bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Study of Clinical Profile of Patients with Snake Bite Attending a Tertiary Care Hospital in the North Bank of the Brahmaputra
Authors: Baruah Chitralekha , Baruah Bhaskar , Bhattacharjee Subhadeep , Hazarika Karuna 
Published: June 2023

Background:
Snake bite envenomation is a neglected tropical disease which needs urgent medical attention and anti-snake venom (ASV) infusion but is often overlooked and under-reported owing to the age-old tradition of local aid by quacks, poor transportation facilities, and lack of public awareness. This leads to delays in hospitalization and causes increased morbidity and mortality. WHO’s global target is to reduce the number of snake bite deaths to half by 2030 and India needs to play an important role in achieving the target.

Aims and Objectives:
(a) To study the clinical profile of patients, 12 years of age or above, presenting with snake bites, attending OPD and Emergency in the Department of Medicine, TMCH. (b) To study the effectiveness of ASV and adverse effects following its use.

Materials and Methods:
(a) Study design—hospital based cross-sectional study. (b) Duration—1st January 2020 to 30th June 2022. (c) Number of cases—221.

Results:
Out of 221 cases, non-venomous bites and venomous bites were 88.2% and 11.7%, respectively. Out of the venomous cases, 61.5% were hemotoxic and 38.4% were neurotoxic. A total of three patients died during our study and all of these were from neurotoxic bites.

Conclusion:
Snake bite is an important rural and occupational hazard. Delay in hospitalization following snake bite creates a hindrance in timely administration of ASV leading to deleterious effects which may prove fatal. In the present study neurotoxic bites proved to be more fatal in comparison to hemotoxic bites.
A Cross-Sectional Study of Lipid Profile in Anemic Patients in a Tertiary Care Center
Authors: Beeravelli Sruthisri , Kinathankaraiyan Nagarajan , Manickam Rajendran 
Published: June 2023

Background:
Various studies have reported a correlation (both positive and negative) between the status of anemia and lipid profile. Studies observed that the lipoproteins levels were significantly lower in anemic patients, and this reduction was proportional to the severity of anemia and not related to the type of anemia.

Objectives:
To study the lipid profile among the anemia patients and the correlation between the severity of the anemia and lipid subfractions.

Materials and Methods:
This is a cross-sectional study among 85 subjects with anemia in a Tertiary care hospital, who satisfied the eligibility criteria. After detailed history, clinical examination and blood investigations including blood counts, hemoglobin, and lipid profile were done.

Results:
The mean hemoglobin (g/dL) among the subjects was 7.86 (±2.03) g/dL ranging from 3 to 11 g/dL. Among the 85 subjects, 35 (41.18%) had dimorphic anemia followed by 21 (24.71%) had microcytic hypochromic anemia, 15 (17.65%) had normocytic hypochromic anemia, and 14 subjects (16.47%) had normocytic normochromic anemia. Body mass index was not significantly associated with the type and severity of anemia. Lipid subfractions were not associated with the type of anemia and significantly decreased with an increase in the severity of anemia.

Conclusion:
The lipid profile parameters in our study were not associated with type of anemia and significantly decreased with an increase in the severity of anemia.
Predictive Value of Urinary Neutrophil Gelatinase-Associated Lipocalin in Detection of Severe Acute Kidney Injury in Critically Ill Children
Authors: Roy Aniket , Sarkar Mihir , Nandi Mousumi , Raut Sumantra 
Published: June 2023

Aims and Objectives:
The primary objective was to determine the positive and negative predictive values, sensitivity, and specificity of urinary neutrophil gelatinase-associated lipocalin (uNGAL) for diagnosis of severe acute kidney injury (AKI). The secondary objectives were to find the association between uNGAL with day-3 cumulative fluid balance (CFB), requirement of kidney replacement therapy (KRT), and length of pediatric intensive care unit (PICU) stay.

Materials and Methods:
In this prospective cohort, uNGAL was done by chromatography on patients admitted at PICU in a tertiary care hospital with Pediatric Risk of Mortality III (PRISM III) score of >10. AKI was defined by KDIGO 2012 criteria. Urinary NGAL was done on all patients (>3 months to ≤12 years) with PRISM III score >10 on day 1 and day 3 of PICU admission who had no AKI on admission.

