Showing papers in "International Journal of Medical Science and Public Health in 2016"
TL;DR: Diabetes and its key risk factors are strongly reflected in the targets and indicators - reduction of exposure to unhealthy diet and physical inactivity, zero rise in the prevalence of diabetes, improved access to treatment and reduction of premature mortality.
Abstract: The first WHO Global Report on Diabetes was launched on World Health Day 7 th April 2016 which was dedicated to Diabetes (1). Diabetes has been described in ancient scripts and recognized as a serious illness, but it does not appear to have been frequently encountered by physicians or healers. It is in the past few decades that human health and development is increasingly affected by the rising numbers of people with this condition. Diabetes, together with cardiovascular disease, cancer and chronic respiratory disease has been targeted in the Political Declaration on the Prevention and Control of Noncommunicable Diseases (NCDs) at the Un High-level Political Meeting in 2011. In 2013 WHO member states endorsed a global monitoring framework for noncommunicable diseases, with 9 targets to be reached by 2025. Diabetes and its key risk factors are strongly reflected in the targets and indicators - reduction of exposure to unhealthy diet and physical inactivity, zero rise in the prevalence of diabetes, improved access to treatment and reduction of premature mortality. As part of the 2030 Agenda for Sustainable Development, Member States have set an ambitious target to reduce premature mortality from NCDs - including diabetes - by one third; achieve universal health coverage; and provide access to affordable essential medicines - all by 2030( http://www.un.org/sustainabledevelopment/sustainable-development-goals/).
473 citations
TL;DR: PMS was found to be an important health problem of adolescent girl students in rural areas and associated with mother’s occupation, amount of blood flow during menstruation, and presence of dysmenorrhea.
Abstract: Background: Various studies in India have observed an incidence of premenstrual syndrome (PMS) to be 20% in general population, with 8% revealing severe symptoms
Objective: To study the sociodemographic characteristics of adolescent rural school girls, assess the prevalence of PMS among them, and find out the factors associated with PMS, if any
Materials and Methods: This was a descriptive study with cross-sectional design, conducted in Purba Medinipur district of West Bengal from July to August 2014 Multistage random sampling method was used Totally, 244 students were included in the study Data were analyzed with the help of statistical software SPSS, version 200, using mean, standard deviation, proportion, and X2-test
Result: PMS was reported by 615% of girls Of the affective symptoms in ACOG criteria, 627% girls reported depression and 705% girls anger Irritability was reported to be as high as 848% Anxiety and confusion were reported by 760% and 668% adolescent girls, respectively Around one-third of girls experienced breast pain, and 553% of girls have also faced social rejection during that period Headache and abdominal distension were reported by around 55% students Only147% of them reported limb swelling in premenstrual period PMS was found to be associated with mother’s occupation, amount of blood flow during menstruation, and presence of dysmenorrhea (p < 005)
Conclusion: PMS was found to be an important health problem of adolescent girl students in rural areas
35 citations
TL;DR: The level of satisfactory knowledge, positive attitude, and good practice of studied HCWs significantly improved after exposure to the program, as it increased from 43.3%, 45%, and 57.4% before intervention to 67.9%, 63.8%, and 64.8% after intervention.
Abstract: Background: Saudi Arabia (KSA) showed a higher number of Middle East respiratory syndrome—coronavirus (MERS-CoV) infection in Eastern Mediterranean Region. Satisfactory knowledge, positive attitude, and healthful practice of health-care workers (HCWs) regarding MERS-CoV are a cornerstone in prevention of virus spread and disease outbreak.
Objective: To assess and improve knowledge, attitude, and practice (KAP) of HCWs toward MERS-CoV.
Materials and Methods: An interventional prospective study was conducted during the year 2015 on a randomly selected 398 HCWs in primary health-care centers of Makkah Al-Mukarramah, KSA. The participants were invited after their consent to fill a predesigned closed-ended Arabic-based questionnaire before and 3 months after exposure to a structured health education program.
Result: The level of satisfactory knowledge, positive attitude, and good practice of studied HCWs significantly improved after exposure to the program, as it increased from 43.3%, 45%, and 57.4% before intervention to 67.9%, 63.8%, and 64.8% after intervention, respectively (P < 0.001). Older age, previous training, and experience were positively correlated with higher scores of knowledge.
Conclusion: The study reflected the importance of health education as a cornerstone element in improving KAP toward MERS-CoV infection in preventing the virus spread and disease outbreak.
31 citations
TL;DR: Higher percentages of self-medication practices were seen among the males, higher educational and socioeconomic status, and younger age group, compared with the rest of the population.
Abstract: Background: Self-medication can be described as a double-edged sword for its users, because it has both beneficial and harmful effects. The practice of self-medication is influenced by various factors. Meghalaya being an antimalarial drug resistant region is very much vulnerable to harms of self-medication.
Objective: Therefore, this study was initiated to determine the prevalence of self-medication for allopathic drugs among the rural population and to find out the association between certain socio-demographic characteristics and self-medication.
Materials and Methods: The study was a community-based, cross-sectional study carried out at Sohiong area of Mawphlang Block, East Khasi Hills district, Meghalaya, India. A total of 400 respondents of 18 years of age or more were randomly selected for the study.
Result: Prevalence of self-medication was found to be 55% for allopathic drugs. Higher percentages of self-medication practices were seen among male gender (54.7%), people educated at least up to high school (64%), and in the younger age group (55%). Mild illness (30%) was the most common reason for self-medication followed by unwillingness to go to doctors (27%). Cough and common cold (28.3%) were found to be the most common symptoms for self-medication. Most common source of information for self-medication was family members and friends (38.7%).
Conclusion: Higher percentages of self-medication practices were seen among the males, higher educational and socioeconomic status, and younger age group. Health education to people regarding responsible self-medication is necessary to prevent misuse and adverse effect of self-medication.
27 citations
TL;DR: Good knowledge but poor attitude and practice toward anemia among adolescent girls is highlighted, which can lead to several complications.
