bluuebunny/crossref_metadata_2025 huggingface dataset:
Study of immediate neurological and autonomic changes during kapalbhati pranayama in yoga practitioners
Authors: Malhotra Varun , Javed Danish , Wakode Santosh , Bharshankar Rajay , Soni Neha , Porter Patrick K.
Published: February 2022

Background:

Kapalbhati is a fast pace respiratory exercise or pranayam, which is supposed to be practiced by yogis to clean their brain. Pranayamas are well known to improve heart rate variability (HRV) ultimately leading to better autonomic functions. Other studies have observed the immediate effect of kapalbhati on various neurological (brain and spine) and autonomic functions, but their results are varied and inconclusive.

Objective:

The aim of this study is to find out the changes in HRV and brain waves during and after practice of kapalbhati as compared with the baseline values of different parameters.

Methods:

Various parameters were measured at baseline, during and after kapalbhati pranayam with the help of Dinamika HRV-Advanced HRV Test System, Moscow, Russia. Statistical analysis was accomplished employing repeated measures analysis of variance with Bonferroni post-hoc analysis and Holm’s multiple comparisons using the Version 28.0.0.0 of the Statistical Package for the Social Sciences (SPSS) for Windows (190) SPSS Inc., Chicago.

Results:

We found that during and after kapalbhati, changes in HRV were significant in time and frequency domain showing parasympathetic withdrawal and insignificant changes in brain waves as compared with reference point values.

Conclusion:

Kapalbhati is initially energizing, cleansing, and heating. There occurs parasympathetic withdrawal and sympathetic activation during pranayama. There is an increase gamma wave activation post pranayama showing control of the default mode network.
Comparative analysis of big five personality traits in obese and normal weight type 2 diabetes mellitus patients
Authors: Mukherjee Anurup , Yadav Bhupendra S. , Sarvottam Kumar
Published: February 2022

Background and Objectives:

Type 2 diabetes has multifactorial causation, with obesity and metabolic dysregulation being two of them. Personality traits are also known to influence many metabolic processes and have been associated with the pathogenesis of diabetes as well as obesity. The objective of the study was to analyze the differences in the big five personality traits of normal-weight type 2 diabetes mellitus, obese type 2 diabetes mellitus patients, and healthy controls.

Methods:

A total of 70 subjects were included in the study after outpatient-based screening, of which 40 were type 2 diabetes patients (20 obese and 20 normal weight) and 30 were healthy controls. After the anthropometric screening, the personality assessment of the subjects was done using the Neuroticism, Extraversion, Openness, Agreeableness, and Conscientiousness-Five Factor Inventory (NEO-FFI). The differences in the scores of each trait for every group were analyzed by analysis of variance (ANOVA) with Tukey’s honest significant difference (HSD) post hoc corrections. The difference in the scores between controls and diabetes patients was also compared by independent samples t-test.

Results:

The neuroticism score was significantly higher in both the normal-weight diabetes group (P = 0.01) and obese diabetes group (P = 0.02) as compared to the control group. All diabetes patients when compared with healthy controls had a significantly higher neuroticism score (P = 0.00) while their score of openness was significantly lower (P = 0.035) than healthy controls.

Interpretation and Conclusion:

This study identifies the association of personality with type 2 diabetes mellitus. The diabetes patients have higher neuroticism and lesser openness to experience as traits of personality. Importantly, this association is present irrespective of the obesity status of the patients.
A study on the clinical, epidemiological profile and the outcome of the snake bite victims in kashmir valley
Authors: Yaqoob Arjimand , Ali Mufti Showkat
Published: February 2022

Background:

India is estimated to have the highest snakebite mortality in the world. In India, around 250,000 incidents of snake bite are reported annually with 50,000 deaths. There are about 236 species of snakes in India, most of which are nonpoisonous. Most snakes found in Kashmir valley are nonvenomous of colubridae family (ptyas mucosus or grass snake).

Materials and Methods:

This Hospital-based retrospective and prospective study was conducted at Sher-i-kashmir Institute Of Medical Sciences Srinagar, a multispeciality teaching hospital having clinics for various medical and surgical specialities. All snake bite patients admitted in department of Emergency Medicine, other specialities, and critical care medicine were taken in this study over a period of 3 years.

Results:

Among a total of 108 cases of snake bite, majority were males (57.40%) and mostly 20 to 50 years of age (68.51%).Majority of victims were from rural areas (93.5%) and most of the bites occurred during day time (87.96%) mainly on the lower limbs (63.88%). Highest number of cases occurred from May to October (98.14%). Most of the victims were farmers. Bleeding was present in 13.88% patients and coagulopathy ( International normalized ratio (INR)>1.2) in 63.88% of patients. Neuroparalytic features were present in 8.33% patients. Mortality in our study was 2.8%.

