bluuebunny/crossref_metadata_2025 huggingface dataset:
Understanding community perception and disability weights – A qualitative exploration of reasons associated with values in two states of India
Authors: Nanda Lipika , Lobo Eunice , Anilkumar Aiswarya , Akhouri Shuchi Sree , Srinivas Nallala
Published: October 2022

Background:

Health state valuation attempts to evaluate health states based on the perception of individuals. The values are used to derive disability weights (DWs) —an important metric for estimation of disability-adjusted life years and thereby calculation of the burden of diseases. Several studies have calculated DWs using different methods of valuation, however, very few have attempted to explore the underlying cause for assigning values to different health states. This study aims to document the perceptions, preferences, and social context in assigning DWs to given health states.

Methods:

A total of 42 community members and 21 service providers (from public and private sectors) across urban and rural Odisha and Telangana were interviewed between July to September 2018. A face-to-face in-depth interview and a rank ordering technique through card sort exercise was employed to explore reasons and perceptions of individuals in the context of health states using the thematic framework approach.

Findings:

Six themes emerged through analysis: awareness of the health state, nature of the disease, disease consequences, treatment-related issues, social implications, and case burden. Each theme captured an individual’s reason for valuing one health state as different from the other, with differences and/or similarities between community members and service providers.

Conclusion:

Our study provides a comprehensive comparison between contrasting groups of individuals, thereby suggesting mere acceptance of ‘experts’ reasoning may not always suffice. Further research studies in the future need to be conducted for a better insight into the health perspective of a culturally diverse community. It can also help estimate the burden of disease for decision making and resource allocation in developing countries.
Perceptions and practice of physicians treating HIV patients in the private sector in India: A cross sectional study
Authors: Pant Rashmi , Valan A. S. , Anusuya Ganesh Shanmugasundaram , Allam Ramesh R. , Chowdavarapu Prabakar
Published: October 2022

Objectives:

To understand the perceptions of the private HIV physicians regarding HIV case management and reporting practices followed by the National AIDS Control Programme, India.

Methods:

We conducted this cross-sectional study among 142 private practitioners attending Chennai ART Symposium 2017, from five south Indian states. We used a pre-structured questionnaire to collect information on demography, qualification, the number of HIV patients treated, ART regimen, and the reporting practices. EpiInfo 7.2 was used for data analysis.

Results:

Out of the 142 private practitioners, 89 (63%) responded. All respondents had diagnosed and/or treated at least 10 HIV patients in the past 12 months. About 42% of respondents reported attending an orientation program on ART by the State AIDS Control Society (SACS). Seventy percent of respondents were aware of the National AIDS Control Organization’s (NACO) Public Private Partnership (PPP) initiative for private clinics, and 44% (39) reported sharing monthly reports with SACS. However, 77% of physicians were not interested to enroll due to increased paperwork and complicated reporting mechanisms.

Conclusion:

Private sector physicians treating People Living with HIV (PLHIV) are aware of NACO guidelines and reporting mechanisms. A simplified reporting process and an engaging platform are needed to facilitate reporting.
Client satisfaction among HIV positive and HIV negative attendees in a military hospital in Southwest Nigeria
Authors: Ogbo-Okeke Ivy Ifeoma , Ogunyemi Adedoyin , Olubodun Tope
Published: October 2022

Background:

In the management of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) and other diseases, client satisfaction is of utmost importance as it improves hospital visits, and thus, allows sustainable decline in the prevalence rates. The aim of this study was to compare client satisfaction among HIV-positive and HIV-negative clients in a military secondary health center.

Methods:

This was a comparative cross-sectional study conducted in a military hospital, among 200 HIV-positive and 200 HIV-negative patients, using structured interviewer-administered questionnaires. The data analysis was done with the SPSS version 20 software. The comparison of satisfaction with the quality of healthcare between HIV-positive and HIV-negative subjects was assessed using Chi-square tests.

Results:

A higher proportion of HIV-positive respondents (40.5%) than HIV-negative respondents (13.0%) answered in the affirmative that healthcare workers were unwilling to care for them (P = < 0.001). Ninety-seven percent of the HIV-positive respondents and 71.5% of the HIV-negative respondents felt satisfied with how warmly they were received at the clinics (P = <0.001). Ninety-three percent of the HIV-positive respondents and 79.8% of the HIV-negative respondents were satisfied with the client confidentiality (P = <0.001). Regarding the overall client satisfaction, 68.0% of the HIV-positive respondents were satisfied while 45.5% of the HIV-negative respondents were satisfied (P < 0.001).

Conclusion:

Overall, the HIV-positive clients were more satisfied than the HIV-negative clients. Efforts should be made to ensure that client satisfaction does not decline among the HIV population but should be optimized.
Determinants of quality of life of geriatric population in rural block of Haryana
Authors: Rajput Meena , Pinki  , Shiba  , Kumar Sunil , Ranjan Ravish
Published: October 2022

Background:

The quality of life (QOL) of the geriatric population in India is an important issue because of the lack of social security schemes and dilution of Indian culture which ensures due care and regard to the elderly. The primary health care physicians have to face more challenges in handling the elderly patients in comparison to the younger patients because the elderly have more physiological and emotional problems along with medical conditions and illnesses which, in turn, affect their QOL. The study aims to find out the determinants that affect the QOL of the elderly in a rural area of Haryana.

