Journal of Preventive Medicine and Hygiene (JPMH)
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Knowledge, attitudes, and practices related to the prevention of adverse pregnancy outcomes among samples of females in Al‐Suwaira city, Wasit Governorate, Iraq
Full text linkIntroduction: Adverse pregnancy outcomes pose serious health risks to both periconceptional women and newborns. This study aimed to investigate the levels of knowledge, attitudes, and practice (KAP) toward adverse pregnancy outcomes among women of reproductive age in Al-Suwaira, Wasit governorate, Iraq.
Methods: During November 2021 to February 2022, a cross-sectional research of randomly selected women was performed. The KAP was evaluated with a standard, self-administered questionnaire. The outcomes were described using a descriptive analysis.
Results: The questionnaire was completed by 118 women. Participants had good knowledge and positive attitudes and practices toward adverse pregnancy outcomes. The findings revealed that the majority of participants were between the ages of 20 and 25 (n = 57, 48.3%) and had a Bachelor\u27s degree (n = 106, 89.8%). Knowledge gaps were discovered in the areas of the danger of pregnancy at a young age of less than 17 years (30.5%), the link between lack of maternal education and poor births (24.6%), and the influence of drug misuse on the fetus (17.8%). The participants learn more around pregnancy-related risk factors via internet (n = 38, 32.2%) and university (n = 34, 28.8%).
Conclusions: The participants in this study had good knowledge, positive attitude, and positive practice regarding adverse pregnancy outcomes. However, there were some knowledge gaps. Therefore, to raise awareness among local women, it seems advisable to strengthen and strictly apply awareness-raising plans.
 
Perspectives on AI use in medicine: views of the Italian Society of Artificial Intelligence in Medicine
Full text linkThe first annual meeting of the Italian Society for Artificial Intelligence in Medicine (Società Italiana Intelligenza Artificiale in Medicina, SIIAM) on December 7, 2023, marked a significant milestone in integrating artificial intelligence (AI) into Italy\u27s healthcare framework. This paper reports on the collaborative workshop conducted during this event, highlighting the collective efforts of 51 professionals from diverse fields including medicine, engineering, data science, and law. The interdisciplinary nature of the participants played a crucial role in generating ideas for innovative AI solutions tailored to healthcare challenges.
Central to the discussions were several AI applications aimed at improving patient care and streamlining healthcare processes. Notably, the use of Large Language Models (LLMs) in remote monitoring of chronic patients emerged as an area of focus. These models promise enhanced patient monitoring through detailed symptom checking and anomaly detection, thereby facilitating timely medical interventions. Another significant proposal involved employing LLMs to improve empathy in medical communication, addressing the challenges posed by cultural diversity and high-stress levels among healthcare professionals.
Additionally, the development of Machine Learning algorithms for standardizing treatment in pediatric emergency departments was discussed, along with the need for educational initiatives to enhance AI adoption in rural healthcare settings. The workshop also explored using LLMs for efficient data extraction and analysis in scientific literature, interpreting healthcare norms, and streamlining Hospital Discharge Records.
These discussions underscored SIIAM\u27s commitment to leveraging AI for healthcare innovation, setting a precedent for the future of healthcare in Italy. This paper provides a comprehensive overview of the ideas and solutions proposed at the workshop, reflecting the participants\u27 forward-thinking vision and the potential of AI to revolutionize healthcare
Aerobic or Resistance Exercise for maximum Cardiovascular Disease Protection? An Appraisal of the Current Level of Evidence: Aerobic, Resistance Exercise and CVD
No full textThe beneficial role of physical activity on the cardiovascular system has been well established and appreciated. The aim of this narrative review was to present a summary of the latest recommendations for physical activity, and to evaluate the most recent scientific evidence regarding the role of aerobic and or resistance exercise in relation to atherosclerotic cardiovascular disease (ASCVD) risk. The guidelines of major Organizations (i.e., European Society of Cardiology, American College of Cardiology/ American Heart Association, American College of Sports Medicine, and World Heart Federation, World Heart Organization) were also retrieved and presented here. Engagement in regular aerobic exercise is strongly recommended for all people and by all scientific organizations for reducing ASCVD mortality and morbidity. Resistance exercise should be implemented in addition to aerobic, however, its individual effects on ASCVD risk are not well established. A reduction of sedentary behavior at population level reduces the healthcare costs by multiple ways. Effective approaches should be implemented that include behavior theory-based interventions, e.g., goal-setting, re-evaluation of goals, self-monitoring, and feedback. Most important is to encourage activity that individuals enjoy and/or can be included in their daily life
Eosinophil count and clinical outcome in patients with acute exacerbation of Chronic obstructive pulmonary disease
Full text linkIntroduction
We examined the association of blood eosinophil counts at the time of AECOPD hospitalization with the risk of ICU admission as well as the hospital lengths of stay and mortality.
