Publications by authors named "Archana Kumari"

102 Publications

Weight management in postpartum women - An Indian perspective.

Diabetes Metab Syndr 2021 Sep 20;15(6):102291. Epub 2021 Sep 20.

Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.

Background And Aims: This narrative review is intended to present an evidence and opinion-based weight management module for Indian postpartum women to be used by clinicians.

Material And Methods: Electronic databases such as PubMed and Google Scholar were accessed to extract relevant studies to derive evidence-based information. The reference list of the extracted studies was also checked to obtain further relevant articles. The opinion-based information was achieved from the consensus among the gynaecologists, nutritionists and doctors from Medicine according to their practical experiences in real time. In this review, we have used the term "postpartum" to represent the time period of two years after delivery.

Results: A postpartum weight management module consisting of information about diet, physical activity, sleep and breastfeeding was devised to be used in regular clinical practice, particularly in the Indian settings.

Conclusion: Postpartum women deal with various unique challenges as compared to other population groups. Individualised weight management strategies should be adopted to facilitate sustainable postpartum weight management.
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http://dx.doi.org/10.1016/j.dsx.2021.102291DOI Listing
September 2021

Defensive capabilities of contrasting sorghum genotypes against Atherigona soccata (Rondani) infestation.

Protoplasma 2021 Sep 22. Epub 2021 Sep 22.

Department of Vegetable Crops, Punjab Agricultural University, Ludhiana, 141004, India.

Plants are equipped with a wide range of defensive mechanisms such as morphophysiological, biochemical, molecular, and hormonal signaling for protecting against insect-pest infestation. The infestation of a devastating pest shoot fly [Atherigona soccata (Rodani)] at seedling stage causes huge loss of sorghum crop productivity. In morphophysiological screening ICSV700, ICSV705, and IS18551 have been categorized as resistant, PSC-4 moderately resistant, SL-44 and SWARNA as susceptible. The present study focused on the role of defensive gene expression and its products viz: superoxide dismutase (SOD), catalase (CAT), ascorbate peroxidase (APX), glutathione reductase (GR), polyphenol oxidase (PPO), phenyl alanine ammonia lyase (PAL), responsive enzymes, and metabolites restoring redox status in sorghum plants against shoot fly infestation. In both leaf and stem tissue of sorghum genotypes, shoot fly infestation induced SOD, APX, DHAR, GR, PAL, and PPO activities while CAT activity was significantly declined at 15 and 21 days after emergence (DAE). IS18551 with resistant behavior showed upregulation of SOD, GR, APX, and DHAR along with accumulation of ascorbate, glutathione enhancing redox status of the plant during shoot fly infestation at later stage of infestation. While SWARNA with susceptible response exhibited enhanced activity of phenylpropanoid pathway enzymes PAL and PPO which in turn increased the levels of secondary metabolites like o-dihydroxyphenol and other phenols deterring the insect to attack the plant. The qRT-PCR data predicted that stress-responsive genes were initially unregulated in SWARNA; however, at 21 DAE, multifold higher expression of SOD, CAT, APX, and PPO (24.8-, 37.2-, 21.7-, and 17.9-fold respectively) in 1S18551 indicates the resistance behavior of this genotype against insect infestation owing to sustainable development capability.
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http://dx.doi.org/10.1007/s00709-021-01703-4DOI Listing
September 2021

Predictors of Breastfeeding Initiation Among Postnatal Mothers at Tertiary Care Center of a Tribal Dominant State in India: A Regression Analysis.

Cureus 2021 Aug 6;13(8):e16936. Epub 2021 Aug 6.

Preventive and Social Medicine, Rajendra Institute of Medical Sciences, Ranchi, IND.

Background Early initiation of breastfeeding (EIBF) is one of the most important predictors for the survival of a child, spacing between two children, and prevention from childhood infections. Breastfeeding plays an important role in reducing child mortality and morbidity but the practice of EIBF globally is way behind the required time for initiation of breastfeeding after delivery. So, we planned to evaluate the early time of initiation of breastfeeding among the postnatal mothers and to determine the predictors of early initiation of breastfeeding in a tertiary hospital setting. Methodology A hospital-based cross-sectional study was conducted in the postnatal ward of Rajendra Institute of Medical Sciences (RIMS), Ranchi, Jharkhand for a period of three months (March-May 2017). Our study included 200 postnatal mothers who delivered normal and healthy babies. Mother-infant dyads enrolled in our study were interviewed personally during six hours of the postpartum period. Irrespective of the mode of delivery, all babies born during the study period whose mothers consented to be a part of the study were included. Data collected were entered in MS Excel and analyzed using IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp. Results A total of 200 postnatal mothers fulfilling the study criteria were enrolled during the study. Of them, the majority 98 (49%) belonged to the age group 18-25 years. A hundred and twenty-six (63%) of them resided in rural areas, 182 (91%) were housewives, and only 86 (43%) of them had completed secondary education & above. Early initiation of breastfeeding was found to be only 43 (21.5%) among postnatal mothers. Predictors found to be statistically significant with EIBF were mother's residential status [odds ratio (OR): 2.98; 95% confidence interval (CI): 1.25-7.13], educational status of mother (OR: 3.18; 95% CI: 1.12-9.01) mode of delivery of the baby (OR: 8.93; 95% CI: 2.66-30.06) and ante-natal care (ANC) visits (OR: 0.441; 95% CI: 0.311-0.651). Women's age, religion, ethnicity, occupation, type of family, and socioeconomic status displayed no statistically significant relationship with EIBF. Conclusions It is concluded that nearly one-fifth of mothers in the study initiated breastfeeding within one hour of post-delivery. Maternal education, frequent ANC visits, place of residence, and mode of delivery were also associated with EIBF in India. Nursing staff, as well as clinicians, should reinforce the importance of early initiation of breastfeeding by providing proper health education to post-natal beneficiaries.
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http://dx.doi.org/10.7759/cureus.16936DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8418779PMC
August 2021

Assessment of White Spots with Quantitative Light-Induced Fluorescence in Patients Undergoing Fixed Orthodontics.

