bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinico-epidemiological profile and outcomes of adults with COVID-19: A hospital-based retrospective study in Kerala, India
Authors: Anand Marthanda Pillai , Mini G. K. , Bobby Moses W. , Anilkumar Asokan , Kamala S. , Kutty LR Mohammed , Harikrishnan S. , Lordson Jinbert A. , Koya Shaffi Fazaludeen , Chandran Sachin , Chitra Grace A. , Lal S. S. , Nayar K. R. , Pillai A. Marthanda ,   GIPH COVID-19 Research Team
Published: June 2022

ABSTRACT

Introduction:
The clinical and epidemiological presentations of patients with coronavirus disease 2019 (COVID-19) in India is still not well explored. We studied the epidemiological and clinical profile and outcomes of COVID-19 patients admitted to a tertiary care private hospital in Kerala, India.

Methods:
In this retrospective study, we analyzed data of 476 adult (≥18 years) COVID-19 patients admitted to a tertiary care hospital in Kerala from September 1, 2020 to March 31, 2021. The patients were categorized into mild, moderate, and severe cases and followed till discharge or death. Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 23.0 with a significance set at P < 0.05.

Results:
The median age was 57 years (56% men). Mild, moderate, and severe cases accounted for 17%, 65%, and 18%, respectively. Around 75% had at least one comorbidity, and 51% had multiple comorbidities. The most common comorbidities were diabetes (45%), hypertension (44%), dyslipidemia (15%), and cardiac problems (12%). The elevated D-dimer values among patients in different categories were significantly different, with 74% in severe, 46% in moderate, and 19% in mild category patients. Serum ferritin, C-reactive protein, lactic acid dehydrogenase, and neutrophil to lymphocyte ratio values were significantly higher for severely ill patients. Thirty deaths (67% men) occurred during the study period, with a case fatality rate of 6.3%. Mortality mainly happened in the older age group (80%) and those with multimorbidity (90%).

Conclusion:
Age and multimorbidity are the major contributing factors for death in hospitalized COVID-19 patients. Generalization of the findings necessitates well-designed large-scale studies.
Endometrial carcinoma in asymptomatic post-menopausal women with a thickened endometrium and its influencing factors - A cross-sectional study
Authors: Pegu Bhabani , Saranya T Sri , Murugesan Rajeswari 
Published: June 2022

ABSTRACT

Background:
A thickened endometrium upon trans-vaginal ultrasound in asymptomatic post-menopausal women always poses a clinical dilemma.

Objectives:
To investigate the frequency of endometrial malignancies by histopathological examination and identify the associated factors influencing the thickened endometrium in asymptomatic post-menopausal women.

Methods:
In trans-vaginal ultrasonography, we enrolled 72 asymptomatic post-menopausal women with a thickened endometrium (>5 mm). Dilatation and curettage were performed for all cases, and the specimen was sent for histopathological examination. According to the data distribution, all the continuous variables were stated as mean ± standard deviation/median (inter-quartile range), categorical variables were expressed in frequency, and percentage will be compared using the Chi-square test/Fisher exact test.

Results:
In our study, most of the women were multipara. The age of post-menopausal women ranged from 46 to 68 years, and the mean duration of menopause was 8.10. The most common histological findings were benign in 72.22% of the cases. We identified pre-malignant and malignant lesions of the endometrium in 18.05% and 9.72% of the cases, respectively. To predict the condition of the lesion, we noticed no definite cut-off value of endometrial thickness to indicate the state of the lesion. We observed that none of the patient’s characteristics showed a significant difference with a thickened endometrium.

Conclusion:
We observed an increased frequency of endometrial pathology irrespective of the presence or absence of risk factors. The result of this study is justified enough for the need of further evaluation of a thickened endometrium in asymptomatic post-menopausal women.
Attitude and hesitancy of human papillomavirus vaccine among Saudi parents
Authors: Alhusayn Khalid O. , Alkhenizan Abdullah , Abdulkarim Ahmed , Sultana Habiba , Alsulaiman Thamer , Alendijani Yaser 
Published: June 2022

ABSTRACT

Background:
Human papillomavirus (HPV) is closely associated with cervical cancer. The HPV vaccine is expected to protect against two-thirds of cervical cancer cases in Saudi Arabia.

