bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of antenatal group discussion on fear of childbirth among pregnant women in a Nigerian tertiary hospital
Authors: Eleke Chinemerem , Steve-Tamuno Ogochukwu Francisca , Agu Ifeyinwa S. , Ngbala-Okpabi Sabinah O. , Samuel Joy C.
Published: June 2023

Background: Antenatal group discussions (AGDs) are utilized in antenatal peer support. Its application in controlling fear of childbirth (FOC) has not been widely studied in Africa. We examined the effect of AGDs on FOC among pregnant women.
Methods: This experiment was done between in 2020 at a teaching hospital in Nigeria. We randomly assigned 218 consenting primigravid women into treatment (n = 111) and control groups (n = 107) and followed them from 31 to 38 weeks of gestation. The treatment group had one AGD session per week for 6 weeks, with each session lasting 120 minutes. The control group had no AGDs. The FOC Questionnaire was used for collecting data at 31 and 38 weeks of gestation. Inferential statistics were used for data analyses at a 5% significance level using SPSS 21.
Results: At 31 weeks of pregnancy, 80.2% and 72.9% of participants in the treatment and control groups had unhealthy FOC (range 5 - 9) with no significant difference between the groups (p = 0.204). At 38 weeks, FOC was significantly less in the treatment group compared to the control group (17.1% vs. 48.6%, p<0.001). The AGD reduced the likelihood of unhealthy FOC by 65.0% (RR: 0.35, 95%CI: 0.22 - 0.55).
Conclusions: Participation in AGDs reduced FOC among pregnant women, hence recommended. The current caesarean statistics may further reduce if pregnant women were encouraged to utilize AGDs.
Incidence of complications in breast reconstruction with autologous tissue in a third level hospital
Authors: Martínez-Martínez Grecia C. , Ramírez-Guerrero Rene , Moreno-Hernández Sergio G. , Hernández-Campos Alan M. , Mejía-Rivera Samaria E. , Torres-Piña Raymundo
Published: June 2023

Background: The objective of this study is to analyze the incidence of complications after breast reconstruction with pedicled or free flaps at the hospital general de Mexico "Dr. Eduardo Liceaga”.
Methods: A retrospective, single-center study, including 44 female patients, who underwent immediate or delayed breast reconstruction after breast cancer, between 2019 and 2020, and had at least a 2-year follow up, evaluating the association between patient risk factors (age, history of radiotherapy, presence of overweight or obesity and immediate or delayed reconstruction) with the presence of complications such as seroma, hematoma, wound infection or wound dehiscence. We analyzed data with SPSS software, v23.0.
Results: There was no statistically significant difference for the presence of complications associated with risk factors studied.
Conclusions: We need more prospective, multicenter studies, including larger sample and strict follow up of patients.
Epidemiological aspects of facial trauma in a third level hospital in Mexico
Authors: Mejía Rivera Samaria E. , Olivares Eduardo P. , Del Pino Paulina S. , Monroy Ricardo C. , Piña Raymundo T. , Martinez Grecia C. M. , Campos Alan M. H.
Published: June 2023

Background: Facial trauma is common in early adulthood and may require complex surgery and even high mortality.
Methods: Retrospective, cross-sectional study at the Hospital General de México during the period from January 2018 to December 2021. Patients with a diagnosis of fracture of the facial region, who had a complete clinical record, of any age, were included. Patients who did not comply with the treatment in the hospital unit, with incomplete clinical records, were excluded. Through non-probability sampling, a sample of 156 patients was formed. The descriptive data analysis was carried out by calculating frequencies and percentages for the qualitative variables. For the quantitative variables, measures of central tendency and dispersion were calculated according to the distribution of the variables (mean and standard deviation). for variables with normal distribution and median with interquartile range for variables with non-normal distribution).
Results: 156 patients were included, the male sex predominated (89.7%), the age group from 21 to 30 years (35.3%), the injury mechanism of aggression by a third party (54.5%). Facial fractures occurred in the following descending order: orbit (64.7%), zygoma (41.7% n=65), mandibular (23.1% n=36), nasal (22.4% n=35), maxilla (21.8% n=34), NOE (4.5% n=7), Le Fort (3.8% n=6), and palate (3.8% n=6). Within orbital fractures, the most frequently affected region was the orbital floor (42.3%). The patients with orbital fracture were mostly men (88.1% versus 11.9%). The highest frequency of these fractures was between the ages of 21 and 30 (38.6%). Surgical treatment of fractures in general was established in 44.9%, performing open reduction and internal fixation of fractures in 41.0%.
Conclusions: The most frequent facial fractures are: orbit, zygoma, and mandibular; they mainly affect the male sex in the second decade of life, they are produced mainly by aggressions to third parties. The management of facial fractures is predominantly surgical, through open reduction and internal fixation.
Correlation study of stress biomarkers, endocrinopathies, semen quality and quantity in infertile men in Abuja, Nigeria
Authors: Peter Abriba Simon , Humphrey B. Osadolor
Published: June 2023

