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Journal of Family Medicine and Primary Care
Number of Followers: 10  Open Access journalISSN (Print) 2249-4863 - ISSN (Online) 2278-7135 Published by Medknow Publishers  [444 journals]
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- Building a healthy nation: A white paper on Olympic sports and the Indian
education system
Authors: Kumar; Raman
Abstract:
The Indian education system has produced top-class global corporate leaders in recent decades. The combination of a solid educational foundation, work ethic, adaptability, technical and analytical skills, leadership abilities, networking, entrepreneurial spirit, and cultural values collectively contribute to the success of Indian students and professionals in the corporate world. On the contrary, India’s overall performance in Olympic sports has been modest compared to its population and potential. The education system of any country has a significant role in sporting success. To fully harness the potential of sports in schools, addressing these challenges and creating a supportive environment that values and promotes sporting abilities alongside academic excellence is essential. This will require concerted efforts from various stakeholders, including the schooling system, educational institutions, government, sports organizations, corporate sponsors, and the community. This white paper aims to systematically organize the available knowledge and debates around India’s sporting performance in the background of mainstream education culture. This paper also addresses the systemic devaluation, exclusion, disfranchisement, and stereotyping of sports and sportspersons in India. One key argument put forward in this paper is to extend absolute equivalence to Olympic sports disciplines (e.g., football) at par with general academic disciplines (e.g., mathematics) in terms of examinations and award of qualifications within the mainstream education system of India. And India must host the Olympics before 2047.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Empowering patients: Harnessing mnemonics for non-communicable disease
management
Authors: Das; Subhashree; Pal, Debkumar; Kiran, Swosti; RoyChowdhury, Arka; Taywade, Manish; Patro, Binod Kumar
Abstract:
The epidemiological transition caused a significant non-communicable disease burden in all countries, including India. It can be tackled appropriately by integrating pharmacological and non-pharmacological interventions. The outcome of the disease or control status related to the disease condition depends significantly on patient education. Mnemonics is already an accepted way of improving cognition. The newer learning theories talk about different types of mnemonics and their role in imparting knowledge. We developed three mnemonics regarding essential information related to hypertension, diabetes mellitus, and obesity. It will help achieve better control status in those diseases by improving cognition.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Unsettling trend: The alarming rise of human abuse of veterinary drugs and
its consequences
Authors: Sharma; Ambika; Choudhary, Chahat; Vardhan, Gyan; Kumar, Vikas; Dhamija, Puneet; Kumar, Ashish
Abstract: Veterinary practitioners often prescribe many controlled drugs to animals that may include sedatives, tranquilizers, and painkillers. Unfortunately, many of these drugs are drugs that can be abused by humans, especially among the pet owners. Adequate measures are required to prevent or detect the misuse of veterinary drugs. In this article, the phenomenon of the rising misuse of veterinary medications by humans and their potential health hazards which can accompany the unsettling trends in society has been highlighted. This article aims to shed light on the extent of issues, exploring reasons behind human abuse and its consequences.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Impact of COVID-19 pandemic on the elderly in the United Kingdom: A review
study
Authors: Sharma; Anurag; Sharma, Sucheta
Abstract:
The coronavirus disease 2019 (COVID-19) pandemic has significantly altered the lives and lifestyles of several older populations in the United Kingdom. It was important to note how it has affected their physical, mental, and social health and well-being during the first wave of the Covid-19 pandemic. To study the impact of the Covid-19 pandemic and the imposed restrictions on the day-to-day lives of the elderly population in the United Kingdom. A review of the published literature on the first wave of the Covid-19 pandemic and its consequences on the older population in the United Kingdom is done. Search engines used for medical databases were Pubmed, Google Scholar, and Internet Explorer. It was found that physical as well as mental well-being was affected in the elderly citizens of the United Kingdom. Mental health studies noted an obvious increase in anxiety and depressive symptoms. Social isolation and reduced access to healthcare services had a deteriorating impact on their social health. Covid-19-related lockdown and pandemic-associated physical, mental, and social well-being effects have been evident in the elderly population in the United Kingdom. The reasons identified for such findings are lack of physical activity, poor social interactions, social isolation, the perceived threat of a pandemic, and poor access to healthcare facilities.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Characterization of clinical trials in Ecuador and their association with
disease burden: Are there research gaps'
Authors: Salgado; Carla; Rivadeneira, Josue; García Méndez, Nayely; Manterola, Carlos
Abstract:
This study offers a detailed analysis of clinical trials conducted in Ecuador from 2010 to 2022 to assess alignment with the country’s disease burden as indicated by the Global Burden of Disease study. Utilizing data from five registries, including ARCSA and Clinicaltrials.gov, we analyzed characteristics and coverage of 75 CTs after removing duplicates and ineligible studies. Findings reveal a 50% research gap across disease groups, with neoplasms being the only category matching disease burden. The scarcity of clinical research highlights the disparity between CTs and prevalent diseases such as cardiovascular and kidney diseases, diabetes, and other non-communicable conditions. Our results underscore the urgent need for increased clinical research investment addressing these critical health challenges in Ecuador.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Role of augmented reality and virtual reality from the Indian healthcare
education perspective – A systematic review
Authors: Mondal; Ramkrishna
Abstract:
Augmented reality (AR) and virtual reality (VR), are upcoming technologies with considerable potential to revolutionizing healthcare education, enhancing patient safety, and improving healthcare quality particularly in the Indian context. This review is conducted to view the current scenario of Indian context considering the impact of COVID-19. The current systematic review study was done following PRISMA 2020 guidelines using the key terms “Augmented Reality,” “Virtual Reality,” “Healthcare,” and “India.” Only the PubMed database was selected based on its reputation and authenticity, which is the only limitation of this study and strength. Both qualitative and quantitative methods are used for synthesis of results. In Indian context, 12 (1.7%) and 36 (2.2%) articles related to AR and VR were found, respectively. Six abstracts could not be retrieved, and after screening abstracts, three were found not suitable in VR and eight were found duplicate. A total of 30 articles were considered for this review. 18 (50%) were original, 12 (33.3%) were review, and 6 (16.7%) were other articles. 03 (8.3%), 21 (58.3%), and 12 (33.3%) articles were related to AR, VR, and both AR and VR, respectively. Considering the single database search and six unretrievable abstract, AR, VR, mixed reality (MR), soft e-skin, and extended reality (XR) technologies have the potential to revolutionize healthcare education and training, reducing real-life errors and improving patient safety. Although the Indian healthcare sector only contributes 1.7–2.2% to PubMed publications related to AR and VR.. The review was not registered.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Early identification of people at high risk of oral cancer—A review of
existing risk prediction models
Authors: Mocherla; Monica; Krishnappa, Pushpanjali
Abstract:
Prediction plays a ubiquitous role in cancer care. At every stage of the illness, the patient, the physician, and the family must make numerous decisions. Utilizing epidemiological, clinical, biological, lifestyle, and genetic factors, a cancer-specific risk assessment model calculates the likelihood of developing cancer. In India, oral cancer ranks as the fourth most common cancer, affecting nearly 3,000,00 individuals annually. Because it is in the premalignant stage, oral cancer is easily detectable in the oral cavity. Prompt identification of this lesion can result in better outcomes and a higher standard of living. Advanced statistical techniques have been used to develop prediction algorithms or risk scores that identify individuals with a high risk of developing oral cancer. With the aid of these risk assessment models, specific individuals can be screened to aid in the early detection of the disease, which may result in better outcomes and lifestyle modifications. Finding the best model among the current risk models for oral cancer may be aided by a thorough examination of all these models. Finding and assessing the risk model that primary care physicians can use and easily apply in clinical practice will be made easier with a succinct and straightforward comparison of the models. This review compares the current models to determine which has the best performance metrics, which could lead to a better understanding of the advantages and disadvantages of various risk prediction models of oral cancer.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Fatty liver disease - non alcoholic to metabolic - A transition of
concepts!!
Authors: Bawiskar; Nipun; Acharya, Sourya; Kumar, Sunil
Abstract:
Metabolic dysfunction associated fatty liver disease (MAFLD) was a concept suggested lately. Initially, the only criterion for the diagnosis of MAFLD was the absence of alcohol intake. With rising prevalence and studies assessing this condition, certain “positive criteria” were put forth. Experts from 22 countries proposed a simple yet comprehensive definition for the condition independent of other liver diseases. The presence of hepatic steatosis in addition to diabetes mellitus type 2, metabolic dysregulation, and obesity is generally observed. Criteria to define MAFLD-associated cirrhosis were also proposed. Reaching an agreement on MAFLD criteria will help define a protocol (for example: for International classification of Diseases (ICD) - coding), which will improve clinical care and advance the clinical and scientific field of liver research. As it is a condition that increases the risk of diabetes mellitus, chronic kidney disease (CKD), cirrhosis, hepatocellular carcinoma, and cardiac disorders it is important to recognize it at an early stage which makes it essential part of family medicine and primary care.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Evaluation of case based simulation teaching to improve the Family
Medicine residents urgent care management skills at a teaching hospital
Authors: Bhombal; Swaleha T.; Babar, Shazia; Qureshi, Asra; Zaki, Samar; Jabeem, Ismat; Farid, Rubia
Abstract:
Context: Simulation based teaching is effective strategy to allow trainees to acquire skills, develop clinical judgment and to become competent in order to manage the patients in a safe environment. The Case-based simulation improves the assessment and management skills of the trainees to prepare them as a competent physician.Aim: Evaluation of case based simulation teaching to improve the Family Medicine residents urgent care management skills at a teaching hospital.Setting and Design: An Interventional study (Pre and post design) was conducted on the residents of the Family Medicine department of the Aga Khan University hospital Karachi.Methodology: After getting their consent, pre intervention Objectively structured clinical examination (OSCE) was conducted at the Center for Innovation in medical education, AKUH. The scenarios were based on urgent care problems presenting in the Family Medicine setting. It was followed by the case based simulation teaching intervention by the facilitators and debriefing. The post intervention OSCE was conducted in order to assess the resident’s performance. Statistical Analysis: The data was analyzed in Stata version15 software in two stages; descriptive and inferential. In descriptive analysis frequency and proportion were calculated for categorical variables. Median and inter quartile range were reported for continuous variable. Paired T-tests were applied to compare the pre and post test results.Results: The resident’s scores significantly improved after case based simulation in majority of the post intervention OSCE stations proving the effectiveness of the intervention.Conclusion: Case based simulation is an effective teaching strategy for the learning process of the Family Medicine residents regarding the urgent care management skills. It is advised to use this strategy in the teaching and learning process of other Family medicine residency programs.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Assessment of the services provided at the family medicine staff clinics
in King Saud Medical City, Riyadh
Authors: ELNasieh; Abdulrahman M.; Almesned, Mohammed; Alomran, Yousef A.; Alhadlaq, Razan K.; Alhazmi, Akram N.; Alhuwaidi, Faisal; Hazazi, Yahya O.; Alawami, Hawra M.; Derani, Maria A.; Ahmed, Amani A.
Abstract:
Background: Patient satisfaction is the subjective evaluation of a patient’s cognitive and emotional responses. This reflects their expectations regarding the ideal healthcare to be provided. This study aims to assess the satisfaction level of the attendees to the family medicine staff clinics at King Saud Medical City, Riyadh.Materials and Methods: A descriptive cross-sectional study recruited 378 participants. An adapted and piloted questionnaire was used to gather the data. The questionnaire enquires about the communication skills of the receptionist, the triage nurse, and the assigned physician. It included questions regarding the structure of the clinics.Results: Females represent the majority of about 255 (67.5%). About 2/3 of the respondents were within the age group of 18-34 years, 245 (64.8%). A high level of satisfaction was reported by the participants regarding the professionalism, kindness, interest of the staff member, and waiting time. Gender, marital status, and age group have no significant effect on the satisfaction level; the P value was uniformly more than 0.05.Conclusion: The result of this study identified high satisfaction responses regarding the communication skills of the receptionist, triage nurse, and physicians. The overall evaluation of the experience during staff clinic visits was satisfactory. Periodic evaluation of these attributes and other indicators that promote patient-centered care should be undertaken to improve the overall quality of care.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Epidemiological study of health profile and quality of life of
postmenopausal women in the urban field practice area of a teaching
medical institute in a metropolitan city
Authors: Singh; Khushboo; Rawat, Shalini; Dhutraj, Pooja; Gokhe, Seema S Bansode
Abstract:
Background: Menopause is one of the most significant phases in the life of a woman which brings about various physiological changes called postmenopausal syndrome. A health programme catering to the needs of postmenopausal women is lacking in our health system.Methodology: A cross-sectional study was conducted in an urban health and training centre. Sample size of 171 was taken by simple random sampling. Women of age more than or equal to 45 and having 12 months of amenorrhea were enrolled in the study after obtaining their consent.Results: The mean age of menopause was found to be 45.31 years. In the vasomotor domain, the most common postmenopausal symptom was hot flushes (47.95%) followed by sweating (25.73%) while in the psychological domain it was seen that the most common symptom was feeling depressed down or blue (37.43%) followed by being dissatisfied with personal life, feeling anxious or nervous (36.26%) and being impatient with other people and feelings of wanting to be alone (34.50%). In physical domain, the most common symptom was ache in muscles and joints (92.98%) followed by low backache (86.55%), feeling tired or worn out (84.80%), decrease in physical strength (83.63%) and aches in the back of neck or head (81.87%). The other domain was the sexual domain in which the most common symptom was a change in sexual desire (93.57%) followed by avoiding intimacy (92.98%).Conclusion: It was found that the domain, most severely affecting quality of life was sexual followed by physical and psychological domain. Awareness should be created regarding the psychosocial, physical, nutritional and sexual needs of postmenopausal women.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Prevalence and risk factors of depressive symptoms in the postpartum
period: An experience from urban West Bengal, India
Authors: Roy; Sunetra K.; Majumdar, Sukanta; Singh, Rashmi; Paul, Avijit
Abstract:
Introduction: Postpartum depression (PPD) is a form of depression that affects new mothers within the first year after childbirth. PPD can negatively impact both the mother’s quality of life and the child’s development. Untreated PPD can lead to adverse outcomes, such as infant growth retardation, poor child survival, impaired development, and undernutrition. The burden of PPD is a significant public health concern, with a global prevalence increase of 18.4% from 2005 to 2015. Early detection and intervention of PPD can mitigate the severity and chronicity of symptoms.Aims: This study aimed to determine the prevalence of PPD among mothers in an urban area of Kolkata and identify any influencing factors.Materials and Methods: The study utilized a cross-sectional design, surveying 189 mothers within the postpartum period of 6 weeks to 1 year. Edinburg Postnatal Depression Scale was used to identify possible PPD.Results: About 29% of the women had probable PPD, 19% had possible depression, and 15% had no depression. Factors associated with depression included low birth weight and primiparity, while financial independence served as a protective factor. Multinomial regression analysis revealed that low-birth-weight babies, marital conflict, lack of support at home, and primiparity had higher odds of depression, whereas financial independence was a protective factor. Age was not statistically significant.Conclusion: A high prevalence of PPD and significant associations with factors emphasized the importance of screening all mothers for PPD, providing medical care and counselling, and ensuring acceptance and support from partners, family, and society.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- The prevalence of anaemia in rural adolescent girls – A cross-sectional
study to understand the sociodemographic and dietary determinants in
Dharwad District, India
Authors: Pavithran; Sreeshma; Patil, Sachin Kumar
Abstract:
Context: Anaemia is one leading cause of morbidity among adolescent girls. Prevention, early detection, and treatment can break the intergeneration cycle of malnutrition.Aims/Objectives: The aim of the study was to estimate the prevalence of anaemia and assess its sociodemographic determinants and understand its association with the dietary pattern of rural adolescent girls.Settings and Design: A cross-sectional study was conducted among 350 adolescent girls studying in the school of Kalgatigi Taluk, Dharwad district. The school girls were interviewed using a predesigned structured questionnaire by interview method. A food frequency questionnaire was used to assess the dietary pattern. Haemoglobin levels were estimated using Sahli’s method.Statistical Analysis Used: Data were entered in Microsoft Excel and analysed using SPSS version 19 and the Chi-square test was applied to study the significance.Results: Rural adolescent school girls between the age group of 13–16 years were included. The prevalence of anaemia among them was found to be 47.4% and was significantly associated with the educational status of the mother, their socioeconomic status (SES), and type of diet. Vegetarian girls had a higher prevalence of anaemia. The frequency of meat and egg consumption was significantly associated with anaemia. The prevalence of anaemia was higher in thin and severely thin girls based on WHO-BMI.Conclusions: Anaemia in rural adolescent girls is of high burden and public health importance with a prevalence of 47.4% and significant association with dietary habits, SES, and BMI.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Awareness, knowledge and challenges faced by beneficiaries and
non-beneficiaries of Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana
with special reference to eyecare in three districts of Uttar Pradesh
state: A cross-sectional study
Authors: Sabherwal; Shalinder; Sood, Ishaana; Khurana, Ashi; Chauhan, Lokesh; Saini, Shivani; Shroff, Kamna; Majumdar, Atanu
Abstract:
Purpose: The aim was to analyse the knowledge and awareness regarding Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) within the operational districts of two high-volume non-profit eye organisations in Uttar Pradesh. Challenges faced by beneficiaries and non-beneficiaries are also examined.Methods: A prospective cross-sectional survey from November 2021 to April 2022 was conducted across operational districts of organisations A and B. Cluster sampling was used to select participants in randomly selected villages with 200 or more households, within 10–15 km of existing vision centres. A semi-structured interview schedule was used to collect data. The means of AB-PMJAY indicators were estimated. Awareness was estimated as a summed score. Multivariate logistic regression was applied to check the effects of the socio-economic and socio-demographic factors on the awareness of AB-PMJAY for both organisations separately and together.Results: A total of 1151 participants were interviewed: 52.9% from the catchment area of organisation A and 47.1% from that of organisation B. From the catchment of organisations A and B, 82.6% and 22.9% participants, respectively, had heard of the scheme, mostly from family and friends. Whereas 43% interviewees from the catchment area of organisation A and 8.5% from that of organisation B had knowledge about at least one topic, only 8.5% and 2.8%, respectively, were knowledgeable about all topics. Village effect was found to be significant for most of the knowledge and awareness indicators in both catchments. Only 37.8% and 20.2% of the catchment from organisations A and B, respectively, were AB-PMJAY cardholders. Of the services availed, 50% were cataract surgery. Almost 40% of the applicants faced some challenges while securing the AB-PMJAY card and 9% while using the AB-PMJAY card. Family income was found to be the only common predictor of knowledge at both locations.Conclusion: Varied awareness and limited knowledge in catchment villages put the onus on community eyecare organisations to spread awareness in their catchment, which may increase the uptake and utilisation of the scheme.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Handgrip strength, and erectile dysfunction among men with metabolic
syndrome attending an institutional primary care clinic in Malaysia: A
cross-sectional study
Authors: Kadir; Nik A. Nik Abdul; Abdul-Razak, Suraya; Daher, Aqil M.; Nasir, Nafiza Mat
Abstract:
Background: Erectile dysfunction (ED) is an independent predictor for cardiovascular diseases (CVD). The prevalence increases with age, but little is known about the relationship between handgrip strength (HGS) and ED, especially among men with a high risk of CVD. This study aimed to determine the prevalence of ED among men aged ≥40 years with metabolic syndrome (MetS) and its association with HGS.Materials and Methods: A cross-sectional study at an institutional primary care clinic in Malaysia was conducted between June 2021 and October 2021. HGS and erectile function were assessed using a hand dynamometer and International Index of Erectile Function (IIEF-5) questionnaire, respectively. Multiple logistic regression analyses were performed to determine the association between sociodemographics, clinical characteristics, and HGS with ED.Results: A total of 334 participants were recruited. The prevalence of ED was 79% (95% confidence interval [CI]: 0.75-0.84). ED was associated with elderly aged ≥60 years (odds ratio [OR] 3.27, 95%CI: 1.60-6.69), low HGS (OR 15.34, 95%CI: 5.64-41.81) and high total cholesterol (OR 0.36, 95%CI: 0.16-0.78).Conclusion: In conclusion, age above 60 years and those with low HGS are at higher risk of ED. Thus, robust screening of ED among men with MetS and improving muscle strength and physical fitness may be warranted.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Clinico-radiological and pulmonary function assessment of post-COVID-19
patients with respiratory symptoms
Authors: Behera; Nilakantha; Patra, Jeetendra Kumar; Dash, Bijay Kumar; Pattnaik, Manoranjan; Sahu, Deepak; Rambhoopal Reddy, Bayyaram
Abstract:
