bluuebunny/crossref_metadata_2025 huggingface dataset:
Virtual learning during the COVID-19 pandemic
Authors: Khobragade Sujata Yadneshwar , Soe Htoo Htoo Kyaw , Khobragade Yadneshwar Sudam , Abas Adinegara Lutfi bin
Published: November 2022

CONTEXT:

Virtual learning is not without challenges. It can cause stress, lack of motivation, and social isolation. Due to COVID-19 pandemic, our college shifted from face-to-face to virtual teaching–learning style. the aim was to find out the barriers in virtual learning among medical students and provide solutions to overcome them.

MATERIALS AND METHODS:

This cross-sectional study was conducted among 3rd- and 4th-year Bachelor of Medicine and Bachelor of Surgery students in 2020. Prevalidated electronic survey forms on institutional barrier, technical barrier, and individual barrier were sent to students, 160 students responded. SPSS version 12 was used to calculate descriptive statistics and independent t-test.

RESULTS:

The students had the highest mean score in individual barrier (mean: 2.82 [standard deviation (SD): 0.72]) followed by institutional barrier (mean: 2.79 [SD: 0.74]) and technological barrier (mean: 2.72 [SD: 0.75]). Regarding technological barriers, 38.6% of the students agreed difficulty in procurement of the laptop and 66.4% faced slow Internet connection. Regarding institutional barriers, 75.9% were stressed to join one lecture to another lecture as the lectures were continuous, 69.6% had limited opportunity to interact with lecturers, and 62.7% had poor communication between lecturers and students. Regarding individual barriers, 74.1% of the students were not motivated for online learning, 71.5% of the students could not learn as well as they were in the classroom, and 58.2% disagreed taking online courses in future.

CONCLUSION:

Low motivation, communication, Internet connectivity, and technical problems were the main barriers. Smaller size class, highly motivated and well-trained lecturers, and interactive lectures may help in breaking the barriers of virtual learning.
Health literacy and its dimensions in elderly people in Farsan city, Iran
Authors: Mahmoodi Reza , Hassanzadeh Akbar , Rahimi Majid
Published: November 2022

BACKGROUND:

Health literacy is an important variable in the promotion and improvement of the health of all social groups, especially the elderly people. It indicates cognitive and social skills that specify the individuals’ motivation and ability to access and perceive information using methods for health retention and improvement. The present research aimed to study health literacy and its relevant dimensions in a population over 60 years of age in Farsan city.

MATERIALS AND METHODS:

A cross-sectional study on 384 older people in Farsan city was conducted, using a standard health literacy questionnaire including 33 items and 5 dimensions on a 5-point Likert scale for collecting data. Data analysis was done using descriptive and analytical statistics, using the multiple linear regression analysis.

RESULTS:

Among the dimensions, the highest and lowest scores belonged to decision-making and reading skill dimensions, respectively. The multiple linear regression analysis revealed that among the demographical variables, education level, age, sex, and job were the best predictors of total scores of health literacy (P < 0.001).

CONCLUSIONS:

The health-related institutions should make effort to improve the elderly people's health literacy based on general literacy, using suitable methods with less need to read and paying attention to personal characteristics.
Investigation of correlation between Internet addiction and parent–child relationship in girls’ adolescence in the COVID-19 pandemic
Authors: Ahmadian Mahboobeh , Namnabati Mahboobeh , Joonbakhsh Fatemeh
Published: November 2022

BACKGROUND:

Today, the increasing process with the using internet is a kind of disease among adolescents, especially in the COVID-19 pandemic. The activities such as learning–educational process and online games will become one of the problems for families. This study aimed to determine the relationship between internet addiction and parent–child relationships in high school girls in Isfahan.

MATERIALS AND METHODS:

This descriptive-correlational study was conducted in girls' high school in Isfahan, Iran. One hundred and sixty students and one of their parents had participated through cluster sampling method. They filled out the Young Internet Addiction Questionnaire and the Fine et al.'s Child-Parent Questionnaire (PCRS). Data were analyzed using descriptive statistical tests and Pearson correlation test. The significance level of the data was considered 0.05.

RESULTS:

The mean score (standard deviation) of internet addiction was 52.15 (5.67). 62.5% of the participants were not addicted to the use of the nternet. The mean score of the parent–child relationship was 118.24 (85.35). The results of the Pearson correlation test show that there is a significant negative correlation between parent–child relationships and Internet addiction in adolescent girls (P < 0.01).

CONCLUSIONS:

Therefore, in the girl high school students who have a stronger parent–child relationship, the rate of Internet dependence is lower. Due to the current situation of the COVID-19 pandemic in terms of Internet addiction and the parent–child relationship, the present study can help nurses, teachers, and educational planners to provide a suitable information for appropriate intervention.
Investigating the effect of teach-back method on improving the lifestyle of health ambassadors in Urmia
Authors: Jadgal Mohammad Saeed , Movahed Ehsan , Zareipour Moradali , Amirzehni Jalileh , Samieizadehtoosi Tayebeh , Ghorbani Fatemeh , Haghi Fahimeh
Published: November 2022

BACKGROUND:

Adopting a healthy lifestyle is necessary to maintain and promote health. The aim of this study was to determine the effect of teach-back method on improving the lifestyle of health ambassadors in Urmia.

