bluuebunny/crossref_metadata_2025_split huggingface dataset:
Proportion of subjects remaining abstinent following alcohol de-addiction treatment and factors associated with abstinence - A 3 months prospective cohort study
Authors: Nair Ariya , Arathil Praveen , Narayanan Dinesan 
Published: April 2021

Aims:
The aim is to study prevalence of abstinence rates for 3 months follow-up in individuals of alcohol dependence undergoing de-addiction treatment. Also to assess for possible co-relation between sociodemographic, clinical, personality, cognitive functioning and laboratory variables of relapsed and abstinent individuals.

Subjects and Methods:
Eighty-six individuals who were admitted for alcohol deaddiction treatment were taken for the study after taking consent. Sociodemographic and clinical variables were assessed using a pro forma. The Mini-International Neuropsychiatric Interview was administered to rule out other disorders. Clinical Institute Withdrawal Assessment of Alcohol, revised scale to assess the severity of withdrawal. Personality was assessed using 16PF. The Tower of London (ToL) test was used to assess executive function. Individuals were followed up after discharge till 3 months from the admission date to assess for the maintenance of abstinence.

Results:
Out of 86 individuals, only 24 individuals maintained abstinence at 3 months. About 72.08% of those who had previous deaddiction treatment did not maintain abstinence or were lost to follow-up. Duration of hospitalization was significantly more in abstinent individuals (15.63 ± 6.31, P = 0.001). On 16PF individuals who did not maintain abstinence had higher perfectionism scores (5.97 ± 1.9, P = 0.027) similarly on the ToL test they had lower scores on the total number of problems solved on the minimum number of moves (7.02 ± 1.76, P = 0.001).

Conclusion:
There is the low rate of abstinence among individuals having undergone deaddiction treatment at the end of 3 months. Modifying treatment for individuals who have past relapses, personality disturbances, and avoiding early discharge may help in increasing the abstinence rate.
Defeat and entrapment in the pathogenesis of suicidal behavior
Authors: Nukala Srikrishna , Singisetti Srinivas , Vinnakota Archana , Chilikuri Shvetha , Garapati Abhilash , Sanapala Vidya , Nambaru Laxman 
Published: April 2021

Introduction:
Human behavior is very complex and driven by different motivations. At times, we find a deviant escape behavior in some situations, characterized by streaks of self-destruction or “suicidal behavior.” Defeat and entrapment have been hypothesized as central to this behavior.

Aim:
We aimed to study the relationship between defeat, entrapment, suicidal ideation, and suicidal attempt.

Materials and Methods:
This study was a cross-sectional study of fifty patients who attempted suicide and survived the attempt. When medically fit for psychological assessment, they were approached in a person in the hospital psychiatric ward. These patients were subjected to a detailed psychiatric interview, and any psychiatric illness in the patients was diagnosed using the Diagnostic and Statistical Manual of Mental Disorders V criteria. They were assessed on the defeat and entrapment scales by Gilbert and Allan. The Modified Scale for Suicidal Ideation by Ivan W. Miller was used to determine the presence or absence of suicidal ideation and severity of suicidal ideation.

Results:
The presence of a current depressive disorder diagnosis and planning of attempt had a significant association with higher scores on internal entrapment, total entrapment, defeat, and suicidal ideation scales. The scores on defeat, internal entrapment, total entrapment, and suicidal ideation scales correlated positively and highly significantly.

Conclusion:
Entrapment and defeat are identified as important in the pathogenesis of depression and self-harm. Arrested escape and flight appear as motivation for suicidal behavior.
A cross-sectional study of psychological distress in patients hospitalized for COVID-19
Authors: Pingali Srilakshmi , Joopaka Ajay Kumar , Telkapalli Pradeep Sharma , Umashankar Molanguri 
Published: April 2021

Introduction:
The novel coronavirus disease-19 (COVID-19) which started in China has now spread across the world. Many measures to contain the pandemic are being employed like hospitalization of patients tested positive, quarantine of contacts, and social distancing. The consequent social isolation and the uncertainty of the disease has led to psychological distress.

Aims and Objectives:
The aim was to study the psychological distress and its associated factors in patients hospitalized for COVID-19.

Materials and Methods:
A cross-sectional study was done in a designated COVID center where patients tested positive were admitted from all over the state. A total of 222 hospitalized COVID-19 patients were screened using the Patient Health Questionnaire-4 and those who screened positive had their diagnosis confirmed by using the International Classification of Disease 10 criteria.

