Comparative study on Saliva and Nasopharyngeal swabs and the outcome of RT-PCR test in patients with mild symptoms of SARS-CoV-2 / Estudio comparativo de muestras de saliva y nasofaríngeas y el resultado de la prueba RT-PCR en pacientes con síntomas leves de SARS-CoV-2

Aim A simple and reliable method for diagnosing COVID 19 infections is the needed. The role of saliva in the transmission of the infection has already been established. Method Saliva and nasopharyngeal swabs from patients suspected to have COVID 19 infections were taken simultaneously, and the results of the RT-PCR were compared. Result Total 405 samples were collected, of which 250 males and 155 females. In the 391 samples included for analysis, 370 (94.63%) samples were found to have concordance results, and 21 (5.37%) samples had discordant results. Conclusion The use of saliva to diagnose COVID 19 infection is reliable, and its use can be recommended. (AU)

Objetivo Un método simple y confiable para diagnosticar infecciones por COVID 19 es necesario. Ya se ha establecido el papel de la saliva en la transmisión de la infección. Método Se tomaron simultáneamente hisopos de saliva y nasofaríngeos de pacientes con sospecha de infección por COVID 19 y se compararon los resultados de la RT-PCR. Resultado Se recogieron 405 muestras, de las cuales 250 hombres y 155 mujeres. En las 391 muestras incluidas para el análisis, se encontró que 370 (94,63%) muestras tenían resultados de concordancia y 21 (5,37%) muestras tenían resultados discordantes. Conclusión El uso de la saliva para diagnosticar la infección por COVID 19 es confiable y se puede recomendar su uso. (AU)

The Benefit of YouTube Videos as a Source of Information on Tinnitus for Patients

Abstract Introduction Tinnitus is one of the most common otological complaints encountered. Patients often use the internet, especially YouTube videos, as a source of information regarding their health condition. There is a need to analyze the standard and quality of information in these videos so that the patients receive correct information. Objective The purpose of the present study was to evaluate the reliability and utility of YouTube videos on tinnitus. Methods The first 100 videos on YouTube using the search terms tinnitus and ringing in the ear were identified. Three subject experts assessed the reliability using the modified five-point DISCERN score and utility using a usefulness score. Various indices like view ratio, like ratio, video power index, and interaction index were also calculated. Results Out of the 100 videos selected, 34 were excluded; collectively the remaining 66 videos were viewed 12,797,730 times. The most common upload sources were hospital/physician (39%), paramedic health care providers (19%), and alternative medicine (19%). The discern score was the highest in hospital/physician group (mean 19.3) and lowest in patient experience group (mean 13.4). A negative correlation was observed between the number of views (correlation coefficient -0.214), number of likes (correlation coefficient -0.242), number of comments (correlation coefficient -0.242), and the usefulness score. Conclusion Although there are multiple videos on YouTube regarding tinnitus, the overall educational content and reliability of the videos are poor. Video popularity is not associated with usefulness. Healthcare providers should counsel patients regarding videos on YouTube and try to create more comprehensive videos.

The Benefit of YouTube Videos as a Source of Information on Tinnitus for Patients.

Introduction Tinnitus is one of the most common otological complaints encountered. Patients often use the internet, especially YouTube videos, as a source of information regarding their health condition. There is a need to analyze the standard and quality of information in these videos so that the patients receive correct information. Objective The purpose of the present study was to evaluate the reliability and utility of YouTube videos on tinnitus. Methods The first 100 videos on YouTube using the search terms tinnitus and ringing in the ear were identified. Three subject experts assessed the reliability using the modified five-point DISCERN score and utility using a usefulness score. Various indices like view ratio, like ratio, video power index, and interaction index were also calculated. Results Out of the 100 videos selected, 34 were excluded; collectively the remaining 66 videos were viewed 12,797,730 times. The most common upload sources were hospital/physician (39%), paramedic health care providers (19%), and alternative medicine (19%). The discern score was the highest in hospital/physician group (mean 19.3) and lowest in patient experience group (mean 13.4). A negative correlation was observed between the number of views (correlation coefficient -0.214), number of likes (correlation coefficient -0.242), number of comments (correlation coefficient -0.242), and the usefulness score. Conclusion Although there are multiple videos on YouTube regarding tinnitus, the overall educational content and reliability of the videos are poor. Video popularity is not associated with usefulness. Healthcare providers should counsel patients regarding videos on YouTube and try to create more comprehensive videos.

Development and validation of structured training module for healthcare workers involved in managing pediatric patients during COVID-19 pandemic using "Objective Structured Clinical Examination" (OSCE).