MATERIALS AND METHODS:

In this quasi-experimental study, 200 health ambassadors were participated. The research sample was obtained using simple random sampling method. Data collection tool was a questionnaire including demographic characteristics and lifestyle standard. The educational intervention was performed in 4 sessions of 45 min based on the teach-back method. Data were collected through a lifestyle questionnaire before and 3 months after the educational intervention. Then, the data were analyzed by mean and standard deviation, independent t-test, paired t-test, and Chi-square test through SPSS 19.

RESULTS:

The results showed that 24% of the control group and 21% of the intervention group had a good lifestyle before the educational intervention. After the educational intervention 27% of the control group and 54% of the intervention group were in good lifestyle. The results also showed that the mean score of total lifestyle and all its dimensions in the intervention group increased compared to the control group after the educational intervention and the difference between the mean score of total lifestyle and all its dimensions in the intervention group after the intervention was significant (P < 0.05).

CONCLUSIONS:

Among health ambassadors, teach-back communication is more effective in improving the lifestyle. Therefore, it is suggested that this method must be used in designing training programs for health ambassadors.
Teacher-led versus student-led seminar blended with portfolio for “assessment of learning”
Authors: Jagzape Arunita , Jagzape Tushar Bharat
Published: November 2022

BACKGROUND:

Increase in competitive demands has led to the promotion of seminar presentation by the students to increase active learning and for the assessment of learning. Portfolios are an important tool for assessment for learning. The objectives of the study were to compare the gain in knowledge among the conventional and the blended seminar groups (intervention group), analyze the working portfolios to assess for learning, and to gather the perception of students.

MATERIALS AND METHODS:

This was an interventional study (2016) with convenience sampling that included 27 students each in the conventional and interventional groups. It was conducted in a medical college in central India. The conventional group was teacher led and the blended seminar group was student led with interaction with the students regarding the contents of the portfolio. Student's unpaired and paired t tests were used for statistical analysis. P < 0.05 was considered as the level of significance. Class average normalized gain (g) was used as a measure of effectiveness of the intervention. Quantitative questions were analyzed using percentages and qualitative data using categorization.

RESULTS:

Significant difference was found between the conventional and intervention groups (P < 0.05) with gain “g” being 0.52 for the intervention group. On evaluation of the feedback, students commented regarding its interactive nature and progress during the learning process. The reflections were coded as text as the unit of coding and student as the unit of coding. It was also found that the students who were critical reflectors were the ones who scored > 50% in the posttest scores.

CONCLUSION:

The present study showed that seminar when blended with portfolio yielded positive results in the process of learning, and hence was effective in assessment for learning.
Participation’ goals of Community- based organizations in the COVID-19 pandemic based on capacity gaps
Authors: Rezaei Fatemeh , Keyvanara Mahmoud , Yarmohammadian Mohammad H
Published: November 2022

BACKGROUND:

There have been criticisms that local authorities develop disaster planning independently, which led to less sensitiveness and responsibility of community-based organizations (CBOs). Disasters planning should incorporate into CBOs’ management processes. This study aims to set goals of a community-based plan based on preparedness capacities that CBOs need to have in the COVID-19 pandemic.

MATERIALS AND METHODS:

This cross-sectional study used a prevalidated and reliable questionnaire assessing (CBOs). The tool assesses preparedness in the field of planning, training, and infrastructure. Forty CBOs met the inclusion criteria as assisting or cooperating agencies during the COVID-19 pandemic. Then, key informants, who simultaneously have been working in the health system and CBOs, prioritized low-scale items that have shown capacity gaps according to effects on the vulnerable group, sustainability, and capability of the health system. Descriptive statistics performed using SPSS18 software (SPSS Inc., Chicago, USA).

RESULTS:

The results showed that the preparedness of CBOs was weak in the field of planning, training, and infrastructure. Besides, overlaps of CBOs' resources and covering the clients' medical needs in the COVID-19 pandemic were the most priority that needs to be intervened.

CONCLUSION:

Providing medical needs by CBOs require legal legitimacy assigned by health authority, especially in epidemic-prone diseases. In addition, assigning a coordinator to set a priority list and mutual agreements authoried by health departments can solve the problem of overlapped resources. Therefore, functional roles of CBOs in the pandemic should focus mostly on resource allocation and the medical needs of clients to set goals and functional objectives.
Comparison of the effect of face-to-face training and telemedicine on self-care in adolescent pregnant women
Authors: Khayat Samira , Palizvan Maryam , Navidian Ali , Fanaei Hamed , Sheikhi Zahra Pahlavani
Published: November 2022

BACKGROUND:

Improving self-care in adolescent pregnancy leads to improved maternal and neonatal outcomes of pregnancy. However, self-care in adolescent pregnancy is less than other women. The aim of this study was to compare the effect of face-to-face training and telemedicine on self-care in adolescent pregnant women.

MATERIALS AND METHODS:

The present study is a quasi-experimental study that was conducted in Zahedan in 2021 and 120 adolescent pregnant women with a gestational age of 15–20 weeks participated in it. The sampling was done in multistage, and the samples were divided into three groups: Face-to-face training, telemedicine, and control. Face-to-face training was presented in five sessions and the telemedicine group received the similar educational content through the mobile applications. The samples completed a researcher-made self-care questionnaire before the intervention and at 28 weeks of gestation. SPSS software version 21 was used for the analysis, and data were analyzed by ANOVA, Tukey post hoc, Kruskal–Wallis, and Mann–Whitney tests.

RESULTS:

There was no significant difference in face-to-face and telemedicine training in improving the scores of nutritional performance, smoking and narcotics use, personal hygiene, and routine pregnancy care (P > 0.05), but face-to-face training caused more improvement in the scores of sports and physical activity as compared to telemedicine group (P = 0.04). Face-to-face training and telemedicine training in all domains led to a significant improvement in scores as compared to the control group (P < 0.05).