Results:
A total of 222 patients were screened of which 22.1% showed distress, 12.6% showed mild distress, and 9.5% moderate distress. Depression criteria were met by 5.5% and 3.2% had generalized anxiety disorder. Factors significantly associated with distress were deaths in the family and duration of hospitalization, whereas family members affected with COVID-19 were inversely related to psychological distress.

Conclusion:
Having a number of family members affected and simultaneously admitted in the same hospital seems to have acted as a buffer against psychological distress. However, deaths in the family due to COVID-19 and long duration of hospitalization were found to be factors associated with psychological distress. Efforts should be made to treat not only the physical health but also address the psychological distress in patients hospitalized for COVID-19.
Prevalence and pattern of dry eye symptoms among “okada” riders in Southwest Nigeria using the ocular surface disease index
Authors: Adenekan Adetunji Olusesan , Ilo Olubanke Theodora , Alabi Adegboyega Sunday , Aribaba Olufisayo Temitayo , Akinsola Folasade Bolanle 
Published: April 2021

Background:
Dry eye is a common disorder of the tear film that results in epithelial damage and the disruption of normal homeostasis at the ocular surface. It is a common ocular condition that is often missed in clinical diagnosis. The objectives of this study were to determine the prevalence and pattern of dry eye symptoms using the Ocular Surface Disease Index (OSDI) among commercial motorcyclists and also identify factors that may be responsible for dry eye symptoms in this population.

Methods:
This was a descriptive, cross-sectional, population-based study. Using a multistage random sampling technique, 422 commercial motorcyclists were surveyed from 10 units of registered commercial motorcyclists. Interviewer-administered OSDI questionnaires (face to face) were used, and visual acuity (VA) measurement was done.

Results:
The prevalence of dry eye symptoms in this study was 83.42%. Using the OSDI, the pattern of dry eye symptoms in this study showed that 21.56% had mild dry eye, 54% had moderate dry eye, and 7.82% had severe dry eye. Riders aged >50 years (86.90%), P < 0.05, 95% confidence interval: 0.012–0.021; nonuse of protective spectacles (87.46%), P < 0.05, 95% confidence interval: −0.235–−0.087; and use of helmets with face shields while riding (92.89%), P < 0.05, 95% confidence interval: −0.160–−0.062, were risk factors for dry eye symptoms. All respondents who had diabetes mellitus (P < 0.05, 95% confidence interval: 0.084–0.429) and a larger proportion (84.86%) of those not on topical medications (P < 0.05, 95% confidence interval: −0.365–−0.066) had dry eye. Visual impairment (VA <6/18) was observed in three respondents, with uncorrected refractive errors as the cause. Multivariate analysis showed that respondents aged <50 years, nonuse of protective spectacles, use of crash helmets with face shield, medical conditions, particularly diabetes mellitus, and nonuse of topical medications were significantly associated with dry eye symptoms.

Conclusion:
The prevalence of dry eye symptoms was high, and majority had moderate dry eyes based on OSDI grading. Furthermore, public health awareness program should be commenced to educate motorcyclists on the importance of using protective goggles in preventing dry eye disease.
Surrogate markers and predictors of insulin resistance in Nigeria patients with Type 2 diabetes mellitus
Authors: Odeniyi Ifedayo Adeola , Odife Ukamaka Beatrice , Fasanmade Olufemi Adetola , Ohwovoriole Augustine Efedaye 
Published: April 2021

Background:
This study set out to identify and compare surrogate markers of insulin resistance (IR) in males and females and compare the prevalence of IR using different surrogate markers.

Methods:
The study was an analytical cross-sectional hospital-based study among Nigerians with Type 2 diabetes mellitus (T2DM). A total of 234 (131 T2DM and 103 healthy) persons were invited to participate in the study. One hundred and ninety-nine persons completed the study. The following anthropometric measurements were taken (height [m], weight [kg], waist circumference [cm], and hip circumference [cm]). IR score (IRS) was derived using these six measurements: fasting basal insulin, fasting C-peptide, glucose-insulin ratio, quantitative insulin sensitivity check index, homeostasis model assessment (HOMA-IR), HOMA-c-peptide.

