bluuebunny/crossref_metadata_2025 huggingface dataset:
Randomised controlled study to compare preoperative and postoperative effectiveness of rectal misoprostol for preventing blood loss in elective caesarean delivery
Authors: Upadhyay Priyanka , Wani Iram , Khan Ruhina
Published: March 2022

Background: Comparison between pre-operative and post-operative effectiveness of rectal misoprostol for preventing blood loss in elective caesarean delivery.Methods: A single-blind randomized controlled study of 180 full-term pregnant women were scheduled for elective caesarean delivery. Computerized random allocation of women were done in group 1 to receive 400μg rectal misoprostol at urinary catheter insertion plus 400μg rectally after abdominal closure (preoperative group i.e. group 1, n=90) and group 2 who received 800μg of rectal misoprostol after abdominal closure (postoperative group i.e. group 2, n=90). Primary result was intraoperative blood loss.Results: Intraoperative blood loss was significantly lower in the preoperative misoprostol group who was compared with the postoperative group (526.3±112.8 ml versus 735.4±135.7 ml; p<0.001). Postpartum hemorrhage (PPH) during the first 24 hours after delivery was also lower in the preoperative group against the post-operative group (205.1±77.4 ml versus 289.5±130.1 ml; p<0.001). Fewer women in the preoperative group needed additional uterotonics (8 versus 19; p<0.001) and after delivery, the decrease in haemoglobin levels was also significantly less in the preoperative group (−6.25 versus −14.28%; p<0.001).Conclusions: Preoperative rectal administration of misoprostol significantly reduced intraoperative and postoperative blood loss during and after elective caesarean delivery.
Nutritional status of children in districts of Haryana an analysis from National Family Health Survey (NFHS-4 and 5)
Authors: Singhal Parul , Ohlan Sunny , Singh Sandeep
Published: March 2022

Malnutrition in early life either undernutrition or particularly obesity, can be the underlying cause of many non‐communicable diseases. Nowadays child growth failure phenomena are an enduring public health concern in lower and middle-income countries like India. DBM (Double burden of malnutrition) that is underweight and overweight is also a global concern. Recently, National Family Health Survey (NFHS-5) 2019-21 of India, data reported that 35.5 % of children age less than 5 years are stunted or they are too short for their age; 20% of children are too thin for their height (wasted) and 32% under 5 children are underweight.  The district-level data of nutritional status of children indices were extracted from the district fact sheets of Haryana state, published by NFHS, India. This study is based upon two-time frames of the NFHS (NFHS-4 and NFHS-5) series. District wise change detection of nutritional status of children. Results found that the prevalence of stunted children is still present and increased in 4 districts of Haryana whereas wasted and underweight decreased from previous Survey in all districts of Haryana. As per data reported in the NFHS-5 fact sheet, there are 11 districts in Haryana which shows increased in overweight in children. This study may beneficial for health policy and program makers to understand the dynamic trends of changes in nutritional status of children of under 5 years of age group across the various districts of Haryana.
Re: Non-disabled and disabled women sexual health comparison
Authors: Verma Manvi , Khoiwal Kavita , Chaturvedi Jaya
Published: March 2022

The authors stressed the fact that the provision of sexual and reproductive health services to disabled women poses a special challenge as these women do not seek medical help when in need. We opine that the disabled subset of women deserves a compassionate and unprejudiced attitude from health care professionals towards their sexual well-being.According to WHO, sexual health is defined as - ‘a state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence. For sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected and fulfilled’.2 Free of discrimination and violence is the key here, wherein we suggest that disabled women need to be protected with special legal and social protection which is easily accessible to them.
Echocardiography assessment of right ventricular dysfunction during postoperative period following total correction of tetralogy of Fallot
Authors: Kabir Rashadul , Hussain M. Zahid , Islam M. Tariqul , Chowdhury Naharuma Aive Haider , Karim Tahmina , Rahman Arifur , Sharmin Rubaba
Published: March 2022

Background: Despite major advances in intracardiac surgery since Lillehei and Varco reported the first tetralogy of Fallot (TOF) repair by an open-heart procedure in 1954, right ventricular (RV) dysfunction remains an important clinical problem during the postoperative periods following TOF correction.Methods: This was a cross-sectional study conducted at the department of paediatric cardiology in Bangabandhu Sheikh Mujib medical university (BSMMU), Shahbag, Dhaka in collaboration with national heart foundation hospital and research institute (NHFH and RI) Mirpur, Dhaka, Bangladesh during the period from July 2018 to June 2019. Ethical consideration was approved by the proper concerns. The final sample size was 49. Data analysis was carried out by using the social science (SPSS) version 23.0 windows software. Results: The study was conducted on 49 patients, comprising 30 males and 19 females’ children, and their mean age was 75.38±52.22 months. RV dysfunction global was 63.3% at 24 hours of operation, significantly reduced 49% and 32.7% at 7th and 30th POD respectively. Chi-square test was done where p<0.05. Global dysfunction was 13 (54.2) in ≤5 years, 18 (72.0) in >5 years aged patients.Conclusions: RV dysfunction was more frequent after 24 hours of the postoperative period then it gradually decreases over a period of time
Frequency of hypophosphatemia in critically ill children: risk factors and outcome
Authors: Saman Uroosa , Noreen Asma , Jamil Mohammad T. , Khalid Muhammad , Haq Sidra , Haque Anwarul
Published: March 2022

