bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risks assessment of Adherence to non-pharmaceutical measures towards COVID-19 among residents of Mashhad in the North-East of Iran during the awful wave of the epidemic
Authors: Abdollahzadeh Hasan , Rahmanian Vahid , Sharifi Nader , Zahedi Razieh , Bajestani Majid Jafari Nejad , GholianAval Mahdi , Esmaeilzadeh Nayereh , Hadjzadeh MousaAlReza , Ahmadian Mohammad 
Published: October 2021

Background:
Since the Coronavirus disease 19 (Covid-19) rampaged in Iran, three waves of the epidemic occurred.

Objective:
In the present study, two issues are considered. First: What proportion of the people adhere to the mitigation approaches towards the disease? Second: Which are the reasons to disobey these rules?

Methods:
A cross-sectional, population-based phone survey was applied among the population aged over 16 years in Mashhad between November 5 and December 1, 2020. A valid and reliable knowledge, attitude, and performance (KAP (designed questionnaire was used and logistic regression was performed with STATA 14.

Results:
The final sample size was 776; 90.59, 89.8 and 48.1% of the participants had sufficient reliable knowledge, attitude, and practice, respectively; 20.1% of the participants did not wear masks; nearly half of them visited traditional healers for the prevention and cure; 97.8% of them believed the efficiency of the vaccine and stated that they will consume it if it is distributed. Among the sociodemographic factors, only the unemployed had low adherence to the preventive approach; 51.7% of the main worry was the weak economic situation and 69% of jobs and expenditures were poorly affected. The odds ratio (OR) for optimising attitude reduced from 4.64 to 3.22, and for good performance from 5.64 to 5.43 after adjusting for the economic, knowledge and perception factors.

Conclusion:
Despite all the health rules and probably COVID-19 vaccines global access (COVAX), it seems that the most effective way to reverse this horrific wave and its economic consequences is the improvement of the economy and livelihood of the society.
Comparison of actigraphy indices among patients with depression and schizophrenia
Authors: Ransing Ramdas , Patil Pradeep , Patil Swaroopa , Agrawal Shruti 
Published: October 2021

Background:
Schizophrenia (SCZ) and depression (MDD) are associated with changes in sleep and activity patterns. However, because of a lack of objective evaluation, the diagnostic or clinical value of these sleep-activity patterns is unknown. In this study, we attempted to assess and compare the sleep and activity patterns using actigraphy.

Materials and Methods:
We have recruited 35 patients with SCZ (mean age: 29.29 ± 7.54 years) and 42 patients with MDD (mean age: 27.5 ± 5.59 years) in this cross-sectional study. The actigraphy indices [Time in bed (minutes), Onset latency (minutes), Total sleep time (Minutes), Sleep efficiency (%), WASO (minutes), number of awakening, and activity duration (minutes) were compared among the two groups using unpaired t-test and Fisher exact test.

Results:
In the MDD group, the time in bed (minutes) was significantly higher than in the SCZ group (402.7 ± 41.97 vs. 379.1 ± 40.45, P = 0.01), while the sleep efficiency was lower in the SCZ group than in the MDD group (60.04 ± 9.25 vs. 65.05 ± 7.16, P = 0.0092). An increase in onset latency (minutes) was observed in the SCZ group compared to the MDD group (49.06 ± 16.09 vs. 43.6 ± 10.14, P = 0.074). The difference in WASO (minutes), the number of awakenings, and activity duration (minutes) among the two groups were insignificant.

Conclusion:
Actigraphy parameters such as sleep efficiency and time in bed may be a useful sleep process, etiological, and prognostic markers in patients with SCZ and MDD. The longitudinal studies are needed to estimate the predictive role of these parameters for therapeutic outcome in these patients.
Evaluation of nutritional status and health behaviors of patients infected with COVID-19
Authors: Karimi Saba , Tondro Amirhossein , Hematpour Behzad , Karimi Maryam , Ehyaei Parvin 
Published: October 2021

Introduction:
Coronavirus disease 2019 (COVID-19) was a health emergency for the world in which started in 2019. Various factors are involved in the pathogenesis of this virus, including age, gender, body mass index (BMI), the type of diet, the degree of observance of health protocols, and the health status of people. The purpose of this study was to evaluate the nutritional status and health behaviors of patients infected with COVID-19.

