bluuebunny/crossref_metadata_2025 huggingface dataset:
Biofilm Formation in Methicillin-Resistant and Methicillin-Sensitive Staphylococcus aureus Strains
Authors: Singhal Ankita , Jain Manisha , Gaind Rajni
Published: May 2024

Background:

The combination of methicillin resistance (MR) and the ability of biofilm formation of Staphylococcus aureus (SA) makes treatment difficult. Biofilm is formed by distinct genetic mechanisms in MRSA and methicillin-sensitive SA (MSSA), and hence, there is difference in the prevalence of biofilms in them. This study investigated the biofilm production in SA and analyzed its correlation with MR.

Materials and methods:

A total of 261 consecutive Staphylococcus aureus isolated from various clinical samples from January to April 2019 were included in the study. Antibiotic sensitivity was carried out as per Clinical and Laboratory Standards Institute guidelines and cefoxitin disk was used for screening for MR. Total of 147 MSSA and 114 MRSA were taken for further processing. Biofilm formation was determined by tube and microtiter plate methods in all the isolates. The data were analyzed for statistical significance using Microsoft excel software.

Results:

Resistance to erythromycin, clindamycin, gentamicin, cotrimoxazole, and inducible clindamycin resistance was significantly higher in all the MR Staphylococcus strain including biofilm forming MRSA strains. The biofilm formation was significantly higher in MSSA isolates by both the tube (78.2%) and microtiter plate methods (64.9%).

Discussion:

Although the antimicrobial resistance was higher in MRSA, the ability to form biofilms was significantly higher in MSSA. Biofilms of MSSA are usually less prevalent than MRSA probably because of the distinct genetic mechanisms involved in the formation of biofilms. The higher biofilm forming ability of MSSA in our study highlights the need for determination of other genes involved in biofilm formation and virulence mechanisms in SA.
Experiences with Horizontal and Vertical Integration in Competency-based Physiology Education
Authors: Mahajan Aarti Sood , Rakheja Garima , Kaushik Smita , Arora Prerna , Chitkara Anubhuti , Verma Rashmi
Published: May 2024

Integrated teaching is a well-known concept in medical education and has been reintroduced in the competency-based curriculum. The physiology department started the exercise in the topic of hematology in 2019 in the offline mode and again in 2021 in the online mode (due to the pandemic). This article is an attempt to describe what went through in its conceptualization and implementation. The background of integration, types of integration, how the exercise was planned, and the feedback of the faculty are included. This could benefit the phases 2 and 3 faculty members who must be planning similar exercises now. In addition, it would act as a screenshot to others, phase 1 faculty included, to help them do a similar or other exercises in the coming years. Integration in competency-based curriculum is here to stay. We can gradually improve upon it and innovate it.
Innovative Strategies in Medical Education for Addressing Gaps in Health-Care Service in Rural India
Authors: Banerjee Bratati
Published: May 2024

At least half of the world's population still do not have full coverage of essential health services and the available health-care services are also not equitably distributed, the rural areas being the generally underserved ones. Several factors influence attraction and retention of doctors in rural areas which are related to international and national contexts, work-related factors, environmental and living conditions, and individual or personal factors which includes family and social support, in addition to personal aspirations. Innovative strategies have been worked out and implemented to address these problems and fill the gaps in the areas of educational, regulatory, financial and professional and personal support. This review discusses the educational strategies which are targeted at all levels viz. selection of candidates for admission, and subsequent undergraduate, internship, and postgraduate teaching and training that can be oriented toward rural health and health-care services
Workplace-Based Assessment
Authors: Singh Kirti , Singh Arshi
Published: May 2024

Workplace-based assessment (WPBA) is a method of assessment which measures working of a healthcare professional when performing his duties. The shift in undergraduate medical education to competency-based medical education in curriculum of India makes this WPBA a very attractive option of evaluation, as it measures competency outcomes in real-time scenarios on patients. This article discusses the strengths of WPBA, its lacunae, its essential components of direct observation, conduction at workplace, and constructive, immediate feedback. It also details the methodology, types, utility index, strengths, and lacunae of WPBA along with strategies to improve implementation.
Anxiety and Depression in Undergraduate Students Due to Altered Screen Time and Physical Activity Patterns in Covid Times
Authors: Gupta Aditya , Trivedi Siddharth , Singh Keshave , Bagwe Sagar , Maini Lalit
Published: May 2024

Objective:

This study was done to assess anxiety and depression in undergraduate students due to altered levels of screen time (ST) and physical activity (PA) during the COVID-19 pandemic. Various studies have been carried out about the mental health impacts of ST and PA, but there is a paucity of literature when it comes to exploring these parameters in undergraduate students and the Indian population. This study aims to address this gap.

Methods:

Data were collected through a survey using an online questionnaire. Participants reported daily ST and weekly PA, both moderately vigorous physical activity (MVPA) and vigorous physical activity (VPA). Symptoms of anxiety and depression were ascertained using the Hospital Anxiety and Depression Score.

Results:

Out of the total 165 students analyzed, we found that 63% had borderline or pathological anxiety levels while 41.2% had borderline or pathological depression levels. There was a negative correlation between depression score and PA, for both MVPA (r = –0.233, P = 0.001) and VPA (r = –0.268, P = 0.0002). A negative correlation was found between anxiety score and PA for MVPA (r = –0.151, P = 0.024). There was a positive correlation between ST and scores of anxiety (r = 0.305, P = 0.006) and depression (r = 0.257, P = 0.02) in females but no correlation was found in males.

