bluuebunny/crossref_metadata_2025_split huggingface dataset:
Drug Effects on the Nervous System: Mechanisms and Future Directions in Neuropharmacological Therapy
Authors: Mishra Vaishnavi H , Khade Ajay , Noman Obaid 
Published: November 2024

Abstract
Neuropharmacology explores how drugs influence the nervous system and their potential in treating neurological and psychiatric disorders. This review provides a comprehensive overview of the mechanisms through which various drugs impact neural processes and their therapeutic applications. It covers major drug classes, including antipsychotics, antidepressants, anxiolytics and neuroprotective agents, highlighting their modes of action, efficacy and limitations. Advances in drug development, such as targeted therapies and novel compounds, are discussed about their potential to improve the treatment outcomes for disorders such as schizophrenia, depression, anxiety and neurodegenerative diseases. Understanding these mechanisms is crucial for developing more effective and safer treatments.
Prevalence of Tobacco Use and the Attitude towards Quitting Tobacco Habit amongst Hamals in Navi Mumbai, India – A Cross-sectional Study
Authors: Sharma Aakash , Murthy Naveen Narasimha , Jogi Naval Kant , Singh Jagdish , Dubey Rishee , Tiwari Shraddha 
Published: November 2024

Abstract

Introduction:
As per the World Health Organisation, tobacco tends to be the growing global cause of death (4.9 million people a year) worldwide and also is associated with many fatal diseases. The objective of the study is to determine the prevalence of tobacco use amongst the study group and also to evaluate their attitude towards quitting tobacco habit.

Materials and Methods:
A self-designed structured questionnaire was used by the single-trained examiner for interviewing the participants. Three hundred and six (298 males and 8 females) hamal workers of Navi Mumbai were surveyed after ethical approval by the institution. Data were collected through face-to-face interviews. Data obtained were analysed using the SPSS software version 16 (SPSS < 0.005 considered Inc. Chicago, IL, USA). Descriptive statistics were calculated with P as significant.

Results:
Out of 306 hamals, 245 (80.01%) were using tobacco amongst which 210 (85.7%) consumed on a daily basis and 23 were past tobacco users that is only 7.5% were able to quit. Out of the 268 present and past tobacco users, 134 (50%) tried to quit of which 111 (85%) were unsuccessful and 23 (15%) were successful. 82.5% of current tobacco users expressed a desire to quit but needed help.

Conclusion:
A high prevalence of tobacco consumption was seen amongst the surveyed hamals and most of them need help to quit the habit. Employers, trade associations and worker representatives can work in partnership with their state and local health departments in implementing evidence-based policies and programmes to reduce the prevalence of tobacco use amongst these working population.
Effects of aerobic training on brain architecture, hippocampal volume, cardiorespiratory parameters, and health-related quality of life among patients with schizophrenia: A systematic review
Authors: Sharma Abhishek , Sharma Nidhi , Singh Rahul K. , Chahal Aksh 
Published: November 2024

Background:
Schizophrenia is considered to be a condition that usually manifests at any age but commonly seen in young people and is associated with a genetic propensity in brain development.

Aim:
The study explores the impact of aerobic training on brain architecture, hippocampal volume, cardiorespiratory parameters, and quality of life in young individuals with schizophrenia. The investigation focuses on the correlation between genetic predisposition, hippocampal atrophy, and diminished cardiorespiratory fitness, aiming to discern potential benefits of aerobic exercise on both physical and mental health outcomes.

Methods:
A systematic search was conducted in major online databases, such as Cochrane, Embase, PEDro, Web of science and PubMed (Medline). Two authors independently evaluated possibilities of bias, retrieved data and decided which trials should be included in the analysis. Total of 13 published articles (randomized clinical and controlled trials) with 656 patients was included from January 2010 to December 2020.

Results:
Following aerobic exercise training, people with schizophrenia presented with an increased hippocampus volume and enhanced cardiorespiratory endurance (P ˂0.05). Due to a lack of information, we rated the majority of the studies’ risk of bias in relation to random sequence creation, allocation concealment, and selective reporting as uncertain.

