bluuebunny/crossref_metadata_2025 huggingface dataset:
Duration of viral shedding in patients with COVID-19 and the redetectable positive cases with SARS-CoV-2: A hospital experience
Authors: Al Qahtani A A. , Bin Rasheed A M , Al Abood A , Selim Mohie E. , Al Khalifah A K , Aurkmany A. , Al-Odayani A , Te M C
Published: June 2022

ABSTRACT

Background:

The study aimed to estimate the duration of viral shedding (DVS) in patients with confirmed coronavirus disease 2019 (COVID-19), investigated the factors affecting that duration, and identified the redetectable positive (RP) cases in the recovered COVID-19 patients in Prince Sultan Military Medical City (PSMMC).

Methods:

The study was a retrospective record base design in the PSMMC that included 171 confirmed COVID-19 patients from 15 March to 31 May 2020. Their clinical characteristics and laboratory findings were retrieved and reviewed based on the PSMMC COVID-19 database and the Ministry of Health (MOH) Health Electronic Surveillance Network. Data analysis used the SPSS software package to measure the DVS, explore its potential factors, and identify the RP cases. The data presented as frequency distribution tables, medians, and interquartile range (IQR). Mann–Whitney U and Kruskal–Wallis tests compared the medians to explore the significant variables that affect DVS.

Results:

The median DVS was 11 days, IQR was 7 to 15 days, and statistically significant longer the patient presented with fever (P = 0.025), among health care workers (HCWs) (P = 0.020), and the age group above 65 (P = 0.039). Overall, 13 patients (7.6%) were RP, statistically significantly higher among the contacts to confirmed COVID-19 cases.

Conclusions:

The DVS in PSMMC COVID-19 patients is comparable to the isolation period approved by MOH. Fever was a risk factor for a prolonged DVS, advised an extended follow-up period for these patients. RP cases were significantly higher among the contacts to COVID-19 cases than non-contacts. The study suggests future comprehensive research on the RP characteristics.
Knowledge and practice of depression management among primary healthcare physicians
Authors: Alanazi Abdulaziz , Alsharif Saad , Alzahrani Ziyad , Alanazi Ahmed
Published: June 2022

ABSTRACT

Background:

Depression is a mood disease that affects the energy, behavior, and mood of individuals. Depression is associated with an increased risk of chronic disease. Primary healthcare physicians play an important role in the diagnosis and management of depression. We aim to determine the knowledge of primary healthcare physicians on depression.

Methods:

This is an observational cross-sectional study that was conducted on primary healthcare physicians using a structured validated questionnaire. Statistical analysis was conducted using SPSS 22nd edition.

Results:

This study included 235 primary healthcare physicians, and the mean ± standard deviation of age was 29 ± 3 years. Males were predominant in the study (62%), and the large majority were residents (94.9%). There were 79.5%, 91.5%, and 27.8% who had good knowledge, a positive attitude, and a good practice, respectively. There was no factor found to affect the knowledge and attitude, whereas only the position of participants was significantly associated with the level of practice (P = 0.027).

Conclusion:

There were good knowledge and a positive attitude of primary healthcare physicians regarding depression; however, their practice was poor.
Clinical profile of COVID-19 patients and their length of stay: Tertiary care hospital experience
Authors: Sachdeva Mandeep K. , Suri Vikas , Saini Vikas , Kumar Ashok , Mohindra Ritin , Rohilla Kusum K. , Kumar Mahendra , Soni Roop K. , Singh Harjeet , Sharma Praveen , Kumar Sanjay , Jain Arihant , Naidu GSRSNK , Rastogi Ashu , Prasad Kuruswamy T. , Bhogal Ranjit Pal S.
Published: June 2022

ABSTRACT

Background:

SARSCoV-2, a coronavirus that causes COVID-19, is spreading rapidly. By the middle of August-2021, it has affected over 3 million confirmed cases in India. The main aim of this study was to examine the clinical profile of COVID-19 patients and their length of stay during treatment in a hospital.

Materials and Methods:

It was a hospital-based retrospective study conducted by using a total enumeration technique in July–August 2021 at Nehru Hospital, Postgraduate Institute of Medical Education and Research (PGIMER) in India. The present study was conducted on 72 COVID-19 patients who took treatment in 4C and 5C wards. Structured questionnaires were used to collect data, which included bio-demographic factors and questions about their treatment and length of stay.

Results:

The majority of the 72 COVID-19 positive patients were men (62%), belonged to the age group of 41–60 years (35%), had SpO2 levels ranging from 91%–95% (45%), and received room air O2 therapy (63%) during their treatment in the hospital. Female patients had a longer length of stay (7.33 days), patients under the age of 20 years had the longest hospital stay (11.5 days), patients with SpO2 less than 70% had the longest hospital stay (8 days), and patients who received oxygen using a non-rebreathing mask had the longest hospital stay (11 days).

Conclusion:

To avoid panic situations, regular admission and discharge of patients was essential due to the considerable increase in cases during the second wave. Patient length of stay was reduced as a consequence of collaboration and cooperation among all physicians, residents, staff nurses, and paramedics, with the goal of discharging the patient after a room air trial and follow up if needed.
COVID-somnia: Sleep disturbance among Indian nurses during COVID-19 pandemic
Authors: Kumar Mahendra , Kumari Anita , Rohilla Kusum K. , Dhawan Shelly , Singh Anushi , Sharma Nivedita , Kriplani Namrata , Barari Neha , Soni Roop Kishor
Published: June 2022

ABSTRACT

Background:

Sleep is vital for every aspect of human life. Inadequate sleep has a massive negative impact on health and work. There is very limited information about the impact of COVID-19 on the sleep disturbance of health-care workers. In our current study, we aim to find answers to certain questions about the impact of the COVID-19 pandemic on sleep patterns on nurses working in COVID care area.

