bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Heat Treatment on Chemical Plating of Ni-Cr-P on 65Mn Alloy Steel
Authors: Mei Shunqi , Yang Jinyu , Xu Bin , Chen Jia , Zhou Cong
Published: July 2024

The chemical plating of Ni-Cr-P significantly affects the improvement of the structure and characteristics of the metal surface. This study aimed to investigate the impact of various plating solution components and process parameters on the deposition rate and surface hardness of Ni-Cr-P coatings on 65Mn alloy steel. Additionally, the study examined the changes in coating properties resulting from different heat treatment temperatures. The specimens coated with Ni-Cr-P underwent heat treatment at temperatures of 180°C, 200°C, 220°C, and 240°C, respectively. The testing results indicate that the plating layer achieves its highest level of performance when subjected to a heat treatment temperature of 200°C. The heat-treated coating exhibits superior wear and corrosion resistance compared to the 65Mn steel substrate. Additionally, the coefficient of friction decreases from 0.5 to 0.4. The self-corrosion potential shifts positively from -569 mV to -389 mV, and the corrosion current decreases from 61.4 μA to 14.48 μA. Furthermore, the impedance improves from 234 Ω·cm2 to 3512 Ω·cm2.
Optimization Method of College Students' Entrepreneurial Path Based on Improved Multi-Objective Gray Wolf Algorithm
Authors: Qiu Baorong
Published: July 2024

The traditional entrepreneurial resource decision-making model that relies on empirical decision-making or simple template matching is difficult to adapt to the current complex social environment. Therefore, the multi-objective grey wolf algorithm (MOGWO) is used to solve the Pareto frontier of the problem model, replacing the optimal solution with the optimal solution set, and then selecting the optimal scheduling plan according to the actual situation, so as to make the decision-making plan more scientific and reasonable. In order to optimize this algorithm, two improvement strategies are proposed on the basis of analysing the movement of individual grey wolves. The research in this paper provides an important reference for the machine learning algorithm and the improved multi-objective grey wolf algorithm. The experimental results show that the MOGWO algorithm can overcome the shortcomings of the basic grey wolf algorithm (GWO) in terms of insufficient exploratory ability and local convergence, and has higher search efficiency, better optimality finding ability and stability.
Factors associated with delays in seeking treatment for leptospirosis: a prospective study in Monaragala District, Sri Lanka
Authors: Kumari Prabha , Vidanapathirana Janaki , Amarasekara Jagath , Karunanayaka Lilani
Published: July 2024

Introduction: Leptospirosis is a life-threatening zoonotic infection and delayed seeking treatment has been associated with complications and poor prognosis. The aim of this study was to analyze socio-demographic factors associated with delays in seeking treatment of patients with leptospirosis in Monaragala District.Methods: A hospital-based descriptive cross-sectional study was conducted to analyze the factors associated with delays in seeking treatment of patients with leptospirosis using 450 clinically diagnosed leptospirosis patients admitted to base and above hospitals in Monaragala district, using a pretested interviewer administered questionnaire among laboratory confirmed leptospirosis.Results: The incidence of leptospirosis in Monaragala district during the study period from the present study was 59.8 per 100,000 population.  Significant socio-demographic factors associate with delays in seeking treatment by laboratory confirmed patients in bi variable analysis was marital status (OR=1.85; CI=1.02-3.33), monthly income (OR=2.63; CI=1.02-7.14), time taken to reach a health care facility (OR=4.95; CI=1.48-16.62) and cost of travel (OR=2.73; CI=1.10-6.75), while age (OR=1.25; CI=0.68-2.28), sex (OR=1.44; CI=0.69-2.98), education (OR=1.5; CI=0.88-2.77), nationality (OR=1.64; CI=0.39-6.66), occupation (OR=1.01; CI=0.56-1.81), distance from home to a health care facility (OR=1.44; CI=0.79-2.59) and mode of travel  (OR=1.78; CI=0.92-3.57) was not significant. After adjusting for the effect of confounders, only the source of infection of leptospirosis showed a significant association (AOR=3.65; 95% CI=1.48-8.98) with delay in seeking treatment. Conclusions and Recommendations: Awareness of the source of the leptospirosis infection should be more emphasized and raising awareness is needed all year to prevent medical complications and deaths.
Prevalence of being ‘high-risk’ of hospitalization due to exacerbation among asthma patients aged ≥ 20 years in a district of Sri Lanka.
Authors: Punyadasa Dhanusha , Kumarapeli Vindya , Senaratne Wijith
Published: July 2024

