bluuebunny/crossref_metadata_2025 huggingface dataset:
Strengthening of cancer care services in Bihar: A situational analysis
Authors: Raj Shraddha , Goel Akhil D. , Upadhyay Vivekanand , Singh Rajesh K. , Bhardwaj Pankaj
Published: September 2024

Background:

The status of cancer care in Bihar is in elementary stages, with limited knowledge of epidemiology and insufficient comprehensive cancer care centers. State Cancer Institute (SCI) of Bihar is actively working to address these gaps by continuously upgrading its facilities and services.

Objectives:

The present article aims to define the problem and conduct a situational analysis for strengthening cancer care services in Bihar through the expansion and integration of services at SCI, Indira Gandhi Institute of Medical Sciences (IGIMS), Patna.

Materials and Methods:

A problem statement was initially developed following a comprehensive review of the literature from January 2023 to September 2023, with an updated review conducted in August 2024. Full-text articles containing the keywords “cancer,” “incidence,” and “Bihar” were searched on PubMed and manually screened for relevance based on titles and abstracts. Additional information was collected through Google searches of public domain websites and newspaper portals, and relevant articles were also identified through a manual review of references. Furthermore, a situational analysis was conducted using SWOT analysis and power-interest matrix to identify and evaluate the stakeholders.

Results:

Accurate cancer incidence data for Bihar are lacking. Almost half of the estimated new cancer cases seem to be registered within the state, while the rest remain unaccounted. Presently, there are only eight comprehensive cancer centers operational in the state. The SWOT analysis highlighted opportunities for SCI based on inherent strengths, while limited manpower and inadequate collaborations were identified as critical weaknesses. Key stakeholders were identified as the crucial players in mitigating threats and supporting positive policy and financial frameworks.

Conclusion:

Properly addressing the needs of stakeholders and fully utilizing available opportunities are essential for strengthening healthcare services in the state. The SCI could play a vital role in the process. The article also provides background on devising strategies to address the current cancer care needs of the state.
Plurihormonal pituitary neuroendocrine tumor causing acromegaly with subclinical Cushing’s disease
Authors: Nachankar Amit S. , Shekhawat Vikram Singh , Modi Sachin , Sharma Mandeep , Kumar Ashish , Santosha Mantha
Published: September 2024

Macrosomatotropinoma is the most common cause of acromegaly. Plurihormonal pituitary neuroendocrine tumor causing acromegaly often has growth hormone (GH) and prolactin excess. Here, we present a case of acromegaly with adrenocorticotrophic hormone (ACTH) excess due to macrosomatocorticotropinoma. A 32 years old man presented with left-sided progressive painless loss of vision. Clinically, he had acromegaloid features with overt diabetes mellitus (DM) without any discriminatory features of Cushing’s disease or hypertension. The hormonal evaluation revealed elevated insulin-like growth factor 1 with nonsuppressible GH and elevated plasma ACTH. Overnight, the dexamethasone test was nonsuppressible but the low-dose dexamethasone test was suppressible. Magnetic resonance imaging showed pituitary macroadenoma with optic chiasmal compression. Perimetry revealed left anopia. He underwent endoscopic transnasal transsphenoidal resection of macrosomatotropinoma with full recovery of vision. Immunohistochemistry confirmed pleurihormonal (GH and ACTH) pituitary adenoma. Postoperatively, his secondary DM is well controlled on oral antidiabetic agents. He underwent gamma knife surgery for residual lesion and is presently on long-acting somatostatin receptor ligand octreotide for active acromegaly. This is an extremely rare case of overt acromegaly with subclinical Cushing’s disease due to plurihormonal macrosomatocorticotropinoma. A total of 25 similar cases have been recorded in world literature to date. In the presence of GH–ACTH excess, signs of acromegaly are often clinically dominant and Cushing’s disease is usually but not always silent.
Catecholamine-Secreting Adrenal Myelolipoma in the Absence of Hypertension: A Rare Case Report
Authors: Jain Abhinay , Daksh Seema , Ranjan Karishma , Tanveer Nadeem , Mangla Pragya , Raizada Nishant , Madhu Sri Venkata
Published: September 2024

Adrenal myelolipoma (AML) is a benign neoplasm of the adrenal gland composed of fat and myeloid components. Most of these tumors are asymptomatic and non-secretory. We describe the case of a 22-year-old female who was being evaluated for right abdominal flank pain. She was detected with a 7.1 × 5.2 cm right adrenal mass with −55 mean HU on computed tomography (CT) scan, suggestive of myelolipoma. Her 24-hour urine normetanephrine level was elevated. Regular blood pressure monitoring was carried out, but she was normotensive. Right-sided unilateral adrenalectomy was performed. Histopathologic analysis confirmed the diagnosis of adrenal myelolipoma. Urine normetanephrine levels normalized post-surgery. Very few cases of catecholamine secretion by AML have been described in the literature. All of these cases had hypertension. To the best of our knowledge, this will be the first case reporting catecholamine secretion by AML in a normotensive patient.
Thoracic Epidural Anesthesia with Ipsilateral Interscalene Nerve Block for Modified Radical Mastectomy in Patients with Cardiorespiratory Compromise: A Prospective Feasibility Case Series
Authors: Jain Amrita , Shah Pratibha Jain , Ayalasomayajula Sashank
Published: September 2024

