bluuebunny/crossref_metadata_2025 huggingface dataset:
Diversité et état de conservation de la flore ligneuse des îlots forestiers du massif montagneux de Lubero (R.D. Congo)
Authors: Ndavaro Norbert Kambale , Sahani Walere Muhindo , Natta Armand Kuyéma , Hegbe Apollon D.M.T. , Dramani Ramdan , Dicko Aliou
Published: May 2024

Connaître les mesures classiques de la diversité floristique est crucial pour étayer les stratégies de conservation des ressources végétales des forêts dégradées. La présente étude vise premièrement à apprécier les paramètres de diversité spécifique et structurale de la flore ligneuse des îlots forestiers du massif montagneux de Lubero et deuxièmement, à déterminer son état de conservation afin de proposer des mesures appropriées pour sa gestion durable. Un échantillonnage stratifié par grappe a été effectué pour les inventaires forestiers. À cet effet, 297 placeaux de 50 m2 chacun ont été matérialisés dans dix îlots forestiers. Les indices de diversité spécifique ont été calculés et les paramètres dendrométriques ont été déterminés. L’entropie de Renyi a été calculée pour comparer la diversité alpha des espèces ligneuses entre les îlots forestiers. Le test rang de Kruskal-Wallis et l’analyse de variance ont permis de comparer les paramètres de diversité structurale entre les peuplements ligneux. Au total, 104 espèces ligneuses (86 genres et 45 familles) ont été recensées. La richesse spécifique des îlots forestiers varie entre 11 et 78. L’indice de diversité de Shannon-Wiener est très variable (1,98 à 4,03 bits) et l’équitabilité de Pielou est assez élevée (0,83 à 0,94). Des différences hautement significatives de densité (degré de liberté ddl=9, chi-square = 93.1316, P<0,0001), de diamètre moyen (ddl=9, statistique F =23.163, P<0,0001), de surface terrière (ddl=9, statistique F =53.568, P<0,0001) et de hauteur de Lorey moyenne (ddl=9, statistique F =208.454 ; P<0,0001) des espèces ligneuses ont été notées entre les îlots forestiers. Du point de vue de la conservation, 87 espèces ligneuses sont rapportées sur la liste rouge de l’Union internationale pour la conservation de la nature (UICN). Les espèces ligneuses déclarées « Vulnérables », « Quasi menacées » et « En danger » méritent une attention particulière des décideurs politiques et des gestionnaires forestiers.
Food-Related YouTube Influencer Marketing
Authors: Dam Linda
Published: May 2024

Influencer marketing on YouTube has become an increasingly popular method for building engagement with consumers. This study examines how perceived homophily and interactivity with social media influencers impact the effectiveness of food-related YouTube influencer marketing and consumer engagement with social media. An online survey (N = 404) found that perceived homophily and interactivity both positively relate to intentions to engage with social media. In addition, perceived expertise and physical attractiveness of the social media influencer mediated the relationship between both perceived homophily and interactivity and social media engagement. Study results provide evidence-based implications for influencer marketing strategies and insight into consumer engagement with food-related YouTube content.
Leveraging Artificial Intelligence for Ethical Social Media Influencer Communication
Authors: Hewapathirana Isuru Udayangani
Published: May 2024

This chapter explores the connections between artificial intelligence (AI) and the ethical dimensions of influencer communication on social media. The ethical aspects are evaluated according to the criteria outlined in the Professional Code of Ethics of the Public Relations Society of America (PRSA). The study reviews the multiple aspects of influencer communication, including emerging challenges and legal implications resulting from the continued development of AI in social media. Furthermore, a dataset was collected from the social media platform Reddit, and a case study analysis was performed using the NodeXL software. This empirical investigation aims to investigate social media users' perspectives on specific ethical concerns associated with integrating artificial intelligence (AI). The findings presented in this chapter provide scholars with an advanced understanding of AI capabilities, offer industry professionals valuable guidance for ethical decision-making, and offer lawmakers guidance for developing regulatory frameworks.
Symptom Exacerbation and Adverse Events During a Randomized Trial of Early-Stage Rehabilitation After Sport-Related Concussion: Safety Outcomes From the Active Rehab Study
Authors: Register-Mihalik Johna K. , Guskiewicz Kevin M. , Marshall Stephen W. , McCulloch Karen L. , Mihalik Jason P. , Mrazik Martin , Murphy Ian , Naidu Dhiren , Ranapurwala Shabbar I. , Schneider Kathryn J. , Gildner Paula , Salmon Danielle M. , Auton Brandon , Bowman Thomas G. , Hall Eric E. , Hynes Loriann M. , Jewell Elizabeth , Ketcham Caroline J. , Siler Caroline Wesley , Sullivan S. John , Kostogiannes Vasiliki , McCrea Michael A. ,   Active Rehab Study Consortium
Published: May 2024

Context

Authors of few studies have used randomized controlled trials (RCTs) to quantify clinical intervention safety of rehabilitation after sport-related concussion across sport levels.

Objective

Describe symptom exacerbation and adverse events (AEs) associated with two concussion rehabilitation interventions.

Design

Cluster RCT (NCT02988596)

Setting

Sports medicine clinic and field settings.

Patients or Other Participants

The RCT enrolled 251 concussed athletes (median age = 20 years; female, n = 48) across 28 sites from New Zealand professional rugby (n = 31), Canadian professional football (n = 52), US/Canadian colleges (n = 128) and US high schools (n = 40).

