bluuebunny/crossref_metadata_2025 huggingface dataset:
How healthy is the health budget of Amrit Kaal: 2023-24?
Authors: Majhi Madan M. , Mishra Anshita , Garg Suneela , Kumar Raman
Published: February 2024

ABSTRACT

Political will is the key to public health policy-making and a major driving force for the attainment of Universal Health Coverage (UHC) in any nation. To achieve UHC, the Indian government laid down National Health Policy in 1983 and updated it in 2002 and recently in 2017. This recent policy emphasized increasing healthcare spending and economic growth. In the current budget, there is an increment in the share of GDP of 0.34% from the previous year’s allocation, but still staggering for the envisaged 2.5% to achieve UHC. Enthusiastic announcements of opening 157 new nursing colleges, a separate programme for eliminating sickle cell anemia by 2047, and Centers of excellence establishment for pharma companies for promoting research and development and focusing on Particularly Vulnerable Tribal Groups (PVTGs) are the few overarching and new highlights in the current budget. But, in a country so huge and varied in terms of its needs in every sector, the announcements in the financial budget speech taking India forward in becoming a “shining star” is a matter of debate. This is an attempt to review the budget for this financial year in the healthcare sector and what it means: is the country willing to build a self-driven healthcare sector in the Amrit Kaal with strong public finances and a robust financial sector through “efforts by all”?
Cervical cancer awareness, knowledge, behavioural patterns, and practice of screening and vaccination in females of hilly regions of North India – A hospital-based observational study
Authors: Yadav Pooja , Gaurav Amrita , Ravi Anoosha K. , Khoiwal Kavita , Bahadur Anupama , Bora Lihiri , Yerkade Vasundhara , Chaturvedi Jaya
Published: February 2024

ABSTRACT

Aim:

The mainstay of cervical cancer elimination and control is an effective screening and education program. The present study was conducted to assess awareness about cervical cancer, knowledge of cervical cancer symptoms, risk factors, screening and vaccination, attitude towards various aspects of cervical cancer, and screening and vaccination practices amongst women of Uttarakhand.

Method:

The present study was a prospective observational study. A total of 215 patients were recruited from Gynecology OPD, AIIMS, Rishikesh, from January to December 2021, and 195 women meeting the eligibility criterion were finally analyzed based on the KAP questionnaire interview method.

Results:

The study population had 40% illiterate participants. Of all participants, 87% were aware of cervical cancer as a disease entity, only 0.5% had good knowledge, and 99.5% had poor knowledge of symptoms, risk factors, screening, and vaccination for cervical cancer. 87% showed a favourable attitude. Only 1 out of 195 participants was ever screened previously, and none of them were vaccinated.

Conclusion:

The main hindrance in the context of hilly or challenging-to-serve areas is mainly the education and information services. The resource allocation to difficult health-inaccessible areas is required to bring a major change in practices for prevention of cervical cancer; this can be dramatically improved by population-based screening and vaccination programs at affordable prices.
Living will: Todays thoughts and actions
Authors: Kale Bhairavi , Jaiswal Priyanka , Masurkar Deepika
Published: February 2024

ABSTRACT

Introduction:

The word “Euthanasia” relates to two different words from the Greek language “Eu which indicates good and Thanatosis which indicates death”, suggesting a “satisfactory Death” or “easy and painless Death” The phrase “mercy killing” has become associated with this meaning. It comprises inflicting painless death on a person suffering from an incurable and dreadful illness. It’s the practice of terminating a person’s life by administering a lethal injection or ceasing medical treatment. Informed and shared decision-making between the patient and the health professional caring for him or her is crucial for the quality of care and its outcomes. Living wills are nothing more than a tangible representation of this truth. As a result of their legal approval, patients’ autonomy has been recognized. However, there are some differences in the regulations that have been adopted, and the health practice linked with these documents raises a number of practical and ethical questions that should be considered.

Materials and Methods:

PUBMED and COCHRANE databases were searched, with no language constraints, up to July 2021. Trial registration studies, hand searching, and bibliographic references of pertinent literature were also checked. Individual authors were responsible for data collection and analysis. The studies were evaluated independently by three review authors.

Conclusion:

A thorough assessment of the current accessible literature on living will be conducted, just to focus on the knowledge of euthanasia in detail. Most importantly, the social impact of the concept of euthanasia needs to be understood by the society. Moreover, it must be considered that euthanasia is different from suicide. Few communities may show the interference of their religion with euthanasia. So it is essential to enlighten the idea of euthanasia in legal ways for different countries.
Caregiving burden and associated factors among family caregivers of individuals with schizophrenia in Bangladesh: A cross-sectional study
Authors: Tabassum Tahsin T. , Rahman Nur-A-Safrina , Hossain S. M. Shakhawat , Abdullah Faisal , Nawar Lubaba Tasneem , Lima Fahmida I. , Gupta Mridul , Kona Suraiya P. , Podder Vivek
Published: February 2024

ABSTRACT

Introduction:

Schizophrenia is a severe mental disorder affecting millions worldwide. Family caregivers play a vital role in patient treatment and recovery, but their responsibilities can be physically and emotionally exhausting. There is limited research on caregiver burden in Bangladesh, prompting this study to identify factors associated with the burden among caregivers of schizophrenic patients.

