bluuebunny/crossref_metadata_2025 huggingface dataset:
Resorting to information technology methods to strengthen our fight against coronavirus disease-2019 pandemic
Authors: Shrivastava Saurabh RamBihariLal , Shrivastava Prateek Saurabh
Published: November 2021

The coronavirus disease-2019 (COVID-19) pandemic has affected almost every person across the world and it is high time that we reach to each and every one of them with reliable information at the earliest to minimize the risk of acquisition as well as transmission of the infection. In these testing times, there is an immense need to utilize the communication technology in the various activities of the disease mitigation, treatment and advocacy, communication and social mobilization. It is important to acknowledge that this is the first pandemic in which technology and social media are simultaneously being utilized to ensure people safety. In conclusion, in the battle against the COVID-19 pandemic, information technology and social media have emerged as one of the important tools for the health sector to create not only awareness about the disease, but also it has aided in the prevention and control of the novel viral infection.
COVID-19 and mental health: A review and the role of telehealth and virtual reality
Authors: Sainz-Fuertes Ricardo , Gelabert Mir Joan Miquel , Valderas Jose María , Bullock Kim , Giersch Anne , Vogeley Kai , García Ariadna Torres , Huguet Marta Argiles , Russell Tamara , Hollingdale Jack , Lopez -Moriñigo Javier-David , Delgado Isidro Navarro , Selsick Hugh , Gurr Howard , Fitzpatrick Tim , Maddox Todd
Published: November 2021

On March 12, 2020, with more than 20,000 confirmed cases and almost 1000 deaths in the European Region, the World Health Organization classified the COVID-19 outbreak as a pandemic. As of August 15, 2020, there are 21.5 million confirmed cases of COVID-19 and over 766,000 deaths from the virus, worldwide. Most governments have imposed quarantine measures of varied degrees of strictness on their populations in attempts to stall the spread of the infection in their communities. However, the isolation may have inflicted long-term psychological injury to the general population and, in particular, to at-risk groups such as the elderly, the mentally ill, children, and frontline healthcare staff. In this article, we offer the most up-to-date review of the effects of COVID-19 confinement on all the disorders listed in the Diagnostic and Statistical Manual of Mental Disorders. We make data-driven predictions of the impact of COVID-19 confinement on mental health outcomes and discuss the potential role of telemedicine and virtual reality in mental health screening, diagnosis, treatment, and monitoring, thus improving the above outcomes in such a difficult time.
Encouraging the use of mobile technology for the effective delivery of medical education and clinical training
Authors: Shrivastava Saurabh RamBihariLal , Shrivastava Prateek Saurabh
Published: November 2021

Considering the extensive use of mobile devices by medical teachers, undergraduate students, postgraduate residents, and patients, it becomes an indispensable need to deploy mobile technologies in various areas of the health professions education, medical training, and patient care. The purpose of the current review is to explore the scope and utility of mobile technology in ensuring the effective delivery of medical education and clinical teaching. An extensive search of all materials related to the topic was carried out in the PubMed search engine and a total of 15 articles were selected based on their suitability with the current review objectives and analyzed. The use of mobile technologies creates a gamut of educational experiences and learning opportunities for medical students and thereby enhances the efficiency and effectiveness of the learning process. The adoption of mobile technology in medical training is more of a student-centered approach and ensures active engagement of the students with an ultimate goal to become a competent health-care professional. In conclusion, in the best interest of the medical students, it is high time to employ mobile-based applications and technologies in the period of medical training as it is expected to play an important role in the accomplishment of learning outcomes and patient care.
Design and development of simulation training system for positron emission tomography/computed tomography disassembly and maintenance
Authors: Xie Yi , Wei Jing , Xie Xiaoxuan , Zhang Nianyu , Han Yanming , Xu Xuan , Cui Hao , Yu Meng , Shi Meilin
Published: November 2021

In view of the shortage of equipment resources and the inability for on-site disassembly and assembly training in the current teaching of positron emission tomography/computed tomography (PET/CT), a simulation training system for PET/CT based on Unity 3D engine and C# language is designed by 3ds Max and Cinema 4D. The system realizes the simulation interaction of the equipment, thus providing a simulation environment for the operation training of equipment disassembly and maintenance. Through practical application, more users have a great interest in learning, and the comprehensive quality of operation and maintenance ability has been significantly improved, which shows that the system effectively improves teaching quality and reduces teaching costs. Taken together, we can see that it is worth rolling out.
Intraoperative lung protective ventilation in peritonitis patients undergoing emergency laparotomy: A randomised controlled trial
Authors: Chowdhury Apala Roy , Subramanian Rajkumar , Maitra Souvik , Bhattacharjee Sulagna , Lakshmy Ramakrishnan , Baidya Dalim Kumar
Published: November 2021

Background and Aims:

Lung protective ventilation (LPV) is recommended in acute respiratory distress syndrome. However, role of intraoperative LPV in elective laparotomy is controversial and it has not been evaluated in emergency laparotomy (EL). The aim of the study was to identify whether use of intraoperative LPV in EL in peritonitis patients reduces postoperative pulmonary complications (POPC).

