bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bacterial urinary tract infections and its relation with CD4+ T lymphocyte cell count among people living with HIV in Ajmer City, Center of Rajasthan
Authors: Chandwani Jyotsna , Meena Preeti , Mathur Surbhi , Parihar Geeta 
Published: December 2022

ABSTRACT

Introduction:
Acquired immunodeficiency syndrome (AIDS) is a global health problem which weakens the immune system and makes it vulnerable to secondary opportunistic infections such as urinary tract infections (UTIs). In case of impaired immunity, asymptomatic UTIs may progress into symptomatic infection or even to sepsis and death. The current study was performed to determine the occurrence of UTI among HIV positive patients and its co-relation with CD4+ count.

Materials and Methods:
Sociodemographic data along with CD4+ cell count data of people living with HIV presented with signs and symptoms of UTIs were collected. Midstream urine samples were collected and sent to microbiology for culture and sensitivity testing.

Result:
Among the 101 participants, 79 had pathogen isolated from their urine specimens. Pseudomonas species was the most common isolate followed by CoNS, S. aureus, E. coli, Yeasts, Streptococcus species, and Enterobacter species. Pseudomonas species were found highly sensitive to Meropenem, Ampicillin-Sulbactan, Ciprofloxacin, and Norfloxacin. Nitrofurantoin was recorded as most effective antibiotic against both gram-positive as well as gram-negative bacteria (except Pseudomonas species). Among the 70 individuals having bacterial UTIs, 40 had CD4+ cell count <200 cells/mm3 followed by CD4+ cell count between 200 and 500 cells/mm3 in 22 individuals and only 08 person had CD4+ cell count >500 cells/mm3.

Conclusion:
Low CD4+ cell count acts as a risk factor for bacterial UTIs. Pseudomonas species becoming a common pathogen among people living with HIV which is intrinsically resistant to Nitrofurantoin, a broad spectrum antibiotic used commonly to treat UTIs.
Efficacy of atropine for myopia control in children: A meta-analysis of randomized controlled trials
Authors: Kumari Shalini , Anand Raj , Tripathi Shashank , Mishra Rajesh C. , Jha Simant Kumar 
Published: December 2022

ABSTRACT

Objective:
To conduct a meta-analysis of randomized controlled trials (RCTs) on the effects of atropine eye drop in slowing myopia progression.

Methods:
A systematic search of relevant articles was done through a computerized search on PubMed, Medline, Cochrane Library, and Google Scholar on June 16, 2022. A supplementary search was done on ClinicalTrials.gov on the same date. After thorough search and analysis, seven relevant RCTs, double-masked with atropine eye drop as intervention arm and placebo as control arm, were selected for meta-analysis. Jadad scoring was used to evaluate the quality of RCTs. The outcome measurements included in the present meta-analysis are mean changes in the spherical equivalent (SE) of myopic error, and mean changes in axial length (AL) during the study period.

Result:
Pooled summary effect size, calculated by random effect model, for SE of myopia progression was 1.08 with 95% confidence interval (CI) (0.31–1.86) which was statistically significant (P-value = 0.006). Pooled summary effect size, calculated by random effect model, for axial length was − 0.89 with 95% CI (−1.48 to − 0.30) which was statistically significant (P-value = 0.003).

Conclusion:
In summary, atropine was demonstrated to be effective in controlling myopia progression in children. Both outcome measures, mean SE changes and mean AL elongation responded to atropine intervention compared to placebo.
Urinary tract infection in children with Nephrotic syndrome: One of the hurdles for primary care physician and pediatrician towards timely diagnosis and optimum management of the disease
Authors: Indurkar Shubham K. , Mohan Kriti , Omar Balram Ji , Chacham Swathi , Kumar Manish 
Published: December 2022

ABSTRACT

Background:
Urinary tract infection (UTI) is a common infection in children with nephrotic syndrome (NS). Clinical experience suggests that childhood nephrotic syndrome is frequently diagnosed incorrectly and managed inadequately on the top of this existing UTI in the episode becomes an additive obstacle for the primary care physicians or pediatricians towards optimum management, leading to poor outcome. So, we have conducted this clinico- microbiological study of UTI in NS in children to provide the exact picture of UTI with NS so that the primary care providers can be helped in having high index of suspicion of this infection and knowing prevalent organisms and their antimicrobial sensitivity pattern.

