bluuebunny/crossref_metadata_2025_split huggingface dataset:
Provision and utilization of basic maternal healthcare during the pandemic in Ecuador: The health workers’ perspective
Authors: Espinosa-Henao Olga Elena , Becerril-Montekio Victor , Osorio-López Erick Antonio , Espinoza-Suarez José B. , Morales-Sucasaire Paulo Cesar , Quevedo-Pinos Martí A. , Alcalde-Rabanal Jacqueline Elizabeth 
Published: November 2024

ABSTRACT

Context:
Ecuador was one of the most affected counties in Latin America during coronavirus disease 2019 (COVID-19). Its health system already faced financing and organizational problems before the pandemic.

Aims:
To analyze the effects of the pandemic on the provision and utilization of maternal health services in units of the Public Health of Ecuador as perceived by the health personnel.

Material and Methods:
This is a mixed methods study with two rapid evaluation cycles. The first cycle collected information during January–March and the second one during April–June, 2021. An online questionnaire and semistructured interviews were applied to professionals involved in the management and provision of maternal health programs. Both instruments explored provision and utilization of maternal health services. Questionnaires were processed using SPSS and descriptive statistics. Interviews were exported to Atlas-Ti and were codified using the explored categories.

Results:
A total of 207 health workers participated in the first cycle, and 200 in the second one. They recognized that during the pandemic, healthcare personnel were reduced by more than 30% due to the presence of risk factors among them as well as the lack of budget for new contracts. The availability of materials and supplies was also reduced by nearly 50%, mainly due to the lack of budget. The demand for maternal healthcare in public health units was reduced because people feared being infected by COVID-19 and nearly 25% goes to the private sector.

Conclusions:
The pandemic has had a negative effect on the provision as well as utilization of maternal healthcare services. Nevertheless, health professionals implemented diverse strategies to reduce this negative effect on maternal care.
Prevalence of economic violence among the geriatric population and their knowledge and utilization of social security schemes in Chengalpattu district, Tamil Nadu
Authors: Ramadass Divyabharathy , Sivaprakasam Sangeethapriya , Venkatesan Murugan 
Published: November 2024

ABSTRACT

Context:
Economic independence is an important factor in the prevention of violence among the elderly. Optimal utilization of various social security schemes in India helps them in achieving financial independence and proper utilization of health care services. However, there is a knowledge and service utilization gap among the elderly in our population.

Aim and Objectives:
To assess the prevalence of economic violence and awareness and utilization of social security schemes among the geriatric population.

Settings and Design:
Community-based cross-sectional study conducted in rural and urban field practice areas of the tertiary care center.

Methods and Material:
A simple random sampling method was adopted. The data were collected using a pilot-tested semistructured questionnaire among 406 participants from three selected villages and wards of Venmalagaram and Maduranthakam during January to July 2023.

Statistical Analysis Used:
Frequencies and proportions were used for categorical variables, and Chi-square test was applied to test the level of significance. P <0.05 was considered statistically significant.

Results:
The prevalence of economic violence was found to be 12.1%. Among them, neglect was seen in a major proportion (61.2%). Awareness about the old age pension was seen in 70.7%, followed by Annapurna scheme (17%) and PMVVY (4.9%). The utilization of these schemes was found to be 34.0%, 11.6%, and 2.7%, respectively.

Conclusions:
The prevalence of economic violence among the geriatric population was in the form of neglect and property misuse. The knowledge and utilization of social security schemes were poor among the elderly.
Correlation between serum vitamin B12, vitamin D, and suboptimal semen parameters in male infertility: A hospital-based cross-sectional study
Authors: Kumar Navneet , Jadhao Anand Gautam , Yadav Ravi Ramkishan 
Published: November 2024

ABSTRACT

Background:
Micronutrients such as vitamin B12 and D have recently gained attention for their potential roles in male reproductive health. Despite their significance, there’s a critical gap in understanding their association with male infertility, particularly concerning suboptimal semen parameters. This study aimed to address this knowledge gap by examining serum vitamin B12 and D levels in infertile males, providing insights that could inform targeted interventions for couples facing male infertility challenges.

