bluuebunny/crossref_metadata_2025 huggingface dataset:
Quantification of Oral Candidal Carriage Rate and Prevalence of Oral Candidal Species in HIV Patients with and Without Highly Active Antiretroviral Therapy
Authors: Perla Nitesh , Kumar Sourab , Jadhav Abhishek , Bhalinge Payoshnee , Dadpe Mrunalini , Acharya Siddharth
Published: August 2024

Background:

Most documents review decrease in the prevalence of HIV related oral lesions to the tune of 10-50% following the advent of HAART. However long term use of HAART on oral health status of HIV infected subjects is poorly documented. Also antifungal agents can effectively treat mucosal candidiasis. However their use can lead to colonization with less susceptible strains among normal susceptible strains.

Aims and Objectives:

To know the candidal carriage rate (i.e. presence/absence of candidal growth), candidal density(CFUs/ml) & species variations (species diversity) in HIV positive individuals with and without highly active anti-retroviral therapy (HAART), attending the regional voluntary Counselling and Confidential Testing Centre (VCCTC).

Materials and Methods:

The study population were categorized into 3 groups. Method followed were Germ tube test, Chlamydospore formation test, CHROM-Agar test.

Results:

Quantification comparison study of candidal carriage rate, density with detection of various candidal species in the oral cavity of HIV-positive individuals with and without HAART therapy was conducted.

Conclusion:

HIV positive individuals with HAART therapy treatment prooved higher candidal carriage rate and lower density than Non-HAART category.
The Fetus Points to the Diagnosis of Rare Skeletal Dysplasia: Stuve–wiedemann Syndrome: Retrospective Case Series and Prenatal Review
Authors: Begam Muzibunnisa A , Hasan Muhammad , Chedid Fares , Mirghani Hisham
Published: August 2024

Background:

Stuve–Wiedemann syndrome (SWS) is a rare skeletal abnormality with extensive postnatal literature but limited prenatal studies. Our group had published a diagnostic algorithm to identify prenatal cases, yet, the challenge continues, especially when there is no family history of a similar condition.

Methods:

We retrospectively analyzed our experience of prenatal diagnosis of SWS over an 8-year period with ethical approval. Literature review of articles published until July 30, 2023 from PubMed, GeneReviews, and Genetics Home Reference using search parameters, “SWS,” “prenatal,” and “ultrasound” was conducted.

Results:

Three cases (diagnosed during the routine anomaly scan) were identified from our institutional review, and 11 cases from six studies from the literature review. Eight out of these 11 cases had a positive family history. SWS was recognized without positive family history in two patients from literature review and the three patients in the current study. The consistent findings that helped in reaching the suspicion were the typical pattern of long bone involvement (bowing of tibia > femora, relative sparing of the fibula and upper limb bones, normal scapulae, and clavicles), and the presence of camptodactyly. Despite the lack of sonographic evidence of narrow thorax, SWS is highly lethal, due to dysautonomic symptoms.

Conclusion:

In SWS, accurate ultrasound diagnosis is crucial to provide prognostic information as the lethality does not depend on pulmonary hypoplasia. Examination of the hands looking for camptodactyly is crucial in skeletal dysplasias to distinguish SWS from other bent bone osteochondrodysplasias, namely, campomelic and kyphomelic dysplasias. This prenatal distinction has important implications for prognosis.
Long-acting Muscarinic Antagonists and Their Role in Children with Recurrent Wheezing or Asthma: An Updated Review
Authors: Sengupta Soma , Ramakrishna Golla , Gulla Krishna Mohan , Kumar Ketan , Das Rashmi Ranjan
Published: August 2024

Long-acting muscarinic antagonists (LAMAs) are a class of bronchodilators that work by blocking the muscarinic receptors in the airway smooth muscle, leading to bronchodilation and reduced mucus secretion. They are primarily used in the management of chronic obstructive pulmonary disease, but their use in asthma, including in pediatric patients, has been increasing, especially in cases where asthma is not well-controlled by standard therapies. The Global Initiative for Asthma includes LAMAs as add-on therapy for children with severe asthma who are not adequately controlled with inhaled corticosteroid and long-acting beta-agonists. They are not recommended as a first-line treatment for children with mild asthma. The most commonly used LAMA in children with asthma is tiotropium, which has been studied for its efficacy and safety in this population. In this updated review, we have discussed the pharmacology, efficacy, and safety of LAMAs in children with recurrent wheezing and asthma.
Pharmacognostical standardization of Coccinia grandis (L.) Voigt root
Authors: Sundharamoorthy Susikumar , Marimuthu Haripriya , Natarajan Jayanthi , Sundharamoorthy Gokula Kannan , Marimuthu Gokul , Mattummal Rubeena , Narayana Sunil Kumar Koppala
Published: August 2024

Introduction:

Coccinia grandis is known for its hypoglyceamic and antidiabetic activities. Various parts of the plant have been reported to possess potential therapeutic activity through literature survey. The goal of this study is to identify this traditional medicine by evaluating the pharmacognostic and phytochemical properties of C. grandis roots. Macro-microscopic features, powder microscopic analysis and histochemical screening assist the proper discrimination between species within the genus Coccinia.