Background: The quality and quantity of sperm cells in the male determines his fertility potentials. It has been reported that 40-45% cases of infertility is attributable to men, and that stress compromises fertility indices. Therefore, the study was done to assess the correlation between some stress biomarkers, male endocrinopathies, sperm quality, and quantity in infertile men.
Methods: This was a cross sectional case- control study. A total of 154 participants were recruited into the study, which consist of 100 males having the challenge of infertility as study group and 54 fertile male which serves as control group. Serum testosterone, LH, FSH, prolactin, salivary cortisol and amylase were analyzed using ELISA techniques; while the semen was examined after liquefaction according to WHO criteria.
Results: In the study group, higher values of stress biomarkers correlated with significantly decreased testosterone and FSH values (p=0.001), and increased prolactin, salivary cortisol amylase (p<0,001); semen quality and quantity correlate with stress biomarkers (p<0.001). There are both positive and negative correlation between the stress biomarkers, sex hormones, sperm quality and quantity.
Conclusions: Higher values of stress biomarkers in infertile male show both negative and positive correlation with abnormal sex hormones, decreased semen quality and quantity.
Evaluating the effect on tensile bond strength between commonly used acrylic denture base material lined with two variety of soft liners after using three varieties of denture cleansers-an in vitro study
Authors: Ambadkar Shraddha O. , Thombare Ram , Nipane Ronika , Warghane Komal Khond , Barabde Aparna , Thombare Bhagyashri , Wankhade Bhushan , Shirbhate Ashwini V.
Published: June 2023

Background: Long-term use of denture causes significant changes in its supporting structures and can lead to constant pain and discomfort. Soft lining material extensively used in field of prosthodontics to improve fit of conventional acrylic resin denture for restoring optimal health of abused oral tissue showing degenerative change.
Method: Specially designed metal mould used for fabrication of 80 acrylic resin blocks. Applying soft liner between 2 acrylic sample using metal mould and grouping these samples for immersion in solution of denture cleansers. These acrylic samples were then divided into 2 groups of 40 samples each for applying 2 variety of soft liner for each group (L1 and L2). Keeping specimen in solution of denture cleanser per day for 8 h keeping each specimen 3 times a day=equals to 3 days treatment. Thus, keeping the specimen for 30 days×3 exposure=amount to 90 days (3 months) exposure and then tensile bond strength measured using universal testing machine (Instron). ANOVA test is applied.
Results: Tensile bond strength of Viscogel soft liner with acrylic based is decreased with more Polident denture cleanser followed by Efferdent, Clinsodent and least affected by water which is statistically significant.
Conclusions: The clinician should choose denture cleanser by considering the microbiologic properties of cleansers and material aspects such as the compatibility of denture cleanser with soft liners.
High prevalence of alpha thalassemia in the tribal community of the western part of India! Reality or myth? Can simple hematology parameters; MCV and MCH act as screening tools at birth?
Authors: Dhanani Hiren J. , Patel Ramesh Z. , Vadodaria Jankita K. , Joshi Sanmukh R. , Vaghani Utsav P. , Dhanani Nandini H. , Tandel Palak D.
Published: June 2023

Background: The majority of adult tribal subjects in the western part of India, show microcytic hypochromic red cells, and borderline anemia with a normal iron profile, suggesting a high prevalence of thalassemia in this population.
Methods: The current study was designed to perform qualitative (to screen for Hb Bart’s) and quantitative (to estimate percentage of Hb Bart’s) hemoglobin electrophoresis with modification of the method, to evaluate the prevalence of α thalassemia and to determine gene frequency of α+ thal gene. Furthermore, the present study also aimed to evaluate common hematology parameters like MCV and MCH as screening tools to suspect α thalassemia at birth.
Results: Based on hemoglobin electrophoresis, the prevalence of α thalassemia in all its forms was found to be 66.66%. The estimated gene frequency for α+ thal was found to be 0.7453 and based on that, the extrapolated prevalence of α thalassemia was 93.52% (55.55% homozygous and 37.97% heterozygous). MCV<100 fl and MCH<31 pg were found to be reliable screening tools to predict α thalassemia at birth in full-term uncomplicated pregnancy.
Conclusions: Tribal community in the western part of India bears a very high prevalence of α thalassemia, it’s a reality and not a myth. Simple hematological parameters like MCV (<100 fl) and MCH (<31 pg) measured at birth can prove to be cost-effective surrogate markers for α thalassemia. Large scale study using confirmatory genetic analysis is required to validate the findings.
Comparison of preload versus coload by crystalloid in parturients undergoing caesarean section under spinal anaesthesia: an analytical study
Authors: Bairwa Pawan Kumar , Sharma Rajeev , Atal Dharmpal , Verma Mahendra Kumar
Published: June 2023

