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Volume-21 (2022);
No. 2 (April-June)
Published on July 30, 2022
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2022;1:1
Original Article |
Chinnaiyan S, Palanisamy B, Dharmaraj A.
Association Between Social Determinants and Dietary Diversity Among Indian Tribal Children- Insights from NFHS-4. |
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Abstract: Background: Early childhood nutrition is an important stage in human development characterized by rapid cognitive development. The study aimed to determine the consumption of food patterns and dietary diversity among indigenous children according to socioeconomic status.
Subjects/Methods:
We used cross-sectional data from the National Family Health Survey (NFHS-4, 2015–16). Our study included 13,963 tribal children aged six to twenty-three months. A 24-hour dietary recall questionnaire was used to collect data from the mother on 21 foods, 7 food categories, and an ADDI was calculated. The relationship between household wealth, maternal education, food consumption, and ADDI was studied using multivariate regression models. The study used two models. MODEL 1: Adjusted for sex, birth order, religion, children's age, mother education, house type, and family type. Model 2: only for sex and age. Results:
The median (IQR) age of the 13963 children was 14 (10-19) months, with a female/male ratio of 1:1.06. Overall, the mean score for dietary diversity was low (2.47, 95% [CI] 2.44–2.49), and the prevalence of ADDI was only 26.9 percent. In model 1, higher-income households were shown to be as likely to consume dairy products. (aOR 2.20; 95% CI 1.90-2.54) and eggs (aOR 1.28; 95% CI 1.06-1.55) than those from poor households. Higher educated mothers were more likely to consume dairy products (aOR 1.52; 95 percent CI 1.26-1.83), eggs (aOR 1.32; 95 percent CI 1.02-1.69), and other fruits and fresh vegetables (aOR 1.32; 95 percent CI 1.04-1.67) compared to mothers with no education. Conclusion: The diverse dietary consumption of Indian tribal children was inadequate. Efforts should be taken to improve their nutritional status through nutrition education and nutrient sensitive farming, including kitchen gardens.
Key words: Dietary pattern; Tribal Children; Malnutrition; ADDI. |
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2022;2:2
Review |
Mhamane S, Ramanathan V.
Addressing the Social Determinants of Childhood Malnutrition: A Review. |
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Abstract: Social determinants of malnutrition play a significant role in dictating the course of malnutrition outcomes in any population. Sustained efforts to optimize these determinants are indispensable to sustainable changes in the status of nutrition of the affected population. Despite the efforts undertaken, such a high prevalence of child malnutrition in India defies logic. Multiple causes of child mortality exist. Malnutrition accounts for 69% of these under-five deaths in India losing up to US$3.5 trillion loss per year, globally. Understanding the social determinants of malnutrition and its impact on child health is crucial to formulate sound and equity-based policies and interventions yielding fruitful outcomes. The situation has further worsened due to the COVID 19 pandemic. The paper emphasizes gaining cognizance of the grim and longstanding issues of malnutrition, its social determinants, and existing interventions to curb the issue.
Key words: Social determinants, Malnutrition, Child Health, Child Nutrition |
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2022;2:3
Original Article |
Malik D, Gupta ED, Kant R, Juneja NS.
A School-based Health Awareness Program MISSION SHAKTTI, with an Assessment of Health Literacy Among School Children of Delhi: A Qualitative Study. |
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Abstract: Background: Worldwide, more than 1.2 billion population is adolescents. Nutrition, physical activity, psychological health, and sanitations are few areas that affect adolescents, making them more vulnerable to diseases and contributing in disease burden. The present study was part of the Indian Council of Medical Research’s (ICMR) school based health program Mission SHAKTTI which focused, and reported on adolescents’ awareness and health literacy about nutrition, physical activity, and sanitation in Delhi. Methods: A cross-sectional qualitative study was conducted with students (aged 11-19 years), and the Mission SHAKTTI program was devised using the pillars of Gandhi’s teachings for good health. Data were collected using a pre-tested open ended questionnaire (n=1796). For data analysis, deductive approach was adopted, and thematic content analysis was done with 95% confidence intervals (CI). Results: The study showed that students were somewhat aware of various health-related issues pertaining to Mahatma Gandhi’s ideology of health, with 49.5% (CI: 46.72-51.39) reported that Gandhiji’s mantra for staying healthy was simply a clean environment and proper sanitation. A gap between their understanding and perceptions of a balanced diet was observed, since many felt that merely eating enough food could labelled as balanced diet (36.46%; CI: 34.24-38.74). Conclusions: Findings may be useful in developing a suitable health-based educational program to inculcate knowledge about healthy practices among school-aged children through Gandhian health ideology. This may also help in forging a stronger and more aware foundation of nation leading to prevention of numerous diseases in the near future.
