Pub Date : 2024-04-01DOI: 10.4103/jfmpc.jfmpc_1237_23
Shazia Hamid, A. Badyal, Vishali Sumberia
ABSTRACT Human immunodeficiency virus (HIV)-related morbidity and mortality have declined over time, but this increased longevity may lead to the development of other diseases, which may further manifest as the metabolic syndrome (MS). To find out the point prevalence of MS in HIV positive patients, a cross-sectional prospective observational study was conducted on 200 patients who approached ART plus Centre of Government Medical College and Hospital Jammu, including 50 symptomatic patients HIV negative as controls. The mean age group in MS was 37.85 ± 6.61. Males consisted of 55% (110) and females consisted of 45% (90). The overall prevalence of MS was 13.5%, with prevalence in males being 16.3% and in females 10%. Patients receiving first line highly active antiretroviral therapy (HAART) showed a 24% prevalence, while that of second line HAART showed a 14% prevalence. Central obesity (47.3%) was the most common component of MS followed by hyperglycemia (43.3%), hypertriglyceridemia (38.6%), and low high density cholesterol (HDL-C) level (38.6%). Out of 84 males with MS, 94% (79) males were having hypertriglyceridemia, 88% (74) were hypertensive, and 72% (60) were having FBS >=100. Out of 66 females with MS, 100% (66) females had central obesity and 88% (58) had hypertriglyceridemia and low HDL-C levels. The metabolic complications as a result of treatment with HAART leave HIV patients at a risk of developing cardiovascular disease and diabetes in spite of improvements in morbidity and mortality. Risk factors like central obesity, hypertension, hyperglycemia, and hypertriglyceridemia should be taken into consideration well before to prevent the add-on effect of developing MS.
摘要 随着时间的推移，与人类免疫缺陷病毒（HIV）相关的发病率和死亡率有所下降，但寿命的延长可能导致其他疾病的发生，这些疾病可能进一步表现为代谢综合征（MS）。 为了了解 MS 在 HIV 阳性患者中的点流行率，我们对查谟政府医学院和医院 ART 加中心的 200 名患者进行了一项横断面前瞻性观察研究，其中包括 50 名有症状的 HIV 阴性患者作为对照。 MS 患者的平均年龄为 37.85 ± 6.61 岁。男性占 55%（110 人），女性占 45%（90 人）。MS的总发病率为13.5%，其中男性为16.3%，女性为10%。接受一线高效抗逆转录病毒疗法（HAART）的患者发病率为24%，而接受二线HAART疗法的患者发病率为14%。中心性肥胖（47.3%）是多发性硬化症最常见的病因，其次是高血糖（43.3%）、高甘油三酯血症（38.6%）和高密度胆固醇（HDL-C）水平低（38.6%）。在 84 名男性 MS 患者中，94%（79 人）患有高甘油三酯血症，88%（74 人）患有高血压，72%（60 人）的 FBS >=100。在 66 名女性多发性硬化症患者中，100%（66 人）患有中心性肥胖，88%（58 人）患有高甘油三酯血症和低高密度脂蛋白胆固醇水平。 尽管发病率和死亡率有所改善，但使用 HAART 治疗导致的代谢并发症使艾滋病患者面临罹患心血管疾病和糖尿病的风险。中心性肥胖、高血压、高血糖和高甘油三酯血症等风险因素应及早考虑，以防止罹患多发性硬化症的叠加效应。
{"title":"Point prevalence of metabolic syndrome in HIV positive patients","authors":"Shazia Hamid, A. Badyal, Vishali Sumberia","doi":"10.4103/jfmpc.jfmpc_1237_23","DOIUrl":"https://doi.org/10.4103/jfmpc.jfmpc_1237_23","url":null,"abstract":"ABSTRACT\u0000 \u0000 \u0000 \u0000 Human immunodeficiency virus (HIV)-related morbidity and mortality have declined over time, but this increased longevity may lead to the development of other diseases, which may further manifest as the metabolic syndrome (MS).\u0000 \u0000 \u0000 \u0000 To find out the point prevalence of MS in HIV positive patients, a cross-sectional prospective observational study was conducted on 200 patients who approached ART plus Centre of Government Medical College and Hospital Jammu, including 50 symptomatic patients HIV negative as controls.\u0000 \u0000 \u0000 \u0000 The mean age group in MS was 37.85 ± 6.61. Males consisted of 55% (110) and females consisted of 45% (90). The overall prevalence of MS was 13.5%, with prevalence in males being 16.3% and in females 10%. Patients receiving first line highly active antiretroviral therapy (HAART) showed a 24% prevalence, while that of second line HAART showed a 14% prevalence. Central obesity (47.3%) was the most common component of MS followed by hyperglycemia (43.3%), hypertriglyceridemia (38.6%), and low high density cholesterol (HDL-C) level (38.6%). Out of 84 males with MS, 94% (79) males were having hypertriglyceridemia, 88% (74) were hypertensive, and 72% (60) were having FBS >=100. Out of 66 females with MS, 100% (66) females had central obesity and 88% (58) had hypertriglyceridemia and low HDL-C levels.