bluuebunny/crossref_metadata_2025_split huggingface dataset:
Monitoring the Family Health Centres in Kerala, India: Findings from a facility survey
Authors: Sankar Hari , Joseph Jaison , Negi Jyotsna , Nair Arun B. , Nambiar Devaki 
Published: December 2023

Introduction:
Kerala, a south Indian state, has often been cited globally as a model for better health outcomes at low cost but faces unique challenges in achieving Universal Health Coverage (UHC). To propel the efforts in achieving UHC, the Government of Kerala announced the “Aardram” health reform initiative, emphasising improving the quality of primary care service delivery. The reforms started in 2017, and in the first stage, 170 of 848 Primary Health Centres (PHCs) were upgraded to Family Health Centres (FHCs). The facilities were provided with additional doctors, nurses, and paramedical staff; the working hours were extended, and the range of services offered increased. In support of these processes, we carried out a facility assessment to assess differences between upgraded FHCs and existing PHCs.

Materials and Methods:
We conducted a facility-based cross-sectional assessment in eight primary care facilities of Kerala, FHC (N=4) and PHCs (N=4) from June to October 2019. A structured questionnaire covering utilisation and coverage of selected priority services for various populations and health outcome data was filled out by health staff to report data for the financial year 2018-19. Data were analysed in Microsoft Excel spreadsheets for easy analysis and replication by state stakeholders.

Results:
Coverage indicators such as full antenatal care and full immunization coverage were not appreciably different in FHCs as compared to PHCs. However, key reform-related differences were observed. On average, FHCs had 0.8 medical officers and one staff nurse per 10,000 population, whereas PHCs had 0.7 medical officers and less than 0.4 staff nurses per 10,000 population, even as the size of populations served by these human resources varied greatly across both types of facilities. The number of outpatient department visits per 10,000 population annually was 11,343 persons in FHCs and 9,580 persons in PHCs. FHCs also provided additional services such as screening for depression and chronic obstructive pulmonary disorders.

Conclusion:
Aardram primary healthcare reforms are still in their early days and appear to be associated with improved service coverage at the institutional level. However, some patterns are uneven: reforms should be carefully documented, and population-level impacts monitored over time.
Study of the prevalence of tobacco consumption among apparently healthy adult males in an urban area
Authors: Ahmed Shafique , Nimonkar Ravi A. , Sharma Vishal , Pardal Maninder Pal Singh , Rajiva K. 
Published: December 2023

Background:
Keeping in view the role of tobacco consumption as a modifiable risk factor in various diseases and gaps in scientific knowledge among the apparently healthy adult male population in India, the researchers chose to undertake this study.

Materials and Methods:
A cross-sectional study was conducted among apparently healthy adult males employed in various government offices to determine the prevalence of tobacco consumption. The minimum sample size to estimate a 95% confidence interval for the prevalence of tobacco consumption with 5% absolute precision was calculated to be 340. However, 500 subjects were included in the study. The tool used for data collection was the “personal interview technique.” Standard statistical methods were utilized for data analysis.

Results:
The overall mean age (standard deviation (SD)) of the study subjects was 30.96 yrs (4.32). Overall, the mean (SD) of number of years of tobacco use was 5.64 years (1.98). The mean (SD) of number of cigarettes smoked per day was 6.36 (3.09). The prevalence of current smokers showed a statistically significant increase from the age groups of 20–29 yrs to 50–59 yrs (P < 0.001). All subjects in the study were able to name at least three harmful effects of tobacco consumption. The overall mean amount spent on tobacco consumption per month was Rs 536.97 (1.44% of basic salary). Overall, the most common reason for smoking was peer pressure, where 40 (93.02%) gave this reason. Of forty-three tobacco users, 27 (62.79%) expressed a desire to quit tobacco consumption. The most common reason for expressing a desire to quit tobacco was the ill effects of tobacco consumption, where 23 (85.18%) tobacco users gave this reason.

