bluuebunny/crossref_metadata_2025 huggingface dataset:
Role of tunica vaginalis flap and dartos flap in tubularized incisional plate for primary hypospadias repair: A retrospective monocentric study
Authors: Ahmed Faisal , Nikbakht Hossein-Ali , Al-Naggar Khalil , Al-Wageeh Saleh , Alyhari Qasem , Ghabisha Saif , Al-Shami Ebrahim , Dajenah Menawar , Aljbri Waleed , Mohammed Fawaz , Al-Hajri Abdu
Published: June 2022

Background: In the tubularized incised plate (TIP) procedure, flap interposition between the skin and neourethra is highly recommended to decrease the postoperative fistula rate. However, there is no consensus regarding the ideal flap for this procedure. This study aimed to report our experiences in the one-stage TIP hypospadias surgery utilizing dartos flap (DF) (penile skin subcutaneous tissue) and tunica vaginalis flap (TVF) (parietal layer of the testis) as a tissue coverage of neourethra. Methods: In a retrospective study from Sep 2018 to May 2021, 16 cases of hypospadias with different types, ranging from midpenile to penoscrotal types, were managed with TIP urethroplasty using DF or TVF as a tissue coverage of neourethra were enrolled. The demographic characteristics of the participants, type of hypospadias, outcome, and complications were analyzed and compared. Results: We used TVF and DF as soft tissue coverage in 11 (68.8%) and 5 (31.3%) patients, respectively. The mean age was 56.38 ± 47.83 months. Mid-penile, proximal, and penoscrotal hypospadias were presented in 3 (18.8%), 8 (50.0%), and 5(31.2%) patients, respectively. The total success rate was 14 (87.5%), while 2 (12.5%) patients developed a urethrocutaneous fistula, which required delayed closure later. In comparison between TVF and DF groups: the TVF was applied in all patients with moderate and severe chordee and all patients with penoscrotal hypospadias, and six patients with proximal hypospadias, while only three patients with mild chordee and two patients with proximal hypospadias used the DF and showed statistical significance between groups (p < 0.001 and 0.012) respectively. The success rate was 90.9% vs. 80.0% in TVF and DF groups, respectively, with no statistical significance between groups (p = 1.000). Conclusions: In the primary TIP repair, the TVF is a practical option as a DF for the interposition cover of a neourethra, especially in penoscrotal and proximal hypospadias with severe chordee.
Cyber pornography use and masturbation outburst. Considerations on 150 italian patients complaining erectile dysfunction and trying to solve it
Authors: Pozza Diego , Pozza Mariangela , Mosca Augusto , Pozza Carlotta
Published: June 2022

Objective: We aimed to verify the rate of masturbation (Mst) in a group of 150 Italian patients complaining Erectile Dysfunction (ED). Materials and methods: Our diagnostic protocol for penile and sexual problems included the collection of the patient's history, general and local clinical examination, and metabolic and hormonal analyses. Selected patients were also submitted to nocturnal penile tumescence test (Rigiscan), Duplex ultrasound of the penis, Magnetic Resonance Imaging, neurological tests and cardiological examination. A group of 150 Italian males (aged between 20 and 86 years) who complained ED and who presented to our Andrological Center to research the possibility of correcting their ED and being able to recover adequate sexual erectile activity were included in this study. In this group of patients suffering from ED we decided to evaluate the practice of Mst by asking specific questions: 1. Do you sometimes practice Mst? 2. How often in a week? 3. Is Mst hidden or known by the partner? 4. What do you use as a masturbatory sexual stimulus? The frequency of Mst was assessed according to a Likert scale as follow: a: No Mst; b:1-2/week; c: 2-3/week; d: > 3/week; e: daily or more. We also asked if it was possible to have penetrative marital intercourse on the same day as Mst (1-10 hours). We also asked what they used as a triggering sexual stimulus: press magazines, TV movies, the WEB. Results: Only 5/150 patients did not report Mst while 27/145 pts (aged 20-30 years) reported it more than 3 times a week; 44/145 (aged 31-50 years) 1-3 times a week and 27/145 (51-86 years) 1-2 times a week. Almost all patients used WebPorn as a stimulus for Mst. A group of patients over the age of 50 said they were quite satisfied with the physical results of Mst even though they would prefer to have sex as part of a couple relationship. Conclusions: The outburst of Mst in this web-dominated era could affect the sexual activity of individual males and couples.
A single - center retrospective observational study on patients undergoing Encephalo-Duro-Arterio -Myo-Synangiosis in patients with moyamoya disease
Authors: Hazra Darpanarayan , Chandy Gina Maryann , Ghosh Amit Kumar
Published: June 2022

BACKGROUND:

Many cases of moyamoya disease are refractory to conventional medical therapy, hence surgical revascularization techniques have emerged as one of the primary choices of treatment. In this study, we present the functional and angiographic outcomes of patients undergoing encephalo-duro-arterio-myo-synangiosis (EDAMS).

METHODS:

This is a retrospective observational cohort study, done over 8 years (2012–2020) in a neurological center in Eastern India. Data were retrieved from the hospital's electronic system, recorded in a standard data abstract sheet, and analyzed.

