bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychometric Properties of the Persian Version of the Multiple Sclerosis Work Difficulties Questionnaire (MSWDQ) Questionnaire
Authors: Mirmosayyeb Omid , Shaygannejad Vahid , Najdaghi Soroush , Ghajarzadeh Mahsa 
Published: May 2024

Background:
Patients with multiple sclerosis (MS) suffer from a wide range of psychological and physical problems. Employment status is a crucial issue for patients with MS as unemployment while it is not completely evaluated in patients with MS.

Objectives:
To assess psychometrical properties of the Persian version of the Multiple Sclerosis Work Difficulties Questionnaire (MSWDQ).

Methods:
One hundred and sixty patients were enrolled. They were asked to fill valid and reliable Persian version of the Fatigue Severity Scale (FSS), social support scale, and Short Form Health Survey (SF-36) and translated version of the MSWDQ questionnaire. Twenty cases filed the questionnaire two weeks later to assess reliability. The intra-class correlation coefficient (ICC), Cronbach's alpha, correlation coefficients were used.

Results:
Mean age and mean duration of the disease were 36.8 ± 9.1, and 7.5 ± 5.1, respectively. The Cronbach alpha for psychological/cognitive barriers subscale was 0.87, for Physical barriers was 0.83 and for external barriers was 0.86. The Cronbach α for the whole questionnaire was 0.89. There was a significant positive correlation between FSS and MSWDQ score, and a significant correlation with SF-36 and social support. The ICCs of all questions were acceptable.

Conclusions:
Persian version of MSWDQ questionnaire is a valid and reliable instrument for evaluating work-related problems in patients with MS.
Prevalence of Nonalcoholic Fatty Liver Disease in Children with Renal Failure Underwent Treatment with Dialysis
Authors: Madihi Yahya , Tavakoli Reza , Riahinezhad Maryam , Mostofizadeh Neda , Mehrkash Mehryar , Rostampour Noushin , Hovsepian Silva 
Published: May 2024

Background:
In this study, we aimed to investigate the prevalence of nonalcoholic fatty liver disease (NAFLD) in children with renal failure under treatment with dialysis and its association with biochemical measurements.

Methods:
In this cross-sectional study, children aged less than 18 years with chronic kidney disease (CKD) who were under treatment with dialysis at least 3 months ago were enrolled. To evaluate fatty liver in those patients who had no recent liver ultrasonography (last 6 months), liver ultrasonography was performed. The characteristics of patients with renal failure with and without NAFLD based on the ultrasonographic evaluation were compared. The association between NAFLD and the studied variables was evaluated.

Results:
In this study, 39 children (31 males and 8 females) with renal failure who underwent treatment with dialysis were included. From the studied population, six (19.4%) had NAFLD based on ultrasonographic evaluation. There were no differences between renal failure patients with and without NAFLD regarding the biochemical and anthropometric characteristics (P > 0.0).

Conclusions:
The prevalence of NAFLD in our studied children with renal failure who underwent treatment with dialysis was like the general population and it was not associated with the biochemical and anthropometric characteristics of the patients. Given the importance of NAFLD in renal failure patients as well as its subtle nature, it is recommended to screen patients with CKD for NAFLD.
Relationship between Severity and Complexity of Coronary Artery Involvement and Obstructive Sleep Apnea Based on STOP-BANG Questionnaire
Authors: Naghshtabrizi Nima , Alizadeh Soroosh , Naghshtabrizi Behshad , Jalali Arash , Salarifar Mojtaba 
Published: May 2024

Background:
Obstructive sleep apnea (OSA), which has a known correlation with cardiovascular disease, is a possible risk factor of coronary artery disease (CAD) that is preventable.

Aims:
We sought to put lights on the relationship between OSA based on the STOP-BANG questionnaire (SBQ) and the severity and complexity of coronary artery involvement.

Methods:
This cross-sectional, single-center, retrospective study was conducted among 145 patients who underwent selective coronary angiography (SCA) between October 2018 and March 2019, admitted to the Tehran Heart Center, Tehran, Iran. OSA risk was assessed in patients based on SBQ categories. Also, the severity and complexity of coronary artery involvement calculated according to SYNTAX and Gensini scores. Analysis performed by statistical software SPSS 25.