Objectives:
To determine the awareness and attitude regarding the HPV vaccine among Saudi parents attending family medicine clinics in Riyadh.

Materials and Methods:
All Saudi parents of patients of Family Medicine Pediatric Clinics, King Faisal Specialist Hospital and Research Centre (KFSH&RC), Riyadh, were invited to participate in this study between November 2019 and May 2020. A culturally sensitive and specially designed questionnaire was administered using an interview-based model. The data collected included sociodemographic information, knowledge of HPV and its vaccine, and attitudes regarding HPV acceptance.

Results:
A total of 296 study participants completed our questionnaire on the HPV vaccine. About 70.6% of the participants were not aware of the HPV vaccine and the majority of them either did not know or did not associate HPV as an etiology for cervical cancer (38.8 and 37.8%, respectively). Only 28.6% of the participants were aware that cervical cancer can be prevented by a vaccine and 89.5% of the study participants did not receive the HPV vaccine for themselves or their children. The employee status was significantly associated with a history of receiving the HPV vaccine (χ2 (2) = 10.607, P =0.005), while age and the level of education had a statistically significant relationship with planning on having the HPV vaccine ((χ2 (9) = 51.841, P <.001) and (χ2 (12) = 23.977, P =0.02), respectively). The level of awareness of the HPV vaccine was significantly associated with a history of having the HPV vaccine; (χ2 (1) = 38.486, P <.001) as well as with planning on having the HPV vaccine (χ2 (1) = 38.486, P <.001). Moreover, the reasons for hesitancy were a statistically significant factor for unvaccinated respondents who were not planning to have the HPV vaccine (χ2 (21) = 97.689, P <.001) while it was not significantly associated with the unvaccinated respondents who were planning to have the HPV vaccine (χ2 (9) = 6.989, P =.63).

Conclusion:
Our study clearly demonstrated a poor level of awareness and attitude toward the HPV vaccine among Saudi parents. A higher level of awareness of the HPV vaccine was significantly associated with planning on having the vaccine. There is a need for effective awareness programs for better HPV-related education in order to increase the acceptance of the HPV vaccine among Saudi parents.
Frequency of skeletal dysplasia in children with short stature presenting to endocrine clinic: An observational study
Authors: Seema  , Abbas Saira , Ahsan Muhammad Nadeem , Asghar Muhammad Sohaib 
Published: June 2022

ABSTRACT

Objective:
To determine the frequency of skeletal dysplasia in children with short stature presenting to the endocrine clinic of a tertiary care hospital.

Methods:
This descriptive cross-sectional study was performed in the Outpatient Department of Endocrinology of National Institute of Child Health, Karachi, for 6 months of duration. A total of 200 children coming to endocrine OPD of NICH of either gender, having the age less than 14 years and height more than -2.5 SD below the mean (<3rd percentile), and growth failure (<4 cm/yr) were enrolled. A complete general physical examination including height, weight, fronto-occipital circumference (FOC), arm span, and U/L (upper/lower) segment ratio (using SI units and SDS) was performed.

Results:
Out of 200 children with short stature, skeletal dysplasia was diagnosed in 23 (11.5%) children with the mean age of 4.7 (±3.7) years. Proportion of skeletal dysplasia among short stature was high in females. Out of 75 girls, skeletal dysplasia was diagnosed in 10 (13.3%) girls, while out of 125 boys, skeletal dysplasia was diagnosed in 13 (10.4%) boys, whereas when we see proportion among skeletal dysplasia out of 23 children of skeletal dysplasia, 13 (56.5%) were boys, while 10 (43.5%) were girls.

