bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence and Risk Factors of COVID-19 Vaccine Hesitancy among Healthcare Workers at a Tertiary Care Center
Authors: Kokiwar Prashant R. , Gaiki Varun Vijay 
Published: August 2024

Background:
Vaccine hesitancy is hesitancy to take vaccine. Studies are required to identify prevalence of coronavirus disease 2019 (COVID-19) vaccine hesitancy. It is equally important to recognize factors responsible for this hesitancy. This data will help to plan health education measures so that healthcare workers can overcome the barriers for vaccine hesitancy.

Objective:
The objective of this article is to study prevalence and factors associated with COVID-19 vaccine hesitancy among healthcare workers.

Methods:
This was a single-center, cross-sectional study carried out over a period of two months among 1063 healthcare workers. Those with missing information, not consenting and absent on the day of survey were excluded. Healthcare workers included doctors including postgraduates, nurses, para-medical staff, admin staff, and housekeeping staff either working in hospital or medical college.

Results:
Prevalence of vaccine hesitancy was 15.1%. On logistic regression, as age increased odds of vaccine hesitancy decreased significantly (OR = 0.95; 95%CI = 0.92-0.98; P < 0.05). Patient contact of <10/day was associated with the decreased odds of vaccine hesitancy compared to those with patient contact of >40/day. Odds of vaccine hesitancy among those with poor knowledge was 2.84 (95%CI = 1.91-4.21; P < 0.05) times more compared to those with good knowledge. Odds of vaccine hesitancy was 3.22 (95%CI = 1.09-9.48; P < 0.05) times and 3.31 (95%CI = 1.05-10.48; P < 0.05) times more among educated up to primary and illiterate respectively compared to higher educated persons.

Conclusion:
We conclude that low levels of education, poor knowledge, and young age were independently and significantly associated with vaccine hesitancy among healthcare workers. Prevalence of vaccine hesitancy was still high at 15.1%.
A Study to Evaluate the Effect of the COVID-19 Pandemic on the Mental Health of Junior Doctors of a Government Medical College in West Bengal
Authors: Das Shouvik , Chaudhuri Arunima , Sinha Parthasarathy , Saldanha Daniel 
Published: August 2024

Background:
The COVID-19 pandemic had posed huge challenges to junior doctors as they had to work as frontline health workers during this emergency.

Objectives:
To evaluate the mental health status of junior doctors during the present pandemic using Depression, Anxiety, Stress Scale-21 (DASS-21) and impact of even scale-revised (IES-R) scale scores.

Methods and Participants:
This longitudinal study was conducted over a time period of 8 months after taking Institutional Ethical Clearance and informed consent of 220 participants. This online survey was conducted using Google Forms and DASS-21 and IES-R scores were evaluated twice in an interval of 6 months.

Results:
Depression scores, anxiety scores, and stress scores were significantly increased on the second assessment. Gradation of depression, anxiety, and stress in month 1 among participants were as follows: Depression scores (normal; mild; moderate; severe; extremely severe): 82; 40; 52; 33; 13. Anxiety scores (normal; mild; moderate; severe; extremely severe): 113; 21; 55; 16; 15. Stress scores (normal; mild; moderate; severe; extremely severe): 137; 33; 41; 8; 1.

ISE-R scores:
<24 = 98; 24–32 = 39; 33–36 = 15; ≥37 = 68. Gradation of depression, anxiety, and stress in month 6 were the following: Depression scores (normal; mild; moderate; severe; extremely severe): 50; 19; 63; 26; 62. Anxiety scores (normal; mild; moderate; severe; extremely severe): 34; 5; 67; 25; 89. Stress scores (normal; mild; moderate; severe; extremely severe): 61; 12; 42; 38; 67.

ISE-R Scores:
<24 = 73; 24–32 = 34; 33–36 = 11; ≥37 = 102.

