bluuebunny/crossref_metadata_2025 huggingface dataset:
Involvement of TLR4 in Acute Hepatitis Associated with Airway Infection of Murine γ-Herpesvirus 68
Authors: Kanai Kyosuke , Kageyama Seiji , Yoshie Osamu
Published: September 2023

Extrahepatic viral infections are often accompanied by acute hepatitis, as evidenced by elevated serum liver enzymes and intrasinusoidal infiltration of CD8+ T cells, without direct infection of the liver. An example is infectious mononucleosis caused by primary infection with EBV. Previously, we demonstrated that airway infection of mice with murine γ-herpesvirus 68 (MHV68), a murine model of EBV, caused liver inflammation with elevated serum liver enzymes and intrahepatic infiltration of IFN-γ–producing CD8+ T cells and NK cells. Mechanistically, the expression of the CXCR3-ligand chemokines, which are commonly induced by IFN-γ and attract IFN-γ–producing Th1-type cells via CXCR3, was upregulated in the liver. Importantly, the liver inflammation was suppressed by oral neomycin, an intestine-impermeable aminoglycoside, suggesting an involvement of some products from the intestinal microbiota. In this study, we showed that the liver inflammation and the expression of the CXCR3-ligand chemokines in the liver were effectively ameliorated by i.p. administration of anti-TLR4 mAb or C34, a TLR4 blocker, as well as in TLR4-deficient mice. Conversely, intrarectal inoculation of Escherichia coli as an extraintestinal source of LPS aggravated liver inflammation in MHV68-infected mice with increased expression of the CXCR3-ligand chemokines in the liver. In contrast, the lung inflammation in MHV68-infected mice was not affected by oral neomycin, i.p. administration of C34, or TLR4 deficiency. Collectively, the LPS–TLR4 pathway plays a pivotal role in the liver inflammation of MHV68-infected mice at least in part by upregulating the CXCR3-ligand chemokines in the liver.
The Role of Implantable Loop Recorder in Patients with Cryptogenic Stroke
Authors: Mavromoustakou Kiriaki , Katzouridi Symeoni , Soulaidopoulos Stergios , Doundoulakis Ioannis , Papadopoulos Achilleas , Arsenos Petros , Sideris Skevos , Dilaveris Polychronis , Tsiachris Dimitris , Kordalis Athanasios , Tsioufis Konstantinos , Gatzoulis Konstantinos A.
Published: September 2023

Objective:

The objective of this study was to provide data on implantable loop recorder (ILR)-based atrial fibrillation (AF) rates, recurrent stroke rates, and predictors of AF in patients with cryptogenic stroke (CS) after 1, 6, 12, 24, and 36 months of follow-up.

Methods:

We searched MEDLINE/PubMed, Cochrane Central Register of Controlled Trials, EMBASE, Web of Science, and reference lists of retrieved reports, which were published by April 30, 2023, which was the date of our last search. We utilized random-effects meta-analysis for detection rates, and meta-regression analysis, t-test (for normally distributed variables), and Mann-Whitney (for skewed variables) for predictor factors.

Results:

Thirteen studies were analyzed, which included data from 3,377 patients with CS or embolic stroke of undetermined source. The ILR-based AF rates in patients with CS were 4.73% (95% confidence interval [CI] 3.91–5.71) at 1 month, 13.45% (95% CI 12.19–14.81) at 6 months, 17.5% (95% CI 16.25–18.82) at 12 months, 20.69% (95% CI 19–22.49) at 24 months, and 25.98% (95% CI 23.21–28.58) at 36 months. Age and CHA2DS2-VASc score were positively associated with AF detection. Specifically, the mean difference of age and CHA2DS2-VASc score in the group with AF versus the group without AF was 7.47 (95% CI 4.58–10.36, P < 0.001) and 0.75 (95% CI 0.22–1.28, P = 0.01), respectively. Finally, AF detection was positively associated with recurrent strokes with an estimated risk ratio of 1.27 (95% CI 0.69–2.31).

Conclusions:

There is a correlation between AF detection rate and ILR monitoring duration. One out of eight patients was diagnosed with AF after 6 months of follow-up and about one quarter after 3 years. Our results demonstrate the critical use of ILRs, especially in older patients, and in patients with high CHA2DS2-VASc scores.
Mental Stress Contributes to the Pathogenesis of Atherosclerotic Heart and Brain Diseases
Authors: Geng Yong-Jian
Published: September 2023

Atherosclerotic vascular diseases have two life-threatening complications, namely myocardial and cerebral infarcts. The development of the two pathological conditions involves interplays between genetic, epigenetic, and environmental factors. Mental stress is an independent factor that contributes to the pathogenesis of atherosclerotic heart and brain diseases. Increased mental stress is linked to heightened vascular stiffness, inflammation, atherosclerosis, and hypertension. Neuroendocrinological impacts of stress include the involvement of the renin-angiotensin system and its active peptides, particularly angiotensin II (Ang II), in stress-related disorders. In a circadian manner, Ang II and its two subtypes of receptors exist in the stress-responsive brain hypothalamus–adrenal–pituitary axis. Mental stress can cause broken heart syndrome or stress cardiomyopathy. Stress resilience is an important factor that regulates the susceptibility to stress-associated cardiovascular dysfunction and the development of adverse events. Preventive and therapeutic approaches are developed on multiple fronts aimed at mitigating the stress-associated vascular responses and development of atherosclerotic vascular disorders.
Perspectives of Barry A. Franklin, PhD
Authors: Franklin Barry A. , Zhang Icey , Liu Meiyan
Published: September 2023

