bluuebunny/crossref_metadata_2025 huggingface dataset:
Prophylactic treatment abandonment in people bitten by suspected rabid animals, El Salvador, 2013-2017
Authors: Chavarría Larisa , Quinteros Edgar , Sánchez Mario , Domínguez Rhina
Published: October 2022

Introduction:

Around the world 60,000 people die from rabies each year. The main form of exposure to rabies is by the bite of animals infected with the virus. More than 20,000 cases of rabies-transmitting animal bites are reported each year, in El Salvador, a country located in Central America. People exposed should be managed with rabies prophylaxis.

Objective:

To determine the abandonment of post-exposure prophylaxis (PEP) cumulative incidence (CI) in humans bitten by suspected rabid animals in El Salvador from 2013 to 2017.

Methodology:

This is an ecological study based on the cases of bites by suspected rabid animals reported between 2013 and 2017 in the public health system of El Salvador. Descriptive and correlation analysis was performed using Statistical Package for the Social Sciences (SPSS) version 24. The municipality CI, expressed per 100,000 inhabitants.

Results:

The national CI of abandonment PEP in humans bitten by suspected rabid animals was 25.6 × 100,000 inhabitants. Simple bivariate correlation analysis shows that the departments with the highest CI of bites caused by cats, wild animals, and bites on the neck (R
2 = 0.99 P < 0.05) are mostly associated with dropping out of the PEP.

Conclusion:

In El Salvador, the abandonment CI of PEP is lower than other countries, however, bites by rabid suspected animal are frequent, this represents a public health problem due to the presence of the rabies virus in wild animals and the high lethality of the disease. Municipalities where head bites are common are the most related to the abandonment of PEP.
Hypertension as a silent epidemic among late adolescent girls, its associated demographic factors, and pregnancy outcome: A report from national family health survey (NFHS) IV data
Authors: Chandrashekarappa Smitha , Malhotra Sumit , Nagendraswamy Chandan , Gopi Arun , Murthy MR Narayana , Upadhyay Kritika , Goel Sonu
Published: October 2022

Background:

Hypertension is predominantly considered to be a disease frequently occurring after the fifth decade of life, its occurrence among adolescents has not received much public health attention. Pathophysiological and epidemiological evidence suggests that essential hypertension initiate in childhood and often goes unnoticed unless explicitly observed for this age group.

Aim:

The current study estimates the prevalence of hypertension, its predictors, and pregnancy outcome among late adolescent girls (15–19 years).

Material and Methods:

The study used secondary data from the NFHS 4 from January 2015 to December 2016. The sample of 1,24,878 adolescent girls out of 6,99,686, national women’s data was obtained through a stratified two-stage sample using a population proportionate to size sampling methodology. Descriptive statistical tests and inferential statistics were performed to find the relation of hypertension with the independent variables and Chi-square analysis to study association of hypertension during pregnancy and its adverse pregnancy outcomes.

Results:

The prevalence of hypertension among the late adolescents was 16.4% [CI: 16.2-16.6] (n=20,532). On multivariable logistic regression (after adjusting for all the variables) only age [AOR: 1.09 (1.08-1.11)]; education [AOR: 1.09 (1.006 – 1.2)], and wealth index [AOR: 1.17 (1.11 – 1.24)] retained the significance with hypertension. A significant association was seen between hypertension status of the adolescents and adverse pregnancy outcomes (c2 = 4.550, P = 0.033).

Conclusion:

Nearly 1/6th of late adolescents found to be hypertensive, significantly contribution to disease burden. Also, a significant association is seen between hypertension status of adolescents and adverse pregnancy outcomes. Hence, it is imperative to make the National Programme inclusive for adolescents and have a focused approach to health promotion, prevention, and management of non-communicable diseases.
Relationship between tinnitus and headache in Riyadh, Saudi Arabia
Authors: Alluhaymid Yousef M. , Alsiwat Lojain J. , Basodan Sundus , Almomani Murad Omar
Published: October 2022

Objective:

Our aim was to estimate prevalence rates of different headache forms among tinnitus patients in Arabia, to investigate whether there is a relationship between tinnitus laterality and headache laterality in patients with unilateral tinnitus and unilateral headache, to explore the relationship between tinnitus and headache over time, and to know the effect of headache pain medications in tinnitus in Riyadh, Saudi Arabia.

Method:

The study is a quantitative observational cross-sectional study with a convenient sample by data from patients with tinnitus. The participants received a self-administrated electronic questionnaire measuring demographics, prevalence of an associated headache, and the relationship between tinnitus and headache.

Results:

A total of 226 patients enrolled themselves into the study, and all of them came from the capital city Riyadh of Saudi Arabia. 58% were females, and the remainder of them were males. Females reported significantly more ear tinnitus than males, and patients aged 51 years or older were significantly less inclined to report ear tinnitus compared to those younger; however, those aged 20–31 years were found to be significantly more inclined to report ear tinnitus. There was a statistically significant association between patients experiencing headaches and those experiencing ear tinnitus. Surprisingly, patients who take medications of any type to alleviate their headaches were significantly less inclined to report ear tinnitus than those who do not take medications. However, patients with ear tinnitus experienced longer headache duration in years than those who had no history of tinnitus. Moreover, those people who experienced right-sided tinnitus tended to report significantly more right-sided headaches, and the same goes for left-sided headaches.

