bluuebunny/crossref_metadata_2025_split huggingface dataset:
Study of aggression and its factors among school going adolescents of Delhi, India
Authors: Kumar Mukesh , Kapoor Richa , Hiremath Ravishekar N. , Nimonkar Ravi , Goswami Arpita 
Published: December 2023

Background:
Adolescence is an important developmental phase of life associated with various ideas and emotions filled with energy, many times spent in the form of aggressive behavior. Mental Health, as an important part of healthy well-being, cannot be ignored, and hence it becomes imperative to study aggression and associated factors among adolescents.

Objective:
To determine the prevalence of aggression among school-going adolescents and to study factors associated with aggression amongst study participants.

Materials and Methods:
A cross-sectional study was conducted using a self-administered semi-structured questionnaire having questions regarding socio-demographic data, details of friends, history of substance use etc. and the Buss and Perry Aggression Questionnaire (BPAQ). Data were analyzed using appropriate statistical tests. Ethical clearance was obtained from the Institutional Ethics Committee of Safdarjung Hospital, and informed written consent was taken from participants.

Results:
The study involved a total of 463 school-going adolescents with a mean age of 13.78 ± 2.06 years. More than half (50.5%) of the participants were found to be aggressive. Male gender, history of family member ever jailed, parent's argument in front of them, ever tried cigarette/smoking, being involved in some fight and provocation by friends for aggression were the factors found to be significantly associated with aggression.

Conclusion:
The prevalence of aggression among school-going adolescents of Delhi was quite high. There is a need to make the students aware about aggression and how to deal with it. A holistic approach may be adopted in which all authorities and stakeholders must work together to provide safer and nurturing environment to all students.
Drivers for COVID 19 vaccine hesitancy among breastfeeding women in Eastern tribal state, India
Authors: Trivedi Kiran , Anand Shikha , Atta Prami , Kujur Manisha , Kujur Anit , Singh Shashibala , Prasad Anupa , Kiran Kumari Asha 
Published: December 2023

Background:
In the COVID-19 pandemic age, vaccination hesitancy also known as vaccine refusal is a cause for worry since it hinges on the five Cs of confidence, complacency, convenience, calculation, and shared responsibility. The current study was to pinpoint the elements that contribute to breastfeeding women's hesitation to receive the coronavirus disease-19 (COVID-19) vaccine.

Materials and Methods:
A cross-sectional observational study was carried out at the Department of Obstetrics and Gynaecology, Tertiary Care Hospital, Ranchi, Jharkhand.

Result:
Out of 365 nursing mothers, 242 (66.3%) were hesitant to get the COVID-19 vaccination. Those who chose not to receive the COVID-19 vaccination mostly belong to those aged 18 to 25 (38.1%), living in rural regions (44.9%), and belonging to non-tribal ethnic groups (41.1%). On application of logistic regression, it was found that rural areas had 3 times higher rate of vaccine hesitancy than urban residents, and that husbands' education levels up to the 12th grade had a 3.55 times higher rate and 5 times agriculture by husband's occupation, which was statistically significant (P value less than 0.05) The most prevalent grounds for rejection were fear of side effects (85.8%) and worry of adverse effects on newborns (83.48%).

Conclusion:
Both husband and wife, who had completed high school and were aware of the vaccination, were fearful of the COVID-19 vaccine. Concerns about the side effects and undesirable effects of vaccination on their newborns were the main reasons for refusal.
Role of Pro-BNP in predicting outcome in acute heart failure patient presenting to a medical emergency: An observational study from North India
Authors: Singhal Arjun K. , Singh Gaurav , Singh SK , Karunanand Busi , Agrawal Sonu 
Published: December 2023

Background:
Acute heart failure (AHF) is a clinical syndrome defined as the new onset or acutely decompensated heart failure (ADHF) leading to signs and symptoms of heart failure (HF). The critical cut-off values for these biomarkers that suggest high mortality are not clearly defined in previous studies. More studies are required to better understand the correlation of Pro- BNP and its association with HF. The primary objective is to study the role of Pro-BNP and critical factors in predicting outcomes in AHF patients presenting to a medical emergency.

Materials and Methods:
The data from the patients presented with symptoms of HF in the Department of Medical Emergency at our hospital were recorded and analysed. AHF is a clinical syndrome defined as the new onset or ADHF leading to signs and symptoms of HF, as based on the European Society of Cardiology.