Methods:

After institutional ethics committee approval and informed written consent, 98 adult patients undergoing EL for peritonitis were randomised into two groups. Patients in group 1 received LPV (tidal volume 6–8 ml/kg, positive end expiratory pressure (PEEP) 6–8 cm H2O and recruitment manoeuvre every 30 min) and patients in group 2 received conventional ventilation (tidal volume 10-12 ml/kg, without PEEP/recruitment). Primary outcome was incidence of POPC on day 7.

Results:

Data of 94 patients (n = 45 in group 1 & n = 49 in group 2) were available. Baseline demographic & laboratory parameters were comparable. Incidence of POPC was similar in both the groups [42.9% in group 1 vs. 53.3% in group 2; risk difference -10.4% (-30.6%, 9.6%);P= 0.31]. Mortality during hospital stay was 26.7% patients in group 1 and 26.5% patients in group 2 [risk difference (95% CI) 0.14%, (-17.7, 18.0);P= 0.98]. Length of hospital stay [median interquartile range (IQR) 13 (9–18) days in group 1 vs. 13 (8–21) days in group 2;P= 0.82] and length of intensive care unit stay [median (IQR) 7 (4–10) days vs. 6 (3–12) days;P= 0.88] were also similar in both groups.

Conclusion:

LPV during EL in peritonitis patients does not reduce the incidence of POPC compared to conventional ventilation.
Comparison of sensory posterior articular nerves of the knee (SPANK) block versus infiltration between the popliteal artery and the capsule of the knee (IPACK) block when added to adductor canal block for pain control and knee rehabilitation after total knee arthroplasty---A prospective randomised trial
Authors: Padhy Shibani , Patki Abhiruchi Yeshwant , Kar Akhya Kumar , Durga Padmaja , Sireesha L
Published: November 2021

Background and Aims:

Adductor canal block (ACB), though an effective procedure for postoperative analgesia in total knee arthroplasty (TKA), does not provide analgesia to the posterior articular aspect of the knee joint. Infiltration between the popliteal artery and the capsule of the knee (IPACK block) and sensory posterior articular nerves of the knee (SPANK block) are two single injection techniques that have been shown to provide effective analgesia in posterior knee pain. This study aims to compare the effect of IPACK block and SPANK block when combined with ACB for analgesia and postoperative rehabilitation in TKA.

Methods:

A total of 82 patients were randomised into two groups: (1) ACB combined with IPACK, (2) ACB combined with SPANK block. The primary outcome was the pain scores from 6 h to 48 h after surgery and the duration of postoperative analgesia. The secondary outcome measures were 24 h opioid consumption, ambulation parameters like mobilisation ability, quadriceps muscle strength and patient satisfaction score at discharge.

Results:

Numerical rating scale (NRS) scores at rest and on movement, duration of analgesia, total opioid consumption, and patient satisfaction were significantly better (P< 0.05%) in the IPACK group than in the SPANK block. There were no significant differences in the knee rehabilitation parameters between the blocks.

Conclusion:

ACB with IPACK block offers better analgesia, less opioid consumption and better patient satisfaction with comparable knee rehabilitation parameters in the immediate postoperative period after TKA compared to ACB with SPANK block.
An innovative ‘Prop technique’ of mouth opening in post-COVID-19 mucormycosis maxillectomy: Finding a new way with minimal efforts
Authors: Sapate Manisha , Munde Ashwini , Narkhede Harsha , Mane Ajit
Published: November 2021

General anaesthesia is associated with damage to teeth, particularly during laryngoscopy. Dental injury is more probable when pre-existing dental pathology or risk factors are present. Post-coronavirus disease -2019 mucormycosis is a rare, fulminant, lethal, angio-invasive, opportunistic fungal disease and is increasingly recognised in diabetic and immunocompromised patients. Since the flange of the laryngoscope blade appears to be the source of tooth injury, alternate methods of wide mouth opening during laryngoscopy should be examined, especially when mouth opening is limited. In this case series, we have studied 12 cases of maxillectomies with an aim to improve restricted mouth opening by using the ‘Prop technique’ resulting in a minimum hinging force of the flange of the blade on teeth. Preoperatively, patients were warned about the possibility of dental injuries during anaesthesia or surgery.
Length of the middle finger of hand as a simple and reliable predictor of optimal size of uncuffed endotracheal tube in paediatric patients: An observational study
Authors: Saikia Priyam , Thottan Rohan S.
Published: November 2021

Background and Aims:

A recent study suggested middle finger length-based formula as a better predictive guide compared with age-based formula for selecting uncuffed endotracheal tubes (ETTs) in children. But that study did not meet sample size requirement. Thus, we primarily aimed to determine the accuracy of formula using length of the middle finger to determine the internal diameter of the uncuffed ETT and to compare its accuracy with the Cole’s formula. As a secondary objective, we desired to compare its accuracy with some commonly used length and weight-based formulae.

Methods:

This prospective observational study included children aged up to 12 years posted for elective surgery under general anaesthesia. The length of the middle finger on the palmar aspect of the hand was measured in the preoperative period and the characteristics of the airway used were noted. A predefined criterion of optimal size of the uncuffed ETT was used.

Results:

A total of 139 patients were included in the final analysis. It was observed that the formula based on middle finger length can predict the optimal size of uncuffed ETT within an error of 0.5 mm in more than 90% instances and its predictive performance is better than Cole’s formula. As a secondary outcome, we also observed that its accuracy is better than other formulae under evaluation.

