bluuebunny/crossref_metadata_2025 huggingface dataset:
Acute onset of massive epistaxis due to post-traumatic cavernous internal carotid artery pseudoaneurysm
Authors: Swain Santosh Kumar , Das Alok , Acharya Satyabrata , Shajahan Nibi , Agrawala Rohit
Published: January 2021

Rationale:

Cavernous internal carotid artery (ICA) pseudoaneurysm caused by non-penetrating head trauma is a rare cause of massive epistaxis. The sudden onset of epistaxis due to such a fatal aneurysm protruding into the sphenoid sinus is extremely rare in clinical practice. The management is often challenging because of anatomical inaccessibility of the bleeding point.

Patient's concern:

A 42-year-old man with a history of head trauma showing an ICA aneurysm eroding the sphenoid sinus followed by massive epistaxis.

Diagnosis:

A computerized tomography (CT) scan showed a fracture in the sphenoid sinus. CT angiogram revealed cavernous ICA pseudoaneurysm.

Interventions:

Endovascular coil embolization.

Outcomes:

The patient recovered well and was discharged without any neurological deficits

Lessons:

Cavernous ICA pseudoaneurysm may lead to a life-threatening situation. If a patient has a history of head trauma, post-traumatic cavernous ICA pseudoaneurysm should be considered a differential diagnosis of massive epistaxis.
Infant and Child Feeding Index and nutritional status of children aged 6 to 24 months in a Metropolitan city
Authors: Palanichamy Maheswari , Solanki Mridula J.
Published: January 2021

Background:

The nutritional status of children is influenced by feeding practices. Infant and Child Feeding Index (ICFI) is an age-specific composite index to assess the feeding practices of children.

Objectives:

To determine the association between ICFI and the nutritional status of children aged 6 to 24 months. To find whether ICFI has value as a tool for detecting poor nutritional status. To determine the association of ICFI and nutritional status with sociodemographic and other factors.

Methods:

A cross-sectional study was conducted in the urban field practice area of a tertiary care institute among 149 children aged 6 to 24 months and their mothers. Data on feeding practices were obtained and ICFI scores were calculated. The weight and length of the children were measured and Z scores (WAZ, LAZ, and WLZ) were calculated. A Chi-square test was used to find the association between the categorical variables.

Results:

We found no association between ICFI and any of the three nutritional indicators such as WAZ, LAZ, and WLZ. The sensitivity of the ICFI was low for detecting underweight (10.0%), stunting (29.4%), and wasting (11.1%). ICFI was significantly associated with the growth monitoring of children and mothers' education. WAZ was significantly associated with mother's education and socioeconomic class.

Conclusions:

There is no association between ICFI and the nutritional status of children. ICFI has limited value in detecting the poor nutritional status of children in this urban setting. Maternal education and growth monitoring of children play an important role in infant and child feeding practices.
COVID-19—A new normal Indian community
Authors: I K Rohisha , M Jibin
Published: January 2021

Novel coronavirus disease has affected the different segments of community. As the positive cases are increasing day by day across the world and in India, everything should be back to new normal. The community should be trained to live along with the virus. During or after this pandemic, there will be a new normal life for the Indians and they will be used to these life-style changes to protect themselves and the community from communicable diseases. The changes have occurred in the field of education, health sector, economic system, and the lifestyle of the people.
Prevalence and cross states comparison of case fatality rate and recovery rate of COVID 19/SARS-COV-2 in India
Authors: Z. Ansari Ajaz Ahmed , Desai Hardik D. , Sharma Kamal , Jadeja Dhigishaba M. , Patel Rahul , Patel Yesha , Desai Harshil M.
Published: January 2021

Background and aim:

CFR and RR are important indicator of disease pandemic. As of now no data is available about cross-states analysis of these. We aimed to evaluate CFR and RR of COVID-19 across majorly affected States in India.

Method:

We observed and compared data of confirmed COVID-19 cases, number of deaths, number of recovered/discharged cases and calculated CFR and RR across majorly affected States/UT in India from official database of Government of India, State Government official bulletin, accurate database worldometer.

Results:

The data showed that Gujarat, Madhya Pradesh, West Bengal reported highest CFR on 8th April, 22nd April, 6th May, 1st June 2020 (95% CI 4.91 – 6.99). Kerala showed encouraging recovery rates 24.32%, 70.31%, 93.24%, 45.81% on 8th and 22nd April, 6th May and 1st June 2020 respectively. India had an average estimated weekly Recovery rate of newly discharged/recovered cases was 32.68% from 19th March to 1st June 2020. (95% CI 20- 45.4%). (The Recovery rate across India was 80.83% as on 22nd September 2020.).

Conclusion:

The CFR of a disease varies greatly in different regions of the same Country and is influenced by numerous factors such as health control policies, medical standards, and detection efficiency and protocols apart from number of screening tests done. This comparison discusses need of evaluating policies with optimal reporting of medical history of affected persons when comparing COVID-19 case and fatality rates in different regions of the Country.
Broad guidelines for primary care practitioners/standalone private health facilities/frontline healthcare facilities in view of COVID-19 pandemic
Authors: Raina Sunil Kumar , Kumar Raman , Kumar Ajay , Kumar Dinesh , Raina Sujeet , Gupta Rajiv , Joshi Harshdeep
Published: January 2021

In view of India unlocking, to secure a large population of this country, the healthcare facilities delivering primary care as well standalone health facilities need to be secured from impacts of COVID-19 pandemic. This document dwells on the broader guidelines for primary care practitioners/standalone private health facilities/frontline healthcare facilities to mitigate the impact of COVID-19 Pandemic. The authors understand that the situation is evolving, so the guidelines too will keep evolving.
The relationship between use of aluminum-containing anti-perspirant and hair color with breast cancer
Authors: Mousavi Maryam , Vaghar Mohammad I
Published: January 2021

Introduction:

Breast cancer is one of the most important and common types of cancer in most countries of the world and its incidence are increasing in Iranian women. Understanding its contributing factors is important in planning for prevention. This study was conducted to investigate the association between aluminum-containing antiperspirant and hair color use with breast cancer.

