bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Study of Anatomy of Tarsal Tunnel in Human Fetuses by Dissection Method
Authors: Chaithra Rao B. R. , Annam Sucharitha , Sunkeswari Sreepadma , Patil Sandeep 
Published: April 2021

Background:
The flexor retinaculum of foot extends from the medial malleolus to the calcaneus to form the roof of tarsal tunnel. The structures passing through the tunnel are tendons of tibialis posterior, flexor digitorum longus & flexor hallucis longus, the tibial nerve & the posterior tibial artery with its venae comitantes. In order to understand the pathogenesis and improve the treatment of tarsal tunnel syndrome, we investigated the tarsal region of human foetuses anatomically.

Methodology:
The study was done on aborted/ stillborn foetuses in the Department of Anatomy of Sapthagiri Institute of Medical, Sciences, Bangalore. The structures passing under the flexor retinaculum of foot were dissected in 68 normal limbs of 34 foetuses of gestational age ranging from 10 weeks to term.

Results:
It was noted that the structures were arranged in two planes. Most commonly the superficial plane contained the tendon of tibialis posterior, posterior tibial artery & tibial nerve from medial to lateral side. In the deeper plane were the tendons of flexor digitorum longus medial to that of flexor hallucis longus. The bifurcation of tibial nerve mostly occurred under cover of flexor retinaculum and that of posterior tibial artery was distal to it.

Conclusion:
The understanding of arrangement of structures under cover of flexor retinaculum is important for diagnosis and treatment of tarsal tunnel syndrome in adults and also for the surgical correction of clubfoot, poliomyelitis & other deformities of foot in children.
The Utility of Screening Ultrasound in Early Diagnosis of Gall Bladder Cancer among High-Risk Population
Authors: Sreen Amit , Anadure Ravi K. , Singh H. P. , Sharma Anuj K. , Sharma Rohit , Mohimen Aneesh , Gupta Simmi 
Published: April 2021

Background:
Screening has led to reduction in mortality for cancers of the cervix, prostate, and colon. Advanced gall bladder carcinoma (GBC) have a poor prognosis, compared to early-stage GBC. The aim of this study was early detection of GBC by ultrasound screening, in a high-risk population. Data were analyzed to look at the impact of screening on staging, operability, and survival.

Materials and Methods:
In this prospective study spanning 4 years, 978 high-risk individuals as per defined criteria, were screened by ultrasound of the abdomen. The clinical profile of patients with screened GBC (S-GBC) and clinically evident GBC (C-GBC) was studied in terms of stage of detection, operability, and median overall survival (mOS).

Results:
Six cases of GBC were detected as S-GBC. These were compared with a control population of 119 GBC cases presenting to the cancer outpatient department (C-GBC) in the same period. It was found that S-GBC patients compared to C-GBC, had early stages of diagnosis (P = 0.001) and all underwent curative radical cholecystectomy compared to only 18.8% in C-GBC cases (P = 0.004). At 2 years follow-up, mOS was not reached for S-GBC patients as all patients were alive, compared to 9 months mOS in C-GBC cases (P < 0.05).

Conclusions:
Screening for GBC leads to the detection of GBC in early stages, ensures surgical resection, and significantly improves mOS. Ultrasound screening in high-risk population is recommended to improve the poor prognosis of GBC.
Lymph Node Metastasis in cT1/T2 Buccal Mucosa Squamous Cell Carcinoma
Authors: Vyas Siddharth Mahesh , Kantharia Rajesh Arvind , Kantharia Shehnaz Rajesh , Teli Zahoor Ahmad , Mistry Yogesh Matadin 
Published: April 2021

Objectives:
To analyze the incidence of cervical lymph node metastasis in cT1/T2 buccal mucosa cancers, correlate it with the depth of invasion and study the percentage of occult metastasis. Through this study, we also attempt to look into subsite-specific buccal mucosa data which are lacking in literature and will help us improve the understanding of the disease.

