bluuebunny/crossref_metadata_2025 huggingface dataset:
Pre-emptive versus preventive analgesia for postoperative pain: a systematic review and meta-analysis
Authors: Tantri Aida Rosita , Firdaus Riyadh , Angkasa Hansen , Natanegara Ahmad Pasha , Maulana Muhammad A. I.
Published: September 2023

BackgroundPostoperative pain is a type of nociceptive pain that originates from tissue damage due to trauma caused by surgery. Pre-emptive analgesia is treatment that starts before surgery, to prevent or reduce the establishment of sensitization of dorsal horn neurons caused by tissue injury, the sensitized neurons being supposed to amplify postoperative pain. Pre-emptive analgesia consists of administering analgesic medication before tissue injury, that is, before the reception, transmission, modulation, and nociception of the aggressive stimulus, aiming to prevent hyperalgesia. This review aims to compare the efficacy of pre-emptive analgesia and preventive analgesia in postoperative pain.
MethodsArticle searching was done on five databases (PubMed, ProQuest, Scopus, ScienceDirect, ClinicalKey). Hand-searching was also done to find additional articles. We have only included double-blind, randomized, controlled trials (RCT). A total of fifteen articles were included and all were RCT studies comparing pre-emptive analgesia with preventive analgesia. The quality of the included studies was evaluated with Cochrane risk-of-bias assessment tools. Quantitative analysis was performed by Review Manager 5.4.
ResultsFifteen studies comprising 830 subjects were included in this study. Our analysis revealed that pre-emptive analgesia significantly improved visual analog scale (VAS)/numeric rating scale (NRS)/verbal rating scale (VRS) 4 hours postoperatively [mean difference (MD) = -0.25, 95% CI: [- 0.49, -0.02]; I2 = 94%]. Unfortunately, pain scoring at 6, 12 and 24 hours after surgery did not differ significantly between pre-emptive and preventive analgesia. Duration of analgesia was comparable between the two groups. Time to rescue analgesics was similar between the two groups, but the pre-emptive group was associated with less analgesic consumption postoperatively than the preventive group.
ConclusionPre-emptive analgesia provided better pain relief than preventive analgesia during the short term. Time to rescue analgesics is comparable between both groups, but pre-emptive analgesia is associated with lower amounts of rescue analgesics postoperatively.
Guthrie Cards: Exploring Their Use for Nasopharyngeal Sample Storage
Authors: Martin Gabriel , Fidalgo Ana , Prada Roberto , Carvajal Reyes , Fernández Virginia , Nieto Carmen , Ferrero María , Ramos Rainer , tales Isabel
Published: September 2023

With SARS-CoV-2 pandemic, a great amount of samples have been received on the different laboratories for diagnosis, sometimes in amounts difficult to handle in time, with the associated stability and quality risks. So this study analyses the possibility to use Guthrie cards of cellulose for the storage of nasopharyngeal samples from patients with a respiratory virus infection. With this aim, a total of 70 samples obtained on the classic UTM tube for sample collection from different patients were replicated on Guthrie cards; then, genome extraction and amplification for different viruses was performed and compare to stablish detection when samples are recovered from the cards. Results show detection percentages of 66% for SARS-CoV-2, 75% for Picornavirus, 100% for Respiratory Syncytial Virus and 50% for Adenovirus after one week of storage.
Impact of Food Hygiene on Purchase Intentions and its Mechanism in Bangkok Street Food under the Influence of COVID-19
Authors: Ratasuk Akaraphun
Published: September 2023

This research examined the impact of the food hygiene perception of street food customers on their purchase intentions and its mechanism driven by their trust and perceived risk under the influence of the COVID-19 pandemic. Cross-sectional data collected from 571 street food customers in Bangkok were computed using partial least squares structural equation modeling (PLS-SEM). The results revealed a significant positive and direct influence of perceived food hygiene on customer purchase intentions (β=0.211; p<0.001). It also drove customer trust (β=0.726; p<0.001) and reduced perceived risk (β=-0.215; p<0.001). Customer trust was found to have a positive impact on purchase intentions (β=0.366; p<0.001), while perceived risk was negatively associated with purchase intentions (β=-0.264; p<0.001). In addition, the results confirmed a negative impact of customer trust on perceived risk (β=-0.371; p<0.001). Therefore, Sobel’s test results demonstrated partial positive moderations of customer trust (t= 8.211; p<0.001) and perceived risk (t= 4.066; p<0.001) between perceived food hygiene and purchase intentions. Finally, perceived was also found to partially and positively mediate between customer trust and purchase intentions (t= 5.289; p<0.001). This study provided novel and additional knowledge and evidence in the literature. It can also be applied as a guideline for street food operators and relevant governmental agents to raise the standard of street food sustainably under the influence of the COVID-19 pandemic.
Opium and Opioid Receptors: From the Ancient Times to a Possible Novel Therapeutic Target for Diabetic Retinopathy
Authors: Faria Jacqueline
Published: September 2023