Methods:

In this observational cross-sectional descriptive study, 384 patients with breast cancer referred to selected hospitals of Tehran University of Medical Sciences in 2017 and 384 person as control group were randomly selected. The anti-perspiration use of aluminum-containing and hair color was compared. In this study, data were collected and descriptive and inferential statistics were used to analyze them. Absolute and relative frequency distribute tables, mean, and standard deviation were used to descriptive statistics. Chi-square and independent t-tests were used for data analysis.

Results:

The use of antiperspirant was similar in this study, with 23.2% of breast cancer patients and 22.4% of control group using antiperspirant (P = 0.796). Frequency distribution of the use of hair color was similar among the studied subjects and 35.9% of breast cancer patients and 32% of control group consumed hair color (P = 0.253).

Conclusion:

Based on the results, it can be concluded that there is no significant relationship between the use of aluminum-containing anti-perspiration and hair color with breast cancer.
Quality of life (QOL) among older persons in an urban and rural area of Bangalore, South India
Authors: Krishnappa Lalitha , Gadicherla Suman , Chidambaram Priyadarshini , Murthy Nandagudi S.
Published: January 2021

Introduction:

The increasing ageing population of India has unique challenges due to changing social structure, health issues and inaccessible healthcare facilities. These challenges can adversely affect the quality of life (QOL) of older persons. Hence, this study was undertaken with the objective of assessing the QOL among older persons in an urban and rural area of Bangalore.

Materials and Methods:

Cross-sectional study was done among 977 older persons 60 years and above. Census enumeration blocks in urban areas and villages in rural areas were randomly selected and all older persons meeting the inclusion criteria were administered the WHOQOL-Bref questionnaire.

Results:

Mean QOL scores (SD) in the physical, psychological, social relationship and environmental domains were 50.5 (5.5), 49.2 (5.5), 49.4 (6.5) and 49.3 (5.1) in rural areas and 57.4 (8.9), 58.6 (8.8), 64.6 (10.8) and 60.0 (9.4) in urban areas, respectively. Compared to urban, rural older persons uniformly have lower QOL irrespective of sex, education or financial dependence.

Conclusion:

Inequitable health resource distribution and inadequate social support systems must be addressed to improve the QOL of older persons, especially in rural areas. Primary care providing essential services can bridge this urban–rural divide and improve QOL of older persons.
Case report of infective spondylodiscitis due to nalidixic acid-resistant Salmonella paratyphi A
Authors: Das Sohini , Bandyopadhyay Rini , Hansdak Samuel G.
Published: January 2021

Spondylodiscitis due to typhoidal Salmonella presents a therapeutic challenge for clinicians. Factors that complicate treatment include drug-resistant strains, poor antibiotic bone penetration, potential for neurological compromise and lack of established protocols and guidelines. We discuss a 57-year-old man with Salmonella paratyphi A spondylodiscitis involving lower thoracic vertebrae and discuss various aspects of management.
Assessment of knowledge, attitude, and practice about first aid among male school teachers in Hail city
Authors: Alshammari Khalid O.
Published: January 2021

Introduction:

Children in schools are more prone to get injured during their activities. Awareness toward first aid is vital for teachers to provide solutions in case of the occurrence of accidents. Our work aimed to assess the knowledge, attitude, and practice of first aid and the associated factors among male school teachers in Hail city.

Methodology:

This is a cross-sectional study. A questionnaire-based survey was performed among teachers in primary, middle, and secondary male schools in the Hail region, Saudi Arabia. Statistical analysis was performed using STATA 12 software, Continuous variables were presented as mean, and SD and inter-group differences were compared using t-test. Categorical variables showed as numbers and percentages. P values <0.05 were considered statistically significant.

Results:

A total of 604 teachers were included in our sample; all completed an online structured questionnaire formed of 20 questions. The majority of participants were male teachers (80.96%). The teachers had a mean age of 39 ± 7.8 years old. Most of the teachers (90.9%) knew about first aids. More than one-half of teachers (58.28%) had not taken first aid training, and the majority of participants (87.9%) need to learn first aid principles. Age, sex, and marital status were significantly (P < 0.05) associated with the knowledge of first aids. Most of our samples depend on media and social media to gain information regarding first aid principles.