Introduction: Hospitalizations due to exacerbated asthma remai ns high in Sri Lanka leaving a huge burden on the healthcare system. Identification of the burden of ‘high risk asthma  patients’ for hospitalization due to exacerbation is a cost-effective strategy for prioritizing management options. Objectives: To estimate the prevalence of ‘high-risk asthma patients ’ and selected risk predictors for hospitalization due to exacerbation among asthma patients aged ≥20 years in the district of  Gampaha, Sri Lanka Methods: A community-based descriptive cross-sectional study was  conducted among 1200 asthma patients aged ≥20 years, selected using a multistage sampling technique. The risk for hospi talization was assessed using a newly developed and validated risk prediction model. High-risk asthma patients were defi ned according to the cut-off value of the summary risk score of the model. Results: The prevalence of ‘high-risk asthma patients’ for hospitali zation due to exacerbation was 16.4% (95% CI: 14.2, 18.6). The prevalence of selected risk predictors: age ≥ 60 years 24.2%  (95% CI: 21.9, 26.7), poor educational attainment 67.3% (95% CI: 64.5, 70.0), having diabetes mellitus 18.8% (95%  CI: 16.5, 21.0), family history of asthma 41.3% (95% CI: 38.5, 44.2), ever smoked 12.2% (95% CI: 10.2, 14.1), ever int ubated or given intensive care 2.8% (95% CI: 1.8, 3.7), previous hospitalizations due to exacerbations 6.6% (95% CI: 5.1, 8.0) , having uncontrolled asthma 63.6% (95% CI: 60.8, 66.7), having symptomatic GORD 18% (95% CI: 15.7, 20.2) and ha ving body mass index (BMI) ≥ 25 kg/m2 36.3% (95% CI: 33.5, 39.0). Conclusions & Recommendations: A significant proportion of asthm a patients being at risk of hospitalization indicates the need to adopt cost-effective asthma management strategies to ac hieve better control of the disease. Prompt primary healthcare interventions are required to address modifiable risk predi ctors among asthma patients.
Novel mutations in LRRC23 cause asthenozoospermia in a nonconsanguineous family
Authors: Tang Song-Xi , Liu Si-Yu , Xiao Hong , Zhang Xin , Xiao Zhuang , Zhou Shan , Ding Yi-Lang , Yang Peng , Chen Qiang , Huang Hai-Lin , Chen Xi , Lin Xi , Zhou Hui-Liang , Liu Ming-Xi
Published: July 2024

The cause of asthenozoospermia (AZS) is not well understood because of its complexity and heterogeneity. Although some gene mutations have been identified as contributing factors, they are only responsible for a small number of cases. Radial spokes (RSs) are critical for adenosine triphosphate-driven flagellar beating and axoneme stability, which is essential for flagellum motility. In this study, we found novel compound heterozygous mutations in leucine-rich repeat-containing protein 23 (LRRC23; c.1018C>T: p.Q340X and c.881_897 Del: p.R295Gfs*32) in a proband from a nonconsanguineous family with AZS and male infertility. Diff-Quik staining and scanning electron microscopy revealed no abnormal sperm morphology. Western blotting and immunofluorescence staining showed that these mutations suppressed LRRC23 expression in sperm flagella. Additionally, transmission electron microscopy showed the absence of RS3 in sperm flagella, which disrupts stability of the radial spoke complex and impairs motility. Following in vitro fertilization and embryo transfer, the proband’s spouse achieved successful pregnancy and delivered a healthy baby. In conclusion, our study indicates that two novel mutations in LRRC23 are associated with AZS, but successful fertility outcomes can be achieved by in vitro fertilization-embryo transfer techniques.
Myxoid Fibroadenoma of the Breast: A Rare Histological Variant Case Report and Literature Review
Authors: Al-Darwish Abdullah S. , AlKhalidi Hisham , Akram Hammad , Alsaleh Nuha A.
Published: July 2024

Breast myxoid fibroadenoma (MFA) is a rare entity characterized by hypocellular myxoid stroma and is either sporadic or associated with the Carney complex, an inherited disorder caused by PRKAR1A-inactivating germline mutations. Here, we present the case of a 17-year-old girl who presented with a 3-cm mass in her left breast, suggestive of fibroadenoma. The mass was surgically excised, and histopathology revealed MFA. We sought to review breast MFA and compare it to conventional fibroadenoma.
Role of Peripheral Blood Smear in Rapid and Confirmative Pertussis Diagnosis: A Case Report
Authors: Alswailmi Omar , El Shahidy Samar
Published: July 2024

Whooping cough remains a global health problem, especially in infants who are too young to receive vaccination. Effective vaccination and high vaccination coverage limit the spread of the pathogen; however, the duration of protection is limited and lifelong booster vaccinations are recommended. The diagnosis of pertussis in early infancy may be missed due to overlap with other diseases such as bronchiolitis and bronchopneumonia associated with viral infections. Peripheral blood smear and real-time polymerase chain reaction are effective, rapid, and confirmatory tools in the diagnosis of pertussis. This is a case of a 2-month-old infant who presented to the emergency department with vomiting, coughing, and cyanosis during feeding with notable respiratory distress. A peripheral blood smear proved to be a good, rapid, reliable, and cost-effective tool for the initial preliminary pathognomonic characteristic of pertussis. Bordetella pertussis was detected and confirmed using real-time polymerase chain reaction based on a positive nasopharyngeal swab.
Toothpick Perforation of the Stomach Causing Gastro-hepatic Recess Abscess Treated by Laparoscopy: A Case Report and Review of the Literature
Authors: Alkhulaifi Sumaya A. , Saffaf Mohannad K. , Aldarwish Abdullah S. , Alhawassi Sami
Published: July 2024

Intraabdominal abscess due to gastric perforation by a foreign body is rare and may be fatal. In such cases, diagnosis is usually difficult due to non-specific symptoms and failure to remember the ingestion event by the patient as well as low clinical suspicion by the physician. This article demonstrates a rare case of gastro-hepatic recess abscess secondary to a toothpick perforating the lesser curvature of the stomach, diagnosed by a computed tomography scan. Laparoscopy was performed to drain the abscess and extract the foreign body without complications; the patient made a complete uncomplicated recovery. Our case highlighted the clinical challenges in the diagnosis and treatment of such rare cases.
Adaptation of a New Maternal Vaccination to the National Antenatal Care Program among Obstetricians and the Impact on the Patient’s Acceptance after the COVID-19 Pandemic
Authors: Alhudhud Majed , Marzoug Amani , Al Johani Hanan , Zainalabedin Noora , Aldulhum Anfal
Published: July 2024

The idea of maternal immunization has attracted significant interest in recent years; however, its adaptation has been slower than expected. The coronavirus disease 2019 (COVID-19) pandemic has shed light on the importance of the role of healthcare providers and the weight they place on society to encourage and introduce the concept of maternal immunization to a higher level.