RESULTS:

This study included 75 patients, with a male (n = 42; 56.0%) preponderance. Majority belonged to the pediatric age group (≤18 years) (n = 70; 93.3%); remaining adult population included 5 (6.6%) patients. The most common presenting complaint was that of an ischemic cerebrovascular accident (CVA) (n = 57; 76.0%). Symptomatic hemispheres (n = 69; 92.0%) were treated and later followed if they had progressed to bilateral disease formation. Preoperative DSA showed 50 (71.4%) to have Suzuki grade 3 type of angiographic findings. Postoperative complications included worsening unilateral hemiparesis 4 (40%), slurring of speech (n = 2; 20.0%), hematoma (n = 2; 20.0%), and surgical site infection (n = 2; 20.0%). One patient succumbed to his illness on the second postoperative day. A postoperative angiogram showed regression of moyamoya vessels in the majority (n = 69; 93.3%) of patients. All (n = 74; 100%) had an intensification of transdural vessels; none had a regression. None of the study participants showed an intensification of moyamoya vessels. Many of our patients (83.8%) had a good grade of revascularization (modified Matsushima and Inaba A and B), while 16.2% had low-grade revascularization (grade C). On assessing outcomes using a modified Rankin Score, a large number of our patients had an excellent (n = 45, 60%) neurological outcomes.

CONCLUSION:

There was a bimodal age distribution with most of them presenting with ischemic CVA. This procedure (EDAMS) had good angiographic (Matsushima and Inaba) and functional (modified Rankin Score) outcomes.
Suction thrombectomy using a microcatheter as a salvage method for acute distal occlusion during cerebral aneurysm embolization
Authors: Drakopoulou Maria , Giannopoulou Athanasia , Zampakis Petros , Messinis Lambros , Theofanopoulos Andreas , Constantoyannis Constantine , Panagiotopoulos Vasileios Evangelos
Published: June 2022

The aneurysm coiling process presents a risk of thromboembolic complications, mostly in patients with ruptured aneurysms, given the fact that they cannot receive antiplatelet therapy. Management strategies include medical anticoagulation or antiplatelet therapy, intra-arterial thrombolysis, and mechanical thrombectomy using direct aspiration first-pass technique or stent retrievers. We report our own experience of using an Excelsior SL-10 Microcatheter (Stryker, Fremont, California, USA) with an internal diameter of 0.0165”, originally designed for coil delivery, for contact aspiration of a thrombotic occlusion of a distal anterior cerebral artery during coiling of a broad-based trilobar anterior communicating artery aneurysm. The clot was removed under continuous manual aspiration, and complete recanalization has been accomplished. Mechanical thrombectomy through microcatheter aspiration may be a safe and feasible treatment option for acute distal artery occlusions, especially in the case of tortuous distal vessels during embolization of cerebral aneurysms.
Intraoral biosensors
Authors: Dogra Shefali , Dhawan Pankaj , Tomar Shivam Singh , Kakar Ashish , Kakar Era
Published: June 2022

The article encompasses a research on intraoral biosensors, which was conducted using keywords such as “Intraoral biosensors,” “health care monitoring devices,” “biomarkers”, “cloud servers,” “Internet of dental things (IoDT)” and “wireless sensors” in the databases of PubMed/Medline and Google Scholar between 1990 and 2020. Biomedical devices such as intraoral biosensors that are involved in continuous healthcare monitoring have garnered the attention of several researchers across the world. These devices function as an interconnecting link between the human systems and the outer environment. Recently, chair-side monitoring and early diagnostic tests are highly valuable for periodic monitoring and treatment planning for patients. These devices use biological reactions to detect and measure a particular chemical compound substance and then send an electronic signal. The chief advantages of these ubiquitous devices are high sensitivity and fast response. Intraoral biosensors integrate various materials and devices on one unique chip, hence functioning as the latest analytical and diagnostic tool of dentistry. This review highlights the basic concepts, principles and role of intraoral biosensors in the diagnosis of caries, periodontitis, oral cancer and dental fluorosis.
Comparison of biochemical characteristics between an endemic and a nonendemic area for CKDu Sri Lanka
Authors: Medagedara A. , Hewavitharane Pasan , Chandrajith Rohana , Abeysundara Hemalika T. K. , Thatil R. O. , Thennakoon S. , Mahanama Buddhisha , Weerasuriya N. , Thilakarathne A. , Nanayakkara Nishantha
Published: June 2022

Introduction:

Chronic kidney disease with uncertain etiology (CKDu) was first recognized in the 1990s in Sri Lanka. Considering the distribution of CKDu in the country, clusters of endemic and nonendemic areas can be identified. This study was carried out to compare the biochemical characteristics between CKDu endemic and nonendemic areas in Sri Lanka.

Materials and Methods:

A cross-sectional study was carried out among randomly selected males between the age category of 30 and 60 years in selected villages of Wilgamuwa (endemic) and Hanguranketha (nonendemic), located in the dry and wet zone, respectively.