Opium prescriptions date from the Sumerian era about 8,000 years ago, and they were commonly abused among wounded soldiers during the American Civil and Prussian French wars. With the isolation of morphine in 1805 by Setürner, the synthesis of morphine by Tschudi in 1952 and the manufacturing of synthetic derivatives called opioids, a new era of research began. In normal conditions, the endogenous opioid levels are elevated under stress conditions as a part of adaptive response. This mechanism implies in b-endorphin release, not only from the hypothalamus but also by immune circulating cells as lymphocytes. This system is powerful against pain, ischemic insult and oxidative imbalance protecting the tissues. The recognition of opioid receptors, particularly the delta subtype in retinal tissue, has broadened the potential for clinical applications. In the eye, opioid receptors were demonstrated to be present in optic nerve head, ganglion cells and pigmented epithelium cells. As such, studies have revealed that opioid receptors play a role in the pathogenesis of DR preserving the outer blood retinal barrier and also acting as a retinal neuroprotective agent. In this scenario, the modulation of the opioid receptor in the retina might become an attractive therapeutic target in the treatment of this devastating complication. Thus, this review assesses recent and scarce findings on this topic which deserves to be further investigated
Diagnostic impact of emergency ultrasound for cholecystitis
Authors: Alshibani Lubna , Alebrahaimi Ftoon Abdulrahman , Ahmed Noura Syed , Najjar Raneem Hesham , Alsulaiman Azouf Majed , Alfraih Sarah Ibrahim , Alrashid Sarah Omar , Aloushan Amairah Fahad , Alharthi Falwah Faisal
Published: September 2023

Background: Previous studies reported different rates of accuracy considering the use of POCUS in diagnosis of cholecystitis indicating that POCUS is not enough when deciding the management. The aim of this study is to compare POCUS findings in the diagnosing of the acute cholecystitis performed by both emergency medicine residents and radiologists.
Methods: A retrospective chart review was conducted in the ED of KAMC, Riyadh, Saudi Arabia. The population consisted of patients presented to the ER with RUQ (right upper quadrant pain) and had an abdominal ultrasound performed in the past 6 year. The study used BEST Care system to access the data of patients who underwent ultrasonography, since January 2016 using a data collection sheet.
Results: Our results included 1871 patients admitted in KAMC. Emergency physicians had success rate of 25% in correctly reporting the presence or absence of wall thickening, and 44.1% for pericholecystic fluid. In addition, scanning by emergency physicians has a success rate of 60% in detecting CBD dilatation, 12.7% for Murphy’s sign, and 46.3% for acute cholecystitis. Moreover, we found that the presence of thickened gallbladder wall in the ultrasonographic finding is a significant predictor for cholecystitis as it is increasing its incidence by 2.09 times (P=0.038).
Conclusions: Ultrasonography conducted by emergency department could be useful in detecting characteristics of gallbladder however, in our study, it showed low accuracy in detecting gallstones and acute cholecystitis compared with surgical and pathological finding.
Characterization and frequency of biofilms in adenotonsillitis: a retrospective study from a tertiary hospital in North-Eastern Nigeria
Authors: Chiwar Hassan Musa , Mailafiya Hajja Inna Muhammad , Isa Isa Saidu , Chiroma Fatima Aliyu
Published: September 2023

Background: Adenotonsillitis, a common condition characterized by inflammation of the adenoids and tonsils, is caused by bacterial and fungal pathogens. Biofilm formation has been linked to disease chronicity and antibiotic resistance. However, the role of biofilms in adenotonsillitis remains poorly understood. This study aims to explore biofilms in adenotonsillitis biopsies, focusing on their characterization, frequency, and demographic distribution by determining the expression of polysaccharides in the biofilm matrix using Congo red stain, determining the presence and frequency of bacterial as well as fungal biofilms in adenotonsillar tissue, investigating any potential associations with disease severity, and evaluating the age and sex distribution of patients with adenotonsillitis.
Methods: This retrospective study analyzed formalin-fixed paraffin-embedded adenotonsillitis biopsies (n=50) collected from the university of Maiduguri teaching hospital. The expression of polysaccharides in the biofilm matrix was assessed using congo red stain. Bacterial and fungal biofilms were visualized using crystal violet and Gomori methenamine silver (GMS) stains, respectively. Data on patient demographics, diagnoses, and biofilm characteristics were analyzed.
Results: Adenoidtonsillitis was the most common diagnosis (82%), predominantly affecting children aged 0-9 years (76%). Gram's reaction was positive in 70% of cases, while Congo red staining indicated polysaccharide expression in 60%. GMS staining revealed fungal elements in 18% of cases.
Conclusions: This study sheds light on the characterization and frequency of bacterial and fungal biofilms in adenotonsillitis, emphasizing importance of biofilms in disease development and persistence. Understanding biofilm-associated infections can improve diagnostic and treatment strategies for adenotonsillitis in Nigeria and beyond
Understanding Saudi’s preferences of emergency physicians attire a cross-sectional study
Authors: Alsalamah Majid , Aldahaian Dahian , Alghamdi Khaled , Alharthi Falwah , Albusair Malek , Algharbi Abdullah
Published: September 2023

