bluuebunny/crossref_metadata_2025_split huggingface dataset:
Obesity in Patients with Hypertension Attending a Medical Outpatient Clinic in a Tertiary Health Facility in Enugu, Southeast Nigeria
Authors: Nkemdilim Ijoma Uchenna , Ezeala-Adikaibe Birinus Adikaibe , Donatus Onodugo Obinna , Innocent Okoye , Ernest Nwazor , Nkeiruka Mbadiwe , Chidimma Orah-Okpala , Pauline Onodugo Nkiru , Benneth Anyim Obumneme 
Published: May 2024

Introduction:
The prevalence of obesity is increasing in sub-Saharan Africa which reflects the current global trend. Epidemiological data have consistently shown a strong relationship between obesity and hypertension in Africans, and this association is stronger for central obesity. The aim of this study was to describe the pattern of overweight/obesity among patients living with hypertension in a tertiary hospital in Enugu, Southeast Nigeria.

Methods:
This was a cross-sectional study conducted in the Medical Out-Patient Clinic of the Enugu State University Teaching Hospital in Enugu, Enugu State, Southeast Nigeria. Data were analyzed using the SPSS version 22.

Results:
Data were collected from a total of 450 consenting patients, most of whom 64% (288) were females. The mean body mass index (BMI) was 28.9 ± 6.1 kg/m2 higher in females than males (29.8 ± 6.5 kg/m2 vs. 26.7 ± 5.2 kg/m2, P < 0.001). The gender distribution of classes of obesity showed female preponderance. A little more than one-third of the patients were overweight, whereas about four out of every ten patients were obese. While overweight did not differ significantly across gendeWr (P = 0.67), more feWmales than males were significantly obese (P < 0.001). The age distribution of BMI showed increasing rates of underweight and decreasing rate of morbid obesity with age. About 86.8% of the females had substantially increased waist circumference compared to 26.5% of the males. Overall, 53% of the males and 97.6% of the females have abnormal waist circumferences. Waist–hip ratio was equally abnormal in 89.3% of the study population even though no statistically significant difference was observed across gender.

Conclusion:
Overweight and obesity are common among patients with hypertension as demonstrated in this study. There is need to set up an aspect of health education which specifically sensitizes the public against the untoward consequences of overweight and obesity.
Assessment of Breastfeeding Techniques in Enugu, South-East Nigeria
Authors: Nduagubam Obinna C. , Ndu Ikenna K. , Bisi-Onyemaechi Adaobi , Onukwuli Vivian Ozoemena , Amadi Ogechukwu F. , Okeke Ifeyinwa B. , Ogbuka Francis N. , Ezenwosu Osita U. , Iheji Chukwunonso C. 
Published: May 2024

Background:
Good breastfeeding technique is important in ensuring adequate milk delivery and preventing breastfeeding problems. Exclusive breastfeeding rate is quite low, and requisite skills regarding proper positioning and attachment of an infant while breastfeeding appears lacking among mothers in Nigeria. This study was undertaken to assess breastfeeding techniques of mothers attending the well-child clinics of two tertiary hospitals in southeast Nigeria.

Materials and Methods:
This cross-sectional descriptive study of 396 mother and child pairs who attend the well child clinics of two tertiary hospitals in Enugu (Enugu state University Teaching Hospital and University of Nigeria Teaching Hospital) between September 2018 and February 2019. An interviewer administered, well-structured pro forma was used to collect data while mothers were observed closely as they breastfed and scored using the World Health Organization criteria. Data were analyzed using SPSS version 22.

Results:
Most of the mothers studied (357; 90.2%) attended ante-natal care, and 365 (92.2%) of the deliveries were assisted by a health worker. Only 194 (49%) of mothers practiced good breastfeeding techniques. Maternal age (20–30 years) (P < 0.001, odds ratio [OR] 0.464), attendance to antenatal clinic (P < 0.001; OR 8.336), health education and demonstration on breastfeeding techniques before and after delivery (P = 0.001) and maternal level of education (χ2 = 13.173, P = 0.001) but not parity (P = 0.386; OR 1.192) were significantly associated with good breastfeeding techniques.

