Asian Pacific Journal of Health Sciences
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Development and Validation of Attitudes and Concerns toward COVID-19 Vaccination Scale
Get PDFBackground: COVID-19 vaccines are one of the fastest developed vaccines to date. People have different views and opinions about it. A positive attitude can strengthen the vaccination program, whereas a negative attitude will be an obstacle for a healthy and safe nation. This study aimed at developing and validating the Attitudes and Concerns toward the COVID-19 vaccination. Methods: Initial draft of 48 items was developed based on literature review and interview of experts. After content validation with four experts and semantic validation with 20 respondents, 32 items were retained and administered to 607 Indian adults aged 18–60 years. Results: Data were analyzed by IBM-SPSS Version-23 with AMOS. Exploratory factor analysis supported the two-factor structure for the attitude toward COVID-19 vaccination and three factors structure for the concern domain. Cronbach alpha for “Vaccine Acceptance” and “Vaccine Hesitance” was.825 and.721. The reliability of religious concerns (α = 0.785), social concerns (α = 0.714), and health concern (α = 0.699) subscales was acceptable. The confirmatory factor analysis results verified two-factor model of attitude and three-factor model of concerns as the model indices were close to 1; RMSEA was 0.000 and PCLOSE values were 0.861 and 0.927, respectively, for Parts I and II. Conclusion: This is 12-item scale that measures vaccine acceptance, vaccine hesitance, religious concerns, social concerns, and health concerns related to COVID-19 vaccination
Exploring the Analgesic Potential of Homeopathic Formulation of Tincture Apis
Get PDFApis is a homeopathic formulation developed from the venom of Apis mellifera. Apis is extensively used to treat various skin disorders, pleurisy, and peritonitis. The Global Burden of Disease Study 2016 firmly stated the high prominence of pain and pain-related diseases are the leading cause of disability and disease burden globally. The current investigation was aimed to explore the analgesic effect of homeopathic formulation tincture Apis using formalin induced flinching, acetic acid induced writhing and Eddy’s hot plate test. Tincture Apis pretreatment significantly reduced the number of flinching’s in both neurogenic and inflammatory phase in formalin test. Moreover, in Acetic acid and Eddy’s hot plate test, tincture Apis pre-treatment significantly reduced the acetic acid induced writhing’s and increased the paw licking latency, respectively. The effect of Apis was prominent to that observed with standard diclofenac in formalin and acetic acid test. Amino acid analysis revealed that tincture Apis contains 14 amino acids including seven essential amino acids. Furthermore, morphological studies revealed that administration of 10 times concentrated tincture Apis had no visible changes in acute toxicity screening such as change in skin color, salivation, convulsions, tremors, diarrhea, and paralysis or mortality in 14 day study. However, abnormal movement of body and eye were observed in the first 4 h. Overall outcome of present study revealed that tincture Apis has an excellent analgesic potential, which might be linked to the presence of essential amino acids including leucine, histidine, and GABA in tincture Apis
Effect of Pesticides on Nervous System or Neural Health
Get PDFPesticides will be utilized to manage pests that are important to agriculture and health care, and they will continue to be necessary for the future related to food security and prevention and control. Pesticides are unlikely to be phased out in the foreseeable future, but they should be handled with prudence. The majority of pesticides are hazardous to humans and can cause serious health problems which lead to death. During chemical spraying, skin contact accounts for about all of the body exposure. Contamination, such as for local farmers in open vegetable farming or pesticide industry employees, may result in direct exposure. Indirect exposure can occur through dietary goods such as food and drinking water, as well as the usage of repellents in homes. Some neurotoxic effects are immediately apparent, while others might take months or even years to appear. A variety of variables, including the toxin’s characteristics and the dosage a person, is exposed to, determine the consequences of neurotoxicity. Amyotrophic Lateral Sclerosis, Intermediate syndrome, Parkinson’s disease, and Alzheimer’s disease are diseases that highly damage the mental health and the neural health of a person. This review is mainly focused on types of pesticides, route of pesticide entry in body, their effect on human health, and how these pesticides induce neural diseases
Laser-assisted Management for Orthodontic Treatment-induced Gingival Enlargement: A Case Series
Get PDFDifferent ways can be used to remove tissue during gingivectomy and generate a good gingival margin; the most common is the traditional gingivectomy, which is performed with a scalpel; however, laser technology is becoming more commonly available and can be utilized to perform procedures. Hence, this case series emphasize the importance of laser treatment in cases of gingival overgrowth seen due to ongoing orthodontic treatment. In this case series, three clinical reports are discussed in detail, comparing the efficiency of scalpel and diode laser therapy for treating gingival overgrowth and patient perception of the need of taking pain killer after the surgery and the presence of discomfort during eating and speech. Based on them, it can be concluded that diode laser gingivectomy can be a valuable tool for achieving faster and greater improvements in gingival health, implying its usefulness for orthodontic patients with gingival overgrowth, particularly when oral hygiene is insufficient to achieve normal healthy gums. For many years, scalpels were been used in performing gingivectomy and there is a dilemma whether to use scalpel or laser for gingivectomy procedures. The dilemma of the clinician was resolved confirming that laser therapy offers many more advantages for the gingivectomy procedure along with added benefits of lasers to reduce patient discomfort and accelerate healing