Conclusions:
Junior doctors working during the COVID-19 pandemic developed increased levels of stress, anxiety, and depression with the progression of the pandemic. They were the major frontline health workers to combat COVID-19 which may be the cause of their decreased psychological resilience resulting in mental health issues. Psychological counseling sessions can be used among these young doctors to build up their mental resilience.
Breakthrough SARS-Cov-2 Infection After Covid-19 Vaccination – A Retrospective Observational Clinico-Epidemiological Study from North-Western India
Authors: Gupta Shilpi , Rathore Shweta Singh , Kapoor Umesh , Gupta Ankush , Mamoria Ved Prakash 
Published: August 2024

Introduction:
Mass vaccination is considered one of the most crucial weapons in fighting against the ongoing COVID-19 pandemic. However, the occurrence of breakthrough infections (BTIs) has questioned the vaccine effectiveness of the currently available vaccines. The present study aimed to determine the breakthrough SARS-CoV-2 infections in the vaccinated population and to compare the clinic-epidemiological profile and outcomes between breakthrough cases and unvaccinated SARS-CoV-2 positive cases.

Methods:
This retrospective case-control study was conducted between April 15, 2021, and June 15, 2021, in a zonal military hospital in Jaipur. We evaluated individuals with BTI as cases which were SARS-CoV-2 positive after 14 days of the second dose of vaccine and unvaccinated SARS-CoV-2-positive individuals as control. The clinical and demographic data was collected from the Indian Council of Medical Research and specimen referral forms were filled out for all persons who had undergone testing for SARS-CoV-2. The outcome of positive cases in terms of discharge and deaths were collected from hospital records.

Results:
A total of 162 breakthrough COVID 19 infections and 925 unvaccinated positive confirmed controls were recorded within the study duration. The majority of cases presented with mild infection in both case (80.2%) and control groups (72.4%). The risk of hospitalization and occurrence of moderate to severe disease was 2.3 and 4 times more in the non-vaccinated group as compared to the vaccinated group, respectively. No mortality was reported among the breakthrough cases.

Interpretation and Conclusions:
Despite the occurrence of BTIs, the benefits of vaccines are far greater. Our findings suggest that vaccination is associated with a lower risk of hospital admission, severe disease, and mortality against COVID-19.
Allgrove Syndrome: Case Series on 4A and Triple A Syndrome in Children with Rare Presentation
Authors: Roy Saheli , Gupta Priyanka , Basu Suprit , Das Mrinal K. , Datta Sumana 
Published: August 2024

ABSTRACT

Introduction:
Allgrove or Triple A syndrome is a rare familial multisystem disorder with autosomal recessive inheritance. Usual features include varied combination of alacrima, achalasia cardia, and adrenocorticotrophic hormone (ACTH) resistant adrenal insufficiency along with autonomic dysfunction and other neurological problems in some cases when it is known as 4A syndrome. Basic defect is in the Achalasia Addisonianism Alacrima Syndrome gene (AAAS) located on chromosome 12q13.

Case Details:
This report relates to two unrelated girls aged 7 and 12 years, who presented with orbital cellulitis with acute adrenal crisis and initial episode of nephrotic syndrome, respectively. Both had history of hyperpigmentation of skin, especially palmer creases and knuckles and absence of tear from both eyes while first patient also had autonomic dysfunction. Ophthalmological examination, biochemical evaluations for adrenal function, barium swallow study and magnetic resonance imaging (MRI) of orbits were all consistent with Allgrove Syndrome. Patients were adequately treated for the complications and then put on hormone replacement therapy and ocular lubricants resulting in remarkable improvement on follow up study.

Conclusion:
Despite lack of definitive treatment, supportive treatment and hormone replacement can improve quality of life of Allgrove patients.
The Effect of Music Therapy on Hemodynamic Parameter and Pain Score in Patients Under Going Abdominal and Lower Limb Surgeries Under Spinal Anaesthesia
Authors: Bagle Aparna Abhijit , Phansalkar Shivani Shrirang , Gaur Shivangi 
Published: August 2024

ABSTRACT

Background:
Surgical processes can be associated with a stress and anxiety in the patient triggering changes in blood pressure and heart rate adversely effecting the induction and recovery process from anesthesia. These effects are more pronounced in setting of regional anesthesia where the patient is awake intraoperatively. A calm and quite environment maintained during surgery can be helpful in blunting the stressful response of the patient. Hence, we studied the effect of music therapy on hemodynamic parameters in patients undergoing spinal anesthesia for abdominal and lower limb surgeries and its effect on the visual analog scale (VAS), patient satisfaction, and Spielberger State-Trait Anxiety Inventory (SSTAI) score.

