bluuebunny/crossref_metadata_2025_split huggingface dataset:
A cross-sectional study on the frequency and risk factors for neonatal hypoglycemia in babies born in rural Kerala
Authors: Pillai Swapna K. , Fhausiya V.K 
Published: December 2022

ABSTRACT

Introduction:
Glucose is the main source of energy for the developing brain. Hypoglycemia is a commonly encountered and treatable problem in the neonatal period. The newborn baby should be breastfed soon after delivery and continued on demand breastfeeding. As families become nuclear, mothers may not have the necessary skills and knowledge about the importance of exclusive breastfeeding. Health care workers play an important role in preparing the mothers for exclusive breastfeeding and ensuring that the newborn remains euglycemic. Problems encountered during breastfeeding should be corrected on an individual basis, and uninterrupted feeding should be ensured as per BFHI guidelines.

Aim:
To find out the frequency and risk factors of hypoglycemia and its relation to feeding in babies of GDM mothers, large for gestational age, and small for gestational age babies in a baby-friendly hospital adhering to the BFHI guidelines.

Materials and Methods:
A single-center, observational study was carried out among 160 consecutively born babies born to mothers with gestational diabetes, large for gestational age and small for gestational age for a period of one year from October 2018 to September 2019. Data was collected using an interviewer administered proforma and from antenatal and postnatal records. Glucose monitoring was done and values were recorded. Data was analysed using SPSS software. Qualitative data was expressed as percentage. and quantitative data was expressed as mean and standard deviation. Association with risk factors was studied using the Chi-squared test.

Results:
The overall incidence of hypoglycemia was 15.3% in our study. The main risk factors identified were prematurity and small for gestational age. Maximum incidence of hypoglycemia was noted in the first 24 hours after birth. Incidence of hypoglycemia in exclusively breastfed babies was only 10.5% compared to those on formula feeds where breastfeeding was contraindicated due to medical reasons and where the incidence was found to be 33.3%. Incidence of hypoglycemia was 50%. The most common symptoms of hypoglycemia were jitteriness and poor feeding. Eleven per cent of babies had asymptomatic hypoglycemia. In babies detected to have hypoglycemia, prompt treatment with oral feeds or intravenous (IV) dextrose was started. There was no mortality in the study population.

Conclusion:
Incidence of hypoglycemia was maximum in the first hour of life, highlighting the need to start early feeds and to do meticulous monitoring in high-risk babies like pre-term babies, small for gestational age, large for gestational age and babies of diabetic mothers. The incidence of hypoglycemia in exclusively the breastfed group was 10.5%. This showed that confident and successful breastfeeding with the support of health care staff should be the norm to prevent hypoglycemia, and preparation for breastfeeding should begin right from the antenatal period.
Awareness about reproductive tract infection, its relation with menstrual hygiene management and health seeking behaviour: A cross-sectional study among adolescent girls of Lucknow
Authors: Singh Ankita , Kushwaha Sonam 
Published: December 2022

ABSTRACT

Background:
The reproductive tract infection (RTI) is one of the major health issues associated with menstrual hygiene management which often goes unnoticed and hence remains underdiagnosed and untreated, resulting in devastating health effects on women. It gives way to some common complications like pelvic inflammatory disease (PID), ectopic pregnancy, infertility, adverse outcomes of pregnancy, neonatal morbidity and death (in case of a coexisting grievous disease like Human immune deficiency virus (HIV)).

Method:
A cross-sectional study was conducted in the rural and urban government schools of Lucknow, using two-stage cluster sampling separately for both urban and rural areas. Two schools (one co-education and one all girls) were chosen from each area. A total of 629 participants were taken for the study, 389 from urban and 240 from rural schools. The study subjects were taken proportionately from each school for an interview-based session using a pre-designed and pretested questionnaire. Descriptive analysis and Chi-square tests were used to analyse the quantitative data.

Result:
A total of 629 participants were taken for the study, from rural (240) and urban schools (389) of Lucknow. From urban, 50.9% had fair knowledge about RTI. Whereas 71.3% from urban had fair knowledge about RTI. Lower abdominal pain (54.8%) and vaginal discharge (32.6%) were the most common complaint reported by the participants related to RTI. Only 58.1% from urban and 32.6% from rural used sanitary pads as menstrual absorbents. The presence of vaginal discharge showed a significant relation (P value < 0.001) with the type of menstrual absorbent used.