J Pharm Bioallied Sci 2021 Jun 5;13(Suppl 1):S312-S314. Epub 2021 Jun 5.

Department of Prosthodontics and Crown and Bridge, Awadh Dental College, Jamshedpur, Jharkhand, India.

Background: The present study determined white spots with the help of quantitative light-induced fluorescence (QLF) in patients undergoing fixed orthodontics.

Materials And Methods: Sixty-four patients undergoing fixed orthodontics above 12 years underwent debonding, and the presence of carious lesion was assessed at baseline and after 6 weeks, 6 months, and 2 years. QLF images were taken with intraoral fluorescence camera. QLF images were examined visually for signs of demineralization, and scoring system was used.

Results: It is found that there was fluorescence loss over a period of time. The median sum of fluorescence loss per patient was 55.6% and 29.2% and 101.4% at quartiles at baseline which changed to 51.2% and 26.5% at the first quartile and 101.4% at the second quartile. At 2 years, it was 43.7% and at the first quartile was 22.1% and at the second quartile was 99.1%. There was significant improvement at T2 ( < 0.05), however, between baseline and F1 and between F1 and F2, there was nonsignificant improvement ( > 0.05). The median value for total lesion area per patient was 3.6 mm with quartiles 1.2 mm and 8.2 mm at baseline, 2.6 mm with quartiles 0.7 mm and 6.3 mm at 6 weeks, 2.3 mm with quartiles 0.7 mm and 6.3 mm at 6 months, and 1.8 mm with quartiles 0.5 mm and 5.8 mm at 2 years which was statistically significant ( < 0.05).

Conclusion: The authors found that white spots during fixed orthodontic treatment and after debonding is a common phenomenon. Although there was improvement in disappearance of these lesions, complete removal cannot be ensured.
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http://dx.doi.org/10.4103/jpbs.JPBS_812_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8375892PMC
June 2021

Evaluation of Preoperative Salivary Cortisol Level in Patients Undergoing Major Maxillofacial Surgery.

J Pharm Bioallied Sci 2021 Jun 5;13(Suppl 1):S120-S123. Epub 2021 Jun 5.

Private Practitioner, Patna, Bihar, India.

Aim: The main purpose of the study was to compare the preoperative salivary cortisol levels 3 days before the major surgery under general anesthesia and to compare it with the patients undergoing extraction under local anesthesia.

Materials And Methods: Forty-two patients were undergoing major surgery and 42 age- and sex-matched patients undergoing dental extraction were included and their salivary cortisol levels were analyzed before and after the dental procedure.

Results: Results showed that there is a significant increase in the mean salivary cortisol concentration after extraction (23.7 ± 9.2) than before extraction (18.9 ± 23.7) in the study group ( = 0.015) as well as in the control group. The comparison between salivary cortisol in the study group before (18.9 ± 23.7) and after (23.7 ± 9.2) surgery was significantly higher than the control group (15.2 ± 5.5) ( = 0.013 and 0.005), respectively.

Conclusion: We have concluded from this study that the salivary cortisol level shows a significant increase on the day of surgery.
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http://dx.doi.org/10.4103/jpbs.JPBS_598_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8375804PMC
June 2021

Evaluation of Healing of Periapical Tissue in Permanent Incisors with Open Apices after Unintentional Extrusion of Mineral Trioxide Aggregate - A Retrospective Study.

J Pharm Bioallied Sci 2021 Jun 5;13(Suppl 1):S97-S100. Epub 2021 Jun 5.

Private Practitioner, Patna, Bihar, India.

Aim: The aim of the present study was to retrospectively assess the healing of periapical lesions in permanent central incisors with open apices after unintentional extrusion of mineral trioxide aggregate (MTA).

Materials And Methods: The clinical and radiographic records of 75 maxillary permanent central teeth treated by MTA apexification were evaluated. Teeth with unintentionally extruded MTA formed the study group (Group 1, = 28), whereas the teeth with no MTA extrusion formed the control group (Group 2, = 47). For both the groups, the records were analyzed for a follow-up period of 3 years.

Results: Complete healing (CH) was observed in 25 teeth in the study group, whereas all the teeth in the control group showed CH ( > 0.05). Within the study group, 6 teeth (21%) showed CH in the 6 month in Group 1, whereas in the control group, 34 teeth (72.3%) showed CH ( < 0.001). At the 1-year follow-up appointment, 19 teeth (67.8%) showed CH in Group 1, whereas 9 teeth (19.1%) showed the same result in Group 2 ( < 0.001). At the end of the 3-year follow-up period, it was noticed that in 21 (84%) teeth, extruded MTA remained unchanged, whereas it was reduced in 4 (16%) of them ( < 0.001).

Conclusion: Extrusion of MTA does not have a significant effect on the healing of the periapical lesion. However, it may lead to a delay in the healing of periapical healing. Patients should be informed about the complication and consequences of extruded MTA and should be kept on follow-up to observe periapical healing.
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http://dx.doi.org/10.4103/jpbs.JPBS_570_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8375778PMC
June 2021

Role of Selective Serotonin Reuptake Inhibitors in Prognosis Dental Implants: A Retrospective Study.

