bluuebunny/crossref_metadata_2025_split huggingface dataset:
Middle ear status – structure, function and pathology: A scoping review on middle ear status of COVID-19 positive patients
Authors: Sebothoma Ben , Khoza-Shangase Katijah 
Published: August 2022

Background: The coronavirus disease 2019 (COVID-19) pandemic is the latest public health emergency that has presented challenges globally. Limited evidence exists on the association between COVID-19 and middle ear pathologies, regardless of the respiratory nature of some of the core symptoms.Objective: This scoping review aimed at exploring evidence on the effects of COVID-19 on middle ear functioning as part of symptom mapping and preventive planning for ear and hearing care.Method: Electronic bibliographic databases, including Medline, ProQuest, PubMed, Science Direct, ERIC and Scopus, were searched to identify peer reviewed publications, published in English, between December 2019 and January 2022, related to the effects of COVID-19 on middle ear functioning. The keywords used as MeSH terms included ‘middle ear pathology’, ‘middle ear disorder’, ‘otitis media’, ‘hearing loss’, ‘hearing impairment’, ‘audiology’ and ‘COVID-19’ or ‘coronavirus’.Results: From eight studies that met the inclusion criteria, the findings revealed that middle ear pathologies occur in this population, with the occurrence ranging from 1.15% to 75%. Tympanic membrane structural changes, otitis media and conductive hearing loss (CHL) were commonly reported. The current findings must be interpreted with caution given that most of the studies reviewed had extremely small sample sizes or were case studies or series, thus limiting generalisability.Conclusion: The findings highlight the value of strategic research planning to collate data during pandemics, ensuring that future studies use appropriate and well-designed methodologies. Trends and patterns of middle ear pathologies in this population must also be established to determine the need for periodic monitoring.
Prevalence of erectile dysfunction in Type 2 diabetes mellitus (T2DM) and its predictors among diabetic men
Authors: Parmar Ramkesh S. , Verma Stuti , Neelkamal  , Pathak Vineet K. , Bhadoria Ajeet S. 
Published: August 2022

Background:
Diabetes mellitus (DM) is one of the common causes of morbidity and mortality globally. It has also been associated with erectile dysfunction (ED) adding to poor quality of life. The present study aimed to determine the prevalence of ED and its predictors among diabetic men.

Material and Methods:
A hospital-based cross-sectional observational study was conducted at a tertiary care centre including 357 diabetic men recruited over one and half years. ED was identified using International Index of Erectile Function score and independent predictors were identified using multiple logistic regression analysis.

Results:
ED was found in 212 (59.38%) diabetic males. A strong negative correlation was found between potency score and age (r = −0.647), and a moderate negative correlation with duration of DM (r = −0.324), systolic blood pressure (SBP), and diastolic blood pressure. BMI, fasting blood sugar, serum cholesterol, and serum creatinine showed a weak negative correlation with potency score. Serum testosterone level showed a strong positive correlation with potency score. Age, SBP, duration of diabetes, fasting blood sugar, and serum-free testosterone (P < 0.05) were independent predictors of ED.

Conclusion:
Prevalence of ED is high in diabetic males. Better blood sugar control and blood pressure control could reduce sexual dysfunction in diabetic men and improve quality of life.
The first consultation with a depressed patient
Authors: Arroll Bruce , Roskvist Rachel , Moir Fiona , Walsh Esther , Louis Deana , Buttrick Lily , Khalil Nada , Mount Vicky , Dowrick Christopher 
Published: August 2022

Background:
The first consultation with a depressed patient is important because many patients do not return for subsequent visits. Therefore, the first consultation provides a unique opportunity for diagnosis (if required) and treatment, but there are risks of both under and over-diagnosis.

Aim:
To understand how general practitioners utilize diagnosis when patients present with a new episode of depression.

Method:
We approached a random selection of twenty-one general practitioners (GPs) in Auckland, New Zealand and asked them to participate in a semi-structured telephone interview. The interviews explored “the first consultation for a depressed/distressed patient” were undertaken to theme saturation. Interviews were hand-written and later transcribed.