Results:
Out of 288 patients admitted with PRISM III score >10 and normal kidney function on admission, 58.3% developed AKI and 29.9% developed severe AKI. Day-3 uNGAL was found to be superior to day-1 uNGAL in detecting AKI with 96.4% sensitivity, 84.4% specificity, 85.04% PPV, and 96.26% NPV. The percentage increase in day-3 CFB and risk of requiring KRT was significantly (P < 0.001) higher in the groups with raised day-1 uNGAL and day-3 uNGAL. The length of PICU stay was significantly correlated to the group with raised day-3 uNGAL (P < 0.001).

Conclusion:
Urinary NGAL had a good predictive value in detecting severe AKI in critically ill children. It is also associated with requirement of KRT and day-3 CFB. Duration of PICU stay was significantly associated with day-3 uNGAL (P < 0.001).
Prevalence of Bladder Bowel Dysfunction in Children with Autism Spectrum Disorder and Response to Urotherapy
Authors: Kalra Suprita , Bamal Manu , Sharma Aditi , Gupta Aparajita , Goswami Jyotindra Narayan 
Published: June 2023

Background:
Children with autism spectrum disorder (ASD) have a high prevalence of bladder bowel dysfunction (BBD), with symptoms including urinary incontinence, dribbling, voiding postponement, constipation, and encopresis. BBD is, however, underdiagnosed and has been studied prospectively in few studies.

Methodology:
All children, aged 2–14 years, diagnosed with ASD using the Childhood Autism Rating Score (CARS), were reviewed in the outpatient department and objectively evaluated for lower urinary tract symptoms using the dysfunctional voiding and incontinence symptoms score, and presence of constipation using the Rome IV criteria. The presence of voiding dysfunction and/or constipation was correlated with the severity of ASD. All children with BBD were advised standard urotherapy and followed up for improvement over the next 3 months. Adherence to the prescribed urotherapy was assessed using the Brief Adherence Rating Scale (BARS) adapted for children with ASD.

Results:
Of 54 children included, 40 (70.1%) were boys. The mean ± standard deviation of age was 7.5 ± 2.5 years. ASD was mild to moderate in 24 children and severe in 30 children. Nineteen (35.2%) patients had constipation, including four with mild-to-moderate ASD and 15 with severe ASD. Seventeen (31.5%) patients had voiding dysfunction, including nine who could not be toilet trained, and 12 of these patients had moderate-to-severe ASD. Ten (18.5%) patients had both constipation and voiding dysfunction. The presence of voiding dysfunction and/or constipation correlated with the severity of ASD (correlation coefficient 0.55). Adherence to urotherapy correlated inversely with CARS. Children with BARS score >70 showed improvement in constipation and/or voiding dysfunction.

Conclusions:
Children with ASD have a high prevalence of BBD, and the presence of BBD correlates strongly with the severity of ASD. Children with ASD should be evaluated for BBD and managed appropriately to prevent associated morbidity.
Quality of Life assessment among post-COVID-19 undergraduates of a tertiary institution in India
Authors: Ibirogba Damilola , Dinesh Avani , Jose Ankitha , Bisheko Muganyizi J 
Published: June 2023

Abstract

Background:
The coronavirus disease (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 virus has been devastating, with over a billion confirmed cases and seven million deaths globally. Studies suggest that the virus can be transmitted through fecal-oral routes, in addition to respiratory transmission. Survivors of COVID-19 often experience long-term symptoms known as post-COVID-19 syndrome, which can have a significant impact on their Quality of Life (QOL) for years after infection. This study aims to evaluate the QOL of undergraduate students who have experienced post-COVID-19 syndrome and identify any associated risk factors.

Materials and Methods:
The EQ-5D-5L questionnaire was distributed to undergraduate students via online platforms using convenience sampling. The survey received 213 responses (76.5% of whom were women and 22.5% were men). The questionnaire included the health dimensions and levels, as well as the Euro quality of life visual analogue scale. Socio-demographic and clinical data were also included. All statistical analyses were carried out using the Statistical package for the social sciences statistical software.

