bluuebunny/crossref_metadata_2025 huggingface dataset:
Trichoscopy and LC-OCT findings in sonidegib-induced alopecia in patients with advanced basal cell carcinoma
Authors: Ciobotariu Irina , Palmisano Gerardo , Caldarola Giacomo , Piccerillo Alfredo , Tassone Francesco , Cappilli Simone , Di Stefani Alessandro , Peris Ketty
Published: September 2024

Sonidegib is a Hedgehog pathway inhibitor (HHIs) used as first-line systemic treatment for patients with advanced basal cell carcinoma (aBCC). Alopecia is reported as a frequent adverse event (AE), occurring in 49% of patients. Forty-five patients with aBCC were treated with sonidegib between December 2022 and December 2023; among them, 11/45 patients developed alopecia. Trichoscopic features included yellow dots, black dots, exclamation mark hairs, and broken hairs. Upon LC-OCT examination, yellow dots were seen as dilated follicular dark spaces containing malted nonhomogeneous material and outlined by bright collarets; black dots corresponded to normal-sized follicular ostia filled with bright, homogeneous material and cadaverized hair; exclamation mark hairs were short dark dysmorphic hairs with a different size of proximal and distal end and broken hairs were short dysmorphic hairs. LC-OCT may provide additional insights of early signs and clinical evolution of sonidegib-induced alopecia in patients with aBCC.
The principles of the scientific method: from Hippocrates to Claude Bernard
Authors: Cappelletti Vincenzo
Published: September 2024

Methodological, epistemological, anthropological discourse has always existed in medicine and must have the virtue of being brief and aiming at the self-awareness of the method. The latter is irreplaceable for physicians who, as managers of experience, must then create their own style of thinking and conduct towards theoretical and practical problems.
Scientific methodology in medicine: possible deviations
Authors: Federspiel Giovanni
Published: September 2024

Not available.
For a philosophy of medicine
Authors: Cattorini Paolo
Published: September 2024

Not available.
Morality and law in the face of in vitro fertilisation
Authors: Caffara Carlo
Published: September 2024

Not available.
A novel mutation in a case of XY DSD with progressive virilization at puberty
Authors: Wadhwa Jyoti , Namburi Divyasri , Kunnuru Sumana , Kauloorkar Bhoomika , Anne Beatrice
Published: September 2024

We present a case of ambiguous genitalia, not being evaluated at birth and presenting with progressive virilization at puberty. The usual set of differential diagnoses in a patient with the presence of bilateral gonads and progressive virilization includes five alpha-reductase deficiency, 17 beta-hydroxysteroid dehydrogenase 3 deficiency, partial androgen insensitivity syndrome, and partial gonadal dysgenesis. Human chorionic gonadotropin (HCG) stimulation test performed on our patient suggested the presence of five alpha-reductase deficiency with a testosterone/dihydrotestosterone (T/DHT) ratio of 32; however, the genetic analysis revealed the presence of autosomal dominant, heterozygous pathogenic mutation in NR5A1 gene Exon 5 with autosomal dominant heterozygous mutation in DHX37 gene Exon 18. While NR5A1 mutation is a known cause of testicular dysgenesis; DHX37 is a novel gene associated with ambiguous genitalia and there are only a few case reports presenting with a combined mutation. The patient exhibited a high T/DHT ratio on HCG stimulation and also exhibited poor virilization despite being on testosterone therapy for 2 years. Whether these mutations affect five alpha-reductase enzymes inhibiting testosterone to dihydrotestosterone conversion is unknown.
Understanding sexual differentiation: A case series on persistent Mullerian duct syndrome
Authors: Stephen Samuel Frank
Published: September 2024

Introduction:

Persistent Mullerian duct syndrome (PMDS) is a rare form of sexual differentiation, where the failure to produce functional anti-Mullerian hormone (AMH) or a defective type II AMH receptor (AMHRII) leads to the persistence of Mullerian ducts in otherwise normal males.

Materials and Methods:

Cytogenetic testing was done on lymphocyte cultures from samples of peripheral blood. G-banding was done, and cultures were analyzed using the Ikaros software to visualize metaphase chromosomes and reported as per the International System for Human Cytogenetic Nomenclature.

Results:

A series of eight patients with PMDS with 46 XY on karyotyping were identified between 2001 and 2016 from 22 days to 24 years of age. PMDS was diagnosed incidentally through clinical pointers such as inguinal hernia (n = 5, 62.5%) and undescended testes (n = 5, 62.5%). Male type II (n = 4, 50%) was the most common morphological type. Two of the older patients aged 4 and 24 years had intra-tubular germ cell neoplasia and mixed germ cell tumor, respectively.