Conclusion:
There are suboptimal breastfeeding techniques among mothers. Increased awareness creation and regular demonstration of breastfeeding techniques are needed.
Clinical Screening for Menorrhagia and Other Bleeding Symptoms in Nigerian Women
Authors: Nwagha Theresa Ukamaka , Okoye Helen Chioma , Ugwu Angela Ogechukwu , Ugwu Emmanuel Onyebuchi 
Published: May 2024

Objective:
The objective of the study was to evaluate the prevalence of perceived bleeding symptoms in Nigerian women and the usefulness of a simple clinical screening tool for bleeding symptoms.

Materials and Methods:
A population-based cross-sectional survey of 1524 women of 16–50 years in Southeast Nigeria using a structured, prevalidated, pretested questionnaire was conducted.

Results:
A total of 1524 (85%) women responded with the mean age of 26 (10.6) years. Prevalence of bleeding symptoms was 24.6% and 11% of the women reported a positive family history of bleeding symptoms. There was a significant association between having a positive family history of bleeding disorder and experiencing bleeding symptoms (adjusted odds ratio: 0.12, 95% confidence interval: 0.06–0.22 P < 0.0001). Two hundred and six women experienced at least one bleeding symptom, 125 (8.2%) experienced at least two, whereas 43 (2.8%) experienced >3 bleeding symptoms. The most common perceived bleeding symptom was heavy menstrual bleeding (HMB) present in 83 women (22.2%), 141 (9.3%) reported a past history of HMB, 202 (13.3%) had heavy bleeds during most of their monthly cycle, and 351 (23%) requiring resuscitation with blood support.

Conclusion:
The prevalence of perceived bleeding symptoms among women is high, and HMB is the most common bleeding symptom. This clinical screening tool is easy and cost-effective in routinely identifying women with bleeding symptoms needing further hemostatic and obstetrics evaluation.
Assessment of Health-Related Quality of Life of Vesicovaginal Fistula Patients Attending a Repair Center in Northwest Nigeria
Authors: Raji Mansur O. , Raji Ismail Abdullateef , Hassan Mairo , Raji Hadija Olaide , Bashir Abubakar Mohammad , Suleiman Ismail Nazrill , Abubakar Hauwa Ummi 
Published: May 2024

Introduction:
Vesicovaginal fistula (VVF) has devastating effects on a woman's hygiene, self-esteem, interpersonal relationships, and environment disrupting all elements of her health. Despite VVF being a persistent condition, very few researches have been conducted in Nigeria to determine the quality of life (QoL) of these patients. This study was carried out with the aim of assessing the QoL of VVF patients receiving care in a repair center in Sokoto, Northwest Nigeria.

Materials and Methods:
This was cross-sectional study conducted at a VVF repair center in Sokoto. Study population comprised of patients who had undergone VVF repair at the health facility. The total number of study participants present at the facility was 81, and all were recruited into the study. The study assessed socio-demographics and QoL of the respondents. Data obtained were entered into IBM software package and subsequently analyzed. Level of significance was set at 5%.

Results:
The environmental domain had the highest mean score of 51.7 ± 11.8 while psychological domain had the least score of 41.3 ± 14.3. The mean overall QoL and general health were 49.5 ± 10.2. There was a moderate positive correlation between physical domain score and Age, (r = 0.258, P < 0.005). There was also a positive correlation between psychological domain score and Husband's educational status (r
pb = 0.241, P < 0.05). Social relationship domain score positively correlated with being married (r
pb = 0.414, P < 0.01).

Conclusion:
Older study participants had higher mean scores for physical and psychological domains, while younger study participants had higher overall QoL and general health scores compared with older study participants. Future research should compare the pre and postoperative QoL of women who undergo repair of obstetric fistula.
Menstrual Characteristics of Sickle Cell Disease Patients Seen at a Tertiary Institution in North Western Nigeria
Authors: Mohammed-Durosinlorun Amina , Bello-Manga Halima , Adze Joel , Ijei Ifeoma P. , Stephen Bature 
Published: May 2024

Introduction:
The burden of sickle cell disease (SCD) is high in Sub-Saharan Africa, including Nigeria, and with improved care and survival, reproductive health issues, including menstruation, have become increasingly important and may impact on long-term health and social wellbeing.

Objectives:
This study was carried out to characterize the menstrual characteristics of SCD patients.

Methodology:
Using a cross-sectional study design, a semi-structured questionnaire was administered and information collected on bio-demographic data, medical history of SCD, reproductive, and menstrual history.

