bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient Satisfaction with the Outpatient Department Services at a Tertiary Care Hospital in Northern India and Root Cause Analysis of the Lowest-Scoring Attribute using Fishbone Diagram
Authors: Yadav Kriti , Goyal Pooja , Parashar Lokesh , Nassa Khushboo 
Published: July 2024

Abstract

Background:
Assessing patients’ satisfaction is an easy and cost-effective method of evaluating the outpatient services provided by health-care institutions.

Objectives:
The objectives of this study were to determine patient satisfaction among patients attending various outpatient departments (OPDs) at a tertiary care hospital and the factors affecting their satisfaction.

Materials and Methods:
A cross-sectional study was conducted among patients attending various OPDs at a tertiary care hospital in Faridabad. Exit face-to-face interviews were conducted for 334 patients above 18 years of age who availed OPD services followed by pharmacy services. Information regarding sociodemography, rating of satisfaction with various attributes of OPD services on a 5-point Likert scale, and reasons for dissatisfaction was collected. Data were analyzed using SPSS version 22. Root cause analysis for the lowest-scoring attribute was done using fishbone diagram.

Results:
About 64% of the patients were satisfied with the OPD services. “Attitude and communication of doctors” was the prime contributor to patient satisfaction. “Promptness at medicine distribution counter” was the attribute that scored lowest followed by “waiting time at the registration counter.” The mean waiting time for registration was 38.2 min, for consultation with doctor 41.3 min, for collection of samples 49.6 min, and for drug dispensing 61 min.

Conclusion:
The issues related to pharmacy services need to be promptly acknowledged and addressed.
Machine Learning Approach to Study Social Determinants of Chronic Illness in India: A Comparative Analysis
Authors: Agarwala Aakanksha , Barua Barun , Chyrmang Genevieve , Deka Manab , Bora Kangkana 
Published: July 2024

Abstract

Background:
Several studies on noncommunicable diseases (NCDs) have been carried out worldwide, the basis of most of which is the identification of risk factors-modifiable (or behavioral) and metabolic. Majority of the NCDs are due to sociodemographic factors, lifestyle, and behavior, which can be prevented to a great extent. Thus, it is a health challenge and a necessity to identify such factors of NCDs.

Objectives:
The objective is to make a thorough systematic and comparative analysis of diverse machine learning (ML) classifiers and identify the best-performing model to study social determinants of NCDs.

Materials and Methods:
We used data from the Longitudinal Ageing Study in India, and predicted the prevalence of NCDs based on a set of sociodemographic, lifestyle, and behavioral risk factors by conducting a comparative analysis among 25 different algorithms.

Results:
Evaluating the performance metrics, the random forest model was found to be the most-suited method with 87.9% accuracy and hence chosen as the final model for the analysis. The model’s performance was optimized by a hyper-parameter tuning process using grid-search with a 5-fold cross-validation strategy and results suggested that it was able to make accurate predictions on new instances.

Conclusion:
The epidemic of chronic illness cannot be completely addressed without comprehending the social determinants. With advancements in medical and health-care industry, ML has been applied to analyze diseases based on clinical parameters. This work is an attempt by the authors to explore and encourage the use of ML in the field of social epidemiology.
Prevalence of Second Hand Smoke Exposure and Measures to Overcome: A Cross Sectional Study among Youth in Urban Hyderabad
Authors: Varma Pavani , Mohandas Anu , Rudrashetty Sindhu , Prasad K. Satya Vara , Balakrishna N. , Pattnaik Snigdha 
Published: July 2024

Abstract
In India, the prevalence of secondhand smoke (SHS) exposure is 29.5% in general and 11.2% at home. The youth may expose themselves to SHS without knowing the risk factors and consequences involved. This study is intended to determine the prevalence of SHS exposure and the measures adopted by the youth to avoid exposure. A cross-sectional study was conducted among 338 youth in an urban area in Hyderabad. A modified Global Youth Tobacco Survey questionnaire was used for data collection on SHS exposure and avoidance. The total prevalence of SHS exposure was 35.21%. The mean days of SHS exposure/week were 1.419 (standard deviation -1.806) days. Belonging to the age group 18–21 years, and male gender were significant predictors of SHS exposure. Education of the head of family was a significant predictor of SHS avoidance behavior. Creating awareness among young adults regarding the deleterious effects and preventive strategies of SHS exposure, thereby making them responsible for the health of their family can be a protective long-term strategy.
Availability and Accessibility of Healthy and Unhealthy Foods in Neighborhood and their Association with Noncommunicable Diseases: A Scoping Review
Authors: Sachdeva Barkha , Puri Seema , Aeri Bani Tamber 
Published: July 2024

