Annals of the National Academy of Medical Sciences India最新文献

{"title":"Acceptance of COVID-19 Vaccination in India, after First Phase-Out: A Cross-Sectional Community-Based Study","authors":"N. Shukla, M. Agarwal, A. Khanna, A. C. Shukla, Anila Varghese","doi":"10.1055/s-0042-1743136","DOIUrl":"https://doi.org/10.1055/s-0042-1743136","url":null,"abstract":"\u0000 Background India rolled out the world's largest vaccination program on January 16, 2021, marking the beginning of an effort to vaccinate a population of 1.3 billion against coronavirus disease 2019 (COVID-19) infection. However, the hesitancy toward safe and effective vaccine against severe infection is a major global health threat. Hence, public acceptance of COVID-19 vaccine would be an essential deterrent to the pandemic control.\u0000 Materials and Methods A cross-sectional online study was conducted among the Indians from January 1 to January 31, 2021. The online questionnaire addressed several variables, including the sociodemographic parameters, COVID-19 vaccine acceptance, and concerns regarding COVID-19 vaccine.\u0000 Results Out of total 450 participants, majority of them (97.1) were aware about the COVID-19 vaccination drive. Only 66.2% showed their willingness to accept vaccination, 26.0% were still indecisive, and 7.8% did not want to accept it.\u0000 Conclusion Despite numerous efforts by various scientific organizations, public health experts, and media outlets, to educate the general population about the COVID-19 vaccine, significant portion of the Indian population may experience vaccine hesitancy, which poses dangers to both the individual and their community. Therefore, we must target these potential candidates, who are indecisive, for intervention to increase vaccine acceptance across the country. In this regard, large-scale study is required to understand the knowledge, expectation, and apprehension covering various economic and occupational strata of the society.","PeriodicalId":53332,"journal":{"name":"Annals of the National Academy of Medical Sciences India","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44762534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Best Practice Guidelines for Breast Imaging, Breast Imaging Society, India","authors":"S. Chakrabarthi, Shikha Panwar, Tulika Singh, S. Lad, J. Srikala, N. Khandelwal, S. Misra, S. Thulkar","doi":"10.1055/s-0042-1742586","DOIUrl":"https://doi.org/10.1055/s-0042-1742586","url":null,"abstract":"Breast imaging is one of the prerequisites for providing high-quality breast health care. Choosing the appropriate investigation is central to diagnosing breast disease or the absence of it in women and men who present to health professionals for treatment. Patients with breast disease present to doctors of different subspecialties as well as general practitioners in our country. It is important therefore to provide uniform guidance to doctors in different health care setups of our country, urban and rural, government and private, for breast diseases to be diagnosed and treated optimally. These guidelines framed by the task group set up by the Breast Imaging Society, India have been formulated focusing primarily on the Indian patients and health care infrastructures. These guidelines aim to provide a framework for the referring doctors and practicing radiologists, to enable them to choose the appropriate investigation for patients with breast symptoms and signs. The guidelines encompass all aspects of breast imaging including mammography, breast ultrasound, breast magnetic resonance imaging, as well as breast interventions. Algorithms for investigation of specific common breast symptoms and signs have been provided in this document. The aim has been to keep this framework simple and practical so that it can guide not only subspecialists in breast care but also help doctors who do not routinely deal with breast diseases, so that breast cancer is not missed. Breast screening is an integral part of breast imaging and guidelines for the same have been incorporated in this document. In the absence of a population-based screening program in India, the guidelines to be followed for those women who wish to be screened by mammography have been provided. Overall, the aim of this document is to provide a holistic approach to standardize breast care imaging services in India.","PeriodicalId":53332,"journal":{"name":"Annals of the National Academy of Medical Sciences India","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43702784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"External Limiting Membrane, Photoreceptor Ellipsoid Zone Disruption, and Retinal Pigment Epithelium Alterations in Diabetic Retinopathy","authors":"Nibha Mishra, Gurkiran Kaur, S. Saxena","doi":"10.1055/s-0042-1742585","DOIUrl":"https://doi.org/10.1055/s-0042-1742585","url":null,"abstract":"Abstract Objective  Diabetic retinopathy (DR), a microvascular complication of diabetes, is a leading cause of preventable blindness. Spectral domain optical coherence tomography (SD-OCT) provides cross-sectional and topographical imaging of the retina. SD-OCT resolves outer retinal layers into three hyperreflective bands—external limiting membrane (ELM), ellipsoid zone (EZ), and retinal pigment epithelium (RPE). In this article, we have studied the role of these outer retinal layers in structural and molecular changes taking place in DR. Materials and Methods  Articles with clinical features, pathogenesis, diagnosis, and