bluuebunny/crossref_metadata_2025_split huggingface dataset:
Medication Adherence and its Predictors among Type 2 Diabetes Mellitus Patients: A Cross-Sectional Study
Authors: Sharma Deepak , Goel Naveen Krishan , Cheema Yuvraj Singh , Garg Keshav 
Published: September 2023

Abstract
Medication adherence is vital in managing noncommunicable diseases like diabetes. Illness perception and an individual’s knowledge regarding the disease may influence medication adherence. The present study aimed to assess the prevalence and predictors of medication adherence among type 2 diabetic patients. A cross-sectional study was conducted among 400 diabetes mellitus patients attending an outdoor patient department (OPD) of a tertiary care hospital in North India. Brief Medication Questionnaire (BMQ) and Brief Illness Perception Questionnaire (B-IPQ) were used to study medication adherence and illness perception, respectively. Descriptive and analytic statistics were computed using Epi Info software for Windows (CDC, Atlanta, GA, USA). The prevalence of medication adherence was 79.5% (82/400). The odds of medication adherence increased with higher age (odds ratio [OR] = 1.8 [1.1–2.9]) and more duration of illness (OR = 1.8 [1.0–3.2]) Patients having good knowledge of diabetes were more likely to adhere to medications. [OR=1.8(1.1-3.1). Diabetes medicine-adherent patients had a higher perceived understanding of the disease, felt having lesser negative consequences, and were less concerned about the illness than their counterparts. A high proportion adhered to diabetes medication. The guiding factors to further improve medication adherence are age, duration of illness, illness perception, and knowledge regarding the disease.
Effectiveness of Diabetes Self-Management Education on Distress and HbA1C among Indian Type 2 Diabetes Mellitus Patients: A Randomized Controlled Trial
Authors: Anjali M , Khapre Meenakshi , Kant Ravi , Kumar Santosh , Pandey Pragya 
Published: September 2023

Abstract

Introduction:
The interrelationship of diabetes with mental illness has increased in recent years. Diabetes-related distress is the emotional burden, stress, and worries associated with diabetes, which does not reach the threshold for depressive disorder. A diabetes self-management education (DSME) is a structured educational approach to improve glycemic control and diabetes-related distress. This study aimed to assess the effectiveness of DSME in comparison with usual diabetes care in improving glycemic control and diabetes-related distress.

Material and Methods:
This is a single-center, parallel randomized controlled trial. A total of 106 participants were recruited for both intervention and control groups with 53 participants each. The control group received only routine outpatient department (OPD) care. The intervention group received DSME in addition to routine OPD care. Diabetes-related distress and HbA1C were assessed after 3 months. The data were analyzed using IBM Statistical Package for the Social Sciences (SPSS) version 25. Per-protocol analysis was done.

Results:
Of 127 patients screened, 106 met the eligibility criteria and were randomized. At 3-month follow-up, the reduction in mean HbA1C, fasting blood sugar (FBS), postprandial blood sugar (PPBS), and diabetes distress were significant in the intervention group compared with the control group (p 0.001). The mean HbA1C reduction in the intervention group was significant (mean difference: -1.3, SD: 0.4). The mean DDS had decreased significantly in the intervention group from 2 to 1.2 (mean difference: -0.8, SD: 0.1).

Conclusion:
The DSME was effective in improving the glycemic control, diabetes-related distress, and self-care among type 2 diabetes (T2DM) mellitus patients.
Mild Cognitive Impairment among Elderly Persons Residing in an Urban Resettlement Colony in Delhi
Authors: Achary MG Thejas , Kaur Ravneet , Vibha Deepti , Mani Kalaivani , Kant Shashi , Gupta Sanjeev Kumar 
Published: September 2023

Abstract

Background:
Mild cognitive impairment (MCI) is a transitional state between normal cognition and clinical dementia. MCI is associated with an increased risk of dementia and mortality. Progression of MCI to dementia can be prevented by cognitive and lifestyle interventions. There is limited evidence on the burden and risk factors associated with MCI in India. To estimate the prevalence of MCI among elderly persons, and to study the factors associated with MCI.