Conclusion:

Formula based on middle finger length can be used as a predictor of optimal size of uncuffed ETT in paediatric patients and it is a better predictor than Cole`s formula.
Simulation with a colour indicator to help reduce contamination during airway management in COVID-19 times: An experience from a tertiary centre in India
Authors: George Leah R. , George Smitha E. , Dhawan Ira , Babu Malavika , Sahajanandan Raj , Joselyn Anita S.
Published: November 2021

Background and Aims:

The coronavirus disease 2019 (COVID-19) pandemic has initiated modified protocols for aerosol-generating procedures. A simulation study using dye was conducted to highlight contamination at intubation and extubation and to encourage adherence to the new COVID-19 protocol among anaesthesia personnel in our institution.

Methods:

A video demonstrating the new COVID-19 protocols was circulated in the Department of Anaesthesiology a week prior to the study. Thirty teams, each comprising an anaesthesia resident and a staff technician, were enroled. Each team was asked to demonstrate the steps of preparation, intubation and extubation on a mannequin in a COVID-19 scenario. Checklists were used to assess points of contamination and adherence to the protocols. Following debriefing, a repeat simulation was conducted. The use of a dye highlighted the points of contamination. The study subjects provided feedback on the usefulness of the session and practical difficulties encountered in adapting to the new protocols.

Results:

The average contamination scores decreased by 3.4 (95% confidence interval (CI): 2.4–4.4,P< 0.001) in the post-debrief session. Adherence to the steps of the modified protocol improved by a score of 2.7 (CI: 3.6–1.83) among anaesthesiologists and by 4.3 (CI: 5.3–3.3) among technicians. Further, 93% felt that the use of the colour indicator reinforced awareness of the possible points of contamination.

Conclusion:

Simulation with a low-fidelity mannequin by using colour indicator for secretions is an effective teaching tool to reduce health hazards during airway management in COVID-19 times.
Serum Paroxonase 1 level may be an Indicator and Predictor of the Severity of Androgenetic Alopecia
Authors: Tantawy Maha , Khabir Ahmed Abdel , Mahsoub Nancy , Zohdy Marwa
Published: November 2021

Background:

Androgenetic alopecia (AGA) is a common stressful form of hair loss caused by androgen excess, genetic factors, and exposure to oxidative stress (OS) with the formation of reactive oxygen species (ROS). Paraoxonase 1 (PON1) is an enzyme synthesized in the liver bound to high-density lipoproteins to prevent lipid peroxidation.

Aim:

The aim of our work is to estimate serum PON1 level in patients with AGA and correlate its levels with disease severity which may help in determining if there is a role of ROS in pathogenesis of AGA.

Subjects and Methods:

This study was carried out as a case and control on 40 patients with AGA (diagnosed by typical clinical and dermoscopic finding) versus 40 control subjects. Blood samples were taken from all subjects to assess serum PON1enzyme using enzyme-linked immunosorbent assay kits.

Results:

There was a significant decrease in serum PON1 concentration level in AGA patients in comparison to controls, in addition, there was a significant decrease correlated with AGA severity (P < 0,001). The study proved that PON1 is considered highly sensitive and specific for AGA cases and a good predictive factor of AGA in healthy subjects.

Conclusion:

This is the first study done to reveal that the level of PON1 significantly decreased in AGA patients, which may give additional proof that OS has role in the pathogenesis of AGA and hence may help in the management of AGA by adding antioxidants in treatment.
A Clinico-trichological Study of Female Androgenetic Alopecia
Authors: Verma Isha , Madke Bhushan , Singh Adarsh Lata , Choudhary Sanjiv
Published: November 2021

Background:

Female Androgenetic Alopecia (FAGA) is one of the most common cause of diffuse scalp hair loss in women. FAGA is insidious in onset, gradually progressive, non scarring alopecia. Trichoscopy is a newly developed non invasive, objective, bed side analytical method of hair imaging based on video dermoscopy of scalp. The objective of this study is to study the clinical features of female androgenetic alopecia, to study the trichoscopic features in patients of female androgenetic alopecia and to correlate the trichoscopic features according to clinical grade of female androgenetic alopecia.

Methods:

Study enrolled 50 females with FAGA and 50 normal females. FAGA cases were divided into subgroups according to sinclair scale. Laboratory investigations including hemoglobin level, triiodothyronine (T3), thyroxine (T4) thyroid stimulating hormone (TSH) and serum ferritin level were carried out in both cases and controls. After clinical diagnosis, trichoscopic examination was done and categorised using Diagnostic Criteria set by Rakowska A. et al and trichoscopic findings were coorelated with clinical grades.

Results:

>4 yellow dots in frontal area, >2:1 ratio of single hair units (frontal: occiput) & >3:1 ratio of hair with perifollicular discoloration (frontal: occiput) are mainly seen in late stages of FAGA i.e. grade 4 & 5 and >1.5:1 ratio of vellus hairs (frontal :occiput) in early stages i.e. grade 2 & 3 while lower mean hair thickness in frontal area & > 10% thin hairs in frontal area are seen in all stages of FAGA Conclusion: Trichoscopy not only confirms the diagnosis by assessing the trichoscopic features of FAGA but also coorelates them with clinical severity. And as the age increases, grade of clinical severity increases. Not necessarily hemoglobin, thyroid and serum ferritin levels will be dearranged in FAGA cases.

