bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring challenges of teenage pregnancy and motherhood from beneficiaries and providers’ perspectives: A qualitative study in a rural area of Purba Bardhaman District, West Bengal
Authors: Dutta Kumarjit , Naskar Somnath , Das Dilip K. , Banerjee Niladri 
Published: December 2022

ABSTRACT

Context:
Teenage pregnancy and motherhood are globally important public health concerns. In India, 6.8% women between 15 and 19 years were already mothers or pregnant, whereas in Purba-Bardhaman district of West Bengal it was 21.9% (National-Family-Health-Survey-5). Challenges of teenage pregnancy and motherhood needs to be understood from beneficiaries’ and providers’ perspectives.

Aims:
This study aimed at exploring the various challenges faced by teenagers during their pregnancies and motherhood and understanding the barriers of service delivery to them in a block of West Bengal.

Settings and Design:
A qualitative study with phenomenological approach was conducted between January and June 2021 in Bhatar community development block of Purba-Bardhaman district, West Bengal.

Methods and Material:
In-depth interview (IDI) of 12 purposively selected teenage mothers and two sessions of Focus Group Discussions (FGDs) among 17 Auxiliary Nurse Midwives (ANMs) were conducted. Data was collected by audio recording the IDI and FGD sessions as well as by taking notes.

Analysis Used:
Inductive thematic analysis was done by using NVIVO software (Release 1.0, QSR International).

Results:
Throughout teenage pregnancy and motherhood, subjects were found to face various types of medical problems, lack of awareness, and non-supportive family environment. Various social constraints and psychosocial stressors emerged as significant challenges. Communication gaps, behavioural barriers, socio-cultural issues, and administrative issues were major themes emerged as barriers of service delivery.

Conclusions:
Lack of awareness and medical problems were important challenges faced by the teenage mothers whereas behavioural barriers were the most important service level barriers perceived by the grass root level service providers.
A study on infant and young child feeding practices and its associated factors among mothers of under two years children attending immunisation clinic in a medical college of Kolkata
Authors: Dey Rituraj , Kumar Mukesh , Mukherjee Dipankar , Joardar Gautam Kumar 
Published: December 2022

ABSTRACT

Introduction:
Appropriate feeding practices play a crucial role in achieving optimal health outcome. Feeding practices since birth at least up to young infancy has vital physical and mental health-related implications. Exclusive breast feeding (EBF) has an important role in prevention of diarrhoea and other leading causes of childhood morbidity and mortality. In this background, this study was conducted with the following objectives.

Objectives:
To assess the birth history of child and their feeding history, to find out the various socio-demographic profile of the mothers, to assess the knowledge on EBF and to find out the factors associated (if any) with the practice of EBF.

Methodology:
A cross-sectional study was conducted among mothers of children aged 0 to 24 months, who were attending the immunisation clinic in a medical college in Kolkata. As per NFHS-4, 47.7% of the children were breast fed within 1 hour of birth in Kolkata. This value is considered to calculate sample size. With 95% confidence interval, 10% allowable absolute error and 5% non-respondent, final sample size came to be 101. Data was collected by interviewing the mothers, using a semi-structured, pre-designed and pre-tested oral schedule which was mainly based on Infant and Young Child Feeding (IYCF) practices mentioned by the World Health Organization. Data was collected from 6 January 2020 to 21 February 2020.

Results:
In this study, male was 45 (44.6%), female was 56 (55.4%). Majority (75.2%) belonged to urban area. About 18.8% of mothers were educated up to secondary level. 53.5% were delivered in private facility and 55.4% delivered by caesarean section. Only 32.7% of new-borns were initiated breast feeding within 1 hour and 31.7% of new-borns given pre lacteal feeding. Majority (88.1%) of the children received colostrum and 52.5% of the children were given EBF. Majority (63.4%) of mothers had knowledge about EBF. EBF was significantly associated with mothers’ knowledge about EBF, [OR (95%CI) = 5.52 (2.26-13.51). EBF also had significant association with the normal vaginal type of delivery of the baby [OR (95%CI) = 3.42 (1.49-7.83)] as well as with the mother who were homemaker [OR (95%CI) = 4.29 (1.52-12.09)].