Methods:

This cross-sectional study collected data from 175 caregivers from January to December 2020 in Dhaka, Bangladesh. A semi-structured questionnaire and a validated Bangla version of the Zarit Burden Interview (ZBI) scale were used to assess the burden of primary caregivers and associated factors in caring for patients with schizophrenia.

Results:

Participants’ mean age was 34.02 ± 10.45 years, with 26.9% in the 34-41 age group. 49.1% were housewives, with most earning 5000 to 15000 taka monthly. Spouses accounted for 28.6% of caregivers. Most patients had an illness duration of less than five years (66.3%). Mean ZBI score was 49.49 ± 12.06, indicating moderate to severe burden. Factors significantly associated with caregiver burden included age, gender, occupation, income, marital status, house condition, relationship with patients, illness stage, and duration.

Conclusion:

This study highlights the burden experienced by caregivers of schizophrenic patients in Bangladesh and identifies factors associated with the burden. It recommends community interventions and psychosocial provisions to address this issue and inform targeted interventions to reduce caregiver burden. These findings provide insights for a comprehensive plan to manage such cases in the future.
Efficacy of a levothyroxine dosage regimen based on serum thyrotropin level, for primary hypothyroidism. An open label dose finding study
Authors: Nair Abilash , Chellamma Jayakumari , Gopi Anjana , Sujatha Chintha , Sarayu Soumya , Jabbar P. K.
Published: February 2024

ABSTRACT

Background:

There are no guidelines on individualized initial levothyroxine dosage in primary hypothyroidism. This prospective observational study was done to assess whether a predetermined dose of levothyroxine based on Thyroid Stimulating Hormone (TSH) levels would be able to make the patient euthyroid during a period of six weeks and to find other factors which influence the levothyroxine requirement.

Materials and Methods:

Newly diagnosed patients with primary hypothyroidism or those patients who were not on levothyroxine therapy were divided into TSH-based groups—Group 1, 5–9.99, Group 2, 10–29.99, Group 3, 30–99.99 and Group 4, >100 μIU/ml and treated with an initial levothyroxine dose of 25,50,75 and100 μg/day for next six weeks. Factors correlating with levothyroxine requirement were determined.

Results:

Of the 171 patients who were included 142 completed the study, 34,46,28 and 34 patients were included in groups 1 to 4, respectively. Normalization of TSH with the above criteria was achieved in 111 (78.7%) out of 141 patients, and 91%, 67%, 75%, and 82% respectively in the 4 groups. Among adequately replaced patients pre-treatment TSH level (r = 0.81), T4 level (r = 0.61), and body weight (r = 0.19) correlated with the levothyroxine requirement. Based on these factors predicted initial dose (μg/day) was found to be 0.54 (Body Weight [Kg]) +0.47 (TSH [μIU/m]) - 1.4 (Total T4 [μg/dl]) +17.79 or 0.27 (Body Weight) +0.553 (TSH) +21.

Conclusion:

Serum thyrotropin-based categorization for initial levothyroxine dose leads to euthyroidism in nearly four of five patients with primary hypothyroidism. The dose required for adequate replacement of levothyroxine has correlation with pre-treatment serum TSH levels serum thyroxine levels and body weight.
Lichen planus triggered by COVID-19 vaccination: A case series
Authors: Narasimhan Murali , Ramakrishnan Ramachandran , Varri Divya Sree , Sivasubramanian Muthubharathi
Published: February 2024

ABSTRACT

Lichen planus, an autoimmune inflammatory condition, has been linked to medications, vaccinations, and infections. Several clinical studies have shown that majority of vaccines trigger a Th1 response, which raises the blood levels of IL-2, TNF & IFN, and may be linked to the development of lichen planus. It has recently been documented to happen with mRNA-based COVID-19 vaccinations, especially the Pfizer/BioNTech vaccine. We present a case series of lichen planus that appeared after receiving the COVISHIELD vaccine from Oxford-AstraZeneca. In order to rule out any further potential triggers, like recent infections, prior drug use, smoking, dental treatments, etc., a thorough history was collected in each instance. Skin biopsies were used to confirm each case’s diagnosis. In nearly all of the cases, skin biopsies revealed typical dermatopathological features of lichen planus.
Perception of self and it’s effect on anxiety and depression among adolescent girls
Authors: Singh Shambhavee , Singh Shivendra K. , Kar Sujita K. , Manar Manish K. , Gupta Abhishek
Published: February 2024

ABSTRACT

Introduction:

Perception of self is a primary source for fostering negative influences in an adolescent’s life. This stage may increase the risk for various psychiatric disorders.

Objectives:

To assess the grade of anxiety and depression and to study their relationship with various factors of perception of self, among adolescent girls.

Materials and Methods:

School-going adolescent girls from two government schools at Lucknow were selected using a two-stage random sampling technique. A total of 200 participants were personally interviewed for their socio-demographic details, perception of self, and screened for symptoms of anxiety and depression.

Results:

Of the 200 school-going adolescent girls who participated in the study, 63.5% screened positive for the symptoms of anxiety and 73.0% for symptoms of depression. A total of 11.5% and 3.5% school-going adolescent girls had severe anxiety and major depression; severe severity, respectively. Both anxiety and depression among school-going adolescent girls were significantly associated with factors like possessing qualities that they are ashamed of (P = 0.005 and 0.011), body image dissatisfaction (P = 0.004 and 0.017), and getting suicidal thoughts in times of difficulties (P < 0.001).