Results:
One hundred and sixty female patients participated in the study. The mean age was 24.9 years (standard deviation [SD] ± 8.8). The mean age at menarche was 15.6 years (SD ± 2.7) for those menstruating. Most respondents had regular menstrual cycles 120 (82%); normal menstrual cycle lengths 120 (81%) significantly associated with respondent's age (P < 0.05); normal duration of flow 140 (97%); light menstrual flow 104 (71%) significantly associated with body mass index BMI (P < 0.05). Overall, however, 114 (78%) had abnormal menses and 32 (22%) had normal menses. Eighty-one respondents (56%) experienced menstrual pain, which was severe in only 28 cases (35%). The presence of menstrual pain did not significantly affect the annual frequency of crisis (P > 0.05).

Conclusion:
The mean age at menarche was high at 15.6 years. Most respondents had light menstrual flow and overall abnormal menstrual patterns. Menstrual pain was common but was not significantly associated with the frequency of crisis.
Prevalence of Congenital Heart Disease among Patients with Down Syndrome in Southwestern Saudi Arabia
Authors: Taura Magaji Garba , Alshahrani Abdullah Mohammed , Alqahtani Dhafer Obeid 
Published: May 2024

Background:
There is a paucity of data on the prevalence and pattern of congenital heart disease (CHD) among patients with Down syndrome (DS) in Bisha, Saudi Arabia. The aim of the study was to determine the prevalence and patterns of CHD in patients with DS and explore the association of participants’ sex with CHD in DS patients.

Methodology:
A total of 42 patients with confirmed DS were enrolled in the study. Relevant data were obtained from the patients’ records. The spectrum of CHD was analyzed and classified accordingly. Pearson's Chi-square was used to determine the association of gender with CHD.

Results:
Approximately 81% of the study participants had CHD. The most common CHD was atrial septal defect (28.5%), followed by ventricular septal defect (25%), patent ductus arteriosus (16%), and atrioventricular septal defect (14.3%). No significant association was found between CHDs and sex.

Conclusion:
The prevalence of CHD in the study group was consistent with reports from other regions of Saudi Arabia and globally. Participants’ sex was not associated with the occurrence of CHD in DS patients in this study.
Influence of thyroid status on pulmonary functions in bronchial asthma patients
Authors: Kumar Kaushal , Mahajan Aarti Sood , Haldwani Dayaram , Bhadoria Dharam Pal , Goswami Binita 
Published: May 2024

BACKGROUND:
Asthma is a serious global health problem affecting all age groups. It is being recognized for its health impact on the working status of adults, and uncontrolled asthma is associated with significant morbidity, mortality, and socioeconomic problems. The knowledge of comorbidities of asthma, including thyroid disorders, is important for its management.

METHODOLOGY:
A case–control study was conducted in 60 diagnosed patients of bronchial asthma in the age group of 20–40 years attending medicine outpatient departments and Chest Clinic of Lok Nayak Hospital, New Delhi. Thirty controls were taken from the normal population. Pulmonary function tests using "Schiller SP1 portable top spirometer" were done, and forced vital capacity (FVC), forced expiratory volume in 1st s (FEV1), FEV1/FVC ratio, and peak expiratory flow rate (PEFR) were analyzed. The thyroid function was assessed by estimating levels of serum thyroid-stimulating hormone (TSH), free T3, and free T4 using the Cobas e411 autoanalyzer.

RESULTS:
Based on TSH analysis of asthmatic patients, 25% were hypothyroid, 16.7% were hyperthyroid, and 58.3% were euthyroid. There were significant reductions in FEV1, FEV1/FVC ratio, and PEFR in asthmatics compared to controls, but no significant differences were found in these parameters among the asthmatics with different thyroid status.

CONCLUSION:
The thyroid functions varied in asthmatics. However, the variation in the thyroid function did not affect the pulmonary function in asthmatic patients.
Prevalence of Vitamin E deficiency and its correlation with symptoms, spirometry, and serum eosinophil in patients of asthma: A pilot study
Authors: Patel Anand , Ashara Bhamini , Udhwani Richa , Arumugasamy Lalithambigai , Adalja Mayur 
Published: May 2024

BACKGROUND:
Asthma is one of the most prevalent chronic respiratory diseases. Immunomodulatory effects of Vitamin E have been recognized in human and animal models under disease and normal conditions.

OBJECTIVE:
To observe the serum level of Vitamin E of patients suffering from asthma and to study the relation of serum Vitamin E levels with serum eosinophil, pulmonary function test, and asthma control.

