bluuebunny/crossref_metadata_2025_split huggingface dataset:
Public knowledge, attitudes, and practices toward COVID-19
Authors: Gupta Chandani , Gupta Riya , Kumari Rashmi , Gupta Rajiv Kumar , Bhagat Preeti , Mir Mehak T , Nazir Heena , Raina Sunil Kumar 
Published: April 2021

Background:
COVID-19, since its emergence, has become a global health problem with countries adopting unprecedented measures to control the spread of this pandemic. Adherence of the populations to control measures is affected by their knowledge, attitude, and practices (KAP) towards the disease. It was with this aim that the present study was conducted among the residents of UT of J&K to assess their KAP toward COVID-19.

Methodology:
A cross-sectional online survey of 464 J&K residents was conducted between 1st May and 10th May 2020. Survey Monkey tool was used to develop a link and KAP questionnaire was used for data collection. The survey instrument consisted of demographic characteristics, 11 items on knowledge, 5 items on attitudes, and 7 items on practices. Data collected was represented in descriptive statistics, and one-way analysis of variance was the test of significance.

Results:
Mean knowledge, attitude, and practice scores were 7.69 ± 0.74, 4.70 ± 0.57, and 4.32 ± 0.68, respectively, among the respondents. Majority (99%) knew the sign and symptoms, mode of transmission of the disease and avoided attending large gatherings. Use of mask was almost universal and about 38% were taking supplements like vitamins or herbal medicines. Good knowledge, positive attitude, and appropriate practices among the respondents about COVID-19 suggest that community based health education programs play a key role in containment and mitigation of this disease.

Conclusion:
Sustained messaging and updates from the national and local health authorities on COVID-19 to the public are likely to help control the transmission of the disease.
Impact of nutritional education in malnourished elderly patients with the comparison of Mini nutritional assessment (MNA) score
Authors: Karthikeyan Megha S. , Vijaykumar Priya , Chandana Linqalla , Paul Alex Baby 
Published: April 2021

Introduction:
Prevalnce of malnutrition is high in the elderly. Very few studies exists mentioning the prevalnce of malmutrtion in elderly. In india around 7.7% of the total population belong to elderly age group and in kerala older adults constitute 13% of its population. The health of the elderly contributes to the health status of the population. Malnutrition is commonly seen in elders. There are multiple factors contributing to malnutrtion in this age group.

Material and Methods:
A sample of 30 patients, 60 years and above fulfilling the inclusion criteria are enrolled in the study. Malnutrition was assessed by MNA score. The score ranges from 0 to 30 points. The score above 24 show patient that are healthy with no nutritional problem, scores within range 17-23.5 indicate patients vulnerable to malnutrition and score below 17 as malnourished. MNA scoring was repeated after 3 months giving the dietary education.

Results:
29 patients were found to be at risk of malnutrition and 1 patient was found to be malnourished After 3 months of dietary intervention, 23 attained normal.

Conclusion:
MNA is a very accurate and effective tool for identifying malnutrition in elderly. Nutrition is an important area that need to be addressed in elder population.
Pattern of Tobacco consumption among urban slum population in Jammu region
Authors: Choudhary Neha , Sangra Sonika 
Published: April 2021

Introduction:
Consumption of tobacco leads to a myriad of ill effects among the smokers as well as those in their proximity. The study related to tobacco consumption was conducted among individuals over 15 years of age, residing in urban slums.

Objective:
To assess the pattern of tobacco consumption in urban slum population, using WHO standardized questionnaire which is Global Tobacco Surveillance System (GTSS); questions related to tobacco from the surveys, which are the subset of GATS 2nd Edition key questions.

Materials and Methods:
The present study was observational cross-sectional in nature which was conducted over a period of 6 months i.e., from September 2019 to February 2020 in urban slums of Trikuta Nagar, urban health training centre which is a field practice area of Postgraduate Department of Community Medicine, GMC Jammu. The information about the tobacco consumption was gathered by interview sessions after taking consent from all the participants. Totally, 718 individuals were met, out of which, 539 were over 15 years of age and 510 agreed to participate in the study.