\u0000 \u0000 \u0000 \u0000 The metabolic complications as a result of treatment with HAART leave HIV patients at a risk of developing cardiovascular disease and diabetes in spite of improvements in morbidity and mortality. Risk factors like central obesity, hypertension, hyperglycemia, and hypertriglyceridemia should be taken into consideration well before to prevent the add-on effect of developing MS.\u0000","PeriodicalId":509702,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140782217","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}
Pub Date : 2024-04-01DOI: 10.4103/jfmpc.jfmpc_792_23
Sushma S. Rapelly, Shraddha Singh, Narsingh Verma, Sandeep Bhattacharya, S. Rungta
ABSTRACT Portal hypertension commonly occurs due to liver cirrhosis, and esophageal varices (EV) is one of the major complications associated with it. The most common cause of death in liver cirrhosis is EV bleeding. Hence, GE screening for EV is required, which is an invasive procedure. Regular use of endoscopy results in low compliance due to cost and discomfort for patients. Hence, identifying non-invasive markers that could grade EV provides a useful screening tool for family physicians and primary health centers (PHCs) by referring the patient to higher centers for definitive treatment, which could reduce mortality due to variceal bleeding in cirrhotic patients. To assess non-invasive predictors of grade EV in patients diagnosed with liver cirrhosis. Cross-sectional study. A total of 109 patients with liver cirrhosis underwent clinical and biochemical evaluation, USG abdomen with spleen bipolar diameter, ascitic fluid analysis, and upper GE with a grade of EV are recorded. SPSS software with Student t-test, Chi-square t-test, analysis of variance, receiver operator characteristic (ROC) curves, and Spearman correlation with 95% CI is used. P <0.05 is considered significant. Aminotransferase to Platelet count Ratio Index (APRI) score >1.815, PC/SD ≤909, and SAAG >1.1g/dl showed EV in liver cirrhosis (P < 0.05). The order of prediction with ROC curves shows APRI score > PC/SD > SAAG. In grading EV, APRI scores of 1.9–2.5 and >2.5 showed small and large EV, respectively (P < 0.05). APRI score may be used in PHC as an early intervention to grade EV and refer the patient to higher centers for definitive treatment. This would prevent the progression of varices to rupture and reduce mortality due to variceal bleeds in liver cirrhosis patients.
摘要 肝硬化常导致门静脉高压，食管静脉曲张（EV）是与之相关的主要并发症之一。食管静脉曲张出血是肝硬化患者最常见的死亡原因。因此，需要对食管静脉曲张进行内镜筛查，这是一项侵入性检查。由于费用和患者的不适感，定期使用内窥镜检查的依从性很低。因此，确定可对EV进行分级的非侵入性标记物可为家庭医生和初级保健中心（PHC）提供有用的筛查工具，将患者转诊至更高级别的中心进行明确治疗，从而降低肝硬化患者因静脉曲张出血而导致的死亡率。 评估肝硬化患者EV分级的非侵入性预测因素。 横断面研究。 共有 109 名肝硬化患者接受了临床和生化评估、腹部 USG（含脾脏双极直径）、腹水分析，并记录了 EV 分级的上腹部 GE。 使用 SPSS 软件进行学生 t 检验、卡方 t 检验、方差分析、接受者操作特征曲线（ROC）和斯皮尔曼相关性（95% CI）。P 1.815、PC/SD ≤909、SAAG >1.1g/dl显示肝硬化患者有EV（P < 0.05）。ROC 曲线的预测顺序为 APRI 评分 > PC/SD > SAAG。在对EV进行分级时，APRI评分为1.9-2.5和>2.5分别显示小EV和大EV（P < 0.05）。 APRI 评分可作为早期干预措施，用于对 EV 进行分级，并将患者转诊至更高一级的中心进行明确治疗。这将防止肝硬化患者的静脉曲张恶化至破裂，并降低因静脉曲张出血导致的死亡率。
