bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acceptance and Knowledge of COVID-19 Vaccine among Health-Care Professionals in Western Uttar Pradesh, India
Authors: Patrick Shilpa , Singh Preeti , Choudhary Ruchi , Matreja Prithpal Singh 
Published: June 2021

Introduction:
Knowledge and acceptance of COVID-19 vaccine among health-care professionals (HCPs) are an important aspect in the success of the vaccination drive in India, as HCPs are the first group to receive the vaccine. Various factors affecting the attitude of getting COVID-19 vaccine and to better address those factors will help in widespread acceptance among the general public.

Materials and Methods:
This was a cross-sectional study which was conducted among HCPs by circulating Google form. The form was distributed among the medical students and physicians through social networking sites such as E-mail and WhatsApp. The questionnaire consisted of 18 questions focusing on the assessment of knowledge and acceptance about COVID-19 vaccine. It was a self-administered and pilot-validated questionnaire.

Results:
Out of total participants, 473 (78%) were willing to take vaccination and were in the opinion that getting vaccination is a good idea. Eighty-eight percent of the participants were worried about the effectiveness of the COVID-19 vaccine. Fifty-five percent of the participants were anxious regarding getting vaccine and its efficacy.

Conclusion:
Knowledge and acceptance were moderate, but overall attitude of getting vaccination was positive. Majority of the HCPs are still anxious about the long-term efficacy; therefore, appropriate steps need to be taken to address the factors contributing to the low acceptance of the COVID-19 vaccine.
Health-Care Personnel's Perspective on COVID-19 Vaccination – A Cross-Sectional Study
Authors: George Neethu , Shagirunisha Rizvana Abdul Malik , Vignesh Kumar Nawin Jai , Britto Rock 
Published: June 2021

Introduction:
The COVID pandemic was a modern world disaster which had physical, psychological, and economical impact among the people. This made the governing agencies and others to rollout vaccine in a prompt basis. The objectives were to assess the attitude of health-care personnel toward COVID-19 vaccination using online survey and to assess the willingness of COVID-19 vaccination and factors affecting it among health-care personnel.

Materials and Methods:
We conducted a cross-sectional study using web-based platforms among 471 health-care personnel's within a period of a month (December 2020–January 2021). The study was conducted after obtaining institution ethic committee approval and informed consent. The questionnaire contains sociodemographic detail, COVID profile section, and questions which reveal the beliefs and attitude toward vaccination particularly COVID-19. The data collected was entered in Microsoft Excel and analyzed using SPSS version 16 software.

Results:
Among the participants, 56 (11.9%) were diagnosed with COVID-19 and 119 (25.3%) were not willing to take vaccine. Participants who were hesitant about the role of vaccine in immunity, afraid of side effects, doubtful about effectiveness and protection and who doubt about the production involving cost and supply have showed unwillingness to vaccination (P < 0.05).

Conclusion:
A quarter of the present study population showed unwillingness to take COVID vaccine, and evidence of uncertainty about the vaccine safety and production was exposed in the study. The results should be looked upon gravely as the issues appeared here can be maximized when the vaccine rollout happens in public.
A Cross-Sectional Study on Physical Activity, Sedentary Behavior, and Sleep among Under-Five Children in Slum Areas of Burdwan Municipality, West Bengal
Authors: Goswami Prosun , Chakraborty Amitava , Das Dilip Kumar , Ray Soumalya 
Published: June 2021

Introduction:
Less time in physical activity, increase in sedentary time, and screen time have various negative health consequences and are a matter of concern for childhood health now-a-days. The study was to find out the prevalence of adequate physical activity and sleep, the status of sedentary behaviour and screen time among under-five children residing in the slum areas of Burdwan Municipality and their association with selected demographic and socioeconomic characteristics of study participants.

Materials and Methods:
This cross-sectional study was done among 180 under-five children residing in slums of Burdwan Municipality in Purba Bardhaman District of West Bengal, India, during January to March 2020. A predesigned, pretested schedule was used to collect necessary information on physical activity, sedentary, and sleep behavior of under-five children following the recent guideline by the World Health Organization. Ethical approval was obtained from the Institutional Ethics Committee of Burdwan Medical College and Hospital. Data were analyzed using the Statistical Package for the Social Sciences (SPSS), software version 20.