Conclusion:
Our study on the prevalence of tobacco consumption among government employees provides an adequately clear picture of this public health epidemic in India. There is an immediate need for target group-specific policies for tobacco control, which should be integrated with the relevant national health programs at all levels.
Risk factors and fetomaternal outcome in pregnancy-related acute kidney injury
Authors: Sandilya Shipra , Rani Kumari Usha , Kumar Rajesh 
Published: December 2023

Introduction:
Pregnancy-related acute kidney injury (PRAKI) is acute kidney injury (AKI) occurring during pregnancy, labor, and postpartum period. AKI is defined as suddenly impaired kidney function with the retention of nitrogenous and other waste products. In high population country like India, not all deliveries are done tertiary care. Even not all are registered one if delivery is conducted at a hospital setup. The majority of patients are being managed by available obstetrician at local places. Early diagnosis and timely management of complications related to pregnancy are very important to avoid PRAKI. We aim to study maternal risk factors and fetomaternal outcome in PRAKI.

Materials and Methods:
A prospective study is conducted between 2021 and 2022 in the Department of Obstetrics and Gynaecology, VMMC, and Safdarjung Hospital, New Delhi. For antenatal and delivered women up to 6 weeks, 50 patients were recruited according to KDIGO (Kidney Disease International Global Outcomes) criteria. Patients were followed with CBC, serum electrolytes, serial KFT, urine input/output monitoring, and USG-KUB. Dialysis was done if indicated. Complete renal recovery was considered if S.Cr ≤1.0 mg/dl within 6 weeks of diagnosis of AKI. For statistical significance, a P value of less than 0.05 was considered.

Results:
The majority of patients were unbooked, 21–25 years of age, and belonged to lower socioeconomic status (54%). Risk factors were: preeclampsia (28%), puerperal sepsis (24%), PPH (20%), abruption (14%), pyelonephritis (4%), acute gastroenteritis (4%), gestational hypertension with superimposed preeclampsia (2%), antepartum eclampsia (2%), and thrombotic microangiopathy (2%). Hemodialysis is required in 23 (46%). Complete renal recovery was seen in 40 (80%) and partial renal recovery in 3 (6%). Maternal mortality was 14% and causes were: puerperal sepsis (57%), preeclampsia with severe features with MODS (29%), and antepartum eclampsia with hepatorenal failure (14%). Fetal outcome: 76% live birth, 24% intrauterine death, and 16% early neonatal death.

Conclusion:
Most common risk factors for PRAKI are preeclampsia followed by puerperal sepsis and PPH where all are preventable causes.
Prevalence and Etiological Profile of Anemia in Hospitalized Geriatric Patients
Authors: Lohmror Anurag , Seervi Dinesh , Yadav Mahesh , Yadav Ramnarayan , Agarwal Mahendra Kumar 
Published: December 2023

Abstract

Background:
Anemia is a common health problem in the elderly and is associated with a wide range of adverse outcomes. The prevalence of anemia at older age is increasing as a result of improved diagnostics and demographic changes in our societies. The aim was to determine the prevalence of anemia in a cohort of hospitalized geriatric population and the possible underlying etiology.

Subjects and Methods:
This was a cross-sectional study among patients aged more than 60 years hospitalized in medical wards. Anemia was defined based on the World Health Organization criteria: Hb <12.0 g/dL in women and Hb <13.0 g/dL in men.

Results:
Anemia was observed in 214 patients (73.3%). The average age of the study participants was 68.16 ± 1.32 years. The mean hemoglobin level was 8.48 ± 2.26 g/dl. About 51% had moderate anemia and 34% had severe anemia. Morphologically, microcytic anemia was the most common type (49.5%). Overall, nutritional causes of anemia exceeded nonnutritional causes (49%, n = 105 vs. 42.5%, n = 91). Iron deficiency anemia was the most common nutrient deficiency anemia seen in 49 participants (22.9%), followed by Vitamin B12 in 34 (15.9%) and folate in 10 (4.7%). Anemia of inflammation was diagnosed in 69 (32.2%) and hematological disorders in 6.1%. Common chronic diseases causing anemia were infection/autoimmune disorders in 35 (16.3%), chronic renal failure in 20 (9.3%), and solid-organ malignancies in 14 (6.5%). The etiology was multifactorial in 19 patients (8.9%) and unexplained in 8 (3.7%).