{"title":"Non-invasive predictors to grade esophageal varices in liver cirrhosis patients","authors":"Sushma S. Rapelly, Shraddha Singh, Narsingh Verma, Sandeep Bhattacharya, S. Rungta","doi":"10.4103/jfmpc.jfmpc_792_23","DOIUrl":"https://doi.org/10.4103/jfmpc.jfmpc_792_23","url":null,"abstract":"ABSTRACT\u0000 \u0000 \u0000 \u0000 Portal hypertension commonly occurs due to liver cirrhosis, and esophageal varices (EV) is one of the major complications associated with it. The most common cause of death in liver cirrhosis is EV bleeding. Hence, GE screening for EV is required, which is an invasive procedure. Regular use of endoscopy results in low compliance due to cost and discomfort for patients. Hence, identifying non-invasive markers that could grade EV provides a useful screening tool for family physicians and primary health centers (PHCs) by referring the patient to higher centers for definitive treatment, which could reduce mortality due to variceal bleeding in cirrhotic patients.\u0000 \u0000 \u0000 \u0000 To assess non-invasive predictors of grade EV in patients diagnosed with liver cirrhosis.\u0000 \u0000 \u0000 \u0000 Cross-sectional study.\u0000 \u0000 \u0000 \u0000 A total of 109 patients with liver cirrhosis underwent clinical and biochemical evaluation, USG abdomen with spleen bipolar diameter, ascitic fluid analysis, and upper GE with a grade of EV are recorded.\u0000 \u0000 \u0000 \u0000 SPSS software with Student t-test, Chi-square t-test, analysis of variance, receiver operator characteristic (ROC) curves, and Spearman correlation with 95% CI is used. P <0.05 is considered significant.\u0000 \u0000 \u0000 \u0000 Aminotransferase to Platelet count Ratio Index (APRI) score >1.815, PC/SD ≤909, and SAAG >1.1g/dl showed EV in liver cirrhosis (P < 0.05). The order of prediction with ROC curves shows APRI score > PC/SD > SAAG. In grading EV, APRI scores of 1.9–2.5 and >2.5 showed small and large EV, respectively (P < 0.05).\u0000 \u0000 \u0000 \u0000 APRI score may be used in PHC as an early intervention to grade EV and refer the patient to higher centers for definitive treatment. This would prevent the progression of varices to rupture and reduce mortality due to variceal bleeds in liver cirrhosis patients.\u0000","PeriodicalId":509702,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140790108","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}
Pub Date : 2024-04-01DOI: 10.4103/jfmpc.jfmpc_1325_23
R. Hadaye, Aditi Dey
ABSTRACT Research on the working conditions and health hazards of fishing communities in developing countries is scarce. 1) To assess the occupational health hazards among women fish vendors. 2) To understand the morbidity profile in them. 3) To analyze various challenges faced by them at the workplace in this occupation. 4) To suggest various measures including ergonomic solutions that they can take to reduce these health hazards. Community-based observational cross-sectional study. Eight fish markets comprising women fish vendors working for more than one year (age > 30 years) in Mumbai were selected. A cluster sampling method was used. The sample size was 225. The period of the study was 2 years. Chi-square test The majority of study subjects had diabetes mellitus (24%) and were overweight (54.7%). Of all participants, 55.1% had musculoskeletal pain of which low back pain (69; 30.7%) was most common. There was a significant association between musculoskeletal pain status and mode of carrying boxes, χ2 (1) =56.35 as well as with duration of occupation, χ2 (3) =89.67, P < 0.001. Of all participants, 90.2% got injured of which the majority had incisional wounds (124; 61.1%). Of all participants, 55.1% suffered from skin infections of which the majority (28; 12.4%) had itching and redness of hands and legs. There was a significant association between skin infections and duration of occupation, χ2 (3) =140.53 as well as with the use of gloves (63.2% participants), χ2 (1) =20.395, P < 0.001. Various measures including ergonomic solutions that women fish vendors can take to reduce these health hazards need to be addressed.
