bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment of prescription pattern of under-five diarrhea cases in Western Odisha
Authors: Panda Manasee , Satapathy Sushree Priyadarsini , Bhue Pradip Kumar , Agrawal Anil Kumar , Meher Tushar Kanti
Published: October 2023

Introduction:

Diarrhea is the second leading cause of death among under-five children. Prescription review by the authorities of the health facilities every month for the improvement of the quality of prescription writing of Medical practitioners is very essentials. With this background, the present study was conducted to assess the prescription patterns of healthcare providers for under-five diarrhea cases and to study the factors responsible for nonadherence to protocol of prescription patterns.

Methodology:

This cross-sectional study was conducted in the health facilities of two aspirational districts of Odisha. All secondary- and tertiary-level health institutions with 2–3 randomly selected PHCs of that blocks of the two districts were the study units. Mixed methods were used for data collection. Primary data were collected by in-depth interview of doctor and pharmacist. Secondary data were collected by review of records such as OPD ticket, IPD ticket, OPD register, dispensing register, and stock registers.

Results:

Of the 64 health facilities visited, a total of 516 prescriptions [217 (42%)] scanned/carbon copy of OPD ticket, 238 (46%) data from register on drug prescription, and 61 (11.8%) IPD record data were collected. Duration of diarrhea illness was not mentioned in any of the prescriptions which is important criteria for classifying the type of diarrhea and treatment. Signs of dehydration and degree of dehydration were mentioned in very few prescriptions of both the district. For the treatment of diarrhea cases, 2 to 4 medicines were prescribed in majority of 146 (67.3%), followed by more than four medicines in 38 (17.5%) prescriptions, and less than two medicines were prescribed in 33 (15.2%) cases. All prescriptions from MCH and SDH had ORS and zinc. Though all of them knew about the management protocol as per IMNCI, to be on the safe onside they used to prescribe more medicines to under-five diarrhea cases. None had the knowledge on five types of management plan.

Conclusion:

For under-five diarrhea cases, care should be taken to write the detail examination finding, weight of the child, associated comorbid condition, and advice on feeding in the prescription.
Pattern of congenital heart defects among children in Jazan Region, Saudi Arabia: A five-year hospital-based study
Authors: Names Abdellh A. , Alqassim Ahmad Y. , Jareebi Mohammad A. , Aldhamdi Mohammed A. , Abutaleb Alaa A. , Alwani Abdulaziz A. , Shami Mohammed O. , Alneel Ghadeer A. , Alhazmi Abdurahman H. , Gohal Hassan M. , Hadad Basel A. , Alaksham Hamad M.
Published: October 2023

ABSTRACT

Background:

Congenital heart defects (CHDs) are the leading cause of death and morbidity in children under one year around the world. This study explores the prevalence, patterns, and interventions of congenital heart defects in children in the Jazan region, Saudi Arabia.

Methods:

This was a descriptive cross-sectional study, conducted in the Jazan region, Saudi Arabia. We looked back at all of the CHD patients who went to the two tertiary hospitals in the Jazan region between January 2017 and December 2021 and collected and analyzed their background information and diagnosis.

Results:

During the study period, 1,275 CHD patients aged under 15 years old were identified. A total of 717 (56.24%) were males, while 558 (43.76%) were females. Acyanotic CHDs were the most common, accounting for 79.21% of all cases, while cyanotic CHDs accounted for only 20.79%. Ventricular septal defect (VSD), atrial septal defect (ASD), and patent ductus arteriosus (PDA) were the most common acyanotic CHDs, accounting for 35.69%, 24.31%, and 8% of total cases, respectively. The most common cyanotic CHDs were Tetralogy of Fallot (7.14%) and Total Anomalies of Pulmonary Venous Connection (TAPVC) (1.57%). The most common Cath intervention was patent ductus arteriosus (PDA).

Conclusions:

This study’s results are similar to those described in previous studies from around the world, except for the unreported Transposition of the Great Arteries (TGA) cases. This kind of information is very important for setting priorities in the Saudi Arabian health sector in light of the National Transformation Program.
Association between COVID-19 infection and herpes zoster: A case series
Authors: Narasimhan Murali , Ramakrishnan Ramachandran , Durai Priya Cinna T. , Sneha Boggarapu
Published: October 2023

Herpes zoster (HZ) is a manifestation of the reactivation of latent varicella zoster virus (VZV) infection in the dorsal root ganglion. The occurrence of HZ has been reported in association with COVID-19. Herein, we describe 10 cases who developed classic HZ within 2–3 weeks of acquiring COVID-19 infection. The triggers in these patients could be severe stress (related to quarantine issues, fear of hospitalisation and death) immune dysregulation and systemic steroid therapy in treating COVID-19. The clinical patterns and therapeutic responses observed were similar to HZ in immunocompetent persons. Increased expression of NKG2A on NK and CD8+ T cells has been proposed as a pathophysiologic mechanism in triggering HZ at the molecular level in COVID-19 patients. Primary physicians should be aware of this association to counsel and treat such patients appropriately, as initiating early treatment could minimise the risk of complications like postherpetic neuralgia.
Anemia burden in pregnancy and birth outcomes among women receiving antenatal care services from a secondary level hospital in South India: A record review
Authors: Biradar Bhoomika , Arasu Sakthi , Ramesh Naveen
Published: October 2023

ABSTRACT

Introduction:

Anaemia in pregnant women is a major public health problem and is associated with adverse outcomes both in pregnant mothers and new-borns. According to NFHS-5, 45.7% of women in urban India were affected by anaemia during their pregnancy. The objectives of this study were to estimate the proportion of pregnant women who were anaemic and its effect on maternal and birth outcomes, and additionally, to assess the various socio-economic factors contributing to anaemia during pregnancy.

