bluuebunny/crossref_metadata_2025 huggingface dataset:
Ghrelin reduces cerebral ischemic injury in rats by reducing M1 microglia/macrophages
Authors: Tian Rong , Mao Gengsheng
Published: January 2022

The purpose of this study was to investigate the effect of Ghrelin on the polarization of microglia/ macrophages after cerebral ischemia (CI) in rats. 60 wild-type SD rats were randomly divided into sham group, CI group, CI+Ghrelin group, 20 rats in each group. The modified Longa suture method was used to establish the middle cerebral artery occlusion (MCAO) model in rats. Before surgery, Ghrelin was injected subcutaneously (100μg/kg, twice a day) for 4 consecutive weeks. After modeling, neurological function scores were performed with three behavioral experiments: mNSS score, Corner test, and Rotarod test, to evaluate the recovery of neurological function after Ghrelin treatment. At the same time, the brain tissues were collected and stained with 2,3,5-triphenyltetrazolium chloride (TTC) to detect the cerebral infarct volume. RT-qPCR was used to detect the expression of TNF-α and IL-1β in the ischemic brain tissue, and the TUNEL staining was used to detect the apoptosis of brain tissue. Flow cytometry was used to detect the percentage of M1 type microglia/macrophages which were isolated by trypsin digestion of fresh cerebral cortex. Then, the Western blotting and immunofluorescence method were used to detect the phosphorylation level of AKT (P-AKT) and AKT. Compared with the CI group, the neurological function of the rats in the CI+Ghrelin group was dramatically improved, and the cerebral infarction area was dramatically reduced. At the same time, the expression of TNF-α and IL-1β in the ischemic brain tissue of rats in the CI+Ghrelin group decreased, and the apoptotic cells in the brain tissue also decreased. Compared with the CI treatment group, the activation of M1 microglia/macrophages in the cortex of the ischemic side of the infarct and the peri-infarct area in the CI+Ghrelin group was dramatically inhibited. At the same time, the ratio of P-AKT/AKT of the brain tissue in the CI+Ghrelin group was dramatically higher than that of the CI group. In the rat cerebral ischemia model, Ghrelin can promote the repair of brain damage and the recovery of neurological function after ischemia. Its mechanism may be related to activating AKT to selectively reduce M1 microglia/macrophages, reducing inflammation and cell apoptosis in brain tissue.
A case of Pneumocystis jirovecii pneumonia in a patient with acquired immune deficiency syndrome who showed eosinophilia and an increased serum TARC/CCL17 level
Authors: Yabuuchi Yuki , Matsuyama Masashi , Matsumura Sosuke , Nakajima Masayuki , Kiyasu Yoshihiko , Takeuchi Yuto , Murata Yoshihiko , Matsuoka Ryota , Noguchi Masayuki , Hizawa Nobuyuki
Published: January 2022

Pneumocystis jirovecii pneumonia (PCP) in patients with acquired immune deficiency syndrome (AIDS) shows eosinophilic pneumonia like condition. The detailed mechanisms how AIDS-associated PCP causes eosinophilic pneumonia has not been elucidated, but it has been suggested that beta-D-glucan, a major component of Pneumocystis jirovecii, and T helper type 2 immunity may be involved in the mechanism of eosinophilia in the lung. We experienced the case who developed an eosinophilic pneumonia-like condition in a patient with AIDS-associated PCP, whose clinical course indicated the importance of TARC/CCL17 but not IL-4 and IL-5 as involved in eosinophilia caused by HIV and Pneumocystis jirovecii infection.
Preoperative dexmedetomidine and intraoperative bradycardia in laparoscopic cholecystectomy: a meta-analysis with trial sequential analysis
Authors: De Cassai Alessandro , Sella Nicolò , Geraldini Federico , Zarantonello Francesco , Pettenuzzo Tommaso , Pasin Laura , Iuzzolino Margherita , Rossini Nicolò , Pesenti Elisa , Zecchino Giovanni , Munari Marina , Navalesi Paolo , Boscolo Annalisa
Published: January 2022

Background: While laparoscopic surgical procedures have various advantages over traditional open techniques, artificial pneumoperitoneum is associated with severe bradycardia and cardiac arrest. Dexmedetomidine, an imidazole derivative that selectively binds to α2-receptors and has sedative and analgesic properties, can cause hypotension and bradycardia. Our primary aim was to assess the association between dexmedetomidine use and intraoperative bradycardia during laparoscopic cholecystectomy. Methods: We performed a systematic review with a meta-analysis and trial sequential analysis using the following PICOS: adult patients undergoing endotracheal intubation for laparoscopic cholecystectomy (P); intravenous dexmedetomidine before tracheal intubation (I); no intervention or placebo administration (C); intraoperative bradycardia (primary outcome), intraoperative hypotension, hemodynamics at intubation (systolic blood pressure, mean arterial pressure, heart rate), dose needed for induction of anesthesia, total anesthesia requirements (both hypnotics and opioids) throughout the procedure, and percentage of patients requiring postoperative analgesics and experiencing postoperative nausea and vomiting and/or shivering (O); randomized controlled trials (S). Results: Fifteen studies were included in the meta-analysis (980 patients). Compared to patients that did not receive dexmedetomidine, those who did had a higher risk of developing intraoperative bradycardia (RR: 2.81, 95% CI [1.34, 5.91]) and hypotension (1.66 [0.92,2.98]); however, they required a lower dose of intraoperative anesthetics and had a lower incidence of postoperative nausea and vomiting. In the trial sequential analysis for bradycardia, the cumulative z-score crossed the monitoring boundary for harm at the tenth trial.Conclusions: Patients undergoing laparoscopic cholecystectomy who receive dexmedetomidine during tracheal intubation are more likely to develop intraoperative bradycardia and hypotension.
COVID-19: Contrasting experiences of South African physiotherapists based on patient exposure
Authors: Hassem Tasneem , Israel Nicky , Bemath Nabeelah , Variava Tarique
Published: January 2022

