Category: Nevin Manimala

Cureus. 2023 Nov 4;15(11):e48259. doi: 10.7759/cureus.48259. eCollection 2023 Nov.

ABSTRACT

Background The COVID-19 pandemic has caused a devastating disruption in medical education worldwide. The influence on training, mainly for undergraduate MBBS pupils, has been noteworthy, especially the significant and unexpected shift to online learning. Materials and methods We performed a two-month, cross-sectional study from June to August 2022 at Kasturba Medical College in Mangalore, India. The study participants were second- and third-year MBBS students at Kasturba Medical College. The sample size was 319. We collected data using a pre-structured, validated, printed questionnaire, then coded and entered the data into SPSS Statistics for Windows, version 25.0, for interpretation. Results A total of 319 people took part in the study. Of these, 60.2% were females, 39.4% were males, 71.8% were from the batch of 2019-2020, and the remaining 28.2% were from the batch of 2018-2019. Among the participants, 90 students suffered from COVID-19, including 72.7% (n = 65) from the second year. Twenty-four percent of the population did not contract COVID-19, including 88 from the second year. A total of 153 participants were unsure whether they were infected with COVID-19, including 57.5% from the second year and 42.5% from the third year. The study group’s p-value of <0.0001 is statistically significant. On multivariate analysis, 54.5% of the study participants said the pandemic caused a significant disruption to their medical education. A majority of students (51.7%) agreed that the pandemic hampered practical/clinical work; 42.9% of participants somewhat disagreed that the pandemic hampered their interest in pursuing medical education in the future; and 21.9% of students said the pandemic hindered their interest in further studying medicine. Regardless of gender, a majority of the participants (78.1%) felt that online education negatively affected their time management skills and ability to cover the syllabus. Nearly half (46.4%) reported proficiency in using electronic devices. The medical students encountered multiple challenges: approximately 88% indicated that anxiety over the possibility of contracting the disease led to changes in personal behavior and interactions with family and friends. The study also revealed that 71% exhibited anxiety traits, and 11% displayed depressive symptoms, which may have been pre-existing. Furthermore, 77.1% of the participants experienced poor sleep quality, which, according to another study, is a significant predictor of depression and anxiety during COVID-19. Our findings show a significant correlation between undergoing COVID-19 testing and increased anxiety and stress levels among students, most of whom were infected during the pandemic’s second wave in India. Conclusion The study has shed light on the effect of the COVID-19 pandemic on MBBS scholars and the students’ reactions to this unparalleled situation. This aligns with Sustainable Development Goal 3, which focuses on “good health and well-being.” The medical community has been significantly impacted by the pandemic due to its frontline position, and medical students’ struggles to thrive academically. The knowledge gained from this study will assist facilitators and students of the medical fraternity in carrying out effective teaching modalities during this pandemic and any future outbreaks.

PMID:38054153 | PMC:PMC10694999 | DOI:10.7759/cureus.48259

Cureus. 2023 Nov 4;15(11):e48256. doi: 10.7759/cureus.48256. eCollection 2023 Nov.

ABSTRACT

Introduction Glaucoma can be considered a heterogeneous group of diseases with characteristic progressive optic neuropathy, which causes the development of visual field dysfunctions and irreversible blindness. Glaucoma is the most prevalent cause of irreversible blindness worldwide. Aim This study aimed to assess the awareness and knowledge of glaucoma and its associated risk factors among the adult population in Jazan, Saudi Arabia, in 2022. Methods A community-based cross-sectional study was conducted with 384 participants aged 40 years and above in the Jazan region. A convenience sampling technique was adopted to obtain the target sample size. Data were collected using a self-administered electronic questionnaire on Google Forms. Results A majority (73.1%) of the 387 respondents to the questionnaire were in the age group of 40-50 years, with the average age being 47.43 years. No statistically significant difference was found between different age groups’ level of knowledge (p=0.769). In addition, the difference between levels of knowledge based on participants’ residence was also statistically insignificant (p=0.387). Of the participants who were not diagnosed with glaucoma, 55% had poor knowledge of glaucoma; however, only 3.10% of the participants diagnosed with glaucoma had poor knowledge of the condition. Consequently, there was a statistically significant difference between participants’ levels of knowledge based on their diagnosis of glaucoma (p=0.04). Conclusion The study revealed low knowledge and awareness levels regarding glaucoma among adults aged 40 years and above in the Jazan region.