Limitation:

The study is done on few number of patients. Further studies needs to be done to validate results.
Hair Loss in Children
Authors: Shetty Varsha M. , Shanmukhappa Asha Gowrappala , Nataraj H. V. , Aradhya Sacchidanand Sarvajnamurthy
Published: November 2021

Background:

Scalp hair loss in children is one of the common complaints encountered in dermatological practice. Accurate diagnosis of hair loss in children is of major significance as it can have severe psychological implications given the cosmetic importance of hair.

Aims:

This study aims to study the different causes and clinical presentations of scalp hair loss in children.

Materials and Methods:

This was a hospital-based descriptive study that enrolled a total of 170 children with scalp hair loss. A detailed history, scalp, and hair examination were done. Bedside investigations such as KOH mount, hair shaft microscopy, and hair pull tests were conducted. Scalp biopsy and dermoscopy were done wherever necessary to confirm the diagnosis.

Results:

Majority of the children with scalp hair loss were school going and adolescents accounting for 62.4% of cases; 52.4% of patients were male and 47.6% were female. Asymptomatic hair loss was the most common presenting complaint contributing to 71.2% of cases. Patchy pattern of scalp hair loss formed a majority (86.5%) compared to diffuse pattern (13.5%). Around 89.4% of scalp hair loss were of acquired type and remaining 10.6% were of congenital type. Neonatal occipital alopecia (38.9%) was the most common cause of congenital hair loss. However, in the acquired group, 90.1% had nonscarring and 9.9% had scarring alopecia. In the nonscarring group, tinea capitis, alopecia areata, and telogen effluvium accounted for 47.4%, 37.9%, and 8.8% of cases, respectively.

Conclusion:

Childhood alopecia is different from adult alopecia in terms of causes and the pattern of presentation. There is a scarcity of literature on childhood alopecia from India, hence, this study can serve as a useful guide in understanding the different causes and its presentation in our population. In addition, this study signifies the importance of simple diagnostic tests such as KOH and hair shaft microscopy in the diagnosis of common hair loss conditions in children.
Recovery of Alopecia Universalis with Associated Nail Dystrophy Treated with Tofacitinib
Authors: Dube Vineet
Published: November 2021

An emerging treatment modality whose established efficacy in systemic inflammatory diseases is now being actively explored for cutaneous disorders: tofacitinib, an oral Janus kinase inhibitor, is one such treatment. Alopecia universalis has been reported to improve with the use of tofacitinib in various case reports and case series. Nail dystrophy is a diverse skin disorder that has been linked to autoimmune illnesses such as psoriasis and psoriatic arthritis in certain subtypes. Alopecia areata and alopecia universalis are also commonly associated with nail dystrophy. In the present case report, we see that there are also improvements in nail dystrophy in the patient with alopecia universalis who is using tofacitinib.
Pemphigus Vulgaris Localized to the Scalp with Complete Response to Topical Steroids
Authors: Vega-Diez David , Lario Ana Rodríguez , Zubiaur Alba Gómez , Medina Susana
Published: November 2021

Pemphigus vulgaris (PV) is an anti-cadherin autoimmune disease, characterized by the production of anti-desmoglein 3 (and to a lesser extent anti-desmoglein 1) antibodies, producing acanthosis, typically suprabasal, which clinically translates into flaccid blisters and erosions, generally starting on mucous membranes, with subsequent appearance of skin lesions. Only about 25 cases of PV of exclusively cutaneous location have been described in the literature. Treatment with potent topical steroids is usually sufficient to control the symptoms. We present the case of a 68-year-old female patient with localized PV in the scalp, presenting as alopecic and scabby plaque, with excellent response and hair regrowth with topical corticotherapy.
18F fluorodeoxyglucose positron-emission tomography–computed tomography in the diagnosis of brachial plexopathy in carcinoma breast
Authors: Medara Suma Tammineni , Sricharan K. B. , Mohan V. Sai Krishna , Manthri Ranadheer Gupta , Lakshmi A. Y. , Kalawat Tek Chand
Published: November 2021

We report the case of a 42-year-old female who had received treatment for carcinoma left breast, now presenting with pain in the left upper limb for 2 months and paraesthesia for 1 month. Magnetic resonance imaging of the brachial plexus revealed altered signal intensity involving divisions and cords of the brachial plexus on the left side. 18F fluorodeoxyglucose (FDG) positron emission tomography-computed tomography revealed moderately increased FDG concentration in multiple ill-defined nodules, along the left brachial plexus suggestive of metastatic brachial plexopathy.
Evaluation of the effect of Jaftex herbal mouthwash on the growth of Candida albicans and Candida tropicalis
Authors: Amin Mansour , Babadi Fatemeh , Baghipour Najme , Sadeghi-Nejad Batool
Published: November 2021

Background:

Increased resistance of Candida albicans to standard antifungal agents has caused special attention to medicinal plants. The aim of this study was to evaluate the effect of Jaftex mouthwash on the growth of C. albicans and Candida tropicalis.