Conclusion:

Snake bite in our valley is an occupational hazard affecting working class engaged in farming in fields, fruit orchards, and forests in rural areas. There is seasonal variation with most envenomations occurring in peak months of agricultural activities. Non recommended first aid measures like tourniquet and incision are commonly encountered. Regular public health programmes regarding prevention, prehospital management (first aid), and immediate transfer to hospital should be emphasized.
COVID-19 fear-induced anorexia nervosa and obsessive-compulsive disorder leading to fatal megaloblastic anemia: Lethal psychological complication of the pandemic
Authors: Khanna Shivam , Talwar Dhruv , Kumar Sunil , Acharya Sourya , Shukla Samarth
Published: February 2022

We report a young female having severe pallor and breathlessness on presentation, being diagnosed as a case of megaloblastic anemia, which was confirmed on bone marrow biopsy. On detailed history taking, she was revealed to have anorexia nervosa precipitated due to extreme fear of COVID-19 along with obsessive-compulsive disorder. Thus, a psychiatric disorder presenting due to simple phobia of COVID-19 can also have a fatal outcome in the young. Therefore, psychiatric health needs urgent attention by physicians, governments, and policymakers across the globe to prevent the surge of mental illness during the ongoing pandemic.
Kerala & Mizoram; High COVID-19 case load but low mortality: Role of precautionary principles
Authors: Raina Sunil K. , Kumar Raman
Published: February 2022

A small state in Northeast, Mizoram, with credentials in education sector similar to Kerala, like Kerala is attracting attention for the wrong reason; the high COVID-19 case load. So, what may be driving the high case load in these high literacy level states. Is the low mortality level (due to COVID-19) leading to a lack of emphasizing caution to prevent infection transmission behind this surge?
Factors affects the performance of red crescent paramedics, Bisha, Saudi Arabia
Authors: Alsaeed Sultan A. , Alkarani Ahmed S.
Published: February 2022

Context:

Saving lives is the ultimate purpose of the Red Crescent paramedics. It is crucial to enable safe, effective, and efficient performance of paramedics globally. In Saudi Arabia, the Red Crescent faces at least over 280,000 cases every year.

Aims:

Therefore, this study aims to address the factors affecting the performance of the Red Crescent paramedics.

Methods and Material:

Descriptive qualitative study and all data processed were analyzed using thematic analysis.

Settings and Design:

In total, 31 paramedic staff in Bisha city were invited to participate in this descriptive qualitative study. Among them, 11 paramedics agreed to participate in an in-depth semi-structured interview.

Results:

The findings of the research indicated three themes. The first theme was a lack of awareness in society, with three sub-themes: types of emergency calls, the crowd that gathers at the incident location, and people interruptions. Theme 2 was the long distance and road obstacles, and other factors that affect the paramedics were the third theme.

Conclusions:

Policymakers and the community should obtain a clear understanding of the Red Crescent paramedic interventions to help to create policies, legislation, and guidelines suitable for the needs of paramedics.
Are women with more of ‘social capital’ more empowered? A cross-sectional analysis from rural Wardha, Central India
Authors: Ikhar Madhuri R. , Banerjee Sitikantha , Bandhopadhyaya Kajari , Tiwari Mithilesh Kumar , Deshmukh Pradeep
Published: February 2022

Background:

Despite international commitment and government policies and programmes, a vast majority of women of rural India are socially and economically deprived in the patriarchal sociocultural framework. Strategies to improve women empowerment need context-specific field-based evidence. Objectives: This study was undertaken to address the research question: “Are women with a higher level of social capital more empowered than their counterparts?”

Methods:

A community-based cross-sectional analytical study was carried out in the Wardha district of Maharashtra, where a two-stage cluster random sampling technique was used to select the 300 study subjects. The outcome variable, women empowerment was assessed using four domains: mobility, inter-spouse communication, household decision-making and asset ownership. The independent variables included social capital along with potential sociodemographic confounders. Multivariate linear regression was applied using the backward stepwise method.

Results:

The participants had better women empowerment percentage score in the “Household decision-making” domain compared to the other domains. The women empowerment score was found to be significantly higher in the participants with increasing age, higher education, those involved in business/service, above poverty line (ABL), nuclear family, married, and those having at least one living child. In the adjusted analysis, the social capital was found to be a significant determinant of women empowerment, along with age, education, religion, marital status and family type.

Conclusion:

The improvement of social capital in the form of community-based development projects through Self-Help Groups (SHG) and microfinance programmes need to be encouraged by the Government and NGOs, as this strategy has the potential to improve women empowerment through community-driven development.
Effectiveness of lifestyle modification on quality of life among uncontrolled diabetics and hypertensives in India – Community based intervention study
Authors: Kundapur Rashmi , Modi Bhavesh , Ansari Remiza , Deepthi R , Santhosh P , Saxena Deepak
Published: February 2022

Background:

Diabetes and hypertension contribute to more than half of morbidity, mortality and years lived with disability in developing countries like India. It impacts the quality of life (QoL) of patients and their family. Management of these diseases is in infancy and emphasis is laid on pharmacological interventions. Though nonpharmacological measures are crucial for management, their implementation is questionable. Hence, this study was conducted to measure the effectiveness of lifestyle modifications on QoL among uncontrolled hypertensives and diabetics in rural India.

Methods:

An interventional study was done in 3 villages with 100 participants each, where village one received lifestyle modification as intervention and village two physical activity and village three control receiving standard care. The baseline data included socio-demographic characteristics such as awareness of hypertension, diabetes, lifestyle pattern and physical activity, and WHO QoL. The participants were trained, followed up, and assessed after 12 months following intervention. QoL scores between groups and pre- and post-intervention in the group were compared using Mann–Whitney U and Wilcoxon signed-rank test, respectively.

