International Journal of Applied and Basic Medical Research最新文献

Background: Water, sanitation, and hygiene (WASH) in health-care facilities is fundamental for providing quality, people-centered care and critical to achieving quality and accessible health services. This study aimed to assess the status of the WASH infrastructure in health-care facilities of Raipur district, Chhattisgarh, India.

Methodology: This was a hospital-based cross-sectional study carried out in all public health-care facilities of Abhanpur block, Raipur district, Chhattisgarh, India, between 2019 and 2020 using an adapted version of joint monitoring program's (JMP) core questions, indicators, and service ladder framework.

Results: A total of 2 community health centers (CHCs), 7 primary health centers (PHCs), and 34 subhealth centers (SHCs) were included in the present study. All CHCs (100%) had essential water, sanitation, hygiene, and waste management services. Among PHCs, 85.7% had water from improved and hygienic sources, only 57.1% had basic sanitation, and 100% had vital essential waste management services. Among SHCs, 55.9% had essential water, 2.9% had basic sanitation, 20.6% had basic hygiene, and 35.3% had necessary waste management services. Overall, it was found that 62.8% of health-care facilities had necessary water services, 16.3% had basic sanitation services, 34.9% had essential hygiene services, and 48.8% had basic waste management services.

Conclusion: The status of WASH infrastructure in health-care facilities of Raipur district is either limited or not available, especially concerning sanitation services, hygiene, and waste management services. It is the need of the hour to ensure a coordinated response that in all health-care facilities, WASH services are made available and accessible.

Purpose: The purpose of this study was to evaluate face mask-associated factors causing dry eye among medical students.

Methodology: This was a cross-sectional study conducted on undergraduate medical and dental students, of all phases, while they were attending offline classes and were required to wear face masks in accordance with the government regulations. Sociodemographic data, ocular and medical history, face mask-wearing practices, screen usage, and quantification of symptoms using the modified Ocular Surface Disease Index (OSDI) questionnaire were collected. Objective tests were conducted in students having dry eye. The association of quantitative variables was done using ANOVA, Mann-Whitney, and Kruskal-Wallis test, whereas the Chi-square test was done for qualitative variables. Multivariate logistic regression was used to identify the risk factors for varying severity of dry eye.

Results: The mean age of the 410 students was 21 ± 1.6 years. According to the OSDI, 39.51% (162/410) of students had dry eyes, 23.41% (96/410) had mild dry eye, 8.78% (36/410) had moderate dry eye, and 7.32% (30/410) had severe dry eye. Face mask-associated factors which were significantly linked to dry eye were N95 masks, loose-fit masks, and 6-8 h of continuous mask use. The Schirmer's test and tear film break-up time were performed on 29 and 20 students, respectively, mean values being 19.25 ± 5.29 mm and 10.15 ± 1.41 s for nonsevere and 6.53 ± 1.55 mm and 5.3 ± 0.98 s for severe dry eye, respectively.

Conclusion: It is important to educate medical students and create awareness regarding "face mask-appropriate behavior" to reduce the chances of dry eye secondary to face masks use.

Introduction: Xpert Ultra (Cepheid, USA) is recently introduced with an extra category of trace-positive results and higher sensitivity for tuberculosis (TB) diagnosis.

Objective: The objective of the study was to assess the diagnostic accuracy of Xpert Ultra for extrapulmonary samples using culture and composite reference standard (CRS) as the gold standard.

Materials and methods: In a 1-year (March 2021-22) prospective observational study, samples of suspected extrapulmonary TB (EPTB) patients were subjected to Ziehl-Neelsen staining, culture, and Xpert Ultra (Cepheid, Sunnyvale, CA) tests. Relevant clinical and treatment information was noted. The diagnostic accuracy of Xpert Ultra compared with culture and CRS was calculated.