Interventions

Two medically supervised interventions: (1) enhanced graded exertion (EGE): international return-to-sport strategy and sport-specific activities only (EGE only, n = 119); and (2) multidimensional rehabilitation (MDR) followed by EGE: early symptom-directed exercises once symptoms were stable, followed by EGE after symptoms resolved (MDR + EGE, n = 132).

Main Outcome Measure(s)

Primary outcomes were intrasession total symptom severity score exacerbation and significant intersession (increase 10+ severity points) sustained total symptom severity exacerbation, each measured with the Postconcussion Symptom Scale (132 total severity points on scale). Reported AEs were also described. Activity-based rehabilitation sessions (n = 1437) were the primary analysis unit. Frequencies, proportions, medians, and interquartile ranges were calculated for outcomes by treatment group.

Results

The 251 postinjury participants completed 1437 (MDR + EGE = 819, EGE only = 618) activity-based intervention sessions. A total of 110 and 105 participants contributed data (those missing had no documented session data) to at least 1 activity-based session in the MDR + EGE and EGE-only arms, respectively. Intrasession symptom exacerbations were equivalently low in MDR + EGE and EGE-only arms (MDR + EGE: 16.7%, 95% CI = 14.1%, 19.1%; EGE only: 15.7%, 95% CI = 12.8%, 18.6%). In total, 9/819 MDR + EGE sessions (0.9%) and 1/618 EGE-only sessions (0.2%) resulted in a presession to postsession symptom exacerbation beyond a 10+ severity point increase; 8/9 resolved to <10 points by the next session. Two study-related AEs (1 in each arm) were reported.

Conclusions

Participants in MDR + EGE and EGE-only activities reported equivalently low rates of symptom exacerbation.
Effects of Alternate Nostril Breathing Exercise on Cardiorespiratory Functions in Healthy Young Adults
Authors: Jahan Iffat , Begum Momtaz , Akhter Shahin , Islam Md Zakirul , Jahan Nusrat , Samad Nandeeta , Das Pranta , Rahman Nor Azlina A. , Haque Mainul
Published: May 2024

Introduction:

Alternate nostril breathing (ANB) is an effective breathing exercise with therapeutic benefits on cardiorespiratory functions for healthy and diseased individuals. This study was conducted to assess the effects of ANB exercise on cardiorespiratory tasks in healthy adults.

Materials and Methods:

This randomized experimental study was conducted in the Department of Physiology, Chittagong Medical College, Chattogram, from July 2017 to June 2018. A total of 100 1st-year students, aged between 18 and 20 years, were included by a random sampling method. Fifty participants (25 males and 25 females) were enrolled in the experimental group, while age- and body mass index-matched another 50 participants (25 males and 25 females) served as the control group. Experimental group participants performed ANB exercise for 4 weeks. Cardiorespiratory parameters (pulse rate, blood pressure, forced vital capacity, forced expiratory volume in 1st s [FEV1], and peak expiratory flow rate [PEFR] were measured. Data were taken at the start and after 4 weeks in both groups.

Results:

Independent t-test showed no significant differences in the cardiorespiratory functions between the experimental and control groups among the male and female participants, except for the females’ PEFR which showed small differences. On the other hand, repeated measure ANOVA shows significant improvement in the experimental groups among males (P < 0.001–0.028) and females (P < 0.001–0.001) in all the cardiorespiratory functions measured, except for the FEV1 and PEFR among males.

Conclusion:

The results of this study suggest that cardiorespiratory functions were improved after breathing exercise, and therefore, ANB can be recommended for increasing cardiorespiratory efficiency.
Obesity in Patients with Hypertension Attending a Medical Outpatient Clinic in a Tertiary Health Facility in Enugu, Southeast Nigeria
Authors: Nkemdilim Ijoma Uchenna , Ezeala-Adikaibe Birinus Adikaibe , Donatus Onodugo Obinna , Innocent Okoye , Ernest Nwazor , Nkeiruka Mbadiwe , Chidimma Orah-Okpala , Pauline Onodugo Nkiru , Benneth Anyim Obumneme
Published: May 2024

Introduction:

The prevalence of obesity is increasing in sub-Saharan Africa which reflects the current global trend. Epidemiological data have consistently shown a strong relationship between obesity and hypertension in Africans, and this association is stronger for central obesity. The aim of this study was to describe the pattern of overweight/obesity among patients living with hypertension in a tertiary hospital in Enugu, Southeast Nigeria.

Methods:

This was a cross-sectional study conducted in the Medical Out-Patient Clinic of the Enugu State University Teaching Hospital in Enugu, Enugu State, Southeast Nigeria. Data were analyzed using the SPSS version 22.

Results:

Data were collected from a total of 450 consenting patients, most of whom 64% (288) were females. The mean body mass index (BMI) was 28.9 ± 6.1 kg/m2 higher in females than males (29.8 ± 6.5 kg/m2 vs. 26.7 ± 5.2 kg/m2, P < 0.001). The gender distribution of classes of obesity showed female preponderance. A little more than one-third of the patients were overweight, whereas about four out of every ten patients were obese. While overweight did not differ significantly across gendeWr (P = 0.67), more feWmales than males were significantly obese (P < 0.001). The age distribution of BMI showed increasing rates of underweight and decreasing rate of morbid obesity with age. About 86.8% of the females had substantially increased waist circumference compared to 26.5% of the males. Overall, 53% of the males and 97.6% of the females have abnormal waist circumferences. Waist–hip ratio was equally abnormal in 89.3% of the study population even though no statistically significant difference was observed across gender.

