Tariq Janjua, A. Agrawal, Hefzi Montaño-Bayona, L. Moscote-Salazar
{"title":"Cascade concept: Situations where an unexpected finding can lead to inappropriate handling in neurocritical care","authors":"Tariq Janjua, A. Agrawal, Hefzi Montaño-Bayona, L. Moscote-Salazar","doi":"10.4103/jme.jme_22_22","DOIUrl":"https://doi.org/10.4103/jme.jme_22_22","url":null,"abstract":"","PeriodicalId":251651,"journal":{"name":"Journal of Medical Evidence","volume":"118 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114286072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Doctor G: Trying to break medical gender stereotypes in India – Well, almost","authors":"J. Rahul, Shreya Adhikari","doi":"10.4103/jme.jme_37_23","DOIUrl":"https://doi.org/10.4103/jme.jme_37_23","url":null,"abstract":"","PeriodicalId":251651,"journal":{"name":"Journal of Medical Evidence","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129720059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Elephant attack survivor - A case report with review of literature","authors":"Awaneesh Katiyar, Ajay Mahaputra Kumar","doi":"10.4103/jme.jme_36_21","DOIUrl":"https://doi.org/10.4103/jme.jme_36_21","url":null,"abstract":"","PeriodicalId":251651,"journal":{"name":"Journal of Medical Evidence","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122254786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. Asha, Mahendra Singh, P. Aggarwal, Nandita Sharma, Ajun Narayanan, M. Anjali, R. Namitha
Background: Ensuring high immunisation coverage and its acceptance among the beneficiaries are crucial for a healthy society. Hence, this study aimed to estimate vaccine coverage and barriers of immunisation among children of age 12–23 months in urban areas of Rishikesh, Uttarakhand. Aims: To estimate the immunization coverage rate among children of age 12-23 months in urban area of Rishikesh. Objectives: To identify the barriers towards immunization in children of age 12-23 months in urban area of Rishikesh. Materials and Methods: A community-based cross-sectional study was done in urban areas of Rishikesh for 1 year, including 210 children, using the WHO's 30 × 7 cluster sampling technique to collect data on immunisation status. Results: About 92% of the children were fully immunised. Bacillus Calmette–Guérin has the highest coverage rate (99.5%), whereas the coverage was the lowest for the measles vaccine (93.8%). Full immunisation coverage was found to be statistically significant with the education of the respondent, socio-economic status (SES) of the family and birth order of the child. Additional vaccines uptake showed a significant association between SES of the family and the place of vaccination. Conclusion: There were significant variations in childhood immunisation coverage across socio-economic and demographic factors. These findings emphasize on the need for regular monitoring and evaluation of immunisation coverage to achieve the benefits of vaccination in all strata of society.
{"title":"Study of coverage and barriers of immunisation among children of age 12–23 months in urban areas of Rishikesh","authors":"T. Asha, Mahendra Singh, P. Aggarwal, Nandita Sharma, Ajun Narayanan, M. Anjali, R. Namitha","doi":"10.4103/jme.jme_99_22","DOIUrl":"https://doi.org/10.4103/jme.jme_99_22","url":null,"abstract":"Background: Ensuring high immunisation coverage and its acceptance among the beneficiaries are crucial for a healthy society. Hence, this study aimed to estimate vaccine coverage and barriers of immunisation among children of age 12–23 months in urban areas of Rishikesh, Uttarakhand. Aims: To estimate the immunization coverage rate among children of age 12-23 months in urban area of Rishikesh. Objectives: To identify the barriers towards immunization in children of age 12-23 months in urban area of Rishikesh. Materials and Methods: A community-based cross-sectional study was done in urban areas of Rishikesh for 1 year, including 210 children, using the WHO's 30 × 7 cluster sampling technique to collect data on immunisation status. Results: About 92% of the children were fully immunised. Bacillus Calmette–Guérin has the highest coverage rate (99.5%), whereas the coverage was the lowest for the measles vaccine (93.8%). Full immunisation coverage was found to be statistically significant with the