Conclusion:

The present study suggests that there is a high prevalence of borderline and pathological anxiety and depression amongst undergraduate students. High levels of PA and low levels of ST are separately associated with a lesser risk of anxiety and depression.
Prevalence and Determinants of Exclusive Breastfeeding Among Children Less Than Two Years of Age in a Rural Area of Delhi, India
Authors: Singh Pallavi , Kumar Rajesh , Meena Gajendra S , Lal Panna
Published: May 2024

Context:

Exclusive breastfeeding for the first 6 months of life is highly beneficial to the child. Unfortunately, it is frequently not practiced among women due to a lack of knowledge.

Aims:

The study aims to to find the prevalence of exclusive breastfeeding among children aged less than 2 years of age and to study the factors influencing the practice of exclusive breastfeeding among the mothers of the study participants.

Methods and Material:

The design was a community-based cross-sectional study. Between January 2019 and January 2020, we enrolled 190 children aged less than 2 years of age and their mothers residing in a rural area of Delhi, India. We collected baseline sociodemographic data and details of feeding practices followed using a pretested semi-structured questionnaire. To measure association, the chi-square test or Fischer exact test was used.

Statistical analysis used:

Collected data was entered into MS-Excel and analyzed using IBM Statistical Package for the Social Sciences – 25 for descriptive and inferential statistics.

Results:

Of the 190 participants with complete information, 74 were under 6 months of age and it was found that 57 (77.0%) of those were exclusively breastfed till their present age. The remaining 116 children were aged between 6 and 23 months and the prevalence of exclusive breastfeeding in these children was found to be 55.2% (64). The mean duration of exclusive breastfeeding was 5.75 ± 1.79 months. The age of the child was found to be statistically significant with the practice of exclusive breastfeeding (P = 0.01).

Conclusions:

The exclusive breastfeeding up to 6 months of age was practiced only by approximately half of the mothers.
A Case Report of Sudden Bradycardia and Impending Cardiac Arrest by Intramyometerial Vassopressin in Laproscopic Myomectomy
Authors: Sharma Shubhangi , Raj Sameer
Published: May 2024

Vasopressin has long been used in myomectomy to decrease blood loss. Its efficacy is beyond doubt. But at the same time, it is known to cause some of the serious cardiovascular side effects. We are here to report a case of severe bradycardia and impending cardiac arrest caused by intramyometerial infiltration of 13 IU of vasopressin.
Neuroimaging of Pediatric Brain Tumors − A Review
Authors: Sneha Harish C. , Singh Sapna , Dixit Rashmi , Prakash Anjali
Published: May 2024

Brain tumors are the second most common malignancy and the most common solid tumors in the pediatric population. Most brain tumors in the pediatric population are primary in origin contrary to the adult population. The various factors useful for establishing the diagnosis include the age of the patient, imaging characteristics, and location of the tumor. Infratentorial tumors are more common between 4 and 10 years of age, whereas supratentorial tumors are common in neonates and infants up to 3 years. Conventional computed tomography and magnetic resonance imaging are of paramount importance in the diagnostic evaluation of these tumors which help in their characterization and allow accurate assessment of their extent. The updated World Health Organization classification of brain tumors has incorporated various genetic and molecular parameters. It is essential for the radiologists to be familiar with the imaging features of genetic tumor subtypes as it plays a role in patient management and prognostication. Advanced neuroimaging provides additional information regarding the metabolism and physiology of these lesions, thereby aiding in their diagnosis and follow-up.
Comparison of Ease and Success of Intubation through LMA Blockbuster and Ambu Aura-I in Patients Receiving General Anesthesia
Authors: Manohar Manisha , Tirupathi Hemanth Kumar , Kumar Prashant , Kaur Kiranpreet , Vashishth Sumedha , Bangarwa Nidhi
Published: May 2024

Background:

Airway gadgetry is expanding at an exponential rate. It is imperative to understand the intubating characteristics of supraglottic devices so that the choice of device in patients is based on evidence rather than just the design. The present study was conducted to compare blind intubation with blockbuster LMA and Ambu Aura-i.

Methodology:

Sixty patients of either sex, 20 to 60 years of age, ASA I–III, scheduled to undergo elective surgery under general anesthesia, were included in this prospective, randomized, comparative study. Group A (n = 30) patients were intubated with AmbuAura-i, and Group B (n = 30) patients were intubated using BlockBuster LMA.

Results:

Endotracheal intubation was found easy in 76% of the patients and difficult in 10% of the patients intubated with Ambu Aura −i. A 13.3% failure rate was observed in group A. Intubation success rate of 100% was observed in Group B. 86.6% of patients were easily intubated, and seven patients were intubated with a bit of difficulty (P-value 0.010). The mean time of SGD insertion in Group A was 14.77 ± 5.563 seconds, and in Group B was 21.87 ± 7.186 seconds (P-value 0.000). SGD insertion attempts were significantly higher in Group B when compared to Group A (P-value 0.025).

