bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors affecting the outcome of endoscopic sinus surgery: Our experience in a resource-constraint setting
Authors: Ngamdu Yusuf B , Adamu Auwal , Kirfi Abdullahi M , Edem Kingsley P , Abubakar Adamu , Shirama Yakubu B , Adebola Shofoluwe N , Ahmad Babagana M 
Published: October 2023

Abstract

Background:
Endoscopic sinus surgery (ESS) has recorded an excellent success rate, ranging from 80%–98% in the developed countries. However, the outcome in a resource-constraint setting may not be the same due to several factors associated with the patient, the clinical course, and the management of the disease.

Objective:
The aim of this study was to examine the factors that affect the outcome of ESS in a resource-constraint setting.

Materials and Methods:
Clinical, radiological, surgical, and outcome data of patients who had ESS at a newly established tertiary hospital from January 2018 to June 2022 were reviewed. Patients with complete resolution of symptoms and absence of disease on postoperative endoscopy were considered to have “satisfactory outcome.” Those with either recurrence or residual disease were considered to have “unsatisfactory outcome.” Chi-square and logistic regression analyses were carried out to determine the factors and predictors of outcome.

Results:
Fifty-three patients were evaluated, comprised of 29 (54.7%) males and 24 (45.3%) females. The age of the patients ranged between 11 and 67 years with a median of 33 years. The majority of the patients (67.9%) had satisfactory outcome, but 32.1% had unsatisfactory outcome. The complication rate was 26.4%, although the majority (24.5%) had minor complications. Factors associated with outcome were nasal allergy (P = 0.000), nasal polyps (P = 0.000), and anatomical variation (P = 0.045). However, only nasal allergy (P = 0.046) and nasal polyps (P = 0.004) were significant predictors of unsatisfactory outcome on logistic regression analysis.

Conclusion:
The outcome of ESS is also good in resource-constraint setting. However, a significant unsatisfactory outcome was recorded, factors such as the presence of allergy and nasal polyps may predict the unsatisfactory outcome. Therefore, allergy and nasal polyps should be evaluated thoroughly while preparing patient for ESS.
Knowledge of and attitude toward attention-deficit/ hyperactivity disorder (ADHD) assessed among primary schoolteachers of Makkah City in Saudi Arabia
Authors: Alshareef Hadeel H. , Elzahrany Suha R. , Alharthi Reem Abdullah , Alsulmai Amal A. , Aljabri Shuaa G. , Alamri Ghadeer E. , Alharbi Ibrahim , Alkhotani Amal M. 
Published: October 2023

ABSTRACT

Background:
One of the most prevalent pediatric medical conditions is attention-deficit/hyperactivity disorder (ADHD). It is characterized by symptoms of hyperactivity, impulsivity, and/or inattention. The first people to notice a child’s ADHD symptoms are typically their teachers, who may then offer data that are typically helpful in its diagnosis. The purpose of this study was to assess teachers’ knowledge of ADHD, its causes and etiology, as well as the key demographic factors that influence said knowledge.

Method:
The study was conducted among schoolteachers of primary schools located in different regions of Makkah City, Kingdom of Saudi Arabia. We used a stratified random sampling technique to collect our sample, with the inclusion criteria being teachers who were working in a primary school and who were directly involved in teaching students. Data analysis was performed using the IBM SPSS Statistics software version 21.

Results:
We received 335 responses to our questionnaire. The age of the participants ranged from 18 to 59 years, with the mean age being 40.2 ± 13.8 years. About 66.9% of teachers were women. Most of the teachers in this sample had a bachelor’s degree (73.4%), and only 21.8% had diplomas. Regarding the years of teaching experience, 34.6% had teaching experience exceeding 20 years, whereas 20.6% had less than five years of teaching experience. Regarding general knowledge of the teachers, (5.4%) of the teachers had a good level of knowledge. Only 63.6% of teachers were aware that ADHD students frequently struggled with task and activity organization, and only 7.5% of teachers had good knowledge of ADHD treatment, compared to 40.9% who had a good awareness of symptoms and diagnosis. Only the teachers’ education level was significantly associated with their knowledge level of ADHD: 25% of teachers with a postgraduate degree had an overall good level of knowledge versus 2.7% of those with a diploma (P = 0.006)

