bluuebunny/crossref_metadata_2025_split huggingface dataset:
Short- to intermediate-term surgical outcome of Keiki Mehta valve implantation in refractory glaucoma
Authors: Mitra Ankita , Bhadra Tania Ray 
Published: December 2023

Background:
Keiki Mehta body pressure (BP) valve is a glaucoma drainage device that works on the simple mechanism of body pressure.

Purpose:
To evaluate the short- to intermediate-term efficacy and safety of Keiki Mehta valve implantation in treating refractory glaucoma.

Methods:
This was a prospective, interventional, institution-based study. Adult patients (age >18 years) having refractory glaucoma who underwent Keiki Mehta valve implantation from May 2019 to December 2019 in a tertiary hospital in eastern India were followed up to 18 months.

Results:
Twenty patients (20 eyes) with refractory glaucoma who underwent Keiki Mehta valve implantation were followed up on postoperative day 1 and at 1, 3, 6, 12, and 18 months postoperatively. Visual acuity, intraocular pressure (IOP), antiglaucoma medications, and success rate were measured at every visit. There was significant reduction in mean IOP from the preoperative values at every postoperative follow-up (P < 0.05). Kaplan–Meier survival analysis demonstrated a probability of 50% complete success and 20% qualified success at 18 months. Hypotony was the most common postoperative complication.

Conclusion:
Keiki Mehta valve implantation is an effective and safe treatment for refractory glaucoma.
Utilizing peripheral blood inflammatory biomarker (PBIB) to predict response to systemic therapy in patients with breast cancer
Authors: Abusanad Atlal 
Published: December 2023

Background:
Inflammation is a recognized factor in cancer progression and resistance to treatments. Several studies correlated inflammation-related peripheral blood inflammatory biomarkers (PBIB) to disease progression and poor survival in various cancer types and different populations. Nonetheless, inflammation is affected by the distinctive characteristics and environmental exposure of each population. There is no prior study addressing the association of pre-treatment inflammatory markers with outcomes in patients with breast cancer (BC) from Saudi Arabia. In this study, we evaluated the prognosis of locally advanced breast cancer (LABC) in relation to several PBIB.

Materials and Methods:
We retrospectively analyzed the data of female patients with LABC undergoing neoadjuvant chemotherapy (NACT). Demographics, body mass index (BMI), clinicopathologic characteristics and stage of the tumor, follow-up status, and response to treatment were collected. Outcomes were evaluated in relation to pre-treatment peripheral blood indices that were grouped based on the local laboratory cutoff values. Objective response rate (ORR) was predefined and assessed according to the post-NACT magnetic resonance imaging (MRI) breast and subcategorized into complete response (CR), partial response (PR), stable disease (SD), and progressive disease (PD).

Results:
A total of 172 female patients with BC met the eligibility criteria from January 2014 to December 2019. The mean age at diagnosis was 53.4 ± 11, and BMI was 31.2 ± 6. Left BC accounted for 54.7%, and the majority was invasive ductal carcinoma (85.5%), moderately differentiated (51%), stage III (AJCC 8th edition) (73%), and estrogen receptor (ER)-positive tumor (79.1%). Human epidermal growth factor receptor 2 (HER2)-positive BC was reported in 32% and triple-negative breast cancer (TNBC) in 10%. Radiologic CR accounted for the majority of ORR (71.5%). Higher percentage of patients with normal red cell distribution width (RDW) of red blood cell (RBC) and low neutrophil–lymphocyte ratio (NLR) had CR with a significant P value of 0.003 and 0.014, respectively.

Conclusion:
Among several peripheral blood indices, RDW and NLR significantly influenced ORR. They can be explored further to potentially predict response after systemic therapy in patients with LABC. The great advantage of these biomarkers stems from their availability and affordability in routine clinical practice.
Clinical study to determine the predictability of significant rebound hyperbilirubinemia in neonates after phototherapy and conditions likely to be associated with it: Prospective observational study in a teaching hospital in Eastern India
Authors: Belide Shivakumar , Uddin Md Waseem , Kumar Sushil , Sethi Rajesh Kumar , Diwakar Kumar , Jhajra Sandeep 
Published: December 2023

Aim:
Neonatal hyperbilirubinemia is defined as yellowish discoloration of the skin, conjunctive, and sclera from the elevated serum or plasma bilirubin in the newborn. The standard of care for the management of neonatal hyperbilirubinemia is phototherapy to prevent long-term neurological sequelae. The aim of this study was to ascertain the predictability of significant rebound hyperbilirubinemia (SRH) in neonates after phototherapy and the factors associated with it.