Conclusion:

Knowledge of the presenting features, morphology, and histopathology of PMDS enables a better understanding of the intricacies of normal and abnormal sexual differentiation.
Anti-GAD-65 antibody positivity in an 11-year-old boy with diabetes and pancreatic calcification: Exploring the role of autoimmunity in type 3c diabetes
Authors: Chatterjee Subhankar , Sarkar Debalina , Sinha Pallab , Bhattacharya Ranita , Ranjan Prabhat , Bhattacharjee Rana , Sinha Anirban , Maiti Animesh
Published: September 2024

Chronic calcific pancreatitis in children is rare, and type 3c diabetes (T3cD) with extensive pancreatic calcification in the first decade of life is even rarer. We describe a case of T3cD in an 11-year-old boy who presented with hyperglycemic osmotic symptoms. Initial pancreatic autoantibody testing was positive for high titer, creating a diagnostic dilemma. This article examines the role of autoimmunity in the pathogenesis of post-pancreatitis diabetes and emphasizes the importance of performing pancreatic imaging before, or in addition to, carrying out pancreatic autoantibody tests, even in pediatric diabetes cases. This unique case also highlights the shortcomings in the current diagnostic criteria for T3cD.
A Study Comparing Pediatric Caudal Epidural Analgesia Using Ropivacaine Alone and in Combination with Dexamethasone or Magnesium Sulfate in Infraumbilical Surgeries
Authors: Chatha Prableen Kaur , Joshi Chhaya , Padara Basavaraj , Koppal Ramesh , Hulakund S. Y.
Published: September 2024

Background and Aims:

Caudal block is a commonly used regional anesthesia technique providing perioperative analgesia for young children with the disadvantage of a short duration of action after a single shot. Dexamethasone and magnesium as adjuvants could offer significant analgesic benefits. We compared the analgesic effects of dexamethasone or magnesium added to caudal ropivacaine in pediatric patients undergoing infraumbilical surgery.

Methods:

A total of 75 children (aged 6 months–9 years) were randomly assigned to three groups in a double-blinded manner. Group DR received ropivacaine 0.2% 1.5 mL/kg combined with dexamethasone 0.1 mg/kg in 0.9% normal saline, Group MR received magnesium 50 mg in 0.9% normal saline with 0.2% ropivacaine 1.5 mL/kg, and Group R received 1.5 mL/kg of 0.2% ropivacaine. The primary objective was the duration of analgesia. The secondary objectives were the duration of motor blockade, hemodynamic changes such as heart rate, mean arterial pressure, and adverse effects. One-way analysis of variance, Kruskal–Wallis, and Chi-square tests were applied for statistical analysis.

Results:

The groups were comparable with respect to age, sex, and duration of surgery. The hemodynamic parameters were comparable among all groups intraoperatively and postoperatively. The mean duration of analgesia in Group DR was 1216.6 ± 153.5 min, Group MR was 542.3 ± 111.7 min, and Group R was 325.8 ± 37.1 min (P < 0.001). The duration of motor block and adverse effects was comparable among all groups.

Conclusion:

The addition of dexamethasone to caudal ropivacaine significantly prolonged the duration of postoperative analgesia compared to magnesium as an adjuvant.
Low-temperature Radiofrequency Lesioning for Glossopharyngeal Neuralgia
Authors: Chakravarty Ashish
Published: September 2024

Glossopharyngeal neuralgia (GPN) is a rare craniofacial disorder of the ninth cranial nerve characterized by severe neuralgic pain occurring along the distribution of the glossopharyngeal nerve. Antiepileptics such as carbamazepine and oxcarbazepine form the frontline treatment for the condition. Percutaneous radiofrequency thermoablation (PRT) is a minimally invasive neuroablative procedure which has shown good results in medically refractory cases. Currently, for the management of GPN pulsed radiofrequency treatment is preferred over PRT as it offers neuromodulatory rather than neurodestructive effects. Low-temperature PRT has shown to preserve the neuronal architecture and maintain the potential for nerve repair. This modality can be a useful alternative for the management of GPN.
Efficacy and Tolerability of Rizatriptan and Sumatriptan in Acute Migraine in Indian Patients: A Comparison between Two Frontiers
Authors: Kushwah Anjali , Shinde Meghna
Published: September 2024

Introduction:

Migraine is a debilitating, neurological disorder, characterized by episodes of ipsilateral headache, often associated with symptoms such as nausea, vomiting, vertigo, and other sensory symptoms. The role of commonly used triptans (5 HT1B/1D agonists) – rizatriptan and sumatriptan – is very scarcely explored in Indian population with migraine. Thus, this study was done to assess the efficacy and tolerability of 10 mg oral rizatriptan versus 50 mg oral sumatriptan for the treatment of acute moderate-to-severe migraine.

Materials and Methods:

A total of 113 migraine patients attending the neurology outpatient department were enrolled in our study. The efficacy parameters included in our study were pain relief, pain free at 2 h, and sustained pain-free response in both the groups. Adverse drug reactions, if any, were recorded as a measure of tolerability.

Results:

Overall rizatriptan showed superior efficacy in terms of pain relief at 2 h (71.92% vs. 60.71%) with a statistically significant difference at 1.5 h (P = 0.0084) and 2 h (P = 0.0099) and complete abolition of headache (pain free) at all the four time points spaced 30 min apart (43.85% vs. 26.78%). Twenty-four hours sustained pain-free response was also more in the rizatriptan group (63.42% vs. 47.06%) as compared to that in the sumatriptan group. The frequency of adverse effects was seen more in the sumatriptan group (83.89%) than those receiving rizatriptan (49.68%).

Conclusions:

Rizatriptan 10 mg was found to be more efficacious and tolerable as compared to sumatriptan 50 mg.
Occupational Exposure to Artificial Ultraviolet Radiation from Welding in Australia
Authors: Fritschi Lin , Driscoll Tim , Nguyen Ha , Carey Renee N.
Published: September 2024

Background:

Artificial ultraviolet radiation (UVR) is produced during welding and can cause damage to both the eyes (ocular) and the skin (dermal). We aimed to investigate the protection used by welders to reduce their exposure to ocular and dermal UVR.