Conclusion:

Overweight and obesity are common among patients with hypertension as demonstrated in this study. There is need to set up an aspect of health education which specifically sensitizes the public against the untoward consequences of overweight and obesity.
Assessment of Breastfeeding Techniques in Enugu, South-East Nigeria
Authors: Nduagubam Obinna C. , Ndu Ikenna K. , Bisi-Onyemaechi Adaobi , Onukwuli Vivian Ozoemena , Amadi Ogechukwu F. , Okeke Ifeyinwa B. , Ogbuka Francis N. , Ezenwosu Osita U. , Iheji Chukwunonso C.
Published: May 2024

Background:

Good breastfeeding technique is important in ensuring adequate milk delivery and preventing breastfeeding problems. Exclusive breastfeeding rate is quite low, and requisite skills regarding proper positioning and attachment of an infant while breastfeeding appears lacking among mothers in Nigeria. This study was undertaken to assess breastfeeding techniques of mothers attending the well-child clinics of two tertiary hospitals in southeast Nigeria.

Materials and Methods:

This cross-sectional descriptive study of 396 mother and child pairs who attend the well child clinics of two tertiary hospitals in Enugu (Enugu state University Teaching Hospital and University of Nigeria Teaching Hospital) between September 2018 and February 2019. An interviewer administered, well-structured pro forma was used to collect data while mothers were observed closely as they breastfed and scored using the World Health Organization criteria. Data were analyzed using SPSS version 22.

Results:

Most of the mothers studied (357; 90.2%) attended ante-natal care, and 365 (92.2%) of the deliveries were assisted by a health worker. Only 194 (49%) of mothers practiced good breastfeeding techniques. Maternal age (20–30 years) (P < 0.001, odds ratio [OR] 0.464), attendance to antenatal clinic (P < 0.001; OR 8.336), health education and demonstration on breastfeeding techniques before and after delivery (P = 0.001) and maternal level of education (χ2 = 13.173, P = 0.001) but not parity (P = 0.386; OR 1.192) were significantly associated with good breastfeeding techniques.

Conclusion:

There are suboptimal breastfeeding techniques among mothers. Increased awareness creation and regular demonstration of breastfeeding techniques are needed.
Clinical Screening for Menorrhagia and Other Bleeding Symptoms in Nigerian Women
Authors: Nwagha Theresa Ukamaka , Okoye Helen Chioma , Ugwu Angela Ogechukwu , Ugwu Emmanuel Onyebuchi
Published: May 2024

Objective:

The objective of the study was to evaluate the prevalence of perceived bleeding symptoms in Nigerian women and the usefulness of a simple clinical screening tool for bleeding symptoms.

Materials and Methods:

A population-based cross-sectional survey of 1524 women of 16–50 years in Southeast Nigeria using a structured, prevalidated, pretested questionnaire was conducted.

Results:

A total of 1524 (85%) women responded with the mean age of 26 (10.6) years. Prevalence of bleeding symptoms was 24.6% and 11% of the women reported a positive family history of bleeding symptoms. There was a significant association between having a positive family history of bleeding disorder and experiencing bleeding symptoms (adjusted odds ratio: 0.12, 95% confidence interval: 0.06–0.22 P < 0.0001). Two hundred and six women experienced at least one bleeding symptom, 125 (8.2%) experienced at least two, whereas 43 (2.8%) experienced >3 bleeding symptoms. The most common perceived bleeding symptom was heavy menstrual bleeding (HMB) present in 83 women (22.2%), 141 (9.3%) reported a past history of HMB, 202 (13.3%) had heavy bleeds during most of their monthly cycle, and 351 (23%) requiring resuscitation with blood support.

Conclusion:

The prevalence of perceived bleeding symptoms among women is high, and HMB is the most common bleeding symptom. This clinical screening tool is easy and cost-effective in routinely identifying women with bleeding symptoms needing further hemostatic and obstetrics evaluation.
Assessment of Health-Related Quality of Life of Vesicovaginal Fistula Patients Attending a Repair Center in Northwest Nigeria
Authors: Raji Mansur O. , Raji Ismail Abdullateef , Hassan Mairo , Raji Hadija Olaide , Bashir Abubakar Mohammad , Suleiman Ismail Nazrill , Abubakar Hauwa Ummi
Published: May 2024

Introduction:

Vesicovaginal fistula (VVF) has devastating effects on a woman's hygiene, self-esteem, interpersonal relationships, and environment disrupting all elements of her health. Despite VVF being a persistent condition, very few researches have been conducted in Nigeria to determine the quality of life (QoL) of these patients. This study was carried out with the aim of assessing the QoL of VVF patients receiving care in a repair center in Sokoto, Northwest Nigeria.

Materials and Methods:

This was cross-sectional study conducted at a VVF repair center in Sokoto. Study population comprised of patients who had undergone VVF repair at the health facility. The total number of study participants present at the facility was 81, and all were recruited into the study. The study assessed socio-demographics and QoL of the respondents. Data obtained were entered into IBM software package and subsequently analyzed. Level of significance was set at 5%.

Results:

The environmental domain had the highest mean score of 51.7 ± 11.8 while psychological domain had the least score of 41.3 ± 14.3. The mean overall QoL and general health were 49.5 ± 10.2. There was a moderate positive correlation between physical domain score and Age, (r = 0.258, P < 0.005). There was also a positive correlation between psychological domain score and Husband's educational status (r
pb = 0.241, P < 0.05). Social relationship domain score positively correlated with being married (r
pb = 0.414, P < 0.01).

