bluuebunny/crossref_metadata_2025 huggingface dataset:
Seroprevalence and hematological profile of dengue among healthy inhabitants of Mayo Kebbi province: South of Tchad
Authors: Djibrine Mahamat Baharadine , Ngum Ngum Lesley , Maurice Boda , Chedjou Jean Paul Kengne , Netongo Palmer Masumbe
Published: October 2024

ABSTRACT

Introduction:

Dengue is one of the most serious and rapidly spreading major mosquito borne diseases in the world. Despite many acute febrile illnesses in Tchad, the burden of illness due to dengue in the country is largely unknown. Hence, the present study aimed to determine the seroprevalence of dengue viral (DENV) infection and its association with hematological parameters.

Method:

A cross sectional study was carried out in Bongor Provincial Hospital. Blood samples were collected from each participant and were used to determine the hematological profile and to diagnose the presence of DENV infection. A total of 130 participants were enrolled in the study. Among these, 114 (87.7%) were diagnosed positive for DENV infection.

Results:

The majority of the positive cases were of the age group 21 to 40 years old. Leukocytosis was the most common hematological parameter affecting 120 (92.3%) of them followed by anemia and thrombocytopenia affecting 69 (53.1%) and 16 (12.3%) of them, respectively, and then lymphocytosis affecting 5 (3.8%) of them. No case of leukopenia was recorded.

Discussion:

The seroprevalence rate among participants suggests that the dengue virus is in circulation in Mayo Kebbi province: south of Tchad. The abnormal hematological parameters may contribute to the severity of the infection like the incidence of bleeding in the case of thrombocytopenia.
JAK 1-3 inhibitors and TYK-2 inhibitors in dermatology: Practical pearls for the primary care physician
Authors: Beard Abigail , Trotter Shannon C.
Published: October 2024

ABSTRACT

Guidelines for primary care clinicians on monitoring and safety guidelines regarding Janus kinase and tyrosine kinase 2 inhibitors in the treatment of inflammatory skin conditions are often unclear. This review aims to provide the primary care physician with a review of clinically relevant and updated information regarding the monitoring and overall profile of these medications. To do so, a systematic review was conducted using the PubMed database and relevant Food and Drug Administration (FDA) approved drug inserts from manufacturers. Janus kinase and tyrosine kinase 2 inhibitors have recently gained FDA approval for the treatment of several inflammatory skin conditions including atopic dermatitis, plaque psoriasis, alopecia areata, and vitiligo. There is a known box warning associated with the Janus kinase inhibitors that create the need for monitoring and close follow-up while patients are undergoing these treatments. Although these medications are often prescribed by specialists, as their use becomes more prevalent and therapies continue to gain approval for the treatment of these commonly encountered conditions, it is important for the primary physician to be updated and aware of the current monitoring guidelines and safety profile for this class of medication. Both Janus kinase inhibitors and tyrosine kinase 2 inhibitors display significant efficacy in the treatment of their approved conditions and research continues to move forward with the approval of more medications from these classes.
Clinical and epidemiological characteristics of COVID-19 mortality in Saudi Arabia: A retrospective multi-center study
Authors: Mahmoud Mahmoud A. , Altaluoni Alaa Anwar , Alshargi Abdulrahman Abdullah , Al-Zalabani Abdulmohsen H.
Published: October 2024

ABSTRACT

Background/Aim:

Coronavirus disease 2019 (COVID-19) increased morbidity and mortality in health institutions worldwide. The present study describes the epidemiological and clinical characteristics of COVID-19 mortality rates. Investigating the factors that affect COVID-19 mortality will be helpful in reducing the burden of morbidity and mortality in healthcare systems.

Materials and Methods:

The current retrospective observational study was carried out in the Kingdom of Saudi Arabia. COVID-19 cases resulting in death were admitted to hospitals from March 2020 to June 2020. The epidemiological and clinical characteristics of these cases of COVID-19-related death were collected and evaluated.

Results:

A total of 3260 COVID-19 death cases were included. The mean age of the subjects was 55 years. COVID-19 deaths more frequently in patients aged 50–59 years, 60–69 years, and 40–49 years (26%, 22%, and 17%, respectively). A greater percentage of COVID-19-related deaths (47%) was observed in June than in March (>1%), April (15%), and May (37%). Men accounted for most death cases (76%) compared to women. The COVID-19 mortality rate was higher among non-Saudi (71%) than Saudis (29%). The highest COVID-19 mortality was observed in Tabuk Region, whereas the lowest was observed in Najran. The mean stay duration of COVID-19 cases in the intensive care unit (ICU) was 11 days. The independent t-test indicated a statistically significant increase in the life expectancy (6 days) of ICU cases compared to non-ICU cases.

Conclusion:

The findings suggest that older age, male gender, and non-Saudi are risk factors that enhance COVID-19 mortality rates, while medical care increases the life expectancy of COVID-19 cases.
First-aid knowledge and practices towards patients with epileptic seizures among the dental students in Saudi Arabia – A cross-sectional study
Authors: Al-Qahtani Zainah , Mahmood Syed Esam , Alshahrani Mariam S. , Alosaimi Maram N. , Bakri Khulud Ali A. , Alqarni Shahd Mohammed , Alshehri Ebtihaj , Alqarni Amal Merei M.
Published: October 2024

ABSTRACT

Background:

Dental care of patients with epilepsy and seizures must be performed by dentists who are familiar with these disorders. Improper training and incapability to manage medical emergencies, including epileptic seizures, may cause thoughtful consequences and legal actions. Therefore, dental students must have a proper knowledge of the disease and its consequences. They should have the ability to provide first-aid measures helping a patient experiencing an epileptic seizure in their clinics. This study aims to evaluate the first-aid knowledge and practices towards patients with epileptic seizures among the dental students in Saudi Arabia.