Methods:

We conducted a cross-sectional online survey in Australia that asked welders about their welding tasks and the control measures they used to protect against UVR exposure.

Results:

There were 634 respondents, of whom 411 undertook welding themselves, 36 supervised other welders, and 130 both supervised and welded. Dermal UVR exposure occurred in 7.8% of welders and 14.4% of supervisors, whereas ocular UVR exposure occurred in 16.8% of welders and 33.1% of supervisors. The use of personal control measures was much lower among supervisors than welders; however, the presence of warning signs or barriers was reported more often by supervisors.

Conclusions:

Despite the well-known acute and chronic effects of exposure to UVR from welding, there are still many welders and supervisors who do not use adequate protection.
Investigating the effect of teaching assistants (TA) on the level of satisfaction of undergraduate anesthesia students with training in the internship unit
Authors: Maroufi Shahnam Sedigh , Babajani Alireza , Taghizadeh Shaqayeq , Gholamzadeh Mohammad , Mousavibaghi Seyyedeh Haniyeh , Azizi Darbandi Mohammad Mehdi
Published: September 2024

BACKGROUND:

Clinical training in the internship unit is the heart of professional training, and teaching assistants can be considered an essential component in the clinical training program. Therefore the present study was conducted to investigate the effect of teaching assistants (TA) on the degree of satisfaction of undergraduate students of Anesthesia with training in the internship unit.

MATERIALS AND METHODS:

This descriptive-cross-sectional study was conducted in 2023. The sample of the research was the Anesthesia undergraduate students who were included by census method. First, a questionnaire was designed and psychometric to check the level of satisfaction (ICC = 0.992). then it was given to students who had completed at least 1 unit of internship with TAs. The results were analyzed with SPSS software Version 22 and one-way-ANOVA and independent t-statistical tests (P Value <0.05).

RESULTS:

A total of 60 questionnaires were completed and analyzed. Among them, 39 were female students and 21 were male students who were studying in the 4th, 6th, and 8th semesters. the level of satisfaction of Anesthesia students with training by teaching assistants is at a favorable level with an average of 61.06. There was no statistically significant difference between the variables of gender and academic semester with the degree of satisfaction. 6th-semester students had the highest level of satisfaction with an average satisfaction of 61.63.

CONCLUSION:

According to the results, Anesthesia undergraduate students are satisfied with the clinical training by TAs, at a favorable and high level. Therefore it is recommended that teaching assistants in education be used to improve students’ satisfaction and learning levels.
The effect of self-regulatory program based on Leventhal’s model on the illness perception and resilience of people with multiple sclerosis
Authors: Karampour Sanaz , Masoudi Reza , Raeisi Hadi , Etemadifar Shahram , Bayati Asghar
Published: September 2024

BACKGROUNDS:

The study at hand seeks to examine the influence of a self-regulation program rooted in Leventhal’s model on the illness perception and resilience of patients with multiple sclerosis (MS). By exploring the impact of Leventhal’s model-based interventions, healthcare professionals can enhance their ability to effectively address the challenges associated with this disease. In addition, this research endeavor can serve as a valuable resource for the development of nursing knowledge in the realm of MS patient care.

MATERIALS AND METHODS:

This study was a semiexperimental two-group study. The statistical population of the study consisted of all patients with RRMS-type MS in Shahrekord city. Ninety patients were initially selected through convenience sampling and then randomly allocated into intervention and control groups (each with 45 participants) using the Random Allocation software. Before the intervention program was provided, the patients’ perception of the disease and their resilience were assessed using the Illness Perception Questionnaire-Revised (IPQ-R) and Connor-Davidson Resilience Scale (CD-RISC), respectively.

RESULTS:

The intervention group had a mean age of 34.78 ± 4.27 years, whereas the control group had a mean age of 34.51 ± 4.43 years. After the Leventhal self-regulatory model, a statistically significant difference was observed in the mean scores of illness perception and the mean score of resilience between the intervention and control groups, both immediately and two months later, implying that the intervention group had a higher score in illness perception and the mean score of resilience (P value < 0.001).

CONCLUSION:

Our study indicated that the Leventhal self-regulatory model had a significant positive effect on improving both illness perception and resilience in individuals with MS. Therefore, enhancing these factors among MS patients can have a tremendously positive impact on their psychological health, quality of life, and treatment adherence.
Prevalence of common mental disorders and perspective toward mental health in an urban resettlement colony of Delhi, India: A mixed-method study
Authors: Singh Gaurav , Patra Somdatta , Upadhyay Madhu K. , Srivastava Shruti
Published: September 2024

BACKGROUND:

The paucity of community-based research and misunderstandings surrounding mental illness in low- and middle-income countries impede the provision of proper care in this domain. The objective of this research was to assess the prevalence of common mental disorders in an urban resettlement colony in Delhi, India, explore associated factors, and understand the community’s perspective on mental health.

MATERIALS AND METHODS:

A community-based mixed-method study was conducted in which 130 participants were selected through multistage systematic random sampling and 12 key community members by purposive sampling. To assess the prevalence of common mental disorders, the 20-item Self-Reported Questionnaire (SRQ-20) was used, while the community’s viewpoint on mental illness was explored using an in-depth interview guide. The odds ratio (OR) for risk factors was calculated using Pearson’s Chi-square test, Fisher’s exact test, and multiple logistic regression. For the qualitative component, themes were analyzed and presented.

