Development & validation of scales to assess stigma related to COVID-19 in India

Background & objectives: COVID-19 pandemic has triggered social stigma towards individuals affected and their families. This study describes the process undertaken for the development and validation of scales to assess stigmatizing attitudes and experiences among COVID-19 and non-COVID-19 participants from the community. Methods: COVID-19 Stigma Scale and Community COVID-19 Stigma Scale constituting 13 and six items, respectively, were developed based on review of literature and news reports, expert committee evaluation and participants’ interviews through telephone for a multicentric study in India. For content validity, 61 (30 COVID-19-recovered and 31 non-COVID-19 participants from the community) were recruited. Test–retest reliability of the scales was assessed among 99 participants (41 COVID-19 recovered and 58 non-COVID-19). Participants were administered the scale at two-time points after a gap of 7-12 days. Cronbach’s alpha, overall percentage agreement and kappa statistics were used to assess internal consistency and test–retest reliability. Results: Items in the scales were relevant and comprehensible. Both the scales had Cronbach’s ? above 0.6 indicating moderate-to-good internal consistency. Test–retest reliability assessed using kappa statistics indicated that for the COVID-19 Stigma Scale, seven items had a moderate agreement (0.4-0.6). For the Community COVID-19 Stigma Scale, four items had a moderate agreement. Interpretation & conclusions: Validity and reliability of the two stigma scales indicated that the scales were comprehensible and had moderate internal consistency. These scales could be used to assess COVID-19 stigma and help in the development of appropriate stigma reduction interventions for COVID-19 infected, and mitigation of stigmatizing attitudes in the community.

A Comparative Study between Single versus Double Layered Bowel Anastomosis in a Tertiary Care Hospital

Background: Intestinal anastomosis is a frequently performedprocedure equally in elective and emergency cases andtherefore, it is authoritative for surgeons and residents to beacquainted with the art of bowel anastomosis. The technique ofanastomosis is dependent upon the site, situation of the boweland the fundamental disease etiology, and the generalcomplaint of the subject. As per a recent Cochrane reviewcomparing the effectiveness of single layer and double layergastrointestinal anastomosisMaterials and Methods: The present prospective, randomizedcomparative study was conducted in the general surgicaldepartment of the Hospital for a period of 2 years. Subjectsrequiring intestinal resection were evaluated for eligibility to theward. All subjects received same antibiotics postoperativelylike Injection Ceftriaxone and Metronidazole including astandard postoperative care. Subjects were followed up for twoweeks after surgery. Any instant or late complications werenoted. All the data thus obtained was arranged in a tabulatedform and analyzed using SPSS software. Probability value ofless than 0.05 was considered as significant.Results: There were total 100 subjects included in the study,out of which 50 were managed by Single layered and 50 byDouble layered technique. The mean age of the subjects was37.53+/-4.22years. The mean duration of nasogastric tube insitu was 1.92±0.80 and 2.35 ± 1.03 days respectively in singleand double layer technique. The return of bowel soundpostoperatively was 2.45±1.13 days in single layer and 3.2 ±1.36 days in double layer technique. There was a significantdifference in both the groups. There was 1 case of anastomoticleak with double layered technique. Abdominal abscess wasseen in 2 cases each.Conclusion: The hospital stay duration, operating time wascomparatively lesser with single layer technique. It was alsocost effective and easy to perform.

Hypoxia influences expression profile of Pleckstrin homology-like domain, family A, member 2 in Indian catfish, Clarias batrachus (Linnaeus, 1758): A new candidate gene for hypoxia tolerance in fish.

Several physiologically important genes were found to be regulated by hypoxia at the transcriptional level. The Pleckstrin homology-like domain, family A, member 2 (PHLDA2) gene was previously identified as an imprinted gene. The present study was aimed to determine the structure of complete cDNA and the deduced protein of PHLDA2 along with analysing the changes in its mRNA expression in Clarias batrachus tissues under hypoxic conditions. The complete cDNA of CbPHLDA2 gene consisted of 1009 nucleotides with an open reading frame of 417 nucleotides. The deduced CbPHLDA2 protein of 139 amino acids shared high homology with PHLD2A of other fishes as well as that of vertebrates. Importantly, a single amino acid (asparagine/lysine) insertion was identified in the PH domain of CbPHLDA2 and other fishes, which was absent in other vertebrates studied. Furthermore, under normoxic conditions, CbPHLDA2 was constitutively expressed with varying levels in analysed tissues. Short- and long-term hypoxia exposure resulted in significant changes in the expression of CbPHLDA2 in liver, spleen, head kidney, brain and muscle in a time-dependent manner. The results suggested that CbPHLDA2 might play an important role for adaptive significance under hypoxia.

A biochemical and histopathological evaluation of generalized pulp calcification in young permanent teeth.

Pulp calcifications are a frequent finding on bitewing and periapical radiographs in older age-groups but their occurrence in the entire dentition in young subjects is unusual. We report such an unusual occurrence of generalized pulp calcification in a 13-year-old Indian female. Radiographic examination of the dentition revealed pulp calcifications in all permanent teeth, located mostly in the pulp chamber but with some in the root canals. The patient's dental, medical, and family history was noncontributory. Biochemical analysis of the removed pulp calcification from one of the teeth during endodontic treatment showed large amounts of calcium, phosphorus, and carbonate. However, metabolic evaluation of patient through liver and kidney function tests and other blood investigations did not reveal any metabolic disorder. The patient was also evaluated for any systemic, syndromic, or genetic involvement but this was also noncontributory. Therefore, we propose that this unusual case of generalized pulp calcification is of idiopathic origin. In this work, histopathological and biochemical evaluations of the pulp calcification was done to try and understand the initiation and progress of calcifications in pulpal tissue.

Hemoperitoneum as a first manifestation of HCC with bleeding from ruptured aberrant vessel: a case report.

A young man presented with a history of abdominal pain and distension for 4 days. Diagnosis of spontaneous hemoperitoneum was made after clinical examination, abdominal USG and a diagnostic peritoneal tap. Emergency laparotomy revealed massive hemoperitoneum with extensive bilobar hepato-cellular carcinoma (HCC). A ruptured aberrant vessel communicating between the intercostal vessel and HCC in the liver had caused massive hemoperitoneum.