Key words: Adolescent health, health literacy, mission SHAKTTI, non-communicable diseases, qualitative research. |
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2022;2:4
Original Article |
Alharbi MF, Nair KS.
Healthcare Financing in Saudi Arabia: Recent Trend and Future Challenges. |
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Abstract: This paper provides an overview of the present healthcare financing system in the Kingdom of Saudi Arabia (KSA) and identify critical issues and challenges that need to be addressed in achieving healthcare system financing goals envisioned under the Saudi Vision-2030. This paper employed a descriptive framework based on literature review, documentation analysis, and secondary data on healthcare financing in the KSA collected from various reports. The study shows that the overall health expenditure as a percentage of Gross Domestic Product has increased from 4.4% (2001) to 6.4% (2018). The per capita expenditure on healthcare was US dollar (US$) 1484.6 in 2018, out of which the government's share was US$ 926.95. After the introduction of mandatory employer-based health insurance, the percentage of public funding on healthcare has slowly declined from 75.2% (2001) to 62.4% (2018), and out-of-pocket spending on healthcare reduced from 18.46% (2000) to 14.37% in 2018. The health financing system in the KSA faces several challenges, including health insurance coverage, access to care, equity, and quality of care.
Key words: Healthcare Financing, Vision-2030, Health Insurance, Out-of-pocket Payment |
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2022;2:5
Original Article |
Vicerra PMM.
Regional Disparity of Physical Function Limitation Among Older Adults in Thailand. |
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Abstract: Thailand was among the first to introduce a universal healthcare coverage among low- and middle-income countries but, regional disparities remain in the health status of people. Using the 2016 Population Change and Well-being in the Context of Ageing Societies, a nationally-representative survey, the prevalence of having limitations in physical function activities, instrumental activities of daily living, or activities of daily living were identified to estimate how each was associated with region of residence, sociodemographic and health behaviour and conditions. It was observed that living in Bangkok was associated with having limitations in any form than the other four regions of the country where generally the socioeconomic status of its older population is lower. Although higher prevalence of functional status was consistently observed in Bangkok, older people in the rural areas have a disadvantage in healthcare because of lower socioeconomic capacity and less access to healthcare facilities.
Key words: Regional differences, Functional status, Older population; Ageing in Thailand |
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2022;2:6
Review |
Ali S, Bhargava D, Bansal P, Hasti A, Choudhary A, Singh S.
Oral Microbiome and Adverse Pregnancy Outcomes: An Update. |
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Abstract: From last decade of the 20th century, numerous epidemiological studies and intervention trials have attempted to prove the relationships between maternal oral diseases and adverse pregnancy outcomes (APO). Several physiological, immunological and hormonal changes occurring during pregnancy ensures the woman’s body maintenance throughout the gestational period and the development of foetus. Studies have reported changes in the maternal microbiome in the gut, vagina, and oral cavity during pregnancy. Infections at the foetomaternal interface are known to upregulate the production of local proinflammatory cytokines, metalloproteinases and prostaglandins leading to membrane weakening, early rupture of membranes and uterine contractions. A clear understanding of the association between oral microorganisms and adverse birth outcomes conveys significant health implications. In this paper we reviewed the current literature regarding the link between oral microbiome and adverse pregnancy outcomes including preterm birth, chorioamnionitis, neonatal sepsis, stillbirth, and preeclampsia.
Key words: Microbiome, Oral pathogens, Pregnancy, Periodontal disease, Premature, Pre-eclampsia |
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2022;2:7
Original Article |
Jairajpuri ZS, Sehgal S, Khetrapal S, Jetley S, Rana S.