Methodology:

Data was collected by reviewing records between December 2018 and December 2021 of 302 pregnant women who had received antenatal care at a secondary level health facility in Krishnagiri, Tamil Nadu. The data included details of socio-economic parameters, parity, haemoglobin levels, mode of delivery, pregnancy related complications during the antenatal period and during delivery, including need for blood transfusions in mothers. Birth-related outcomes like miscarriages, intra-uterine death, low birth weight (LBW), need for NICU admission and congenital defects were also analysed. Variables in the study are described as frequencies and proportions. Appropriate tests were used to check for association and a P- value of less than 0.05 was considered as statistically significant.

Results:

The mean age of the women was 24 ± 3.72 years and the mean Haemoglobin level during the first trimester was 10.5 ± 1.12 gm/dl. The proportion of women with anaemia in the first trimester was 174 (57.6%). Among the anaemics, 15 (8.6%) required treatment in the form of injectable iron and 29 (16.7%) required blood transfusion. Gestational diabetes mellitus (GDM) (31.6%) (P < 0.05), preeclampsia (38.9%) (P < 0.02) less among anaemic. Hyperemesis (66.7%) (P = 0.58), risk of miscarriage (57.8%) (P = 0.94), postpartum haemorrhage (PPH) (80.0%) (P = 0.15) was higher in the anaemic group. Adverse Neonatal-related outcomes such as low birth weight babies (52.0%) (P = 0.54), meconium aspiration (72.7%) (P = 0.25) and need for NICU admission (75.0%) (P = 0.25) was higher in babies born to anaemic pregnant women.

Conclusions:

The proportion of anaemic women was 57.6%. There was no significant difference in maternal demographic characteristics or obstetric factors between anaemic and non-anaemic pregnant women. GDM, pre-eclampsia was less prevalent among anaemic women. Hyperemesis, risk of abortion, postpartum haemorrhage and low birth weight (LBW) infants was higher in anaemic pregnancies. The need for providing education regarding iron supplementation and early detection of anaemia during pregnancy should be emphasised to avoid complications.
Coronavirus infection and ABO blood grouping: Correlation or coincidence?
Authors: Bhalchandra Awale R. , Sanjeev Om P. , Chaudhary Rajendra , Sharma Swati , Katharia Rahul , Nath Alok , Singh Chandrakanta , Singh Ratender K. , Mishra Prabhakar K.
Published: October 2023

ABSTRACT

Background:

Association between the ABO blood group and patient outcomes in COVID-19 patients is still unexplored. A known association may help to understand possible risks in advance to the management of such COVID-19 patients. The present study was designed to test such association if there is any, between the ABO blood group and the severity of COVID-19 patients.

Methods:

The present hospital-based observational study was conducted at a COVID-19 dedicated tertiary care hospital in North India over a period of six months during the first wave of the pandemic in the country. Five hundred consecutive patients, who tested positive for COVID-19 using RT-PCR on oropharyngeal/nasopharyngeal swabs, admitted to the hospital were included in the study. ABO and Rhesus (Rh) blood grouping was done on leftover hematology blood samples using gel column agglutination technology. Required clinical details of patients including age, gender, clinical symptoms, comorbidities, outcomes, etc., were obtained from the patient’s case sheets.

Results:

The most common blood group was ‘B’ (42.8%) followed by ‘O’ (23.4%), and ‘A’ (22.4%) while the least common was ‘AB’ (11.4%). Rh positive was seen in 96.2% while 3.8% were negative. Baseline characteristics were comparable including length of hospital stay, duration of symptoms, and associated comorbid illnesses. The need for intensive care unit (ICU) admissions (P = 0.05) and intubations (P = 0.20) was similar across all four blood groups. Differences in the severity of COVID-19 disease and mortalities among the groups were non-significant.

Conclusion:

There was no observed association found between the ABO blood group and COVID-19 infection requiring hospitalization, ICU admission, intubation, and outcomes. However, there was a higher proportion of breathlessness and the presence of at least one comorbidity in blood group O as compared to others.
Yoga as a complementary therapy in neuropathic pain: A systematic review and meta-analysis of randomized controlled trials
Authors: Bhardwaj Praag , Ahuja Navdeep , Parchani Ashwin , Singh Shiana , Sethi Dilasha , Pathania Monika
Published: October 2023