Aim of the Study:

To examine the impact of the COVID-19 pandemic on physicians’ attitudes towards the immunization protocol of the adaptation of a newly introduced maternal immunization vaccine for tetanus, diphtheria and acellular pertussis (TDAP) to pregnant women between 27 and 36 weeks of gestation in the Kingdom of Saudi Arabia.

Method:

This was a retrospective observational study conducted between February 2021 and December 2021. Initially, the rate of antenatal utilization of the TDAP vaccine was assessed for 3 months by our booked patients. Another assessment of vaccine uptake was conducted after another 3 months, where more education and encouragement to healthcare providers was provided at the same hospital.

Results:

The initial adaptation of the TDAP vaccination by both healthcare providers and patients was below expectation [100 out of 716 patients (approximately 14%)]. After further education and involvement of the doctors in the national maternal vaccination program, the second round of assessment of 1928 patients showed that 749 patients received the vaccine with an uptake rate of 38.85%. These findings suggest the pivotal role of doctors during the COVID-19 pandemic in enhancing the adaptation of the new maternal vaccination. When more doctors were convinced of the importance of maternal immunization and offered it to their patients, there was a significant improvement in the utilization of the vaccine.
Adherent Right Atrial Cardiac Lipoma with Obstructive Symptoms: An Unusual Case Report
Authors: Pawar Ranjit , Konsam Rima , Garg Anurag , Dolas Ashish , Maheshwari Ankit , Bajaj Jayant
Published: July 2024

Benign cardiac tumors are rare, and cardiac lipomas constitute a small proportion. Since the majority of these lipomas vary in morphology, size, clinical presentation, and diagnosis, it is difficult to diagnose them until they become symptomatic. Management of large adherent cardiac lipomas presenting with obstructive symptoms can be challenging. It can be arduous to excise them completely, as they may involve vital structures and may sometimes need debulking only, leading to the possibility of recurring tumors. We report a case of a 60-year-old male with complaints of chest pain and dyspnea on exertion, diagnosed with a large right atrial mass, extensive involvement of the right atrial wall, and impingement on the tricuspid valve and was managed by surgical resection with a positive clinical result. This case highlights that obstructive or symptomatic cardiac lipomas can be effectively resected with favorable outcomes.
Sleep, Sleep Disorders, and Mental Health: A Narrative Review
Authors: Howarth Nathan E. , Miller Michelle A.
Published: July 2024

Evidence suggests that sleep is a vital component of physical and health well-being. However, while sleep problems are present in individuals with mental health problems such as depression, it has not been clear whether these conditions are independent or whether they might be causally related. Indeed, if sleep or sleep disorders predispose or modify onset and outcomes of mental health issues, treatment of these factors could be explored as new mental health prevention or treatment options. The aim of this review was to examine in detail the bidirectional relationship between sleep, sleep disorders, and mental and physical health and well-being. It has considered the evidence that sleep architecture disruption, occurring through both quantity, quality, and timing of sleep as well as through the presence of sleep disorders may both influence mental health and well-being as well as be disrupted by both physical and mental health conditions. Also, the review has explored the effects of sleep disruption on mental health and performance through fatigue, mood, and vigilance. The review has considered the bidirectionality between sleep, sleep disorders, and mental health to examine how these may lead to or exacerbate mental health disorders such as affective, anxiety, autism, depressive and schizophrenia disorders but also considers how these conditions can affect sleep. The review highlights that poor sleep or the presence of a sleep disorder can increase the risks from mental health conditions such as suicidality. Furthermore, mental health conditions such as anxiety and worry can cause racing or repetitive thoughts that can keep an individual awake, leading to shortened sleep. It is important that sleep and sleep disorders are considered potential modifiable factors that could improve mental health outcomes. The important interconnect between both physical and mental health and sleep, in patient evaluations, also needs to be considered as these may affect treatment pathways and patient outcomes. Further, more robust and perspective research is required to establish the triad relationship of physical, mental health, and sleep.
Early identification of people at high risk of oral cancer—A review of existing risk prediction models
Authors: Mocherla Monica , Krishnappa Pushpanjali
Published: July 2024

ABSTRACT

Prediction plays a ubiquitous role in cancer care. At every stage of the illness, the patient, the physician, and the family must make numerous decisions. Utilizing epidemiological, clinical, biological, lifestyle, and genetic factors, a cancer-specific risk assessment model calculates the likelihood of developing cancer. In India, oral cancer ranks as the fourth most common cancer, affecting nearly 3,000,00 individuals annually. Because it is in the premalignant stage, oral cancer is easily detectable in the oral cavity. Prompt identification of this lesion can result in better outcomes and a higher standard of living. Advanced statistical techniques have been used to develop prediction algorithms or risk scores that identify individuals with a high risk of developing oral cancer. With the aid of these risk assessment models, specific individuals can be screened to aid in the early detection of the disease, which may result in better outcomes and lifestyle modifications. Finding the best model among the current risk models for oral cancer may be aided by a thorough examination of all these models. Finding and assessing the risk model that primary care physicians can use and easily apply in clinical practice will be made easier with a succinct and straightforward comparison of the models. This review compares the current models to determine which has the best performance metrics, which could lead to a better understanding of the advantages and disadvantages of various risk prediction models of oral cancer.
Characterization of clinical trials in Ecuador and their association with disease burden: Are there research gaps?
Authors: Salgado Carla , Rivadeneira Josue , García Méndez Nayely , Manterola Carlos
Published: July 2024