In the interview, Prof. Barry A. Franklin discussed his perspectives on physical activity, cardiorespiratory fitness, and cardiovascular health. He also unraveled how soft skills can empower superachievers. His major viewpoints are: (a) exercise benefits cardiac patients; yet, too much exercise may be risky, (b) exercise prescription should be scientifically based and varies by different objectives for each individual, (c) patients' motivation to change their behaviors matters during cardiac rehabilitation, (d) physical activities could play a protective role for dementia prevention, (e) technology and virtual approaches enable more patients to participate in cardiac rehab programs, (f) patients with heart failure may benefit even more from exercise training than other patient populations, (g) psychosocial stressors may partially explain some cardiac events, (h) novel risk factors help identify people at increased risk of cardiovascular disease, such as genetics, coronary calcium score, air pollution, and inflammation, and (i) soft skills are needed by all people, regardless of their field.
Psychosocial Assessment in Perinatal Mental Health: Insights, Strategies, and Future Directions
Authors: Nagendrappa Sachin , Murugesan Manisha
Published: September 2023

Perinatal mental health is a complex and multifaceted area influenced by various psychosocial risk factors that impact the well-being of individuals during pregnancy and the postpartum period. This article provides insight into the intricacies of perinatal mental health challenges, emphasizing the importance of comprehensive support systems. It highlights prominent risk factors, including exposure to stressful life events, strained marital relationships, inadequate social support, lower socioeconomic status, single marital status, unwanted pregnancies, obstetrical stressors, and infant temperament. The article discusses various psychosocial interventions, including psychoeducation, cognitive restructuring, problem-solving techniques, behavioral activation, and befriending. It also emphasizes the importance of specialized care for women experiencing postpartum psychosis. The National Institute of Mental Health and Neurosciences-Mother–Baby Unit Model, a multidisciplinary approach to perinatal mental health care, is explored, highlighting its comprehensive psychosocial assessment and tailored interventions. The article emphasizes the need to focus on psychosocial risk factors and culturally sensitive interventions in perinatal mental health care.
Beliefs and Cultural Behaviors in Iranian Postpartum Women after Childbirth: An Exploratory Study in Qom, Iran
Authors: Miraj Sepideh , Akbari Faeze , Derakhshani Maryam , Mohammadbeigi Abolfazl , Asgarian Azadeh
Published: September 2023

Background:

Women during pregnancy and childbirth experience different customs, which are different across nations and cultures. Cultural differences can be seen in the birth and postpartum periods, where some traditional practices are used to protect postpartum women and their newborns.

Aims and Objectives:

The study aimed to investigate the cultural beliefs and practices of postpartum women.

Methodology:

A cross-sectional analytical study was conducted on 217 mothers referred to Qom Obstetrics and Gynecology Hospital, Qom. The subject’s data were collected 4 weeks after delivery for up to 1 year. Data collection was conducted by a two-part questionnaire including demographic characteristics and general behaviors in five categories: general, maternal, nutrition, and infant-related behaviors and beliefs regarding the infant. Pearson correlation coefficient, Chi-square, independent t-test, analysis of variance, and multivariate linear regression were used for data analysis.

Results:

A total of 217 mothers referred to Qom Obstetrics and Gynecology Hospital were included in the study. The results show that the average age of participants was 29.8 ± 6.71 years. The highest mean score among different of postpartum behaviors was obtained for beliefs regarding infant and nutritional beliefs as 42.7 ± 7.19 and 33.4 ± 8, respectively. The multivariate regression showed that Persian ethnicity has a positive relationship with behaviors related to cultural beliefs (b = 0.203, P = 0.002) and living in urban areas was related to a higher score of behaviors related to cultural beliefs (b = 0.172, P = 0.010).

Conclusion:

Cultural and traditional postpartum beliefs and practices are common among postpartum women in Iran. To change postpartum behaviors, identification of beliefs and practices is necessary first to correct the unhealthy beliefs to achieve women’s health in the postpartum period.
Psychosocial Interventions in Perinatal Mental Illness
Authors: Vaiphei Kimneihat , Manukrishnan  , Lobo Remy
Published: September 2023

Mental health problems are among the most common morbidities during pregnancy and the postnatal period, and they may have adverse effects on the woman, her child, and other members of her family. Psychosocial factors are a major factor in this significant public health issue since some women may experience poor mental health during the perinatal period. Preventive, promotional, curative, and rehabilitative psychosocial interventions are crucial in perinatal mental health, alongside other pharmacological treatments. A psychosocial intervention at the systemic level can improve maternal knowledge, attitudes, and skills related to parenting, mental health, quality of life, and physical health. An effective psychosocial intervention during perinatal mental health is one that identifies the strengths and challenges of women and their families, fosters healthy parental-child relationships, and advocates for long-term services in the health-care setting and the community that benefits women and their families.
Psychosocial Functioning and Quality of Life in Remitted Males with Dual Diagnosis of Bipolar Affective Disorder and Alcohol Dependence Syndrome: A Cross-Sectional Study from South India
Authors: Ramanath Meera , A Nisha , Varghese P Joseph
Published: September 2023

Background:

Studies on psychosocial functioning and quality of life (QOL) of Bipolar Affective disorder (BPAD) patients with comorbid alcohol dependence syndrome (ADS), during BPAD remission and sobriety from alcohol, are sparse.

