bluuebunny/crossref_metadata_2025 huggingface dataset:
Using theory of reasoned action to reduce high-risk sexual behaviors among patients with HPV: A randomized controlled trial
Authors: Pourgholamamiji Nima , Shahsavari Hooman , Manookian Arpi , Soori Tahereh , Zandkarimkhani Maryam , Zare Zahra
Published: January 2023

BACKGROUND:

Sexually transmitted diseases are a major health problem in all countries. Human papillomavirus (HPV) infection is the most common viral sexually transmitted disease in both genders. High-risk sexual behaviors (HRSBs) are among the major risk factors for HPV infection. Lack of knowledge can contribute to HRSBs and hence, education can potentially reduce HRSB risk. This is a study using theory of reasoned action to reduce the high-risk sexual behaviors among patients with HPV.

MATERIALS AND METHODS:

This study was a two-grouped, randomized, controlled trial. The educational program was developed based on the results of a survey into the most important components of the theory of reasoned action contributing to HRSBs among 100 patients recruited from Razi hospital, Tehran, Iran. Then, 110 patients from the same hospital were consecutively recruited and randomly allocated to a control (n = 55) and an intervention (n = 55) group. Then, each participant in the intervention group was provided with the developed educational program. Their counterparts in the control group solely received routine care services. Three months after the first educational session, HRSBs were reassessed in both groups. Data were analyzed via the SPSS software (v. 21.0).

RESULTS:

After the intervention, the mean score of HRSBs significantly decreased in the intervention group (P < 0.001) but did not significantly change in the control group (P = 0.70). The post-test mean score of HRSBs in the intervention group was significantly less than the control group (P = 0.015).

CONCLUSION:

Education based on the theory of reasoned action is effective in significantly reducing HRSBs. Nurses can develop and use educational interventions based on this theory to reduce HRSBs and HPV infection.
Designing unified trans-diagnostic interventions and their efficacy on the common mechanisms of the comorbid obsessive personality disorder with anxiety, depression, and obsessive-compulsive disorder: A protocol study
Authors: Zirakbash Amin , Naderi Farah , Marashian Fatemeh Sadat , Makvandi Behnam
Published: January 2023

BACKGROUND:

The immense comorbidity among disorders could be ascribed to common trans-diagnostic processes. The term trans-diagnostic has been of interest in both pathology and psychology. Trans-diagnostic treatments were created as opposed to treatments based on single-diagnosis treatments. It addresses the common underlying mechanisms in a range of comorbid disorders. Trans-diagnostic treatment is one of the new psychological treatments, and its efficacy has been proven on many psychological variables. The main focus of the current study is on designing unified trans-diagnostic interventions and their efficacy on the shared mechanisms of comorbid obsessive personality disorder with anxiety, depression, and obsessive-compulsive disorder.

MATERIALS AND METHODS:

the sequential transformative strategy has two stages; qualitative and quantitative. In The first and qualitative section of the research, explanatory research will be carried out to investigate the trans-diagnostic intervention using a systematic review. To validate the trans-diagnostic intervention, and simultaneously with the trans-diagnostic intervention, a questionnaire has been prepared and given to 10 psychology experts and professionals in the treatment field concerning content validity by evaluators.

Quasi-experimental research will be assessed with a pre-test, post-test, and a two-month follow-up after confirming the validity and reliability of the intervention in the quantitative section.

CONCLUSION:

Designing unified trans-diagnosis interventions and their efficacy on the common mechanisms of comorbid obsessive personality disorder with anxiety, depression, and obsessive-compulsive disorder is an effective treatment method for helping those suffering from a personality disorder. Clinical psychologists, psychology experts, psychiatrists, and mental health experts are all the immediate beneficiaries of this study. Moreover, clients could benefit from this intervention with less money and time.
Development and validation of a questionnaire based on the protection motivation theory to predict cigarette smoking preventive behavior in the Iranian university students
Authors: Abdollahi Salime Zare , Mahmoodabad Seyed Saeed Mazloomy , Lotfi Mohammad Hasan , Ardakani Seyed Mojtaba Yassini
Published: January 2023

BACKGROUND:

Prevention of smoking is very important at a young age and during the student period. Because of the lack of a questionnaire based on the prevention of smoking behavior, this study was conducted to design and standardize a tool according to the protection motivation theory (PMT).

MATERIALS AND METHODS:

This was an analytical cross-sectional study where information and opinions of experts and then designing tools and assessing the face validity in the first phase and content validity, construct validity, test–retest reliability, and internal consistency of questions in the second phase were examined. The initial themes and structures were determined based on the literature Review and the opinion of experts. Three hundred students of Yazd Universities were selected by cluster sampling and included in the study. All analyses were performed in SPSS and AMOS software version 24 with a significance level of less than 5%.

RESULTS:

The final version of the scale had 39 questions in eight dimensions. The overall Cronbach's alpha value was 0.89, and for each dimension, it was more than 0.7. The content validity ratio and content validity index for the whole tool were 0.87 and 0.94, respectively. The results of confirmatory factor analysis showed that the latent construct model had good fit (X2/df = 4.31; RMSEA = 0.07; CFI = 0.94; NFI = 0.92; TLI = 0.91, P < 0.001).