Results:
36% (maximum) belonged to 36-45 year age group and lowest (3%) among individuals >66 years. 48% prevalence of active smoking; maximum indulgence (53%) observed in 36-55 year group. Highest exposure to passive smoking seen in 56-65 year group (75%). 45% prevalence of smokeless tobacco consumption, highest in 56-65 year group (72%), lowest in 15-25 year age group (17%).

Conclusion:
Regular conducting of IEC activities for generating awareness with the strict implementation of tobacco control measures by the government needs to be carried out as urban slum population is a vulnerable group and most susceptible to the vicious cycle of disease and poverty.
Impact of structured educational interventions on the prevention of pressure ulcers in immobile orthopedic patients in India
Authors: Kathirvel Soundappan , Kaur Sukhpal , Dhillon Mandeep Singh , Singh Amarjeet 
Published: April 2021

Background:
Pressure ulcer (PU) is one of the common, neglected and avoidable complications among bedridden patients. Despite the potential to reduce PU incidence, the evidence on the effect of patient/caregiver education is low. This pragmatic randomized controlled trial (CTRI/2011/07/001862) compared the impact of two structured educational interventions to patients and caregivers on prevention of PU in immobile orthopaedic patients.

Methodology:
Ninety-two orthopedically immobile patients (Braden score ≤12 or stage I PU) and their caregivers were (block) randomized into two equal groups. One group was offered Prevention Package 1 (PP1), i.e., self-instruction manual (SIM), one to one training and counselling on PU care practices. The second group (PP2) was given SIM only. Patients were followed equally at the hospital and home after discharge. Intention to treat analysis was conducted.

Results:
The cumulative incidence of PU was 8.7% in PP1 and 21.7% in PP2 for the entire study period. PU incidence rate in PP1 and PP2 was 0.9 and 2.41 per 1000 person-days, respectively. Incidence rate ratio was 2.67 (95% CI: 0.89, 8.02, p-0.04). The Kaplan-Meier survival curves of PP1 and PP2 were statistically significantly different (p-0.043). PP1 also showed statistically significant improvement in knowledge on the prevention and management of PU compared to PP2 at post-intervention (p < 0.001).

Conclusion:
Individualized, structured education of patients and caregiver is effective in improving the knowledge and preventing the PU in immobile orthopaedic patients. A comprehensive approach involving hospital administrators, health care professionals, patients and caregivers may be further researched upon for a sustainable reduction in PU.
Determinants of smoking cessation counseling favorable practice for primary care physicians
Authors: Maraqa Beesan , Nazzal Zaher , Jabareen Jurouh , Al-Shakhrah Kamal 
Published: April 2021

Background:
Smoking cessation counseling is not well established in Middle East countries including Palestine. This study assesses the practice of smoking cessation counseling among primary healthcare (PHC) physicians in Palestine and its determinants.

Methods:
Over the period from April to September 2019, general practitioners, family medicine physicians, obstetricians and gynecologists, and dentists working at the PHC Centers in Palestine were approached through a cross-sectional design using a self-reported questionnaire. Proportionate stratified random sampling approach has been used. Sociodemographic, medical background, smoking cessation counseling training, smoking history, practice, knowledge, attitude, and confidence were evaluated. The proportion of favorable practice has been determined and its relationship with all variables has been evaluated. Ethical approval was received from the National University of An-Najah.

Results:
295 physicians were enrolled in the study with an 86% response rate. 75.5% (n = 222) were males with a mean age of 39.9 ± 9 years. The majority were General Practitioners (76.5%, n = 252). Most of them (84.3%, n = 215) had not received any training. The favorable practice was seen in 36.6% (95% CI 31–41%). Attitude is the main predictor of favorable practice (P value = 0.002, adjusted OR = 1.1).

Conclusion:
Palestinian PHC physicians have a low level of counseling for smoking cessation. Given the efficacy of counseling for smoking cessation and the high level of the tobacco epidemic in the area, health policy to ensure all healthcare personnel-especially physicians-receive training in cessation counseling and call for a public health campaign for control of tobacco should be taken into account.
Changing trend in the pattern of ocular diseases in patients attending ophthalmology department of a teaching institute in North India during COVID-19 pandemic
Authors: Kauser Hina , Khan Taskin 
Published: April 2021

Purpose:
The objective of this study is to report the changing trend in ocular diseases during COVID-19 pandemic.