Results:
Overall 69.4%, 70%, and 63.3% of the children were physically active, restrained themselves in enjoying their sedentary life and screen viewing within recommended timeframe, respectively. 84.4% children had adequate sleep time with nap. Logistic regression revealed that the absence of siblings was associated with inadequate physical activity (adjusted odds ratios [AOR] =3.82 [1.88, 7.77]) and more than recommended sedentary lifestyle (AOR = 5.01 [2.45, 10.26]) while more than recommended screen viewing was associated with age (AOR = 4.84 [2.34, 10.00]) and house condition (AOR = 6.54 [2.32, 18.42]).

Conclusions:
This study put emphasis on the requirement of focussed intervention on increasing physical activity and reduction in screen-based engagement among under-five.
Maternal and Neonatal Risk Factors for Neonatal Jaundice and Readmission – An Indian Perspective
Authors: Kaur Navjot , Dhillon Gurpreet Kaur , Sasidharan Shibu , Dhillon Harpreet Singh 
Published: June 2021

Introduction:
Neonatal hyperbilirubinemia is a common neonatal ailment and is mostly benign except in few cases where it might progress to kernicterus. Neonatal jaundice is preventable and treatable if detected in time, and therefore, it is crucial to identify risk factors for developing severe hyperbilirubinemia.

Materials and Methods:
A prospective observational study was conducted with the aim to examine the risk factors for significant jaundice and also for readmission to the hospital.

Results:
A total of 1159 neonates were enrolled, of which 11.2% (n = 134) developed significant neonatal jaundice prior to discharge and 2.1% (n = 25) were readmitted with significant jaundice. The maternal risk factors for significant jaundice were primigravida with age range between 23 and 27 years, "O" blood group, conception by in vitro fertilization and embryo transfer (IVF-ET), antenatal oxytocin use, and lower segment cesarean section delivery. The neonatal risk factors for significant jaundice were late preterm male neonates born with birth weight between 2 and 2.5 kg and delayed cord clamping (DCC). The maternal risk factors for readmisssion jaundice were young primigravida with "O" blood group hailing from North India with antenatal use of oxytocin and gestational diabetes mellitus. The neonatal risk factors for readmission jaundice were low birth weight, DCC, twin pregnancies, neonates discharged between 48 and 72 h after birth.

Conclusion:
The statistically significant factors (P < 0.05) associated with an increased risk of developing significant hyperbilirubinemia requiring readmission included low birth weight, gestational age 35–36 weeks and 6 days, DCC, and IVF-ET conception.
Association of Estrogen and Progesterone Receptors with Clinicopathological Prognostic Factors in Breast Cancer
Authors: Abdul-Kareem Ali Abdul Hadi , Mahdi Qahtan A. 
Published: June 2021

Background:
The detection of the estrogen receptor (ER) and progesterone receptor (PgR) in women with breast cancer (BC) is considered a crucial step for prognostic evaluation and treatment choice in clinical practice.

Objectives:
This study aimed to evaluate the expression of the hormonal receptors (ER and PgR), their distribution, and their association with clinicopathologic prognostic parameters in a sample of Iraqi women with BC.

Materials and Methods:
The paraffin-embedded blocks from a total of 80 women diagnosed with primary invasive breast carcinomas with BC were examined by immunohistochemistry to assess the expression of ER and PgR status. Demographic and clinical data were collected from each patient in the preformed questionnaire. The association of steroid receptor expression with clinicopathologic parameters was assessed using binary logistic regression.