Materials and Methods:

Pharmacognostical studies such as macroscopic, anatomical characters of root, powder microscopy and histo-chemistry were performed. Phytochemical characteristics of root was determined by HPTLC methods.

Results:

Pharmacognostical studies provided accurate authentication of the root sample. Histochemical study confirmed the presence of alkaloids, starch grains, oil globules, phenolics, lignin, etc., in the root. HPTLC profiling revelaed chemical fingerprint of the root sample.

Discussion and Conclusion:

This study revealed the macro-microscopical properties and phytochemical characteristics of C. grandis. The presence of therapeutic compounds in the root revealed in histochemical localisation can be attributed to the antidiabetic, hypoglyceamic and antioxidant activities of the plant.
A case study on Manjalkaram (medicated alkaline lotion) in the management of Powthiram (fistula-in-ano)
Authors: Sritharan Anpuchelvy , Sritharan Ganesh , Ganesan Sabaratnam
Published: August 2024

Background:

Abscesses around the lower rectum and anal canal are known as anorectal abscesses. These are crucial as they often culminate in fistula-in-ano. Anorectal abscess and fistulas are one of the most frequent results in the manifestation of simple or complex and extensive fistulous tracts. Karam (herbo-mineral preparation) therapy is a Siddha parasurgical technique commonly used to cure anal disease.

Materials and Methods:

Manjalkaram is a medicated alkaline lotion preparation that acts as herbal chemical cauterization agent to cure anal disease. A 60-year-old male patient, already treated with allopathy, experienced a recurrence of fistula-in-ano. The patient decided to get Siddha treatment and presented with the complaints of pain in the anal area, swelling, and discharge of pus with stool and mild irritation. The patient was diagnosed with fistula-in-ano. Purgatives were given the previous night to clean the bowel, and the following day, local cleaning was carried out by providing Triphala decoction as a herbal antiseptic lotion. A probe was inserted into the fistula, and a Manjalkaram-soaked medicated thread was inserted through the fistula and tied through an external opening to the internal opening with help of the probe. A Manjalkaram-soaked gauze (Manjalkaraseelai) was inserted and changed once in a week.

Result:

Even though fistula-in-ano is very difficult to treat, the patient got completely healed within 2 months with the effect of Manjalkaram application.

Conclusion:

Manjalkaram application is found to be an effective, time-saving, affordable, and acceptable treatment for fistula-in-ano.
A randomized, double-blind clinical trial of poly-herbal traditional decoction for the management of type 2 diabetes in comparison with standard Western treatments
Authors: Paheerathanan Vijitha , Piratheepkumar Rajadurai , Sritharan Ganesh , Menike Arachchillage Anusha Indukumari Senevirathne , Arulanandem Kandasamy , Pholtan R. S. Rajamanoharan
Published: August 2024

Introduction:

Type 2 diabetes mellitus (T2DM) known as Mathumegam is a significant health concern in the twenty-first century. Despite great advances in contemporary science, there is a lack of moderately safe and effective drugs for treatment. The purpose of this study was to evaluate the efficacy of a poly herbal traditional decoction containing 10 herbs such as Senna auriculata (root & bark), Cissampelos pareira (root), Ficus racemosa (bark), Terminalia arjuna (bark), Acacia arabica (bark), Syzygium cumini (bark), Curcuma longa (rhizome), Terminalia chebula (fruit pulp), Phyllanthus emblica (dry fruit), and Terminalia bellirica (fruit pulp) in the management of T2DM.

Materials and Methods:

It was a double-blind, randomized controlled trial involving 100 T2DM patients who were not well managed by diet or exercise. For a period of 12 weeks, 50 patients in group A were administered 5g of the test medication mixed with 100ml (one tumbler) of hot water for 10 to 15 min, as well as standard Western therapy. Group B patients (n=50) received a placebo in addition to normal Western therapy. The main focus of the study was to achieve a 3-month decrease in glycosylated hemoglobin (HbA1c) levels from the starting point, with additional objectives including lowering fasting blood glucose (FBG) levels and observing changes in diabetic symptoms.

Results:

At the end of the trial, mean fasting blood glucose levels decreased to 119.04 ± 11.52 and 176.90 ± 13.91 mg/dL in the test and control groups, respectively. Group A showed a more significant decrease in mean fasting blood glucose levels compared to group B. This indicates that the daily use of poly herbal traditional decoction along with standard allopathic medical therapy for 3 months led to notable reductions in FBG levels. Similarly, group A showed greater improvement in the measured signs and symptoms of diabetes, such as polydipsia, polyuria, polyphagia, weariness, and burning sensation in the hands and feet compared to group B throughout the trial. At baseline, the mean HbA1c (%) in group A and group B was 7.47 ± 0.70 and 7.39 ± 0.66, respectively. After 12 weeks of investigation, the levels of glycated hemoglobin were lowered to 5.03 ± 0.53 and 6.79 ± 0.51 respectively. There were no adverse events reported during the trial period.