Background: Respiratory symptoms may persist for several weeks following the initial coronavirus disease 2019 (COVID-19) infection. The aims and objectives were to assess the clinical symptoms, pulmonary functions, and radiological changes and to assess the cardio-vascular complications in post-COVID-19 patients.Methods: This observational study was conducted in the Department of Pulmonary Medicine in collaboration with the Department of Cardiology, SCBMCH, Cuttack, from March 2021 to August 2022 on 75 post-COVID-19 patients with respiratory symptoms from 4 weeks to 2 years after treatment for COVID-19 infection. Post-COVID patients having previous respiratory diseases were excluded from the study.Results: Among 75 patients, the most common age group was 18–30 years with a male-to-female ratio of 2.5:1. Based on O2 requirement, patients were divided into the mild symptomatic group and moderate to severe pneumonia group. The most common respiratory symptom was dyspnea, followed by cough with expectoration. Bilateral crepitations were found in 17% of cases. C-reactive protein (CRP) and D-dimer were increased in 38.6% and 32% of patients, respectively. 42.6% had abnormal chest X-ray, and the most common abnormal finding was reticular thickening. In spirometry, the restrictive pattern and mixed pattern were the predominant types documented in 49.3% and 13.3% of cases, respectively, which were significant in the moderate–severe group. Diffusion capacity of the lungs for carbon monoxide (DLCO) was performed in only 19 patients (mild group 13 and moderate–severe group 6). Twelve (63.2%) patients had abnormal DLCO. P- values were significant for RV (0.0482) and RV/TLC (0.0394). High-resolution computed tomography (HRCT) of the thorax was abnormal in 55.7% with the most common abnormalities as inter- and intra-lobular septal thickening. The left ventricular ejection fraction was preserved in all patients, with right atrium and right ventricle enlargement in 2.6% and pulmonary hypertension in 4.0% of participants.Conclusion: All post-COVID-19 patients having respiratory symptoms after recovery from acute COVID-19 may be referred by family care physicians to a dedicated post-COVID center for further evaluation, management, and early rehabilitation to decrease the morbidity in recovered patients. Persistent increased blood parameters like TLC, N/L ratio, RBS, CRP, and D-dimer seen in recovered post-COVID-19 patients. The long-term impact of CT findings on respiratory symptoms, pulmonary functions, and quality of life is unknown. Cardiovascular abnormalities in post-COVID-19 patients are infrequent.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Comparative study of spirometry parameters in chronic smokers with and
without Type 2 Diabetes Mellitus (T2DM)
Authors: Vaishnav; Bhumika T.; Gangani, Seherish K.; Anand, Shubhangi; Pailla, Ruchitha; Mondkar, Saish
Abstract:
Aim: The study aimed to know the changes in spirometry parameters in chronic smokers and evaluate how the presence of type 2 diabetes mellitus (T2DM) affects their lung function.Materials and Methods: A prospective, cross-sectional, observational study was done for 12 months at a tertiary care hospital in the western region of Maharashtra State in India. Two groups of patients and one group of healthy volunteers aged 18 years or more were studied (with 50 in each group, n = 150). Group A consisted of smokers with T2DM, Group B- smokers without T2DM and Group 3- healthy controls who were non-smokers and non-diabetic. Spirometry was done for the following parameters: forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), FEV1/FVC ratio, and peak expiratory flow (PEF) and results compared between the three groups.Results: The mean age of the participants was 51.13 ± 10.74 years. There were 137 (91.3%) males and 13 (8.6%) females. Among the enrolled subjects, 66% had smoked for more than ten years. All spirometry parameters were significantly different across all three groups. When the spirometry parameters were compared between smokers with and without T2DM, all the parameters were significantly decreased (P < 0.05). FEV1 and FEV1/FVC were significantly decreased in T2DM patients with HbA1c>7%.Conclusion: The presence of T2DM in smokers significantly affects their pulmonary function tests. Uncontrolled T2DM (HbA1c>7%) can result in increased abnormality in the spirometry parameters studied. Thus, adequate glycemic control and cessation of smoking can be beneficial for the improvement of lung functions in smokers.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- The relationship between the duration of diabetes and dimensions of
general health and quality of life associated with the health of diabetic
patients
Authors: Nickzad; Sepehr; Foroutan, Majid; Hedayati, Amir Hossain; Pourmohseni, Mohammad Reza; Asl, Nemat Sotodeh
Abstract:
Introduction: Diabetes is one of the most common chronic diseases in the world. Diabetes has a major impact on the quality of life of patients. The purpose of this study is the relationship between the duration of diabetes and dimensions of general health and quality of life associated with the health of diabetic patients.Materials and Methods: In this cross-sectional-analytical study, diabetic patients with more than 1-year history who were not suffering from other chronic diseases were included in the study. Then, using 15 questions for diabetes quality of life, questionnaires and GHQ28 general health were investigated in terms of quality of life and general health. The data were statistically analyzed using SPSS version 24 software.Results: The average age was equal to 42.8 ± 14.4 years (with a median of 40 years). The average duration of the disease in the patients was equal to 7.7 ± 7.2 years (with a median of 5 years). The average quality of life score of the patients was equal to 50.3 ± 7.8 (out of 75). A negative and significant correlation between age and quality of life of patients was observed (P < 0.001). The duration of the disease had a direct and significant relationship with the general health score. But a significant difference between the quality of life of married and single people was not observed (P = 0.613). A direct and significant relationship between duration of disease, age with physical symptoms (P < 0.001), anxiety and insomnia (P = 0.001), social activity failure (P = 0.013), and depression (P = 0.001) was observed and was also observed with the overall score of general health (P < 0.001).Discussion and Conclusion: The duration of diabetes disease affects the quality of life and general health of diabetic patients, and discomfort, depression, and anxiety are the main problems that affect the quality of life of diabetic patients.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Effect of mindfulness-based intervention on perceived stress among breast
cancer patients undergoing chemotherapy
Authors: Naskar; Soumi; Dixit, Sanjukta; Varadharasu, Sivasankari; Pattnaik, Jigyansa I.; Singh, Reena
Abstract:
Introduction: Breast cancer is the second most prevalent disease among women in India and one of the most dangerous and lethal. Chemotherapy-treated breast cancer patients may have perceived stress, which is defined as emotions of mental or physical exhaustion that make them feel angry or anxious. Mindfulness-based intervention (MBI) gives some ideas in line with the conventional mindfulness technique.Purposes: (i) To assess the effect of MBI on perceived stress among breast cancer patients undergoing chemotherapy. (ii) To determine the association between perceived stress with selected demographic variables among breast cancer patients undergoing chemotherapy.Methods: The current quantitative pre- and postexperimental study was carried out in two oncology departments of selected cancer hospitals, Bhubaneswar. A total number of 40 breast cancer patients of perceived stress receiving chemotherapy and data were gathered by using a self-structured socio-demographic proforma and a structured Perceived Stress Scale 10. The experimental group received MBI, and a posttest was conducted on the 17th day on both the groups after 10 days of the termination of intervention. This MBI was provided to breast cancer patients for five sessions over five days continuously, each session for 45 min with mindfulness breathing exercises, progressive muscle relaxation techniques, practising meditation, and guided imagery technique.Results: The study findings illustrated that reduction of perceived stress among female breast cancer patients undergoing chemotherapy with (t = 2.2463) (P = 0.0306) at the P < 0.05; furthermore, there is one socio-demographic variable which had association with perceived stress that is history of psychiatric illness (χ2 = 14.1176) (P = 0.0009) and others had no association with perceived stress.Conclusion: MBI was an effective therapy for reducing the perceived stress of breast cancer patients undergoing chemotherapy.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Outcome of Fournier’s gangrene in relation to Fournier Gangrene
Severity Index (FGSI) score
Authors: Kundan; Meghraj; Ambedkar, Shivlok N; Kumar, Rambharosh; Nyekha, Vekhotso
Abstract:
Introduction: Fournier’s gangrene is a rapidly progressive necrotizing fasciitis, involving perineum mainly. The purpose of the study is to evaluate etiology, treatment, and outcome of Fournier’s gangrene so that such type patient’s management can be done by primary care physicians with best outcomes.Method: This was a retrospective study including 156 patients, treated for Fournier’s gangrene, between Jan 2012 and Dec 2018. The outcome and prognosis of Fournier’s gangrene were reviewed.Result: The mean age and mode among survival patients were 47.94 ± 14.9 and 60 years, and the mean age and mode in nonsurvival patients was 47.64 ± 15.9 and 65 years. The most common predisposing factor was diabetes mellitus (n = 49, 31.4%) having mortality rate was 9% (n = 14). Most common causative bacteria were E. coli. In the study, the survival rate was 100% in patients having Fournier Gangrene Severity Index (FGSI)≤3. As FGSI increased from 3, the mortality rate increased.Conclusion: Fournier gangrene is a surgical emergency. Early diagnosis, serial surgical debridement, and broad-spectrum antibiotics decrease the mortality and morbidity of patients. The sensitivity and specificity of FGSI determine the prognosis of Fournier’s gangrene. FGSI is a simple method to know the severity and prognosis.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Nutritional status, food security and other correlates among adult
tuberculosis patients in a block of Murshidabad district, West Bengal
Authors: Roy; Avik K.; Adhikary, Mrinmoy; Bandyopadhyay, Prithwish; Ghosh, Ritu; Das, Dilip K.
Abstract:
Background: Tuberculosis (TB) and malnutrition are epidemiologically interrelated two major public health problems in India. Food security also influences nutritional status. This aspect needs evaluation in diverse geographical areas. This study aimed to assess the level of food security, nutritional status and correlates among adult TB patients in a block of Murshidabad, West Bengal.Methods: This cross-sectional study was undertaken in the Nabagram block of Murshidabad district during April–July 2023. All adult (≥18 years) patients registered under the Tuberculosis Unit of the block during a reference period of 6 months (October 2022–March 2023) were considered study subjects. Eighty such eligible participants recruited randomly were interviewed with a pre-designed schedule for socio-demographic and programmatic characteristics. Household food security was measured using a validated U.S. Household Food Security Survey Module. Anthropometric measurements were taken, and nutritional status was determined based on body mass index. Statistical Package for the Social Sciences (SPSS) version 26 was used for analysis.Results: Among 80 TB patients, 51% were underweight and 20% were severely underweight. The majority (90%) of them had high or marginal food security, and 10% had low or very low food security. On multivariable logistic regression, Hindu religion (adjusted odds ratio (AOR): 6.74, 95% confidence interval (CI): 2.12–29.39), presence of any chronic morbidity (AOR: 11.61, 95%CI: 2.71–49.78) and receipt of dietary counselling by a health worker (AOR: 7.25, 95%CI: 1.22–43.13) appeared as predictors of underweight.Conclusions: Underweight among TB patients is quite prevalent in the area, and few programmatic interventions are influencing factors. This underscores the importance of nutritional counselling services and the universal provision of Poshan benefits.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Utility of anthropometry in defining overweight and obesity in urban South
Indian children
Authors: Solomon; Ritchie S.; Solomon, Adlyne R.
Abstract:
Introduction: Waist-based indicators of obesity are being used to detect central obesity and are predictive for metabolic syndrome (MS). The aim of the study is to assess the basic anthropometric indices in children, to determine the prevalence of overweight and obesity, and to determine the association between various waist-based measurements and body mass index (BMI).Methodology: A cross-sectional study was conducted among children aged 10 to 15 years attending government corporation schools in Chennai. Basic anthropometric measurements were taken. BMI, waist circumference/height ratio (WHtR), and waist circumference/hip circumference ratio (WHR) were calculated. The percentiles (Indian reference cutoffs) were determined for waist circumference (WC) and BMI. The prevalence of overweight and obesity was determined and compared to waist-based parameters.Results: Of 820 children, males constituted 47.1%. Stunting was seen in 9.8% and 7.8% were underweight. 8.2% had BMI less than the 3rd percentile. The prevalence of overweight and obese children was 9% and 3.2%, respectively, with female predominance. The majority had WC less than the 5th percentile. The prevalence of children under risk for MS based on WC>70th percentile was 4.5% and based on WHtR>0.5 was 8.2%. A significant association was identified between all waist-based anthropometric measurements to detect children at risk for MS and overweight/obese children as per BMI category. WHtR>0.5 was an indicator of overweight/obese children in logistic regression analysis.Conclusion: Early identification of children at risk of MS would require a combination of BMI to detect general obesity and waist-based anthropometric measurements to identify central obesity.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Clinical cohort of nonalcoholic fatty liver disease in a primary care
setting
Authors: Gips; Julia R.; Yanek, Lisa; Wu, Jiajun; Hamilton, James P.; Woreta, Tinsay A.; Clark, Jeanne M.
Abstract:
Background and Aims: Nonalcoholic fatty liver disease (NAFLD) is increasingly common, and primary care physicians (PCPs) are often the first to diagnose NAFLD. While guidelines on NAFLD management in primary care exist, there are limited data on clinical practice patterns.Approach: We gathered data from over 370,000 patients with at least one PCP visit between July 2016 and September 2023. Using ICD-10 codes to identify patients with a diagnosis of NAFLD or Nonalcoholic Steatohepatitis (NASH), we extracted demographics, comorbidities, laboratory results, prescriptions, imaging orders, and referrals to describe their care.Results: We identified 10,334 patients with a diagnosis code of NAFLD (93.1%) and/or NASH (16.7%) during a PCP visit. Just over half (54.8%) were female, mean age was 52.8 years, and mean BMI was 33.2 kg/m2 with 90% having overweight or obese. More than 50% had hypertension and hyperlipidemia, and 38% had diabetes. At the diagnosis visit, 2.7% had ultrasound elastography ordered, 2.7% liver biopsy, and less than 1% magnetic resonance elastography. During follow-up ranging from 0 to 7 years, patients had a mean of 15 encounters, during which 4% were diagnosed with fibrosis or cirrhosis. Only 24.2% of patients were referred to a nutritionist and 18% had an appointment, and only 0.7% were referred to hepatology and 3.8% saw a hepatologist.Conclusion: PCPs have not widely implemented clinical practice guidelines for NAFLD, resulting in suboptimal care including for the substantial minority with fibrosis or cirrhosis. Patients might benefit from targeted NAFLD education for PCPs and improved decision and management support.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Sarcopenia and frailty among the elderly population in the community: An
observational study
Authors: Gupta; Nalina; Kumar, Palani G.; Patel, Divya J.
Abstract:
Context: There are few studies on the prevalence of sarcopenia and frailty in India.Aims: The aim of this study was to assess sarcopenia and frailty using simple clinical tools among the elderly population in the community.Settings and Design: This was an observational study. The elderly population with an age group of>60 years residing in villages within 10–15 km of Sumandeep Vidyapeeth, Vadodara, formed the sampling frame of the study.Methods and Material: A total of 785 participants were approached, of whom 556 were included in the study based on inclusion criteria. Participants were assessed for grip strength, muscle mass, gait speed, and frailty.Statistical Analysis Used: The data were analyzed using STATA-IC statistical software version 13. A nonparametric Chi-square (χ2) test was used for categorical variables, and an independent-samples t-test was used to analyze the difference between various variables. Statistical significance was considered at P < 0.05 with a 95% confidence interval (CI).Results: Based on the Indian criteria, 205 participants (36.1%) were diagnosed as having sarcopenia, and 351 participants (63%) were diagnosed as having “no sarcopenia.” 5.6% of participants were found to be frail, 19.2% to be pre-frailty, and 75.2% to be no frailty. The χ2 analysis showed a significant association of sarcopenia with gender and different age groups (P value < 0.001).Conclusions: In this study, 36.9% of the elderly participants were found to have “sarcopenia,” and 5.6% of the participants had frailty. Simple clinical tools used were easy to administer and suitable for field screening.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Anemia and its association with glycemia and transaminitis in patients
with type 2 diabetes mellitus: A cross-sectional pilot study
Authors: Agarwal; Harsh; Kapoor, Gautam; Sethi, Prayas; Ghosh, Tamoghna; Pandey, Shivam; Sehgal, Tushar; Meena, Ved P.; Ranjan, Piyush; Vikram, Naval K.
Abstract:
Background and Aims: Anemia impairs glucose homeostasis, affects glycemic control, and predisposes to complications in diabetics. It correlates with oxidative stress and increases the risk of developing microvascular and macrovascular complications. However, it is an underrecognized comorbidity in diabetics. This study was conducted to assess the prevalence of anemia in diabetic patients and compare the metabolic profiles of anemic and non-anemic diabetics.Methods: This is a cross-sectional study, conducted among type 2 diabetes (T2DM) patients, at the outpatient clinic. Patients with chronic kidney disease (CKD), known hematological disorders, and chronic inflammatory disorders were excluded.Results: Of the 97 patients, 37 (38.14%) were found to be anemic (hemoglobin (Hb): male
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Prevalence and correlates of depression, anxiety, and stress among
adolescents in urban and rural areas of Mysuru, South India
Authors: Prakash; G. Hari; Kumar, D. Sunil; Arun, Vanishri; Hegde, Saurish; Yadav, Deepika; Gopi, Arun
Abstract:
Background: Adolescence, a volatile period of growth between the ages of 10 and 19, is associated with increased vulnerability to mental health problems. Factors such as academic pressure can contribute to these challenges.Objectives: The current study aimed to evaluate the factors and prevalence of depression, anxiety, and stress among adolescents in the urban and rural areas of Mysuru district.Materials and Methods: A cross-sectional study was conducted in private high schools in both urban and rural regions. Prior permission and informed consent were obtained from participants and their legal guardians aged 18 years and older.Results: The gender distribution in urban areas was 60.2% female and 39.8% male, while in rural areas, it was 51% male and 49% female. The prevalence of depression was higher in rural (39.3%) than in urban areas (24.2%), while anxiety was more prevalent in urban (50.6%) than in rural areas (49%). Stress was also more common in rural (16.6%) than urban adolescents (14.6%). Factors significantly associated with mental health outcomes included monthly family income, parenting practices, academic pressures, and self-esteem. Key needs identified were mobile mental health applications, online counseling services, and access to school counselors.Conclusion: This study provides insights into the prevalence and correlates of common mental health issues among adolescents in this region of South India. The findings emphasize the necessity of providing mobile applications and offline counseling services to effectively support and meet the needs of adolescents in these settings.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Adverse pregnancy outcomes with respect to treatment modalities in women
with gestational diabetes mellitus at a rural tertiary care teaching
hospital
Authors: Bailore; Vidyasri; Basany, Kalpana; Banda, Maheshwari
Abstract:
Objectives: To estimate the prevalence of gestational diabetes mellitus (GDM) and compare adverse pregnancy outcomes with respect to treatment modalities in a peri-urban teaching hospital in Telangana.Methods: A prospective study was conducted on GDM cases delivered from January 2019 to March 2020. GDM was diagnosed using a two-step procedure of screening using IADPSG criteria. Women diagnosed with GDM were divided into four groups – diet group, metformin group, metformin plus insulin group and insulin group based on the treatment modalities. Adverse pregnancy outcomes of the women managed with different treatment modalities were recorded.Results: Good glycaemic control (FBS, P = 0.04, 2 hrs PLBS, P = 0.01) was achieved in diet and metformin groups. Incidence of Gestational hypertension (P = 0.01) and preeclampsia (P = 0.01) were found to be higher in the insulin group when compared to the metformin and insulin group, metformin group and diet group. No difference was noted with respect to polyhydramnios, preterm birth, premature rupture of membranes, induction labour and caesarean delivery rates between the treatment groups. Apgar score at 5 min of 24 hrs (P = 0.03) and neonatal hypoglycaemia (P = 0.01) were found to be higher in insulin-required groups. Rates of shoulder dystocia, stillbirth, early neonatal death within 1 week and respiratory distress did not vary significantly between the treatment groups.Conclusion: Universal screening of women for GDM and multidisciplinary management of women once diagnosed tend to lessen maternal and fetal complications. Metformin can be an effective, cheaper and non-invasive alternative to insulin in the management of GDM.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Assessing the knowledge and skill of ASHA community health workers in
blood pressure measurement and primary care of hypertension
Authors: Dewangan; Mukesh; Garg, Samir; Nanda, Prabodh; Sahu, Ashu; Xalxo, Lalita; Tandan, Pradeep; Quereishi, M Jawed; Sahu, Anand Kumar
Abstract:
Introduction: India has a high burden of hypertension, and community health workers (CHWs) can contribute to its primary care. Studies of small-scale interventions have shown that trained CHWs can be useful contributors to hypertension care. No assessments are available in India on effectiveness of CHW training when conducted on a large scale.Methods: A study was conducted in Chhattisgarh, where 38,000 Accredited Social Health Activist (ASHA) CHWs had been trained in blood pressure (BP) measurement and counselling skills related to hypertension. The study involved a skill test and a knowledge test with ten points each, administered to two representative samples of trained CHWs – 433 in rural areas and 422 in urban slums.Results: The mean skill score out of 10 was 7.79 (7.59–7.99) and 8.11 (7.93–8.29) for the rural and urban CHWs, respectively. Around 75.3% (71.0–79.1%) of the rural and 80.3% (76.2–83.9%) of urban CHWs were able to score 70% (7 out of 10) or higher in the skill test. The mean knowledge score out of 10 was 8.18 (8.04–8.33) and 8.82 (8.78–8.93) for the rural and urban CHWs, respectively. Around 83.2% (79.3–86.4%) and 95.0% (94.4–96.7%) of the rural and urban CHWs, respectively, were able to score 70% or higher in the knowledge test.Conclusion: The ASHAs in Chhattisgarh demonstrated the necessary competence to contribute to BP measurement and primary care of hypertension. It shows feasibility of training a large number of CHWs in such skills. Efforts to equip and support the 1 million strong cadre of ASHAs across India need to be speeded up.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Prevalence of unintentional injuries and its risk factors among under-five
children residing in urban poor resettlements in Rishikesh
Authors: Ajun; UN; Sinha, Smita; Saxena, Vartika; Sriram, Shyam K.; Hariprasad, ; Salam, Ajmal
Abstract:
Background: A community-based study on childhood injuries would provide valuable information on the epidemiology of injuries to undertake appropriate preventive measures. Therefore, the current study was conducted in urban poor resettlements of Rishikesh to estimate the prevalence of unintentional injuries and to document the sociodemographic risk factors associated with unintentional injuries among under-five children.Aims and Objectives: Estimation of the prevalence of unintentional injuries and their risk factors among under-five children of urban poor resettlements in Rishikesh.Materials and Methods: A community-based cross-sectional study was conducted in urban poor resettlement areas of Rishikesh for a period of 1 year. It included 300 children selected using a simple random sampling technique to collect data on injury status.Results: The prevalence of unintentional injury among study participants was 16%. Falls were (64.6%) the major cause of injury, followed by dog bites (12.5%). The major sites of the injury were the head (25%), face (22.9%), upper limb (27.1%), and lower limb (18.8%).75% of the injuries happened at home. 66% of injuries happened when the child was playing alone or playing with peers. About 20.8% of injuries were bruises or superficial injuries. 39.6% of children had cut/bite/open wound injuries. Fractures happened in 14.6% of injured children. More than half (54.2%) of children did not develop any physical disability due to injury. Among children who developed a disability, more than 90% are able to recover completely. The majority of study participants were taken to nearby hospitals (66.6%) or health centers (10.4%). Only one of them went to a traditional bone setter, rest all visited either a general practitioner or pharmacy. The median expenditure for the treatment of the injured child was INR 425 (175-2750). The age of the child and unintentional injury showed a statistically significant association.Conclusion: The prevalence of the injury was 16% (12–20.7%) similar to a number of similar studies. Although the majority of the injuries were mild in severity, injuries have also contributed to temporary disability among children and have led to loss of school days.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Arterial stiffness as a screening tool for cardiovascular risk in health
and disease
Authors: Ganji; Vidya; Sowganthikashri, A; Taranikanti, Madhuri; Kalpana, M; Madhusudhan, U; Gaur, Archana; John, Nitin A.
