bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparing topical administration of lidocaine alone and in combination with alfentanil in children undergoing bronchoscopy
Authors: Takzare Alireza , Ariana Parastou , Malekianzadeh Bita , Goudarzi Mehrdad , Espahbodi Ebrahim 
Published: April 2021

Introduction:
Airway surgery and endoscopy in pediatric patients are always associated with challenges in anesthesia management. Deep anesthesia is required for preventing patient bucking during the procedure but patient breath should be maintained; in this regard, a combination of general and topical anesthesia can be beneficial. There is also evidence of the peripheral effects of opioids. The main objective of this study is to compare using lidocaine topically alone and combined with alfentanil opioids with respect to the central effects of opioids.

Methods:
In this study, 40 ASA class I and II children, aged 1–6 years, who were candidates for flexible diagnostic bronchoscopy were divided into two groups through block randomization using the random number table after obtaining parents' consent in complete health conditions. In this clinical trial, for collecting the data a special data collection form was used at the bedside of patients undergoing bronchoscopy at Pediatric Medical Center in 2017. Data including demographic information (age, weight, gender), duration of anesthesia, blood pressure before and after drug administration, duration of bronchoscopy, and recovery time were recorded in a form.

Findings:
In terms of demographic variables, there were not any significant differences between the two studied groups, indicating that the groups were matched and randomized appropriately. Although there were not any significant differences between the two groups of using lidocaine alone and in combination with alfentanil in other variables, in the recovery time a significant difference was observed between the two groups, with a mean of 13.05 min in the lidocaine group and 18.75 min in the lidocaine combined with alfentanil group.

Conclusion:
Topical administration of opioid with lidocaine through bronchoscopy had no impact on blood pressure, heart rate, anesthesia duration, and the frequency of perioperative complications.
Coverage, utilization, and impact of Ayushman Bharat scheme among the rural field practice area of Saveetha Medical College and Hospital, Chennai
Authors: Sriee G.V Vishnu Priya , Maiya G. Rakesh 
Published: April 2021

Introduction:
Ayushman Bharat scheme, otherwise called as Pradhan Mantri Jan Arogya Yojana (PMJAY), is a National Health Protection Scheme introduced on 23 September 2018 by the government of India to aid the economically disadvantaged families.

Aim:
The study was initiated to estimate the coverage, utilization, and impact of Ayushman Bharat scheme in the rural field practice area of Saveetha Medical College and Hospital, Chennai.

Settings and Design:
This is the cross-sectional study conducted in the rural field practice area of Saveetha Medical College and Hospital, Chennai.

Methods and Material:
This cross-sectional study done among 300 households in Mappedu region of Thiruvallur district, Tamil Nadu. Simple random sampling was done to choose the study participants to reach the sample size of 300. Data was collected using semi-structured questionnaire. After the entry of data, the descriptive statistics was presented in frequency tables and graph.

Result:
The study found that out of 300 households only about 42.33% of the households were covered under Ayushman Bharat scheme. Among the households covered under Ayushman Bharat scheme, 47.24% households have availed Ayushman Bharat scheme in the past 1 year and only 10% of those availed the scheme has spent additional amount for health care. Around 39.88% of the households not having Ayushman Bharat scheme has faced financial burden because of health care expenditure.

Conclusion:
Creating awareness, appropriate governance, and working toward quality assurance, prompt referral pathways in both public and private healthcare providers can make Ayushman Bharat scheme effective.
Prevalence and predictors of exclusive breastfeeding in urban slums, Bihar
Authors: Kazmi Shahwar , Akparibo Robert , Ahmed Danish , Faizi Nafis 
Published: April 2021

Objective:
Various socio-cultural factors influence infant feeding practices and thus early childhood nutrition and child survival in India. This study aimed to examine the prevalence of exclusive breastfeeding, its promoters and barriers in urban slums of Bihar, India.

Methods:
We conducted a community based cross-sectional survey involving 297 mothers living in slum settlements in Bihar. Data were collected using structured questionnaire on exclusive breastfeeding practices, and the factors that could influence this. Descriptive analysis was done to estimate the prevalence of exclusive breastfeeding and regression model was performed to identify the predictors of exclusive breastfeeding.

