Indian journal of public health最新文献

Background: The burden of wasting among under five children in India, has not reduced in the last decade.

Objectives: We used child-level data from the latest nationally representative Comprehensive National Nutritional Survey (CNNS) to estimate the prevalence of wasting at the national and state level in India.

Methods: We explored the association of wasting with maternal, child and household factors using multivariable logistic regression for the age group of 0-5, 6-23 and 24-59 months.

Results: The overall prevalence of wasting was 17.3%, ranging from 5.8% to 29.1% across states, 23.3% in children 0-5 months, 19.6 % in children 6-23 months and 15.4 % in children 24-59 months of age. Higher birthweight i.e., every 100g increase (0-5 months aOR = 0.96, 6-23 months aOR = 0.94, 24-59 months aOR = 0.96), higher maternal BMI (0-5 months aOR = 0.51, 6-23 months aOR = 0.62, 24-59 months aOR = 0.67), increasing child age in months (0-5 months aOR = 0.84) and female sex of the child (24-59 months aOR = 0.82) was found to have significantly lower odds of wasting. The odds of wasting were significantly higher for poorest wealth quintile (0-5 months aOR = 1.99, 6-23 months aOR = 2.13), maternal unemployment (0-5 months aOR = 2.25), and lower levels of maternal education (6-23 months aOR = 1.74).

Conclusions: Our analyses showed that burden of wasting continues to remain high in India. Preventive interventions must target reduction of low birthweight. Early identification and management of wasting should be done, especially during the first six months of life who are not part of current therapeutic feeding programme.

Summary: Invasive fungal sinusitis is a highly lethal infection in an immunocompromised population that can spread rapidly to involve the adjacent structures by direct invasion or through vascular invasion. Involvement of cerebral parenchyma by vascular invasion is a devastating complication in these patients which may lead to vasculitis, thrombus formation, cerebritis, or abscess formation. Here, we present a case of a young male with uncontrolled diabetes mellitus who initially presented with COVID-19 lung disease and later developed sinonasal mucormycosis complicated with left orbital cellulitis and pulmonary mucormycosis.

Background: Acute lymphoblastic leukemia (ALL) is the most common childhood cancer. Immunophenotype (IPT) and cytogenetics are essential for diagnosis, risk stratification, and management for ALL.

Objectives: Evaluating the burden of immunophenotypic and cytogenetic profile of pediatric ALL patients.

Materials and methods: A descriptive cross-sectional study was conducted on 100 patients of ALL (1-18 completed years) attending a tertiary-care center in Kolkata, Eastern India.

Results: Ninety-six percent of patients had B-cell ALL (94.00% pre-B ALL and 2.00% Pro-B ALL) and 4.0% had T-ALL. 60% B-cell ALL were CD19/CD10 positive, 10% were CD79a positive, 9% were only CD19 positive, and 7% were only CD10 positive. Thirty-three percent of T-ALL were CD3+, whereas 22% were positive each for CD4 and CD7. 51.0% of patients had diploid, 46.0% hyperdiploid, and 3.0% hypodiploid karyotype. Among hyperdiploids, 98% had good prednisolone response and 89% had measurable residual disease (MRD) <0.01.

Conclusion: The most commonly diagnosed ALL by IPT was pre-B ALL. Among the detectable cytogenetic abnormalities, t(12; 21) ETV6-RUNX1 was the most common. ZNF-384 gene arrangement was also detected in our study. t(12;21) ETV6-RUNX1 had a good treatment response, while t(9;22) BCR-ABL, t(1;19) TCF3-PBX1, iAMP-21, MLL gene rearrangement, and ZNF-384 gene arrangement had poor treatment response in terms of MRD.

Background: Several studies on noncommunicable diseases (NCDs) have been carried out worldwide, the basis of most of which is the identification of risk factors-modifiable (or behavioral) and metabolic. Majority of the NCDs are due to sociodemographic factors, lifestyle, and behavior, which can be prevented to a great extent. Thus, it is a health challenge and a necessity to identify such factors of NCDs.

