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Volume-21 (2022);
No. 3 (July-September)
Published on November 15, 2022
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2022;3:1
Original Article |
Chakrabarty S.
Regional Differences of Child Undernutrition in India: The Reflection of Composite Index of Anthropometric Failure (CIAF) from CNNS-2016-18 Data. |
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Abstract: Background: The Composite Index of Anthropometric Failure (CIAF) has its multifaceted application in understanding child undernutrition. The nationwide data of Community National Nutrition Survey (CNNS) 2016-18 in India has unfolded this opportunity to re-examine the use of CIAF and its determinants. One recent study showed significant differences in child undernutrition between rich and poor wealth index households using this CNNS -16-18 data. But, the study did not consider regional as well as state-wise CIAF variation. However, it is a fact that regional understanding of child undernutrition is equally vital for national and regional health and nutritional planning, specifically in India. Therefore, the present study aims to understand the geographical region and state-wise distribution of CIAF and determine some selected determinants of CIAF. Methods: The study used secondary data set from the Community National Nutrition Survey (CNNS), India undertaken in 2016-18. The study sample comprised of 32941 children aged 0-59 months. The multivariate logistic regression models were used to explore the determinants of CIAF. Results: The results revealed that nearly half of the under-five children suffered from undernutrition (CIAF-46.71%). The final adjusted multivariate regression models showed that the higher CIAF prevalence was mainly confined in the central region states like Madhya Pradesh (56.0%) and Uttar Pradesh (52.0%). Besides, the Jharkhand state in the eastern region showed the highest percentage of CIAF (57.0%). The prevalence of child undernutrition was more elevated in poor economic households and Muslim households. Children in the age group ≥12 months, boys, who did not consume milk other than breast milk and lived in rural areas, had a higher prevalence of undernutrition. In the case of mother characteristics, mother's age at birth < 20 years, mother never attended school and mother did not watch television had a higher number of undernourished children. Despite several significant determinants associated with child undernutrition, the considerable impact of the region was consistent throughout the statistical models. Conclusion: Therefore, the vulnerable geographical regions and states in terms of child undernutrition should prioritise nutrition-sensitive interventions in India and consider the involvement of other key risk factors.
Key words: India, Children, Undernutrition, CIAF, State, Region |
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2022;3:2
Original Articlce |
Mishra HK, Sahu R, Ratnawali.
Growth and Nutritional Status of Kandra (Fisherman) Adolescent Girls from Ganjam, Odisha, India. |
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Abstract: Introduction: The National Family Health Survey-4 data from Odisha shows, adolescent growth spurt and nutritional level needs to be studied comprehensively for designing appropriate policies. Kandra community of Odisha is a Schedule Caste (SC) community with low socio-economic status. No study has been done on growth spurt of girls from this community. Hence, the paper examined growth and nutritional trend and test for significant difference on height, weight, and Body Mass Index (BMI). Methodology: Cross-sectional study with 78 sample were collected from one Gram Panchayat of Ganjam district, India. Somatometric measurements i.e., height, weight, chest, and calf circumference were collected from school-going adolescent, randomly. Mean difference between early and middle adolescent were seen through Levene's Test for equality of variances and independent sample-t-test. Result: Findings say, adolescent growth spurt was highest at age 13-14 years. The overall median height and weight were reported less than Indian and National Center for Health Statistics (NCHS) standards. The difference between 12-13 years and 14-16 years were significant at p<.001 for BMI. Conclusion: Findings were like the gaps reported in NFHS-4 nutritional indictors and is a concern as the girls are going to be future mother, and deficiency may pull their life into risk.
Key words: Adolescent-growth, Growth spurt, BMI, Undernutrition, Somatometric |
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2022;3:3
Original Article |
Mukherjee K.
Healthcare Innovation Lifecycle and Policy Ecosystem: Insights from India. |
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Abstract: Purpose: Healthcare innovations are one of the drivers of healthcare sector growth in India. Innovation policies are challenging because of the uncertainty regarding the outcome of the innovations. Hence, there is a need to understand the interface between policies and healthcare innovations to identify gaps and propose timely recommendations. Acoordingly, this study uses the Indian healthcare startup sector as a case study to analyse the above linkages, gaps and propose recommendations. Methodology: Quantitative data from the startup India portal along with qualitative data from key informant interviews have been analysed to draw insights. Findings: Healthcare startups have made significant contributions to the economy and healthcare sector, but there are gaps and room for improvement especially in the areas of awareness, funding and mentoring. Conclusions: Based on the study findings a conceptual framework has been created for understanding the nature of gaps and their linkages in the healthcare innovation lifecycle.
