bluuebunny/crossref_metadata_2025_split huggingface dataset:
Knowledge and practice regarding menstrual hygiene and alternatives to sanitary pad among Indian undergraduate medical students
Authors: Nalini Y. C. , Gaonkar Sonal , Anjusha I. B. , Basavarajegowda Abhishekh 
Published: September 2022

INTRODUCTION:
While the availability and use of disposable sanitary pads have increased considerably in the last two decades, awareness about disposal and menstrual waste management has been neglected. This study was designed to determine the knowledge and practice of sanitary pad usage, disposal, and alternative methods of menstrual hygiene attitude toward menstrual leave among Indian undergraduate medical students.

MATERIALS AND METHODS:
The study participants were Indian undergraduate medical students. Self-administered online questionnaires were utilized, using Google Forms that requested personal details, menstrual history, usage and disposal of the sanitary pad, alternatives to the sanitary pad, and opinions about paid menstrual leave or sick leave policy. Quantitative data were summarized using mean and standard deviation, whereas qualitative data were summarized using percentages and frequencies. Data collected were analyzed using SPSS software version 20.

RESULTS:
Four hundred sixty-four students participated in the study. The mean age at menarche was 13 years. Menstrual bleeding lasted an average of 5.2 ± 1.6 days. Cycle length was 21–35 days in 92% of cases. Approximately 42.9% of respondents reported dysmenorrhea. 98% reported using the sanitary pad; among them, 48% reported they use a single pad (nonbio-degradable pads) for more than 6 h, and the most common mode of disposal is by wrapping in a newspaper. Menstrual cup followed by tampons is common alternatives to the sanitary pad. 48.7% reported that sometimes menstruation keeps them away from colleges. Eighty-two percent expressed menstrual leave policy of 1–2 days would be a positive and welcome move.

CONCLUSIONS:
Knowledge about sanitary pad disposal and alternatives is adequate among Indian undergraduate medical students but what is inadequate is the practice. Emphasis should be made on strategies that can be adopted to prevent the dumping of unsorted disposed of unsafe menstrual waste across the landfills resulting in a global health issue.
A comparative study on knowledge and awareness regarding type-2 diabetes mellitus and its complications among urban and rural patients
Authors: Darivemula Surendra Babu , Vishwajeeth G. , Pooja G. , Prathyusha G. , Pavani G. , Sahithya G. , Dharani G. , Shankar G. Ravi , Katkuri Sushma 
Published: September 2022

BACKGROUND:
Type-2 diabetes mellitus (DM) is the most challenging public health problem. Most of the people are unaware of the disease and its preventive measures and complications. It is important to acknowledge the gap in the knowledge and awareness of the disease to prevent the disease and effectively plan public health care.

METHODOLOGY:
This was a cross-sectional study with the objective to assess the level of knowledge and awareness regarding type-2 DM and its complications among urban and rural population and to compare them. The sample size was calculated as 404 among >30 years of age with Type-2 DM with >1 year of duration with or without complications. Data was collected on demographic details, knowledge, awareness, complications and lifestyle modifications by using the structured questionnaire. The collected data was compared among urban and rural patients and the association was seen between different factors by appropriate statistical test.

RESULTS:
The knowledge on normal blood sugar was (45.6% and 27.2%) in urban and rural, HbA1C (63.8% and 49.5%), family history of diabetes (59.4% and 43.1%), whether DM2 is a multi system disorder, monitoring of blood sugar levels and frequency of monitoring and checkups were found to be more in the urban compare to the rural with P < 0.05. The awareness on complications like the rate of complications with increase in time (66.3% and 57.0%), awareness of diabetic foot (52.9% and 37.1%), prone to infections (67.3% and 58.9%), prone to COVID 19 infection (74.7% and 64.9%), most common organ involved as the complication arise was kidney (39.6% and 33.7%) with P < 0.05.