Results:
Based on SBQ risk assessment categories, 22 (15.2%), 64 (44.1%), and 59 (40.7%) of the patients were low, intermediate, and high-risk for OSA, respectively. By comparing the means of coronary artery involvement, there was no significant difference in SYNTAX score 17.15 ± 13.67 (10.56–23.74) in low, 15.67 ± 9.78 (13.19–18.16) in intermediate, and 16.93 ± 9.21 (14.42–19.45) in high-risk groups; P value: 0.754, and Gensini score 66.4 ± 70.75 (35.04–97.77) in low, 66.21 ± 55.05 (52.45–79.96) in intermediate, 74.61 ± 56.33 (59.93–89.3) iin high risk groups; P value: 0.697 with groups of OSA risks. Also, after adjusting confounding factors, there was still no statistically significant difference in terms of coronary involvement scores.

Conclusions:
There was no statistically significant difference in SYNTAX and Gensini scores of different groups of OSA risk categories based on the SBQ. However, our results can't be extended into the connection between OSA and CAD.
Diet Quality Indices in Relation to Cardiovascular Risk Factors in T2DM Patients
Authors: Sepandi Mojtaba , Parastouei Karim , Samadi Mohammad 
Published: May 2024

Background:
Dietary quality indices are practical as an instrument to investigate the extent of adhering to a special diet to prevent cardiovascular disease (CVD) in type 2 diabetes mellitus (T2DM). Considering the lack of any systematic review with regards to this issue, our aim was to examine observational studies to test the relationship between dietary quality indices and CVD risk factors in T2DM.

Methods:
Systematic search was performed in Web of knowledge, PubMed, Cochrane, Science direct, Google Scholar and Scopus databases from January 1990 to July 2020. The studies exploring the relationship between dietary quality indices (diet quality score (DQS), dietary diversity score (DDS), healthy diet indicator (HDI), healthy eating index (HEI), diet quality index (DQI), Mediterranean diet score (MDS)) and lipid profile, anthropometric indices, glucose profile as well as blood pressure were eligible to be included in this review. Overall, mean changes, odd ratio (RR), correlation coefficients, and beta coefficient of outcomes were extracted, with the quality assessment of studies performed applying The Newcastle-Ottawa scale.

Results:
From among 1627 papers, 10 articles were included: Eight cross-sectional and two prospective (cohort) studies. The association between HEI as well as MDS and CVD risk factors was more evident in the included studies. Fasting blood sugar, hemoglobin A1c, body mass index, and waist circumference revealed the greatest inverse significant relationship with dietary quality indices in adults with T2DM.

Conclusion:
Overall, the findings of this study suggest that the level of CVD risk factors in T2DM decreases significantly with increase in the score of dietary quality indices. Further studies in future are required to confirm these findings.
Effect of Short-Term Practice of Left Nostril Breathing on Various Sleep Parameters in the Medical Students
Authors: Gajbhiye Himanshu A. , Vij Vinu , Raje Dhananjay 
Published: May 2024

Background:
Various recent studies have reported that exclusive right nostril breathing (RNB) and left nostril breathing (LNB) has an immediate and sustained effect under various medical conditions. In the present study, we evaluated the effect of short-term left nostril breathing on various sleep parameters in medical students.

Methods:
We hypothesized that the increase in vagal tone because of LNB can help in improving the quality of sleep. The baseline sleep quality was documented before the start of study in the case and the control group using the ’Pittsburgh Sleep Quality Index’ (PSQI) questionnaire. A PSQI global score of more than 5 indicates poor sleep quality. The case group practiced LNB in a graduated manner for a period of 4 weeks. Thereafter, sleep quality was documented for both the groups using the PSQI questionnaire.

Results:
Practicing LNB significantly lowered all the seven component scores (p < 0.05) and the global PSQI score in the case group (p-value < 0.0001), suggesting that this practice effectively improved the sleep quality in the individuals of this group.