Abstract
Worldwide, 7 million mortalities and 187.7 million morbidities have been associated with dietary risks. Poor diets emerge because of an obesogenic environment. However, clear evidence indicating an association between food environment and noncommunicable diseases (NCDs) is inconclusive. The present review was conducted to study the associations between the availability/accessibility of healthy/unhealthy foods and the risk of NCDs among adults of the age group above 18. Studies published between 2012 and 2022 were reterived using three databases - PubMed, Google Scholar, and Science Direct. Following Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR), (2018) guidelines and based on the selection criteria, 3034 studies were retrieved, of which 64 were included in this review. Maximum studies were conducted in high-income countries and adopted a cross-sectional study design. Overall, the results of the review illustrate mixed findings. Compared to healthy food, direct associations between obesity and the availability/accessibility of unhealthy foods were reported (n = 12). In case of diabetes, supermarket availability was more likely to be protective (4 positive) compared to negative association with unhealthy food stores (3 associations in 11 studies). For cardiovascular diseases, an increased number of cases with fast-food outlets (n = 6) outnumbered positive associations with healthy food (n = 3). Studies concerning multiple NCDs reported direct association with unhealthy food outlets (n = 5) while inconclusive associations with healthy food. Despite a large number of studies, a weak, inconclusive relationship between food environment and NCDs was found. The use of standardized tools and longitudinal and interventional studies are warranted to rationalize the execution of the policies related to the food environment.
Distribution of Infectious Disease Outbreaks in India before and after the COVID-19 Pandemic: Analysis of National Weekly Surveillance Data
Authors: Agiwal Varun , Chaudhuri Sirshendu , Naskar Somnath ,   IIPHH Surveillance Group
Published: July 2024

Abstract
National surveillance data were collected to study the outbreak trends of infectious diseases/syndromes before and during the COVID-19 pandemic period, spanning from 2018 to 2022. The study found that out of 4208 outbreaks, 2972 occurred before the COVID-19 period, affecting 147,425 people, while 1236 outbreaks affected 52,324 people during the pandemic. The number of outbreaks for diseases such as acute flaccid paralysis, fever with rashes, leptospirosis, rabies, and scrub typhus increased during the pandemic. The geographic distribution of outbreaks remained similar for some reemerging diseases in both periods. The trends for dengue, Japanese encephalitis, and cholera remained consistent with peaks mostly from July to September in both periods. We observed a considerable reduction in morbidity and mortality due to outbreaks in India during the pandemic. Despite similar distributional patterns, the study indicates a strong suspicion of persistent outbreak-initiating factors, necessitating an efficient and vigilant surveillance system in the country.
Airborne Infection Control Practices in Homes for the Aged in the Context of Tuberculosis Elimination
Authors: Nujum Zinia T. , Sindhu S. , Rakesh P. S. , Remya G. , Anuja U. 
Published: July 2024

Background:
National Strategic Plan to End tuberculosis (TB) in India 2020–2025 aims to prevent the emergence of TB in susceptible populations. Airborne infection control (AIC) practices in high-risk settings like homes for the aged (HFA) will be essential to achieve this.

Objective:
The objective is to assess the AIC practices (AICPs) in HFA in the Kollam district in Kerala, India.

Materials and Methods:
A mixed method approach was used. the study was done in five HFA s in a southern district of Kerala to find AICPs. Using purposive sampling, in-depth interviews was conducted among inmates with recent respiratory infection and administrators. Environmental measures were assessed using an observation checklist.

Results:
Ventilation was inadequate in 25%–40% of HFA. Air change per hour and distance between beds were less. Very few inmates were aware of the need for proper ventilation and personal hygiene. Wearing masks and hand hygiene was not practiced. Administrators faced shortages of space, funds, and human resources for caring for hospitalized inmates, and psychiatric and terminally ill patients.