Conclusion:

Our study concluded that the school teachers in Hail city had good knowledge and attitude about the first aid. However, more training workshops were recommended for improving the first aid practice of teachers.
Cutaneous manifestations associated with COVID-19 in children
Authors: Shah Seema , Akhade Kiran , Ganguly Satyaki , Nanda Rachita , Mohapatra Eli , Goel Anil Kumar
Published: January 2021

Cutaneous manifestation of COVID 19 in children has not yet been reviewed systematically. Hence, this review gives the clinicians a future direction to be vigilant for skin presentations during pandemics. The Pubmed database used for literature search with keywords COVID 19, children, and skin in different combinations. Articles published in English with cases of age one month to 18 years were eligible. The outcome included varied aspects of cutaneous and COVID 19 infection. The authors did not register review protocol. Of 51 publications identified, 13 studies containing 149 children met the eligibility criteria. Acrally located erythematous maculopapular lesion was the most common finding in 138 children. The researcher reported Erythema multiforme, varicella like exanthem, and Kawasaki disease like presentations in the rest of the cases. The duration of the skin lesion was 1 2 weeks in 43%. Skin biopsy done in 18 patients revealed superficial and deep perivascular and peri eccrine lymphocytic infiltrate and lymphocytic vasculitis. RT PCR was positive13.8% cases. Serological markers for HSV, parvovirus B19 analyzed across various studies, were negative, except positive mycoplasma pneumonia in 2 of 20 cases tested. Clinicopathologic analysis established chilblains like lesion in 43% cases with no confirmed etiology like cold exposure, autoimmune dysfunction, drug reaction, or viral infection. The usual cephalo caudal spread of a viral exanthem was also missing. However, a low number of discussed cases was a limitation of the study. The absence of any confirmed etiology for such cutaneous manifestations, the possibility of COVID 19, should be explored and thoroughly evaluated and isolated during such a pandemic.
Acute kidney injury and electrolyte abnormalities in patients with scrub typhus admitted to a tertiary care hospital in southern India
Authors: Grover Raghav , Mehalingam Vadivelan
Published: January 2021

Introduction:

Scrub typhus is an acute febrile illness that is seen in many parts of India. Acute kidney injury (AKI) can occur in patients with scrub typhus who are not diagnosed and treated in the early stage of the disease. Such patients can have associated electrolyte abnormalities also.

Objectives:

This study was done to find out the incidence of occurrence of AKI and electrolyte abnormalities among patients with scrub typhus and correlate the latter with the severity of AKI.

Methods:

This prospective, observational study included 38 patients with scrub typhus admitted to a tertiary care hospital in south India. Serum sodium and serum potassium levels of all the patients were measured at hospital admission. Also, serum creatinine levels of patients on all days of the hospital stay was measured along with other parameters like hemoglobin, leucocyte count, and platelet count.

Results:

The incidence of AKI among patients with scrub typhus was 13.16%. However, electrolyte abnormalities though seen in the patients did not correlate with AKI.

Conclusion:

AKI is not an uncommon phenomenon in patients with scrub typhus. Electrolyte abnormalities in these patients did not correlate with the severity of AKI.
Knowledge, awareness, and vaccination compliance of hepatitis B among medical students in Riyadh's governmental universities
Authors: Altamimi Abdulrahman R. , Alqahtani Taif M. , Ahmed Jumanah A. , Aldosari Lama H. , Alzahrani Manar M. , Alotaibi Ghala S. , Moukaddem Afaf K.
Published: January 2021

Background:

Hepatitis B is a blood-borne infectious liver disease caused by the Hepatitis B Virus (HBV) and it is best prevented by immunization. Due to occupational exposure, medical students have an increased risk of contracting HBV. Therefore, it is essential for all medical students to have good knowledge about HBV and to complete their HBV vaccinations.

Aims:

The aim of this study was to assess and compare HBV knowledge, awareness, and vaccination compliance among pre-clinical medical students in four universities.

Settings and Design:

A cross-sectional study was conducted in September 2018 at the College of Medicine of four governmental universities: King Saud Bin Abdulaziz University for Health Sciences, King Saud University, Princess Noura university, and Imam Mohammed bin Saud Islamic University, in Riyadh, Saudi Arabia.

Methods and Materials:

Two-hundred-sixty-three pre-clinical medical students completed a questionnaire with sections about demographics, HBV awareness, knowledge, and vaccination compliance.

Statistical analysis used:

The data was transferred to Excel and SPSS version 22 was used for statistical analysis. A significance level of P < 0.05 was considered statistically significant.

Results:

The overall knowledge about HBV and vaccination compliance were poor. KSU students had the highest vaccination compliance (n = 52, 54.2%) and KSAU-HS the lowest (n = 19, 23,8%). The most-cited reasons for noncompliance were “forgetting about the vaccine” and “busy schedule“.

Conclusion:

Overall, most of the participants had poor HBV knowledge and vaccine compliance. Therefore, we recommend the implementation of pre-clinical vaccine checking and the addition of an infectious disease awareness and prevention program.
Prediction of hospital outcome in emergency medical admissions using modified early warning score (MEWS)
Authors: Bhatnagar Mini , Sirohi Nikita , Dubey Aruna Bhagat
Published: January 2021

Objective:

To evaluate the applicability of modified early warning (MEWS) Score for prediction of hospital outcomes of medical emergency patients.

Design:

Prospective hospital based observational study.

Setting:

A tertiary care level medicine emergency unit in a medical college of North India.

Study Population:

300 Patients admitted in medicine emergency.

Method:

Patients of both sexes of age more than 18 years who were admitted in medical emergency unit at MMIMSR, Ambala were evaluated. Patients who were in cardiac arrest at arrival and those who died within the first 24 hours were excluded and 300 patients were included. Modified Early Warning Score based on physiological parameters was recorded at admission for each patient and monitored over the next 24 hours in the emergency unit. Hospital outcome of the patient in terms of mortality, need for critical care, prolonged stay and uneventful discharge were recorded and correlated with MEWS scores over the first 24 hours in the emergency unit. Receiver Operating Characteristic (ROC) curves was generated to evaluate the utility of MEWS as a tool to predict patient outcome in medical emergency setting.