ABSTRACT

Yoga is an ancient wisdom comprising a multitude of physical and mental practices that are aimed toward a state of optimum physical, mental, social, and spiritual health. Neuropathic pain (NP) is caused by a lesion or disease of the somatosensory nervous system that is often unresponsive to currently available modes of treatment, portending an inferior quality of life for patients. This systematic review and meta-analysis aim to investigate the effect and the potential role of yoga in NP syndromes. PubMed, Scopus, Elton Bryson Stephens Company (EBSCO), and Cochrane Library were screened for randomized controlled trials (RCTs) assessing the effects of yoga in patients on NP. Usual care, no treatment, or any active treatments were acceptable as control interventions. Primary outcome measures were objective or subjective assessment measures of pain intensity. For each outcome, standardized mean differences and 95% confidence intervals (CIs) were calculated. A total of four studies were included for qualitative synthesis. Meta-analysis of three studies revealed an overall effect (Z) in the favor of yoga as an intervention for NP, when compared to controls, although the effect was not statistically significant (three RCTs; Z = 1.10 [P = 0.27]; Heterogeneity: τ2 = 0.37; χ2 = 27.78, df = 2 [P < 0.00001]; I
2 = 93%). This review divulged the overall favorable effect of yoga in NP, although it was not statistically significant. It highlights the promising role of yoga on pain intensity and quality of life in NP syndromes while showing that yoga has the advantage of being an inexpensive and easily accessible mode of therapy. Extensive research on the efficiency and safety of yoga must be conducted using robust RCTs with rigorous methodologies.
A retrospective study of life skills promotes healthy Internet use among adolescents
Authors: Ramakrishna Satish Kumar , Vranda Mysore Narasimha , Sharma Manoj Kumar , Majhi Gobinda , Gunasekaren Duraimurukan , Cicil Radhakrishna Vasanthra
Published: October 2023

ABSTRACT

Background:

Since the beginning of COVID-19 pandemic, studies highlight the augmentation in the use of Internet and smartphone, especially among the adolescents. However, little is known about the effect of technology addiction on adolescent mental health following reopening of the schools.

Aim:

The study aims to assess the level of technology addiction, life skills, and mental health impact among adolescents during the COVID-19 pandemic in India

Materials and Methods:

A cross-sectional research was conducted from July 2021 to October 2022. A nonprobability convenience sampling was used to collect the data from 352 adolescents using an Internet addiction test, smartphone addiction scale, life skills scale, and patient health questionnaire.

Results:

More than half of the adolescents were moderately addicted to the Internet and Smartphone. Three-fourth of the adolescents had mild-to-moderate depression. Those with moderate life skills were found to be moderately addicted to the Internet and Smartphone. Religion was found to be associated with Internet addiction. Age, religion, and parental monthly income were significantly associated with smartphone addiction among adolescents. Furthermore, class and life skills were significantly associated with depression among adolescents.

Conclusion:

Early-life skills training can help to prevent dysfunctional Internet use and mental and psychological problems among adolescents in schools and colleges.
Prevalence of self-reported noncommunicable diseases in grassroot-level health worker of Petlad taluka: A cross-sectional study
Authors: Mistry Charvi P. , Bhanderi Dinesh J.
Published: October 2023

ABSTRACT

Context:

Noncommunicable diseases (NCDs) kill 41 million people each year globally. The financial burden of NCDs, including lifelong and expensive treatment with loss of income, forces many people into poverty. Healthcare workers (HCWs) are an essential group of the workforce in building a healthier society. They must choose a healthy lifestyle to have better health for themselves.

Aim:

To estimate the prevalence of self-reported NCDs in grassroot-level HCWs of Petlad taluka along with the study of various healthcare and lifestyle practices among them

Methods and Material:

In this cross-sectional study, grassroot-level HCWs of Petlad taluka of Anand district were given a self-administered questionnaire, which included their demographic details, their current health status, and health practices followed by them

Statistical Analysis:

The data collected were entered in Microsoft Excel-2019 and analysed by SPSS version 15. Descriptive analysis and univariate analysis were performed.

Results:

NCDs’ prevalence was 10.2%. Hypertension and diabetes were the commonest. Nearly 50% HCWs have their body mass index in a normal range. The majority of them were aware of healthy diet practices and exercise.

Conclusions:

Our study reported a lower prevalence of NCDs than other studies (50%). Dietary practices appear to be healthy, but a significant proportion of them are overweight. The majority of them prefer to consult at a government hospital. Healthy behaviour and practices should be encouraged and maintained in HCWs.
Normative data of Ankle brachial pressure Index and Toe brachial index in normal healthy male adult using fully automated vascular Doppler
Authors: Chouhan Sunil , Hulke Sandip M. , Parashar Rachna , Thakare Avinash E. , Tripathi Sonali
Published: October 2023

ABSTRACT

Context:

Peripheral vascular disease affects some 12%–14% of the general population, and the majority of people with the disease are asymptomatic. Risk factors for it are smoking, diabetes mellitus, hyperlipidemia, hypertension, obesity, and syndrome X. The Ankle Brachial Pressure Index (ABPI) is one of the screening noninvasive methods for the diagnosis of peripheral vascular disease. Assessment is performed by fully automated vascular Doppler, which is considered to be accurate; however, normative data are limited.

