bluuebunny/crossref_metadata_2025_split huggingface dataset:
Undiagnosed Hypertension and Diabetes
Authors: Oparah Sidney Kelechi , Ukweh Ofonime Nkechinyere , Ukweh Ikechukwu Henry , Iya-Benson Joy N 
Published: February 2021

Background:
Hypertension and diabetes rank high among cardiovascular risk factors, and in Africa, many affected persons are undiagnosed. Urban market traders are constrained from regular clinic visits by the fear of revenue loss occasioned by their absence from the stores, contributing to the reportedly high rates of undiagnosed and poorly treated cardiovascular conditions. This study determined the rate of undiagnosed hypertension and diabetes among traders in an urban market in Calabar, Nigeria.

Methods:
In this cross-sectional study, we used an interviewer-administered questionnaire to collect data from 105 traders at Marian market Calabar, including information on demographic characteristics and self-reported statuses regarding hypertension and diabetes. Subsequently, blood pressure and random blood sugar values were measured.

Results:
Forty-three (41.0%) of the respondents correctly reported their statuses regarding hypertension and 93.3% of the respondents correctly reported their statuses regarding diabetes. 62 (59%) and 7 (6.7%) of them had hitherto undiagnosed hypertension and diabetes, respectively. Only two (9.5%) out of those with a self-reported history of hypertension had normal blood pressure values. There was no agreement between the self-reported and actual profiles of hypertension among the respondents (kappa = 0.000, P = 0.008), and a weak level of agreement between the self-reported and actual profiles of diabetes among the respondents (kappa = 0.559, P < 0.001). Educational level was the identified predictor of correct self-report of status regarding hypertension (P = 0.031);

Conclusion:
There was a high rate of undiagnosed hypertension and, to a lesser extent, diabetes among this set of urban market traders.
Assessment of Zinc Level and its Relationship with Some Hematological Parameters among Patients with Sickle Cell Anemia in Abakaliki, Nigeria
Authors: Ugwu Ngozi Immaculata , Okike Clifford , Ugwu Collins N. , Ezeonu Chinonyelum T , Iyare Festus E. , Alo Chihurumnanya 
Published: February 2021

Background:
Sickle cell anemia (SCA) is an inherited hemoglobin (Hb) disorder with susceptibility for oxidative damage due to chronic redox imbalance in red blood cells (RBCs) which often results in hemolysis, endothelial injury, recurrent vaso-occlusive episodes, and derangement in hematological parameters. Zinc is an antioxidant which helps to reduce oxidative damage. This study aimed to assess the serum level of zinc and its relationship with some hematological parameters in patients with SCA (HbSS).

Materials and Methods:
This was a cross-sectional comparative study which involved HbSS patients in steady state with sex- and age-matched HbAA control. Assay of Hb phenotype, serum zinc level, and some haematological parameters were done. Ethical approval was gotten from the institutional review board, and each participant gave informed written consent before recruitment into the study. Analysis of all data obtained was done using SPSS software, version 20.

Results:
Thirty adult patients with SCA and thirty sex- and age-matched controls with a mean age of 26.7 ± 7.6 years and 27.7± 5.3, respectively, were studied. There was a significant decrease in serum zinc level among patients with HbSS compared to those with HbAA (P = 0.038). Similarly, patients with HbSS had significantly lower Hb level, packed cell volume, and RBC count compared to HbAA control (P < 0.05). On the contrary, patients with HbSS had significantly higher white cell count and platelet count compared to HbAA individuals (P < 0.05). Correlation between serum zinc level and blood counts showed weak positive relationship between zinc level and Hb level (r = 0.04, P = 0.8) and weak negative relationship between serum zinc level and platelet count (r = −0.3, P = 0.1), as well as zinc and white blood cell (WBC) count (r = −0.2, P = 0.4).