ABSTRACT

This study offers a detailed analysis of clinical trials conducted in Ecuador from 2010 to 2022 to assess alignment with the country’s disease burden as indicated by the Global Burden of Disease study. Utilizing data from five registries, including ARCSA and Clinicaltrials.gov, we analyzed characteristics and coverage of 75 CTs after removing duplicates and ineligible studies. Findings reveal a 50% research gap across disease groups, with neoplasms being the only category matching disease burden. The scarcity of clinical research highlights the disparity between CTs and prevalent diseases such as cardiovascular and kidney diseases, diabetes, and other non-communicable conditions. Our results underscore the urgent need for increased clinical research investment addressing these critical health challenges in Ecuador.
Evaluation of a short-structured learner-centric training program on rational drug prescribing for medical interns: A quasi-experimental study
Authors: Nishanthi Anandabaskar , Mahendran Rajalakshmi , Ganapathy Kalaiselvan , Shanthi Manickam
Published: July 2024

ABSTRACT

Introduction:

Rational drug prescribing skills of interns remain bleak despite clinical pharmacology training during their second year, warranting the need for further training. This study was designed to evaluate the effectiveness of a short-structured learner-centric training program using the World Health Organization (WHO) guide to good prescribing in improving interns’ knowledge of rational drug use and their rational drug prescribing skills.

Methods:

This quasi-experimental study was implemented at a tertiary care teaching hospital in South India. We conducted a short-structured learner-centric training program on rational drug prescribing for interns in September 2022, using the WHO guide to good prescribing. The medical interns who consented to participate were included in the study. A pre-test was administered at the start of the training, followed by a post-test and feedback questions at the end of the program. Statistical tests used for quantitative data were the Wilcoxon signed-ranks test and McNemar’s Chi-square test. Qualitative data were analyzed using manual content analysis.

Results:

Of the 77 interns who attended the training program, 73 provided consent and completed both the pre-test and the post-test. Their mean age was 22 years, with a slight preponderance of female participants (53.4%). Overall, there was a statistically significant increase in the median (interquartile range) total scores from 52 (44.6 – 60) to 84 (70 – 88) after the training (P = 0.001), out of a maximum score of 93. Also, a significantly greater number of them wrote legible prescriptions (grade 4/excellent – 44 in pre-test vs 52 in post-test; P = 0.001) after the training.

Conclusion:

The short-structured learner-centric training program based on the WHO guide to good prescribing significantly improved the knowledge of rational drug use and rational drug prescribing skills among medical interns.
Empowering patients: Harnessing mnemonics for non-communicable disease management
Authors: Das Subhashree , Pal Debkumar , Kiran Swosti , RoyChowdhury Arka , Taywade Manish , Patro Binod Kumar
Published: July 2024

ABSTRACT

The epidemiological transition caused a significant non-communicable disease burden in all countries, including India. It can be tackled appropriately by integrating pharmacological and non-pharmacological interventions. The outcome of the disease or control status related to the disease condition depends significantly on patient education. Mnemonics is already an accepted way of improving cognition. The newer learning theories talk about different types of mnemonics and their role in imparting knowledge. We developed three mnemonics regarding essential information related to hypertension, diabetes mellitus, and obesity. It will help achieve better control status in those diseases by improving cognition.
Assessment of the services provided at the family medicine staff clinics in King Saud Medical City, Riyadh
Authors: ELNasieh Abdulrahman M. , Almesned Mohammed , Alomran Yousef A. , Alhadlaq Razan K. , Alhazmi Akram N. , Alhuwaidi Faisal , Hazazi Yahya O. , Alawami Hawra M. , Derani Maria A. , Ahmed Amani A.
Published: July 2024

ABSTRACT

Background:

Patient satisfaction is the subjective evaluation of a patient’s cognitive and emotional responses. This reflects their expectations regarding the ideal healthcare to be provided. This study aims to assess the satisfaction level of the attendees to the family medicine staff clinics at King Saud Medical City, Riyadh.

Materials and Methods:

A descriptive cross-sectional study recruited 378 participants. An adapted and piloted questionnaire was used to gather the data. The questionnaire enquires about the communication skills of the receptionist, the triage nurse, and the assigned physician. It included questions regarding the structure of the clinics.

Results:

Females represent the majority of about 255 (67.5%). About 2/3 of the respondents were within the age group of 18-34 years, 245 (64.8%). A high level of satisfaction was reported by the participants regarding the professionalism, kindness, interest of the staff member, and waiting time. Gender, marital status, and age group have no significant effect on the satisfaction level; the P value was uniformly more than 0.05.

