bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcome of Treatment of Children with Epilepsy in a Nigerian Tertiary Hospital
Authors: Okike Clifford O. , Emeagui Diana O. , Ajaegbu Obinna C. , Muoneke Uzoamaka V. 
Published: December 2021

Background:
Epilepsy, the most predominant noncontagious neurologic disorder affecting children and carrying profound levels of social stigma, is an important cause of childhood morbidity globally.

Objectives:
This study aims at describing the prevalence, etiological risk factors, seizure pattern/associated comorbidities, and outcome of treatment with antiepiletic drugs (AEDs) among patients with epilepsy attending the neurology clinic of Federal Medical Center, Asaba, Delta State, Nigeria.

Materials and Methods:
A 10-year review of all patients seen at the neurology clinic of the tertiary institution. Information including history/physical examination, socio-demographic variables, and electroencephalogram (EEG) findings was collected from the clinic records of the patients between January 2009 and December 2019. A total of 105 patients presented with clinical features of epilepsy classified based on the 2017 International League Against Epilepsy classification. All data obtained from the clinic records were analyzed using the SPSS, Version 23.0, software.

Results:
Of the 302 patients seen with different neurologic morbidities, 105 had epilepsy, giving a prevalence rate of 34.7%, occurring more in children aged 6 months to 3 years with a male predisposition (55.2%). Generalized tonic-clonic (GTC) seizure was identified as the most predominant type 9/105(8.6%), severe birth asphyxia and cerebral palsy were the most common cause, and comorbidity of epilepsy, respectively. Sodium valproate was the commonly used AED with 55.8% good outcome.

Conclusion:
Epilepsy is still an underreported childhood neurologic morbidity in our environment. Good outcome recorded can be attributed to high levels of adherence to medication and absence of associated metabolic disorders or intracranial structural lesions.
Novel approach in the evaluation of ultrasound BI-RADS 3 & 4 breast masses with a combination method of elastography & Doppler
Authors: Reghunath Anjuna , Mittal Mahesh Kumar , Chintamani Chintamani , Prasad Rajni 
Published: December 2021

Background & objectives:
Ultrasound BI-RADS categories 3 and 4 constitute those breast masses which cannot be confidently classified as benign or malignant, owing to their morphological characteristics. These masses are further managed by follow up and biopsy, respectively. This study aims to evaluate the role of strain elastography and Doppler in better characterization of these sonographically indeterminate breast masses as benign or malignant.

Methods:
Fifty female patients with ultrasound BI-RADS 3 or 4 were evaluated with strain elastography and color Doppler including spectral analysis. Eight variables were assessed by elastography and Doppler, including a new phenomenon called bidirectional arterial flow (BAF). The findings were correlated with the gold standard diagnostic method of histopathology/cytology. Based on findings of combined elastography and Doppler method, the initial ultrasound BI-RADS categories of masses were re-categorized by up-gradation or down-gradation. Sensitivity, specificity, accuracy, positive predictive value, negative predictive value and receiver operating characteristic (ROC) curves were used to estimate the diagnostic performance of the combination method.

Results:
Using ROC analysis, the positivity of ≥3 among the total eight variables correlated with malignancy on histopathology. Sensitivity, specificity and accuracy of the combination method using cut-off score ≥3 (i.e. at least three out of the eight parameters in the combination method being positive) for the prediction of malignancy was 100, 76.47 and 92 per cent, respectively, with the area under curve being 0.967. In addition, BAF was found predictive of malignancy with a diagnostic accuracy of 70 per cent.

Interpretation & conclusions:
This non-invasive, cheaper and readily accessible combination method of strain elastography and Doppler imaging can improve the diagnostic characterization of sonographically indeterminate breast masses and may obviate the need of magnetic resonance imaging and unnecessary biopsies, thus proving helpful in resource-poor countries.
A qualitative analysis of the Parliamentary questions on the issue of obesity raised over the past two decades in India
Authors: Gauthaman Jeevitha 
Published: December 2021

Background:
Obesity is a major health issue that is drastically affecting the Indian population in the recent years. It is a major predisposing factor for non-communicable diseases.