Conclusion:
There was a significantly low level of zinc among patients with HbSS compared with HbAA controls. Patients with HbSS had zinc levels that weakly correlated with Hb level positively but weakly negatively correlated with platelet and WBC counts. Further studies are required on a wider scale to assess whether zinc supplementation may improve blood counts in patients with SCA.
Telemedicine for Children with Sickle cell Anemia in a Resource-Poor Setting During COVID-19 Pandemic
Authors: Nlemadim Anthony Chibueze , Okoi-Obuli Jacintha Banku , Odey Friday Akwagiobe , Meremikwu Martin Madu 
Published: February 2021

Background:
The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic has continued to disrupt medical care among patients with sickle cell anemia (SCA). The city lockdowns and restrictions to minimize virus transmission in countries have created gaps in the optimal management of children with SCA.

Aim:
The aim of this study was to access the clinical experience in the use of mobile health telemedicine for the care of children with SCA.

Methods:
At the start of national lockdown, text messages were sent to parents of children with SCA who are attending a tertiary hospital in Nigeria. The message included advice to call consultants in the pediatric hemato-oncology unit whenever their wards were sick or due for a routine clinic visit. Information obtained include date of call or text message, complaints, intervention prescribed, and feedback from the parents.

Results:
There were 115 calls and 43 texts from the parents from April through July 2020. The proportion of calls increased from 16.5% to 33.9%, while texts increased from 23.3% to 30.2% over the months. Responses were significant (P = 0.047). Respiratory symptoms (40%) were the most common complaints. The most frequent interventions were counseling (59%) and drug prescriptions (31%) with the resolution of most symptoms by day 7 (P < 0.001). Parents (60.8%) preferred phone interactions across the months (P < 0.05). No confirmed case of SARS-CoV-2 was recorded.

Conclusion:
Mobile health telemedicine is a beneficial tool in the maintenance of care and possibly prevention of SARS-CoV-2 infection among children with SCA in a resource-limited region. Efforts should be made by stakeholders to institute and promulgate telemedicine during this pandemic.
Burden of Care among Caregivers of Patients with Bipolar Affective Disorder at the Federal Neuropsychiatric Hospital, Calabar
Authors: Okafor Chidi John , Emedoh Thomas 
Published: February 2021

Background:
The advent of community-based care and de-institutionalization of persons with mental disorders have led to a progressive shift of care from formal health-care systems to informal care providers such as the family. This shift of care, from hospitals to the families, has led to a significant level of the burden on the family caregiver. This study aimed to identify factors which are associated with burden of care among caregivers of patients with bipolar affective disorder (BAD) seen at the Federal Psychiatric Hospital, Calabar.

Materials and Methods:
A simple random sampling technique of “yes or no” balloting was utilized to select 105 caregivers of bipolar patients seen at the outpatient clinic of the hospital. The selected caregivers (those who picked “yes”) were recruited along with their respective patients after obtaining their consent. They were assessed using a set of five questionnaires, of which three (Patient Health Questionnaire-9 [PHQ-9], Young Mania Rating Scale [YMRS] and Brief Psychiatric Rating Scale [BPRS]) were administered by the researchers on the patients whereas the remaining two (sociodemographic questionnaire and Family Burden Interview Schedule) were self-completed by the caregivers.

Results:
One hundred out of the 105 caregivers who were recruited completed the study procedure and returned properly filled questionnaires. The rates of objective and subjective burden on the caregivers were 79% and 74%, respectively. While the objective burden was associated with the patient's educational attainment and his/her scores on the YMRS and BPRS, the subjective burden was associated with the caregiver's monthly income and marital status, the patient's gender, number of suicide attempts, and scores on PHQ-9, YMRS, and BPRS. Of all the variables, the patients' scores on YMRS (P = 0.025) and PHQ-9 (P = 0.011) were the significant predictors of objective and subjective burden, respectively.

Conclusion:
This study identified the extent and factors associated with burden of care on caregivers of patients with BAD. Awareness of those factors might guide clinicians in instituting treatment strategies toward reducing the burden on caregivers.
Sonographic Evaluation of Maternal Splenic Dimensions in Normal Pregnancy
Authors: Udoh Benjamin Effiong , Ukpong Ekaete Vincent , Paulinus Samson Omini , Okokon Comfort , Erim Akwa Egom 
Published: February 2021

Aim:
We aimed to establish sonographically the range of splenic dimensions in healthy pregnancy and to investigate their relationships with gestational age, maternal age body mass index (BMI), and parity of the mother.