Methods:
A retrospective review of patients attending the ophthalmology department of a teaching institute was conducted. We studied the 3 months of the COVID period from April 2020 to June 2020. For comparison, we took the corresponding period of April 2019 to June 2019. Data were collected from the medical record section of the Hospital.

Results:
Overall, 876 patients presented during the 2020 period compared to 7,242 patients in the 2019 period. Percentage of female patients decreased from 53.1% to 49.1% in the 2020 period (P = 0.0251). There is significant decrease in pediatric group in the 2020 period (P < 0.0001). In the 2019 period, refractive errors was the most common (57.6%) followed by cataract (12.29%), allergic conjunctivitis (3.82%), diabetic retinopathy (3.37%). While in the 2020 period refractive errors, constitute 22.37%, followed by allergic conjunctivitis (8.56%), scleritis/episcleritis (7.19%), dry eyes (7.08%), infective conjunctivitis 6.85%), anterior uveitis (6.74%). In the 2020 period, there was significant decrease (P < 0.00001) in the percentage of refractive errors, cataract and diabetic retinopathy, and significant increase in painful symptomatic conditions. The features of ocular trauma in the two study periods were also quite different.

Conclusion:
There is significant decrease in patients of curable/avoidable blindness. We should be ready for the increase burden of curable/avoidable blindness and should plan various strategies to overcome the potential backlog of blindness.
Rare but not Abdicated
Authors: Rathaur Vyas K. , V. Vigneshwar N. K. , Imran Ayesha , Pathania Monika , Agrawal Sonam , Chacham Swathi , Verma Prashant K. , Bhat Nowneet K. 
Published: April 2021

Background:
Haemophilia is one of the bleeding disorders, which is inherited, in an xlinked recessive pattern. The diagnosis is by estimation of factor levels of 8 and 9. Timebound treatment for people living with Haemophilia (PWH) is factor replacement during bleeding manifestation. The prevalence of Haemophilia was mostly underestimated, and it is more so in hilly terrains like the state of Uttarakhand.

Materials and Method:
This is a crosssectional study by compiling the data of PWH visiting the tertiary care centre for Haemophilia in Uttarakhand. We collected data from the patients with bleeding disorder reporting to the Haemophilia centre from July 2017 to December 2018. In this manuscript, we try to describe the pattern of Haemophilia and the degree of severity and incidence of inhibitors among the sample population of PWH who represent the population of Uttarakhand. The magnitude of problems faced by PWH from this hilly terrain to assess basic treatment in case of emergency is also being depicted.

Result:
We reported Haemophilia A contributing about 80% of the PWH in our centre. Average distance a PWH has to travel to obtain treatment was about 131.5 km (SD ± 83.7 km). Incidence of inhibitors was about 5%.

Conclusion:
We infer from our study that Hemophilia A is more common than Hemophilia B. Through this manuscript we hope to spread awareness of the Haemophilia care that is ongoing, the role of prophylaxis therapy and the future role of primary care physicians that may change the care of PWH in future.
A qualitative study on attitude towards smoking, quitting and tobacco control policies among current smokers of different socio-economic status
Authors: Chellappa Lalitha Rani , Balasubramaniam Arthi , Indiran Meignana Arumugham , Rathinavelu Pradeep Kumar 
Published: April 2021

Introduction:
Tobacco consumed as smoke and smokeless forms is an important preventable public health issue projected to be the single largest cause of mortality worldwide. The aim of the study was to qualitatively assess the attitudes towards smoking, quitting and tobacco control policies among current smokers of different socio-economic status.

Materials and Methods:
An in-depth interview for 10 current smokers and a focus group discussion comprising of 10 current smokers was conducted with a guide and moderator which was audio recorded. About 6, 8 and 6 subjects from white collar, blue collar, and black collar employee status participated in the study. Their tobacco consumption and dependence using the Fagerstrom Test for Nicotine Dependence scale (FTNDS) was assessed.

Results:
About 50% of the participants had low; 30% had moderate and 20% had high nicotine dependency. Most of the participants started smoking by peer influence and continued as it made them to socialize. Relapses during their quit attempt was mainly due to work stress. Participants heard about the control of tobacco act but were unsure of the features in it. They perceived that no changes will happen if government bans production and selling of tobacco products. Also anti-tobacco commercials in social media will have no use. Nicotine replacement therapy may help in quitting the habit.