Conclusion:
The findings of this study lead to the conclusion that elementary school instructors have an inadequate understanding of ADHD. Some teachers misunderstand the signs and general facts associated with ADHD, thereby indicating the need for further training in this area.
Demographic and clinical characteristics of primary lung cancer patients in Kerala: Analysis of data from six teaching centers
Authors: Jose Nisha K. , Soman Biju , Thulaseedharan Jissa V. , Varghese Bipin T. , Thomas Shaji , Tom Jeremiah J. , Warrier Narayanankutty , Avaronnan Manuprasad , Jeemon Panniyammakal 
Published: October 2023

Background:
Lung cancer continues to be the leading cause of cancer-related deaths in men and women. A breakdown by level of economic development shows no differences in cancer deaths in men but a higher rate of lung cancer deaths in women in industrialized countries as compared with developing nations. The risk factors for lung cancer most commonly include lifestyle, environmental, and occupational exposures. The role these factors play varies depending on geographic location, sex and race characteristics, genetic predisposition, as well as their synergistic interactions.

Materials and Methods:
It was a hospital-based registry, wherein hospitals were selected from three zones—north, central, and south zones of Kerala. The study was registered with clinical trial registry of India with Registration No. CTRI/2021/02/031299. Registry of lung cancer patients was prepared at all sites and institutional ethical clearance was received from all sites. All patients with primary lung cancer, histologically proven of all age groups were included in the study.

Results:
A total of 761 patients were registered from six teaching hospitals in Kerala who were diagnosed with primary lung cancer during the period 2017–2019. The mean age of the study population was 65.1 ± 10.2 years. Of all, 81.1% of them were males and 18.9% were females. Histologically, 56.4% had adenocarcinoma and 25.6% had squamous cell carcinoma.

Conclusion:
It was observed that the proportion of females diagnosed with primary lung cancer is increasing. Patients get diagnosed at a later stage of the disease, which calls for screening and early detection of lung cancer. As it accounts for the highest mortality among all other cancers, there is high scope for prevention and screening strategies.
A study to compare the performance of anganwadi workers in owned and rented anganwadi centers in a district of the western part of India
Authors: Somani Abhishek , Shah Sonal , Patel Maharshi , Parmar Piyushkumar C. 
Published: October 2023

ABSTRACT

Introduction:
The Integrated Child Development Services (ICDS) scheme is one of the flagship programs, and under this, various activities like non-formal education on one hand and breaking the vicious cycle of malnutrition, morbidity, and mortality on the other hand are carried out by anganwadi worker (AWW). The aim of this study is to assess the AWWs performance and beneficiary participation in respect to the ICDS scheme.

Methodology:
This is a community-based, cross-sectional study done in two stages using a simple random sampling technique. Ahmedabad Municipal Corporation (AMC) area is divided into 10 parts called ghatak, and out of these 10 ghataks, 6 were chosen in the first stage, and in the second stage, 12 anganwadi centers were selected from these 6 selected ghataks using simple random sampling.

Result:
In this study, 58.3% of anganwadi workers were graduates. While talking about work related to “Home Visit” and “Immunization Sessions,” there was no statistically significant difference between owned and rented anganwadi center noted. While in “Nutrition & health education”-related work, there was a statistically significant difference between owned and rented anganwadi centers observed. Accuracy of weighing, plotting, and interpretation skill was more than 90% found in both the rented and owned anganwadi center. An almost similar level of nutritional status was observed in both owned and rented centers.

Conclusion:
In terms of performance and participation, there was not much difference between corporation own and rented anganwadi centers, although there were shared concerns related to frequent changes of place of rented anganwadi centers affecting the participation of beneficiaries.
Facility assessment of the best functioning facility providing emergency obstetric care in the selected blocks of Varanasi, Uttar Pradesh
Authors: Singh Arun K. , Kumari Kalpana , Pandey Pallavi 
Published: October 2023

ABSTRACT

Background:
UP has the 2nd highest MMR which is 197 compared with national average of 113 (RGI-SRS-2016-2018).Although institutional deliveries in India has been increased from 78.9% (NFHS-4) to 89% (NFHS-5) [ UP from 67.8% to 83.4%] but still we are far away from SDG -3 target. It reflects that there may be increase in crude coverage but not in effective coverage.