Results:
Only 23% of mothers initiate breastfeeding within 1 hour of delivery and 27.6% mothers practise exclusive breastfeeding up to six months. Mother's education was found to be associated with duration of exclusive breastfeeding (OR 11, 95% CI 2-59). Term babies were more likely to be breastfed exclusively for six months than pre-term babies (OR 8.6, 95% CI 1.6-47.6). Antenatal care visits and completing immunization were significantly associated with duration of exclusive breastfeeding (P < 0.001). The majority of mothers acquire exclusive breastfeeding knowledge through television/radio (OR 68, 95% CI 5.5-832.5) and newspaper advertisements (OR 14, 95% CI 2.6-76).

Conclusion:
Prevalence of exclusive breastfeeding up to six months of age and early initiation of breastfeeding remains low in slums of Bihar. Exclusive breastfeeding and early initiation of breastfeeding rates could be improved by educating and counselling mothers during health facility contacts by primary care providers.
Diploma in primary care psychiatry
Authors: Pahuja Erika , Santosh K.T. , Harshitha Nisha , Malathesh Barikar C. , Manjunatha Narayana , Kandasamy Arun , Kumar Channaveerachari Naveen , Math Suresh Bada 
Published: April 2021

Background:
Cannabis is one of the most used illicit substances in India but is under-recognized and under-represented in clinical settings of India, especially at primary care. Patients usually do not seek treatment primarily for cannabis use, but it is identified on pro-active questioning by doctors. The aim is to study the clinical profiles of patients with cannabis use disorders (CUD) at primary care and to derive learning points from collaborative consultations to devise an optional module for CUD primarily for primary care doctors (PCDs).

Methods:
File review of general patients with cannabis use, identified by PCDs during collaborative video consultation module of Diploma in Primary Care Psychiatry, was performed, and their profile and management difficulties were assessed.

Result:
Twelve patients with a mean age of 31.25 ± 12.04 years were identified by PCDs over a year. All were males with psychosis being the most common comorbidity. None of the patients presented primarily for cannabis use disorder.

Conclusion:
Identifying cannabis use among patients visiting PCDs becomes all the more important as the use of cannabis is not usually revealed spontaneously unless specifically probed. This warrants establishing guidelines for CUD specifically for use of PCDs for identifying and managing CUD.
Antimicrobial resistance (AMR) at the community level
Authors: Balachandra Swathi S. , Sawant Prathamesh S. , Huilgol Poorva G. , Vithya T. , Kumar GS , Prasad Ramakrishna 
Published: April 2021

Context:
The emergence of antimicrobial resistance (AMR) is a major public health crisis in India and globally. While national guidelines exist, the sources of data which form the basis of these guidelines are limited to a few well-established tertiary care centres. There is inadequate literature on AMR and antibiotic mismatch from India at community level and even less literature on AMR patterns from rural India.

Aims:
The aims of this study were as follows: 1) to describe the patterns of AMR at an urban tertiary care hospital and a rural 100 bedded hospital; 2) to compare and contrast the AMR patterns noted with published ICMR guidelines; 3) to examine the issue of AMR and antibiotic mismatch; and 4) to identify local factors influencing drug-bug mismatch at the local level.

Settings and Design:
The data were obtained from two independently conceived projects (Site 1: Urban tertiary care hospital, Site 2: Rural 100-bedded hospital).

Methods and Materials:
Local antibiograms were made, and the antibiotic resistance patterns were compared between the urban and rural sites and with data published in the 2017 ICMR national guideline for AMR.

Statistical Analysis Used:
Descriptive statistics including means and medians were used.

Results:
Our data reveal: a) a significant mismatch between sensitivity patterns and antibiotics prescribed; b) The national guidelines fail to capture the local picture of AMR, highlighting the need for local data; and c) challenges with data collection/retrieval, access and accuracy of diagnostic tools, administrative issues, and lack of local expertise limit antimicrobial stewardship efforts.

