bluuebunny/crossref_metadata_2025 huggingface dataset:
Making Transfusion Medicine a Journey from Good to Great by Using Quality Indicators and Bringing in Continuous Quality Improvement
Authors: Gupta Monica
Published: August 2023

From its foundational years, transfusion medicine (TM) has been associated with errors and their reporting. Patient safety and quality were brought to the forefront of health care through the Institute of Medicine's two reports followed by the WHO (2004) forming a world alliance of 140 nations. Error reporting in TM has gradually evolved into continuous quality improvement (CQI) and risk management. The review provides insights into the use of quality indicators (QIs), quality tools, and CQI and the models for improvement in TM. QIs in TM have been identified in the past decade; a comprehensive list is provided by the International Society of Blood Transfusion (2019). Analysis of QIs by different tools aids decision-making. Root cause analysis is best carried out using the 5 Whys along with fishbone analysis. Failure-mode-effect-analysis is useful for risk assessment. A process map helps in identifying bottlenecks in a process. A Pareto diagram identifies the “vital few” problems. Likewise, histogram, run diagrams, scatter diagram, and driver diagram, have their own use. Underperforming indicators need to be taken up for quality improvement projects (QIPs). QIPs are designed and implemented by using any of the models available, depending on the problem on hand: the Model for Improvement, FOCUS-PDCA, Six Sigma, and Lean Six Sigma. The utility of clinical audits in improving the quality of transfusion practices and processes cannot be overemphasized. With a structured approach, “goodness” in TM can be measured, and made better. CQI ensures that the journey does not end at “good to great” but continues to progress from “great to greater.”
COVID-19 Immunoglobulin G Antibodies in Healthy Blood Donors Paving Way to Herd Immunity
Authors: Sareen Rateesh , Gupta GN , Agarwal Pankaj , Saini Shyan
Published: August 2023

Background and Objectives:

Herd immunity is the immunity or resistance to particular infection that occurs in group of people when a very high percentage of individuals have been vaccinated or previously exposed to infection. The goal of this study was to assess the development of herd immunity to COVID-19 in parts of Western India.

Methods:

The study was conducted at a tertiary care hospital in India on routine blood donors who were tested for SARS-CoV-2 immunoglobulin G (IgG) antibody. We systematically investigated 808 healthy donors at various points of time in the 3-month period starting from September 2020 to November 2020 for SARS-CoV-2 seroprevalence.

Results:

The results of November month show a sudden increase (51.96%) in the later half. The seroprevalence in healthy donors in other towns and cities shows an aggregate average of SARS-CoV-2 IgG antibody 13.59% (200/1472) as against Jaipur city with 36.12% (292/808). Deedwana has higher seropositivity in blood donors 31.5% (24/76) whereas Sujangarh and Jhunjhunu did not have any donors with seropositive status.

Conclusion:

Our findings could be the tip of iceberg of emerging herd immunity to SARS-CoV-2 infection in India. Future research will determine how long these antibodies will last. Will they be protective toward future COVID-19 infection?
BRCA1 promoter methylation & its immunohistochemical correlation in sporadic breast cancer
Authors: Khan Fatima , Agarwal Preeti , Gupta Sameer , Maurya Malti Kumari , Singh Pooja , Agarwal Apoorva , Singh Kulranjan , Sonkar Abhinav Arun , Goel Madhu Mati
Published: August 2023

Background & objectives:

Studies have shown that apart from hereditary breast carcinomas, breast cancer susceptibility gene 1 (BRCA1) mutations conferring to its loss are seen in sporadic breast carcinomas (SBC) as well. The aim of the present study was to assess BRCA1 methylation in females presenting at King George’s Medical University, Lucknow, with SBC by both immunohistochemistry (IHC) and methylation PCR with respect to hormonal profile and various morphological prognostic parameters. The primary objective was to look for the association between BRCA1 protein expression and DNA promoter methylation.

Methods:

81 mastectomy specimens from SBC of invasive breast carcinoma (no special type) were included in this study. After a detailed morphological assessment, formalin fixed paraffin embedded tissue from a representative tumour area was selected for BRCA1 IHC by heat-mediated antigen retrieval under high pH and DNA extraction and further bisulphate treatment. BRCA1 was studied for methylation by methylated and unmethylated PCR-specific primers.

Results:

BRCA1 promoter methylation was present in 42/81 (51.9%) participants, with significant BRCA1 protein loss (72.7%; P=0.002). A significant association between BRCA1 loss and hormonal profile was found (P=0.001); maximum in triple negative breast carcinoma (TNBC) (72%; 18/25). Most of the TNBC also harboured methylation (68%). Although not significant grade II and III tumours, lymph vascular invasion, ductal carcinoma in situ, and nodal metastasis (≥3) were seen in a higher percentage in methylated tumours. Mortality in SBC was significantly associated with BRCA1 loss (30.3%; P=0.024).

