bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing the knowledge of medical undergraduates on oral anticoagulation therapy
Authors: Sarkar Chayna , Wahlang Julie B. , Syiem Reuben P. , Langstieh Arky J. , Das Biswadeep , Surong Melam 
Published: September 2023

ABSTRACT

Objective:
Oral anticoagulant drugs, such as warfarin, are widely used for preventing and treating vascular and thromboembolic disease in patients with chronic atrial fibrillation, venous thrombosis, and coronary heart disease. As oral anticoagulant therapy has such a narrow therapeutic range, complications in administering these drugs can prove to have a detrimental effect on patients such as life-threatening bleeding might occur. It is therefore necessary to have an adequate knowledge about its actions and its interactions with other dietary factors or any other medication involved. This study was therefore formulated in order to evaluate the knowledge as well as to impart proper awareness to the medical undergraduate students about oral anticoagulation therapy such as to prevent any untoward situation that may arise from the process.

Methods:
A cross-sectional descriptive study was used to assess the knowledge on oral anticoagulant therapy among the medical undergraduates of a tertiary care hospital. A pre-validated structured questionnaire consisting of 28 questions was adopted, and a separate questionnaire was used for each student. Timing of answering the questionnaire was set at 30 minutes. Scores were evaluated such as a correct answer was given a score of one and wrong answer awarded as zero. Adequate knowledge sore was set above 70% and inadequate knowledge at less than 40%.

Results:
The response rate was found out to be 67.33% with gender distribution observed to be 71% females and 29% males. From the answers evaluated, overall average score of 67.3 ± 15.9 was obtained indicating that most of the respondents have adequate knowledge about the different mechanism, drug–drug interactions, drug–food interactions, and side effects of anticoagulant therapy, and 100% of the students are well aware about the complications and procedures involved to dissipate information about warfarin therapy.

Conclusions:
Adequate exposure of students to clinical cases will further help them to focus on the importance of anticoagulation and strengthening their knowledge regarding anticoagulant drug therapy. This will influence the process of physician–patient communication for improving anticoagulation outcome.
Hypertension-related distress and its associated factors: findings from an urban primary health centre of South Delhi, India
Authors: Alwani Anam A. , Singh Udita , Sankhyan Sujata , Chandra Ankit , Rai Sanjay K. , Nongkynrih Baridalyne 
Published: September 2023

ABSTRACT

Background:
Living with hypertension (HTN) has been found to cause distress, which adversely affects one’s self-care and may lead to elevated blood pressure. There is a paucity of data regarding the prevalence of HTN-related distress. This study was conducted to estimate the prevalence of HTN-related distress among adults with HTN attending an outpatient department in an urban primary health centre and to determine the factors associated with distress.

Methods:
This was a cross-sectional study conducted at the outpatient department of an urban primary health centre in Delhi, India. The enrolled participants were administered a questionnaire, which included a Distress Scale for patients with diabetes mellitus and/or hypertension (DSDH17 M) (to assess for HTN-related distress) and Health-Related Quality of Life, Healthy Days Measure. A descriptive analysis was performed. Factors associated with HTN-related distress were tested using logistic regression.

Results:
One hundred forty-one participants were enrolled in this study. Most were women (73.76%) with a mean age of 60.15 years (standard deviation [SD]: 0.78). The prevalence of HTN-related distress (average DSDH17 M score ≥3) was 14% (95% confidence interval [CI]: 9.30–21.03). Patients with HTN-related distress had significantly poor health and reported a greater number of days where they were physically or mentally unhealthy. Patients with uncontrolled blood pressure had six times the odds (95% CI: 1.69–21.77, P value = 0.006) of HTN-related distress compared to those with controlled blood pressure.