Material and Methods:

This observational study with a cross-sectional design was carried out among 400 elderly (60 years and above) in a rural area of district Jhajjar, Haryana. The world health organization quality of life scale (WHOQOL-BREF) scale was used. Data entry and analysis were performed using Statistical Package for Social Sciences (SPSS) version 20.0.

Results:

The mean score of the environmental domain was the highest (62.72 ± 14.18), followed by the physical health domain (60.77 ± 15.82). Education, age group, caste, marital status, occupation, and socioeconomic status exhibited significant relationships with different domains of QOL.

Conclusions:

With the advancement of age, QOL deteriorates. Higher education and higher socioeconomic status of the study participants help them to live a better QOL. Those participants who were married and were busy in any kind of work experienced a better QOL.
Comparison of the outcomes of normal vaginal delivery with and without spinal anesthesia in mothers admitted to the maternity ward of Firoozabadi Hospital
Authors: Larijani Samaneh Saghafian , Niksolat Maryam , Mirfakhraee Hosna , Rahimi Maryam , Asadi Shima , Mahdavynia Soheila , Mousavi Ashraf , Larijani Roshana Saghafian
Published: October 2022

Introduction and Objective:

The study of the methods of controlling labor pain is very important. One of the methods of pain relief is spinal anesthesia. Due to the different opinions about the effects of spinal anesthesia on the delivery process and maternal and fetal consequences, this study aimed to evaluate the effects of spinal anesthesia and compare it with normal vaginal delivery without spinal anesthesia.

Methods:

In this retrospective cohort study, 120 mothers, who were admitted to the maternity ward of Firoozabadi Hospital for delivery, were examined. The patients who met the inclusion criteria were divided into two groups of 60 people, one group receiving spinal anesthesia and one without spinal anesthesia, and then, were evaluated in terms of clinical variables and complications of the mother and fetus. Data were analyzed using SPSS statistical software.

Results:

The mean age of the mothers was 26.6 ± 5.9 years. Five mothers (4.2%) who received spinal anesthesia underwent emergency cesarean section and a significant difference was shown between the two groups (P = 0.02). The mean duration of the active phase of labor did not show a statistically significant difference between the two groups (P = 0.2), but the duration of the second phase of labor was significantly longer in the mothers who received spinal anesthesia (P = 0.008).

Conclusion:

Spinal anesthesia can be used as a low-complication method in vaginal delivery to reduce pain.
Incidence of mortality and its predictors among patients with head injury admitted to adult intensive care unit at AaBET and ALERT hospitals, Addis Ababa, Ethiopia
Authors: Aregago Gezehagn , Gishu Teshome , Getaneh Ermias , Tirore Lire Lemma , Abame Desta Erkalo , Meskele Simeon
Published: October 2022

Background:

Traumatic head injury, referred to as the “silent epidemic”, remains a growing public health concern and the leading cause of mortality in young adults, with a disproportionate burden of disability and death occurring in low-income and middle-income countries, including Ethiopia. However, estimates of the traumatic brain injury burden from low and middle-income countries are scarce. The aim of this study was to assess outcome and its associated factors among patients with head injury admitted to the Adult Intensive care unit at AaBET and ALERT hospitals, Addis Ababa, Ethiopia.

Methods:

Institution-based retrospective cohort study was conducted at AaBET and ALERT hospitals from February 01, 2019 to January 30, 2020. All head injury patients’ records were reviewed. A structured checklist was used to collect data. Binary logistic regression analysis was used to identify factors associated with death among head injury patients.

Result:

Out of 205 patients, 178 (86.8%) improved, while 27 (13.2%) died. Road traffic accident was the most common cause of head injury (Adjusted odds ratio (AOR) = 46.3%). Patients with pulse rate admission (AOR = 1.49), NA + level (3.48), type of head injury (AOR = 3.67), mechanical ventilation (AOR = 4.70) were significant predictors of death among patients with head injuries.

Conclusion:

The incidence of death among head injury patients was 13.2% (27). Road traffic accident was the leading cause of head injury. Pulse rate, plasma sodium level, penetrating head injury, being on a mechanical ventilator were predictors of death among traumatic head injury (THI) patients treated for head injuries. Prevention of road traffic accidents and continuous awareness creation about the consequences of a road traffic accident is recommended.
Evaluation of demographic and rare clinical characteristics of patients with thoracic carcinoid tumor in Razi and Aria Hospitals of Rasht during 2006-2016
Authors: Aghajanzadeh Manouchehr , Asgary Mohammad Reza , Fomani Ali Alavi , Jafarinegad Alireza , Tangestaninejad Azita , Asli Hossein Hosseinzadeh , Khan beige Maryam Ahmad , Asli Rastin Hosseinzadeh , Asgari Mohammad Madi
Published: October 2022

Introduction:

Carcinoid tumors are malignant neoplasms of neuroendocrine cells. This study tended to evaluate the demographic and rare clinical characteristics of patients with thoracic carcinoid tumor during 2006-2016 at Razi and Aria Hospitals in Rasht.