Materials and Methods:
It is a cross sectional study conducted in May – June 2017. Out of 8 blocks of rural Varanasi, 4 blocks were selected randomly. Best functioning facility for EmOC services in each selected block were assessed using Facility Gap Assessment Schedule of IPHS.

Result:
None of the facility met the recommended standard for BEmOC .Tracking of drop out of ANC and PNC services, use of Partograph, treatment of abortion-related complications, were not found at all the 4 facility. Blood grouping and RH typing was also not functional at 2 of the 4 centers. Caesarean section and availability of blood bank were also lacking in CHC (FRU).

Conclusion:
If condition of best functioning facility in a block is not according to the recommendation then how can we expect to provide a good maternal health service to public.
Clinico-epidemiological profile of non-survivors of COVID-19 during the last two waves in a tertiary care hospital of North India: A retrospective descriptive study
Authors: Husaini Syed H. M. , Waseem Shah M. A. , Siddiqui Zia , Ali Wasif M. , Nasreen Farah , Athar Manazir , Ahmad Manzoor , Khan Haris M. 
Published: October 2023

Background:
SARS-CoV-causing COVID-19 resulted in mortality, and the clinic-epidemiological profile at the time of admission of patients who died later could provide an insight into pathophysiological consequences due to infection.

Method:
Retrospective observational study of 64 RTPCR-confirmed COVID-19 non-survivors was conducted from April - June 2021 and January February 2022. Data were analyzed, and a P value<0.05 was taken as significant.

Results:
60.94% and 39.06 % were males and females, and 26.57% & 73.43 % of patients had moderate and severe disease, respectively. Fever, cough, and dyspnea were the most common presenting symptoms. 78.12% and 21.88% had pre-existing (diabetes and hypertension were most common) and no co-morbidities, respectively. 65.62 & 17.19 % of patients had bilateral and unilateral ground glass opacities, respectively. Thrombocytopenia, lymphopenia, neutrophilia, elevated monocytes, and neutrophil-lymphocyte ratio (NLR) of 7.52 were hematological findings. D dimer was elevated. ABG showed low PaO2 and SPO2 %. ALT and AST were elevated. Tachycardia was also present. Compared to the first wave, no significant association of gender with severity was found. However, the percentage of male patients was higher. The association of the duration of stay and co-morbidity with disease severity was significant in both the first and subsequent waves of COVID-19.

Conclusion:
Co-morbidity, disease severity, and radiological lung opacities play a role in the outcome of COVID-19. The associated findings are hematological, renal, liver, cardiovascular, and arterial blood gas derangements.
An observational analysis of profile and outcome of children with malnutrition admitted at malnutrition treatment centre
Authors: Gupta Ajay , Grover Somya , Kumar Abhishek , Kumawat Pragya , Meena Sadhana 
Published: October 2023

ABSTRACT

Introduction:
Nutritional status is an important health indicator and children bear maximum burden of it. Poor nutrition during first thousand days of a child’s life can lead to stunted growth. Comorbid condition adversely affects treatment outcome of malnutrition. This study is aimed to describe the profile and treatment outcome of malnourished children.

Materials and Methods:
This record-based retrospective, analytical observational study was conducted from October to December 2020. Data of severe acute malnourished children who were admitted in malnutrition treatment centre during August 2017 to September 2020, collected. Totally, 264 eligible children were enrolled in the study. The data were collected through medical records of patients. Data were entered in excel spreadsheet and analysed.

Results:
Most of the children belonged to 6-24 months of age, almost equal proportion of male and female, and more than three-fourth of children were from rural area. The mean length of stay in hospital was 15.19 ± 6.64 days and average weight gain of children was 7.6 ± 6.7 gm/kg/day. There was significant increase in Z-score (Weight/Height) and MUAC at the time of discharge (P value <0.05). There was no significant association of treatment outcome with the presence of comorbidities (P value >0.05).

Conclusion:
Most vulnerable age group for malnutrition was 6 months to 2 years. Majority of children with malnutrition improve with standard treatment protocol of malnutrition. We can improve the ability of community health workers to significantly reduce child malnutrition at the primary care level and in the community by equipping them with the required knowledge, tools, and assistance.
Demographic predictors of central sensitization in patients of knee osteoarthritis
Authors: Jain Shweta , Anand Vijender , Gupta Ajay , Khorwal Bhawna 
Published: October 2023

Context:
Evidence suggests that central sensitization (CS) may contribute to pain in osteoarthritis (OA) knee patients, which cannot be treated by locally directed treatment strategies.