Conclusion:
Considerable proportion of children were born at private facility and delivered by caesarean section. A significant percentage of new-borns were given pre-lacteal feeding. EBF were significantly more among educated mothers.
Etiology of new-onset seizures in adult patients of different age groups presenting to the emergency department in North India and their outcomes
Authors: Bhatia Mandip Singh , Sharda Saurabh C. , Yadav Gaurav , Mehta Sahil , Attri Ritu , Singla Neeraj 
Published: December 2022

ABSTRACT

Introduction:
Seizures are one of the most common neurological emergencies encountered in both urban and rural India. There is only limited research work on the etiology of new-onset seizures in adult patients of different age groups presenting to the emergency department, especially from the Indian sub-continent. A new-onset seizure can be the first presentation of stroke, or it may be a symptom of brain infections, metabolic abnormality, brain tumor, systemic disease, or an early phase of epilepsy, which needs scrutiny and appropriate management. A dedicated study of the underlying etiology of new-onset seizures among different age groups and their incidence and prevalence can help in the prognostication and clinical management of these patients.

Materials and Methods:
This was a prospective observational cross-sectional study conducted in the Emergency Medical Out-patient Department and emergency medical ward of the Post-graduate Institute of medical education and research, Chandigarh.

Results:
In our research, males out-numbered females. The most common seizure type recorded in our study was generalized tonic-clonic. In the younger age group between 13 and 35 years, infective etiologies were dominant. In the middle age group between 36 and 55 years, cerebrovascular accidents were the dominant etiology, followed by infective causes and metabolic causes. In the older age group above 55 years, the most dominating etiology found was cerebrovascular accident. Almost 72% had abnormal brain imaging. The most common abnormality found was ischemic infarcts. The second most common abnormality detected was a meningeal enhancement. A small percentage of patients had an intra-cranial bleed, and a very small percentage had a subarachnoid hemorrhage.

Conclusions:
In younger patients, infections such as tubercular and pyogenic meningitis and cerebral malaria are the most common causes of new-onset seizures, followed by malignancy and metabolic causes, in descending order. In the middle age group, stroke is the most common etiology, followed by central nervous system (CNS) infections and metabolic causes, in descending order. In elderly patients, stroke is the leading etiology for new-onset seizures. Physicians working in rural and remote areas routinely face challenges in managing patients with new-onset seizures. Knowledge of different etiologies in different age groups will equip them to make informed decisions regarding investigations and treatment of patients with new-onset seizures. It also encourages them to aggressively search for CNS infections, especially in younger patients.
Poorly controlled hypertension among adults treated for hypertension in Tshwane District, South Africa
Authors: Mokwena Kebogile , Modutoane Margaret 
Published: December 2022

ABSTRACT

Background:
Adequate control of hypertension (HTN) is essential to prevent complications such as cardiovascular and kidney diseases. Despite the use of established clinical protocols on the treatment of HTN in primary health facilities in South Africa, the HTN of many patients remains poorly controlled. The objectives of this study were to determine the prevalence of poorly controlled HTN as well as identify related associated risk factors in a sample of adult attendees in primary health care facilities.

Methods:
A cross-sectional study was conducted among adult hypertension clinic attendees at primary health care facilities in Tshwane District, South Africa. Data were collected using the WHO Stepwise instrument on chronic disease risk factor surveillance and anthropometric and blood pressure (BP) measurements. Stata Version 13 was used for data analysis.

Results:
Of the 327 patients who participated in the study, 72.2% were female and 27.8% were male. Their mean age was 56 years (SD = 10.8 years). The prevalence of uncontrolled HTN was 58%, with the mean systolic BP and diastolic BP of 142.18 and 87.43, respectively. The prevalence of poorly controlled HTN increased with age. Factors associated with poorly controlled HTN were age, gender, being unemployed, source of income, smoking, alcohol use, lack of physical activity, and skipping of medication. By multi-variate analysis, both the mean systolic and diastolic blood pressures were found to be significantly associated with poorly controlled BP.