Conclusion:

A fair number of adolescent girls had severe anxiety and major depression of severe severity. Therefore, adolescents must be screened for mental disorders from time to time and those at high risk must be identified.
Dermoscopy aids in lesion selection for microbiological and histopathological assessment of mycetoma
Authors: Al Jarallah AlQahtani AbdulElah , Alshahrani Mohammed Saad , Alfadni Salaheldin Ahmed , Nassar Mostafa , Shah Sayed Agha , Nassar Ahmed Helmy
Published: February 2024

ABSTRACT

Mycetoma, a chronic granulomatous infection of the skin and the subcutaneous tissue, is characterized by discharge of exudate containing grains. This report illustrates the importance of dermoscopy in selecting lesions for both microbiological and histopathological assessment, which are considered the gold standard of diagnosis in mycetoma.
Augmenting the spirit of research among nursing personnel: A narrative review
Authors: Rani Manisha , Podder Lily , Bhardwaj Geeta
Published: February 2024

ABSTRACT

Background:

In health-related technology, the professionalism paradigm has shifted from a traditional-based approach to evidence-based nursing practice (EBP). For nurses, EBP as a systematic approach to problem solving is well supported and is based on translating the best current research findings into a decision made on patient care or nursing intervention.

Objective:

To review the strategies to develop the research capacity among nurses.

Design:

A keyword search was used to locate relevant articles. Bibliographic data were retrieved from PubMed, Google Scholar, Scopus, CINAHL, and Medline. A total of 100 articles were retrieved, and 27 were included in the article.

Results:

Major challenges affecting the development of research skills have been identified including lack of time for research, high teaching loads, and need to balance this work with administrative and clinical responsibilities, Lack of funding, shortage of skilled personnel, and absence of research infrastructure. Some of the skills identified in the literature for augmenting research capacity, i.e., infrastructure development, promotion of research cultures and environments, and facilitation of training.

Conclusion:

However, more empirical studies are needed to understand the process of implementing and evaluating capacity building in nursing, clinical as well as academic. Capacity building is globally important because it can improve the quality of nursing education, the caliber of nurses, and the standard of care that patients receive.
Risk factors and etiology of early-onset neonatal sepsis in Northeastern part of India: Case–control study
Authors: Kumar Sudesh , Bhattacharya Piyali , Kaur Simranjit , Ray Prajna , Chattopadhyay Nandita
Published: February 2024

ABSTRACT

Background:

Sepsis, the second most common cause of neonatal mortality, causes more than one million deaths annually. India has the highest incidence of clinical sepsis (17000/100000 live birth).

Objective:

This study aimed to determine the risk factors and organisms of early-onset neonatal sepsis (EONS) in a tertiary care hospital in Northeast India.

Materials and Methods:

It was a case–control study conducted in the neonatal unit of MGM Medical College, Kishanganj, Bihar, from January 2022 to April 2023. All neonates admitted to the neonatal intensive care unit (NICU) within 72 hours of life constituted the study population. Neonates diagnosed as EONS by clinical and laboratory parameters were considered as cases and those not diagnosed for EONS as controls. Maternal and newborn information and laboratory parameters were collected and analyzed. For risk factor identification, the bivariate logistic regression was used.

Result:

An equal number of cases (78) and control (78) were enrolled in the study. Maternal age >30 years (adjusted odds ratio [aOR] = 3.017, confidence interval [CI]: 1.238 to 7.352; P < 0.015), maternal urinary tract infection (UTI) in the third trimester (aOR = 5.435, CI: 2.647 to 11.158; P < 0.0001), and premature rupture of membranes (PROM) (aOR = 2.918, CI: 4.61 to 33.73, P < 0.004) were significant predictors of EONS. Pseudomonas (41.02%), Klebsiella (16.66%), and coagulase-negative Staphylococcus aureus (20.51%) were commonly isolated organisms, which were highly resistant to cephalosporin, meropenem, aminoglycosides, and quinolones.

Conclusion:

Proper and adequate antenatal screening for diagnosis and treatment of maternal infection and high-risk pregnancies for perinatal management of newborn is recommended to prevent neonatal sepsis-related morbidity and mortality. Rational use of antibiotics may minimize the hazard of antibiotic resistance.
Acceptability and effect of ShishuPoshan mHealth application on knowledge, attitudes and practice of breastfeeding among primi mothers availing postnatal care at a rural tertiary hospital
Authors: Jaiswal Shashwat , Baviskar Mandar Padmakar , Potdar Priyanka Prakash , Kamble Motiram , Pundkar Rutuja , Muneshwar Sujata , Deshpande Ajit , Bangal Vidyadhar , Phalke Deepak B.
Published: February 2024

ABSTRACT

Introduction:

ShishuPoshan is a free Android application for mothers that provides scientific guidance on breastfeeding and baby care issues in the local language. We aimed to assess its effect and acceptability in primi mothers in a rural area of Maharashtra, India.

Material and Methods:

A before and after study was conducted in 50 primi mothers to study the acceptability and effect of ShishuPoshan mHealth application on knowledge, attitude and practice about breastfeeding in primi mothers in a rural tertiary care hospital.

