bluuebunny/crossref_metadata_2025_split huggingface dataset:
Are numbers deceptive? Is death auditing a solution for death analysis, among the COVID-19 deceased?
Authors: Goyal Pooja , Sachdeva Ruchi Arora , Parashar Lokesh , Sikary Asit Kumar , Tarique Aamir 
Published: April 2021

Background:
COVID-19 pandemic has havocked the entire world and India has not been spared. The focus is not only on the containment but on the reduction in mortality also. The objective of the study was to know the trend of COVID-19 deaths in a 510-bedded dedicated COVID-19 hospital and to determine the cause of death and various factors associated with these deaths.

Method:
A descriptive study was conducted in a COVID-dedicated hospital setting to analyze deaths occurring during April--July, 2020 using a standard death audit proforma.

Results:
A total number of 95 COVID-19 patients died in ICU. The mortality rate among ICU patients varied from 24.6% to 52.9%. Most of the cases were referred from other hospitals. About 64% of the deceased was admitted in severe condition and 34% of cases were referred on ventilator support. The week-wise trend revealed a positive association between the number of deaths and the number of referred cases as well as the number of patients received on ventilator support and in severe condition. About one-third of cases were late in seeking treatment at health centers with the same weekly trend. Being unaware of the condition (1%) and the stigma associated with the disease (32%) were the reasons behind it. Common direct causes of death were pneumonia (73%), pneumonia complicated with sepsis (16%), and acute respiratory disease syndrome (ARDS) (7%).

Conclusion:
High case fatality rate in the ICU of a referral COVID-dedicated hospital is mainly because of the admission of patients in severe conditions.
Exploring the perspective of nursing staff or caregivers on birthing positions in Central India
Authors: Yadav Anita , Kamath Anusha , Mundle Shuchita , Baghel Jyoti , Sharma Charu , Prakash Avinash 
Published: April 2021

Introduction:
Maternal birthing positions refer to the various physical postures a pregnant mother may assume at the time of delivery. The World Health Organisation recommends that woman should be given an opportunity to make a choice on the type of position to use during labour. Alternative birth positions are associated with lower incidence rates of performing episiotomy, less perineal tears and less use of instrumental deliveries. Nurses' perspective on women's positions has rarely been explored in India. Present study aims at assessing the knowledge regarding alternative birth positions among nursing officers.

Materials and Methods:
This cross-sectional observational study was conducted on 52 nursing officers who were posted in the labour room. A pretested questionnaire was administered to them. Data analysis was done using SPSS software version 22.

Results:
Majority (82.7%) of nursing officers felt that there is a need of giving a choice to the woman regarding alternate birth position. 76.9% of them were aware of position other than lithotomy. Around 48.1% would recommend squatting position to a woman in labour. Ease and convenience in conducting the delivery was the foremost reason chosen in advocating a birth position. Whereas overcrowding in the labour room, ignorance about alternate positions and difficulty in converting to instrumental delivery were cited as reasons of not recommending these positions.

Conclusion:
Educating nursing officers about emerging evidence regarding birthing positions will enable them to give accurate information to women.
Self-care practice and its predictors amongst Type-2 Diabetes Mellitus patients in the outpatient department of a tertiary hospital of Kolkata, Eastern India - A cross-sectional study
Authors: Burman Jayeeta , Bhattacharya Aritra , Chattopdhyay Amitabha , Dey Indira , Sembiah Sembagamuthu , Negi Rudresh 
Published: April 2021

Purpose:
The purpose of this study is to find out the pattern and factors associated with self-care practices among diabetic patients as self-care was considered imperative for the control of disease and enhancement of patient's quality of life.

Methods:
This is a cross-sectional clinic-based observational study conducted among the type 2 diabetes mellitus patients who came for follow up to the outpatient department of a tertiary hospital of Kolkata from September to December 2019. Self-care practice assessed using questions adapted from the “Summary Diabetes Self-Care Activities Questionnaire” by face-to-face interview. Logistic regression used to find out the predictors of self-care practice.

Results:
Self-care practice was unsatisfactory among 67.5% of the patients. Near half (56%) of the patients had mild to moderate distress and about 18% were severely distressed. Self-care practice was significantly associated with the educational level, family history, presence of hypertension, advice given regarding self-care activities, and diabetes distress levels of the participants.