J Pharm Bioallied Sci 2021 Jun 5;13(Suppl 1):S92-S96. Epub 2021 Jun 5.

Private Practitioner, Patna, Bihar, India.

Background: Many recent research shows that antidepressants interfere with the osseointegration of implants. The main purpose of this study was to determine the association between selective serotonin reuptake inhibitors (SSRI) and dental implant failure.

Materials And Methodology: A retrospective study consisted of 410 patients (720 dental implants). Patients' records were used to retrieve the history of SSRI use and medication. The study consists of two groups. Group I (SSRI users) consisted of 128 patients (245 dental implants) patients, whereas Group II (non-SSRI users) was formed by 282 patients (475 dental implants). The implant failure rate was evaluated and statistically examined using the Chi-square test.

Results: Group I had 30 implant failures with 13 (12%) males and 14 (11.8%) females, whereas Group II had 28 implant failures with 12 (6.3%) males and 16 (5.6%) females. In Group I, 26% of the implants failed in the age group >50 years, whereas it was 10.4% in Group II. However, in the age group <50 years, it was 6% and 4.2% Groups I and II, respectively. Group I shows that out of 40 implants in diabetic patients, 12 had failure, whereas in Group II, out of 32 implants placed in diabetics, 7 had failure. In smokers, 48% of the implants failed in Group I, and 29% in group II. In non-smokers the failure was seen in 7.7% cases in Group I and 2.1% cases in Group II. The difference was statistically significant ( < 0.05).

Conclusion: The usage of SSRIs is associated with an increased rate of implant failure. It has a deleterious effect on bone remodeling and leads to excessive osteoporosis.
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http://dx.doi.org/10.4103/jpbs.JPBS_569_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8375817PMC
June 2021

An Observational Study of Different Treatment Practices for Aggressive Posterior Retinopathy of Prematurity.

J Pediatr Ophthalmol Strabismus 2021 Jun 1:1-7. Epub 2021 Jun 1.

Purpose: To evaluate risk factors and outcomes of preferred practice for infants with aggressive posterior retinopathy of prematurity (APROP) at a tertiary eye center in India.

Methods: This was an observational study of infants with APROP where patients were divided into three groups after 2 weeks of initial treatment depending on the treatment received: anti-VEGF only, laser only, and combination of anti-VEGF injection followed by laser within 2 weeks of anti-VEGF injection (combined group). All infants were evaluated for risk factors and followed up at 1, 2, 4, 8, and 12 weeks to determine treatment outcomes in terms of regression, vascular re-growth, progression, and recurrence of the disease.

Results: Sixty eyes of 31 infants were included in the study, with 26 eyes in the anti-VEGF only group, 19 eyes in the laser-only group, and 15 eyes in the combined group. Infants in the combined group presented late with lower birth weight (BW), smaller gestational age (GA), and a history of longer duration of ventilatory support. After 3 months of follow-up, regression occurred in 73.08% in the anti-VEGF only group, 89.5% in the laser-only group, and 86.66% in the combined group ( = .07). Zone of vascularization was greater in the anti-VEGF only group and the combined group compared to the laser-only group. Disease recurrence was seen in 27% in the anti-VEGF group, none in the laser-only group, and 13.33% in the combined group ( < .001). However, progression to stage 4 ROP requiring surgery was noted in 2 eyes in the laser-only group.

Conclusions: Infants with APROP who have a lower GA or BW or require longer ventilatory support are possibly a subset best suited for planned combination therapy. A combination of anti-VEGF therapy followed by laser treatment within 2 weeks allows for early regression, a stable course, lower recurrence, and a larger area of retinal vascularization. .
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http://dx.doi.org/10.3928/01913913-20210423-01DOI Listing
June 2021

Tools for the evaluation of the psychological impact of COVID-19: A practical guide for Family physicians and Primary Care Practitioners.

J Family Med Prim Care 2021 Apr 29;10(4):1503-1507. Epub 2021 Apr 29.

Department of Obstetrics and Gynecology, AIIMS, New Delhi, India.

The COVID-19 pandemic has affected the global population significantly and has resulted in physiological, psychological, social, and behavioral changes among the individuals. The prominent mental health effects of COVID-19 on the general and clinical populations have been well recognized. The family physicians and primary care practitioners from various disciplines are likely to encounter patients who are experiencing psychological distress manifested in the form of anxiety, depression, stress, insomnia, increased substance use, or other symptoms. This narrative review is aimed to present a bird's eye view of the psychological impact of COVID-19 on the general population and the various tools that are used to evaluate them. Besides, we intend to suggest a set of tools/questionnaires that can be used by the family physicians and primary care practitioners for generating data on the psychological impact of this pandemic.
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http://dx.doi.org/10.4103/jfmpc.jfmpc_2107_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8144778PMC
April 2021

Knowledge, barriers and facilitators regarding COVID-19 vaccine and vaccination programme among the general population: A cross-sectional survey from one thousand two hundred and forty-nine participants.

Diabetes Metab Syndr 2021 May-Jun;15(3):987-992. Epub 2021 May 1.

Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.

Background And Aims: The success of the COVID-19 vaccination program is dependent on people's knowledge and attitude regarding the vaccination program. Higher vaccine acceptance can be ensured by strengthening the facilitators and limiting the barriers being observed among the general population.

Material And Methods: Indexed study is a cross-sectional web-based survey using a pre-validated questionnaire to assess knowledge, barriers and facilitators of COVID-19 vaccine and vaccination programme administered on adults across India using a Google online survey platform.