Results:

Most participants (84%) downloaded the application, and 60% used it regularly. Major reason for not using the app was discomfort with mobile phone (7%) and not having anyone to read the content in the house (7%). The application was easy to use by 48%, and 10% did not find time to use it. Enablers were regional language, easy-to-understand content, simple interface, and frequently asked question (FAQ) format to give information. Barriers to adoption were that women preferred tips from family members, were uncomfortable with mobile phones, and did not have anyone to help them use them.

Conclusion:

It successfully delivered key messages like exclusive breastfeeding, colostrum use, proper maternal nutrition, and demand to feed, but it needs to further emphasise early initiation of feeding. Incorporation of feedback like adding videos, myth busters, and making app more interactive may further improve its effectiveness. mHealth interventions like ShishuPoshan are promising modalities for the dissemination of appropriate information.
Level of physical activity among adolescents in Ernakulam District, Kerala: A cross-sectional study
Authors: George Leyanna S. , Jacob Arun , Mohandas K. Sreelakshmi , Ali Hyfa M. , Mathew Minu M.
Published: February 2024

ABSTRACT

Introduction:

For children aged 5–17 years, WHO recommends moderate-to-vigorous intensity physical activity for at least 60 minutes daily which would account for 420 minutes of physical activity per week regardless of working days or holidays. With the increasing prevalence of non-communicable diseases in Kerala, this study aimed to assess the level of physical activity among high school students in Ernakulam District, Kerala.

Materials and Methods:

A school-based cross-sectional study was conducted among ninth and tenth standard students of two randomly selected schools in Ernakulam District. A total of 303 children were recruited for the study. Consent rate and response rate of the study were 100%. A structured questionnaire adapted from MRC-CPAQ (Children’s Physical Activity Questionnaire) was used to collect the data.

Results:

The study revealed that out of 303 students, 72.9% were < 15 years, 77% were males, and 59% were urban residents. More than 70% of the participants were actively involved in physical activity of moderate-to-vigorous intensity. Males, in the age group of 15 years and above, having a separate play area, and those with no siblings were found to have significantly higher levels of physical activity.

Conclusion:

The study was able to identify a positive trend for physical activity among adolescents. Town planning and building of play areas are essential to develop and retain the habit of physical activity among adolescents.
The Autonomous Post Graduate Medical Education Board (PGMEB) of National Medical Commission (NMC): Minimum Standard of Requirements for Postgraduate Courses-2023 (PGMSR-2023) - Impact on Family Medicine/ Family Physician Vocational Training for Indian Medical Graduates
Authors: Kumar Raman
Published: February 2024

ABSTRACT

The National Medical Commission (NMC) of India has issued new guideline for post graduate medical courses in India on 15th January 2024. These Guidelines may be called the “Minimum Standard of Requirements for Postgraduate Courses-2023 (PGMSR-2023)”. These guidelines will come into force with immediate effect. Unfortunately, Family Medicine specialty has been entirely excluded from this document, despite clear mandate in the National Medical Commission Act 2019. Previously, the Undergraduate Medical Education Board of NMC did not include the Family Medicine as a mandatory department for training at MBBC Course. In the absence of a specific policy on medical education, a careful planning is required for number of post graduate residency positions across India depending upon population coverage and morbidity patterns. So, far during past three decades the increase in the number of post graduate residency posts/ seats have been random. There has been no clear-cut policy by the government or by the regulator itself. There appears to be no mapping for specialty need across geographical territories and population density in the background of the morbidity pattern. Under section 24(1)(c) of the National Medical Commission Act 2019 The Under-Graduate Medical Education Board shall perform the following functions, namely: — (c) develop competency-based dynamic curriculum for addressing the needs of primary health services, community medicine and family medicine to ensure healthcare in such areas, in accordance with the provisions of the regulations made under this Act; Under section 25. (1)(j) National Medical Commission Act 2019 The Post-Graduate Medical Education Board shall perform the following functions, namely: — (j) promote and facilitate postgraduate courses in family medicine. Under section 57. (1) The Commission may, after previous publication, by notification, make regulations consistent with this Act and the rules made thereunder to carry out the provisions of this Act. (2), and without prejudice to the generality of the preceding power, (p) the curriculum for primary medicine, community medicine, and family medicine under clause (c) of sub-section (1) of section 24. It is to be noted that Family Medicine is a community-based clinical discipline, all parameters for the graduate Family Medicine department, training, and faculty eligibility have been kept as per other hospitalist disciplines. It is the mandate of the Post Graduate Board of NMC to promote the PG program in Family Medicine. Suggestions articulated in this paper may be worthy of consideration of the esteemed members of National Medical Commission.
A Case Series on Psychoimmunological Exploration of Psychogenic Purpura – An Enigmatic Psychosomatic Condition
Authors: Ray Anindya Kumar , Mitra Saikat , Bose Debdas
Published: February 2024

Psychogenic purpura is a rare but interesting psychosomatic condition where there are transient dermatohematological manifestations in response to antecedent psychological disturbances most commonly depression, whose pathophysiology is still an enigma. The objective of this case series is finding out the missing link between antecedent psychological disturbances and resultant purpura through psychoimmunologic exploration. In all four cases, patients were female, aged between third–fifth decade with depression being the common diagnosis, where transient painful bruising appeared only during antecedent stressful conditions. Immune-cytokine work-up in all the patients showed type 1/type 2 cytokine shift during bruises. With psychiatric treatment, there was not only improvement in depression and bruises, cytokine alterations were also normalized. Rise in pro-inflammatory cytokines with type 1/type 2 shift during stresses may cause these bruises by increasing the vascular permeability.
Study of Attitude toward Psychotropic Medications among the Undergraduate Medical Students
Authors: Patel Vishal Kanaiyalal , Patel Falguni Babubhai , Kumar Parveen , Mehta Hemil , Tiwari Deepak Sachidanand
Published: February 2024

Background:

Misconceptions about psychotropic medicines would compromise the treatment of medical students with psychiatric illnesses.