Evaluation of Causes and Rate of Wastage of Blood and its Components – An Important Quality Indicator in Blood Banks. |
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Abstract: Background:
The evaluation of wastage of blood products represents an important element in the appropriate use of blood components, a critical control point in the system of blood administration. Discarding or wastage of blood can be attributed to several reasons namely time expiry, wasted import, non-usage of ordered blood, broken bags and seal with leakage, hemolytic reasons, clotted blood, returned after 30 min, and miscellaneous others.Wasting of blood and blood components are an inefficient use of resources and may be avoided. The present study was undertaken with aim of primarily to determine the frequency of blood products wasting and secondarily to determine the factors that affect blood products wastage at our institute.
Methods:
The present study is a retrospective cross sectional descriptive study conducted in a tertiary teaching hospital located in South Delhi catering to low socioeconomic population. Blood component wastage was defined as components that did not meet the required standards of hospitals or fractionation centres during collection, processing and storage. The main reasons included expiry date, inappropriate volume, haemolysis of red blood cells (RBCs), contamination of plasma or platelets with RBCs, blood bag leakage, reactive infectious disease tests and inappropriate temperature during storage or transportation. The required data from clinical units and blood bank were collected and analyzed for a period of 7 years.
Results:
A total of 13728 blood units were received during the specified period. Overall wasted factor was of 18.5% with maximum wastage of platelet concentrate units (53.7%). Analyzing the causes of blood and blood product wastage in the hospital for this study showed that blood and blood product wastage were associated with many causes of which the common causes, included the expiration of the usability period (69.2%), sero-reactivity for infectious diseases (13.7%) and Quality Control units (9.2%). Conclusion:
Blood is an irreplaceable precious resource which needs to be properly utilized with minimal wastage. Although present study was limited due to its retrospective nature but it still outlines the importance to emphasize that measures should be taken into account for formulating guidelines, effective policies, and training efforts for personnel.
Key words: Wastage, Blood, Blood Components, Quality Indicator, Blood bank |
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This Article |
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2022;2:8
Original Article |
Ghasempouri SK, Turi H, Hosseininejad SM, Abbasi A, Khosravi N, Memarian A.
Epidemiological Study of Deaths due to Carbon Monoxide Poisoning Referred to Forensic Medicine in Mazandaran, Iran. |
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Abstract: Background: Carbon monoxide (CO) poisoning is the leading cause of death as a result of poisoning. Objective: This study aimed to investigate the epidemiology and prevalence of CO poisoning in Mazandaran province from 2016 to 2018. Methods: This is a descriptive-analytical and retrospective study on the information obtained from the files of the deceased individuals who died because of CO poisoning in the forensic medicine department of Mazandaran province during the years 2016 to 2018. Results: In this study, 83 deaths due to CO poisoning were recorded. 32.5% of these people were over 50 years old, 81.9% of them were men, and 61.4% of them were married. The level of education in 92.8% of them was reported to be less than a bachelor's degree and the bedroom (66.3%) was the main place of poisoning. 56.6% of these poisonings were due to city gas poisoning and 56.6% of deaths were reported as groups death. The bruises color was rosette in 53% of the deaths. The Carboxyhemoglobin levels in most of them were +2 (63.9%) and most deaths occurred in January (19.3%). The age group, source of CO, place of poisoning, carboxyhemoglobin level, education level, and the month of poisoning was significantly different among these three years. Conclusion: CO poisoning is still a substantial public health issue. City gas is defined as the main source of CO poisoning. Low educational level was related to CO deaths. Raising the awareness of the people can reduce the number of Co poisoning cases in the Mazandaran.
Key words: Carbon monoxide, Poisoning, Death, Epidemiology |
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2022;2:9
Original Article |
Sanghvi PB, Mehrotra S, Sharma MK.
