bluuebunny/crossref_metadata_2025_split huggingface dataset:
IJCM_29A: Expenditure incurred by cancer patients covered under National Health Protection Scheme attending a tertiary care hospital in Mangalore
Authors: Unnikrishnan Bhaskaran , Rathi Priya , Saxena P U Prakash , Sudha K V , Suresh Meghana , Kamath Akshay , Lokesha Sanjana B. , Aishani K , Rekha T , Mithra Prasanna , Kumar Nithin , Holla Ramesh 
Published: April 2024

Background:
Over the past decades, cancer has become the second leading cause of death and morbidities around the world, accounting for nearly 1 in 6 of the total global deaths. The cost of treatment depends on the type of cancer, the duration of treatment, the type of hospital, and whether they are covered under any health insurance.

Objectives:
1. Cost of cancer treatment, before and after registration under VAS, among cancer patients attending an empanelled tertiary care hospital in South India 2. Pattern of OOPE incurred by households of cancer patients. 3. Proportion of expenditure spent on cancer treatment in comparison to the annual family income.

Methodology:
A hospital-based cross-sectional study was conducted in tertiary care centre among cancer patients covered under VAS, from April to May 2018. Patients who were not covered under the schemes were excluded from the study.

Results:
Out of the 150 cancer patients actively receiving cancer treatment, a majority, i.e., 65% of them were females. More than half of them (66%) were in the age group of 20-60 years. Only 9% of patients had additional health insurance to aid their expenditures while the rest were dependent only on VAS. The median (IQR) monthly income of the patient and family members was 153(83;293) USD. The overall median (IQR) cost was 525(230;980) in our patients. Costs before initiation of treatment under VAS constituted almost 90% of direct medical OOPE spent by the patient and his family. The overall mean OOPE in this study was 856 USD. 70% of the patients incurred a monthly cost of ≥40% of their monthly family income and 41% of the patient’s OOPE was more than 100% of their monthly family income.

Conclusion:
A monthly cost-to-income ratio of 240% is seen in 70% of the patients, Loans were taken and donations received to combat the expenditures. Hence VAS should reimburse the medical cost before enrolment under VAS. VAS can step up and protect its objectives by reimbursing the diagnostic costs and any long-term non-medical costs associated with the illness, as this would help reduce the OOPE by 1/3 making a huge difference to their financial status.
IJCM_290A: Death Audit Analysis from a single Covid-19 DCH of Madhya Pradesh, India
Authors: Bhatia Manohar 
Published: April 2024

Background:
In response to the escalating Covid-19-related fatalities in smaller towns and villages, the State Government initiated a daily death audit through the Death Audit Committee in each district. The aim of committee was to comprehensively review Covid-19-related deaths, utilizing the findings to inform policy decisions and prevent future mortalities.

Objectives:
To gain critical insights into the circumstances surrounding Covid-19 deaths, aiding in the identification of gaps and the development of strategies to avert future fatalities.

Methodology:
It was a cross-sectional study conducted in DCH Datia, the research encompassed all Covid-19-related deaths in Datia and Niwari districts during the first and second waves of the pandemic. The study period extended from March 2020 to July 2021, encompassing both waves. A total of 118 death audits were conducted by the Govt. Medical College Datia team, covering aspects such as age, gender, duration of ICU admission, comorbidities, and treatment including Remdesivir administration.

Results:
The second wave exhibited a significantly higher death rate (11.7%) compared to the first wave (0.04%). Among the 118 death audits, males accounted for 70 deaths (59.32%), with a majority (24.28%) occurring in the 51-60 age group. The presence of comorbidities (42.37%) was linked to increased mortality. Longer stay was associated with increased mortality. Remdesivir was administered in 39.83% of cases.