Background: The coronavirus disease 2019 (COVID-19) pandemic has exposed physiotherapists to unique work-related challenges. However, there is a lack of research regarding the mental health and lived experiences of South African physiotherapists during the COVID-19 pandemic.Objectives: To determine levels of mental and physical health, burnout, depression, anxiety and resilience and coping strategies used by a sample of South African physiotherapists with and without exposure to patients with COVID-19. Lived work experience, perceived health and sources of support were also explored.Method: A non-experimental, cross-sectional, mixed-method design was used. Physiotherapists completed an online survey comprising: a demographic questionnaire; scales assessing mental and physical health, burnout, depression, anxiety and coping strategies and six open-ended questions. A total of 171 physiotherapists participated in our study, 43.3% of whom were exposed to patients with COVID-19.Results: The exposure group scored significantly higher on self-reported mental health, anxiety, depression and burnout than the non-exposure group. No significant differences were reported for physical health and resilience. Significantly more maladaptive coping strategies were employed by the exposure group. Participants’ lived experiences highlighted similar experiences, as well as work-related challenges. Both groups reported that primary sources of support were significant others, but highlighted the lack of organisational support.Conclusion: Irrespective of the degree of exposure to COVID-19, the mental health and lived experiences of physiotherapists working in South Africa has been negatively impacted by COVID-19.Clinical implications: Understanding physiotherapists’ well-being and lived experiences during the pandemic may guide workplace interventions. Our findings suggest the need for psycho-educational intervention programmes to be implemented at an organisational level.
“Congruency the ART of Being Real” - 46XY DSD Due to 5 α Reductase Deficiency - Challenges in Decision Making
Authors: Subbiah Sridhar , Priyanka Raghavendran , Jayaraman Sangumani
Published: January 2022

Disorders of sexual development (DSDs) are heterogenous group of disorders characterized by discrepancy in chromosomal, gonadal, and phenotypic sex. DSD is a Medico-Social Emergency. 5 α reductase type 2 deficiency is one of the rare causes of 46 XY DSD. The degree of under virilization varies from clinically female to a near male phenotype. Müllerian structures were absent. At puberty, there might be features of virilization. Gender incongruence or dysphoria occurs frequently during puberty. An important marker for diagnosis is an elevated testosterone to dihydrotestosterone ratio in the basal state or following HCG stimulation. All 46 XY DSD require an appropriate molecular diagnosis prior to gender assignment and gender reassignment surgery. Gender reassignment surgery and/or Gonadectomy should be performed only after 18 years if there are compelling indications like suspicion of malignancy or presence of gender dysphoria or gender incongruence.
The Utility of 68Ga-DOTATATE PET/CT in Localizing Primary/Metastatic Pheochromocytoma and Paraganglioma: Asian Indian Experience
Authors: Jaiswal Sanjeet Kumar , Sarathi Vijaya , Malhotra Gaurav , Verma Priyanka , Hira Priya , Badhe Padma , Memon Saba Samad , Barnabas Rohit , Patil Virendra A , Anurag  , Lila R , Shah Nalini S , Bandgar Tushar
Published: January 2022

Purpose:

Pheochromocytoma and paraganglioma (PGL), together called PPGL, are rare tumors with a limited number of studies on the diagnostic performance of68Ga-DOTA (0)-Tyr (3)-octreotate positron emission tomography-computed tomography (68Ga-DOTATATE PET/CT) from the Asian-Indian subcontinent.

Materials and Methods:

In this retrospective study, PPGL suspects (n= 87) who had undergone at least contrast-enhanced computed tomography (CECT) and68Ga-DOTATATE PET/CT, were included. Lesion-wise, patient-wise, and region-wise sensitivities of68Ga-DOTATATE PET/CT,18F fluorodeoxyglucose positron emission tomography CT (18F-FDG PET/CT,n= 53),131I-metaiodobenzylguanidine (131I-MIBG,n= 37), and CECT were compared, and diagnostic performance of68Ga-DOTATATE PET/CT in the detection of PPGL was calculated.

Results:

68Ga-DOTATATE PET/CT had significantly higher lesion-wise sensitivity than131I-MIBG for both primary (94% vs 75%,P= 0.004) and metastatic disease (85% vs 59%,P= 0.001) and higher sensitivity than CECT for metastatic lesions (83% vs 43%,P= 0.0001). The lesion-wise sensitivity of68Ga-DOTATATE PET/CT was similar to18F-FDG PET/CT for both primary tumors (94% vs 85%,P= 0.08) and metastatic lesions (82% vs 84%,P= 0.76) in the whole cohort but tended to be inferior in the head to head comparison.