Result:

Of the 300 patients studied, the mean age of patients was 49 years, and the majority of the patients were male (61%). A MEWS Score of >5 at 24 hours of admission was associated significantly with in-hospital mortality of patients (p < 0.0001). The ROC (Receiver Operator Characteristic) curve revealed that in those patients who had a 24 hours MEWS >/= 5, the area under curve was (AUC) = 0.9. (95% CI: 0.95-0.98). Thus, MEWS was an effective predictor of in hospital mortality with sensitivity (78%) and specificity (94%).

Conclusion:

MEWS, a scoring system based on easily recordable physiological parameters can be used as an effective tool to triage and monitor patients in medical emergency units, to identify patients who are at greater risk of clinical deterioration and need close monitoring or early transfer for critical care or other timely interventions. Thus, application of MEWS in medical emergency units can be a useful tool to improve patient care, ensure optimal utilization of resources and prevent inappropriate discharge or neglect of sick patients.
Glycemic control and its associated factors among women with gestational diabetes mellitus in a tertiary care Centre, Puducherry, South India
Authors: Meena Garima , Venkatachalam Jayaseelan , Chinnakali Palanivel , Olickal Jeby J. , Kumar Karthiga V. , Subramanian Sadhana , Dasari Papa
Published: January 2021

Background:

Worldwide, one in ten pregnancies is related with diabetes; 87.6% of which are gestational diabetes mellitus (GDM). Maternal hyperglycaemia affects the successful progression of pregnancy.

Objectives:

To determine the proportion and the factors associated with poor glycaemic control among women with gestational diabetes.

Methods:

This hospital-based cross-sectional study was conducted in a tertiary care hospital, Puducherry, South India from September to October 2019. Pregnant women diagnosed as GDM and on treatment for at least one month were approached consecutively for the study. A fasting blood sugar (FBS) ≥92 mg/dl and postprandial blood sugar (PPBS) 1 hour ≥180 mg/dl or PPBS 2 hour ≥153 mg/dl were considered as poor glycaemic control.

Results:

A total of 301 women with GDM were included and the mean (SD) age was 27 (5) years. Of total, 29 (10%) reported GDM during their previous pregnancy and 95 (32%) got diagnosed before reaching the tertiary care hospital. Lifestyle modifications (77%) were the most common mode of management for GDM. Of total, 116 (38.5%; 95% CI 33%-44.3%) had poor glycaemic control. Multigravida women (46.9%) and those on pharmacological treatment for GDM had poor glycaemic control.

Conclusion:

One-third of women with GDM at a tertiary care centre had poor glycaemic control. Therefore, a novel approach to improve awareness about GDM control both among pregnant women and the medical fraternity is needed.
Seizure as a presenting manifestation of Wernicke's encephalopathy induced by hyperemesis gravidarum
Authors: Ghosh Ritwik , Mandal Arpan , Roy Devlina , Chatterjee Subhankar , Ghosh Mrinal Kanti , Dubey Souvik , Lahiri Durjoy , Finsterer Josef , Ray Biman Kanti
Published: January 2021

Wernicke's encephalopathy (WE) is an acute neurological condition characterized by the triad of ophthalmoparesis with nystagmus, ataxia, and global confusion. WE is a life-threatening illness caused by thiamine deficiency, primarily affecting the peripheral and central nervous systems. Thiamine deficiency is predominantly associated with chronic alcoholism, but various other causes have also been reported, including severe malnutrition, prolonged parenteral nutrition, malignancies, immunodeficiency syndromes, liver disease, hyperthyroidism and severe anorexia nervosa, and hyperemesis gravidarum. We, hereby, report a unique case of WE induced by hyperemesis gravidarum that presented in mid-trimester of pregnancy in a rather extremely unusual way with focal seizures and secondary generalization but fortunately ended up with a good feto-maternal outcome.
Prevalence of knee osteoarthritis, its determinants, and impact on the quality of life in elderly persons in rural Ballabgarh, Haryana
Authors: Jaiswal Abhishek , Goswami Kiran , Haldar Partha , Salve Harshal Ramesh , Singh U.
Published: January 2021

Background:

Osteoarthritis (OA) is the most common type of arthritis and a very common disease of elderly. It is one of the leading causes of disability. The present study was conducted to estimate the burden of the knee OA among rural elderly.

Methods:

A community-based cross-sectional study was conducted among 500 randomly selected elderly resident of rural Ballabgarh, Haryana. A semi-structured interview schedule was used by a trained investigator for face-to-face interview, clinical examination of knee using American College of Rheumatology criteria, and quality of life assessment using WHOQOL-BREF.

Results:

Almost two-third of the participants among 454 elderly recruited, suffered from knee OA (292, 64.3%) had knee OA. History of a knee injury, a family history of knee pain, current physical activity and smoking status were found to be significantly associated with knee OA, in multivariate logistic regression model. Elderly suffering from knee OA had significantly lower quality-of-life scores contrasted to those not (p-value < 0.001). The scores were significantly lower for all the domains (P-value <0.001) among elderly suffering with the knee OA, with the maximum effect seen in psychological, and physical domain.