Conclusion:

This study found that the experimental medication was beneficial in T2DM, radically lowering FBG and HbA1c levels in diabetic individuals after 12 weeks of treatment.
Consequences of COVID-19 Lockdown on Self and Perceived Adaptive Functioning in Persons with Parkinson’s Disease and Caregiver Burden: A Cross-Sectional Study
Authors: D’souza Jude John , Tinaikar Saachi , Gardas Shailesh
Published: August 2024

Abstract

Background:

People across the world experienced abrupt changes in their daily lives because of the coronavirus disease 2019 lockdown, with a focus on social distancing and self-isolation. Furthermore, the lockdown restricted access to healthcare and physical exercise, potentially leading to the worsening of motor and nonmotor symptoms in vulnerable populations such as persons with Parkinson’s (PwP). Consequently, there was a greater need to evaluate how functional capacity of PwP affected their quality of life and how that impact affected the caregiver’s burden throughout the course of the disease.

Methods:

The Parkinson’s Disease Quality of Life Questionnaire (PDQ-8) was used to interview 85 PwP and their caregivers over the phone and in person in the outpatient department. Convenience sampling was used, and the caregivers were evaluated using the Instrumental Activities of Daily Living Scale (IADL) and Physical Self-Maintenance Scale (PSMS). The Caregiver Strain Index (CSI) was used to assess the strain that caregivers were experiencing. The scores were noted and analyzed.

Results:

Responses were analyzed using the Spearman rank correlation test. There was a significant positive correlation (0.565) between PDQ-8 and CSI scales, and there was a significant negative correlation between PDQ-8 and PSMS (-0.565), and between PDQ-8 and IADL scores (-0.565).

Conclusion:

The PwP recruited in this study had minimal symptoms, and their quality of life was only mildly affected. Hence, patients showed better capacity to perform the activites of daily living (ADLs), and subsequently, the strain experienced by their respective caregivers was mild to moderate.
Stress Experienced by Parents of Children with Neurodevelopmental Delay (NDD): A Correlation with Various Factors
Authors: Jeevannavar Jyoti S. , Shinde Akshata S. , Prasad Vaishnavi
Published: August 2024

Abstract

Background:

Families of children with disabilities have to face the realities of their diagnosis, make significant adjustments to their care, and most importantly, future expectations with regards to their development. Consequently, these parents experience stress that may influence their compliance with therapy, and consequently, their rehabilitation outcomes.

Objective:

To study the level of stress experienced by parents of children with neurodevelopmental delay (NDD) and identify the problems of concern of these parents.

Materials and Methods:

Parents of 98 children with NDD who met the inclusion criteria were asked to fill the parental stress scale forms and return them to the primary investigator. The forms were screened for completeness, and the individual stress score was calculated. The collected data were subjected to statistical analysis.

Results:

All the parents of children with NDD experienced stress [44.03 (±10.17)]. The differential stress levels were as follows: moderate stress [43.24 (±5.75)], followed by severe [30.05 (±3.34)] and mild [59.47 (±4.36)] stress. Stress significantly correlated positively with the age of the children and the number of domains of delay. Overall, 69% of the parents were concerned about the motor delays while 31% were concerned about other associated problems.

Conclusion:

All parents experienced differing levels of stress due to child-related factors.
Effects of Aerobic, Resistance, and Stretching Exercises on Perinatal Depression among Women: A Literature Review
Authors: Raj Ankita , Nageswari Chockalingam
Published: August 2024

Abstract

Perinatal depression (PND), a prevalent mental health issue affecting pregnant and postpartum women, poses significant challenges to maternal and infant wellbeing. Exercise is recognized as a potential nonpharmacological intervention for reducing depressive symptoms during the perinatal period. This systematic review aims to synthesize existing literature to evaluate the effects of aerobic, resistance, and stretching exercises on PND in women. Data extraction and quality assessment were performed using predefined criteria. Overall, the literature suggests that exercises and physical activity help reduce PND. In addition, and importantly, it is recommended that pregnant women with PND should perform stretching exercises routinely as they are safe and effective.
Perception of Medical Professionalism Among Ophthalmology Residents in Saudi Arabia
Authors: Alghulaydhawi Fahad A. , Hersi Reem M. , Al-shahwan Sami
Published: August 2024

PURPOSE:

Studies have shown that there are significant differences in the concepts of medical professionalism among residents. Very few studies have specifically evaluated the perception of medical professionalism in a specific specialty. The aim of the study is to evaluate the perception of medical professionalism among ophthalmology residents and to assess the differences in the concept of professionalism between junior and senior residents.

METHODS:

This cross-sectional study used a questionnaire to survey ophthalmology residents enrolled in different regions of Saudi Arabia in 2020. The ophthalmology residents included both junior and senior residents. In this study, “professionalism” concurred with the definition in the American Board of Internal Medicine's “Project Professionalism” and the Accreditation Council for Graduate Medical Education.

RESULTS:

A total of 167 participants were recruited in the study. Out of the 127 participants who completed the survey, 60 (47.24%) were junior residents and 67 (52.76%) were senior residents. The scores for the attributes varied markedly. The lowest score obtained was 6.54 ± 3.349 for the attribute “In an emergency putting the welfare of others over my own safety” in the “Altrusim” domain and the highest score obtained was 9.62 ± 0.854 for the attribute “respect for co-workers” in the “Respect for others” domain. Out of the total residents who completed the survey (n = 127), 84 (66.14%) agreed that professionalism is teachable through a residency curriculum and 85 (66.93%) thought that it is testable.

