bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluating the metformin use on type 2 diabetes prevention in high-risk populations in primary care
Authors: Álvarez-Villalobos Neri A. , Ramírez-Torres Andony I. , Ruiz-Hernández Fernando G. , Omaña Gabriela G. Elizondo , García-Hernández Rosa M. , Peña Pablo J. Moreno , Rojo-Garza Sandra S.
Published: November 2024

ABSTRACT

Purpose/Background:

To identify the proportion of patients with prediabetes who have prescribed metformin and factors related to doing so as a preventive measure for diabetes in primary care at a Family Medicine Unit in northeastern Mexico.

Methods:

This retrospective observational study included 372 adults who met the criteria for prediabetes diagnosis according to the American Diabetes Association. Data was collected from medical records from January 2020 to December 2021. Possible associations between the variables of interest and the prescription of metformin were tested via hypothesis tests, furthermore, binary logistic regression was performed.

Results:

Nearly 85% of the patients met at least one criterion for receiving metformin according to ADA recommendations, but only 60% of them were prescribed this medication. Patients with metformin prescriptions differed from those without in aspects such as having a documented diagnosis of prediabetes in their medical records, a higher BMI, and higher glucose levels.

Conclusions:

Almost one out of two patients with a high risk of type 2 diabetes are not treated with metformin as a preventive measure. Factors associated with metformin prescription included a high BMI, elevated baseline glucose levels, and a prediabetes diagnosis in the medical record. These findings suggest the need for studies to evaluate physicians’ reasons for different treatments and implementation of recommendations for type 2 diabetes prevention in patients with prediabetes in primary health care.
Endobronchial actinomycosis with broncholithiasis presenting with hemoptysis—A case report
Authors: Mathew Aleena Mariam , Baburao Archana , Kanabur Thirthashree , Babu Ajay
Published: November 2024

ABSTRACT

Pulmonary actinomycosis is a rare chronic pulmonary infection caused by actinomyces. Pulmonary involvement is uncommon and often leads to a misdiagnosis of pulmonary tuberculosis or lung cancer. Endobronchial involvement is very rare, and broncholithiasis has occasionally been reported in association with pulmonary actinomycosis. Herein, we report a case of a 50-year-old male patient, who presented with a history of cough and hemoptysis diagnosed to be endobronchial actinomycosis with broncholithiasis by transbronchial biopsy.
Dealing with dichotomies in health care: Case reports
Authors: Nayar Kesavan Rajasekharan , Suresh Divya , Mithunrosh Nayana
Published: November 2024

ABSTRACT

Dichotomies with respect to medical orientations and public health have been common in the past and even in the present probably orchestrated by the traditional versus modern medical concepts that became eternal arena for disquiet in the healing world of many countries. In public health, the so-called technology tradition was especially dominant which assumed the power of technology and the paternalistic ‘managerial mode’ regarding disease control programs. Such a ‘managerial perversion’ has demolished the positivity of primary health care as well as the social determinants framework. It is important to consider cultural background, the belief systems and perceptions of the people in shaping the health behaviour of the people. We are presenting here two case reports on distinct scenarios in order to show the conceptual problems with respect to the notion of dichotomies and the linkages with health. These are based on our empirical explorations using qualitative methodologies. The first case is on non-communicable diseases in a tribal society in Kerala and the second one on utilization of Traditional Complementary and Alternative Medicine (TCAM) among palliative cancer patients from a district in Kerala. It is seen that as new problems emerge or when people struggle with diseases as presented in the two case reports, they tend to depend on the positivity of the deeply entrenched cultural artefacts in combination with modern systems and they tend to bridge the dichotomies rationally instead of viewing them retrograde. It is necessary to examine the reasons for engaging in such syncretic health behaviour which could be popular realizations on the positive and negative features of both health orientations. This approach of the people could be used effectively for managing such health problems in the community.
Pustular and crusted lesions in systemic lupus erythematosus: A case report
Authors: Reddy Allam P. , Ramakrishnan Ramachandran , Narasimhan Murali
Published: November 2024

ABSTRACT

Systemic lupus erythematosus (SLE) is the prototype of an autoimmune disease with various manifestations in the skin and several other organs. Subacute cutaneous lupus erythematosus may present with annular and psoriasiform lesions. There have been case reports of pustular lesions in SLE. Herein, we describe a known case of SLE, who developed pustular and crusted lesions which complicated the course of the disease. We considered Acute Generalised Exanthematous Pustulosis, Subcorneal Pustular Dermatosis, Pustular Psoriasis, Pustular Vasculitis, and Pustular Folliculitis as our initial differential diagnosis. A potassium hydroxide mount from crusted lesions showed scabies mites. With these findings, a diagnosis of SLE complicated with crusted scabies was made. She was managed with multiple systemic immunosuppressant and antiscabetic measures following which clinical improvement was seen with remission of her lesions.
Using 5 alpha reductase inhibitors safely: What primary care physicians need to know
Authors: Meenrajan Senthil R.
Published: November 2024

