bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of frailty and outcome of an ethnogeriatric population in periurban slums of Delhi, India – An interventional strategy in a primary health care setting
Authors: Panda Meely , Islam Farzana , Roy Sushovan , Pathak Rambha , Kashyap Varun 
Published: July 2021

Introduction:
The burden of frailty and aging will have a profound impact on the economy along with the deteriorating clinical condition of the olds.

Aim:
This study aim was to assess frailty of an ethnogeriatric cohort and associate it with domains of quality of life in Delhi along with a follow-up outcome assessment.

Method:
Edmonton frail scale on an ethnogeriatric cohort of 200 individuals in periurban slums of Delhi was used and associated with quality of life, calculated by the WHO-BREF –QOL questionnaire. An interventional strategy for healthy aging was adopted, and a follow-up outcome assessment was done to look out for mortality or morbidity.

Result:
There were 37% frail with a mean score of 60 and 25% prefrails beyond 60 years with a significant increase in frailty with age. Females, single, working, and illiterate elderly were frailer as compared to their counterparts. Social domain followed by psychological domain of the QOL had least scores in the frail elderly. Olds, away from their place of origin were 25 times more likely to be frail and had lesser family integration, assessed by regression analysis. Nearly 6% died, with 21% of hospital readmissions after a 6-month follow-up.

Discussion:
An earlier start of assessment would give us more time to react and respond and be pro-active for healthy aging besides taking into consideration the diverse ethnography in our country.

Conclusion:
Cross-cultural variations need the physicians to address the health care disparities and language barriers so as to make interventions more convenient.
Exercise among pregnant females in maternity and children hospital in Jeddah, Saudi Arabia, 2019
Authors: Aljehani Marwa A. , Alghamdi Liqaa F. , Almehwari Ohoud B. , Hassan Abdul-Hameed M. 
Published: July 2021

Objectives:
To estimate the prevalence and explore factors of adequate physical activity among pregnant women in maternal care.

Materials and Methods:
A cross-sectional study conducted in healthy pregnant women visiting the antenatal clinics of the Maternity & Children's Hospital, Jeddah, Saudi Arabia. A structured questionnaire was administered face to face to collect the following: 1) sociodemographic and obstetrical data; 2) the Arabic version of the Pregnancy Physical Activity Questionnaire (PPAQ) developed by Lisa Chasan-Taber; and 3) barriers to exercise. The PPAQ enabled calculating average weekly energy expenditures in various activities, in metabolic equivalent (MET-h/week) and determining two levels of physical activity (active versus inactive).

Results:
Two hundred and five pregnant women were included: 49.3% were multiparous (gravida >2) and 55.6% declared exercising before pregnancy. The median overall energy expenditure was 108.0 MET-h/week, and household/caregiving activities accounted for the most important share (median = 45.7 MET-h/week), followed by transportation (12.6 MET-h/week). Of the total, 45.9% met the WHO criteria of adequate physical activity. There was no statistically significant difference between physically active and inactive participants across demographic factors. The most common barriers to being active were lack of energy, fatigue, or drowsiness (70.2%), lack of education by doctors (68.3%), and inconvenient weather (62.0%).

Conclusion:
Women in Saudi Arabia have decline in physical activity during pregnancy, and less than 50% maintain a level of exercise that enables beneficial effects on their overall health and pregnancy outcome. Health authorities and decision makers should consider implementing a national strategy and guidelines for the promotion of physical activity during pregnancy.
A study of risk factors and complications in elderly hypertensive subjects
Authors: Sri Hari TY. , Sree Sudha TY , Varghese Anjaly Mary , Krishna Sasanka K S B S , Thangaraju Pugazhenthan 
Published: July 2021

Background:
Hypertension among the elderly is a major, highly prevalent yet treatable cardiovascular disease.

Aims & objectives:
Study aims to highlight the risk factors for hypertension in the elderly in an urban setup for the benefit of improving quality of life and also reduce the incidence of the cardiovascular related complications.

Methodology:
This is a Cross-sectional observational study. Included 125 study subjects based on selection criteria. The selected patients were subjected to a preformed and pretested schedule of questions pertaining to the risk factors.

