The effect of social determinants of health on severity of microbial keratitis presentation at a tertiary eye care hospital in Southern India

Purpose: Understanding the association between social determinants of health (SDoHs) and microbial keratitis (MK) can inform underlying risk for patients and identify risk factors associated with worse disease, such as presenting visual acuity (VA) and time to initial presentation. Methods: This was a cross?sectional study was conducted with patients presenting with MK to the cornea clinic at a tertiary care hospital in Madurai, India. Patient demographics, SDoH survey responses, geographic pollution, and clinical features at presentation were collected. Descriptive statistics, univariate analysis, multi?variable linear regression models, and Poisson regression models were utilized. Results: There were 51 patients evaluated. The mean age was 51.2 years (SD = 13.3); 33.3% were female and 55% did not visit a vision center (VC) prior to presenting to the clinic. The median presenting logarithm of the minimum angle of resolution (logMAR) VA was 1.1 [Snellen 20/240, inter?quartile range (IQR) = 20/80 to 20/4000]. The median time to presentation was 7 days (IQR = 4.5 to 10). The average particulate matter 2.5 (PM2.5) concentration, a measure of air pollution, for the districts from which the patients traveled was 24.3 ?g/m3 (SD = 1.6). Age? and sex?adjusted linear regression and Poisson regression results showed that higher levels of PM2.5 were associated with 0.28 worse presenting logMAR VA (Snellen 2.8 lines, P = 0.002). Patients who did not visit a VC had a 100% longer time to presentation compared to those who did (incidence rate ratio = 2.0, 95% confidence interval = 1.3–3.0, P = 0.001). Conclusion: Patient SDoH and environmental exposures can impact MK presentation. Understanding SDoH is important for public health and policy implications to mitigate eye health disparities in India.

Evaluation of the agreement and reliability of Transpalpebral Tonometers compared with Goldmann Applanation Tonometer – A systematic Review and Meta-Analysis Protocol

In 2020, the global prevalence of glaucoma was estimated to be 76 million and it was projected to increase to 111.8 million by 2040. Accurate intraocular pressure (IOP) measurement is imperative in glaucoma management since it is the only modifiable risk factor. Numerous studies have compared the reliability of IOP measured using transpalpebral tonometers and Goldmann applanation tonometry (GAT). This systematic review and meta-analysis aims to update the existing literature with a reliability and agreement comparison of transpalpebral tonometers against the gold standard GAT for IOP measurement among individuals presenting for ophthalmic examinations. The data collection will be performed using a predefined search strategy through electronic databases. Prospective methods-comparison studies published between January 2000 and September 2022 will be included. Studies will be deemed eligible if they report empirical findings on the agreement between transpalpebral tonometry and Goldmann applanation tonometry. The standard deviation and limits of agreement between each study and their pooled estimate along with weights and percentage of error will be reported using a forest plot. Cochrane’s Q test and the I2 statistic will be used to assess heterogeneity, and the publication bias will be investigated using a funnel plot, Begg’s and Egger’s tests. The review results will provide additional evidence on the reliability of transpalpebral tonometers that, in turn, could possibly assist practitioners to make informed decision about using it as a screening or diagnostic device for clinical practice, outreach camps, or home-based screening. Institutional Ethics Committee registration number: RET202200390. PROSPERO Registration Number: CRD42022321693.

Evaluation of Structural and Compositional Changes on the Root Surface Exposed to Diode Laser (810 nm): An In?vitro Study

Background: The laser therapy has been used as an adjuvant for conventional periodontal disease as they exhibit a bactericidal effect on scaling and root planning by its thermal and photo disruptive effects on the pathogens. This study focuses on the structural and compositional changes induced on the root surfaces of teeth following diode laser (DL) application with increasing quantum of exposure time. Objective: The objective of this study was to evaluate the structural and compositional changes on the root surface of extracted human permanent teeth after application of DLs (810 nm) with varying time interval. Materials and Methods: Twenty samples of single?rooted periodontally compromised extracted teeth were utilized for this study. Root planning was done and the roughness caused by the instrumentation was measured using profilometric analysis. Then, the samples were divided into four groups, with DL application time: Group 1 – laser application for 15 s, Group 2 – laser application for 30 s, Group 3 – laser application for 45 s, and Group 4 – laser application for 60 s. A scanning electron microscope was used to examine the cemental surface and energy?dispersive X?ray analysis software assesses the compositional changes of the teeth in each group. Results: This study reveals that on exposure of DL (810 nm) on the root surface when time of exposure increases, there were relative increases in surface irregularities and charring. There were significant changes in the chemical composition of the tooth surface.