ABSTRACT

5 Alpha Reductase Inhibitor (ARI) is a widely used class of medication; for benign prostatic hypertrophy, androgenetic alopecia and hirsutism. While generally considered safe, ARIs class of medication does have a number of side effects, which can sometimes persist long after discontinuation of the medication. Since this class of medication is generally thought of as being benign, it can be overlooked as a potential cause of new clinical symptoms patients might experience. The purpose of this review is to alert primary care physicians to the more common side effects, so as to always keep adverse drug reaction related to 5ARI as a cause of new symptoms, when evaluating patients, young and old.
The effects of the paramedics’ field work on their mental status in Jeddah
Authors: Alsulami Maher , Al Nufaiei Ziyad F. , Alruwaili Hanan Saleh , Almukhlifi Yasir , Allaf Abdulaziz Abdullah , Alruwaili Abdullah , Algrene Uzaud Ayidh , Alruwaili Huda S. , Alqahtani Osama Saad , Alhassan Abdulaziz Ibrahim , Alanazy Ahmed Ramdan M. , Alsulami Adnan
Published: November 2024

ABSTRACT

Background:

Paramedics are continuously exposed to stressful events, making them liable to mental disorders. This study assesses the health of paramedics in Jeddah, focusing on their mental, emotional, and physical well-being.

Methods:

This cross-sectional study included fieldwork paramedics in Jeddah through an online survey distributed on social media. With a response rate of 86.09%, 192 complete responses were analyzed. Outcomes included mental health, mood and somatic effect, self-esteem, and sleep.

Results:

Most participants were males (83.85%), married (50%), non-heavy smokers (51.04%), and non-alcohol drinkers (51.04%). A significant number reported health-related work or daily life difficulties, with 62.5%–67.18% attributing these to physical and emotional issues, respectively. Over half rated their mental health as poor or somewhat poor, impacting their relationships significantly. Additionally, 70.31% frequently felt anger, and many faced limitations in physical activities. About 14.58% had a prior mental illness diagnosis, with nearly a quarter on medication, and 61.98% had recently sought psychiatric help. Sleep deprivation affected 61.98%, with 38.53% reporting poor sleep quality.

Conclusions:

The findings highlight the negative impact on paramedics’ mental health, showing a substantial diagnosis rate of mental disorders, activity limitations, negative mood, and relationship issues. Despite significant sleep problems, a positive aspect is their proactive psychiatric help-seeking behavior.
Assessment of egg quality, food safety, and hygiene practices among commercial and non-commercial farms of Barwala district of Panchkula, Haryana
Authors: Srivastava Rachana , Halder Pritam , Khanna Poonam , Kushwaha Savitesh
Published: November 2024

ABSTRACT

Background:

The aim of the present study was to assess the egg quality, food safety, and hygiene practices in egg production among commercial and non-commercial farms.

Methods:

A total of six, each commercial and non-commercial farm, were randomly selected form Barwala district, Panchkula, Haryana, for this study in 2019. A detailed interview on hygiene practices of farm workers was conducted. Egg samples were procured for external (N = 60) and internal (N = 24) egg quality determination. The swap samples (N = 24) were also analysed for bacterial contamination. Descriptive statistics were used for reporting the results, and Chi-square test was conducted for determining significant differences between commercial and non-commercial farms.

Results:

The egg yolk percentage (34.49%) and egg shell percentage (12.76) were higher among non-commercial farms. However, no significant external (P = 0.890) or internal (P = 0.367) egg quality difference was found between commercial and non-commercial farms. The biosecurity and disinfection management, daily waste disposal practice, fly and rodent control practice, farm activity record, and flock health monitoring were relatively better among commercial farms. There were no significant differences found in any of these assessments. The colony forming units (cfu) for salmonella and coliform were acceptable in three and four procured samples from commercial farms, respectively, whereas none were within acceptable levels among non-commercial farms.

Conclusion:

The internal egg quality, food safety, and hygiene practices were relatively better among commercial farms as compared to non-commercial farms. This requires further validation through a large sample-sized study.
Which antidiabetic drugs do patients of T2DM prefer in India and why? A discrete choice experiment
Authors: Vaidya Shrutangi , Atal Shubham , Joshi Rajnish
Published: November 2024

ABSTRACT

Background:

Uncontrolled diabetes persists despite guideline-based treatment, partly attributed to inadequate patient involvement. This research addresses shared decision-making by eliciting patient preferences in Type 2 Diabetes Mellitus (T2DM) treatment based on certain key attributes and explores their correlation with socio-demographic-clinical profiles.

Methods:

A discrete choice experiment (DCE) was conducted among T2DM outpatients in an Indian tertiary care center. A choice card was developed using the contextual choice framework, having six second-line antidiabetic drugs (ADs) from different classes incorporating seven attributes. Face-to-face interviews were conducted with patients, and elicited preferences were analyzed using descriptive statistics, Chi-square analysis, and multinomial logistic regression.

Results:

Out of the 87 evaluated participant choices, the most preferred drug was Glimepiride (51.7%), followed by Dapagliflozin (22.9%) and Teneligliptin (17.2%). Overall, the most important attributes were the effect on weight (29%), followed by route of administration (24%), and additional benefits offered by the drug (18%). Significant associations were found between participants’ drug preferences and their age (P = 0.002), socioeconomic status (P = 0.04), occupation (P = 0.004), and monthly income (P = 0.03). Age was not a significant predictor of drug choice for any of the drugs. Multinomial logistic regression showed that the overall model was statistically significant (P = 0.025), and it correctly predicted drug choice for 58.6% of the participants.

