bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ocular manifestations in HIV patients attending a tertiary care hospital in Eastern India and correlation of posterior segment lesions with CD4+ counts
Authors: Swain Jyotirmayee , Sharma Pramod Kumar , Mohanty Loknath , Panigrahi Pradeep Kumar 
Published: November 2023

Purpose:
We aimed to study the ocular manifestations in human immunodeficiency virus (HIV)-infected patients and the correlation of posterior segment lesions with CD4+ counts.

Methods:
This hospital-based, cross-sectional study enrolled HIV-positive patients attending the ophthalmology department of a tertiary care hospital in Eastern India. Complete demographic information was obtained for each patient. Comprehensive ophthalmic evaluation was done in each case.

Results:
A total of 184 HIV-positive patients were enrolled in the study. Ocular manifestations were detected in 62 cases. The prevalence of ocular manifestations in the present study was 33.69%. Mean age of patients included in the study was 34.8 ± 10.77 years. Prevalence of ocular manifestations was highest in the age group of 30–39 years (41.93%). Highest prevalence of ocular manifestations was noted in patients with low level of education and poor socioeconomic status. Sexual transmission was the major route of HIV transmission (in 92% of cases). Posterior segment lesions were seen in 69.35% of cases. HIV retinopathy was the most common posterior segment manifestation noted in 25 eyes. Significant positive correlation was noted between severities of posterior segment findings and CD4+ counts, which we found to increase with decrease in CD4+ counts (P < 0.001).

Conclusion:
Detailed ophthalmic evaluation including fundus examination is must in all cases of HIV/acquired immunodeficiency syndrome (AIDS) patients as it may help in early diagnosis, treatment, and prevention of sight-threatening complications due to opportunistic infections.
Prevalence and pattern of refractive errors among school-going children in district Baramulla, Kashmir: A cross sectional study
Authors: Hassan Sabreena , Nabi Sahila , Zahoor Nazia , Khan Shabana , Makayee Abdul A , Wahab Abdul 
Published: November 2023

Purpose:Uncorrected refractive error is one of the most important causes of visual impairment worldwide. Addressing childhood vision impairment (VI) is one of the main goals of the World Health Organization (WHO) to combat blindness strategies.Objective:To ascertain the prevalence and pattern of refractive errors among children aged 10 to 16 years in Baramulla district, Kashmir.Methods:A cross-sectional study was carried out among 680 school children during an eye camp under the school health program of the national program for control of blindness. The screening was conducted in four schools in Baramulla district, Kashmir. The schools were selected using the non-probability convenient sampling technique.Results:A total of 680 school children from classes sixth to tenth aged 10–16 years participated in the study. Out of 680 students, 545 (80%) had normal vision, 97 (14%) had impaired visual acuity ranging between 6/9 and 6/24, and 38 (6%) had severe VI ranging from 6/36 to 6/60. Among the various types of refractive errors, myopia was the most prevalent affecting 54 children. Age distribution of refractive errors showed myopia to be more prevalent in the age group 13–14 years (16, 14 cases), hypermetropia was more prevalent in the age group 14–15 years (10, 8 cases), and astigmatism 5 cases in the age group 14–15 years.Conclusion:The study provides useful and baseline data about the refractive error amongst the school children of the Baramulla district. A larger study needs to be conducted in all schools of the state to get a clear picture of RE and other eye-related problems to detect vision problems earlier.
The Pattern of Midface Fractures in Jordan: A Retrospective Review of Medical Records
Authors: Bataineh Anwar B. , Khader Yousef 
Published: November 2023

Introduction:
Midface fracture incidence and trauma patterns vary across countries, due to socioeconomic, environmental, and cultural factors. The aim of this retrospective study was to assess the etiology, pattern, and treatment of midface fractures in North of Jordan during 2018–2021.

Methods:
This single-center retrospective study was based on the review of the medical records of patients who had suffered midface fractures and were treated at the Department of Oral and Maxillofacial Surgery at the King Abdullah University Hospital. The dataset for this investigation spanned the 4-year period from January 2018 to December 2021.

