bluuebunny/crossref_metadata_2025_split huggingface dataset:
A qualitative study on barriers and strategies to hospital preparedness against chemical, biological, radiological, and nuclear incidents
Authors: Baikmohammadi Saeid , Amirheidari Bagher , Dehesh Tania , Moghadam Mahmood Nekoei , Yazdi-Feyzabadi Vahid , Hassani Ebrahim , Habibzadeh Hossein 
Published: February 2024

BACKGROUND:
The effects of chemical, biological, radiological, and nuclear (CBRN) incidents on human society can be irreparable. Preparing the health system for these incidents is essential. This study aims to identify obstacles to hospital preparedness against CBRN incidents and provide solutions.

MATERIALS AND METHODS:
This qualitative study was conducted using semi-structured interview method in 2022. The research community included experts in the fields of CBRN, and 17 persons were included in the study through purposive sampling. The interviews were collected by interview guide and recorded face-to-face and online and were analyzed using thematic content analysis method in MS Word 2016.

RESULTS:
The interviews’ analysis was classified into two main categories and 34 sub-categories. Some of the most important obstacles to the hospital preparedness against CBRN incidents were the lack of proper crisis management, the lack of specialist staff, the stress of employees, the lack of turnover and sufficient rest for employees, legal gaps, and so on. The main strategies were determining the type and extent of the risk factor, strong crisis management, the lack of parallelism, continuous monitoring, having a protocol and road map, appropriate training programs, having skilled personnel, rapid response of personnel, positive attitude of the staff, and the favorable condition of the building.

CONCLUSION:
The appointment of an expert in the field of CBRN and having a specialized unit, the existence of specialized and trained staff along with access to the required facilities, clear instructions, and intra-departmental and inter-departmental cooperation affect the readiness of hospitals against CBRN incidents.
The effect of iron supplementation on menstrual bleeding volume and hemoglobin level during menstrual bleeding : A randomized clinical trial
Authors: MokhtarKalimi Elnaz , Loripoor Marzeyeh , Rezaeian Mohsen , Gholamrezapour MohammadReza 
Published: February 2024

BACKGROUND:
Many women around the world avoid taking iron supplements during their menstrual bleeding, thinking that menstrual bleeding will increase after taking these supplements. Due to the lack of relevant scientific evidence in this regard, this study was performed to determine the effect of iron supplementation on menstrual blood volume and hemoglobin level during menstrual bleeding.

MATERIALS AND METHODS:
In this three-blind randomized clinical trial, 160 non-anemic female students of Rafsanjan University of Medical Sciences were selected through a public call and then they were randomly assigned to two intervention and control groups. The intervention group was given a ferrous sulfate tablet containsing 50 mg of elemental iron daily in the first four days of bleeding for three consecutive menstrual cycles, and the control group received a placebo simultaneously. Before and after the intervention, the level of hemoglobin was measured and the Higham chart was completed in each menstrual cycle by the participants of the two groups. The obtained data were analyzed using the SPSS software version 21 and Chi-square, independent t-test, paired t-test, analysis of variance with repeated measures, and nonparametric tests.

RESULTS:
Before performing the intervention, the mean Higham score and hemoglobin level of the two groups were not statistically significant (P = 0.307, P = 0.670). The mean Higham score after each intervention was not statistically significant between the two groups over time or when considering the interaction of the time group (P = 0.77, P = 0.916). The hemoglobin level of these two groups did not change significantly after the intervention compared with that before the intervention (P = 0.444).

CONCLUSION:
Compared with a placebo, taking iron supplements containing 50 mg of elemental iron during the first four days of menstrual bleeding in non-anemic women did not change the volume of menstrual bleeding and hemoglobin level.
Is fat-to-lean mass ratio a better predictor of heart variability than body mass index?
Authors: Aggarwal Piyush , Kuppusamy Saranya , Prakash Praveen , Subramanian Senthilkumar , Fredrick Jean 
Published: February 2024

BACKGROUND:
Body mass index (BMI) may not accurately predict cardiometabolic risk due to confounders like age, gender, relatively high lean mass, and the “thin-fat phenotype” prevalent in south Asian populations. Fat-to-lean mass ratio (FTLM), which assesses the balance between fat and lean body mass, may provide a more complete assessment of cardiometabolic health.

MATERIALS AND METHODS:
This cross-sectional analytical study investigated the relationship between FTLM ratio, BMI, and heart rate variability (HRV) in apparently healthy male adults. 88 participants recruited through convenience sampling underwent anthropometric assessments, bioimpedance body composition analysis, and HRV testing. Pearson’s or Spearman’s correlation and linear regression analyses were performed where appropriate to assess the relationship between FTLM ratio, BMI, and HRV.