Conclusion:
The high prevalence of poorly controlled BP among patients who are on treatment suggests the need to re-consider the appropriateness of the current integrated management and treatment of HTN used in primary health care facilities in South Africa. The results suggest that the established clinical protocols and standard treatment for HTN are not beneficial for all patients and that physicians should use the treatment response of individual patients to make clinical decisions.
Microbiological profile and their antibiogram of bloodstream infections amongst first and second surge of the COVID-19 patients in a tertiary care hospital
Authors: Saini Vikas , Nirmal Kirti , Ahmad Nadeem , Das Shukla , Singh Narendra P. 
Published: December 2022

ABSTRACT

Introduction:
The world is experiencing a pandemic of coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2. The prescription of a superfluity of unnecessary antibiotics without regard for the potential for increased antimicrobial resistances is extensive and unimpeded during the COVID-19 pandemic.

Aims:
To compare the microorganisms and the pattern of antimicrobial resistance of bacteremia during the first and second waves of the COVID-19 pandemic in a tertiary care hospital.

Methods and Material:
This retrospective observational study, to compared the blood culture of the COVID-19 pandemic during the first wave (April 2020 to September 2020) and the second wave (April 2021 to September 2021). All the blood culture isolates were identified and the antimicrobial susceptibility testing was done according to standard guidelines.

Results:
Out of 1470 blood culture samples, 259 (17.6%) blood bacterial isolates were grown in the first wave and, out of 4200 blood culture samples, 711 (16.9%) bacterial isolated during the second wave of the COVID-19 pandemic. Coagulase-negative staphylococcus (CONS) was 32.8% followed by Staphylococcus aureus 29.7% in COVID first wave and staphylococcus aureus (48.9%) followed by Klebsiella pneumoniae (11.6%) during COVID second wave were the most prevalent isolates.

Conclusions:
This study shows that coagulase-negative staphylococcus aureus and multidrug-resistant Klebsiella spp. are the leading causes of bloodstream coagulase-negative infections during both the first and second wave in the bloodstream COVID-19 pandemic.
The risk of cancer in primary care patients with thrombocytosis: A retrospective observational study within a family medicine setting in Saudi Arabia
Authors: Ahmed Mayada , McWalter Patricia , Al Sharif Meshal 
Published: December 2022

ABSTRACT

Background:
An elevated platelet count, or thrombocytosis, is a risk factor for cancer. This study will highlight the importance of primary health care providers’ awareness of the potential for malignancy in patients with thrombocytosis.

Aim:
To evaluate the prevalence of cancer among patients aged above 40 years with elevated platelet counts.

Objectives:
The purpose of the study was to analyze the prevalence of cancer among patients aged above 40 years at King Faisal Specialist Hospital and Research Centre (KFSHRC) who had thrombocytosis and a platelet count above 450 × 109/L. A secondary objective was to examine whether primary care physicians were prompt in initiating investigation of these patients. This study’s findings will help primary care physicians thoroughly investigate thrombocytosis and develop guidelines that can be applied in primary care settings.

Materials and Methods:
This study was an observational cohort study. The data used originated from the family medicine patient Records at KFSHRC. The data were collected from electronic records by searching all the patient consultations and laboratory results that were available.

Results:
In total, 338 patients aged above 40 years had a platelet count above 450 × 109/L. Of these patients, 68 were men (20%) and 270 were women (80%). Cancer was diagnosed within two years of thrombocytosis in 7.8% of patients (n = 26), of whom 8 were men and 18 were women.

Conclusion:
It is necessary to enhance primary health care professionals’ awareness of the need to investigate the prevalence of cancer in patients with thrombocytosis.
Epidemiology of mucormycosis in post-COVID-19 patients treated in a tertiary care hospital, Visakhapatnam, Andhra Pradesh
Authors: Manda Venkata Vijayasekhar , Patruni Manoj , Nagendra MPA Babu , Bharthi M. Swatantra , Nagappa Vivek , Kurumella Hema Swaroop 
Published: December 2022

ABSTRACT

Introduction:
Mucormycosis is associated with high mortality (45–90%) in average-income countries including India. Prevention of mucormycosis associated with coronavirus disease 2019 (COVID-19) or in patients recovering from COVID-19 needs a further understanding on epidemiology and underlying risk factors.

