bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sale of antibiotics without prescription in stand-alone pharmacies in Tamil Nadu
Authors: Chandran Deena Sangeetha , Manickavasagam Prema Prathicksha 
Published: October 2022

Abstract

Background:
Non-prescription sale of antibiotics is one of the major causes for increased consumption of antibiotics which facilitates the emergence of drug resistance. Over-the-counter sale of antibiotics in India, without prescription and often at partial doses, is quite common even though the practice is not legal.

Objectives:
(1) To interview pharmacists about the sale of over-the-counter medication, and prescription drugs sold without a prescription, in particular; (2) to obtain an understanding of the reasons for such sale from the perspective of the pharmacist.

Methods:
Pharmacists were interviewed with the help of a pre-validated questionnaire in 15 stand-alone pharmacies in a metropolitan city and a tier-2 city in Tamil Nadu. Major points of interest were characteristics of customers requesting antibiotics without a valid prescription, common diseases for which they were sold without prescription, whether patients asked for antibiotics by name or as treatment for their symptoms, and reasons for such requests.

Results:
Pharmacists readily admitted to selling prescription drugs, including antibiotics without a valid prescription. While they know of antibiotic resistance, not a single pharmacist interviewed by us knew of the causes of antibiotic resistance.

Conclusion:
The intervention listed in the National Action Plan on Antimicrobial Resistance to develop awareness campaigns targeted at dispensers regarding existing rules and appropriate use of antimicrobials and mandatory training programs on optimal antimicrobial use must be implemented immediately.
Community response towards health care providers delivering health care services during COVID-19 pandemic: A strategy framework based on findings of a qualitative study in Odisha, India
Authors: Patel Kripalini , Mishra Bijaya K. , Kanungo Srikanta , Bhuyan Dinesh , Som Meena , Marta Brajesh , Pati Sanghamitra , Palo Subrata K. 
Published: October 2022

Abstract

Context:
While there are studies on peoples’ behaviour toward health professionals (doctors and nurses) during the Coronavirus diesease (COVID-19) pandemic in hospital settings, there is limited literature on Community Health Workers (CHWs). Our study attempted to explore the behaviour of community people towards CHWs during the pandemic and its underlying reasons.

Material and Method:
A qualitative study using In-depth interviews (IDI) and focus group discussions (FGD) was conducted among CHWs and community people from six districts of Odisha from February to April 2021. The researchers transcribed the audio recordings in the vernacular language of the Odisha province, i.e., Odia, and later translated them into English. A qualitative content analysis method was used to prepare the detailed report using Max Weber Qualitative Data Analysis (MAXQDA) software.

Result:
The study found two major categories-Reflection on community behaviour towards CHWs during the COVID-19 pandemic and reflection on availing health care services by community people during a pandemic. Many CHWs revealed that the community people acknowledged their work and dedication and extended all sorts of co-operation and support. However, few community people were non-cooperative and non-supportive. Community reluctance owing to perceptions that the CHWs might be infected, was the significant cause that they faced a lack of support from the community. Further, to create awareness of COVID-19 infection among community people, CHWs adopted different strategies such as door-to-door visits, wall painting, poster display, and awareness through mikes.

Conclusion:
The efforts made by the CHWs during health emergencies need to be recognized and appraised.
Health literacy on hygiene and sanitation, nutrition, and diseases among rural secondary school children – Findings from a qualitative study in Odisha, India
Authors: Patel Kripalini , Palo Subrata K. , Kanungo Srikanta , Mishra Bijaya K. , Pati Sanghamitra 
Published: October 2022

Abstract

Context:
Health literacy among school children is a priority to promote their health, hygiene, and nutrition behaviours and practices. Although in schools they learn from their peers and teachers, their domestic and social conditions also contribute to learning and adopting in practice. The level of health literacy is also influenced based on socio-demographic features.

Aims:
It is imperative to explore and understand the practices including existing gaps and challenges for future improvement.

Methods and Material:
A qualitative study consisting of 17 focus group discussions (FGDs) among students and teachers in six rural secondary schools was carried out in a rural block of the Cuttack district, Odisha. All FGDs were audio-recorded; transcribed and compiled data were imported into Atlas.ti for analysis.

Results:
An existing gap in health literacy and healthy practices with respect to hygiene and sanitation, nutrition, and diseases was observed. A low socio-economic status, inaccessibility to clean and safe drinking water, toilet facility, and nutritional food items were major factors preventing their health literacy and practice. Many schools have adopted measures such as poster presentation, practical teaching and demonstration, school play, and competitions at the school and in the community, which were found to be effective for creating awareness. Improving infrastructural facilities, ensuring availability of essential commodities, and having more health-promotional activities are required for improving health literacy and practice.