Conclusion:

The result of this study identified high satisfaction responses regarding the communication skills of the receptionist, triage nurse, and physicians. The overall evaluation of the experience during staff clinic visits was satisfactory. Periodic evaluation of these attributes and other indicators that promote patient-centered care should be undertaken to improve the overall quality of care.
Adverse pregnancy outcomes with respect to treatment modalities in women with gestational diabetes mellitus at a rural tertiary care teaching hospital
Authors: Bailore Vidyasri , Basany Kalpana , Banda Maheshwari
Published: July 2024

ABSTRACT

Objectives:

To estimate the prevalence of gestational diabetes mellitus (GDM) and compare adverse pregnancy outcomes with respect to treatment modalities in a peri-urban teaching hospital in Telangana.

Methods:

A prospective study was conducted on GDM cases delivered from January 2019 to March 2020. GDM was diagnosed using a two-step procedure of screening using IADPSG criteria. Women diagnosed with GDM were divided into four groups – diet group, metformin group, metformin plus insulin group and insulin group based on the treatment modalities. Adverse pregnancy outcomes of the women managed with different treatment modalities were recorded.

Results:

Good glycaemic control (FBS, P = 0.04, 2 hrs PLBS, P = 0.01) was achieved in diet and metformin groups. Incidence of Gestational hypertension (P = 0.01) and preeclampsia (P = 0.01) were found to be higher in the insulin group when compared to the metformin and insulin group, metformin group and diet group. No difference was noted with respect to polyhydramnios, preterm birth, premature rupture of membranes, induction labour and caesarean delivery rates between the treatment groups. Apgar score at 5 min of <7 (P = 0.02), neonatal intensive care unit admissions for >24 hrs (P = 0.03) and neonatal hypoglycaemia (P = 0.01) were found to be higher in insulin-required groups. Rates of shoulder dystocia, stillbirth, early neonatal death within 1 week and respiratory distress did not vary significantly between the treatment groups.

Conclusion:

Universal screening of women for GDM and multidisciplinary management of women once diagnosed tend to lessen maternal and fetal complications. Metformin can be an effective, cheaper and non-invasive alternative to insulin in the management of GDM.
The investigation of the characteristics of inflammatory factors and cardiac enzymes in children with Covid-19 hospitalized with the initial manifestation of fever without other symptoms hazrat Ali-Asghar Hospital in Tehran in 2018–2019
Authors: Khosravi Shaqayeq , Dezfouli Seyedeh Mahsa Mahmoudinezhad , Nateghian Alireza , Khajoei Sanaz , Nabavi Seyed Salaheddin , Nasersaeid Mitra , Javid Asma , Hemmati Sahar
Published: July 2024

ABSTRACT

Introduction:

The prevalence of asymptomatic fever among children is high and may be confused with fever caused by corona. The purpose of this study is to investigate the characteristics of inflammatory factors and cardiac enzymes in children with Covid-19 hospitalized with the initial manifestation of fever without other symptoms.

Methods:

In this descriptive-analytical cross-sectional study, all 200 children with positive Covid-19 were hospitalized in Hazrat Ali-Asghar Hospital in Tehran between 2018 and 2019. For gathering data, clinical records and demographic information of patients were noted in the made-researcher’s checklist and the collected data were analyzed using SPSS software version 24

Results:

It was found that the relationship between the degrees of fever of the patients with the number of platelets was also inverse and significant. In addition, there was a significant relationship between the degree of fever of the patients and the LDH number, ALT number and segment and lymphocyte percentage of the patients. In addition, it was found that the passing time of fever has a significant relationship with ALT and ESR in such a way that with the passage of time, there is a higher probability of seeing an increase in ESR, but in the case of ALT, it increases in a shorter period of time and decreases more after the passage of time.

Conclusion:

According to the results of the present study, in case of suspected to Covid and fever in patients, along with other tests, AST, ALT, D-dimer, and CKMB can be used to diagnose Covid, in such a way that in Covid, AST is probably normal and mentioned other tests can be higher than normal.
Prevalence and correlates of depression, anxiety, and stress among adolescents in urban and rural areas of Mysuru, South India
Authors: Prakash G. Hari , Kumar D. Sunil , Arun Vanishri , Hegde Saurish , Yadav Deepika , Gopi Arun
Published: July 2024

ABSTRACT

Background:

Adolescence, a volatile period of growth between the ages of 10 and 19, is associated with increased vulnerability to mental health problems. Factors such as academic pressure can contribute to these challenges.

Objectives:

The current study aimed to evaluate the factors and prevalence of depression, anxiety, and stress among adolescents in the urban and rural areas of Mysuru district.

Materials and Methods:

A cross-sectional study was conducted in private high schools in both urban and rural regions. Prior permission and informed consent were obtained from participants and their legal guardians aged 18 years and older.

Results:

The gender distribution in urban areas was 60.2% female and 39.8% male, while in rural areas, it was 51% male and 49% female. The prevalence of depression was higher in rural (39.3%) than in urban areas (24.2%), while anxiety was more prevalent in urban (50.6%) than in rural areas (49%). Stress was also more common in rural (16.6%) than urban adolescents (14.6%). Factors significantly associated with mental health outcomes included monthly family income, parenting practices, academic pressures, and self-esteem. Key needs identified were mobile mental health applications, online counseling services, and access to school counselors.