Abstract: Background: Anemia is one of the most widespread nutritional deficiency diseases. It affects all age groups and both sexes in most states of India. Profoundly affected groups are adolescent girls (74%–98%). Anemia in adolescents is a critical public health problem in India. Lack of nutritional knowledge is one of the most significant reasons of nutritional problems and consequently improper practice, which can lead to several complications.
Objectives: (1) To know knowledge, attitude, and practice regarding anemia among adolescent girls. (2) To know treatment-seeking behavior regarding anemia among adolescent girls.
Materials and Methods: It is a cross-sectional study conducted among adolescent school girls aged 11–15 years from five government schools under urban field practice area of JJM medical college, Davangere. The study was conducted from 1st September to 30th November 2014 for a period of 3 months by using a pre-designed, pre-tested, semi-structured questionnaire.
Result: Age of students ranged from 11 to 15 and the mean age was 13 years. One hundred sixty (91%) had heard of anemia; 53 (33%) girls told poor diet is the only cause for anemia; 49 (31%) told tiredness is the only feature of anemia; 20 (13%) answered anemia impacts on physical growth, learning process, and decreases work capacity; and 88 (55%) girls told they will consult doctor and takes iron tablets.
Conclusions: The study has highlighted good knowledge but poor attitude and practice toward anemia among adolescent girls.
24 citations
TL;DR: There was no statistical significance in RBCs, Hb, platelets, PT, and PTT between pregnant women in the three different trimesters, whereas WBCs count showed significant differences among the three groups, the highest value was found in the second group followed by the third group and the lowest value found inThe first group.
Abstract: Background: Pregnancy is a period of reproduction during which a woman carries one or more live offspring from implantation of a fertilized zygote in the uterus throughout gestation. There are several physiological changes that occur in pregnancy. Physiology of a normal pregnancy involves major changes in both the coagulation system and hematological parameters. These changes appear to be related to the development of the uteroplacental circulation and provide a protective mechanism during delivery.
Objective: To study the normal changes that occur to red blood cells (RBCs), white blood cells (WBCs), hemoglobin (Hb), platelets, and hemostatic profile (prothrombin time [PT] and partial thromboplastin time [PTT]) among pregnant Sudanese women and compare it within the three different trimesters.
Materials and Methods: A total of 50 apparently healthy pregnant women (gestational age 6–40 weeks) with age range between 20 and 40 years were recruited into the study. They were attending Khartoum teaching hospital, Khartoum, Sudan. There were no special preparation for subjects or questionnaires, and direct interviews were used to collect demographic and clinical data. After informed consent was obtained from the participants, 5 mL of venous blood was subsequently collected from an antecubital vein, with the subject comfortably seated, into ethylenediaminetetraacetic acid and citrate vacuum tubes. Hematological parameters including WBC, RBC, Hb, packed cell volume, and platelets were measured by Sysmex. The plasma clotting time, PT, and PTT were measured manually.
Results: The hematological parameters were represented as follows: mean value of WBCs was 7.580 cell/mm3, RBCs was 4.1 × l012/L, Hb was 11.79 g/dL, platelets was 256 × 109/L, PT mean value of the study group was 13.40 s, and PTT was 36.20 s.
Conclusion: There was no statistical significance in RBCs, Hb, platelets, PT, and PTT between pregnant women in the three different trimesters, whereas WBCs count showed significant differences among the three groups, the highest value was found in the second group followed by the third group and the lowest value found in the first group.
23 citations
TL;DR: The positive effect of physical activities on HGS and the weight training of the muscles increases their efficiency due to more acquisition of strength and development, and can be implemented as a useful parameter by the coach in their fitness and training program.
Abstract: Background: This study was conducted on two different exercising groups, that is, gymnasium (powerlifters) and gymnastics (ring users). Although the type of physical activity is different, but both of the groups require stamina and coordination of central nervous system and skeletal muscles. In the two groups, the muscle strength of the upper body is remarkable and the handgrip has to be effectual for holding rings (gymnastics) and weights (gymnasium). Also, the time for which the grip can be maintained, which determines the endurance of the individual, is vital.
Objective: To find the difference in handgrip strength (HGS) and handgrip endurance (HGE) among the two physically active groups.
Materials and Methods: This study was conducted on a total of 75 subjects, divided into three groups of 25 each, namely, gymnastics, gymnasium, and control, that is, non-exercising group. Anthropometric hand measurements and skinfold thickness, forearm circumference, and forearm muscle were taken with HGS and HGE. Statistical analysis was then done to draw inference.
Result: The study revealed statistically significantly high HGS and HGE in exercising group, in comparison to the control group, also the HGS was maximum in the gymnasium group (p < 0.0001). Moreover, the forearm circumference and the forearm muscle area were maximum (p < 0.0001) and the skin fold thickness was found to be the least in the gymnasium group. The study revealed positive correlation among HGS and HGE with forearm muscle mass. Thus, the study concluded the positive effect of physical activities on HGS and the weight training of the muscles increases their efficiency due to more acquisition of strength and development.
Conclusion: In view of the fact that our day-to-day activities, right from household work, official work, to sports, require good HGS, a consistent assessment of handgrip forms an integral part of rehabilitation, not only to assess the strength of muscles involved in gripping but also to apply as a tool in rehabilitating patients with variable levels of hand injuries and in many clinical conditions such as diabetes. Also, in the field of sports, it affects the performance and, therefore, can be implemented as a useful parameter by the coach in their fitness and training program.
22 citations
TL;DR: It was concluded that education and contraceptive practices were directly related and health workers and mass media are playing very important roles in disseminating information about the promotion of contraceptive practices and can overcome the knowledge/practice gap.
Abstract: Background: By 2050, the world’s population is expected to reach 9 billion. India accounts for 17.5% of the world’s population. In the year 2011, the couple protection rate was about 40% for India, which is still far behind to achieve the 60% couple protection rate goal. Since the inception of the program, several knowledge, attitude, and practice studies have been conducted.
Objective: To assess the knowledge, attitude, and practices of the family planning methods and various sociodemographic parameters and enhance the contraceptive practice among the eligible couples in an urban area of Haryana.