Aim:
The aim of the study was to study clinical features and identify the responsible organisms with its drug sensitivity pattern with response to treatment in various types and stages of NS with UTI in children.

Methods:
This cross-sectional hospital based study was conducted on 50 children of 2-18 years of age with NS attending nephrology clinic or admitted to the Paediatric ward of AIIMS, Rishikesh. Demographic, clinical, and microbiological data were recorded and details were entered in a predesigned proforma sheet.

Results:
Out of 50 cases, 8 (16%) had a positive urine culture. Six (75%) out of them had first episode and two (25%) were frequent relapsers of NS. Fever, decreased urine output, and generalized edema were the presenting features. The most common bacteria responsible for UTI was Pseudomonas aeruginosa (in around 25% isolates). Escherichia coli and Citrobacter koseri were the most resistant organisms. Patients were treated with antibiotics according to sensitivity pattern which resulted in resolution of symptoms and repeat urine culture became sterile subsequently.

Conclusion:
About one-sixth of children with Nephrotic Syndrome had UTI. UTI should be ruled out in every case of NS in active phase to prevent long-term morbidity and mortality.
Analysis of CD4, CD8, CD19, CD56-16, CD64, QuantiFERON biomarkers in exudative lymphocyte-dominant pleural effusion
Authors: Mehraban Zahra , Pourdowlat Guitti , Mortaz Esmaeil , Atefeh Abedini , Ghaforian Amin R. , MalAmir Mehrdad Dargahi , Bakhtiari Nima 
Published: December 2022

ABSTRACT

Background:
There are two main causes of exudative effusion including malignancy-induced effusion and tuberculosis. Considering that in reactive ejections, such as tuberculosis-induced effusion, the role of B lymphocytes and in the malignant effusion, the role of T lymphocytes are more important, in this study we analyzed the frequency of CD4, CD8, CD19, CD56-16, CD64, QuantiFERON in the pleural and serum samples of patients with exudative lymphocytic-dominant effusion.

Methods:
In total, 73 patients were enrolled in the study by exudative lymphocyte effusion, and finally, 63 patients had definite diagnoses. The patients were sorted into three groups including malignant, tuberculosis, and none. The sample of blood plasma and pleural effusion were collected and CD markers were analyzed using flow cytometry.

Results:
The mean age in the malignancy and tuberculous (TB) groups was 63.16 ± 12 and 52.15 ± 22.62, respectively. There was no significant difference in the frequency of CD8, CD4, and CD16-56 cells in blood samples of patients with tuberculosis and malignancy. Compared to those with tuberculosis, the percentage of CD64 cells was significantly higher in patients with tuberculosis than in malignant subjects. Moreover, a comparison of the frequency of cells with CD8, CD4, CD19, CD64, CD16-56, and CD14 markers in pleural samples showed no significant difference between groups. Other inflammatory factors were also investigated. The erythrocyte sedimentation rate (ESR) value for tuberculosis patients was significantly higher than malignancy. Also, QuantiFERON was positive in 14.3% of malignant patients, and 62.5% of patients with TB, which had a significant difference.

Conclusion:
Considering that there are many confounding variables in the study, such as previous medications, subtypes of Mycobacterium, and race of patients conducting studies in different groups and performing data mining for using a set of parameters can be used to detect the exact diagnosis.
Public awareness of diabetes complications and its effect on treatment compliance in Asir region, Saudi Arabia
Authors: Alhammadi Nouf Ahmed , AL Qahtani Amar Abdullah , Hosiky Majed Fahad , AL Shahrani Faleh Saeed , AL Shehri Saeed Mofareh , AL Ghamdi Meshari Ata , AL Shehri Faisal Mofareh 
Published: December 2022

ABSTRACT

Background:
Diabetes mellitus [DM] is the most prevalent disease that affects modern human life in Saudi Arabia. People with DM must have a comprehensive understanding of the nature, risk factors, complications, and treatment methods to mitigate complications.

Aim:
The aim of the study is to assess diabetic patient awareness of complications and their effect on treatment compliance in the Asir region of Saudi Arabia. A cross-sectional study was conducted targeting available diabetic patients in the Asir region, Saudi Arabia. Patients aged 18 years or more living in the Asir region with type 1 or type 2 diabetes were included. Data were collected from eligible patients using a pre-structured electronic questionnaire. The tool covered the following data: patients’ sociodemographic data, patients’ diabetes duration, patients’ compliance with medical care and treatment, patients’ awareness regarding diabetes-related complications, and patients’ experienced complications. The questionnaire was uploaded online using social media platforms by researchers.

