bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of peripheral artery disease risk in building construction workers by Ankle-Brachial index measurement with automated oscillometric and hand-held Doppler device
Authors: Verma Manish K. , Gangwar Vibha , Jasrotia Rajani B. , John Nitin A. 
Published: February 2022

Background:
Peripheral arterial disease (PAD) remains underdiagnosed, partly because of the limitations of the Doppler ankle-brachial index (ABI) with regards to equipment, training, and time constraints.

Aims:
To compare the accuracy and validity of automated oscillometric ABI measurement in detecting PAD in primary care settings against a gold standard Doppler device.

Settings and Design:
A cross-sectional observational study was conducted at the physiology department, Dr. Ram Manohar Lohia Institute of Medical Sciences (DrRMLIMS), Lucknow.

Methods and Material:
A total of 200 male building construction workers of all types of age groups between 20 and 40 years were recruited. The ABI measurement was performed using the Watch BP Office and hand-held HI.dop, BT-200 Vascular Doppler device.

Statistical Analysis Used:
The Bland-Altman plot and receiver operator characteristics (ROC) curve were determined to analyze the agreement between the two methods. For the reliability of the test, Pearson’s correlation with linear regression was done and the intraclass correlation (ICC) coefficient was calculated.

Results:
The mean ABI (Osc) and ABI (Dop) were 1.13 ± 0.09 and 1.06 ± 0.08, respectively. The ABI (Dop) and ABI (Osc) methods were highly correlated Pearson’s correlation coefficient of 0.96 with 95% confidence interval (CI) ranges between 0.985 and 1.066 (P < 0.001). On linear regression analysis, the ABI (Dop) predicted ABI (Osc) 92.6% correctly. The paired mean difference between the two measuring devices was 0.07 (95% CI = −0.03 to −0.12). At 0.90 cut-off value of diagnosing PAD, the sensitivity is 50%, specificity 100%, positive predictive value 100%, and negative predictive value 97% by an oscillometric automated device.

Conclusion:
Our finding suggested that ABI measurement by the automated oscillometric device is reliable, free of examiner bias, and less time-consuming.
Hyperglycaemic and hypoglycaemic emergencies among patients with diabetes mellitus who participated in pilgrims of the 2019/1440H Hajj season
Authors: Alfadhly Abdulaziz , Darraj Hussain , Alamlki Basim , Alfaez Saad , Alzahrani Mohammed , Mubarak Ali , Albogami Safar , Almalki Daifallah , Alshehri khalid , Alqarni Ali , Alzahrani Ali , khalid Hamzah , Altwairiqi Rami , Alselmi Adhari , Almajnouni Afnan , Kamal Turki , Kamal Mohammed , Almatrfi Fahad , Osman Mugtaba , Alotaibi Abdulkareem 
Published: February 2022

Background:
Diabetic emergencies are serious acute life-threatening complications of diabetes mellitus (DM). The Hajj season requires the health system in Saudi Arabia to prepare efficiently for the healthcare of millions of pilgrims, particularly for diabetic emergencies. Thus, diabetic emergencies need rapid recognition, diagnosis and treatment. This study aimed to explore the frequency and associated factors of diabetic emergencies among the pilgrim's patients with DM during Hajj, Mecca 2019.

Methods:
This is a prospective study which was conducted on 153 patients with DM. They were selected from three major healthcare-providing facilities during Hajj, which are Arafat, Muzdelefah and Muna healthcare centres. The study was conducted from Aug 5 to 12, 2019. All the patients who presented with any of the hypoglycaemic or hyperglycaemic emergencies had their demographic and clinical characteristics recorded to estimate the prevalence of each emergency and identify its significant associated factors.

Result:
More than 90% of the study participants were patients with type 2 diabetes mellitus (T2DM), while around 7% had type 1 diabetes mellitus (T1DM). Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycaemic state (HHS) and hypoglycaemia were presented in (n = 11, 7.2%), (n = 19, 12.4%) and (n = 28, 18%), respectively, of the participants. Moreover, the study found that “younger age” (odds = 30.4, P = 0.0115) and “type of medication” are significantly associated with DKA. Furthermore, “older age”, “type of medication”, “having Cardiovascular Disease (CVD)” and “diabetes duration” were found to have a significant association with HHS. Moreover, hypoglycaemia was associated with neuropathy complication (odds = 3.54948, P = 0.0187).