Conclusion:
The knowledge related to RTI and menstrual hygiene practices has not changed significantly with time. Which is amongst the primary prevention that could be employed to prevent RTI and the consequences arising from a physiological cause.
Stake holder perspectives on the role of accredited social health activists (ASHAs) in Indian public mental healthcare space: A qualitative study
Authors: Varshney Prateek , Malathesh Barikar C. , Nirisha P.L. , Harshitha Nisha R. , Kulal Nithesh , Kumar Channaveerachari N. , Gajera Gopi , Suhas Satish , Rahul Patley , Harshitha H.A , Manjunatha Narayana , Manjappa Adarsha A. , Math Suresh B. , Thirthalli Jagadisha 
Published: December 2022

ABSTRACT

Background:
Community health workers such as Accredited Social Health Activists (ASHAs) are existing resources who can facilitate the bridging of the mental health treatment gap. Knowing about the perspectives of ASHAs in delivering mental health care and other professionals with experience working in the area of community mental health is imperative.

Method:
As part of an implementation research project aimed at comparing the effectiveness of two training methods for community health workers (ASHAs), we conducted five focussed group discussions including four with ASHAs (n = 34) and one with other stakeholders (n = 10). Focussed Group Discussion (FGD) was conducted under the following themes: acceptance and feasibility of provision of mental health services from ASHA’s point of view and understanding the supply and demand side opportunities and challenges. The discussion began with open-ended questions, allowing for new themes to emerge until saturation was reached.

Results:
ASHAs were willing to incorporate mental health identification (and referral) in their regular activities without additional perceived burden. ASHAs were easily able to identify severe mental disorders (SMDs). For substance use disorders (SUDs), due to factors such as normalization of substance consumption and stigma, there was a felt difficulty in the recognition by ASHAs. ASHAs’ difficulty in identifying the CMDs was because of poor awareness in both those with mental illness and ASHAs. Incentivizing the work of ASHAs was thought to yield more returns.

Conclusions:
ASHAs have the potential to be excellent resources for easy screening, identification, and follow-up of those with mental health concerns in the community. Policies to involve them need to evolve.
A cross-sectional study of various clinical and laboratory parameters in snakebite and their association with mortality at a tertiary care centre in Jharkhand
Authors: Kumar Awanish , Dungdung Ajit , Kumar Abhinav , Shashank  , Kumar Ravi , Pandey Vikas , Priya Shimpy 
Published: December 2022

ABSTRACT

Background:
Snakebite is a common occupational hazard in tropical countries such as India. India has the highest number of snakebites and accounts for nearly 50% of global snakebite deaths. Jharkhand is a state with abundant flora and fauna, with a large rural population, prone to snakebite deaths. We aimed to study various clinical and laboratory parameters in snakebite patients and their association with mortality.

Material and Methods:
This study was an analytical cross-sectional study conducted from October 2019 to April 2021. Snake-bitten individuals admitted in the in-patient department (General Medicine) of a tertiary care centre of Jharkhand state were included in this study. Information regarding gender, species of the snake, site of bite, symptoms (neurological and haematological), signs, reaction to ASVS, procedures performed (haemodialysis), general examinations, systemic examinations, and investigations were collected and analysed to predict mortality.

Results:
Out of 60 snakebite patients, 39 (65%) were males and 21 (35%) were females. Snakebite in 41.67% patients was because of unknown species, snakebite in 26.67% patients was because of Russell’s viper, snakebite in 21.67% was because of krait, and snakebite in 10% was because of cobra. 41.67% of individuals sustained bites over the right leg, 23.33% over the left leg, 18.33% over the right arm, and 15% over the left arm. Mortality was seen in 8 (13.33%) patients. Haemorrhagic manifestations including haematuria and haemoptysis were seen in 10 (16.66%) and 3 (5%) patients, respectively. Neurological symptoms were present in 27 (45%) patients. In laboratory examination, the total leucocyte count, international normalised ratio, d-dimer, urea, creatinine, and amylase were significantly high in the non-survivor group (all P values < 0.05). In this study, mortality was significantly associated with increased requirement of haemodialysis because of renal failure and an increase in duration of hospital stay (P value < 0.05). The duration of hospital stay independently predicts mortality with an odds ratio of 0.514 (95% confidence interval 0.328 to 0.805; P = 0.004).