Modified radical mastectomy (MRM) is the most common surgical procedure performed for breast carcinoma. It is usually performed under general anesthesia (GA), which becomes challenging in patients with respiratory compromise and multiple comorbidities. Thoracic epidural anesthesia is adequate for simple mastectomies, and when combined with ipsilateral interscalene nerve block, it provides adequate anesthesia for MRM, which involves axillary lymph node (LN) dissection in an outstretched arm that can be a discomfort to the patient. We describe our experience of giving thoracic epidural anesthesia with ipsilateral interscalene brachial plexus block (IBPB) in ten patients posted for MRM. A thoracic epidural was introduced under local anesthesia at T6-T7 intervertebral space and ultrasonography (USG)-guided ipsilateral IBPB was given. A satisfactory anesthetic effect was proved by the absence of tactile sensation over the operative mammary region and axilla within 30 min. This case series demonstrated that combined thoracic epidural anesthesia with ipsilateral IBPB can be used very efficiently in patients posted for MRMs without the need for GA.
Early Outcome of Percutaneous Cooled Radiofrequency Ablation in Degenerative Lumbar Facet Arthropathy and Sacroiliac Dysfunction with Associated Comorbid Illness: A Prospective Observational Study
Authors: Shamim Parvez , Ahmed Abrar , Mullick Joydeep
Published: September 2024

Study Design:

This was a prospective observational study.

Objectives:

We report clinical outcomes in a clinical study of patients treated with cooled radiofrequency ablation for chronic back pain associated with lumbar facet arthropathy with sacroiliac dysfunction (unilateral as well as bilateral) associated with multiple medical comorbidities.

Summary of Background Data:

A clinical study was conducted on patients with lumbar facet arthropathy with sacroiliac dysfunction. A significant difference was observed postprocedure during periodical follow-ups.

Materials and Methods:

A prospective observational study of 56 patients suffering from lumbar facet arthropathy with sacroiliac joint dysfunctions was conducted at Apollo Multi-Speciality Hospital, Kolkata, from July 2022 to July 2023 over 1 year. Inclusion criteria are chronic low back pain with degenerative lumbar facet arthropathy with sacroiliac dysfunction with sacroiliitis and patients with failed back syndrome which fails on conservative management for at least 3 months in more than 30-year-old patients. The outcome assessment of all patients was done by the Visual Analog Scale (VAS) scores and Oswestry Disability Index (ODI) scores and followed up for 0, 1, 3, and 6 months and 1 year.

Results:

We found significant relief in pain with a significant statistical difference on subsequent follow-up over 6 months to 1 year using VAS and ODI scores. We did not get any major complications in our study despite elderly patients with multiple medical comorbidities.

Conclusion:

Cooled radiofrequency significantly improves the pain associated with lumbar facet arthropathy with sacroiliac dysfunction with promising results.
Headache Due to Spontaneous Intracranial Hypotension Treated with Cervical Epidural Blood Patch
Authors: Mutha Sandeep , Manohar Manas , Mahazoom MV , Phalgune Deepak
Published: September 2024

Spontaneous intracranial hypotension (SIH) is caused by spinal leakage of cerebrospinal fluid and it is characterized by an orthostatic headache without a history of trauma or dural puncture. Epidural blood patches have been regarded as the mainstay of therapy for SIH, often providing instantaneous relief of symptoms in 90% of cases regardless of the site of the leak. We present a rare case report of an epidural leak treated with a cervical epidural blood patch.
Innovative Approaches to Severe Intractable Cancer Pain Due to Malignant Psoas Syndrome
Authors: Turkoz Ayda , Kangarli Nigar , Tepe Gulpınar
Published: September 2024

Malignant psoas syndrome (MPS) is associated with proximal lumbosacral plexopathy and is characterized by severe intractable pain, despite multimodal medical treatment. Spinal dexmedetomidine and lumbar sympathetic nerve block in combination with pulsed radiofrequency (PRF) are rarely performed for intractable lumbosacral plexopathy pain. We present a combination of spinal dexmedetomidine lumbar sympathetic nerve block and caudal-epidural PRF in the management of MPS, refractory to medical and physical treatment. A 49-year-old female with recurrent lung adenocarcinoma was admitted with shooting pain on the right side over the psoas muscle with irradiation into the right groin and weakness of quadriceps at motion. She was managing her pain with a number of opioids, including oxycodone, morphine, fentanyl, and intramuscular meperidine. The total oral morphine equivalent opioid dose equaled 460 mg. At the first admission, we successfully palliated pain with spinal dexmedetomidine and simultaneously reduced the patient’s opioid addiction. On the second admission, lumbar sympathetic nerve block at L3 with additional caudal-epidural PRF led to a significant reduction in her thigh pain visual analog scale (VAS) score to 1–2/10. In addition, improvement in quadriceps functionality and sleep quality, along with a remarkable reduction in analgesic medicine doses, earned patients high satisfaction. Our patient passed away 6 months later with average VAS severity of 4/10. Spinal dexmedetomidine, caudal-epidural PRF, and lumbar sympathetic nerve block should be added as a therapeutic option to the treatment guidelines for the management of MPS, acquired due to lumbosacral plexopathy.
Preventive Effects of Crocin, a Key Carotenoid Component in Saffron, Against Nicotine-Triggered Neurodegeneration in Rat Hippocampus: Possible Role of Autophagy and Apoptosis
Authors: Gholami Mina , Klionsky Daniel J. , Motaghinejad Majid
Published: September 2024

Background:

Nicotine is a behavioral stimulant that in high doses, through the neuro-inflammatory and oxidative stress pathway, can induce apoptosis and autophagy leading to cell death. Previous data indicate that crocin has neuroprotective properties. The aim of the current study is to investigate crocin’s neuroprotective effects against nicotine-triggered neuro-inflammation, apoptosis, and autophagy in rat hippocampus.

