bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of WHO Pain Ladder Management versus Severity-based Pain Management in Patients Presented with Acute Abdominal Pain Visiting Emergency Department
Authors: Choudhury Mahasweta , Mathiazhagan Nithyanand , Reddy J. Shiva Ranjan 
Published: October 2023

Aimand Objectives: The present study was undertaken to evaluate whether patients that are administered analgesics depending on their initial pain severity are more satisfied with their treatment than those who are given analgesics in accordance with the WHO pain ladder management protocol. Materials and Methods: First consecutive 100 patients (Group I) with abdominal pain were treated with WHO pain ladder management and for the next 100 patients (Group II), the pain management was done based on their intensity of pain. All patients were assessed for relief of pain every 15 min based on visual analog scale (VAS). Results: The visual analog pain score started decreasing after the administration of analgesics in both groups. The VAS was monitored once every 15 min for 60 min and in each measurement, the score was slightly lower in Group II in comparison to Group I ( P > 0.05). At the end of 60 min, the mean score was <4 in both groups. Eighty-six percentage of the patients in Group II and 79% of the patients in Group I were satisfied with their pain relief. Although the satisfaction level of patients was higher in Group II, it was not found to be statistically significant ( P = 0.282). Conclusion: The usage of analgesics for pain management can be decided based on the severity of the pain instead of following the pain ladder management proposed by WHO. This can prevent the unnecessary usage of analgesics such as paracetamol and certain side effects due to that.
Health-care-seeking Behavior of Postmenopausal Women in an Urban Slum of Srikakulam Town
Authors: Roy Paromita , Bose Saptarishi , Suvvari Tarun Kumar , Sivaraj Nagarjuna 
Published: October 2023

Introduction: The majority of Indian women tend to ignore and neglect their menopausal symptoms, which can diminish in intensity over time, leading to a reduced health-related quality of life. We aimed to assess the health-care-seeking behavior of postmenopausal women in light of the increasing burden of menopausal symptoms. Methodology: A cross-sectional study was carried out within urban neighborhoods, involving 384 postmenopausal women aged 45–60, to investigate the health-related issues they faced. The Menopause Rating Scale (MRS) was used to assess the symptoms experienced during the postmenopausal stage. In addition, a predesigned and pretested questionnaire was used to gather information on their health-care-seeking behavior. The participants underwent a comprehensive physical examination, including anthropometric measurements. To analyze the data, descriptive statistics were used. Results: The results showed that 34% of the 384 women were between the ages of 45 and 49 years. Based on the MRS assessment, it was found that around 70% of women experienced mild symptoms, whereas 24% had moderate symptoms, and a mere 2% reported severe symptoms. Regarding treatment, approximately 85% of women had sought medical intervention. However, satisfaction with the treatment was reported by only 71% of the participants. Among the women with modest symptoms, 70% received medical care, compared to 28% of the women with moderate symptoms. Women who were employed, widowed, three-generation family women, and Class IISES women made the most use of health-care facilities, with 90%, 89%, 88%, and 97%, respectively. Conclusion: The prevalence of faint symptoms was significantly higher than that of moderate and severe symptoms. Although most women sought treatment, many were unsatisfied with it. Therefore, behavior modification communication is necessary among postmenopausal women who seek medical care. In addition, the National Health Mission should incorporate components addressing the specific health requirements of postmenopausal women.
Web-based intervention in improving the mental health status among patients with type 2 diabetes in Southern India
Authors: Anil Deepak , Kumar D. Sunil , Shivaswamy Rajendra Prasad , Arun Vanishri , Gopi Arun , Yadav Deepika , Prakash Hari , Murthy M. R. Narayana 
Published: October 2023

Abstract

Background:
Diabetes is one of many medical diseases that correlate with depression. This disease impacts several life implications due to its complications, ranging from economic burden to lifelong dependency. The present study was conducted to assess the effectiveness of a web-based model in improving the mental health status among patients with type 2 diabetes mellitus (T2DM) attending a tertiary care hospital in Mysuru, southern India.