Introduction:
The parliament is a powerful organization that holds sessions on regular basis and allows a question hour at the end of each session. Members ask varied questions on major issues and these documented questions are a valuable source of data for policy analysis.

Material and Methods:
Questions on obesity were collected from the official websites of Lok Sabha and Rajya Sabha and thematic analysis was done with inductive reasoning. Themes and subthemes were categorized and questions were coded into nodes using N Vivo software.

Results:
A total of 134 questions on obesity were asked in both the houses, out of which 101 questions were from Lok Sabha and 33 questions were from Rajya Sabha. Majority of the questions were asked to the ministry of health and family welfare. Only a total of 48 unique parliamentarians from 13 states have asked questions on obesity in the past two decades.

Discussion:
The questions were of competing interests with majority of questions on incidence of obesity. A number of questions on school and community based interventions were asked and new suggestions were given by members. Questions on BMI documentation of individuals and gender predisposition showed presence of awareness and knowledge among the members on obesity. Most of the existing policies are malnutrition based and obesity has not been adequately addressed. More questions with stronger representation from all states of the country can help in effective policy planning and implementation of programs to eliminate obesity.
Home management scheme for patients with severe covid-19 in Duhok city, Kurdistan region of Iraq
Authors: Hussein Nawfal R. , Saleem Zana Sidiq M. , Rashad Brisik H. , Naqid Ibrahim A. , Ibrahim Nashwan , Musa Dildar H. , Khezaqia Nina D. , Yousif Ahmed H. 
Published: December 2021

Aim:
This study investigated the clinical characteristics and outcomes of patients with severe coronavirus disease 2019 (COVID-19) who were involved in the home management scheme in Duhok city.

Materials and Methods:
This prospective descriptive study enrolled Kurdish patients diagnosed with severe COVID-19 between June 1 and November 1, 2020, and were treated at home.

Results:
The average age of the patients was 59.77 ± 14 years and 51 (56.04%) of them were males. Seven of these patients (7.69%) were smokers. Most patients (72.52%) had one or more comorbidities. Fever (87.1%) was the most commonly presented symptom in older patients. The case fatality rate was 3/91 (3.29%). This rate was not found to be associated with sex, history of smoking, or comorbidities. The age of deceased patients (40 ± 25 years) was significantly lower than that of cured patients (60 ± 13 years) (p = -0.025).

Conclusions:
The case fatality rate of patients enrolled in this scheme was comparable to those who received treatment in hospitals. Therefore, this scheme could provide a good alternative for treating patients with severe COVID-19 and family physicians could lead the scheme through the primary care network.
Community perception regarding diarrhoea management practices in a tribal predominant aspirational district of Odisha
Authors: Behera Priyamadhaba , Bhatia Vikas , Sahu Dinesh P. , Sahoo Durgesh P. , Kamble Raviraj U. , Panda Prem S. , Singh Arvind K. 
Published: December 2021

Context:
Childhood diarrhea is still a major problem in developing countries, and the condition is worse in tribal areas.

Aims:
The study aims to assess the community perception related to diarrhea management in an aspirational district of Odisha, India.

Subjects and Methods:
A mixed-method study was conducted in Kandhamal, an aspirational district of Odisha, Eastern India, from June to October 2018. An in-depth interview was conducted among community health workers, and a cross-sectional survey was done for the household interview. The data were collected in a mobile-based application, Epicollect5, and in-depth interviews were recorded digitally.

Statistical Analysis Used:
The data were analyzed in the Statistical Package for Social Sciences (SPSS) version 22.0. Categorical variables are presented in proportions. Force-field analysis was conducted to assess the driving and restraining forces of diarrhea. Content analysis was done for the digitally recorded data.

Results:
Nine out of ten people were aware of the benefit of breastfeeding during diarrheal episodes in children aged under 5 years, and <50% were aware of zinc benefit. Poor sanitation, lack of safe water, poor hygiene practices, socioeconomic status, and illiteracy are the major challenges in diarrheal control in the tribal area.

