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Severe nutritional anemia among hospitalized children in Central India – Descriptive study 印度中部住院儿童严重营养性贫血——描述性研究
Pub Date : 2023-03-23 DOI: 10.32677/ijch.v10i3.3827
C M Bokade, Spurti Kulkarni, Nikita Singh, Bhagyashree Tirpude, Dr Ketaki Nawlakhe
Despite numerous efforts, pediatric nutritional anemia remains one of the most serious health issues in developing countries. Severe nutritional anemia is associated with a number of modifiable risk factors, which can be overcome if the risk factors are accurately identified and addressed for different population groups. The purpose of this descriptive study is to focus on severe nutritional anemia in hospitalized children aged 1–5 years in a tertiary care center in Central India. Hospitalized children were enrolled in the study, and demographic, socioeconomic, clinical, and laboratory data, as well as clinical and laboratory images, were reviewed. For defining severe anemia, the World Health Organization cutoff value was used. Out of total 9850 children of 1–5 years of age group admitted in hospital for 2 years, 197 children had severe nutritional anemia, indicated the incidence of 2%. Lower socioeconomic status and malnutrition were significantly correlated to severe nutritional anemia.
尽管作出了许多努力,儿童营养性贫血仍然是发展中国家最严重的健康问题之一。严重营养性贫血与许多可改变的危险因素有关,如果准确识别并针对不同人群处理这些危险因素,就可以克服这些危险因素。本描述性研究的目的是集中在印度中部三级保健中心1-5岁住院儿童的严重营养性贫血。住院儿童被纳入研究,并对人口统计学、社会经济、临床和实验室数据以及临床和实验室图像进行了回顾。对于严重贫血的定义,使用了世界卫生组织的临界值。在住院2年的9850名1-5岁儿童中,197名儿童患有严重营养性贫血,发生率为2%。较低的社会经济地位和营养不良与严重的营养性贫血显著相关。
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引用次数: 0
Anti-myelin oligodendrocyte glycoprotein – antibody presenting as tumefactive demyelination and hemiparesis in a pediatric patient 抗髓鞘少突胶质细胞糖蛋白抗体表现为儿童患者的膨生性脱髓鞘和偏瘫
Pub Date : 2023-03-20 DOI: 10.32677/ijch.v10i3.3871
M. N, Architha G, Jyotsna A, S Prashanth, Ramu A, M R Savitha
Anti-myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease is an immune-mediated central nervous system demyelinating disorder with a variety of phenotypic presentations such as acute disseminated encephalomyelitis, optic neuritis, and transverse myelitis but rarely presents as tumefactive lesion, particularly in children. We present a case of an adolescent girl with an anti MOG antibody-related disorder that manifested as a tumefactive lesion.
抗髓鞘少突胶质细胞糖蛋白(MOG)抗体相关疾病是一种免疫介导的中枢神经系统脱髓鞘疾病,具有多种表型表现,如急性播散性脑脊髓炎、视神经炎和横切性脊髓炎,但很少表现为扩散性病变,特别是在儿童中。我们提出一个案例的青春期女孩与抗MOG抗体相关的疾病,表现为肿瘤病变。
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引用次数: 0
Influence of sociodemographic factors on the use of maternal health-care utilization among Muslim women in urban slum of Mumbai, India 社会人口因素对印度孟买城市贫民窟穆斯林妇女孕产妇保健利用的影响
Pub Date : 2023-03-14 DOI: 10.32677/ijch.v10i2.3867
V. Pinjari, Bal Rakshase, Ashish Pardhi
Background: Low and middle-income countries such as India face significant challenges in improving maternal health and reducing maternal mortality rate. To combat this problem, it is essential to utilize maternal health-care services.Objective: This study aims to assess the utilization of maternal health-care services (Antenatal care [ANC] and skilled attendance at birth) and the determining factors of maternal health-care utilization.Materials and Methods: This study is cross-sectional. The study is carried out in an urban slum in Mumbai, India. The respondents were selected using a multistage sampling procedure, and 300 Muslim women who delivered in the past 2 years in the reproductive age group (15–49 years) were selected. The data were collected using a structured interview schedule. Data were analyzed using logistic regression analysis.Results: The study shows that maternal health-care utilization among respondents was unsatisfactory. Only 43.8% of the respondents utilized full ANC service and 27.3% still delivered at home with unskilled birth attendance (traditional Dai). A medical emergency, high cost, and lack of quality of services were the most common reasons to deliver at home. Respondents’ age at marriage, education (respondents and partners), monthly income, number of children, and type of family are the most important determining factors for the utilization of maternal health-care services.Conclusion: Better utilization of maternal health-care services can be achieved by improving the overall socioeconomic status of Muslim women. To improve maternal healthcare, special attention is required to be paid to the education of women and spouses. Furthermore, policies may address the women’s subordinate position in socioeconomic parameters. Similarly, close monitoring is required by the government through different agencies on the utilization of maternal health-care services.