Results:
We identified three major themes in GPs’ approach to diagnosis. The issue of diagnosis was underpinned by a complex understanding of depression and the GP role. GPs did not always make a formal diagnosis, but the experience of a patient’s distress/depression was understood by drawing on a range of factors and resources. These included time, screening tools, clinician experience, and patient affect. GPs were careful about how they communicated a diagnosis, both in their documentation and in their conversations with patients.

Conclusion:
At an initial appointment, the distressed/depressed patient can present to their GP with various symptoms and differing degrees of distress. GPs draw upon a variety of skills and resources to negotiate these complexities. The value of a diagnosis was questioned and issues such as impairment may be more useful concepts for GPs. This is the first study to report the findings of the first visit.
Prevalence of fall and associated risk factors among the elderly living in a rural area of Kolar
Authors: Bhoomika Venkateshappa , Chandrappa Muninarayana , Reddy Mahendra M. 
Published: August 2022

Background:
Falls in elderly persons are one of the leading causes of death. Falls are responsible for 10–15% of all emergency department visits among elderly. The study was conducted to determine the prevalence of falls in rural areas and to assess the various socio-demographic factors associated with falls.

Methodology:
It was a community-based, cross-sectional study conducted in Rural Health Training Centre (RHTC), Devarayanasamudra, Department of Community Medicine, among the elderly persons aged ≥ 60 years. The total sample size was 511, calculated using a previous study using OpenEpi software. The data were collected using a pretested semi-structured questionnaire. The period prevalence of falls was assessed by asking for history of falls in the past 12 months. Chi-square and regression analysis were performed with statistically significant P value defined as less than 0.05.

Results:
Out of 511 elderly persons aged ≥60 years, females accounted for about 54.8% and most of them were of 60–69 years age-group. The majority of the study subjects were illiterates (77.3%), and most of them were married (77.2%). The prevalence of falls in elderly persons was 46.8%. The elderly aged ≥70 years, females, chronic diseases, and use of walking aid were observed to have a statistically significant association with falls (p < 0.005).

Conclusion:
Elderly falls are very common. The primary healthcare providers in rural areas play an important role in prevention of falls in elderly. Caregivers, along with elderly, should be given more detailed health education related to fall prevention.
Foot care knowledge, attitude and practices of diabetic patients
Authors: Alharbi Maha Obaid , Sulaiman Amel Abdalrahim 
Published: August 2022

Background:
Among diabetes complications, diabetic foot disease (DFD) is the most common and the most preventable complication. This study aimed to assess the level of knowledge, attitude and practice of foot care among type two diabetes mellitus (DM) patients attending the Diabetic and Endocrine Center at King Fahad Specialist Hospital in Buraydah-Qassim region, Saudi Arabia.

Methods:
A descriptive cross-sectional facility-based study was conducted randomly among type two diabetic patients; respondents were 260 patients. Participants were interviewed using a pretested semi-structured questionnaire.

Results:
Of the total studied patients, 54.2% were males with median age of 58 years. Majority 56.5% of patients had good knowledge and 56.9% had good practices regarding diabetic foot care. The mean knowledge score was 4.0 (±1.86) out of 6. About 39.2% of participants received advice regarding foot care from their physicians. Only 41.5% of the patients examined their feet daily, 41.9% carefully dried between the toes after washing, and 40.8% were walking barefooted at home. About 68.5% of the participants had a history of diabetic foot complications. A significant statistical association was found between the good knowledge and patients’ age, educational level, family monthly income, duration of diabetic illness and having prior knowledge regarding foot care (P-value <0.05). While, good practice of the participants towards the diabetic foot care was found to be statistically associated with the family monthly income and the prior knowledge regarding diabetic foot care (P-value <0.05).

