bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical and Social Correlates of Duration of Untreated Psychosis and Impact on Short-Term Outcome in Patients with First-Episode Psychosis
Authors: Sood Mamta , Sharan Pratap , Kattimani Shivanand , Sreenivas V , Arumugham Shyam Sundar 
Published: September 2023

Abstract

Background:
The duration of untreated psychosis (DUP) impacts symptomatic and functional outcome in patients with psychosis.

Objectives:
This study assessed DUP, its association with sociodemographic and clinical factors and its impact on short-term clinical and functional outcome in patients with first episode psychosis.

Methodology:
Sixty-nine first contact patients with first episode psychosis who had not received adequate treatment for psychosis (adequate treatment - antipsychotic medication of ≥3.5 mg haloperidol equivalents for ≥ 4 weeks) previously were assessed with Symptom Onset in Schizophrenia Inventory to determine DUP. They were followed up for 12 weeks. Positive and Negative Syndrome Scale and World Health Organization Disability Assessment Scale – II were used to assess symptoms and functioning at presentation and after 12 weeks.

Results:
The mean DUP for the sample (n=69) was 56.7 ± 89.1 weeks (13.2 ± 20.8 months). About three fifths (60.9%) of the subjects had DUP ≤ 3 months (short DUP) and two fifths (39.1%) had DUP > 3 months (long DUP). Univariate analysis found age, employment, mode of onset and diagnosis to be significant. At followup, treatment-related improvement in positive, general and total symptom scores was significantly negatively correlated with DUP and improvement in functioning was significantly greater in patients with DUP < 3 months. A step-wise multiple logistic regression model identified mode of onset, age, and history of prior attempts at treatment as independent predictors of membership to the two DUP categories; insidious onset led to a 20-fold and a history of prior treatment attempts indicated a 400% increase in the odds of belonging to the long DUP category. An average of 9% increase in odds of having long DUP was observed with every one-year increase in age.

Conclusion:
Early detection (short DUP) of psychosis was found to have a salutary impact on clinical and functional outcome.
Factors associated with osteoarthritis in menopausal women: A registry study of osteoporosis sarcopenia and osteoarthritis
Authors: Tsai Chia-Jen , Wang Yu-Wei , Chen Jung-Fu , Chou Chen-Kai , Huang Chung-Cheng , Chen Ying-Chou 
Published: September 2023

ABSTRACT

Background:
Bone and muscle mass decline after menopause. The risk of osteoarthritis (OA), sarcopenia, and osteoporosis increases in later life. Our objective aimed to assess the possible factors affecting osteoarthritis in menopausal women.

Methods:
This is a registry study of osteoporosis, sarcopenia, and osteoarthritis. All subjects accepted bone mineral density (BMD) and body composition studies, and X-rays of both knees were performed. A medical history was taken and biochemical data were recorded. Logistic regression analyses were used to examine the associations between the presence of osteoarthritis and BMD, muscle mass, and other parameters.

Results:
A total of 139 patients were enrolled. The mean age of the patients was 73.86 ± 5.83 years in the osteoarthritis group and 74.53 ± 9.90 in the non-osteoarthritis group (p = 0.663). The mean body mass index (BMI) was 24.36 ± 3.64 kg/m2 in the osteoarthritis group, compared with 23.78 ± 3.61 in the non-osteoarthritis group (p = 0.366). The lumbar spine T score was -2.06 ± 1.33 g/cm2 in the osteoarthritis group, and -1.25 ± 1.76 in the non-osteoarthritis group (p = 0.006). There were no significant differences in smoking, alcohol consumption, diabetes, hypertension, cardiovascular disease, neurological disease, and chronic kidney disease between the two groups. When we used osteoarthritis as the outcome, we found that the lumbar spine T score had a significant association with osteoarthritis, with a high T score associated with less osteoarthritis formation (p = 0.024, odds ratio (95% confidence interval) 0.06 (0-0.69)).

Conclusions:
Knee osteoarthritis was associated with lumbar spine bone density. This study provides the initial information required to develop clinical algorithms for the early identification of potential high-risk populations, as well as essential information for the development of policies for the detection and prevention of osteoarthritis in menopausal women.
Quality in neonatal mortality audits: Results of pilot study from district of Dhule, Maharashtra
Authors: Pande Bhanupriya Shivshankar , Patel Aashutosh Ramkant , Patil Amit Jagannath , Patel Shraddha , Shaikh Mohammed Usman 
Published: September 2023

ABSTRACT

Introduction:
As per WHO guidelines, it is important to have quality among mortality audit documents to improve outcome in health services.