Conclusions:
Anemia was frequently diagnosed in this series of elderly hospitalized patients with a high burden of moderate-to-severe anemia. Most of them had an underlying treatable etiology. Potentially correctable nutritional deficiencies, such as iron, Vitamin B12, or folate deficiency, were identified as the most common causes. Unexplained anemia appears to be rare in hospitalized older patients.
Spectrum of Biopsy Proven Renal Disease in the Elderly – A Retrospective Observational Study from South India
Authors: Thangaraju Sugan Gandhi , Ramudu Venkatraman , Thoppalan Balasubramanian 
Published: December 2023

Abstract

Background:
Despite the increasing proportion of the elderly population, renal biopsies are restricted to few centers. We studied the elderly renal biopsy data from a tertiary care center in South India.

Materials and Methods:
A retrospective observational study was done in patients more than 60 years of age who underwent native kidney biopsy for various clinical indications from January 2014 to June 2022 and was compared with the renal pathology data of adults 18–60 years of age who underwent native kidney biopsy for various indications during the same study.

Results:
Hundred and five (n = 105) elderly biopsies were included in the study. The mean age was 65.7 years (interquartile range: 60–85 years). Forty-two (40%) were type 2 diabetics. Infection-related glomerulonephritis (IRGN) (20, 19.04%), acute tubular necrosis (ATN) (15, 14.28%), membranous nephropathy (11, 10.47%), and acute interstitial nephritis (10, 9.52%) were the common pathologies observed in the elderly. The most common indication for renal biopsy was rapidly progressive renal failure (RPRF) (n = 28, 26.6%) and IRGN was the most common cause of RPRF. 76.2% of diabetics had nondiabetic renal disease, the most common being IRGN (8, 25%). Crescentic glomerulonephritis (GN), ATN, and cast nephropathy were observed significantly more frequent in the elderly than in those 18–60 years of age. IRGN and pauci-immune vasculitis were the causes of crescentic GN in the elderly.

Conclusion:
Our study highlights the importance of IRGN as the most frequent pathology in the South Indian elderly population both in diabetics and nondiabetics.
Clinical Profile of 100 Elderly Patients Admitted to Critical Care Unit
Authors: Ul Huq Abrar Mohammed , Kumar Sandeep , Ambali Anand P. 
Published: December 2023

AbstractIntroduction:The population of older people (≥60 years) is a growing segment of society, leading to enhanced stress on the global health-care system. Critical care admissions with multiple comorbidities result in prolonged hospital stay and are associated with increased mortality. There is a need to study the profile of older adults admitted to the intensive care unit (ICU) so as to know and understand the challenges of delivery of health care in an intensive care setup.Materials and Methods:A prospective observational study was conducted with the aim to assess the clinicodemographic profile, disease pattern, and clinical outcome in elderly patients admitted to the medical ICU. One hundred elderly people of either gender with medical emergencies admitted during the study period of 6 months were included in the study after obtaining informed consent.Results:The mean age of 100 elderly patients admitted to medical ICU was found to be 70.75 ± 9.22 years. There were 57 males and 43 females. The most common systemic cause of admission to the critical care unit was pertaining to the respiratory system in 45 patients (25.4%) such as exacerbation of chronic obstructive pulmonary disease, pneumonia, and cor pulmonale. The mean number of comorbidities in our study subjects was 1.13 ± 1.12. The common comorbidities were hypertension 39 (34.2%) and diabetes mellitus 22 (19.3%). The mortality in patients with >2 comorbidities was found to be 52.5% and with ≤2 comorbidities was found to be 13.4%, the difference being statistically significant (P< 0.001). Thirty-four percent of patients required invasive mechanical ventilation, and the overall mortality rate was found to be 14%. Mortality was significantly higher among males (71.42%). The mean length of ICU stay was 7.24 ± 6.60 days. Length of stay was significantly higher in patients with <2 comorbidities and with the diagnosis of cerebrovascular disorders.Conclusion:Older people admitted to ICUs are more challenging because of preexisting multiple comorbidities and have a significantly higher risk of poor outcomes. Diseases of the respiratory system, cardiovascular system, and central nervous system are more common among older people with increased length of ICU stay and higher mortality.
Abdominal Tuberculosis Presenting as Anemia Refractory to Standard Therapy in an Elderly Male
Authors: Sharma Gaurav , Rani Deepa , Verma Ashish , Chakrabarti Sankha Shubhra 
Published: December 2023

