Factors associated with delays in the search for care in under-5 deaths in Yucatán, Mexico / Factores asociados con demoras en la búsqueda de atención en muertes de menores de cinco años en Yucatán, México

Abstract: Objective: We examined delays during the search for care and associations with mother, child, or health services characteristics, and with symptoms reported prior to death. Materials and methods: Cross-sectional study comprising household interviews with 252 caregivers of children under-5 who died in the state of Yucatán, Mexico, during 2015-2016. We evaluated the three main delays: 1) time to identify symptoms and start search for care, 2) transport time to health facility, and 3) wait time at health facility. Results: Children faced important delays including a mean time to start the search for care of 4.1 days. The mean transport time to the first facility was longer for children enrolled in Seguro Popular and there were longer wait times at public facilities, especially among children who also experienced longer travel time Conclusions: Providing resources to enable caregivers to access health services in a timely manner may reduce delays in seeking care.

Resumen: Objetivo: Analizar las demoras en la búsqueda de atención y su asociación con características de la madre, del niño y los servicios de salud, así como con los síntomas reportados antes de la defunción. Material y métodos: Diseño transversal con entrevistas a 252 cuidadores que se encargaron de niños menores de cinco años que fallecieron en el estado de Yucatán, México, durante 2015-2016. Se evaluaron tres demoras: 1) tiempo en identificar la complicación e iniciar el proceso de búsqueda; 2) tiempo de transporte; y 3) tiempo de espera en la unidad de salud. Resultados: Los niños enfrentaron demoras importantes en la búsqueda de atención. La media de tiempo para iniciar la búsqueda de atención fue de 4.1 días. La media de tiempo de transporte a la primera unidad de atención fue mayor para niños inscritos en el Seguro Popular y hubo tiempos de espera más largos en unidades de salud del sector público, especialmente entre niños que tuvieron tiempos de transporte largos. Conclusión: Proporcionar recursos que permitan a los cuidadores acceder a los servicios de salud de manera oportuna puede reducir las demoras en la búsqueda de atención.

A study of hypertensive disorders of pregnancy and the fetal outcome in a tertiary care hospital: a prospective study

Background: Pregnancy induced hypertension is one of the major causes of feto maternal morbidity and mortality in pregnancy. The exact cause of PIH is unknown certain factors are known to increase the risk of PIH such as risk factor includes that young women with first pregnancy.Methods: The objective of this study was to assess the socio-demographic and clinico-pathological profile of the patients with hypertensive disorders of pregnancy and its associated fetal outcomes. A prospective study was conducted in department of obstetrics and gynecology Shri B. M. Patil Medical College, Hospital and Research Centre, BLDE (Deemed to be University), Vijayapura Karnataka from 15th July to 15th December 2018. All women admitted to labour ward with diagnosis of hypertensive disorders of pregnancy were included in the study after ruling out the exclusion criteria and thorough history, examination and laboratory evaluation were done and followed till delivery.Results: A total of 123 pregnant women with hypertensive disorder of pregnancy were enrolled in the study. Most of the participants were in the age group of 20 to 30 years. The PIH was seen mostly in primigravida, lower socioeconomic status and with lower educational levels. Emergency LSCS is the most common mode of delivery.Conclusions: The hypertensive disorder in pregnancy affects the majorly younger age group. It is most commonly seen in low socio-economic and uneducated population. Hence, there should be provided with proper antenatal care, early detection of hypertensive disorders for better feto-maternal outcome.

The effectiveness of magnesium oxide combined with tissue conditioners in inhibiting the growth of Candida albicans: An in vitro study.