Background: Phosphorus plays a vital role in maintaining metabolism and energy of body. The objective of this study was to determine the frequency, risk factors and outcome of hypophosphatemia (HP) in critically ill children admitted in pediatric intensive care unit.Methods: This retrospective study included all critically-ill children having phosphate levels within 24 hours of admission from July 2019 to December 2020. Demographic, clinical and laboratory variables were collected.  HP is defined as serum phosphorus level ≤4 mg/dl in this study. Descriptive statistics along with logistic regression analysis have been reported. Results: Prevalence of HP was 53.7% (94/175). Median age was 2 year (0.5-15) and male were 58.5% (106). Serum magnesium level [2.2 (1.5-12.1) vs. 1.8 (1.2-4.0) mg/dl] and serum calcium level [8.7 (.18-10.7) 8.0 (1.8-14.0) mg/dl] were significantly low in the HP group as compared to the normo-phosphatemic group.  There was no significant association of hypo-phosphataemia with admitting diagnosis, ICU therapies, and medications on univariate analysis. Hypo-phosphataemia at admission had no effect on mortality. On multivariate analysis, only male gender demonstrated independent association with HP (OR: 2.2; 95% CI 1.2-4.1; p<0.01).Conclusions: HP is common in critically ill children and is significantly associated with male gender.  Prospective, larger sample size studies are needed to study the prevalence and risk factors of HP at pediatric intensive care units.
Neonatal multisystem inflammatory syndrome associated with prenatal maternal SARS-CoV-2 exposure: a case series
Authors: Tambekar Harish J. , Ashtekar Satish D. , Mirgunde Shishir P. , Khot Swati , Mane Shrikant
Published: March 2022

Multisystem inflammatory syndrome (MIS-C) in children (MIS-C) associated with severe acute respiratory syndrome coronavirus-2 (SARS-CoV2) is well recognised in children, however, rarely reported in newborns. It usually presents as fever and multiorgan involvement, with blood investigations showing increased inflammatory markers weeks after exposure to SARS-CoV-2. Unlike older children, the mechanism is unique in neonates as COVID-19 infection and the subsequent inflammatory reaction leading to MIS-C occur in two different individuals. We reviewed the perinatal history, clinical features, and outcomes of 3 neonates with features consistent with MIS-N related to maternal SARS-CoV-2, from August 2021 to December 2021. Anti-SARS-CoV-2 IgG and IgM antibodies were tested in all neonates. Clinical picture comprised multiorgan dysfunction (gastrointestinal, cardiorespiratory, haematological and dermatological), positive inflammatory markers, high ferritin and high D-dimer levels, elevated Cardiac enzymes. Blood cultures were sterile. Positive anti-SARS-CoV-2 IgG in both the mother and the infant, along with epidemiological evidence of maternal contact with COVID-19, clinched the diagnosis of MIS-C. Immunomodulatory drugs (intravenous immunoglobulin and systemic steroids) were administered. Multisystem inflammatory syndrome should be considered as a differential diagnosis in all critically ill neonates, particularly with maternal history of COVID-19 infection or epidemiological contact. This neonatal presentation is the reflection of fetal inflammatory response syndrome associated with maternal SARS-CoV-2 infection. Having no fever throughout the course of illness, in some neonates, suggests that neonates respond differently compared with children.
Langerhans cell histiocytosis in an infant: a case report
Authors: Singhal Nehal , Nagar Rajendra , Nagori Gautam
Published: March 2022

Langerhans cell histiocytosis is a rare non-malignant disease characterized by a clonal proliferation of pathological cells with the characteristics of Langerhans cells in single or multiple sites. A 7-month-old infant presented with continued fever and recurrent cough with progressive rash over the whole-body including palms and soles for over a month. On examination there was respiratory distress, generalized lymphadenopathy, hepatosplenomegaly and skin rash. The diagnostic workup for underlying causes showed ground glass opacity, pulmonary oedema and retroperitoneal lymphadenopathy on CT scans of thorax and abdomen respectively. The histopathology specimens of skin and lymph node biopsy further confirmed the suspicion of Langerhans cell histiocytosis. The patient was sent for treatment with vinblastine and prednisone to a higher centre. In this case report we highlighted the unusual presentations and prognosis of a child with Langerhans cell histiocytosis.
Acute disseminated encephalomyelitis in SARS-CoV2 seropositive child
Authors: V. Arul Prasath S. , J. Rini Evangeline , Samuel Steeve Gnana
Published: March 2022

In this case report, a 2-year-old boy presented with UMN type of diplegia with involvement of cerebral cortex. He was afebrile with normal inflammatory markers, negative RT-PCR throat swab, negative COVID IgM and positive IgG antibodies with CSF showing elevated proteins with lymphocytosis on a background of MRI brain depicting a picture of white matter hyperintense signals on T2 FLAIR and resolution on follow-up MRI which confirms the possibility of acute disseminated encephalomyelitis (ADEM) following recent SARS-CoV2 infection.
COVID-19 in children with congenital heart disease in Asia: clinical features and recommendations for management
Authors: Akhtar Samaa , Asif Assma
Published: March 2022