CONCLUSION:

In this study, a valid and reliable tool based on PMT to predict smoking behavior in students was introduced. This tool can be used in interventional and etiological studies. It also has questions related to the coronavirus disease 2019 (Covid 19) virus and can be used in the coronavirus pandemic.
Home health care of Iranian elderly with dementia: Study protocol for guideline adaptation
Authors: Irajpour Alireza , Maleki Fatemeh , Shati Mohsen , Najafii Mohamad R.
Published: January 2023

BACKGROUND:

Advanced stages of dementia interfere with elderly self-care. Consequently, they need caregivers who take responsibility for their care in the long-term. Restrictions to the caregiver's access to information, resources, and organizational support have created problems in their caregiver role, which is why the World Health Organization (WHO) emphasizes caring for caregivers by providing evidence-based information and training programs. As there is no clinical practice guideline for home care in the Islamic Republic of Iran, this study aims to develop a home health care guideline for the elderly with dementia.

MATERIALS AND METHODS:

The ADAPTE process provided by the Guidelines International Network was considered as the basis. In order to identify the care needs of Iranian patients with dementia, semi-structured interviews were added to this guideline.

DISCUSSION:

The identification and implementation of the perspectives of patients and caregivers during the process of guidelines adaptation increase the applicability of the guidelines. Improved quality of life for the patients in their place of residence is one of the expected consequences of this guideline's implementation. The developed guidelines will be used at home health care centers, and dementia and Alzheimer's associations in Iran.
Metamemory functioning and memory strategies used among medical students
Authors: Kancharla Kinjari , Kanagaraj Sagayaraj , C. N. Ram Gopal
Published: January 2023

BACKGROUND:

Metamemory can be described as an intentional endeavor to guide or control one's memory processes. In other words, awareness and knowledge of one's own memory process and strategies for using the memories effectively. Planning, allocating cognitive resources, selecting strategies, assessing understanding, and evaluating performance all rely heavily on metamemorial information. For efficient learning, good memory abilities are necessary. This study aimed to understand metamemory functioning and to see if there were any gender differences in metamemory functioning among medical students.

MATERIALS AND METHODS:

This cross-sectional study was conducted by collecting data from 350 medical students using the Memory Functioning Questionnaire in 2021. The sample group was selected from medical colleges in South India such as Kerala, Karnataka, Tamil Nadu, Telangana, and Andhra Pradesh using a purposive sampling technique. This questionnaire focused on the seriousness of forgetting, the rate at which people recalled things over time, and frequency of use of mnemonics and techniques that assist memory. Descriptive statistics, independent sample t-test, correlation, and regression were used for analysis.

RESULTS:

There was a significant difference based on gender among medical students in general memory functioning and frequency of forgetting (P < 0.001). Similarly, it was also found that gender was a major predictor of general memory functioning and frequency of forgetting among medical students (P < 0.001).

CONCLUSION:

Most medical students believe they have a minor memory issue. Even if the majority of medical students forget information, the vast majority of them believe they have an exceptional memory. Gender acts as a significant predictor of general memory performance and forgetfulness.
Challenges of providing health services to patients with cardiovascular diseases during disasters in Iran: A qualitative study
Authors: Moslehi Shandiz , Shirazi Fahimeh Barghi
Published: January 2023

BACKGROUND:

Cardiovascular diseases are the most common causes of death in the world. Because of the rate of emergencies and disasters in the country, this study was conducted to investigate the challenges of providing health services to cardiovascular patients in emergencies and disasters in Iran.

MATERIALS AND METHODS:

This conventional content analysis study was conducted in 2020. Subjects were selected from among 16 Iranian experts) epidemiologists, cardiologists, PhD in Disaster Health, and PhD in Nursing (using purposeful and snowball sampling methods. Data were collected using semi-structured interviews and were analyzed by the content analysis.

RESULTS:

The results were obtained after analyzing the data in the pre-emergency phase (lack of training on medication and nutrition, lack of training vulnerable groups, lack of databases of cardiovascular patients, and lack of identification of patients before disasters), the emergency response phase (lack of sleep and rest patterns, lack of health forces, lack of blood pressure control, lack of proper nutrition, increased medication needs, and lack of mental health interventions), and the post-emergency phase (lack of planning, lack of management of patients' mental problems).

CONCLUSION:

Developing strategies for planning, training, providing resources, and mental health during the three phases of the emergency management cycle for specific groups such as cardiovascular patients together with empowering these patients in the event of disasters is one of the key strategies which can be used after curbed emergencies and disasters to reduce the rate of mortality.
Prevalence and predictors of vaccine hesitancy among mothers of under-five children: A hospital-based cross-sectional study
Authors: Goruntla Narayana , Akanksha Kokkala , Lalithaasudhaa Katta , Pinnu Vikash , Jinka Dasaratharamaiah , Bhupalam Pradeepkumar , Doniparthi Jyosna
Published: January 2023

BACKGROUND:

The World Health Organization (WHO) states that vaccine hesitancy is one of the top 10 threats to global public health. Evidence shows that vaccine hesitancy studies in India are limited and targeted toward individual vaccines. The study aimed to fill this gap by exploring the relationship between demographics and SAGE factors toward vaccine hesitancy.