Interpretation & conclusions:

Study results highlight the concept of “BRCAness” in SBC as well. Hence, we can confer that identification of BRCA1 loss in SBC can make it a perfect candidate for poly ADP-ribose polymerase inhibitors or cisplatin-based therapy like hereditary ones.
Mortality Rate and Acute Kidney Injury Prevalence Reduction in COVID-19 Critical Patients Treated with Hemoperfusion
Authors: Barriga-Moreno Adriana P. , Lozano-Sanchez Marcela , Barón-Alvarez Rafael A. , Cordoba Juan P. , Aroca-Martinez Gustavo , Dianda Daniela , Gonzalez-Torres Henry , Musso Carlos G.
Published: August 2023

Introduction:

Coronavirus disease 2019 (COVID-19) induces organic damage mainly through the patient’s immune overreaction. Hemoperfusion (HPF) can remove inflammatory cytokines and can reduce the negative effects of cytokine storm in COVID-19. We compared the mortality rate, inflammatory response, and acute kidney injury (AKI) prevalence among patients suffering from respiratory insufficiency secondary to COVID-19 treated with and without HPF with HA330 cartridge.

Methods:

Mortality rate, serum creatinine, and ferritin values were compared between patients suffering from respiratory insufficiency secondary to COVID-19 who received conventional treatment and another group of patients who additionally received four sessions of HPF with HA330.

Results:

Of 116 patients suffering from acute respiratory insufficiency secondary to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), one group (n: 84) received support treatment and the other group (n: 32) additionally received HPF with HA330 cartridge. Both groups had no renal disease and similar age and comorbidities at admission, except for obesity and mechanical ventilation requirement, which were significantly higher in the HPF group. Mortality rate (61% vs. 31%, P: 0.008), serum creatinine (1.4 vs. 0.5 mg/dl, P < 0.001), and post-HPF serum ferritin (2868 vs. 1675, P < 0.001) were significantly lower in the HPF group.

Conclusion:

Mortality rate, serum ferritin, and AKI were significantly reduced in critical COVID-19 patients who received HPF with HA330 cartridge than in those who did not receive it. These results were obtained despite the HPF group risk factors, such as obesity and mechanical ventilation, worsening its prognosis.
Hydroxychloroquine-Induced Phospholipidosis – A Forgotten Complication of a Common Drug
Authors: Kothapalli Nagamounika , Padiyar Shivraj , Nair Aswin M. , Manikuppam Prathyusha , Matthai Smitha M. , Roy Sanjeet , Pulimood Anna , Alexander Suceena , Mathew John
Published: August 2023

Hydroxychloroquine (HCQ) has immunomodulatory and immunosuppressive properties and is used in many rheumatological conditions like systemic lupus erythematosus, rheumatoid arthritis, and Sjogren’s syndrome. It is usually a widely used and well-tolerated DMARD (Disease Modifying Anti Rheumatic Drugs). Its most feared toxicities include retinopathy and, rarely, cardiomyopathy. Among its other reported side effects is drug-induced phospholipidosis. Here, we report two cases of HCQ-induced phospholipidosis based on renal biopsy electron microscopy. HCQ-induced phospholipidosis, although uncommon, must be considered as one of the differentials in a patient with persistent proteinuria.
Genetic polymorphisms of microsomal epoxide hydrolase and UDP-glucuronosyltransferase (UGT) and its effects on plasma carbamazepine levels and metabolic ratio in persons with epilepsy of South India
Authors: Venkatraman Shravan , Ramasamy Kesavan , Nair Pradeep Pankajakshan
Published: August 2023

OBJECTIVES:

Carbamazepine (CBZ), an anti-seizure drug, is widely prescribed for the management of focal seizures. At a given therapeutic dose, CBZ exhibits marked interindividual variation in the plasma CBZ levels. The aim wasto study the influence of EPHX1 c.337 T>C and UGT2B7*2 genetic polymorphisms on plasma carbamazepine (CBZ) levels in persons with epilepsy (PWE) from South India.

METHODS:

115 PWE belong to South India origin who are on carbamazepine monotherapy were recruited. Genotyping of the two variants weredone using RT-PCR method. PWE who had seizure freedom for one year and their last dose which was not changed for one year duration were included and their plasma levels of CBZ and its active metabolite CBZ 10,11 epoxide were analysed by reverse phase HPLC.

RESULTS:

In EPHX1 c. 337 (T>C) polymorphism, the PWE carrying CC had lower plasma CBZ levels when compared to CT genotype (2.45 μg/ml vs 3.15 μg/ml. In UGT2B7*2, PWE carrying homozygous mutant TT had higher levels when compared with CT (3.09 μg/ml vs 2.74 μg/ml) genotype but found no statistical significance. Mutant genotype of EPHX1 (CC) had higher metabolic ratio compared to TT genotype (1.33 vs 1.17) but not found to be statistically significant. Mutant genotype of UGT2B7*2 (TT) was found to be having lower metabolic ratio when compared with CC genotype (1.18 vs 1.35; p value =0.08).

CONCLUSION:

PWE carrying EPHX1 c.337 T>C (rs1051740) and UGT2B7*2 (rs7439366) genetic polymorphisms did not affect the plasma CBZ levels and metabolic ratio of PWE of South Indian origin. However, this finding should be confirmed in a larger sample size which may help in optimization and personalized CBZ therapy in South Indians.
Carpal tunnel syndrome ascribed to low-dose combined oral contraceptive pills
Authors: Yedla Deepthi , Vijayan Sharmila , Babu Thirunavukkarasu Arun
Published: August 2023