PMID:38054142 | PMC:PMC10694846 | DOI:10.7759/cureus.48256

Cureus. 2023 Nov 3;15(11):e48245. doi: 10.7759/cureus.48245. eCollection 2023 Nov.

ABSTRACT

BACKGROUND: Effective and clear communication between the dentist and dental technician plays a vital role in rendering quality prostheses for patients. When fabricating a removable dental prosthesis, it is uncertain if the information received by the dental laboratory technician is clear and sufficient. This investigation aimed to assess dental technicians’ perceptions of the quality of dentists’ communication on the fabrication of removable partial dentures (RPDs) in Saudi Arabia.

METHODOLOGY: After obtaining the institutional review board (IRB) approval from Riyadh Elm University, Riyadh, Saudi Arabia, a cross-sectional survey on a convenient sample of 115 dental technicians registered with the Saudi Commission for Health Specialties was conducted in January 2022. The voluntary participation of 94 technicians fabricating RPDs was included. A 19-item online questionnaire was developed, including quality of written instruction, selection of impression trays, and impression materials for RPD fabrication, shared through Google Docs. Descriptive statistics were tabulated, and responses were displayed as a percentage of the total.

RESULTS: Of the 94 study subjects, 35% had less than five years of experience, 44% stated that they routinely receive work authorizations with clear instructions, 13% always used digital technology to fabricate prostheses, and 58% reported difficulty with communicated work authorization by dentists having less than five years of experience. Thirty-three respondents (35.1%) reported that 75% or more of the fabricated partial dentures were cast framework partials. Thirty-three respondents (35.1%) indicated that the master casts received for partial framework construction were usually accurate. Tooth alterations, however, were reported as usually adequate by only 28 respondents (29.8%). For creating the artificial gingiva portion of cast partials, 56 respondents (59.6%) preferred heat-cured acrylic resin. Furthermore, 40 respondents (42.6%) said that 75% or more of the requested partials were entirely made out of acrylic resin. Regarding case design discussions, 26 respondents (27.7%) always engaged with dentists, while 39 (41.5%) did so occasionally.

CONCLUSION: The obtained assessments pointed to the fact that dental technicians expressed a perception of inadequacy regarding the work authorizations provided by dentists for the fabrication of RPDs, where they seemingly felt that the instructions conveyed by the dentists were not sufficiently comprehensive or clear.

PMID:38054138 | PMC:PMC10694483 | DOI:10.7759/cureus.48245

Cureus. 2023 Nov 3;15(11):e48241. doi: 10.7759/cureus.48241. eCollection 2023 Nov.

ABSTRACT

INTRODUCTION: Depression is one of many comorbid conditions associated with diabetes. The rationale for this study is to examine the prevalence of depressive symptoms in adults with diabetes mellitus type II. Furthermore, the association between depressive symptoms and glycemic control will also be analyzed.

MATERIALS AND METHODS: A chart review of 59 diabetes mellitus type II patients from a family practice clinic in San Juan, Texas was performed. These patients were screened for depressive symptoms using the Patient Health Questionnaire-9 (PHQ-9) during their annual physical exam. Since many of these patients have been treated in this clinic for many years for their multiple comorbidities, it is possible to evaluate their responses to the PHQ-9 over consecutive years and compare them with their glycemic control using a HbA1c level. Data was evaluated by using biological parameters, such as age and gender, and the clinical parameter of a HbA1c level. Inferential statistics, such as prevalence, frequency, correlation, and p-value, were also used in analyzing the data.

RESULTS: Depressive symptoms were analyzed using the PHQ-9. In 2016, 2017, and 2018, female diabetics were found to have a higher prevalence of depressive symptoms. When comparing diabetes and age, in 2016, those who were between the ages of 65 and 74 and 75 and older had a higher incidence of depressive symptoms. Furthermore, in 2017 and 2018, patients 75 and older also had a higher frequency of depressive symptoms. The controlled diabetic population was also found to have a greater rate of depressive symptoms. However, after careful analyzation, there was no significant relationship between glycemic control and depressive symptoms.