Results:
Among the known hypertensive patients above 60 years of age, 125 subjects were included in the study. Smoking (62%), alcohol consumption (21%), family history of hypertension (26%), family history of diabetes (70%) were statistically significant risk factors observed for the development of hypertension.

Conclusion:
Sedentary lifestyle (physically less active) and anthropometric measures like overweight and obesity, abnormal waist circumference, and abnormal waist hip ratio were all identified as remarkable risk for hypertension. Myocardial infarction (20%), stroke (14%), and heart failure (12%) were the chart buster complications of hypertension in the vulnerable geriatric population.
The adverse effects of Ketamine on Procedural Sedation and Analgesia (PSA) in the Emergency Department
Authors: Dilip TS , Chandy Gina Maryann , Hazra Darpanarayan , Selvan Jagadesha , Ganesan Priya 
Published: July 2021

Background:
Procedural sedation and analgesia (PSA) in the emergency department (ED) is mainly used for wound irrigation, reduction of fractures, and wound closure. Ketamine is one of the most commonly used drugs for PSA in the ED. The study was conducted in the ED of a large tertiary care hospital in southern India to evaluate the adverse effects of Ketamine on PSA.

Materials and Methods:
This is a prospective observational study performed in the ED for 6 months (October 2019–March 2020) in 151 patients who required Ketamine for PSA. Titrated doses of Ketamine was administered in all patients; hemodynamic variables and adverse events were recorded at timed intervals.

Results:
During the study period, a total of 151 patients in the ED required PSA. The mean age of the study Cohort was 37 ± 15 years, and males accounted for 83%. All individuals obtained adequate sedation and pain relief. It was found that the incidence of adverse reactions to Ketamine was higher in young people (18- to 40-year-old), which was 63%. The most common adverse reaction in the study population was 39 cases of hypertension (44.8%), followed by vomiting in 25 cases (28.7%) and delusion in 6 cases (4%). There was no significant adverse effect in any patients which necessitated admission.

Conclusion:
Ketamine is a drug with good analgesic, sedative properties and has been shown to have a good safety profile with minimal adverse events for use as PSA in ED. Side effects were most common in the younger adult age group and hypertension was the most common side effect.
Voluntary blood donation among female health care university students in Saudi Arabia, knowledge and status
Authors: Alaskar Shaddin A. , Alsadhan Jumanah A. , Alanazi Rawan M. , Alnashi Lama S. , Almutairi Razan K. , Chachar Yusra S. , Damlaj Moussab 
Published: July 2021

Context:
Blood donation is an essential lifesaving procedure. There is a continuous effort to supply the high demand in hospitals.

Aims:
To assess the current status, knowledge, and attitudes of female health care students in King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS) regarding blood donation.

Settings and Design:
A cross-sectional study was done with students in the female campus of KSAU-HS in Riyadh.

Methods and Material:
The sample was categorized based on the college and year of study. A self-administered questionnaire was distributed during the first semester of the 2018–2019 academic year to an estimated 20%–25% of students per batch.

Statistical analysis used:
Statistical Package for Social Sciences version 22 (SPSS Inc., Chicago, IL).

Results:
A total of 302 students completed the questionnaire with a median age of 21 years and a range of 18–30 years. Only 14.6% of the sample previously donated blood, with half of this group donating more than once. Just less than half (48.7%, n = 147) have been exposed previously to a university campaign related to blood donation. The majority (74.5%, n = 225) knew their blood type, small proportions (16.6%, n = 50) and (10.9%, n = 33) reported knowing family members or friends requiring blood products. More than half (57.6%) of the students admitted not having sufficient knowledge regarding blood donation, and the majority (75.1%) were not aware of the quantity of blood collected during a donation. Two-thirds, 31.4% and 32.1% agree and strongly agree, respectively, that blood donation is a duty that every individual should perform. Just more than half (53%) of the students strongly agreed that they are motivated to donate blood on moral or religious grounds.