Methods:
A descriptive-analytical research method was used in this study. One of the outpatient centers for the patients infected with COVID-19 in Kermanshah was selected as the research setting. The study population included all patients infected with COVID-19 and the sample size was 200 people. Data were analyzed by SPSS version 22.

Results:
Most patients (51%) were females and most of them suffered from body aches (81%) and headaches (94%). Most of the patients (76%) did not use a mask. Regarding the nutritional status, a large number of patients used all food groups such as carbohydrates, proteins, fruits, and vegetables less than the standard amount.

Conclusion:
It can be concluded that people with underlying diseases are more prone to the disease than others and adherence to social distancing and mask use helps a lot to control the disease. In addition, the appropriate intake of food groups reduces the severity of the disease by strengthening the immune system in people.
Designing a curriculum for postgraduate training in family medicine in India
Authors: Rajkumar Honest Prince Christopher , David Kirubah V. , Rahman Sajitha P.M.F. , Sankarapandian Venkatesan 
Published: October 2021

Context:
Family physicians, trained in handling primary care problems through the principles of family medicine (FM), were needed in India. The training required a comprehensive and detailed curriculum that could be implemented across the country.

Aim:
The aim was to create a document that includes rationale, goals, subject-based objectives, educational methods and assessment methods that align to the objectives.

Design and Methods:
Kern's Six-Step-method was used to create a curriculum document. The six steps are (a) problem identification and general needs assessment, (b) targeted needs assessment, determining and prioritizing content, (c) writing goals and objectives, (d) selecting teaching/education strategies,(e) implementation of the curriculum and (f) evaluation and application of the lessons learnt.

Results and Conclusions:
Based on the given steps, a team of faculty identified needs, requirements and barriers, wrote goals and objectives along with aligned educational and assessment methods. The curriculum document was created for FM resident training. The first set of residents have been trained based on this curriculum and an evaluation is being planned.
Prevalence of breast imaging reporting and data system (BIRADS) categories and breast consistencies in Central India –A cross-sectional survey
Authors: Mittal Megha , Deolia Shravani , Agrawal Amit , Chaturvedi Himanshu , Agrawal Gaurav , Chhabra Kumar G. 
Published: October 2021

Background:
For recognizing the initial stages of breast cancer, mammography is regarded as one of the best modalities and plays a crucial part to lessen morbidity and mortality. For collaborative studies and planning of preventive strategies, it is significant to have baseline data. Thus, in this survey, the frequency distribution of breast imaging reporting and data system (BIRADS) classification and breast consistencies was investigated during the mammographic screening program in the Gwalior region, India.

Material and Methods:
A descriptive, cross-sectional survey was conducted in the Gwalior region, India, in which 1,838 patients were screened with the aid of mammography. The mammography films were evaluated by a single radiologist who determined the BIRADS score, breast composition, and any other abnormal findings. After tabulating the data into MS Excel (MS Office version 2007 developed by Microsoft, Redmond, WA), descriptive analysis and Chi-square test were performed to determine the association between the BIRADS score and breast consistency and setting significance level at (below) 0.05.

Results:
The most commonly found BIRADS score was score 1 (53.4%), followed by score 2 (20.4%), and score 5 was of the least frequency (1.3%). Similarly, the most common consistency found was fatty (48.2%) and the least common was heterogeneously dense (3.97%). The most BIRADS category of 0 was seen in heterogeneously dense (n = 22; 26%) followed by dense breast compositions (n = 18; 25%). The most common consistency found with known breast malignancy (BIRADS 6) patients was the extremely dense breast (n = 11; 40.7%).

Conclusion:
In this study, it was observed that about 57.3% of all the cases were categorized as BIRADS 1 and 20.8% as BIRADS 2.
Evaluation of liver function in symptomatic COVID-19 patients
Authors: Singhai Abhishek , Pavan G. Sai , Panda Smritimayee 
Published: October 2021

Context:
The coronavirus disease 2019 (COVID-19) is a viral respiratory illness which was first detected in Wuhan, Hubei Province, China. A few case studies demonstrated that 14–53% of the cases of COVID-19 reported abnormal levels of liver enzymes during disease progression. Patients with severe COVID-19 seem to have higher rates of hepatic dysfunction.