Conclusions:
There is an urgent need to improve the health literacy and practice among rural school children. Innovative practical-oriented education at schools and improved awareness among parents and community people would achieve better adherence to healthy practices.
Determining the relative frequency of ultrasound findings in women under 30 years of age with a breast mass
Authors: Roostaee Ayda , Soleimani Mahseta , Younesi Ladan , Poornia Sepideh Mirani , Lima Zeinab Safarpour 
Published: October 2022

Abstract

Introduction:
Mammography and ultrasound are the most reliable and common imaging techniques for early detection of breast mass. The aim of this study was to determine the relative frequency of ultrasound findings in women under 30 years of age by a feeling of mass in the breast.

Methods:
This cross-sectional study was performed on women under 30 years of age with a feeling of mass in the breast. The result evaluated in this study was the final opinion of the radiologist on the ultrasound report, which was expressed in the form of Breast imaging-reporting and data system (BIRADS) based on one to five scores. Ultrasound status of patients was reported to be normal, fibrocystic changes, and tumors (solid-cystic-mixed). The obtained data were analyzed using SPSS statistical software version 23. Significance level was considered to be < 0.05.

Results:
The most common reason for referral was palpable mass in the left breast (56.2%). The shape of the mass was oval in most cases (91.2%). The highest frequency in terms of mass margin was related to Macrolobulated (82.4%), Hypoechoic (85%), and Solid (87.6%). Most of masses belonged to 12 o’clock (21.2%). According to the standard sonography report based on BIRADS, the highest frequency belonged to B4a (57.5%). Pathology report showed that the highest frequency was related to fibroadenoma (71.4%).

Conclusion:
Considering that most of the cases in this research with a feeling of mass in the breast in women under 30 years of age were BIRADS 4, and among the cases that underwent biopsy, 14.5% were diagnosed with cancer pathology. Therefore, ultrasound examination is very important in these cases, even at a young age.
Client satisfaction with telemedicine services during COVID-19 pandemic: A cross-sectional survey from a teaching institute of North India
Authors: Aneja Jitender , Goyal Tarun , Verma Madhur , Kaur Gurpreet , Mirza Moonis , Gupta Satish 
Published: October 2022

Abstract

Introduction:
Telemedicine has emerged as an essential interface between health care providers and patients during the pandemic. The present study was done to assess this technology’s level of acceptance and satisfaction amongst the patients.

Methods:
We did a retrospective study amongst patients >18 years (n = 300) who had availed telemedicine services in different departments of a tertiary care hospital between May and August 2020. The patients were interviewed telephonically using a pre-tested semi-structured tool that collected information about the socio-demographic and clinical characteristics of the patients, and satisfaction was measured on a 5-point Likert Scale.

Results:
Fifty-five percent patients received teleconsultation via a telephone call, while the others preferred video calling services on WhatsApp messenger. Overall, more than 97% of the clients depicted satisfaction with the telemedicine services in three major domains: registration/appointment services, consultation with the doctor and post-consultation services. Some of the common feedback included difficulty in getting medicine using the scanned copy of prescription slip generated by the hospital, problems faced in reimbursement of the bills, long waiting period, and poor quality of video calls due to slow internet.

Conclusion:
Telemedicine proved to be an efficient means of communication for many patients during the pandemic. Though patient satisfaction was high with the services received by them, timely assessment of the problems encountered in the implementation of telemedicine services will help evolve the services not just during the pandemic but even after that.
Change in attitude and help-seeking pattern of caregivers and patients with mental disorders in the community - Recent findings from India
Authors: Raj Shirley , Das Sudipta Kumar , Pattnaik Jigyansa Ispita , Das Ramachandra , Das Namita , Ravan Jayaprakash Russell 
Published: October 2022

Abstract

Knowledge of factors related to patients’ and primary caregivers’ health-seeking behaviour is required for a complete early intervention for the management of mental illness. Previous research has found that men are more likely to seek care and that a considerable proportion of patients seek help from native healers before obtaining psychiatric help. The goal of this study was to see if there had been any changes in the paths to psychiatric care, as well as the socio-demographic characteristics that were linked to early help-seeking behaviour among patients with mental illnesses in metropolitan eastern India.

Method:
The researchers utilised a cross-sectional study design. A face-to-face interview was used to collect data using the WHO Encounter Form. Using a successive sample technique, patients with various diagnoses of mental illness undergoing Psychiatry outpatient therapy at a tertiary care medical college were included in the study.