Conclusion:

Our results showed that there is a relationship between headaches and tinnitus. Painkillers also showed a protective effect against tinnitus. High awareness about the relationship between headaches and tinnitus among physicians and patients may lead to early recognition and lead to early implementation of primary prevention, which is the cornerstone of family medicine practice, and treatment without referring to other specialties. However, the pathophysiology is still not clear. Further studies should be performed to know the pathophysiology.
Readmission rates and predictors of avoidable readmissions in older adults in a tertiary care centre
Authors: Samuel Stephen V. , Viggeswarpu Surekha , Wilson Benny P. , Ganesan Maya P.
Published: October 2022

Context:

Thirty-day readmissions are used to gauge health care accountability, which occurs as part of the natural course of the illness or due to avoidable fallacies during the index admission. The utility of this metric is unknown in older adults from developing countries.

Aim:

To ascertain the unplanned 30-day readmission rate and enumerate predictors of avoidable hospital readmission among early (0–7 days) and late (8–30 days) readmissions.

Settings and Design:

A retrospective chart audit of 140 older adults who were readmitted to a premier tertiary care teaching hospital under Geriatrics from the neighboring states of Tamil Nadu, Andhra Pradesh, and Kerala were undertaken.

Methods and Materials:

Data from health records were collected from the hospital electronic database from May 2015 to May 2020. The data was reviewed to determine the 30-day readmission rate and to ascertain the predictors of avoidable readmissions among both early and late readmissions.

Results:

Out of 2698 older adults admitted to the geriatric wards from the catchment areas, the calculated 30-day hospital readmission rate was 5.18%, and 41.4% of these readmissions were potentially avoidable. The median duration from discharge to the first readmission was ten days (Interquartile range: 5–18 days). Patients had to spend INR 44,000 (approximately 602 USD) towards avoidable readmission. The most common causes for readmission included an exacerbation, reactivation, or progression of a previously existing disease (55.7%), followed by the emergence of a new disease unrelated to index admission (43.2%). Fifty-eight patients (41.4%) were readmitted within seven days following discharge. Early readmissions were seen in patients with malignancies [8 (13.5%) vs. 4 (4.8%); P = 0.017], on insulin (P = 0.04) or on antidepressants (P = 0.01). Advanced age was found to be an independent predictor of avoidable early readmission (OR 2.99 95%CI 1.34–6.62, P = 0.007), and admission to a general ward (as compared to those admitted in a private ward) was an independent predictor of early readmissions (OR 2.99 95%CI 1.34–6.62, P = 0.007).

Conclusion:

The 30-day readmission rate in a geriatric unit in a tertiary care hospital was 5.2%. Advanced age was considered to be an independent predictor of avoidable early readmission. Future prospective research on avoidable readmissions should be undertaken to delineate factors affecting 30-day avoidable hospital readmissions in developing nations.
Risky sexual behavior and associated factors among secondary and above-education-level students in Ethiopia: A systematic review and meta-analysis
Authors: Aynalem Bewket Yeserah , Alemu Addisu Alehegn , Zeleke Liknaw Bewket , Kassa Getachew Mullu
Published: October 2022

Background:

Risky sexual behavior is defined as the behavior that increases the susceptibility of an individual to problems related to sexuality and reproductive health. The main aim of this study was to determine the pooled prevalence of risky sexual behavior and its associated factors in Ethiopia.

Methods:

Systematic review and meta-analysis (PRISMA) rules were used. During the searching period, MEDLINE, PUBMED, Cochrane Library, EMBASE, Google Scholar, and CINAHL were used with search terms. The STATA form 14 program was utilized to perform the meta-analysis. I2 statistics was used to test heterogeneity, and publication bias was assessed using Begg’s and Egger’s tests. Odds ratio (OR) with a 95% confidence interval (CI) was presented using forest plots.

Results:

There were 24 studies, and 13,440 study participants were included in this meta-analysis. The pooled prevalence of risky sexual behavior in Ethiopia was 40% (95% CI: 32%, 48%). The associated factors for risky sexual behavior were substance use [OR: 2.41 (95% CI: 1.49, 3.89)], watching pornography [OR: 2.59 (95% CI: 1.01, 6.69)], and night club visit, [OR: 2.53 (95% CI: 1.64, 3.90)].

Conclusion:

Risky sexual behavior among secondary school and above-education-level Ethiopian students was high.
The intergenerational relationship patterns between aging parents and their adult children
Authors: Torabian Maryam , Zanjari Nasibeh , Fadayevatan Reza , Froughan Mahshid , Harouni Gholamreza G.
Published: October 2022

Background:

Older parent-child relations and their impact on the elderly’s lives are of importance; thus, the present study aimed to investigate the patterns of the intergenerational relationships between aging parents and their adult children.

