New Emirates Medical Journal - Volume 5, Issue 1, 2024
Volume 5, Issue 1, 2024
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Incidentally Discovered Rare Case of Solitary Fibrous Pleural Tumor (SFPT) during Residency Medical Clearance Examination
Background:A wide variety of tumors affect the pleura, both primary and secondary. The most common are metastatic carcinomas, usually of pulmonary origin. They manifest as malignant pleural effusion or multifocal pleural lesions. The extrapulmonary source of metastasis is mentioned but occurs less frequently. Pleural primary tumors other than diffuse malignant mesothelioma are either uncommon or rare and have received less attention. The World Health Organization (WHO) classified primary tumors of the pleura into three broad histogenetic classes of neoplasms, namely mesothelial tumors, mesenchymal tumors, and lymphoproliferative disorders.
Case Report:A 41-year-old male patient was referred to our facility from the prevention medicine department with consolidation in the right lower zone of the chest, diagnosed as a case of encysted pleural effusion to rule out TB. This was discovered during a routine health examination for residency visa renewal. After laps and imaging workup, it was diagnosed as Solitary Fibrous Pleural Tumor (SFPT). The first surgical intervention was hampered by bleeding from the mass itself. Therefore, the patient underwent a second intervention after successful embolization of the arterial supply of the tumor by the interventional radiologist.
Conclusion:Primary pleural neoplasms represent a small but significant group of heterogeneous tumors, many of which may mimic each other. Modern imaging modalities permit diagnosis and play a major role in staging and assessing surgical respectability. Novel molecular and immunohistochemical markers now allow confirmation of diagnosis and potentially form the basis for future targeted therapies. Embolization of tumor perfusion has a lifesaving role when needed.
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Medical Uses and Health Benefits of Caffeine - A Study among the Students of Medical University in the United Arab Emirates
Authors: Madjda Khemissa, Ganna Amr Ibrahim Sabri, Boshr Hamdoun and Mohamed Anas PatniBackgroundCaffeine, a stimulant for the central nervous system, is extensively consumed worldwide and can be found in various items such as coffee, tea, chocolate, and energy beverages. In addition to its stimulating properties, caffeine has been shown to provide numerous health advantages, including relief from migraines, treatment for neonatal apnea, and possible protective effects against neurodegenerative diseases and metabolic disorders. Despite its widespread use, the understanding of caffeine's therapeutic uses among healthcare professionals is still quite limited.
ObjectiveThis study was conducted to measure the awareness and knowledge regarding the health impacts of caffeine among medical students and interns at RAKMHSU.
MethodsA cross-sectional study was carried out over six months (September 2023–April 2024) involving 190 participants selected through purposive sampling. Data were gathered using a structured, pretested questionnaire and analyzed with SPSS v29. Both descriptive and inferential statistical methods, including chi-square and independent t-tests, were employed.
ResultsThe majority (70.5%) of the participants were female, with an average age of 20.52 years. Although 67.4% acknowledged caffeine's efficacy in migraine management, awareness of its neuroprotective properties (Parkinson's: 22.6%; Alzheimer's: 28.4%) and metabolic advantages was notably low. Students in clinical years exhibited significantly higher knowledge scores compared to their preclinical peers (p = 0.041). However, no significant differences were found based on gender, college affiliation, or residential status.
ConclusionThere are evident gaps in knowledge regarding caffeine’s health benefits among healthcare students, especially concerning its emerging therapeutic roles. These results highlight the necessity for focused educational initiatives within health sciences programs to improve the understanding and application of evidence-based dietary practices.
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Echocardiographic Features of Cardiac Amyloidosis: Insights from a Case Series
Authors: Mohammed Alghamdi, Hatim Kheirallah, Khalid Alkhalifa and Khalid AlanaziIntroductionCardiac amyloidosis, characterized by amyloid fibril deposition in the heart, often leads to heart failure and has a high mortality rate. The early detection of cardiac amyloidosis is critical for improving patient prognosis; however, the subtle and variable presentations of this condition can make early diagnosis challenging. Echocardiography is pivotal for diagnosing this condition. Through this study, we aim to improve the understanding of the echocardiographic features of cardiac amyloidosis.
