bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prescription audit of a teaching hospital in South India using World Health Organization core prescribing indicators – A cross-sectional study
Authors: Meenakshi R. , Selvaraj Nitya , Anandabaskar Nishanthi , Dhamodharan Anuranjani , Badrinath A. K. , Rajamohammad Meher Ali 
Published: January 2021

Aim:
World Health Organization (WHO) core prescribing indicators are highly standardized tools in reliably assessing the essential aspects of drug utilization pattern. It is critical that the rational use of drug prescribing is scrutinized for the utmost benefit of patient welfare. In this study, we aim to assess the prescription pattern and prescribing behavior of physicians using the WHO-recommended core prescribing indicators at a teaching hospital in South India.

Materials and Methods:
A prospective, descriptive cross-sectional study was conducted in the general medicine outpatient department of a tertiary care hospital for a period of 1 month in June 2019. A total of 600 prescriptions were sampled based on the WHO “How to investigate drug use in health facilities” document recommendation. The WHO guidelines and methods were observed to ensure data reliability. Descriptive statistical analyses such as frequencies, percentages, mean, and standard deviation were used to present the data.

Results:
The WHO core prescribing indicators analysis revealed that the average number of drugs per encounter was 2.38 ± 1.1 and only 796 (55.4%) of the drugs were prescribed by generic name. Whereas, the percentage of encounters prescribed with an antibiotic 44 (7.3%) and an injection 63 (10.5%) was less than the ideal recommendations as per WHO and 1265 (88%) of the drugs were prescribed from the National List of Essential Medicines.

Conclusion:
This study on prescription pattern audit done using the WHO core prescribing indicators highlights that prescriptions encountered with antibiotic and injection use were in accordance with the WHO recommendations.
Adoption of the World Health Organization access, watch reserve index to evaluate and monitor the use of antibiotics at a tertiary care hospital in India
Authors: Bansal Alka , Sharma Rajni , Prakash Ravi 
Published: January 2021

Background:
The World Health Organization classification of antibiotics classifies key antibiotics into access, watch, and reserve (AWaRe) categories. Categorization provides a novel metrics called “AWaRe index” to study and monitor antibiotic consumption globally and within the same setting over time.

Aim:
The aim of this study is to compare the use of antibiotics in 2 years using the AWaRe index tool.

Materials and Methods:
A retrospective study was conducted in SMS Hospital, Jaipur to collect data regarding total antibiotics consumed between January 2017 and December 2018 from drug distribution centers in hospital premises using the AWaRe classification. Data were then compared on yearly basis.

Results:
In 2017, 53.31% of antibiotics consumed belonged to access, 40.09% to watch, and 3.40% to reserve category, respectively, as compared to 41.21%, 46.94%, and 8.15%, respectively, in 2018.

Conclusion:
Increased use of watch (17%) and reserve antibiotics (140%) over 1 year with the same infection scenario in a similar setting indicates resistance in evolution.
Current status of clinical research using artificial intelligence techniques
Authors: Karekar Sonali Rajiv , Vazifdar Arzan Khurshed 
Published: January 2021

Background and Objectives:
Artificial intelligence (AI) as a field has recently gained a lot of importance and is expected to revolutionize the health-care scenario in the near future. There have been no studies done worldwide to review the status of research with respect to the use of AI in health care. Hence, we conceptualized this study to get an overview of the clinical studies being conducted in the field of AI, by analyzing those registered on the Food and Drug Administration trial registry website.

Methodology:
All the clinical studies conducted in the field of AI registered on the ClinicalTrials.gov website up to September 2019 were reviewed and analyzed. The variables such as geographical distribution, study design, status of study whether ongoing or completed, therapy area, type of intervention tested, type of funding, and year of initiation of study were recorded. The data were analyzed using descriptive statistics using SPSS for Windows, Version 16.0 (SPSS Inc. Chicago, IL, USA).