Background: Patient centered care (PCC) is defined as the practice of attending to patients that includes listening, informing, and involving patients in their health care as per picker’s eight principles. A part of the patients’ rights is the presentation of the caring physician which includes attitude and attire. In Saudi Arabia, it has been known that doctors present with white coat. Several studies showed that physician dress-code improve patients’ satisfaction. Our aim in this study is to identify Saudi population preference on the attire of emergency physicians.
Methods: This was cross-sectional study in Riyadh, Saudi Arabia. Questions were asked to Saudi population in malls and hospital’s waiting areas regarding physician attire by online survey. Participants were asked demographic questions then they were asked in detail about their preferences.
Results: Total 486 participated in the study, where 52.15% strongly care about emergency physician’s look. 82% would like to see their male physician wearing scrubs/medical coat, 43% agreed on a face cover for their female physician but still prefer scrubs/medical coat with 45%.  Lastly participants had equal thoughts when it came to experience and reliability as 38% agree that looks can affect these two qualities. When it came to the relation of looks to knowledge as percentage were very close with 31% neutral and 32% agreed.
Conclusions: Both Saudi sexes equally consider emergency physician external look as a representation on their respectfulness, reliability, and experience, but not that significant to the knowledge he has.
Usefulness of pleural fluid cholesterol in the diagnosis of tuberculous pleural effusion
Authors: Paul Susanta Kumar , Ahmed Shamim , Chakrabortty Rajashish , Majumder Shuvo , Sarker Dip Jyoti , Kumar Paul Shamrat , Islam Samprity , Atiqur Rahman Mohammed
Published: September 2023

Background: Tuberculous pleural effusion (TPE) is the most common etiology of exudative pleural effusion in high tuberculosis burden countries like Bangladesh. The usefulness of pleural fluid cholesterol for the diagnosis of TPE is not evaluated yet. This study aimed to assess the usefulness of pleural fluid cholesterol for the diagnosis of TPE.
Methods: This cross-sectional study was conducted at the department of respiratory medicine at Bangabandhu Sheikh Mujib medical university. A total of thirty-five TPE was included in this study. Pleural fluid aspiration followed by cytological (total count, differential count), and biochemical (protein, glucose, lactate dehydrogenase, adenosine deaminase, and cholesterol) investigations were done. At the same time, blood was sent for biochemical (protein, glucose, and lactate dehydrogenase) investigation. Pleural biopsy followed by a histopathological examination was done to confirm TPE. Ethical clearance was obtained from the institutional review board (IRB) prior to starting this study.
Results: In our study, the mean age of the participants was 35.54±14.13 years, and male predominant (74.3%). The mean pleural fluid cholesterol was 99.87±23.82 mg/dl. With a cut of value 69.85, the sensitivity, specificity, and accuracy were 97.14%, 57.14%, and 77.14% respectively.
Conclusions: Pleural fluid cholesterol has significant diagnostic usefulness for the diagnosis of tuberculous pleural effusion.
Forecasting machine performance check output using Holt-Winters approach
Authors: Gloi Aime M. , Stankovich Vladimir , Rodriguez Benjamin , Mayas Stanley
Published: September 2023

Background: Machine Performance Check (MPC) is an automated TrueBeam quality control (QC) tool used to verify beam output, isocenter, and uniformity. The aim of this study was to build an MPC output variation time series modeled on the Holt-Winters method over thirty days.
Methods: After AAPM TG-51 and baseline data were established for the Edge TrueBeam, daily MPC output data were gathered and analyzed through a Holt-Winters (additive and multiplicative) method. The model's performance was assessed via three standard error measures: the mean squared error (MSE), the mean absolute percentage error (MAPE), and the mean absolute deviation (MAE). The aim was achieved using a nonlinear multistart solver on the Excel platform.
Results: The results showed that MPC output variation forecasting is energy and model dependent. Both additive and multiplicative Holt-Winters methods were suitable for the analysis. The performance metrics MSE, MAPE, and MAD were found to be well within acceptable limits.
Conclusions: A Holt-Winters model was able to accurately forecast the MPC output variation.
Diversity of microbiological pathogens in diabetic foot ulcers in an African population
Authors: Oyan Boma , Abere Sarah , Gomba Victoria Eno , Lawson Stephenson , Okoli Nkemegbunam , Tonye-Abere Orabelema
Published: September 2023

Background: Diabetic foot ulcer is a devastating complication of diabetes and the commonest cause of non-traumatic amputation worldwide. It constitutes a huge socioeconomic burden to the patient and health care system. The aim of this study was to determine the spectrum of bacterial isolates cultured from diabetic foot ulcers and assess their in vitro susceptibility to commonly used antibacterial agents.
Methods: The study was a retrospective descriptive study where records of all diabetic foot ulcer samples sent to the microbiology department for microscopy, culture and sensitivity between January 2020 to December 2021 were extracted. The bacteriological isolation and antimicrobial sensitivity tests of the isolates was carried out by standard microbiological methods.
Results: A total of sixty-one patients results were retrieved and included in this study. The commonest organism isolated was Staphylococcus aureus which constituted almost half 40 (46.0%) of the organisms isolated, followed by Escherichia coli and Proteus mirabilis which accounted for 23.0% and 18.4% respectively of the organisms. Pseudomonas aeruginosa was the least common organism and was seen in only 3 (3.4%) samples. Concerning antibiotic sensitivity, 55.0% of S. aureus, 50.0% of K. pneumoniae, 60.0% of E coli and P. mirabilis were sensitive to cefpodoxime whereas 50.0% of S. aureus and K. pneumoniae, 90% of E coli and 68.8% of P. mirabilis were sensitive to cefuroxime.
Conclusions: Diabetic foot ulcers are infected with polymicrobial organisms and S. aureus was the predominant organism isolated. However, there is an emerging pattern in the spectrum of antibiotic sensitivity which is an important consideration in management.
Seasonal variance in the incidence rate of epistaxis
Authors: Ahsanuzzaman Khan M. , Wahab M. Abdul , Alam M. Monsur , Tabassum Taniza
Published: September 2023