{"title":"A cross-sectional study to assess the occupational health hazards among fisherwomen in a metropolitan city","authors":"R. Hadaye, Aditi Dey","doi":"10.4103/jfmpc.jfmpc_1325_23","DOIUrl":"https://doi.org/10.4103/jfmpc.jfmpc_1325_23","url":null,"abstract":"ABSTRACT\u0000 \u0000 \u0000 \u0000 Research on the working conditions and health hazards of fishing communities in developing countries is scarce.\u0000 \u0000 \u0000 \u0000 1) To assess the occupational health hazards among women fish vendors. 2) To understand the morbidity profile in them. 3) To analyze various challenges faced by them at the workplace in this occupation. 4) To suggest various measures including ergonomic solutions that they can take to reduce these health hazards.\u0000 \u0000 \u0000 \u0000 Community-based observational cross-sectional study.\u0000 \u0000 \u0000 \u0000 Eight fish markets comprising women fish vendors working for more than one year (age > 30 years) in Mumbai were selected. A cluster sampling method was used. The sample size was 225. The period of the study was 2 years.\u0000 \u0000 \u0000 \u0000 Chi-square test\u0000 \u0000 \u0000 \u0000 The majority of study subjects had diabetes mellitus (24%) and were overweight (54.7%). Of all participants, 55.1% had musculoskeletal pain of which low back pain (69; 30.7%) was most common. There was a significant association between musculoskeletal pain status and mode of carrying boxes, χ2 (1) =56.35 as well as with duration of occupation, χ2 (3) =89.67, P < 0.001. Of all participants, 90.2% got injured of which the majority had incisional wounds (124; 61.1%). Of all participants, 55.1% suffered from skin infections of which the majority (28; 12.4%) had itching and redness of hands and legs. There was a significant association between skin infections and duration of occupation, χ2 (3) =140.53 as well as with the use of gloves (63.2% participants), χ2 (1) =20.395, P < 0.001.\u0000 \u0000 \u0000 \u0000 Various measures including ergonomic solutions that women fish vendors can take to reduce these health hazards need to be addressed.\u0000","PeriodicalId":509702,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140762864","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}
Pub Date : 2024-04-01DOI: 10.4103/jfmpc.jfmpc_947_23
Ketankumar Hitendra Patil, Nitin Sanjay Tawar, A. Kudale
ABSTRACT To assess the resilience of primary healthcare workers (HCWs) by determining the factors associated with developing resilience post-coronavirus disease 2019 (COVID-19). A cross-sectional study in selected municipal hospitals. Connor–Davidson Resilience Scale was used to assess the resilience of the 245 HCWs, including the nurses and paramedics working in Pune Municipal Corporation (PMC) hospitals in Pune City. Data were analysed using the Chi-square test, one-way analysis of variance (ANOVA), independent-samples t-test and correlational analysis using the Statistical Package for the Social Sciences (SPSS) version 28. The mean resilience score of the HCWs in PMC hospitals post-COVID-19 was 75.09 (±9.25). The score for hardiness, optimism, resourcefulness and purpose was 20.15 (±3.87), 21.22 (±3.39), 17.24 (±2.76) and 16.40 (±2.17), respectively. Seven factors were significantly associated with the resilience of nurses and paramedics, namely age (P < 0.001), work experience (P < 0.001), monthly income (P < 0.001), having faced financial problems during COVID-19 (P < 0.001), hospital setting (P < 0.05), marital status (P < 0.01) and professional category (P < 0.001). In addition, 60% of the participants reported mental health issues due to routine workloads such as irritation/anger, frustration and tension/worry, fatigue and work-related stress, and sadness and anxiety. Suggestions for improvement were mainly increasing human resources, proper management, skilled staff, improved facilities and funding, and cooperation among staff. The resilience of primary HCWs in Pune post-COVID-19 was higher than HCWs in other countries assessed during COVID-19. Further, resilience was found more among nurses than paramedics. Modifiable factors affecting resilience must be addressed to improve the resilience of HCWs to build everyday resilience and strengthen health systems for public health emergencies.