Conclusions:
Among the pilgrims with diabetes participating in Hajj, a considerable proportion with a range of diabetic emergencies present to the onsite medical facilities. Preparation is required in terms of logistics and health education about diabetic emergencies to meet the needs of pilgrims with DM, especially those who use insulin and have longstanding diabetes. Further research on DM and the creation of guidelines for health providers and patients with DM during Hajj are important focuses for the future.
Prevalence of neck and shoulder pain among Saudi universities’ students who are using smartphones and computers
Authors: Elsiddig Amal I. , Altalhi Ibtisam A. , Althobaiti Manal E. , Alwethainani Manal T. , Alzahrani Amjad M. 
Published: February 2022

Aim:
This study aimed to identify the prevalence and associated factors of neck and shoulder pain that result from using smartphones and computers among Saudi university students.

Methods:
A cross-sectional study was conducted on 516 students. An online questionnaire containing data about participants’ characters, type of device used, reason and duration of use and position when using smartphones, suffering neck or shoulder pain, severity, pain relief medicines, exercises for the neck and shoulder after use, and effect of pain on daily routine was distributed on Google Form.

Results:
45% of participants were using smartphones; 35.1% spent 6–9 hours on average. Further, 40.5% used mobiles with one hand with a slight neck tilt below the horizon line; 59.1% complained of neck or shoulder pain while using devices, and only 2.7% of those suffering from pain were using pain relief medicines. Moreover, 34.3% were doing exercises after using devices, and 20.3% experienced pain in their daily routines. Participants using both iPads or tablets and computers had a significantly higher percentage of neck or shoulder pain compared to other user devices. Participants using devices for studying accounted for a significantly higher percentage of suffering from neck or shoulder pain compared to those using it for other purposes. Participants using mobile with one hand with a large neck tilt below the horizon line had a significantly higher percentage of suffering from neck or shoulder pain.

Conclusion:
University students should be given top attention when it comes to raising awareness about health and safety risks associated with computer use.
Deliberate self-poisoning and harm
Authors: Abhilash Kundavaram Paul Prabhakar , Murugan Sanjay , Rabbi N Abel S. , Pradeeptha Sharon , Kumar Sathish , Selvaraj Bagyalakshmi , Gunasekaran Karthik 
Published: February 2022

Background:
Deliberate self-poisoning and harm (DSPH) is an unabating problem with a wide variation in the methods used across the world. Hence, this study was conducted to understand the current spectrum of methods used for DSPH by patients in our geographic locality and catchment area with special emphasis on newer compounds and drugs used.

Methods:
This retrospective study included patients presenting with DSPH to the emergency department (ED) between January 2017 and December 2018.

Results:
This study included 1802 patients, with a mean age of 32 ± 12.7 years. Of the patients, 85% were in the young to middle age group (16–45 years). Agrochemicals (n = 604, 33.5%), drugs (n = 498, 27.6%), plant toxins (n = 150, 8.3%) and rodenticides (n = 145, 8%) were the predominantly used compounds. The major emergency resuscitation procedures required in the ED were intubation (n = 321, 18%), vasopressor support (n = 73, 4%) and cardiopulmonary resuscitation (n = 27, 1.4%). A quarter (23.2%) was discharged stable from the ED, whereas a further 56.5% were discharged stable after hospital admission. The in-hospital mortality rate was 3% (n = 47). Multivariate logistic regression analysis showed rodenticides (odds ratio (OR): 22.32; 95% confidence interval (CI): 8.05–61.88; P = 0.005) and plant poisons (OR: 23.92; 95% CI: 8.95–63.94; P = 0.005) to be the independent predictors of mortality.

Conclusion:
DSPH is prevalent in the highly productive young age group. Agrochemical ingestion and drug overdose are the most common methods used, whereas rodenticide and plant poisoning are associated with significant mortality.
Anthropometric indices and its association with hypertension among young medical students
Authors: Lahole Swapnil , Rawekar Rajendra , Kumar Sunil , Acharya Sourya , Wanjari Anil , Gaidhane Shilpa , Agrawal Sachin 
Published: February 2022

Introduction:
Obesity, defined on the basis of anthropometric measures is a global epidemic and threatening to healthy population worldwide. A research from China among young adults (20--44 years) recorded six and two times the risk of hypertension (HTN) in individuals who were obese and overweight, respectively, relative to normal weight individuals. This study highlights about anthropometric indices and its association with HTN among young medical students at rural medical college.