CONCLUSION:

The results of this study showed that the face-to-face training and telemedicine methods were proper methods for self-care education in pregnant adolescent women. It is recommended to use these methods in promoting self-care in pregnant adolescent women.
Effect of a community-based multicomponent intervention on cervical cancer behavior among women – A randomized controlled trial
Authors: George T Jisa , Batra Kiran
Published: November 2022

BACKGROUND:

Cervical cancer is the leading cause of death worldwide, especially in developing countries. More than one-fifth of newly diagnosed cervical cancer cases are occurring in India. Cervical cancer is a highly preventable and curable cancer compared with other types of cancer, if detected at an early stage. The present study has been carried out to assess whether a community-based, multicomponent, nurse-led intervention program improves cervical cancer screening behavior of women.

MATERIALS AND METHODS:

An experimental randomized controlled trial was carried out by recruiting 419 women in the age group of 30–60 years (246 in the experimental group and 173 in the control group) residing in a selected rural community (selected tribal settlements) of Idukki district of Kerala, India, using multistage cluster sampling. The intervention comprising small group education followed by reinforcement session, telephonic reminders, navigation and guidance for Pap smear, and follow-up visit by the investigator was administered to the experimental group, and the control group did not receive any intervention. Knowledge, attitude, and screening behavior of women related to prevention of cervical cancer were assessed before and twice after the intervention.

RESULTS:

The experimental and control groups were homogenous in all baseline sociodemographic variables. The community-based intervention program was effective in improving knowledge (P < 0.001), attitude (P < 0.001), and screening behavior (P < 0.001) of women regarding the prevention of cervical cancer. A significant moderate positive correlation was found between knowledge and screening behavior (r = 0.408). Significant association was found between knowledge, attitude, and practice regarding prevention of cervical cancer with education, age at the time of marriage, and number of pregnancies.

CONCLUSION:

The community-based, multicomponent, nurse-led intervention program was effective in improving cervical cancer screening behavior among women. Repeated motivation and reinforcement are needed to bring behavioral change and to increase uptake of screening services among rural women.
A comparison of physiotherapy students’ perception about blended learning with online learning during COVID-19 pandemic
Authors: Swaminathan Narasimman , Ravichandran Latha , Ramachandran Sivakumar , Milanese Steve
Published: November 2022

BACKGROUND:

The COVID-19 pandemic has affected face-to-face teaching across the globe. The sudden shift in learning methods has impacted learning experiences significantly. Students' perception about online compared to blended learning might affect learning. The objective of this study was to evaluate physiotherapy students' perception of blended compared to online learning.

MATERIALS AND METHODS:

This mixed-method study documents physiotherapy students' perception about the courses delivered through blended learning (BL) mode during the COVID-19 pandemic. Physiotherapy graduates and postgraduate students who completed their evidence-based physiotherapy practice courses at Sri Ramachandra Institute of Higher Education and Research, Chennai (N = 68) participated in this study. The participants' perceived experience about synchronous online mode and BL during the pandemic was assessed using a questionnaire and focus group discussion.

RESULTS:

All the participants felt that the course outcomes were met and that they gained knowledge and skills in evidence-based practice. Most of the students (93%) recommended a blended mode of learning compared to online learning alone. Thematic analysis of the focus group discussion (FGD) identified enhanced learning experience, collaborative learning as enablers to BL, and availability of gadgets and quality of online contents as barriers.

CONCLUSION:

Participants showed par preference for blended learning over online learning as it provided flexibility and facilitated active learning compared to online learning alone.
Establishing a minimum data set for Parkinson's (PMDS) in Iran
Authors: Chitsaz Ahmad , Ajami Sima , Varnaseri Maryam
Published: November 2022

BACKGROUND:

The minimum data set (MDS) is one of the important steps in the development of health care information systems. According to the Ministry of Health in Iran, a central and national registry along with Parkinson's MDS (PMDS) has not yet existed. So, this research was conducted to establish a PMDS in Iran.

MATERIAL AND METHODS:

This study was a descriptive–comparative method, which was done in 2019–2021 in four phases: (1) determining data elements related to Parkinson's disease in Iran and selected countries; (2) extracting and categorizing the data elements; (3) making a PMDS draft; (4) evaluating a draft by Delphi technique. The research population was the MDS in Australia, Canada, the United States of America, and Iran. After extracting the data elements of Parkinson's disease from various resources, the primary draft PMDS was developed. Then, the research group divided it into two categories (administrative and clinical). After that, it was sent to 50 healthcare professionals for validation by the Delphi method.

RESULTS:

Following the results of the two rounds of Delphi technique, Finally, PMDS was established including a total of 223 data elements in two categories: administrative and clinical with 72 and 151, respectively. Every category included 10 and 14 subcategories.

CONCLUSION:

The first and the most important step for standardization of data collection nationally is creating MDS. Due to the necessity of the existence of PMDS, a complete list of PMDS was established for collecting data on Parkinson's patients.
Digital technology for facilitating inquiry-based learning during the COVID pandemic for human anatomy course
Authors: Vedi Neeraj , Dulloo Puja , Singh Praveen
Published: November 2022

BACKGROUND:

Linking anatomy with the clinical approach for creating an inquisitive mind for a millennium via the digital platform is the need of the hour. Traditional lecturing makes students have rote memorization of the human anatomy. The inquiry-based project will allow undergraduate medical students to have a deeper understanding of human anatomy along with team building and interpersonal skill development. This approach of teaching would allow students to link the content taught for human anatomy with its clinical applicability and probably generate inquisitiveness for further exploring the course content. The study aimed to appraise and assess the perception of medical students and faculty about the inquiry-based digitalized project presentation.