Materials and Methods:
This was a prospective, randomized, and comparative study where 60 patients of either gender between 18 and 65 years were divided into two groups of 30 patients each. The patients belonged to American Society of Anesthesiologists Grade I or II. The patients were randomized into Group M (those who listened to music) and Group C (those who did not listen to music). After the induction of spinal anesthesia, headphones were applied to all the patients and music was started in Group M. The intraoperative parameters such as heart rate, blood pressure, the VAS, and the SSTAI scale were recorded and compared in both the groups. Patient satisfaction was also recorded.

Results:
Patients who listened to music during surgery had significantly better VAS score, SSTAI score, and patient satisfaction. The hemodynamic parameters in both groups were comparable.

Conclusion:
Music therapy intraoperatively in patients undergoing lower limb and abdominal surgeries under spinal anesthesia can have better patient outcomes with a higher patient satisfaction.
Body Composition Analysis Using Karadascan in Indian Collegiate Population: An Observational Study
Authors: Singh Amrinder , Dangat Disha P. , Shenoy Shweta , Sandhu Jaspal S. 
Published: August 2024

ABSTRACT

Background:
There is an increased prevalence of obesity, which is an important risk factor for cardiovascular and mortality risk. Because of the large population, a preferred method of measuring body fat should be simple, portable, and reliable. This study was aimed at measuring the body composition of Indian Adults using the karada scan Omron HBF-701 model.

Methods:
Sixty-four healthy adults participated in this study including 30 males and 34 females with a mean age of 21 ± 2.60 years and a mean body mass index (BMI) of 22.58 ± 2.85 kg/m2. The measurement was taken with the prescribed guidelines.

Results:
The results included mean fat % of 25.31 ± 6.01, body age 28.96 ± 8.29, resting metabolism 1422.13 ± 227.86 kcal, visceral fat % of 4.90 ± 2.97, subcutaneous fat % of 19.74 ± 6.09, total muscle mass 31.20 ± 6.27, arms fat % of 31.27 ± 10.81, trunk fat % of 16.89 ± 5.43, and legs fat % of 29.43 ± 9.45.

Conclusion:
This study concluded that the Karada scan is a novel and rapid method to reliably measure the different variables of body composition.
Effect of Human Milk Banking on Immediate Neonatal Morbidity and Mortality
Authors: Mane Shailaja Vijaykumar , Salunkhe Shradha , Agarkhedkar Sharad , Lakhwani Priyanka , Malwade Sudhir 
Published: August 2024

Introduction:Human milk banking (HMB) is a service established for collection, screening, processing, storage, and distribution of donated human milk. HMB is the best way of ensuring a safe supply of human milk to all the needy neonates. It helps to decrease infections, neonatal sepsis, and necrotizing enterocolitis, thus reduces neonatal morbidity and mortality.Methodology:This is a short-term student research project conducted as an observational, comparative, cross-sectional study. It was conducted in the neonatal intensive care unit (NICU) and HMB of a tertiary care hospital in a metropolitan city, conducted after approval from the Ethics Committee of the Institute. A total of 50 neonates from the NICU who had received pasteurized donor human milk (PDHM) were enrolled in one group (Group I – PDHM). The data of 50 newborns from NICU of the same institute were also collected retrograded for comparison before the establishment of HMB, as they had not received PDHM and enrolled in another group (Group II – non-PDHM).Results:It was observed that in Group I (PDHM), 55% of neonates were full term and 42.5% were preterm, and in Group II, 45% were full terms and 57.5% were preterm. Sepsis was seen in 30% of Group 1 and 54% of Group 2 and hyperbilirubinemia was seen in 22% of Group 1 and 42% of Group 2. There was a 24% decrease in sepsis and 20% decrease in hyperbilirubinemia in PDHM group. Mortality was seen in 40% of Group 1 and 60% of Group 2. A decrease in mortality was seen in PDHM group.Conclusions:HMB is imperative for the reduction of neonatal morbidity and mortality. It is a feasible, cost-effective option and a boon for neonates, particularly in developing countries like India.
A Study on Correlation of Hematological Parameters with Computed Tomography Severity Score in COVID-19 Patients in a Tertiary Care Center
Authors: Chandran Jayanthi , Amirthalingam Umamageswari , Abinizha S , Sindhuri R 
Published: August 2024

Background:
COVID-19 is a rapidly spreading infectious pandemic. Increase in the level of systemic inflammatory markers is known to play fugitive role in the prognosis of the patients. This study retrospectively correlates the various hematological parameters with computed tomography severity score in COVID-19 patients.