Background: Epistaxis, commonly known as a nosebleed, is a medical term that refers to the occurrence of bleeding from the nose. This study aimed to assess the seasonal variance in the incidence rate of epistaxis.
Methods: This was a cross-sectional observational study that was conducted in the department of otolaryngology and head-neck surgery (ENT) at Combined Military hospital (CMH), Chattogram from January 2013 to December 2016 and in CMH, Dhaka from January 2017 to July 2019. In total 165 patients who reported complaints of nose bleeding to the ENT Outpatient Department or Emergency unit of the aforementioned hospitals were enrolled in this study as the study subjects. All the patients were diagnosed based on, clinical examination, history, and radiological and laboratory investigations. All data were processed, analyzed and disseminated by using MS office.
Results: The mean age of the participants was 34.44 years; the majority (21.8%) were from the age group of 11-20 years. Bilateral nasal bleeding was in 108 (65.5%) cases, 125 (75.8%) patients had the first episode of bleeding and 117 (70.9%) patients had anterior epistaxis. In analyzing the monthly wise incidences rate of epistaxis among participants we observed that, in February (11%), March (10%), June (10%), July (13%) and December (15%) the incidence rates were higher than in other months. In evaluating the seasonal variation of epistaxis among our participants we observed that the highest incidences occurred in the winter season which was 32% followed by 30% in the summer season.
Conclusions: Younger male individuals are mainly prone to epistaxis. The frequency of the incidence of epistaxis during the winter and summer seasons is higher than in other seasons.
Influence of head rotation on ease of mask ventilation: a randomized crossover study
Authors: Ravula Ramakrishna , Tappa Rabbani , Jonnavithula Nirmala
Published: September 2023

Background: Mask ventilation is an essential part of airway management. Head rotation increases the cross-sectional area of upper airway and improves upper airway patency.
Methods: A prospective crossover study in 40 patients aged 18-69, ASA physical status I, II, III and who needed general anesthesia with tracheal intubation were selected, divided into two groups of 20 each, group I and Group II. When apnea was achieved after standard general anaesthesia, mask ventilation was performed using pressure-controlled ventilation, peak inspiratory pressure 15 cm of water, 10 breaths per minute, I:E ratio 1:2. Face mask held by two hands. Group I patients received mask ventilation with the head in a neutral position for one minute, after which the head was turned to the right for one minute and the head is returned to the neutral position for one minute. In group II patients, mask ventilation was performed from right lateral position to neutral position to right lateral position. In each position, airway pressure, compliance and expiratory tidal volume were measured.
Results: There was no statistically significant difference between groups with respect to demographic data. The mean expiratory tidal volume was high in head rotation than neutral position (469.545±120.09 ml vs. 397.815±86.03 ml) p value <0.05. A statistically significant (p value=0.045) seen with respect to compliance which was slightly higher in head rotation (35.83) than neutral position (29.31).
Conclusions: Head rotation to the lateral position increases the expiratory tidal volume and compliance significantly as compared to head in neutral position and improves mask ventilation after induction of anaesthesia.
Efficacy and safety of SilverNovaTM skin cream in post-aesthetic skin procedures
Authors: Poojary Shital , Rao Kshitija , Jadhav Avinash , Purohit Sanjay , Kondadi Pooja , Mehta Anirudh
Published: September 2023

Background: The objective of this study was to evaluate the efficacy and safety of SilverNovaTM skin cream in post-aesthetic skin procedure subjects.
Methods: In this prospective, interventional, open-label, multicentric study, subjects who undergone post aesthetic procedures were enrolled to receive the application of SilverNovaTM skin cream twice daily. The subjects received the topical application for seven days, after which they were followed up for the next seven days.  Endpoints were assessed at baseline and the end of the treatment (EOT). Primary endpoints were the investigator-assessed erythema, edema, dryness/scaling score, and the subject-assessed product tolerability in terms of burning, stinging, itching, and dryness/tightness.
Results: A total of 60 subjects completed the study. There was a significant improvement in erythema (-0.62), edema (-0.55), and dryness/scaling score (-0.40) (p<0.0001). There was also significant improvement in burning (-0.18), itching (-0.17), and dryness/tightness scores (-0.20). The physician global improvement assessment scale score was reduced from 3.3 to 1.38 (p<0.0001), showing the resolution of the symptom severity post-treatment with SilverNovaTM skin cream. Colorimetric characterization showed significant improvement in values at the end of the study, reflecting the improvement in skin color and erythema reduction. No adverse events were reported during the study.
Conclusions: The application of SilverNovaTM cream in the immediate post procedure period significantly reduced the downtime of the treatment and improved patient acceptance of the treatment. This indicates that SilverNovaTM skin cream is a promising therapeutic option for managing the complications associated with aesthetic skin procedures without any safety concerns.
Addition of temozolamide as radiosensitizer in brain metastasis: experience from a resource limited centre in sub-Himalayan region
Authors: Sharma Jyoti , Fotedar Vikas , Gupta Manish , Vats Siddharth , Dhiman Pravesh , Upadhyay Mrinalini , Negi Naina
Published: September 2023