CONCLUSION: Many diabetics have comorbid depressive symptoms. Even though this study showed no relationship between depressive symptoms and glycemic control, the treatment of depressive symptoms in diabetics may help to prevent the multiple life altering complications that diabetes can cause.

PMID:38054137 | PMC:PMC10694021 | DOI:10.7759/cureus.48241

Cureus. 2023 Nov 2;15(11):e48190. doi: 10.7759/cureus.48190. eCollection 2023 Nov.

ABSTRACT

Background In Andhra Pradesh, India, tribal communities face unique nutritional challenges due to limited access to healthcare and a predominantly plant-based diet. Maternal undernutrition is a significant concern, impacting the well-being of both mothers and their offspring. This study focuses on assessing the prevalence of undernutrition among tribal mothers in Andhra Pradesh using the BMI-for-age criterion. Objectives The aim of this study was to comprehensively evaluate the prevalence of undernutrition among tribal mothers, explore associations with demographic factors, and assess the impact of a nutritional intervention program. The ultimate goal was to contribute to targeted interventions and policies for improving the health and well-being of these communities. Materials and methods A cohort study was conducted in the Guntur district of Andhra Pradesh, involving 340 lactating mothers and their infants. Data collection and anthropometric measurements were performed. Results The study found that 67 (19.71%) of tribal mothers were underweight at baseline. There were statistically significant associations with the Yenadi tribe, low educational status of the mother, and history of lower segment Caesarean section with a high prevalence of being underweight. No significant associations with age, occupation, or socioeconomic status were observed. Undernutrition was more common among mothers with older children and was associated with specific obstetric factors. Conclusion While the prevalence of undernutrition is lower than in some previous studies, it remains a critical concern, particularly within disadvantaged communities. These undernourished mothers face health risks, including anemia. Urgent policy interventions and nutritional programs are needed to address this issue and enhance the well-being of tribal communities in Andhra Pradesh.

PMID:38054136 | PMC:PMC10694381 | DOI:10.7759/cureus.48190

Cureus. 2023 Nov 1;15(11):e48087. doi: 10.7759/cureus.48087. eCollection 2023 Nov.

ABSTRACT

INTRODUCTION: The dentoskeletal morphology of various malocclusions has been analyzed in cephalometric studies. It is important to understand the vertical and horizontal components of orthodontic treatment. To provide accurate treatment, an orthodontist needs to understand the facial types of an individual. This study aims to evaluate a correlation between vertical and horizontal components of skeletal and dental malocclusion by assessing cephalometric radiographs of the population of Jazan province.

METHODS: The cephalometric radiographs of 267 eligible participants were assessed digitally. Fourteen skeletal and dental parameters were used to evaluate the association. Reliability was checked with the intra-class coefficient. Statistical analyses included descriptive statistics and Spearman’s rho test. Statistical significance was set at P ≤ 0.05.

RESULTS: Correlations were found between anterior facial height (AFH), posterior facial height (PFH), FH ratio (Jarabak ratio), upper incisor to NA (U1-NA), lower incisor to NB (L1-NB), and upper incisor to the palatal plane (U1/PP). In dental class I, AFH (N-Me) had a strong positive correlation with L1-NB (0.300), U1/PP (0.164), and L1/MP (0.215). In dental class II, AFH negatively correlated with U1-NA (-0.735) and positively correlated with L1-NB (0.292), L1/MP (0.085), and U1-NA. PFH (S-Go) positively correlated with L1-NB (0.525) in class I but negatively correlated in class II. However, a negative relation was observed between all the vertical and horizontal components in class III.

CONCLUSION: This study suggests potential associations between vertical and horizontal components in developing skeletal and dental discrepancies.

PMID:38054125 | PMC:PMC10694803 | DOI:10.7759/cureus.48087

Cureus. 2023 Nov 4;15(11):e48269. doi: 10.7759/cureus.48269. eCollection 2023 Nov.

