Objective:To assess the factors associated with knowledge,attitude and behavior of contraception use among urban slum population in Chennai.Methods:A cross-sectional study was conducted in the urban slum of Anakaputhu...Objective:To assess the factors associated with knowledge,attitude and behavior of contraception use among urban slum population in Chennai.Methods:A cross-sectional study was conducted in the urban slum of Anakaputhur,Chennai.Married couples between ages of 19-49 years and living in slum areas were taken up for the study by simple random sampling.Pregnant women,postnatal and postmenopausal women were excluded from the study.Data collection was done using a pretested structured questionnaire focusing on details regarding contraception knowledge,attitude,and practices.Data analysis was done using IBM SPSS version 22.Analytical test like Chi square and odds ratio(OR)were used to identify association between knowledge,attitude,and behavior of contraception with the associated variables and enter method of logistic regression analysis was done.Results:Out of the 360 respondents,228 were females,with a mean age of(34±5)years.Approximately 43%demonstrated adequate knowledge of contraception use,and 91%were aware of at least one contraceptive method.Notably,72%exhibited a positive attitude towards contraceptive use.Nevertheless,43%(155 individuals)did not utilize any contraceptive method.Among contraceptive users,intrauterine devices were the most commonly adopted,followed by barrier methods and female sterilization.There was significant association between knowledge of contraception and education(aOR 7.29,95%CI 2.93-18.10,P<0.05),age(aOR 2.04,95%CI 1.19-3.50,P<0.05)and socioeconomic class(aOR 3.66,95%CI 1.71-7.85,P<0.05;aOR 3.97,95%CI 2.12-7.49,P<0.05).Regarding attitude towards contraception use,education(aOR 8.54,95%CI 2.35-31.03,P<0.05),sex(aOR 0.15,95%CI 0.06-0.37,P<0.05),age(aOR 0.53,95%CI 0.28-0.99,P<0.05),socio-economic class(aOR 4.42,95%CI 1.97-9.92,P<0.05;aOR 9.83,95%CI 3.63-26.58,P<0.05)and number of children(aOR 10.04,95%CI 4.26-23.66,P<0.05)were the variables that had a significant association.Conclusions:These findings underscore the imperative for enhanced dissemination of health education pertaining to contraception use within the slum population.The health sectors of the area and other stakeholders need to make sure to extend penetration of family planning related services to the urban slum population.展开更多
Objective: We studied the feasibility of using Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) linked with Brief Intervention (ALBI) in treating Substance Use Disorder in Nigeria. There is a clear ...Objective: We studied the feasibility of using Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) linked with Brief Intervention (ALBI) in treating Substance Use Disorder in Nigeria. There is a clear gap in meeting the needs for treatment and care for people with drug use disorders in Nigeria with many users reporting a self-perceived need for treatment and about 40% of them wanting to receive drug treatment but were unable to access such services. Methods: ASSIST questionnaire was used to gather baseline data, and ALBI along with Motivational Interviewing (MI) was used to intervene for 6 weeks following which ASSIST score was repeated and compared with baseline. Results: Majority of the participants were aged 21 - 30 years, mostly males with (61.3%) lacking steady jobs. Lifetime prevalence of any drug use was (88.2%). Three months prevalence was nicotine (72.0%), alcohol (66.7%), cannabis (47.3%), opioids (11.8%) among others. The ASSIST scores were mostly on the severe ranges. ASSIST result after six weeks showed marked reduction. The Mean Difference (MD) in the ASSIST scores after intervention was significant for tobacco, opioids, alcohol, and cannabis. The Cohen’s D effect size was large for tobacco (1.08), alcohol (0.92) and cannabis (0.73) but low for other substances. Conclusion: ALBI along with MI was helpful in combating the menace of substance use.展开更多
Objective:To investigate the epidemiology of injuries and risk factors in Raipur,Chhattisgarh,India.Methods:A community-based cross-sectional study was conducted in 10 selected wards of Raipur.Data were collected from...Objective:To investigate the epidemiology of injuries and risk factors in Raipur,Chhattisgarh,India.Methods:A community-based cross-sectional study was conducted in 10 selected wards of Raipur.Data were collected from injured individuals using a structured questionnaire.Socio-demographic characteristics,injury mechanisms,medical care-seeking behavior,and outcomes were assessed.Results:312 individuals with injuries were included,with 193 men and 119 women.Males were more likely to be injured than females(61.86%v.s.38.14%).Younger adults aged 21-30 were at highest risk(21.5%).The most common injuries were falls(38.8%)and road traffic accidents(34.9%).Injuries occurring on-road are the most frequent,followed by,at home with a highly significant association(P<0.001).Most individuals sought medical care(90.1%),primarily in private facilities(51.3%).Conclusions:This study provides valuable insights into the epidemiology of injuries in Raipur.The findings can inform the development of evidence-based interventions to reduce the burden of injuries and improve the health and well-being of the population.展开更多
Background: Worldwide, Female Genital Mutilation/Cutting (FGM/C) has been practiced for generations. This study examined the practice of FGM/C and identified factors influencing its continuity in Osu, a rural communit...Background: Worldwide, Female Genital Mutilation/Cutting (FGM/C) has been practiced for generations. This study examined the practice of FGM/C and identified factors influencing its continuity in Osu, a rural community in Osun State, Nigeria. Methods: This study employed a mixed method cross-sectional design. The quantitative aspect involved interview of 294 women using a semi-structured questionnaire while the qualitative aspect entailed 16 in-depth interviews using an in-depth interview guide to seek information from selected spouses of the respondent, women leaders, religious leaders and health workers. The study took place between January and June 2023. The quantitative data were subjected to descriptive and inferential statistics while the qualitative data were analyzed using thematic content analysis. Results: Ninety four percent of the women had poor knowledge of the health risks associated with FGM/C practice. About three-third (76.5%) had undergone FGM/C while 77.2% intend to continue FGM/C practice on their daughters. The predictors of continuing FGM/C practice include being married (AOR 2.03, 95% CI 1.12 - 3.65, p = 0.019), none/primary education (AOR 10.02, 95% CI 2.88 - 34.88, p = 0.0001), lower income (AOR 3.17, 95% CI 1.54 - 6.55, p = 0.002) and having undergone FGM/C (AOR 14.65, 95% CI 5.31 - 40.37, p = 0.0001). In-depth interviews revealed that the factors sustaining FGM/C in the community include curbing promiscuity, religious rites, community customs and traditions. Conclusion: Socio-cultural factors continue to sustain FGM/C practice in the community. It is necessary to target married women and other community leaders in the campaign against FGM/C practice.展开更多
This editorial comments on the article by Desai et al,which investigates the impact of coronavirus disease 2019(COVID-19)on in-hospital mortality among patients with recurrent stroke using data from the 2020 National ...This editorial comments on the article by Desai et al,which investigates the impact of coronavirus disease 2019(COVID-19)on in-hospital mortality among patients with recurrent stroke using data from the 2020 National Inpatient Sample.The findings reveal significantly higher mortality rates in COVID-19-positive patients compared to non-COVID-19 patients,particularly among middle-aged individuals,males,and ethnic minorities.This editorial explores the underlying mechanisms contributing to these outcomes and discusses the clinical implications for targeted management strategies in high-risk groups.The results emphasize the need for comprehensive approaches to mitigate the heightened risks faced by recurrent stroke patients during the COVID-19 pandemic.展开更多