Materials and Methods:
This community-based cross-sectional study was carried out among 365 persons aged 60 years or older, residing in an urban resettlement colony of Delhi. Participants with dementia (score <23 on the Hindi version of the Mini-Mental State Examination) were excluded. Objective cognitive impairment and functional disability were assessed by the Montreal Cognitive Impairment-Basic (MoCA-B) tool and Barthel’s Activities of Daily Living, respectively. The prevalence of MCI was estimated by Petersen’s criteria, i.e., subjective memory impairment, objective cognitive impairment (MoCA score 19–25), functional independence, and absence of dementia. Univariate analysis was performed, followed by stepwise multivariate logistic regression. The association of socio-demographic and other health conditions with MCI was assessed.

Results:
The prevalence of MCI was 9.3% [95% confidence interval (CI) 6.7–12.7], 13.3% (95% CI 8.8–19.7) among men, and 6.5% (95% CI 3.9–10.6) among women. The risk of MCI was higher among current smokers.

Conclusions:
MCI was common among the elderly. Early detection of MCI may be included in health programs for elderly persons.
Disability Certification for Parkinson’s Disease in India: Challenges and the Way Forward
Authors: Arun M , Thomas Priya Treesa , Kamble Nitish L. , Yadav Ravi , Pal Pramod Kumar 
Published: September 2023

Abstract
Disability certification is mandatory for people with Parkinson’s disease to avail any schemes and benefits in India. The process of certification of the extent of disability in a complex disorder like Parkinson’s needs to be made less cumbersome and streamlined to ensure that people for whom the benefits are meant are able to avail them.
Relationship between parenting practices and behavioral problems of children attending a Tertiary Mental Health Institute of North East India
Authors: Ahmed Amina , Baruah A , Siddeswara L B 
Published: September 2023

Introduction:
The parent plays a vital role in promoting and supporting the overall development of children from infancy to adulthood. Parenting practices are related to different outcomes in children's life. Hence, the researcher aimed to assess the relationship between parenting practices and behavioral problems of children.

Subjects and Methods:
A quantitative approach and correlational design was used. Total 80 primary caregivers of children (6–17 years), attending a Tertiary Mental Health Institute of North East India were selected using systematic random sampling technique. Data were collected using Sociodemographic Pro forma, Alabama Parenting Questionnaire, Strength and Difficulties Questionnaire after obtaining written informed consent from the participants.

Results:
Overall 55% of the participants had scored toward more positive parenting practices and 56.2% toward less negative parenting practices. Regarding behavioral problems of children, 77.5% had total difficulty levels in the abnormal range with 52.5% at substantial risk for emotional symptoms, 78.8% for conduct problems, 43.8% for hyperactivity/inattention, and 73.8% for peer problems. Participant's negative parenting practices were positively correlated with total difficulty score as well as with conduct problems, hyperactivity, and peer problems. Finding further showed that participant's positive parenting practices had a significant association with their educational status, occupation, family income, place of residence, children's birth order, use of mobile phone by children, and negative parenting practices had a significant association with their history of substance use, fights between parent, and children's last academic performance. These findings can be incorporated for developing intervention module for parents of children in the hospital setting as well as in the community.
Exploring Burnout in Clinical Psychologists
Authors: Bhattacharyya Bidisha , Banerjee Ushri 
Published: September 2023

Objective:
Clinical psychologists, as professionals, come across various people and their problems frequently. Regular exposure to information which are distressing, stressful, and sometimes traumatic can create health issues and burnout, which is a psychological syndrome of emotional exhaustion, depersonalization, and reduced personal accomplishment, in them. A number of psychological variables can contribute to the burnout of clinical psychologists. The ones taken in this study are personality, empathy, countertransference (CT) and compassion fatigue. The study had been conceptualized to find the relation and contribution of the mentioned variables on burnout of clinical psychologists.