CONCLUSION:
The study suggests that there is a need to improve knowledge about DM and its complications, and there is a need for diabetes-specific health awareness campaigns on behavior and lifestyle changes, adherence to treatment and self-care.
Challenges faced by 1st phase MBBS students during online teaching of competency-based medical education curriculum – COVID times
Authors: Sofia B Persis , Subhaprada S Cynthia 
Published: September 2022

BACKGROUND:
Competency-based medical education (CBME) is a learner-centered, outcome-based approach which motivates self-learning. Currently, the world is experiencing COVID-19 pandemic which led to shutdown of colleges, and hence, online teaching has become a key component in the continuity of medical education. The main aim of the study is to analyze the impact of COVID-19 pandemic on online teaching among 1st-year MBBS students and to assess the challenges faced during this time.

METHODS:
After obtaining institutional ethics committee clearance, a mixed-method study design was used to collect data from 100 respondents among 1st-year MBBS students of Kurnool Medical College, Kurnool, during the month of September 2020. A prevalidated, semi-structured questionnaire was sent to the participants through Google Forms. The quantitative analysis was done through survey questions on a five-point Likert scale.

RESULTS:
The reported challenges to online medical education during COVID-19 pandemic were lack of in-person communication (57%), technical issues while attending online classes (49%), difficulty in time management (50%), confusion in understanding course expectations/competencies (44%), and more focused on theory than practicals (59%). Some of them stated that “having online classes is really helpful than not having any classes at all.”

CONCLUSIONS:
Hence, we conclude that though challenges mentioned above were faced during online teaching of CBME curriculum, effective leadership and student teamwork would be helpful in successful online teaching.
Evaluation of quality of life using Sinonasal Outcome Test-22 among patients with chronic rhinosinusitis postendoscopic sinus surgery
Authors: Afolabi Abdulrahman O. , Uche-Okonkwo Kenechukwu , Shittu Nasiru O. , Ayodele Samuel O. , Busari Nafeesat O. , Segun-Busari Segun , Omokanye H. K. , Idris Saad O. , Alabi Biodun S. , Dunmade Adekunle D. , Ologe Foluwasayo E. 
Published: September 2022

BACKGROUND:
The background of this study was to assess the quality of life (QoL) of patients with chronic rhinosinusitis (CRS) before and after endoscopic sinus surgery Sinonasal Outcome Test-22 (SNOT-22).

MATERIALS AND METHODS:
This was an observational prospective cohort study carried out at the Ear, Nose and Throat Department of Kogi State Specialist Hospital, Lokoja, and University of Ilorin Teaching Hospital, Ilorin. Both of which are tertiary-level hospitals in North-Central Nigeria offering advanced rhinology services after ethical approval was obtained. The total score for each subject was derived from the 22-item psychometrically validated self-administered SNOT-22 questionnaire. Lower scores postoperatively represent better health-related QoL (HRQOL).

RESULTS:
A preliminary report of 40 consecutive patients with rhinosinusitis were enrolled. There were 19 males and 21 females aged between 16 and 80 years (mean age: 34.95 ± 2.69 years). There was a significant improvement in SNOT-22 scores from the preoperative period: 37–88 (mean: 67.45 ± 15.10) to 22–43 (mean: 31.73 ± 5.61) 6 weeks after surgery, giving a percentage improvement of 52.97% (P = 0.0002), thus statistically significant.

