-Eastern Bihar: A retrospective study
Authors: Dasari Amos , Jacob Priya M. , Jeyapaul Shalini , Mathew Arpit J. , Abraham Vinod J. , Cherian Anne G.
Published: November 2022

ABSTRACT

Background:

Hypertension is one of the most common medical disorders complicating pregnancy. In India, high blood pressure contributes to 7.1% of maternal deaths. This study was carried out to describe the characteristics and pregnancy outcomes of patients presenting with eclampsia or pre-eclampsia to a secondary care hospital in rural India.

Methods:

Patients diagnosed with pre-eclampsia or eclampsia between January 2018 and April 2021 were identified and included in the study. Medical records were searched and general patient characteristics, obstetrical history, information about the antenatal period, mode of delivery and outcomes were documented and analysed.

Results:

Among the 3651 women who delivered in this hospital during this time period, 2.3% (n = 83) presented with eclampsia and 1.9% (n = 71) with pre-eclampsia. More than 50% of the women delivered by lower segment caesarean section among both the eclamptics and pre-eclamptics. The stillbirth rate among those with either pre-eclampsia or eclampsia was 1 per 1000. The number of low birth weight babies born to those presenting with eclampsia (66.7%) was significantly more than those presenting with pre-eclampsia (48.6%). Eclampsia/pre-eclampsia accounted for 21% of all maternal deaths with a case fatality rate of 2.6%.

Conclusions:

This study identified that in this setting the patients presenting with eclampsia were much higher than those presenting with pre-eclampsia which is in stark contrast to the status even in developing countries. This could be an important finding indicating poorer health-seeking behaviour among the population and will need more studies on various interventions to change this status.
New onset diabetes mellitus in post-COVID-19 patients
Authors: Keerthi B Y , Sushmita G , Khan Ehsan A. , Thomas Vimala , Cheryala Vikram , Shah Chirali , Kumar G. Ravi , Haritha V
Published: November 2022

ABSTRACT

Background:

Diabetes, is known to have a bilateral relationship with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Precise mechanism of diabetes onset in COVID-19 patients remains unclear.

Aim:

To analyse the incidence of new onset diabetes (NODM) among COVID-19 patients, as well as the effect of body mass index (BMI), family history, and steroid use on the incidence of the disease.

Methods:

Adult, not known diabetic patients, tested positive with Rapid Antigen Test or RT-PCR admitted to a tertiary care hospital and research institute were included in the present prospective observational study. The patients who developed NODM and NOPD (New Onset Pre-diabetes) during the three months follow-up and the risk factors associated were assessed. Patients with HbA1c >6.4% were diagnosed with NODM. An HbA1c of 5.7% to 6.4% was used to characterize NOPD.

Results:

Out of 273 previously not known diabetic COVID-19 infected individuals, a total of 100 were studied for three months after consent. Mean age of the patients 48.31 ± 19.07 years with male predominance (67%). Among these, 58% were non-diabetics and 42% were pre-diabetics. 6 (10.3%) of the 58 non-diabetics developed NOPD, and 8 (13.8%) developed NODM. 6 (14.2%) of the 42 pre-diabetics became non-diabetic, and 16.6% (7) developed NODM. Family history of DM (P < 0.001), severity at admission (P < 0.006), diabetic ketoacidosis (P < 0.0275), and persistent symptoms were associated significantly with NODM. Those with NODM had significantly greater BMI, O2 duration, steroid duration, FBS, and PPBS (P < 0.001 for all). Nearly 67% of the patients who developed NOPD had shortness of breath as the common symptom at time of admission (P = 0.0165).

