bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of frailty and its association with lifestyle factors among elderly in rural Bengaluru
Authors: Shilpa K , Norman G 
Published: May 2022

Background:
There are nearly 10.4 crores elderly in India, with 65% of them living in rural areas. Accessibility to healthcare is limited in rural areas. Primary care physicians deal with a fairly large number of patients from the geriatric age group. With the steady increase in the proportion of elderly, there is a corresponding increase in the prevalence of frailty. Frailty among the elderly leads to increased dependency, adverse health outcomes and mortality. Early identification and targeted interventions by primary care physicians could prevent these adverse outcomes and even reverse its occurrence. Knowledge about environmental and lifestyle influences on frailty would further assist primary care physicians to prevent and manage it optimally

Methods:
We interviewed 502 participants (>60 years of age) from four taluks of rural Bengaluru. Participants with frailty scores of 3 and above were considered frail, scores of 1-2 were considered prefrail. Association of frailty with lifestyle and environmental factors were tested using the Chi-square test. A value of P < 0.05 was considered significant

Results:
Prevalence of frailty was 24.70% and prefrailty was 62.75%. Elders in age group 60 to 74 years, those living alone or with others (other than the spouse), illiterate, working elders, elderly with less than two diagnosed comorbidities, elderly with low social score and low physical activity were associated with frailty

Conclusion:
The young old population seems vulnerable to frailty. Health programs aimed at prevention, early detection and treatment of morbidities and frailty will improve their health.
COVID-19 infection among health care workers
Authors: Jamil Md , Bhattacharya Prasanta K. , Barman Bhupen , Topno Noor , Narang Naku , Phukan Pranjal , Dey Biswajit , Saikia Bishwajeet , War Gwenette Andrea , Hynniewta Yasmeen 
Published: May 2022

Background:
COVID-19 can infect any individual, but the group most susceptible is the Health Care Workers (HCWs) who are directly involved in COVID-19 patient care. Despite adhering to the recommended personal prospective equipment, a disproportionately large number of cases of COVID-19 were reported among the HCWs.

Aims and Objectives:
To study the burden of COVID-19 infection among the HCWs and to study the probable factors associated with increased risk of COVID-19 infection among HCWs.

Materials and Methods:
A hospital-based prospective cross-sectional study was conducted at a tertiary care teaching institute in the state of Meghalaya, India for the period between 1st May 2020 and 30th June 2021 and included only laboratory-confirmed COVID-19 cases. Data collected included: A) Demographic data – age, gender, category of HCW, B) History of exposure, place of posting, C) Clinical presentation and disease category.

Results and Observations:
A total of 144 cases were included in the study. The mean age of affected HCWs was 33.83 ± 1.408 years and male to female ratio was 0.47:1. The commonest age group affected was 18 to 30 years of age (45.14%). The majority of the HCWs were Nursing Officers (staff) (52.78%) followed by Resident Doctors (18.06%). Out of all cases, 135 (93.75%) were either asymptomatic or had mildly symptoms. In 96 (66.67%) HCWs, there was high-risk contact with a known case of COVID-19. High-risk contact outside the COVID-19 designated area of the hospital was noted in 53 (36.81%) cases; however, only 22 (15.27%) patients had a history of working in the COVID-19 designated area at the workplace.

Conclusion:
The most common group that got infected was the nursing staff followed by the resident doctors, with more than ninety percent of the cases having either mild symptoms or were asymptomatic. The risk of contracting COVID-19 infection was higher in non-COVID-19 as compared to COVID-19 designated areas of the hospital.
Comparison of nutritional status of HIV positive children with homecare and institutional care/ orphanage – An eye opener cross sectional study
Authors: Pushkar Kumar , Hiremath Ravishekar N. , Gupta Rajul K. , Ghodke Sandhya 
Published: May 2022

Background:
Nutrition has an important bearing on the health of Human immunodeficiency virus (HIV) positive children. Ascertaining the nutritional demands correctly and provisioning the nutritional needs to HIV positive/ Acquired Immunodeficiency syndrome (AIDS) children will go a long way in maximizing the therapeutic benefits reaped through ever improving pharmaceutical initiatives, and thus, contribute to prolonging the longevity of these children who have a whole life ahead of them.

