bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of Full Outline of Unresponsiveness (FOUR) and Glasgow Coma Scale (GCS) in Determining Outcome among Patients in Critical Care Units – A Prospective Study
Authors: Amirtharaj Anandhi Deva , Balachandran Shreedevi , Gujjar Arunodaya Ramarao , Arulappan Judie , Jaypal Sathish Kumar
Published: October 2023

Accurate assessment and monitoring of level of consciousness is fundamental for prompt management and recognising warning signs of deterioration in the patient. The Glasgow coma scale (GCS), a widely used tool was compared with full outline of unresponsiveness (FOUR) score as an alternate tool for assessment and prognostication of the outcome. The purpose of this study aimed to compare and evaluate the accuracy between GCS and FOUR score (FS) tool in the neurological assessment and predicting the functional outcome. Materials and Methods: For this observational study, 131 patients were recruited from two major teaching hospitals in Middle Eastern countries. Data was collected on admission from emergency department and reassessed on day two & four. Patient was followed on discharge and outcome evaluated using the Glasgow outcome scale (GOS). Results: The mean age was 56.39±17.29 (18- 87years) with 83(63.4%) male patients. 93 (71%) patients admitted with neurological problems. In terms of predicting the outcome using the GOS, the area under the ROC curve was 92% (CI- 95%, 0.870-0.975) for FS and 74.73 % (CI-95%, 0.825-0.951) for GCS. The sensitivity and specificity for FS on admission (0.976 & 0.543), day two (0.971 & 0.495) & day four (0.971 & 0.340) and for GCS is (0.918 & 0.370) (0.941 & 0.433) (0.971 & 0.330). Conclusions: The FS tool is precise in predicting power of mortality and is an ideal complementary or substitute tool for GCS.
Gut microbiome-based dietary intervention in Parkinson disease subject: A case report
Authors: Sulthana Ayesha , Paneyala Shasthara , H.S. Sindhu , Narayan Meghana Kowlagi , Hediyal Tousif Ahmed , Sharma Sonali , Senthilkumar Arunsaikiran , Dave Paul , Mahalakshmi Arehally M. , Chidambaram Saravana Babu , Monaghan Tanya M. , Sulakhe Dinanath
Published: October 2023

A 54-year-old woman was seeking medical treatment for Parkinson disease (PD) in the neurology outpatient department in JSS Hospital, Mysore, India. She was challenged in terms of reduced mobility and had sought several treatment options to control her PD symptoms without successful outcome. After examination and confirmation of diagnosis, the decision was taken to design a precision nutritional intervention using a gut microbiome-based diet combined with medical treatment. After 2 months of a superfood dietary intervention, the patient showed signs of clinical improvement as evidenced by improved mobility and a change in the Hoehn and Yahr clinical severity scale from stages 3 to 2. In conclusion, it is possible to modulate the gut microbiome to reverse the established gut dysbiosis associated with the neurodegenerative process in PD, which can lead to clinical benefit by reducing functional disability.
Impact of SARS-CoV-2 AstraZeneca Vaccine on Safety and Blood Elements of Egyptian Healthcare Workers
Authors: Meshref Taghreed S. , Hamad Dina A. , Aly Mai M. , Kamal Dalia T. , Elkhayat Mariam R. , Elghazally Shimaa A.
Published: October 2023

Background:

Many coronavirus disease 2019 (COVID-19) vaccines were approved worldwide. Their safety was the primary concern. In Egypt, Oxford–AstraZeneca (AZ) vaccine was the first approved vaccine initially for healthcare workers (HCWs).

Objective:

We aim to determine adverse events and hematological abnormalities following the COVID-19 AZ vaccine and estimate the infection rate of the candidates by COVID-19 between the first and second doses of vaccination.

Methods:

Within 8–10 days of receiving their initial dose of the AZ vaccine, 909 HCWs were assessed for adverse events as part of a prospective longitudinal study. Complete blood counts (CBCs) were evaluated before and one month after vaccination.

Results:

37.2% of the candidates experienced side effects following vaccination. Pain at the injection site was the most common (25.4%) and more frequent in participants between 20 and 40 years (27.9%). The mean total leukocyte count (TLC), absolute leukocyte count (ALC), absolute neutrophil count (ANC), and absolute monocyte count (AMC) increased one month following vaccination (P < 0. 001). Sixty-six vaccinated HCWs were infected with COVID-19 between the two vaccine doses. 82% were infected after 14 days of the first dose, while 18% were infected before 14 days (P < 0.0001).

Conclusions:

Most of the vaccinated personnel did not experience any side effects after the first dose of the vaccine. Furthermore, the most common complaints were pain at the injection site, fatigue, fever, headache, arthralgia, myalgia, and chills. Infected people with COVID-19 after the first dose had significantly more severe disease if they were infected before 14 days than those who got infected later on.
Pesticide Use and Health Effects among Nepalese Farmers: A Cross-Sectional Study in Tokha Municipality
Authors: Karki Rajesh , Dangol Kanchan
Published: October 2023

Background:

Pesticides are essential for agricultural development, but their increased use in developing countries like Nepal poses health risks to farmers.

Methods:

A cross-sectional study was conducted in wards 1, 2, and 3 of the Tokha Municipality in Kathmandu District to identify the health effects of pesticides and associated factors among farmers. The study included 333 respondents who were interviewed between April 26 and June 04, 2022.