Conclusion:

Glimepiride was the most preferred option overall while the effect on weight was the most important attribute for patients in determining their preference. The study highlighted the importance of shared decisions and can guide practitioners in considering patient preferences when prescribing antidiabetic drugs.
An umbrella review of meta-analysis to understand the effect of coffee consumption and the relationship between stroke, cardiovascular heart disease, and dementia among its global users
Authors: Gill Harmeet , Patel Neel , Naik Nishthaben , Vala Lovekumar , Rana Rishabh K. , Jain Sakshi , Sirekulam Vaishnavi , Jain Shika M. , Khan Tanzina , Kinthada Sudharani , Patel Rashi B. , Nanjundappa Athmananda , Siripuram Chandu , Patel Urvish
Published: November 2024

ABSTRACT

Coffee has long been popular worldwide. The rise in lifestyle-related diseases such as cardiovascular disease, diabetes, stroke, dementia, and others has motivated coffee usage and illness prevalence studies. Some studies show coffee consumers are at risk for such diseases, whereas others show its active components protect them. Policymakers and the public need a comprehensive umbrella review to make healthy choices and enjoy coffee. Coffee consumption and stroke, CHD, and dementia outcomes have been distinguished using the PICO search strategy in PubMed with a filter for meta-analysis. We included 10 years of investigations until October 2023. MeSH terms “coffee intake,” “stroke, dementia,” and “transient ischemic attack,” comparing stroke risk with coffee consumption were used. The study excluded case reports and non-human, non-English observational research. The stroke risk of coffee was examined using RevMan software. Coffee consumption’s stroke risk ratio (RR), 95% CI, and I2 were estimated. Forest plots with P values ≤ 0.05 are significant. The umbrella review includes 11 meta-analyses from 457052 papers, totalling 11.96 million individuals. Drinking up to 4 cups of coffee daily reduced stroke risk by 12% compared with not drinking any coffee (0.88 (CI of 0.84-0.92, I2 of 13%, P < 0.00001)). Coffee drinkers had a 1.19 risk ratio for cardiovascular diseases compared to non-coffee drinkers (CI: 0.99–1.38, I2 = 84%, P < 0.00001). The dementia risk ratio for caffeine users was 0.90 (95% CI: 0.82-0.97, I2 = 46%, P < 0.00001) compared with non-consumers. Our analysis covering 5.42 million individuals found that 4 cups of coffee consumed a day reduced stroke risk by 12%. Coffee may reduce ischemic and haemorrhagic strokes by preserving endothelium and antioxidants. Coffee may lessen dementia risk, according to our study’s 0.94 pooled risk ratio after sensitivity analysis. Heavy coffee drinkers had a greater CHD risk, as per our findings. Heavy coffee drinkers were more at risk.
Bell’s palsy characteristics, clinical manifestations, complications, and prognosis in a primary care setting, a single center study: A retrospective cohort study
Authors: Alamodi Mohammed , Joueidi Faisal , Sayed Ahmed Gamal , Alsarari Abdulrahman , Alaswad Hani , Alhamdan Wejdan , Alendijani Yaser , Almufrij Sarah , Alkhenizan Abdullah
Published: November 2024

ABSTRACT

Background:

Bell’s palsy (BP) is a cranial nerve disorder in which unilateral or bilateral paralysis of the facial nerve occurs. The study aims to study BP’s characteristics, including its clinical manifestations, prognosis, and complications among adult patients aged 18 years and above.

Methods:

A retrospective study of adult patients diagnosed with BP in a primary care setting] [January 2015 to December 2022].

Results:

The study included a total number of 92 patients with an incidence rate of 23 cases per 100,000 people. The mean age was 43.52 years. The most common symptoms reported were dropping of the mouth at 38.9%, loss of forehead muscle movement at 24.4%, loss of nasolabial fold at 22.2%, loss of facial expressions at 20%, and headache at 18.9%. Immunodeficiency affected 2.3% of the patients. The management of patients involved the use of steroids in 76.1% and the use of antiretroviral medications in 48.9%. Physiotherapy was used in 29.5%. The complete recovery rate during the first year was 90.8%. The rate of complete recovery within two years was 96.9%.

Conclusion:

The incidence of BP in the region seems to be similar to the incidence rate reported elsewhere in the world. The use of antiviral therapy seems to be high despite the controversy around the use of antivirals in the management of BP. The majority of patients with BP recover within the first year.
Biochemical profile of term neonates with perinatal asphyxia and their correlation with severity of asphyxia
Authors: Bhoye Sachin V. , Bhongale Neha D. , Thorat Rohit M. , Wade Poonam A.
Published: November 2024

ABSTRACT

Background:

Birth asphyxia is a major cause of neonatal mortality and neurological morbidity. This study was aimed to determine biochemical (sodium, potassium, and calcium) abnormalities and their correlation across different severities of perinatal asphyxia in term neonates.

Methods:

This observational analytical study was conducted in term neonates with perinatal asphyxia admitted at the neonatal intensive care unit of a tertiary care centre for a period of 18 months. Blood collection was done at baseline, 24 hours, and 48 hours of treatment to evaluate electrolyte abnormalities. The abnormality in serum electrolytes was correlated across different stages of hypoxic ischaemic encephalopathy (HIE) as per severity and at different time intervals.