Results:
Among 80 BC women involved in the study, 54 (67.5%) and 39 (48.75%) had high expression of ER and PgR, respectively. High ER expression was significantly associated with older age (odds ratio [OR] = 4.8, 95% confidence interval [CI] = 1.16-19.81, P = 0.03), postmenopausal status (OR = 3.6, 95% CI = 1.25–10.33, P = 0.015), smaller tumor (OR = 0.27, 95% CI = 0.09–0.75, P = 0.01), and with noninvolvement of lymph node (OR = 0.11, 95% CI = 0.02–0.51, P = 0.005). High PgR expression, on the other hand, was significantly associated with older age (OR = 4.44, 95% CI = 1.02–19.39) and postmenopausal status (OR = 3.13, 95% CI = 1.24–7.88, P = 0.016). Concomitant overexpression of both receptors was significantly associated with postmenopausal status and noninvolvement of lymph nodes.

Conclusion:
High expression of ER and PgR seems to be a good prognostic indicator because it was associated with less aggressive tumors.
Results of Flexible Nails for Fixation of Tibial Diaphysis Fractures in Children
Authors: Mohammed Mariwan Saleem , Yousif Othman Sami , Barawi Omer Ali Rafiq 
Published: June 2021

Background:
Fracture tibia is one of the most common fractures in the pediatric age group. It accounts about 15% of cases. In majority of cases, close reduction and plaster application is the mainstay of treatment.

Objectives:
The objective was to assess the outcome of flexible nails in the treatment of tibial diaphysis fractures in children and to evaluate the results regarding the union rate and complications including limb length discrepancy, angular deformities, and pain.

Materials and Methods:
This prospective descriptive case–control study which included 30 children with 30 unilateral tibial diaphysis fractures in which the physis were open, all were closed, and open (type 1 and type 2) fractures, and with displaced transverse, short oblique, and spiral fractures, in which the trial of close reduction was failed. All patients are admitted and operated at West Erbil Emergency Hospital. Alignment of fractures, any infection, delayed union, nonunion, limb length discrepancy, motion of knee joint, time of complete union, and skin irritation were assessed with minimum follow-up period of 6 months.

Results:
In the current study, the complete union was achieved in 9–11 weeks in 20 (66.7%) patients, while in 6 (20%) patients, achieved in 12 weeks, and in 4 (13.3) patients, achieved in 13–16 weeks that were regarded as a delayed union. In 6 (20%) patients, there were nail protrusion and skin irritation, no shortening more than 0.5 cm was recorded, shortening <0.5 cm recorded in 12 (40%) patients, and no lengthening was recorded. In 3 (10%) patients, the angulations in coronal and sagittal views were 5°–10°. There was no case of nonunion.

Conclusion:
Elastic nails are an effective way for the treatment of the pediatric tibial diaphysis fractures. It is a simple and easy method but with radiation risk, although elastic nails have complications, all are avoidable and minor that will be managed with minimal intervention.
Primary Sinonasal Non-Hodgkin's Lymphoma
Authors: Swain Santosh Kumar , Panda Soumya Surath 
Published: June 2021

Background:
Primary sinonasal non-Hodgkin's lymphomas (NHLs) are uncommon malignancies. The lack of specific clinical presentations often causes delayed visit to the clinician and so diagnosis is done in late with advanced stage.

Objective:
The objective of the study was to study the primary sinonasal NHL with respect to clinical presentations, management, and outcome.

Materials and Methods:
This is a retrospective study conducted in a tertiary care teaching hospital from March 2010 to April 2020. The clinical data of the patients of primary sinonasal NHL were evaluated with respect to the age, sex, clinical presentations, staging, diagnosis, treatment, and outcome.

Results:
The mean age of the participants was 62.45 years with male-to-female ratio of 1.5:1. All the cases of sinonasal NHL involved with paranasal sinuses and nasal cavity. Nasal obstruction was the most common symptom. All were diagnosed with large B-cell lymphoma and treated with combined chemotherapy and radiation. Five patients were died during follow-up period.

Conclusion:
Primary sinonasal NHLs are extremely uncommon clinical entity. The diagnosis is based on the histological examination with immunohistochemical study. Early diagnosis and prompt treatment with chemo-regimen and radiotherapy are essential to achieve an optimum outcome. Early diagnosis and treatment improves the treatment outcome.
Nonadherence to Guideline-Directed Anticoagulations in Atrial Fibrillation in Iraq
Authors: Mohammad Ameen M. , Nerway Delshad A. Ramadhan 
Published: June 2021

Background:
Anticoagulations remain an essential step to minimize the mortality and morbidity associated with thromboembolic phenomena in atrial fibrillation (AF). Nevertheless, the adherence to OAC stands for (Oral Anticoagulant) throughout the paper is not universal among the different populations. In Iraq, there are no data about adherence to (OAC) in patients with AF.

