Tag: pubmed

J Family Med Prim Care. 2024 Oct;13(10):4623-4627. doi: 10.4103/jfmpc.jfmpc_425_24. Epub 2024 Oct 18.

ABSTRACT

BACKGROUND: Immunisation services does not reach over one third of urban poor children. There is clear cut difference of children completely immunised in the low as compared to high standard of living index in urban areas. This difference is more marked in low performing states like Rajasthan and this difference as compared to better performing states like Kerala. Such inter-state differentials indicate the importance of extra focus on low performing states like Rajasthan.

METHODOLOGY: A cross-sectional study was conducted among 550 children aged 12-23 months in an urban slum of a district in southern Rajasthan. Along with the immunisation coverage, determinants associated with incomplete immunisation was assessed. The child’s immunisation was ascertained using the immunisation cards/Mamta cards or in whom cards not available WHO recall method was used. The Chi-square test was used to find out statistical significance.

RESULTS: Of 550 children studied, 417 (75.8%) were fully immunised, 117 (21.3%) were partially immunised and 16 of them were non immunised (2.9%). When the determinants of incomplete immunisation were assessed, all were found statistically significant.

CONCLUSION: The present study concluded that immunisation coverage is lower than that of the target. The factors thought to have influenced immunisation such as religion, family composition, education of mother and gender of child were discovered to be statistically significant.

PMID:39629424 | PMC:PMC11610829 | DOI:10.4103/jfmpc.jfmpc_425_24

J Family Med Prim Care. 2024 Oct;13(10):4217-4224. doi: 10.4103/jfmpc.jfmpc_153_24. Epub 2024 Oct 18.

ABSTRACT

BACKGROUND: Dental care of patients with epilepsy and seizures must be performed by dentists who are familiar with these disorders. Improper training and incapability to manage medical emergencies, including epileptic seizures, may cause thoughtful consequences and legal actions. Therefore, dental students must have a proper knowledge of the disease and its consequences. They should have the ability to provide first-aid measures helping a patient experiencing an epileptic seizure in their clinics. This study aims to evaluate the first-aid knowledge and practices towards patients with epileptic seizures among the dental students in Saudi Arabia.

METHODS: A cross-sectional study was conducted targeting dental students in Saudi Arabia from 15 September 2022 to 15 December 2022 using convenience sampling. An online questionnaire was sent to the students via social media platforms for data collection. The data analysis was conducted using the Statistical Package for the Social Sciences (SPSS) version 16.0.

RESULTS: Of the 499 dental students included, 154 (30.86%) students had ever seen an epileptic patient in the clinics. About 16% of students did not know about performing cardiopulmonary resuscitation (CPR) on patients. The majority (66.5%) would call the ambulance after the patient’s seizure stops. About 82% of students prefer to call an ambulance if the patients face difficulty breathing or waking up after the seizure. More than 60% of students were taking precautions before treating an epilepsy patient. About 58.5% of the students were using local anaesthesia for an epilepsy patient. Nearly 41.9% do not have the confidence to treat an epilepsy patient. About 28.0% would swipe the vagus nerve stimulation (VNS) magnet over the left side of the chest. Of 154 students, who had ever seen epileptic patients, the majority (68.8%) refused to treat patients if they observe noncompliance with medication and follow-up among the patients who had any recent illness or seizures (16.2%).

CONCLUSION: The undergraduate dental students had an intermediate knowledge regarding epilepsy and epileptic seizure first aid. However, some students lacked the confidence to deal with the epileptic cases in their clinics. Educational campaigns on epilepsy and first-aid courses targeting dental students are highly recommended.

PMID:39629417 | PMC:PMC11610869 | DOI:10.4103/jfmpc.jfmpc_153_24

J Family Med Prim Care. 2024 Oct;13(10):4693-4698. doi: 10.4103/jfmpc.jfmpc_48_24. Epub 2024 Oct 18.

ABSTRACT

BACKGROUND: Insomnia affects both quality of life and productivity at work, and it raises the risk of other diseases, such as depression, that coexist with insomnia. Nowadays, it is highly advised to treat insomnia with behavioral and psychological therapeutic methods to ensure the quality of your sleep.