Conclusion:

Rural elderly of Ballabgarh, Haryana, had a high burden of knee OA. Elderly suffering from knee OA had significantly lower perception of their quality of life most affected is the psychological and physical domains of quality of life.
Proportion of anaemia and factors associated with it among the attendees of the antenatal clinic in a teaching institute of northeast India
Authors: Debnath Arpita , Debbarma Asish , Debbarma Saru Kumar , Bhattacharjya Himadri
Published: January 2021

Background:

Anaemia is an important cause of maternal morbidity and mortality in India. According to National Family Health Survey-4, the prevalence of anaemia among pregnant women in Tripura was 54.4%, but the proportion of anaemic women attending antenatal clinics is not known.

Objectives:

To find out the proportion of anaemia and associated factors among pregnant women attending antenatal clinic at Agartala Government Medical College.

Materials and Method:

This hospital-based cross-sectional study was conducted among 200 pregnant women attending the antenatal clinic of Agartala Government Medical College from 14th July to 7th August 2019 chosen by consecutive sampling.

Results:

Majority (69.5%) of the women were aged either ≤ 25 years, 94.5% were Hindu, 37% belonged to scheduled caste community, 58.5% from a rural area, 28% belonged to BG Prasad's class II socioeconomic status and 52.5% had only primary education. The proportion of anaemia was found to be 60%. It was 63.3% among ≤ 25 years age group and 62.9% among those who studied up to primary level. Mean (SD) Hb level was 9.9 ± 0.6 g%. Among the anaemic, 57.5% were primigravida and 45% were carrying the third trimester of pregnancy. Only 1% of the study women reportedly consumed either 200 or more number of iron tablets. Age < 25 years, (OR = 1.824, 95% CI = 1.231–2.108, P = 0.003), holding BPL or similar ration cards (OR = 3.482, 95% CI = 1.201–5.371, P = 0.031) and getting at <18 years (OR = 4.482, 95% CI = 2.317–6.451, P = 0.003) were identified as the significant predictors of anaemia during pregnancy.

Conclusion:

The proportion of anaemia among attendees of the antenatal clinic was higher than the state prevalence of anaemia among pregnant women. Lower literacy, lower socioeconomic status, rural residence, etc., had significant associations with anaemia in this population.
Use of ABI to detect peripheral arterial disease in diabetes – A recommendation for primary care physicians
Authors: Mishra Nibedita
Published: January 2021

Background:

India is considered the diabetes capital of the world. As per current practice, most of the diabetes patients go to primary care physicians for their monitoring and follow up. One of the dreaded complications of long-term diabetes is peripheral arterial disease.

Methods:

A cross-sectional observational study was conducted in a diabetes workshop. Totally, 48 patients were selected who satisfied the inclusion criteria. All were subjected to ankle-brachial index measurement (ABI) and doppler ultrasound was done to assess patency of the lower extremity arteries. The results were compared. The ankle-brachial index of less than 0.99 was considered abnormal.

Results:

Out of a total of 48 included patients 26 patients had normal ABI and 22 patients were found to have abnormal ABI. Out of those with normal ABI, 2 patients had features of peripheral arterial disease proved by doppler, whereas 3 patients with abnormal ABI had no feature of peripheral arterial disease in doppler. MedCalc software was used for statistical comparison.

Conclusion:

In the selected diabetic population prevalence of peripheral arterial disease was found to be 56.25%. Measurement of ABI was found to be quite a sensitive and specific method for diagnosing peripheral arterial disease of diabetics.
Effect of Motivational Enhancement Therapy (MET) on the self efficacy of Individuals of Alcohol dependence
Authors: Kumar Saurav , Srivastava Mona , Srivastava Manushi , Yadav Jai S. , Prakash Shiv
Published: January 2021

Introduction:

Motivational enhancement therapy is characterized as a directive, client-centered intervention which helps in modification of behavior by helping subjects in identifying and resolving the ambivalence toward a change in self. In order to free one from the vicious cycle of the alcohol trap one needs self-efficacy, which serves a protective role to prevent from relapses. The study aims to assess and compare the effectiveness of MET on the self-efficacy of individuals pre and posttest with control design were applied.

Methods:

A total of 40 subjects, alcohol-dependent persons fulfilling International classification of Diseases-10 criteria were selected through purposive sampling method from Outdoor and Indoor Service of Psychiatry Department IMS BHU, Varanasi, were randomly divided into two groups. 1st group 20 subjects were given motivational enhancement therapy session for 10 sessions along with treatment as usual (MET + TAU), whereas 2nd group control group were given treatment as usual (TAU) at the end of intervention post level of self-efficacy were measured through self-efficacy scale. Modified Kuppuswamy Socioeconomic Status Scale, Alcohol use disorder identification test, Self-Efficacy Scale as tools were used.

Result:

The result shows that the mean value of self-efficacy in (MET + TAU) group before intervention was 56.30 ± 2.99 and mean value of self-efficacy in (MET + TAU) after intervention was 60.75 ± 2.65 which shows significant difference is found in self-efficacy after intervention.