Abstract
India bears a significant proportion of tuberculosis cases, accounting for approximately 28% of the global burden. Among the reported global cases, around 16% constitute extrapulmonary tuberculosis (EPTB). EPTB diagnosis and treatment are usually challenging. The diagnosis frequently requires the application of contemporary methods, such as acquiring extrapulmonary samples and utilizing advanced diagnostic tools that involve immunological and molecular techniques. Here, we present a case of an elderly male who presented with constitutional symptoms and severe anemia which was refractory to standard hematinic and transfusion therapy. The patient was diagnosed to be a case of abdominal tuberculosis and improved with antitubercular therapy.
Effect of video distraction on preoperative anxiety scores in pediatric patients undergoing general anesthesia in ophthalmic daycare procedures: A randomized controlled trial
Authors: Bandyopadhyay Soumily , Kaur Manpreet , Sinha Renu , Muthiah Thilaka , Ayub Arshad , Subramaniam Rajeshwari 
Published: December 2023

Abstract

Background and Aims:
Parental separation, fear, and exposure to the operating room environment lead to stress and anxiety in pediatric patients. This study aims to identify the research gaps in the effect of video distraction on pediatric patients of Indian origin. We hypothesized that video distraction along with parental presence would reduce preoperative anxiety in pediatric patients undergoing ophthalmic procedures under general anesthesia compared with parental presence alone.

Material and Methods:
In this prospective randomized trial, 145 patients aged 2–8 years, ASA I-II, with at least one functional eye undergoing elective ophthalmic daycare procedures were enrolled. They were randomly allocated to two Groups: Group V had distraction by watching a video/playing a video game together with parental presence, whereas control Group C had parental presence alone without any video distraction. The primary objective of the study was to compare preoperative anxiety using the Modified Yale Preoperative Anxiety score (mYPAS) and heart rate (HR), whereas the secondary objective was to compare child fear, emergence delirium, and parental satisfaction between the two groups. The three time points for intergroup comparisons were the preoperative holding area 10 min before induction (T0), transport of the child to the operating room (T1), and face mask introduction (T2).

Results:
There was a statistically significant difference between mYPAS score in groups V and C at all time points (P = 0.036, P = 0.0001, P = 0.0000), parental satisfaction score at all three time points (P = 0.0049, P = 0.0000, P = 0.0000), and Child Fear Score at T1 and T2 (P = 0.0001, P = 0.0001, respectively). However, there was no statistically significant difference in the emergence of delirium between the two groups.

Conclusions:
Video distraction together with parental presence has a promising role for implementation in hospitals with heavy workload settings where pharmacological intervention would not be feasible, to alleviate preoperative anxiety in children. However, preoperative anxiety may not translate into increased postoperative emergence delirium as was earlier believed.
Characterization of evisceration and enucleation following ocular trauma in Medellín, Colombia
Authors: Giraldo Natalia Rodríguez , López Sebastián Vallejo , Julio-Doria Luis Fernando , Calle Diana Carolina Gómez , Ochoa Oscar Alonso Villada , Posada Mariana López 
Published: December 2023

Abstract

Introduction:
Ocular trauma is a significant cause of visual loss with long-term sequelae, including reduced quality of life and loss of productivity for young patients. Surgical treatment depends on the injury; enucleation and evisceration are viable options in nonrecoverable eyes. Our study aims to describe the epidemiological and clinical profiles of patients undergoing evisceration/enucleation due to ocular trauma in a tertiary care center in Medellin, Colombia, over 10 years.

Methods:
We conducted a cross-sectional descriptive study of eyes that were eviscerated or enucleated due to trauma at the SHospital Universitario San Vicente Fundación in Medellin, Colombia, between 2011 and 2021. We studied sociodemographic characteristics, factors related to ocular trauma, and the surgical procedure performed.