Conclusion:
In this study, skeletal dysplasia was diagnosed in 11.5% children with short stature with the mean age of 4.7 years. It is concluded that the frequency of skeletal dysplasia in this institute is fairly high.
Utility of anthropometric measures to identify small for gestational age newborns: A study from Eastern India
Authors: Annigeri Saba , Ghosh Arindam , Hemram Sunil Kumar , Sasmal Ritayan , Mythri JP 
Published: June 2022

ABSTRACT

Introduction:
Small-for-gestational-age (SGA) is one of the important factors for neonatal mortality. Early identification and necessary intervention of these newborns is crucial to increase their chances of survival and reduce long-term disabilities. However, in low- and middle-income countries a large portion of pregnant women are unaware of their accurate gestational age (GA) due to the limited availability of ultrasonography. The purpose of our study was to build an alternative tool to identify SGA.

Methods:
A institutional-based, prospective observational study was conducted from August-2018 to February-2020, with 1451 live singleton-newborns of 30-40 weeks of gestation. Ultrasonography was used to evaluate accurate GA in early pregnancy and a reference chart for the Asian population, constructed by the National Institute of Child Health and Human Development (NICHD) Fetal Growth Studies was used to classify newborns as SGA. Neonatal anthropometry was measured within 48 hours of birth. Receiver operating characteristic curves were developed to identify the best cut-off point for each anthropometric parameter and the area under the curve (AUC) was estimated to assess the overall precision.

Results:
Prevalence of SGA was 34.3%. The AUC was 0.888 for head circumference (HC), 0.890 for chest circumference (CC), and 0.865 for mid-upper arm circumference (MUAC). The optimal cut-offs to classify SGA were ≤32.45 cm for HC, ≤29.75 cm for CC and ≤8.55 cm for MUAC with sensitivities of 85.9%, 86.9% and 85.4%, specificities of 75.5%, 85.1% and 72.1%, positive predictive values of 0.64, 0.75 and 0.61 and negative predictive values of 0.91, 0.93 and 0.90 respectively.

Conclusion:
All three anthropometric measurements could be used to identify SGA but, overall CC is the best.
Do learning styles influence learning outcomes in anatomy in first-year medical students?
Authors: Padmalatha K , Kumar J Prathap , Shamanewadi Amritha N. 
Published: June 2022

ABSTRACT

Background:
Learning styles are a key element for teachers for any given learning environment. The Visual, Aural/Auditory, Reading/write, Kinesthetic (VARK) instrument is easy to administer and can have an impact on the quality of learning environment. The present study was done to understand the learning styles preferred by the students using VARK questionnaire and correlating learning styles with their academic performance.

Materials and Methods:
The study was conducted on 100 first-year MBBS students.

Students were categorized into five groups of learners:
visual, auditory, read/write, kinesthetic, and multimodal, based on their scores obtained after administering VARK questionnaire. First internal marks of theory and practicals were collected. One-way analysis of variance (ANOVA) was done in five groups of learning styles.

Results:
Out of 97, 13 were visual, 25 were auditory, 5 were read/write, 40 were kinesthetic, and 14 were multimodal type of learners. Three students were chronic absentees and were excluded from the study. The student who scored highest in theory internal assessment belonged to visual and kinesthetic type of learner, whereas who scored least was a kinesthetic learner. The student who scored highest in practical internal assessment was a multimodal learner and who scored least was a kinesthetic learner, The P value for theory was 0.773 and for practicals was 0.26, ANOVA for theory is 0.33 and for practicals is 0.057.

Conclusion:
There was no statistic difference in theory performance, however with respect to practicals, the ANOVA value was 5%. Hence, the aforementioned results may be suggestive of correlation between learning style and academic performance.
Comparison of frequency domain parameters of heart rate variability between women with polycystic ovarian disease and apparently healthy women
Authors: Tiwari Ritu , Bajpai Manish , Tiwari Sunita , Agrawal Smriti 
Published: June 2022

ABSTRACT

Background:
Polycystic ovary syndrome (PCOS) patients shows common features like increased insulin resistance and adiposity, which have been known to correlate with sympathetic hyperactivity.

Objective:
The aim of this study is to analyze the characteristics of heart rate variability in women with PCOS. To compare frequency domain parameters of heart rate variability (HRV) between women with PCOS and apparently healthy women. To study the impact of cardiometabolic parameters such as BMI and blood pressure on frequency-domain HRV parameters.