Conclusion:
Findings from the present review propose aerobic exercise program as a meaningful therapeutic intervention for schizophrenia patients in terms of maintaining appropriate brain architecture, increasing the hippocampal volume, improving cardiorespiratory parameters and health related quality of life.
Systems delay in women with breast cancer – A sequential explanatory mixed-methods study from central rural India
Authors: Raut Juhi , Joshi Abhishek , Mudey Abhay 
Published: November 2024

ABSTRACT

Background:
Globally, breast cancer is the most common malignant tumor in both developed and developing nations, with an incidence of 2 million cases every year and around 6 lakh deaths. Even after the availability of healthcare facilities, delays in the management of breast cancer are seen in both developed and developing countries.

Objectives:
To assess the patient and system-level delays and to determine the factors that cause the identified delays in women with breast cancer from central rural India.

Methodology:
The present Mixed-method study was conducted in a tertiary care hospital in central rural India among 128 female breast cancer patients. Socio-demographic and clinical information of the patients was summarized using frequency and proportions. Delays were reported using a median number of days and interquartile range. To assess the factors associated with the delays, we used Negative log-binomial regression analysis. Qualitative data analysis was done by manual thematic analysis.

Results:
The mean age of the study participants was 50.54, SD was 10.46, Median was 50, and the Interquartile range (IQR) was 43-58 years. A median patient delay of 45 days, and IQR was 15-120. A median system delay of 19 days and IQR was 7-35 days. We identified seven themes addressing the factors influencing delays at various levels by thematic analysis. Negative log-binomial regression models were built for the association of the socio- demographic and clinical variables with patient and system delays.

Conclusion:
Our study concludes that there is a substantial delay at patient level reporting to healthcare care providers, which needs an increase in awareness levels in the community through dedicated Behavior Change Communication strategies along with addressing identified socio-cultural and economic determinants influencing delay at various levels.
Academic performance of pediatric epileptic patients at King Abdulaziz University Hospital
Authors: Muthaffar Osama Y. , Bakheet Hadeel , AlKhoshi Abdulaziz , Alsaiari Maha , Algarni Saher , Shaheen Abdulaziz , Zuhairy Abdullah 
Published: November 2024

ABSTRACT

Background:
Epilepsy is a prevalent neurological condition affecting children worldwide, with a particularly high incidence in Saudi Arabia. Children with epilepsy can experience poor school performance due to cognitive deficits and frequent absences. This study investigates the impact of seizures on school attendance among children with epilepsy.

Methods:
This cross-sectional study was conducted at King Abdulaziz University Hospital (KAUH) in Jeddah, Saudi Arabia, including pediatric epilepsy patients from 2016 to 2022. Data were collected via an online questionnaire and analyzed using IBM SPSS. Factors examined included seizure frequency, medication use, comorbidities, teacher awareness, and absenteeism.

Results:
The study included 207 pediatric epilepsy patients, predominantly Saudi nationals (87%). Most parents had higher education backgrounds (70%). Participants’ mean age was 9.66 years, with 57% diagnosed before the age of 5. Most (45%) patients took daily medication with 57% experiencing no side effects. Over half (56%) of the population reported focus and memory problems, significantly related to age at diagnosis (P < 0.001). Comorbidities were reported by 35%, with a significant relationship to absenteeism (P < 0.01). Teacher awareness was reported in 58% of cases. Regarding absenteeism, over half (57%) were absent fewer than 10 days during the past academic year, with 41% attributing absenteeism to non-seizure reasons. Seizure attacks at home caused 22% of absences. A significant relationship existed between the etiology of absenteeism and seizures (P < 0.001). Bullying at school due to seizures was reported, with a significant relationship to absenteeism (P = 0.02).

Conclusion:
This study highlights the complex relationship between epilepsy, school attendance, and associated factors among pediatric patients in Saudi Arabia, shedding light on the importance of poor academic experience to improve the quality of life for children with epilepsy.
Investigating emergency rescue readiness on Indian national highways: A case study of Jaipur-Jodhpur Highways (India) using a geospatial approach
Authors: Dandabathula Giribabu , Roy Subham , Ghosh Koushik , Chadha Ishani , Rathore Sejal , Kumar Gaurav , Joshi Nitin K. , Bhardwaj Pankaj , Bera Apurba Kumar , Srivastav Sushil K. , Raikwar Madhu 
Published: November 2024

ABSTRACT

Background:
Highways represent the most significant capital asset that any country’s public sector holds. A system of national highways with easy access to ambulance and trauma centers is termed emergency rescue ready and helps reduce the mortality due to road accidents. Given the rich impetus for road infrastructure development by the government of India, there is a need to consider emergency rescue readiness on highways. Previous research suggests that on typical Indian highways, an ambulance can reach the accident scene within 30 minutes; the remaining 30 minutes of golden hour is essential for saving the life of the injured by admitting to a healthcare facility with a trauma unit.