Materials and Methods: This cross-sectional study was conducted in an urban health-training center area of Rohtak district, Haryana. The study participants involved were currently married women aged 15–45 years (eligible couples). The line listing of all the eligible couples was done, and by systematic random sampling methodology, 10% of the currently married women were selected, which came out to be 320. Statistical analysis was done using SPSS software, version 16.0 (Statistical Package for the Social Sciences); we calculated percentages and applied the X2-test wherever necessary and required.
Results: In this study, the total sample consisted of 318 participants, and the mean age of the participants was 32.76 ± 4.6 years. Moving to other variables, it was observed in this study that most of the participants were presenting socioeconomic status (SES) as middle class (35.7%) and lower-middle class (37.2%), followed by upper-middle class (19.6%), and the least participants belonged to the upper class (3.3%) and lower class (4.2%). Around 62% participants were currently using one or more of the various family planning methods. Female sterilization (45.6%) was the most common chosen method used among the contraceptive users, followed by intrauterine contraceptive device (23%) and condom (22%); the least preference was given to oral contraceptive pill (OCP) (9.2%). When asked specifically regarding the individual type of family planning method, most awareness was toward OCP (97.7%) and the least awareness observed for the traditional methods (30.5%). The awareness source for family planning methods were mainly doctors/multipurpose health workers/anganwadi workers (70.4%).
Conclusion: On the basis of observations of our study, it was concluded that education and contraceptive practices were directly related. Health workers and mass media are playing very important roles in disseminating information about the promotion of contraceptive practices and can overcome the knowledge/practice gap.
21 citations
TL;DR: It is shown that the physical domain of QoL was significantly affected in diabetic persons, so, apart from taking regular medications and health checkup, there is a need to address other components of physical domain so that theirQoL will improve.
Abstract: Background: India is regarded as the “Diabetes Capital” of the world owing to the existence of the largest number of people with diabetes in this country. Diabetes is a serious public health problem that has a strong negative impact on the health-related quality of life (HRQoL).
Objective: To know the quality of life (QoL) of diabetic persons and compare them with normal subjects.
Materials and Methods: This cross-sectional study was done among 85 diabetic patients and 85 age- and sex-matched normal comparison group. We used the World Health Organization Quality of Life Questionnaire—short version (WHOQoL-BREF) to assess QoL.
Result: The mean QOL-BREF instrument score, indicating the QoL of the patients, was 57.80. Domain-wise, 55% of the patients revealed good physical QoL, 47% good psychological QoL, 55% good social QoL, and 45% good environmental QoL. The mean score of physical domain of diabetic patients was significantly lower than nondiabetic subjects.
Conclusion: This study has shown that the physical domain of QoL was significantly affected in diabetic persons. So, apart from taking regular medications and health checkup, there is a need to address other components of physical domain so that their QoL will improve. While it might not be easy to modify clinical outcomes with good services and support, it might be much more effective in bringing a change in QoL.
20 citations
TL;DR: High prevalence of anemia among pregnant women indicates anemia to be a major public health problem in the rural community and factors such as socioeconomic status, birth interval, and gravida contribute to this high prevalence.
Abstract: Background: Anemia is the most common hematological disorder during pregnancy. According to the reports of World Health Organization reports, from 35% to 75% (56% on average) of the pregnant women in developing countries are anemic. Prevalence of anemia in South Asian countries is among the highest in the world. India has the highest prevalence of anemia (87%).
Objective: To determine the prevalence of anemia and factors influencing its causation among pregnant women.
Materials and Methods: A community-based cross-sectional study was carried out among 446 pregnant women from July 2013 to June 2014 in the rural population of Kolar district, Karnataka, India. The study participants were selected by using multistage sampling method. The hemoglobin estimation was done by using HemoCue method, and data were collected in a pretested questionnaire. Data were analyzed with SPSS version 22. The X2-test and correlation coefficient was used to test the degree of significance.
Result: A high prevalence (64%) of anemia was observed among pregnant women. The mean hemoglobin level was found to be 10.3 ± 1.53 g%, ranging from 5 to 15 g%. Anemia was predominantly observed among below poverty line families (59.4%) compared with above poverty line families (5.4%). The prevalence of anemia increased with increase in gestational age and gravida and decreased with increase in birth interval.
Conclusion: High prevalence of anemia among pregnant women indicates anemia to be a major public health problem in the rural community. Factors such as socioeconomic status, birth interval, and gravida contribute to this high prevalence.
20 citations
TL;DR: Though this study shows increased prevalence of awareness of health insurance, there is still an alarming need to improve the awareness with regard to their knowledge about health insurance covering the medical expenses in the rural communities.
Abstract: Background: Health insurance is a rapidly emerging social security instrument for the rural poor, for whom, chronic health problems, arising due to prevalence of diseases and inaccessibility to an affordable health care system is a major threat to their income earning capacity. Insurance is one of the risk management strategies. The need for an insurance system that works on the basic principle of pooling of risks of unexpected costs of persons falling ill and needing hospitalization by charging premium from a wider population base of the same community. There is a need to increase the awareness of health insurance among rural population therefore this study was undertaken.
Objective: (1) To study the socioeconomic and demographic characteristics of study population; and (2) to analyze the awareness of health insurance of study population.
Materials and Methods: A pretested semi-structured questionnaire was used for collecting data on sociodemographic and economic characteristics of the study population and their awareness of the benefits and purpose of taking health insurance. Study was from October 2015 to December 2015. The data were analyzed using percentages and proportion. A total of 1084 sample houses were visited and among them 399 were interviewed.
Result: Of the 399 respondents, 302 (75.7%) of them were aware of health insurance. Among 302 only 202 (66.9%) had procured health insurance. Of these, 187(95.5%) had government insurance and 15(7.5%) of them had private health insurance. Awareness of health insurance was associated with socioeconomic status and education (p < 0.05).
Conclusion: The determinants of awareness of health insurance were education and socioeconomic status. Though this study shows increased prevalence of awareness of health insurance there is still an alarming need to improve the awareness with regard to their knowledge about health insurance covering the medical expenses in the rural communities.
TL;DR: The use of common salt in treating umbilical granuloma is simple, cost-effective, curative, and safe, and easily administered and can be performed by parents at home.
