bluuebunny/crossref_metadata_2025_split huggingface dataset:
A prospective study on the effectiveness of a combination regime (Mifepristone and Misoprostol) in comparison with Misoprostol for missed abortion
Authors: Gupta Nidhi , Tripathi Reva , Sharma Sumedha , Nigam Aruna , Panesar Sanjeet 
Published: October 2023

Introduction:
Misoprostol is widely used in the medical management of missed abortions. However, pretreatment with Mifepristone has shown to be effective but still not recommended to be used in missed abortions.

Aims and Objectives:
To compare the outcome of medically managed missed abortion or blighted ovum using combination regime (Mifepristone and Misoprostol) vs Misoprostol alone.

Materials and Methods:
It was a prospective single-centre study performed in the Department of Obstetrics and Gynaecology, HIMSR and HAHC hospital, New Delhi, over, for one year. All the patients with diagnosed missed abortions were randomized into two groups (Group A and Group B). Group A was given Mifepristone 200 mg orally followed by Misoprostol 800 microgram per vaginal. Group B was given Misoprostol 800 microgram per vaginal. All the patients were observed for 24 hours for the expulsion of products of conception following the given regime. Ethical approval was taken from the Institutional Ethical Committee.

Results:
Both groups were comparable in demographic characteristics. On applying Fisher’s exact test, it has been observed that the odds of nonexpulsion of the product of conception, time taken in expulsion, and surgical evacuation because of excessive bleeding were significantly higher in Group B (Misoprostol) compared with Group A (Mifepristone followed by Misoprostol). The cost-effective analysis showed that the cost is higher among Misoprostol Group B compared with combination drugs of Group A (Mifepristone + Misoprostol), but this result is not significant.

Conclusion:
Mifepristone can be considered before Misoprostol in missed abortions. This regime might decrease the need for surgical evacuation.
Breakthrough infection among healthcare personnel following exposure to COVID-19: Experience after one year of the world’s largest vaccination drive
Authors: Das Arghya , Khan Salman , Vidyarthi Ashima Jain , Gupta Raghav , Mondal Saikat , Singh Sheetal , Wundavalli LaxmiTej , Bhatnagar Sushma , Singh Urvashi B. , Chaudhry Rama 
Published: October 2023

ABSTRACT

Context:
The COVID-19 vaccination drive globally was supposedly a game-changing event. However, the emerging variants of the virus and waning immunity over time posed new challenges for breakthrough infections. Standing at the frontline of defense against COVID-19, healthcare personnel (HCP) were vulnerable to such infections.

Aims:
This study estimates i) the vaccine breakthrough infections (VBI) among HCP following exposure to COVID-19 cases, and ii) the mean interval between the second dose of vaccine and laboratory-confirmed SARS-CoV-2 infection

Materials and Methods:
A cross-sectional study was conducted including 385 HCP with a history of exposure to COVID-19 cases during January and February 2022. Demographic details and clinical and vaccination history were collected from the test forms and the Web-based hospital management system. Laboratory testing of COVID-19 was carried out by real-time RT-PCR test.

Results:
The majority of the HCP were males (262; 68.05%) and nurses (180; 46.75%) by occupation. Two doses of vaccines were received by 278 (87.7%) HCP. VBI was confirmed in 185 (66.55%) HCP. No significant difference in VBI between the COVAXIN and COVISHIELD recipients (P = 0.69) was observed. The interval between the second dose and confirmed SARS-CoV-2 infection was significantly higher (P < 0.00001) in COVAXIN recipients (median 228 days) than in COVISHIELD recipients (median 95 days).

Conclusions:
The incidence of VBI was very high among the HCP, but not statistically different among the COVAXIN and COVISHIELD-recipients. Waning immunity over time suggests boosting immunity with a third dose because of emerging variants.
Comparative study on menstrual disorders in post-tubal ligated and non-ligated women
Authors: Verma Pahula , Saxena Swarnima , Gunjan  , Hiremath Ravishekar N. , Sinha Pooja 
Published: October 2023

Background:
The term post-tubal sterilization syndrome has been used variously to include abnormal menstrual bleeding, pre-menstrual dysmenorrhea distress, hysterectomy, and miscellaneous other conditions like the need for recanalization, the feeling of regret, and menopausal syndrome.