Globally, around 1.35 million children are born with a congenital heart disease’s every year. Making CHDs one of the world's most common congenital anomaly and, thus, a significant global health issue. The CHD prevalence rate is highest in Asia (9.3 per 1000 live births) which is followed by Europe (8.2 per 1000 live births) and lowest in Africa (1.9 per 1000 live births). The existing high CHD burden on pediatric health infrastructures around the world has been worsened due to the global coronavirus (COVID-19) pandemic. Approximately, a total of 22.9 million children and adolescent cases of COVID-19 have been recorded. The highest infectivity rate has been in children under 3 years of age.3 90% of reported pediatric cases have been categorized as mild or moderate disease, 5.2% as severe and 0.6% as critical.4 Over 12,300 children and adolescents have died due to COVID-19. Of these deaths, 58% have occurred in the 10-19 age group and 42% in the 0-9 age group. Which can prove to be exceedingly detrimental in Low to Middle Income regions, such as Asia, where the medical infrastructure is less robust and usually poorly accessible. According to a systematic review on the association of COVID-19 and pediatric co-morbidities, around 5.1% of severely ill children have had an underlying comorbidity, such as CHD. However, at present, the data from Asia is very limited. There are only a handful of large, observational cohort studies. These have been conducted primarily in China, Iran, and India.
Clinical characteristics, serum albumin and eosinophil levels as risk factors for drug induced hepatitis in tuberculosis patients receiving fixed-dose combination anti-tuberculosis drug
Authors: Anastasia Andriani Sheila , Somia I Ketut Agus , Arisanti Ni Luh Putu Eka , Candrawati Ni Wayan , Kusumawardani Ida Ayu Jasminarti Dwi , Artana I Gusti Ngurah Bagus , Rai Ida Bagus Ngurah
Published: March 2022

Background: Drug-induced hepatitis (DIH) is a side effect of the usage of anti-tuberculosis (TB) drugs, which can cause alteration in treatment regiments and prolonged treatment. This study aim is to identify the risk factors that can be used to predict the occurrence of DIH on tuberculosis (TB) patients.Methods: This was a case-control study, conducted at Sanglah central general hospital in Denpasar from January to June 2021. Data collection was carried out through the medical records of inpatients and outpatients who received fixed-dose combination anti-TB drug.Results: There were 62 research samples which were divided into 31 samples in the case group and 31 samples in the control group. The clinical manifestations of DIH were vomiting (32.8%), nausea (15.7%), abdominal pain (13.1%), and hepatic encephalopathy (1.3%). Median time to onset of DIH was 18 (Interquartile range: 19) days. Low BMI was a significant risk factor for DIH (AOR=22.4; 95% CI 4.147-121.575; p<0.001). Other clinical characteristic variables such as age, female, extrapulmonary TB, positive HIV status, diabetes mellitus, hypoalbuminemia, and eosinophilia were not proven risk factors for DIH-TB.Conclusions: Low BMI was a significant risk factor for DIH. Other variables such as age, female, extrapulmonary TB, positive HIV status, diabetes mellitus, hypoalbuminemia, and eosinophilia were not risk factors for DIH in TB patients.
A study of correlation between prevalence of pulmonary artery hypertension with severity of bronchiectasis
Authors: Vidyasagar Sachin , Ganesan Natesh , Vadivelu Gangadharan
Published: March 2022

Background: Pulmonary artery hypertension (PAH) dreadful complication in bronchiectasis. The 6th world symposium on pulmonary hypertension have taken mPAP of 20 mmHg as normal. Not much studies have been done based on the current cut off values, so we have incorporated values based on the new guidelines and made following observations.Methods: This study was designed as an observational cross-sectional study consisting of 27 patients, who were admitted in Pulmonary medicine department.Results: Out of 27 study subjects 15 were female’s and 12 were males. It was found that 70.3% had less than 5 segments involved and 29.6% had more than 5 segments involved. Mean value of PAH was 34.48±18.06 mmHg. Analysis showed a significant correlation (r=0.67) between number of segments involved and incidence of pulmonary hypertension.Conclusions: It is essential to evaluate the cardiac status of bronchiectasis patients at the time of diagnosis as cardiac manifestations are one of the dreadful complications.
Initial investigations and clinical outcome in COVID-19 patients
Authors: Shrivas Vijay K. , Rai Manoj K. , Chandel Sandhya
Published: March 2022

Background: Coronavirus disease 2019 (COVID-19) has significant impact on the health infrastructure all over the world including India. We wanted to see whether the routine initial investigations done in COVID 19 patients reflect the prognosis and outcome of the patient.Methods: It is a retrospective study involving the confirmed covid 19 patients admitted between April 2021 to May 2021. The initial investigations done at the time of admission were studied in relation to outcome of the patient in the form of survival or death of the patient.Results: A total of 364 patients were studied. 295 (81.05%) patients survived and 69 (18.96%) patients died. Highest mortality was observed in 60% of patients with hemoglobin below 7.0 mg/dl, 40.00% of patients with platelet count below 50000/cml, 28.80% with neutrophil lymphocyte ratio more than 5.5, 32.81% with CRP more than 100 mg/L, 100% with D dimer more than 5000 ng/ml, 33.33% with Ferritin more than 1500 ng/ml, 29.54% with IL-6 more than 100 pg/ml, 23.14% with Random blood sugar more than 200 mg/dl, 37.50% with creatinine more than 2.0 mg/dl, 75% with Bilirubin more than 2.0 mg/dl, 42.85% with SGOT more than 201 mg/dl, 22.22% with SGPT more than 201 mg/dl, 38.46% with serum Procalcitonin more than 2.0 mg/dl. CT Chest severity score of 21 to 30 and 31 to 40 lead to mortality of 19.51% and 40.00% respectively.Conclusions: The physician who is taking care of COVID-19 patients must get extra cautious regarding prognosis if he gets above initial parameters deranged in isolation or combination.
Comparative study of CURB-65 and expanded CURB-65 score in community acquired pneumonia in a tertiary care hospital of Assam
Authors: Das Parag Kumar , Phukan Jayanta Dhekial , Sharma Suresh , Goswami Debasish , Yepthomi Atovili K.
Published: March 2022

