International Journal of Research in Medical Sciences
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Risk factor profiling in congenital heart disease: maternal and foetal determinants
Get PDFCongenital heart defects (CHDs) pose a substantial challenge to global public health, significantly impacting infant morbidity and mortality rates. This investigation seeks to examine the environmental factors, such as air and water pollution, and workplace exposures, that may influence the occurrence of CHDs in the area. The study evaluated mothers' exposure to various environmental contaminants, lifestyle choices, maternal health, and local industrial activities. Initial results indicate that exposure to high concentrations of air and water pollutants, especially from nearby mining and agricultural operations, may be strongly associated with a higher incidence of CHDs. Moreover, socioeconomic conditions, consanguineous marriages, and insufficient access to prenatal care were identified as important contributing factors
Comparison between single point versus double point injection in supraclavicular block incidence: ulnar sparing
Get PDFBackground: This study compared the efficacy of single-point versus double-point injection techniques in ultrasound-guided supraclavicular brachial plexus blocks, focusing on success rate, procedural time, onset and duration of sensory and motor block, and complications.
Methods: Twenty patients (20-80 years) undergoing forearm surgery over one hour were randomized into two groups. Group D received 20 ml of 0.5% bupivacaine divided into two 10 ml injections (superior cluster and inferior corner pocket). Group S received the entire 20 ml in the superior cluster pocket. Ultrasound guidance was used to locate the brachial plexus. Sensory and motor blockade onset were assessed by pinprick test and Bromage scale. Procedural time was recorded from ultrasound scanning to drug administration completion. Duration of blockade and adverse events were also noted.
Results: Group D showed a significantly higher success rate (p<0.0001) and longer procedural time compared to group S. Onset of sensory and motor block was faster, and duration was significantly prolonged in group D.
Conclusions: Double-point injection results in faster onset, longer duration, and higher success rate of supraclavicular blocks compared to single-point injection, but requires more procedural time
Management of internet addiction in an 18-year-old female with endoxifen: a case report
Get PDFInternet addiction has emerged as one of the rising health concerns in the adolescent age group in recent years, which is traditionally treated with psychotherapy. However, some patients require pharmacotherapy to manage their symptoms. This case report explores the treatment of an 18-year-old female diagnosed with internet addiction. The treatment regimen included endoxifen as adjunctive therapy alongside vilazodone, clonazepam and behavioural therapy. Over one-month period, notable improvements were observed in her symptoms, assessed through clinical global impressions and standardized internet addiction testing. The finding indicates that endoxifen, a direct protein kinase C (PKC) inhibitor, may be an effective treatment for such patients, especially those who do not respond to conventional therapies. This case report emphasizes the future studies focusing on the role of endoxifen in patients with behavioural addiction
Clinical characteristics and outcomes of rivaroxaban 2.5 mg in chronic coronary syndrome: insights from the RICCS India study
Get PDFBackground: The US Food and Drug Administration approved rivaroxaban 2.5 mg twice daily for the prevention of recurrent adverse cardiovascular events in patients with stable coronary heart disease and peripheral artery disease. This study aimed to understand the clinical characteristics and outcomes of Indian patients with chronic coronary syndrome (CCS) treated with rivaroxaban 2.5 mg, either as monotherapy or in combination therapy.
Methods: This retrospective, non-randomized, non-comparative, multi-center study was conducted across approximately 175 sites in India. Patients of either gender, aged >18 years, diagnosed with CCS, and who received rivaroxaban 2.5 mg were included. Patient data, including demographic details, medical history, and the treatment pattern of rivaroxaban 2.5 mg, were collected from the medical records and analyzed.
Results: A total of 1299 patients were included, with a median age of 62.00 years. Most patients were men (67.82%). The median systolic and diastolic blood pressures of the patients were 138.00 mmHg and 90.00 mmHg, respectively. Patients had a medical history of diabetes mellitus (41.72%), hypertension (38.95%), and cardiovascular disease (36.25%). Nearly 70% of patients received rivaroxaban 2.5 mg twice daily with low-dose aspirin (75 mg). The treatment duration was >3 months for 21.94% of patients, 1-3 months for 41.57%, and ≤1 month for 11.24%. Major bleeding events were reported in 24 patients (1.85%), while major adverse cardiovascular events occurred in 35 patients (2.69%).
Conclusions: This study provides real-world insights into clinical characteristics, treatment pattern, and outcomes of rivaroxaban 2.5 mg in patients with CCS in India
Ubiquitous analysis of thyroid disorders in reproductive age group females in rural field practice area of tertiary care hospital and its correlation with body mass index
Get PDFBackground: Thyroid is a vital hormone producing gland that plays a major role in regulating metabolism, growth and development in the human body. It also regulates body mass index (BMI) and other metabolic functions.
