Category: Nevin Manimala

J Infect Dev Ctries. 2024 Jun 30;18(6):957-963. doi: 10.3855/jidc.19559.

ABSTRACT

INTRODUCTION: Blood donation is vital for healthcare; however, transfusion-transmitted infections (TTIs) pose a serious risk. This study investigated the seroprevalence of TTIs among Saudi blood donors.

METHODOLOGY: This retrospective study included male blood donors aged ≥ 18 years who donated blood at Al-Noor Specialist Hospital in Makkah from January 2017 to December 2022. The blood units were screened for hepatitis B surface antigen (HBsAg) and core antibodies (HBc-IgG), hepatitis C antibodies (HCV-Abs), syphilis, HIV-1 antigen/antibody (HIV-1 Ag/Ab), human T-lymphotropic virus 1, 2 (HTLV-1/2), and malaria.

RESULTS: There were 40,287 donors with an average age of 44.33 ± 18.12 years, and 62.3% (n = 25103) were Saudis. The overall rate of TTIs seropositivity was 7.4% (n = 2953); HBc-IgG (6.1%; n = 2473) was the most common, followed by HCV-Abs (0.4%; n = 177), and syphilis (0.34%; n = 136). All cases were negative for malaria, whilst HIV and HTLV positive donors were 0.06% (n = 24) and 0.13% (n = 52), respectively. Syphilis was more prevalent among non-Saudis (0.24%; n = 83) than among Saudis (0.1%; n = 53), whereas anti-HBc antibodies seropositivity was significantly higher among Saudi (3.4%; n = 1373) than non-Saudi donors (2.7%; n = 1100).

CONCLUSIONS: Hepatitis B virus was the most frequently detected bloodborne pathogen, followed by hepatitis C virus and syphilis. Hepatitis B virus was also more prevalent among Saudi donors, whilst expatriates had higher rates of syphilis. Additional prospective multicenter studies are needed to accurately determine the prevalence of TTIs in Saudi Arabia.

PMID:38991002 | DOI:10.3855/jidc.19559

J Infect Dev Ctries. 2024 Jun 30;18(6):937-942. doi: 10.3855/jidc.19426.

ABSTRACT

INTRODUCTION: Invasive device-associated nosocomial infections commonly occur in intensive care units (ICUs). These infections include intravascular catheter-related bloodstream infection (CRBSI), ventilator-associated pneumonia (VAP), and catheter-associated urinary tract infection (CAUTI). This study aimed to evaluate the factors associated with invasive device-associated nosocomial infections based on the underlying diseases of the patients and antibiotic resistance profiles of the pathogens causing the infections detected in the ICU in our hospital over a five-year period.

METHODOLOGY: Invasive device-associated infections (CRBSI, VAP, and CAUTI) were detected retrospectively by the laboratory- and clinic-based active surveillance system according to the criteria of the US Centers for Disease Control and Prevention (CDC) in patients hospitalized in the ICU of the tertiary hospital between 1 January 2018 and 30 June 2023.

RESULTS: A total of 425 invasive device-associated nosocomial infections and 441 culture results were detected (179 CRBSI, 176 VAP, 70 CAUTI). Out of them, 57 (13.4%) patients had hematological malignancy, 145 (34.1%) had solid organ malignancy, and 223 (52.5%) had no histopathologic diagnosis of any malignancy. An increase in extended-spectrum beta lactamase (ESBL) and carbapenem resistance in pathogens was detected during the study period.

CONCLUSIONS: Antibiotic resistance of the Gram-negative bacteria associated with invasive device-associated infections increased during the study period. Antimicrobial stewardship will reduce rates of nosocomial infections, reduce mortality, and shorten hospital stay. Long-term catheterization and unnecessary antibiotic use should be avoided.

PMID:38990999 | DOI:10.3855/jidc.19426

J Infect Dev Ctries. 2024 Jun 30;18(6):925-931. doi: 10.3855/jidc.18949.

ABSTRACT

INTRODUCTION: Bacterial vaginosis (BV) is the most frequent vaginal infection affecting women of childbearing age worldwide. It is associated with significant adverse healthcare outcomes, especially during pregnancy. Although screening for BV could reduce potential pregnancy-related obstetric complications, there is no routine screening of pregnant women for BV in Vietnam. We aimed to identify the prevalence of BV among pregnant women and the associated factors in two tertiary hospitals in Hue, Vietnam.