Results:

A total of 74 neonates were included in the study and classified into HIE stage 1 (n = 37), stage 2 (n = 18), and stage 3 (n = 19). At baseline, hyponatremia, hyperkalaemia, and hypocalaemia were observed in 36.5% (n = 27), 20.3% (n = 15), and 10.8% (n = 8), respectively. The difference between mean serum sodium (p: 0.007), potassium (P: 0.004), and calcium levels (p: 0.001) at baseline in stage 1 and stage 3 was statistically significant. The degree of hyponatremia and hyperkalaemia was more and statistically significant as per increasing severity of HIE. All the deaths (n = 6.8.1%) belonged to stage 3 of HIE.

Conclusion:

The degree of hyponatremia, hypocalaemia, and hyperkalaemia in the asphyxiated newborns correlated with the severity of birth asphyxia. The mortality rate was greater in asphyxiated neonates with severe HIE and electrolyte abnormality. Effective perinatal care and meticulous management of dyselectrolytemia are crucial for improving neonatal outcomes.
Aerobic bacteria study, clinical spectrum, and outcome of patients with community-acquired multidrug-resistant pathogens
Authors: Talari Sree Chandra Sekhar , Calerappa Ravi Shankar , Anke Geethanjali
Published: November 2024

ABSTRACT

Context:

Infectious diseases are the leading cause of death in developing countries like India. Hence, even small relative increases in the mortality rate for infections due to multidrug-resistant pathogens would lead to substantial increases in the number of deaths as a result of infections worldwide.

Aims:

The aim of the study was to study the microbiological data of community-acquired pathogens and the corresponding outcomes due to antibiotic-resistant versus antibiotic-susceptible bacterial microorganisms.

Settings and Design:

A single-center prospective cohort study for two years undertaken during the study period of March 2022 to 31 October 2023.

Materials and Methods:

All clinical samples of 402 patients diagnosed microbiologically as community-acquired infections were included. Culture samples were collected and processed according to standard operating procedures and clinical details were recorded.

Statistical Analysis Used:

Categorical variables were expressed as counts and percentages. Fisher’s exact test was used for testing differences in proportions. Two-sided distribution P values of <0.05 were considered significant.

Results:

Among Gram-positive organisms, Staphylococcus aureus and Streptococcus pyogenes were predominant isolates. Escherichia coli and Klebsiella species were the majority of the pathogens among Gram-negative isolates. Mortality rates observed in community-acquired respiratory tract infections (CA-RTIs), community-acquired urinary tract infections (CA-UTIs), community-acquired skin and soft tissue infections (CA-SSTIs), and community-acquired bloodstream infections (CA-BSIs) were 13.6%, 6.56%, 4.5%, and 31.5%, respectively. The length of hospital stay of more than three days was found as 56.06%, 36.2%, 40.9%, and 73.6% in CA-RTIs, CA-UTIs, CA-SSTIs, and CA-BSIs, respectively.

Conclusions:

Performing cultures earlier during hospitalization and determining the timing of colonization can allow more targeted choices and reduce morbidity and mortality rates among infected patients.
Reliability of the documented blood group in motor vehicle driving license in Kerala, India - A public health concern?
Authors: Gafoor Jasmin Abdul , Rajendran Vinu , Aziz Ramiz Raja Abdul , Jose Prinu
Published: November 2024

ABSTRACT

Introduction:

Blood groups documented in motor vehicle driving licenses can provide quick information during emergency transfusion requirements and imbibe self-awareness about one’s blood group. The tendency of applicants to mention blood groups without verification during the application may result in incorrect documentation of blood groups in their driving license. The study aims to assess the reliability of the blood groups in driving licenses and their association with sociodemographic variables.

Methods:

This was a single-center cross-sectional study conducted over 6 months. Donors who were accepted for donation and willing to participate were included. Donors without a valid driving license were excluded. The blood group details and sociodemographic variables were collected and analyzed. Cross tabulation and Chi-square test were done for bivariate analysis.

Results:

In our study, 33 out of 446 (7.39%) participants had incorrect documentation in their driving licenses. Out of 33, 30 were ABO and three were Rh discordant results. Blood group was not mentioned in the case of 37 donors (8.3%). Incorrect documentation was significantly higher for individuals of younger age and those who acquired a license before 2018.

Conclusion:

Eight out of 100 individuals had incorrect documentation in their driving license, which is a concern, especially in the situation of emergency transfusion requirements. Approximately 19% of participants revealed that they did not undergo blood grouping during the application process. License issuing authorities should ensure proper blood group verification during the application process.
Barriers to implementing nursing evidence-based practice at the Palestinian Medical Complex: A cross-sectional study
Authors: Khaled Hamdallah H.
Published: November 2024

ABSTRACT

Background:

The use of nursing evidence-based practice (EBP) has grown more and more important for healthcare professionals globally in their goal of delivering high-quality patient care.

Objective:

The aim of this study is to assess barriers to implementing EBP among Palestinian nurses at the Palestinian Medical Complex (PMC).

Methods:

The study was carried out at the PMC over the course of a month and employed a cross-sectional descriptive approach. Data were gathered from 100 nurses who satisfied the inclusion criteria by using convenient sampling. Barriers to the application of EBP were measured by the BARRIER Scale.

