bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of disruption due to COVID-19 on operating room utilization: Experience from a secondary care hospital in Riyadh, Saudi Arabia
Authors: Althaqeel Mamdouh F. , Alshanwani Mohammad N. , Alqahtani Khalid , Khan Mohammad Shibly , Zeidan Zeidan A. , Mohaideen Noorulzaman K. , Albahooth Khalid , Altassan Walid , Alzoman Assem S. A. , Alkhaldi Abdulaziz S. 
Published: October 2022

Abstract

Introduction/Background:
The disruption caused due to corona virus disease-2019 (Covid-19) has affected the overall health care delivery worldwide. The elective services were foremost to face the restrictions and closure, subsequently they were resumed only after adoption on newer protocols.

Aims:
We aimed to estimate the effect of COVID-19 restrictions on operative room utilization.

Methodology:
This is a retrospective descriptive study. The surgical volume indicators were calculated and a comparison was made between pre-COVID-19 (April–June 2019) and COVID-19 phase (April–June, 2020). Pre-operative covid assessment through the RT-PCR test among the cases waiting for elective surgeries.

Results:
Overall surgical volume decreased by 53%, which included 87% decrease in elective procedures and 8% decrease in emergency procedures. The overall OR utilization reduced by 63%. Highest reduction in the surgical volume was noted in bariatric surgery (no surgeries conducted in the COVID-19 phase), ophthalmology (99% reduction), and Ear, Nose and Throat surgery (ENT) surgery (92% reduction). Six patients tested positive for pre-operative RT–PCR from the sample of 261 cases posted for elective surgery during resumption phase of elective services, thereby giving the positivity rate of about 2.2%.

Conclusion:
We found a high level of reduction in the operating room utilization in a secondary care public sector hospital. The pre-operative assessment has enabled to find out the COVID-19 cases and hence preventing the unwanted spread of infection during the surgical procedures.
Geospatial epidemiology of hypertension and its risk factors in India: Findings from National Family Health Survey (2015–2016)
Authors: Saleem Sheikh Mohd , Singh Gurpreet , Zaidi Ilham , Haq Inaamul , Singh Ijyaa , Anjum Sahifa , Singh Mahendra P. , Goel Sonu 
Published: October 2022

Abstract

Background:
The fourth round of National Family Health Survey (2015–2016) measured blood pressure for the first time and provided a unique opportunity of exploring trends in hypertension prevalence across states and districts for the first time.

Aim:
This study will be the first in India to estimate the geospatial variation of hypertension among those in the 15–49 years age group in India.

Materials and Methods:
Out of a total of 616,346 selected occupied households, 601,509 were successfully interviewed, giving a response rate of 98%. We adjusted the proportion of hypertension obtained by using national sample weights. We built a multivariable logistic regression model to assess the determinants of hypertension.

Results:
The overall weighted prevalence of hypertension was 11.7%, and the prevalence was 11.1% in females and 11.0% in males. Urban areas had a higher prevalence (13.0%) compared to rural areas (11.0%). Those with no education (14.4%) and those who reported smoking (16.5%) had hypertension. Consumption of alcohol, fruits, and eggs was also found to be significantly related to hypertension.

Conclusion:
Hypertension epidemic is spreading alarmingly in India across rural and urban populations. Disturbingly, the hypertension prevalence is now becoming more concentrated among the poor. This phenomenon has serious implications for the country’s social and economic well-being. Urgent preventive measures need to be taken at a multidisciplinary level.
Association of single nucleotide polymorphism rs113420705 of CASP3 in children with Kawasaki disease from North India
Authors: Das K Gokul , Bhattarai Dharmagat , Kaur Anupriya , Kaur Anit , Kumrah Rajni , Srivastava Priyanka , Rawat Amit , Singh Surjit 
Published: October 2022

Abstract

Background:
Kawasaki disease is a pediatric, systemic, vasculitic disorder. Its exact etiology is still unknown. Genetic polymorphisms are being investigated as susceptibility factor for this disorder. These are likely to vary among different populations.