Results:
We studied 161 eyes of 160 patients, of which 2 were enucleated and 158 eviscerated due to ocular trauma. The male-to-female ratio was 7.9:1, and the mean age was 36.6 years (standard deviation = 18.3). 52.2% were due to aggression or violence; the most frequent mechanism was a gunshot wound (28.1%). 98.1% were classified as open ocular trauma, of which 84.5% were ruptured globes. Of the eyes with reported visual acuity, 93.3% did not perceive light. Of the 161 eyes, 58.4% suffered an orbital fracture, and 29.2% suffered cranioencephalic trauma. Primary evisceration was performed in 98.8%, with half of the patients operated in 2 days or less and 75% in 4 days or less. An orbital implant was used in 90.7%. Seventy-five percent of patients were followed up at 36 days.

Conclusions:
The majority of ocular trauma resulting in loss of the eyeball occurred in young men who had suffered aggression or violence and presented with ocular rupture, with primary evisceration and orbital implant being performed in most cases, in contrast to what is reported in international series where secondary evisceration is preferred, possibly due to the initial severity of the traumatized eyes.
A Qualitative Study of the Experience of COVID-19 Patients in Burkina Faso
Authors: Konaté Blahima , Médah Rachel , Traoré Isidore , Ouedraogo Samiratou , Kaboré Nongodo Firmin , Mamguem Ariane Kamga , Billa Oumar , Kania Dramane , Badolo Hermann , Ouédraogo Esperance , de Rekeneire Nathalie , Poda Armel , Diendéré Arnaud Eric , Ouédraogo Boukary , Tinto Halidou , Dabakuyo-Yonli Tienhan Sandrine 
Published: December 2023

ABSTRACT.
In Burkina Faso, the health system is characterized by systemic insufficient and antiquated health-care infrastructures. Consequently, few health-care establishments have the required resources to diagnose and manage patients with COVID-19, and fewer still have intensive care facilities for severely ill patients with COVID. Furthermore, there is a widespread scarcity of qualified health-care staff. The aim of this study was to explore the experiences of patients with COVID-19 who recovered after being cared for in Bobo Dioulasso and Ouagadougou. Using individual semistructured interviews, we performed a cross-sectional qualitative, descriptive study from June 12 to 30, 2020 with the aid of 13 well-educated patients who had survived COVID-19. The results reveal that prior to hospital admission, the main reason that prompted patients to seek care was onset of symptoms of COVID-19, regardless of whether they had been in contact with suspected or confirmed cases. Transmission was mainly believed to have occurred in the community, in the hospital, and during travel. Patient management was punctuated by frequent self-medication with medicinal plants or pharmaceutical drugs. The participants reported a negative perception of hospitalization or home-based management, with several forms of stigmatization, but a positive perception influenced by the satisfactory quality of management in health-care centers. This report of patient experiences could be helpful in improving the management of COVID-19 in Burkina Faso, both in the health-care setting and in home-based care.
Artificial Intelligence (AI) and Automation in the World of Work: A Threat to Employees?
Authors: Mabungela Mvuyisi 
Published: December 2023

The introduction of machines driven by artificial intelligence (AI) and automation technologies has already had a significant impact on the manufacturing, automotive, logistics, retail, and wholesale industries, and the repercussions of their replacement on the human labour has been a hotly disputed subject. AI and automation technical advancements are having a big influence on workforce turnover. The aim of this study was to look at employees' attitudes on Artificial Intelligence and Automation at work, specifically whether they see AI as a threat or not. Secondary data sources from several authors were utilised in this article. This data was gathered from published and peer-reviewed publications, internet sources, and textbooks pertinent to the issue under consideration. Some researchers contend that automation is likely to add to South Africa's high unemployment rate. There is a scarcity of empirical data in the form of published empirical research concentrating on the stress that AI and automation place on employees, hence the study is being conducted. Based on this study, it appeared that employees feel threatened by this rise of Artificial Intelligence and Automation.