Results:

In this study, there was a significant improvement in overall QoL and in all the four domains, namely physical, psychological, social relationship, and environmental domains in both the intervention villages. QoL was significantly better in both the intervention groups following intervention than compared to the control group.

Conclusions:

QoL improves with intervention on uncontrolled diabetics and hypertensives. It is time to emphasize on the collaboration among physicians and on the holistic integrative health services delivery for non-communicable diseases.
Liver: Function and dysfunction in COVID-19
Authors: EJ Harisha , Gosavi Siddharth , Rao Amogh A. , Sahana GV , Manjunath Sanath , Meghana TC
Published: February 2022

Context:

COVID-19 is known to cause extrapulmonary manifestations, including gastrointestinal and abnormal liver functions. Multiple mechanisms have been proposed to explain the pathobiology of liver damage: ACE2 receptor cholangiocytes mediated systemic inflammation, cytokine storm, hyperinflammation, and hypoxic changes. This was a cross-sectional study done in Department of General Medicine,JJM Medical College Davangere between July and September 2020 of patients falling under Category B and Category C.

Materials and Methods:

The aim is to describe the clinical characteristics in patients of COVID-19 and investigate the gender difference with particular regard to liver impairment.Confirmation of COVID-19 positivity was based on RT-PCR for SARS-CoV-2 RNA. Laboratory investigations and clinical data was analyzed using SPSS Statistics 27.

Results:

The final study population consisted of 116 patients. On performing the Mann Whitney U test, adjusted P values reveal a significant difference in ALT (P = 0.0348), total bilirubin (P = 0.0012) and direct bilirubin (P = 0.0024). The degree of hypoalbuminemia in males was significantly higher than in females (P = 0.0075). Other biochemical parameters, however, did not show significant difference amongst patients based on gender. Acute kidney injury was the most prevalent condition, present in 67.2% of the patients. Other co-morbidities were diabetes mellites, chronic liver disease, hypertension, hepatitis B and C, and hypothyroidism.

Conclusion:

Ultrasonography of the abdomen is an essential investigation for all patients testing positive for COVID-19. Pre-existing disease may aggravate the viral hepatic injury, thereby worsening the clinical outcome. The profiles of liver toxicity of the drugs used in the treatment of COVID-19 also warrant watchful monitoring of liver function.
Serum complements and immunoglobulin profiles in systemic lupus erythematosus patients: An observational study at a teaching hospital
Authors: Rana Ranjan Singh , Naik Bitan , Yadav Mahima , Singh Usha , Singh Anup , Singh Shailja
Published: February 2022

Context:

Serum complement proteins and autoantibodies play an important role in the pathogenesis and diagnosis of systemic lupus erythematosus (SLE). Abnormalities in various immunoglobulin levels are described in patients of SLE.

Aims:

To study the spectrum of clinical manifestations and measure the serum levels of complement C3, complement C4, autoantibodies and immunoglobulin G (IgG) in patients of SLE and compare with healthy controls.

Settings and Design:

The present study is a prospective hospital-based observational study conducted between May 2014 and December 2018.

Statistical Analysis Used:

Unpaired t-test was used to compare the mean values between the SLE patients and healthy controls.

Material and Methods:

A total of 100 cases of SLE and 100 healthy controls were included in the study. The clinical data were retrieved. Serum antinuclear antibody, anti-ds DNA antibody, and anti-Smith antibody levels, and complements C3, C4 and IgG were measured.

Results:

Arthritis (89%) and anaemia (65%) were two common clinical presentations. The low complement C3 levels and C4 were detected in 64 and 62% of the SLE patients. Serum IgG was increased in 41% of the patients. A reduced level of IgG was detected in 6% of the patients.

Conclusion:

Primary care physicians should be aware of the clinical and serological manifestations of SLE as early detection will reduce end-organ damage. Autoantibody testing and complement testing should be done in all suspected cases. This study showed a significantly reduced C3 and C4 and elevated IgG in many cases of SLE as compared to control. Hypogammaglobulinemia was also present in a minority of the cases.
Relationship between Sense of Coherence and Knowledge on Early Childhood Caries Among Pregnant Women in Bangalore Rural and Urban District
Authors: Krishnan Gopika , Dhananjaya G.
Published: February 2022

Context:

Sense of coherence (SOC), as stated, is a global orientation that views life as comprehensible, structural, manageable, and coherent. Pregnancy is considered as a crucial time period where an individual experiences increased stress and apprehension which could indirectly affect the child's Quality of Life. Hence, it is important to assess the SOC during this phase of life.

Aims:

This study aimed to assess the SOC and knowledge about early childhood caries (ECC) among pregnant women and to correlate SOC, level of education, and oral health status of the pregnant women.

Materials and Methods:

A questionnaire-based cross-sectional study was conducted on pregnant women. The oral health status of the pregnant women was assessed using ICDAS II index and the education status of the participants was also obtained.

Statistical Analysis Used:

Chi-square test was used for intergroup comparison. Mann–Whitney U-test and Pearson's correlations were done to compare the variables between urban and rural population. Simple linear regression analysis and binary logistic regression were done to determine if SOC varied with change in other variables.

Results:

The mean SOC among rural and urban population were 33.64 and 41.01, respectively. It was seen that urban pregnant women had more knowledge regarding ECC and less Decayed Missing Filled Teeth (DMFT) as compared to rural pregnant women. There was an inverse relation of knowledge on ECC and SOC with DMFT among urban and rural pregnant women and a direct correlation between knowledge on ECC and SOC with education.