RESULTS:

The study found an 18.5% prevalence of common mental disorders in the area. Socioeconomic status, hypertension, chronic health conditions, and the impact of the coronavirus disease 2019 (COVID-19) pandemic on personal life were significant predictors (P < 0.05). The qualitative study identified that community members have a negative perspective on mental illness. Women are a vulnerable group because of their susceptibility to violence and certain cultural factors.

CONCLUSION:

Insufficient knowledge and societal stigmatization act as barriers to accessing mental health services. Certain groups, such as people of lower socioeconomic strata, living with a chronic disease are more affected. Targeted interventions are required to address these effectively.
Prevalence, severity, and predictors of dysphagia among patients with acute stroke in Oman
Authors: Al-Mamari Raya Said , Lazarus Eilean Rathinasamy , Al-Harrasi Maryam , Al-Noumani Huda , Al Zaabi Omar
Published: September 2024

BACKGROUND:

Up to 80% of stroke patients suffer from dysphagia. It is associated with increased morbidity, mortality, and healthcare costs due to aspiration, pneumonia, and malnutrition, which represent a significant burden to stroke survivors, their relatives, and the healthcare system. Early recognition and management of post-stroke dysphagia is key to reducing its complications and enhancing patients’ quality of life. Despite the importance of dysphagia following a stroke and its adverse consequences, no study has investigated dysphagia after stroke in Oman. This study was conducted to estimate the prevalence of post-stroke dysphagia and its severity among acute stroke patients, assess the association between the selected factors and dysphagia, and identify dysphagia predictors.

MATERIALS AND METHOD:

A cross-sectional descriptive study design was utilized to identify the prevalence and risk factors for post-stroke dysphagia among acute stroke patients (n = 274) admitted to two Omani tertiary hospitals over 6 months. Dysphagia was assessed using the Gugging swallowing screen. Descriptive analysis, correlations, and regression analysis were computed.

RESULTS:

The prevalence of dysphagia following stroke was 70.1%. Among those who had dysphagia, 37.5% had severe, 31.25% moderate, and 31.25% mild dysphagia. Aging, obesity, having a medical co-morbidity, hypertension, stroke location, low Glasgow Coma Scale (GCS) score, and the use of thrombectomy or thrombolysis therapy were contributing factors and were found to be correlated with post-stroke dysphagia. This study revealed that old age [odds ratio (OR) = 0.961, 95% confidence interval (CI): 0.933–0.989, P = 0.007)], obesity (OR = 0.387, 95% CI: 0.157–0.952, P = 0.039), and low GCS score (OR = 0.027, 95% CI: 0.009–0.077, p=<0.001) were predictors of dysphagia after stroke.

CONCLUSION:

Post-stroke dysphagia is more common among acute stroke patients. There are various risk factors correlated with dysphagia following a stroke. Therefore, dysphagia predictors should be considered when designing dysphagia prevention strategies to reduce its adverse consequences. Recognition of such predictors may help with the early detection and treatment of dysphagic patients and the implementation of preventive approaches.
Empowering self-care through patient education in heart failure patients: A multimodal approach comprising of P-PILs, videos, and personalized advice
Authors: Philip Anu , Shastry Chakrakodi Shashidhara , Unnikrishnan Muzhuvanchery Kesavan , Utagi Basavaraj
Published: September 2024

BACKGROUND:

Heart failure (HF) patients, in developing countries like India, have limited access to information regarding their health/disease state. To identify patient problems and patient expectations through focused group discussions (FGD) and develop a multimodal educational tool consisting of a pictogram-based patient information leaflet (P-PIL), HF video, and personalized counseling (PC) for HF patients.

MATERIALS AND METHODS:

Based on the results of the FGD with stakeholders, we developed, validated, and tested educational tools such as P-PIL and HF videos and personalized counseling for enhancing patient education.

RESULTS:

FGD identified major patient-related barriers, and we developed and validated P-PIL and HF videos. Ninety heart failure patients participated in user testing knowledge assessment. The mean scores in knowledge significantly increased from 39.37 to 85.18 (P < 0.001), with 95% of patients favoring P-PIL for its layout design and content. P-PIL, HF videos, and personalized counseling together enhanced patient awareness and self-care, indicating positive healthcare outcomes in HF.

CONCLUSION:

A well-developed and validated PIL can be reinforced by videos and personalized counseling and enhancing knowledge levels in HF patients which eventually translates to better outcomes.
The effects of Korean hand acupressure on postoperative pain, nausea, vomiting, and retching after thyroidectomy: A randomized controlled study protocol
Authors: Gür Sevgi , Öztekin Seher Deniz , Öztekin İlhan , Yalçın Orhan
Published: September 2024

BACKGROUND:

The aim of this study is to determine the effect of Korean hand acupressure applied after thyroidectomy on postoperative pain, nausea, vomiting, and retching of number and severity.