Methods:
Fifty one clinical psychologists participated in the study. Maslach Burnout Inventory, NEO Five-Factor Inventory, Questionnaire of Cognitive and Affective Empathy, Assessment of CT Scale and Compassion fatigue (CF), and satisfaction self-test for helpers were used for assessing the constructs. Relevant statistical analysis were performed.

Results:
Findings show that there are significant correlations between personality variables, i.e., neuroticism, agreeableness, and conscientiousness with other variables, i.e., compassion fatigue, empathy, and CT. Some of the personality variables are correlated to burnout. Empathy, CT, and CF contribute significantly to burnout.

Conclusion:
The study shows the probable indicators which can cause burnout in clinical psychologists, and which, if correctly addressed, may help in the maintenance of sound mental health among professionals.
Imaging Features of COVID-19 Pneumonia
Authors: Puvvada Charitha , Chetambath Ravindran 
Published: September 2023

ABSTRACT
Coronavirus disease 2019 after its origin in Wuhan, China, had spread globally and was declared as a pandemic by the WHO on March 11, 2020.? The WHO identifies it as a controllable pandemic with the key role existing in precautionary measures to curb the recent global crisis. The current diagnostic methodologies include the rapid antigen test, serology tests to detect antibodies, and the real-time polymerase chain reaction.? Anecdotal experiences have shown that imaging characteristics are crucial in the diagnosis and management of the disease as radiological evidence of disease appears before the clinical manifestations and evolves overtime as the disease progresses, which is useful in predicting the stage, severity, and prognosis of the disease. Owing to few specific features and early changes, computed tomography scan is more sensitive than a chest roentgenogram in highlighting these changes.
To Study the Efficacy of Transforaminal Epidural Steroid Injection in Relieving Lumbosacral Radiculopathy
Authors: Bhatti Mohd Javed , Pathak Vineet , Sajid Imran 
Published: September 2023

Objective:
The objective of this study was to evaluate the effectiveness of transforaminal epidural steroid injection (TFESI) using a preganglionic Kambin’s triangle approach for treating lumbar radiculopathy caused by nerve root compression due to lateral recess stenosis or posterolateral disc herniation.

Materials and Methods:
This prospective observational study was conducted between July 2018 and March 2021. A total of 70 patients were included in the study. However, 20 patients were lost to follow-up and 50 patients were followed up for 6 months post-injection. The epidural space was approached through the neuroforamen using 22-G spinal needles in 70 adult patients with lumbosacral radicular pain, and a mixture of 40 mg methylprednisolone and 0.25% plain bupivacaine (2 mL per level) was injected. Pain intensity and functional impairment were assessed with the Numeric Pain Rating Scale (NPRS) and the Oswestry Disability Index (ODI) scores, respectively, at the first visit, 3 months, and 6 months.

Results:
There was a mean reduction of 4.7 points in NPRS from a mean of 8.2 preinjection to 3.5 at 6 months follow-up (P = 0.001). Likewise, a mean ODI score of 29 was recorded at 6 months follow-up (mean reduction of 13.7 points in ODI score) as compared to 42.7 at baseline (P = 0.001).

Conclusion:
TFESIs provided significant pain relief and improved function in patients with low back pain with radiculopathy caused by nerve root compression due to intervertebral disc herniations.
A Randomized Controlled Trial Between Autologous Platelet-Rich Plasma Injection and Corticosteroid Injection in the Treatment of Plantar Fasciitis
Authors: Varshney Pankaj , Verma Ajeet Kumar , Agarwal Saumya , Prakash Shivank , Garg Pragya , Agrawal Prachi 
Published: September 2023

Background:
Plantar fasciitis is the most common cause of chronic pain beneath the heel in adults, which may cause significant discomfort and disability. Local corticosteroid injections are a popular method of treating the condition but only seem to be useful in the short term and only to a small degree. Autologous platelet-rich plasma (PRP) is rich in growth factor, which stimulates reparative process unlike corticosteroids.

Materials and Methods:
A total of 30 patients were allocated in each group. Group A consisted of patients who received single 2 ml local corticosteroid injection, that is 80 mg methylprednisolone acetate, and group B consisted of patients who received single 3 cc autologous PRP injection locally.