Conclusions:
Primary care physicians should be encouraged to give practical aspects of self-care practices and counseling regarding diabetes distress. To perform self-care practices adequate, support from the family level and community level is imperative.
Anxiety, depression and quality of life (QOL) related to COVID-19 among frontline health care professionals
Authors: Sharma Suresh K , Mudgal Shiv K , Thakur Kalpana , Parihar Aashish , Chundawat Digpal Singh , Joshi Jaydeep 
Published: April 2021

Background:
During this pandemic everyone is facing the wrath of this novel coronavirus but nurses who are meticulously working in closed contact with diseased are at more risk for developing anxiety, depression and compromised quality of life. This study was conducted with an intent to identify anxiety, depression and quality of life and its predictors among nurses who are actively involved in caring of COVID-19 patients.

Methods:
A cross-sectional online survey was carried out among nurses who were actively involved in COVID-19 duties at government tertiary health care institutes of India and data was collection through convenience sampling. Standardized tools (HADS, WHOQOL-BREF) were preferred for the assessment of participants' anxiety, depression and quality of life. Multivariate regression analysis was used to identify predictors for anxiety and depression.

Results:
Of 354 nurses, 12.1% were suffering from anxiety while 14.7% had depression. Mean score for physical, psychological, social and environmental domains were 14.75 ± 1.86, 14.92 ± 2.46, 15.21 ± 3.01, and 14.48 ± 2.38 respectively. Nurses' education was a significant predictor for anxiety (odds ratio [OR] = -0.262, 95% CI: -0.510- -0.014, and P value = 0.038). Similarly for depression, designation of nurses acts as a contributing factor (odds ratio [OR] = 0.287, 95% CI: 0.016- 0.557, and P value = 0.038).

Conclusion:
Nurses are providing their services beyond boundaries so that we can overcome with hard time of COVID-19 pandemic. Although less but still nurses are suffering from anxiety and depression which need to be addressed to protect and enhance their mental well-being.
Seroprevalence of anti-SARS-CoV-2 of IgG antibody by ELISA
Authors: Saple Pallavi , Gosavi Shriram , Pawar Tushar , Chaudhari Govind , Mahale Hitesh , Deshmukh Pradeep , Kurundkar Ashish , Pedgaonkar Sarang , Thakare Sapana 
Published: April 2021

Background:
Given the high incidence of asymptomatic or subclinical SARS-CoV-2 infection, reported cases likely underestimate the overall prevalence and infectivity of COVID-19. Serological test for IgG can provide a better measure of disease activity by identifying asymptomatic or subclinical infection. This study was conducted to estimate the seroprevalence of SARS-CoV-2 infection and to the determinants of SARS-CoV-2 infection in the hotspot area of COVID-19.

Method:
It was a community-based, cross-sectional study using multistage sampling with a sample size of 360. After informed consent, the demographic information, past history of SARI/ILI, contact, COVID-19 status were collected. The blood samples were taken from one family member for anti-SARS-CoV-2 IgG antibody by ELISA testing kit.

Results:
Majority of the study subjects had no history of SARI (86%) or any contact with COVID-19 case (98%). Overall seroprevalence of anti-SARS-CoV-2 of IgG antibody was 40% (95% CI 35–45%), infection fatality rate (IFR) was 0.7%. Seroprevalence varied significantly depending on religious background; with Muslims (53%) seroprevalence compared to other religious groups. Seroprevalence of homemaker/unemployed (49%) and laborer (55%) was significantly higher compared to business (30%) and service occupation (21%). Subjects with overcrowding conditions and poor ventilation was significantly associated with higher seroprevalence with odds ratio of 2.5 and 2.3, respectively.

Conclusion:
The antibody testing detects a large number of asymptomatic cases or previously infected cases which would have been missed by clinical history. Thus, the number of undiagnosed cases was found significantly higher even with rigorous implementation of lockdown.
Knowledge and attitude of Attention-Deficit and Hyperactivity Disorder (ADHD) among male primary school teachers, in Riyadh City, Saudi Arabia
Authors: Alanazi Fahad , Al Turki Yousef 
Published: April 2021

Objective:
The aim of this study was to explore teachers' knowledge about the ADHD, its origin, causes, and identify the main demographic variables affecting their knowledge.

Methods:
The study was conducted among male school teachers of ten government primary schools that are found in different regions of Riyadh city, the Kingdom of Saudi Arabia. We used a stratified random sampling technique to collect our sample with inclusion criteria of being male teachers who currently working in male government primary school and are directly involved on teaching of students. Data analysis was performed using SPSS software statistical program version 21.