Conclusion:

Although AA-i requires less time for the placement of SGD, blockbuster LMA remains the better choice with a 100% success rate of blind orotracheal intubation.
Impact of COVID-19 on the Work Performance of Healthcare Workers in Neurosurgery Operation Theater at a Tertiary Care Institute
Authors: Abhishek Katyal , Parth Modi , Neeraj Rai , Daljit Singh
Published: May 2024

Background:

The novel corona virus disease 2019 (COVID-19) pandemic had a massive impact on healthcare systems, increasing the risks of psychologic distress in health professionals in response to chronic emotional and interpersonal stressors on the job; especially associated with surgical care.

Aims and Objectives:

To assess the impact of COVID-19 on the psychologic health and work performance of healthcare workers (HCWs) in operation theaters (OTs).

Methodology:

A questionnaire-based survey study was conducted among health professionals associated with neurosurgery OT.

Results:

Sixty-five HCWs (including doctors, nursing staff, and other HCWs) participated in the survey. The fear of spread of COVID-19 infection to family members was found in majority of HCWs especially nursing staff (96%). The fear of COVID-related death was least among the other HCWs (8%). Majority of the HCWs followed COVID protocols at work place. Transportation issues were a major complaint by other HCWs (67%), whereas majority of the HCWs (71%) were of the opinion that donning and doffing practices affected their daily work routine.

Conclusion:

Fears and stigmas associated with COVID −19 had an impact on the psychosocial health of HCWs in the neurosurgery OT and affected their workplace performance.
A Prevalence Study of Post-Traumatic Stress Disorder and Its Sociobiological Determinants During Second Wave of COVID-19 Pandemic Among General Population of National Capital Territory of Delhi
Authors: Purwar Neeti , Chauhan Ambren , Singh Anshu , Juneja Khushboo , Mahajan Harsh , Srivastava Shalini
Published: May 2024

Introduction:

Nationwide lockdown during COVID-19 pandemic, rapid transmission of SARS-CoV-2 and more intense second wave of pandemic in terms of high caseload, reduced essential supplies and scarcity of beds, and unpredictable mortality had a huge impact on mental health of general population.

Objectives:

This study aimed to estimate the prevalence and determine the factors of Post-Traumatic Stress Disorder (PTSD) among the general population of India during the second wave of pandemic.

Methodology:

An online survey was conducted to estimate the prevalence and assess the factors responsible for PTSD among 614 participants who were above 18 years of age. The prevalence of PTSD was measured using PTSD checklist for Diagnostic and Statistical Manual of Mental Disorder-5 (DSM-5).

Results:

In the present study, there were a total of 614 participants and the mean age of the participants was 23.64 years. More than half of the participants were female and majority of them were unmarried (76.7%). The prevalence of PTSD was 30.62%. A significant association was observed between occupation and PTSD prevalence. Also, COVID-19 illness, COVID-19 infection among the family members, work outside the home, hospital admissions, difficulty in acquiring the required medication were significantly associated with PTSD.

Conclusion:

COVID-19 pandemic and nationwide lockdown led to increased prevalence of psychological effects like PTSD. This highlights the importance of focusing on mental health during the pandemic.
COVID-19 in Children
Authors: Madan Siddharth , Srishti
Published: May 2024

Clinical manifestations of SARS-CoV-2 in children are not typical. These range from relatively mild to no symptoms in 90% of patients to a severe Kawasaki like disease compared to adults. The outcome is usually favorable in children. There are relatively few studies related to coronavirus disease (COVID-19) in children, no major clinical trials exist. The experience of this novel disease in adults is being extrapolated to manage pediatric COVID-19 cases. This review summarizes the current understanding of pediatric COVID-19 with regards to the epidemiology, clinical manifestations and management.
Successful management of endotracheal tube cuff rupture in case of difficult airway scenario for oropharyngeal surgery
Authors: Lalwani Parin , Venkateswaran Vineeta
Published: May 2024

Endotracheal tube (ETT) cuff leaks can be encountered in the operating room with variable consequences ranging from a mere annoying bubbling sound to life-threatening respiratory compromise requiring immediate intervention. This scenario becomes more challenging if there is a difficult airway with limited mouth opening and oromaxillofacial surgery where nasal intubation is required with a north pole tube. ETT replacement can expose the patient to airway loss or life-threatening hypoxemia during the ETT exchange. There are no recommended guidelines on how to deal with an ETT cuff leak and no published step-by-step safe management strategy. With the lack of defined protocols and guidelines to manage intraoperative cuff leaks, the presence of mind and ability to make critical decisions by the anesthesiologist cannot be overemphasized. We present a case report of a 40-year-old patient weighing 70 kg diagnosed with carcinoma retromolar trigone posted for wide local excision and posterior segmental mandibulectomy. On airway examination, he had a limited mouth opening of <1 cm, with both nostrils of equal and adequate size. As mask ventilation was not difficult after induction of general anesthesia, we did fiberoptic-guided right nasal intubation with North Pole tube. We were unable to inflate the cuff of ETT and there was a significant leak. Here, we discuss how we exchanged the ETT in this difficult airway scenario.
Tuberculous and Nontuberculous Lesion of Lymphnodes − Histopathological and Cytological Correlation
Authors: Patel Deep , Bhalodia Jignasa , Patel Shraddha J.
Published: May 2024

Background:

The lymph node is one of the major anatomic components of the immune system. Lymph nodes are the most widely distributed and easily accessible component of lymphoid tissue and hence they are frequently examined for diagnosis of lymphoreticular disorders. Lymph node swellings are one of the commonest clinical presentation of patients and it encompasses a wide spectrum ranging from inflammation to a malignant lymphoma or a more obnoxious metastatic malignancy.