Results:

The majority of farmers (36.6%) were aged between 40 and 49 years, with a median (IQR) age of 45.0 (38.0 to 51.0) years. All farmers reported using pesticides, with 100% usage in vegetables. Most respondents (73%) reported experiencing health effects: headache (69.5%), skin irritation (42.8%), and burning eyes (31.3%) were the most common symptoms. Only 8% sought medical care. Additionally, 94.6% of respondents had not received training on integrated pest management, and none of them reported using a complete set of personal protective equipment. The study found that older age groups, females, those who were unable to read and write, and those of the Hindu religion, as well as respondents with longer pesticide use, more frequent spraying, and not detecting wind direction, had significantly higher odds of self-reported health problems (P < 0.05).

Conclusion:

Our findings show that all farmers in the study were using pesticides, and the majority had reported health effects. Therefore, we recommend that farmers receive training on integrated pest management, use a complete set of personal protective equipment, and promptly seek medical care if they experience health issues.
An insight regarding oral hygiene among 10–15-year-old schoolchildren in the rural area of Jaipur district – A questionnaire study
Authors: Nagaraj Anup , Deka Barsha Priya , Tambi Swasti , Sarma Shruti Madhuri , Mathur Gaurav
Published: October 2023

Background:

Good oral health is a barometer of overall health which empowers an individual to eat, speak, and socialize without active disease, discomfort, or embarrassment, which contributes to general quality of life. Schools can provide a supportive environment for promoting oral health. Children are the ideal target group for early intervention because healthy behaviors and lifestyles developed at a young age are more sustainable.

Aim:

The aim of the study was to assess the knowledge, attitude, and practice (KAP) among school-going children 10–15 years aged in rural areas of Jaipur district.

Materials and Methods:

A study sample of schoolchildren aged between 10 and 15 years old in Bhanpur rural area of Jaipur district were examined to assess oral sanitation awareness. Data on oral hygiene were collected by a survey form, which were prepared with the help of a self-administered structured questionnaire translated into Hindi language. The questionnaire was calibrated before data collection and inter-examiner agreement during calibration was measured using kappa statistic (K = 0.86). All participants were requested to complete 18 close-ended questionnaires. The observation was reviewed and analyzed.

Results:

Among the total 275 children, 41% (n = 113) boys and 57.8% (n = 159) girls, of age between 10 and 15 years with a mean years of age is 13 years. Fifty-six percentage knew that they should brush their teeth once daily. About 46.5% of subjects were aware that limiting sweet snacks from diet will prevent tooth decay.

Conclusion:

Results of the study proved that KAP among schoolchildren is poor and needs to be improved.
A retrospective analysis of the trends in modern contraceptive use among adolescents and young women (15–24 years) in the Democratic Republic of the Congo in the last two decades
Authors: Kaniki Freddy R. , Sanni Olaniyi F. , Kyampof Kirota N. , Lazare Sebitereko R.
Published: October 2023

ABSTRACT

Introduction:

The increasing rate of unsafe abortion among adolescents and young women (AYW) in Sub-Saharan Africa may be attributed to a high rate of undesirable pregnancies and limited access to contraception services. The study looked at the prevalence of current contraception use among young women (15–24 years old) in the Democratic Republic of the Congo (DRC).

Methods:

The study analyzed secondary data from the demographic health survey (DHS) and UNICEF concerning AYW aged 15–24 years using IBM Corp. Released 2021. IBM SPSS Statistics for Windows, Version 28.0. (Armonk, NY: IBM Corp.). The study population included 15,319 female adolescents and young adults in DRC. DHS datasets for 2001, 2010, 2017/2018, and UNICEF 2007 and 2013–2014 were downloaded after permission to use the data.

Results:

The AYW aged 20–24 accounted for 67% of the study population. The use of modern contraceptives has followed a roller coaster course. It dropped significantly from 2.6% in 2001 to 0.1% in 2007; it climbed to 2.7% in 2010 and 3.3% in 2013/14 but dropped to 2% in 2017/18. The most used method was male condoms (1.76%). A higher proportion of unmarried (2.3%) used any methods than married (1.8%). Those who attained secondary/higher education (2.6%) used modern contraceptives more than those with no formal education (1.5%), P < 0.0001. Those residing in the urban areas (4.5%) used modern contraceptives compared to those who lived in rural areas (1.7%) P < 0.0001. Modern contraceptive use among those with birth histories (2.6%) was comparatively higher than those who have not (2.3%), P < 0.0001. Those who lived in urban areas were adjusted odds ratio (AOR) = 2.504 times (95% confidence interval (CI): 1.793–3.497) more likely to use birth control than those in rural areas (P < 0.001)

Conclusion:

As reported in this study, the proportion of AYW’s awareness of modern contraceptives is deficient in DRC, which might be attributed not only due to a lack of knowledge or enlightenment but also due to healthcare facilities’ limited capacity to provide reproductive and sexual health services. Educating the AYW about modern contraceptive methods and interventions, including parents, the school system, and youth organizations, and strengthening the capacity of health facilities to provide modern contraception should be considered.
Feeding practices and nutritional status of children (6-23 months) in an urban area of Raipur, Chhattisgarh, India
Authors: Prasad Reshma , Shukla Arvind , Galhotra Abhiruchi
Published: October 2023

Background:

The first 1,000 days of a child’s life is a critical window for growth faltering, deficiencies, and common childhood illnesses. Even with optimum breastfeeding, children 6-23 months are at higher risk of being undernourished if they do not receive adequate and appropriate complementary feeding. Therefore, this study was carried out to assess the nutritional status of children 6-23 months and find the association between sociodemographic profile and nutritional status.

