bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adherence to gluten free diet and problems faced by children with celiac disease and type 1 diabetes mellitus
Authors: Verma Anjali , Rani Shilpi , Verma Surender , Khanna Alok 
Published: October 2024

ABSTRACT

Introduction:
Celiac disease (CD) in children can be associated with Type 1 Diabetes Mellitus (T1DM) as both share autoimmune etiology. Mainstay of treatment in celiac disease is total avoidance of gluten in diet whereas treatment in child with both the diseases will be Insulin therapy, exercise along with gluten free diet (GFD). There is dearth of literature regarding adherence to GFD and barriers for children with both T1DM and CD.

Methods:
A questionnaire-based study was done at a tertiary care institute so as to compare the self-reported gluten adherence and the problems faced by children with dual diseases (TIDM and CD) and CD alone. Thirty children of age group 5-14 years each withType 1 DM and CD (T1DMCD group) and celiac disease (CD group) were selected consecutively. A questionnairewas filled by asking questions from either children (above 8 years) or parents (below 8 years) and the results were compiled, compared and further analysed.

Results:
Baseline demographic parameters were comparable in both the groups. Gluten adherence was found to be worse in T1DMCD group as compared to CD group. Greater number of problems were experienced by children with both TIDM and CD as compared to children with CD alone (P < 0.05). Financial burden more so in T1DMCD group, unawareness about disease and benefits of GFD, less availability and social isolation were found to be the most significant barriers to diet adherence.

Conclusion:
As these children face dual diseases, they should be made more aware regarding benefits of GFD. Such information is valuable to primary care physicians for better management and rehabilitation of children suffering from these chronic diseases.
Service delivery in postpandemic period for routine childhood immunization in Assam following capacity building with BRIDGE IPC Skill tool
Authors: Mahanta Tulika Goswami , Nirmolia Nabanita , Biswas Abhijit Basu , Barua Swarnali D 
Published: October 2024

ABSTRACT

Background:
For COVID-19 pandemic and associated factors, around 25 million children missed routine immunization in 2021. NFHS-5 for Assam reported 67% coverage with routine immunization in 2019–21 which is below national average (77%) and lowest among Indian States/UTs. Lack of knowledge and skill among provider can reduce coverage. To address vaccine hesitancy and demand generation for routine immunization, BRIDGE IPC Skills (Boosting Routine Immunization Demand Generation) training in routine immunization for frontline workers considered an effective tool.

Objectives:
To estimate the service delivery in postpandemic period for routine childhood immunization in Assam following capacity building with a BRIDGE IPC Skill tool.

Materials and Methods:
This cross-sectional comparative study was conducted among immunization service providers from April 2022 to March 2023, where training coverage of service providers on BRIDGE IPC Skill was assessed. Comparison was made between functionalities of trained services by service providers with untrained ones.

Results:
A total of 2312 session sites were visited, of which 67.7% of frontline workers were trained, while 32.3% were not trained. Alternate vaccine delivery was present in 58.5%. Updated due list was present in 64.1% vs 29.8% in trained and untrained sites. Significant association was found between delivery of key message and status of frontline worker on BRIDGE IPC Skill training.

Conclusion:
Capacity building of frontline workers on BRIDGE IPC Skill can boost efficiency of frontline workers and may facilitate in addressing gaps that EXIST between health care system and community.
Do the fathers matter? Paternal perspective of exclusive breastfeeding practices: A community-based cross-sectional study in urban slums of Bhubaneswar, Odisha
Authors: Roy Payel , Dora Susmita , Giri Prajna Paramita , Behera Binod Kumar , Subba Sonu Hangma 
Published: October 2024

ABSTRACT

Introduction:
Although various policies have been framed to improve exclusive breastfeeding outcomes in India, the father’s role in breastfeeding is grossly ignored. Gender inequalities are still predominant in several parts of India. Fathers’ involvement in breastfeeding decision-making plays a significant role in improving the outcome. However, till now, this domain has been neglected in India. Henceforth, we aimed to see the knowledge and attitudes of fathers regarding breastfeeding in a community setting.

Methods:
It was a community-based cross-sectional study done in the urban slums of Bhubaneswar, Odisha. One hundred seventy-one fathers with their children between six months and one year were recruited by simple random sampling. Knowledge was assessed with a semi-structured questionnaire, and attitude was measured with the Iowa Infant Feeding Attitude Scale (IIFA).