MethodsThis retrospective case series was based on the data of patients diagnosed with amyloid transthyretin-related cardiac amyloidosis (ATTR cardiac amyloidosis) from 2020 to 2024 at the Prince Sultan Cardiac Center in Riyadh, Saudi Arabia. The collected data included demographic characteristics, medical history, laboratory results, medication use, 12-lead electrocardiography results, and echocardiographic parameters.
ResultsFifteen patients (11 males and four females, aged 41–88 years) were included in the analysis. The most common comorbidities were hypertension (seven patients) and atrial fibrillation (nine patients). The key echocardiographic characteristics were increased left ventricular (LV) wall thickness (mean: 19.9 mm), reduced global longitudinal strain (mean: −10%), and apical sparing. Six patients were positive for the 5-5-5 sign and pericardial effusion.
ConclusionRecognizing echocardiographic features, such as apical sparing and increased LV wall thickness, is essential for the early diagnosis of cardiac amyloidosis. Improved clinical awareness and diagnostic protocols could enhance early detection and patient outcomes.
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Connecting the Dots: The Role of Pollution in Lung Cancer Onset
A disproportionately large number of cancer-related deaths are caused by lung cancer, making it a worldwide public health concern. Lung cancer has a complex etiology, although carcinogenic chemicals are key contributors. In this chapter, we delve into the complex web of connections between carcinogenic pollution and the development of lung cancer. An overview of lung cancer, its prevalence, causative factors, and its various subtypes is covered to begin with. A focused discussion of carcinogenic pollutants, their diverse sources encompassing air pollutants, industrial emissions, indoor contaminants, lifestyle-related exposures, and mechanisms of action is also covered. The article delves into factors that have been proven to increase the risk of lung cancer, such as cigarette smoking, air pollutants, occupational risks, and interior pollutants. The chapter delves further into the topic, explaining how environmental influences and genetic predisposition interact in intricate ways. There is extensive citation and reporting of epidemiological, case-control, and cohort research that have confirmed the link between exposure to carcinogenic pollutants and the occurrence of lung cancer. As the chapter progresses, it also explores preventive measures and interventions, including environmental regulations, public health policies, and lifestyle modifications, aimed at reducing pollutant exposure and mitigating lung cancer risk. It provides valuable insights for clinicians, researchers, policymakers, and the general public, facilitating a collective effort to prevent or combat this formidable disease.
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Electrocardiographic Predictors of Improvement of Systolic and Diastolic Functions in Ischemic Cardiomyopathy Patients undergoing Percutaneous Coronary Intervention
BackgroundCoronary artery disease (CAD) is a significant contributor to 50%-70% of cardiac failure cases. Successful reperfusion is linked to improved systolic and diastolic functions.
Aim and ObjectivesThis study aimed to detect the correlation between ECG parameters (QRS duration and fragmentation, QTc, Tpe, and Tpe / QTc ratio), which were proved to be correlated with improved reperfusion post-PCI and associated with the improvement in systolic and diastolic function.
MethodsThis prospective research was performed on 54 ischemic cardiomyopathic cases from March 2019 to September 2022. All patients with Ischemic cardiomyopathy (ICM) and an EF less than 40%, along with viable myocardium determined by Dobutamine stress Echocardiography, underwent Complete revascularization of PCI amenable vessels.
ResultsThere was a statistically significant positive correlation between the QTc interval and EF% after 1 month (r=0.29) and between the QTc interval and the percentage of improvement in both systolic and diastolic functions (EF& E/é) with a more positive correlation with improvement in EF (r=0.35 and 0.27 respectively). A stronger positive and significant correlation between the percentage of improvement in EF% with both Tpe interval, Tpe/QTc ratio, and QRS duration (r= 0.57, 0.50, and 0.58, respectively) was found. Also, there was a positive significant correlation between the percentage of improvement in E/é with both Tpe interval, Tpe/QTc ratio, and QRS duration (r= 0.37, 0.26, and 0.32 respectively)
ConclusionECG parameters are capable of predicting improvement of systolic and diastolic functions in ischemic cardiomyopathic patients as observed by improvement in ejection fraction and E/é after PCI compared to before PCI.