CONCLUSION:

The characteristics of different attributes of professionalism varied significantly among the residents. The findings of the present study highlights that the conceptualization and perception of professionalism is changing and there is a need to focus on the resident curriculum to instill the values of professionalism. Targeted training is needed on the concepts of professionalism to develop behaviors consistent with medical professionalism and to evaluate the levels of professionalism among residents.
Clinicopathological Study of Meibomian Carcinoma of Eyelids – An Experience of Two Years in a Tertiary Care Center
Authors: Dasgupta Senjuti , Jain Parul , Bhattacharyya Nirmal K. , Khatoon Rojina
Published: August 2024

PURPOSE:

Meibomian carcinoma is a rare and aggressive malignant neoplasm of the eyelids. The clinical presentation often mimics benign conditions thereby making the diagnosis challenging. The aim of the study was to analyze cases of meibomian carcinoma, the specimens of which were received, in the past 2 years in the pathology department.

METHODS:

This retrospective observational study was undertaken for 2 years and included 9 patients of meibomian carcinoma. For each case, detailed history and clinical findings were retrieved from the hospital records. Histopathological examination was undertaken in all cases after preparing hematoxylin and eosin-stained slides from tissue blocks preserved in the department.

RESULTS:

The mean age of the patients was 55 ± 15 years. Six (66.7%) patients were females, and the other three (33.3%) were male. Following surgery, gross examination of the specimens revealed that the mean size of the excised tumors was 2.45 ± 1.45 cm. The tumors were classified based on histopathological features according to growth pattern, cell type, and cytoarchitecture. Most cases had lobular growth pattern (5, 55.6% cases), consisted of epidermoid cells (5, 55.6% cases), and exhibited infiltrative cytoarchitecture (8, 88.9% cases).

CONCLUSION:

Early diagnosis of meibomian carcinoma is important to reduce mortality from the aggressive tumor. The knowledge of clinicopathological aspects of the tumors that were biopsied in the department of pathology in the past 2 years will help in diagnosis and management of such tumors in future.
Tubercular Episcleritis
Authors: Aldebasi Tariq M. , Alasiri Abdulelah A. , Alnahdi Muhannad A. , Alfarhan Abdulrahman
Published: August 2024

Episcleritis is rarely reported to be associated with tuberculosis (TB). In this review, we highlight this underreported entity and elaborate on the natural history of the reported cases in the literature. Eighteen articles were found to describe numerous cases throughout the past century. Forty patients diagnosed with tuberculous episcleritis were found in the literature. The majority of the patients presented with a latent form of TB and fewer cases were linked with active/pulmonary disease. The natural history of episcleritis was found to have chronic and recurrent attacks refractory to traditional treatment, and the most commonly reported type was the nodular form. The described cases were eventually treated by quadruple antituberculous therapy, and fortunately, recurrence after treatment completion was not documented. It is imperative to highlight such entities that may be underreported in endemic countries, as successful therapy would decrease ocular morbidity and prevent potential unforeseen tuberculous complications.
Fate of Abstracts Presented at the Saudi Ophthalmology Society Conferences 2015–2018
Authors: Alsarhani Abdulaziz K. , Almater Abdullah I. , Alobrah Mansour A. , Al Malawi Rahaf M. , Alsarhani Waleed K.
Published: August 2024

PURPOSE:

The aim of the study was to determine the publication rates of abstracts presented at the annual Saudi Ophthalmology Society (SOS) Conferences from 2015 to 2018.

METHODS:

This is a cross-sectional study on abstracts collected from the scientific programs for the SOS meetings from 2015 to 2018. Titles and first authors' names were used in the search process on PubMed. A Chi-square test was conducted to compare between the categorical variables. Kruskal–Wallis test was used for nonnormally distributed variables.

RESULTS:

A total of 365 abstracts were presented in the SOS Conferences from 2015 to 2018. In the SOS meetings (2015–2018), the publication rate was 45.7%. Seventy-two (43.1%) of the published abstracts were published in journals with an impact factor. The mean impact factor was 1.4 ± 1.9. The median time to publication was 12.0 months (range: 0–60 months). On univariate analysis, basic science (P < 0.001), abstracts on rare diseases (P = 0.003), affiliation with eye hospitals (P < 0.001), and public hospitals (0.007) were associated with a higher publication rate. On multivariate analysis, basic science studies (odds ratio [OR]: 4.23, confidence interval [CI]: 1.77–10.12, P = 0.001), rare topic-related abstracts (OR: 2.03, CI: 1.22–3.38, P = 0.007), and eye center affiliation (OR: 1.67, CI: 1.03–2.68, P = 0.036) were associated with a better publication rate. The factors associated with publication in high impact factor journals were oral abstracts (P = 0.007) and noncase report abstracts (P = 0.023).

CONCLUSION:

Basic science studies, rare topic-related abstracts, and first author affiliation with an eye center were all associated with a higher publication rate. Orally presented and noncase report abstracts increased the chance of publication in higher impact factor journals.
Efficacy of Transcranial Magnetic Stimulation in Tobacco Abstinence Among Adult Tobacco Users Compared to Usual Care or no Treatment – A Systematic Review
Authors: Mehra Rashmi , Mehra Karn
Published: August 2024

Objective:

This study aimed to systematically identify and assess randomized controlled trials (RCTs) that evaluated the efficacy of transcranial magnetic stimulation (TMS) for increasing tobacco abstinence.