Results:
Using an IRS of >11 as criteria for IR, 52 (41.6%) of T2DM, and 21 (28.4%) of the control group were found to have IR. Forty-five percent of the DM females and 36.4% of DM males had IR, respectively, whereas 31.8% of the control females and 23.3% of control males had IR, respectively. Visceral Adiposity Index (VAI) had the best predictive value with the highest area under the receiver operating characteristic curve (0.648).

Conclusion:
The prevalence of IR is nonsignificantly higher in females than males. VAI is the best surrogate marker to predict the presence of IR among the male study participants, while waist circumference is the best surrogate marker to predict the presence of IR among the female study participants.
Histopathological analysis of male breast cancer in Southwestern Nigeria
Authors: Ajani Mustapha Akanji , Odetola Segun Samson , Awosusi Babatope L. , Fatunla Ebenezer O. , Salami Ayodeji A. 
Published: April 2021

Background:
Breast cancer in men is still an uncommon and largely understudied disease. It accounts for 1% of all breast cancers. The aim of this study was to review all the male breast cancer cases diagnosed at the tertiary medical institution in South West Nigeria over a 10-year period and to compare the findings with other similar studies done in Nigeria and globally.

Methods:
We retrospectively reviewed all histologically diagnosed cases of male breast cancers in the Department of Pathology, Tertiary Medical Institution in South West Nigeria over a 10-year period from January 1, 2009, to December 31, 2018. Clinicopathological parameters including patients' age, laterality, and specific histological sub-types were extracted from surgical day book and Cancer Registry of the Department. The data were analyzed using the IBM SPSS Statistics (version 22; IBM Corporation, Armonk, New York, USA). The results were subsequently presented in tables, relative frequencies, group percentages, and photomicrographs.

Results:
Forty-two cases of male breast cancer were seen accounting for 1.7% of all breast cancer cases. The age range was between 22 and 91 years with a mean age of 60.3 years, and a peak occurrence was in the 8th decade. The right breast was more affected than the left accounting for 52% of the total number of cases seen. The most common histological sub-type found was invasive ductal carcinoma accounting for 88% of all the cases.

Conclusion:
Male breast cancer is relatively uncommon compared to female breast cancer. It is more common in the older age group, and invasive ductal carcinoma is still the most common histological subtype.
Evaluation of the use and effectiveness of telemedicine among the health professionals during the COVID 19 lockdown period
Authors: James Olutayo , Akinboboye Bolanle Oyeyemi , Okunade Kehinde Sharafadeen , Adekunle Adeola Adegbayi , Adeyemo Wasiu Lanre 
Published: April 2021

Background:
Telemedicine has been documented as a viable option in attending to patient's need where distance is a critical factor. The Federal Government of Nigeria on March 27, 2020, imposed a total lockdown in Lagos state in order to curb the spread of the coronavirus disease 2019 (COVID-19) pandemic. The restriction in movement prevented many patients from attending their regular clinics and physical consultations. The aim of this study was to evaluate the use and effectiveness of telemedicine among the hospital health professionals during the lockdown period.

Methods:
This was an online cross-sectional study among doctors at a tertiary health facility in Lagos. Ethical approval was obtained from the institutional ethical committee. A list of the telephone and WhatsApp contacts of doctors were obtained from the hospital directory; the SurveyMonkey tool was used as an online web-based structured questionnaire for data collection. The information obtained was analyzed to find means and averages.

Results:
A total of 104 doctors completed the survey. The proportion of participants who used telemedicine was 93.3%, with the most commonly used telemedicine option being phone call (27.1%) and WhatsApp video call (27.1%). The main management provided during this period was counseling (56.6%). Seventy-nine percent of the participants were satisfied with the result of the management provided through telemedicine options, but the major concern was that of ethical issues (36.2%). Majority (44.2%) of the respondents agree that telemedicine was effective during the COVID-19 lockdown period. There was no association found between gender, age, designation, and perceived effectiveness of telemedicine by respondents in this study (P = 0.88, 0.4, and 0.07, respectively).