Methods:

A cross-sectional study was conducted on 305 health-care workers who were purposively enrolled for this study. The study was conducted at the Postgraduate Institute of Medical Education and Research, Chandigarh, India, from April to June 2021. An e-survey method was used to collect data. A questionnaire including sociodemographic characteristics, queries about sleep disturbances, and the patient health questionnaire-9 scale to assess anxiety among participants are among the research tools.

Results:

Mean age of health-care workers was 26.3 years (SD = 6.3). Most of them were women (81%) with a bachelor’s degree in nursing (62%), nursing interns (46%), and married (71%). The majority of nurses (85%) were not infected with COVID and were given suitable personal protective equipment (46%) in the hospital. The majority of participants (45%) got 6–8 h of sleep per night did not receive any sleep therapy (90%). The most of participants (42%) reported that they did not enjoy performing activities and were under moderate stress (15.4).

Conclusion:

Health-care workers are struggling to cope with the COVID-19 pandemic with limited and almost hackneyed resources. Healthy sleep is everyone’s right. The current situation of the pandemic has a great impact on the psychological health of frontline health-care workers by affecting their professional performance.
Correlation of serum uric acid with lipid profile in patients with type 2 diabetes mellitus with normal creatinine level: Report from a tertiary care hospital in India
Authors: Kumar Sandeep , Mondal Himel , Lata Manju , Behera Joshil Kumar , Priyadarshini Bhagyajyoti
Published: June 2022

ABSTRACT

Background:

Increased serum uric acid (SUA) level is considered a risk factor for kidney diseases in type 2 diabetes mellitus (T2DM) patients. Deranged lipid profile in T2DM is an overall risk factor for cardiovascular complications.

Aim:

This study aimed to find the correlation between SUA and serum lipid profile in T2DM patients who had serum creatinine levels within normal limits.

Materials and Methods:

This cross-sectional observational study was conducted in a tertiary care hospital in eastern India. Serum creatinine level was measured first. Then, patients with serum creatinine levels within normal limits were recruited as the final sample. Anthropometric measurements were conducted by an experienced clinician. A 12-h fasting venous blood sample was used to measure serum urea, lipids, sugar, and glycated hemoglobin.

Results:

A total of 176 (male = 104 [59.1%], female = 72 [40.9%]) T2DM patients with a median age of 46 (Q1–Q3 = 40–55) years participated in the study. There was no gender difference in fasting blood sugar (FBS) (P = 0.57), SUA (P = 0.42), and high-density lipoprotein-cholesterol (HDL-C) (P = 0.17). Females showed higher total cholesterol (TC) (P < 0.0001), triglyceride (TG) (P = 0.002), low-density lipoprotein-cholesterol (LDL-C) (P = 0.0002), and very-low-density lipoprotein-cholesterol (VLDL-C) (P = 0.01). SUA showed significant positive correlation with TG (rs = 0.65, P < 0.0001) and VLDL-C (rs = 0.63, P < 0.0001) and significant negative correlation with HDL-C (rs = −0.35, P < 0.0001) and FBS (rs = −0.45, P < 0.0001).

Conclusions:

A higher level of SUA, an indicator for kidney disease in T2DM patients, may be associated with a higher TG and VLDL-C and lower FBS and HDL-C. Thus, SUA should be monitored along with lipid profile for early detection of the risk of kidney diseases.
Quality of care provided to diabetic patients attending primary health care centers in National Guard in Makkah Region, Saudi Arabia
Authors: AlZahrani Abdullah M. , BinDajam Osama S. , AlGhamdi Sultan Ahmed , AlQarni Saad Salem , Farahat Fayssal M.
Published: June 2022

ABSTRACT

Background:

Diabetes is a costly and serious health problem that is increasing markedly. The quality of care is a major issue among diabetic patients. This study aims to assess the quality of care provided to diabetic patients using the American Diabetes Association (ADA) indicators.

Methods:

This was a cross-sectional study conducted using a retrospective chart review. The population was adult diabetic patients (type 2) who had attended the National Guard’s primary healthcare centers, Makkah region, Saudi Arabia, from January 1, 2017, to December 31, 2018.

Results:

We studied 400 adult diabetic patients aged 30–97 years with a mean age of 58.25 (SD = 11.9). The length of time with diabetes ranged from 1 to 42 years with a mean of 9.66 years (SD = 7.6). Among all the primary healthcare centers (PHCs), specialized polyclinic (SPC) had the highest number of patient visits. Furthermore, the SPC had the highest number of patients with complications; the primary healthcare center with the fewest complications was Iskan-Jeddah. The results show that the control of hemoglobin A1C (HbA1C) was better in 2018 than in 2017.