Key words: Healthcare Startup, Innovation, Entrepreneurship, Health Technology, Emerging market economy, COVID-19 |
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This Article |
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2022;3:4
Original Article |
Aishwarya TR, Naveen Kumar P.
Relative Risk Analysis of Patient Return Within 72 Hours to Emergency Department. |
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Abstract: Introduction: Transparency in patient care in an emergency department can be projected by capturing data from the medical records of patients. Policy makers envision that transparency in this data will allow the patient to choose the right hospital of his choice. Relative risk is a ratio of the probability of an event occurring in the exposed group versus the probability of the event occurring in the non-exposed group. It is usually used in the scenario of clinical events. In this study we have used it to analyse one of the key performance indicators used in Emergency Department, as per Emerald standards. The problem statement identified in the study is the returning of patients to the Emergency department of a private, tertiary care hospital within 72 hours after the initial visit. A revisit in this study is assumed as an unplanned visit done by the patient within 72 hours with similar presenting complaints. Methodology: A retrospective cohort study for all emergency visits between January to June 2021. People who returned to EMD within 72 hours were compared to other non-re attending patients based on medical diagnosis, patient demographics, mode of arrival, triage category and qualification of doctors in charge. Multivariate analysis using the generalized linear model was conducted on variables associated with 72-hour ED re-attendance. Result: Among 18,355 patients, 128 (0.69%) were in the 72-hour re-attendees’ group. Multivariate analysis showed female gender as more, above 60 years of age, arrival by ambulance, triaged as yellow. Among the ICD-10 diagnosis for the patients who returned, it was not possible to identify one specific condition. But abdominal pain was one reason for the re-visit of a few patients. There was also a significant difference in the seniority ranking of the doctor-in-charge between both groups. Conclusion: Identification of characteristics of patients lead to improved care by surgeons and gastroenterology.
Key words: Returning patients, emergency medicine, re attendees, Abdominal pain, Gastroenterology, ICD-10 |
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2022;3:5
Original Article |
Dutta U, Teotia A.
Gratitude, Life Satisfaction And Forgiveness Among Acid Attack Victims: Rehabilitation Through Three Good Things Intervention. |
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Abstract: Violence against women is mostly done to show the dominance of the males over the females. Among the various forms of violence, acid attack has been a least researched area. The victims of acid attack are left with scars that they have to carry with them forever, and this leads them to unending trauma and physical pain. In this study, pre-assessment scores were taken from 25 acid attack survivors on the scales of gratitude, life satisfaction and forgiveness. An intervention was carried out with them, where they were asked to keep a daily-dairy, noting down 3-good things that happened to them during the day. After the 14th day, post-assessment scores were taken. Results showed that there was significant correlation between gratitude, life satisfaction and forgiveness in the post-assessment scores. There was also significant increase in the mean score of all the variables. These findings provide evidence for showing that gratitude intervention is effective in increasing the gratefulness, life satisfaction and forgiveness among the acid attack victims, despite their trauma and pain. This study involved a small, difficult-to-reach and often ignored sample. Moreover, implications for the effective use of this intervention with trauma survivors have been discussed.
Key words: Acid Attack, gratitude, life satisfaction, forgiveness. |
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This Article |
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2022;3:6
Original Article |
Balambigai N, Kanagamuthu P, Lancy S, Rifa.
Use of Personal Listening Devices Among College Students in India During the COVID-19 Pandemic. |
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Abstract: Objective: The objective of the study was to understand the college students' knowledge practices, and preferences regarding the use of Personal Listening Devices (PLDs) during the Covid-19 pandemic. Method: An online questionnaire consisting of 21 closed set questions was completed by 894 college students from varied specialities in India. Results: The majority of the participants were attending online classes using their mobile phones with the supplied wired earbuds. And the majority reported using PLDs for 1-4 hours/day for online classes and for less than 2 hours/day for leisure. Most participants listened at moderate to loud volume levels and used it continuously for 3 hours or more per day, and some used it in a noisy environment. The participants were aware that listening at loud levels and for long-duration could be damaging. Conclusion: The students require professional guidance on hearing health, in order to prevent hearing difficulties and develop a cautious attitude towards hearing conservation.