Results:
During the 4-year period, 267 patients presented with 376 different maxillofacial fractures. Of those, 140 patients had 250 midface fractures, with a mean of 1.79 per patient. Their age ranged from 2 to 68 years (mean [standard deviation] = 25.8 [12.0] years). The most frequent injury cause was road traffic accidents (RTA) (n = 72, 51.3%), followed by falls (n = 27, 19.3%). Among midface fractures, the most frequent were orbit fractures (42.4%), followed by zygomatic fractures (31.6%) and maxillary fractures (26%). The majority of fractures (77.9%) were treated through open reduction and internal fixation (ORIF), while the remaining (15.7%) required closed reduction and conservative treatment was sufficient in 6.43% of fractures.

Conclusions:
Midface fractures were more common among males, and primarily occurred in the orbital floor due to the high incidence of RTAs. Maxillary fractures were mostly of the LeFort I Type and ORIF was the most common treatment modality.
Orthostatic hypotension in the elderly: Prevalence and its management by simple isometric limb tensing exercises
Authors: Tephilla Epsibha , Elizabeth Tharion , Shalini Jeyapaul , Vinod Abraham 
Published: November 2023

Objective:
Orthostatic hypotension (OH), an important cause of falls in the elderly, is grossly underdiagnosed. Our study aimed to determine the prevalence and associated factors of OH among the elderly attending a secondary care hospital. Furthermore, we assessed and compared the effectiveness of simple arm and leg tensing exercises, performed just prior to standing, to mitigate the orthostatic fall in blood pressure (BP) in elderly OH patients.

Materials and Methods:
A cross-sectional study screened elderly patients (≥65 years) for OH and recruited them into a randomized controlled trial (CTRI/2020/08/027182) of two parallel groups performing either arm tensing or leg tensing exercises just before standing up. We performed an interim analysis of the ongoing trial using paired t-test for within-group comparisons. Patients identified to have OH based on systolic or diastolic fall in BP were analyzed separately. Chi-square analysis compared the improvement in OH status between the two groups.

Results:
Nineteen out of 186 screened elderly patients were diagnosed with OH (10.21%, 95% CI: 7.99–12.43). Arm exercise significantly reduced the orthostatic-induced fall in systolic and diastolic BP, while leg exercise effectively reduced only the systolic fall in BP among patients with OH. The proportion of patients with OH after arm exercise (20%) was significantly lower than after leg exercise (77.8%) (P = 0.023, Fischer's exact test).

Conclusion:
We found a 10.21% prevalence of OH in our elderly population. Furthermore, we found that simple isometric arm tensing exercise ameliorates the fall in BP on standing up in OH patients.
An epidemiological study of period poverty among females of reproductive age group in Lucknow (U.P.)
Authors: Singh Swati , Kunwar Rajesh , Sengar Mili , Gupta Abhishek 
Published: November 2023

Background:
Females in developing countries face brunt of lack of access to affordable menstrual supplies and inequitable distribution of menstrual health education and are victims of period poverty. The objective of the present study was to estimate prevalence of period poverty and to determine association of period poverty with socio-demographic determinants, menstrual knowledge, menstrual hygiene management practices, and reproductive health.

Materials and Methods:
This was an analytical cross-sectional study, conducted at an urban primary health care centre. Reproductive age group (20–49 years) females attending the primary health care centre from December 2022 to May 2023 were selected for study. Data were collected on semi-structured, pre-tested questionnaires. The collected data were entered in M.S Excel and analysed in STATA version 17.0. Chi-square test was used for comparison of qualitative data, and for quantitative data, unpaired t-test was used.

Results:
The prevalence of period poverty in the present study was 92 (29.7%). The mean age of females with period poverty was 29.72 ± 7.13 years, and it was 26.45 ± 6.62 years with no period poverty (P 0.001). Period poverty was significantly associated with socio-demographic variables. Period poverty had significant association with menstrual knowledge, menstrual hygiene management practices, and reproductive health.