Results:
With a mean and standard deviation age of 19 ± 1.3, we discovered that 131 (61.5%) of our respondents have a poor QOL, whereas 82 (38.5%) have a good QOL. Furthermore, 5.1% of respondents stated that they have no post-COVID symptoms. The most common symptoms among those who presented symptoms were fatigue (99.6%) and hair loss (92.4%). Among participants, EQ-5D-5L utility scores were distributed as follows: pain/discomfort 58 (27.2%), anxiety/depression 94 (44.1%), usual activities 58 (27.2%), mobility 57 (26.8%), and self-care 32 (15.1%). With a P-value of 0.001, we discovered that students with comorbidities such as asthma, coronary artery disease, and others are further affected post-COVID.

Conclusion:
COVID-19, like every other pandemic, has been shown to have deleterious effects on patients even months after recovery. To this end, it is imperative to monitor closely, the QOL of these patients to understand the long-term impact of the disease on them and also to offer timely interventions.
Pathways of intersection between climate extremes and health risk
Authors: Abhilash S 
Published: June 2023

Abstract
Climate change can lead to a multitude of deleterious effects. These include increase in frequency and severity of heat waves, decline in cold-related mortality, increase in floods and droughts, malnutrition, and changes in the distribution of vector-borne infectious diseases. Climate change adaptation, its mitigation, and human health are intricately linked. Current human activities like urbanization, deforestation, and energy usage will put enormous strain on natural ecosystems, accelerating climate change and having consequences for human health. Yet another harmful environmental element is the loss of biodiversity. The functioning of ecosystems and services that are vital to our health, such as food systems and nontoxic places to live in, is supported by biodiversity. This acknowledges the interdependence and tight relationship among the health of people, domestic and wild animals, plants, and the larger (planetary) environment. Hence, the well-being of the former depends on the well-being of the latter. It is necessary to stop the degradation of flora and fauna that make up the living systems of Earth. All of humanity will be impacted by the effects of climate change. However, as with other social parameters, inequity will result in inequality. Depending on their capacity to adjust to the stressors, different people, societies, and countries will suffer the negative health effects of climate change to varying degrees. A comprehensive plan must prioritize human health, via adaptation to and mitigation of climate change. We must take action, especially to address the issues at their source, particularly at the ecosystem levels. In the context of climate change and health, it is time to activate that old proverb: “Prevention is better than cure.”
Climate change and marine ecosystems: Implications for human health
Authors: Abdulla Mohamed Hatha 
Published: June 2023

Abstract
Despite serious progress in the development of nonconventional energy resources, fossil fuel continues to remain the most convenient source of energy across the globe. Ever-increasing usage of fossil fuels has resulted in a significant increase in the concentration of carbon dioxide in the air, which has resulted in global warming and climate change. While the degree of warming varies across various geographical locations, there is a consensus that the net effect of increasing CO2 emissions is that of warming. Another effect is the increased dissolution of CO2 in sea water resulting in ocean acidification. This has dire consequences for marine life, especially to the calcareous shell-forming organisms such as molluskans. There is also clear-cut evidence that the harmful algal blooms (HABs) are increasing in frequency and intensity, leading to massive fish kills and entry of potential toxins to the food chain, endangering even human life. Warming trends in the subtropics and near-polar regions also favor mesophilic pathogens to extend their range to these regions. The characteristic feature of climate change is the frequent occurrence of extreme weather events. It is a sobering thought that the countries affected, both developed and developing, do not have the wherewithal to fight against the powers of nature and are in danger of incurring losses, both economic and lives.
Nutritional Status of Underprivileged Indian Children and Youth with Type-1 Diabetes - A Multicentre Study
Authors: Khadilkar Anuradha V. , Oza Chirantap , Mondkar Shruti A. , Khadilkar Vaman , Kanungo Alok , Sethi Bipin K. , Kumar KM Prasanna , Tandon Nikhil , Rao P V , Kumar Surendra , Bandgar Tushar R. , Raghupathy Palany 
Published: June 2023

Background:
India has the highest number of prevalent type-1 diabetes (T1D) cases in the under-20-year age population. Data on the anthropometry of underprivileged Indian children with T1D are scarce. In economically disadvantaged countries like India, poor growth in patients with T1D is a major concern due to limited accessibility and affordability. Besides, due to the double burden of malnutrition, the prevalence of obesity is increasing mirroring the global trends, which may lead to the development of insulin resistance.