BACKGROUND: COVID-19 (Coronavirus disease-19) is an ongoing pandemic. COVID vaccine administration in adults has provided some degree of protection from infection but children are still susceptible So, we have to be prepared to handle COVID-19 infection in children by training our healthcare workers by updating both their knowledge and skills. We developed a training module to train our healthcare workers in all domains of learning and also planned related assessment methods to know the effectiveness of the module. MATERIALS AND METHODS: This was a quasi-experimental study with pre- and post-intervention conducted at a tertiary-level teaching medical college in southern India from July to September 2021. The training module was developed as per the "ADDIE" model of the development process module. It was further validated by five experts before implementation. In addition to the quasi-experimental method of evaluation like pre- and post-test, Observed Skill clinical examination (OSCE) had been also used as an assessment tool at the completion of training. A total of 92 participants have been trained as per this module in our tertiary-level care hospital. The association between continuous and categorical variables was assessed using an independent t-test and ANOVA, and paired t-test was used for comparing the difference between pre- and post-test scores. RESULTS: Pre-test scores had no association with years of experience (P = 0.803) and previous training status of participants (P = 0.350). The mean difference of pre- and post-test scores was 3.8 and it was statistically significant (P value < 0.001) A weak positive correlation between pre- and post-test was present by the Spearmen correlation test (r = 0.337). The correlation between post-test score and OSCE score does not have a significant correlation. CONCLUSION: Structured training module was effective in training the participants. Multimode assessment method (Pre-test, Post-test, and OSCE) is an important step to evaluate any training program as compared to only the pre- and post-test methods of evaluation.

Population-Based Detection of Cancer Cases Using Digital Platforms in Mangalagiri Mandal of Guntur District, Andhra Pradesh.

Background and objectives Cancer is one of the major causes of illness and mortality in India. The cancer burden in India will roughly triple over the next 20 years. Population-based cancer registries (PBCRs) are crucial not only for formulating cancer control policies and assessing their effectiveness but also offer essential inputs for programs aimed at preventing cancer. The state of Andhra Pradesh after the division in 2014 has been left with no PBCR. Hence, with the aim to pilot the development of a population-based cohort of cancer cases with digital reporting and monitoring mechanisms, this study was carried out with the objective of finding the prevalence and incidence of various types of cancer in Mangalagiri Mandal, Guntur district, Andhra Pradesh. Materials and methods A cross-sectional survey during the period January 2021 to June 2022 was conducted to actively search for cancer cases among 160303 people residing in 42639 households in the Mangalagiri Mandal, Guntur district, State of Andhra Pradesh, India. The respondents were asked if anyone in the household had cancer and the location was mapped, the information was recorded by the Accredited Social Health Activist (ASHA) workers in the pre-tested questionnaire. The total number of cancer cases identified was 107. Results Mangalagiri Mandal had 24 cases of cancer among men and 83 cases of cancer among women as recorded during the study period. Most of the male (37.5%) and female (31.3%) cancer cases were in Stage 2 of cancer and the majority of them (91.6%, 94%) had completed their treatment and were on regular follow-up. The most common cancer among both sexes was breast cancer (5.45 per million population). Oral cancer was the most prevalent in men (0.747 per million of the population) whereas, breast cancer (4.253 per million population) was the most prevalent among females. A total of 47.1% of the males had cancer at sites that were related to tobacco usage. Conclusion The data on cancer incidence and prevalence along with the socio-demographic profile is essential to know the burden of cancer. This baseline data can be used in planning cancer control activities and knowing the future trend of cancer in the Mangalagiri Mandal, in the new state of Andhra Pradesh.

Comparative study on Saliva and Nasopharyngeal swabs and the outcome of RT-PCR test in patients with mild symptoms of SARS-CoV-2.

AIM: A simple and reliable method for diagnosing COVID 19 infections is the needed. The role of saliva in the transmission of the infection has already been established. METHOD: Saliva and nasopharyngeal swabs from patients suspected to have COVID 19 infections were taken simultaneously, and the results of the RT-PCR were compared. RESULT: Total 405 samples were collected, of which 250 males and 155 females. In the 391 samples included for analysis, 370 (94.63%) samples were found to have concordance results, and 21 (5.37%) samples had discordant results. CONCLUSION: The use of saliva to diagnose COVID 19 infection is reliable, and its use can be recommended.

A comparative study on third trimester fetal biometric parameters with maternal age.