Methods:

Five electronic databases were searched from inception to May 2021 to identify RCTs evaluating the efficacy of TMS interventions for tobacco cessation or abstinence. Using predetermined eligibility criteria, two reviewers screened literature and assessed the quality of included studies using the Critical Appraisal Skills Programme tool.

Results:

Out of 222 records, six RCTs with TMS intervention were shortlisted. Two studies assessed TMS in conjunction with other active tobacco cessation treatment, while other four studies used TMS as only active form of treatment. The limited number of included studies had short follow-ups, large dropout rates, and heterogeneous interventions and comparators, which precluded clear detection of treatment effect of TMS interventions.

Conclusions:

TMS intervention differed significantly from comparator group in their effects on tobacco use. However, low-quality limited evidence with variability in study design among existing studies suggests the need for high-quality, long follow-up and robust RCTs to be conducted.
Implementation of Flipped Classrooms in Medical Colleges
Authors: Shrivastava Saurabh RamBihariLal , Shrivastava Prateek Saurabh
Published: August 2024

The effective delivery of a lecture class poses a major challenge for the faculty members, especially in the field of medical education due to the involvement of vast knowledge and complicated concepts. The “flipped classroom” has emerged as one of the most effective ways to impart curricular delivery during a large group teaching session. The teaching is termed as flipped classroom as acquisition of the knowledge/content is shifted to outside class and is then subsequently followed by the application of the gained knowledge in the class within the presence of a teacher. In conclusion, flipped classroom encourages the role reversal, wherein it is the responsibility of the students to acquire knowledge before coming to the class, while the application part becomes the responsibility of the teacher. Even though it is quite an effective approach of teaching–learning, the implementation of the same requires careful planning and support from the faculty members.
Advocating Introduction of Programmatic Assessment in Post Graduation Courses in India
Authors: Shrivastava Saurabh RamBihariLal , Shrivastava Prateek Saurabh
Published: August 2024

Programmatic assessment has been advocated in the field of medical education as it advocates for the continuous collection and analysis of the findings of the formal assessments with a solitary intention to improve the learning and enable the teachers to take an evidence-based high-stakes decision. In most of the postgraduation courses, there are no exams in the 3 years duration of the course and finally, at the end of the course, a summative assessment is conducted, which defines the fate of the students. This is regardless of the fact of how a student has been professionally in the entire course period, and it is very much possible that a deserving candidate might not pass due to a wide range of factors related to students, examiners, and pattern of examination, etc. In conclusion, the introduction of programmatic assessment in postgraduate courses is the need of the hour to neutralize all the subjectivity and unorganized assessments which is prevailing at present. The concept of programmatic assessment can very much justify the process of certification of a student by ensuring that all the core competencies are acquired by the student.
Clinical Profile of SARS-CoV-2 Infection-Associated Pediatric Multisystem Inflammatory Syndrome (MIS-C)
Authors: Gandhi Vipulkumar V. , Kavade Sandeep , Gore Shankar , Chopra Komal
Published: August 2024

Background and Objectives:

Multisystem inflammatory syndrome (MIS-C) is a SARS-COV-2 infection-associated dreaded clinical sequelae in pediatric patients. Its epidemiology is complex and differs from severe acute COVID-19 infection in children. The present case-series report describes the various clinical features, laboratory markers, and interventions among 222 pediatric patients from one of the states in India with the highest prevalence of COVID-19 infection.

Methods:

An observational study was conducted at one of the tertiary healthcare institutes in the western region of Maharashtra state of India. Twenty-two children were hospitalized with diagnosed MIS-C, aged from 2 months to 18 years, from January to June 2021. Demographic and clinical characteristics and diagnostic and treatment parameters were collected from each subject. Statistical Package for Social Sciences version 21 software was used as a data analysis tool.

Results:

Clinical assessment revealed high-grade fever, non-purulent conjunctivitis, and abdominal complaints, which were the leading presentations of MIS-C. In inflammatory markers, serum IL-6 levels and D-dimer levels took a longer duration for normalization in the severe MIS-C group. Almost half of the mild–moderate MIS-C patients were managed with only systemic corticosteroids. All remaining patients recovered with the dual therapy of intravenous immunoglobulins (2 g/kg) and systemic corticosteroids with an improved clinical and biological response.

Conclusions:

The present clinical case-series report concluded that almost all MIS-C cases have a favorable prognosis with dual therapy of corticosteroids and immunoglobulins. With the principle of early diagnosis and prompt treatment, it is possible to manage patients without any critical support. However, long-term follow-up studies of these cases are warranted to validate the clinical approach.
Mucormycosis and COVID-19
Authors: Kaushik Ankit , Jaiswal Anamika , Pandey Hari S. , Singh Paramjeet
Published: August 2024