CONCLUSION:
SNOT-22 tool is a valuable tool to evaluate the HRQOL of patients with CRS and endoscopic sinus surgery as surgical intervention improves the HRQOL of patients with reduction in the mean score of all items in the SNOT-22 in the postoperative state compared to the preoperative state.
COVID-associated rhino-orbito-cerebral mucormycosis
Authors: Megharaj Priyanka C. , Patil Vikram M. , Reddy Santosh 
Published: September 2022

INTRODUCTION:
Rhino-orbito-cerebral mucormycosis (ROCM), a life-threatening, acute fungal infection of the nasal cavities and paranasal sinuses, once considered a rare and lethal complication in immunocompromised patients, is now having a massive increase in ROCM incidence in India associated with COVID-19, i.e., COVID-associated mucormycosis with more than 15,000 cases as of May 2021. Early imaging by computed tomography (CT) and magnetic resonance imaging (MRI) is not only helpful in assessing the extent of involvement of this lethal disease but also helps in early diagnosis leading to prompt and aggressive treatment. The present study is aimed at determining and comparing the imaging findings on CT and MRI in ROCM patients, for early diagnosis in suspected cases of ROCM.

MATERIALS AND METHODS:
The present study is a comparative study of CT and MRI done on 11 patients suspected of ROCM, for 2 months from May to June 2021.

RESULTS:
Among 11 patients in the study group, ranging from 29 to 65 years of age, 45.4% belonged in 41–60 years of age group, with female predominance. 90.90% cases (10 patients) had maxillary sinus involvement among which 7 cases were diagnosed with ROCM, followed by 63.60% cases (7 patients) had ethmoidal sinus involvement among which 6 cases were diagnosed with ROCM. The involvement of retromaxillary space, pterygopalatine fossa space and masticator space, and cellulitis in premaxillary and preseptal spaces were findings seen only in diagnosed cases of ROCM. Erosions of bones were seen in ROCM cases, 27.20% cases (3 patients) had erosions of walls of maxillary sinus and lamina papyracea each. Orbital involvement in the form of intraconal space and extraocular muscles involvement was seen in 27.20% cases (3 patients) each. Optic nerve involvement was seen in 18.10% cases (2 patients) followed by extraconal space involvement in 9.01% cases (1 patient). Taking KOH staining and/or histopathology (HPR) as standard of reference, CT has a Sensitivity (Sn) of 71.40%, Specificity (Sp) of 100%, Positive predictive value (PPV) of 100%, Negative Predictive Value (NPV) of 66%, and Diagnostic accuracy (DA) of 81% as compared to MRI which has a Sn of 85.7%, Sp of 100%, PPV of 100%, NPV of 80%, and DA of 90.9%.

CONCLUSIOIN:
CT and MRI play a complementary role in diagnosis of ROCM, as CT is better in detecting bone erosions, whereas MRI is better in detecting soft tissue, orbital and central nervous system involvement. In the acute state of emergency as in the current pandemic with rising cases of ROCM and acute shortage of amphotericin-B, MRI is the single best modality for accurate detection of ROC, helping clinicians in the judicious use of Amphotericin-B.
Decreasing fertility trend in Sikkim
Authors: Chauhan Bal Krishna , Bhutia Dechenla Tshering 
Published: September 2022

AIMS:
Factors determining low fertility in Sikkim, India.

PRIMARY OBJECTIVE:
The primary objective was to determine the factors for the low fertility in Sikkim.

SECONDARY OBJECTIVE:
The secondary objective was to find out the prevalence of contraceptive use and its types in Sikkim.

SUBJECTS AND METHODS: Study Setting:
The study was conducted in the State of Sikkim.

Study Period:
The study period was 1 year (from February 2020 to January 2021).

Study Population:
The study population was female counterpart of the eligible couple. An eligible couple refers to a currently couple wherein the wife is in the reproductive age, which is between 15 and 49 years.

Inclusion Criteria:
Inclusion criteria were female counterparts of the eligible couple who consent to participate in the study.

Exclusion Criteria:
Exclusion criteria were male counterparts of the eligible couple.

Study Tool:
Structured pre-tested questionnaire was used to take the interview of the participants.

Statistical Analysis Used:
SPSS version 25 was used for statistical analysis.