Conclusion:
Early evaluation of clinical and laboratory parameters is needed to identify various complications (haematological and neurological) as they may prolong the hospital stay, leading to an increase in mortality.
Quality of life among those with diabetes mellitus type II attending a secondary outpatient facility in South India
Authors: Thomas Zachariah , Mathew Anna , Jowil Gabrin , Sriram M Karthick , Ranjan Manogya , Dhinagar Manoj J. , Abraham Vinod J. 
Published: December 2022

ABSTRACT

Context and Aim:
Diabetes mellitus (DM) can affect one’s quality of life (QoL). Literature on the association of QoL among type II diabetics with drug compliance and diet quality among rural communities is poor. This study aimed to determine the QoL among those with type II DM attending an outpatient clinic at a secondary hospital in Tamil Nadu.

Settings and Design:
A cross-sectional, interview-based study was carried out among those with type II DM. A questionnaire comprising the WHO-BREF tool, Diabetes Healthy Eating Index, Hill-Bone Medication Adherence Scale was administered to participants selected via systematic random sampling.

Results:
The prevalence of good QoL was estimated to be 51.7% (n = 45, 95% CI: 41.20–62.20). There was no association between good QoL and medication compliance. None of the patients had a good diet quality. Bivariate analysis revealed significant association (p < 0.05) between good QoL and higher education (OR-2.70), those not on medication for complications (OR-2.81) and decreased frequency of general random blood sugar (GRBS) monitoring (OR-2.44). Multivariable analysis adjusting for gender, education, treatment/medication for complications, hospitalisation for DM and GRBS frequency demonstrated significant association between good QoL, lack of medication for complications/co-morbidities and decreased GRBS monitoring frequency with likelihood ratios of 3.25 and 3.44, respectively.

Conclusions:
The drop in QoL observed could be due to the aftermath of the COVID pandemic. Keeping in mind the impact of healthcare interventions on the QoL of type II DM patients, primary physicians must consider dietary and treatment plans suited to their socio-economic status.
Is the National Institute of Health Stroke Scale a valid prognosticator of the aftermath in patients with ischemic stroke?
Authors: Ramachandran Kavitha , Radha Devarajan , Gaur Archana , Kaliappan Ariyanachi , Sakthivadivel Varatharajan 
Published: December 2022

ABSTRACT

Background:
Cerebrovascular disease is the second most common cause of death in people more than 60 years of age. Predicting the outcome of the stroke is a great challenge for physicians. Various risk factors such as age, sex, co-morbidities, smoking and alcohol habits, type of stroke, National Institute of Health Stroke Scale (NIHSS) score, modified Rankin Scale (mRS), and others play the role in the outcome of stoke.

Aim:
To assess the degree of impact of NIHSS score in comparison to the other traditional risk factors on the functional outcome and 30-day mortality by mRS in the patients with acute ischemic stroke.

Materials and Methods:
Patients with acute ischemic stroke and age more than 18 years were included. Their admission NIHSS score and the 30-day mRS were analyzed. Patients were divided into two groups as survivors and non-survivors.

Results:
The mean age of survivors and non-survivors was 59.77 ± 10.99 and 65.58 ± 6.67 years, respectively. The NIHSS score on day 1 for non-survivors was 21.21 ± 8.21, and almost half of this score was seen in survivors. The NIHSS score on day 1 had a significant association with mortality with a relative risk of 0.79 (95% CI = 0.70–0.89). The NIHSS score has 73.7% sensitivity and 74.1% specificity with cutoff value of 15.5 for discriminating the outcome of ischemic stroke.

Conclusion:
The NIHSS and mRS scales are simple, validated, easily applicable, and reliable tools for assessing the mortality and the functional outcome of ischemic stroke patients.
Cutaneous granular cell tumor: A case series, review, and update
Authors: Fahim Shabnam , Aryanian Zeinab , Ebrahimi Zahra , Kamyab-Hesari Kambiz , Mahmoudi Hamidreza , Alizadeh Nilufar , Heidari Nazila , Livani Fatemeh , Ghanadan Alireza , Goodarzi Azadeh 
Published: December 2022

ABSTRACT

Background:
Granular cell tumor (GCT) or Abrikossoff’s tumor is an uncommon neuro-derived tumor in which Schwann cells are found and express S-100 protein. Often, it is a benign lesion. Histopathologically, there are granular cell infiltrations through the entire dermis without necrosis which are periodic acid Schiff (PAS) stain positive and reactive with S-100. The aim of this study is the clinicopathological evaluation of GCT.