Methodology:
A hospital-based observational cross-sectional study was performed in a dermatology ward and neurosurgery ward, King George Hospital, Visakhapatnam (dedicated wards for mucormycosis), during May–June 2021 (60 days). After obtaining permission from Institutional Ethics Committee, the convenience sampling method was used and 115 cases admitted for mucormycosis who are post-COVID-19 patients were included in the study. Complete case history including the demographic data and signs and symptoms including the course of hospitalisation for COVID-19 was collected through a semi-structured questionnaire, and detailed clinical examination was conducted in relation with mucormycosis. Data collected were entered in MS excel 2010, and the analysis was performed using SPSS Version 21 for testing the level of significance with P < 0.05.

Results:
The majority of the patients belong to the 51–60 years (31.3%) age group, and 76.5% of them were females. Diabetes mellitus (76.5%) was the most common co-morbidity. Inhalational oxygen was given to 68 (59.1%) of patients. Pain in the eyes and nose was the most common complaint in patients with mucormycosis. Oxygen therapy during hospital admission and the presence of co-morbidities were significantly associated with findings of broad aseptate fungal hyphae on KOH mount.

Conclusions:
Prevention of COVID-19-associated mucormycosis needs to focus on aiming for appropriate oxygen therapy and better glycaemic control in COVID-19 patients and monitoring the use of systemic corticosteroids in treating severe cases.
Time series analysis of animal bite cases attending anti-rabies clinic
Authors: Grover Somya , Gupta Ajay , Dua Avtar S. 
Published: December 2022

ABSTRACT

Background:
Rabies is a disease transmitted mostly through animal bites in humans, and seasonal variation in animal bites has been reported by different studies. There has been no study in India using time series analysis for studying monthly variation in animal bite cases.

Aim:
(a) To find out long-term trends and monthly variations in new animal bite cases. (b) To make projections for new animal bite cases. (c) To find out the difference between actual and projected new animal bite cases following the COVID-19 pandemic.

Methodology:
A retrolective, record-based study was conducted in a tertiary care facility, Jaipur, and data of new Category II and Category III animal bite cases were taken from January 2007 to December 2021. A multiplicative model was used for conducting time series analysis. The projected monthly number of cases was estimated using the line of best fit based on the least square method.

Result:
An increasing trend in the annual number of animal bite cases was observed from 7,982 in 2007 to 10,134 in 2019. The monthly index was lowest for the months July to November (0.88 to 0.95), peaked in January (1.14), remained higher from January to June, and fell in July (0.95). The monthly number of new animal bite cases from April 2020 to December 2021 was significantly lower than the projected number (P-value < 0.001).

Conclusion:
Because the monthly index of animal bite cases was high from January onward, information education and communication (IEC) activities should be increased in the preceding months (November onward) for making people aware of immediate care to be provided to animal bite cases and seek prompt medical care.
Assessment of oral mucosal lesions among HIV positive transgenders residing in Odisha with and without Antiretroviral therapy
Authors: Rai Shilpa , Subramanyam Gautham Bala , Kumar Gunjan , Bhushan Vidya 
Published: December 2022

ABSTRACT

Purpose/Background:
Transgenders are a highly vulnerable subset within the high-risk group for human immunodeficiency virus (HIV) in India. Oral manifestations are among the early signs of HIV infection. This study was conducted with the aim to assess the oral mucosal lesions among the HIV-positive transgenders in Odisha taking antiretroviral therapy as well as those not taking antiretroviral therapy.

Methods:
A cross-sectional study was carried out among HIV-positive transgenders in four districts of Odisha. Snowball nonprobability sampling technique was adopted, and type IV clinical examination was performed using the modified WHO record form for oral manifestations in HIV/AIDS (2013). Independent sample t test was used to compare mean age among those taking ART with those not taking ART. Chi-square test was used to detect the associations among categorical variables.

