bluuebunny/crossref_metadata_2025_split huggingface dataset:
A study on the knowledge and practices of menstrual hygiene among the adolescent girls of Nagaon, Barpeta District, Assam
Authors: Boruah Beeva , Hakmaosa Annamika , Hajong Sudipta 
Published: November 2022

ABSTRACT

Background:
The onset of menstruation is an important event in a woman’s lifecycle. It is associated with taboos and sociocultural restrictions. Faulty hygienic practices increase the risk of reproductive tract infections (RTI), leading to further complications if left untreated. With this background, the study was planned to assess adolescent school girls’ knowledge of menstruation and menstrual hygiene as well as their practices of menstrual hygiene.

Materials and Methods:
A community-based cross-sectional study was conducted in Nagaon, Barpeta district, Assam, among 170 adolescents aged between 10 and 19 years, using a convenient sampling technique. A predesigned, pretested, semi-structured questionnaire was used to collect the information from the study participants. Data analysis was done using SPSS version 17 and the results were expressed in percentages.

Results:
The study reveals that 91.76% of the adolescents knew that menstruation was normal. About 27.65% of the study participants did not know the cause of menstruation, and 54.12% did not know about the source of menstrual bleeding. Only 33.53% knew that uterus is the source of bleeding. About 61.76% of the study participants knew about the duration of a normal menstrual period. Regarding practices, 74.12% of the adolescents use sanitary pads during menstruation, 18.82% use cloth, and 7.06% use both cloth and sanitary pads. In about 63.53%, the method of disposal of used absorbent was throwing with domestic waste.

Conclusion:
The current study has revealed that menstruation and menstrual hygiene knowledge is poor among adolescent girls and practices regarding menstrual hygiene are not optimal.
Comparative study between “case-based learning” and “flipped Classroom” for teaching clinical and applied aspects of physiology in “competency-based UG curriculum”
Authors: Kumar Tarun , Sakshi Pooja , Kumar Chandan 
Published: November 2022

ABSTRACT

Background:
The new curriculum is competency-based and revised. The student must be imparted and should have learned these competencies. New teaching–learning methods such as “Case-based learning (CBL)” and “Flipped classroom (FCR)” can help medical students to be competent Indian medical graduates.

Aims and Objectives:
This study was aimed to evaluate the effectiveness of “CBL” over “FCR” for teaching clinical and applied aspects of physiology.

Materials and Methods:
Faculty and residents of the department of physiology and first-year MBBS students were introduced and oriented to the study and concept of CBL and FCR. Students were divided into two groups; one was taught clinical and applied aspects of cardiovascular physiology by CBL and another group by FCR. Pre- and post-test with a validated questionnaire were conducted for both groups. Feedback from the students was collected on 5-point Likert’s scale and the marks obtained by them were analyzed statistically by paired t-test.

Results:
Both CBL and FCR improved the post-test marks significantly when compared to pre-test marks (P < 0.0001). CBL and FCR methods showed no significant difference, but the mean post-test marks were higher in FCR. As per the students’ feedback, 62% of students strongly agreed that CBL is useful for clinical and applied aspects of physiology.

Conclusion:
CBL and FCR both are equally important and complementary to each other. CBL was found to be slightly more effective for later days of clinical practices, whereas FCR slightly more effective for better performance in university examinations.
Coverage of home-based newborn care and screening by ASHA community health workers: Findings from a household survey in Chhattisgarh state of India
Authors: Garg Samir , Dewangan Mukesh , Krishnendu C , Patel Kavita 
Published: November 2022

ABSTRACT

Background and Objectives:
Community health workers known as Accredited Social Health Activists (ASHAs) provide home visits for home-based newborn care (HBNC) in India. The objectives of the study were to assess coverage of HBNC, to assess current practices of newborn care by the care providers and to assess status of screening of sick newborns by ASHAs in rural Chhattisgarh.

Methods:
The study was a quantitative cross-sectional study. Multi-stage random sampling was applied to draw a representative sample from rural Chhattisgarh. The survey collected primary data of 1928 newborns by interviewing the caregivers. Descriptive statistical analysis using cross tabulations was performed. Confidence intervals at 95% were computed for key indicators.