Aims and objectives:

The aim of this study is to evaluate the diagnostic accuracy of Fine Needle Aspiration Cytology (FNAC) in correlation with histopathology in cases of cervical lymphadenopathies.

Material and methods:

Patients referred to the Department of Pathology, GMERS Medical College and Hospital, Sola Ahmedabad for period of 12 months from June 2021 to May 2022 for palpable lymph node swelling on whom FNAC procedure was performed were included in the study. FNAC diagnosis of patients was compared with histopathology in cases which underwent surgical excision and its diagnostic accuracy was studied.

Results:

Out of 100 cases which were included in the study, lymph node biopsy was carried out in all 100 cases. Most were in age group of 21 to 30 years. Gender wise, there was male preponderance. Benign lymphadenopathies were diagnosed in 93% of cases. Metastatic deposits were diagnosed in 7% of cases. On correlation of FNAC findings with histopathology, overall correlation rate was 85.2%.

Conclusions:

FNAC is especially helpful as lymphnode biopsy is a difficult and invasive procedure. Although excision biopsy is the gold standard, FNAC is preferred as first-line investigation.
Prevalence and Etiology of Thrombocytopenia in Pregnant Women in a Tertiary Care Hospital in Delhi
Authors: Singh Sarika , Balhara Kirti , Oberoi Mansi
Published: May 2024

Background:

Thrombocytopenia is the second most common hematologic abnormalities in pregnancy next to anemia. Its etiology is not well understood in the pregnant females.

Aim:

To find out the prevalence of thrombocytopenia (hospital based) in pregnant women and the various etiologic factors responsible for thrombocytopenia in pregnant Indian women.

Setting and Design:

This was a prospective, cross-sectional study.

Materials and Methods:

One thousand pregnant registered females attending the antenatal clinic were studied with detailed history, examination, hemogram on Sysmex KX-21 hematology analyzer (Transasia: Mumbai, India Diamed, Switzerland) five part differential analyzer in blood collected in ethylenediaminetetraacetic acid vials, liver and kidney function tests, and other relevant special hematologic tests depending upon the clinical diagnosis.

Statistical Analysis:

By using the Chi-squared test, values of P < 0.05 being considered statistically significant.

Results:

The prevalence of thrombocytopenia in pregnancy was 134/1000 (13.4%). Moderate thrombocytopenia was observed in 72/134 (53.7%) and severe thrombocytopenia in 14/134 (10.4%). About 125/134 (93.3%) of the thrombocytopenic patients were in the third trimester. Majority of them belonged to 21 to 25 years of age and had B+ blood group. Most common etiology was gestational thrombocytopenia (GT) in 46/134 (34.3%). Anemia was found in 27/134 (20.1%) patients.

Conclusion:

In Indian thrombocytopenic female, most common cause is GT but lesser than western world. The prevalence of associated anemia is higher in this part of world.
In Vitro Isolation and Molecular Characterization of Genomic DNA from Ancient Human Long and Hip Bones
Authors: Kumar Dinesh , Jeena Lalit Mohan , Shekhawat Devendra , Verma Ira , Sana Sidd
Published: May 2024

Background:

A simple and effective modified ethanol precipitation-based protocol was described for the extraction of genomic DNA from ancient human bones. The qualitative and quantitative evaluation of genomic DNA was done based on DNA purity (260/280) and the PCR method.

Method and Materials:

In this study, a total of 50 embalmed ancient bones, including 20 long and 30 hip bone samples, were taken for genomic DNA extraction. The efficiency of the genomic DNA extraction was demonstrated on >50-year-old ancient human HIP and long bone samples. In vitro quantitative and qualitative analysis of extracted genomic DNA was performed by 0.8% agarose gel electrophoresis and PCR amplification. To assess the quality of extracted genomic DNA, a mitochondrial-specific ATPase6 gene primer was used to obtain sequence information of 675 bp.

Result:

Our data show that a concentration of genomic DNA between 1.6 and 2.0 at 260/280 resulted in successful PCR amplification. Our results demonstrated that the extraction of DNA from ancient bone samples with a manual approach will increase the amplification efficiency of the polymerase chain reaction (PCR).

Conclusion:

In the present study, a simple, time-saving, and cost-effective protocol is described for the extraction of genomic DNA from ancient human bones. Further, we believe the extraction of genomic DNA from ancient bone samples with this approach will increase the success rate of PCR amplification.
A randomized controlled study to compare the dose requirement of oxytocin for management of uterine atony in patients receiving prophylactic phenylephrine during caesarean delivery
Authors: Nairita Mayur , Madhuri Biswas R. , Mondal Shatanik
Published: May 2024

Background & Aims:

Most common side effect of subarachnoid block during caesarean delivery is postspinal hypotension which can lead to increased maternal and neonatal morbidity and mortality. Phenylephrine has been shown to be effective in preventing commonly encountered hypotension associated with spinal anesthesia (60% to 70%) in obstetric patients and has become the vasopressor of choice. The following study was conducted to compare the dose requirement of intravenous oxytocin between patients receiving an infusion of prophylactic intravenous phenylephrine to those receiving a saline control infusion under spinal anesthesia in patients undergoing caesarean delivery.