METHODOLOGY: This cross-sectional descriptive study included 885 pregnant women in third trimester, who received routine antenatal care in the Hue Central Hospital and Hue University Hospital of Medicine and Pharmacy, Hue city, Thua Thien Hue province, Vietnam. Gram-stained vaginal smears were used for calculating the Nugent score and recording the fungal elements.

RESULTS: In total, 435 (49.1%) women had a normal BV score, 352 (39.8%) had intermediate vaginal microbiota, and 98 (11.1%) had BV. Among the 98 women with BV, 71 (72.4%) also had fungal infection. There was a significant association of BV with discharge (p = 0.004) and abnormal cervix (p = 0.014). BV was significantly more frequent among the women who reported previous abortion or miscarriage (p = 0.007).

CONCLUSIONS: About a tenth of women in Thua Thien Hue province have BV in the third trimester of pregnancy being associated with previous adverse outcome. Discharge with fishy odour is still a characteristic feature among subtle clinical presentations of BV. Better awareness about this disease and routine test-and-treat management during pregnancy may improve pregnancy outcome.

PMID:38990996 | DOI:10.3855/jidc.18949

Indian J Ophthalmol. 2024 Jul 11. doi: 10.4103/IJO.IJO_3257_23. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the surgical outcomes for patients with superior oblique paralysis (SOP) who underwent the inferior oblique weakening and the graded partial inferior rectus muscle tenotomy in the contralateral eye.

METHODS: Medical records were retrospectively reviewed for those SOP patients who had hyperdeviation of 4△ -20△ in the primary position and 8△ -25△ in the downgaze position. Patients were subdivided into three subgroups according to their vertical deviation angle in the downgaze position. They underwent an ipsilateral inferior oblique muscle recession and a graded partial tenotomy of the contralateral inferior rectus muscle. The vertical deviation angles, abnormal head position, and fundus torsion were compared statistically before and after operations. All patients were followed up at least 1 year.

RESULTS: Forty-seven patients were included in this study. The mean follow-up period was 17.2 months after surgery (ranging from 12 to 28 months). The vertical deviation angle was averaged preoperatively to 7.74△ ± 3.23△ in the primary position and 15.30△ ± 5.92△ in the downgaze position and reduced postoperatively to 0.85△ ± 1.15△ in the primary position and 1.53△± 1.49△ in the downgaze position (P < 0.001). All patients had an abnormal head position preoperatively and had improved significantly postoperatively. Fundus extorsion had been improved significantly postoperatively.

CONCLUSION: The surgical procedure of IO weakening combined with contralateral graded partial inferior rectus muscle tenotomy is a successful intervention for the correction of small deviation in primary position of SOP.

PMID:38990635 | DOI:10.4103/IJO.IJO_3257_23

Indian J Ophthalmol. 2024 Jul 11. doi: 10.4103/IJO.IJO_3370_23. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed to evaluate the choroidal vascular characteristics of patients followed up with different headache diagnoses.

DESIGN: Prospective comparative study.

METHODS: This study included 21 patients with migraine with visual aura (MwA), 20 with migraine without aura, 29 patients experiencing episodic tension-type headache, and 30 healthy participants. The participants was performed refraction values, axial length, and intraocular pressure were examined. Choroidal thickness was determined in all participants with HD-line optical coherence tomography (OCT) in the subfoveal, nasal, and temporal quadrants 500 μm from the fovea. Using special image processing software, luminal area (LA), stromal area, total choroidal area, and choroidal vascular index (CVI) values were calculated in both macular and peripapillary regions. OCT was also used to perform peripapillary retinal nerve fiber layer (pRNFL) thickness and optic disc head measurements.

RESULTS: Spherical refraction, axial length, and intraocular pressure values did not significantly differ among the four groups with similar gender and age distributions (P > 0.05). The LA values in both macular and peripapillary regions were found to be statistically significantly lower in the MwA group (P = 0.007 and P = 0.005, respectively). There was no statistically significant difference among the groups in terms of the remaining choroidal area parameters or CVI values (P > 0.05). The groups also did not show any significant difference in the pRNFL or optic disc head measurements performed in different quadrants (P > 0.05).