Conclusion:

Motivational enhancement therapy tries to decrease ambivalence so as to enhance the change in the subject's self-efficacy which assists the individuals in abstinence from alcohol.
Severe COVID-19
Authors: Garg Ravindra Kumar , Singh Gyan Prakash , Garg Rajiv , Kumar Neeraj , Parihar Anit
Published: January 2021

Severe coronavirus disease-2019 (COVID-19) is a distinct entity that rapidly evolves and may abruptly culminate in to a critical illness. As per Chinese experience, approximately, 15% of patients of COVID-19 progress to severe disease and 5% become critically ill. The incidence of severe and critical illness is higher among men, patients older than 65 years of age and in persons with other medical comorbidities. Cytokine storm cause pronounced lung damage and multiorgan failure. Coagulopathy is a key component of severe COVID-19. Critically ill patients are generally predisposed to a high risk of thromboembolism as well. Lymphopenia predisposes to severe disease. None of the antiviral or immunomodulators has proven efficacy in severe COVID-19. Supplemental oxygen need be administered in patients with hypoxemia. Excessive breathing effort, acute respiratory distress syndrome (ARDS), encephalopathy, and multiorgan failure are indications for mechanical ventilation. In a large number of patients, the overall outcome is poor. Health care workers in intensive care units are exposed to the enormous risk of acquiring hospital acquired SARS-COV-2 infection.
Postnatal newborn care practices and knowledge of newborn danger signs among mothers in rural area of Lucknow, Uttar Pradesh
Authors: Pathak Pankaj K. , Singh J.V. , Agarwal Monika , Kant Surya
Published: January 2021

Introduction:

The postnatal period is the most critical period for mothers and her newborn especially during the hours and days after birth. Proper utilization of postnatal care services plays a vital role in dropping the maternal mortality ratio and infant mortality rate.

Methods:

The community based, cross-sectional study was carried out in the field practice area of Primary Health Centre (PHC) Sarojini Nagar, Lucknow UP. A total of 200 mothers of newborn (age 03 days to 60 days) born in the catchment area of PHC Sarojini Nagar during eight months period were included in this study. A semi-structured pre-tested questionnaire was used for interview of eligible mother. The objective of study was to assess the postnatal newborn care practices and the knowledge of newborn danger sign among mothers in rural area of Lucknow, U.P.

Results:

The results showed that 49.50% of mothers applied substances to the stump after birth. 52.5% of mothers applied Kajal on the eye of the baby after birth. More than half of the mothers breastfed the baby within 1-4 hours of birth and Exclusive breastfeeding were practiced by nearly half (47%) of the mothers. Less than one-third of mothers used ambulance service 102/108 as their means of transportation to the health facility.

Conclusion:

Unsafe and harmful traditional newborn care practices are more prevalent in the rural areas. Health education and awareness programmes are recommended to improve maternal knowledge on the various aspects of newborn care.
Harnessing the potential of the primary healthcare facilities in India to respond COVID-19 pandemic
Authors: Royal Abhishek , Mali Marcelo Amaral , Kumar Vaibhav , Wagh Indrani Alhad , Bhushan Shashi , Mokal Avishkar Nitin , Mehta Kedar , Bhattacharya Sudip
Published: January 2021

COVID-19 has resulted in an unprecedented loss of human lives and sufferings across the world. It has resulted in the collapse of public health systems and economy across the globe. As most of the national health systems lack organized surveillance infrastructure, resources, and expertise to respond to a pandemic, most of the countries failed to mount an effective response to contain the spread of this virus initially. As primary healthcare (PHC) has better access to the community, the settings where PHC services are inadequate or weak, hospitals are overwhelmed with patients, thus overburdening, and wasting meager specialist resources. PHC interventions can manage mild to moderate cases (>80% of total cases) and their contacts, along with addressing the needs of general population while only severe cases may require specialized hospital care. As PHC interventions have huge potential to tackle this pandemic, strengthening and inclusion of PHC in pandemic response could play a significant role in relieving the workload on secondary and tertiary healthcare facilities and minimizing loss of lives and its short and long term socioeconomic consequences. This article explores the scope and importance of strengthening PHC in breaking the chain of the transmission of this infectious disease, building an adequate response to minimize its disastrous consequences and prevent future emerging and reemerging disease outbreaks, if any.
Minimally invasive intraarticular platelet rich plasma injection for refractory temporomandibular joint dysfunction syndrome in comparison to arthrocentesis
Authors: Chandra Lokesh , Goyal Manoj , Srivastava Dhirendra
Published: January 2021

Context:

Internal derangements of temporomandibular joint (TMJ) with associated symptoms which do not respond to conservative therapies are refractory cases of temporomandibular joint dysfunction syndrome (TMD). Minimally invasive techniques like arthrocentesis and platelet rich plasma (PRP) injections are usually employed to improve TMJ symptoms and function in these cases.

Aims:

To compare PRP with arthrocentesis for evaluating the effectiveness of PRP in relieving symptoms of refractory TMJ pain dysfunction syndrome.

Setting and Design:

A clinical study was carried out on 52 patients of refractory Temporomandibular joint dysfunction syndrome. The patients were divided in two groups that is Group A - test group and Group B -control Group.

Methods and Material:

Group A consisted of 26 patients who underwent intraarticular PRP injection in TMJ and Arthrocentesis of TMJ was done in 26 patients of Group B. TMJ pain, Maximium Interincisal opening and TMJ clicking were assessed among the group as well as between the groups over a period of 6 months.

Statistical Analysis Used:

Repeated Measure ANOVA was used to compare the parameters within the groups and T test was used for group comparison at 0.05 level of significance.

Result:

There was statistically significant difference in pain intensity improvement 1 ± 0.75 versus 3.17 ± 2.13, maximum interincisal opening 39.86 ± 2.86 versus 37.59 ± 4.03 and clicking 6 versus 16 between the PRP group and arthrocentesis group at P < 0.05.

Conclusions:

Intraarticular PRP injection for the management of refractory TMD is more effective than arthrocentesis in reducing symptoms and functional improvement.
Knowledge, attitude and perception of sex education among school going adolescents in urban area of Chennai, Tamil Nadu
Authors: Siva VK , Queen Nesan G Shiny Chrism , Jain Timsi
Published: January 2021

Introduction:

Adolescence is a significant period of one's life, the students or children at this age should be taught about sex education in order to lead a healthy reproductive life, to prevent sexually transmitted disease and to avoid unwanted pregnancies.