Background: Community acquired pneumonia is one of the leading causes of morbidity and mortality in developing countries like India. The presentation of CAP may range from mild pneumonia characterized only by fever and productive cough to severe pneumonia leading to respiratory distress and sepsis syndrome requiring management in ICU. Any delay in ICU admission has been shown to be associated with increased mortality. This study was conducted to compare Expanded CURB-65 with CURB-65 scoring system in a tertiary care centre in Assam for early stratification of patients with CAP based of severity and expected prognosis.Methods: This hospital based prospective study was conducted between September 2020 to August 2021, and a total of 100 patients were taken and followed up form admission to up to 30 days. CURB65 and expanded CURB 65 score was calculated for each patient and the accuracy of each score was statistically compared.Results: In our study out of 100 patients mean age of 60±17.97 with Mortality rate of 16%. Total 29% patients were need ICU care. The Sensitivity, Specificity, PPV and NPV for predicting mortality and for ICU admission of Expanded CURB-65 score is found to be superior to CURB-65 Score.Conclusions: In comparison to the CURB-65 score system, the expanded CURB-65 score prioritises both clinical and laboratory criteria and is a more reliable marker for evaluating CAP severity and may improve the effectiveness of forecasting death in CAP patients.
Fatal systemic reactions, concurrent of anaphylaxis and systemic toxic reactions to hymenoptera-sting
Authors: Suryana Ketut , Sindhughosa Dwijo Anargha
Published: March 2022

Hymenoptera-sting can cause localized and systemic reactions (SR). SRs such as anaphylaxis and systemic toxic reactions (STR). It is estimated to occur in 3% of adults and can be life-threatening. Diagnosis is based on clinical manifestations, previous of allergic history, IgE-mediated confirmation and the offending insect identification. Anaphylaxis patients should immediately receive adrenaline intramuscularly, emergency medical attention and other supporting treatment. We report a 36-year-old man with fatal SRs, concurrent of anaphylaxis and systemic toxic reaction due to multiple hymenoptera-stings.
CRISPR-Cas9 gene editing technology in human gene therapy: the new realm of medicine
Authors: S. Manasa M.
Published: March 2022

Gene therapy has a huge clinical relevance in the present therapeutic world and is one of the many research fields of biology which received many benefits from the recent advancements of modern clustered regularly interspaced short palindromic repeats (CRISPR)-Cas9 gene editing technology. Researchers are on the way to make significant changes in the ways of treating genetic abnormalities. An increase in the number of approved clinical trials of CRISPR based gene therapy shows we are not too far from eliminating deadly diseases such as acquired immunodeficiency syndrome (AIDS), cancer and many inherited genetic conditions from the society. However, there are some challenges associated with the development of CRISPR technology in medical field most of which revolves around its safety, efficiency and ethics. Lack of an optimized method by which the CRISPR-Cas9 expression cassette can be delivered to cells is one of the main challenges when it comes to its application in human gene therapy. Although viral vectors are the most common delivery systems used in gene therapy, recent researches show promising results on using lipid- based l delivery systems such as liposome-templated hydrogel nanoparticles (LHNPs). As these could eliminate the safety concerns of using viral vectors, it is expected to have potential therapeutic applications in future. Nevertheless, the efficiency of non-viral systems is still not fully comparable with that of viral vectors. Hence, CRISPR based therapies might take longer than expected to be prevalent in the medical field. In this short review, the recent advances of CRISPR technology in gene therapy is discussed along with its challenges and limitations.
Prevalence and possible causes of antibiotic self-medication among rural dwellers and volunteer health workers in Nattalin Township, Bago region, Myanmar
Authors: Hlaing Thein , Lat Tun W. , Myint Zaw M.
Published: March 2022

Background: In Myanmar, the emergence of antibiotic-resistant strains is increased, but its exact causes remain unrecognized. This cross-sectional study examined the prevalence and possible causes of antibiotic self-medication (ASM) among rural dwellers and volunteer health workers (VHWs).Methods: 445 adult rural dwellers from 24 villages and all the 133 registered VHWs within Nattalin Township were examined for illnesses, types and sources of antibiotics, knowledge, perception and possible causes for ASM practices within the last six months. The significant causes of ASM were determined by 95% CI resulting from bivariate and multivariate analysis.Results: The ASM proportions of rural dwellers and VHWs were 14.2% and 84.2%. The top three most frequent illnesses for ASM were sore throat-(28.6%), respiratory symptoms-(15.8%) and diarrhoea-(17.9%) among rural dwellers and the common cold-(30.4%), sore throat-(25.0%) and respiratory symptoms-(20.6%) among VHWs. In ASM of rural dwellers and VHWs, amoxicillin-(46.0% and 67.9%) was used for the most frequency followed by cefixime-(33.3% and 29.5%), ampicillin-(22.2% and 8.9%) and penicillin-V-(6.3% and 10.7%). For ASM practice, convenience-(54.0% and 65.2%), their prior experiences-(60.3% and 49.1%) and cost reduction advantages-(31.7% and 25.0%), and for the availability of antibiotics, community pharmacies-(88.9% and 78.6%) were mentioned among rural dwellers and VHWs respectively. Among rural dwellers and VHWs, ASM was significantly associated with knowledge-(AOR: 0.5, 95% CI-0.2, 0.9, AOR: 0.2, 95% CI-0.05, 0.8) and keeping antibiotics-(AOR: 64, 95% CI-14, 292, AOR: 45, 95% CI-5.1, 395).Conclusions: Through multisectoral approaches, it is necessary to promote awareness of the consequences of irrational antibiotic use, enforce national drug laws, and regular inspections on community pharmacies, and provide easy access to public health infrastructures.
Evaluation of knowledge, awareness, treatment and prevention towards pregnancy induced hypertension among the pregnant women in Bangladesh: a hospital based cross-sectional study
Authors: Zohora Fatama T. , Aktar Salma , Hossain M. Imam
Published: March 2022