Materials and Methods:
Neonates ≥ 35 weeks of gestation, who received treatment for hyperbilirubinemia and admitted in our hospital from 15th of March 2019 to 15th of September 2020 were enrolled after taking parental consent. SRH was defined as bilirubin levels crossing the treatment threshold within 72 hours of phototherapy termination. Logistic regression analysis was used to identify the predictability of SRH.

Results:
Out of 400 neonates treated with phototherapy, 10% developed SRH. Prematurity (Gestational age < 37 weeks), low birth weight (Birth weight < 2000 gram), ABO and Rh incompatibility, Glucose-6-phophate dehydrogenase deficiency (G6PD) deficiency, sepsis, and longer duration of primary phototherapy were found to be significantly associated with rebound hyperbilirubinemia. The probability of SRH increases for all American Academy of Paediatrics (AAP) risk categories as the gestational age decreases and total serum bilirubin at the stoppage of phototherapy increases.

Conclusions:
The presence of risk factors should be taken into account while planning discharge and follow-up of neonates admitted for neonatal hyperbilirubinemia to prevent long-term complication of bilirubin neurotoxicity.
A Study on Community needs, perceptions and demand regarding the use of the health services during COVID-19 pandemic in district Kathua, J and K
Authors: Sangra Sonika , Razdan Nazuk , Gupta Sujata , Dwivedi Nidhi 
Published: December 2023

Introduction:
The impact of the COVID-19 pandemic on essential health services is a source of great concern. Health gains made during the last 2-3 decades have been halted due to shifting of resources to fight the COVID-19 pandemic.

Aim and Objective:
This study was conducted to identify community needs, demands, and perceptions regarding the effectiveness of using health services during the pandemic.

Methodology:
This was a qualitative study which was conducted through focus group discussions. The participants comprised of three groups: community leaders, healthcare providers, and field workers. Discussion among the participants was conducted using the standardized World Health Organization community assessment tool.

Result:
In our study, it was reported that most of the essential health services were disrupted due to COVID-19 pandemic. The barriers to accessing essential health services have been exacerbated and the provision of community-based services is effected due to this. In regard to COVID-19 vaccination also, there remain individuals who are reluctant to be vaccinated.

Conclusion:
Our study shows that the community faced barriers in accessing and using health services during the pandemic. To ensure the public's access to health services and strengthen healthcare preparedness strategies like health budget allocation, manpower, infrastructure, trainings, integration with primary healthcare, etc., need to be carried out during and after the pandemic. Thus, participation and inter-sectoral coordination across levels are required to overcome these barriers.
Sleep hygiene a neglected paediatric identity – A cross-sectional study
Authors: Maniraj Pradeep , Jegadeesan Podhini , Ananthakrishnan Shanthi 
Published: December 2023

Background:
Sleep is the physiological need of any human being; its role in paediatric mental and physical development is irreplaceable. However, in recent days, the rising trend of childhood obesity makes it essential to assess the sleep hygiene of the children to know if there is any adjacent association.

Objectives:
1. To estimate the prevalence of poor sleep quality using Sleep Hygiene Index Scoring. 2. To determine the association of sleep quality with academic performance and body mass index among the school children.

Materials and Methods:
The present cross-sectional study was conducted among 322 children aged between 7 and 12 years attending paediatric OPD of a private tertiary care hospital, Puducherry. Using Sleep Hygeine Index scoring with the cut off 16, prevalence of poor sleep quality was assessed and its association with BMI and academic performance was determined. Frequency, proportion, and Chi-square test were used for analysis; P value < 0.05 was considered statistically significant.

Results:
The mean age of the participants was 8.8 ± 2 years, and most of them were boys. Around 53% of the children had poor quality of sleep, and there was a positive association between poor sleep quality with obesity (P value: 0.0003) and unfavourable academic performance (P value: 0.00001).