Methods
In the current retrospective study, the association between blood eosinophil counts in COPD patients at the time of AECOPD hospitalization and the risk of subsequent ICU admission as well as mortality was assessed. The chi-squared test and t-test were used to compare categorical and continuous variables. The statistical significance level was set at 0.05. Kaplan–Meier curves for mortality as well as ICU admission up to 40 days after discharge from the index hospitalization were constructed using the determined optimal eosinophil threshold derived above and for the predetermined ≥300 vs <300 cells/μL threshold. All analyses were performed using SPSS version 19.
Results
Antibiotic prescription was significantly associated with increased ICU admission (OR=1.57; confidence interval [95%CI] =1.02–2.42. Patients with higher FEV1 had decreased ICU admission (OR=0.98, 95% CI=0.97–1.01, p=0.1) as well as all-cause mortality compared (OR=0.98, 95% CI=0.92–1.04, p=0.58). There were significantly greater mortality rates for patients with higher ESR (OR=1.02, CI=1.01–1.03, p=0.01) and CRP (OR=1.02, 95% CI=1.01–1.03, p=0.01). There were significantly lower ICU admission rates for patients with higher FVC (OR=0.97, 95% CI=0.95–0.98, p=0.002).
Conclusion
Blood eosinophil count could help determine the risk of ICU admission as well as mortality in COPD patients at the time of hospitalization
Healthcare infections and antimicrobial consumption in pre-COVID-19 era: a point prevalence survey in three hospitals in a region of central Italy: Hospital infections and antimicrobials use
No full textHealthcare-associated infections (HAIs) are a major global public health concern, increasing the transmission of drug-resistant infections. This point prevalence survey investigated HAIs occurrence and antimicrobial consumption (AMC) in pre-COVID-19 era in the public hospitals of a region of Central Italy. Data were collected using the protocol standardised by the European Centre for Disease Prevention and Control. Three-hundred and sixty-four patients were included (59.3% male) in the study. Overall, HAIs prevalence was 6.6% (95%CI 4.4-9.5), ranging from 5.2% to 7.1% within the surveyed hospitals, with at least one infection in 24 patients (ten each in medical and surgical specialties wards, and four in intensive care). Risk factors for HAIs were advanced age, having undergone surgery and wearing invasive devices. At time of the survey, 44.7% (95%CI 39.7-49.9) of patients was under treatment with at least one antibiotic, and AMC varied between 43% and 48% within hospitals. In all hospitals, a prevalence higher than 10% was found for the prescription reasons other than prophylaxis or therapy. The results revealed a HAIs prevalence lower than that estimated compared to the most recent national data, in contrast to higher antimicrobial usage. These findings highlight the need to reinforce hygiene practices and develop bundles for HAIs, as a broad implementation of infection prevention and control practices extensively applied to both hub and spoke hospitals could significantly reduce their occurrence, as well as to implement antimicrobial stewardship for prescriptive appropriateness
Prevalence of excess screen time among secondary school children in rural India: a cause for concern: Screen time among secondary school children in rural India
No full textIntroduction: Screen time has increased during the COVID-19 pandemic, especially among children and teenagers. This has come at the expense of their healthy eating habits, physical activity and adequate amount of quality sleep. The excessive use of screen-device can lead to addiction which starts during adolescent years Objectives: 1) To assess prevalence of excess screen time among secondary school children. 2) To correlate BMI, sleep duration, duration of physical activity and food habits with screen time duration. Study settings and design: Cross-sectional study was conducted in secondary schools in the rural field practice area of a private medical college in Pune, India Methods and Material: The study included 184 school children from eighth to tenth standard. Data was collected using a self-administered, validated questionnaire. Results: Prevalence of excess screen time among secondary school children was 83.2%. Mobile phone was the most used device (98.9 %). There was a significant association between excess screen time and inadequate sleep. Conclusions: The present study reports high prevalence of excess screen time in rural school going children in rural India. There is a need for strategies to combat this in school health programs on priority
Assessment of workhour feeding practices, healthy behaviour score and body mass index of physicians in Northern Nigeria: a cross-sectional multi-centre study
Full text linkBackground: The increasing obesity/overweight prevalence among health workers calls for an appraisal of their lifestyle. This study assessed medical practitioners\u27 workhour feeding and lifestyle practices and explored the relationship between these practices and their body mass index (BMI).
Methods: The survey involved 321 medical practitioners selected from 9 northern Nigeria hospitals in 2021. Data collected included biodata, medication history, workhour feeding characteristics, lifestyle behaviours, blood pressure, height, and weight measurements. Data were analyzed using Epi info software (version 7).