Aims:

To measure the normative data of ABPI and Toe brachial index (TBI) in a healthy adult

Settings and Design:

A cross-sectional study done in male (n = 59) volunteers in the age group of 18 to 50 years of age group

Methods and Material:

Smartdop XT fully automatic Doppler-14 ports (Hadeco, Japan) was used to measure ABPI and Toe brachial index (TBI)

Statistical analysis used:

Normative value (Mean, SD, Range) was calculated using Systac 13 software

Results:

Right-side Ankle Brachial Pressure Index (ABPI) and left-side ABPI at the posterior tibial artery (PT) were 1.061 ± 0.098, and 1.105 ± 0.139, respectively. Right-side ABPI and left-side ABPI at the dorsal pedis artery were 0.86 ± 0.129 and 0.86 ± 0.115. Right-side toe Brachial Pressure Index (TBPI) and left-side ABPI was 0.85 ± 0.185 and 0.822 ± 0.2, respectively.

Conclusions:

ABPI index of more than 0.9 may be considered normal in the male population in Bhopal; however, we recommend further Multicentric trials across the Indian population.
Improving self-management and diabetes indicators in adolescents with type 1 diabetes through self-care education
Authors: Asghari Narges , Dashtebozorgi Bahman , Rostami Shahnaz , Ghanbari Saeed , Riahi-Ghahfarokhi Kourosh
Published: October 2023

ABSTRACT

Introduction:

The frequency of type 1 diabetes (T1D) as one of the most prevalent endocrine disease in adolescents is increasing globally. This type of diabetes is a progressive degeneration β cells of the islets of Langerhans, which decreases insulin production and causes permanent dependence on insulin injection. It is essential to control diabetes in adolescents and increase awareness about the effective factors (self-care) on the health of adolescents with diabetes. Therefore, this study aimed to evaluate the effect of self-care training intervention on self-management subscales and some diabetes indicators (glycosylated hemoglobin level and fasting blood sugar) in adolescents with T1D.

Materials and Methods:

This study was conducted on 50 adolescents with T1D, who were referred to the Diabetes Clinic of Golestan Hospital, aged 12 to 18 and selected for this semi-experimental intervention and case–control study by the census. Six one-hour self-help sessions were held for adolescents and their parents. The data collection tools were the Adolescent Self-Care Questionnaire and the Diabetes Index Form for T1D (SMOD-A), used before and three months after the intervention. Chi-square, t-pair tests, and SPSS software version 23 were utilized for statistical data analysis.

Results:

There was no significant difference between the case and control group regarding gender, age, race, course of the disease, education level, and family history of diabetes (P = 0.771, 0.551, 0.074, and 0.111, respectively). Three months after the intervention, a significant increase was observed in all subscales of self-management and total self-management (P < 001), and a significant decrease was seen in fasting blood sugar (P = 0.001) and glycosylated hemoglobin changes (P = 0.001).

Conclusion:

Based on the results, training adolescents through a T1D self-care program effectively improved their overall and subscale self-management and reduced fasting glucose and HbA1c levels.
Prevalence and social determinants associated with oral cancer in Al-Baha Region of Saudi Arabia: A seven-year retrospective cohort hospital-based study
Authors: Alzahrani Abdullah Ali H.
Published: October 2023

ABSTRACT

Background:

The region of Al-Baha area of interest is associated with risk factors; yet no research in the literature has explored oral cancer (OC) and its associated social determinants and risk factors in this region. The aim of this study was to access the prevalence of OC in the Al-Baha region and its association with the social determinants and risk factors in this population.

Methods:

A retrospective cohort hospital-based study was conducted in Al-Baha Region between January 2012 and December 2019. Data collected from all the patients diagnosed with OC were extracted. OC was assessed based on the hospital records, histopathological data, and Tumor, Nodes, Metastasis (TNM) staging aided in cancer assessment. Detailed demographic data associated with OC was collected using semistructured telephonic interviews. Risk assessment was reviewed based on population, exposure of interest, and outcome.

Results:

A total of 19°C patients out of 421 cancer patients were diagnosed. The mean age for OC in males was 59.72 ± 15.83 years and 69.14 ± 5.86 years in females. Oral squamous cell carcinoma of the tongue was the most with one case of metastasis. The average estimate per day smoking, E- cigarettes, water pipe smoking was 14.55 ± 7.15, 11.15 ± 3.55, and 0.52 ± 4.7, respectively, with males’ habits more than females. These contributes to the risk factors associated with socioeconomic factors.

Conclusions:

Al Baha region experiences different socioeconomic determinants with a lower prevalence of OC. The risk of OC is associated with various adverse oral habits, which can be prevented.
The role of digital health in emergency medicine education
Authors: Sarbadhikari Anindya , Sarbadhikari Suptendra N.
Published: October 2023