Conclusions:
Improving the demand by creating community awareness regarding management of diarrhea, availability of essential drugs (ORS and zinc) at the community level, and capacity building of community health workers for management of diarrhea can reduce diarrhea-related morbidity and mortality in tribal areas of India. Handwashing, hygiene practices, and availability of safe water need to be promoted in the tribal region. In the long term, the socioeconomic determinants have to be addressed.
Handling the pandemic our way
Authors: George T Jisa , Shafqat Naseema , Verma Ranjana , Bali Surya 
Published: December 2021

Introduction:
The Coronavirus disease 2019 (COVID-19) pandemic created havoc within a few weeks of its outbreak affecting over 100 countries. The rapid increase in the established cases urged for the prevention and control of COVID-19 belligerently on both national and worldwide fronts to prevent the healthcare systems from collapsing. For the sake of successfully preventing and restricting a fatal pandemic outbreak such as COVID-19, it requires the apex health institutions to have a uniform, urgent, flexible and effective policy response framework ensuring strict adherence too. In this regard, the Apex Institutes of National Importance in India (INIs) have released a series of documents on COVID-19 prevention and management.

Methods:
Documents regarding COVID-19 preparedness and management were retrieved from the official websites of the INIs in India. The general population and healthcare workers’ guidelines, standard operating procedures (SOPs) on COVID-19 prevention and management, action and response plans were included in the study. The full text of each document was analysed in detail and themes and subthemes were derived through content analysis.

Results:
A total of 68 documents was included in the study. Five major themes and 12 subthemes were formulated after content analysis. A major similarity was found across all INIs on screening and testing and infection prevention control measures. The INIs formulated guidelines adhering to the World Health Organization, Indian Council of Medical Research and Ministry of Health and Family Welfare Recommendations.

Conclusion:
Common measures like quarantine, social distancing, travel bans and mass gathering restrictions were adopted to prevent the spread of COVID-19 during the initial period. The INIs have developed policies and standard operating protocols on COVID-19 management based on the Government of India guidelines. Better understanding of these guidelines will help in effective implementation of the nationwide pandemic management.
Efficacy of external cold and a vibrating device in reducing pain and anxiety during local anaesthesia
Authors: Jain Nivedita , Juneja Preene , Masih Updesh , Bhushan A.K. Bharath , Bhaduaria Upendra Singh , Badjatya Khushboo 
Published: December 2021

Background and Aim:
To evaluate and compare the efficacy of external cold and a vibrating device in reducing the pain and anxiety amidst children receiving maxillary infiltration anaesthesia over conventional methods.

Method:
A sum of thirty subjects aged between 5 and 10 years who had undergone dental procedures requiring maxillary infiltration were enrolled in the current split-mouth randomised control study. The control intervention constitutes infiltration of 1.8 mL of 2% lignocaine in addition to 1:100,000 adrenaline (Lox, Neon Laboratories Mumbai, India) whereas, the experimental group used external cold and a vibrating device (Buzzy®, MMJ Labs, Atlanta, GA, USA) in annexation to the control protocol. Simultaneous to LA administration, pulse rate was employed as an objective measure and the subjective measure was recorded using RMS Pictorial Scale (RMS-PS) for the child’s discomfort. To document the child’s pain as anticipated by the dentist the revised face, limbs, arms, cry and consolability (FLACC-R) scale was employed.

Result:
Lower pain sensation and anxiety was recorded in the experimental group using Buzzy when compared to control.

Conclusion:
External cold in adjacent with vibrations might be efficient in lowering pain as well as anxiety in children experiencing infiltration dental anaesthesia though further research work is requisite with a larger sample size.
Pattern of inflicted injuries to motorcyclists referred to Hazrat-E-Rasoul Akram hospital in Tehran during 2015 – 2016
Authors: Memarian Azadeh , Aghakhani Kamran , Sani Sahar Rismantab , Abdolkarimi Leyla , Soltani Siamak 
Published: December 2021

Introduction:
In recent years, road accidents have been one of the leading causes of death in Iran, with the majority of victims being motorcyclists. Accurate knowledge of the pattern of injuries to those injured is a strategy to reduce the consequences of these fatal accidents. The aim of this study was to investigate the pattern of injuries to motorcyclists.