Results:
ASHAs were present during 84.3% of the deliveries. 74.1% newborns received the designated six home visits from ASHAs whereas 3.6% newborns did not receive any visits. Coverage of different important messages ranged from 74% to 90%. Around 95% of newborns were screened by ASHAs for signs of sickness. ASHAs identified 12.9% of newborns as sick. Of the identified sick newborns, 48.1% were referred by ASHAs to health facilities, whereas 34.7% were treated directly by ASHAs by using amoxicillin. Early initiation of breastfeeding was reported for 85.4% of newborns and skin-to-skin contact was practiced for 63.6%.

Conclusions:
ASHAs were able to achieve an adequate coverage of HBNC in rural Chhattisgarh. Uptake of desired newborn care practices by caregivers was found. Identification of sick newborn was also adequate. Further research is recommended to identify factors facilitating the coverage under HBNC.
Effect of single-dose methotrexate injection to prevent neoplastic changes in high risk complete hydatidiform mole: A randomised control trial
Authors: Biswas Jhuma , Dasgupta Shyamal , Datta Mallika , Datta Mousumi , Saha Santa , Pradhan Parthapratim 
Published: November 2022

ABSTRACT

Background:
Complete hydatidiform mole affects women in their reproductive age. About 15-20% develops persistent molar gestational trophoblastic neoplasia (GTN), which is linked with delayed (beyond 56 days) normalization of serum βHCG after surgical evacuation.

Objective:
The objective of the article is to shorten the duration of normalization time of βHCG with single-dose methotrexate injection in women with high risk complete hydatidiform mole (CHM) after suction evacuation.

Methods:
Total 76 women with CHM were randomized into intervention and control groups. In the intervention arm (n = 34) women received single dose 100 mg intramuscular methotrexate injection post evacuation and the control group (n = 42) had standard care. Surveillance was done in both groups at two weeks intervals for next six months and duration of normalization of βHCG level was recorded.

Results:
Total 94.7% women completed follow-up. Mean of normalization time was significantly lower in the intervention group compared to controls (9.7 weeks versus 14.7 week; P < 0.01). Time to event curve showed significantly earlier cumulative normalization time for the intervention group.

Conclusion:
Single-dose 100 mg methotrexate injection is a low-cost, simple intervention to help one out of three women with CHM with high-risk features to achieve normalization of βHCG within 56 days. This might be helpful for people in resource-poor countries where adherence to prolonged surveillance is poor.
The clinical course and risk factors in COVID-19 patients with acute kidney injury
Authors: Shahidi Shahrzad , Vahdat Sahar , Atapour Abdolamir , Reisizadeh Shadi , Soltaninejad Forogh , Maghami-Mehr Asieh 
Published: November 2022

ABSTRACT

Background:
Acute kidney injury (AKI) has the most prevalent complications in COVID-19 patients. A variety of factors is involved in the disease progression and its associated outcomes. The present study aimed at both examining the correlated clinical features of COVID-19 disease and AKI and evaluating its clinical outcomes.

Materials and Methods:
In the present retrospective study, 102 COVID-19 patients that encountered AKI were enrolled and categorized into three AKI stages. Basic and clinical characteristics, clinical signs and symptoms, laboratory and imaging findings, and treatment approaches were examined. Then, clinical outcomes as well as the factors associated with the mortality of patients were evaluated.

Results:
Diabetes was the only significant clinical characteristic among the patients (P = 0.004). An increasing trend was observed for neutrophil-to-lymphocyte ratio (P = 0.027) and potassium (K) (P = 0.006), and a decreasing trend was seen for hemoglobin (P < 0.001), albumin (P = 0.005), and calcium (P < 0.001) factors at higher stages of AKI. Secondary infection (P = 0.019) and hypoproteinemia (P = 0.018) were the most significant clinical outcomes. Chronic obstructive lung disease (OR = 1.362, P = 0.007), renal replacement therapy (OR = 2.067, P = 0.005), lung consolidation (OR = 0.722, P = 0.032), and bilateral pulmonary infiltration (OR = 4.793, P = 0.002) were the factors associated with mortality rate of COVID-19 patients with AKI.