Abstract:
Background: Cardiovascular diseases (CVD) account for approximately one-third of all deaths worldwide. The incidence of cardiovascular events such as myocardial infraction has been reported to be progressively increasing with age, especially with existing comorbidities such as hypertension, diabetes and obesity. Assessing arterial stiffness indices may serve as a screening tool in identification of population at risk of cardiovascular diseases and assist in implementation of preventive measures and early treatment in this population.Objectives: To measure and compare the arterial stiffness indices in healthy adults with diabetes, hypertension and obesity.Methods: A total of 184 adults in the age group of 30-50 years were included in the study who were divided into 4 groups: Group I (n = 64) (diabetic), group II (n = 40) (hypertensives), group III (n = 40) (obese) and group IV (n = 40) (control). The arterial stiffness indices were measured by using a certified oscillometric device in all the participants.Results: The arterial stiffness indices were assessed by using a certified oscillometric device in all the participants. The mean values of right baPWV and left baPWV are found to be significantly higher in hypertensive subjects compared with obese, diabetic and healthy controls.Conclusion: The pulse wave velocity, ASI and pulse pressure serve as independent predictors of cardiovascular mortality and outcomes in hypertension, diabetes and obesity as well as healthy individuals.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Understanding pediatric snakebites: Clinical and epidemiological insights
from a healthcare center in Bihar, India
Authors: Kumar; Rajan; Kumar, Manoj; Kumar, Deepak; Raj, Akanksha; Sheikh, Nishat A.
Abstract:
Background: Snakebites are a common medical emergency and occupational hazard for children in India, particularly in rural areas where poverty is prevalent. However, there is limited data on the epidemiology of snakebites on the Indian subcontinent.Objective: This cross-sectional, observational study aims to investigate the epidemiology, major clinical manifestations, and outcomes of snakebites in children under the age of 15 who were admitted to a tertiary care center in Bihar, a state in East India, and draw attention to this public health concern.Methods: A cross-sectional observational study was conducted at the Department of Paediatrics, Patna Medical College and Hospital, Patna. The study included all cases of snakebites with features of envenomation involving patients less than 15 years of age who were brought to the department over a 2-year period. Data were collected using a data collection form and analyzed using the Statistical Package for the Social Sciences, version 11.0 (SPSS Inc., Chicago, IL, USA).Results: A total of 59 cases were recorded, with 62.71% (n = 37) being male and 37.28% (n = 22) being female. Kraits were responsible for 38.9% (n = 23) of cases, vipers for 42.3% (n = 25), and cobras for 5% (n = 3). Fang marks were present in 67.7% (n = 40) of cases, and the majority of bites (84.7%, n = 50) occurred on a lower limb during the day. The age distribution showed that 16.9% (n = 10) were below 5 years old, 44% (n = 26) were between 5 and 10 years old, and 22% (n = 13) were above 10 years old. Traditional treatment was used in 44.7% (n = 22) of cases, with the most common treatments being local incision + tourniquet (22%, n = 13) and no traditional treatment (55.9%, n = 33). The highest number of cases occurred during July–September (35.5%, n = 21).Conclusion: Snakebites are a significant public health issue in Bihar, India, with the majority of cases occurring in rural areas. The study highlights the importance of increased awareness and preparedness among healthcare providers and the general public, particularly during the monsoon season. Early hospital transfer, prehospital management, and prevention should be promoted through regular public health initiatives.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Yoga and nutritional therapies for promoting health-related quality of
life in persons with metabolic syndrome—An interventional observational
study
Authors: Sorout; Jitender; Kacker, Sudhanshu; Saboo, Neha; Kumar, Munesh
Abstract:
Introduction: A group of related risk factors known as central obesity, elevated blood pressure, impaired fasting glucose, elevated triglycerides (TGs), and low levels of high-density lipoprotein (HDL) are collectively referred to as metabolic syndrome (MetS). A low quality of life (QoL) in terms of health is linked to MetS. This study sought to determine how lifestyle modifications affected the health-related quality of life (HRQoL) of primary care patients with MetS.Materials and Methods: In this study, we randomized 300 subjects diagnosed with MetS as per the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria, into control, yoga, and yoga + diet groups according to their intervention which was given for 6 months. Socio-demographic, anthropometric, and physiological and biochemical parameters were collected at baseline, 3 months, and 6 months. The 36-Item Short Form Health Survey (SF-36) was also used to assess HRQoL.Results: The results of this study indicate that yoga + diet and yoga intervention led to significant decrease in metabolic risk factors, such as waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), TGs, and increase in HDL at 3 months and 6 months from baseline. SF-36 score also showed increment (from 0 score to 100) at 3 months and 6 months, which indicates improvement in HRQoL.Conclusion: Dietary changes and yoga are useful strategies for reducing the risk of MetS, which improves QoL in relation to health. Incorporating yoga practices and advocating a balanced diet within primary care systems can significantly benefit individuals with or at risk of MetS.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Knowledge and utilization of Integrated Child Development Services among
antenatal women during COVID-19 pandemic
Authors: Ferdina; Taniyaa Cruz; Vellingiri, Deepanchakravarthi; Raja, N Sabari; Paulin Dharmalingam, Gracy
Abstract:
Introduction: The coronavirus disease 2019 (COVID-19) pandemic has affected the healthcare delivery system in both developed and developing countries. Many antenatal women skipped their regular antenatal check-ups due to fear of viral contamination and lack of transport facilities. Integrated Child Development Services (ICDS), which plays a major role in antenatal care, also suffered a great deal during the pandemic.Objectives: 1. To assess knowledge and utilization of ICDS services by antenatal women during the COVID-19 pandemic. 2. To determine factors influencing the knowledge and utilization of ICDS services by antenatal women. 3. To determine the barriers to utilization of ICDS services during the pandemic.Methodology: This study was conducted as a descriptive study in a tertiary care center. Antenatal women whose pregnancy period coincided with the second wave of the COVID-19 pandemic were interviewed using a structured questionnaire. The sample size was calculated as 198. Data were entered in Microsoft Excel and analyzed using Statistical Package for Social Sciences (SPSS).Results: Around 61% of the study population had adequate knowledge about ICDS services. The proportion of antenatal women utilizing ICDS services reduced from 87.8% to 69.6% during the pandemic. Only a few of the mothers were followed up by the Anganwadi workers during the pandemic. The main barriers to not utilizing ICDS services were fear of the spread of the pathogen and lack of awareness about the availability of services during the pandemic.Conclusion: There has been a reduction in the utilization of ICDS services by antenatal women during the COVID-19 pandemic. Measures should be taken by the government to ensure undisrupted care for antenatal women during such hard times.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Prevalence of obsessive-compulsive symptoms among adult population in
primary care centers in Bahrain – A cross-sectional study
Authors: Alsaweer; Abeer A.; Tareq Darraj, Muneera; Mahmood Janahi, Shaikha; Yusuf Aljowder, Fatema; Salem Almoammari, Nasra; Isa Alkhater, Nayla; Aldoseri, Alhanoof Bader; Alshaikh, Abeer Abdullatif; Ali, Aysha Khalid; Khaliqi, Faezah Ahmed; Mohsen, Amal Ali; Almarabheh, Amer; Husni, Mariwan
Abstract:
Background: The global increasing prevalence of obsessive-compulsive disorders and symptoms among various age groups and nationalities is considered a great clinical challenge. However, limited data are available on this topic in the Middle East and Gulf Council Countries. This study aimed to raise awareness of obsessive-compulsive symptoms among adults in Bahrain by determining its prevalence and risk factors among patients attending primary healthcare centersMaterials and Methods: A cross-sectional study was conducted among adult patients attending primary healthcare centers in Bahrain. A self-administered online questionnaire using Google form, a free online survey-creating website, was distributed through WhatsApp messages. A snowball sampling technique was used. The questionnaire consisted of three parts: the socio-demographic data of participants, the Maudsley Obsessional-Compulsive Inventory, and the Yale-Brown Obsessive-Compulsive Scale. Descriptive and inferential analyses were conducted.Results: A total of 614 participants were included with a mean age of 30.04 ± 13.04 years. Most participants were females (82.5%) and single (n = 347, 56.5%). The estimated prevalence of obsessive-compulsive symptoms among the participants was 15%; most of them reported mild symptoms (85%). Significantly higher obsession and compulsion symptoms were found among non-Bahraini (P < 0.001 and P < 0.002), single (P < 0.001 and P < 0.033), and student participants (P < 0.001 and P = 0.002) compared to their counterparts, respectively. In addition, undergraduates reported higher obsessions compared to other participants (P = 0.005).Conclusions: Approximately, one in every eight people in Bahrain were found to suffer from obsessive-compulsive symptoms, especially single, students, and non-Bahraini participants. These findings highlight the need for raising awareness of obsessive-compulsive disorder and its symptoms as well as the importance of early detection and management of obsessive-compulsive disorder.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- The association of continuous glucose monitoring with glycemic parameters
in patients with uncontrolled type 2 diabetes: A prospective observational
study
Authors: Chaubey; Abhishek; Chaubey, Deepika; Dwivedi, Abhishek; Dwivedi, Saurabh; Mishra, Tanu
Abstract:
Background: Uncontrolled glycemic parameters in type 2 diabetes mellitus (T2DM) are a major concern. The present study aimed to evaluate the effectiveness of continuous glucose monitoring (CGM) on glycemic control in type 2 diabetics on insulin therapy.Materials and Methods: This prospective observational study was done in the Outpatient Department of General Medicine from January 1, 2021 till December 31, 2021 on patients with confirmed T2DM and on insulin therapy. Patients underwent detailed history and physical examination. The CGM device was inserted to record blood glucose levels throughout the day and night for monitoring. Parameters like glycosylated hemoglobin (HbA1c), fasting blood sugar (FBS), post-paradial blood sugar (PPBS), and lipid profile parameters [cholesterol, triglyceride (TG), and low-density lipoprotein (LDL)] were compared at baseline and after a follow-up of 3 months. P-value < 0.05 was used to indicate significant difference.Results: Of 107 patients screened, 100 were included in the study and seven were excluded. The mean age of the patients was 60.6 ± 11.1 years. Fifty-six (56%) of the patients were males, and 44 (44%) were females. The mean body mass index (BMI) was 22.9 ± 2.4 kg/m2. Compared to baseline values, after 3 months of CGM, there was significantly decreased HbA1c (9.41 ± 0.83 vs 9.87 ± 1.16 g%, P < 0.001), FBS (194.640 ± 22.4587 vs 205.10 ± 35.7758 mg/dl, P = 0.002), PPBS (271.160 ± 29.1235 vs 299.180 ± 42.3798, P < 0.001), cholesterol (184.470 ± 28.5192 vs 198.430 ± 38.8367 mg/dl, P < 0.001), LDL (102.410 ± 22.8973 vs 112.040 ± 30.8859, P < 0.001), and TG (140.890 ± 18.0979 vs 146.730 ± 20.8665 mg/dl, P < 0.001).Conclusion: There was a significant improvement in the glycemic parameters and lipid profile parameters with the adoption of CGM. Overall, CGM is a novel method for practical use for management of patients with T2DM.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Serum 25(OH) vitamin D deficiency among young adults in the East Khasi
Hills district of Meghalaya and its influence on bone mineral density:
Investigating the involvement of the RANKL/RANK/OPG system
Authors: Ruram; Alice A.; Chutia, Happy; Bhattacharyya, Himashree; Handique, Akash
Abstract:
Introduction: Vitamin D’s precise role in bone mineral density regulation remains elusive. Nevertheless, its deficiency is linked to increased bone turnover through the upregulation of RANK ligands by osteoblasts. This study aimed to (i) evaluate vitamin D status in young adults and (ii) assess the association between vitamin D deficiency and bone turnover markers receptor activator of nuclear factor-κB ligand (RANKL), RANK, and the osteoprotegerin (OPG) in determining bone mineral density.Materials and Methods: This cross-sectional study involved 474 participants from the East Khasi Hills district, Meghalaya. Vitamin D levels were measured using the UniCel DxI 800 system, while OPG, RANK, and RANKL were assessed through enzyme-linked immunosorbent assay (ELISA). Additionally, a whole-body dual X-ray absorptiometry (DEXA) scan determined bone mineral density. Vitamin D deficiency was categorised as
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Serotype-specific clinical features and spatial distribution of dengue in
northern Kerala, India
Authors: Vaman; Raman Swathy; Valamparampil, Mathew J.; Somasundaran, Aswathi Kodenchery; Balakrishnan, Anjali Jayasree; Janardhanan, Prajit; Rahul, Arya; Pilankatta, Rajendra; Anish, Thekkumkara Surendran
Abstract:
Background: Collection and compilation of spatial, meteorological, entomological, and virological data are critical in mitigating climate-sensitive emerging infections like dengue. This study was a holistic attempt to understand the dengue situation in the Kasaragod district of Kerala, India.Methods: This cross-sectional study was conducted in 13 health institutions from June to July 2021. Adult patients presenting with fever and testing positive for NS1 ELISA were subjected to Dengue RT-PCR and serotyping. The spatial and clinical features of the RT-PCR-positive patients, the district’s meteorological data, and the vector indices were studied.Results: The pre-epidemic months were marked by intermittent rainfall, peak ambient temperature and high larval indices. Among the 136 dengue RT-PCR patients studied, 41.2% had DENV2 followed by DENV1 (22.8%), DENV3 (5.9%) and DENV4 (4.4%); with 25% mixed infections. DENV1 showed a higher risk of gastrointestinal manifestations (80.6%, p=0.019) and musculoskeletal symptoms (77.4%, p=0.026) compared with other serotypes.Conclusions: In the context of dengue hyperendemicity, the possibility of an emerging serotype’s dominance coupled with the mixing up of strains should warn the health system regarding future outbreaks. Furthermore, the study emphasizes the importance of monitoring larval indices and the window of opportunity to intervene between environmental predictors and dengue outbreaks.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Awareness of school teachers about students common emergencies during
school time in the eastern region, Saudi Arabia: A cross-sectional study
Authors: Alruwaili; Abdullah; Al Sulaiteen, Hajar; Alanazy, Ahmed; Almousa, Zahraa; Alshaqaqiq, Maryam; Alhofufi, Albatool; Almulhem, Noura; Alibrahim, Zahraa
Abstract:
Background: Schools have to ensure student safety and well-being. However, medical emergencies involving injuries are common, requiring teachers to provide prompt first aid before professional care arrives. This study assessed knowledge and awareness of first aid among school teachers to identify areas needing improvement.Methods: This cross-sectional study surveyed 371 teachers from the eastern region primary schools using a standardized questionnaire assessing first aid knowledge across areas like bleeding control, fractures, seizures, choking, and burns. Demographic factors were analyzed for correlations with knowledge levels. Pearson’s Chi-square tests analyzed bivariate relationships comparing correct knowledge identification percentages across teacher sociodemographic. The level of statistical significance was at a P value
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Effectiveness of training on primary care nurses’ knowledge and
screening practice in identification of children at risk for developmental
delay: An Indian perspective
Authors: Ramu; Rajalakshmi; Govindan, Radhakrishnan; Marimuthu, Palaniappan
Abstract:
Background: In India, overall, 1.5–19.8% of the children were found to be developmentally delayed. The evaluation of development in young children and health professionals’ early referrals for diagnostic assessment will accelerate appropriate early intervention as early as possible. Nurses can screen the children and help the parents by providing the necessary information and support.Aim: To train the primary care nurses on developmental screening and early identification of developmental delay (DD) in children and find the effectiveness of the same.Objectives of the study: To evaluate the effectiveness of the training program on the knowledge and screening practice of the nurses towards the identification of children at risk for DD and to find out the relationship between nurses’ knowledge and screening practice.Methods and Materials: A quasi-experimental, one-group pretest, post-test design was adopted among 69 nurses, who were providing child care services and working in the selected government hospitals in Bengaluru, South India. Nurses’ knowledge and screening practice in identifying children at risk for DD were assessed before and after the training. SPSS package 21.00 version was used to analyse the descriptive and inferential statistics.Results: The training program was effective in the enhancement of primary care nurses’ knowledge and screening practice in the identification of DDs in under-five children.Conclusion: The findings of this study concluded that developmental screening can be performed by nurses with suitable training programs. The training program played a significant role in the enhancement of nurses’ knowledge and screening practice in the identification of DDs in under-five children.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- A postmortem study of demographics and severity of thoracoabdominal
injuries among patients attending a teaching hospital in northeast India
Authors: Datta; Anupam; Siddappa, Santhosh C.; Dey, Debaleena; Nath, Anamika
Abstract:
Introduction: The global estimate reflects 4.4 million injury-related deaths every year and the thoracoabdominal region is frequently injured since it is a wide area.Methods: An autopsy-based cross-sectional study was conducted using a convenient sampling technique for three years. A Chi-square test was conducted for categorical variables. A P value of less than 0.01 was considered statistically significant.Results: Out of 80 cadavers, the male:female ratio was 1:0.31. The commonest age group was 20–29 years. Victims of road traffic accidents were 54 (67.5%) followed by falls from height 10 (12.5%). External thoracic injuries were commoner than internal and vice versa in abdominal injuries. Liver injuries were major in number. Combined thoracic-abdominal and associated injuries were observed in 67 (83.75%) victims. The commonest cause of death was craniocerebral injury combined with hemorrhagic shock (36.25%). Eighteen (22.5%) victims died on the spot having an Injury Severity Score (ISS) of 73.37 followed by a survival time of 1–7 days in 17 (21.25%) cases. A significant correlation was found between ISS and survival period.Conclusion: All thoracic and abdominal injuries represent a possible increase in morbidity and mortality; hence, working toward their prevention and timely intervention is necessary.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Comparative analysis of nutritional status among institutionalised and
community-dwelling elderly women and its association with mental health
status and cognitive function
Authors: Shakil; Somaiya; Ghosh, Joyeta; Singh, Khusboo; Chaudhury, Sudrita Roy
Abstract:
Introduction: Population pyramids are significantly impacted by the global phenomena of ageing. It has been reported that depression and cognitive function have an impact on the nutritional status of older adults. Depression is the most common psychiatric problem in old age, and cognitive deterioration is frequently observed in this age group.Objective: This descriptive and comparative study set out to compare the cognitive abilities, nutritional health and depression status of older adults who lived in community settings and in assisted living facilities.Materials and Methods: A total of 250 older women (125 from institutionalised old age home and 125 from community) participated in a cross-sectional study (residing at Rajarhat, Newtown area). The lengthy version of the Mini Nutritional Assessment tool (MNA®) was used to evaluate the participants’ nutritional status. The Geriatric Depression Scale (GDS 30) was used to evaluate the severity of the depression. Using the Folstein Mini-Mental State Examination (MMSE), cognitive function was assessed. Using SPSS software, the Chi-square, Kruskal–Wallis test, and Spearman’s rho correlation coefficient were computed.Results: In the present study, it was observed that only 30.4% of the respondents who are community-dwelling elderly had normal MNA score, whereas 69.6% were at risk of malnutrition or already malnourished. Considering institutionalised elderly it was observed that only 7.2% were normal and 92.8% were malnourished/at risk of malnutrition. Statistically significant association was observed between nutritional status and mental health status (P = 0.00) as well as cognitive function (P = 0.00) among old age home residing elderly. Among the community-dwelling elderly mental health status has significant association with their nutritional status (P = 0.00) and cognitive function (P = 0.00) as well.Conclusions: Community-dwelling elderly were relatively healthy compared to old age home residents. Maintaining the nutritional, cognitive, and mental health of institutionalised and community-dwelling elderly women requires the implementation of physical and cognitive stimulation activities as well as interventions targeted at improving a healthy diet.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- A retrospective analysis of the trends in the prevalence of female genital
mutilation and associated factors among women of reproductive age in
Nigeria 2011–2021
Authors: Sanni; Felix O.; Sanni, Elizabeth A.; Onyeagwaibe, Collins; Ahamuefula, Tukwasi
Abstract:
Background: Female genital mutilation (FGM) is widely acknowledged globally as a violation of the fundamental human rights of girls and women. FGM is still widely practiced in Nigeria but at diminishing rates. Primary care physicians must educate and campaign to end this hazardous practice in Nigeria, especially in high-incidence areas. This study fills the knowledge gap by identifying FGM determinants to help policymakers reduce it.Method: The study employed a retrospective cross-sectional design using data from the United Nations International Children’s Emergency Fund for 2011, 2016–2017, and 2021. The sampling involved multistage cluster sampling. Data analysis utilized IBM-SPSS, presenting FGM prevalence across years and exploring associations with various factors.Results: This study analyzed 63,365 Nigerian women across a decade (2011, 2016–2017, and 2021). FGM awareness fluctuated (35.1% in 2016–2017, 33.0% in 2011, and 31.9% in 2021), while FGM prevalence increased from 46.6% (2011) to 69.5% (2021). Education correlated with lower FGM prevalence. Geographic disparities were observed, with the Southwest having the highest (70.1%) and the Northeast having the lowest (34.5%) prevalence. Religion influenced FGM rates, with Christians (54.2%) and those with other/no religion (58.0%) showing higher rates than Muslims (52.6%). Urban women had a slightly lower prevalence (52.6%) than rural women (54.2%), and wealth quintiles displayed variations. Variability was also evident among states, ranging from 2.0% to 86.3%. Daughters’ circumcision was influenced by maternal circumcision status, education, region, religion, and wealth quintile. Common FGM procedures involved removing genital flesh (63.7%) and nicking without removal (55.1%), often performed by nurses/midwives (63.7%).Conclusion: The study emphasized the urgent need for continuous awareness campaigns and education to combat FGM among Nigerian women. Education emerged as a critical factor in reducing FGM, highlighting the importance of investing in girls’ education.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Characterization and assessment of exposure risks of healthcare personnel
during the COVID-19 pandemic
Authors: Das; Arghya; Garg, Rahul; Singh, Ravindra; Banerjee, Tuhina
Abstract:
Introduction: Healthcare personnel have the right to decent, healthy, and safe working conditions during COVID-19. Despite our best efforts to safeguard them against SARS-CoV-2 infection, a substantially large number of healthcare personnel fell ill and succumbed to COVID-19. This study aimed to characterize the SARS-CoV-2 exposures among healthcare personnel and determine the risk level of those events, thereby identifying and focusing on the key areas that influence workplace safety.Materials and Methods: A pre-tested questionnaire was used to collect data from healthcare personnel on the type of exposure, place, and use of preventive measures, along with demographic and occupational data. Exposure events were categorized into low, moderate, and high-risk by using a risk categorization protocol.Results: Doctors were primarily found to be involved in the aerosol-generating procedure, which had 94 times higher odds (95% CI: 43.9926–201.17) for high-risk exposures than other activities. In contrast, nurses were more likely to experience close-contact exposures (OR: 2.77, 95% CI: 1.44–5.33). Both critical care units and operation theaters were identified to have higher odds (OR: 2.34, 95% CI: 1.33–4.23 and OR: 2.31; 95% CI: 0.99–5.42, respectively) than the wards for high-risk exposures. Use of personal protective equipment was poor, with breaches reported in 10.2% of all exposure events. The lacunae in practice were addressed by repeated training and counseling and by ensuring the adequacy of resources in required areas.Conclusions: The assessment was beneficial for safeguarding healthcare personnel and assuring a safer workplace during the early phase of the COVID-19 pandemic.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Carbon monoxide-related fatalities: A fifteen-year single institution
experience
Authors: Kumar; Rajesh; Sheikh, Nishat A.; Vasudeva, Abhimanyu; Kumar, Adarsh; Yadav, Abhishek; Gupta, Sudhir K
Abstract:
Introduction: The winter climate in Delhi is severe, with temperatures dropping below 10°C. As a result, individuals often resort to utilizing diverse heat sources such as electrical heating appliances, coal and gas geysers. Unfortunately, these sources are commonly associated with the emission of carbon monoxide (CO) which can accumulate in inadequately ventilated spaces. Exposure to this noxious gas can lead to acute lethargy and debilitation, leaving individuals in a state of helpless distress.Materials and Methods: The present study utilized a retrospective descriptive analysis to examine cases of fatal carbon monoxide exposure retrieved from the Department of Forensic Medicine archives at the esteemed All India Institute of Medical Sciences, New Delhi. Autopsy records were thoroughly examined with respect to various parameters including age, gender, seasonality of the incident, circumstances surrounding the death, source of carbon monoxide generation, post mortem observations, as well as toxicological analysis reports.Results and Discussion: This study entailed an analysis of 56 individuals who fell victim to carbon monoxide poisoning, with a staggering 95% of fatalities occurring during the winter season. The majority of the individuals affected belonged to the age bracket of 21–30 years. The most common sources of carbon monoxide exposure were linked to the use of coal-burning earthen or iron vessels for room heating, as well as structural fires. With the exception of one case, all incidents were accidental in nature. Additionally, nearly all of the victims were discovered in enclosed spaces with heating equipment in close proximity, and evidence of a struggle was noted on the crime scene or with the deceased.Conclusion: The findings of this study indicate that the principal contributor to the inadvertent build-up of lethal concentrations of carbon monoxide gas is the utilization of heating appliances within inadequately ventilated, enclosed spaces. Due to the scentless and non-irritating properties of this gas, individuals who are asleep may be unable to detect its presence in their surroundings, thereby leading to a silent death. To mitigate such risks, the installation of carbon monoxide detectors is crucial. Additionally, it is of utmost importance to raise public awareness regarding the perils associated with using fire pots, coal burning and electrical heating appliances in areas with insufficient ventilation.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Quality of sleep among hypertensive patients attending a rural health
training centre
Authors: Venkatesh; Aishwarya; Varadarajan, Suresh
Abstract:
Introduction: Sleep is a vital biological, reparative, and restorative phenomenon, and poor sleep has a serious detrimental effect on health. Poor sleep quality is a serious problem as it adversely affects a person’s ability to function physically and socially, as well as their potential for profession and quality of life. The degree of hypertension directly affects sleep quality, and poor sleep can exacerbate hypertensive symptoms. This study assesses hypertension patients’ sleep quality in a rural health training centre in Chennai.Objectives: 1. To study the prevalence of poor sleep quality among hypertensive patients. 2. To determine the association between selected socio-demographic factors and sleep quality among these patients.Materials and Methods: Hypertensives attending the outpatient department of a rural health and training centre were selected in a systematic manner and administered a semi-structured interview schedule and the Pittsburgh Sleep Quality Index (PSQI) questionnaire followed by a basic clinical examination. Using the PSQI, they were categorised as having either poor or good sleep quality and the association between selected socio-demographic factors and sleep quality was assessed.Results: Out of the 179 study participants, there were almost equal numbers of male and female participants. The mean age of participants was 57.80 years (standard deviation (SD) = 9.8 yrs.). Among the study participants, 44.13% had completed secondary level of school as an education qualification and 6.70% were illiterate. By the modified BG Prasad classification 2022, most of the study participants (34.08%) came under the class II socioeconomic classification. A large proportion (78.8%) of study participants had poor sleep quality. The difference in sleep quality was observed with respect to gender, socio-economic class, alcohol consumption and body mass index (BMI).Conclusion: This observational study shows that individuals with hypertension suffer significantly from poor sleep. A poor quality of sleep was reported by 78.77% of the patients in this study. Statistically significant factors that influenced sleep quality were gender, alcohol consumption and BMI.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Assessment of clinical and histopathological characteristics in
COVID-19-associated mucormycosis (CAM) patients correlating with outcome:
A hospital-based cross-sectional study
Authors: Gupta; Rakesh K.; Nagarkar, Nitin M.; Chowhan, Amit K.; Mehta, Rupa; Singh, Alok; Simon, Ankita
Abstract:
Background: The second wave of the COVID-19 pandemic led to a very dreaded complication of mucormycosis. Immunosuppressive action of the COVID-19 virus, co-morbidities, for example, diabetes mellitus (DM), hypertension, use of steroids, and humidified oxygen, are among the important factors that make the patients susceptible to developing mucormycosis.Objective: The present study was conducted to identify and understand all the significant histological changes including the type and extent of tissue involvement, the pattern of inflammation, the volume of fungal hyphae, hemorrhage, etc., in patients with COVID-19 associated mucormycosis (CAM) and correlate with clinical outcome.Method: It was a retrospective cross-sectional observational study involving all the patients of CAM, who underwent debridement or biopsy over a period of 5 months, from April 01, 2021, to August 31, 2021. CAM was classified based on the radiological evaluation, clinical features, and organs involved. Different demographic, clinical, laboratory, and histologic parameters were recorded. The variables were assessed for their association with poor clinical outcomes using multiple logistic regression. P < 0.05 was considered statistically significant.Results: A total of 146 patients were included in the study with a mean age of 49.4 years and 71.2% were male. Sino-naso-palatal was the most common type of CAM (32.9%), while sino-naso-cerebral was the least common (14.3%). DM was present in 54.1% of patients, out of which 26.6% were recently diagnosed. The death occurred in 21.9% of patients. Maximum mortality was observed in CAM of sino-naso-cerebral involvement (42.9%). Total leucocyte count (TLC) [OR = 0.87; 95%CI: 0.76-0.97; P = 0.02] and C-reactive protein (CRP) [OR = 0.97; 95%CI: 0.96-0.99; P = 0.008] were significantly associated with poor outcomes. Other factors, that is, high prothrombin time, DM, ferritin, and the involvement of muscle, skin, and cartilage, were also associated with poor clinical outcomes but were not statistically significant. Similarly, high fungal volume and the presence of thrombosis were also associated with poor outcomes but were not statistically significant.Conclusion: CAM more commonly affects males with co-morbidities. TLC and CRP were significantly associated with poor outcomes. Histologically, the involvement of skin, muscle, and cartilage and the presence of excessive fungal hyphae and thrombosis were also associated with poor outcomes.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Prevalence and influencing factors of metabolic syndrome among rural adult
population in a district of South India
Authors: Latha; P Swarna; Sangeetha, S; Vijayakarthikeyan, M; Shankar, R
Abstract:
Background: Metabolic syndrome has increased globally due to sedentary lifestyles, unhealthy diets and obesity, which is posing a substantial burden on healthcare systems. Understanding the determinants of metabolic syndrome like lifestyle factors, socioeconomic status and the environment are vital for devising effective prevention and management. Research into these determinants helps to identify high-risk populations and develop interventions to reduce its occurrence.Objectives: i. To estimate the prevalence of metabolic syndrome among the adult population. ii. To determine the factors associated with metabolic syndrome among the adult population.Methodology: A cross-sectional study was carried out among 410 adults (≥18 years). A semi-structured questionnaire was used to collect data and National Cholesterol Education Program’s Adult Treatment Panel III criteria was used to diagnose metabolic syndrome. Continuous and categorical data were represented as mean and proportion, respectively. The strength of the association was determined using the prevalence ratio and adjusted prevalence ratio.Results: The mean age of the participants was 44.97 ± 14.7, about 58.3% of them were females. Metabolic syndrome prevalence was 39.8%. Multivariate regression analysis demonstrated that being over 40 years old, marital status, higher socioeconomic status, skilled workers, physical inactivity and obesity were independently linked to metabolic syndrome.Conclusions: The burden can be reduced by identifying the risk factors at the early stage through screening and by adopting a healthy lifestyle.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Assessment of treatment outcomes of daily fixed-dose combination therapy
among drug-sensitive pulmonary tuberculosis patients: A prospective study
from Bengaluru, India
Authors: Sumana; M; Saraswathi, S; Mukhopadhyay, Amita; Debata, Ipsita; Ranganath, TS
Abstract:
Context: The annual incidence cases report depicts India as having the highest tuberculosis (TB) burden globally. Following a programmatic change, the daily fixed-dose combination (FDC) anti-TB treatment regimens were introduced by the Indian government’s National Tuberculosis Elimination Program (NTEP).Aims: The aim of the study was to assess the treatment outcomes among drug-sensitive pulmonary TB patients receiving daily FDC drugs and the associated factors influencing the treatment outcomes.Settings and Design: A prospective study was conducted among 300 drug-sensitive pulmonary TB cases in the Bruhat Bengaluru Mahanagara Palike (BBMP) area.Materials and Methods: The TB units and designated microscopic centers (DMCs) were selected by multistage random sampling. Data were collected through a pre-tested and semi-structured questionnaire. Patients were followed up until treatment completion.Statistical Analysis Used: Data were compiled and analyzed using IBM Statistical Package for Social Sciences (SPSS) statistics version 20.0. Descriptive statistics and the Chi-square test were used for interpretation. A P-value less than 0.05 was considered statistically significant.Results: Around 86.33% of patients were cured, 4% had completed treatment, and 1% had treatment failure. Older age, human immunodeficiency virus (HIV) reactive status, alcohol intake, tobacco use, and migrants were associated with poor outcomes.Conclusions: The daily FDC regimen had better outcomes than intermittent regimens. Smokers, alcoholics, migrants, and patients with co-morbidity need to be given priority in management as they are prone to poorer outcomes.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Public health preparedness, syndromic surveillance, and response during
the largest religious gathering at the Catholic pilgrimage center of
Velankanni in South India: 2016
Authors: Ponnaiah; Manickam; Virumbi, Viduthalai; Sharma, Upasana; Muthappan, Sendhilkumar; Parasuraman, Ganeshkumar; Balasubramanian, Premkumar; Venkatachalam, Vijayalakshmi; Karumanagoundar, Kolandaswamy
Abstract:
Background: The dynamicity and mobility of the population in a mass gathering setting pose a challenge to traditional disease surveillance methods and strain the local health services. Velankanni is one of the most sacred Christian pilgrimage places located in Nagapattinam, Tamil Nadu, India. We participated in the Velankanni festival to describe the public health preparedness, surveillance, and response activities carried out during the festival.Methods: This was a cross-sectional study. We reviewed the national and international guidelines and published literature and discussed with the key stakeholders. We developed a checklist to observe public health preparedness activities. We facilitated the staff and monitored the activities by the implementers. We established the syndromic surveillance in the designated locations of the event and used tracker software to capture the data. Emergency medical teams were formed with trained health personnel to respond to medical emergencies.Results: The team monitored all the public health activities. There are 59 primary care public health facilities and nine ambulatory Mobile Medical Units, with 160 medical officers available at the site. Of the 16,169 persons who attended the medical camps, 9863 (61%) were males and 8408 (52%) were aged 15–44. Acute diarrheal disease was the most frequent of the reported syndromes, followed by injuries, acute febrile illness, and animal bites.Conclusions: There was no outbreak of any disease either identified or reported. Our findings suggest that risk assessments should be used, and establishing an Incident Command Center is vital for executing command and control mechanisms during mass gatherings.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- The socio-demographic profile of family physician graduates of
blended-learning courses in India
Authors: Velavan; Jachin; Marcus, Tessa S.
Abstract:
Context: India’s lean cadre of 250,000 general practitioners and 30,000 government doctors has limited options to update themselves. Since 2006, Christian Medical College (CMC) Vellore has run blended-learning programs in family medicine, namely, postgraduate diploma in family medicine (PGDFM) and master in medicine in family medicine (M.MED FM) training more than 3000 doctors. A graduate follow-up study was undertaken in 2022.Aim: The aim of the study was to describe the socio-demographic characteristics of family physicians (FPs) in India who graduated between 2008 and 2018 from the FM blended-learning programs run by the CMC, Vellore.Settings and Design: Informed by an empirical-analytic paradigm, this descriptive study used a cross-sectional survey design to uncover graduate FPs’ profiles, practices and experiences.Methods and Materials: Using a purposively designed, piloted and validated electronic questionnaire, data were collected between March and July 2022, deidentified and analysed using Statistical Package for Social Sciences (SPSS)TM and Epi InfoTM.Results: Among the 438 FP respondents (36%), there was an almost even split in gender (49.3% male, 50.7% female). Moreover, 25.8% were below the age of 40 years, 37.4% were in the 40–49 age group, and 33.8% were 50 years of age or older; 86% lived and worked in urban areas. The PGDFM or M.MED FM was the highest educational qualification of 64.4% of the doctors. Male FPs pursued postgraduate studies at a significantly younger age and earned significantly more than their female counterparts.Conclusions: The blended learning model creates an important pathway for doctors, especially women, to pursue higher education with flexibility. Preferential selection criteria can target rural-based physicians. Strong policy-level advocacy is needed to establish FM as a specialty with equitable pay scales. Socio-demographic profiling can be used as an effective advocacy tool.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Cultural practices and beliefs followed for new born care in Santhal
pargana - A cross sectional study
Authors: Gaur; Rakhi; Kumar, Rajan; Kaur, Navjot; Kumar, Manoj; Das, Sarthak; Patel, Rashmi B.