MATERIALS AND METHODS:
This cross-sectional study was carried out in the Department of Pulmonary Medicine of GMERS Medical College and Hospital, Gotri, Vadodara, Gujarat, on adult patients of asthma. After obtaining a detailed history and performing thorough physical examination of the patient, blood sample was collected for measurement of serum vitamin E and serum eosinophils. Then, patients were subjected to spirometry. Serum Vitamin E levels were measured by the calorimetric method.

RESULTS:
The serum Vitamin E is lower in asthma patients. The level of serum Vitamin E was significantly lower in patients with severe asthma as compared to mild and moderate asthma as well as it was also significantly lower in patients with uncontrolled asthma as compared to controlled asthma.

CONCLUSION:
The serum Vitamin E is lower in asthma patients and its level correlated well with spirometry and asthma control test (ACT) scores. Hence, Vitamin E supplementation may be beneficial for patients with poor ACT scores and severe disease in spirometry along with other treatments.
Personalized Intervention in Correcting Insulin Injection Errors and its Impact on A1C in the Study: A Cross-sectional Study
Authors: Krishnan Gopika , Kesavadev Jothydev , Mohammed Rafiq , Raj Sumesh , Prasobh P. Sunil , Sreelakshmi R. , Chandran Vysakh , Raj Sourav , Basanth Anjana 
Published: May 2024

Background:
Ever since the discovery of insulin, it has become an inevitable part of diabetes management in both type 1 and type 2 diabetes (T2D). Administering insulin subcutaneously following the correct insulin injection technique is often flawed in a considerable number of people with diabetes. Incorrect insulin techniques lead to poor glycemic control and invite serious adversities.

Aims and Objectives:
The study aims to evaluate impact of imparting educational intervention on reducing insulin injection errors and subsequent improvement in glycated hemoglobin in people with T2D.

Materials and Methods:
The study employed a survey-based cross-sectional design to evaluate the impact of the educational interventions on the injection techniques for the diabetes cohort. The data were collected from people with T2D visiting the outpatient department of four different comprehensive diabetes research centers in Kerala, India. All the statistical analysis was performed using R version 4.2.3.

Results:
Results showed a significant reduction in the HbA1c in people with type 2 diabetes.

Conclusion:
The cross-sectional study demonstrates that repeated educational interventions contribute to statistically significant improvement in HbA1c.
Pattern of bacterial infections in neutropenic febrile patients (experience of the Specialized BMT center - Medical city complex - Baghdad, Iraq)
Authors: Shakir Zahraa Sameer , Saeb Sarah Muayad , Yousif Fawaz Salim , Shakir Sinaa Mahdi , Al-Bakri Zina Ali , Faraji Safa A , Al-Saeed Raghad Majid , Taha Kanar Tahseen 
Published: May 2024

Abstract:

BACKGROUND:
Infectious complications occur in most of the patients undergoing hemopietic stem cell transplantation (HSCT), these carry high risk of mortality mainly due to Gram-negative bacteria unless effective antibiotic treatment is provided.

OBJECTIVES:
The aims of the study were to review bacterial isolates from different samples in febrile neutropenic patients underwent HSCT in terms of incidence, types, and antimicrobial resistance, and to assess the efficacy of infection control measures used in transplantation ward.

PATIENTS AND METHODS:
This is retrospective study. The medical records of a total of 82 patients who underwent HSCT in the Specialized BMT Center, Baghdad Medical City, in 2021 and 2022 were reviewed; for any patient with neutropenic fever (NF), the clinical assessment was made, and samples were taken for culture any sensitivity before starting empirical antibiotics. The study was reviewed by the ethical committee of the hematology transplant center in the Medical City Complex, and since the study is retrospective, no consent is needed from the patient.

RESULTS:
There were 57 patients who developed NF, two at the time of collection, while 55 patients during transplant. In 16 patients, there was a clinical focus for NF, most commonly respiratory. From 175 samples sent for culture and sensitivity, bacterial growth was detected in 103 samples, and the incidence of bloodstream infection was 53%. Polymicrbial bacterial growth was detected in 6 patients with NF. Gram-positive bacteria were slightly more common than Gram negative. Staphylococcus epidermidis and Burkholderia cepacia were the most common Gram positive and Gram negative, respectively. An increasing number of patients admitted to transplant centers were associated with more infections. Ten out of 13 bacteria were multidrug resistant (MDR). Only two patients died from infection posttransplant.

