bluuebunny/crossref_metadata_2025_split huggingface dataset:
Communication, Counseling and Compassionate Care
Authors: Raman Praveena 
Published: January 2021

Background:
Globally, the sixth most common malignancy is oral cancer, which is predominantly due to consumption of potent, proven carcinogens which includes smoking and smokeless form of tobacco and areca nut. Habits associated oral malignancies are mostly preceded by clinically asymptomatic oral lesions collectively referred under the umbrella term as oral potentially malignant disorders (OPMDs). There is a delayed presentation of oral pre cancer and oral cancer in India, as approximately 50% of patients are diagnosed at last stage since the asymptomatic pre cancer lesions are missed by oral physicians/dentists either due to lack of timely communication and habit counseling, lack of knowledge, or inappropriate attitude, putting all in a nut shell --- sheer lack of empathy and commitment towards patient care and society. Early diagnosis greatly increases patient's chances of survival. Patient awareness is much spoken in literature; however, the flip side of the coin lies within the attitude of the primary care physician. They play a pivotal role in effective communication and timely counseling of patients with OPMDs and should prevent malignant transformation to improve quality of life of patients. Poor compliance to attend for oral cancer screening links to the attitude and ignorance of the primary care physician. Palliative care concepts should be integrated to dentistry especially to oral medicine speciality.

Clinical Significance:
The author believes that the three most important, least explored and challenging palliative care approaches namely, “Communication,” “Counseling,” and “Compassionate care,” should be effectively practiced by a primary care physician, to improve their level of commitment to society and attitude towards patient care which can help in early diagnosis of OPMDs and decreased incidence of oral cancer, thus improving quality of life of patients.
Family physicians/GP and Internist opinions, familiarity and practice behaviour regarding clinical practice guidelines (CPGs) of common medical conditions in Nigeria
Authors: Desalu Olufemi O. , Adeoti Adekunle O. , Makusidi Muhammad A. , Fadare Joseph O. , Aremu Gbolahan O. , Amao Emmanuel A. , Opadijo Oladimeji G. 
Published: January 2021

Background:
Few studies exist on physicians' opinions, attitudes, familiarity and practice behaviour regarding clinical practice guidelines in sub-Saharan Africa.

Objectives:
To determine the opinions, familiarity, and practice behaviour regarding clinical practice guidelines (CPGs) and factors associated with their use among internists and family physicians/GP in Nigeria.

Methods:
A semi-structured questionnaire regarding guidelines of five common medical conditions: hypertension, diabetes mellitus, tuberculosis, asthma and hepatitis B encountered in everyday medical practice were self-administered by 183 doctors across the country.

Results:
Over 90% of respondents believed that guidelines were evidence-based, improved management outcomes, and quality of care, nevertheless, 57.4% were against using them in litigations against doctors. The majority (>70%) of the respondents were familiar with the guidelines except that of hepatitis B. Overall, guidelines were used regularly by 45.9%, used in part by 23.5% and 30.6% never used it. Approximately 50% of physicians had immediate accessibility to them at the point of care. The proportions of respondents reporting a change in practice behaviour ranged from 37.7-57.9% depending on the guideline. The factors associated with guideline-related behaviour change were familiarity with its contents, postgraduate educational training, increased helpfulness score, and practiced >5 years.

Conclusions:
The present study shows that most physicians have favourable opinions and are familiar with these guidelines, however, the proportions reporting changes in their patient management because of the guidelines are not satisfactory. It is important to ensure guidelines accessibility and promotes factors that encourage their implementation in medical practice.
Prevalence and risk factors of asthma among school going children in urban area of North India
Authors: Patra Pratap Kumar , Bhattarai Dharmagat , Prasad Arun , Jain Hansmukh , Ranjan Suprabhat , Ranjan Alok 
Published: January 2021

Introduction:
Bronchial asthma is a chronic respiratory illness of global importance. Recent reports depict the increasing prevalence of this disorder in urban areas.

Methods:
An observational study was designed with a sample size of 1163 children from grade 4 to grade 12, involving 8 randomly selected schools in 2015-2016. Modified International Study of Asthma and Allergy in Childhood [ISAAC] questionnaire in local language [Hindi version] was used for data collection. The data of assessed risk factors were collected and analysed.