Conclusions:

This study concludes that SOC and knowledge on ECC are low among rural pregnant women. Furthermore, the SOC correlates with the level of education and oral health status of pregnant women in urban and rural districts of Bangalore, Karnataka.
Assessment of Oral Health Care Practices and Smokeless Tobacco Habit Among Adults in Odisha
Authors: Mahapatra Shilpa , Chaly Preetha Elizabeth , Mohapatra Smruti Chandan
Published: February 2022

Background:

Tobacco chewing is an ancient habit dating back to more than 2000 years. Since then, it has spread with remarkable rapidity, seeping into all sections of the society.

Aim:

The study was carried out to compare the oral health care practices among the tobacco chewers and nonchewers and to record the tobacco chewing habit among the tobacco chewers of Khordha city, Odisha.

Materials and Methods:

A cross-sectional descriptive study was conducted from March 2015 to August 2015, among 25–64 years old patients attending the dental out-patient department of Gopabandhu Khordha District Headquarter Hospital. The study sample of 512 subjects (256 tobacco chewers and 256 nonchewers), who were age and sex matched, were then interviewed regarding their oral hygiene practices and tobacco chewing habit using a closed-ended questionnaire, derived from the National Youth Tobacco Survey Questionnaire, 2012 and the WHO Oral Health Questionnaire for Adults, 2013. Data obtained were analyzed using Chi-square test. The significance level was set atP≤ 0.05.

Results:

All the study subjects had people at home who had the habit of chewing some or the other form of tobacco. Most (73.4%) of the tobacco chewers felt that tobacco chewing probably makes young people look cool or fit in their peer group. Furthermore, 72.2% never saw a warning label on a smokeless tobacco product and 95.3% never had family or friends talk to them about not using any type of tobacco product. However, 87.1% were willing to quit this habit if proper guidance was provided.

Conclusion:

Tobacco chewing is a socially and culturally acceptable habit in Khordha city, Odisha. Awareness about the harmful effects of tobacco chewing among the users was very low, emphasizing the need to educate and promote awareness about smokeless tobacco products.
Efficacy of Ozone Oil Compared with Chlorhexidine Gluconate Gel (1% w/w) for the Treatment of Gingivitis
Authors: Bulani Mahima B. , Shetiya Sahana Hegde , Agarwal Deepti
Published: February 2022

Background:

Ozone oil has both antimicrobial and antiinflammatory properties. This study was undertaken to compare the efficacy of ozone oil with chlorhexidine gluconate 1.0% w/w gel for the treatment of gingivitis.

Methods:

A triple-blind, controlled trial with parallel design was conducted for 28 days as a pilot study. Thirty participants aged 14–17 years were recruited. After baseline data collection involving gingival index (GI) and plaque index (PI), the products were distributed, scaling of teeth was done, and oral hygiene instructions were given. The participants were asked to apply the gel and oil topically and followed up on days 7 and 28.

Results:

A statistically significant difference (P< 0.01) was seen within the ozone and chlorhexidine groups at the end of 28 days, showing a reduction in the plaque and gingival scores. At day 28, the reduction in plaque and gingival score was significant for the chlorhexidine group. It was found that chlorhexidine gel showed a greater reduction in the clinical parameters than the ozone oil, which was statistically significant but clinically similar. Both the products showed a substantial reduction in plaque scores. The participants from both the groups showed an improvement, having mild gingivitis post intervention.

Conclusion:

Ozone oil showed a significant reduction in the clinical parameters of PI and GI similar to chlorhexidine gel, thereby signifying its antimicrobial and antiinflammatory effects on the gingival tissues without any adverse effects, implicating the possession of properties required by a chemotherapeutic agent.
Impact of Oral Frailty on General Frailty in Geriatric Population
Authors: Ayoob Aneesa Karuthora , Neelamana Sandhya Kizhakke , Janakiram Chandrashekar
Published: February 2022

Background:

Oral health is believed to be an important component of aging and frailty. Poor oral health is highly prevalent among older adults and has been linked to general health and chronic diseases including different components of frailty. Literature previous evidence has demonstrated a strong link between self-reported oral health and nutrition.

Objectives:

The objective of the study was to find the current impacts of oral frailty on general frailty in geriatric population.

Sources of Evidence:

A systematic search was conducted in one electronic bibliographic database (PubMed) to identify relevant peer-reviewed studies. Sources included different types of information such as practice guidelines, reviews, and quantitative and qualitative research.

Charting Methods:

Pie charts, sunburst, and tree map were used.

Results:

The searches from the databases hit a total of 8697 records (PubMed: 180) that led to a total of 180 titles and abstracts that were screened after the removal of duplicates. We retrieved a total of 55 full-text articles from our different libraries. Six records were excluded with full text. The full-text screening stage led to 49 potential articles relevant to our scoping review. A total of 49 articles (39 quantitative and 3 qualitative studies, 6 reviews, and 1 Practice guidelines) were included in our final analysis. Maximum studies were found in Asia (44.8%), Europe (22.4%), and North America (14.2%) of the articles related to Oral frailty on General frailty. The included articles used a variety of terminology to describe physical and oral Frailty. The prevalence of physical frailty ranged from 1.5% to 66.6% and oral frailty ranged from 4.1% to 63.7%.