ABSTRACT To assess the resilience of primary healthcare workers (HCWs) by determining the factors associated with developing resilience post-coronavirus disease 2019 (COVID-19). 在选定的市级医院进行横断面研究。 康纳-戴维森复原力量表（Connor-Davidson Resilience Scale）用于评估 245 名医护人员的复原力，其中包括在浦那市市政公司（PMC）医院工作的护士和护理人员。使用社会科学统计软件包（SPSS）28 版对数据进行了卡方检验（Chi-square test）、单因素方差分析（ANOVA）、独立样本 t 检验和相关分析。 PMC 医院的医护人员在 COVID-19 后的平均复原力得分为 75.09（±9.25）分。坚韧、乐观、机智和目的的得分分别为 20.15（±3.87）分、21.22（±3.39）分、17.24（±2.76）分和 16.40（±2.17）分。年龄（P < 0.001）、工作经验（P < 0.001）、月收入（P < 0.001）、在 COVID-19 期间遇到过经济问题（P < 0.001）、医院环境（P < 0.05）、婚姻状况（P < 0.01）和专业类别（P < 0.001）这 7 个因素与护士和护理人员的抗压能力明显相关。此外，60% 的参与者报告了因日常工作量而产生的心理健康问题，如烦躁/愤怒、沮丧和紧张/忧虑、疲劳和工作压力，以及悲伤和焦虑。改进建议主要包括增加人力资源、适当管理、熟练工作人员、改善设施和资金以及工作人员之间的合作。 与 COVID-19 期间评估的其他国家相比，COVID-19 后普纳初级医护人员的抗压能力更高。此外，护士的复原力高于护理人员。必须解决影响复原力的可调节因素，以提高医护人员的复原力，从而建立日常复原力并加强应对公共卫生突发事件的卫生系统。
{"title":"A post-COVID-19 assessment of resilience of nurses and paramedical workers in municipal hospitals of urban Pune, India","authors":"Ketankumar Hitendra Patil, Nitin Sanjay Tawar, A. Kudale","doi":"10.4103/jfmpc.jfmpc_947_23","DOIUrl":"https://doi.org/10.4103/jfmpc.jfmpc_947_23","url":null,"abstract":"ABSTRACT\u0000 \u0000 \u0000 \u0000 To assess the resilience of primary healthcare workers (HCWs) by determining the factors associated with developing resilience post-coronavirus disease 2019 (COVID-19).\u0000 \u0000 \u0000 \u0000 A cross-sectional study in selected municipal hospitals.\u0000 \u0000 \u0000 \u0000 Connor–Davidson Resilience Scale was used to assess the resilience of the 245 HCWs, including the nurses and paramedics working in Pune Municipal Corporation (PMC) hospitals in Pune City. Data were analysed using the Chi-square test, one-way analysis of variance (ANOVA), independent-samples t-test and correlational analysis using the Statistical Package for the Social Sciences (SPSS) version 28.\u0000 \u0000 \u0000 \u0000 The mean resilience score of the HCWs in PMC hospitals post-COVID-19 was 75.09 (±9.25). The score for hardiness, optimism, resourcefulness and purpose was 20.15 (±3.87), 21.22 (±3.39), 17.24 (±2.76) and 16.40 (±2.17), respectively. Seven factors were significantly associated with the resilience of nurses and paramedics, namely age (P < 0.001), work experience (P < 0.001), monthly income (P < 0.001), having faced financial problems during COVID-19 (P < 0.001), hospital setting (P < 0.05), marital status (P < 0.01) and professional category (P < 0.001). In addition, 60% of the participants reported mental health issues due to routine workloads such as irritation/anger, frustration and tension/worry, fatigue and work-related stress, and sadness and anxiety. Suggestions for improvement were mainly increasing human resources, proper management, skilled staff, improved facilities and funding, and cooperation among staff.\u0000 \u0000 \u0000 \u0000 The resilience of primary HCWs in Pune post-COVID-19 was higher than HCWs in other countries assessed during COVID-19. Further, resilience was found more among nurses than paramedics. Modifiable factors affecting resilience must be addressed to improve the resilience of HCWs to build everyday resilience and strengthen health systems for public health emergencies.\u0000","PeriodicalId":509702,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140794331","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}
Pub Date : 2024-04-01DOI: 10.4103/jfmpc.jfmpc_1788_23
Mantu Jain, C. Mohanty, R. Radhakrishnan
{"title":"In reply to pattern of injuries among patients presenting to level 1 trauma center","authors":"Mantu Jain, C. Mohanty, R. Radhakrishnan","doi":"10.4103/jfmpc.jfmpc_1788_23","DOIUrl":"https://doi.org/10.4103/jfmpc.jfmpc_1788_23","url":null,"abstract":"","PeriodicalId":509702,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140758444","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}
Pub Date : 2024-04-01DOI: 10.4103/jfmpc.jfmpc_652_23
Sanjay Prakash, Harsh Patel, Sunil Kumar, C. Shah
ABSTRACT Serotonin syndrome (SS) is an iatrogenic life-threatening condition caused by serotonergic agents. The treatment for SS involves the administration of a serotonin antagonist (cyproheptadine). However, the dosing schedule for cyproheptadine is not uniform in the literature. We retrospectively evaluated 23 adult patients (>18 years) admitted to the Neurology Department and met the Hunter criteria for SS. The mean age was 35.2 years, and 52% were female. Ten patients were managed in the intensive care unit (ICU), whereas thirteen patients were admitted to the ward. Hyperreflexia was the most common clinical feature (100%), followed by clonus (91%), tachycardia (83%), and tremor (83%). Other common clinical features were rigidity (65%), increased bowel sound (61%), diaphoresis (48%), fever (43%), hypertension (39%), and myoclonus (30%). All but one patient received two or more serotonergic drugs. Tramadol was the most common serotonergic agent (39%), followed by sodium valproate (21%), and amitriptyline (21%). Cyproheptadine was administered to all patients. All patients admitted in the ICU received a loading dose of 12 mg followed by 2 mg every 2 h for at least 24 h. All patients admitted to the ward were given 4 mg of cyproheptadine three times each day. Every patient showed at least some response to cyproheptadine within 24 h. The total doses of cyproheptadine and the length of treatment differed between patients. Any response to cyproheptadine at a therapeutic dose within 24 h, even a partial one, could be a diagnostic indicator of the existence of SS.