Methods: The present study was done on 200 females of reproductive age group in the field practice area of tertiary care hospital JIIU’s Indian institute of medical science and research, Jalna. Data collection involved general and thyroid examinations of subjects and blood sample collection for a thyroid profile. Body weight and height were also noted.
Results: Thyroid disorders and their prevalence among the overall study subjects show that 79% of the population has normal thyroid function, 11% have hypothyroidism, 4.5% have hyperthyroidism, 4% have goiter, 0.5% have thyroid adenoma, 0.5% have thyroid carcinoma, and 0.5% have thyroid cyst. The Thyroid disorders in the age group 15-24, 25-34, 35-44 and 44 and older years are 8%, 5.5%, 5% and 2.5% respectively.
Conclusions: Thyroid disorders are prevalent in reproductive age group females of rural Maharashtra commonest being subclinical hypothyroidism (SCH). Early diagnosis and treatment of thyroid disorders not only improve the quality of life of patients but also plays an important role in mitigating adverse maternal and fetal outcomes in the future. Further studies with larger sample sizes are needed to address the problem of thyroid disorders in rural areas
Expert opinion survey on medication error awareness, reporting and its challenges among nursing leaders in India
Get PDFBackground: Medication errors (MEs) remain a significant concern in healthcare settings globally, particularly in India, where Nurses play a vital role in preventing MEs. This expert opinion survey explored the experience of nursing leaders in handling and reporting of MEs.
Methods: This expert opinion study was based on a descriptive survey conducted among 51 nursing leaders from top corporate hospitals in India. The survey consisted of 15 questions covering four key areas: (1) frequency and types of errors, (2) barriers to error reporting, (3) department-related factors, and (4) training/education. Responses were collected through an online self-administered questionnaire between June and November 2024.
Results: Most of the nursing leaders (96%) reported encountering MEs. Among them, 39.2% of respondents observed MEs weekly, while 19.6% encountered these errors daily. The common types of errors included prescribing errors (71%), dispensing errors (69%), wrong dosages (63%), and wrong timing (61%). Notably, 37% of nursing leaders perceived underreporting of MEs. Identified barriers to MEs reporting included extra time for documentation (47%), fear of blame (45%), lack of knowledge (47%), absence of anonymous reporting systems (33%), and inadequate information for reporting errors (31%). A significant proportion of respondents (86%) emphasized the need for more comprehensive training to improve ME reporting practices.
Conclusions: This survey highlighted the need for transformative changes in ME awareness and reporting in hospitals. Establishing blame-free, anonymous reporting systems and enhancing training are essential. Additionally, advanced technological solutions should be utilized to support nursing staff in improving patient safety via prevention of MEs
Comparison of opioid based and opioid free anaesthesia in short obstetrics and gynecological day care procedures: a prospective, randomized, and comparative study
Get PDFBackground: There is scarce of data in resource-limited settings on comparing the feasibility, safety and efficacy of opioid based and opioid free anaesthesia in obstetrics and gynecological day care procedures.
Methods: This is a prospective, randomized, comparative study consisting total of 100 patients. Patients were randomly allocated in to two groups viz. group CGA (control) received standard fentanyl-based general anaesthesia i.e., fentanyl l µg/kg IV bolus and propofol 2-2.5 mg/kg IV for induction and group OFA (intervention) received multimodal opioid-free anaesthesia (OFA) i.e., lidocaine 1 mg/kg IV over 5 min, ketamine 0.5 mg/kg IV bolus, paracetamol 1g IV (or 15 mg/kg if <50 kg), and propofol 2-2.5 mg/kg IV for induction.
Results: Majority of the study subjects i.e., 28% were belonged to age group of 31-40 years in both group CGA and group OFA. BMI was majorly (70%) in the range of 18.5-24.9 kg/m2. The incidences of PONV were significantly (p=0.019) higher in control group (44%) as compared OFA group (22%). The composite hemodynamic stability score (p=0.005), time to first analgesic requirement (p<0.001), overall patient satisfaction mean score (p<0.001), recovery time (p<0.001), were significantly better in group OFA as compared to group CGA. The total complication rate observed was comparatively lower in in group OFA (2%) as compared to group CGA (12%). Overall incidences of side-effects were lower in group OFA (2%) as compared to group CGA (12%).