ABSTRACT

Despite the need for a well-trained emergency medicine (EM) workforce in India, there are still many shortcomings. The COVID-19 pandemic has brought to the limelight the critical importance of digital health data, tools, technologies, and services in monitoring and combating adverse health effects of the pandemic. On the other hand, relevant health care stakeholders have often been underprepared to embrace digital health solutions wholeheartedly and rise to the pandemic challenge. The Global Strategy on Digital Health 2020–2025 clearly states how relevant digital health interventions (DHI) would enhance the access and improve the health outcomes, if used judiciously. Currently, India’s G20 Presidency health priorities are focussed on health emergencies prevention, preparedness, and response, by incorporating digital health at its core. Keeping these policy directives in mind, health professional educators should actively incorporate DHI as an integral part of health professional education for the domain of EM. To attain an optimal growth of EM as an academic discipline in India, the curriculum has to be made up to date, incorporating the latest DHIs. The PG curriculum committees of both the National Medical Commission and the National Board of Examination must form a consensus for implementing such curriculum throughout India. The modern-day emergency room (ER) or casualty may soon have AI-enabled robots doing a lot of repetitive and precise activities to save lives. Healthcare professionals working in the ER have to be aware and efficient in handling these robots and other clinical decision support systems well.
Assessment of knowledge, attitude and practices of tobacco cessation counselling and nicotine replacement therapy among dental professionals
Authors: Shete Anagha V. , Shete Mrinal V. , Nerkar Rajbhoj Ashwini , Rajpurohit Ladusingh , Hajarnavis Arti , Sande Abhijeet
Published: October 2023

ABSTRACT

Background:

Establishment of Tobacco Cessation Centres across all dental institutions has been made mandatory by the Dental Council of India. To make it a success, adequate knowledge and training, positive attitude and practices are expected by the dental health care professionals. Our study aims to assess the knowledge, attitude and practices of dentists towards Tobacco Cessation Counselling (TCC) and Nicotine Replacement Therapy (NRT).

Materials and Methods:

200 participants (60 faculty members, 20 postgraduate students and 120 interns) participated in this cross-sectional study. A self-designed questionnaire of 27 questions was used to assess the knowledge, attitude and practices of the participants regarding TCC and NRT. A descriptive analysis of the data was done. Frequency and percentage were calculated for each variable. The data were processed and analysed using SPSS software version 19-SPSS Inc. Chicago, IL, USA.

Results:

22% candidates were trained for TCC as opposed to 78% candidates who didn’t have an idea about it. 65% participants knew about various agents which are used for NRT but many did not know how to prescribe them. 83.5% were not willing to spare time for tobacco cessation in their private practice. Only 12% were currently practising TCC or NRT at workplace.

Conclusion:

Inclusion of TCC in the undergraduate curriculum, training and updating of dental faculty and students regarding TCC and NRT will help in serving the noble cause.
Psychosocial and clinical profile of chronic long-stay psychiatric patients in teaching institution
Authors: Vranda Mysore N. , Ranjith James P. , Agadi Shivaleela , Vasanthra Cicil R. , Thirthalli Jagadisha , Kumar Channaveerachari Naveen , Thirumoorthy Ammapattian , Amaresha Anekal C.
Published: October 2023

Background:

A good number of psychiatric patients continue to stay in psychiatric hospitals for longer period of time despite their recovery. Inevitably, they tend to experience limitations to their freedom, personal choice and social isolation, and loss of self. It is important to assess the characteristics of these patients and the challenges in social integration.

Materials and Methods:

A cross-sectional study was conducted at a mental health hospital from May 2018 to January 2023. The data were collected from a retrospective review of 101 case files of all the long-stay patients (LSPs) who were admitted to psychiatric closed wards. Furthermore, cases were utilized to analyze the psychosocial situations of LSP.

Results:

This study reveals that the majority of the subjects were unmarried, females, unemployed, and hailing from rural background. Nearly 50% of the patients’ families are untraceable. About three-fourths of those patients had the wrong address and lacked community psychiatric rehabilitation facilities and employment opportunities in their neighborhood. Caregivers’ burden and poverty are major causes for prolonged or long-term hospitalization of patients in the mental hospital and barriers to community reintegration.

Conclusion:

Facilitating the transition of patients from the psychiatric hospital to community care is the need of the hour.
Accidental iron poisoning in children – Experience from a teaching institution
Authors: Chandran Jolly , Sanketh R , Vyasam Siva , Chrysolyte Asha , Ebenezer Kala
Published: October 2023

Background:

Acute iron toxicity is fatal in children resulting from an accidental overdose of maternal iron tablets at home. There is scanty literature on children looking at the profile and outcome. We report a case series of five children presenting after accidental ingestion of iron tablets. Two presented with fulminant hepatic failure at 48 h, and despite supportive management and plasmapheresis in one child, both succumbed to illness.

Materials and Methods:

This retrospective study was conducted in the pediatric intensive care unit (PICU) of a teaching institution in South India between January 2009 and December 2019. All children with accidental iron poisoning were included in the analysis.

Results:

During the study period, five children presented to our PICU after accidental iron tablet ingestion. The mean age was 25.8 months [standard deviation (SD): 13.9]. All the children had consumed iron tablets from their pregnant mothers. Two children presenting with liver failure succumbed to illness. Treatment included a standard protocol of gastric lavage and desferrioxamine. Most of them (3/5) received whole bowel irrigation. We did plasmapheresis in one child who presented with fulminant hepatic failure. The majority were discharged alive (3/5). The presence of coagulopathy, acute liver failure, and delayed presentation were associated with high mortality.