Results:
The present study highlights the various risk factors of AHF in patients and their association with mortality. In the present study, mortality in patients with very high Pro-BNP levels ≥2000 pg/ml was significantly higher than in patients with moderately elevated Pro-BNP. The patients who survived after 5 days of hospitalization had Pro-BNP levels ≤2000 pg/ml, suggesting that very high Pro-BNP levels ≥2000 pg/ml are associated with fatal outcomes.

Conclusion:
To conclude, diabetes and sepsis are critical factors for the hospitalization and mortality of patients with AHF in northern India. Very high Pro-BNP levels ≥2000 pg/ml in patients with AHF requiring hospitalization and associated with fatal outcomes.
Effect of the home care model in orthopedic wounds management
Authors: Lei Xinhuan , Xiang Jie , Chen Xiaoxiao , Pan Wenjun 
Published: December 2023

Objective:
To explore the effect of home care on orthopedic wound management.

Materials and Methods:
Patients with orthopedic wounds admitted from January 2020 to December 2022 were divided into a control group and a nursing group, with 23 cases in each group. After discharge, the control group was given routine health guidance and the nursing group was given home care. The mood score of the two groups of patients was evaluated, the time and cost were compared, and the patients' degree of trust and satisfaction with the medical staff were investigated.

Results:
The patients received home care had higher scores in mood, degree of trust and satisfaction with medical staff, and spent less time (P < .05). However, the cost was significantly higher than that of the control group (P < .05).

Conclusions:
Home care for patients with orthopedic wounds can significantly reduce the time spent on medical treatment. Moreover, improve patients' moods and trust and satisfaction with medical staff in a certain extent. However, better service often means more economic cost.
Assessment of the relationship of systemic vascular dysfunction and cardiac autonomic neuropathy (CAN) with diabetic retinopathy
Authors: Hari Prakash KJ , Parija Sucheta , Kar Manisha 
Published: December 2023

Context:
Diabetic retinopathy, a form of microvasculopathy, is the leading cause of the visual abnormality. However, there is no conclusive evidence of the relationship of systemic vascular dysfunction with retinal microvasculopathy. In addition, diabetes-associated cardiac autonomic neuropathy may also compromise vascular function.

Aims:
The present study intends to correlate arterial stiffness, endothelial function, and heart rate variability (HRV) as a standardized measure of cardiac autonomic neuropathy with diabetic retinopathy.

Settings and Design:
The present cross-sectional, observational study was conducted in the Department of Physiology.

Materials and Methods:
Twenty subjects were recruited in group 1 (T2DM, type 2 diabetes mellitus patients, without retinopathy) and group 2 (T2DM with retinopathy). The vascular parameters such as heart rate, peripheral and central blood pressure, augmentation index [AIx (%)], brachial -ankle pulse wave velocity (baPWV), and reactive hyperaemia index (RHI) were recorded.

Statistical Analysis Used:
Independent sample t-test (for parametric data) and Mann–Whitney U test (for non-parametric data) were employed to compare the variables of two groups. Spearman correlation was used to examine the relationship among the parameters. Linear regression analysis was performed to examine the important vascular predictor for diabetic retinopathy.

Results:
baPWV was significantly higher in group 2 than in group 1 and positively associated with group 2. RHI was significantly less in group 2 than group 1 and negatively associated with group 2. Among HRV metrics, standard deviation of successive differences (SDSD), root mean square of successive differences between normal heartbeats (RMSSD), and high frequency (HF) power were significantly decreased in group 2 than in group 1. SDSD, RMSSD, and HF power were negatively associated with group 2. RHI emerged as a significant predictor of diabetic retinopathy following linear regression.

Conclusions:
Overall, the result of the present study indicates that metabolic dysregulation of glucose may affect the normal functioning of the autonomic nervous system and vascular function. Therefore, screening of vascular function and cardiac autonomic tone may be advocated in diabetic patients in routine clinics to examine the existence of any comorbid condition, such as diabetic retinopathy, as systemic vascular changes may also affect ophthalmic vasculature.
Sexual dysfunction in bipolar depression: Gender differences
Authors: Malik Gunjan , Mishra Preeti , Chaurasia Neha , Garg Shobit 
Published: December 2023