Materials and Methods:

The present study was performed on records of 43 patients with lung carcinoid tumors referred to Razi and Aria Hospitals of Rasht during 2006-2016. Information on age, gender, rare clinical symptoms, smoking history, diagnosis tools, treatment, and outcome were analyzed.

Results:

Of 43 patients treated with definitive diagnosis of carcinoid tumor pathology, 31 patients had typic carcinoid tumor and 12 patients with atypic carcinoma (mean age 43.14 ± 15.16 years). The most common clinical symptom was cough and hemoptysis. Two cases presented with cushing syndrome, The most common diagnostic method in this study was simultaneous use of both CT scans and bronchoscopy. In 95.3% of cases, the tumor was pulmonary and in 4.7% of cases, it was extrapulmonary. Right lower lobe was the most common site of tumors and most of the surgeries used were lobectomy.

Conclusion:

This study showed that the most common clinical sign of thoracic carcinoid is cough and the tumor is pulmonary in 95.3% of cases. Right lower lobe was the most common site of tumors and most of the surgeries used were lobectomy. outcome was good.
Prevalence and predictors of low bone mineral density among adults aged 50 years and above in Chandigarh, India
Authors: Kalia Meenu , Chaturvedi Ruchi , Rohilla Ravi , Grover Parneet K. , Goel Naveen K. , Dalal Manjesh , Kaur Ravneet
Published: October 2022

Background:

Osteoporosis, defined as skeletal disorder characterized by reduced bone density and strength, is prevalent in both developing and developed countries. Dual energy X-ray absorptiometry (DEXA) is an effective tool to diagnose low bone mineral density (BMD).

Objective:

This study objective was to know the prevalence and predictors of low BMD in a community-based screening program among the adult population using DEXA scan.

Methods:

In this community-based study conducted between January and June 2016, a population-based screening program was offered to both males and females of age 50 years and above. BMD was measured to derive T-scores and classify as normal, osteopenic, and osteoporotic individuals.

Results:

A total of 455 subjects were enrolled where 62.4% proportion was women; 42.6% subjects were in the age group of 50 to 59 years. The prevalence of osteoporosis and osteopenia was 20.9% and 48.1%, respectively. Hypertension (23.7%) and diabetes (8.4%) were common comorbidities. Age and gender (female) were independent predictors of low BMD.

Conclusion:

Osteoporosis/osteopenia is present in both genders with increasing trend with age advancement. Institution of timely screening will prevent the morbidity associated with fractures due to low BMD.
Development of a personalized shared decision-making tool for knee osteoarthritis and user-testing with African American and Latina women
Authors: Jones Lynne C. , Maurer Anne M. , Parks Michael L. , Noble Philip C. , Harwell Carla , Harrington Melvyn , Bay Katherine G. , Nelson Charles L. , O’Connor Mary I.
Published: October 2022

Background:

Patients with chronic knee pain are often unaware of treatment options and likely outcomes—information that is critical to decision-making. A consistent framework for communicating patient-personalized information enables clinicians to provide consistent, targeted, and relevant information. Our objective was to user-test a shared decision-making (SDM) tool for chronic knee pain.

Methods:

A cross-functional team developed a Markov-based health economics model and tested the model outputs with patient panels, patient and clinician focus groups, and clinical specialists. The resulting SDM tool was user-tested in a parallel-designed, randomized controlled study with 52 African American and 52 Latina women from geographically representative areas of the US. Participants were randomized to counseling with or without the SDM tool. Feedback was collected at intervention and at 1 month after intervention and analyzed with Student’s t-tests and Chi-squared analyses (alpha = 0.05).

Results:

Qualitative results indicated patients understood the material, rated the overall experience highly, and were likely to recommend the physician. The SDM group reported high satisfaction with the tool. A greater proportion of the SDM group (56%) reported increased physical activity over baseline at 1 month compared with the control group (33%) (P = 0.0005). New use of medications for knee pain (58% SDM; 49% control) did not differ significantly between groups (P = 0.15).

Conclusion:

Use of this innovative SDM tool was associated with high satisfaction and a significant increase in self-reported physical activity level at 1 month. The SDM tool may elicit behavioral changes to promote musculoskeletal health.
HIV positive children living in orphanages and home care: Assessment of nutritional deficiencies and opportunistic infections
Authors: Hiremath Ravishekar N. , Nimonkar Ravi , Thombre Rahul , Kumar Pushkar
Published: October 2022

Objectives:

With the introduction of antiretroviral treatment (ART), opportunistic infections (OIs) reduced a lot and most HIV-associated OIs are preventable and treatable with safe cost-effective interventions. But however, in order to prevent and early diagnosis, we need to have baseline estimation of OIs among HIV positive children and other factors associated, especially nutritional deficiencies.

Methodology:

A cross-sectional study was carried out in pediatric outpatient department (OPD) of a large multicentric hospital among 106 children. Data were collected by means of pretested predesigned semi-structed questionnaire prepared on consultation with experts in the subjects and clinical assessment was done in day light to detect signs of nutritional disorders. Institutional ethical clearance was taken, and strict confidentiality was maintained.