Aims:

This study aims to estimate attitude of medical students toward psychotropic medicines.

Materials and Methods:

This was a cross-sectional and observational study carried out among the undergraduate medical students over the period of 5 months. Participants were informed before interactive session for the maximum attendance. Self-report attitude toward psychotropic medications questionnaire was used to measure the attitude of medical students toward psychotropic medicines. Descriptive statistics, Mann–Whitney U-test, and Pearson correlation test were used to find the variables association with the attitude toward psychotropic medications questionnaire.

Results:

A total of 500 participants completed the pro forma. The mean age of the participant was 20.34 ± 1.12. Out of them, 39.2% were male and 60.8% were female. Although many medical students believed psychotropic medicines would be a better treatment option and positive attitude toward taking prescribed dose of medication, they were ambivalent toward efficacy and tolerability of medications. Being male, from rural domicile, and living in a joint family significantly reported a negative attitude toward psychotropic medicines.

Conclusions:

Medical students significantly reported ambivalent attitude toward efficacy and tolerability of psychotropic medicines. Workshop on myths related to psychiatric illness and psychotropic medicines should be organized to correct their negative belief.
Models of Consultation-Liaison Psychiatry: A Scoping Review
Authors: Grover Sandeep , Naskar Chandrima
Published: February 2024

Consultation-liaison psychiatry (CLP) is a subspecialty of clinical psychiatry that includes clinical, teaching, and research activities of psychiatrists and allied mental health professionals in the nonpsychiatric divisions of a general hospital. The development of C-L psychiatry began slowly in the early 20th century (1900–1930s), when psychiatric treatment started moving from mental hospital setting to a general hospital setting. Since then, it has evolved significantly as a subspecialty, and, over the years, various models and approaches towards consultation and liaison with other departments have been proposed by different authors. In this scoping review, we attempt to understand the path of evolution of CLP, the various models that have been proposed over the years, and the available evidence for their efficacy and utility. Though many studies have been done regarding the various approaches towards CLP, much more robust, longitudinal research focussed on the impact of the various models of service and their interconnections need to be undertaken.
Psychiatric Presentation of Subacute Sclerosing Panencephalitis in Pregnancy: A Rare Case Report
Authors: Sawant Neena S. , Rathod Anuradha , Kokkalki Rohini , Pawar Neil
Published: February 2024

Subacute sclerosing panencephalitis (SSPE) is a rare disease seen more frequently in children although cases of adult onset have also been described. There are very few cases of SSPE in pregnancy and most have been diagnosed on autopsy. It is a debilitating condition usually resulting in death within 1–3 years. Due to its etiology and presenting features which occur 6–8 years after measles infection, SSPE often gets misdiagnosed or remains undiagnosed. We describe a case of SSPE in pregnancy who presented with psychiatric manifestations 7 days postpartum, and was treated as a case of postpartum psychosis. Her presenting neurological symptoms of confusion, ocular symptoms, and rigidity were masked by the behavioral component due to which the diagnosis of SSPE was a distant thought.
To Study the Correlation Between Perceived Stress, Insomnia Severity Index, and Cognitive Function Levels of Elderly Diabetic Individuals Attending the Diabetic Clinic of a Tertiary Care Hospital
Authors: Banerjee Sumitaksha , Chaudhuri Arunima
Published: February 2024

Background:

The link between perceived stress, insomnia, and dementia in diabetic patients can provide new insights into understanding the causes of dementia and developing more effective treatment strategies.

Objectives:

To estimate the Insomnia Severity Index (ISI) scores, Perceived Stress Scale (PSS) scores, and cognitive function levels by Revising Hasegawa’s Dementia Scale (HDS-R) and Mini-Mental State Examination (MMSE) Scale and to correlate and compare them with patients of normal cognition and mild cognitive impairment (MCI).

Methodology:

The cross-sectional study was conducted after taking institutional ethical clearance and informed consent from 150 participants. The diabetic elderly patients attending the diabetic clinic were interviewed and MMSE, ISI, PSS, and HDS-R scores were evaluated.

Results:

Elderly diabetic patients with MCI had higher levels of stress and insomnia compared to those with normal cognitive function. The PSS and ISI scores for the MCI group were 22.4 ± 6.99 and 14.43 ± 5.29, respectively, whereas the scores for the normal group were 17.1 ± 4.54 and 9.05 ± 4.16. Both PSS and ISI scores were found to be negatively correlated to HDS-R scores. Increases in age, blood pressure, blood sugar levels, and Hb1c levels were found to be significant factors for the development of dementia.