Results: Out of 1720 suspected patients of EPTB, 223 (13%), predominantly males 135 (60%), with a mean age of 41.46 ± 19.81 years, were diagnosed as TB positive following CRS criteria. The maximum cases were of pleural TB (35.4%), followed by central nervous system TB (17.9%), gastrointestinal TB (17.5%), and lymph node TB (12.1%). Of all samples, 150 (8.7%) were microbiologically confirmed, including 141 detected by Xpert ultra, 67 culture positive, and only 16 smear positive. Among the Xpert Ultra-positive samples, 35 showed trace results, including six false-positive results. Considering culture and CRS as the gold standard, the sensitivity (86.57%, 59.64%) and specificity (94.98%, 99.47%) of Xpert Ultra were calculated, respectively. Rifampicin resistance was detected in 1 (0.70%) sample.

Conclusion: Diagnosis of EPTB is a challenge and Xpert Ultra may detect TB at a very early stage. However, it is essential to rule out false-positive results. Additional studies are needed on Xpert Ultra to interpret trace results better.

Background: Nonalcoholic fatty liver disease (NAFLD) has been projected, within the next 20 years, to become the major cause of liver-related morbidity and mortality as well as a leading indication for liver transplantation. Affected South Asian Indians are at higher risk for the development of metabolic syndrome (MS), type 2 diabetes, and cardiovascular disease. There is a dearth of data related to NAFLD and its various sequelae and correlation with cardiovascular disease in South Asia.

Materials and methods: It was an observational, prospective study conducted over 2 years on 80 patients in a tertiary care hospital in Mumbai. All patients diagnosed with NAFLD were investigated for MS according to the National Cholesterol Education Program Adult Treatment Panel III criteria, and a relationship between NAFLD and MS was correlated.

Results: MS was found to be present in 72.5% of the patients. Significant results were obtained while correlating MS parameters and fatty liver grading, implying that patients with a higher fatty liver grading were more likely to have derangements in metabolic markers.

Conclusion: NAFLD was found to be associated with an increased incidence of MS and thereby a higher risk of cardiovascular disease, warranting a high index of suspicion for both. A higher ultrasound grading of fatty liver was found to be associated with an increased incidence of MS.

Background: Overactive bladder (OAB) is a common condition in elderly men with coexisting benign prostatic enlargement (BPE), and it significantly impairs their quality of life (QoL).

Aim: This study aimed to assess the safety and efficacy of adding beta-3 adrenergic receptor agonist (mirabegron 50 mg) to tamsulosin 0.4 mg for symptomatic men with BPE and OAB symptoms (OABS).

Materials and methods: It was an open-labeled randomized controlled trial. Ninety men with BPE and International Prostate Symptom Score (IPSS) of more than seven with predominant OABS were enrolled for the study. A detailed history, uroflowmetry, and baseline scores, including IPSS, OABS score (OABSS), and QoL assessment, were done for each patient. After written informed consent, patients were randomized into two groups of 45 each. Group-1 received tamsulosin 0.4 mg and placebo, and Group-2 received a combination of tamsulosin 0.4 mg plus mirabegron 50 mg once daily at bedtime. Follow-up of patients was done at 2^nd, 4^th, and 8^th weeks. Efficacy at 8 weeks was assessed using repeat history for symptoms, uroflowmetry, IPSS, OABSS, and QoL score.

Results: After 8 weeks of therapy, collected data were compared to baseline parameters in both groups. Significant improvement with respect to OABSS (P = 0.046), IPSS (P = 0.006), and QoL (P = 0.038) was observed with combination therapy versus tamsulosin alone. There were mild adverse effects, which were self-limiting.

Conclusions: A combination of tamsulosin with mirabegron is effective and safe in improving the OABSS, IPSS, and QoL in men with BPE who have predominant OABS.

Background: Globally, prevalence of diabetes is 10.5%, and in 2019, approximately 463 million adults were living with diabetes by 2045; this will increase to 700 million (10.9%). India is a diabetic capital of world, prevalence of diabetes in India is 8.3%.

Aim: This study aimed to assess self-care practices (SCPs) among type 2 diabetes mellitus (T2DM) patients, its predictors, and effect of SCP on glycemic control.

Materials and methods: A cross-sectional hospital-based study was conducted among 300 known T2DM patients in the age group of 18-60 years attending noncommunicable diseases clinic at Secondary and Tertiary Care Hospitals of Lucknow, Uttar Pradesh, selected using two-stage purposive sampling method. Data were collected using a predesigned and pretested semi-structured questionnaire. Data were collected from consenting respondents on the sociodemographic profile (about their residence, gender, marital status, type of family, educational status, family income, employment status, etc.). SCP was assessed using Summary of Diabetes Self-Care Activities. Data were analyzed using SPSS.