Context : The presence of Candida albicans on the fitting surface of the denture is a major causative factor in denture stomatits. A treatment method is by combining tissue conditioner and antifungal agents. Aims : The main objective of this study is to test the efficacy of magnesium oxide combined with two tissue conditioners (Viscogel and GC Soft), in inhibiting the growth of Candida albicans. Settings and Design : Microbiological study was done in the Department of Microbiology, K S Hegde Medical Academy, Nitte University, Mangalore. Materials and Methods : A total of 154 plates were prepared using Muller Hilton with Glucose and Methylene Blue dye medium and inoculated with 24-hr old standard Candida culture. Plates were divided into control and combination. Test discs with different concentrations of MgO were equidistantly placed in MgO Control, while sterile discs embedded with respective tissue conditioner were equidistantly placed in Viscogel and GC Soft controls. For combination groups, the tissue conditioners were mixed and the discs with MgO (1%, 3%, 5%, and 7%) were embedded in the mix. After 24 h of incubation, inhibition diameters were noted. Statistical Analysis Used : The data was analysed using Mann Whitney U Test, ANOVA, Tukey HSD test. Results : The inhibition effect of magnesium oxide 1% combined with tissue conditioners (VGC and GCC) is not significant in both the groups. The inhibition effect of MgO 5% and 7% combined with tissue conditioners (VGC and GCC) is very highly significant ( P < 0.001). Conclusions : Magnesium oxide in combination with tissue conditioners are effective against Candida albicans; GC soft with magnesium oxide showed a better result than Viscogel with magnesium oxide; Increasing the concentration of magnesium oxide increases the zone of inhibition of Candida albicans.

Prosthetic rehabilitation of a completely edentulous patient with palatal insufficiency.

This article presents a case report of a completely edentulous patient with palatal insufficiency successfully rehabilitated with closed hollow bulb obturator prosthesis and also describes a simple technique for fabricating a two-piece hollow bulb obturator that allows for control of the bulb's wall thickness and weight of the prosthesis.

Effect of myoinositol on sporangiospore-yeast transformation of Mucor circinelloides Tieghem cultivated in synthetic broth.

Mucor species exhibit fungal dimorphism in controlled environments. In this work, we examined the effect of myoinositol supplementation on the growth and morphology of Mucor circinelloides. Using sporangiospores as inoculums, diverse morphologies were induced in synthetic broth incubated at pH 4.5, temp. 20 degrees C, ambient. The morphologies included thallic suptypes (holoblastic-, holothallic-, enterothallic conidia as well as vesicular conidial headgroups), which were determinate in growth, and proliferating yeast forms. Analysis of variance, p<0.05, showed that time had significant impact on growth. A separation of means, l.s.d. 14.34, p<0.05, indicated that myoinositol supplementation at 500 microM supported the least growth, but 2.0-3.0 mM levels had the higher values, and this was followed by the control, 300 microM, 1.0, 2.0, 5.0 mM supplementations. Although the predominant morphology, that is, terminal budding yeast cells was not quantitated, observation showed that it was more preponderant, had optimal size and cell shape became more regular at 2.0 mM myoinositol supplementation.

Child rearing and positive deviance in the development of preschoolers: a microanalysis.

OBJECTIVE: To study the maternal child-rearing behaviors, parental attributes and socio-economic status of the family and to analyze their association with positive deviance in the developmental status of preschool children between 1-5 years of age. DESIGN: Cross-sectional. SETTING: Rural community. METHODS: A total of 260 children and their mothers were evaluated. Weight and height-for-age indices were used to assess growth. ICMR Developmental Screening Test was used to assess psychosocial development. Bhatia's Performance Test was used to assess maternal intelligence. Narayan Rao's Rating Scale was used to assess socio-economic status and a child-rearing interview schedule developed and pretested for the purpose of the study to assess maternal child-rearing practices and behaviors. RESULTS: Stepwise multiple regression with psychosocial development as dependent variable indicated significant associations between specific maternal behavioral categories and psychosocial development of 1-5 year old children. Children, whose mothers were responsive to their needs, were consistent in their interaction with them and were also emotionally stable during specific child rearing situations were those identified as "positive deviants" with regard to their development. Other factors, which were significantly associated with positive deviance in children, were paternal literacy and nuclear type of family. Significant differences were observed between genders. CONCLUSIONS: The data generated from the study could identify the important factors that were associated with "positive deviance" in the development of children. These factors can be useful components for parental counseling in clinical practice and as educational material in community programmes such as the ICDS and self-help groups at the village level.