BACKGROUND Diabetic ketoacidosis(DKA)remains a serious and potentially preventable complication among children with type 1 diabetes mellitus(T1DM),particularly in Saudi Arabia.Psychological constructs such as perceive...BACKGROUND Diabetic ketoacidosis(DKA)remains a serious and potentially preventable complication among children with type 1 diabetes mellitus(T1DM),particularly in Saudi Arabia.Psychological constructs such as perceived severity and susceptibility influence health behaviour,yet their role in pediatric diabetes management remains underexplored.AIM To examine psychological predictors of DKA in children with T1DM using the health belief model,and to assess the role of caregiver-perceived understanding in influencing adherence and DKA occurrence.METHODS A case-control study was conducted at Prince Sultan Military Medical City in Riyadh,Saudi Arabia,involving 191 caregivers of children with T1DM(96 cases with a history of DKA and 95 controls without).Validated questionnaires measured perceived severity,susceptibility,understanding,and adherence.Statistical analyses included independent t-tests,Pearson and Spearman correlations,and multiple regression.RESULTS Perceived understanding was the strongest predictor of adherence(β=1.03,P<0.001)and was inversely associated with DKA occurrence(P<0.001).Children without a DKA history had significantly higher levels of perceived understanding and adherence.Perceived severity had a moderate positive association with adherence,while perceived susceptibility showed a weak negative correlation.CONCLUSION Caregiver-perceived understanding plays a critical role in adherence and DKA prevention.These findings support expanding the health belief model to include perceived understanding as a distinct construct and highlight the importance of integrating comprehension-focused strategies into pediatric diabetes education.展开更多
Cancer prevention via regular physical activity has been studied across the world.This minireview aimed to present the latest updates in research in the context of the role of physical activity in the cancer preventio...Cancer prevention via regular physical activity has been studied across the world.This minireview aimed to present the latest updates in research in the context of the role of physical activity in the cancer prevention.The various mechanisms at the molecular level were studied in depth.The essential processes at play involving hormonal balance,weight reduction,adiposity,inflammation,immunity,sunlight exposure and vitamin D levels and insulin resistance were critically analyzed here.The dose response of exercise with respect to cancer prevention was appraised.Strong evidence supports an inverse relationship between physical activity and cancer risk,particularly for breast,liver,lung and colorectal cancers.There is limited evidence for hematologic,head and neck,ovarian,pancreas,prostate,brain,thyroid and rectal cancer.Prehabilitation plays a key role in tertiary prevention of cancer and patient symptom alleviation.The role of physical activity was studied under the entire cancer continuum,from primary to tertiary prevention.The minireview highlights the need for interventional trials involving holistic methods combing modern and traditional medicine/therapies in cancer prevention.展开更多
BACKGROUND The rising global prevalence of gastroesophageal reflux disease(GERD)has been closely linked to lifestyle changes driven by globalization.GERD imposes a substantial public health burden,affecting quality of...BACKGROUND The rising global prevalence of gastroesophageal reflux disease(GERD)has been closely linked to lifestyle changes driven by globalization.GERD imposes a substantial public health burden,affecting quality of life and leading to potential complications.Early intervention through lifestyle modification can prevent disease onset;however,there is a lack of effective risk prediction models that emphasize primary prevention.AIM To develop and validate a GERD Risk Scoring System(GRSS)aimed at identifying high-risk individuals and promoting primary prevention strategies.METHODS A 45-item questionnaire encompassing major lifestyle and demographic risk factors was developed and validated.It was administered to healthy controls and GERD patients.Two regression models-one using continuous variables and another using categorized variables-were used to develop a computational prediction equation and a clinically applicable scoring scale.An independent validation cohort of 355 participants was used to assess model performance in terms of discrimination(C-index),calibration,sensitivity,specificity,internal consistency(Cronbach's alpha),and test-retest reliability(intraclass correlation coefficient,Bland-Altman analysis).RESULTS Significant associations were observed between GERD and key lifestyle factors.The derived GRSS equation and scoring scale demonstrated strong discriminative ability,with high sensitivity and specificity.The scoring system exhibited excellent internal consistency(Cronbach’s alpha)and strong test-retest reliability.The C-index indicated excellent predictive accuracy in both derivation and validation cohorts.CONCLUSION GRSS offers a novel and validated approach to GERD risk prediction,combining a robust equation for digital applications and a practical scale for clinical use.Its ability to accurately identify at-risk individuals supports a paradigm shift toward primary prevention,underscoring its significance in addressing the growing burden of GERD at the population level.展开更多
Infertility has been regarded as a global public health concern,affecting both men and women irrespective of geographical region,race,ethnicity,and socioeconomic class[1].The available global estimates suggest that al...Infertility has been regarded as a global public health concern,affecting both men and women irrespective of geographical region,race,ethnicity,and socioeconomic class[1].The available global estimates suggest that almost 17%of people of reproductive age experience infertility during their lives[1],with 55 million men and 110 million women living with infertility worldwide and varying estimates across different global regions[2].The consequences of infertility go beyond just medical suffering,and result in huge social and psychological consequences,including marital strains,stigma,and mental health problems[1].The current paper explores infertility in cultural context,enlists herbal remedies and traditional healers for infertility,and proposes targeted public health interventions to minimize the utilization of herbal treatment in dealing with cases of infertility.展开更多
Background:Hypertension is a significant public health concern and a leading cause of cardiovascular diseases worldwide.Urbanization has contributed to an increased prevalence of hypertension by introducing lifestyle-...Background:Hypertension is a significant public health concern and a leading cause of cardiovascular diseases worldwide.Urbanization has contributed to an increased prevalence of hypertension by introducing lifestyle-related risk factors such as physical inactivity,unhealthy dietary patterns,and stress.Region-specific tools for assessing hypertension risk factors are essential for designing effective public health interventions.Objectives:This study aimed to develop and validate a questionnaire to assess the risk factors for hypertension in the urban population of Mysuru and identify the prevalence of key modifiable and nonmodifiable risk factors.Materials and Methods:A cross-sectional study was conducted among 100 participants aged 18-60 years in urban Mysuru.A 40-item questionnaire was developed based on literature review and expert input.It included domains such as sociodemographic factors,lifestyle habits,and clinical history.Reliability was evaluated using Cronbach’s alpha,while construct validity was assessed through exploratory factor analysis.Descriptive statistics and Chi-square tests were used for data analysis.Results:The questionnaire demonstrated high internal consistency(Cronbach’s alpha>0.7)and satisfactory construct validity.Key findings included a high prevalence of low physical activity(60%),high salt intake(50%),and overweight individuals(30%).In addition,40%of participants reported a family history of hypertension,and 18%had prediabetes.These findings emphasize the role of modifiable risk factors in the rising hypertension burden in urban settings.Conclusion:The developed and validated questionnaire is a reliable and valid tool for assessing hypertension risk factors in urban populations.展开更多
