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Volume-17 (2018);
No. 2 (April-June)
Published on July 25, 2018
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2018;2:1
Original Article |
Petse S, Goon DT, Okafor UB, Yako EM.
Antiretroviral Treatment Adherence Among Patients in Selected Health Facilities in East London, South Africa: A Cross-Sectional Study. |
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Abstract: Studies on antiretroviral therapy (ART) adherence reported variations about the predictors and risk factors, which warrant regional and context-specific research on non-adherence profiles. The purpose of this study was to examine the underlying contributing factors to antiretroviral treatment non-adherence among HIV positive patients in selected health facilities. Methods: This was a descriptive cross-sectional study involving 371 HIV positive patients on antiretroviral treatment in six primary health care facilities in East London, South Africa. A self- designed structured questionnaire was the tool for data collection.
Result: The majority (70%) of the participants were non-adherents. About 64% of the participants had been counselled before starting ARV treatment (92.2%) so had a good knowledge of HIV. The majority of the participants experienced no side effects. About 55.0% of the participants had a history of non-adherence, with 26.0% non-adherence rate in the previous month and 19.0% recorded in the previous week. Marital status (married) (p=0.005), having no formal education (p=0.035), being Christian (p=0.007), alcohol consumption (p= 0.021) and viral load suppression had significant associations with non-adherence to ARV treatment. After adjusting for confounders, only non-Christians and unsuppressed viral loads were the independent predictors of non-adherence. Participants who were non-Christians had 3.2 times the likelihood of failing to adhere to ARVs compared to those who were Christians. Furthermore, participants with unsuppressed viral loads were 3 times more likely to be non-adherent to their ARVs compared to participants with suppressed viral loads. The majority of the participants were satisfied with the quality of care they received while accessing the health facility. Concerning viral load distribution, 52% were undetectable, 26% unsuppressed and 22% suppressed. Conclusion: The main contributing factors to ART non-adherence among the participants on ARVs were marital status, level of education, religion and alcohol consumption. Non-Christians and unsuppressed viral loads independently predicted non-adherence among patients in this setting. The majority of the participants, though satisfied with other indicators of quality of care they received, had to wait for more than two hours before receiving service.
Key words: Antiretroviral, Non-adherence, HIV, East London, South Africa |
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This Article |
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2018;2:2
Original Article |
Devi NK, Longkumer I, Chandel S, Mondal PR, Saraswathy KN.
No Effect of High Physical Activity on Body Mass Index Among Bhil Tribal Population in India. |
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Abstract: Background: Lifestyle behaviours are implicated as modifiable risk factors for non communicable diseases. The objective of this study was to estimate the physical activity level and to assess the general dietary trends prevailing in a tribal population. Methods: This was a population based cross sectional study conducted using random sampling method among Bhil tribal population in India. A total of 258 individuals were assessed for physical activity level while a total of 222 individuals were assessed for dietary pattern using appropriate questionnaires. Demographic and somatometric data were also recorded. Results: It was found that 86.43% of population adhered to the WHO recommended physical activity level. Females were seen to be significantly more active as compared to males which was in contrast to other findings in India. Maximum physical activity was observed to be in the occupational domain. With regards to dietary intake, the population practiced an imbalanced diet high in sugars and other carbohydrates and fats and low in vegetables and fruits. Conclusion: This study supports the need for increasing awareness regarding health benefits of physical activity (especially of leisure-time) and to promote healthy and balanced diet.
Key words: Non-communicable diseases, Obesity, Physical inactivity, Dietary habits, Tribal population |
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2018;2:3
Original Article |
Sahni N, Bansal S, Nagarjuna GVK, Malhotra S.
Food Perceptions of Obstructive Sleep Apnea Patients. |
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Abstract: Background: Obese people have extrinsic narrowing of the area surrounding the collapsible region of the pharynx which may lead to a periodic collapse of the upper airway during sleep leading to obstruction of the airway (OSA). Objective: Initial assessment of current food perceptions, patient-perceived barriers to healthy eating. Methods: A survey, which contained free response questions, yes or no statements, 24-hour recall and Epworth Sleepiness Scale Questions was utilized. Results: Of the
64 surveys collected (56 males and 8 females), 43.24 % patients were overweight, 43.2% were obese grade-1, 9.9% obese grade-2 and
6.25% obese grade-3. Awareness of relation of obesity and CVD, diabetes & OSA was 62%, 36% & 3.9% respectively.
Fresh juice was considered to be healthier over fresh fruits by
35.6% and 73% perceived refined/olive oil to have fewer calories than animal fat.