Key words: Personal Listening Devices, College Students, Covid-19, Online Education, Hearing loss |
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2022;3:7
Original Article |
Alvi Y, Sameen S, Khalique N.
HIV/AIDS and Depression: When Two Conditions Coincide – Prevalence and Associated Factors. |
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Abstract: Introduction: Depression is the most common mental illness among people living with HIV/AIDS (PLHA). While depression is common among other chronic illnesses, it is expected to be more with HIV/AIDS, which is a more stressful state. Thus, in this study, we tried to estimate the prevalence of depression along with its associated factors in people with HIV/AIDS. Method: This cross-sectional study was done at one ART Centre in North India. Over a period of one year, HIV/AIDS patients taking antiretroviral therapy were interviewed, estimating depression with PHQ-9. Using multivariate logistic regression, we examined the association of various factors with depression among HIV patients. Results: We observed that 16% of PLHA suffered from depression, while 3% had moderate and moderately severe depression. Among the factors associated with depression, we found alcohol consumption [OR 2.553; 95%CI 1.180 - 5.526], lower CD4 cell counts [OR 2.630; 95%CI 1.297 - 5.330], side effects from ART [OR 2.442; 95%CI 1.302 - 4.577], unsatisfaction from family support [OR 2.683; 95%CI 1.334 - 5.394] and no improvement from ART [OR 0.412; 95%CI 0.190 - 0.896] to be individually and significantly associated. Conclusion: Higher prevalence of depression among HIV/AIDS patients and its association with various factors should worry policymakers, prompting them to take necessary action.
Key words: Depression, PLHA, HIV/AIDS, Antiretroviral therapy |
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This Article |
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2022;3:8
Original Article |
Raj S, Jetley S, Jairajpuri ZS.
Cytomorphometry in Oral Lesions - An Objective Approach to Cytological Diagnosis. |
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Abstract: Objectives:
The present study focusses on cytomorphological evaluation of the scrapings and cytological appearance of a spectrum of lesions of the oral cavity, Morphometric nuclear and cytoplasmic parameters were used to distinguish between benign, premalignant and malignant lesions. Material and Methods: The samples were obtained by scraping the lesion firmly till tiny pin point bleeding points were seen to ensure adequate sampling. Adequate sampling was defined as 50 cells consisting of transepithelial cytology specimen (superficial, intermediate and basal cells). Results: A total of 80 patients were evaluated with predominance in males and mean age of presentation was 45.05± 12.8 years. Cytomorphomteric analysis revealed an increasing trend in nuclear parameters as the spectrum of oral lesion moved from benign to malignant category while a decline was observed in cellular parameters. A significant p value of <0.0001 was found between cytomorphometrical parameters and histopathological subtypes. Sensitivity and specificity of conventional exfoliative cytology in conjunction with cytomorphometry was 100% and 94.74% respectively. Negative predictive value and positive predictive value of cytology for malignant lesions was 100% and 93.75% respectively. Diagnostic accuracy of cytology in predicting malignancy taking histopathology as gold standard was 97.0. Conclusion: Grading and scoring of oral cytosmears according to morphology showed a positive correlation with histopathological diagnosis. In addition, cytomorphometry increases the diagnostic accuracy of oral conventional exfoliative cytology and hence is seen to have an impact on early detection of cellular alterations and prompt treatment. Therefore, it is a sensitive and useful adjunct to monitor the cellular transformation.
Key words: Oral cancer, Exfoliative cytology, Morphometry, Tobacco, Early detection |
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2022;3:9
Original Article |
Chandana N, Vijay Shankar S, Amita K.