Materials and Methods:
Retrospective analysis of the prospectively collected data of 109 patients with cT1/T2 buccal mucosa cancer operated from January 2018 to August 2019 was done. Information regarding the pathological T stage, depth of invasion, presence or absence of cervical node metastasis, occult metastasis, size of the metastatic lymph nodes, and the presence of extracapsular extension was collected from the final histopathology reports.

Results:
Twenty-five out of 109 (22.94%) patients had cervical node metastasis. Nine out of 93 (9.68%) clinically N0 patients had occult metastasis. No metastasis was observed for the patients with depth of invasion <4 mm. Of these 25 patients, 17 were pathologically staged T2 (68%), whereas 8 were staged T1 (32%). P value obtained by the Fisher's exact test was 0.003 and validated the hypothesis generated by our results.

Conclusion:
Through this study, we can conclude that the possibility of cervical node metastasis in cT1/T2 buccal mucosa cancers with depth of invasion <4 mm is negligible and the percentage of occult metastasis stands low. Our study also reflects the lack of robust data in context to early-stage buccal mucosa cancers and offers an insight on the importance of subsite specific research.
A comparative diffusion tensor imaging study of patients with and without treatment-resistant schizophrenia
Authors: Aggarwal Anisha , Grover Sandeep , Ahuja Chirag , Chakrabarti Subho , Khandelwal Niranjan , Avasthi Ajit 
Published: April 2021

Aim:
The aim was to study the brain connectivity using diffusion tensor imaging (DTI) among patients with treatment-resistant schizophrenia (TRS) and compare the same with a group of patients without TRS.

Methods:
Twenty-three patients with TRS and 15 patients without TRS underwent DTI using a 3T magnetic resonance imaging machine. DTI data were processed with the calculation of fractional anisotropy (FA) and apparent diffusion coefficient. Patients were also assessed on Brief Psychiatric Rating Scale, Positive and Negative Symptom Scale, Global Assessment of Functioning Scale, and Clinical Global Impression severity scale.

Results:
Patients with TRS and non-TRS differed significantly in the FA values in the region of right superior longitudinal fasciculus and right uncinate fasciculus, with more integrity of tracts in the non-TRS group. However, these differences disappeared when Bonferroni correction was used for multiple comparisons.

Conclusion:
The present study suggests lack of significant difference in DTI findings between patients with TRS and non-TRS.
Pain threshold and pain tolerance as a predictor of deliberate self-harm among adolescents and young adults
Authors: Miglani Mitthat , Chavan Bir Singh , Gupta Nitin 
Published: April 2021

Background:
Recently, the assessment of pain has been used as a parameter to differentiate adolescents who indulge in deliberate self-harm from healthy individuals.

Aims and objectives:
The present study was conducted to compare pain sensitivity between three groups, i.e., nonsuicidal self-injury/nonsuicidal self-harm (NSSI), suicide attempters (SA), and matched healthy control (NSSI, SA, and healthy controls).

Materials and Methods:
Ninety participants (30-NSSI, 30-SA, and 30 matched control) between the age of 10 and 25 years were inducted from the individuals who came for help at the outdoor and emergency services for recent self-harm. Pain sensitivity was assessed by cold pain stimulation test through a cold pressor task.

Results:
Pain threshold, pain tolerance, total pain index as well as pain experience intensity were significantly different in the three groups.

Conclusion:
Participants who indulge in NSSI and SA have significantly higher pain threshold, pain tolerance, total pain index, and pain experience intensity as compared to healthy control. Although all the pain parameters were higher in the NSSI group as compared to SA group, the difference did not reach to significant level.
Psychosocial intervention model for migrant workers during extended lockdown
Authors: Chavan B. S. , Arun Priti , Singh Gurvinder Pal 
Published: April 2021

Background:
Human suffering and future uncertainty due to extended lockdown is enormous and this is much more among migrant workers.

Aim:
The aim of this study was to design and utilize a model for psychosocial intervention for migrant workers during the extended lockdown.

Materials and Methods:
In Chandigarh, due to lockdown, 61 migrant workers from various states were lodged in a shelter home at village Maloya, located in the outskirt of Chandigarh. Since no specific model was available to handle the psychosocial issues of this specific population, hence, an attempt was made to prepare a model for psychosocial intervention using Maslow's hierarchy of needs.