Objective:To find sexual dysfunction in acute-phase bipolar depression patients and subsequently characterize the gender-wise differences in sexual functioning.Materials and Methods:A cross-sectional, descriptive, observational, purposeful, and hospital-based study was done with 45 patients (age range: 18–59 years) with moderate to severe acute phase bipolar depression (HAM-D scores >18). The domain-wise (Pleasure, Desire/Frequency Desire/Interest, Arousal/Excitement, and Orgasm/Completion) sexual functioning was assessed by the Change in Sexual Functioning Questionnaire (CSFQ-14) (≤41 for females, ≤47 for males as a cut-off for dysfunction). This study is registered in the CTRI (Clinical Trials Registry India, Number: CTRI-2021-07-035182).Results:The prevalence of sexual dysfunction was 91% of bipolar disorder patients with more male participants (53.3%) compared to females (46.7%). The mean HAM-D score for the study sample was 27.93 ± 8.035. The female gender had more dysfunctional scores in desire/frequency (t = 2.229,P= 0.031), desire/interest (t = 2.448,P= 0.019), orgasm/completion (t = 2.974,P= 0.005), and overall total CSFQ (t = 2.946,P= 0.005). The odds of sexual dysfunction were significant given a one-unit increase in suicidal ideation in the index episode (adjusted OR = 1.222, 95% CI: 1.004-1.488,P= .049).Conclusion:Acute-phase bipolar patients have very high sexual dysfunction rates. Females have both global and specific sexual response cycle deficits in comparison to acute phase bipolar depressed males. Future trials shall amuse neurobiology grounded, more individualistic sexual rehabilitation-based interventional paradigms, and longitudinal research models in acute phase bipolar depression.
Prevalence of oral lesions and evaluation of the periodontal status among diabetic females attending Princess Nourah Bint Abdulrahman University (PNU)
Authors: Alkaabinah Wejdan , Alghenaim Farah , Basha Soha , Shawky Heba 
Published: December 2023

Objective:
To evaluate the prevalence of different oral lesions and periodontal status among diabetic Saudi female patients in the College of Dentistry, PNU University.

Materials and Method:
A retrospective study was performed by reviewing the files of all patients who visited the College of Dentistry, PNU University, during the last 5 years. We selected diabetic 20–40-year-old Saudi female patients. Ethical approval was obtained from the Institutional Review Board of PNU University. Data collection sheets were used to gather information on demographics, education, medical and dental history, and extra and intra-oral findings. Data on the duration of diabetes, any major complications, and type of diabetes therapy were retrieved from medical records. The data were entered into an Excel sheet, and descriptive statistics were performed. The analytical phase proceeded to correlate oral lesions with patient age, type of diabetes, and periodontal status.

Result:
A total of 226 diabetic patients were found after reviewing the records. The most common oral mucosal lesions were traumatic ulcers (10.2%), cheek biting (8.8%), and fissured tongue (8.4%). Furthermore, 81.86% of them had periodontitis, and 18.14% had a healthy periodontal status.

Conclusion:
The prevalence of periodontitis among diabetic female patients is higher than that of oral lesions. Stage III periodontitis showed the strongest association to oral lesion.
Prescription Analysis and Evaluation of Potential Drug–Drug Interactions among Patients Attending the Geriatric Unit at a Tertiary Care Hospital
Authors: Joshi Harsh , Majumdar Falguni D. , Patel Shreya N. , Modi Krishna Bhavin , Rathod Jaydeep , Kanani Parth , Shah Karan B. , Malhotra Supriya Deepak 
Published: December 2023

Abstract

Background:
The elderly stand a greater risk of drug-drug interactions (DDIs). This study was an earnest attempt at in-depth prescriptions analysis and evaluating the potential DDIs (pDDIs) among patients in the geriatric outpatient department (OPD).

Aims and Objectives:
The aim is to conduct prescriptions analysis of patients and to evaluate the pDDIs among patients in the geriatric OPD.

Materials and Methods:
A retrospective observational study began after Institutional Review Board approval. Demographic details, clinical profile, and drugs prescribed were recorded. The prescription analysis was done by prespecified criteria and pDDIs were identified using various tools.

Results:
Prescriptions of 202 patients with a mean age of 68.76 years were collected. Mean drugs prescribed were 6.07. Total number of fixed-dose combinations (FDCs) and over-the-counter drugs were 669 (40.50%) and 430 (26.03%), respectively. 129 (63.9%) prescriptions were incomplete in terms of dose, duration, frequency, or dosage form. Maximum interactions - 367 (34.42%) were found with aspirin followed by cardiovascular drugs. Total prescriptions with pDDIs were 137 (67.82%) Out of 34 (3.82%) serious interactions, pharmacodynamic pDDIs were seen with aspirin and enalapril/ramipril and pharmacokinetic were between omeprazole/rabeprazole and clopidogrel. Consequences of common pDDIs were identified as deterioration in renal function and hyperkalemia. The number of interactions was positively correlated with number of FDCs and number of drugs prescribed (r = 0.427, P = 0.0001 and r = 0.189, P = 0.0001, respectively).