Materials and Methods:

Mothers of 411 children of age 6–23 months in an urban area of Raipur were interviewed using a pretested questionnaire based on the WHO indicators to record their complementary feeding practices. Weight, height, and mid-upper arm circumference (MUAC) was taken to assess the nutritional status. Overall and specific (sex-wise and severity-wise) prevalence rate of stunting, wasting, and underweight were calculated. The distribution of these according to various factors like infant and young child feeding practices, and details of study subject and family were calculated. Chi-square test of significance was applied to find the association between nutritional status and independent variables and their strength of association.

Results:

The prevalence of wasting was 25%, underweight 30%, and stunting 15%. Statistically significant association of underweight with age of the parents, both mother and father, was observed (P < 0.05). Minimum dietary diversity was achieved by only 4.1% and minimum acceptable diet by 2.4% children.

Conclusions:

The prevalence of wasting and undernutrition was assessed. Complementary feeding indicators were unsatisfactory among children. Ending all forms of malnutrition is the global goal. The Sustainable Development Goals (SDGs) that directly affect or indirectly influence nutrition have to be recalled at this stage and addressing malnutrition is a key element required to achieving them.
A systematic review: The relationship of COVID-19 to iron, zinc, and vitamin D
Authors: Alsharif Meshal M. , Alyousef Raghad , Alturki Abdullah , Kofi Mustafa A.
Published: October 2023

Background:

Primary care physicians are crucial in identifying SARS-CoV-2 infection and transferring suspected cases since they are on the front lines of health care. Micronutrients are used as an adjunctive treatment for viral respiratory infections. Because there is currently no effective antiviral therapy for COVID-19, micronutrients such as iron, zinc, and vitamin D may be important for the survival of critically ill patients.

Objective:

To establish and emphasize a relationship between iron, zinc, and vitamin D to COVID-19.

Materials and Methods:

PubMed database was used for articles selection. All relevant articles to our review with the topics regarding the use of iron, zinc and vitamin D in COVID-19 patients. We excluded other articles, which are not related to this field and did not match inclusion criteria. The data extracted according to specific form and double reviewed by the group members.

Results:

The search of the mentioned database returned a total of 3614 studies that were included for title screening. 2910 of them were included for abstract screening, which lead to the exclusion of 1064 articles. The remaining 1846 publications full texts were reviewed. The full-text revision led to the exclusion of 1812 studies, and 34 were enrolled for final data extraction.

Conclusion:

This study raised the idea of employing zinc, iron, and vitamin D as ingredients to either protect SARS-CoV-2 patients or to speed up recovery, decrease symptoms severity and decrease mortality rates.
Frequency and risk factors stratification of hypertension among the rural population of Bangladesh
Authors: Acherjya Goutam Kumar , Tarafder Keya , Dutta Debasish , Mortuza Md. Golam , Sarkar Alok Kumar , Das Nanda Lal , Ali Mohammad
Published: October 2023

Background and Objectives:

Hypertension is one of the major risk factors of premature morbidity and mortality in our daily clinical practice. Various studies carried out in the urban settings, but there is scarcity of epidemiological data regarding hypertension among the rural people in Bangladesh. Therefore, this current study has been designed to find out the frequency and risk factors stratification of hypertension among the rural people in Jashore, Bangladesh.

Materials and Methods:

A cross-sectional study recruited 1812 participants above 18 years attending on national hypertensive week of 2019 in Bagherpara and Keshabpur upazila (subdistrict) health complex in Jashore, Bangladesh. 2020 International Society of Hypertension Global Hypertension Practice Guidelines had been demonstrated to classify hypertension.

Results:

Out of the total study population, the frequency of hypertension was 20.6% (Grade 1 and Grade 2 hypertensive patients 15.8% and 4.9%, respectively), and high normal blood pressure was 9.0%. The mean age of the study population, Grade 1 hypertensive and Grade 2 hypertensive cohorts were 42 ± 16, 49 ± 15 and 51 ± 14 years, respectively, with a male and female ratio was 1:2. Progressive rise of mean systolic and diastolic blood pressure were noticed with increasing age. Age (P: <0.001), sex (P: 0.004), occupation (P: <0.001), BMI (P: <0.001), family (P: <0.001) and past history (P: <0.001) of hypertension, sedentary life style (P: 0.004), additional salt intake (P: <0.001) and smoking (P: 0.011) were significantly associated with hypertension following bivariate analysis. Multivariate logistic regression analysis revealed that age after 50 years (AOR = 1.866, 95% CI: 1.210-2.876), positive past history of hypertension (AOR = 3.493, 95% CI: 2.676-4.558), additional salt intake (AOR = 0.591, 95% CI: 0.453-0.770) and obesity (AOR = 3.389, 95% CI: 1.830-6.274) were significantly associated with developing hypertension.