Abstract:
Introduction: Newborn care practices and beliefs vary word-wide, country to country and region to region. These care practices play a vital role in morbidity and mortality of newborn. A descriptive cross-sectional study was conducted to assess the newborn care practices and beliefs of newborn care.Methods: Data was collected from 429 post-natal mothers, who delivered in selected government hospitals of Santhal parganas, Deoghar, Jharkhand. Convenience sampling technique was used to collect the data from February 2023 to April 2023.Results: Findings of the study are, 86.9% mothers accepted that they massage the baby with oil before bath, 89.3% participants have given breastfeeding within one hour of delivery, 93.7% have given prelacteal feeds to the newborn. Applying Heeng (Asafoetida) over the umbilicus was found a common practice to cure the abdominal pain, 70.8% accepted that they apply ashes or powder or cow dung on the umbilical cord, and 88.3% rub the dough on baby’s skin to remove excess hairs, 99.3% mothers had firm belief that hot and cold foods in their diet could harm the baby. In continuation 98.8% believed that tooth eruption is associated with diarrhoea, 95.6% are applying kajal in the eyes of new born. Majority 98.8% believed that baby’s skin should be exposed to sunlight in case of jaundice and 94% avoid dressing of new born with yellow clothes.Conclusion: Continuous Health Education programs must be organized in Community to Educate the people about beneficial and harmful newborn care practices, which will help to reduce morbidity and mortality in newborn.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Effectiveness of “SAFAL MATRUTV GATS” (Stunting alleviation by
facilitation of antenatal-postnatal-interventions for low birth weight
reduction) – A peer-led self-empowerment group at rural villages in
Eastern Maharashtra: Protocol for a pragmatic cluster randomized
controlled trial
Authors: Pusdekar; Yamini; Hajare, Shilpa; Dani, Akanksha; Saoji, Ajeet
Abstract:
Background: Stunting or chronic malnutrition has been one of the major challenges to mankind for ages. The trends from the National Family Health surveys are more or less stagnant with a huge failure of the public health systems to tackle the problem of malnutrition. Innovative approaches are needed to tackle malnutrition.Objective: This pragmatic cluster randomized controlled trial (CTRI registration no. Trial REF/2023/08/071521) is planned to assess the effectiveness of a multifaceted antenatal and postnatal health educational intervention package implemented from the first trimester of pregnancy up to one year of infant age in reducing the rates of Low Birth Weight and improving the maternal-infant growth and developmental indicators in a cohort of rural pregnant women as compared to existing standards of care. Implication - The study emphasizes the importance of an ongoing continuum of care during the first 1000 days for effective birth weight, preventing malnutrition, and fostering infant growth and development as its programmatic pathway to impact.Results: We anticipate that the intervention will complement the existing health programs and will be implemented through the grassroot-level workers along with a community peer named “Safalta Tai” enabling community ownership of the intervention.Discussion: It also has a robust inbuilt monitoring and evaluation system through participatory action research for making it scalable and sustainable beyond the implementation period.Conclusion: The program leverages on the existing goverment programs like the poshan abhiyaan and the digital health mission. It has the potential to be incorporated in the exsiting health infrastructure without any additional resources and scaled up if found effective in reduction of low birth weight which is an important determinant of stunting in under five children.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Exploring influential factors in childhood vaccine delays in Riyadh, Saudi
Arabia
Authors: Basham; Karam; Al Mutairi, Faris; Baw, Bara; Al Said, Leila
Abstract:
Introduction: Infectious diseases present a substantial worldwide health challenge, yet vaccines have played a crucial role in significantly decreasing illness rates. Despite their effectiveness, global vaccination coverage stands at 85%, leaving a considerable number of infants without routine immunization. Our study seeks to examine the occurrence of delayed primary vaccination and the factors influencing it in Riyadh, Saudi Arabia addressing a critical void in current research.Methodology: A cross-sectional investigation was carried out in the primary care facilities of the first health cluster in Riyadh, Saudi Arabia. Information was gathered utilizing a well-structured questionnaire, modified from a prior study. The study encompassed children aged two years and younger, accompanied by their parents who brought their vaccination cards for the visit. Non-probability convenience sampling was employed for data collection. Subsequently, the data underwent thorough cleaning in Excel (Microsoft Excel) and was subjected to analysis using IBM SPSS 29 (IBM SPSS Statistics 29).Results: The study involved 402 participants, primarily over 12 months old, with a balanced gender distribution. Noteworthy findings indicate a 20.9% prevalence of childhood vaccine delays, with reasons such as high-grade fever (33.3%) and travel (26.2%). Significant associations were found in children aged 6–12 months (25.8%, P = 0.039), families with over four children (31%, P = 0.010), perceptions of vaccine harm (50.0%, P = 0.013), and acknowledgment of neglect (96.4%, P = 0.001).Conclusion: The research illuminates the complex factors influencing childhood vaccine delays in Saudi Arabia. Stressing the significance of personalized interventions, it underscores the necessity to tackle challenges specific to age, parental perspectives, and access issues for improved vaccination outcomes.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Validity and reliability of the translated Marathi version of the 14-item
health literacy scale
Authors: Patil; Sanika S.; Deshpande, Sonal R.; Patil, Sonali S.; Deshmukh, Maithili R.; Pande, Bhanupriya S.
Abstract:
Introduction: Various tools for measuring health literacy are designed to assess reading comprehension and numeracy in English speakers. There is a need to develop a tool in the vernacular language and estimate health literacy levels in Indian settings. The present study was conducted with the objectives to develop a Marathi version of a 14-item health literacy scale (HLS-14) to test the reliability and validity of its Marathi version and to estimate the health literacy among patients attending the out-patient department at a tertiary care centre.Methodology: The present study was conducted among 50 adult patients attending the out-patient department of a tertiary hospital from July 2022 to December 2022. The 14-Item Health Literacy Scale available in English was translated into Marathi and back-translated to English, and the final version was developed. Bilingual study subjects were asked to fill the scales on day 0 and on day 7. Cronbach’s alpha was calculated for internal validity, and the correlation coefficient was calculated for the reliability of the tool and health literacy was estimated.Results: When items of the Health Literacy Scale were analysed, all the items barring 2, 6, and 10 gave an r-value of more than 0.70, which shows good reliability of each translated item. The Cronbach’s alpha value found for the current translated Marathi questionnaire is 0.66. Internal consistency is good. The mean total health literacy score was 51.16 ± 6.81.Conclusions: A translated Marathi version of HLS-14 is developed, which is valid and reliable. The health literacy among the study participants is marginal.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Neutrophil-to-lymphocyte ratio in community-acquired pneumonia: Diagnostic
potential and its limitations in the COVID era
Authors: Abrol; Ritika; Ahmed, Sohaib; Khanduri, Rakhee
Abstract:
Objective: To determine the diagnostic potential of neutrophil-to-lymphocyte ratio (NLR) as a POC marker to discriminate tuberculous from non-tuberculous CAP and identify limitations if any at a tertiary care centre in Uttarakhand, India.Methods: 225 patients presenting with respiratory complaints were recruited from the General Medicine clinics and investigated. NLR was noted at onset and correlated with final diagnosis.Results: NLR from both groups did not exhibit a statistically significant difference. The area under curve (AUC) exhibited an accuracy of 49.1% in differentiating tuberculous from non-tubercular CAP, and an anomalous effect of prior steroid exposure on NLR was noted as a limitation.Conclusion: The disparity of our results from previous studies warranted a review of literature which rendered a significant limitation of NLR. The NLR is affected by catecholamines, which makes the marker unreliable in patients with exogenous steroid exposure. This was not noted in the previous studies. We presume indiscriminate steroid usage in the pandemic confounded our findings. We propose that this limitation be accounted for in future studies so that NLR’s true utility may be identified.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- How safe is Autheem therapy for young Saudi infants' A question worth
asking
Authors: Bin Alamir; Abdulrahman Ahmed; AlShammari, Alanoud M.; Almutairi, Maram M.; Aldhafiri, Hamad J.; Alnasser, Yossef
Abstract:
Background: In Saudi Arabia, a traditional therapy for a folk labeled problem known as “Autheem – JOURNAL/jfmpc/04.03/01697686-202413080-00056/inline-graphic1/v/2024-07-26T044321Z/r/image-tiff” is often offered to infants. The procedure involves manipulating an infant’s soft palate to alleviate pain associated with infant colic and poor feeding. However, concerns remain about this procedure’s impact on infant health and its potential to transmit infections. This study focused on perceptions that Saudi mothers hold about Autheem therapy.Methods: A descriptive, cross-sectional, community-based study was conducted via an online platform to reach Saudi mothers in the Riyadh region of Saudi Arabia.Results: Five hundred and thirty-six Saudi mothers participated; half were older than 30 years of age. Despite a high rate of college degree attainment, the majority of mothers relied on their elders as a source of information (88.4%). Autheem was viewed to be a stand-alone disease by 86.5% of respondents; 71.4% believed it could not be treated with modern medicine. Most infants were under six months of age when they received Autheem therapy (72%). Roughly 13% of mothers found that their infant had a fever after the therapy; we found an association between Autheem therapy and viral illnesses. About 13% of mothers altered their child’s vaccination schedule after Autheem therapy.Conclusion: Older mothers have more positive attitudes towards and stronger beliefs in Autheem therapy than younger mothers. The therapy’s strong association with viral illnesses and its negative impact on vaccination schedules are major public health concerns.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Comparison of isometric handgrip test among pregnant offspring of
hypertensive parents and pregnant offspring of non-hypertensive parents
Authors: Shankari; CS Siva; Raju, Aruna; Vadakaluru, Uthpala; Niveatha, S
Abstract:
Context: A family history of hypertension is one of the important risk factors for the development of pregnancy-induced hypertension (PIH). Offspring of hypertensive parents should be screened for PIH. The isometric handgrip (IHG) test is used to assess autonomic function among them. Autonomic function dysregulation can indicate their predisposition to develop PIH later in the course of pregnancy.Aim and Objectives: To compare the IHG among pregnant offspring of hypertensive parents (Group 1) and non-hypertensive parents (Group 2).Methods and Materials: This is a cross-sectional study done among 100 pregnant women in the second trimester (50 participants in each group). Blood pressure responses to sustained hand grip for 2 minutes of maximum voluntary contraction (MVC) were recorded, immediately at the end of the IHG test and after 5 minutes of the IHG test.Statistical Analysis: Independent t-test and Mann–Whitney U test were used to compare the responses in two groups.Results: There is no statistical difference in basal blood pressure and heart rate between the two groups. Group 1 exhibited a significant increase in systolic blood pressure (SBP) and diastolic blood pressure (DBP) compared to Group 2 immediately after 2 minutes of the IHG test. There is a significant increase in SBP after 5 minutes of the IHG in Group 2.Conclusions: Offspring of hypertensive parents have increased sympathetic reactivity and restoration of the blood pressure is significantly less compared to offspring of normotensive parents, which may predispose them for PIH. IHG can be applied as a convenient tool to screen the population who are at risk of PIH in places like primary health centres or field screenings where IHG is one possible option.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- An evaluation of lower urinary tract symptoms among patients with
hypertension: A cross-sectional study
Authors: Hamshari; Suha; Sholi, Sara; Jamous, Mais Abu; Taha, Ahmad; Aghbar, Amir; Alwafa, Rola Abu; Abushamma, Faris
Abstract:
Background: Hypertension (HTN) is a prevalent and impactful health concern associated with cardiovascular morbidity and mortality. This research delves into the intricate relationship between HTN and lower urinary tract symptoms (LUTS), acknowledging the multifaceted nature of these conditions and their potential impact on individuals’ quality of life.Materials and Methods: This cross-sectional study, conducted in Nablus, Palestine, employed convenient sampling to recruit hypertensive patients from the Ministry of Health clinics between September and December 2023. The inclusion criterion involved confirmed hypertensive patients, while the exclusion criterion included individuals with specific health conditions. The collected data included demographic, comorbidity, and lifestyle factor data. The study utilized the urogenital distress inventory 6 (UDI-6) and Incontinence Impact Questionnaire (IIQ)-7 short forms to assess urinary distress symptoms and the impact of urinary incontinence on quality of life. All the statistical analyses, including Pearson, Chi-square, Fisher’s exact, Kruskal-Wallis, and Mann-Whitney tests, were performed with various tests for significance, and the significance level was set at P < 0.05.Results: Among the 351 participants meeting the inclusion criteria, females (62.1%) and married individuals (83.5%) were the predominant participants. The majority were aged 58–67 (42.5%), had a high school education (39.0%), and had a body mass index (BMI) of 30–34.9 (30.2%). Significant correlations were found between UDI-6 scores and sex, age, marital status, education level, employment status, and comorbidities. The IIQ-7 score was significantly correlated with female sex, marital status, age, comorbidities, duration of HTN, employment status, and education level. Both the UDI-6 and IIQ-7 scores revealed considerable impacts on urinary symptoms and quality of life. A significant negative correlation (r = −0.579) between the IIQ-7 score and UDI-6 score emphasized the interconnectedness of urinary distress symptoms and their impact on quality of life (P < 0.001). These findings underscore the multifaceted nature of LUTS and their profound effects on hypertensive patients’ well-being.Conclusion: Our study revealed a significant association between HTN and LUTS, especially among females and specific demographic groups. This emphasizes the need for comprehensive management. The observed negative impact on quality of life emphasizes the significance of adopting holistic approaches to address both conditions.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Prognostic Nutritional Index (PNI) and Systemic Immune-Inflammatory Index
(SII) as markers of severity among patients having COVID-19 infection
Authors: Reddy; Rithika Manjunatha; Suthana, Sana; Karthikeyan, Aditya; Kulkarni, Ashwin; Aslam, Shaikh Mohammed; Suhail, K Mohammed
Abstract:
Background: Prognostic nutritional index (PNI) and systemic immune-inflammatory index (SII) are two novel markers that have emerged as potential candidates as an early indication of the severity of the disease in coronavirus disease 2019 (COVID-19) patients.Objective: The objective of the study is to assess the utility of the prognostic nutritional index (PNI) and systemic immune-inflammatory index (SII) as markers of severity among patients with COVID-19 infection.Methods: This is a retrospective study conducted in a tertiary care centre in South India. A total of 80 patients diagnosed with COVID-19 were included in the study. The patients were divided into mild, moderate, and severe groups based on the clinical parameters as per Indian Council of Medical Research guidelines. Lab values taken at admission were obtained from patient records, using which the PNI and SII were calculated using standard formulae. These markers were correlated with the severity of the COVID-19 illness.Results: PNI and SII were significantly elevated in the patients with severe COVID-19 illness as compared with mild COVID-19 illness. The mean PNI among subjects with mild COVID-19 and severe COVID-19 being 46.62 ± 6.51 and 34.09 ± 5.81, respectively. The mean SII among subjects with mild COVID-19 was 9,52,287.2 ± 1,42,113, and among subjects with severe COVID-19 was 15,39,461 ± 8,04,285. The cut-off value for PNI and SII for predicting severity of COVID-19 illness was 35.93 and 5,82,400, respectively. The sensitivity for PNI was 87.5, and the SII was 95.Conclusion: The present study showed a significant correlation between the SII and PNI as markers used to determine the severity of COVID-19. Based on these findings, it can be effectively used independently of other markers to predict critical illness among COVID-19 patients.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Effect of protein supplements on cardiovascular health and exercise
performance of young adult males
Authors: Khandelwal; Ekta; Chawali, Krishna Dutt; Bhavya, S
Abstract:
Introduction: The modern fitness culture, propelled by celebrity influence and media exposure, has led to widespread acceptance and consumption of protein supplements, particularly among young adult males aspiring for an ideal physique. Despite the surge in usage, limited research has explored the impact of these supplements on cardiovascular health and exercise performance. This study aims to bridge this gap by clinically examining the cardiovascular system using heart rate variability (HRV) and comparing outcomes between those using protein supplements and a control group.Methodology: This study was conducted at the Department of Physiology, AIIMS Raipur. The cross-sectional study involved 60 young adult males aged 18–25 years. Participants were divided into two groups: group I (n = 30), comprising individuals using commercially available protein supplements for a minimum of three months, and group II (n = 30) as age-matched controls. Cardiovascular assessments, including HRV analysis, were performed at rest and after the Harvard step test. Pre-exercise and post-exercise parameters were statistically analyzed, and participants in the test group provided information on supplement labels.Results: Participants in both groups exhibited comparable pre-exercise cardiovascular parameters. However, post-exercise results did not reveal significant variations in systolic blood pressure, diastolic blood pressure, mean blood pressure, low frequency/high frequency (LF/HF) ratio, Standard deviation of the successive differences between adjacent NNs (SDNN), and standard deviation of successive differences (SDSD) between the test and control groups. The average exercise duration for the control group was longer than that of the test group. Amino acid profiles and nutritional content varied among 13 different protein supplement brands.Conclusion: The study found no statistically significant positive influence of protein supplements on cardiovascular health or exercise performance in young adult males.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- A retrospective study of prostate-specific antigen and international
prostate symptoms scores from participants at a men’s health screening
initiative in Trinidad
Authors: Khan; Raveed; St. Hill, Ramona; Awe, Olusegun; Bhola, O’Reon; Orumwense, Osayimwense; Deosaran, Pavitra; Seecharan, Priya; Avula, Puneeth; Mohammed, Rafiah; Terapalli, Ashni; Jardine, Rebecca M.