Methods:

A cross-sectional study was conducted targeting dental students in Saudi Arabia from 15 September 2022 to 15 December 2022 using convenience sampling. An online questionnaire was sent to the students via social media platforms for data collection. The data analysis was conducted using the Statistical Package for the Social Sciences (SPSS) version 16.0.

Results:

Of the 499 dental students included, 154 (30.86%) students had ever seen an epileptic patient in the clinics. About 16% of students did not know about performing cardiopulmonary resuscitation (CPR) on patients. The majority (66.5%) would call the ambulance after the patient’s seizure stops. About 82% of students prefer to call an ambulance if the patients face difficulty breathing or waking up after the seizure. More than 60% of students were taking precautions before treating an epilepsy patient. About 58.5% of the students were using local anaesthesia for an epilepsy patient. Nearly 41.9% do not have the confidence to treat an epilepsy patient. About 28.0% would swipe the vagus nerve stimulation (VNS) magnet over the left side of the chest. Of 154 students, who had ever seen epileptic patients, the majority (68.8%) refused to treat patients if they observe noncompliance with medication and follow-up among the patients who had any recent illness or seizures (16.2%).

Conclusion:

The undergraduate dental students had an intermediate knowledge regarding epilepsy and epileptic seizure first aid. However, some students lacked the confidence to deal with the epileptic cases in their clinics. Educational campaigns on epilepsy and first-aid courses targeting dental students are highly recommended.
Dietary practices of children and adolescents residing in an area of Chakdaha Block, Nadia district, West Bengal
Authors: Ghosh Sonali , Das Semanti , Palepu Sarika , Ahamed Farhad
Published: October 2024

ABSTRACT

Background:

Childhood and adolescence are crucial developmental stages during the life course. They develop and establish lifelong dietary and lifestyle habits. Unhealthy food environments that influence the risk of obesity and other nutrition-related NCDs by affecting the dietary patterns. Assessment of dietary patterns and factors affecting them will help to provide targeted interventions to improve the same.

Methods:

A community-based cross-sectional study was conducted among children aged more than 6 months and adolescents by interviewing their mothers regarding the dietary patterns. A two-stage sampling method was followed for selection of the participants.

Results:

A total of 325 participants were interviewed. Dietary diversity (DD) was present in 55.4% of the participants. Children of mothers who were educated beyond middle school (aOR = 3.81 (1.87-7.73), P = 0.000) and children who stayed in a joint family (aOR = 1.73 (1.11-2.72) P < 0.05) had higher odds of having dietary diversity in their diet, after adjusting for age and sex. Fast food shop location (aOR = 0.14 (0.05-0.38), P value = 0.000) was found to have a significant association with fast food intake among participants.

Conclusion:

Children and adolescents residing in the study area have a distinct dietary pattern compared to prevalent dietary practices in India. To improve dietary diversity of children and adolescents, maternal education, family dynamics, and community food environment, which include fast food and market locations, can be points of targeted interventions
The prevalence of depression among patients with diabetic foot ulcers at King Khalid University Hospital, Riyadh, Saudi Arabia
Authors: Aljamili Alaa , Alyousif Lina , Barhoush Mazen , Almasoud Reema
Published: October 2024

ABSTRACT

Background and Aim:

The prevalence rates of depression and anxiety among diabetic patients with diabetic foot ulcers (DFU) vary from one study to the other. We aimed to determine the prevalence of depression and the associated risk factors among patients with DFU.

Methods:

We conducted a cross-sectional study using a self-reported questionnaire on adult patients aged 18 years old and above with DFU at our institution. We used the 9-item Patient Health Questionnaire to evaluate the presence of depressive symptoms.

Results:

A total of 75 patients, 56 (74.7%) males and 19 (25.3%) females, participated in the study; 33 (44.0%) were more than 60 years old. The prevalence of moderate to severe depression among our patients was 35 (46.7%). Patients who had DFU for more than 1 year had a higher proportion of moderate to severe depression (P = 0.032). There were no significant differences in the proportion of patients who had depression according to age groups (P = 0.456), gender (P = 0.095), level of education (P = 0.145), employment (P = 0.514), type of diabetes (P = 0.561), duration of diabetes (P = 0.704), level of HbA1c (P = 0.525), smoking history (P = 0.163), and previous history of DFU (P = 0.713). Logistic regression analysis showed that patients who had DFU for more than 1 year were three times more at risk to have moderate to severe depression (P = 0.049).

Conclusion:

Patients with DFU have a high frequency of moderate to severe depression regardless of age, gender, or other sociodemographic characteristics, with patients with long-standing DFU having triple the risk of depression as those with freshly diagnosed DFU. Diabetic persons should be thoroughly assessed to reduce the diabetes result, and preventative actions and patient education about DFU are crucial.
Determinants of teenage pregnancy and knowledge about contraception, sexually transmitted diseases among pregnant women: A case-control study in Eastern India
Authors: Priyadharshani A , Sahoo Bimal Kumar , Mishra Abhisek , Singh Arvind Kumar , Parida Swayam Pragyan , Panda Ashutosh
Published: October 2024

ABSTRACT

Context:

Each year, about 21 million girls aged 15–19 in developing regions experience pregnancy, posing significant challenges for their health, well-being, and economic stability due to its vast impact.