Conclusion:
Our study revealed that more than half of the participants had good knowledge and practices of diabetic foot care. However, the role of physicians and medical staff in annual foot examination and health education is crucial. An awareness program implementation for diabetic foot care is highly needed.
Knowledge and practices of bioethics – Need for periodic assessment and reinstatement for budding family physicians
Authors: Sinha Pooja , Chourey Niraj , Hiremath Ravishekar N. , Ghodke Sandhya , Sharma Atul , Vaswani Pallavi 
Published: August 2022

Objective:
The study has been designed to assess the knowledge of ethics amongst young students and professionals, and practices of health care ethics among medical professionals in a government teaching hospital in India.

Methodology:
A cross-sectional study was carried out at one of the teaching hospitals in Southern India with a sample size of 84 among fresh medical graduates, post-graduate trainees, and young consultants with work experience of 6 months to 8 years. The data were collected by means of a structured and validated questionnaire, and the questionnaire was administered before and after a lecture/seminar on ethical principles, and results were analyzed using SPSS software.

Results:
The maximum participants were in the age group of 20 to 24 years with 0–2 years of clinical experience. The basic awareness and practices before the workshop were quite less when compared to after the workshop which showed a very good improvement in the correct responses to the questions. The maximum change seen, reflected in curiosity to learn bioethics. The workshop was an eye-opener for many participants in terms of the Nuremberg Code and its origin. The ethics committee was an alien concept to many participants, and it was reflected in the response postworkshop. The students felt a strong need to discuss ethics and implement them postworkshop. The segment on attitudes in clinical practice showed an impact on autonomy and truth-telling (32% to 50%). The segment on ethical practices reflected a confused audience. The increase in sensitivity to police information, and the concept of error of judgment and negligence were positive. The fact that medical practitioners are legally bound to help accident victims showed a positive response.

Conclusion:
Based on the assessment of pre-and post-workshop, there is a strong need to stress the ethical principles and revision of these ideas from time to time. Workshops and interactive sessions are a good way for periodic assessment and reinstatement of these values in our research and clinical practice. Thus, these should be part of the curriculum across all educational institutions for budding primary care providers and family physicians.
Continuous Positive Airway Pressure (CPAP)—Can this be a boon to tide over ICU crisis in pandemic? A case series
Authors: Tryphena Cherryl B , Panchanathan Ilangovan , Godwin Rajan , Stephenson Sam Jenkins , Davis Kirubakaran , Sahajanandan Raj 
Published: August 2022

Introduction:
Coronavirus Disease 19 (COVID-19) disease has caused unusual overload of health care systems all over the world. We describe four severe COVID cases managed by non-intensivist.

Cases and Outcome:
We had four unvaccinated cases with acute onset influenza like illness with signs of respiratory failure. Apart from general and COVID-specific measures, we started Continuous Positive Airway Pressure (CPAP) trial for these patients. All these patients were weaned off CPAP and were discharged once they recovered.

Discussion:
Limitation of bed numbers in ICU has caused unforeseen stress upon the system to manage sudden increase of severe acute respiratory distress syndrome during COVID pandemics. Studies have shown non-invasive ventilation (NIV) and high frequency nasal cannula (HFNC) have improved patient outcomes. But managing NIV and HFNC is resource intensive in terms of manpower and equipment. We have found that patients with severe COVID disease can be managed safely using CPAP in secondary care with minimal training of non-intensivist healthcare workers in a cost-effective and efficient way of treating severe COVID who are unlikely to worsen.

Conclusion:
With the imminent third COVID wave looming, it is high time to strengthen our existing primary and secondary health care system by these novel methods to reduce the burden of our tertiary care.
A retrospective study to find out the correlation between NAFLD, diabetes, and obesity in Indian patients
Authors: Saran Mohit , Sharma Jugal Kishore , Ranjan Aastha , Deka Saurav , Sabharwal Mudit , Palukari Srivani , Chandolia Betina 
Published: August 2022

Background:
Nonalcoholic fatty liver disease (NAFLD) is present in the body with metabolic disorders such as Type 2 diabetes mellitus (T2DM), obesity, and cardiovascular disease. However, no significant evidence has been found till date exhibiting their association epidemiologically in Indian patients.