Methods:

Seventy adult male Wistar rats were divided into the following seven groups: Group one received normal saline (0.2 ml/rat), group two was treated with nicotine 10 mg/kg intraperitoneally, groups 3 to 6 were treated simultaneously with nicotine and crocin (10, 20, 40, and 80 mg/kg, intraperitoneally), group 7 was treated with crocin-alone (80 mg/kg, intraperitoneally). The period of the mentioned agent administration was 21 days. On the 22nd day, an open field test (OFT) was used for evaluation of anxiety and motor activity changes. Inflammatory and oxidative stress factors and also apoptosis and autophagy biomarkers were evaluated.

Results:

All mentioned doses of crocin could decrease the nicotine-induced OFT behavioral changes. Crocin also could decrease levels of hippocampal TNF/TNF-α (tumor necrosis factor), IL1B/IL-1β (interleukin 1 beta), oxidized glutathione (GSSG), unphosphorylated and phosphorylated forms of JNK, BECN1 (beclin 1), BAX (BCL2 associated X, apoptosis regulator), and phosphorylated/inactive forms of BCL2 (BCL2 apoptosis regulator) in nicotine-dependent rats. Crocin treatments also caused increases in the reduced form of glutathione (GSH) content and activity of CAT (catalase) and mitochondrial complex enzymes in nicotine-addicted subjects.

Conclusions:

Crocin can modulate JNK-BCL2-BECN1 or JNK-BCL2-BAX signaling pathways and reduce neuronal oxidative stress, neuro-inflammation, and mitochondrial respiratory chain enzymes and exert neuroprotective effects against nicotine-induced neurodegeneration.
Development and psychometric testing of an instrument for team-based learning assessment
Authors: Mojtahedzadeh Rita , Mohammadi Aeen , Kolahdooz Sima , Parmelee Dean X. , Hassanzadeh Gholamreza
Published: September 2024

BACKGROUND:

In team-based learning (TBL), students actively participate in the learning process and are responsible for their learning through preclass studying and team work with other classmates. Evaluation of the TBL method by students provides information for its better implementation. Due to extensive use of TBL method in medical curriculum at medical universities, we aimed to develop a questionnaire for its evaluation from the viewpoints of students.

MATERIALS AND METHODS:

This mixed-method cross-sectional study with a Qual-Quan design was conducted on 168 medical students in the basic sciences stage of their studies. We evaluated students’ satisfaction with this teaching method and its effectiveness by semistructural in-depth individual interviews until data saturation (12 interviews). We performed content analysis of the interviews and designed the questionnaire. Psychometric characteristics of the questionnaire were assessed in terms of content validity, test-retest reliability, internal consistency, and construct validity through explanatory factor analysis.

RESULTS:

The final tool was a 25-item questionnaire (reliability = 0.87 and α = 0.93) with five components of “learning enhancement,” “satisfaction,” “technical aspects,” “teacher’s capabilities,” and “appropriate testing.” Explanatory factor analysis showed that 64.68% of total variances were explained by these five components.

CONCLUSION:

In addition to academic performance outcomes, a successful instructional strategy should generate positive experiences for the learner. This study has created an assessment tool to be part of an evaluation process of the effectiveness of TBL in a given curriculum for medical students.
A cross-sectional study to estimate the prevalence of eating disorders and ascertain factors for eating disorder risk among senior college students in a metropolitan city
Authors: Hadaye Rujuta S. , Rahini S
Published: September 2024

BACKGROUND:

Eating disorders are more prevalent in Western countries and their prevalence is on the rise in India, mainly due to peer pressure and the influence of media. However, research on eating disorders is limited in India. The aim of this study is to estimate the prevalence of eating disorders among senior college students and to ascertain factors for eating disorder risk.

MATERIALS AND METHODS:

A cross-sectional study was conducted among 807 students attending 2 of the arts and science colleges in a metropolitan city (Mumbai) over a period of 12 months from June 2019 to June 2020. A predesigned case record form was used to collect information on sociodemographic profiles and other factors related to eating disorder risk. Eating Attitude test (EAT-26) was used as a screening test to find the prevalence of those at risk for eating disorders. Munich-ED quest was used for the diagnosis of the eating disorder.