Background: Spinal anesthesia is popular, simple and well accepted reliable technique for below umbilicus surgery. It is frequently used for lower segment section because of its rapid onset, a dense neural block, avoidance of risk of airway, little risk of local anesthetic toxicity and minimal transfer of drug to the fetus, as well as little risk of failure of block. Objectives of this study was to compare incidence and severity of hypotension, dose requirement of mephentermine and maternal bradycardia, shivering, nausea, vomiting.
Methods: ASA grade I, II parturients posted for elective cesarean section were randomly allocated in two study groups of 55 each to receive either preload or co-load with Ringers lactate solution, blood pressure, heart rate, mephentermine requirement and other outcomes recorded at regular interval.
Results: Hypotension was observed significantly less in co-loading group (37.18%) than preloading group (61.81%). Mean vasopressor requirement was also significantly more in preload group. Heart rate change, nausea, vomiting and fetal outcome remained same across both the groups.
Conclusions: Co-loading with crystalloids is more effective strategy than preloading in prevention of spinal induced hypotension. We can save valuable time given for preloading in case of emergency caesarean sections.
A comparative study of dexmedetomidine and fentanyl as adjuvants to ropivacaine on analgesic efficacy in supraclavicular brachial plexus block
Authors: Debnath Malin , Singh Takhelmayum Hemjit , Singh Thokchom Rupendra , Kirha Nongosal , Das Mahasweta , Pious Pabin
Published: June 2023

Background: Various adjuvants have been added to improve the quality of the supraclavicular brachail plexus block and prolong postoperative analgesia. The aim of the present study was to compare the onset and duration of sensory and motor blockade provided by dexmedetomidine and fentanyl as adjuvants to ropivacaine in such block.
Methods: In this study 60 patients with American Society of Anesthesiologists grade I/II scheduled for elective upper limb surgeries were randomly allocated into two groups. Group A received 30 mL of 0.5% ropivacaine with 1 µg kg-1 dexmedetomidine, and group B received 30 mL of 0.5% ropivacaine with 1 µg kg-1 fentanyl for supraclavicular brachial block. The onset and duration of sensory and motor block and adverse events during the perioperative period were noted.
Results: The onset of sensory and motor blockade was 13.47±1.73 min and 22.87±2.27 min respectively in the dexmedetomidine group and 14.80±2.20 min and 24.33±2.63 min respectively in the fentanyl group which was statistically significant (P<0.05). The duration of the sensory blockade was significantly higher in the dexmedetomidine group as compared with fentanyl (826±58.29 vs 592±51.62 minutes, p< 0.0001).
Conclusions: Dexmedetomidine provides faster onset of sensory and motor block with longer duration of block as compared with fentanyl when used as an adjuvant with ropivacaine in supraclavicular brachial plexus block without any significant side effects.
Study of heart rate recovery in diabetic women to predict the risk of cardiovascular disease
Authors: Yadav Kritika D. , Gunjal Sambhaji
Published: June 2023

Background: Diabetes mellitus is characterized by rise in the level of glucose concentration. Diabetes increases the risk of heart attack by four times in women and two times in men. An attenuated HRR immediately after exercise is considered an index to identify silent autonomic dysfunction. Individuals with low values for HRV and HRR present a higher risk of cardiovascular outcome.
Methods: 50 diabetic participants with a mean age of 54.52 and SD±8.63 years. All the participants were assessed for heart rate and blood pressure before the assessment and after the 3-minute YMCA step test. Post test heart rate was assessed immediately after 1, 2 and 3 minutes. Heart rate recovery was calculated by subtracting heart rate immediately after 3 minutes of test to heart rate after 1 minute.
Results: 50 diabetic women with the mean age of 38.96 and SD±9.36, the age ranged from 20 to 50. The resting heart rate mean was 98.08 and standard deviation was ±9.82. Mean and SD of heart rate immediately after 3 minutes was 142.66 and SD was ±8.05 and after 1 min was 130.86 and ±7.84 respectively. The heart rate recovery mean was 11.8 and SD was ±4.25.
Conclusions: Study concluded heart rate recovery is delayed in diabetic women and it is associated with increased risk of cardiovascular disease.
Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio as markers of early sepsis and mortality in pediatric burns: a prospective evaluation
Authors: Aggarwal Nupur , Karki Durga , Gaind Rajni , Muthukumar Vamseedharan , Matlani Monika , Gupta Akshat , Karki Divyanjali
Published: June 2023

Background: Delay in the diagnosis of sepsis in pediatric burns results in advertently high mortality and morbidity. Our study aimed at evaluating the role of two upcoming biomarkers- neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR)- as predictors of early sepsis and mortality in this group of patients.
Methods: This was a prospective study conducted at a tertiary care burn centre of northern India over 18 months. 90 pediatric burn cases, aged 1-16 years, presenting within 24 hours of burns, with >10% body surface area of thermal burns/scalds were included in the study. Cell counts were measured on day 1, 3, 5 and 7 of burns. Patients were followed up till discharge, 30th post burn day or death, whichever was earlier.
Results: Sepsis was clinically present in 49 cases out of 90 (54.44%) with 30% median total body surface area (TBSA) of burns. Mortality was seen in 31cases out of 90 (34.44%) with 35% median TBSA burns. Higher PLR levels were seen in the sepsis group. NLR and PLR were also elevated in the survival group. Both parameters were found to be reliable markers of sepsis as well as mortality, particularly on days 5 and 7, in this cohort of patients.
Conclusions: Indices like NLR and PLR, which can easily be derived from complete blood count, have potential utility as determinants of both sepsis and mortality in children afflicted with thermal injuries.
Hollow viscus perforation with gas under diaphragm: a misnomer?
Authors: Dutta Pooja , Wadhawan Gaurav , Arora Raghav , Sharma Shruti
Published: June 2023