AIM: This study aimed to find the efficacy of sleep hygiene techniques in improving sleep quality and mental ability among insomnia clients.

METHODS: Self-structured questionnaires used to evaluate sleep quality and the McQuaig Mental Ability Test to test mental ability were used to collect data during the study’s six-week duration, which involved the recruitment of 50 participants using a purposive sample technique. A paired sample t-test and Pearson correlation were used for the statistical analysis.

RESULTS: Data analysis shows that sleep quality (t = 33.35) (P = 0.0000) and mental ability (t = 35.33) (P = 0.0001) are both highly significant at P =0.0001. Correlation regression data of sleep hygiene elements such as schedule, avoiding caffeine and beverages, relaxation routine, and sleep-stimulating environment shows that there is a positive correlation with the quality of sleep at r = 0.9, 0.89, 0.75, and 0.68, whereas P = 0.000, 0.01, and 0.023, respectively. Similar to this, there is a positive association between mental ability and good sleep habits such as a relaxing routine, a sleep-promoting environment, and a schedule with r = 0.91, 0.88, and 0.92, respectively, with P values of 0.0001, 0.001, and 0.001.

CONCLUSION: The results of the study provide compelling evidence that good sleep hygiene can help enhance insomniacs’ mental ability and sleep quality. Furthermore, those with moderate levels of sleep quality, those between the ages of 18 and 38, and those with higher education benefited more than others.

PMID:39629415 | PMC:PMC11610801 | DOI:10.4103/jfmpc.jfmpc_48_24

J Family Med Prim Care. 2024 Oct;13(10):4499-4504. doi: 10.4103/jfmpc.jfmpc_221_24. Epub 2024 Oct 18.

ABSTRACT

CONTEXT: Over-medicalization of normal pregnancy is associated with unnecessary inductions of labor leading to operative deliveries. In a busy outpatient department (OPD) or low-resource setup where ultrasound availability, experience, and cost will be a concern, routine ultrasound at term can be avoided if the clinical estimation of fetal weight is more or less equal to the actual birth weight.

AIMS: To assess the reliability and validity of fetal weight estimation at term by ultrasound and clinical estimation.

SETTINGS AND DESIGN: A prospective study of diagnostic accuracy was done over a period of 1.5 years in a tertiary hospital, which included 100 women with term singleton pregnancies admitted in obstetric wards or labor room.

METHODS AND MATERIAL: To find out the agreement between actual birthweight and ultrasound fetal weight interclass correlation coefficient (ICC) was used. Mean difference plots (Bland-Altman plots) were done. The mean percentage error was compared with the consultant estimate and registrar estimate across groups. The sensitivity, specificity, and predictive values by clinical and ultrasound estimate were calculated for actual birth weight ≤ 2.5 kg.

RESULTS: Both methods of fetal weight estimation have moderate reliability in predicting the actual birth weight. The sensitivity of identifying birthweight < 2.5 kg babies by ultrasound was slightly higher. For birth weight less than 2.5 kg, there was an overestimation of fetal weight by clinical estimation done by postgraduate with mean percentage error being statistically significant as compared with ultrasound estimation.

CONCLUSIONS: In a developing country like ours where ultrasound is not readily available in all healthcare setups, the clinical method is an easy, cost-effective, simple one that can be used by all medical professionals after adequate training.

PMID:39629413 | PMC:PMC11610859 | DOI:10.4103/jfmpc.jfmpc_221_24

J Family Med Prim Care. 2024 Oct;13(10):4569-4574. doi: 10.4103/jfmpc.jfmpc_409_24. Epub 2024 Oct 18.

ABSTRACT

BACKGROUND: Recurrent pregnancy loss (RPL) is a common problem affecting many women. This study aimed to investigate the baseline characteristics of 400 women with RPL and to examine any differences in baseline characteristics of the recruited women with RPL throughout the years.

METHODS: This study used retrospective data, which included the records of patients with RPL who visited King Khalid University Hospital’s obstetric clinic between 2019 and 2022. The records of 400 patients who met the inclusion criteria were reviewed and analyzed.

