bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cardiac catheterization laboratory activation by social media reduces reperfusion time of patients transferred for primary percutaneous coronary intervention in community hospital
Authors: Wang Guozhong 
Published: June 2022

Objective:
The objective of the study is to evaluate the impact of cardiac catheterization laboratory (CCL) activation by WeChat in community hospitals transfer for primary percutaneous coronary intervention (PCI) bypassing emergency department (ED) on time delay in ST-segment elevation myocardial infarction (STEMI) patients.

Methods:
This was a retrospective, cohort study of STEMI patients who were transferred from community hospitals to Luhe Hospital for primary PCI. Patients were divided into two groups: in CCL group, electrocardiogram (ECG) was transmitted through WeChat in the community hospital and the patients were transferred directly to CCL by emergency medical services (EMS) (n = 43); in control group, patients without ECG transmission were transferred by EMS to ED before CCL arrival (n = 57). The primary endpoint was median first medical contact (FMC)-to-device (FMC2D) times. The secondary endpoint was door-to-device (D2D) times.

Results:
The baseline clinical data and angiographic features among the two groups were similar (all P > 0.05. There was no difference in the symptom onset-to-FMC time (median interquartile range [IQR] min, 100.00 [74.50–247.00] vs. 105.00 [70.00–180.00], P > 0.05) between the two groups. Compared to control group, CCL group had shortened FMC2D times (median IQR min, 95.00 [72.60–160.58] vs. 160.79 [124.72–205.50], P < 0.001) and shortened D2D time (median IQR min, 17.18 [13.77–21.15] vs. 49.27 [40.26–64.90], P < 0.001). Achievement of the FMC2D time goal of <120 min rose from 29.82% in the control group to 76.74% in the CCL group (P < 0.001).

Conclusion:
CCL activated by WeChat can reduce reperfusion time of STEMI patients who are transferred for PCI from community hospitals.
Evaluation of palliative care training program for medical interns in a tertiary care teaching hospital, South India
Authors: Elayaperumal Suguna , Venugopal Vinayagamoorthy , Adinarayanan S. , Dongre Amol R. 
Published: June 2022

Introduction:
The Department of Community Medicine has been training medical interns for providing hospital-based palliative care (HBPC) and community-based palliative care (CBPC) services with an interprofessional team. This study was done to evaluate the training program on palliative care developed for medical interns.

Material and Methods:
It was a retro-pre type of program evaluation done among 172 interns between January 2016 and December 2017. One day program was conducted for the interns by faculty trained in palliative care, followed by placement in HBPC and CBPC program. At the end of training, self-perceived improvement in knowledge was collected on a five-point Likert scale. Certificates were issued on completion. Data were entered and analyzed using Epi Info (version 7.2.2.6) software. Wilcoxon signed-rank test was applied between pre- and post-scores. Manual content analysis was done for open-ended questions.

Results:
The mean age of the participants was 22.5 ± 0.8 years, with 76 (44.2%) males and 96 (55.8%) females. There was statistically significant improvement in perceived knowledge scores after attending the training. Areas of learning, values learned, and uses of learning in future career and suggestions for improving the training program were the categories obtained.

Conclusion:
The training program improved the self-perceived knowledge on palliative care among medical interns. The exposure to HBPC and CBPC program had a positive effect on their attitude and perceived skills for caring of chronically ill patients. Such programs can be initiated by other palliative care providing institutions for training medical interns.
Medical officer's perspectives and professional challenges in handling poisoning cases in rural India
Authors: Mahadik Kakasaheb , Raut Asawari , Chowdhury Monidipa , Asad Ali Haider , More Shubham 
Published: June 2022

Introduction:
Poisoning is a significant public health problem in developing countries, more so in rural areas. Very little is known about the treatment available for poisoning cases in the context of rural health care provision in India. This study explores the perceptions of the primary health care medical officers regarding the management of poisoning cases.

Material and Methods:
A semistructured, self-designed survey form was used to interview the medical officers in Pune district. The interview focused on understanding rural hospital settings in terms of infrastructure, available facilities, and medical officers' perception of professional challenges in the management of poisoning cases.