Results:
Prevalence of asthma in the studied population was 2.8%. Multivariate analysis revealed a significant association of risk of asthma with use of firewood kitchener for cooking, keeping pet animals at home, high body mass index (BMI), absence of ventilator measures like chimney and aero-vent. Logistic regression analysis revealed use of firewood kitchener for cooking (odds ratio (OR) = 4.9, 95% confidence interval (CI) = 2.93-11.3), absence of smoke outlet (OR 2.8, 95% CI 1.3-5.8) and keeping pet animals (OR 3.2, CI 1.6-6.8) at home were observed to be significantly associated with asthma.

Conclusion:
Prevalence of asthma in our cohort was significantly lesser than that of developed world. Household smoke was the most conspicuous risk factor contributory to childhood asthma in this part of world.
Clinicopathological features of hemophilia in a tertiary care centre of India
Authors: Pawan Pandey K. , Mahima Yadav , Vijai Tilak , Manjula Lader 
Published: January 2021

Context:
Inherited bleeding disorders are common in India and hemophila and von Willebrand diseases are the most common among them. These patients can present in any department including paediatrics, medicine, orthopaedics and even gynaecology so knowledge about hemophilias and facilities for specialized tests for diagnosis are required. Few centres of north-eastern part of India perform these tests so hemophilias remain an underdiagnosed and underreported disease.

Aims:
The objective of this study was to estimate the prevalence of hemophilia in patients referred to this tertiary care centre and study the clinicopathological profile of these patients.

Settings and Design:
Prospective study.

Methods and Material:
Patients referred with suspicion of bleeding disorders in a time period of 4 years were evaluated. Complete clinical details, family history was retrieved and tests like complete blood counts, bleeding time, prothrombin time, activated partial thromboplastin time and factor assays were performed.

Results:
A total of 1126 patients with suspected bleeding disorder were tested and 237 were diagnosed of inherited bleeding disorders. Hemophilia A (HA) was diagnosed in 151 patients (63.7%), Hemophilia B (HB) in 31 (13%). Mean age was 10 years in HA and 11 years in HB patients. Clinical features of hemophilia varied according to Factor VIII levels. Coagulation type of bleeding such as hemarthrosis and hematoma were much more frequent than mucosal type bleeding.

Conclusions:
The present study is one of the very few studies from the north-eastern part of India estimating the prevalence and clinicopathological features of hemophilia, highlighting the need of specialized diagnostic facilities in this part of India.
Effect of head down tilt on heart rate variability
Authors: Malhotra Varun , Thakare Avinash E. , Hulke Sandip M. , Wakode Santosh L. , Parashar Rachna , Ravi Naveen 
Published: January 2021

Context:
Sirshasan is supposed to increase blood flow to the brain and considered to be beneficial for intellectual function, however mastering these techniques may be difficult.

Aims:
To see the effect of headstand using a tilt table on heart rate variability (HRV).

Settings and Design:
A cross-sectional study that was done on 26 healthy volunteers.

Methods and Material:
HRV was assessed in the supine position and 30° head tilt position for 5 min. HRV recording was done on the power lab (AD Instruments P Ltd, Castle Hill Australia). The tilt table used was Medica Podium, New Delhi, HLT-200.

Statistical analysis used:
Paired t-test.

Results:
All the HRV parameters showed non-significant change except low-frequency parameters which showed significant change during head tilt.

Conclusions:
Headstand to a 30° using tilt table cause a decrease in the autonomic activity which is mainly because of decrease in sympathetic activity.
Assessment of magnitude and predictors of postpartum depression among mothers attending immunization clinics in Bihar, India
Authors: Singh Geetika , Ranjan Alok , Agarwal Neeraj , Kumar Pragya 
Published: January 2021

Background:
Postpartum depression (PPD) is characterized by a protracted phase of emotional turmoil which ensues at the time of major life change and increased responsibilities in the upkeep of a newborn child. In fact, it represents a considerable public health problem and has been found to have multiple etiologies including sociodemographic, economical, psychosocial, obstetrical, and medical risk factors. Hence, this study was conducted with the objective of estimating the proportion of PPD among mothers attending the immunization clinics and its association with various sociodemographic and other risk factors.

Methods:
All eligible mothers (up to 3 months after delivery) attending the immunization clinics at the health centers were interviewed using a pre-designed questionnaire and relevant information on sociodemographic, obstetrical, and other psychosocial factors was obtained. PPD was assessed using the Edinburgh Postnatal Depression Scale (EPDS) where the cutoff score of ≥ 13 was considered as being at risk for PPD.