Objectives:
To compare the menstrual disorders in post-tubal ligated and non-ligated women and also to compare the histopathology of endometrium in both post-tubal ligated and non-ligated groups in order to compare the menstrual disorders.

Materials and Methods:
It is a comparative cross-sectional study on 200 women between 30 and 50 years, divided into two groups and further into two sub-groups in each group. Group 1 includes cases (post-tubal ligated), and group 2 includes controls (non-tubal ligated); sub-group I includes patients with abnormal uterine bleeding (AUB), and sub-group II includes patients without AUB. Data were recorded using standard performa along with investigations and detailed examination.

Results:
In the case group (post-tubal ligated), maximum patients of 39.22% were having polymenorrhea and 29.41% patients had menorrhagia, whereas in the control group (non-tubal ligated), maximum patients of 38.78% had polymenorrhea and 30.61% had menorrhagia, respectively. However, the difference is statistically non-significant (P value = 1.00).

Conclusion:
Our study suggests that the incidence of menstrual disorders did not differ significantly with tubal ligation. The patients worried about the effects of tubal ligation on their future life that must be counseled and that tubal ligation has no adverse effect on their life including their menstrual pattern. The findings of the study help family physicians in educating the clientele. We also recommend large studies with multiple centers so as to give statistically significant findings of associations.
Knowledge, attitude, and practice about cervical cancer among adult women in rural Jaipur: An observational analysis
Authors: Sakrawal Komal , Meena Govardhan , Gupta Ajay , Malav Kapil , Grover Somya 
Published: October 2023

Introduction:
To identify gaps in knowledge and attitudes that can inform targeted interventions and improve cervical cancer prevention strategies, this study was designed with the objective of assessing the level of knowledge, attitude and practice related to cervical cancer among adult women and associated factors with this in rural areas of Jaipur.

Materials and Methods:
This community-based analytical cross-sectional study was conducted among 300 adult women in village Naila, Jaipur, for a period of 1 year from December 2021 to November 2022. Systematic random sampling was used to identify the houses, and women were selected for interview via simple random sampling. Institutional Ethics Committee approval and informed consent from study participants were taken. A pre-tested semi-structured questionnaire was used for data collection.

Results:
The mean age of participants was 30 ± 9.7 years. Out of 300, 27 (9%) women had ever heard of cervical cancer. Most 189 (63%) women agreed to undergo screening for cervical cancer if opportunity was provided but only four (1.3%) women had practiced regular and/or yearly check-ups with doctors. Association of knowledge of cervical cancer was significant with socioeconomic status and caste (P value <0.05), while association of knowledge of cervical cancer symptoms with other sociodemographic variables was not significant (P value >0.05).

Conclusion:
Most of the women surveyed had poor knowledge about cervical cancer, its risk factors, signs and symptoms, causal relation with HPV, mode of transmission, screening method and prevention through HPV vaccination.
A Study to Carry out Always better control and Vital, Essential, and Desirable Analysis in the Dispensary of a Tertiary Care Teaching Hospital
Authors: Kaur Balpreet , Garg Neeraj , Gad Vasudev , Patel Neelesh 
Published: October 2023

Introduction:
Due to the advancement of medical technology, it is difficult to monitor the vast inventory in hospitals. Thirty-three percentage of the hospital operating budget are spent on buying materials and supplies. Out of all the inventory control measures, Always better control (ABC) and Vital, essential, and desirable (VED) are the most used inventory control techniques. The present study was conducted at a tertiary care specialty hospital to study drug management through the application of inventory control techniques.

Aim and Objectives:
The present study aimed at studying the drug management system by application of ABC and VED analysis and to give recommendations for an efficient inventory management system.