Results:
We received 400 response for our questionnaire, mostly younger than 40 years old. Most of teachers in this sample had a bachelor's degree, only 6% had diploma while 8% had a higher degree, while most of them had experience more than 5 years in teaching (74.2%). only 8%of teachers admitted that they had not heard about ADHD before. 78% of teachers had read about ADHD at least once before. This knowledge was more from reading books (32.8%) followed by reading internet websites (28.7%), TV/Media (14.6%) while magazine and social media represent (23.9%). Most of the teachers showed that they had attended courses/training about ADHD (76.7%) however only 40.4% of them thought that they had the enough information about the disease. 51.5% of teachers showed that they had already asked before to assess a child who was suspected to have ADHD and 65.3% had taught a child with the disease.

Conclusion:
From the results of this study, it is concluded that the knowledge regarding ADHD among elementary school teachers is suboptimal. Some teachers had misunderstanding about ADHD symptoms and general information, which indicated the further needing for courses to enhance this knowledge.
Universal Health Insurance coverage and utilization among women in urban slum of Rajnandgaon, Chhattisgarh
Authors: Mendhe Harshal Gajanan , David Rohit , Singh Daneshwar , Makade Kiran G. 
Published: April 2021

Background:
Universal Health Coverage refers to health care system that provides health care and financial protection to all the citizen. Rashtriya Swasthya Bima Yojna as National Health Insurance Scheme initiated in Chhattisgarh State in 2009 for below poverty line families. Second scheme is Mukhyamantri Swasthya Bima Yojna initiated in 2012, which covers non below poverty line families.

Objectives:
To assess socio demographic factors among women residing in slum of Rajnandgaon, to find their universal health insurance coverage under RSBY/ MSBY and to assess the extent of concerned treatment under RSBY/MSBY.

Methods:
It was a community based cross sectional study, conducted in the urban slum area of Rajnandgaon amongst 188 women above 18 years of age who were hospitalized 6 months prior to the study using snow ball technique as a sampling method. They were interviewed using semi structured questionnaires by the investigator with the help of anganwadi worker.

Result:
77.65% respondents/study subjects were enrolled under the universal health insurance (RSBY card/ MSBY card). Subjects belonging to Lower socio-economic status and having BPL card were enrolled under scheme more than upper socio-economic group. Out of 146 smart card holders, a mere 1.36% subjects incurred catastrophic OOPE. Out of 42 respondents not having smart card, 40.47% subjects incurred catastrophic OOPE

Conclusion:
The RSBY card reduced the inpatient OOPE. RSBY card prevented catastrophic OOP in most of the respondent. RSBY has made health services accessible to all sections of community at minimal cost.
Prevalence of home related injuries among children under 5 years old and practice of mothers toward first aid in Buraidah, Qassim
Authors: Al-Bshri Soad Abdulrhman , Jahan Saulat 
Published: April 2021

Background:
Unintentional injuries are reported to be the most common mechanism of childhood injuries; large proportion of these occur in or around home. Quick response and appropriate first aid is vital in saving life and preventing negative outcomes.

Objectives:
The aim of this study was to determine prevalence of home injuries among children five years old and younger and to explore their mothers' knowledge, attitude and practice toward first aid.

Methods:
A cross-sectional study was conducted among 250 mothers attending well baby clinics at primary health care centers (PHCC) in Buraidah city. The survey was conducted from February to June 2020. Simple random sampling was used to select PHCCs and systematic random sampling was used for participant selection. A self-administered, semi-structured questionnaire was used to collect data.

Results:
A history of home-related injury to the youngest child was reported by 114 (46.3%) mothers. The common home injuries were falls (50%), cut wounds (15.2%) and burns (10.7%). Among less than one-year age, injuries were more prevalent among males (41.4%) as compared to females (27.6%). Majority (58.2%) of mothers had fair knowledge about first aid. Internet websites (53.6%) followed by social media (47.6%) were the main sources of their knowledge. Mothers showed appropriate practice in dealing with suspected fracture (85.9%) and foreign body ingestion (80%) while burn (55.5%) and choking (43.2%) had the lowest appropriate practice.