Conclusions:
There is a need to train the staff and inmates on AIC. Infrastructural improvements, like the use of partition screens in the short term and the creation of model airborne infection control HFA in the long run, with a collaborative effort from health professionals and architects, are needed for TB elimination efforts to succeed.
Predictors of 5-year Survival of Elderly with Hypertension. A Prospective Cohort Study
Authors: Naghdi Babaei Fatemeh , Bijani Ali , Hosseini Seyed Reza , Ghadimi Reza , Mouodi Simin 
Published: July 2024

Background:
Given the high prevalence of hypertension in older adults, this study was conducted to identify the factors affecting the 5-year survival of older people with hypertension.

Materials and Methods:
In this cohort study, individuals aged 60 and over living in Amirkola, north of Iran who were diagnosed with hypertension were followed up for 5 years, and the effect of various factors on their survival was analyzed.

Results:
Among 1439 older people, 892 individuals (61.99%) had hypertension. Age (adjusted hazard ratio [aHR] =1.052, 95% confidence interval [CI] =1.019–1.086, P = 0.002), diabetes mellitus (aHR = 2.166, 95% CI = 1.398–3.354, P = 0.001), serum creatinine (aHR = 2.163, 95% CI = 1.391–3.363, P = 0.001), female gender (aHR = 0.460, 95% CI = 0.276–0.766, P = 0.003), body mass index ≥30 kg/m2 (aHR = 0.386, 95% CI = 0.212–0.701, P = 0.002), physical activity score >150 (aHR = 0.382, 95% CI = 0.162–0.898, P = 0.027), each one unit increase of social support score (aHR = 0.914, 95% CI = 0.861–0.970, P = 0.003), and instrumental functional ability score (aHR = 0.907, 95% CI = 0.843–0.974, P = 0.009) showed a significant effect on 5-year survival of older people.

Conclusion:
Multiple factors (such as age, gender, social support, lifestyle behaviors, and comorbidities including diabetes mellitus and renal function) might predict the 5-year survival of the elderly with hypertension. They should be considered in health-care package of these patients.
The Relationship between Leptin Hormone and Central Obesity in the Women Suffers from Polycystic Ovary Syndrome: A Case–Control Study
Authors: Al-Asadi Ekhlas Hatem 
Published: July 2024

Abstract

Background:
One of the hallmarks of polycystic ovarian syndrome (POCS) is central obesity (CO), and conditions brought on by PCOS are likely to worsen when CO is present. The hormone leptin acts as a conduit to transmit metabolic signals from the brain’s neural networks to the pituitary-ovarian axis.

Objective:
It is to find the correlation between central adiposity and blood levels of leptin in women with PCOS.

Materials and Methods:
For this study, 150 women were recruited: 75 were control (n = 75) and 75 were PCOS (n = 75). The body mass index (BMI); waist circumference; hip circumference; waist/hip ratio and level of circulating serum leptin were assessed for each individual. The data analysis was conducted utilizing SPSS software (version 23).

Results:
Leptin hormone, a higher significant in the group of PCOS when compared with the control group (P > 0.05). A positive significance correlation was found between the level of leptin with BMI, waist circumference, and hip circumference (P < 0.05). Leptin level showed an AUC of 0.93 at a cutoff point of 10 ng/mL, giving a sensitivity (93%) and specificity (96%).

Conclusion:
The positive association between serum leptin and CO with BMI could be the cause of the increased leptin levels in the PCOS women.
The Comparison between the Effect of Probiotics and Antibiotics against Enterotoxin A Produced by Staphylococcus aureus Microbial and Histopathological Study
Authors: Al-Khafaji Nawras M. , Al-Sabbagh Juman Khaleel , Jabber Eman Jawad , Mousa Rana Fadhil , Hassan Mayada S. 
Published: July 2024

Abstract

Background:

Staphylococcus aureus is a significant pathogen that causes nosocomial infections as well as community-acquired diseases; the spectrum of S. aureus infections ranges from pimples and furuncles to toxic shock syndrome and sepsis. Probiotics, which are defined as “live microorganisms that, when taken in suitable proportions, impart a health benefit on the host beyond basic nourishment,” have attracted increasing public and scientific interest in recent years; probiotics are crucial for preserving the integrity of the gut mucosal barrier and preventing the expansion of potentially harmful bacteria.