MATERIALS AND METHODS:

A hospital-based, cross-sectional, analytical study was conducted in a non-governmental organization (NGO) hospital with 330 beds, located in Bathalapalli, Andhra Pradesh, India. Mothers of under-five children who attended outpatient departments of pediatrics or obstetrics and gynecology were included. A total of 574 mothers were enrolled and vaccine hesitancy was determined by reviewing the mother–child protection card for the presence of delay or refusal of the recommended vaccine. A face-to-face interview was conducted to obtain demographics and WHO–SAGE variables from the participants. Binary logistic regression analysis was performed to associate independent variables (demographics and SAGE variables) with the dependent variable (vaccine hesitancy).

RESULTS:

Out of 574 respondents, 161 mother's children were noted as vaccine-hesitant (refusal = 7; delay = 154); and the prevalence of vaccine hesitancy was 28.05%. The delay was observed in all recommended vaccines, but the refusal or reluctance was seen in only four vaccines (hepatitis B birth dose = 1; IPV 1 and 2 = 2; Measles 1 and 2 = 3; and Rota 1, 2, and 3 = 1). The respondents' demographics like no or lower parent education (OR = 3.17; 95%CI = 1.50–6.72) and fewer antenatal visits (OR = 2.30; 95%CI = 1.45–3.36) showed higher odds, whereas the upper socioeconomic status showed lower odds (OR = 0.09; 95%CI = 0.02–0.36) toward vaccine hesitancy. The WHO–SAGE dimensions like awareness (OR = 0.14; 95%CI = 0.03–0.53), poor access (OR = 7.76; 95%CI = 3.65–16.51), and low acceptability of the individual (OR = 07.15; 95%CI = 1.87–27.29), community (OR = 6.21; 95%CI = 1.58–24.33) were significantly associated with vaccine hesitancy.

CONCLUSION:

The study concludes that the prevalence of vaccine hesitancy was high. Vaccine safety and children's health are primary concerns for parents' refusal/reluctance. To achieve 100% immunization coverage, policymakers need to reduce vaccine hesitancy by developing strategies based on demographic and WHO–SAGE working group predictors.
Knowledge, attitude, and practice toward seasonal influenza vaccine during the COVID-19 pandemic among students at King Saud bin Abdulaziz University for Health Sciences-Jeddah, Saudi Arabia
Authors: Abushouk Amir , Ahmed Mohamed Eldigire , Althagafi Zaher , Almehmadi Abdulrhman , Alasmari Samer , Alenezi Fares , Fallata Muhannad , Alshamrani Rayan
Published: January 2023

BACKGROUND:

Annual influenza vaccine is recommended among health professionals especially, health science undergraduates; although, studies suggest that there is a low level of vaccine coverage among health care undergraduates. Thus, the study aimed to investigate students' knowledge, attitudes, and practices regarding the seasonal influenza vaccine at King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) in Jeddah, Saudi Arabia.

METHODS:

A cross-sectional, unicentral study was carried out during the period of April to November 2021. A total of 341 validated questionnaires that included four sections were distributed in all four different colleges of KSAU-HS. Data management and analyses were carried out using Statistical Software for Social Sciences (SPSS) version 25.

RESULTS:

Out of 341 respondents, 336 participants completed the full survey (98.53% completion rate). The majority of participants were males (67.6% and the most participants were from the college of medicine (60.4%). The mean knowledge score of students was found to be (11.3 ± 2.0) out of 14 points. The most common barrier to vaccination among healthcare students was not having enough time to take the vaccine (23.8%), while the second one was the COVID-19 pandemic (22.32%). The vaccination rate in 2020 was 103 (30.7%), while 235 (80.4%) students stated that they have received the vaccine previously. School/work requirements and the student's awareness of the vaccine's importance were the most common reasons for taking the influenza vaccine.

CONCLUSION:

Even though students showed a high level of knowledge and a positive attitude towards the influenza vaccine, they generally had a low level of vaccine uptake. To enhance immunization rates, we encourage vaccine campaigns in all healthcare colleges. Further studies are needed to identify influences on students' attitudes and practices regarding influenza vaccination.
Perceptions of medical undergraduate students toward biomedical research – A sequential, explanatory, mixed-method study from Puducherry, South India
Authors: Narayan Gaurang , Rajagopal Anandaraj , Moharana Lopamudra
Published: January 2023

BACKGROUND:

Biomedical research is not given adequate attention during undergraduation due to the failure of the medical curriculum to motivate the students to take up research, teach the research methodology, and emphasize the scope of research in the future. Our objective was to study the perceptions of medical undergraduate students toward biomedical research and to explore the facilitators and barriers to biomedical research.

MATERIALS AND METHODS:

This was an explanatory, sequential, mixed-method study. Consenting medical undergraduate students, irrespective of their previous contribution to research, were interviewed by a pretested questionnaire concerning biomedical research, its barriers, and facilitators. For the qualitative component, two focused group discussions (FGDs) were conducted among students in the nonclinical and clinical phases. Data were analyzed and expressed as percentages. Thematic manual content analysis of the transcribed manuscripts was performed.