RESULTS:

Data were analyzed using SPSS version 16.0. The Chi-square test was used to find the association of various factors with eating disorder risk. Our study found the overall proportion of eating disorder risk to be 42.25%. Among them, 19 (2.35%) individuals had night eating syndrome and 7 (0.86%) had binge eating syndrome as per DSM-5 criteria using Munich ED Quest. On logistic regression, we found fasting once or twice a week (OR: 2.916;95%CI: 1.524–5.574; P = 0.001), increase in duration of physical activities for more than 10 h a week (OR: 3.874; 95% CI: 2.200–6.821; P < 0.001), being commented for weight by friends/relatives (OR: 1.695; 95% CI: 1.244–2.309; P = 0.001), and thought of being overweight (OR: 1.763;95% CI: 1.178–2.639; P = 0.006) to be significantly associated with risk of eating disorders. The age group of 18–20 years (OR: 0.519;95%CI: 0.345-0.782; P = 0.002) was found to be at lower risk for eating disorders compared to the 22–24 year age group.

CONCLUSION:

Screening of students with a simple tool like EAT-26 would prove beneficial in the early identification of those at risk of eating disorders.
Correlation between moral distress and compassion fatigue in the emergency department nurses: A cross-sectional study from Ardabil Province, Iran
Authors: Karimollahi Mansoureh , Mazaheri Effat , Khangah Hassan Almaspoor , Pourhamzeh Sulmaz
Published: September 2024

BACKGROUND:

Nurses working in the emergency department increasingly face moral distress due to the nature of their profession, negatively affecting their love and compassion toward the patient. Therefore, this study sought to determine the correlation between moral distress and compassion fatigue in the nurses of the emergency departments of the hospitals in Ardabil.

MATERIALS AND METHODS:

The current cross-sectional (descriptive correlational) study was conducted using consensus sampling. The study population comprised all nurses working in the emergency departments of hospitals in Ardabil in 2022. Data were gathered using two standard questionnaires, comprising compassion fatigue by Figley (2002) and moral distress by Hamric et al. (2012). The data were analysed using SPSS-20 software and descriptive and inferential statistics, including independent T-test, Pearson’s correlation coefficient, and one-way ANOVA.

RESULTS:

Moral distress was higher than average in governmental hospitals (2.12±0.58) and below average in private and social security hospitals (1.72±0.68). Besides, the nurses' compassion fatigue was lower than average in all studied hospitals (2.17±0.43). There was also a significant positive correlation equal to 0.29 between moral distress and compassion fatigue in emergency department nurses (P<0.01).

CONCLUSION:

According to the results, the higher the level of moral distress, the greater the compassion fatigue. The level of moral distress and its relationship with compassion fatigue reflects the impact of conditions causing moral distress on the quality of care and the necessity to prevent such conditions by providing appropriate solutions. Informing nurses about moral distress and its consequences and providing periodic counseling can contribute to its identification and control.
Effect of hypnosis on anxiety and blood pressure of pregnant women with preeclampsia: A double-blind controlled clinical trial study
Authors: Seitz Farzaneh , Pourasghar Mehdi , Hosseinnataj Abolfazl , Hoseinnezhad Seydeh Zeynab , Eshraghi Nooshin , Ganji Jila
Published: September 2024

BACKGROUND:

The risk is on the level of blood pressure, and blood pressure is one of the prominent characteristics of preeclampsia. The aim of this study is to assess the effect of hypnosis on the pressure and blood pressure of pregnant women with preeclampsia.

MATERIALS AND METHODS:

In this controlled clinical trial study, 44 pregnant women from 20 to 32 weeks referred to Shahid Akbarabadi Hospital in Tehran in 2022 were randomly assigned to two intervention and control groups. Hypnotherapy was conducted individually and online for five sessions. Evaluation of performance and blood pressure (primary outcome) was done using the DASS-21 questionnaire and sphygmomanometer before, during maintenance, and 4 weeks after the intervention. Twenty people in each group entered the analysis stage. Independentt-test, Chi-square, analysis of variance with repeated measures and mixed model were used, and effect size (Cohen’s D) was used to evaluate the strength of the intervention effect. The data were entered into the SPSS software version 22 and a significance level of 0.05 was considered.

RESULTS:

The results showed that the two groups did not differ in terms of background changes (P= 0.757). The score after the intervention decreased by 10.25 (P< 0.001) and the time 1 month after the intervention decreased by 9.93 (P< 0.001). The blood pressure after the intervention was reduced by 7.90 (P< 0.001) and the blood pressure 1 month after the intervention by 7.52 (P< 0.001).

CONCLUSION:

It is suggested to use hypnotherapy as a complementary treatment to reduce anxiety and preeclampsia symptoms.
Exploring empathy among undergraduate nursing students at universities in India and South Africa
Authors: Aranha Priya Reshma , Chacko Leena K. , Bimray Portia , Chipps Jennifer
Published: September 2024

BACKGROUND:

Empathetic involvement is an essential ingredient in forming a therapeutic nurse–patient relationship, which would lead to more optimal patient care. It is one of the essential professional values possessed by nurses. This study aimed to assess empathy among nursing students at two universities on different continents.

MATERIALS AND METHODS:

This was a cross-sectional online questionnaire-based study conducted among the Bachelor of Science (BSc) nursing students at Yenepoya Deemed to be University (YU), India, and the University of the Western Cape (UWC), South Africa. A total of 377 students from India and 245 students from South Africa voluntarily took part in the study. The study participants were selected based on convenience sampling techniques. A sociodemographic proforma and the Jefferson Scale of Empathy were used to collect the data. An analysis of variance (ANOVA)/t-test was computed to compare the empathy between students at two universities. The level of significance was fixed at a probability of <0.05.

