International Journal Of Community Medicine And Public Health

Advantages and limitations of monolithic zirconia restorations

Sat, 07 Jan 2023 00:00:00 +0000

Due to their biocompatible nature and advantageous mechanical characteristics, zirconia treatments have been utilized effectively in by dentists for many decades. A zirconia core is typically veneered with porcelain as they are not translucent, which renders treatments poorer since the bonding between the two substances fails. All-ceramic zirconia treatments have recently been made available in the dentistry market in an effort to address this issue. In addition to the absence of chipping, monolithic zirconia (MZ) fillings appear to have the benefit of requiring less occlusal room. To advocate this comparatively recent approach for restorative therapy, however, requires scientific proof. MZ could be the optimum material for rear fixed partial prostheses in the case of powerful occlusal pressures and little occlusal restorative room, according to the findings of in vitro investigations. To come to a clear consensus, the findings should be validated by many more in vivo and especially in vitro investigations.

Oral health problems and dental service utilization in children with hearing impairment: a narrative review

Amandita Parameswari, Armasastra Bahar, Melissa Adiatman — Fri, 20 Jan 2023 00:00:00 +0000

Children with hearing disability face challenges on accessing healthcare services caused by their lack of ability to express their oral health problems and affect their oral health status. This narrative review aims to explore oral health status in hearing impaired children and discuss in detail about dental service utilization in children with hearing impairment. Many studies assessed oral health status of children with hearing impairment. A comprehensive retrieval of the English literature from 2012 to 2022 was done in PubMed, ScienceDirect and ProQuest. Oral health assessments including dental caries, gingival problems and periodontal condition. Healthcare seeking behavior of the parents of hearing-impaired children is reflected by dental service utilization. Hearing impaired children have a high prevalence of caries, high caries activity and poor gingival condition compared to their counterparts. There are unmet dental treatment needs due to their dependence on parents or caregiver on decision making. Proper oral health educational method for hearing impaired children and their parents or caregiver is needed to improve oral health status and dental service utilization.

Causes, risk factors and complications of dental implant failure

Thu, 12 Jan 2023 00:00:00 +0000

Osseointegration, which refers to the direct attachment of dental implants (DIs) to the neighboring host bone, is a great predictor of the therapeutic efficacy of DIs. The factors that determine whether DIs are successful have been evolving over time. Presently, these factors comprise the lack of mobility at the beginning of the prosthetic stage. DIs have a high chance of success; however, they occasionally fail. The failure of properly implanted DIs has been attributed to inappropriate patient identification; inadequate dental hygiene associated with microbial plaque buildup. The three most significant factors that lead to early implant failure appear to be a paucity of basic stability, surgical injury, and infection. Due to disruption of the basic bone recovery process, initial symptoms of infection may portend a far more serious outcome than if similar issues arise later. It appears that peri-implantitis and occlusal overloading are the main causes of late failure. Among the predisposing variables for implant problems and failure include poor prosthesis fabrication and subpar implant design.

Outbreak investigation of cholera in a rural community, Rivers State Nigeria: an interventional epidemiological study

Fri, 27 Jan 2023 00:00:00 +0000

Cholera is a potentially life-threatening public health menace caused by a gram-negative rod-shaped bacterium known as Vibrio cholerae. This study was an epidemiological investigation of the cholera outbreak in Degema local government area (LGA), Rivers State, Nigeria. An interventional epidemiological study was conducted in a rural community between December 2021 to February 2022. All suspected cases were identified using the World Health Organization (WHO) case definition of acute watery diarrhoea. The standard outbreak investigation procedures (active case search, case management, water sanitation, hygiene) were implemented. The cholera outbreak observed two waves within an at-risk population of 373,071 in the affected LGA. Of the 35 line-listed suspected cases (male-20 versus female-15), the highest frequency was observed among those aged 0-5 years. The index case was reported on the 3^rd of December in the 47^th week of 2021 and abated by the 49^th week, while the 2^nd wave began in the 1^st week of 2022 and abated by the 6^th week. The stool samples result revealed; six positives for RDT, while four samples were positive by microscopy. All patients received home-based treatment except for two cases that were managed at the healthcare facility. The attack and case fatality rates were 0.01, and 8% respectively. The Rivers State public health emergency operation centre deployed standard epidemiological interventions for the containment of acute watery diarrhoea (cholera) aimed at reducing morbidity and mortality; however, vaccines were not part of the response. The deployment of vaccines and provision of potable water will improve response outcomes.

Efficacy and safety of carbamide peroxide tooth-whitening gels

Thu, 12 Jan 2023 00:00:00 +0000

Carbamide and hydrogen peroxide are the most frequently utilized compounds for various whitening techniques, that differ as per peroxide level, method of administration, and exposure period, when it comes to the active solutions accessible for important tooth whitening. The 10±1% carbamide peroxide dosage was the only level to date to acquire the American Dental Association's stamp of approval, ensuring its safety and effectiveness for at-home tooth whitening with customized trays. There has been a noticeable growth in the range of in-office tooth whitening compounds commercially available, which typically use elevated carbamide peroxide levels (30 to 37%) with or without an additional illumination. Even though tooth sensitivity appears to be the most frequent side effect of carbamide peroxide bleaching, discomfort goes away when the plan of care is finished. Sensitivity is typically linked to a background of sensitive teeth, greater administration rate, or use of greater carbamide peroxide levels. Additionally, studies have showed that using 10% carbamide peroxide at home to lighten teeth had comparable effectiveness to other methods (over the counter or in-office whitening). Patients generally prefer home vital bleaching with 10% carbamide peroxide to office procedures with 35% hydrogen peroxide. When comparing the safety utilizing 16% carbamide peroxide for nightguard vital bleaching to a placebo or 10% carbamide peroxide, patients receiving 16% reported higher gingival soreness than those administered a 10% carbamide peroxide or a placebo.

Clinical features of neonates born to mothers with coronavirus disease-2019: a systematic review of 403 neonates

Lekshmi M. K., Revathi S. Nair — Fri, 27 Jan 2023 00:00:00 +0000

The COVID-19 pandemic emerged and spread fast affecting countries across the world consequently becoming a public health crisis. The impact of the virus on the health of adults and children has been increasingly understood but its effects on neonates born to infected mothers remain still unclear. This study aimed to throw light on the impact of novel SARS CoV-2 on pregnant patients and to examine maternal and neonatal outcomes along with the analysis of the extent of maternal-foetal transmission. A comprehensive literature search was conducted on PubMed and Google scholar till April 3 2022 using keywords COVID-19, SARS-CoV-2 and pregnancy, neonate, newborn and infant. 8 articles were reviewed, and clinical characteristics of 400 COVID-19-infected pregnant women and 403 neonates born to them were considered. Almost half of the women (56.5%) were asymptomatic. ICU admission was required by 3.75% of mothers and 1.75% mortality was reported. Out of 257 tested neonates, the positivity rate was 4.7%. Most of the neonates were asymptomatic (87.14%) and the neonatal mortality rate was 2.97%. To conclude, current evidence suggests most neonates born to covid infected mothers are not much affected by morbidity or mortality. As samples of breast milk or amniotic fluid were not tested so chances of vertical transmission cannot be ascertained. Nevertheless, considering the positivity rate in neonates as 4.7% we suggest further study in this regard. So, such infants should receive tests for SARS-CoV-2 and appropriate treatment should be initiated when needed.

Pulp stones and its relation with co-morbid diseases

Thu, 12 Jan 2023 00:00:00 +0000

Pulp stones are nodular, calcified masses that can develop in the pulp of healthy, damaged or even developing teeth. In addition to a number of other factors and idiopathic factors, a number of theories have been put forward about the etiological factors behind the occurrence of pulp stones. These include age, genetic susceptibility, pulp degeneration, pulp circulatory disturbances, inductive interactions between pulp tissue and epithelium, and orthodontic tooth movements. Recently, pulp stones development has been linked to a number of systemic disorders, including diabetes, renal diseases, autoimmune diseases, and coronary artery disease. Osteopontin appears to contribute to plaque calcification and is a component of atheromatous plaques. Calcifications have also been noted in renal and carotid arteries with osteopontin, and numerous studies have shown a relationship between atheromatous plaques in arteries and the development of pulp stones. The development of pulp stones, kidney stones, joint calcification, and atheromatous plaques in arteries are thought to share the same mechanism of apatite formation. It has been hypothesized that the biological apatite that nanobacteria produce on their cell walls, which is comparable to kidney stones and calcified tissue, may be a common cause of both pulp stones and atheromatous plaques seen in coronary artery disease. As per the findings of several studies, pulp stones are more severe in coronary artery disease patients. The purpose of this research is to review the available information about pulp stones and its relation with co-morbid diseases.

Quality of life: concepts, needs, psychometric measurement, factors associated and treatment responsiveness in depression disorder

Sanjay Sevak, G. Balamurugan — Fri, 27 Jan 2023 00:00:00 +0000

Quality of life (QOL) is a multifaceted concept that warrants attention, especially in depression disorder. This review aimed to summarize the empirical evidence regarding concepts, needs, psychometric measurement, factors associated, and treatment responsiveness in depression disorder. The narrative review was conducted based on studies published in English databases from the last three decades to 2022 on the evidence from extensive electronic databases using PubMed, SCOPUS, PsychINFO, ScienceDirect, SpringerLink, and Google Scholar. The significant findings from books, journals and grey literature were also included. Based on relevant and significant facts the concepts were developed and evidence-based narrations were made under each concept to understand QOL in depression disorder. This review found a significant association between poorer QOL with the severity of depression and, its association with age of respondents, the intensity of the depressive symptoms, lower education, subjective perception of health, lower socio-economical status, and social support. The review signifies the needs and psychometric instruments of QOL in patients with depressive disorder. The review revealed that psychoeducation, multimodal and community-based lifestyle intervention, self-awareness and body-mind-spirit interventions, CBT, group therapy and mental health promotion intervention improved the QOL in depression disorder. The study concluded that QOL is a patient-centric approach, and should be involved as the standard measure of evaluating care outcomes, satisfaction, and cost-effectiveness through the incorporation of the various treatment approaches in clinical practice. Despite being an essential component QOL is received relatively little attention in depression disorder by clinicians and mental health professionals.

Geographic information systems applications in India's public health are we moving towards the right direction?