Aim:

To identify the risk factors contributing to teenage pregnancy as compared to Pregnancy in pregnant women in the rural area of the Khordha district with the assessment of their knowledge and, health-seeking behaviour (Contraception and STDs) among teenage and adult pregnant women in the study area.

Settings and Design:

Hospital-based case-control study conducted at Bhubaneswar’s Community Health Centre.

Material and Methods:

The study, conducted from April to July 2022, recruited 138 participants using consecutive sampling and interviewed them using a pretested semi-structured questionnaire.

Statistical Analysis:

Chi-square and logistic regression assessed association and strength.

Results:

Factors contributing to teenage pregnancy include education below high school (AOR = 2.46; 95%CI 0.89–6.79), SC and ST caste (AOR = 2.34; 95%CI 0.94–5.82), having more than three siblings (AOR = 4.45; 95%CI 1.53–12.96), and lack of communication about sexual issues (AOR = 2.84; 95%CI 1.25–6.39). Awareness of contraceptive methods was 34.8% among cases and 56.5% among controls (p = 0.02). Regarding STD awareness and symptoms, 15.2% of cases and 42.4% of controls were knowledgeable and experienced symptoms (p < 0.01).

Conclusions:

This study suggests that factors such as lower education, minority caste, having more than three siblings, and lack of communication about sexual issues contribute to early pregnancy. These findings could enhance existing ARSH platforms by integrating regular engagement and sensitization efforts.
Adherence to gluten free diet and problems faced by children with celiac disease and type 1 diabetes mellitus
Authors: Verma Anjali , Rani Shilpi , Verma Surender , Khanna Alok
Published: October 2024

ABSTRACT

Introduction:

Celiac disease (CD) in children can be associated with Type 1 Diabetes Mellitus (T1DM) as both share autoimmune etiology. Mainstay of treatment in celiac disease is total avoidance of gluten in diet whereas treatment in child with both the diseases will be Insulin therapy, exercise along with gluten free diet (GFD). There is dearth of literature regarding adherence to GFD and barriers for children with both T1DM and CD.

Methods:

A questionnaire-based study was done at a tertiary care institute so as to compare the self-reported gluten adherence and the problems faced by children with dual diseases (TIDM and CD) and CD alone. Thirty children of age group 5-14 years each withType 1 DM and CD (T1DMCD group) and celiac disease (CD group) were selected consecutively. A questionnairewas filled by asking questions from either children (above 8 years) or parents (below 8 years) and the results were compiled, compared and further analysed.

Results:

Baseline demographic parameters were comparable in both the groups. Gluten adherence was found to be worse in T1DMCD group as compared to CD group. Greater number of problems were experienced by children with both TIDM and CD as compared to children with CD alone (P < 0.05). Financial burden more so in T1DMCD group, unawareness about disease and benefits of GFD, less availability and social isolation were found to be the most significant barriers to diet adherence.

Conclusion:

As these children face dual diseases, they should be made more aware regarding benefits of GFD. Such information is valuable to primary care physicians for better management and rehabilitation of children suffering from these chronic diseases.
Service delivery in postpandemic period for routine childhood immunization in Assam following capacity building with BRIDGE IPC Skill tool
Authors: Mahanta Tulika Goswami , Nirmolia Nabanita , Biswas Abhijit Basu , Barua Swarnali D
Published: October 2024

ABSTRACT

Background:

For COVID-19 pandemic and associated factors, around 25 million children missed routine immunization in 2021. NFHS-5 for Assam reported 67% coverage with routine immunization in 2019–21 which is below national average (77%) and lowest among Indian States/UTs. Lack of knowledge and skill among provider can reduce coverage. To address vaccine hesitancy and demand generation for routine immunization, BRIDGE IPC Skills (Boosting Routine Immunization Demand Generation) training in routine immunization for frontline workers considered an effective tool.

Objectives:

To estimate the service delivery in postpandemic period for routine childhood immunization in Assam following capacity building with a BRIDGE IPC Skill tool.

Materials and Methods:

This cross-sectional comparative study was conducted among immunization service providers from April 2022 to March 2023, where training coverage of service providers on BRIDGE IPC Skill was assessed. Comparison was made between functionalities of trained services by service providers with untrained ones.

Results:

A total of 2312 session sites were visited, of which 67.7% of frontline workers were trained, while 32.3% were not trained. Alternate vaccine delivery was present in 58.5%. Updated due list was present in 64.1% vs 29.8% in trained and untrained sites. Significant association was found between delivery of key message and status of frontline worker on BRIDGE IPC Skill training.

Conclusion:

Capacity building of frontline workers on BRIDGE IPC Skill can boost efficiency of frontline workers and may facilitate in addressing gaps that EXIST between health care system and community.
Do the fathers matter? Paternal perspective of exclusive breastfeeding practices: A community-based cross-sectional study in urban slums of Bhubaneswar, Odisha
Authors: Roy Payel , Dora Susmita , Giri Prajna Paramita , Behera Binod Kumar , Subba Sonu Hangma
Published: October 2024

ABSTRACT

Introduction:

Although various policies have been framed to improve exclusive breastfeeding outcomes in India, the father’s role in breastfeeding is grossly ignored. Gender inequalities are still predominant in several parts of India. Fathers’ involvement in breastfeeding decision-making plays a significant role in improving the outcome. However, till now, this domain has been neglected in India. Henceforth, we aimed to see the knowledge and attitudes of fathers regarding breastfeeding in a community setting.