MATERIALS AND METHODS:

A descriptive cross-sectional study was conducted for inquiry-based project presentation where students were divided into 15 groups with 15 inquiries, which were presented as projects on a digital platform under the guidance of the facilitator. The perception of students and faculty for the inquiry-based approach was collected using a validated survey questionnaire. The quantitative data were analyzed by SPSS-version 15, using descriptive statistics, Friedman's rank, and thematic analysis for qualitative data.

RESULT:

In total, 117 students participated in the pre-test and 129 in the post-test part of the study. Also, 79.1% of students appreciated that the inquiry-based project presentation approach allowed them to link anatomy with different courses; 73.6% agreed that this approach has a positive impact on their attitude toward learning anatomy. Then, 75.2% students appreciated of learning new skills using the digital platform. They agreed to have developed leadership (65.1%) and team-building skills (83.7%) and self-directed learning (SDL) improvement (71.3%). However, some students (9.3%) and faculty (16.7%) had been ostracized for presenting their inquiry-based projects on a digital platform, whereas 65.1% of students appreciated this approach.

CONCLUSION:

Inquiry-based learning approach would allow students to have a deeper understanding of the subject knowledge and skills for the SDL and learn strategies for the usage of virtual technology for literature search.
Effectiveness of a school-based nutrition education program on waist circumference and dietary behavior among overweight adolescents in Puducherry, India
Authors: Ponnambalam Sumathy , Palanisamy Soundararajan , Singaravelu Rajeswari , Arambakkam Janardhanan Hemamalini
Published: November 2022

BACKGROUND:

The influence of western lifestyle such as high-caloric dense food and sedentary lifestyle has a great influence on Indian children, and the current prevalence of childhood overweight in India ranges between 4% and 22%. The primary aim of the study was to determine the change in growth parameters (waist circumference) as well as dietary behaviors at baseline and at the end of first, third, sixth, and ninth months among overweight adolescent girls and boys following a school-based nutritional education program.

MATERIALS AND METHODS:

The study was conducted in 2019 in four urban schools at Puducherry which were randomly assigned to study and control groups by lottery method, and 140 overweight children aged 11–14 years were in the study group and 140 children were in the control group. Simple random sampling method was used to select the samples A nutrition education program highlighting the importance of balanced nutrition and the ill effects of obesity was imparted to students in the study group through a PowerPoint presentation. As a means of reinforcement, posters and pamphlets were distributed. The waist circumference and the mean calorie, protein, and fat intake were assessed at baseline and at the first, third, sixth, and ninth months and compared between groups using independent t test.

RESULTS:

There was a statistically significant reduction in waist circumference in the study group when compared to the control group at P < 0.05. A significant decrease in the calorie intake at P < 0.001 and fat intake at P < 0.01 was observed in the study group. The protein intake in the study group increased at the end of 9 months, which was significant at P < 0.001.

CONCLUSION:

School-based nutritional education program has been found to be a successful intervention in controlling unnecessary weight gain among overweight adolescents.
Telemedicine in lung cancer during COVID-19 outbreak
Authors: Garavand Ali , Aslani Nasim , Behmanesh Ali , Shams Roshanak
Published: November 2022

The coronavirus disease 2019 (COVID-19) pandemic has negatively affected the medical services, particularly cancer diagnosis and treatment, for vulnerable cancer patients. Although lung cancer has a high mortality rate, monitoring and following up of these patients can help to improve disease management during the pandemic. Telemedicine has proven to be an effective method of providing health care to these patients. As a result, the purpose of this study was to identify telemedicine applications in the management of lung cancer patients during the COVID-19 pandemic. In this scoping review, studies published in online scientific databases such as Web of Science, Scopus, and PubMed between January 1, 2020 and September 1, 2021 were systematically searched and screened. The studies were chosen using predetermined inclusion and exclusion criteria. The bibliometric information and technological aspects of included studies were collected using a data extraction form and the data was analyzed using the content analysis approach. A total of 68 articles were found, from which four articles were finally selected based on specific inclusion/exclusion criteria. Real-time consultation was one of the most common applications of telemedicine to deliver health-care services to cancer patients. Health-care providers used applications such as Zoom, Facetime, WeChat, and e-mail, as well as devices including PCs, phones, and smartphones to provide real-time consultation to patients via videoconferencing, phone calls, and messaging, as well as store and forward consultation via e-mail. Telemedicine in the COVID-19 pandemic provides health-care services to lung cancer patients at their homes by enabling physicians and patients to communicate in real time. Several telemedicine services are still unavailable for patients with lung cancer. As a result, health experts, politicians, and entrepreneurs must pay special attention to this issue.
Psychometric evaluation of the Arabic version of the Perceived Stress Scale in clinical practicum
Authors: Ksiksou Jamal , Maskour Lhoussaine , Sfendla Anis , Alaoui Moulay Smail
Published: November 2022

BACKGROUND:

During clinical practicum, nursing students are subjected to stressors that can affect their well-being, academic performance, and technical skills. The purpose of this study was to evaluate the psychometric properties of the Arabic version of the Perceived Stress Scale of Clinical Practicum (PSS-CP) in a sample of Moroccan nursing students.