Conclusion:
AKI, as an important complication of COVID-19, that can predict the higher mortality rate as well as the laboratory and clinical characteristics should receive more due consideration in order to employ proper preventive or supportive treatment approaches that are the pivotal key to reduce the mortality rate in target patients.
Investigation of nurses’ readiness levels in different wards of the hospital
Authors: Khosravi Shaqayeq , Dehkourdi Narges Jafari , Mousivand Farhad , Gapleh Najmeh 
Published: November 2022

ABSTRACT

Introduction:
The level of nurses’ readiness and knowledge can significantly influence on the quality of treatment and patients’ health. Nurses should have a high level of knowledge and understanding of clinical care and its aspects. According to this issue, our study has been performed with the aim to compare the readiness of different wards of the hospital in evaluating important indicators of clinical care.

Methods:
This descriptive cross-sectional study was performed on 99 medical staff working in different wards of the hospital – during July 2020 to December 2021. Nurses in different wards of the hospital were compared in terms of care indicators. The tool used was a checklist for the effectiveness and evaluation of clinical care. The data were analyzed by SPSS statistical software.

Findings:
About 16.3% of the nurses were male, and 85.7% were female. Nurses in different wards were significantly different in terms of catheter and ligament care, blood transfusion and products, serum therapy and IV therapy, communication and training skills, pharmaceutical processes, and working with ventilators (p < 0.05). Emergency and general wards’ nurses showed better readiness for pharmaceutical processes and emergency, and neonatal intensive care unit (NICU) ward nurses showed the best readiness in relation to catheter care and absorption and excretion processes and blood transfusion and products (p < 0.05).

Conclusion:
Despite an appropriate readiness in many wards, care readiness was placed on a lower extent in some wards. There were also limitations, strengths, and weaknesses in some aspects, including medication, care and standards, and infection control, which, because of this issue, can help improve nurses’ performance in the future.
Facilitators and barriers influencing the post-crash emergency care of road traffic injuries in district Aligarh of Uttar Pradesh
Authors: Urfi  , Khalique Najam , Ahmad Anees 
Published: November 2022

ABSTRACT

Context:
Road traffic injuries (RTIs) will become the fifth leading cause of death by 2030. It is often possible to mitigate the consequences of serious injury if victims have access to prompt, effective pre-hospital care within minutes following the crash.

Aims:
To find out the facilitators and barriers for providing post-crash emergency care in Road traffic injuries in district Aligarh.

Settings and Design:
The present study was undertaken on both the National highways (NH-91 and NH-93) and the bypass roads passing through district Aligarh of Uttar Pradesh.

Subjects and Methods:
All the individuals who met road traffic accidents (RTA) between the earmarked areas from 1st October 2018 to 30th November 2020 and reported for treatment to the selected hospitals were included in the study.

Statistical Analysis Used:
Data is presented in the form of frequency tables and percentages.

Results:
A total of 1126 patients were interviewed during the study period. Out of 1126, 937 (83.2%) were males, and 189 (16.8%) were females, with M:F ratio being 4.96:1. Six hundred sixty-two (58.8%) of the respondents identified the layperson or common man as the first person to respond at the time of the crash. 1110 (98.58%) respondents identified the layperson as the facilitator in providing post-crash emergency care, followed by police and roadside shopkeepers/dhabawalas. The role of the layperson in calling for help by utilizing the helpline numbers, suggesting a nearby health facility together with facilitating for transportation of the victim to the nearby health facility was appreciated by the majority of the respondents. An ambulance was the best available mode of transportation. Seven hundred thirty-three (65.10%) of the total respondents were aware of the toll-free number to be dialled in case of RTA. However, only 320 (43.70%) among them used this toll-free facility after meeting the crash.