Objective:
To assess quality of facility-based neonatal mortality audits implementation.

Methodology:
Mixed-method descriptive analysis was conducted. Totally, 96 death review documents were reviewed. The 25 healthcare workers were interviewed in depth. Observation analysis done for audit meetings using WHO modified checklist for quality in audit toolkit.

Results:
The observation of audit meetings highlighted that almost half of the members were not communicated regarding vision of audit and framework of audit and review meetings. In quantitative analysis, it was found that secondary care hospitals were not having accuracy and consistency in audit documentation.

Conclusion:
The quality of neonatal death audit was poor due to challenges faced by the hospitals in creating an enabling atmosphere, which can be overcome by sharing the vision of audit with the whole staff of the hospital. A standard operating procedure for audit committee to be adopted to implement action plans. Commitment, investment, and intentional leadership from everyone, including all healthcare workers, can make these ambitious goals attainable.
Dysmenorrhea and heavy bleeding as complications in COVID-19-positive women: An observational study
Authors: Deogade Meena Shamrao , Tahlan Nidhi , Anjum Sadaf , Parwati  , Jena Swarnakant , Bhati Deepak , Acharyya Amitava , Nesari Tanuja Manoj 
Published: September 2023

ABSTRACT

Immunological dysregulation and inflammation may play a role in the nature of menstruation. Coronavirus disease 2019 (COVID-19) can produce a systemic inflammatory reaction that involves extrapulmonary organs and can also affect the immune system. This study aimed to analyze changes in the menstrual cycle in coronavirus (COVID)-positive women of reproductive age.

Methods:
The data of 35 women of reproductive age were collected telephonically from said patients admitted to the COVID Health Centre (CHC) ward of All India Institute of Ayurveda, New Delhi, during June 20, 2020, to October 31, 2020. Purposive sampling was used for data collection. Wyatt menstrual pictogram and Visual Analogue Scale (VAS) were used to assess the bleeding pattern and pain during menstruation, respectively.

Results:
Clinically, changes were noted in post-COVID menstruation such as irregularity, polymenorrhea, oligomenorrhea, clots, and menstrual flow in days. However, all results were statistically non-significant. But significant (P = 0.003) menstrual pain was reported.

Conclusion:
Menstrual changes were observed in COVID-19-positive women belonging to the reproductive age group.
Effect of collaborative care intervention on productivity losses among people with comorbid common mental disorders and cardiovascular disease in rural Karnataka
Authors: Fathima Farah Naaz , Selvam Sumithra , Heylen Elsa , Srinivasan Krishnamachari , Ekstrand Maria 
Published: September 2023

ABSTRACT

Introduction:
Common mental disorders (CMD) and cardiovascular diseases (CVD), common health problems among patients seeking primary healthcare, contribute to high economic productivity losses. Collaborative care programs for CMDs and CVDs have shown improvement in clinical outcomes for both conditions; however, data on productivity outcomes are scarce. Objective: Effect of integrated collaborative care on productivity among people with comorbid CMD and CVD in rural Karnataka primary health clinics.

Methods:
Participants were recruited within a randomized trial in rural South India, where patients received either collaborative or enhanced standard care. In this substudy, 303 participants were followed for 3 months and assessed with the iMTA Productivity Cost Questionnaire (iPCQ).

Results:
We found a reduction in the proportion of individuals reporting productivity loss at 3 months (66%) compared to baseline (76%; P = 0.002). Productivity losses decreased from INR 30.3 per person per day at baseline to 17.7 at 3 months. Reductions were similar in the two treatment conditions.

Conclusion:
Medical intervention may foster reduced productivity losses among patients with CMD and CVD. Collaborative care did not translate into higher reductions in productivity losses than “enhanced standard care.”
To study ultrasound and chest X-ray findings and their role in the diagnosis of dengue fever in children
Authors: Lakra Mahaveer S. , Karotkar Sagar A. , Lakhkar Bhavana , Dhawan Vaishali , Lakra Ashwini 
Published: September 2023

ABSTRACT

Introduction:
Dengue fever is a fatal viral illness affecting almost all age groups and is seen in almost all tropical countries. Ultrasonography (USG) can be a useful tool for the assessment and diagnosis of dengue fever.