Conclusion:

The incidence of NODM was strongly influenced by positive family history of DM, higher BMI, steroid dosage, and its duration. Hence, patients with COVID-19 need to be under surveillance for blood glucose screening.
The master impersonator: Pulmonary tuberculosis mimicking diffuse cystic lung disease – A mini case series of a rare presentation
Authors: Vinay V , Abdullah Yasir , Garg Abhimanyu , Verma Paras , Singh Gaurav Kumar , Sharma Amit
Published: November 2022

ABSTRACT

Pulmonary tuberculosis has diverse clinical presentations. Cysts in the lung can arise due to large number of causes out of which tuberculosis is very rare. We report two immunocompetent cases of pulmonary tuberculosis who presented with multiple cysts in the lung parenchyma. The diagnosis was confirmed by the transbronchial lung cryobiopsy in first case and by analysis of bronchoalveolar lavage fluid in the second. Both had spontaneous pneumothorax which was treated with chest drain and pleurodesis. Both showed an excellent response to anti-tubercular therapy and steroids. Tuberculosis presenting as cystic lung disease is atypical and rare.
Salmonella Paratyphi and multiorgan dysfunction: A rare case report
Authors: Kumar Manish , Sunder Ashok
Published: November 2022

ABSTRACT

Salmonella typhi (S. typhi) and Salmonella paratyphi A (S. paratyphi A), together known as typhoidal Salmonella, are causal agents for an invasive, serious, and sometimes fatal disease of humans called typhoid fever or paratyphoid fever (also known as enteric fever). S. Typhi, the lineage causing typhoid fever, is the main group; whereas S. Paratyphi A, the lineage causing paratyphoid fever, belongs to the second group, which comprises a set of three paratyphoid types (the other two being S. Paratyphi C and d-tartrate-negative S. Paratyphi B). All these lineages are adapted to humans, with S. Typhi and S. Paratyphi A being strictly restricted to growth in humans, and S. Paratyphi C being able to establish infections in experimental animals quite easily (at moderate infection doses); the host-restriction status of d-tartrate-negative S. Paratyphi B is so far unclear. The potential source of infection is the use of sewage-contaminated water in plants and vegetable irrigation and clinical presentation is varied, mainly presenting with fever, malaise, abdominal discomfort, and nonspecific symptoms often confused with other causes of the febrile syndrome. S. Paratyphi is usually a mild form of disease without any complication, but we report a complicated case of Paratyphi, who presented with fever and gastrointestinal symptoms complicated by multiorgan dysfunction needing mechanical ventilatory support, multiple hemodialysis, and blood transfusion. Fortunately, he recovered from all the insults and was discharged home in stable condition on the 26th day of hospitalization.
The symptomatology of fever: A step towards qualitative definition of fever
Authors: Kapoor Mayank , Kumar Nitin , Panda Prasan K.
Published: November 2022

ABSTRACT

Background:

The old definitions of fever are based on cross-sectional surveys of the population without analyzing the associated symptomatology as fever is a sign, not symptom. Therefore, a longitudinal follow-up study is the need of hour to analyze associated symptoms with fever.

Methods:

In a longitudinal study over one year, 196 participants recorded three temperature readings daily, one after waking up, one between 12 and 3 PM, one before sleeping, and filled the symptomatology questionnaire in a thermometry diary.

Results:

Per protocol analysis was done for febrile participants (n = 144). Fatigue (50.3%), warmth (47.3%), headache/head heaviness (47.0%), feeling malaise/general weakness (46.7%), loss of appetite (46.5%), muscle cramps/muscle aches (45.6%), chills/shivering (44.6%), increased sweating (43.0%), nausea (42.5%), irritability (38.9%), increased breathing rate (37.1%), and restlessness/anxiety/palpitations (36.5%) were the symptoms maximally seen during the febrile phase. A higher number of associated symptoms are associated with higher temperature readings. Dehydration suggested the numerically highest temperature values (100.86 ± 1.70°F) but seen in few febrile patients.

Conclusions:

Incorporation of symptom analysis in febrile patients is the need of the hour. Fatigue and warmth are found to be the most prevalent symptoms during febrile phase. Associated symptoms can help in predicting the intensity of fever also.
Mortality in patients with Coronavirus disease 2019 (COVID- 19) and its clinicoradiological and laboratory correlates: A retrospective study
Authors: Jain Payal , Agarwal Neema , Saxena Vikas , Srivastav Saurabh , Solanki Hariom
Published: November 2022

ABSTRACT

Aim:

To delineate and analyze the mortality from COVID -19 in our institute during the devastating second wave of pandemic.

Settings and Design:

A retrospective cohort analysis.

Methods and Materials:

A comprehensive mortality analysis of 142 laboratory-confirmed severe acute respiratory syndrome coronavirus 2-infected deceased patients from our hospital’s medical records was done. These patients presented with severe disease at the time of admission and were managed in intensive care units.