Conclusion:
A layperson is the single most important facilitator for providing post-crash emergency care.
Comparing community-driven COVID-19 vaccine distribution methods: Faith-based organizations vs. outpatient clinics
Authors: McElfish Pearl A. , Rowland Brett , Hall Spencer , CarlLee Sheena , Reece Sharon , Macechko Michael D. , Shah Sumit K. , Rojo Martha O. , Riklon Sheldon , Richard-Davis Gloria , Marin Luis Paganelli , Laelan Melisa , Maddison Benetick K. , Alik Eldon , Selig James P. 
Published: November 2022

ABSTRACT

Background:
Minority and low socioeconomic communities may face practical barriers to vaccination, including decreased access to health care and less trust in healthcare organizations; however, few studies have focused on these barriers as the cause of differential vaccine uptake. We worked with community partners to implement and evaluate two community-driven approaches to COVID-19 vaccination distribution—through faith-based organizations (FBOs) and outpatient clinics—with a focus on understanding the differences between the populations who accessed each distribution method.

Methodology:
Participants who came to the vaccination locations were approached and asked to complete a survey during their 15 min post-vaccination observation period. Differences between distribution locations were examined using Chi-square tests.

Results:
The survey rendered 1,476 valid responses, with a total of 927 participants recruited at clinical locations and 519 at FBOs during vaccination events. There were significant differences by race/ethnicity, with distribution methods at FBOs reaching a higher proportion of Hispanic/Latino and Marshallese participants. The proportion of uninsured participants who had lower health literacy and had lower educational attainment was higher with the FBO distribution method. FBO participants were more likely to report “completely” trusting the COVID-19 vaccine. There was no significant difference between FBO and clinic participants with regard to the level of vaccine hesitancy. There were no statistically significant differences with regard to access.

Conclusion:
A higher proportion of Hispanic/Latino and Marshallese participants utilized FBOs for vaccination, suggesting collaborations with FBOs can potentially increase vaccination uptake among minority communities and help mitigate vaccination disparities.
Mortality analysis of COVID-19 cases during the second wave and its comparison with the first wave: A hospital-based study
Authors: Goyal Pooja , Sikary Asit Kumar , Sachdeva Ruchi Arora , Parashar Lokesh , Tarique Aamir 
Published: November 2022

ABSTRACT

Objectives:
This study was undertaken to determine the characteristics of COVID-19 deaths during the second wave and to compare these characteristics with the mortality during the first wave in a dedicated COVID hospital (DCH).

Study Design:
It was a hospital record–based descriptive study.

Methodology:
The study was conducted in a tertiary care COVID hospital, using a standard death audit proforma. The data were analyzed to know various demographic characteristics and factors related to mortality during the second wave from March to June 2021. The findings were compared with the mortality data during the first wave from April to July 2020 at the same hospital.

Results:
A total of 264 deaths occurred at the center during the study period with a mortality rate of 22.8%. Male cases were more in number, the age group was 21–70 years, the highest number of mortality was seen in the mid of the study period, duration of stay was five days on average and common causes of death were pneumonia alone or with acute respiratory distress syndrome with sepsis. In comparison to the first wave, the mortality rate was four times higher, the age group was younger and opportunistic infections viz. mucormycosis and aspergillosis were present during the second wave.

Conclusion:
The mortality rate was significantly higher and the younger age groups were involved during the second wave, with opportunistic fungal infections due to the use of immunomodulators.
Factors associated with diarrhea in children under 12 years of age referred to Ostad Motahari hospital of Jahrom in 2020
Authors: Mogharab Vahid , Rajput Shabnam 
Published: November 2022

ABSTRACT

Background and Objective:
Despite the relatively high prevalence of diarrhea among children, clinical features and factors associated with the incidence of diarrhea in children have not been yet studied in Jahrom. Therefore, this study aimed to determine the factors associated with diarrhea in children under 12 years of age referred to Ostad Motahari Hospital of Jahrom, Iran, in 2020.

Materials and Methods:
The present study was a descriptive cross-sectional study, in which 385 children under 12 years of age with diarrhea complaints were selected using the census sampling method. The checklist used to collect data included patient-related factors, maternal factors, family factors, type of diarrhea, and stool test.

Results:
There was a significant relationship between the availability of proper hand-washing facilities, the use of water purifier, a history of antibiotic use, and the incidence season with a possible factor of diarrhea, type of diarrhea, the frequency of diarrhea per day, and pus cell outcome (P < 0.0001). However, no statistically significant relationship was observed between the availability of safe drinking water, travel history of patients, and consumption of raw or undercooked foods with a possible factor of diarrhea and OB/OP results (P < 0.05).