Aim:
To investigate the association of single nucleotide polymorphism (SNP) rs113420705 of CASP3 in Kawasaki disease (KD) from North India.

Settings and Design:
Observational, case–control study.

Methods:
Polymerase chain reaction and bidirectional Sanger sequencing was used for determining genotypes of SNP rs113420705 in 45 cases of KD and 50 healthy age- and sex-matched controls. Allele and genotype frequencies were assessed and compared between the groups.

Results:
Among 45 cases, 32 had TT (71.1%), 13 had CT (28.9%) and none had CC genotype of SNP rs113420705. No significant differences in allele, genotype, or carrier frequencies of rs113420705 were found between the two groups. A comparison was also made between subgroups of KD with coronary abnormality (7 children; 15.5%) and KD with normal coronaries (38 children; 84.4%). The C allele was significantly overexpressed in KD with coronary abnormality group (P = 0.005). However, no difference was noted in the genotype frequencies.

Conclusion:
CT genotype of rs113420705 of CASP3 showed a trend to significance with the occurrence of KD in children in North India. However, we could not establish any association between minor allele C and susceptibility to KD. C allele appeared to be over expressed in children with KD with coronary abnormalities. Larger studies will help us to reach conclusive evidence applicable to all ethnicities.
Scrub typhus presenting as cryptogenic organizing pneumonia in a young female: A first case report
Authors: Khanna Shivam , Talwar Dhruv , Kumar Sunil , Acharya Sourya , Hulkoti Vidyashree 
Published: October 2022

Abstract
We report the case of a young female suffering from fever and generalized weakness on presentation and was diagnosed to be a case of cryptogenic organizing pneumonia (COP). She developed breathlessness on rest and required oxygen support and on further evaluation diagnosed with Scrub typhus IgM positive status. This case report highlights the importance of a rare presentation of Scrub typhus in a young female presenting with clinically silent chest changes initially and preventable worse outcomes if detected and managed for scrub typhus infection early in the course of disease.
Development and implementation of a sustainable COVID-19 training package for healthcare workers: Experience from a teaching hospital of North India
Authors: Khan Amir Maroof , Patra Somdatta , Jain Anil K. , Madhu SV , Saxena Ashok , Aggarwal Anju , Suneja Amita , Tyagi Asha , Avasthi Rajnish , Singh Narendra P. , Shah Dheeraj , Dhall Anjana , Kalra Rajesh , Arora Rajesh , Gupta Sanjay , Vaney Neelam 
Published: October 2022

Abstract

Background:
With the impending threat of future COVID-19 waves, it is imperative that teaching hospitals develop, implement, and evaluate a systematic training program to render HCW elastic in delivering COVID-19 related services. We present our experience in developing, implementing, and evaluating a sustainable and scalable COVID-19 patient management training package for healthcare workers.

Materials and Methods:
A mixed-methods study design was used. Rapid assessment to understand the need of the trainees and identify the available resources was done followed by planning of the training module and its implementation. The program was evaluated for effectiveness and sustainability. Data analysis was done using descriptive statistics and qualitative data generated from open-ended questions in the feedback forms and the discussions were analyzed using rapid content analysis.

Results:
A total of 66.8% of the doctors and 18.9% of the nurses were trained by online synchronous mode while 55.0% of the nursing officers and 47.1% of the nursing orderlies and paramedical staff were trained in onsite skill development sessions. Need assessment identified that healthcare workers were ill-prepared to use medical devices such as Bipap machines, ventilators, and oxygen delivery devices. The participants mentioned that the multidisciplinary approach and video-based demonstrations facilitated their online learning while the incremental learning approach, easy-to-understand terminology and hands-on experience facilitated their onsite skill development sessions.