Results:
In terms of gender, ladies (53.3%) were seen to use psychiatric services more than males (46.7%) from an urban or semi-urban background. For dissociative disorders, the median time from onset to first contact with a care provider was 0.1 years; 0.3 years for mood episodes; 0.6 years for anxiety disorders; one year for psychotic disorders; and seven years for Substance Use Disorders (SUD). However, interaction with current psychiatric services took an average of six months for dissociation; 3.5 years for mood disorders; three years for anxiety disorders; six years for psychotic disorders; and a maximum of seventeen years for SUD. Participants in the study who had a family history of mental illness sought care more quickly (OR = 4.3, 95 percent CI 1.19 to 7.11, P = 0.03). The fact that 73 percent of patients have a GP or mental health professional as their first point of contact for various mental diseases is good. Higher education status, urban background, dwelling closer to the mental health centre, and having a biological attribution model for psychological illness were the other clinical and demographic characteristics important for quicker paths to mental health treatment.

Conclusions:
In most cases of psychosis and SUD (substance use disorders), there is still a significant delay in receiving modern psychiatric therapy. The number of initial contacts with Native Healers ha s decreased. The majority of people said mental illness was caused by environmental or biological factors. Education and scientific information regarding mental health have aided the process of seeking treatment, and there should be a provision of training programmes for family physicians and community health professionals to facilitate the process of help-seeking behavior of psychiatric patients in the Indian subcontinent.
Hospice care in India: A review
Authors: Shukla Rushikesh , Singh Nihaal , Acharya Sourya , Shukla Samarth 
Published: October 2022

Abstract
Palliative care is the need of the hour, especially in a country like India where the number of terminally ill patients has always been a concern, and with projections showing this number to only go up and increase exponentially, it is much more important that we now shift our focus to providing quality hospice care to the ones that are in need of it. In this article, the authors start out by defining Palliative care and hospice care, all the while maintaining the distinct features of them both. Once the foundation is set for the same, we dive into the history of palliative care in this country and how it has evolved over the years. We then move on to the present scenario of hospice care in India and try to look at it through a more contemporary lens. Further, we discuss the impact of some diseases that most adversely affect individuals and require end-of-life care in its more advanced stages. These include, but are not limited to, end-stage cancer, multidrug resistant (MDR)–tuberculosis and Human immunodeficiency virus-associated acquired immune deficiency syndrome (HIV–AIDS). We then move on to discuss the importance of academic interventions to strengthen the role of hospice care in the India and how research and education can help improve the condition of end-of-life care in all domains. We finally talk about how we can move forward and what positive changes we can bring about in order to make inroads into better and more sustainable hospice care in the Indian context. We hope that our work will cause healthcare professionals, and other people alike to better understand the role of hospice care in their own lives and livelihoods.
Prevalence of pre-perimetric primary open angle glaucoma in hypertensives of North India
Authors: Garg Pragati , Malik Mehvish , Rai Nishant , Singh Abhay , Chellaiyan Vinoth G. 
Published: October 2022

Abstract

Background:
Systemic hypertension is alleged to increase the risk of glaucoma. As clinically Primary Open angle Glaucoma (POAG) is diagnosed only after approximately 40% of ganglion cell loss has occurred, therefore this study was commenced with an aim to determine the prevalence of pre-perimetric glaucomatous damage and its association with systemic hypertension using optical coherence tomography (OCT).

Materials and Methods:
A total of 680 study participants were enrolled in this cross-sectional study. Among them 340 patients were of systemic hypertension (Group 1) and 340 patients without hypertension (Group 2). All patients underwent detailed history, ocular and systemic examination including slit lamp examination, fundus examination by +90 D lens, Humphrey field analyser for field charting and OCT for nerve fiber analysis. For glaucomatous nerve damage.

Results:
Group 1 and Group 2 had Male: Female ratio of 1:8 and 1:9, respectively (P = 0.809). Maximum participants 48.8% and 54.4% in Group 1 and Group 2, respectively, were in age group 50–59 years. Statistically significant difference was seen in the percentage of pre-perimetric glaucomatous patients between the two groups (P < 0.001). On OCT analysis between pre-perimetric glaucomatous eyes and healthy eyes significant difference in thickness was seen in temporal inner macula, inferior outer macula, temporal outer macula, superior outer macula and nasal outer macula. Significant difference in volume was seen for inferior temporal and nasal outer macula (P < 0.001).

Conclusion:
In hypertensives, glaucomatous optic nerve damage starts much earlier before the obvious clinical signs of POAG appear, as compared to normotensive individuals.
The effects of intrinsic foot muscles strengthening exercises on foot kinetic parameters in pronated foot subjects during forward jump landing
Authors: Karimzadeh Atefeh , Kouhzad Mohammadi Hosein , Mehravar Mohammad , Zahednejad Shahla , Taheri Navid , Sadeghi Marzieh 
Published: October 2022

Abstract

Background:
Pronated foot is one of the most important factors that may lead to musculoskeletal injuries of the lower extremities. Among all treatments for this disorder, intrinsic foot muscles strengthening exercises (IFMSE) have an important role in management of the individuals with pronated foot. Although the effect of the IFMSE is well accepted in this population; however, their impacts on foot kinetic are yet to be clarified. The present study aims to identify the effects of the IFMSE on foot kinetic parameters in pronated foot individuals during forward jump landing.