Conclusions:
Hypertension-related distress was present in 14% of adults with HTN. Patients with uncontrolled blood pressure had six times the odds of HTN-related distress.
Role of information sources in carrying government reproductive health scheme to tribal women in India: A case study among women belonging to Koraga community
Authors: Lakshmikantha Nandini , Javali Shivalingappa B. 
Published: September 2023

ABSTRACT

Context:
To improve the health status of its people irrespective of their socio and economic status, the government will design various schemes. In taking the government schemes effectively to the target group, the role of information sources is crucial. For the study purpose, Koraga community residing in and around Udupi—a district of Karnataka State, which has earned a name not only for its mythological significance but also for its culture of having their women empowered is considered. In the present study, role of information sources in taking the Janani Shishu Kalyan Yojana planned towards improving the pre- and post-natal health of women to reduce maternal death is considered. The results of the study enable us to understand the preference and dependency of the target group on various sources regarding the information received. Since the government-proposed health schemes should reach the target group to bring in a better health index which is one of the SDGs set for 2030, this study gains importance.

Aims:
The study intends to examine the role of information sources in educating the women, particularly those belonging to Koraga community, who fall under the particularly vulnerable tribal groups (PVTG) category among the tribals of India about the government schemes earmarked for safe motherhood.

Settings and Design:
It was conducted in the colonies designated for Koraga community near Udupi of Karnataka using a questionnaire.

Materials and Methods:
Based on the results obtained from the pilot study, a final questionnaire was prepared and was personally demonstrated among Koraga women during the month of January 2020. Data were collected from 117 women belonging to Koraga community. SPSS version 17.0 software, Microsoft Word and Excel were used in data handling and analysis.

Results:
The results obtained out of the study reveal that among the sources, the respondents consider doctors as dependable sources followed by ASHA/Anganwadi workers. The target group is not aware of the nomenclature of the scheme nor the benefits to expect, but they are receiving medical support during their pre- and post-natal period.

Conclusion:
The governments may initiate schemes for the benefit of the public, but the schemes will become successful only when the desired information reaches the target group. The study intended to examine the role of information sources in educating the women particularly those belonging to Koraga community and found that the dependency of the target group on various sources of information regarding government projects is evident and should be further strengthened.
Public awareness of side effects of systemic steroids in Asir region, Saudi Arabia
Authors: Alhammadi Nouf Ahmed , Mohammed Al Oudhah Saud Mushabbab , Mofareh Asiri Mofareh Ahmed , Alshehri Mohammed Abdullah , Almutairi Bassam Ahmed B. , Mohammed Abdullah Thalibah Abdullah , Asiri Fahad Nasser Mohammed , Alshahrani Abdullah Saad Aldarani 
Published: September 2023

ABSTRACT

Background:
Corticosteroids have been used since the 50s and it represent the most important and frequently used class of anti-inflammatory and immunosuppressive drugs for the treatment of several diseases such as numerous neoplastic, asthma, allergy, rheumatoid arthritis, and dermatological disorders. This study aims to determine the public awareness of side effects of systemic steroids in Asir region, Saudi Arabia.

Methods:
A descriptive cross-sectional web-based study was used. An online questionnaire was developed by the study researchers based on the literature review and consultations of the field experts. The questionnaire included the following components: Participants demographic data, medical history, and steroids use. Also, it covered participants awareness regarding systemic steroids and side effects.

Results:
A total of 439 participants fulfilling the inclusion criteria completed the study questionnaire. Ages ranged from 18 to 65 years with mean age of 26.1 ± 13.9 years old, of those, 227 (51.7%) respondents were males. Around 346 (78.8%) had poor overall awareness level while only 93 (21.2%) had good awareness regarding systematic steroids. The study also showed that awareness was significantly higher among young aged participants in the health care field and among those who previously used steroids. Two hundred and eighty two (64.2%) of the respondents reported previous use of steroids.

Conclusion:
In conclusion, the current study showed that nearly one out of each five people know about systemic steroids and related side effects which is below the satisfactory level. Higher awareness was observed with regards drug associated side effects and long-term use consequences.
Association of pruritus with sleep in patients with psoriasis and chronic spontaneous urticaria: A cross-sectional study
Authors: Shukla Prakriti , Verma Parul , Tripathi Srishti , Dwivedi Alok K. , Shukla Mukesh , Suvirya Swastika 
Published: September 2023

ABSTRACT

Background:
Pruritus is a frequent complaint associated with various inflammatory dermatoses. Sleep is often disturbed because of pruritus but the impact of severity and diurnal pattern of pruritus has not been studied so far.

