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   Table of Contents - Current issue
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May-August 2022
Volume 11 | Issue 2
Page Nos. 83-158

Online since Monday, August 22, 2022

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REVIEW ARTICLE  

Recent update on treatment and preventive modalities for COVID-19 Omicron variant (B.1.1.529) in India: A comprehensive review p. 83
Deep Inder, Seema Manak, Md Faiz Akram, Pawan Kumar
DOI:10.4103/sjhs.sjhs_42_22  
In India, Omicron (B1.1.529), a variant of concern of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has challenged the existing drug treatments options and available vaccines. Extensive search has been done to review updated information through original research articles, meta-analysis, and case reports available at EMBASE, SCOPUS, and Google Scholar, for treatment and preventive strategies against Omicron. Excessive mutations in SARS-CoV-2 (Omicron) led to immune escape witnessed for monoclonal antibodies, leaving very limited drug options to treat Omicron infected patients. Protection offered by existing vaccines appeared as a matter of concern as far as efficacy against Omicron is concerned. Although vaccination will not prevent re-infection in actively and passively immunized individual, but will prevent serious respiratory illness and death. The current review article imparts knowledge regarding pharmacotherapeutic agents, showing promise against Omicron. The present review also highlights updated data on newer vaccine candidates for their safety and efficacy for Omicron, based on postmarketing surveillance and Phase III clinical trials across the globe. There is a need to generate more data on drugs as well as vaccines specifically targeting Omicron, in order to contain SARS-CoV-2 new variant.
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ORIGINAL ARTICLES Top

Parent's eyecare seeking behavior for young children in Saudi Arabia p. 91
Ashwaq Mohammed Almalki, Lina Hassan Raffa, Ayat Mohammed Aldosari, Roaya Ayed Alsulami
DOI:10.4103/sjhs.sjhs_35_22  
Background: In Saudi Arabia, school health services lack adequate vision screening. To date, limited data on access to eye care in young children in Saudi Arabia exist. Aim: This study aims to evaluate whether parents who reside in Saudi Arabia know how to access eye care for their young children, and what barriers might exist to prevent them from seeking care. Materials and Methods: A cross-sectional study among parents of children 14 years or younger who reside in Saudi Arabia was conducted using an online questionnaire. Results: A total of 1023 completed questionnaires were analyzed. Of all responses, the majority 57.9% (n = 592) of parents reported that vision screening did not take place in their children's schools. Over half of the parents (n = 522, 58.9%) reported that their children had never undergone an eye examination before. Most common reason to seek eye care would be for concerns over poor vision reported in 59.5% (n = 609). The most common barrier to accessing eye care was not knowing how to access an eye test in 33.9% (n = 347) followed by a quarter of parents citing other reasons (n = 258, 25.2%) such as having no concerns and no clear reason to have their child's eyes examined. Conclusion: Parents in Saudi Arabia have some concerns and challenges in seeking eye care for their young children. Planned awareness programs to educate parents and help them overcome the barriers that hinder them from seeking eye care for their children are recommended.
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Association between demographic, academic, and behavioral characteristics with physical activity levels among international students in China during COVID-19 pandemic p. 97
Willy Nivyimana, Rogious Mbasani, Djivoh Sènan Yollande, Zhou Daan, Claudette Bayumvire, Manyu Wang
DOI:10.4103/sjhs.sjhs_58_22  
Background: International students face multiple challenges due to cultural distance, cultural shock, social support, stress and anxiety, language barriers, and classroom transition. Moreover, the outbreak of COVID-19 complicated the living situation for international students. Physical activity (PA) can be a coping strategy in overcoming health challenges as it is known to have health benefits, improve socialization and integration skills. Aim: The study aimed to determine PA levels of international students in China during COVID-19 and analyze the associated characteristics. Setting and Design: A cross-sectional study was conducted among international students in China. Subjects and Methods: An online questionnaire that included demographic, academic, and behavioral characteristics together with International Physical Activity Questionnaire Short Form tool was used to collect the data. Statistical Analysis: Descriptive statistics, Chi-square test, and Mann–Whitney U test were employed to analyze the data. Results: One thousand and hundred and twenty international students were recruited into the study. 71.3% of the participants were engaged in low, 15% in moderate and 13.8% in high PA. PA of international students was associated with gender, body mass index, marital status, continent of origin, student residence, study language, time spent in China and alcohol consumption P < 0.01; academic level P < 0.05. However, there was no significant association of PA with age and smoking status P < 0.05. Conclusion: This study indicates a lower level of PA among international students in China. International education management may consider the promotion of PA as a good intervention to the health of international students during COVID-19.