Conclusion:

High frequency of hypertension was found among the rural population in Bangladesh where presence with a lot of significantly associated risk factors. The data would be helpful for the health policymakers dealing noncommunicable diseases to reach the sustainable goal and mitigate morbidity and mortality of cardiovascular diseases in Bangladesh.
Men’s knowledge, attitudes, and associated factors toward obstetric danger signs: A community-based cross-sectional study in Debre Tabor North West, Ethiopia
Authors: Ayalew Abeba B. , Sisay Filorenes A. , Erga Besfat B. , Ferede Wassie Y. , Kebede Habtamu B.
Published: October 2023

Introduction:

Maternal mortality remains a public health challenge worldwide, particularly in developing countries. Men should be informed about these danger signs to be better equipped to act if they occur. Studies on the topic have been limited in the area. The study aimed to assess men’s knowledge, attitudes, and related factors about obstetrics danger signs in Debre Tabor, Ethiopia.

Materials and Methods:

A study was conducted in Debre Tabor Town with 609 participants using a pre-tested questionnaire. The data were analyzed using EpiData version 4.6 and SPSS version 25. Variables with P values ≤0.2 were analyzed with multi-variable logistic regression. A statistically significant association was determined using an adjusted odds ratio with a 95% confidence interval (CI) and a P value <0.05.

Results:

In this study, 609 men were interviewed, with a response rate of 96.9%. Men’s knowledge of obstetric danger signs was 44.8%, while their attitudes were 35.6%. Wives’ education level (AOR = 7.27, 2.13–8.83), history of obstetric danger signs (AOR = 5.34, 3.49–8.16), receiving antenatal care (AOR = 2.44, 1.29–4.64), giving birth in a hospital (AOR = 4.38, 1.69–11.31), and having a health development army leader (AOR = 3.86, 1.38–10.75) were all associated with knowledge at 95% CI. Having a higher wealth index (AOR = 6.30, 3.44–11.53) and having two or more children (AOR = 2.80, 1.51–5.25) at 95% CI were associated with attitude.

Conclusions:

Men’s awareness and attitudes concerning obstetric danger signs were low. The husband’s education, place of birth, and prenatal care are all important factors in increasing men’s understanding and attitudes. As a result, the government and stakeholders must prioritize education, attitude reform, and health education for men.
A prospective study on the effectiveness of a combination regime (Mifepristone and Misoprostol) in comparison with Misoprostol for missed abortion
Authors: Gupta Nidhi , Tripathi Reva , Sharma Sumedha , Nigam Aruna , Panesar Sanjeet
Published: October 2023

Introduction:

Misoprostol is widely used in the medical management of missed abortions. However, pretreatment with Mifepristone has shown to be effective but still not recommended to be used in missed abortions.

Aims and Objectives:

To compare the outcome of medically managed missed abortion or blighted ovum using combination regime (Mifepristone and Misoprostol) vs Misoprostol alone.

Materials and Methods:

It was a prospective single-centre study performed in the Department of Obstetrics and Gynaecology, HIMSR and HAHC hospital, New Delhi, over, for one year. All the patients with diagnosed missed abortions were randomized into two groups (Group A and Group B). Group A was given Mifepristone 200 mg orally followed by Misoprostol 800 microgram per vaginal. Group B was given Misoprostol 800 microgram per vaginal. All the patients were observed for 24 hours for the expulsion of products of conception following the given regime. Ethical approval was taken from the Institutional Ethical Committee.

Results:

Both groups were comparable in demographic characteristics. On applying Fisher’s exact test, it has been observed that the odds of nonexpulsion of the product of conception, time taken in expulsion, and surgical evacuation because of excessive bleeding were significantly higher in Group B (Misoprostol) compared with Group A (Mifepristone followed by Misoprostol). The cost-effective analysis showed that the cost is higher among Misoprostol Group B compared with combination drugs of Group A (Mifepristone + Misoprostol), but this result is not significant.

Conclusion:

Mifepristone can be considered before Misoprostol in missed abortions. This regime might decrease the need for surgical evacuation.
Breakthrough infection among healthcare personnel following exposure to COVID-19: Experience after one year of the world’s largest vaccination drive
Authors: Das Arghya , Khan Salman , Vidyarthi Ashima Jain , Gupta Raghav , Mondal Saikat , Singh Sheetal , Wundavalli LaxmiTej , Bhatnagar Sushma , Singh Urvashi B. , Chaudhry Rama
Published: October 2023

ABSTRACT

Context:

The COVID-19 vaccination drive globally was supposedly a game-changing event. However, the emerging variants of the virus and waning immunity over time posed new challenges for breakthrough infections. Standing at the frontline of defense against COVID-19, healthcare personnel (HCP) were vulnerable to such infections.

Aims:

This study estimates i) the vaccine breakthrough infections (VBI) among HCP following exposure to COVID-19 cases, and ii) the mean interval between the second dose of vaccine and laboratory-confirmed SARS-CoV-2 infection

Materials and Methods:

A cross-sectional study was conducted including 385 HCP with a history of exposure to COVID-19 cases during January and February 2022. Demographic details and clinical and vaccination history were collected from the test forms and the Web-based hospital management system. Laboratory testing of COVID-19 was carried out by real-time RT-PCR test.