Materials and Methods:
In this quasi-experimental study, 20 asymptomatic male and female subjects (mean age of 22.65 ± 2.51 years) with pronated foot structures were selected by using a simple non-random sampling method. The ground reaction force (GRF), rate of loading (ROL), and the resultant vector of time to stabilization (RVTTS) were examined during a forward jump landing task by using a force plate before and after six weeks of the IFMSE.

Result:
The findings showed that the following parameters were not significantly change before and after of the IFMSE: GRF (1.97 ± 0.49 vs. 2.03 ± 0.54, P =0.667), ROL (.09 ±0.12 vs. 08 ±.12, P =.632), and RVTTS (2836.60 ± 1144.62 vs. 2644.35 ± 704.71, P =.479).

Conclusion:
In the pronated feet subjects, the IFMSE alone was not capable of changing the kinetic parameters of the foot, or the duration of using these exercises. In this study, six weeks may not be enough to make changes the foot kinetic parameters and therefore these exercises should be used for a longer period of time.
Strengthening the immunization supply chain through EVM assessment: Comparing India’s two successive national assessments
Authors: Sharma Lokesh , Gupta Ginisha , Kapuria Bhrigu , Singh Snehil Kumar , Gupta Sanjay , Agarwal Mahesh Kumar , Thakur Harshad 
Published: October 2022

Abstract

Background:
Effective immunization supply chain (iSC) is crucial for safe and timely transport of potent vaccines to the beneficiary. India’s iSC, with a network of ~29,000 cold chain points (CCP), measures its quality standards using the World Health Organization–United Nations International Children’s Emergency Fund (WHO–UNICEF) global tool on effective vaccine management (EVM). The two national EVM assessments (EVMA) were conducted in 2013 and 2018. This study helps to see the impact of policies and practices through EVMA in maintaining an efficient iSC for effective implementation of immunization program.

Materials and Methods:
We conducted a desk analysis using EVMA reports to summarize and compare the findings of the two studies. Cut-off of 80% was considered ideal for each category/criteria score.

Results:
Both EVMA 2013 and 2018 were conducted using Android-based global EVM tool, though across a wider sample of CCP. Maximum and minimum changes in scores were sub-national and lowest distribution (16% each) and national buffer stores (7%), respectively. Maximum and minimum improvements were seen in vaccine management (29%) and MIS and supportive functions (3%), respectively. The improvement was statistically significant for the overall scores (P = 0.02), primary (P = 0.01), subnational (P = 0.02), and lowest distribution stores (P = 0.03). Among the 36 recommendations of 2013 assessment, 78% and 22% were fully and partially implemented (or ongoing), respectively.

Conclusion:
Implementation of EVM recommendations has significantly led to improvement and continues to provide a benchmark for iSC and its processes. Follow-up assessments every 3–5 years can further help to evaluate iSC and ascertain the impact of recommendations.
Study of cases of puerperal sepsis, its socio-demographic factors, bacterial isolates, and antibiotic sensitivity pattern
Authors: Singh Preeti , Tirkey Sarita , Trivedi Kiran , Hansda Rani , Prakash Jay 
Published: October 2022

Abstract

Objective:
Due to the lack of resources for culture and antibiotic susceptibility testing in most underdeveloped countries, puerperal sepsis is treated empirically with a wide range of antibiotics. Empirical treatment, on the other hand, does not ensure treatment effectiveness and may even contribute to antibiotic resistance. So, we studied cases of puerperal sepsis, its socio-demographic factors, bacterial isolates, and antibiotic sensitivity in a tertiary health center.

Material and Methods:
This was a cross-sectional study conducted at the obstetrics and gynecology department of a tertiary health center in India from April 2019 to September 2020. During this time, all patients with sepsis who met the criteria for inclusion were included. After granting an informed written consent, the subjects were registered on a pre-designed proforma.

Results:
There were 2,049 obstetrical admissions throughout this period, with 106 (5.1%) of these having puerperal sepsis. The majority of these women (58.7%) were between the ages of 21 and 30, were multiparous (96.5%), and unbooked. Fever 104 (98.1%) was the most prevalent clinical characteristic, whereas wound gape was the most common consequence (47.1%). Klebsiella aerogens was the most common organism found in various cultures. Many organisms were shown to be multidrug-resistant and sensitive to gentamycin and amikacin.

Conclusion:

Klebsiella aerogens wasthe most common cause of puerperal sepsis in this investigation. Because the causal agents of puerperal sepsis and their antibiotic sensitivity patterns change over time, positive blood culture and antibiotic susceptibility of the isolates are the best guides for selecting the optimum antimicrobial therapy for treating sepsis.