bluuebunny/crossref_metadata_2025_split huggingface dataset:
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.
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.
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.
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

ABSTRACTBackground: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.
Clinical and hematological evaluation of geriatric anemia
Authors: Krishnamurthy Srinivasan , Kumar Bhargavi , Thangavelu Saravanan 
Published: June 2022

ABSTRACT

Background:
Anemia in the elderly is a cause of concern. It is not merely physiological due to aging and requires appropriate evaluation. Anemia has a significant negative impact on cardiac function, cognition, sleep, frequent hospitalization, mobility, morbidity, and mortality. Anemia in the elderly is attributable to many causes: nutrient deficiencies, chronic inflammatory diseases, thyroid disorders, diabetes mellitus, gastrointestinal (GI) tumors and bleeding, chemotherapy-induced anemia, and drug-induced hemolysis.

Objectives:
We aimed to evaluate the clinical and hematological profile of anemia in 100 patients aged above 60 years.

Methods and Material:
We performed a cross-sectional type of study in a tertiary care center including male and female patients aged 60 years and above and whose hemoglobin was less than 13 g/dl and less than 12 g/dl, respectively. Clinical history, complete blood picture, and peripheral smear were obtained in all patients. Serum iron profile was done in patients with micro-normocytic anemia. Vitamin B12 and folate assays were done in patients with normo-macrocytic anemia and those with pancytopenia. Bone marrow studies and endoscopies were done in cases wherever deemed appropriate.

Results:
The majority of the patients had either severe or moderate anemia. 49% of the patients had normocytic anemia. The commonest cause for anemia was nutritional deficiencies (45%) followed by anemia of chronic inflammation (40%) and unexplained anemia (8%).

Conclusions:
It is essential that anemia deserves its due attention in clinical practice in older patients and is not normal always.
Identification of musculoskeletal problems using pGALS examination in school going boys in Chennai, India
Authors: Bhaskar Nithya , Bhogavalli Lakshmi Harshita , Pasupathy Umapathy , Janarthanan Mahesh 
Published: June 2022

ABSTRACT

Background and Aim:
pGALS (pediatric Gait Arms Legs Spine) is a useful screening tool in identifying musculoskeletal problems in children. Although musculoskeletal problems are common in children, only a small fraction of them have an underlying serious pathology. There is limited data on this subject from north India but none from south India. Our aim was to identify the prevalence of musculoskeletal problems in school going boys in the local community.

Methods:
We conducted a prospective cross-sectional study among school boys 7–17 years of age from September 2017 to July 2019, in Chennai. The parents or the boys were asked pGALS screening questions and this was followed by the extended pGALS examination including Beighton’s scoring for hypermobility. If abnormalities in the screening tool were found, the subjects were then referred to a pediatric rheumatologist for further evaluation.

Results:
A total of 1543 boys were included in this study. Of these 37% of the study group were found to be hypermobile. According to our study, the prevalence of growing pains was 4.6%. Of 2 boys with suspected pathology 1 boy had enthesitis-related arthritis and another had slipped upper femoral epiphysis (SUFE). The estimated prevalence of juvenile idiopathic arthritis (JIA) was 65/100000. According to our study 12.3% of the children were obese.

Conclusion:
pGALS is a useful tool to screen for musculoskeletal problems in school going boys. The estimated prevalence of JIA was 65/100000. Of them, 37% of the children had hypermobility. Obese children were more likely to complain of musculoskeletal pain (P value 0.00).
Social support among persons with depressive disorders during COVID-19 pandemic
Authors: Dan V. Hubert , Ponnuchamy L. , Anand Nitin , Bhaskarapillai Binukumar 
Published: June 2022

ABSTRACT

Context:
The extent of depressive disorders is wide in the Indian population as reported by epidemiological studies, warranting a necessary area of intervention to cover the rampant treatment gap. Social support is known to vary as per the community-level changes, which may be attributed to events kickstarted by COVID-19.

Objectives:
This study aimed to assess the social support among persons with depressive disorders.

Methods:
This was a cross-sectional study conducted among 75 individuals of age ranging from 18 to 46 years from multi-ethnic communities across India. We used the Beck Depression Inventory-II and Multidimensional Scale of Perceived Social Support.

Results:
This sample had a mean age of 32 years (SD: 7.88 years), and recurrent depressive disorder was the larger prevalent psychopathology diagnosed during their routine clinical consultation in the hospital (69.3%). The majority of the respondents experienced moderate depression (n = 42), followed by mild depression (n = 14) and severe depression (n = 5). Social support and resilience were found to be mildly correlated with each other for persons with mild depression (r = 0.620; P = 0.018).

Conclusion:
Persons with mild depressive features may benefit from low-cost and community-based interventions directed to enhance social support and thus impact resilience. Psychosocial interventions must address the impact of moderate depression and recurrent depressive disorder and include social support at all spousal, family, and societal levels.