Indian journal of public health最新文献

Summary: Malignancies in human immunodeficiency virus (HIV) positive individuals have a larger role in morbidity and mortality. Appropriate clinical acumen is required for a clinician to anticipate the occurrence of lymphoma after starting antiretroviral therapy, especially in patients with CD4 <100 cells/mm3. Here is a 30-year-old man with weight loss and appetite, found to be retroviral disease positive status with low CD 4 counts. He was started on antiretroviral treatment, and following that, he developed Hodgkin's lymphoma of mixed cellularity. He is planned for an ABVD regimen and received one cycle of the same without any complications. To our knowledge, we are reporting the first case of an HIV patient with a mixed cellularity form of classical Hodgkin's lymphoma from India.

Background: The footfall and admission rates post-COVID-19 scenario have come down in the case of patients with cardiac problems with larger delays leading to complications as per several studies. Studies have primarily focused on the disruptions due to lockdown but not much study has been done to understand how it has affected the lifestyle of the patients and changed the mentality leading to lower patient arrivals.

Objectives: The current study deals with understanding how the patient arrival pattern has changed and what are the factors affecting the same during COVID-19 times.

Materials and methods: Analysis of the data for patients with acute coronary syndrome from April to June for pre (2019)- and post (2020)-COVID-19 times admitted to a government cardiology and cardiac care hospital is studied for patient-based and accessibility-based parameters.

Results: A significant reduction in admissions (4230-880) with higher arrival times from the onset of symptom (80% rise) although the overall mean distance traveled reduced (63.8-47.4 km) leading to greater health risks. Furthermore, problems due to physical inactivity, diabetes, smoking, and drinking have also risen by about 3%-5% in each case.

Conclusion: The need for better health-care system connectivity and the need for online platforms-based consultation systems, especially in times of such a pandemic have been highlighted. The results from this study will be helpful in addressing the issues related to delayed care for heart patients, thereby helping in reducing the mortality rate and improving overall health.

Background: Developmental delay happens when a child fails to attain age-appropriate milestones. Identification of developmental delay in children is important to initiate early intervention in them which will facilitate the children to have a productive life in their later years.

Objectives: The objective was to study the prevalence of developmental delay among 12-36-month-old children from the area of Primary Health Centre, Bela, in rural Nagpur, Maharashtra.

Materials and methods: This was a community-based cross-sectional study design. A total of 314 children were selected through simple random sampling and assessed for delay using the Pediatric Development Screening Tool (PDST).

Results: 14.9% had developmental delay in at least any one domain and 3.5% had global developmental delay. Domain-specific developmental delay was highest for language delay (10%) followed by fine motor (5%). Gross motor and personal social delays had the same prevalence (3.1%). On multivariable lower literacy, level of mother and Composite Index of Anthropometric Failure were significant variables for any developmental delay. Hospitalization of the child during the 1st month of life and lower parenting scores were the significant factors associated with global delay.

Conclusion: Development delay is present in a sizeable proportion of children <3 years of age which affects their future growth and achievement. We recommend annual community-based screening for delays to detect and manage such children.

Summary: A cross-sectional study conducted in a semi-urban tertiary healthcare hospital in South western Nigeria to assess health promotion practices and associated sociodemographic factors among pregnant women attending antenatal clinics. A total of 220 pregnant women were studied. Results showed that 95.0% of the participants had good health promotion practices with physical activities having the lowest while spiritual values had the highest score. Moreover, age, religion, education, and occupation were significantly associated with health promotion practices among the pregnant women.

Summary: A cross-sectional, web-based survey was conducted to assess the health-care professionals (HCPs)' perception toward existing medical device postmarket surveillance (PMS) practices in India. A total of 1756 responses (medical practitioners [19.8%], nurses [22.5%], pharmacists [21.4%], and biomedical engineers [13.8%]) were recorded and analyzed. About 71.2% of participants were aware about the ongoing PMS program, 87.5% were aware that medical devices are under regulation in India, and 83.3% were aware about who can report medical device adverse event (MDAE). About 56.3% of participants agreed that they take regular feedback from patients after using high-risk medical device. Majority of participants (69.4%) were aware about tools for reporting MDAE and the online reporting form is the most preferable tool among users. About 76.2% of participants were agreeing that reporting of MDAE is their professional/ethical responsibility. This study reveals that Indian HCPs show a good understanding of PMS practices and a positive perception toward MDAE reporting. However, underreporting still remains a challenge in India.

Summary: Cytomegalovirus (CMV) is known to cause fatal pneumonia in human immunodeficiency virus (HIV) infected children. There is a paucity of literature on pediatric HIV and CMV coinfection in India. We describe six cases of severe pneumonia in infants infected with HIV. Four of these infants also had CMV coinfection, detected by urine polymerase chain reaction. There was a lack of antenatal and postnatal care in all cases. All four infants with CMV coinfection succumbed to severe acute respiratory distress syndrome, whereas the other two survived. In conclusion, a high index of suspicion for CMV should be kept in HIV-infected infants presenting with severe pneumonia, although CMV pneumonia is difficult to diagnose with certainty. The important role of antenatal care for mothers with HIV infection, as well as postnatal care for babies born to HIV-positive mothers, cannot be overstated.

Background: Food insecurity prevails in people at all phases of their life course and causes remarkable health, social, and financial repercussions. In Sarawak state, Malaysia, information regarding household food insecurity is limited.

Objectives: The objective of this study was to examine the prevalence of household food insecurity, together with its predictors and coping strategies among the Sarawak indigenous communities.

Materials and methods: This cross-sectional study was conducted among 953 Indigenous households (women) located in six districts throughout Sarawak using multistage sampling. Interviewer-administrated questionnaires were used. Simple and multiple logistic regressions were employed to draw inferences.

Results: The prevalence of food insecurity was 42.2%. Large household size (adjusted odds ratio [AOR] =1.57 [1.04-2.45]), hardcore poor (AOR = 12.26 [5.07-29.65]), and absolute poor families (AOR = 3.01 [1.76-5.15]), recipient of financial assistance (AOR = 1.94 [1.27, 2.96]), no savings (AOR = 1.63 [1.08-2.46]), increased resource loss (AOR = 1.004 [1.001-1.008]), and employment of coping strategies (AOR = 3.78 [2.50-5.72]) were significantly related to a higher risk of household food insecurity. High level of perceived social support (AOR = 0.73 [0.58-0.93]), optimism (AOR = 0.91 [0.86-0.96]), and general perceived self-efficacy (AOR = 0.88 [0.85-0.91]) among respondents were protective against household food insecurity.

Conclusion: Nearly half of the Indigenous households faced food insecurity in the current study. The findings suggest that incessant effort by pertinent stakeholders is warranted via diverse strategies to enhance the socioeconomic status and nutrition intervention programs that incorporate components of perceived social support, optimism, and perceived general self-efficacy to mitigate the level of food insecurity among the Sarawak Indigenous communities.