Treatment of MIS-C in Children with Only Steroid - Our Experience in a Tertiary Health Care Center in Rural Bihar
Get PDFIntroduction: During the COVID pandemic, initially the children were less affected or were asymptomatic. Later in 2021 many children and adolescents who suffered from COVID-19 infection either symptomatic or asymptomatic, got serious complication known as Paediatric Multisystem Inflammatory Syndrome (MIS) associated with severe acute respiratory syndrome coronavirus 2 (also known as MIS in children [MIS-C]). We admitted many such cases of MISC from surrounding community of Kishanganj located in Bihar. Clinical presentations were fever, shock with hyper‑inflammation, and multiorgan dysfunction, neurological, cardiological, and gastrointestinal dysfunction. This complication of COVID 19 infection was likely a post infection hyper‑inflammatory response as almost 90% of these children were tested positive for antibodies against CoV‑2 with significant rise in inflammatory markers and cytokine levels. Intravenous immunoglobulin (IVIG), aspirin, low molecular weight heparin, and steroids were the cornerstones of treatment protocol. We report here 41 cases of similar presentation, treatment, and outcome of children from Pediatrics Department of MGM Medical College, Kishanganj, Bihar. Materials and Methods: Forty-one cases suspected of MIS-C fulfilling the criteria set by the WHO were taken for this study at Mata Gujri Memorial Medical College and Hospital Kishanganj for a tenure of 10 months (June 2021–March 2022). After initial clinical assessment, blood investigation was sent for various biochemical (C-reactive protein, complete blood count, and neutrophil lymphocyte ratio) and microbiological (D-dimer, COVID IgG) assessment to come to a diagnosis of MIS-C. Treatment protocol includes steroid (methyl prednisolone, dexamethasone) and in two cases IVIG. Results: Among all the 41 patients treated with steroid, 38 cases (92.7%) patient were successfully recovered and discharged. We also noticed there were significant neurological (39%), gastrointestinal (14.6%), and respiratory (24.4%) manifestation. We found association of coinfection with other organism among 3 cases (7.3%) among these 41 patients. Conclusion: MIS-C is a hyperinflammatory syndrome associated with SARS‑CoV‑2 in children and adolescents with fevers, shock, and multiorgan dysfunction. Steroids, IVIG, and aspirin are the first line of management. Refractory cases may need repeat doses of IVIG, steroids or immune‑modulating drugs. However, in our study, we have demonstrated that most of the cases respond (92.7%) significantly to Methyl prednisolone alone
Discharges against Medical Advice: A Study on Patient’s Profile from the Emergency Ward of BPKIHS, Dharan in East Nepal
Get PDFIntroduction: Discharge against medical advice in the emergency department (ED) is particularly important as the patient may be threatening his life by choosing to leave and thus not receive adequate or timely medical care. Patients who leave against medical advice (LAMA) may be severely ill and at risk of experiencing adverse events and revisit to ED. Reasons for LAMA include, but are not limited to, family obligations or financial responsibilities. In Nepal, however, a paucity of data exists regarding LAMA and factors that might influence it. Therefore, this study will find out the characteristics of patients leaving LAMA and also identify factors and reasons behind LAMA discharges that might allow the physician to decrease such discharges and improve patient care. Methods: A semi-standardized questionnaire was used to record relevant demographic and clinical information’s. The questionnaire included sociodemographic characteristics (age, sex, marital status, education status, occupation, etc.) and clinical and administrative elements (diagnosis, date of admission and discharges, length of stay, previous LAMA history, and hospital stay). They were also asked for a reason for LAMA, hospital as well as patient-related factors. Results: Out of 358 LAMA discharges, the mean age was 51 SD (21.73). The majority of patients had an Australian triage score of 2 (61.5%) at triage. The majority of the patients were married 79.6%, illiterate (40%), and uninsured as well (87.7%). About 50% of the patients stayed for 12–24 h in the ED before LAMA. Discharge diagnosis was mainly gastrointestinal (GI) (21.8%), poisoning (12%), neurologic (11.5%), and pulmonary (11.2%). Most of the patients who left against medical advice were due to patients related factors accounting 94.7% rather than hospital-related factors 16.8%. Critical conditions and patients not improving were the most common reasons 31.6% followed by feeling better (28.8%). Conclusion: Critical patients, mainly with GI diagnosis, non-critical patients with poisoning, and patients with a longer length of stay are high-risk patients for LAMA discharges
Engaging Apparel Employees to Identify and Decide Actions to Address Selected Determinants using Health Promotion Approach