Conclusion:

68Ga-DOTATATE PET/CT had higher sensitivity for detection of PPGL than131I-MIBG (primary and metastatic) and CECT (metastatic) but similar to18F-FDG PET/CT (primary and metastatic).
The Weight of Words: Indian Physicians’ Perspectives on Patient Communication to Promote Diabetes Adherence
Authors: Selvan Chitra , Lathia Tejal , Chawak Shweta , Katdare Praneeta , Nayak Reshma , Chittem Mahati
Published: January 2022

Background:

Effective communication by physicians can lead to improved patient adherence, resulting in better patient outcomes and increased patient satisfaction. This study: (i) examined communication with patients when they were non-adherent, (ii) examined attitudes toward common communication cues, and (iii) explored communication approaches to encourage diabetes adherence used by Indian physicians.

Methods:

Using a concurrent mixed methods approach, Indian physicians, specialized in diabetes and/or endocrinology were recruited, to complete a survey containing quantitative (n= 834) and qualitative (n= 648) questions. The questions included (i) whether physicians expressed disappointment and used scare tactics for non-adherent patients, (ii) to rate the importance of common communication cues when promoting adherence, and (iii) nested, qualitative questions to understand their communication approach to promote adherence. The data were analyzed using descriptive statistics and qualitative content analysis, respectively.

Results:

The quantitative study reported that the majority of the physicians sometimes showed their disappointment in their patient's progress (44.4%), sometimes used scare tactics to convey disease severity due to non-adherence (34.3%), and rated all communication cues as most important. The qualitative findings revealed that physicians used paternalistic (authoritative, educational, authoritarian) or collaborative (multistakeholder, patient-centered) approaches and the language cues of fear, blame, and threats to promote patient adherence.

Conclusion:

These findings highlight the need for communication skill training programs for Indian physicians focused on empathic, non-verbal, supportive, and inclusive techniques so as to promote patient adherence. Further, these trainings need to use role-playing, video recording, and peer feedback methods to show physicians how to implement these skills during patient interactions.
Comparative Analysis of Brainstem Auditory Evoked Potential Patterns between Menstruating and Menopausal North Indian Females
Authors: Arora Supriya , Mittal Shallu , Gupta Sharat , Loona Sonika , Singh Kamal D. , Mehra Kashish
Published: January 2022

Introduction:

Various studies suggest a significant impact of gonadal hormones on many neuronal functions, including auditory processing. Although a few researchers have independently investigated the brainstem auditory evoked potential (BAEP) patterns during various phases of menstrual cycle and also during menopause, there is an acute paucity of comparative data between their BAEP patterns. This study was conducted to compare the BAEP patterns between normally menstruating females and menopausal females from North India.

Materials and Methods:

A cross-sectional study was done on 90 females aged 17–21 years who were in the follicular phase of their menstrual cycle and 100 menopausal females aged 46–70 years. BAEP recording was done using standardized protocol. The data were analyzed using SPSS software. It contained mean wave latencies I, II, III, IV, V, and Interpeak Latencies (IPL) I-V, I-III, and III-V.

Results:

The mean values of latencies of waves I, III, and V and also of IPL I-III, I-V, and III-V were significantly higher (P >0.05) in menopausal females. However, the difference between mean values of wave latencies II and IV of both groups was statistically non-significant (P >0.05).

Conclusion:

The increased latencies in menopausal females indicate subtle degenerative changes that start appearing within the central auditory pathway after menopause and are probably due to a decline in ovarian hormones, especially estrogen.
Hyperleptinaemia and its Association with Postprandial Hypertriglyceridemia and Glucose Intolerance
Authors: Aslam M. , Madhu S. V. , Sharma K. K. , Sharma Arun K. , Galav V.
Published: January 2022

Introduction:

Leptin resistance is believed to cause insulin resistance though the exact mechanism is not fully understood. The present study aims to investigate the temporal profile of postprandial triglyceride (PPTG) and leptin levels, and their association with each other as well as with markers of metabolic syndrome.

Materials and Methods:

Serum leptin and PPTG levels were measured longitudinally till 26 weeks in Wistar rats fed on controlled diet (group 1) and high sucrose diet (HSD) (group 2). Two additional groups fed on HSD were taken and treated with pioglitazone (group 3) and atorvastatin (group 4). Body weight, homeostasis model assessment of insulin resistance (HOMA-IR), and glucose intolerance were also measured during this period. Comparison of the groups were done and Pearson's correlation coefficient was used to ascertain the association.

Results:

Leptin levels were significantly higher in all three groups receiving HSD compared to controlled diet group from week 2 to week 26 (P< 0.01). The postprandial triglyceride area under the curve (PPTG AUCs) were significantly higher in group 2 than controls during this period (P< 0.001). Body weight, HOMA-IR and glucose AUC were found to be significantly higher in group 2 rats than controls only from week 6, 8, and 12 respectively. In HSD-fed rats, but not in control, mean serum leptin levels from 2-26 weeks as well as peak (10thweek) and 26thweek were strongly associated with corresponding as well as preceding PPTG levels. Leptin levels significantly predicted HOMA-IR and prediabetes in group 2.

Conclusion:

This study found significant hyperleptinemia associated with postprandial hypertriglyceridemia that predicted insulin resistance and prediabetes in high sucrose diet–fed rats.
Panorama of multidetector-row computed tomography findings of carcinoma gall bladder - A retrospective observational study
Authors: Mohakud Sudipta , Sidhu Simran , Deep Nerbadyswari , Naik Suprava
Published: January 2022

Background:

Carcinoma of the gall bladder (Ca GB) has marked ethnic and geographical variations with a broad spectrum of imaging findings on multidetector-row computed tomography (MDCT). We aim to study the spectrum of the imaging findings of Ca GB on MDCT in an Eastern Indian hospital as these imaging findings help in accurate diagnosis and staging of this lethal disease.