Methodology:
A 3-month quasi-experimental study was conducted among 545 T2DM patients attending the outpatient department of a tertiary care hospital in Mysuru, southern India. Patients were asked to use diabetes care (https://www.diabetes-care.co.in/), a website that can predict the risk for uncontrolled diabetes and recommends lifestyle changes. The Depression, Anxiety, and Stress Scale-21 items questionnaire was used to assess participants’ mental health at the beginning of the study and 3 months later.

Results:
Depression (moderate depression from 3.7% to 2% and severe depression from 0.4% to 0%), anxiety (severe anxiety from 1.3% to 0.2%), and stress (moderate stress from 5% to 0.7%). scores showed a reduction during post assessment period compared to the initial assessment. However, this difference was not statistically significant (<0.05). There was a negative correlation between all domains of quality of life (QoL) and depression, anxiety, and stress scores, implying that lower QoL scores were associated with more depression, anxiety, and stress scores and vice versa.

Conclusion:
Patients with T2DM using the web-based model that predicts the risk of uncontrolled diabetes and suggests lifestyle changes experienced an improvement in their mental health status 3 months’ postintervention.
Introduction to Psychodermatology
Authors: Latheef Ettappurath N Abdul , Hafi Bishrul N A 
Published: October 2023

Abstract
Psychodermatology is an emerging newer subspecialty of dermatology, which comprises dermatology, psychiatry, and psychology. Eventhough the concept is old this dictum has acquired tremendous importance in recent decades. The mind and body are considered as a single unit instead of mind versus body dualism, and this stresses the need for holistic approach of disease management. Formerly, the biomedical concept of disease was very prevalent, which compared the human body to a machine and the doctor was like a technician doing the repair work of human machine, where the mind was completely neglected. But in this recent concept the mind has very important role in health, disease causation and healing. Skin is a part of neuro-immuno-cutaneous-endocrine system. So any disease affecting skin can affect the mind and vise versa. The psycho physiological conditions are highly stress related and secondary psychiatric comorbidities are very common in dermatological conditions especially on visible part of our.
Psychological Interventions in Psychodermatological Practice
Authors: Latheef Ettappurath N Abdul , Hafi Bishrul N A 
Published: October 2023

Abstract
There is a well-established connection between the skin and the mind. Based on current evidence, many dermatological conditions are triggered or exacerbated by stress. Therefore, intervention needs to target stress, anxiety, and other psychiatric comorbidities which may be secondary to skin conditions or may lead to aggravation of the illness. Psychological interventions should be based on the underlying emotional issues that may affect the way skin problems respond to medical treatment. Before starting the intervention, it is very important to know which psychodermatological conditions will be targeted. In primary psychocutaneous illness (delusion of parasitosis, obsessive-compulsive disorder, dysmorphophobia, etc.) the target is to modify or eliminate the symptoms of illness with specific models and approaches. If stress is playing an active role in the etiology and course of skin conditions (e.g., psoriasis, atopic dermatitis, and urticaria) or it is delaying the improvement, then the aim should be to apply stress reduction techniques. In some skin conditions (pemphigus vulgaris, Hansen’s disease, etc.), the aim of the intervention should be to strengthen the defenses and teach new and better mechanisms to maintain control. The common psychotherapy procedures useful in dermatology practice include psychoeducation, behavior therapy, habit reversal, relaxation procedures, biofeedback, cognitive behavior therapy, hypnotherapy, and group therapy.
A Hospital-based Cross-sectional Study of Clinical, Wood’s Lamp, and Dermoscopic Findings in Melasma
Authors: Herle P. M. Amrutha , Doshi Bhavana Ravindra 
Published: October 2023

Abstract

Background:
Melasma is a common pigmentation disorder with female predominance. Depending on melanin depth, it can be epidermal, dermal, and mixed type. Assessment of this helps to chalk out a proper treatment plan. Dermoscopy is a device which helps to examine and assess pigment color and depth.

Objective:
Due to the relative dearth of literature on the correlation between clinical, dermoscopy, and Wood’s lamp findings, we undertook this study to classify melasma and correlate dermoscopic features with clinical and Wood’s lamp findings.