Results:
Out of all the studies registered, 156 were related to AI. Of these 156 studies, 84 were interventional and 72 were observational. The most common therapy area under study was oncology with 26.3% studies, followed by cardiology, ophthalmology, psychiatry, and neurology. Devices comprised the most common intervention being studied, accounting to 34% of studies, followed by diagnostics which included 28% of studies. In the first 8 months of 2019 itself, 65 studies had been registered.

Conclusion:
The study revealed an increasing trend in the studies being conducted using AI techniques, with majority being conducted in the area of oncology, with medical devices being the most common intervention being tested.
Drug use evaluation of cephalosporins in a tertiary care hospital
Authors: Shetty Yashashri C. , Manjesh P. S. , Churiwala Widhi , Jain Sakshi M. , Singh Vishal K. 
Published: January 2021

Background:
Infectious disease burden in India is among the largest in the world. Cephalosporins are being used extensively in the current scenario, both empirically and as definitive treatment. With this information, we tried to evaluate the prescription pattern of drugs for infections in medicine and general surgical wards of a tertiary care hospital and evaluate the utilization of cephalosporins in the same.

Methodology:
The study was conducted for a duration of 3 months in a tertiary care hospital after approval from the Institutional Ethics Committee, and permission of the respective heads of the surgery and medicine departments was obtained. After satisfying the inclusion criteria, participants' demographic details and the prescription notes by the treating doctor were noted and analyzed. The WHO prescription indicators were analyzed and the prescriptions were evaluated for the completeness of them. The utilization of cephalosporins was evaluated based on the institutional standard treatment guideline (STG) – Guidelines for Antimicrobial Therapy and Prophylaxis, 2014. Data were analyzed using descriptive statistics.

Results:
A total of 600 patients were recruited, of which 350 were male and 250 were female. A total of 4341 drugs were prescribed. On an average, 7 drugs per prescription were found. The generic drugs prescribed were 27% (1163). Among the drugs prescribed, 19% (850) were antibiotics, of which 36.94% (314) were cephalosporins and 81% (3491) were other drugs. Ninety-four percent (565) prescriptions were incomplete (in terms of dose, frequency, duration, or dosage form). After referring to the STG, we found that cephalosporins were prescribed empirically in 40% (126) cases, of which medicine prescriptions accounted for it the most.

Conclusion:
Cephalosporins are extensively prescribed in medicine and surgery wards of the tertiary care hospital.
Has mandatory prospective registration of all studies brought about a change? A 1-year audit of studies registered in the Clinical Trials Registry of India [CTRI] before and after April 1, 2018
Authors: Shetty Nayana S. , Salvi Rachana A. , Thatte Urmila M. , Gogtay Nithya J. 
Published: January 2021

Introduction:
The Clinical Trials Registry of India (CTRI) that initially permitted retrospective registration moved to mandatory prospective registration of studies with effect from April 1, 2018. The present study was an audit that compared registration 1 year post the rule versus a year prior to it.

Materials and Methods:
All studies registered with the CTRI from April 1, 2017, to March 31, 2018, and subsequently from April 1, 2018, to March 31, 2019, were included for the analysis. The extents of retrospective registration a year pre and a year post April 1, 2018, of all studies were evaluated.

Results:
A total of 4628 studies were registered prior to April 1, 2018, and 5438 post that. Pre April 1, 2018, 2687 / 4628 (58.06%) studies were retrospectively registered, while post that, 1100 / 5438 (20.23%) studies were retrospectively registered (cOR: 5.46 [5.0, 5.9], P < 0.001). Regardless of whether the studies were PG theses, regulatory studies, observational studies, or interventional studies, there was a statistically significant reduction in the number retrospectively registered post April 1, 2018, relative to the year predating it.