education of the respondent, socio-economic status (SES) of the family and birth order of the child. Additional vaccines uptake showed a significant association between SES of the family and the place of vaccination. Conclusion: There were significant variations in childhood immunisation coverage across socio-economic and demographic factors. These findings emphasize on the need for regular monitoring and evaluation of immunisation coverage to achieve the benefits of vaccination in all strata of society.","PeriodicalId":251651,"journal":{"name":"Journal of Medical Evidence","volume":"84 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133328020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Cochrane India and evidence synthesis","authors":"Meenu Singh, A. Pradhan","doi":"10.4103/jme.jme_36_23","DOIUrl":"https://doi.org/10.4103/jme.jme_36_23","url":null,"abstract":"","PeriodicalId":251651,"journal":{"name":"Journal of Medical Evidence","volume":"135 3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121342011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A giant duodenal adenoma","authors":"S. Jena, A. Yadav, S. Nundy","doi":"10.4103/jme.jme_152_22","DOIUrl":"https://doi.org/10.4103/jme.jme_152_22","url":null,"abstract":"","PeriodicalId":251651,"journal":{"name":"Journal of Medical Evidence","volume":"168 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125237320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"High altitude/trauma emergency training for medical personnel deployed at medical facility on chardham yatra route","authors":"Latika Mohan, J. Pant","doi":"10.4103/jme.jme_142_22","DOIUrl":"https://doi.org/10.4103/jme.jme_142_22","url":null,"abstract":"","PeriodicalId":251651,"journal":{"name":"Journal of Medical Evidence","volume":"86 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131111420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. S. Sunil Kumar, Lakshmi Hulugappa, R. Vidya, S. Manjula
Background: Coronavirus disease 2019 (COVID-19) has caused unprecedented harm to humanity and economies worldwide. A study of economic impact of COVID-19 patients in urban slums is limited. Aims: Hence, this study was undertaken to estimate the out-of-pocket expenditure (OOPE), and compare amongst admissions in public and private hospitals and home isolation of COVID-19 patients. Patients and Methods: A community-based cross-sectional study was conducted in urban slums under the urban field practice area of a medical college between September 2021 and November 2021. Data from 108 COVID-19 patients were collected by a pre-tested semi-structured questionnaire by interview method. Results: The mean age of respondents was 41.99 ± 10.49. The most common symptom was fever 91.6%, followed by cough 69.4%. History of travel was present in 64% and contact with family member was 69%. The mean OOPE for COVID-19 disease was 36756 INR per patient. Overall, the mean direct cost for COVID-19 admission was 29143 INR and mean indirect cost was 7529.62 INR. On applying Krushkal Wallis test, OOPE for direct cost on COVID-19 patient hospital admission, lab investigations, medications was H=65.85, 53.52, 28.98 with P value< 0.05 respectively and was found statististically significant. Similarly for Indirect cost , Loss of wages, travel expenses of the patient and attenders was H=10.45, 31.23 respectively and was found to be statistically significant at P <0.05. Overall the mean direct cost with government, private, home isolation COVID-19 patients was highly significant χ2 = 33.92, P = 0.000, and mean indirect cost χ2 = 9.48, P = 0.002. Conclusions: The OOPE for COVID-19 disease was high. The direct and indirect cost in government facility was minimal. The government's timely response to the pandemic was able to reduce the costs to the patients or else the economic burden would be higher.
背景:2019冠状病毒病(COVID-19)对人类和全球经济造成了前所未有的危害。关于城市贫民窟COVID-19患者经济影响的研究有限。因此，本研究旨在估算自费支出(OOPE)，并比较公立医院和私立医院的入院情况以及COVID-19患者的家庭隔离。患者和方法:于2021年9月至2021年11月在一所医学院城市野外实习区下的城市贫民窟进行了一项基于社区的横断面研究。采用预测半结构化问卷访谈法收集108例新冠肺炎患者的数据。结果:调查对象平均年龄为41.99±10.49岁。最常见的症状是发烧(91.6%)，其次是咳嗽(69.4%)。有旅行史的占64%，与家庭成员有接触的占69%。COVID-19疾病的平均OOPE为每位患者36756印度卢比。总体而言，COVID-19入院的平均直接成本为29143印度卢比，平均间接成本为7529.62印度卢比。应用Krushkal Wallis检验，OOPE对COVID-19患者住院、实验室调查、用药的直接成本分别为H=65.85、53.52、28.98,P值< 0.05，差异有统计学意义。间接成本方面，患者的工资损失、差旅费损失和护理人员的差旅费损失H=10.45、31.23,P <0.05，差异有统计学意义。总体而言，政府、私人和家庭隔离COVID-19患者的平均直接成本χ2 = 33.92, P = 0.000，平均间接成本χ2 = 9.48, P = 0.002。结论:2019冠状病毒病OOPE较高。政府设施的直接和间接成本是最低的。政府对大流行的及时反应能够减少患者的成本，否则经济负担将会更高。