Aims and Objectives:

To evaluate the current knowledge of school going adolescents on reproductive health and its association with their socio demographic profile and determining their behaviour and understanding of school sex education.

Methodology:

A cross sectional analysis was carried out in 2 private schools at Chennai among the students of 9th to 12th standard. A sample of 346 was taken and a structured questionnaire was used to evaluate. The data was analysed by SPSS software version 22. Chi square test was used (<0.05 is significant).

Results:

Out of 346, 44.2% were males and 55.8% were females. 85.9% of students from nuclear family responded True for the statement 'Male hormone is called as Testosterone'. Females had better knowledge on sex education than Males which was significant. XII standard students had better and positive attitude towards sex education than IX standard students. Only 5% responded to have sex-related information from Parents than others who responded friends, doctors and teachers.

Conclusion:

It is seen that among school going adolescents there is lack of knowledge and varied perceptions towards sex education. So, sex education should be implemented more efficiently in the developing countries and so it can lead to a healthy reproductive life and sexual health among the adolescents.
Burnout and its correlates among nursing staff of intensive care units at a tertiary care center
Authors: Kumar Amit , Sinha Archana , Varma Jagdish R. , Prabhakaran Anusha M , Phatak Ajay G. , Nimbalkar Somshekhar M.
Published: January 2021

Background:

Burnout syndrome has been widely reported in nursing staff. It is more pronounced in intensive care setting (up to 80%). This survey was designed to assess the prevalence of burnout and its correlates among critical care nurses.

Methods:

Anonymous questionnaire was distributed to all ICU nursing staff of a tertiary care teaching hospital. Questionnaire had 25 questions covering – demography, job characteristics, Visual Analogue Scale for stress, co-worker support, work–life balance, question for measuring burnout, job satisfaction, turnover intention, organizational commitment, for depression screening and psychosomatic symptoms. The burnout scale score was used to dichotomize into low burnout (<3) or high burnout (> = 3) group. These two groups were compared using Chi-square test, Fischer's exact test for categorical variables and independent t-test for continuous variables. Significant variables were entered in multivariate logistic regression analysis.

Results:

Out of 150 ICU nurses, 125 (83.3%) gave completely filled questionnaires which were evaluated. 47 (37.6%) participants reported experiencing high burnout. Binary logistic regression model revealed that lack of specialized ICU training (OR = 4.28, 95% CI: 1.62 to 11.34, P = 0.003), performing extra duty in last month (OR = 5.28, 95% CI: 1.90 to 14.67, P = 0.001), High physical symptoms in last 12 months (OR = 4.73, 95% CI: 1.56 to 14.36, P = 0.006) and mid-level experience (1–5 years) were significantly associated with burnout.

Conclusions:

Burnout is significantly prevalent (37.6%) among intensive care nurses. Specialized training and limiting work hours can help in mitigating this problem. High frequency of physical symptoms could be early indicators of burnout.
A clinical study on surgical causes of Hematuria
Authors: Newme Kewithinwangbo , Hajong Ranendra , Bhuyan Ratna Kanta
Published: January 2021

Introduction:

Hematuria is a clinical sign and symptom that every individual would have a worst nightmare and invokes a physician to carefully evaluate possible causes of hematuria. It may be medical or surgical causes. A thorough examination is required to exact the primary pathology. As such, a study on hematuria in North east India is not sufficiently researched or published.

Material & methods:

Here we present an observational study in our institution on that very topic. A study was done purely on surgical causes of hematuria on symptomatic patients. It was done on the inpatient and outpatient basis in Assam Medical College, Dibrugarh during the period of 2016–2019. Total 43 patients were evaluated, who came with symptomatic hematuria.

Results:

Out of 43 cases of symptomatic hematuria, 34 were male and 9 were females patients. Carcinoma urinary bladder was the commonest cause of hematuria, followed by BPH, urolithiasis, carcinoma prostrate, carcinoma upper urinary tract, etc.

Conclusion:

Benign prostatic hyperplasia was found to be the most common benign cause and carcinoma bladder was the commonest malignant cause of hematuria.
Women's experiences and perception of symptomatic pelvis organ prolapse
Authors: Prateek Shashi , Mundhra Rajlaxmi , Bahadur Anupama , Kunwar Kiran , Jha Prerna , Chawla Latika
Published: January 2021

Background:

Pelvic Organ Prolapse (POP) negatively affects the health of a woman in terms of physical, social and emotional wellbeing.

Objective:

The aim of this study was to elucidate the experience of living with prolapse and its impact on daily life.

Methods:

Women undergoing surgery for pelvic organ prolapse were interviewed to evaluate their sociodemographic profile with subsequent impact on their daily life.

Results:

Among the 45 cases with POP, 80% belonged to rural areas. Mean age of study group was 53.68 years. Young age at marriage (mean age 17.31), early first child birth (mean age being 20.5 years) and increased parity (86.66% had parity 3 and above) with majority of children born at home under supervision of untrained dais (77.78%) could probably attribute to their prolapse. Approximately 51% thought that prolapse occurs as a result of hard manual work and 64% cases considered it non treatable. POP was associated with poor quality of life in terms of physical, social and sexual life. Decreased sexual frequency was seen in 86.67% cases. 50% cases reported bladder problems. Sense of incomplete evacuation was seen in nearly 35% and constipation was reported by 37%.