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Death and COVID-19 Anxiety and its Association with Patients' Experiences and Satisfaction in the COVID-19 Outbreak
IntroductionWith the spread of COVID-19 around the world, this disease became a serious threat to global health and exposed people to coronavirus anxiety and death. Hospitalized patients have faced more anxiety about coronavirus and death, which can affect both the experiences and satisfaction of patients.
AimThe present study investigated the relationship between death anxiety, COVID-19 anxiety, experiences, and satisfaction of patients during the COVID-19 outbreak.
MethodsThis correlational study was performed on 239 patients admitted to Ali-Ibn Abi-Talib Hospital of Rafsanjani, southern Iran, during the COVID-19 outbreak. The socio-demographic characteristics, Templer death anxiety scale (DAS), Corona disease anxiety scale (CDAS), short-form of the Hong Kong inpatient experience questionnaire (SF-HKIEQ), and patient satisfaction instrument (PSI) were used to collect data. The data were then analyzed using SPSS 25.
Results10.9% of participants had high COVID-19 anxiety, and 69.0% had high death anxiety. 77.8% of the participants had problems in the inpatient experience. 69.9% of participants were dissatisfied, and 30.1% had moderate satisfaction. A significant negative correlation between death anxiety and COVID-19 anxiety (r = -0.13; p = 0.04) was observed. Death anxiety hurt experiences, and COVID-19 anxiety had a positive impact on patients' experiences. Also, we found a significant positive correlation between experiences and patients' satisfaction. COVID-19 anxiety, age, death anxiety, and infection with COVID-19 predicted 37% of the variance of patients' experiences. COVID-19 anxiety, inpatient experience, and marital status predicted 14% of the variance in patient satisfaction (p < 0.05).
ConclusionPatients have experienced high levels of death anxiety and moderate levels of COVID-19 anxiety during the outbreak of the COVID-19 pandemic, which has affected their experiences and satisfaction. Professional assistance is needed to improve patient experience and satisfaction during pandemics such as COVID-19 disease. The results of this study may help to prepare suitable future interventions and programs to increase patient satisfaction in hospitals.
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Hemolacria in Children with Hematological Disorders: Case Reports
BackgroundHemolacria, the presence of blood in tears, is an uncommon condition with various underlying etiologies. Although it can be alarming, its occurrence is often linked to a range of medical conditions, particularly in pediatric patients.
Case Presentation:We present two pediatric cases involving hematological diseases who developed hemolacria as a manifestation of their underlying conditions. Case 1 includes that of an eight-year-old girl with chronic immune thrombocytopenia (ITP) who developed hemolacria during an episode of epistaxis. Case 2 is of a seven-year-old girl with acute lymphoblastic leukemia (ALL) who presented with hemolacria during maintenance chemotherapy. Both cases illustrate the importance of considering hematological disorders in the differential diagnosis of pediatric hemolacria. Both cases were managed using a multidisciplinary strategy tailored to their underlying conditions. Systemic treatments, including intravenous immunoglobulin, thrombopoietin receptor agonists, and chemotherapy, addressed the primary hematological disorders. Localized ocular therapies, such as artificial tears, topical steroids, and antihistamines, were employed to manage symptoms and prevent complications. Supportive care measures, including patient education and infection prevention protocols, were integral to both management plans.
Conclusion:These two cases underscore the importance of recognizing hematological diseases as potential causes of hemolacria in children. Effective management requires a comprehensive, multidisciplinary approach that combines systemic treatment of the underlying disease with targeted local therapies and supportive care. Timely intervention is critical to ensuring favorable outcomes in these rare but significant presentations.
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Emotional Intelligence Levels among Nursing Students at RAK Medical and Health Sciences University, United Arab Emirates
Authors: Victoria Funmilayo Hanson, Sneha Pitre and Eman Abdelaziz DabouBackgroundEmotional intelligence (EI) plays a pivotal role in the effectiveness and efficiency of nursing students in their academic and professional pursuits. EI levels differ across academic years and tend to increase with age, often being higher in female students.
AimThis study aimed to assess the EI of RAKMHSU nursing students in the UAE.