Get PDFLow level of employee engagement is one of the most alarming global economic problems. It declines work performance and productivity of employees. The objective of this qualitative study is to identify and decide actions to address selected probable determinants which affect employee engagement. The health promotion principals with participatory approach were implemented with sewing machine operators in an apparel factory in Sri Lanka of age 18–55 (n = 64). The duration of determinant identification took around 3 months while intervention period took around 6 months. Initiation, maintenance and continual monitoring, and re-direction toward greater effectiveness were done as the components of a health promotion process. Group discussions with employees and key informant interviews with managerial personals were recorded, transcribed, translated to English, and thematically analyzed. Without the involvement of the principal investigator, employees were able to identify eight determinants while managerial personals identified three determinants. Among those identified probable determinants, four of which corresponded with those already mentioned in published studies. After facilitation, employees could identify six determinants and they could identify determinants by conducting some interactive activities and while measuring employees’ changes using “health promotional tools” as well. From the identified determinants, employees prioritized four determinants that were addressed and nine actions were developed with the employees to address them in this process. Employees could identify the probable determinants that affect employee engagement in their own work place by themselves and they could decide actions to address selected determinants successfully with minimum guidance through a health promotion approach
Awareness of National Health Mission Beneficiaries on Antenatal Care Services
Get PDFAntenatal care (ANC) is considered universally important for women health. The present study aims to assess the awareness level of National Health Mission beneficiaries on maternal health services during antenatal period. The study was conducted in four selected districts of Assam, where 400 respondents were interviewed with structure interview schedule. Results shows that majority of the respondents were somewhat aware regarding ANC services and the accessibility of the maternal health services of study area was satisfactory. The findings indicated that awareness level of the respondents is associated with selected variables education, monthly income, age, and organizational membership
A Study of Nosocomial Infections in Intensive Care Units of Local Tertiary Care Hospitals
Get PDFIntroduction: It has been reported that the incidence of nosocomial infections in the intensive care unit (ICU) is about 2–5 times higher than in the general in-patient hospital population. The objectives of the present study were to determine the incidence of nosocomial infection, to identify possible risk factors for these infections, to clarify the distribution of the causative pathogens, and to evaluate the outcome of the infected patients in terms of length of ICU and hospital stay and mortality. Methods: This was a retrospective and analytical study. For classification of the different causative pathogens associated with nosocomial infections, all the microorganisms isolated on culture from each of the patients with confirmed infection according to the Centers for Disease Control and Prevention definitions were recorded and their relative frequency of isolation was determined as percentage. Bacterial isolates were identified by Gram stain, cultures on routine media and where necessary, selective media, and specific biochemical tests following standard protocols. Results: Nosocomial infections were in 28 patients. The most frequently diagnosed nosocomial infection was nosocomial pneumonia. A total of 39 pathogens were isolated on culture and accounted for the nosocomial infections in 28 patients. Some infections were polymicrobial. Gram-negative Enterobacteriaceae were the most frequently isolated pathogens. There was no statistically significant difference between the hospital mortality rates among the patients with and without nosocomial infection. Conclusion: Gram-negative Enterobacteriaceae, as a group, were the most frequently isolated pathogens, while Pseudomonas aeruginosa was the single most frequent causative organism. The acquisition of nosocomial infections in the ICU resulted in significantly increased length of ICU and hospital stay, but did not result in statistically significant increase in ICU or hospital mortality. These findings can now be utilized toward planning a surveillance program for nosocomial infection in our ICU setting as a first step toward a better infection control strategy
Impact of Acne on the Quality of Life of Adolescent School Children and University Students
Get PDFAcne is a common skin disorder caused due to the inflammation of pilosebaceous units in the skin and has affected around 9.4% of the global population. This study evaluated the impact of acne on the quality of life (QoL) of adolescent school children and university students in Sri Lanka. The study also assessed the treatment methods, risk factors, and associations between acne severity and risk factors. A cross-sectional analytical study was conducted using 100 advanced level students and 200 university students with self-reported acne. Data were collected using a self-administered questionnaire with the Children’s Dermatology Life Quality Index (CDLQI). The family history, premenstrual period, cosmetic usage, stress, oily skin, and oily foods were identified as severity factors for acne. There were statistically significant associations between acne severity and risk factors; oily food (χ2 = 15.241, P = 0.002), family history (χ2 = 15.241, P = 0.002), premenstrual period (χ2 = 16.593, P = 0.001), and oily skin (χ2 = 30.952, P = 0.000). The majority, 55% of school children and 73% of university students use home remedies to treat acne. The mean score of CDLQI was 1.3 in school children and 2.13 in university students. There was a statistically significant association between severity of acne and QoL (χ2 = 72.834, P = 0.000). The university students presented higher experiences of the impact of acne on QoL than school children