Conclusion:

This study provides insights into the prevalence and correlates of common mental health issues among adolescents in this region of South India. The findings emphasize the necessity of providing mobile applications and offline counseling services to effectively support and meet the needs of adolescents in these settings.
Awareness, knowledge and challenges faced by beneficiaries and non-beneficiaries of Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana with special reference to eyecare in three districts of Uttar Pradesh state: A cross-sectional study
Authors: Sabherwal Shalinder , Sood Ishaana , Khurana Ashi , Chauhan Lokesh , Saini Shivani , Shroff Kamna , Majumdar Atanu
Published: July 2024

ABSTRACT

Purpose:

The aim was to analyse the knowledge and awareness regarding Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) within the operational districts of two high-volume non-profit eye organisations in Uttar Pradesh. Challenges faced by beneficiaries and non-beneficiaries are also examined.

Methods:

A prospective cross-sectional survey from November 2021 to April 2022 was conducted across operational districts of organisations A and B. Cluster sampling was used to select participants in randomly selected villages with 200 or more households, within 10–15 km of existing vision centres. A semi-structured interview schedule was used to collect data. The means of AB-PMJAY indicators were estimated. Awareness was estimated as a summed score. Multivariate logistic regression was applied to check the effects of the socio-economic and socio-demographic factors on the awareness of AB-PMJAY for both organisations separately and together.

Results:

A total of 1151 participants were interviewed: 52.9% from the catchment area of organisation A and 47.1% from that of organisation B. From the catchment of organisations A and B, 82.6% and 22.9% participants, respectively, had heard of the scheme, mostly from family and friends. Whereas 43% interviewees from the catchment area of organisation A and 8.5% from that of organisation B had knowledge about at least one topic, only 8.5% and 2.8%, respectively, were knowledgeable about all topics. Village effect was found to be significant for most of the knowledge and awareness indicators in both catchments. Only 37.8% and 20.2% of the catchment from organisations A and B, respectively, were AB-PMJAY cardholders. Of the services availed, 50% were cataract surgery. Almost 40% of the applicants faced some challenges while securing the AB-PMJAY card and 9% while using the AB-PMJAY card. Family income was found to be the only common predictor of knowledge at both locations.

Conclusion:

Varied awareness and limited knowledge in catchment villages put the onus on community eyecare organisations to spread awareness in their catchment, which may increase the uptake and utilisation of the scheme.
Post-vaccine immune status surveillance of Covishield vaccine and associated AEFI in previously SARS-Cov-2 infected seropositive and seronegative population in Assam
Authors: Gogoi Gayatri , Gogoi Gourangie , Mahanta Bhupendra N. , Borkakoty Biswajyoti , Borpujari Porikhit , Ahmed Tanzil S. , Neog Rahul , Roy Sunia , Medhi Mithu
Published: July 2024

ABSTRACT

Background:

COVID-19 an infectious disease caused by the SARS-CoV-2 virus, started in late 2019 and became a pandemic within a short period. To respond to the pandemic vaccines like Covishield, Covaxin, Sputnik V, Covovax, etc., were developed rapidly. However, there were raising concerns about the development of immunity as well as adverse events following vaccination.

Objectives:

To compare anti-SARS-CoV-2 IgG antibody titres at different time-points post-vaccination between baseline seropositive and seronegative groups and to assess the adverse events following the 1st dose of Covishield vaccine among adult beneficiaries attending vaccination centre in a tertiary care hospital of Upper Assam.

Materials and Methods:

Prospective Cohort study was conducted from July 2021 to June 2022 among adult beneficiaries receiving the Covishield vaccine. The oral questionnaire was used incorporating socio-demographic variables, and clinical profiles including co-morbidities and adverse events following vaccination. Data analysis was done by Microsoft Excel and SPSS

Results:

Out of a total of 146 study participants, IgG estimation showed 61% as seropositive and the rest as seronegative. A total of 55.40% had minor adverse events, majority of them were females (53.08%) and 88.80% belonged to 18–59 years compared to 11.11% above 60 years of age. The majority (71.60%) did not have any co-morbidities and the major AEFI was NIL among the study participants. The study group had 61% seropositive previously infected.

Conclusion:

Covishield vaccination induces an immune response and 90% seroconversion is achieved after 1st dose (booster dose). Antibody titres of the seropositive group by natural infection of SARS-CoV-2 were higher than seronegative cohort seroconverted by vaccination. The AEFI observed were minor and can be commented as safer.
Intravenous levetiracetam versus intravenous phenytoin as second Line treatment in pediatric convulsive status epilepticus- open label randomized controlled trial
Authors: Kartek Mamum , Kannan Abinaya , Anand Varun , Sahoo Manas R.
Published: July 2024

ABSTRACT

Background:

Benzodiazepines (BZDs) are recommended as the initial therapy of choice in status epilepticus (SE). The age-old second-line treatment for BZD refractory convulsive SE is intravenous phenytoin (PHT) based predominantly on nonrandomized clinical trial data. We did this study to compare the efficacy and safety of intravenous levetiracetam (LEV) and PHT as second-line antiseizure medication (ASM) for children with SE.

Methodology:

A prospective, randomized controlled, open-label study was conducted in children 3 months to 15 years of age with SE in Pediatric Emergency. A total of 41 children were randomly allocated to either group 1 (Levetiracetam) or group 2 (Phenytoin) on the basis of computer-generated randomization. Children who were already on antiseizure medications, either LEV or PHT, or receiving these drugs outside for SE were excluded. Data analysis was done by SPSS V25

Results:

The most common age group presenting with SE was 12 months to 5 years. Clinical cessation of seizure 5 minutes after the completion of drugs was 85% (17/20) in Levetiracetam group and 90.5% (19/21) in Phenytoin group. Recurrence of seizure within 24 hours was noted in 35% (7/20) in Levetiracetam group and 38.1% (8/21) in Phenytoin group. There was no statistically significant difference noted in both the groups in terms of seizure cessation, adverse events, and recurrence.

