bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcome of Biliary-enteric Reconstruction with Hepaticoduodenostomy Following Choledochal Cyst Resection: A Prospective Study
Authors: Goyal Ashok Kumar , Gupta Rahul , Meena Neelam 
Published: January 2024

AbstractBackground:The two most commonly performed methods of biliary-enteric reconstruction following choledochal cyst resection are Roux-en-Y hepaticojejunostomy (HJ) and hepaticoduodenostomy (HD). There is a lack of consensus regarding the better technique between them. This study aimed to evaluate the outcomes, efficacy and early complications of HD as a mode of biliary reconstruction after surgical resection of a choledochal cyst.Materials and Methods:This was a multi-institutional prospective study carried out in high-volume tertiary care teaching institutes from January 2010 to December 2022. All children managed with HD following choledochal cyst resection were analysed for their early complications and outcomes.Results:A total of 74 patients were included in this study. There were 59 (79.73%) females and 15 (20.27%) males. Thirty-nine (52.70%) patients had jaundice at the time of presentation. Magnetic resonance cholangiopancreatography was performed in 57 (77.03%) patients following ultrasonography. Intraoperatively, malrotation was present in 2 (2.70%) patients. In our study, operating time ranged from 60 to 195 min (mean: 118 min). Hospital stays ranged from 8 to 17 days (mean: 11.5 days). The post-operative biliary leak was seen in 7 (9.50%) patients, out of which 6 (8.11%) minor leaks were managed conservatively. Roux-en-Y HJ was performed on 1 (1.35%) patient with a major leak. In our series, 4 (5.40%) patients developed cholangitis; post-operative haemorrhagic nasogastric aspirate 5 (6.76%), post-operative pancreatitis 3 (4.05%) and wound infection 4 (5.40%) were observed and managed conservatively. None of the patients in our study developed an anastomotic stricture, bile gastritis and adhesive small bowel obstruction.Conclusion:Resection of choledochal cyst with HD reconstruction is safe and feasible with short operative time. HD is a viable option for operative management of choledochal cyst with low complication rates and faster recovery.
Congenital Urethrocutaneous Fistula
Authors: Suman Bijay Kumar , Singh Ram Jeewan , Sinha Amit Kumar , Kumar Bindey 
Published: January 2024

Abstract
Male congenital urethrocutaneous fistula is an extremely rare anomaly that is commonly associated with chordee or anorectal malformations. It is characterised by an abnormal urethral opening on the ventral aspect of the penis with well-formed distal urethra and meatus at the tip of the glans. The treatment is individualised according to the site of the fistula, associated anomalies and condition of the distal urethra. The principles of hypospadias surgery should be strictly followed.
Community Pharmacist’s Awareness, Knowledge and Attitude Towards use of Vitamin Supplements in Pimpri-Chinchwad Municipal Corporation (PCMC) Area of Pune, India: A Descriptive Cross Sectional Study
Authors: Patil Pravin J. , Patil Vilas S. , Malu Jayesh S. , Aswale Divya M. 
Published: January 2024

Background:
US FDA defines: dietary supplements is a product that intended to supplement a person’s diet, it’s generally consist of at least one or more of the following dietary ingredients, vitamin, minerals, a herb or other botanical and amino acid by increasing the daily consumptions of an extract metabolite concentration, constitute or combinations of these medication. Excessive and inappropriate use of medicines has been recognised as a public health problem resulting in increased likelihood of adverse drug event, drug interaction, and inappropriate drug prescribing and increased cost.

Material and Methods:
This was the cross-sectional study conducted in year 2022 at Pimpri Chinchwad (Pune). The total 250 questionaires are distributed and from that 226 response were received. Target population consist of community pharmacists working in the drug store in this area (n=226).

Results:
Data was represented in three domains of study i. e. awareness, knowledge and attitude. Correlation coefficient using Pearson’s method were determined to evaluate strength of correlation between awareness-knowledge, Knowledge-attitude and awareness-attitude. Correlation coefficient were calculated by comparing most relevant and equal number of questions.