Results:

Majority (39.6%) of the children belong to 5–9 years. Children were equitably distributed between orphanage and family care giver. Bitot’s spots, cheilosis, and gum bleeding were found to be more than twice as common in subjects living with family, as compared to those living in orphanage while aphthous ulcer, knock knee, bow leg were found to be more than twice as common in female subjects as compared males. The prevalence of Pneumonia, Mumps, Herpes zoster, Pulmonary Tuberculosis, Oral candidiasis, and recurrent upper respiratory tract infections (URTI) was found to be about twice as common in subjects living with family, as compared to those living in orphanage while males had more Chicken pox, Herpes zoster, Pulmonary Tuberculosis, Oral candidiasis, and Recurrent URTI as compared to those in females.

Conclusion:

Vitamin deficiencies and opportunistic infections were higher than the prevalence reported by the various studies done on normal children. All efforts to be made to improve adequate nutrition to HIV positive children and ensure protection against opportunistic infections especially for children in home-based care.
A review of perioperative anemia: A modifiable and not so benign risk factor
Authors: Pan Kelsey , Pang Shiyi , Robinson Michael , Goede Dianne , Meenrajan Senthil
Published: October 2022

Anemia is a commonly encountered finding either during the preoperative assessment or during the postoperative management of the patient. Anemia often gets overlooked while more emphasis is paid to cardiovascular and pulmonary evaluation. Evidence, however, suggests that the presence of anemia in the perioperative period can predispose patients to other complications. Awareness of the consequences of anemia in the perioperative period can lead to better recognition and early management of this potentially modifiable risk factor. In this review, we focus on the effects of anemia on the cardiac, pulmonary, neurologic, cognitive, and functional status outcomes of patients. We also review management strategies that could be employed, depending on the available time and resources.
Symptom attribution and stress level in patients with medically unexplained symptoms in a Mexican emergency department
Authors: Ramírez Aranda José Manuel , González Sanchez Marco Sebastián , Hernández Guedea Marco Antonio , Ordóñez Azuara Yeyetsy Guadalupe , Treviño Uresti Yarezzi Karolina , Barahona Heredia Samara Ailet
Published: October 2022

Background:

Patients who come to the emergency department are different from those seen in outpatient clinics. The former suffer greater stress.

Aim:

Establish an association between the attribution of the symptoms (psychosocial or organic) by the patient and the level of perceived stress in patients with Medically Unexplained Physical Symptoms (MUS) in an emergency department.

Methods:

A correlational cross-sectional study was conducted in 138 patients with MUS in the emergency department of a 3rd level public hospital where the psychosocial or organic attribution of nonspecific symptom(s) by patients and the perceived stress were measured with validated scales. Bivariate analysis was performed with Chi square for categorical variables, and a Spearman correlation, p <0.05.

Results:

75% of patients with psychosocial attribution have higher stress compared to patients with organic symptom attribution (25%). In Spearman’s correlation, a medium but statistically significant correlation was obtained.

Conclusions:

The psychosocial attribution of the patient’s complaint might coexist in MUS patients with higher level of perceived stress by the patients. Health professionals might need to address both psychosocial attributions and stress in MUS patients.
Epidemiological, clinical and mycological characteristics of pityriasis versicolor: Results of a study from a teaching hospital in rural part of Northern India
Authors: Singla Pooja , Sharma Nidhi R. , Mane Pratibha , Patil Anant , Sangwan Jyoti , Sharma Sudhanshu
Published: October 2022

Background and Objectives:

Pityriasis versicolor is a common fungal infection of the skin which leads to the formation of scaly and discoloured small lesions on skin. The main objective of this study is to describe clinical and mycological characteristics and the predisposing factors in patients with pityriasis versicolor.

Material and Methods:

In this prospective, observational, hospital-based cross-sectional study, patients of all ages with clinically suspected lesions of pityriasis versicolor were included. After detailed history and thorough clinical examination, skin scrapings were examined with 10% potassium hydroxide (KOH) under light microscope. The scrapings were also subjected to culture examination.

Results:

A total of 113 patients [78 (69.0%) male; 35 (31%) female] were included in the study. A total of 87 (76.9%) patients were from rural area. Outdoor occupation and positive family history of pityriasis versicolor was present in 65 (57.5%) and 38 (33.6%) patients, respectively. Recurrent episodes were reported by 66 (60%) patients. Excessive sweating and oily skin were seen in 36 (31.8%) and 24 (21.1%) patients, respectively. History of occlusive clothing was present in 22 (19.4%) patients. Chest, back, and shoulders were affected in 36 (31.8%), 22 (19.4%), and 08 (07.0%) patients, respectively. Hypopigmented lesions were seen in 97 (85.8%) patients. Patches and macules were observed in 60 (53.1%) and 53 (46.9%) patients, respectively. A total of 27 (23.8%) patients reported mild prutitus. A total of 79 (69.9%) patients were KOH positive and culture negative, whereas 26 (23.0%) patients were KOH as well as culture positive. Eight (7.0%) patients were both KOH and culture negative.