RESULTS: The mean age of enrolled women was 36.5 ± 5.4 years, and the mean RPL was 3.8 ± 2.5. The study also revealed that there were significant statistical differences in obesity and vitamin D deficiency among women with RPL based on year (P = 0.013 and P = 0.036, respectively), whereas no significant statistical differences were found between women with RPL in terms of age, parity, diabetes, hypothyroidism, hyperprolactinemia, antiphospholipid antibodies (APLs), uterine malformation, or consanguinity.

CONCLUSION: Advanced maternal age, number of previous miscarriages, parity, diabetes, hypothyroidism, APLs, uterine malformations, first-degree consanguinity, and vitamin D deficiency were found to be significant risk factors associated with RPL among women in Saudi Arabia.

PMID:39629412 | PMC:PMC11610887 | DOI:10.4103/jfmpc.jfmpc_409_24

J Family Med Prim Care. 2024 Oct;13(10):4539-4544. doi: 10.4103/jfmpc.jfmpc_91_24. Epub 2024 Oct 18.

ABSTRACT

INTRODUCTION: Water, sanitation, and hygiene (WASH)-related infectious diseases contribute to approximately 5% of the global disease burden. Despite sanitation being a human right, 673 million people worldwide had limited access to toilets. To tackle the same, Swachh Bharat Mission-Gramin (SBM-G) was launched in 2014 to facilitate the construction of over 100 million individual household latrines (IHHLs) across India. However, literature evidence on acceptance of SBM-G in Tamil Nadu, particularly in Coimbatore, is scarce.

OBJECTIVES: The primary objective was to investigate the utilisation of the SBM-G scheme and its associated factors in rural Coimbatore.

MATERIALS AND METHODS: In 2022, a mixed-methods study incorporating quantitative (using a purpose-designed questionnaire) and qualitative (using in-depth interviews and focus group discussions) components was conducted among 60 SBM-G beneficiaries in Kovai Medical Center and Hospital Institute of Health Sciences and Research (KMCH IHSR)’s rural field practice area. Quantitative data were analysed using Statistical Package for the Social Sciences (SPSS) v23 and qualitative data using manual thematic content analysis.

RESULTS: Before IHHL construction, 93.7% of respondents practiced open-air defecation (OAD). The issues perceived with OAD were distance (28.8%) and privacy concerns (12.5%). After SBM-G implementation, 78.3% reported using the IHHL ‘all the time’, reflecting a substantial shift in behaviour. Most respondents received financial aid within about six months (INR 8,000), often in a single instalment. The majority had constructed their IHHLs before 2015. The expenditures incurred varied significantly, with 58.3% spending extra costs ranging between INR 10,000 and 30,000. Water supply to households significantly influenced IHHL usage.

CONCLUSION: While rural villagers appreciate the SBM-G financial assistance for IHHLs, concerns about the inadequacy of the sanctioned amount for proper piped water supply and septic tanks persist. Nonetheless, there is a clear demonstration of positive behavioural change, marked by reduced OAD and increased IHHL usage.

PMID:39629408 | PMC:PMC11610852 | DOI:10.4103/jfmpc.jfmpc_91_24

J Family Med Prim Care. 2024 Oct;13(10):4560-4568. doi: 10.4103/jfmpc.jfmpc_63_24. Epub 2024 Oct 18.

ABSTRACT

INTRODUCTION: Globally, road traffic injuries (RTIs) are the eighth leading cause of death, with an estimated 1.35 million deaths yearly. In India, road traffic accidents (RTAs) are one of the major causes of mortality among the younger generation. We analyzed Tamil Nadu’s comprehensive Road Accident Data Management System (RADMS) data and described the epidemiological indicators of RTI in this setting.

METHODS: We obtained the data from the RADMS database for 2011-2016 and used 2011 population census data to project and standardize for different age groups and genders to calculate incidence. We calculated average annual percentage changes (AAPC) with a 95% confidence interval for the whole period. We computed Joinpoint regression analysis for trends and calculated the age-adjusted incidence rate with standard error (SE) using R statistical computing software.