Methods:
This cross-sectional study, conducted at Tertiary Health care centre in north India for 2 years, enrolled 73 infertile males aged 20–40 years from the fertility clinic (participants exhibited suboptimal semen parameters). Clinical and demographic data were collected through interviews and record reviews, while semen samples underwent meticulous processing for the analysis of various parameters. Blood samples were collected after overnight fasting for serum vitamin B12 (ELISA) and vitamin D (CLIA) assessment. Statistical analyses, performed using SPSS, included t-tests, Chi-square tests, and Pearson’s correlation analyses to explore associations between serum vitamin levels and semen parameters, with a significance level set at P < 0.05.

Results:
The study comprised 73 infertile males with suboptimal semen parameters. Serum vitamin B12 levels (mean ± SD: 243.4 ± 69.3 pg/mL) and vitamin D levels (22.5 ± 13.2 ng/mL) were measured. Low vitamin B12 (<200 pg/mL) was observed in 29 participants (39.7%), while low vitamin D (<20 ng/mL) was noted in 51 participants (69.9%). Semen parameters revealed significant differences in sperm count, motility, and morphology between low and normal vitamin B12 groups. Similar patterns were observed with vitamin D levels, emphasizing potential associations between vitamin status and semen quality.

Conclusion:
Our findings suggest a potential link between low serum vitamin B12 and D levels and suboptimal semen parameters in infertile males. Addressing these nutritional deficiencies may hold promise for improving male fertility outcomes. Further research is warranted to elucidate the mechanisms involved and explore targeted interventions.
Exploring electrocardiographic alterations and the prolongation of QT interval in patients with diabetes mellitus
Authors: Arya Tushar , Kumar Rajendra , Aziz Tarique , Alam Md Shadab , Kujur Anit 
Published: November 2024

ABSTRACT

Background:
Diabetes mellitus (DM) affects a substantial proportion of the world’s population and is associated with an increased risk of sudden cardiac death (SCD) due to cardiac arrhythmias, specifically prolonged QT intervals. This study investigates the correlation between glycemic control and cardiac health in 77 diabetic patients.

Methods:
Patients with both type 1 and type 2 DM aged 14 to 82 years were included. Various clinical and metabolic parameters were evaluated, including glycated hemoglobin (HbA1C). QT intervals were measured using electrocardiograms (ECGs), and patients were categorized based on their QTc intervals. SPSS was used for statistical analysis, including one-way ANOVA tests.

Results:
The study revealed diverse age and gender representation among diabetic patients. Most patients had type 2 diabetes (87%) with varying illness durations. Patients ranged in age from 14 to 82 years, with a mean of 48.14 16.58 years. The gender distribution was even (49% male and 51% female). Most participants had diabetes for less than five years (57%) and varied treatment histories (71% managed with oral hypoglycemic agents, 17% with insulin, and 12% with a combination). The ECG revealed ST-T alterations (4%) as well as sinus tachycardia (13%) and left ventricular hypertrophy (19%).

Conclusion:
This study sheds light on the intricate relationship between diabetes, glycemic control, and cardiac health. QTc interval variations were observed even though the clinical and metabolic profiles of the patients varied. The influence of glycemic control on QT intervals and cardiovascular outcomes in diabetic patients requires additional study.
Assessment of appropriate utilization of out-of-office diagnostic tools for the diagnosis of hypertension
Authors: Jnaid Hussam , Aldosari Mohammed , Ahmad Mohammad Waqar , Alendijani Yaser , BaGubair Amira , Alhaffar Dalal , Albasheer Zainab , Alrasheed Mansour 
Published: November 2024

ABSTRACT

Background:
Out-of-office blood pressure (BP) measurement devices, such as ambulatory BP monitoring (ABPM) and home BP monitoring (HBPM), enhance the accuracy and reliability of BP readings, detecting white-coat and masked hypertension. The American Heart Association (AHA) advises confirming hypertension diagnoses with ABPM to prevent overdiagnosis, emphasizing the importance of precise out-of-office diagnostic tools. This study aimed to 1) explore the prevalence of ABPM and HBPM use prior to hypertension diagnosis; 2) assess the adherence to AHA recommendations regarding ABPM utilization; and 3) investigate the association between patient characteristics and out-of-office BP monitoring practices.