Conclusion:

Pytiriasis versicolor is more common in young adults and males with the most common presentation of hypopigmentation lesions. In our study population, presentation with large patches was more common than macular lesions. Pruritus was more in patients with large patches than those with macules.
The assemblage of skin findings in the type 1 DM with incorrect injection technique: A case report
Authors: Pujari Shrinivas S. , Kumar Vinod , Bhat Nowneet K. , Verma Prashant K.
Published: October 2022

Correct insulin administration technique, insulin type, and dose play a pivotal role in attaining glycemic control. An error in any of the steps may lead to poor glycaemic control, which affects the patient in the short and long term. We are presenting here unusual skin findings in children with the wrong injection technique. A 10-year-old male child already diagnosed with type 1 Diabetes Mellitus (DM), presented with poor glycemic control. On examination, we found skin rashes encircling most of his abdominal area circularly. Rashes were round to oval, well-circumscribed, hyperpigmented to hypopigmented to depigmented macules to papules surrounded by a hyperpigmented halo, 0.5 to 1 cm in diameter, painless varying in color from white to pinkish-red to light brown to brownish-black. On observing the administration technique of insulin, we found it was administered incorrectly as intradermal instead of subcutaneous. Proper Diabetes education and insulin administration techniques remain the cornerstone in the management of type 1 DM. We should ensure appropriate insulin administration on every visit.
Management of pregnant female with Haemophilia-A: A case report
Authors: Lata Indu , Gupta Amrit , Saxena Deepti , Rekhi Ashmina , Sahu Sandeep
Published: October 2022

Haemophilia-A is a rare, X-linked recessive inherited disease affects males and females are carrier results in prolonged bleeding after minor injuries, procedures or surgery. Spontaneous or recurrent bleeding may occur in deep muscles, joints but intracranial haemorrhage can be dangerous. Women with a family history of bleeding disorder, personal history of bleeding (menorrhagia, mucous membrane, postoperative bleeding and PPH) or a prolonged activated partial thromboplastin time (aPTT) should be screened for haemophilia by measuring coagulation factor VIII level during hospital visits for these reason or antenatal care (ANC). Female heterozygote carriers may have variable presentation of bleeding due to reduced levels of clotting FVIII and may experience excessive bleeding due to gynaecologic issues, during spontaneous abortion, medical termination of pregnancy or invasive prenatal diagnostic techniques in first trimester of pregnancy, antepartum and postpartum haemorrhage in later part of gestation and after delivery.
Assessment of serum nitric oxide level and its correlation with anthropometric parameters and lipid profile in diabetic patients: A hospital-based study from Tripura
Authors: Goswami Bidhan , Sarkar Swapan , Sengupta Shauli , Bhattacharjee Bhaskar
Published: October 2022

Background:

Endothelial dysfunction is a well-known finding in hyper-cholesterolaemic patients. Multiple factors including increased inactivation of nitric oxide by radicals and inhibition of nitric oxide formation by different mechanisms contribute to this.

Objectives:

(i) To estimate serum nitric oxide (NO) levels among diabetic and non-diabetic subjects attending a tertiary care hospital of Tripura and (ii) to determine the correlation of serum nitric oxide with different anthropometric parameters and lipid profile among the study subjects.

Methods:

This cross-sectional study was conducted during June 2019 to May 2020 among 227 subjects. Anthropometric measurements like weight, body mass index (BMI), body fat percentage, visceral fat percentage were measured by using OMRON Body Composition Monitor (HBF 701). Serum NO levels were measured using standard NO colorimetric assay kit and HbA1C and lipid profile were analyzed by using a Biochemical Autoanalyser. Statistical analysis was performed by using SPSS software version 25.

Result:

One hundred fifteen (115) diabetics were considered as test group whereas One hundred twelve (112) non-diabetic subjects were included as control. The mean serum level of NO in the diabetic group was 86.91 ± 14.13 mmoles/L whereas in the non-diabetic group it was 33.23 ± 12.90 mmoles/L which is statistically significant. Significant correlation is also found between serum NO level and different anthropometric parameters, namely, age, BMI and visceral fat percentage.

Conclusion:

In this study, positive correlation is found between serum NO, BMI, and body visceral fat. As NO is considered as a potential biomarker for diabetic patients developing hypertension, BMI, and body visceral fat may be considered as a good prognostic parameter in future development of diabetic complications. While dealing with diabetic patients the family physicians should be aware of these two parameters and besides treating them, physicians should convince the diabetic patients to maintain ideal BMI and body visceral fat by following proper life style.
Tobacco cessation by prescription - A 180 degree turn
Authors: Ahamed Mohd S. , Chhabra Kumar G. , Reche Amit , Paul Priyanka
Published: October 2022