Aims:
Our aim was to investigate the changes in the liver function test in COVID-19 patients admitted to hospital and its association with the severity of the disease, length of hospital stay, and outcome of patients.

Settings and Design:
This was a cross-sectional study involving 678 COVID-19 patients, who were admitted at AIIMS, Bhopal.

Methods and Material:
The case records of 678 patients were evaluated by the research team from the Department of Medicine, AIIMS, Bhopal, and data were analyzed. All laboratory data were obtained. The liver function tests (LFT) including alanine aminotransferase, aspartate aminotransferase, and total bilirubin values were recorded, and liver dysfunction defined as any parameter having more than the upper limit of normal value.

Results:
From April 2020 to September 2020, a total of 678 COVID-19 patients were screened, and 600 were assessed for eligibility; 78 were excluded due to either significant alcohol history or due to prior liver disease. Among the 600 patients, 265 patients (44.16%) had liver dysfunction while 335 patients (55.83%) had a normal liver function. The patients having a severe disease were more affected by liver dysfunction than the mild disease patients. The average hospital stay was more in those patients having liver dysfunction than in those patients with normal liver function. Among the patients with normal LFT on admission, 97.9% got cured while 2.1% died. Among the patients with liver dysfunction, 80.4% got cured and 19.6% died.

Conclusions:
Hepatic injury is common in severe COVID-19 patients, which may be caused by direct injury to the bile duct cells by a virus or indirectly by a cytokine storm. The liver function should be evaluated in all symptomatic COVID-19 patients. In patients with pre-existing liver diseases, special attention should be paid to monitoring and treatment.
COVID-19 treatment in children
Authors: Panda Prateek Kumar , Sharawat Indar Kumar , Natarajan Vivekanand , Bhakat Rahul , Panda Pragnya , Dawman Lesa 
Published: October 2021

Background:
Exact information about the efficacy of various medications proposed by regulatory bodies in children with COVID-19 is limited due to the lack of controlled trials in the existing literature.

Methods:
Different electronic databases (MEDLINE, EMBASE, Web of Science, COCHRANE CENTRAL, LitCovid, medRxiv, and bioRxiv) were searched for articles describing the management of COVID-19 cases in children with 18 shortlisted medications. Prospective/retrospective studies/case series (with at least 20 cases) reporting COVID-19 in patients aged ≤14 years were searched to collect information regarding clinical details and severity of participants, medications used, and outcome. The pooled estimate of these parameters across studies was performed using a random-effect or fixed-effect meta-analysis depending on the degree of heterogeneity.

Results:
From a total of 5794 records, 97 studies/case series (8243 patients) fulfilled the eligibility criteria and were included in this systematic review. A total of 21% children received at least one medication specifically used for COVID-19. While antivirals were used in 15.3% of children, remedesivir was the most commonly used antiviral drug in 6.2% of included children without many reports of serious adverse effects. There was a more prevalent use of anti-inflammatory medications including corticosteroids (27.8%, P = 0.01). Total 91% of severe cases described in literature in children received some anti-inflammatory medications. Among them, corticosteroids (17%) and Intravenous immune globulin (IVIG) (17.5%) were the most predominant followed by interferon (4.2%), tocilizumab (1.5%), and anakinra (0.8%). The most predominant therapy among multisystem inflammatory syndrome in children (MIS-C) cases were IVIG (81%), followed by aspirin (67%), corticosteroids (64%), inotropes (62%), and anticoagulation (56%, mostly low molecular weight heparin, LMWH). Overall mortality was only 1.3%, but when we analyzed separately including only cases with moderate and severe disease, the mortality rate was 4.6%.