Background: Brain metastasis is a common, debilitating and undesirable neurological complication of systemic cancer and a significant cause of morbidity and mortality.
Methods: 39 patients of brain metastasis with Ca breast/Ca lung as primaries were randomized into a study arm and control arm in between 1st August 2018 to 31st July 2019 at IGMC Shimla. Control arm consisted of WBRT (30 GY/10 fractions/5 days a week). Study arm consisted of WBRT with same dose and temozolamide administered 75mg /m2/day during RT days.
Results: Out of 39 patients 34 patients completed treatment out of which 17 in study and 17 in control arm. Response to brain lesions could not be assessed in 20 out of 39 patients. In remaining 19 patients 36.8% patients in study arm and 20% patients in control arm had partial response (PR). 5.3% patient in study arm and none in control arm has complete response (CR). 25% patients in control arm and 15.8% patients in study arm had stable disease. Improvement in QOL (FACT- G) seen in both study and control arm post Rx, however improvement sustained in study arm at 1st F/u.
Conclusions: Leveraging the additional radio-sensitizing effect of TMZ may hold promise as an attractive strategy to enhance the quality of life in patients with a favourable performance status. Moreover, RPA could serve as a decisive factor in tailoring the treatment approach, guiding the choice between palliative radiotherapy and best supportive care for these individuals.
Adverse drug reaction profile of anticancer agents in a tertiary care centre of rural Maharashtra: a cross-sectional study
Authors: Agrawal Palak , Narwane Sandeep , Gulve Priyanka , Kolhe Prajakta , Singhal Shreya , Goyal Sonakshi , Shukla Amitesh
Published: September 2023

Background: The present study was undertaken to analyse the clinical spectrum, pattern of ADR reported, most common suspected drugs, timing of reporting of suspected ADR, outcome, severity and causality assessment of adverse drug reactions among oncology patients reported at our ADR monitoring Centre.
Methods: The descriptive cross-sectional study was carried out for two months in the oncology department of a tertiary care rural hospital. ADR reporting form Version 2.4 was used for recording information of all patients of any gender and age who were suspected cases of adverse drug reactions receiving chemotherapy.
Results: Total 83 ADRs were reported within the duration of two months. The number of males and females were 21 and 62, respectively with mean age 56.9±11.6 years for males and 59.6±8.8 years for females. The age group most commonly reported with suspected ADR was 61-70 years (28.9%). Of the 83 ADR reported, the most common suspected drug was Paclitaxel (47, 56.6%). The most common indications for the use of these anticancer drugs was reported to be CA breast (43, 51.8%). Most of the ADRs (38, 45.8%) were reported immediately. On applying Naranjo’s Causality Assessment Scale, 61 and 22 ADRs fell in the category of Probable and Possible, respectively.
Conclusions: The occurrence of ADR among patients on chemotherapy is high. The reported ADR were common and predictable. Hence diligent monitoring in ADR may help manage and prevent morbidity associated with anti-cancer drugs.
A study on birth preparedness and complication readiness in the field practice area of RHTC of a tertiary care establishment in Central India
Authors: Banerjee Maj Indrayudh , Arora Vinod , Banerjee Suchandra , Madhwani Kishore P. , Singh Jitendra K. , Sahasrabuddhe Aarti
Published: September 2023

Background: Every pregnant woman faces the risk of sudden, unpredictable complications that could end in death or injury to herself or to her infant. Birth preparedness and complication readiness is a strategy that encourages pregnant women, their families, and communities to effectively plan for births and deal with emergencies, if they occur. Objectives were to study the Knowledge of Birth Preparedness & Complication Readiness among the study subjects in the field practice area of RHTC of a tertiary care establishment in Central India.
Methods: This cross-sectional study was carried out from January 2016 to June 2017 in the field practice area of RHTC of a tertiary care establishment in Central India. In the study d 420 women were included as per criteria. Data was recorded in the predesigned and pre tested proforma and were analysed by using SPSS V.20 software.
Results: Out of the total 420 mothers, 75% belonged to the age group 20-25 years. Maximum study subjects (33.1%) belonged to General Category while 23.1% of mothers were Schedule Caste. Maximum mothers (70%) were homemakers, the rest were occupied in various capacities. The BPCR index overall was 49.86, with 85% institutional deliveries; ANC visits initiation at 68%. General awareness shows certain gaps which needs attention of health care workers.
Conclusions: Lack of awareness about possible complications during the time of pregnancy, that of time of delivery or post-natal period was observed while interviewing the mothers.
Caregivers’ knowledge and attitude scale towards drug: development and validation
Authors: Chaudhuri Pamela Datta , Roy Suvendu , Sikdar Deb Prasad
Published: September 2023