Results:
Underreporting of poisoning cases in these primary health centers (PHCs) and transferring to higher hospitals without basic first aid provided was noted through interviews.

Conclusion:
Medical officers in rural PHCs lack the necessary training and knowledge required for the management of poisonings which is further worsened by lack of resources. There is a need to focus on poison management in continuous medical education. Training programs and education for medical officers are needs of the hour.
COVID-19 pandemic
Authors: Sharma Priya , Rattan Saurabh , Katoch Vikram , Gupta Gurdarshan , Narain Jai P. 
Published: June 2022

Introduction:
Coronavirus disease or COVID-19 emerged in December 2019 in China and thereafter spread to all regions of the world including India. In the Himalayan state of Himachal Pradesh, India, the first case was identified in the month of March 2020. As the most populous district of the state of Himachal Pradesh, Kangra not only identified the first case in the state but also thereafter suffered disproportionately due to the virus causing severe health and economic disruption. The study was carried out to better understand the pattern and trends of COVID-19 pandemic in the district since its emergence, covering the first and the second wave to use the data to prepare the future course of action.

Materials and Methods:
A robust database comprising real-time data in a line list format was created. The observations covered all confirmed COVID-19 cases in the district from March 20, 2020, to June 30, 2021, in terms of disease progression and distribution in time, place, and person, and the possible risk factors for severe disease.

Results:
During the study period, 45,871 cases and 1030 deaths were reported in Kangra district, with a case fatality rate of 2.2%. Of the 12 districts of the state, Kangra reported the highest number of cases (22.6%) and deaths (29.7%). Ninety percent of all cases occurred during the second wave. While the first wave peaked in December 2020 with 2596 cases, the highest number of cases occurred in May 2021 when as many as 25,625 cases were reported. The test positivity rate of 15.2% during the second wave which was many times higher than that seen during the previous year. The case fatality rates during the first and second waves were 2.2% and 2.1%, respectively.

Conclusions:
The study highlights an explosive surge in COVID-19 cases during the second wave, indicating the highly infectious nature of the virus. While absolute number of deaths was several times greater during the second wave, the case fatality rates did not differ greatly between the two waves.
Multiplicity of noncommunicable diseases among the elderly in a suburban area of Delhi
Authors: Prabhakar Tushar , Goel Manish Kumar , Acharya Anita Shankar 
Published: June 2022

Introduction:
Continuing advancements in quality of health care has led to increased life expectancy over time. This in turn has resulted in increased prevalence of noncommunicable diseases (NCDs), especially among the elderly. An appropriate portrayal of its epidemiology is essential to adequately understand the health-care needs of the population. The evidence generated from the study will give us an incentive to address the rising burden of polymorbidities. We did the study to assess the prevalence and pattern of NCDs in the elderly above 60 years of age and to determine age- and sex-wise distribution of single and multiple NCDs.

Materials and Methods:
A community-based cross-sectional study was conducted among 350 elderly participants over 60 years of age in Mehrauli area of Delhi. Data were collected using a semi-structured questionnaire. Detailed general and systemic examination was also done.

Results:
A total of 87.4% of the study population were suffering from at least one NCD. The number of NCDs per person is 2.41. Overall, 80 out of the total 350 study participants (22.9%) had a single NCD, whereas 226 (64.6%) had two or more NCDs. Hypertension was the most prevalent NCD, followed by cataract, osteoarthritis, diabetes mellitus, and obesity.

Conclusion:
The prevalence of NCDs was quite high among the elderly. Multimorbidity was more common among the oldest-old age group and elderly women. This calls for increased focus on timely and comprehensive screening for NCDs in adults and asserts the need to approach the screening and management of NCDs in a more holistic way and not as isolated health events.
Cost analysis of outpatient department prescriptions in the community pharmacies during the coronavirus disease-2019 pandemic in Maharashtra
Authors: Reji Sharon , Mishra Preeti Santosh , Retiwale Salman , Deshpande Prasanna R. 
Published: June 2022

Introduction:
Community pharmacy is a place under the direct supervision of the pharmacist where the prescription orders are compounded and dispensed. In India, there are limited studies published on the economic evaluation of community pharmacy. This study aimed to conduct a cost analysis of outpatient department prescriptions in the community pharmacies during the coronavirus disease-2019 pandemic on various parameters such as the total cost, average cost/prescriptions, age-wise cost, prescribers, drug class, pharmacy wise, route of administration, and diagnosis cost.