Results:
The study comprised of 163 participants, 109 (71.24%) who were taking antiretroviral therapy, while 44 (28.76%) not taking antiretroviral therapy. The mean age was 32.56 + 7.69 years. Sex work was the most predominant occupation. Majority of the participants reported of having hyperpigmentation of different parts of oral mucosa. Aphthous ulcer and angular cheilitis was noticed in 14.72% and 9.20%, respectively. Other manifestations noticed included erythematous candidiasis, pseudomembranous candidiasis, oral hairy leukoplakia, necrotizing ulcerative gingivitis, necrotizing ulcerative periodontitis, herpetic stomatitis/gingivitis and/or labialis, herpes zoster, warty like lesions/human papillomavirus, other ulcerations (not otherwise specified/necrotizing ulcerative stomatitis), and dry mouth due to decreased salivary flow.

Conclusion:
Careful evaluation of oral manifestations can improve the quality of life of these marginalized, highly vulnerable population.
Measuring impact of Covid-19 pandemic at a teaching hospital in north India
Authors: Gupta Harish , Patwa Ajay K. , Kumar Satish , Atam Virendra , Vidyarthi Vikas C. , Nigam Nitu 
Published: December 2022

ABSTRACT

Introduction:
Government runs teaching hospitals to impart a high-quality medical education to budding medicos and paramedical students in training. The experiences these trainees at various tenure positions get then and there shape their worldview for rest of the life and have an indelible impression. The Covid-19 pandemic disrupted all the routines at the hospitals around the world—including ours—and we make an attempt to measure it in one dimension in this study.

Materials and Methods:
We obtained attendance data of patients at out patient department and in patient department of our hospital. During the pandemic for a certain duration offline (physical) registrations were closed and they were attended only by online ones. Hence that data (actually a part of it) got captured electronically and we analyzed it to get an idea of the traversed course of the scourge.

Results:
When the pandemic surged during the spring and summer of 2021, our hospital was turned into a Covid facility. Hence average routine attendance of patients got reduced to a significant extent, elective surgeries/interventions and procedures were postponed and this data is reflected in an electronic system, perhaps making a long-lasting effect on the budding trainees. This fact needs to be realized so as to take appropriate action.

Conclusion:
We need to realize that the effects of the viral communicable disease may be enduring, not only for the infected patients and their families but also for those who learn on those patients. Therefore, the transmissible diseases disabled not only our society, economy, and health care services when they ascended but pedagogy too. Online learning came to rescue but only up to a certain extent and with several caveats and limitations.
Family support and well-being programme (FSWP): A specialized family strengthening psychosocial services for parents of children in conflict with law
Authors: Jangam Kavita V. , Ganie Aasim Ur Rehman , Purushothaman Kalpana , Nambiar Priyanka P. , Kommu John Vijay Sagar 
Published: December 2022

ABSTRACT

Background:
A multidimensional family support and well-being programme (FSWP) was initiated to support the families of children in conflict with law (CICL) and strengthen their participation in the integration process. This programme aims to successfully reintegrate children into the family and build parental capacity to manage them. This study presents the overview of the multidimensional FSWP initiated in an observation home, facility for CICLs, Bengaluru, a metropolitan city of India.

Methods and Materials:
The team of psychiatric social workers systematically delivered the family support programme to promote families’ involvement at multiple levels (individual, relationships, community, and societal) for successful reintegration of children in communities. The preliminary data about the participants was collected using strengths and difficulties questionnaire and parent interview schedule.

Results:
The programme activities consisted of engaging parents and family members in the parenting management training programme, addressing their psychosocial issues, identifying resources for postrelease rehabilitation and promotive interventions with children and their parents. The FSWP activities are developed to increase positive outcomes like favorable behavioral changes in children and emotional regulation, frequent participation and support of parents in the trial and rehabilitation process, and encouraging parental involvement in for successful community reintegration and placements of children.

Conclusion:
The family characteristics are integrally related to delinquency and practioners need to integrate such factors to improve parenting behaviors and enhance positive relationships between families and children.