Material & Methods:

It was a double-blinded, randomized controlled study having 48 subjects in test and control arm each.

Results:

The mean oxytocin dose administered was higher in the phenylephrine group than in the control group (6.1 ± 2.7 (IU) vs. 5.2 ± 2.3 IU, respectively). The proportion of patients who required a secondary uterotonic agent was higher in the phenylephrine intervention group (22% vs. 8%, respectively).

Conclusion:

Obstetricians and anesthesiologists must pay close attention to uterine tone for patients receiving a phenylephrine infusion for the prevention of postspinal hypotension and the increased dose requirement of oxytocin. Future multicentric studies are required to further establish the effects of continuous infusion as found in our study.
Secondary Amyloidosis with Fatal Outcome in a Child with Meningomyelocele
Authors: Bharadwaj Madhavi , Dabas Aashima , Mantan Mukta , Batra Vineeta , Yadav Sangeeta
Published: May 2024

Amyloidosis constitutes a group of diseases characterized by extracellular deposition of fibrils composed of low molecular weight subunits of a variety of proteins. Secondary amyloidosis may result from chronic inflammatory conditions such as familial Mediterranean fever, juvenile idiopathic arthritis, tuberculosis, and bronchiectasis. Myelomeningocele is reported rarely in literature as a cause of amyloidosis. We report here a case of 6-year-old boy with operated congenital lumbar myelomeningocele with paraparesis and neurogenic bladder, who was diagnosed with nephrotic syndrome with hypertension. He underwent a renal biopsy which showed amyloidosis. During the course of treatment, he acquired a perigenital infection and later succumbed to it. A closer follow-up of patients with neurogenic bladder can help identify and manage renal complications early.
Internet Gaming Disorder and Its Harmful Health Effects among the Medical Students in a Tertiary Care Teaching Hospital
Authors: Singh Anshu , Shree Tuhina , Kumar Prem
Published: May 2024

Background:

Online gaming has gained a lot of popularity due to easy accessibility of Internet-enabled devices. This has given rise to a new phenomenon of gaming addiction. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) published by American Psychiatric Association, in 2013, included the term Internet gaming disorder (IGD). Impact of IGD on physical and psychologic health warrants further exploration.

Objectives and methods:

A cross-sectional study was carried out among medical students to find out the prevalence of IGD and the associated health effects. The study was conducted from July to September 2019. Data collection was carried out using a semistructured self-administered questionnaire consisting of sociodemographic profile, Pittsburgh sleep quality index, DSM-5 criteria for IGD and examination of participants. Data were entered and analyzed using frequency, percentage, and Chi-square test.

Results:

Almost three-fourth participants (72.2%) engaged in the online games out of which 30.9% had IGD. A higher proportion of male students were found to be suffering from IGD. Sleeping disorder was also found to be significantly more among those who had IGD.

Conclusion:

Prevalence of IGD was found to be high among medical students. The majority of gamers also faced various health consequences of which sleeping disorder was the major problem.
Gadolinium-induced acute respiratory distress syndrome
Authors: Gupta Lalit , Prathap T H
Published: May 2024

Gadolinium-based magnetic resonance imaging (MRI) contrast is considered stable and safe compared to iodine-based contrast agents; however, unseen and unexpected complications may occur at any time. We present the case of a 45-year-old patient who was posted for MRI contrast of the abdomen. After a few minutes of contrast injection, the patient was found having shortness of breath, chest pain with nausea, and vomiting. Pulmonary auscultation revealed bilateral fine crepitations, but he did not develop rash or angioedema and was immediately managed with steroids and with supplemental oxygen support. However, he started desaturating and shifted to the nearby emergency department where high-resolution computed tomography (HRCT) was done and showed ground-glass opacities. Coronavirus disease (COVID) swab test was negative and the patient was shifted to intensive care unit (ICU) with the provisional diagnosis of developing acute respiratory distress syndrome (ARDS). He was managed conservatively on bilevel positive airway pressure (BiPAP) and discharged after 10 days with full recovery. There is no specific biomarker for ARDS triggered by MRI contrast, and the clinical presentation is indistinguishable from other causes. Gadolinium contrast-induced ARDS is a rare but potentially life-threatening complication that should be considered in the differential diagnosis of respiratory failure following an MRI contrast injection. It is critical to be aware of this potential complication in order to provide the best outcome for the patient's management.
The New Normal Anesthesiologist and the Challenging Post-COVID-19 Mucormycosis Patients − Our Experience
Authors: Wadhawan Sonia , Husain Farah , Agarwal Munisha
Published: May 2024

Rhino-orbital-cerebral mucormycosis (ROCM) is an aggressive, lethal, angioinvasive fungal infection that has presented as an opportunistic infection in the backdrop of a highly infectious and severe second coronavirus disease 2019 (COVID-19) wave in India. The dominant delta strain during the second wave led to an unprecedented rise in hospital admissions with moderate to severe COVID-19 illness. A working staging system is helpful in triaging these patients to prioritize surgical debridement and liposomal amphotericin B induction therapy. The evaluation and optimization of post-COVID-19 sequelae becomes a cornerstone in achieving a favorable perioperative outcome. As anesthesiologists, we share our experience in managing this novel subset of patients. Post-COVID-19 sequelae with a prothrombotic state and multisystem involvement, challenging and shared airway, and amphotericin B-related complications are being the key concerns.
COVID-19 and Blood Disorders
Authors: Khan Sheeba , Aggarwal Sunita , Kumar Ankitesh , Garg Sandeep , Bharti Praveen , Choudhary Deepshikha
Published: May 2024