Results:
In the present study, 1.18% of fathers had good knowledge regarding breastfeeding. 46.2% had average knowledge regarding breastfeeding, and 57.3% had positive attitudes toward formula feeding.

Discussion:
We have found that most fathers had a positive attitude toward formula feeding, and very few fathers had good knowledge of breastfeeding. Henceforth, further focus in this area is required to improve breastfeeding outcomes.
Can tele-physiotherapy help in filling treatment gaps during pandemics in multiple sclerosis?
Authors: Kumar Gunjan , Kaur Darshpreet , Singh Ajay Kumar 
Published: October 2024

ABSTRACT

Background:
Published data demonstrate promising results for rehabilitation in patients with multiple sclerosis (MS), including telerehabilitation technologies. Given the travel limitations during the coronavirus disease 2019 (COVID-19), telerehabilitation may provide a viable alternative to in-person physiotherapy.

Objective:
To determine the efficacy of telerehabilitation in MS patients during COVID-19.

Design/Methods:
A total of 42 patients participated in the study of which 24 were followed up till the end of 6 weeks. The investigated group consisted of 15 females and 09 males; the mean age was 42 ± 10 years. The telerehabilitation was provided for a duration of 6 weeks at a frequency of three classes per week. The patients used either laptops or mobile phones for attending these sessions. The inclusion criteria were a 6-minute walk test (with or without assistance). Motor function was evaluated using the Timed Up and Go (TUG) test and the 30-Second Sit-to-Stand (30STS) test. Patients were required to fill out two questionnaires also: 12-item MS Walking Scale (MSWS) and Modified Fatigue Impact Scale (MFIS). All the patient assessments were made by an independent physiotherapist before and after the intervention.

Results:
There was a statistically significant improvement in motor performance and MFIS and 12-item MSWS. The following results were observed: statistically improved parameters of TUG, 30STS, 12-item MSWS and MFIS.

Conclusions:
Based on the findings, it is reasonable to infer that the use of telemedicine in the rehabilitation of MS patients is very promising.
The quality of life of primary caretakers of children with cerebral palsy
Authors: Kondekar Alpana , Ansari Qudsiya , Ghatol Hrishikesh 
Published: October 2024

ABSTRACT

Background:
Cerebral palsy (CP) is a heterogeneous group of disorder affecting the development of movement and posture, which is permanent nonprogressive. Previous studies in different regions have shown links between caregivers’ mental health and children’s well-being. However, the lack of such detailed research for the caretakers of children with CP and correlation of quality of life affected the type and severity of the condition; this necessitates the development of a new study to assess caregivers’ quality of life.

Aim:
Quality of life among caregivers of disabled children is an important concern in healthcare. We aim to evaluate the quality of life among caregivers of children with CP and to assess the factors affecting the caregivers’ quality of life, namely, age, gender, type, and gross motor function in children with CP.

Methodology:
This was a cross-sectional observational study, conducted over a period of 6 months. It included the caregivers of children with CP at a tertiary care hospital of Mumbai. Data were collected using the WHO BREF questionnaire. The children were divided into two groups (2 to 7 years and 7 to 12 years). The qualities of life of the caretakers of these two groups were compared in four domains, namely, physical, psychological, social, and environmental.

Results:
The study included 50 participants. Mothers (80%) and fathers (10%) were the primary caregivers. Caretakers of the children with cerebral palsy showed significant affected quality of life as calculated from WHO QOL BREF score in both age groups (2–7 and 7–12 years) and in all domains. Overall, the most affected domain in our study was of psychological health and the least affected domain was of the environmental domain.

Conclusion:
This study provides a snapshot of the impact of having a child with cerebral palsy on the lives of the caregivers Most of the caregivers in the study were mothers, and quality of life was affected in all domains mainly in psychological and physical domains. The study showed that there is a need for interventions in caregivers which can have an indirect impact on the children with CP.
Early versus late-onset of weight struggles among patients with obesity: Data from the ACTION-IO study
Authors: Alfadda Assim A. , Isnani Arthur C. , Almubark Rasha A. , Alqahtani Saleh A. , Alqarni Ali , Shams Mahmoud , Yahia Moataz 
Published: October 2024

ABSTRACT

Background and Aim:
The prevalence of obesity is increasing and people with obesity (PwO) continue to struggle with their weight. We aimed to describe the experiences of people who struggled with their weight at an early age (EAO) or at a later age (LAO), their discussions with their healthcare practitioners (HCPs) and episodes of depression and anxiety.