Background: Pregnancy induced hypertension (PIH) is one of the major causes of maternal and neonatal morbidity, mortality and premature birth. 99% of the maternal deaths is occurring in developing countries like Bangladesh. Almost 12% of the maternal deaths is associated with hypertensive disorders such as PIH in pregnancy. It can be prevented by proper knowledge, awareness of the disease and its complications. We investigated the knowledge, awareness of PIH and its related factors during pregnancy among the pregnant women in Tangail, Bangladesh.Methods: A descriptive cross-sectional study among 200 pregnant women in between March 2021 to June 2021 was conducted by using a questionnaire at Sheikh Hasina Medical College Hospital (SHMC) of Tangail district, Bangladesh. Factors associated with the knowledge and awareness of PIH were investigated separately using Chi square test.Results: In this study, 92.5% of the pregnant women had heard about PIH and 10.5% pregnant women had PIH. Age group 30-35, >35 and post graduate respondents were more knowledgeable and aware than others about PIH and urban respondents were highly knowledgeable and aware to PIH compare to rural respondents. The age of the respondents, area of residence, educations, occupations, socioeconomic status were found to be significantly associated with PIH knowledge and awareness.Conclusions: The study result showed that there is need to increase public knowledge and awareness about PIH. Health educational programs throughout the rural and urban areas need to be intensified to reduce PIH-related deaths among the pregnant women in Bangladesh.
Perception of people of seeking dental care during COVID-19 among adults in Madurai city: a cross sectional study
Authors: G. Ramalakshmi , Chavan Sangeeta , K. Umesh , R. Palanivel Pandian
Published: March 2022

Background: This study aimed to assess the perception of people seeking dental care during COVID-19 pandemic, among adults in Madurai city.Methods: It is a cross sectional questionnaire study conducted among subjects visiting outpatient department of public health dentistry, in best dental science college, Madurai city, Tamil Nadu, India. A pretested questionnaire consisting of 13 items was used to record perception of receiving dental treatment during COVID-19. Results: The Study results showed that 60.5% people considered dental clinic visit as a risk of COVID and 16.5% of study population considered teleconsultations were effective.60% feared of seeking dental treatment during COVID pandemic.Conclusions: The results of the study revealed that there is an apprehension among people visiting dental clinic during pandemic, the treatments has to be made safe for dentist as well as the patients.
Knowledge, attitude and preventive behaviours regarding COVID-19 infection among medical students of Solapur, Maharashtra
Authors: Ram P. S. Nithes , Haralkar Santosh , Gawande Abhishek , Soni Akhil
Published: March 2022

Background: It is important for medical students to know about COVID-19 in order for them to be a well-versed future health workers.  The aim of the study was to assess the knowledge, attitude, and practice regarding COVID-19 infection among medical students at government medical college in western Maharashtra. To study the knowledge, attitude and practice regarding COVID-19 infection among medical students and to find the association between KAP levels and demographic variables.Methods: An observational descriptive study with cross sectional design was conducted during July 2021 on 400 Under Graduate medical students of a Government medical college.Results: Out of 400 students 53%- female (212); 47%- male (188). Most of the students belong to Hindu religion 86.75% (347), rest Muslim 39 (9.75%), Christians 14 (3.5%). Overall, 92%, 81%, 90.5% of surveyed medical students had adequate knowledge, attitude and practice towards COVID 19 pandemic respectively.Conclusions: In our study, students exhibited good knowledge, positive attitude, and sensible practices regarding COVID-19. Such KAP studies should be conducted across other medical college and we should educate our medical students so that we can use the help of medical students for management of mild covid cases if manpower crisis occurs.
A cross-sectional study to assess the knowledge and awareness regarding thyroid disorder among university students, Chandigarh, India
Authors: Sharma Charu , Rohilla Ravi , Kumar Manoj
Published: March 2022