Materials and Methods:
A prospective cross-sectional descriptive study of splenic dimensions was performed on 339 healthy, normal pregnant women aged 23–42 years. The spleen was measured with women in supine position on the couch. Scanning of the spleen was done with the women in deep inspiration so that the spleen descends. A Sonoline Omnia ultrasound imaging system with serial number 526,206,526 and model number Cc-13 H71 fitted with a 3.5 MHz ultrasound probe was used in scanning the spleen along the lower left costal margin from the 9th to the 11th rib at the anterior, mid, and posterior axillary lines with the woman in the right lateral decubitus position using the oblique intercostal approach. Data were analyzed using SPSS software version 20.0 (SPSS Inc., Chicago, IL, USA). The relationship between splenic dimensions and gestational age, maternal age, and BMI was assessed using Pearson's correlation coefficient. P ≤ 0.05 was considered statistically significant.

Results:
The result of the study shows that the mean length, width, thickness, and volume of the spleen of the mothers were 11.9 ± 0.7 cm, 5.7 ± 0.7, 9.5 ± 0.8 cm, and 381.6 ± 111.4 cm3, respectively. Gestational age was significantly correlated positively with splenic length and splenic volume of the mother (r = 0.37 and 0.31, P = 0.000).

Conclusion:
Splenic dimensions are higher in pregnant women compared to values reported for nonpregnant women and increases with gestational age and BMI of the mother.
Sociodemographic and clinical profile of drug treatment seekers attending the State Psychiatric Hospital and Drug De-addiction Center at Agartala, Tripura
Authors: Majumder Udayan , Das Joysree , Barman Swapan Chandra , Ghosh Jyotirmoy , Bhowmic Bimal Krishna 
Published: February 2021

Background:
Substance use disorders have become a widespread public health problem, especially in the northeastern states, and limited studies have been undertaken to reflect the picture of the same.

Aims:
The aim of the study was to study the sociodemographic and clinical profile of drug treatment seekers attending a State Psychiatric Hospital and De-addiction Center of Northeastern India.

Materials and Methods:
It was a cross-sectional hospital-based study conducted from October 2018 to August 2019. Two hundred and ten consecutive treatment-seeking patients, fulfilling inclusion and exclusion criteria and diagnosed with the International Classification of Diseases version 10 for substance dependence, were included in the study.

Results:
Most common abused drug was opioids (42.9%), followed by alcohol (14.3%), whereas 29.0% were people who inject drugs. Peer pressure in 55.2% and curiosity in 32.9% were reported to be the most common causes for initiating substances. Hepatitis C was the most common (52.4%) comorbidity related to intravenous drug users.

Conclusions:
Results of the current study will definitely encourage further large-scale community-level studies to assess the prevalence of substance abuse in the state as well as in drug policymaking.
Parenting skills of patients with chronic schizophrenia
Authors: Rabha Anjumoni , Padhy Susanta Kumar , Grover Sandeep 
Published: February 2021

Aim of the Study:
This study aims to evaluate the parenting skills of patients with schizophrenia as perceived by themselves and their children and compare the same with a matched healthy control group of parents and their children.

Materials and Methods:
Fifty-one patients with schizophrenia and their 51 children were assessed on the Alabama Parenting Scale. A healthy control group of 51 parents and their children were also assessed for parenting.

Results:
The mean age of parents with schizophrenia was 45.23 years. Compared to the parents in the healthy control group, patients with schizophrenia reported deficits in the domains of positive involvement, positive parenting; more often report poor monitoring/supervision, and inconsistent discipline. When the children of patients with schizophrenia and children of healthy parents were compared, children of healthy control parents reported higher positive involvement, positive parenting; and lower corporal punishment and inconsistent discipline. Except for few associations, parenting was not affected by demographic and clinical profile of the patients with schizophrenia.