RESULTS:

This study included 553 participants. Only 5.52% had previous experience undertaking research. Self-interest and acquiring deeper knowledge were identified as drivers. Lack of motivation, proper guidance, and training in research methodology was found to be the barrier among 90% of the subjects. The FGD reflected the perceptions of students and variations in their ideologies toward taking up research.

CONCLUSION:

It becomes important to analyze the factors that promote or avert a student from taking up research. A thorough investigation in this regard will be helpful for future cohorts of medical students and will impact their decisions on taking up research and in seeking a career in research-based fields.
Adherence to medical nutrition therapy and it's challenges among antenatal women with gestational diabetes mellitus in South India- A sequential explanatory mixed-method study
Authors: Ravel Vanessa , Jayaseelan Venkatachalam , Rengaraj Sasirekha , Lakshminarayanan Subitha , Kannusamy Sivaranjini , Susindhran Balaji
Published: January 2023

BACKGROUND:

Globally, one in ten pregnant women have diabetes; out of which, 90% contribute to gestational diabetes mellitus (GDM). Medical Nutrition Therapy (MNT) is the cornerstone for GDM treatment yet adherence to MNT among the masses is not adequately monitored as part of the routine antenatal services. The study aimed to estimate the proportion of adherence to MNT and determine the factors related toadherence among antenatal women with GDM. This study also explores the facilitators, barriers, and possible suggestions for improving adherence.

MATERIALS AND METHODS:

This facility-based sequential explanatory mixed-method study was conducted among 341 antenatal women with GDM at, Puducherry. The study was conducted in 2021. Dietary adherence was evaluated using Perceived Dietary Adherence Questionnaire and based on the scores obtained they were selected for in-depth interviews to explore the facilitators and barriers. Collected data wereanalysed by Chi-square test using STATA version 16.

RESULTS:

Out of 341 participants, the proportion of participants adherent to MNT was 135 (39.6%) with 95% CI of 34%–44%. Thepredictors for poor adherence were unemployment (PR: 0.65; 95%CI: 0.48–0.88) and good adherence was antenatal women in the 2nd trimester (PR: 1.541; 95%CI: 1.18–2.025). Barrierstonon-adherence were financial crisis, lack of awareness ofthe need for MNT, and joint family pressure.

CONCLUSIONS:

About two-thirds of antenatal women with GDM are non-adherent to MNT. Unemployment and period of gestation were found to be theirdeterminants. Appropriate action has to be implemented for improving the adherence rate.
Prevalence of disability among the elderly people in an urban slum of Chennai – A cross-sectional study
Authors: Ravi Jeevapriya , Kuzhali S , Ramamoorthy Parameswary
Published: January 2023

ABSTRACT

Background:

Human population is ageing worldwide. Disabilities are common with ageing; but most of the studies focused on the medical model of disability. However, “disability and elderly” encompasses a larger spectrum of conditions and needs to be studied as a broader concept. This study was done to estimate the prevalence of disability in elderly people in terms of WHO DAS 2.0 Scale and to identify the factors associated with disability in the elderly people.

Methodology:

A sample of 220 elderly people was enrolled by multistage random sampling from TP Chatram, a slum in Chennai. A pre-tested semi-structured questionnaire about the socio-demographic details was administered. The disability was assessed by WHO DAS 2.0 Scale. The data entered in Microsoft Excel were analysed using SPSS 21.0. Results are expressed in mean, proportions, and odds ratio appropriately.

Results:

The prevalence of disability was found to be 20.9%. The mean disability scores were more in the domain of getting along with people (34.68 ± 14.70), followed by the domain of getting around (30.64 ± 24.33) and societal participation (25.55 ± 21.97). Advancing age, female gender, presence of chronic illness were the factors increasing the risk of disability. Education confers significant protection against the development of disability.

Conclusion:

It is not only the physical inability that disables the elderly but also the lack of societal participation. So it becomes the responsibility of every individual to make the elderly people socially inclusive apart from screening them to detect disability in the earlier stage itself.
Intrapartum respectful maternity care practices and its barriers in Eastern India
Authors: Yadav Pooja , Smitha Moonjelly Vijayan , Jacob Jaison , Begum Jasmina
Published: January 2023

ABSTRACT

Background:

Respectful maternal care (RMC) is increasingly recognized globally as critical to improving the quality of maternity care as women deserve respectful and dignified care. Numerous women face disrespectful maternal care during labor and delivery, especially in low- and middle-income countries, which dissuades them from seeking institutional care. Women, the consumers of care, are better positioned to report on the level of respectful care they receive. Health care workers’ perspectives on barriers to delivering respective maternity care are seldom explored. Thus, this study aims to assess the levels of respectful maternity care and its barriers.

Methods:

This cross-sectional study assesses the level of RMC and its barriers in the labor room of tertiary care hospital in Odisha among 246 women selected by consecutive sampling technique by a questionnaire.

Results:

More than one-third of women reported good RMC. Although women rated high in domains of environment, resources, dignified care, and non-discrimination, non-consented care and non-confidential care were poorly rated. Barriers that adversely affect the delivery of RMC perceived by health care workers were lack of resources, staffing, uncooperative mother, communication issues, privacy issues, lack of policies, workload, and language problems. There was a significant association of RMC with age, education, occupation, and income. In contrast, residence, marital status, number of children, antenatal visit, type of institute of antenatal care, mode of delivery, and gender of health care provider were not associated with RMC.