Background: Globally, despite being the most prevalent chronic medical condition, thyroid disorder is one of the most under-diagnosed and overlooked health problems which account for a significant number of complaints in adolescents, and adults. The objective of the study was to assess the knowledge and awareness among students related to the spectrum of thyroid diseases.Methods: This was a questionnaire-based, cross-sectional study conducted at Panjab University, Chandigarh, India between February 2020 and August 2020. Purposive sampling was employed. The nature of the data was quantitative and was analyzed through statistical package for the social sciences (SPSS) (version 20.0).Results: Out of 224 students enrolled, of which 60.7% were females, 38.9% were males, and 0.4% transgender with a mean age of 23.52±2.47 (max-min=18-32 years). Around 45.2%, 55.7%, and 46.1% students had incorrect/no knowledge that irregular menstrual cycles, swelling in the neck, and stress/depression were manifestations of thyroid disorder, respectively. Students had poor knowledge regarding various risks associated with thyroid such as infertility (56.2%), hereditary disorder (46.1%), and medications causing thyroid (58%). 65.7% were not aware that thyroid disorder affects the level of IQ. 43.4% respondents undergone thyroid screening on the suggestion of a doctor (50.5%), while 7.4% self-prescribed themselves after reading on online portals. Significant associations were found between gender and the different levels of knowledge and awareness.Conclusions: This study identified significant lacuna in the knowledge and awareness about the symptoms, factual statements, and fallacies associated with the thyroid disorder.
A comparative study on breastfeeding in rural and urban areas of Kanpur nagar, Uttar Pradesh
Authors: Ratan Shiv , Nigam Seema
Published: March 2022

Background: Appropriate infant feeding, with early initiation of breastfeeding along with colostrum as the first food, exclusive breastfeeding to six months, followed by the introduction of complementary foods with continued breastfeeding, is important for survival as well as physical growth and mental development of the child. World breastfeeding week (WBW) is celebrated every year from 1 to 7 August to encourage breastfeeding and improve the health of children around the world. Our objective was to determine the knowledge and practice of EBF among study subjects. To compare knowledge and practice of EBF among rural and urban study subjects.Methods: The study was a cross-sectional study conducted amongst mothers having children between 0-24 months of age group in the area of RHTC and UHTC of department of community medicine, GSVM Medical College Kanpur. Data was collected using a predesigned and pretested questionnaire after the house-to-house survey and Chi-square test used.Results: Pre-lacteal feeds were given in 21.25% of children. Colostrum was given in 67.2% of babies. 18.5% of mothers initiate breastfeeding within 1 hour after delivery. 31.75% of babies were exclusively breastfed for more than 6 months. The majority of the mother (72.25%) continues breastfeeding up to 2 years. Majority (73%) of mothers give breastfeeding from both sides.Conclusions: In our study, awareness about breastfeeding, early initiation of breastfeeding and avoiding pre-lacteal feed. It supplies all the necessary nutrients in the proper proportions and protects against allergies, sickness, and obesity.
The acceptability of a self-guided psychological intervention for patients with COVID-19 in isolation and quarantine
Authors: Suman Aarzoo , Shouan Anish , Singh Shubh Mohan , Kumar Krishan
Published: March 2022

Background: A significant number of patients not requiring intensive care would experience psychological symptoms and distress. This may necessitate mental health care services which may be not be feasible given the number of patients involved and paucity of mental health care workers. An innovative solution for such a scenario may be in the form of a self-guided psychological intervention. The aim of the study was to test the acceptability of a brief self-guided psychological intervention for patients in quarantine and isolation with COVID-19.Methods: The authors developed a brief, self-guided psychological intervention handout targeted towards reducing psychological distress and enhancing the coping of patients in quarantine and isolation due to COVID-19. This was developed concurrently in English, Hindi and Punjabi languages. This was administered to 60 patients. Assessments were done at baseline and at two weeks.Results: Assessments were completed in 51 patients (21 isolated and 30 quarantined). A majority of the patients in both groups found the intervention to be appropriate in form and content, relevant to the situation, had a positive emotional impact on them, enhanced their understanding of the situation and was perceived as being useful overall. The intervention was found to be highly acceptable.Conclusions: The study demonstrates the acceptability and feasibility of using this intervention in patients in isolation and quarantine due to COVID-19. The intervention lends itself to ease of use and can be scaled up at little cost.
A LEARN model approach in health care for improvising the doctor-patient relationship
Authors: Ohlan Sunny , Singhal Parul , Dagar Rakesh , Goyal Mukta , Goyal Sanket
Published: March 2022

The LEARN model was originally developed to help physicians and other clinicians working in ethnically diverse communities. However, it has broad applicability in the prevention setting. The LEARN (Listen, Explain, Acknowledge, Recommend, Negotiate) model is a framework for cross-cultural communication that helps build mutual understanding and enhance community engagement. Community-engaged communication is much important in the community with culturally relevant and authentic solutions. COVID-19 pandemic has re-ignited the discussions regarding the need of the effective communication across cultures in health care professionals. Culture is central to effective COVID-19 messaging for community engagement. Culture may appear neutral, but its power to define identity and communities as a collective is based on values expressed through institutions such as health care, education, and families. Be careful about the biases and values that you may be bringing to medical encounters. Try to resolve and applied a tailored treatment plan approach that involves the patient’s immediate family, extended family or other community members, as appropriate. Find out the various diversities exists within ethnic and cultural background as much as between groups and avoid generalizing or stereotyping cross-cultural encounters. Assess the literacy levels of your patients or families and then give appropriate advice accordingly. The aim of the study was to improvise doctor-patient communication and the doctor-patient relationship using LEARN model.
Expounding nested case control studies in the year of COVID-19: a scoping review and sub group meta-analysis
Authors: Tapnikar Lata Ajay , Joshi Mohan P. , Soni Antara A. , Saoji Ajeet V.
Published: March 2022