Conclusion:
Sleep hygiene importance should be taught to the parents and periodical assessment helps in predicting the neglected reason for obesity and poor academic performance, which could be managed easily with small lifestyle changes.
View Score: An early warning score to detect possible complications among COVID-19 patients
Authors: Bhakare Meenakshi , Nikalje Rajkumar , Patil Reshma , Shukla Urvi , Bokade Rupesh , Sakhare Gajanan , Joshi Shardul , Pais Aditi 
Published: December 2023

Introduction:
Understanding pulmonary function at various phases after coronavirus disease 2019 (COVID-19) infection is critical for determining the exact pathophysiological mechanism of COVID-19.

Research Question:
What is the correlation between spirometry indices and clinical indicators in COVID-19 patients over a 6-week follow-up?

Objectives:
1) To assess deterioration or improvement in spirometry parameters including forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and ratio FEV1/FVC in COVID-19 patients. 2) To study the correlation between FVC, FEV1, and FEV1/FVC with oxygen saturation and clinical findings.

Materials and Methods:
A prospective observational study was conducted for a 6-week period among 25, COVID-19 patients who were either asymptomatic or mildly symptomatic. Each patient received a home-use-connected spirometer—SpiroPRO®, a pulse oximeter, and a thermometer from Briota Technologies Pvt Ltd. (BRIOTA). Patients and healthcare professionals were given training for performing spirometry twice a day as well as access to mobile apps was provided. Spirometry indices, patient symptoms, and vital statistics were used to calculate the VIEW™ score using machine learning algorithms.

Result:
The Bland–Altman plots showed that FEV1 reduced slightly up to 21–28 days and comes back to normal around 42 days. VIEW™ score increased up to day 21 and then decreased toward day 42. An increase in VIEW™ score increases the risk of COVID-19 complications. VIEW™ score and FEV1 showed a significant correlation.

Conclusion:
Home-based spirometry acts as an effective tool for COVID-19 patients to predict lung complications and also promote self-monitoring thereby reducing the burden on the health system.
Comprehensive, continuous, and compulsory monitoring of frailty in elderly
Authors: Deore Hiranya S. , Taranikanti Madhuri , Gaur Archana , Varatharajan Sakthivadivel , John Nitin A. , Katta Roja , Taranikanti Sai Shriya , Umesh Madhusudhan , Ganji Vidya , Medala Kalpana 
Published: December 2023

Background:
The increasing elderly population makes frailty an increasing concern in society with vulnerability to stress and functional decline. Unrecognised comorbidities are common among the elderly due to lack of mention by the patients. Physicians should be equipped with effective interviewing skills along with the use of screening tools to assess any impairments in activities of daily living, cognition and signs of depression.

Objectives:
To measure the degree of independence or dependence using scales and stratify patients based on Clinical Frailty Scale (CFS) so as to recommend it as a routinely usable tool.

Materials and Methods:
In total, 191 elderly subjects above the age of 65 years were recruited for geriatric assessment. Tools that assess performance in daily living activities and cognition were used. The prevalidated CFS was used to score frailty to stratify patients into frail and non-frail groups, and the parameters were compared.

Results:
Mean age of the study population was 69.54 years with 53.4% males and 46.6% females. Mean Katz index and mean Lawton score were >5. The mean Global Deterioration Scale (GDS) score was 1.5, and the mean clinical frailty score was 3.55. Significantly high number of male individuals were found in the frailty group. Hypertension was significantly higher in the frail group. The mean Katz scores were significantly lower, and mean GDS scores were significantly higher in the frailty group. Multivariable logistic regression has shown gender to be an important determinant of frailty with an odds ratio of 0.05 (CI-0.01-0.20). The higher Lawton score and GDS scores were significantly associated with frailty with an odds ratio of 0.33 (CI: 0.21–0.52) and 2.62 (CI: 1.14–6.02), respectively.

Conclusion:
Men are more frail than women and co-morbidities like hypertension and coronary artery disease contribute to frailty with cognitive decline and decreased autonomy. A comprehensive assessment to identify frailty will provide a holistic view of well being among the elderly.
“Paediatricians brace thyself” – Healthcare provider perspectives on childhood and adolescent hypertension: A qualitative study
Authors: Pusdekar Yamini Autkar , Dixit Jagannath V. , Dani Akanksha P. 
Published: December 2023

Context:
Paediatric and adolescent hypertension is becoming a public health concern as it contributes to the development of cardiovascular diseases. However, the problem largely remains undiagnosed. This makes early detection and institution of appropriate preventive measures difficult. The existing diagnostic guidelines and management policies for paediatric hypertension are complex. They have individual specific cut-offs (based on age, gender and height), making their interpretation difficult.