Materials and Methods:
Clinical, Wood’s lamp, and dermoscopic examination with Dino-Lite Premier AM4113ZT were conducted in 160 patients of clinically diagnosed melasma. Findings of light-brown network and perifollicular sparing were considered for diagnosing epidermal melasma; gray-to-brown pigmentation, perifollicular or arciform pattern of hyperpigmentation for diagnosing dermal melasma. Patients with a combination of both were classified into mixed melasma. This was correlated with clinical and Wood’s lamp findings.

Results:
Data analysis by statistical software R version 4.0.2 and Microsoft Excel showed female predominance (80%, n = 128). On clinical and Wood’s lamp examination, the majority had mixed type of melasma; this was followed by epidermal and dermal melasma, respectively. Dermoscopic examination showed a mixed type of melasma in majority, followed by dermal and epidermal type. By Cohen’s kappa, there was substantial agreement present between dermoscopic impression and Wood’s lamp examination (K = 0.6112, P < 0.00001).

Conclusion:
Dermoscopic evaluation as a noninvasive tool provides a better insight on classifying the melasma patterns versus clinical and Wood’s lamp examination and hence decides upon its further management.
How and when to Use Psychotropic Drugs in Psychodermatology
Authors: Deshpande Sharmishtha S. , Bhailume Sanket 
Published: October 2023

Abstract
A significant number of patients coming to dermatologists have psychiatric symptoms as predisposing, precipitating, and perpetuating factors. Assessment and treatment of these conditions is complex. However, looking at the number of patients with these problems, dermatologist needs to be well versed with an assessment of these patients and use of some of the psychotropic drugs. Some such drugs are discussed here along with a discussion about the decision to use them. Benzodiazepines such as clonazepam and lorazepam, doxepin, selective serotonin reuptake inhibitor like fluoxetine, escitalopram, and low dose of antipsychotics like risperidone, haloperidol, and olanzapine are discussed. As the patients are often reluctant to visit a psychiatrist, a dermatologist needs to help in allaying the initial anxiety and to provide understanding about the psychiatric conditions and available options for treatment. In long term, liaison with a psychiatrist can be established and joint treatment by both consultants can be continued.
The Primary Psychiatric Conditions: Clinical Characteristics
Authors: Prabhu Smitha S , Goyal Shivam 
Published: October 2023

Abstract
Primary psychiatric conditions are those conditions, wherein the cutaneous manifestations are secondary to functional psychopathology in the brain. These comprise of psychiatric disorders with dermatologic manifestations and include conditions such as dermatitis artefacta, delusions of parasitosis, obsessive–compulsive disorders, body-focused repetitive behavior disorders, or somatoform disorders. Herein, we describe the clinical features and diagnostic methods of the individual primary psychiatric conditions, most of which have definitive diagnostic criteria in Diagnostic and Statistical Manual of Mental Disorders, and discuss the differential diagnoses encountered in clinical practice, in brief.
Association of Mastoid Pneumatization with Deviated Nasal Septum: A Clinicoradiological Study
Authors: Basuroy Siddhartha , Goel Leena , De Sa Carnegie , Goel Megha , Varughese Kevin Mathew , Vernekar Sunidhi Mohandas , Vijaykumar Rashmi 
Published: October 2023

Background:
Deviated nasal septum (DNS) has been reported to jeopardizing the nasal aerodynamics. This in turn may affect the pressure dynamics in the nasopharynx and eventually affect the development and pneumatization of mastoid air cells. Few studies done previously have shown a positive correlation between nasal pathologies and mastoid pneumatization.

Objectives:
This study was undertaken to see for the possible association of mastoid cell pneumatization, with DNS. Materials and Methods: Limited high-resolution computed tomography temporal bone and computed tomography nose and paranasal sinuses were used to calculate the mastoid air cell volume and angle of septal deviation. The degree of septal deviation was graded into mild, moderate, and severe. The mastoid air cell system volume was calculated on the side of the convexity of the septal deviation and the other side.

Results:
It was found that there is a statistically significant difference in the mastoid volume on the affected side of the DNS vis a vis the unaffected side. Further, the degree of reduction of the volume was not a linear function of the degree of septal deviation.