Results: A total of 1294 responses (age: 38.02 ± 13.34 years) were collected. Most of the participants had limited knowledge regarding the eligibility of vaccines in vulnerable population groups such as people with allergies (57.89%) and immune-compromised patients (62.98%), pregnant and lactating women (41.89%) and patients with chronic illness (34.78%). Older participants (>45 years) were more willing to take the COVID-19 vaccine (p < 0.001) as they believed the vaccine is not harmful and considered it as societal responsibility. Younger participants (<45 years) and those residing in urban settings raised concerns on the availability of the vaccine and authenticity of the vaccine (p < 0.001).

Conclusion: There is a scope for improvement in people's knowledge regarding COVID-19 vaccine and the vaccination programme by addressing the barriers and facilitators which can improve the participants' turnover at vaccination centres.
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http://dx.doi.org/10.1016/j.dsx.2021.04.015DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8087578PMC
June 2021

Variable presentation of diabetic papillopathy and treatment dilemma- A case series.

Nepal J Ophthalmol 2020 Jul;12(24):382-332

Biratnagar Eye Hospital, Biratnagar, Nepal.

Introduction: Diabetic papillopathy (DP) is a diagnosis of exclusion in type 1 and type 2 diabetics with transient disc edema. It was initially described in young patients with type1 diabetes mellitus (DM) as a bilateral disease with minimal visual symptoms which resolved spontaneously. Lately, DP has been a focus of controversy because of its wide clinical spectrum.

Cases: We describe three variable cases of DP. These are unilateral DP with Proliferative Diabetic Retinopathy (PDR) with macular edema (ME), unilateral DP with severe Non Proliferative Diabetic Retinopathy (NPDR) with ischemic maculopathy and a case of bilateral DP with Moderate NPDR with ME. We also discuss viable treatment for the variable presentation. DP has been reported in this case series in moderate NPDR, severe NPDR as well as PDR. Macular involvement in the form of macular edema as well as ischemia has been demonstrated to result in diminution of vision. It shows both unilateral and bilateral presentation. Remarkable visual loss seen, in these cases, call for intervention.

Conclusions: DP has a wide spectrum of presentation and its knowledge is eminent to make a complete diagnosis. Individualisation of treatment has to be done for variable presentation and realistic outcomes should be explained to the patients.
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http://dx.doi.org/10.3126/nepjoph.v12i2.25186DOI Listing
July 2020

Development of a Questionnaire to Assess the Psychosocial Effects of COVID-19 on Peripartum Women.

Cureus 2021 Apr 3;13(4):e14270. Epub 2021 Apr 3.

Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, New Delhi, IND.

Objective The social and behavioral changes brought about by the coronavirus disease 2019 (COVID-19) pandemic have led to adverse consequences on the psychosocial functioning of peripartum women. Therefore, we developed and validated a tool to assess the psychosocial effect of the pandemic among these women. Methods The questionnaire was developed using a scientifically accepted systematic methodology comprising literature search, focus-group discussion (FGD), expert evaluation, pretesting, and validation. Results The final questionnaire consists of 38 questions, and it has a Cronbach's α value of 0.90 and a Kaiser-Meyer-Olkin (KMO) value of 0.773. Conclusion The questionnaire has good reliability and face, content, and construct validity. It can be used to assess the psychosocial functioning of peripartum women in low middle-income countries and help perinatal mental health specialists to devise strategies to cope with the psychological impact of COVID-19-like pandemics on peripartum women.
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http://dx.doi.org/10.7759/cureus.14270DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8091138PMC
April 2021

Development and validation of a questionnaire to assess knowledge, attitude, practices, and concerns regarding COVID-19 vaccination among the general population.

Diabetes Metab Syndr 2021 May-Jun;15(3):919-925. Epub 2021 Apr 20.

Department of Medicine, All India Institute of Medical Science, New Delhi, India.

Background And Aims: There seems to be hesitation in the general population in accepting COVID 19 vaccine because of associated myths and/or misinformation. This study is dedicated to develop and validate a tool to interpret vaccine acceptance and/or hesitancy by assessing the knowledge, attitude, practices, and concerns regarding the COVID vaccine.

Material And Methods: Mixed methods study design was used. In phase 1, the questionnaire was developed through literature review, focus group discussion, expert evaluation, and pre-testing. In phase 2, the validity of the questionnaire was obtained by conducting a cross-sectional survey on 201 participants. The construct validity was established via principal component analysis. Cronbach's alpha value was used to assess the reliability of the questionnaire.

Results: The 39-item questionnaire to assess the knowledge, attitude, practices, and concerns regarding the COVID-19 vaccine was developed. The Cronbach's alpha value of the questionnaire was 0.86 suggesting a good internal consistency.

Conclusion: The developed tool is valid to assess the knowledge, attitude, practices and concerns regarding the COVID-19 vaccine acceptance and/or hesitancy. It has the potential utility for healthcare workers and government authorities to further build vaccine literacy.
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http://dx.doi.org/10.1016/j.dsx.2021.04.004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8056878PMC
June 2021

Development and validation of a questionnaire for assessing preventive practices and barriers among health care workers in COVID-19 pandemic.

Indian J Med Microbiol 2021 Apr 23;39(2):200-211. Epub 2021 Apr 23.

Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India.

Objectives: COVID-19 has affected thousands of health care workers worldwide. Suboptimal infection control practices have been identified as important risk factors. The objective of this study was to develop and validate a questionnaire to holistically assess the preventive practices of health care workers related to COVID-19 and identify the reasons for shortcomings therein.