Objectives:
To study the nutritional status, including dietary assessment and anemia status of HIV-positive children, and compare the outcomes among children under homecare (staying with families) and orphanages/institutional care.

Methodology:
A cross sectional study was carried out among children between 2 and 15 years who were attending Pediatric Outpatient department (OPD) of a tertiary care hospital in western Maharashtra. Data were collected from 106 children by the interviewer himself using pretested validated questionnaire along with anthropometric measures and relevant blood tests. A 24-h recall method was used to collect the dietary intake. Institutional ethical clearance was taken, and data were collected through informed consent of the parent/guardian accompanying the children.

Results:
Out of the 106 subjects studied, 54 (50.9%) were living in orphanages and 52 (49.1) were living with the family. Out of the 52 subjects of children under caregivers, 48.1% of the caregivers were unskilled workers and more than half of the subjects had a monthly family income of less than Rs 3,000. About 46.1% of the subjects’ caregivers were illiterate. In the orphanage, 28 (51.8%) were males and 26 (48.2%) were females; 52 (49.1%) children were living with family of whom 30 (57.7%) were males and 22 (42.3%) were females. The prevalence of anemia (86.5%) and undernutrition (61.1%) was more among those living with family compared to the orphans living in orphanages and the same was statistically significant (P < 0.05). Among the children living in orphanages, the mean intake for most of the nutrients was more across all age groups. Within homecare, the mean nutrient intake of the females for all nutrients was more than the males across all age groups except 3–9 years, where it was more in males. Overall, all the children received less of water-soluble vitamins compared to recommended daily allowances (RDA), and the children of age group 5–15 years received less vitamin A and iron also.

Conclusion:
Adequate nutrition, which is best achieved through the consumption of a balanced healthy diet, is vital for health and survival for all HIV-infected children. Specific measures to be directed to children under homecare and measures directed to improve social factors need to be undertaken.
Poor sleep and the metabolic derangements associated with obesity in adult males
Authors: Ankita Annu , Mehta Bharati , Dutt Naveen , Nayak Prasunpriya , Sharma Praveen 
Published: May 2022

Context:
Short sleep and obesity have a causal association with each other. Obesity is also associated with metabolic imbalances. However, a subset of 20%–30% of obese population have only few metabolic complications, known as metabolically healthy obese (MHO) and rest with worsened metabolic profile are known as metabolically abnormal obese (MAO)

Aims:
To find the association between sleep quality and metabolic health of adult obese males.

Settings and Design:
The study was a cross-sectional study conducted at medicine out-patient department of the institute.

Methods and Material:
In this study, hundred adult obese males of age group 25–60 years, with Body mass index (BMI) ≥ 25 Kg/m2, were divided into MHO and MAO, based on their metabolic health using Joint Interim criteria. Sleep quality was assessed using Pittsburgh sleep questionnaire index (PSQI).

Statistical analysis used:
The data obtained were analyzed using PAST statistical software

Results:
The two groups MHO and MAO presented with significant differences in their mean age and BMI (P = 0.0001). The global score of PSQI was significantly high for MAO than MHO with mean values of 8.24 ± 3.60 and 6.65 ± 3.58, respectively (P = 0.016). Sleep disturbances score was significantly high in MAO (P = 0.0001). Significant associations were observed for global score with age, BMI, waist circumference, fasting blood sugar, and triglycerides

Conclusions:
Poor sleep quality was significantly associated with detrimental metabolic profile and BMI. The metabolic health worsened with increasing age and obesity.
Physician’s knowledge, attitude and practice of fixed drug combinations
Authors: Singh Alok , Dhaneria Suryaprakash , Gupta Dhyuti 
Published: May 2022