Conclusions:

Oral frailty is a crucial aspect of general frailty. More cohort studies need to establish a causal relationship between oral and physical frailty. Medical–dental collaboration is inadequate and should be improved in geriatric medicine.
Crowd-sourcing the COVID data
Authors: Patel Sandeep , Khan Shahnawaz , Kumar Ritesh , Sharma Siddhartha , Kumar Vishal
Published: February 2022

Web based surveys have gained importance in last 20 years due to ease of internet access. It has proven to be a boon in terms of minimized contacts and still be able to churn out statistically valid results and on the other hand, it has faced a lot of criticism due to lack of repeatability and other scientific validity pillars. To increase the validity of such studies, a central database should be maintained and the questionnaires should be short and to the point and should take into considerations the diversity in culture and languages.
Medical cyclotron
Authors: Kumar Rajeev , Kumar Arunav , Kumar Santosh , Suman Sanjay Kumar , Biswas Nihar R.
Published: February 2022

Cyclotron is a type of particle accelerator invented by Ernest O. Lawrence in 1930 at the University of California, Berkeley and patented in 1932. Lawrence was awarded the Nobel Prize in Physics 1939 for this invention. It is based on a combination of radiofrequency acceleration and bending of charged particles in a magnetic field. This way the same electrode is used over and over again to give acceleration to the particles. Lawrence built the first cyclotron in 1931 and it produced Protons of 1.25 MeV. In a conventional Cyclotron, the charged particles move in two semicircular metal containers called Dees (because of the D-shaped electrodes). In most of the modern medical cyclotrons, there are four gaps with four pie-shaped Dees instead of two. The particles pass through the same acceleration gap many times with increasing radius before they acquire the desired energy. The entire accelerating system is maintained at high vacuum (10-6 to 10-8 Torr), and the Dees are housed in a vacuum chamber. Hydrogen gas is passed through an arc current to produce the ion source for the acceleration in the cyclotron. The ion source is pulled toward the center of Dee structure by applying a positive bias voltage. A high voltage (>36 kV) is applied to the Dee structure with the help of an oscillator. The ion located at the center is thus attracted toward a Dee that happens to be at the opposite potential at that particular moment. As the magnetic and electric fields (in Dees) in the cyclotron are at right angles to each other the ion beam moves in a circular path inside the hollow Dees. In the present scenario, negative ion cyclotron accepted everywhere in the medical field. The objective of this article is to educate the new generation of physicians and share the knowledge of medical cyclotron and its integrity mainly among our colleague apart from nuclear medicine. Hence, that they can understand about this complex and complicated equipment and its medical utility for patients benefit.
A Study to assess the impact of an ongoing capacity building program for nursing staff on augmentation of Knowledge, Attitude and Practice (KAP) of the trainees at Program Study Centre (PSC), Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS), Lucknow
Authors: Harsvardhan Rajesh , Alvi Saima , Arora Tanvi , Srivastava Ankita
Published: February 2022

Introduction:

The Government of India had notified Department of Hospital Administration (DoHA), Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS) as Program Study Center (PSC) to provide comprehensive training to selected candidates for Bridge Program on Certificate in Community Health Nursing. To fulfill a commitment, to assess the effectiveness of the assigned program, the PSC: DoHA, SGPGIMS endeavored to create a reliable, valid, and accurate assessment of program decisions and outcomes.

Aim:

The aim of the study was to assess the impact of an ongoing capacity building program for nursing staff on augmentation of Knowledge, Attitude, and Practice (KAP) of the trainees at PSC, SGPGIMS, Lucknow.

Objectives:

Methodology:

Interventional study.

Results:

Preintervention score: Knowledge – 68.5%, Attitude – 75.2%, Practice – 44.65%. Postintervention score: Knowledge – 86.846%, Attitude – 82.4%, and Practice – 51.15%. Increase: Knowledge – 18.346%, Attitude – 7.2%, and Practice-6.5%.

Conclusion:

The training program was successful in achieving a significant improvement in trainees' knowledge and awareness regarding delivery of comprehensive primary care services which was reflected as improvement and change in their attitude. The performance was better in the postinterventional phase as compared to preintervention. Therefore, it is of utmost importance to sustain the present and provide occasions for further improvement in the knowledge and skills to health-care providers as a measure for continuous quality improvement.
A study on low-cost model of hospital pharmacy at a government healthcare teaching institute, as a feedforward measure of control
Authors: Harsvardhan Rajesh , Kushwaha Ruchi , Gupta Rakesh
Published: February 2022

Introduction:

There are very few government institutes that have “Hospital Supply Chain Management” of drugs and medicines, surgical goods, vendor-managed inventory, and outsourcing of patient care and services. Instead, they continue to have traditional Store and Purchase and Accounts departments and have often failed to appreciate the power of “Business Process Re-engineering.” The traditional Store and Purchase and Accounts departments are not able to encounter the new age “Challenges and Opportunities” and are entirely dependent on funds from the government to procure medicines and consumables.