Conclusion:
The study demonstrated positive attitude among surveyed community pharmacists in Pune, India. There is lacuna in accurate and adequate awareness, knowledge and attitude of vitamin deficiency, efficiency, recommended daily allowance (RDA), toxicity and interactions among pharmacist as one of the stakeholders of healthcare in India. Few of the remedies viz. framing of guidelines, inclusion in formal education syllabus, continuous education, updation exams etc. may be of use.
Utilization of Untied Fund and Factors Affecting the Utilization at Sub-Centers of Rural Odisha: A Mixed-Method Study
Authors: Antony Annu , Singh Arvind K. , Sahu Dinesh P. , Mishra Abhisek , Parida Swayam P. 
Published: January 2024

Introduction:
The untied funds at sub-centers provided flexibility for local action at block and down below levels. Effective utilization of untied fund can strengthen the healthcare. So, our study aims at assessing the knowledge of health workers, male/female (HWF/M), and effectiveness of utilization of untied funds at the sub-center (SC) level.

Material and Methods:
A mixed method (cross-sectional study and qualitative study) was conducted at Tangi Block, Khordha district, Odisha, in the year 2020. Health workers, male and female in sub-centers, and local stakeholders were interviewed using a structured interview schedule. The tool comprises financial records, a semi-structured questionnaire, and an in-depth interview guide. Universal sampling was adopted. For the cross-sectional study, 24 health workers were male/female, and for the qualitative study, all local stakeholders and 24 health workers female/male were interviewed. The study was conducted as a part of an academic program, and ethics approval was approved by AIIMS Bhubaneswar Institute Ethics Committee.

Results:
Seven out of 24 sub-centers did not spend any money, with a median unspent amount of 4260 INR (Q1-0, Q3-17300). As many as 36.8% of sub-centers had a delay of 9 months to get the untied fund, which significantly affected the utilization of funds. 37% of HWF/M utilized the fund inappropriately. None of the health workers had complete knowledge regarding the appropriate usage of untied fund. Communication gap, multiple engagements, non-cooperation from officials, delay in technical processing, and irregular Garam Sabha meetings were found to be barriers.

Conclusion:
Our study found out under-utilization of money in untied fund. Communication gap, non-cooperation form village leaders, poor knowledge, overburdened health workers, improper reporting, and lack of felt need were found to be barriers for prompt utilization.
A Preliminary Study on the Impact of Household Air Pollution on Adult Respiratory Health in Urban and Rural Settings of Jaipur, India
Authors: Sharma Arun Kumar , Dhabahi Anukrati , Mohanty S. S. 
Published: January 2024

Background:
This study aimed to investigate the association between household air pollution and chronic respiratory illness (CRI) in Jaipur, India.

Materials and Methods:
A total of 147 participants over 18 years of age from 45 households were randomly included in the study, and follow-up visits were conducted once every fortnight over a three-month period. Spirometry tests were conducted using a portable hand-held digital spirometer. A self-designed, pretested, semi-structured questionnaire was utilized to collect socio-demographic information from the participants. Statistical tests, such as t-tests were used to analyze the association between household air pollution and CRI.

Results:
The prevalence of COPD and bronchial asthma was 2% and 4%, respectively. Various risk factors for CRI were identified within households, and only 4 episodes of acute exacerbation of chronic respiratory illness were observed, resulting in no incidence density calculation. The mean values of forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) were significantly lower in females (P < 0.001) Also, the mean values of FVC and FEV1 were significantly lower in rural areas (P < 0.005) than urban areas.