Conclusion:
Home injuries are common among children. However, mothers' knowledge and practice of first aid is inadequate. To reduce the injuries' related morbidity and mortality, increasing awareness and organizing first aid training courses are recommended.
A longitudinal study to evaluate the bleeding pattern of patients on low dose aspirin therapy following dental extraction
Authors: VS Sunu , A Roshni , M Ummar , Aslam Sachin A. , Nair Rakesh B. , Thomas Tom 
Published: April 2021

Background and Aims:
Antiplatelet dugs are often interrupted preceding invasive dental extraction because of concern of bleeding complications. The fear of uncontrolled bleeding often prompts medical and dental practitioners to stop aspirin intake for 7 to 10 days before any surgical procedure, which puts the patient at risk from adverse thrombotic events. The aim of the study conducted was to evaluate the bleeding pattern after routine dental extraction among patients on low dose long term aspirin therapy.

Methods:
A total of 104 subjects in the age group of 30-65 years, who continued to have aspirin intake during extraction were included in the study. Dental extraction was performed without stopping aspirin therapy under local anesthesia. The post-operative blood loss was quantified by weighing the gauze pre and post operatively and adding total volume of fluid in the suction jar.

Results:
Of these 104 patients treated, 87% of patients had mild bleeding (<20 ml) and 13% of patients had moderate bleeding (20-30 ml). The total study population showed a mean blood loss of 16.15 ± 3.5 ml.

Conclusion:
Within in the limitations, our study concluded that the routine dental extraction in patients under low dose aspirin therapy did not cause clinically significant post extraction hemorrhage. Aspirin intake can be continued during routine dental extraction as post extraction bleeding encountered will be negligible.
Short- and long-term outcomes after minimally invasive versus open spleen-saving distal pancreatectomies
Authors: Chee Madeline , Lee Chuan-Yaw , Lee Ser-Yee , Ooi London L. P. J. , Chung Alexander Y. F. , Chan Chung-Yip , Goh Brian K. P. 
Published: April 2021

Introduction:
This study aimed to compare the perioperative outcomes of patients who underwent minimally invasive spleen-preserving distal pancreatectomy (MI-SPDP) versus open surgery SPDP (O-SPDP). It also aimed to determine the long-term vascular patency after spleen-saving vessel-preserving distal pancreatectomies (SSVDPs).

Methods:
A retrospective review of 74 patients who underwent successful SPDP and met the study criteria was performed. Of these, 67 (90.5%) patients underwent SSVDP, of which 38 patients (21 open, 17 MIS) had adequate long-term post-operative follow-up imaging to determine vascular patency.

Results:
Fifty-one patients underwent open SPDP, whereas 23 patients underwent minimally invasive SPDP, out of which 10 (43.5%) were laparoscopic and 13 (56.5%) were robotic. Patients who underwent MI-SPDP had significantly longer operative time (307.5 vs. 162.5 min, P = 0.001) but shorter hospital stay (5 vs. 7 days, P = 0.021) and lower median blood loss (100 vs. 200 cc, P = 0.046) compared to that of O-SPDP. Minimally-invasive spleen-saving vessel-preserving distal pancreatectomy (MI-SSVDP) was associated with poorer long-term splenic vein patency rates compared to O-SSVDP (P = 0.048). This was particularly with respect to partial occlusion of the splenic vein, and there was no significant difference between the complete splenic vein occlusion rates between the MIS group and open group (29.4% vs. 28.6%, P = 0.954). The operative time was statistically significantly longer in patients who underwent robotic surgery versus laparoscopic surgery (330 vs. 173 min, P = 0.008).

Conclusion:
Adoption of MI-spleen-preserving distal pancreatectomy (SPDP) is safe and feasible. MI-SPDP is associated with a shorter hospital stay, lower blood loss but longer operation time compared to O-SPDP. In the present study, MI-SSVDP was associated with poorer long-term splenic vein patency rates compared to O-SSVDP.
Good to excellent Quality of Life in patients suffering from severe obesity post bariatric surgery - A single-center retrospective study report using BAROS Questionnaire
Authors: Khaitan Manish , Gadani Riddhish , Pokharel Koshish Nandan , Gupta Ankita 
Published: April 2021

Context:
Despite the positive outcomes reported in terms of weight loss and resolution of co-morbidities, the impact of bariatric surgery on patient-reported outcomes of quality of life (QoL) still remains scarce, particularly in the Indian population. The present study was conducted to evaluate the efficacy of laparoscopic sleeve gastrectomy (LSG) and Roux-en-Y gastric bypass (RYGB) procedures in patients with severe obesity over a period of 2 years in terms of weight loss, resolution of comorbidities, safety and changes in QoL using the Bariatric analysis and reporting outcome system (BAROS).