RESULTS: We included 3,67,094 RTAs and 5,50,447 RTIs. We observed that the incidence of RTAs and RTIs declined between 2011 and 2016. Most injured were males (82%) and aged 20-39 years (49%). The highest number of accidents occurred on the state highways (65.2%) and on Sundays (17%). Age-adjusted incidence (per 1,00,000) declined from 121.87 (SE 0.4) in 2011 to 92.73 (SE 0.34) in 2016 (AAPC = -4.5% (95% CI = -7.8 to -1)). The age groups 30-39 and 20-29 were 9.82 (z = 8.98; P < 0.05) and 9.02 (z = 8.65; P < 0.05) times at a higher risk compared to 0-9 years old. The motorcyclists (14-27 times; P < 0.05) and pedestrians (12-23 times; P < 0.05) had the maximum risk of RTIs.

CONCLUSION: Young adults, drivers, motorcyclists, and pedestrians remain vulnerable populations for RTIs. More accidents occurred in the state highways and on Sundays. The analysis provides insights on RTIs and RTAs, which will be used to reduce the burden of RTIs and save millions of lives.

PMID:39629407 | PMC:PMC11610803 | DOI:10.4103/jfmpc.jfmpc_63_24

Otol Neurotol. 2024 Nov 29. doi: 10.1097/MAO.0000000000004378. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the difference in overall, hospital, and out-of-hospital cost difference of day-case stapes surgery, compared with inpatient stapes surgery, while maintaining equal hearing outcomes and quality of life (QoL).

STUDY DESIGN: A single-center, nonblinded, randomized controlled trial in a tertiary referral center.

METHODS: A total of 112 adult patients planned for primary or revision stapes surgery for clinically suspected otosclerosis were randomly assigned to either the day-case or inpatient treatment group. An evaluation was performed of the difference in total health care-related costs (hospital and out-of-hospital costs) from a hospital and patient perspective over the course of 1 year. Audiometric measurements included pure-tone audiometric measurements and speech audiometry measured at 2 months and 1 year postoperatively. QoL was assessed at 3 months and 1 year postoperatively, using the EQ-5D and HUI3 questionnaires.

RESULTS: A total of 109 cases (100 patients) were analyzed due to three dropouts. The total health care-related costs were €16,586 in the inpatient group (n = 54) and €16,904 in the day-case group (n = 55). The mean postoperative hospital stay was 0.9 days (mean costs of €854) in the inpatient group and 0.5 days (mean costs of €561) in the day-case group (both mean differences statistically significant), with a crossover rate from day-case to the inpatient group of 36% (n = 20) and a crossover rate from inpatient to the day-case group of 11% (n = 6). There were no differences in postoperative complications and objective hearing outcomes. Besides an increased number (0.2) of postoperative telephone consultations in the day-case group, there were no statistically significant differences in postoperative hospital and out-of-hospital costs or visits. The QoL showed no statistically significant differences.

CONCLUSION: A day-case approach in primary or revision stapes surgery does not result in a statistically significant reduction of health care-related hospital and out-of-hospital costs compared with an inpatient approach. It also does not affect the surgical outcome (objective audiometric measurements and complication rate), QoL, and postoperative course (number of postoperative hospital and out-of-hospital visits).Level of evidence: 1.

PMID:39627898 | DOI:10.1097/MAO.0000000000004378

Clin Diabetes Endocrinol. 2024 Dec 4;10(1):41. doi: 10.1186/s40842-024-00208-2.

ABSTRACT

BACKGROUND: Effective diabetic retinopathy screening (DRS) programmes are important in preventing vision impairment and blindness caused by diabetes. This study focuses on identifying the factors affecting attendance or non-adherence to DRS among children and young adults with diabetes mellitus (DM) in Bangladesh.

METHODS: A mixed-methods approach was used, which included patients diagnosed with DM aged 12-26 years from Bangladesh who were registered at BIRDEM Women and Children hospital in Dhaka. Data collection occurred between July 2019 and July 2020, mainly through telephone and email due to restrictions imposed by the COVID-19 pandemic. Statistical analyses, including chi-squared tests, t-tests, and logistic regression, were used to assess the demographic and clinical factors influencing attendance at DRS.