Objectives:
This study aims to assess the prevalence of malnutrition in Indian children and youth with T1D and to identify the determinants of short stature.

Methods:
A registry-based cross-sectional analysis of data collected from various centres across India enrolled in the Changing Diabetes in Children (CDiC) programme.

Results:
We observed that 6.4% were undernourished (3.4% severe undernutrition) and 17.7% (overweight 13.2%) had combined overweight/obesity. 21.2% of participants had short stature (adjusted for mid-parental height) with 7.4% cases of familial short stature. Longer duration of illness and insulin requirement were significant positive predictors of short stature while glycaemic control, insulin regimen and mid-parental height did not have a significant relationship with short stature. Participants on basal-bolus regimen had significantly higher insulin requirements and better glycaemic control than the ones on mixed-split regimen.

Conclusion:
We report that around one-fifth of children and youth with T1D were overweight/obese and around a fourth were stunted, especially those with longer duration of diabetes and higher insulin requirements. Close monitoring of anthropometric parameters is necessary for all children with T1D to optimize growth and nutrition.
A study on the prevalence of RLS in OSA and the consequences of co-occurrence
Authors: Gothi Dipti , Kumar Rahul , Anand Shweta , Patro Mahismita , Malhotra Nipun , Vaidya Sameer 
Published: June 2023

ABSTRACT

Background:
Restless leg syndrome (RLS) is common among patients with obstructive sleep apnoea (OSA) but the prognostic importance of this is not studied. We have called OSA and RLS coexistence as ComOSAR.

Materials and Methods:
A prospective observational study was done on patients referred for polysomnography (PSG) with the aims to evaluate 1) the prevalence of RLS in OSA and comparing it with RLS in non-OSA, 2) the prevalence of insomnia, psychiatric, metabolic and cognitive disorders in ComOSAR versus OSA alone, 3) chronic obstructive airway disease (COAD) in ComOSAR versus OSA alone. OSA, RLS and insomnia were diagnosed as per respective guidelines. They were evaluated for psychiatric disorders, metabolic disorders, cognitive disorders and COAD.

Results:
Of 326 patients enrolled, 249 were OSA and 77 were non-OSA. 61/249 OSA patients, i.e. 24.4% had comorbid RLS, i.e. ComOSAR. RLS in non-OSA patients was similar (22/77, i.e. 28.5%); P = 0.41. ComOSAR had a significantly higher prevalence of insomnia (26% versus 10.1%; P = 0.016), psychiatric disorders (73.7% versus 48.4%; P = 0.00026) and cognitive deficits (72.1% versus 54.7%, P = 0.016) compared to OSA alone. Metabolic disorders like metabolic syndrome, diabetes mellitus, hypertension and coronary artery disease were also observed in a significantly higher number of patients with ComOSAR versus OSA alone (57% versus 34%; P = 0.0015). COAD was also seen in a significantly higher number of patients with ComOSAR compared to OSA alone (49% versus 19% respectively; P = 0.00001).

Conclusion:
It is essential to look for RLS in patients with OSA as it leads to a significantly higher prevalence of insomnia, and cognitive, metabolic and psychiatric disorders. COAD is also more common in ComOSAR compared to OSA alone.
Role of sleep questionnaires in predicting obstructive sleep apnea amongst interstitial lung diseases patients
Authors: Kamgo Tome , Spalgais Sonam , Ravishankar N , Kumar Raj 
Published: June 2023

ABSTRACT

Introduction:
The co-existence of obstructive sleep apnea (OSA) and interstitial lung diseases (ILD) results in significant morbidity and mortality. So screening for OSA is important for its early diagnosis among ILD patients. The commonly used questionnaires for screening of OSA are Epworth sleep score (ESS) and STOP-BANG. However, the validity of these questionnaires among ILD patients is not well studied. The aim of this study was to assess the utility of these sleep questionnaires in detection of OSA among ILD patients.