MATERIALS AND METHODS:

The type of study is a randomized study with a post-test-control group. The protocol was prepared according to the SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) 2013 checklist. The CONSORT 2017 guideline was followed in reporting the protocol. The study was conducted with 42 patients (intervention/control group = 21) who underwent thyroidectomy in a hospital in Istanbul between February 2021 and June 2022, who met the inclusion criteria, and whose verbal and written informed consent was obtained. Korean hand acupressure was applied for 3 min using mung bean seeds 30 min before anesthesia was given to the patients in the intervention group. The application was continued every 2 h after the operation. The application was terminated at the eighth hour. The control group (patients) received routine post-operative treatment and care. Pain severity, nausea, vomiting, and retching number and severity, antiemetic use, and Rhodes nausea, vomiting, and retching index score at the end of the 24th hour were evaluated at the 2nd, 6th, and 24th hour postoperatively. Data analysis was done with the SPSS 25.0 program.

CONCLUSION:

For the patients in the intervention and control groups, it was found that the number and severity of nausea and vomiting were highest in the 6th hour after surgery. The application of Korean hand acupressure was an effective nursing intervention on the retching state (number/severity) that developed at the 6th hour after thyroidectomy and reduced the use of antiemetics.
Exploring the learning environment through an organizational theory lens: A case study from nursing education
Authors: Meyer Rhoda , Archer Elize , van Schalkwyk Susan C.
Published: September 2024

BACKGROUND:

The calls for curricula review to adequately prepare nursing graduates have increased over the last decade. In response, many nursing education institutions across the world have considered ways to review and renew their curricula. Part of these renewal processes seeks to prepare nursing graduates to function within highly dynamic and challenging environments. The aim of this study was to explore the private healthcare context as a learning environment using an organizational theory lens, with a view to informing and enhancing curriculum development and implementation in nursing education.

MATERIALS AND METHODS:

A qualitative case study methodology within an interpretivist paradigm was used, drawing on organizational theory. The population included educators who teach undergraduate nursing students at a private higher education institution in South Africa and managers at the clinical sites where these students undertake their clinical learning. Data collection, which was undertaken over the period 2018–2020, included observations, focus group discussions, and interviews. Thematic analysis was undertaken, and a three-tiered analytical approach was followed to analyze the data.

RESULTS:

Four themes were identified: the learning environment as a site of tension, a site of cultural layering, a site of role complexity, and a site of hierarchy.

CONCLUSION:

Nursing education is dynamic, providing a range of learning experiences. An understanding of this environment from an organizational theory perspective provides some insights into potential challenges and opportunities for learning. Curriculum developers should consider ways of optimizing the opportunities so that students can be provided with learning experiences that enhance the development of the necessary competence.
Effect of meditation, muscle relaxation exercises, dietary and lifestyle modification on depression, anxiety, stress and self-esteem among women undergoing infertility treatment: A randomized controlled trial: Pilot protocol
Authors: Aulakh Rajbir K. , Uppal Harjit K. , Pahwa Sangeeta
Published: September 2024

BACKGROUND:

Infertility is not only a reproductive health problem; it’s also emotionally painful. Currently, treatments for infertility are receiving more attention, but emotional support is equally important. The aim of this study was to assess the effect of meditation, exercises, dietary, and life-style modifications on depression, anxiety, stress, and self-esteem among infertile women.

MATERIAL AND METHODS:

This randomized controlled trial was carried out on randomly assigned 60 infertile women (30 experimental and 30 control groups) with the above-mentioned distress at the Infertility Clinic of a tertiary-level hospital in India during the period from 01.07.2020 to 30.6.2021. Infertile women were enrolled using a systematic random sampling technique. The pretest was done with the Depression, Anxiety and Stress Scale (DASS) and the Rosenberg self-esteem scale. Interventions were operated on an experimental group for five subsequent visits for 60 minutes and the control group received routine care. A post-test was done on sixth visit.

RESULTS:

The pretest mean score of infertile women was 16.13 ± 4.95 for depression, 18.93 ± 4.26 for anxiety, 29.27 ± 4.59 for stress and 10.47 ± 3.49 for self-esteem, respectively. The post-test mean score was 9.07 ± 3.14 for depression, 10.73 ± 3.17 for anxiety, 18.4 ± 3.77 for stress, and 17.5 ± 1.96 for self-esteem. The study results showed the post-test mean score was significantly different in the experimental and control groups atP< 0.001.

CONCLUSION:

These complementary therapies could potentially lessen the emotional distress experienced by infertile women and boost pregnancy rates. So, infertility management should be comprehensive instead of only using medical treatment to get a better outcome.
To study the knowledge, attitude, and practice about Pap smear among healthcare professionals
Authors: Latika  , Suri Ridhi , Dahiya Pushpa
Published: September 2024

BACKGROUND:

Papanicolaou (Pap) smear has been found to be an effective, safe, economical, and time-sensitive tool for screening cervical cancer in various studies. We studied existing levels of awareness, attitude, and practices related to the Pap smear among healthcare workers.

MATERIALS AND METHODS:

This was a cross-sectional study undertaken in different departments of Pt B. D. Sharma PGIMS, Rohtak. The study’s target group was all married female HCWs of varied experience levels posted in different departments. This study employed a meticulously crafted questionnaire in the English language. The survey included a total of 21 items covering different aspects related to the knowledge, attitudes, and practices of the study topic. Subgroup analysis was conducted using the ANOVA and Pearson Chi-square test.

RESULTS:

A total of 424 participants were enrolled in the study. The majority of the participants were in the age group of 31–40 years (45%), followed by the age group of 20–30 years. On descriptive analysis, the mean knowledge score of the participants was 29.4575 (SD = 10.77661, minimum score = 0.00, maximum score = 55).