Objectives:

To assess the psychosocial functioning, QOL and associated factors in remitted males with dual diagnosis of BPAD and ADS.

Methods:

132 males aged 18–60 years on psychiatry outpatient department follow-up from a tertiary care center, having BPAD– Currently in remission (F31.7) and co-morbid ADS (F10.2) according to the International classification of mental and behavioral disorders, Diagnostic Criteria for Research (ICD-10 DCR) were enrolled. Semi-structured proforma, Kuppuswamy’s Socioeconomic status Scale, Functioning Assessment Short Test (FAST), and WHO QOL– BREF scales were administered. Statistical analysis was performed using R software (EZR).

Results:

68.94% had moderate impairment in psychosocial functioning (FAST score 21–40). The median WHO QOL-BREF total score was 72 (interquartile range 68, 77) – lowest scores were for social relationships and psychological domain. Age (P = 0.014), residential area (P = 0.031), age of onset of ADS (P = 0.038), duration of ADS (P = 0.003), and total duration of BPAD (P = 0.05) showed significant association with FAST scores. Binge-drinking pattern was significantly associated with WHO QOL-BREF total scores. The total FAST scores showed a weak negative correlation with WHO QOL-BREF total scores (rs = −0.15, P = 0.01).

Conclusion:

Psychosocial functioning and QOL of dual diagnosis patients with BPAD and ADS were significantly impaired, even while in remission from both the disorders, which makes the elucidation of the associated factors a pressing priority.
Pattern and Experience of Internet Use among Persons with Severe Mental Disorders: A Qualitative Study
Authors: Chawla Nishtha , Sood Mamta , Chadda Rakesh Kumar
Published: September 2023

Aims:

To understand the current patterns and experience of using internet among individuals with severe mental disorders and assess the impact of internet technology in their daily life, particularly mental health-related issues.

Methods:

In-depth interviews were conducted on individuals diagnosed with bipolar disorder (BD)/ schizophrenia (DSM-5) (N=20), aged ≥ 18 years who could read and write in Hindi/ English, using an interview guide. HAM-D, YMRS, SAPS, and SANS were used as screening instruments. The interview guide contained questions related to internet use in daily life, internet use for health-related issues, particularly BD/ schizophrenia.

Results:

All individuals used the internet in day-to-day life for the purpose of communication, entertainment and getting information. They predominantly use internet to find out about their illness & medications. For their illness, most common source of searching was Google (N=20), followed by YouTube (N=17). Three themes could be identified about patterns and experience of internet use: health/ illness-related reasons for searching internet, beliefs about the suggestions on internet, risky practices regarding suggestions from internet. The impact of internet use was variable. They often believed that they were misinformed or unsure of the information available online. Most of them did not discuss about their internet use for their disease with their treating doctor. But they tend to follow advice that they perceive might be harmless.

Conclusion:

Patients with SMD commonly use internet for retrieving information about their illness. They tend to follow perceivably harmless advice available online.
Patient stories: Integrated learning for family physicians and primary health care teams
Authors: Rahman Sajitha P. MF , Harika Narabanda , Kumar Vijaya , Jebaraj Alfred
Published: September 2023

ABSTRACT

A family physician’s open-ended commitment to the patient, not limited by the type of health problem or by a defined endpoint opens the door to the patients’ world. Family physicians are uniquely privileged to provide all the key aspects of primary care—first contact care, comprehensive care, coordination and personalisation of care. The family physician as the trained primary care clinician is the interface between the illness experience of patients in primary care and the healthcare system in which patients undergo treatment. Based on our experience of working with communities, we submit that commitment to the person of the patient needs long-term relationship with communities. The breadth of knowledge and patient–doctor relationship in the compendium of a family physician skill set is a challenging and rewarding experience. This learned skill is attainable for all healthcare professionals.
Impact of COVID-19 on thyroid gland functions with reference to Graves’ disease: A systematic review
Authors: Vamshidhar I. S. , Rani S. S. Sabitha , Kalpana Medala , Gaur Archana , Umesh Madhusudhan , Ganji Vidya , Saluja Rohit , Taranikanti Madhuri , John Nitin A.
Published: September 2023