RESULTS:
It was seen that having two or more children was higher for mothers who had married below 30 years than after 30 years with 14.9% and 6.9%, respectively (P = 0.03) and maximum mothers belonged to 30–34 years age group. The perception of the family size of the mother was that three-fourth (76.1%) responded to having two children, whereas 10.7% perceived one child to be sufficient and 13.2% mentioned having three or more. The overall contraceptive prevalence rate was found to be 73.8%.

CONCLUSIONS:
Causes for low fertility rate are multifactorial; some important ones are the perception and practice of concise and small family size and high contraceptive prevalence rate.
Hydrogen gas promotes apoptosis of lung adenocarcinoma A549 cells through X-linked inhibitor of apoptosis and baculoviral inhibitor of apoptosis protein repeat-containing 3
Authors: Zhang Yu , Chen Gang , Yan Zhenfeng , Wang Lifei , Wang Dongchang 
Published: September 2022

Objective:
Lung cancer is currently the cancer with the highest incidence and death toll worldwide. Hydrogen gas has been found to affect a variety of diseases; however, the effect of hydrogen gas on patients with lung cancer has not been reported. Therefore, we determined the effect of hydrogen gas on apoptosis of lung adenocarcinoma in vivo and in vitro.

Materials and Methods:
A549 cells in the logarithmic phase were treated with 20%, 40%, or 60% hydrogen gas. Cell apoptosis was evaluated by flow cytometry. The A549 cell suspension was inoculated into 15 nude mice. The mice were randomly divided into control, hydrogenation (inhalation of 60% hydrogen gas), and cisplatin groups (intraperitoneal injection of cisplatin [4 mg/kg]). After 3 weeks, the tumor tissue was removed and measured. We identified differentially expressed genes by transcriptional profiling. The levels of X-linked inhibitor of apoptosis (XIAP), baculoviral inhibitor of apoptosis protein repeat-containing 3 (BIRC3), and BCL2-associated X and apoptosis regulator (BAX) protein expression were detected by Western blotting and immunohistochemistry.

Results:
Compared with the control group, the apoptosis rates in the 20%, 40%, and 60% hydrogen gas groups were significantly increased (P < 0.01). The levels of XIAP and BIRC3 protein expression were clearly decreased in the hydrogen gas group compared to the control group. Moreover, cisplatin and hydrogen gas reduced the tumor volume in nude mice (P < 0.01). Transcriptome sequencing showed that XIAP, BIRC2, BIRC3, BAX, PIK3CD, and ATM were related to apoptosis. Hydrogen gas further decreased the levels of XIAP and BIRC3 expression than in nude mice (P < 0.01).

Conclusion:
Hydrogen gas promoted apoptosis of A549 cells by reducing the expression of XIAP and BIRC3 protein.
Low-grade adenosquamous carcinoma of the breast: A rare case presentation
Authors: Abrari Andleeb , Shehwar Durre , Akhtar Kafil 
Published: September 2022

ABSTRACT
Low-grade adenosquamous carcinoma of the breast is a rare variant of metaplastic mammary carcinoma. It shows indolent behavior contrary to the usual aggressive nature of metaplastic carcinomas and has a good prognosis despite being triple negative. Recurrence rates tend to be high and a consequence of incomplete excision. Although this variant has an infiltrative growth pattern, owing to its bland cytologic features, it is liable to be confused with benign sclerosing adenotic breast lesions. We present here a case of a 55-year-old postmenopausal female, who presented with a painless, mobile, hard, and nontender lump in the lower outer quadrant of the left breast, with normal overlying skin and nipple–areola complex. No associated axillary lymphadenopathy was seen. On mammography, a high-density mass of architectural distortion, characterized as BIRADS category 4C, was found. Core-needle biopsy showed haphazard glands lined by a double layer of epithelium and nests of squamoid cells arranged in an infiltrative fashion within a fibromyxoid stroma. On immunohistochemistry, tumor cells showed a lack of expression of estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 receptor and were positive for CK 5/6 and CK7. There was counterintuitive, but characteristic positivity for myoepithelial markers calponin and CD 10 around the neoplastic nests and stromal cells expressed smooth muscle myosin. Subsequently, the patient underwent a wide local excision with free margins and sentinel lymph nodes were negative for tumor deposits. This patient remains well and free of recurrence well into follow-up.
Stromal microenvironment namely angiogenesis, tumor-infiltrating lymphocytes, and matrix metalloproteinase in invasive breast carcinoma
Authors: Srivastava Gunjan , Pant Leela , Kudesia Madhur , Singh Sompal , Gupta Ruchika 
Published: September 2022