Methodology:

A prospective analytical study was conducted from May 2021 to October 2021 at Hospital Pharmacy at a Government Healthcare Teaching Institute, wherein frequently prescribed antibiotics, whose multidrug resistance-associated protein was very high and patient needs to procure from outside medical stores were procured directly from the pharma companies through the rate contracts instead of local vendors. Further, these antibiotics were kept at hospital pharmacy for sale by applying minimal surcharges up to maximum of 10% of the purchased price and patients were requested to procure from it rather than outside pharmacy.

Results:

Over the duration of 4 months, it was observed that revenue generated per month for the hospital pharmacy was between INR 8000/- and 14,000/- but at the same time, there was a remarkable reduction in out-of-pocket expenditure (OOE) of the patient, between INR 63,000/- and 2 Lakhs and there was more satisfaction among patients.

Conclusions:

Based on the results, it can be safely concluded that it is the need of the hour for the government-funded hospitals to make a shift from the conventional system of procurement to this self-sustainable model of procurement. It will not only enable the hospital to be financially independent by reducing the need for budgetary support from the government but will also reduce the OOE of the patients leading to more satisfaction among them.
An Unusual Case of Massive Pleural Effusion
Authors: Marwah Vikas , Choudhary Robin , Verma Shipra , Singh Shalendra
Published: February 2022

Lung carcinoma is a major cause of mortality worldwide. Small-cell lung cancer (SCLC) constitutes of about 10%–15% of cases of all lung cancer. It generally affects males more commonly than females and has smoking as a high-risk factor. It is generally a solid central tumor which spreads very rapidly to mediastinal lymph nodes and distant organs. It generally presents with mass effects such as cough, wheezing, superior vena cava syndrome and hemoptysis and also causes paraneoplastic syndrome. It is very rare for SCLC to present as isolated massive pleural effusion. Here in, we describe a case of massive pleural effusion which was diagnosed as small cell carcinoma with thoracoscopic pleural biopsy, and was managed with pleurodesis and cisplatin-based chemotherapy.
Primary Sternal Osteomyelitis and Sickle Cell Anemia
Authors: Mohammed Ismail Inuwa , Ahmad Jameel , Oyebanji Tunde , Abdurrhman Mamuda Ahmad , Adamu Kabir Musa , Abubakar Kabir Mohammed , Aliyu Ibrahim
Published: February 2022

Osteomyelitis of the sternal bone is very rare and is usually secondary to trauma or surgery. Primary sternal osteomyelitis and secondary sternal osteomyelitis commonly are caused by Staphylococcus spp, and in drug addicts by Pseudomonas aerugenosa, while in sickle cell anemic children, Salmonella spp are mostly implicated. We, therefore, present an unusual causative organism, Streptococcal spp in a sickle cell anemic child.
Local Infiltration Analgesia Improves Functional Outcome after Total Knee Arthroplasty: A Randomized Controlled Trial
Authors: Vig Varun , Sud Ajaydeep , Singh Chandermohan , Thakur Kamparsh
Published: February 2022

ABSTRACT

Background:

Total knee arthroplasty (TKA) may be associated with severe postoperative pain, which requires prolonged hospital stay to provide effective analgesia. Increasing postoperative pain is associated with increased hospital stays and readmissions, lower patient satisfaction, longer time to rehabilitation and physiotherapy milestones and diminished range of motion (ROM).

Purpose:

This randomized controlled trial compared the functional outcome following the use of local infiltration analgesia (LIA) with combined spinal epidural analgesia (CSEA) versus CSEA alone in patients undergoing primary unilateral osteoarthritis of the knee.

Methods:

Between December 2017 and June 2019, a total of 30 patients undergoing primary unilateral TKA were included in the study. The patients were randomized into two groups, 15 patients each. Patients in Group A were administered LIA intraoperatively while patients in Group B were not. Both groups were given CSEA as their primary modality of anesthesia. Primary outcome was ROM of knee on 1st, 5th, and 14th postoperative days. Secondary outcomes were pain assessment using visual analog scale score on 6th, 24th, and 48th h postsurgery, total opioid consumption in 1st 48 h, and duration of hospital stay.

Results:

Mean ROM at 1st, 5th and 14th day was significantly higher in Group A compared to Group B (P < 0.05 for all). Mean pain score at 6 h, 24 h, and 48 h was significantly higher in Group B compared to Group A (P < 0.05 for all). Mean total opioid consumption was significantly higher in Group B (455.20 ± 38.84 g) compared to Group A (325.73 ± 50.18 g) (P < 0.001). Mean duration of hospital stay was significantly higher in Group B (7.07 ± 0.96 days) compared to Group A (5.73 ± 0.59 days) (P < 0.001).

Conclusion:

LIA provides significant pain relief in the early postoperative period and hence is associated with higher patient satisfaction. LIA also allows early and improved pain-free ROM at knee and contributes to achieving rehabilitation milestones earlier. It significantly reduces opioid requirement and thus reducing opioid-related side-effects.
Blocking Toll-like receptor 9 attenuates bleomycin-induced pulmonary injury
Authors: Alzahrani Badr , Gaballa Mohamed M. S. , Tantawy Ahmed A. , Moussa Maha A. , Shoulah Salma A. , Elshafae Said M.
Published: February 2022