Results:

The majority of the HCP were males (262; 68.05%) and nurses (180; 46.75%) by occupation. Two doses of vaccines were received by 278 (87.7%) HCP. VBI was confirmed in 185 (66.55%) HCP. No significant difference in VBI between the COVAXIN and COVISHIELD recipients (P = 0.69) was observed. The interval between the second dose and confirmed SARS-CoV-2 infection was significantly higher (P < 0.00001) in COVAXIN recipients (median 228 days) than in COVISHIELD recipients (median 95 days).

Conclusions:

The incidence of VBI was very high among the HCP, but not statistically different among the COVAXIN and COVISHIELD-recipients. Waning immunity over time suggests boosting immunity with a third dose because of emerging variants.
Comparative study on menstrual disorders in post-tubal ligated and non-ligated women
Authors: Verma Pahula , Saxena Swarnima , Gunjan  , Hiremath Ravishekar N. , Sinha Pooja
Published: October 2023

Background:

The term post-tubal sterilization syndrome has been used variously to include abnormal menstrual bleeding, pre-menstrual dysmenorrhea distress, hysterectomy, and miscellaneous other conditions like the need for recanalization, the feeling of regret, and menopausal syndrome.

Objectives:

To compare the menstrual disorders in post-tubal ligated and non-ligated women and also to compare the histopathology of endometrium in both post-tubal ligated and non-ligated groups in order to compare the menstrual disorders.

Materials and Methods:

It is a comparative cross-sectional study on 200 women between 30 and 50 years, divided into two groups and further into two sub-groups in each group. Group 1 includes cases (post-tubal ligated), and group 2 includes controls (non-tubal ligated); sub-group I includes patients with abnormal uterine bleeding (AUB), and sub-group II includes patients without AUB. Data were recorded using standard performa along with investigations and detailed examination.

Results:

In the case group (post-tubal ligated), maximum patients of 39.22% were having polymenorrhea and 29.41% patients had menorrhagia, whereas in the control group (non-tubal ligated), maximum patients of 38.78% had polymenorrhea and 30.61% had menorrhagia, respectively. However, the difference is statistically non-significant (P value = 1.00).

Conclusion:

Our study suggests that the incidence of menstrual disorders did not differ significantly with tubal ligation. The patients worried about the effects of tubal ligation on their future life that must be counseled and that tubal ligation has no adverse effect on their life including their menstrual pattern. The findings of the study help family physicians in educating the clientele. We also recommend large studies with multiple centers so as to give statistically significant findings of associations.
Knowledge, attitude, and practice about cervical cancer among adult women in rural Jaipur: An observational analysis
Authors: Sakrawal Komal , Meena Govardhan , Gupta Ajay , Malav Kapil , Grover Somya
Published: October 2023

Introduction:

To identify gaps in knowledge and attitudes that can inform targeted interventions and improve cervical cancer prevention strategies, this study was designed with the objective of assessing the level of knowledge, attitude and practice related to cervical cancer among adult women and associated factors with this in rural areas of Jaipur.

Materials and Methods:

This community-based analytical cross-sectional study was conducted among 300 adult women in village Naila, Jaipur, for a period of 1 year from December 2021 to November 2022. Systematic random sampling was used to identify the houses, and women were selected for interview via simple random sampling. Institutional Ethics Committee approval and informed consent from study participants were taken. A pre-tested semi-structured questionnaire was used for data collection.

Results:

The mean age of participants was 30 ± 9.7 years. Out of 300, 27 (9%) women had ever heard of cervical cancer. Most 189 (63%) women agreed to undergo screening for cervical cancer if opportunity was provided but only four (1.3%) women had practiced regular and/or yearly check-ups with doctors. Association of knowledge of cervical cancer was significant with socioeconomic status and caste (P value <0.05), while association of knowledge of cervical cancer symptoms with other sociodemographic variables was not significant (P value >0.05).

Conclusion:

Most of the women surveyed had poor knowledge about cervical cancer, its risk factors, signs and symptoms, causal relation with HPV, mode of transmission, screening method and prevention through HPV vaccination.
A Study to Carry out Always better control and Vital, Essential, and Desirable Analysis in the Dispensary of a Tertiary Care Teaching Hospital
Authors: Kaur Balpreet , Garg Neeraj , Gad Vasudev , Patel Neelesh
Published: October 2023

Introduction:

Due to the advancement of medical technology, it is difficult to monitor the vast inventory in hospitals. Thirty-three percentage of the hospital operating budget are spent on buying materials and supplies. Out of all the inventory control measures, Always better control (ABC) and Vital, essential, and desirable (VED) are the most used inventory control techniques. The present study was conducted at a tertiary care specialty hospital to study drug management through the application of inventory control techniques.

Aim and Objectives:

The present study aimed at studying the drug management system by application of ABC and VED analysis and to give recommendations for an efficient inventory management system.

Materials and Methods:

It was an observational study conducted at the dispensary of a tertiary care teaching hospital. The data of annual consumption and expenditure incurred on each item of the dispensary for the fiscal year 2021–2022 were collected. The annual expenditure of individual items was arranged in descending order. The cumulative cost percentage and the cumulative percentage of number of items were calculated, and the list was then categorized into three subdivisions: A, B, and C categories. For classifying drugs into VED, inputs from the concerned clinicians were sought. Data were analyzed using statistical tools of MS Excel. ABC-VED matrix was formed to couple the items into various categories and groups so that managers can efficiently monitor them.