Methods:

It was a community-based cross-sectional study done in the urban slums of Bhubaneswar, Odisha. One hundred seventy-one fathers with their children between six months and one year were recruited by simple random sampling. Knowledge was assessed with a semi-structured questionnaire, and attitude was measured with the Iowa Infant Feeding Attitude Scale (IIFA).

Results:

In the present study, 1.18% of fathers had good knowledge regarding breastfeeding. 46.2% had average knowledge regarding breastfeeding, and 57.3% had positive attitudes toward formula feeding.

Discussion:

We have found that most fathers had a positive attitude toward formula feeding, and very few fathers had good knowledge of breastfeeding. Henceforth, further focus in this area is required to improve breastfeeding outcomes.
Female cancer screening in India: Results from the National Family Health Survey (NFHS-5) and the way forward
Authors: Subramanian Sivakami Sundari , Bhaskarapillai Binukumar , Jayakrishnan Radhakrishnan
Published: October 2024

ABSTRACT

The incidence of cancer is increasing in India, reflecting global trends. This study attempts to identify various socioeconomic factors associated with breast and cervical cancer screening in females aged 30-49 years using the National Family Health Survey-5 (NFHS-5) data. Data focused on sociodemographic variables, cancer awareness, and information on breast and cervical cancer screening. Poisson regression was used to identify factors and reported adjusted prevalence ratio (APR) and 95% confidence intervals (CI). The proportion of women who had undergone breast and cervical cancer screening all over India was 0.9% and 1.9%, respectively. Socioeconomic factors seem to play a role as the poor and middle wealth index groups were less likely to undertake breast (APR = 0.60; 95%CI: 0.37, 0.99) and cervical cancer (APR = 0.68; 95%CI: 0.51, 0.92) screening compared to the wealthier groups. Moreover, 43% of participants in the poor wealth index category had not undergone cervical cancer screening (APR = 0.57; 95%CI: 0.33, 0.96). Further, women who watched messages on visual media were more likely to undergo screening for breast (APR = 2.00; 95%CI: 1.12, 3.57) and cervical cancer (APR = 1.46; 95%CI: 1.18, 1.82) within a week. In conclusion, screening for cancer among Indian females is remarkably low, which highlights the need for a uniform protocol for message dissemination on cancer and to collect information based on risk assessment. Furthermore, the negligible community participation in cancer screening points to the potential role of sociodemographic characteristics in taking up cancer screening, which was reflected in less participation among socioeconomically disadvantaged groups.
Can tele-physiotherapy help in filling treatment gaps during pandemics in multiple sclerosis?
Authors: Kumar Gunjan , Kaur Darshpreet , Singh Ajay Kumar
Published: October 2024

ABSTRACT

Background:

Published data demonstrate promising results for rehabilitation in patients with multiple sclerosis (MS), including telerehabilitation technologies. Given the travel limitations during the coronavirus disease 2019 (COVID-19), telerehabilitation may provide a viable alternative to in-person physiotherapy.

Objective:

To determine the efficacy of telerehabilitation in MS patients during COVID-19.

Design/Methods:

A total of 42 patients participated in the study of which 24 were followed up till the end of 6 weeks. The investigated group consisted of 15 females and 09 males; the mean age was 42 ± 10 years. The telerehabilitation was provided for a duration of 6 weeks at a frequency of three classes per week. The patients used either laptops or mobile phones for attending these sessions. The inclusion criteria were a 6-minute walk test (with or without assistance). Motor function was evaluated using the Timed Up and Go (TUG) test and the 30-Second Sit-to-Stand (30STS) test. Patients were required to fill out two questionnaires also: 12-item MS Walking Scale (MSWS) and Modified Fatigue Impact Scale (MFIS). All the patient assessments were made by an independent physiotherapist before and after the intervention.

Results:

There was a statistically significant improvement in motor performance and MFIS and 12-item MSWS. The following results were observed: statistically improved parameters of TUG, 30STS, 12-item MSWS and MFIS.

Conclusions:

Based on the findings, it is reasonable to infer that the use of telemedicine in the rehabilitation of MS patients is very promising.
The quality of life of primary caretakers of children with cerebral palsy
Authors: Kondekar Alpana , Ansari Qudsiya , Ghatol Hrishikesh
Published: October 2024

ABSTRACT

Background:

Cerebral palsy (CP) is a heterogeneous group of disorder affecting the development of movement and posture, which is permanent nonprogressive. Previous studies in different regions have shown links between caregivers’ mental health and children’s well-being. However, the lack of such detailed research for the caretakers of children with CP and correlation of quality of life affected the type and severity of the condition; this necessitates the development of a new study to assess caregivers’ quality of life.

Aim:

Quality of life among caregivers of disabled children is an important concern in healthcare. We aim to evaluate the quality of life among caregivers of children with CP and to assess the factors affecting the caregivers’ quality of life, namely, age, gender, type, and gross motor function in children with CP.

Methodology:

This was a cross-sectional observational study, conducted over a period of 6 months. It included the caregivers of children with CP at a tertiary care hospital of Mumbai. Data were collected using the WHO BREF questionnaire. The children were divided into two groups (2 to 7 years and 7 to 12 years). The qualities of life of the caretakers of these two groups were compared in four domains, namely, physical, psychological, social, and environmental.