Method:
The demographic, hematological, and radiological parameters of 150 patients were collected and analyzed. The performance of complete blood count (CBC) indexes for monitoring and predicting the severity of COVID-19 in patients was evaluated by analyzing and comparing CBC results with radiological severity score.

Results:
Neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) correlated positively while lymphocyte correlated negatively with chest computed tomography severity score. Neutrophil, lymphocyte, eosinophil, monocyte, NLR, and PLR showed a significant difference between radiologically mild and severe COVID-19 cases (P < 0.05).

Conclusion:
The prognostic value of NLR in predicting the severity of illness is well established in our study. Increased NLR should prompt the clinicians to predict increased lung involvement by COVID-19 and should cater the treatment accordingly.
COVID-19 Knowledge, Attitudes and Practices Survey among Population of Western Maharashtra
Authors: Asha B. Thomas , Bhalchandra K. Vaidya , Sneha R. Chandani , Anand Kawade , Sohan S. Chitlange , Varsha S. Sarode , Manish Arya , Dharmendra Sharma 
Published: August 2024

Background:
In wake of COVID-19 pandemic in India, basic knowledge of mode of transmission of the disease, precautionary hygiene practices to be adopted to contain the infection and specific dietary modifications to be made as per government advisories are critical from public health and safety viewpoint.

Objective:
The objective is to find out the perception of population in Maharashtra state, India with specific emphasis on their knowledge, attitudes, and practices (KAP) during the pandemic.

Methods:
KAP was assessed through a systematic survey employing a structured questionnaire and was carried out through online-platform among the Indian population in Maharashtra state. The questionnaire was designed as per WHO guidelines. Data were collected from 1770 respondents across Maharashtra state, India from April 1, 2021, to April 30, 2021. Data were systematically analyzed using correlation and ordinal logistic regression models.

Results:
Data collected from 1648 participants across Maharashtra state indicated that 82.9% of respondents had high level of knowledge about the disease. However, it alarming to observe that 78.7% of respondents still demonstrated low COVID-19 related practices score. The pandemic also affected the psychological well-being of 81% of respondents; with major socio-economic implications (55%). The regression analysis showed that female participants displayed higher knowledge than males. Also, educational qualification had an impact on practices-1 (general) while both gender and educational qualification affected practices-2 (COVID-19 related).

Conclusion:
Findings of this KAP survey demonstrated good knowledge of the average population but relatively lower levels of attitudes and practices toward the pandemic. This highlights the need of training/counseling programs that can impart positive attitudes and improved practices to Indian citizens to fight the COVID-19 pandemic.
Patients’ Perception Toward Doctors’ Appearance and its Influence on Doctor–Patient Relationship: A Cross-Sectional Study
Authors: Laikhuram Priya , Umar Yanal , Gupta Avantika , Christina Soubam , Devi Thoudam R. , Sungoh Luckystar , Devi Hanjabam S. 
Published: August 2024

ABSTRACT

Background:
Despite technological advances and changes that the medical fraternity has experienced in the last few decades, the physical appearance of physicians still influences the patients’ perception of doctors. The basis of medical practice depends on a robust doctor–patient relationship and efforts should be made to build rapport to foster a partnership to provide patient-centered care.

Objective:
The aim of this objection is to determine the patient’s perception of doctors’ appearance and its influence on the doctor–patient relationship.

Materials and Methods:
A cross-sectional study was conducted among patients attending OPD in health-care centers of Manipur from January 2022 to February 2022. Five hundred and forty-four patients were interviewed using a pretested structured questionnaire. A Chi-square test was performed to check for an association between independent and outcome variables (P < 0.05).

