Professional Quality of Life (ProQOL) of Health Care Providers in Manipur, India

Introduction: Professional Quality of Life (ProQOL) relates to comfort and satisfaction in a profession. Health care providers are exposed to great level of stress and traumatic events in their job. This study aimed at de-termining the ProQOL of health care providers in Bishnupur district. Methodology: A cross sectional study was conducted among health care providers of Bishnupur district, Ma-nipur during 24 January- 24 February 2021. The participants were 153 healthcare providers from district hospital, CHCs and PHCs using a convenience method. The instrument for collecting data consisted of “Profes-sional Quality of Life Measure version 5(ProQOL-5)” questionnaire. Chi square test and Pearson’s r correlation was used for analysis. Results: Mean age of the participants was 37.54 + 9.1 years. The mean values for the domain compassion sat-isfaction (CS), secondary traumatic stress (STS), burnout (BO) was 36.7 + 5.2, 23.2+ 4.5 and 23.3 + 5.6 respec-tively. BO and STS were positively correlated. There was no significant association between other domains. Participants who had night shifts had more BO level compared to others. Conclusion: Majority of the participants had moderate CS and STS. Those having prolonged duty hours expe-rienced more burnout compared to others.

Immunogenicity and Safety of a DTaP-IPV//PRP~T Vaccine (Pentaxim) Booster Dose During the Second Year of Life in Indian Children Primed with the Same Vaccine.

Objective: To evaluate the immunogenicity and safety of a pentavalent (diphtheria, tetanus, acellular pertussis, inactivated poliovirus, Hib polysaccharide-conjugate) combination vaccine booster dose. Design: Multicenter, open, Phase III clinical study. Setting: Two tertiary-care hospitals in Delhi and Vellore, India. Participants/patients: 207 healthy Indian children. Intervention: The DTaP-IPV//PR~NT vaccine (Pentaxim) was given at 18-19 months of age to children who had been primed with the same vaccine at 6,10,14 weeks of age. Main outcome measures: Immunogenicity was assessed before and 1 month after the booster. Safety was evaluated from parental reports, and investigator assessments. Results: At 18-19 months of age, before boosting, the SP rates against diphtheria, tetanus, poliovirus and PRP were 82.3-100%; 90.0% of participants had anti-PRP ≥0.15 μg/mL. Anti-poliovirus titers were ≥1:8 dilution in 97.9-98.4% of participants. Anti-PT and FHA titers (≥5 EU/mL) were detectable in 82.5% and 90.8% of participants, respectively. One month after the booster dose, SP rates were 99.5% for PRP (≥1.0 μg/mL), 100% for diphtheria, tetanus (≥0.1 IU/mL) and polioviruses (≥8:1/dilution). Seroconversion (4 fold post-booster increase in anti-PT and -FHA concentration) occurred in 96.8% and 91.7%, respectively. Geometric mean concentrations (GMC) increased from 11.7 to 353.1 EU/mL and from 18.2 to 363.4 EU/mL for anti-PT and anti- FHA, respectively. Anti-PRP GMC increased from 1.75 to 70.5 μg/ mL. Vaccine reactogenicity was low; severe solicited reactions were reported by <1.4% of participants. Conclusion: The DTaP-IPV//PRP-T vaccine booster at 18-19 months of age was well tolerated and induced strong antibody responses.

Immunogenicity and safety of a pentavalent diphtheria, tetanus, acellular pertussis, inactivated poliovirus, haemophilus influenzae type b conjugate combination vaccine (pentaxim™) with hepatitis B vaccine.

Objective: To obtain immunogenicity and safety data for a pentavalent combination vaccine (diphtheria, tetanus, acellular pertussis, inactivated poliovirus, Hib polysaccharide-conjugate). Design: Multicenter, open, Phase III clinical study. A DTaP-IPV//PRP~T vaccine (PentaximTM) was given at 6,10,14 weeks of age; and Hepatitis B vaccine at 0,6,14 or at 6,10,14 weeks of age. Immunogenicity assessed 1 month post-3rd dose; safety assessed for 30 minutes by the investigator, then by parents and investigators to 8 days and 30 days post-vaccination. Setting: Tertiary-care hospitals. Participants/patients: 226 healthy Indian infants (6 weeks of age). Main outcome measures: Immunogenicity and safety. Results: Immunogenicity was high for each vaccine antigen, and similar to a historical control study (France) following a 2,3,4 month of age administration schedule. Post-3rd dose, 98.6% of subjects had anti-PRP ³0.15 mg/mL and 90.0% had titers ³1.0 mg/mL; the anti-PRP GMT was 4.1 µg/mL. Seroprotection rates for diphtheria and tetanus (³0.01 IU/mL) were 99.1% and 100%; and 100%,99.1% and 100%, for polio types 1,2 and 3 (³8 [1/dil]) respectively. Anti-polio GMTs were 440.5,458.9, and 1510.7 (1/dil) for types 1,2 and 3 respectively. The vaccine response rates to pertussis antigens (4-fold increase in antibody concentration) were 93.7% for PT and 85.7% for FHA; the 2-fold increase was 97.1% and 92.4%. Vaccine reactogenicity was low with adverse reaction incidence not increasing with subsequent doses. Conclusion: The DTaP-IPV//PRP~T vaccine, given concomitantly with monovalent hepatitis B vaccine, was highly immunogenic at 6, 10 and 14 weeks of age in infants in India. The vaccine was well tolerated.