Methods: The development of the questionnaire involved item generation through literature review, focus group discussions and in-depth interviews with health care workers and experts, followed by validation through expert opinion, pilot testing and survey. A cross-sectional survey on 147 healthcare workers was done using an online platform and/or interviews in August 2020 in New Delhi, India. Exploratory factor analysis using principal component extraction with varimax rotation was performed to establish construct validity. Internal consistency of the tool was tested using Cronbach's alpha coefficient.

Results: The developed questionnaire consists of two sections: Section A contains 29 items rated on a five-point Likert scale to assess preventive practices and Section B contains 27 semi-structured items to assess reasons for suboptimal practices. The first section has good validity (CVR = 0.87, S-CVI/Av = 0.978) and internal consistency (Cronbach's alpha coefficient = 0.85) CONCLUSIONS: This questionnaire is a valid and reliable tool for holistic assessment of preventive practices and barriers to it among health care workers. It will be useful to identify vulnerable practices and sections in health care settings which would assist policymakers in designing appropriate interventions for infection prevention and control. This will also be useful in future pandemics of similar nature.
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http://dx.doi.org/10.1016/j.ijmmb.2021.03.006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8063603PMC
April 2021

What Indians Think of the COVID-19 vaccine: A qualitative study comprising focus group discussions and thematic analysis.

Diabetes Metab Syndr 2021 May-Jun;15(3):679-682. Epub 2021 Mar 26.

Department of Medicine, All India Institute of Medical Science, New Delhi, India.

Background And Aims: The study aims to interpret current knowledge, attitude, perceptions and concerns regarding COVID-19 vaccine in the Indian population.

Methods: Eight focus group discussions were conducted. Participants were recruited via purposive sampling. Discussions were recorded and transcribed verbatim. Key themes were extracted using thematic analysis method.

Results: There were 19 males and 24 females, with a mean age of 36 ± 11 years. Sub-themes identified were knowledge, attitude, perception and concerns regarding COVID-19 vaccine, leading to the main theme, i.e., views about the COVID-19 vaccine.

Conclusion: People have mixed perceptions regarding COVID-19 vaccine. Channelling correct messages may improve people's willingness to get vaccinated.
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http://dx.doi.org/10.1016/j.dsx.2021.03.021DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7997146PMC
June 2021

Gynecological laparoscopic surgeries in the era of COVID-19 pandemic: a prospective study.

Obstet Gynecol Sci 2021 Jul 1;64(4):383-389. Epub 2021 Apr 1.

Department of Obstetrics and Gynaecology, All India Institute of Medical Science, New Delhi, India.

Objective: The novel coronavirus pandemic led to the suspension of elective surgeries and the diversion of resources and manpower towards pandemic control. However, gynecological emergencies and malignancies must be addressed despite the restricted resources and the need for protective measures against COVID-19. This study aimed to determine the types of gynecological surgeries performed, difficulties encountered, and their outcomes in the setting of the pandemic.

Methods: We performed a prospective cohort study over 6 months at a single tertiary center, including 60 women with gynecological complaints, categorized as emergencies and semi-emergencies, who underwent further surgery. Their surgical outcomes were measured through various parameters.

Results: We found that 68.3% were emergency cases, while the rest were classified as semi-emergencies. Fibroid and adenomyosis with failed medical management (48.3%), followed by cervical intraepithelial neoplasia (10%), and malignancies (10%) accounted for the semi-emergency cases, while ruptured ectopic pregnancies (13.3%) and torsion and ovarian cysts (18.4%) comprised the emergency cases. The decision to incision time between emergency and semi-emergency cases varied widely due to the safety prerequisites during the pandemic, ranging from 1 hour in emergency cases to 48 hours in semi-emergency cases. In addition, we studied the ease of preoperative preparation, patient satisfaction, and the average number of personnel available to run the operation theaters at these times. No serious perioperative adverse events were observed in the present study.

Conclusion: In conclusion, gynecological surgeries could continue to be safely performed with all precautions in place against COVID-19 infection and related morbidities.
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http://dx.doi.org/10.5468/ogs.21029DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8290147PMC
July 2021

A descriptive audit of healthcare workers exposed to COVID-19 at a tertiary care center in India.

Int J Gynaecol Obstet 2021 Jun 18;153(3):393-397. Epub 2021 Apr 18.

Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India.

Objective: To provide a descriptive audit of healthcare workers (HCWs) exposed to COVID-19, and their contacts, to understand the dynamics of transmission among HCWs.

Methods: Retrospective analysis of contact tracing data of infected HCWs was done from March 1, 2020 to July 31, 2020 at a tertiary care center in New Delhi, India. Contacts were categorized according to the nature of contact and followed for 14 days.

Results: Qualitative RT-PCR testing was performed on 106 HCWs (from a total of 257) owing to exposure or development of symptoms. Positive results were found in 16 HCWs (6.2%) who were exposed to 120 other HCWs, generating 197 exposure incidents. Of these, 30 (15.2%) exposure incidents were high risk with multiple exposures in 48 (40.0%) HCWs. Exposure to infected HCWs was noted in 3 (18.8%) of 16 positive cases. Of the 197 exposure incidents, 54 (27.4%) were deemed avoidable exposures. Infection prevention and control policies were periodically reviewed, and the department implemented mitigating steps to minimize the risk to healthcare providers.

Conclusion: Instituting appropriate infection prevention and control policies and use of adequate precautions by HCWs is vital to minimize high-risk exposure to COVID-19.
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http://dx.doi.org/10.1002/ijgo.13691DOI Listing
June 2021

Laparoscopic gynecological surgery in COVID-19 pandemic.