Barriers and Enablers of Professional Help-Seeking for Common Mental Health Concerns: Perspectives of Distressed Non-Treatment Seeking Young Adults. |
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Abstract: Despite a high prevalence of common mental health concerns, especially among young adults, majority of them do not seek professional help. This study explored perceived barriers and enablers of professional help-seeking for common mental health concerns among distressed non-treatment seeking young adults in the urban Indian context. The study utilized an explanatory sequential mixed methods design. A brief survey was conducted with distressed non-treatment seeking young adults (N=37) to assess their current distress level, duration, perceived severity, effect on functioning, self-help methods, past treatment history, inclination to seek help and barriers to professional help-seeking. Semi-structured interviews were conducted with a sub-sample of 10 participants to explore their perceived barriers and potential enablers of professional help-seeking. Quantitative data were analyzed using descriptive statistics and interviews using thematic analysis. The survey revealed significant distress for 75.7% (N=28) of the total sample. Out of these, 25% were either not inclined or had practical constraints to seek help. The mean score for inclination to seek help was highest for partner/friend (4.7). Qualitative findings have been discussed under personal and general barriers and enablers. This is the first study to highlight the complex interplay of barriers and enablers of professional help-seeking among distressed non-treatment seeking young adults in the urban Indian context. There is an urgent need to incorporate the factors that hinder and facilitate professional help-seeking while devising help-seeking interventions to reduce the treatment gap.
Key words: Help-seeking, barriers, enablers, young adults, distressed non-treatment seekers, mental health |
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2022;2:10
Original Article |
Sehgal S, Khan S, Jetley S, Alvi Y.
Evaluation of Abnormal Hemoglobin Variants and Hemoglobinopathies on D-10 analyzer – An Institutional Experience from North India. |
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Abstract: Background:
High performance liquid chromatography (HPLC) is the most commonly used method for detection and quantitative estimation of hemoglobin variants. Hemoglobinopathies are amongst the most common genetically inherited disorders, however, the exact magnitude of different hemoglobinopathies is obscure in India. This study was done with the aim of analyzing the different findings in HPLC using D-10 analyzer and evaluating the spectrum of different hemoglobin disorders in a hospital-based population of South Delhi. Such a prevalence study would be useful to review the various strategies that can be implemented for effective control and prevention of these disorders.
Methods:
A hospital based descriptive observational study was conducted in which all OPD and IPD patients who were advised HPLC during their clinical workup were included. Analysis of EDTA blood samples was done by Bio Rad D10 Dual program HPLC instrument. The exact percentage of HbA, HbA2, HbF and any other variant hemoglobin was estimated. Presumptive identification of hemoglobin variants was made primarily by their percentage, retention time (RT) and peak characteristics. HPLC findings were correlated with the clinical history, family history and the CBC and peripheral smear findings in all cases. Results:
On HPLC analysis, 79% of the patients had no abnormality detected and the report was within normal limits. The commonest hemoglobinopathy was Beta Thalassemia Trait followed by HbE trait. The other hemoglobinopathies detected were HbD Punjab Heterozygous (3 cases, 0.5%), Beta thalassemia homozygous (3 cases, 0.5%), Sickle cell Heterozygous (2 cases, 0.3%), HbJ Meerut Heterozygous (2 cases, 0.3%). One case each of Sickle cell Homozygous (0.15%), Compound Heterozygous HbS/beta thalassemia trait (0.15%), HbE Homozygous (0.15%), Compound Heterozygous HbE/beta thalassemia trait (0.15%), and Homozygous delta beta thalassemia (0.15%) were also diagnosed.
Conclusion:
This study gives an important insight to the present day scenario of hemoglobinopathies in patients in South Delhi in relation to the hematological profile. It highlights the chromatogram findings of different hemoglobinopathies on the D10 analyzer. The comprehensive data obtained by such series can help in the formulation and development of infrastructure and policies for hemoglobinopathy prevention, diagnosis and management.
Key words: Hemoglobin variant, Hemoglobinopathy, D-10 analyzer, North India |
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2022;2:11
Original Article |
Narayan N, Satish KS, Subeesh V, Swaroop AM, Praveen GVS.
