bluuebunny/crossref_metadata_2025_split huggingface dataset:
IJCM_103A: Cost Benefit Analysis Related to Community Acquired Pneumonia inpatients among Geriatric Age Group-A Study Conducted in A Tertiary Care Hospital
Authors: Behera Abhimanyu , Sethy Debasish , Pradhan Somen Kumar , Satapathy Durga Madhab 
Published: April 2024

Background:
Community-acquired pneumonia (CAP) is a common acute infectious disease among elderly people, and is associated with high rates of hospital admission and mortality. Old Age and male sex are known risk factors for CAP among adults and many comorbidity are also risk factors for CAP, such as chronic obstructive pulmonary disease (COPD), diabetes, cancer, dementia, congestive heart failure, and liver function failure.

Objective:
This study aimed to estimate the economic burden of community- acquired pneumonia (CAP) among elderly patients in Berhampur, Odisha. In addition, the study evaluated the relationship between total treatment cost and CAP risk factors.

Methodology:
A cross-sectional study was conducted in the IPD of MKCG MKCG Medical College of Berhampur in the period of September-November 2023. Purposive sampling was used and data was collected using semi structured questionnaire and analyzed by MS Excel 2017

Results:
Among 348 are inpatient CAP episodes the mean ages were 63±8 years in outpatient group and 70±4 yrs in inpatient groups respectively. The Median treatment cost is Rs.3000/-INR per outpatient episode and Rs 10060/-INR per inpatient episode.Old patient, Male sex, Diabetes, Chronic obstructive Pulmonary Disease, liver dysfunction were associated with increased treatment cost.

Conclusion:
The economic burden of CAP might be decreased by reducing the number of hospitalizations for mild CAP and the incidence of severe CAP. Therefore, preventative care (e.g. oral hygiene or pneumococcus vaccination) is recommended for patients with related risk factors, such as male sex, older age, diabetes, chronic obstructive pulmonary disease.
IJCM_104A: Polypharmacy and medication adherence among elderly population in a rural area of Ernakulam district, Kerala.
Authors: Rasheed Amina , Aswathy S 
Published: April 2024

Background:
Polypharmacy is the concurrent use of multiple medications. Although there is no standard definition, polypharmacy is often defined as the routine use of five or more medications. This includes over-the-counter, prescription and/or traditional and complementary medicines used by a patient

Objective:
The aim of the study was to assess the prevalence of polypharmacy, describe the number and types of drugs used, and to determine medication adherence in elderly population

Methodology:
A cross sectional study was conducted among 364 elderly population residing in Vypin Block of Ernakulam district, Kerala by probability-proportional-to-size sampling. A semi structured questionnaire was administered by face-to-face interview to collect details on sociodemographic profile, regular medications and Morisky Medication-Taking Adherence Scale- MMAS (4-item) to assess medication adherence. The study participants were categorized into poor and good adherence based on MMAS score

Results:
More than half (53%) of the elderly were females, with a mean age of 69 ± 7 years. The prevalence of polypharmacy among the study population was 14.6% [95% CI, 11-18.2]. The most commonly used medications (35%) were oral blood glucose-lowering agents, followed by antihypertensive drugs and lipid-modifying agents. The vast majority (86.5%) had good medication adherence according to MMAS score. The independent determinants of medication adherence in our study were males (aOR=2.53 CI 1.09-5.08; p= 0.03) Christian religion (aOR=3.84 CI 1.43-10.34; p=0.008), staying along with family (aOR=8.15 CI 2.04-32.5; p=0.003), having polypharmacy (aOR=3.69 CI 1.54-2.82; p=0.003) and not having to pay for medications (aOR=3.4 CI 1.51- 7.64; p=0.003) were found statistically significant with medication adherence

Conclusion:
In order to improve medication adherence, the health care system should focus on women, those who stay alone and those who have to pay for medications
IJCM_112A: Impact of competitive spirit on weight, waist circumference and HbA1c among the followers of Dixit Lifestyle participating in 90 Days weightloss and Diabetes Reversal Challenge
Authors: Dixit Jagannath 
Published: April 2024

Background:
Author has initiated World free of obesity and diabetes campaign since 2013. This lifestyle suggests taking only two meals in a day and go for any cardio exercise for 45 minutes at a stretch every day. This lifestyle is showing great results in weight loss and diabetes prevention/remission. Through the campaign 90 days weight loss and diabetes reversal challenge was organized from 1t August to 31st October 2023.