MATERIALS AND METHODS:

In this study, a translation and back-translation method and comparisons were made with the original version. The study population consisted of 215 nursing students. The construct validity of PSS-CP was measured using exploratory (EFA) and confirmatory factor analysis (CFA). Convergent validity was demonstrated by correlation with the Arabic version of the Depression, Anxiety, and Stress Scale (DASS-21). For reliability, Cronbach's alpha and test–re-test reliability (with a 10-day interval) were used. Data were analyzed using IBM SPSS Statistics V. 23.0 (SPSS) and AMOS V.21.0 (SPSS) software.

RESULTS:

The results showed that the PSS-CP is a reliable and valid scale with good internal consistency and test–re-test reliability. In terms of convergent validity, the PSS-CP showed a positive and significant correlation with the DASS-21 scale items. The results of this study led to a two-factor model consisting of 29 items.

CONCLUSION:

The PSS-CP is a valid and reliable instrument for assessing clinical stressors among nursing students in Morocco.
A comparative study of the effects of multimedia training materials on mini CEX scores of internal medicine residents in Isfahan University of Medical Sciences
Authors: Shokrollahi Soheila , Ashrafi Farzaneh , Iraj Bijan , Omid Athar , Mansouri Vahid
Published: November 2022

BACKGROUND:

Role of multimedia training materials on Mini-CEX scores of internal medicine residents. We aimed to assess the effect of multi multimedia training materials on Mini-CEX scores of internal medicine residents of Isfahan University of Medical Sciences.

SETTINGS AND DESIGN:

A quasi-experimental action research study on 1st, 2nd, and 3rd-year internal medicine residents were implemented.

MATERIALS AND METHODS:

The Mini-CEX test measures students' performance in six core skills necessary for medical practice. Mini-CEX scores of 135 internal medicine residents in 2017–2018 were compared before and after the training with prepared multimedia materials. We used repeated measured ANOVA and Mann–Whitney U test to compare the distribution of Mini-CEX scores across corresponding groups. Analysis was done using the SPSS software version 23 (IBM SPSS Statistics for Windows. Armonk, NY, USA: IBM Corp).

RESULTS:

The median Mini-CEX score (IQR) of students in preintervention and postintervention groups were 16.14 (5.19) and 19.62 (3.13), respectively. Findings of this study showed a significant increase in mini-CEX scores of the groups who used the multimedia learning material compared to those who did not use it (P< 0.001).

CONCLUSIONS:

Multimedia learning resources demonstrated a promising influence on internal residents' mini-CEX scores in this study. They demonstrate significantly greater performance after using multimedia learning materials compared to their same-year residents who did not benefit from it. This demonstrates the favorable effect of multimedia on the acquisition of practical skills such as obtaining a history or performing a physical examination.
Unusual Solitary Rectal Relapse of Mantle Cell Lymphoma After Second Remission
Authors: Nongkynrih Anthialisha , Jagtap Vikas , Kumar Sumit , Nayan Navin , Dey Biswajit , Raphael Vandana
Published: November 2022

Mantle cell lymphoma is a rare type of B cell non-Hodgkin's lymphoma (NHL) comprising only 3%–6% of all NHL. It is aggressive and prone to relapse. Around 15%–30% of the patients present with gastrointestinal tract involvement. Solitary rectal mantle cell lymphoma is rare and there are very few reports of the same. Till date, there is no report of a solitary rectal relapse of mantle cell lymphoma occurring after second remission. We report a relapse of solitary rectal mantle cell lymphoma presenting with rectal bleeding after second remission in primary gastric mantle cell lymphoma.
Radiotherapy Target Volumes in Esophageal Cancer
Authors: Sarma Gautam , Nath Jyotiman , Sarma Biswajit
Published: November 2022

Incidence of carcinoma esophagus accounts for approximately 6% of all gastrointestinal malignancies. According to GLOBOCAN 2020 data, 604,100 cases of carcinoma esophagus were detected (3.1% of total cases), and it was the 8th most common cancer in the world. The first choice of treatment for resectable esophageal cancer is surgery. Neoadjuvant radio-chemotherapy improved the overall survival (OS) of patients with advanced carcinomas of the esophagus by about 10% in 5 years, as shown by different studies. In unresectable cases, carcinoma esophagus definitive chemoradiation is the treatment of choice. Determination of the target volume of the esophagus has changed with time due to the advancement of technology. Determining the target volumes accurately is essential to achieve precise dose delivery to the targets. Controversies still exist between different regions and societies regarding target volume determination. However, the choice of the treatment volumes, techniques, and dose for optimal use must be individualized. Patients' disease status, preference, and comorbidities should also be considered while making decisions. This article will review the different target volumes, techniques, and doses used in various large trials used in definitive, neoadjuvant, and adjuvant studies.
Pigmented Dermatofibrosarcoma Protuberans: A Case Report and Review of Literature
Authors: Aashita  , Sharma Rajiv , Yadav Vikas , Kapoor Anuja , Singh Nisha
Published: November 2022

Dermatofibrosarcoma protuberans (DFSP) is a rare cutaneous sarcoma. Bednar tumor (BT) or pigmented DFSP is a rarely reported variant of it. The only differentiating feature between them is the presence of melanocytes on histopathological examination. We report a case of a 23-year-old female who presented with a recurrent lump in the right thigh that on histopathological evaluation was diagnosed as BT. Less than hundred cases of BT have been recorded to date, with only five cases originating from the thigh. Clinicopathological features of recurrent cases have been compared as local recurrence is less commonly reported.
Ovarian Clear Cell Carcinoma with Bilateral Breast Metastasis
Authors: Aashita  , Sharma Rajiv , Yadav Vikas , Thakur Pragyat
Published: November 2022