Background: Drug abuse is a prevalent issue in society, often used to reduce stress and improve mental health. It is often seen as a personal disorder, causing harm to users and their loved ones. In today’s globalized world, society strives for better care, emphasizing the importance of solving problems and emphasizing the role of caregivers in supporting drug addicts.
Methods: A standardized knowledge and attitude scale was developed to assess 60 caregivers of drug addicts in Kolkata, India. The scale was self-administered and tested at 21-day intervals. The Pearson’s correlation coefficient method was applied for questionnaire validity. The scale was used to eliminate poor items and ensure reliability.
Results: The tool primarily consists of twenty-two (22) knowledge and twenty-two (22) attitude items towards drug. Following item analysis, four (4) distracting items from the knowledge scale are dropped in accordance with the difficulty index and discrimination index. The discrimination indices from the attitude scale were used to eliminate 1 distracting item.  As a result, 18 items for the knowledge scale and 21 items for the attitude scale were retained. The knowledge and attitude tools’ final form has found high significant correlation.
Conclusions: The study explained how to create a standardized scale with good items and significant reliability to evaluate knowledge and attitude towards drug addicts.
Psychological impact of COVID-19 pandemic and mental health problems of Indian medical health workers: a cross sectional study
Authors: Harsh Shobha , Chhangani Amresh , Tuteja Rajat Kumar , Pratap Bhanu , Mathur Shyam Lal
Published: September 2023

Background: The COVID-19 pandemic had burdened tremendously health, economic and social status of all. Populations across globe and MHW are also affected physically, economically and mentally too. The primary aim of this study was to assess the psychiatric and mental health issues.
Methods: A face-to-face interview and cross-sectional study were carried out in hospitals associated to Dr. SNMC Jodhpur from April 2020 to July 2021. Evaluation and assessment of insomnia, anxiety and depression was done using insomnia severity scale (ISI); generalized anxiety disorder (GAD-7) and depression on patient health questionnaire (PHQ-9) scale. A total number of 218 persons participated.
Results: Compared with non-medical health workers (n=82); medical health workers (n=136) had higher score for insomnia (8.26±7.28 verses 6.35±5.29; p=0.039); generalized anxiety (8.26±6.25 verses 6.32±4.76; p=0.016) and depression (8.45±5.96 verses 6.18±4.72; p=0.035). Similarly higher prevalence rate in medical health workers was found for insomnia (23.3% versus 14.6%); generalized anxiety 31% versus 19%) and depression (14.7% versus 3.66%). These psychiatric symptoms were found in higher intensity (moderate to severe type) in all groups.
Conclusions: During COVID-19 pandemic medical health workers are exposed to severe type of insomnia, generalized anxiety and depression. It requires more attention and recovery programs to combat the symptoms.
Shiftwork related health problems among nurses: a cross sectional study in a tertiary care centre of Central India
Authors: Lanjewar Shilpa , Gawande Bhagyashree , Narlawar Uday , Lihitkar Nikhil , Gawande Bhushan
Published: September 2023

Background: The nurses have an essential role to play in the provision of hospital healthcare services round the clock, which means that shifts are compulsory for them. Such work schedules have been related to numerous health problems including cardiovascular and gastrointestinal problems. This study has therefore been performed to assess the health problems associated with shift work among nurses.
Methods: A cross‑sectional study among 375 nurses conducted in a tertiary care centre of central India. Nurses working in a shift duties and had worked for more than a year were included. Data were collected with the help of a pre designed pre tested questionnaire. Health problems related to shift work were assessed by using standard shift work index questionnaire. Blood pressure and blood sugar levels were measured. Data analysis was done using IBM SPSS Statistics Version 23.
Results: Mean age of the study participants was 38.36±8.69 (23-57) years. Most frequently reported gastrointestinal symptom was disturbed appetite (33%) whereas most frequently reported cardiovascular symptom was headache (32.80 %). Common health problems reported by nurses after engaging in shift work were anaemia, chronic back pain, hypertension, varicose veins, diabetes, haemorrhoids, arthritis.
Conclusions: Due to high proportion of health problems among nurses as compared to general population institutions must pay attention on their health and take measures for their well being.
Knowledge, attitude, and perception of prescribers about antimicrobial stewardship in a tertiary care hospital
Authors: Patil Jayesh Pralhad , Baig Mirza Shiraz , Kulkarni Vishal Ashok
Published: September 2023

Background: Irrational antimicrobial use has contributed to amplification and spread of antimicrobial resistance (AMR). Antimicrobial stewardship by healthcare personnel can reduce AMR. The World Health Organization (WHO) has established a worldwide action plan to address AMR, including free online availability of open WHO courses. So, our study sought to ascertain knowledge, attitude, and practice (KAP) of healthcare personnel concerning AMS at tertiary care hospital.
Methods: Study was conducted as a KAP survey among practitioners (faculty, senior and junior residents) from several departments of Government Medical College, Aurangabad, Maharashtra. A validated questionnaire with 30 questions was prepared and distributed to 100 participants. The data collected in MS excel was analyzed with descriptive statistics and results expressed as mean and standard deviation, frequencies, and percentages.
Results: Response rate was 16.7% (n=100). Knowledge on AMS was observed among doctors’ with >80% near correct responses in each question. Insignificant knowledge gap was found comparing between faculty members, senior residents, and junior residents (p>0.005) in the knowledge, attitude and practice of antimicrobial use. All participants felt that ASP is a requirement of hospital, and it minimizes healthcare expenditures and negative impacts of inappropriate AM prescribing.
Conclusions: All HCPs have a knowledge gap on ASP, although there is no significant difference in knowledge, attitude, and practice of antimicrobial use between faculty members and senior and junior residents. This demonstrates importance of faculty members taking lead in incorporating more practice and education into ASP.
Management of epidermal hyperpigmentation with a novel depigmenting formulation: a research survey
Authors: Gautam Manish
Published: September 2023