Background: Acute respiratory distress syndrome (ARDS) is one of the most common complications in coronavirus disease 2019 patients suffering from acute lung injury (ALI). In ARDS, marked distortion of pulmonary architecture has been reported. The pulmonary lesions in ARDS include hemodynamic derangements (such as alveolar edema and hemorrhage), vascular and bronchiolar damage, interstitial inflammatory cellular aggregations, and eventually fibrosis. Bleomycin induces ARDS-representative pulmonary damage in mice and rats; therefore, we used bleomycin model mice in our study. Recently, Toll-like receptor 9 (TLR9) was implicated in the development of ARDS and ALI.Methods: In this study, we evaluated the efficiency of a TLR9 blocker (ODN2088) on bleomycin-induced pulmonary damage. We measured the apoptosis rate, inflammatory reaction, and fibroplasia in bleomycin- and bleomycin + ODN2088-treated mice.Results: Our results showed a significant amelioration in bleomycin-induced damage to pulmonary architecture following ODN2088 treatment. A marked decrease in pulmonary epithelial and endothelial apoptosis rate as measured by cleaved caspase-3 expression, inflammatory reaction as indicated by tumor necrosis factor α expression, and pulmonary fibrosis as demonstrated by Van Gieson staining and α-smooth muscle actin immunohistochemistry were observed following ODN2088 treatment.Conclusions: All these findings indicate that blocking downstream TLR9 signaling could be beneficial in prevention or mitigation of ARDS through hemodynamic derangements, inflammation, apoptosis, and fibrosis.
2021 KSCCM clinical practice guidelines for pain, agitation, delirium, immobility, and sleep disturbance in the intensive care unit
Authors: Seo Yijun , Lee Hak-Jae , Ha Eun Jin , Ha Tae Sun
Published: February 2022

Background: To revise and expand the “2010 Guideline for the Use of Sedatives and Analgesics in the Adult Intensive Care Unit (ICU).”Methods: We revised the 2010 Guideline based mainly on the 2018 “Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption (PADIS) in Adult Patients in the ICU,” which was an updated 2013 pain, agitation, and delirium guideline with the inclusion of two additional topics (rehabilitation/mobility and sleep). Since it was not possible to hold face-to-face meetings of panels due to the coronavirus disease 2019 (COVID-19) pandemic, all discussions took place via virtual conference platforms and e-mail with the participation of all panelists. All authors drafted the recommendations, and all panelists discussed and revised the recommendations several times. The quality of evidence for each recommendation was classified as high (level A), moderate (level B), or low/very low (level C), and all panelists voted on the quality level of each recommendation. The participating panelists had no conflicts of interest on related topics. The development of this guideline was independent of any industry funding.Results: The Pain, Agitation/Sedation, Delirium, Immobility (rehabilitation/mobilization), and Sleep Disturbance panels issued 42 recommendations (level A, 6; level B, 18; and level C, 18). Conclusions: The 2021 clinical practice guideline provides up-to-date information on how to prevent and manage pain, agitation/sedation, delirium, immobility, and sleep disturbance in adult ICU patients. We believe that these guidelines can provide an integrated method for clinicians to manage PADIS in adult ICU patients.
Differential Incidence of Malaria in Neighboring Villages in a High-Transmission Setting of Southern Mali
Authors: Fofana Bakary , Takala-Harrison Shannon , Ouattara Amed , Sagara Issaka , Togo Amadou H. , Diakité Hamadoun , Keita Mohamed , Sanogo Kassim , Touré Sekou , Doumbo Ogobara K. , Djimde Abdoulaye A.
Published: February 2022

Throughout a phase IIIb/IV efficacy study of repeated treatment with four artemisinin-based combination therapies, significant heterogeneity was found in the number of clinical episodes experienced by individuals during the 2-year follow-up. Several factors, including host, parasite, and environmental factors, may contribute to the differential malaria incidence. We aimed to identify risk factors of malaria incidence in the context of a longitudinal study of the efficacy of different artemisinin-based combination therapy regimens in Bougoula-Hameau, a high-transmission setting in Mali. Risk factors including age, residence, and treatment regimen were compared among individuals experiencing eight or more clinical episodes of malaria (“high-incidence group”) and individuals experiencing up to three clinical episodes (“low-incidence group”). Consistent with the known association between age and malaria risk in high-transmission settings, individuals in the high incidence group were significantly younger than individuals in the low-risk group (mean age, 7.0 years versus 10.6 years, respectively; t-test, P < 0.0001). Compared with individuals receiving artemether-lumefantrine, those receiving artesunate-amodiaquine had greater odds of being in the high-incidence group (odds ratio [OR], 2.24; 95% CI, 1.03 – 4.83, P = 0.041), while individuals receiving dihydroartemisinin-piperaquine had a lower odds of being in high incidence group (OR: 0.30, 95% CI, 0.11–0.85; P = 0.024). Individuals residing in the forested areas of Sokourani and Karamogobougou had significantly greater odds of being in the high-incidence group compared with individuals residing in the semi-urban area of Bougoula-Hameau 1 (Karamogobougou: OR, 3.68; 95% CI, 1.46–9.31; P = 0.0059; Sokourani: OR, 11.46; 95% CI, 4.49–29.2; P < 0.0001). This study highlights the importance of fine-mapping malaria risks even at sub-district levels for targeted and customized interventions.
Gender access to microfinance banks’ credit and profitablity of cassava production in Imo State, Nigeria
Authors: Anene H.U. , Orebiyi J.S. , Oguoma N.N.O. , Gbolagun A.O.
Published: February 2022