Objectives:
The aim of this study was to evaluate the efficiency of probiotics to protect against the Staphylococcal enterotoxin A (SEA) of S. aureus on different organs of rats comparing with the effect of antibiotics.

Materials and Methods:
Twenty-five isolates were obtained from a variety of clinical locations. The gene sea was detected by using specific primer, 20 rats were used in this study and randomly divided into 5 groups. A complete necropsy was performed for all the animals.

Results:
The results of the sea gene showed that 16 out of 25 isolates harbored this gene. And the photomicrograph of liver and intestine, after treatment by probiotics (bacteria and yeast), revealed normal hepatocytes and newly formed villi with mild thickness and intact a muscular layer, respectively. At the same time, after treatment with antibiotics, the results showed remarkable reversible changes of hepatic architecture, areas of hepatocytes with normal arrangements and reversible changes, and these were represented by a significant villi length and the areas of necrosis in a muscular layer in liver and intestine, respectively.

Conclusion:
The conclusion revealed, probiotics of both types (bacteria and yeast) showed curable effect in the organs under study that were altered by SEA and gave efficient effect as much as antibiotics, and also suggested the usage of probiotics instead of antibiotics for better health.
Anatomy and function: Understanding the parietal lobe’s role in psychiatry
Authors: Bazaz Abhay , Saran Brijesh , Tiwari Harshit , Kaushal Parth Sarthi 
Published: July 2024

ABSTRACT

Background:
This essay explores the complex structure of the parietal lobe, explaining its distinct characteristics and their role in cognitive processes. The relationship between parietal lobe abnormalities and psychiatric symptoms is also examined in this article.

Methods:
A thorough examination of the anatomy, physiology, and function of the parietal lobe, as well as its involvement in a range of mental conditions, is given in the research article. These are based on the review of literature of several relevant and ground breaking research papers on parietal lobe dysfunction, as well as an informative and concise summation of the structure and function of the parietal lobe.

Result:
One of the most important parts of the human brain, the parietal lobe, is in charge of several cognitive processes, such as information processing, sensory perception, and spatial awareness. This article seeks to explore the complex structure of the parietal lobe, explaining its distinct characteristics and their role in cognitive processes. The relationship between parietal lobe abnormalities and psychiatric symptoms is also examined in this article. It offers strong proof that anomalies in the parietal lobe are connected to a variety of neuropsychiatric disorders.

Conclusion:
The healthcare system faces challenges in managing parietal lobe diseases due to limited resources, health-care access disparities, insufficient comprehensive data, and insufficient neuropsychological assessments. Holistic management requires understanding patients’ neuropsychological impairments and cognitive retraining techniques. Further research is needed to understand the disease burden, address health-care gaps, and enhance health-care infrastructure.
A case of pie (pulmonary infiltrates and eosinophilia)
Authors: Goel Nancy , Sharma Manish Kumar , Mahendran C. S. 
Published: July 2024

ABSTRACT
Tropical eosinophilia is a rare but clinically significant condition caused by an exaggerated immune response to filarial parasites, predominantly Wuchereria bancrofti and Brugia malayi. We present a case of a 19-year-old male who presented with a 2-month history of cough, peripheral eosinophilia, elevated serum immunoglobulin E levels, and diffuse pulmonary infiltrates on imaging. The patient, returning from a tropical region, was diagnosed with tropical eosinophilia based on clinical presentation and laboratory findings. Prompt initiation of diethylcarbamazine therapy and albendazole resulted in the resolution of symptoms and radiographic abnormalities. This case highlights the importance of considering tropical eosinophilia in the differential diagnosis of respiratory symptoms in individuals with a history of travel to endemic regions and underscores the necessity of early diagnosis and treatment to prevent long-term complications.
Ultrasonography evaluation of endometrial hyperplasia: A prospective case–control study
Authors: Khajuria Atul , Aan Qurhatul 
Published: July 2024

ABSTRACT

Introduction:
Endometrial hyperplasia is a condition characterized by the thickening of the endometrium, which is the lining of the uterus. This thickening is caused by an increased number of endometrial glands relative to the stroma. The condition is often due to prolonged exposure to estrogen without the counterbalancing effect of progesterone.