{"title":"A community-based cross-sectional study on out-of-pocket expenditure for coronavirus disease patients in urban slums, Bengaluru Rural","authors":"D. S. Sunil Kumar, Lakshmi Hulugappa, R. Vidya, S. Manjula","doi":"10.4103/jme.jme_128_22","DOIUrl":"https://doi.org/10.4103/jme.jme_128_22","url":null,"abstract":"Background: Coronavirus disease 2019 (COVID-19) has caused unprecedented harm to humanity and economies worldwide. A study of economic impact of COVID-19 patients in urban slums is limited. Aims: Hence, this study was undertaken to estimate the out-of-pocket expenditure (OOPE), and compare amongst admissions in public and private hospitals and home isolation of COVID-19 patients. Patients and Methods: A community-based cross-sectional study was conducted in urban slums under the urban field practice area of a medical college between September 2021 and November 2021. Data from 108 COVID-19 patients were collected by a pre-tested semi-structured questionnaire by interview method. Results: The mean age of respondents was 41.99 ± 10.49. The most common symptom was fever 91.6%, followed by cough 69.4%. History of travel was present in 64% and contact with family member was 69%. The mean OOPE for COVID-19 disease was 36756 INR per patient. Overall, the mean direct cost for COVID-19 admission was 29143 INR and mean indirect cost was 7529.62 INR. On applying Krushkal Wallis test, OOPE for direct cost on COVID-19 patient hospital admission, lab investigations, medications was H=65.85, 53.52, 28.98 with P value< 0.05 respectively and was found statististically significant. Similarly for Indirect cost , Loss of wages, travel expenses of the patient and attenders was H=10.45, 31.23 respectively and was found to be statistically significant at P <0.05. Overall the mean direct cost with government, private, home isolation COVID-19 patients was highly significant χ2 = 33.92, P = 0.000, and mean indirect cost χ2 = 9.48, P = 0.002. Conclusions: The OOPE for COVID-19 disease was high. The direct and indirect cost in government facility was minimal. The government's timely response to the pandemic was able to reduce the costs to the patients or else the economic burden would be higher.","PeriodicalId":251651,"journal":{"name":"Journal of Medical Evidence","volume":"117 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134471333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Bansal, A. Chaudhary, Sangeeta Girdhar, Tiber Jain, Dr. Sarit Sharma, Mahesh Satija, V. Gupta, Pranjl Sharma, S. Singh
Introduction: In this era of epidemiological transition where noncommunicable diseases are on a significant rise, cancer is a major public health problem globally. Out of all cancers, breast cancer is the most common female cancer worldwide. Aim: To determine the knowledge of breast cancer and its risk factors and breast self-examination (BSE) practice amongst urban women of North India. Patients and Methods: A cross-sectional study was carried out amongst 370 women aged between 20 and 60 years of age using pretested self-administered questionnaire. The collected information was entered into Microsoft Excel sheet and analysed using SPSS. Results: Mean age of the study participants was 40.3 ± 12.1 years and majority of the study participants (87%) were married. It was seen that the proportion of women who were aware increased as their literacy status increased, and this was statistically significant (P = 0.00). About 18.4% of the participants were aware regarding BSE. The most mentioned reason for not practicing BSE amongst those who were aware was that they considered themselves healthy (63.2%). Conclusions: In the current study, half of the women were aware of breast cancer and few were aware of BSE and very few were practicing BSE. It was seen that women with a higher level of education had better knowledge regarding breast cancer than women with low educational status. For the prevention of breast cancer, women are the most important stakeholder. There is a need to sensitise women regarding risk factors of breast cancer and preventive practices like BSE.