Nested case control studies (NCCS) are mainly a type of cohort study due to its forward direction and temporality. This design is done only under two circumstances. a. disease must be new and rare in the population b. The diagnostic test must be fairly expensive. Thus, this study design is defined as ‘a small case control study nested within a big cohort study’. The paper has expounded existing literature on nested case control studies by using scoping review and meta-analysis on hypertension sub-group. The data was systematically searched with following databases: Medline, NLM which had free articles and Google scholar. The aim of the study was to scope review of English language research papers from May 2020 to May 2021. 86 studies were excluded and 9 studies were selected after reviewing the title and abstract of 209 studies based on the PRISMA. The research has made a unique contribution, in a resource crunched setting, in expounding the study design implementations by lending critical viewing, theoretical revision and, new perspectives on use of nested case control studies in field settings.
Acute appendicitis in twin appendices: case report
Authors: Tesfay Goytom Knfe , Tesfaye Netsanet , Yirga Yeneneh , Zeleke Alemu
Published: March 2022

A double appendix is a rare congenital malformation with a frequency ranging from 0.004 to 0.009% and only a small percentage of instances presenting as appendicitis. Although the cause of appendiceal duplication is unknown, it poses a difficult clinical picture in patients with right lower quadrant pain. In this case report, we presented two cases of operative treatment of acute appendicitis in a doubled vermiform appendix in 4 and 17 years old male patients. Both cases did not have any pertinent prior medical condition and presented with shifting right lower quadrant (RLQ) abdominal pain associated with nausea, vomiting and anorexia. Clinical exam, laboratory investigations as well as imaging findings were consistent with features of acute appendicitis. In both patients, the diagnosis of the duplicated appendices was unsuspected until two tubular structures arising from the cecal wall were discovered intraoperatively and confirmed on histopathological examination after appendectomy of the two appendices was performed. Hence, in all situations where acute appendicitis is suspected clinically and radiologically, surgeons must maintain a high level of suspicion for the potential of duplicated appendices to avoid missing the duplication and resulting post-operative difficulties and medicolegal concerns.
COVID associated mucormycosis and its etiopathological correlation
Authors: Sachdeva Kavita , Shukla Amrita , Kabade Mayur V. , Chandrakapure Deepankar , Tom Stephy Maria , Raj Lakshmy V.
Published: March 2022

Background: During COVID-19 pandemic, patients with diabetes mellitus (DM) and immunocompromised condition were at risk of opportunistic infections among which mucormycosis came with most dreadful consequences. Mucormycosis is a potential life-threatening, opportunistic fungal infection caused by fungi belonging to the order mucorales. Most vulnerable patients at risks are observed to be patients with uncontrolled blood sugar and diabetic ketoacidosis (DKA), patients with immunocompromised state, severe neutropenia in viral infections, on steroid therapy, oxygen therapy, chemotherapy. Despite aggressive and disfiguring surgeries paired with antifungal therapy, the mortality and morbidity rate are high. The mentioned epidemiological factors were observed and correlation between these were analysed to avoid the predisposing factors in future.

Methods: The study was conducted over 160 patients as prospective cross-sectional design, admitted in mucor ward of NSCB and MCH, Jabalpur. Patients were assessed clinically with related investigations. Consent was taken after explaining the nature and purpose of study.

Results: In our study, mucormycosis was found to affects elderly males more commonly, with immune-compromised state especially in diabetic population, received unsupervised steroid or oxygen therapy in unhygienic setups.

Conclusions: To ensure better outcome, along with early surgical intervention and medical management, environmental predisposing factors must be taken care of. Immunocompromised state especially uncontrolled diabetes and acidosis should be corrected, judicial use of steroids, healthy life style, oxygen supplementation with aseptic masks and tubings, use of distilled water in humidifiers, immunity build-up may bring a major change in prognosis.
Endoscopic management of retrosternal goitres through cervical approach: a single centre experience
Authors: Puntambekar Shailesh , Bhaumik Abhishek , Bharambe Suyog , Chitale Mihir , Sathe Ravindra , Panse Mangesh , Manerikar Kshitij , Langade Yogesh , Attar M. Azharuddin Azim , Gandhi Nikesh , Bhat Apoorv , Ghuge Ashutosh , Pimpale Renu
Published: March 2022

Background: Retrosternal extension of thyroid poses a significant challenge due to its size and high vascularity. The objective of this study was to assess the outcomes of endoscopic approach via cervical approach for retrosternal thyroid removal.Methods: This was a hospital based retrospective cross-sectional study, conducted among 12 patients of goitres with retrosternal extension who fulfilled the inclusion criteria for endoscopic excision via cervical approach from January 2016 to December 2020. The data was collected using patient record sheet. STATA 15.0 was used to analyse the data. Results: The median age of the participants was 62 (18.5) years. Approximately 66.7% (N=8) and 33.3% (N=4) of the patient’s respectively presented with the complaint of unilateral and bilateral swelling in the neck. The majority of the patients reported due to cosmetic reasons (58.3%), breathlessness (33.3%), hoarseness and dysphagia (8.3%). Among the patients all were euthyroid. There was no incidence of haemorrhage, tracheal and esophageal injury in the patients intraoperatively. Postoperative histopathology showed benign multinodular goiter (41.7%) and colloid formation (58.3%).Conclusions: The traditional thyroidectomy is widely accepted by the surgeons for retrosternal goitres however the results of our study suggest that the endoscopic technique is minimally invasive and safe procedure that offers excellent cosmetic satisfaction. With the careful selection of cases and surgeon expertise endoscopic thyroidectomy can yield results similar with the traditional approach however, with less complication rates and morbidity.
Secondary hyperparathyroidism induced parathyroid adenoma masquerading as a solitary thyroid nodule-a case report
Authors: Yadav Mukesh Kumar , Sahu Pankaj Kumar , Kumar Sanjay , Singh Roohie , Paramasivam Praveen Kumar , Dogra Natasha
Published: March 2022