Conclusion:

Elderly diabetic patients with MCI had higher levels of stress scores and ISI as compared to those with normal cognitive functions. Stress scores and insomnia severity scores were negatively correlated with cognitive function.
Functional Outcome of Intra-articular Distal Radius Fractures Treated with Volar Variable Angled Locking Compression Plate at a Tertiary Care Center
Authors: Lal Jaya Vaishnavi , Krishnan Rinju , George Akhshay John , Krishnamurthy Sunil Laxmipura , Pilar Anoop , Amaravathi Rajkumar S.
Published: February 2024

Context:

Distal radius fractures (DRFs) are the most prevalent fractures involving the upper extremity, accounting for nearly 18% of all fractures treated by orthopedic surgeons. Although numerous treatments have been established for the management of DRF, the “gold standard” treatment for intra-articular DRF is still debated.

Aims:

This study aimed to assess the functional and radiological outcome of intra-articular DRF treated with volar variable angled locking compression plate (LCP) at a tertiary care center with a follow-up of 2 years.

Settings and Design:

This was a retrospective observational study.

Subjects and Methods:

Thirty patients with intra-articular DRF who underwent volar variable angled LCP stabilization were included in the study and followed up for 2 years after surgery. Three-column classification was used to classify the included individuals. Disabilities of the Arm, Shoulder and Hand (QuickDASH), the Modified Mayo Wrist Score (MMWS), and the Visual Analog Scale (VAS) were utilized to assess the functional outcome. The follow-up radiographs were analyzed using the Batra anatomical score.

Statistical Analysis Used:

IBM SPSS (Version 20.0, Armonk, NY: IBM Corp, USA) was used for statistical analysis.

Results:

Thirty patients with a mean age of 44 years (34–59 years) were included in the study. Eighteen individuals had all three columns affected and 12 had two-columnar intra-articular DRF. At 2-year follow-up, the median QuickDASH Score was 2.3, MMWS was 85, VAS was 1, and the median Batra score was 90. Handgrip of the operated limb was comparable to the uninjured limb.

Conclusions:

Volar variable angled LCPs restore the articular architecture allowing for an excellent range of motion, good grip strength, and early functional mobility with minimal complications. Hence, LCPs appear to be superior to existing treatment techniques for DRF.
A Case Series of Repair Using a Cost-effective Suture Anchor for Upper Limb Surgeries
Authors: Kamath B. N. Jagannath , Nayak U. Keerthan Ranga. , Kamath Ramachandra K. , Thaleppady Megha , Rajasekaran Pranav , Singh Aayush
Published: February 2024

Objective:

The purpose of this study is to focus on various cases which were operated using an affordable suture anchor for soft-tissue bone repairs of upper limb surgeries in our series of patients.

Study Design:

Case series; Level of evidence, 4.

Materials and Methods:

Eighteen patients with minimum 1-year follow-up after various upper limb surgeries using modified suture anchor were assessed both clinically and radiographically. The Visual Analog Scale (VAS) was used to assess the intensity of pain. We used the disabilities of arm, shoulder, and hand (DASH) to assess the functional outcome.

Results:

VAS score improved from 5.39 ± 1.85 at 1-month postoperative period to 0.45 ± 0.51 at 12 months (P < 0.05). DASH score improved from 47 ± 18.99 at 1-month postoperative period to 8.89 ± 4.98 at 12 months (P < 0.05). There was no incidence of breakage of suture material or loosening of the implant seen during the insertion. There were no complications related to the implant noted.

Conclusion:

Clinical failures did not occur in this group of 18 patients undergoing repair using modified suture anchor. Following soft tissue-to-bone fixation, patients showed excellent short-term clinical and radiographic outcomes. This innovative method is quick, simple, inexpensive, repeatable, and saves time by transforming a basic screw and suture material into an effective suture anchor.
Fracture Dislocation in the Cervical Spine – A Case Series Analysis of 32 Cases and Review of Literature
Authors: Pillai Suresh S. , Arjun K. , Raj Amal , Joseph Nikhil Tom
Published: February 2024

Complex cervical spine injuries result from road traffic accidents, fall from height, diving in the swimming pool, fall along with the ladder etc. This is a major cause of disability, morbidity and mortality and dependence. Most of these injuries are preventable by proper care, social reforms, teaching civic sense to students at an early age, adoption of safety measures while climbing heights, enforcement of traffic rules, building up of infrastructure, educating the people and mandatory emergency room service for the offenders. Fracture dislocations of the cervical spine mostly flexion distraction injuries. Dislocations can range from perched facets, unilateral facet dislocations to bilateral facet dislocations and spondyloptosis. These result in varying degrees of neurological deficit. The recovery of these patients depend on the initial magnitude of the injury, the safe transport of the victim to the trauma centre, careful management of the injuries and rehabilitation. Here a case series of 32 patients with varying degrees of fracture dislocations of the cervical spine are analyzed retrospectively.
Zinc Enhancement through Supplementation and Dietary Implementation – Does It Affect Oxidative Stress and Antioxidant Status in Chronic Kidney Disease Patients?
Authors: Sahni Nancy , Rathi Manish
Published: February 2024

Background:

Chronic kidney disease (CKD) patients might be zinc deficient due to compromised nutritional intake and dietary protein restrictions; protein foods being rich in zinc. Zinc deficiency might cause increased oxidative stress and consequently reduced antioxidant parameters. Tailored dietary counseling along with zinc supplementation may play a major role in affecting the zinc and antioxidant status of patients.