Conclusion:
Many females cannot afford menstrual health products to meet their monthly needs, and this may affect their education and socio-economic status. Improved access to affordable sanitary products is requisite of females.
Patients' satisfaction towards Wasfaty services in Al Ahsa province, Saudi Arabia – 2022
Authors: AlGhadeer Sarah Z. , AlAbdullah Meriam , Alibrahim Zainab , AlSalman Zahra , AlHaddad Hasan M. 
Published: November 2023

Background:
The e-prescriptions service connects primary healthcare centers and hospitals to selected community pharmacies in various locations to allow easy access to the nearest pharmacy in the neighborhood, thus facilitating the process of drug dispensing. This study aims to assess patients' satisfaction towards Wasfaty services delivered by Ministry of Health healthcare centers.

Materials and Methods:
A cross-sectional study was conducted in Al Ahsa province in Saudi Arabia among adult patients who used Wasfaty services. An electronic Arabic questionnaire including demographic characteristics of patients and questions to assess their satisfaction level with the e-prescription “Wasfaty” service in terms of different aspects.

Results:
A total of 481 participants were included in the study. Females represented 53.4% of them, and 28.1% were aged 50 years or over. Overall, most of the patients (84.1%) were either satisfied or strongly satisfied with the service (4.28 ± 0.57). After controlling for confounding, patients with chronic diseases were more satisfied with the “wasfaty” service compared to those without chronic diseases. The history of chronic disease was responsible for approximately 2.4% variability of patient satisfaction (r-square = 0.024). Patients' geographic region, age, sex, and educational level were not significantly associated with their satisfaction with “wasfaty” service.

Conclusion:
The majority of patients, particularly those with chronic diseases, were satisfied with Wasfaty service. However, less satisfaction was observed regarding medication availability.
Prevalence and factors associated with anaemia among pregnant women attending antenatal care in a district hospital and its feeder community healthcare centre of the Limpopo Province, South Africa
Authors: Ntuli Thembelihle S. , Mokoena Oratilwe P. , Maimela Eric , Sono Khanyisa 
Published: November 2023

Background:Pregnancy anaemia is a significant public health concern in South Africa (SA), particularly in rural areas, but little is known about its prevalence and risk factors in rural areas. The objective of the study was to determine the prevalence and identify risk factors of pregnancy anaemia in the public health facilities of Limpopo Province (LP), SA.Methods:A cross-sectional study was conducted among a consecutive sample of 211 pregnant women attending antenatal care at Seshego Hospital and its feeder health centre (May to June 2019). Anaemia was defined as haemoglobin (Hb) <11 g/dL and classified as mild (10–10.9 g/dL), moderate (7–9.9 g/dL) and severe anaemia (<7 g/dL). A multiple logistic regression analysis was used to identify predictors of anaemia.Results:The mean age of the women was 28.4 ± 5.7 years (range from 18 to 41 years). Over half (52%) had secondary education, 65% were unmarried, 72% were unemployed, 34% were nulliparous, 15% were human immunodeficiency virus (HIV) infected and 67% were in the third trimester. The anaemia prevalence was 18.0% and was significantly associated with parity, HIV status and body mass index (BMI) in a multivariate logistic regression analysis.Conclusion:This study found that less than one-third of pregnant women were affected by anaemia, associated with parity, HIV infected and BMI. It is essential to promote routine screening for anaemia, health education and prompt treatment of infections to reduce this burden. In addition, further studies on risk factors for anaemia during pregnancy in both urban and rural communities should be conducted to strengthen these findings.
Management of COVID-19 during the second wave at a tertiary care public hospital in Eastern India: An experience from the administrative control room
Authors: Mishra Siddharth , Mondal Ramkrishna , Pillai Jawahr S. K. , Sahoo Mukunda Chandra 
Published: November 2023

Context:
Though many arrangements had been made during the first wave, multiple complaints were reported regarding the arrangements made for COVID patients. The control room was set up as a 24 × 7 administrative coordination center to attend to issues after the initial setup of COVID units.

Aim:
To identify the major problems reported to the control room during the second wave of COVID-19 and find the related cause for the same.