Abstract: Background: Umbilical granuloma is the most general umbilical difficulty in neonates and young infants. It is commonly noted by the parents owing to persistent drainage or moisture involving the umbilicus, after the cord has dried and separated. If umbilical granuloma remains untreated, it could ooze and present with persisting irritation for several months. Many treatment modalities are available for umbilical granuloma such as chemical cauterization with silver nitrate or copper sulphate, electrocauterization, cryocauterization, granuloma ligation, and surgical excision.
Objective: To evaluate the therapeutic effect of common salt (table or cooking salt) on umbilical granuloma in infants.
Materials and Methods: This prospective study was conducted on 50 infants with umbilical granuloma. Parents of these 50 infants were instructed on the treatment regimen and administration to the infant at their home. The treatment consisted of application of common salt on the lesion twice a day, washing 30 min later, and repeating the procedure for 5 days.
Result: All 50 infants with umbilical granuloma showed complete resolution after the 5-day course of common salt treatment.
Conclusion: The use of common salt in treating umbilical granuloma is simple, cost-effective, curative, and safe. It is easily administered and can be performed by parents at home.
TL;DR: Two to 3% of healthy donors are seropositive for TTI and reveal potential of transmitting them through transfusion and screening with higher-generation ELISA kits can help to identify and avoid transfusion of infectious blood products.
Abstract: Background: Transmission of infectious diseases such as HIV, hepatitis, syphilis, and others through donated blood needs a serious monitoring to provide safe blood for transfusion, which forms an integral part of medical and surgical therapy.
Objective: To access the seroprevalence of transfusion-transmitted infections (TTIs) in Malwa region and assess the level of blood safety.
Material and Methods: A prospective observational study was conducted for the duration of 12 months. The known seropositive donors for any of these infections (HIV, HBV, HCV, syphilis, and malaria) and hemoglobin less than 12.5 g% were excluded. All donor samples were screened for HIV, HBsAg, and anti-HCV by ELISA methods; syphilis and malaria screening was done by card test.
Result: Among the total 4,007 donors, 92% were replacement donors while 8% were voluntary donors. Female donors comprised only 1.62%; the remaining 98.38% were male donors. The donor population was mostly in the young age group of 18–30 years (69.1%). Totally, 2.05% (n = 83) blood bags were seropositive for TTI. HBV was the most common TTI (1.77% bags); HIV was the second most common TTI (0.14% bags); HCV was detected in 0.099% bags, whereas syphilis was the least common TTI (0.04% bags).
Conclusion: Two to 3% of healthy donors are seropositive for TTI and reveal potential of transmitting them through transfusion. Thus, strict and proper donor selection criteria and screening with higher-generation ELISA kits can help to identify and avoid transfusion of infectious blood products.
TL;DR: The prevalence of smoking among PHC physicians in Makkah was relatively high and current smokers either occasionally or daily are more likely to show incorrect smoking-related knowledge compared with nonsmokers.
Abstract: Background: Tobacco smoking is one of the main preventable reasons for death on the planet and is a noteworthy general well-being issue in both developed and developing nations. The primary health-care (PHC) doctors speak to an imperative resource in the battle against smoking.
Objective: To detect the prevalence of smoking, smoking-cessation knowledge, and attitude among physicians in PHC centers in Makkah and evaluate the smoking-cessation counseling practices of these physicians.
Materials and Methods: A cross-sectional study was conducted at 80 PHC centers in Makkah over a period of 2 months. Data were collected by a validated self-administered questionnaire “Global Health Professional Survey” that was adopted from the WHO.
Result: The study included 262 PHC physicians. The prevalence of daily current smoking was (18.7%), while male and female prevalences were 26.7% and 1.2%, respectively. Only (7.3%) were occasional smokers. Majority of ever-smoked physicians reported thinking of quitting smoking. Incorrect knowledge was reported among 25.6% of physicians. Logistic regression revealed that physicians of experience ranged between 2 and 10 years were less likely to express incorrect smoking-related knowledge compared with those with an experience of 1 year or less. Current smokers have approximately four-fold risk for incorrect smoking-related knowledge compared with nonsmokers [adjusted odds ratio (AOR) = 4.04; 95% CI: 2.21–7.36]. Negative attitude was reported among 26.2% of physicians. Logistic regression revealed that physicians aged between 36 and 45 years showed a significant negative attitude toward smoking compared with those in the age group 25–35 years (AOR = 5.83; 95% CI: 2.88–11.79). Bad practice regarding smoking cessation was reported among 52.7% of the physicians. Logistic regression revealed that physicians with longer experience of working in PHC centers were significantly less likely to show bad practice regarding smoking cessation compared with those with an experience of 1 year or less. When compared with residents, senior registrars were less likely to exhibit bad practice regarding smoking cessation (AOR = 0.19; 95% CI: 0.05–0.69).
Conclusion: The prevalence of smoking among PHC physicians in Makkah was relatively high. Current smokers either occasionally or daily are more likely to show incorrect smoking-related knowledge compared with nonsmokers. Most of PHC physicians showed positive attitudes toward smoking cessation activities, with no significant difference between current smokers and nonsmokers. Almost a 25% of primary health-care physicians did not receive sufficient training in smoking cessation activities.
TL;DR: The data suggest that biofilm formation as a potential virulence factor might show a higher significance for non-albicans Candida species than for C. albicans species, and that the biofilm structure varies with the different species and strains of Candida, the nature of the colonized surface, and its localization.
Abstract: Background: Candida species can be either commensals or opportunistic pathogens with the capacity to bring about several infections, extending from superficial to life-threatening. Nosocomial infections owing to Candida are also getting progressively significant. Early and precise diagnosis, correct treatment, and prohibition of candidemia owing to biofilms create a big task for microbiologists and clinicians worldwide. In addition to this is the emerging trend of antifungal drug resistance among the biofilm-producing strains of Candida.
Objective: To detect biofilm production in Candida species isolated from various clinical samples obtained from patients at a tertiary-care hospital in Ahmedabad.