Background: Epidermal hyperpigmentation is an important dermatological concern with a high prevalence in the Indian population. Kojic acid-based depigmenting formulations have proven to be effective in the management of epidermal hyperpigmentation. A questionnaire-based survey was conducted to assess physicians’ knowledge about epidermal hyperpigmentation and practice patterns about a novel depigmenting formulation containing a combination of kojic acid dipalmitate 4%, azelaic acid 12%, glycolic acid 3%, niacinamide 4%, arbutin 2%, glycogen liquid 2%, sodium hyaluronate solution 2%, and shea butter 1% for epidermal hyperpigmentation treatment in India.
Methods: The survey was conducted among 235 dermatologists across different geographical regions of India over 3 months. The questionnaire evaluated prevalence and choice and duration of therapies for epidermal hyperpigmentation in Indian clinical practice, and dermatologists’ real-life experience with efficacy of the novel formulation. Descriptive statistics were used to summarize survey results.
Results: All 235 dermatologists completed the questionnaire and responded to questions based on experience in treating patients with epidermal hyperpigmentation. In all, 58% dermatologists preferred kojic acid-based combinations. Furthermore, 57% of dermatologists agreed that glycolic acid can enhance the penetration of kojic acid and azelaic acid, 47.45% strongly agreed that a kojic acid-based formulation could be a safe alternative to steroid and hydroquinone-based formulations. Overall, 67% of dermatologists agreed that the kojic acid-based formulations with additional moisturizers helped in faster resolution of epidermal hyperpigmentation compared to other depigmenting formulations.
Conclusions: The survey findings indicate that the novel kojic acid-based formulation with additional moisturizers could be a preferred choice for epidermal hyperpigmentation management.
Maternal age and pregnancy outcomes in elderly mothers
Authors: Amin Fiza , Tali Tavseef Ahmad , Ara Rifat , Amin Huda
Published: September 2023

Background: Aim of the study was to compare pregnancy outcomes between women aged 40 or older and those aged 20 to 39 years.
Methods: The retrospective cohort study was conducted at SKIMS medical college, Srinagar between March 2020 to April 2022 in which hospital records of 170 patients who delivered during the study period were analysed.
Results: Among patients of 40 years old and above, obstetric complications are significantly more frequent, with an increased risk of gestational diabetes, pre-eclampsia, gestational hypertension and caesarean delivery. Fetal risk of IUGR, prematurity was significantly greater in patients 40 years of age or older.
Conclusions: A 40-year-old or older mother is more likely to experience medical issues and have more invasive deliveries. Additionally, there is a strong correlation between highly advanced maternal age and unfavourable perinatal outcomes such preterm birth and fetal growth restriction.
Green dentistry: a systematic review for objective and subjective research
Authors: Saxena Vrinda , Datla Asmita , Deheriya Manish
Published: September 2023

Dentistry's significant environmental impact and resource-intensive nature are concerning issues. Factors such as the environmental effects of biomaterials throughout lifecycle, radiation usage, and hazardous waste generation, including mercury and lead, need careful consideration. To counteract the environmental consequences of global warming, there is a growing global push to incorporate sustainability and green solutions. In response, dentists must transition from conventional practices to sustainable ones, embracing "green dentistry," which integrates sustainable development principles into dental care, underpinned by the 4 R’s: Reduce, Reuse, Rethink, and Recycle. To assess the knowledge, attitude, and practices of dental professionals towards green dentistry, a questionnaire-based study was conducted. The search for relevant literature encompassed terms like "green dentistry," "eco-friendly dentistry," "recycling dental waste," and "sustainability in dentistry" through PubMed from 2001 to 2023, including English-language scientific and grey literature. Analysis of dental professionals' responses revealed notable disparities in eco-friendly dentistry knowledge between postgraduates (97.1%) and undergraduates (84.7%). Postgraduates exhibited better awareness of sterilization pouch disposal (68.1% vs. 49.2%) and mercury waste (85.5% vs. 61.9%). A substantial 82.9% recognized the potential for equipment recycling. While 16 articles were found from the PubMed database, spanning 2001 to 2023, originating from various sources, a broader exploration of quantitative and qualitative data on extraction was limited. There's a dearth of national research trends in this field. The study participants displayed satisfactory awareness of eco-dentistry, along with reasonable attitudes and adoption rates. However, continuous high-quality research is essential to comprehensively understand the impacts of environmentally friendly dental practices.
Efficacy and safety of hair serum containing Greyverse, EUK 134 and Amisol trio in premature greying of hair
Authors: Chandrashekar B. S. , Agarwal Rashmi , Uttamani Ruhi , Chakraborty Abhijit
Published: September 2023