背景:印度等低收入和中等收入国家在改善孕产妇保健和降低孕产妇死亡率方面面临重大挑战。为了解决这一问题,必须利用产妇保健服务。目的:本研究旨在评估孕产妇保健服务(产前保健[ANC]和熟练助产)的利用情况以及孕产妇保健利用的决定因素。材料与方法:本研究为横断面研究。这项研究在印度孟买的一个城市贫民窟进行。回答者采用多阶段抽样程序选择,并选择了300名在过去2年内生育年龄组(15-49岁)分娩的穆斯林妇女。数据是通过结构化的访谈时间表收集的。数据采用logistic回归分析。结果:调查对象对孕产妇保健服务的利用情况不满意。只有43.8%的受访者利用了全面的ANC服务,27.3%的受访者仍然在家中由不熟练的助产人员(传统傣族)接生。医疗紧急情况、费用高和服务质量差是在家分娩的最常见原因。受访者的结婚年龄、受教育程度(受访者和伴侣)、月收入、子女数量和家庭类型是利用孕产妇保健服务的最重要决定因素。结论:通过提高穆斯林妇女的整体社会经济地位,可以更好地利用孕产妇保健服务。为了改善产妇保健,必须特别注意妇女及其配偶的教育。此外,政策可以解决妇女在社会经济参数中的从属地位。同样,政府要求通过不同机构密切监测孕产妇保健服务的使用情况。
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引用次数: 0
A case study of congenital adrenal hyperplasia 先天性肾上腺增生1例
Pub Date : 2023-03-10 DOI: 10.32677/ijch.v10i3.3880
R. Kamat, Upendra Chaudhary, Sangita Trivedi
Congenital adrenal hyperplasia (CAH) is a rare condition with a variety of symptoms. The most serious “salt losing” scenario is a medical emergency. A lack of 21 a-hydroxylase causes more than 90% of cases of CAH (21aOH). The adrenals produce excess sex hormones rather than cortisol. The vast majority of patients are unable to produce enough aldosterone. Girls are virilized, there is rapid somatic growth with the early epiphyseal fusion in both sexes, and there is even life-threatening hyponatremic dehydration. The following case report evaluates the clinical features, signs, and symptoms of CAH. A 1-day-old baby was admitted to the Neonatal Intensive Care Unit at the Department of Pediatrics, New Civil Hospital, Surat, for ambiguous genitalia. Various studies were conducted, and karyotyping suggestive of 46xx 17OH progesterone decreased. The sodium level was 114.64 mmol and the potassium level was 4.81 mmol on electrolyte analysis. CAH is an autosomal recessive disorder, in which 21-hydroxylase deficiency is the most common cause. In children, hydrocortisone is the preferred treatment.