Materials and Methods:
It was an observational study conducted at the dispensary of a tertiary care teaching hospital. The data of annual consumption and expenditure incurred on each item of the dispensary for the fiscal year 2021–2022 were collected. The annual expenditure of individual items was arranged in descending order. The cumulative cost percentage and the cumulative percentage of number of items were calculated, and the list was then categorized into three subdivisions: A, B, and C categories. For classifying drugs into VED, inputs from the concerned clinicians were sought. Data were analyzed using statistical tools of MS Excel. ABC-VED matrix was formed to couple the items into various categories and groups so that managers can efficiently monitor them.

Results:
Of the 291 items used, 15% of the items were A items which need strict monitoring by the top-level management as they are the costliest. VED analysis revealed 37% of the items as vital which should be present at all times in the hospital and are inescapable requirements. ABC-VED matrix analysis showed 10% of the items as A items from ABC and vital items from VED (AV) items which are costly and should be present at all times at the hospital, thereby demanding strict managerial control.

Conclusion:
Using inventory control techniques, substantial improvement could be brought about in patient care by ensuring the uninterrupted availability of vital and essential medicines all the time. It can also be used to identify drugs that require stringent control for the optimal use of financial resources and the elimination of out-of-stock conditions at the dispensary.
Profile of Pelvic Stress Fractures in Indian Women during Military Training and Approaches for Prevention
Authors: Kunte Marshal Renuka , Chatterjee Kunal , Basannar D 
Published: October 2023

Introduction:
Pelvic stress fractures have been reported commonly among women military trainees from worldwide. They have been reported as the most common stress fracture in women in Indian military training academies. With the recent increase in avenues for women to join the armed forces and other paramilitary forces, there is a need for medical personnel to be familiar with the epidemiology of pelvis stress fractures unique to women. This article presents a clinical and epidemiological profile of these fractures and suggests approaches for their prevention.

Methods:
Fifty-one cases of pelvic stress fractures were observed among a cohort of 608 women trainees in the military training establishments of the Indian, Army, Navy, and Air force. Data on clinical presentation, diagnosis, and management were collected for those women trainees who developed radiologically confirmed pelvic stress fractures. Information was also taken to identify the possible risk factors. Measures which can be implemented during training have been suggested to reduce the risk of these fractures during training.

Results:
All women trainees with stress fracture pelvis presented with groin pain and difficulty in running and drill usually in the 6–9th week of training. X-rays showed involvement of the inferior pubic ramus. All of them made good recovery with conservative management. A large number of training-related factors and certain individual-related anatomical and physiological factors seem to have a role specifically leading to these fractures. Approaches to minimize the risk of pelvic stress fractures have been recommended for making the changes in training and managing individual factors.

Conclusion:
Specific measures for the prevention of pelvic stress fractures are required to be instituted, addressing the risk factors for Indian women undergoing military training along with general measures.
Epstein–Barr Virus Infection in Children Presenting with Acute Cervical Lymphadenopathy
Authors: Augustya Priyanka , Bhandari Ashok , Mukund Bal 
Published: October 2023

Introduction:
The aim of this study was to estimate the prevalence of Epstein–Barr virus (EBV) infection among children presenting with acute cervical lymphadenopathy and describe the clinical characteristics of children with primary EBV-induced cervical lymphadenopathy.

Materials and Methods:
This was a prospective observational study in a tertiary care hospital.

Results:
Twenty-two children out of 127 patients evaluated had primary EBV infection among children presenting with acute cervical lymphadenopathy. The most common symptoms noted were fever (95.5%), loss of appetite (63%), and sore throat (45.5%). Posterior and anterior cervical lymph nodes (99.5% and 86.4%) were most commonly affected with a frequency of 2–6 nodes (mean of 3 nodes) and an average size of 2.4 cm (range: 2–6 cm). Maculopapular, nonpruritic rash was noted in 27.3% and Hoagland sign in 9.1% of cases. Hepatomegaly and clinical splenomegaly were noted in 81% and 59%, respectively, among EBV-positive patients.