Background: Hollow viscus perforation is suspected when radiographs show the presence of gas under diaphragm and is usually an indication for surgical abdominal exploration. This is significant because in cases of hollow viscous perforation, plain radiography may be used as the first line of diagnosis. Concerns regarding diagnosing those 30% cases of hollow viscus perforation which was not detected by the plain radiography.
Methods: A bound prospective study of patients who were managed for perforated hollow abdominal viscus, when no abnormality was appreciated on radiographs, confirmation was done either on the basis of clinical examination, further investigations or by exploratory laparotomy performed on basis of selection of cases.
Results: Based on the study, 15 patients were found with no gas under diaphragm on radiographs and perforation was confirmed on the grounds of clinical, physical examination, further investigations or by exploratory laparotomy on basis of cases. The results obtained in the present study shows male predominance, duodenal perforation being the most common perforation amongst hollow viscus perforations and age group of 20-40 years were affected mainly.
Conclusions: It is important to note that not all the cases of pneumoperitoneum indicate perforated abdominal viscus or vice versa.  This study highlights the difficulty in pre-operative diagnosing pneumoperitoneum with upright chest and abdominal X-rays provided its sensitivity varied from 50-98%.
Patient satisfaction towards the quality of nursing care among the patients of private hospitals of Jodhpur, India
Authors: Parihar Raju Ram , Suthar Anju
Published: June 2023

Background: Patient satisfaction is a good indicator for measuring the quality of nursing care delivered by a nurse to a hospitalized patient. This will help the nursing administrator to identify ways of improving nursing and health care services. The study aims to assess the level of patient’s satisfaction towards quality of nursing care among the patients.
Methods: A descriptive survey study was carried on 100 patients selected using non-probability purposive sampling, who were discharged from the selected private hospitals at Jodhpur, Rajasthan. A Modified form of Dr. Laschinger’s “Patient Satisfaction with Nursing Care Quality Questionnaire” (PSNCQQ) was used to measure patient satisfaction. A written permission was obtained to conduct study from the authority and an informed consent was taken from each participant.
Results: The study findings indicate that majority (70%) of the sample were highly satisfied with nursing care with mean patient satisfaction score 61.38±9.692 (76.72%). Majority (66%) patients were satisfied with “Information given regarding investigations and treatments” and only (26%) were satisfied with “Coordination of care after discharge.” Patients aged 18-30 years, belonged to urban area, up to secondary educated and admitted through OPD were found more satisfied.
Conclusions: The study showed that majority of the participants were highly satisfied with quality of nursing care provided in private hospital. The PSNCQQ is a useful instrument for evaluating and improving nursing care. The nurse administrator can contribute to quality service provision by evaluating patient satisfaction to develop and improve nursing care based on patients' expectations.
Factors affecting death due to COVID-19: an analytical study from a tertiary care hospital of Assam
Authors: Mahanta Bipanchi , Saikia Deepjyoti , Doley Rana , Umbon Jawgam , Barua Purnima
Published: June 2023

Background: Globally, the Case Fatality Rate (CFR) due CoVID19 ranges from 0.1-4.7%. CoVID-19 death remained 0.5% till April 2021 in Assam as compared to India (1.3%). Though pre-existing diseases greatly contributes to CFR yet its association study from India is scarce. This study documents association of such death with comorbidities in a tertiary hospital of Assam.
Methods: Retrospective analysis of 234 COVID death from May 2020 to December 2020 in Jorhat Medical College (JMCH) were done. Demography, comorbidities at admission and blood parameters were analyzed in Epi-Info version7.2.4.0. Continuous variables were presented as mean±SD or median (interquartile ranges) and correlated with death.
Results: Out of 3781 confirmed cases admitted in JMCH, 234 died (72% male) with CFR of 0.06. Highest deaths occurred between 61 to 70 years. Median duration of disease was 4 days (IQR 2-8days). Acute respiratory distress or pneumonia was most common (53.1%) symptom followed by septicemia (24.6%) at admission. Diabetes mellitus (36.6%), hypertension (24.8%), diabetes with hypertension (11.4%) and chronic kidney diseases (22.4%) were common chronic comorbidities. About 64% cases had thrombocytopenia, and 66.9% had leukocytosis at admission. Many cases had coronary artery diseases, left ventricular failure, post-operative complications, post-partum complications, severe hemoptysis, severe anemia, metabolic encephalopathy, acute myocardial infarction, non-ketotic coma and acute gastroenteritis and SARS-COV2 infection.
Conclusions: CoVID19 associated mortality in Assam was low and mostly among elderly with chronic comorbidities. CKD was most significantly associated with mortality. Superimposed bacterial infection at admission contributed to many fatal outcomes in COVID19, thus warranting proper empirical antibiotic.
Clinical approach, diagnosis and medical management of acute pancreatitis among patients attending tertiary care hospital in Prakasam district, Andhra Pradesh, India
Authors: Konda Nikitha , Venkateswarlu D. , Rao B. Thirumala , Suresh V. , Ameena S. K. , Manasa D.
Published: June 2023