先天性肾上腺增生症(CAH)是一种罕见的疾病,有多种症状。最严重的“盐流失”情况是医疗紧急情况。超过90%的CAH (21aOH)病例是由于缺乏21 A -羟化酶引起的。肾上腺分泌过多的性激素,而不是皮质醇。绝大多数患者无法产生足够的醛固酮。女孩是男性化的,两性都有快速的躯体生长和早期的骨骺融合,甚至有危及生命的低钠性脱水。以下病例报告评估了CAH的临床特征、体征和症状。一个1天大的婴儿住进新生儿重症监护室儿科,新民事医院,苏拉特,不明生殖器。进行了各种研究,核型提示46xx 17OH黄体酮减少。电解质分析钠含量为114.64 mmol,钾含量为4.81 mmol。CAH是一种常染色体隐性遗传病,其中21-羟化酶缺乏是最常见的原因。对于儿童,氢化可的松是首选的治疗方法。
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引用次数: 0
A rare case of sacroccocygeal teratoma type II with malignant yolk sac component 伴卵黄囊恶性成分的II型骶囊肿畸胎瘤1例
Pub Date : 2023-03-10 DOI: 10.32677/ijch.v10i2.3840
Radha Reddy Syamala, C V S Lakshmi, Praman Kushwah
Sacrococcygeal teratoma (SCT) is one of the most common neoplasms diagnosed prenatally. Obstetric ultrasound plays a role in the diagnosis and management of these tumors during pregnancy. In this case report, we discuss the postnatal outcome and a multidisciplinary approach in a neonate with massive SCT and preterm delivery. A 36-year-old mother with a pregnancy complicated by gestational diabetes and polyhydramnios and a large mass in the sacrococcygeal region delivered a girl child at 35+4 weeks gestation by elective cesarean section following an in utero transport to our center. The teratoma, measuring 15×12 cm, was completely excised along with the coccyx and perineum postnatally on day 3 of life. As histopathology revealed a small cluster of pre-malignant yolk sac tissue, the infant is under the care of a hemato-oncologist. Multidisciplinary care including good obstetric practices with serial monitoring with ultrasonography, in utero transfer to a center with Level III Neonatal Intensive Care, and pediatric surgery services with good nursing care result in improved outcomes in these complexes prenatally diagnosed tumors.
骶尾畸胎瘤(SCT)是一种最常见的肿瘤诊断产前。产科超声在诊断和管理这些肿瘤在怀孕期间发挥作用。在本病例报告中,我们讨论了新生儿大量SCT和早产的产后结果和多学科方法。一位36岁妊娠合并妊娠糖尿病、羊水过多及骶尾骨区大肿块的母亲,在子宫内转运后,于妊娠35+4周择期剖宫产产下一名女婴。畸胎瘤,尺寸为15×12 cm,在出生后第3天与尾骨和会阴一起完全切除。由于组织病理学显示一个小簇的前恶性卵黄囊组织,婴儿是在血液肿瘤医生的照顾下。多学科护理,包括良好的产科实践,超声连续监测,子宫内转移到三级新生儿重症监护中心,以及良好护理的儿科外科服务,可改善这些复杂的产前诊断肿瘤的预后。
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引用次数: 0
Improving swallowing function in a child with cerebral palsy: A single case study on the efficacy of intervention strategies 改善脑瘫儿童吞咽功能:干预策略疗效的个案研究
Pub Date : 2023-03-05 DOI: 10.32677/ijch.v10i2.3864
Priya Kapoor, Shrunga Manchanapura Shivalingaiah
The study explored the efficacy of Oromotor exercises and proprioceptive neuromuscular facilitation (PNF) to improve swallowing abilities pre- and post-behavioral intervention in a child with cerebral palsy (CP). A 4-year-old female child diagnosed with global developmental delay secondary to spastic quadriplegic CP and poor feeding skills was taken up for study. Oro-motor stimulation and PNF with taste, temperature, and texture were used. Therapy was given twice a week for 30 min. Pre- and post-intervention, a detailed Oro motor and feeding evaluation was performed. Post-therapy evaluation revealed significant increase in body weight, oromotor movements, International Dysphagia Diet Standardization Initiative, Eating Drinking Ability Classification System level, frequency of water, and meal intake. The intense application of oromotor and PNF stimulation seemed to have effected significant improvements in feeding and swallowing abilities which translated to increased weight and positive parental feedback. This might have been responsible for positive outcomes seen in the present study as well.