MethodsThis descriptive cross-sectional study used the Schutte EI Scale to assess the EI of 214 undergraduate nursing students. The Schutte EI Scale is a five-point Likert scale comprising 33 questions that yields scores between 33 and 165, including reverse scoring for three questions. Data were analysed using IBM SPSS Version 25.
ResultsApproximately 82.7% of the study participants were female and 91.6% were unmarried. The age range of the participants was 18–22 years. Scores of 33–77, 78–121, and >122 on the Schutte EI Scale were considered low, moderate, and high, respectively. No differences were found in the average EI scores of nursing students by academic year. Overall, 68.15% of the students had high EI, 23.83% had moderate EI, and 7% had low EI. The study found no correlation between the EI scores and demographic factors. All EI domain scores except those for emotion perception were consistent between first- and final-year nursing students.
ConclusionThe study showed that many of the nursing students exhibited high EI, which is essential for communication, patient care, and professional development. Further, demographic parameters, including age, gender, and academic year, did not significantly affect the EI scores, suggesting that EI in this cohort of students was stable. Most students demonstrated strong EI, although the perception of the cohort could be improved. These findings highlight the need to integrate EI training in nursing universities to improve students’ emotional abilities, thereby improving patient outcomes and the nursing profession.
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Impact of Online Teaching During the COVID-19 Era on Senior Physiotherapy Students’ Clinical Self-efficacy at Fatima College of Health Sciences, UAE
Authors: Salwa B. El-Sobkey and Muhammad Al JarrahIntroductionEntry-level physiotherapists function as autonomous healthcare practitioners within a complex healthcare system, requiring professional competence in the clinical domain. Physiotherapy (PT) educational programs typically emphasize onsite teaching and use summative assessments to evaluate students' achievement of program objectives and learning outcomes. However, possessing knowledge and skills does not guarantee efficacy or confidence in clinical practice. This study aimed to assess the impact of online teaching approaches (TAs) during the COVID-19 era on the physiotherapy self-efficacy (PSE) of senior FCHS physiotherapy students across three clinical areas: musculoskeletal (MSK), neurological (N), and cardiorespiratory (CR), and to explore the influence of academic factors on PSE scores.
MethodsResearchers collected data for this cross-sectional study using a four-section questionnaire. One section specifically addressed the PSE. The study focused on three cohorts of pre-graduation senior PT students at Fatima College of Health Sciences (FCHS) who encountered a combination of onsite, online, and blended TAs due to COVID-19. Nonparametric statistical analysis was employed to analyze the data.
ResultsOf the seventeen participating students (68% participation rate, median age 22), the results indicate a statistically significant decrease in self-efficacy from MSK to N and CR clinical areas. The impact of online TAs on PSE varied by course specialty; TAs related to CR specialty courses significantly correlated with PSE scores, showing a preference for onsite TA to enhance self-efficacy over blended and online TAs. Furthermore, greater exposure to clinical cases and verbal encouragement from clinical educators were associated with higher self-efficacy. Physiological reactions, such as body pain, were also found to be influenced by the specific clinical area.
ConclusionThe impact of online TAs, implemented during the COVID-19 pandemic, on the self-efficacy of senior PT students is dependent on the specialty of the courses. This impact was most significant in CR specialty courses. Moreover, other factors, such as the sufficiency of exposure to clinical cases and clinical educators’ verbal encouragement, significantly contributed to students' self-efficacy.
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Can the Fluctuation Observed in the Endotracheal Tube with Compression Applied to the Epigastric Region be Used as a Confirmation Method for Endotracheal Intubation?
Authors: Mustafa Boğan, Tufan Alatlı, Ceren Karakeçili, Kudret Selki, Emre Erdem, Salih Karakoyun and Özkan KömürcüBackgroundThe traditional methods are mostly used to detect tracheal localization and to exclude esophageal localization. Therefore, the aim of this study was to investigate the usefulness of epigastric manual compression in the confirmation of esophageal placement of the tube.