Conclusion:
Recognizing environmental risk factors to inform parents about preventing diarrhea in children can be an effective strategy to avoid imposing a heavy financial burden on the health system.
Telogen effluvium after COVID-19 vaccination among public in Saudi Arabia
Authors: Alharbi Mana 
Published: November 2022

ABSTRACT

Background:
Number of reports linked Telogen effluvium to coronavirus disease 2019 (COVID-19) infection. However, data about Telogen effluvium after COVID-19 vaccination are limited.

Objectives:
To estimate prevalence of Telogen effluvium among those who received COVID-19 vaccination.

Methods:
A cross-sectional study was performed during July 2021. Adults who received one of recognized COVID-19 vaccine irrespective of previous COVID-19 infection were asked to fill a questionnaire.

Results:
The majority of participants were females (90.3%). The most common age group was between 21 and 30 years (51.9%). Out of 991 participants who were included in the current analysis, 670 (67.6%) reported post-vaccination hair fall. The probable causes of post-vaccination hair fall were vaccine-related in 185 (27.6%) participants, other causes in 326 (48.7%) participants, and unclear in 326 (48.7%) participants. Post-vaccination hair fall was significantly higher among females compared with males (68.5% versus 57.9%, P = 0.036), those who did not suffer compared with those who suffered from hair fall before vaccination (72.1% versus 63.4%, P = 0.003), and those who did not report compared with those who reported preexisting conditions that might be related to hair fall (74.5% versus 57.3%, P < 0.001).

Conclusion:
We are reporting a high prevalence of post-vaccination hair fall, which affected approximately two-thirds of participants who received COVID-19 vaccines. Only 28% of these participants were apparently vaccine related. The role of COVID-19 infection and stress caused by infection and vaccine cannot be excluded. Primary care physician and dermatologist need to consider the possibility of COVID-19 vaccine as a potential cause of hair loss.
Analysis of daily COVID-19 death bulletin data during the first two waves of the COVID-19 pandemic in Thiruvananthapuram district, Kerala, India
Authors: Krishnan Retnakala Anjali , Ravindran Rekha M. , Vincy V. S. , Arun P. , Shinu K. S. , Jithesh V. , Varma Ravi P. 
Published: November 2022

ABSTRACT

Context:
Coronavirus disease 2019 (COVID-19) mortality trends can help discern the pattern of outbreak evolution and systemic responses.

Aim:
This study aimed to explore patterns of COVID-19 deaths in Thiruvananthapuram district from 31 March 2020 to 31 December 2021.

Setting and Design:
Secondary data analysis of COVID-19 deaths in Thiruvananthapuram district was performed.

Materials and Methods:
Mortality data were obtained from the district COVID-19 control room, and deaths in the first and second waves of COVID-19 were compared.

Statistical Analysis:
We summarised data as proportions and medians with the inter-quartile range (IQR) and performed Chi-square tests to make comparisons wherever applicable.

Results:
As on 31 December 2021, 4587 COVID-19 deaths were reported in Thiruvananthapuram district, with a case fatality rate of 0.91%. We observed high mortality among older persons (66.7%) and men (56.6%). The leading cause of death was bronchopneumonia (60.6%). The majority (88.5%) had co-morbidities, commonly diabetes mellitus (54.9%). The median interval from diagnosis to hospitalisation was 4 days (IQR 2–7), and that from hospitalisation to death was 2 days (IQR 0–6). The deaths reported during the second wave were four times higher than those of the first wave with a higher proportion of deaths in the absence of co-morbidities (p < 0.001). The majority of the deceased were unvaccinated. Ecological analysis with vaccine coverage data indicated 5.4 times higher mortality among unvaccinated than those who received two vaccine doses.

Conclusions:
The presence of co-morbidities, an unvaccinated status, and delay in hospitalisation were important reasons for COVID-19 deaths. Primary level health providers can potentially help sustaining vaccination, expeditious referral, and monitoring of COVID-19 patients.