Material and Methods:
In this paper, we described the experience of 6 patients with a GCT in different locations (4 cases in the skin and 2 cases in the mucosa), for example, a case with a tumor in the abdomen and a keloidal-like presentation with a highly sclerotic pattern (an uncommon pathological feature). Another case developed a lesion secondary to physical trauma.

Result:
In one case, the presence of a lesion in the lower lip associated with actinic damage secondary to chronic sun exposure resulted in misdiagnosis with actinic cheilitis and squamous cell carcinoma.

Conclusion:
Histopathologically, there were granular cell infiltrations through the entire dermis without necrosis which are PAS-positive and reactive with S-100.
Propranolol-induced hyperkalemia in infantile hemangioma patients: How serious is it?
Authors: Alakeel Abduallah , Alsalman Hanan , Alotaibi Ghadah , Somily Haneen , Alsohime Fahad 
Published: December 2022

ABSTRACT

Background:
Infantile hemangioma is the most frequent benign vascular tumor of infancy, which has a specific clinical history of early growth, followed by spontaneous remission. Since the fortuitous discovery of propranolol’s efficacy in 2008, the management of infantile hemangioma has been quickly developing.

Methods:
This study is a retrospective cohort study. Electronic search in the patient’s registry of King Khalid University Hospital, Riyadh, Saudi Arabia, was performed using the keywords hemangioma, haemangioma, infantile hemangioma, and vascular tumors. The search revealed a total of 101 subjects for which 56 were included and 45 were excluded.

Results:
A total of 56 patients with infantile hemangioma were evaluated in this study. The majority were females. The F: M ratio is 3.4:1. The highest percentage of the patients was delivered by the elective cesarian section, that is, 23 (41.1%), followed by spontaneous vaginal delivery, that is, 19 (33.9%). Full-term patients were 27 (48%), whereas the pre-term patients were 21 (37%). The total number of patients who developed hyperkalemia while on propranolol was 12 (31%). There was no statistically significant difference (P > 0.05) between patients who developed hyperkalemia and patients who did not develop hyperkalemia in terms of gender, gestational age, mode of delivery, size and location of hemangioma, or concomitant topical timolol use.

Conclusion:
Hyperkalemia is benign and transient, although solid conclusive opinions cannot be drawn because of the small sample size and the retrospective nature of the study.
Delayed lung function testing after COVID-19 to detect persistent lung function abnormalities – The DELTA – COVID-19 lung function study
Authors: Nirmal Aparna S. , Venkitakrishnan Rajesh , Augustine Jolsana , R Divya , Cleetus Melcy , Vijay Anand , John Susan 
Published: December 2022

ABSTRACT

Background:
Coronavirus disease 2019 (COVID-19) has made its presence felt as the worst pandemic witnessed till date in the 21st century. The mortality and morbidity associated with COVID-19 does not end with the acute pneumonia and respiratory failure and consequences extend well into the subsequent weeks to months in a minority. After recovery from severe disease, symptoms, lung function abnormalities and radiological changes are known to persist for varying length of time in a small proportion of patients. Various studies report different incidences of lung function abnormalities post-COVID-19. The present study describes the occurrence, severity, pattern and risk factors for persistent lung function abnormalities post-COVID-19 patients.

Aim:
The present study was aimed to find out the occurrence of persistent lung function abnormalities in patients hospitalised with COVID-19 at three months of discharge who had normal previous lung function prior to COVID-19. In those with persisting abnormal lung function, the severity, pattern and risk factors for persistent lung function abnormalities were also studied.

Methods:
The present study was a retrospective study in patients hospitalised with COVID-19 who had radiological evidence of pneumonia at admission. Patients with prior abnormal lung function were excluded from the study. Lung function was analysed with spirometry, 6-min walk test and diffusion capacity between day 85 and 95 of hospital discharge and the occurrence, severity and pattern of impairment was described. Lung function impairment was correlated with baseline characteristics and univariate regression analysis was done to identify risk factors for persisting functional impairment.