Methods:
We gathered information from 1,000 adults PwO, categorized them into EAO and LAO and analyzed their responses regarding weight loss attempts, discussions with their HCP, perceptions about obesity and episodes of depression/anxiety.

Results:
Mean age was 36.6 years old, and 73.0% were AAO. EAO had significantly fewer weight loss attempts and had fewer interactions with their HCP. EAO reported less HCP support for weight management, were less motivated to lose weight, and experienced more episodes of anxiety/depression. Significant association between greater obesity class with longer duration of weight problems, and depression and anxiety. EAO PwOs were less likely to discuss weight problems with their HCP.

Conclusion:
It is fundamental that HCPs recognize and address weight issues in PwO who are at risk of obesity in adulthood as early as adolescence. They should also take the lead in addressing these psychophysiological concerns by involving the parents in the decision-making process and facilitating shared planning. These may enhance their motivation to lose weight, boost self-confidence, and reduce the complications of obesity.
Nerve conduction velocity studies in diabetic peripheral neuropathy involving sural nerve—A meta-analysis
Authors: Prashant Praveen , Pal Sat , Bansal Abhishek , Fotedar Sanjay 
Published: October 2024

ABSTRACT

Introduction:
Diabetes mellitus (DM) poses a significant health burden globally, impacting millions due to its metabolic disruptions. Among its complications, diabetic peripheral neuropathy (DPN) is a prevalent concern, affecting sensory and motor nerves. While various diagnostic methods exist, discrepancies persist in prevalence estimates of DPN among diabetic populations.

Objective:
This meta-analysis aimed to assess the prevalence of DPN in individuals with DM, focusing on sural nerve conduction velocity (NCV) measurements. Additionally, the study explored how different evaluation techniques influenced prevalence estimates.

Methods:
A systematic literature search was conducted following PRISMA guidelines across multiple databases. Studies reporting sural nerve NCV measurements in diabetic patients were included. Data extraction, quality assessment, and statistical analyses were performed to synthesize findings.

Results:
Twenty-six studies met the inclusion criteria, providing insights into sural nerve NCV among diabetic individuals. Pooled analysis revealed a mean sural nerve NCV of 42.12 m/s (95% CI: 39.87-44.36), indicative of reduced conduction velocity in diabetic populations. Furthermore, sural nerve amplitude was significantly lower in diabetic individuals, with a pooled mean of 4.68 μV (95% CI: 3.11-6.25).

Conclusion:
Individuals with type 2 DM exhibit impaired sural nerve function, as evidenced by reduced NCV and amplitude measurements. Timely NCV assessment, alongside glycemic monitoring, is crucial for identifying and managing DPN to prevent further complications. Interventions addressing glycemic control, dietary regulation, and lifestyle modifications are recommended to mitigate the progression of neuropathy in diabetic populations.
A clinicoepidemiological study of serologically diagnosed acute febrile illness in a teaching hospital, Kolkata
Authors: Kundu Suman , Mondal Purnima , Choudhury Kabita , Chakraborty Shruti , Banik Ankita , Pramanik Kaushik , Sinha Arijit , Bhattacharjee Swagata Ganguly , Dey Jayanta Bikash 
Published: October 2024

ABSTRACT

Introduction:
Similar presenting manifestations in early phase and lack of awareness of aetiology of acute febrile illness (AFI) are major challenges in management of AFI.

Material and Methods:
This was a retrospective observational cross-sectional study conducted in the Department of Microbiology, NRS Medical College, from 1 July 2022 to 30 June 2023 in serologically diagnosed febrile patients attending the outpatient department or admitted. Clinical and epidemiological data and laboratory parameters were recorded in a pretested structured questionnaire study tool, and collected data were analysed on MS-Excel sheets with various charts and tables.