Conclusion:

There is improved and adequate care provided to patients among the assessed primary healthcare centers in the Makkah region. Nevertheless, there remains a need for interventions to maintain comprehensive data on diabetes performance. Monitoring and proper education on diabetic care to patients are suggested to achieve better control of diabetes and delay the occurrence of complications.
Tobacco smoking habits and nicotine dependence among the college students of University of Delhi, India
Authors: Kamble Bhushan D. , Acharya Bhabani P. , Jethani Sumit , Chellaiyan Vinoth G. , Singh Sunil K. , Chaku Satish
Published: June 2022

ABSTRACT

Background:

According to the report on tobacco control in India, tobacco use causes eight to nine lakh deaths annually in India. Tobacco use is on the rise among youngsters especially the college students. The Government of India has made a mandatory display of pictorial health warnings for both smoking and smokeless forms of tobacco products under the Cigarettes and Other Tobacco Product Act, 2003. The objective of the present study was to assess the prevalence of tobacco smoking and to assess nicotine dependence among the college students of the University of Delhi.

Methods:

A cross-sectional study was conducted among 400 college students of Delhi University from October to December 2019. A semi-structured self-administered questionnaire method was used to collect data on smoking; pictorial warnings and Fragerstrom criteria were used to assess nicotine dependence.

Result:

Out of the 400 study participants 92 (23%) participants were ever smokers. Among 62 current smokers, the mean age (±SD) of initiation of smoking was 17.3 years (±2.07), median (interquartile range [IQR]) number of cigarettes smoked per day was 3 (2–6), a majority (80.7%) used to smoke after 30 min of waking up in the morning, majority (59.7%) had low nicotine dependence. About half of the past smokers 47% (14 out of 30) and the current smokers 58% (36 out of 62) told that they had no effect of pictorial warning for quitting or decreasing smoking.

Conclusion:

The present study revealed the tobacco smoking pattern among college students of Delhi. The majority of smokers and non-smokers perceived that pictorial warning is ineffective in driving to quit smoking.
Association of sleep duration and sleep quality with body mass index among young adults
Authors: Gupta Preeti , Srivastava Neena , Gupta Vani , Tiwari Sunita , Banerjee Monisha
Published: June 2022

ABSTRACT

Background:

It is evident from the research in recent years that short sleep has been found as a risk factor for obesity. However, we still need enough evidence in this field. Therefore, we explored the directionality of the association between sleep duration and sleep quality with body mass index (BMI).

Aims:

The aim of this study is to evaluate the association of sleep duration and sleep quality with BMI among young adults.

Objectives:

(a) To assess the association of sleep duration with BMI. (b) To assess the quality of sleep with BMI.

Methods:

In this cross-sectional study, 88 individuals selected from King George’s Medical University were taken as participants. Majority of patients were males (67%). There were 29 (33.0%) females. Sex ratio of study was 2.03, and we used Pittsburgh sleep quality index (PSQI) questionnaire to assess time spent in bed and sleep quality. BMI was divided into 3 categories. Underweight (BMI <18.5 kg/m2), normal weight (18.5–22.9 kg/m2), overweight (23–24.9 kg/m2), obese grade I (25–34.9 kg/m2), obese grade II (35.0 kg/m2), and above.

Results:

We observed that short sleep duration ± SD (h) <6 h/day f = 9.04; P < 0.001 is associated with greater chances of being overweight and obese and mean sleep quality (mean PSQI ± SD) f = 12.24; P < 0.001 was poor in obese grade I and II. Mean neck and waist circumference also showed a significant increasing trend with increasing BMI category (P < 0.001).

Conclusion:

This study concludes that short sleep duration and poor sleep quality were associated with overweight obesity among young adults.
Serological prevalence of SARS-CoV-2 antibody among children and young age group (between 2 and 17 years) in India: An interim result from a large multicentric population-based seroepidemiological study
Authors: Misra Puneet , Kant Shashi , Guleria Randeep , Rai Sanjay K. , Kishore Surekha , Baidya Subrata , Singh Arvind Kumar , Chinnakali Palanivel , Medigeshi Guruprasad R. , Chaturvedi Pradeep Kumar , Joshi Hari Shanker , Mandal Suprakash , Sangral Meenu , Yadav Kapil , Bairwa Mohan , Haldar Partha , Kardam Priyanka , Patil Sharanabasava , Jha Shreya
Published: June 2022

ABSTRACT

Background:

Estimating seroepidemiolgical prevalence of SARS-CoV-2 antibody is an essential public health strategy. There is insufficient evidence of prevalence among those belonging to young age population in India.

Objective:

To compare the SARS-CoV-2 seropositivity rate between children and adults in selected sites from India.

Materials and Methods:

This was a multicentric population-based seroepidemiological study conducted in selected urban and rural areas of five sites selected from four states (Delhi, Odisha, Uttar Pradesh, Tripura) of India. Participants aged ≥1 year were included from different clusters of each area. Total serum antibody against SARS-CoV-2 virus was assessed qualitatively by using a standard enzyme-linked immunosorbent assay (ELISA) kit.

Results:

Data collection period was from 15 March 2021 to 10 June 2021. Total available data was of 4509 participants, of whom 700 were <18 years of age and 3809 were ≥18 years of age. The site-wise number of available data among those aged 2–17 years was 92, 189, 165, 146 and 108 for the sites of Delhi urban, Delhi rural, Bhubaneswar rural, Gorakhpur rural and Agartala rural area, respectively. The seroprevalence was 55.7% in the <18 years age group and 63.5% in the ≥18 years age group. The prevalence among female children was 58% and among male children was 53%.