本研究探讨了奥罗运动训练和本体感觉神经肌肉促进(PNF)在脑瘫(CP)患儿行为干预前后改善吞咽能力的效果。我们选取了一名4岁的女性儿童作为研究对象,该儿童被诊断为痉挛性四肢瘫痪CP继发的整体发育迟缓和不良的喂养技能。采用Oro-motor刺激和味觉、温度和质地的PNF。治疗每周两次,每次30分钟。干预前和干预后,进行详细的Oro运动和喂养评估。治疗后评估显示体重、运动运动、国际吞咽困难饮食标准化倡议、饮食能力分类系统水平、饮水频率和膳食摄入量显著增加。强烈应用口腔运动和PNF刺激似乎对喂养和吞咽能力有显著改善,这转化为体重增加和积极的父母反馈。这可能也是本研究中看到的积极结果的原因。
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引用次数: 0
Spontaneous remission in nephrotic syndrome relapses followed up for 6 months – A prospective cohort study 肾病综合征复发自发性缓解随访6个月——一项前瞻性队列研究
Pub Date : 2023-01-27 DOI: 10.32677/ijch.v10i1.3829
Venu Kulkarni, Anil Kumar Hanumanna, Mallesh Kariyappa
Background/Objectives: Nephrotic syndrome (NS) relapses are usually triggered by infections. Treatment of infections will be sufficient to cause resolution of symptoms. Our study aimed to determine frequency of spontaneous remission and its predictors. In addition, our main objective was to know the outcome of children after spontaneous remission of relapses for next 6 months.Materials and Methods: Prospective cohort study included all children who presented with NS relapses. Seventy-four children were enrolled from November 2016 to May 2018. Both, spontaneous remission YES and NO groups, were followed up for 6 month duration to study relapse free period and relapse rate.Results: About 53.7% relapses remitted spontaneously with only stress dose steroids. Duration of illness more than 24 months could predict likely chances of spontaneous remission RR 0.49, 95% CI 0.29–0.87 (p=0.003). Outcome parameters, that is, relapse free period and relapse rate were similar in both groups.Conclusion: About 50% of NS relapses will remit spontaneously with only stress dose of steroids and if required antibiotics. Waiting period of 1 week for clearance of infection and occurrence of spontaneous remission may be necessary before contemplating long steroid course for all relapses. Further studies are required with large sample size.
背景/目的:肾病综合征(NS)的复发通常由感染引起。对感染的治疗足以使症状得到缓解。我们的研究旨在确定自发性缓解的频率及其预测因素。此外,我们的主要目的是了解儿童在未来6个月的复发后自发性缓解的结果。材料和方法:前瞻性队列研究包括所有表现为NS复发的儿童。74名儿童在2016年11月至2018年5月期间入学。自然缓解组和自然缓解组均随访6个月,观察无复发时间和复发率。结果:仅使用应激剂量类固醇治疗后,约53.7%的复发自行缓解。病程超过24个月可以预测自发缓解的可能性,RR为0.49,95% CI为0.29-0.87 (p=0.003)。两组的预后参数无复发期和复发率相似。结论:约50%的NS复发可自行缓解,只需应激剂量的类固醇和必要的抗生素。在考虑所有复发的长期类固醇疗程之前,可能需要等待1周的感染清除和自发缓解期。需要更大样本量的进一步研究。
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引用次数: 0
Risk factors and trends in neonatal mortality in NICU in a tertiary care hospital in India 印度一家三级医院新生儿重症监护室新生儿死亡率的危险因素和趋势
Pub Date : 2023-01-27 DOI: 10.32677/ijch.v10i1.3830
Sadashiva B Ukkali, Nagamani Kulkarni, Punitha Badsheshi, Ravindra Naganoor, A. Thobbi
Introduction: The most vulnerable period of human life is neonatal period, which accounts for most of the morbidities and mortalities. Most of them are preventable with adequate health-care facilities.Objectives: The aim of the study was to determine the trends of neonatal mortality and identify the risk factors, most of which are preventable and measure the progress of health-care services.Methods: A retrospective study was conducted in neonatal intensive care unit (NICU) of Al-Ameen Children Hospital (AMCH) Vijayapura, Karnataka, India. Data were extracted from paper medical records at AMCH of a period of 1 year and digitized. Data obtained included age, sex and birth weight, place of delivery, morbidity profile, mortality profile, diagnosis, and period of stay in NICU.Results: A total of 648 neonates were admitted in NICU during the study period of 1-year duration, between January and December 2021. A total of 382 (58.9%) infants were discharged on recovery, 65 (10.3%) were referred due to unavailability of advanced surgical intervention, 39 (6%) were discharged against medical advice, 162 (25%) died due to various reasons. Male neonatal deaths outnumbered female neonates (56.8%). Among the total neonatal deaths, 82 (50.6%) were preterm neonates, 73 (45.1%) were term neonates and 7 (4.3%) were post-term neonates. It was noticed that among neonatal deaths, 87 (54.3%) babies were out-born and 75 (46.2%) babies were inborn. In this study, it was noticed that the mortality percentage of the neonate falling in the category of 1.5–1.9 kg was high compared to other categories. In our study, respiratory distress syndrome was the main cause of mortality accounting for 19.1% (31 cases) of total cases and prematurity was the most common risk factor.Conclusion: Improving the standard of antenatal care and encouraging deliveries in institutions having good NICU facility and early identification of risk factors help to reduce the mortality and its complications.