Conclusion:
The study underscores the heightened risk associated with long duration of stay and the impact of comorbidities on mortality. Further research on the efficacy of Remdesivir is warranted. The findings may help in shaping the policy & strategy in future outbreaks both at district & state level
IJCM_293A: A Reflective study about knowledge assessment and feedback of medical officers involved in the training programme for management of Animal bite as per NRCP guidelines & Snakebite in Tertiary HealthCare Centre in Central India
Authors: Prasad Pankaj , Mahant Seema P , Kumar Krishna , Dabar Deepti 
Published: April 2024

Background:
A training program for Management of Animal-bite as per NRCP (National Rabies Control Program) guidelines & Snakebite of Medical Officer was conducted in the Tertiary Healthcare Centre. Evaluation of such training has been rarely reported.

Objective:
The objective of this study was to reflect on the quality of this training program regarding knowledge assessment and feedback.

Methodology:
A pre-test and post-test cross-sectional assessment of knowledge of medical officers working at health facilities of Bhopal district of Madhya Pradesh government, who attended one-day training program at AIIMS Bhopal in 2023, were conducted through the same questionnaire having 18 single-answer multiple choice questions. Anonymous feedback was also taken through a semi-structured questionnaire. Data were analyzed using R statistical software. The Chi-square test and Wilcoxon signed-rank test was used to compare the pre-and post-test proportions of correct responses and scores, respectively.

Results:
Out of a total of 54 participants, 64.8% were males. The median (IQR) age was 41 (31,52) years. The majority of the participants (68.5%) had the qualification of MBBS, 14.8% had PG degree, and the rest, 16.6%, had BAMS degree. Median (IQR) pre and post-test scores were9.0 (9.0, 12.0) and 15 (12, 16.0) respectively. All participants agreed that the training was very useful for the patient care and gave positive feedback related to the management of training.

Conclusion:
This training was very useful in terms of improvement of knowledge is concerned. More Tertiary Healthcare institutions should take the initiative to conduct such training programs for capacity building of Medical Officers working at community level.
IJCM_296A: Assessment of burden of Long Covid, and it's determinants among patients with Long Covid in the rural community in Bengaluru Rural District – A community based cross sectional study.
Authors: Gowthami P 
Published: April 2024

Background:
Longer-term consequences after SARS-CoV-2 infection are becoming an important burden to societies and healthcare systems. Long COVID-19 and post COVID-19 conditions are terms used clinically to describe ongoing or new symptoms that occur beyond 12 weeks of recovery from an acute infection, that cannot be explained by an alternative medical diagnosis. It is now understood that COVID-19 can impact on multiple organ systems, which can lead to a diverse range of persistent symptoms including fatigue, breathlessness, cough, loss of taste and/or smell, myalgia, memory issues and gastrointestinal problems. Very few studies have been conducted globally to assess the burden of Long Covid which are in hospital setting and none published in Karnataka state. This community based cross sectional study intends to bridge the gap in existing evidence pool and to influence evidence-based policy decisions at local administrative level.

Objectives:
To assess the prevalence of Long covid among people infected with COVID-19 in rural community Bengaluru rural district.

Methodology:
Community based cross sectional study was conducted between October 2023 to November 2023 in Orohalli & Jadigenahalli Panchayaths of Hoskote Taluk. After obtaining written and informed consent from the participants, all adults > 18years of age residing in identified villages, with COVID-19 RTPCR positive status, tested at least 12 weeks/ 3 months prior to the date of interviewed using a prevalidated questionare and Fatigue Assessment Scale. Data is analysed using SPSS trial version 21.

Results:
420 participants were interviewed in 17 villages. Mean period between date of COVID positivity to date of interview was 490 days. 27 (6.4%) participants reported residual symptoms from COVID 19 infection suggestive of Long Covid. Majority of them complained of fatigue. Out 25 respondents with fatigue, 18 people had a score > 22 on FAS, indicative of clinical fatigue. Older age >60years, female gender, and ICU admission during infection, were associated with higher prevalence of long covid and are statistically significant (p value< 0.05)

Conclusion:
It is essential to determine the burden of longer-term consequences of SARS-CoV-2 infection and the needs of affected individuals, to successfully plan healthcare services and efficiently allocate public health resources.
IJCM_297A: Perception and practices of human papilloma virus and it’s vaccine among medical students.
Authors: Shalini Baby S , Govindu S. , Lakshmi Y. Venkata , Afreen Saleha 
Published: April 2024

Background:
Human Papilloma Virus is a DNA virus that causes wart, precancerous lesions, depending on the site affected increase the risk of cancer of the cervix, vagina, penis, anus, mouth, tonsils or throat. In India, cervical Cancer is the 2nd leading cause of cancer deaths in women aged 15 to 44 yrs. Recombinant vaccines Gardasil and Cervarix have been approved, Due to lack of knowledge, fear of side-effects & high-cost acceptance was found to be poor.