Aims:
The aim of this study was to examine differences in demographic profile of patients with and without central sensitization in osteoarthritis knee.

Settings and Design:
Observational cross-sectional study at tertiary care hospital.

Materials and Methods:
The study was conducted in the Department of Physical Medicine and Rehabilitation, VMMC and Safdarjung Hospital in 345 OA knee patients. Demographic profiles including age, gender, education, occupations, type of family, marital and socioeconomic status and central sensitization were assessed. The association between CS and various demographic parameters was investigated.

Statistical Analysis Used:
Statistical Package for Social Sciences (SPSS) software, IBM manufacturer, Chicago, USA, version 21.0. For statistical significance, P value of less than 0.05 was considered statistically significant.

Results:
Ninety out of 345 (26%) of study subjects had CS; out of which 96% were females. Younger homemaker and those with unskilled/semiskilled type of job had higher chances of having CS in comparison with those with skilled and professional job (P < .001).

Conclusions:
Elicitation of specific demographic factors that can predict CS in people with knee OA may help in early identification and management of CS in OA knee patients.
Seroprevalence with epidemiological determinants of hepatitis C virus and Treponema pallidum infection in blood donors of a teaching hospital in southwest Punjab, India: A 5-year study
Authors: Bansal Nidhi , Gupta Anshul , Sidhu Tanvir K. , Maharishi Ram Niwas , Gupta Saurabh , Roychoudhury Arnav K. 
Published: October 2023

ABSTRACT

Background:
A high seroprevalence of various transfusion-transmitted infections (TTIs) in donated blood is the main safety concern, especially in low- and middle-income countries. As per the World Health Organization (WHO) recommendation, all blood donations must be tested for human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), Treponema pallidum infection, and malaria, which mainly comprises the major bulk of TTIs.

Aims:
The purpose of this study is to observe the seroprevalence of hepatitis C virus and Treponema pallidum infection over the period of 5 years in blood donors of our blood center along with their epidemiological determinants with respect to age, sex, residence, occupation, and type of donors

Materials and Methods:
Retrospective study was conducted for the period of 5 years, from 1st January 2017 to December 2021, estimating the seroprevalence of hepatitis C and Treponema pallidum infection in the blood donors along with their epidemiological determinants

Results:
Out of 19,689 donations in 5 years, 690 (3.50%) units were positive for transfusion-transmissible infections with 1.67% donors seropositive for HCV, 1.23% for Treponema pallidum infection, 0.42% for HBV, and 0.18% for HIV. The prevalence of TTIs was found to be highest in 2020 (4.52%) and least in 2017 (2.57%). Out of a total of 330 HCV cases detected in 5 years, 84.85% of cases were seen in voluntary donors. Rural donors constituted 71.21% of cases. The majority of cases were seen in the age group of 18–30 years, i.e., 61.82%, and a maximum number of cases were seen in the farmers (31.21%), followed by laborers and construction workers (21.21%). Out of a total of 242 cases of Treponema pallidum infection, 84.29% were seen in voluntary blood donors. Demographic data showed 70.24% of cases in rural donors. Occupational data revealed a maximum number of cases in farmers (34.29%), followed by laborers (21.90%).

Conclusion:
Higher seroprevalence of HCV and Treponema pallidum infection in our region as compared with other areas is a matter of great concern about the growing infection rate of these in our area. Stringent use of donor selection criteria and more vigorous donor screening is utmost need of the hour for reducing the burden of TTIs in blood transfusion services.
Persistent symptoms and functional health status among Covid-19 patients after discharge from a Covid hospital
Authors: Kulkarni Meenal V. , Nayse Vedant J. , Bansod Chetan M. 
Published: October 2023

Background:
After recovery from acute Covid infection, many patients are found to be experiencing persistent symptoms.

Objectives:
To find out the proportion of patients with persistent symptoms after discharge from a Covid hospital and to assess post-Covid-19 functional status.