Conclusions:
Septal deviation significantly reduces the mastoid air cell volume on the affected side Thus, early correction of pathological DNS in adults, irrespective of the etiology, is important, so as to avoid the chances of developing chronic ear pathologies in later life.
Evaluation of Cognitive Function Using P300 Latency and Amplitude in Children with Profound Sensorineural Hearing Loss Using Hearing Aids: A Comparative Cross-sectional Study
Authors: Aryanti Gita , Zizlavsky Semiramis , Soebadi Amanda , Hendrawan Donny , Prihartono Joedo , Suwento Ronny , Sriyana Ayu Astria 
Published: October 2023

Introduction:
As hearing function is directly linked to language and communication abilities, hearing loss may negatively affect children’s cognitive development. Therefore, it is important that hearing-impaired children undergo cognitive function assessments to better understand how to alleviate this comorbidity. The P300 event-related potential measurement is a neurophysiological test increasingly used to objectively measure cognitive function.

Aim:
The aim of the study was to compare the latency and amplitude of P300 waves in children with profound sensorineural hearing loss (SNHL) with hearing aids and normal-hearing children aged 7–15 years old.

Methods:
A comparative cross-sectional study involving 15 children with profound SNHL and 15 children with normal hearing was conducted. The latency and amplitude of P300 waves in these children in response to auditory and visual stimuli were recorded and analyzed.

Results:
The mean P300 wave latency in children with SNHL was slightly longer than that in children with normal hearing, albeit insignificant (P = 0.578). Similarly, the amplitude of the P300 waves was not significantly smaller in children with SNHL (P = 0.885).

Conclusions:
SNHL children with hearing aid habilitation have comparable P300 amplitude and latency compare to normal-hearing children.
Efficacy of Oral versus Intratympanic Steroids in the Treatment of Idiopathic Sudden Sensorineural Hearing Loss: A 1-year Randomized Control Trial
Authors: Tejaswini J. S , Walia Manwinder , Bansal Sandeep , Soni Samanvaya 
Published: October 2023

Background:
Sudden sensorineural hearing loss (SSNHL) is a common otologic emergency, with hearing loss of 30 dB or greater at three contiguous frequencies, and an abrupt onset within 3 days or fewer, with no recognizable cause.

Aims and Objectives:
In this study, the efficacy of intratympanic (IT) injections of dexamethasone are compared with oral prednisolone and the behaviour of the different audiometric curves in response to both the steroid therapies in studied.

Materials and Methods:
Patients presenting with SSNHL to the Department of ENT, Head and Neck Surgery at Government Multi Speciality Hospital, Chandigarh, were subjected to routine tests. Informed written consent was taken from each patient, and cases meeting the selection criteria were included in the study. Pure-tone audiometry was done before starting treatment. Patients were randomly assigned into two groups based on their enrollment number. Those in Group 1 were treated with three doses of 0.3–0.6 mL IT injections of dexamethasone (4 mg/mL) on alternate days and those in Group 2 received OP 1 mg/kg/day with tapering doses. Pure-tone audiogram (PTA) will be repeated after 2 weeks, 4 weeks, and 8 weeks from the first dose.

Results:
In the IT dexamethasone group, the pretreatment PTA was 61.05 dB while the posttreatment PTA was 37.45 dB. The hearing gain was 23.6 dB. In the oral steroid group, pretreatment PTA was 66.79 while posttreatment PTA was 47.36 dB. The hearing gain was 19.43 dB. The hearing gain in both the groups was statistically significant; however, there was no statistical difference between the two in terms of superiority of efficacy (P > 0.05).

Conclusion:
The treatment of SSNHL still remains a challenge among the otologists. The present study establishes that the efficacy of IT steroids was as good as the oral steroid therapy for the management of SSNHL as both the modalities showed significant hearing improvement. Hence, IT steroid can be used as a first-line therapy in patients with. Our study also uncovered the fact that patients who come with shorter duration of onset recover quickly compared to those patients who delay their treatment. Hence, IT steroid can be used as a primary modality of treatment instead of a salvage therapy in the selected group of patients.
Reconditioned and new pacemakers in low-resource countries: A pilot study
Authors: Edafe Emmanuel Auchi , Sotonye Dodiyi-Manuel , Iseko Iseko Iyoko , Akpa Maclean R. , Sani Mahmoud Umar , Ocheli Emmanuel , Alasia Datonye Dennis , Crawford Thomas Christopher , Puroll Eric , Dunning Joel 
Published: October 2023