The arterial pulse tapping artifact,known as Aslanger’s sign,is an electrocardiographic artifact resulting from the transmission of arterial pulsation onto the limb electrodes of the standard 12-lead electrocardiogra...The arterial pulse tapping artifact,known as Aslanger’s sign,is an electrocardiographic artifact resulting from the transmission of arterial pulsation onto the limb electrodes of the standard 12-lead electrocardiograph(ECG)which are placed near the radial or posterior tibial arteries.[1-16]This electromechanical artifact is of cardiac origin and is synchronous with the cardiac cycle.[17]Nearly all reported cases of Aslanger’s sign exhibit an unusual waveform morphology in all 12 leads except one limb lead.[1-14,16]However,we previously reported a case of Aslanger’s sign that showed distorted waveforms from the ST to TP segments observed only in five limb leads among 12 leads.展开更多
The pandemic highlighted significant gaps in the public health infrastructure impacted by shortages of public health workers, an undertrained workforce, and years of disinvestment. These gaps required innovative probl...The pandemic highlighted significant gaps in the public health infrastructure impacted by shortages of public health workers, an undertrained workforce, and years of disinvestment. These gaps required innovative problem-solving by public health agencies (PHAs), including local health departments (LHDs), to respond to rapidly changing community conditions during and after the pandemic. Many schools and programs of public health (SPPH) worked with PHAs to mobilize public health (PH) students through practice-based teaching (PBT). Current research indicates PBT benefits all stakeholders—PHAs, students, faculty, SPPH, and ultimately the community served. However, more research is needed on the utility of PBT in addressing a community’s systemic public health issues, the extent to which the academic-community collaboration enhances a PHA’s capacity, and the impact of the pedagogy on preparing the workforce for an evolving PH landscape. This paper examines the process of a semester-long PBT course, guided by the PBT STEPS framework, which includes five steps from collaboration to implementation to evaluation of a PBT course. The collaborating PHA and its student group addressed community trauma and resilience issues during the semester. Additionally, it examines the longer-term impacts after the semester for the PHA, community, and the workforce by 1) conducting a formative evaluation to understand needs and gaps in the community;2) redesigning an intervention that merged the results of the formative evaluation with the intervention developed during the semester;and 3) securing funding and resources for intervention sustainability. Through the documentation of a post-course partnership between an LHD and faculty at a large school of public health, this case study illustrates the potential for PBT to lay the foundation for ongoing research that supports more impactful interventions for PHAs while bolstering the workforce abilities of students as future practitioners.展开更多
BACKGROUND Severe acute cholangitis is a potentially life-threatening disease in low-middle income countries(LMIC).Due to limited endoscopic services,these patients mostly undergo percutaneous transhepatic biliary dra...BACKGROUND Severe acute cholangitis is a potentially life-threatening disease in low-middle income countries(LMIC).Due to limited endoscopic services,these patients mostly undergo percutaneous transhepatic biliary drainage(PTBD).Studies from developed countries reported more complications with PTBD as compared with endoscopic retrograde cholangiopancreatography(ERCP).AIM To compare safety,therapeutic success,and survival among the PTBD and ERCP procedure in severe cholangitis in LMIC.METHODS A retrospective study was conducted in the Aga Khan University Hospital from January 2017 to December 2023.All patients who had severe acute cholangitis and underwent ERCP or PTBD were included.Patients were followed for complications,procedure success,and mortality.Data was gathered through an electronic medical record system and analyzed usingχ²and two sample t-tests.RESULTS A total of 33 patients were recruited,consisting of 12 females and 21 males with a mean age of 61 years.Among these participants,12 patients underwent ERCP,and the remaining 21 patients underwent PTBD.Therapeutic success was seen more in the ERCP group[11/12(97.1%)]than in the PTBD group[12/21 patients(57.1%)].Post-procedure complications were seen in both groups;however,more were observed in the PTBD cohort with a significant P value of 0.02.There were no mortalities among the patients who underwent ERCP while 5(23.8%)mortalities were seen in the PTBD group.CONCLUSION Fewer post-procedure complications and deaths were observed after ERCP than after PTBD,laying the foundation for large prospective studies and shifting the local paradigm of acute cholangitis treatment in LMICs.展开更多
Background: Severe acute malnutrition (SAM) is one of the major public health problems associated with increased mortality in under-five children. In low-income countries, renal dysfunction (RD) contributes to about 3...Background: Severe acute malnutrition (SAM) is one of the major public health problems associated with increased mortality in under-five children. In low-income countries, renal dysfunction (RD) contributes to about 34% mortality in under-five children with severe acute malnutrition. This study aimed to determine the impacts of severe acute malnutrition on the kidney among the admitted under-five children. Methods: In this prospective longitudinal observational study, a total of 190 children aged 6 to 59 months were enrolled from Iringa and Dodoma tertiary hospitals. Socio-demographic, clinical and laboratory data were collected using a structured questionnaire. Estimated Glomerular Filtration Rate (eGFR) and urine albumin creatinine ratio (uACR) were used to determine RD. Data analysis was done using SPSS version 26 and statistical significance was assumed for factors with p-value Results: Out of 190 children with severe acute malnutrition, 36 (19%) had renal dysfunction. Factors associated with RD in malnourished children were the history of local herbs used within one week (AOR = 5.85, 95% CI [1.41, 24.319], p = 0.0152), Acute watery diarrhea with severe dehydration (AOR = 2.15, 95% CI [1.033, 4.711], p = 0.0166), and positive urine leukocytes (AOR = 19.91, 95% CI [4.09, 96.989], p = 0.0002). At three months of follow up, out of 36 children with RD, 20 (55.56%) attained full recovery, while 4 (11.11%) developed chronic kidney disease (CKD). Children with RD had prolonged hospital stays for more than 14 days with a mean 12.25 ± 5.00 days compared to those with no RD with a mean 6.29 ± 1.68 days (p Conclusion: Renal dysfunction is common among children with severe acute malnutrition. It is associated with prolonged hospital stays and increased mortality. Further studies which can determine the burden of RD in children with severe acute malnutrition as compared to those with no severe acute malnutrition are needed.展开更多