Conclusion:

SARS-CoV-2 seropositivity rate among children was high and comparable to that of the adult population. Hence, it is unlikely that any future third wave by prevailing SARS-CoV-2 variant would disproportionately infect children 2 years or older.
Knowledge and attitude towards emergency department utilization in Riyadh
Authors: Mahmoud Mahmoud A. , Alhijli Fras W. , Alotabi Yaser , Alanazi Salman , Alghamdi Abdullah , Alrasheed Mansour , Alafandi Fawaz
Published: June 2022

ABSTRACT

Background:

Because the emergency department (ED) is such an important element of health care, efficient usage must be taken into account while planning and creating the scope of service for emergency care. Our study’s goal is to assess the participants’ knowledge and attitude towards ED. Concerns among the general public over the use of emergency rooms (ER).

Materials and Methods:

A cross-sectional study was carried out among the sample of Saudi Arabia’s population of Riyadh City in the year 2020. There were 440 people who responded. The information was gathered with a self-administered questionnaire. Statistical Package for Social Sciences (SPSS) version 23.0 was used to analyze the data.

Results:

As a result of the findings, 22 symptoms were reported as the cause of ER visits, ranging from acute, urgent, and cold symptoms. Of these, 45.7% of those polled said they visited an ER if they get sick, then seek primary care, online consultation, and community pharmacy, which was 28.2%, 17.5%, and 8.6%, respectively. Around 14.32% of the visitors had a chronic condition, with asthma accounting for 41.3%, diabetes for 23.8%, and hypertension for 11.1%. In terms of the frequency of visits, 66.4% said they visit the emergency care once in every 3–6 months, and 47.7% said they visit once in a month. With a mean score of 16.16 ± 3.02/high in knowledge, the results revealed that the participants possessed a high degree of knowledge, with a significant difference among married group (F = 4.83, P < 0.05 = 0.003), and those from 24 to 29 years of age (F = 3.26, P < 0.05 = 0.012).

Conclusions:

Because there were characteristics connected to population knowledge, limited hours, and ED overutilization without necessity, the findings of our study could be valuable in understanding the reasons for ED overutilization without necessity. In Riyadh’s primary health care centers (PHCCs), there are limited medical resources. Thus, we recommend that the primary health care (PHC) admission process should be improved putting in place a triage mechanism that determines the best location for patient care that is suited.
Prevalence and determinants of musculoskeletal pain among school-going children carrying schoolbags: A cross-sectional study from Central India
Authors: Choudhary Yachana , Bhatia Padma , Kumar Mohan , Dubey Manju
Published: June 2022

ABSTRACT

Musculoskeletal disorders constitute 1,194 prevalent cases per 1,00,000 among children aged 5 to 19 years in India. School bags with a weight exceeding 10% of the bodyweight is a common cause of backache in school children.

Methods:

School children aged 8–15 years from four private schools of Bhopal were included, resulting in a sample of 934 participants. An author-assisted questionnaire was used for data collection.

Results:

The school bags were 16.5% of the average weight of students. 55.9% of the students experienced pain in the last 12 months, 41.6% in the last ten days and 21.3% had visited a doctor for the same. On analysis, bags with ³ three compartments (AOR: 3.7), using both shoulders to carry bags (AOR: 0.10), and the absence of lockers in schools (AOR: 17.80) were significant predictors of pain in the last ten days (P < 0.05).

Conclusion:

Massive advocacy and orientation are required at all levels for educational administrators, teachers, parents and students.
Study on types of anaemia and foetomaternal outcome in antenatal patients
Authors: Hansda Rani , Tirkey Sarita , Trivedi Kiran , Singh Preeti , Prakash Jay
Published: June 2022

ABSTRACT

Anemia is the most common haematological disorder in pregnancy. Anemia increases maternal morbidity and mortality. It is a condition that can be diagnosed and treated during antenatal period, preventing the serious complications of anemia during pregnancy and labour.

Aims:

This study investigated the prevalence of types of anemia during pregnancy and fetomaternal outcomes among pregnant women.

Study Design:

This was a cross-sectional study that enrolled 1100 pregnant women who were in the third trimester of pregnancy with haemoglobin level <11.0 gm/dl between March 2019 and August 2020.

Methods and Material:

Participants were selected by consecutive sampling and baseline data were collected by using a predesigned and pretested structured questionnaire.

Data Analysis:

Data were entered and analysed by using SPSS version 20.

Results:

The prevalence of anemia in third-trimester pregnancy in this study was 91.05%. Iron deficiency anemia was most common (69.18%) among pregnant women followed by megaloblastic anemia (2.5%). Most of pregnant women (45.90%) were mildly anemic. Mean ± SD of haematological parameters among the anemic pregnant women during third trimester of pregnancy were haemoglobin (8.08±2.24 gm/dl), haematocrit (28.92±7.78%), mean corpuscular volume (MCV) (93.02±11.32fl), mean corpuscular haemoglobin (MCH) (26.03±2.90 pg), mean corpuscular haemoglobin concentration(MCHC) (27.99 ± 2.01 gm/dl), RBC count (3.05 ± 0.67million/mm3). Most common maternal complications due to anemia in pregnancy was preterm labour (30%). Fetal outcome in the form of an alive term, most commonly seen in mild anemia (34.7%), fetal complications like Preterm alive (11.3%), preterm intrauterine fetal death (IUFD) (2.7%) most commonly associated with severe anemia.