Results:

The total participation percentage from the endemic area was 74.7% (224 out of 300 invitees). Out of 150 participants invited from the nonendemic area, only 100 participated in the study cohort. There was a striking difference between the two areas in serum creatinine levels (P = 0.001). When considering the behavioral patterns of the two study areas, the main occupation was farming and there was no significant difference between the behaviors of the people in the selected areas. A significant number of participants (n = 31, 13.8%) from the endemic area had high serum creatinine levels with a mean of 109 μmol/L (standard deviation [SD] = 66.41) (normal: 90–116 μmol/L). Whereas, in the nonendemic area, only 3 (3%) participants had elevated creatinine levels with a mean value of 85.41 μmol/L (SD = 18.78). A significant difference was observed in the two groups in the mean values of serum creatinine levels (P = 0.001). The mean value of random blood sugar (RBS) was 113.56 mg/dL (SD = 44.38) and 119.10 mg/dL (SD = 50.48) in endemic and nonendemic areas, respectively. There was no significant difference between the mean values of RBS (P = 0.2). The mean serum cholesterol was slightly higher in Wilgamuwa (119.26 mg/dl, SD = 45.31) compared to Hanguranketha (189.02 mg/dl, SD = 45.09). However, that was not statistically significant (P = 0.6).

Conclusions:

Serum creatinine is remarkably increased in CKDu endemic areas. RBS and serum cholesterol are less significant according to the endemicity of CKDu.
Knowledge, attitudes and utilization of food labels among undergraduate medical students in a medical college in Chennai – A cross sectional survey
Authors: Annamalai Sinthiya , Gopichandran Vijayaprasad
Published: June 2022

Introduction:

Food labeling is an important method of providing food-related information on the package of food products, to facilitate people's choice of safe and appropriate foods. Medical students are potential agents of change in food label utilization behavior in the community. The objectives of this study were to evaluate the knowledge, attitudes, and utilization of food labels among undergraduate medical students in a medical college in Chennai.

Material & Methods:

We conducted a cross-sectional survey of 200 students studying in the 1st to 3rd year in a medical college through an online Google Forms survey, self-administered by the students after online informed consent was obtained. We gathered information on their knowledge, attitudes, and utilization of food labels.

Results:

Of 400 students approached, 200 responded to the online survey. They had good knowledge about food labels. Female students had 3.4 (1.59 to 7.25) times better knowledge compared to men. The students had a positive attitude toward food labels, and a majority thought that the food labels are useful. Utilization of food labels to understand the nutritive content (55%), additives (57%), and manufacturer details (47%) was poor. Utilization of food labels was 2.7 times more (1.142–6.587) among those who did regular exercise, and it was 0.2 (0.09 to 0.9) times less among those who were on a strict diet.

Conclusion:

Medical students had a sound knowledge and good attitude toward food labels, but their food label utilization patterns were still poor. There is a need to incorporate food labeling in the undergraduate medical curriculum and inculcate better food label utilization behavior.
Outcomes in Live Renal Allograft Transplants with Different Modalities of Induction
Authors: Hota Datteswar , Chakraborty Sucharita , Dash Kumar Avijeet , Kar Chittaranjan , Rout Shashi Bhusan , Acharya Aruna , Mahali Debasish
Published: June 2022

Introduction:

The immunosuppressant regimen after kidney transplantation typically includes initial induction therapy followed by a maintenance regimen. The induction therapy was introduced with the aim of reducing acute rejections. A retrospective study was conducted to compare the outcomes in patients with different modalities of induction.

Materials and Methods:

This is a hospital-based retrospective study where 148 patients who have undergone live renal allograft transplantation at SCB Medical College and Hospital from March 2012 to February 2019 were included in the study. All cases included were crossmatch negative, ABO-compatible live renal allograft transplantations. All patients received tacrolimus, mycophenolate sodium, and steroids. Induction therapy varied depending on immunological risk and changes in protocol over time. Basiliximab, anti-T-lymphocyte globulin (ATLG), and anti-thymocyte globulin (ATG) were given in 56, 21, and 21 patients, respectively, and no induction therapy in 50 patients. All patients with an acute rise in serum creatinine and without an obvious cause of graft dysfunction were subjected to renal biopsy. The incidence of acute rejection, patient survival, and graft survival was calculated from the follow-up records and compared among patients receiving different induction therapies.

Results:

In the high-risk category patients, 31%, 20%, and 18.2% of patients (P = 0.6) and in the low risk category, 37%, 27.3%, and 20% of patients (P = 0.6) had acute rejections in basiliximab, ATLG, and ATG group, respectively. The patient survival at 1 year was 79.3%, 70%, and 81.8% in high-risk group patients (P = 0.84) and 88.9%, 81.8%, and 80% in low-risk group patients (P = 0.88) in the basiliximab, ATLG, and ATG groups, respectively. The graft survival at 2 years was 96.6%, 90%, and 90.9% in high-risk group patients (P = 0.32) and 88.9%, 90.9%, and 90% in low-risk group patients (P = 0.65) in the basiliximab, ATLG, and ATG groups, respectively.