Materials and Methods:

The MDCT images of 100 biopsy-proven cases of adenocarcinoma of GB performed from January 1, 2017, to December 31, 2018, in our hospital were retrospectively reviewed by two experienced radiologists blinded to the diagnosis. The CT protocol was a plain scan followed by triple-phase contrast-enhanced CT. Reconstructed images in the form of maximum intensity projection, volume-rendered technology, and minimum intensity projection images were also assessed. Descriptive statistics were used for data analysis.

Results:

Ca GB showed a female predominance (female:male –1.9:1). The mean age of presentation was 54.7 years (females) and 58 years (males). The morphological patterns were a mass replacing the GB (46%), focal or diffuse wall thickening (26%), and an intraluminal polypoidal mass (28%). Direct extension was to liver (76%), duodenum (32%), colon (19%), pancreas (9%), and abdominal wall (1%). Biliary dilatation (53%), vascular invasion (14%), omental involvement (23%), ascites (22%), N1 (40%), and retroperitoneal lymphadenopathy (33%) were common. Distant metastasis comprised of hepatic (42%), pulmonary (7%), Krukenberg's tumor (6%), and osseous (1%) lesions. The stages at diagnosis were I or II (3%), IIIA (4%), IIIB (16%), IVA (10%), and IVB (67%).

Conclusions:

Ca GB has a broad spectrum of findings on MDCT and it mostly presents at an advanced stage. MDCT with reconstructions is beneficial in the assessment of locoregional and distant spread and cancer staging which has a direct implication on patient management, survival, and mortality.
Enhanced expression of death receptor 5 is responsible for increased cytotoxicity of theophylline in combination with recombinant human TRAIL in MDA-MB-231 breast cancer cells
Authors: Tapadar Poulami , Pal Ambika , Dutta Siddhartha , Pal Ranjana
Published: January 2022

Background:

Theophylline has been reported to induce cytotoxicity and cell cycle arrest in cancer cells. On the other hand, TRAIL, a secretory ligand, is known for its unique ability to induce cell death only in tumor cells. In the present study, we elucidated the mechanism behind the cytotoxic effect of theophylline in combination with recombinant human TRAIL (rhTRAIL) on cancer cell line MDA-MB-231.

Materials and Methods:

Cytotoxicity of theophylline in combination with TRAIL was measured via trypan blue assay and MTT assay. Protein levels were assessed using Western hybridization. Reactive oxygen species (ROS) levels were measured using 2',7'–dichlorofluorescin diacetate and mitochondrial membrane potential (MMP) assay was conducted using tetramethylrhodamine, ethyl ester.

Results:

We observed theophylline in combination with rhTRAIL to be significantly cytotoxic to the cancer cells in comparison to theophylline and rhTRAIL alone. Next, western hybridization showed combination treatment to upregulate cleaved form of caspase-8, 9 and 3, in comparison to the cells treated with rhTRAIL and theophylline alone. Theophylline in combination also increased the levels of ROS and reduced MMP. Interestingly, combination treatment increased the protein level of death receptor 5 (DR5), sensitizing the cells towards TRAIL-induced apoptosis.

Conclusion:

Theophylline in combination with TRAIL significantly increases cytotoxicity in the MDA-MB-231 breast cancer cell line when compared to theophylline and rhTRAIL alone via upregulation of DR5 levels.
Association of MLH1-93G>A polymorphisms toward lung cancer susceptibility and its association with clinical outcome in North Indian patients treated with platinum-based chemotherapy
Authors: Singh Sidhartha , Singh Navneet , Baranwal Manoj , Sharma Siddharth
Published: January 2022

Background:

Lung cancer is one of the most prevalent and main causes of malignancy-related deaths worldwide, especially in developed countries. Epidemiological studies have demonstrated that individuals having alterations in a particular gene may have a high risk of developing certain types of cancer.

Materials and Methods:

In the present study, 500 Indian lung cancer patients and 500 healthy controls were enrolled. Polymerase chain reaction-restriction fragment length polymorphism method was used to identify the genotype of enrolled individuals and MedCalc statistical package was used for carrying out statistical analysis.

Results:

In this study, we found a reduced risk of developing adenocarcinoma in patients harboring variant (P = 0.0007) and combined type genotype (P = 0.008), whereas an increased risk for small-cell lung carcinoma (SCLC) development for those subject harboring GA genotypes (P = 0.03) was also observed. Further, heterozygous type and combined type genotype of heavy smokers for MLH1 polymorphism reported a 2-fold (P = 0.001) and 1.8-fold increased risk toward lung cancer development, respectively (P = 0.007). In case of females, the subjects harboring a variant allele have a significantly reduced risk for lung cancer development (P = 0.0001). For MLH1 polymorphism, reduced risk of developing tumor to T3 or T4 stage was observed (P = 0.04). Moreover, this is the first study reporting overall survival (OS) association for north Indian lung cancer patients with platinum-based doublet chemotherapy; for docetaxel, a three-fold increase in hazard ratio and corresponding low median standard survival time (8.4 months) for mutant and combined type genotype (P = 0.04) was observed.

Conclusions:

These results suggest that MLH1-93G>A polymorphism is involved in modulating the risk toward lung cancer. Our study also concluded a negative association of OS in patients undergoing carboplatin/cisplatin and docetaxel chemotherapy.
Awareness and utilization of urgent care services among patients attending Al-Wazarat PHCC in Riyadh, Saudi Arabia 2020
Authors: Albalahi Naif Meshal , Al Bargawi Mashael , Kofi Mostafa
Published: January 2022

Background:

Urgent Care Clinics (UCCs) offer unscheduled appointments with a “treat and release” length of visits not exceeding 60 min. The growth of clinics is dictated by patients’ demand for quality care that is unscheduled, expedited, and ubiquitous, making them accessible and available.