Aims:
The present study aims to gain insights into paediatrician's perspectives on childhood hypertension.

Settings and Design:
Qualitative Studies using Key Informant Interviews (KIIs) were conducted with paediatricians to know about their perspectives on blood pressure assessment in children and adolescents, its barriers, their experience, practices and expectations for main streaming hypertensive screening in national health programmes. The interviews were audio recorded after taking their consent.

Statistical Analysis Used:
Grounded theory was used to analyse transcripts.

Results:
A total of 40 providers within the public and private health sector were invited to participate; 36 consented and completed the interviews. There was a perception of increased prevalence of paediatric hypertension. Several system, provider and patient-level barriers, like unavailability of paediatric-sized cuffs, and complicated guidelines for interpreting blood pressure, prevented screening and accurate diagnosis.

Conclusions:
Despite the lack of guidelines for screening, paediatricians still recommended lifestyle interventions. They expressed concerns about implementing standard guidelines for screening. They also expressed the need for a clinical assessment tool to assist in accurate diagnosis. They were willing to contribute to the development and implementation of training programme for health providers to overcome barriers to blood pressure measurement in children.
Vocational skill training programs for persons with intellectual disability (PID) and trainers' perspective during and post vocational skill training
Authors: Venkatesh Kundurthi , Reddy Shanivaram K , Angothu Hareesh 
Published: December 2023

Background:
Employment is one of the primary goals of persons with intellectual disabilities (PID). Employment can lead to positive psychosocial and economic benefits for people with ID, but people with disabilities are not afforded this opportunity to contribute to society through work due to multiple challenges, as well as the transition from vocational skill training to getting employed for PID is more challenging.

Materials and Methods:
Seven vocational skill trainers were chosen from the seven vocational skill training centres offering skill training for PID and located in urban Bengaluru were selected using a purposive sampling design for this study. The trainers were interviewed to understand their perspectives on challenges during and post vocational training for PID.

Results:
Training offered to PID in several vocational centres ranged from unskilled to semi-skilled. A range of barriers including gaps in awareness and knowledge of the various training programs for PID challenges associated with their transition after training, unique challenges in placing the trained PID into external organizations, stigma, and attitudinal barriers associated with disability are described to be influencing the skill training of PID and their subsequent employment.

Conclusion:
Skill training offered for PID across the centres with significant challenges while providing the training and supporting their transition into the community for employment. The challenges of the PID need to be studied at a broader level through including all the stakeholders.
Frailty assessment: An emerging concept in aged People Living with HIV (PLHIV)
Authors: Mehta Adhya , Halder Sohini , Pandit Sanjay , Anuradha Subramanian 
Published: December 2023

Introduction:
As the life expectancy of People Living with HIV (PLHIV) has improved with effective antiretroviral treatment (ART), they now face the challenges of accelerated ageing. Frailty is an emerging concept in the management of PLHIV and up to 28% of PLHIV are identified as frail. Frailty is a determinant of adverse clinical outcomes and is a complex clinical endpoint that has not been studied in India. This exploratory study was done to evaluate frailty and its determinants among PLHIV in India.

Materials and Methods:
This was a cross-sectional study in 76 PLHIV aged 50 years or more. All the study subjects underwent a comprehensive clinical assessment. The Fried's criteria and Veterans Aging Cohort Study (VACS) Index were used to evaluate for frailty. Socio-demographic, clinical, immunological, and virological variables were assessed for their association with frailty. The study was registered under Clinical Trials Registry-India (ICMR-NIMS): REF/2019/05/025616.

Results:
The mean age of the subjects was 56.05 ± 5.8 years (range 50-76), and males constituted 81.57% (62/76) of the subjects and majority (60.53%) were underweight. On frailty assessment, 57.89% of the PLHIV were identified as prefrail/frail. Frailty had a significant association with low CD4 count (P = 0.0001) and number of comorbidities (P = 0.017) especially when comorbidities ≥2 (P = 0.04) and polypharmacy (P = 0.033). VACS index, polypharmacy, and low CD4 count ≤200 cells/mm3 were strong predictors of frailty. On multivariate regression analysis, CD4 count ≤200 emerged as the strongest independent predictor of frailty.