Material and Methods:
The analysis of total and average cost per prescription was conducted. The study was carried out for 6 months during. The number and type of drugs prescribed and the frequency and total cost of the prescriptions were noted. Statistical analysis was conducted for different demographics and various parameters.

Results:
A total of 1166 prescriptions were analyzed in the study. Out of 3704 drugs prescribed 99.9% were branded ones. The average number of drugs/prescriptions was 3.17. The predominance of male patients (60%) was seen. On the overall cost of prescriptions the statistical significance of the overall cost was established at (P < 0.00001). The sum of all the prescriptions accounted for .10, 86,504.65. The average cost/prescription was .931.82.

Conclusion:
The average total cost/prescription was found to be higher in our study. There is a need for further studies to be done in the field of community pharmacy.
Awareness, Attitude, and Perception toward Organ Donation in General Population of Haryana, India
Authors: Varshney Shyamli , Kansra Pooja , Perumallapalli Aditya , Garg Anurag 
Published: June 2022

Introduction:
Organ donation is defined as an act of giving one or more organs, without compensation, for transplantation to another person the shortage of organ donation remains one of the biggest barriers globally to the organ transplantation process. The state of Haryana has in the recent past grown leaps ahead in terms of medical tourism, but according to recent data by the MOHAN Foundation, Haryana is among the poorest performers in organ donation, more specifically cadaveric organ donation. This study aimed to assess the attitudes and awareness of organ donation in the general population of Haryana and to find out the barrier to the low organ donation numbers in the state.

Materials and Methods:
This study was a community-based cross-sectional study carried out among the general population of Haryana. A questionnaire was administered to 500 randomly selected people above the age of 18 in the chosen population. The data were coded and analyzed using Microsoft Excel and SPSS software.

Results:
A large number, 40.6% (203/500), of the participants in the survey were unaware of the term “organ donation.” Only 24.5% (72/293) of participants were able to correctly identify that “organ donation” was possible from both cadavers and living human beings. 98.6% (289/293) of the participants of the survey were unaware of any legislation regarding organ donation. A dismal 27.3% (80/293) of participants were willing to donate their organs after death. Of those unwilling, 60.1% (128/213) reported that they did not want to donate because of their religion. Of those willing to donate, 28.7% (23/80) reported that they would only donate to a person of the same religion.

Conclusion:
The overall levels of awareness about the organ donation and acute shortage of organ donors in Haryana as well as awareness about the prevalent low rates themselves remain low. There are various religious biases leading to negative attitude toward organ donation.
Is Inferior Vena Cava Diameter, a Reliable Indicator for Fluid Status in End-Stage Renal Disease Patients? - A Prospective Observational Study
Authors: Trivedi Viral , Prajapati Megha , Prajapati Devendra Jayantibhai , Bhosale Guruprasad , Nayak Janki , Panchal Harsh 
Published: June 2022