Conclusion:
The COVID-19 training package developed was multidisciplinary, effective, sustainable, and scalable in a resource-limited setting. We suggest that this model can be adapted by healthcare organizations to develop and implement such training packages for their healthcare workers.
Association between high-sensitivity-CRP and liver elastography and cardiac ischemic diseases in patients with fatty liver
Authors: Nayebi Morteza , Seyedian Seyed Saeed , Hashemi Seyed Jalal , Parsi Abazar , Hajiani Eskandar 
Published: October 2022

Abstract

Objective:
Inflammatory markers are among the possible contributing factors with a proposed role in hepatic and ischemic heart disease. The present study aimed to determine the association between high-sensitivity-C-reactive protein (hs-CRP), liver elastography, and cardiac ischemic diseases in patients with fatty liver.

Methods:
In this cross-sectional comparative study, 103 consecutive patients with fatty liver were enrolled to undergo angiography. They were divided into groups with and without cardiac ischemia.

Results:
The results demonstrated that the mean hs-CRP was 2.3 and 10.9 mg/L in normal and ischemic angiography groups, respectively (P = 0.001). According to the receiver operating characteristic (ROC) analysis, the predictive role for hs-CRP was 94.5% that had sensitivity and specificity of 95.2% and 90%, respectively, with a cut-off point of 3.1.

Conclusion:
This study showed that there is an association between the fatty liver, cardiac ischemia, and hs-CRP level.
Self-health assessments in Saudi Arabia: Directions for an integrated primary healthcare
Authors: Salam Asharaf Abdul 
Published: October 2022

Abstract

Background:
Public health data for dissemination and discussion in Saudi Arabia, for the purposes of primary healthcare, are limited but the new initiatives of General Authority of Statistics creates many national surveys. One of the most recent one, the Family/Household Health Survey - 2017 aims to fill the gaps, at the same time, aids in discussions on primary healthcare.

Objectives:
Analyses done in this research are aimed at appraising the self-assessed health and to examine age-sex and geographic differentials and their probable interconnections with chronic diseases, injuries, and periodic examinations.

Data and Methods:
This survey conducted in October–December, 2017 covered both native and foreigner households from all the 13 administrative areas through a random sample procedure involving primary sampling units and secondary sampling units. A portion of the published data on self-assessment of health, chronic diseases, injuries, and periodic medical examinations were analyzed.

Results:
More than half of the persons in the Kingdom, reportedly, are in good health; more so among females than males: proportions decreased with increasing age up to 40 years, thereafter increased sharply. Moreover, the major regions have lesser proportion of people with good health. Prevalence of chronic diseases increases with age, in both total and native population, but with variations across specific diseases – hypertension, diabetes, cancer, and cardiovascular diseases (CVDs) and with geographic differentials. On the other hand, there are injuries (from traffic accidents and others) occurred at house, work/school, public place, and other places; pertinent with geographic variations. Moreover, age, sex, and regional differences in periodic health examinations have a contributing effect on health assessments. Moreover, the median age shows a pattern resembling adults assessing good health; chronic diseases after 50s; injuries before 40s; periodic medical examinations in 50s; with females at a lower age, in both groups of population.

Conclusions:
The national health system played an important role not only in health status and health assessments but also in building confidence and trust and thereby enhancing optimism, realism, recognition, self-awareness, and acceptance of physical condition. Thus, age, sex, and regional variations in health assessment are born out of chronic diseases, injuries, and periodic medical examinations and also of expectations and experiences. Generation of such information, effective dissemination, and regular discussions at various levels followed by in-depth analyses raise the primary healthcare and thus the population health.
Elder care: The need for interprofessional collaboration between Family Physicians, Clinical Pharmacists, and Physiotherapists in home-based primary care teams
Authors: Anwari Colis , Balasubramanian Swaathi , Sawant Prathamesh S. , Kuri Ushnaa , Anand Ashoojit K. , Rao B. C. , Prasad Ramakrishna 
Published: October 2022

Abstract

Background:
Elderly patients with pain and falls are commonly seen in family practice.

Aims:
(1) Highlight the role of a physiotherapist in the primary care team; (2) Discuss the collaboration between a family physician clinical pharmacist dyad and the physiotherapist that emerged; and (3) Share practice tools that emerged from our teamwork.