CONCLUSION:

The study highlights a moderate level of knowledge but a significant gap between the attitudes and actual practices related to Pap smear and cervical cancer screening among healthcare professionals.
Assessing the efficacy of mind mapping as a learning technique to enhance information retrieval in nursing students
Authors: Jabade Mangesh , Nadaf Husain
Published: September 2024

BACKGROUND:

Nursing education, rooted in conventional methods like didactic lectures and clinical experiences, is evolving to incorporate innovative learning strategies. This study delves into the effectiveness of mind mapping, an interactive technique, in enhancing information retrieval skills among nursing students. Departing from linear note-taking, mind maps visually organize information, aligning with contemporary learning theories emphasizing visual and interactive modalities.

MATERIALS AND METHODS:

Methodologically, a quasi-experimental design with a crossover intervention was employed, involving 144 nursing students in Pune City, Maharashtra; the time taken to conduct the study was 2 months. The study focused on acquired immunodeficiency syndrome and chronic renal failure (CRF), employing pre-tests, post-tests, and long-term retention assessments.

RESULTS:

Results indicated significantly higher knowledge gains and retention with mind mapping, substantiated by effect size analyses. Student perceptions, assessed through a Likert scale, revealed widespread agreement on mind mapping’s clarity, effectiveness, and positive impact on understanding and retention. Challenges included the need for faculty and student training, highlighting the importance of integration and support in educational institutions.

CONCLUSION:

This study explores the effectiveness of mind mapping as a learning technique in nursing education, aiming to enhance knowledge acquisition, retention, and critical thinking skills, departing from traditional approaches. Results indicate that mind mapping significantly improves knowledge retention compared to conventional methods. Hence, we strongly recommend mind mapping as an integral learning technique in nursing education; this will impact on enhancing knowledge acquisition, retention, and critical thinking skills among nursing students, surpassing the outcomes of traditional methods.
Comparison of the accuracy and the response time to behavioral pain scales (BPS and CPOT) during painful procedures in the intensive care unit
Authors: Sedighi Ladan , Shirozhan Shima , Talebi-Ghane Elaheh , Taher Abbas , Eliasi Ensieh , Gomar Razieh , Mollai Zhale
Published: September 2024

BACKGROUND:

Pain is one of the most common symptoms in the patients hospitalized in intensive care units, and its correct and timely diagnosis is important. Identifying tools that accurately assess pain in a shorter time will help patients better manage pain. The aim of this study was to compare the accuracy and the duration of response to behavioral pain scales (BPS and CPOT) during painful procedures in the intensive care unit.

MATERIALS AND METHODS:

The descriptive-comparative study was conducted in two groups, each including 16 nurses, in the intensive care unit of Besat Hospital in Hamadan in 2022. Each group separately evaluated the patients’ pain during position change and secretion suction based on BPS and CPOT scales along with an evaluator. At the same time, the accuracy of the scores given by each nurse and the duration of pain diagnosis were compared using the determined evaluator, and the results were analysed.

RESULTS:

Comparing the durations of response to the scales, the average duration of response for BPS and CPOT tools were 13.21 and 13.63, respectively; in general, their difference was significant (P < 0.001). Examining the accuracy of the nurses and the evaluators in pain evaluation revealed a significant difference between the two tools, and the results of adaptability were higher for CPOT, in all cases, in comparison with BPS (P = 0.024).

CONCLUSIONS:

The results showed that CPOT assesses the pain more accurately compared to BPS, but the duration of pain evaluation is a little longer via CPOT. The results of the study can help the nurses working in ICUs by choosing more accurate tools with shorter evaluation duration.
Human Immunodeficiency Virus-positive Patients on Highly Active Antiretroviral Therapy Continue to Have a Decline in Renal Function Irrespective of Tenofovir Usage
Authors: Joshi Kavita Sanjeev , Jadhao Viplove Fulsing , Gujarathi Rushabh , Churiwala Widhi , Natu Anuya Ajit
Published: September 2024

Introduction:

Human immunodeficiency virus (HIV) patients may undergo renal damage due to disease or nephrotoxic drugs. Tenofovir has been associated with the development of renal impairment. The aim of this study was to compare trends in creatinine clearance (CrCl) and estimated glomerular filtration rate (eGFR) in patients on highly active antiretroviral therapy (HAART) and to compare the same between patients on tenofovir- and nontenofovir-based regimens.

Methods:

A prospective observational study was conducted. We followed 244 patients for 2 years. The demographic, clinical, and laboratory parameters of the patients were recorded at baseline, 1 year of therapy, and 2 years of therapy. The data were analyzed using dividing patients into tenofovir- and nontenofovir-based groups. Statistical analysis was performed using the Chi-square test, paired and unpaired t-tests, and Fisher’s exact test.

Results:

The mean blood urea nitrogen and serum creatinine in both groups were comparable at the start of the therapy. The decline in CrCl and eGFR in all patients on HAART for 2 years was statistically significant, irrespective of tenofovir usage. The mean decrease in eGFR in the tenofovir group was 12.4 mL/min/1.73 m2 and in the nontenofovir group, 9 mL/min/1.73 m2, though the differences between eGFR and CrCl were not significant between the two groups at any point.