treatment of DR were thoroughly studied. Articles were searched on PubMed, MEDLINE, and Cochrane Library from 2000 to 2020. Studies focusing on the role of ELM, EZ, and RPE in pathogenesis of DR based on SD-OCT were included. Results  The long-standing hyperglycemia leads to protein glycosylation resulting in formation of advanced glycation end products (AGEs). AGEs have an impact through their effect on retinal microvasculature, vascular endothelial growth factor (VEGF), intercellular adhesion molecule-1, nitrosative and oxidative stress, and vitamin D and calcium metabolism. All these factors have been linked with disruption of outer retinal layers. AGEs lead to vascular endothelial dysfunction and release of proangiogenic factors by increasing the expression of VEGF in retinal pericytes and RPE cells. This leads to leakage and fluid accumulation resulting in diabetic macular edema (DME). In DME, there is sequential disruption of ELM and EZ and decrease in visual acuity (VA). The RPE alterations have been reported to be associated with the severity of DR and decrease in VA. Anti-VEGF therapy, most common treatment of DME, leads to restoration of barrier effect of ELM, it was found to be restored first followed by EZ restoration. Newer anti-AGEs agents and their receptor blockers are being developed which have a positive effect on maintaining the health of RPE. Conclusion  A complex molecular association exists between the structural changes in ELM, EZ, and RPE in DR. SD-OCT is an indispensable tool to study these changes as integrity of these outer layers of retina is essential for maintaining visual function of retina in DR.","PeriodicalId":53332,"journal":{"name":"Annals of the National Academy of Medical Sciences India","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42325941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Latent Autoimmune Diabetes in Adult Based on the Presence of GAD 65 Antibodies in North-Eastern Uttar Pradesh, India","authors":"H. Sangma, Anshul Singh, A. Srivastava, V. Misra","doi":"10.1055/s-0041-1741063","DOIUrl":"https://doi.org/10.1055/s-0041-1741063","url":null,"abstract":"Abstract Objective The objective of this paper was (1) to study the prevalence of latent autoimmune diabetes in adult (LADA) in the region of north-eastern Uttar Pradesh, India, based on the positivity for glutamic acid decarboxylase 65 (GAD65) antibodies and (2) to compare the glycemic profile between GAD65-positive and GAD65-negative subjects. Materials and Methods The subjects were of more than 30 years of age, with either recently diagnosed pre-diabetes/diabetes presenting with the hemoglobin A1c (HbA1c) level of ≥5.7% or already diagnosed cases of type 2 diabetes mellitus (T2DM) who had no requirement of insulin therapy for at least 6 months from the time of their diagnosis. All the patients were natives of north-eastern Uttar Pradesh. The GAD65 test was done by the enzyme-linked immunosorbent assay. Further, the glycemic status of GAD-positive and GAD-negative subjects were compared on the basis of fasting blood sugar (FBS), fasting insulin (FI), and homeostatic model assessment for insulin resistance (HOMA-IR). Statistical Analysis The “unpaired t-test” was used to compare and assess the significance of differences between the glycemic profile of GAD65-positive and GAD65-negative subjects using the GraphPad Prism Scientific Software, San Diego, CA, United States. The p-value of <0.05 was considered to be significant. Results A total of 77 patients were included in the study, with the age group ranging from 30 to 75 years (47.81 ± 12.9 years) with the male–female ratio of 1:2.6. The prevalence of LADA was found to be 51.95%. On comparing GAD65-positive and GAD65-negative groups, a higher value of HbA1c levels and FBS were found in the former, whereas FI and HOMA-IR were found to be higher in the latter. On testing for significance of difference, only FI and HbA1c values were significant (p-value <0.0001). Conclusion LADA can no longer be considered a rare type of diabetes mellitus, with the present study showing a high prevalence of LADA in this north eastern region of Uttar Pradesh. Identification of adult-onset diabetics accurately as LADA or true T2DM is very crucial for the appropriate treatment, as LADA patients require insulin inevitably and much earlier than true T2DM patients, who can be managed mostly on oral hypoglycemic agents with seldom requirement of insulin.","PeriodicalId":53332,"journal":{"name":"Annals of the National Academy of Medical Sciences India","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46071885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Difference in Antihypertensive Medication Pattern in the First Year Compared to More than a Year of Maintenance Hemodialysis: A Northern India Tertiary Care Experience","authors":"A. Chandra, N. Rao, D. Srivastava, Prabhaker Mishra","doi":"10.1055/s-0041-1742140","DOIUrl":"https://doi.org/10.1055/s-0041-1742140","url":null,"abstract":"Abstract Introduction There is a high prevalence of hypertension in maintenance hemodialysis patients. Information regarding prevalent pattern of antihypertensive medications will help modify it to prevent future cardiovascular morbidity and mortality. Materials and Methods In this cross-sectional study, patients on maintenance hemodialysis, aged ≥18 years visiting Nephrology outpatient department (OPD) from April 2019 to May 2020 were included. The patients were divided into two groups