Results:

Participants identified key barriers such as inadequate time (62%, M ± SD: 3.34 ± 1.066) and lack of assistance (30%, M ± SD: 3.15 ± 1.029). Concerns included literature dispersion (45%, M ± SD: 3.23 ± 0.973), inadequate facilities (53%, M ± SD: 3.70 ± 1.010), and methodological issues (52%, M ± SD: 3.16 ± 1.012). In addition, 57% felt that research is published too slowly (M ± SD: 3.39 ± 0.898), 33% noted unjustified conclusions (M ± SD: 3.01 ± 0.882), and 35% highlighted a lack of replication (M ± SD: 3.07 ± 0.879).

Conclusion:

This study found that head nurses and men perceived more significant barriers to research quality, while individuals with baccalaureate degrees reported fewer barriers. There was an association between perceived barriers and age and work experience, indicating age as a positive predictor of barriers related to research quality.
Unveiling challenges of maternal health in India’s tribal mothers: Insights from a case series of maternal deaths
Authors: Toppo Neelam Anupama , Thakur Aditya , Singh Archana G. , Soni Deepali
Published: November 2024

ABSTRACT

Maternal mortality remains a significant public health concern globally, with disparities often evident among marginalized populations, including tribal communities. This case series delves into the complexities surrounding maternal mortality among tribal populations in India, shedding light on the multifaceted factors contributing to this persistent public health issue. Through verbal autopsy and retrospective review of medical records, a series of maternal deaths among tribal mothers were examined. Maternal deaths have been broadly divided into two categories Bottlenecks in quality antenatal services and missed opportunities.
‘Quality assessment of infection control measures in delivery points in a tribal district of Maharashtra’ - An observational study
Authors: Bharadwaj Gauri , Sankhe Lalit , Bharadwaj Shubhendra
Published: November 2024

ABSTRACT

Background:

Maternal and neonatal mortality rates remain alarmingly high in low-resource settings, with infections acquired during childbirth contributing significantly to this burden. Effective infection control measures at delivery points are crucial for mitigating these risks. This observational study aimed to assess the quality of infection control practices in delivery points in a tribal district of Maharashtra, India.

Methods:

A community-based study was conducted at delivery points across eight talukas in Palghar district. A total of 15 delivery points were selected using convenient sampling, representing three levels of facilities (L1, L2 and L3) which are healthcare facilities divided on the basis of the provision of services by Maternal and Newborn Health Toolkit. Data was collected using the validated LaQshya programme’s checklist through direct observation from June 1st to June 18th, 2021. Compliance with infection control protocols was scored based on predefined criteria.

Results:

The majority of L1 delivery points showed non-compliance in criteria such as surface microbiological surveillance and monitoring of infection control practices, 20–40% of Delivery points also showed non-compliance in the availability of personal protective equipment and waste management practices.

Conclusion:

This study highlights the need for targeted interventions to improve infection control practices in delivery points, particularly in lower-level facilities. Strengthening adherence to established protocols, enhancing staff training, ensuring availability of essential supplies and implementing robust monitoring systems are imperative for reducing the burden of maternal and neonatal infections and improving healthcare outcomes in resource-constrained settings.
Intussusception in children with celiac disease
Authors: Alhussaini Bakr H
Published: November 2024

ABSTRACT

Celiac disease (CD) is a chronic illness. Blood testing for tissue transglutaminase antibodies is the initial screening test for the diagnosis of CD, and upper gastrointestinal endoscopy and duodenal/jejunal biopsy are used to confirm CD. Intussusception (IS) is the process in which a proximal segment of the bowel invaginates through the lumen of a distal segment. The association between pediatric IS and CD has been described but is still not widely recognized. Herein, we report a case of IS as the first manifestation of CD in a child. A 3-year-old girl presented to the emergency department with a 1-week history of marked abdominal distention and lethargy, but there was no history of fever, bleeding per rectum, or jaundice. A second-degree relative had a family history of CD. Clinical examination: The patient was a lethargic child with pale conjunctiva and bilateral lower limb edema. She was a febrile and had a normal hemodynamic status. The adipose tissue was diminished throughout the patient’s body; her weight was 8 kg (<5% weight percentile for girls), and her height was 81 cm (<5% height percentile for girls). Laboratory results included the following: Hb of 9 g/dL, serum ferritin of 10 ng/mL (30–400 ng/mL), normal liver function test results except for hypoalbuminemia at 21 g/L (35–52 g/L), and low blood cholesterol of 0.94 g/L (1.54–2.01 g/L). The patient’s blood sugar level was 98 mg/dL, and her renal function test results were normal, with negative septic screening. Abdominal radiography revealed several air–fluid levels, suggestive of an obstruction in the small bowel. Abdominal ultrasonography revealed typical features confirming the diagnosis of IS. Abdominal computed tomography demonstrated an enteroenteric IS with no other signs of organic causes, such as lymphoma or other tumors. Based on the high index of suspicion of CD, a workup confirmed the diagnosis. A gluten-free diet [A1] was started during the hospital course, and the patient improved dramatically regarding her symptoms and was discharged home. In conclusion, this case highlights the association between IS and CD. Intussusception is an emergency condition and usually idiopathic. However, in atypical or recurrent typical presentations underlying causes, we should do proper investigations to initiate appropriate management. [A1]Abbreviations are generally avoided for terms that are not repeated in the text. In this case, this abbreviation is not used elsewhere in the Abstract. Hence, I have deleted the abbreviation. Categories: Pediatrics, Gastroenterology.
Hemorrhagic stroke and atherogenic markers – is there any relation?
Authors: Masic Nejra , Begic Edin , Aziri Buena , Mehmedika-Suljić Enra , Mahmutbegović Nevena , Fajkic Almir , Lepara Orhan , Krupic Ferid
Published: November 2024

ABSTRACT

Background:

The triglyceride/high-density lipoprotein (TG/HDL) ratio emerges as a promising marker for cardiovascular risk. However, the relationship between overall serum lipid levels and hemorrhagic stroke (HS) remains uncertain. Therefore, our study aims to explore the association between this novel index and mortality in HS patients.