Abstract:
Background: This study describes the characteristics of men attending a primary health care screening initiative, determines the proportion of men who have elevated International Prostate Symptom Score (IPSS) scores and prostate-specific antigen (PSA) levels, and determines any correlation between these scores as indicators for benign prostatic hyperplasia (BPH) or prostate cancer.Methods: Data were collected from all patient records during men’s health screening initiatives that occurred in December 2018, January 2019, and March 2019 in Trinidad and Tobago. A total of 350 medical records were analyzed to record patient demographics, PSA levels, and IPSS scores. Analysis of the data was performed with the use of Statistical Package for the Social Sciences software (version 27).Results: Most men who attended the screening initiative belonged to the 61–65 age group (20.57%), with more than half of the men being married (57.71%) and employed (52.57%) and of patients with comorbidities (17%), the most prevalent included hypertension (6%) and diabetes mellitus (3.7%). A mean PSA level of 2.94 ng/ml and a mean IPSS of 7.62 were recorded. Moreover, 11.5% of the males had elevated PSA levels (>4 ng/ml) and 32.9% had elevated IPSS levels (>8). There were correlations between PSA and IPSS values (r = 0.161 and P = 0.006). Age was a predictor of both IPSS and PSA values (r = 0.214, P = 0.000 and r = 0.192, P = 0.000, respectively). Among diabetic participants, a small but significant correlation between IPSS and diabetes was shown (r = 0.223, P = 0.028). As a predictor of elevated IPSS, diabetes had an odds ratio of 1.132 (95% confidence interval (CI): 1.021–1.255).Conclusion: Our findings are similar to those described in previous studies; however, further investigations are required to fully describe the relationship between PSA and IPSS. This may assist in advancing screening measures and improving health outcomes for men with BPH and prostate cancer. Primary care physicians should recognize the possible association between BPH and diabetes mellitus and offer appropriate screening where indicated.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Alterations in hematologic, coagulation, and inflammatory markers based on
fever status in hospitalized COVID-19 patients: A retrospective study
Authors: Chatterjee; Bijoya; Modi, Nikunj; Desai, Khushi; Murugan, Yogesh; Trivedi, Ami
Abstract:
Background: Laboratory markers like lymphopenia, thrombocytopenia, elevated D-dimer, and C-reactive protein (CRP) predict worse outcomes in coronavirus disease 2019 (COVID-19). However, a comprehensive analysis of hematologic and coagulation parameter alterations based on fever status is lacking.Methods: This retrospective study analyzed 300 COVID-19 patients hospitalized from March to December 2020. Demographic, clinical, and laboratory data were extracted from electronic medical records. Patients were stratified into fever (n = 200) and no fever (n = 100) groups. Hematologic, coagulation, and inflammatory markers were compared between groups using appropriate statistical tests. Multivariate regression identified independent predictors of fever.Results: Fever was associated with leukocytosis, neutrophilia, lymphopenia, thrombocytopenia, elevated CRP, D-dimer, procalcitonin, interleukin-6, neutrophil to lymphocyte ratio (NLR), and ferritin compared to no fever (all P < 0.05). D-dimer (r = 0.42), CRP (r = 0.52), NLR (r = 0.48), and interleukin-6 (r = 0.46) demonstrated the strongest correlation with fever (P < 0.001). High D-dimer>1000 ng/mL (adjusted odds ratio 2.7), CRP>100 mg/L (3.1), lymphopenia 4 (2.9), and thrombocytopenia
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Clinical profile, treatment patterns and one-year outcome of heart failure
patients admitted in tertiary care hospital of North India
Authors: Shah; Usaid A.; Rashid, Aamir; Mufti, Showkat A.; Khan, Saba; Qazi, Zahid M.; Masoom, Injeela; Khuja, Zubair A.; Bukhari, Immia; Kakroo, Shahood A.; Rather, Hilal
Abstract:
Introduction: Because of wide heterogeneity in the epidemiology of heart failure among different populations, it is imperative to establish population-specific databases.Aims and Objectives: To describe the clinical profile, treatment patterns, and outcomes of heart failure patients admitted to our tertiary care hospital.Material and Methods: The study was a prospective observational study conducted over two years at our tertiary care hospital. It included patients admitted with acute and acute-on-chronic heart failure.Results: We recruited 264 patients. Mean age of the study population was 57.8 ± 15.14 years. Males were 157 (59.5%). Dilated cardiomyopathy was the most common cause followed by ischemic heart disease. Most common risk factors were hypertension, tobacco use, anemia, and diabetes. Heart failure with reduced ejection fraction was present in 154 (62%) patients. Acute de novo heart failure was present in 91 (34.5%) patients. The most common precipitant for heart failure exacerbation was infection, followed by ischemic causes and non-adherence to drugs. The mean duration of hospital stay was 7.5 ± 3.1 days. The in-hospital mortality was 8.7%, and cumulative six-month and one-year mortality was 23% and 28%, respectively. In multivariate analysis, renal failure, readmission, and not being on guideline-directed medical treatment were significant predictors of mortality.Conclusion: Our patients were younger, predominantly males, with dilated and ischemic cardiomyopathy as commonest etiology. Hypertension and tobacco smoking were most common risk factors, with infections as most common precipitants. Only one-third of patients were on guideline-directed medical therapy. The one-year mortality was 28% and was higher in those without guideline-directed medical therapy.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Evaluation of a short-structured learner-centric training program on
Authors: Nishanthi; Anandabaskar; Mahendran, Rajalakshmi; Ganapathy, Kalaiselvan; Shanthi, Manickam
Abstract:
Introduction: Rational drug prescribing skills of interns remain bleak despite clinical pharmacology training during their second year, warranting the need for further training. This study was designed to evaluate the effectiveness of a short-structured learner-centric training program using the World Health Organization (WHO) guide to good prescribing in improving interns’ knowledge of rational drug use and their rational drug prescribing skills.Methods: This quasi-experimental study was implemented at a tertiary care teaching hospital in South India. We conducted a short-structured learner-centric training program on rational drug prescribing for interns in September 2022, using the WHO guide to good prescribing. The medical interns who consented to participate were included in the study. A pre-test was administered at the start of the training, followed by a post-test and feedback questions at the end of the program. Statistical tests used for quantitative data were the Wilcoxon signed-ranks test and McNemar’s Chi-square test. Qualitative data were analyzed using manual content analysis.Results: Of the 77 interns who attended the training program, 73 provided consent and completed both the pre-test and the post-test. Their mean age was 22 years, with a slight preponderance of female participants (53.4%). Overall, there was a statistically significant increase in the median (interquartile range) total scores from 52 (44.6 – 60) to 84 (70 – 88) after the training (P = 0.001), out of a maximum score of 93. Also, a significantly greater number of them wrote legible prescriptions (grade 4/excellent – 44 in pre-test vs 52 in post-test; P = 0.001) after the training.Conclusion: The short-structured learner-centric training program based on the WHO guide to good prescribing significantly improved the knowledge of rational drug use and rational drug prescribing skills among medical interns.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Influences of role models and other factors on physical activity amongst 6
to 16 years overweight and obese students
Authors: Batish; Rohit; Oberoi, Simmi; Singh, Harmanjeet; Jain, Ira; Singh, Amandev; Garg, Arsh; Suri, Bani; Kaur, Avneet
Abstract:
Background: Physical activity is an essential aspect of living a healthy lifestyle, which offers a myriad of benefits for both the body and the mind. Nonetheless, a family history of obesity can pose significant challenges to achieving and maintaining a healthy weight, which is further exacerbated by the academic stress. Individuals who have a role model that prioritizes physical activity are more likely to develop positive and healthy habits in their lives.Objectives: The study aimed to examine how role models affect physical activity and its impact on addressing challenges of family obesity history and academic stress in school children.Methods: This cross-sectional study was conducted from October 2019 to April 2020 in three schools in Amritsar district selected by lottery method of simple random sampling. Out of 4226 students, 355 overweight and obese students were interviewed regarding their physical activity. An informed written assent and consent was taken from the children and guardians respectively. Mothers of 6 to 11-year-old students and students aged 12 to 16 were interviewed using a pre-designed, validated, semi-structured questionnaire.Results: 51.3% had a family history of obesity while 14.9% and 14.6% of parents of overweight students had hypertension and diabetes, respectively. Over half (52.7%) lacked interest in physical activity and almost 33.5% of males were inactive. Students who chose movie actors as role models (71.1%) and those who found their role models’ information reliable (83.2%) were more likely to participate in physical activity. Of the 247 students who were knowledgeable about healthy living, a significant majority of 70.4% engaged in physical activity while 76% of overweight/obese students reported academic stress as a barrier.Conclusions: Study shows majority engage in physical activity regardless of gender. Over 70% have family history of obesity and healthy lifestyle knowledge. Stress reduces physical activity and students with movie/sports/fitness role models have better activity levels. Reasons for not engaging included dislike for sports and lack of time.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Analysis of occurrences and causes of abnormal liver function in 109
patients with COVID-19
Authors: Deng; Man-Ling; Min, Fu; Peng, Jing-Lin; Yang, Xia; Dai, Yan-Dan; Yang, Xue-Feng
Abstract:
Context: COVID-19 is a novel coronavirus pneumonia, which is related to abnormal liver function. Thus, it is important to explore the occurrences and causes of abnormal liver function with COVID-19.Methods: We chose 109 patients with COVID-19 in 2020 and studied the relationship between gender, age, basic diseases, antiviral drug treatment, disease classification, and abnormal liver function, and analyzed the causes of abnormal liver function in patients with COVID-19Results: Among patients, 46 (42.20%) had abnormal liver function at admission; 37 (80.43%) had mild abnormal liver function; and 9 (19.57%) had severe liver function. Compared with other age groups, the abnormal rate of serum ALP in the group younger than 21 years old were the highest (P < 0.05). The abnormal rates and concentrations of serum ALT, AST and γ-GT in the male groups were higher than in female groups (P < 0.05), basic disease group were higher than those in the non-basic disease group (P < 0.05). Serum γ-GT concentration after 1 week of antiviral treatment was higher than that before treatment (P < 0.05). The abnormal rate of ALT and AST at discharge was lower than that after antiviral treatment for 1 week (P < 0.05). Serum TB and AST concentrations at discharge were lower than those before treatment (P < 0.05). Serum AST and γ-GT concentrations in severe/critical type group were higher than those in mild or ordinary type group (P < 0.05)Conclusions: In this study, we found male sex, basic diseases, antiviral drugs, and severe/critical types are related to the occurrence of abnormal liver function in COVID-19 patients.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Pattern of occupational lung disease among industrial workers attending a
medical college of Eastern India
Authors: Chaudhuri; Susmita; Jaison, Merin K.; Chattopadhyay, Biswadip; Paul, Kalyan Kumar; Sengupta, Trina
Abstract:
Background: Occupational lung diseases (OLDs) contribute a significant proportion to the global burden of pulmonary morbidities but are grossly misdiagnosed due to the relative lack of attribution given to occupational exposures. Obstructive lung diseases are known to be associated with long-lasting disability and loss of earning capacity (LOEC) among workers in industrial setups, thus reducing nationwide productivity.Objective: In this context, the study aimed to find out the pattern of OLD and factors associated with the severity of it among patients in a tertiary care hospital.Materials and Methods: The study was a record-based secondary data analysis conducted in the Medical Records Department of a Medical College in Kolkata. A computerized database of patients attending Special Medical Board (SMB) examinations from the Department of Medical Records was utilized for data collection. A data abstraction format was constructed to collect information on pulmonary morbidity, occupational exposure, and sociodemographic and behavioral variables. Extracted data were analyzed in Microsoft Excel and Statistical Package for Social Sciences (SPSS) softwareResults: After a review of records, it was shown that 62.3% (66 out of 106 people) of the study subjects had an obstructive type of OLD, the most common being Jute Byssinosis. A negative correlation (Spearman’s ρ = -0.136) was found between pulmonary function (FEV1/FVC) and LOEC (%) in the study subjects. In the multivariable logistic regression, exposure to organic dust was found to be significantly associated with worsened lung function {adjusted-Odd’s Ratio (95% Confidence Interval) =3.11 (1.1–8.8), P value = 0.03}.Conclusion: OLD is an understated health issue, especially in an industrial diaspora of developing countries, like India. Healthcare facilities should utilize their resources properly for the advancement of medical surveillance in industries where organic dust is produced. Health education of the stakeholders regarding the consequences of OLDs and the benefits of preventive primary approaches will go a long way in alleviating the burden of disease.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Rhinocerebral mucormycosis: A clinicopathological analysis of
COVID-19-associated mucormycosis
Authors: Bahal; Neelima; Piyush, AR; Kala, Pooja Sharma; Dogra, Shruti; Thapliyal, Naveen
Abstract:
Background: During the coronavirus disease 2019 (COVD-19) pandemic, the incidence of mucormycosis also increased, especially affecting individuals who have had the COVID-19 infection in the past.Aims: The aim of the study is to assess risk factors and clinical and histopathological features of mucormycosis in post-COVID-19 cases.Methods: This is a retrospective study conducted in a tertiary care COVID-19-dedicated hospital, Dehradun, Uttarakhand, India, over a period of 2 months during the COVID-19 pandemic. All surgical specimens submitted for histopathology with a suspected diagnosis of mucormycosis were included. Histopathology was considered the gold standard. All histopathologically confirmed cases were studied in detail with respect to histopathology, clinico-radiological features, and microbiological resultsResults: Of 25 cases with clinical diagnosis of mucormycosis, nine were histopathologically confirmed as mucormycosis. Seven patients had diabetes, while two did not have any co-morbidity. The fungal load was heavy in 50% cases, and the proportion of necrosis was higher with diabetes mellitus, as compared to non-diabetic and non-co-morbidity patients. Angioinvasion (33.3% cases), soft-tissue invasion (44.4%), Splendor–Hoeppli phenomenon (44.4%), and neural invasion (11.1%) were also present. Mixed infection (Mucormycosis and Aspergillus species) was present in three of the cases who also had diabetes. The microbiological investigations were positive in only 55.5% cases.Conclusion: Post-COVID Mucormycosis has fatal outcomes. Early diagnosis and treatment are the key to successful treatment. Early and reliable diagnosis can be offered by histopathological examination.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Obstructive sleep apnea risk among adults with type 2 diabetes mellitus in
an urban primary care setting of Mangalore, India
Authors: Narayan; Anusha; Raghuveer, Pracheth
Abstract:
Background: Obstructive sleep apnea (OSA) is an under-evaluated and under-treated problem, particularly among individuals with type 2 diabetes mellitus (T2DM). Therefore, in this study, we aim to determine the risk of OSA among adults with T2DM residing in an urban area of Mangalore and to elucidate the determinants of OSA among the study participants.Materials and Methods: A cross-sectional study was conducted for a period of 2 months among adult patients (≥ 18 years) with T2DM seeking health care at a primary care setting located in an urban area of Mangalore. Face-to-face interviews were conducted using a semi-structured proforma. STOP-BANG questionnaire was used to assess the risk of OSA among the study participants. The measurements, such as height, weight, and neck circumference, were conducted using standard techniquesResults: The mean age of the study participants was 58.12 ± 11.60 years. The majority, (58.30%), were males, and 45.0% reported a family history of T2DM. A total of 108 (60.0%) experienced loud snoring while asleep, while 149 (82.80%) experienced tiredness during daytime. The mean body mass index (BMI) was 24.64 ± 4.9 kg/m2, while a neck circumference of>40 cms was found in 28.90%. A total of 69 (38.30%) had a high risk of OSA with a STOP-BANG score ranging from 5 to 8, while 71 (39.40%) had a score ranging from 3 to 4 (intermediate risk). The statistically significant associations were found between age>50 years, male gender, and diabetes for ≥ 7 years and high risk of OSA (P < 0.001).Conclusion: More than a third of the study participants had a high risk of OSA. Age> 50 years, male gender, and diabetes for ≥7 years were the factors associated with OSA.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Prevalence of urinary incontinence in nulliparous Indian sportswomen
Authors: Syeda; Fizzia; Pandit, Unnati
Abstract:
Introduction: A common gynaecological problem among women that leads to a negative impact on quality of life and causes distress is the involuntary loss of urine which is addressed as urinary incontinence (UI). Females involved in playing various types of sports perform high-intensity activities which can serve as risk factors for UI and pelvic organ prolapse. According to the available literature, there is a scarcity of information regarding data on the prevalence of UI in Indian female athletes. Therefore, the purpose of the present study was to evaluate the prevalence of UI in nulliparous Indian sportswomen.Methodology: For a duration of 6 months, a cross-sectional study was carried out in various sports centres across the states of Telangana, Maharashtra, Gujarat, and Delhi. A total of 560 nulliparous Indian female sportswomen were involved based on the selection criteria. The various sports involved were malkhamb, kabaddi, kushti, weightlifting, gymnastics, basketball, badminton, and athletics. All the participants were provided with a questionnaire for female UI diagnosis (QUID), which was the primary outcome measureResults: Out of 560 women enrolled in the study, the highest prevalence was found for stress urinary incontinence (SUI), consisting of 126 (22.5%) women, followed by mixed urinary incontinence (MUI), involving 49 (8.8%) women, and urge urinary incontinence (UUI), including 47 (8.4%) women. Additionally, the prevalence of UI was highest in obese and overweight Indian sportswomen. Moreover, the highest prevalence of SUI among women was for weightlifting, whereas for UUI and MUI, malkhamb and kushti sports were the most prevalent, respectively.Conclusion: The present study concluded that the highest prevalence among nulliparous Indian sportswomen was for SUI, followed by MUI and UUI. Additionally, weightlifting sport showed the highest prevalence for SUI, followed by malkhamb for UUI and kushti for MUI. The prevalence of UI in Indian sportswomen is important as it imparts knowledge and awareness among women and benefits professionals in designing appropriate preventive and rehabilitative protocols for curtailing such problems in the near future.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Prevalence of diabetes distress and its correlates among adults with type
2 diabetes mellitus in a primary health center of Bihar − A
cross-sectional study
Authors: Naik; Bijaya N.; Rao, Rajath; Verma, Manisha; Nirala, Santosh K.; Pandey, Sanjay; Gera, Mounica; Ramalingam, Anuvarshini
Abstract:
Context: Diabetes is a chronic disease associated with many complications. Approximately 20% of people living with diabetes suffer from some form of depression. “Diabetes distress” (DD) is used to describe the significant negative psychological reactions related to emotional burdens and worries specific to an individual’s experience to manage severe, complicated chronic disease such as diabetes.Aim: To determine the proportion having DD and to identify the sociodemographic and morbidity related factors associated with the presence of DD among adults with Type2DM who are being treated at PHC Naubatpur, Bihar.Material and Methods: This facility based cross-sectional analytical study was done over 3 months among 260 Type2DM patients attending PHC Naubatpur. Sociodemographic details and morbidity related details were collected followed by PAID questionnaire to assess DDResults: Around 60% of the participants were of age ≤60 years. Majority (63.8%) of the participants were having diabetes from past 1-10years. One-fourth (24.6%) of them were having score of ≥40, therefore having DD. Alcohol consumption and presence of diabetes complications in the participants were found to be independent predictors of DD.Conclusion: This study showed a high (24.6%) prevalence of DD. It is essential to identify high-risk patients with different mental health needs. Healthcare providers should focus on reducing DD and devise ways to increase self-care practices and coping skills.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Satisfaction of mothers with supplementary nutritional services through
Anganwadi centres in an urban area of Meerut, India
Authors: Pandey; Gargi; Chopra, Harivansh; Bano, Tanveer; Jain, Seema; Singh, Ganesh
Abstract:
Background: Undernutrition in children under 5 years of age is still a great public health burden. Integrated child development services (ICDS) were launched with an idea of making a dent on this age-old issue. Various studies in the past have been done to identify lacunae in the programme, but very few studies are done focussing on the satisfaction of mothers with the supplementary nutrition provided through ICDS programme. The utilisation of the programme depends on various factors, one of which is client satisfaction.Methods and Material: The Anganwadi centres of urban areas of Meerut were line-listed after taking a list of Anganwadis from the Child Development Office. There are 297 Anganwadis in urban areas of Meerut. With help of random number tables, three Anganwadis were selected, and to complete the sample of 152, 51 children from two Anganwadis and 50 from one Anganwadi centre were selected with help of simple random tables. The data thus collected were analysed using Epiinfo version 7.2.3.1Results: The prevalence of underweight was found to be 34.2%, wasted 19.7%, and stunted 11.2%. Among the characteristics assessed, a majority of mothers, 58.5%, were dissatisfied with the frequency at which supplementary nutrition was provided from the Anganwadis. All children were provided Take Home Ration, and 100.0% of mothers reported using it for all family members. Still 63.2% of mothers were unaware about the iron supplementation in childhood and only 65.8% of mothers had satisfactory handwashing practicesConclusions: In this study, a majority of mothers were dissatisfied with the frequency at which supplementary nutrition was provided to their children. Also, the prevalence of underweight children was significantly higher when mothers were not aware about the factors affecting nutrition in children. The Take Home Ration given for children was shared among family members in 100.0% families.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Impact of multidisciplinary management via special clinic for the outcome
of diabetic foot disease: A prospective observational study
Authors: Meena; Satya P.; Badkur, Mayank; Lodha, Mahendra; Rodha, Mahaveer S.; Chaudhary, Ramkaran; Sharma, Naveen; Kala, Prakash C.; Gaur, Ravi; Bishnoi, Sumit
Abstract:
Introduction: Diabetic foot is a common complication of diabetes mellitus, affecting approximately 15–20% of individuals with diabetes. It is a comorbid condition that significantly impacts the routine life of patients. This study aimed to assess multidisciplinary management strategies and their impact on the outcomes of patients with diabetic foot.Methods: A prospective observational study was conducted on 56 patients with diabetic foot. Outcome measures included the type of surgery, frequency of surgery, morbidity, mortality, patient satisfaction, return to work, and the number of patients using prosthesesResults: The majority of the patients (87%) received surgical treatment. The most common type of surgery performed was debridement (55%), followed by minor amputations (toes amputation/forefoot amputation) (28%) and major amputations (below-knee (B/K) or above-knee (A/K)) (15%). More than 70% of patients had multiple surgeries. The mortality rate was low (7%), and 71% of surviving patients were satisfied with their treatment. Sixty-seven percent of patients had an early return to work. The number of patients using prostheses was also high (73% of major amputation cases).Conclusion: Multidisciplinary management is the most effective approach for diabetic foot patients. These patients may experience less morbidity and an early return to work. A specialized care clinic for diabetic foot patients is essential to prevent treatment failure, loss of follow-up records, permanent limb loss, and economic burdens on society.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- A study to assess medication adherence and quality of life among epilepsy
patients seeking treatment at AIIMS Bhopal
Authors: Pallavi; ; Verma, Ranjana; Gupta, Rajratan; Shafqat, Naseema; Phalswal, Uma
Abstract:
Background: Epilepsy is a disorder of the brain with a permanent predisposition to produce epileptic seizures. There are cognitive, psychological, neurological, and social causes of this condition. It is the second most common problematic neurologic disorder, affecting more than 70 million people throughout the world. More than 65% of the global burden of epilepsy occurs in developing countries.Objective: To assess medication adherence and quality of life among epilepsy patients and to find any correlation between medication adherence and quality of life.Material and Methods: This descriptive study was conducted on epileptic patients who were seeking treatment at AIIMS Bhopal. Two hundred epileptic patients were enrolled in this study via purposive sampling techniques. Data was collected through face-to-face interview method. The data was analysed using descriptive and inferential statisticsResults: In this study, a total of 200 patients with epilepsy were found to be eligible to participate; there were 23 patients (11.5%) with low medication adherence, 95 patients (47.5%) with moderate medication adherence, and 82 patients (41%) with high medication adherence. Patients with epilepsy who follow recommended treatment have a good quality of life, particularly in the spiritual sector (169; 85%). The overall quality of life is moderate for 142 patients (71%) and good for 58 patients (29%). Medication adherence and quality of life were shown to be strongly positively correlated, with a Karl Pearson correlation coefficient of 0.67.Conclusion: The result of this study concluded that improving medication adherence is important to improving the quality of life among epilepsy patients.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Emerging role of vitamin D deficiency as a risk factor for retinal venous
occlusions and need for public health measures for its prevention
Authors: Sahu; Pramod Kumar; Gautam, Priyanka; Das, Gopal Krushna; Gogoi, Priyanka; Beri, Nitika; Bhatia, Rahul
Abstract:
Purpose: To estimate levels of serum vitamin D in patients of retinal vein occlusion (RVO) and compare with age- and sex-matched controls.Methods: A prospective case-control study of 54 patients of RVO and 54 age- and sex-matched attendants of patients presenting to a tertiary care hospital in Delhi was performed. Patients on vitamin D supplementations and RVO due to infective or immunological causes or patients of glaucoma were excluded. Serum vitamin D levels of all the study participants along with relevant blood investigations with history and examination were documented. Vitamin D deficiency was defined as
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Trends of endometrial cancer incidence in Sri Lanka from 2011 to 2020: An
analysis of annual national cancer incidence data reports
Authors: Wijesinghe; Rajitha D.; Hapuachchige, Chinthana
Abstract:
Introduction: The incidence of endometrial cancer in low-income countries is rising at a rapid rate. This could be due to changes in risk factors and socio-economic transitions occurring in developing countries. The main aim of this study was to assess the changes in endometrial cancer incidence in Sri Lanka.Materials and Methods: Incidence data for uterine corpus cancer and endometrial cancer between 2011 and 2020 were extracted from the National Cancer Register of Sri Lanka. This included the crude rate, age standardised incidence rate, and age-specific incidence. Joinpoint trend analysis software was used to analyse the temporal pattern of incidence. The estimated annual percentage change of incidence (EAPC) was calculatedResults: A total of 8332 patients with uterine corpus cancer were reported with the highest incidence in the 60–70-year-old age group. The EAPC of uterine corpus cancer was 9.26%, while it was 8.26% for endometrial cancer. The highest rise of age-specific incidence was observed in the 70 years plus age group (EAPC 13.3968%, 95% confidence interval (CI): 9.6916–17.1994).Conclusion: There is a clear rise in endometrial and uterine cancer incidence in Sri Lanka. While part of this could be due to better reporting of new cases, a true increase in incidence should have occurred due to different rates of EAPC among age categories. Studies to evaluate the factors leading to the rising incidence of endometrial cancer are recommended.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Burden of depression and anxiety among caregivers of children having
structural epilepsy
Authors: Pahwa; Kumud; Acharya, Rohan; Bhalla, Kapil; Yadav, Dinkar
Abstract:
Context: Epilepsy is one of the most common chronic neurological disorders in childhood. Structural malformations of the cerebral cortex are an important cause of developmental disabilities and epilepsy; this leads to a significant amount of psychological burden on parents of such children. Despite being a common and debilitating neurological illness, there is a paucity of data on the burden of stress and depression in parents of such children.Aims: The objective was to find out the burden of these illnesses on caregivers of such children.Settings and Design: This was a hospital-based cross-sectional, questionnaire-based study conducted in the Department of Pediatrics (both inpatient and outpatient), PGIMS Rohtak, during the period of June–September 2023. Parents of children with structural epilepsy (age: 2–14 years) were study subjects.Methods and Material: A cross-sectional study involving parents of 100 children with structural epilepsy (aged 2–14 years) was conducted using Hamilton Depression Rating Scale (HDRS) and Hamilton Anxiety Rating Scale (HAM-A).Statistical Analysis Used: Data were recorded in Microsoft Office Excel. Statistical analysis was performed using Statistical Package for Social Sciences v22. Statistical significance was checked by P value (two-tailed) considering value < 0.05 as significantResults: Higher levels of anxiety and depression were seen in parents of children having structural epilepsy. Relatively higher levels were seen in parents of such children who were receiving polytherapy (HDRS (P = 0.002); HAM-A (0.001))Conclusions: This study shows a higher prevalence of anxiety and depression among caregivers of children having structural epilepsy. Parents of such children require extra support as they appear to be a population prone to illnesses that will hinder the proper care of children with structural epilepsy and their quality of life. This circle has to be broken for better upbringing and treatment compliance for such children. Preventive and therapeutic interventions need to be taken to reduce the burden of such psychiatric illness at the community level.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- An epidemiological study on morbidity profile among food handlers in
Panaji city, Goa
Authors: Pradhan; Saili S.; Cacodcar, Jagdish A.; Jose, Dhanya; Akarkar, Nikhil S.