COVID-19 presents severely in persons with immunocompromised states such as diabetes mellitus. Steroids are used in the management of COVID-19. The use of steroids in immunocompromised persons increases the chances of opportunistic infections. Mucormycosis infects immunocompromised individuals. The aim of this systemic review was to study the clinico-epidemiological features of mucormycosis in patients of COVID-19. PubMed, Medline, Embase, and Google Scholar were searched for “mucormycosis”, “COVID-19”, and “SARS-Cov 2”. A total of 30 studies were included in this study, which included 22 case reports and 8 original articles. The median age of patients was 54.80 years; 79.56% (74/93) were diabetic. Steroid administration history was present in 74.19% (69/93) of patients. Rhino-orbital mucormycosis constituted 46.98% (39/83) of the cases, rhino-orbital-cerebral type in 37.35% (31/83) cases, pulmonary mucormycosis in 10.84% (9/83) cases, 1 case of gastric mucormycosis, 1 case of cutaneous mucormycosis, 1 case of palatal mucormycosis, and 1 case of disseminated mucormycosis. The median duration of presentation of mucormycosis was 14 days after hospital admission. The total number of deaths was reported in 32.26% (30/93) of the cases. The most common species found was Rhizopus, and amphotericin B was the most common antifungal administered. The COVID-19 pandemic is creating a massive pool of susceptible patients having poorly controlled diabetes mellitus and receiving steroids for COVID-19 management, thus creating an unholy alliance with mucormycosis. Mucormycosis started as a new epidemic in India, which is an otherwise rare opportunistic fungal infection.
Correlation between Severe Acute Respiratory Syndrome Coronavirus-2 and Cytomegalovirus
Authors: Al-Hussainy Ahmed Danbous Obayes , AL-Khikani Falah Hasan Obayes , Allah Hussein Aliaa Zaraa Allah , Alshamary Rasha Salih Mahdi
Published: August 2024

Background:

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV2), which causes the novel betacoronavirus 2019 disease (COVID-19), has become the first global pandemic in 100 years. Cytomegalovirus (CMV) is a prevalent herpesvirus that affects 40%–70% of the general population. This study aimed to see how CMV affected the presentation of COVID-19 infections as a prospective risk factor.

Material and Methods:

This study was conducted in Babylon, Iraq, from January to March, 2022. A total of 120 people were engaged in this study divided into four groups: mild, moderate, severe, and control group, 30 individuals in each group. Ninety patients identified with SARS-CoV-2 by PCR testing and 30 people serving as a control group. IgG antibody titer in blood samples were detected by mini vidas biomerieux. The samples were processed with the complete blood count (CBC) and ABO blood group. Independent T and Chi-square tests were used to examine the data using SPSS 21 software.

Results:

COVID-19 infection was more frequent in females than males. The COVID-19 patients were detected to have increased white blood cell count (p < 0.0001) and decreased lymphocytes compared to the healthy persons (p < 0.0001). No significant correlation between CMV and COVID-19 was discovered. CMV titer was not associated with disease severity. Blood group A is the most predominant type in patients compared to healthy persons.

Conclusion:

This study revealed no significant correlation between the severity of COVID-19 and CMV in spite of slightly increased in severe patients at mean 66.53 compared to the control group 58.80 (p = 0.26). Reactivation of CMV in COVID-19 patients may be associated with complications, so more attention should be taken into consideration regarding this virus, especially in severe patients.
Prevalence and Risk Factors of COVID-19 Vaccine Hesitancy among Healthcare Workers at a Tertiary Care Center
Authors: Kokiwar Prashant R. , Gaiki Varun Vijay
Published: August 2024

Background:

Vaccine hesitancy is hesitancy to take vaccine. Studies are required to identify prevalence of coronavirus disease 2019 (COVID-19) vaccine hesitancy. It is equally important to recognize factors responsible for this hesitancy. This data will help to plan health education measures so that healthcare workers can overcome the barriers for vaccine hesitancy.

Objective:

The objective of this article is to study prevalence and factors associated with COVID-19 vaccine hesitancy among healthcare workers.

Methods:

This was a single-center, cross-sectional study carried out over a period of two months among 1063 healthcare workers. Those with missing information, not consenting and absent on the day of survey were excluded. Healthcare workers included doctors including postgraduates, nurses, para-medical staff, admin staff, and housekeeping staff either working in hospital or medical college.

Results:

Prevalence of vaccine hesitancy was 15.1%. On logistic regression, as age increased odds of vaccine hesitancy decreased significantly (OR = 0.95; 95%CI = 0.92-0.98; P < 0.05). Patient contact of <10/day was associated with the decreased odds of vaccine hesitancy compared to those with patient contact of >40/day. Odds of vaccine hesitancy among those with poor knowledge was 2.84 (95%CI = 1.91-4.21; P < 0.05) times more compared to those with good knowledge. Odds of vaccine hesitancy was 3.22 (95%CI = 1.09-9.48; P < 0.05) times and 3.31 (95%CI = 1.05-10.48; P < 0.05) times more among educated up to primary and illiterate respectively compared to higher educated persons.

Conclusion:

We conclude that low levels of education, poor knowledge, and young age were independently and significantly associated with vaccine hesitancy among healthcare workers. Prevalence of vaccine hesitancy was still high at 15.1%.
A Study to Evaluate the Effect of the COVID-19 Pandemic on the Mental Health of Junior Doctors of a Government Medical College in West Bengal
Authors: Das Shouvik , Chaudhuri Arunima , Sinha Parthasarathy , Saldanha Daniel
Published: August 2024

Background:

The COVID-19 pandemic had posed huge challenges to junior doctors as they had to work as frontline health workers during this emergency.