In December 2019, a new type of coronavirus, severe acute respiratory syndrome coronavirus 2 was detected in Wuhan, Hubei province, China. It is currently a pandemic, with more than 185 million cases and roughly 4 million deaths globally as of July 9, 2021, with the United States and India leading the way. Coronavirus disease 2019 (COVID-19) may show multisystem involvement with significant impact on hematopoietic system and hemostasis. Blood count abnormalities, that is, lymphopenia (83.2%) and neutrophilia (34.5%), are of prognostic significance. Changes in hemostatic biomarkers represented by increase in D-dimer (23.3%) and associated thrombocytopenia (36.3%) indicate the essence of coagulopathy reported in these patients leading to fatal implications such as disseminated intravascular coagulation and serious thrombotic complications. Hence, accurate evaluation of laboratory indicators at the beginning and during COVID-19 can help health professionals in adjusting appropriate treatment and providing special and prompt care for those who need it. This study aims to highlight these abnormalities and appropriate interventions aimed to reduce the associated mortality of the disease. The effect of COVID-19 in patients with hematologic abnormalities and role of vaccination are also outlined.
Serum Lipids in COVID-19
Authors: Rani Anita , Choudhari Omkar K. , Kumar Rohit , Bhatia Paarth
Published: May 2024

Background:

The coronavirus disease 2019 (COVID-19) pandemic still remains as an evolving condition. The available literature suggested that the level of various biochemical parameters was found to be associated with severity of the infection and can be used as markers of severity in patients with COVID-19. However, speculation for association of hypolipidemia with COVID-19 severity was also postulated. Hence, present study is conducted to find association of lipid profile with the severity of the disease.

Materials and methods:

A case–control study was carried out in the months of August to October 2020 in Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India. Cases included 103 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) real-time polymerase chain reaction (RT-PCR)-positive admitted patients (52 with moderate disease and 51 with severe disease), whereas control included 100 SARS-CoV-2 RT-PCR-negative patients visiting outpatient clinic of Department of Respiratory Medicine of the hospital. Total cholesterol, triglycerides, high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) values of participants were evaluated and compared among severe COVID-19 cases and controls as well as in moderate and severe COVID-19 diseased.

Results:

Among 103 patients, 52 patients had moderate disease and 51 had severe COVID-19 on admission. The mean serum total cholesterol level in cases was 145 ± 64.21 and 161.43 ± 43.48 mg/dL in controls (P = 0.035). Mean serum triglyceride level was 167.22 ± 99.04 mg/dL in COVID-19 cases and 141.73 ± 71.76 mg/dL in control (P = 0.037). Mean serum LDL-C level was 93.77 ± 38.68 mg/dL in cases and 110.74 ± 43.11 mg/dL in control (P = 0.004). Mean serum HDL-C level was 29.61 ± 11.71 mg/dL in cases and 42.35 ± 13.87 mg/dL in control population (P < 0.001).

Conclusion:

Hypolipidemia was found to be significantly associated with COVID-19 infection in the current study. There was no statistically significant difference found in patients with moderate and severe COVID-19 in this small group study.
Atypical Posterior Reversible Encephalopathy with Spinal Cord Involvement (PRES-SCI) − A Rare Entity
Authors: Ranjan Rahul S. , Namrata  , Singh Anil Kumar , Kumar Varun
Published: May 2024

Posterior reversible encephalopathy (PRES) is a clinico-radiological syndrome that is characterized by headache, altered mental status, seizure, and visual disturbances and is associated with vasogenic edema of white matter predominantly affecting the posterior circulation, that is, occipital lobe and parietal lobe of brain. Atypical sites of involvement include temporal lobes, deep white matter, ganglio-thalamic complexes, brain stem, and cerebellum. Posterior reversible encephalopathy with spinal cord involvement (PRES-SCI) is a new rare entity first described in 2014 by Havenon with about 21 cases reported till 2017. As is with PRES, PRES-SCI is also mostly seen in setting of acute accelerated hypertension with clinical presentation of headache, vomiting, and acute hypertensive retinopathy. This variant of PRES has been reported to be more common in young male patients. In this case report, we present two rare cases of PRES-SCI in a 14-year-old female and 6-year-old male.
Prevalence and determinants of dysmenorrhea
Authors: Anusha D. V. B. , Shridevi K. , Manoj P. , Goparaju A.
Published: May 2024

Background:

Dysmenorrhea is a medical condition of pain during menstruation. A variety of factors effect dysmenorrhea which include early menarche, younger age, diet, prolonged and aberrant menstrual flow, psychological disturbances, and pelvic infections; these interfere with dysmenorrhea symptoms. Genetic factors, exertion, and activity patterns affect prevalence and severity of dysmenorrhea. Various studies in India revealed that the prevalence of dysmenorrhea varies from 33 to 79.67.

Objective:

To study the prevalence, characteristics, and determinants of dysmenorrhea.