Abstract:
Context: Access to safe and nutritious food is key to promoting good health. An estimated 600 million fall ill after eating contaminated food, for which food handlers may constitute a common source of contamination. In addition to unhealthy food handlers, disease carriers handling the food play an equally important role in transmitting these diseases and pose a significant threat to public health. This study, therefore, aimed to know the morbidity profile among the food handlers employed in various food establishments in Panaji city.Methods and Material: Using stratified sampling techniques, we conducted a cross-sectional study among 227 participants selected from 12 food establishments. We did three visits to each food establishment. We excluded food handlers who were unavailable despite three visits at fortnightly intervals and those who did not consent to the study. We administered a pre-designed and pre-structured questionnaire to each participant. A general examination and laboratory investigations, including stool and urine routine, were performed on all participants. We performed descriptive and analytical statistics by using SPSS version 14Results: Out of the 227 study participants, 79 (34.8%) had at least one morbidity at the time of examination. None of the food handlers had received a single dose of typhoid, hepatitis A, or cholera vaccines. Most (74.4%) study participants did not administer deworming tabletsConclusions: We found that the health status of the study participants was substandard. Food safety may be in peril among food handlers with lower education backgrounds with morbidities as they may have little understanding of the risk of microbial contamination of food. Therefore, it is essential to create awareness among them.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Work and health habits of Thai physicians
Authors: Tangjitgamol; Siriwan; Bunsiricomchai, Paisan; Kaewwanna, Watcharagan; Ativanichayapong, Natapon; Parinyachet, Supattra; Manusirivithaya, Sumonmal
Abstract:
Background: Physicians usually have a high responsibility in caring for people. Many times, they encounter work-life imbalances that can impact both their personal health and the quality of medical services they provide.Objective: To evaluate the works and health habits of Thai physicians.Methods: Thai physicians who participated in the hospital’s Corporate Social Responsibility “Save Doctors’ Heart” project, conducted between February 14, 2022 and October 31, 2022, were invited to participate in the study. Data collected was personal data, work habits, including workplace, work hours, and health habits, including fiber in the diet, exercise, sense of well-being, history of health surveillance, and health coverage system. The characteristic features associated with their work and health habits were studiedResults: The responses to each question varied among the 1,244 physicians who agreed to join the study. The median age was 45.0 years (IQR 39,56 years). Almost all (98.6%) were still active in medical practice, with>1 workplace in 14.7%. Nearly half (44.5%) worked>40 hours per week. Most reported a moderate to high fiber diet (80.8%), but only 29.7% exercised>3 days per week. Some degree of stress was revealed in 82.1%, being moderate to severe in 25.8%. The younger physicians with less exercise were significantly associated with moderate/severe stress. Only slightly more than half (53.0%) had a good sense of well-being. Nearly 30% had irregular health surveillance. The two most common reasons were unavailability/no time and having no symptoms.Conclusion: Thai participating physicians were still active professionally and had mixed health habits. Most consumed a moderate to high fiber diet and had regular health surveillance; however, with less exercise and some degree of stress. More than half were self-assessed to have a good sense of well-being.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Prevalence of metabolic syndrome and its risk factors among newly
diagnosed type 2 diabetes mellitus patients – A hospital-based
cross-sectional study
Authors: Krishna; S Teja Rama; Bahurupi, Yogesh; Kant, Ravi; Aggarwal, Pradeep; Ajith, Athulya V.
Abstract:
Context: Metabolic syndrome (MetS) raises the chance of cerebrovascular accidents and cardiovascular illness in type 2 diabetes mellitus (T2DM) individuals. Early identification of MetS allows for suitable prophylactic and treatment strategies to reduce the risks.Aim: To estimate the prevalence of MetS and its risk factors in T2DM individuals.Settings and Design: This cross-sectional study investigated MetS and its component’s prevalence among newly diagnosed T2DM at the tertiary care hospital.Methods and Material: The study was conducted from January 2022 to December 2022 and included 300 participants above 18 years, with most being men (55%, 165), and using the World Health Organization (WHO) STEPS questionnaire for assessing selected risk factors. Along with blood glucose, different components of MetS were assessed, that is serum triglyceride (TG) level, serum high-density lipoprotein (HDL) level, blood pressure (BP) and waist circumference (WC), as per the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) criteria.Statistical Analysis Used: Data analysis includes mean and standard deviation (SD) for numerical variables with an unpaired t-test to compare means and percentage and proportions for categorical variables with the Chi-square test for the associations. Multivariate logistic regression was used for assessing the predictors of MetSResults: The prevalence of components of MetS, that is obesity, hypertension (HTN), TG and HDL components, was 64.0% (192), 45.7% (137), 46.0% (138) and 30% (90), respectively. Overall, MetS was 57% (170). Moderate activity of 150 min/week, sitting/reclining, WC, diastolic BP, TG and HDL had a significant association with MetSConclusions: MetS was highly associated with newly diagnosed T2DM with obesity being the most common component.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- The investigation of the characteristics of inflammatory factors and
cardiac enzymes in children with Covid-19 hospitalized with the initial
manifestation of fever without other symptoms hazrat Ali-Asghar Hospital
in Tehran in 2018–2019
Authors: Khosravi; Shaqayeq; Dezfouli, Seyedeh Mahsa Mahmoudinezhad; Nateghian, Alireza; Khajoei, Sanaz; Nabavi, Seyed Salaheddin; Nasersaeid, Mitra; Javid, Asma; Hemmati, Sahar
Abstract:
Introduction: The prevalence of asymptomatic fever among children is high and may be confused with fever caused by corona. The purpose of this study is to investigate the characteristics of inflammatory factors and cardiac enzymes in children with Covid-19 hospitalized with the initial manifestation of fever without other symptoms.Methods: In this descriptive-analytical cross-sectional study, all 200 children with positive Covid-19 were hospitalized in Hazrat Ali-Asghar Hospital in Tehran between 2018 and 2019. For gathering data, clinical records and demographic information of patients were noted in the made-researcher’s checklist and the collected data were analyzed using SPSS software version 24Results: It was found that the relationship between the degrees of fever of the patients with the number of platelets was also inverse and significant. In addition, there was a significant relationship between the degree of fever of the patients and the LDH number, ALT number and segment and lymphocyte percentage of the patients. In addition, it was found that the passing time of fever has a significant relationship with ALT and ESR in such a way that with the passage of time, there is a higher probability of seeing an increase in ESR, but in the case of ALT, it increases in a shorter period of time and decreases more after the passage of time.Conclusion: According to the results of the present study, in case of suspected to Covid and fever in patients, along with other tests, AST, ALT, D-dimer, and CKMB can be used to diagnose Covid, in such a way that in Covid, AST is probably normal and mentioned other tests can be higher than normal.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Evaluating the consequences of critically ill patients with pediatric
cancer at Aliasghar Children’s Hospital
Authors: Charmduzi; Forugh; Ebrahimi, Hamidreza Khoshnezhad; Jafarnejad, Shabahang; Gharab, Saeid Gholami; Iranmanesh, Saeideh; Jafarnejad, Meissa; Mousaeinejad, Negin
Abstract:
Background: Despite significant progress in supportive care and advancements in chemotherapy treatments, cancer remains a leading cause of mortality in children. The objective of this study was to assess the potential correlation between various risk factors and the consequences of patients with pediatric cancer who were admitted to the pediatric intensive care unit (PICU).Methods: The present investigation is a retrospective cohort study that examined children with cancer who were between the ages of 1 month and 17 years and had been admitted to the PICU. Demographic and clinical information of all patients, including such as the age, type of cancer, sex, BMI, history of specific disease, PICU admission time, disease condition on PICU admission, patient’s status at PICU admission, and number of organ failures, were extracted from each patient fileResults: The number of pediatric oncology patients admitted to the PICU was 127. The highest mortality rate was observed among children with heart problems (75%), followed by CNS involvement (54.2%) and sepsis (42.9%). The study found that various factors had a significant effect on the outcomes of patients who were admitted to the PICU, including but not limited to the primary type of malignancy, disease status, indications for hospital admission, patient’s condition, inpatients’ length of stay (LOS), tumor type, and the extent of organ failure at the time of admission to the PICU.Conclusion: Despite recent advancements in healthcare, the prognosis of patients admitted to the PICU in underdeveloped areas remains suboptimal in comparison to those in developed regions. Poor outcomes were found to be significantly associated with various factors, including the primary type of malignancy, disease status, the reason for admission to the PICU, patient’s condition, LOS, tumor type, and the extent of organ failure, especially in cases involving hematological malignancies.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Influence of shift work on sleep quality and circadian patterns of heart
rate variability among nurses
Authors: Panwar; Aprajita; Bagla, Rahul K.; Mohan, Mamta; Rathore, Bharti B.
Abstract:
Background: Shift work implementation is essential for providing continuous patient care in hospitals. However, working in shifts on a routine basis may disrupt the circadian pattern and alter the sleep-wakefulness cycle in nurses. Stress due to shift work can influence the adaptability of the cardiovascular system, produce psychophysiological strain and deteriorate work performance in female nurses.Objective: This study investigated the effect of morning and night shift work on sleep quality and circadian patterns governing heart rate variability (HRV) in female nurses working in a tertiary care hospital.Methods: Thirty-eight healthy female nurses were recruited. Frequency and time domain parameters of HRV were recorded as markers of cardiac autonomic function. A student t-test was used to investigate differences in HRV between morning and night shift workers. Mann-Whitney non-parametric test was applied for the difference between Pittsburgh Sleep Quality Index (PSQI) scores in the two groupsResults: Standard deviation of the normal-to-normal interval (SDNN) (msec), total power (ms2) and high-frequency (HF) band power (ms2) were significantly reduced in night shift nurses than in morning shift nurses. The low-frequency (LF)/HF ratio was significantly increased in night shift nurses. The differences in standard deviation of the averages of NN intervals (SDaNN) (msec), root mean square of successive differences between adjacent NN intervals (RMSSD), mean NN, very low-frequency (VLF) band power (ms2) and LF band power (ms2) were not statistically significant. The global PSQI score was significantly higher among night shift workers than in morning shifts.Conclusion: Inadequate sleep can disrupt the body’s ability to regulate heart rhythm and increase the risk of cardiovascular diseases and mortality. The research suggests a propensity for autonomic imbalance in night shift workers when compared to their counterparts on morning shifts.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Assessment of water, sanitation and hand hygiene practices in rural
households of Tamil Nadu: A cross-sectional study
Authors: Fazeela; A; Borkar, Rajnish S.; Mer, Hetal T.
Abstract:
Context: Water is a basic human right essential to all for sustainable development. Sanitation is one of the determinants of quality of life and the human development index. Drinking unsafe water impairs health through illnesses such as diarrhoea, and untreated excreta contaminates ground waters and surface waters used for drinking, bathing and household purposes.Aims: To assess the existing facilities and practices related to drinking water, sanitation, and hygiene among household members in the rural population of Tamil Nadu and to assess whether accessibility and availability of safe drinking water and adequate sanitation under sustainable development goal 6 is being achieved in the rural population of Tamil Nadu.Methodology: This community-based cross-sectional study was carried out among 200 households in the rural field practice area of the Medical College and Hospital, Thiruvallur district, Tamil Nadu. The participants were interviewed using a predesigned semi-structured questionnaire on their existing water, sanitation, and hand washing facilities and practicesResults: Our study observed that 71.5% of households had piped water supply into their dwellings, 82% were using sanitary latrines and 28% had closed drainage for draining wastewater. Twenty-eight percent were using soap and water for hand-washing before food, and 82.5% were doing hand-washing with soap after using the toilet. In our study, the association between sanitary practices and education, occupation and socioeconomic status was statistically significantConclusions: Our study emphasized the need for strengthening health education and behaviour change communication regarding sanitation and hand hygiene practices.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Distribution of non-thyroid neck swellings and their clinicopathological
correlation
Authors: Chaturvedi; Himani Tiwari; Patel, Bhupesh; Chaturvedi, Chandrashekher; Damor, Paresh Kumar; Patel, Varsha; Vasava, Rahul
Abstract:
Background: Neck swellings are frequently found and can present the vast pathological spectrum from simple benign to highly malignant, which sometimes can pose a diagnostic dilemma. They are broadly classified as developmental, inflammatory, and neoplastic on the basis of etiology. The aim of the study is to assess the distribution of neck swelling according to etiology and its relation to age groups, as well as to assess their clinicopathological correlation as benign and malignant.Materials and Methods: The study was conducted from January 2020 to February 2023 on the basis of retrospective and prospective sampling. All the patients with neck swellings, except thyroid, who had undergone an excisional or incisional biopsy, were included in this study. Data was collected from in-patient records for retrospective sampling, and fine-needle aspiration cytology (FNAC), radiological investigation, and excisional or incisional biopsy were performed for prospective sampling after proper history and examination. Cytological and pathological correlation was analyzed as benign and malignant. Sensitivity and specificity were calculated. (P value
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Post-vaccine immune status surveillance of Covishield vaccine and
associated AEFI in previously SARS-Cov-2 infected seropositive and
seronegative population in Assam
Authors: Gogoi; Gayatri; Gogoi, Gourangie; Mahanta, Bhupendra N.; Borkakoty, Biswajyoti; Borpujari, Porikhit; Ahmed, Tanzil S.; Neog, Rahul; Roy, Sunia; Medhi, Mithu
Abstract:
Background: COVID-19 an infectious disease caused by the SARS-CoV-2 virus, started in late 2019 and became a pandemic within a short period. To respond to the pandemic vaccines like Covishield, Covaxin, Sputnik V, Covovax, etc., were developed rapidly. However, there were raising concerns about the development of immunity as well as adverse events following vaccination.Objectives: To compare anti-SARS-CoV-2 IgG antibody titres at different time-points post-vaccination between baseline seropositive and seronegative groups and to assess the adverse events following the 1st dose of Covishield vaccine among adult beneficiaries attending vaccination centre in a tertiary care hospital of Upper Assam.Materials and Methods: Prospective Cohort study was conducted from July 2021 to June 2022 among adult beneficiaries receiving the Covishield vaccine. The oral questionnaire was used incorporating socio-demographic variables, and clinical profiles including co-morbidities and adverse events following vaccination. Data analysis was done by Microsoft Excel and SPSSResults: Out of a total of 146 study participants, IgG estimation showed 61% as seropositive and the rest as seronegative. A total of 55.40% had minor adverse events, majority of them were females (53.08%) and 88.80% belonged to 18–59 years compared to 11.11% above 60 years of age. The majority (71.60%) did not have any co-morbidities and the major AEFI was NIL among the study participants. The study group had 61% seropositive previously infected.Conclusion: Covishield vaccination induces an immune response and 90% seroconversion is achieved after 1st dose (booster dose). Antibody titres of the seropositive group by natural infection of SARS-CoV-2 were higher than seronegative cohort seroconverted by vaccination. The AEFI observed were minor and can be commented as safer.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Intravenous levetiracetam versus intravenous phenytoin as second Line
treatment in pediatric convulsive status epilepticus- open label
randomized controlled trial
Authors: Kartek; Mamum; Kannan, Abinaya; Anand, Varun; Sahoo, Manas R.
Abstract:
Background: Benzodiazepines (BZDs) are recommended as the initial therapy of choice in status epilepticus (SE). The age-old second-line treatment for BZD refractory convulsive SE is intravenous phenytoin (PHT) based predominantly on nonrandomized clinical trial data. We did this study to compare the efficacy and safety of intravenous levetiracetam (LEV) and PHT as second-line antiseizure medication (ASM) for children with SE.Methodology: A prospective, randomized controlled, open-label study was conducted in children 3 months to 15 years of age with SE in Pediatric Emergency. A total of 41 children were randomly allocated to either group 1 (Levetiracetam) or group 2 (Phenytoin) on the basis of computer-generated randomization. Children who were already on antiseizure medications, either LEV or PHT, or receiving these drugs outside for SE were excluded. Data analysis was done by SPSS V25Results: The most common age group presenting with SE was 12 months to 5 years. Clinical cessation of seizure 5 minutes after the completion of drugs was 85% (17/20) in Levetiracetam group and 90.5% (19/21) in Phenytoin group. Recurrence of seizure within 24 hours was noted in 35% (7/20) in Levetiracetam group and 38.1% (8/21) in Phenytoin group. There was no statistically significant difference noted in both the groups in terms of seizure cessation, adverse events, and recurrence.Conclusion: The efficacy and safety of LEV were found to be comparable to those of PHT in controlling seizure as second-line ASM in SE.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Long-term outcome of patients with diabetic-range hyperglycemia first
detected during admission for COVID-19: A single-center observational
study
Authors: Agarwal; Ketan; Kirti, Ravi; Shyama, Shyama; Kumar, Pragya; Biswas, Ratnadeep; Ojha, Vishnu S.