Objective:
To investigate the emergency rescue readiness for a stretch of highway between two cities in India. The main objective is to determine the possibility of transporting the injured due to the accident on the highway to the nearest available trauma center within 30 minutes.

Methods:
A Geographic Information System (GIS)-based network analysis method has been adopted to find the possibility of transporting the injured anywhere on the circuit of a national highway to the nearest healthcare unit within 30 minutes.

Results:
A map representing the status of emergency rescue readiness has been presented for the study area. For a circuit of national highway with a length of 805 km, in a stretch of 89.5% (718.5 km), the injured can be transported to the healthcare unit within 30 minutes. In the remaining 10.5% of the highway, the healthcare units are significantly far from the highways and may hamper the post-crash rescue operations.

Conclusion:
There exists a wide disparity in trauma care delivery in the study area. Currently, the healthcare units established to serve the areas with dense populations also serve as emergency rescues during accidents on the national highways. Using GIS techniques for highway stretches with difficulty reaching the trauma centers, a national-level assessment is highly recommended.
Determinants of malnutrition among adolescent females of age 15–19 years in an urban slum of Raipur city
Authors: Das Sakthi , Shukla Arvind Kumar , Galhotra Abhiruchi 
Published: November 2024

ABSTRACT

Context:
Adolescent girls suffer the brunt of malnutrition due to increased nutritional needs to facilitate rapid growth spurt including menstruation and increased physical activity. This vulnerable group has low social power and is subjected to peer and social pressures related to body image and weight. All these factors along with the sociocultural milieu may lead to a spectrum of nutritional problems in them.

Aims:
To determine factors associated with malnourishment among adolescent females of age 15–19 years in an urban slum of Raipur City.

Settings and Design:
The study setting was the urban field practice area of the institute in Raipur. The study was an analytical cross-sectional study done from January 2022 to June 2023 among 401 adolescent girls of age 15–19 years.

Methods and Material:
The sampling was done using the consecutive sampling method. The study tools used were a semi-structured questionnaire on sociodemographic variables and details of the respondents, anthropometric measurements, dietary assessment using the 24-hour food recall method, and food consumption patterns using a food frequency questionnaire.

Statistical Analysis Used:
The Chi-square test of significance was applied to find the association between malnourishment with the input variables. For calculating the strength of the association, the odds ratio was estimated for those variables with P value < 0.2 in the Chi-square test, and later the odds ratio was adjusted for confounding with the same variables, using multivariable logistic regression.

Results:
According to BMI-for-age Z scores, 2% were severely thin (< −3 SD), 9.7% were thin (−3 to − 2 SD), 5% were overweight (1 to 2 SD), and 1.5% were obese (>2SD). While measuring the height-for-age Z scores, 5.5% had severe stunting and 21.9% had moderate stunting. Those respondents with educational status of high school or below [AOR 3.5 (1.8–6.8), P < 0.001] and those who did not consume a non-vegetarian diet [AOR 2.1 (1.1–4.1), P = 0.02] had significantly higher adjusted odds of being undernourished (severely thin or thin) as compared to those with educational status above high school and those who consumed a mixed diet, respectively. The respondents who are currently not going to school/college had significantly higher adjusted odds [AOR 2.2 (1.2–3.8), P = 0.007] of being stunted when compared to those who are attending school/college.

Conclusions:
The significant levels of malnutrition observed in this study among late adolescent girls aged 15–19 years—11.7% undernourishment, 6.5% overnourishment, and 27.4% stunting—highlight the concerning vulnerability of this population. The higher prevalence of stunting throws light onto the chronicity of malnutrition. As seen from the significant associations, proper education, and a mixed diet will help nurture a healthy female adolescent population.
Exploring sleep-related disorders in patients with multiple sclerosis: A questionnaire-based approach
Authors: Bamaga Ahmed K. , Aljohani Awatif , Muthaffar Osama Y. , Alyazidi Anas S. , Bahowarth Sarah Y. , Almasry Nouf A. , Bakhsh Danya Y. 
Published: November 2024

ABSTRACT

Background:
Multiple sclerosis (MS) is considered the most prevalent neurological disorder in young adults with many patients manifesting sleep-related disorders (SRD) due to its pathomechanisms. This is subsequently reflected in patients’ quality of life and physical activities.