Conclusion:
The study concluded that people in low socio-economic status had high nicotine dependency with inadequate knowledge on tobacco control policies. They strongly believe that an individual's self-restrain only can succeed him in quitting the habit.
Assessment of knowledge, attitude, and practice of child abuse amongst health care professionals working in tertiary care hospitals of Karachi, Pakistan
Authors: Nihan Khuld , Makda Aamir , Salat Huzaifah , Khursheed Munawar , Fayyaz Jabeen , Khan Uzma Rahim 
Published: April 2021

Introduction:
UNICEF report (2004) states that a significant percentage of total child population under the age of 5 years suffered malnutrition. Child sexual abuse remains undiscussed across Pakistan. Health care professionals (HCPs) are usually the first notifiers of child abuse and are ethically obliged to manage and report it.

Objective:
This study was conducted to assess HCPs' response in dealing with patients of child abuse. With a better understanding, we can have a better outcome for the victims.

Methods:
A total of 101 participants filled out a structured questionnaire by HCPs working in three tertiary hospitals of Karachi i.e., Aga Khan University, National Institute of Child Health (NICH), and Civil Hospital. Data were entered into SPSS 19.0.

Results:
HCPs believed that young male relatives were thought to be most likely the offender, and that every child regardless of class is prone to get abused triggered by financial stressors and the absence of parents. Proper physical exams helped identify cases. A proper system of reporting was required in hospitals, but HCPs were reluctant to report the cases to authorities. There was a significant difference noted between public and private hospitals.

Conclusion:
Our findings indicate that HCPs have limited knowledge in defining various types of abuse and most were unaware of any reporting facility in hospitals. Senior HCPs as consultants have a better understanding of child abuse than nurses or interns. Mandatory reporting should be implicated so that prompt action could be taken. There could be a more successful outcome of managing a child abuse victim with proper training.
Prevalence of erectile dysfunction and associated factors among males visiting family medicine clinics in a Tertiary Care Hospital in Karachi, Pakistan
Authors: Saeed Rabeeya , Amin Faridah , Durrani Noureen , Ali. Saif Syed M. , Zafar Muhammad Talha 
Published: April 2021

Background:
The burden of erectile dysfunction (ED) among the developed countries is found to be quite high. However, there is a paucity of data among developing countries to know its actual burden and factors associated with it.

Methods:
The current study is cross-sectional and was conducted in Family Medicine clinics of Liaquat National Hospital during May 2017–January 2018. A total of 450 males participated in this study with the age range of 24–77 years. More than half of the participants were graduates or above.

Results:
On multivariable analysis, age (aOR = 5.47, 95% CI: 2.74–10.89), alcohol use (aOR = 5.23, 95% CI: 1.45–18.84), diabetes (aOR = 6.61, 95% CI: 3.27–13.36), and current smoking (OR = 2.41, 95% CI: 1.35–4.31) were significantly associated with ED. ED risk was significantly lower in those who either attended secondary school (aOR = 0.33, 95% CI: 0.13–0.88) or were at least graduates (aOR = 0.40, 95% CI: 0.17–0.96) than illiterate when model was adjusted for other covariates.

Conclusion:
Erectile dysfunction in a Pakistani male population highlights the need for routine screening at the primary care level. There is a possibility that the actual burden is underreported due to cultural stigmatization; hence, further research is warranted to validate the findings.
Impact of the COVID-19 pandemic on rural obstetrics practices in New Mexico
Authors: Sells Colleen E. , Maes Aurora M. , Fleddermann Rachel A. , Otero-Bell Eliana L , Hartley Rebecca S. 
Published: April 2021

Context:
During pregnancy, the immune system is altered, putting women at increased risk of complications from respiratory viruses. There is limited information about the effects of COVID-19 on pregnant women and obstetrics programs, particularly in rural regions.

Aims:
Most published reports have been from large urban hospitals. This study sought to gain insight into how the COVID-19 pandemic is impacting rural obstetrics programs.

Materials and Methods:
This qualitative study surveyed participants who worked in rural obstetrics programs in New Mexico using a free response questionnaire.