Results:

The study included 50 participants. Mothers (80%) and fathers (10%) were the primary caregivers. Caretakers of the children with cerebral palsy showed significant affected quality of life as calculated from WHO QOL BREF score in both age groups (2–7 and 7–12 years) and in all domains. Overall, the most affected domain in our study was of psychological health and the least affected domain was of the environmental domain.

Conclusion:

This study provides a snapshot of the impact of having a child with cerebral palsy on the lives of the caregivers Most of the caregivers in the study were mothers, and quality of life was affected in all domains mainly in psychological and physical domains. The study showed that there is a need for interventions in caregivers which can have an indirect impact on the children with CP.
Dyke-Davidoff-Masson syndrome – A dainty spectrum with a diligent diagnosis
Authors: Palani Anitha , Periyanayagam Ajitha , James Saji , Thangavel Ramya , Sudarsan Aiswarya
Published: October 2024

ABSTRACT

Dyke-Davidoff-Masson syndrome is a rare condition of unknown frequency resulting from brain injury, especially in early life, due to a multitude of causes. We present the case of a 2-year-old, developmentally normal female who presented with one episode of unprovoked generalized tonic-clonic seizures. This child had a history of complex febrile seizures at 1.5 years of age and was started on levetiracetam (20 mg/kg/day). During the current evaluation, a magnetic resonance imaging (MRI) brain showed left hemi cerebral atrophy. The literature review revealed that these findings are consistent with Dyke-Davidoff-Masson syndrome. The child was discharged with oral levetiracetam (30 mg/kg/day) and counseling from parents regarding the need for long-term treatment and follow-up. Due to its rarity, Dyke-Davidoff-Masson syndrome may easily be missed by the treating physician. Knowledge of its radio-imaging features enables timely and accurate diagnosis, allowing appropriate management.
Early versus late-onset of weight struggles among patients with obesity: Data from the ACTION-IO study
Authors: Alfadda Assim A. , Isnani Arthur C. , Almubark Rasha A. , Alqahtani Saleh A. , Alqarni Ali , Shams Mahmoud , Yahia Moataz
Published: October 2024

ABSTRACT

Background and Aim:

The prevalence of obesity is increasing and people with obesity (PwO) continue to struggle with their weight. We aimed to describe the experiences of people who struggled with their weight at an early age (EAO) or at a later age (LAO), their discussions with their healthcare practitioners (HCPs) and episodes of depression and anxiety.

Methods:

We gathered information from 1,000 adults PwO, categorized them into EAO and LAO and analyzed their responses regarding weight loss attempts, discussions with their HCP, perceptions about obesity and episodes of depression/anxiety.

Results:

Mean age was 36.6 years old, and 73.0% were AAO. EAO had significantly fewer weight loss attempts and had fewer interactions with their HCP. EAO reported less HCP support for weight management, were less motivated to lose weight, and experienced more episodes of anxiety/depression. Significant association between greater obesity class with longer duration of weight problems, and depression and anxiety. EAO PwOs were less likely to discuss weight problems with their HCP.

Conclusion:

It is fundamental that HCPs recognize and address weight issues in PwO who are at risk of obesity in adulthood as early as adolescence. They should also take the lead in addressing these psychophysiological concerns by involving the parents in the decision-making process and facilitating shared planning. These may enhance their motivation to lose weight, boost self-confidence, and reduce the complications of obesity.
Nerve conduction velocity studies in diabetic peripheral neuropathy involving sural nerve—A meta-analysis
Authors: Prashant Praveen , Pal Sat , Bansal Abhishek , Fotedar Sanjay
Published: October 2024

ABSTRACT

Introduction:

Diabetes mellitus (DM) poses a significant health burden globally, impacting millions due to its metabolic disruptions. Among its complications, diabetic peripheral neuropathy (DPN) is a prevalent concern, affecting sensory and motor nerves. While various diagnostic methods exist, discrepancies persist in prevalence estimates of DPN among diabetic populations.

Objective:

This meta-analysis aimed to assess the prevalence of DPN in individuals with DM, focusing on sural nerve conduction velocity (NCV) measurements. Additionally, the study explored how different evaluation techniques influenced prevalence estimates.

Methods:

A systematic literature search was conducted following PRISMA guidelines across multiple databases. Studies reporting sural nerve NCV measurements in diabetic patients were included. Data extraction, quality assessment, and statistical analyses were performed to synthesize findings.

Results:

Twenty-six studies met the inclusion criteria, providing insights into sural nerve NCV among diabetic individuals. Pooled analysis revealed a mean sural nerve NCV of 42.12 m/s (95% CI: 39.87-44.36), indicative of reduced conduction velocity in diabetic populations. Furthermore, sural nerve amplitude was significantly lower in diabetic individuals, with a pooled mean of 4.68 μV (95% CI: 3.11-6.25).