Background: There has been an increase in the incidence of acute pancreatitis reported globally and despite of improvements in access to care and interventional techniques, acute pancreatitis continues to be associated with significant morbidity and mortality. The present study was aimed to assess the clinical profile of acute pancreatitis and to assess the efficacy of various severity indices in view of   outcome of patients.
Methods: A hospital based prospective cross-sectional study was conducted from October 2022-March 2023 in Gastro and Liver care center in Ongole, Prakasam District, Andhra Pradesh India. All consecutive 72 patients with a diagnosis of acute pancreatitis were included in this study.
Results: Out of total acute Pancreatitis cases   61 (84.7%) were males and 11 (15.3%) were females and acute abdominal pain (97.2%) and decreased appetite (95.8%) were the most common presenting complaints, 54.2% cases were due to Alcoholism, followed by hyperlipidemia with 20.8% and Gall stones 13.9%.  All 72 (100%) received pancreatic supplements, 68 (94.4%) were given pain killers, and 65 (90.3%) were taken anti-ulcer agents. Twenty-three (31.9%) patients with 0 to 3 points as per CTSI Score and 4-6 range points were observed in 47 (65.3%) pancreatitis patients. Maximum (40.3%) were improved on 2nd day, 22 (30.6%) were on 3rd day.  Positive correlation noticed between Amylase and in diagnosing acute Pancreatitis, it is significant at 0.05 level.
Conclusions: Early assessment of the clinical severity and identification of patients at risk is important for early intensive management and timely intervention and to improve quality of life. So, it is mandatory to assess the clinical severity using different scoring systems. and appropriate treatment based on guidelines.
The first year of the COVID-19 pandemic in nursing homes: a meta-analysis study
Authors: Sungur Sevda , Metintaş Selma , Kılınç Ali , Oktar Didem , Önsüz Muhammed Fatih
Published: June 2023

Severe impact of COVID-19 on nursing homes and the morbidity and mortality rates in nursing home residents can be higher than in the community during a pandemic. This study aimed to meta-analyse the COVID-19 attack, fatality and mortality rates among nursing home residents and to meta-analyse the risk ratio values by comparing these rates with those of the countries in which the nursing homes are located. The data was obtained from COVID-19 attack, mortality, and fatality rates of nursing home residents. Additional meta-analysis was performed using risk ratio calculated by dividing the data obtained from nursing homes by the expected numbers calculated using case, death, and population data from COVID-19. A total of 6,758,241 COVID-19 patients from 8 different countries and 19 studies were included during the meta-analysis study period. In nursing home residents compared to the general population, the risk ratio (95%CI) for COVID-19 attack rate was 148.19 (99.45 to 220.82), the mortality rate was 341.16 (211.94 to 549.15), and the fatality rate was 2.36 (1.90 to 2.93) (each p<0.001). A meta-analysis of well-documented studies has shown that community morbidity and mortality rates can reach higher levels compared to community during a pandemic. Finding the exact causes can only be achieved after adjusting nursing home infection rates with regional rates. To ensure better community management of the COVID-19 pandemic and prevent future pandemics, preventive measures should be taken earlier.
Case series of gallstone ileus: only enterolitotomy, one stage or two stage surgery?
Authors: C. Velazquez Carlos A. , L. López José E. , J. Silva Jessica , M. Bufajer Juan M. , R. Espino Jesús E. , G. Méndez Omar
Published: June 2023

Biliary ileus is a rare disease and an infrequent cause of intestinal obstruction, occasionally occurs in frail elderly patients and has a certain predilection for the female sex. The diagnosis is complex and requires a high clinical suspicion and complementary examinations such as abdominal radiography and contrasted abdominal tomography. Treatment should be individualized according to the clinical characteristics of each patient, with the alternatives being resolution only by enterolithotomy, one stage surgery and two stage surgery. We report 3 cases of biliary ileus, each one managed with a different surgical procedure. The decision was aimed at resolving the intestinal obstruction by enterolithotomy, and the definitive management was performed according to the clinical characteristics of each patient; however, there is no consensus or algorithm that recommends the ideal surgical technique. The recommended surgical procedure for the resolution of biliary ileus will be discussed.
Mucinous neoplasia of appendix: imaging and its relevance to management
Authors: K. Lathiya Hardikkumar , Gupta Priya , Kamat Ritesh D. , Patankar Roy S.
Published: June 2023

Appendiceal mucocele is a rare pathology of the appendix that can present with non-specific symptoms. Therefore, imaging evaluation is essential for accurate diagnosis and proper management. To document importance of pre-operative imaging, we reviewed the scans, reports, and clinical data of nine patients with appendiceal mucocele who were treated at our institute. We also studied the literature on CT findings, histopathology, surgical management, prognosis, and recent guidelines for appendiceal mucocele. We suggest that pre-operative imaging can aid surgeons in selecting the most appropriate treatment plan for each patient, resulting in better outcomes. Certain critical imaging features, such as mural nodularity, irregular wall thickening, lymphadenopathy, cecal involvement, presence of free mucus, or pseudomyxoma peritonei, can alert surgeons to prepare for frozen section and an appropriate surgical approach. In conclusion, we recommend pre-operative imaging as a crucial tool for the diagnosis and management of appendiceal mucocele. Its use in identifying critical imaging features can help surgeons decide on the best surgical approach for each patient and ultimately lead to better outcomes.
Intestinal obstruction and cystic fibrosis: a case report
Authors: Aboulfeth El Mehdi , Abdellaoui Othmane Alaoui , Bouchentouf Sidi Mohamed , Bounaim Ahmed
Published: June 2023