Assessment of Vaccination Status Among Pediatrics in a Tertiary Care Setting. |
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Abstract: Purpose: Vaccination is one of the best cost-effective methods for preventing childhood morbidity and mortality. The objective of this study was to identify children with missed and delayed vaccinations along with factors associated with incomplete vaccinations. Methodology: A prospective observational study was conducted for 7 months. Relevant data was collected through a face-to-face interview and immunization status was evaluated based on their vaccination card which was compared against UIP. Result: Out of 347 subjects, 93.94% of them were completely immunized and majority of the missed vaccines were measles 1st dose (58.82%), Japanese Encephalitis vaccine 1st dose (29.41%). Lack of access to health care, less contact of adolescents to physicians, missed opportunities for vaccination, resistance towards immunization and poor birth weight were the reasons identified for incomplete vaccination. Conclusion: Immunization is one of the biggest health accomplishments saving millions of lives. Our study concluded that most of the participants were completely immunized indicating a positive attitude towards immunization. However, further exploration is required to assess and improve the vaccination coverage among rural population.
Key words: Vaccination, Immunization, Universal Immunization Program, Care-taker |
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2022;2:12
Original Article |
Ominde BS, Enakpoya P, Ogheneyoma E, Igbigbi PS.
Retrospective Study on the Radiographic Wrist Indices in a Nigerian Population. |
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Abstract: Background: Evaluation of the degree of carpal collapse using radiographic wrist indices is important in the management of wrist diseases. These indices vary in different population groups, hence, the need for population-specific normal references. This study aimed at assessing the carpal height ratio using wrist radiographs of adult Nigerian patients.Materials and Methods: This retrospective study assessed wrist radiographs stored in the Radiology department of Delta State University Teaching Hospital, Oghara, Nigeria, following institutional approval. Apparently normal unpaired wrist radiographs of 135 adults (54 males and 81 females) were used to assess the 3rd metacarpal length, carpal height and capitate length which were used to calculate the carpal height ratio (CHR) and revised carpal height ratio (CHRr). Statistical Package for Social Sciences (SPSS) version 22 was used to analyze these quantitative variables. Independent t-test and Analysis of Variance (ANOVA) were used to probe for differences in gender groups and 10 years' age-groups respectively. Significance was considered at p<0.05. Results: The mean carpal height, capitate length and length of the 3rd metacarpal was 31.77 mm, 23.34 mm and 67.34 mm respectively. The mean CHR and CHRr was 0.47±0.04 and 1.36±0.07 correspondingly. All variables except CHRr were significantly larger in males than in females (p<0.05). All the parameters had no significant association with the age-groups (p>0.05). Conclusion: The CHR and CHRr in this study were lower than reports from other population groups. This study provides a reference database for our studied population to aid in accurate diagnosis and effective management of carpal collapse.
Key words: Carpal height, carpal collapse, radiograph, wrist |
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2022;2:13
Original Article |
Sreedevi PA, Joshi S, Mohan SS.
Eating Behaviour and Body Mass Index of Patients with Severe Mental Illness Attending a Tertiary Hospital, Kochi, Kerala. |
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Abstract: Background: Persons with severe mental illness are at increased risk of overweight and obesity both from the illness itself and from its treatment. Purpose: This study aimed to examine the eating behaviour and Body Mass Index (BMI) of patients with severe mental illness and to correlate these two variables. Methods: This descriptive cross sectional study was conducted at the psychiatry outpatient department of a tertiary hospital, Kochi, among 100 patients with severe mental illness who reported for follow up. Patients were interviewed individually after ethical procedures, using Personal information schedule and Three Factor Eating Questionnaire Revised-18, a standardized measure of eating behaviours. Anthropometric measurements were taken and BMI was calculated as per the WHO guideline for Asians. Results: The mean age and BMI of the sample were 49.5± 15.24 and 26.08 ± 4.79 kg/m2 respectively. Cognitive restraint was found to be the most frequently used eating behaviour (48%). Only 39% of the subjects had normal body weight. Overweight and obesity were observed in 39% and 19% respectively. BMI was positively correlated with uncontrolled eating (r=0.244, p<0.015), emotional eating (r=0.223, p<0.026) and eating behavior total score (r=0.293, p<0.003). Uncontrolled eating was high in patients who are non-vegetarian, taking thyroid medications and who reported parental obesity (p<0.05). Stepwise linear regressions revealed parental obesity as the most significant predictor of BMI (F=4.198, p<0.002). Conclusion: The chronic mentally ill require counseling and education about the role of eating behaviours in overweight and obesity and the ways of reducing body weight.
Key words: Body Mass Index (BMI), Overweight, Obesity, Eating behavior, Severe mental illness |
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2022;2:14
Original Article |
Roy A, Jahan F.