CONCLUSION: While LA, one of the choroidal vascular parameters, was found to be lower in the MwA group in both the macular and peripapillary regions, there were no statistically significant differences between the groups in terms of the peripapillary or macular CVI values.

PMID:38990631 | DOI:10.4103/IJO.IJO_3370_23

Indian J Ophthalmol. 2024 Jul 11. doi: 10.4103/IJO.IJO_574_23. Online ahead of print.

ABSTRACT

CONTEXT: Effect of serum ferritin on severity of coronavirus disease 2019 (COVID-19)-associated rhino-orbito-cerebral mucormycosis.

PURPOSE: To study the association between increased serum ferritin and severity of orbital disease in COVID-19-associated rhino-orbito-cerebral mucormycosis.

SETTINGS AND DESIGN: A cross-sectional study.

METHODS: Hundred (n) out of 155 treatment-naive patients of COVID-19 infection presenting with the signs and symptoms of rhino-orbito-cerebral mucormycosis were enrolled in study. Based on the classification proposed by Honavar, the study patients were classified into four stages: Stage 1: involvement of the nasal mucosa (n = 11), Stage 2: involvement of paranasal sinuses (n = 14), Stage 3: involvement of the orbit (n = 37), Stage 4: involvement of the central nervous system (n = 38). Stage 3 was further divided into four substages: 3a: nasolacrimal duct, medial orbit, vision unaffected (n = 4); 3b: diffuse orbital involvement (>1 quadrant or >2 structures), vision unaffected (n = 15); 3c: central retinal artery occlusion or ophthalmic artery occlusion, superior ophthalmic vein thrombosis, involvement of superior orbital fissure, inferior orbital fissure, orbital apex, diminution or loss of vision (n = 13); 3d: bilateral orbital involvement (n = 5). Fasting blood sugar (FBS), postprandial blood sugar (PPBS), and inflammatory markers (serum ferritin, interleukin-6, C-reactive protein, and D-dimer) were assessed. Serum level of ferritin was analyzed by using chemiluminescence immunoassay method.

RESULTS: Mean FBS (mg/dl) was 165.03 ± 70.43 for stage 1, 185.67 ± 64.82 for stage 2, 159.05 ± 68.60 for stage 3, and 158.20 ± 62.05 for stage 4. Mean PPBS (mg/dl) was 238.70 ± 141.29 for stage 1, 252 ± 103.69 for stage 2, 257.09 ± 103.48 for stage 3, and 229.53 ± 76.81 for stage 4. Mean serum ferritin (µg/l) was 302.67 ± 266.95 in stage 1, 444.19 ± 116.36 in stage 2, 504.85 ± 205.99 in stage 3, and 825.95 ± 777.30 in stage 4. A statistically significant increase in serum ferritin levels with severity of disease (P = 0.005) was noted. Similar trend was observed in substages of stage 3. Pearson correlation analysis showed a positive correlation between serum ferritin and severity of disease (P = 0.0007).

CONCLUSION: Increased serum ferritin was significantly independently associated with severity of orbital disease in COVID-19-associated rhino-orbito-cerebral mucormycosis.

PMID:38990622 | DOI:10.4103/IJO.IJO_574_23

Indian J Ophthalmol. 2024 Jul 11. doi: 10.4103/IJO.IJO_2803_23. Online ahead of print.

ABSTRACT

PURPOSE: To determine the influence of different types of orbital fractures on the radiographic post-treatment outcomes.

METHODS: The investigation was a retrospective cohort study involving CT data of all patients who underwent delayed primary or secondary surgery for orbital/zygomatico-orbital trauma between 2019 and 2021. The sample was divided into three groups 1, 2, and 3: isolated floor, floor and medial wall, and combined orbit and zygomatic complex fractures. The type of orbital fracture was the exposure, while the outcome measures were reduction in enophthalmos and intraorbital volume and linear relationship between the two variables. Data were analyzed for variance between groups and association. Statistical significance was set at < 0.05.