BACKGROUND Glaucoma is the leading cause of irreversible blindness worldwide,with 60.5 million affected individuals,of whom 11 million are from India.Due to its asymptomatic nature,the disease largely remains underdia...BACKGROUND Glaucoma is the leading cause of irreversible blindness worldwide,with 60.5 million affected individuals,of whom 11 million are from India.Due to its asymptomatic nature,the disease largely remains underdiagnosed or diagnosed in advanced stages,where little can be done to salvage functional vision.The literature suggests that a lack of knowledge is one of the reasons for its grave consequences.Assessment of awareness is the first step in planning management.Several studies have been conducted in the Indian community,but data from healthcare providers,who play a significant role in educating the masses directly or indirectly,are limited.AIM To identify awareness,knowledge,and attitudes about glaucoma among healthcare workers in a tertiary center in India.METHODS This cross-sectional study was conducted at a tertiary care institute in Eastern India.Data were collected from 423 participants by systematic stratified sampling after Institutional Ethics Committee approval via a pretested,self-designed,semistructured,validated questionnaire.Statistical analyses were performed using the Statistical Package for Social Sciences Software v22.0.Continuous variables are expressed as the means±SD for parametric values and medians with interquartile ranges for nonparametric values.The associations between the variables were studied via multivariate linear and logistic regression.P<0.05 was considered statistically significant.RESULTS Most respondents were 20–30 years old(n=345,81.6%).The knowledge regarding glaucoma was good,and almost 56.3%of the participants gained knowledge from their medical training.The majority were aware that it has a familial predisposition and is secondary to high intraocular pressure,leading to irreversible peripheral vision loss.Only 42%knew about the life-long requirements of treatment.The resident group scored highest on knowledgeand attitude-based questions,whereas the faculty group scored highest on practice-based questions.Although 62%of the nursing staff had good attitude scores,their knowledge and practice scores were lower.The occupation group response difference was statistically significant(P<0.05)for all the knowledge-based questions.CONCLUSION Although the majority of healthcare providers are aware of glaucoma,there is a dearth of knowledge about treatment modalities.Education via seminars and media can improve their knowledge,attitudes,and practices.展开更多
Introduction:Having a primary care usual source of care(USC)is associated with better population health outcomes.However,the percent of adults in the United States(US)with a usual primary care provider is declining.We...Introduction:Having a primary care usual source of care(USC)is associated with better population health outcomes.However,the percent of adults in the United States(US)with a usual primary care provider is declining.We sought to identify factors associated with establishing a USC at an urgent care clinic or emergency department as opposed to primary care.Methods:We analyzed data from 57,152 participants in the All of Us study who reported having a USC.We used the Andersen Behavioral Model of Health Services Use framework and multivariable logistic regression to examine associations among predisposing,enabling,and need factors,according to the source of usual care.Results:An urgent care clinic,minute clinic,or emergency department was the source of usual care for 6.3%of our sample.The odds of seeking care at this type of facility increased with younger age,lower educational attainment,and better health status.Black and Hispanic individuals,as well as those who reported experiencing discrimination in medical settings or that their provider was of a different race and ethnicity,were also less likely to have a primary care USC.Financial concerns,being anxious about seeing a provider,and the inability to take time off from work also increased the likelihood of having a non‐primary care USC.Conclusions:Improving the rates of having a primary care USC among younger and healthy adults may be achievable through policies that can improve access to convenient,affordable primary care.Efforts to improve diversity among primary care providers and reduce discrimination experienced by patients may also improve the USC rates for racial and ethnic minority groups.展开更多
Objective:The aim of the study is to evaluate the effect of neck massage on increased breast milk secretion among postnatal mothers.Materials and Methods:The current study adopted a quasi-experimental design conducted...Objective:The aim of the study is to evaluate the effect of neck massage on increased breast milk secretion among postnatal mothers.Materials and Methods:The current study adopted a quasi-experimental design conducted among 60 primi postnatal mothers(30 in each group).Study was conducted at the Postnatal ward of IMS and SUM Hospital,Bhubaneswar,Odisha.Tools used were structured sociodemographic pro forma,structured breast milk adequacy questionnaire,and structured rating scale to assess the adequacy of breast milk production.The duration of the study is 1 year.All the postnatal mothers who were primigravida and undergone cesarean section were chosen as the sample through a convenience sampling technique.Then,the samples were assigned to the intervention group(receiving neck massage)and control group(receiving standard postnatal care).The data were collected and analyzed using both descriptive and inferential statistics by SPSS version 20.Results:The study resulted a significant difference between the pretest and posttest score of breast milk production after neck massage(P=0.000).The mean score of the posttest(2.90±0.36)is more than the mean score of the pretest(2.89±0.36)of the baby’s weight(P<0.001).Further,the number of urination and stool passed in 24 h was more in the intervention group than the control group(P<0.001).The Chi-square analysis showed statistical significance between breast milk production after neck massage with religion of the postnatal mothers(P<0.05).Conclusion:The neck massage is found effective in improving the breast milk production among primi c-section mothers with improve newborn parameters.展开更多
Dear Editor,Reproductive healthcare and autonomy are integral to overall health,well-being,and human fundamental rights[1].However,for individuals with disabilities,access to reproductive healthcare and their autonomy...Dear Editor,Reproductive healthcare and autonomy are integral to overall health,well-being,and human fundamental rights[1].However,for individuals with disabilities,access to reproductive healthcare and their autonomy is significantly jeopardized due to a combination of parameters[1].Disabled people have to deal with a wide range of social barriers while they decide to access healthcare facilities for reproductive health[2,3].展开更多
Objective:To assess the teaching efficacy of clinical instructors for MNS postgraduates,this study aims to gather insights into clinical educators’perceptions concerning MNS postgraduate training and identify key com...Objective:To assess the teaching efficacy of clinical instructors for MNS postgraduates,this study aims to gather insights into clinical educators’perceptions concerning MNS postgraduate training and identify key competencies required for effective teaching.Methods:This study utilized a cross-sectional design.An online questionnaire survey was distributed among clinical faculty members engaged in the education of MNS postgraduates.The survey addressed 4 areas:general teaching conditions,perceptions regarding training for MNS postgraduates,core competencies expected from clinical teachers,and implementation strategies for delivering clinical instruction tailored to these graduates.Results:A total of 143 clinical teachers supervising MNS postgraduates completed the questionnaire.Of these respondents,101(70.62%)held a bachelor’s degree while 42(29.37%)possessed a master’s degree.Although these clinicians demonstrated certain core competencies,they exhibited lower proficiency in understanding trends related to scientific advancements and current research priorities along with limited research capabilities 4.00(3.00,4.00).Notably,>95.8%of teachers recognized differences between the 2 categories of postgraduate students;only 4.2%were completely unaware of such distinctions.There was no statistically significant relationship between the demographic data of clinical educators and their core competencies(P>0.05).Conclusions:This study revealed no significant correlation between the general characteristics of clinical teachers and the core competencies of MNS postgraduates.Additionally,we identified a lack of effective communication and collaboration between MNS postgraduate supervisors and clinical educators.The findings from this research offer valuable insights for further investigation into the factors that influence the core competencies of clinical teachers,as well as strategies to enhance the clinical teaching standards for MNS postgraduates.展开更多