Distal intestinal obstruction syndrome is one of the frequent digestive complications of cystic fibrosis; due to a more or less complete small bowel obstruction. Proximal intestinal obstruction syndrome is a rarer variant, but has been more often described since the improvement of the management of CF that has led to enhance CF patient survival. We described a 19-year-old male followed in the pediatrics department of the HMIMV for cystic fibrosis complicated by exocrine pancreatic insufficiency and type 1 diabetes, who presented an intestinal obstruction syndrome for two days, consisting on abdominal pain, bloating, bilious vomiting and cessation of stool and gas. Imaging has suspected a mechanical obstruction of the small bowel however no transitional zone could be identified. A conservative treatment was start and because of the inefficiency of this first approach, the decision was made to proceed with a laparotomy. Intra-operatively, a mid-jejunum point with inssipationed stool was noticed to be the transitional aera of the obstruction and conducted us to proceed for an entrotomy and digitaly empty the proximal bowell. PIOS is a more rare intestinal complication but should be considered when the ileo cecal clinical location is absent in an obstruction syndrome. Its treatment is based on laxatives however surgery should wisely be considered in front of failure of the conservative approach or critical condition.
A rare delayed presentation of giant vesical calculus: the largest vesical calculus to be reported in a female
Authors: Singh Anshuman , Gali Kasi Viswanath , Pai Vivek , Hegde Padmaraj
Published: June 2023

Vesical calculi are infrequent in females, and the occurrence of giant vesical calculus is even rarer. We report a case of giant vesical calculus in an elderly female which was undiagnosed and empirically treated for six years for recurrent urinary tract infection. On presentation, it was managed by open cystolithotomy. Upon surgical retrieval, the stone measured 11x7.5x7.4 cm in largest dimensions and weighed 672 gm, which to the best of our knowledge, is the largest vesical calculus to be reported in a female patient. This case highlights the need for adequate evaluation of every case of recurrent urinary tract infection with good imaging. Early diagnosis allows for the management of vesical calculi by minimally invasive endoscopic techniques. If missed, it leads to the formation of giant vesical calculi, which require treatment by a much more invasive open surgical approach.
Current understanding and management of clostridioides difficile infection: an overview
Authors: Paudel Rama
Published: June 2023

Clostridiodes difficile infection (CDI) is a major cause of healthcare-associated infections worldwide, with a significant morbidity and mortality. The incidence of this infection has been increasing in recent years, particularly among elderly patients and those with comorbidities. The pathogenesis of CDI involves the disruption of the gut microbiota, followed by the production of toxins that lead to colonic inflammation and tissue damage. The clinical presentation varies from mild diarrhea to severe pseudomembranous colitis, toxic megacolon, and sepsis. The diagnosis of CDI is based on the presence of clinical symptoms, laboratory testing, and imaging studies. The treatment of CDI involves antimicrobial therapy, supportive care, and infection control measures. Recently, there have been significant developments in the management of CDI, including the use of fidaxomicin, fecal microbiota transplantation (FMT), and monoclonal antibodies. This manuscript reviews the epidemiology, pathogenesis, clinical presentation, diagnosis and updated guidelines for the management of CDI.
Review on myths about infertility-an attempt to clear the air
Authors: Abishek A. , Jayendiran K. , Jose Cindy
Published: June 2023

Infertility, defined as the inability to conceive after one year of regular unprotected sex, affects 48 million couples and 186 million individuals globally. There are several myths without factual basis regarding infertility, with the increase in prevalence of infertility in the world, the spread of such myths also increases. Such myths include concepts like infertility is a woman’s problem, it is a psychological or stress induced issue, health and lifestyle habits do not affect infertility. While others include, misconceptions about medications and treatment, some supernatural beliefs, frequency of sexual contact, sexual practices which do not have any positive impact on infertile couples. These are few among many other stories revolving around fecundity. Myths about reproductive health and chances of conception may directly or indirectly affect the emotional state of infertile couples or may give a false hope for them to get conceive faster and easier, which have no evidence. Some of the myths might not be harmful, or even do some good, but many of the prevailing myths put infertile couples, especially infertile women in an excruciating position leading to a great deal of mental distress. It is thus important to root out the myths about infertility and help the affected ones lead a less stressful life. This article is an attempt to bust some of the most common myths being spread and explains the actual facts that should be known to people of the reproductive age group.
Impact of diet on attention-deficit hyperactivity disorder in a tertiary care hospital of Rawalpindi
Authors: Khan Tayyab Mumtaz , Akram Jehanzeb , Zamir Zarish , Rafay Abdul , Saher Sania , Khalid Rudabah , Munir Muhammad Arslan , Mehmood Atif , Tariq Rida , Khan Shahrukh
Published: June 2023