MethodsOut-of-hospital ETE was performed by experienced paramedics working in the emergency ambulance service, while ETE in the emergency department was performed by emergency medicine residents or emergency medicine specialists with at least 2 years of emergency department experience. Epigastric compression was performed by applying pressure to the epigastric region at least three times (in 5 sec) with the volar side of the intubated patient while the patient was ventilated with a balloon-valved mask. Immediately after ETI was performed, Ultrasonography (USG) was performed as the gold standard confirmation method. If a double path sign was observed and the pleural sliding motion was not seen, it was considered unsuccessful.
ResultsA total of 78 patients were included in the study (an equal number of successful and unsuccessful ETE applications). Approximately 59% (n=46) of the patients were female, median age was 73 years (64-80), and 22(28.2%) patients were intubated due to traumatic etiology. The specificity and sensitivity of epigastric fluctuation for esophageal intubations were 83.33% and 60%, respectively. The positive predictive value was 92.31%, and the negative predictive value was 38.46%. Epigastric auscultation airflow sound had a specificity of 86.96% and a sensitivity of 65.45% for esophageal intubation.
ConclusionAlthough the fluctuation that occurs in the tube with epigastric compression is not as sensitive and specific as USG, it is a better method than lung auscultation.
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Innovative Gut Microbiome-targeted Strategies: A Promising Frontier for Pediatric Inflammatory Bowel Disease
BackgroundPediatric inflammatory bowel disease [IBD] impacts affected children with many diagnostic, therapeutic, and life challenges. The traditional drugs used for induction and maintenance of remission had many unwanted side effects. Therefore, there was an urgent need for safer, more effective therapeutic strategies. Hence, modifying the gut microbiota [GM] was proposed as an innovative approach based on the theory that restoring the disturbed GM harmony will have a positive impact on IBD activity and remission.
AimThis review aimed to examine each modality used to modify the gut microbiota in children with IBD, addressing their action mode, effectiveness, limitations, and side effects for a more holistic approach to children with IBD.
MethodsFour electronic databases were searched, including WOS, Cochrane Library, PubMed, and Scopus, for articles that investigated modulating GM via exclusive enteral nutrition, prebiotics, dietary fiber, probiotics, fecal microbiota transplantation, and antibiotics.
ResultsThe available evidence was encouraging regarding their effectiveness and safety; however, those studies were hindered by their small sampling size and inconsistency in recruiting cases.
ConclusionFurther work should identify other therapeutic and prognostic avenues for modulating GM for these vulnerable groups.
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Association of the ABCB1 C3435T Polymorphism with the Mixed Form of Ankylosing Spondylitis in the Algerian Population: A Case-control Study
IntroductionAnkylosing spondylitis (AS), also known as rheumatic pelvic spondylitis, is considered the primary condition in a group of chronic inflammatory rheumatic diseases collectively referred to as spondyloarthropathies.
ObjectivesThis study aimed to explore the association between ABCB1 C3435T polymorphism and the predisposition to ankylosing spondylitis (AS) in the Algerian population. The frequency of this polymorphism was compared between the group of AS and healthy subjects.
MethodsA case-control study involving 81 AS patients and 98 controls was conducted. DNA genotyping was done using predesigned probe-based allelic discrimination TaqMan® assays. Allele and genotype frequencies were compared between cases and controls, and statistical analyses were executed using SAS software (version 9.1, SAS Institute Inc., Cary, NC).
ResultsNo statistically significant differences were observed in the frequencies of ABCB1 genotypes and alleles between AS cases and the control group. In contrast, the recessive model (CC+CT/TT) (OR = 8.99 [11.97-40.99], p = 0.004) was significantly associated with the mixed form of the disease, while the heterozygous 3435CT genotype provided protection against the axial form. Moreover, a positive association was also found between the ABCB1 C3435T polymorphism and BMI (OR: 5.19 [1.41-19.9], p = 0.01).
ConclusionThis is the first study to explore the association of ABCB1 polymorphisms with susceptibility to ankylosing spondylitis in an Algerian population. It was determined that the ABCB1 C3435T SNP does not influence the risk of AS but rather affects the disease phenotype and body mass index (BMI).
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Prevalence and Impact of Selenium in Iron-deficiency Anemia: Insights from a Clinical Trial on Anemia Correction and Symptom Improvement
IntroductionIron-Deficiency Anemia (IDA) is a global burden affecting more than a billion individuals. It is most prevalent due to nutritional deficiencies. Researchers have linked Selenium (Se) to anemia and erythropoiesis.