Conclusion:

The present study concludes that the prevalence of anemia among pregnant women in third trimester of pregnancy was 91.05% which is a serious public health problem. Proper counselling to the patients and their family members regarding cause of anemia, effect of anemia and complications of anemia. So, that such preventable condition can be prevented.
Assessment of mental health status among adolescents in Puducherry, India – A mixed method study
Authors: Gunasekaran Kalaipriya , Vasudevan Kavita , Srimadhi Muthaiyan
Published: June 2022

ABSTRACT

Context:

Adolescence is a crucial period during which biological and psychosocial changes occur in an individual. The prevalence of mental disorders among Indian adolescents was 7.3%. Early recognition and intervention will help to have favorable outcomes.

Aims:

To determine and compare the prevalence and risk factors associated with mental health illness among urban and rural adolescents in Puducherry.

Methods and Material:

An explanatory mixed-method design wherein the quantitative phase (an analytical cross-sectional study) was followed by qualitative phase (focus group discussion). Adolescents aged 13–17 years attending Government schools in urban and rural Puducherry were selected by stratified random sampling. Mental health status was screened using a validated Youth Report Measures for Children and Adolescents – SDQ and students with higher score were considered to be at risk of mental health illness.

Results:

Among 329 adolescent, 25.5% are found to be at risk of mental health illness. The mean total score and sub-domain scores of hyperactivity and emotional symptoms were found to be significantly higher in urban when compared to rural. Among those at risk of mental health illness, significant difference between urban and rural area was seen with respect to variables like family monthly income and parent’s occupation. Behaviour change and deterioration in academic performance were the most common presentation as perceived by the teachers.

Conclusions:

One fourth of the adolescents were found to be at risk of mental health illness, so periodic screening could be done at schools, for early identification and proper treatment of mental disorders.
Impact of milk on malnutrition and cognitive skills among school children: Evidence from gift milk initiative from a tribal state of India
Authors: Rana Rishabh K. , Nag Alka R. , Soren Santosh , Kumar Dewesh , Kumar Chandramani , Sagar Vidya , Singh Shashi Bhushan , Hedayetullah Syed , Kujur Anit
Published: June 2022

ABSTRACT

Background:

The objective of this study was to assess the impact of fortified milk on various aspects of growth and development among school children in a tribal-predominant district of Jharkhand, India.

Materials and Methods:

A longitudinal study was planned in 16 schools (eight in intervention group and eight in control group) of Latehar district of Jharkhand in India. Out of the total 962 study participants, only 528 study participants were considered in study analysis, who were present both during baseline and endline study after 1 year of milk introduction. The study participants were assessed for nutrition, intelligence quotient, and hemoglobin levels with the help of study tools and instruments.

Results:

The decrease in malnutrition was more evident in the intervention group during endline assessment, with 95% confidence interval (95% CI; 7.37, 7.42) and 95% CI (10.63, 10.58) for the difference in proportion in the intervention and control groups for stunting and thinness, respectively. This was statistically significant (P < 0.05). Anemia also improved with better cognition in the intervention group, and the difference was statistically significant (P < 0.05).

Conclusion:

In our study, beneficial effects of milk on malnourished children were evident, particularly in combating stunting and thinness, and it also had a positive impact on cognitive skills in school children.
Continuing medical education about postexposure prophylaxis of rabies in tribal area medical college hospital of Gujarat, India: One step towards rabies elimination
Authors: Bariya Bhavesh , Patel Mitali , Mahyavanshi Darshan , Nayak Sunil
Published: June 2022

ABSTRACT

Background:

Continuing Medical Education (CME) is an essential feature of the clinical practice and helps to improve the health care provider’s ability to provide quality patient care. The World Health Organization has given a global strategic plan to end human deaths from dog-mediated rabies by 2030 known as “Zero by thirty.”

Methodology:

A CME session was organized for staff nurses working in a tertiary medical care hospital of Valsad district about anti rabies vaccination. Ninety-one participants were administered the questionnaire about antirabies vaccine (ARV) and related practical aspects before and after the CME session.

Results:

Mean pre- and post-CME Score of the participants was 5.38 and 8.68 out of 10, respectively which was statistically significant. The majority of the participants could score from 5 to 6 (33, 36.2%) before CME which rose to 9 to 10 after CME (58, 63.7%). A total of 52 participants (57%) showed improvement in total score by more than 5 points after attending CME, whereas 13 (14%) showed no improvement. The maximum improvement (52.1%) was found in the fact that currently available vaccine vials are the same for intradermal (ID) and intramuscular (IM) regimes, followed by the need for immunoglobulins in category III animal bites (44.3%).

Conclusion:

CME showed significant improvement in knowledge regarding rabies and antirabies vaccination. The knowledge regarding the similar schedule for both adults and children needs improvement. Subsequent CME programs should focus on these aspects for the effective management of animal bite patients.
Mother and child protection card as a resource tool for health care providers on VHND sessions: Providers’ views in rural area of Valsad district in south Gujarat, India
Authors: Mahyavanshi Darshan , Bariya Bhaveshbhai R. , Patel Mitali , Nayak Sunil
Published: June 2022

ABSTRACT

Background:

The Mother and Child Protection card (MCP card) is used for tracking of each child right from conception till 3 years of age by community health workers. It is a rich source of information for HCPs about mother and child health. A well-versed health care provider (HCP) can deliver the services efficiently to the beneficiaries.

Objectives:

To assess knowledge of HCPs about information provided in the MCP card.