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Active surveillance of adverse events following the first dose of COVID-19 vaccination – Oxford–AstraZeneca (Covishield) vaccine p. 104
Sangeetha Merrin Varghese, Grace Mary John, Geomcy George, Linda Jacob, Mammen Paul, Arun Sachu, Abel K Samuel Johnson, George Mateethra Chandy
DOI:10.4103/sjhs.sjhs_59_21  
Background: COVID-19 vaccines have been the most rapidly developed vaccines in history and consequently, fears of its safety and efficacy intrigue the minds of the common man. Aims: This study was intended to determine the adverse events following COVID-19 vaccination and thereby reduce vaccine hesitancy in the people. Methods and Materials: An active vaccine safety surveillance study was carried out on health-care workers of a tertiary care center in Central Kerala using a prestructured interview schedule documenting a description of adverse events following immunization (AEFI), time of occurrence, management and outcome of AEFI, knowledge about AEFIs, and fear of COVID-19 vaccination. A telephonic survey was carried out on 475 randomly selected COVID vaccine beneficiaries. Results: Overall, 86% of the participants reported at least one postvaccination symptom. Fever (51.8%), injection-site pain (46.9%), headache (29.3%), myalgia (28.4%), and fatigue/tiredness (25.1%) were the most common symptoms. None of the symptoms were severe/serious to warrant hospital admission. Side effects were more common in females (P = 0.003) and reactogenicity of the COVID-19 vaccine decreased with advancing age (P = 0.001). The vaccine did not have any difference in side effects among those who had previous COVID-19 infection. Conclusion: This study shows that COVID vaccines are safe in the Indian population and the side effects are similar to any other vaccine. It may help to dispel any fear and misinformation regarding COVID-19 vaccination and thus maximize the benefit of the nationwide immunization program.
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The preferences and practices regarding refractive surgeries among Saudi Ophthalmology Society members p. 110
Abdullhamid S AlGhamdi, Rahma A AlGethami, Nada Ahmad Almalki, Abdulrahman Mohammed Al-Amri, Ma'an Al-Barry
DOI:10.4103/sjhs.sjhs_81_22  
Background: Refractive errors are the leading cause of visual impairments in the Kingdom of Saudi Arabia (KSA). Laser refractive eye surgeries are getting huge popularity for correcting these visual impairments in KSA and other gulf countries. Aims: The study assessed the preferences and practices regarding refractive surgeries The preferences and practices regarding refractive surgeries among Saudi ophthalmology society members. Setting and Design: A cross-sectional study was conducted using an online questionnaire among the Saudi Ophthalmology Society members. Methods and Materials: The questionnaire was pilot tested and had 28 items that included sociodemographic details and practices related to refractive eye surgery of participating ophthalmologists. Statistical Analysis: The collected data was analyzed using Pearson's Chi-square test to determine the relationship between categorical variables. Results: Excimer laser platform EX500 (Alcon) was the most commonly used refractive surgery system. There were region-wise differences observed in the type of refractive surgery system where surgeons from Central KSA used AMARIS 1050 RS (SCHWIND) (83.4%) and AMARIS 500 (SCHWIND) (68.4%) comparatively more than other regions (P < 0.05). The majority of the eye surgeons (84.4%) used Pentacam comprehensive eye scanner preoperative screening, and corneal topography was the most commonly used preoperative examination method. Only 9.1% of the surgeons had refractive eye surgery on 75%–100% of their patients, and the most commonly preferred refractive eye surgery (RES) by the surgeons in our study was photorefractive keratectomy. Conclusion: The findings showed that refractive eye surgery trends are changing, and surgeons are shifting to more reliable techniques with fewer postsurgical complications.
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Serum copper, zinc, and copper − zinc ratio in children with malaria p. 119
Belinda Onosen Jimoh, Moyosoreoluwa Temiloluwa Fadipe, Mathias Abiodun Emokpae
DOI:10.4103/sjhs.sjhs_62_22  
Background: Nutrition is not only vital to reducing the risk of individual's susceptibility to malaria infection but enhances the prevention and treatment of disease. Nutrition can also modify the course of malaria infection, especially among children. Aims: The aim of this study was to determine the concentrations of copper, zinc, and copper − zinc ratio in children with malaria infection and correlate same with parasite density. Setting and Design: A cross-sectional study of malaria-infected children randomly recruited from two secondary health institutions in Benin City, Nigeria. Methods: A total of 200 malaria-infected children (age range 0.5–11 years, 113 (56.3%) males and 87 (43.7%) females were recruited in the study. Semi-structured questionnaire was used to collect the sociodemographic data. Blood sample was collected from each of the participants and malaria parasite density was determined using thick blood film. Serum zinc and copper were determined using atomic absorption spectrophotometry. Statistical Analysis Used: The categorical and continuous data were compared using the Chi-square, unpaired Student's-test, and analysis of variance, respectively. Results: Serum copper was significantly higher among malaria-infected children than nonmalaria infected children, while zinc was significantly lower in malaria-infected subjects than controls. The copper/zinc ratio was significantly higher in malaria infected than nonmalaria infected children. Serum copper and copper/zinc ratio correlated positively while zinc correlated negatively with malaria parasite density. Conclusion: The observed significantly higher copper and copper/zinc ratio and lower zinc level may indicate oxidative stress, inflammation, and lower immune status in malaria infection.