Conclusions:
Our study finds the burden of AMR high in both rural and urban sites, reinforcing that AMR burden cannot be ignored in rural settings. It also highlights that national data obtained from tertiary care settings fail to capture the local picture, highlighting the need for local data. Mechanisms of linking rural practices, primary health centres, and small hospitals with a common microbiology laboratory and shared data platforms will facilitate antibiotic stewardship at the community level.
Readmissions after cholecystectomy in a tertiary UK centre
Authors: Omar Islam , Hafez Ahmed 
Published: April 2021

Context:
Although cholecystectomy is a widely performed procedure, post-operative readmissions place a heavy burden on healthcare facilities.

Aims:
This study assesses the incidence, causes and burden of 30-day readmissions after cholecystectomy in a tertiary UK centre.

Settings and Design:
This study was conducted at a university hospital, and the study design involves retrospective cohort study.

Materials and Methods:
Information was obtained from our prospectively maintained database and hospital's computerised records.

Statistical Analysis:
The encounters are expressed in numbers and percentages. The hospital stay, body mass index and age are expressed in mean, standard deviation (SD), min-max and median. Microsoft Excel® was used to calculate the means, SD, min-max and median.

Results:
Out of the 1140 cholecystectomies performed over this time, there were 75 true readmissions and 29 revisits; thus, the actual readmission rate is 6.58%. Non-specific abdominal pain ± deranged liver function test (LFT) is the most common cause of readmissions/ revisits in (38; 36.54%) cases, followed by (18; 17.31%) wound infections and (12; 11.54%) collections/bile leaks/abscess. This cost the centre 93 scans, 30 procedures and 295 days of hospital stay.

Conclusions:
Non-specific abdominal pain ± deranged LFT is the most common cause of readmissions/revisits in the centre. Readmissions after a cholecystectomy are a significant encumbrance.
Evaluation of the Ascending Utricular and Descending Saccule Pathway Using Cervical Vestibular Evoked Myogenic Potential and Ocular Vestibular Evoked Myogenic Potential in Diabetic Polyneuropathy
Authors: Akan Onur , Berkiten Güler , Tutar Belgin , Karaketir Semih , Tuna Ömür Biltekin 
Published: April 2021

Background:
Chronic hyperglycemia can affect the vestibular system by causing injury in cells and neural structures. In addition to alterations in the microvasculature and connective tissues, changes in inner ear fluid metabolism can also contribute to otolithic damage in patients with diabetes. We aimed to evaluate the effects of neurovascular degeneration occurring in diabetic polyneuropathy (DPN) on the vestibular system.

Methods:
Thirty-five patients with DPN (n = 70 ears) and 34 (n = 68 ears) healthy controls were enrolled. Patients were classified into two subgroups as sensorial axonal PNP and sensory-motor axonal PNP. To assess vestibular functions, cervical vestibular evoked myogenic potential (cVEMP) and ocular vestibular evoked myogenic potential (oVEMP) testing were bilaterally performed.

Results:
Bilateral cVEMP and oVEMP P1 latency and N1 latency were significantly prolonged, whereas amplitude values were significantly decreased in patients with DPN compared with the controls (P = 0.001). The cVEMP amplitude asymmetry ratio (AAR) was statistically higher in the DPN group than in controls (P = 0.001); oVEMP AAR was not significant between the patient and control groups (P = 0.095). The cVEMP AAR values were found to be increased in both patient subgroups, and oVEMP AAR was elevated in the sensorineural PNP subgroup. In the DPN group, the nonresponse rate was 48.6% (n = 17) in cVEMP and 51.4% (n = 18) in oVEMP, significantly higher compared with the controls (P < 0.05). In cVEMP, nonresponse rates were found to be lower in both DPN subgroups. In oVEMP, the nonresponse rate was found to be higher in the sensory-motor PNP subgroup when compared with the sensorial PNP subgroup (P = 0.008 and P = 0.003, respectively).