Aim:

The aim of this study was to investigate the effect of zinc supplementation and dietary counseling on oxidative stress and antioxidant parameters in CKD patients.

Materials and Methods:

185 subjects were enrolled for the study (145 were predialysis patients [Group-1 (Stage-3 CKD) and Group-2 [Stage-4 CKD]) on the basis of Kidney Disease Outcomes Quality Initiative CKD stages from 1 to 5; and 40 apparently healthy controls. Zinc supplementation alone (Intervention 1) was given to 50 CKD patients (30 Group-1 and 20 Group-2). Diet counseling (Intervention 2) consisted of 45 patients (25 Group-1; 20 Group-2). 50 patients (30 Group-1 and 20 Group-2) received both zinc supplementations along with diet counseling (Intervention 3). Dietary zinc status, oxidative stress and antioxidants were accessed for all subjects.

Results:

Intervention-1 and 3 groups exhibited highly significant improvement in antioxidant status and lowering of oxidative stress.

Conclusion:

Improving zinc status through dietary counseling and supplementation may help in combating enhanced oxidative stress by improving antioxidant parameters in renal failure patients.
Dietary Management in Patients with Liver Cirrhosis and Renal Failure
Authors: Sinha Archana , Prasad Narayan
Published: February 2024

Cirrhosis patients are prone to develop kidney dysfunction. Hepatorenal failure (HRS) is one of the most severe complications of cirrhosis. Majority of cirrhosis patients have higher nutritional requirements owing to hyper catabolic state. The macronutrient intake is tailored to suit liver failure in cirrhosis patients with renal failure while regarding fluid and minerals like sodium; potassium etc weightage is given for the renal failure. Energy intake of 30 kcal/kg/day and protein intake of 1.2 g/kg/day for maintenance of nutritional status and 35 kcal/kg/day and 1.5 g/kg/day protein for improvement of nutritional status is recommended. Dietary protein of at least 1.0-1.2g/kg/day may be sufficient to prevent negative nitrogen balance. Multiple meals and snacks containing food rich in carbohydrates should be given to reduce the risk of hypoglycemia, Late evening snacks and a breakfast containing some proteins to shorten the period of fasting is recommended. Medium chain triglycerides should be used in case of fat malabsorbtion. In cirrhotic patients with ascites the recommended intake of sodium is nearly 80 mmol day or 2 g of sodium. Hyperkalemia may occur in HRS (or AKI) and patients using potassium sparing diuretics Hypokalemia has to be avoided as it can precipitate HE Micronutrients and vitamins need to administer for treating confirmed or clinically suspected deficiency Appropriate, adequate and timely nutritional management with individualized and intensive dietary counselling is the key component to prevent malnutrition.
Controlling Oxidative Stress and Inflammation in Chronic Kidney Disease: The Role of Nutritional Interventions
Authors: Anandh Urmila , Saxena Anita
Published: February 2024

Multiple factors impact kidney health. Underlying comorbidities (diabetes and hypertension), medications, genetic predisposition, autoimmunity, and environmental insults all play an important role. The vulnerability of the kidneys is to some extent because of the large proportion of blood it receives. It is the recipient of multiple deleterious substances with very few defense mechanisms. Over the years, low-grade subclinical inflammation and oxidative stress have been shown to play an important role in the progression of chronic kidney disease (CKD). Kidneys unfortunately have very few anti-oxidative defense mechanisms. Furthermore, there is a complex interplay of multiple factors resulting in persistent inflammation in patients with CKD. Both oxidative stress and inflammation worsen as the glomerular filtration rate declines. Researchers involved in this area have tried many medications, probiotics, and dietary interventions to mitigate both oxidative stress and inflammation in patients with CKD with little success. There has been considerable research in this area, and this review summarizes the interventions available to clinicians taking care of these vulnerable patients.
Evaluation of Proteolytic Enzyme on Hemodialysis Patients with Protein–Energy Wasting and Associated Variables
Authors: Joseph K. Merina Elizabeth , Anandhi D. , Abraham Georgi , Shankar Bhuvneshwari , Rajagopal A.
Published: February 2024

Introduction:

Protein–energy wasting (PEW) is very commonly seen among hemodialysis (HD) patients. This study was carried out to estimate the nutrition status of HD patients receiving aminase tablets, a proteolytic enzyme with a high-protein diet, for reducing PEW.

Methods and Materials:

The outpatients who visited the HD unit were nutritionally assessed using the Subjective Global Assessment (SGA). Malnourished patients were selected for the study. Diet advice was given on a high-protein diet as per the standard renal guidelines. They were nutritionally assessed pre- and postsupplementation at 0–6 months gap using SGA, malnutrition-inflammation score (MIS), bioelectrical impedance analysis, hand grip dynamometer, C-reactive protein (CRP), serum albumin, and total iron-binding capacity. Patients were given proteolytic enzyme 2 capsules daily after food (morning and night) for 6 months and high-protein diet.

Results:

A significant improvement (P < 0.05) was seen in the intracellular water, body cell mass, skeletal muscle mass, and protein mass. An improvement in the mean hand grip strength and mean reduction of CRP, SGA, and MIS scores were observed.