ABSTRACT

Coronavirus disease 2019 (COVID-19) is caused due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Both immediate and long-term adverse effects arise out of this disease’s aftermath. It involves various organs, which include endocrine glands, nervous system, musculoskeletal system, and other organs. The long-term outcomes of the SARS-CoV-2 infection are influenced by preexisting comorbidities. Genetic, environmental, and immunological factors contribute to the development of various autoimmune diseases, which include Graves’ disease (GD). The growing mystery surrounding this virus is exacerbated by auto-inflammatory diseases, such as pediatric inflammatory multisystemic syndrome (PIMS) or multisystem inflammatory syndrome in children (MIS-C), which raises concerns about the nature of the virus’ connection to the autoimmune and auto-inflammatory sequelae. There is a need to understand the underlying mechanisms of developing GD in post-COVID-19 patients. There are limited data regarding the pathogenesis involved in post-COVID-19 GD. Our goal was to understand the various mechanisms involved in post-COVID-19 GD among patients with confirmed COVID-19 infection. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for 2020, a literature search of medical databases (PubMed, Cochrane Central Register of Controlled Trials, and Scopus) from February 2021 to February 2022 was performed by five authors. The keywords used were “Post COVID-19,” “Grave’s disease,” “Cytokine storm,” “Autoimmunity,” and “Molecular mimicry.” This review revealed three underlying mechanisms that resulted in post-COVID GD, which included cytokine storm, molecular mimicry, ACE2 receptor concentration, and cell-mediated immunity. The full spectrum of the effects of COVID-19 needs to be researched.
Patients’ perception about polycystic ovarian syndrome (PCOS) in Sub-Himalayan region of India-A facility-based cross-sectional study
Authors: Jaswal Richa , Tripathi Shailesh , Singh Dhananjay , Gupta Nand Lal , Chauhan Hoshiar Singh , Kaur Suchpreet , Sharma Shireen , Bhattacharya Sudip
Published: September 2023

ABSTRACT

Background:

In modern times, metabolic disorders are most common and one of them is polycystic ovarian syndrome (PCOS) in women, which causes high morbidity and complications. PCOS has largely been a neglected and less researched area; however, it is gaining importance in recent times as PCOS is increasing as well as it can be prevented to a considerable extent.

Methods:

A cross-sectional study was conducted to assess knowledge among females in government hospitals in Northern India. Data were collected using a pretested structured questionnaire on 300 women (completed 270), selected by proportionate sampling technique, and admitted in government hospitals. Data were analyzed by SPSS version 23.

Results:

The results showed that the mean age of respondents was 33.02 ± 9.039 years, the mean age at menarche was 12.33 ± 2.13 years, and the mean of gravida status was 1.82 ± 0.78 years. Only half of the respondents had good knowledge about PCOS.

Conclusion:

This study suggests that efforts are needed to reinforce women’s knowledge through setting-based awareness campaigns and health education in this context to enable them to identify and seek timely treatment and improve their quality of life.
Clinical presentations and microbiological analysis of cerebrospinal fluid samples in cases of suspected bacterial meningitis patients attending a 1600 bedded teaching hospital from 2019 to 2022: A retrospective study
Authors: Kar Mitra , Jamwal Ashima , Dubey Akanksha , Sahu Chinmoy , Patel Sangram Singh , Fatima Nida
Published: September 2023

ABSTRACT

Background:

Meningitis can be attributed to bacterial, fungal, or viral agents. In this study, we demonstrate the common bacterial agents causing meningitis along with their antibiotics susceptibility pattern in patients of all age groups.

Material and Methods:

This retrospective, observational study was carried out in the Department of Microbiology with cerebrospinal fluid (CSF) samples collected from November 2019 to May 2022. We collected 1986 nonrepeat CSF samples from clinically suspected patients of bacterial meningitis, and clinical information about the patients was extracted from the hospital information system.

Results:

Out of the 1986 CSF samples included in our study, 150 (7.55%) were found to be positive on bacterial culture. Most of our patients were in the age group of 0–20 years. Common clinical manifestations observed in our patients were: high-grade fever, 87 patients (58%); severe headache, 126 patients (84%); neck rigidity, 47 patients (31.3%); altered mental status, 76 patients (50.7%) and photophobia, 83 patients (55.3%). The most commonly isolated bacteria was Acinetobacter species (30%). The mean length of hospitalization (37.76 ± 25.30), the mean total cell count, high levels of protein (mg/dl) and low levels of glucose (mg/dl) of CSF were statistically significant in meningitis caused by multidrug-resistant bacteria.

Conclusion:

We recognized the spectrum of pathogens causing meningitis at our center along with the antibiotic resistance pattern to guide and facilitate early treatment by primary health care professionals and family medicine practitioners.
Cognitive reserve and other determinants of cognitive function in older adults: Insights from a community-based cross-sectional study
Authors: Kaur Amandeep , Sonal Akanksha , Ghosh Tandra , Ahamed Farhad
Published: September 2023

ABSTRACT

Background:

India will be the home of 323 million elderly persons by 2050. This means a surge in the dependent population primarily due to age-related cognitive decline. Evidence suggests that life course factors may have a modulatory role on cognitive function. The present study explores such potential influence by investigating the effect of cognitive reserve (a latent construct using education and occupation) and physical, psychological, and social determinants on cognitive function in community dwelling elderly.

Methods:

A community-based cross-sectional study was conducted in urban areas of West Bengal (India) among elderly aged ≥60 years. Data was collected by personal interviews for socio-demographic and medical profile. Cognitive function was assessed using Bangla Adaptation of Mini-Mental State Examination (BAMSE). Educational level and occupational complexity were used as proxy indicators for calculating cognitive reserve.

Results:

Of the 370 elderlies interviewed (mean age = 68.9 years), cognitive function was abnormal in 13.5%. The cognitive function had a significant inverse relationship with depression symptoms, loneliness, hypertension, anemia, and basic activities of daily living. There was a significant difference in the cognitive reserve of the elderly with normal and abnormal cognitive function (mean 33.7 and 26.8, respectively). In the presence of covariates like sleep quality, depression, hypertension, and hemoglobin levels, the effect of age on cognitive function had a significant mediation influence of cognitive reserve − total effect = −0.2349; 95% CI = (−0.2972 to −0.1725) and direct effect = −0.2583; 95% CI = (−0.3172 to −0.1994).