Objectives:

To evaluate the mental health status of junior doctors during the present pandemic using Depression, Anxiety, Stress Scale-21 (DASS-21) and impact of even scale-revised (IES-R) scale scores.

Methods and Participants:

This longitudinal study was conducted over a time period of 8 months after taking Institutional Ethical Clearance and informed consent of 220 participants. This online survey was conducted using Google Forms and DASS-21 and IES-R scores were evaluated twice in an interval of 6 months.

Results:

Depression scores, anxiety scores, and stress scores were significantly increased on the second assessment. Gradation of depression, anxiety, and stress in month 1 among participants were as follows: Depression scores (normal; mild; moderate; severe; extremely severe): 82; 40; 52; 33; 13. Anxiety scores (normal; mild; moderate; severe; extremely severe): 113; 21; 55; 16; 15. Stress scores (normal; mild; moderate; severe; extremely severe): 137; 33; 41; 8; 1.

ISE-R scores:

<24 = 98; 24–32 = 39; 33–36 = 15; ≥37 = 68. Gradation of depression, anxiety, and stress in month 6 were the following: Depression scores (normal; mild; moderate; severe; extremely severe): 50; 19; 63; 26; 62. Anxiety scores (normal; mild; moderate; severe; extremely severe): 34; 5; 67; 25; 89. Stress scores (normal; mild; moderate; severe; extremely severe): 61; 12; 42; 38; 67.

ISE-R Scores:

<24 = 73; 24–32 = 34; 33–36 = 11; ≥37 = 102.

Conclusions:

Junior doctors working during the COVID-19 pandemic developed increased levels of stress, anxiety, and depression with the progression of the pandemic. They were the major frontline health workers to combat COVID-19 which may be the cause of their decreased psychological resilience resulting in mental health issues. Psychological counseling sessions can be used among these young doctors to build up their mental resilience.
Measures Adopted for Weight Reduction Among Obese and Overweight Individuals
Authors: George Neethu , Rajasekar Soundararajan , Ravi Keerthana , Radhakrishnan Madhumitha , Sherwin J. Leavae Anto
Published: August 2024

Overweight and obesity are termed as excessive or abnormal fat accumulation which eventually leads to major life-threatening problems. The up strike is due to demographic transition, modernization, and industrialization. Irregular physical activity, high-calorie diet, and unhealthy lifestyle are the major reasons for obesity. The management of obesity or overweight comprises diet restrictions, by increasing physical activity, certain weight-loss program, and medical management that is by certain drugs that had a great challenge in reduction of weight. The article tried to discuss various weight reduction strategies adopted by obese and overweight individuals. The search strategy includes using the words “weight reduction strategies,” “obese,” and “overweight.” The platforms which the authors searched include PubMed, Google Scholar, and Scopus.
Pancytopenia, a Rare Presentation of Waldenström’s Macroglobulinemia: Approach to Diagnosis and a Brief Review of Literature
Authors: Bharati Purnima , Misra Sunayana , Kumar Vijay
Published: August 2024

ABSTRACT

Waldenström’s macroglobulinemia (WM) is a low-Grade B-cell neoplasm characterized by infiltration of the bone marrow by a lymphoplasmacytic infiltrate along with immunoglobulin M (IgM) monoclonal gammopathy. We report the case of a 70-year-old male who presented with pancytopenia and a relative prominence of lymphoplasmacytoid cells. The patient had no lymphadenopathy or any organomegaly. The diagnosis of WM was made after morphological and immunohistochemical examination of bone marrow of the patient along with IgM and kappa monoclonal band on immunofixation electrophoresis.
Breakthrough SARS-Cov-2 Infection After Covid-19 Vaccination – A Retrospective Observational Clinico-Epidemiological Study from North-Western India
Authors: Gupta Shilpi , Rathore Shweta Singh , Kapoor Umesh , Gupta Ankush , Mamoria Ved Prakash
Published: August 2024

Introduction:

Mass vaccination is considered one of the most crucial weapons in fighting against the ongoing COVID-19 pandemic. However, the occurrence of breakthrough infections (BTIs) has questioned the vaccine effectiveness of the currently available vaccines. The present study aimed to determine the breakthrough SARS-CoV-2 infections in the vaccinated population and to compare the clinic-epidemiological profile and outcomes between breakthrough cases and unvaccinated SARS-CoV-2 positive cases.

Methods:

This retrospective case-control study was conducted between April 15, 2021, and June 15, 2021, in a zonal military hospital in Jaipur. We evaluated individuals with BTI as cases which were SARS-CoV-2 positive after 14 days of the second dose of vaccine and unvaccinated SARS-CoV-2-positive individuals as control. The clinical and demographic data was collected from the Indian Council of Medical Research and specimen referral forms were filled out for all persons who had undergone testing for SARS-CoV-2. The outcome of positive cases in terms of discharge and deaths were collected from hospital records.

Results:

A total of 162 breakthrough COVID 19 infections and 925 unvaccinated positive confirmed controls were recorded within the study duration. The majority of cases presented with mild infection in both case (80.2%) and control groups (72.4%). The risk of hospitalization and occurrence of moderate to severe disease was 2.3 and 4 times more in the non-vaccinated group as compared to the vaccinated group, respectively. No mortality was reported among the breakthrough cases.