Conclusion:

Given the above findings, we recommend vigorous efforts to improve the institutional policies, resources, training, and supervision of health care professionals on women’s rights during childbirth to strengthen the quality of care for positive birth experiences.
Effects of zinc sulfate on schizophrenia symptoms in patients undergoing atypical antipsychotic pharmacotherapy
Authors: Behrouzian Forouzan , Nazarinasab Masoumeh , Sadegh Amirali Moghadam , Abdi Layla , Sabzevarizadeh Mansooreh
Published: January 2023

ABSTRACT

Introduction:

It has been noticed that inadequate levels of zinc (Zn) can have adverse effects on the nervous system, which in turn leads to cognitive disorders. The present study was conducted to determine the effects of Zn sulfate on eliminating the symptoms of schizophrenia.

Methodology:

This study was a double-blind intervention study conducted in 2020. PANSS and HAM-D questionnaires as well as demographic information were completed for the participants. The patients were assigned to two groups with an equal number of 44 (n = 44). Zinc sulfate 220 mg capsules were delivered to the patients every 8 hours, and the control group received the placebo. Finally, the data of both groups were entered into the software and compared with one another.

Results:

No significant differences were found among the 88 participants regarding variables of age (P = 0.607), gender (P = 0.792), job (P = 0.596), income (P = 0.293), length of the illness (P = 0.965), and education (P = 0.281). Positive symptoms (P = 0.426), negative symptoms (P = 0.891), and psychopathologic symptoms (P = 0.100) had no significant statistical difference between the two groups before the intervention. However, within the second week, positive symptoms had significant differences between the groups (P = 0.029), and they were significantly lower in the experimental group. The fourth week following the therapy was associated with significant differences in positive (P = 0.005), negative (P = 0.036), and psychopathological (P = 0.002) symptoms in both groups. Moreover, within the sixth week, significant differences in positive (P = 0.007), negative (P = 0.002), and psychopathological (P = 0.008) symptoms were found between both groups, which were significantly lower in the experimental group.

Conclusions:

According to the observations made in this study, zinc sulfate improved symptoms of schizophrenia in the patients.
Association of serum vitamin D levels with ectopic pregnancy
Authors: Abedini Golnaz , Parsapour Hamideh , Khanlarzadeh Elham , Alizamir Aida
Published: January 2023

ABSTRACT

Background and Aim:

A few studies have addressed the possible role of vitamin D in decrement of ectopic pregnancy. Therefore, because of the widespread of vitamin D deficiency, especially among Iranian women, in this study, the association of serum vitamin D levels and ectopic pregnancy in pregnant women during the first trimester of pregnancy was investigated.

Methods:

This study is a cross-sectional study that has a control group. The cases group consisted of 51 pregnant women with ectopic pregnancies, and the control group consisted of 51 pregnant women with normal pregnancies. From all pregnant women participating in the study, 5 cc of blood samples were taken to determine the concentration of vitamin D serum. Serum vitamin D level was measured using enzyme-linked immunosorbent assays. The collected data were statistically analyzed using SPSS Statistical Software Package Version 16.0. P value less than 0.05 was considered as statistically significant level.

Results:

The differences between the two groups based on the demographic characteristics, including mean age, body mass index, and number of deliveries, were not statistically significant. The level of vitamin D in blood (ng/ml) was significantly higher in the control group (34.31 ± 7.32) compared to the participants with ectopic pregnancy (20.95 ± 20.68) (<0.001). Based on the results of the present study, women with inadequate serum levels (less than 30 ng/ml) are 6.40 times more likely to have an ectopic pregnancy than normal pregnant women (OR = 6.40; 95% CI; 3.260–15.834).

Conclusion:

Based on the results of this study and considering the association of serum vitamin D levels and ectopic pregnancy, it seems necessary to measure the level of serum vitamin D in women before their pregnancy.
Needs assessment of general practitioners in Pakistan: A descriptive cross-sectional survey
Authors: Farazdaq Hamida , Gilani Jaleed A. , Qureshi Asra , Khan Unab I.
Published: January 2023

ABSTRACT

Background:

With the growing and complex nature of medicine, it is imperative for physicians to update their knowledge and skills to reflect current standards of care. In Pakistan, 71% of primary care needs are met by general practitioners (GPs). GPs are not required to complete structured training and no regulatory mandates exist for continuing medical education. We conducted a needs assessment to evaluate the readiness for competency-based updating of knowledge and skills, and the use of technology by practicing GPs in Pakistan.

Methods:

A cross-sectional survey inviting registered GPs across Pakistan was administered online and in-person. Questions pertained to physician demographics, practice characteristics, confidence in knowledge and skills, and preferred modes of updating knowledge and barriers. Descriptive analyses were performed for GPs and patient-related characteristics and bivariate analyses to evaluate the relationship between parameters of interest.

Results:

Of the 459 GPs who responded, 35% were practicing for <5 years and 34% reported practicing for >10 years. Only 7% had a post-graduate qualification in family medicine. GPs reported needing practice in neonatal examination (52%), neurological exam (53%), depression screening (53%), growth charts (53%) and peak flow meter use (53%), interpretation of electrocardiograms (ECGs, 58%) and insulin dosing for diabetes (50%). High workload (44%) was the most common barrier to updating clinical knowledge. Sixty-two percent used the Internet on a regular basis.