Discussion and Conclusion:
The success of CTRI's decision to move to prospective registration is seen in the overall reduction in the total number of retrospective registrations from nearly two-thirds in the year predating April 1, 2018, to just a quarter in the year post that, indicating significant inroads made by the CTRI with regard to raising awareness. Some regulatory studies continue to be retrospectively registered and this presents a significant ethical and regulatory breach. This could be potentially addressed by linking ethics committee approval with trial registration.
An evaluation of drug lag for new drugs approved by the Indian regulator relative to the United States, European Union, and Japanese regulatory agencies
Authors: Konwar Mahanjit , Maurya Mitesh R. , Nishandar Tushar B. , Thatte Urmila M. , Gogtay Nithya J. 
Published: January 2021

Background:
The approval process of every drug regulatory agency differs, and hence, the time required for the approval of a new drug varies. This results in a drug lag and India is no exception to this phenomenon. A drug lag precludes Indian patients from accessing new medicines at the same time as they are approved elsewhere. Against this backdrop, we assessed the absolute and relative drug lags of the Indian regulator relative to three regulators in mature markets, namely United States (US), European Union (EU), and Japan.

Methods:
International nonproprietary names were used to identify new drugs. Their dates of approval (2004-2018) from the online database of four regulatory agencies were identified. Both absolute and relative drug lags were calculated for India as compared to US, EU, and Japan as well for all the agencies relative to the Indian regulator.

Results:
We identified a total of 453, 473, 424, and 472 new drugs approved over the study period in India, US, EU, and Japan, respectively. The absolute drug lag of Central Drugs Standard Control Organization (CDSCO) was 19 and 18 relative to the US Food and Drug Administration (FDA) and Japan Pharmaceuticals and Medical Devices Agency (PMDA), respectively. The relative drug lag for the CDSCO vis-a-vis the US FDA, European Medicines Agency, and PMDA was 43.2 (2.1–1287.8), 25.6 (0.03–1310.5), and 30.3 (1.2–1242) months, respectively.

Conclusion:
Our study shows a significant drug lag between India and other three developed nations (US, EU, and Japan). However, in some therapeutic areas, Indian regulator has proactively approved new drugs much before other agencies. The New Drugs and Clinical Trials Rule of 2019 has brought hope for reduction in drug lag in the near future.
Who Will Pay for the COVID-19 Vaccines for Africa?
Authors: Lucero-Prisno Don Eliseo , Ogunkola Isaac Olushola , Imo Uchenna Frank , Adebisi Yusuff Adebayo 
Published: January 2021

ABSTRACTAfrica’s health systems are strained by the COVID-19 pandemic. There are global efforts toward the development and trial of COVID-19 vaccines. However, considering the challenges and economic conditions of African nations, there could be limited access and availability of the vaccines on the continent. This will be the result of high cost and technical requirements to acquire the vaccines. There are indications that possible donor funding for COVID-19 vaccines from rich countries maybe put off considering the various challenges they face currently and the moves they are making in response to the disease. The issue of justice in health for protecting the vulnerable populations and regions also supports the need for COVID-19 vaccine availability on the African continent. Means to achieve uniform control of the disease burden across the globe should be adopted. Governments of African nations should also scale up their efforts toward COVID-19 vaccine acquisition and utilization through viable efforts. It is therefore important to assist the African continent in acquiring the COVID-19 vaccines by leveling all power dynamics that will affect access and distribution.
Reconfigurable High Gain and Wide Band Antenna for 5G Communication
Authors: V Seethalakshmi , S Geetha , G Vetrichelvi , G Saranya , S Manikandan 
Published: January 2021

This paper introduces the specification and performance analysis of broad frequency range antenna for 5 G mobile phones. The suggested antenna functions at the frequency spectrum of 28 GHz and its configuration are permanently matched over very high frequency bands,
including 4.25 GHz, 7.055 GHz, 12.48 GHz and 15.26 GHz, as well as for the reallocation of the expanded 5 G spectrum of communications.	Mobile	terminals are compliant with the antenna that is being built.
A Clinical Audit Of Management Of Third And Fourth Degree Perineal Tears
Authors: Saida Abrar  , Raheela Mohsin Rizvi  , Urooj Kashif  , Admin  
Published: January 2021