Results:
Changes in infrastructure and facilities provided to migrant workers due to implementation of this model for psychosocial intervention helped the participants seeing beyond their problems.

Conclusion:
Psychosocial intervention model based on Maslow's theory was found suitable for migrant workers in shelter home in Chandigarh.
Sexual functioning during the lockdown period in India
Authors: Grover Sandeep , Vaishnav Mrugesh , Tripathi Adarsh , Rao T. S. S. , Avasthi Ajit , Dalal P. K. , Mehra Aseem , Sahoo Swapnajeet , Manohar Shivanand , Chandran Suhas , Kumar Ajay , Sharma Pratheek , Rao Suman S. 
Published: April 2021

Aim:
This study aimed to evaluate the impact of lockdown on sexual functioning in India. In addition, impact of lockdown on relationship with the partner and mental health was evaluated.

Materials and Methods:
An online survey was conducted using changes in sexual functioning questionnaire, Patient Health Questionnaire-4, and a self-designed questionnaire.

Results:
The mean age of the participants was 41.5 (standard deviation: 11.2; range: 22–77; median: 39.5) years, with the majority being males 385 (85.6%). The participants reported that lockdown led to reduction in the frequency of sexual intercourse and also touching the partner (fondling, caressing, touching, or kissing) when not indulging in sexual intercourse. Majority of the participants reported improvement in the overall relationship, communication with the partner, and interpersonal conflicts. About two-fifths of the participants reported engaging in sexual intercourse more than twice a week or more. About one-fifth screened positive for psychiatric morbidity, with 14.2% screened positive for anxiety, 14.8% screened positive for depression and 8.7% screened positive for both. In both genders, presence of depression and anxiety were associated with lower sexual functioning in all the domains.

Conclusion:
Lockdown led to a reduction in the frequency of sexual intercourse, and reduction in the frequency of intimacy in the form of fondling, caressing, touching, or kissing partner when not doing sexual intercourse. However, lockdown led to the improvement in overall relationship and communication with the partners and a reduction in interpersonal conflicts.
Early-onset bipolar disorder, stress, and coping responses of mothers
Authors: Paul M. Sam , Bhattacharjee Dipanjan , Khanande Roshan Vitthalrao , Nizamie Shamsul Haque 
Published: April 2021

Background:
Providing care and nurturance to a child with bipolar disorder (BPAD) is a challenging task for parents, especially mothers. In Indian contexts, mothers are the primary caregivers of ailing children and they have to keep intrafamily situation stable, which makes their role more stressful.

Objectives:
The objective of the study was to assess maternal stress and coping in mothers of adolescents with BPAD.

Materials and Methods:
This study was a comparative one and carried out on sixty mothers of adolescents; of which thirty were adolescents with BPAD, and the remaining thirty were the mothers of normal adolescents. The participants were selected purposively as per the mothers' age and education level, and the socioeconomic status of the families they belong to. Sociodemographic and clinical data sheet, Parenting Stress Index/Short Form (PSI/SF), and Brief COPE were applied on the mothers for data collection.

Results:
Mothers' of the BPAD adolescents reported higher scores in the both PSI/SF and Brief COPE.

Conclusion:
Mothers of the adolescents with BPAD tend to perceive high level of stress and they also use maladaptive coping more in dealing with stressful situations.
Religiosity and Spirituality of patients with severe mental disorders
Authors: Grover Sandeep , Dua Devakshi , Chakrabarti Subho , Avasthi Ajit 
Published: April 2021

Background:
Religion and spirituality form an integral part of life, yet have been poorly studied in patients with mental illness.

Aim:
This study evaluated the religious and spiritual practices, a sense of purpose/connection, religious/spiritual belief and sense of hope/control among clinically stable patients diagnosed with schizophrenia, bipolar disorder, and depression and compared the same with healthy controls. It also aimed to evaluate the association of residual psychopathology with various dimensions of religiosity and spirituality.

Materials and Methods:
Patients diagnosed with schizophrenia, bipolar disorder, and major depressive disorder, in a state of clinical remission were assessed on the Spiritual Attitude Inventory and compared with a healthy control group.