Objectives:
1) To find out the effect of competitive spirit on weight and waist circumference among the participants 2) To find out the effect of competitive spirit on HbA1c and doses of diabetes medicines

Methodology:
Through messages on social media people were informed about the 90 days weight loss and diabetes reversal challenge. To join the challenge it was mandatory to submit there latest HbA1c and fasting insulin report, weight (Kg) and waist circumference (cm). Participants were categorized and added to non diabetic, prediabetic and diabetic WhatsApp groups having senior coordinators who monitored their progress. Members had to post screen shot of daily exercise and photo of daily meals. Weekly quizzes and various competitions were organized. Members filled daily google form and progress tracker at the end challenge with all parameters.

Results:
Out of 648 members 544 submitted all data at the end of three months which included 68 non diabetics, 253 prediabetics and 223 diabetics. Average weight loss was 4.12 Kg and waist circumference loss was 2.29 inches. Average HbA1c reduction was 0.428 gm%. 80 diabetics converted to prediabetic status and 10 to non diabetic status. 53 prediabetics became non diabetics. In 44 diabetics medicines were reduced and in 16 they were stopped.

Conclusion:
Competitive spirit while following Dixit Lifestyle has shown great results as regards weight loss, inch loss and HbA1c reduction.
IJCM_118A: Pathway of healthcare for breast cancer: A mixed method study among women with breast cancer attending a tertiary healthcare institute in Bihar
Authors: Ramalingam Anuvarshini , Naik Bijaya Nanda , Singh Pritanjali , Nirala Santosh Kumar 
Published: April 2024

Background:
Breast cancer is the most common cancer among women; however, the majority of them visit hospitals at an advanced stage. Knowledge of pathway of care will aid in timely intervention and better prognosis.

Objectives:
To find the pathway of health care for breast cancer and its correlates among the patients who have attended AIIMS Patna. To identify the reasons for seeking delayed definitive care.

Methodology:
A mixed-method cross-sectional design with quantitative and qualitative parts was conducted at AIIMS Patna between March 2021 and December 2022 among breast cancer patients. A total of 171 breast cancer patients were enrolled in this study. Piloted study tools were used. Descriptive analysis for quantitative part and manual thematic analysis for qualitative part were performed.

Results:
Out of total 171 participants, 88.9% (83.3–92.77%) had visited AIIMS Patna indirectly. About 60 (20.6%) visited informal providers or quacks, and 60 (39.5%) of the study participants visited more than one hospital before arriving at AIIMS Patna. The place of residence, treatment delay, and stage of cancer were found to be independent predictors of the pathway of healthcare for breast cancer. The reasons behind seeking delayed definitive care were identified under two major themes: presentation delay (misunderstanding or difficulty in identifying symptom, neglect of disease, lack of awareness about the disease, family support, financial constraints) and treatment delay (misdiagnosis, multiple referrals, dissatisfaction with the treatment, COVID-19 lockdown, informal providers/quacks)

Conclusion:
9 out of 10 breast cancer patients had not come directly for definitive care, and among them, 3 out of 5 had visited multiple healthcare providers. So, it is important to educate the public on breast cancer, make systematized referral pathways, orient the private sector, and have trained manpower for screening purposes.
IJCM_120A: Factors associated with neonatal sepsis in tertiary care hospitals of Mangalore: A retrospective study
Authors: Verma Srishti , Mithra Prasanna , Unnikrishnan Bhaskaran , Rekha T , Kumar Nithin , Subhadarshini Divyasha , Dhal Sukanya , Jain Somesh , Mukhopadhyay Amrtapreeti 
Published: April 2024

Background:
Neonatal sepsis remains a significant cause of morbidity and mortality globally, particularly in developing countries like India. Early and late onset sepsis present unique challenges in diagnosis and management, with maternal and neonatal factors playing crucial roles in the manifestation of the condition.