Methodology:

It was a descriptive cross-sectional study carried out in the rural area of Valsad. Nineteen HCPS were interviewed on VHND sessions for their knowledge about health information provided in MCP card.

Results:

Mean age of HCPs was 38.11 years with mean 9.3 years of work experience. Of these 94.7% were providing the MCP card while registering the beneficiary. Around 78.9% knew growth chart, 68.4% knew vaccination information and nearly half were aware about the various government schemes. About 36.84% could mention five cleans of safe delivery at home.

Conclusion:

HCPs were aware about vaccination, antenatal care, growth chart but their knowledge about five cleans of home delivery and postnatal care needs to be improved.
Assessment of anaemia and nutritional status of antenatal women attending a tertiary care hospital
Authors: Arora Kanupriya , Bahadur Anupama , Mishra Divya , Mundhra Rajlaxmi
Published: June 2022

ABSTRACT

Aim:

The aim of this study was to assess and grade anaemia in antenatal women at a tertiary care hospital.

Materials and Methods:

This cross-sectional study was conducted on 151 participants over 4 months at All India Institute of Medical Sciences (AIIMS), Rishikesh, a tertiary care hospital in Uttarakhand, India. Extensive work on quantifying daily nutritional intake and requirement was done to estimate antenatal women’s nutritional status suffering from anaemia.

Results:

The proportion of anaemia among pregnant women was 37.09%, with mean haemoglobin of 11 g/dl, mode and median of 11.3 g/dl with higher and moderate anaemia than mild. It was in direct proportion with the number of abortions, gravid status and trimester of pregnancy. There was a protein deficit of 30–60% in 73.2% of the anaemic patients. Iron tablets were taken regularly by 85.5% of anaemic patients and 87.1% of non-anaemic patients. None of the anaemic patients met their 100% calorie requirement. The least calorie deficit was found to be 14.4%. A calorie deficit of 30–60% was found in 75% of the anaemic patients. Patients with severe anaemia had a calorie deficit of 40–60%.

Discussion:

Poverty, ignorance and non-availability of resources are the key factors underlying this condition. The lacunae in the delivery chain of beneficence to antenatal women offered by the government need to be looked at. Family planning has a pivotal role in controlling anaemia, as a high frequency of abortions and pregnancies were associated with anaemia.
The outcomes of carpal tunnel decompression based on electro-diagnostic approaches and clinical symptoms in patients suffering from carpal tunnel syndrome (CTS)
Authors: Erfanifam Taher , Anaraki Pouria Hashemie , Vahedi Leila , Nourmohammadi Jalal , Emami Bashir , Khameneh Amin
Published: June 2022

ABSTRACT

Introduction:

The main objective of this study was to assess the outcomes of carpal tunnel release surgery based on the electro-diagnostic approaches and its clinical symptoms in patients who suffered from carpal tunnel syndrome (CTS).

Methods:

This was a prospective cross-sectional study that consisted 50 participants of 100 patients of which 22 of them were men, and 78 of them were female. All the participants were examined through their clinical symptoms including pain, by parentheses, and also using the Levine-Katz Questionnaire before and after the open surgical operation. Additionally, patients with electrophysiological (EP) disorders were evaluated using electromyography (EMG) and nerve conduction velocity (NCV) (EMG-NCV) tests. Then, the association of the findings and results of this study was analyzed and then compared together using a particular statistical analysis model before and after the surgical procedure.

Findings:

The data achieved from the present study demonstrated that a significant improvement in both sexes and age groups was observed, and there was no significant difference in the level of improvement based on age and gender. Moreover, there was a significant correlation between the improvement severity of clinical symptoms and the improvement of severity of muscle nerve disease and their functions.

Conclusion:

It was observed that the surgical procedure for the treatment of carpal tunnel syndrome, improves its clinical symptoms in patients tested with electrodiagnostic techniques. Moreover, diversity of age and sexual condition did not affect the results of the study.
Blood supply management amid COVID 19 pandemic: Challenges and strategies
Authors: Raghuwanshi Babita , Behera Prateek , Singh Pooja , Khan Ruby , Munshi Rakesh , Patil Ankita , Chouhan Sunil
Published: June 2022

ABSTRACT

Background:

Blood supply management amid the coronavirus disease 2019 (COVID-19) pandemic became a cause of concern. Blood donations in the pandemic reduced significantly because of travel restrictions and fear of contracting the virus by visiting blood banks. The WHO (World Health Organization), NACO (National AIDS Control Organization) and the SBTC (State Blood Transfusion Council) published guidelines to ensure the safety of blood donors and staff during the pandemic and to ensure correct procedures are followed. The blood centre physicians took measures for appropriate clinical use of blood and blood products, which reduced the number of transfusions and thereby safeguarded the blood supply for those who needed it the most.

Materials and Methods:

The study was conducted at the All India Institute of Medical Sciences, Bhopal, and 33 blood banks from 33 districts of Madhya Pradesh in collaboration with the National Health Mission and NACO. This was a retrospective study from pre-lockdown to lockdown and unlock phases 1 to 5 for nine months (February 2020 to October 2020) from 33 district-level blood centres of Central India, and the study compared the impact on blood supply from pre-pandemic time to the COVID-19 pandemic time. During the stipulated time period of 9 months, which included the pre-pandemic blood supply, the phases of lockdown when Section 144 was imposed in the country and the unlock phases, the management of transfusion services by the district blood banks of Central India during the COVID-19 pandemic was evaluated. The strategies adopted to maintain the blood supply and adequate inventory were studied.