Conclusion:
Prespecified prescription analysis criteria were one of the most useful tools to improve prescribing patterns. Drug interactions can be reduced by prescribing minimum drugs in elderly, alteration in time of dosing and fractionation of dose along with amalgamating the use of online DDI checker in hospital information system. Training of prescribers especially in geriatric patients is the need of the hour.
A Curious Case of Hypervitaminosis D-related Hypercalcemia
Authors: Tom Rose , Idiculla Jyothi Mariam 
Published: December 2023

Abstract
Hypercalcemia can manifest with various symptoms and poses diagnostic challenges due to its multifactorial etiology. This case highlights a 74-year-old patient with hypercalcemia of complex origin. The patient had a history of chronic liver disease, chronic kidney disease, and a previous episode of hypercalcemia associated with excessive oral Vitamin D intake. On admission, the patient presented with disorientation and increased drowsiness. Further evaluation revealed persistently high serum calcium levels, low parathyroid hormone levels, and elevated levels of Vitamin D. Investigations identified a duodenal nodule with multiple lymph node enlargement, suggesting a malignancy as the underlying cause. Other potential factors contributing to hypercalcemia, such as a granulomatous disease, prolonged immobilization, and a deactivating mutation of the 24-hydroxylase gene (CYP24A1), were also considered. Despite interventions, including hemodialysis and denosumab administration, the patient’s condition deteriorated due to sepsis and hypotensive shock, ultimately resulting in death. This case emphasizes the importance of considering multiple etiologies in cases of hypercalcemia in the elderly and the challenges involved in managing severe symptomatic hypercalcemia. Medical professionals must employ sound clinical reasoning and comprehensive diagnostic approaches to accurately identify and address the underlying cause. Hemodialysis may be necessary in refractory cases to achieve serum calcium normalization.
Successful Thrombolysis of an Ischemic Stroke Immediately following Transurethral Resection of Prostate in an Elderly Male
Authors: Rathinasabapathi Muneeshwaran , Tiwari Ashutosh , Kumar Mritunjai , Kumar Niraj 
Published: December 2023

Abstract
The overall incidence of stroke in the perioperative period following noncardiac, nonneurologic, and noncarotid surgery has been reported to be between 0.1% and 0.8%. Thrombolysis in the postoperative stroke is controversial, with a possible high risk of surgical site hemorrhage (SSH) and intracerebral hemorrhage. We report a case of an old male who developed an ischemic stroke on postoperative day 0 of transurethral resection of prostate. He was thrombolysed with tenecteplase but developed minor SSH as well as cerebral hemorrhagic transformation (HI2). Both complications were managed with appropriate measures. The patient recovered completely (NIHSS 0) and was discharged 1 week later. To the best of our knowledge, this is the first report of a successful thrombolysis in a patient developing acute ischemic stroke following a major urologic surgery on the day of surgery.
Gastric Antral Vascular Ectasia as a Reversible Cause of Upper Gastrointestinal Bleeding in the Oldest Old
Authors: Shrestha Manisha , Rayamajhi Anusha , Basnet Rohan , Poudel Shanta , Bhattarai Urza , Risal Ujjwol , Sharma Sanjib Kumar 
Published: December 2023

Abstract
Gastric antral vascular ectasia (GAVE) is a rare condition which accounts for 4% of the nonvariceal acute upper gastrointestinal (GI) bleeding. The mean age of diagnosis is 70 years. This condition is often misdiagnosed as hemorrhagic antral gastritis or portal hypertensive gastropathy. In this case report, we report the oldest person to date in the South Asian population with upper GI bleeding caused by GAVE. An 87-year-old, female, known case of chronic obstructive pulmonary disorder and systemic hypertension under medication for 2 years, current smoker, previous alcohol consumer presented to the emergency department with complaints of hematemesis, melena, and easy fatigability. On general physical examination, pallor was present. A provisional diagnosis of chronic anemia secondary to upper GI bleeding was made. Upper GI endoscopy revealed ectatic vessels radiating from the gastric antrum which was diagnosed as GAVE. Blood transfusion was done, and three sessions of argon plasma coagulation were done. In the oldest old, GAVE is an overlooked cause of GI bleeding and persistent severe anemia. It might also mimic the signs and symptoms of GI malignancy. However, the frail older adult and their caretakers must be counseled about its reversibility, good prognosis, and nonmalignant nature. Simple intervention can improve the quality of life in the frail oldest old.
Ultrasound-guided quadratus lumborum block: Posterior versus anterior approach in paediatrics undergoing laparoscopic inguinal hernia repair
Authors: El Malla Dina A. , El Mourad Mona B. 
Published: December 2023