Background: Attention-deficit hyperactivity disorder (ADHD) is a prevalent neuropsychiatric disorder of children that affects almost all aspects of the life. The role of diet in the management of the ADHD is understudied in Pakistan.
This study aimed to assess the impact of different types of diet on the symptoms of ADHD among the children with ADHD.
Methods: This descriptive cross-sectional study was conducted among 58 children with ADHD in Rawalpindi. Ethical approval and informed consent were obtained. Patients’ recruitment was done via developed criteria and Convenient sampling technique. Descriptive statistics and one-way ANOVA were used to determine the difference of ADHD severity among various frequencies of different included foods via Conner Parent rating scale-revised short form. Data analysis was performed by SPSS version 25.0.
Results: The difference in hyperactivity index, impulsivity, and learning problems score on CPR-RS among various frequencies of carbohydrate, protein rich and fat foods, was statistically significant and with the increase intake of carbohydrate and protein rich foods, the score on CPR-RS of hyperactivity index, impulsivity, and learning problems also goes up. Whereas, with the increase intake of fat rich foods, the score of hyperactivity index, impulsivity, and learning problems goes down.
Conclusions: In short, the high intake of carbohydrate and protein rich foods, increase the severity of the symptoms of ADHD, while, high intake of fat rich foods decreases the severity of the symptoms of ADHD among children.
Impact of clinical practicals on the mental health status of university nursing students
Authors: Gaoses Stephanie L. , Amakali-Nauiseb Taimi , Ndafenongo Sesilia
Published: June 2023

Background: Mental health has been slightly neglected in all aspects of life. The aim of the study was to explore the impact of clinical practicals on the mental health status of 4th year nursing degree students at the University of Namibia main campus. The objective of the study was to explore the impact of clinical practicals on the mental status and describe the general attitude of 4th year nursing degree students at the University of Namibia main campus towards clinical practicals.
Methods: A cross-sectional, explanatory research study with a qualitative approach was employed. The participants were among 104, fourth year 2021 nursing degree students at the University of Namibia main campus. Virtual interviews were conducted via Microsoft teams until saturation point was reached, the thematic/grounded theory was used to establish themes from the context.
Results: Clinical practicals have an impact on the mental health status of fourth year nursing degree students at the University of Namibia main campus. The students experience slightly negative attitude towards clinical practicals due to immense requirements and limited time to complete them.
Conclusions: The School of Nursing and Public Health at the University of Namibia have to provide professional services to cater for the mental health status of students such as a counsellor, social worker, psychologist, conducive environment or management skills to help students to cope. In addition, this is thought to also improve the attitude of students towards clinical practicals, in producing- effective and efficient students.
Factors associated with mental health status among the students living in girls’ hostel of Baneshwor, Kathmandu
Authors: Bhatta Himani , Bhatt Ashish
Published: June 2023

Background: The purpose of this study was to identify factors associated with mental health status among students residing in girls' hostels in Baneshwor, Kathmandu.
Methods: From June 2022 to November 2022, a cross-sectional survey was carried out among 253 students residing in several girls’ hostels in the Baneshwor, Kathmandu. Face-to-face survey took place amongst them.
Results: The study found that 67.2% (n=253), 84.6% (n=253), and 69.2% (n=253) of individuals have (mild/moderate/severe/extremely severe) depression, anxiety, and stress, respectively. Factors such as self-blame were linked to feelings of depression, anxiety, and stress. Other characteristics such as roommate disturbance, abuse, lack of assistance from others, homesickness, and a safe and supportive environment were all linked to one or both depression, anxiety, and stress. Other characteristics, such as the death of a family member in the previous two years and meal satisfaction, were not linked to DAS.
Conclusions: Students in female hostels had greater levels of depression, anxiety, and stress. It is vital to assist and offer a necessary environment for female students living in hostels far from home in order to mitigate the severe toll that mental illness impose.
Public perception of hospital-based nursing care: a study of the Tamale Metropolis in Ghana
Authors: Agyei Kofi G. , Agambire Ramatu , Ansong Cecilia A. , Tano Priscilla F. , Mohammed Rumana Saeed , Azumah Fawzia , Yoobe Roger Z.
Published: June 2023

Background: A key contributor for the improvement of patients’ health outcomes and their holistic well-being after hospital stay is the quality of nursing care received in hospitals of which may also be influenced by the perceptions the public precisely patients have about nursing care. This study assessed the public perception of hospital-based nursing care in the Tamale metropolis.
Methods: The study was conducted at the Tamale Central Hospital in Ghana and employed a qualitative approach with an in-depth interview guide in collecting primary data from 30 participants. The interviews were transcribed and analysed using thematic analysis and the common themes identified were presented in line with the objectives of the study.
Results: With respect to the experiences the patients had, it was revealed that they had both negative and positive experiences. While the positive experiences were related to the quality of care, the negative experiences on the other hand were on the attitude of nurses. The study also revealed that nurses’ attitudes, mode of service delivery and professional ethics which include respect for patient and communication were the major factors that influence patients’ satisfaction.
Conclusions: The study revealed that the public have negative perception towards nursing care resulting from unmet expectations. Policies should be formulated to ensure effective communication, empathy, and respect which will help ensure patients satisfaction with healthcare delivery at the hospitals since these appear to be the best predictors of patients’ satisfaction.
Risk perceptions among high-risk pregnant women in an aspirational district of India: a qualitative study
Authors: Rinku Borah  , Roychoudhury Parimita , Yasmin Sabrina
Published: June 2023