Methods:
In this cross-sectional study, 1,000 medical students had been enrolled. Anthropometric indices like body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR), neck circumference (NC) as per South East Asian guidelines were measured in all students.

Results:
Among young medical students, the prevalence of obesity defined by BMI, WC, WHR, and NC was 46.5%, 32.4%, 57.3%, and 8.4%. Among males, there was significant positive correlation of BMI with SBP (P < 0.0001) and DBP (P < 0.0001), whereas WC (P < 0.0001) and WHR (P = 0.012) had positive and significant correlation with SBP but not with DBP. Correlation of NC with SBP and DBP was negative but did not reach statistical significance (P = 0.266 and P = 0.670, respectively). Among females, there was significant positive correlation of BMI with SBP (P < 0.0001) and DBP (P < 0.0001), WC had significant positive correlation with SBP (P < 0.0001,) and DBP (P < 0.0001). Correlation of WHR was significant with DBP (P = 0.002) but not with SBP (P = 0.055).

Conclusion:
The prevalence of HTN in this study was 9.8% in young medical students overall and varies according to anthropometric indices. The prevalence rate varies in males and females depending on the anthropometric measures.
Clinical profile of obsessive-compulsive disorder in children
Authors: Rajith Ravindren K. , Krishnakumar Padinharath 
Published: February 2022

Introduction:
Most studies on obsessive-compulsive disorder (OCD) among children and adolescents pertain to adolescents and Indian data on childhood-onset OCD are scant.

Objective:
To evaluate the clinical profile of OCD among children and adolescents with onset before the age of 12 years.

Methods:
Children and adolescents who attended the outpatient clinic with a clinical diagnosis of OCD were included in the study. Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) was used to assess the phenomenology and severity of OCD. The diagnoses of OCD and comorbid disorders were based on DSM5 diagnostic criteria. Children with the onset of symptoms before the age of 12 years were analyzed.

Results:
Among the 46 children with OCD, 31 (16 boys and 15 girls) had onset before the age of 12 years. The youngest child was 6 years old and in 29% of children, OCD symptoms began before the age of 8 years. Family history of OCD, other mental illnesses, and tics disorder was present in 48.4%, 29%, and 12.9% of children, respectively. Comorbid tics disorder was present in 12 (38.6%) children and 1 (3%) child each had depression and conduct disorder. Common obsessions and compulsions were obsessions of contamination (77.4%) and washing and cleaning compulsions (87.1%). Miscellaneous obsessions and compulsions occurred in 25.8% and 77.4% of children, respectively.

Conclusion:
OCD is not uncommon in young children. The present study provides preliminary data on childhood-onset OCD among children and adolescents and points to the need for larger community-based studies.
Job satisfaction among medical officers working in Delhi
Authors: Anand Tanu , Kaur Gurmeet , Gupta Kalika , Thapliyal Sunil , Lal Panna 
Published: February 2022

Background:
Satisfied human resource is an essential asset for high productivity, efficiency, and quality of care in a healthcare organization. Job satisfaction among healthcare professionals assumes further significance for the purpose of maximization of human resource potential in the context of the shortage of manpower in the health sector in India. Objectives: The objective of the study was to assess the job satisfaction among medical officers (MOs) working in Delhi and to study the factors influencing the satisfaction level amongst them.

Material and Methods:
It was a cross-sectional study conducted amongst selected MOs (by convenience) in all the districts of Delhi. A structured, self-administered questionnaire was used to collect data from the participants.

Results:
A total of 115 MOs completed the questionnaire. There were 61 (53%) female doctors and 54 (47%) male doctors. The mean age of the study participants was 38.28 ± 7.37 years. The experience of the study group ranged between 1 and 28 years (9.59 ± 6.47 years). Of the total, 59.1% of participants were found to be satisfied with their job. The most common reason given for satisfaction with job was the timing of their job that suits them. The reason given for not being satisfied with job was salary not at par with work pressure. A significantly higher proportion of male participants considered “lack of accommodation” (P < 0.03) and “frequent detailment” (P < 0.031) are big problems faced in their jobs as compared with the female participants. Only 37 (32.2%) participants felt that the MO is able to give enough time to patients for clinical assessment in Out Patient Department.