Greying of hair, also known as achromotrichia or canities, is a part of ageing. Premature canities is a widespread, poorly characterised dermatological condition with little clinical and demographic information. We conducted this study to evaluate the efficacy and safety of hair serum containing Greyverse, EUK 134 and Amisol trio in premature greying of hair. Ten cases of premature canities (onset before 25 years of age) were recruited from the outpatient department at Cutis Academy of cutaneous sciences, Bengaluru. The participants were recruited after written informed consent from patients (>18 years age); whereas in patients <18 years age, it was provided by their parents/guardians. The Revgrey® hair serum formulation was asked to be applied twice daily for three months and its efficacy and safety was analyzed during follow-up at day 30 and 90. In our study, we found that the mean age of onset of greying was 14.9±4.33 years. The frontal region was the earliest affected area. The investigator’s assessment and patient’s self-assessment was recorded after completion of the treatment at 12 weeks. The investigator’s assessment revealed that 4 patients (0.4%) showed slightly increased recovery of hair while 3 patients (0.3%) showed moderately increased recovery of hair. The small sample size of the study was its limiting factor in arriving at a definite conclusion. We concluded that application of Revgrey® hair serum formulation in males and females suffering premature greying of hair is both safe and beneficial.
COVID-19 related multisystem inflammatory syndrome in children: a case series from a tertiary care hospital
Authors: Prashanth Badam , Uppalapati Tanmayi , Erregowda Adarsh
Published: September 2023

Multisystem inflammatory syndrome in children (MIS-C) is a rare but serious medical condition associated with COVID-19. Approximately 40-50% of children with MIS-C meet criteria for complete or incomplete Kawasaki disease (KD). In this study, we aim to review and summarize the clinical presentation, laboratory parameters, outcome and management of MIS-C cases presenting to a tertiary care pediatric hospital of RRMCH. Here we report the case series of 7 children diagnosed with MISC. To study the clinical presentation, laboratory parameters, outcome and management of MIS-C cases presenting to a tertiary care pediatric hospital, RRMCH. Retrospective observational study done for a period of 10 months from June 2021 to March 2022. Detailed history taking, clinical examination, laboratory workup, management and outcome recorded were studied. During this period, a total of 22 children were positive for COVID-19 by RT-PCR, and 7 of these patients fulfilled the WHO criteria for MIS-C and were managed in our hospital. The study showed male preponderance with most common feature of presentation being fever constituting to 85.7%, 100% showing hyper inflammatory status and 4 out of 7 patients having cardiac involvement and zero mortality rate. Due to the increasing trend of post covid complications, strong clinical suspicion is required to diagnose MIS-C. As this condition has severe effects on major systems, awareness among pediatricians is required for timely evaluation and treatment to prevent morbidity and mortality associated with MIS-C.
Clinical features of multisystem inflammatory syndrome in children challenges for clinicians: a case report
Authors: Matsiyeuskaya Natallia Vasileuna , Sadadiwala Mehul Hitesh , Patel Grishma Rajendrakumar , Mistry Jabir Rafique , Potapchik Aleksandra Leonidovna
Published: September 2023

A variety of complications came to light after the SARS-CoV-2 pandemic of 2020. One such post-covid complication that manifests itself in the form of a hyperinflammatory syndrome in the pediatric population is multisystem inflammatory syndrome in children (MIS-C). It results in severe inflammation of a variety of organ systems, including the heart, lungs, brain, kidneys, gastrointestinal system, skin, and eyes. Surprisingly, clinicians can easily mistake this type of presentation for many other diseases due to overlapping features, especially Kawasaki disease (KD). An interesting case report on a patient admitted to the Grodno regional infectious diseases clinical hospital, Grodno, Belarus. The patient was initially diagnosed with enteroviral infection (EVI) at the time of admission. The clinicians in charge observed the underlying cause to be masked by Kawasaki-like presentation, how they diagnosed MIS-C, Kawasaki-like phenotype: exanthema, cheilitis, scleritis, infectious cardiopathy, gastrointestinal syndrome, coagulopathy and managed this patient is described in this scientific paper. Although the presenting signs and symptoms of MIS-C overlap with other diseases, certain additional features can be helpful in differentiation. Mainly MIS-C is present in a relatively older subgroup along with gastrointestinal symptoms that are uncommon for KD. The patient was treated with IVIG and steroids after which he attained full recovery. MIS-C associated with COVID-19 is serious, rare, and potentially fatal. Clinicians, primary care physicians, and emergency department pediatricians must be quick to recognize it and treat it at the earliest by deploying immunomodulatory strategies to subdue systemic injury caused by hyper-inflammation.
Colonic adenocarcinoma an underlying malignancy of dermatomyositis: case report
Authors: García-Cerda Daniel , Vazquez-Camacho Mabi , Carrillo-Manguart Valeria , Marín-Rosales Miguel , Torre Ignacio Garcia-de la
Published: September 2023

Idiopathic inflammatory myopathies (IIM) are a heterogeneous group of chronic, autoimmune connective tissue disorders that affect muscles primarily. A few cases have reported the correlation between IIM and paraneoplastic manifestations, primarily dermatomyositis (DM). We described the case of a 47-year-old woman with dermatomyositis and the finding of a colonic adenocarcinoma, who presented alternating diarrhoea and hematochezia. The immunoassay for myositis-specific antibodies showed anti-Mi-2a, anti-MDA5, and anti-Ro52 antibodies, while the colonoscopy showed a one-centimetre mass in the sigmoid. Literature reviews have contemplated an underlying malignancy in patients with dermatomyositis, particularly in those with anti-Mi-2 antibodies and atypical features or unexplained symptoms. A correlation between DM and colonic adenocarcinoma has-been documented in a few reports, particularly in patients with unexplained gastrointestinal symptoms or weight loss. The mechanisms of the association of dermatomyositis and malignancies, especially colonic malignancies, are still unknown and need more research for better strategies.