ABSTRACT

Background Insulin resistance can result from various genetic and lifestyle factors. Initially, symptoms of insulin resistance may not be readily noticeable, but as the condition progresses, individuals may start experiencing symptoms. This study aimed to investigate the factors contributing to the development of insulin resistance among medical students at a private college in Saudi Arabia. Methodology We conducted a cross-sectional study using a convenient non-probability sampling technique, with a sample size of 241 participants. We employed validated questionnaires to gather information on physical activity, sleep, dietary habits, and stress. Specifically, we used the International Physical Activity Questionnaire (IPAQ)-Short Form for assessing physical activity, the Single-Item Sleep Quality Scale (SQS) for evaluating sleep quality, the Healthy Eating Quiz (HEQ) to gauge dietary patterns, and the stress questionnaire designed by the International Stress Management Association (ISMA) to measure stress levels. Additionally, we collected anthropometric measurements, as well as systolic and diastolic blood pressure readings. We calculated prevalence using percentages and employed the chi-square test to analyze variables, with a significance level set at p-values <0.05. Results This study investigated risk factors associated with lifestyle, focusing on waist circumference as an indicator of insulin resistance. Our findings revealed that a majority of individuals with high waist circumference were physically inactive and more susceptible to stress, and this difference was statistically significant when compared to those with normal waist circumference. Additionally, we observed that sleep deprivation and poor nutrition were more prevalent among individuals with high waist circumference, although these differences were not statistically significant. Conclusions This study highlights a high prevalence of elevated waist circumference, indicating insulin resistance, among medical students. Furthermore, it underscores the significant presence of well-known risk factors associated with insulin resistance within this population of medical students.

PMID:38054122 | PMC:PMC10695479 | DOI:10.7759/cureus.48269

Eur J Cancer Prev. 2023 Nov 30. doi: 10.1097/CEJ.0000000000000845. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the quality of apps for prostate cancer antigen (PSA) dosage, available for downloading on the iOS and Android platforms, discussing the potential role of mobile health applications (MHAs) in update the screening protocol.

METHODS: An observational cross-sectional descriptive study of all smartphone apps for PSA dosage was performed through the most used platforms (iOS and Android). On 10 February 2023, a total of 457 apps were found according to the search criteria. Mobile Application Rating Scale (MARS) was adopted to assess apps’ quality. Then, MARS items were analyzed through descriptive statistics and bivariate correlations between study variables with Pearson’s coefficient.

RESULTS: Of all samples, 24 MHAs were included in the final analysis: 12% (n = 3) from the iTunes App Store and 88% (n = 21) from the Google Play Store. According to the MARS quality assessment, the mean values 2.61, 2.94, 3.11, 2.97, 2.94, and 2.63 were measured for the engagement, functionality, aesthetics, information, overall mean score, and subjective quality, respectively.

CONCLUSION: The MHAs for PSA were under the acceptability threshold and future improvements are required. Moreover, MHAs appropriately developed could play an active role in PSA screening campaign and adherence of follow-up regimens. Finally, the virtual instrument could both reduce the social divide of access to care for patients in rural areas and improve PCA detection, speeding up the active treatment.

PMID:38051582 | DOI:10.1097/CEJ.0000000000000845

JMIR Form Res. 2023 Dec 5;7:e49786. doi: 10.2196/49786.

ABSTRACT

BACKGROUND: While the COVID-19 pandemic dramatically increased virtual care uptake across many health settings, it remains significantly underused in urgent care.

OBJECTIVE: This study evaluated the implementation of a pilot virtual emergency department (VED) at an Ontario hospital that connected patients to emergency physicians through a web-based portal. We sought to (1) assess the acceptability of the VED model, (2) evaluate whether the VED was implemented as intended, and (3) explore the impact on quality of care, access to care, and continuity of care.

METHODS: This evaluation used a multimethods approach informed by the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework. Data included semistructured interviews with patients and physicians as well as postvisit surveys from patients. Interviews were transcribed and analyzed using thematic analysis. Data from the surveys were described using summary statistics.