Methods and Material:

In this in vitro study, standard strains of C. albicans and C. tropicalis were used. Jaftex mouthwash was prepared with the active ingredient (10g/100cc) of aqueous extract of oak fruit hull (Jaft), Zataria multiflora, and Satureja bachtiarica. The mouthwash was diluted in half, 8 different concentrations were obtained. 10 μl volume of each dilution was poured on discs mounted linearly on the culture medium inoculated with the target fungus. After 24 h, due to the slow growth rate of these fungi, the Petri dishes were incubated at 37°C and the mean minimum inhibitory concentration (MIC) was determined for each fungus. The modified E. test method was used to measure the MIC of Jaftex mouthwash for the two fungi. The experiment was repeated three times for each fungus and the mean value was measured.

Results:

The mean value of MIC for C. albicans and C. tropicalis was 0.0625 (mg/mL) and 0.0833 (mg/mL), respectively. Candida albicans appeared to be more sensitive to Jaftex, but no statistically significant difference was observed.

Conclusion:

Jaftex mouthwash inhibits the growth of C. albicans and C. tropicalis. The use of this mouthwash is recommended for treatment of oral candidiasis.
Effect of yoga on pulse rate and blood pressure among women
Authors: Kaleeswari G. , Kalyani C. Vasantha , Jayarani J. S. , Rohilla Kusum K.
Published: November 2021

Objectives:

Change in the past few decades in human life style, nowadays international health organizations, i.e., World Health Organization are also focusing on prevention along with treatment aspect of chronic illness. Researches focus that women of age group 30–45 years are at increased risk for hypertension and heart disease due to increased weight. Yoga is an effective method to control our physiological variables like blood pressure (BP), pulse, etc. The main aim of this study was to identify the effects of yoga on physiological variables.

Methods:

The study was an experimental study with two group, pretest and posttest control group, design, which was conducted on 40 female participants. Pranayama and meditation for a period of 6 weeks was done by these women.

Results:

Yoga therapy significantly reduced the BP (0.000*) and pulse rate (0.000*) of women, which was also statistically proved.

Conclusions:

Yoga therapy can be an effective method to control BP and pulse rate of patients with chronic diseases.
TG/HDL Ratio
Authors: Chauhan Ajay , Singhal Ayushi , Goyal Parul
Published: November 2021

Background:

The spectrum of Diabetes Mellitus and various complications associated with it have been regarded as major global health challenges. Raised TG/HDL has been regarded as one of the valid markers for Insulin resistance. It leads to increased risk of CVD by causing Insulin resistance and also by its own effect on the vessel wall. Detection of raised TG/HDL ratio and early intervention before the patients develop clinical disease can help in mitigation of future consequences of CVD.

Aims:

The aim of our study was to compare TG/HDL ratio between prediabetics and controls and further to look for any correlation between the TG/HDL ratio value with HOMA-IR and Carotid Intima Media Thickness (CIMT) in prediabetics.

Settings and Designs:

A cross sectional study

Methods and Material:

Study was done at ABVIMS and Dr RML Hospital, New Delhi. 60 prediabetics and 60 age, sex, BMI matched controls were employed. In both cases and controls fasting and postprandial blood glucose, glycated Hemoglobin (HbA1C) and fasting Insulin levels were measured. HOMA-IR values in both the groups were calculated using fasting glucose and Insulin levels. Serum lipid profile was obtained and TG/HDL ratio was analysed in two groups. Values obtained were compared between the two groups. CIMT was only measured in cases using B mode ultrasonography.

Statistical Analysis and Results:

Median (IQR) of fasting plasma Insulin (µIU/ml) in cases was 11.3 (10.175-13.505) versus that in controls being 5.73 (4.3-7.1). HOMA-IR (IQR) values in cases and controls were 3.12 (2.73 - 3.595) and 1.21 (0.918 – 1.505) respectively. Median (IQR) for TG/HDL ratio was 3.26 (2.712 – 4) for cases and 2.05 (1.755- 2.502) for controls. However no correlation was observed between either the mean CIMT (mm) or HOMA-IR with TG/HDL ratio.

Conclusions:

Diabetes Mellitus and its various complications are of a great burden to society. Diagnosing the risk factors early before the onset of these manifestations can help us in combating these major issues. One of the risk factors among them is raised TG/HDL ratio. Early detection of elevated TG/HDL in prediabetics may serve in early detection of atherosclerotic complications and help physicians in framing primary preventive strategies for tackling ASCVD in patients with prediabetes and full-blown Diabetes.
High-resolution chest computed tomography findings of coronavirus disease 2019 (COVID-19) – A retrospective single center study of 152 patients
Authors: Kaur Navdeep , Sahoo Soumya S. , Chhabra Harvinder S. , Kaur Amandeep , Singh Navdeep , Garg Shivane
Published: November 2021

Introduction:

Coronavirus disease 2019 (COVID-19) pandemic has engulfed the world, within a short span of time crippling many health systems. The disease in its ever-evolving course is exhibiting a myriad of symptoms and imaging manifestations. This retrospective study was conducted to generate evidence from the chest computed tomography (CT) findings of patients with COVID-19 pneumonia to aid in the diagnosis and disease management.