Conclusion:
The proportion of prior blood donation in the sample was low. This is due, in part, to inadequate knowledge about the donation process. Given that many students felt motivated to donate, it is possible that raising awareness through educational interventions could increase donations in female health care students.
Impact and perception about distant online medical education (tele-education) on the educational environment during the COVID-19 pandemic
Authors: Vishwanathan Karthik , Patel Geetika Madan , Patel Devanshu Jayeshbhai 
Published: July 2021

Introduction:
The impact of online medical education using videoconferencing platforms on the education environment during the present COVID-19 pandemic is not known. The objectives were to evaluate the impact of online teaching using videoconferencing platforms on the education environment, satisfaction, and perception of the medical undergraduate students to online teaching.

Methods:
This prospective observational survey undertaken at a medical college included voluntarily participating medical undergraduate students from first (2nd semester), second (4th semester), and third year MBBS (6th and 8th semesters). The education environment was evaluated using the validated Dundee Ready Education Environment Measure (DREEM). The perception of the students was evaluated using questionnaire with five point Likert scale response.

Results:
The response rate in our survey was 77.5% (465 out of 600 students). The mean DREEM score of medical undergraduate students was 132.3 ± 19.8. Domains of DREEM evaluated were students’ perception of learning (30.1 ± 6.3), students’ perception of teachers (29.7 ± 4.6), students’ academic self-perception (21.3 ± 4.9), students’ perception of atmosphere (32.5 ± 6.2), and students’ social self-perception (18.7 ± 3.5). Two hundred and fifty five students (54.8%) were extremely satisfied and quite satisfied with the online teaching–learning modalities. Two hundred and fifty eight students (55.5%) rated online learning methods to be very useful and quite useful during the lockdown period.

Conclusion:
The educational environment at our medical college was positive and students had a positive perception and attitude toward the role of the videoconferencing platforms for learning (telemedicine) during the COVID-19 pandemic lockdown.
Tobacco smoking and depressive symptoms among male medical students in Al-Baha University
Authors: Alzahrani Hawthan A. , Alghamdi Mohammed S. , Alzahrani Abdullah A. , Alzahrani Abdulaziz A. 
Published: July 2021

Background:
Smoking is a psychosocial problem regarding its causes mainly. In primary health care units, depression is the most common problem that affects the whole body and arises with physical, emotional, and cognitive symptoms. This study aimed to determine the prevalence rate of tobacco smoking and depressive symptoms among male medical students of Albaha university. Also, to investigate the association between tobacco smoking and depressive symptoms among male medical students of Albaha university.

Method:
A cross-sectional study was conducted on All the male medical students in the all-academic year levels of Al-Baha medical college using a self-administrated questionnaire.

Results:
Two hundred and eight medical students completed the study. About half of the participants (49.5%) weren't smokers. More than two-thirds (69.5%) started smoking in the first academic year. Our statistical analysis results reported; a significant correlation regarding the marital status (P-value = 0.000). The abnormality was significantly higher among current smokers (P-value = 0.013) and markedly lower among nonsmokers (P-value = 0.004). Regarding types of smoking, cigarette smokers were seriously depressed (P-value = 0.000).

Conclusion:
There is a relationship between smoking and depressive state among medical students. Researches must be conducted to explain this relation of depression symptoms with tobacco and not to increase the prevalence of smoking by helping students quit smoking.
Together let us confront it
Authors: Varghese Sangeetha Merrin , Sheeja A.L , Samuel Johnson Abel K. , Sushan Abey , Nandini C.S , Chandy George M. , Rakesh P.S , Joseph Marina Rajan , David Alice , Mathew Geethu , Alexander Prince 
Published: July 2021

Introduction:
Hepatitis B is a potentially life-threatening liver infection caused by the Hepatitis B virus (HBV). The established routes of transmission are from mother to infant, sexual contact, and exposure to blood or body fluids. Though HBV is preventable by vaccine and robust infection control practices, outbreaks of HBV infection do occur in India. However, the state of Kerala with its health parameters, one among the best in the country, cannot afford to have continuing outbreaks. An unusual increase in the reported cases of Hepatitis B in a rural area of Pathanamthitta district of Kerala, called for an outbreak investigation.

Aims:
To describe the epidemiological features, to determine the risk factors associated with HBV transmission, and to suggest measures to prevent future transmission.