Statistical Analysis Used:

Statistical Package for Social Sciences software, IBM manufacturer, Chicago, USA, version 21.0 was used.

Results:

The number of deceased males (82, 62.6%) was higher than females (53, 37.3%). Median age of deceased patient was 57 (44.25–69.75) years. Most frequent comorbidities were diabetes mellitus (42, 29.6%) and hypertension (41, 28.9%). Most common symptoms being shortness of breath (137, 96.5%), fever (94, 66.2%) and cough (73, 51.4%). Median peripheral capillary oxygen saturation (SpO2) at time of admission was 86% (77.25–90). Median time interval from symptom onset to admission in hospital was 3 (2.25–5) days. Neutrophil lymphocyte ratio was more than 5 in 117 (90.7%) patients. Complications seen were acute respiratory distress syndrome in 82.3%, acute liver injury in 58.4%, acute kidney injury in 26.7%, sepsis in 13.3% and acute cardiac injury in 12% patients. The median high-resolution computed tomography score was 20 (17–22).

Conclusions:

Male and elderly patients with underlying comorbidities had poorer outcome and involvement of multiple organ systems was common. A short time interval between symptom onset and admission/mortality, particularly encountered was worrisome.
How to make services adolescent friendly? A cross-sectional study on awareness of adolescent friendly health clinics in Central India
Authors: Bali Surya , Chatterjee Anirban , Nagi Raunaq Singh , Gupta Suruchi , Singhal Kritika
Published: November 2022

ABSTRACT

Background:

India’s flagship program on adolescent health – Rashtriya Kishor Swasthya Karyakram (RKSK) emphasises the importance of strengthening Adolescent Friendly Health Clinics (AFHCs) under its facility-based approach for improving the health of adolescents. AFHCs are intended to provide targeted intervention in six domains – nutrition, injuries & violence (including gender-based violence), mental health, sexual & reproductive health, substance abuse and noncommunicable diseases.

Objective:

The current study was conducted to assess the determinants of awareness and utilisation of AFHC services in districts with RKSK services in Madhya Pradesh.

Subjects:

In total, 1605 adolescents (both males and females) within the age group of 10–19 years were included in the study.

Methods:

Multistage stratified random sampling was employed to enrol participants from three districts of Madhya Pradesh, where AFHC services have been launched.

Results:

The mean age of the participants was 15.07 ± 2.32 years. Only 153 (9.5%) adolescents were aware of AFHC services. On multivariate logistic regression, awareness of AFHC was seen to be associated with being aware of RKSK, being a part of the peer educator-led peer group, having had adolescent health days organised in the village and belonging from one of the financially better off districts. Utilisation rate of AFHC services was lower still – at 2.74%.

Conclusion:

Both awareness and utilisation of AFHC services remain very low among adolescents. There is a pressing need to focus on awareness generation campaigns – via mass media, but more importantly, through community health workers and peer educators – in order to sensitise target beneficiaries about the available services.
Study of pattern of foods given to the infants during weaning period in an urban field practice area in Vijayapura
Authors: Ganganahalli Praveen , Patil Santosh D. , Yankanchi Sandeep , Tellur Laxmi
Published: November 2022

ABSTRACT

Background:

The first 2 years of life are a critical period for a child’s growth and development. Exclusive breastfeeding for 6 months and continued breastfeeding with safe, appropriate, and adequate feeding are recommended as a global health policy in both developing and developed countries.

Objective:

The objective was to study the pattern of foods given to the infants during the weaning period in an urban field practice area in Vijayapura.

Materials and methods:

The mothers of infants (aged 6–12 months) were interviewed by using predesigned and pretested questionnaires regarding different types of foods given to their infants and also about their immunization status, incidence of diarrhea and acute respiratory infection (ARI).

Results:

A total of 95 mothers with infants aged between 6 and 12 months were enrolled in the study during the period of 1 month. Majority of the infants were fed with milk (animal) as a type of complementary food.

Conclusion:

Poor complementary feeding practices were observed in urban areas, and urgent health education and demonstration of weaning foods in the community play a major role in preventing diseases.