Introduction:Adequate allograft perfusion is the key component of renal-transplant surgeries. This requires meticulous management of volume status in end-stage renal disease (ESRD) patients on maintenance hemodialysis (MHD). Various methods have been tried to unveil the most dependable parameter. So far, central venous pressure (CVP) has been a reliable parameter for guiding fluid therapy. Recently, in the past decade, inferior vena cava (IVC) diameter (IVCD) has emerged as a promising indicator for volume assessment in critically ill patients. However, very limited data are available regarding use of IVC diameter in ESRD patients. This study is an attempt to determine the efficacy of IVC diameter in predicting the volume status of renal-transplant recipients by comparing it with conventional method, CVP.Methods:Enrolling 60 live donor renal-transplant recipients from a single center, the mean IVCD and IVC collapsibility index (IVC-CI) were measured and compared with CVP. IVC measurements were recorded using bedside ultrasonography. CVP was measured using central venous catheter placed in superior vena cava, through a water column on a standardized scale. The data were analyzed using SPSS Version 20.Results:The mean age of the participants was 38.92 ± 10.46 years. The mean CVP was 6.78 ± 2.86 cmH2O, the mean IVCD was 1.30 ± 0.43 cm, the mean IVC-CI was 24.27% ± 15.45%. Based on Pearson's correlation test, there was no linear correlation between CVP and IVCD as well as CVP and IVC-CI.Conclusion:For the assessment of fluid status and fluid responsiveness in ESRD patients with MHD, ultrasound assessment of IVCD and IVC-CI is not routinely helpful.
A Study Comparing Office Blood Pressure with Ambulatory Blood Pressure in Successful Adult Kidney-Transplant Recipients at a Tertiary Care Center in North India
Authors: Bhat Tariq , Idrees Mohammad , Wani Muzafar Maqsood , Naik Muzafar , Wani Imtiyaz Ahmad , Wani Abdul Ahad , Wani Mohammad Saleem , Bhat Mohammad Ashraf , Hamid Arif 
Published: June 2022

Introduction:
Hypertension is common following successful renal transplantation and has adverse effects on cardio-vascular and graft health. Blood pressure (BP) readings obtained during clinical visits can be misleading and ambulatory blood pressure monitoring (ABPM) is a more reliable and accurate non-invasive method of BP monitoring.

Aims and Objectives:
To compare office BP with ambulatory BP recordings in successful adult kidney transplant recipients (KTRs).

Material and Methods:
Office BP (OBP) was measured with mercury sphygmomanometer according to standardized procedure as the mean of two readings taken 1 minute apart; thereafter, 24 hour ABPM was done using automated oscillometric device (Meditech device) in 56 KTRs.

Results:
OBP missed hypertension in 68% of KTRs who had normal OBP (masked phenomenon) and OBP overestimated hypertension in 11% of KTRs with uncontrolled OBP (white coat phenomenon). Thirty-four percent of patients were normal dippers, 32% non-dippers, 25% reverse dippers and 9% were extreme dippers.

Conclusions:
ABPM is a valuable tool in detecting dipping status, white coat and masked phenomena which are frequent problems among KTRs and should be considered as part of routine management of hypertension in KTRs.
Remdesivir in Renal Transplant Patients with Coronavirus Disease 2019
Authors: Latief Muzamil , Abbas Farhat , Iqbal Mohd , Hassan Zhahid , Goud L. Naresh , Shafi Obeid 
Published: June 2022

Introduction:
Remdesivir has shown broad-spectrum antiviral activity. This drug is approved by the Food and Drug Administration for coronavirus disease 2019 (COVID-19) management. Other than a few case series and case reports, not much information is available on its use in kidney transplant recipients (KTRs).

Materials and Methods:
We describe our experience of seven KTRs with COVID-19. All the patients were hypoxemic. High-resolution computed tomography (CT) chest was done in all the patients. Injection remdesivir 200 mg on day 1 followed by 100 mg daily was given for a maximum of 5 days irrespective of estimated glomerular filtration rate (eGFR).

Observations and Results:
Mean age of patients was 46.28 ± 10.41 years and one patient was female. Mean CT severity score was 15. In our study, 2 patients who required mechanical ventilation expired. None of our patient had worsening of acute kidney injury (AKI) or new-onset AKI after institution of remdesivir.

Discussion:
Optimal management for this patient population remains unknown, therefore, treatment of COVID-19 in KTRs varies from center to center. The studies on remdesivir use in KTRs with COVID-19 are not extensive. Our series does indicate safety of remdesivir in KTRs.