Results:

The blood donation percentage in the district hospitals of Madhya Pradesh dropped drastically by 61.5% in February 2020 (pre-pandemic time) to 3.35% in April 2020 (COVID-19 pandemic). The nadir of fall in blood donations was seen in April 2020 (phase 1 of COVID-19 pandemic lockdown) with a zenith in February 2020 (pre-pandemic time). The minimum number of donations 8,037 (3.32%) in all 33 districts of Central India was seen in April, when the lockdown restrictions in the country were the strictest. In response to the reduced blood supply, the blood centres adopted strategies to maintain the inventory. Routine requests and inventory were monitored strictly for judicious and rational use of blood and its components.

Conclusion:

The motivation, dedication and the judicious use of blood products in addition to blood conservation strategies, first-in-first-out policy, maintaining an emergency stock of blood and strict monitoring by blood centre physicians led to the gradual upward trend of blood stocks, and hence blood supply management amid the COVID-19 pandemic could be sustained.
Incidence of Fungal Keratitis in Libya
Authors: Atia Ahmed , Ashour Abdulsalam , Alfaigh Hanan
Published: June 2022

Background and Objectives:

Eye infection may lead to loss of visual function or impairment, causing severe disability. The cornea is particularly sensitive, and the amount of scarring or inflammation that is relatively mild in other areas of the body may have a substantial consequence on the cornea. The aim of this study was to assess the occurrence of eye fungal infection among patients attending the Eye Hospital in Tripoli city, Libya.

Methods:

Seventy-one patients with ocular fungal infections were subjected to clinical and microbiological investigations. They were selected from patients attending the outpatient department, casualty, and floor of Tripoli Eye Hospital. The specimens of the external ocular infections were collected using sterile swab and inoculated to different culture media.

Results:

The current findings showed that the Aspergillus was the most common causative agent, being responsible for 91.54% of the all cases, it was followed by Candida albicans (8.46%).

Conclusion:

Knowledge of the pathological course and clinical features of fungal keratitis will undoubtedly be added in early diagnosis and treatment, with reduction in ocular morbidity.
Contact Tracing in the Hospital Setting for COVID-19
Authors: Desai Devashish , Aggarwal Anivita , Singh Komal , Naik Shivdas Rajaram , Kumar Arvind , Kaur Ravneet , Wig Naveet
Published: June 2022

In this commentary, we relate our experience with contact tracing within the setting of a tertiary care institute and how it evolved over the course of the pandemic. The need for a contact tracing mechanism arose when the hospital's first COVID-19 positive employee emerged at the end of March 2020. The central contact tracing team (CCTT) was subsequently established to perform this essential function. We describe the methodology followed by the CCTT as well as the practical hurdles encountered during contact tracing. The benefits of setting up an institutional contact tracing mechanism cannot be overemphasized. We strongly recommend setting up such a mechanism in all health-care institutes, not just for the COVID-19 pandemic but also for future respiratory disease outbreaks as well.
The correlation between viral shedding duration and blood biomarkers in COVID-19-infected patients
Authors: Sadeghi Somayeh , Nasri Peiman , Nasri Elahe , Solgi Hamid , Nasirian Maryam , Pourajam Samaneh , Fakhim Hamed , Mirhendi Hossein , Ataei Behrooz , Mobarakeh Shadi Reisizadeh
Published: June 2022

Background:

Since December 2019, the world is struggling with an outbreak of coronavirus disease-2019 (COVID-19) infection mostly represented as an acute respiratory distress syndrome and has turned into the most critical health issue worldwide. Limited information is available about the association between dynamic changes in the naso/oropharyngeal viral shedding in infected patients and biomarkers, aiming to be assessed in the current study.

Materials and Methods:

This quasi-cohort study was conducted on 31 patients with moderate severity of COVID-19 manifestations, whose real-time polymerase chain reaction (RT-PCR) test was positive for severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) RNA at baseline. RT-PCR was rechecked for patients every 3–4 days until achieving two negative ones. In parallel, biomarkers, including lymphocyte count, lactate dehydrogenase (LDH), and C-reactive protein (CRP), were assessed every other day, as well. Viral shedding also was assessed.

Results:

Spearman's correlation test revealed a significant direct correlation between the viral shedding from the symptom onset and the time, in which CRP (P = 0.0015, r = 0.54) and LDH (P = 0.001, r = 0.6207) return to normal levels after symptom onset, but not for lymphocyte count (P = 0.068, r = 0.34).

Conclusion:

Based on the current study's findings, the duration of SARS-CoV-2 RNA shedding was directly correlated with the required time for LDH and CRP return to normal levels. Therefore, these factors can be considered the determinants for patients’ discharge, isolation, and return to social activities; however, further investigations are required to generalize the outcomes.
Research studies on screening tests
Authors: Aggarwal Rakesh , Ranganathan Priya , Pramesh C. S.
Published: June 2022

Screening tests are done to diagnose asymptomatic disease in apparently healthy people with the aim to reduce mortality and morbidity from the disease. Certain criteria need to be fulfilled before we adopt population-level screening for any disease. Several biases exist in evaluating screening studies, and the ideal study design would be a randomized trial with hard endpoints such as mortality and morbidity.
Advances in orphan drug development
Authors: Thakur Sayanta
Published: June 2022