Conclusion:
The present study suggests that patients with schizophrenia have deficits in parenting and there is a need to improve the parenting skills of the patients with schizophrenia.
Addiction-like behavior associated with social media usage in undergraduate students of a government medical college in Delhi, India
Authors: Basu Saurav , Sharma Ragini , Sharma Pragya , Sharma Nandini 
Published: February 2021

Background:
Excessive use of social media is increasingly being recognized as a source of technological addiction in young people globally.

Objective:
The aim of this study is to assess social media addiction in medical students using a self-designed questionnaire.

Materials and Methods:
We collected data from undergraduate medical students (MBBS) in Delhi, India using a self-administered 20-item social media addiction questionnaire (SMAQ) to measure addiction-like behavior, and the Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality.

Results:
We enrolled 264 (62.3%) male and 160 (37.7%) female participants of mean (standard deviation) age 19.83 (1.6) years. The Cronbach's alpha of the SMAQ was 0.879. A principal component analysis revealed a 4-component SMAQ structure based on eigenvalue cutoff (>1), loading score >0.3, and inspection of the Scree-plot that explained 54.7% of the total variance. We observed strong loadings of impaired control items on Component 1, decreased alternate pleasure items on Component 2, intense desire items on Component 3, and harmful use items on Component 4. The mean SMAQ score was significantly higher in the students reporting poor sleep quality and older students.

Conclusion:
The SMAQ has acceptable psychometric properties, with higher scores associated with sleep deprivation. A majority of students were unable to reduce their time spent on social media despite wanting to do so, signifying the presence of tolerance and impaired control.
Adverse effects and short-term developmental outcomes of infants exposed to atypical antipsychotics during breastfeeding
Authors: Sinha Santosh Kumar , Kishore M. Thomas , Thippeswamy Harish , Kommu John Vijay Sagar , Chandra Prabha S. 
Published: February 2021

Background:
Postpartum period in women is vulnerable to the occurrence and exacerbation of psychiatric disorders. Mothers with postpartum psychosis or bipolar disorder need treatment with psychotropic medications, especially atypical antipsychotics. However, many mothers and families will have reservations about the use of psychotropics during the perinatal period, particularly during breastfeeding because of its presumed side effects and adverse developmental outcomes of the child. Since there are limited data in this area, the present study aimed to examine the adverse effects, if any, and the short-term developmental outcome of infants exposed to atypical antipsychotics during breastfeeding.

Methods:
The study involved infants of postpartum women (n = 28) who were admitted in the mother and baby inpatient psychiatry unit of a tertiary care center in India. The medication side effects were checked every alternate day for 1–2 weeks using a checklist based on common side effects that infants may experience due to lactation exposure of atypical antipsychotics. Developmental assessments of the infants were done using the Developmental Assessment Scales for Indian Infants and through anthropometric measurements such as weight, length, head circumference, and chest circumference in follow-up when they came as an outpatient after 1–3 month interval.

Results:
The occurrence of adverse side effects was quite low (17.85%). The main side effects directly attributable to atypical antipsychotics were constipation and sedation. Of the 17 infants who attended follow-up, 52.9% (n = 9) showed some form of developmental delay at the time of the first follow-up. However, low birth weight, higher maternal age (>35 years), and exposure to medications (quetiapine and phenytoin) during pregnancy may be confounding risk factors.

Conclusions:
The acute adverse effects of atypical antipsychotics such as sedation and constipation in the infant through breast milk were seen in less than a fourth of the sample. Developmental delay was noted in a proportion of infants; however, this may be due to other risk factors.
Memory changes following adjuvant temporo-parietal repetitive transcranial magnetic stimulation in schizophrenia
Authors: Gupta Preeti , Sahu Anamika , Prasad Surjit , Sinha Vinod Kumar , Bakhla Ajay Kumar 
Published: February 2021

Objective:
The use of repetitive transcranial magnetic stimulation (rTMS) in schizophrenia has shown improvement as well as deficits in memory. Though most studies had focused on dorsolateral prefrontal cortex only, but impact of rTMS on cognitive functions remain inconclusive. The need of the study is to assess the impact of rTMS on memory in schizophrenia.