{"title":"Knowledge regarding breast cancer and breast self-examination amongst urban females of North India: A cross-sectional study","authors":"P. Bansal, A. Chaudhary, Sangeeta Girdhar, Tiber Jain, Dr. Sarit Sharma, Mahesh Satija, V. Gupta, Pranjl Sharma, S. Singh","doi":"10.4103/jme.jme_115_22","DOIUrl":"https://doi.org/10.4103/jme.jme_115_22","url":null,"abstract":"Introduction: In this era of epidemiological transition where noncommunicable diseases are on a significant rise, cancer is a major public health problem globally. Out of all cancers, breast cancer is the most common female cancer worldwide. Aim: To determine the knowledge of breast cancer and its risk factors and breast self-examination (BSE) practice amongst urban women of North India. Patients and Methods: A cross-sectional study was carried out amongst 370 women aged between 20 and 60 years of age using pretested self-administered questionnaire. The collected information was entered into Microsoft Excel sheet and analysed using SPSS. Results: Mean age of the study participants was 40.3 ± 12.1 years and majority of the study participants (87%) were married. It was seen that the proportion of women who were aware increased as their literacy status increased, and this was statistically significant (P = 0.00). About 18.4% of the participants were aware regarding BSE. The most mentioned reason for not practicing BSE amongst those who were aware was that they considered themselves healthy (63.2%). Conclusions: In the current study, half of the women were aware of breast cancer and few were aware of BSE and very few were practicing BSE. It was seen that women with a higher level of education had better knowledge regarding breast cancer than women with low educational status. For the prevention of breast cancer, women are the most important stakeholder. There is a need to sensitise women regarding risk factors of breast cancer and preventive practices like BSE.","PeriodicalId":251651,"journal":{"name":"Journal of Medical Evidence","volume":"88 25 Pt 1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126312940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gene therapy is the treatment of abnormal or mutated genes present in cells through the addition of healthy genes or replacement/deletion/site-specific modification of faulty genes. Deoxyribonucleic acid, messenger ribonucleic acid (RNA), small interference RNA, microsomal RNA and antisense oligonucleotides are the genetic materials implicated in gene therapy. They are inserted into the diseased cells using viral or non-viral vectors through an in vivo or ex vivo transduction. Gamma retrovirus, lentivirus, herpesvirus, adenovirus and adeno-associated virus are common viral vectors, while transposons, cationic polymers, dendrimers and cell-penetrating peptides or liposomes are common non-viral vectors. Allologous or autologous T cells, haematopoietic stem cells and chimeric antigen receptor T cells are used for ex vivo gene transduction. Conventional gene therapy of inserting new genetic material shows toxicity such as off-target effects, altered immune responses, inflammatory reactions and possible oncogenic transformation in the recipient. Newer gene editing techniques such as zinc-finger nuclease, transcription activator-like effector nucleases and clustered regularly interspaced short palindromic repeats allow the site-specific correction or control of expression of mutated genes present in cells. Until August 2020, 23 gene-based medicines received approval from drug regulatory agencies in various countries and 362 were in development. Single-gene disorders have shown encouraging results, but evidence of using gene therapy in polygenic and common age-related diseases is still required. Recently, the horizon of gene therapy widened to include COVID vaccines and as an adjunct to chemotherapy. If we could overcome its limitations such as immunogenicity, mutagenicity and high costs, gene therapy can be the medicine of the next generation.
{"title":"Gene therapy and its applications","authors":"A. Bansal, R. Prakash, Swati Agarwal, U. Advani","doi":"10.4103/jme.jme_65_21","DOIUrl":"https://doi.org/10.4103/jme.jme_65_21","url":null,"abstract":"Gene therapy is the treatment of abnormal or mutated genes present in cells through the addition of healthy genes or replacement/deletion/site-specific modification of faulty genes. Deoxyribonucleic acid, messenger ribonucleic acid (RNA), small interference RNA, microsomal RNA and antisense oligonucleotides are the genetic materials implicated in gene therapy. They are inserted into the diseased cells using viral or non-viral vectors through an in vivo or ex vivo transduction. Gamma retrovirus, lentivirus, herpesvirus, adenovirus and adeno-associated virus are common viral vectors, while transposons, cationic polymers, dendrimers and cell-penetrating peptides or liposomes are common non-viral vectors. Allologous or autologous T cells, haematopoietic stem cells and chimeric antigen receptor T cells are used for ex vivo gene transduction. Conventional gene therapy of inserting new genetic material shows toxicity such as off-target effects, altered immune responses, inflammatory reactions and possible oncogenic transformation in the recipient. Newer gene editing techniques such as zinc-finger nuclease, transcription activator-like effector nucleases and clustered regularly interspaced short palindromic repeats allow the site-specific correction or control of expression of mutated genes present in cells. Until August 2020, 23 gene-based medicines received approval from drug regulatory agencies in various countries and 362 were in development. Single-gene disorders have shown encouraging results, but evidence of using gene therapy in polygenic and common age-related diseases is still required. Recently, the horizon of gene therapy widened to include COVID vaccines and as an adjunct to chemotherapy. If we could overcome its limitations such as immunogenicity, mutagenicity and high costs, gene therapy can be the medicine of the next generation.","PeriodicalId":251651,"journal":{"name":"Journal of Medical Evidence","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131600438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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