Conclusion:

Most GPs have no structured training and encounter gaps in knowledge and skills in clinical practice. Flexible, hybrid, and competency-based continuing medical education programs can be used to update knowledge and skills.
Magnitude and associated factors of menstrual irregularity among young girls: A cross-sectional study during COVID-19 second wave in India
Authors: Bhardwaj Priya , Yadav Sunita K. , Taneja Jyoti
Published: January 2023

ABSTRACT

Background:

Several symptoms are typically experienced after a coronavirus disease 2019 (COVID-19) infection. Worldwide, a lot of women are reporting irregularities in their menstrual cycles post-COVID-19 infection. The purpose of this study is to investigate the prevalence of menstrual pattern among young girls during the second wave of COVID-19 pandemic and to determine the risk factors related to lifestyle among young girls.

Methods:

A cross-sectional study was conducted using a self-designed questionnaire encompassing details of the menstrual pattern, features of hyperandrogenism, lifestyle, and comorbidity among young girls aged 16-24 years.

Results:

The data from 508 girls fulfilling the inclusion criteria were analyzed. The prevalence of irregular menstrual cycle was found to be 29.1%. Further analysis revealed that a significant percentage of girls with irregular menstrual cycle suffer from depression (14.9%) and are often staying stressed (40.5%) in comparison to the girls having regular menstrual cycle. Also, a total of 58 girls out of 508 were diagnosed with polycystic ovary syndrome (PCOS). Among various comorbid conditions, obesity was found in 60% of girls having PCOS followed by an eating disorder.

Conclusions:

A significant increase in irregular menstrual cycle in young girls was found during the second wave of COVID-19. The risk factors for causing the irregular menstrual cycle were found to be insomnia, stress, and depression
Comparison of clinical features, management, and outcomes between children and adolescents diagnosed with multi-system inflammatory syndrome in children
Authors: Kumar Pancham , Sharma Deepak , Sood Ambika , Sharma Sanya , Sharma Rakesh
Published: January 2023

ABSTRACT

Background:

The present study aimed to compare clinical features, management, and outcomes between children and adolescents admitted as cases of multi-system inflammatory syndrome in children (MIS-C) in Indira Gandhi Medical College (IGMC), Shimla.

Material and Methods:

We conducted a cross-sectional study for MIS-C from January to July 2021, in the pediatric ward of IGMC in Himachal Pradesh. All children admitted with a diagnosis of MIS-C were included in the study. Data regarding socio-demographic factors, clinical features, and treatment modalities were extracted and analyzed using Epi Info V7 software.

Results:

A total of 31 children diagnosed as cases of MIS-C were included. The mean age was 7.12 ± 4.78 years. 71% were in group 0–10 years, followed by 29% in 11–18 years. Although the duration of hospital stay, mortality, and Kawasaki disease cases were more in children as compared to adolescents, the difference was not significant. Similarly, fever, rash, cough, hematemesis, tachypnea, respiratory distress, hypotension, vomiting, bleeding diathesis, hematuria, seizure, encephalopathy, hepatomegaly, splenomegaly, and lymphadenopathy were greater in children as compared to adolescents but were not significant. Likewise, abnormalities in various biochemical, hematological, inflammatory, and cardiac markers were deranged to a greater extent in children as compared to adolescents, but there was no significant difference. The need for various treatment modalities such as IVIG, methylprednisolone, low-molecular weight heparin, aspirin, respiratory Support, O2, ventilatory support, and inotropic support was more in children as compared to an adolescent, but there was no significant difference.

Conclusion:

There was no significant difference in socio-demographic factors, clinical presentation, diagnostic test, mode of treatment, duration of stay, and mortality among children and adolescents.
Insight into women with dermal fillers perceptions in Riyadh to uptake the Coronavirus vaccine
Authors: Al Otaiby Shahad , Al Otaiby Farah , Bahlol Arwa , Al Nassar Sara
Published: January 2023

ABSTRACT

Background:

Vaccination is considered to be the ideal way for population immunity, and willingness in taking the COVID-19 vaccine has been a controversial issue worldwide. The commonly reported adverse events of the COVID-19 vaccination have made people question the safety of the vaccine, especially for women with dermal filler and using cosmetics injections. It has been reported that some COVID-19 vaccines can cause side effects in women with dermal filler injections. In this study, we aimed to assess the perception and attitude of females with dermal fillers in Riyadh towards the COVID-19 vaccine using a self-answered questionnaire.

Methods:

A total of 352 females participated in the study of different ages and nationalities. our study findings indicate that the mean knowledge and attitude scores of females with dermal fillers regarding the COVID-19 vaccine are sub-optimal.

Results:

Knowledge is significantly related to factors such as educational level, and chronic disease status, while attitude scores are significantly associated with nationality, educational level, COVID-19 vaccination status, previous history of taking the seasonal flu vaccine, and source of information related to COVID-19.