Conclusions:
Overall, this study suggested that exclusive LNB practice could serve as an important lifestyle modification that can be incorporated in the routine of medical students for improving their sleep quality.
Effect of Short Course on the Knowledge and Practice of Housewives Peer Group Activists as Assistance to Lactating Mothers in Providing Exclusive Breastfeeding
Authors: Nugraheni Sri Achadi , Sulistiawati S , Suyatno S , Sulistyowati Etik , Kartasurya Martha Irene , Nandini Nurhasmadiar 
Published: May 2024

Background:
Efforts to increase the coverage of exclusive breastfeeding require extraordinary innovation supported by many parties, such as community leaders, including Housewives Peer Group activist living as a neighborhood of lactating mothers. The aim of this study was to analyze the effect of a short course on the knowledge and practice of Housewives Peer Group activists as assistance to lactating mothers in providing exclusive breastfeeding.

Methods:
The method of the research was pre and post-test of quasi-experimental. The population was Housewives Peer Group activists in the working area of Tlogosari Wetan Community Health Center, Semarang City. Samples were chosen using purposive random sampling to 37 Housewives Peer Group activists. The intervention given was a short course which should be attended by the group, and the post-test was assessed 1 month after conducting the pre-test.

Results:
The results of the Wilcoxson Match Paired test showed differences in knowledge (P < 0.05) and practice (P < 0.05) of the Housewives Peer Group activists before and after attending a short course regarding exclusive breastfeeding and lactation management. At the end of the study, the knowledge and practice of the Housewives Peer Group activists increased by 4.21 points and 3.73 points, respectively.

Conclusions:
Short course on exclusive breastfeeding and lactation management significantly influences the increased knowledge and practice of Housewives Peer Group activists that further improve the quality of transferred information, monitor public health, especially to increase the coverage of exclusive breastfeeding and lactation management for breastfeeding mothers.
Association of Maternal Obesity and Diabetes Mellitus with Exclusive Breastfeeding Among Saudi Mothers in Jubail, Saudi Arabia
Authors: Al-Anazi Ohud Mohammed , Mohammad Haneef Mohammad Shafee , Zafar Mubashir , Ahsan Mohammad 
Published: May 2024

Background:
Obesity and diabetes are common public health issues in Saudi Arabia. The aim of this study is to evaluate the association of maternal obesity and diabetes with exclusive breastfeeding among Saudi Mothers at the Royal Commission Service Primary Health Care Centers in Jubail City, Saudi Arabia.

Methods:
It is a cross-sectional study and 360 mothers were selected from primary health center through a simple random sampling. A validated and structured questionnaire was used. Body mass index was used for calculation of obesity and fasting blood sugar to find out the diabetic status. Chi-square test was used to assessing the difference between obese and nonobese and diabetic and nondiabetic group with respect to exclusive breastfeeding. Logistic regression was used to determine the association of obesity and diabetes with exclusive breastfeeding.

Results:
Obesity and diabetic prevalence among study participants were 81.9% and 65.5%, respectively. Exclusive breastfeeding prevalence among total study participants was 36.9%. Among obese, it was 28.8% and diabetes, it was 29.1% and this difference is statistically significant when compared to nonobese and nondiabetic group (P-value 0.04). The obese [OR1.30 (1.12–4.85) with P value 0.02] and diabetic [OR 1.56 (1.35–3.9) with P value 0.00] mothers were more than one time more likely associated with nonexclusive breastfeeding.

Conclusions:
The study concludes that the rate of exclusive breastfeeding decreased among obese and diabetic mothers and the positive association of obese and diabetes with nonexclusive breastfeeding. Intervention is required to reduce the prevalence of obesity and diabetic among breastfeeding mothers.
Incidence and Source of COVID-19 Infection Among Health Care Workers in a Tertiary Hospital in South India—A Prospective Cohort Study
Authors: Mohan Yogesh , Charumathi B. , Anantha Eashwar V. M. , Jain Timsi , Abiramasundari V. K. 
Published: May 2024

Background:
Data for COVID-19 incidence and the source of infection among health care workers (HCWs) in Indian population are limited. The main objective of the study was to assess the incidence of COVID-19 infection and identify the source of infection among the HCWs in a tertiary teaching hospital.