Methods:
A retrospective cross-sectional study analyzed a random sample of adult patients newly diagnosed with essential hypertension at a tertiary hospital primary care center in Riyadh, Saudi Arabia, between 2016 and 2022.

Results:
This study evaluated the use of ABPM and HBPM in a sample of 268 newly diagnosed hypertensive patients, with a mean age of 49.17 ± 12.69 years. Although ABPM orders were placed for 57.8% of patients, only 48.5% completed the procedure. Notably, 42.2% of hypertension diagnoses were solely based on ABPM, while 7.1% and 1.1% utilized HBPM alone or in combination with ABPM, respectively. This analysis revealed a lower utilization of ABPM among older adults, individuals with diabetes or chronic kidney disease, and married patients (P < 0.05). However, this association with marital status, diabetes, and chronic kidney disease was no longer statistically significant in a fully adjusted model (P > 0.05).

Conclusion:
Out-of-office BP monitoring, particularly ABPM, was underutilized in newly diagnosed hypertensive patients, especially in older age groups and patients with specific comorbidities, who may benefit the most from this method. These results underscore the need for increasing physician knowledge and compliance with the existing guidelines.
Association of serum uric acid levels with glycated haemoglobin in diabetic patients and healthy controls
Authors: Patel Seema , Singh Mitasha , Kahlon Namrata 
Published: November 2024

ABSTRACT

Introduction:
Uric acid is formed from purine degradation. Hyperuricemia has emerged as a risk factor for various metabolic diseases including Diabetes mellitus (DM). Uric acid may act as a glucometabolic indicator for Type 2 Diabetes mellitus (T2DM). Glycated haemoglobin (HbA1c) is an indicator of long-term glycaemic control used for diagnosing and monitoring T2DM. However, the association between HbA1c and uric acid is controversial. The present study aimed to study the association of serum uric acid (SUA) levels with HbA1c.

Materials and Methods:
This cross-sectional comparative study was conducted in a Tertiary Care Hospital in Northern India after permission from the institutional Ethical committee. The study included patients attending the Outpatient Department of the hospital during the study period. Diagnosed cases of DM as per World Health Organization criteria were included as cases. Controls comprised of apparently healthy subjects of the age group 18–50 years attending OPD Patients and Health Care workers. Both cases and control were divided into two groups those with normal uric acid levels and the hyperuricemia group in both males and females to study the association between HbA1c and uric acid levels.

Results:
The study constituted 1460 participants of which 880 control and 580 DM. The overall prevalence of hyperuricemia was 17.8%. HUA prevalence was 17.04%–18.9% in the control and diabetic population, respectively. SUA levels in T2DM patients were negatively correlated with glycated HbA1c, and FBS whereas positively correlated with glycated HbA1c in controls.

Conclusion:
While non-diabetic individuals tend to exhibit higher SUA levels, a decreasing trend has been observed in diabetic individuals. A negative association was observed between SUA level and HbA1c in DM in contrast to controls. Therefore, the utilization of SUA as a marker for assessing glucose metabolism should be approached with careful consideration taking care of these complex dynamics.
Assessment of risk of developing diabetes mellitus using Indian diabetes risk score (IDRS) among adult population living in an urban field practice area
Authors: Ruchita Tammineni , Chandrika Surada , Kalyani Manchu 
Published: November 2024

ABSTRACT

Background:
The Indian Diabetes Risk Score (IDRS) is a simple and cost-effective tool for the early detection of undiagnosed cases in the community and is most suited for the Indian population to assess the risk of developing diabetes.

Aim and Objectives:
To assess the risk of Type 2 Diabetes Mellitus among the adult population living in an urban area by using the Indian Diabetes Risk Score (IDRS). To determine associated risk factors among the study population.