Conclusion:
In diabetes mellitus with multisystemic effects, particularly in patients with polyneuropathy, vestibular testing before the onset of vestibular symptoms may be an early and beneficial diagnostic method for detecting the presence or degree of neurovascular degeneration.
Exploring fertility decisions among pregnant HIVpositive women on antiretroviral therapy at a health centre in Balaka, Malawi: A descriptive qualitative
Authors: Biseck T , Kumwenda S , Kalulu K , Chidziwisano K , Kalumbi L 
Published: April 2021

Background The proportions of women of reproductive age living with the human immunodeficiency virus (HIV) vary between different regions of the world, with significantly higher proportions in sub-Saharan Africa. Family planning is one of the major issues that couples and families affected with HIV must confront. We aimed to assess the cultural and social factors associated with childbearing and family planning knowledge, decisionmaking, and practices among HIV-positive pregnant women attending antenatal clinic at a health centre in Balaka, Malawi.Methods This was a qualitative descriptive study carried out at Kalembo Health Centre in Balaka. A purposive sampling technique was used to select pregnant women enroled in the antiretroviral therapy (ART) programme. A sample size of thirty-five women was decided upon after data saturation. Qualitative inquiry was used during data collection. Data were analysed using systematic text condensation, while numbers and percentages were generated using Microsoft Excel.Results Out of 35 participants, 20 were aged between 25 and 34 years, and 18 had been married at least three times. All 35 women wished to have their own biological child. Factors, reported by participants, that promote childbearing included: the desire to please their husbands, fear of losing their husbands to others if they did not bear children, the knowledge that ART would help prevent their children from acquiring the virus, the desire to prove to others that they can also bear children, and a lack of family planning leading to unplanned pregnancies.Conclusions The factors that lead to pregnancies among women on ART in Balaka ranged from assured safety of the child from HIV, lack of contraception, to other factors related to their partners. The authors recognize and support the freedom for women to become pregnant and bear children, and, in the context of HIV infection, fertility and reproductive services should include a comprehensive approach towards addressing issues of HIV and AIDS and childbearing among infected women.
Maximizing HIV partner notification opportunities for index patients and their sexual partners in Malawi
Authors: Kamanga G , Brown L , Jawati P , Chiwanda D , Nyirenda N 
Published: April 2021

Introduction HIV testing and counselling (HTC) is important to effect positive sexual behaviour change and is an entry point to treatment, care, and psychosocial support. One of the most practical initiatives to increase HTC is to encourage sexual partners of HIV-infected persons to test for HIV. However, partner notification strategies must be feasible in the healthcare setting and acceptable to the population.Methods We conducted a qualitative study during the pilot phase of an HIV partner notification trial to complement its assessment of feasibility and acceptability of methods of partner notification. We performed in-depth interviews with 16 consecutive HIV-positive index participants who consented and their 12 identifiable sexual partners. We also conducted two focus group discussions with healthcare workers to supplement the patient perspectives. In the main study, newly diagnosed HIV cases (index cases) were randomized to one of three methods of partner notification: passive, contract, and provider referral. Clients in the passive referral group were responsible for notifying their sexual partners themselves. Individuals in the contract referral group were given seven days to notify their partners, after which a healthcare provider contacted partners who had not reported for counselling and testing. In the provider group, a healthcare provider notified partners directly.Results Although most index participants and partners expressed a preference for passive notification, they also highlighted benefits for provider-assisted notification and the universal right for all HIV-exposed persons to know their HIV exposure and benefit from HIV testing and access antiretroviral treatment. Several participants mentioned couples counselling as a way to diffuse tension and get accurate information. All mentioned benefits to HIV testing, including the opportunity to change behaviour.Conclusions Provider-assisted partner notification is not preferred, but it is acceptableand may complement the passive method of notification. Couples counselling should also be encouraged.
INDIAN IT FIRMS CREATING MANAGEMENT CODES FOR FOREIGN EXCHANGE RISK
Authors: Shankar Nitin , Beena Fatima 
Published: April 2021