Methods:
A community-based case-control study (1:2) was undertaken. A total of 162 participants (54 cases and 108 age, gender, and neighborhood matched controls) took part in the study. Focus group discussions were conducted with subject experts to develop an interview schedule assessing 40 risk factors. It was further reviewed by the University of Sydney. Data was collected by trained Junior Health Inspectors and Junior Public Health Nurses of the Primary Health Centers. Data was analyzed using SPSS v. 20. Proportions were compared by Univariate analysis, sub-group analysis, and logistic regression. Population Attributable Risk (PAR) was also calculated.

Results and Conclusion:
More than 90% of the infections were IgM anti-HBc positive, suggesting a recent infection. Interventions during hospitalization [OR: 7.98 (95% CI – 2.17--29.4)], family history of Hepatitis B [OR. 4.14 (95%CI – 1.73--9.9)], and laboratory investigations [OR: 3.99 (1.72--9.31)] were found to be significant risk factors. PAR was highest for laboratory interventions (32%). Vaccinating household contacts and strict enforcement of infection control practices could substantially reduce the burden of this fatal disease.
Total knee replacement at Southwestern Saudi Arabia
Authors: Al-Otaibi Mohammed Lafi 
Published: July 2021

Background:
Knee replacement enables the surgical management of end-stage knee joint osteoarthritis. In Saudi Arabia, there has been a recent increase in total joint replacement surgery. However, there is insufficient literature regarding patient outcomes in this region. Here, we assessed characteristics of patients who underwent total knee arthroplasty and their improvements on knee society score, timed up and go test, and 2-min. walk test.

Methods:
Patients who underwent primary total knee replacement at our tertiary care private hospital in Abha from January 2013 to January 2020 were included. The same orthopedic surgery performed primary cemented cruciate-substituting knee replacement. Knee function was evaluated using the knee society scoring system, timed up and go test, and 2-min. walk test.

Results:
Out of 420 patients, 350 were females (83.33%) and 70 males (16.67%). The mean age was 69.50 ± 7.48 years (range, 48–90). Most patients had osteoarthritis (84.5%), either degenerative or secondary because of trauma. Knee society functional and knee scores were poor preoperatively (mean, 38.21 ± 9.65; SD, 36.89 ± 8.23) but improved postoperatively (mean, 81.42 ± 12.74; SD, 85.49 ± 11.69; P < 0.001). The timed up and go test significantly changed from 28.51 ± 3.29 s to 18.18 ± 3.17 s (P < 0.001) and 2-min. walk test from 51.83 ± 6.48 m to 85.72 ± 8.92 m (P < 0.001).

Conclusion:
Despite knee replacement's late acceptance in Saudi Arabia, there have been increased cases in recent years and excellent improvements in knee function. The resulting knee society functional and knee scores, timed up and go tests, and 2-min. walk tests were better or similar to results seen by other researchers worldwide.
Computer vision syndrome among Saudi population
Authors: Turkistani Alaa N. , Al-Romaih Arwa , Alrayes Majd M. , Al Ojan Abdulrazaq , Al-Issawi Wisam 
Published: July 2021

Introduction:
In the recent era of technological evolution, electronic devices have become an essential part of our lives, not merely in professional work settings, but also in daily leisure activities. Although these devices have simplified our lives, they are associated with a wide variety of health complaints. Thus, the so-called computer vision syndrome (CVS) has become a growing public health problem and has gained significant attention as it plays an important role in the quality of life of each individual, which in turn has put an increased burden on the health care system. Eye symptoms are among the most reported, yet extraocular symptoms were frequently described as adding an extra load.

Method:
An electronic survey was distributed randomly through social media platforms among the general population in Saudi Arabia, between the period from July to December 2017, irrespective of their sociodemographic factors, aiming to determine the prevalence of CVS and to verify the most common associated risk factors.

Results:
In total, 690 participants were involved in our study, with a mean age of 33.8 years. Of these, 77.6% suffer from CVS, with eye-burning being the most common ocular symptoms (71%), as well as itching (67.5%), blurred vision (65%), tearing (62.3%), and other eye symptoms being reported. Neck/shoulder pain was found to be the most prevalent extra ocular symptom (85.2%); also back pain and headache are frequently expressed (78% and 70% respectively). A significant positive correlation was observed between CVS symptoms and time spent using the devices (P-value: 0.002).