Effect of Aging and Thermocycling on Flexural Strength of PEEK as a Provisional Restoration for Full Mouth Rehabilitation – An In vitro Study

Introduction: To compare the flexural strength of autopolymerizing poly methyl methacrylate resins (PMMA) resin, CAD/CAM milled PMMA and CAD/CAM milled poly ether ether ketone (PEEK) when used as provisional restorative materials for long span situations in full mouth rehabilitation after aging and thermocycling. Materials and Methods: Sixty samples (25 mm × 2 mm × 2 mm) were fabricated using autopolymerizing PMMA resin (GROUP I), CAD/CAM milled PMMA (GROUP II) and PEEK (GROUP III). The groups were subdivided into A and B and subjected to 7 days of aging and 500 cycles of thermocycling (subgroup A) and 14 days of aging and 1000 cycles of thermocycling (subgroup B), respectively, and flexural strength was evaluated using a three?point bend test. The data were analyzed with student t test and pair?wise comparison of mean values was done by ANOVA. Results: The flexural strength of PEEK subjected to 7 days of aging and 500 cycles of thermocycling (III (A) ? 6628.70 MPa) was the highest among all groups followed by PEEK subjected to 14 days of aging and 1000 cycles of thermocycling (III (B) ? 3760.50 MPa). Conclusion: The mean flexural strength of PEEK was statistically significant than the other two materials tested and hence can be recommended for use as a provisional restorative material for long span situations in full mouth rehabilitation. However, the mean flexural strength of PEEK reduced approximately by 44% when subjected to further aging

Satellite and historical data, and statistical modeling to predict potential fishing zones for dolphinfish, Coryphaena hippurus (Perciformes: Coryphaenidae) in Colombian Pacific / Datos satelitales e históricos, y modelado estadístico, para predecir zonas de pesca potencial del pez dorado, Coryphaena hippurus (Perciformes: Coryphaenidae) en el Pacífico colombiano

Introduction: The prediction of potential fishing areas is considered one of the most immediate and practical approaches in fisheries and is an essential technique for decision-making in managing fishery resources. It helps fishermen reduce their fuel costs and the uncertainty of their fish catches; this technique allows to contribute to national and international food security. In this study, we build different combinations of predictive statistical models such as Generalized Linear Models and Generalized Additive Models. Objective: To predict the spatial distribution of PFZs of the dolphinfish (Coryphaena hippurus L.) in the Colombian Pacific Ocean. Methods: We built different combinations of Generalized Linear Models and Generalized Additive Models to predict the Catch Per Unit Effort of C. hippurus captured from 2002 to 2015 as a function of sea surface temperature, chlorophyll-a concentration, sea level anomaly, and bathymetry. Results: A Generalized Additive Model with Gaussian error distribution obtained the best performance for predicting PFZs for C. hipurus. Model validation was performed by calculating the Root Mean Square Error through a cross-validation approach. The R2 of this model was 50 %, which was considered suitable for the type of data used. January and March were the months with the highest Catch per Unit Effort values, while November and December showed the lower values. Conclusion: The predicted PFZs of C. hippurus with Generalized Additive Models satisfactorily with the results of previous research, suggesting that our model can be explored as a tool for the assessment, decision making, and sustainable use of this species in the Colombian Pacific Ocean.