Dermatoglyphic peculiarities in children with oral clefts.

In humans, the development of the primary palate and the lip is completed by the 7th week of intra uterine life and that of secondary palate by 12th week. The dermal ridges develop in relation to the volar pads, which are formed by the 6th week of gestation and reach maximum size between 12th and 13th weeks. This means that the genetic message contained in the genome - normal or abnormal is deciphered during this period and is also reflected by dermatoglyphics. Hence this study was done in order to observe the differences in dermatoglyphic patterns between the children with oral clefts and normal children and to determine the usefulness of dermatoglyphics in studying the genetic etiology of oral clefts. Dermatoglyphic data from 50 oral cleft children and 50 normal children were collected using the ink method and comparison was done between them. In the present study, we found an increase in the ulnar loop patterns on the distal phalanges of the ten fingers, an increase in the atd angle and an increase in the fluctuating asymmetry of the atd angle in the oral cleft children which indicates the degree of developmental instability of the oral cleft individual.

Cardiovascular responses to application of lower body negative pressure of male volunteers in seated position.

Lower body negative pressure (LBNP) has been used to evaluate orthostatic tolerance and for studying the effects of +Gz induced physiological strain and hence has great practical significance in aerospace medicine. Cardiovascular responses in man on application to LBNP (-40 mmHg) in seated (upright) position in a specially designed LBNP chamber have been studied in eight normal healthy male volunteers between the age group of 25-36 yrs. They were subjected to -40 mmHg negative pressure in steps of -10 mmHg for a duration of 5 min each. The total duration of the experiment was 20 min. Heart rate (HR), blood pressure (BP) Cardiac output (CO) were measured and mean blood pressure (MBP) and total peripheral resistance (TPR) were computed. The results indicate a significant increase in HR (P < 0.01), SV (P < 0.01). Studies on limited number of subjects on application to LBNP (40 mmHg) in supine position have also been carried out and compared with the physiological strain induced in subjects in seated position. Study of HR, SV, CO, responses of the subjects on exposure to LBNP in seated position elicit similar response in subjects exposed to +Gz stress as reported by other workers. It is concluded that LBNP technique can be used to study the effects of +Gz induced physiological strain in man.

Pulmonary function of Indian athletes and sportsmen: comparison with American athletes.

Studies were conducted to evaluate pulmonary functions in Indian athletes and sportsmen associated with different athletic events and games. It was found that swimmers were having significantly higher vital capacity (VC) and forced expiratory volume (FEV1) values than all other athletic groups studied. Results have been discussed keeping in view the physiological, functional and structural demands in various events. Pulmonary function values of Indian athletes have also been compared with American athletes of standardized height for a better appraisal of athletic potentiality in our athletes. The importance of athletic training from childhood have been ascribed to be the reason for superior lung volumes and capacities in US athletes.

Physiological factors associated with the success in marathon running.

Marathon running is the most gruelling athletic event in international sport. Success of well trained athlete largely depends upon his perfect coordination of movements in relation to speed and optimum physiological adjustments. In order to identify the physiological factors which play crucial contributory role in successful marathon runners an evaluation study was conducted on 7 successful Indian athletes from among many competitors. Results of the study were compared between the 1st and the 7th rankers vis-a-vis the world champion in this event. Results indicated that the maximal aerobic power and economy in 'work' involved in marathon running were most important factors for the success in this event. In addition, a comparison of the blood lactic acid level of Indian with that of the world champion revealed that the latter could sustain at 85% of his maximal aerobic power for 2 hours compared to 78% and 62% of 1st and 7th ranker Indian athletes. There was not much of a difference between the world and Indian champion in this respect. Further, thermoregulatory efficiency was also found to play an important contributory role in determining success in this event. It is considered that a suitable index incorporating all the above factors is likely to be the most appropriate screening procedure in the evaluation programme of marathon runners for the reasons as discussed.

Body temperature and basal metabolic changes during acclimatization to altitude (3,500 m) in man.

Oral temperature (Tor), mean weighted skin temperature (Ts), mean body temperature (Tb) and basal oxygen consumption were studied on twelve young men at sea level. Then they were flown to an altitude of 3,500 m and the readings were continued after 24 hours of their arrival and thereafter at four day intervals for a period of 25 days. Thereafter the subjects were flown back and retested at sea level. Oxygen consumption was recorded at weekly intervals only. The changes in body temperature were compared with those of their basal oxygen consumption. The results indicate that there is a slight rise in the Tor on arrival at altitude and thereafter a gradual fall. A steady and continuous fall was recorded in Ts and Tb throughout the stay at altitude. The basal oxygen consumption showed an initial rise which has come back to normal by the third week of their stay at altitude. On retest, the valves of body temperature and oxygen consumption reached their own initial sea-level pattern. The observation suggests that central mechanisms are involved in bringing about a fall in body temperature during altitude acclimatization.