Materials and Methods: A total of 67 Candida species (26 Candida albicans and 41 nonalbicans Candida species) isolated from various specimens (urine, sputum, endotracheal tube secretion, tissue, oral swabs, and other samples) were included in the study. The various Candida isolates were identified by using conventional methods, and their ability to produce biofilm was detected by the tube method and Congo red agar method.
Result: Of 67 Candida species, Candida tropicalis [38 (56.78%)] was the predominant species isolated. Biofilm positivity was seen with 46 (68.65%) isolates, and the biofilm production was observed more with non-albicans Candida species [30 (65.21%)] when compared with C. albicans species [16 (34.78%)]. Among the non-albicans Candida species, strong biofilm producers were Candida parapsilosis and C. tropicalis. Biofilm positivity was found to be higher in the tissue, endotracheal aspirate, and urine of Candida isolates when compared with isolates from other sites.
Conclusion: This study suggests an increasing prevalence of non-albicans Candida species in the various clinical samples isolated and shows them as strong biofilm producers when compared with C. albicans species. These data suggest that biofilm formation as a potential virulence factor might show a higher significance for non-albicans Candida species than for C. albicans and that the biofilm structure varies with the different species and strains of Candida, the nature of the colonized surface, and its localization. Thus, more remains to be determined about biofilms formed by the non-albicans Candida species, as they are now frequently encountered species in catheter-associated candidemias.
TL;DR: Author aimed to opine to use validation study as a separate study design rather than the current trend of assigning cross-sectional study design.
Abstract: Psychometrics has a very important role and with the increase in the number of cross-cultural research projects, there is a need to adapt health status measures. In validation study, there are different scientific steps during translation, cultural adaptation, sample size estimation and assessing reliability and validity with distinct statistical analysis. Author aimed to opine to use validation study as a separate study design rather than the current trend of assigning cross-sectional study design.
TL;DR: Implementation of training programs for breast-feeding women in various techniques of breast- feeding, especially with regard to latching and maternal positioning, can improve the knowledge and attitude of postnatal mothers and aid in better practices of feeding, which in turn promotes comfortable and successful lactation.
Abstract: Background: Successful lactation is determined by the early initiation of breast-feeding and continuation of lactation, which in turn is determined by positioning, an important aspect to get neonates to latch on to the breast.
Objective: To explore the knowledge, attitude, and practices (KAP) of postnatal mothers in the immediate postpartum period regarding the techniques of breast-feeding and to reassess their KAP following education.
Materials and Methods: This observational study was conducted in a teaching hospital in a coastal district of Karnataka, which involved 118 postnatal mothers within the first week of delivery who were breast-feeding. The study was done as per the standard KAP methodology using a preformatted structured questionnaire involving 12 questions, which were evaluated under various domains such as initiation of feeding, latching, maternal positioning, and postfeed techniques. Assessment was done with the help of a scoring system carried out before and after education, and the results were analyzed with appropriate statistical tests. When the participants answered more than minimum specified number of questions correctly for each domain, the score was considered satisfactory, and the percentage of such women were calculated both pre- and posteducation; any improvement in the performance domain-wise and total scores were noted.
Result: The KAP mean scores of participant women at the time of recruitment with different demographic variables were compared in various domains of breast-feeding techniques, and it was found that educated women having antenatal care at higher centers and who received information regarding breast-feeding techniques before delivery showed higher scores (P < 0.001). The mean scores of these domains were also compared before and after administering lactational education, and it was found that such a training session improved KAP of postnatal women in all the domains significantly (P < 0.001).
Conclusion: Implementation of training programs for breast-feeding women in various techniques of breast-feeding, especially with regard to latching and maternal positioning, can improve the knowledge and attitude of postnatal mothers and aid in better practices of feeding, which in turn promotes comfortable and successful lactation.
TL;DR: The overall awareness regarding HBV disease was found to be lacking among the dental students in Mysore, Karnataka, India.
Abstract: Background: Hepatitis B virus (HBV) infection is a major worldwide public health problem. Nearly 45% of the world’s population lives in areas of high endemicity, with India being a country of intermediate endemicity.
Objective: To assess the knowledge, attitude, and practices of dental students about HBV infection at a private dental institution in Mysore, Karnataka, India.
Materials and Methods: A cross-sectional survey was conducted using a pretested, structured, and validated questionnaire containing 16 questions on awareness, transmission, prevention, diagnosis, treatment, vaccination status, and postexposure prophylaxis of HBV infection. Descriptive statistics were carried out along with chi-square test and contingency coefficient.
Result: The response rate was 100% (n = 486). A total of 88.7% of the students knew about the transmission of HBV infection. Only 64% students were immunized against HBV. Majority of the students (91.1%) agreed for vaccination against HBV infection. Only 28.4% students knew about the postexposure treatment against HBV infection. About 58.8% students knew about the preventive measures against HBV infection.
Conclusion: The overall awareness regarding HBV disease was found to be lacking among the dental students.
TL;DR: The findings may help in developing instructional design for ethics education in qualitative research and stimulate the generation of separate guidelines for the conduct of qualitative research in the future, in India.
Abstract: Background: We have been conducting workshops on “Qualitative Methods in Health Research” since last 5 years for health professionals in India.
Objective: To explore the concerns and suggestions of the participants during their learning of ethical issues in qualitative research in a workshop setting.
Materials and Methods: We obtained responses in an interactive session on ethical issues in qualitative research from a group of newly trained participants in workshops conducted in the years 2011 (n = 13) and 2013 (n = 30). A summative manual content analysis was done to identify themes generated. The results were compiled by two authors in which one was trained in qualitative research and another was trained in ethics in biomedical research. The discussion was developed in consensus.
Result: The ethical challenges in qualitative research that emerged were (1) ensuring confidentiality, (2) selecting a tool and an approach for studying sensitive topics, (3) developing a consent form for a flexible interview, (4) addressing risks, (5) ethical reviewing of qualitative research proposals, and (6) publishing qualitative research findings. Participants suggested the need for training of researchers and ethics committee members in qualitative research methods.
Conclusion: The findings may help in developing instructional design for ethics education in qualitative research and stimulate the generation of separate guidelines for the conduct of qualitative research in the future, in our country.