AimThis interventional-study was designed to investigate the plasma Se concentration and its supplementation impact in IDA patients receiving standard treatment.
MethodologyIn the present study, a total of 215 IDA patients were enrolled from different departments of AIIMS, New Delhi, after getting ethical authorization from the Institutional-Ethical Committee. Iron supplements were administered to patients with only IDA, while a combination of iron and selenium supplements was given to patients with selenium-deficient IDA for 90 days. Parameters such as hemoglobin, hematocrit, RBC count, serum ferritin, transferrin, TIBC, and plasma Se levels were measured on the baseline and the 90th day.
ResultsAll blood parameters were significantly below the normal reference range on the 0th day. Se levels were found to be higher in the study population {57% (122/215) in IDA}. Further, in low plasma Se IDA patients 26% (55/215), treatment with iron and Se supplements for 90 days significantly improved all blood parameters and led to a subjective improvement of the patient’s well-being.
ConclusionSelenium levels are variable in patients with IDA, and no correlation can be drawn for the benefit of selenium in the IDA. Further, the high prevalence of nutrition-related disorders such as IDA highlights the need to avoid blind Se supplementation along with iron. These combination in the form of nutritional supplements having Se are rampantly available and sold over the counter. So, supplements with Se shouldn’t be generalized to IDA patients..
Clinical Trial Registration No.CTRI/2023/04/051405
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Prevalence of Gestational Diabetes in Metformin-Treated and Non-Treated PCOS Women: A Comparative Analysis
BackgroundPolycystic Ovary Syndrome (PCOS) is one of the most prevalent endocrinal disorders in the reproductive age of women and is, therefore, a risk factor for Gestational Diabetes Mellitus (GDM). One of the medications used in the management of PCOS is metformin and its use has been proposed to decrease the occurrence of GDM. The purpose of this study focuses on the effects of the dose and duration of metformin treatment on the prevalence of GDM among pregnant women affected by PCOS.
MethodsA cross-sectional survey was carried out on 112 pregnant women diagnosed with PCOS in tertiary care hospitals in Karachi. Data were collected through a structured questionnaire, in which 55 patients received metformin and others did not receive metformin. Both groups were compared for the prevalence of GDM. Chi-square test was used in data analysis at a significance level of p < 0. 05.
ResultsGDM was found to be significantly higher in non-metformin group than metformin group (60% vs 40%, P=0.03). The data analysis extended this finding, which concluded that metformin use is inversely related to GDM risk (p = 0.02).
ConclusionThis study shows that metformin therapy reduces the incidence of GDM in pregnant PCOS patients and may be used to prevent GDM in such patients. Such outcomes indicate the possibility of the use of metformin as a means of preventing GDM in this group of patients.
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Awareness, Pro-environmental Behaviours, and Strategies for Mitigation of Plastic Pollution among Nursing Students in the United Arab Emirates
Authors: Ramya Kundayi Ravi, Vimala Edwin, Fathima Abdul Rasheed and Aleena Mary JaisonBackgroundThe healthcare sector plays a significant role in the control and mitigation of plastic pollution-associated threats to the environment and human health.
AimThis study aimed to investigate the awareness, pro-environmental behaviors, and strategies for mitigating plastic pollution among nursing students.
MethodsA cross-sectional survey was conducted with 210 undergraduate nursing students using a structured questionnaire. Convenience sampling was used to recruit study participants. Data were analyzed using the Statistical Package for the Social Sciences version 26.
ResultsThe results of the study revealed that the majority of nursing students (71%) had moderately adequate levels of awareness regarding plastic pollution, whereas 70.48% of the students engaged in inadequate levels of pro-environmental behaviors.
ConclusionThe present findings demonstrate the necessity of reinforcing nursing students regarding the reduction of plastic pollution through specific policies and educational involvement. These measures would contribute to further initiatives and encouragement of their student period, future nursing practice, and patient safety at all levels.