Conclusion:

Older study participants had higher mean scores for physical and psychological domains, while younger study participants had higher overall QoL and general health scores compared with older study participants. Future research should compare the pre and postoperative QoL of women who undergo repair of obstetric fistula.
Menstrual Characteristics of Sickle Cell Disease Patients Seen at a Tertiary Institution in North Western Nigeria
Authors: Mohammed-Durosinlorun Amina , Bello-Manga Halima , Adze Joel , Ijei Ifeoma P. , Stephen Bature
Published: May 2024

Introduction:

The burden of sickle cell disease (SCD) is high in Sub-Saharan Africa, including Nigeria, and with improved care and survival, reproductive health issues, including menstruation, have become increasingly important and may impact on long-term health and social wellbeing.

Objectives:

This study was carried out to characterize the menstrual characteristics of SCD patients.

Methodology:

Using a cross-sectional study design, a semi-structured questionnaire was administered and information collected on bio-demographic data, medical history of SCD, reproductive, and menstrual history.

Results:

One hundred and sixty female patients participated in the study. The mean age was 24.9 years (standard deviation [SD] ± 8.8). The mean age at menarche was 15.6 years (SD ± 2.7) for those menstruating. Most respondents had regular menstrual cycles 120 (82%); normal menstrual cycle lengths 120 (81%) significantly associated with respondent's age (P < 0.05); normal duration of flow 140 (97%); light menstrual flow 104 (71%) significantly associated with body mass index BMI (P < 0.05). Overall, however, 114 (78%) had abnormal menses and 32 (22%) had normal menses. Eighty-one respondents (56%) experienced menstrual pain, which was severe in only 28 cases (35%). The presence of menstrual pain did not significantly affect the annual frequency of crisis (P > 0.05).

Conclusion:

The mean age at menarche was high at 15.6 years. Most respondents had light menstrual flow and overall abnormal menstrual patterns. Menstrual pain was common but was not significantly associated with the frequency of crisis.
Prevalence of Congenital Heart Disease among Patients with Down Syndrome in Southwestern Saudi Arabia
Authors: Taura Magaji Garba , Alshahrani Abdullah Mohammed , Alqahtani Dhafer Obeid
Published: May 2024

Background:

There is a paucity of data on the prevalence and pattern of congenital heart disease (CHD) among patients with Down syndrome (DS) in Bisha, Saudi Arabia. The aim of the study was to determine the prevalence and patterns of CHD in patients with DS and explore the association of participants’ sex with CHD in DS patients.

Methodology:

A total of 42 patients with confirmed DS were enrolled in the study. Relevant data were obtained from the patients’ records. The spectrum of CHD was analyzed and classified accordingly. Pearson's Chi-square was used to determine the association of gender with CHD.

Results:

Approximately 81% of the study participants had CHD. The most common CHD was atrial septal defect (28.5%), followed by ventricular septal defect (25%), patent ductus arteriosus (16%), and atrioventricular septal defect (14.3%). No significant association was found between CHDs and sex.

Conclusion:

The prevalence of CHD in the study group was consistent with reports from other regions of Saudi Arabia and globally. Participants’ sex was not associated with the occurrence of CHD in DS patients in this study.
Restrictive Cardiomyopathy
Authors: Kundu Soumi , Dasgupta Malay Kumar , Majumder Biswajit , Pradhan Sayan
Published: May 2024

Restrictive cardiomyopathy is an unusual form of cardiomyopathy accounting only for 2%–5% of all pediatric cardiomyopathies. It is mostly idiopathic. Gaucher disease in association with restrictive cardiomyopathy is extremely rare. We herein report a case of cardiac failure in an 8-year-old male child caused by restrictive cardiomyopathy. Pathogenesis of which was attributed to Gaucher disease. In any case of restrictive cardiomyopathy, Gaucher disease should be included in differential diagnosis and investigated accordingly.
Panhypopituitarism in Acute Myocardial Infarction
Authors: Ghosh Ritwik , Chatterjee Subhankar , Roy Devlina , Dubey Souvik , Lavie Carl J
Published: May 2024

While hypopituitarism is known to be associated with increased cardiovascular morbidity and mortality, panhypopituitarism as a complication of myocardial infarction (MI) is very rare. Here, we report a case of rapidly developing empty sella syndrome with florid manifestations of panhypopituitarism after MI (due to critical stenosis in the left anterior descending artery) complicated by cardiogenic shock in a 65-year-old man. The patient was initially stabilized with conservative management of non-ST-elevated MI and cardiogenic shock, but after initial improvement, he again deteriorated with refractory shock (not adequately responding to vasopressors), seizures, hypoglycemia, hyponatremia, hyperkalemia, and metabolic acidosis. After ruling out recurrent cardiogenic shock or other causes of refractory hypotension, panhypopituitarism was diagnosed with the help of hormonal assays and imaging. With no prior evidence of hypopituitarism, we suspect that panhypopituitarism developed due to acute pituitary apoplexy secondary to initial cardiogenic shock. The patient was successfully survived by the emergency endocrine management followed by secondary coronary angioplasty.
Influence of thyroid status on pulmonary functions in bronchial asthma patients
Authors: Kumar Kaushal , Mahajan Aarti Sood , Haldwani Dayaram , Bhadoria Dharam Pal , Goswami Binita
Published: May 2024

BACKGROUND:

Asthma is a serious global health problem affecting all age groups. It is being recognized for its health impact on the working status of adults, and uncontrolled asthma is associated with significant morbidity, mortality, and socioeconomic problems. The knowledge of comorbidities of asthma, including thyroid disorders, is important for its management.