人类生命中最脆弱的时期是新生儿期,占发病率和死亡率的大部分。其中大多数是可以通过适当的保健设施预防的。目的:研究的目的是确定新生儿死亡率的趋势,确定风险因素,其中大多数是可以预防的,并衡量保健服务的进展。方法:对印度卡纳塔克邦Vijayapura Al-Ameen儿童医院(AMCH)新生儿重症监护病房(NICU)进行回顾性研究。数据从AMCH 1年的纸质病历中提取并数字化。获得的数据包括年龄、性别和出生体重、分娩地点、发病率概况、死亡率概况、诊断和在新生儿重症监护病房的住院时间。结果:在2021年1月至12月为期1年的研究期间,共有648名新生儿入住NICU。382例(58.9%)康复出院,65例(10.3%)因无法获得先进的手术干预而转诊,39例(6%)不遵医嘱出院,162例(25%)因各种原因死亡。男婴新生儿死亡人数超过女婴(56.8%)。在新生儿死亡总数中,早产儿82例(50.6%),足月新生儿73例(45.1%),足月后新生儿7例(4.3%)。值得注意的是,在新生儿死亡中,87名(54.3%)婴儿是外产的,75名(46.2%)婴儿是先天性的。在这项研究中,我们注意到1.5-1.9 kg类别的新生儿死亡率高于其他类别。本研究中,呼吸窘迫综合征是导致死亡的主要原因,占总死亡病例的19.1%(31例),早产是最常见的危险因素。结论:在新生儿重症监护病房条件良好的机构提高产前护理水平,鼓励分娩,及早发现危险因素,有助于降低新生儿死亡率和并发症。
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引用次数: 0
Nutritional rehabilitation of special cases of malnourished children aged 0 to 6 months at the Maradi Regional Hospital, Niger 尼日尔马拉迪地区医院对0至6个月营养不良儿童的特殊病例进行营养康复治疗
Pub Date : 2023-01-26 DOI: 10.32677/ijch.v10i1.3818
Issoufou Amadou, Mazou Hamadou, Oumarou Samna Soumana
Malnutrition is a pathological state resulting from the relative or absolute deficiency or excess of one or more essential nutrients, whether this state manifests itself clinically, or whether detectable only by biological, anthropometric, or physiological analyses. This study uses a cross-sectional survey conducted on a representative sample of 60 mothers with their children aged 0–6 months (special cases) admitted at the Intensive Nutritional Education and Recovery Center of the Maradi Regional Hospital from May 23 to July 23, 2022. The main objective of this study is to evaluate the nutritional rehabilitation of children in special cases within this service. Data collection was done on 60 children with severe acute malnutrition. A questionnaire was addressed to the mothers of malnourished children. The hospital records were also used to access information on the anthropometric parameters, thus determining the nutritional status of the children studied. The study results show that children aged 0–3 months are the most affected by malnutrition and are special cases with a weight/height ratio below minus 3 z-score. They most often suffer from diarrhea with a rate of 41.6% and fever with a rate of 21.7%. These children generally come from parents with no schooling and with limited resources. It can also be noted that most of these malnourished children come from mothers who practiced mixed breastfeeding. To get done, during treatment, the majority of patients have to use the diluted F100 as the type of diet and a mode of feeding with the cup. The supplementary suckling technique was applied to get heal the special cases in need. In conclusion, the study affirms that socioeconomic and environmental factors play a very important role in the persistence of malnutrition in this part of the world.