Background: Attitude and behavior towards health seeking decisions are affected by one’s risk perceptions. This formed a key component in many health behavior-change theories and is responsible for reduction of perinatal mortality. A woman’s perception of risk affects her decisions about seeking obstetric care. This study explored the perceptions of high-risk pregnancy among women with high risk factors.
Methods: A qualitative study was conducted in an aspirational district of India. Participants included pregnant women in third trimester with high risk factors. In-depth interviews were conducted with 34 participants using semi-structured interview schedule.
Results: Three main themes emerged in this study: (i) knowledge of risk (ii) attitude towards risk (iii) adoption behavior. The study found out women’s lack of understanding on high-risk conditions during pregnancy, especially among younger age group. Majority denied the risk factor and normalized delivery on one’s faith.
Conclusions: The findings of this study provide a glimpse into how women perceived risk and the reasons that lead them to deny the risks. Women must understand their risk in the same way as their healthcare providers. If an event is not appraised as severe, there will be no change in behavioral intentions inspite of all the efforts put by the government for reducing perinatal mortality.
Correlating the altered bowel habits among young medical doctors when exposed to rural posting in the course of their training in India
Authors: Gohri Jay , Hegde Saurish , K. S. Sahana , Doddaiah Sunil Kumar
Published: June 2023

Background: Altered bowel habits, is a commonly encountered presentation, especially among training professionals. During training, young doctors move to rural areas, experience the stress factors in food and environment causing the altered bowel habits. Hence correlating altered bowel habits among young medical doctors when exposed to relative culture barriers was the main aim of the study.
Methods: It was a cross sectional study among interns and postgraduates from all over the country for a duration of 2 months from January 2023 to March 2023 for 150 participants. A self-administered questionnaire with socio- demographic variables and a standard PAC-SYM was used for the scoring of altered bowel habits. Data entered into Excel and analysed using SPSS software. Descriptive statistics were taken and Kruskal Wallis test was done for statistical significance.
Results: 60% of the students belong to 20-24 age group. 55% of participants were female. 48.7% of mothers were homemakers and 46.6% were professionals. 90% of students were exposed to rural areas and 32% of them stayed there for more than 2 months. Gender, duration of stay, frequency of food consumption and bathroom comfort were statistically significant with the symptoms of altered bowel habits.
Conclusions: From the above study, we have tried to prove poor water supply, poor hygiene, and multiple people sharing the toilet are significant stressor factors for the medical trainee during their stay in rural health centres across the country.
Knowledge, attitude and practices regarding immunization among parents with children in the age group 12 to 24 months
Authors: Jayaraj Jaippreetha , Ganesan Swathi , Geminiganesan Sangeetha
Published: June 2023

Background: Immunization is one of the most indispensable community-based health interventions with unquestionable ability to improve a nation’s health status. In spite of evidences about the effectiveness of vaccines, millions of children around the world are lagging behind exposing them and their community to a risk of epidemics. Despite efforts taken to improve vaccination coverage, India has only succeeded in achieving 65% coverage in childhood immunization. We aim to determine parental knowledge, attitudes and practices regarding childhood immunization.
Methods: It is a questionnaire-based observational study involving 95 parents with children aged 12 to 24 months, conducted in a tertiary care hospital in Tamil Nadu.
Results: Ninety children have been completely immunized according to age. Nearly 60% children did not receive vaccinations according to prescribed schedule. More than half parents believed that vaccines are efficient in preventing diseases, which was statistically associated with education of parents. Although there is a good immunization coverage in our locality, 17.89% parents still doubt the safety of vaccines and one-fifth of respondents had misapprehensions that vaccines may cause long-term consequences in children.
Conclusions: We found that multiple factors play a role in determining the immunization status of the population, including sociodemographic characteristics, level of knowledge and attitudes towards immunization. Therefore, improving knowledge, attitudes and practices regarding immunization among parents is one of the key initiatives towards building a disease-free nation.
Mortality statistics in a tertiary care teaching hospital in Bagalkot, Karnataka in the year 2022
Authors: Shankar Gowri , Sidenur Bhagyalaxmi , Kalburgi Eshwar B.
Published: June 2023

Background: Mortality statistics is important for epidemiological purposes to find any unusual rise in deaths for investigation of the causes so as to take public health action at an early stage. Cause of death statistics from hospitals are routinely amalgamated along with mortality statistics from other sources to constitute essential statistics on the health of a population. This study was done to understand the mortality pattern in a tertiary care teaching hospital and to undertake preventive action as much as possible.
Methods: A retrospective hospital based study was done with all the medical records of patients who died in Hangal Sri Kumareshwar hospital and medical research centre in the year 2022, attached to S. N. Medical College, Bagalkot, Karnataka. After IRB, the medical records were analyzed to study the pattern of disease causing deaths which were classified under ICD 10th revision. Age, sex, month of admission, place of residence and underlying cause of death was used for analysis using chi square test and percentages.
Results: Out of 501 deaths, 316 (63.07%) were male and 185 (36.93%) were female. Majority of the deaths 152 (30.34%) occurred between the ages of 41 to 60 years. Non communicable diseases contributed to 71.05% of deaths and communicable diseases to 28.95% of deaths.
Conclusions: Continuation of the maternal and child health program and effective implementation of the National health programs to overcome non communicable diseases can reduce avoidable premature mortality in the population.