Conclusion:
Our findings highlight the importance of government and stakeholder action to implement clean air policies and protect respiratory health. Further studies are needed to expand on these findings and delve deeper into understanding the complex interactions between various risk factors and respiratory health in this population.
Prevalence of Physical Nicotine Dependence and its Determinants among Tobacco users in the Rural Field Practice Area of a Tertiary Care Hospital in Tamil Nadu, India
Authors: Sharmila Jamine , Anugraha J , Umadevi R , Easwar Anantha 
Published: January 2024

Background:
Tobacco is the major cause of preventable death globally, which kills one person prematurely every six seconds. In India, around 46.9% of men and women aged 15 years and above use any kind of tobacco, according to NFHS-5. Tobacco use for longer duration with increased frequency is often addictive. Nicotine in tobacco is often associated with dependence, which is recognized as a public health menace and the single most significant factor for premature death. Hence, assessment of nicotine dependence among tobacco users is essential to implement tobacco control measures effectively. To estimate the prevalence of nicotine dependence among tobacco users and to study the factors associated with nicotine dependence among those tobacco users in a rural area of Kancheepuram district, Tamil Nadu.

Material and Methods:
A community-based descriptive cross-sectional study was conducted among 375 tobacco users aged 18 years and above residing permanently in the rural field practice area of the Rural Health and Training Centre (RHTC) attached to a Tertiary Care Hospital in Tamil Nadu. The study has been conducted for 6 months. A systematic random sampling technique was used to recruit the study participants. Data was collected by conducting personal interviews using a pre-tested semi-structured questionnaire. The data obtained was subjected to statistical analysis using SPSS version 23.

Result:
About 48.7% of the study participants had high dependence, 25% had moderate dependence, and 26.3% had low physical dependence on nicotine. The duration of tobacco use (P < 0.0000) and age of initiation of tobacco use (mean age was 28 ± 7.1 years) (P < 0.0001) was found as a significant risk indicator for nicotine dependence.

Conclusion:
The high nicotine dependence (48.7%) among the study participants is quite alarming and warrants more visible and aggressive anti-tobacco campaigns and targeted preventive strategies.
Immunization Status of Children 12–36 Months Age of Migrant Workers and Factors Associated with it in Urban Areas of Bangalore East
Authors: Kurkuri Shweta Neminath , Subramanian Mangala 
Published: January 2024

Background:
Immunization is a cost-effective weapon against vaccine preventable diseases. Children of migrant workers suffer from lack of immunization because of frequent shift of places, poor knowledge, and low socioeconomic status. To assess the immunization status of children 12–36 months of age of migrant workers and factors associated it. To identify the reasons for non-immunization or partial immunization among these children.

Material and Methods:
A cross-sectional study was conducted among 500 migrant workers’ children aged 12–36 months residing in Urban Bangalore east from February 2019 to August 2020. A cluster sampling method was incorporated. The data were collected using pre-tested semi-structured questionnaire. Data were analyzed using Epi-info™ Version 7.2.1 and SPSS version-21. Data were summarized in percentages, mean, standard deviation, and logistic regression.

Results:
The mean age of the children was 25.2340 ± 8.42 months. Out of 500 children, 88.60% were fully immunized, 11.40% were partially immunized, and no child was unimmunized. Significant predictors of immunization status of children were education of father and immunization card. Common reasons for dropout were inconvenient time (80.70%), unaware of need (77.19%), and busy schedule of parents (75.44%). The dropout rate of BCG to MR-1, Penta-1 to Penta-3, and Penta1to MR-1 was 6.49%, 0.85%, and 2.12%, respectively.

Conclusions:
Immunization coverage in the present study was 88.60%. Inconvenient time was the main reason behind partial immunization.
Economic Burden of Accidents and Injuries in India: What Does 75th Round of National Sample Survey Imply?
Authors: Thomas M Benson , Pandey Anuj K. , Gautam Diksha , Gopinathan Sandeep , Panolan Sajna 
Published: January 2024

Background:
Accidents and injuries constitute a sizable share of mortality and morbidity in low- and middle-income countries. This affects the most productive age group and increases disability-adjusted life years (DALYs). It results in a substantial financial burden on the households. To explore the economic burden of accidents and Injuries on Indian households and to find how the catastrophic health expenditure (CHE) from accidents and injuries affects the population. Another objective is to explore Catastrophic out-of-pocket expenditures (OOPE) patterns and distressed financing of households in India.

Materials and Methods:
The study used data from the 75th round of nationally representative surveys, that is, the National Sample Survey (NSS). Authors have analyzed the data using descriptive binary logistic regression analysis to estimate the rate and average days of hospitalization, average OOPE, and share of the population experiencing the catastrophic impact from the health expenditure separately from the public and private healthcare institutions.