Conclusions:
Although majority (59%) of the study group was satisfied with their job, there were numerous problems faced by the doctors at their workplace. Low pay was one of the important reasons cited for being dissatisfied. There is an urgent need to address all the factors affecting job satisfaction through proper planning and implementing relevant human resource policies for improvement in the work environment at public health institutions.
Antibiotic-prescribing pattern in the outpatient departments using the WHO prescribing indicators and AWaRe assessment tool in a tertiary-care hospital in South India
Authors: Priyadharsini R. P. , Ramasamy Kesavan , Amarendar Sura 
Published: February 2022

Context:
Rational drug use has a great role of influence in health care. The fact sheet given by the World Health Organization (WHO) shows that around 50% of the drugs are prescribed, dispensed, and sold inappropriately. One of the major consequences of irrational drug use in infections is antibiotic resistance.

Aim:
The present study aims to assess the antibiotic-prescribing pattern by auditing the prescriptions in a teaching hospital.

Settings and Design:
A prospective cross-sectional study was conducted in the pharmacy of a teaching hospital to evaluate the prescriptions of the outpatient department.

Materials and Methods:
The prescriptions used to treat symptoms suggestive of infections were taken into consideration. A total of 1,000 prescriptions were analyzed.

Data Analysis:
The data was analysed using Microsoft Excel.

Results:
A total of 2,536 drugs were prescribed. The average number of drugs per prescription was 2.5. The percentage of encounters with antibiotics prescribed was 17.5%. The percentage of encounters prescribed with a generic name and with drugs from the essential drug list was 87.5% and 65%, respectively. There were no injections prescribed. Amoxicillin and ciprofloxacin were the most common antibiotics prescribed. The duration of the treatment was mentioned in all the prescriptions.

Conclusions:
Our study shows that the percentage of antibiotic usage is within the WHO standard value. The average number of drugs per prescription was slightly higher than the WHO value. Steps should be taken to improve the generic prescribing by the physicians.
Socio demographic determinants of violence among school-going adolescent girls in a rural area of North India
Authors: Vinay  , Kumar Neelam , Malik J.S. , Sachdeva Aman , Kumar Mukesh , Kumar Hement , Rathee Manjeet 
Published: February 2022

Background:
The United Nations defines violence against women as “any act of gender-based violence that results in, or is likely to result in, physical, sexual or mental harm or suffering to women, including threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or in private life”.[1] Violence can take many forms, including physical, sexual or emotional and varies in its severity. Gender discrimination, norms and practices mean that adolescent girls are likely to experience certain forms of violence, such as sexual violence, at much higher rates than boys.

Methods:
This cross-sectional study was conducted in a rural block of North India. A total of 500 adolescent girls in the age group of 13–19 years studying in class VIII to class XII in 10 government and private senior secondary schools of the Lakhanmajra block were included in the study. A pre-designed pre-tested semi-structured interview schedule was used.

Results:
In this study, we found the prevalence of physical, sexual and emotional violence among adolescent girls as 6.6, 5.4 and 5.2%, respectively. The most frequent perpetrator of physical violence was the parent and of sexual violence was the neighbour followed by friends or relatives. Higher emotional violence was experienced by adolescent girls from middle-class families (P < 0.05). The prevalence of physical violence among adolescent girls was maximum in the younger age group 13–14 years (10.2%), followed by 15–17 years (4.0%). This association was found statistically significant (P < 0.05).

Conclusions:
There are several restrictions on free communication about violence-related topics in our highly conservative society. Blaming the victim is the rule rather than the exception and sexual abuse is usually linked to a loss of virginity and family honour in our patriarchal society. Hence, girls may be more reluctant to disclose their experience of violence.
Clinical experience of tocilizumab treatment among a cohort of patients with COVID-19 infection from Western India
Authors: Surana Prince D. , Nayak Rupesh , Sheikh Arif , Haldankar Pradnya , Kale Jyoti 
Published: February 2022

Background:
Initiation of tocilizumab (TCZ) treatment in patients with coronavirus disease 2019 (COVID-19) during the early phases of cytokine storm is crucial. This study evaluated the clinical experience of TCZ use in the treatment of patients with COVID-19.