Materials and Methods:
Forty right-handed male patients with schizophrenia were included by purposive sampling and rated on Positive and Negative Syndrome Scale (PANSS) before starting the rTMS treatment with the experimental group. Low frequency 1 Hz rTMS including 1200 stimulations were given over temporo-parietal cortex for 20 min as add on to medications. At the end of 10 session treatment (5 days a week for 2 weeks), the patients were re-evaluated.

Results:
A total of 39 patients (20 for experimental group and 19 for control group) with mean age of 29.70 ± 9.05 and 31.26 ± 7.78 years, respectively, shows significant difference to pre- and post-treatment mean PANSS score in positive, negative and general psychopathology domains. The pre- and post-treatment mean Postgraduate Institute Memory Scale Scores with multivariate repeated measures analysis of variance revealed significant improvements in all memory domains (P < 0.01) except remote memory in both experimental and control groups.

Conclusion:
RTMS in combination with antipsychotics has shown improvement in psychopathology in patients of schizophrenia without any deterioration of memory.
Qualitative research methods in psychiatry in India
Authors: Mahapatra Pranab , Sahoo Krushna Chandra , Jitendriya Pritam , Samal Mousumi , Pati Sanghamitra 
Published: February 2021

Background:
Qualitative research methods (QRMs) bear a critical role in psychiatry as they explore the phenomenology of psychiatric illness and its sociocultural dimensions. However, there is limited evidence regarding its use in psychiatric research in India.

Aim:
This study, under the aegis of mapping qualitative health research in India initiative, attempted to landscape the use of QRMs in psychiatry and elicited expert opinion on its potential, perceived quality, and scope for improvement.

Materials and Methods:
We reviewed studies using qualitative methodology published in the Indian Journal of Psychiatry (IJP) and the abstracts presented at the Annual Conference of the Indian Psychiatric Society (ANCIPS) between 2010 and 2019. Titles and abstracts were screened and shortlisted; full-text articles were checked to identify the relevant ones. In addition, ten experts comprising psychiatry journal reviewers, editors, and conference scientific committee members were interviewed to elicit their views and suggestions.

Results:
Out of 356 papers published in IJP between 2010 and 2019, only 12 papers used QRMs: five qualitative and seven mixed methods. Out of 2297 abstracts published between 2010 and 2019 in ANCIPS, only 28 had used QRMs, consisting of 20 qualitative and eight mixed methods. The findings reveal that qualitative research is still an understudied domain in Indian psychiatry with a substantial need for rigor and quality.

Conclusions:
To catalyze the use of qualitative research in Indian psychiatry, continuing medical education programs through workshops or webinar mode need to be imparted. These trainings should aim at building skills on qualitative study design, data collection, analysis, and writing.
Development and validation of Vellore Inventory of Life Skills among people with severe mental illness
Authors: Chandran Meghana C. , Saji Febin , Samuel Reema , Jacob K. S. 
Published: February 2021

Background and Aim:
Rehabilitation for people with severe mental illness is incomplete without life skills assessment and intervention. The aim of the study was develop a culturally specific performance-based measure assessing life skills of patients with severe mental illness.

Materials and Methods:
The items for the Vellore Inventory of Life Skills (VILS) were drawn after consultation with a reference group and from existing standardized scales. The items were categorized into two sections with six components each, which was further hierarchically arranged into activities at either basic, intermediate, or advanced level. One hundred consecutive clients between 18 and 60 years of age who provided written informed consent were assessed on the Comprehensive Evaluation of Basic Living Skills (CEBLS) and the VILS to evaluate convergent validity and inter-rater reliability. The General Health Questionnaire (GHQ-12) was used to evaluate divergent validity. The assessments were repeated after a week to evaluate test–retest reliability.

Results:
The scale had good inter-rater reliability 0.938 (95% confidence interval [CI] 0.887–0.967) and test–retest reliability 0.907 (95% CI 0.865–0.937). The correlation between total score of VILS and CEBLS (Pearson's correlation coefficient [PCC] = 0.611; P = 0.001) suggested moderate convergent validity. The correlation between total score of VILS and GHQ-12 (PCC = −0.260; P = 0.105) implied good divergent validity.

Conclusion:
Preliminary data suggest that the VILS is clinically useful for the Indian population.