Methods:
The present study was a cross-sectional study that was performed in Rasoul Akram (PBUH) Educational and Medical Center in Tehran. The information was extracted from 500 hospital records of the patients admitted due to motorcycle accidents from September 2015 to September 2016, which was recorded in the data collection checklist.

Results:
About 67.9% of the injured did not have head injuries and 32.0% of the sample group suffered head injuries. Out of 160 people from the head injury group, 7.2% have Abbreviated Injury Scale (AIS) index = 1 and 93.8% have AIS ≥ 2. A total of 82% of the injured had no neck injuries and 18.0% of the sample group had neck injuries. Of these, 72.2% had AIS = 1 and 17.8% had AIS ≥ 2. About 65.0% of the injured did not have facial injuries and 35.0% of the sample group suffered facial injuries.

Conclusion:
An accurate knowledge of the pattern of injuries to this group of injured, providing pre-hospital services, timely diagnosis and treatment and the use of corrective and effective factors, has an effective role in reducing the incidence and consequences of this deadly accident.
Study of organophosphorus compound poisoning in a tertiary care hospital and the role of Peradeniya Organophosphorus Poisoning scale as a prognostic marker of the outcome
Authors: Kamath Sangita D. , Gautam Vinit K. 
Published: December 2021

Introduction:
Organophosphate compounds (OPC) cause most self-poisoning deaths in India due to their easy availability and lack of stringent laws.

Aim:
To evaluate the clinical profile and outcome of the patients presenting with OPC poisoning and to study the prognostic value of Peradeniya Organophosphorus Poisoning Scale (POPS) in predicting the clinical outcomes.

Methods and Materials:
This was a prospective study involving 100 patients of OPC poisoning admitted to Tata Main Hospital from June 2018 to May 2020 based on the inclusion criteria. Demographic profile, clinical features, treatment details, and need for ventilatory support were noted. POPS was applied on admission, and the patients were followed up for the outcome in terms of morbidity and mortality.

Observations:
Of the 100 patients, most patients were between 20 and 29 years with male to female ratio being 1.2:1. Vomiting (94%), followed by excessive secretions (84%) were the most common symptoms. Overall mortality was 22%. On grading of severity as per the POP scale, 27% of the patients had mild poisoning, 37% patients had moderate, whereas 36% had severe poisoning. Only 11.11% of the patients with POPS 0–3 required ventilator support, whereas 16.2% of the patients with POPS 4–7, and 100% of patients with POPS 8–11 required ventilator assistance (P < 0.0001). Similarly, the total dose of atropine required (P < 0.0001), length of intensive care unit (ICU) stay, complications, and mortality (P < 0.0001) were significantly associated with higher POPS.

Conclusion:
POPS at admission, correlated well with the need for ventilator support, the total dose of atropine required, length of stay in the ICU, complications, and mortality. It can thus be used for prognostication and risk stratification of patients with OPC poisoning.
The Bobath Concept (NDT) as rehabilitation in stroke patients
Authors: Pathak Abhishek , Gyanpuri Vyom , Dev Priya , Dhiman Neetu Rani 
Published: December 2021

Background and Objectives:
The Bobath approach, also known as neurodevelopmental treatment (NDT), is a widely used concept in the rehabilitation of stroke patients with hemiparesis in many countries. This technique is being used since years all over the world; however, strong evidence of its usefulness is still not present. This review is aimed to find out its effectiveness based on the randomized controlled trials in the rehabilitation of stroke patients with motor disability and to compare it with other therapeutic techniques.

Materials and Methods:
A systematic literature search on PubMed Central, Science-Direct, Cochrane, Scopus, Clinical Trial Database, and Indian Clinical Trial Registry in English till 31st July 2021 was undertaken. The review is published in Prospective Register of Systematic Reviews (PROSPERO) with registration number “CRD42019125400.” Physiotherapy Evidence-based Database (PEDro) score has been used for the quality assessment of the studies. Randomized clinical trials that studied the comparative effect of the NDT/Bobath concept on motor activity outcomes and cognition/behavior in stroke patients in comparison with other rehabilitative techniques were included.