Carpal tunnel syndrome (CTS) is the most prevalent compressive focal mononeuropathy brought on by median nerve compression, and common manifestations include pain in the wrist joint, decreased sensations along the distribution of the median nerve, a reduction in two-point discrimination, nighttime awakening, and, in more advanced stages, thenar muscle wasting and weakening. CTS, although common, yet underreported adverse effects of oral contraceptives. We report a case of 21-year-old female who developed CTS after using low-dose combined oral contraceptive pills for irregular cycles with polycystic ovary disease.
A cross sectional analysis of medical device associated adverse events with radiotherapy devices - A materiovigilance study
Authors: Raghav M. V. , Geetha A. , Purushotham V. S. , Mamatha K. , Rajesh J. , Raghuvanshi Rajeev , Kalaiselvan Vivekananda , Shukla Shatrunjay , Hariharan V. , Gowda B. Naveen
Published: August 2023

BACKGROUND:

Materiovigilance is a method for tracking, documenting, and analyzing the causal factors of adverse outcomes or complications associated with the use of medical devices. In addition, it recommends that the Indian regulatory authority takes necessary steps with the aim of enhancing patient safety. The present study was taken up as there are hardly any studies available in the public domain on adverse events due to radiotherapy.

OBJECTIVE:

The objective of the study is to analyze the pattern of adverse events due to medical devices used in the department of radiation oncology.

METHODS:

It was a cross-sectional study carried out from June to September, 2022. The patients who were treated with the medical devices in radiation oncology at Victoria Hospital affiliated with Bangalore Medical College and Research Institute, Bengaluru, were included. The medical device used on the patients causes adverse events. The data were collected from the patient's health records available in the department of radiotherapy.

RESULTS:

Total 40 adverse events collected as per inclusion and exclusion criteria were analyzed. All the adverse events associated with medical devices were filled in the medical device adverse event reporting form and submitted to materiovigilance program, which also included the causality assessment. All the adverse events were caused due to external beam radiotherapy/teletherapy device. Dermatitis was the most common adverse event found in the reported cases (n = 20, 50%).

CONCLUSION:

Materiovigilance program is in budding stage. It was observed that the adverse events in patients were due to medical devices used in radiation oncology. Medical devices with skin-sparing effect (radiation is converged onto tumor) should be promoted and more research and engineering are required in designing of advanced medical devices for the treatment of cancer across the globe.
Pediatric Psoriasis: A Closer View on Clinical Presentations
Authors: ALHamdi Dooha Khalil , ALHamdi Khalil Ismail
Published: August 2023

Introduction:

Psoriasis in children is not uncommon. The study is an attempt to shed light on its clinical presentations among children in Basrah, Iraq.

Materials and Methods:

A cross-sectional observational clinical study of 416 children with psoriasis was conducted in the department of Dermatology of Basrah teaching hospital and two private clinics, Basrah, Iraq, from November 2018 to December 2021. Detailed history and a complete clinical examination were done. In cases of doubt, skin biopsy was performed.

Results:

Four hundred and sixteen children with psoriasis were enrolled in this study, their age ranged from 11 months to 12 years, 236 of them were females, and the remaining 180 were males. Psoriasis of the scalp, eyelid, blepharitis, follicular, and guttate were the most common types reported in 61.8%, 11.05%, 10.3%, and 9.8%, respectively. Plaque psoriasis was reported in only 6.2% of the patients. Atypical presentations in shape and site were reported in 122 (29.3%) of the patients. Infections, emotional stress, and environmental factors were the most common precipitating causes.

Conclusions:

Psoriasis is not uncommon among children; the presentations may be atypical regarding clinical features, site affected, symptoms, family history, and gender, so that it should be considered in any child with chronic recurrent erythematous scaly skin lesions, especially when they are recurrent with poor response to treatment.
Eczema Coxsackium: An Unusual Manifestation of Hand, Foot, and Mouth Disease
Authors: Indra C. Kanmani , Mathews Jerene , Devanda Rajendra , Munisamy Malathi
Published: August 2023

Eczema coxsackium is an atypical manifestation of hand, foot, and mouth disease (HFMD). It is a rare manifestation and can be easily mistaken for eczema herpeticum or impetigo. We report two male infants (twins) of 6 months of age who presented with 2 days of fever and diarrhea followed by an erythematous rash over the diaper region with multiple eroded papules. As the presentation coincided with a seasonal clustering of HFMD cases, eczema coxsackium was suspected. Polymerase chain reaction for pan-enteroviral RNA was positive in a throat swab, and a diagnosis of eczema coxsackium over the diaper dermatitis was made.
Pattern of Noninfectious Pediatric Dermatoses at a Tertiary Care Center in Gujarat
Authors: Agarwal Pooja , Jagati Ashish , Patel Shefali , Ambasana Akshay R. , Chaudhari Snehal V. , Rathod Santoshdev P.
Published: August 2023

Introduction:

Pediatric dermatoses are commonly encountered in the dermatology outpatient department with various presentations in the form of infective and noninfective dermatoses. The incidence and severity of these dermatoses are influenced by geographic, cultural, genetic factors and socioeconomic status. This study was planned to evaluate the burden and pattern of disease among children.

Materials and Methods:

This was an ambispective observational cohort study, and all the children <12 years of age with noninfectious dermatoses were included from July 2020 to December 2020.

Results:

We included a total of 1206 pediatric patients in 0–12 years of age with dermatological complaints, of which noninfectious dermatoses were 53% (n = 639) and infectious dermatoses 47% (n = 567). Out of them, 340 (53%) were males and 299 (47%) were females. Among all noninfectious dermatoses, eczema (30%) was found to be the most common dermatosis in our study.