Objectives: The objective is to make a thorough systematic and comparative analysis of diverse machine learning (ML) classifiers and identify the best-performing model to study social determinants of NCDs.

Materials and methods: We used data from the Longitudinal Ageing Study in India, and predicted the prevalence of NCDs based on a set of sociodemographic, lifestyle, and behavioral risk factors by conducting a comparative analysis among 25 different algorithms.

Results: Evaluating the performance metrics, the random forest model was found to be the most-suited method with 87.9% accuracy and hence chosen as the final model for the analysis. The model's performance was optimized by a hyper-parameter tuning process using grid-search with a 5-fold cross-validation strategy and results suggested that it was able to make accurate predictions on new instances.

Conclusion: The epidemic of chronic illness cannot be completely addressed without comprehending the social determinants. With advancements in medical and health-care industry, ML has been applied to analyze diseases based on clinical parameters. This work is an attempt by the authors to explore and encourage the use of ML in the field of social epidemiology.

Summary: This article addresses the escalating privatization of health-care services in Kerala, an Indian state. While Kerala's public health-care system has been consistently lauded for its commendable strategy of providing high-quality and affordable health care, recent developments have seen the emergence of large commercial multispecialty hospitals and the integration of private insurance into the public health sector, transforming health care into a profitable industry. This situation underscores the significance of equity, accessibility, and affordability in the health-care sector. Substantial government intervention becomes imperative to curb the increasing involvement of private entities in health-care services.

Abstract: In India, the prevalence of secondhand smoke (SHS) exposure is 29.5% in general and 11.2% at home. The youth may expose themselves to SHS without knowing the risk factors and consequences involved. This study is intended to determine the prevalence of SHS exposure and the measures adopted by the youth to avoid exposure. A cross-sectional study was conducted among 338 youth in an urban area in Hyderabad. A modified Global Youth Tobacco Survey questionnaire was used for data collection on SHS exposure and avoidance. The total prevalence of SHS exposure was 35.21%. The mean days of SHS exposure/week were 1.419 (standard deviation -1.806) days. Belonging to the age group 18-21 years, and male gender were significant predictors of SHS exposure. Education of the head of family was a significant predictor of SHS avoidance behavior. Creating awareness among young adults regarding the deleterious effects and preventive strategies of SHS exposure, thereby making them responsible for the health of their family can be a protective long-term strategy.

Background: Depression is a serious illness; approximately 40%-60% of patients develop relapse, and this risk increases up to 90%. Interpersonal psychotherapy (IPT) is an effective method to minimize depressive symptoms and relapse.

Objectives: This randomized control trial study is designed to assess the effectiveness of IPT on depression symptom reduction and relapse prevention.

Materials and methods: Three hundred depressed patients from a selected psychiatric hospital in UP, India, were recruited by a simple random sampling technique that randomly allocated 150 participants to the experimental group and 150 to the control group by tossing a coin. Depressive symptoms were assessed using the Hamilton Depression Rating Scale, which has 17 items. On the 2nd day of the trial, the experimental group received IPT. It helped the participants recognize their emotions and urge themselves to express them, both of which had a direct positive impact on their sad mood. The IPT efficacy assessment was done at the end of the 4 weeks of the intervention, and the relapse prevention assessment was undertaken 4 months later. The control group was kept with the actual treatment modalities and psychoeducation sessions, and they were assessed in the same way as the experimental group.

Results: Findings illustrated that the reduction of depressive symptoms with (t = 33.61) (P = 0.0000) and relapse prevention with (t = 2.7484) (P = 0.0067) are significant, respectively. Furthermore, symptom reduction and relapse prevention had an association with some demographical data at P < 0.05, 0.001.

Conclusion: IPT is an effective intervention for reducing depressive symptoms and preventing relapse.

Summary: We present four cases of ocular surface and adnexal appendage injuries resulting from exposure to hazardous materials in various industrial occupations. These injuries occurred due to the absence of protective eye equipment while working. Emphasizing the irrefutable importance of protective eye gear is the aim of this article as it is crucial to mitigate such unfortunate incidents.