Objective:
To assess the association among NAFLD, T2DM, and obesity, and to validate the scoring system with grades of fatty liver (severity of liver disease) estimated by ultrasound vs. NAFLD fibrosis score, BARD score, and aspartate aminotransferase to platelet ratio index (APRI) score.

Methodology:
A retrospective, observational study was conducted out in patients with NAFLD (n = 316) where diagnosis and grades of fatty liver were established via ultrasound reports. The patients were divided into two groups, Group A (n = 114, NAFLD with T2DM) and Group B (n = 202, NAFLD without T2DM). R 4.0.0 was used for statistical analysis.

Results:
The mean age (in years) of the patients was 54.08 ± 10.78 in Group A and 48.10 ± 15.36 in Group B. The mean BMI in Group A was found to be slightly higher as compared to Group B, 27.49 ± 4.94 and 26.56 ± 4.68, respectively, and the difference was found to be statistically significant (p-value <0.05). The overall predictive ability of the NAFLD scoring system matched that to ultrasonography liver grading fibrosis report for approximately 53% of patients. The BARD scoring system was found to be matched with ultrasonography reported Grade 1 fatty liver (198/316). In the case of the APRI scoring system, the association was not observed with ultrasonography reports in any grades of fatty liver.

Conclusion:
Body mass index might be an independent risk factor for NAFLD. NAFLD fibrosis score appears to be a reliable non-invasive tool to determine the severity of liver fibrosis in NAFLD patients. BARD score may predict Grade 1 liver fibrosis. However, APRI scores do not correlate with imaging evidence of fibrosis like NAFLD and BARD scores.
Development and implementation of optimized chest CT protocol in COVID-19
Authors: Pandya Radhika H. , Shinde Mayur Kiran , Patel Viral B. , Phatak Ajay Gajanan , Pandya Himanshu V. 
Published: August 2022

Background:
Several studies have justified use of chest computed tomography (CT) in diagnosis, evaluation of severity, treatment response, and complications of coronavirus disease 2019 (COVID-19) pneumonia. Increased utilization of CT in patients with known or suspected COVID-19 pneumonia has resulted in concerns of overuse, lack of protocol optimization, and radiation exposure.

Aims:
The study was conducted to develop and implement optimized protocol for chest CT for reducing radiation dose in adult patients suspected or diagnosed to have COVID-19 infection. Setting and Design: The study was conducted in the department of radiology of a rural tertiary care teaching hospital in western India. Clinical audit was used as a tool to impart and assess the impact of optimized chest CT protocol.

Methods and Material:
The pre-intervention audit included radiation dosimetry data, number of phases and length of scan of 50 adult patients, undergoing non-contrast chest CT scans in March 2021. A brief educational intervention outlining the parameters of optimized protocol was conducted on April 1, 2021.The post-intervention audit consisted of two cycles for 109 and 67 chest CT scans in the months April and May 2021.

Results:
The optimized protocol was found clinically adequate with a good inter-rater reliability. The compliance to the optimized protocol was weak in audit cycle 2, which improved significantly in audit cycle 3 after reinforcement. The mean (SD) per scan Computed Tomography Dose Index-Volume (CTDI-vol) reduced significantly across audit cycles [22.06 (12. 31) Vs. 10.58 (7.58) Vs. 4.51 (2.90) milli Gray, respectively, P < 0.001]. Similar findings were noted for Dose Length Product (DLP).

Conclusion:
Clinical audit of chest CT protocol and resultant radiation doses provided adequate feedback for dose optimization. A simple educational intervention helped achieve dose optimization.
Clinical profile of the patients at Siddha Covid Care Centre, Theni, Tamil Nadu, India – A cross-sectional study
Authors: Chandrasekaran Anbarasi , Palanibommu Sankararaj , Shanmugasundaram Natarajan , Pandian Mariappan 
Published: August 2022

Introduction:
The Indian Government issued various guidelines to the state government wherein introduced plan for setting up COVID care centres (CCC) to isolate and monitor asymptomatic and mild COVID-19 patients. The Government of Tamil Nadu, apart from CCC used the strength of traditional Siddha medicine, one of the Indian systems of medicine, by opening Siddha Covid Care Centres (SCCC) at various facilities like community hall, housing board homes, school and college hostels, across the state in 37 districts.