Conclusion:

The quantum of effect of the age on cognitive function decreases with good cognitive reserve as a cognitive reserve has a significant mediation effect on the relationship between age and cognitive function.
Achieving health equity through healthcare technology: Perspective from India
Authors: Gupta Prakamya , Choudhury Ranjan , Kotwal Atul
Published: September 2023

ABSTRACT

India aims to provide universal health coverage to all individuals and communities thus ensuring accessibility, promotive, curative, preventive, rehabilitative, and palliative health services to all. Healthcare technologies play a critical role in ensuring eliminating healthcare disparities and encouraging quality healthcare at all levels. Technology solutions such as indigenous medical devices and diagnostic products, telemedicine, artificial intelligence, and drone technology can best integrate rural needs, improve health outcomes, patient safety, and healthcare quality and experience for patients’ values and strengths and can therefore be important contributors to advancing rural health equity. These technologies can transform India’s healthcare system by providing quality care and mitigating the risk of catastrophic financial hardship.
Peripartum cardiomyopathy in an elderly woman: A case report
Authors: Bondre Ojas , Bhalerao Anuja V.
Published: September 2023

ABSTRACT

Cardiomyopathy accounts for 11.5% cause of pregnancy-related deaths. The causes of peripartum cardiomyopathy (PPCM) are unknown, including predisposing factors such as abnormal response to the greater hemodynamic burden of pregnancy, viral myocarditis, malnutrition, inflammation, and apoptosis. Elderly women, twin gestation, preeclampsia, smoking, and anemia are potential high-risk factors for PPCM. Here, rare case of a patient is described that presented with complaints of breathlessness, cough, and symptoms of heart failure and was diagnosed early as PPCM based on 2D echocardiography and was managed with medical therapy and timely delivery of fetus. Symptomatic relief of symptoms was relieved by diuretics, inotropic drugs, and beta-blockers. The left ventricular ejection fraction increased eventually over 3 weeks and now the patient is a follow-up case since two years from the time of episode. In conclusion, PPCM is rare, which requires prompt management and heightened mindfulness; therefore, early detection and timely treatment can reduce maternal mortality.
Postnatal Kangaroo mother care practice at home and comparison of improvement in vital parameters in low-birth-weight babies in-home setup and non-teaching hospital setup in rural coal mines area Jharkhand, India: A community-based observational study
Authors: Prasad Tulsi , Roy Ashish K.
Published: September 2023

ABSTRACT

Introduction:

Low birth weight (LBW) newborns especially those <2000 g are more prone to hypothermia due to which other physiological parameters gets deteriorated in the 1st week of life. The objective of this observational study was to continue Kangaroo mother care practice at home and to ascertain whether KMC was effective in improving the vital parameters of LBW babies when it is given at home in a rural coal mines area, in Jharkhand, India.

Materials and Methods:

This study was a community-based prospective observational study, done over three years from November 2019 to November 2022. In this study, we included 156 pairs of both mothers and LBW babies (weight 1500 g to <2000 g). After discharge from the hospital on day 3, KMC was continued at home on day 4, day 5, and day 6. Data of four physiological parameters, namely, temperature, oxygen saturation, respiratory rate, and heart rate were collected before and after KMC and analyzed.

Results:

Among 400 newborns, 156 LBW babies (39.0%) who were given KMC at home showed similar but statistically significant improvement of vital parameters, especially in temperature and oxygen saturation (P < 0.0001) compared to the same babies 156 (39.0%) given KMC in the hospital (P < 0.001).

Conclusion:

Kangaroo mother care, which was continued at home, has a significant role in the Improvement of vital parameters, especially concerning temperature and oxygen saturation. If the babies in the weight range of 1500 g to <2000 g are healthy, well-breast-fed, and have no other risk factors, they can be discharged early and managed at home by delivering supportive care and nursing care along with Kangaroo mother care with continuous follow-up.
Determination of sputum eosinophil count and serum absolute eosinophil count in patients with bronchial asthma and its correlation with disease severity and response to treatment
Authors: Mangattu Parambil Princia Banu , Mohapatra Amrut K. , Behera Debasis , Subhankar Saswat , Jagaty Suman K. , Singh Pratima
Published: September 2023

ABSTRACT

Background:

Sputum eosinophils can be used to assess severity of disease and response to treatment in bronchial asthma. Eosinophilic inflammation in the airways can also be marked by blood eosinophilia. In this study, we tried to determine the sputum eosinophil count and serum absolute eosinophil count in patients with asthma and correlate them with disease severity and treatment response.

Materials and Methods:

It was a cross-sectional intervention study including all consecutive cases with a diagnosis of bronchial asthma based on spirometry and clinical history. An induced sputum sample and blood were sent for eosinophil count to the laboratory. All the patients were started on inhaled corticosteroids and followed up at the end of 1 month with spirometry, sputum eosinophil count and AEC. Statistical Package for the Social Sciences for Windows v20.0 (IBM SPSS Corp.; Armonk, NY, USA) was used for statistical analysis.

