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   Table of Contents - Current issue
January-April 2023
Volume 4 | Issue 1
Page Nos. 1-42

Online since Wednesday, March 1, 2023

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Sarcopenic obesity: A new challenge for primary care physicians p. 1
Himel Mondal, Sudip Bhattacharya
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Blood counts and homocysteine in acute stroke: What is the relation? p. 3
Debabrata Chakraborty, Pradipta Bhattacharjee, Sadanand Dey, Sanjay Bhaumik, Aditya Choudhary, Kishalaya Karan, Priyanjita Sen, Mohuya Mukherjee, Gobinda Pramanick, Nirmalya Ray, Anupam Chakrapani, Satya Narayan Singh, Binod Kumar Singhania, Biswajit Sengupta, Kajal Das, Aditya Mantry, Bhaskar Ukil, Rahul Ghosh
Objectives: Stroke is the second-leading cause of death and the third-leading cause of death and disability combined in the world. We need to find easy, available, and reliable parameters on which we can depend to prevent stroke, predict outcome, and determine prognosis. This will help in stroke management in the future. Materials and Methods: We noted blood counts and serum homocysteine levels in acute stroke patients after the exclusion of confounding factors. Our team recorded the detailed demographic and blood parameters (blood counts and homocysteine) of acute stroke patients who got admitted to different departments of our hospital in 5 months. We later correlated or tried to find the association between these parameters and stroke severity (NIHSS), other clinical parameters such as dysarthria and stroke outcome (Modified Rankin Score (mRS) at discharge and at 3 months). The team also tried to find relationships, if any, with different stroke subtypes as per the Trial of ORG 10172 in Acute Stroke Treatment classification. Results: Out of 100 patients (34 females and 66 males), we had 28 patients with hyperhomocysteinemia (HHcy). The high neutrophil count and total leukocyte count correlated with stroke severity, dysarthria, and outcome at 3 months (poor mRS). While, it was the opposite in the case of lymphocyte count. Homocysteine level did not correlate with stroke severity or outcome but with dyslipidemia. HHcy was more prevalent among patients with large artery atherosclerotic disease. Conclusion: Findings of our study were agreeable to earlier studies on the relationship between blood counts and stroke prognosis. Although high homocysteine level was associated with stroke, its level was not found to be related to stroke severity or outcome. However, further study with a larger sample size is required to draw a confident conclusion.
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Severe acute respiratory syndrome coronavirus 2 Omicron variant and psychological distress among frontline nurses in a major COVID-19 center: Implications for supporting psychological well-being p. 10
Hanita Dahiya, Harshita Goswami, Chanchal Bhati, Ekta Yadav, Bhanupriya , Divya Tripathi, Deepa Rani, Deepika , Gayatri Pal, Geeta Saini, Lalita Yadav, Rajesh Kumar
Background: Coronavirus outbreak severely affected the psychological health of frontline health-care workers, including nurses. Nurses relatively face many more psychological problems compared to other health-care workers. This study aimed to assess nurses' fear, stress, and anxiety status during the Omicron, a new variant of the severe acute respiratory syndrome coronavirus 2, outbreak in India. Materials and Methods: This questionnaire survey included 350 frontline nurses working at a tertiary care teaching hospital in North India. The information was collected using the Coronavirus Anxiety Scale, Impact of Event Scale-Revised, and Fear of COVID-19 Scale. Nurses working in the hospital since COVID-19 outbreak were included in the study. Appropriate descriptive and inferential statistics were applied to compute the results. Results: Nurses hospitalized after contracting an infection (odds ratio [OR] – 3.492, 95% confidence interval – 1.644–9.442, P < 0.002) and attended training on COVID-19 (OR – 2.644, 95% CI – 1.191–5.870, P < 0.017) reported high distress than their counterparts. Likewise, nurses hospitalized after contracting an infection (β = 3.862, P < 0.001 vs. β = 2.179, P < 0.001) and have no training exposure on COVID-19 management and care (β = 2.536, P = 0.001 vs. β = 0.670, P = 0.039) reported higher fear and anxiety, respectively. Likewise, married participants (β = 1.438, P < 0.036) who lost their friends and colleagues in the pandemic (β = 0.986, P = 0.020) reported being more frightened and anxious. Conclusions: Participants reported experiencing psychological burdens, especially nurses hospitalized after contracting an infection and who lost their friends and colleagues to COVID-19. High psychological distress may be a potential indicator of future psychiatric morbidity. Authors recommend a variant-specific training to improve nurses' mental health to combat the pandemic.