Conclusion:
EBV primary infection is a common cause of acute cervical lymphadenopathy among Indian children with EBV responsible for approximately 17% of such clinical presentation. A high index of clinical suspicion and timely diagnosis of EBV in these children will be useful in limiting investigations and avoidable use of antibiotics by clinicians in such presentation.
Correlation of Transvaginal Sonography and Hysteroscopy in the Detection of Retained Products of Conception Immediately after Suction Evacuation in First-trimester
Authors: Panda Shakti Prasad , Kapur NM Anupam , Sharma Sanjay , Khan Shazia 
Published: October 2023

Introduction:
Retained products of conception are a frequent outpatient dilemma faced by gynecologists. Blind dilatation and curettage can lead to endometritis, perforations and hemorrhage. We aimed to study the correlation of transvaginal sonography (TVS) and hysteroscopy in the detection of retained products of conception (RPOC) immediately after dilatation and suction evacuation (S and E) in first-trimester abortion.

Materials and Methods:
This was a prospective observational study conducted at the gynecology department in a university-affiliated hospital. All women with a diagnosis of intrauterine RPOC by TVS showing a heterogeneous intrauterine sac of more than 15 mm thickness, without endometritis, treated with S and E for RPOC, who also underwent subsequent hysteroscopy and TVS, were enrolled in the study.

Results:
Since no literature is available comparing these two modalities directly, 50 cases as a pilot study were studied. TVS findings of RPOC with endometrial thickness >15 mm and hyperechoic area or area of mixed echogenicity along with hysteroscopy findings of RPOC were tabulated and correlated. The strength of agreement between TVS and hysteroscopy was determined. In our study, 28% of the participants who had S and E done for first-trimester abortion had RPOC on TVS. The sensitivity and specificity of RPOC on TVS were 69.2% and 86.5%, respectively, with a positive predictive value of 64.3%. Twenty-six percent of the participants had RPOC on hysteroscopy who later underwent re-evacuation procedure using operative hysteroscopy.

Conclusion:
Hysteroscopy is the gold standard for removal of RPOC. A combination of TVS and hysteroscopy for detection of RPOC would lower rates of complications and postoperative intrauterine adhesions.
Knowledge, Attitude, and Practice of Rabies Postexposure Prophylaxis among Young Doctors
Authors: Shukla Rajat , Singhal Anuj , Shaw Subash Chandra , Manthene Mahesh , Sharma Raghav , Soman K. P. , Singhal Aditya 
Published: October 2023

Objectives:
The objective of this study was to assess the knowledge, attitude, and practice (KAP) of young doctors on rabies prophylaxis and to determine the impact of the interactive lecture on the KAP of young doctors.

Methods:
After the formulation of the questionnaire, and review by the faculty of Medical Education, the access web link of the questionnaire was shared in What’sApp with all the young doctors of the hospital. After collecting pretest data, an interactive lecture was delivered, after the lecture, the same questionnaire was again shared, and responses were collected and analyzed.

Results:
All the young doctors who participated in the study acquired good KAP on rabies prophylaxis, overall 6% of doctors corrected themselves and there was an improvement in rightly answering 11 questions.

Conclusion:
KAP survey can be an effective tool in achieving the goal for imparting knowledge regarding effective disease prevention and management.
Positive well-being and usefulness of brief mindfulness-based intervention for pain in cancer
Authors: Chaturvedi Mudita , Bajaj Manoj Kumar , Singh Gurvinder Pal , Mitra Sukanya 
Published: October 2023

ABSTRACT

Background and Aim:
The experience of pain is a pivotal issue in the management of cancer. It has a detrimental impact on the overall well-being of the patients. Psychological management of pain remains an oblivious component of pain management in health-care facilities. The main aim of the study was to explore the relationship between positive well-being variables positive emotion, engagement, relationship, meaning & accomplishment (PERMA) with pain perception in persons suffering from cancer pain and to investigate the usefulness of brief mindfulness-based intervention in reducing cancer pain.