RESULTS:

On the statistical analysis, it was shown that respondents from both settings showed a higher level of empathy. Overall, students at UWC showed higher empathy scores than those at YU (P < 0.05). Empathy scores of students from UWC did not differ significantly based on their age, year of study, and ethnicity, whereas empathy scores showed significant differences for students from YU in terms of gender, year of study, and religion (P < 0.05).

CONCLUSION:

In this study, the majority of respondents from both settings showed a higher level of empathy. Though students demonstrated high level of empathy, nurse educators need to pay more attention to value training, during undergraduate education for preparing the nurses to work in today’s complex healthcare context.
Academic success of students with low socioeconomic status: Explanation and evaluation of a model with a mixed-methods approach
Authors: Seyyedmoharrami Iman , Kareshki Hossein , Kimiaei Seyed Ali , Bordbar Maryam
Published: September 2024

BACKGROUND:

In this research, a model of factors affecting students’ academic success with low socioeconomic status (SES) was explained and evaluated.

MATERIALS AND METHODS:

A mixed-methods research design was used to explain academic success and evaluate it. From this point of view, the research was divided into two parts: grounded theory (GT) and structural equation modeling (SEM). For the qualitative part, semi-structured interviews were held with 49 students, parents, and teachers from Roshtkhar City, one of the less privileged areas of the department of education in Razavi Khorasan Province in Iran. In the second part, this model was tested using the multistage cluster random sampling method on 314 students from Roshtkhar City with the SEM method. The instrument used in the quantitative section was a researcher-made questionnaire whose validity and reliability have been confirmed.

RESULT:

It was found that the causal conditions had significant effects on the phenomenon of the academic positive perspective of students with low SES (β = 0.77), academic positive perspective on the implementation of academic success strategies in low SES areas (β = 0.6), context background on the implementation of strategies (β = 0.28), intervening conditions on the implementation of strategies (β = 0.12), and implementation of interactions and strategies of students with low SES on the consequences of academic success (β = 0.86). The phenomenon of academic positive perspective clarified the complexity of the academic success of students with low SES.

CONCLUSION:

The examined paradigm model can be a suitable model for the academic success of students with low SES.
Explaining the framework of the pro-natalist policy implementation process in Iran: A study protocol
Authors: Sahebi-Rizi Morteza , Amini-Rarani Mostafa , Shaarbafchizadeh Nasrin
Published: September 2024

BACKGROUND:

Population policies and programs around the world are considered as the basis for socio-economic' development. Demographic data in recent years show that Iran has faced a marked decrease in fertility, which makes it inevitable to take emergency measures and plan properly to increase childbearing. A significant point in this field is the basic role of the health system and universities of medical sciences. Therefore, it seems necessary to formulate and present the framework for the correct implementation of population increase policies.

MATERIALS AND METHOD:

This study endeavors to provide a comprehensive analysis of executive policies related to population growth and to present a proposed framework in a qualitative manner using the General Implementation Framework method in three phases. Initially, a conceptual review study will be conducted to determine the current situation. Then, the process of implementing a population growth policy in Iran is identified in two stages. In the second phase, using semistructured interviews, the challenges of the population growth policy implementation for Iran will be identified. In the last phase, the initial framework of the population increase policy implementation process has been explained, and finally, this framework will be validated and finalized through the Delphi technique.

DISCUSSION:

Due to the decrease in Iran’s population growth rate and the concern of population aging, the complete stop of the population control policy, the growth of births, and the increase of childbearing have been put on the agenda. However, in Iran, despite the existence of different policies and directives at micro and macro levels regarding population and policies related to it, there is no unanimity in the implementation of policies on this subject.
Differences in compassion satisfaction and compassion fatigue among oncology nurses in Oman: A multi-center cross-sectional study
Authors: Jacob Devakirubai , Muliira Joshua K. , Lazarus Eilean R. , Al Zaabi Omar
Published: September 2024

BACKGROUND:

Oncology nurses are constantly exposed to occupational exposure to the suffering of others, which can lead to vicarious traumatization, low professional quality of life (ProQOL), and inability to provide quality nursing care. The purpose of the study is to explore the ProQOL of oncology nurses working in Oman and the characteristics that lead to differences in compassion satisfaction (CS) and compassion fatigue (CF).

MATERIALS AND METHODS:

A cross-sectional design was conducted between March and December 2020 using the ProQOL scale to collect data from 242 oncology nurses in Oman using a convenience sampling technique. The rates of CS and CF [(secondary traumatic stress (STS) and burnout (BO)] were summarized using descriptive statistics. The characteristics leading to differences in CS and CF were assessed using the independent-sample t-test.

RESULTS:

Only 35% reported high levels of CS. Most nurses reported moderate STS (60%) and BO (65%). Nurses aged ≥36 years, ≥10 years of professional experience, ≥6 years of oncology experience, married, and desiring to work with cancer patients reported higher levels of CS.