Background: Advanced maternal age is an important parameter associated with increased risk of feto-maternal complications and it is an evolving trend in society for women planning for pregnancy in late ages. However there are no studies done whether advanced maternal age has its effects on expression of growth pattern in the fetus. So this study was done to compare the maternal age with the third trimester fetal biometric parameters. Methods: This study was done in 100 antenatal women and divided into two groups: Group 1: optimal maternal age group between 21-29 years of age and Group 2: advanced maternal age 30 and above. The pre-pregnant maternal weight, gestational age and third trimester fetal biometrics using ultrasound are noted and compared between the groups. Results: The maternal weight gain between the groups was optimal but the third trimester fetal parameters were significantly less in advanced maternal age. The abdominal circumference in optimal age group and head circumference in advanced maternal age group was closer to calculated estimated date of delivery (EDD) and would be specific in calculating the gestational age. Conclusions: Though there is no significant difference in maternal weight gain, there are fetal growth restrictions in advanced maternal age group due to which the third trimester fetal parameters are lesser than the optimal age group. Head circumference would be specific in calculating the estimated date of delivery in advanced maternal age group.

A triple-blind, randomized controlled trial, comparing combined letrozole and clomiphene versus only letrozole for ovulation induction in women with polycystic ovarian syndrome.

OBJECTIVE: To evaluate the efficacy of combination treatment of letrozole and clomiphene citrate (CC) in comparison to that of letrozole alone to induce ovulation in infertile women with polycystic ovary syndrome (PCOS). METHODS: The current study was designed as a single-center, double-arm and triple-blind, randomized, controlled trial. The study was prospectively registered with the clinical trials registry in India and was conducted after approval from the institutional ethics committee. Study patients were randomly assigned to treatment with either a combination of 2.5 mg of letrozole and placebo (n = 40) or a combination of 2.5 mg of letrozole and 50 mg of CC (n = 40) starting from cycle days 3 to 7 for a single treatment cycle. RESULTS: Ovulation induction with combined letrozole and CC provided a higher ovulation rate, with a 35% absolute difference in its favor. The authors found an ovulation rate of 73% versus 38% (P = 0.003) for treatment with a combination drug and letrozole alone, respectively, while the ovulation rate ratio was 1.93 (95% CI, 1.24-3.01). CONCLUSION: Combined treatment of letrozole and clomiphene may be considered as one of the first-line ovulation induction agents for infertile women with PCOS because of its affordability and better safety profile.

A Cross-Sectional Study on the Effect of Chronic Noise Exposure on the Vestibular Function of Traffic Policemen and Automobile Drivers.

Introduction: Noise is a preventable occupational hazard for certain professions like automobile drivers and traffic police personnel. The harmful auditory effects of noise are well known. However, little is known about the status of the vestibular function in chronic noise exposure without noise induced hearing loss. Our objective was to assess the vestibular function in chronic noise exposure. Methodology: : The study was conducted with a sample size of 242 (chronic noise exposure group - 121, group without chronic noise exposure - 121). Noise estimation was carried out across various traffic intersections to assess the noise exposure levels of the exposed group. All participants underwent a detailed vestibular evaluation in the clinical vestibulometry laboratory. Results: There was no difference in nystagmus, saccades, caloric function between the two groups. The latency and amplitude of vestibular evoked myogenic potentials (VEMP) were similar in both the groups. However, dynamic posturography showed a significant difference in the Adaptation test between the two groups (P < 0.05). We also found a statistically significant difference between the static and dynamic subjective visual vertical (SVV) and the dynamic visual acuity (DVA) between the two groups (P < 0.05). Conclusion: We did not find any clinical evidence of vestibular dysfunction in the noise exposed group. However, the statistical significance of SVV and DVA as seen in this study needs to be evaluated further as an early marker for vestibular dysfunction. It remains to be seen whether the statistically significant prolongation is reversible after the noise exposure is withdrawn.

Oral manifestations associated with COVID-19 disease: An observational cross sectional study.

Objectives: The aim of present study was to investigate oral manifestations associated with COVID-19 disease. Materials and methods: This cross-sectional study comprised 367 suspects with mild/moderate COVID-19 symptoms who reported to a tertiary care hospital's screening OPD. An in-depth case history was taken, and an oral cavity examination was performed to detect any oral findings. All participants were tested for SARS-CoV-2 using a naso-pharyngeal swab and reverse transcription polymerase chain reaction.Oral manifestations and the results of RT-PCR testing were correlated. Statistical analyses were performed using Epi Info and R software. To estimate the prevalence of oral symptoms, the Pearson chi-square test was used. Results: Oral manifestations were found in 58% of the study population. The difference in the prevalence of oral manifestations between RT-PCR positive COVID-19 patients versus RT-PCR negative suspects was statistically significant (p = 0.007) with xerostomia and dysgeusia being significantly higher in positive patients (p = 0.036 and p = 0.044 respectively) while the prevalence of stomatopyrosis and other intraoral signs was insignificant. Conclusion: Xerostomia and dysgeusia are the common oral manifestations of COVID-19.