Objective:
To determine the Perception and practices of HPV virus and its vaccine among medical students.

Methodology:
A cross-sectional study was conducted from JUNE to AUGUST 2023, in a tertiary care centre, among medical students from 1st to final yr. List of all the students were obtained and 75 participants from each year were selected through simple random sampling using random number table method & total 300 participants were included in the study. Data was collected by using google form, using a self-made validated questionnaire. Data was entered into Microsoft Excel & analyzed using SPSS version 26.

Results:
The study found that 61.5% of respondents were aware of HPV, with 76.5% believing it causes over 50% of cervical cancer cases. Awareness about mode of transmission was found as 88% sexually, 70.5% through needle sharing & 66.4% during pregnancy. Awareness about preventive measures found that 91.3% knew about condoms as partial protection & 39.7% said OCPs. 80% of participants being aware of the HPV vaccine, only 18.3% received it. reasons for not getting vaccinated were 56.4% had lack of knowledge &16.8% fear of side-effects. 81.9% of them aware of HPV vaccine, 24.4% said HPV vaccine’s availability for 9-14 yrs, 36.9% knew about recommended doses, 34.6% about the vaccine type.

Conclusion:
Despite of having awareness about HPV vaccine only few participants had taken the vaccine.
IJCM_298A: Assessment of Knowledge, Attitude and Practice about Hepatitis B among Medical Students
Authors: Pratap Bhadade Snehal , Gattani P. L. 
Published: April 2024

Background:
Hepatitis B is a major public health problem. India is in the intermediate HBV endemicity zone (HBsAg prevalence among the general population ranges from 2% to 8%) with 50 million cases which makes it the second largest global pool of chronic HBV infection. Health workers, especially physicians and medical students are always in direct contact with patients and are vulnerable to acquire Hepatitis B infection. Present study aims to evaluate Knowledge, Attitude and Practice (KAP) towards Hepatitis B infection and vaccination among medical students.

Objective:
To evaluate the knowledge, attitude, and practice (KAP) of medical students regarding Hepatitis B infection and vaccination.

Methodology:
This was a cross sectional study conducted in Government Medical College. Junior resident and medical undergraduates were involved to assess their Knowledge, Attitude and Practice (KAP) about Hepatitis B infection and vaccination using a self-administered questionnaire.

Results:
Out of 317 participants 44.4% were males and 55.6% were females. 97.2% medical students have heard about the Hep B infection. 97.8% respondents indicated that they were aware of availability of a vaccine for hepatitis B. 54.6% (173) of total participants had received the Hepatitis B vaccination, of which only 142(82.08%) had received 3 doses of Hepatitis B vaccination.

Conclusion:
More than 50% of the surveyed participants have been vaccinated indicates a positive trend in immunization. Further efforts are needed to ensure complete vaccination especially in high-risk medical professionals.
IJCM_300A: Clinical medicine and Public health: Is the dichotomy justified? Epidemiological investigation of a Hepatitis A case admitted at a tertiary care hospital
Authors: Shibu Deepthi , Mridul M , Avinash S , Akshaya KM 
Published: April 2024

Background:
Outbreaks of Hepatitis A Virus (HAV) infection have been associated with poor sanitation, inadequate sewage disposal and contamination of food and water.

Objective:
To identify the epidemiological factors associated with a patient who presented with fever and vomiting and diagnosed with Hepatitis A.