Conclusion:
Telemedicine was found to be a useful tool for effective patient's management during the lockdown period although there exist ethical concerns. The formulation of policies guiding its use will ensure the security of information and patient's confidentiality.
Acute Electrocardiographic Changes during Smoking and Tobacco Chewing
Authors: Gupta Himanshu , Bhargava Balram , Seth Sandeep , Pruthvi C R , Ramakrishnan Sivasubramanian 
Published: April 2021

Background:
Smoking increases the risk of coronary artery disease. Very few studies have evaluated the temporal relationship of electrocardiographic changes with smoking. We sought to study and compare the electrocardiogram (ECG) changes during smoking and tobacco chewing in current smokers and tobacco chewers presenting with atypical chest pain with either negative or mild positive exercise ECG test (treadmill test [TMT]).

Materials and Methods:
We screened male smokers and tobacco chewers with atypical chest pain with TMT. A total of 60 patients, 30 in each group in whom TMT was either negative or mildly positive, underwent a 24-h Holter monitoring. We asked patients to note down their time of smoking and tobacco chewing along with the timing of symptoms if any.

Results:
All patients were male with an average age of 45 years in smokers and 42 years in the tobacco chewer group. The mean number of cigarettes consumed was 6 ± 2.8 and tobacco chewed was 5 ± 4.7 g/day. Heart rate (HR) in smokers increased from 82.5 ± 14.56/min 10 min before smoking to 90.63 ± 15.34/min, during smoking with peak HR achieved at the time of smoking (P < 0.0001). HR in the tobacco chewers peaked at 10 min after chewing from 80.62 ± 13.52/min 10 min before to 87.89 ± 13.86/min 10 min after chewing (P < 0.0001). Smoking was associated with a significant increase in supraventricular ectopics (VEs) from 3.98/h before smoking to 7.43/h during and 6.92/h after smoking (P < 0.0001). Two patients in the smoker subgroup had spontaneous smokeless tobacco -T changes lasting for 10–25 min. Smoking was associated with a significant decrease in HR variability (HRV) index than the controls (P = 0.023). Tobacco chewing was not associated with any significant changes in the HRV parameter.

Conclusions:
Smoking and tobacco chewing both significantly increase the HR acutely. Smoking leads to an increase in both supraventricular and VEs. We observed reduced HRV in patients who smoked cigarettes.
Clinical and Angiographic Outcomes of Coronary Bifurcation Lesions Treated by TAP- Stenting as an Initial Two Stent Strategy
Authors: Parvathareddy Krishna Malakonda Reddy , Karella Naga Chaitanya , Ravi Srinivas , Nagula Praveen , Kolli Jagadeesh Reddy , Imamuddin Syed 
Published: April 2021

Context:
The T-stenting with small protrusion (TAP) technique is a relatively new strategy among the bifurcation lesion interventions. Apart from being technically easy, there is complete coverage of the side-branch ostium and minimal overlap of the stent struts.

Aims:
We sought to report the outcomes of TAP technique in the management of the bifurcation lesions.

Settings and Design:
Prospective observational study between December 2017 and December 2019.

Subjects and Methods:
Patients with a diagnosis of coronary artery disease and bifurcation lesion on angiography were included in the study. Patients who underwent intervention with TAP technique were analyzed at baseline and followed up for a period of 1 year. The measured endpoints include major adverse cardiac events (MACE), target vessel revascularization (TVR), stent thrombosis (ST), and binary restenosis at 1-year follow-up.

Results:
During the study period, 152 bifurcation lesions in 148 patients were treated by percutaneous coronary intervention using drug-eluting stents. Of these, 15 patients (10.13%) underwent TAP stenting. The median age was 60 years. The procedural success was 100% in all the patients. At 1-year follow-up, MACE was seen in 13.3%, TVR in 6.66%, and binary stenosis in 6.66%.

Conclusion:
The TAP stenting as an initial two-stent strategy is associated with acceptable clinical outcomes (MACE and in-stent restenosis). There was no case of definite ST.
Critical Care Preparedness and Conduct in COVID-2019 Crisis
Authors: Sahu Manoj Kumar , Vaswani Prateek 
Published: April 2021

Background:
COVID-19 pandemic has stirred an unexpected turmoil in health care worldwide. The strategic conduct of critical care would warrant an effective preparedness plan, thorough knowledge of the disease manifestations, and relevant therapeutic strategy to sail through this crisis.

Methods:
English medical literature with MeSh database was searched using the key words such as “COVID-19 pandemic,” “ICU preparedness,” “COVID-19 management,” “COVID-19 therapy,” and “COVID-19 systemic effects.” The relevant studies were included with significant inputs from interdepartmental meetings for the formulation of a plan.