While 62.5% considered high fiber cookies as being healthy, 49.8 % patients considered ‘sugar-free' sweets to be calorie free and hence indulged.
Of the subjects, 46% did not consider homemade potato pyramids or funnel cake as junk just because they were Indian snacks and homemade. Consumption of frozen foods
and eating out was thrice and twice a week respectively reportedly due to food preparation barrier at home or celebrating weekends' culture. Food addiction/ food palatability to various spices and sauces used in outside food was reported. Epworth sleep scale showed most poor results in morbidly obese patients followed by obese grade 2 and 1. Conclusion: Nutrition surveys to gauge awareness about healthy eating are a must since lack of knowledge lead to many sound eating barriers in OSA patients.
Key words: Perceptions; Food; Apnea; Sleep |
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2018;2:4
Original Article |
Bajaj G, George VM, Bhat JS, Monappa D, Shrunga MS, Hullathi N, Mridula J..
Effect of Age on Strategic Problem Solving Abilities Using an Open Ended Version of the Twenty Questions Task. |
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Abstract: The study explores the age-related trends for an open ended version of the Twenty Questions task, which requires an individual to freely choose questions pertaining to a category in order to organize concepts and solve problems, further making it sensitive in assessing frontal lobe functions. The study comprised of 63 adult participants with 21 participants each, in the young, middle and old age group, to whom an open-ended Twenty Questions task was administered. The accuracy of response, number and type of questions asked and impulsivity were measured. Statistically significant differences in performance were observed between old vs. young (p<0.05) and old vs. middle aged (p=0.002) adults. Older adults obtained lower accuracy scores (Median= 0.333) and highest number of hypothesis scanning questions (Median=6.1667) and impulsivity (Median=3.333). The study highlights a reflection of frontal lobe functioning on the age-related differences in concept formulation with problem solving abilities, on a Twenty Questions task.
Key words: Aging, Problem solving, Twenty questions task, Frontal lobe |
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This Article |
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2018;2:5
Original Article |
Lestari E, Yuliyanti S.
Community Based Interprofessional Learning Promotes Equality of Participation among Health Professions Students. |
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Abstract: Background
The complex health issues require comprehensive health practice involving various professions. Inter-professional education employing various learning activities method has been proposed to improve the quality of collaboration and attitude toward other profession. This study aimed to explore students’ participation and social interaction within community based IPE, and finding out the result of community health problems that had been addressed by the group.
Method
A total of 78 final pre-clinical year students from medical, nursing, and midwifery were randomly divided into 15 interprofessional groups. Interprofessional education program employing surveys and discussion to solve community health problems was conducted. The information and result of community health problems that had been managed by the groups were collected from the groups’ report. Students’ discussion sessions were video-recorded and the conversations were verbatim transcribed. Content analysis was applied to evaluate students’ participation and social interaction dimension; included eternalization, elicitation, quick consensus building, integration oriented, conflict-oriented consensus building. Statistical analysis was applied to evaluate the data.
Results
There were various community health problems, which were identified and successfully managed by the students. There were no different number of participation, externalization, elicitation among the professions (p=0.104, p=0.871, p=0.557 and p=0.072 respectively) during discussion session. Externalization was the most produced statement for sharing knowledge. Equal production of eternalization implies that students gave equal contribution in constructing knowledge during the discussions.
Conclusion
Student interprofessional public healthcare teams were potential to solve complex community problems. Community based interprofessional learning promotes equal participation and equal contributions among learners from different health professional background.
Key words: Community health, Problem solving, Learning, Interprofessional Education, Interprofessional collaboration |
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This Article |
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2018;2:6
Original Article |
Balabaskaran S, Dongre AR.
Household Environmental Risk Factors for Fall in Older People (≥ 65 Years) in Rural Pondicherry. |
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Abstract: Background: Most households in rural India have potential environmental hazards for fall among older people. There is limited information available on magnitude of these factors in our context. Objective: To assess the potential environmental risk factors for fall in and around the rural households of older people. Methods: The cross sectional survey was done in 14 villages of Primary Health Care Centre (PHC) Thirubhuvanai, Pondicherry. Representative samples of 570 houses were observed for risk factors using pre-designed and pre-tested checklist, which was carried out by the trained post-graduates in Community Medicine. Environmental factors such as the type of house, presence of stairs without support, unstable furniture, adequate lighting arrangement, presence/use of latrine, supports in the toilet and bathroom were observed. Frequencies of variables were obtained by using SPSS (Version 24.0). Results: Out of 570 houses, 285(50%) houses were pucca and 340 (59.6%) houses had cemented floor. Unstable furniture was present in 203 (59.4%) houses. Among houses, the latrine was present in 333 (58.4%) houses, where toilet was in use 284 (85.2%) and 315 (94.3%) houses don’t have any support in their latrine. Bathroom was present in 338 (59.3%) houses and only 11 bathrooms (3.2%) had support. Majority of the houses had adequate lighting in living room and toilets; however, it was relatively low in the kitchen. Conclusion: Majority of households had potential environmental risk factors. Interventions at household level are required to minimize these risk factors. The results of this study indicate the need for environmental inspection and hazard reduction measures in their houses.