Objectives:
This study aimed to assess the adherence to oral anticoagulants (OAC) based on the American College of Cardiology/American Heart Association performance measures in eligible patients with a CHA2DS2-VASc ≥2 in patients with AF in Duhok, Iraq.

Materials and Methods:
A total of 132 patients who were diagnosed with AF were consecutively reviewed during 2018–2019 in Azadi Teaching Hospital, Duhok, Kurdistan Region, Iraq. For eligibility of taking an OAC, the VAS score derived from CHA2DS2-VASc for all patients was calculated.

Results:
The mean age of the patients was 65.29 (standard deviation [SD]: 17.18 years). The average duration of AF was (2.0) years. The mean of VAS score was 2.97 (SD: 1.75, ranged between 0 and 8.0). 78.0% of all patients were eligible for OAC at admission. Only 15.9% of the patients were on OAC. In the logistic regression analysis, none of the patient's characteristics predict significantly the nonadherence to OAC.

Conclusion:
The present study showed that a high percentage of AF patients were eligible for OAC. However, only a small percentage of them were receiving OAC at admission in our area.
Relationship between the ABO Blood Group and Lung Cancer Susceptibility
Authors: Hussein Zahir Salih 
Published: June 2021

Background:
Lung cancer (LC) is one of the well-known fatal malignant neoplasms worldwide.

Objective:
The objective of this study was to determine the potential relationship between ABO and Rhesus blood groups with LC.

Materials and Methods:
A retrospective case series study was done on 500 patients diagnosed with LC using hospital case reports of both Nanakali Hospital and Rizgary Teaching Hospital and 182,408 healthy blood donors in Erbil city of Iraqi Kurdistan Region.

Results:
Blood groups of 500 LC patients were as follows: blood group A, 156 (31.2%); blood group B, 111 (22.2%); blood group O, 196 (39.2%); and blood group AB, 37 (7.4%), whereas blood groups of healthy donors were as follows: blood group A, 56,546 (31%); blood group B, 43,413 (23.8%); blood group O, 68,221 (37.4%); and blood group AB, 14,228 (7.8%). The difference was statistically not significant by Pearson's Chi-square (P = 0.909). Rh of patients was as follows: Rh negative in 42 patients (8.4%) and Rh positive in 458 patients (91.6%), whereas Rh of healthy donors was as follows: Rh negative in 18,241 patients (10%) and Rh positive in 164,167 patients (90%). The difference was statistically not significant by Pearson's Chi-square (P = 0.381).

Conclusion:
According to the results of the study, we found that there was no statistically significant relationship between ABO-Rhesus blood groups' LC susceptibility in general and also between different histopathological types.
Parents' Knowledge and Attitudes toward Seasonal Childhood Influenza Vaccination for Children Aged Below 5 Years in Hilla City/Iraq
Authors: Hameed Huda Ghazi , Jubair Ruaa Sabah 
Published: June 2021

Background:
Seasonal influenza is an acute, highly infectious viral infection. Immunization of the children can protect not only the children but also the community from seasonal influenza. Parents' knowledge and attitudes can play an important role in the immunization coverage.

Objectives:
To assess parents' knowledge and attitudes toward childhood seasonal influenza vaccination for children aged below 5 years in Hilla governorate and to determine the relationship between them and socioeconomic status.

Materials and Methods:
A cross-sectional study was done on 288 parents who visited a six randomly selected primary health care centers in Hilla city and who had children aged between (6 and 59) months. Data were collected from May 1, 2018, to August 4, 2018, by interviewing parents using a questionnaire form after taking their consent, including a full assessment of parents' attitude and knowledge toward seasonal childhood influenza vaccination.