Results:
The analysis of the respective studies highlighted the requirements of COVID-19 designated intensive care units (ICUs) with special provisions and the therapeutic agents being used in critical patients with emphasis on Remdesivir, Dexamethasone, Convalescent Plasma, and insight into newer agents. The systemic manifestations of COVID-19 requiring ICU care such as acute respiratory distress syndrome, myocardial injury, arrhythmias, hypercoagulable state, and acute renal dysfunction have been highlighted. The need of updating records with research protocols cannot be disregarded. The care of patients should not compromise the health-care personnel requirements.

Conclusion:
The evidence-based preparedness strategy can curtail the critical care crunch in COVID-19 management; however, institutional specific approach should be formulated.
Assessment of Thirst Intensity and Thirst Distress and the Practices for its Management among Heart Failure Patients Admitted to the Cardiology Unit
Authors: Thapa Karuna , Das Smita , Pathak Pragya , Singh Sandeep 
Published: April 2021

Background:
Thirst is reported as a troublesome symptom in patients with heart failure (HF), and very few studies have been done to assess thirst in these patients. Therefore, this study aims to assess thirst intensity, thirst distress, and practices of HF patients to manage thirst.

Methods:
A descriptive, cross-sectional study was conducted on 75 HF patients admitted to the cardiology department. Purposive sampling technique was used for collecting data from July 2019 to November 2019. Visual analog scale (0–100 mm) was used to assess thirst intensity, and 8-item thirst distress scale was used to assess thirst distress. The practices of the participants were assessed using a self-developed questionnaire.

Results:
The mean age of the participants was 44.83 ± 15.51 years and the majority (72%) was male. The majority of the participants (82.7%) had fluid restriction, and almost 97.3% of all of the participants were receiving diuretics. The median (interquartile range) thirst intensity was 33 (16–50) mm. About 66.7% of the participants had moderate-to-severe thirst distress. Both thirst intensity and thirst distress were associated with fluid restriction, New York Heart Association functional class, and serum urea level. The participants reported that they drink a small amount of water frequently, gargle with water, eat cucumber, drink buttermilk, lemon juice, and coconut water. Very few participants had made changes in their food habits and lifestyle.

Conclusion:
Two-thirds of the participants had moderate-to-severe thirst distress. Fluid restriction was associated with both thirst intensity and thirst distress. Thus, nurses are responsible to assess thirst among HF patients and help them to manage their thirst effectively.
A Comparative Assessment of the Severity of Coronary Artery Disease in Patients with Low Ankle–Brachial Index and Normal Ankle–Brachial Index
Authors: Sharma Awadhesh Kumar , Kejriwal Mohit P , Sinha Santosh Kumar , Razi M M , Pandey Umeshwar , Shukla Praveen , Thakur Ramesh , Verma C M , Krishna Vinay 
Published: April 2021

Objectives:
The ankle–brachial index (ABI) is an efficient tool and an indicator of generalized atherosclerosis. Still, there is uncertainty regarding the severity of coronary artery disease (CAD) in patients having low ABI. The uniqueness of this study is that it is the first largest study done with the aim to determine the severity of CAD in the form of a number of involvements of coronary vessel in patients with low ABI.

Materials and Methods:
It is a hospital-based cross-sectional observational-analytical study. A total of 500 patients of suspected CAD were recruited. ABI was measured first and then all patients were sent for coronary angiography. Based on ABI values, patients were divided into two groups, i.e., Group A (patients with low ABI or ABI ≤0.9) and Group B (patients with normal ABI or ABI >0.9).

Results:
Twenty-three, i.e., 4.6% of patients had ABI <0.9. All patients having low ABI had CAD. In assessing CAD severity, it was reported that in Group A, triple-vessel disease (TVD) was present in 65.2% (P = 0.0001), double-vessel disease in 21.7% (P = 0.72), single-vessel disease in 8.6% (P = 0.06), and noncritical CAD in 4.3% (P = 0.9) as compared to Group B. In patients with Group A, 52.1% were smoker (P = 0.01), 69.5% have increased body mass index (P = 0.71), 43.4% have a history of hypertension (P = 0.73), and 60.8% were diabetic (P = 0.0005).

Conclusion:
CAD is widely prevalent almost in all patients with low ABI and more than half of these patients have TVD on angiographic assessment.