BACKGROUND Sagittal spinopelvic alignment(SSA)is essential for preserving a stable and effective upright posture and locomotion.Although alterations in the SSA are recognised to induce compensatory modifications in th...BACKGROUND Sagittal spinopelvic alignment(SSA)is essential for preserving a stable and effective upright posture and locomotion.Although alterations in the SSA are recognised to induce compensatory modifications in the pelvis,hips,and knees,the inverse relationship concerning knee pathology undergoing total knee arthroplasty(TKA)has been examined by a limited number of studies,yielding inconclusive results.AIM To generate evidence of the effect of TKA on the SSA from existing literature.METHODS Databases like PubMed,EMBASE,and Scopus were used to identify articles related to the“knee spine syndrome”phenomenon using a combination of subject terms and keywords such as“spinopelvic parameters”,“sagittal spinal balance”,and“total knee arthroplasty”were used with appropriate Boolean operators.Studies measuring the SSA following TKA were included,and research was conducted as per preferred reporting items for systematic review and metaanalysis guidelines.RESULTS A total of 475 participants had undergone TKA,and six studies measuring SSA were analysed.Following TKA,pelvic tilt was the only parameter that showed significant changes,while lumbar lordosis(LL),pelvic incidence,and sacral slope were non-significant,as evident from the forest plots.CONCLUSION The body's sagittal alignment is a complex balance between pelvic,spine,and lower extremity parameters.TKA,while having the potential to correct the flexion contracture,can also correct it.Still,the primary SSA for spinal pathology,i.e.,LL,may not be corrected in patients with co-existent spinal degenerative disease.展开更多
文摘Objective:To assess the factors associated with knowledge,attitude and behavior of contraception use among urban slum population in Chennai.Methods:A cross-sectional study was conducted in the urban slum of Anakaputhur,Chennai.Married couples between ages of 19-49 years and living in slum areas were taken up for the study by simple random sampling.Pregnant women,postnatal and postmenopausal women were excluded from the study.Data collection was done using a pretested structured questionnaire focusing on details regarding contraception knowledge,attitude,and practices.Data analysis was done using IBM SPSS version 22.Analytical test like Chi square and odds ratio(OR)were used to identify association between knowledge,attitude,and behavior of contraception with the associated variables and enter method of logistic regression analysis was done.Results:Out of the 360 respondents,228 were females,with a mean age of(34±5)years.Approximately 43%demonstrated adequate knowledge of contraception use,and 91%were aware of at least one contraceptive method.Notably,72%exhibited a positive attitude towards contraceptive use.Nevertheless,43%(155 individuals)did not utilize any contraceptive method.Among contraceptive users,intrauterine devices were the most commonly adopted,followed by barrier methods and female sterilization.There was significant association between knowledge of contraception and education(aOR 7.29,95%CI 2.93-18.10,P<0.05),age(aOR 2.04,95%CI 1.19-3.50,P<0.05)and socioeconomic class(aOR 3.66,95%CI 1.71-7.85,P<0.05;aOR 3.97,95%CI 2.12-7.49,P<0.05).Regarding attitude towards contraception use,education(aOR 8.54,95%CI 2.35-31.03,P<0.05),sex(aOR 0.15,95%CI 0.06-0.37,P<0.05),age(aOR 0.53,95%CI 0.28-0.99,P<0.05),socio-economic class(aOR 4.42,95%CI 1.97-9.92,P<0.05;aOR 9.83,95%CI 3.63-26.58,P<0.05)and number of children(aOR 10.04,95%CI 4.26-23.66,P<0.05)were the variables that had a significant association.Conclusions:These findings underscore the imperative for enhanced dissemination of health education pertaining to contraception use within the slum population.The health sectors of the area and other stakeholders need to make sure to extend penetration of family planning related services to the urban slum population.
文摘Objective: We studied the feasibility of using Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) linked with Brief Intervention (ALBI) in treating Substance Use Disorder in Nigeria. There is a clear gap in meeting the needs for treatment and care for people with drug use disorders in Nigeria with many users reporting a self-perceived need for treatment and about 40% of them wanting to receive drug treatment but were unable to access such services. Methods: ASSIST questionnaire was used to gather baseline data, and ALBI along with Motivational Interviewing (MI) was used to intervene for 6 weeks following which ASSIST score was repeated and compared with baseline. Results: Majority of the participants were aged 21 - 30 years, mostly males with (61.3%) lacking steady jobs. Lifetime prevalence of any drug use was (88.2%). Three months prevalence was nicotine (72.0%), alcohol (66.7%), cannabis (47.3%), opioids (11.8%) among others. The ASSIST scores were mostly on the severe ranges. ASSIST result after six weeks showed marked reduction. The Mean Difference (MD) in the ASSIST scores after intervention was significant for tobacco, opioids, alcohol, and cannabis. The Cohen’s D effect size was large for tobacco (1.08), alcohol (0.92) and cannabis (0.73) but low for other substances. Conclusion: ALBI along with MI was helpful in combating the menace of substance use.
文摘Objective:To investigate the epidemiology of injuries and risk factors in Raipur,Chhattisgarh,India.Methods:A community-based cross-sectional study was conducted in 10 selected wards of Raipur.Data were collected from injured individuals using a structured questionnaire.Socio-demographic characteristics,injury mechanisms,medical care-seeking behavior,and outcomes were assessed.Results:312 individuals with injuries were included,with 193 men and 119 women.Males were more likely to be injured than females(61.86%v.s.38.14%).Younger adults aged 21-30 were at highest risk(21.5%).The most common injuries were falls(38.8%)and road traffic accidents(34.9%).Injuries occurring on-road are the most frequent,followed by,at home with a highly significant association(P<0.001).Most individuals sought medical care(90.1%),primarily in private facilities(51.3%).Conclusions:This study provides valuable insights into the epidemiology of injuries in Raipur.The findings can inform the development of evidence-based interventions to reduce the burden of injuries and improve the health and well-being of the population.
文摘Background: Worldwide, Female Genital Mutilation/Cutting (FGM/C) has been practiced for generations. This study examined the practice of FGM/C and identified factors influencing its continuity in Osu, a rural community in Osun State, Nigeria. Methods: This study employed a mixed method cross-sectional design. The quantitative aspect involved interview of 294 women using a semi-structured questionnaire while the qualitative aspect entailed 16 in-depth interviews using an in-depth interview guide to seek information from selected spouses of the respondent, women leaders, religious leaders and health workers. The study took place between January and June 2023. The quantitative data were subjected to descriptive and inferential statistics while the qualitative data were analyzed using thematic content analysis. Results: Ninety four percent of the women had poor knowledge of the health risks associated with FGM/C practice. About three-third (76.5%) had undergone FGM/C while 77.2% intend to continue FGM/C practice on their daughters. The predictors of continuing FGM/C practice include being married (AOR 2.03, 95% CI 1.12 - 3.65, p = 0.019), none/primary education (AOR 10.02, 95% CI 2.88 - 34.88, p = 0.0001), lower income (AOR 3.17, 95% CI 1.54 - 6.55, p = 0.002) and having undergone FGM/C (AOR 14.65, 95% CI 5.31 - 40.37, p = 0.0001). In-depth interviews revealed that the factors sustaining FGM/C in the community include curbing promiscuity, religious rites, community customs and traditions. Conclusion: Socio-cultural factors continue to sustain FGM/C practice in the community. It is necessary to target married women and other community leaders in the campaign against FGM/C practice.