Methodology:
Data were collected from tertiary care hospitals affiliated with Kasturba Medical College, Mangaluru. A structured proforma was used to gather information on maternal factors, birth history, neonatal conditions, and complications. Statistical analysis was performed using Chi- square test and student’s ‘t’ test.

Results:
Out of 132 cases, 50.75% were early onset sepsis (EOS) and 49.25% were late onset sepsis (LOS). Blood culture reports were positive in 46.1% cases. Maternal comorbidities included gestational diabetes mellitus (GDM), antepartum hemorrhage (APH), and pregnancy-induced hypertension (PIH). Neonatal comorbidities such as convulsions, congenital malformations, neonatal jaundice, preterm birth, and low birth weight were observed. Positive blood culture reports correlated with low birth weight and preterm births. Staphylococcus aureus was the most common organism, followed by Citrobacter Spp., Enterobacter Spp., and Pseudomonas aeruginosa. Sensitivity analysis revealed varying degrees of susceptibility to different antibiotics.

Conclusion:
Maternal factors like GDM, APH, and PIH showed no significant correlation with neonatal sepsis, whereas neonatal factors such as low birth weight and preterm birth were associated with an increased risk. Consanguinity also emerged as a potential risk factor. Staphylococcus aureus was the predominant causative organism, with varying antibiotic sensitivities. This study underscores the importance of understanding maternal and neonatal factors in the prevention and management of neonatal sepsis.
IJCM_123A: Knowledge, Attitudes and Practice Regarding Travel Medicine among Health Care Students in Mangalore
Authors: Hassan Fizreena Izzyanti binti , Abdullah Sharifah binti , Lahiri Srutarshi , Johri Bhavini , Manoj Rohan , Kumar Nithin , Rekha T , Unnikrishnan Bhaskaran , Mithra Prasanna , Holla Ramesh 
Published: April 2024

Background:
Travel medicine is crucial in addressing the health risks associated with international travel, especially among young adults who are increasingly mobile. Despite the growth in global travel, studies indicate a lack of awareness and adherence to preventive measures among travellers.

Objectives:
To assess the knowledge, attitudes, and practices of medical and dental students regarding travel medicine.

Methodology:
A cross-sectional study was conducted among medical and dental students at Kasturba Medical College and Manipal College of Dental Sciences, Mangalore, India. A convenient sampling method was employed, and data was collected using a pre-tested semi-structured questionnaire. The questionnaire assessed participants’ knowledge, attitudes, and practices related to travel medicine. Data analysis was performed using SPSS v20.0.

Results:
A total of 195 students participated, with a majority being female (72.3%) and in the age group ≤20 years (48.2%). Most participants had traveled internationally (71.3%) for purposes such as holidays (51.3%) and returning home (44.6%). While awareness of travel medicine was high (75.4%), knowledge levels were predominantly poor (50.3%). Participants showed high-risk perception towards health threats during travel but demonstrated low adherence to pre- and post-travel health check-ups. Key sources of information included the internet/social media (41.0%) and family/friends (35.9%).

Conclusion:
Despite high awareness, medical and dental students exhibited poor knowledge and inadequate adherence to preventive measures related to travel medicine. There was a notable disparity between perceived importance and actual practice of pre- and post-travel health check-ups. Efforts should be made to enhance education and awareness regarding travel medicine among young adults to mitigate travel-related health risks effectively.
IJCM_135A: Tobacco Burden, Legal Awareness, and Attitudes toward Control Measures among Healthcare Students, Professionals, and Staffs: Insights of an Online Survey in Bihar & Jharkhand, India
Authors: Biswas Bijit , Varshney Saurabh , Jahnavi G. , Narasimha Venkata Lakshmi , Nath Santanu , Venugopal Vinayagamoorthy , Ayub Arshad , Alam Benazir , Kumar Ujjwal , Jha Niwedita 
Published: April 2024

Background:
Healthcare professionals, students, and workers are vital change agents in the global battle against tobacco. Yet, it’s important to note a concerning trend: there’s a high prevalence of tobacco use among them in India, although data on this is limited.

Objective:
This study aimed to assess tobacco use prevalence, awareness of related laws, and attitudes among healthcare professionals, students, and staff in Bihar and Jharkhand, India.