Conclusion:

The efficacy and safety of LEV were found to be comparable to those of PHT in controlling seizure as second-line ASM in SE.
Prevalence of unintentional injuries and its risk factors among under-five children residing in urban poor resettlements in Rishikesh
Authors: Ajun UN , Sinha Smita , Saxena Vartika , Sriram Shyamkumar , Hariprasad  , Salam Ajmal
Published: July 2024

ABSTRACT

Background:

A community-based study on childhood injuries would provide valuable information on the epidemiology of injuries to undertake appropriate preventive measures. Therefore, the current study was conducted in urban poor resettlements of Rishikesh to estimate the prevalence of unintentional injuries and to document the sociodemographic risk factors associated with unintentional injuries among under-five children.

Aims and Objectives:

Estimation of the prevalence of unintentional injuries and their risk factors among under-five children of urban poor resettlements in Rishikesh.

Materials and Methods:

A community-based cross-sectional study was conducted in urban poor resettlement areas of Rishikesh for a period of 1 year. It included 300 children selected using a simple random sampling technique to collect data on injury status.

Results:

The prevalence of unintentional injury among study participants was 16%. Falls were (64.6%) the major cause of injury, followed by dog bites (12.5%). The major sites of the injury were the head (25%), face (22.9%), upper limb (27.1%), and lower limb (18.8%).75% of the injuries happened at home. 66% of injuries happened when the child was playing alone or playing with peers. About 20.8% of injuries were bruises or superficial injuries. 39.6% of children had cut/bite/open wound injuries. Fractures happened in 14.6% of injured children. More than half (54.2%) of children did not develop any physical disability due to injury. Among children who developed a disability, more than 90% are able to recover completely. The majority of study participants were taken to nearby hospitals (66.6%) or health centers (10.4%). Only one of them went to a traditional bone setter, rest all visited either a general practitioner or pharmacy. The median expenditure for the treatment of the injured child was INR 425 (175-2750). The age of the child and unintentional injury showed a statistically significant association.

Conclusion:

The prevalence of the injury was 16% (12–20.7%) similar to a number of similar studies. Although the majority of the injuries were mild in severity, injuries have also contributed to temporary disability among children and have led to loss of school days.
Handgrip strength, and erectile dysfunction among men with metabolic syndrome attending an institutional primary care clinic in Malaysia: A cross-sectional study
Authors: Kadir Nik A. Nik Abdul , Abdul-Razak Suraya , Daher Aqil M. , Nasir Nafiza Mat
Published: July 2024

ABSTRACT

Background:

Erectile dysfunction (ED) is an independent predictor for cardiovascular diseases (CVD). The prevalence increases with age, but little is known about the relationship between handgrip strength (HGS) and ED, especially among men with a high risk of CVD. This study aimed to determine the prevalence of ED among men aged ≥40 years with metabolic syndrome (MetS) and its association with HGS.

Materials and Methods:

A cross-sectional study at an institutional primary care clinic in Malaysia was conducted between June 2021 and October 2021. HGS and erectile function were assessed using a hand dynamometer and International Index of Erectile Function (IIEF-5) questionnaire, respectively. Multiple logistic regression analyses were performed to determine the association between sociodemographics, clinical characteristics, and HGS with ED.

Results:

A total of 334 participants were recruited. The prevalence of ED was 79% (95% confidence interval [CI]: 0.75-0.84). ED was associated with elderly aged ≥60 years (odds ratio [OR] 3.27, 95%CI: 1.60-6.69), low HGS (OR 15.34, 95%CI: 5.64-41.81) and high total cholesterol (OR 0.36, 95%CI: 0.16-0.78).

Conclusion:

In conclusion, age above 60 years and those with low HGS are at higher risk of ED. Thus, robust screening of ED among men with MetS and improving muscle strength and physical fitness may be warranted.
Comparative study of spirometry parameters in chronic smokers with and without Type 2 Diabetes Mellitus (T2DM)
Authors: Vaishnav Bhumika T. , Gangani Seherish K. , Anand Shubhangi , Pailla Ruchitha , Mondkar Saish
Published: July 2024

ABSTRACT

Aim:

The study aimed to know the changes in spirometry parameters in chronic smokers and evaluate how the presence of type 2 diabetes mellitus (T2DM) affects their lung function.

Materials and Methods:

A prospective, cross-sectional, observational study was done for 12 months at a tertiary care hospital in the western region of Maharashtra State in India. Two groups of patients and one group of healthy volunteers aged 18 years or more were studied (with 50 in each group, n = 150). Group A consisted of smokers with T2DM, Group B- smokers without T2DM and Group 3- healthy controls who were non-smokers and non-diabetic. Spirometry was done for the following parameters: forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), FEV1/FVC ratio, and peak expiratory flow (PEF) and results compared between the three groups.

Results:

The mean age of the participants was 51.13 ± 10.74 years. There were 137 (91.3%) males and 13 (8.6%) females. Among the enrolled subjects, 66% had smoked for more than ten years. All spirometry parameters were significantly different across all three groups. When the spirometry parameters were compared between smokers with and without T2DM, all the parameters were significantly decreased (P < 0.05). FEV1 and FEV1/FVC were significantly decreased in T2DM patients with HbA1c >7%.