Subjects and Methods:
The data of 100 patients who underwent RYGB and LSG between March 2014 and December 2017 were analyzed. The study endpoints such as QoL, major and minor complication rates, co-morbidity resolutions and the percentage of excess weight loss (%EWL) were measured using the Moorehead-Ardelt BAROS questionnaire II.

Results:
At a follow-up point of 2 years, patients achieved a mean %EWL of 79.2 (±28.9) % and the mean postoperative body mass index decreased to 31.7 (±6.22) kg/m2. No major complications were reported to have occurred. Excellent global BAROS outcome was obtained in 20% of patients, very good in 47%, good in 29%, fair 2% and failure in 2% patients 24 months post-surgery. The mean BAROS score was 5.8 ± 1.73, and a ‘good’ to ‘excellent’ QoL outcome was observed in 96% of patients.

Conclusion:
RYGB and LSG are safe and effective bariatric procedures. These procedures provided substantial results in good to excellent health-related QoL, weight loss and medical conditions.
Assessment of pain in patients with primary immune deficiency
Authors: Al Banyan Maram , Al Shareef Saad , Aljayar Dina Mahmoud Ahmad , Abothenain Fayha Farraj , Khaliq Agha M. Rehan , Alrayes Hassan , Arnaout Rand , Sheikh Farrukh 
Published: April 2021

Background:
Primary immune deficiency (PID) patients may develop acute or chronic pain. Pain has not been studied in this population until now.

Objectives:
This study systematically assessed the pain of various durations in PID patients using validated pain questionnaires.

Subjects and Methods:
A Short-Form McGill Pain Questionnaire (SF-MPQ), already validated in the Arabic language, was used to ascertain the characteristics and severity of pain. Additionally, an Arabic version of the Neuropathic Pain Questionnaire-Short Form (NPQ-SF) was employed to evaluate neuropathic pain in the same group of patients.

Results:
Forty-six patients participated in the study. The mean age of the patients was 25 years. The most commonly diagnosed PID was a common variable immune deficiency (32.6%), followed by severe combined immune deficiency (19.57%). Based on the SF-MPQ, the pain was experienced by 30.4 % of the subjects who participated in the study; 57% of whom were on regular pain medications. The most common site reported for pain was the abdomen (35.7%). The mean duration of pain was 36.1 days ± 34.6 days. The most common comorbidities in these patients were bronchiectasis, followed by immune thrombocytopenic purpura, and scoliosis. None of the PID patients had significant neuropathic pain based on NFQ-SF.

Conclusion:
To the best of our knowledge, this is the first study to assess the prevalence as well as the severity and duration of pain in PID patients. There were significantly more subjects who had continuous pain. Treatment of pain in PID patients will have a significant effect on improving their quality of life.
A report on management practices and milk production from jersey cows raised in Ibadan
Authors: Olorunnisomo OA , Oni AA , Abiola JO 
Published: April 2021

In order to kick-start milk production and upgrade genetic base of local zebu cattle at the University of Ibadan, four in-calf Jersey heifers and one bull were acquired in September 2012, from a pure herd of Jersey cattle maintained on a private farm in Shonga, Kwara State, Nigeria. Management at Shonga was based on an intensive, zero-grazing system. The animals were apparently in a good state of health at the time of procurement. At the University of Ibadan, management was also intensive, with partial grazing, fortified grass silage and concentrates supplementation. Health management of Jersey cattle involved preventive and curative measures. Calving occurred within 7 and 156 days of arrival at Ibadan. Two out of four heifers calved successfully while two had still-births. Calves were allowed to suckle their dams for 14 days after calving and bottle-fed from milk collected from their dams afterwards. Milking was done twice daily at 7am and 4pm using a portable milking machine. Milk yield averaged 8.8 kg/cow/day with lactation length ranging between 93 and 246 days. Average composition of milk was 13.69, 3.60, 4.73, 0.65 and 4.71% for total solids, protein, fat, ash and carbohydrate respectively. In order to maximize milk production from Jersey cattle under the humid tropical condition of Ibadan, there is need to maintain a high plane of nutrition, adopt a preventive healthcare system and incorporate a cooling system to ameliorate the effects of high ambient temperatures.Key words: calving age, dairy cattle, lactation length, milk composition, milk yield