文摘This editorial comments on the article by Desai et al,which investigates the impact of coronavirus disease 2019(COVID-19)on in-hospital mortality among patients with recurrent stroke using data from the 2020 National Inpatient Sample.The findings reveal significantly higher mortality rates in COVID-19-positive patients compared to non-COVID-19 patients,particularly among middle-aged individuals,males,and ethnic minorities.This editorial explores the underlying mechanisms contributing to these outcomes and discusses the clinical implications for targeted management strategies in high-risk groups.The results emphasize the need for comprehensive approaches to mitigate the heightened risks faced by recurrent stroke patients during the COVID-19 pandemic.
基金Supported by the Ongoing Research Funding Program at King Saud University,Riyadh,Saudi Arabia,No.ORF-2025-1315.
文摘BACKGROUND Diabetic ketoacidosis(DKA)remains a serious and potentially preventable complication among children with type 1 diabetes mellitus(T1DM),particularly in Saudi Arabia.Psychological constructs such as perceived severity and susceptibility influence health behaviour,yet their role in pediatric diabetes management remains underexplored.AIM To examine psychological predictors of DKA in children with T1DM using the health belief model,and to assess the role of caregiver-perceived understanding in influencing adherence and DKA occurrence.METHODS A case-control study was conducted at Prince Sultan Military Medical City in Riyadh,Saudi Arabia,involving 191 caregivers of children with T1DM(96 cases with a history of DKA and 95 controls without).Validated questionnaires measured perceived severity,susceptibility,understanding,and adherence.Statistical analyses included independent t-tests,Pearson and Spearman correlations,and multiple regression.RESULTS Perceived understanding was the strongest predictor of adherence(β=1.03,P<0.001)and was inversely associated with DKA occurrence(P<0.001).Children without a DKA history had significantly higher levels of perceived understanding and adherence.Perceived severity had a moderate positive association with adherence,while perceived susceptibility showed a weak negative correlation.CONCLUSION Caregiver-perceived understanding plays a critical role in adherence and DKA prevention.These findings support expanding the health belief model to include perceived understanding as a distinct construct and highlight the importance of integrating comprehension-focused strategies into pediatric diabetes education.
文摘Cancer prevention via regular physical activity has been studied across the world.This minireview aimed to present the latest updates in research in the context of the role of physical activity in the cancer prevention.The various mechanisms at the molecular level were studied in depth.The essential processes at play involving hormonal balance,weight reduction,adiposity,inflammation,immunity,sunlight exposure and vitamin D levels and insulin resistance were critically analyzed here.The dose response of exercise with respect to cancer prevention was appraised.Strong evidence supports an inverse relationship between physical activity and cancer risk,particularly for breast,liver,lung and colorectal cancers.There is limited evidence for hematologic,head and neck,ovarian,pancreas,prostate,brain,thyroid and rectal cancer.Prehabilitation plays a key role in tertiary prevention of cancer and patient symptom alleviation.The role of physical activity was studied under the entire cancer continuum,from primary to tertiary prevention.The minireview highlights the need for interventional trials involving holistic methods combing modern and traditional medicine/therapies in cancer prevention.
文摘BACKGROUND The rising global prevalence of gastroesophageal reflux disease(GERD)has been closely linked to lifestyle changes driven by globalization.GERD imposes a substantial public health burden,affecting quality of life and leading to potential complications.Early intervention through lifestyle modification can prevent disease onset;however,there is a lack of effective risk prediction models that emphasize primary prevention.AIM To develop and validate a GERD Risk Scoring System(GRSS)aimed at identifying high-risk individuals and promoting primary prevention strategies.METHODS A 45-item questionnaire encompassing major lifestyle and demographic risk factors was developed and validated.It was administered to healthy controls and GERD patients.Two regression models-one using continuous variables and another using categorized variables-were used to develop a computational prediction equation and a clinically applicable scoring scale.An independent validation cohort of 355 participants was used to assess model performance in terms of discrimination(C-index),calibration,sensitivity,specificity,internal consistency(Cronbach's alpha),and test-retest reliability(intraclass correlation coefficient,Bland-Altman analysis).RESULTS Significant associations were observed between GERD and key lifestyle factors.The derived GRSS equation and scoring scale demonstrated strong discriminative ability,with high sensitivity and specificity.The scoring system exhibited excellent internal consistency(Cronbach’s alpha)and strong test-retest reliability.The C-index indicated excellent predictive accuracy in both derivation and validation cohorts.CONCLUSION GRSS offers a novel and validated approach to GERD risk prediction,combining a robust equation for digital applications and a practical scale for clinical use.Its ability to accurately identify at-risk individuals supports a paradigm shift toward primary prevention,underscoring its significance in addressing the growing burden of GERD at the population level.
文摘Infertility has been regarded as a global public health concern,affecting both men and women irrespective of geographical region,race,ethnicity,and socioeconomic class[1].The available global estimates suggest that almost 17%of people of reproductive age experience infertility during their lives[1],with 55 million men and 110 million women living with infertility worldwide and varying estimates across different global regions[2].The consequences of infertility go beyond just medical suffering,and result in huge social and psychological consequences,including marital strains,stigma,and mental health problems[1].The current paper explores infertility in cultural context,enlists herbal remedies and traditional healers for infertility,and proposes targeted public health interventions to minimize the utilization of herbal treatment in dealing with cases of infertility.
文摘Background:Hypertension is a significant public health concern and a leading cause of cardiovascular diseases worldwide.Urbanization has contributed to an increased prevalence of hypertension by introducing lifestyle-related risk factors such as physical inactivity,unhealthy dietary patterns,and stress.Region-specific tools for assessing hypertension risk factors are essential for designing effective public health interventions.Objectives:This study aimed to develop and validate a questionnaire to assess the risk factors for hypertension in the urban population of Mysuru and identify the prevalence of key modifiable and nonmodifiable risk factors.Materials and Methods:A cross-sectional study was conducted among 100 participants aged 18-60 years in urban Mysuru.A 40-item questionnaire was developed based on literature review and expert input.It included domains such as sociodemographic factors,lifestyle habits,and clinical history.Reliability was evaluated using Cronbach’s alpha,while construct validity was assessed through exploratory factor analysis.Descriptive statistics and Chi-square tests were used for data analysis.Results:The questionnaire demonstrated high internal consistency(Cronbach’s alpha>0.7)and satisfactory construct validity.Key findings included a high prevalence of low physical activity(60%),high salt intake(50%),and overweight individuals(30%).In addition,40%of participants reported a family history of hypertension,and 18%had prediabetes.These findings emphasize the role of modifiable risk factors in the rising hypertension burden in urban settings.Conclusion:The developed and validated questionnaire is a reliable and valid tool for assessing hypertension risk factors in urban populations.