Conclusion:

Individuals with type 2 DM exhibit impaired sural nerve function, as evidenced by reduced NCV and amplitude measurements. Timely NCV assessment, alongside glycemic monitoring, is crucial for identifying and managing DPN to prevent further complications. Interventions addressing glycemic control, dietary regulation, and lifestyle modifications are recommended to mitigate the progression of neuropathy in diabetic populations.
A clinicoepidemiological study of serologically diagnosed acute febrile illness in a teaching hospital, Kolkata
Authors: Kundu Suman , Mondal Purnima , Choudhury Kabita , Chakraborty Shruti , Banik Ankita , Pramanik Kaushik , Sinha Arijit , Bhattacharjee Swagata Ganguly , Dey Jayanta Bikash
Published: October 2024

ABSTRACT

Introduction:

Similar presenting manifestations in early phase and lack of awareness of aetiology of acute febrile illness (AFI) are major challenges in management of AFI.

Material and Methods:

This was a retrospective observational cross-sectional study conducted in the Department of Microbiology, NRS Medical College, from 1 July 2022 to 30 June 2023 in serologically diagnosed febrile patients attending the outpatient department or admitted. Clinical and epidemiological data and laboratory parameters were recorded in a pretested structured questionnaire study tool, and collected data were analysed on MS-Excel sheets with various charts and tables.

Results:

A total of 1711 serologically diagnosed febrile patients showed preponderance of dengue (38.3%), followed by leptospirosis (25%), scrub typhus (23.9%), malaria (12.6%), and enteric fever (1.92%). A majority of cases were male, less than 40 years of age, and from the rural population (73.2%), except in malaria (urban = 79.6%). The mean duration of fever was 9 days. Febrile cases were recorded maximum during the monsoon and postmonsoon periods (66.5%). The common manifestations are fever, headache (46.2%), pain abdomen (7.8%), nausea, and vomiting (9.4%). Thrombocytopenia with bleeding manifestation was higher in dengue (18%) cases. Mortality in dengue cases was recorded with multiorgan dysfunction syndrome (MODS). Scrub typhus cases showed seizure (8.3%) and altered sensorium (5%) due to fatal meningoencephalitis. Fatality in leptospirosis was mostly due to acute kidney injury (29.5%) and Weil’s disease (4.4%).

Conclusion:

Misdiagnosis or incorrect diagnosis and delay in initiation of appropriate treatment results in increased morbidity and mortality in AFI. Determination of epidemiological features and clinical manifestations of AFI along with timely correct diagnosis will benefit clinicians in proper treatment initiation, thereby reducing morbidity and mortality.
Anaemia and selected micronutrient deficiencies among young women in rural North India – A community-based study
Authors: Srinath Kathirvel , Kaur Ravneet , Singh Archana , Kalaivani Mani , Kant Shashi , Misra Puneet , Gupta Sanjeev K.
Published: October 2024

ABSTRACT

Introduction:

Anaemia is a major problem which affects half of young Indian women, impacting their health, education, and offspring. Despite ongoing efforts, a comprehensive understanding of anaemia remains limited. This study aims to assess the prevalence of anaemia among young women in rural Haryana and explore its causes comprehensively, which would help in tailoring targeted interventions for anaemia at a primary health care level.

Methods:

Young, non-pregnant women aged 15–24 years (n = 422) were assessed for socio-demographic details, menstrual/diet history, and anthropometry. Dietary diversity was assessed using Minimum Dietary Diversity for Women scale. Venous haemoglobin (Hb) was estimated using an auto-analyser. Serum ferritin, folate, and vitamin B12 were assessed for 260 participants. Anaemia was classified based on micronutrient deficiency. The morphology of anaemia was classified based on Red Blood Cell (RBC) indices. Multivariable analysis examined associations of anaemia with socio-demographic and clinical variables.

Results:

The prevalence of anaemia was 60.7%. Among those participants tested for micronutrient deficiency (n = 260), 170 (65.4%), 48 (18.5%), and 124 (47.7%) participants had deficiency of ferritin, folate, and vitamin B12, respectively. Iron deficiency anaemia (39.1%) and dimorphic anaemia (38.5%) were the two most common types of anaemia. The mixed morphology of RBCs was the most common morphology (41.8%). Almost all participants (98.2%) had inadequate dietary diversity. Being overweight was associated with lesser odds of having anaemia [OR = 0.41; 95% CI: 0.24 – 0.71 (P = 0.01)].

Conclusion:

The high magnitude of anaemia is high, and there is a need for nutrition-based interventions for anaemia at a primary health care level among young women in rural India.
Gestational weight gain and body mass index in Asian Indian women: Impact of timing and amount on fetomaternal outcomes
Authors: Rafat Dalia , Nawab Tabassum , Khan Tamkin
Published: October 2024

ABSTRACT

Background:

The aim of the study was to describe pre-pregnancy body mass index (BMI), total gestational weight gain (TGWG), and trimester-specific gestational weight gain (TSGWG) among Asian Indians and examine their association with adverse fetomaternal outcomes (AFMO).

Methods:

Using a prospective cohort study design, 557 pregnant women were recruited in the first trimester and followed up until delivery. Maternal BMI, TGWG and TSGWG were assessed and categorised according to the World Health Organisation (WHO) Asia Pacific BMI guidelines and the Institute of Medicine (IOM) recommendations, respectively. Maternal clinical characteristics and pregnancy and neonatal outcomes were assessed to predict AFMO. Logistic regression models in univariate and multivariate analysis were performed to estimate the odds ratios (OR) and 95% confidence intervals (CI).