Methods:
A prospective cohort study was conducted among the 2134 HCWs recruited by purposive sampling from a tertiary teaching hospital from May to August 2020 (4-month period—123 days). Over the 4-month period, all the HCWs who had symptoms or those were close contacts of COVID positive patients were traced and tested using validated COVID diagnostic test (reverse transcription–polymerase chain reaction [RT–PCR] test). A semi-structured questionnaire was used to interview each positive HCW to identify the source of exposure of the infection.

Results:
Incidence proportion was 9.3% among HCWs and was two times higher among males compared to females. Hazard ratio was found to be higher among males and HCWs working in the non-COVID areas. Test positivity rate was found to highest (around 57.8%) among those aged less than 30 years. The most common source of infection was infected HCW colleagues (40.9%) followed by exposure to patients in non-COVID areas (27.3%). Only 5.1% of total infection was found in HCWs who had worked in COVID zones.

Conclusions:
People working in non-COVID areas, those using shared workplace, dining halls, and staff hostels, must follow strict COVID protocols by using appropriate Personal Protective Equipment (PPE) and following social distancing measures.
Stepped Care Model for Developing Pathways of Screening, Referral, and Brief Intervention for Depression in Pregnancy
Authors: Kukreti Prerna , Ransing Ramdas , Raghuveer Pracheth , Mahdevaiah Mahesh , Deshpande Smita N , Kataria Dinesh , Puri Manju , Vallamkonda Omsai Ramesh , Rana Sumit , Pemde Harish K , Yadav Reena , Nain Shilpi , Prasad Shiv , Garg Bhavuk 
Published: May 2024

Background:
Depression in pregnancy affects nearly one in five women in low- and middle-income countries and is associated with adverse obstetric and neonatal outcome. Burden of morbidity is high, but specialized mental health resources are meager. Effective low intensity psychosocial interventions hold promise to fill the treatment gap for maternal depression. In this paper, we aim to describe the process of development of a stepped care model incorporating screening, providing brief intervention, and referral pathways developed for managing depression in pregnancy in antenatal care health facilities in India.

Methodology:
Using complex intervention development and evaluation method of Medical Research Council, United Kingdom, we searched evidence-based strategies from preexisting manuals, conducted formative research for need assessment and stakeholder engagement, and developed the intervention following an expert review panel. We conducted pilot testing to assess the feasibility and acceptability of intervention supplemented by three focused group discussions.

Results:
Manual review identified psychoeducation, empathetic listening, behavior activation, and supportive counseling as important elements. Need assessment revealed huge gap in perinatal mental health knowledge. Nearly 92% of total 272 perinatal women had poor awareness and 35%–70% of total 62 health-care providers had poor knowledge. In qualitative interview, women reported depressive symptoms as a normal part of pregnancy and had poor help seeking, behavior symptoms of depression were more prominent. A stepped care algorithm was developed for screening all expectant mothers in each trimester for depression using Patient Health Questionnaire-9 (PHQ-9). Women with PHQ-9 score >19 or reporting self-harm ideation were urgently referred to psychiatrist. Women with PHQ-9 score 5–19 were given brief intervention for depression in pregnancy intervention by antenatal nurse. The intervention developed consists of three sessions of psychoeducation, relaxation exercise, and mental health promotion, each lasting 20 min and at gap of 2 weeks each. Service providers and mothers reported good acceptability of psychosocial intervention and reported satisfaction with content and delivery of intervention.

Conclusion:
Low intensity brief psychosocial interventions can be adapted for implementation if relevant stakeholders are engaged at each step right from development of such as screening, intervention pathway to delivery, and effectiveness study.
Association of Physical Activity with Gestational Diabetes Mellitus among Pregnant Women in a Rural Area of Maharashtra: A Community-based Cross-sectional Study
Authors: Prabhakar Manish Chandra , Halder Pritam 
Published: May 2024

Abstract

Objective:
Our objective was to determine the association of physical activity with gestational diabetes mellitus (GDM) among pregnant women in a rural area of Maharashtra.

Methods:
The current community-based cross-sectional study was conducted among 965 pregnant women from 3 primary health centers of the field practice area of the Department of Community Medicine, MGIMS, Sevagram, who were included in the ICMR-funded Central India Rural Pregnancy Cohort Project from October 2016 to May 2018. After assuring informed written consent, a pretested semi-structured questionnaire was administered. The Diabetes in Pregnancy Study Group India criteria were used for screening. The level of 2-h plasma glucose >140 mg/dL with 75 g oral glucose load was used to diagnose GDM irrespective of the duration of the last meal. The Pregnancy Physical Activity Questionnaire (PPAQ) was administered to assess the association of physical activity and GDM among the participants.