based on their dialysis vintage, ≤12 months and >12 months. Their antihypertensive medication patterns and two-dimensional (2D) echocardiography (ECHO) findings were compared. Independent t-test was used to compare continuous variables. One-way analysis of variance was used to study the antihypertensive drug-dosing pattern in both the groups. Results Out of 250 patients, 131 had a dialysis vintage of ≤12 months, whereas 119 had a vintage of >12 months. There was no significant difference in the number of antihypertensive agents used in either of the vintage groups. Calcium channel blockers (87.02 and 89.07%, respectively, in ≤12 and >12 months' vintage groups) and β blockers (64.12 and 65.54%, respectively, in ≤12 and >12 months' vintage groups) were the commonly used antihypertensive agents. Metoprolol use was higher in ≤12 months' group, whereas carvedilol usage was higher in >12 months' group (p = 0.028). Mean pill burden was more than five in both the groups. Concentric left ventricular hypertrophy was significantly more common in >12 months' group. Renin–angiotensin system (RAS) blocking agent use was limited to 3% of patients. Conclusion This study shows a high antihypertensive pill burden in dialysis patients likely due to underlying chronic volume overload in addition to the perceived efficacy of certain class of drug in a frequent dosing pattern. Low use of RAS blocking agent was also underlined. This study highlights the need to bring about changes in the antihypertensive prescription pattern in line with the existing evidence.","PeriodicalId":53332,"journal":{"name":"Annals of the National Academy of Medical Sciences India","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48227664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opinions, Attitudes, and Prescribing Practices of Oral Contraceptive Pills of General Practitioners and Gynecologists in India","authors":"Sandeep Kumar, Varsha Dwivedi, Y. Pradeep, Abhijeet Pakhare, G. G. Agrawal, A. Saksena, Vishwajeet Kumar","doi":"10.1055/s-0041-1740924","DOIUrl":"https://doi.org/10.1055/s-0041-1740924","url":null,"abstract":"\u0000 Background Prescribing behavior of oral contraceptive pills (OCPs) by physicians, gynecologists, and alternative medicine practitioners (AMPs).\u0000 Materials and Methods Close-ended questionnaire-based cross-section study was performed between 1st September 2012 and 28th February 2014 in three groups of responders, i.e., AMP, general medical practitioners (GMPs), and obstetricians and gynecologists (ObGy). A stratified random cluster sample was used. Data of 400 subjects in all three groups were obtained using both univariate and multi-variate sophisticated statistical analyses for analyzing attitude and practices and were recorded on an ordinal scale using appropriate non-parametric test.\u0000 Results Of the 1,237 subjects surveyed, 400 completed questionnaires were received from each of the three groups viz; AMPs, GMPs, and ObGy. Remaining 37 incomplete questionnaires were not included in the final analysis.\u0000 Conclusion There are equal misconceptions regarding OCPs among users and prescribing physicians. Preference for OCPs in married and unmarried women is also equally low. OCP usage and their prescription practices can be improved by removing potential barriers, developing public–private partnership, and training promoters.","PeriodicalId":53332,"journal":{"name":"Annals of the National Academy of Medical Sciences India","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47791554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obesity, A Risk Factor for Mortality in SARS CoV-2 Infection: A Narrative Systematic Review","authors":"S. Reddy, M. Ganie, P. Koul, Tajali Sahar, Shaista Showkat","doi":"10.1055/s-0041-1736506","DOIUrl":"https://doi.org/10.1055/s-0041-1736506","url":null,"abstract":"Abstract SARS CoV-2 is a β-coronavirus responsible for the current COVID-19 pandemic. Although there is increase severity and mortality described in the elderly population and people with co-morbidities, all age groups are susceptible to COVID-19. Recent data showed that obesity has also emerged as a significant risk factor for COVID-19 mortality. As per the WHO, most of the world's population lives in countries where obesity is highly prevalent. In this context, we aimed to review various studies that showed obesity as an independent risk factor for mortality in SARS CoV-2 infection. We followed the PRISMA guidelines to search for two databases including PubMed and Google Scholar using the key terms “COVID-19, OBES* and MORTALITY,” SARS CoV-2, OBES* and MORTALITY” “COVID-19, OBESITY, and MORTALITY,” SARS Cov-2, OBESITY and MORTALITY,” respectively, up to August 3, 2020. Twelve studies were finally included in this review after applying inclusion and exclusion criteria. All 12 studies included in the review consistently showed that obesity is a risk factor for mortality in patients with SARS CoV-2 infection. These studies have also shown evidence that obesity leads to increased hospitalization, ICU admission, increased need for mechanical ventilation, and poor prognosis among patients with SARS CoV-2 infection. Obesity is an independent risk factor for mortality in patients infected with this novel coronavirus. Appropriate triage, monitoring, and vigilance are required while dealing with individuals with obesity with SARS CoV2 infection, especially in the young obese population. More epidemiological studies need to be