Debajyoti Bhattacharya — Fri, 27 Jan 2023 00:00:00 +0000

Governments worldwide focus particularly on digital healthcare sensors for leveraging data and technology like Geographic Information Systems (GIS) to improve governance and service delivery. Geoinformatics technology can help with epidemiological research and outbreak response, minimizing the health consequences in communities beforehand, during, and then after epidemic episodes. We can all agree that location and time play a crucial role in carrying out an efficient public health response. Since location information is essential for every stage of planning, response, and recovery, GIS helps the location-based support of public health preparedness programmes like support for decisions, resource allocation, communication and collaboration, and civic participation. GIS scales to situations ranging from adverse weather to pandemics. Public health professionals can coordinate their efforts with those of other organizations and external stakeholders due to maps and apps. The public health preparedness community may achieve significant strides by incorporating GIS data, models, communication and engagement centres, and location-centric apps. GIS technology can help with this efficient method for gathering data, performing analysis, where they are most needed, interacting with decision-makers, and finally achieving health equity can be created with the aid of a location-based strategy. During COVID-19, this reality was disseminated more extensively through the news media and the national, state, and local governments. This paper evaluates the application of GIS in the Indian public health system and the various aspects of public health where GIS may emerge as a game-changer for future policy decisions.

Co-epidemics: implications of COVID-19 outbreak associated with human immune-deficiency virus, tuberculosis and Lassa fever in a low resource economy-a call for proactive measures

Osho P. Olanrewaju, Osho E. Omosalewa, Lawrence Okoro, Ojo-Rowland Olawale — Fri, 27 Jan 2023 00:00:00 +0000

As the global struggle to combat the quadruple burden of COVID-19, human immunodeficiency virus, tuberculosis and Lassa fever continues to increase, Sub-Saharan Africa has been the most affected region, especially Nigeria. There is a close interaction between these four diseases and a clear understanding of each of these diseases is very crucial. People living with chronic medical conditions such as HIV, TB and Lassa fever are more likely to experience poor outcomes from COVID-19 even though there are still some unknown facts as regards the burden of COVID-19 on patients with TB, Lassa fever and HIV in our low-middle–income nation. This study was conducted to review different researches on COVID-19 associated with HIV, TB and Lassa fever co-infections, to understand the interactions between them and its implications on clinical investigations and health management in high burden countries of COVID-19, especially Nigeria. The research was designed to accommodate research and reports from different geopolitical zones of Nigeria where the diseases has been reported and centering on Ondo State reports. This was done using search engines, with reference to valid studies from academic sources like ResearchGate, PubMed and Google Scholar. We also evaluated various related titles, abstracts and full reports for eligibility. Ondo state was the centre of study as it is one of the states with high prevalence of Lassa fever, TB, HIV and COVID-19 co-infections in Nigeria. Structured diagnostic algorithms and clinical management are suggested to improve COVID-19/HIV/TB/Lassa fever or COVID-19/Lassa fever co-infection outcomes. With low quality of health care facilities for laboratory diagnosis of COVID-19 and Lassa fever, reliance on clinical acumen and high index of suspicion may be the only process that health professionals may rely upon to make early diagnosis.

Diabetes mellitus-a true immunosuppression

Manigandan Gopi, M. S. Seshadri — Tue, 10 Jan 2023 00:00:00 +0000

Uncontrolled diabetes mellitus predisposes to variety of infections which are very difficult to manage. Here we report a case of diabetes mellitus with pulmonary tuberculosis who did not respond to anti tubercular therapy (ATT). On further evaluation patient found to have nocardiosis co-infection which usually occurs in immunocompromised patients like malignancy/ in HIV virus infected patients. This patient did not have any such condition other than uncontrolled diabetes mellitus which predisposed to nocardiosis co-infection. This co-infection of pulmonary tuberculosis and nocardiosis is very uncommon in HIV negative individuals and is reported because of this rare presentation.

Evaluation of in vitro anti-acne activity of methanolic extracts of Cyperus rotundus and Nymphaea nouchali

Fri, 27 Jan 2023 00:00:00 +0000

Background: The objective of this study was to evaluate in vitro anti-acne activity against Staphylococcus aureus (S. aureus), Staphylococcus epidermidis (S. epidermidis), and Escherichia coli (E. coli) using the agar well diffusion method.

Methods: Air-dried and ground, matured rhizomes of Cyperus rotundus (CR), petals and pollen of Nymphaea nouchali (NN) were macerated in methanol. The resultant extracts were concentrated using a rotary evaporator. The anti-bacterial activity was performed against Staphylococcus aureus (ATCC 25923), Staphylococcus epidermidis (ATCC12228), and Escherichia coli (ATCC 25922) using the agar well diffusion method, and gentamicin was used as a positive control. The whole experiment was done in triplicates.

Results: The data obtained from dose-response curves, methanolic extracts of Cyperus rotundus rhizomes against staphylococcus aureus (IC50=819.2 µg/ml), Nymphaea nouchali pollens against Staphylococcus epidermidis (IC50=787.7 µg/ml) and combination against Escherichia coli (IC50=813.6 µg/ml) were exhibited the highest potency. A strong positive statistically significant correlation was exhibited between the zone of inhibition and the concentrations of all plant extracts. The p value was less than 0.05 (p<0.05) and all the R² values were around 1.

Conclusions: The maximum anti-bacterial potency against gentamicin equivalent was observed in S. aureus, S. epidermidis, and E. coli at the concentration of 15625 µg/ml in combination. The present study might bring progress in the treatment of acne using herbs and in developing herbal formulations for safe and effective management of the disease.

Determinants of commodity management practices in public health facilities in devolved health systems: a case of essential medicines in Makueni County, Kenya

Daniel I. Mwangi, Kezia Njoroge, Musa Oluoch — Fri, 27 Jan 2023 00:00:00 +0000

Background: Good health commodities management is an essential component of effective and affordable health care services globally. Curative, preventative and rehabilitative care involve the utlization of medicines and medical supplies. The specific focus of the research was on the impact of: healthcare worker training; policy and institutional framework; healthcare budgetary allocations; and, available infrastructure on effective management of essential medicines in publicly owned health facilities in a devolved system.

Methods: The researcher used descriptive cross-sectional research design and a mixed method of qualitative and quantitative data collection techniques in collecting both primary and secondary data. The study adopted a stratified random sampling procedure to choose targeted 50 public health facilities in Makueni County from a population of 162 health facilities. The calculated size of the sample was 96 respondents through stratified sampling technique. The analysed data was presented using tables, charts and narration for qualitative data.

Results: The study findings established that health worker training, health budgetary allocations and available infrastructure had significant and positive effect on management practices of essential medicine in Makueni County, Kenya. However, the effect of policy and institutional framework was found to insignificant in predicting the management practices of essential medicines in Makueni County.

Conclusions: The study concluded that healthcare sector is a dynamic sector that faces different changes on a daily basis. Health worker training; policies and institutional structures; budget allocation; and infrastructure need to be advanced to meet the expectations in the evolving healthcare sector.

Pain intensity and sexual satisfaction: a comparison of cyanoacrylate adhesive glue and vicryl for episiotomy skin closure in Kano Nigeria

Usman Abba, Abubakar Musa, Ibrahim S. Abdullahi, Muhammed K. Abdullahi — Fri, 27 Jan 2023 00:00:00 +0000

Background: Episiotomy is a deliberate incision made on the perineum and posterior vaginal wall during vaginal delivery. Mothers that have a new baby are in great need for wound care and pain relief. We assessed and compared pain intensity and sexual satisfaction using cyanoacrylate adhesive glue and vicryl for episiotomy skin closure at AKTH, Kano Nigeria.

Methods: A randomised control trial was conducted among 100 women who had spontaneous vaginal delivery in the labour ward of AKTH from June to October 2019 after randomization into study group I and control group II. Cyanoacrylate and vicryl were used for skin closure following episiotomy and the patients were followed up for pain and sexual satisfaction for 14 days. Data were analysed using SPSS version 21.0 and p<0.05 was set statistically significant.

Results: The mean±SD ages of the women in the study and control groups were 22.71±9.14 and 23.66±9.00 years, respectively. In group I 84% perceived no pain and 72% perceived mild pain in group II during cyanoacrylate adhesive glue procedures. At all-time intervals, pain intensity was lower in group I (p<0.05). A significant difference was observed regarding sexual function between group I and group II (p<0.001) but the difference was not significant in other cases.

Conclusions: Cyanoacrylate glue compared to Vicryl was found to be effective in reducing short-term pain, the need for analgesia and better sexual satisfaction following episiotomy after childbirth.

Heroin use among clients receiving methadone treatment in Dar es Salaam Tanzania: a qualitative study

Idda H. Mosha — Fri, 27 Jan 2023 00:00:00 +0000

Background: Simultaneous heroin use among methadone-maintained clients is a recognized phenomenon worldwide. Tanzania is the first sub-Saharan African country to offer methadone treatment. This study explored reasons for heroin use among clients on methadone treatment clinics in Dar es Salaam, Tanzania.

Methods: This was exploratory cross-sectional study. Purposive sampling was used to select ten study participants. In in-depth interview guide was used to collect data. The interviews were conducted in Kiswahili and lasted for about sixty minutes. Audio-recordings of the interviews were transcribed verbatim and translated into English. Transcribed data was analysed and subjected to thematic analysis with the help of Nvivo 12 software.

Results: Many reasons were mentioned for concurrent use of heroin and methadone among clients on methadone treatment. Some of the mentioned reasons were inadequate methadone dose, treatment, healthcare providers’ attitudes, and healthcare provision environment, lack of family support, peer influence homeless and easy availability of heroin.

Conclusions: Different measures should be taken by methadone programs and stakeholders to overcome concurrent use of heroin and methadone among clients receiving methadone treatment.

Factors leading to reluctance of blood donors from blood donation in Derna/Libya

Raga A. Elzahaf, Khalid A. Khalil, Hawwa Alshareff, Amnah Bufajra — Fri, 27 Jan 2023 00:00:00 +0000

Background: Blood donation is a major concern to the society as donated blood is lifesaving for individuals who need it. In Libya, the concept of voluntary blood donors is almost non-existent due to the absence of blood donor motivation and retention strategies. The objective of this study was to assess the factors leading to reluctance of blood donors from blood donation blood donation among general population in Derna.

Methods: Descriptive cross-sectional survey design was used to collect data of barriers towards blood donation in Derna/Libya between August 2021 and September 2021. 425 Libyan living in the city of Derna were selected by convenience sampling design. Self-administered structured questionnaire was used which was adopted from previous studies. Data analysis was performed in statistical package for the social sciences (SPSS) version 25.

Results: Of the 425 participants, the majority of them were male (70.1%). 195 (45.9%) reported that they had donated blood at least once in their lifetime, 186 (95.4%) were male and 9 (4.6%) were female. People who never donated blood most commonly (54.1%) reported that they never donated because they did not feel comfortable in hospital, followed by blood donation causes weakness and fainting or dizzy and they have never been asked to donate.