METHODOLOGY:

A case–control study was conducted in 60 diagnosed patients of bronchial asthma in the age group of 20–40 years attending medicine outpatient departments and Chest Clinic of Lok Nayak Hospital, New Delhi. Thirty controls were taken from the normal population. Pulmonary function tests using "Schiller SP1 portable top spirometer" were done, and forced vital capacity (FVC), forced expiratory volume in 1st s (FEV1), FEV1/FVC ratio, and peak expiratory flow rate (PEFR) were analyzed. The thyroid function was assessed by estimating levels of serum thyroid-stimulating hormone (TSH), free T3, and free T4 using the Cobas e411 autoanalyzer.

RESULTS:

Based on TSH analysis of asthmatic patients, 25% were hypothyroid, 16.7% were hyperthyroid, and 58.3% were euthyroid. There were significant reductions in FEV1, FEV1/FVC ratio, and PEFR in asthmatics compared to controls, but no significant differences were found in these parameters among the asthmatics with different thyroid status.

CONCLUSION:

The thyroid functions varied in asthmatics. However, the variation in the thyroid function did not affect the pulmonary function in asthmatic patients.
Prevalence of Vitamin E deficiency and its correlation with symptoms, spirometry, and serum eosinophil in patients of asthma: A pilot study
Authors: Patel Anand , Ashara Bhamini , Udhwani Richa , Arumugasamy Lalithambigai , Adalja Mayur
Published: May 2024

BACKGROUND:

Asthma is one of the most prevalent chronic respiratory diseases. Immunomodulatory effects of Vitamin E have been recognized in human and animal models under disease and normal conditions.

OBJECTIVE:

To observe the serum level of Vitamin E of patients suffering from asthma and to study the relation of serum Vitamin E levels with serum eosinophil, pulmonary function test, and asthma control.

MATERIALS AND METHODS:

This cross-sectional study was carried out in the Department of Pulmonary Medicine of GMERS Medical College and Hospital, Gotri, Vadodara, Gujarat, on adult patients of asthma. After obtaining a detailed history and performing thorough physical examination of the patient, blood sample was collected for measurement of serum vitamin E and serum eosinophils. Then, patients were subjected to spirometry. Serum Vitamin E levels were measured by the calorimetric method.

RESULTS:

The serum Vitamin E is lower in asthma patients. The level of serum Vitamin E was significantly lower in patients with severe asthma as compared to mild and moderate asthma as well as it was also significantly lower in patients with uncontrolled asthma as compared to controlled asthma.

CONCLUSION:

The serum Vitamin E is lower in asthma patients and its level correlated well with spirometry and asthma control test (ACT) scores. Hence, Vitamin E supplementation may be beneficial for patients with poor ACT scores and severe disease in spirometry along with other treatments.
The Plethora of Possibilities with a Smartphone in Diabetes Prevention and Care
Authors: Johnson Brijit , George Joe , Basanth Anjana , Chandran Vysakh , Kesavadev Jothydev
Published: May 2024

The advent of smartphone technology has revolutionized the management and care of diabetes, offering innovative solutions to enhance patient outcomes and streamline health-care processes. This review explores the multifaceted role of smartphones in diabetes management, encompassing prevention, monitoring, education, and the utilization of smart tools. Smartphones facilitate real-time tracking of vital parameters, such as blood glucose levels and physical activity, through integrated devices and applications, supporting personalized and informed decision-making in diabetes care. These applications give patients the tools they need to take charge of their health by providing features such as glucose monitoring, medication reminders, and customized nutrition programs. Timely modifications to treatment plans and interventions in the event of difficulties are made possible by real-time communication between patients and health-care providers. Better health outcomes, increased patient participation, and improved access to high-quality healthcare have all resulted from the use of smartphones in diabetes care. The integration of smartphones into diabetes care represents a paradigm shift, offering convenient access to health-care services, personalized interventions, and ultimately, improved health outcomes for individuals with diabetes.
The Historical Evolution of Continuous Glucose Monitoring - The Story of 25 Years
Authors: Kesavadev Jothydev , Saboo Banshi , Chawla Manoj , Parikh Rakesh , Sahay Rakesh , Joshi Shashank R , Gupta Amit , Bhartia Mithun , Shankar Arun , Sreelakshmi R. , Krishnan Gopika , Jothydev Krishnadev
Published: May 2024

With the advent of ever more sophisticated technologies, the notion of conventional glucose monitoring has been transforming. The potential benefits of continuous glucose monitoring have been touted since its introduction more than 20 years back. People with diabetes are now well aware of the multitude of benefits they can harness with continuous glucose monitoring systems that can enhance their quality of life. The review sheds insight into the history and evolution of continuous glucose monitoring.
Personalized Intervention in Correcting Insulin Injection Errors and its Impact on A1C in the Study: A Cross-sectional Study
Authors: Krishnan Gopika , Kesavadev Jothydev , Mohammed Rafiq , Raj Sumesh , Prasobh P. Sunil , Sreelakshmi R. , Chandran Vysakh , Raj Sourav , Basanth Anjana
Published: May 2024

Background:

Ever since the discovery of insulin, it has become an inevitable part of diabetes management in both type 1 and type 2 diabetes (T2D). Administering insulin subcutaneously following the correct insulin injection technique is often flawed in a considerable number of people with diabetes. Incorrect insulin techniques lead to poor glycemic control and invite serious adversities.