Results:
A total of 466 diabetic patients fulfilling the inclusion criteria completed the study questionnaire. Patients’ age ranged from 18 to more than 50 years old, with a mean age of 38.9 ± 12.6 years old, Of the 279 patients, 59.9% were males. 143 [30.7%] patients reported measuring HbA1c every three months. 363 [77.9%] reported having a blood glucose meter at home, but only 205 [44%] reported having a good concern to measure their blood sugar and 211 [45.3%] had good diabetic control, while 124 [26.6%] reported excellent control. Of those, 218 [46.8%] patients had good awareness levels regarding diabetes-related complications, while 248 [53.2%] had poor awareness levels.

Conclusions:
Our study showed that diabetic patients living in Asir region had an average awareness level regarding diabetes-related complications, especially newly diagnosed, young people. Interestingly, diabetic patients showed good-to-excellent adherence to medical care and medications.
Assessment of pulmonary function test in brick factory workers
Authors: Bansal Nandini , Lanjewar Ajay , Acharya Sourya , Shukla Samarth 
Published: December 2022

ABSTRACT

Background:
Industrial workers are exposed to dust and pollutants and thus they get occupational disorders when exposed for a long duration. Occupational diseases mainly affect the respiratory system more than other systems. Some of the respiratory occupation disorders are asbestosis, silicosis, coal worker’s pneumoconiosis, work-related asthma, and so on, as the duration of exposure of pollutants increases the pulmonary function decreases.

Method:
A total of 100 subjects working in the Brick factories near Wardha district, Maharashtra were examined using a portable spirometer. Their pulmonary function test was assessed three times and the best out of three values was taken. A pretested questionnaire was filled out by the workers which consisted of their sociodemographic details. Consent was obtained from all the subjects for this in their native language. Similarly, a pretested questionnaire was filled by 50 subjects among the normal population, that is, those not working in brick factories, and consent was obtained from all. And then, their pulmonary function test was carried out using a portable spirometer and the best out of the three values was taken. Statistical analysis was done by using descriptive and inferential statistics using the software.

Results:
As analyzed by the pulmonary function test data values collected among the brick factory workers and the control group, there was a significant decrease seen in the values of the pulmonary function test of brick factory workers. And as analyzed by the pulmonary function test values of smokers and non-smokers among the brick factory workers, it was seen that there was a significant P value of 0.0001, thus a decrease in pulmonary function test among smokers.

Conclusion:
In this study, we evaluate the respiratory function test among the brick factory workers and the control group and make the workers aware of the damage their habits have on their lung capacity and function based on the evaluation of the predicted and the actual value and thus helps them lead a better life. In this study, we also compare the values of pulmonary function tests among the brick factory workers and control groups.
Saving oxygen when it was most needed
Authors: Bhaskar Vikram , Panwar Neha , Saryan Smriti , Masih Sarita 
Published: December 2022

ABSTRACT

Background:
Oxygen is one of the most commonly prescribed drugs across the globe. The ongoing Covid-19 pandemic has put enormous burden on hospital infrastructure and oxygen demand. There is lack of knowledge among healthcare workers regarding optimal utilization of oxygen delivery devices, target oxygen saturations and adequate oxygen prescription. A quality improvement project was designed to optimize the oxygen usage in wards.

Methods:
A core team comprising one each of consultant, senior resident, junior resident and nursing officer was formed. Fish bone analysis was done to find deficiencies in the existing system and strategy was planned to overcome these deficiencies. The key intervention included education and training of staff, Formulation of Standard Operating Procedures, use of lower target oxygen saturation and use of oxygen concentrators.

Results:
The project was carried out for a very short period of 5 days, and a total of 180,000 liters of oxygen was saved. The use of oxygen concentrators increased from zero to 9.5% and thus reducing the load on central oxygen supply.