Conclusions: Blood donation practice in this study was found to be low. Ministry of health and Red Cross association have to work in strengthen manner to improve the practice of blood donation to plan strategy of awareness about blood donation should be encouraged among general population.

Role of specific interventions to prevent stunting in children under five years in the first thousand days of life

Sugeng Wiyono, Moch Rachmat, Rosmida M. Marbun — Fri, 27 Jan 2023 00:00:00 +0000

Background: Indonesia faces the problem of stunting in children under five years by 24.4%. Boys aged 3 years with severe stunting have 15.0 points lower reading ability and girls have 11.0 points compared to mild stunting, resulting in a decrease in intelligence (IQ), so that learning achievement becomes low. Objective was to obtain information on the role of specific interventions to prevent stunting in children under five years in the first thousand days of life.

Methods: Case-control design analytical research, in the stunted locus area, Jagakarsa Subdistrict, South Jakarta, Special area of the capital Jakarta Indonesia from 1 to 30 September 2021. Case samples of all stunting in children under five years and controls were normal height children who were matched for age and sex with 28 children each. The inclusion criteria in this research were ages 6-59 while the exclusion criteria in this research were toddler who had physical disabilities.

Results: Variables that showed a significant relationship with stunting in children under five years (p<0.05) were the length of a baby at birth (p=0.005) OR 4.958 (95%CI: 1.529-15.987), maternal height (0.002) OR 5.727 (95%CI: 1.765-18.507), father’s education p=0.006 OR 5.169 (95%CI:1.520-17.580, and family income (p=0.012) OR 9.800 (95%CI: 1.116-86.041.

Conclusions: Babies born <48.0 cm are at risk of 12.306 times of becoming stunting after controlling for variables such as maternal height, father’s education, energy intake, protein, iron, colds, exclusive breastfeeding, supplementary feeding for pregnant women and children and early initiation of breastfeeding.

Readiness for self-directed learning and learning style preferences among first year’s medical students

Amira E. Abdelsalam, Maha E. Eltwansy — Fri, 27 Jan 2023 00:00:00 +0000

Background: Self-directed learning (SDL) is a core element in enhancing learning outcomes and academic performance. It can be promoted through increasing students’ awareness of their own SDL skills and learning styles assessment.

Methods: A cross sectional study was conducted on 320 first year medical students (Zagazig University) during August and September, 2022. Using two standardized questionnaires: self-directed learning scale (assessing the readiness for SDL) and VARK questionnaire that assess different learning styles (visual, aural, read and write, kinesthetics).

Results: Almost 65% of the studied participants scored below the optimum score for self-directed learning readiness. Regarding the learning styles, all the participants reported multimodal learning styles. kinesthetic learning and visual styles were the most preferred (28% and 20.7% respectively). There was significant positive correlation between SDLR and kinesthetic learning style (p≤0.05).

Conclusions: Although the low overall SDLR score, but the students had a high desire for learning. As kinesthetic style was the most preferred that can increase the students’ self-directed learning.

Non-exclusive breastfeeding as the risk factor of stunting among Indonesian toddler in coastal areas

Nova Hellen Kapantow, Yulianty Sanggelorang, Hilman Adam — Fri, 27 Jan 2023 00:00:00 +0000

Background: Indonesia is ranked fifth in the world for the problem of stunting. Stunting in children under the age of five requires special attention, due to its inhibiting effect on children’s physical and mental development. Stunting has been associated with several factors, one of which is non-exclusive breastfeeding. This study aimed to analyse non-exclusive breastfeeding as the risk factor of stunting among Indonesian toddler in coastal area.

Methods: This study was an observational analytic study with cross sectional approach, which was carried out for 6 months, from March to September 2022. The sample population was children aged 36-59 months, who lived with their mothers in the coastal areas of Bitung city, north Sulawesi province. Sampling was done by purposive sampling to get 120 samples. Data collection using questionnaires by interview, secondary data in the maternal and child health (MCH) book, and anthropometric measurements using height for age index, for indicated stunting.

Results: The results showed the history of exclusive breastfeeding (POR=2.630), energy intake (POR=2.492) and protein intake (POR=1.857) as the risk factors of stunting. It showed that in the group of children who were not exclusively breastfed, have less energy and protein intake, and poor parenting, have a higher risk of stunting compared to children from other groups.

Conclusions: Stunting among toddler can be prevent by controlling many factors, such as guarantees that every mother provides exclusive breastfeeding, and maintains adequate energy and protein intake during the growth period, especially in the first 1000 days of a child’s life.

Prevalence of Staphylococcus aureus, its antimicrobial resistance and relation to food hygiene practices of food handlers: analysis of food and non-food items from market food shops in Yangon, Myanmar

Fri, 27 Jan 2023 00:00:00 +0000

Background: Staphylococcus aureus is the common cause of food poisoning and its rising antibiotic resistance poses a severe threat to public health. In Myanmar, S aureus isolation and AMR pattern in food and non-food objects studied at the markets are still limited. This research filled the information gaps regarding the prevalence of S aureus in food and non-food items from market food shops relation to hygienic practices of the food handlers and assessed its antimicrobial resistance.

Methods: Cross-sectional study was conducted at sixteen markets in Yangon during 2022. The study included 75 food handlers to assess their hygiene practices. From each shop, one food and one non-food samples were taken to reach the total 150 samples. Chi-square test was used for analysis.

Results: S aureus was found in 4% of food samples and 5.3% of non-food samples. Bacterial contamination in food was satisfactory, 17.3% to unsatifactory, 60% while non-food samples were 4%, clean to 73.3%, very contaminted. Drug resistance to Benzyl penicillin, azithromycin, erythromycin, clindamycin, lincomycin in food samples and tetracycline in both samples were found. Hygiene practices was good among 57.3% of food handlers and there was no association between practices and S aureus prevalence although positivity was higher among the samples taken from the shops of handlers with poor hygiene practices.

Conclusions: The prevalence of S aureus was not different between food and non-food samples and not associated with the hygiene practices of food handlers.

Occupational health and safety hazards faced by health care professionals in Kathmandu based hospital: a cross-sectional analytical study

Ramita Marasini, Pratik Shrestha, Yaman Chaudhary — Fri, 27 Jan 2023 00:00:00 +0000

Background: Occupational health and safety is a broad discipline that covers several specialized fields, including physical, psychological, chemical, biological, and mechanical/electrical, and assesses the health and safety of employees in a broader context. Healthcare workers including physicians and nurses get regularly exposed to occupational hazards. The objective of the study was to analyse the occupational health and safety hazards faced by healthcare professionals in Kathmandu.

Methods: A quantitative cross-sectional analytical study was conducted in the hospitals of the Kathmandu district. Ethical approval was taken from National Academy for Medical Sciences and hospitals. Purposive sampling was used to select the hospitals and convenience sampling was used to collect the data from respondents using semi-structured questionnaires. The total sample size was 247. Data collected from respondents were entered into Epidata and were analysed and expressed using SPSS version 25.

Results: Back pain (64.8%) and needle injury (59.5%) were the most perceived injury that might occur in hospitals along with hepatitis B (35.2%) and covid (23.9%) as infections. The majority (88.7%) of health workers used PPE while working and biological hazards (88.3%) were the most suffered hazards followed by chemical hazards (87%). The age group of 50-60 years, higher secondary level graduates, government health workers, doctors, and nurses were statistically significant with safety practices whereas Buddhist, married participants, governmental health workers, nurses, and radiologists were associated with hazards.

Conclusions: The development and updates of existing policy on OHS and training/workshop, exposure to information, and awareness are necessary for improving occupational health and safety of health care workers in Kathmandu valley.

Evaluation of impact of COVID-19 pandemic on the burden and pattern of severe malaria in Nigerian children

Fri, 27 Jan 2023 00:00:00 +0000

Background: Malaria is an infectious disease caused by the protozoan Plasmodium, accounting for 36% of under-five mortality. About 4.5% of all malaria-infected children reported at least one symptom of severe malaria, with worsening outcome. COVID-19 and malaria shared similar clinical presentation in children this similarity may lead to delay in initiation of treatment for malaria, with progression from uncomplicated to severe forms and consequently high mortality. Thus, we set out to study the extent COVID-19 impacted on the burden and pattern of severe malaria.

Methods: It was a retrospective study of all the children admitted into the children’s emergency room severe malaria, from March 2018 to February 2022. The data collected included the total number of admissions within the period, the month and year of admission, age, gender, the component of severe malaria that was the final diagnosis and outcome of management. Data were analysed using NCSS 9 statistical software.

Results: There were 4761 admissions within the study period: males were 54.7%, subjects 1-<60 months were 60.5% and pre COVID-19 period were 63.7%. The prevalence rates of severe malaria in CHER were 2.6%. Among those with severe malaria, the case fatality rate was 10.7%. Severe malarial anemia was the most common accounting for 49.2% and has predilection for the younger age. Cerebral malaria was predominantly diagnosed during the COVID-19 period.

Conclusions: The prevalence of severe malaria was 2.6% and severe malaria anaemia was the most common mode of presentation while cerebral malaria was diagnosed more during the COVID-19 period.

Factors influencing implementation of electronic health records system in Nyeri level 5 hospital

Geoffrey M. Mukuria, Kezia Njoroge, Daniel Muendo, Catherine Zioka — Fri, 27 Jan 2023 00:00:00 +0000

Background: The six WHO blocks can be utilized to find numerous opportunities for health improvement. Each component of the WHO structure is critical. In order to improve performance, prosperous reinforcement of the health system necessitates pertinent, well-timed, and precise information. Adoption of an EMR system has been found to increase patient safety by reducing flaws in paper-based medical records.

Methods: The study used a descriptive survey design with a quantitative methodology. The study targeted 422 healthcare workers operating within the outpatient and inpatient department with a sample of 205 respondents. Questionnaires were used to collect quantitative data. Data was analysed using the Statistical Package for Social Science computer application (SPSS) version 26. Quantitative data were organized, presented, analysed, and interpreted using descriptive and inferential statistics.

Results: The results suggested that the implementation of the electronic health records system was positively and significantly influenced by health infrastructure (β=0.402, p˂0.05), human workforce (β=0.154, p˂0.05), health leadership (β=0.452, p˂0.05), and service delivery β=0.168, p˂0.05). Health leadership was key in the implementation of the Electronic Health Records System as it is the one that carries the vision of the hospital. Based on the survey results, it was evident that there were a number of factors influencing the implementation of an electronic health records system.

Conclusions: There was a favorable and significant impact of health infrastructure, human workforce, health leadership and service delivery on implementation of electronic health records system.