Objective:
The Indian pharmaceutical market is flooded with different fixed drug combinations (FDCs), many of which lack a rational justification. The study aimed to assess the knowledge, attitude, and practice (KAP) regarding FDCs among the physicians of a tertiary-care teaching center

Method:
The target sample size for this cross-sectional study was calculated as 75, and the study was conducted between February and August 2020 by using a content-validated questionnaire. Descriptive statistics had been utilized for data analysis, and Chi-square test had been applied for intergroup comparison (with P < 0.05 considered to be significant)

Results:
The mean age of the physicians who participated in this survey was 33.2 years. While 44% of them could identify all the potential advantages of using FDCs, only 09% could correctly recognize all the disadvantages associated with the same. Among the list of rational and irrational FDCs, only 49% could single out the irrational ones. And though the majority (83%) of the respondents do check for the rationality of FDCs before prescribing them, still out of 25 most commonly prescribed FDCs, 16 lacked any scientific justification for combination, and 09 (out of 16) had been banned by the Government of India

Conclusion:
The outcome of this cross-sectional questionnaire-based study reflects the deficit in the knowledge regarding FDCs, as well as incoherence among the knowledge, attitude, and prescription practice. Though the physicians have cultivated a healthy attitude towards prescribing FDCs, the same is not reflected in their practice. In order to rectify these disparities, the authors have proposed certain recommendations within this article.
Evaluation of the effect of intrauterine injection of platelet-rich plasma on the pregnancy rate of patients with a history of implantation failure in the in vitro fertilization cycle
Authors: Ershadi Sara , Noori Narjes , Dashipoor Alireza , Ghasemi Marzieh , Shamsa Nahid 
Published: May 2022

Objectives:
Implantation failure is a major problem in reproductive medicine, and despite the various methods described for treatment, there is little consensus on the most effective method. This study was conducted to investigate the effect of intrauterine injection of platelet-rich plasma (PRP) on the pregnancy rate of patients with a history of implantation failure in the in vitro fertilization (IVF) cycle.

Study Design:
In this study, women attending the infertility clinic of Ali ibn Abi Taleb Hospital, who had a history of implantation failure and were candidates for frozen embryo transfer (FET), were examined in Zahedan (Iran) in 2019. The patients were divided into two groups of PRP recipients and the control group. IVF was performed routinely, and in the PRP-receiving group, an intrauterine injection was given 48 h before embryo transfer (ET). The number of gestational sacs, the rate of implantation, the frequency of chemical and clinical pregnancies as well as the frequency of abortion were compared in the two groups. The collected data were analyzed by the SPSS software version 21

Results:
Ninety patients with a history of implantation failure participated in the study, and finally, the information of 85 patients was studied. The frequency of chemical pregnancy was 40% in the experimental group, 27% in the control group, and regarding clinical pregnancy, 33% in the experimental group and 24% in the control group, but there was no significant difference between the two groups. The rate of implantation, the mean thickness of the endometrium, and the frequency of abortion did not differ significantly between the two groups

Conclusion:
In patients with endometrial thickness greater than 8 mm with a history of recurrent implantation failure, intrauterine injection of PRP had no effect on the fertility outcome.
Impact of self-efficacy and sense of coherence on tobacco cessation motivation and readiness among slum dwellers in Ajmer city during COVID-19 health emergency
Authors: Vyas Deepika , Patel Mamta , Sharma Ashish , Chhabra Kumar Gaurav , Gupta Aditi , Mundra Rohit 
Published: May 2022

Background:
Tobacco cessation motivation majorly depends on self-efficacy and sense of coherence. Hence the aim and objective of the present study was to explore how self-efficacy (SE) in addition to sense of coherence (SOC) affected tobacco cessation motivation and readiness among slum dwellers during the COVID-19 health emergency.

Materials and Methods:
The ongoing research was a cross-sectional, descriptive questionnaire study. The research started in November and ended in December 2020. The research took place in primary health centres located in Ajmer’s urban slums. In this analysis, east, west, north and south directions of Ajmer were chosen at random from each direction, and each slum had an associated primary health centre (PHC). From these 16 PHCs, people coming from slum areas were interviewed. The questionnaire consisted of demographic details, tobacco motivation and readiness, SOC and SE.