Conclusion:
The proper training and sensitization of health care workers can help in saving oxygen, which further helps in saving precious human life.
Usefulness of STOPP/START criteria and Beers criteria for prescribing in geriatric patients in a tertiary health care center, Raipur, Central India
Authors: Keche Yogendra Narayanrao , Gaikwad Nitin R. , Wasnik Preetam N. , Siddiqui Sabah , Nagpure Keshao , Dhaneria Suryaprakash 
Published: December 2022

ABSTRACT

Background:
Polypharmacy and inappropriate prescribing are risk factors for adverse clinical outcomes in older people. Screening tools can identify potential medicine-related patient safety incidents for the elderly on multiple medicines and with chronic diseases.

Methods:
In this prospective observational study, details of demography, diagnosis, history of constipation/peptic ulcer disease, over-the-counter medications, and clinical and laboratory findings were noted. Information obtained was reviewed and analyzed with the help of STOPP/START and Beers 2019 criteria. At 1 month follow-up, improvement was assessed with the help of a structured questionnaire.

Results:
As per the criteria, modification in drugs was recommended for 213 drugs; it was actually performed for 27.73% and 48.71% drugs as per Beers and STOPP/START criteria, respectively. Glimepiride was replaced with short-acting sulfonylureas because of hypoglycemia, and angiotensin receptor blockers were stopped because of hyperkalemia as per Beers criteria. Statins were started in 19 patients by START criteria. Overall general health improvement was observed at 1 month, but an increase in anxiety, tension, worry, depressed feel, and insomnia was observed in initial days of the coronavirus disease 2019 pandemic.

Conclusions:
In view of polypharmacy in the prescriptions, the combination of prescribing criteria need to be considered while prescribing medications to the elderly to get optimum therapeutic benefits and improvement in the quality of life. The quality of primary care of the elderly can also be improved by use of screening tools such as STOPP/START and Beers criteria by a primary/family physician. Prescription evaluation by a trained pharmacologist/physician for possible drug/food/disease interactions and for therapy modification can be incorporated for routine geriatric care at a tertiary care center.

Clinical trial registry of India registration number: CTRI/2020/01/022852
Compulsive buying disorder (CBD) among medical students in colleges of medicine, dentistry and pharmacy at King Saud University in Riyadh
Authors: Amin Hussain S. , Binobaid Alkaseem A. , Nagshabandi Khalid N. , Alammari Omar B. , Alshunaybir Omar H. , Alhammad Sultan A. , Almezaini Abdulrahman I. 
Published: December 2022

ABSTRACT

Background:
Compulsive buying disorder (CBD) is a dysfunctional chronic and extreme consumer attitude that attributes to negative overall impact on psychological and mental wellbeing.

Objective:
This study was aimed to examine the prevalence of compulsive buying disorder (CBD) among medical college students, particularly from colleges of medicine, dentistry and pharmacy. Secondary to this, we also examined (i) the association between sociodemographic factors and CBD; and (ii) the association between the five factors of CBD as per (II) Edward’s Compulsive Buying Scale (ECBS) and participants’ gender.

Method:
This cross-sectional survey was conducted among 263 college students from the colleges of medicine, dentistry and pharmacy of King Saud University from February till March 2021.

Results:
The results showed that the majority of participants were male (144, 54.8%) with mean age 20.1 ± 3.1 (range: 17–23); statistically significant difference was observed in compulsive buying disorder with respect to gender (P-value = 0.02), field of study (P < 0.0001) and educational year (P = 0.03).

Conclusion:
The study concluded that the prevalence of compulsive buying among university students was more frequent among female students in comparison to male students in Riyadh city. This study provided baseline data for the estimation of CBD prevalence among adolescent and youth in KSA, particularly Riyadh city.
Safer citalopram use in primary care: Can staff education and prescribing prompts improve adherence to national guidance? A closed loop clinical audit, service evaluation and quality improvement study
Authors: Waller Mark 
Published: December 2022

ABSTRACT

Background:
Citalopram is a drug with many important safety considerations in prescribing including dosage adjustments, pre-prescription testing and multiple interactions. Because of this, the UK government issued advice regarding the prescription of citalopram and escitalopram in its Drug Safety Update Vol 5 Issue 5, Dec 2011,[1] and the expectation is that all prescribers adhere to this.

Purpose/Aim:
To establish the adherence to prescribing guidance of citalopram at the practice level, implement change to address the lack of adherence and then evaluate the effectiveness of the change using re-audit techniques.