Results:
The postinjection mean Foot and Ankle Ability Measure (FAAM) score was significantly higher at 4 weeks, 8 weeks, and 12 weeks in the steroid group as compared to that in the PRP group, but at 24 weeks, the mean FAAM score was significantly higher in the PRP group as compared to that in the steroid group. This shows that the maximum effect of PRP on the FAAM score was at 24 weeks, whereas in the steroid group, it was at 12 weeks. Also the maximum effect of PRP on Visual Analog Scale was at 24 weeks, whereas in the steroid group, it was at 12 weeks. There was 39.21% reduction in mean plantar fascia thickness in the steroid group and 43.27% reduction in the PRP group.

Conclusion:
Autologous PRP therapy is better than local corticosteroid injection in the long-term effect.
Evaluation of Outcomes of Distal Femoral Fractures Treated by Retrograde Nailing Technique
Authors: Bhartiya Raj Kumar , Singh Santosh Kumar , Singh Pulkesh , Gill S.P.S. , Mishra Luxminath , Arora Jitesh 
Published: September 2023

Background:
Distal femur fractures are less common injuries accounting for approximately 1% of fractures in the elderly. They occur due to high-velocity injury in adults and simple fall in the elderly. Management of these type injuries in the elderly is more challenging because of osteoporosis. Retrograde nailing represents an established fixation method for fractures of the distal femur and offers an alternative to the existing technique of antegrade nailing.

Materials and Methods:
Prospective study of 70 patients, aged between 16 and 85 years, whose distal femoral fractures were treated with a retrograde femoral nail from December 2016 to November 2018 in the department of orthopedics of a tertiary care centre in North India were followed to assess the outcome of treatment. The fracture was caused by a motor-vehicle accident in 58 patients (82.85 percent) and a fall on the ground in 12 (17.14%). 26 (37.14%) of the fractures were open. All the patients were followed up at about 3 weeks, 6 weeks, 3 months, 6 months, and 1 year. On each visit pain, functional range of movements was noted and the union was assessed clinically and radiologically at regular intervals.

Results:
Out of 70 patients, 60 patients were males and the remaining patients were female. Twenty-six patients had open fractures and 44 patients had closed fractures. All the patients in our study united without any case of nonunion and knee infection. The mean time required to achieve union was 5.42 ± 2.48 months in closed fractures, while in open fractures, it was 5.7 ± 1.65 months. The mean range of knee movement in open fractures was from 15.0° ± 12.57° to 113.75° ± 14.69 °, while in closed fractures, it was from 5.38° ± 6.43° to 122.18° ± 15.0°. Five patients had loosening of the distal interlocking screws impinging on the skin. Based on the criteria recommended by Schatzker the outcome was assessed as excellent in 33 (47.14%) cases, good in 27 (38.57%) cases, and fair in 7 (10%) cases. The outcome in 3 (04.29%) cases was graded as poor.

Conclusions:
Retrograde intramedullary nailing makes possible a biological osteosynthesis of distal femoral fractures. It also produces good functional results even in elderly patients.
Perceived challenges and barriers for medical students in the COVID-19 crisis
Authors: Mohamadi Mohsen , Aghamirzaee Tahereh , Aqatabar Roudbari Jamileh , Mohseni Afshar Zainab , Taghvaee Yazdi Maryam , Kheirkhah Farzan 
Published: September 2023

BACKGROUND:
Unpredictable and immediate changes, especially in the clinical and practical fields of medical sciences following the coronavirus disease (COVID-19) epidemic, have posed many challenges for medical students. This study was conducted to identify the experiences and students' understanding of the challenges in the COVID-19 crisis.

MATERIALS AND METHODS:
The present qualitative research was conducted by performing semi-structured interviews with the students along with holding a student panel. The study population consisted of 30 clinical and basic medical students of Babol, Iran and Kermanshah universities of medical sciences who were selected by purposive sampling method. Data were collected based on students' perceived experiences of challenges, obstacles, and problems in the COVID-19 crisis. The data analysis process was performed by conducting interviews and information obtained from the panel using v10 R150410 software. Finally, the related factors and components were identified.