Settings and Design:
Home Based Primary Care Practice (a core component of family practice). We have described our home based primary care practice model in earlier publications. Our model utilizes a team based approach to address the prevention of diseases, promotion of health, provision of care for acute and chronic conditions (especially concurrent multi morbidity), and delivery of rehabilitation services in the home setting.

Methods and Materials:
Selection of three cases from our daily practice. Reflective discussion and learning towards arriving at novel insights and improving our care model.

Results:
Case discussion from the perspectives of the family physician, clinical pharmacist, and physiotherapist reveal important insights on the roles, responsibilities, benefits and tensions. A process flow to facilitate team based care is also outlined along with a referral communication tool.

Conclusion:
For our population of the elderly with falls and pain, there was a need for a physiotherapist, as part of the team, instead of a mere referral service. This was felt because of the growing needs of patients, multiple gaps in communication with external referrals, mismatch of values and approaches, and missed opportunities for high quality care. This enhances access, optimizes clinical outcomes, delivers patient centred care, reduces unnecessary hospitalizations, and avoids catastrophic and unwarranted costs. The paper highlights the critical need for interprofessional collaboration between family physicians, clinical pharmacists and Physiotherapist in elder care.
An update on epidemiology and management practices of Scorpion envenomation in India
Authors: Kumar Rakesh 
Published: October 2022

Abstract

Introduction:
Scorpion envenomation is a life-threatening condition, particularly for children. Therefore, it is essential for primary care health providers to suspect, identify, and manage this condition early to prevent death and minimize morbidity.

Objective:
To identify the key epidemiological characteristics of scorpion envenomation and update the primary care health workers regarding the latest management practices of scorpion envenomation.

Methodology:
A non-systematic review was performed by searching the key terms on databases such as PubMed, Medline, Scopus, Google Scholar, and ResearchGate.

Results:
Worldwide, over 2.5 billion people are living at risk of scorpion stings. Every year, over 1.2 million are stung by scorpions leading to the death of at least 3,250 people globally. The most vulnerable group includes farmers, laborers, and those living in rural areas. Adults are most frequently stung but envenomation is more severe among children. Prazosin is a key drug to prevent death due to cardiovascular complications.

Conclusion:
Most of these stings and deaths could be preventable with proper awareness, safety precautions, and timely access to treatment. Government and local hospitals should ensure the availability of key drugs such as prazosin.
Medical education in post-pandemic times: Online or offline mode of learning?
Authors: Rastogi Aayushi , Bansal Akanksha , Keshan Pranav , Jindal Ankur , Prakash Arun , Kumar Vinay 
Published: October 2022

Abstract

Background and Objective:
With the advent of the COVID-19 pandemic, face-to-face training was suspended considering social-distancing norms. The training needs of the healthcare workers (HCWs) were being met by the online mode. Initially, the use of the online mode was limited but was eventually popularized with increased use. This would have led to a change in the perception toward the online mode. However, the use of online learning has financial and temporal obstacles. With this objective, a study was conducted among the HCWs to assess the perception, satisfaction, and preference associated with the modes of learning.

Methods:
A cross-sectional study was conducted from February to April 2021 among the HCWs. An online link to the survey was circulated among the HCWs who attended online or/and offline training. The questionnaire had 38 questions assessing the sociodemographic details, perception, satisfaction level, and preferences of the participants. Univariable and multivariate logistic regression were performed using SPSS v-22.

Results:
A total of 1,113 responses were received with the mean age of 33.17 ± 8.13 years and approximately 63% of the participants were females. Approximately 54% perceived the online mode of learning as a better mode of learning. Also, 67% preferred and 80.5% recommended the online mode whereas mean satisfaction was found to be more for the offline mode as compared to the online mode.