Methods:

The current cross-sectional study was conducted on 463 elderly men and women, aged ≥60 years who were residing in Tehran City, Iran. The study participants were selected using the stratified cluster sampling method. The Bai’s (2017) 13-item Intergenerational Relationship Quality Scale for Aging Parents (IRQS-AP) was used to evaluate the patterns of intergenerational relationships among the study subjects. The obtained data were analyzed in SPSS. The significance level of the tests was set at P ≥ 0.05. The logistic regression model was employed to investigate the factors related to the patterns of intergenerational relationships.

Results:

The mean ± SD age of the explored aging parents was 67.93 ± 7.0 years. Besides, the mean ± SD number of children in the study participants was 3.55 ± 1.80. The mean ± SD scores of solidarity (structural, associational, consensual, affectual, functional, and normative) and conflict were measured to be (58.95 ± 17.55) and (64.10 ± 20.92), respectively. Furthermore, the mean ± SD score of the ambivalence pattern was calculated as (51.46 ± 21.61). The mean score of conflict was higher than those of solidarity and ambivalence. Additionally, the mean score of consensual-normative solidarity was higher than those of other dimensions of solidarity. The obtained data suggested a significant difference between age and the patterns of intergenerational relationships (p ≤ 0.05). Moreover, the mean scores of solidarity and conflict in the examined female elderly and their adult children were higher than those of their male counterparts and their adult children; however, the mean score of ambivalence in the male elderly and their adult children was higher than that in their female counterparts. Logistic regression analysis results indicated that aging parents who were literate (OR = 1.5), those who lived alone (OR = 1.2), and those who assessed their general health status as good (OR = 4), reported high levels of solidarity with their adult children.

Conclusion:

The present research results demonstrated that the level of conflict between aging parents and their adult children exceeded the solidarity level, indicating the intergenerational gap. Therefore, the necessary implications should be adopted to promote intergenerational relationships within the family by providing family counseling. Further research is recommended to consider the essential role of predictive factors, such as age, gender, educational level, occupational status, living arrangements, health status, and socioeconomic status of aging parents concerning the intergenerational relationships between aging parents and their adult children.
Effect of intra-articular hyalase, Ketorolac, marcaine and triamcinolone, versus Ketorolac, marcaine and triamcinolone for reducing knee joint pain other than joint replacement
Authors: Daneshian Maryam , Montazemi Maryam , Abbaskhani Davanloo Ali
Published: October 2022

Introduction:

Knee pain is one of the causes of physiological complications in patients with osteoarthritis of the knee. It is necessary to provide a solution to reduce pain in these patients. Our study aimed to compare the effect of intra-articular hyalase, ketorolac, marcaine, and triamcinolone versus ketorolac, marcaine, and triamcinolone for reducing knee joint pain after knee surgery.

Methods:

This clinical study was performed on 30 candidates for knee surgery other than knee replacement from 2019 to 2020. The patients were randomly divided into two groups: hyalase, ketorolac, marcaine, and triamcinolone (group 1) and ketorolac, marcaine, and triamcinolone (group 2). The patient’s pain score was recorded by the Numeric Rating Scale (NRS) and range of motion (ROM) at the end of the first week, the end of the first month, and the end of the third month as well as the sixth month and the twelfth month after surgery.

Results:

The mean age of the patients was 42.3 years. On average, the group receiving hyalase (first group) received about 30% better scores and had less pain (P < 0.05). In the first week, first month, and third month, no significant difference was observed between the two groups. But the pain scores for the first and second groups were 3.1 and 4.5 during the sixth to twelfth months, respectively (P < 0.05). Moreover, the increase in ROM during the sixth to twelfth months was significantly higher in the group receiving hyalase (P < 0.05).

Conclusion:

Adding hyalase to ketorolac, marcaine, and triamcinolone could improve pain control in the short and long term and this could be capable of reducing the need for additional drugs.
Growing concerns on male reproductive health amidst COVID-19 pandemic
Authors: Agrawal Megha , Kumar Vikas , Vardhan Gyan
Published: October 2022

Blood–testis barrier is body’s innate mechanism to defend germ cells by creating a physical and immunological barrier. But some viral infections are known to evade it. As ACE2 and TMPRSS2 are present all over the body including male reproductive tract, it is worth exploring how coronavirus disease (COVID-19) could possibly affect male fertility. A review of literature was done using search engines like PubMed, Medline, Google Scholar, etc., and all the latest articles up to May 2021 were considered. Some studies have substantiated the presence of orchitis in COVID patients using semen and tissue samples. Though most studies report the absence of virus in testis, involvement of seminiferous tubules has been seen in pathological analysis suggesting defective spermatogenesis. This can be primarily attributed to inflammation and increased vascular permeability. Other factors that could affect male fertility are fever, autoimmune response, drugs, and erectile dysfunction. Male fertility is an important aspect of health care and must be looked into. Further studies can be done to understand host immunity towards SARS-CoV-2 in the testis. It will be worthwhile to know whether viral orchitis and its sequelae are acute or chronic in nature, and if they are reversible. Effect of the virus on female reproductive tract can also be assessed further. Counselling can be given to affected/recovering patients along with correct selection of drugs to prevent these long-term complications.
Prevention of melioidosis
Authors: Mohapatra Prasanta Raghab , Mishra Baijayantimala
Published: October 2022