Results:
The pandemic has changed the obstetrics experience in rural New Mexico by impacting the relationship between patients and providers and altering the family-centered model of birth. Difficulties unique to rural obstetrics included lack of transportation, limited hospital rooms and limited staff, including OB providers, nurses and housekeeping. Wellness has been impacted for providers, manifested in increased anxiety, stress and burnout. Patients reported increased anxiety, decreased family support, and potential disruptions in maternal-infant bonding.

Conclusions:
Rural hospitals and clinics in New Mexico and across the United States operate with challenges at baseline, with many clinics across the nation closing, leading to increasing shortages of healthcare services in rural areas. This study showed that COVID-19 has increased the challenges that rural obstetrics providers face, altering the way they practice and creating uncertainty for the future due to potentially permanent changes to their practice. Future research will explore the lasting effects of the pandemic on rural obstetrics providers specifically, and rural hospitals generally.
A prospective cohort study of patients presenting to the emergency department with upper gastrointestinal bleeding
Authors: Shenoy Vrinda , Shah Sarina , Kumar Sathish , David Deepu , Gunasekaran Karthik , G Priya , Selvaraj Bagyalakshmi , Prabhakar Abhilash Kundavaram Paul 
Published: April 2021

Background:
Upper gastrointestinal (UGI) bleeding is a common presentation to the Emergency Department (ED), and is associated with re-bleeding and significant mortality. Although several studies have described etiology and outcome of UGI bleeding, few have been done in the EDs.

Materials and Methods:
This prospective observational cohort study included all patients presenting with hematemesis or melena, between June 2016 and January 2017 to the ED. Demographic data, risk factors, endoscopy findings and prognosticating scores were noted. Patients were followed up through telephonic communication after 3 months to assess re-bleeding rate and mortality.

Results:
The study cohort included 210 patients with a male predominance (76.2%). The mean (SD) age was 51 (16.8) years. They presented with either hematemesis (33.8%), melena (28.6%), or both (37.6%). One third (35.7%) had variceal bleed, 21% had peptic ulcer disease (PUD), and 43.3%bled due to other etiology. UGI scopy was performed in 85.2% of patients with banding (25.1%) and sclerotherapy (14%) being the most frequently performed procedures. Endoscopic intervention was not required in 58.6%of patients. Packed red cells were transfused in 46.7% patients. The 48-h re-bleed rate among variceal bleeders was 5.3% and 11.4% among peptic ulcer bleeders. The 3-month re-bleeding rate was 42.9% and the 3-month mortality rate was 17.5% among the variceal bleeders and the same was 5.6% and 2.8%, respectively, among the peptic ulcer bleeders. The overall mortality was 12.4%.

Conclusions:
Variceal bleeding and PUD were the predominant causes of UGI bleeding. Overall, a quarter of our patients had a re-bleed within 3 months, with majority being variceal bleeds.
Effects of nationwide COVID-19 lockdown on lifestyle and diet
Authors: Singh Birgurman , Jain Srishti , Rastogi Ashu 
Published: April 2021

Aims, Settings, and Design:
The COVID-19 pandemic has forced upon sudden lifestyle changes because of nationwide lockdowns mandating isolation at home, affecting daily habits and lifestyle changes. The present study was conducted with an aim to assess these changes brought about because of COVID-19 lockdown restrictions.

Methods:
The web-survey aimed to understand the immediate impact of the COVID-19 lockdown on people by using a structured questionnaire collecting demographic, lifestyle, and dietary information. The survey was disseminated online among the literate, urban, adult population with internet access.

Results:
Of the 1,200 people who received the survey, a total of 1,008 respondents participated in the study, aged between 18 and 81 years (Median- 24). An increase in daily screen time has been observed in 56.7% of the population. A decrease in work-related stress was observed in 43% of the population, sleep pattern improved in 36.7% people, and 27.1% of the inactive population showed increased physical activity. A significant decrease in the proportion of people consuming junk food (73.8%), alcohol (27.6%), and smoking (8.1%) was observed.

Conclusions:
The present web-based survey study suggests a significant change in the lifestyle and dietary patterns of people brought about because of the COVID-19 lockdown most highly seen as a major increase in screen usage and a decrease in junk food consumption.