The Role of Tumour Budding as a Prognostic Factor in Primary Invasive Ductal Carcinoma of Breast. |
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Abstract: Background: Tumor budding is considered as an essential step in invasion and as a poor prognostic factor in carcinoma.It is used as the main prognostic factor in colon cancer but it is now gaining popularity in other tumor types. Objectives of the study was to determine tumor budding and categorize it into low grade and high grade in primary invasive breast cancer patients and to determine the association of tumor budding with clinicopathological characteristics. An attempt was also made to compare cytokeratin expression in intra- tumoral and budding sites. Method: It was an observational-analytical study including 50 cases of surgically resected modified radical mastectomy specimens diagnosed as invasive breast carcinoma in the tertiary care hospital from October 2018 to March 2020. Tumor buds were counted in H&E and IHC stained sections in 10 high power fields. IHC marker used was pan cytokeratin. Cases were classified into low tumor budding and high tumor budding. Correlation of tumor budding was done with all the established clinicopathological characteristics. Cytokeratin expression was compared in tumor proper and budding sites. Results: Among the 50 casesof invasive breast carcinoma, 24 cases showed high tumor budding (>4/10HPF) and 26 cases showed low tumor budding (≤4/10HPF). High tumor budding was seen with larger size of the tumor, higher primary tumor staging, higher lymph node staging, presence of lymphovascular invasion, lymph node involvement and presence of necrosis with a significant correlation. Also cytokeratin expression was similar in tumor proper and budding sites in 92% of the cases. Interpretation & Conclusion: Tumor budding showed significant correlation with tumor size, primary tumor staging, lymph node staging, lymph node involvement, lymphovascular invasion and tumor necrosis. Thus it can be considered as a significant prognostic factor in the invasive breast carcinoma and can be incorporated in the reporting protocol for breast cancer.
Key words: Tumor budding, carcinoma, mastectomy, prognosis, cytokeratin, tumor staging, lymph node |
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This Article |
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2022;3:10
Original Article |
Prema PG, Balaji A, Praveena DA, Jeyaraman S.
Gynaecological Disorders Among Adolescent Girls Attending a Tertiary Care Hospital in South India: a Cross-Sectional Study. |
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Abstract: Background: Adolescents in India contribute to 22% of the country’s population and are susceptible to various preventable and treatable health issues. Objectives: To estimate the burden and to describe the pattern of gynaecological disorders among adolescent girls attending the outpatient and inpatient departments of a private medical college hospital in South India. Materials and methods: This was a hospital based cross sectional analytical study done among 500 adolescent girls of 10-19 years age group in a private medical college hospital in South India during December 2020 to December 2021 using a pretested questionnaire. Data was analysed using IBM SPSS version 23. Chisquare test or Fischer exact test was done to find the association between categorical variables. Mann Whitney U test was used to compare the difference between means. P value less than 0.05 was considered to be significant for all comparisons. Results: Mean age of study population was 15.94 ± 2.52 years. Menstrual abnormalities reported in 303 (60.6%) girls followed by 240 (48%) girls had leucorrhoea, 68 (13.6%) had urinary tract infection and 54(10.8%) had PCOS. Conclusion:
There is a high burden of gynaecological disorders and lack of awareness on various components of adolescent reproductive and sexual health among adolescents.
Key words: Adolescent, Gynaecology, Menstruation, Abnormalities, Menorrhagia |
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2022;3:11
Case Report |
Shetty P, Shetty P, Bhat R.
Intentional Replantation to Rehabilitate and Preserve the Integrity of Maxillary Central Incisor with Complicated Crown En-masse Fracture. |
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Abstract: The present case aims to describe the management of a complicated crown en masse fracture in a maxillary central incisor due to trauma by intentional replantation as the chosen treatment modality. Intentional replantation aiming towards successful endodontic therapy comprises intentional therapeutic extraction of the tooth and an endodontic procedure in a controlled environment followed by replantation. A 24-year-old female patient presented to the department with a chief complaint of broken upper front teeth following trauma. The teeth were tender on percussion. The periapical radiographic examination revealed a complicated fracture involving the pulp without significant periapical changes. A diagnosis of Ellis Class III was established and intentional reimplantation was planned with the patients consent. Following an atraumatic extraction, conventional root canal treatment was completed. Subsequently, a fibre-post was used to reinforce the tooth structure. The tooth was placed back into the socket and splinted. One year of follow up examination revealed absence of pain and periapical healing. The treatment yielded a clinical, aesthetic and functionally satisfactory result, establishing intentional replantation to be a feasible treatment option in complicated crown en masse fracture of the tooth.
Key words: Tooth reimplantation, Tooth fracture, Avulsed tooth, Endodontics |
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