{"title":"Cyproheptadine in serotonin syndrome: A retrospective study","authors":"Sanjay Prakash, Harsh Patel, Sunil Kumar, C. Shah","doi":"10.4103/jfmpc.jfmpc_652_23","DOIUrl":"https://doi.org/10.4103/jfmpc.jfmpc_652_23","url":null,"abstract":"ABSTRACT\u0000 \u0000 \u0000 \u0000 Serotonin syndrome (SS) is an iatrogenic life-threatening condition caused by serotonergic agents. The treatment for SS involves the administration of a serotonin antagonist (cyproheptadine). However, the dosing schedule for cyproheptadine is not uniform in the literature.\u0000 \u0000 \u0000 \u0000 We retrospectively evaluated 23 adult patients (>18 years) admitted to the Neurology Department and met the Hunter criteria for SS.\u0000 \u0000 \u0000 \u0000 The mean age was 35.2 years, and 52% were female. Ten patients were managed in the intensive care unit (ICU), whereas thirteen patients were admitted to the ward. Hyperreflexia was the most common clinical feature (100%), followed by clonus (91%), tachycardia (83%), and tremor (83%). Other common clinical features were rigidity (65%), increased bowel sound (61%), diaphoresis (48%), fever (43%), hypertension (39%), and myoclonus (30%). All but one patient received two or more serotonergic drugs. Tramadol was the most common serotonergic agent (39%), followed by sodium valproate (21%), and amitriptyline (21%). Cyproheptadine was administered to all patients. All patients admitted in the ICU received a loading dose of 12 mg followed by 2 mg every 2 h for at least 24 h. All patients admitted to the ward were given 4 mg of cyproheptadine three times each day. Every patient showed at least some response to cyproheptadine within 24 h. The total doses of cyproheptadine and the length of treatment differed between patients.\u0000 \u0000 \u0000 \u0000 Any response to cyproheptadine at a therapeutic dose within 24 h, even a partial one, could be a diagnostic indicator of the existence of SS.\u0000","PeriodicalId":509702,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140759404","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}
Pub Date : 2024-04-01DOI: 10.4103/jfmpc.jfmpc_1787_23
S. Chinnaiyan, Jenifer Sylvia, Sowmiya Kothandaraman, B. Palanisamy
ABSTRACT In recent years, a multitude of studies have been conducted to investigate the assessment of quality of life (QoL) among individuals affected by thalassemia. This scoping review aimed to examine the existing knowledge regarding the QoL and its associated factors among individuals with thalassemia in India. Databases, such as PubMed, SCOPUS, Web of Science, and the Preferred Reporting Items for Systematic Review and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR) guidelines, were searched. A total of nine articles were included in the review. The included studies mainly investigated children. The Pediatric Quality of Life Inventory (PedsQL) is the most common instrument used most often. Overall, the research findings indicate that individuals who underwent blood transfusion exhibited a lower QoL than those who did not receive blood transfusion. Additionally, it was observed that children diagnosed with thalassemia reported a lower QoL than adults. Nevertheless, the studies exhibited notable methodological deficiencies that constrained the validity and generalizability of the results. Hence, it is imperative to undertake comprehensive QoL research encompassing all regions of India and various thalassemia populations within the country to bridge this evidentiary void.