Rare diseases remain a challenge for many of the countries in the world. The millions of people collectively suffering from rare diseases, in the context of raging COVID-19 pandemics globally, require an innovative and recent solution from different stakeholders. Regulatory bodies such as the Food and Drug Administration and the European Medicines Agency have come up with many different approaches including financial assistance to prompt drug development and approval. Novel approaches pertinent to clinical trials of such drugs such as patient centricity, early interaction with regulatory bodies, and establishing clinical outcome of interest have been experimented. Various international organizations including cross-country collaborators have initiated various projects or consortiums to bridge the gap between knowledge and practice. The challenges remain more pivotal in developing countries such as India, which has adopted few noteworthy initiatives by involving relevant stakeholders in the presence of limited resources, infrastructures, and a nascent regulatory framework. Therefore, it is imperative to revisit the key aspects of orphan drug development to fulfill the unmet needs of such patients suffering from various rare diseases.
Multidimensional Impact of Mental Illness on Tribal Families in India
Authors: Subudhi Chittaranjan , Biswal Ramakrishna , Pathak Abhijit
Published: June 2022

Background:

Mental illness and burden of care on family is widely discussed in the context of the general population. However, mental health in tribal people also needs the same attention from researchers. In this study, the authors intended to find out the effect of mental illness on tribal families having a person with mental illness.

Methods:

A descriptive study was done to collect data at the Ispat General Hospital from 50 tribal respondents who were admitted to the Department of Psychiatry. We used open-ended questions to collect the qualitative data. Then, we did content analysis to build themes of the issues of their mental illnesses.

Results:

We found that the effect of mental illness is on education, marriage, financial crisis, family stress, disruption of family routine activities, physical abuse and violence in the family, social isolation, lack of caregiver's personal care and care for other children in the family, as well as damage to household accessories.

Conclusion:

In this study, the authors created major themes, to dissect and trisect into adverse events, which were frequent and appear the same in the general and tribal family having a patient with mental illness.
Coronavirus Phase and Major Influencing Factors in Determining Anxiety, Depression, and Posttraumatic Stress Disorder in Patients with COVID-19
Authors: Satapathy Sujata , Wundavalli Laxmi Tej , Chadda Rakesh Kumar , Satpathy Sidhartha , Tiwari Shraddhesh Kumar , Singh Sheetal , Singh Angel Rajan , Kumar Yogesh , Barre Vijay Prasad
Published: June 2022

Objectives:

We investigated the prevalence and risk factors of psychological distress, depression, anxiety, and posttraumatic stress disorder (PTSD) among COVID-19 inpatients during the initial and peak coronavirus phase in the largest public sector hospital in India.

Methods:

With a prospective observational design, we included 761 male and female COVID-19-hospitalized patients. The Self-Reporting Questionnaire, Primary Care PTSD Screen for DSM-5 (PC-PTSD-5), and Hospital Anxiety and Depression Scale were used.

Results:

Totally, 612 males and 149 females had a mean age of 36.68 ± 11.72 (mean ± standard deviation) years. The prevalences of psychological distress, anxiety, depression, and PTSD symptoms for the total sample were 12.6%, 19.2%, 19.2%, and 8.4%, respectively. Significant differences existed in the prevalence of psychological distress, anxiety, and depression between the initial coronavirus and peak coronavirus phase (13.7% vs. 11%, χ
2 = 9.37 p < 0.01), 22.1% vs. 14.7%, χ
2 = 23.04, p < 0.01), 21.04% vs. 16.3%, χ
2= 15.78, p < 0.01) but not in that of PTSD. Except for psychological distress, there was no gender difference. Coronavirus phase and employment status had significant interaction effects (p < 0.01) on anxiety and depression.

Conclusion:

Younger age, males in full-time jobs, in marital relationship, poor socioeconomic status were the risk factors, and comorbidity was the important risk factor. The result of this study could highlight the need for compulsory mental health screening and necessary medical/non-medical mental health support to all admitted patients.
Associations between Brain-derived Neurotrophic Factor Val66Met Polymorphism, Melancholic Feature, and Treatment Refractoriness in Patients with Treatment-Resistant Depression
Authors: Lin Yu-Shiou , Tsai Shih-Jen , Chen Mu-Hong
Published: June 2022

Background:

Brain-derived neurotrophic factor (BDNF) Val66Met polymorphism is related to the pathophysiology of treatment-resistant depression (TRD). But whether the Val66Met polymorphism is associated with the clinical manifestations of TRD (such as treatment refractoriness and melancholic and anxious distress features) remains unclear.

Methods:

Totally, 106 patients with TRD were genotyped for the BDNF Val66Met polymorphism. We used the 17-item Hamilton Depression Rating Scale evaluate depressive symptoms (melancholic and anxious distress features) and Maudsley Staging Method to measure treatment refractoriness. Logistic regression models were constructed to study the relationships among the Val66Met polymorphism, melancholic or anxious distress features, and treatment refractoriness.

Results:

The risk of Val/Met heterozygosity was associated with significantly greater melancholic features than that of Val/Val homozygosity (odds ratio [95% confidence interval (CI)] = (4.67 [1.16–14.24], p < 0.05). The melancholic feature in Val/Met heterozygosity was significantly higher to have the risk in treatment refractoriness than that of Val/Val homozygosity odd ratio (95% CI) = (6.42 [1.70–24.25], p < 0.05).

Conclusion:

Patients with TRD carrying the BDNF Val/Met genotype are more likely to present with melancholic feature, which is in turn related to high treatment refractoriness.