Results:
The study observed that hospitalization in the private sector imposes 72% of households incur CHE at more than 10% cut-off and 41% at more than 25% cut-off. In comparison, it is less in the public sector, with 22% of households incurring CHE at more than 10% of annual per capita household income and 9% at more than 25%.

Conclusion:
The increasing incidence of road traffic accidents (RTA) is a concern for the overstretched health system. The government should provide better healthcare facilities and universal health insurance coverage to ensure patients’ speedy recovery and financial security.
Suicide Attempt by Hanging - A Study on Patients Admitted in Tertiary Care Hospital in Eastern India
Authors: Sahoo Manoj Kumar , Biswas Harshita 
Published: January 2024

Background:
Suicide is defined as a fatal self-injurious act with some evidence of intent to die. Despite the evolution of sophisticated methods to commit suicide, hanging remains one of the commonest methods to commit suicide across the world. To evaluate the individuals using hanging as a method of suicide and identify the contributing factors for this behaviour.

Material and Methods:
The study was carried out in a tertiary care hospital, over a period of 1 year on the suicide attempters using the method of hanging. Semi-structured in-depth interviews were conducted with all the 46 attempters. The questions focused on the precipitating events present before the attempt. After the in interview the risk factors of the conversations were identified, tabulated and categorized using descriptive analysis.

Results:
Findings from descriptive analysis reveals that significant age group using this method was below 19 years followed by 20-29 age group, female attempters were more compared to male. Psychiatric diagnosis was present in 8 attempters and 4 attempters had alcohol/substance dependence. The most common personality component in attempters was impulsivity. The most common immediate stressor found were financial stress, conflict with family, spouse, humiliation, substance abuse, exam stress and domestic violence.

Conclusion:
This study demonstrates that the reasons for suicide attempt by hanging is multifactorial. which includes, psychiatric diagnosis, personality factors, immediate stressors, ease of use, and accessibility, Overall, our study adds to understanding the intricates of this method and will help in developing effective suicide prevention strategies.
Food Insecurity and its Association with Dietary Diversity: A Cross-Sectional Study in Rural Households in Jammu
Authors: Langer Bhavna , Gupta Rajiv Kumar , Kumari Rashmi , Mahajan Richa 
Published: January 2024

Background:
Food insecurity is a matter of public health concern as it is associated with adverse health outcomes particularly among vulnerable population. Accessibility and availability of nutritious and culturally appropriate food is paramount to achieve zero hunger. To assess the prevalence of household food insecurity, to estimate the household dietary diversity and its association with household food insecurity.

Material and Methods:
Using multistage sampling 381 rural households were surveyed. Household Food Insecurity Access Scale and House hold Dietary Diversity Scale were used as study instruments. Chi square test was used to compare the two groups and P < 0.05 was considered to be statistically significant.

Results:
Prevalence of household insecurity was 33.3% (127) among the surveyed households and 8.1% (31) had severe food insecurity. The mean HFIS score was 6.85 ± 4.82. The household Dietary diversity score was 8.14 ± 1.54 for food secure and 6.51 ± 1.38 for severely food insecure households. There was a statistically significant difference in intake of milk and milk products, fruits, eggs and meat/poultry among food secure and insecure households (P < 0.001 respectively).

Conclusion:
Food insecurity was high in rural households and was associated with lower dietary intake of foods from protein group, necessitating a need to reinforce the food security programmes in rural India with focus to enhance protein rich diet.
A Cross-sectional Study to Estimate the Proportion and Ascertain Risk Factors for Osteoarthritis Knee among Women above 45 Years of Age Attending a Tertiary Care Hospital
Authors: S Rahini , Hadaye Rujuta S. 
Published: January 2024

Background:
With aging, women face various health issues, the most common of which are musculoskeletal disorders. Osteoarthritis accounts for 15% of all musculoskeletal disorders in patients above the age of 45 years but receives little attention. This study aims to estimate the proportion of women above 45 years suffering from Osteoarthritis (OA) knee and to ascertain its risk determinants.