Conclusion:

The present study focused on noninfectious dermatoses and highlighted the fact that they form a considerable burden of pediatric dermatoses.
Do past and present adverse experiences impact the mental health of children? A study among children in the Juvenile Justice System in India
Authors: Srinivasan Shiva Prakash , Arumugam Chiranjeevi , Anandan Ananya , Ramachandran Padmavati
Published: August 2023

Background:

Children in the Juvenile Justice System (JJS) in India include children who may have engaged in criminal acts and children who cannot be cared for by their families of origin for various reasons. Given the nature of the children in such circumstances, they face multiple challenges growing up. Few studies from India have systematically explored interpersonal experiences, including adverse childhood experiences (ACEs) or bullying experiences, and their effects on these children’s mental health.

Materials and Methods:

A cross-sectional study was conducted using standardized scales to identify the frequencies of and relationships between life experiences and current mental health outcomes (stress, well-being, and psychopathology) faced by children residing in seven child care institutions (CCIs) across two states in India.

Results:

Of the 278 children who participated in the study, at least one ACE was endorsed by 86.7%, and at least one instance of bullying was experienced by 71.7%. A significant negative correlation was noted between the number of ACEs, bullying experiences, and well-being and a significant positive correlation with stress and psychopathology. Information about the family of origin was significantly associated with lower psychopathology and stress scores.

Conclusions:

This study highlights the relationship between mental health outcomes, ACEs, and bullying experiences in children in the JJS in India. The study identifies the immediate and ongoing effects of these experiences on children’s mental health and, thus, focuses on the need for appropriate interventions to allay the effects of these experiences.
Effect of vortioxetine versus venlafaxine on cognitive functions in adults with major depressive disorder: A randomized-controlled trial
Authors: Manna Chayan K. , Ranjan Rajeev , Kumar Pankaj , Ahmad Shamshad , Nath Santanu
Published: August 2023

Background:

Vortioxetine and venlafaxine are antidepressants which have shown established efficacy to treat major depressive disorder (MDD). There are no studies that compared them for their efficacy in cognitive symptoms of depression. The study aimed to compare the effect of vortioxetine and venlafaxine on the change in cognitive scores in adults with MDD.

Methods:

The present study was an open-label, active-controlled parallel design randomized clinical trial. After randomization, baseline clinical evaluations by Montgomery–Asberg Depression Rating Scale (MADRS) and Social and Occupational Functioning Assessment Scale (SOFAS) were done and coding (subset of WAIS-IV), WCST, TMT, Stroop test, PGI memory were used to assess cognition in 100 unmedicated MDD patients. They were reassessed after eight weeks of monotherapy with vortioxetine or venlafaxine.

Results:

Primary cognitive measure (coding score) was found to be significantly higher (Mean Difference = 0.680; 95% CI:.202 to 1.158; P = 0.006) in vortioxetine in comparison with venlafaxine. Stroop test scores (word score, color score, color–word score) were also found to be significantly higher with vortioxetine. In other cognitive measures (WCST scores: total trials, total errors score, total perseverative responses score, total perseverative errors scores; TMT-A and B scores), a significant decrease in scores with vortioxetine in comparison with venlafaxine were observed. A significant decrease in MADRS and increase in SOFAS scores were observed with vortioxetine in comparison with venlafaxine. Both the drugs alleviated the symptoms of depression but vortioxetine was better tolerated.

Conclusion:

Our study findings suggest that improvement in cognitive scores is significantly higher with vortioxetine than venlafaxine over the eight weeks of monotherapy.

Clinical Trial registration number:

CTRI/2020/07/026819 (Registered with Clinical Trials Registry- India).
Depression, sleep, body image, and lifestyle: Prevalence and associated factors of depression among school-going adolescents in Delhi National Capital Region
Authors: Khanna Tejasvini , Banerjee Bratati , Majhi Madan M. , Futela Dheeman
Published: August 2023

Background:

Adolescents are known to be vulnerable to depression, which worsened during the COVID-19 pandemic. They also exhibit poor sleep quality and body image issues (BIIs) which are considered risk factors for depression. There is a paucity of Indian studies regarding adolescent depression and its correlation with lifestyle.

Aims:

To detect the prevalence of depression in adolescents, and understand its association with sociodemographic variables, sleep quality, BIIs, and lifestyle factors.

Materials and Methods:

A cross-sectional study was conducted among 392 adolescents attending classes 8th–12th in two schools in Delhi National Capital Region. A pre-tested semi-structured questionnaire was used to collect sociodemographic and lifestyle data. Depression anxiety stress scale-21 was used to detect depression. Pittsburgh Sleep Quality Index and Stunkard Figure Rating Scale were used to evaluate sleep quality and BIIs. Data was analyzed using Statistical Package for Social Sciences Version-25.

Results:

Depression was present in 40.3% of students. It was more common in girls, older students, students in higher classes, who lacked siblings and whose mothers were engaged in professions as well as those with BIIs. However, after multivariate analysis, the association of depression with poor sleep quality, meal skipping, lack of exercise, family history of mental illness, and inverse association with open discussion of one’s thoughts and worries with family remained significant.