Methods and Materials:
Issues reported to the control room were recorded from April to June (2021). The control room residents were asked to allocate each problem into six categories. Next, the residents allotted a frequency score to each of the problems depending on how regularly it was reported. Secondary data from various reports were also considered.

Statistical Analysis Used:
Data were analyzed using MS Excel software.

Results:
Various administrative issues were identified to be due to issues in communication and coordination (23%), policy and procedures (22%), human resource and training (16%), administration and implementation (15%), infrastructure (14%), and HMIS and IT (10%).

Conclusion:
Most frequent problems reported to the control room were related to infrastructure, policy implementation, and manpower training. After the initial implementation of new processes, there was a requirement for regular follow-up and coordination. This model of setting up an administrative control room and evidence-based approach will serve as a template for public hospitals to ensure coordination of hospital operations.
Early neonatal hypoglycemia in exclusively breastfed babies in a developing country – India
Authors: Gill Simran K. , Peterson Rachel R. , Christ Joy H. , George Carolin E. 
Published: November 2023

Background:
Neonatal hypoglycemia has been a cause for concern due to increasingly frequent reports of long-term sequelae, leading to undue concern and inadvertent administration of formula feeds. Though hypoglycemia is usually encountered only in neonates with classical risk factors, hypoglycemia is also rarely seen even in babies with no known risk factors. These babies may present only with sequelae in later childhood.

Methods:
This is a hospital-based observational, prospective study. We included 299 exclusively breastfed neonates who were shifted to mother's side with no congenital malformation or need for neonatal intensive care unit (NICU) admission. The neonates were studied in two groups: “ At Risk” and “No Risk.” The “At Risk” group included babies with known risk factors like low birth weight, late preterm (34–36 weeks), small for gestational age (birth weight <10th centile), infant of a diabetic mother, or large for gestational age (birth weight >90th centile). Hypoglycemia was the primary outcome measured independent of feeding time for both groups. For the “At Risk” group, monitoring was done at 0, 1, 2, 3, 4, 12, 24 plus 48 h. For the “Not At Risk” group, it was done at 12 and 24 h of life. The factors associated with both groups were studies as the secondary outcome.

Results and Conclusion:
Out of 299 exclusively breastfed neonates, 13% were hypoglycemic. 27.06% were hypoglycemic in the “At Risk” group. In the “At Risk” group, low birth weight and primiparity were significant risk factors. The incidence of hypoglycemia in the “No Risk” group was 1.80%. Breast problems and breastfeeding problems, low education status of mother, young age, and primiparity were significant risk factors in the “No Risk” group.
The determining factors of medical students in considering a specialty as a future career path: A cross-sectional multinational study in the Middle East
Authors: Alyazidi Anas S. , Gaddoury Mahmoud A. , Alotibi Fahad A. , Aljehani Khalid M. , Ahmed Renad A. , Alhudaifi Saeed A. , Aldharrab Abdulmohsen S. , Alkhallagi Abdulaziz S. , Al-Raddadi Rajaa 
Published: November 2023

Background and Aims:
Throughout their years of study, undergraduate medical students are expected to gain broad comprehension of all medical specialties. After acquiring an undergraduate degree, the decision to choose a specialty is critical for every student's life as it determines the rest of their career path. This study aims to determine factors influencing medical students' choices between various specialties in different countries in the Middle East and North Africa.

Subjects and Methods:
A cross-sectional study was conducted in March 2022 targeting medical students from the Middle East and North African countries. A questionnaire was used to collect data from the students, which consisted of four sections. Ethical approval was obtained from the Unit of Biomedical Ethics Research Committee at King Abdulaziz University. Participation was voluntary and anonymous. For statistical analysis, IBM Statistical Package for the Social Sciences (SPSS) Statistics for Windows (Version 21.0; IBM Corp., Armonk, NY, USA) was used. Categorical variables were presented using numbers, associated frequencies, and percentages (%). Categorical variables were correlated using the Chi-square test. One-way analysis of variance (ANOVA) test was used to compare the means of three or more independent groups. Logistic regression, odds ratio (OR), and 95% confidence interval (CI) were used to identify the factors associated with specialty selection. P < 0.05 was considered statistically significant.