Conclusion:

Even though previous studies have suggested that HAART usage can slow the decline in kidney function in people living with HIV, patients who receive HAART still show a statistically significant decline in renal function parameters, akin to the observations of other such studies in low-resource settings.
Cryptococcal meningitis in a diabetic
Authors: Prakash Jyoti , Anil B. , Sharma Tanushree
Published: September 2024

A 75-year-old male, a known case of hypertension and diabetes, from Bihar, India, had presented to the medicine department with a complaint of fever for the last 1 month and drowsiness for the last 5 days. In view of drowsiness, a cerebrospinal fluid study was done which was suggestive of cryptococcosis (budding yeast in India Ink Preparation). Cryptococcal meningitis is usually found in cases of immunocompromised states like HIV and it is quite less in non-HIV patients like diabetics. Liposomal amphotericin B was started as per protocol. The patient, however, developed anuria and septic shock and succumbed to his illness. Therefore, clinicians should suspect cryptococcal meningitis in nonimmunocompromised patients also because timely treatment may be given as it has a potential cure.
Edward’s syndrome neonate, a management conundrum of an anaesthesiologist
Authors: Singh Kunal , Rawal Shreem , Ramesh Athira , Kumar Amarjeet
Published: September 2024

Chromosomal disorders manifest with multiple congenital anomalies, which is associated with high morbidity as well as mortality. Trisomy 18 also known as Edward’s syndrome is a rare chromosomal disorder. We report a case of Edwards’ syndrome in a 15-day-old female neonate, with typical syndromic features. Infant’s clinical condition was superimposed by respiratory distress, necessitating a comprehensive, multidisciplinary management involving neonatologist, anesthesiologists, and orthopedic specialists. Considering the intricacies of Edwards’ syndrome and hence contributing to refining protocol for enhanced care and meticulous support. Furthermore, emphasizes the requirement for further research to advance understanding of the clinical condition and propagate future management.
Observation of the protagonist effect of body fluid load in the pathogenesis of sinonasal polyposis
Authors: Abhinandan Amit , Shekhar Ravi , Krishna Amresh , Singh Rakesh Kumar
Published: September 2024

Background:

The objective is to assess the association of body fluid load in the pathogenesis of sinonasal polyposis.

Subjects and Methods:

The targeted cases with chronic rhinosinusitis (CRS) with nasal polyposis and control of CRS without polyposis were randomly taken from the admitted patients. Two groups of 30 people each were taken. Demographic details such as name, age, and gender were noted. Excess body water was then calculated by subtracting the perfect body water from the total body water (TBW).

Results:

Of 30 cases and 30 controls aged 18–60, the median was 30.5, and the mean was 34 ± 12.8 years. The gender of the case was 18 males and 12 females, while in control, the males and females were of equal number. The mean TBW was 34.4 ± 5.27 L in cases and 32.4 ± 5.87 L in controls. Total body weight was found to be higher in cases than in controls but not found to be statistically significant (P = 0.160). Excess body water was found in 60% of nasal polyps cases and 46.7% of controls, which was statistically insignificant (P = 0.301).

Conclusion:

There is a complex interplay between our body fluid dynamics and nasal polyp pathogenesis in CRS with polyposis. While our findings suggest potential trends with small sample sizes, further research with more extensive and diverse populations is needed to authenticate and expand on these observations.
Nonoperating room regional anesthesia in pediatric patients: A review of indications and challenges
Authors: Chandra Vikram , Kumar Amarjeet , Sinha Chandni , Kumar Ajeet
Published: September 2024

Nonoperating room regional anesthesia (NORRA) involves providing regional anesthesia in environments other than the standard operating rooms, such as in intensive care units, emergency departments, or interventional radiology suites. Although regional anesthesia is well-documented for its benefits in perioperative care, its application in nonoperating room environments remains limited. We conducted a narrative literature review using various databases such as PubMed, Embase, Medline, Ovid, PMC, and Google Scholar. Our search strategy involved using different combinations of terms associated with regional anesthesia, nonoperating room anesthesia, intensive care units, and pediatric patients. Regional anesthesia offers significant benefits for pediatric patients, such as reducing the need for opioids and enhancing autonomic, metabolic, and immunological responses. Techniques used in NORRA include central neuraxial blocks, peripheral nerve blocks, and topical anesthesia, with common anesthetic agents being lidocaine, bupivacaine, and eutectic mixture of local anesthetic cream. This review investigates the applications, indications, challenges, and future prospects of NORRA in pediatric patients.
Menstrual Blood Stem Cell Banking: Blessings in Disguise
Authors: Chadha Lisa , Kashyap Geetika , Rahane Swapnil
Published: September 2024

Menstruation is a natural part of the reproductive cycle occurring in the female body when she attains menarche. However, it was widely influenced by many socio-cultural aspects and stigma in a woman’s life. The concept has changed with the discovery of mesenchymal stem cells present in the menstrual blood, which was previously considered waste and dirty. The unique capability of the cell for its self-renewal and differentiation attracts researchers and medical professionals towards a new approach and gives them an alternate stem cell scope. Menstrual blood banking appears to be a ground-breaking, promising, cost-effective, novel and ethically acceptable substitute concept that needs to be popularised in medicine.
First-year Medical Undergraduate Students’ Perception of Seminar-based Online Classes Conducted during COVID-19 - The Lessons Learnt
Authors: Mohan Latika , Shah Zinkal , Pant Jayanti
Published: September 2024

Background:

Seminar-based classes are designed to facilitate students’ participation in teaching and learning. This method promotes self-directed learning and improves presentation skills and builds confidence of the students.