Results:
A total of 1711 serologically diagnosed febrile patients showed preponderance of dengue (38.3%), followed by leptospirosis (25%), scrub typhus (23.9%), malaria (12.6%), and enteric fever (1.92%). A majority of cases were male, less than 40 years of age, and from the rural population (73.2%), except in malaria (urban = 79.6%). The mean duration of fever was 9 days. Febrile cases were recorded maximum during the monsoon and postmonsoon periods (66.5%). The common manifestations are fever, headache (46.2%), pain abdomen (7.8%), nausea, and vomiting (9.4%). Thrombocytopenia with bleeding manifestation was higher in dengue (18%) cases. Mortality in dengue cases was recorded with multiorgan dysfunction syndrome (MODS). Scrub typhus cases showed seizure (8.3%) and altered sensorium (5%) due to fatal meningoencephalitis. Fatality in leptospirosis was mostly due to acute kidney injury (29.5%) and Weil’s disease (4.4%).

Conclusion:
Misdiagnosis or incorrect diagnosis and delay in initiation of appropriate treatment results in increased morbidity and mortality in AFI. Determination of epidemiological features and clinical manifestations of AFI along with timely correct diagnosis will benefit clinicians in proper treatment initiation, thereby reducing morbidity and mortality.
Anaemia and selected micronutrient deficiencies among young women in rural North India – A community-based study
Authors: Srinath Kathirvel , Kaur Ravneet , Singh Archana , Kalaivani Mani , Kant Shashi , Misra Puneet , Gupta Sanjeev K. 
Published: October 2024

ABSTRACT

Introduction:
Anaemia is a major problem which affects half of young Indian women, impacting their health, education, and offspring. Despite ongoing efforts, a comprehensive understanding of anaemia remains limited. This study aims to assess the prevalence of anaemia among young women in rural Haryana and explore its causes comprehensively, which would help in tailoring targeted interventions for anaemia at a primary health care level.

Methods:
Young, non-pregnant women aged 15–24 years (n = 422) were assessed for socio-demographic details, menstrual/diet history, and anthropometry. Dietary diversity was assessed using Minimum Dietary Diversity for Women scale. Venous haemoglobin (Hb) was estimated using an auto-analyser. Serum ferritin, folate, and vitamin B12 were assessed for 260 participants. Anaemia was classified based on micronutrient deficiency. The morphology of anaemia was classified based on Red Blood Cell (RBC) indices. Multivariable analysis examined associations of anaemia with socio-demographic and clinical variables.

Results:
The prevalence of anaemia was 60.7%. Among those participants tested for micronutrient deficiency (n = 260), 170 (65.4%), 48 (18.5%), and 124 (47.7%) participants had deficiency of ferritin, folate, and vitamin B12, respectively. Iron deficiency anaemia (39.1%) and dimorphic anaemia (38.5%) were the two most common types of anaemia. The mixed morphology of RBCs was the most common morphology (41.8%). Almost all participants (98.2%) had inadequate dietary diversity. Being overweight was associated with lesser odds of having anaemia [OR = 0.41; 95% CI: 0.24 – 0.71 (P = 0.01)].

Conclusion:
The high magnitude of anaemia is high, and there is a need for nutrition-based interventions for anaemia at a primary health care level among young women in rural India.
Gestational weight gain and body mass index in Asian Indian women: Impact of timing and amount on fetomaternal outcomes
Authors: Rafat Dalia , Nawab Tabassum , Khan Tamkin 
Published: October 2024

ABSTRACT

Background:
The aim of the study was to describe pre-pregnancy body mass index (BMI), total gestational weight gain (TGWG), and trimester-specific gestational weight gain (TSGWG) among Asian Indians and examine their association with adverse fetomaternal outcomes (AFMO).

Methods:
Using a prospective cohort study design, 557 pregnant women were recruited in the first trimester and followed up until delivery. Maternal BMI, TGWG and TSGWG were assessed and categorised according to the World Health Organisation (WHO) Asia Pacific BMI guidelines and the Institute of Medicine (IOM) recommendations, respectively. Maternal clinical characteristics and pregnancy and neonatal outcomes were assessed to predict AFMO. Logistic regression models in univariate and multivariate analysis were performed to estimate the odds ratios (OR) and 95% confidence intervals (CI).