Conclusions: Opioid-free anaesthesia regimen for a low-resource setting like our study setting has a promising success rate with reduced incidence of side-effects
Estimation of progression of pediatric myopia in school going children among 4-15 years of age
Get PDFBackground: Pediatric myopia, or nearsightedness in children, has become a growing public health problem in globally. The increasing prevalence, in rural populations, because lack of eye awareness and, is linked to lifestyle changes such as increased screen time, not proper maintain hygienic condition and reduced outdoor activity.
Methods: A prospective study was conducted among 350 school going children aged 4-15 years attending the primary school in rural area. Comprehensive ophthalmic examinations and binocular vision assessment including subjective refraction were performed. Demographic data and family history were collected using structured questionnaires.
Results: A total of 350 students of primary school Chandikhera were assessed for this study. Of those 57 students come under these criteria (Pediatric myopia). Of these patients, 61% of patients were male, while 39% female. Overall, 16.28% of total patients had pediatric myopia. The prevalence of myopia increased by the time of 6 months (March to August 2023) from 16.28% to 22.85% (57-80 pediatric myopia patients) in which male pediatric myopic increment about 11.14% to 14.28%, (39-50 male) while in female about 5.14% to 8.57% (18-30 female).
Conclusions: The study found a significant association between lack of eye education, increased screen time, not proper diet maintain and higher myopia prevalence in children. Early detection and lifestyle modification are crucial for pediatric myopia control. Promoting outdoor activities, regular eye checkup, maintain diet and hygienic condition and important eye awareness may help reduce progression in pediatric myopia populations especially in rural area
Quality of life disparities among mothers of autistic children and mothers having normal children in Baghdad city-2024
Get PDFBackground: Raising children with autism spectrum disorder (ASD) is well known to have a long-term negative impact on parents' quality of life (QOL). However, there is limited evidence about the QOL for parents of autistic children in Iraq. Objectives were to assess the overall QOL, general health, and the QOL domains (physical, social, psychological, and environmental) among mothers of autistic children as compared to mothers of normal children.
Methods: Respondents in this comparative cross-sectional study were mothers of children with ASD and mothers of normal children who visited the consultation clinics of the pediatric welfare teaching hospital-medical City/Baghdad-Iraq and the consultation clinic of the national center for autism. A WHO-validated questionnaire was used.
Results: The study involved five hundred forty mothers from both groups (two hundred seventy for each one). Mothers of autistic children reported significantly poorer general QOL (35.9% vs. 24.8%, p=0.01) and general health (18.2% vs. 8.1%, p=0.001) compared to mothers of normal children. Substantial disparities and significant differences with poorer physical (24% vs. 15.92%, p=0.01) and psychological well-being (22.96% vs. 18.14%, p=0.03) were observed between the two groups.
Conclusions: Given the importance of QOL for mothers and its impact on their general health and family dynamics, it is essential to establish programs that promote better resolution in this risk group
Integrative analysis of protein-protein interaction networks: linking cellular functions to cancer and diabetes mechanisms
Get PDFBackground: Protein-protein interactions (PPIs) are vital in regulating cellular functions, including signal transduction, metabolic control, and intracellular transport. In diseases such as diabetes and cancer, analyzing PPI networks provides valuable insights into underlying molecular mechanisms and potential therapeutic targets. Focusing on disease-specific subnetworks enables the identification of key proteins and their functional relationships.
Methods: A subset of the human PPI network associated with diabetes and cancer was analyzed to identify proteins involved in signaling, trafficking, and metabolism. Proteins such as ARF5, M6PR, FKBP4, CYP26B1, NDUFAF7, and FUCA2 were included in the dataset annotations. We utilized visualization techniques to generate PPI (protein-protein interaction) maps, isolate diabetes modules with key genes like INS, GCK, IGF1, PPARG, and GLUT4, and investigate their relationships with different cancer types using the adjusted p-value threshold.
Results: In this study, each protein contributed a unique aspect and function to the overall analysis. M6PR regulated the transport of lysosomal enzymes, while ARF5 played a role in Golgi-associated vesicle trafficking. Hormone receptor microtubule FCBP4, along with hormone-receptor microtubule dynamics, was involved in retinoic acid metabolism and germ cell development. NDUFAF7 played a crucial role in mitochondrial complex I assembly, while FUCA2 participated in glycoprotein catabolism. Furthermore, the diabetes-specific interaction modules revealed a core regulatory axis, which comprised INS, GCK, IGF1, PPARG, and GLUT4. These genes are significant insulin signaling and glucose metabolism genes. Beside that, notable associations were observed with endometrial, melanoma, and colorectal cancers.
Conclusions: Recording the interplay of metabolic pathways underscores the importance of ppi subnetworks in metabolic regulation, signal transduction, and associated disorders, which supports further drug target investigations in diabetes and cancer