Results:

Of the 291 items used, 15% of the items were A items which need strict monitoring by the top-level management as they are the costliest. VED analysis revealed 37% of the items as vital which should be present at all times in the hospital and are inescapable requirements. ABC-VED matrix analysis showed 10% of the items as A items from ABC and vital items from VED (AV) items which are costly and should be present at all times at the hospital, thereby demanding strict managerial control.

Conclusion:

Using inventory control techniques, substantial improvement could be brought about in patient care by ensuring the uninterrupted availability of vital and essential medicines all the time. It can also be used to identify drugs that require stringent control for the optimal use of financial resources and the elimination of out-of-stock conditions at the dispensary.
Profile of Pelvic Stress Fractures in Indian Women during Military Training and Approaches for Prevention
Authors: Kunte Marshal Renuka , Chatterjee Kunal , Basannar D
Published: October 2023

Introduction:

Pelvic stress fractures have been reported commonly among women military trainees from worldwide. They have been reported as the most common stress fracture in women in Indian military training academies. With the recent increase in avenues for women to join the armed forces and other paramilitary forces, there is a need for medical personnel to be familiar with the epidemiology of pelvis stress fractures unique to women. This article presents a clinical and epidemiological profile of these fractures and suggests approaches for their prevention.

Methods:

Fifty-one cases of pelvic stress fractures were observed among a cohort of 608 women trainees in the military training establishments of the Indian, Army, Navy, and Air force. Data on clinical presentation, diagnosis, and management were collected for those women trainees who developed radiologically confirmed pelvic stress fractures. Information was also taken to identify the possible risk factors. Measures which can be implemented during training have been suggested to reduce the risk of these fractures during training.

Results:

All women trainees with stress fracture pelvis presented with groin pain and difficulty in running and drill usually in the 6–9th week of training. X-rays showed involvement of the inferior pubic ramus. All of them made good recovery with conservative management. A large number of training-related factors and certain individual-related anatomical and physiological factors seem to have a role specifically leading to these fractures. Approaches to minimize the risk of pelvic stress fractures have been recommended for making the changes in training and managing individual factors.

Conclusion:

Specific measures for the prevention of pelvic stress fractures are required to be instituted, addressing the risk factors for Indian women undergoing military training along with general measures.
Epstein–Barr Virus Infection in Children Presenting with Acute Cervical Lymphadenopathy
Authors: Augustya Priyanka , Bhandari Ashok , Mukund Bal
Published: October 2023

Introduction:

The aim of this study was to estimate the prevalence of Epstein–Barr virus (EBV) infection among children presenting with acute cervical lymphadenopathy and describe the clinical characteristics of children with primary EBV-induced cervical lymphadenopathy.

Materials and Methods:

This was a prospective observational study in a tertiary care hospital.

Results:

Twenty-two children out of 127 patients evaluated had primary EBV infection among children presenting with acute cervical lymphadenopathy. The most common symptoms noted were fever (95.5%), loss of appetite (63%), and sore throat (45.5%). Posterior and anterior cervical lymph nodes (99.5% and 86.4%) were most commonly affected with a frequency of 2–6 nodes (mean of 3 nodes) and an average size of 2.4 cm (range: 2–6 cm). Maculopapular, nonpruritic rash was noted in 27.3% and Hoagland sign in 9.1% of cases. Hepatomegaly and clinical splenomegaly were noted in 81% and 59%, respectively, among EBV-positive patients.

Conclusion:

EBV primary infection is a common cause of acute cervical lymphadenopathy among Indian children with EBV responsible for approximately 17% of such clinical presentation. A high index of clinical suspicion and timely diagnosis of EBV in these children will be useful in limiting investigations and avoidable use of antibiotics by clinicians in such presentation.
Correlation of Transvaginal Sonography and Hysteroscopy in the Detection of Retained Products of Conception Immediately after Suction Evacuation in First-trimester
Authors: Panda Shakti Prasad , Kapur NM Anupam , Sharma Sanjay , Khan Shazia
Published: October 2023

Introduction:

Retained products of conception are a frequent outpatient dilemma faced by gynecologists. Blind dilatation and curettage can lead to endometritis, perforations and hemorrhage. We aimed to study the correlation of transvaginal sonography (TVS) and hysteroscopy in the detection of retained products of conception (RPOC) immediately after dilatation and suction evacuation (S and E) in first-trimester abortion.

Materials and Methods:

This was a prospective observational study conducted at the gynecology department in a university-affiliated hospital. All women with a diagnosis of intrauterine RPOC by TVS showing a heterogeneous intrauterine sac of more than 15 mm thickness, without endometritis, treated with S and E for RPOC, who also underwent subsequent hysteroscopy and TVS, were enrolled in the study.

Results:

Since no literature is available comparing these two modalities directly, 50 cases as a pilot study were studied. TVS findings of RPOC with endometrial thickness >15 mm and hyperechoic area or area of mixed echogenicity along with hysteroscopy findings of RPOC were tabulated and correlated. The strength of agreement between TVS and hysteroscopy was determined. In our study, 28% of the participants who had S and E done for first-trimester abortion had RPOC on TVS. The sensitivity and specificity of RPOC on TVS were 69.2% and 86.5%, respectively, with a positive predictive value of 64.3%. Twenty-six percent of the participants had RPOC on hysteroscopy who later underwent re-evacuation procedure using operative hysteroscopy.