Conclusion:
As technology advances, electronic devices have become a common tool that is used for different purposes on daily basis. We found in our study that the so-called computer vision syndrome is a growing public health problem. Thus, community education about the impact of such a lifestyle for proper handling of electronic devices must be addressed to avoid such health complaints.
Oral Health Status and Treatment Need in Geriatric Patients with Different Degrees of Cognitive Impairment and Dementia
Authors: Kumar Santosh , Jha Prakash C. , Negi Bhupender S. , Haidry Nazia , Kulkarni Pranay , Gulati Saakshi , Muttu Jayalakshmi 
Published: July 2021

Background:
Health can be defined as more than an absence or lack of disease. It is generally related to personal, physical, social, along with spiritual wellness. However, the importance of good health is comparable with a progressive physical and cognitive limitations due to aging and hence, its clear definition is not possible. Hence, most of the important aims or goals in aging are unrelated to finding a cure but rather toward achieving an optimal function. Thus, a healthy aging process that encompasses physical, mental, psychological, and spiritual well-being is always much desired.

Aim and Objectives:
The aim and objective of this study is to assess the oral health status and degree of cognitive impairment along with dementia, if present.

Materials and Methods:
This is a prospective and cross-sectional analysis comprising of 300 study participants of which 150 are males while 150 are females. Cognitive ability is assessed using the Standardized Mini-Mental State Examination (SMMSE) scoring test. A score value lesser than or equal to 23 is considered as low, whereas a score of 24 and above represents normal cognitive abilities. Subjects with low score are selected for the study. Oral health status is assessed by examining a) total numbers of teeth present; b) presence or absence of denture use; and c) capacity for masticatory or chewing ability (recorded as yes or no). Demographic variables parameters include age, gender, and presence of smoking habit. Clinical parameters or variables are analyzed by employing the independent t-test and Chi-square test. Pearson's correlation analysis is used to test a correlation between impairment of cognitive capacity, oral health status, masticatory capability, and use of dentures, if present. Two-tailed t-test is used to derive a P value for significance.

Results:
The total numbers of teeth present are significantly correlated with a lower SMMSE score (R = + 0.56; P = 0.03) while a significant association is noted between ability for mastication and lower SMMSE score (P = 0.05).

Conclusion:
This study concluded that loss of cognition or dementia is closely related to a poor oral health status.
Prevalence of Common Mental Disorders among pregnant women—Evidence from population-based study in rural Haryana, India
Authors: Jha Shreya , Salve Harshal Ramesh , Goswami Kiran , Sagar Rajesh , Kant Shashi 
Published: July 2021

Background:
Mental disorders during pregnancy is one of the major public health problem because of its effect on both mother and child.

Objectives:
The objective of the study was to assess the burden of common mental disorders (CMDs) among pregnant women in rural Haryana, North India.

Methods:
A community-based cross-sectional study was conducted in 28 villages of rural Haryana in 2016. Pregnant women in the study area with period of gestation 25–34 weeks were enrolled and assessed for presence of CMDs in two phases. Primary Care Evaluation of Mental Disorders—Patient Health Questionnaire was used for screening and Mini International Neuropsychiatric Interview (MINI) for diagnosis of CMDs.

Results:
A total of 457 pregnant women were included in the study. Mean age of pregnant women was 23.9 years (SD- 3.9). Prevalence of CMDs was 15.3% (95% CI, 12.0–18.6). Of these, major depression was 2.8% (95% CI, 1.4– 4.4), and Generalized Anxiety Disorder was 15.1% (95% CI, 11.8–18.4) as per MINI. On multivariate analysis, no statistically significant association was found between CMDs during pregnancy with any obstetric, sociodemographic determinants, and child health outcomes.

Conclusion:
High prevalence of CMDs, especially anxiety, observed among pregnant women in rural area necessitates the need for integration of screening of CMDs during routine antenatal care in India.