Results:

There was no significant difference in the mean sputum eosinophil count (%) in mild, moderate and severe disease (f = 0.24; P = 0.79) or in AEC (f = 1.48; P = 0.24). At follow-up, all patients with moderate and severe disease showed significant improvement in FEV1 (P = 0.0001). The mean sputum eosinophil count and AEC (%) in the three subgroups was also seen to decrease at the end of the follow-up period (f = 0.08; P = 0.9 and f = 2.75; P = 0.07, respectively).

Conclusion:

Sputum eosinophils and AEC are important markers of airway inflammation. All our patients showed improvement in FEV1, sputum eosinophil count and AEC after 1 month of treatment thus confirming the role of ICS in the treatment of eosinophilic asthma.
Study of pattern and outcome of acute poisoning cases at tertiary care hospital in North India
Authors: Aggarwal Naman , Sawlani Kamal K. , Chaudhary Shyam C. , Usman Kauser , Dandu Himanshu , Atam Virendra , Rani Shivani , Chaudhary Rajat
Published: September 2023

ABSTRACT

Introduction:

The WHO 2021 data estimate that 2 million lives and 53 million disability-adjusted life-years were lost in 2019 due to exposures to selected chemicals. It is important to know the pattern and outcome of acute poisoning cases for proper planning, prevention and management. Knowing the pattern will also help in designing training modules for primary care physicians to make them aware about newer poisons and their management. Awareness regarding newer poisons consumed is necessary for early identification, initial management and timely referral to higher centres by primary care physicians. This study was performed to see the pattern and outcome of acute poisoning cases in North Indian population and various factors related to outcome.

Materials and Methods:

This study was conducted in department of medicine of a teaching institute in North India after approval by the Institutional Review Board. Patients admitted in the department during the study and fulfilling the inclusion criteria were enrolled in the study after obtaining consent.

Results:

A total of 417 patients with poisoning were recruited in the study. Out of 417 patients, majority were males (59.5%). Maximum number of patients were in the age group of 21–30 years (33.8%), and rural population (79.9%) was found to be more affected. Most of the patients were students and private employees. Most common types of poisoning were snakebite (n = 109, 26.1%), organophosphate (n = 49, 11.8%) and aluminium phosphide (n = 39, 9.3%). Out of 417 patients, 349 (83.69%) improved, while 68 (16.3%) expired. Requirement of ventilatory support was most commonly associated with aluminium phosphide poisoning (30.12%) followed by organophosphate poisoning (24.1%).

Conclusion:

Poisoning was more common in young males and more prevalent in rural population. Pesticides and snakebite were major causes of poisoning. Among suicidal cases, family conflict (problem/altercation with family members/marital discord) was main reason for the consumption of poison. There is need for creation of poison information centre along with separate toxicological units in tertiary care hospitals.
Acute invasive fungal rhinosinusitis (AIFRS) – A histopathological analysis of expanding spectrum of fungal infections in backdrop of COVID-19 pandemic
Authors: Aswal Priyanka , Parashar Vibhu S. , Jaiswal Anamika , Kaushik Ankit
Published: September 2023

ABSTRACT

Context:

Acute invasive fungal rhinosinusitis (AIFRS) is an aggressive infection affecting immunocompromised patients and carries a high morbidity and mortality. It is commonly seen in immunocompromised patients, mainly in uncontrolled diabetes, malignancy, acquired immunodeficiency syndrome, and so on. However, there has been an exponential increase in the incidence of AIFRS in relation to recent coronavirus disease 2019 (COVID-19) infection.

Aims:

We present this study to assess histomorphological features of fungal infections in the background of COVID-19 era.

Materials and Methods:

The study includes interpretation of 34 biopsies of suspected AIFRS in post COVID-19 patients. The demographic details like patients age, sex, diabetic status, COVID-19 status, and history of steroid intake were collected. All specimens were stained with hematoxylin and eosin and PAS stain. Detailed microscopic examination including the presence of fungal hyphae in the tissue, characterization of inflammatory response, presence of tissue invasion, angioinvasion, and necrosis was noted for each case.

Results:

Thirty-four biopsy specimens from various sites – nasal cavity, maxillary sinus, ethmoid sinus, and so on – were studied. The mean age of the patients with AIFRS was 52.68 years. The dominant fungi were Mucorales in 31 (91.3%), Aspergillus and Mucorales in 1 (2.9%), a combination of Mucorales and Candida identified in 1 (2.9%) case, and Candida alone in 1 case (2.9%). Bony invasion and perineural invasion were observed in 5 cases (14.7%) and 1 (2.9%) case, respectively.

Conclusion:

Histopathological examination plays an essential role in the diagnosis and appropriate management of the patients. Histopathological features including characterization of fungi, angioinvasion, and bone invasion may provide information on rare dreaded infections in post-COVID-19 patients for possible prognostic characteristics on histology.
Adverse reactions after Covid-19 vaccination in persons affected by leprosy: A scoping review
Authors: Ramasamy Senthilkumar , Galhotra Abhiruchi , Agrawal Sanjana
Published: September 2023

ABSTRACT

Background:

Leprosy reactions are the main pathway leading to severe nerve damage and disability. These reactions can occur at any time. The coronavirus disease 2019 (Covid-19) pandemic led to a catastrophic loss of human life and has had a devastating impact on persons affected by leprosy.

Objective:

To achieve deep insight into the subject of adverse reactions acquired after Covid vaccinations in persons affected by leprosy through a literature review.