Conclusion:
Among pharmacological modalities, anti-inflammatory agents like corticosteroids and antivirals like remdesivir have the most promising evidence for severe cases of pediatric COVID-19. Intravenous immunoglobulin and other anti-inflammatory/immunomodulatory agents like anakinra, aspirin, and anticoagulants have important therapeutic role in cases with MIS-C. Most of the mild cases recover with conservative treatment only.
Impact of alternative strategies to improve the pool of blood donation by off-hour donation
Authors: Raghuwanshi Babita , Maheshwari Ashish 
Published: October 2021

Background:
The escalating need for blood component due to increasing accidents and surgeries are always challenging for blood banks and hospitals. In this fast and busy world, collecting blood from a healthy and voluntary donor is quite challenging due to time constraints. Many blood donors who wish to donate blood were unable to go to the blood bank because of simultaneous operational timings of the blood bank and office hours of the donors. We dealt with this concern by extending the donation hours and also started collecting blood on the weekends following LAARC (Listen, Acknowledge, Assess, Respond, Confirm) methodology as a pilot project for improving blood donor convenience and satisfaction at the blood bank.

Methodology:
It was a prospective observational pilot study conducted at the government tertiary care institute in the Department of Transfusion Medicine from December 2018 to June 2019. All blood donations were made as per the guidelines laid down by the Drug and Cosmetic Act. The donation timings were divided as office-hour donations (8 am to 5 pm on weekdays) and off-hours donations (5 pm to 8 pm, weekends and holidays).

Results:
In this pilot project, over 7 months out of a total of 1,591 donations, 664 donations (41.73%) were done during the off-hours. The donor experiences were pleasing, and they felt extra cared due to the convenient donation timings.

Conclusions:
Increasing the donation base needs more donor-friendly timings for the pleasant donation experience without hampering their work. More extensive studies should be conducted to include such strategies for increasing voluntary blood donation.
Mothers' role in promoting oral health in children aged 6 months to 1 year
Authors: Kabiri Bahareh , Hidarnia Ali Reza , Alavijeh Mehdi Mirzaei , Motlagh Mohammad Esmaeel 
Published: October 2021

Introduction:
It is essential for parents, and especially mothers, to become aware of the factors that affect oral health-promoting behaviors in children through behavior change theories. This study aimed to determine mothers' role in improving children's oral health based on the health belief model (HBM).

Methods:
The population of this descriptive, analytical, cross-sectional study comprised 240 mothers in Ilam (Iran), selected via stratified random sampling. The data collection instrument was a self-report questionnaire with two sections, including seven demographic and contextual questions, four items for perceived severity, four items for perceived benefits, four items for perceived barriers, three items for cues to action, and five items for perceived self-efficacy. The data were analyzed in SPSS 21 by using descriptive and inferential statistics, including independent samples t-test, linear regression analysis, and Pearson correlation coefficient, at a significance level of 0.05.

Results:
The participants aged 20–47 with a mean of 31.8 ± 5.67 years. The linear regression analysis indicated that the constructs of perceived severity (B = 0.073, P < 0.001), perceived benefits (B = 0.013, P < 0.001), perceived barriers (B = 0.111, P < 0.01), cues to action (B = 0.517, P < 0.001), and perceived self-efficacy (B = 0.292, P < 0.001) explained 55% of the variance of behavioral intention.

Conclusion:
With respect to the effects of perceived barriers and perceived severity on predicting oral health behaviors, effective outcomes can be achieved by emphasizing these two constructs in educational programs based on the HBM.
Basic knowledge among GP trainees regarding HIV pre- and post-exposition-prophylaxis
Authors: Flössner Christian , Avetisyan Meri , Frese Thomas 
Published: October 2021

Introduction:
Preventing human immunodeficiency virus (HIV) infection is central to containing the HIV pandemic. For pre- and post-exposure prophylaxis (PrEP and PEP), drugs approved in Germany are available. Basic information on this should be obtained from physicians in further training to become specialists in General Practice (GP) since they may have to deal with this topic of high relevance for the health of patients at risk and also the physicians' health after a possible exposure in the professional context.

Methodology:
A multiple-choice questionnaire was handed out to doctors in further training in General Practice on seminar days of the Competence Centre for General Practice Saxony-Anhalt for an immediate answer.