Objectives:

This study aimed to assess the patient’s level of awareness and utilization pattern of UCCs in Wazarat Health Care Center (WHCC) and assess factors associated with them.

Aim:

This study aims to provide information contributing to the support of decision-makers about the level of awareness among patients on urgent care services and their pattern of use within primary health care.

Methods:

This cross-sectional study included 288 patients visiting PHC clinics to measure their level of awareness and pattern of utilization using a self-administered questionnaire.

Results:

A total of 288 patients participated, 55.99% were females, and the highest percentage was in the age group of 18-38 years at 60.07%. Only one quarter, 73 (25.35%) of the patients were aware of the term urgent clinics, from them, more than a half (53.42%) visited such clinics 1–3 times in the three months before the time of study conduction, and the main cause of the visits was the common cold (25.76%). Less than half of the participants reported visiting the primary clinics without booking an appointment in advance at 44.79%. The reason for this was mainly because of having difficulty booking appointments at 54.55%. Awareness level was the highest (28.32%) among the lowest age group (18-38 years) and decreased gradually by increasing the age. A significantly higher percentage of low educational level participants reported visiting primary clinics without booking an appointment in advance at 51.33% vs. 37.68% of the university and above participants. According to patients ‘ income, there was a significant (0.023) difference in the awareness level; the highest was among participants with an income of 6000-12000 SAR at 32.86%.

Conclusion:

Only one-quarter of the studied patients know about the UCCs. More than half of the patients reported visiting these clinics because of difficulties in booking an appointment at the primary healthcare centers and convenience with the services provided at the UCCs. The common cold was the main reason for visiting the UCCs.
A cross sectional study exploring determinants for vaccine awareness, belief and hesitancy among health care professionals regarding Covid-19 vaccine, findings from a teaching hospital based in coal capital of India
Authors: Thakur Susmita , Rana Rishabh Kumar , Kumari Mona , Jha Ravi R. , Bhushan Rabi , Verma Raj Kishore
Published: January 2022

Background:

India intends to start its 1st dose of vaccination against Covid-19 on January 16th, 2021 prioritizing its frontline health care professionals with either of the two vaccines—Covaxin or Covishield. Whenever a new vaccine is launched, it is marred with controversy and myths. To understand the doubts and concerns better, this study was conducted on health care professionals working in a tertiary care hospital.

Materials and Methods:

Willing respondents, who are working in the institute, were administered the questionnaire asking their views on knowledge, beliefs, and reasons for hesitancy regarding Covid-19 immunization. A Likert scale was used to quantify the responses regarding participants’ knowledge, beliefs, and hesitancies regarding immunization with the available vaccines. Data were analyzed using MS office Excel sheets and JASP software was used to analyze the data thus obtained.

Results:

Out of 122 complete responses, we had 73 (60%) doctors, while 30 (24%) were nursing staff, the rest comprised of other health care workers, such as housekeeping staff, janitorial, etc., 66 (54%) respondents were unaware, while 25 (20%) respondents had hesitancy and 23 (18%) were having extremely negative views regarding vaccination. Some of the variables, such as age, role, marital status, gender, etc., were found to be possibly associated with these scores.

Conclusion:

Issues like concerns over vaccine safety, efficacy, reliability, etc., are deterrents for individuals and whole programme and vaccination drive across the nation. Time and again it has been seen that despite the vaccines’ contribution in breaking the transmission, concerns are making people either hesitant or unmotivated to get the vaccines. More dialogues from the authorities regarding the issues of concern may pave the way for more motivation to accept vaccination and increase the vaccination coverage.
Comparison of anxiety level in patients under uterine fibroid treatment by myomectomy and uterine artery embolization (UAE) and its relationship with pain and duration of postoperative hospitalization in Ahvaz educational hospitals in 2018
Authors: Nazarinasab Masoumeh , Motamedfar Azim , Ahmadzadeh Azar , Seyedhoseini Mehrnaz
Published: January 2022

Introduction:

Uterine fibroids are the most common benign tumors in women. Preoperative anxiety is due to concerns about the consequences of surgery and prevents recovery and high prevalence of postoperative pain and increases the length of stay in the hospital. In this study, we tried to investigate the level of anxiety in patients who are candidates for uterine artery embolization (UAE) and myomectomy surgery and its relationship with the length of hospitalization and postoperative pain.

Methods:

The present descriptive-analytical study was performed on candidates for uterine fibrinoid treatment referred to Ahvaz educational hospitals in 2018. A total of 41 candidates for uterine fibroid treatment were segmented into two groups of 24 candidates for myomectomy surgery and 17 for UAE treatment considering the inclusion and exclusion criteria after informed consent. Data were analyzed by SPSS VER 20 software using Mann–Whitney test, multiple regression, and Chi-square.

Results:

Myomectomy surgery group recorded more overt and covert anxiety, followed by a longer hospital stay and more postoperative pain (P < 0.05). The demographic criterion of age was significantly associated with overt and covert anxiety (P < 0.05). The level of education was significantly associated with overt anxiety (P < 0.05) and marital status and BMI were not significantly associated with overt and covert anxiety levels (P > 0.05).