摘要 近年来，对地中海贫血患者的生活质量（QoL）评估进行了大量研究。本范围综述旨在研究印度地中海贫血患者的 QoL 及其相关因素的现有知识。研究人员检索了 PubMed、SCOPUS、Web of Science 等数据库，并参考了《系统综述和荟萃分析扩展指南》（Preferred Reporting Items for Systematic Review and Meta-Analysis Extension for Scoping Reviews，PRISMA-ScR）指南。共有九篇文章被纳入综述。纳入的研究主要以儿童为调查对象。儿科生活质量量表（PedsQL）是最常用的工具。总体而言，研究结果表明，输血者的生活质量低于未输血者。此外，研究还发现，被诊断患有地中海贫血症的儿童的 QoL 值低于成人。然而，这些研究在方法上存在明显缺陷，限制了研究结果的有效性和普遍性。因此，当务之急是对印度所有地区和国内各种地中海贫血人群进行全面的 QoL 研究，以弥补这一证据空白。
{"title":"Quality of life and thalassemia in India: A scoping review","authors":"S. Chinnaiyan, Jenifer Sylvia, Sowmiya Kothandaraman, B. Palanisamy","doi":"10.4103/jfmpc.jfmpc_1787_23","DOIUrl":"https://doi.org/10.4103/jfmpc.jfmpc_1787_23","url":null,"abstract":"ABSTRACT\u0000 \u0000 In recent years, a multitude of studies have been conducted to investigate the assessment of quality of life (QoL) among individuals affected by thalassemia. This scoping review aimed to examine the existing knowledge regarding the QoL and its associated factors among individuals with thalassemia in India. Databases, such as PubMed, SCOPUS, Web of Science, and the Preferred Reporting Items for Systematic Review and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR) guidelines, were searched. A total of nine articles were included in the review. The included studies mainly investigated children. The Pediatric Quality of Life Inventory (PedsQL) is the most common instrument used most often. Overall, the research findings indicate that individuals who underwent blood transfusion exhibited a lower QoL than those who did not receive blood transfusion. Additionally, it was observed that children diagnosed with thalassemia reported a lower QoL than adults. Nevertheless, the studies exhibited notable methodological deficiencies that constrained the validity and generalizability of the results. Hence, it is imperative to undertake comprehensive QoL research encompassing all regions of India and various thalassemia populations within the country to bridge this evidentiary void.","PeriodicalId":509702,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140765961","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}
Pub Date : 2024-04-01DOI: 10.4103/jfmpc.jfmpc_673_23
Chaitanya Sheoran, N. Nayar, Abhinit Kumar, Kunal Kumar, Shruti Sharma, Nikita Maan
ABSTRACT The basic objective of any civilization is to preserve a happy family. The quality of one’s sexual encounters is crucial to a happy marriage. Couples’ dissatisfaction in this area may be the cause of several social, psychological, and medical issues. The way reality is interpreted, which shapes behaviors and emotions, is established by beliefs. These beliefs, which are among the most frequent causes of male sexual problems, include those relating to high performance, women’s sexual enjoyment, and sexual conservatism. To identify the misconceptions about sexuality among psychiatry patients. Method This cross-sectional study was carried out at the School of Medical Sciences and Research, Sharda University. We enrolled 200 samples and it is assessed through Sexual Beliefs Questionnaire (Male version). Sexual beliefs were assessed in different domains as well as overall sexual belief score was also estimated. The different domains in which the sexual beliefs were scored were sexual conservatism, female sexual power, macho belief, beliefs about women’s sexual satisfaction, restrictive attitude toward sex, and sex as an abuse of men’s power. The development of both psychiatric and sexological care will benefit from the early identification of the intricate relationships between psychopathology, the adverse effects of antipsychotic medicines, and sexuality. However, longitudinal studies are needed to anticipate the relationship more accurately between sexual dysfunction and sexual beliefs at a larger sample size. Sexual beliefs are significant contributors to sexual dysfunction.