Aims:

To conduct these classes for 1st year medical undergraduate students online during the COVID-19 pandemic was challenging and needed extra efforts both from the organisers and the students. Hence, the present survey was conducted to understand the students’ perception, pitfalls and challenges about the classes conducted through online mode.

Method and Materials:

Each session was of 90 min duration and comprised previously allotted topics presented by eight students individually. This was followed by discussions amongst peers and concerned teachers. The students had to voluntarily participate in an anonymous online survey.

Results:

Thirty-nine per cent of students faced technical issues in the form of interrupted electricity supply, whereas 76% of students were dependant on their smartphones to attend classes. Lack of time for preparation, self-study, appropriate discussions and piecemeal understanding of the topics with lesser retention were reported by the students.

Conclusions:

Seminar-based classes conducted online have certain pitfalls, and they are best accepted by the students when conducted in the physical presence of the students and the teachers.
Quality of Life of Patients with Scabies in an Urban Slum Area of Ludhiana
Authors: Bansal Priya , Girdhar Sangeeta , Chawla Avantika , Kohli Aditya , Chaudhary Anurag , Sandhu Jaspriya
Published: September 2024

Introduction:

Scabies affects 200–300 million individuals annually around the globe and it is a serious public health issue causing social stigmatisation in patients. With this background and its substantial impact on morbidity, this study was undertaken with the objective to find the demographic profile, clinical morphology and quality of life in patients suffering from scabies in urban slums of Ludhiana.

Materials and Methods:

A cross-sectional, time-bound hospital-based study was carried out for a period of 2 months. A total of 173 patients with a diagnosis of scabies comprising all adults and children >5 years of age attending skin outpatient department were included in the study. The collected information was entered in Microsoft Excel sheet and analysed using SPSS.

Results:

The mean age of the study population was 34.85 ± 17.48 years. The most affected age groups were 18–40 years (46.9%), followed by 41–60 years (26.0%) and 17.9% in children. The majority of patients had difficulty in working and feelings of embarrassment, and in three-fifths of patients, their sexual relationship was affected due to scabies. In children, more than half experienced teasing and feeling of embarrassment and their routine activities such as playing were affected.

Conclusion:

In the present study, scabies moderately affected the quality of life of the patients in the form of embarrassment and stigma associated with disease. As it is a contagious disease, early diagnosis and prompt treatment can be helpful in the prevention and control of disease.
Adolescent obesity and mental health: Narrative review of modulation factors
Authors: Singh Som Prabh , Srinivas Sharan , Sundaram Trisha , Chockalingam Anand
Published: September 2024

Clinical obesity and impairment in an individual’s mental health remain global health concerns despite growing interest in advocacy and health-care initiatives. Among the adolescent population, these predispose individuals to a greater risk for poor metabolic status and quality of life in the long term, given the unique pubertal characteristics of this age category. The relationship between the causation of adolescent obesity and mental health is believed to have bidirectional properties but remains unclear. The aim of this article was to narratively examine genetic and socioeconomic modulatory mechanisms that contribute to the bidirectional model. Among these modulatory mechanisms, the presence of three catalytic factors seems to play a critical role in the bidirectional model: food deserts, cultural acceleration, and parental influence.
Cigarette availability and affordability among school-going adolescent smokers in Zambia: Results from the 2011 Global Youth Tobacco Survey
Authors: Luputa Catherine , Ng’ambi Wingston Felix , Zyambo Cosmas
Published: September 2024

Introduction:

Cigarette smoking is a major cause of preventable disease and death globally. In several countries in sub-Saharan Africa, there is a dearth of knowledge on adolescent’s access to cigarette smoking despite cigarette access being a critical determinant of smoking initiation among adolescents.

Objective:

The objective of this study is to understand the availability and affordability of cigarettes among school-going adolescent smokers in Zambia.

Methods:

This study utilized the secondary data from the 2011 Global Youth Tobacco Survey done in Zambia. Logistic regression was used to obtain unadjusted ratios (uOR) and adjusted odds ratios (AORs) and 95% confidence interval (CI) to examine cigarette availability and affordability among adolescent smokers.

Results:

A total of 1857 adolescents were included in the analysis. Of these, 13.8% had tried smoking, 25.39% had not been refused sell of cigarettes due to age, 20.70% had obtained cigarettes through buying from a store, shop, or from katemba, 21.09% were not asked proof of age when buying cigarettes, and 25% were not refused the purchase of cigarettes due to age. In multivariate analysis, cigarette availability and affordability were associated with trying cigarette smoking (AOR: 7.74, CI: 1.24–50.88: AOR: 2.181, CI: 1.13–4.22).

Conclusion:

Cigarette availability and affordability were associated with an adolescent trying cigarette smoking. Adolescents in Zambia could buy cigarettes without being refused due to age or asked for proof of age. Cigarette availability and affordability among adolescents play a critical role in smoking initiation among them. There is a need to augment policy on protecting adolescents by demanding proof of age whenever the adolescents are buying cigarettes.
Derived categories of Grassmannians: a survey
Authors: Fonarev Anton Vyacheslavovich
Published: September 2024

We discuss what is known about the structure of the bounded
derived categories of coherent sheaves on the Grassmannians
of simple algebraic groups.
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