文摘The arterial pulse tapping artifact,known as Aslanger’s sign,is an electrocardiographic artifact resulting from the transmission of arterial pulsation onto the limb electrodes of the standard 12-lead electrocardiograph(ECG)which are placed near the radial or posterior tibial arteries.[1-16]This electromechanical artifact is of cardiac origin and is synchronous with the cardiac cycle.[17]Nearly all reported cases of Aslanger’s sign exhibit an unusual waveform morphology in all 12 leads except one limb lead.[1-14,16]However,we previously reported a case of Aslanger’s sign that showed distorted waveforms from the ST to TP segments observed only in five limb leads among 12 leads.
文摘The pandemic highlighted significant gaps in the public health infrastructure impacted by shortages of public health workers, an undertrained workforce, and years of disinvestment. These gaps required innovative problem-solving by public health agencies (PHAs), including local health departments (LHDs), to respond to rapidly changing community conditions during and after the pandemic. Many schools and programs of public health (SPPH) worked with PHAs to mobilize public health (PH) students through practice-based teaching (PBT). Current research indicates PBT benefits all stakeholders—PHAs, students, faculty, SPPH, and ultimately the community served. However, more research is needed on the utility of PBT in addressing a community’s systemic public health issues, the extent to which the academic-community collaboration enhances a PHA’s capacity, and the impact of the pedagogy on preparing the workforce for an evolving PH landscape. This paper examines the process of a semester-long PBT course, guided by the PBT STEPS framework, which includes five steps from collaboration to implementation to evaluation of a PBT course. The collaborating PHA and its student group addressed community trauma and resilience issues during the semester. Additionally, it examines the longer-term impacts after the semester for the PHA, community, and the workforce by 1) conducting a formative evaluation to understand needs and gaps in the community;2) redesigning an intervention that merged the results of the formative evaluation with the intervention developed during the semester;and 3) securing funding and resources for intervention sustainability. Through the documentation of a post-course partnership between an LHD and faculty at a large school of public health, this case study illustrates the potential for PBT to lay the foundation for ongoing research that supports more impactful interventions for PHAs while bolstering the workforce abilities of students as future practitioners.
文摘BACKGROUND Severe acute cholangitis is a potentially life-threatening disease in low-middle income countries(LMIC).Due to limited endoscopic services,these patients mostly undergo percutaneous transhepatic biliary drainage(PTBD).Studies from developed countries reported more complications with PTBD as compared with endoscopic retrograde cholangiopancreatography(ERCP).AIM To compare safety,therapeutic success,and survival among the PTBD and ERCP procedure in severe cholangitis in LMIC.METHODS A retrospective study was conducted in the Aga Khan University Hospital from January 2017 to December 2023.All patients who had severe acute cholangitis and underwent ERCP or PTBD were included.Patients were followed for complications,procedure success,and mortality.Data was gathered through an electronic medical record system and analyzed usingχ²and two sample t-tests.RESULTS A total of 33 patients were recruited,consisting of 12 females and 21 males with a mean age of 61 years.Among these participants,12 patients underwent ERCP,and the remaining 21 patients underwent PTBD.Therapeutic success was seen more in the ERCP group[11/12(97.1%)]than in the PTBD group[12/21 patients(57.1%)].Post-procedure complications were seen in both groups;however,more were observed in the PTBD cohort with a significant P value of 0.02.There were no mortalities among the patients who underwent ERCP while 5(23.8%)mortalities were seen in the PTBD group.CONCLUSION Fewer post-procedure complications and deaths were observed after ERCP than after PTBD,laying the foundation for large prospective studies and shifting the local paradigm of acute cholangitis treatment in LMICs.
文摘Background: Severe acute malnutrition (SAM) is one of the major public health problems associated with increased mortality in under-five children. In low-income countries, renal dysfunction (RD) contributes to about 34% mortality in under-five children with severe acute malnutrition. This study aimed to determine the impacts of severe acute malnutrition on the kidney among the admitted under-five children. Methods: In this prospective longitudinal observational study, a total of 190 children aged 6 to 59 months were enrolled from Iringa and Dodoma tertiary hospitals. Socio-demographic, clinical and laboratory data were collected using a structured questionnaire. Estimated Glomerular Filtration Rate (eGFR) and urine albumin creatinine ratio (uACR) were used to determine RD. Data analysis was done using SPSS version 26 and statistical significance was assumed for factors with p-value Results: Out of 190 children with severe acute malnutrition, 36 (19%) had renal dysfunction. Factors associated with RD in malnourished children were the history of local herbs used within one week (AOR = 5.85, 95% CI [1.41, 24.319], p = 0.0152), Acute watery diarrhea with severe dehydration (AOR = 2.15, 95% CI [1.033, 4.711], p = 0.0166), and positive urine leukocytes (AOR = 19.91, 95% CI [4.09, 96.989], p = 0.0002). At three months of follow up, out of 36 children with RD, 20 (55.56%) attained full recovery, while 4 (11.11%) developed chronic kidney disease (CKD). Children with RD had prolonged hospital stays for more than 14 days with a mean 12.25 ± 5.00 days compared to those with no RD with a mean 6.29 ± 1.68 days (p Conclusion: Renal dysfunction is common among children with severe acute malnutrition. It is associated with prolonged hospital stays and increased mortality. Further studies which can determine the burden of RD in children with severe acute malnutrition as compared to those with no severe acute malnutrition are needed.
文摘BACKGROUND Glaucoma is the leading cause of irreversible blindness worldwide,with 60.5 million affected individuals,of whom 11 million are from India.Due to its asymptomatic nature,the disease largely remains underdiagnosed or diagnosed in advanced stages,where little can be done to salvage functional vision.The literature suggests that a lack of knowledge is one of the reasons for its grave consequences.Assessment of awareness is the first step in planning management.Several studies have been conducted in the Indian community,but data from healthcare providers,who play a significant role in educating the masses directly or indirectly,are limited.AIM To identify awareness,knowledge,and attitudes about glaucoma among healthcare workers in a tertiary center in India.METHODS This cross-sectional study was conducted at a tertiary care institute in Eastern India.Data were collected from 423 participants by systematic stratified sampling after Institutional Ethics Committee approval via a pretested,self-designed,semistructured,validated questionnaire.Statistical analyses were performed using the Statistical Package for Social Sciences Software v22.0.Continuous variables are expressed as the means±SD for parametric values and medians with interquartile ranges for nonparametric values.The associations between the variables were studied via multivariate linear and logistic regression.P<0.05 was considered statistically significant.RESULTS Most respondents were 20–30 years old(n=345,81.6%).The knowledge regarding glaucoma was good,and almost 56.3%of the participants gained knowledge from their medical training.The majority were aware that it has a familial predisposition and is secondary to high intraocular pressure,leading to irreversible peripheral vision loss.Only 42%knew about the life-long requirements of treatment.The resident group scored highest on knowledgeand attitude-based questions,whereas the faculty group scored highest on practice-based questions.Although 62%of the nursing staff had good attitude scores,their knowledge and practice scores were lower.The occupation group response difference was statistically significant(P<0.05)for all the knowledge-based questions.CONCLUSION Although the majority of healthcare providers are aware of glaucoma,there is a dearth of knowledge about treatment modalities.Education via seminars and media can improve their knowledge,attitudes,and practices.