Conclusion:

Proteolytic enzyme along with a high-protein diet could be recommended for better clinical outcomes in dialysis patients.
Speckle Noise Removal from Biomedical MRI Images and Classification by Multi-Support Vector Machine
Authors: Hemalatha B , Karthik B , Krishna Reddy C V
Published: February 2024

INTRODUCTION: Image Processing (IP) methods play a vital role in medical images for diagnosing and predicting illness, as well as monitoring the patient's progress. The IP methods are utilized in many applications for example in the field of medicine.
OBJECTIVES: The images that are obtained by the MRI magnetic Resonance imaging and x rays are analyzed with the help of image processing.
METHODS: This application is very costly to the patient. Because of the several non-idealities in the image process, medical images are frequently tainted by impulsive, multiplicative, and addictive noise.
RESULTS: By replacing some of the original image's pixels with new ones that have luminance values which are less than the allowed dynamic luminance range, noise frequently affects medical images.
CONCLUSION: In this research work, the Speckle type noises are eliminated with the help of Mean Filter (MF) and classify the images using Multi-SVM classifier.  The entire system developed using python programming.
Triple clasp formulas for $G_{2}$
Authors: Bodish Elijah , Wu Haihan
Published: February 2024

We use Kuperberg’s diagrammatic description of homomorphisms between fundamental representations of

G_{2}

to give explicit recursive formulas for the idempotent projecting to the highest weight irreducible summand in each tensor product of fundamental representations.
On the interpolation of the spaces $W^{l,1}( \mathbb{R}^{d})$ and $W^{r,\infty }( \mathbb{R}^{d})$
Authors: Curcă Eduard
Published: February 2024

We study some properties of spaces obtained by interpolation of the Sobolev spaces

W^{k,1}(\mathbb{R}^{d})

and

W^{l,\infty}(\mathbb{R}^{d})

, where

l

and

r

are nonnegative integers, and

{d\geq 2}

. We are concerned with the standard real and complex methods of interpolation. In the case of the real method, an old result of De Vore and Scherer (1979) gives that

(W^{l,1}(\mathbb{R}^{d}),W^{l,\infty }(\mathbb{R}^{d}))_{\theta,p_{\theta}}= W^{l,p_{\theta}}(\mathbb{R}^{d}),

where

\theta\in (0,1)

and

1/p_{\theta}=1-\theta

. We complement this result by considering the case

l\neq r

. We prove that, when

l\neq r

,

(W^{l,1}(\mathbb{R}^{d}),W^{r,\infty }(\mathbb{R}^{d}))_{\theta,q}=B_{q}^{\sigma ,q}(\mathbb{R}^{d}), \tag{$\star$}

where

\sigma :=( 1-\theta ) l+\theta r

and

1/q= 1-\theta

, if and only if

l-r\in \mathbb{R}\setminus [1,d]

. Also, we prove a similar fact when

W^{l,1}

is replaced in

(\star)

by a space

W^{s,p}

where

s\neq r

is a real number and

p\in (1,\infty)

. Several other problems like the boundedness of the Riesz transforms on interpolation spaces are also considered. In the case of the complex method, it was proved by M. Milman (1983) that, for any

1<p<\infty

,

(W^{l,1}(\mathbb{R}^{d}),W^{l,p }(\mathbb{R}^{d}))_{\theta}=W^{l,p_{\theta}}(\mathbb{R}^{d}), \tag{$\star\star$}

where

1/p_{\theta}=(1-\theta)+\theta/p

. We show by simple arguments that

(\star\star)

fails when

p=\infty

and

l\geq 1

, answering a question of P. W. Jones (1984). As an immediate consequence of these arguments, we show that certain closed subspaces of

(C(\mathbb{T}^{d}))^{N}

(with

N\in \mathbb{N}^{*}

) that are described by Fourier multipliers are not complemented in

(C(\mathbb{T}^{d}))^{N}

.
Survey of Medical Applications of Federated Learning
Authors: Choi Geunho , Cha Won Chul , Lee Se Uk , Shin Soo-Yong
Published: February 2024

Objectives: Medical artificial intelligence (AI) has recently attracted considerable attention. However, training medical AI models is challenging due to privacy-protection regulations. Among the proposed solutions, federated learning (FL) stands out. FL involves transmitting only model parameters without sharing the original data, making it particularly suitable for the medical field, where data privacy is paramount. This study reviews the application of FL in the medical domain.Methods: We conducted a literature search using the keywords "federated learning" in combination with "medical," "healthcare," or "clinical" on Google Scholar and PubMed. After reviewing titles and abstracts, 58 papers were selected for analysis. These FL studies were categorized based on the types of data used, the target disease, the use of open datasets, the local model of FL, and the neural network model. We also examined issues related to heterogeneity and security.Results: In the investigated FL studies, the most commonly used data type was image data, and the most studied target diseases were cancer and COVID-19. The majority of studies utilized open datasets. Furthermore, 72% of the FL articles addressed heterogeneity issues, while 50% discussed security concerns.Conclusions: FL in the medical domain appears to be in its early stages, with most research using open data and focusing on specific data types and diseases for performance verification purposes. Nonetheless, medical FL research is anticipated to be increasingly applied and to become a vital component of multi-institutional research.