Materials and Methods:

Community-based cross-sectional study was carried out which included 165 women from urban field practice area who have attained menarche but not completed menopause aged 15-50 years. Data were collected using semi-structured questionnaire by direct interview. The data were analyzed by percentages, proportions. Chi-square test was used.

Results:

The prevalence of dysmenorrhea was 60%. The correlation between the age and the dysmenorrhea grades was statistically not significant while the correlation between the age at menarche and the dysmenorrhea grades was found to be statistically significant. Majority of the participants had less than two hours of pain (33.3%) and most of them experienced the pain in the abdomen region (36.4%) and majority, i.e. 46.5% had mild pain. The duration of menstruation and duration of menstrual cycles were comparable in two groups but the heavy flow was significantly more in dysmenorrhea group compared to the normal group (P < 0.05)

Conclusion:

The prevalence of dysmenorrhea was high and it was related with age at menarche. Heavy flow was significantly more in dysmenorrhea patients.
Cesarean scar endometriosis
Authors: Mailaram Sowmya , Singh Alpana , Kumari N. Sreemani
Published: May 2024

Endometriosis is a common disorder in women of reproductive age. Scar endometriosis is an infrequent type of extrapelvic endometriosis associated with obstetrical and gynecological surgeries but is rarely observed in abdominal scar after cesarean section. We are reporting here a case of scar endometriosis in a 30-year-old woman involving subcutaneous and muscular planes following cesarean section. Preoperative diagnosis of cesarean scar endometriosis was made by clinical examination, radiological imaging, fine-needle aspiration cytology, and confirmed histologically after surgical excision.
Inclusion of scenario-based teaching in undergraduate medical education
Authors: Shrivastava Saurabh RamBihariLal , Shrivastava Prateek Saurabh
Published: May 2024

The process of medical education delivery and training of medical students with regard to making them competent in discharging a wide range of activities are a challenging task. The purpose of the current review was to explore the introduction of scenario-based teaching in the delivery of medical education in the undergraduation period. An extensive search of all materials related to the topic was carried out in the PubMed search engine, and a total of 8 articles were selected based upon the suitability with the current review objectives. The keywords used in the search include scenario-based teaching, coronavirus disease-2019, case scenario, and medical education in the title alone only. Scenario-based teaching has emerged as a useful and effective teaching-learning approach in the field of medical education for imparting the desired complex skills to the undergraduate medical students. These scenarios can be created either using a simulation with an aim to expose the medical students to a complex and an authentic scenario, which they are expected to encounter in the daily clinical practice. In the process of resolving the given scenarios, the students develop critical thinking, clinical reasoning, teamwork, leadership, and communication skills, which help them to be better in their roles. In conclusion, the scenario-based teaching is an effective approach to prepare the fresh crop of undergraduate medical students to the rapidly advancing needs of the branch of medicine. The best approach will be to incorporate scenario-based teaching along with other instructional strategies across different professional years and supplement the same with timely constructive feedback.
Prevalence and risk factors of overweight and obesity among college-going adolescents in Siddipet district
Authors: Ameer Shaik Riyaz
Published: May 2024

Background:

Obesity among children is a major public health problem in industrialized world and also in the developing countries such as India. The prevalence is increasing at an alarming rate worldwide. India is going to become fourth country in terms of the greatest number of children with obesity.

Objective:

To study the prevalence and risk factors of overweight and obesity among college-going adolescents.

Methods:

Present cross-sectional study was carried out among 600 adolescents of 15–19 years. Pretested questionnaires were used to collect personal information, socioeconomic particulars, lifestyle patterns, and dietary habits. Body mass index (BMI) was calculated by formula weight (kg)/height (m2). Based on the BMI charts developed by IAP, percentile for BMI was taken as a standard. Underweight students were excluded from the analysis. First correlation was carried out among BMI and all other variables. Significantly correlated variables were entered in the multiple linear regression model. Significant variables (P < 0.1) on Chi-square were entered in multiple logistic regression (MLR) model. Adjusted odds-ratio (OR) were compared with the crude odds ratio for each variable. P < 0.05 was considered statistically significance.

Results:

The prevalence of overweight and obesity in both the sexes was found to be 17.7% in the present study. On crude analysis, being female (OR = 1.957 [1.272–3.01]), father being skilled or professional (OR = 8.184 [4.539–14.76]), father being educated at intermediate or higher (OR = 6.567 [4.132–10.44]), belonging to Social Class I and II (OR = 6.29 [3.362–11.77]), being nonvegetarian (OR = 1.663 [1.035–2.671]), and eating four times/day (OR = 1.717 [1.045–2.823]) were found to be significant risk factors for being overweight and obese among adolescents. However, final model of MLR showed that being female, father being highly educated, and belonging to higher social class were significant predictors of overweight and obesity.