Utilisation of tobacco is one of the most serious problems affecting human health worldwide, despite the fact that the early fatality caused by tobacco use are growing, regardless of the fact that it is avoidable tobacco consumption is very common, considerable resources have been allocated to this issue. On tobacco prevention, a range of strategies have been tested but the ratio of death due to tobacco and number of tobacco consumers is increasing day by day. Various impediments to tobacco quitting have been recognized, all of which contribute to the failure of various tobacco cessation programs and methodologies. Individuals in the India have attempted or considered quitting smoking at some point in their lives but ended in failure. Existing tobacco cessation programs have not out-turned in a decrease in the figure of tobacco users or deaths, necessitating a new strategy. Tobacco cessation on prescription, developed from physical activity on prescription (PAP), can be a useful method in terms of public health. But yet no studies have ever been conducted over this. Further studies on this can explore results of tobacco quitting after prescription from general physician or other medical practitioner, evaluative beliefs about tobacco consumption and barriers in quitting even after prescription. Hence the present review was done with explore the outcomes for cessation of tobacco based upon utilization of tobacco cessation by prescription (TCP) methodology in Indian scenario. This review paper focuses on TCP as a need for newer approach pertaining to Indian perspective. Future study should look at whether raising the rate of stop attempts are improving the tobacco cessation rate in the general population after the implementation of TCP.
Facilitators and barriers to bicycle helmet use: A qualitative evidence synthesis
Authors: Panigrahi Sucharita , Parveen Samina , Kshatri Jaya Singh , Pati Sanghamitra , Bhaumik Soumyadeep
Published: October 2022

Background:

Bicycles are environment-friendly and is an effective physical activity intervention to decrease risk of non-communicable diseases. Family physicians and primary care workers play a key role in promoting its usage, including addressing safety concerns through the use of bicycle helmet use. The uptake of bicycle helmets is low in many settings. We aimed to understand facilitators and barriers to bicycle helmet use.

Method:

We searched five major electronic databases, screened references and manually searched conference abstracts for qualitative studies that focused on facilitators and barriers to bicycle helmet use. We critically appraised the studies using the Critical Appraisal Skills Programme (CASP) checklist and used PROGRESS-Plus tool for an equity-focused analysis. We conducted a thematic synthesis for analysis and used GRADE-CERQual to report confidence in findings.

Results:

We included 15 studies from high-income countries. We identified 4 themes: 1. Perceptions on helmet design, it’s quality and cost together with experiences influencing helmet use (10 studies, low confidence); 2. Perceived risk and benefits of helmet use through a gender lens (10 studies, moderate confidence); 3. Parental strategies influencing children’s behavior regarding helmet use (6 studies, moderate confidence); 4. Adoption and enforcement of laws that shape perception and usage of bicycle helmets (8 studies, very low confidence).

Conclusion:

Our study identified facilitators and barriers and can be considered for developing programs and strategies to influence bicycle helmet use, but the confidence in findings is not high. Family physicians and primary care workers should consider these factors when promoting bicycle helmet for injury prevention. There is a need for more qualitative studies in different contexts to develop more robust evidence.
Is new onset hypertension in obese women more likely to be Gestational Hypertension? - A retrospective study
Authors: Jacob Smitha E. , Ebenezer Emily Divya , Tirkey Richa Sasmita , Rathore Swati , Benajmin Santosh , Mahasampath Gowri , Mathews Jiji E. , Yenuberi Hilda
Published: October 2022

Introduction:

New onset hypertension is more common in antenatal women with increased Body Mass Index (BMI). This may be due to either gestational hypertension (GH) or pre-eclampsia (PE). GH unlike PE is not associated with poor perinatal outcomes and would not require interventions such as increased antenatal visits and induction of labour. Our study assessed the prevalence of GH and PE in women with increased BMI as compared to women with normal BMI.

Setting and Design:

Historical cohort of a large tertiary centre.

Method and Materials:

Data from the electronic birth registry of the labour room was used to identify women who had a BMI ≥ 35 kg/m2 at delivery. Women with a normal BMI matched for the mode of delivery was taken as control. 148 women with BMI ≥ 35 kg/m2 were compared with 140 women of normal BMI.

Results:

New onset hypertension was seen in 41.2% (61/148) and 8.6% (12/140) in the non-obese group RR 4.81 (2.7-8.54) P (<0.001). GH was seen in 24.3% in obese women and 2.9% in normal controls, RR (9.65 (3.54,26.34)), P (<0.001). PE was seen in 16.9% of obese women and 5.7% of women with normal BMI, RR (3.79 (1.78,8.08)) P (<0.001). Proportion of GH in women with new onset hypertension was seen in 59% of obese women with new onset hypertension and 33% of normal controls.

Conclusion:

This clinically relevant trend towards an increased proportion of GH highlights the importance of identifying pathophysiological mechanism for high BP in obesity when there is new onset hypertension.
Influencing demographic characteristics, comorbidities disease, and radiologic finding on mortality due to Covid-19 in Iran
Authors: Gharebakhshi Farshad , Haghjoo Purya , Sabkara Akram , Rahmani Roya , Raji Parisa , Mousapour Razieh , Kermani Sara Ghaseminejad , Tavafizadeh Zaynab , Fazeli Alireza
Published: October 2022

Introduction:

Recognition of death risk factors is urgently needed, not only to identify the defining clinical and epidemiological characteristics with greater precision but also to facilitate the appropriate supportive care and prompt access to the intensive care unit (ICU) if necessary. This study aimed to investigate the influencing demographic characteristics, comorbidities disease, and radiologic finding on COVID-19 death.