Methods:

This retrospective study included all patients with reverse transcriptase polymerase chain reaction confirmed COVID-19 disease who underwent chest CT between 1st June to 31st December 2020 at a tertiary care institute of North India. Anonymized data of 152 COVID-19 positive patients was used for the evaluation of the clinical profile and imaging findings.

Results:

The common presenting clinical symptoms were fever, cough, myalgia and sore throat. The most frequent CT imaging feature consisted of ground-glass opacities (GGOs), consolidation and crazy paving distributed bilaterally, peripherally in subpleural location with a predilection for the posterior parts of lungs. Reverse halo sign was observed in 12 patients and halo sign in 3 patients. Dilated pulmonary vessels with mild bronchiolectasis were observed in the involved lung parenchyma. Less common findings included pleural effusion, mediastinal lymphadenopathy, and pericardial effusion. The mean CT severity score gradually increased with increasing age.

Conclusion:

The predominant imaging finding of COVID-19 pneumonia was peripheral GGO’s distributed bilaterally in peripheral subpleural region and having predilection for the posterior parts of the lungs which gradually evolve into organizing pneumonia patterns. Although COVID-19 shares imaging findings with other viral pneumonias, however in the context of the current pandemic, we must keep COVID-19 a differential diagnosis, in all patients with fever and respiratory symptoms.
Dietary behaviour and anthropometric parameters across the spectrum of pregnant and lactating mother, infant, young children, adolescent girls and reproductive age group females
Authors: Yadav Surbhi , Ahmad Shamshad , Chaudhary Neha , Kumar Mahendra , Gahlot Anju
Published: November 2021

Introduction:

The Kol is an ancient tribal community, who resides in the backward Bundelkhand and Baghelkhand regions bordering UP and MP. Reports claim the high level of exploitation and marginalisation of them by feudal landed landlords. Due to the dearth of studies on Kol community their plight hasn’t been addressed effectively so far. Thus, this study was undertaken to assess the dietary behaviour and anthropometric parameters across the spectrum of Maternal, Lactating, Infant, Young Children, Adolescent girls, and reproductive-age women (MIYC-AR) of Kol Community.

Methodology:

It was a descriptive observational cross-sectional study, conducted over a period of 6 months; in hard to reach area of Manikpur block, Mangawa, in Chitrakoot district. Pregnant, lactating mothers, infant, young children, adolescent and reproductive age females who were found eligible, were included in the study. A total of 180 participants (30 from each group) were recruited by non-probability purposive sampling. A structured questionnaire was used to collect information regarding Iron folic acid and calcium intake, frequency of major meals and snacks, feeding history of infant and young child. Weight, height, head circumference and mid upper arm circumference were noted and the participants were classified accordingly. Statistical analysis was done using STATA version 13 software.

Results:

Only 36% and 30% of the pregnant and lactating mother, respectively, consumed IFA and calcium. The mean diet diversity score was inadequate for all the groups. Maximum among adolescents (70%) and half of the reproductive age group female (50%) were underweight. More than half of the infants (57%) were found to be malnourished on MUAC measurement, while the similar proportion among young children were found to be normal (p < 0.001). Half of the young children had timely initiation of complimentary feeding. But, none among young children received Vitamin A syrup.

Conclusion:

Significant higher prevalence of malnutrition was found among infants, adolescents, and reproductive age group females. Strengthening the public distribution system and rigorous supplementary nutrition services through ICDS are the priority intervention needed to address the poor nutritional status of tribe.
Cardiovascular manifestations of COVID-19
Authors: Kaeley Nidhi , Chawang Hannah J. , Baid Himanshi , Pillai Aadya
Published: November 2021

COVID-19 is known to present with respiratory symptoms, which can lead to severe pneumonia and respiratory failure. However, it can have multisystem complications such as cardiovascular and neurological manifestations. Cardiovascular complications of SARS-CoV-2 infection are still underreported in India. We have compiled four cases received in our emergency department with different cardiovascular manifestations at presentation and were diagnosed with COVID-19. The cardiovascular manifestations reported by previous studies comprise myocarditis, cardiogenic shock, arrhythmias, pulmonary embolism, deep vein embolism, acute heart failure, and myocardial infarction. Hence, a thorough cardiac examination with ECG correlations and point of care cardiac markers should be done in all the patients with COVID-19 infection. Immediate initiation of prophylactic anticoagulation in COVID-19 hospitalized patients is mandatory. Geriatric patients and those with co-morbidities can have a fulminant course of illness; so our treatment protocol should be more vigilant in these patients. However, most importantly, we must not forget the significance of bedside echocardiography, lung ultrasound, and point of care markers.
Out-of-pocket expenditure and its predictors for illness of under-five children
Authors: Mohanty Parimala , Satpathy Sudhir Kumar , Patnaik Sibabratta , Patnaik Lipilekha
Published: November 2021

Introduction

Out-of-pocket (OOP) expenditure influences the access to the healthcare of the marginalized and vulnerable population including under-five children (U5C). The aim of the study is to estimate the OOP expenditure and its predictors in Bhubaneswar, a region of eastern India.