TL;DR: Increased sympathetic activity caused by acute mental stress may be the cause for this altered electrical activity of the heart in ECGs in acute stress state.
Abstract: Background: Electrocardiogram (ECG) waveforms are influenced by physiological, pathological, and psychological factors. Acute mental stress affects the hypothalamic–pituitary–adrenal axis resulting in alterations in various physiological functions of the body particularly the cardiovascular system.
Objective: To study the ECG changes during acute mental stress and also to understand the reasons for the changes in ECG caused by acute mental stress.
Materials and Methods: ECG was recorded in relaxed state and in acute stress state in healthy male subjects in the age group of 18–24 years. ECG recordings in relaxed state were compared with those in acute stress state.
Result: Increased heart rate, decreased PR interval, decreased QT interval, and prolonged QTc interval were observed in ECGs in acute stress state which were statistically significant. Also an increase in QRS duration and change in QRS axis were observed during acute stress which were statistically not significant.
Conclusion: Increased sympathetic activity caused by acute mental stress may be the cause for this altered electrical activity of the heart.
TL;DR: FNAC being a reliable, safe, rapid, and economical procedure is useful as an outdoor diagnostic procedure for the diagnosis of tubeculous lymphadenitis.
Abstract: Background: Tuberculous lymphadenopathy is an important form of extrapulmonary tuberculosis. The role of fine needle aspiration cytology (FNAC) in the diagnosis of such lesions is a well-known fact.
Objective: To study the incidence, utility, limitations of FNAC, and various cytomorphological presentations in reference to Ziehl–Neelsen staining in tuberculous lymphadenitis.
Materials and Methods: A total 496 patients presenting with palpable cervical lymphadenopathies were referred to the cytology section of Pathology Department, Government Medical College, New Civil Hospital, Surat, Gujarat, India, over a period of 1 year (January to December 2014) were included in the study. The data entry was carried out using Microsoft Office Excel worksheet and analyzed.
Result: Of the 496 lymph node aspirations, 277 (45.8%) cases were diagnosed as tuberculous lymphadenitis. The age of the patient ranged from 5 months to 65 years. The maximum number of cases 167 (73.6%) suggestive of the cytomorphology of tuberculous lymphadenitis were aged in the range of 11–30 years. There were 113 (49.7%) female and 114 (50.3%) male subjects. Male subjects showed a slight predominance for tuberculosis. In this study, the most common site of the involved lymph nodes was of the cervical region in 91.2% (227/249) cases. The caseating epithelioid granulomatous pattern of tubercular lymphadenitis was the most common cytomorphological pattern seen in 47.6% of patients in this study. Acid-fast bacilli (AFB) positivity was the maximum in necrotizing and suppurative lymphadenitis (44.7%). The highest AFB positivity for tubercle bacilli was found in the aspirates, which were purulent in gross appearance (42.8%).
Conclusion: FNAC being a reliable, safe, rapid, and economical procedure is useful as an outdoor diagnostic procedure for the diagnosis of tubeculous lymphadenitis. From the cytomorphologic pattern and the AFB positivity, a rough estimate about the immune status can be made.
TL;DR: De Ritis ratio can be used as a prognostic marker of liver disorder and can be considered as a noninvasive, cost–effective means of screening liver diseases.
Abstract: Background: Liver diseases are one of the common disorders encountered in clinical practice. Investigations in liver-associated diseases are used to detect type of hepatic abnormality, to measure its severity, to define its structural effect on the liver, to find out etiology of disorder, to assess prognosis, and to evaluate therapy. One should aim at a diagnosis with simple and possibly noninvasive means, avoiding extensive examinations. De Ritis ratio (the ratio of serum aspartate aminotransferase to serum alanine aminotransferase) has been proposed a valuable diagnostic marker to screen liver disorder.
Objective: To assess the significance of De Ritis ratio as a diagnostic marker in population of hepatic disorder.
Materials and Method: This is a retrospective study performed on records of 102 patients with liver diseases who were treated at the out-patient clinic or admitted to Nobel Medical College, Biratnagar, Nepal, between June 15, 2015 and July 15, 2015. De Ritis ratio of all the patients were calculated from documented biochemical tests of AST and ALT. De Ritis ratio and demographic profile of all the patients were analyzed by independent t -test and one-way ANOVA using software SPSS 20 version.
Results: De Ritis ratio was significantly decreased (p < 0.05) in viral hepatitis (0.8006 ± 0.14811) than the control group (1.0934 ± 0.13508) and markedly increased (p = 0.000) in alcoholic liver disorder. Similarly, It is significantly increased (p < 0.05) in nonalcoholic fatty liver disorder (1.2204 ± 0.17954), whereas insignificantly increased (p = 0.408) in cholestasis (1.1378 ± 0.18045).
Conclusion: De Ritis ratio can be used as a prognostic marker of liver disorder and can be considered as a noninvasive, cost–effective means of screening liver diseases.
TL;DR: Awareness sessions on voluntary blood donation should be held regularly to create positive attitude, and to remove misconceptions among the college students about voluntary blooddonation.
Abstract: Background: Voluntary blood donation is considered as backbone of blood safety and safe transfusion practices. There is a serious need to improve the recruitment and retention of voluntary donor population to ensure a sustainable safe blood transfusion practice.
Objectives: The objective of our study is to perceive various factors like knowledge, aptitude, and practices about voluntary blood donation among undergraduate medical students so that their doubts and misconceptions regarding blood donation can be removed and they can be inspired to become regular non-remunerated blood donors.
Material and Methods: This study has been carried out among second professional medical students in M.M. Medical College and Hospital, Solan, Himachal Pradesh, North India. Pre-designed and pre-arranged questionnaires were used to evaluate the knowledge, attitude, and practices regarding blood donation among 150 medical students.