Clear cell carcinoma of ovary (CCCO) is a rare subtype of epithelial ovarian tumors that is associated with poorer prognosis due to relative chemoresistance and higher chances of recurrence. Metastasis to the breast is extremely rare. Here, we report a case of ovarian cancer with metastasis to bilateral breasts. A 46-year-old female presented with pain abdomen and mild distension. Examination revealed pelvic mass and bilateral breast lumps. Staging laparotomy and fine-needle aspiration cytology from bilateral breast lumps were done. Histopathology revealed CCCO with metastasis to bilateral breasts. Due to the rarity of CCCO, there are no standard guidelines for management. The patient should be subjected to maximum cytoreduction and chemotherapy. Metastasis to the breast from ovary can occur either due to retrograde lymphatic or hematogenous spread that confers a worse prognosis. Hence, in a patient with breast mass especially with a history of malignancy, breast metastasis should be differentiated from primary breast cancer.
Study of Comparison of Acute Toxicities between Sequential Intensity-Modulated Radiation Therapy and Simultaneous Integrated Boost Intensity-Modulated Radiation Therapy in Head-and-Neck Cancers
Authors: Sequeira Lanisha Jolitha , Shankar Sharaschandra , Rao Sandesh B , Fernandes Donald , Jacob Tony , Krishnaraj H
Published: November 2022

Purpose:

The purpose of this study is to assess and compare the acute toxicities between sequential intensity-modulated radiation therapy and simultaneous integrated boost (SIB) intensity-modulated radiation therapy in head-and-neck cancers using Common Terminology Criteria for Adverse Events (CTCAE) version 4.03.

Materials and Methods:

Patients with histologically proven squamous cell carcinoma of head and neck at the department of radiotherapy (RT), from December 2018 to July 2020, were taken up for this study. Patients were divided into sequential intensity-modulated RT (IMRT) arm and SIB-IMRT arm. Patients treated with sequential IMRT were treated so as to receive a total dose of 70 Gy in 35 fractions, 2 Gy/fractions, 5 fractions per week – 70 Gy in 35 fractions to the primary tumor, 66 Gy in 33 fractions to high-risk clinical target volume (CTV1), 60 Gy in 30 fractions to high-risk CTV2 and 50 Gy in 25 fractions to elective nodes/low-risk CTV3. Patients treated with SIB-IMRT were treated so as to receive a total dose of 66 Gy in 30 fractions – 2.2 Gy/fraction to gross tumor volume/PTV 66, 60 Gy in 30 fractions – 2.0 Gy/fraction to high-risk nodes (PTV 60), 54 Gy in 30 fractions – 1.8 Gy/fraction to elective nodes (PTV 54), respectively. Patients received concurrent chemotherapy with weekly injections cisplatin (35mg/m2) or injection carboplatin (AUC 2). Toxicities were assessed using CTCAE v 4.03.

Results:

Higher grades of radiation-induced dermatitis and mucositis were observed in patients in SIB-IMRT. No patients experienced Grade 4 toxicity. The results confirm that irradiation according to our SIB-IMRT protocol is a treatment option with acceptable toxicity.

Conclusion:

SIB-IMRT is feasible, although associated with increased rates of skin and mucosal toxicity.
Comparative efficacy and safety of glycopyrronium/formoterol fixed-dose combination versus glycopyrronium monotherapy in patients with moderate-to–severe COPD
Authors: Salvi Sundeep , Jain Manish K. , Krishnamurthy Srikanth , Balki Akash , Kodgule Rahul , Tandon Monika , Bhagat Sagar , Panchal Sagar , Khatri Nishtha , Wu Wen , Pendse Amol , Patil Saiprasad , Barkate Hanmant
Published: November 2022

Background:

The safety and efficacy of fixed-dose combination (FDC) of glycopyrronium bromide 12.5 mg/formoterol fumarate 12 mg (GB/FF) twice daily as dry powder inhalers (DPIs) compared to glycopyrronium 50 mg monotherapy (GLY) once daily as DPI in subjects with moderate-to-severe chronic obstructive pulmonary disease (COPD) were evaluated.

Methods:

This was a phase-3, randomized, double-blind, active-controlled, parallel-group, superiority study conducted in India. COPD patients aged ≥40 to ≤65 years, current or ex-smokers with FEV1/FVC <0.70, using ICS, LAMA, or LABA for ≥1 month were included. Subjects were randomized (1:1) to GB/FF or GLY for 12 weeks. The primary efficacy endpoint was the change from baseline in peak FEV1 at the end of 12 weeks. The study is registered with the Clinical Trials Registry of India (CTRI/2017/02/007814).

Results:

Between March 2017 and July 2018, 331 patients were enrolled and randomized into GB/FF FDC (165 patients) and GLY monotherapy (166 patients) groups. At week 12, the difference in change from baseline in the peak FEV1 for GB/FF DPI versus GLY was 0.115 L (SE = 0.02; 95% CI = 0.061, 0.170; P < 0.0001). Trough FEV1 increased significantly in the GB/FF group compared to the GLY group with a treatment difference of 0.078 L (SE = 0.02; 95% CI = 0.015, 0.14; P = 0.01). There were no significant differences in adverse events between the groups.