Methods:
It was a prospective observational study of one year in a tertiary chest centre in India. We enrolled 41 stable cases of ILD who were subjected to self-reported questionnaires (ESS, STOP-BANG, and Berlin questionnaire). The diagnosis of OSA was done by Level 1 polysomnography. The correlation analysis was done between the sleep questionnaires and AHI. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for all the questionnaires. The cutoff values of STOPBANG and ESS questionnaire were calculated from the ROC analyses. P value of <0.05 was considered to be significant.

Results:
OSA was diagnosed in 32 (78%) patients with mean AHI of 21.8 ± 17.6.The mean age was 54.8 ± 8.9 years with majority being female (78%) and mean body mass index (BMI) was 29.7 ± 6.4 kg/m2. The mean ESS and STOPBANG score were 9.2 ± 5.4 and 4.3 ± 1.8, respectively, and 41% patients showed high risk for OSA with Berlin questionnaire. The sensitivity for detection of OSA was highest (96.1%) with ESS and lowest with Berlin questionnaire (40.6%). The receiver operating characteristics (ROC) area under curve for ESS was 0.929 with optimum cutoff point of 4, sensitivity of 96.9%, and specificity of 55.6%, while ROC area under curve for STOPBANG was 0.918 with optimum cutoff point of 3, sensitivity of 81.2% and specificity of 88.9%.The combination of two questionnaires showed sensitivity of >90%. The sensitivity also increased with the increasing severity of OSA. AHI showed positive correlation with ESS (r = 0.618, P < 0.001) and STOPBANG (r = 0.770, P < 0.001).

Conclusion:
The ESS and STOPBANG showed high sensitivity with positive correlation for prediction of OSA in ILD patients. These questionnaires can be used to prioritize the patients for polysomnography (PSG) among ILD patients with suspicion of OSA.
Childhood Routine Immunization Data in Enugu: Findings from a Quality Assessment Survey
Authors: Ugwu George O. , Bisi-Onyemaechi Adaobi I. , Uche Ezema G , Odii Aloysius , Nympha Enebe O , Joy Ugwu I , Charity Onyishi , Chinyere Okeke C , Uzochukwu BSC , Obinna E Onwujekwe 
Published: June 2023

ABSTRACT

Background:
Immunization data are critical for the effective delivery of immunization programs, health planning, and-decision-making. It can also help to identify gaps in vaccine coverage and service delivery. Immunization data quality is dependent on the quality of the collection process at individual health facilities and its transmission to an integrated system.

Aim:
This study set out to appraise the quality of childhood routine immunization data across the different levels of transmission in selected health facilities in Enugu, Nigeria.

Materials and Methods:
This was a cross-sectional, analytical study of the immunization data of two vaccine antigens in 103 health facilities across 10 local council areas offering routine immunization services in Enugu state. Accuracy, discrepancy consistency, completeness, and timeliness of the data for the year 2020, the study period, were determined using WHO data quality assessment tools.

Results:
This study noted that childhood routine immunization data from health facilities to the state are inconsistent, incomplete, and untimely in the transmission. Accuracy ratios were 110 and 108, discrepancy -10 and -8 for BCG and Penta III, respectively, at the health facility level. These signify the underreporting of the two vaccine antigens. This pattern was observed to be reversed as the data were transmitted from the local councils to DHIS 2. Timeliness of reporting did not go beyond 65% for the entire year 2020, while the completeness of reporting was below 80% for the same period.

Conclusion:
There were significant changes in childhood routine immunization data as it were transmitted across the different levels of the data management processes in the state. Routine immunization data from health facilities in the state are inconsistent, incomplete, and untimely in their transmission. This calls for interventions to improve data quality and make use of it in decision-making.