Conclusion:

In the low-risk group, the use of different modalities of induction does not have any advantage over no induction therapy in reducing the incidence of acute rejection, or improving patient and graft survival. In the high-risk group, all the induction therapies used lead to similar outcomes and none show any advantage over the other in terms of statistical significance. However, patients who received ATLG or ATG have an increased incidence of septicemia as compared to basiliximab and no induction group.
Clinical Perspectives towards Improving Risk Stratification Strategy for Renal Transplantation Outcomes in Indian Patients
Authors: Kher Vijay , Kute Vivek B , Sahariah Sarbeswar , Ray Deepak S , Khullar Dinesh , Guleria Sandeep , Bansal Shyam , Gang Sishir , Bhalla Anil Kumar , Prakash Jai , Abraham Abi , Shroff Sunil , Bahadur Madan M , Das Pratik , Anandh Urmila , Chaudhury Arpita Ray , Singhal Manoj , Kothari Jatin , Raju Sree Bhushan , Pahari Dilip Kumar , Siddini G Vishwanath , Sudhakar G , Varughese Santosh , Saha Tarun K.
Published: June 2022

Graft loss and rejections (acute/chronic) continue to remain important concerns in long-term outcomes in kidney transplant despite newer immunosuppressive regimens and increased use of induction agents. Global guidelines identify the risk factors and suggest a framework for management of patients at different risk levels for rejection; however, these are better applicable to deceased donor transplants. Their applicability in Indian scenario (predominantly live donor program) could be a matter of debate. Therefore, a panel of experts discussed the current clinical practice and adaptability of global recommendations to Indian settings. They also took a survey to define risk factors in kidney transplants and provide direction toward evidence- and clinical experience-based risk stratification for donor/recipient and transplant-related characteristics, with a focus on living donor transplantations. Several recipient related factors (dialysis, comorbidities, and age, donor-specific antibodies [DSAs]), donor-related factors (age, body mass index, type – living or deceased) and transplantation related factors (cold ischemia time [CIT], number of transplantations) were assessed. The experts suggested that immunological conflict should be avoided by performing cytotoxic cross match, flow cross match in all patients and DSA-(single antigen bead) whenever considered clinically relevant. HLA mismatches, presence of DSA, along with donor/recipient age, CIT, etc., were associated with increased risk of rejection. Furthermore, the panel agreed that the risk of rejection in living donor transplant is not dissimilar to deceased donor recipients. The experts also suggested that induction immunosuppression could be individualized based on the risk stratification.
Lessons Learnt from Progressive Vascular Calcification in a Renal Transplant Recipient
Authors: Anandh Urmila , Kumar Ritesh , Ramesh G.
Published: June 2022

Chronic kidney disease − mineral bone disorder is a common complication in patients with renal failure. Vascular calcification is the part of this clinical syndrome and progresses over the years. A successful renal transplantation ameliorates the uremic milieu and retards the progression of vascular calcification. In some cases, the vascular calcification is progressive even after transplantation leading to undesirable complications. We describe a case of renal allograft recipient who developed renal allograft dysfunction secondary to his progressive vascular disease. His extensive vessel calcification was missed in routine investigations. This case illustrates the need for dedicated evaluation of vascular calcification in high-risk patients undergoing renal transplantation.
Oral haemangiomas- Series of two case reports and review of management
Authors: Gupta Sonam , Kumar Raman , Pandav Gaurav , Pandav Sakshi , Gulati Prerna
Published: June 2022

ABSTRACT

Haemangiomas are one of the most common of all human birth defects and are based on vascular tissues. These lesions are mainly identified into two groups which are named as (a) capillary and (b) cavernous haemangioma. Capillary haemangioma consists of small capillary vessels which show lobules formation. Cavernous haemangioma consists of large dilated vessels and they can reach to large sizes. Many treatment modalities are evaluated in which some modalities are successful and some are quite disappointing. Surgical excision, irradiation, CO2 freezing, sclerosing agents, cauterization, steroid therapy and watchful waiting are among the treatment methods evaluated. The treatment plan established for Haemangiomas must consider aspects such as size, location, lesion hemodynamics, patient’s age and viability of the technique to be used. In the present series of two case reports, the management of haemangioma was done using two different modalities depending on their presentation so that major complications can be avoided and more attention should be paid to more conservative treatment modalities.
The burden of soil-transmitted helminths infections among pregnant women in Maharashtra and Rajasthan states of India
Authors: Gaidhane Abhay , Kirti Vipul , Bharadawaj Pankaj , Gaidhane Shilpa , Khatib Nazli , Saxena Deepak , Telrandhe Shital , Patil Manoj , Choudhari Sonali , Zahiruddin Quazi Syed
Published: June 2022

ABSTRACT

Context:

Soil-transmitted helminths (STH) infections are among the most common and widespread infections in developing countries where sanitation facilities are inadequate.

Aims:

This study aimed to estimate the prevalence of STH infections in prenatal mothers in two states in India.

Settings and Design:

A cross-sectional survey was conducted in Maharashtra and Rajasthan state of India. We randomly selected one municipal corporation and one rural block from a selected district in each state.

Methods and Material:

Out of 2400 contacted, 2206 pregnant women gave stool samples for microscopy for parasitological study. The response rate was 89.91%. Stool specimens were transported to an accredited lab and examined microscopically within 24 hrs.

Results:

Prevalence of STH was 8.34 (95%CI 7.22–9.57). The prevalence in rural and urban areas was 10.01% (95%CI 8.51–11.74) and 5.76% (95%CI 4.39–7.52), respectively. Ascaris lumbricoides (34.7%) were the most common, followed by Entamoeba histolytica (30.43%), and 20.1% were mixed infections. Higher age, walking barefoot, weight gain during pregnancy were significantly associated with STH (p < 0.05). The mean hemoglobin value in women with STH was significantly less (8.75 gm%; SD 4.04) compared to those without STH (10.23 gm%; SD 1.23) (p < 0.05), and average weight gain during pregnancy was significantly less among women with STH (3.80 kg; 4.11) compared to women without STH (8.45 kg; 2.83); (p = 0.000).