CONCLUSIONS:
The predominance of Gram-positive cocci and Burkholderia cepacia complex supported the need to review the adherence to infection control policy. The empirical antibiotic protocol should be guided by local antibiogram, and since the high rate of blood stream infection (BSI) with MDR pathogens, a de-escalating strategy utilizing carbapenems – as advised by the ECIL-4 guidelines – would be more appropriate while awaiting culture result. The ability to quickly identify infections and their susceptibility profile is still crucial for choosing antibiotic therapy.
Effect of Aromatherapy with Essential oil of Lavandula Angustifolia Mill- Citrus Bergamia and Mindfulness-Based Intervention on Sexual Function, Anxiety, and Depression in Postmenopausal Women
Authors: Mojtehedi Mandana , Salehi-Pourmehr Hanieh , Ostadrahimi Alireza , Asnaashari Solmaz , Esmaeilpour Khalil , Farshbaf-Khalili Azizeh 
Published: May 2024

Background:
Due to the importance of psychological support for women during menopause as a period with a high prevalence of mental health problems, this study aimed to evaluate the effect of the essential oil of lavender-Bergamot (La-Ber) and Mindfulness-Based Intervention (MBI) on sexual function, anxiety (primary outcome), and depression score (secondary outcome) in postmenopausal women with sexual dysfunction.

Materials and Methods:
This controlled randomized trial with a factorial design was performed on 132 postmenopausal women. Participants were randomly allocated into four equal groups: Aromatherapy-Routine Care (Aroma-RC), MBI-Placebo (MBI-P), Aromatherapy-MBI (Aroma-MBI), or Routine Care-Placebo (RC-P). Two to three drops of La-Ber or a similar placebo were inhaled three times a day for 8 weeks. Eight sessions of MBI intervention were conducted. At the end of the intervention and eight weeks afterward, the outcomes were assessed.

Results:
The sexual function score improved significantly in Aroma-MBI (adjusted Mean Difference [aMD]: 2.4, 95% CI: 0.01 to 4.80) and MBI-P (aMD: 2.6, 95% CI: 0.2 to 5.1) groups compared to the RC-P group. The anxiety score was reduced in the Aroma-RC group at the end of the intervention (aMD: -4.12, 95% CI: -7.41 to -0.72; p = 0.020) and eight weeks later as well as in the Aroma-MBI group. In terms of depression, the mean score of depression was significantly lower than the RC-P group in the Aroma-RC group at the end of the intervention (p = 0.011).

Conclusions:
MBI and aromatherapy seem effective on sexual function and menopausal anxiety. MBI improves sexual function, while aromatherapy ameliorated anxiety and depression.
Humanistic Care in Nursing
Authors: Taghinezhad Fakhredin , Mohammadi Eesa , Khademi Mojgan , Kazemnejad Anoshirvan 
Published: May 2024

Background:
Despite the importance and prominent role as a clinical, theoretical, and research approach in nursing practice, humanistic care nature and boundaries are not explicit and challenging for nurses to understand. This study was conducted to clarify the concept of humanistic care in nursing.

Materials and Methods:
Based on Rogers's evolutionary concept analysis, keywords such as “humanistic car *,” “caring behave *,” “humanistic nurs *,” “humanistic model of care,” were searched in PubMed, SCOPUS, Science Direct, Web of Science, WILEY, Springer, SAGE, ProQuest, SID, Iranmedex without time limit until November 2018. Sixty-five documents in nursing and ten documents in the medical discipline were finalized for thematic analysis.

Results:
Nine attributes of the humanistic care, including “excellence in clinical literacy,” “creating a healing environment,” “a comprehensive and unique viewpoint,” “contribution to clients' adaptation and flourishing of their talents,” “unrequited love and affection,” “preservation of human dignity,” “real presence,” “constructive dynamic interaction,” and “nurse's self-care,” were recognized. Assessing the historical and evolutionary course of the concept's semantic tendency revealed three periods: The focus in first, second, and third was on the nurse-patient relationship, quantitative tendency/measurement, and metaphysics/spiritual humanism, respectively. The comparison of interdisciplinary differences indicated greater semantic comprehensiveness and depth in the nursing discipline.

Conclusions:
Clear and practical definition and identification of humanistic care in nursing can be helpful in the further development of existing knowledge, instrumentation, designing guidelines, clinical interventions, knowledge translation, and correction of concept misuse. The identified antecedents and consequences can be in various aspects of clinical management.