done taking BMI also into consideration in COVID-19 patients to find the exact cause of increased severity and mortality and develop appropriate preventive and therapeutic strategies.","PeriodicalId":53332,"journal":{"name":"Annals of the National Academy of Medical Sciences India","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44222673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 Pandemic: Perspective on Medical Professionalism","authors":"H. Sra, Meenu Singh, K. Talwar","doi":"10.1055/s-0041-1736507","DOIUrl":"https://doi.org/10.1055/s-0041-1736507","url":null,"abstract":"COVID-19 has disrupted the life of millions with frontline healthcare workers being at the greatest brunt of this pandemic. The second wave of the COVID-19 pandemic has crippled India enormously. It caught the entire country unprepared with daily numbers and deaths soaring record high. In this perilous predicament, doctors and nurses have tried their hardest to deliver the best possible treatment to those affected with the disease. In the absence of any effective medication and a highly infectious behavior of the virus, many healthworkers got infected and even lost their precious lives. Going by the numbers given by the Indian Medical Association, more than 500 doctors have lost their lives to this deadly virus in the secondwave andmore than700during the first wave.1 Many doctors and other health professionals have faced mental stress and fear of passing on the disease to familymemberswhile goingback homefromduties.However, this was a testing time for all of us as wewere fighting against an unknown enemywhile doing the sacred duty in the service of society. Doctors and nurses are frontline warriors in this struggle; hence, some casualtieswere expected. Our physician friendswho lost their lives in this strugglewill be remembered for their sacrifices. This pandemic has taught us many lessons and exposed the weakness of our health system. We not only need adequate infrastructure but also competent professionals. The quality of training and development of specialities is the need of the time. We have very few critical care specialists and infectious disease specialists in the country. Similarly, the number of trained nurses in the ICU care is limited. The medical profession needs serious reforms. The long duration and lack of opportunities for professional growth has seriously affected the attraction to join this profession. Presently, it is no longer the preferred career attraction amongst the bright students. The society cannot afford to have their health care needs in the hands of mediocre students. This pandemic has taught that health profession needs dedicated bright brains with excellent training to handle serious health issues. The importance of having public health specialists to handle such health crisis has been amply realized. Hope, the new NMC addresses these issues to ensure quality training, development of new desired medical disciplines and ensure adequate opportunities. Another lessonwe learnt during this pandemic is having adequate resources for providing adequate infrastructure and facilities to health professionals. Problems concerning the (re)allocation of scant medical services are pervasive, with healthcare professionals not only fighting to combat the virus, but also limiting accessibility and the grade of treatment for several other patients, presenting underlying ethical considerations of equality and equity.2 Guidance control (capacity to complete a planned activity) and regulatory discretion (capacity to select amongst opti","PeriodicalId":53332,"journal":{"name":"Annals of the National Academy of Medical Sciences India","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48948771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leprosy Masquerading as Tinea Faciale","authors":"M. Daroach, Hitesh Bhallavi, T. Narang","doi":"10.1055/s-0041-1736508","DOIUrl":"https://doi.org/10.1055/s-0041-1736508","url":null,"abstract":"","PeriodicalId":53332,"journal":{"name":"Annals of the National Academy of Medical Sciences India","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49129251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical Schools in National Capital Territory—A Historical and Functional Perspective","authors":"S. Dwivedi, A. Aggarwal","doi":"10.1055/s-0041-1736505","DOIUrl":"https://doi.org/10.1055/s-0041-1736505","url":null,"abstract":"Abstract Establishment of a medical school is predominantly a political decision. Its basic aim is to further the cause of medical education. Inbuilt within this objective is looking after sick people, bringing improvement in their health, and indirectly improving their understanding of health. Delhi, being the capital city of the country, is governed by the state as well central authorities, thereby enjoying dual benefits. Currently, it has some 10 medical schools/institutes with the objectives of providing quality medical education, research and health to its people. Notably, each one has its own historical legacy and distinctive character, as evident in their respective names, logo, motto and mission statement. This article briefly discusses the historical, socioeconomic, geopolitical, and distinctive characters of each of these institutions.","PeriodicalId":53332,"journal":{"name":"Annals of the National Academy of Medical Sciences India","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46310271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}