Conclusion:

The study provides valuable insights into the burden and intensity of STH in pregnant women that may support the policy recommendation for deworming during pregnancy.
Relationship between vascular endothelial growth factor expression and thyroid stimulating hormone level in benign and malignant thyroid lesions
Authors: Bariya Deepak , Mishra Shashi Prakash , Akshay BR , Kumari Sweety , Akanksha  , Khanna Rahul , Meena Ram Niwas
Published: June 2022

ABSTRACT

Background:

Vascular endothelial growth factor (VEGF) stimulates angiogenesis, increases vascular permeability and seems to correlate to aggressiveness of tumors. Thyroid cancer has been found to have higher levels of VEGF expression. Thyroid stimulating hormone (TSH) is the most important thyroid hormone, yet few researches have been done on its relationship with VEGF.

Aim:

To study the clinical and demographic profile of thyroid lesions (benign and malignant) and to explored the relationship between VEGF expression (using immunochemistry) and serum TSH level.

Methods:

This prospective, observational study includes 61 patients of thyroid lesions who underwent partial, hemi, subtotal or total thyroidectomy as the primary treatment from June 2014 and July 2016. Tissue specimens of thyroid lesions for immunohistochemistry study of VEGF expression were done. Serum TSH was done using Chemiluminiscence technique and correlated to VEGF expression.

Results:

The mean age of patient was 36.26 ± 11.53 years (range 20-50 years) with female preponderance. Swelling was the most common presenting symptom. Of 61 patients, 37 (60.65%) patients were benign and 24 (39.35%) were malignant thyroid lesions. The mean TSH level in benign group was 1.92 ± 0.94 mIU/liter and malignant group was 2.73 ± 1.74 mIU/liter which was statistically significant (P = 0.023). VEGF expression was strongly positive (3+) in 26 (42.62%) patients and negative/equivocal (1+ & 2+) in 35 (57.38%) patients. In benign group, 10 (27.0%) patients were strongly positive for VEGF whereas in malignant group, 16 (66.7%) patients were strongly positive for VEGF showed significant association (P = 0.002). On comparing TSH level of benign, malignant and total patients separately with VEGF expression, significant association were also observed (P < 0.001, P = 0.004 and P < 0.001, respectively).

Conclusion:

VEGF was strongly expressed in malignant thyroid lesions which are having high serum concentration of serum TSH level. Serum TSH levels reveal a significant correlation with VEGF expression.
Hypertriglyceridemia induced acute pancreatitis: 4 years’ experience from a tertiary care institute and quick literature review
Authors: Kumar Budumuri Gautam V , Prasad Krishna , Singh Davinder , Sethy Purna Ch
Published: June 2022

ABSTRACT

Hypertriglyceridemia (HTG) is infrequent but an established etiology that can trigger recurrent episodes of acute pancreatitis. The risk of acute pancreatitis is significant when serum triglycerides levels surpass >1000 mg/dL. Although the severity of HTG-induced acute pancreatitis (HTG-AP) may be correlated to higher HTG levels in the early stages, the overall clinical outcomes are similar to other aetiologies. The initial management also differs from the routine recommendations with additional diagnostic and therapeutic challenges. This retrospective case series includes a 4-year experience with HTG-AP at our facility and a brief literature review.
Barriers and facilitators of noncommunicable disease (NCD) prevention in Kerala: A qualitative study
Authors: Jose Nisha K. , Sruthi MV , Rachel Jerry , Jerome Kerline , Vaz Clint , Saju CR
Published: June 2022

ABSTRACT

Context:

The burden of noncommunicable diseases (NCD) is increasing at an alarming rate, contributing to about 23% of the mortality in the rural and 30% of the total mortality in the urban population in India. Even with high health literacy in Kerala, the state has higher rates of NCD risk factors and lower diabetes and hypertension control rates.

Aims:

The objectives were to qualitatively assess the facilitators and barriers of NCD prevention from the patients’ and health care providers’ perspectives and assess the perceptions of healthy lifestyle behaviors among NCD risk persons and patients.

Settings and Design:

This was a qualitative study conducted in Thrissur district, Kerala, India.

Methods and Material:

Qualitative study was conducted using the grounded theory approach. A total of nine in-depth interviews and ten focus group discussions were conducted among health care providers and NCD risk persons and patients. The audio-recorded data were transcribed, coded, and thematically analyzed.

Statistical Analysis:

The data were transcribed and analyzed using the Framework approach to qualitative data analysis.

Results:

The main themes identified were healthy lifestyle behaviors, facilitators, and barriers to NCD prevention. The main facilitators for NCD prevention were NCD screening, the national program for NCD, health education sessions, and yoga classes in school. Lack of time, laziness, unavailability of space for exercise, and safety issues were identified as barriers to physical activity.

Conclusions:

People are aware of the facilitators and barriers of NCD prevention. Availability of a favorable environment and behavior change is needed to combat the silent epidemic of NCDs.
Challenges in delivering primary care via telemedicine during COVID-19 pandemic in India: A review synthesis using systems approach
Authors: Singh Vanita , Sarbadhikari Suptendra Nath , Jacob Anil G. , John Oommen
Published: June 2022

ABSTRACT

Background:

Countries, including India, were quick to adopt telemedicine for delivering primary care in response to the widespread disruptions due to the coronavirus disease 2019 (COVID-19) pandemic. This expeditious adoption was critical and the challenges faced during this exigency could guide the design and delivery of future telemedicine applications toward strengthening primary healthcare services.