Conclusion:

According to the results of the study, overt and covert preoperative anxiety in women undergoing myomectomy surgery for symptomatic uterine fibroids is longer than in UAE treatment. And have more pain after surgery.
Healthcare in post-COVID India
Authors: Pramesh C. S. , Seshadri D. V. R. , Fernandez Evita , Rao Gullapalli N. , Dutta Manisha , Mohan Pavitra
Published: January 2022

Over the years, healthcare system in India has been largely centralized, expensive and impersonal. In a country where expenditure on healthcare is low, most healthcare expenditure is out-of-pocket and where most of the population continue to live in rural areas or in urban fringes, such a care is inaccessible, unresponsive and unaffordable. COVID pandemic exposed these realities further. Based on experiences of directly managing health services during COVID-19 pandemic in different settings and across different levels, authors of this paper argue for a decentralized, distributed and responsive health systems for India, that is likely to be more effective and sustainable in normal times, and in times of crisis.
Optimizing the treatment of newly diagnosed type 2 diabetes mellitus with combination of dipeptidyl peptidase-4 inhibitors and metformin
Authors: Das Ashok K. , Gandhi Pramod , Saboo Banshi , Reddy Sanjay , Chawla Rajeev , Zargar Abdul Hamid , Kovil Rajiv , Chawla Manoj , Sharma S.K. , Gupta Sunil , Makkar B.M. , Mittal Vinod , Goswami Soumik , Arvind S.R. , Jaggi Shalini , Bajaj Sarita , Das Sambit
Published: January 2022

The expanding burden of Type 2 Diabetes Mellitus (T2DM) in today’s world, with respect to incidence, prevalence, and cost incurred, is an existential risk to society. Various guidelines recommend individualization of treatment. This expert opinion aims to review the recent evidences and reach a consensus on the preferable combination therapy for use in newly diagnosed Indian T2DM patients with HbA1C >7.5%. The core committee included seventeen diabetes specialists. Three statements were developed, discussed, and rated by specialists and recommendations were noted. Specialists were requested to rate the statements using a 9-point Likert’s scale with score of 1 being “Strongly Disagree” and 9 being “Strongly Agree”. Statement-specific scores of all the specialists were added and mean score of ≥7.00 was considered to have achieved a consensus. Statements used to meet the consensus were: Statement 1. Majority of newly-diagnosed Indian diabetics have HbA1C >7.5%; Statement 2. Patients with HbA1C >7.5% may be initiated with dual therapy of dipeptidyl peptidase-4 inhibitors (DPP4Is) + Metformin; and Statement 3. In Indian patients with HbA1C >7.5% at diagnosis, DPP4Is + Metformin may be considered as a first-line therapy. Literature review revealed that HbA1C level at the time of diagnosis in majority of Indian T2DM patients is >7.5%. Consensus was reached that dual anti-diabetic therapy should be initiated in patients with HbA1C >7.5%. DPP4Is + Metformin is the preferred cost-effective option and may be considered as a first-line therapy in Indian T2DM patients with HbA1C >7.5% at diagnosis.
Determinants of socio-demographic and environmental barriers in prevention of COVID-19 pandemic
Authors: Atri Mansi , Srivastava Roomani , Oberoi Sukhvinder Singh , Chadha Minni , Rastogi Shweta , Maurya Neha , Tiwari Sharad
Published: January 2022

Aim and Objectives:

This study assessed the knowledge, attitude, and practice of patients with ESIC, who are insured patients with the public health sector about COVID-19.

Materials and Method:

This was a cross-sectional observational study that used a questionnaire developed for the purpose of the survey. The questionnaire was divided into five parts including the demographic variables and environmental variables that are enablers for positive preventive practices of COVID-19, knowledge, attitude, and preventive practices followed with respect to COVID-19.

Results:

The mean age of the study population was 36.96 ± 13.05 (18–73) years with almost an equal proportion of males and females. The knowledge about measures to be taken for prevention of corona infection such as Balanced diet, Lockdown, Social distance, frequently wash hands often, using face mask and regularly cleaning with disinfectant surfaces was significantly better among females. Majority of the subjects displaying good attitude toward the corona disease prevention. Preventive practices were found to be satisfactory among the study population. Use of soap and handwashing was more than the use of sanitizer. Hand washing, use of mouth mask, and taking bath after returning home from outside was significantly better among males.

Conclusion:

There are increased worries and apprehensions among the public regarding acquiring the COVID-19 infection. People have higher perceived needs to deal with their anxiety towards acquiring the infection.
Sociodemographic factors and their association with menstrual hygiene practices among adolescent girls in Urban slums of Dibrugarh town, Assam
Authors: Sonowal Pranjal , Talukdar Kaushik , Saikia Hiranya
Published: January 2022

Introduction:

For good physical and mental health in adolescent girls, menstrual hygiene practices play an important role. Adolescent girls are incredibly susceptible to various physical and mental issues during this period, and sociodemographic factors play a crucial function in menstrual hygiene practices; thus, it is very critical to preserve good menstrual hygiene practices.

Aim and Objectives:

1) to assess the knowledge and menstrual hygiene practices among adolescent girls and 2) to assess the sociodemographic factors influencing knowledge and menstrual hygiene practices. Materials and Methods: A cross-sectional study was conducted in July–September 2019 among 150 adolescent girls. A predesigned, pretested questionnaire was used in the study. Descriptive statistics were applied in data analysis, and multivariate analysis was applied to find out the association.