Abstract

Introduction:
Cardiac pacemakers have brought a paradigm shift to the management of symptomatic bradyarrhythmia. It has led to a dramatic reduction in morbidity and mortality from cardiovascular disease over the many decades. Despite these merits, pacemakers remain unaffordable and beyond reach for many patients in low-and middle-income countries (LMICs) including Nigeria. These challenges and regulatory obstacles may be overcome with postmortem pacemaker reuse if they are proven to be feasible and safe as cost-effective strategy to provide life-saving therapy to patients in LMICs. The aim of this pilot study was to review the usefulness of reconditioned pacemakers among patients that could not afford new devices.

Materials and Methods:
A total of 16 patients were recruited for the pilot study. These included patients with a pacing indication who could not afford a new pacemaker or a battery change. The 16 patients were grouped into A and B. Group B had 8 patients that received new pacemaker batteries. Group A comprised 8 patients who received refurbished pacemaker batteries. All the pacemaker leads used in the study for both the groups were new. Implant charges were free. Ethical approval was got from the University of Port Harcourt Teaching Hospital, and the Cardiocare Multispecialty Hospital, Abuja, before commencement of the study. The refurbished pacemaker batteries were donated by the relatives of deceased patients, with a minimum 70% of remaining battery life. The donated pacemaker batteries were received from Pace4 life and My Heart Your Heart, University of Michigan, Michigan, United States. These reconditioned batteries were resterilized. Pacemaker functions were rechecked before and after sterilization. The devices were programmed on nonpacing (ODO) mode with adaptive pacing mode swift off. These devices were shipped to us for use. All sterile techniques were followed during implantation. Data were collected on wound healing and device malfunction during implant and follow-up for 3 months.

Results:
The average age for the patients was 62 ± 13 years. There was no pocket hematoma among both the groups. There were no complications during the 1–3-month follow-up period. There was no evidence of lead or battery malfunction among the two groups. The means of battery longevity for the new and refurbished pacemakers were 10.38 and 10.57 years, respectively. There was no statistical difference between the pulse generator longevity among new and refurbished pacemakers with P = 0.681. There was no infection and device malfunction in the 3 months.

Conclusion:
The reused pacemaker batteries are safe and do no increased risk of infection and malfunction. This provides an effective option for patients who cannot afford a new device or a replacement battery.
Satisfaction With Abortion Training in an Abortion-Restrictive State
Authors: Du Angela , Smith Rachel M. , Rivlin Katherine 
Published: October 2023

Background With increasingly disparate patient access to abortion care and resident access to abortion training opportunities following the Dobbs v Jackson Women’s Health Organization decision, educators must better understand how legal restrictions affect obstetrics and gynecology (OB/GYN) resident training experiences and residents’ desire to provide abortions.
Objective To characterize how resident perceptions of abortion restrictions affect satisfaction with training and intent to provide abortion.
Methods We recruited OB/GYN residents training in Ohio, a state restrictive to abortion, to complete surveys capturing training experiences between 2019 and 2020. Logistic regression models were used to estimate associations between perception of the legal climate on training and satisfaction with training and intent to provide abortions. To provide additional context to survey responses, we reviewed open-ended responses to the effect of the legal climate on training.
Results Of 343 eligible residents, 88 (26%) responded from 13 of 15 programs (87% of programs). Most (73%) felt that the legal climate affected their training, and these respondents were more likely to be unsatisfied with their training (adjusted odds ratio [aOR] 16.6; 95% CI 2.83-97.22). We found no association between perception of legal climate on training and intent to provide abortions. In open-ended responses, most residents described a desire for more abortion training and barriers to patient care. Some highlighted the positives of training in a restrictive environment, which allowed for an improved understanding of the skills required for patient advocacy.
Conclusions Many residents felt that the legal climate in Ohio affected their abortion training, a perception that was associated with decreased satisfaction with training.