Materials and Methods:

A scoping review was conducted in the studies published between July 2021 and June 2022 using the Preferred Reporting Items for Systematic Review and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR) checklist.

Results:

Using the search strategy, a total of 130 articles were found, of which five were relevant to the study. The adverse reactions were acquired mostly in males [9 (81.8%)]; the majority of them belong to borderline tuberculoid [4 (36.4%)], and most of them were released from treatment (multi-drug therapy) [7 (63.6%)].

Conclusion:

Surveillance and management of adverse events following immunization (AEFI) are essential; even minor AEFI should be reported and documented in a line list.
A cross-sectional study to assess the anxiety and coping mechanism among primary caregivers of children admitted in PICU
Authors: Sharma Girraj P. , Sharma Mukesh C. , Mohan Remiya , Khera Daisy , Raghu VA
Published: September 2023

ABSTRACT

Introduction:

PICU admission of a child may cause anxiety and stress among the caregivers. The criteria for admission to a PICU are terrifying and may legitimately cause parents to fear that their child may pass away or suffer a serious disability. They may be overburdened with stress and anxiety of illness and compliment medical information while trying to maintain a balance with other family demands. They must learn coping mechanisms and use resources to stay stable when they face challenges. Evidence on the coping mechanisms used by primary caregivers to control their stress and anxiety is scarce so this study assessed the anxiety and coping mechanism among the primary caregivers of children admitted in PICU.

Materials and Methods:

A cross-sectional study was conducted among 143 primary caregivers by using convenience sampling technique at PICU, AIIMS, Jodhpur, from April 31, 2021, to January 20, 2022. The participants were enrolled after obtaining informed consent and were interviewed by the researcher.

Results:

Study findings revealed that primary caregivers had 38% severe anxiety, 54% moderate anxiety, and 8% mild anxiety. They used emotion-focused coping (43.5%) followed by problem focused coping (37.2%) and avoidant coping (19.3%). Also, there was a significant association found between anxiety of primary caregivers and gender of the child (P = 0.012).

Conclusion:

Anxiety and stress are one of the expected psychological problems faced by caregivers of children admitted in PICU. Healthcare workers must make concerted attempts to support caregivers adaptive coping mechanisms, so they can retain a sense of balance.
Prevalence and determinants of community members utilizing preventive services offered by family physicians in Riyadh, Saudi Arabia
Authors: Alqahtani Nayef G. , Alotaibi Mujib M. , Aldhawyan Nawaf M. , Afify Ayman , Kofi Mostafa , Alqahtani Lama G. , Alotaibi Turki S.
Published: September 2023

ABSTRACT

Introduction:

Early detection and prevention of diseases can reduce morbidity, mortality, and economic burden. There is need to assess the utilization of preventive services for common chronic diseases, cancers, and vaccinations. This study aimed to estimate the prevalence and sequence of utilization of preventive services for common chronic diseases, cancers, and vaccinations in addition to exploring community perspectives on these services.

Materials and Methods:

This study was a cross-sectional survey, which was conducted at primary healthcare centers in Prince Sultan Military Medical City covering Riyadh region from October 2022 to January 2023. The study used a self-administered questionnaire to collect data from attendees aged 18 years and older, focusing on the utilization of eight preventive services (blood glucose testing, blood pressure measurement, cholesterol testing, screening for breast cancer, screening for cervical cancer, screening for colorectal cancer, screening for prostate cancer, and flu and pneumococcal vaccines). Descriptive statistics of the study were reported in frequencies and percentages. Chi-square test was used to assess association between outcome variables.

Results:

Participants were mostly married and had a higher educational degree. However, a considerable number is not accessing primary healthcare services regularly. The results showed that the rate of utilizing preventive services was as follows: blood pressure screening (91%), blood glucose testing (72%), cholesterol testing (65.8%), vaccination utilization (39.5%), breast cancer screening (8%), prostate cancer screening (4.6%), colon cancer screening (4.2%), and least utilized was cervical cancer screening with frequency of (3%).

Conclusion:

The results underscore the importance of increasing awareness and accessibility of primary healthcare services to promote better health outcomes in the region.
Assessment of nurses’ knowledge of the prevention of hospital-associated venous thromboembolism in a tertiary health institution in Nigeria
Authors: Onianwa Patricia Obiajulu , Akanbi Folashade Omobisi Mary , Ayorinde Mary Oyenike , John Oluwatosin Esther , Are Olufunke Olabisi , Ojerinde Ogonna Eze , Alaka Sariyat Yetunde
Published: September 2023

Objective:

This study assessed the level of nurses’ knowledge of the prevention of venous thromboembolism (VTE) in a tertiary health institution.

Materials and Methods:

This descriptive cross-sectional study was conducted with 328 eligible respondents, selected using a random sampling method in a teaching hospital in Nigeria. A self-administered structured questionnaire was used to collect data on the basic knowledge, risk factors, and preventive measures of VTE.

Results:

Findings from the study revealed that 51.2% scored above the mean score of 28.6 ± 3.1. The educational status of the respondents had a significant influence on their knowledge of risk factors of VTE (F = 4.696, P = 0.031).