Objectives:
The study aimed to evaluate X-ray and ultrasound findings in children with dengue fever.

Material and Methods:
This was a prospective and cross-sectional study that was carried out in a hospital in Mumbai for over one year. All relevant data were collected, validated, and analyzed statistically on the software Epi Info 7.

Results:
Abnormal X-ray findings noticed were pleural effusion, pneumonia, and bilateral nodular opacities. Pleural effusion and respiratory complications were more common in severe dengue (P < 0.05). Out of the 37 patients on whom USG was done, 33 (89.18%) had abnormal and 4 (10.81%) had normal USG findings. Of the 17 patients with dengue who showed warning signs, 16 (89.9%) had abnormal USG findings. Plasma leakage in the form of ascites and effusion was commonly seen. One hundred percent of patients with severe dengue had abnormal USG findings. The abnormal USG findings were more commonly detected between 5–7 days and were more commonly associated with IgG + IgM–positive serology.

Conclusion:
Ultrasonography is a good modality for the diagnosis and evaluation of dengue patients. Serial ultrasound should be done for the assessment and evaluation of said patients.
A study of modified Wells score for pulmonary embolism and age-adjusted D-dimer values in patients at risk for deep venous thrombosis
Authors: Singh Sweety , Goel Atul 
Published: September 2023

ABSTRACT

Aims:
Pulmonary embolism (PE) is the most severe complication of deep venous thrombosis (DVT). This study was designed to evaluate the usefulness of modified Wells score combined with age-adjusted D-dimer cut-off levels as a clinical pre-test probability assessment for predicting PE in patients ‘at risk for DVT.’

Methods:
This was a cross-sectional study including 200 in-patients at risk for DVT. Patients were categorized as ‘pulmonary embolism unlikely’ or ‘pulmonary embolism likely’ using modified Wells score and underwent D-dimer testing. PE was considered excluded in patients classified as unlikely with normal D-dimer levels, whereas the rest of the patients underwent computed tomography pulmonary angiogram (CTPA).

Results:
Out of 200 patients, 163 patients (81.50%) were ‘pulmonary embolism unlikely,’ whereas 37 patients (18.50%) were ‘pulmonary embolism likely.’ Of 163 patients categorized as ‘pulmonary embolism unlikely,’ 67 patients (41.5%) had normal D-dimer values and were excluded from CTPA. PE was detected in 24.2% of the patients who underwent CTPA.

Conclusion:
The combined strategy using modified Wells score and age-adjusted D-dimer cut-off value has 100% sensitivity and a negative predictive value and can be used to safely exclude PE in in-patients.
Situational analysis of women empowerment in urban field practice area of Dr. M. K. Shah Medical College and Research Center, Ahmedabad
Authors: Shah Yash , Patel Hely , Oza Jasmin , Geriya Disha 
Published: September 2023

ABSTRACT

Introduction:
Women empowerment in society and family are closely linked to decision-making. Empowerment of women is essentially the process of upliftment of economic, social, and political status of women, the traditionally underprivileged ones, in society. It involves the building up of a society wherein women can breathe without the fear of oppression, exploitation, apprehension, discrimination, and the general feeling of persecution which goes with being a woman in a traditionally male dominated society. The present study was conducted to assess women’s empowerment status and factors affecting it.

Material and Method:
Community-based cross-sectional study was carried out among 175 women residing in urban field practice area of Dr. M. K. Shah Medical College and Research Centre, Ahmedabad. A pre-designed questionnaire was used for data collection by interviewing the women through house to house survey. Data were entered in Microsoft Excel and analyzed using (Statistical Package for the Social Sciences (SPSS).

Result:
Around 85.71% of women were involved in decisions regarding trivial issues. A total of 17.72% of the women reported that they had suffered some form of domestic violence in their life. Around 23% of the women were not involved in any financial decisions of the family. Association between education of the women and involvement in decision-making was found statistically significant. Employment increases the participation of women in financial decision-making. 88.89% of employed women participated in financial decisions, while 71.42% of housewives were participating in these decisions.