Results:
The majority of study participants (178, 56.7%) were not seriously considering reducing their tobacco intake. The majority of study subjects had poor sense of coherence {137 (43.6%)}, self-efficacy {141 (44.9%)} and tobacco cessation motivation and readiness {156 (49.7%)}. Using the logistic regression model, it was discovered that study participants with high SE and a high SOC had a substantial impact on successful tobacco cessation motivation and readiness (P = 0.01*), (P = 0.00*).

Conclusion:
It was concluded that the study participants with high self-efficacy and high sense of coherence had a significant impact on good tobacco cessation motivation and readiness.
Estimate and determinants of SARS-CoV-2 RNA clearance time among non-severe COVID-19 patients
Authors: Aljunaid Mohammed A. , Albeshry Abdulrahman M. , Alshahrani Najim Z. , Barabie Samaher S. 
Published: May 2022

Objectives:
To estimate SARS-CoV-2 RNA clearance time among non-severe COVID-19 patients and explore factors associated with delayed negative conversion.

Methods:
A retrospective cohort study was conducted at the COVID-19 unit of a tertiary care center in the Western region of Saudi Arabia. Reverse transcriptase-polymerase chain reaction (RT-PCR) confirmed COVID-19 patients diagnosed between April 1 and June 30, 2020, were considered. The primary outcome was the time (days) from disease onset to first negative RT-PCR, which was analyzed using Kaplan–Meier and Cox regression survival methods. Demographic data, clinical history, baseline clinical, radiological and laboratory findings and management, and outcome data were collected and analyzed as factors associated with the viral RNA clearance time.

Results:
One hundred and forty-four patients were included. The mean (standard deviation [SD]) age was 36.93 (14.41) years, 50.7% were females, and 45.1% were healthcare workers. COVID19 was asymptomatic, mild and moderate in 11.1%, 71.5% and 17.4% of the participants, respectively. Fever (59.4%) and cough (58.0%) were the dominant onset symptoms. The mean viral RNA clearance time was 22.9 days (SD = 8.6; 95% confidence interval [CI] = 21.5–24.3 days). Extended clearance time was associated with older age (mean = 24.0 vs. 22.0 days; log-rank = 0.037), married status (23.2 vs. 22.6 days; log-rank = 0.021), working in health sector (24.2 vs. 21.8 days; log-rank = 0.006), and having a chronic disease (24.8 vs. 21.9 days; log-rank = 0.028), compared to their counterparts, respectively. In the adjusted model, the job sector was the only factor that was independently associated with clearance time. Non-healthcare sector showed hazard ratio 1.8 (95% CI = 1.3–2.7; log-rank = 0.002) with reference to healthcare sector.

Conclusion:
SARS-CoV-2 RNA clearance time is likely to be longer in non-severe COVID-19 patients, representing an additional risk for the virus dissemination among the community and calling for higher caution among the population.
Profile of comorbidity and multimorbidity among women attending antenatal clinics
Authors: Pati Sanghamitra , Puri Parul , Sinha Rajeshwari , Panda Meely , Pati Sandipana 
Published: May 2022

Background:
Multimorbidity is being recognized as a crucial maternal health challenge in India. However, pregnancy remains an exclusion criterion in most multimorbidity estimation studies resulting in a deficient understanding of the problem in this population. The present study aims to estimate the prevalence of multimorbidity, identify its correlates, and assess healthcare utilization and expenditure outcomes among women availing of antenatal care clinics

Methods:
An exploratory cross-sectional study was conducted among 127 pregnant women attending three antenatal clinics of Bhubaneswar, Odisha, from February to July 2016. Data were collected using a “multimorbidity assessment questionnaire for primary care,” contextualized for antenatal settings. The prevalence and correlates were determined using descriptive analysis, and the outcomes were measured by the number of healthcare visits, medications, and healthcare expenditure. About 15% of antenatal women were multimorbid