Melioidosis is a complex tropical disease linked with many complications. It is increasingly diagnosed in India. The clinical mimicry of this disease with several other common causes of pneumonia has kept the clinicians in ignorance. Usually, the diagnosis and appropriate management get delayed. The organism closely resembles the common contaminant Pseudomonas and is easily misidentified in microbiology laboratories. The diagnosis is often missed because of poor diagnostic sensitivity of blood culture, the gold standard of the diagnosis. All this contributes to increased morbidity and mortality. The rampant use of high-end broad-spectrum antibiotics like ceftazidime and meropenem at suboptimal dose and duration suppresses the diagnosis without eradicating the disease, leaving the chance of recurrence from its latency even after years. As an infectious disease, the cure and prevention depend on early diagnosis and treatment. An awareness of its peculiar presentations and history can differentiate clinically and suspect the condition much easily from other mimickers of tuberculosis to sepsis. Ultimately, the prevention of melioidosis remains the critical strategy. Increasing the number of cases and intricated management of this fatal but potentially curable disease had prompted us to take up the mission of preventing the disease by spreading knowledge and awareness.
Incidence of recovery from severe pneumonia and its predictors among children 2–59 months admitted to pediatric ward of Ayder Comprehensive Specialized Hospital, Tigray, Ethiopia: A retrospective Cohort study
Authors: Amare Rigeat Atsbha , Fisseha Girmatsion , Berhe Awtachew , Tirore Lire Lemma
Published: October 2022

Background:

Pneumonia is a major reason for hospital admission among children, particularly in resource-poor areas. A hospital stay (length of stay) alone is found to contribute for 46.8% of a household cost for single episode of severe pneumonia. The aim of this study was to determine the incidence of recovery from severe pneumonia and predictors among children 2–59 months of age admitted to pediatric ward of Ayder Comprehensive Specialized Hospital (ACSH).

Methods:

A retrospective facility-based cohort study was conducted among under-five-year-old children admitted in ACSH. Three years medical records from July 7, 2015 to July 6, 2018 were reviewed. A total of 285 children with severe pneumonia admitted to pediatric ward of ACSH were included. Kaplan-Meier Survival Curve was used to estimate recovery time. The independent effects of covariates on recovery time are analyzed using multivariate Cox-proportional adjusted model.

Result:

The median survival time was four days (95% CI = 3.732 – 4.268). The incidence of recovery was 92.3%. Co-morbidity (AOR: 3.47, 95%CI, 2.21, 5.4), malnutrition (AOR = 1.9, 95%CI, 1.2, 3.1), duration of chief complaint (AOR = 0.72, 95%CI: 0.54, 0.94), and vaccination (AOR = 0.32, 95% CI, 0.13, 0.81) were significant predictors of time to recovery from severe pneumonia.

Conclusion:

High recovery rate and short length of hospital stay was observed in this study. Increased duration of chief complaint, presence of co-morbidity, being malnourished, and vaccination were factors that associated with time to recovery. Therefore focuses have to be given in increasing the community’s health seeking behavior to visit health facility early and especial attention should be given for children with co-morbidity, malnutrition, and unvaccinated children.
Parental knowledge of children’s developmental milestones in Aseer, Saudi Arabia
Authors: Habbash Asma Saad , Qatomah Aishah , Al-Doban Rehab , Asiri Raghad
Published: October 2022

Background:

Better parental knowledge about developmental milestones of children is linked to better parent–child interaction. Only a handful of surveys have been conducted to evaluate parental knowledge of developme ntal milestones in Arabic-speaking countries.

Materials and Methods:

The study is a cross-sectional, questionnaire-based observational investigation using a simple random sampling scheme. The sampling frame consisted of all parents attending the family medicine services during the period of conduct of the study. Poisson regression modelling techniques were used to analyse the adjusted effect of sociodemographic factors on knowledge score.

Results:

Three hundred and seventy-five parents agreed to be included in the study. Only 29 (7.7%) had an excellent knowledge level. Poor knowledge was found among 141 (37.6%) participants. Also, 180 (48%) participants were found to have an acceptable level of knowledge. Mothers achieved acceptable knowledge of developmental milestones better than fathers, and better knowledge was found in less-crowded houses. Physical developmental milestones were known by 304 (81.1%) participants, followed by cognitive development milestones (n = 78, 20.8%), social development milestones (n = 47, 12.5%) and emotional development milestones (n = 85, 22.7%). The internet was the most used source (n = 83, 22.1%). The most avoided sources were educational workshops (n = 230, 61.3%), followed by doctors (n = 159, 42.4%) and social media (n = 130, 34.7%).

Conclusions:

We confirmed in this work that parental knowledge of children’s developmental milestones is suboptimum among Saudi parents. Use of the internet and avoidance of healthcare professionals is a source of concern. Care is required for children coming from overcrowded homes in terms of their developmental progress. Focus should be on educating parents about the social and emotional developmental milestones.
Construction of the health risk assessment index system for assessing the chronic diseases based on the general health
Authors: Hao Ran , Zhang Meng , Jin Haoyu , Zuo Jinfan , Hu Jie
Published: October 2022

Aims:

This study aimed to construct a standardized health risk assessment index system (HRAIS) under the guidance of general health and facilitate the family doctors to carry out chronic disease management.