Conclusion:

The overall knowledge of nurses is satisfactory, although the majority could not answer correctly questions on the administration of prefilled anticoagulants and identification of some key risk factors of VTE.
Postoperative pain assessment and management among nurses in selected hospitals in Benin City, Edo State, Nigeria
Authors: Ehwarieme Timothy Aghogho , Josiah Uzezi , Abiodun Oluwaseun Oluwafunmilayo
Published: September 2023

Objective:

This study was designed to determine the nurse assessment of postoperative pain and its management in selected hospitals, Benin City, Edo State, Nigeria.

Materials and Methods:

A descriptive cross-sectional survey was adopted. The target population consist of 222 purposely nurses who are in the cadre of nursing officer II to chief nursing officer who works in the various surgical wards/units of the selected health facilities. The data were collected from the participants using the pretested structured questionnaire developed by the researcher.

Results:

Results showed that 66.2% of nurses had a poor level of knowledge on postoperative pain assessment. The McGill Pain Questionnaire was the most used pain assessment tool with a mean score of 2.84 whereas the Dallas Pain Questionnaire was the least used with a mean score of 1.90. “Providing clean, calm, and well-ventilated ward environment” (3.69 ± 0.61) was the most used nonpharmacological method for postoperative pain management, followed by “distraction, relaxation, and guided imagery” (3.52 ± 0.50), “dressing, bandage, splint, and reinforce wound sites postoperatively” (3.39 ± 0.54), and “early ambulation/exercise” (3.20 ± 0.62). The most used pharmacological interventions were “acetaminophen” (3.63 ± 0.55), “topical anesthetic” (2.92 ± 0.62), “nonselective nonsteroidal anti-inflammatory drugs” (2.87 ± 0.43), and “mixed opioid agonist–antagonist” (2.56 ± 0.56).

Conclusion:

There is a poor level of knowledge on postoperative pain assessment among nurses in this study setting. It is, therefore, pertinent for hospitals to organize continuous in-service training for postoperative pain assessment and management, especially on nonpharmacological approaches among nurses.
Formy współpracy między państwami w celu odzyskania utraconych dóbr kultury – uwagi wokół poszukiwania optymalnego wzorca Forms of cooperation between
Authors: Gerecka-Żołyńska Anna , Branicka Zofia
Published: September 2023

In the search for an optimal pattern of conduct for the settlement of disputes concerning the ownership of cultural property, the article characterises the legal means and conciliation initiatives available to states. The discussion is limited to the forms of cooperation confirmed in international law instruments, developed especially in the framework of UNESCO’s period of activity, as adopted in the second half of the 20th century and thereafter. In this context, the use of litigation before both the International Court of Justice and national courts is discussed. Attention is also given to conciliatory forms of dispute resolution, distinguishing between consensus initiatives involving only the states interested in resolving the dispute and forms extended to include the participation of impartial mediators supporting the parties in their search for a satisfactory solution. The article assumes that the development of an out-of-court compromise is particularly desirable when the settlement of a dispute concerning the ownership of a cultural asset by an international tribunal or national courts, due to the legal status in force, limits the prospect of obtaining a substantive settlement satisfactory to all parties involved in the conflict.
Problemy konstytucyjne diagnozowane na kanwie ustawy o ochronie zabytków i opiece nad zabytkami – uwagi w świetle spraw zawisłych przed Trybunałem Konstytucyjnym
Authors: Miaskowska-Daszkiewicz Katarzyna
Published: September 2023

The constitutional review of the provisions of the Act on Protection of and Care of Historical Monuments has so far been initi­ated eleven times, with the use of various procedures and with differ­ent results, because so far only three matters have been substantially resolved. The subject of this study is an analysis of constitutional problems diagnosed in pleadings instituting proceedings before the constitutional court. The analysis of the research material leads to the conclusion that the repeated accusation of unconstitutionality is a disproportionate interference with property rights and reveals deficits in the procedural justice mechanism of property protection. As can be seen from the Tribunal’s statements, it does not give pri­ority to any of the values involved in the actual conflict when consid­ering requirements for the protection of national heritage contrasted with the expectations of effective protection of the right to property, but rather seeks a solution based on the principle of proportionality.
Kilka słów krytycznych przy okazji jubileuszu 50-lecia Konwencji UNESCO z 1972 roku
Authors: Zeidler Kamil
Published: September 2023

2022 marked the 50th anniversary of the adoption of the 1972 UNESCO Convention on the Protection of the World Cultural and Natural Heritage. On the occasion of this anniversary, the article uncharacteristically contains criticism of both UNESCO itself and doubts about the 1972 Convention. However, all these remarks flow from concern for the fate and future of this international organisation, whose activities and achievements in the protection of the world cultural heritage ultimately deserve recognition. The problems do not merely arise within UNESCO, but rather with other members of the international community, particularly some states and their actions toward the organisation. Problems also arise from the implementation of and compliance with international law. The allegations against UNESCO are organised and discussed here according to three criteria: formalism, time and costs. On the other hand, the 1972 UNESCO Convention itself is presented from two perspectives – first, in the normative layer as an international legal act, which serves as a sui generis constitution of the world’s protection of cultural and natural heritage; and second, in the empirical layer. In the latter context, attention was paid to the role of the UNESCO World Heritage List. Regardless of the criticisms, as well as the weaknesses and problems highlighted, it is clear from the article that it emphasises the value of both the 1972 UNESCO Convention, one of whose main advantages is that it has resisted the passage of time, and the great role of UNESCO itself, as an important international organisation with considerable achievements and merits.