Abstract:
Background and Objective: Diabetic-range hyperglycemia has been reported for the first time in many patients during their hospitalization with coronavirus disease 2019 (COVID-19). This study was undertaken to determine the proportion of such patients who actually have new-onset diabetes mellitus rather than transient hyperglycemia during acute illness.Methods: This descriptive study included patients with diabetic-range hyperglycemia first detected at or during admission for COVID-19 but no prior history of diabetes. The study protocol involved patient identification, data recording from the case-notes, and telephonic follow-ups. Blood sugar levels done at least two weeks after discharge or the last dose of steroids, whichever was later, were recorded, and patients were categorized as diabetic, pre-diabetic, or non-diabetic accordinglyResults: Out of 86 patients, ten (11.6%) were found to have developed diabetes, and 13 (15.1%) had pre-diabetes on follow-up. About 63 (73.3%) patients had become normoglycemic. Eight (80%) out of the ten patients with new-onset diabetes were on treatment, with five (50%) achieving the target glycemic levels. The associations of new-onset diabetes with age, gender, comorbidities, intensive care stay, and steroid administration were not found to be statistically significant (p-values 0.809, 0.435, 0.324, 0.402, and 0.289, respectively).Interpretation and Conclusions: While a majority of post-COVID patients with diabetic-range hyperglycemia returned to a normoglycemic state after the acute illness had settled down, one in ten developed new-onset diabetes, and an additional one in seven had impaired glucose tolerance. Thus, regular glucose screening is crucial for such patients and lifestyle modifications should be encouraged to reduce the risk of diabetes. Loss to follow-up and reliance on a single set of blood sugar readings for classification were some of the limitations of this study.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Self-medication in medical students in urban India: Exploring the extent
of this dangerous practice
Authors: Honnekeri; Amalesh; Bhaveshaikh, Nachiket; Shah, Medha; Nayak, Usha
Abstract:
Objectives: To assess the prevalence of self-medication in urban Indian medical students and explore possible factors associated with this practice.Methods: After obtaining institutional ethics approval, 180 medical students from six medical colleges in Mumbai were recruited to participate via social media. They were administered a pre-validated questionnaire that assessed self-medication as a practice, along with the perceived stress scale (PSS-10) online. Anonymity and confidentiality were maintainedResults: The prevalence of self-medication in medical students was found to be 83.9%, with no significant difference between genders or between academic years of medical education. The most used source of information for self-medicating was older prescriptions, and for procuring drugs was pharmacist stores. Common cold was the most cited indication. Anti-pyretics and anti-inflammatory drugs were the most commonly self-medicated drugs. It was found that 73.3% of medical students had self-medicated with non-over-the-counter (OTC) drugs. It was observed that 6.1% of medical students had experienced adverse drug reactions, and alarmingly, 0.6% of medical students continued self-medicating despite experiencing adverse drug reactionsConclusions: Most of the study participants admitted to having practised self-medication. It was alarming to find that an appreciable fraction of the study population had uncontrolled access to non-OTC drugs. Thus, there needs to be a greater emphasis on the education of medical students with respect to the problems encountered by self-medicating and a need to enforce stricter regulations, as well as to establish a more watertight monitoring system, to curb this hazardous practice.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Predictors of mortality in scrub typhus: A hospital-based study
Authors: Goyal; Chandan; Ahmad, Sohaib; Chauhan, Rishabh; Tewatia, Pavit
Abstract:
Purpose: Scrub typhus is a potentially life-threatening febrile illness associated with serious complications viz. pneumonia, acute respiratory distress syndrome, hepatic failure, acute kidney injury, encephalitis, and shock often culminating in mortality. We aimed to identify the predictors of mortality in scrub typhus.Methods: This prospective observational study was conducted in a tertiary referral hospital of the north Indian state of Uttarakhand on in-patients of scrub typhus hospitalized over 1 yearResults: Of the 109 cases studied (54.1% males), 44% were aged
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Rapid and non-invasive diagnosis of hyperkalemia in patients with systolic
myocardial failure using a model based on machine learning algorithms
Authors: Torshizi; Hamid M.; Khorgami, Mohammad R.; Omidi, Negar; Khalaj, Fattaneh; Ahmadi, Mohsen
Abstract:
Background: Hyperkalemia is a potentially life-threatening electrolyte disturbance that if not diagnosed on time may lead to devastating conditions and sudden cardiac death. Blood sampling for potassium level checks is time-consuming and can delay the treatment of severe hyperkalemia on time. So, we propose a non-invasive method for correct and rapid hyperkalemia detection.Methods: The cardiac signal of patients referred to the Pediatrics Emergency room of Shahid Rejaee Hospital was measured by a 12-lead Philips electrocardiogram (ECG) device. Immediately, the blood samples of the patients were sent to the laboratory for potassium serum level determination. We defined 16 features for each cardiac signal at lead 2 and extracted them automatically using the algorithm developed. With the help of the principal component analysis (PCA) algorithm, the dimension reduction operation was performed. The algorithms of decision tree (DT), random forest (RF), logistic regression, and support vector machine (SVM) were used to classify serum potassium levels. Finally, we used the receiver operation characteristic (ROC) curve to display the resultsResults: In the period of 5 months, 126 patients with a serum level above 4.5 (hyperkalemia) and 152 patients with a serum potassium level below 4.5 (normal potassium) were included in the study. Classification with the help of a RF algorithm has the best result. Accuracy, Precision, Recall, F1, and area under the curve (AUC) of this algorithm are 0.71, 0.87, 0.53, 0.66, and 0.69, respectivelyConclusions: A lead2-based RF classification model may help clinicians to rapidly detect severe dyskalemias as a non-invasive method and prevent life-threatening cardiac conditions due to hyperkalemia.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Sleep quality and glycemic control in adults with type 2 diabetes mellitus
Authors: Borzouei; Shiva; Ahmadi, Asma; Pirdehghan, Azar
Abstract:
Aim: Type 2 diabetes mellitus (T2DM) is a common disease that imposes a substantial burden on the healthcare system and patients. Lifestyle modification such as sleep hygiene plays a crucial role in glycemic control. Sleep disorders impact many aspects of health. In this study, we aimed to investigate the correlation between sleep quality and glycemic control in T2DM. Method: This cross-sectional study was performed on 163 T2DM patients, attending Shahid Beheshti Hospital in Hamadan, Iran from March 2020 to 2021. Besides recording the demographic data and HbA1c level of participants, they were asked the Pittsburgh Sleep Quality Index questionnaire for evaluating sleep quality. We employed SPSS ver. 21 for data analysis and considered 0.05 as a significant levelResults: Among all participants, 62 (38%) were female and 30.7% were illiterate. The mean age was 56.67 ± 12.90 years, and HbA1c was 9.03 ± 1.92 mg/dL. Among sleep metrics, mean waking time was 8.74 ± 1.74 hours, and average sleep time was 12.90 ± 4.90 hours. Overall, 58.2% of the participants had poor glycemic control and 44.8% were suffering from poor sleep quality. We found that patients with poor glycemic control exhibited significantly higher levels of sleep disturbances compared to those with good glycemic control (P < 0.001).Conclusion: Sleep quality is associated with glycemic control in patients with T2DM. Sleep disorders are common among diabetic patients. Thus, healthcare providers need to consider sleep quality improvement in their holistic approach to diabetes management.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Family medicine viewed through the public lens: A national cross-sectional
study in Lebanon
Authors: Shalak; Manar; Nepal, Manoj; Al Ghadban, Yasmina; Antoun, Jumana; Romani, Maya
Abstract:
Background: Family medicine (FM) is a medical specialty that provides continuing, comprehensive health care for the individual and the family. This study aimed to describe Lebanese citizens’ knowledge, attitudes, and practices toward FM as a specialty.Methods: This is a national cross-sectional phone-based survey targeting the knowledge of the public about FM and its scope of practice. Questions were asked whether participants had primary health care doctors and their specialtiesResults: A total of 373 participants were included, with a response rate of 85.2%. Two-thirds were aware of the specialty of FM, while only 16.6% of the participants had previously visited a family physician. Most participants (69.7%) had a doctor they regularly consulted. One-third of participants had a general practitioner as their regular doctor. More than 80% of the participants agreed that FM physicians treat all family members with common and chronic diseases. Around 60% to 75% of participants knew that family physicians provide medical care to children, treat patients with psychiatric impairments, and perform minor surgeries. There was a significant gap in the participants’ knowledge of FM physicians’ role in managing obstetric or gynecologic patients.Conclusion: Despite public awareness of FM, limited understanding and system challenges hinder its utilization in Lebanon. Educational campaigns, government-supported FM practices, and collaborations with public health initiatives are crucial to bridging the knowledge gap and establishing FM as the cornerstone of primary care. This knowledge gap challenges the specialty’s identity and necessitates promoting FM as the cornerstone of primary care, potentially requiring a system-wide endorsement.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Prevalence of intestinal parasites in humans and domestic animals in Jirel
community, Dolakha, Nepal
Authors: Dhakal; Pitambar; Dhakal, Medhavi; Dhakal, Dipa; Shakya, Pramita; Singh, Barsha; Gupta Kalwar, Rabina; Shahi, Rekha; Pandey, Sophiya; Niraula, Darwin; Karki, Anita; Mahato, Mukesh Kumar; Tamang, Semsal; Chhetri, Basanti; Thapa, Muna; Parajuli, Rameshwor; Subedi, Janak Raj; Pandey, Kishor; Maharjan, Mahendra; Parajuli, Rajendra Prasad
Abstract:
Introduction: Gastrointestinal (GI) parasites are major health concerns in both humans and domestic animals. Livestock farming is one of the common livelihood practices in rural Nepal. The proximity at human and domestic animal interface increases the chances of dissemination of enteric parasites, especially those of zoonotic importance. This study was aimed at finding the parasite prevalence and risk factors in both humans and their domestic animals in Jirel community.Materials and Methods: A field survey was conducted on the Jirel ethnic people and their domestic animals in Dolakha district, where a total of 152 fresh fecal samples from humans and domestic animals (cow, pigs, goats, chickens, ducks, and pigeons) were collected. The feces were examined by wet mounts and concentration techniques. A structured questionnaire survey was carried out among the local people and owners of the domestic animals to gather sociodemographic information, awareness, and hygienic practices in relation to parasite transmissionResults: The enteric parasite prevalence was found to be highest in goats (80.0%;12/15), followed by pigs (55.55%;5/9), cows (45.45%;6/11), chickens (11.7%;4/34), and humans (1.41%;1/71), while the fecal samples of ducks and pigeons did not contain any parasites. The only parasite identified in humans was Ascaris lumbricoides. Similarly, three genera of GI parasites (Eimeria sp., Strongyloides sp, and Trichuris sp.) from goats, two genera each from cow (Eimeria sp. and Strongyloides sp.), pigs (Entamoeba sp. and A. suum), and chickens (Eimeria sp. and Ascaridia galli), were detectedConclusions: Based on the direct field observation, questionnaire survey and laboratory analysis, it is concluded that the Jirel community people are aware of health and hygiene; however, intervention measures are necessary to prevent parasitic infection in their domestic animals.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Rise in rabies cases in Jammu region: A problem that requires urgent
attention
Authors: Dewan; Deepika; Langeh, Sahil; Kotwal, Suresh; Gupta, Rajat; Kumar, Dinesh
Abstract:
Context: Rabies is a fatal zoonotic disease that is endemic in India. Both forms of rabies, namely, encephalitic and furious, invariably lead to coma and death. Lack of awareness is the most critical barrier in accessing timely post-exposure prophylaxis that can prevent the progression to clinical disease.Aims: To report the case series of fourteen clinically suspected rabies cases.Settings and Design: We followed a retrospective study design. Data were collected from the Anti Rabies Section of Government Medical College, Jammu, which is a tertiary care hospital of Jammu Division.Methods and Material: We collected data of all patients over a period of three years, from 2017 to 2020, who were diagnosed as cases of clinically suspected rabies on the basis of classic signs and symptoms and who finally succumbed to the disease.Statistical Analysis Used: Descriptive statistics was used to describe the results of the studyResults: In the present description, the mean age of the patients was 31 ± 18.6 years. Out of 14 suspected cases, 9 had not received any post-exposure prophylaxis—neither vaccine nor serum—and instead visited spiritual faith healers. The remaining patients had history of either incomplete, unknown, or incorrect vaccination status. Median duration of presentation of symptoms after dog bite was 42 days, with a range of 15–180 days. Mean survival of patients after presentation of symptoms was around 1.8 daysConclusions: Low level of awareness resulted in non-seeking of health-care services after animal bites.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Dengue encephalitis – An unusual case series
Authors: Khosla; Saniya; Chauhan, Rahul; Aggarwal, Ayush; Patel, Nupur B.
Abstract:
Dengue infection can take on many different forms, ranging from no symptoms to a mild fever, all the way to a severe condition known as dengue shock syndrome. Although the typical symptoms of dengue are well known, the virus can also cause rare neurological complications. Dengue encephalitis is a severe form of neuroinvasive dengue that can be fatal as the virus directly affects the central nervous system. This case series provides a comprehensive overview of dengue, its clinical spectrum, and the potential for severe neurological complications such as dengue encephalitis. It highlights the importance of considering dengue as a possible diagnosis in patients with encephalitis, particularly during a dengue epidemic.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Excess of high-caffeinated energy drinks causing ventricular arrhythmias
Authors: Walia; Rohit; Kaur, Sirat
Abstract:
A young male patient had palpitations after consumption of few high caffeinated energy drinks which he took after his office hours to relieve fatigue. He immediately seeked medical help. Electrocardiogram showed multiple runs of non-sustained ventricular tachycardia and ventricular bigeminy and trigeminy. Echocardiography was normal. The patient was admitted to intensive care unit and treated with anti-arrhythmic drugs to which the arrhythmias responded and subsided. Cardiac magnetic resonance imaging of heart did not reveal any structural heart abnormality and treadmill stress test was negative ruling out significant coronary artery disease. High caffeinated energy drinks can produce serious ventricular arrhythmias if taken beyond safe doses. These ventricular arrhythmias are known to be causative factor for sudden cardiac arrest and therefore a caution & regulation is needed in widespread unrestricted used of these drinks.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Sexual pleasure with ruptured corpus luteum cyst that ends in emergency
room: A case report
Authors: Bobo; TI; Ano-Edward, GH; Bakare, TY; Ogunlaja, AO
Abstract:
Rupture of corpus luteum cyst from sexual pleasure is an uncommon event that has not been reported in our environment (Africa). The patient is a 30-year-old primiparous woman who developed severe lower abdominal pain thirty minutes after sex; the pain was unrelenting despite the use of over-the-counter analgesic drugs and local herbs. Twelve hours after sex, when the problem persisted and she complained of dizziness and weakness, she was rushed to the emergency room of our facility for medical treatment. An initial diagnosis of ruptured ectopic gestation was made. She had an emergency laparotomy with repair of the ruptured cyst and blood transfusion. Incisional biopsy was taken from the cyst and pathological examination revealed a ruptured corpus luteum cyst. She did well post-surgery and was discharged to follow up in the clinic on the third day after surgery. Ruptured corpus luteum cyst from sexual pleasure is a rare event. Thus, a high index of suspicion is necessary to elicit a history of sex, which patients are often unwilling to disclose.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Falling into complexity: A case of digitalis-induced fall, trauma,
symptomatic bradycardia, and syncope
Authors: Ravikumar; Rajathadri H.; Pegu, Baby; Bansal, Himanti; Soni, Kapil Dev
Abstract:
Digoxin, a cardiac glycoside, functions by inhibiting the sodium potassium ATPase pump. It’s crucial to note that digoxin has a very narrow therapeutic range. Its serum level vary due to changes in body weight, age, renal function, hepatic impairment and concomitant drug therapy. Chronic toxicity can lead to different types of arrrythmia,which span from heart blocks to ventricular tachycardia.This report present a case of an elderly male, where Digoxin toxicity resulted in syncope and mild traumatic brain injury. Initially upon patient’s presentation ECG indicated myocardial infarction, subsequently bradycardia and complete heart block. The patient had a known history of chronic kidney disease and was prescribed 0.25mg of digoxin regularly without dose adjustment, which might have resulted in reduced digoxin elimination, leading to toxicity. Thus this case demonstrates a classic presentation of digoxin toxicity. Multiple risk factor such as old age, impaired renal function with continued digoxin treatment without dose adjustment was likely the cause of toxicity.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Unprecedented association: Enormous calculus concomitant with salivary
gland tumor
Authors: Pattnaik; Naina; Singh, Dhirendra Kumar; Pathi, Jugajyoti; Sangamesh, NC; Jalaluddin, Mohammad; Bhola, Kumari Lucy
Abstract:
Calculus represents a mineralized form of bacterial plaque, commonly developing on natural tooth surfaces exposed to a continuous supply of saliva. The salivary composition significantly influences the degree of calculus formation in individuals, exerting a pivotal role in this aspect. Reduced salivary output elevates vulnerability to oral diseases. Numerous contributing elements might be associated with the development of significant calculus, potentially implicating the existence of a salivary gland tumor, notably related to the left parotid gland. This report stands as notable documentation of an extraordinary and infrequent occurrence of calculus formation associated with a salivary gland tumor, presenting an exceptional case within the scope of medical literature.
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Mental health and well-being amongst adolescents in today’s times
Authors: Gharde; Pramita Muntode; Choudhari, Sonali
Abstract: No abstract available
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Psychological impact of COVID-19 lockdown period on students of healthcare
colleges: Comment
Authors: Pawar; Vikas V.; Farooqui, Safia
Abstract: No abstract available
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Strategies to improve evidence-based practice competencies in nursing
education: Addressing the need of the hour
Authors: Panneerselvam; Suganya; Ramasamy, Senthilkumar
Abstract: No abstract available
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Strengthening millet promotion: A path for addressing malnutrition and
fostering sustainable food system
Authors: Ahmed; Sana; Choudhari, Sonali G.; Ahamed, Ansar; Gaidhane, Abhay
Abstract: No abstract available
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Some concerns on ‘clinico-epidemiological profile and outcome of
snakebite patients presented to a teaching institute – A descriptive
retrospective review’
Authors: Mohanty; Chitta R.; Barik, Amiya K.; Radhakrishnan, Rakesh V.; Samuel, Stephen P.
Abstract: No abstract available
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- How to spark the potential of research in nursing students'
Authors: Mukhida; Sahjid; Kumar, Lokesh
Abstract: No abstract available
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Vaginal tobacco – A hidden addiction in the African continent
Authors: Kengadaran; Shivashankar; Anusha, Divvi
Abstract: No abstract available
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Why CBNAAT not called as gold standard test for TB'
Authors: Mukhida; Sahjid; Das, Nikunja K.
Abstract: No abstract available
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Medical complications in pregnancy
Authors: Gupta; Harish
Abstract: No abstract available
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Before creatine-kinase is proposed as a biomarker for tubal ectopic
pregnancy, all alternative causes must be off the table
Authors: Finsterer; Josef
Abstract: No abstract available
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- India’s union budget 2023–24 and health care allocation
Authors: Gupta; Harish
Abstract: No abstract available
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Analysis of acute poisoning cases at a tertiary care hospital
Authors: Gupta; Harish
Abstract: No abstract available
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Reducing screen time for health: Uniting against childhood obesity
Authors: Nair; Gayatri R.; Akhil, R
Abstract: No abstract available
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Advancing insights into non-alcoholic fatty liver disease: A critical
analysis of ultrasonography and beyond
Authors: Ghonge; Swati; Vajjala, Sai Mahesh
Abstract: No abstract available
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Measuring up: Harnessing neck circumference as a powerful tool in battling
obesity epidemic
Authors: Nair; Gayatri R.; Jadhav, Sudhir L.
Abstract: No abstract available
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Factors which can delay the ambulance response
Authors: Mukhida; Sahjid; Das, Nikunja Kumar
Abstract: No abstract available
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- A task shifting strategy for elimination of cervical cancer by 2030
Authors: Agrawal; Sanjana; Panneerselvam, Suganya; Ramasamy, Senthilkumar
Abstract: No abstract available
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Mental health during COVID-19 times
Authors: Gupta; Harish
Abstract: No abstract available
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- 1947 Partition of India and its lessons
Authors: Gupta; Harish
Abstract: No abstract available
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Publications by compulsion in medical field. How far it is yielding'
Authors: Das; Nikunja Kumar; Mukhida, Sahjid
Abstract: No abstract available
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Acknowledging the role of family physicians in India
Authors: Palal; Deepu; Akhil, R
Abstract: No abstract available
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Empowering nursing research: Overcoming challenges and embracing
opportunities to improve patient care
Authors: Dhane; Amol S.
Abstract: No abstract available
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- What is best choice for battle with multi drug resistant Acinetobacter'
Newer antibiotics or prevention'
Authors: Mukhida; Sahjid; Kannuri, Sriram
Abstract: No abstract available
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Water, sanitation, and hygiene (WASH) strategies in the fight against
waterborne diseases in the young and old
Authors: Madamanchi; Divya
Abstract: No abstract available
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Lichen planus triggered by COVID-19 vaccination: Comment
Authors: Daungsupawong; Hinpetch; Wiwanitkit, Viroj
Abstract: No abstract available
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Rural revitalization: Uniting forces for tobacco-free communities
Authors: Sidhu; Logesh
Abstract: No abstract available
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
- Response to “A study on the prevalence of diabetic peripheral neuropathy
in diabetic patients attending a rural health and training center”—A
letter to the editor
Authors: Haward; Raymond; Sanvi, Kanakath
Abstract: No abstract available
PubDate: Fri, 26 Jul 2024 00:00:00 GMT-