Results:
No strong documentation describing the effectiveness of this neuro-developmental treatment or its supporting neuro-developmental treatment in comparison with other advanced neuro-physiotherapeutic techniques has been found so as to consider it as the recommended treatment for post-stroke hemiplegia/hemiparesis. Methodological aspects of selected studies for further research are suggested.

Interpretation and Conclusions:
This study is inconclusive in determining the effectiveness of the Bobath approach for the movement rehabilitation of stroke patients. These results are similar to the results of previous reviews done on the same topic.
Attitude towards COVID-19 vaccination among the public in Kerala
Authors: Leelavathy Manju , Messaline Sunitha , Ramachandran Divija , Sukumaran Anilbindu , Jose Regi , Noufel Ahmed N. 
Published: December 2021

Context:
As COVID-19 spread across the world, vaccines were developed to fight against the spread of the new disease. Negative attitude and unwillingness to vaccinate when available may be a major hurdle in attaining effective vaccination coverage.

Aims:
The aim of this study was to assess the attitudes towards the COVID-19 vaccine and identify the predictors of negative attitudes towards the vaccine and identify groups most at risk of uncertainty and unwillingness to receive a COVID-19 vaccine.

Settings and Design:
General public of Kerala, cross-sectional survey.

Methods and Material:
The study was conducted in Kerala during the period from 16 January 2021 to 22 February 2021. An online semi-structured questionnaire was sent via google forms with a consent form appended to it. Attitude towards vaccination was measured using a 20-item scale.

Statistical Analysis Used:
Collected data were analysed using SPSS software version 16. Ordinary least-squares (OLS) regressions were carried out to examine socio-demographic predictors of attitude towards vaccination. Multinomial logistic regression model was fitted to examine associations of socio-demographic with uncertainty and disagree to vaccinate against COVID-19.

Results:
In this study, 1345 subjects participated. Mean attitude score was 48.68 with SD 13.55. Most of the study subjects were agreeable to take the vaccine once it is available (88.8%). Religion, occupation, and monthly income were found to be the predictors of attitude towards vaccination.

Conclusions:
The willingness for vaccine uptake was found to be high in our study. However, other aspects such as doubt regarding its safety, effectiveness and duration of protection are considerable and need to be addressed.
Nicotine dependence, perceived stress, and self-efficacy among primary health care professionals during the times of Covid-19 pandemic – A cross-sectional descriptive study
Authors: Gaur Tarun , Rao Dhanesh Singh , Jadhav Atul Ashok , Dagur Lokendra Singh , Dhaka Harinarayan , Pathak Prakhar , Chhabra Kumar Gaurav 
Published: December 2021

Background:
Nicotine dependency would have increased during the times of COVID-19 among the primary health professionals, which would can be attributed to perceived stress and can also be influenced by self-efficacy; hence, the aim of the present study was to determine the relationship between nicotine dependence with perceived stress, self-efficacy among primary health care professionals during the times of covid-19 pandemic.

Materials and Methods:
The present study was a cross-sectional descriptive questionnaire study. The study was conducted among primary health workers of Ajmer district; stratified random sampling technique was used to collect data. A questionnaire was prepared that consists of demographic details, questions on perceived stress, self-efficacy, and nicotine dependence.

Results:
Perceived stress and nicotine dependence was high among study participants. Self-efficacy was low. There was significant (P ≤ 0.05) association between high nicotine dependence and high perceived stress. It was also reported that majority of study participants {58 (30.4%)} with high self-efficacy significantly (P ≤ 0.05) was associated with low nicotine dependence.

Conclusion:
High nicotine dependence was significantly associated with high perceived stress, while low nicotine dependence was significantly lower among primary health care workers’ low perceived stress. Low nicotine dependence was significantly associated among study participants with high self-efficacy.