RESULTS:
Both BMI and FTLM showed significant positive correlation with normalized LF power and LF-HF ratio and a negative correlation with normalized HF power, RMSSD, and pNN50. However, FTLM ratio showed a stronger association with HRV parameters than BMI and could explain a greater percentage of the variability in LF-HF ratio (32% compared to 18.4%, P < 0.001).

CONCLUSION:
Assessment of both fat and lean mass, expressed as a ratio, is a better index of quantifying adiposity and predicting the influence of altered body composition on cardiometabolic health.
Association of heart rate variability and C-reactive protein in patients with depression
Authors: Singh Soni , Singh Shraddha , Shukla Neeraja , Shukla Abhishek 
Published: February 2024

ABSTRACT

Background:
Depression has been shown to be correlated with cardiovascular (CV) morbidity and mortality. Inflammation and autonomic nervous system (ANS) dysfunction are possible causes. Numerous clinical studies have found an association between inflammatory pathways and the ANS. The aim of this study was to investigate the relationship between different heart rate variability (HRV) parameters and C-reactive protein (CRP) levels in depressed patients without concomitant diseases.

Materials and Methods:
Sixty-five depressed patients who were not taking medication participated in this cross-sectional study. The Tenth Revision of the International Classification of Diseases and Related Health Problems (ICD-10) categorization of mental and behavioral disorders served as the basis for the diagnosis of depression. HRV processing and analysis were performed using ADInstrument’s Pro LabChart (PowerLab 8Pro) data analysis software. HRV was recorded for 5 min in an upright sitting position using a lead II electrocardiogram (ECG) (short-term HRV). CRP levels were measured using an ELISA (enzyme-linked immunosorbent assay) test.

Results:
None of the measures of HRV showed a significant relationship with pulse rate, systolic blood pressure, diastolic blood pressure, or body mass index (BMI). Weight and BMI were strongly positively related (r = 0.420, P = 0.003) to pRR50 (percentage of successive RR intervals differing by more than 50 ms). Very low frequency (VLF), low frequency (LF), and the LF/HF (high frequency) ratio were all strongly positively correlated with CRP (r = 0.595, P = 0.001), whereas HF was also significantly negatively correlated (r = 0.383, P = 0.007). CRP had a significant negative correlation with the logarithm (ln) HF and a significant positive correlation with lnVLF, lnLF, and lnLF/HF.

Conclusion:
Measurement of resting HRV and CRP may be helpful in detecting CV disease in depressed patients. Low HRV and elevated serum CRP should prompt physicians to begin treatment for risk CV as soon as possible.
Efficacy of combination therapy with unkeito and boiogito for menopausal arthralgia: A retrospective observational study
Authors: Nogami Tatsuya , Taniguchi Daigo , Miyatake Noriko , Tsuruta Toko , Arai Makoto 
Published: February 2024

ABSTRACT

Context:
Arthralgia affects menopausal patients.

Aim:
Here, we report a retrospective observational study evaluating the therapeutic efficacy of a combination of unkeito and boiogito for menopausal arthralgia.

Settings and Design:
Patients treated with a combination of unkeito and boiogito for menopausal arthralgia between April 2020 and October 2022 at three Japanese Kampo outpatient clinics were retrospectively examined. Treatment effectiveness was determined based on the patient’s description of pain. Adverse events associated with this treatment regimen were also recorded. The study design was approved by the Tokai University Ethics Committee (Approval number: 22R196).

Methods and Material:
This study was conducted by retrospectively analysing the medical records of patients who attended the three medical facilities. All patients received Kampo medicines based on traditional medical diagnoses. Outpatients with a diagnosis of menopausal arthralgia were selected, and information on those who were treated with a combination of unkeito and boiogito was collected.

Statistical Analysis:
The age, height, and weight of all patients are represented as the mean ± standard deviation. Statistical analyses were not performed in this study as there was no comparison group.

Results:
During the study period, nine patients with menopausal arthralgia received the unkeito and boiogito combination. Four patients showed a “significant” response to the combination treatment, four showed an “effective” response, and one patient showed an “ineffective” response. One patient reported headache as an adverse event.

Conclusion:
The combination of unkeito and boiogito may be effective in the treatment of menopausal arthralgia.
Undernutrition and its determinants among under-five children in a tribal community of Meghalaya
Authors: Singh Aabha , Sundaram Shanthosh P. , Ningombam Joenna Devi 
Published: February 2024

ABSTRACT

Background and Objectives:
Malnutrition among under-five children is a rampant and major public health problem in developing countries. The paucity of studies on undernutrition among tribals made it imperative to determine the prevalence and the factors associated with undernutrition among the tribal under-five children.