Methods:

To identify the challenges in delivering primary care via telemedicine technology in the Indian context, a scoping review was conducted. Drawing from the systems approach in healthcare delivery, the review findings are summarized at four levels, patient, provider, healthcare organizations, and policy.

Results:

The initial search yielded 247 articles and 13 met our inclusion criteria. This review highlighted that telemedicine facilitated the continuity of care during COVID-19 but not without challenges. Low levels of education and computer literacy along with the language barriers posed the predominant challenges at the patient level. Providers had concerns related to digital literacy, clinical process flows, legal liabilities, and unethical behavior of the patients. The policy-level challenges include data privacy and security, reimbursement models, unethical behavior by the patient, or provider, and regulating prescriptions of psychotropic drugs. A lack of an integrated telehealthcare model covering diagnostics, prescriptions, and medication supply mirrored the existing fragmentation of care delivery.

Conclusion:

Telemedicine has the potential to improve primary healthcare delivery even beyond COVID-19. Currently, telemedicine applications in India are only facilitating a remote consultation wherein an integrated person-centered care is lacking. There is a need to acknowledge and factor in the inter-connectedness of health system elements for ensuring an effective and efficient healthcare delivery via telemedicine.
Evaluating the effectiveness of ‘AETCOM Module’ on the medical interns posted in peripheral health centres of a tertiary care medical college in Kanchipuram, Tamil Nadu
Authors: Jain Timsi , Mohan Yogesh , Maiya G. Rakesh , Nesan G. Shiny Chrism Queen , Boominathan Charumathi , Eashwar Anantha V. M.
Published: June 2022

ABSTRACT

Introduction:

Effective communication skills between doctor and patient leads to enhanced patient satisfaction, better compliance to treatment and improved health outcomes.

Aims and Objectives:

To evaluate the effectiveness of Attitude, Ethics and Communication (AETCOM) module in improving the communication skills of the interns posted in peripheral health centres after methodical training and approach.

Methods:

A Module based interventional study was conducted among the medical interns posted in in the months of December 2019 and February 2020 at Rural Health Training Center (RHTC) and Urban Health Training Center (UHTC). The tool used to assess the interns was Kalamazoo Essential Element Communication checklist (KEEC) based on Kalamazoo Consensus Statement (KCS) comprising 7 components.

Statistical Analysis:

The difference in the means of pre test scores and post test scores were analyzed for statistical significance using Paired T test (p value < 0.05 considered significant).

Results:

The post-test scores were higher when compared to the pre-test scores with regard to batch, gender, mother tongue, center where the interns were posted and type of batch and these findings were statistically significant. Females had better competencies of opening discussion, understanding the patient’s perspective, reaching agreement and providing appropriate enclosure to discussion than males and it was found to be statistically significant.

Conclusion:

AETCOM Module is effective in improving the communication skills of the medical students, which in turn will prevent malpractices and litigations against doctors in the near future.
Reduction in HbA1c through lifestyle modification in newly diagnosed type 2 diabetes mellitus patient: A great feat
Authors: Dixit Jagannath V. , Badgujar Shraddha Y. , Giri Purushottam A.
Published: June 2022

ABSTRACT

A 45-year-old male, resident of Texas, U.S.A, was diagnosed with type-2 diabetes mellitus on September 05, 2020 with HbA1c 14.9%. His physician prescribed oral hypoglycemic agents (OHA) starting immediately due to his high HbA1c levels. However, the patient was reluctant to be on lifelong medications. Thus, he chose conservative management of lifestyle modification by enrolling in “World free of Obesity and Diabetes” campaign that advised “only two meals a day and exercise” regime for diabetes reversal. He followed the plan very meticulously and his HbA1c was successfully reduced by 9.8% (HbA1c from 14.9% to 5.1%) within 3 months without any medications. The patient follows the regime without any burden of compromising his quality of life and has maintained his HbA1c to 4.6% till April 2021. Diabetes reversal by lifestyle modification is a healthier option, and must be encouraged in all the patients in prediabetes group (HbA1c: 5.7%–6.4%) and those with newly diagnosed type 2 diabetes mellitus (HbA1c: >6.5%) without any complications, thus promoting good health-seeking behavior. American Diabetes Association (ADA) suggests that metformin should be started to the prediabetes and newly diagnosed group of patients along with lifestyle modifications. However, there are evidences of complete diabetes reversal of the patients with HbA1c ranging from 8%–15% by just lifestyle modification and that too without any complications among the patients registered under “World free of obesity and diabetes” campaign, which challenges the current prescribed guidelines for the management of type 2 diabetes mellitus.
Clinical characteristics and outcome of patients presenting to emergency department during the second wave of COVID-19
Authors: Mathew Roshan , Bhaskararayuni Jyothiswaroop , Kumar Akshay , Rai Ravi , Imran Mohammed , Roshan PK , Akpza Jameel , Bhat Rachana , Sahu Ankit , Jamshed Nayer , Aggarwal Praveen , Ekka Meera , Ranjan Prakash
Published: June 2022

ABSTRACT

Background:

COVID 19 resurgence in multiple waves and the highly infectious variant of SARS-CoV-2 (B.1.617) has wreaked havoc across healthcare systems in India. We conducted a study to delineate the clinico-epidemiological profile of COVID-19 patients in this second wave of the pandemic.