Breastfeeding practices among mothers attending a tertiary care hospital in Kashmir

Syed Najmul Ain, Reyana Qulsum, Amtul Rizwan — Tue, 17 Jan 2023 00:00:00 +0000

Background: According to world health organization (WHO), exclusive breastfeeding (EBF) for the first 6 months of life is vital for optimal growth and development of a child. During this period, other liquids or breastfeeding substitutes should not be given to infants except for medicine or oral rehydration solution.

Methods: This cross-sectional study was conducted in the child health clinic of the department of community medicine, SKIMS. The study participants were mothers accompanying their infants coming for immunisation at the child health centre. A semi-structured, questionnaire was used to interview the mothers regarding breast feeding practices of their infants. The data was entered in Microsoft excel 2010 and analysed using SPSS Version 20.

Results: The prevalence of EBF was 38.7%. Mixed feeding was received by 54% and 7.3% were formula-fed. Variables that were significantly associated with EBF include residence and mother’s education. Infants from rural area were more likely to be exclusively breastfed compared to those from urban area (OR=0.365; 95% CI=0.166-0.802; p=0.012). Mothers with up to 9 years of formal education were more likely to exclusively breastfed their children than those with more than 9 years of formal education (OR=0.300;95% CI=0.121-0.744, p=0.009).

Conclusions: To ensure that the rate of EBF among the mothers is increased, all the stakeholders (spouse, family and government) as well as the people at work place must play their part to the best extent.

Perception of undergraduate students towards online teaching during COVID-19 pandemic in a medical college in Hyderabad, India

Tue, 10 Jan 2023 00:00:00 +0000

Background: The emergence of the COVID-19 pandemic has affected medical education and clinical training and forced medical schools to switch over to online teaching. To assess the success of online learning, knowing students' perceptions is an important criterion. The present study evaluated the students' insight toward online teaching and learning. Aim of the current study was to evaluate the students' perspective toward online teaching through an online questionnaire in the challenging time of the SARS-CoV-2 pandemic. Objective of the study was to assess students' perception of online teaching and barriers faced by them.

Methods: This institutional-based cross-sectional study was conducted between 1 September to 30 September 2021 at medical college, Hyderabad. Out of 600 students of MBBS 1 to 4 year, 329 agreed to participate. They were given an online questionnaire that included the Dundee ready education environment measure, to assess students' perception of the educational environment. A part of it was used, i.e., SPL (students' perception of learning) domain, to assess the student’s perception.

Results: Overall score of perception of online teaching-learning according to the SPL domain was 23.41±4.61, which was less than the optimal score of 25, which indicated many problems in this method of online teaching-learning. 67.5% preferred face-to-face teaching to online teaching.

Conclusions: The COVID-19 pandemic has drastically affected traditional teaching-learning methods, and online teaching has emerged as a boon to continue the learning process. However, many students faced many obstacles adapting to this new learning model. Hence, the offline mode of teaching was preferred over the online mode.

COVID-19 vaccination status and its effect on outcome and disease severity

Anand Andrews, Anju C. Mathew, Thushara Mathew — Thu, 12 Jan 2023 00:00:00 +0000

Background: The cardinal method for preventing future SARS-CoV-2 infections, hospitalizations, long-term sequelae, and death is COVID-19 vaccination, despite the possibility that the epidemiology of COVID-19 may change as new variants appear. There is little research on the vaccination status of adult COVID-19 patients and the role of vaccines in mitigating the severity and clinical presentation of COVID-19 patients among local population in Kerala. Objectives were to assess vaccination status and clinical profile of adult COVID-19 patients in Arpookara, Panchayath in Kerala and its association with disease severity and outcome among same.

Methods: A cross sectional study was conducted in Arpookara Panchayath in central Kerala, among adult COVID-19 patients during the months of September and October 2021. The required 380 samples were selected by simple random sampling and data was collected by interviewing the subjects using semi structured questionnaire.

Results: It was found that 46.1% of the study population were unvaccinated, whereas 30.8% of the population were partially vaccinated and 23.1% were fully vaccinated at the time of COVID-19 infection. A significantly higher proportion of unvaccinated population required hospital admissions, oxygen support and ICU stay when compared to those who took at least one dose of vaccine.

Conclusions: Increasing the vaccination coverage of at least single dose of vaccine can reduce rate of hospital admission, ICU stay, oxygen requirement and can improve the outcome of disease. Steps to increase vaccine coverage should be implemented for better outcome of COVID-19 disease as well as to reduce the admission load on the hospitals.

Alternative care takers for children of health care workers during COVID-19 pandemic in Kashmir valley: a cross sectional study

Rabia Ahmad, Uroosa Farooq, Darakshan Ali, Ab Qayoom Shah — Fri, 20 Jan 2023 00:00:00 +0000

Background: COVID-19 pandemic forced health care workers to seek alternatives of child care due to strong standard operating procedures (SOPs). Informal child care workers include patrilineal, matrilineal, immediate family members, neighbours, friends and housemaids. The present study tried to explore and highlight the role of Informal child care workers in alternative spaces.

Methods: The present study aimed to reveal new facts about COVD-19 pandemic, its implications in relation to the alternative child care spaces available to the children of health workers in the valley of Kashmir. Total sample size constituted 100 respondents including doctors, Para medicals and other supportive staff chosen through snowball sampling technique. For data collection, a structured questionnaire was constructed and sent to respondents through different social media platforms like Facebook, e-mail ids and WhatsApp.

Results: In the study majority of dual career families especially health workers working as frontline COVID warriors in the valley of Kashmir reported that their children were taken care either by alternative care takers mostly patrilocal or matrilocal family members.

Conclusions: The study reveals that dual career families of Kashmir prefer largely female members as alternative care takers as compared to male members. The immediate family members are the most preferable choice of Alternative care followed by housemaids.

Clinical and radiological follow up of post-COVID patients in tertiary care centre

Fri, 27 Jan 2023 00:00:00 +0000

Background: COVID-19 is potentially fatal infection caused by novel corona virus SARS COV2.SARS patients may present with a spectrum of symptoms and signs ranging from relatively asymptomatic to fulminant pneumonitis and death. Out of which, most frequent symptoms are cough, fever, myalgia, dyspnoea and altered smell/taste. The primary objective of the study is to describe the clinical evolution and symptoms persistence [at day 30 and day 60] during 2 months follow up in adults with COVID-19 and to follow up the changes in lung radiographic pictures within 2 months after discharge.

Methods: This is an institutional based, prospective clinical observational study conducted in Asram medical college, Eluru from September 2021 to November 2021 on 25 COVID-19 Patients.

Results: In our study two thirds of patients still reported symptoms at day 30 and half of the patients reported symptoms at day 60. Out of 50 patients, 38 (76%) patients had at least one symptom at day 30 and 25 (50%) patients had symptoms at day 60 and 9 (18%) patients had chest X-ray abnormalities during follow-up after 2 months.

Conclusions: Follow up studies of COVID-19 will improve our understanding of natural history of COVID-19 sequelae and enable us to assess the efficacy of therapeutic interventions to mitigate the long-term consequences of COVID-19 It is necessary to follow up these recovered patients for detection and appropriate management towards their psychological, physical and social realm. It is highly important to provide counselling, moral support to restore to normalcy.

Prevalence of under nutrition among under-5 children in the urban field practice area of a medical college in Muzaffarnagar, Uttar Pradesh

Umer Farooq, Sangeeta J. Sharma; Santosh Raghav — Fri, 27 Jan 2023 00:00:00 +0000

Background: In India, undernutrition in children mal the age of five is a serious public health issue. Despite India's expanding economy, both urban and rural areas still have significant rates of undernutrition-related child mortality. There are hardly many studies that concentrate on cities. In order to determine the prevalence of undernutrition in the urban field practice area of a medical college in Muzaffarnagar, Uttar Pradesh, the current study was conducted. Objective of the study was using World Health Organization (WHO) growth standards, to determine the prevalence of undernutrition among children under the age of five.

Methods: A community-based cross-sectional study was conducted in the urban field practice region of the medical college Muzaffarnagar, India, from August 2022 to November 2022. From 1875 registered families, 400 under-five-year-old children were randomly chosen, and a house-to-house survey was used to collect the study's data. The study's goals were explained to the parents, and their written agreement was obtained. The children who were accessible during the study period had their anthropometric measurements taken in accordance with WHO criteria. For nutritional deficits and other morbidities, the kids were checked. Data analysis was performed using the statistical package for the social sciences (SPSS) 23 programme and the Chi square test.

Results: A total of 400 under 5 were examined by going from house to house, and 257 (64.2%) of them were underweight. Boys had significantly (p=0.001) more undernutrition than girls. In the age range of 49 to 60 months, it peaked.

Conclusions: Children's malnutrition continues to be a problem for public health, especially among underprivileged populations.

A cross sectional study to assess the vaccination practices regarding hepatitis B among health care personnel of a tertiary care hospital in Kashmir

Basina Gulzar, Anjum Fazili, Rohul Jabeen Shah, Syed Najmul Ain — Fri, 27 Jan 2023 00:00:00 +0000

Background: Vaccination is one of the most successful public health interventions that has saved millions of lives so far. Due to the occupational exposure, health care workers have an increased risk of contracting hepatitis B. Objectives were to assess the vaccination practices regarding hepatitis B among healthcare personnel (HCP) and to study the factors associated with the vaccination practices regarding hepatitis B of these HCP.

Methods: This cross sectional hospital based study was conducted for a period of 1 year at Sher-I-Kashmir Institute of Medical Sciences (SKIMS) among 450 HCP including doctors, nursing staff, laboratory staff and others and the required sample was drawn from each category on the basis of probability proportionate to size technique. Information was collected from participants by using predesigned, pretested structured and validated questionnaire.

Results: It was found that only 34.9% were vaccinated against hepatitis B. The coverage was highest among doctors 55.5% followed by technicians 25.6%, nurses 23.6%. The main reasons for not receiving this vaccine were: taking all necessary precautions (49.1%), hospital does not provide the vaccine (20.8%), not aware about hepatitis B vaccine (20.5 %).

Conclusions: The study revealed that the hepatitis B vaccination coverage of these healthcare personnel was quite low in spite of the importance of the vaccine for healthcare personnel who are always at risk of getting exposed to the virus during their duties.

Self-efficacy in the urban Indian culture- exploring values, self-construal and personality

Gitanjali Narayanan, Kiran Rao — Fri, 27 Jan 2023 00:00:00 +0000

Background: Personality and cultural influences on self-efficacy have not been examined among urban Indian adults, though they are relevant. Of specific importance is the relationship between self-efficacy and an individual’s perceptions of relatedness and autonomy, and their values.