Method:

Descriptive cross-sectional study included adult patients with COVID-19 from Imam Hossein. Demographic characteristics, comorbidities disease, chest CT scan findings, and outcome (death/survive) data were extracted from information health system (HIS), by using a data collection check list. To explore the influencing factors on mortality, logistic regression method was used.

Result:

Result demonstrated that most patients who died because of Covid-19 were men (63.4%), more than 60 years (86.4%), married (95.8%), and self-employed (37.1%) with a mean age of 72.1 ± 15.46 years ranging from 22 to 93 years. Having comorbidities disease such as cancer, cardiac disease, diabetes, age, and pathologic chest CT findings was associated with death. In contrast, gender, marital, job, cerebral vascular disease, and HTN were not correlated.

Conclusion:

Identification of demographic characteristics, comorbidities disease, and radiographic finding correlated with death of COVID-19 can help clinicians in order to with rapid diagnose and triages of high-risk patients to have a better plan for the care of these patients.
Picking up an insulinoma – The challenges ahead
Authors: Sunder Ashok , Saha Sudip , Satyanarayan Bhagyalakshmi , Kumar Manish , Sarkar Nilanjan
Published: October 2022

Insulinoma is a rare pancreatic neuroendocrine tumour (PNET) with an incidence rate of 4 per million population, and the most common cause of hypoglycaemia due to endogenous hyperinsulinism. We present the story of a 61-year-old male, who was extensively evaluated at many hospitals for his symptoms of giddiness, uneasiness and recurrent black outs for the last 3 months, his symptoms disappearing with a carbohydrate rich meal or sweets. Random sugar and fasting sugar values noted were low, with elevated insulin and C-peptide levels. Diagnosis of insulinoma was confirmed by a DOTA PET scan involving the tail of the pancreas and then surgically removed. Early detection is crucial for early surgery to allay symptoms. We describe our diagnostic and treatment plan with reference to previously published reports.
Integration of primary palliative care into geriatric care from the Indian perspective
Authors: Atreya Shrikant , Sinha Abhik , Kumar Raman
Published: October 2022

The rising trend in the ageing population alongside social, cultural, and economic changes poses a major threat to the health care system in the country. Elderly population have dynamic and complex health care needs, are debilitated by the progressive chronic life-threatening diseases, and live a compromised quality of life. Palliative care, with its multifaceted approach, can provide respite to the elderly population. A decentralized approach in which palliative care is provided by the local community will ensure seamless continuity of care and care at an affordable cost. General practitioners or family physicians play a vital role in delivering primary palliative care to the elderly population in the community. An integrating primary palliative–geriatric care model will ensure that care is provided in alignment with the patients’ and their families’ wishes along the trajectory of the life-threatening illness and at the patients’ preferred place. However, delivering primary palliative care in the community can be riddled with challenges at various levels, such as identification of patients in need of palliative care, interpersonal communication, addressing patients’ and caregivers’ needs, clarity in roles and responsibilities between general practitioner and family physicians and specialist palliative care teams, coordination of services with specialists, and lack of standard guidelines for palliative care referral. Various geriatric–palliative care models have been tested over the years, such as delivering palliative and end-of-life care for disease-specific conditions at specified care settings (home or hospice) and provision of care by different specialist palliative care teams and general practitioners or family physicians. Akin to the aforementioned models, the National Health Program in the country envisages to strengthen the integration of geriatric and palliative care. The integrated geriatric–palliative care model will ensure continuity of care, equitable distribution of service, impeccable inter-sectoral collaboration and care at an affordable cost.
Study of readiness and performance of nurses in evaluating clinical care and processes of care and nursing
Authors: Khosravi Shaqayeq , Dehkourdi Narges J. , Dezfouli Seyedeh M. M. , Javid Asma , Hemmati Sahar , Delavar Motahare A. , Nasersaeed Mitra , Koudarzi Mozhdeh
Published: October 2022

Background:

Clinical care and nursing skills are important issues that can influence the efficacy of treatment, the health of patients, and medical errors. The aim of this study was to investigate the readiness of medical staff in the field of effectiveness and evaluation of clinical care and nursing skills.

Materials and methods:

This descriptive, cross-sectional study was performed on 99 medical staff working in hospitals from August 2020 to December 2021. The instrument used was a checklist for the effectiveness and evaluation of clinical care based on the findings of the nursing reports. Data were analyzed by statistical software.

Results:

The mean age of nurses was 37.5 years. Among the participants, 16.3% were male and 85.7% were female; 56.6% of nurses had completed clinical care. The overall performance of nurses in drug-related care and nursing processes was observed to be acceptable. Nurses were successful in performing many aspects of the nursing processes of repulsion, absorption, and dressing and showed good preparation. In relation to gavage, a high percentage of nurses performed the procedure well. However, in some cases, such as medication-related care, handwashing, and the use of personal protective equipment, where there is a possibility of touching the blood or other body fluids of the patients, the performance of nurses was moderate.