Conclusion:
We observed that remdesivir can be used in KTRs with COVID-19 with hypoxemia irrespective of eGFR. We suggest that large-scale studies should be done to substantiate these findings.
Organ Donation and the Medicolegal Aspects
Authors: Thyagarajan Ishwarya , Kanvinde Hemal , Shroff Sunil , Sahi Muneet Kaur 
Published: June 2022

Context:
In India, the majority of brain-dead organ donors are victims of road traffic accidents, thereby making them entities in medicolegal cases (MLC). This places an additional burden and complicates the organ donation process, as an inquest must be conducted by the police station closest to the accident spot before the possibility of organ donation is considered. Following organ retrieval and donation, a postmortem is required before the body is handed back to the police. These procedures cause delays in the organ donation process and subsequently in families receiving the body of their loved ones. The problem is compounded by the fact that there are variations in the inquest and postmortem procedures in different states.

Aim:
The study aims to comprehensively enumerate the medicolegal protocols followed by the states having an active deceased organ donation program.

Design and Methods:
A survey, using a structured questionnaire, was conducted among the senior Transplant Coordinators (key stakeholders in the organ donation process) of eight states. Their experiences handling MLC and the state protocols adhered to were captured.

Results:
It was found that there were differences in protocols followed by the states with respect to medicolegal organ donation cases. Significant variations were observed in the police inquest and postmortem procedures. A need for training of the police personnel in the medicolegal aspects of the organ donation process is evident from the survey responses.

Conclusions:
The undue delays lead to difficulties in completing the donation and also cause distress among the family members who have said yes to organ donation despite their grief. The study recommends the need for uniformity in protocols to ease pain points in this program. This is of paramount importance in instances of interstate-organ donation cases.
Outcomes of ABO-Incompatible Kidney Transplantation with Respect to Baseline Isoagglutinin Immunoglobulin G Titers
Authors: Gaur Lovy , Bhalla Anil Kumar , Shingada Aakash , Gupta Ashwani , Malik Manish , Gupta Anurag , Bhargava Vinant , Gupta Pallav , Joshi Anant , Jauhari Harsh , Ranjan Vivek , Khillan Kamini , Rana D. S. 
Published: June 2022

Background:
ABO-incompatible kidney transplantation is one of the ways to increase the donor pool by as much as 30%–35%. Studies comparing baseline titers have shown conflicting results with respect to graft outcomes. This study attempts to evaluate the outcomes of ABO-incompatible transplant with high and low baseline immunoglobulin G (IgG) isoagglutinin titers to the outcomes of ABO compatible transplant.

Materials and Methods:
This was a retrospective observational study, in which 954 renal transplant recipients were included in the study. Of these, 873 patients had undergone ABO compatible kidney transplantation. Of the 81 patients who underwent an ABO-incompatible transplantation, 67 belonged to the low titer group (defined as the baseline IgG ≤ 1:64) and 14 belonged to the high titer group (defined as baseline IgG ≥ 1:128). Patients were followed up for a period of 1 year. Laboratory assessments were performed at baseline and at each visit. Graft survival, rejection episodes, patient survival, and infections were assessed on a continuous basis. Graft loss was defined by the need to return to dialysis.

Results:
Death censored graft survival was 92.3% in the high titer group as compared to 98.2% in ABO compatible group, but this difference was not significant (P = 0.231). Graft survival in the low titer group (96.8%) was comparable to the compatible group (P = 0.328). The proportion of patients who developed biopsy-proven rejections was lower in ABO compatible groups (6.5%) when compared to ABOi high (21.4%) and low titer groups (13.4%), respectively (P = 0.063 and 0.033, respectively). Antibody-mediated rejections were significantly fewer in ABO compatible group (1.8%) versus high titer group (21.4%) and low titer group (11.9%) (P = 0.003 and P < 0.001, respectively). Patient survival was higher in ABOc group (97.9%) as compared to high (92.9%) and low titer (94.0%) groups though the difference did not achieve statistical significance. Most of the deaths were attributed to infections.

Conclusion:
ABO-incompatible transplantation is an acceptable treatment for those with end-stage renal disease; however, this comes with a caveat of increased risk of acute rejections and infections in patients with baseline titers of 1:128 or higher.