Introducción: La predicción de zonas potenciales de pesca se considera uno de los enfoques más inmediatos y efectivos en las pesquerías, es una técnica importante para la toma de decisiones en el manejo de los recursos pesqueros. Ayuda a los pescadores a reducir su costo de combustible y también a disminuir la incertidumbre de sus capturas, esta técnica permite contribuir a la seguridad alimentaria nacional e internacional. En este estudio, se construyeron diferentes combinaciones de modelos estadísticos predictivos como modelos lineales generalizados y modelos aditivos generalizados. Objetivo: predecir la distribución espacial de las zonas potenciales de pesca del pez dorado (Coryphaena hippurus L.) en el Pacífico colombiano. Métodos: La variable de respuesta se expresó en escala de captura por unidad de esfuerzo, es decir, el número de individuos de C. hippurus capturados por un número total de anzuelos disponibles entre 2002 y 2015. Temperatura de la superficie del mar, concentración de clorofila, anomalía del nivel del mar y batimetría, se utilizaron como variables explicativas para los meses de estacionalidad de C. hippurus (noviembre - marzo). Resultados: El modelo con mejor rendimiento para la predicción de zonas potenciales de pesca fue un modelo aditivo generalizado con distribución de error gaussiana y función de enlace de registro, que se seleccionó en función del criterio de información de Akaike, el R2 y la desviación explicada. La validación del modelo se realizó calculando el error cuadrático medio a través de un enfoque de validación cruzada. El ajuste de este modelo fue del 50 %, lo que puede considerarse adecuado para el tipo de datos utilizados. Enero y marzo fueron los meses con mayor captura por unidad de esfuerzo y noviembre-diciembre los meses con menor. Conclusión: Las zonas potenciales de pesca previstas coincidieron satisfactoriamente con investigaciones anteriores, lo que sugiere que nuestro modelo es una herramienta poderosa para la evaluación, toma de decisiones y uso sostenible de los recursos pesqueros de C. hippurus en el Pacífico colombiano.

Immunohistochemical Evaluation of Galectin?3 Expression in Oral Squamous Cell Carcinoma, Oral Leukoplakia and Normal Mucosa

Background: Galectin 3 (Gal?3) has diverse functions critical in cancer biology including cell proliferation, apoptosis, evasion of immune responses and angiogenesis. The expression of Gal?3 is heterogeneous in normal and neoplastic tissues. In oral squamous cell carcinoma (OSCC) and oral leukoplakia (OL), both increased and decreased expressions of Gal?3 were elicited in numerous studies. Aims: To evaluate, compare and correlate the immunohistochemical expression of Gal?3 in OSCC, OL and normal oral mucosa. Settings and Design: The study was conducted at the Department of Oral Pathology and Microbiology at PMS College of Dental Science and Research, Vattapara, Thiruvananthapuram. This is a retrospective analytical study. Methods and Material: Clinically diagnosed and histopathologically confirmed cases of OSCC (n = 21), OL (n = 21), and normal oral mucosa (n = 21) were included in the study. Paraffin?embedded tissues were subjected to immunohistochemical analysis for Gal?3 expression. Gal?3 staining expression, staining distribution and cellular localisation were evaluated. All sampled categories were compared using immunohistochemical scoring analysis such as the H?score, labelling index (LI), immunoreactive score (IRS) and staining intensity (SI). Statistical Analysis: The results were statistically analysed using multivariate analysis of variance (MANOVA) within and among the groups. Results and Conclusion: The statistical inferences obtained found that the H?score could be used as a guideline for better differentiation between the groups and among the groups. The P value obtained was < 0.0125 and was found to be significant. The observation in our study shows that the immunohistochemical expression of Gal?3 gradually decreased from normal oral mucosa to OL to OSCC.

Prevalence of Depression among the Patients with Type 2 Diabetes MellitusAttending the Urban Health Training Centre, Thirumazhisai, Tamilnadu

Introduction: Depression is the more common mental health condition found among the chronic diseases. The prevalence of both diabetes and depression are rapidly increasing and the presence of depression in patients with type 2 diabetes could hinder the adherence and effectiveness of treatment. Objective: This study aimed to estimate the prevalence of depression and to identify the factors influencing depression among patients with type 2 diabetes mellitus in Non Communicable Disease(NCD) clinic. Method: A cross – sectional study was conducted among Type 2 diabetes mellitus attending the NCD clinic of the urban health training centre between January and April 2021. Demographic, clinical and diabetes related information was collected through a semi – structured questionnaire. Level of depression was assessed using a standard questionnaire (PHQ – 9 questionnaire). The total score of 5 – 9, 10 – 14 and >15 were graded as mild, moderate and severe forms of depression respectively. Data analysis was done using SPSS software version 21. The mean age of the study subjects was 53 7 yrs and majority (60%)Results: + were males. The prevalence of depression was 30.8 % and among them 71.7 % had mild depression while 12.8 % had severe form of depression. Factors such as female gender, higher educational status and substance use such as alcohol and smoking were found to be significantly associated with the presence of depression. It is imperative to screen for depression and lay emphasis on counseling servicesConclusion: for the effective management of diabetes thereby improve the quality of their life