Materials and Methods:
A descriptive cross-sectional study was conducted among patients discharged from a Covid hospital. Records of patients were obtained from the medical records department. Data were collected by using a prevalidated close-ended questionnaire. The questionnaire consisted of information regarding the socio-demographic status, history of persistent symptoms, and functional status of patients. Patients were contacted and interviewed telephonically. History regarding common persistent symptoms and functional status was asked. Statistical analysis was done by using Epi info statistical software.

Results:
Out of 133 patients, persistent symptoms after discharge were reported among 92 (69%) patients. The common symptoms reported by the patients were fatigue (48.12%), weakness (42.10%), dyspnea (27.82%), and myalgia (12%). Loss of taste was reported by 10 (7.5%) and loss of appetite by 8 (6.01%). Seventy-four (55.63%) patients reported functional limitations.

Conclusions:
The proportion of persistent symptoms among Covid-19 patients after discharge was found to be high. More than half of the patients reported functional limitations. Patients should be screened for persistent symptoms and health care services should be provided.
Awareness of risk factors, symptoms and screening of breast cancer: A cross-sectional survey among 35–65-year-old women in Alappuzha district, Kerala, India
Authors: Mohan Reshmy , Thulaseedharan Jissa Vinoda 
Published: October 2023

Background:
Breast cancer awareness is vital to enhance early detection and treatment, thus improving women’s quality of life and reducing the breast cancer burden in a country. This paper describes breast cancer awareness among women in the Alappuzha district, Kerala.

Methods:
A community-based cross-sectional survey was conducted among 320 women aged 35–65 using a multi-stage cluster-sampling method. The data were collected using a structured interview schedule and analysed using IBM SPSS Statistics-25. The Chi-square test was used to test associations, and binary logistic regression was used to estimate odds ratios and 95% confidence intervals.

Results:
The most reported risk factor and symptoms were unhealthy food habits (29.6%) and breast lumps (91.7%), respectively. Nearly half of the women spoke about at least one risk factor (53.8%), and 39.8% mentioned at least two symptoms of breast cancer. Awareness of breast self-examination and mammography were 85.7% and 39.5%, respectively. Compared to women with a primary level of education, women with a higher secondary or above level of education were more likely to report at least one risk factor (AOR = 8.96; 95%CI: 3.44-23.36), more than two symptoms (AOR = 4.73; 95%CI: 1.82-12.27) and mammogram as a screening method (AOR = 61.1; 95%CI: 6.56-394.63). Women detected with breast cancer (n = 6) were excluded from the analysis.

Conclusion:
Women are unaware of most of the risk factors and symptoms of breast cancer, and breast cancer awareness are highly associated with women’s education. Breast cancer awareness creation is essential to improve the early detection of breast cancer among women, especially in the low socioeconomic strata.
Impact of school start time and sleep pattern of adolescents on their mood and sleep quality
Authors: Singh Ruchi , Roy Moutrisha M. , Chouhan Sunil , Joshi Ankur , Rai Nirendra K. 
Published: October 2023

Objective:
The physiological delay in bedtime among adolescents, compounded with the early start of school, results in insufficient sleep, especially on school days. The present study compared the sleep pattern and moods of students attending two schools with different start timing.

Materials and Methods:
The study involved adolescents from two schools with different start times: School A (7 am) and School B (8 am). Pittsburgh Sleep Quality Index, Depression Anxiety Stress Scales-21, and Pediatric Daytime Sleepiness Scale questionnaires were used to assess students’ mood, sleep duration, sleep quality, and daytime sleepiness. The clinical trial registry number is CTRI/2022/06/043556.

Result:
A total of 640 students (mean age 13.7 ± 2.0 years; 47.5% male) participated in this study. Students from School B had longer sleep duration, with 72.9% reporting sleep deprivation compared to 87.1% of School A (P = 0.00001). School A students reported having (P ≤ 0.001) higher daytime sleepiness, higher daytime dysfunction (P = 0.023), and poorer sleep quality. Students at School A scored higher for all mood derangements, with significantly higher scores for depression (P = 0.041).

Conclusion:
The study illustrates that though not much differences are observed in the bedtime of adolescents of the two schools, however, due to the early school start time of School A, students have to compulsorily wake up early, leading to higher sleep deprivation and greater mood derangements among them.