Methods:
Single group quasi experimental pre-to postintervention design was employed and 30 adult participants of any gender diagnosed with any cancer except lung cancer with breathing difficulties reporting pain were recruited. The tools administered were Mini International Neuropsychiatric Interview (to screen the presence of any psychiatric illness) PERMA Profiler (only at baseline), Brief Pain Inventory, Pain Catastrophizing Scale, and Cognitive and Affective Mindfulness Scale-Revised before the intervention and at 4 weeks following brief mindfulness-based intervention for cancer pain (BMBI-CP).

Results:
The findings indicate that among positive well-being variable (PERMA), the domain of relationship was found to be in a slightly higher range in comparison to other domains. There was a statistically significant difference found in the values of pain severity (t = 6.09, P < 0.01), pain interference (t = 7.79, P < 0.01), pain catastrophization (t = 4.68, P < 0.01), rumination (t = 5.20, P < 0.01), magnification (t = 3.03, P < 0.01), helplessness (t = 4.19, P < 0.01), and mindfulness traits (t = −2.82, P < 0.01) post intervention (BMBI-CP).

Conclusion:
Brief mindfulness-based intervention is useful in terms of the ease of delivery and managing psychological aspects of pain perception. Positive well-being variables are significantly associated with pain perception, which would help in the further therapeutic management of cancer pain.
Economic burden on stroke survivors in Asian and African countries: A protocol for systematic review, meta-analysis, and meta-regression
Authors: Shaikh Summaiya Zareen , Patil Anant , Ali Mohammed Usman , Karajgi Asmita 
Published: October 2023

ABSTRACT

Introduction:
Stroke is one of the leading causes of morbidity and mortality worldwide accompanied by huge financial burden on an individual and society.

Objective:
The objective is to estimate the economic burden by calculating the costs (per capita Gross Domestic Product (GDP)) on stroke survivors in African and Asian countries.

Materials and Methods:
Published electronic articles from inception till August 2022 will be screened from five databases: MEDLINE (PubMed), Scopus, Embase, Science Direct, and Web of Science. Effect sizes in the form of risk ratios and risk differences will be calculated for estimating the burden per capita income of the country. In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis 2020 Guidelines, titles and abstracts will be screened by two authors independently. Any disagreements will be resolved by the third author. Rayyan QCRI software will be used for the inclusion of articles and removing of duplicates. Quality assessment will be conducted by the National Institute of Health (NIH) tool for observational and cross-sectional studies whereas risk of bias will be assessed using the Cochrane’s ROBINS-I tool for observational studies. RevMan 5.4 software will be used for plotting forest plots and further analysis. In case, heterogeneity is observed in the outcomes data, I
2 statistics will be calculated to further the possibility of a meta-analysis. Publication bias will be assessed by plotting a funnel plot and “trim-and-fill method”. This systematic review will estimate the economic burden by collating data using socioeconomic indicators of stroke in African and Asian countries. The results will help policymakers in designing and allocation of resources in the two continents.
Case Report: An Imported Case of Typhoid Fever Combined with Rhabdomyolysis and Multiple Organ Lesions in China
Authors: Huang Qian , Shi Yue , Xu Jingying , Wang Fei , Li Yinghui 
Published: October 2023

ABSTRACT.
Here, we report a case of blood culture-confirmed typhoid fever, rhabdomyolysis, and multiple organ damage that arrived in our country from overseas. A 23-year-old male patient presented at our hospital with fever and muscle pain; the condition progressed rapidly. Six days after the onset of symptoms, the patient developed rhabdomyolysis and liver/kidney damage; levels of creatine kinase (CK; maximum peak: 729,869 U/L) and myoglobin (> 3,000 ng/mL) were extremely high, although the extent of renal damage was relatively mild. Blood culture showed Salmonella typhi. The patient received a combination of meropenem and levofloxacin anti-infective therapy, as well as fluid and nutritional metabolic support. He gradually recovered and was discharged after two negative blood cultures. This case highlights the fact that typhoid-induced rhabdomyolysis is a serious, life-threatening disease and that the levels of CK and myoglobin are useful indicators for evaluating typhoid-induced rhabdomyolysis. Clinicians should remain vigilant regarding travel-related illnesses associated with enteric fever.