营养不良是由于一种或多种必需营养素相对或绝对缺乏或过量而导致的一种病理状态,无论这种状态是否在临床上表现出来,还是只能通过生物学、人体测量学或生理学分析来检测。本研究采用横断面调查方法,对2022年5月23日至7月23日在马拉迪地区医院强化营养教育和康复中心住院的60名母亲及其0-6个月大的孩子(特殊病例)进行代表性样本进行调查。这项研究的主要目的是评价该服务中特殊情况下儿童的营养康复情况。收集了60名患有严重急性营养不良的儿童的数据。向营养不良儿童的母亲发了一份调查表。医院记录还用于获取人体测量参数信息,从而确定所研究儿童的营养状况。研究结果表明,0-3月龄儿童营养不良最严重,是体重/身高比低于- 3 z-score的特殊情况。他们最常见的症状是腹泻,占41.6%,发烧占21.7%。这些孩子的父母通常没有受过教育,资源有限。还可以指出的是,这些营养不良的儿童大多来自实行混合母乳喂养的母亲。为了做到这一点,在治疗期间,大多数患者必须使用稀释的F100作为饮食类型和用杯子喂养的方式。采用补充哺乳技术治疗特殊病例。总之,该研究证实,社会经济和环境因素在世界这一地区持续的营养不良中起着非常重要的作用。
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引用次数: 0
COVID-19 Pandemic: Effect of prolonged lockdown on adolescents and young adults COVID-19大流行:长期封锁对青少年和年轻人的影响
Pub Date : 2023-01-01 DOI: 10.32677/ijch.v9i12.3749
Devina Pande, Zahi Parekh, S. Kanhere
Objective: This study was conducted to assess the impact of the prolonged lockdown, due to the Coronavirus Disease 2019 (COVID-19) pandemic, on the daily life, education, mental and family health, and general well-being of adolescents and young adults in India.Materials and Methods: A total of 210 participants aged 12–21 years formed the study sample. After approval from the Institutional Ethics Committee, a cross-sectional study was conducted using a pre-designed validated online questionnaire. Consent/assent was taken and confidentiality was assured. The questionnaire consisted of 33 questions. The data were analyzed using Microsoft Excel, expressed as frequency and percentages, and converted to charts and graphs.Results: Most (88%) of the respondents understood the severity of the pandemic. The majority (85%) of educational institutions conducted online classes; however, classroom lectures were preferred over online lectures by 171 (81.4%) students. Thirty-seven (36.7%) students had been affected by the cancellation of entrance exams. Eagerness to return to school/college was found amongst 135 (64.2%) participants. Lockdown restrictions led to 56% of activities being screen-based, leading to headaches and eye strain in 167 (79.5%) students. Participants were bored, irritated, and anxious, but 56.2% of them remained positive by developing new hobbies, reading, or spending time with family. Sixty-nine (32.8%) respondents or their close family members suffered from mild COVID symptoms; however, it was a major strain on their mental health.Conclusion: Overall, the pandemic and prolonged lockdown had a mixed impact on 82 (39%), a negative impact on 65 (31%), and a positive impact on 63(30%) of adolescents and young adults.
目的:本研究旨在评估2019年冠状病毒病(COVID-19)大流行导致的长期封锁对印度青少年和年轻人的日常生活、教育、心理和家庭健康以及总体福祉的影响。材料与方法:研究样本共210人,年龄12-21岁。经机构伦理委员会批准后,采用预先设计的有效在线问卷进行横断面研究。同意/同意并保证保密。问卷共有33个问题。使用Microsoft Excel对数据进行分析,以频率和百分比表示,并转换为图表。结果:大多数应答者(88%)了解大流行的严重性。大多数(85%)教育机构开设在线课程;然而,171名(81.4%)学生更喜欢课堂授课而不是网络授课。37名(36.7%)学生受到取消入学考试的影响。135名(64.2%)受访者有重返学校/大学的渴望。封锁限制导致56%的活动与屏幕有关,导致167名(79.5%)学生头痛和眼睛疲劳。参与者感到无聊、烦躁和焦虑,但56.2%的人通过培养新的爱好、阅读或与家人共度时光保持积极态度。被调查者或其近亲属中有69人(32.8%)出现轻度症状;然而,这对他们的心理健康造成了很大的压力。总体而言,大流行和长期封锁对82人(39%)产生了不同的影响,对65人(31%)产生了负面影响,对63人(30%)产生了积极影响。
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引用次数: 0
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The Indian journal of child health
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