Conclusion:

The findings of this research demonstrated that there are limitations, strengths, and weaknesses in terms of some aspects such as medication, care and nursing processes, compliance with standards, and infection control, which can be considered to improve the performance of nurses in the future.
Impact of health education intervention on menstruation and its hygiene among urban school-going adolescent girls in Thiruvallur, Tamilnadu
Authors: Parasuraman Gomathy , Vijay Vinodhini , Balaji S , Nisha B , Dutta Ruma , Jain Timsi , Eshwar P Anantha
Published: October 2022

Introduction:

Adolescent girls require specific and special attention since they are the most vulnerable group not only in terms of their social status but also their health. Poor menstrual hygiene can lead to developing infections and other complications. Therefore, this study was conducted with the aim of assessing the impact of health education on menstrual hygiene among urban school-going adolescent girls.

Methodology:

A quasi-experimental, pre and post-test study was conducted among adolescent girls aged between 11 to 17 years from two public schools in the urban field practice area of tertiary care medical college in Thiruvallur district of Tamilnadu. A pre-interventional survey was done using a pretested validated questionnaire. Multipronged health education intervention was administered, and its effectiveness was measured after four months using the same tool. Frequencies, percentages, median, and range were used to describe variables. ‘Wilcoxon signed-rank test’ and the “Mann–Whitney U-” test were used for inferential statistics.

Results:

There was a statistically significant (P = 0.0001) improvement in the knowledge of menstruation, perceived attitude, and practice of good menstrual hygiene from pre to post-test after the intervention. Demographic factors such as age, mother’s education, and socio-economic status, and Menstrual characteristics such as age at menarche, regular menstrual flow, absence of dysmenorrhea, and getting menstruation advice before menarche were found to be significantly associated with the post-test median scores.

Conclusion:

A planned and structured health education program should be addressed to adolescent girls both at schools and community settings for improving menstruation-related knowledge and practices.
An algorithmic approach to shoulder pathology
Authors: Hind Jamie , Sidhu Gur Aziz S. , Arealis Georgios , Khadabadi Nikhil A. , Ashwood Neil
Published: October 2022

Introduction:

Shoulder pain is a common presentation in both hospitals and the community. Shoulder pain can result from a number of different pathologies and to manage the shoulder pain, an accurate diagnosis is needed.

Method:

An accurate diagnosis can often be made following a detailed history and examination. Investigations, such as imaging and blood tests may also be required. In this study, we provide an algorithmic approach to shoulder pain that can be used in the clinical setting.

This algorithm can be used in hospitals and the community to help identify and manage the different causes of shoulder pain.
A community-based, cross-sectional study of gender egalitarianism: A promising scenario from an urban field practice area attached to a teaching institute from Central India
Authors: Choudhary Sanjeev M. , Kubde Sanjay , Ukey Ujwala U. , Agrawal Sanjay B. , Shinde Rani R.
Published: October 2022

Context:

Gender-based discrimination is more predominant in India. In spite of various laws, gender inequality is an evil that plagues society even today. This is an important challenge for meeting our Sustainable Development Goals.

Methods:

This cross-sectional study was carried out in an urban field practice area. Study subjects were married women and their husbands in the age-group of 15–49 years along with their under-five children. Gender egalitarianism was assessed for factors like education, employment and media exposure. Factors which were studied for revealing gender egalitarianism among children included sex ratio, immunization status, nutritional status and health care expenditure. Completed family size and preference for the sex of the child were enquired about to assess the inclination towards male gender of the baby. Anthro software was used for statistical analysis.

Results:

Gender egalitarianism was found with regards to education. However, significant difference was noted in the employment status of men and women. Overall, sex ratio was in favor of girls. Though gender inequality was evident from the results, it was more in favor of girls. There was no evidence of gender bias for immunization of children. It was observed that more boys were stunted than girls and almost equal proportion of boys and girls were wasted.

Conclusions:

Factors like high literacy, control over income, access to financial resources made women more empowered and such empowered women were less likely to show son preference. Hence, there was no gender inequality among children in the present study.
Developing an operational research model for strengthening policy and programs on prevention and control of hypertension in India
Authors: Goel Sonu
Published: October 2022

Hypertension is one of the significant risk factors for many noncommunicable diseases (NCDs) including cardiovascular diseases (CVDs), diabetes, stroke and chronic artery diseases. Despite the dismal scenario of CVDs in India, there is paucity of research in the field, which hampers effective decision making. In cognizance of the crucial role played by operational research (OR) in NCD policy design and program implementation, the Resource Center of Cardiovasuclar Health issued an open call for a manuscript writing program on hypertension using secondary data of National Family Health Survey-4. After thorough screening of the concept proposals of the applicants, 30 researchers were selected. Each of the 30 selected researchers further formed team of 3–7 researchers per team, thus having almost 150 + researchers on the board. Besides receiving the short workshops for the finalization of research question and manuscript writing, each team of researchers was assigned an OR mentor for guidance, review and finalization of the manuscript. There were two levels of peer review for each manuscript. In this first-of-its-operational research (OR) model on hypertension, we built the capacity of young researchers from various medical and research institutes of country in OR related to hypertension in India. The models’ success is proved by its cost-effective approach and development of 30 high-quality research articles on hypertension. While we faced challenges in the process, several lessons were learned which will be instrumental in the future planning and implementation of such OR programs for other public health issues.