Methods:
This retrospective observational study included patients (>18 years) with confirmed COVID19 treated with TCZ alone/in combination with other drugs. Data related to demographics, clinical characteristics, radiological parameters, oxygen/ventilator/vasopressor support, treatment parameters, laboratory investigations pre- and post-TCZ treatment, and clinical outcomes were retrieved from medical records.

Results:
Out of 95 patients (mean age, 55 years), 68.4% and 31.6% of patients had moderate and severe COVID-19 disease, respectively. The mean time to TCZ administration from symptom onset was 8.7 days. At the time of admission, the mean oxygen saturation (SpO2) was 90.4% and mean concentration of fraction of inspired oxygen (FiO2) was 80.6%. The most commonly received dose of TCZ was 400 mg (84.2%) intravenously. The mean concentration of FiO2 and SpO2 improved significantly during the treatment (P < 0.001) compared to before TCZ initiation. The change in median levels of C-reactive protein (CRP) from baseline to post-treatment (63.0 vs. 4.5 mg/dL; P < 0.001) was significant. Post TCZ treatment, 73.6% of patients improved; whereas 26.4% of patients died. Acute respiratory distress syndrome (23.2%) and elevated transaminases (12.6%) were the most commonly reported adverse events.

Conclusion:
Tocilizumab administration during earlier phase of cytokine storm syndrome leads to reversal of abnormal SpO2 and FiO2 concentrations to normal levels and rapid decline of elevated CRP levels in patients with COVID-19.
Paradigm shift in pattern and prevalence of poisoning during COVID-19 pandemic
Authors: Behera Ashish , Singla Neeraj , Sharma Nalin , Sharma Navneet 
Published: February 2022

Objective:
To assess the pattern, prevalence and outcome of poisoning cases reporting to hospital in North India during COVID-19 pandemic.

Material and Methods:
An observational, prospective study was conducted for 100 patients reporting to medical emergency with history of poisoning intake from April 2020 to January 2021. Age range was 14-85 years. Obtained data were analysed using descriptive statistics and results were expressed as percentage and mean.

Results:
Out of 100 patients (77M, 33F), mean age of 32.6 years, most cases belong to age group of 20-30 years and 50% were matriculates and majority of the patients belonged to Punjab and Himachal Pradesh. The most common poisoning agents consumed were corrosives (34%) followed by Aluminium Phosphide (24%). Respiratory distress (53%), loss of consciousness (43%), acute kidney injury (36%) were the common clinical presentations. PSS (Poisoning Severity Score) was moderate in 52% of patients, severe in 14%, fatal in 16% and minor PSS in 18% of patients. 16 patients with fatal PSS and 16 patients with moderate to severe PSS got expired. High mortality of 33% was seen in our study.

Conclusions:
The most vulnerable group in our study was of young males in age group of 21-30 years and less educated, who had lost their jobs due to COVID-19 pandemic lockdown. Corrosives were the most commonly consumed poison during lockdown. Our study found that scoring systems PSS and GCS were good assessment tools for degree of severity of poisoning at an early stage.
Determinants of depression among undergraduate medical students of a private medical college in Lahore
Authors: Uzma Zafar  , Seema Daud  , Attiqa Khalid  
Published: February 2022

Objective: To assess the prevalence and determinants of depression in undergraduate medical students within their learning environment.
Methods: The descriptive cross-sectional study was conducted at the Lahore Medical and Dental College, Lahore, Pakistan, from May to June 2015, and comprised medical students of all the five professional years. A structured questionnaire was used to collect data. Section one of the questionnaire related to demographic information, section two comprised Patient health questionnaire-9 for screening depression, and section three was the Dundee ready education environment measure inventory to gather students' perceptions of their learning environment. Data was analysed using SPSS 22.
Results: Of the 533 students, 206(39%) were males, 327(61%) were females, 213(40%) were of preclinical years and 320(60%) were of clinical academic years. Overall, 399(75%) students were found to be depressed. Of them, 255(64%) were females and 144(36%) were males. Among the students, 96(18%) had negative perception of their learning environment, and out of these, 91(95%) were found to be depressed. There was significant association of depression with female gender (p=0.037) and negative perception of the students of their learning climate (p<0.001).
Conclusion: The prevalence of depression was found to be high among the medical students and it was associated with female gender and negative perception of the learning environment.
Keywords: Patient health questionnaire-9, Depressive symptoms, Environmental determinants, DREEM inventory