Determinants To Prefer Paccss By Members: An Anlysis With Challenges

Co-operative banks offers a wide range of services including improved access to markets, natural resources, information, communications, technologies, credit, training and warehouses to farmers and rural entrepreneurs. In this paper, it is mainly focused on to examine the determinants to prefer the Primary Agricultural Co-operative Credit Societies (PACCSs) and challenges faced by the members of PACCSs in Erode district of Tamil Nadu. For this paper, primary data have been collected from 140 members of the PACCSs. Such collected data have been analysed with the help of MS Excel and SPSS 22.0. Kendall's 'W' Test and Henry Garrett Ranking Technique have been used for this research

Career Preferences Among Final Year Medical Students and Interns: A Cross Sectional Study

Introduction: The increase in the number of undergraduate medical seats in India, suggests the need for faculties trained in specialist fields to ensure adequate education at the university level. Career selection is considered an important aspect of medical course admission and some career options are often overlooked by students. An insight into factors affecting the decision making could aid preparing workforce to prevent the over or under supply of doctors in various specialties. Aim: To determine the career preferences among final year medical students and interns in a private medical college in Tamilnadu, India. Materials and Methods: A cross sectional survey was conducted among final year part two MBBS students and CRRI’s who were going to complete their internship in three months, by a pre validated questionnaire consisting of two sections, the first section consisting of demographic details and the second section consisting of fixed response questions about their career choices. A sample of 100 final year students and 140 CRRI’s participated in this study. The primary data is analysed with SPSS software, and chi square test was done. Results: Female students mostly preferred General medicine, Obstetrics & gynaecology and Paediatrics, while male students preferred General medicine, Paediatrics, General Surgery and Radiology. Among the students who participated in the study, 20.4% have not decided which speciality to pursue. Conclusion: The medical students career options in our medical college was in favour of a few departments.

Short term outcomes with dual chamber versus single chamber pacing for atrioventricular block - A crossover trial

A total of 42 patients were studied for primary outcomes of quality of life and 6MWD between VVIR and DDD modes. At end of 2 months after device implantation, randomization was done and the device was programmed to VVIR or DDD modes. At the end of 2 months in this mode QOL and functional was assessed and the patient was switched to other mode. The same protocol was followed at the end of 2 months. We found no difference in functional capacity and quality of life between the two pacing modes. None of the patients developed pacemaker syndrome and there was no preference for any of the modes.

Effectiveness of chlorhexidine oral rinse in preventing plaque accumulation and gingivitis in patients undergoing orthodontic treatment- a systematic review and meta analysis / Eficacia del enjuague oral de clorhexidina en la prevención de la acumulación de placa y la gingivitis en pacientes en tratamiento de ortodoncia: una revisión sistemática y metaanálisis

Aim: The aim of this review was to systematically assess and report the effectiveness of chlorhexidine (CHX) mouthwash in preventing plaque accumulation and gingivitis in patients undergoing orthodontic treatment. Material and Methods: The review was prepared according to the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines and registered under PROSPERO database (CRD42020170776). Four electronic databases were systematically searched along with a complimentary manual search of orthodontic journals until June 2022. Only Randomized Control Trials (RCTs) reporting on antiplaque and antigingivitis efficacy of Chlorhexidine mouthwash compared with placebo or control in orthodontic patients were included. Risk of bias assessment was done using Cochrane ROB-2. Quantitative analysis (Random-Effects Model and Standard Mean Difference (SMD)) with 95 % confidence interval was used. Results: Six RCTs were included for qualitative analysis and four were included for quantitative analysis with a total of 211 participants. Out of six studies, 3 were judged to have a low risk of bias, two had some concerns and one of them had high risk of bias. Random effects meta-analysis performed for anti-plaque effect reported a significant reduction of -1.2 SMD for CHX at 4 to 6 weeks with low heterogeneity (I2-35%). The anti-gingivitis effect at 4 to 6 weeks was significant for CHX with a SMD of -1.03 and a moderate heterogeneity (I2-65%). Conclusion: On analyzing the available evidence a moderate level of certainty supports a short-term reduction in plaque accumulation and gingivitis in orthodontic patients subjected to rinsing with chlorhexidine oral rinse.