Aims and Objectives:

The study aims to evaluate impact of imparting educational intervention on reducing insulin injection errors and subsequent improvement in glycated hemoglobin in people with T2D.

Materials and Methods:

The study employed a survey-based cross-sectional design to evaluate the impact of the educational interventions on the injection techniques for the diabetes cohort. The data were collected from people with T2D visiting the outpatient department of four different comprehensive diabetes research centers in Kerala, India. All the statistical analysis was performed using R version 4.2.3.

Results:

Results showed a significant reduction in the HbA1c in people with type 2 diabetes.

Conclusion:

The cross-sectional study demonstrates that repeated educational interventions contribute to statistically significant improvement in HbA1c.
Pancreatic Exocrine Insufficiency in Type 2 Diabetes
Authors: Naina M Junaid , Prasad Mohan VG , Jothydev Krishnadev , Sreelakshmi R , Ashik Asha , Chandran Gopika Beena , Kesavadev Jothydev , Krishnan Gopika
Published: May 2024

Pancreatic exocrine insufficiency (PEI) is defined as malabsorption caused by impaired nutrient digestion, particularly of fats. Studies have demonstrated that one of the factors that contribute to the increased risk of PEI is diabetes. It is unfortunate that very often PEI is underdiagnosed and undertreated or misdiagnosed which leads to severe adversities. This report describes the case of a 50-year-old male with PEI misdiagnosed initially and later treated effectively with appropriate diagnosis and prompt interventions.
Pattern of bacterial infections in neutropenic febrile patients (experience of the Specialized BMT center - Medical city complex - Baghdad, Iraq)
Authors: Shakir Zahraa Sameer , Saeb Sarah Muayad , Yousif Fawaz Salim , Shakir Sinaa Mahdi , Al-Bakri Zina Ali , Faraji Safa A , Al-Saeed Raghad Majid , Taha Kanar Tahseen
Published: May 2024

BACKGROUND:

Infectious complications occur in most of the patients undergoing hemopietic stem cell transplantation (HSCT), these carry high risk of mortality mainly due to Gram-negative bacteria unless effective antibiotic treatment is provided.

OBJECTIVES:

The aims of the study were to review bacterial isolates from different samples in febrile neutropenic patients underwent HSCT in terms of incidence, types, and antimicrobial resistance, and to assess the efficacy of infection control measures used in transplantation ward.

PATIENTS AND METHODS:

This is retrospective study. The medical records of a total of 82 patients who underwent HSCT in the Specialized BMT Center, Baghdad Medical City, in 2021 and 2022 were reviewed; for any patient with neutropenic fever (NF), the clinical assessment was made, and samples were taken for culture any sensitivity before starting empirical antibiotics. The study was reviewed by the ethical committee of the hematology transplant center in the Medical City Complex, and since the study is retrospective, no consent is needed from the patient.

RESULTS:

There were 57 patients who developed NF, two at the time of collection, while 55 patients during transplant. In 16 patients, there was a clinical focus for NF, most commonly respiratory. From 175 samples sent for culture and sensitivity, bacterial growth was detected in 103 samples, and the incidence of bloodstream infection was 53%. Polymicrbial bacterial growth was detected in 6 patients with NF. Gram-positive bacteria were slightly more common than Gram negative. Staphylococcus epidermidis and Burkholderia cepacia were the most common Gram positive and Gram negative, respectively. An increasing number of patients admitted to transplant centers were associated with more infections. Ten out of 13 bacteria were multidrug resistant (MDR). Only two patients died from infection posttransplant.

CONCLUSIONS:

The predominance of Gram-positive cocci and Burkholderia cepacia complex supported the need to review the adherence to infection control policy. The empirical antibiotic protocol should be guided by local antibiogram, and since the high rate of blood stream infection (BSI) with MDR pathogens, a de-escalating strategy utilizing carbapenems – as advised by the ECIL-4 guidelines – would be more appropriate while awaiting culture result. The ability to quickly identify infections and their susceptibility profile is still crucial for choosing antibiotic therapy.
Effect of Aromatherapy with Essential oil of Lavandula Angustifolia Mill- Citrus Bergamia and Mindfulness-Based Intervention on Sexual Function, Anxiety, and Depression in Postmenopausal Women
Authors: Mojtehedi Mandana , Salehi-Pourmehr Hanieh , Ostadrahimi Alireza , Asnaashari Solmaz , Esmaeilpour Khalil , Farshbaf-Khalili Azizeh
Published: May 2024

Background:

Due to the importance of psychological support for women during menopause as a period with a high prevalence of mental health problems, this study aimed to evaluate the effect of the essential oil of lavender-Bergamot (La-Ber) and Mindfulness-Based Intervention (MBI) on sexual function, anxiety (primary outcome), and depression score (secondary outcome) in postmenopausal women with sexual dysfunction.

Materials and Methods:

This controlled randomized trial with a factorial design was performed on 132 postmenopausal women. Participants were randomly allocated into four equal groups: Aromatherapy-Routine Care (Aroma-RC), MBI-Placebo (MBI-P), Aromatherapy-MBI (Aroma-MBI), or Routine Care-Placebo (RC-P). Two to three drops of La-Ber or a similar placebo were inhaled three times a day for 8 weeks. Eight sessions of MBI intervention were conducted. At the end of the intervention and eight weeks afterward, the outcomes were assessed.