Material and Methods:
This is a cross-sectional study at a tertiary care center. Patients diagnosed with MS were enrolled, and assessment of their sleep patterns and related disorders were measured using pre-validated scales. A questionnaire consisting of 38 items was used, and the obtained data were analyzed using RStudio software.

Results:
A total of 260 patients participated in the study. Most participants were aged 31–40 (n = 112) with a mean age of 36.49 ± 8.41 (age range: 18–56 years). The most used medications were rituximab (27%) and ocrelizumab (25%). Shapiro–Wilk Test was significant (P = 0.04) and just below the significance level of α = 0.05, suggesting potential significant deviation in the distribution of age. Logistic regression model was applied, and the female probability of sleeping more than six hours was 3.60 times the probability of sleeping six hours or less.

Conclusion:
Sleep quality is multifaceted and requires intensive investigation in patients with chronic disorders including MS. In this study, several novel data have been presented in a population that has very little literature data.
Gastrointestinal pathology in patients presenting with iron deficiency anaemia: A single-centre cross-sectional study
Authors: Tahaseen Shaik Mohammad , Kirti Ravi , Kumar Ramesh , Pandey Sanjay , Rao Rajath , Kumar Anjani , Arya Rahul , Maji Tanmoy , Biswas Ratnadeep 
Published: November 2024

ABSTRACT

Background:
About a third of the world’s population is estimated to suffer from anaemia, and iron deficiency is expected to account for about half of all anaemia cases. This study was designed to get an estimate of the proportion of patients with iron deficiency anaemia (IDA) who have a significant gastrointestinal (GI) pathology, in particular a GI malignancy, and to identify any risk factors or predictors for the same.

Methods:
This cross-sectional study was conducted at a hospital in Eastern India. The study population comprised males above the age of 18 and postmenopausal females with IDA, excluding those haemodynamically unstable or with chronic diseases. Data collection included a detailed history, sociodemographic details, dietary habits, GI symptoms, and severity of anaemia. Faecal occult blood tests (OBTs) were conducted, and patients were referred for upper and lower GI endoscopy with biopsies.

Results:
Out of the 257 patients, 50.97% (n = 131) had a significant GI pathology, and 25.68% (n = 66) had a GI malignancy. Male gender (AOR: 5.203, 95% CI: 1.725–15.698) and a positive stool OBT (AOR: 6.516, 95% CI: 2.255–18.828) were found to be independent risk factors for any GI pathology. Age 40 years or above (AOR: 11.376, 95% CI: 1.199–107.946), loss of appetite (AOR: 15.548, 95% CI: 1.416–170.735), pain abdomen (AOR: 5.566, 95% CI: 1.149–26.953), dysphagia (AOR: 7.945, 95% CI: 1.036–60.915), family history of malignancy (AOR: 46.726, 95% CI: 4.076–535.645), and positive OBT (AOR: 22.430, 95% CI: 3.933–127.915) were found to be independent risk factors of GI malignancy.

Conclusions:
This study shows that a large proportion of adult males and postmenopausal females presenting with IDA in India have significant GI pathology. Furthermore, a significant proportion of them have GI malignancies. Thus, bidirectional endoscopy should be considered for these patients. Male patients, age >40, those with history of loss of appetite or weight, pain abdomen or dysphagia, positive family history, and positive OBT should be prioritised for the investigation.
Evaluation of biofilm formation and carbapenem resistance in Klebsiella pneumoniae isolated from clinical samples at a rural hospital in western Uttar Pradesh
Authors: Jaisal Shashikant , Singh Amit , Verma Rajesh K. , Ram Vidya Sagar , Verma Shesh Kumar , Yadav Himanshi , Prakash Vijay 
Published: November 2024

ABSTRACT

Introduction:

Klebsiella pneumoniae commonly causes healthcare-associated infections and shows multidrug resistance. K. pneumoniae can produce biofilm. Carbapenem resistance in K. pneumoniae is due to the production of carbapenemases mainly. This study was done to evaluate the formation of biofilm and carbapenemase resistance in K. pneumoniae isolates.