Abstract
Objective: To perform a clinical audit of the practices of third and fourth degree preineal tears management in our institution.
Methods: A review of medical records was performed, of women having singleton term vaginal delivery sustaining obstetric anal sphincter injuries (OASIS) at Aga Khan University Hospital (AKUH), Karachi from January 2008 to December 2018. We compared the change in practices regarding management of OASIS with the results of our previous study done at AKUH in 2008.
Results: The frequency of OASIS in our department is 0.56% (142/25370). The documentation of OASIS improved compared to previous study ( 20.7% to 87%). There was also a significant increase in documentation of the method of repair, use of delayed absorbable suture material for the repair of external anal sphincter and follow-up at 06 weeks to see the success of repair and plan next delivery. The use of vaccum vaginal delivery increased to 27(19%) from 5(4%) but there was decrease in the OASIS complicated by instrumental vaginal deliveries, which may be due to the decrease in the use of forceps from 64% to 26%.
Conclusions: Despite of increase in the number of deliveries , frequency of OASIS remained similar to the previous study. There was a significant increase in the vaccum vaginal delivery, documentation of degree of tears, use of delayed absorbable suture material and long-term follow-up and decrease in the use of forceps. The compliance to international guideline increased as compared to our previous paper. Continuous...
DEMOGRAPHIC FACTORS ASSOCIATED WITH INCREASING INCIDENCES OF BURNS AMONG ADULT PATIENTS ADMITTED IN THE KENYATTA NATIONAL HOSPITAL BURNS UNIT
Authors: Amakobe Nelly C , Moronge Dr. Makori 
Published: January 2021

Purpose: The purpose of the study was to establish the demographic factors associated with increasing incidences of burns among adult patients admitted in the Kenyatta National Hospital Burns UnitMethodology: The population of this research consisted of all patients in the burns unit at Kenyatta hospital. The study used primary data in particular used questionnaires. The questionnaire consisted of structured closed ended statements. Data was analyzed using Statistical Package for Social Sciences (SPSS) mainly by use of descriptive statistics. Descriptive statistics included mode, mean, median, standard deviation. Data was presented by use of graphs, pie charts and tables.Results: The study findings indicated that there has been an increase in number of patients with burns which is associated with various demographics factors causing the increased incidences among the patients. Unique contribution to theory, practice and policy: From the study findings the researcher recommend that it’s important to educate the citizens in order to make them more aware of the dangers associated with various factors such as illegal electricity connection and lack of access roads. In doing this more cases of fire would be reduced and reduce loss of lives and property in more fire prone areas. The study also recommends that the Government through the Ministry of Public Health and Sanitation should impart knowledge related to the burns especially on how people can take preventive measures and emergency measures against fire outbreak.
THE INFLUENCE OF SOCIAL ECONOMIC FACTORS ON THE INCREASING INCIDENCES OF BURNS AMONG ADULT PATIENTS ADMITTED IN THE KENYATTA NATIONAL HOSPITAL BURNS UNIT
Authors: Amakobe Nelly C , Moronge Dr. Makori 
Published: January 2021

Purpose: The purpose of the study was to establish the influence of social economic factors on the increasing incidences of burns among adult patients admitted in the Kenyatta National Hospital Burns Unit.Methodology: The population of this research consisted of all patients in the burns unit at Kenyatta hospital. The study used primary data in particular used questionnaires. The questionnaire consisted of structured closed ended statements. Data was analyzed using Statistical Package for Social Sciences (SPSS) mainly by use of descriptive statistics. Descriptive statistics included mode, mean, median, standard deviation. Data was presented by use of graphs, pie charts and tables.Results: The study findings indicated that there has been an increase in number of patients with burns which is associated with various social economic factors causing the increased incidences among the patients. Unique contribution to theory, practice and policy: From the study findings the researcher recommend that it’s important to educate the citizens in order to make them more aware of the dangers associated with various factors such as illegal electricity connection and lack of access roads. In doing this more cases of fire would be reduced and reduce loss of lives and property in more fire prone areas. The study also recommends that the Government through the Ministry of Public Health and Sanitation should impart knowledge related to the burns especially on how people can take preventive measures and emergency measures against fire outbreak.
PROGNOSIS OF PEDIATRIC NON HODGKIN LYMPHOMAS TREATED WITH FAB/LMB96 IN TERTIARY CENTER, SAUDI ARABIA
Authors: Shehadah Moussa Mohamed , Abdalla Khalid Abdalla , Mustafa Omima Abdullah , Elimam Naglla , Baothman Abdullah A. 
Published: January 2021