Methods:

A cross-sectional study was conducted using a semi-structured interview schedule in 20 urban slums of Bhubaneswar. The survey was carried out by using the National Sample Survey Office (NSSO) health consumption schedule 25.0 in which mothers of U5C with illness (n = 530) were interviewed. For data analysis, the nonparametric Wilcoxon rank-sum test and Kruskal–Wallis test were used as tests of significance.

Results:

The study revealed that the mean OOP expenditure for outpatient department (OPD) care was

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375.9 (

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219.48). The mean approximated expenditure was

JOURNAL/jfmpc/04.03/01697686-202110100-00058/math_58MM3/v/2022-10-03T183005Z/r/image-tiff

1669.8 (

JOURNAL/jfmpc/04.03/01697686-202110100-00058/math_58MM4/v/2022-10-03T183005Z/r/image-tiff

1131.9) for inpatient department (IPD) care. In OPD care, doctors’ fee and medicine cost constituted 65.01% and 50.46% of OOP expenditure, respectively. In IPD care, medicine cost and doctors’ fee contributed to 36.62% and 30.54% of OOP expenditure, respectively. The major significant predictors that contributed to increased OOP were gender and delay in approaching the source of treatment in OPD, whereas in IPD no such predictors were observed.

Conclusions:

This study prominently sheds light on the issue of accessibility and affordability of health services without a comprehensive health insurance scheme for U5C illness among the vulnerable urban slum dwellers to achieve universal health coverage.
A review of applying transarterial chemoembolization (TACE) method for management of hepatocellular carcinoma
Authors: Ghanaati Hossein , Mohammadifard Mahyar , Mohammadifard Mahtab
Published: November 2021

Liver cancer is one of the most ordinary reasons for death among cancers. Hepatocellular carcinoma (HCC) is the most common type of liver cancer. In spite of the fact that various remedial methods have been approved particularly the survival effects of the transcatheter arterial chemoembolization (TACE) method have been accomplished widely in the HCC treatment. By applying the TACE method correctly, good survival outcomes can be achieved without harmfully affecting the hepatic functions. Transarterial chemoembolization mixes the effect of avascular necrosis (AVN) with the effect of regional chemotherapy those are under the influence of arterial embolization. By knowing the fact that the metastases of liver cancer and also perfusion indices in hepatocellular carcinoma (HCC) are via hepatic arteries, doctors chose the TACE method for the treatment of liver cancer. On the other hand, in this method, the radiologists can easily convey antitumor remedies via the arteries. Anyway, medium-level HCC is a sensitive stage of the heterogeneous disease that many patients suffer from, so specialists must consider it as a hazardous syndrome. The TACE procedure could be applied just in cases that the liver function of patients is appropriate yet, the patient liver portal vein do not have any problems and the patients do not have ascites disorder. This review is aimed to figure out the evident advantages of TACE especially by a comprehensive view on the medium level HCC. Because of that this treatment method is suggested as a first-line remedy. At last, the future landscape of the initial factors of research in managing HCC disorders have been summarized.
Convalescent plasma therapy in COVID-19 and discharge status
Authors: Agarwal Neeraj , Mishra Shradha , Ayub Arshad
Published: November 2021

Objective:

Covid19 has emerged as a greatest threat of the decade worldwide. At present there is no certain treatment for treating coronavirus diseases, while some antiviral drugs (Remdesivir , Lopinavir and Ritonavir) are under investigation. Many countries including India have adopted the convalescent plasma therapy in the treatment of moderate to severely ill patients. Despite the treatment being given ,there are no such evidences on the utility and efficacy of convalescent plasma.Hence this study tries to find out the impact on the discharge status from hospital of the patients receiving the very therapy.

Design:

Systematic review and meta analysis.

Setting:

An extensive search was made, following PRISMA guidelines on online databases such as Pubmed, Google scholar and Science direct.Studies those fulfilled the inclusion and exclusion criteria ,were included and reviewed and analyzed for a common outcome(discharge status).

Participants:

A total of 6 eligible studies were analyzed qualitatively and quantitatively which included three case control, two case series and one case report.

Results:

The overall pooled discharge rate from the above studies was 75.7% after the CP therapy. When analyzed for relative risk , it showed CP therapy having a lower risk of staying in hospital (not getting discharged) when compared to Standard therapy ,overall RR (relative risk) being 0.946.

Conclusion:

Our study shows that there is always a higher rate of discharge and low risk of prolonged hospital stay in those patients who receive plasma therapy. CP therapy being a low cost and easy to administer therapy with very less adverse events, requires more focus on further research as it has a potential to become an ideal effective treatment option for COVID-19.
Prevalence and pattern of geriatric emergencies in a teaching hospital of North India
Authors: Kaeley Nidhi , Kumar Jainendra , Kumar Manish , Vempalli Nagasubramanyam , Dhar Mridul , Bhardwaj Bharat B , Kumar Subodh , Kabi Ankita , Arora Poonam
Published: November 2021

Introduction:

Changing demographic patterns worldwide and improvement in healthcarehas contributed to increasing visits to the emergency department byelderly patients. Geriatric patients usually have multiple co-morbidities and declining physiological functional status. This complex interplay of various factors requires a specific and curated approach from the emergency physicians.Our aim was to study the pattern and prevalence of geriatric emergencies and the profile of infectious and non-infectious causes of fever in geriatric population in our tertiary care center.