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A Study on Bacterial Urinary Tract Infections, Antibiogram, and Antimicrobial Practices among Healthcare Providers in a Tertiary Care Facility in India
BackgroundGlobally, urinary tract infections (UTIs) have attracted the attention of clinicians and have become a serious public health threat. Management of UTIs has become a growing concern for clinicians due to increased antimicrobial resistance (AMR). The present study was conducted to identify the most diagnosed uropathogens causing UTIs among Inpatient Department (IPD) and Outpatient Department (OPD) patients visiting a tertiary care health centre and also to analyse the patterns of prescribed antibiotics based on physicians’ empirical and urine culture-based approach. Furthermore, this study sought to evaluate the sensitivity patterns of selected bacteria against antibiotics used to treat UTIs among patients.
MethodsThis study was undertaken for a period of three years at the Department of Medicine in collaboration with the Department of Microbiology. Mid-stream clean catch urine samples were collected from UTI suspects from both IPD and OPD patients and processed for culture and susceptibility testing as per standard guidelines. Univariate and bi-variate descriptive statistical techniques were used to analyse the data.
ResultsA total of 2400 urine samples were processed for culture and sensitivity testing, out of which 200 samples were found positive. Escherichia coli was the most frequently isolated urinary pathogen in both OPD and IPD patients (55.3% and 74.4%, respectively). Empirically, the most commonly prescribed antibiotic was piperacillin/tazobactam (13%), while the culture-based antibiotic was nitrofurantoin (20%). The findings highlight that more than 95% of isolates of the most prevalent uropathogen E. coli were sensitive to amikacin, ciprofloxacin, imipenem, and nitrofurantoin, whereas more than 90% were sensitive to ceftazidime, cefoperazone sulbactam, and piperacillin/tazobactam.
ConclusionIncreasing resistance to common antibiotics necessitates a reevaluation of both empirical and culture-based antibiotic approaches. The findings of this study are of significant importance and highlight the need to develop a targeted antibiogram for UTI, understand the trends in antimicrobial resistance (AMR), and ensure the rational selection and antibiogram both in empirical and culture-based approaches.
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Antimicrobial Resistance: Challenges and Innovative Solutions
Authors: Ibtsam Ghulam Nabi, Madiha Khan and Hira MubeenAntimicrobial Resistance (AMR) poses a critical threat to global health, contributing to increased morbidity, mortality, and substantial economic burden. This review highlights the profound clinical and financial consequences of infections caused by multidrug-resistant (MDR) bacteria. Of particular concern is the escalation of bacterial resistance linked to the indiscriminate use of antibiotics during the COVID-19 pandemic, which could lead to increased mortality rates. Additionally, this article emphasizes the significance of Antimicrobial Stewardship (AMS), which is a healthcare strategy aiming to encourage, develop, monitor, and assess the sensible use of antimicrobials in order to protect their long-term success. Consequently, it highlights the value and effects of an Antimicrobial Stewardship Program (ASP) in combating resistance and protecting global health.
Furthermore, the necessity of adopting a holistic “One Health” approach, an integrative, multisectoral strategy, is discussed as essential in addressing the growing AMR crisis. The review advocates for evidence-based policies that support the “One Health” framework, enhance immunization programs, educate healthcare professionals, and raise public awareness about AMR. This article provides a comprehensive overview of the scale, consequences, and potential solutions to AMR, urging collaborative efforts across sectors and stringent measures to combat this global health challenge.
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Incidental Gastric Adenomyoma during Bariatric Surgery: Diagnostic and Management Challenges - A Case Report
Authors: Pulimuttil James Zachariah and Rana SalehBackgroundIncidental gastric tumours, including benign gastric adenomyoma (GA) during bariatric surgery, can pose diagnostic and management dilemmas, resulting in misdiagnosis, inappropriate procedures, or even abandoning the procedure.
Case PresentationWe report a rare case of an incidental prepyloric GA discovered during a one-anastomosis gastric bypass performed for diabetes management. Preoperative gastroscopy was unremarkable, but intraoperative laparoscopy revealed a mass near the pylorus resembling a gastrointestinal stromal tumour (GIST). An initial histopathological examination was non-confirmatory. However, subsequently, it was confirmed to be a GA. The patient underwent a staged surgical approach, achieving diabetic control during the primary procedure and tumour excision subsequently. This is the first documented case of GA discovered during bariatric surgery.