Key words: Fall, Older adults, Housing for the elderly, Risk factor, Lighting |
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This Article |
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2018;2:7
Original Article |
Rani NHA, Zin RRM, Samsudin AT, Aun CJ.
Lymphovascular Invasion is a Significant Prognostic Marker of Distant Metastasis in Breast Carcinoma. |
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Abstract: Lymphovascular invasion (LVI) is not incorporated in most staging systems although assessment of LVI is now part of the minimum data set for breast carcinoma pathology reporting. This study investigates the correlation between LVI with clinical staging, grading and prediction of patients’ survival in patients with invasive breast carcinoma. This was a retrospective study using data obtained from reviewing archival histological material and patients’ medical records at Queen Elizabeth Hospital, Sabah, Malaysia. Breast carcinoma samples from 117 female patients at all stages of disease were included in this study. Correlation was performed between LVI and staging, grading, lymph node (LN) status and patient’s clinical outcome after five years of diagnoses. LVI showed significant correlation with LN involvement and distant metastasis but no significant correlation between LVI and grading. LVI correlates with clinical staging and is a reliable predictor of outcome in patients with invasive breast carcinoma.
Key words: Invasive breast carcinoma, Lymphovascular invasion, Staging, Grading, Prognosis. |
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This Article |
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2018;2:8
Original Article |
Jathanna PNR, Dhamala JD.
Awareness and Utilization of Health Insurance Among Selected Population of State of Sikkim, India. |
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Abstract: On an average, 10% Indians are covered under different types of health insurance schemes, mostly inadequate. This low coverage might be because of lack of awareness about health insurance or might be because of lack of financial literacy. The aim of the present study was to investigate the awareness, and utilization of health insurance in the selected population of State of Sikkim.
A cross-sectional descriptive study was carried out in northeastern region (NER) of India, which is considered as one of the backward regions of the country. Sample unit was revisiting Central Referral Hospital Manipal, Gangtok Sikkim. The study was conducted among 1500 Out-patients revisiting the various outpatient departments of the hospital.
Finding was significant for awareness of health insurance; enrolment for the scheme; reason for non- enrolment. 49.9% of the non-enrollees were not aware of the health insurance schemes. 25.1% of the participants have utilized the services more than five times in a year.
An important finding of the current study is that education and economic class seldom influence peoples’ enrollment in health insurance schemes. The study supports this statement as 89.6% of literates were from non-enrollees group and 77.7% were from lower middle class and upper lower income groups. This indicates the need for financial education for people and their families to take up better financial investment decision and increase their health security. Enhancing the financial literacy and to create awareness and benefits of health insurance among the people of the selected region is important. It is suggested that the issues related financial literacy can be taken up by insurance companies or the organizers by conducting more and more awareness programs in identified regions of low and moderate enrolment across the country.
Key words: Health insurance, Awareness, Utilization, Financial education |
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This Article |
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2018;2:9
Original Article |
Covantev S, Mazuruc N, Belic O.
Renal Arteries: A Morphological and Angiographic Assessment. |
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Abstract: In comparison with other organs, variants of blood supply to the kidneys were always at special attention. In many respects, the relevance of the topic can be explained by the presence of a large number of surgical and non-surgical procedures performed on this organ, the number of which continues to grow. We therefore analyzed renal artery variations by the method of macroscopic anatomical dissection on 56 kidneys and retrospectively analyzed the data of 93 aortography performed using the Seldinger technique. In our study, one renal artery was encountered in 45 cases (80.34%) based on dissection method and in 156 cases (83.87%) based on angiography. Two renal arteries were found in 11 cases (19.64%) according to the dissection method and in 30 cases (16.13%) according to the data of the aortography. Bifurcation of the renal artery occurred in 5 cases (8.93%) and trifurcation – 2 cases (3.57%). Based on the angiography data bifurcation was detected in 16 cases (8.60%) and in trifurcation in 3 case (1.61%). Extrarenal division occurred in 10 cases (17.86%). Based on dissection method the superior polar arteries were recorded in 12 cases (21.43%). On angiographies, the superior polar arteries were encountered in 10 cases (5.38%) and inferior polar arteries – in 2 cases (1.08%). The data provided in the article can be used by specialists in urology, nephrology, vascular surgery, as well as in other therapeutic and surgical specialties.