Methods:
As a cross-sectional study, we evaluated the clinical profile of the laboratory confirmed COVID-19 patient admitted in SCCC, Theni district, Tamil Nadu, India, which was opened on 8 May 2021.

Results:
During this month, 585 COVID-19 positive patients were admitted. Among them 60.9% were males, 39.1% were females. 40% of the admitted patients were in the age the group 31–50 years. 13% of the patient had at least one of the co-morbid condition and 80% were symptomatic with fever 40% and cough 36% as more common.

Discussion:
Patients were treated with the Siddha system of medicine adhering to the guidelines and were discharged after 10 days treatment. Nearly 4% who required further medical treatment observing their clinical condition and SpO2 levels were referred to the nearby medical college hospital.

Conclusion:
This study illustrated that SCCC offered appropriate clinical triaging and daily monitoring and hence it was considered as safe alternative to medical institutions during the pandemic.
A case control study of needlescopic herniotomy versus open herniotomy in children
Authors: Hajong Ranendra , Newme Kewithinwangbo , Moirangthem Thoiba 
Published: August 2022

Introduction:
Since the inception of laparoscopy, it has been explored in many fields of surgery, like in the abdomen, hernia, thorax, etc., Laparoscopic hernioplasty in adults is being practiced by many surgeons nowadays. However, the role of laparoscopic inguinal hernia repair in pediatric patients is not well-established, even though it is being explored as an alternative to open herniotomy procedure. In the present study, laparoscopic needlescopic hernia repair was compared with the conventional open herniotomy procedure.

Material and Methods:
The study was a case-control study conducted in a tertiary care hospital in northeast India during 2018–2021. A total of 25 patients underwent needlescopic hernia repair, the outcome of which was compared by collecting data of 25 more patients who earlier underwent open herniotomy repairs.

Results:
The laparoscopic needlescopic repair took a longer operative time as compared to the open technique with a smaller-sized incision.

Conclusion:
Laparoscopic needlescopic hernia repair is a safe and feasible procedure with a similar outcome to open herniotomy but with a smaller scar.
Menstrual hygiene among adolescent girls studying in a university of Gujarat
Authors: Parikh Vidhi , Nagar Shashwat 
Published: August 2022

Background:
Menstruation marks the beginning of the reproductive life of a girl. A poor menstrual understanding and its unhealthy practices may increase the risk of reproductive infections, urinary tract infections, and even cancer. Therefore, the main objective of this study was studying the knowledge and attitude regarding menstrual hygiene among adolescent girls so that it can be then taken as a background for designing necessary interventions in the community.

Objectives:
1) To study the knowledge and attitude towards menstruation among adolescent girls and 2) to study the menstrual hygiene practices and health-seeking behaviour of the adolescent girls.

Methods:
This was a university-based descriptive cross-sectional study carried out by directly interviewing the subjects using the interviewer-administered questionnaire – pre-tested and pre-designed proforma. The data were analysed statistically by simple proportions.

Results:
Among the study subjects, 79% had proper knowledge about menstruation. 82% had a normal menstrual pattern. Nearly 96% used sanitary pads, and 2.36% used reusable cloths. Regarding restrictions, 74.80% restrained themselves from visiting the places of worship, 21% avoided physical exercise, and 7.87% had to remain isolated with minimal social contact. Nearly 19% made conscious efforts for dietary changes during menstruation.

Conclusion:
A majority of the subjects had a regular menstrual cycle, but menstrual problems were found to be more among those having irregular periods, those changing absorbents infrequently, with an inadequate frequency of cleaning, and those using plain water for cleaning. The study however does reflect the fact that menstrual hygiene was unsatisfactory among adolescent girls. Therefore, they need to be educated about the facts of menstruation and proper hygienic practices.