Methods:
Patients were identified using data searching techniques on EMIS for February–April 2020. Parameters searched for included age, hepatic impairment, cardiac disease, known QT prolongation and concomitant use with other QT-prolonging medication. Following the first cycle teaching on the safer use of citalopram was delivered to all prescribers and an EMIS prompt was also set up. A second audit cycle was then carried out. Data was analysed using Statistical Package for Social Sciences software to assess the significance of the results.

Results:
Following the presentation of the first cycle findings and the introduction of the EMIS safety prompt, there was a statistically significant reduction in incorrect citalopram dose prescription in the over 65s (8 vs 1), a statistically significant reduction in the incidence of dangerous drug interactions involving citalopram (44 vs 8) and a significant reduction in the incidence of unsafe prescribing of citalopram overall (47 vs 9).

Conclusion:
The introduction of an EMIS prompt and one-off prescriber teaching resulted in a statistically significant reduction in incorrect prescriptions of citalopram when re-audited a year later. These interventions resulted in improved patient safety and more effective use of resources and could easily be replicated at other practices throughout the country both for citalopram and other drugs with multiple safety considerations.
Beneficial esthetic lightening effects of Cuscuta extract on skin darkness in healthy individuals: A clinical trial study
Authors: Roohaninasab Masoumeh , Mojtabaee Mahdis , Livani Fatemeh , Heidari Nazila , Alizadeh Nilufar , Khosravi Sepehr , Goodarzi Azadeh 
Published: December 2022

ABSTRACT

Background and Objective:
Many biological activities and pharmacological usages have been revealed for the Cuscuta species. The present study aimed to assess the beneficial effects of Cuscuta on removing skin dark spots in healthy individuals, which is an important cosmetic concern, especially in women.

Materials and Methods:
This prospective, interventional before–after trial was conducted in 70 healthy individuals without any evidence of skin or systemic disorders who presented for consultation on removing skin darkening. The Cuscuta extract was prepared and then assessed for plant quality control and lack of microbial contamination. The content of melanin at baseline and at 1 and 3 months after intervention was assessed using Dermacatch, an accurate skin colorimetric measurement tool.

Results:
Comparison of the melanin content of the lesions and treated area to the surrounding normal area at baseline and at 1 month after treatment showed a significant reduction in melanin content from 519.61 ± 45.09 to 498.50 ± 39.35 (P < 0.001). This reducing trend remained significant from the first month to the third month after treatment (from 498.50 ± 39.35 to 483.53 ± 40.99, P < 0.001). This decreasing trend was persistent even after adjusting baseline characteristics including gender, age, and duration of skin lesions. Both patients and investigators had high satisfaction level with the anti-melanogenesis effect of Cuscuta extract.

Conclusion:
Cuscuta extract is useful for removing hyperpigmented lesions and for skin lightening in healthy individuals.
Knowledge and attitude of physicians toward child abuse and reporting in a tertiary hospital in Riyadh
Authors: Alaraik Enas Fahad , Saad Hussain , Al Lafi Abrar Humoud Fahad , Alshuniefi Abeer Suliman Abdulaziz , Alruwayshid Mashael Suwailem Mohammed , Alaraik Ayman Fahad , Alsaad Samaher Z. 
Published: December 2022

ABSTRACT

Background:
Child abuse is a common global devastating issue for the patient and physician. It can lead to much unpleasant and danger and even death. One of the most essential parts of a doctor’s job is to help people in need and a child should be top priority as they are dependent for protection and care.

Objectives:
To analyze the experience and knowledge of Saudi residents from both specialty family medicine and pediatrics working in Riyadh city toward the recognition and diagnosis of child abuse and neglect and spot the light on the barriers that prevent its reporting and to assess the need for further training.

Method:
A cross-sectional study was conducted in four major tertiary hospitals in Riyadh (KKUH, National Guard Hospital, King Fahad Medical City, Prince Sultan Medical City) from March 2019 to January 2020.

Results:
Most participants did not have sufficient knowledge regarding the physical assessment of suspected child abuse and neglect. The result showed no significant difference in terms of knowledge and attitude between family physicians and pediatrics working in tertiary centers in Riyadh.

Conclusion:
The study concluded that the Saudi residents from both specialties, that is, family medicine and pediatrics, had insufficient knowledge regarding child abuse. In addition, the residents had positive attitudes toward child abuse prevention. Finally, the study recommends conducting awareness campaigns to increase the knowledge of physicians about child abuse and the predictive factors.