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A comparative evaluation of the antimicrobial effect of six natural products in comparison to 2.5% sodium hypochlorite against Enterococcus faecalis: An in vitro study p. 125
Jameel Abdulsalam Abuljadayel, Jamal Suhail Shafei, Mooayad A Fairaq, Ammar F Mirza, Abdulelah N Bin Samman, Asim A Abdulshakoor, Naif A Jalal, Sami S Ashgar, Hamdi Mustafa Al-Said
DOI:10.4103/sjhs.sjhs_149_21  
Background: Enterococcus faecalis (E. faecalis) is known to play a key role in the etiology of constant endodontic infections. Recently, suggestions of natural alternatives to overcome the downsides of sodium hypochlorite (NaOCl) have been discussed in the literature. Aims: The present study investigates the antibacterial effect and compares the bacteria-killing time of six possible natural alternatives in comparison to 2.5% NaOCl, namely net Manuka Honey (MaH), crude black seed oil (BSO), 100% apple vinegar (AV), castor oil, crude sesame oil, and a novel plant extract (Bactil®). Materials and Methods: Agar well-diffusion assay was used to determine the antibacterial effect of the products against E. faecalis. Muller‒Hinton broth (MH broth) was used to determine the minimum inhibitory concentration (MIC) and the minimum bactericidal concentrations (MBC). Time-kill assay was performed to investigate the killing time required by the tested product to inhibit E. faecalis at 30, 60, 90, and 120 s. Results: Four out of the six tested products (crude BSO, 0.2% Bactil®, 100% AV, and net MH) exhibited an antibacterial activity against E. faecalis. While after MBC and MIC determination, only two of the products (0.4% BSO and 0.2% Bactil®) were able to inhibit the growth of E. faecalis within 30 s of exposure similar to the positive control 2.5% NaOCl. Conclusion: Within the limitations of this study, both 0.4% BSO and 0.2% Bactil® were as effective as 2.5% NaOCl against E. faecalis and could be suggested for further testing as promising natural alternatives to disinfect the root canal system.
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Quality of life assessment and supportive management in a cancer outpatient setting in Saudi Arabia p. 131
Kim Sadler, Gassan Abudari, Ala Sami Sweilem, Musab Aldhari, Fahhad Motni AlShammari
DOI:10.4103/sjhs.sjhs_36_22  
Background: Despite improvement in treatment modalities, a cancer diagnosis and its related treatments continue to cause significant distress. Aims: This study analyzed the prevalence of common symptoms, as well as the influence of various sociodemographic, clinical, and treatment characteristics on the quality of life (QoL). Methods and Materials: Data were gathered through the administration of the Quality of life questionnaire (QLQ-C30) from the European Organization for Research and Treatment of Cancer Patients (EORTC) to a Saudi adult population receiving treatments. Statistical Analysis: Data were analyzed using t test, one way analysis of variance (ANOVA), Pearson's correlation test and linear regression analysis. Results: Four hundred patients (median age = 48) were surveyed (women = 58.5%). More than half had breast or gastrointestinal cancer. The Global QoL score was 71.1 with a 95% confidence interval (68.9–73.3). The lowest functional scale was Physical (69.8%). The most prevalent symptoms were fatigue (40.6%) and insomnia (39.1%). Men showed a higher emotional (P = 0.048) and cognitive (P = 0.013) functioning. Married patients reported better physical (P = 0.027) and cognitive (P = 0.004) functioning. Education was associated with better physical functioning (P = 0.003). More financial stress was present when caring for children (P = 0.017), living alone (P = 0.01), and living outside the treatment region (P = 0.001). Gaps were found between reported symptoms and provided treatments, especially for pain, constipation, and insomnia. Palliative care was involved in 7.5% of cases and mostly when higher levels of fatigue (P = 0.002), pain (P = 0.001), dyspnea (P = 0.05), and lower functioning were present. Conclusion: Significant differences were found according to sociodemographic, clinical, and treatment patients' characteristics, as well as significant gaps between reported symptoms and management plans in place. This study showed that various factors can influence the QoL and this knowledge can enable the provision of better support to maintain the QoL.