Objectives:
To estimate the prevalence of nocturnal itch (NI) and its association with itch severity, sleep disturbance and quality of life (QoL) compared with non-NI in chronic plaque psoriasis (CPP) and chronic spontaneous urticaria (CSU).

Methods:
We performed a cross-sectional study in patients aged ≥18 years with CPP or CSU for at least 6 weeks. A comprehensive in-house questionnaire designed for study formed the basis for categorizing patients into NI and non-NI. Validated instruments like visual analog scale, pruritus grading system, General Sleep Disturbance Scale, and Dermatology life quality index were used to assess itch severity, sleep, and QoL.

Results:
A total of 255 patients (CPP: 131; CSU: 124) were included in this study. Prevalence of NI was 43.5% (95% confidence interval: 34.9%-52.4%) in CPP and 29% (95% confidence interval: 21.2%-37.9%) in CSU. NI was strongly associated with higher pruritus grading system scores in CSU and CPP (regression coefficient = 1.5, P =0.004 and regression coefficient = 1.3, P =0.004, respectively), with impaired sleep (OR = 2.97, P = 0.025) in CPP and with itch-affected sleep in CSU. Itch severity was associated with impaired sleep; however, the association was modified by the presence of NI in CSU patients.

Conclusion:
Nocturnal itch is prevalent in chronic dermatoses and significant for sleep deficit and impaired QoL. Early screening and management of sleep disturbance among patients presenting with nocturnal itch should be routinely undertaken.
Treatment trends of benign bone lesions in a suburban New York healthcare system
Authors: Muran Andrew , Fallon John , Jung Byeongho , Dzaugis Peter , Zhang Aaron , Fitzgerald Michael , Goodman Howard J. , Kenan Samuel , Kenan Shachar 
Published: September 2023

ABSTRACT

Introduction:
The management of benign bone lesions is controversial as it is dependent on a multitude of factors such as age, anatomic location, comorbidities, lesion metabolic activity, surgeon preferences, and goals of care, among others. Thus far, many studies have attempted to report on these lesions; however, most are heterogeneous compilations of benign and malignant lesions with nearly all failing to report patient treatment and none of which have originated from a suburban area of the United States. The goal of this study was to establish a modern database dedicated solely to benign bone tumors to reflect current diagnosis and treatment trends in suburban New York.

Materials and Methods:
This was a multicenter retrospective observational study with inclusion criteria limited to benign bone lesions of all ages. Malignant lesions were excluded. Patients were drawn from both primary care provider and surgeon records, with documentation of their associated management.

Results:
A total of 689 patients met inclusion criteria. The overall operative rate for this cohort was 71.6%. In agreement with current literature, aneurysmal bone cysts, giant cell tumors, and osteochondromas underwent surgery more frequently than enchondromas; older patients underwent surgery less frequently; benign bone lesions were more commonly found in younger males, and the distal femur and proximal tibia were the most common locations for lesions (P < .05 for all findings).

Conclusion:
This study demonstrates the management of a globally representative variety of benign bone lesions in a diverse suburban population of New York and should facilitate future research on how lesion type, location, management, and other factors relate to patient outcomes.
Clinico-epidemiological characteristics of the biliary samples and their antibiotic susceptibility pattern at a teaching hospital in Northern India
Authors: Kar Mitra , Dubey Akanksha , Singh Romya , Sahu Chinmoy , Patel Sangram Singh , Tiwari Ankita 
Published: September 2023

ABSTRACT

Introduction:
Bile is deemed a sterile fluid, with the presence of clinical conditions like cholelithiasis, cholecystitis, previous biliary interventions, biliary strictures, and so on, leading to bile stasis, and increases the chances of bacteriobilia. In this study, we recognize the bacterial spectrum of microorganisms isolated from bile samples, diagnostic parameters, and antibiotic sensitivity patterns.

Methods:
A retrospective observational study was carried out by compiling data from the hospital information system of a tertiary care center from 2021 to 2022 to evaluate biliary infections in patients who underwent surgical procedures related to the biliary tract and associated organs.