Obstet Gynecol Sci 2021 May 27;64(3):322-326. Epub 2021 Jan 27.

Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India.

The major concern that has confronted surgeons during the COVID-19 pandemic is the risk of infection during surgery. So far, no studies have found SARS-CoV-2 in surgical smoke, and if it was found, whether it was infectious or not is unknown. To date, no evidence shows that respiratory viruses can be transmitted through a surgical plume or an aerosolized gas. There are various advantages of laparoscopy over laparotomy that must be kept in mind in the COVID-19 era, such as early recovery and shorter hospital stay, which can greatly help to conserve valuable hospital resources, and reduced risk of spillage of blood and body fluids, which can help to reduce transmission risk; most importantly, the distance between surgeons and between surgeons and patient is greater. Certain precautionary measures can be taken to reduce SARS-CoV-2 transmission during laparoscopy. Whenever possible, it should be the surgical option of choice.
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http://dx.doi.org/10.5468/ogs.20312DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8138069PMC
May 2021

Regulation of salt-stressed sunflower (Helianthus annuus) seedling's water status by the coordinated action of Na/K accumulation, nitric oxide, and aquaporin expression.

Funct Plant Biol 2021 05;48(6):573-587

Laboratory of Plant Physiology and Biochemistry, Department of Botany, University of Delhi, Delhi-11007, India; and Corresponding author. Email:

Among abiotic stresses, salt stress is a major threat to crop production all over the world. Present work demonstrates the profuse accumulation of Na+ in 2-day-old, dark-grown sunflower (Helianthus annuus L.) seedlings roots in response to salt stress (NaCl). The pattern of K+ accumulation in response to salt stress is similar to that of Na+ but on relatively lower scale. Application of nitric oxide (NO) donor (DETA) scales down Na+ accumulation in salt-stressed seedlings. The impact of NO donor on K+ accumulation is, however, different in control and salt-stressed seedling roots. In control seedlings, it enhances K+ accumulation, whereas, it gets reduced in salt-stressed seedlings. Specialised channels called 'aquaporins' (AQPs) play a major role maintaining the water status and transport across plant parts under salt-stress. Thus, accumulation of plasma-membrane intrinsic proteins (PIPs) and tonoplast-intrinsic proteins (TIPs), localised on plasma-membrane and vacuolar-membrane, respectively was undertaken in 2-day-old, dark-grown seedling roots. Salt stress increased the abundance of these isoforms, whereas, NO application resulted in decreased accumulation of PIP2 and TIP1. PIP1 and TIP2 isoforms remained undetectable. Present work thus, puts forward a correlation between AQP expression and ions (Na+ and K+) homeostasis in response to salt stress and NO.
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http://dx.doi.org/10.1071/FP20334DOI Listing
May 2021

Study of photo induced charge transfer mechanism of PEDOT with nitro groups of RDX, HMX and TNT explosives using anti-stokes and stokes Raman lines ratios.

Spectrochim Acta A Mol Biomol Spectrosc 2021 Apr 22;251:119360. Epub 2020 Dec 22.

Advanced Centre for Research in High Energy Materials, University of Hyderabad, Telangana, 500046, India. Electronic address:

The paper reports the charge transfer mechanism between poly (3,4-ethylenedioxythiophene) (PEDOT) and high energy materials such as RDX, HMX and TNT, respectively in terms of ratios of anti-stokes (AS) and stokes(S) Raman lines of NO bands. Generally it works as an effective sensing medium for the detection of explosives when mixed in an equal proportion and are subjected to 532 nm wavelength without any chemical treatment [1]. The pristine PEDOT is less sensitive to 532 nm wavelength (2.33 eV) but influences the Raman S and AS lines of explosives in the mixture. The study also reveals that a small quantity (one milligram) of PEDOT is sufficient to initiate the positive charge transfer mechanism between its oxidized state to the lone pairs of electrons on the oxygen atoms of the nitro group of the explosive molecules. Consequently, the intensity of the Raman spectra of RDX, HMX and TNT is dropped by an order of 22.5, 11.45 and 17.2 times, respectively along with the shift of the NO vibrational modes. It is also attributed to Photon-electron-phonon interaction. Finally, we have estimated the reduced mass of the functional group to ascertain the force constant and the intensity ratios of AS /S lines to confirm the charge transfer mechanism. The effect of charge transfer mechanism is also reflected in drastic change in transmission /absorption characteristics of FTIR spectra of same PEDOT and explosive mixtures.
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http://dx.doi.org/10.1016/j.saa.2020.119360DOI Listing
April 2021

Role of para-cervical block in reducing immediate postoperative pain after total laparoscopic hysterectomy: a prospective randomized placebo-controlled trial.

Obstet Gynecol Sci 2021 Jan 12;64(1):122-129. Epub 2021 Jan 12.

Minimally Invasive Unit, Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India.

Objective: To study the efficacy and safety of 0.5% bupivacaine in paracervical block to reduce immediate postoperative pain after total laparoscopic hysterectomy.

Methods: A prospective, randomized, double-blind, placebo-controlled study was conducted at a tertiary referral center involving thirty women each in the treatment and placebo groups. Paracervical block with 10 mL of 0.5% bupivacaine (treatment group) or 0.9% saline (placebo group) was administered following general anesthesia and prior to proceeding with total laparoscopic hysterectomy. Visual analogue scale (VAS) scores at 30 and 60 minutes post extubation and mean VAS score (average VAS score at 30 and 60 minutes) were compared. Adequate pain control was defined as mean VAS score ≤5. Additional postoperative opioid requirement, hospital stay, and readmissions were also compared.