Conclusion:

These findings suggest the need to increase awareness regarding the COVID-19 vaccine and improve the attitude toward it.
Incidence and outcome of gastrointestinal bleeding in patients receiving aspirin with or without clopidogrel over 10 years- An observational study
Authors: Ray Gautam
Published: January 2023

ABSTRACT

Aims:

To determine the long-term incidence and outcome of gastrointestinal (GI) bleeding in users of aspirin with (dual antiplatelet therapy, DAPT) or without clopidogrel.

Settings and Design:

Prospective hospital based 12-year study.

Methods and Material:

There were 1047 patients on either aspirin 150 md/day alone (n = 574, 54.8%) or aspirin 75 md/day + clopidogrel 75 md/day (n = 473, 45.2%) were followed up for any incident GI bleed, rebleed and mortality. Those simultaneously using other drugs known to cause GI bleeding were excluded. Comorbidities, concomitant use of proton pump inhibitors and statins were noted.

Results:

GI bleed occurred in 11.8% after 8,683 person years of follow up. 56 (45%) patients had lower GI source of bleed [colon 9 (7%), small gut 47 (38%)] and 68 (55%) had upper GI source [duodenum 39 (32.3%), stomach 28 (22.6%) and oesophagus 1 (0.1%)]. Whereas stomach and duodenum were the chief sites in the first year, small gut predominated in later years. The cumulative bleeding rate after 1, 5 and 10 years was 5%, 8% and 11%, respectively, higher in the DAPT group. Bleeding stopped spontaneously in 98% on drug withdrawal, and 7.3% patients rebled in the next 6.2 years. The overall mortality was 33.1% but only 1.6% was due to the bleed being significantly lower in the DAPT group. On multivariate analysis coronary interventions, diabetes mellitus, renal and multiorgan dysfunction were the significant predictors of GI bleed and mortality.

Conclusions:

Though the incidence and mortality are low, GI bleed increases with longer use of antiplatelet agents predominantly from the lower GI tract.
Post-vaccination COVID-19 infection among health care workers in a medical college hospital
Authors: Bhat Sowmya , Dsouza Agnes Moira Preethi , Suresh Sucharitha
Published: January 2023

ABSTRACT

Introduction:

The world witnessed the pandemic of coronavirus disease (COVID)-19, caused by the virus Severe acute respiratory syndrome coronavirus 2, wreaking havoc on all our lives. The healthcare sector in India was faced with numerous challenges and struggles. The health care workers of this developing country risked everything against this pandemic, which put them at a higher risk of transmission of this infection. The risk of contracting Covid infection was not nullified, even though vaccination was introduced and was made available to these healthcare workers at the earliest. Hence this study aimed to understand the severity of COVID-19 infection, post covid vaccination.

Materials and Methods:

A cross-sectional study was conducted among 95 health care workers of Father Muller Medical College hospital who were infected with COVID-19, post their vaccination. A validated preformed questionnaire was used to collect the data from the participants. Data were analyzed using IBM SPSS 21stversion. Descriptive statistics were used. A value ofP< 0.05 was considered significant.

Results:

In our study, 34.7% of health care workers required hospital admission for COVID-19 treatment. The mean duration is taken by health care workers to return to work after COVID was 12.59 days (SD—4.43). The severity of COVID-19 infection was significantly higher among females, the younger population, and the nursing cadre.

Conclusion:

The severity of COVID-19 infection among health care workers and long COVID can be reduced by timely vaccination.
Use of the modified early obstetric warning system chart as a predictor of peri-partum obstetric morbidity in a rural teaching institute: A two-year cross-sectional study
Authors: Singhal Sonakshi , Acharya Neema , Madaan Sparsh , Mohammad Shazia , Acharya Sourya
Published: January 2023

ABSTRACT

Background and Objectives:

The occurrence of obstetric morbidity is on the rise in developing countries. The peri-partum period is very crucial as most of the deaths occur during labour or in the first 24 hours of the post-partum period. Early recognition and treatment of disease entities leading to obstetric morbidity can be performed by the “track and trigger” system of parameters on a chart, thus preventing the obstetric morbidity and mortality. Therefore, the MEOWS chart (Modified Early Obstetric Warning System chart) was recommended by the Confidential Enquiry into Maternal and Child Health report in order to evaluate the patient at an urgent basis with timely diagnosis and treatment.

Material and Methods:

We conducted an observational study in a rural tertiary care centre based in central India over the span of 2 years from September 2017 till August 2019. Physiological parameters of 1000 patients which included pregnant women in labour >28 weeks of gestation were recorded on the MEOWS chart. Trigger was defined as either one red zone (any one parameter that was markedly abnormal, with values in the red zone) or two yellow zones (when simultaneously any two parameters were moderately de-ranged with values in yellow zones). Based on trigger, patients were categorised as triggered and non-triggered groups. Further based on the obstetric morbidity during hospital stay, triggered and non-triggered groups were divided into category 1 (patients who did not have any obstetric morbidity during hospital stay) and category 2 (patients who had any obstetric morbidity during hospital stay).

Results:

Out of the total 1000 patients, 24.8% patients had an abnormal MEOWS chart and were categorised into the triggered group. Out of a total of 248 patients in the triggered group, 47.5% (118) patients had obstetric morbidity during hospital stay (category 2). The MEOWS chart was found to be 85.51% sensitive and 84.92% specific with a positive predictive value of 47.58% and a negative predictive value of 97.34%. The accuracy of the MEOWS chart was 85%.