Methods:

Available chronic disease surveillance systems and indexes were reviewed to identify potential indexes. The Delphi method was performed to establish the HRAIS, and the analytic hierarchy process was used to calculate the index weight.

Results:

HRAIS included four first-level indexes and 38 second-level indexes. The authority coefficient was 0.86. The Kendall’s W for the two rounds of Delphi consultation were 0.202 and 0.210 (p < 0.001). The weights of the first-level indexes from high to low were physiological health (0.409), psychosocial health (0.290), health-related behaviors (0.205), and environment (0.097). Thus, HRAIS is a multi-dimension and multi-index tool, which can be used as a guideline for family doctors in early screening, early intervention, and classified management of main chronic diseases.
Knowledge, Attitude and Practices of rabies during an outbreak in Samtse Municipality, Bhutan: A cross-sectional study
Authors: Lhendup Karma , Wangdi Kinley
Published: October 2022

Background:

A rabies outbreak in dogs occurred on February 22, 2021, in the Samtse Municipality, Bhutan. A rapid response team (RRT) was activated comprising of human and animal health teams to investigate and contain this outbreak. An assessment of the knowledge, attitude, and practice (KAP) on rabies was elicited during this period to develop evidence-based education material.

Methods:

A face-to-face KAP questionnaire was administered to a volunteer member of 55 households in two communities (Norbuling and Xing Workshop areas) following the rabies outbreak in the Samtse Municipality from March 15 to 22, 2021. Descriptive statistics were used to describe the demographic characteristics. The associations between the KAP scores were assessed using the Pearson correlation coefficient.

Results:

Of the 55 respondents, 63.6% (35) had poor knowledge, 90.9% (50) and 63.6% (35) reported good attitude and practice toward rabies. Three (5.5%) participants had not heard about rabies. The other misconceptions were that rabies can be prevented with antibiotics (67.3%, 37), dressing the bite wounds (20.0%, 11), and seeking treatment from the local healer (5.5%, 3). Correct knowledge was reported on excessive salivation as the sign of the rabid animal (58.2% 32), rabies prevention through vaccination (81.8%, 45), and seeking medical care on the same day (94.5%, 52). Eighty-nine percent (49) vaccinated their dogs and domestic animals annually, 100% received post-exposure prophylaxis (PEP) after an animal bite, 78.2% (43) washed the animal bite wounds with soap and water, and 9.1% (5) would consult the local healer for animal bites. A majority (78.2%, 43) of them agreed that rabies is a serious public health problem in the Samtse Municipality and 49.1% (27) agreed that the public was adequately informed about rabies. A positive correlation was observed between the knowledge-practice scores (r = 0.3983, P value = 0.0026), and attitude-practice scores (r = 0.4684, P value < 0.001).

Conclusion:

The poor knowledge of rabies in this study needs to be addressed urgently. The main misconceptions included were that rabies is not fatal, dressing animal bite wounds, and seeking dog and animal bite care from local healers. Health education should focus on these misconceptions.
Sale of antibiotics without prescription in stand-alone pharmacies in Tamil Nadu
Authors: Chandran Deena Sangeetha , Manickavasagam Prema Prathicksha
Published: October 2022

Background:

Non-prescription sale of antibiotics is one of the major causes for increased consumption of antibiotics which facilitates the emergence of drug resistance. Over-the-counter sale of antibiotics in India, without prescription and often at partial doses, is quite common even though the practice is not legal.

Objectives:

(1) To interview pharmacists about the sale of over-the-counter medication, and prescription drugs sold without a prescription, in particular; (2) to obtain an understanding of the reasons for such sale from the perspective of the pharmacist.

Methods:

Pharmacists were interviewed with the help of a pre-validated questionnaire in 15 stand-alone pharmacies in a metropolitan city and a tier-2 city in Tamil Nadu. Major points of interest were characteristics of customers requesting antibiotics without a valid prescription, common diseases for which they were sold without prescription, whether patients asked for antibiotics by name or as treatment for their symptoms, and reasons for such requests.

Results:

Pharmacists readily admitted to selling prescription drugs, including antibiotics without a valid prescription. While they know of antibiotic resistance, not a single pharmacist interviewed by us knew of the causes of antibiotic resistance.

Conclusion:

The intervention listed in the National Action Plan on Antimicrobial Resistance to develop awareness campaigns targeted at dispensers regarding existing rules and appropriate use of antimicrobials and mandatory training programs on optimal antimicrobial use must be implemented immediately.
Community response towards health care providers delivering health care services during COVID-19 pandemic: A strategy framework based on findings of a qualitative study in Odisha, India
Authors: Patel Kripalini , Mishra Bijaya K. , Kanungo Srikanta , Bhuyan Dinesh , Som Meena , Marta Brajesh , Pati Sanghamitra , Palo Subrata K.
Published: October 2022

Context:

While there are studies on peoples’ behaviour toward health professionals (doctors and nurses) during the Coronavirus diesease (COVID-19) pandemic in hospital settings, there is limited literature on Community Health Workers (CHWs). Our study attempted to explore the behaviour of community people towards CHWs during the pandemic and its underlying reasons.