RESULTS:
Challenges and perceived obstacles of medical students in the COVID-19 crisis were identified in the form of eight factors including student life factors, interaction and communication, psychological factors, educational technology, factors related to the professors, limitations of educational and research planning, crisis management, and educational evaluation.

CONCLUSION:
Identifying the challenges of medical education perceived by students in this study and adopting appropriate strategies to overcome existing barriers open new opportunities for expanding the scope of the curriculum, providing education, and promoting community health to universities; moreover, the challenges of medical education and any skill-based discipline, such as medical sciences in the COVID-19 pandemic will require much attention and investigation in cognitive sciences.
Study protocol: The effect of motivational interviewing on self-management in adult kidney transplant recipients (MIAKTR)
Authors: Erdem Cigdem , Cebeci Fatma 
Published: September 2023

BACKGROUND:
The aim of the study is to examine the effect of motivational interview sessions on self-management that will be conducted in accordance with the post-discharge requirements of adult kidney transplant recipients. Patient-centered motivational interviews make a significant contribution to activating patients' sense of being capable of changing to realize their self-management.

MATERIAL AND METHODS:
This study is a single-center, single-blind, prospective randomized controlled trial. The participants of the study will consist of 80 kidney transplant recipients at an organ transplant center in Turkey. The study is a randomized controlled trial compatible with SPIRIT. The CONSORT flow diagram has been used in this study protocol. The sample will consist of participants within the 3rd, 4th, 5th, and 6th months after the kidney transplant. The measurements will be performed in the first and third months after the interviews. The study continues via the collection of data from the intervention and control groups.

CONCLUSION:
In order to support or improve the self-management of kidney transplant recipients, new tools are required that are suitable for this population. Patient-centered motivational interviews can make a significant contribution to activating patients' sense of being capable of changing to realize their self-management. The first motivational interview program to promote a healthy lifestyle in kidney transplant recipients, prevent unwanted conditions after transplantation, and improve self-management will be used in this study. After the intervention has been developed, we expect improvements in self-management with a motivational interviews through creating their own strategies for behavioral changes and improvements in health outcomes.
Assessing knowledge, attitude, and readiness to use e.health among doctors in a tertiary health care unit in Bhubaneswar city, Odisha - A cross-sectional survey
Authors: Mandal Yagnaseni , Jha Kunal , Kumar Gunjan , Singh Arpita , Barman Diplina , Menon Ipseeta 
Published: September 2023

BACKGROUND:
The term “”e-health”” refers to all technological applications in the delivery of a more affordable, high-speed, and widely accessible mode of health care. It is a definite solution to managing the public's health and well-being during the coronavirus disease (COVID-19) pandemic, and doctors from all fields of expertise are required to be at par with it in terms of knowledge, attitude, and readiness to use it to their advantage under the current circumstances.

MATERIALS AND METHOD:
A cross-sectional survey was conducted among the faculty, postgraduates, and interns of the medical and dental schools of a university, which used an expert-validated self-administered questionnaire assessing knowledge, attitude, and readiness to use e-health.

RESULTS:
Among the 400 participants, it was observed that the categories of age (P < 0.0001), gender (P = 0.018), designation (P = 0.031), and years of service (P < 0.0001) have significant differences across the groups. It was seen that the mean e-health knowledge (3.55 ± 0.52) and mean attitude (2.42 ± 0.59) to use e-health were more in dentists while participants from the medical field showed higher mean readiness (1.97 ± 0.58) to use e-health in daily practice. It was observed that male professionals had more mean knowledge (3.54 ± 0.60) than female professionals (3.43 ± 0.52) while female participants had more mean e-health readiness (1.96 ± 0.57).

CONCLUSION:
In a broad sense, the majority of participants responded positively to using e-health in their everyday practice. While medical doctors have a stronger outlook and preparedness, dentists showed more literacy and a supportive attitude to adopting e-health and telemedicine. Thus, it is necessary to step up comprehensive e-health workshops and training sessions for health care experts.