Results: Most respondents were male (70.7%). Their mean age was 38±7.4 years. During their last workhours, 84.1% had lunch, 46.4% took sugary drinks, 2.7% brought lunch from home, and 1.3% took nothing. Only 18.7% patronize their hospital canteen weekly. Most reported healthy behaviour towards alcohol (99.7%) and, fruit/vegetable (54.8%) consumption, and smoking (98.4%), but only 22.4% were physically active. Their mean healthy behaviour score and BMI were 2.8±0.7 and 26.1±4.6 kg/m2, respectively. The obesity and overweight rates were 18.4% and 37.7%, respectively. Their source of lunch during workhours, age, sex, years of practice, employment duration, marital status, job category, systolic blood pressure, anti-hypertensive, and antidiabetic medication use were significantly associated with mean BMI. However, only antihypertensive medication use, being married, inadequate fruit/vegetable consumption and workhour sugary drinks consumption predicted obesity. The predictors of overweight/obese were long practice experience (<10y) and use of antihypertensive medications.
Conclusions: Overweight and obesity rates were high. Most were physically inactive. Workhour sugary drink consumption predicted obesity. Effective workplace and community interventions to improve practitioners\u27 lifestyle behaviour and curtail obesity and overweight are needed
ERRATA CORRIGE - Journal of Preventive Medicine and Hygiene 2023;64:E411‐E115. https://doi.org/10.15167/2421‐4248/jpmh2023.64.4.3152
Full text linkERRATA CORRIGE
Journal of Preventive Medicine and Hygiene 2023;64:E411‐E115. https://doi.org/10.15167/2421‐4248/jpmh2023.64.4.315
The fight against smallpox during the Savoy kingdom in Genoa between 1815 and 1859.: The challenges in fighting smallpox in the region of Genoa.
No full textIntroduction. The article aims to outline the features of the efforts for smallpox eradication within the pre-unitary context of the Kingdom of Sardinia, characterized by a long tradition in medical-health prevention. This tradition is partly inherited from the health magistracies of the Italian states during the ancient regime and partly adopted from policies initially outlined by Napoleon and later by other European states. In addition to prevention activities, authorities also engage in a vigorous information and awareness campaign aimed at eliminating common prejudices and doubts about vaccination among the population.
Methods. In analyzing the authorities\u27 achievements in combating smallpox, this study examines the two epidemic waves (1829-30 and 1852-54), along with the legislative developments before, during, and after these periods. It also compares these regulatory changes with those in other European contexts.
Discussion. The epidemiological situation turned out to be more complex to manage than the authorities had anticipated, as evidenced by the increasing controls imposed. Scientific and political communities, both in the Kingdom of Sardinia and in other European nations, found themselves divided on the legitimacy of proposing restrictive measures by the state. Some advocated for restricted access to public places and imposed mandatory vaccination for vulnerable individuals.
Conclusions. The comparison with smallpox resulted in a gradual improvement in of health security levels, although vaccination coverage did not reach the desired targets. Several factors contributed to this failure, including the limited expertise and reluctance of medical personnel, who were burdened with much of the operation\u27s costs. Additionally, particularly in rural areas, there was widespread mistrust among the population towards doctors. Despite these challenges, the fight against smallpox enabled authorities to develop population control tools in the name of public health protection. However, it was not until 1888 that mandatory vaccination was introduced
Comparison of the Short-Term Effect of Intra-Articular Hyaluronic Acid and Platelet-Rich Plasma Injections in Knee Osteoarthritis: A Randomized clinical trial
Full text linkIntroduction
Osteoarthritis (OA) is one of the most common degenerative joint diseases which involved all joints. It is very important to choose a treatment method with high efficiency to reduce the pain and disability of patients and also to improve their quality of life. The current study aimed to investigate the therapeutic effects of intra-articular injection of PRP and hyaluronic acid (HA) in the knee of people with knee osteoarthritis (KOA).
Methods
In this randomized clinical trial study, 90 patients with KOA were randomly divided into two groups of intra-articular HA and PRP. The patients of the two groups were followed up for five months and different outcomes were recorded. The McMaster index (WOMAC) evaluated all patients at rest and during movements. Measurements were taken at the beginning and after the third month of follow-up.
Results
Three month after the last injection (5th month) and after adjusting of baseline value using analysis of covariance, the mean of knee pain, stiffness, physical function and finally total score in the PRP group, was significantly lower than the HA group. Regarding the Osteoarthritis grade, the mean of knee pain, Stiffness, Physical function and finally total score in the PRP group was significantly lower than the HA group in all Osteoarthritis grades. Also, there were no complications in the studied groups.
Conclusion
The results of the current study showed that pain and stiffness reduction as well as physical function of the knee joint in the PRP group was better than in the HA group