Materials and Methods:
A cross-sectional study was conducted among 380 women above 45 years of age attending the Orthopedic outpatient department of a tertiary care hospital over a period of 18 months. American College of Rheumatology clinicoradiological criteria were used for the diagnosis of OA knee. A predesigned case record form was used to collect information on sociodemographic profile and other risk factors.

Results:
Data were analyzed using SPSS version 16.0. Our study found the overall proportion of OA knee to be 69.2%. The Chi-square test was used to find the association of various factors with OA knee. On logistic regression, diabetes mellitus, hypertension, menopause, and increased body mass index were found to be significant for OA Knee.

Conclusion:
The study concludes the possibility of prevention of disabilities by early screening for OA Knee in those with risk factors as a part of wellness clinics.
Prevalence and Barriers of Menstrual Hygiene Practices among Women of Reproductive Age Group in Rural Field Practice Areas of a Tertiary Care Center in Rishikesh
Authors: Saini Bhavana , Khapre Meenakshi , Kumar Prakash , Bharadwaj Ranjan , Gupta Anupam , Kumar Santosh 
Published: January 2024

Background:
Menstruation is a natural, physiological process experienced by all adolescent girls and women. The reproductive age group is the largest and most susceptible to various health and illness-related risk factors. This study aims to find the prevalence of satisfactory menstrual hygiene management (MHM) among women of reproductive age group and we also want to explore the cultural practices and beliefs related to menstruation and barriers to satisfactory MHM.

Material and Methods:
This study was conducted in rural field practice areas of Department of Community and Family Medicine, AIIMS, Rishikesh including 271 participants; women of reproductive age group using a mixed method study design (sequential quan–qual). Quantitative data were collected by household surveys and government schools using a validated structured questionnaire. Descriptive statistics were used to analyze the data. Focus group discussions (FGD) were conducted to have insights about understanding menstrual hygiene and barriers to satisfactory hygiene practices.

Results:
It was found that only 70 (29.6%) participants adhered to satisfactory menstrual hygiene practices. The age group of 20–24 years had a higher proportion compared to other groups. Through FGD, the main themes derived were practices related to menstruation (maintenance of personal hygiene), daily activities (physical and mental problems during menses), and barriers faced (cultural, economic, privacy concerns, and shyness).

Conclusion:
The prevalence of satisfactory menstrual hygiene practices was very low only 29.6%, which is a cause of concern; either Taboos associated with menstruation, socio-cultural, economic barriers, or lack of awareness related to menstrual hygiene in the community can be contributing factors for low prevalence.
Comparative Study on Elder Abuse and Neglect Among Geriatric Population in the Rural and Urban Field Practice Areas of a Medical College
Authors: Kumar Prianka Shashi , Rashmi Anusha , Anil Manjula , Sindhu B M 
Published: January 2024

Background:
Elder abuse is a multidimensional problem of public importance. According to the World Health Organization (WHO), 16% of older people were victims of elder abuse. A study conducted by HelpAge India in 2018 showed that Mangaluru ranks the highest in elder abuse (47%). Given the scarce literature, this study sought to determine the prevalence of elder abuse and its associated sociodemographic factors.

Material and Methods:
A community-based cross-sectional study was conducted among the senior population in the rural and urban field practice a medical college in Mangaluru for one and a half years. The sample size was 280.

Results:
Most of the study population was in the age group of fewer than 75 years (75.4%), with 50.4% females, 60% Hindus, 56.4% married, 39.3% illiterate, and 88.9% of them retired. The prevalence of elder abuse was 44.6% (rural = 50.7% and urban = 38.6%). Binary logistic regression showed that elder abuse was statistically significant among the unemployed, extended family members, and staying with children.

Conclusions:
The study brings to light the sociodemographic factors that play a role in detecting elder abuse. It also shows the importance of awareness of elder mistreatment among older people. These elements must be considered for implementing and enforcing laws and legislation to help curb elder abuse.