Conclusion:

FDC of GB/FF (12.5/12 mg twice daily) as a DPI provides superior bronchodilation and lung function improvement over GLY (50 mg once daily) monotherapy. It is safe and well tolerated in symptomatic COPD patients.
The diagnostic utility of ultrasound elastography to differentiate tuberculosis and sarcoidosis during endobronchial ultrasound–guided transbronchial needle aspiration (EBUS-TBNA)
Authors: Madan Manu , Mittal Saurabh , Tiwari Pawan , Hadda Vijay , Mohan Anant , Guleria Randeep , Pandey Ravindra M , Madan Karan
Published: November 2022

Introduction:

Elastography is a non-invasive tool that may allow differentiation between benign and malignant lymph nodes during endobronchial ultrasound–guided transbronchial needle aspiration (EBUS-TBNA). In tuberculosis (TB) endemic areas, clinicoradiological features of mediastinal TB and sarcoidosis often overlap, rendering an accurate diagnosis challenging. There is interest in the identification of modalities to aid in this differentiation. There are currently no published data on the utility of EBUS-elastography in differentiating between TB and sarcoidosis.

Methods:

Subjects undergoing EBUS-TBNA were prospectively enrolled, and elastography features were observed. Subjects with definitive diagnosis of TB or sarcoidosis were enrolled. The elastography features recorded included the three-colour classification patterns and strain ratio.

Results:

We enrolled 96 subjects with a definitive diagnosis (53 with TB and 43 with sarcoidosis). Of the 27 patients in whom the lymph nodes were classified as type 1 on endobronchial ultrasound elastography colour pattern, 17 had a diagnosis of TB (62.9%), while 10 were sarcoidosis (37%). For type 2 lymph nodes, 20/45 (44.4%) were TB and 25/45 (55.6%) were sarcoidosis. Type 3 lymph nodes were TB in 16/24 (66.7%) and sarcoidosis in 8/24 (33.3%). In classifying type 1 as ‘sarcoidosis’ and Type 3 as ‘tubercular’, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy were 48.5%, 55.6%, 66.7%, 37%, and 0.51, respectively. The strain ratio (Median [IQR]) was 1.29 (0.37–5.98) in TB and 2.10 (0.83–4.52) in sarcoidosis group (P = 0.48).

Conclusion:

Ultrasound elastographic lymph node characteristics have a poor diagnostic utility to differentiate between TB and sarcoidosis during EBUS-TBNA.
Dendriform pulmonary ossification in a patient with sickle cell disease
Authors: Halpern Alex I. , Woddor Navitha , Gordon Olivia , Mortman Keith
Published: November 2022

Dendriform pulmonary ossification (DPO) is a rare condition characterised by the formation of bones in lung tissues. This case report describes the first reported case of DPO in a patient with sickle cell disease (SCD), identifying DPO as a potential pulmonary consequence of SCD.
Prevalence of chronic obstructive pulmonary disease (COPD) among rural population
Authors: Haque Md Atiqul , Salwa Marium , Islam Mohammad Tanvir , Sultana Sarmin , Rahman Farhana , Ahmed Shamim , Khan Md Maruf Haque , Hossain AKM Mosharraf , Mamun Mohammad Abdullah Al , Bhuiyan Mahfuzur Rahman , Choudhury Sohel Reza
Published: November 2022

Background:

In Bangladesh, there is a scarcity of nationally representative data on the burden of chronic obstructive pulmonary disease (COPD).

Methods:

To estimate the COPD prevalence in rural settings, this cross-sectional, population-based study was conducted in all eight administrative divisions of Bangladesh, and involved adults aged 40 years and above. By using multi-stage random sampling, 2,458 individuals were enrolled. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines were used to diagnose COPD based on post-bronchodilator lung function, while additional participant data was gathered through computer-assisted personal interviews.

Results:

A 2% COPD prevalence (95% CI: 1.45, 2.55) was found in the study sample with a statistically significant difference between males (2.7%; 95% CI: 1.8, 3.6) and females (1.2%; 95% CI: 0.59, 1.81). Increasing age significantly inflated the odds of having COPD irrespective of sex (OR: 1.03; 95% CI: 1.00, 1.05; P value < 0.05). Furthermore, prevalence of COPD was higher among manual workers, cigarette smokers, and those that used the indoor kitchen and did not have a primary education. Sex-based analysis showed that smokeless tobacco consumption was significantly associated with COPD occurrence among males (OR: 2.14; 95% CI: 1.05, 4.37; P value < 0.05), but not females. Further, using an indoor kitchen increased the odds of developing COPD by 400% among female participants (OR: 4.39; 95% CI: 1.37, 14.10; P value < 0.05).

Conclusion:

This study provides a comprehensive sex-based estimation of COPD prevalence among rural population and imparts significant contribution to the growing database on COPD prevalence in Bangladesh.
Diffuse cystic lung diseases
Authors: Singh Priya , Verma Amit K. , Pandey Gaurang
Published: November 2022