Materials and Methods:
A community-based cross-sectional analytical study was conducted among 196 under-five children residing in the village under the rural field practice area of North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Meghalaya. Sociodemographic and clinical data were collected using a pretested semi-structured questionnaire, and burden of food insecurity was collected using the Food Insecurity Experience Scale Survey Module (FIES-SM). Anthropometric measurements, such as height, weight, and mid-upper arm circumference, were measured for all the children, and Z-scores were calculated for weight for age, height for age, and weight for height.

Results:
Of the 196 children, the mean age of the children was 36.7 (15.3) months. The prevalence of underweight, stunting, and wasting was 9.2% (95% confidence interval (CI): 5.7%–14.3%), 28.6% (95% CI: 22.5%–35.5%), and 6.1% (95% CI: 3.3%–10.7%), respectively. There was a significant association for girls, birth weight, and age of the mother during first childbirth and immunization status with underweight. Similarly, there was a significant association for girls with wasting and education of the mother and birth weight with stunting.

Conclusion and Recommendations:
The prevalence of underweight wasting and stunting was lesser with an observable enhancement in the nutritional status of the children; however, the undernutrition status is still alarming, which warrants health and nutritional education along with behavioral change communication.
Effect of pranayama on sympatho-vagal imbalance and cognitive deficit in premenstrual syndrome
Authors: Feula A Jothi Marie , Yerrabelli Dhanalakshmi , Pal Gopal Krushna 
Published: February 2024

ABSTRACT

Context:
Premenstrual syndrome (PMS) is a prevalent and often neglected condition that affects around 80% of women of reproductive age. In PMS, abnormal fluctuations in gonadal hormones cause altered homeostasis, resulting in sympatho-vagal imbalance and poor cognition.

Aim:
To compare autonomic function parameters and cognitive performance between PMS and control groups, and to study the effect of pranayama on the above parameters in PMS women.

Settings and Design:
It was a randomized control trial.

Materials and Methods:
We recruited 40 women of reproductive age who fit the inclusion criteria. They were asked to complete the Premenstrual Syndrome Screening Tool (PSST) questionnaire and were categorized as having PMS (n = 20) or not having PMS (n = 20). All study participants had their baseline CAFT, HRV, BRS, P300, and MOCA values recorded. Following that, participants in the PMS group were divided into two groups of ten at random. For 8 weeks, one group received pranayama training. Following that, all baseline data were recorded again in both the pranayama and no-intervention groups.

Statistical Analysis Used:
SPSS version 20 was used to analyze the data. For parametric data, the unpaired t test was used to compare between the PMS and no PMS groups, whereas the Mann–Whitney U test was employed for non-parametric data. To compare the parameters before and after intervention, the Students paired ‘t’ test for parametric data and the Wilcoxan-signed rank test for non-parametric data were used.

Results:
According to the findings, autonomic function and cognition were considerably affected in the PMS group and improved significantly in the PMS group following pranayama intervention.

Conclusion:
Pranayama is an effective and safe non-pharmacological method for treating PMS and improving women’s quality of life.
Effect of vaginal douching with normal saline before insertion of dinoprostone vaginal insert for labor induction
Authors: Verma Manju Lata , Pandey Manjari , Singh Uma , Sachan Rekha , Sankhwar Pushp Lata 
Published: February 2024

ABSTRACT

Objective:
Vaginal pH has been suggested to be one of the causative factors, responsible for variation in prostaglandin efficacy for induction of labour. The purpose of this study was to analyse the effect of vaginal douching with normal saline before insertion of dinoprostone vaginal insert for induction of labour.

Methods:
This randomised controlled study was done in the Department of Obstetrics and Gynaecology for a period of 1 year. Using a computer-generated random number table, subjects were allocated in two groups. In group A (study group), vaginal douching was done with 20 cc of sterile 0.9% NaCl and vaginal pH was again measured with pH paper strips just before inserting dinoprostone pessary. Dinoprostone pessary was inserted without douching in group B (control group).

Results:
There was a significant increase in the vaginal pH after douching with normal saline (4.91 vs 5.52, P < 0.001). Mean intrinsic vaginal pH (pH before inserting dinoprostone insert) in women who delivered vaginally was significantly higher than that of the women who had a caesarean section (5.10 vs 4.63, P < 0.001). Time interval between dinoprostone insertion to active phase of labour, duration of active phase of labour, time interval between dinoprostone insertion, and complete cervical dilatation and mode of delivery were not significantly different between the two groups.

Conclusion:
Although douching with normal saline increases vaginal pH, douching does not help in increasing the chances of vaginal delivery because it gives a transient effect. Rather, it is intrinsic vaginal pH, which is a better decisive factor for successful vaginal delivery.
Impact of lockdown due to COVID-19 pandemic on neurobehavioral profile of children aged 6–12 years (NeuBeC study)
Authors: Pasi Rachna , Ravi Kumar Satish , Babu Thirunavukkarasu Arun , Jamir Limalemla , Aravindakshan Rajeev 
Published: February 2024

ABSTRACT

Background:
The lockdown due to the COVID-19 pandemic has affected the lives of children and resulted in behavioral and emotional disturbances in children. This study was planned to identify the prevalence of these problems in Indian children. The aim of the study was to estimate the effect of lockdown on the neurobehavioral profile of children 6–12 years of age by using the Child Behavior Checklist (CBCL) scale. CBCL is the most widely used validated scientific tool to detect behavioral and emotional problems in children.