Results: Among 300 patients with a mean age 50 ± 8.9 years, the prevalence of good SCPs was 37%. Out of 189 T2DM patients with poor SCPs, 66.4% had uncontrolled blood sugar level (285.4 ± 67 mg/dL). Out of 73 T2DM patients with poor SCPs, 65.7% had uncontrolled glycated hemoglobin level (8.4% ± 2%), and this was statistically significant.

Conclusion: The practice of self-care was found to be suboptimal among patients with T2DM in the study.

Dyke-Davidoff-Masson syndrome (DDMS) is a rare neuro-osteal syndrome of childhood and a constellation of cerebral hemiatrophy, facial asymmetry, seizures, osseous changes, and hemiplegia. It commonly presents with seizures and hemiplegia. The involvement of the kidney in DDMS is not known in the available literature, except in a case report that described ectopic kidney in DDMS. We present the case of a 15-year-old boy who presented with recurrent seizures, right facial palsy, left hemiparesis, and advanced renal failure. The neuroimaging revealed diffuse right cerebral atrophy, dilatation of the ipsilateral lateral ventricle, and ipsilateral thickening of the calvaria. The nephrological evaluation suggested the diagnosis of chronic kidney disease stage VD, probably secondary to congenital hypoplasia of the kidney.

Introduction: Mobile phones are frequently used in environments of high bacteria presence. These can harbor various potential pathogens and become an exogenous source of nosocomial infections. Even in recent outbreak of COVID-19, it has become a point which needs to be sanitized to prevent and control further disease transmission as it is equally important for health-care professionals to use mobile phones in the hospital and other health and care settings, especially for communication. The present study was conducted to determine the potential role of mobile phones in the dissemination of disease.

Objective: To compare the evaluation of microbial contamination on the mobile phones used by dental health-care professionals and faculty of senior secondary school and to access the microbial contamination of mobile phones by measuring the percentages of pathogens and to determine the type of bacteria commonly present on mobile phones. It also assesses the efficacy of 70% ethyl alcohol to be used as decontamination solution.

Materials and methods: A total of 126 mobile phones were screened in the study; 63 mobile phones belonging to dental health-care personnel from nine different specialties of dental college (Group 1 - test group) and 63 mobile phones belonging to nonhealth-care personnel like school teachers of senior schools (Group 2 - control group). All the samples were taken before and after cleaning with 70% ethyl alcohol. A total of 252 swab samples were taken.

Results: Microbial contamination was approximately 68% in swab samples taken from mobile phones before cleaning with 70% of ethyl alcohol but even with one time disinfection with alcohol, decontamination was found to be only 95% effective. Coagulase-negative Staphylococcus was the most common isolated organism in swabs collected from dental college. Pathogenic bacteria were more prevalent in samples of dental college than to school samples.

Conclusion: Ninetythree percentage of cell phones of health-care workers were contaminated and they act as potential source of nosocomial infections. Alcohol should be used to disinfect the mobile phones.

Background: Around 80% of preterm births (PTBs) occur spontaneously. Various biomarkers are being evaluated to assess the possible role of chorioamniotic inflammation in PTBs.

Aim: The aim of this study was to establish the accuracy of serum bio-markers( cut off values of ferritin and alpha-fetoprotein [AFP] at midtrimester) along with cervical length [CL] assessment to predict preterm delivery among low-risk women.

Methods: Three hundred low-risk pregnant women attending the antenatal clinic of a tertiary health care facility were included and underwent CL measurement during mid-trimester by transvaginal ultrasonography and their serum levels of ferritin and AFP were recorded. All were followed up till delivery.

Results: Receptor-operated characteristic curves for ferritin, AFP, and CL were constructed. Area under curves and Youden Index calculated for each marker were very low (<0.5) which is statistically considered very poor for a screening test.

Conclusion: Serum ferritin and AFP together with CL measurement in the second trimester of pregnancy had poor discriminatory value in predicting preterm delivery among low-risk asymptomatic pregnant women.