Conclusions:

Depression is common among adolescents and shows associations with poor sleep quality and lifestyle choices. Awareness of these associations may enable better screening and early intervention for vulnerable adolescents.
Exploring internet addiction and its associated factors among college students in Western Rajasthan, India: A mixed-methods study
Authors: Rajasekhar Thota , Naveen Kikkeri Hanumantha Setty , Raghav Pankaja , Aneja Jitender , Thirunavukkarasu Prasanna , Dutta Gitashree , Srinivasan Srikanth , Sharma Prem Prakash , Gupta Manoj Kumar , Goel Akhil Dhanesh
Published: August 2023

Background:

With near universal use of internet by college students, there is propensity for internet addiction (IA) among them. This study aimed to estimate the prevalence and predict the factors for internet addiction among college students in Jodhpur, Rajasthan, India, and qualitatively explore the factors associated with internet addiction.

Materials and Methods:

Explanatory sequential (QUAN-QUAL) mixed-methods design was used. A cross-sectional questionnaire-based survey was conducted among three streams of undergraduate colleges (health, engineering, and others). Survey instruments included Young’s internet addiction test (IAT), Pittsburgh Sleep Quality Index (PSQI), and Depression, Anxiety, and Stress Scale-21 (DASS-21) Items. Focus group discussions (FGDs) and in-depth interviews (IDIs) among the students with mild-to-moderate levels of addiction were conducted to understand the reasons for excessive internet use.

Results:

The prevalence of internet addiction (IA) among the college students was 51% and the rates for mild, moderate, and severe addiction were 31.8%, 18.5%, and 0.7%, respectively. Predictors of IA were male gender, age in years, age of first internet use in years, urban origin, accessing internet at college, mobile internet use, using internet to make online friendship, sleep disturbance, depression, anxiety, and stress. Qualitative study identified five major themes related to situations initiating internet use for nonacademic purpose, content of internet use, triggers for internet overuse/addiction (IA), perceived impact of IA, and measures to overcome IA.

Conclusions:

Internet addiction was found to be highly prevalent in college students across various streams. Qualitative results provide deeper insights into IA among college students. It is imperative to screen for IA among the students and devise suitable preventive interventions, which can be easily implemented at community level.
Usage and cost-effectiveness of anti-psychotics in psychiatry OPD among various clinical conditions: A prospective observational study in a tertiary care center
Authors: Saini Reshabh , Dhinakaran Chandrasekaran , Raina Rohit , Gandhibabu Ramanathan , Krishnasamy Kathiresan
Published: August 2023

Background:

Psychotropic medications are prescription drugs that are commonly used to control some symptoms associated with many different types of mental ill health. Although they cannot cure a patient illness, they can assist with the management of some extremely distressing symptoms and this in turn can facilitate individuals in leading a more fulfilled life.

Aims and Objective:

This study attempts to collect the demographic details of the outpatient in the psychiatric department and to describe the usage, prescribing trends and cost-effectiveness of antipsychotics in psychiatry OPD among various clinical conditions to older and younger patients with psychiatry disorders.

Material and Methods:

This study was a prospective observational study, conducted over a period of 6 months from November 2021 to April 2022 in the Department of Psychiatry, Chidambaram Government Medical College and Hospital, a 1400 bedded multi-specialty tertiary care teaching hospital, Tamil Nadu Dr. M.G.R. Medical University Chennai, Tamil Nadu. The recruitment of subjects was carried out with the help the physicians who had the knowledge of patient’s history and caregivers consenting to the study protocol and patients with case sheets carrying antipsychotics prescription.

Observation and Results:

A total number of 150 cases were enrolled in this study. All psychiatric OPD cases were studied and the results were taken. Based on the inclusion and exclusion criteria, 93 were the anti-psychotics prescribed cases and 57 were the non-anti-psychotics prescribed cases. Out of 93 patients, 69.89% (65 patients) were male and 30.10% (28 patients) were female. Out of non-psychotic 57 patients, 27 were male patients and 30 were female patients. Out of the 93 OPD patients, 40% of the patients have psychological based symptoms followed by 17% of patients have behavioral symptoms. 86.02% of patients received atypical antipsychotic medications in comparison with 36.55% of patients received the typical antipsychotic medications.

Conclusion:

In this study, we had observed the usage and types of anti-psychotic drugs to control and minimize the different psychotic symptoms among the OPD patients. Maximum antipsychotics studied were cost-effective and cheaper in Pradhan Mantri Bhartiya Janaushadhi Pariyojana (PMBJP) as compared to Intas, Torrent, Sun, Linux, Cipla, Abbott, Alkem, and Sanofi.
A cross-sectional study of opinion about mental illness among undergraduate medical students with and without exposure to the psychiatry clinical rotation/postings during their undergraduate training
Authors: Raj B. Neeraj , Shivakumar B. K. , Vinay H. R.
Published: August 2023

Background:

A positive attitude toward mental illness is a prerequisite for the provision of holistic care. Thus, a study was undertaken to know the opinion about mental illness among medical students with and without exposure to the psychiatry clinical rotation/postings during their undergraduate training.

Materials and Methods:

This is a descriptive, cross-sectional study conducted at Adichunchanagiri Institute of Medical Sciences (AIMS), Karnataka. The sample comprised medical undergraduate students with and without exposure to psychiatry clinical postings, respectively. Self-administered socio-demographic and opinion about mental illness (OMI) questionnaires were used to collect the data.