Conclusion:
Education and employment were found to have impact on decision-making. So, education of girls should be given the priority.
Prevalence of diabetes distress and cross-cultural reliability of DDS-17 scale in rural Haryana
Authors: Ranjan Ravish , Rajput Meena , Sachdeva Aman , Saha Arup , Jyotsana  , Yadav Kapil 
Published: September 2023

ABSTRACT

Background:
Diabetes distress associated with diabetes is an important under-appreciated domain of diabetes management. The aim of the study is to assess the prevalence of diabetes distress among T2DM patients in Jhajjar district of Haryana, using widely accepted DDS-17 scale along with testing the scale’s reliability through Cronbach’s α.

Material and Methods:
This observational study with cross-sectional design was carried out among 503 T2DM patients in district, Jhajjar, Haryana. DDS-17 scale was used for diabetes distress assessment. Data entry and analysis were performed using appropriate software.

Results:
37.97% subjects had diabetes distress either in moderate (DDS-17 Score ≥2) or severe (DDS-17 Score ≥3) form. English version of DDS-17 scale showed good internal consistency reliability (α = 0.79).

Conclusions:
This study conclusively showed that diabetes distress is very common among T2DM patients as more than one third of the T2DM patients had diabetes distress and diabetes distress scale (DDS-17) is an easy, well-accepted questionnaire with good reliability.
Barriers of household toilet utilization among toilet owners in a rural area of Northern India: An analytical cross-sectional study
Authors: Takhelchangbam Nilima D. , Saxena Deepanshi , Sachan Divyata , Jain Pankaj K. , Shukla Sushil K. , Srivastava Dhiraj K. , Bajpai Prashant K. 
Published: September 2023

ABSTRACT

Background:
Open defecation continues to prevail among toilet owners despite effective implementation of the Swachh Bharat Mission (Gramin). We conducted this study to determine toilet utilization rates and learn about the barriers to toilet use in the rural areas. By understanding the barriers, physicians can provide targeted education and become better equipped to manage their patients’ conditions and advocate for their demands.

Materials and Methods:
We conducted a cross-sectional study on the households of the rural field practice areas of the department in central Uttar Pradesh by the census method. House listing was procured from the departmental records. The questionnaire was directed at both the household level and individual level.

Results:
The proportion of households with access to a toilet was found to be 91.1% of which 504 households were included in the study. Among the toilet owners, 115 (22.8%) households were not using toilets exclusively by all the members. At the individual level, age groups (of 20–59 years, and ≥60 years) and female gender were found to be significantly associated with open defecation. At the household level, government assistance for toilet construction and livestock keeping was found to be associated with open defecation. Major barriers to toilet use were childhood habits, dearth of toilets in the farming grounds/workplace, women during menstruation and having a non-functional toilet.

Conclusion:
This study indicates that merely installing a household toilet does not ensure exclusive utilization of toilet and the practice of open defecation might continue to be prevalent if corrective measures are not undertaken.
Stressors and coping strategies among medical students in Jazan, Saudi Arabia: A cross-sectional study
Authors: Salih Sarah , Mahmoud Samy S. , Abudeyah Manal Ahmed , Albeladi Fatimah Ibrahim , Mohsen Waad Mohammed , Hayyan Alanoud Ibrahim , Alfaifi Nada Ali Y. , Hakami Ghadah Mohammed , Alnamazi Noura Ali 
Published: September 2023

ABSTRACT

Background:
Medical education is known to be stressful and demanding. Medical students face a various stressors, which include academic pressure, fear of not reaching goals, and difficulty integrating into systems. This study aims to assess levels of stress and coping strategies among medical students at Jazan University in Saudia Arabia.

Materials and Methods:
A descriptive cross-sectional study was conducted that comprised of 240 students at Jazan Faculty of Medicine using a self-administrated questionnaire to obtain data on socio-demographic characteristics, perceived stress, stressors, and coping strategies.