Methods: The aim of the present study was to examine the association between self-efficacy with self-construal, personality and individual values in an urban community sample from Bangalore city, India. A snowballing technique was used to recruit community participants (N=304, mean age=24.80±4.35 years). The tools used were the self-efficacy scale, the self-construal scale, the temperament character inventory-revised, and the portrait values questionnaire. Data was fitted into a linear regression model.

Results: About seventy percent of self-efficacy was associated with was positively associated with personality dimensions of persistence and self-directedness, and negatively associated with novelty seeking and harm avoidance. Moreover, there was a significant positive association with the family value of benevolence and a negative association with security.

Conclusions: It is important to study self-efficacy which has implications for domains such as quality of life, sense of contribution to society, well-being and positive beliefs held by individuals and the community at large regarding their self-worth and control. The study highlights the role of personality and values; all suggestive of a shift from the collectivist.

The cost of conducting rapid assessment of avoidable blindness survey in Andhra Pradesh State, India

Fri, 27 Jan 2023 00:00:00 +0000

Background: To determine the cost of conducting a rapid assessment of avoidable blindness survey in Andhra Pradesh State, India. RAAB is a simple rapid survey methodology that can provide data on prevalence and causes of blindness and visual impairment. As per the manual published by international centre for eye health, ICEH London United Kingdom the cost of doing a RAAB survey was US $ 20000 to 30000. No data were available regarding the cost required for doing the RAAB survey in India or from any other developing country. Hence the present study was conducted to arrive at the average cost of a RAAB survey in Indian scenario.

Methods: The Andhra Pradesh right to sight society conducted RAAB surveys in three different tribal areas by three teams in the year 2009. The average cost of doing RAAB survey was arrived by calculating the mean expenditure of the three surveys.

Results: The average cost of doing a RAAB survey in India was Rs.2, 30,541.66 (US $4,433.50). which was 15 to 22%of the cost mentioned in the RAAB Instruction Manual version 4.02 published by ICEH.

Conclusions: As the cost of doing RAAB survey is very much less in India, this may encourage the epidemiologists and researchers to undertake the rapid assessment surveys with limited budget and can easily be repeated every 5 years to know the trends.

Prevalence of tobacco dependence among rural population of Mysuru District

Poorvitha H. P., Sunil Kumar D., Dodda Basava J. — Fri, 27 Jan 2023 00:00:00 +0000

Background: Tobacco is generally a leaf with 1-3% of the alkaloid nicotine Consuming it becomes so dangerous that it is the leading cause of mortality worldwide. Tobacco risks include heart attack, gum disease and pre-cancerous mouth lesions etc. The purpose of the current study is to investigate the prevalence of Tobacco dependence and factors that contribute to tobacco dependence among rural populations. Objectives of current study was to estimate the prevalence of tobacco dependence and to assess the factors influencing Tobacco dependence among rural population.

Methods: A community based cross sectional study was carried out in rural areas of Nanjangud taluk for 6months from January 2022 to June 2022. Multistage sampling Technique was adopted to select the study population.one subcentre is selected randomly by lottery method, PPS sampling technique will be applied to select the required number of participants from the villages in the selected subcentre. Sample size is 362 individuals aged above 18years who comes under ICD10 criteria were included in the study. The data were gathered using the pre-tested, semi-structured questionnaire by interview method, and the FRAGESTROM test to assess dependence on nicotine SPSS version 25 was used for analysis.

Results: The overall prevalence of Tobacco dependence among rural population of Nanjangud taluk is 62.40%. We found that tobacco dependence was significantly associated with gender, age group, occupation education, and socioeconomic status and there is no significant association between caste and Tobacco dependence.

Conclusions: The present study concludes that the prevalence of tobacco dependence is high in a rural population. More tobacco free initiatives to be implemented.

Marital and family relationships among women with severe mental illness during perinatal period admitted to a mother baby psychiatric unit, India

Fri, 27 Jan 2023 00:00:00 +0000

Background: Pregnancy and transition to parenthood is often a stressful event and brings about more profound changes than any other developmental stage of the family life cycle. Consequently, pregnancy and post-partum are times of increased vulnerability for the onset or relapse of a mental illness. The current paper aimed at understanding the marital and family relationships among women with severe mental illness during the perinatal period in India.

Methods: The study included a retrospective chart review of mothers admitted to a mother-baby unit between the years January 2015 to March 2020. We included all mothers who were married and had onset of SMI in the perinatal period. Details of socio-demographic, clinical profile and descriptive understanding of relationships were collected.

Results: The total sample was 149, mean age of women in years was 25.27 (SD=4.97). The clinical diagnosis included non-affective psychosis (45.5%), affective psychosis (42.2%) with 130 (87.24%) women having their first episode of SMI during the postpartum period. More than half of the women admitted to the ward reported having problems in their marital relationship, with 25% experiencing violence from their spouses and in-laws. Interpersonal issues with their in-laws in the context of violence, household chores and poor support.

Conclusions: This study highlights the importance of routine assessments of the quality of marital and family relationships including domestic violence. There is a need to provide interventions aimed at helping women deal with difficulties in intimate and social relationships.

Technical expertise and behavior of the doctor- a major determinant of waiting time of OPD patients

Cherry Bansal, Mamta Bansal, Mandeep Narang, Sanjiv Goyal, Parveen Bansal — Fri, 27 Jan 2023 00:00:00 +0000

Background: The study was conducted to understand various factors affecting waiting time spent by the patients in outpatient department (OPD) and to provide recommendations for reducing the waiting time in OPD of the selected hospital.

Methods: It was a descriptive cross-sectional pretested questionnaire-based study involving all new 100 consenting patients at OPD recruited into the study using a systematic sampling technique after calculating the sampling interval.

Results: The study indicates that 70% of patients were satisfied and only 30% were dissatisfied with the attention given by the OPD staff, cleanliness, attentiveness of doctor but shows great dissatisfaction regarding the waiting time spent by them in the outpatient department. Most of the subjects gave the reason for their satisfaction despite more time because of expertise of the doctor, behavior of the doctor, association of hospital with non-government organizations and insurance companies for free medicine and surgery. The dissatisfaction was not because of lack of administration but because of low level of awareness amongst patients attending the OPD about internet booking of appointment, COVID protocols, priorities given to recommendations given by other doctors/VIPs and walk in OPDs attended without prior appointment.

Conclusions: A very important observation which evolved from the study was the version of patients that waiting time does not matter because they want to be treated from same doctor due to his/her expertise. Second important observation was that the addressing and greeting of patient by his/her name gave a great satisfaction and level of comfort to patients and affects the waiting time.

Profiling of mucormycosis in district of central rural India during COVID-19 pandemic: a record-based study

Fri, 27 Jan 2023 00:00:00 +0000

Background: Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been associated with a wide range of opportunistic bacterial and fungal infections. Several cases of Mucormycosis in people with COVID-19 have been increasingly reported world-wide, in particular from India. The primary reason that appears to be facilitating Mucorales spores to germinate in people with COVID-19 is an ideal environment of low oxygen (hypoxia), high glucose (diabetes, new onset hyperglycemia, steroid-induced hyperglycemia).

Methods: Secondary data was obtained from District health office Wardha. We took Mucormycosis related data for May 2021 to August 2021. A Secondary data analysis was done as an age wise distribution, Sex wise distribution, classification of Mucormycosis and case load in Wardha district.

Results: Total cases (overall) was about 132. 91% cases are totally recovered. In overall cases, 106 males and 26 females were affected due to Mucormycosis. Out of 132 cases, 128 cases were of Rhino cerebral type of Mucormycosis. 48% cases of Mucormycosis were from 45 to 60 years old patients.127 cases of Mucormycosis were related with COVID history and only 5 cases of Mucormycosis were not related with COVID history. 53% cases were needed oxygen support prior onset of case.

Conclusions: A multidisciplinary strategy should incorporate early diagnosis, antifungal therapy, any necessary surgical consultation and treatment, as well as reversal of the underlying illness. Identification of individuals at risk, strict glycaemic control and avoidance of unnecessary corticosteroid in non-severe COVID-19 cases (normal oxygen saturation on room air) can help in preventing this complication.

Impact of COVID-19 pandemic on vaccinations in children in a primary health centre in Northern India

Arushi Vemprala, Rajshekhar Vemparala, Shyam Sundar — Fri, 27 Jan 2023 00:00:00 +0000

Background: Pandemics and disease outbreaks necessitate the continuation of routine immunization and vaccination for a specific age group along with safety measures for healthcare professionals. India witnessed the COVID-19 pandemic with a drastic rise in the number of cases across the states and union territories in 2020. Routine childhood immunizations suffered mainly because of an overburdened health system coupled with the fear of COVID-19 infection. The present audit is aimed to study the impact of the interventions made to improve routine immunization in the post-COVID-19 period in children in the age group of 0-16 years suitable for immunization under the National Immunization Scheme.

Methods: A cross sectional study was conducted by retrieving records in the PHC for the impact of COVID-19 on routine immunizations for vaccine preventable disease in the 0-16 age group. Data were retrieved and collected in a predesigned proforma. Archives of each of the years 2019, 2020, 2021, and 2022 for the month of April. The effect of the interventions for improving vaccine coverage in the rural population was evaluated.

Results: A comparison of pre-covid and covid periods showed a significant drop in routine immunization (p=0.007). Higher immunization rates were observed in post covid compared to the COVID period indicating the positive effect of interventions (p=0.0000014)

Conclusions: Vaccination rates improved significantly following interventions in the rural population. Health education on safety precautions for COVID-19 and the importance of routine immunization in the pediatric age group has helped to improve vaccination status.

Knowledge, attitude and practices about Nipah virus infection among people visiting urban and rural health training centres

Shruti Kardalkar, Bhavana R. Hiremath, Swetha K. — Fri, 27 Jan 2023 00:00:00 +0000

Background: Nipah virus infection is an emerging infectious disease of south-east Asia region, which has gained public health importance. Nipah virus is classified internationally as a biosecurity level (BSL) 4 agent. Objective was to assess knowledge, practice and attitude regarding Nipah virus infection.

Methods: A cross sectional study was done in urban and rural health training centers among adult population, data was collected using pre-designed and pre-tested proforma. Data was entered in Microsoft excel, frequencies and percentages were calculated.

Results: In present study majority of study participants belonged to less than 25 years. Nuclear families were common in both urban (76%) and rural (44%) areas. 41% and 35% of urban and rural study participants belonged to class II status respectively. In present study it was found that both urban and rural study participants had heard about Nipah virus infection in recent few months. 73% of urban study participants considered themselves at risk of Nipah virus infection when compared to 36% of rural participants. Rural study participants did not have clarity of spread, signs and symptoms. 11% and 6% of urban and rural study participants had heard health education talks about Nipah virus infection respectively and most common source was social media.