Purpose: This study aimed at describing prognosis of pediatric B-NHL patients treated with FAB LMB-96 based protocol without dose modification, and to identify possible prognostic factors influencing the outcome and the treatment related toxicities.Methodology: Through a retrospective study design, the researchers traced 48 pediatric cases who had been diagnosed with Mature B-NHL and treated at Prince Nora Oncology Center (PNOC) in the period from January 2007 to December 2016. Data were retrieved from the medical records, radiology images and pathology specimen for cases who met the inclusion criteria. For operational definition, cases were defined according to WHO classification, while staging was performed according to Murphy’s classification. Kaplan Meier survival function analysis was used to determine overall survival and Event Free Survival; and Chi Square test was used to verify significance in the differences according to characteristics of the cases. Findings: Out of all cases (n=48), Saudis formed (85.4%) and male to female ratio was 2.4:1, with a median age at diagnosis of 5.6 years. Most of the cases were diagnosed as Burkitt’s lymphoma (87.5%), mainly in stage III (37.5%) and stage IV (39.6%), chiefly as primary abdominal retro-peritoneal tumors (47.9%). Almost all cases (97.9%) developed chemotherapy related hematologic toxicity and fever neutropenia, and one third (34.8%) had septic shock. At the end of follow-up (median=112 months), there were 40 patients (83.3%) achieved remission, out of them, 6 (12.5%) relapsed. Death was attributed to disease recurrence (3 cases) and treatment related toxicities (4 patients). No statistically significant difference detected in the overall and Event Free survival rates according to their age, gender, histology, biochemical markers, disease locations, staging and FAB group classifications (P >0.05).Conclusion and recommendations: Childhood non-Hodgkin lymphomas are almost all high grade and frequently extranodal. They fall mainly into the categories Burkitt lymphoma, lymphoblastic lymphoma and anaplastic large cell lymphoma. Our findings are comparable with those reported in other international trials
REVIEW ARTICLE: EPIDEMIOLOGY OF COVID’19
Authors: Courage Idahor , Oghenevwede Okuma , Gene-Genald Anugom , Gabriel Willie , Chukwunonso Akwazie   , Oyetayo Boluwatife 
Published: January 2021

Purpose: To carefully review and understand the cause, distribution, progression, determinants and deterrents of COVID-19.
Methodology: Peer reviewed data relevant to study was collected from PubMed, Google Scholar, WHO database, Research gate and Wikipedia based on pre-set inclusion and exclusion criteria.
Findings: Covid-19 is a principally respiratory illness caused by the novel Corona Virus (SARS-CoV2). It started as an epidemic in Wuhan, China in December 2019, became a pandemic in March 2020 and have now infected almost 22 million people over 216 countries causing about three-quarter of a million deaths. It spreads primarily through droplets, aerosols or contact with contaminated surfaces. Illness is usually mild to moderate flu-like symptoms but can be asymptomatic as well as severe especially in patients with underlying co-morbidities. Testing can either be antigen based through polymerase chain reaction or antibody based. Treatment is generally supportive while the efficacy of diverse pharmacological remains controversial. Public education, early diagnosis and isolation, restriction of gatherings and movements have been the main method used worldwide to tackle this outbreak.
Unique contribution to theory, practice and policy: Emphasizes the infectivity of SARS-CoV2 virus and need for health practitioners and general public to adhere strictly to preventive measures in order to avert a global second wave of the pandemic.
Conclusion: COVID-19 is an infectious disease that have rapidly spread from china to the world at large. A lot of efforts and policies have been made to prevent and control its spread. There’s need to adhere to guidelines in order to reduce spread and subsequent mortality especially amongst vulnerable groups. As many countries commence protocols to re-open, there’s need to do so in line with lessons learnt during this outbreak to avoid a more devastating second wave.