Results:

Out of 150 adolescent girls, 78% belong to the Hindu religion and 76.7% are of nuclear family. In total, 28.7% mothers of adolescent girls are illiterate, and most of the adolescent girls (50%) belong to the 14–16-years age group; 38.7% adolescent girls belong to class V socioeconomic status. Multivariate analysis shows that Muslim religion has a significant association with knowledge regarding menstrual hygiene practices (OR: 2.846, P < 0.05) and sanitary disposal of absorbent by adolescent girls (OR: 2.528, P < 0.05). There is a significant association between joint family (type of family) and absorbent used by adolescent girls (OR: 0.253, P < 0.05).

Conclusion:

It is usually essential to enhance information and practices of good menstrual hygiene among adolescent girls so that they can lead a healthy productive life. Improvement of mothers’ knowledge is also a major area to be focused on.
The association between the knowledge on prostate cancer screening with the beliefs and behaviors of Saudi men attending King Khalid University Hospital
Authors: Alshammari Sulaiman , Alojayri Raed , AlJehani Muaath , Almuhid Faisal , Alotaibi Omar , Alqahtani Mohammed , AlGhamdi Abdulaziz
Published: January 2022

Background:

The evidence showed that prostate cancer (PC) is the second most common malignancy in men globally. Unfortunately, it rarely produces symptoms, and the diagnosis is delayed until the tumor is advanced.

Objectives:

To determine the participants’ uptake of prostate cancer screening (PCS). Also, to assess their perceptions regarding PCS. Furthermore, to evaluate the association between patients’ knowledge of PC and their beliefs and behaviors towards PCS.

Methods:

This cross-sectional study recruited men aged older than 40attending the King Khalid University Hospital (KKUH) between October 2020 and March 2021. SMS messages were sent to a random sample of 228 participants, inviting them to participate in an online self-administered questionnaire. The questionnaire consisted of 1- demography and history of PCS; 2- the knowledge questionnaire about PC; 3-the Champion’s Health Belief Model (HBM).

Results:

Out of the 228 participants, 45.2% were men aged 60 years and above, 54.4% with college degrees and postgraduate studies, and 92.5% were married. The median knowledge score was 5, and the range was 12. Most men (72.4%) had a low knowledge score, and 79.4% of them did not have a previous PCS. Men aged 60 + were more likely to undergo the screening than their counterparts, with P values of 0.005. Higher knowledge scores were associated with the perceived benefits of prostate-specific antigen (PSA), digital rectal examination (DRE), and health motivation, P values of 0.0001, 0.0001, and 0.02, respectively. PSA and DRE[Single Right-Pointing Angle Quotation Mark]s perceived barriers were associated with low knowledge scores, P values of 0.0001 and 0.003, respectively. A higher probability of PCS participation was associated with the older age group, a P value of 0.001. Low participation was associated with perceived barriers of DRE, a P value of 0.031.

Conclusion:

The majority of the participants had poor knowledge regarding PC and PCS. Only a fifth of the men did PCS. High knowledge was associated with PSA and DRE perceived benefits and health motivation.
Cost effectiveness of bariatric surgery in patients with obesity related comorbidities
Authors: Dohayan Al-Dohayan Abdullah , Qamhiah Danah Farhan , Abukhalaf Abdulelah Adnan , Alomar Ali Abdullah , Almutairi Faris Jamal , Alsalame Nayef Mosleh , Alasbali Majed Mohammed
Published: January 2022

Background and Aim:

Bariatric surgery has been reported to be an effective but expensive method for obesity management. This study aimed to determine the economic benefit for patients who underwent bariatric surgery.

Methodology:

We conducted a retrospective chart review of patients who underwent bariatric surgery and was on medications for obesity-related comorbidities at the Obesity Research Center in King Khalid University Hospital, Riyadh, Saudi Arabia. Data on the use and cost of medications before and after bariatric surgery were collected.

Results:

A total of 266 patients, 107 males (40.23%), and 159 Females (59.77%) with a mean age of 41.06 years were included in the study. There was a reduction in the mean number of medications used by patients before and 1-year post-op (before: 1.84, after: 0.52), with a significant reduction in the cost of medications (SAR5152.24 before, and SAR1695.36 after, 67% reduction, P < 0.001). Patients < 32 years old had the most reduction in medications cost (76.64% reduction). No significant difference in the cost reduction after surgery between genders (P = 0.971). There were significant reductions in numbers of out-patient clinic visits (2.26 ± 2.43 to 1.57 ± 1.42) and in-patient hospitalizations (0.31 ± 0.57 to 0.10 ± 0.36) after surgery (P < 0.001 and P < 0.001, respectively).

Conclusion:

Bariatric surgery can be considered as a cost-effective treatment for patients with obesity-related comorbidities. A significant reduction has been found in post-operative medications cost, out-patient clinic visits and in-patient hospitalizations after bariatric surgery.
Effectiveness of health education on awareness of child sex abuse among school children
Authors: Mathew Maria , Iswarya Santhanakrishnan , Paul Arun Vijay
Published: January 2022

Introduction:

Child sexual abuse (CSA) is a serious and hidden problem in India. Despite being such a huge problem a culture of silence surrounds the subject of CSA. Empowering children to protect themselves and disclose the abuse is the only way to overcome the hidden problem of CSA. Hence the present study was designed to evaluate the effectiveness of health education.