CONCLUSION:

Omani oncology nurses have low levels of CS. The nurses’ desire to work with cancer patients, professional experience, and the age of cancer patients regularly affected the experience of CF. The identified characteristics can be exploited to mitigate deterioration in oncology nurses’ ProQOL using targeted interventions for high-risk individuals. Beneficial interventions may focus on continuing education, stress management, coping, work environment, teamwork, and communication of oncology nurses and other members of the healthcare team.
Post debridement – Mental health and body image satisfaction among mucormycosis patients: Concern beyond surgical debridement
Authors: Nair Rathish , Thomas Priyanka Elizabeth , Mohanan Keerthi , Bhawana Kranti , Thakur Monika
Published: September 2024

A sudden surge in the cases of mucormycosis forced India’s coronavirus disease 2019 task force to issue evidence-based advisory on the disease. Severity was seen as comparatively high among diabetic and immuno-compromised individuals. Surgical procedures leading to scars of incision and disfigurement of the face might trigger dissatisfaction with body image and poor mental health. The study was conducted to assess mental health and level of satisfaction with body image among patients diagnosed with mucormycosis during the post-operative period. A descriptive cross-sectional study was conducted among patients diagnosed with mucormycosis who underwent surgical debridement in a tertiary care hospital among 56 patients selected by the total enumeration sampling technique. Data were collected using DASS-21 and a modified version of the body image scale. Among 56 patients, most participants (n = 43) were highly satisfied with their body image. In terms of mental health, patients reported mild levels of depression (12.5%), anxiety (7.1%), and stress (1.8%) after surgery. Body image scores were positively correlated with stress scores (r = 0.323) at P < 0.05. Among the sub-scales of mental health, scores of anxiety and stress were found to be correlated (r = 0.457) at P < 0.01. A statistical association was found between occupational status and level of depression (χ2 = 13.501, P = 0.007), body image and number of post-operative days (χ2 = 13.654, P = 0.033), and body mass index and level of depression (χ2 = 12.396, P = 0.005). Early identification of predictors of mental health disorders due to dissatisfaction with body image among post-debridement mucormycosis patients could help in planning psycho-social interventions.
Effect and impression of structured feedback in formative assessment of medical undergraduates of Eastern India
Authors: Chakraborty Sanghamitra , Vagha Sunita , Chakrabarty Sebanti
Published: September 2024

Feedback, the integral component of formative assessment, should be timely, specific, and methodical. Feedback is a stop-gap that helps the learner to assess their performance and reinforce their desire to learn. This study was conducted to explore the effectiveness of feedback in improving the performance of medical undergraduates in formative assessment and assessment of perceptions of students about feedback. This comparative interventional study was conducted to monitor the improvement in formative assessment scores after the structured feedback. Medical undergraduates of phase1 (Bachelor of Medicine and Bachelor of Surgery (MBBS) Batch 2022–2023) of Bankura Sammilani Medical College and Hospital were included as the study participants. The proportion of students having scores <50% and >50% between the two formative assessments were compared using the Chi-square test. A questionnaire in the Likert scale was devised to assess the perception of students regarding quality of feedback and analyzed by Tastle and Wierman formula. The number of students scoring > 50% as well as their mean formative assessment scores increased significantly after feedback (P = 0.0009). The majority of the students proclaimed that feedback was non-judgmental and motivated for the study. Feedback motivated students to assess their deficits and encouraged the desire to study to overcome the lacunae. The majority of the students (65.9%) strongly voiced that the feedback was effective, valuable, and non-judgmental.
Pattern and correlates of Internet gaming disorder among medical students – A cross-sectional study from a tertiary care health institute, Rajasthan
Authors: Kumar Abhishek , Gupta Ajay , Raj Dilip , Kumar Amit
Published: September 2024

BACKGROUND:

Internet gaming disorder (IGD) is a global problem associated with several psychological complications, such as insomnia, poor academic performance, and aggression. The present study aimed to explore the pattern and correlates of gaming disorder among a sample of medical college students from India and determine the motivational basis for it.

MATERIALS AND METHODS:

An analytical cross-sectional study was conducted at a medical college in Rajasthan from January 2021 to June 2021 after obtaining approval from the Institutional Ethical Committee. The study participants were all medical undergraduate students of age 18 years or more, who were engaged in Internet gaming during the past year (i.e., the last 12 months. It was a web-based online survey in which a pre-designed, semi-structured questionnaire was used to collect information on the socio-demographic profile of the respondents, Internet Gaming Disorder Scale–Short-Form (IGDS9-SF) and Motives for Online Gaming Questionnaire (MOGQ) scale. Multivariate regression analysis was performed for the prediction of dependent variables on the basis of several independent variables like gender, substance abuse, relationship status, and weekly time and money spent on gaming.

RESULTS:

The study included 864 undergraduate students, out of which 675 were engaged in Internet gaming during the last 12 months, so analyses were made on 675 students to assess the severity of IGD. The proportion of disordered gamers was 2.1%. Substance abuse [odds ratio (OR) = 7.026], owning a game console or other dedicated gaming devices (OR = 10.099), and weekly time spent on gaming (OR = 7.026) were significantly associated with higher odds of being a disordered gamer. Similarly, the weekly amount of money spent on gaming and the age of initiation of gaming were also significant predictors for IGD.