Autism Spectrum Disorder Categories and Social Responsiveness among Adults with Autism Spectrum Disorder. |
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Abstract: Introduction: Autism spectrum disorder (ASD), refers to a broad range of conditions characterized by challenges with social skills, repetitive behaviors, speech and nonverbal communication. Individuals with autism spectrum disorder usually have problems with social responsiveness which in turns effects their social communication and results in confined repetitive pattern of behaviour and interests. However the existing literature is limited in demonstrating the importance of social responsiveness and its impact on gender and ASD categories. Objective: The purpose of this study was to determine the impact of ASD categories on social responsiveness in adults with ASD and investigate social responsiveness among male and female adults with ASD. Methodology: The study utilized data from 60 adults diagnosed with autism spectrum disorder with categories mainly, mild, moderate and high functioning. Adults of both genders (male and female) participated in this study with Social Responsiveness (SR) as a variable over 7 months from October 2021 to February 2022, using the Social Responsiveness Scale-2 (SRS-2 Adult Relative/Other online form). Results and Conclusion: One-way ANOVA test showed significant difference (p<0.001, df=2) between ASD categories. Tukey's Post Hoc Analysis revealed significant (p<0.001) difference between ASD categories from each other. Gender had no significant impact on ASD, and the severity of ASD varies between groups. Thus, this study fills a large knowledge gap on the influence of gender, categories and social responsiveness on adults with ASD.
Key words: Social Responsiveness, Adults, Autism spectrum disorder, gender |
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2022;2:15
Original Article |
Biswas R, Nayak MG, Latha T.
Assess Life Skills, Self-Esteem, and Self-Reported Lifestyle Practices Among Adolescents: A Descriptive Correlational Study. |
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Abstract: Background: Life skills are essentially those abilities that help to promote mental wellbeing and competence in adolescents as they face the realities of life. Life skills education is to educate the young people in schools and beyond to develop an organized, acceptable, and beneficial lifestyle. Objectives: The current study aimed to assess life skills, self-esteem, and self-reported practices among adolescents in Kolkata and to find out the correlation between life skills and self-esteem. Methods: Descriptive study was conducted from January to March 2020 among 422 adolescents between the age group 13 years to less than 18 years from three selected schools under Bidhannagar Municipal Corporation, Kolkata, using the multistage cluster sampling technique. The data were collected by self-reporting questionnaire and analyzed using SPSS software (version 20.0). Results: Most of the adolescents had low life skills (52.4%) and average self-esteem (64%). About self-reported lifestyle practices among adolescents that they do physical exercises daily in the form of walking (52.6%), cycling (52.1%), swimming (21.8%), and yoga (17.8%). Most of the adolescents responded that they spend leisure time listening to music (43.4%), watching television (43.1%), drawing (36.3%), reading (40.5%), surfing mobile (46.7%), 51.9% of adolescents had smartphones, and that they are using for academic purpose (55.7%), playing games (35.5%), entertainment (19.9%), and to read the news (19.2%). Only 5.2% of adolescents were using substances (tobacco). Conclusion: There is a need for ongoing life skills training program for adolescents in school to increase their self-esteem which helps them to face the challenges of changing life situations.
Key words: Life skills, self-esteem, lifestyle practices, adolescents |
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2022;2:16
Case Report |
Nayak SB, Soumya KV.
A Rare Variation in the Course of C5 Root of Brachial Plexus. |
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Abstract: Variations in the formation of the upper trunk of the brachial plexus are relatively rare. Knowledge of its possible variation is useful to orthopedic surgeons dealing with the problems of cervical spine, anesthesiologists performing brachial plexus blocks and general surgeons performing lower neck surgeries. In this report, we present a variation in the formation of the upper trunk of the brachial plexus. The upper trunk was formed by the union of ventral rami of fifth and sixth cervical spinal nerves. The fifth cervical ventral ramus passed ventral to the scalanus anterior muscle, while the sixth cervical ventral ramus passed between the scalanus anterior and medius muscles. The upper trunk was formed at the lateral border of the scalenus anterior muscle.
Key words: Brachial plexus, upper trunk, scalenus anterior, variation, Erb’s point |
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