Results:
Respondents mean age was 22.08 ± 1.82 years and 52.7% were female. Of these, 51.9% were in preclinical years of study, 29.5% were in the second academic year, and 39.8% had a GPA greater than 4. Students stress level ranges from moderate to high. The most common causes were academic problems and frequency of examinations and work overload (92.1%), worrying about the future (61.8%), and lack of entertainment and time for recreation (58.9%). The most common coping strategy was recreational activity such as going to movies, watching TV, reading, sleeping, or shopping (36.5%). Mean perceived stress scale (PSS) and Brief-COPE scores were 24.1 ± 4.85 and 66.16 ± 10.71, respectively. Participant age and PSS score have significant positive correlation (P < 0.05).

Conclusion:
Stress level is moderate to high especially among students in preclinical years and among females. It is recommended to improve teaching and learning environment plus proper counseling and academic support. Also, active involvement of students in the educational process may help reduce academic stressors.

Plain Language Summery:
Medical students face a range of stressors due to the demands of study. This research found medical Students suffer stress level ranging from moderate to high. Most common causes of stress are academic problems, frequency of examinations, and work overload. Most common coping strategy performed by students was recreational activities like going to movies, watching TV, reading, sleeping, or shopping. It is recommended to improve teaching and learning environment plus proper counseling and academic support. Also, active involvement of students in the educational process may help reduce academic stressors.
Prevalence of cardiac autonomic neuropathy in patients with type 2 diabetes mellitus
Authors: Karthikeyan Aditya , Manjunath PR , Latha A Tharuni , Sultana Sana 
Published: September 2023

ABSTRACT

Introduction:
Cardiac autonomic neuropathy (CAN) is one of the microvascular complications of diabetes mellitus, which is due to the involvement of autonomic nerve fibers innervating the heart and blood vessels. CAN was found to have a greater degree of morbidity and mortality than their non-CAN counterparts as it is underdiagnosed. Hence, this study aims to determine the prevalence and severity of CAN in type 2 diabetics in the South Indian setting.

Materials and Methods:
Forty-two patients with type 2 diabetes mellitus were enrolled in the study. Patients underwent tests for CAN, with the severity of CAN estimated as a CAN score, which was the sum of the scores of the four cardiovascular autonomic function tests.

Results:
Out of the 42 patients, a total of 36 patients (85.7%) were diagnosed with CAN. Among those with CAN, 24 patients had early CAN (57.1%), and 12 were diagnosed with definite CAN (28.6%). Patients with any form of CAN (early and definite CAN) had higher HbA1c and mean glucose values than those without CAN. CAN was also found to be more severe among older patients with diabetes.

Conclusion:
In the present study, we found that more than 50% of the study population had early CAN and around 28.6% patients had definite CAN indicating higher prevalence of CAN in our population. Also, there was a positive correlation between the severity of CAN and the age of the patients. This study highlights the importance of understanding the importance of screening the diabetic patients for CAN to prevent adverse cardiovascular events.
Knowledge and perception regarding adverse drug reactions among undergraduate medical students of Bihar, Eastern India
Authors: Sidhu Gurcharan S. , Kumar Jatinder , Kumar Dharmendra , Dey Nakshatra , Ranjan Gyan , Sinha Tanay , Pal Ranabir 
Published: September 2023

ABSTRACT

Background:
Adverse drug reactions (ADRs) have national and international monitoring and are part of teaching–learning of undergraduate medical course and curriculum.

Objectives:
To find the knowledge and perception of ADRs among undergraduate medical students in a tertiary care teaching institute in eastern India.

Materials and Methods:
This was an observational cross-sectional study conducted among the MBBS medical students by administration of pre-designed, pre-tested, semi-structured questionnaires. The data on their knowledge and candid reflections on ADRs were analyzed question by question using software and compared with peers.

Results:
The responses from the participants on knowledge and perception of ADRs varied widely. Final-year students had the most precise response on classification, filing an ADR report, national reporting centers, and the first step in monitoring ADRs; the majority accepted their first- hand experience and legal and professional responsibilities on ADRs. Third-year students responded well on objectives, methods, and scope of patients on direct reporting or drug overdose and monitoring; respect patient confidentiality while reporting; and expect feedback from monitoring centers, with special training on ADR. Second-year students responded well on definitions, pharmacovigilance programs in India, alertness of banned drugs because of ADR, and related capacity building.

Conclusions:
The awareness and insight on ADRs of the undergraduate medical students were quite reasonable. However, further reinforcement is needed in future to be updated to relevant issues to their practice as primary care physicians.