Material and Method:

A qualitative study using In-depth interviews (IDI) and focus group discussions (FGD) was conducted among CHWs and community people from six districts of Odisha from February to April 2021. The researchers transcribed the audio recordings in the vernacular language of the Odisha province, i.e., Odia, and later translated them into English. A qualitative content analysis method was used to prepare the detailed report using Max Weber Qualitative Data Analysis (MAXQDA) software.

Result:

The study found two major categories-Reflection on community behaviour towards CHWs during the COVID-19 pandemic and reflection on availing health care services by community people during a pandemic. Many CHWs revealed that the community people acknowledged their work and dedication and extended all sorts of co-operation and support. However, few community people were non-cooperative and non-supportive. Community reluctance owing to perceptions that the CHWs might be infected, was the significant cause that they faced a lack of support from the community. Further, to create awareness of COVID-19 infection among community people, CHWs adopted different strategies such as door-to-door visits, wall painting, poster display, and awareness through mikes.

Conclusion:

The efforts made by the CHWs during health emergencies need to be recognized and appraised.
Health literacy on hygiene and sanitation, nutrition, and diseases among rural secondary school children – Findings from a qualitative study in Odisha, India
Authors: Patel Kripalini , Palo Subrata K. , Kanungo Srikanta , Mishra Bijaya K. , Pati Sanghamitra
Published: October 2022

Context:

Health literacy among school children is a priority to promote their health, hygiene, and nutrition behaviours and practices. Although in schools they learn from their peers and teachers, their domestic and social conditions also contribute to learning and adopting in practice. The level of health literacy is also influenced based on socio-demographic features.

Aims:

It is imperative to explore and understand the practices including existing gaps and challenges for future improvement.

Methods and Material:

A qualitative study consisting of 17 focus group discussions (FGDs) among students and teachers in six rural secondary schools was carried out in a rural block of the Cuttack district, Odisha. All FGDs were audio-recorded; transcribed and compiled data were imported into Atlas.ti for analysis.

Results:

An existing gap in health literacy and healthy practices with respect to hygiene and sanitation, nutrition, and diseases was observed. A low socio-economic status, inaccessibility to clean and safe drinking water, toilet facility, and nutritional food items were major factors preventing their health literacy and practice. Many schools have adopted measures such as poster presentation, practical teaching and demonstration, school play, and competitions at the school and in the community, which were found to be effective for creating awareness. Improving infrastructural facilities, ensuring availability of essential commodities, and having more health-promotional activities are required for improving health literacy and practice.

Conclusions:

There is an urgent need to improve the health literacy and practice among rural school children. Innovative practical-oriented education at schools and improved awareness among parents and community people would achieve better adherence to healthy practices.
Determining the relative frequency of ultrasound findings in women under 30 years of age with a breast mass
Authors: Roostaee Ayda , Soleimani Mahseta , Younesi Ladan , Poornia Sepideh Mirani , Lima Zeinab Safarpour
Published: October 2022

Introduction:

Mammography and ultrasound are the most reliable and common imaging techniques for early detection of breast mass. The aim of this study was to determine the relative frequency of ultrasound findings in women under 30 years of age by a feeling of mass in the breast.

Methods:

This cross-sectional study was performed on women under 30 years of age with a feeling of mass in the breast. The result evaluated in this study was the final opinion of the radiologist on the ultrasound report, which was expressed in the form of Breast imaging-reporting and data system (BIRADS) based on one to five scores. Ultrasound status of patients was reported to be normal, fibrocystic changes, and tumors (solid-cystic-mixed). The obtained data were analyzed using SPSS statistical software version 23. Significance level was considered to be < 0.05.

Results:

The most common reason for referral was palpable mass in the left breast (56.2%). The shape of the mass was oval in most cases (91.2%). The highest frequency in terms of mass margin was related to Macrolobulated (82.4%), Hypoechoic (85%), and Solid (87.6%). Most of masses belonged to 12 o’clock (21.2%). According to the standard sonography report based on BIRADS, the highest frequency belonged to B4a (57.5%). Pathology report showed that the highest frequency was related to fibroadenoma (71.4%).

Conclusion:

Considering that most of the cases in this research with a feeling of mass in the breast in women under 30 years of age were BIRADS 4, and among the cases that underwent biopsy, 14.5% were diagnosed with cancer pathology. Therefore, ultrasound examination is very important in these cases, even at a young age.
Client satisfaction with telemedicine services during COVID-19 pandemic: A cross-sectional survey from a teaching institute of North India
Authors: Aneja Jitender , Goyal Tarun , Verma Madhur , Kaur Gurpreet , Mirza Moonis , Gupta Satish
Published: October 2022

Introduction:

Telemedicine has emerged as an essential interface between health care providers and patients during the pandemic. The present study was done to assess this technology’s level of acceptance and satisfaction amongst the patients.