Results: Most of the students 123 (82%) were aware about the suitable age group for blood donation and 114 (76%) stated that the minimum gap between donations should be 3 months. Voluntary donors were considered as the inimitable source of blood by 124 (82.67%). There were 85 respondents who had never donated blood and the chief reasons for not donating blood were fear of needle or sight of blood, perception that blood donation can leads to anemia, objection from family members, and never has been asked to donate blood. In total, 65 (43.4%) respondents had donated blood in the past and out of this, 44 (67.69%) respondent donates one time in a year, and 21 (32.31%) donates more than one time in a year. Out of 65 respondents who have previously donated blood, 25 (38.46%) had donated voluntarily whereas 40 (61.54%) had donated on replacement basis.
Conclusion: Awareness sessions on voluntary blood donation should be held regularly to create positive attitude, and to remove misconceptions among the college students about voluntary blood donation.
TL;DR: KAP toward DF was deficient among target populations and school-based educational campaigns and social mobilizations are needed to raise the awareness and to translate knowledge into sound practice within all schools in Makkah City.
Abstract: Background: The incidence of dengue fever (DF) is rapidly increasing globally, and now 128 countries are endemic by it. Today, DF is considered as one of the most important vector-borne diseases in terms of mortality and morbidity. The prevention and control of DF is one of the most important priorities because of the continuous increases in the number of cases globally.
Objective: To evaluate the baseline level of knowledge, attitude, and practice (KAP) about DF and their predictors among high school students in Makkah City, Saudi Arabia.
Materials and Methods: A cross-sectional study was designed and was conducted at Makkah high schools during the educational year 2014/2015. A multistage stratified random sample method with a proportional allocation technique was used in the study. The stratifications took into consideration the gender, school type, geographic educational district, specialty of the student, and educational year. Ten schools were randomly selected in Makkah to evaluate KAPs of students about DF. A total of 362 questionnaires were completed.
Result: This study showed that knowledge about DF was deficient; 59%, 32.7%, and 8.3% of the students obtained poor, fair, and satisfactory knowledge scores, respectively. Having heard about DF was the strongest predictor for having high knowledge score (t test = 4.47, p < 0.001). This was followed by female gender (t test = 5.81, p < 0.001) and positive family history of DF (t test = 3.18, p < 0.01). The only factor that significantly affected the self-reported practices scores was their level of knowledge about the disease (t test = 3.16, p < 0.01).
Conclusion: KAP toward DF was deficient among target populations. School-based educational campaigns and social mobilizations are needed to raise the awareness and to translate knowledge into sound practice within all schools in Makkah City.
TL;DR: This study reports one of the highest prevalence rates of dyslipidemia reported in Saudi Arabia, and patients who were hypertensive and diabetic were more likely to develop dys Lipidemia compared with others.
Abstract: Background: The prevalence of dyslipidemia is high and increasing in many developing countries, including Saudi Arabia because of the westernization of diet and other lifestyle changes.
Objective: To estimate the prevalence and to identify the associated factors of dyslipidemia among Saudi employees in primary health care in Jeddah City.
Materials and Methods: A retrospective cross-sectional study was conducted among primary health care employees in Jeddah. Seven primary health care centers were randomly selected. Sample of 461 Saudi employees’ medical files were taken in to consideration. Their age ranged from 20 to 60 years. Data were collected over a period of 3 months from June 2014 to August 2014. It included demographic characteristics of the patients’ height, weight, lipid profile results, and blood glucose levels. Anthropometric measurements, including weight and height were obtained and body mass index was calculated.
Result: This study included 461 employees; 145 (34.9%) men and 271(65.1%) women. The mean age was 38.1 ± 9.3 years. The prevalence of dyslipidemia was 78%. The prevalence of high total cholesterol was 38.7% whereas those of high low-density lipoprotein, low high-density lipoprotein, and high triglycerides were 43.5%, 45.2%, and 17.4%, respectively. The prevalence of hypertension was 20% whereas those of prediabetes and diabetes were 18.6% and 22.1%, respectively. Multivariate logistic regression analysis revealed that patients with hypertension were almost at an 11-fold risk to have dyslipidemia compared with those with normal blood pressure (crude odds ratio [OR] = 10.85; 95% confidence interval [CI]: 2.32–26.31, p = 0.024). Patients with diabetes were almost at a ninefold risk to develop dyslipidemia compared with those who were without diabetes (crude OR = 9.27; 95% CI: 1.68–52.19, p = 0.019).
Conclusion: This study reports one of the highest prevalence rates of dyslipidemia reported in Saudi Arabia. Patients who were hypertensive and diabetic were more likely to develop dyslipidemia compared with others.
TL;DR: Road crash injury is largely preventable and predictable since it is a human-made problem hence is amenable to rational analysis and countermeasure.
Abstract: Background: Worldwide, the number of people killed in road traffic accidents each year is estimated at almost 1.2 million, whereas the number injured is believed to be as high as 50 million—the combined population of five of the world’s large cities.
Objective: To find out the reasons leading to road traffic accident in the opinion of the road traffic accident victims.
Materials and Methods: It is a descriptive study performed in two tertiary health-care delivery institutes in Kashmir. It included 316 victims of road traffic accidents who reported to BJH & SMHS hospitals in 1 year period. Demographic characteristics of the victims, time, day, and month of accidents were the variables studied. Other study variables included were category of road users involved in road traffic accidents and reasons of accidents in the opinion of the accident victims. Data collected was analyzed in terms of proportions and percentages.
Result: There were 80.7% male and 19.3% female accident victims. Students were the maximum (22.2%) among the victims. Majority of accidents occurred in the second quarter 100 (32%) of the year whereas the first quarter experienced the least 51 (16%) accidents. Those driving the vehicles constituted the largest (44.9%) of the victims followed by pedestrians (31.6%). Among the motorized vehicles, two wheeler drivers were more (44.3%) involved in accidents. The most common substance abused was tobacco 148 (46.8%) whereas alcohol abuse was seen in only 2 (0.6%) cases.
Conclusion: Road crash injury is largely preventable and predictable since it is a human-made problem hence is amenable to rational analysis and countermeasure.
TL;DR: The results suggested that obesity is prevalent in all the classes of society irrespective of their social class and BMI is the best indicator for predicting the metabolic abnormality.