Conclusions: The present study finding is suggestive of good knowledge regarding Nipah virus infection among urban population when compared to rural setting. Continuous health education has to be imparted at all levels of health care so as to make community aware about spread, clinical presentation and prevention aspects of Nipah virus infection.

The association between different types of cooking fuels and common health problems: north India region

Fri, 27 Jan 2023 00:00:00 +0000

Background: The fuel used for cooking is a major source of indoor air pollution because of inefficient combustion and inadequate ventilation. This study was conducted to see if there is any association between the type of cooking fuel and common health problems in light of inadequate ventilation.

Methods: This was a cross-sectional study; 688 subjects were selected randomly from various sectors and the outlying areas of Surajkund. The impact of indoor air pollution on health was assessed by questionnaires, general physical examination, and pulmonary function testing.

Results: One of the key findings of the study has been the implication of LPG, touted as a safe, non-polluting fuel with a definite negative impact on health. There was significantly more breathlessness experienced by LPG users as opposed to the users of wood and cow dung. Though the prevalence of fever in both groups was similar, chest pain, burning of eyes, and fatigue were reported by wood and cow dung users much more frequently. The pulmonary function test showed restrictive pathology in cow dung and wood users, whereas obstructive pathology in LPG users.

Conclusions: LPG is considered “clean” fuel because it does not produce visible emissions. However, improper burner design, blocking and clogging of the flue vent, and insufficient combustion air result in improper combustion and the emission of aldehydes, CO, hydrocarbons, and other organics. It would be folly to believe that LPG is harmless. Even a harmless material may become harmful if used inappropriately.

Socio-economic coordinates and morbidity profile of the inhabitants of a peri-urban area of Srinagar district of Jammu and Kashmir India: a cross sectional study

Javeed Ahmad, Anjum B. Fazili, Rohul J. Shah, Reyana Qulsum — Fri, 27 Jan 2023 00:00:00 +0000

Background: The present study was planned to find out socio-economic coordinates and morbidity profile of the inhabitants of a peri-urban area of Srinagar district- urban field practice area of Sher-i-Kashmir Institute of Medical Sciences (SKIMS).

Methods: A cross-sectional community-based house to house study of Anchar area (peri-urban) was conducted for a period of six months. Out of six localities/mohallas of anchar, three localities/mohallas representing the core area and comprising the major chunk of population were purposively selected for the study. All the households of the selected localities were included in the study.

Results: The inhabitants of area are moderately positioned on socio-economic scale. The area lacks an adequate liquid waste disposal system. The prevalence of tobacco use was found to be 30.61%. 10.94% of the total population was found to be morbid. Most common morbidities found were hypertension (5.15%) followed by diabetes (1.41%), hypothyroidism (1.23%) and cardiovascular disease (0.82%).

Conclusions: Life style diseases are preponderate among the study population. Sustained and regular health check-ups ought to be carried out with a special focus on awareness and education.

Community-based baseline survey regarding prevalence of anemia among females of different age categories under Anemia Mukt Abhiyan in District Ambala, Haryana

Joy Singhal, Minakshi Kharab, Sunidhi Karol, Abhishek, Sunil Hari — Fri, 27 Jan 2023 00:00:00 +0000

Background: Anemia is the most common micronutrient deficiency. Despite repeated efforts taken under the national program, high prevalence of anemia still observed across various life stages of females in India over the past two decades.

Methods: This cross-sectional study aimed to discern the prevalence of anemia in the non-pregnant and non-lactating females of Ambala, Haryana, between the ages of 6 months to 49 years using the gold standard cyan-met-hemoglobin method.

Results: A total of 1, 21, 202 study subjects, with a mean age of 28.9±19.3 years were tested for hemoglobin across 524 villages, out of which 97,305 (80.1%) females were found to be anemic with mean hemoglobin level of 10.8±1.4 gm% with 53.2% of all females being moderately anemic.

Conclusions: This study reported that anemia is extremely prevalent in all walks of life of females. Multipronged strategy is to be followed to curb anemia from various age groups of females.

Knowledge about NCD in medical students and screening for their nutritional status

Fri, 27 Jan 2023 00:00:00 +0000

Background: Creating awareness about NCD prevention and screening medical students’ nutritional status will help them to follow a healthy lifestyle. Thus, ensuring that as future doctors, they will be effective in community education of NCD prevention through their own health.

Methods: A two-hour awareness session was taken for 150 medical students to explain importance of assessing their risk factors for NCD. The age range was 18-21 years. They were offered a free health check-up and 89.33% (136) signed up. For screening of obesity - anthropometric measurements were taken 1) weight by electronic weighing scale 2) height- using analog measuring tape 3) waist hip measurement 4) body fat composition measured by Omron (Karada scan- body composition monitor HBF-375). BMI was calculated using both WHO and Asian cut-offs and waist circumference using WHO and ICMR cut-offs.

Results: In 132 (M=55, F=79) participants, significant incidence was seen of overweight (21.21%), obesity (43.18%) by Asia Pacific BMI standards and 36.36% overweight, 36.36% obesity by total body fat measurement. Abdominal obesity measured by waist circumference was seen in 3.22% of males and 21.52% of females by WHO; 15.09% of males and 41.77% of females by ICMR standards. Females showed a higher incidence of obesity and overweight than males according to Asia Pacific BMI, total fat percent and ICMR waist circumference.

Conclusions: These students will benefit from interventions to inculcate a healthy lifestyle and maintain a healthy weight. Healthy medical students tracking into healthy doctors will act as ambassadors for NCD prevention.

Multi-center study to analyse outcome of integrated treatment approach in COVID-19 patients

Fri, 27 Jan 2023 00:00:00 +0000

Background: This study presents the outcome of integrated treatment approach based on government mandated standard allopathic treatment along with alternatives in COVID-19 patients. The aim of our study was to investigate the outcome of treatment strategy, co-morbid status, recovery and mortality rate of COVID-19 patients at Bhaktivedanta Hospital and Research Institute.

Methods: Post ethics committee approval for multiple centers, data for 1049 COVID-19 patients (RTPCR confirmed cases) of all age groups and genders which were admitted in a dedicated covid hospital from March 2020 to November 2020 was analysed retrospectively.

Results: This study highlights the management of COVID-19 patients with an integrated approach. In our cohort with 36.7%, 44.70 %, 18.58% of mild, moderate and severe cases respectively, mortality rate was only 3.43% of total positive patients admitted at our hospital.

Conclusions: We emphasize that even in healthcare facilities with limited resource and poor infrastructure and lack of ICU facilities, clinical observation-based management can help to reduce mortality considerably. Unique features of our study include use of progesterone as an immune modulator, use of dual antiviral agents and use of age-related lower limit of oxygen saturation.

Knowledge and practices of water and sanitation and prevention of water-borne diseases among the residents of Wabgaon village

Gaurav C. Mittal, R. Naveen Shyam Sundar, Prashanth A. — Fri, 27 Jan 2023 00:00:00 +0000

Background: Globally 1.339 billion U-5s and 79 thousand neonates aged 0-27 days were estimated to be dead due to diarrhoea. India, Nigeria, Afghanistan, Pakistan, and Ethiopia accounts for more than half of the deaths caused by diarrhoea. Our objectives are to understand the knowledge and practices of WASH, preventive and treatment measures of diarrheal diseases, the feeding practices and hygiene among the mothers in the rural village of Wardha district.

Methods: This is a mixed method study with study participants including 72 families randomly selected along with the front-line workers. the descriptive analysis was carried out with the help of R software and other online statistical software.

Results: 90.6 % had their source of water away from a contaminated place such as open drains, manure pits, solid waste disposal areas etc. Though 96.9% had toilets in their household only 93.8% actually used it. All of them washed their hands with soap after using the restroom. Mixed responses were obtained when people were asked about the line of action in case, they suffer from any of the acute diarrhoeal diseases. 90% of them prefer ORS during such times and the source of availing had mixed responses.

Conclusions: An interventional study for the same can be carried out. Regular follow ups might assist in keeping the public free from such communicable discomforts.

Body mass index and body fat percentage in determining overweight and obesity among school going adolescents of urban Mysuru, Karnataka: a cross-sectional study

Fri, 27 Jan 2023 00:00:00 +0000

Background: Overweight and obesity among adolescents is an important global health issue. BMI is the commonly used screening tool but there can be under or over estimation. Body fat percentage estimation using bioelectrical impedance analysis is easy and non-invasive technique and along with BMI can provide a better predictive capacity. Considering importance of early detection of overweight and obesity in adolescents, present study was done among school going adolescents of urban Mysore. Objectives were to determine the prevalence of overweight and obesity using BMI and body fat percentage among school going adolescents and to determine the relationship between BMI and body fat percentage.

Methods: A cross sectional study was conducted among 706 school students in urban Mysuru aged 13-16 years and semi-structured proforma was used to collect data. Anthropometric measurements taken and Omron HBF 701 Karada scan complete digital body composition monitor used to measure body fat percentage. BMI-for-age (5-19 years) WHO 2007 and McCarthy’s body fat reference used to classify participants. Statistical tests like Pearson’s correlation used.

Results: According to BMI, 9.8% and 5% were overweight and obesity prevalence respectively and according to body fat percentage19.4% were over fat and 17.1% were obese. Among adolescents with normal BMI, 18.4% and 11.9% were classified as overfat and obese respectively according to body fat percentage. The correlation between BMI and body fat percentage was statistically significant.

Conclusions: Higher prevalence of obesity seen according to body fat percentage cut-offs than according to BMI.

Postural strain of spinner and casting workers of a small-scale aluminium utensil making factory

Fri, 27 Jan 2023 00:00:00 +0000

Background: Small scale establishments often neglect the worker safety and comfort which impacts both productivity and workers’ safety. Various studies have been conducted in such small-scale establishments but not much has been done on aluminium utensil manufacturing factories. Spinning and casting are two important processes for manufacturing of aluminium utensils. But not much has been studied to assess the hazards of the involved workers. The present study is an attempt to explore this previously unnoticed area.

Methods: The study was conducted in different small scale aluminium utensil factories in West Bengal. Sixteen spinners and seventeen casting workers were evaluated for this study. The analysis of posture was done by rapid upper limb assessment (RULA), rapid entire body assessment (REBA) and Ovako working posture analysis system (OWAS). The body parts discomfort was assessed by using Cornell musculoskeletal discomfort questionnaire and Nordic questionnaire was also used to assess the pain they experience.

Results: All the casting workers are experiencing postural load beyond the recommended limit whereas in case of spinner, five workers experienced less postural load due to favorable work conditions. Casting workers mainly suffered from low back, neck, right shoulder pain whereas spinners suffered from wrist and finger pain followed by lower extremity pain.