Methods:

This was a retrospective, single centre, observational study at the Emergency Department(ED) of a teaching institute in North India. The ED health records were screened for patient files with the diagnosis of COVID -19, age > 14 years, presenting from 10th April to 30th of May. ED clinical notes, disposition, and mortality data were retrieved and analysed.

Results:

1647 files were screened and 253 eligible patients of COVID-19 were included in the study. 60% patients were male, mean age (+ SD) was 54 (+ 14.8 years). Shortness of breath (74.7%), fever (71.9%), cough (57.7%) were the common presenting symptoms. 20% of patients were nil comorbid; Diabetes (44.7%) and Hypertension (41.5%) were the common comorbid illnesses. 73.1% patients had severe COVID illness, 39.9% had oxygen saturation <90% on arrival and 33.2% had <70%. More than 90% patients required respiratory support on arrival. 25% of people presented to hospital after home isolation, of which 81% had severe COVID at presentation. 39 % patients of mild illness had received corticosteroids.

Conclusion:

The second wave of COVID-19 with rapid upsurge of cases overwhelmed the healthcare system with a higher proportion of severe COVID-19 cases and higher mortality, thus stressing the need for prior planning, preparation and strengthening healthcare systems across tiers.
Accidental formalin poisoning in a child with acute fatal manifestations: A rare case report
Authors: Sahu Sindhu Sudha , Naveen Alagarasan , Mohanty Manoj Kumar , Kundu Anirban
Published: June 2022

ABSTRACT

Formalin is a protoplasmic poison, which poses a potential occupational hazard among morticians, embalmers, pathologists, and hospital staff. The crystal-clear appearance of formalin can be easily mistaken for normal saline, local anesthetics, hydrogen peroxide, sodium hypochlorite, and spirit in health care facilities and water in domestic settings. However, accidental poisoning is extremely rare because of its low olfactory threshold, strong irritant nature, pungent taste, and odor. This is also evident from the scarce scientific literature on this topic. Here, we presented a case of accidental, fatal formalin ingestion by a 4-year-old child who succumbed to the poisoning within 12 h of ingestion. The case presented here is unique because of its rarity in causing accidental poisoning by ingestion and first of its kind in a child.
Peripheral squamous odontogenic tumor masquerading as oral squamous cell carcinoma in an elderly female patient: A rare entity
Authors: Saxena Shikha , Mittal Sankalp , Priya Sonal , Sundaragiri Krishna S. , Shekhawat Chandni , Bhargava Akshay , Sankhla Bharat
Published: June 2022

ABSTRACT

Squamous odontogenic tumor is a rare epithelial odontogenic tumor. Only a few cases have been reported in the literature, out of which central cases occurring within the jawbones are more common, and very rarely peripheral cases have been reported. Here, we report a rare case of a peripheral squamous odontogenic tumor occurring in the left lower gingivobuccal sulcus region in a 63-year-old female patient and presented as a firm and fibrotic swelling clinically. Radiographic examination revealed no evidence of a central lesion in the bone. Excisional biopsy of the lesion revealed the characteristic histopathological picture of peripheral squamous odontogenic tumor (PSOT). The healing was found to be satisfactory upon periodic evaluation of the patient done to study the healing and for any recurrence of the lesion.
Investigation of an acute surge of COVID-19 associated mucormycosis (CAM) cases reported to a tertiary health care institution in Bihar, India
Authors: Singh Chandra Mani , Naik Bijaya Nanda , Pandey Sanjay , Singh Prashant Kumar , UR Rajath Rao , Kokkayil Prathyusha , Bhavana Kranti , Singh Prabhat Kumar
Published: June 2022

ABSTRACT

Introduction:

Acute surge in coronavirus disease-2019 (COVID)-associated mucormycosis (CAM) cases was reported during mid-May 2021, which was later declared an epidemic in various states of India including Bihar.

Objective:

We carried out a rapid investigation of CAM cases to describe the epidemiological and clinical profiles and find plausible predictors to guide the initiation of public health actions.

Methods:

A team of public health specialists contacted all the CAM cases reported to our hospital to collect relevant information using a case-investigation-form. In addition, the team visited the Flu Clinic and Ear, Nose, and Throat (ENT) outpatient department (OPD) to capture CAM cases on daily basis during the period of the acute surge of CAM cases.

Results:

About 88% of 130 CAM cases reported during the period of the acute surge were in the advanced stage of mucormycosis. The majority of the CAM cases were younger (less than 60 years) [76.2%], diabetics [65.4%], un-vaccinated [86.9%], and had used steroids for management of COVID-19 [64.6%]. Other findings of public health importance were summarized and possible public health actions were recommended for the prevention of outbreaks in future.

Conclusion:

Optimum management of diabetes including screening for each COVID case, rational use of steroids only when necessary, strict adherence to COVID appropriate behavior by health professionals as well as the public, increasing COVID vaccine coverage, CAM awareness, and setting up a CAM surveillance mechanism may be the key to prevent and control CAM outbreaks in future.
Domestic violence and child maltreatment awareness among medical students at King Abdulaziz University Hospital
Authors: Al-Sofyani Khouloud Abdulrhman
Published: June 2022

ABSTRACT

Background:

Violence is a critical public health problem resulting in more than 1 million yearly deaths. Clinical examination of the victim by a trained physician is vital for abuse discovery.