Results:

The sexual function score improved significantly in Aroma-MBI (adjusted Mean Difference [aMD]: 2.4, 95% CI: 0.01 to 4.80) and MBI-P (aMD: 2.6, 95% CI: 0.2 to 5.1) groups compared to the RC-P group. The anxiety score was reduced in the Aroma-RC group at the end of the intervention (aMD: -4.12, 95% CI: -7.41 to -0.72; p = 0.020) and eight weeks later as well as in the Aroma-MBI group. In terms of depression, the mean score of depression was significantly lower than the RC-P group in the Aroma-RC group at the end of the intervention (p = 0.011).

Conclusions:

MBI and aromatherapy seem effective on sexual function and menopausal anxiety. MBI improves sexual function, while aromatherapy ameliorated anxiety and depression.
Humanistic Care in Nursing
Authors: Taghinezhad Fakhredin , Mohammadi Eesa , Khademi Mojgan , Kazemnejad Anoshirvan
Published: May 2024

Background:

Despite the importance and prominent role as a clinical, theoretical, and research approach in nursing practice, humanistic care nature and boundaries are not explicit and challenging for nurses to understand. This study was conducted to clarify the concept of humanistic care in nursing.

Materials and Methods:

Based on Rogers's evolutionary concept analysis, keywords such as “humanistic car *,” “caring behave *,” “humanistic nurs *,” “humanistic model of care,” were searched in PubMed, SCOPUS, Science Direct, Web of Science, WILEY, Springer, SAGE, ProQuest, SID, Iranmedex without time limit until November 2018. Sixty-five documents in nursing and ten documents in the medical discipline were finalized for thematic analysis.

Results:

Nine attributes of the humanistic care, including “excellence in clinical literacy,” “creating a healing environment,” “a comprehensive and unique viewpoint,” “contribution to clients' adaptation and flourishing of their talents,” “unrequited love and affection,” “preservation of human dignity,” “real presence,” “constructive dynamic interaction,” and “nurse's self-care,” were recognized. Assessing the historical and evolutionary course of the concept's semantic tendency revealed three periods: The focus in first, second, and third was on the nurse-patient relationship, quantitative tendency/measurement, and metaphysics/spiritual humanism, respectively. The comparison of interdisciplinary differences indicated greater semantic comprehensiveness and depth in the nursing discipline.

Conclusions:

Clear and practical definition and identification of humanistic care in nursing can be helpful in the further development of existing knowledge, instrumentation, designing guidelines, clinical interventions, knowledge translation, and correction of concept misuse. The identified antecedents and consequences can be in various aspects of clinical management.
Concerns and Challenges of Living Donors When Making Decisions on Organ Donation
Authors: Bahador Raziyeh Sadat , Farokhzadian Jamileh , Mangolian Parvin , Nouhi Esmat
Published: May 2024

Background:

Mental concerns of living donors can be a solid barrier to logical and informed decision-making for organ donation. The present study explores living donors' mental concerns and problems during the process of decision-making for organ donation.

Materials and Methods:

present study was performed using qualitative content analysis. Twenty-one participants were selected by purposive sampling. The data were collected and recorded through semistructured interviews and analyzed by MAX Qualitative Data Analysis software 12, based on Graneheim and Lundman's contractual content analysis method.

Results:

Data analysis extracted 425 codes, 13 subcategories, 3 main categories, and 1 core theme (conflict between doubt and certainty). The three main categories were individual barriers and concerns (faced by the donor), interpersonal concerns and barriers (experienced by the family), and socio-organizational concerns and barriers (at the community).

Conclusions:

Based on the results, donors have significant concerns and face major problems when deciding on organ donation. Therefore, health-care professionals should take into account organ donors' concerns, raise awareness of donor associations, and formulate policies to increase living donors' satisfaction.
Patient Commitment to Cardiac Rehabilitation
Authors: Sanaie Neda , Darvishpoor-Kakhki Ali , Ahmadi Fazlollah
Published: May 2024

Background:

Commitment to Cardiac Rehabilitation (CR) is one of the essential strategies to reduce the long-term complications of cardiovascular disease. The attributes of patients' commitment have not been defined distinctly. Thus, the present study aimed to describe the attributes of commitment to CR from the participants' perspective.

Materials and Methods:

This qualitative study was carried out in Tehran from 2018 to 2019. Data were collected using semi-structured interviews with 30 participants, including 13 CR specialists, 13 patients, and four caregivers, through purposeful sampling. The analysis was performed through the conventional content analysis using the Elo and Kyngäs approach.

Results:

Commitment to CR has one theme titled the attitudinal-motivational aspect that consists of four categories including attitudinal-cognitive, attitudinal-behavioral, attitudinal-emotional, and motivational as the core features. The commitment to CR is devotion, internal desire, and voluntary obligation to initiate and continue CR cooperatively, all of which are accompanied by the purposeful initiation of the treatment plan.

Conclusions:

The patient's commitment to CR is an intrinsic interest in achieving health that stems from the acceptance of the disease and the need for treatment. Besides, the rehabilitation team facilitates purposeful interpersonal relationships between the patient and the treatment group. It provides the basis for the patient's active efforts to meet the challenges of the treatment process.
Validation of the Persian Version of Health Professionals Communication Skills Scale
Authors: Nia Hamid Sharif , Salimi Seyedeh-Sakineh , Charati Fahimeh Ghasemi , Azimi-Lolaty Hamideh , Shafipour Vida
Published: May 2024

Background:

The need for assessing health-care workers' communication skills is increasingly emphasized by researchers. Achieving such a goal requires the use of a reliable tool. The purpose of this study was to validate the Persian version of Health Professionals Communication Skills Scale (HP-CSS).