Objetivo: El objetivo de esta revisión fue evaluar e informar sistemáticamente la efectividad del enjuague bucal con clorhexidina (CHX) para prevenir la acumulación de placa y la gingivitis en pacientes que reciben tratamiento de ortodoncia. Material y Métodos: La revisión se preparó de acuerdo con las pautas de Preferred Reporting Items for Systematic Reviews (PRISMA) y se registró en la base de datos PROSPERO (CRD42020170776). Se realizaron búsquedas sistemáticas en cuatro bases de datos electrónicas junto con una búsqueda manual gratuita de revistas de ortodoncia hasta junio de 2022. Solo se incluyeron ensayos controlados aleatorios (ECA) que informaron sobre la eficacia antiplaca y antigingivitis del enjuague bucal con clorhexidina en comparación con placebo o control en pacientes de ortodoncia. La evaluación del riesgo de sesgo se realizó mediante Cochrane ROB-2. Se utilizó un análisis cuantitativo (modelo de efectos aleatorios y diferencia de medias estándar (SMD)) con un intervalo de confianza del 95 %. Resultados: Se incluyeron seis ECA para el análisis cualitativo y cuatro para el análisis cuantitativo con un total de 211 participantes. De los seis estudios, se consideró que tres tenían un bajo riesgo de sesgo, dos tenían algunas preocupaciones y uno de ellos tenía un alto riesgo de sesgo. El metanálisis de efectos aleatorios realizado para el efecto antiplaca informó una reducción significativa de -1,2 SMD para CHX a las 4 a 6 semanas con baja heterogeneidad (I2-35%). El efecto antigingivitis a las 4 a 6 semanas fue significativo para CHX con una SMD de -1,03 y una heterogeneidad moderada (I2-65%). Conclusión: Al analizar la evidencia disponible, un nivel de certeza moderado apoya una reducción a corto plazo en la acumulación de placa y gingivitis en pacientes ortodóncicos sometidos a enjuague con enjuague bucal con clorhexidina.

Gene Expression of GSK3, TGF ?-1 and PI3 Kinase in Oral Squamous Cell Carcinoma – A Real Time PCR Based Approach

Background: Oral squamous cell carcinoma (OSCC) is the most predominant type of oral cancer which has a poor prognosis, with 5-year survival rates less than 50%. Clinical characteristics such as tumor position, TNM classification and method of treat- ment, as well as histological grades have all been studied as OSCC prognostic factors but evaluating the genetic expression is the evolving trend in early diagnosis. Aim: To compare the gene expression of TGF-?-1, GSK3, Pi3 kinase in OSCC and normal tissue samples and to correlate the expression levels of these molecules with the pathological grading and survival in OSCC patients. Also to understand the role of GSK3 in Pi3 kinase pathway and TGF-? signaling pathway in OSCC progression thereby attempting targeted therapy in OSCC patients. Materials and Methods: 10 OSCC samples as well as normal healthy samples were collected and RNA isolation was done us- ing RNA easy kit from Qiagen (Valencia, CA), and thensubjected to cDNA synthesis using Human TGF-?1, Human GSK3? and Human Pi3 kinase primers. Real time PCR was performed using gene specific primers at 40 cycles. The results were retrieved, tabulated and analyzed. Results: The current research results revealed that there were up regulation of mRNA expression in GSK3, TGF ?-1 and Pi3 kinase in OSCC patients than in healthy individuals. On comparison, Pi3 kinase showed highest mRNA expression levels than GSK3 and TGF ?-1. Conclusion: The expression of GSK3 and its role in activation of Pi3 kinase pathway plays a crucial role in progression of oral cancer and targeting GSK3?could be a novel and targeted approach for treating OSCC.