Results:
The median BMI was 23.5 kg/m2. Moreover, 24.6% were overweight and 31.2% were obese, according to WHO Asia Pacific BMI cut points. The mean TGWG was 10.8 ± 1.9 kg and the mean TSGWG in the first, second and third trimesters were 1.7 ± 0.7 kg, 4.3 ± 1.1 kg and 4.8 ± 1.2 kg, respectively. We found a significant association of BMI, TGWG and TSGWG with various AFMO. Furthermore, excess third-trimester GWG has been demonstrated as a predictor of adverse maternal outcomes like hypertension and gestational diabetes mellitus.

Conclusions:
Our study reinforces the importance of optimal BMI and TGWG and further emphasises on assessment of TSGWG, which allows for early diagnosis of weight deviations, when prompt interventions can still improve pregnancy outcomes. We also suggest the adoption of BMI categories and GWG recommendations, specific to the socio-demographic characteristics of the population, to optimise the prevention, early diagnosis, and timely management of AFMO.
Psychological effects of Manipur violence among the internally displaced persons residing in relief camps across Imphal valley of Manipur – A cross-sectional study
Authors: Rajkumari Bishwalata , Ingudam Dayananda , Yengkokpam Chitra , Oinam Gunipriya , Yumnam Rajshri 
Published: October 2024

ABSTRACT

Background:
Conflict and violence lead to the displacement of millions of people. A significant number of those who are exposed to potentially traumatic events, such as conflict and violence, may develop post-traumatic stress disorder (PTSD) and other mental health or behavioral conditions. This study plans to estimate the prevalence and associated factors of PTSD and generalized anxiety disorder (GAD) among internally displaced persons residing in different relief camps during Manipur violence.

Materials and Methods:
Community-based cross-sectional study was conducted among internally displaced persons (IDPs) residing in relief camps located in Imphal East District of Manipur using a pretested, semistructured, validated questionnaire consisting of PTSD checklist for DSM 5 (PCL-5) and the Generalized Anxiety Disorders Assessment tool (GAD-7). The study was approved by the Institutional Ethics Committee.

Results:
More than half (65.8%) of the respondents were found to have PTSD. One-fourth of the respondents (24.8%) were found to have moderate anxiety, and 15.2% have severe anxiety. Female gender, age between 20 and 59 years, marital status, and employment status after conflict were found to be significantly associated with PTSD. Marital status and witnessed destruction of property were found to be significantly associated with GAD. Around 3/4th of the respondents (235, 75.8%) reported witnessing destruction and burning of property, and 29 (9.4%) reported witnessing death of family members or friends. Around 58 (18.7%) were currently separated from family, and 25 (8.1%) had experienced some kind of trauma at the time of displacement.

Conclusion:
A majority of the participants have PTSD, whereas 15.2% have severe anxiety. Efforts and interventions should be made to improve the psychological well-being through psychological support and counseling from mental health professionals and provision of vocational training for income generation for the IDPs.
Weight gain in pregnancy and impact of obesity on the obstetric outcome: A retrospective study in a secondary care hospital in South India
Authors: Inian Sandhana , Nadar Sharon R. , Marconi Sam , Sukumar Ashwin , Cherian Anne G. 
Published: October 2024

ABSTRACT

Objective:
To evaluate the patterns of weight gain in pregnancy and the outcomes of pregnancy in overweight and obese mothers.

Materials and Methods:
A retrospective cohort study was performed on 1,352 mothers between October 2020 and August 2021. All pregnant women who presented for antenatal checkups from 20 weeks or earlier, with a singleton pregnancy, were included in the study. Details such as comorbidities, total duration of labor, complications during labor, and neonatal complications were included.

Results:
At the first antenatal visit, 16% of mothers were underweight, 51% of mothers were normal weight, and 33% of mothers were overweight or obese. Women with poor weight gain were two times more prone to give birth to a child with low birth weight than those with adequate weight gain. Excess weight gain in pregnancy in women with a normal body mass index (BMI) had an association with the development of pre-eclampsia. The odds of overweight/obese pregnant women developing gestational diabetes mellitus (GDM) were 2.1 times higher than in pregnant women with normal BMI. The odds of pregnant overweight/obese women undergoing cesarean section were 1.6 times higher than in pregnant women with normal BMI.

Conclusion:
Overweight/obese pregnant women had increased odds of developing GDM and undergoing a cesarean section. Excess weight gain was also seen in overweight/obese women. It is therefore important for physicians to educate women on acceptable weight gain during their pregnancy.