Materials and Methods:

For the present methodological study carried out from September 2016 to February 2017, 400 health workers were selected by convenience sampling from educational hospitals in Mazandaran province in Iran and they were asked to fill out the 18-item HP-CSS. All steps of the scale validity were performed. Exploratory and confirmatory factor analysis were used. The reliability of the tool was measured by internal consistency.

Results:

Two factors of care and verbal clarity with patients and respect for patients' rights, extracted by exploratory factor analysis, explained 47.38% of the variance. Content Validity Index (CVI) and Content Validity Ratio (CVR) of all items were higher than 0.79 and 0.49, respectively. Reliability coefficients of factors were found to be more than 0.70. Model's fitness indicators confirmed the construct of HP-CSS. Both factors had a convergent and divergent validity.

Conclusions:

This study showed that the Persian version of the communication skills scale has a two-dimensional construct and good psychometric properties; also, this scale was found to be useful for the purpose and context in which it will be used, that is, communication skills.
Mental Health of Iranian Pregnant Women During Pandemic of COVID-19
Authors: Toghyani Mojtaba , Toghyani Ali
Published: May 2024

Background:

An evaluation of Iranian pregnant women's mental health during the COVID-19 outbreak is an ignored issue. The current study aimed to investigate the mental health of Iranian pregnant women during the COVID-19 pandemic.

Materials and Methods:

Literature searching was conducted, and studies were published from 01 March 2020 to 30 June 2022 on PubMed, Scopus, ScienceDirect, SID, and Magiran screened for the relevant articles.

Results:

There was a total of 10 studies included in this systematic review. In the present study, the prevalence of moderate to the high level of depression, anxiety, and stress symptoms was 40%, 19 to 74%, and 70%, respectively. There were some protective factors such as physical activity, social support, using progressive relaxation, and husbands' involvement in caring behaviours of their pregnant wives that can enhance the mental health of Iranian pregnant women during the COVID-19 pandemic.

Conclusions:

Regarding the high prevalence of depression, anxiety, and stress among Iranian pregnant women during the current pandemic, the mental health status of pregnant women should be regularly evaluated and essential educational and interventional programs should be provided for this population.
Comparing the effect of two methods of using ear protective device on pain intensity in patients undergoing coronary artery bypass grafting
Authors: Bastani Fatemeh , Kheirollahi Narges
Published: May 2024

Background:

Severe pain is the most prevalent complication after Coronary Artery Bypass Grafting (CABG). The aim of this study is to compare the impact of two methods using ear protective devices on pain intensity in patients undergoing CABG.

Materials and Methods:

The present randomized clinical trial was conducted between October 2019 and February 2020. The participants included 84 patients undergoing CABG, who were randomly divided into two intervention groups (A, B) and a control group. On the first night after the heart surgery, ear protective devices were used for the patients in group A during the evening and night sleep, while they were used in group B only during the night sleep. A demographic questionnaire and Visual Analog Scale (VAS) were the data collection tools used in this study. Data were analyzed using Chi-square test, paired t-test, and one-way Analysis of Variance (ANOVA) in Statistical Package for the Social Sciences (SPSS) software.

Results:

Before the intervention, the mean (SD) of pain intensity in the two intervention groups (A, B) and the control group was 6.46 (1.71), 6.32 (1.36), and 6.54 (1.45), respectively, and there was no significant difference between the groups (F2,81 = 0.14; p = 0.86). However, after the intervention, the mean (SD) of pain intensity in the two intervention groups (A, B) and the control group was 3.39 (1.87), 4.46 (1.55), and 6.39 (1.54), respectively, which showed a significant difference (F2,81 = 23.37; p < 0.001).

Conclusions:

The use of ear protective device is recommended as a non-invasive and accessible way of reducing pain intensity in patients after CABG.
Comparison of Maternal-Infant Attachment in Cesarean Delivery Based on Robson Classification
Authors: Rookesh Zohreh , Kaviani Maasumeh , Zarshenas Mahnaz , Akbarzadeh Marzieh
Published: May 2024

Background:

The Robson criteria allows for standardized comparisons of data and possible driving changes in Cesarean Section (C/S) rates and complications. The aimed to compare maternal-infant attachment in C/S based on Robson Classification.

Materials and Methods:

This cross-sectional prospective study was conducted on 369 women who had undergone C/S in Hazrate Zeinab Peace Be Upon Him (PBUH), Hafez, and Shooshtari hospitals affiliated to Shiraz University of Medical Sciences, Iran from April 2018 to March 2019. The study data were collected using a demographic form, an obstetric form, and Avant Checklist (AC) at postpartum and pre-discharge stages. Each participant was placed in Robson classification and the attachment score was calculated in each Robson Classification, and a comparison was made among the 10 groups. The data were analyzed into the SPSS 16 software and using descriptive statistics and paired t test.

Results:

The total mean (SD) score of attachment was 38.73 (18.65) at 1–7 h postpartum and 90.52 (23.79) at pre-discharge. The highest total mean (SD) score of attachment was observed in group 6 (86.78 (8.70) at postpartum and 118.67 (4.47) at pre-discharge). The lowest total mean (SD) score of attachment was observed in group 10 (12.79 (2.37) at 1–7 h postpartum and 45.44 (7.99) at pre-discharge).

Conclusions:

Obstetric characteristics in Robson Classification, parity, previous C/S, gestational age, onset of labor, fetal presentation, and number of fetuses were effective in clarifying information. The use of this system is necessary to determine the causes of increased C/S cases in low-income and middle-income countries.