Results:
Mean age of the participants was 36.40 years (±12.55). A percentage of 60.80 were females and 64% of the participants were from the tertiary care center, Imphal West. A percentage of 60.5 preferred doctors’ attire to be formal with a white coat. A percentage of 52.9 of them perceived that doctors’ attire will make them seem more approachable. A percentage of 39.7 had preferences in doctors’ gender. Participants from urban health-care centers had significantly more preference for the doctors’ attire to be a formal dress with a white coat (P = 0.04). Age group, gender, type of setting, and education level were significantly associated with gender preference (P < 0.05).

Conclusion:
The majority of the participant had no preference over the doctor’s gender and preferred doctors’ attire to be formal with a white coat. The doctor’s hair dye, facial piercing, and tattoos didn’t bother a majority of the patients.
Assessment of Computed Tomography-Based Sphenoidal and Sellar Parameters Relevant to Transsphenoidal Approach in Sellar and Parasellar Surgeries
Authors: Amirthalingam Umamageswari , Veeramani Raveendranath , Adhithiya Vigneshwar 
Published: August 2024

ABSTRACT

Aim:
To study the sphenoid and sellar parameters relevant to transsphenoidal approach in sellar and parasellar surgeries.

Objectives:
(1) To estimate the types of pneumatization of sphenoid sinus and intersphenoidal septum, (2) To assess the attachment and number of intersphenoidal septum among those who have intersphenoidal septum, (3) To determine the thickness of the anterior wall and floor of sella, and (4) To calculate the intercarotid distance of the intracavernous internal carotid artery.

Methods:
This was a record-based descriptive study. All retrospective computed tomographic (CT) images of head (demonstrating the nasal cavities, sphenoid sinus, and sella) done in the department of radiodiagnosis, using Toshiba Aquilon Prime 160 slice CT scanner, during the period of September 2016–February 2017 for routine diagnostic purpose were included. Following parameters were assessed: The pneumatization pattern of the sphenoid sinus, septation within the sphenoid sinus, intercarotid distance, thickness of the bony anterior sellar wall, in the sellar type sinus, and thickness of the bony sellar floor, in the sellar type sinus.

Results:
About 2% showed non-pneumatization of the sphenoid sinus. The pneumatization pattern was classified into conchal, pre sellar, and sellar types. The sphenoid sinus showed variable septation pattern. The commonest insertion of the septum was on the sellar floor (38.8%), while other insertion patters into the optic canal or carotid canal were also noted. The maximal intercarotid distance was 27 mm.

Conclusion:
The sphenoid sinus has lots of intrinsic variations in pneumatization pattern. Knowledge of detailed anatomy is crucial to minimize and prevent the intraoperative and postoperative complications. Hence, CT plays an inevitable role in the preoperative workup.
First-Year Medical Students’ Perspective on Early Clinical Exposure in the Era of Competency-Based Medical Education: Unraveling by Thematic Analysis
Authors: Kumar Prashanth , Mythri G , Shetty Archana , Yashaswini LS , Chaitra N.D 
Published: August 2024

ABSTRACT

Introduction:
Implementation of Competency-Based Medical Education (CBME) as an outcome-based teaching methodology has brought changes in the curriculum worldwide in terms of teaching and learning. As students are the prime stakeholders in medical education, their feedback is crucial in designing the curriculum framework. We present thematic analysis of medical students’ feedback on Early Clinical Exposure (ECE), which has given an in-depth insight into their perceptions.

Materials and Methods:
A prospective study was conducted post early clinical exposure session for the first-year MBBS students under the CBME curriculum from April to October 2021 in a teaching medical institute. Feedback was collected in text transcripts by two open-ended questions about effectiveness and suggestions for improvement. Qualitative data analysis of thematic type was performed.

Results:
Post-familiarization of data codes were generated for each of the two questions. Codes with similar meanings were grouped into four themes for each question. Analysis of students’ transcripts revealed perspectives on knowledge, doctor–patient relationship, clarity in understanding concepts as themes for effectiveness, the need for case-based learning in the hospital environment, time management, and innovative teaching methods as themes for improvement.

Conclusion:
Students perceived the teaching methodology of early clinical exposure positively and recognized the need to integrate basic science with clinical expertise and professional identity at an early stage in medical school. The study results have brought out implications for improving teaching sessions in terms of technology use, content, and creating a conducive environment for the learners.