Materials and Methods:
All children 6–12 years of age who were fulfilling the inclusion criteria of the study were included from all over India through an online Google form link. The children attending the outpatient department (OPD) at our tertiary-level care medical college were also included in offline mode. Data were collected and entered in an Excel sheet and analyzed statistically.

Results:
A total of 173 children in the age group 6–12 years were enrolled. The mean standard deviation (SD) age of all children was 8.88 (1.84) years, out of which males were of a mean age of 9.2 (1.84) years and females were 8.44 (1.74) years. Total CBCL T-scores (mean (SD)) for internalizing, externalizing, and total scores were 63.07 (7.98), 63.95 (6.51), and 62.39 (4.9), respectively.

Conclusion:
Lockdown has resulted in neurobehavioral changes in normal children. The independent predictors found were the increase in screen-based media use, sleep issues, or behavioral changes like aggression due to restriction of their mobility or confinement. Females exhibited more internalizing problems, and males exhibited more externalizing problems.
Attributes of hypertension among industrial workers in Northern India - An alarming signal
Authors: Goyal Pooja , Goyal Gajinder K. , Yadav Kriti , Bhatt Anshuman , Nassa Khushboo , Raushan Suman K. , Aggarwal Dhairya , Dagar Rakesh 
Published: February 2024

ABSTRACT

Context:
There has been an increasing prevalence of hypertension (HTN) affecting all populations of the world including the special occupational groups and industries workers.

Aims:
To estimate the prevalence of hypertension and to determine the associated factors among industrial workers in the Haryana state of India.

Settings and Design:
A cross-sectional study was conducted among 323 industrial workers of Faridabad, Haryana.

Materials and Methods:
A semi-structured and validated questionnaire was used to collect information regarding sociodemographic characteristics of the workers, their personal habits, and occupational history. The investigator also recorded the height, weight, blood pressure, blood glucose, and lipid profile of the workers.

Statistical Analysis Used:
Analysis of the data was done using SPSS Vs 21.

Results:
The prevalence of hypertension among industrial workers was 48.6%. Age of the worker, presence of smoking or alcohol consumption, having a longer duration of employment, and having deranged total cholesterol/TG/LDL-C levels, diabetes, or obesity were found to be independently associated with hypertension.

Conclusion:
Screening is required for early detection and prevention of complications. Lifestyle modification is of utmost importance. Employers should implement guidelines issued by the government to protect the health of the productive population.
A comparative study of NS1 and IgM using enzyme-linked immunosorbent assay and immunochromatography test for detection of dengue
Authors: Chakraborty Debapriya , Kar Harapriya , Hodiwala Anahita V. Bhesania 
Published: February 2024

ABSTRACT

Background:
Dengue is the most common arboviral infection that spreads by Aedes aegypti and Aedes albopictus mosquitoes, and is quickly gaining prominence as a major mosquito-borne viral disease. One of the major public health issues is dengue fever (DF), which can also cause dengue haemorrhagic fever (DHF) and dengue shock syndrome (DSS). Therefore, this study focused on comparison of dengue antigen non-structural protein (NS1) and immunoglobulin M (IgM) using enzyme-linked immunosorbent assay (ELISA) and immunochromatography test (ICT) for detection of dengue.

Method:
In a Tertiary Care Hospital (TCH), sociodemographic status of probable dengue cases from February 2021 to February 2022 was studied. The results of the Dengue Antigen NS1 and IgM ICT, Dengue NS1 Microlisa, and Dengue IgM Microlisa were compared in order to determine the effective one at managing patients and preventing complications like DHF and DSS.

Results:
In distribution of 100 ICT reactive samples, 50% were NS1 reactive and 50% were IgM reactive. One hundred ICT reactive samples were further processed for IgM antibody capture enzyme-linked immunosorbent assay (MAC-ELISA) for both NS1 and IgM. Sensitivity and specificity of NS1 ICT were 89.3% and 71.4% and that of IgM ICT was 88% and 64.5%. As a result of antigenic cross-reactivity, false positive cases were reported. Platelet count of the patients was correlated with an optical density (OD) value of ELISA for both NS1 and IgM. In the present study, patients having low platelet count showed high OD value.

Conclusion:
In cases of severe thrombocytopenia (platelet count <50000), early diagnosis by screening ICT and confirmation by ELISA (NS1 and IgM) would reduce the complications like DHF and DSS.