Types of Endometrial Hyperplasia:
Simple Hyperplasia (without atypia): Increased number of glands that are cystically dilated.Minimal risk of progression to endometrial carcinoma.

Complex Hyperplasia (without atypia):
Increased number of glands with crowding and branching.Slightly higher risk of progression to cancer compared to simple hyperplasia.

Simple Hyperplasia (with atypia):
Cellular abnormalities (atypia) in glandular cells.Higher risk of progressing to endometrial cancer.
Complex Hyperplasia (with atypia): Significant glandular crowding and branching, with cellular atypia.Considered precancerous, with a substantial risk of progression to carcinoma.

Objective:
To identify the clinical factors and sonographic results related to EH in premenopausal and perimenopausal women.

Materials and Methods:
A prospective case–control study was done in the department of radiodiagnosis in diagnostic center in the field of Jung Ludhiana (Punjab). It was cross-sectional form of study control conducted over a span of 4.5 months (October 15, 2022–March 5, 2023).

Results and Discussion:
Twenty patients were premenopausal, and 18 were postmenopausal. TVS reported EH in 12 cases and pelvic USG shows 11 cases pathology results showed EH in 6 cases including simple cystic hyperplasia in 5 cases atypical, simple hyperplasia in 4 cases, and complex hyperplasia. Among these 38 cases, EH was confirmed by pathology in cases.

Conclusion:
EH is more common in women with postmenopausal bleeding and endometrial hypertrophy, especially when the endometrial image is nonhomogeneous and irregular.
Ng\^o support theorem and polarizability of quasi-projective commutative group schemes
Authors: Ancona Giuseppe , Fratila Dragos 
Published: July 2024

We prove that any commutative group scheme over an arbitrary base scheme of finite type over a field with connected fibers and admitting a relatively ample line bundle is polarizable in the sense of Ng\^o. This extends the applicability of Ng\^o's support theorem to new cases, for example to Lagrangian fibrations with integral fibers and has consequences to the construction of algebraic classes.Comment: comments welcome
Women’s Struggle Reflected in Divakaruni’s The Palace of Illusions: A Feminist Approach
Authors: Senly Darryl Augie  , Siti Hanifa  
Published: July 2024

Gender equality between men and women has been attained in plenty of countries during the past few centuries as the battle for women’s rights has progressed. This research concentrates on the female characters, specifically Draupadi and Amba. The objective of this research is to discover how female characters fight for equality in Divakaruni’s The Palace of Illusions. This research evaluates the data using qualitative methods and Naomi Wolf’s power feminism. The findings indicate that Draupadi strives for equality by wielding power, collaborating with a man, respecting another woman’s beauty choice, being able to voice her opinions, and making significant decision-making. Meanwhile, Amba decides to utilize her power, gain advantage of male strength, and take responsibility to fulfill her own needs.
Mutual Trust and Employee Engagement: Impact of Women Leadership
Authors: Mrs. Aparna Kulkarni  
Published: July 2024

Employee engagement have direct impact on organizational performance. When employee are more engaged with the organization, they feel more attached with their work and overall development of the organization. Effective Leadership plays a vital role in employee engagement by developing mutual trust and understanding between leader and follower. The present study tried to find out the relation between women leadership characteristics and their impact on developing mutual trust between leader and follower to enhance employee engagement in the organization. The data has been collected from more than 200 employees where women are working on higher or higher-middle level positions. Linear regression model has been used to find out the effect of women leadership characteristics on mutual trust and understanding. The questionnaire has been used on five-point lie cart scale. The result showed that idealized influence of women leaders have positive impact on mutual trust whereas contingency reward does not have much impact on mutual trust and understanding. Individual motivation also have positive impact on mutual trust and understanding though individualized consideration does not have much impact on mutual trust and understanding. Employee engagement shown positive correlation with mutual trust. Thus, overall, the study shows that women leadership characteristics have impact partially on mutual trust and understanding to enhance employee engagement.