RESULTS: From December 2020 to December 2021, the VED had a mean of 153 (SD 25) visits per month. Among them, 67% (n=677) were female, and 75% (n=758) had a family physician. Patients reported that the VED provided high-quality, timely access to care and praised the convenience, shorter appointments, and benefit of the calm, safe space afforded through virtual appointments. In instances where patients were directed to come into the emergency department (ED), physicians were able to provide a “warm handoff” to improve efficiency. This helped manage patient expectations, and the direct advice of the ED physician reassured them that the visit was warranted. There was broad initial uptake of VED shifts among ED physicians with 60% (n=22) completing shifts in the first 2 months and 42% (n=15) completing 1 or more shifts per month over the course of the pilot. There were no difficulties finding sufficient ED physicians for shifts. Most physicians enjoyed working in the VED, saw value for patients, and were motivated by patient satisfaction. However, some physicians were hesitant as they felt their expertise and skills as ED physicians were underused. The VED was implemented using an iterative staged approach with increased service capabilities over time, including access to ultrasounds, virtual follow-ups after a recent ED visit, and access to blood work, urine tests, and x-rays (at the hospital or a local community laboratory). Physicians recognized the value in supporting patients by advising on the need for an in-person visit, booking a diagnostic test, or referring them to a specialist.

CONCLUSIONS: The VED had the support of physicians and facilitated care for low-acuity presentations with immediate benefits for patients. It has the potential to benefit the health care system by seeing patients through the web and guiding patients to in-person care only when necessary. Long-term sustainability requires a focus on understanding digital equity and enhanced access to rapid testing or investigations.

PMID:38051562 | DOI:10.2196/49786

J Med Internet Res. 2023 Dec 5;25:e48623. doi: 10.2196/48623.

ABSTRACT

BACKGROUND: Several studies have demonstrated the efficacy and user acceptance of telehealth in managing patients with chronic conditions, including continuous ambulatory peritoneal dialysis (CAPD). However, the rates of telehealth service use in various patient groups have been low and have declined over time, which may affect important health outcomes. Telehealth service use in patients undergoing CAPD has been recognized as a key challenge that needs to be examined further.

OBJECTIVE: This study aimed to explore the rates of telehealth service use over 4 months, identify factors influencing its use, and examine the relationship between telehealth service use and health outcomes in Thai people undergoing CAPD.

METHODS: This cross-sectional study, which was a part of a pragmatic randomized controlled trial study, was conducted at a dialysis center in Bangkok, Thailand. The study included patients who were undergoing CAPD. These patients were randomly enrolled in the intervention group to receive telehealth service and additional standard care for 4 months. Data were collected using self-reported questionnaires, including a demographic form, Functional, Communicative, and Critical Health Literacy Scale, Perceived Usefulness Questionnaire, Brief Illness Perception Questionnaire, Patient-Doctor Relationship Questionnaire, and Kidney Disease Quality of Life 36 Questionnaire. Additionally, Google Analytics was used to obtain data on the actual use of the telehealth service. These data were analyzed using descriptive statistics, repeated-measures ANOVA, and regression analyses.

RESULTS: A total of 159 patients were included in this study. The mean rate of telehealth service use throughout the period of 4 months was 62.06 (SD 49.71) times. The rate of telehealth service use was the highest in the first month (mean 23.48, SD 16.28 times) and the lowest in the third month (mean 11.09, SD 11.48 times). Independent variables explained 27.6% of the sample variances in telehealth service use. Older age (β=.221; P=.002), higher perceived usefulness (β=.414; P<.001), unemployment (β=-.155; P=.03), and positive illness perception (β=-.205; P=.004) were associated with a significantly higher rate of telehealth service use. Regarding the relationship between telehealth service use and health outcomes, higher rates of telehealth service use were linked to better quality of life (β=.241; P=.002) and lower peritonitis (odds ratio 0.980, 95% CI 0.962-0.997; P=.03).

CONCLUSIONS: This study provides valuable insights into factors impacting telehealth service use, which in turn affect health outcomes in patients undergoing CAPD.

PMID:38051557 | DOI:10.2196/48623