CONCLUSIONS:

Substance abuse, owning a game console or other dedicated gaming devices, weekly time spent on gaming, weekly money spent on gaming, and age of initiation of gaming were independent predictors for disordered gamers. Restricting gaming activities and engaging and training in other activities can help overcome the problem.
Comparison of the effectiveness of self-care educational program using animation and role-playing on quality of life in adolescents with type 1 diabetes
Authors: Hosseiniasl Parisa , Karimi Zohreh , Moghadam Abdolkarim G. , Mazaheri Maryam A. , Zoladl Mohammad
Published: September 2024

BACKGROUND:

Type 1 diabetes is a chronic disease and the number of Adolescents diagnosed with it, is at an increase. Self-care education can reduce the complications of this disease. Therefore, this research was conducted to determine and compare the effectiveness of self-care educational programs, using animation and role-playing on quality of life in Adolescents with type 1 diabetes.

MATERIALS AND METHODS:

This quasi-experimental study consists of 111 Adolescents with type 1 diabetes, who visited Imam Hossein (PBUH) pediatric endocrinology clinic, Isfahan, May since August 2021, were selected through convenience sampling. The Diabetes Quality of Life for Youth scale was used, before and after the intervention. The interventions in each group were performed twice a week for 2 months. Data were analyzed through the one-way analysis of variance, Chi-square, Bonferroni post
hoc and paired t-statistical tests.

RESULTS:

After completing the interventions, the mean quality of life score in group 1 (animation) was significantly higher compared to that of group 2 (role-playing) (P = 0.001). In intervention group 1 (animation) and intervention group 2 (role-playing), the quality of life score and its subscales, after the completion of the research interventions had a significant increase, compared to the beginning of the study (P = 0.001).

CONCLUSION:

Both animation and role-playing educational methods caused statistically significant changes in the quality of life score, and the animation educational method was more effective than role-playing. Therefore, it is suggested that managers, policymakers and health team members consider the implementation of these educational methods in the educational program of adolescents with type 1 diabetes and use these two educational methods.
A large language model in solving primary healthcare issues: A potential implication for remote healthcare and medical education
Authors: Mondal Himel , De Rajesh , Mondal Shaikat , Juhi Ayesha
Published: September 2024

BACKGROUND AND AIM:

Access to quality health care is essential, particularly in remote areas where the availability of healthcare professionals may be limited. The advancement of artificial intelligence (AI) and natural language processing (NLP) has led to the development of large language models (LLMs) that exhibit capabilities in understanding and generating human-like text. This study aimed to evaluate the performance of a LLM, ChatGPT, in addressing primary healthcare issues.

MATERIALS AND METHODS:

This study was conducted in May 2023 with ChatGPT May 12 version. A total of 30 multiple-choice questions (MCQs) related to primary health care were selected to test the proficiency of ChatGPT. These MCQs covered various topics commonly encountered in primary healthcare practice. ChatGPT answered the questions in two segments—one is choosing the single best answer of MCQ and another is supporting text for the answer. The answers to MCQs were compared with the predefined answer keys. The justifications of the answers were checked by two primary healthcare professionals on a 5-point Likert-type scale. The data were presented as number and percentage.

RESULTS:

Among the 30 questions, ChatGPT provided correct responses for 28 yielding an accuracy of 93.33%. The mean score for explanation in supporting the answer was 4.58 ± 0.85. There was an inter-item correlation of 0.896, and the average measure intraclass correlation coefficient (ICC) was 0.94 (95% confidence interval 0.88–0.97) indicating a high level of interobserver agreement.

CONCLUSION:

LLMs, such as ChatGPT, show promising potential in addressing primary healthcare issues. The high accuracy rate achieved by ChatGPT in answering primary healthcare-related MCQs underscores the value of these models as resources for patients and healthcare providers in remote healthcare settings. This can also help in self-directed learning by medical students.
Challenges faced by medical faculty in implementation of competency-based medical education and lessons learned
Authors: Agrawal Apurva , Sharma Ashish , Sharma Anita , Agrawal Charusmita
Published: September 2024

BACKGROUND:

Regulations on Graduate Medical Education (Amendment), 2019 (GME) introduced competency-based medical education (CMBE) for undergraduate medical students and were implemented in the 2019 entrance batch in medical colleges all over India. This study aimed to find out the challenges faced by medical teachers in CBME implementation, lessons learned, and the level of preparedness for upcoming batches.

MATERIAL AND METHODS:

A cross-sectional, multi-centric descriptive study was conducted from November 2021 to February 2022 including first-year faculty of medical colleges. A self-administered questionnaire was provided through electronic media, about challenges faced during CBME implementation and suggestions for improvement. Responses were analyzed as descriptive statistics, and content analysis was conducted for open-ended questions.

RESULTS:

A total of 50 responses were analyzed. About 46% believed that the foundation course (FC) could satisfy the GME Regulation’s goal to only some extent. About 60% believed that integration was not optimum, and 40% had not taken any integrated session. About 36% had not taken any attitude, ethics and communication (AETCOM) session, and 30% considered that they were not sufficiently competent. About 68% believed that early clinical exposure (ECE) given is insufficient. “Skills” (50%) and “attitude-communication” (34%) could not be satisfactorily assessed. About 72% believed that the coronavirus disease 2019 (COVID-19) pandemic significantly affected academics, 20% are still confused about the complexities of CBME, and 58% believed they are better prepared for the future. The COVID-19 pandemic (78%), lack of proper training (70%), and adequate faculty (60%) were common difficulties. Frequent hands-on workshops (68%) and better inter-departmental coordination (68%) were suggested.