Abstract: Background: Obesity is one of the strong risk factors in development of metabolic disorders such as type-2 diabetes or hypertension (HTN) in individuals. However, central obesity or overall obesity is the primary risk factor associated with metabolic disorder and not well-established. Hence, this study was planned to investigate the anthropometric parameters such as body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), abdominal volume index (AVI), Conicity index (CI), and skinfold thickness as surrogates in predicting the metabolic disorders in young population.
Objective: To assess the ability of anthropometric parameters mainly AVI and CI, to identify young women at risk of developing diabetes and HTN in future, and to compare the anthropometric measurements among the different socioeconomic status.
Materials and Methods: Eighty-four women in reproductive age group of 20–40 years were assessed for different anthropometric parameters such as weight, height, WC, skinfold thickness, and derived values of BMI, WHR, AVI, and CI. They were also investigated for fasting blood glucose and triglyceride levels, and supine blood pressure was recorded. The population was of different socioeconomic class as classified by Modified Kuppuswamy classification; the study was designed to predict metabolic abnormalities such as diabetes mellitus and HTN based on laboratory and blood pressure values (prediabetes: fasting blood glucose, 100–126 mg/ dL; preHTN, systolic blood pressure, 120–139 mm Hg and/or diastolic blood pressure, 80–89 mm Hg; hypertriglyceridemia, triglycerides >150 mg/dL; or a combination of risk factors). The data were analyzed by analysis of variance (ANOVA) and receiver-operating characteristic curve.
Result: The mean BMI was 24.84 ± 5.34 kg/m2; WC: 96.64 ± 11.5 cm; WHR: 0.96 ± 0.07; AVI: 18.94 ± 4.78; CI: 1.42 ± 0.48; and sum of skinfold thickness: 11.19 ± 3.16 mm. All the mean parameters of the study mentioned earlier were found to have no significant difference when tested by one way ANOVA. Twenty-nine people were detected with metabolic abnormalities that showed significant difference in BMI, AVI, CI, and skin fold thickness.
Conclusion: Our results suggested that obesity is prevalent in all the classes of society irrespective of their social class. BMI is the best indicator for predicting the metabolic abnormality. AVI, CI, and WC can also be used along with the BMI in predicting metabolic abnormality for early management.
TL;DR: Based on the findings, the following components would add value when incorporated into the intervention: engaging families in the treatment process, clear/simple written information, clear nonjargon verbal explanations, and coaching to help patients cope with stigma.
Abstract: Context: Depression and diabetes are highly comorbid, adversely affecting treatment adherence, and resulting in poor outcomes. To improve treatment and outcomes for people dually affected by diabetes and depression in India, we aimed to develop and test an integrated care model. Aims: In the formative phase of this INtegrated DEPrEssioN and Diabetes TreatmENT (INDEPENDENT) study, we sought stakeholder perspectives to inform culturally-sensitive adaptations of the intervention. Settings and Design: At our Delhi, Chennai, and Visakhapatnam sites, we conducted focus groups for patients with diabetes and depression and interviewed health-care workers, family members, and patients. Subjects and Methods: Key informants were asked about experiences with diabetes and depression and for feedback on intervention materials. Analysis: Qualitative data were analyzed using a grounded theory approach. Results: Three major themes emerged that have bearing on adaptation of the proposed intervention: importance of family assistance, concerns regarding patient/family understanding of diabetes, and feedback regarding the proposed intervention (e.g., adequate time needed for implementation; training program, and intervention should address stigma). Conclusions: Based on our findings, the following components would add value when incorporated into the intervention: (1) engaging families in the treatment process, (2) clear/simple written information, (3) clear nonjargon verbal explanations, and (4) coaching to help patients cope with stigma.
TL;DR: Pap smear examination is an effective screening and diagnostic procedure for the detection of premalignant and malignant cervical lesions at an early stage, thereby helping the clinicians in more efficient management of the patients.
Abstract: Background: Cancer of cervix is the second most common cancer in women in the world and one of the leading malignancies seen in Indian women. In India and other developing countries, cervical cancer is the most common cause of morbidity and mortality. Cancer of cervix is preventable if diagnosed at the pre-invasive stage with regular intervals of cytological screening by Papanicolaou (Pap) smears.
Objectives: This study was conducted to determine the importance of conventional Pap smears for the diagnosis of inflammatory, premalignant, and malignant lesions of the cervix.
Materials and methods: This cross-sectional study was conducted from January 2014 to December 2014 on 1808 women coming for a Pap smear examination in Government Medical College attached to New Civil Hospital, Surat. After doing Pap stain, all cases were reported as per the 2001 Bethesda system.
Results: A total of 1808 cases of Pap smears were received out of which 1563 (86.5%) cases were negative for intraepithelial lesion or malignancy, 161 (8.9%) cases were unsatisfactory or inadequate, and 84 (4.65%) cases showed epithelial cell abnormality. Out of the 1563 cases, 647 (41.39%) cases were reported to have no specific pathology, 90 (5.76%) showed changes of atrophy, 333 (21.31%) cases showed inflammatory/reactive changes, whereas organisms were seen in 493 (31.54%) cases.
Conclusion: Pap smear examination is an effective screening and diagnostic procedure for the detection of premalignant and malignant cervical lesions at an early stage, thereby helping the clinicians in more efficient management of the patients. It also suggests a need for further evaluation and follow-up.
TL;DR: PCOS patients have high prevalence of anxiety and depression, according to a cross-sectional observational study conducted in obstetrics and gynecology department of tertiary care centre.
Abstract: Background: Patients of polycystic ovarian syndrome (PCOS) often suffer from psychiatric co morbidities, such as anxiety and depression. Indian literature regarding prevalence of these disorders in PCOS patients is scanty.
Objective: To assess prevalence of anxiety and depression in patients of PCOS.
Materials and Methods: It was a cross-sectional observational study, which was conducted in obstetrics and gynecology department of tertiary care centre. Patients of PCOS were assessed on hospital anxiety depression scale and sociodemographic and clinical information was gathered using semi-structured questionnaire. Data are expressed as proportions.
Result: The prevalence of anxiety of 28% and depression 11% were observed.
Conclusion: PCOS patients have high prevalence of anxiety and depression.