Purpose: India has been a preferred I.T. service sourcing nation globally and has been registering high growth. India has a significant pie of the global sourcing market, accounting for nearly 55 % share. It covers significant global through its more than one thousand centres spread across continents. With a year-on-year growth of 6.1%, India’s I.T. and ITES industry will increase to the U.S. $ 350 million by 2025. The extensive expanse of geographical coverage also translates into foreign exchange risk; hence foreign exchange risk management becomes an important strategy. The current study attempts to assess the impact of foreign exchange risk management on the Indian sector over 2007-2017; the period includes the 2008 financial crisis taken up in the current study.
Design/Methodology/ Approach: We analyzed the Indian I.T. companies listed on the BSE Ltd on their exposure, approach, and management towards foreign exchange risk. We investigated their annual reports from 2007 -2017 to understand their exposure and the adopted external foreign exchange risk management techniques. We further assessed the impact of these foreign exchange risk management techniques on the firm’s value.
Findings: The impact of foreign exchange risk management was significant on small-cap I.T. companies for the study period. Though for the during the 2008 crisis term, it was found to be insignificant.
Practical/Implications: Foreign exchange risk management is crucial for Indian I.T. companies indulging in cross-border trade. The current study incorporates external methods of managing foreign exchange risk management; hence even if the impact were found to be insignificant for Mid Cap and some Large-cap companies, they would be practicing internal hedging methods, which puts a strong case tapping trillion-dollar business through a fully functional competitive International Financial Centre.
Originality/Value: Our paper contributes to the literature on Foreign exchange risk management by Indian I.T. companies, which contributes handsomely to India’s GDP and Foreign exchange reserve.
JEL Classification Codes: F31, G32.
CORPORALIDADES DIVERSAS EN MOVIMIENTO
Authors: Aschieri Patricia 
Published: April 2021

Entre el 20 de Mayo y el 7 de junio del año 2020 se realizó el evento “Ciudad Moviente” uno de cuyos propósitos fue el de poner en circulación prácticas inclusivas e igualdad de los derechos de las personas con discapacidad en el campo de la danza. Aunque fuera pensado originalmente para ser desarrollado de manera presencial, debido a la actual situación de pandemia y aislamiento físico obligatorio dispuesto en Argentina desde el 20 de marzo de este año, los organizadores decidieron convertirlo a la modalidad on line mediante el uso de plataformas y atrayentes estrategias. A partir del trabajo de campo realizado con “participación observante” de la línea de los talleres, algunas entrevistas de carácter público y varias comunicaciones personales, se presenta un análisis crítico de las múltiples mediaciones que atravesaron los diversos encuentros. Posteriormente se discuten algunas situaciones sucedidas durante el evento desde el enfoque de la interculturalidad crítica y la teoría de la performatividad.
ADDA HÜNICKEN Y LA REVOLUCIÓN DE LOS PIES DESCALZOS:
Authors: Antacli Paulina 
Published: April 2021

La presente investigación, en proceso, estudié las bandejas compartidas por Adda Hünicken (Córdoba, 1933-2013) como profesora, coreógrafa y pionera de la danza moderna en Córdoba. A través de la noche del paradigma indicativo, propuesto por Carlo Ginzburg, identificamos filiaciones que son reveladoras para un estudio ubicado en la danza moderna en la ciudad de Córdoba, Argentina. En el transcurso del trabajo, han surgido preguntas reveladoras que nos han llevado a una posición que busca cuestionar las perspectivas universalizadoras heredadas. ¿Es posible escribir una historia de la danza moderna situada ?, esa historia, que es matriz europea y norteamericana, ¿cómo impacta en los cuerpos "locales"?; ¿Puedes analizar lo que sucede artístico y cultural en una época? Las preguntas partían de otros aristas del problema: la historia de lo vivido, la historia de lo perdido, la construcción del mito, el olvido, la necesidad de crónicas que indaguen con fragmentos de la historia pasada y reciente.
En esta presentación, incluimos parte de una entrevista al coreógrafo en 2010, y relatos cruzados, objeto de entrevistas con los coreógrafos de danza: María Rosa Hakimián y Marta Huerta, quienes desarrollaron parte de su trabajo artístico con Hünicken. Testimonios que inscriben una historia de la danza moderna en Córdoba.