RESULTS: The study reported a high 88% attendance rate for DRS among children and young adults in Bangladesh. However, some barriers to attendance were identified. Children under 15 years of age showed a higher tendency to attend their last DRS appointment when compared to older age participants (16-26 years), P < 0.05. Male participants demonstrated a lower likelihood of attending their DRS appointments than females (OR 0.29, CI: 0.17 to 0.50), P < 0.001. Additionally, participants with higher HbA1c levels (mean 9.1%, IQR 2.5) attended their last DRS appointment compared to those with lower levels (mean 8.0%) (p < 0.05). The primary barriers leading to missed DRS appointments were distance to the hospital (15, 31.9%), financial limitations (19, 40.4%), and busy schedules (14, 29.8%).

CONCLUSIONS: Compliance with DRS was high in this setting especially among younger patients, females, and those with higher HbA1c levels, highlighting the effectiveness of current DRS initiatives in Bangladesh. Addressing barriers such as cost, service accessibility and transportation could improve attendance rates further, and strategies such as flexible scheduling, transport subsidies, telemedicine, and use of artificial intelligence may help overcome these challenges.

PMID:39627896 | DOI:10.1186/s40842-024-00208-2

BMC Med. 2024 Dec 3;22(1):574. doi: 10.1186/s12916-024-03802-4.

ABSTRACT

BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is associated with an increased incidence of hepatic and extrahepatic cancers, in particular those linked to obesity. In people with chronic liver disease, aspirin may confer protection against hepatocellular carcinoma (HCC). We explore the potential chemoprotective effect of aspirin/other anti-platelet agents on obesity-related cancers, including HCC in people with NAFLD.

METHODS: We performed a retrospective cohort study of anonymised electronic medical records using the TriNetX network (Cambridge, MA, USA), a global federated database. We identified adults aged 18 or over with a diagnosis of NAFLD, prior to commencing antiplatelet agents. Two groups were created: antiplatelet (1) versus no antiplatelet use (2). We propensity score matched for nine variables. Antiplatelet use was defined as aspirin, ticagrelor, cangrelor, clopidogrel or prasugrel use for at least 1 year. The outcomes of interest were incidence of HCC and other obesity-related cancers. Follow-up was for 5 years. We performed subgroup analyses on aspirin users only and stratified findings for sex and age. Sensitivity analysis was conducted on individuals with 3- and 5-year aspirin exposure.

RESULTS: Post matching, there were 42,192 people per group. Antiplatelet use in people with NAFLD was associated with statistically significant reduction in all obesity-related cancers (HR 0.71, 95% CI 0.65-0.78, p < 0.001) and individually for HCC (HR 0.52, 95% CI 0.40-0.68, p < 0.001), breast carcinoma (HR 0.78, 95% CI 0.66-0.92, p = 0.003), pancreatic carcinoma (HR 0.61, 95% CI 0.47-0.78, p < 0.001) and colorectal carcinoma (HR 0.68, 95% CI 0.56-0.84, p < 0.001). For women, there was a significant reduction in risk of ovarian carcinoma (HR 0.75, 95% CI 0.57-0.98, p = 0.034). Aspirin monotherapy was similarly associated with reduced incidence of HCC (HR 0.46, 95% CI 0.32-0.64, p < 0.001) and all obesity-related cancers (HR 0.71, 95% CI, 0.56-0.90, p = 0.004), with benefits observed in males (HR 0.71, 95% CI 0.56-0.90, p = 0.004), females (HR 0.77, 95% CI 0.67-0.88, p < 0.001) and in older (HR 0.72, 95% CI 0.63-0.82, p < 0.001) but not younger people (HR 0.78, 95% CI 0.60-1.03, p = 0.589).

CONCLUSIONS: Aspirin/antiplatelet agents may have a role in primary cancer prevention in people living with NAFLD.

PMID:39627877 | DOI:10.1186/s12916-024-03802-4