Conclusion:

Accidental iron poisoning is prevalent in children and associated with significant mortality. Parents and caretakers must be counseled by primary care physicians and made aware of the safe storage of iron tablets.
Factors related to parental COVID-19 vaccine hesitancy for children: An exploratory factor analysis model
Authors: Mohan Reenaa , Sindhuri R , Thandapani Kanimozhi , Devi D.S Karthika , Ganapathy Kalaiselvan
Published: October 2023

Introduction:

This pandemic has been accompanied by an overabundance of information and misinformation, an ‘infodemic’ on a global scale which have made acceptability of COVID-19 vaccine a major challenge. The objective of the study was to find out the Beliefs of mothers towards COVID-19 vaccine for children and its impact on vaccine hesitancy.

Materials and Methods:

After obtaining Institutional ethical clearance and informed consent, a total of 360 mothers who were having at least one child from 5 to 18 years were recruited based on simple random sampling. Face-to-face interview was conducted. The questionnaire was based on the WHO-SAGE working group on vaccine hesitancy. Based on Bartlett’s test of sphericity, the model was found to be fit (there is adequate number of correlations for factor analysis) and KMO test results imply the samples are adequate for factor analysis. K means cluster analysis was used to divide the samples into three clusters and individual respondent’s cluster membership was also identified.

Results:

It was found 49.4% of mothers were hesitant to vaccine their children against COVID-19. The seven items (reasons for vaccine hesitancy) were grouped into three dimensions (believes in vaccine effectiveness but concerned about side effects, believes in the importance of taking COVID vaccine, trusts information about COVID vaccine), based on how each item loads on to each of three factors. Cluster 1 was that they believe in effectiveness of vaccine but are concerned about side effects (.92094).

Conclusion:

Mothers’ concerns were mainly about the safety and adverse effects of vaccine.
Knowledge, attitude, and practices of family planning methods among married women from a rural area of Jaipur, Rajasthan: An observational study
Authors: Singh Yadav R. , Gupta Ajay , Sidhu Japneet , Grover Somya , Sakrawal Komal
Published: October 2023

Aim:

This study was planned with the objective to assess the knowledge, attitude, and practices of family planning methods among married women and to find out the factors associated with not using the family planning method.

Materials and Methods:

This community-based cross-sectional observational study was conducted in 300 married women residing in a rural area of Jaipur, Rajasthan. Written informed consent was obtained, and data were collected using a pre-tested semi-structured questionnaire. Knowledge, attitude, and practices were summarised in proportion, and their association was measured using Chi-square test.

Results:

The mean age of the participants was 26.7 years. Most of them (88.8% women) had knowledge of at least one contraception method. Almost two-thirds had positive attitude towards contraceptive use. The most used method was oral contraceptive pills, among 17.7% of participants. Knowledge was significantly associated with educational level and caste of the participants (P value <0.05), and practice was not significantly associated with any socio-demographic factors (P value >0.05).

Conclusion:

Knowledge, attitude, and practices related to modern family planning methods are still not high in rural areas. The media can play a major role in increasing awareness about family planning methods. The involvement of community and family, especially spouse, should be facilitated to maximize the understanding of family planning methods.
Trends in Management of Shoulder Instability: Indian Perspectives
Authors: Sood Munish , Kulshrestha Vikas , Kumar Santhosh , Kumar Pardeep , Singh Shalendra , Bhatnagar Vidhu
Published: October 2023

Objectives:

Shoulder instability is a commonly seen injury in orthopedics practice. The current survey aimed to assess strategies in the management of shoulder instability among orthopedic surgeons in India.

Materials and Methods:

A survey was created by a group of surgeons who are regularly managing shoulder instability and it was distributed among the various orthopedic surgeons from India. The questionnaire included brief details of surgeons and their experience, clinical assessment, management strategies, and the rehabilitation protocol. We also assess any difference in management strategies of Orthopaedic surgeon (OS group) as compared to fellowship trained sports surgeons/shoulder surgeons (FS group).

Results:

Ninety-seven orthopedic surgeons participated in the survey. Sixty-four percent were in the age group between 35 and 50 years. Forty-six percent of them were managing these injuries for more than 12 years. 37.5% of surgeons were from government academic institutes. Eighty percent of respondents treat first-time dislocation conservatively. The decision regarding the type of surgery is based on the percentage of bone loss, the number of dislocations, age of the patients as per the majority of respondents. Arthroscopic Bankart’s repair is the most commonly used procedure for anterior shoulder instability. The common criteria for return to sports include a glenohumeral range of motion, rotator strength, functional performance test, type of sports, and ability of the athlete to perform.

Conclusion:

Bankart’s repair is the most common procedure performed in patients with shoulder instability with minimal bone loss. Computer tomography scan is one of the preferred investigation modalities along with X-ray and magnetic resonance imaging in the first-time dislocation as per FS group. Remplissage in addition to Bankart’s repair is performed by a significantly higher number of participants from FS group as compared to OS group. Level of Evidence: Level V, expert opinion.
Dosimetric Comparison of Radiation Techniques for Comprehensive Radiation Therapy for Left-Sided Breast Cancer: A Treatment Planning Study
Authors: Rather Sajad Ahmad , Banday Muddasir Sharief , Khan Aijaz Ahmad , Wani Shaqul Qamar , Shah Mudasir Ashraf , Mufti Samina
Published: October 2023

Introduction:

The purpose of the study was to determine forward-planned intensity-modulated radiotherapy which improves the sparing of organs at risk (OAR), heart, lungs, and contralateral breast, when compared with multi-field inverse-planned intensity-modulated radiation therapy (RT). The anatomy of the chest wall is curved, which makes it difficult to achieve a homogeneous dose; therefore, it is essential to know the technique by which we can render a better treatment.