This study investigated the gender inequalities in accessing microfinance credit for profitable cassava production in Imo State,Nigeria. Two-stage sampling technique was used to select    120 respondents comprising 60 male and 60 female cassava farming households. Structured questionnaire was used to collect data such as age, marital status, educational level, years of operating an account, savings in the bank, cooperative membership, collateral provision, amount of credit demanded and obtained by the farmers, as well as, costs of farm inputs and revenue of cassava output. Descriptive statistics, net income model and t-test statistics were used to achieve the objectives. The mean amount of credit obtained for female and male cassava farmers was N252,272.73 and N199,137.93 which was 80% and 76% of the amount of credit demanded respectively with the t-cal value of 0.021 less than t-crit.(5%). The farmers’ net margins were N941,537.89 and N889,304.24 for female and male farmers respectively with t-cal value of 0.00138 less than t-crit.(5%). As evident from the analysis, gender of the farmers does not significantly influence their credit access and profitability in cassava production. Regression analyses showed that years of operating account, saving in bank and membership of cooperatives significantly influenced the amount of loan accessed by both gender. Cassava farmers of both gender are therefore encouraged to operate functional accounts with microfinance banks for a reasonable length of time, maintain substantial savings with the bank and form and/or join existing farmers’ cooperatives to increase their access to microfinance credit and improve profitability of cassava production
Socioeconomic determinants of rural households’ food security status in Northern Ghana
Authors: Antwi K.D. , Lyford C.P.
Published: February 2022

National aggregate data to analyze food security status at the national level has often been used in many countries including Ghana to determine food security status. This has been a reason that many interventions that have had minimum or no impact on households’ food security status due to variation within region in the design of such interventions. This study used household level-data data from 2260 rural households to determine rural household food insecurity status, and also identify and analyze the socioeconomic factors that significantly influence rural household level food insecurity. The study used the Food Consumption Score (FCS) as the index for household food security status. An ordinal logit model was used to predict household food security status with respect to twelve explanatory variables. The results showed that 70% of the sampled rural households were food insecure, and in particular, food insecurity was found to be more pronounced among female-headed households. The results further showed that improved education, increased household income, improved access to agricultural credit and large farm size increase the probability of households to attain high food security status. On the other hand, high food prices and large household size were found to reduce the probability of households to attain high food security status. For policy implication, these micro-level factors need to be considered in the implementation of food insecurity interventions programs in order to achieve desired outcomes.
Design of High-speed Delay-FXLMS Hardware Architecture Based on FPGA
Authors: Yuan Jun , Meng Xiangsheng , Ran Jia , Wang Wei , Zhao Qiang , Li Jun , Li Qin
Published: February 2022

In order to improve the convergence and clock speed of DFxLMS adaptive filter, a hardware architecture of fine-grained retiming DFxLMS (HS-TF-RDFXLMS) filter in the form of hardware sharing transpose is proposed. Firstly, the architecture adopts delay decomposition algorithm to solve the problem that the convergence of filter decreases due to the increase of delay and output lag. Secondly, on the premise that the algorithm performance remains unchanged, the adaptive filter module and the secondary path module are transposed to further reduce the critical path to improve the clock speed of the system. The number of registers is reduced by optimizing circuit sub-module. Finally, the area/speed tradeoff of TF-RDFXLMS filter is realized by hardware sharing on the basis of constant critical path. Experimental results show that the convergence speed of the algorithm is 3.5 times that of DFxLMS algorithm, and the critical path is shortened by ([log2N]+1)TADD. The circuit structure of adaptive filter designed in this paper is realized by Xilinx Artix7 FPGA platform. The clock speed of HS-TF-RDFXLMS filter is reduced by 4.386% compared with TF-RDFXLMS filter. However, the resources of LUT and FF are saved by 10.964% and 28.322% respectively. The power consumption is 150.73 mW. This improves the performance of the system.
BIODIVERSITY STATE OF ALGERIAN SHEEP BREEDS
Authors: Djaout Amal , Farida Afri-Bouzebda , Chekal Fakhedine , El-Bouyahiaoui Rachid , Rabhi Abdesselem , Boubekeur Abderrahman , Benidir Mohamed , Chekal Fakhedine , Ameur Ameur Abdelkader , Gaouar Semir Bechir Suheil
Published: February 2022

The richness of the variability of the sheep genetic resources is untapped. We have noted the presence of 12 sheep breeds in Algeria such as Ouled Djellal, Rembi, Hamra, Berber, Barbarine, D'man, Sidaou, Tadmit, Tazegzawt, Ifilene, Srandi and Daraa, which are well adapted to the conditions of the environments. Unfortunately, anarchic crossings lead to dispersion and an erosion of the genetic capital of the breeds, the increase of consanguinity in the herds and a decrease of the returns of the farms. The medium-term risk is the absorption of certain «breeds" by others, and the loss of certain characters that make the specificity of our breeds. In addition, the documentation on the diversity of sheep breeds in Algeria is minimal or absent, so several breeds require a phenotypic and zootechnical description to know their performance. This document describes the sheep genetic resources present in Algeria and the diversity between them based on surveys that have been carried out for more than 17 years, in 40 wilayas, based on the phenotypic characterization of these "breeds" in their cradles, in order to make an updated breed distribution map and a new breed classification.