Background:
The role of stromal microenvironment in growth, invasiveness, and metastatic potential of breast carcinoma (BC) is being recognized increasingly, both to predict prognosis and as potential therapeutic targets. The present study aimed to evaluate the correlation of angiogenesis, tumor-associated lymphocytes, and stromal CD10 expression with clinicopathologic parameters.

Materials and Methods:
This study included 100 consecutive cases of invasive BC undergoing modified radical mastectomy. Relevant clinical details, pathological grade, lymph nodal status, and clinical stage were noted. Paraffin-embedded sections were subjected to immunohistochemistry for CD34, CD20, CD45RO, and CD10. Microvessel density (MVD), tumor-associated lymphocytes, and stromal CD10 expression were estimated from these sections. Statistical analysis was done using nonparametric tests to correlate the clinic-pathologic features with each of these parameters.

Results:
MVD was found to be significantly higher in Grade III, node-positive cases, and higher stage breast cancers (P < 0.05). The number of T-lymphocytes was higher in node-positive cases, while B-lymphocytes were lower in number in higher grade tumors. CD10 expression showed a significant positive association with tumor grade, nodal status, and stage (P < 0.05 for each).

Conclusion:
This study demonstrates that changes in stromal microenvironment of BC such as MVD, tumor-associated lymphocytes, and stromal CD10 expression correlate with the clinicopathological parameters and hence may be exploited as prognostic markers or therapeutic targets, based on further larger studies.
Morbidities and Health-Seeking Behavior of Elderly Patients Attending Primary Health Care in the Kingdom of Bahrain
Authors: Bahram Samya , AlSayyad Adel Salman , Al Nooh Fatima , Al Farra Wafa , Al Ekri Ali 
Published: September 2022

Background:
Understanding the health-seeking behaviors help in increasing the effectiveness and efficiency of the health-care system; however, there is lack of knowledge regarding the health-seeking behavior of the elderly population in the Kingdom of Bahrain.

Objective:
The objective of this study was to identify the morbidity profile and determine the health-seeking behavior of the elderly population.

Methods:
This cross-sectional study included all elderly patients (≥60 years) who attended four primary health-care centers that represent four governorates with the largest catchment area in the Kingdom of Bahrain between June 19 and August 31, 2021. Information concerning their sociodemographic data, morbidity profile and health-seeking behavior were collected through direct interviewing using a structured, predesigned and pretested questionnaire.

Results:
A total of 414 elderly patients were included, with the majority being Bahraini (89.1%) and male (55%). The most prevalent morbidity was hypertension (67.6%), followed by hyperlipidemia (54.7%), diabetes (52.6%), and arthritis (32.1%); arthritis was significantly more common among females than males (P < 0.001). The majority reported the reason for their visit being “repeat prescription” (32.1%). Almost one-third (28.2%) attempted self-management prior to their visit, and almost half (46.7%) reported seeking non-professional medical advice. The majority rated their health as good (39.4%) and moderate (38.2%). Less than one-third (28%) reported having had a health problem for which they did not attend to a health care facility.