Methods:

The three-dimensional field-in-field (FIF) technique for radiotherapy is an advanced state-of-the-art method that uses multileaf collimators to generate a homogeneous and conformal dose distribution through segmental subfields. The planning computer tomography (CT) scans of 30 women with left-sided breast cancer previously treated with whole breast RT on an inclined breast board with both arms supported above the head were retrieved. The whole-breast planning target volume (PTV) was defined by clinical markup and contoured on all relevant CT slices as were the OARs. For each patient, two plans were generated using FIF and five-field inverse-planned IMRT, with a prescription dose of 50 Gy in 25 fractions to the whole breast. The mean and maximum doses to the OARs, conformity index, and homogeneity index (HI) of the whole-breast PTV were compared.

Results:

The FIF technique significantly reduced the maximum dose of the PTV as well as the mean doses of the heart, ipsilateral lung, contralateral lung, esophagus, and contralateral breast (P < 0.001 for each). When the organ at risk volumes irradiated with 10, 20, 30, and 40 Gy were compared, the results were in favor of the FIF technique. The volume receiving <20 Gy of the prescription dose for the ipsilateral lung was significantly decreased using the FIF technique (P < 0.001). The FIF technique allowed us more homogenous dose distribution.

Conclusions:

FIF resulted in a lower mean heart and contralateral breast dose with comparable HI of the whole-breast PTV compared to inverse-planned IMRT using five fields. These results with significantly fewer monitor units essential for therapy in FIF suggest that this technique may be more advantageous during breast irradiation.
Dual-Energy X-ray Absorptiometry Scan: A Neglected but Essential Investigation in Men
Authors: Kumar Anupam , Pushkar Kumar , Bobdey Saurabh , Kapoor Suraj , Panigrahi Chandan Kumar , Sharma Priyanka
Published: October 2023

Introduction:

Osteoporosis is a condition which affects both men and women but occurs a decade later in men as compared to women. Males constitute a very small percentage of patients who report for dual-energy X-ray absorptiometry (DEXA) scan. This difference may be largely because of lack of information about risk factors for secondary osteoporosis in men. In the present study, we have tried to explore the attributes of males undergoing DEXA scan at a tertiary care center.

Materials and Methods:

It was a cross-sectional study conducted in males visiting the general physician outpatient department in a tertiary care institute. All study participants who were males, based on inclusion and exclusion were included in the study. DEXA scan for hip and vertebra was performed for all the participants.

Results:

A total of 486 males fitting the inclusion criteria were included in the study. The mean age of the study participants was 66.98 (standard deviation: 8.55) years. Fifty-six (11.52%) of these participants had hypertension and 41 (8.43%) subjects had diabetes. Patient attributes and DEXA scan parameters of hip and vertebra showed a significant negative correlation with age and positive correlation with body mass index (BMI). Stratified analysis revealed that only 39% of individuals with a BMI of more than 25 kg/m2 had a high risk of osteoporosis (T ≤ −2) as compared to 58.4% of individuals with a BMI of <25 kg/m2.

Conclusion:

Osteoporosis among men remains a neglected aspect among physicians and surgeons. The DEXA scan is available in urban centers even in the developing countries; however, the lack of knowledge about indications seems to be the major factor for not evaluating the condition at the right time.
A Retrospective Analysis of 5-Year Data of Training-Related Injuries in an Institutional Setting
Authors: Singh Amit Kumar , Yadav Arun Kumar , Kumar Shailendra , Yadav Manoj , Yadav Narendra
Published: October 2023

Introduction:

Musculoskeletal injuries sustained during training are not only the major cause of loss of training hours but also lead to attrition of precious workforce. Detailed knowledge of the pattern, type, mechanism of musculoskeletal injury, etc., helps in designing prevention strategies. Hence, the study was conducted to study the epidemiology of injuries sustained by trainees while undergoing training at an institutional training.

Materials and Methods:

The study is a record-based observational study. The data relating to training-related injuries sustained over 5 years (April 2014 to March 2019) were obtained from the record maintained in the medical facility of the training institute in India. The data were extracted using a case record form. The injury data (date of injury, unique identification number, trainee name, diagnosis, and type of treatment taken) were obtained from the medical record register maintained in the medical facility of the training institute. Anthropometric data (height and weight) were obtained from the record of initial medical screening done routinely on the day of joining the training institute. The descriptive analysis of the collected data was done.

Results:

A total of (n= 2946) trainees comprising 2584 male trainees and 362 female trainees underwent training during the period of the study. The total number of visits to the medical facility related to injury during the 5-year study period was 13,579. Most of the injuries are occurring in the 5th–20thweek in the first half of training period and 29–44 week in the second half of training period. Among male trainees, the lower limb injuries alone accounted for 72.8% of total injuries, followed by trunk and back injuries (11.97%) and upper limb injuries (11.95%). Among female trainees although lower limb injuries still account for the majority (79.66%) of injuries, among them, hip and groin injuries accounted for the highest percentage of injuries as compared to leg and knee injuries in male trainees. The twisting injuries of the knee, stress fractures, and acute traumatic fractures accounted for the majority (78.34%) of the injuries leading to repetition of the training by 24 weeks. The twisting injuries of the knee, acute traumatic fractures, traumatic shoulder instability, and head injuries accounted for the majority (83.2%) of the injuries leading to dropout from training institution (withdrawal).