Methods:

We did a retrospective study amongst patients >18 years (n = 300) who had availed telemedicine services in different departments of a tertiary care hospital between May and August 2020. The patients were interviewed telephonically using a pre-tested semi-structured tool that collected information about the socio-demographic and clinical characteristics of the patients, and satisfaction was measured on a 5-point Likert Scale.

Results:

Fifty-five percent patients received teleconsultation via a telephone call, while the others preferred video calling services on WhatsApp messenger. Overall, more than 97% of the clients depicted satisfaction with the telemedicine services in three major domains: registration/appointment services, consultation with the doctor and post-consultation services. Some of the common feedback included difficulty in getting medicine using the scanned copy of prescription slip generated by the hospital, problems faced in reimbursement of the bills, long waiting period, and poor quality of video calls due to slow internet.

Conclusion:

Telemedicine proved to be an efficient means of communication for many patients during the pandemic. Though patient satisfaction was high with the services received by them, timely assessment of the problems encountered in the implementation of telemedicine services will help evolve the services not just during the pandemic but even after that.
Change in attitude and help-seeking pattern of caregivers and patients with mental disorders in the community - Recent findings from India
Authors: Raj Shirley , Das Sudipta Kumar , Pattnaik Jigyansa Ispita , Das Ramachandra , Das Namita , Ravan Jayaprakash Russell
Published: October 2022

Knowledge of factors related to patients’ and primary caregivers’ health-seeking behaviour is required for a complete early intervention for the management of mental illness. Previous research has found that men are more likely to seek care and that a considerable proportion of patients seek help from native healers before obtaining psychiatric help. The goal of this study was to see if there had been any changes in the paths to psychiatric care, as well as the socio-demographic characteristics that were linked to early help-seeking behaviour among patients with mental illnesses in metropolitan eastern India.

Method:

The researchers utilised a cross-sectional study design. A face-to-face interview was used to collect data using the WHO Encounter Form. Using a successive sample technique, patients with various diagnoses of mental illness undergoing Psychiatry outpatient therapy at a tertiary care medical college were included in the study.

Results:

In terms of gender, ladies (53.3%) were seen to use psychiatric services more than males (46.7%) from an urban or semi-urban background. For dissociative disorders, the median time from onset to first contact with a care provider was 0.1 years; 0.3 years for mood episodes; 0.6 years for anxiety disorders; one year for psychotic disorders; and seven years for Substance Use Disorders (SUD). However, interaction with current psychiatric services took an average of six months for dissociation; 3.5 years for mood disorders; three years for anxiety disorders; six years for psychotic disorders; and a maximum of seventeen years for SUD. Participants in the study who had a family history of mental illness sought care more quickly (OR = 4.3, 95 percent CI 1.19 to 7.11, P = 0.03). The fact that 73 percent of patients have a GP or mental health professional as their first point of contact for various mental diseases is good. Higher education status, urban background, dwelling closer to the mental health centre, and having a biological attribution model for psychological illness were the other clinical and demographic characteristics important for quicker paths to mental health treatment.

Conclusions:

In most cases of psychosis and SUD (substance use disorders), there is still a significant delay in receiving modern psychiatric therapy. The number of initial contacts with Native Healers ha s decreased. The majority of people said mental illness was caused by environmental or biological factors. Education and scientific information regarding mental health have aided the process of seeking treatment, and there should be a provision of training programmes for family physicians and community health professionals to facilitate the process of help-seeking behavior of psychiatric patients in the Indian subcontinent.
Hospice care in India: A review
Authors: Shukla Rushikesh , Singh Nihaal , Acharya Sourya , Shukla Samarth
Published: October 2022

Palliative care is the need of the hour, especially in a country like India where the number of terminally ill patients has always been a concern, and with projections showing this number to only go up and increase exponentially, it is much more important that we now shift our focus to providing quality hospice care to the ones that are in need of it. In this article, the authors start out by defining Palliative care and hospice care, all the while maintaining the distinct features of them both. Once the foundation is set for the same, we dive into the history of palliative care in this country and how it has evolved over the years. We then move on to the present scenario of hospice care in India and try to look at it through a more contemporary lens. Further, we discuss the impact of some diseases that most adversely affect individuals and require end-of-life care in its more advanced stages. These include, but are not limited to, end-stage cancer, multidrug resistant (MDR)–tuberculosis and Human immunodeficiency virus-associated acquired immune deficiency syndrome (HIV–AIDS). We then move on to discuss the importance of academic interventions to strengthen the role of hospice care in the India and how research and education can help improve the condition of end-of-life care in all domains. We finally talk about how we can move forward and what positive changes we can bring about in order to make inroads into better and more sustainable hospice care in the Indian context. We hope that our work will cause healthcare professionals, and other people alike to better understand the role of hospice care in their own lives and livelihoods.
Prevalence of pre-perimetric primary open angle glaucoma in hypertensives of North India
Authors: Garg Pragati , Malik Mehvish , Rai Nishant , Singh Abhay , Chellaiyan Vinoth G.
Published: October 2022

Background:

Systemic hypertension is alleged to increase the risk of glaucoma. As clinically Primary Open angle Glaucoma (POAG) is diagnosed only after approximately 40% of ganglion cell loss has occurred, therefore this study was commenced with an aim to determine the prevalence of pre-perimetric glaucomatous damage and its association with systemic hypertension using optical coherence tomography (OCT).