Methodology:
23-year-old, female patient was admitted in the general medicine department of a tertiary care hospital with complaints of fever and vomiting. IgM ELISA tests for Hepatitis A and Hepatitis E were positive. The patient’s mother had similar symptoms. Community Medicine department was informed about the patient. A team comprising of postgraduate students, MSW, ASHA worker and Anganwadi worker visited the patient’s house. Information including clinical history, source of drinking water, history of food and water intake from outside, sanitation and waste disposal methods of the house hold were collected. Stakeholders including the counsellor and members of the self-help group of the area were informed. House to house visit of all houses in 200 meters radius from patients’ house was done to look for more cases and to assess the environment sanitation.

Results:
The team identified that the source of drinking water of the patient’s family was a well which was not sanitary. A nearby house was identified with an open well with open sullage less than one meter away. Seven children of that household had fever and jaundice and were treated from a local hospital, one week prior. Stakeholders were also informed and both the wells were chlorinated and the families were educated about the importance of boiling water before consumption, proper disposal of sullage and waste disposal.

Conclusion:
Interdepartmental communication between clinical medicine and public health played an important role in identifying and eliminating the source of infection even when one patient was diagnosed and helped to prevent HAV outbreak.
IJCM_301A: Perceived stigma and quality of life in patients living with HIV/AIDS attending antiretroviral therapy centre in a tertiary care hospital in Jammu.
Authors: Zaffer Imran , Kumari Rashmi , Gupta Rajiv K 
Published: April 2024

Background:
HIV/AIDS remains a significant global health challenge, affecting the well-being of millions around the world. While HIV treatments have demonstrated effectiveness, ongoing research indicates the persistence of various psychosocial challenges that tend to compromise the quality of life for individuals coping with HIV/AIDS. Notably, stigma associated with HIV/ AIDS remains widespread among affected individuals, exerting detrimental impacts on their overall quality of life

Objective:
To assess the quality of life in patients living with HIV/AIDS and to assess the relationship between perceived stigma and quality of life in patients living with HIV/AIDS attending an antiretroviral therapy centre in a tertiary care hospital in Jammu

Methodology:
This observational cross-sectional study was conducted among patients with HIV/AIDS over a period of 8 months who were attending an antiretroviral therapy centre in a tertiary care hospital of Jammu city of UT of J&K, using systematic random sampling. Patients were administered a questionnaire comprising socio-demographic data, (Pozqol scale) for quality of life and a short version (HSS-12) of the Berger HIV Stigma Scale. Data was analyzed using SPSS version 23.0 software

Results:
A total of 300 patients were included in the study. The mean age of patients was 42.13±10.48. Mean scores for psychological, social, health and functional domains of quality of life were 10.79Â±3.76, 10.18±3.70, 8.81±3.16 and 10.76±3.35 respectively. Overall quality of life was found to be significantly associated with marital status and HIV status of spouse/partner. There were significant negative correlations between various dimensions of stigma and different domains of quality of life

Conclusion:
Our findings indicated that higher HIV/AIDS-related perceived stigma decreases the quality of life in patients living with HIV/AIDS. “Prioritizing efforts to reduce stigma, enhance healthcare plans, and improve economic conditions is crucial for fostering improvements in the overall quality of life and its associated domains in the lives of patients living with HIV/AIDS.”
IJCM_302A: Perceptions related to lifestyle modifications among Diabetes Mellitus (DM) patients in tertiary care hospitals in Mangalore
Authors: Mithra Prasanna , Goyal Parul , Sachdeva Akshay , Manakame Bharath , Shetty Prakyath , Kumar Anand 
Published: April 2024

Background:
Diabetes is a chronic lifestyle disease which can be kept under control by some simple lifestyle modifications like blood sugar monitoring, dietary modification and exercise pattern. Diabetes mellitus (DM) appears to be a global epidemic and an increasingly major non-communicable disease threatening both affluent and non-affluent sections of the society.

Methods:
A cross-sectional study was conducted in tertiary care hospitals in Mangalore involving 109 participants. The study utilized the Summary Diabetes Self-Care Activities questionnaire to collect data. Practices were categorized as good or poor based on an average score, with scores above 75% indicating good and lower scores indicating poorer practices. Data analysis was performed using SPSS version 16.0.