CONCLUSION:

First professional-year faculties are slowly getting accustomed to the transition from a traditional to a competency-based curriculum. These reforms are complex, and the challenges need to be addressed sincerely and timely.
Sexual health promotion interventions in Iranian postmenopausal women: A systematic review of randomized controlled trials
Authors: Masoumi Maryam , Keramat Afsaneh , Farjamfar Maryam , Talebi Seyedeh Solmaz
Published: September 2024

This study aimed to systematically review published articles on sexual health promotion interventions in postmenopausal Iranian women. Five databases including PubMed, ProQuest, Web of Science, Science Direct, and Google Scholar, as well as three Iranian databases, including SID, IranDoc, and Magiran, were searched without a time limit for sexual health promotion interventions in Iranian postmenopausal women. The risk of bias was assessed using the Jadad scale. In total, 48 articles met our inclusion criteria and provided data for this review. The measured outcomes were different aspects of sexual function. Outcomes were measured using a specific questionnaire related to sexual function and its areas. The results obtained from the tools used have led to the classification of the results based on the type of interventions used to improve the sexual health of postmenopausal women. The main groups were drug interventions (chemical and herbal) and non-drug interventions (psychological and educational). Surveys showed that most interventions performed on sexual health in Iranian postmenopausal women were medicinal (herbal) interventions. Numerous studies obtained a good quality score. The results of this study can be used to improve the sexual health of postmenopausal women.
Comparing hoarseness and sore throat after extubation at different endotracheal cuff pressures: A double-blinded clinical trial
Authors: Arabkhazaie Azar , Sadeghi Noghabi Zahra , Basiri Moghadam Mehrsa , Saheban Maleki Mohsen , Aalami Hossein
Published: September 2024

BACKGROUND:

Sore throat and hoarseness are two common complications of intubation in patients with general anesthesia. This research aimed to compare the effect of different endotracheal cuff pressures on sore throat and hoarseness after general anesthesia.

MATERIALS AND METHODS:

The present double-blinded clinical trial was conducted on 45 patients who are candidates for surgery with general anesthesia in autumn and winter 2021. The participants were divided into three groups of 15 through a permuted block randomization. The 20–24 cm H2O (level of pressure) group was labeled as A, and the 25–29 cm H2O group B and the 30–34 cm H2O group was known as group C. All the patients were operated. The endotracheal intubation was done for men with tubes #8-8.5 and for women with tubes 7-7.5. The presence and severity sore throat and the hoarseness after operation were checked by a nurse after recovery. Data were recorded in a researcher-made checklist. The data were analyzed in SPSS 19. P <0.05 was considered.

RESULTS:

The results revealed that the majority of participants suffered a slight hoarseness within the 1st hour (73.3%), 12th hour (91.1%), and 24th hour (100%) after recovery. Similarly, most participants experienced a slight hoarseness in the 1st hour (57.8%), 12th hour (71.1%), and 24th hour (91.1%) after recovery. Kruskal–Wallis test results showed no statistically significant correlation between hoarseness and the level of endotracheal cuff pressure in the three groups (P > .05).

CONCLUSION:

According to the results of the present study, despite the fact that the range of 20 to 34 cm of water is a safe and risk-free range in terms of causing sore throat and hoarseness, and there was no difference between the pressures in the three groups, but at higher pressure (groups 2 and 3), the amount of sore throat and hoarseness was more and there was a statistically significant difference at different times within group. Therefore, as much as possible, the amount of pressure should be adjusted according to the need and avoid applying excess pressure.
COVID-19 and fear of death: Has the pandemic changed our death orientation?
Authors: Khanna Rakesh
Published: September 2024

The recent COVID-19 pandemic set the stage for a major upheaval. The entire world found itself caught in the specter of death. This review article outlines a case vignette of an orthopedic surgeon who was admitted to a COVID-19 ward at the height of the pandemic and was caught between an unfamiliar world of a doctor as a patient tormented by the likelihood of being the next casualty. The term coronaphobia has gained widespread currency. It has become a catch-all phrase for the fear and emotional and social strain experienced by people in the face of the COVID-19 pandemic. Death has been conceptualized in terms of (1) impersonal, (2) interpersonal, and (3) intrapersonal states. People were affected in all three ways. With nearly 7 million deaths even impersonal death mattered. Nearly everyone experienced the loss of one or more family and friends through the pandemic. Many who suffered from the illness had to face the prospect of personal death. As we move from the pandemic to the endemic stage of COVID-19, we must keep in mind the widespread untimely and catastrophic exposure to death. Many complex psychological challenges had to be faced. The lingering effect on people may be worth keeping an eye on. Adjustment disorder, posttraumatic stress disorder, exacerbation or relapse of preexisting conditions, and prolonged grief may be of concern.
Videolaryngoscope as a rescue to fiber-optic intubation in a pediatric patient
Authors: Choudhary Annu , Singh Swati , Annadurai Eshwar
Published: September 2024

We report a case of 6-year-old child posted for excision of a large fragile tumor over the face compromising mask application for ventilation. Fiber-optic intubation with preserved spontaneous respiration was attempted. However, unfortunately, the fiber-optic endoscope stopped functioning, before entering the glottic opening. We assisted the endoscope with a videolaryngoscope to achieve successful intubation without disturbing the mass. This combination technique can be used as a rescue strategy if the fiber-optic endoscope malfunctions.