Results:
39 patients were included in the study. Spirometry at follow up showed a restrictive ventilatory defect in 26 out of 39 patients (64%) and a normal study was noted in 12 patients. One patient had an obstructive ventilatory defect. Diffusion impairment was present in 27 patients and normal transfer factor was seen in 12 patients. The degree of diffusion impairment was mild in 16 patients and moderate in 11 patients. Univariate regression analysis revealed that age, history of systemic hypertension, severe hypoxia at presentation, and extent of lung involvement by CT chest were associated with lung function impairment.

Conclusion:
Almost two-thirds of patients hospitalised with COVID-19 pneumonia have persistent lung function abnormalities at three months post-discharge. Advanced age, severe disease and medical comorbidities increase the risk of persistent functional abnormalities.
Clinical manifestations and cultural correlates of psychogenic nonepileptic seizure symptoms: An Indian perspective
Authors: Sawant Neena S. , Umate Maithili S. 
Published: December 2022

ABSTRACT

Introduction:
Patients with psychogenic nonepileptic seizures (PNES) tend to have more frequent and disabling seizures than those which true epilepsy and are often misdiagnosed as epilepsy due to lack of clear diagnostic criteria and variations in clinical semiology. This study was an attempt to improve the understanding and type of clinical manifestations seen in patients of PNES and the cultural beliefs regarding their symptoms.

Materials and Methods:
In this cross-sectional observational study, 71 patients diagnosed with PNES by neurologists on the basis of their clinical presentation and a two hours normal VEEG recording were enrolled in the study after ethics approval. The clinical manifestations of PNES were recorded in detail along with details of various cultural attributions of the patients to the symptoms which were recorded in open- and closed-ended questions.

Results:
Clinical manifestations included verbal unresponsiveness (74%), whole body rigidity (72%), upper limb (55%) and lower limb movements (39%), vocalizations and head movements in less than 25%, and automatisms in only 6 patients. Pelvic thrusting as a manifestation was seen in only one patient. Thirty-eight patients attributed their symptoms to being possessed by God/ghost/evil spirit; nine to black magic being done on them; twenty-four patients did not relate symptoms to religious beliefs. Sixty-two patients had visited faith healers.

Conclusions:
This study is the first of its kind which looks at various clinical presentations of PNES patients in order to assess if there is any cultural basis for the symptoms.
Clinical profile of patients hospitalized with hemoptysis
Authors: Munjal Sushil Kumar , Natarajan Sekar , Vinay V , Meenakshisundaram Arunachalam 
Published: December 2022

ABSTRACT

Introduction:
Hemoptysis presents as a primary complaint in 8–15% of chest clinic patients. The etiology of hemoptysis varies among different series according to the time of publication, geographic location, and diagnostic tests employed.

Aim:
To study the clinical profile of patients hospitalized with hemoptysis at a tertiary respiratory care center in New Delhi, India.

Methods:
The study was a cross-sectional, observational, hospital-based study. Patients admitted with hemoptysis in emergency from November 2017 to April 2018 were enrolled. A total of 129 patients were evaluated by a detailed clinical history and necessary investigations deemed required for arriving at the diagnosis. Subjects’ hospitalized details were recorded using structured evaluation proforma. Data were evaluated using SPSS version 22.0. The ‘p’ value of less than 0.05 was considered statistically significant.

Results:
A total of 129 patients were recruited, with a mean age of 42.67 years, 59.7% were male. Mild, moderate, severe, and massive hemoptysis were seen in 15.5%, 46.5%, 25.6% and 12.4% cases, respectively. History of pulmonary tuberculosis treatment was present in 40.3%, recurrent hemoptysis in 38% and bilateral chest x-ray involvement in 62.6% cases. Tuberculosis (active and sequelae) was the most common cause (51.9%) of hemoptysis. Recurrent hemoptysis and low hemoglobin were found to be independent risk factors associated with the severity of hemoptysis.

Conclusion:
Tuberculosis remains a significant cause of hemoptysis in our country. Even one episode of hemoptysis should not be ignored and investigated properly as it can potentially cause massive hemoptysis and life-threatening complications in the future.