Results: Baseline variables such as age, previous history of cesarean section, operating time, and weight of the specimen were comparable in both groups. VAS scores at 30 (5.0±2.8 vs. 7.0±1.4) and 60 minutes (5.2±2.8 vs. 7.0±0.8) and the mean VAS score (5.1±2.7 vs. 6.8±0.9) were significantly lower in the treatment group. Adequate pain control (mean VAS score ≤5) was 57% higher and additional opioid consumption was 47% lower in the treatment group. No significant difference was found in the duration of hospital stay and readmission rate.

Conclusion: Paracervical block with bupivacaine was useful in reducing immediate postoperative pain with a 25% reduction in mean VAS score and a 47% reduction in opioid consumption in the first hour after total laparoscopic hysterectomy.
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http://dx.doi.org/10.5468/ogs.20271DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7834753PMC
January 2021

Selective extraction and separation of Li, Co and Mn from leach liquor of discarded lithium ion batteries (LIBs).

Waste Manag 2021 Feb 23;121:452-457. Epub 2020 Dec 23.

Department of Chemistry, Indian Institute of Technology (ISM), Dhanbad 826004, India.

Novel route has been developed to selectively extract lithium (Li), cobalt (Co) and manganese (Mn) from the leach liquor of discarded lithium ion batteries (LIBs) containing 1.4 g/L Cu, 1.1 g/L Ni, 11.9 g/L Co, 6.9 g/L Mn and 1.2 g/L Li. Initially, Cu and Ni were extracted by solvent extraction techniques using 10% LIX 84-IC at equilibrium (Eq.) pH 3 and 4.6, respectively. Subsequently, precipitation studies were carried out at different conditions such as pH, reaction time, precipitant concentration etc., to optimize the parameters for selective precipitation of Co from the leach liquor. Result showed that 99.2% Co was precipitated from the leach liquor (11.9 g/L Co, 6.9 g/L Mn and 1.2 g/L Li) after extraction of Cu and Ni in a range of pH 2.9 to 3.1 using un-diluted ammonium sulfide solution (10% v/v) as a precipitant at 30 °C, while only 0.89% Mn and 0.62% Li were co-precipitated. After Co precipitation, 98.9% Mn was extracted from the filtrate using 10% D2EHPA at equilibrium pH 4.5, and Li remained in raffinate. From the obtained purified solution, metals could be recovered either in a form of salt/metals by precipitation/ evaporation/ electrolysis method.
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http://dx.doi.org/10.1016/j.wasman.2020.10.002DOI Listing
February 2021

Impact of COVID-19 on psychosocial functioning of peripartum women: A qualitative study comprising focus group discussions and in-depth interviews.

Int J Gynaecol Obstet 2021 Mar 31;152(3):321-327. Epub 2020 Dec 31.

Department of Obstetrics & Gynaecology, AIIMS, New Delhi, India.

Objective: Peripartum is a period of profound hormonal changes in the body and COVID-19 seems to have an additional impact on these women's psychosocial functioning. This calls for a need to address the psychosocial and behavioural impact of COVID-19 on peripartum women's lives.

Methods: Three focus group discussions and ten in-depth interviews were conducted. A format to guide discussions and interviews was made to bring uniformity across groups and participants. Participants were recruited through purposive sampling. In verbatim transcription was done, followed by thematic analysis to extract key conceptual themes.

Results: Fourteen pregnant and eleven postpartum women were included. The mean age was 28.5 years. Two major domains were identified: 1) the psychological domain including the categories of thoughts, emotions, and behaviour, and 2) the social domain comprising categories of relationships with family members and friends, perceived loss of social support, doctor-patient relationship, and social determinants of health.

Conclusion: The pandemic has indeed affected the psychosocial functioning of peripartum women. The study results might prove to be helpful for clinicians and mental health specialists who can suggest and develop different coping strategies for peripartum women during this pandemic.
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http://dx.doi.org/10.1002/ijgo.13524DOI Listing
March 2021

Family planning and abortion services in COVID 19 pandemic.

Taiwan J Obstet Gynecol 2020 Nov 10;59(6):808-811. Epub 2020 Sep 10.

Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India.

Many routine and elective services have already been postponed or suspended by both Government and private setups in most parts of the world because of the unprecedented pandemic of COVID-19. Healthcare systems everywhere in the world are under pressure. Being a component of essential health services, family planning and abortion services should continue to cater the population in order to prevent the complications arising from unintended pregnancies and sudden rise in STIs. Due to airborne nature of transmission of the virus, it is advisable for all consultations relating to family planning services to be done remotely unless and until visit is absolutely necessary. Contraception initiation and continuation can be done by telemedicine in most individuals. Post partum contraception can be advised before discharge from hospital. In an individual planning for pregnancy, currently it is not advisable to discontinue contraceptive and plan for pregnancy as not much is known about the effect of the virus on foetal development. Also, pregnancy requires routine antenatal and peripartum care and complications arising from pregnancy may necessitate frequent hospital visits, exposing the individual to the risk of infection. Abortion services are time sensitive therefore should not be denied or delayed beyond legal limit. We need to change from real to virtual consultation to prevent the rise in unplanned pregnancies, sexually transmitted infections and unsafe abortions.
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http://dx.doi.org/10.1016/j.tjog.2020.09.005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7833030PMC
November 2020

Redesigning routine antenatal care in low resource setting during COVID-19 pandemic.

J Family Med Prim Care 2020 Sep 30;9(9):4547-4551. Epub 2020 Sep 30.

Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India.