Results:

The median BMI was 23.5 kg/m2. Moreover, 24.6% were overweight and 31.2% were obese, according to WHO Asia Pacific BMI cut points. The mean TGWG was 10.8 ± 1.9 kg and the mean TSGWG in the first, second and third trimesters were 1.7 ± 0.7 kg, 4.3 ± 1.1 kg and 4.8 ± 1.2 kg, respectively. We found a significant association of BMI, TGWG and TSGWG with various AFMO. Furthermore, excess third-trimester GWG has been demonstrated as a predictor of adverse maternal outcomes like hypertension and gestational diabetes mellitus.

Conclusions:

Our study reinforces the importance of optimal BMI and TGWG and further emphasises on assessment of TSGWG, which allows for early diagnosis of weight deviations, when prompt interventions can still improve pregnancy outcomes. We also suggest the adoption of BMI categories and GWG recommendations, specific to the socio-demographic characteristics of the population, to optimise the prevention, early diagnosis, and timely management of AFMO.
Psychological effects of Manipur violence among the internally displaced persons residing in relief camps across Imphal valley of Manipur – A cross-sectional study
Authors: Rajkumari Bishwalata , Ingudam Dayananda , Yengkokpam Chitra , Oinam Gunipriya , Yumnam Rajshri
Published: October 2024

ABSTRACT

Background:

Conflict and violence lead to the displacement of millions of people. A significant number of those who are exposed to potentially traumatic events, such as conflict and violence, may develop post-traumatic stress disorder (PTSD) and other mental health or behavioral conditions. This study plans to estimate the prevalence and associated factors of PTSD and generalized anxiety disorder (GAD) among internally displaced persons residing in different relief camps during Manipur violence.

Materials and Methods:

Community-based cross-sectional study was conducted among internally displaced persons (IDPs) residing in relief camps located in Imphal East District of Manipur using a pretested, semistructured, validated questionnaire consisting of PTSD checklist for DSM 5 (PCL-5) and the Generalized Anxiety Disorders Assessment tool (GAD-7). The study was approved by the Institutional Ethics Committee.

Results:

More than half (65.8%) of the respondents were found to have PTSD. One-fourth of the respondents (24.8%) were found to have moderate anxiety, and 15.2% have severe anxiety. Female gender, age between 20 and 59 years, marital status, and employment status after conflict were found to be significantly associated with PTSD. Marital status and witnessed destruction of property were found to be significantly associated with GAD. Around 3/4th of the respondents (235, 75.8%) reported witnessing destruction and burning of property, and 29 (9.4%) reported witnessing death of family members or friends. Around 58 (18.7%) were currently separated from family, and 25 (8.1%) had experienced some kind of trauma at the time of displacement.

Conclusion:

A majority of the participants have PTSD, whereas 15.2% have severe anxiety. Efforts and interventions should be made to improve the psychological well-being through psychological support and counseling from mental health professionals and provision of vocational training for income generation for the IDPs.
Weight gain in pregnancy and impact of obesity on the obstetric outcome: A retrospective study in a secondary care hospital in South India
Authors: Inian Sandhana , Nadar Sharon R. , Marconi Sam , Sukumar Ashwin , Cherian Anne G.
Published: October 2024

ABSTRACT

Objective:

To evaluate the patterns of weight gain in pregnancy and the outcomes of pregnancy in overweight and obese mothers.

Materials and Methods:

A retrospective cohort study was performed on 1,352 mothers between October 2020 and August 2021. All pregnant women who presented for antenatal checkups from 20 weeks or earlier, with a singleton pregnancy, were included in the study. Details such as comorbidities, total duration of labor, complications during labor, and neonatal complications were included.

Results:

At the first antenatal visit, 16% of mothers were underweight, 51% of mothers were normal weight, and 33% of mothers were overweight or obese. Women with poor weight gain were two times more prone to give birth to a child with low birth weight than those with adequate weight gain. Excess weight gain in pregnancy in women with a normal body mass index (BMI) had an association with the development of pre-eclampsia. The odds of overweight/obese pregnant women developing gestational diabetes mellitus (GDM) were 2.1 times higher than in pregnant women with normal BMI. The odds of pregnant overweight/obese women undergoing cesarean section were 1.6 times higher than in pregnant women with normal BMI.

Conclusion:

Overweight/obese pregnant women had increased odds of developing GDM and undergoing a cesarean section. Excess weight gain was also seen in overweight/obese women. It is therefore important for physicians to educate women on acceptable weight gain during their pregnancy.
Etiological spectrum of acute kidney injury and adverse outcome: A single-center observation
Authors: Rout Nikunj Kishore , Choudhury Arpita Ray , Dasgupta Sanjay , Pathi Debasis , Panda Bandita , Pandey Rajendra
Published: October 2024

ABSTRACT

Background:

The present study aims to evaluate the etiological spectrum with clinicopathological parameters and adverse outcomes of acute kidney injury (AKI).

Methods:

A hospital-based prospective observational study was conducted for a spectrum of AKI in 103 AKI patients and their AKI-associated adverse outcomes. The AKI patients were included as per the KDIGO definition. The patients with a known chronic kidney disease (CKD) were excluded from the study population. A clinicopathological association with AKI was observed. Adverse outcomes and the need for renal biopsy were recorded in 3 weeks followed up to 6 months.

Results:

A single-center study recorded that the incidence of AKI was 8.6% with a mean age of 34 ± 16 years. The cause of AKI due to medical reasons was maximum (70.8%), followed by obstetric (21.3%) and surgery (7.7%). The AKI mortality rate was 16% (P < 0.05). Renal biopsy in 34 cases showed that acute tubular necrosis was higher (38%), followed by acute cortical necrosis (23%). The spectrum of AKI was very diverse. In the 6-month follow-up, the adverse outcome was observed in 27.2% of patients, where the mortality rate was 16.5% and 10.7% of patients progressed to CKD.