Methodology:

Health education through interactive power point discussion and video was imparted to 200 girls of class 6th to 12th in Government higher secondary school, Coimbatore. Baseline data was collected using self-administered questionnaire. A week after the base line assessment, health education was delivered in five sessions with forty students per session. Interactive session lasting for 60 minutes using power point and videos were used to educate children. Follow-up data was collected after two months using the same questionnaire.

Results:

Initially only 23% of girls were aware about child sex abuse, and then, after intervention witnessed significant improvement to 71.5%. Similarly only 19% of girls were aware of various types of child sex abuse prior to intervention, however significant number of girls became aware post intervention. There was significant improvement in proportion of children (94.5%) who agreed that they will report bad touch to someone they trust until that person believes them. Pre-intervention only 31% of children knew as to what to do if sexually abused, this percentage rose significantly after the intervention. There was a significant improvement in knowledge from 49% to 78% post intervention regarding laws to protect children from sexual offences. Almost 90% of children reported that they knew about the child help line number.

Conclusion:

In this study has proven that health education imparted to girls has improved their knowledge and empowered them to report the events and protect themselves from such incidents
Reliability of Repour of Varying Thickness Alginate Impression Following Extended Storage Time Intervals
Authors: Sayed Mohammed E. , Porwal Amit , Alhazmi Ahlam , Alaki Buthina , Alnemi Mahasin
Published: January 2022

Background:

Obtaining multiple casts from an impression is desirable for the completion of numerous procedures for a patient. Recent literature on newly introduced extended-pour alginates reveals promising results for delayed pouring. However, literature on multiple pouring of impressions and the effects of impression thickness and storage time is not available.

Subjects and Methods:

Conventional and extended-pour alginates of various thicknesses (2, 4, and 6 mm) were evaluated for linear dimensional changes in both the intra-abutment and inter-abutment distances. Casts were poured twice with the time difference between the pours being 45 min; the storage time, however, was varied (15 min, 1 h, and 1, 3, and 7 days). The intra-abutment and inter-abutment measurements were compared with those of the standard metal die.

Results:

Compared with that of the metal die, the casts poured with 6 mm thickness of the impression material showed better accuracy between the first and the second pours and also revealed smaller statistical differences. Further, Cavex performed better than Major and GC brands.

Conclusions:

The dimensional stability of different alginate materials vary with thickness, storage time, and multiple pouring in both conventional and extended-pour alginates. Shorter storage time and greater thickness of the impression material are preferred when the same impression has to be poured twice.

Clinical Significance:

Alginate impressions can be poured twice, if made in adequate thickness and stored for short storage time, to generate additional set of accurate casts that aid in documentation, diagnostic and treatment procedures.
Loin Pain Hematuria Syndrome – A Case Report of a Challenging Diagnosis for Clinicians
Authors: Haider Hussam , Omar Haider Ali , Wani Javed Iqbal , Aziz Shahid
Published: January 2022

Loin pain hematuria syndrome (LPHS) is a rare syndrome of loin pain associated with hematuria, which could be either gross or microscopic in nature. The condition causes severe discomfort for patients and can lead to many limitations in activities of daily life. As such, no primary kidney pathology has been associated with this syndrome which makes it a unique entity, to be diagnosed after exclusion of secondary causes of these symptoms. The symptom complex of Loin pain hematuria has been described classically presenting in young females in their third decade and is known to have spontaneous remissions in almost half of the patients, while as rest of the patients continue to have recurrent episodes of pain and hematuria. A high index of suspicion needs to be developed by treating physician in a patient with recurrent loin pain associated with/out hematuria. We present a patient with a similar clinical course where the diagnosis of LPHS was made on clinical grounds after excluding secondary causes of her symptoms.
Reliability of Multiple Pour between Two Classes of Polyvinyl Siloxane Impression Materials
Authors: Sayed Mohammed E. , Abdullah AL-Makramani Bandar Mohammed , Al-Sanabani Fuad Ateik , Shaabi Fawzia Ibraheem
Published: January 2022

Objective:

To evaluate the accuracy and dimensional stability of casts made from regular set alginate alternative (AA) and monophase additional silicone (MAS) impression materials following multiple pours.

Materials and Methods:

A hard typodont master cast with index holes was used. A total of 20 impressions were made using a modified perforated metal tray with 10 impressions of each material. Each impression was poured four times with type IV die stone with a total of 80 stone casts (40 for each material). The horizontal anterior–posterior (HAP), horizontal cross-arch (HCA), and vertical distances were measured in the recovered stone casts using a stereomicroscope with an accuracy of 0.001 mm. The obtained data were statistically analyzed using two-way analysis of variance and Tukey's HSD post hoc test (P < 0.05).

Results:

The dimensions on the typodont master cast and stone casts were significantly different (P < 0.001), except for the first pour from MAS (P > 0.05). There was a statistically significant difference in the dimensions of the stone casts made from the AA and MAS impression materials among the four pour groups (P < 0.001), with exception of MAS-based casts between first pour and second pour groups at HAP and HCA dimensions. Pairwise comparisons showed statistically significant difference between the two impression materials at all measurement locations, with only one exception of HAP measurements for second-poured casts.

Conclusion:

A clinically acceptable casts can be made by pouring AA and MAS impressions twice. In addition, the third and fourth pours were accurate in the AA group when compared to MAS group.

Clinical Significance:

According the knowledge of the authors, this study is the first to evaluate the predictability of re-pouring alginate alternative impression material and compare to a standard polyvinyl siloxane impression material such as monophase. Therefore, the statement of clinical significance in the abstract will help the dentists to realize the potential uses for alginate alternative impression material and recommendations of this study.