{"title":"Assessment of sexual beliefs among “drug naive male” patients attending psychiatry OPD in a teaching institution: A cross-sectional study","authors":"Chaitanya Sheoran, N. Nayar, Abhinit Kumar, Kunal Kumar, Shruti Sharma, Nikita Maan","doi":"10.4103/jfmpc.jfmpc_673_23","DOIUrl":"https://doi.org/10.4103/jfmpc.jfmpc_673_23","url":null,"abstract":"ABSTRACT\u0000 \u0000 \u0000 \u0000 The basic objective of any civilization is to preserve a happy family. The quality of one’s sexual encounters is crucial to a happy marriage. Couples’ dissatisfaction in this area may be the cause of several social, psychological, and medical issues. The way reality is interpreted, which shapes behaviors and emotions, is established by beliefs. These beliefs, which are among the most frequent causes of male sexual problems, include those relating to high performance, women’s sexual enjoyment, and sexual conservatism.\u0000 \u0000 \u0000 \u0000 To identify the misconceptions about sexuality among psychiatry patients. Method This cross-sectional study was carried out at the School of Medical Sciences and Research, Sharda University. We enrolled 200 samples and it is assessed through Sexual Beliefs Questionnaire (Male version).\u0000 \u0000 \u0000 \u0000 Sexual beliefs were assessed in different domains as well as overall sexual belief score was also estimated. The different domains in which the sexual beliefs were scored were sexual conservatism, female sexual power, macho belief, beliefs about women’s sexual satisfaction, restrictive attitude toward sex, and sex as an abuse of men’s power.\u0000 \u0000 \u0000 \u0000 The development of both psychiatric and sexological care will benefit from the early identification of the intricate relationships between psychopathology, the adverse effects of antipsychotic medicines, and sexuality. However, longitudinal studies are needed to anticipate the relationship more accurately between sexual dysfunction and sexual beliefs at a larger sample size. Sexual beliefs are significant contributors to sexual dysfunction.\u0000","PeriodicalId":509702,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140770136","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}
Pub Date : 2024-04-01DOI: 10.4103/jfmpc.jfmpc_702_23
Navgeet Mathur, Harsh Patel, Ravi Mangalia, Amit Mehta, M. Mathur, A. Verma, Ashish Patyal
ABSTRACT Development of esophageal varices is one of the major complications of liver cirrhosis, and endoscopy is used to see the presence, grading, and long-term monitoring of esophageal varices which is an invasive and unpleasant procedure. There is no adequate data available showing noninvasive methods can be used for the same. Seventy patients with liver cirrhosis participated in the study. Factors like portal vein diameter, spleen size, platelet count, serum bilirubin, Child-Pugh score, prothrombin time (PT), and PT INR were observed and correlated endoscopically with the presence and grading of esophageal varices in all patients. The platelet count, portal vein diameter, serum bilirubin, spleen bipolar diameter, and PT had statistically significant correlations with the presence of varices. Among them, platelet count, portal vein diameter, and serum bilirubin also had statistically significant correlations with the grading of varices. Monitoring of these noninvasive parameters can help in monitoring variceal growth. Noninvasive parameters can be used effectively to predict the presence and grading of esophageal varices and at the same time keep the rate of undiagnosed varices acceptably low. By using noninvasive parameters, patients can be benefited by decreasing the requirement of repeated endoscopic evaluation which is an unpleasant procedure and availability is also limited.
{"title":"Correlation of non-invasive parameters with upper gastrointestinal endoscopy findings for presence and grading of gastroesophageal varices in liver cirrhosis patients","authors":"Navgeet Mathur, Harsh Patel, Ravi Mangalia, Amit Mehta, M. Mathur, A. Verma, Ashish Patyal","doi":"10.4103/jfmpc.jfmpc_702_23","DOIUrl":"https://doi.org/10.4103/jfmpc.jfmpc_702_23","url":null,"abstract":"ABSTRACT\u0000 \u0000 \u0000 \u0000 Development of esophageal varices is one of the major complications of liver cirrhosis, and endoscopy is used to see the presence, grading, and long-term monitoring of esophageal varices which is an invasive and unpleasant procedure. There is no adequate data available showing noninvasive methods can be used for the same.\u0000 \u0000 \u0000 \u0000 Seventy patients with liver cirrhosis participated in the study. Factors like portal vein diameter, spleen size, platelet count, serum bilirubin, Child-Pugh score, prothrombin time (PT), and PT INR were observed and correlated endoscopically with the presence and grading of esophageal varices in all patients.\u0000 \u0000 \u0000 \u0000 The platelet count, portal vein diameter, serum bilirubin, spleen bipolar diameter, and PT had statistically significant correlations with the presence of varices. Among them, platelet count, portal vein diameter, and serum bilirubin also had statistically significant correlations with the grading of varices. Monitoring of these noninvasive parameters can help in monitoring variceal growth.\u0000 \u0000 \u0000 \u0000 Noninvasive parameters can be used effectively to predict the presence and grading of esophageal varices and at the same time keep the rate of undiagnosed varices acceptably low. By using noninvasive parameters, patients can be benefited by decreasing the requirement of repeated endoscopic evaluation which is an unpleasant procedure and availability is also limited.\u0000","PeriodicalId":509702,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140795674","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}
Pub Date : 2024-04-01DOI: 10.4103/jfmpc.jfmpc_1855_23
S. M. Saleem, S. Jan
{"title":"Beyond the h-index: Unveiling nuances and demanding rigor in academic metrics","authors":"S. M. Saleem, S. Jan","doi":"10.4103/jfmpc.jfmpc_1855_23","DOIUrl":"https://doi.org/10.4103/jfmpc.jfmpc_1855_23","url":null,"abstract":"","PeriodicalId":509702,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140794002","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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