Objective:

The present study evaluated the medical students’ awareness levels about the concept of violence with the help of a questionnaire.

Participants and Setting:

The present study is a cross-sectional descriptive study and was conducted among 243 medical students from the Faculty of Medicine, King Abdulaziz University, from December 2018 to March 2019.

Results:

In our study, medical students showed good awareness of the concept of child violence, general violence, and female violence. The Internet was the primary source of knowledge about violence among female students, while the male students used social media. Almost three-fourths of the medical students wanted more information or training about violence. The male and female students shared a significant difference of opinion for a few categories like the concept of violence toward husbands, prevalence of violence, sources of knowledge, and having enough time to study violence.

Conclusion:

In conclusion, the medical students’ current knowledge and attitude toward violence need to be better. Facing real-life situations can improve their awareness. Further, adding knowledge about violence to the curriculum would help the students to learn and deal with violent cases.
Body mass index among elderly population and its association with neurological and musculoskeletal diseases in Aseer, Saudi Arabia
Authors: Assiri Yara Mofarih Ahmed , Alhayyani Roqayya Mohammed Ahmed , Alshahrany Afnan Muslah Mushabab , Othman Lujain Mohammed Abdullah Bin , Alqahtani Nouf Abdulrahman
Published: June 2022

ABSTRACT

Introduction:

An increase in BMI in the elderly may reduce life expectancy and increase the risk of death, cardiovascular disease, and metabolic syndrome. Frailty index, body weight, and pain levels all seem to be linked. Excessively low or high body weight may cause muscle weakness and decrease physical activity, placing the elderly at risk for frailty.

Methodology:

This was a cross-sectional study to investigate BMI among the elderly and neurological and musculoskeletal diseases in the Aseer region, Saudi Arabia conducted during the period from 5 January, 2020 to 26 February, 2020. The data were collected using a self-administered pre-designed questionnaire, and 503 full forms of eligible subjects were included.

Results:

A total of 503 participants were included in this study, 61.2% of them were female, with a mean age of 67 ± 9. The mean BMI was 31.1 ± 7.5. Parkinsonism and hemiplegia were significantly associated with BMI (P = 0.003) and (P = 0.027), respectively. Osteoporosis and participants with no musculoskeletal problems were significantly associated with BMI (P = 0.001) and (P = 0.003), respectively.

Conclusion:

We found a significant association between Parkinsonism and hemiplegia and BMI as these conditions were more common among overweight patients. Moreover, osteoporosis was also significantly associated with BMI, and most of the patients with osteoporosis were underweight.
Assessment of the knowledge on insulin therapy among adult diabetics patients in Jabir Abuleiz center, Khartoum, Sudan
Authors: Osman A Rania , Amir Osman
Published: June 2022

ABSTRACT

Objectives:

The objective of the study is to assess the knowledge and practice concerning insulin therapy in adult diabetic Sudanese patients and relate it with their control of diabetes and selected demographic variables.

Methods:

Personal interview, using a specific pretested designed questionnaire was used to collect data from 200 adult diabetic patients in Jabir Abuleiz center in Khartoum state.

Result:

The result showed that only 15% of the respondent had adequate knowledge about insulin use. Also, good knowledge was associated with a higher level of education and good glycemic control (P < 0.001).

Conclusion:

Knowledge about insulin therapy has an important role in the control of diabetes mellitus. Those who are knowledgeable about insulin therapy are more likely to have good control of HbA1c.
“I lost my faith and stopped taking the medicines” – need for an intervention model based on health belief constructs for improving adherence to tuberculosis treatment
Authors: Solanki Nitinkumar , Sharma Parul , Rupani Mihir P. , Goswami Bharat
Published: June 2022

ABSTRACT

Background:

India is reporting the highest number of tuberculosis (TB) cases worldwide. The health belief model has proved beneficial to understand health-related behaviors among patients with TB. We explored the reasons and solutions for non-adherence to the treatment of TB using the constructs of the health belief model.

Methods:

We conducted in-depth interviews among patients who were reported ‘lost to follow up’ (LFU) and among the service providers under the national TB program in the Patan district based on the constructs of the health belief model – perceived susceptibility, perceived severity, perceived benefits, and perceived barriers. All the interviews were audio-recorded and transcripts were analyzed using thematic analysis.

Results:

The analysis resulted in nine major reasons for LFU which were explained under the health belief model constructs. Perceived susceptibility was reflected by lack of support from health workers, losing faith in government, and dependence on alcohol. Negative counseling by quacks explained perceived severity, while improvement in symptoms corroborated with the perceived benefits. Side effects to anti-TB drugs, high pill burden, stigma, and financial constraints were the perceived barriers reported by the patients.

Conclusions:

The health belief model explains treatment non-adherence behavior among patients with tuberculosis in India. To eliminate TB, program managers in India need to design a comprehensive intervention model to counsel the patients on the benefits of completing treatment, generate awareness to dispel the myths surrounding the disease, and instill confidence through regular visits by health workers. Primary care physicians should try incorporating counselling of patients with TB in their routine care to reduce LFU.