Material and Methods:
A total of 110 K. pneumoniae isolated from various clinical samples were taken, the antibiotic susceptibility test was done by the Kirby disk diffusion method, and biofilm detection was done by the tissue culture plate method. All the carbapenem-resistant isolates were confirmed by multiplex real-time PCR (mPCR). Those found positive for any of the carbapenemase genes were tested by the modified Hodge test (MHT), modified carbapenem inactivation method (mCIM), and ethylenediamine tetraacetic acid (EDTA)-modified carbapenem inactivation method (eCIM).

Results:
Out of 110 isolates, 66% (72/110) were carbapenem-resistant (suggestive of carbapenemase producers) by Kirby-Bauer disk diffusion but 58% (42/72) of Klebsiella isolates were confirmed for carbapenemase production by mPCR. Maximum number of carbapenemase gene were New Delhi metallo-β-lactamase (NDM) 52% (N = 22), 29% (N = 12) coproducers (NDM+OXA-48), and lowest in oxacillinase (OXA-48), 19% (N = 8). The overall sensitivity of MHT and mCIM+eCIM was 62% and 93%, and specificity was 88% and 97%, respectively. Our study showed that moderate biofilm producers were 51% (N = 56) K. pneumoniae isolates, strong biofilm producers 27% (N = 30), and 22% (N = 30) were weak/non-biofilm producers. We also found the correlation between biofilm formation and carbapenem-resistant K. pneumoniae (CR-KP) genes was statistically significant with a P value of 0.01*<0.05.

Conclusion:
Most isolates of K. pneumoniae demonstrated a wide range of antibiotic resistance and were biofilm producers. Our results indicated that the combination of mCIM with eCIM showed high sensitivity and specificity to detect CR-KP compared with MHT.
Diagnostic accuracy of Gorelick 10 point scale in comparison to IMCI scale in identifying significant dehydration in South Indian children? - A prospective observational study
Authors: Sathyakiran Mudiganti , Chandramohan Anandhi , Palanisamy Soundararjan 
Published: November 2024

ABSTRACT

Background:
Unavoidable cause of mortality among under 5 children in India is dehydration resulting from acute diarrhoeal diseases. In spite of various dehydration scales available across the world, the most commonly used dehydration scale in India is IMCI.Gorelick 10 point scale having more clinical indicators could also be considered using if the diagnostic accuracy of the scale in identifying the significant dehydration is in par with that of IMCI scale. Our Objective was to classify the 1month - 60 month aged children admitted with diarrhoeal disease based on dehydration assessment using Body weight, Gorelick 10 point scale, IMCI scale and to compare the diagnostic accuracy of Gorelick 10 point scale vs IMCI scale in identifying significant dehydration.

Methods:
The prospective observational study was done among 224 , 1 month to 60 month aged children admitted with acute watery diarrhea. The children were assessed for severity of dehydration using Body weight, Gorelick 10 point scale, IMCI scale. The diagnostic accuracy of Gorelick 10 point scale vs IMCI scale in identifying significant dehydration was assessed using statistical methods like, Sensitivity, Specificity, Positive Predictive Value PPV,NPV,LR+, LR-, Youden index and accuracy and Kappa statistic to detect inter-rater reliability.

Results:
The proportion of participants classified as to have no dehydration, some dehydration and severe dehydration according to Gorelick 10 point scale, IMCI and percentage of weight loss was 79.9%, 18.8%, 1.3% vs 77.7%,21%,1.3% vs 79.9%,18.8%,1.3% respectively The diagnostic accuracy of IMCI scale in identifying Significant dehydration was higher than Gorelick 10 point scale, as noted by having Sensitivity, Specificity,PPV,NPV,LR+,LR-,Youden index and accuracy as 100%,97.2%,0%,100%35.8,0,0.97,97.7% vs 88.9%,97.2%,88.2%,97.2%,31.8,0.11,0.85,95.5% respectively and k value was 0.9.

Conclusion:
Though the diagnostic accuracy of IMCI was little higher than Gorelick 10 point scale in identifying significant dehydration, having obtained k value of 0.9, indicates posing an excellent agreement Gorelick 10 point scale can be used in place of IMCI to identify Significant dehydration.