Materials and Methods:
A community-based cross-sectional study was done among 145 adults in an Urban field practice area under the Department of Community Medicine, Andhra, Medical College, Visakhapatnam. All males and females aged between 20 and 60 years living in the urban field practice area for the past year or more. The known diabetics and severely ill patients were excluded. Ethical permission was obtained and informed consent was taken from all the study participants.

Results:
Out of 145 study population, 66 people (45.5%) were found to be at the low-risk category, 41 people (28.3%) were in the medium-risk category and 38 people (26.2%) were at high risk based on their IDRS scores.

Conclusion:
The study showed a statistically significant relationship between factors such as gender, age, increased waist circumference, family history of diabetes mellitus, physical activity, and increased risk score.
Unveiling predictors of developmental delay among under-fives: Insights from a community study
Authors: Kiran Kumari A. , Kumar Dewesh , Anand Prerna , Choudhary Jaideep K. , Kujur Manisha , Sahu Surendra , Tanu Tanya , Rajnish Sahil N. , Sagar Vidya , Hembrom Shailesh S. , Raj Mayank 
Published: November 2024

ABSTRACT

Introduction:
The development of a child is a crucial factor that ultimately affects the quality of life of children. Developmental delay can be prevented if it is identified early and adequate attention is given from the start.

Methodology:
A cross-sectional analytical study was conducted between December and November 2022 on 450 children by multistage cluster sampling in the Ormanjhi block of Ranchi, Jharkhand. Development was assessed by using the Denver II developmental screening test. The Chi-square test and logistic regression were applied to predict associations.

Results:
Among 450, 4.9% were found to be developmentally delayed in one or more domains (viz., gross motor, fine motor, language and social domains). The strongest association was seen with the mother’s education and the presence of past illness in the child.

Conclusion:
The study concludes that developmental delay can go unnoticed in our society, but it is very important to identify this early in their lives as it can affect their productivity.
Gender, gestation, and birthweight-based differences in the timing of passage of first urine and meconium in neonates: A prospective observational study
Authors: Chowdhry Bhabesh K. , Gupta Prakriti , Giridhar M.F. , Chaudhary Neha , Kumar Chandramohan , Dalai Richie 
Published: November 2024

ABSTRACT

Introduction:
The cut-off for referral to a higher center and further investigations for the delayed passage of first urine and meconium by a neonate have been traditionally kept after 48 hours of birth. There are very few studies regarding this in Indian neonates, and previous studies have relied primarily on the mother’s recall of the event which may have led to recall bias. Therefore, through this study, we wanted to use hospital intake/output records to identify the risk factors that affect the timing of passage of first urine and stool in neonates delivered at our center and to find out if the cut-off of 48 hours to call it a delay is justifiable.

Methodology:
This was a single-center, prospective observational study conducted in Eastern India. After obtaining ethics committee approval, the eligible neonates delivered at the center were prospectively enrolled between June 2020 to December 2022. The timing of passage of first urine and meconium was noted using 3 hourly collected information from the input/output charts maintained by the nursing staff in the postnatal wards. The median time of passage of first urine and meconium was compared across gender, gestation, and birth weight. To find the factors associated independently with delayed passage of meconium, multivariable logistic regression was used.

Result:
A total of 330 neonates were enrolled prospectively in the study. Approximately two-thirds of them passed first urine (69.7%) and meconium (62.7%) within 6 hours after delivery. The median and interquartile range (IQR) of the time of passage of the first urine was 4 (1-7) hours of life. This did not vary significantly for gender, gestation, and birthweight categories. The median (IQR) of time of passage of meconium was 4 (1-8) hours of life, which was significantly higher for male [5 (2-8.5), (P = 0.029)] and preterm neonates [6.3 (2.5-12), (P = 0.001)], but did not vary significantly for birthweight categories. On multivariable logistic regression, twin gestation [OR 4.15 (95% CI 1.09-15.76); P = 0.036] and preterm birth [OR 2.97 (95% CI 1.18-7.43); P = 0.02] increased the odds of passage of meconium beyond 12 hours’ postnatal age. 99.39% and 98.77% of the neonates passed urine and meconium respectively within 24 hours.