Result:

Medical undergraduates from 1st and 2nd years who were unexposed to psychiatry and students from 3rd and 4th years who had exposure to psychiatry constituted about 52.17% (n = 252) and 47.83% (n = 231) of the overall sample size. A positive opinion toward mental illness was seen across various subsections of OMI questionnaire, especially in students who had attended psychiatry clinical posting.

Conclusion:

Opinions can change based on one’s experiences. A positive opinion toward mental illness was seen across medical undergraduate students who had completed psychiatry clinical postings in our study. The study provides valuable insights across various domains or areas wherein a teacher can focus and adjust the teaching methodologies accordingly. In the long run, it might have a positive influence on medical students to understand mental disorders, diagnose them, and manage patients with mental illness.
Characteristics of Centenarian Studies and Variables Related to Longevity
Authors: Teo Shyh Poh
Published: August 2023

Studying centenarians requires a “positive biology” approach, where rather than focusing on disease, the research aims to understand the causes of positive phenotypes and explain biological mechanisms of health and longevity. This review outlines the characteristics of the key centenarian studies. Variables that may relate to the longevity of these oldest old are also described, including cardiovascular health, cognitive function, physical ability, mental and cognitive health, personality, and the social circumstances of the centenarian.
Nutritional Status and Food Environment of the Elderly Population Residing in Tea Gardens of a Block of Darjeeling District, West Bengal, India
Authors: Sullar Kunal Singh , Dasgupta Pallabi , Ishore Kaushik
Published: August 2023

Objectives:

In India, poverty, illiteracy, and difficult terrains make the tea garden elderly population more vulnerable to malnutrition. The food environment shows the interface through which consumers interact with their food system. Hence, the present study was done to assess the nutrition status and identify the sociodemographic and food environmental factors affecting the nutritional status of the elderly population residing in tea gardens of Naxalbari block, Darjeeling district, West Bengal, India.

Materials and Methods:

A community-based cross-sectional study was conducted in all tea gardens of Naxalbari block, Darjeeling, from March 2022 to September 2022, among older people aged 60 years and above selected by simple random sampling. Using the predesigned, pretested questionnaire, the Mini Nutritional Assessment tool for nutritional assessment and the elderly population's perceived food environment was determined based on five points Likert's scale. Perceived food environment clusters were identified using a two-stage cluster analysis. Binary logistic regression was used to determine predictors of nutritional status.

Results:

Out of the 294 study participants, the majority of 190 (64.6%) of the older people were at the risk of malnutrition, 18 (6.1%) malnourished, and 86 (29.3%) had normal nutritional status. Binary logistics regression showed older people who were illiterate (adjusted odds ratio [AOR] 14.864; 95% confidence interval [CI]; 4.311–51.457) and not working (AOR 3.775; 95% CI; 1.753–8.128) had significantly higher odds of being undernourished. Older people who perceived a favorable food environment (AOR 0.408; 95% CI; 0.214–0.775) had significantly lesser odds of being undernourished.

Conclusion:

Tea garden older population is at higher risk of malnutrition. Illiteracy, working status, and perceived favorable food environment plays important role in altering the nutritional status of the elderly. Prior interventions such as awareness regarding food nutrition and developing elderly friendly food environment are needed.
Socket shield technique: Stress distribution analysis
Authors: Neves Ricardo Guimarães , Lazari-Carvalho Priscilla Cardoso , Carvalho Marco Aurélio , Carvalho Alexandre Leite , Souza João Batista de , Torres Érica Miranda
Published: August 2023

Background:

To analyze through finite element analysis the stress distribution in peri-implant bone tissues, implants, and prosthetic components induced by the socket shield (SS) technique in comparison to other techniques used to treat tooth loss.

Materials and Methods:

A three-dimensional model of a superior central incisor crown supported by implant was modeled and three different placement conditions were simulated: SS – 2.0-mm-thick root dentin fragment positioned between the alveolar buccal wall and implant; heterologous bone graft (HBG) – bovine bone graft positioned the alveolar buccal wall and implant; and control (C) – implant fully placed in bone tissue of a healed alveolus. The model was restricted at the lateral surfaces of the bone tissue and the following loads were simulated: Both oblique (45°) loads of 100 N on the lingual surface of the crown (maximal habitual intercuspation) and 25.5 N on the incisal edge of the crown (tooth contact during mandibular protrusion) were simultaneously applied. Tensile stress, shear stress, compression, and displacement were analyzed in the cortical bone, trabecular bone, dentin root fragment, and bone graft; while equivalent von Mises stresses were quantified in the implant and prosthetic components.

Results:

Stress values of SS and HBG in the bone tissues were higher than C, while slight differences within models were observed for dentin root fragment, bone graft, implant, and prosthetic components.