RESULTS: Forty-four patients (3 females and 41 males) with a mean age of 28.6 years were included in the study. Reductions in enophthalmos (P < 0.001) and intraorbital volume (P = 0.003) demonstrated significant variance between the groups. For every cubic centimeter of reduction in volume, the reduction in enophthalmos was 0.78 mm (P < 0.001) in isolated floor fractures, 0.60 mm (P = 0.013) in combined fractures involving the floor and medial walls, and 0.24 mm (P = 0.456) in combined fractures of the orbit and zygoma.

CONCLUSION: Correction of enophthalmos strongly depends on the type of orbital fracture. There exists a significant linear relationship between enophthalmos and intraorbital volume in fractures involving the internal orbit.

PMID:38990613 | DOI:10.4103/IJO.IJO_2803_23

Death Stud. 2024 Jul 11:1-10. doi: 10.1080/07481187.2024.2376838. Online ahead of print.

ABSTRACT

This article deals with the opinions and attitudes of the adolescent population toward death and its possible treatment in formal education at a public secondary school in Spain. To do so, we use a mixed methodology – DEA-S scale (n = 366) and three focus groups (n = 23), using descriptive statistical analysis, cluster analysis and qualitative thematic analysis. As in other studies, these students show moderately positive attitudes toward the inclusion of death education at their school, but their position is not unanimous, and above all, they admit its inclusion with certain reservations and conditions that reveal a limited conception of the educational potential of death education: they do not consider it appropriate at all educational stages and are critical of the way in which similar topics are usually dealt with at school. The analysis provides important didactic guidelines for the promotion of death awareness in secondary education.

PMID:38990603 | DOI:10.1080/07481187.2024.2376838

J Assoc Physicians India. 2024 Jul;72(7):41-47. doi: 10.59556/japi.72.0538.

ABSTRACT

BACKGROUND AND OBJECTIVES: Indian ethnic and educational diversities necessitate obtaining normative cognitive data in different populations. We aimed to evaluate cognitive scores using a Marathi translation of the Kolkata cognitive battery (KCB) and to study the association of KCB components with depression and sociodemographic variables.

MATERIALS AND METHODS: We studied 2,651 individuals aged ≥40 years without preexisting neuropsychiatric conditions from urban (Mumbai) and rural districts of Maharashtra. For each component of KCB, the lowest 10th percentile score was used to define cognitive impairment.

RESULTS: We studied 1,435 (54%) rural and 1,216 (46%) urban residents equally divided by gender (1,316 women and 1,335 men), average age 54 years. KCB scores were significantly lower with female sex, older age, illiteracy, and depression. The largest effect sizes attributable to these factors were in the domains of calculation (gender), visuoconstructional ability (VCA) (rurality), and verbal fluency (VF) (depression). Scores remained significantly lower in rural residents after controlling for age, sex, and education, particularly for VCA, immediate recall, and calculation.

CONCLUSION: This Marathi KCB, having been validated on large urban as well as rural samples, may be used to study cognition in Marathi-speaking populations with appropriate cutoffs tailored to the degree of urbanization of the population.

PMID:38990586 | DOI:10.59556/japi.72.0538

J Assoc Physicians India. 2024 Jul;72(7):34-40. doi: 10.59556/japi.72.0492.

ABSTRACT

AIM: This study illustrates parameters, procedures, and calculations for the statistical determination of sample size for different clinical study designs.

MATERIALS AND METHODS: In any research process, the sample size is an important consideration for the implementation of the planned study. From time to time, literature on sample size has been documented in the medical literature. However, the situations covered under them lack comprehensiveness in terms of different study designs, demonstration of calculations, and overreliance on statistical software.

RESULTS: The present study provides various facets of sample size determination, such as prerequisite parameters, mathematical formulation, and calculations for clinical study designs [descriptive studies, randomized controlled trials (RCT), correlational studies, comparison of multiple outcomes, survival analysis, sensitivity, and specificity], which will be quite useful.

CONCLUSION: This communication will be a good education and learning source for medical professionals to pick and choose a specific scenario and estimate the sample size.

PMID:38990585 | DOI:10.59556/japi.72.0492