Conclusion:

The prevalence of overweight and obesity among these college-going adolescents was high. Being female, father being highly educated and belonging to higher social class were the significant predictors of overweight and obesity.
Guidelines for Repair Process Evaluation of Aluminum Bonded Structure
Authors:   AMS CACRC Commercial Aircraft Composite Repair Committee
Published: May 2024

This SAE Aerospace Information Report (AIR) is intended to be used as a process verification guide for evaluating implementation of key factors in repair of metal bond parts or assemblies in a repair shop environment. This guide is to be used in conjunction with a regulatory approved and substantiated repair and is intended to promote consistency and reliability.
Elastomer, Acrylonitrile Butadiene Rubber (NBR) 55-65 Type A Durometer Hardness Petroleum-Base Hydraulic Fluid Resistant
Authors:   AMS CE Elastomers Committee
Published: May 2024

This specification covers an acrylonitrile-butadiene (NBR) elastomer that can be used to manufacture product in the form of sheet, strip, tubing, extrusions, and molded shapes. For molded rings, compression seals, O-ring cord, and molded-in-place gaskets for aeronautical and aerospace applications, use the AMS-P-83461 specification or the MIL-PRF-25732 specification.
The Application of Contemporary Methods According to the Curriculum for the Course of the Albanian Language in Primary Education
Authors: Xhemajli Arbona , Mehmeti Liridona
Published: May 2024

The curriculum field "Languages and communication" for primary education enables students to develop simple skills, such as: the difference between literary and non-literary texts, the recognition of the basic language system forms (phonetics, morphology, syntax), the development of expression skills through different linguistic means.This curricular area in primary education, based on the Curricular Framework, contains the following courses: mother tongue, first foreign language (English language, German language). This field also prepares students for functional, clear and substantive communication. Given the importance of using modern teaching methods, we intend to treat this research paper from the point of view of the application of contemporary methods in the Albanian language course, which we consider necessary for the identification of activities that influence the implementation of the curriculum in the course of the Albanian language. In order to carry out the research, we use the qualitative and quantitative method, preparing a questionnaire for the teachers of the Albanian language at the level of primary and lower secondary education, more precisely of grades VI-IX, in the Municipality of Gjilan, Vitia, Kamenica and Ferizaj. We also do a partial observation during the lessons wiin the Albanian Language course. From the findings of the research, we consider that contemporary methods are applied in the teaching of the Albanian language subject in primary education.
Reimagining Postgraduate Supervision: Fostering Inclusivity and Support for Students at-risk in Open and Distance Learning Environments
Authors: Manase Ndakaitei , Ngubane Sindile
Published: May 2024

This qualitative study involves six lecturers who have supervised students with disabilities. Participants were purposively selected and interviewed telephonically using semi-structured interviews. The study adopted a thematic data analysis approach to identify patterns in supervision experiences. The paper problematises a deficit approach that is dominantly adopted to identify and design programmes and manage students-at-risk. The analysis of the supervision of postgraduate students-at-risk is framed within the Humanising pedagogy which advances the accommodation of students’ unique needs to develop their capacities for success. This theoretical framework is not adopted much in the open and distance learning context at postgraduate level and the use of supervisors’ insights adds new knowledge to the field that is dominated by students’ experiences. The study established that students do not communicate their disabilities to supervisors timely for early intervention, supervisors are responsive to students’ challenges which include difficulties in academic writing and limited access to research resources and technologies, and supervisors experience systemic challenges in acquiring assistive technology for students with disabilities. This study proposes a humanised supervision model that advances disability inclusivity.
Lenguaje expresivo en niños con diagnóstico trastorno del espectro autista en etapa escolar
Authors: Vela Calderón Miriam Haydeé
Published: May 2024

PROBLEMA: las limitaciones en la etapa escolar por la ausencia del lenguaje no verbal en los niños con trastorno del espectro autista. OBJETIVO: conocer del lenguaje no expresivo en niños con diagnostico TEA y la escolarización ya que es conocida como un fenómeno de lingüística sin hacer uso y es solo por contacto visual, expresiones faciales, posturas, gestos, uso de señales y la distancia con el contacto físico.  MÉTODO: se realizó un estudio de tipo cualitativo, en el cual se recabó información teórica por medio de buscadores académicos confiables y repositorios de Revistas Académicas Indexadas CUNZAC, tomando en cuenta como universo la población infantil. RESULTADOS: se determinó que el lenguaje no es una conducta por lo cual debe obedecer a estados mentales profundos para desarrollar habilidades pragmáticas que en niños con diagnóstico TEA no pueden conceptualizar, por lo tanto, no hay lingüística. CONCLUSIÓN: no se trata de niños que no tienen habla sino de niños que manifiestan deficiencias que pueden ser cognitivas, dificultades en el desarrollo del lenguaje, así como problemas con el contacto visual y el contacto generando dificultades, que afectan el habla y el lenguaje y esto los hace en mayor grado dependientes de su entorno, de sus padres o cuidadores.
In-silico predictive binding affinity and ADMET of novel n-[5-(2-fluorophenyl)-1, 3, 4-oxadiazole-carboxamide derivatives towards prot
Authors: Chukka Ajay Kumar , Sireesha Ch , M Leela Supraja , M Dileep Chowdary , M Hanumanthu Sai , Sk Irfan , J N.Suresh Kumar
Published: May 2024

Abstract: The present study experimentally investigated the nitro-substituted heteroaromatic carboxamidesas effective against PKnGof Mycobacterium tuberculosis. Here we designed 15 heteroaromatic carboxamides[A1-B5]. The activities of the compounds can be explained in terms of docking results and biological activity by ADMET prediction. Protein Kinase G is a thioredoxin-fold containing eukaryoticlike serine/threonine Protein Kinase is a virulence factor in Mycobacterium tuberculosis. In present study the compounds A7, A2, A5& A6 are the candidates that shows the good results in Molecular Docking and these are tested against the reference compound that is stand Anti-TB agent Isoniazid.