Results:
A total of 234 patients’ bile samples were included in our study. The mean age of patients was 48.04 ± 14.74 years, with more patients below the age of 65 years among those with infected bile samples. One hundred and sixty-three (163/234, 69.66%) patients infected by 209 pathogenic microorganisms were recognized. The most common microorganism isolated was Escherichia coli (83/209, 39.71%), followed by Pseudomonas aeruginosa (37/209, 17.7%). Acinetobacter baumannii and Klebsiella pneumoniae isolate owed to more than 90% penicillin, extended-spectrum beta-lactamase, carbapenem, and fluoroquinolone resistance among all isolates. Length of hospital stay, malignant obstruction, and chronic kidney disease were identified as statistically significant risk factors that lead to the isolation of multi-drug-resistant isolates from bile culture.

Conclusion:
We recognized the spectrum of pathogens causing biliary tract infections at our center along with the antibiotic resistance pattern to guide and facilitate prompt and appropriate treatment by primary health care professionals and family medicine practitioners.
The rationale and guiding principles to design a psychiatric curriculum for primary care nurses of India
Authors: Ohri Uma , Paul James , Vijayalakshmi Poreddi , Govindan Radhakrishnan , Manjunatha Narayana , Kumar Channaveerachari Naveen , Math Suresh Bada 
Published: September 2023

ABSTRACT

Background:
The National Mental Health Survey reports a huge treatment gap for all mental disorders. There is an acute shortage of mental health professionals in India. Hence, there is a dire need to support task-shift interventions by nurses in providing non-pharmacological interventions for persons suffering from mental health issues. The traditional psychiatric nursing curriculum emphasizes nurses’ knowledge and skills rather than their competency in providing mental health care. We designed an innovative, digitally driven, modular-based primary care psychiatry program for nurses (PCPP-N) to incorporate mental health with physical health and emphasize redesigning nursing practice. In this paper, we discuss the rationale and guiding principles behind designing the curriculum of PCPP-N.

Discussion:
The PCPP-N program is based on nine guiding principles to provide skill-based, pragmatic, and feasible modules of a higher collaborative care quotient (CCQ) and translational quotient (TQ) that are essential for upskilling primary care nurses. In this program, nurses are trained through telemedicine-based ‘on-consultation training’ augmented with collaborative video consultations. A tele-psychiatrist/tele-psychiatric nurse will demonstrate how to screen, identify, and plan treatment for patients with psychiatric disorders from patients coming for general medical care using the manual Clinical Schedules of Primary care psychiatry Nursing (CSP-N). The CSP-N manual includes a screener, simplified diagnosing guidelines relevant for nurses and primary care settings, nursing management, pharmacological management, and related side effects, counseling, and follow-up guidelines. This program helps the nurses in identifying the most commonly prevalent adult psychiatric disorders presenting to primary care.

Conclusion:
This PCPN curriculum contains pragmatic modules with higher CCQ and TQ. This curriculum is dynamic as the learning is interactive. Upskilling primary care nurses in integrating mental health with physical health may reduce the mental health burden. Further, the policymakers and administrators plan to integrate mental health along with physical health in national health programs.
Effectiveness of lukewarm water compress on reduction of breast pain and breast engorgement among post-cesarean section mothers
Authors: Chauhan Soni , Nutan Kumari , Agrawal Monica , Tiwari Surya Kant 
Published: September 2023

ABSTRACT

Objective:
The study aimed to assess the effectiveness of lukewarm water compress on breast pain and breast engorgement among post-cesarean primiparous mothers.

Materials and Methods:
This quasi-experimental posttest-only design was conducted with 60 post-cesarean section primiparous mothers between October 2018 and January 2019. A simple random sampling technique was used to allocate 30 participants to both experimental and control groups. The experimental group received lukewarm water compress using a sponge cloth for 20 min twice a day on the second, third, and fourth postnatal days. The control group received routine hospital care. Breast pain and engorgement were assessed using the Visual Analog Pain Scale and Breast Engorgement Assessment Scale on the third, fourth, and fifth postnatal days.