Conclusion:

Hysteroscopy is the gold standard for removal of RPOC. A combination of TVS and hysteroscopy for detection of RPOC would lower rates of complications and postoperative intrauterine adhesions.
Knowledge, Attitude, and Practice of Rabies Postexposure Prophylaxis among Young Doctors
Authors: Shukla Rajat , Singhal Anuj , Shaw Subash Chandra , Manthene Mahesh , Sharma Raghav , Soman K. P. , Singhal Aditya
Published: October 2023

Objectives:

The objective of this study was to assess the knowledge, attitude, and practice (KAP) of young doctors on rabies prophylaxis and to determine the impact of the interactive lecture on the KAP of young doctors.

Methods:

After the formulation of the questionnaire, and review by the faculty of Medical Education, the access web link of the questionnaire was shared in What’sApp with all the young doctors of the hospital. After collecting pretest data, an interactive lecture was delivered, after the lecture, the same questionnaire was again shared, and responses were collected and analyzed.

Results:

All the young doctors who participated in the study acquired good KAP on rabies prophylaxis, overall 6% of doctors corrected themselves and there was an improvement in rightly answering 11 questions.

Conclusion:

KAP survey can be an effective tool in achieving the goal for imparting knowledge regarding effective disease prevention and management.
Positive well-being and usefulness of brief mindfulness-based intervention for pain in cancer
Authors: Chaturvedi Mudita , Bajaj Manoj Kumar , Singh Gurvinder Pal , Mitra Sukanya
Published: October 2023

Background and Aim:

The experience of pain is a pivotal issue in the management of cancer. It has a detrimental impact on the overall well-being of the patients. Psychological management of pain remains an oblivious component of pain management in health-care facilities. The main aim of the study was to explore the relationship between positive well-being variables positive emotion, engagement, relationship, meaning & accomplishment (PERMA) with pain perception in persons suffering from cancer pain and to investigate the usefulness of brief mindfulness-based intervention in reducing cancer pain.

Methods:

Single group quasi experimental pre-to postintervention design was employed and 30 adult participants of any gender diagnosed with any cancer except lung cancer with breathing difficulties reporting pain were recruited. The tools administered were Mini International Neuropsychiatric Interview (to screen the presence of any psychiatric illness) PERMA Profiler (only at baseline), Brief Pain Inventory, Pain Catastrophizing Scale, and Cognitive and Affective Mindfulness Scale-Revised before the intervention and at 4 weeks following brief mindfulness-based intervention for cancer pain (BMBI-CP).

Results:

The findings indicate that among positive well-being variable (PERMA), the domain of relationship was found to be in a slightly higher range in comparison to other domains. There was a statistically significant difference found in the values of pain severity (t = 6.09, P < 0.01), pain interference (t = 7.79, P < 0.01), pain catastrophization (t = 4.68, P < 0.01), rumination (t = 5.20, P < 0.01), magnification (t = 3.03, P < 0.01), helplessness (t = 4.19, P < 0.01), and mindfulness traits (t = −2.82, P < 0.01) post intervention (BMBI-CP).

Conclusion:

Brief mindfulness-based intervention is useful in terms of the ease of delivery and managing psychological aspects of pain perception. Positive well-being variables are significantly associated with pain perception, which would help in the further therapeutic management of cancer pain.
Economic burden on stroke survivors in Asian and African countries: A protocol for systematic review, meta-analysis, and meta-regression
Authors: Shaikh Summaiya Zareen , Patil Anant , Ali Mohammed Usman , Karajgi Asmita
Published: October 2023

Introduction:

Stroke is one of the leading causes of morbidity and mortality worldwide accompanied by huge financial burden on an individual and society.

Objective:

The objective is to estimate the economic burden by calculating the costs (per capita Gross Domestic Product (GDP)) on stroke survivors in African and Asian countries.

Materials and Methods:

Published electronic articles from inception till August 2022 will be screened from five databases: MEDLINE (PubMed), Scopus, Embase, Science Direct, and Web of Science. Effect sizes in the form of risk ratios and risk differences will be calculated for estimating the burden per capita income of the country. In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis 2020 Guidelines, titles and abstracts will be screened by two authors independently. Any disagreements will be resolved by the third author. Rayyan QCRI software will be used for the inclusion of articles and removing of duplicates. Quality assessment will be conducted by the National Institute of Health (NIH) tool for observational and cross-sectional studies whereas risk of bias will be assessed using the Cochrane’s ROBINS-I tool for observational studies. RevMan 5.4 software will be used for plotting forest plots and further analysis. In case, heterogeneity is observed in the outcomes data, I
2 statistics will be calculated to further the possibility of a meta-analysis. Publication bias will be assessed by plotting a funnel plot and “trim-and-fill method”. This systematic review will estimate the economic burden by collating data using socioeconomic indicators of stroke in African and Asian countries. The results will help policymakers in designing and allocation of resources in the two continents.
Framework for Data Provenance Assurance in Cloud Environment using Ethereum Blockchain
Authors: G Narayan , Haveri Pavitra , B Rashmi , Deewan Yashwardhan
Published: October 2023