Results:
Among all participants, 5.39% were GDM positive; 24.45% of pregnant women had metabolic equivalent of task (MET) score <8.5 MET-h/day, and 75.54% had MET-h/day score >8.5 MET-h/day. The odds of having GDM in participants with physical activity < 8.5 MET-h/day was 22% more than that of participants with >8.5 MET-h/day. Two hundred and thirty-six participants (24.45%) reported to have sedentary levels of physical activity, 437 (45.28%) had light-level physical activity, 255 (26.42%) had moderate physical activity, and only 37 (3.83%) had heavy physical activity. With respect to participants with sedentary lifestyle, participants performing light (odds ratio [OR]: 0.76; 95% confidence interval [CI]: 0.21–2.79), moderate (OR: 0.54; 95% CI: 0.15–1.92), and heavy physical activities (OR: 0.65; 95% CI: 0.17–2.41) had 24%, 46%, and 35% lesser odds of having GDM, respectively.

Conclusions:
The current study documented the inverse relationship of physical activity during pregnancy and the risk of developing GDM. With an increase in the intensity of exercise the risk of GDM became lesser respectively. It is advised to all the women to perform regular physical activity during family planning, as early as possible, and to continue during the span of pregnancy to avoid the risk of developing GDM.
Recurrent Brunneroma: A Rare Cause of Duodenal Obstruction
Authors: Majumdar Namrata , Sardar Tapas , Das Dipratim , Halder Pankaj 
Published: May 2024

Abstract
Brunneroma, also known as Bruner’s gland adenoma or hamartoma, is a rare benign tumor of the duodenum. It is usually asymptomatic and sometimes presents with an upper gastrointestinal (UGI) bleed or obstruction. The majority of the cases are detected incidentally during endoscopy for UGI bleeding and may require endoscopic excision. Here, we attempt to highlight a case of recurrent large Brunneroma in a 52-year-old male and reassess the representative features that surgeons need to be aware of. We had to go for a major surgical intervention to relieve the duodenal obstruction.
Pediatric Urinary Tract Infections at a Tertiary Care Center: Microbial Diversity and Antibiotic Resistance Patterns
Authors: Agrawal Manish Kumar , Baveja Sujata , Joshi Anuja 
Published: May 2024

Abstract

Introduction:
Urinary tract infection (UTI) remains a prevalent bacterial infection among the pediatric age group, ranking as the third-most common bacterial infection in children in developing countries, following gastrointestinal and respiratory tract infections. It continues to pose a significant health challenge.

Materials and Methods:
The urine samples underwent gross examination, wet mount, and Gram stain. Semiquantitative cultures were conducted on conventional media (MacConkey agar, blood agar, and CLED agar) and UTI chromogenic media. Uropathogen identification employed standard microbiological techniques. Antibiotic susceptibility was determined using the Kirby–Bauer disk diffusion method, with interpretation based on CLSI guidelines. Plates were incubated overnight, and clear zone diameters around antibiotic discs were measured for sensitivity or resistance determination.

Results:
The study comprised 64.75% male children and 35.25% female children. Analyzing the age distribution, the majority of participants fell within the age range of 1–5 years (35%), followed by those <1 year (33.75%), and the age group of 5–12 years, accounting for 31.25% of the total 400 participants. The findings from our investigation revealed a UTI prevalence of 17.25%, with Escherichia coli and Klebsiella emerging as the predominant uropathogens. Notably, these pathogens exhibited a significant susceptibility to carbapenems, nitrofurantoin, and amikacin.

Conclusion:
Our study identified a male predominance and various age distributions among UTI patients. Antibiotic susceptibility patterns revealed E. coli and Klebsiella pneumoniae’s high sensitivity to key antibiotics, whereas Enterococcus spp. exhibited significant high-level aminoglycoside resistance. This study underscores the importance of tailored antibiotic strategies based on local resistance profiles to combat UTIs effectively.