Interpretation and Conclusions:
The study concludes that the online mode of learning is the most preferred and recommended mode among the HCWs, whereas there is more dissatisfaction with respect to the online mode. The study also emphasizes that the instructors need to improve the practical knowledge of the learners by integrating technical modalities.
Capillary leak syndrome due to Russell’s viper envenomation—A doomy presage for treating clinician
Authors: Hariharan A S , Gopalakrishnan Shivkumar , Abraham Bobby 
Published: October 2022

Abstract
Russell’s viper envenomation is a major challenge to physicians providing intensive care due to diverse presentations and dismal outcomes. The venom can cause idiopathic systemic capillary leak syndrome manifesting with bilateral parotid swelling, hemoconcentration, and refractory shock. Physicians’ awareness about this presentation is lacking. Delayed recognition of this syndrome leads to fatalities despite providing the best possible care. We hereby report a fatal case of Daboia russelii bite presenting as capillary leak syndrome. The aim is to create awareness among tropical physicians who are primary caregivers to these victims.
Effect of non-pharmacological interventions on adults with cardiovascular risk in a rural community
Authors: Kumar Santosh , Kant Ravi , Yadav Poonam , Kumar Barun 
Published: October 2022

Abstract

Background:
Non-communicable diseases (NCDs) are the leading cause of morbidity and mortality worldwide, with three-fourth of deaths occurring in low- and middle-income countries (LMICs) like India. Currently, three out of the top five causes of morbidity and mortality in the country are NCDs.

Objective:
This study evaluated the impact of non-pharmacological interventions as a comprehensive approach toward adults with cardiovascular risk in Indian rural communities.

Material and Methods:
It was a quasi-experimental study conducted in Rishikesh, a holy city of Uttarakhand known as the world’s yoga capital at the foothills of Himalaya. Out of 87 villages, four villages were randomly selected. Eighty-eight participants were enrolled (22 from each village and household). It was a multi-stage random sampling. All the participants with cardiovascular risk and age >30 years were recruited. Pregnant, severely ill, and unwilling to consent were excluded. Non-pharmacological intervention as a comprehensive approach, including yoga, meditation, mental health counseling, dietary counseling, tobacco, and alcohol cessation counseling has been provided to cardiovascular risk participants.

Results:
Data of 76 participants were analyzed as the per-protocol analysis method. The drop-out rate was 13.63%. Male and female participants were 52 (68.4%) and 24 (31.6%) in number. Mean age of the participants was 55.28 ± 13.64 years. Diastolic blood pressure or DBP (P = 0.017*), systolic blood pressure or SBP (P = 0.008**), waist circumference (WC) (P = 0.000**), waist-to-hip ratio (P = 0.000**) and waist-to-height ratio (P = 0.000**) significantly improved in the post intervention group.

Conclusion:
Non-pharmacological interventions as a comprehensive approach can significantly reduce modifiable risk factors for cardio-metabolic disease.
Assessing the SpO2 in a random population – Looking for the best among fingers
Authors: Agrawal Prabhat , Pursnani Nikhil , Gautam Ashish , Singh Akhil Pratap , Garg Ruchika , Pandey Anjana , Agarwal Akanshi 
Published: October 2022

Abstract

Context:
Pulse oximetry is one of the most revolutionary methods used to monitor the patients in the clinical setting, particularly intensive care and anesthesia. We usually use the index or middle finger to measure SpO2 values, but little is known about the inter-digital differences that exist between the fingers.

Aim:
We aim to compare the peripheral capillary oxygen saturation among fingers of both hands. A total of 93 healthy volunteers aged between 18 and 50 years participated in the study.

Materials and Methods:
Their SpO2 values were recorded from each finger with at least 1 minute of resting interval. Their blood pressure, heart rate, and body temperature were recorded as well.

Result:
A total of 930 measurements were obtained from 93 volunteers. The highest average SpO2 value of right-handed volunteers was measured from the left little finger (98.48 ± 0.62) of right-handed volunteers, and it was statistically significant when compared with the right ring finger, right little finger, left thumb, left index, left middle finger, and left ring finger. The highest average SpO2 from left-handed volunteers was obtained from the right index finger, but it was statistically insignificant.

Conclusion:
We assume ethnic and climatic differences to play a role in contradictory results noted from previous studies conducted, and this needs to be investigated further. It is recommended that multiple readings may be obtained from other fingers as well before coming to any conclusion as inter-finger variability cannot be ignored.