Conclusion:
The study highlighted the morbidity profile and the health-seeking behavior among elderly population in Bahrain, which may serve as a point from which further efforts may be directed to improve the services.
Faktor Risiko Kanker Serviks Pada Wanita Lanjut Usia Di Rsd Gunung Jati Kota Cirebon
Authors: Lelly Euis 
Published: September 2022

Berdasarkan data dari Yayasan Kanker Indonesia (YKI) tahun 2016, Penderita kanker di Indonesia pada tahun 2016 sebesar 17,8 juta jiwa dan tahun 2017 menjadi 21,7 juta jiwa. Setiap tahun tidak kurang dari 15.000 kasus kanker serviks terjadi di Indonesia. Wanita yang terdiagnosa kanker serviks rata-rata berumur >45 tahun keatas atau memasuki fase lanjut usia. Penelitian ini bertujuan untuk mengetahui faktor resiko wanita lanjut usia penderita kanker serviks di RSD Gunung Jati Kota Cirebon. Desain penelitian ini menggunakan deskriptif. Populasi dalam penelitian ini yaitu seluruh wanita yang menderita kanker serviks berdasarkan data rekam medis di RSD Gunung Jati Kota Cirebon yang berjumlah 30 responden. Hasil penelitian berdasarkan perilaku seksual, tidak bergonta-ganti pasangan (28%) dan bergonta-ganti pasangan (6,7%), berdasarkan paritas, kurang dari 1 anak (20%) dan lebih dari 3 anak (80%), berdasarkan penggunaan pembersih vagina, menggunakan (26,7%) dan tidak menggunakan (73,3%). Bagi petugas kesehatan diharapkan dapat melakukan penyuluhan tentang kanker serviks dan pencegahan serta pemeriksaan skrining test, agar mencegar penyakit kanker serviks di usia lanjut.
Pengaruh Teknik Relaksasi Napas Dalam Terhadap Penurunan Nyeri Haid Pada Remaja Putri Di Wilayah Kerja Uptd Puskesmas Panglayungan Kota Tasikmalaya
Authors: Rica Arieb  , Kunnati  
Published: September 2022

Indonesia angka dismenorea sebesar 64,25% yang terdiri dari 54,89% dismenore primer dan 9,36% dismenorea sekunder. Biasanya gejala dismenorea primer terjadi pada wanita usia produktif 1-5 tahun setelah mengalami haid pertama dan wanita yang belum pernah hamil. Tujuan penelitian ini untuk mengetahui pengaruh teknik relaksasi napas dalam terhadap penurunan rasa nyeri haid pada remaja putri di wilayah kerja UPTD Puskesmas Panglayungan Kota Tasikmalaya. Metode penelitian ini menggunakan desain penelitian analitik eksperimental jenis pre eksperimental dengan pendekatan pretest-post test one group design. Populasi dalam penelitian ini adalah semua remaja putri yang mengalami nyeri haid di UPTD Puskesmas Panglayungan Kota Tasikmalaya yaitu sebanyak 50 responden dan teknik pengambilan sampel menggunakan non probability sampling yaitu purposive sampling. Teknik pengumpulan data yang digunakan dalam penelitian ini yakni yaitu data primer dan data sekunder. Instrument penelitian ini menggunakan wawancara, observasi,dan angket (kuesioner) dan data di analisa secara univariat dan bivariate. Tempat penelitian dilakukan di UPTD Puskesmas Panglayungan Kota Tasikmalaya dan waktu penelitian akan dilakukan pada bulan Mei 2020. Hasil penelitian ini menunjukkan bahwa Ada pengaruh Teknik Relaksasi Napas terhadap Nyeri Haid pada remaja putri di UPTD Puskesmas Panglayungan Kota Tasikmalaya Tahun 2020 dengan hasil uji statistic dengan uji t tes berpasangan (paired sample t – test) diperoleh hasil p = 0,002 yang berarti p < 0,05. Hasil penelitian ini hendaknya dapat menjadi bahan perbandingan bagi peneliti yang akan datang dalam melakukan penelitian berikutnya tentang teknik relaksasi nafas dalam terhadap nyeri haid pada remaja putri terutama mengenai variabel-variabel penelitian yang belum diteliti.