Key words: Renal arteries, Accessory renal artery, Extrarenal division, Polar artery, Angiography. |
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This Article |
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2018;2:10
Original Article |
Ezeukwu AO, Orji EA, Okezue OC, Ezugwu UA.
Foot Anthropometric Measurement of Primary School Children With and Without Flatfoot: A Comparative Study. |
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Abstract: Objective: The study determined the prevalence of flatfoot and also compared the foot anthropometric variables of both flatfooted and non-flatfooted primary school Children. Subject and Method: The study utilized a descriptive cross-sectional research design and involved 1071(526 males and 545 females) public school pupils above six years. Foot anthropometry variables were obtained using measuring tape (foot length, ball girth, foot instep and heel circumference) and vernier caliper (forefoot width, mid-foot width and heel width). Flatfoot was diagnosed using Staheli Plantar Index, where values >1.15 indicates flatfoot. The prevalence of flatfoot was obtained using Chi-Square analysis, ANOVA was used to compare body anthropometry (weight, height and body mass index) with side of flatfoot (unilateral, bilateral and no flatfoot), while independent t-test was used to compare the foot anthropometric variables of children with flatfoot and those without flatfoot. Result: The prevalence of flatfoot was 14.75%. 64.3% of males and 71.6% of females have unilateral flatfoot while 30% of males and 41% of females have bilateral flatfoot. There was a significant association between higher prevalence of flatfoot and age with 6 and 7year old group showing the highest prevalence. There was a significant difference in foot length, forefoot width, heel width and heel Circumference on the right foot and significant difference in foot length and heel Circumference on the left foot between flatfoot and non-flatfoot children. Conclusion: Footwear manufacturers should consider anthropometric data of different foot types while manufacturing foot wears so as to minimizing foot pain, injuries and deformities.
Key words: Foot, Foot anthropometric variables, Children, Flatfoot. |
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2018;2:11
Case Report |
Nayal B, Singh VK, Sharma S, Archana S, Bhat R.
Primary Ampullary Adenosquamous Carcinoma: Report of Two Cases. |
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Abstract: Introduction: Adenosquamous carcinoma of the ampulla of Vater is a rare neoplasm with its clinicopathological profile limited to a few case reports. Here we report clinical profile, morphology and outcome of two cases of this rare entity. Case report: Case 1 was a 57 year old male who presented with features of obstructive jaundice; Case 2 was a 55 year old female with complaints of pain abdomen. Imaging studies suggested a pre-emptive diagnosis if periampullary malignancy for which both patients underwent Whipple’s pancreaticoduodenectomy. Histopathological examination revealed an ampullary malignancy with variable proportions of adenocarcinoma and squamous cell carcinoma. Case 2 also showed concurrent region lymph node metastasis. Case 1was alive at 15months follow up with no recurrence/metastasis while case 2 survived for only 10 days post surgery. Conclusion: Adenosquamous carcinoma occurring at the ampulla of Vater is a rare event with less than 15 cases documented in the English literature so far. It is an aggressive tumour and is associated with a dismal prognosis. Here we add two more cases to the literature for better understanding of the clinicopathological profile, prognostic indicators and clinical outcome of this rare neoplasm.
Key words: Adenosquamous carcinoma, Ampullar of Vater, Pancreaticoduodenectomy, Periampullay malignancy, Perineural invasion |
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2018;2:12
Case Report |
Chandra S, Chandra H, Verma SK.
Multiple Myeloma Following Primary Solid Carcinoma Post Therapy: Report of Two Cases. |
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Abstract: Secondary malignancies following treatment of primary carcinomas have been reported in the literature and serious debate has emerged regarding the risk of secondary malignancies post therapy along with risk associated with different regimens. (chemotherapy / radiotherapy). The present report describes two cases of multiple myeloma following carcinoma cervix and intraductal carcinoma breast post therapy after three and fifteen years respectively and thus highlights the risk of multiple myeloma associated with different regimens of treatment of solid carcinomas. It also lays the importance of balance between the benefits of therapy of carcinoma and the risk of treatment associated multiple myeloma. The cases specify the need of vigilant follow up of any primary carcinoma, irrespective of time, in the light of early detection of secondary malignancy.
Key words: Multiple myeloma, Carcinoma cervix, Ductal carcinoma breast, Post-therapy |
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