Conclusion:

Though there exists a social stigma associated with pelvic organ prolapse, this study showed that in majority, it was the woman herself who delayed medical help. Health care providers should take initiative in educating women regarding prolapse and to make them aware that it is a treatable condition which can improve their quality of life.
Low carbohydrate diet rescued severe type 2 diabetes patient from insulin injection, a case report
Authors: Iwasaki Koh
Published: January 2021

Fifty-six years old male type 2 diabetes patient with fasting blood sugar (FBS) 414 mg/d and hemoglobin A1c (HbA1c) 10.7% tried low carbohydrate diet (LCD) 30 days. After the diet, his FBS decreased to 174 mg/d and HbA1c was 7.7%. Therefore, he escaped from insulin injection and was able to treat with metformin.
Primordial prevention
Authors: Hussain Masaraf
Published: January 2021

Stroke, and neurodegenerative diseases represents, a major and rapidly growing burden of mortality and morbidity. The risk factors for stroke starts very early in life. Similarly, the changes of neurodegenerative diseases starts decades earlier than the clinical manifestations. Primordial prevention is necessary to prevent the establishment of risk factors to keep the population disease free. This will help to not only increase the life span, but also to prolong the health span.
Potential cause affecting bone quality in Saudi Arabia
Authors: Al-Hariri Mohammed T. , Al Goweiz Roaa , Aldhafery Bander , Alsadah Majed M. , Alkathim Ahmed S. , AlQassab Mohsen Z. , AlRammadan Abdullah H. , AlElaq Mahmoud A.
Published: January 2021

Background:

Osteoporosis (OP) is a silent systemic disease characterized by decrements in bone mineral density (BMD) and bone microstructure. This study aimed to determine the status of bone quality as well as to investigate the relationship between the glycaemic; lipid; bone profiles; and the BMD.

Methods:

A retrospective study was conducted at KFHU, Al Khobar, Saudi Arabia analysis of patients who underwent BMD testing between the periods of 2016 to 2018. Based on the T scores, patients were classified as follows: normal (>−1.0), osteopenic (−1.0 to −2.5), or osteoporotic (≤−2.5). Details about medical and demographic information as well as metabolic and bone profiles (fasting blood glucose [FBG], glycated haemoglobin [HbA1c], cholesterol [Chol], high-density lipoprotein [HDL], low-density lipoprotein [LDL], triglycerides [TG], calcium [Ca], phosphorus [Ph], alkaline phosphatase [ALP], vitamin D 25OHD [Vit D]) were extracted from the medical records system.

Results:

Out of 4838 extracted profiles, there were 4196 females (85.1%). The mean glycaemic variables of patients showed an abnormal profile (FBG 118 ± 49 and HbA1c 6.6 ± 2). The mean T score showed that the majority of patients had either osteopenic (40%) or osteoporotic (24%) changed. Significant increase in mean HbA1c (7.6 ± 1.7) was obvious among the osteopenic patients when judged against the normal (7.5 ± 1.6; P < 0.033) and osteoporotic (7.4 ± 1.8; P < 0.037). Meanwhile, the mean serum ALP was significantly lower (81 ± 26) in the normal group than in the osteopenic (86 ± 33; P < 0.006) and osteoporotic groups (90 ± 40; P < 0.001). Finally, a linear, logistic regression analysis was found that Ca and ALP levels were significant predictors.

Conclusion:

This study finds that the main cause that affects bone quality in Saudi Arabia is diabetes mellitus and/or its related metabolic alteration. These results suggest that bone health is clinically significant and should be carefully assessed in diabetes patients.
Continued Outbreak of Ceftriaxone-Resistant Salmonella enterica Serotype Typhi across Pakistan and Assessment of Knowledge and Practices among Healthcare Workers
Authors: Nizamuddin Summiya , Ching Carly , Kamal Rashid , Zaman Muhammad H. , Sultan Faisal
Published: January 2021

Pakistan is experiencing the first known outbreak of extensively drug-resistant (XDR) Salmonella enterica serotype Typhi (resistant to third-generation cephalosporins). The outbreak originated in Hyderabad in 2016 and spread throughout the Sindh Province. Whereas focus has remained on Sindh, the burden of XDR typhoid in Punjab, the most populous province, and the rest of the country is understudied. Using laboratory data from Shaukat Khanum Memorial Cancer Hospital and Research Centre in Lahore (Punjab Province) and its network of more than 100 collection centers across the country, we determined the frequency of blood culture–confirmed XDR typhoid cases from 2017 to 2019. We observed an increase in XDR typhoid cases in Punjab, with the percent of ceftriaxone resistance among Salmonella Typhi cases increasing from no cases in 2017, to 30% in 2018, and to 50% in 2019, with children bearing the largest burden. We also observed spread of XDR typhoid to the two other provinces in Pakistan. To assess prevailing knowledge and practices on XDR typhoid, we surveyed 321 frontline healthcare workers. Survey results suggested that inappropriate diagnostic tests and antibiotic practices may lead to underdiagnosis of XDR typhoid cases, and potentially drive resistance development and spread. Of those surveyed, only 43.6% had heard of XDR typhoid. Currently, serological tests are more routinely used over blood culture tests even though blood culture is imperative for a definitive diagnosis of typhoid fever. We recommend stronger liaisons between healthcare providers and diagnostic laboratories, and increased promotion of typhoid vaccination among healthcare workers and the general population.