Results:
The results showed that 92.7% (n = 260) of the participants had moderate and good knowledge about seasonal childhood influenza vaccination with significant association with mother's education, age, and family income and 88.9% (n = 256) of them had a positive attitude toward the vaccine which was significantly associated with the family residence, the coverage rate of the seasonal childhood influenza vaccine was 30.6%.

Conclusions:
The majority of participants had good and moderate knowledge and a positive attitude toward seasonal childhood influenza vaccination. Higher knowledge level was reported in mothers of younger age. A very low percentage of illiterate mothers had good knowledge. The majority of parents with good knowledge had low family income.
“Primary Care Physicians” Perspective on Placebos in Clinical Practice
Authors: Karim Syed Irfan 
Published: June 2021

Background:
Global patterns in the clinical use of placebos differ due to physicians' conceptual differences, culture, region, and setting. This study aimed to evaluate the attitudes, beliefs, and prescribing habits of primary care physicians toward the use of placebos.

Methods:
This was a cross-sectional study. An anonymous web-based survey questionnaire was used to collect the information of primary care physicians (2017–2018). Descriptive statistics and frequency distributions were calculated using the Chi-square and Fisher's exact tests.

Results:
The mean age of the participants was 41.3 ± 12 years. Male physicians (67%) outnumbered their female counterparts. There were 87/108 (80.5%) physicians who responded. Minority of the physicians (21%, n = 18) had used a placebo in clinical practice, and only 25% indicated placebo prescription to be ethically acceptable. The most common reasons for placebo use were to satisfy a complaining patient (27.6%), calm the patient (23%), and as a supplemental treatment to other medicines (20.7%). A significant association was found between the age (P = 0.03) and years of experience (P = 0.01) with the placebo prescribing practice. Majority (43.8 %) of non-Saudis compared to 15.5% of Saudi respondents reported using placebos (P = 0.01, odds ratio = 6.35). Majority (75%) of the respondents believed that placebos can be used in clinical practice without giving prior information to the patient.

Conclusion:
Minority of the physicians used placebos in clinical practice. Clinical experience and cross border variation were seen among physicians in placebo prescribing practices. Physicians used placebos primarily for psychological benefit.
A Review of the Sociodemographic Characteristics of Children Immunized with the Rotavirus Vaccine in Adonai Hospital, Karu Local Government Area, Nasarawa State, North-Central Nigeria
Authors: Obute Godwin Adakole , David Esther , Kanmodi Kehinde Kazeem 
Published: June 2021

Introduction:
There is a dearth of literature on existing rotavirus immunization services offered in Nigeria; with only very little information has been documented about it. This study aims to conduct a clinical audit of all children immunized with rotavirus vaccine in Adonai Hospital, Karu Local Government Area, Nasarawa State, north-central Nigeria.

Materials and Methods:
This study was a hospital-based study which adopted a retrospective study design. The population included in this study was children who had received rotavirus vaccine at Adonai Hospital. The study instrument was a data extraction form which obtained information about the sociodemographic data and clinical data of the children registered in the child immunization register. Only the data of all children immunized with rotavirus vaccine at the facility were obtained.

Statistical Analysis Used:
Data collected were analyzed using SPSS version 20 software.

Results:
A total of 111 children had been immunized with rotavirus vaccine in the health facility, 51.4% of them were males, 20.7% were from Igbo ethnicity, 86.5% came from Christian families, and all were residing in urban areas. All the children were within the age of 6 weeks to 40 weeks as the time of rotavirus vaccination. The dropout rate for rotavirus vaccine among the immunized children was 17.1%. Only 2.7% of all the children that received the vaccine developed an adverse event following immunization (AEFI), of which all were minor AEFIs.

Conclusions:
This study recorded a low rate of AEFI among children immunized with rotavirus vaccine in Adonai Hospital. Furthermore, the observed dropout rate in our facility is relatively very low when compared with the general dropout rate observed among children receiving immunization services in Nigeria. Notwithstanding, we recommend that investigations need to be done to explore the reasons why some children have dropped out of the rotavirus vaccination program at the surveyed facility.