Obstetric population because of its unique and varying needs specific for different gestations justifies for distinctive considerations in times of pandemic like COVID-19. Healthcare facilities providing obstetric care need to develop contingency plans for minimizing antenatal visits to limit exposure of both healthy pregnant women and care providers from ill people. However, to mitigate any potential adverse effects of reduced antenatal visits, intelligent and smart use of evolving telemedicine capabilities can provide the continuum of care despite overwhelming burden due to pandemic. A collaborative work-model involving health workers in the community and the regional levels of health centres also has the potential to prevent the catastrophic collapse of obstetric care services during any pandemic like COVID-19.
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http://dx.doi.org/10.4103/jfmpc.jfmpc_831_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7652110PMC
September 2020

Predictors of successful weight loss outcomes amongst individuals with obesity undergoing lifestyle interventions: A systematic review.

Obes Rev 2021 03 16;22(3):e13148. Epub 2020 Nov 16.

Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.

Understanding the predictors of weight loss with lifestyle interventions can help to ascertain the probable outcomes of individuals with obesity who undergo such interventions. This systematic review assessed the evidence of predictors of successful weight loss among individuals who are overweight or with obesity undergoing lifestyle interventions. Four electronic databases (PubMed, Cochrane Reviews, PsychInfo and Wiley) were searched to find relevant literature published in the past 20 years. A total of 1351 titles were identified in the initial search, of which 23 studies were finally included. Predictors were synthesized in the domains of socio-demographic factors, anthropometric parameters, psychological and behavioural factors and intervention-based factors. The overall quality of evidence on predictors was then appraised using an adapted GRADE approach. Patient-specific factors such as being male, older in age, having existing cardiometabolic comorbidities and limited fat intake were significantly associated with weight loss success. Amongst intervention specific predictors, greater initial weight loss and higher adherence to lifestyle advice were associated with greater weight loss success. In this review, initial weight loss came out to be as the most important predictor of successful weight loss outcome.
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http://dx.doi.org/10.1111/obr.13148DOI Listing
March 2021

The value of communicating with patients in their first language.

Expert Rev Pharmacoecon Outcomes Res 2020 Dec 26;20(6):559-561. Epub 2020 Oct 26.

Department of Food and Nutrition, University of Delhi , New Delhi, India.

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http://dx.doi.org/10.1080/14737167.2020.1835474DOI Listing
December 2020

Impact of COVID-19 on lifestyle-related behaviours- a cross-sectional audit of responses from nine hundred and ninety-five participants from India.

Diabetes Metab Syndr 2020 Nov-Dec;14(6):2021-2030. Epub 2020 Oct 6.

Department of Medicine, All India Institute of Medical Science, New Delhi, India.

Background And Aims: The impact of measures taken to contain COVID-19 on lifestyle-related behaviour is undefined in Indian population. The current study was undertaken to assess the impact of COVID-19 on lifestyle-related behaviours: eating, physical activity and sleep behaviour.

Methods: The study is a cross-sectional web-based survey. A validated questionnaire to assess the changes in lifestyle-related behaviour was administered on adults across India using a Google online survey platform.

Results: A total of 995 responses (58.5% male, mean age 33.3 years) were collected. An improvement in healthy meal consumption pattern and a restriction of unhealthy food items was observed, especially in the younger population (age <30 years). A reduction in physical activity coupled with an increase in daily screen time was found especially among men and in upper-socio-economic strata. Quarantine induced stress and anxiety showed an increase by a unit in nearly one-fourth of the participants.

Conclusions: COVID-19 marginally improved the eating behaviour, yet one-third of participants gained weight as physical activity declined significantly coupled with an increase in screen and sitting time. Mental health was also adversely affected. A detailed understanding of these factors can help to develop interventions to mitigate the negative lifestyle behaviours that have manifested during COVID-19.
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http://dx.doi.org/10.1016/j.dsx.2020.09.034DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7537601PMC
January 2021

The impact of a segregated team roster on obstetric and gynecology services in response to the COVID-19 pandemic in a tertiary care center in India.

Int J Gynaecol Obstet 2020 Dec 22;151(3):341-346. Epub 2020 Oct 22.

Department of Obstetrics and Gynaecology, AIIMS, New Delhi, India.

Objective: To determine the impact of roster reorganization on ensuring uninterrupted services while providing necessary relief to healthcare workers (HCW) in the obstetrics department of a tertiary care center amid the COVID-19 outbreak.

Methods: The COVID-19 rostering response began in April 2020 and evolved in two phases: (1) development of new areas for screening and managing suspected/positive cases of COVID-19; and (2) team segregation according to area of work. The impact of these changes on HCWs and patients was assessed 3 months later.

Results: Developing separate areas helped to minimize the risk of exposure of patients and HCWs to those with COVID-19. Residents and consultants worked intensively in clinical areas for 1 week followed by 1-2 weeks of non-clinical or standby assignments, providing adequate opportunity for isolation. Frequent re-evaluation of the roster was nevertheless required as the pandemic progressed. Segregating teams vertically significantly reduced the number of contacts identified on contact tracing and quarantine leaves, while maintaining patient satisfaction with no increase in adverse events. Residents found the roster to be "smart" and "pandemic-appropriate."

Conclusion: The "COVID emergency roster" helped ensure quality care with minimum risk of exposure and sufficient breaks for physical and psychological recovery of HCWs.
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http://dx.doi.org/10.1002/ijgo.13408DOI Listing
December 2020

Adaptive optics imaging in a case of welder's maculopathy.

Indian J Ophthalmol 2020 Oct;68(10):2240-2241

Vitreoretina Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.

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http://dx.doi.org/10.4103/ijo.IJO_2289_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7728048PMC
October 2020
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