Result:
Anemia (52.6%), hypertension (31.6%), acid-peptic diseases (26.3%), and thyroid (26.3%) were the leading chronic conditions. Statistically, significant association was found between multimorbidity and medical consultation, the medicines consumed, and functional limitation. The healthcare expenditure was significantly higher among the multimorbidity groups

Conclusion:
Our findings suggest the inclusion of comprehensive multimorbidity assessment in routine antenatal screening. Preconception care should establish linkages between maternal and reproductive health with chronic disease prevention, and identify ways to reduce healthcare utilization and expenditure. Longitudinal studies to assess the trajectory and impact of multimorbidity on maternal and infant health are warranted.
COVID-19 vaccination hesitancy and attitude post-initiation of vaccination drive, a cross-sectional study across Odisha
Authors: Kuchi Sravya , Parida Swayam P. 
Published: May 2022

Objectives:
To find the prevalence of COVID vaccine hesitancy amongst people of Odisha and reasons for the same

Design:
Observational Study

Setting:
Outpatients, inpatients, and attenders in tertiary health centers in Khorda, Tangi, and Mendhasal, Odisha, India; online data via google forms from people across the state.

Duration of Study:
April to June 2021

Participants:
Convenience sampling of 450 adults aged between 18 and 60

Main Outcome Measure:
Willingness to get vaccinated against COVID-19

Results:
Hesitancy rate stands at 12.7%, with 5.7% in the urban setting and 20.9% in rural (CI 95%, P = 0.000), 3.1% amongst males and 25.4% females (CI 95% P = 0.000), and 42.6% amongst the homemakers. Main reasons for vaccine hesitancy include lack of knowledge about efficacy,fear of side effects, and testing positive despite taking the vaccine

Conclusions:
The near tripling of the hesitancy rates indicates a probable hindrance in stopping the spread of the infection. Family physicians have a significant role in alleviating the myths, counseling people, and managing adverse events.
Serum kallistatin as a marker of severity of liver fibrosis in cirrhosis
Authors: Kularaj Seetaram Singh , Verma Sudhir Kumar , Kumar Vivek , Patwa Ajay Kumar , Chaudhary Shyam Chand , Sonkar Satyendra Kumar , Gupta Kamlesh Kumar , Atam Virendra , Verma Sanjeev Kumar , Bhosale Vivek , Singh Shail 
Published: May 2022

Background:
Liver cirrhosis is among the leading causes of morbidity and mortality worldwide. Although liver biopsy is the gold standard for the assessment of liver fibrosis in cirrhosis, it has its own limitations. Therefore, noninvasive methods to detect liver fibrosis are widely preferred. However, they also have their own limitations. Thus, there is always a need to extend the battery of serum-based assays. Kallistatin is a protein synthesized primarily in the liver. As it is a negative acute-phase protein, its blood level decreases with a decline in liver function. In our study, we explored the relationship between serum kallistatin and radiological evidence of liver fibrosis by transient elastography to determine if kallistatin levels can be used as a diagnostic marker of liver fibrosis.

Materials and Methods:
A cross-sectional study of 1-year duration was conducted at a leading tertiary care hospital in northern India. Patients between 15 and 75 years of age having evidence of chronic liver disease were enrolled. All enrolled patients were evaluated by detailed history, physical examination, and relevant investigations. Serum kallistatin levels were quantified using the ELISA method. Grading of liver fibrosis was done using transient elastography. A FibroScan scoring card was used to convert FibroScan results measured in kPa into the Metavir scale F1–F4

Results:
A total of 128 subjects, including 64 patients with cirrhosis and 64 healthy controls, were enrolled. Our study suggested that FibroScan values were significantly higher in cases as compared to controls. The kallistatin level of cases was significantly lower than that of controls. An inverse correlation was found between FibroScan value and kallistatin level among cases

Conclusion:
We conclude that serum kallistatin levels are low in patients with liver fibrosis and can be used as a potential marker of liver fibrosis.