Conclusion:
The median time of passage of first urine was not influenced by gender, gestation at birth, and birthweight categories. The median time of passage of meconium was significantly higher for male and preterm neonates. Also, with early initiation of direct breastfeeding and good feeding support most neonates pass their first urine and stool by 24 hours of life. So, maybe it’s time to revise the cut-off for referrals or investigations from 48 hours to 24 hours of life. However, further studies with larger sample sizes will be required to confirm this cut-off.
Telemedicine: Future of the healthcare system and its impact on patient satisfaction: A literature review
Authors: Salman Malik , Kimball Ryan , Bromley Sarah , Belleville Troy , Jabbar Ali B. A. , Mirza Mohsin , Hayat Shagufta , Sood Akshat , Tauseef Abubakar 
Published: November 2024

ABSTRACT

Background and Objectives:
The utilization of telemedicine has increased dramatically since the onset of the COVID-19 pandemic. In this review, we examined studies published within the past five years that investigated the impact of telemedicine on patient satisfaction.

Methods:
Four investigators utilized PubMed and Google Scholar to find studies published within the past five years that assessed patient satisfaction with telemedicine in the field of adult primary care, using either the Press Ganey or CAHPS surveys. Studies that compared cost and quality of care between telemedicine and in-patient healthcare were also included to address the secondary aims of this study.

Results:
A total of 11 studies out of the 405 that were investigated were selected for this review. Five studies found no significant difference in patient satisfaction between telemedicine and in-person medicine, with one of those showing a patient preference for telemedicine. One study demonstrated significantly higher satisfaction with in-person medicine vs. telemedicine. Another study found that most physicians and patients reported no perceived difference in quality of care between telemedicine and in-person visitation. One study found no difference in patient satisfaction with telemedicine between immigrants and non-immigrants. Another study showed that patients have higher satisfaction when using telemedicine with their PCP vs. an unfamiliar provider. Two studies found telemedicine to be cost-effective.

Conclusions:
Our review concludes that patient satisfaction with telemedicine is not inferior to that with in-person visits. However, further research should be conducted to determine various factors that may affect patient perception and satisfaction.
Internet Addiction Scale for School and College Students – Construction, validation, and cutoff derivation
Authors: Suganya E , Arvinth A , Abirami R 
Published: November 2024

ABSTRACT

Background:
With young people and teenage children, India has recently become a hotspot for a multiple-fold increase in internet users. The objective of our study was planned to create a psychometric scale specially targeting school and college students with appropriate validation and cut-off derivation, as these groups are collective and also holds a major burden of internet addiction and also a potential risk group for developing internet addiction disorder.

Methods:
This was a cross-sectional study with a sample size of 1530 done among college students and school students studying between IX to XII standard with habit of internet usage. A google form survey questionnaire was used and study was conducted for a period of 2 months. Domain identified was Internet addiction which was followed by Item generation done by both Inductive, Deductive method and Content validity obtained from the field experts. After Cognitive Interviewing, survey was conducted by circulating the constructed scale in the Google form questionnaire to the eligible participants. After collecting the required data from the participants, the scale was subjected to Item Reduction Analysis.

Results:
The mean age of the study participants was 18.96 ±3.68 years and most of them were females. All the individual items had discrimination index value of higher than 0.75 and Cronbach’s alpha of 0.75. The total weighed score calculated by adding the individual weighed score came as 21078. Correction factor obtained by dividing the weighed score to the raw score was 0.89. Using the Internet Addiction Scale for School and College Students (IASSCS) having a cut off value of 16 to delineate a person to have Internet addiction and No Internet addiction, around 63% of the study participants were found to have internet addiction and 37% of them were not having Internet addiction and among them a greater number of Internet addicts were found to be male compared to females.

Conclusion:
Due to the fact that internet addiction is linked to numerous physical and mental health problems, it may be more beneficial to use scale reports as screening tools at the primary health care level in order to identify high-risk groups for health problems caused by internet addiction at the earliest.