Materials and Methods:

This retrospective descriptive study was carried out at a tertiary care hospital of north India and included all patients aged more than 18 years who visited the emergency department over a period of six months (July 2018 to December 2018). Detailed data regarding demographic, clinical and diagnosis was obtained retrospectively from the hospital records system. The patients were divided into two groups, age less than 60 years and elderly patients more than 60 years of age for comparison.

Results:

A total of 24768 patients above the age of 18 years visited the emergency department over a period of six months. Out of which 5399 (27.5%) patients belonged to the geriatric age group more than 60 years of age. 2474 (45.8%) geriatric age group patientswere triaged to critical areas level one and level two as compared to 4668 (24.1%) patients aged less than 60 years. Ninety (1.8%) geriatric patients succumbed to death as compared to 77 (0.4%) patients aged less than 60 years. 651 (21.9%) geriatric patients were shifted to intensive care unit as opposed to 1038 (14.8%) patients of the younger age group.226 (4.2%) geriatric patients presented with fever in the emergency department.116 (73.4%) patients having underlying co-morbidities , had fever due to infectious causes whereas 42 ( 26.5%) patients had fever due to non-infectious causes.

Conclusion:

The clinical presentation mortality and morbidity pattern of geriatric patients differs significantly from that of younger population and requires a customized approach and dedicated emergency setups.
Magnitude and determinants of “Social Capital” among women in reproductive age group - A cross-sectional study from rural Wardha, Central India
Authors: Ikhar Madhuri , Banerjee Sitikantha , Bandyopadhyay Kajari , Tiwari Mithilesh K. , Kumar Manoj , Deshmukh Pradeep
Published: November 2021

Context:

Social capital reflects the trust, norms, values and social processes that governs interaction among people.

Aim:

This study was conducted to estimate the magnitude and determinants of social capital among women of reproductive age group in selected village of rural Wardha, Central India.

Materials and Methods:

It was a community based cross-sectional study where two stage cluster sampling technique was used to select 300 participants from 22 villages. Data were collected using a pre-designed interviewer administered questionnaire by house-to-house survey. Social capital was measured using the core set of Integrated Questionnaire for the Measurement of Social Capital developed by World Bank.

Statistical Analysis:

Multivariate linear regression was applied to find out determinants of social capital.

Results:

Most of the participants had poor social capital score (women having lowest and middle tertile scores were 36.0% and 45%, respectively). social capital poorer in younger women, women with lower educational qualification, not involved in gainful occupation, belonging to below poverty line and unmarried compared to their counterparts. Having at least one son was positively associated with higher social capital. In adjusted analysis, age, education, occupation, marital status, and whether the woman has son were revealed as significant determinants of social capital.

Conclusion:

The study findings reflect the need of improving education and job opportunity among rural women to improve their social capital. Increase of social capital among women having male child reflects the need to percolate the message of gender equity and gender sensitive education.
Understanding social problems during lockdown and its relationship to perceived stress - An online survey among adult residents of India
Authors: Ghosh Ritu , Jana Pulak K. , Bhattacharya Saikat , Mallik Sarmila
Published: November 2021

Context:

Nationwide lock down imposed due to Covid 19 might bring about various social problems, constraints in availing essential services, difficulty in taking care of morbid elderly persons and inaccessibility to health care which can lead to stress.

Aims:

To identify social problems among adult Indian residents during lockdown period, to assess perceived stress among them and to identify the factors associated with it.

Settings and Design:

The study was conducted through the online platform using a google form among adult residents of India. Perceived stress was assessed by Perceived Stress Scale 10.

Statistical Analysis Used:

Data were analysed using SPSS version 16.0., using chi square, Odd’s Ratio and binary logistic regression.

Results:

One fourth of the respondents faced economic problem, 11.7% of them had experienced some sort of violence and worsening of familial relationship. The problems encountered in seeking care were chi square test due to non availability of transportation facilities and health services. Overall 80.78% of the respondents were observed to have moderate and high levels of perceived stress. Multivariate analysis revealed single marital status, owing a debt and experiencing violence had 1.62, 1.8 and 9 times higher odds of having moderate to high perceived stress. Violence was identified as its chief correlate.

Conclusions:

The present study found negative economic and social consequences on the Indian population and also posed an enormous psychological stress due to sudden lock down in pandemic situation.
Issues and challenges of polypharmacy in the elderly
Authors: Sinha Abhik , Mukherjee Shatavisa , Tripathi Santanu , Dutta Shanta
Published: November 2021

The aging population is of growing concern all across the globe as well as in India. Polypharmacy has been defined as the simultaneous use of multiple medications by an individual and the clinical suitability of such use. Polypharmacy is found more frequently in the geriatric population. Researches in India have also reiterated the fact. Polypharmacy in the geriatric population leads to many negative consequences such as increased adverse drug reactions, falls, frailty, and even increased mortality. Moreover, it leads to increased out-of-pocket expenditure. Polypharmacy also poses risk of poor treatment adherence and missed dose in the geriatric population. Mitigation measures in this regard may include increased awareness among physicians, improved medication management and adherence, efforts to reduce self-medication, and improper crosspathy.