Materials and Methods:

A total of 680 study participants were enrolled in this cross-sectional study. Among them 340 patients were of systemic hypertension (Group 1) and 340 patients without hypertension (Group 2). All patients underwent detailed history, ocular and systemic examination including slit lamp examination, fundus examination by +90 D lens, Humphrey field analyser for field charting and OCT for nerve fiber analysis. For glaucomatous nerve damage.

Results:

Group 1 and Group 2 had Male: Female ratio of 1:8 and 1:9, respectively (P = 0.809). Maximum participants 48.8% and 54.4% in Group 1 and Group 2, respectively, were in age group 50–59 years. Statistically significant difference was seen in the percentage of pre-perimetric glaucomatous patients between the two groups (P < 0.001). On OCT analysis between pre-perimetric glaucomatous eyes and healthy eyes significant difference in thickness was seen in temporal inner macula, inferior outer macula, temporal outer macula, superior outer macula and nasal outer macula. Significant difference in volume was seen for inferior temporal and nasal outer macula (P < 0.001).

Conclusion:

In hypertensives, glaucomatous optic nerve damage starts much earlier before the obvious clinical signs of POAG appear, as compared to normotensive individuals.
The effects of intrinsic foot muscles strengthening exercises on foot kinetic parameters in pronated foot subjects during forward jump landing
Authors: Karimzadeh Atefeh , Kouhzad Mohammadi Hosein , Mehravar Mohammad , Zahednejad Shahla , Taheri Navid , Sadeghi Marzieh
Published: October 2022

Background:

Pronated foot is one of the most important factors that may lead to musculoskeletal injuries of the lower extremities. Among all treatments for this disorder, intrinsic foot muscles strengthening exercises (IFMSE) have an important role in management of the individuals with pronated foot. Although the effect of the IFMSE is well accepted in this population; however, their impacts on foot kinetic are yet to be clarified. The present study aims to identify the effects of the IFMSE on foot kinetic parameters in pronated foot individuals during forward jump landing.

Materials and Methods:

In this quasi-experimental study, 20 asymptomatic male and female subjects (mean age of 22.65 ± 2.51 years) with pronated foot structures were selected by using a simple non-random sampling method. The ground reaction force (GRF), rate of loading (ROL), and the resultant vector of time to stabilization (RVTTS) were examined during a forward jump landing task by using a force plate before and after six weeks of the IFMSE.

Result:

The findings showed that the following parameters were not significantly change before and after of the IFMSE: GRF (1.97 ± 0.49 vs. 2.03 ± 0.54, P =0.667), ROL (.09 ±0.12 vs. 08 ±.12, P =.632), and RVTTS (2836.60 ± 1144.62 vs. 2644.35 ± 704.71, P =.479).

Conclusion:

In the pronated feet subjects, the IFMSE alone was not capable of changing the kinetic parameters of the foot, or the duration of using these exercises. In this study, six weeks may not be enough to make changes the foot kinetic parameters and therefore these exercises should be used for a longer period of time.
Strengthening the immunization supply chain through EVM assessment: Comparing India’s two successive national assessments
Authors: Sharma Lokesh , Gupta Ginisha , Kapuria Bhrigu , Singh Snehil Kumar , Gupta Sanjay , Agarwal Mahesh Kumar , Thakur Harshad
Published: October 2022

Background:

Effective immunization supply chain (iSC) is crucial for safe and timely transport of potent vaccines to the beneficiary. India’s iSC, with a network of ~29,000 cold chain points (CCP), measures its quality standards using the World Health Organization–United Nations International Children’s Emergency Fund (WHO–UNICEF) global tool on effective vaccine management (EVM). The two national EVM assessments (EVMA) were conducted in 2013 and 2018. This study helps to see the impact of policies and practices through EVMA in maintaining an efficient iSC for effective implementation of immunization program.

Materials and Methods:

We conducted a desk analysis using EVMA reports to summarize and compare the findings of the two studies. Cut-off of 80% was considered ideal for each category/criteria score.

Results:

Both EVMA 2013 and 2018 were conducted using Android-based global EVM tool, though across a wider sample of CCP. Maximum and minimum changes in scores were sub-national and lowest distribution (16% each) and national buffer stores (7%), respectively. Maximum and minimum improvements were seen in vaccine management (29%) and MIS and supportive functions (3%), respectively. The improvement was statistically significant for the overall scores (P = 0.02), primary (P = 0.01), subnational (P = 0.02), and lowest distribution stores (P = 0.03). Among the 36 recommendations of 2013 assessment, 78% and 22% were fully and partially implemented (or ongoing), respectively.

Conclusion:

Implementation of EVM recommendations has significantly led to improvement and continues to provide a benchmark for iSC and its processes. Follow-up assessments every 3–5 years can further help to evaluate iSC and ascertain the impact of recommendations.