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Nursing students' experiences with blackboard p. 139
Ahmed Saleh Alkarani
DOI:10.4103/sjhs.sjhs_55_22  
Background: The coronavirus disease 2019 pandemic has overwhelmed the nursing workforce through tremendous pressure worldwide. Therefore, the Ministry of Education in many countries had transferred the education system to virtual learning. Thus, blackboard is currently the main tool for delivering education and enabling the interactions between teachers and students. Aims: The aim of this study is to explore nursing students' challenges in using Blackboard, and to explore the advantages and disadvantages of using blackboard among nursing students. Settings and Design: This study used a descriptive qualitative study design. The study collected eleven nursing students. Subjects and Methods: In-depth individual semi-structured interviews were used. Statistical Analysis: The data were analyzed using thematic analysis. Results: The results identified four themes: high student satisfaction in using backboard; the positive impact of using Blackboard; learning obstacles through using blackboard; and students' desire for in-class education instead of the blackboard platform. Conclusion: Blackboard, through its current characteristics and features, makes education easy and available to all students. However, students do not prefer blackboard in practical nursing subjects.
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Umbilical granulomas and umbilical polyps: Comparative evaluation with silver nitrate cauterization and surgical excision p. 145
Rahul Gupta, Shyam Bihari Sharma, Ram Babu Goyal
DOI:10.4103/sjhs.sjhs_34_22  
Background: Umbilical granuloma (UG) and umbilical polyps (UPs) are the most common umbilical abnormalities in neonates, causing inflammation and drainage. Aims: The aim of this study was to compare the effectiveness of the technique of silver nitrate cauterization and surgical excision on both UG and UP in pediatric patients. Settings and Design: A prospective study on UG and UP was carried out in a high-volume tertiary care teaching institute from January 2015 to December 2020. Materials and Methods: The patients were randomly distributed by chit method into two groups: Group A treated with surgical excision and Group B treated with silver nitrate cauterization. Statistical Analysis: The unpaired Student's t-test was used to find the existence of any statistical significance between the parameters of the two groups. Results: There were 105 patients with 59 males and 46 females. There were 70 patients in Group A and 35 in Group B. Most of the patients in both Group A and Group B were between >1 and 3 months of age group. Blood mixed umbilical discharge was the most common complaint. There was complete resolution of symptoms in 100% of patients in Group A. In Group B, success with first attempt with cauterization was achieved in 20 (57.14%) patients and 12 (34.29%) patients after the second attempt. In Group B, successful management was achieved in 2 (5.71%) patients after the third attempt combined with double ligation. In 1 (2.86%) patient, there was an incomplete response to cauterization. Minimal perilesional burn (in the umbilicus) was observed in four cases, two each in the UG and UP groups. Conclusions: The technique of silver nitrate cauterization for both UG and UP is a simple, less expensive, and safe procedure in experienced hands. Most patients show complete responses at the first attempt. In others, complete resolution is accomplished at the second or third attempt. Surgical excision should be performed in cases with an incomplete response and larger lesions.
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CASE REPORTS Top

Great saphenous vein suppurative thrombophlebitis due to Fusobacterium necrophorum infection p. 152
Abduallah Mawkili
DOI:10.4103/sjhs.sjhs_67_22  
Fusobacterium necrophorum (F. necrophorum) is an anaerobic Gram-negative bacterium which does not form spores. F. necrophorum is usually associated with Lemierre's syndrome. The syndrome is characterized by thrombosis of the internal jugular vein with septicemia followed by oropharyngeal infection. In the present case report, a 27-year-old male with a significant medical history of intravenous drug use was presented in the emergency department. The patient presented a 3-day history of left lower extremity pain, redness, and swelling. His serological tests were positive for hepatitis C infection. The Duplex ultrasound (US) of the left lower extremity revealed extensive suppurative thrombophlebitis. The blood culture grew F. necrophorum, thus the patient was treated with IV ampicillin for 2 weeks, followed by additional 2 weeks of oral amoxicillin. At follow-up, 3 weeks later, the patient reported significant improvement in his symptoms. Three months later, lower extremity duplex in the US revealed resolving suppurative thrombophlebitis.
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Respiratory epithelial adenomatoid hamartoma – A neglected entity in the nasal cavity p. 155
Tejas Prasad Vidwans, Abhay Vilas Deshmukh, Vitaladevuni Balasubramanyam Shivkumar
DOI:10.4103/sjhs.sjhs_49_22  
Respiratory epithelial adenomatoid hamartoma (REAH) is a rare subtype of hamartoma which consist of the proliferation of glandular spaces and is lined by ciliated epithelium or goblet cells. Here, we report the case of REAH in a 45-year-old male who presented with bilateral nasal blockage in the past 1 year. The bilateral polypoidal nasal mass was excised. Microscopically, the proliferation of glandular spaces lined by ciliated epithelium and goblet cells and thickened eosinophilic basement membrane was seen. Immunohistochemistry showed positivity for pancytokeratin. One should always consider REAH as one of the differential diagnoses of a symptomatic polypoidal sinonasal mass.
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