Conclusions:

The SS technique presented the highest stress concentration in the peri-implant tissues.
Current state about root coverage using soft-tissue substitutes in the presence of noncarious cervical lesions: A literature review
Authors: Huamán-Mendoza Aldrin André , Reis Isabella Neme Ribeiro Dos , Ganhito Juliana Assef , Carvalho Cassio Volponi , Micheli Giorgio De , Pannuti Claudio Mendes
Published: August 2023

About half of the cases of gingival recession are associated with the noncarious cervical lesion (NCCL), resulting in combined defects (CDs). NCCL negatively affects the root coverage outcomes. In addition, considering the morbidity associated with graft harvesting, soft-tissue substitutes (STSs) appeared as a suitable option for connective tissue grafts for surgical root coverage. Currently, the literature addressing the therapy of CDs employing STSs is scarce. Thus, the present review aimed to update the literature and outline the future perspectives about root coverage of CDs using STSs. A detailed literature search was conducted on MEDLINE, Web of Science, EMBASE, LILACS, Scopus, and Google Scholar databases using keywords and Boolean operators. Randomized clinical trials (2) and case reports (6) were included. None of the selected studies reported any adverse effect using STSs. Based on the limited evidence available, we cannot state that STSs may benefit the periodontal clinical and patient-centered outcomes. Randomized controlled trials are needed to assess the long-term outcomes, surgical approaches, and restorative protocols.
Cell-based therapy in the management of Class III Miller’s recession – A case report with 45-month follow-up
Authors: Meenakshi R. P. , Kiruba R. , Arun K. V. , Sivaram G. , Arumuganainar Deepavalli , Kaveri K.
Published: August 2023

Miller’s Class III gingival recessions (GRs) have always posed a challenge to the clinicians in terms of achieving complete root coverage (CRC). In the present case, a cell-based therapy with autologous fibroblasts seeded onto a Type 1 collagen membrane, through an in-vitro culturing method was utilized. The fibroblasts-seeded membrane was surgically placed under a laterally repositioned flap. The patient presented with a CRC, which was stable even at the postoperative period of 45 months. In addition, a 3-mm substantial gain in the width of keratinized tissue was achieved and maintained throughout the postoperative period. Hence, the results of the cell-seeded therapy emphasize that it can serve as an effective alternative method for the management of Miller’s Class III GRs.
Prevalence of immune mediated vesiculobullous lesions among patients visiting a private dental hospital with special emphasis on gingival manifestation
Authors: Jayaraman Meenakshi , Ramasubramanian Abilasha , Ramani Pratibha
Published: August 2023

Background and Aim:

Vesiculobullous lesions are a group of mucocutaneous lesions that are predominantly immune-mediated but may also have a genetic or viral origin. The most common site of occurrence is buccal mucosa, whereas the number of cases involving gingiva is comparatively low. Based on the literature, although numerous studies have reported the prevalence of vesiculobullous lesions in the nonkeratinized epithelium, there is a dearth of knowledge about its occurrence in keratinized oral mucosa, especially gingiva. The objective of the study was to assess the prevalence of immune-mediated oral vesiculobullous lesions emphasizing the occurrence in keratinized mucosa, especially the gingiva, among patients visiting a private dental hospital.

Materials and Methods:

The study was conducted in a private teaching dental institute and hospital setting. Out of 615 incisional biopsies received in the department of oral pathology, between June 2019 and April 2021, n = 22 samples were immune-mediated vesiculobullous lesions confirmed by clinical and histopathological diagnosis after eliminating lesions of viral origin. Patient details including age, gender, site, duration, and systemic illness were collected from the digital information archiving software and analyzed by appropriate statistics using SPSS software.

Results:

Based on the results, 95.5% of the patients had histopathological features of intraepithelial clefting and only 4.5% of them showed subepithelial clefting. Female predilection was 6.3:1. The most common site of involvement was nonkeratinized mucosa (36.36%) and 59.09% of the patients presented with systemic illness.

Conclusion:

The study shows most of the features of pemphigus is consistent in gingiva and other parts of oral mucosa. The dental practitioners should be aware of the various oral manifestations of such lesions to ensure accurate diagnosis and adequate treatment.
Effect of Obesity on Androgen Receptor and Androgen Levels in the Serum of Women with Infertility in Babylon, Iraq
Authors: Mari Zainab Mohammed , Smaism Maha F. , Al-Hilli Nadia Mudher
Published: August 2023

Background:

Infertility is the inability to get pregnant after engaging in unprotected sexual activity for at least a year. Obesity and overweight are terms used to describe abnormal or excessive weight growth that is harmful to one’s health.

Objectives:

The aim of this study was to measure the androgen receptor (AR), total and free testosterone, and dehydroepiandrosterone sulfates (DHEA-S) levels in the serum of Iraqi women who were having trouble getting pregnant and study the change of these parameters in the case of obesity and infertility.

Materials and Methods:

The case–control group was made up of 45 additional, presumably healthy women, whereas the sick group was made up of 45 obese infertile women. A study was carried out in the Babylon teaching hospital for maternity and children in Hilla city and private clinics from July to January 2022. An enzyme-linked immunosorbent assay (ELISA) was used to evaluate the serum concentrations of DHEA-S, total testosterone, and free testosterone (ELISA). SPSS software was used to conduct the statistical analysis.

Results:

A considerable drop in total testosterone and AR levels, infertile women exhibited significantly greater serum levels of free testosterone and DHEA-S than the control group (P > 0.05).

Conclusion:

Infertile women had considerably lower serum levels of total testosterone and ARs and significantly higher serum levels of free testosterone and DHEA-S. On the basis of the results of this investigation, obesity participates in the pathogenesis of infertility.
A Comparative Microbiological Quality Assessment of Frozen and Fresh Fishes from Erbil City
Authors: Ibrahim Ibrahim Ramadhan
Published: August 2023

Background:

Since ancient times, the majority of humans have been categorized as pescatarians, depending mostly on seafood and fish as well as their byproducts. Fish is currently in greater demand as it is a good source of protein, which is necessary for maintaining the health of muscles, organs, and blood vessels. Due to their sensitive tissues and aquatic environment, fish are especially prone to microbial infections. It has been suggested that one way to assess the quality of fish is through the monitoring of these bacteria.