Conclusion:

The analysis related to the injuries sustained by trainees during the 5 years found out the timings, severity, and location of injuries. The findings may be important for the formulation of preventive program in an institutional training institute.
Comparison of Red Blood Corpuscle Indices versus Hemoglobin High-Performance Liquid Chromatography as a Screen for Hemoglobinopathies in Pregnant Women
Authors: Sengupta Arnab , Bhatia Jasvinder Kaur , Singh Jasdeep , Agarwal Manisha , Singh Brajesh , Bhatia Ravjot Singh
Published: October 2023

Introduction:

Beta-thalassemia plagues India and thalassemia screening of pregnant women is crucial. Hemoglobin (Hb) high-performance liquid chromatography (HPLC) (Hb-HPLC) is the gold standard, however in distant places it is rarely an option. While data on the use of red blood cell (RBC) indices to screen pregnant women for thalassemia trait is still developing, a sensitive and specific RBC index is needed to test for beta thalassemia. In service situations, these affordable indices may be useful without HPLC.

Objective:

We aimed to determine the role of red blood corpuscle indices as a screening tool to differentiate between iron deficiency anemia (IDA) and hemoglobinopathies in pregnant women and to find out the most sensitive and the most specific index.

Methods:

With ethical approval, 500 patients were evaluated from February 2020 to August 2021. Complete blood Counts and peripheral blood smears were performed. Participants with microcytic hypochromic anemia were included. On these patients, the RBC indices (i) Shine and Lal, (ii) Mentzer’s index, (iii) red cell distribution width index, and (iv) Srivastava were calculated. Ferritin, iron, and total iron-binding capacity levels were also tested. Hb-HPLC was utilized as the gold standard. The Mann–Whitney U-test was used to compare continuous variables between groups. Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were calculated for various metrics. A P < 0.05 was statistically significant.

Results:

Hb-HPLC showed 29 (5.8%) heterozygous beta thalassemia and 471 (94.2%) IDA. Based on the updated cutoff value (4.727), Srivastava Index was the best screening tool.

Conclusion:

RBC indices can distinguish IDA from beta thalassemia in pregnant women and are valuable screening tools in service settings.
Outcome of Single and Double Intrauterine Insemination Techniques in Infertility Cases
Authors: Sharma Arunav , Ali Mustajib , Sharma Rajesh
Published: October 2023

Background:

Primary infertility is a serious condition that has a profound impact on the mental and physical health of the couple, and the condition forms a significant proportion of cases seeking treatment at gynecological centers across the world. Intrauterine insemination (IUI) forms the cornerstone in the management of most of such cases. However, there has been an ongoing debate regarding whether single IUI or double IUI: which is better. This randomized control trial aims at comparing the outcomes of both the techniques.

Materials and Methods:

In this randomized control trial, 150 couples having a valid indication for IUI were randomized into two groups. In the first group, single IUI was done at 36 h after human chorionic gonadotropin (HCG) trigger, and in the second group, double IUI was done at 24 and 48 h post-HCG trigger. The outcome measured was pregnancy which was confirmed by urine pregnancy test done on the 18th day after IUI and later followed up till appearance of gestation sac with fetal pole on ultrasound. The Fisher’s exact test for statistical analysis was used to analyze the data for statistical significance.

Results:

In the single IUI cohort of 75 women, 11 tested positive for urine beta-HCG on day 18 and all had confirmed pregnancy (gestational sac with fetal pole). The pregnancy positivity rate for this cohort was 14.67% (11/75 × 100%). In the double IUI cohort of 75 women, 13 tested positive for urine beta-HCG on day 18 and all had confirmed pregnancy (gestational sac with fetal pole); the pregnancy positivity rate for this cohort was 17.33% (13/75 × 100%). Although the double IUI group had a higher yield of positive outcomes, the result was not statistically significant (statistic test value is 0.8242).

Conclusion:

The outcome of single versus double IUI is almost similar. In a resource-poor situation, it will be prudent to stick to single IUI in all cases requiring IUI. However, in a resource-rich situation, one might resort to double IUI in male factor abnormalities such as asthenozoospermia or borderline oligozoospermia.
Case Report: Leptospirosis Complicated by Persistent, Bilateral Sensorineural Hearing Loss
Authors: Campbell Stuart , Stewart James , Quail Gavin , Withey Grant , Smith Simon , Hanson Josh
Published: October 2023

The clinical manifestations of leptospirosis range from mild to life-threatening and can impact on multiple organ systems. A wide array of neurological manifestations of leptospirosis have been reported, although the pathophysiology of neuroleptospirosis remains incompletely understood. We present a case of leptospirosis complicated by bilateral sensorineural deafness, with nodular meningitis demonstrated in the internal auditory meatus on magnetic resonance imaging. The patient was treated with doxycycline, ceftriaxone, systemic and topical steroids, and hyperbaric oxygen therapy, with modest, but incomplete, improvement.