Results:
The dietary modifications were good in 7.3% of the subjects, exercise behavior in 14.67%, foot care practices in 12.6% and sugar monitoring in only 1% of the subjects. Being male and married was associated with better self-care behaviors. People belonging to low socio-economic status had better dietary modification habits.

Conclusion:
Self-care activities with respect to diet and sugar monitoring are poor in the population studied. The self-care activities relating to exercise behavior and foot care are good. Improving self-care behavior among patients with diabetes in India should start with adequate targeted health education.
IJCM_303A: Prevalence and Factors associated with treatment-seeking behaviour of Diarrhoea among children under five in India
Authors: Arya VR , Giri Anjan Kumar 
Published: April 2024

Background:
Diarrhoea forms a significant public health problem in children under five years of age, especially in developing countries. The 2020 National Health Portal of India report shows 23373520 cases and 6229 deaths from diarrhoeal diseases were recorded across India. Current evidence using nationally representative data on determinants of care-seeking behaviour for Diarrhoea is limited in the Indian context. Hence, the present study complements the existing literature by examining the health-care-seeking behaviour regarding Diarrhoea among Indian children under age five.

Objective:
To study the prevalence and Factors associated with treatment-seeking behaviour of Diarrhoea among children under five in India

Methodology:
Study design: Cross-sectional study. Methods: The data for the present study were drawn from the fifth round of the National Family Health Survey (NFHS-5) conducted in 28 states and 8 union territories of India in 2019-21. Out of 222,233 children age less than five years, 16214 children having Diarrhoea were selected to explore the treatment-seeking behaviour.

Results:
Among children under five years, 7.2% suffered from diarrhoea in the two weeks receding the survey, and 76% sought treatment for Diarrhoea.

Conclusion:
Mother’s schooling is found to be important factor in health care-seeking behaviour. Thus, enhancing mothers’ awareness will help advance the healthcare-seeking behaviour.
IJCM_306A: Patient compliance towards Post exposure Prophylaxis with Anti Rabies Vaccine - Hospital based study
Authors: Chalotra Ritika , Gupta Gove Rajiv Kumar , Mahajan Richa 
Published: April 2024

Background:
Rabies is a deadly viral disease that affects the nervous system. The components of rabies post-exposure prophylaxis involve wound treatment, Rabies Immune Globulin, and the anti-rabies vaccine. Proper compliance with the rabies vaccination schedule is crucial to prevent development of Rabies

Objectives:
1) To assess prevalence of non-compliance and delayed compliance towards post-exposure prophylaxis of the anti-rabiess vaccine of GMC, Jammu 2) To study factors associated with and reasons of delayed compliance and non-compliance towards post-exposure prophylaxis of the anti-rabies vaccine of GMC, Jammu Methodology: A cross- sectional study was carried out from September 2022 to July 2023 on 594 animal bite victims presenting to OPD of the anti-rabies clinic of GMC, Jammu for the first time, with category 2 and 3 bites were included

Results:
Males were about 76.9%, and females, 23.1%. Graduates were 29.3%. Animal bites were mainly from stray dogs (58.2%), with category three wounds (93.8%). Wound washing practices were done by 540 (90.9%), about 58 (9.8%) had used only water and about 482 (81.1%) had used only soap and water for wound washing. 71.7% completed the full course of Anti-Rabies Vaccine (ARV), 24.6% showed delayed compliance, and 3.7% were non-compliant or dropouts. Delayed compliance was observed on the second (35%), third (42.4%), and fourth doses (22.6%). Reasons for delayed compliance included distant residence, loss of wages, and forgetfulness. Non-compliance reasons included negligence and health issues. No socio- demographic factors showed an association with compliance with ARV.

Conclusion:
The urgent need to increase awareness and counseling for individuals bitten by animals. Special attention is crucial for promptly administering Anti-Rabies Immunoglobulin in severe cases (category 3 bites) to prevent rabies