The lung cyst is an air-containing lucent area surrounded by thin imperceptible walls. Other lucent lung lesions like centrilobular emphysema, cavity, cystic bronchiectasis, honeycomb cyst, and pneumatoceles are close mimics of a lung cyst on high-resolution computed tomography (HRCT). Various diseases with multiple lung cysts throughout both the lungs are classified as diffuse cystic lung diseases (DCLDs). HRCT is considered the imaging of choice for diagnosis of such diffuse cystic lung diseases. Common DCLDs like lymphangioleiomyomatosis, Birt–Hogg–Dubé syndrome (BHS), Langerhans cell histiocytosis (LCH), lymphocytic interstitial pneumonia (LIP), and desquamative interstitial pneumonia (DIP) can be confidently diagnosed on HRCT without further requirement of histopathological confirmation. The imaging also helps in differentiation of uncommon DCLDs and exclusion of the mimics. This review describes a simple algorithmic approach for DCLDs on HRCT based on scrutinizing the cyst’s distribution, size, and shape, background parenchymal changes, and its correlation with clinical features and extrapulmonary imaging findings.
Aetiology, management, and outcome of lower respiratory tract infection in renal allograft recipients – A report from a tropical country
Authors: Jain Sakshi , Bhadauria Dharmendra , Prasad Raghunandan , Gurjar Mohan , Yaccha Monika , Shanmugham Sabrinath , Kaul Anupma , SK Rungmei Marak , Nath Alok , Prasad Narayan
Published: November 2022

Introduction:

Lower respiratory tract infections (LRTIs) among renal transplant recipients (RTRs) are a significant cause of morbidity and mortality. This study aimed to analyse the aetiology, outcome, and risk factors associated with mortality.

Methods:

We analysed baseline transplant characteristics, symptoms, hospital course, laboratory, serological and microbial results, and their association with the outcome of all RTRs between January 2011 and December 2019.

Results:

A total of 206 LRTI patients out of 1051 RTRs were analysed. The incidence proportion was nearly 22 episodes per 1000 patients per year. The mean age was 39.3 years, with male predominance. Bacterial was the most common aetiology (53%), and staphylococcus was the most common species. Among the fungal causes (14%), 68% had aspergillus infection. More than one-third RTRs died during the hospital course mainly because of bacterial causes (42.6%). The aspergillus infection was the most common fungus associated with 50% mortality. On multi-variate analysis, sepsis, septic shock, and the need for mechanical ventilation independently predicted mortality.

Conclusion:

Bacterial aetiology was the most common cause; though the fungal aetiology was seen less, it was associated with higher mortality. Mortality in RTR with LRTI was associated with sepsis, septic shock, and the need for mechanical ventilation.
The Additive Impact of Transbronchial Cryobiopsy Using a 1.1-mm Diameter Cryoprobe on Conventional Biopsy for Peripheral Lung Nodules
Authors: Kim Soo Han , Mok Jeongha , Jo Eun-Jung , Kim Mi-Hyun , Lee Kwangha , Kim Ki Uk , Park Hye-Kyung , Lee Min Ki , Eom Jung Seop
Published: November 2022

Purpose The diagnostic yield of transbronchial biopsy (TBB) using radial probe endobronchial ultrasound (RP-EBUS) is 71%, which is lower than that of transthoracic needle biopsy. We investigated the performance and safety of sequential transbronchial cryobiopsy (TBC) using a novel 1.1-mm diameter cryoprobe, after conventional TBB using RP-EBUS for the diagnosis of peripheral lung lesions (PLLs).Materials and Methods From April 2021 to November 2021, 110 patients who underwent bronchoscopy using RP-EBUS for the diagnosis of PLL ≤ 30 mm were retrospectively included in our study. All records were followed until June 2022.Results The overall diagnostic yield of combined TBB and TBC was 79.1%, which was higher than 60.9% of TBB alone (p=0.005). The diagnostic yield of sequential TBC was 65.5%, which increased the overall diagnostic yield by 18.2%. The surface area of tissues by TBC (mean area, 18.5 mm2) was significantly larger than those of TBB by 1.5-mm forceps (3.4 mm2, p < 0.001) and 1.9-mm forceps (3.7 mm2, p=0.011). In the multivariate analysis, PLLs with the longest diameter of ≤ 22 mm were found to be related to additional diagnostic benefits from sequential TBC (odds ratio, 3.51; 95% confidence interval, 1.043 to 11.775; p=0.042). Complications were found in 10.5% of the patients: pneumothorax (1.0%), infection (1.0%), and significant bleeding (8.6%). None of the patients developed any life-threatening complications.Conclusion Sequential TBC with a 1.1-mm cryoprobe improved the performance of conventional TBB using RP-EBUS without serious complications.
Local well-posedness for the inhomogeneous biharmonic nonlinear Schrödinger equation in Sobolev spaces
Authors: An JinMyong , Kim JinMyong , Ryu PyongJo
Published: November 2022

In this paper, we study the Cauchy problem for the inhomogeneous biharmonic nonlinear Schrödinger (IBNLS) equation

iu_t +\Delta^2 u=\lambda |x|^{-b}|u|^{\sigma}u,\quad u(0)=u_0 \in H^s (\mathbb{R}^d),

where

d\in \mathbb{N}

,

s\ge 0

,

0<b<4

,

\sigma>0

and

\lambda \in \mathbb{R}

. Under some regularity assumption for the nonlinear term, we prove that the IBNLS equation is locally well-posed in

H^s(\mathbb{R}^d)

if

d\in \mathbb{N}

,

0\le s <\min \{2+\nobreak\frac{d}{2},\frac{3}{2}d\}

,

0<b<\min\{4,d,\frac{3}{2}d-s,\frac{d}{2}+2-s\}

and

0<\sigma< \sigma_c(s)

. Here

\sigma_c(s)=\frac{8-2b}{d-2s}

if

s<\frac{d}{2}

, and

\sigma_c(s)=\infty

if

s\ge \frac{d}{2}

. Our local well-posedness result improves the ones of Guzmán–Pastor (2020) and Liu–Zhang (2021) by extending the validity of

s

and

b

.