Interpretation and Conclusions:

Despite the occurrence of BTIs, the benefits of vaccines are far greater. Our findings suggest that vaccination is associated with a lower risk of hospital admission, severe disease, and mortality against COVID-19.
Allgrove Syndrome: Case Series on 4A and Triple A Syndrome in Children with Rare Presentation
Authors: Roy Saheli , Gupta Priyanka , Basu Suprit , Das Mrinal K. , Datta Sumana
Published: August 2024

ABSTRACT

Introduction:

Allgrove or Triple A syndrome is a rare familial multisystem disorder with autosomal recessive inheritance. Usual features include varied combination of alacrima, achalasia cardia, and adrenocorticotrophic hormone (ACTH) resistant adrenal insufficiency along with autonomic dysfunction and other neurological problems in some cases when it is known as 4A syndrome. Basic defect is in the Achalasia Addisonianism Alacrima Syndrome gene (AAAS) located on chromosome 12q13.

Case Details:

This report relates to two unrelated girls aged 7 and 12 years, who presented with orbital cellulitis with acute adrenal crisis and initial episode of nephrotic syndrome, respectively. Both had history of hyperpigmentation of skin, especially palmer creases and knuckles and absence of tear from both eyes while first patient also had autonomic dysfunction. Ophthalmological examination, biochemical evaluations for adrenal function, barium swallow study and magnetic resonance imaging (MRI) of orbits were all consistent with Allgrove Syndrome. Patients were adequately treated for the complications and then put on hormone replacement therapy and ocular lubricants resulting in remarkable improvement on follow up study.

Conclusion:

Despite lack of definitive treatment, supportive treatment and hormone replacement can improve quality of life of Allgrove patients.
Adoption of a Protocol Among Healthcare Workers to Improve the Containment of the Coronavirus Disease 2019 Outbreak
Authors: Shrivastava Saurabh RamBihariLal , Shrivastava Prateek Saurabh
Published: August 2024

The coronavirus disease-2019 (COVID-19) outbreak, which was first detected in the Wuhan city of China has been considered eligible to meet the requirements of the Public Health Emergency of International Concern. It is a fact that healthcare workers constitute the first line of defense against the infection and are involved in patient care related activities by compromising their own safety and quality of life. The current available disease trends neither indicate about the extent of the infection in hospital settings nor about the potential risk factors among health workers. In an attempt to bridge this gap, a protocol has been formulated to assess the extent of the infection and the risk factors which can facilitate the acquisition of the infection. Further, based on the proposed protocol, we can get vital insights about transmissibility and routes of transmission by periodically analyzing laboratory specimens as a part of follow-up. In conclusion, health workers are at the forefront in containing the COVID-19 outbreak amidst all uncertainty and thus it is our responsibility to adopt a standard protocol not only to safeguard them, but also simultaneously generate adequate evidence for better prevention and control of the disease.
Coronavirus Disease 2019 Pandemic
Authors: Shrivastava Saurabh RambihariLal , Shrivastava Prateek Saurabh
Published: August 2024

The coronavirus disease-2019 outbreak in the Wuhan city of China has been declared as a public health emergency of international concern and as a pandemic, and it is a marker that the caseload of the disease is increasing at a rapid pace. It has been recommended that the suspect cases need to be isolated and monitored in healthcare establishments, keeping in mind the quality of care and security of the general population. However, in special circumstances such as lack of isolation wards or lack of infrastructure/human resources to provide healthcare or even in situations, wherein the existing hospitals refuse admission of suspects due to their own limitations, it becomes quite essential to think about home-based management. However, such a decision should be taken only after thorough clinical evaluation, after thorough assessment of the safety of the home environment, and after healthcare personnel is assigned the responsibility to act as a bridge between hospital and home care till the patient completely recovers. In conclusion, provision of home-based care for asymptomatic contacts or potential suspect with mild symptoms is a crucial domain in settings with limited healthcare infrastructure. However, considering the magnitude of the cases and lack of preparedness, it becomes very much essential to strengthen home-based care.
Understanding Health Politics of India for Galvanizing Public Health
Authors: Murmu Nisha , Kumar Mithilesh , Sagar Vidya , Kumari Neelanjali , Kumar Dewesh
Published: August 2024

ABSTRACT

Health and politics cannot be thought of in isolation as they are intertwined. In India, politics is the center point and has affected health since independence. The post-independence era witnessed austerity in politics and the health subject was in a disarray. From recommendations of Bhore committee to launch and implementation of various health programs, politics has played an important and inevitable role. And the importance of those programs also varied as per the needs and priorities of the government which led to their success. Various flagship programs are launched in the current government since 2014, which need critical appraisal and subtle analyses in terms of strength, weakness, opportunity, and threats. India has spent 90% of government’s expenditure on the revenue side in comparison to less than 2% on health, which shows that though health has been declared as the priority by the government in many of their manifestos, in reality, its implementation is far-fetched. The government in power should strategize more investment in health and prioritize the issues as per the population needs and not as per the political inclination. The government needs to form a strong alliance with various other agents in public health because the factors influencing health outcomes mostly fall outside their direct jurisdiction.