Effect of 4-Week Heartfulness Meditation on Stress Scores, Sleep Quality, and Oxidative and Inflammatory Biochemical Parameters in COVID-19 Patients after Completion of Standard Treatment - A Randomized Controlled Trial.

Context: COVID-19-affected patients showed increased stress, impaired sleep quality, altered complete blood count, and increased inflammatory and oxidative parameters. Yoga is an add-on nonpharmacological treatment that is established to normalize the abovementioned parameters. Heartfulness meditation is a form of Raja yoga. Aims: The present study aimed to study the effects of 4 weeks of heartfulness meditation on the abovementioned parameters in COVID-19 patients following treatment completion. Settings and Design: The present study was a randomized controlled trial carried out in the Department of Physiology, AIIMS, Mangalagiri, Andhra Pradesh. Subjects and Methods: Out of 50 COVID-19 treatment-completed patients recruited for the study, 25 were randomly assigned to the study group who received 4-week app-based heartfulness meditation. Other 25 patients were assigned to the control group who received app-based relaxation for 4 weeks. Perceived stress score, Pittsburgh Sleep Quality Index questionnaire, baseline cardiovascular parameters, complete blood count, serum cortisol, inflammatory parameters, oxidative stress parameters, and antioxidant parameters were assessed before and after 4 weeks of intervention in both the groups. The outcome assessor was blinded in the present study. Statistical Analysis Used: The mean difference between the two groups was tested using the Student's t-test or Mann-Whitney U-test based on data distribution. Effect of intervention was analyzed using paired Student's t-test for dependent samples test or Wilcoxon signed-rank test based on data distribution. Results: The groups were comparable before intervention for all the variables. After 4 weeks of intervention, we observed a significant decrease in stress, circulating cortisol, inflammatory markers, and oxidative stress biomarker in both the groups. Further, we observed improved sleep quality and antioxidant biomarkers in both the groups. These beneficial alterations following intervention were high in the study group compared to the control group. Conclusions: Our results suggest that app-based heartfulness meditation/relaxation can be used as a nonpharmacological adjuvant to hasten the recovery process in patients who have completed the COVID-19 treatment protocol. Beneficial effects in subjects practicing heartfulness meditation were more than that observed in subjects practicing relaxation.

Identification of differentially methylated candidate genes and their biological significance in IUGR neonates by methylation EPIC array.

BACKGROUND: Intrauterine growth restriction (IUGR) is a pregnancy-associated disease manifested by decreased growth rate of fetus than the normal genetic growth potential. It is associated with increased susceptibility to metabolic diseases later in life. Although the mechanisms underlying the origin of metabolic diseases are poorly understood, DNA methylation is a crucial investigation for the identification of epigenetic changes. OBJECTIVES: To assess the degree of change of DNA methylation in IUGR neonates and compare with that of appropriate for gestational age (AGA) neonates and to explore the differentially methylated candidate genes and their biological significance. METHODS: This cohort study was conducted in the Neonatology Department of JIPMER during the period of November 2017 to December 2018. Forty each of IUGR and gestation matched AGA neonates were recruited. Umbilical cord blood samples were collected at birth. DNA was separated from the blood samples; and, using 5-mC DNA ELISA method, the percentage of genomic DNA methylated in these neonates was established. Data were expressed as mean ± standard deviation. Methylation EPIC array was performed to identify the differentially methylated candidate genes. David analysis was used to find out the functional annotation chart by KEGG pathway. RESULTS: Genomic DNA methylation varied significantly between IUGR and AGA neonates (IUGR: 3.12 ± 1.24; AGA: 4.40 ± 2.03; p value: <.01). A global shift toward hypomethylation was seen in IUGR compared with AGA, targeted to regulatory regions of the genome, and specifically promoters. Pathway analysis identified deregulation of pathways involved in metabolic diseases. Altered methylation of PTPRN2 & HLADQB1 genes leads to dysregulation of T-cells and reactive oxygen species (ROS). These changes may lead to complications later among these neonates subjected to IUGR. CONCLUSION: Our findings show significant changes in the methylation pattern of genes among IUGR and AGA babies. Steps for correcting the changes may help in reducing later complications among IUGR babies.