Conclusions: Both group of workers are experiencing postural load and discomfort. In case of casting workers, the prevalence was high and immediate interventions are needed. The discomfort is particularly high during the end of shifts.

A study of growth pattern of school going children of Kolkata, India

Fri, 27 Jan 2023 00:00:00 +0000

Background: In our society only, a few peoples have good physiological status from their childhood. Health status of children and adolescents is important factor for young society. This present study highlights the peoples’ state of health and nutrition. Change in height with respect to age can be seen during puberty and adolescence. Growth can also be dependent upon the geographical regions.

Methods: In this study included 230 adolescent students (boys- 146, girls- 84) in the age group of between 12-18 years. So many related growth parameters were measured using by an anthropometric rod, weighing machine, and slide calliper. BMI, p value was obtained by performing t-test at 0.05 level of significance. Statistical software SPSS version 20 was used.

Results: Growth parameter was found to be increasing with age and it was more pronounced between 16 and 17 years. Interestingly the increment of all the growth parameter was found to be more in urban and less in rural.

Conclusions: The findings of this study showed a progressively increasing of growth-related parameters with ages and the progress vary, indicating a nutritional supplementation are unequal (unequal growth pattern), as it was evident from different growth parameters percentile values of CDC and IAP values. This study will certainly help to create among the children and their parents about the physical growth and health.

Impact of reproductive and sexual health education on late adolescent girls in an urban slum

Mayuri Verma, Yasmeen K. Kazi — Fri, 27 Jan 2023 00:00:00 +0000

Background: Menstruation, although, a natural process, may result in adverse health outcomes. Adolescents having a better knowledge regarding menstrual hygiene and safe menstrual practices are less vulnerable to reproductive tract infections and its consequences. Aim and Objectives were to study the socio-demographic profile of late adolescent girls in an urban slum. To determine the baseline knowledge of girls regarding reproductive and sexual health and menstrual hygiene. To estimate the impact of reproductive and sexual health education on the existing knowledge.

Methods: This study was done among late adolescent girls to assess the impact of health education on their knowledge, attitude and practices regarding menstruation and puberty, conception, contraception, RTI, STI, HIV and AIDS. After collecting sociodemographic details and baseline knowledge, health education session was conducted, which was followed by checking their, post-test knowledge Follow up session was also conducted after a month.

Results: Most of the girls were 16 years old, Hindus and from nuclear families. The baseline knowledge about puberty, menstruation, conception, contraception, RTI, STD, HIV, AIDS was not good. The knowledge increased immediately after the first session, but after the second session, the knowledge was not retained. The menstrual hygiene practices increased after the health education session.

Conclusions: The study stresses the importance of imparting knowledge about menstruation, hygiene during the periods, to the adolescent girls and having a regular revision session so as to have good menstrual hygiene practices.

Relationship between automatic thoughts and mindfulness in patients with dual diagnosis: a correlational study

Sunil Kumar, Deepak Malik, Arunima Gupta — Fri, 27 Jan 2023 00:00:00 +0000

Background: Mental disorders are one of the leading causes of non-fatal disease burden and being experienced by population at large. To overcome the mental health issues like stress, depression, people experience of drug used. Using a substance and co-morbid with any type of illness exaggerate the overall health and using these known as dual diagnosis which pose a significant challenge for the professionals, stakeholders and family. The present study has been taken up to find out the relationship of automatic though and dispositional mindfulness amongst patients with dual diagnosis.

Methods: A descriptive correlational study design was taken up for the present study, in which 150 male patients with dual diagnosis were selected and interviewed individually after ethical procedures, using Personal information schedule and Automatic thought questionnaire Scale, and Five Facet Mindfulness Questionnaire.

Results: A total 150 patients were taken in this study. The majority (55%) were between the ages of 20 and 30, married (62%). Descriptive statistics and Pearson Correlation Coefficient were used to see the relationship among variables. The study showed a negative significant correlation of automatic thought and mindfulness at 0.01 level among patients with dual diagnosis. It also suggests a vicious cycle of negative thoughts and mindfulness in such patients.

Conclusions: It was concluded that the automatic thoughts are negatively correlated with mindfulness. The current findings may help health professionals in providing better management to patients with dual diagnosis.

Impact of third wave of COVID-19 pandemic on mental health and its related lifestyle: a cross sectional survey

Fri, 27 Jan 2023 00:00:00 +0000

Background: The coronavirus outbreak has a detrimental impact on human life. Various measures have been taken to reduce socioeconomic impact, but many problems still persist especially mental health, in particular anxiety. The aim of this study was to examine the prevalence and contributing factors of anxiety among the people aged 18 and above, residents of Noida, during the third wave of COVID-19.

Methods: This was descriptive cross-sectional study with semi structured questionnaire, completed by 401 participants. The questionnaire covered four parts: dysfunctional anxiety, mental health-related lifestyle changes, the indicators of negative mental health impact, and social and family support.

Results: The mean age of participants was 36.9±11.5, and 34.2%, aged between 18 and 30 years. Of 401 participants, only 29 participants (i.e., 7.2%) reported CAS≥9 indicating anxiety. CAS is significantly higher in females, housewives and non-working group. Also, 53% of respondents reported that the pandemic had worsened their financial burden. There was an association between some of the sociodemographic variables and anxiety, different responses of lifestyle choices, negative health impact and social and family support.

Conclusions: The pandemic had some positive results such as impact on social and family support, awareness of mental health issues and lifestyle changes. These positive results might operate as effective defences against the adverse COVID-19 effect. Further studies are required to investigate the positive impacts attributed to COVID-19 which can be supported.

Maternal determinants for 4 Ds in children registered under Rashtriya Bal Swasthya Karyakram program at an urban health centre of Ahmedabad

Fri, 27 Jan 2023 00:00:00 +0000

Background: Maternal determinants influence the outcome of pregnancy and child’s health in early years. Rashtriya Bal Swasthya Karyakram (RBSK) deals with the 4 D (birth defects, chronic diseases, deficiency disorders and developmental delays) among children (from birth till 18^th years). Objectives were to determine and document the association between maternal determinants especially antenatal care (ANC) and 4 Ds and suggest preventive measures.

Methods: Out of 302 children with 4 D’s registered during April 2018-March 2020, 102 children were selected using probability proportionate to sample size (PPS) sampling for each category of 4D. Information of socio demographic details and maternal determinants was gathered on a semi structured questionnaire by interviewing mothers/caretaker.

Results: Relevant information could be gathered from 96 mothers. Mean maternal age was 26.4±4.1 years. Congenital defects were significantly associated with higher maternal age (p<0.0001). Out of 102 cases under study, minimum recommended 4 ANC visits were not taken by 17 (17.7%) mothers. Also, 13 (13.5%) did not take IFA supplementation. Poor health status during pregnancy, was significantly associated for deficiency disorders of child in later life (p<0.04).

Conclusions: Maternal age at pregnancy, health status of mother, ANC care (number of ANC visits, IFA supplementation), health seeking behaviour, birth weight and birth order of child were major determinants of 4Ds.

An assessment of knowledge regarding breast cancer among educated women in Kanpur Nagar, Uttar Pradesh, India

Sapna Singh, Deepak Anand, Preeti Tyagi, Rashmi Gupta — Fri, 27 Jan 2023 00:00:00 +0000

Background: Most common female cancer worldwide including India is breast cancer. Awareness about breast cancer is very necessary for early detection and prevention as diagnosis at advanced stages of disease contributes to the high mortality rate. An assessment of existing levels of knowledge regarding cancer is a pre-requisite to find out gaps and to plan for proper educational programmes.

Methods: This cross-sectional study was carried out in a women’s college, study subjects were students, female faculty members and female staff. A structured questionnaire was given, data was collected and analysed.

Results: In this study it is found that knowledge regarding risk factors for breast cancer was low, only 47.68% knew that family history predisposes for breast cancer, 28.48% knew late menopause is risk factor. 76.82% of respondents knew that lump in breast is a sign of breast cancer, whereas only 31.13% knew that discharge from nipple is sign of breast cancer. Merely 6.40% of respondents knew the procedure of breast self-examination. Majority of respondents i.e. 54.53% told media as source of information.

Conclusions: Regarding breast cancer low level of knowledge was found among the study subjects which suggests that proper information should be provided in colleges, especially health facilities and schools should increase their role in providing related information.

Knowledge and attitude towards human papillomavirus and its vaccination among medical students: a cross sectional study

Mamta Thakur, Najnin Khanam, Rajendra Yadav, Gopal P. Soni, Nitin Kamble — Fri, 27 Jan 2023 00:00:00 +0000

Background: One of the causes of penile cancer in men and cervical cancer in women is infection with the human papillomavirus (HPV). An efficient way to prevent high risk HPV infection is by HPV vaccination. This study was conducted to assess knowledge and attitude towards human papillomavirus and its vaccination.

Methods: The cross-sectional study was done among under graduate medical students. Total 428 students were voluntarily participated. Dichotomous (yes/no) items used to assess knowledge of the students towards human papillomavirus and its vaccination. The 3-point Likert scale (agree, uncertain, disagree) used to assess attitude towards HPV vaccination.

Results: Most 71.49% of them knew that HPV infection may leads to carcinoma cervix whereas only 29.44% knew that HPV infection may leads to penile cancer. Most 76.63% of them agreed to recommend HPV vaccine for adolescent girls whereas only 36.68% agreed to recommend HPV vaccine for adolescent boys.

Conclusions: According to the study, college students had knowledge towards HPV vaccination despite acceptance of HPV vaccination among students were very less. Medical students, can play a big role in giving advice on how to prevent HPV-related penile and cervical cancer.

A cross-sectional study to assess the knowledge, attitude and practice about COVID-19 following the 2nd wave among the residents of Mysuru city

Fri, 27 Jan 2023 00:00:00 +0000

Background: COVID-19 is an infectious disease which emerged at the end of 2019 in China and soon took over the world. Interventional measures such as lockdown and health education were provided to contain the spread of the infection. The present study was conducted to assess the knowledge, attitude and practice of the people of Mysuru and clarify any misconceptions regarding the disease or COVID-19 vaccination following the 2^nd wave of the disease.

Methods: A cross-sectional study was conducted from June to July 2021 to assess the knowledge, attitude and practice about the 2^nd wave of COVID-19 among the people residing in Mysuru city. The aim was to correct any misconceptions about COVID-19 vaccination, black fungus and basic practices to combat the ongoing COVID-19 pandemic. A sample size of 142 was interviewed with a questionnaire through a door-to-door survey.

Results: Though awareness about black fungus and basic etiquette was present among the people, there was poor knowledge about the benefits and use of COVID-19 vaccination among the people.