Methodology:
In July and August 2023, we conducted an extensive cross sectional, online survey across 24 tertiary healthcare institutions. Participants included a diverse group of medical, dental, and nursing students, faculty, resident physicians, nursing professionals, and support staff. The survey covered sociodemographic factors, tobacco use, awareness of laws (26 items) [a: 0.924), compliance practices (9 items) (a: 0.929), and perceptions of tobacco control (10 items) (a: 0.728).

Results:
Our research revealed a significant prevalence of tobacco use: 15.9% reported current use, with 9.6% as daily users. Notably, awareness levels differed noticeably between users and non-users, with non-users displaying deeper knowledge of tobacco-related laws in 61.5% of cases. Our multifactor logistic regression models for current (R2: 0.184, PAR: 84.1%) and daily tobacco use (R2: 0.203, PAR: 90.4%) highlighted various associated factors, including age, gender, marital status, occupation, family income, and native state. Importantly, insufficient awareness emerged as a key factor, correlating with higher chances of current and daily tobacco use. Regional differences were evident, with lower prevalence in southern states. A majority of faculty (90.0%) and students (93.6%) expressed the need for increased emphasis on tobacco control in healthcare curricula.

Conclusion:
Our research highlights disparities in healthcare tobacco use, influenced by age, gender, marital status, occupation, income, and location. Awareness plays a crucial role, emphasizing the need for integrating tobacco education into curricula and sustaining awareness campaigns to address this issue effectively
IJCM_138A: Small group teaching- Perceptions of Students and Faculty of a Medical College in Mangalore, India
Authors: Gupta Urbee , Shahi Anshuman , Apurva J. A. , Dayal Prashansa , Jaiswal Harsh , Kumar Nithin , Rekha T , Unnikrishnan Bhaskaran , Mithra Prasanna , Holla Ramesh 
Published: April 2024

Background:
The demands on Medical Education have greatly increased in the 21st century. For this very reason, there has been an unprecedented growth in the number of medical colleges in India. The teacher’s role is to facilitate rather than to direct, to coordinate as much as to communicate. Small group teaching offers students’ opportunity to discuss and refine their understanding of complex issues, to problem solve and apply their knowledge to new situations and to reflect on their attitudes and feelings. The study aims to assess the perception of undergraduate medical students regarding small group teaching, the perception of faculty regarding Small group teaching, compare the perception of students on small group teaching, with respect to their academic performance and attendance.

Methodology:
93 faculty and 499 undergraduate MBBS students participated in the study and were given a self- administered semi-structured questionnaire. The perception of undergraduate students and teaching faculty on small group teaching was assessed using the 5-point Likert Scale. Independent t-test was applied to find difference in mean perception. Students were categorized based on their academic performance and on their attendance aggregate for the concluded semester.

Results:
In total, 404 students and 45 faculty members responded thus giving response rates of 80.9% and 48.4% respectively. The overall response rate was 75.8%

Conclusion:
The study found that both students and faculty members are favorable to the concept of SGT. They found it not only enhances the academic performance of students but also contributes to the personality development of students. Clinical correlations in all the subjects is well appreciated by students and faculty. Suggestions for improvement of SGT such as exam-oriented study, use of innovative and interactive aids can make SGT sessions more effective.
IJCM_139A: Prevalence of Hypertension among the Urban Adolescents: A Prospective Robust Survey
Authors: Revadi G , Maheshwari Mahesh , Yadav Amit Kumar , Bhaskar Smriti , Jaison Akhil , Pakhare Abhijit P 
Published: April 2024

Background:
Childhood Blood pressure (BP) is a strong indicator of adult blood pressure (BP), hence, early detection and intervention is important in adolescents. Studies from China and United States have shown BP in adolescents to be variable and has indeed outlined the need to obtain three separate readings before diagnosing hypertension. There is a dearth of this documentation of blood pressure readings at different occasions in adolescents from the Indian settings.

Objective:
To determine the prevalence of elevated blood pressure and hypertension among 10-18 years school going adolescents.