Ensuring secure data provenance is crucial for maintaining accountability and confidentiality in cloud environments. Cloud data provenance involves recording the history of creation and operations performed on cloud data objects. However, establishing trust between cloud customers and service providers remains a challenge, highlighting the need for assured data provenance models in cloud storage. Blockchain technology has emerged as a solution for designing data provenance assurance mechanisms. It provides a decentralized and distributed ledger to record the provenance of digital assets. In this context, we present a blockchain-based framework for ensuring data provenance in cloud storage. Initially, we develop a cloud storage application using OpenStack swift storage. This application caters to the storage needs of university students and faculty while providing data provenance capabilities. Subsequently, we design a data provenance assurance framework for confidential files of users using the Ethereum blockchain. To evaluate the scalability and performance of the proposed framework, we analyze various factors such as transaction throughput, latency, network size, and load on the blockchain network. The performance of the system is compared under two consensus algorithms: Proof of Work and Proof of Authority. By conducting this analysis, we aim to assess the effectiveness and efficiency of the blockchain-based solution in ensuring data provenance in cloud storage environments.
On the continuity of the growth rate on the space of Coxeter systems
Authors: Yukita Tomoshige
Published: October 2023

Floyd showed that if a sequence of compact hyperbolic Coxeter polygons converges, then so does the sequence of the growth rates of the Coxeter groups associated with the polygons. For the case of the hyperbolic 3-space, Kolpakov discovered the same phenomena for specific convergent sequences of hyperbolic Coxeter polyhedra. In this paper, we show that the growth rate is a continuous function on the space of Coxeter systems. This is an extension of the results due to Floyd and Kolpakov since the convergent sequences of Coxeter polyhedra give rise to that of Coxeter systems in the space of marked groups.
Overdetermined problems and relative Cheeger sets in unbounded domains
Authors: Afonso Danilo Gregorin , Iacopetti Alessandro , Pacella Filomena
Published: October 2023

In this paper, we study a partially overdetermined mixed boundary value problem for domains

\Omega

contained in an unbounded set

\mathcal{C}

. We introduce the notion of the Cheeger set relative to

\mathcal{C}

and show that if a domain

\Omega\subset\mathcal{C}

admits a solution of the overdetermined problem, then it coincides with its relative Cheeger set. We also study the related problem of characterizing constant mean curvature surfaces

\Gamma

inside

\mathcal{C}

. In the case when

\mathcal{C}

is a cylinder, we obtain further results whenever the relative boundary of

\Omega

or the surface

\Gamma

is a graph on the base of the cylinder.
Case Report: An Imported Case of Typhoid Fever Combined with Rhabdomyolysis and Multiple Organ Lesions in China
Authors: Huang Qian , Shi Yue , Xu Jingying , Wang Fei , Li Yinghui
Published: October 2023

Here, we report a case of blood culture-confirmed typhoid fever, rhabdomyolysis, and multiple organ damage that arrived in our country from overseas. A 23-year-old male patient presented at our hospital with fever and muscle pain; the condition progressed rapidly. Six days after the onset of symptoms, the patient developed rhabdomyolysis and liver/kidney damage; levels of creatine kinase (CK; maximum peak: 729,869 U/L) and myoglobin (> 3,000 ng/mL) were extremely high, although the extent of renal damage was relatively mild. Blood culture showed Salmonella typhi. The patient received a combination of meropenem and levofloxacin anti-infective therapy, as well as fluid and nutritional metabolic support. He gradually recovered and was discharged after two negative blood cultures. This case highlights the fact that typhoid-induced rhabdomyolysis is a serious, life-threatening disease and that the levels of CK and myoglobin are useful indicators for evaluating typhoid-induced rhabdomyolysis. Clinicians should remain vigilant regarding travel-related illnesses associated with enteric fever.
Journal Evaluation Model of the Pracownia Naukoznawstwa IHN PAN: Update of Journal Evaluation Rules and Journal Scoring in the History of Science in 2023
Authors: Kokowski Michał
Published: October 2023

The article presents: a) updating the rules for evaluating journals in the evaluation model developed in the Pracownia Naukoznawstwa IHN PAN (Science Studies and Science-of-Science Unit of the Institute for History of Science, Polish Academy of Sciences), b) scoring journals in the history of science according to the lists of journals of the MNiSW (2017), MEiN (2021), MEiN (2023), PN IHN PAN (2022) and PN IHN PAN (2023), c) comparison of the scoring of journals in history and history of science in the lists of journals: ministerial and PN IHN PAN, as well as Scopus, DOAJ, Index Copernicus International, PKP Preservation Network and Keepers Register.
The conclusion of the article is an open appeal to the Minister of Education and Science to award, in the next update of the ministerial list of journals, 200 points to the journal “Studia Historiae Scientiarum” and 140 to the journal “Kwartalnik Historii Nauki i Techniki”, because these journals, devoted to the history of science, are not inferior in terms of achievements to Polish historical journals, which have already obtained 200 and 140 points by the decision of the Minister of Education and Science of July 17, 2023.
The Activity Report of the PAU Commission on the History of Science in 2022/2023
Authors: Kokowski Michał
Published: October 2023

The activity of the PAU Commission on the History of Science in the academic year 2022/2023 was discussed.
Lists of scientific meetings, conferences, scientific sessions and seminars as well as new publications were presented.