ConclusionGastric tumours identified during bariatric procedures necessitate an individualized approach considering the procedure planned, tumour characteristics, and anatomical location, to achieve the best clinical outcomes.
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Digital Eye Strain: A Cross-sectional Study Among Undergraduate Medical Students in UAE
Authors: Sohaila Fatima, Raqshan Wajih Siddiqui and Tabish Wajih SiddiquiIntroductionDigital eye strain (DES), also known as computer vision syndrome (CVS), is a common condition affecting individuals who spend prolonged periods focusing on screens, leading to symptoms, such as dry eyes, eye strain, headaches, and blurred vision. University students, including medical students, increasingly spend more time staring at screens for study and research. Therefore, this study assesses the prevalence and impact of DES among medical students, a group increasingly dependent on digital resources for their studies.
MethodsThis cross-sectional study was conducted from November 2023 to February 2024 at RAK Medical and Health Sciences University, UAE. A sample of 209 undergraduate medical students was recruited using non-probability convenience sampling. The sample size was calculated based on a 95% confidence level and a ±5% margin of error, representing 46.4% of the eligible population. Data were collected through a validated electronic questionnaire and analyzed using SPSS version 29, employing descriptive and inferential statistics to explore associations between visual symptoms and factors, such as refractive errors, study duration, and ergonomic practices.
ResultsAmong respondents, 69.9% were female, with a mean age of 19.87 ± 1.58 years. The prevalence of myopia was 49.7%, while hypermetropia and astigmatism were reported at 2.9% and 6.7%, respectively. A striking 92.8% experienced at least one DES symptom, with tired eyes (71.3%) and eye strain (58.9%) being the most common symptoms. Significant correlations were observed, including dry eyes associated with myopia (p = 0.002) and difficulty refocusing linked to hypermetropia (p = 0.029). Ergonomic practices revealed that 80.4% of students used screens closer than recommended, which correlated with increased eye strain (p = 0.001) and tired eyes (p = 0.044). Moreover, adherence to the 20-20-20 rule was low (3.8%), associated with heightened symptoms.
ConclusionThis study highlights a high prevalence of DES symptoms among medical students, related to inadequate ergonomic practices. These findings emphasize the necessity for targeted interventions to enhance eye health and ergonomic awareness in this population. Future research should evaluate the effectiveness of such interventions.
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Attention-deficit/hyperactivity Disorder (ADHD) Prevalence among Students aged 7-12 Years Old
Authors: Armon Massoodi, Farzan Kheirkhah, Mojgan Rezvani and Mahdi SepidarkishBackgroundADHD (attention-deficit hyperactivity disorder) is a developmental disorder characterized by inattention and distractibility, as well as hyperactivity.
ObjectiveThis study investigated the prevalence of ADHD in male and female students of primary school in Babol (Iran).
MethodsThis study was a cross-sectional study. The studied population was school-aged children (7-12 years old) in the urban areas of Babol city. A total of 1469 primary school students were included in the study during 2021-2022. In this research, the Revised Conners' Parent Rating Scale (CPRS-R) was used to investigate ADHD disorder.
ResultsThe prevalence of ADHD in the present study was 9.9% (146 people). ADHD subgroups, in the order of prevalence, included mixed type (67 people, 4.6%), hyperactivity-impulsive type (43 people, 2.9%), and then inattentive type (36 people, 2.5%). ADHD prevalence among males and females was 13.4% and 7%, respectively. This was 1.9 times higher in male students than in female students. ADHD subgroups in male students, in order of prevalence, included mixed type (44 people, 50%), impulsive hyperactivity type (32 people, 36.36%), and inattentive type (12 people, 13.63%), and in female students, ADHD subgroups were inattentive type (24 people, 41.37%), mixed type (23 people, 39.65%), and hyperactivity-impulsive type (11 people, 18.96%). ADHD was seen mostly in students with illiterate parents (p≤0.001).
ConclusionIt seems that the prevalence of ADHD in children of elementary schools in Babol was not significantly different from the prevalence reported in other cities of Iran and globally.
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