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Study of anxiety among medical teachers about the recent change in “publication-based faculty promotions” as per the National Medical Commission Guidelines 2022 p. 17
Atul Kawaduji Gowardhan, Priya Manohar Bagade
Background: Primarily collegiate promotions, placement retention, professional progress, and career mobility of any medical fraternity are determined by the growth in their research productivity. Universities and medical institutes also recruit and promote those academicians who have voluminous resume with ample number of publications. However, the mandatory criteria for article publication and the frequent changes made in them, challenge the medical professionals and create a sense of anxiety and insecurity in them about their future prospects. This study aims at screening these medical academicians, for generalized anxiety disorder (GAD) in response to the recent change in "Minimum Teachers Eligibility Qualifications in Medical Institutions Regulations" as per the National Medical Commission (NMC) guidelines 2022. Materials and Methods: It was a cross-sectional pilot study conducted in two medical institutes including 76 medical teachers due for their promotions. Knowledge and anxiety towards the recent change in "Minimum Teachers Eligibility Qualifications in Medical Institutions Regulations" as per the NMC guidelines 2022 was assessed by the GAD-7 scoring system with help of a questionnaire. The medical professionals were grouped into minimal, mild, moderate, and severe anxiety depending on their GAD-7 score. Results: Hundred percent of medical teachers were aware of the recent changes in the promotion criteria laid down by the NMC in February 2022. 31.57% and 34.78% of medical professionals were found to have mild and moderate anxiety respectively about the promotion criteria. Although less, but 15% of them were screened to be severely anxious about the same matter. Conclusion: All the study participants were updated about the recent changes in the promotion criteria put forward by NMC in February 2022 but this revision has created a sense of apprehension and uncertainty among the medical professionals regarding their due promotions.
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Study of prevalence of prehypertension and hypertension among urban school-going children in Tripura p. 24
Aghore Debbarma, Arpita Mohanty, Taranga Reang
Introduction: Prehypertension is defined as an independent category of blood pressure (BP) by the seventh joint national committee on prevention, detection, evaluation, and treatments of BP. Systolic BP (SBP) between 120 and 139 mm Hg or diastolic BP between 80 and 89 mm Hg are considered to have prehypertension. BP ≥140/90 mm Hg is considered hypertension. It is to assess the prevalence of prehypertension and hypertension among urban school-going children. Materials and Methods: A cross-sectional study was conducted among 1011 school-going children of both sexes within 12–17 years of age group and each participant was selected using a simple random sampling technique. Pretested predesigned questionnaire was used for data collection. Results: Prevalence of normotensive, prehypertensive, and hypertensive were 73.6%, 19.4%, and 7%, respectively, when both systolic and diastolic components have been taken into account. Conclusion: This study has showed that more than 19% prehypertensive and 7% hypertensive among the school-going children aged between 12 and 17 years when both systolic and diastolic components have been taken into account.
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Respiratory failure in spinal muscular atrophy: A case report and review of literature p. 28
V Vinay, Sushil Kumar Munjal, M N Dinesh Kanna, Sandeep Jain, Paras Verma, M Arunachalam
Spinal muscular atrophy (SMA) type 2 is a neuromuscular disorder of childhood with high morbidity and mortality caused by the deletion of SMN1 gene (gene 1 of motor neuron survival), located at chromosome 5. It is the respiratory complications that account for the majority of deaths in SMA. This report describes an 18-year-old male patient diagnosed with SMA type 2, who had shortness of breath for 2 weeks and cough for 1 week. CT-Thorax revealed left lung collapse due to mucoid impaction in the left main bronchus. Bronchoscopy was challenging in this case due to severe kyphoscoliosis, and impacted mucus was extracted using bronchoscopy-guided forceps biopsy. Repeat X-ray of the chest following treatment showed no evidence of collapse, and patient was discharged in a stable condition with mucolytics and antibiotics.
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Effect of vatakarma kapalbhati on sinus headache p. 32
Poornima Ravi, V Venugopal, Deenadayalan Boopalan, Akila Anandhan, Yogapriya Chidambaram, Maheshkumar Kuppusamy
Sinusitis is a common inflammatory condition affecting paranasal sinuses encountered by people of all age groups. Vatakarma Kapalbhati is a yogic cleansing technique and pranayama found to be beneficial in sinus headaches. We reported the effect of Vatakarma Kapalbhati on three individual cases with sinus headaches. Three women who had chronic headaches due to paranasal sinusitis were given Vatakarma Kapalbhati as an intervention. Outcome measures such as Pittsburgh Sleep Quality Index (PSQI), Sinonasal Outcome Test-22 (SNOT-22), Headache Impact Test-6 (HIT-6), and Visual Analog Scale (VAS) were used to assess the efficacy of the intervention. Significant improvement in PSQI, SNOT-22, HIT-6, and VAS was found postintervention when compared to the baseline. Vatakarma Kapalbhati could be a potential supportive therapy for the management of sinusitis headaches alongside conventional management.
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A case of polyparasitic infection due to hookworm, Strongyloides stercoralis, and Giardia intestinalis: The need for a stringent behavioral modification p. 35
Srujana Mohanty, Geetarani Purohit, Anupam Dey
In developing countries like India, unhygienic practices such as open-air defecation, keeping untrimmed nails, or eating food fallen on the ground have been observed to be important risk factors for parasitic infections such as soil-transmitted helminths. We report a case of polyparasitic infection with hookworm, Strongyloides stercoralis, and Giardia intestinalis in an adult who resorted to open defecation with the "use of open footwear" in the fields despite having a toilet at home, to re-emphasize the harmful health effects of such unhygienic practices, and create awareness for stringent behavioral modifications for leading a healthy life and establishment of a safe and hygienic community.
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Self-induced sound therapy for sound sleep p. 38
V Venugopal, Deenadayalan Boopalan, R Poornima, K Maheshkumar
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Violence against Doctors in India: A Medical Student's Perspective p. 40
Manas Pustake
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Impact of COVID-19 on tuberculosis spectrum p. 42
Prerna Sharma, Shatrughan Pareek, Gopal Singh
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