Methods:
A total of 30 women with PCOS aged 20 to 40 years (as per Rotterdam criteria) were enrolled as cases and 30 age-matched women having normal ovulatory cycles were enrolled as controls. HRV was recorded using an electrocardiography machine (ECG) machine. The following frequency-domain parameters were assessed: Total power, Very low frequency (VLF), VLF%, Low Frequency (LF), LF%, LF nu, High frequency (HF), HF%, HF nu, LF/HF ratio, short-term variability (SD1), and long-term variability (SD2), respectively.

Results:
Mean age of cases was 28.03 ± 5.33 years. Mean BMI of PCOS women was 25.39 ± 2.69 kg/m2. A total of 18 (60%) had BMI >25 kg/m2. Cases had significantly higher BMI, waist hip ratio, and blood pressure as compared with controls. None of the controls had BMI >25 kg/m2. Majority of cases (66.7%) had systolic blood pressure/diastolic blood pressure (SBP/DBP) >130/85 mmHg as compared with only 6 (20%) of controls (P < 0.001). For different frequency domain parameters, no statistically significant difference between two groups was observed for VLF and LF. Mean VLF%, LF%, LF (nu), and LF/HF were significantly higher in cases as compared with controls. For all, the other mean value was significantly lower in cases as compared with that of controls (P < 0.05).

Conclusions:
Autonomic nervous system is affected by PCOS status of women, and sympathetic hyperactivity is seen.
Cognitive dysfunction and disability in people living with schizophrenia
Authors: Srisudha B. , Kattula Dheeraj , Devika Shanmugasundaram , Rachana Arun 
Published: June 2022

ABSTRACT

Background:
Schizophrenia is a major mental disorder characterized by positive, negative, and cognitive symptoms. Cognitive impairment is a central and enduring feature of schizophrenia and is associated with disability. It has a devastating consequence on the individuals, families, and the society. Our aim was to assess cognitive functioning, disability, and their association with sociodemographic and illness-related variables.

Methodology:
In an outpatient department of psychiatry, 82 adult patients with a diagnosis of schizophrenia were recruited. Schizophrenia Cognition Rating Scale (SCoRS), Positive and Negative Syndrome Scale (PANSS), and Indian Disability Evaluation and Assessment Scale (IDEAS) were used to assess cognitive function, psychopathology, and disability respectively. Socio-demographic and illness-related details were collected using a semi-structured questionnaire. Data were analyzed using STATA version 16.0 using appropriate statistical tests.

Results:
Approximately 93.9% of patients had at least one cognitive symptom even though not severe. The status of being married was associated with better cognitive outcome. No other socio-demographic factor was associated with cognitive dysfunction. Negative symptoms and general psychopathology scores of PANSS were positively correlated with SCoRS scores and IDEAS score. Cognitive dysfunction and disability were significantly associated suggesting higher the cognitive deficit in schizophrenia greater is the likelihood of patient experiencing disability.

Conclusion:
Cognitive deficits are commonly seen in patients with schizophrenia and are associated with disability. Therefore, treatment programs of schizophrenia should have a component to address these deficits using evidence-based cognitive remediation therapies. Family Physicians caring for those with schizophrenia should factor the cognitive deficits and simplify dosage regime and engage caregivers for supervision.
Effect of doxycycline and doxycycline with carica papaya on thrombocytopenia and leucopenia in acute dengue fever patients
Authors: Pambhar Vivek , Mathur Navgeet , Mehta Amit , Mathur Medha , Kumawat Dal Chand , Mangalia Ravi , Verma Anjana , Patyal Ashish 
Published: June 2022

ABSTRACT

Background:
Dengue fever is a mosquito borne disease commonly manifest leucopoenia and thrombocytopenia. Dengue fever and its complications like bleeding manifestation can be life threatening. This study was conducted to study the effect of doxycycline and doxycycline with carica papaya on thrombocytopenia and leucopoenia in acute dengue fever patients.

Methods:
This case control study was conducted amongst the patients suffering from dengue fever with thrombocytopenia. Cases were dengue patients with thrombocytopenia and leucopenia both. Controls were dengue patients with thrombocytopenia with normal leukocyte count. An effect of doxycycline and doxycycline with carica papaya was observed on platelet and leukocyte counts at baseline and first, second, fourth, and seventh day in cases and comparison was done.