Knowledge and awareness about biomedical waste segregation and disposal among pre-final year medical students at a tertiary care hospital

Background:Biomedical waste is any waste that is created during the diagnosis, treatment, or immunisationof human beings or animals, or in research activities pertaining thereto or in the manufacturing or testing of biologicals. India produces 500 tonnes of biomedical waste every day through numerous activities. It is projected that 10-25% of the total wasteis produced by the health care sector, which leads to severe health problems. If an appropriate measure is not incorporated into the current system, the negative effects of medical waste on the public and the environment will be hilarious. With this backdrop, a research study was carried out among medical students perusing under graduating in medicine, aiming to optimise their level of knowledge of biomedical waste segregation and disposal. Methods:A cross-sectional descriptive design was espoused to study among the 3rd year medical students. A random sampling method was chosen to select 150 students. A semi-structured questionnaire was used to collect information from them. Descriptive analysis was employed and the finding was presented intabular and pictorial forms.Results:Half of the students had good knowledge over BMW. Awareness of segregation wastes and colour coding among them was very poor.Conclusions:The study has unearthed the fact that half of the medical students haven’t had adequate knowledge of BMW management. Hands-on training at regular intervals with the updated information would enhance the students' knowledge and skills, and fill the lacuna in this area of research.

A narrative review on invasive brain stimulation for treatment-resistant depression

While most patients with depression respond to pharmacotherapy and psychotherapy, about one-third will present treatment resistance to these interventions. For patients with treatment-resistant depression (TRD), invasive neurostimulation therapies such as vagus nerve stimulation, deep brain stimulation, and epidural cortical stimulation may be considered. We performed a narrative review of the published literature to identify papers discussing clinical studies with invasive neurostimulation therapies for TRD. After a database search and title and abstract screening, relevant English-language articles were analyzed. Vagus nerve stimulation, approved by the U.S. Food and Drug Administration as a TRD treatment, may take several months to show therapeutic benefits, and the average response rate varies from 15.2-83%. Deep brain stimulation studies have shown encouraging results, including rapid response rates (> 30%), despite conflicting findings from randomized controlled trials. Several brain regions, such as the subcallosal-cingulate gyrus, nucleus accumbens, ventral capsule/ventral striatum, anterior limb of the internal capsule, medial-forebrain bundle, lateral habenula, inferior-thalamic peduncle, and the bed-nucleus of the stria terminalis have been identified as key targets for TRD management. Epidural cortical stimulation, an invasive intervention with few reported cases, showed positive results (40-60% response), although more extensive trials are needed to confirm its potential in patients with TRD.

Cost of delivering primary healthcare services through public sector in India

Background & objectives: Public health spending on primary healthcare has increased by four times (in real terms) over the last decade and continues to constitute more than half of the total public health expenditure. The present study estimated the cost of providing healthcare services at sub centre (SC) and primary health centre (PHC) level in four selected States of India. Methods: A total of 51 SCs and 33 PHCs were selected across the four States (Himachal Pradesh, Odisha, Kerala and Tamil Nadu) of India. The economic cost of delivering health services at these facilities was assessed using bottom-up costing methodology during the reference year of 2014-2015. The cost of capital items was annualized and allocation of shared resources was based on appropriate apportioning statistics. Results: The mean annual cost of providing health services at SC and PHC was ? 0.69 million (US$ 11,392) and ? 5.1 million (US$ 83,837), respectively. Nearly 3/4th and 2/3rd of this cost at the level of SC (74%) and PHC (63%) were spent on salaries. In terms of unit cost, the costs per antenatal care and postnatal care visit were ? 221 (173-276) and ? 333 (244-461), respectively, at SCs. Similarly, the costs of per patient outpatient consultation and per bed day hospitalization at PHC level were ? 121 (91-155) and ? 1168 (955-1468), respectively. Interpretation & conclusions: The cost estimates from the present study can be used in economic evaluations, assessing technical efficiency and also for providing valuable information during scale-up of health facilities.