Results:
A total of 284 participants were recruited, which included patients with major depressive disorder (n = 72), bipolar disorder (n = 75), schizophrenia (n = 63), and healthy controls (n = 74). The groups were matched for age and gender. As compared to healthy controls, participants with any severe mental disorder had significantly lower participation in organized religious activities. In terms of existential well-being, all patient groups had significantly lower scores than the healthy control group. Patients with severe mental disorders significantly more frequently used negative religious coping than the healthy controls and also had lower scores on the sense of purpose. No significant difference was observed between the three patient groups on various dimensions of religiosity and spirituality as assessed in the present study. In patients with schizophrenia, higher use of negative religious coping was associated with greater residual psychopathology.

Conclusion:
Considering the association of negative religious coping with residual psychopathology, there is a need to incorporate psychological interventions to address religious and spiritual issues for patients with various severe mental disorders.
Ebola Outbreak amid COVID-19 in the Republic of Guinea: Priorities for Achieving Control
Authors: Aborode Abdullahi Tunde , Tsagkaris Christos , Jain Shubhika , Ahmad Shoaib , Essar Mohammad Yasir , Fajemisin Emmanuel Adebowale , Adanur Irem , Uwishema Olivier 
Published: April 2021

Abstract.In February 2021, a new Ebola outbreak occurred amid the coronavirus disease 2019 (COVID-19) pandemic in the Republic of Guinea. Technical committees and Ebola mitigation mechanisms used during the 2014–2016 Ebola epidemics, have been redeployed by the public health organizations and African health organizations. As the burden on the local healthcare system is rising, fears of socioeconomic disruption are growing as well. Strategies used during the previous epidemic need to be reactivated, and new measures taken during the challenges of COVID-19 are being considered. This perspective discusses the available evidence regarding the epidemic of Ebola in Guinea amid the COVID-19 pandemic, highlights the challenges to be prioritized, and provides evidence-based recommendations.
Effect of Lavender Essential Oil Inhalation on Anxiety Level for Patients Undergoing Closed Magnetic Resonance Imaging
Authors: Dabou Eman A. A. , AbdElazeem Yasmin F. M. , Elshenawie Hend A. E. 
Published: April 2021

Contents: Magnetic resonance imaging (MRI) is one of the medical diagnostic imaging techniques that can provoke or exaggerate anxiety in certain patients. It may sometimes lead to the cancelation of the MRI. The lavender essential oil has a long historical anxiolytic benefit.
Aim: This study aimed to examine the effect of lavender essential oil inhalation with a massage on anxiety level for patients undergoing closed magnetic resonance imaging.
Methods: A quasi-experimental research (study/control group) was used to achieve the aim of this study. The study conducted at Magnetic Resonance Imaging Unit in Main University Hospital, Alexandria, Egypt. A convenient sample of 100 patients divided into the study and control group (50 patients for each). Two tools were used in the present study. Those were structured interview questionnaire that elicited the patients' sociodemographic characteristics, and State-Trait Anxiety Inventory to identify the patients' anxiety levels.
Results: There were no statistically significant differences between both groups concerning the anxiety level before the MRI procedure (χ2=2.041, P = 0.495). While there were statistically significant differences between both groups concerning anxiety level post-MRI procedure and after receiving of interventions (χ2 =35.135, P=0.000), there was a highly statistically significant difference between anxiety level before and after receiving intervention in study group patients (t= 77.059, P=0.000).
Conclusion: Patients undergoing a closed magnetic resonance imaging who inhaled and massaged their hands with Lavender essential oil exhibited a reduced level of anxiety compared to the control group and compared to their preintervention level. The study recommended using the lavender essential oil, which is an inexpensive and noninvasive intervention in reducing MRI anxiety or other anxiety-producing procedures.
FACTORS ASSOCIATED WITH PSYCHOLOGICAL OUTCOMES OF HEALTHCARE WORKERS DURING THE COVID-19 PANDEMIC AND ITS EFFECTS ON QUALITY OF LIFE
Authors: Shalaby Mrs. Hanin , Baroom Nora , Obaid Rawan , Raboe Enaam 
Published: April 2021