Objectives:

The current study aimed to examine the microbiological quality of fresh and frozen fishes.

Materials and Methods:

A comparative study was conducted to evaluate the microbial quality of fresh and frozen common carps to raise food safety concerns, Iraq-Erbil city. A total of 50 samples of fishes were collected from local markets and breeding ponds from September 2021 to January 2022. The most probable number (MPN) method was used for the estimation of the total coliform, whereas the horizontal method was used for the enumeration of Salmonella spp.

Results:

In this study, 53% of frozen samples contaminated with the coliform, whereas 15% of the fresh common carps were contaminated with coliform and passed the acceptable range (<100 MPN/g). Salmonella spp. was not found in any fresh samples, although it was recorded in 20% of the frozen common carps.

Conclusion:

Further investigations are required with molecular techniques including polymerase chain reaction to determine the species and type of contamination in frozen fishes.
Ionizing Radiation-Induced Non-Cancer Diseases
Authors: Faraj Kharman A.
Published: August 2023

People are exposed to both natural and artificial sources of ionizing radiation. The effects of high doses of radiation are known; however, the effects of low doses are still controversial. Several cohorts of epidemiological studies showed that high and low doses of ionizing radiation can induce noncancerous diseases in humans such as cardiovascular disease, brain injury, and liver disease. These diseases are classified as specific tissue reactions determined by threshold dose. In this article, the author reviews the role of radiation to induce the above nonmalignant diseases and outlines the relationship between exposure to ionizing radiation and diseases. At the end of the review evidence of the association between cardiovascular disease, brain injury, and liver disease and exposure to low and high doses of ionizing radiation was found through the presentation of several studies. Most epidemiological studies and authors have indicated an elevated risk of diseases upon exposure to low and high doses of the radiation
Relation of Immunoglobulin Level and White Blood Cell Count with Frequency of Infection in Splenectomized and Non-Splenectomized B Thalassemia Major Patients
Authors: Saud Israa Ali , Majid Liqaa Mohammad
Published: August 2023

Background:

Beta-thalassemia major is an autosomal recessive condition caused by absent (β0) synthesis of the β globin chains of the hemoglobin tetramer.

Objectives:

Evaluation of immunoglobulin level and white blood cell count in splenectomized and non non splenectomized patient as well as comparison of the levels of Ig and WBC with frequency of infection.

Materials and Methods:

This cross sectional study included a total of 60 patients with beta-thalassemia major and 20 age and sex matched apparently healthy individual as a control, blood taken from them for an evaluation of immunoglobulin level and white blood cell count.

Results:

There is no significant difference in immunoglobulin level between splenectomized and non splenectomized B-thalassemia major patients and control groups. Also, there is significant increase in mean Frequency of infection / year for patients with thalassemia major in comparison to control, Specifically, splenectomized patients are having significant increase in frequency of infection in comparison to non splenectomizd. There is a significant difference in mean of White blood cell count, Neutrophil, Lymphocytes in patients with splenectomy, non-splenectomy and control group.

Conclusion:

Immunoglobulin levels are within normal range in thalassemia major patients whether splenectomized or non splenectomized. Leukocytes count mainly neutrophils and lymphocytes are higher in splenectomised patients. Frequency of infection is higher in splenectomed patients and there is a positive correlation with IgA and IgG.
Triglyceride Glucose Index, its Modified Indices, and Triglyceride HDL-C Ratio as Predictor Markers of Insulin Resistance in Prediabetic Individuals
Authors: Suleiman Rojeen Rasheed , Salih Sherwan Ferman , Abdullah Barhav Issa , Ibrahim Ibrahim Hasan , Saeed Zindan Azeez
Published: August 2023

Background:

Prediabetes is a strong hazard for developing of both cardiovascular disorders and diabetes mellitus. Insulin resistant predisposes to prediabetes and type 2 diabetes mellitus that all are strongly correlated with development of cardiovascular disorders. Recently, the triglyceride glucose index, its modified indices and the ratio of triglyceride/ high density lipoprotein-cholesterol have been suggested as sensible surrogate markers of insulin resistant.

Objectives:

The current study aimed to evaluate the triglyceride glucose index, its modified indices and triglyceride/ high density lipoprotein-cholesterol ratio among individuals with prediabetes compared to healthy control.

Materials and Methods:

This study was carried out as a case control among 120 participants, 60 prediabetic individuals and 60 apparently healthy individuals as a control group. Prediabetic individuals were obtained from relatives of patients with diabetes mellitus visiting Endocrinology Unit at Azadi Teaching Hospital and 60 healthy individuals were chosen from medical staffs of Azadi Teaching Hospital.

Results:

There were statistically significant higher mean level of indices in individuals with prediabetes with exception of triglyceride/ high density lipoprotein-cholesterol ratio that was insignificantly higher. There was a significant positive correlation of abnormal homeostatic model assessment of insulin resistance with triglyceride/ high density lipoprotein-cholesterol ratio (r = 0.651), and triglyceride glucose index (r = 0.390) whereas insignificant positive correlation with its modified index.

Conclusion:

The mean level and prevalence of abnormal TyG index, TyG-BMI and TyG-WC were significantly higher in prediabetic individuals, whereas, TG/HDL-c was insignificantly higher compared to control individuals.