Conclusion:

The spectrum of AKI was diverse among the population, and most of the etiologies are preventable. This alarms the need for better preventive strategies with a better referral system. The obstetric population with AKI, which majorly leads to either mortality or progression to CKD, is the section that seeks more attention.
Prevalence of abnormal thyroid function test in adults attending primary care setting in the year 2022 in the Kingdom of Bahrain
Authors: Bahram Samya A. , Alhayki Baheya M. , Matar Hanan A. , Alkhawaja Noor A. , Rabia Noor A. , Mahfoodh Zahra A.
Published: October 2024

ABSTRACT

Background:

Thyroid disease is known to be one of the most common endocrine diseases globally and has serious health implications if left untreated.

Objective:

This study aimed to gain a better understanding of common thyroid diseases and to explore the associated risk factors in the Kingdom of Bahrain.

Methods:

A case-control study was carried out after obtaining all thyroid stimulating hormone (TSH) results done in a primary healthcare setting from January 1, 2022 to December 31, 2022 from the Health Information Department. In total, 500 participants were randomly selected from each group: the abnormal thyroid test group (cases) and the normal thyroid test group (controls). Participants were interviewed using a structured list of associated risk factors with the following sections: sociodemographic characteristics, comorbidities, family history of thyroid disease, BMI, previous radiation therapy, and certain medications.

Results:

The prevalence of abnormal thyroid tests was found to be 11%. Cases were categorized into four groups: hyperthyroidism (26.4%), hypothyroidism (64.6%), hyperthyroidism (4.5%), and subclinical hypothyroidism 13 (4.5%). The results showed significant differences between case and control in the following risk factors: female sex, increasing age, BMI, dyslipidemia, family history of thyroid disease, and previous radiation therapy (P = <0.05).

Conclusion:

In summary, the high prevalence of abnormal thyroid results highlights the need for an organized national screening program for individuals at average risk for developing thyroid disease.
“Is it time to initiate scrub typhus surveillance in Karnataka?”—Lessons from a seroprevalence survey in a rural district
Authors: Chandrasingh Sindhulina , George Carolin E. , Maddipati Tatarao , Joan Roshni F.
Published: October 2024

ABSTRACT

Background:

Scrub typhus, caused by Orientia tsutsugamushi, is a commonly occurring, but underdiagnosed rickettsial infection in India. Considering the high incidence of scrub typhus among patients with acute febrile illness in the hospital setting and the paucity of community seroprevalence studies, we aimed to estimate the prevalence of scrub typhus in the community in the Bengaluru Rural District.

Methods:

A pilot cross-sectional survey was conducted between October and December 2022 among eligible asymptomatic adults from five randomly selected villages of the Bangalore Rural District after obtaining written informed consent. Serum immunoglobin M (IgM) and immunoglobin G (IgG) antibodies were tested using the respective enzyme-linked immunosorbent assay (ELISA) kits from InBios International Inc, Seattle, USA. Seroprevalence was defined as positivity to either IgG or IgM antibodies or both.

Results:

The study reported a seroprevalence of 8.9% (95% CI 4.8%–14.7%) among 146 asymptomatic adults. The IgG and IgM antibodies were positive in 7.5% and 2.1% of participants, respectively.

Conclusions:

A community seroprevalence of 8.9% warrants further epidemiological surveys and surveillance in the context of climate change, variable clinical presentations of scrub typhus, and the possible need to include this disease in the clinical practice algorithm in the primary care setting. We recommend study designs with “One Health” lens to monitor the trend of this re-emerging public health problem.
Perspectives and lived experiences of survivors and caregivers of COVID-19 patients in a teaching hospital in a tribal district of Chhattisgarh, India
Authors: Khanna Shilpa , Abhishek Shriyuta , Shagill Mohammad , Singh Lakhan , Malik Chetanya , Devi Savithri , Priyadarsh T , Kalkonde Yogeshwar
Published: October 2024

ABSTRACT

Background:

The rural–urban healthcare disparity in India was exacerbated during the COVID-19 pandemic, with the second wave hitting rural areas particularly hard due to weak infrastructure. A study in Chhattisgarh aims to explore the experiences of severely ill COVID-19 survivors and caregivers to inform patient-centric care delivery in primary settings.

Methods:

In this qualitative study, we conducted in-depth interviews with seven patients and seven caregivers during home visits or telephonically to understand lived experiences of receiving care for COVID-19 in an ICU in the public health system. Socioecological model was used to guide the qualitative inquiry.

Results:

COVID-19 patients faced stigma due to their diagnosis. The survivors felt lonely due to isolation, uncertainty about their illness, and fear of death. Poor mental health during ICU stay affected their physical health. Patients with caregivers felt supported despite visitor restrictions. Transparent communication with health providers reduced distress.

Conclusion:

The study in Chhattisgarh, India, highlights ICU survivors’ and caregivers’ experiences, revealing fear and loneliness among patients. Effective communication and caregiver presence improve outcomes, emphasizing holistic support. There’s an urgent need for palliative care integration, caregiver inclusion, and comprehensive post-discharge follow-up by primary-level practitioners in rural settings. Lack of state-level palliative care policy emphasizes the need for comprehensive initiatives to enhance healthcare outcomes.