Conclusion:

The presence of T2DM in smokers significantly affects their pulmonary function tests. Uncontrolled T2DM (HbA1c >7%) can result in increased abnormality in the spirometry parameters studied. Thus, adequate glycemic control and cessation of smoking can be beneficial for the improvement of lung functions in smokers.
Characterization and assessment of exposure risks of healthcare personnel during the COVID-19 pandemic
Authors: Das Arghya , Garg Rahul , Singh Ravindra , Banerjee Tuhina
Published: July 2024

ABSTRACT

Introduction:

Healthcare personnel have the right to decent, healthy, and safe working conditions during COVID-19. Despite our best efforts to safeguard them against SARS-CoV-2 infection, a substantially large number of healthcare personnel fell ill and succumbed to COVID-19. This study aimed to characterize the SARS-CoV-2 exposures among healthcare personnel and determine the risk level of those events, thereby identifying and focusing on the key areas that influence workplace safety.

Materials and Methods:

A pre-tested questionnaire was used to collect data from healthcare personnel on the type of exposure, place, and use of preventive measures, along with demographic and occupational data. Exposure events were categorized into low, moderate, and high-risk by using a risk categorization protocol.

Results:

Doctors were primarily found to be involved in the aerosol-generating procedure, which had 94 times higher odds (95% CI: 43.9926–201.17) for high-risk exposures than other activities. In contrast, nurses were more likely to experience close-contact exposures (OR: 2.77, 95% CI: 1.44–5.33). Both critical care units and operation theaters were identified to have higher odds (OR: 2.34, 95% CI: 1.33–4.23 and OR: 2.31; 95% CI: 0.99–5.42, respectively) than the wards for high-risk exposures. Use of personal protective equipment was poor, with breaches reported in 10.2% of all exposure events. The lacunae in practice were addressed by repeated training and counseling and by ensuring the adequacy of resources in required areas.

Conclusions:

The assessment was beneficial for safeguarding healthcare personnel and assuring a safer workplace during the early phase of the COVID-19 pandemic.
Public health preparedness, syndromic surveillance, and response during the largest religious gathering at the Catholic pilgrimage center of Velankanni in South India: 2016
Authors: Ponnaiah Manickam , Virumbi Viduthalai , Sharma Upasana , Muthappan Sendhilkumar , Parasuraman Ganeshkumar , Balasubramanian Premkumar , Venkatachalam Vijayalakshmi , Karumanagoundar Kolandaswamy
Published: July 2024

ABSTRACT

Background:

The dynamicity and mobility of the population in a mass gathering setting pose a challenge to traditional disease surveillance methods and strain the local health services. Velankanni is one of the most sacred Christian pilgrimage places located in Nagapattinam, Tamil Nadu, India. We participated in the Velankanni festival to describe the public health preparedness, surveillance, and response activities carried out during the festival.

Methods:

This was a cross-sectional study. We reviewed the national and international guidelines and published literature and discussed with the key stakeholders. We developed a checklist to observe public health preparedness activities. We facilitated the staff and monitored the activities by the implementers. We established the syndromic surveillance in the designated locations of the event and used tracker software to capture the data. Emergency medical teams were formed with trained health personnel to respond to medical emergencies.

Results:

The team monitored all the public health activities. There are 59 primary care public health facilities and nine ambulatory Mobile Medical Units, with 160 medical officers available at the site. Of the 16,169 persons who attended the medical camps, 9863 (61%) were males and 8408 (52%) were aged 15–44. Acute diarrheal disease was the most frequent of the reported syndromes, followed by injuries, acute febrile illness, and animal bites.

Conclusions:

There was no outbreak of any disease either identified or reported. Our findings suggest that risk assessments should be used, and establishing an Incident Command Center is vital for executing command and control mechanisms during mass gatherings.
Predictors of mortality in scrub typhus: A hospital-based study
Authors: Goyal Chandan , Ahmad Sohaib , Chauhan Rishabh , Tewatia Pavit
Published: July 2024

ABSTRACT

Purpose:

Scrub typhus is a potentially life-threatening febrile illness associated with serious complications viz. pneumonia, acute respiratory distress syndrome, hepatic failure, acute kidney injury, encephalitis, and shock often culminating in mortality. We aimed to identify the predictors of mortality in scrub typhus.

Methods:

This prospective observational study was conducted in a tertiary referral hospital of the north Indian state of Uttarakhand on in-patients of scrub typhus hospitalized over 1 year

Results:

Of the 109 cases studied (54.1% males), 44% were aged <40 years. Fever (95.4%), loss of appetite (55.9%), myalgia (47.7%), pallor (40.3%), hepatomegaly (27.5%), eschar (17.4%), and splenomegaly (13.7%) were the main clinical features. Hepatic transaminitis (69.7%), renal insufficiency (44.0%), respiratory failure (37.6%), shock (33.9%), central nervous system (CNS) involvement (21.1%), and severe anemia (7.3%) were the major complications at presentations. Intensive care and mechanical ventilation were utilized in 33.9% and 15.5% of cases, respectively. Multivariate logistic regression suggested renal insufficiency, CNS involvement, shock, severe anemia, and mechanical ventilation independently associated with death.

Conclusion:

Respiratory failure, renal insufficiency and neurological involvement, mechanical ventilation, shock, and severe anemia at presentation predict mortality in scrub typhus.