Results:
Significant differences were observed between the experimental and control groups on day 1 and day 3 in terms of breast pain and engorgement scores among post-cesarean section mothers (P < 0.001). In addition, no statistically significant differences were found between sociodemographic and breastfeeding parameters and breast pain and engorgement (P > 0.05).

Conclusion:
Lukewarm water compress is effective in reducing breast pain and engorgement in post-cesarean primiparous mothers. Future research can include randomized controlled trials to evaluate the effectiveness of different therapies in treating breast pain and engorgement.
Level of stress among nurses and their adopted coping strategies
Authors: Jamir Alijungla , Piku Angouziia Lily , Zhimomi Boli Vihoyi , Koyu Christie , Chorei Diana , Lyngdoh Deimaia Emi , Ao Bendangmenla 
Published: September 2023

ABSTRACT

Objectives:
This study was aimed at identifying the nurse’s level of stress and the coping mechanism adopted by them.

Materials and Methods:
A descriptive study was done to assess the level of stress and the coping strategies adopted by the nurses in a secondary hospital in North East India, Nagaland. A total enumerative sampling technique was used to select 94 samples for the study. The Nursing stress scale (NSS) by Gray-Toft and Anderson 1981 was used to assess stress, and the Ways of Coping Questionnaire was used.

Results:
Of 94 samples, 68 (72.34%) had a mild level of stress, 25 (26.59%) had a moderate level of stress, and only 1 (0.06%) had a severe level of stress. Thirty-one (32.97%) used minimal coping strategies, and 63 (67.02%) used moderate coping strategies. There was no significant association between the stress level and selected demographic variables such as age, marital status, and years of experience (all P > 0.05). A significant association was found between the stresses of nurses and qualification of nurses (χ2 = 4.10, P = 0.04).

Conclusion:
The study reveals that most nurses had mild levels of stress. Most nurses use moderate coping strategies to relieve their stressors at work. Thus, there is a need to emphasize the importance of using effective coping strategies for nurses to alleviate their stresses and anxiety in their workplace and even in their personal lives.
Effect of sevoflurane, propofol and propofol with dexmedetomidine as maintenance agent on intracranial pressure in the Trendelenburg position during laparoscopic surgeries
Authors: Kamal Manoj , Chawriya Sanjeev Kumar , Kumar Mritunjay , Kaloria Narendra , Sharma Ankur , Bhatia Pradeep , Singariya Geeta , Paliwal Bharat 
Published: September 2023

Abstract

Background and Aim:
Pneumoperitoneum (PP) and the Trendelenburg position (TP) in laparoscopic surgeries are associated with rise in intracranial pressure (ICP). The optic nerve sheath diameter (ONSD) is a surrogate marker of ICP. The study aimed to evaluate the effect of sevoflurane, propofol and propofol with dexmedetomidine as maintenance agent on ICP in TP during laparoscopic surgeries.

Material and Methods:
A total of 120 American Society of Anesthesiologists (ASA) physical status I/II patients, aged 18–65 years were randomly allocated into three groups: sevoflurane as group S, propofol as group P, and propofol with dexmedetomidine as group PD. The intra-abdominal pressure (IAP) was kept in the range of 12–14 mmHg and TP varied between 15°– 45° angle. The primary objective was comparison of ICP and secondary objectives were IOP, intraoperative hemodynamic and postoperative recovery characteristics among groups. The ONSD and IOP were measured in both eyes 10 min after endotracheal intubation (T0), 5 min after CO2 insufflation (T1), 5 min after TP (T2) and 5 min after deflation of gas (T3). The data were analyzed by using the Statistical Package for Social Sciences version 23.

Results:
ONSD and IOP at T1 and T2 were significantly higher than T0 in all groups, but no significant difference was found among the intergroup groups. Significantly lower heart rate and mean blood pressure were observed in PD group at T1 and T2 compared to group S and group P.

Conclusion:
The rise in ICP was comparable among sevoflurane, propofol, and propofol–dexmedetomidine combination as a maintenance agent during laparoscopic surgeries in TP.