Methods:

Utilizing a retrospective-prospective framework from January 2020 to August 2023, we scrutinized data from 104 hospitalized patients diagnosed with HS, with particular attention to their medical backgrounds and lipid profiles.

Results:

Age (odds ratio [OR], 1.078; 95% confidence interval [CI], 1.032–1.125; P = 0.001), atrial fibrillation (OR, 0.237; 95% CI, 0.074–0.760; P = 0.015), glucose level (OR, 1.121; 95% CI, 1.007–1.247; P = 0.037), and TG/HDL index (OR, 0.368; 95% CI, 0.173–0.863; P = 0.020) emerged as independent predictors for in-hospital mortality, as determined by both univariable and multivariable logistic regression analyses.

Conclusion:

Our results add weight to the growing evidence backing the utility of the TG/HDL index in assessing cardiovascular risk among HS patients. They emphasize the necessity of adopting a comprehensive risk assessment and management strategy that incorporates both traditional markers and novel indicators.
Impact of diet on renal stone formation
Authors: Ghoneim Solafa H , Alghaythee Hotoon , Alasmari Bashair , Safdar Osama Y
Published: November 2024

ABSTRACT

Background and Objectives:

The incidence of kidney stones is increasing globally, with a preponderance in adults compared with that in adolescents and children. Dietary habits have been identified as significant contributing factors to kidney stone formation. This literature review aimed to explore the existing evidence on the impact of diet on renal stone formation.

Methods and Study Design:

We conducted a comprehensive literature review and included 81 studies published between 1999 and 2023, limiting the search to articles published in English. The extracted data were analyzed to identify common themes, trends, and patterns related to the impact of diet on renal stone formation. We investigated the influence of dietary habits on the risk of nephrolithiasis.

Results:

Although the role of fluid intake in relation to stone formation is clear, existing evidence on how different types of beverages (coffee, tea, fruit juices, and soft drinks) affect kidney stone formation is conflicting. Other factors such as protein, sodium chloride, calcium, oxalate, fat, and carbohydrate intake have also been discussed as contributors to nephrolithiasis. Thus, diet should be appropriately modified to reduce the risk of stone formation in susceptible individuals. A history of nephrolithiasis has been found to increase the risk of both chronic kidney disease and end-stage renal disease. The review acknowledges the limitations inherent in conducting a literature review, including the potential for publication bias and the reliance on available published studies.

Conclusions:

These findings highlight the importance of understanding and preventing nephrolithiasis.
A study of clinical profile and outcome of patients with snake bite-induced acute kidney injury
Authors: Pushpalatha Avunoori , Itagi Afreen Begum H. , Vamshidhar Immadi S. , Rani S. S. Sabitha , Kalpana Medala , Vidya Ganji
Published: November 2024

ABSTRACT

Background:

Snake bite is a well-known occupational hazard amongst farmers, plantation workers, and other outdoor workers and results in much morbidity and mortality throughout the world. The complications related to kidneys are observed in most patients with snake bites admitted to a hospital. The current study aimed to study the renal involvement in patients with snake bites with reference to clinical features and the time of onset of acute renal failure.

Methods:

A prospective clinical study of 68 patients of snake bite was done to know the clinical profile and outcome in Gandhi Hospital Secunderabad and cases were particularly looked for development of acute kidney injury. Later each case was studied and investigated with respect to onset, clinical features, course in the hospital, need for renal replacement therapy including dialysis, and mortality due to AKI. Patients were followed up till discharge or death. They were treated as per protocol.

Results:

The incidence of AKI was 29.1%. Common signs and symptoms were fang mark (100%), swelling (91.2%), tenderness (91.2%), bleeding manifestations (79.4%) oliguria (26.47%), anuria (5.8%), and haematuria (8.8%). Hypotension was present in 73%, which may be the cause of AKI. All the AKI patients showed coagulation abnormalities in the form of prolonged BT, CT, PT, and aPTT. Thrombocytopenia was seen in 29.4%. All the AKI patients were given ASV for 2 to 3 days. The mean ASV vials used in the present study is 15 ± 5. Hemodialysis was done in 29.4% of patients.

Conclusion:

The cause of AKI in snakebite was multifactorial in origin. Bleeding and hypotension were among the important causes. Thrombocytopenia was significantly related to clinical bleeding. The type of snakebite is an important factor in the development of AKI and Russell’s viper bite is more commonly associated with it. AKI is usually associated with oliguria and generally occurs within 48 hours.
Prevalence of dental caries, oral health status, malocclusion status, and dental treatment needs in thalassemic children: A cross-sectional study
Authors: Mahajan Ankit , Pawar Madhura , Tomer Geetika , Girish PV , Salama Mohamed Tharwat , Dupare Aditya Sudhakar
Published: November 2024

ABSTRACT

Background:

Thalassemia is a hemoglobinopathy-associated genetic disease resulting due to defective synthesis of globin chains, causing defects in the skeletal and oral structures.