Results:
A total of 400 mothers were included. The overall proportion of PPD came out to be 15.0% (95% CI 11.83–18.83%) while the median EPDS score was 6.5. Logistic regression analysis revealed that Muslim religion, preterm or low birth weight baby, current medical illness, family pressure to have male child, lack of support from family networks, and domestic violence remained independent predictors of PPD.

Conclusion:
This study identified certain important risk factors for PPD. Thus, the sensitization of the primary healthcare providers and early screening and counseling of the mothers and their families is essential for reduction of associated morbidities and unfavorable outcomes.
Is data mining approach a best fit formula for estimation of low-density lipoprotein cholesterol?
Authors: Sarangi Rajlaxmi , Bahinipati Jyotirmayee , Pathak Mona , Mahapatra Srikrushna 
Published: January 2021

Background:
With the change in the National Cholesterol Education Program ATP III guidelines, the risk of developing atherosclerosis has been now focused on total cholesterol and low-density lipoprotein (LDL) cholesterol levels. Different treatment modalities are now targeted at lowering LDL cholesterol values. Hence greater emphasis is now led on the accurate and precise measurement of LDL cholesterol. Beta-quantification, though, is the best reference method for LDL cholesterol estimation, it has the disadvantage of being inconvenient in our routine practice. The new generation direct homogenous assay is now the method of choice. But being more expensive, various calculated methods have now been developed. This study is an attempt to compare different calculated formula with direct cholesterol assessment and to find out the best one.

Materials and Methods:
We compared LDL cholesterol measured by direct homogenous assay with the data mining approach (DM) and another calculated formula [Friedewald's Formula (FF) and Anandaraja Formula (AF)] in 266 samples with age greater than 18 years. Enrolled participants were divided into seven groups based upon their TG levels. Mean, percentage difference, and the correlation coefficient was assessed between calculated and direct LDL. Bland–Altman analysis was done to see the agreement between calculated vs direct LDL. All formulas were assessed among various TG levels with direct LDL by the Wilcoxon sign rank test.

Result:
1% level of significance was found between calculated and direct LDL with TG < 600 mg/dl. Mean and the percentage difference between direct and calculated LDL was lowest with the DM approach. Bland–Altman plot shows the best agreement of the DM approach with direct LDL.

Conclusion:
This study indicates that the DM approach is closer to direct LDL compared to FF & AF.
Unique collaboration of modern medicine and traditional faith-healing for the treatment of mental illness
Authors: Saha Somen , Chauhan Ajay , Hamlai Milesh , Saiyad Vikar , Makwana Siddharth , Shah Komal , Pandya Apurvakumar 
Published: January 2021

Background and Aims:
Modern psychiatry brings tremendous value to the treatment of mental illness, however, at times is inadequate in providing holistic care within a patient's broader cultural framework. Traditional healing and modern psychiatry together offer a comprehensive, patient-centred approach to treatment, which encompass a patient's spiritual and religious beliefs. In this context, “Dava-Dua” intervention—combination of psychiatric medicine and faith healing—is implemented by the Government of Gujarat at Mira Data Dargah in Mehsana District. The study assesses intervention outcomes, understand implementation challenges and patients' perspectives on the treatment.

Methods:
Using a multi-method research approach, case records from July 2008 to March 2018 were retrieved for secondary analysis of patients' profile and outcomes; 26 patients from three groups: Dava, Dua and Dava-Dua; and 6 mental health service providers were interviewed to assess perspectives of patients and service providers on mental health, implementation barriers and facilitators.

Results:
Despite some implementation challenges, the findings indicate that collaboration of modern psychiatry medicine and faith-based treatment practices certainly benefit patients with otherwise limited access to mental health care thereby protects human rights of patients.

Conclusion:
Dava-Dua model compliments existing primary healthcare services. It provides an access to modern medicine without compromising patients' religious and spiritual practices. It has the potential to scale-up and replicate where faith-healing is the prime treatment modality to cure mental illness provided implementation challenges are proactively addressed.
On two conjectures about the sum of element orders
Authors: Baniasad Azad Morteza , Khosravi Behrooz 
Published: January 2021