Parathyroid adenoma is associated with both primary and secondary hyperparathyroidism (SHPT). Identification of the adenoma requires a combination of clinical evidence, imaging information and cytological findings due to the challenging distinction between thyroid and parathyroid lesions. Sometimes ultrasound and even fine needle aspiration studies cannot distinguish this lesion from thyroid lesions. We present a case who was incidentally detected to have nodule in the (R) lobe of thyroid on CE-MRI. FNAC was suggestive of follicular neoplasm so managed as right hemithyroidectomy but the final diagnosis was made as parathyroid adenoma on the basis of histopathological examination and immunohistochemistry. Patient was evaluated retrospectively utilizing serum PTH levels, 24 hours urine calcium levels, inorganic phosphorus and USG KUB which turn out to be vitamin D deficiency induced SHPT and was managed with vit D3 supplements.
To determine shoulder function after arthroscopic rotator cuff repair using university of California and Los Angeles score
Authors: Khosla Nitish , Garg Rajnish , Mahindra Pankaj
Published: March 2022

Rotator cuff tears are a common contributing factor ofshoulder pain and occupational disability. Tears of rotator cuff arebecoming increasingly prevalent in today’s population. Shoulderarthroscopy has become a reliable and reproducible method of treatingrotator cuff tears. Arthroscopic surgery allows for a shorter recovery timeand predictably less pain in first few days following procedure than doesany open surgery.

: A prospective and retrospective review of themedical records of 37 cases of rotator cuff tear who underwentarthroscopic rotator cuff repair between January 2017 to May 2020 atDayanand Medical college Hospital, Ludhiana was performed.

In our study, we had measured UCLA shoulder score over 6months period in 37 patients. Our study showed improved functionaloutcome from UCLA score at presentation- 10.27 to UCLA at 6 months-30.41 with a p value <0.001 which is graded as a good result. There wasno significant gender difference in terms of incidence and postoperativefunctional outcome. Maximum incidence was seen in age group- 51-60years with etiological inclination towards precedent trauma. No statisticaldifference between functional outcome of single and double row techniquewas noted.

Arthroscopic repair of rotator cuff tear offers excellent functional outcome; with minimal morbidity. Improvement in pain, range of motion and strength of cuff tendons can be achieved only by meticulous repair techniques and strict rehabilitation programme.
Treatment of unstable bilateral slipped capital femoral epiphysis using modified Dunn procedure along with cc screw fixation in a recurrent epileptic patient
Authors: Arora Aayush , Sanikop Somnath T , Jatti Ravi S , Hanchnal Prathamesh
Published: March 2022

Slipped capital femoral epiphysis (SCFE) is uncommon in daily practise, and diagnosis and treatment are usually delayed. In patients with severe slipped capital femoral epiphysis, the modified Dunn method allows for the restoration of proximal femoral morphology and proper hip function (SCFE). The purpose of this article is to outline the treatment management of unstable bilateral slipped capital femoral epiphysis in an epileptic patient.

A 9-year-old female, a known case of grandmal epilepsy, arrived in the outpatient department with a severe SCFE. The patient underwent modified Dunn osteotomy and fixation of the epiphysio-metaphysis junction with CC screw fixation. Since there is very little awareness regarding slipped capital femoral epiphysis in an epileptic patient, this case report is very rare.

One should be vigilant about children suffering from uncontrolled epileptic attacks. A delay in diagnosis can lead to an unsatisfactory treatment outcome and a poor prognosis.
Prevalence of nasal septum deviation and its association with chronic maxillary sinusitis
Authors: Ashwinirani S R , Kumbhare Shruti , Suragimath Girish , Sande Abhijeet
Published: March 2022

The nasal septum deviation causes alteration in airflow, mucociliary clearance and effects on structures of the lateral nasal wall causing various nasal symptoms and other sinonasal diseases. Deviated nasal septum has been associated with chronic sinusitis.

This present study was aimed to investigate the prevalence of nasal septum deviation in Western population of Maharashtra, to compare the rates between gender and to investigate its association with chronic sinusitis.

The retrospective study was conducted at Krishna institute of medical sciences, Deemed to be university (KIMSDU) in collaboration with School of dental sciences, Karad. The institutional ethical committee clearance was obtained before start of the study with protocol no. 0200/2018-19. A total of 80 patient's paranasal views (PNS views) were enrolled in this study after fulfillment of Inclusion and Exclusion criteria’s.

Out of 80 patients in our study 45 were males accounting for 56% and 35 were females accounting for 44%. In total 80 patients only 50 Patients were having deviated nasal septum accounting for 62.5% and 30 patients were not having DNS accounting for 37.5%.

Based on PNS view in our study the prevalence of DNS was 62.5% and about 88% of patients were having sinusitis associated with DNS and majority of patients were males.