Purpose: This study aimed at assessing the factors associated with psychological outcomes among HCWs in Saudi Arabia (SA) during the pandemic. It also aims to determine the factors affecting their QoL.
Methodology: In this descriptive cross-sectional study, all HCWs who are working in direct and indirect contact with COVID-19 cases in tertiary hospitals of SA were invited voluntarily to complete the validated web-based survey during the study period. A total of 1,182 HCWs from different regions across SA and different specialties including physicians, nurses, pharmacists, health educators, technicians, and others responded to this study between the 1st of June and the 31st of July 2020. Psychological risk factors were evaluated using Patient Health Questionnaire depression scale; and the Generalized Anxiety Disorder (GAD-7) anxiety scale. QoL was assessed using the World Health Organization Quality of Life Questionnaire (WHOQOL). Socio-demographic data were summarized with frequency and percentages. The overall anxiety, depression, WHOQOL scores of the study participants were calculated according to mean value, SD, and median. The association between socio-demographic factors and anxiety, depression scales were examined using independent samples t-tests, one-way ANOVA, and the chi-square test (for categorical depression/ anxiety variables severe depression/severe anxiety against mild/moderate/moderately severe). While those factors and WHOQOL domains were examined using one-way ANOVA. Multivariate analysis was used to identify the front-line work predictors of depression and anxiety.
Findings: Poor QoL scores were observed, especially in the physical and psychological health domains. In general, low QoL was significantly higher among workers who reported higher levels of anxiety and depression. The observed factors affecting the psychological health and QoL were age, gender, living with children and/or older people, occupation, years of experience, participation in front-line work.
Unique contribution to theory, practice and policy: Specific characteristics of HCWs may act as protective or risk factors with regard to depression, anxiety, and QoL. Targeted interventions could mitigate the negative effects of front-line work to maintain medical professionals’ optimal psychological and physical health .More research is needed to further determine how the COVID-19 pandemic and front-line work affect HCWs' mental and physical well-being
Obstructive Sleep Apnea High-Risk Prevalence, Symptoms and Sleepiness among Patients with Uncontrolled Type 2 Diabetes Mellitus Seen at the Out-Patient Department of Philippine General Hospital
Authors: De Leon Maria Lowella F. , Alibutod Nina R. , Jorge II Manuel Peter Paul C. 
Published: April 2021

Objectives. We determined the prevalence of patients at risk for obstructive sleep apnea (OSA) with uncontrolled type 2 diabetes mellitus (T2DM) at the out-patient department (OPD) of the University of the Philippines-Philippine General Hospital (UP-PGH) from December 1, 2018 - February 28, 2019. We described the demographic characteristics of patients with uncontrolled T2DM and compared them with high and low OSA risk, its association, and correlation with the quality of sleep.
Methods. This is a prospective cross-sectional study among uncontrolled T2DM. The questionnaires were Berlin Questionnaire (screen OSA-HR) and Epworth Sleepiness Score (level of sleepiness). Clinicodemographic profile and significant laboratory data were obtained. Descriptive statistics utilized. Chi-square test was used to compare categorical variables between patients with high vs low OSA risk and to determine if an association exists between OSA-HR and sleep quality.
Results. A total of 240 participants, 88 males and 151 females, were included in the study. The overall prevalence of OSA-HR among patients with uncontrolled type 2DM is 58.33%. The majority of the OSA–HR patients (105 /140) was 46 years old and above. There is a significant association of tonsillar grade, Mallampati score, BMI, HbA1c, hypercholesterolonemia, and Epworth sleepiness on OSA High risk. There is also a substantial association with age, BMI, Mallampati score, tonsillar grade, hypertension, asthma, HbA1c, and hypercholesterelonemia on the level of sleepiness of OSA-HR.
Conclusion. There is a high prevalence of high OSA-risk among patients with uncontrolled DM. Factors associated with high OSA-risk among uncontrolled diabetes mellitus include HbA1c, dyslipidemia, BMI, Mallampati score, tonsillar grade, and Epworth score.