AbstractLet G be a finite group and
$\psi (G) = \sum _{g \in G} o(g)$
, where
$o(g)$
denotes the order of
$g \in G$
. There are many results on the influence of this function on the structure of a finite group G.In this paper, as the main result, we answer a conjecture of Tărnăuceanu. In fact, we prove that if G is a group of order n and
$\psi (G)>31\psi (C_n)/77$
, where
$C_n$
is the cyclic group of order n, then G is supersolvable. Also, we prove that if G is not a supersolvable group of order n and
$\psi (G) = 31\psi (C_n)/77$
, then
$G\cong A_4 \times C_m$
, where
$(m, 6)=1$
.Finally, Herzog et al. in (2018, J. Algebra, 511, 215–226) posed the following conjecture: If
$H\leq G$
, then
$\psi (G) \unicode[stix]{x02A7D} \psi (H) |G:H|^2$
. By an example, we show that this conjecture is not satisfied in general.
Evaluating the Efficacy of the Supertowel™ as a Handwashing Product: A Simulation of Real-World Use Conditions
Authors: Torondel Belen , Khan Rummana , Larsen Torben Holm , White Sian 
Published: January 2021

ABSTRACTThe Supertowel is a fabric treated with a permanent antimicrobial bonding and has been designed as a soap alternative in emergency situations. The Supertowel has been shown to be as efficacious as handwashing with soap and water when tested under controlled laboratory conditions. It has also been shown to be a practical, acceptable, and desirable product among crisis-affected populations. The aim of this study was to test whether the Supertowel remains as efficacious when used under conditions which mimic real-world hand cleaning in challenging settings. Two rounds of laboratory tests, with 16 volunteers in each, were conducted to test the efficacy of the Supertowel when used for a shorter duration, when less wet, when used with contaminated water, when visibly dirty, and when dry. Volunteers pre-contaminated their hands with nonpathogenic Escherichia coli. Comparisons were made between hand cleaning with the Supertowel and the reference condition (normally handwashing with soap), using a crossover design. The Supertowel was marginally less efficacious than handwashing with soap when used for 15 seconds (P = 0.04) but as efficacious at 30 and 60 seconds durations. All the other Supertowel conditions were as efficient as their reference comparisons meaning that the Supertowel can effectively remove pathogens from hands when it is wet, damp, or completely dry, when it is used with contaminated water, when visibly dirty with mud and/or oil.
Seroprevalence of and Risk Factors Associated with Exposure to Brucella Spp. in Dairy Cattle in Three Different Agroecological Zones in Rwanda
Authors: Kiiza David , Biryomumaisho Savino , Robertson Ian D. , Hernandez Jorge A. 
Published: January 2021

ABSTRACTLivestock production is a key element for poverty alleviation, food security, and economic growth in Rwanda. In 2017, the national average milk production per cow was about 2.5 L per day; in 2020–2021, it is projected to increase to 3.5 L per day if improvement interventions including those designed to reduce the burden of brucellosis in cattle are implemented. The objective of the study reported here was to estimate the seroprevalence of and identify risk factors associated with dairy farms and cattle classified as seropositive to Brucella spp. in three different agroecological zones in Rwanda. Most study farms (40/85 or 47%) had one head of cattle only. Using the Rose Bengal test, the seroprevalence of brucellosis was 28/85 or 33% (95% CI = 24%, 43%) at the farm level and 63/465 or 14% (95% CI = 11%, 17%) at the animal level. Using logistic regression, at the farm level, the presence of seropositive cattle was associated with herd size (2–45 cattle, odds ratio = 21.2; 95% CI = 2.4, 184.5) (46–220 cattle, OR = 288.5; 95% CI = 24.3, 3,423.1) compared to farms with one animal, after controlling for main breed (local breeds, crossbreeds) on the farm. In addition, the odds of testing seropositive were 10.7 (95% CI = 2.3, 49.1) and 149.5 (95% CI = 19.3, 1,158.7) times higher in farms in Nyabihu district and Nyagatare district, respectively, than in farms in Muhanga district, after controlling for main breed on the farm. The odds of seropositivity to Brucella spp. were 2.8 times higher in farms with mostly local breeds, than in those with mostly crossbreeds; but the association was confounded by herd size and geographic location. At the animal level, the odds of seropositivity to Brucella spp. were 2.6 times higher in adult cattle than in young cattle (95% CI = 1.1, 6.3). Finally, we observed a high frequency of adult cattle (86%) and a high seroprevalence of brucellosis in adult cattle (25%) in Nyagatare; an indication that, in the absence of culling and other control measures, Brucella spp. infection pressure can be relatively constant and a steady source of disease transmission in pastoral systems in that district.
Physico-chemical parameters of Ikere-Gorge, Iseyin, Oyo State, Nigeria
Authors: Ajagbe S.O. , Odulate D.O. , Ariwoola O.S. , Abdulazeez F.I. , Ojubolamo M.T. , Adebisi-Fagbohungbe T.A. , Arabambi I.O. , Olomola A.O. , Oyekan O.O. , Fadimu B.O. , Ganiyu O.A. 
Published: January 2021