Development & validation of scales to assess stigma related to COVID-19 in India

Background & objectives: COVID-19 pandemic has triggered social stigma towards individuals affected and their families. This study describes the process undertaken for the development and validation of scales to assess stigmatizing attitudes and experiences among COVID-19 and non-COVID-19 participants from the community. Methods: COVID-19 Stigma Scale and Community COVID-19 Stigma Scale constituting 13 and six items, respectively, were developed based on review of literature and news reports, expert committee evaluation and participants’ interviews through telephone for a multicentric study in India. For content validity, 61 (30 COVID-19-recovered and 31 non-COVID-19 participants from the community) were recruited. Test–retest reliability of the scales was assessed among 99 participants (41 COVID-19 recovered and 58 non-COVID-19). Participants were administered the scale at two-time points after a gap of 7-12 days. Cronbach’s alpha, overall percentage agreement and kappa statistics were used to assess internal consistency and test–retest reliability. Results: Items in the scales were relevant and comprehensible. Both the scales had Cronbach’s ? above 0.6 indicating moderate-to-good internal consistency. Test–retest reliability assessed using kappa statistics indicated that for the COVID-19 Stigma Scale, seven items had a moderate agreement (0.4-0.6). For the Community COVID-19 Stigma Scale, four items had a moderate agreement. Interpretation & conclusions: Validity and reliability of the two stigma scales indicated that the scales were comprehensible and had moderate internal consistency. These scales could be used to assess COVID-19 stigma and help in the development of appropriate stigma reduction interventions for COVID-19 infected, and mitigation of stigmatizing attitudes in the community.

Comparison of high-resolution manometry parameters among type II diabetes patients and normal volunteers

Background: Gastrointestinal (GI) autonomic neuropathy and reflux esophagitis are common in chronic diabetics. To gauge the adequacy of peristalsis, high-resolution esophageal manometry is considered as a reliable test. Aim and Objective: To compare the GI symptoms and high-resolution manometry parameters between type II diabetes patients and normal volunteers. Materials and Methods: This comparative study was conducted on 35 known type II diabetes mellitus patients (hemoglobin A1c [HbA1c] levels ?6.5%) and 35 normal volunteers between the age group of 35 and 70 years. Sociodemographic details, drug history, disease duration, and GI symptoms were elicited among the study participants. HbA1c and High-resolution manometry were measured for all the participants. Results: The frequency of epigastric pain (31.48%), heartburn (34.28%), pharyngeal irritation (31.43%), and loose stools (37.14%) were significantly higher in the diabetics. Significant difference (P < 0.05) was observed in mean basal expiratory pressure (MBEP) and mean basal inspiratory pressure (MBIP) values between diabetics and controls. There was a positive significant correlation between esophagogastric junction contractile integral and MBIP (r = 0.557), MBEP (r = 0.583), Median Integrated Relaxation pressure (r = 0.410). Conclusion: Hyperglycaemia seems to be an independent risk factor for gastroesophageal reflux disease (GERD). Obesity significantly increments the occurrence of GERD in diabetics. Strict adherence to preventive measures such as weight reduction, diet management, glycaemic control will have a great impact on the occurrence of GERD in diabetics.

Public’s Preferences for Community Pharmacy Attributes and Their Perceptions Towards Pharmacist-led Minor Ailment Services in Malaysia

@#Introduction: The prospect of public accessing community pharmacies for minor ailment advice or treatment highly depends on the pharmacy attributes and their staff. This study aimed to investigate the extent to which community pharmacies are used as a source of minor illness management and the public’s relative preferences for pharmacy features. Methods: A cross-sectional survey among the public in Malaysia was carried out between August and December 2020. The validated self-administered questionnaires were distributed at several pharmacies and shared via email, Whatsapp group, and Facebook. Results: A total of 141 from 153 public respondents completed the survey. From the descriptive and inferential analysis, it was found that about a third of the public goes to a pharmacy for advice or treatment for minor illnesses. The vast majority of respondents had positive perceptions that community pharmacists are knowledgeable and qualified to offer advice or treatment for minor diseases. A significant positive relationship was observed between pharmacy characteristics’ scores and pharmacy staff and pharmacy services’ scores (p<0.001). The increase in pharmacy staff score significantly increased the pharmacy services’ score (p<0.001). Conclusion: The implications of the public acknowledging specific attributes were crucial in further supporting community pharmacists’ services, especially in the private practice setting.