Aim:

This cross-sectional study was designed to analyze the prevalence of dental caries, oral health status, malocclusion status, and dental treatment needs in thalassemic children.

Materials and Methods:

Institutional Ethical committee clearance was obtained before starting the study. The study sample comprised 100 thalassemic and 100 normal children in which oral disease markers like dmft/DMFT index, plaque index, gingival index, and Angle’s classification for malocclusion were used. The statistical tool used was ‘one-way ANOVA’ with the probability set at 0.05.

Results and Observations:

Statistically significant differences in prevalence of dental caries, periodontal disease, malocclusion, and treatment needs were noted in thalassemic individuals when compared to normal subjects.

Conclusion:

The present study has given an insight into the various oral and dentomaxillofacial manifestations of thalassemia, thus considering the importance of routine oral examination for the prevention of dental caries and periodontal diseases.
To evaluate the effect of a structured training program about polycystic ovarian syndrome on the knowledge and perception of nursing students of a government nursing teaching institute in Northern India
Authors: Duhan Latika , Choudhary Rashmi , Dahiya Pushpa
Published: November 2024

ABSTRACT

Background:

The education levels of females have been found to aid in the early detection of polycystic ovary syndrome (PCOS). Early diagnosis and treatment are crucial in mitigating the long-term consequences of PCOS. Nursing students are poised to become the next generation of healthcare professionals, equipped with valuable knowledge that can be utilized to increase awareness among their peers and patients, particularly about this critical subject matter.

Objective:

We conducted this study to assess the current level of knowledge and perception regarding PCOS among nursing students and to evaluate the impact of structured training interventions on their baseline knowledge and perception level.

Methods:

It was a single-group pre-post interventional study done on the nursing students of Govt. Nursing College. A pre-tested questionnaire was used as a study tool. Intervention in the form of a structured training program was imparted to the participants.

Results:

The pre-test group exhibited a lower mean knowledge score (M = 22.5758, SD = 11.02290) than the post-test group (M = 31.3889, SD = 14.50417). A significant difference was observed in the mean knowledge scores (t = −8.107070, P = 0.00001). The pre-test group exhibited a lower mean perception score (M = 35.3535, SD = 3.79637) than the post-test group (M = 36.6616, SD = 3.79576). There was a significant difference in the mean perception score (t = −5.883333, P = 0.00001).

Conclusions:

This study has shown the positive impact of relevant training on the knowledge and perception of nursing students about PCOS.
Prevalence of self-reported symptoms of reproductive tract infections and promoting an awareness of reproductive health among adolescent girls through education approach in Kumbakonam rural region of Tamil Nadu state
Authors: Balamurugan Padma Praba , Praveen Vijaiyalakshimi , Kolli Bhaskari
Published: November 2024

ABSTRACT

Introduction:

Adolescent females in India particularly from rural areas indicate sparse sexual and reproductive health (SRH) information and are at risk of unfavourable sexual and reproductive health outcomes.

Objectives:

The study was primarily intended to assess the effect of structured interventional education on awareness and practices of school-going adolescent girls about sexual and reproductive health.

Methods:

This was an interventional study comprising of interactive strategies, namely peer-led approach, flipped learning, skit, scenario-based discussion and puppetry. The pre- and post-test was conducted among 1232 girls in selected schools at rural block in Kumbakonam rural region of Tamil Nadu State of India.

Results:

The participants reported statistically significant gain in knowledge, attitudes and practices about reproductive health due to educational intervention (P < 0.001). Nearly 50% of participants were aware about various contraceptive methods before intervention. The prevalence of self-reported symptoms of RTIs/STIs was 23.7%. Nearly more than half of participants were aware about various contraceptive methods.

Conclusions:

Peer-led education can be a potential health promotion strategy among adolescent population.
The challenges of frontline health managers during the COVID-19 pandemic in India: A framework analysis study
Authors: Kundapur Rashmi , Rashmi Anusha , Aggarwal Sumit , Panda Meely , Jena Subharanjan , Epari Venkatrao , Baidya Shubratho , Ramesh N.R. Masthi , Sahoo Jyoti Ranjan , Sabat Smaranita
Published: November 2024

ABSTRACT

Background:

Coronavirus was first officially reported in Wuhan city of China in December 2019. As this novel coronavirus spread rapidly throughout the world, health care workers faced many difficulties addressing the pandemic. In the present study, we explored the challenges faced by front-line health managers on human resource management, execution of the central policies, and training and in formulating innovative approaches during the coronavirus disease 2019 (COVID-19) pandemic in India.

Methods:

A qualitative study was conducted using framework analysis among front-line health managers concerning COVID-19 management at the district level. We conducted 120 in-depth interviews among eight states with the use of an interview guide.

Results:

The results are described under five sections: ‘challenges of front-line managers in policymaking and its execution’, ‘human resource management’, ‘gaps in local execution of central policies’, ‘challenges in training workforce and data management’, and ‘innovative approaches adopted during COVID 19’.