Conclusions: Providing health education is essential to provide knowledge to the public. However, clarifying their doubts and queries is also an essential component to ensure better attitude and widespread practice of the containment measures.

Maternal determinants of low birth weight- a record-based study from a tertiary care centre in central India

Parvati Nair, Sarita Wadhva, Ujwala Ukey, Uday Narlawar, Aditi Dabir — Fri, 27 Jan 2023 00:00:00 +0000

Background: Birth weight is a major determinant of child’s health and nutrition. There are various factors which determine birth weight like maternal age, parity, socio economic status etc. A new born weighing less than 2.5 kg is classified as a low birth weight (LBW) baby. Low birth weight can be prevented by improving health status and socio-economic status of the community, improving antenatal care and also by providing proper health education.

Methods: A record-based study was carried out in a tertiary care facility of central India. Labour room records from January 2021 to December 2021 were reviewed. The details on birth weight, gender, gestational age, parity, and mode of delivery were obtained and recorded. The data obtained was entered in Microsoft office excel software. Statistical analysis was carried out with the help of open Epi.

Results: Out of 4266 records which were studied 46.65% mothers were in the age group 21-25 years and 53.52% were multiparas. The proportion of LBW was found to be 41.30%. LBW was found to have a significant association between age of mother, parity, residence and gender of the baby.

Conclusions: In this study, sociodemographic factors, maternal age and multiparity has contributed substantially to LBW. Hospitals should inform pregnant women about the importance of appropriate age at conception. It is high time to discuss the aftereffects of older maternal age in detail and to focus more on biological components underlying these associations.

Assessment of cold chain and vaccine management practices in cold chain points of Bilaspur, Chhattisgarh: a cross-sectional study

Sabhya Pritwani, M. Jawed Quereishi — Fri, 27 Jan 2023 00:00:00 +0000

Background: To maintain the immunization effectiveness, and uninterrupted availability of vaccine functional cold chain is required. This can be achieved by continuous monitoring and supervision. The objective was to assess the functionality and monitoring of cold chain points of Bilaspur district of Chhattisgarh.

Methods: A cross-sectional study conducted in the month of January 2021 in 15 old and new cold chain points, which were selected randomly from all the five blocks of district. Block level “supportive supervision of cold chain and vaccine management” checklist was used to collect the data. The data was presented in frequency and percentages.

Results: The key findings were shortage of staff, placement of cold chain equipment and ice packs not as per the guidelines, irregular monthly review of temperature, and periodic monitoring with available documentation.

Conclusions: There were shortfalls in the basic components of cold chain which requires immediate attention from the officials.

Study on adverse events following immunizations among COVID-19 vaccine recipients at a tertiary care hospital in Kashmir valley

Rohul Jabeen Shah, Reyana Qulsum, Javeed Ahmad — Tue, 17 Jan 2023 00:00:00 +0000

Background: Adverse events following immunization (AEFI) is an event of unexpected medical emergency occurring after vaccination without any causal association with vaccination. It can be any unintended, abnormal laboratory finding or anything. The present study was conducted to evaluate the incidence and severity of AEFI associated with the COVID-19 vaccines.

Methods: All the beneficiaries who had received two doses of Covishield and Covaxin vaccine from SKIMS Soura and provided consent were included in this prospective study. Each beneficiary was contacted telephonically. A self- designed questionnaire was used to interview them. The beneficiaries were contacted twice. The data was entered into and analysed using SPSS version 20.

Results: A total of 267 participants (52.3%) reported at least one of the AEFI following Covaxin vaccine. It was found that participants with AEFIs following the first dose had more chances to develop them following its second dose and this difference was found to be statistically significant (OR=6.8, p=0.0001). A total of 670 participants (38.0%) reported at least one of the AEFI following Covishield vaccine. The incidence of AEFIs was more after the first dose (31.6%) than that of the second dose (6.4%) and this difference was found to be statistically significant (p<0.0001).

Conclusions: Most of the AEFI are minor and can be managed symptomatically. Therefore, these AEFIs should not be a hurdle for vaccination.

A study of COVID-19 infection, severity and associated factors among the patients admitted at a tertiary care center in southern Rajasthan

Jitendra Hirani, Mukul Dixit, Anjana Verma, Medha Mathur — Fri, 27 Jan 2023 00:00:00 +0000

Background: Since December 2019, there has been various outbreaks of corona virus disease 2019 (COVID-19) disease. Whole world is combating this virus, but its reported clinical characteristics as well as outcomes vary greatly amongst studies. This study was conducted to study the clinical features, laboratory findings, comorbidities and severity of the disease among the patients admitted in tertiary care centre in Rajasthan.

Methods: It was a hospital-based cross-sectional study conducted from 1^st January 2021 to 30^th June 2022 in a tertiary care hospital in Udaipur, Rajasthan. All the patients diagnosed with the help of reverse transcription polymerase chain reaction (RTPCR) for COVID-19, during the study period were included in the study. After taking consent, pre designed questionnaire was used to collect the personal, demographic and clinical information. Radiological, laboratory and mortality data were collected from hospital record.

Results: A total of 400 patients were included in the study. Mean age of the patients was 46.83±17.09 years. Fever (88%) and cough (80%) were the most common symptoms followed by breathlessness (65.8%). About 31.8% (127) patients were found to have severe covid. Severity was found to be significantly associated with increasing age, urban area, breathlessness, co morbidities and D dimer, CRP and IL-6 levels (p value <0.05).

Conclusions: India being a diverse country with a range of sociodemographic characteristics existing within the population, needs a robust approach to control the COVID 19 pandemic. This study presents the factors associated with severe disease and can help to formulate preventive and control strategies.

Role of diet in fertility: a descriptive cross-sectional study on the knowledge among medical practitioners in South India

Vishnu Vardhan Yenuganti, Vedapriya Dande Rajasekar, A. Y. Nirupama — Fri, 27 Jan 2023 00:00:00 +0000

Background: Adherence to healthy diets favouring seafood, poultry, whole grains, fruits and vegetables, are related to better fertility in women and better semen quality in men. Along with pharmaceutical treatment, the role of a proper diet and lifestyle has been highlighted in many diseases like hypertension and diabetes. Likewise, the role of diet in fertility is a less explored area which holds great potential. The first step towards implementation of this fact will be increasing the awareness about the same among healthcare professionals, mainly doctors.

Methods: A cross-sectional study including medical practitioners in 3 hospitals each in Tamil Nadu and Kerala. Assuming 50% prevalence and 8% allowable error, sample size was calculated to be 156. Data collection was done using a semi-structured and self-administered questionnaire.

Results: Among the total, 80.1% of the medical practitioners responded that diet played an important role in boosting fertility of an individual and 72.1% had faced questions regarding the foods to improve fertility. In terms of knowledge, 28% of the respondents were able to score more than 60 out of a maximum score of 100.

Conclusions: Future efforts should concentrate on solidifying emerging evidence and to jointly consider female and male diets along with other interventions for infertility management.

A cross sectional study on awareness about cancer screening methods for breast and cervical cancer in women of reproductive age from Jhansi, Uttar Pradesh

Sudha Sharma, Vimal K. Arya, Anil K. Malhotra — Fri, 27 Jan 2023 00:00:00 +0000

Background: Non-communicable diseases (NCDs) are responsible for 63% of all deaths in India of which 9% are due to cancers according to the World Health Organization (WHO) global profile 2018. One in eight men and one in eleven women die from the disease globally (Globocan 2020). To reduce the morbidity and mortality due to the disease early diagnosis of disease and risk factors by regular screening of asymptomatic people is recommended. Objectives of the study were: to assess the awareness about methods for breast and cervical cancer screening among women of reproductive age, and to assess their readiness to go for screening.

Methods: In a health awareness session on cancer screening among women of reproductive age the participants (104 women) were given a self-designed questionnaire which was administered before the session. The questionnaire covered general awareness about cancer, the symptoms and the methods of screening for breast and cervical cancer. The results were expressed in frequency and percentages.

Results: The mean age of participants was 29.8 years (range 21 years-45 years). 88% felt that early diagnosis would improve outcome. Only 11% had heard of Pap test and only 3 had gotten it done. Around 21% had heard about mammography and only 4% had heard about breast self-examination. 86% and 90% were ready to get themselves screened for cervical cancer and breast cancer respectively, if given the opportunity.

Conclusions: This study highlights both the lack of knowledge and the high acceptance of cancer screening among women. Awareness campaigns at regular intervals backed by immediate access to screening facilities are required to address the problem.

Modified B. G. Prasad socioeconomic scale: 2022 update of India

Parul Sood, Supreet Bindra, Pankajpreet Singh — Fri, 27 Jan 2023 00:00:00 +0000

Socioeconomic status (SES) is one of the most important determinants of family’s health as well as access to resources. It is vital to determine the SES of the participant in community-based research for documenting the incidence and prevalence of numerous health related events. The modified BG Prasad SES is one of the most widely used tool to determine the SES of rural and urban population but this scale requires regular update taking into account the inflation and deflation of value of the Rupees as this scale is based on the per capita Income of an individual. It is based on consumer price index (CPI) for industrial workers. The updated version of Modified BG Prasad for year 2022 thus presented.

Prevalence of attention deficit hyperactivity disorder in the Arab Gulf countries: systematic review and meta-analysis

Bandar M. Almojarthe — Fri, 27 Jan 2023 00:00:00 +0000

Attention deficit hyperactivity disorder (ADHD) is an important growing psychiatric health problem of children and adolescents all over the world. This review aimed to investigate the prevalence of ADHD in the Arab Gulf countries. A literature search was conducted on 14 January 2022. Any paper reporting the prevalence of ADHD in Arab Gulf countries was included. R software was used for the meta-analysis. We included 14 papers. The prevalence of ADHD was 5.90% (95% confidence interval (CI)=1.73-20.14). We found no significant difference in the prevalence of ADHD between males and females (odds ratio (OR)=1.48; 95% CI=0.53-4.14; p value=0.456). The leave-one-out sensitivity analysis did not change the statistical significance proving that a single study did not drive the pooled effect size. Regarding parents’ educational level, the prevalence was the highest among children born to fathers with at least a secondary education 51% (95% CI= 22.97-100.00), while the prevalence rate was comparable among those with primary school education 16.6% (95% CI=1.28-100.00) and illiterate fathers 17% (95% CI=12.84-22.59). The difference between different education subgroups was statistically significant (p=0.040). There were no statistically significant differences in ADHD prevalence when comparing different mothers’ educational levels (p=0.260). The estimated cumulative evidence is high but comparable with the reported worldwide rates. Unlike these studies, the prevalence of ADHD was not associated with gender or maternal education. On the other hand, the highest prevalence of ADHD was found among children of fathers with at least a secondary education.