文摘Introduction:Having a primary care usual source of care(USC)is associated with better population health outcomes.However,the percent of adults in the United States(US)with a usual primary care provider is declining.We sought to identify factors associated with establishing a USC at an urgent care clinic or emergency department as opposed to primary care.Methods:We analyzed data from 57,152 participants in the All of Us study who reported having a USC.We used the Andersen Behavioral Model of Health Services Use framework and multivariable logistic regression to examine associations among predisposing,enabling,and need factors,according to the source of usual care.Results:An urgent care clinic,minute clinic,or emergency department was the source of usual care for 6.3%of our sample.The odds of seeking care at this type of facility increased with younger age,lower educational attainment,and better health status.Black and Hispanic individuals,as well as those who reported experiencing discrimination in medical settings or that their provider was of a different race and ethnicity,were also less likely to have a primary care USC.Financial concerns,being anxious about seeing a provider,and the inability to take time off from work also increased the likelihood of having a non‐primary care USC.Conclusions:Improving the rates of having a primary care USC among younger and healthy adults may be achievable through policies that can improve access to convenient,affordable primary care.Efforts to improve diversity among primary care providers and reduce discrimination experienced by patients may also improve the USC rates for racial and ethnic minority groups.
文摘Objective:The aim of the study is to evaluate the effect of neck massage on increased breast milk secretion among postnatal mothers.Materials and Methods:The current study adopted a quasi-experimental design conducted among 60 primi postnatal mothers(30 in each group).Study was conducted at the Postnatal ward of IMS and SUM Hospital,Bhubaneswar,Odisha.Tools used were structured sociodemographic pro forma,structured breast milk adequacy questionnaire,and structured rating scale to assess the adequacy of breast milk production.The duration of the study is 1 year.All the postnatal mothers who were primigravida and undergone cesarean section were chosen as the sample through a convenience sampling technique.Then,the samples were assigned to the intervention group(receiving neck massage)and control group(receiving standard postnatal care).The data were collected and analyzed using both descriptive and inferential statistics by SPSS version 20.Results:The study resulted a significant difference between the pretest and posttest score of breast milk production after neck massage(P=0.000).The mean score of the posttest(2.90±0.36)is more than the mean score of the pretest(2.89±0.36)of the baby’s weight(P<0.001).Further,the number of urination and stool passed in 24 h was more in the intervention group than the control group(P<0.001).The Chi-square analysis showed statistical significance between breast milk production after neck massage with religion of the postnatal mothers(P<0.05).Conclusion:The neck massage is found effective in improving the breast milk production among primi c-section mothers with improve newborn parameters.
文摘Dear Editor,Reproductive healthcare and autonomy are integral to overall health,well-being,and human fundamental rights[1].However,for individuals with disabilities,access to reproductive healthcare and their autonomy is significantly jeopardized due to a combination of parameters[1].Disabled people have to deal with a wide range of social barriers while they decide to access healthcare facilities for reproductive health[2,3].
基金supported by the Medical Education Research Initiative of Henan Province,grant funded by the Henan Provincial Health Commission(No.Wjlx2022186).
文摘Objective:To assess the teaching efficacy of clinical instructors for MNS postgraduates,this study aims to gather insights into clinical educators’perceptions concerning MNS postgraduate training and identify key competencies required for effective teaching.Methods:This study utilized a cross-sectional design.An online questionnaire survey was distributed among clinical faculty members engaged in the education of MNS postgraduates.The survey addressed 4 areas:general teaching conditions,perceptions regarding training for MNS postgraduates,core competencies expected from clinical teachers,and implementation strategies for delivering clinical instruction tailored to these graduates.Results:A total of 143 clinical teachers supervising MNS postgraduates completed the questionnaire.Of these respondents,101(70.62%)held a bachelor’s degree while 42(29.37%)possessed a master’s degree.Although these clinicians demonstrated certain core competencies,they exhibited lower proficiency in understanding trends related to scientific advancements and current research priorities along with limited research capabilities 4.00(3.00,4.00).Notably,>95.8%of teachers recognized differences between the 2 categories of postgraduate students;only 4.2%were completely unaware of such distinctions.There was no statistically significant relationship between the demographic data of clinical educators and their core competencies(P>0.05).Conclusions:This study revealed no significant correlation between the general characteristics of clinical teachers and the core competencies of MNS postgraduates.Additionally,we identified a lack of effective communication and collaboration between MNS postgraduate supervisors and clinical educators.The findings from this research offer valuable insights for further investigation into the factors that influence the core competencies of clinical teachers,as well as strategies to enhance the clinical teaching standards for MNS postgraduates.
文摘BACKGROUND Sagittal spinopelvic alignment(SSA)is essential for preserving a stable and effective upright posture and locomotion.Although alterations in the SSA are recognised to induce compensatory modifications in the pelvis,hips,and knees,the inverse relationship concerning knee pathology undergoing total knee arthroplasty(TKA)has been examined by a limited number of studies,yielding inconclusive results.AIM To generate evidence of the effect of TKA on the SSA from existing literature.METHODS Databases like PubMed,EMBASE,and Scopus were used to identify articles related to the“knee spine syndrome”phenomenon using a combination of subject terms and keywords such as“spinopelvic parameters”,“sagittal spinal balance”,and“total knee arthroplasty”were used with appropriate Boolean operators.Studies measuring the SSA following TKA were included,and research was conducted as per preferred reporting items for systematic review and metaanalysis guidelines.RESULTS A total of 475 participants had undergone TKA,and six studies measuring SSA were analysed.Following TKA,pelvic tilt was the only parameter that showed significant changes,while lumbar lordosis(LL),pelvic incidence,and sacral slope were non-significant,as evident from the forest plots.CONCLUSION The body's sagittal alignment is a complex balance between pelvic,spine,and lower extremity parameters.TKA,while having the potential to correct the flexion contracture,can also correct it.Still,the primary SSA for spinal pathology,i.e.,LL,may not be corrected in patients with co-existent spinal degenerative disease.