Conclusions:

We observed that a centre-down approach was not appreciated much. Many participants felt that there was a need to understand the local context and appropriate amendment. The private system is a part of the Indian health system and can never be ignored; thus, all guidelines should include the private system.
Relationship between proxy behavior in clinic attendance and disease control among persons with hypertension and diabetes at a rural primary health center: A cohort analysis in South India
Authors: Narendiran Viswanath , Ramasamy Nishaant , Sarkar Sonali
Published: November 2024

ABSTRACT

Aims:

Among persons with hypertension and diabetes on treatment for at least 1 year at the Rural Health Centre (RHC) noncommunicable disease (NCD) clinic, 1. To determine the control status for hypertension and diabetes. 2. To assess the relationship between proxy behavior for collection of medications and the control status.

Settings and Design:

Rural Health Centre, Ramanathapuram, Puducherry, India; record-based retrospective observational study.

Methods and Material:

The study employed a universal sampling of 396 eligible persons with diabetes and hypertension who had been on medication for over a year at the RHC NCD clinic and had recorded blood pressure and glucose values within the last 4 months. Case sheets of these patients were retrieved from the Medical Registration Department, and data from the past 12 months were collected and analyzed to assess proxy behaviors and absenteeism.

Statistical Analysis Used:

Data were entered from the case sheets in Epicollect5 and analyzed using Stata v17.

Results:

Among hypertensive patients, 48.01% were aged 60 and above, with 55.63% being female. Fifty-six percent of hypertensive patients had their condition controlled. For diabetic patients, 40.88% were aged 45–59 years, with 59.75% being female. Only 18.24% of diabetic patients had their condition controlled. The multivariable analysis examined factors associated with the control status of hypertension and diabetes. Those aged 30–44 (aRR: 1.47, 95% CI: 1.01–2.15) and 45–59 (aRR: 1.37, 95% CI: 1.03–1.82) had a higher risk of uncontrolled hypertension compared to those aged 60 and above. Gender did not show significant associations with hypertension control status. Regarding attendance status, patients who had both proxy and missed visits (RR: 1.46, 95% CI: 1.02–2.07) had a higher risk of uncontrolled hypertension. There was also a significant association with patients having more than three proxies (aRR: 1.51, 95% CI: 1.10–2.17) exhibiting a higher risk of uncontrolled hypertension. Absenteeism status showed that those absent for 1–3 visits had a higher relative risk (RR: 1.37, 95% CI: 1.03–1.82) of uncontrolled hypertension compared to those with no absenteeism.

Conclusion:

Proxy behavior affects the control status of persons with hypertension and diabetes. A longitudinal study is warranted to assess the relationship between proxy visits and control status.
Pediatric uveitis
Authors: Furtado João M. , Smith Justine R.
Published: November 2024

ABSTRACT

Up to 10% of uveitis cases occur in children, with notable implications due to the risk of chronicity and vision loss. It can result from infections, autoimmune and autoinflammatory diseases, trauma, or masquerade syndromes. Primary care providers are vital in early detection, symptom management, and timely specialist referral. Depending on the etiology, symptoms may include redness, pain, photophobia, vision changes, and sometimes more severe vision loss or intense pain. Conservative initial treatment may include pain relievers and corticosteroid eye drops. Specialist care involves a thorough ocular examination and diagnostic tests to identify the underlying cause. Treatment aims to control inflammation and preserve vision, often necessitating long-term medication, with compliance being crucial. In low-resource settings, telemedicine and generic drugs may be useful to manage costs. Preventative strategies focus on prenatal care to avoid congenital infections, and distinguishing uveitis from conditions like conjunctivitis is essential for proper treatment. Multidisciplinary care ensures comprehensive management of the child’s health. In summary, early intervention and a collaborative approach among healthcare providers are key to mitigating the impact of uveitis on a child’s life.
Risk Prediction of high blood glucose among women (15–49 years) and men (15–54 years) in India: An analysis from National Family Health Survey-5 (2019–21)
Authors: Karri Anjan Kumar , Guthi Visweswara Rao , Githa P Sri Sai
Published: November 2024

ABSTRACT

Context:

Approximately 500 million individuals worldwide are known to have diabetes, representing roughly 1 out of every 11 adults in the world. Approximately 45.8% of adult diabetes cases are believed to be undiagnosed.

Aim:

This study aimed to identify the predictors for high blood glucose and to develop a risk score which helps in early detection of high blood glucose among Indian men (15–54 years) and women (15–49 years).

Methods and Material:

This study utilised data from the National Family Health Survey-5, which were gathered between 2019 and 2021. The study population comprises women aged 15–49 years and men aged 15–54 years in India.

Statistical Analysis Used:

A logistic regression analysis was conducted to determine the predictors of high blood glucose. The results were expressed as odds ratios with 95% confidence intervals. The risk score for high blood glucose was derived through variable shrinking and by employing regression coefficients obtained from the standard logistic regression model. Data were analysed using IBM SPSS version 26.

Results:

The prevalence of high blood glucose in India was 9.3%. The study findings indicated an association between age and the occurrence of high blood glucose levels. The prevalence of high blood glucose was higher among males (11.1% vs 7.5%), individuals living in urban areas (10.7% vs 8.9%), those with a waist circumference exceeding the specified limit (11.7% vs 5.9%), and individuals who were overweight or obese (11.3%). The prevalence of high blood glucose was higher among alcoholics (13.2% vs 8.8%) and various forms of tobacco users (12.1% vs 8.4%).

Conclusions:

Age, sex, place of residence (urban), consumption of alcohol, hypertension, and waist circumference were found to be the significant predictor variables and were used to develop the risk prediction score using the logistic regression model.