Results:
A total of 1109 students responded to the questionnaire. Participants' gender characteristics showed that there were 672 (60.6%) females and 437 (39.4%) males. Among them, 127 were in their second year, 180 in their third year, 362 in their fourth year, 85 in their fifth year, 37 in their sixth year, and 108 were interns. The median age of the participants was 22.0 years (mean = 22.09 ± 2.891). There were 473 (42.6%) students who were undecided about their future medical specialty. Income (759, 68.4%) and career prospects (723, 65.2%) were the most preferred factors in their decision to pursue a future medical specialization.

Conclusions:
In conclusion, medical and surgical specialties have been identified as the preferred future career path. It was discovered that student's decision-making is influenced by income, career prospects, and the sense of competency needed to choose a future medical specialty. Future research would be more revealing.
Ankle brachial index and its correlation with cardiovascular risk factors in pre-diabetes: Two-year cross-sectional study
Authors: Phate Neha G. , Kumar Sunil , Acharya Sourya , Agrawal Sachin R. , Wanjari Anil , Wakode Monish , Gemnani Rinkle R. 
Published: November 2023

Background:
A state of impaired glucose tolerance is called prediabetes. The diagnosis of prediabetes is controversial, yet it still puts a person at risk for developing diabetes. The ankle-brachial index (ABI) is useful for identifying persons at risk for peripheral artery disease and for diagnosing the condition in those who have symptoms in their lower extremities and subclinical atherosclerosis. This study highlights ABI and its correlation with cardiovascular risk factors like lipid profile and anthropometric measurement including neck circumference in prediabetes so that primary care physicians may be able to diagnose early before advancing to diabetes.

Materials and Methods:
This cross-sectional study of 2 years duration from December 2020 to September 2022 was conducted in the Department of Medicine, at a tertiary care teaching hospital situated in a rural area. Patients with pre-diabetes were enrolled and Ankle Brachial Index was calculated. The correlation of ABI with anthropometric measures and lipid profile was assessed.

Results:
On calculating ABI by manual method 21% which is 42 out of 200 had low ABI (<0.9). On the other hand, on calculating ABI by probe method low range of ABI was found to be 37% which is 74 patients out of 200. There was a significant correlation between ABI and body mass index and lipid profile. The diagnostic performance of ABI < 0.9 had 56.8% sensitivity and 100.0% specificity.

Conclusion:
ABI can be used as a noninvasive and cost-effective modality for assessing subclinical atherosclerosis in patients with prediabetes and thus prevent its morbid complications even assessed at the primary care physician level.
Unit costs for allopathic and AYUSH outpatient care in public facilities in Urban Delhi, India
Authors: Garg Charu C. , Goyanka Roopali 
Published: November 2023

Introduction:The National Health Policy, 2017, suggests pluralism in health care with the integrated delivery of AYUSH and allopathic care at public facilities. Information on unit cost of outpatient visits for both types of care at public facilities is useful to guide the policies on health-care delivery.Methods:The costs in 2019–20 were estimated for each type of care at allopathic urban primary health center (UPHC) and AYUSH facilities using top-down methodology and adding out-of-pocket expenditures (OOPE) incurred to reflect true costs. Data from national health survey, annual government budgets, and reports were used.Results:The average cost of an outpatient visit for allopathic care was ₹325 at a UPHC and ₹189 in a homeopathic dispensary and ₹692 in an Ayurvedic dispensary. While OOPE per visit at UPHC was ₹177, no OOPE was incurred at AYUSH facilities. The government expenditure per visit for allopathic care at UPHC at ₹148 was the lowest compared to any type of AYUSH care. The cost per facility for allopathic UPHC was higher than both Ayurvedic and homeopathic dispensaries. Unani dispensaries were least cost-effective, both in terms of cost per visit and cost per facility.Conclusion:Costs per visit at a facility are impacted by footfalls. For Ayurveda, despite lower facility costs as compared to UPHC, per visit costs were higher due to low utilization. Improving evidence-based utilization of AYUSH care is critical for the success of the government policy of mainstreaming AYUSH care at low cost.