Methodology:
This was a prospective longitudinal study conducted across the five urban schools of Bhopal amongst 10-18 years adolescents. Multistage cluster sampling was adopted to cover an estimated sample size of 780 over a one-year period. Those adolescents who were present during the time of survey following their parent’s consent were included. Those who were absent at two occasions during the follow up visit and those who were diagnosed with secondary hypertension were excluded. Those who satisfied the study criteria were given a self-administered WHO STEPS questionnaire initially. The height and weight were obtained followed by measurement of three auscultatory BP readings at an interval of one week apart (American Academy of paediatrics (Updated guidelines 2017) in each student. The R shiny app calculator was used for classifying hypertension in adolescents. The study was funded by AIIMS Bhopal and ethical clearance was obtained from the institute.

Results:
The overall prevalence of elevated BP/hypertension in adolescents was 1.4% (N=795). There was a positive correlation between BMI and (SBP & DBP). The generalised linear mixed model showed age, BMI and boys to have higher predisposition to elevated BP/HTN. There was a significant difference in the SBP and DBP between the 3 visits stratified by sex. Also, the change in SBP and DBP between the readings were significant by ANOVA.

Conclusion:
The prevalence of elevated BP/HTN was 1.4% with girls being protective for girls. The study cannot be generalised as it is limited to the Government schools with relatively small sample size.
IJCM_144A: Demographic Characteristics and Gender Preference Patterns among Postnatal Women at Tertiary Care Hospital in Mangalore
Authors: Gopika J , Rekha T , Unnikrishnan Bhaskaran , Mithra Prasanna , Kumar Nithin , Holla Ramesh 
Published: April 2024

Background:
Gender preference among women remains a significant phenomenon that reflects the imbalance in the sex ratio. Understanding the determinants of gender preference is crucial in addressing associated challenges and promoting gender equality.

Objectives:
To study the socio-demographic profile of post-natal women, gender preference among them and the factors affecting their preference.

Methodology:
A hospital-based Cross-Sectional Study was conducted in a tertiary hospital in Mangalore among 155 multiparous postnatal women. The data were collected using a pre-tested semi-structured questionnaire and was analysed using SPSS version 17.0.

Results:
Overall, 54.83 % of the study participants belonged to the age group of 18-27 years, 57.42% were unaware of any techniques for determining a person’s sex, and the most frequently mentioned method was ultrasound. The proportion of respondents with a preference for a male child was only 20.6%. The most common reason was the male gender carrying the family name. According to 73% of respondents, having two children is ideal for a family, while having an equal number of boys and girls was the most desired combination (60%). There is a significant preference (75%) for the second child to be male if the first child was female.

Conclusion:
It’s noteworthy that the preference for a male child was often tied to cultural and familial considerations, such as carrying on the family name. Interestingly, the study also highlights a prevalent preference for a second child to be male if the first child was female, signifying the persistence of gender-biased attitudes.
IJCM_146A: Development and validation of an infographic educational tool for self-management of hypertension.
Authors: Salins Prajwal , Reshmi Bhageerathy , Furtado Anusha , Sabu KM , Nair Suma , Kundapur Poornima 
Published: April 2024

Background:
Hypertension is a serious condition affecting 33 % of urban & 25 % of rural Indian population. It can be controlled by the antihypertensive medications, but self-management approaches also play a very important role in lowering blood pressure. Infographics are one such material which uses visuals to educate the audience. This study assesses the understandability and actionability of the newly developed infographic aimed at self-blood pressure monitoring, medication adherence and lifestyle modifications with dietary approaches and exercise.

Objectives:
The objectives of the study were to develop an infographic tool for educating the patients with hypertension and to validate the infographic tool using PEMAT A/V.

Methodology:
“The study was divided into two phases. First phase was to develop an infographic tool. An infographic was designed using Canva and Procreate. In the second phase, the infographic was validated using the Patient Education Material Assessment Tool - Audio visual (PEMAT-A/V) by 10 participants. PEMAT is a systematic method to evaluate and compare patient education materials.

Result:
Using Canva, the infographic tool was developed, and then PEMAT-A/V was used to validate it. In terms of understandability and actionability, the mean score was 87.8% and 89.2%. The standard deviations for understandability and actionability were 0.12 and 0.14, respectively.

Conclusion:
The infographic developed in the study scored a mean percentage of more than 70 in both understandability and actionability and hence, it was concluded that it can be easily understandable by the patients.