Results:
The maximum improvement in mean platelet count and leukocyte count was observed in doxycycline with carica papaya group followed by doxycycline alone group followed by controls (conservative treatment) in decreasing order on day 4th and 7th day of admission. Reduced hospital stay was also in the same order.

Conclusion:
The study results indicate that doxycycline and carica papaya are useful modality to improve leucopenia and thrombocytopenia in dengue patients and to minimize hospital stay.
Influencing factors of vision-threatening disease among patients with diabetes in the central region of Saudi Arabia: A case–control study
Authors: Alsolaimi Yaseer A. , Almudaymigh Mohammed S. , Al Essa Mohammed , Gramish Jawaher , Bustami Rami , Al Yami Majed S. , Vasudevan Senthilvel 
Published: June 2022

ABSTRACT

Aims:
Diabetic retinopathy is called as vision threatening disease. It affects retina very severely. DR is a common public health problem in Worldwide. Our main objective was to identify significant risk factors for diabetic retinopathy among diabetes mellitus patients.

Materials and Methods:
The present retrospective Case-Control study was conducted with 404 DM patients’ records were collected from King Abdulaziz Medical City, Riyadh, Saudi Arabia.

Statistical analysis used:
Data were presented as descriptive statistics, multivariate logistic regression, association between variables was using odds ratio and 95% confidence interval.

Results:
Among 404 diabetes patients, 192 (47.5%) were Cases and 212 (52.5%) Controls. In multivariate regression analysis showed that male gender also had a higher likelihood in the development of DR, OR: 1. 68 [95% CI: (1.04 – 2.71); p<0.05]. Patients with poor glycaemic control, OR: 4. 86 [95% CI: (2.21-10.66); p<0.001]. Similarly, HbA1C, Low LDL was prominent risk factor in the progression of DR except age, hypocholesterolaemia, nephropathy wasn’t significant.

Conclusions:
From our study findings, male gender, tobacco habit, poor glycaemic control, and Low HDL were appeared independently associated with the development of vision-threatening disease. By regular check-up, reducing risk factors or retain their stages in the same stage or to prolong the DR incidents among DM patients.
Depression and its socio-demographic correlates among urban slum dwellers of North India: A cross-sectional study
Authors: Pawar Neeraj , Kumar Neelam , A Vikram , Sembiah Sembagamutthu , Rajawat Gaurav 
Published: June 2022

ABSTRACT

Background:
Depression is a common mental health disorder that is characterized by loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, low energy, and poor concentration, insomnia or hypersomnia, and occasionally suicidal thoughts. Apart from biological factors, sociocultural factors also play a key role in development of depression

Objectives:
To determine the prevalence of depression in the study population and to study various socio-demographic correlates of depression in the study population.

Methods:
A community based cross-sectional study was carried out in an urban slum area of Rohtak city during 2016-2017. A total of 600 study participants were selected and interviewed by using PHQ-9 depression scale. The collected data were entered in MS Excel spread sheet and analysed using SPSS software version 20.0.

Results:
Mean age of the study participants was 37.91 ± 11.75 years. Almost all (97.5 %) study subjects were Hindu. Majority (52 %) belonged to General category. Overall prevalence of depression was found to be 16.2%. The distribution for factors like gender, marital status, education, occupation, socioeconomic status, type of family, living arrangement, smoking habit and death of close relatives were found to be statistically significant with depression (P<0.05). Logistic regression analysis showed that female gender, divorce/separation, illiteracy, unemployment, lower socioeconomic class nuclear family living alone, smoking habit, presence of chronic morbidity and death of close relative in past one year, as independent predictors of depression.

Conclusions:
The prevalence of depression among adults in an urban slum of north India was found to be 16.2%. Our findings indicate that depression in urban slum is significantly associated with determinants such as gender marital status, education, occupation, SE class, family type, smoking, living arrangement, death of close relative, chronic morbidities like neurological disorders, diabetes and hypertension.