Conclusion:
The study highlighted the high prevalence of frailty and under nutrition among aged PLHIV. The study emphasizes the need for a shift away from traditional clinical endpoints to other outcome measures for a holistic approach to PLHIV.
Factors influencing the quality of life of GERD patients in the Aseer Region, Saudi Arabia
Authors: Alzahrani Mohammed A. , Alamri Faisal S. , Alshahrani Hatem M. , Alshahrani Ali M. , Mohammed Ali M. , Saif Rayan A. , Alqarni Saeed A. , Godhaif Naif A. , Al Mudawi Abdulrahman Abdullah M 
Published: December 2023

Gastroesophageal reflux disease (GERD) is a common upper gastrointestinal disorder characterized by troublesome symptoms, including heartburn and acid regurgitation. GERD is associated with complications such as peptic stricture, Barrett's esophagus, and esophageal adenocarcinoma, and it negatively affects quality of life (QoL).

Aims:
To assess the factors influencing the QoL of GERD patients in the Aseer region of Saudi Arabia.

Settings and Design:
This descriptive cross-sectional study used self-administered questionnaires in a study population of patients aged ≥18 years from Aseer, Saudi Arabia, between January 15, 2023–February 15, 2023.

Materials and Methods:
A previously validated GERD health-related QoL (GERD-HRQoL) questionnaire was used to assess the patients' sociodemographic data, GERD, and GERD-HRQoL.

Statistical Analysis Used:
Descriptive analysis included describing the frequency distribution and percentage for study variables, including demographic data, GERD-related QoL symptoms, and QoL, which were graphed. Cross-tabulation presented the distribution of GERD-HRQoL scores by their personal data and other factors using the Pearson Chi-square and exact probability tests.

Results:
Overall, 502 participants previously diagnosed with GERD completed the questionnaire. Participants' were aged 18–65 years (mean age of 31.5 ± 14.6 years), and 384 (76.5%) were male. The most frequent symptom affecting QoL was heartburn (85.9%), followed by postprandial heartburn (84.3%), heartburn while lying down (82.7%), bloating or gassy feelings (79.9%), and heartburn while standing up (77.3%).

Conclusions:
Our study showed that patients with GERD had a poor QoL due to GERD-related symptoms, mainly heartburn. Younger age, male sex, and lower educational status were associated with lower GERD-HRQoL scores.
Surveillance of bacterial carriage in the nose and hands of healthcare workers and patients attending maternity and children's hospital
Authors: Mitra Sohini S. , Pachpute Samir R. 
Published: December 2023

Introduction:
Nosocomial infections have been acknowledged as a significant pathogen responsible for human illness due to the rise in the incidence of these infections that are mainly caused by resistant strains. As a result, it is important to prevent nosocomial infections. Therefore, in the epidemiology and pathogenesis of infection bacterial carriage appears to be of great importance and in healthy persons, three patterns of carriage are observed over time. The common ecological niches of microorganisms are the anterior nares and hands; hence, the present study aims to evaluate the surveillance of bacterial carriage from the hands and noses of healthcare workers that involve doctors, nurses, and housekeeping staffs and patients involving pregnant women or mothers.

Materials and Methods:
An observational prospective study was conducted for 1.5 years in which collection of swabs from both the hands and nose were taken and inoculated on mannitol salt agar, blood agar, and MacConkey agar and incubated at 37°C for 24 h following which biochemical reactions were performed from isolates and 160 nasal swabs and hand swabs were studied for bacterial growth.

Results:
The percentages of bacterial growth in the hands of mothers, doctors, housekeeping staff, and nurses were 17.5, 12.5, 52.5, and 25%, respectively, and in the nose were 7.5, 5, 32.5, and 12.5%, respectively. Total bacterial carriage in hand and nose swabs were 26.87 and 14.37%, respectively.

Conclusion:
Methicillin-resistant Staphylococcus aureus was the most common microorganism isolated and as a result to prevent its spread along with other nosocomial microorganisms, appropriate precautions should be taken as the spreading of these organisms can lead to drug resistance strains.