Conclusion and Interpretation:

It was concluded that there was a significant difference between obstetric morbidity in normal (non-triggered) and abnormal (triggered) MEOWS chart findings. The sensitivity and specificity of the MEOWS chart were high. The negative predictive value of the chart was very high. Thus, the MEOWS chart can be used as a bedside screening tool for predicting obstetric morbidity.
Influence of pharmaceutical representatives on prescription decisions by physicians in Qassim province
Authors: Altowayan Waleed M. , Alshubaili Abdullah
Published: January 2023

ABSTRACT

Introduction:

Pharmaceutical representatives are an important part of the marketing of pharmaceutical products and an important source of prescribing information for common practitioners. Thus, this study aims to identify factors that affect physicians’ drug selection decisions, determine the main source of information for physicians about new drugs, and the most effective reminder methods used by pharmaceutical representatives.

Method:

This study is a cross-sectional study that was distributed to doctors in different health specialties and different clinics and hospitals in the Qassim region from February to March 2020. The data collected were analyzed using Microsoft Excel.

Result:

The Internet is the most considered main source of new drug information. Moreover, hospital policy is the most common factor that affects physicians’ drug selection decisions. Finally, leaflets and pharmaceutical sales representatives’ (PRs’) frequent visits are the most effective reminder methods.

Conclusion:

This study showed the main source of new drug information was the Internet. In comparison, the factor that affects the physician’s drug selection decision in this study was hospital policy. Finally, the most effective reminder methods were PRs’ frequent visits and also an equal percentage leaflet.
Prevalence and associated factors of depression among elderly patients attending the primary health clinic in Prince Mansour Military Hospital in Taif, Saudi Arabia
Authors: Alkhammash Sawsan Safar , Alkhaldi Dhelal Musleh , Alotaibi Fawaz S.
Published: January 2023

ABSTRACT

Background:

Depression in the elderly is a common, debilitating, and costly condition. Little is known about the prevalence and correlates of geriatric depression in Saudi Arabia. This study evaluates the prevalence of depression among the elderly and its associated risk factors.

Materials and Methods:

A cross-sectional, questionnaire-based descriptive study was conducted on 259 elderly patients attending the Prince Mansour Military Hospital emergency department family medicine clinic in Taif city. Geriatric Depression Scale (GDS) was used.

Results:

The mean score was 4.4 (standard deviation [SD] = 2.56), ranging between 0 and 13. The median GDS score was 4. According to the results of this study, Cronbach’s alpha for the GDS was 0.61 (95% confidence interval: 0.54–0.68). The prevalence of depression among the study participants was 43.2%. According to the GDS score categorization, 36.3% were mildly depressed, 4.2% were moderately depressed, and 2.7% were severely depressed. The adjusted effect was statistically significant for male gender (odds = 0.39, P < 0.001), older age (odds = 1.11, P = 0.007), diabetes mellitus (odds = 3.04, P = 0.02), asthma (odds = 25.94, P < 0.001), and renal failure (odds = 114.27, P = 0.03).

Conclusion:

Identification and treatment of geriatric depression should be prioritized by the family physicians in Saudi Arabia. Further research should focus on designing better culture-friendly geriatric depression screening tools.
A case report on uneventful anticoagulation and persistence of Type 1 Respiratory Failure post severe COVID-19 infection in a patient of Osler–Weber–Rendu syndrome
Authors: Gautam Sachin , Mawari Govind , Kumar Naresh , Garg Sandeep , Daga Mradul Kumar
Published: January 2023

ABSTRACT

The SARS-CoV-2 pandemic has led researchers worldwide to study the patterns of association of SARS-CoV-2 with different diseases, which have been a prime focus of medical literature. Osler–Weber–Rendu syndrome, also known as hereditary hemorrhagic telangiectasia (HHT), is a rare genetic disorder in which patients present with recurrent epistaxis, nostril manipulations, and multiple arteriovenous malformations (AVMs) along with telangiectasias involving internal organs and mucocutaneous areas. In addition, these AVMs are prone to bleeding or act as a nidus for thrombus formation, apart from other serious complications, such as chronic hypoxemia, anemia, pulmonary artery hypertension, heart failure, and cerebrovascular accidents. Here, we present a case report of a patient who presented with acute onset respiratory complaints, had multiple episodes of epistaxis in the past, and was later diagnosed with HHT as per Curaçao criteria in our hospital. Doppler ultrasound over the left calf region showed an AVM. Contrast-enhanced computed tomography (CECT) angiography of the chest and abdomen revealed multiple pulmonary and hepatic AVMs along with splenic and uterine telangiectasias and malformations, who on acquiring severe COVID-19 infection developed complications such as anemia, pulmonary artery hypertension, sepsis, acute kidney injury, and post-COVID-19 persistence of Type 1 respiratory failure. Furthermore, the risk-benefit ratio of anticoagulation therapy in such patients with COVID-19 infection is tricky and challenging. However, our patient was prophylactically anti-coagulated with enoxaparin for 12 days with an uneventful outcome.