Results:
Of the 109 doctors, 73 completed the questionnaire. A general high relevance of the topic HIV was stated by 95%. In contrast, 71% said it was relevant for family doctor activities. The knowledge questions on the prevalence were answered correctly for all questions with less than 40%; 21% stated that they knew the indication prerequisite for a PEP; 49% answered the question about the period of the highest efficacy of PEP correctly. PrEP as a drug option for prophylaxis is known to a part of the respondents, 79% would prescribe PrEP, 69% were in favour of a health insurance benefit.

Discussion:
The results show that the necessary basic knowledge about HIV is partly available. Basic knowledge on structured action in the fields of HIV testing, PEP and PrEP should be taught in a manner appropriate to the relevance of the topic in the context of the German general practice setting. Even a basic knowledge about PEP may help to ensure that the general practice teams receive proper measures after a possible exposition.
Food consumption patterns of the urban adult population in the field practice area of a teaching hospital in Kolkata, using food frequency questionnaire
Authors: Sarkar Paramita , Mitra Sayeli , Basu Rivu 
Published: October 2021

Background:
Nutrition transition has replaced homemade foods with processed items that increased the prevalence of noncommunicable disease in adult population. But we know little about the food intake pattern of adults specially in urban sector.

Aims:
The study aimed at describing the food-consumption patterns in a sample of adults residing in urban area.

Settings and Design:
An observational cross-sectional study was done from April to June, 2019 at urban field practice area of a teaching hospital of Kolkata.

Methods and Material:
A prevalidated, pretested, 51-item, food-frequency questionnaire was applied to assess the food-consumption pattern of 110 participants.

Results:
Adults reported poor dietary intakes; more than half reported no consumption of green-leafy vegetables (GLV) (66.4%), other vegetables (52.8%), and fruits (63.6%). Whereas 72.7% reported consumption of three or more servings of energy-dense foods and 90.9% reported consumption of three or more servings of energy-dense beverages on previous day. Mean intake of food varied from 0.34 (SD = 0.47) for GLV to 8.19 (SD = 2.39) for cereals. Females consumed more servings of GLV, other vegetables, roots-tubers, and fruits than males. Fruit consumption was low in all age groups. Higher socioeconomic class people strikingly consumed no GLV.

Conclusions:
Study participants reported consumption of more energy-dense snacks, beverages than healthy food like GLV, fruits. Study findings highlight to design strategies to promote nutrition education and practical application of healthy food habits in target population group.
Managing comorbidities in Covid-19 patients
Authors: Sharma Aman , Jain Manish , Yadav Rahul , Rathi Priyanka 
Published: October 2021

Introduction:
In the prevailing COVID-19 pandemic, the Indian healthcare system has worked hard towards restricting the adverse outcomes to the least possible figures. The present study aims to share the experience of a COVID-dedicated tertiary care government hospital in Northern India of managing COVID-19 patients with comorbidities.

Methodology:
A retrospective, observational study was conducted in a COVID-dedicated tertiary health care government hospital in Northern India. Details on sociodemographic data, hospital admission data, and drug utilization pattern of all laboratory-confirmed COVID-19 patients of all age groups, either gender, having comorbidity (s), and admitted between April and September, 2020 were noted and evaluated.

Results:
Among the total study participants (N = 406), 2868 drugs were prescribed. Out of these, 2336 were used for the management of symptoms of COVID-19 and 532 were used for the management of coexistent comorbidity (s). For COVID-19 symptoms, the most commonly prescribed class of drugs were antimicrobials (853, 36.52%), followed by nonsteroidal antiinflammatory drugs (374, 16.01%), proton pump inhibitors (299, 12.80%), antihistamines (232, 9.93%), immunosuppressant drugs (103, 4.41%), and others. For comorbidities most commonly prescribed were antihypertensive (310, 58.60%) drugs, followed by antidiabetic drugs (166, 31.38%), bronchodilators (34, 6.43%), thyroid hormones (11, 2.08%), immunosuppressant drugs (7, 1.32%).

Conclusion:
The most frequently prescribed antihypertensives were calcium channel blockers (CCBs) and least prescribed was beta blocker+CCB. Among the antidiabetic drugs, most frequently prescribed was insulin and least prescribed was DPP-4 inhibitors and Biguanide+DPP-4 inhibitor both.