Water quality determines the distribution of aquatic organisms within aquatic ecosystem. Deterioration of water quality is of a great concern in freshwater ecosystem because of its adverse effects on freshwater organisms. Therefore, the physico-chemical parameters of Ikere-gorge were examined in this study to determine its suitability for fish production. Air and water temperature, transparency, electrical conductivity and totaldissolved solids were determined in-situ. Dissolved oxygen, alkalinity, hardness, phosphate and nitrate were determined with standard analytical methods. The selected parameters examined in this study were determined monthly between January 2017 and December 2018. The mean monthly values of physico-chemical parameters of Ikere-gorge obtained are as follows: air temperature (27.46±1.82 ºC), water temperature (28.14±1.57 ºC), pH (6.50±0.63), water transparency (1.34±0.12 m), dissolved oxygen (5.93±0.29 mg/L), electrical conductivity (130.59±7.59 μS/cm), total dissolved solids (67.67±4.37 mg/L), total hardness (56.70±15.76 mg/L), total alkalinity (58.97±9.53 mg/L), total phosphate (2.22±0.67 μg/L) and nitrate (2.90±1.23 μg/L). Likewise, it was observed that surface water temperature had negative significant relationship with dissolved oxygen at P < 0.05.Transparency has negative significant relationship with phytoplankton abundance at 0.05 (P ˂ 0.05) and with phosphate and nitrate at 0.01 significant level. The annual mean of Trophic Status Index based on total phosphate is 15.04±1.63. This classified Ikere-gorge trophic status as mesotrophic at stage 2. The result of this study reveals the mesotrophic status of Ikere-gorge and water quality are within the ranges recommended for fish production and should be adequately managed for sustainable fish production.
Keywords: Aquatic organisms, Ecosystem, Freshwater, Trophic state, Abundance
Virulent gene detection and antibiogramic profile of methicillin resistant Staphylococcus aureus isolated from birds of a poultry farm
Authors: Omoruyi I.M. , Obodo I.C. , Obukohwo E.O. , Otoide F.E. 
Published: January 2021

Methicillin-resistant strains of Staphylococcus aureus (MRSA) are gaining global attention, largely due to their potential public health significance. In the current study, we investigated the prevalence of MRSA in poultry birds from Benson Idahosa University farm. Twenty-five samples each from poultry droppings, cloacae and nostrils were collected aseptically and screened for total heterotrophic and Staphylococcus aureus counts usingstandard culture-based methods. Phenotypic identification of MRSA was carried out using mannitol-oxacillin agar, while the presence of virulence genes (mecA, entA, entB, entC, SCCmec (I, II, III) and tsstI) was investigated by polymerase chain reaction using specific primers. Also, the antibiogramic activities and multi drug-resistant index were investigated against 6 clinically relevant antibiotics (oxacillin (1 μg), vancomycin (30 μg), ceftazidime (30 μg), ceftriaxone (30 μg), amikacin (30 μg) and ofloxacin (5 μg)). The results showed that total heterotrophic bacterial and S. aureus are prevalent in poultry birds, with mean heterotrophic counts of 243.08 ± 21.01 × 105 cfu, 169.37 ± 25.30 × 105 cfu and 216 ± 15.89× 105 cfu for poultry droppings, cloacae and nostrils respectively and mean S. aureus counts of 176.30 ± 28.85 × 105 cfu for poultry droppings, 16.52 ± 11.92 × 105 cfu for cloacae and 5 2.72 ± 0.41 × 105 cfu for nostrils. Interestingly, 93.33%, 25% and 10.5% of S. aureus isolated from the droppings, cloacae and nostrils respectively were methicillin resistant. The antibiogramic activities showed the majority of isolates to be multi drug-resistant, while only one MRSA (from poultry droppings) had the mecA gene. The presence of these isolates in poultry birds is of a potential public health concern as they may travel through the food chain and efforts should be made by poultry owners to avoid the indiscriminate use of antibiotics.
Keywords: Methicillin-Resistant Staphylococcus aureus; Poultry; Public Health; Virulence Gene