AbstractBackground and Aims:Regional anaesthesia has gained popularity in managing post-operative pain in paediatric patients. Quadratus lumborum block (QLB) is recognised as one of the peri-operative pain management techniques used during abdominal surgeries. However, no consensus about the best approach has been reached.Material and Methods:Sixty paediatric patients with ages ranging from 1 to 6 as well as classification I and II of the American Society of Anesthesiologists, scheduled for laparoscopic inguinal hernia, were allocated to receive either a posterior approach (Group I) or an anterior approach (Group II) QLB. Twenty four-hour morphine consumption, the face, legs, activity, cry, and consolability (FLACC) score, duration of analgesia, performance time, and block-related complications were recorded.Results:Group II showed significantly lower morphine consumption as well as a longer duration of analgesia (P= 0.039*, 0.020*, respectively), with an equivalent period for block performance being reported in the two groups (P= 0.080). At 2, 4, 6, and 12 hours post-operatively, the FLACC scores were substantially diminished in Group II compared to Group I (P= 0.001*, 0.012*, 0.002*, 0.028*, respectively). However, at twenty-four hours, comparable pain scores were observed between both groups (P= 0.626). In addition, there were no block-related complications.Conclusions:In paediatric patients scheduled for laparoscopic inguinal hernia repair, the ultra-sound-guided anterior approach of the QLB was associated with significantly reduced post-operative morphine consumption, a lower FLACC score, and a longer analgesia duration when compared to the posterior approach.
Traditional Chinese medicine (Lianhua Qingwen) as an add-on to Western medicine for mild to moderate COVID-19 patients: A meta-analysis
Authors: Ng Daniel Kwok-keung , Leung Shuk-yu , Au Yi-tak , Li Han-dong , Feng Wei-bin , Yum Chi-hang , Hon Kam Lun E 
Published: December 2023

Abstract

Background:
Proprietary traditional Chinese medicine (TCM) such as Lianhua Qingwen (LQ) has been promoted to be an over-the-counter product for treating infectious diseases including COVID-19. This meta-analysis aimed to evaluate the efficacy of LQ in adults with mild or moderate COVID-19 diseases.

Materials and Methods:
The authors conducted the literature search using six electronic databases (Chinese and English) from the inception dates of the different database to October 31, 2022, using search for relevant keywords, that is, “severe acute respiratory syndrome coronavirus 2,” “COVID-19,” “Lianhuaqingwen,” and “Lianhua Qingwen” to identify randomized controlled trials (RCTs). Three reviewers independently identified studies, extracted the data, and assessed study quality. All analyses were conducted on RevMan 5.3.

Results:
A total of 6 RCT studies involving patients with COVID-19 were identified according to the inclusion and exclusion criteria. The quality of included studies was moderate. LQ was effective in improving overall clinical efficacy (RR = 1.25; 95% CI: 1.14–1.36; P < 0.001), and relieved three features, that is, cough (WMD = –2.04; 95% CI: –3.92 to –0.17; P = 0.03), fatigue (WMD= –2.58; 95% CI: –3.45 to –1.71; P < 0.001), and chest CT resolution (RR = 1.21; 95% CI: 1.02–1.43; P = 0.03) but not resolution of fever (WMD = –0.46; 95% CI: –1.54 to 0.62; P = 0.40) among adults with mild or moderate COVID-19. LQ was also effective in reducing the rate of conversion to severe cases (RR = 0.57; 95% CI: 0.37–0.86; P = 0.007). The adverse events rate (RR = 0.74; 95% CI: 0.40–1.37; P = 0.35) were similar between LQ group and the control group.

Conclusion:
This meta-analysis of six RCT shows that the Lianhua Qingwe (LQ) as an add-on to Western medicine achieves a higher overall clinical efficacy, faster resolution of cough, fatigue and chest CT changes than Western medicine alone in COVID patients. LQ is also effective in reducing the rate of conversion to severe cases. Further double-blinded placebo-controlled randomized studies are warranted for LQ as a stand-alone treatment for the “heat” subtype of mild to moderate COVID diseases.