Prevalence and predictors of depression among college going youth of Meghalaya: A cross-sectional study

Backgrounds: College years are characterized by transitioning from pre-adult to adulthood, a period of turmoil, adjusting to the new condition, separation from parental supervision, independence, and countering new things throughout everyday life. Depression and health-risk behaviors, including alcohol, tobacco, and illicit drug, are often found in college students, particularly during their first year. Aim: To study the prevalence and predictors of depression among college-going youth of Meghalaya, India. Materials and Methods: A cross-sectional community-based study has been undertaken to find the prevalence of depression, alcohol use, and drug use in college-going youth in Shillong, Meghalaya. A random sampling technique was used for the selection of colleges, and total enumeration was used for the selection of college-going students. A total of 358 respondents were selected for the present study. Permission from the college authority was obtained, and written informed consent was taken from the students. The participants have been explained the purpose of the study and the samples were selected voluntarily. The present study’s data were analyzed and interpreted using Statistical Package for Social Sciences version 20.0. Socio-demographic datasheet, Beck Depression Inventory-II, Hamilton Anxiety Rating Scale, Alcohol Use Disorder Identification Test, and drug abuse screening test were administered. Results: In the present study, 40.5% fall under the normal range of depression, while 38.3% had mild mood disturbance, 10.3% had borderline clinical depression, 9.7% had moderate depression, and severe depression was found in 1.1%. Alcohol use, drug use, and gender contribute significantly to the prediction of depression among college-going students ( F[5,19.551] = 855.3, P = 0.000) accounting for 21.7% variance. Conclusion: Our findings highlight the need for a college mental health program for early identification and screening of substance use and depression in college students.

Association of serum lipoproteins and inflammatory parameters derived from the blood test with renal function in COVID-19 outpatients

Abstract Changes in lipoprotein metabolism are among the main causes of hemodynamic impairment in renal function. COVID-19 is an multisystemic inflammatory disease, aggravating this situation. This cross-sectional study investigated the relationship of serum lipoprotein profile with inflammatory parameters and renal function in 95 COVID-19 outpatients in comparison with 173 with flu-like symptoms. Serum samples were collected for the determination of total cholesterol and fractions, apolipoproteins (Apo A-I and Apo B), urea (sUr) and creatinine (sCr). The glomerular filtration rate (eGFR) was calculated. Neutrophil/lymphocyte (NLR) and platelet/lymphocyte (PLR) ratios were calculated as inflammatory parameters derived from the blood tests. COVID-19 patients presented lower high-density lipoprotein cholesterol (HDL-c) (47.90 ± 1.543 vs. 51.40 ± 0.992) and higher PLR (190.9 ± 9.410 vs. 137.6 ± 5.534) and NLR (3.40 ± 0.22 vs. 2.80 ± 0.15). Both NLR and PLR correlated with each other (r = 0.639). Furthermore, the Apo B/Apo A-I ratio was correlated with PLR (r = 0.5818) and eGFR (r = -0.2630). COVID-19 patients classified as at high risk of developing acute myocardial infarction based on the Apo B/ Apo A-I ratio had higher values for sUr/sCr. Thus, serum apolipoproteins, PLR, and NLR could be related to renal dysfunction in COVID-19.

Assessment of knowledge regarding tracheostomy care and management of early complications among healthcare professionals / Avaliação do conhecimento sobre cuidados com a traqueostomia e manejo de complicações precoces entre profissionais de saúde

Abstract Introduction: Tracheostomy is commonly performed surgical procedure in ENT practice. Postoperative care is the most important aspect for achieving good patient outcomes. Unavailability of standard guidelines on tracheostomy management and inadequate training can make this basic practice complex. The nursing staff and doctors play a very important role in bedside management, both in the ward and in the intensive care unit (ICU) setup. Therefore, it is crucial that all healthcare providers directly involved in providing postoperative care to such patients can do this efficiently. Objectives: The objective of this study is to assess the knowledge regarding identification and management of tracheostomy-related emergencies and early complications among healthcare professionals so as to improve practice and further standardization. Methods: Cross-sectional observational study included two hundred and fifty-four doctors and nurses from four large tertiary care hospitals. The questions used were simple and straightforward regarding tracheostomy suctioning, cuff care, cuff management, tube blockage, and feeding management in patients with tracheostomy. Results: Based on evidence from our study, knowledge level regarding tracheostomy care ranges from 48% to 52% with knowledge scores above 50% being considered satisfactory. Significant gaps in knowledge exist in various aspects of tracheostomy care and management among healthcare professionals. Conclusion: Our findings demonstrated an adequate knowledge level among health care professionals ranging from 48% to 52% with knowledge scores above 50% being considered satisfactory and revealed that gaps in knowledge still exist in various aspects of tracheostomy care and management.

HIGHLIGHTS Healthcare workers should be well versed in identifying tracheostomy management, its complications and responding accordingly. Doctors and nurses (131 =52%) possessed good knowledge about various aspects of tracheostomy care and management. The poorest scores were regarding cuff pressure (38.9%), suction pressure (39.4%) and first response in tube blockade (31.1%). Higher scores were found in age group 26 to 30 years (54.2%) and those having 1-3 years of clinical experience (41.2%). No statistically significant assoiation of knowledge regarding tracheostomy care was apparent with age, gender or years of practice.

Resumo Introdução: A traqueostomia é um procedimento cirúrgico comumente feito na prática otorrinolaringológica. O cuidado pós-operatório é o aspecto mais importante para alcançar bons resultados para o paciente. A indisponibilidade de diretrizes padrão para o manejo da traqueostomia e o treinamento inadequado podem tornar complexa essa prática básica. A equipe de enfermagem e os médicos desempenham um papel muito importante no manejo à beira do leito, tanto na enfermaria quanto na unidade de terapia intensiva (UTI). Portanto, é crucial que todos os profissionais de saúde diretamente envolvidos na prestação de cuidados pós-operatórios a esses pacientes possam fazer isso de forma eficiente. Objetivo: Avaliar o conhecimento sobre a identificação e manejo de emergências relacionadas à traqueostomia e complicações precoces entre os profissionais de saúde, a fim de melhorar a prática e sua padronização. Método: Estudo observacional transversal que incluiu 254 médicos e enfermeiras de quatro grandes hospitais terciários. As perguntas foram simples e diretas em relação à aspiração da traqueostomia, cuidados com o cuff, manejo do cuff, obstrução da cânula e manejo da alimentação em pacientes traqueostomizados. Resultado: Com base nas evidências de nosso estudo, o nível de conhecimento sobre os cuidados com a traqueostomia varia de 48% a 52%, com escores de conhecimento acima de 50% considerados satisfatórios. Existem lacunas significativas no conhecimento em vários aspectos dos cuidados e manejo da traqueostomia entre os profissionais de saúde. Conclusão: Nossos achados demonstraram um nível de conhecimento adequado entre os profissionais de saúde, variação de 48% a 52%, com escores de conhecimento acima de 50% considerados satisfatórios e revelaram que ainda existem lacunas no conhecimento em vários aspectos do tratamento e manejo do paciente traqueostomizado.

DESTAQUES Profissionais de saúde devem estar bem familiarizados com a identificac¸ão do manejo da traqueostomia, suas complicac¸ões e como agir de acordo com a necessidade. Médicos e enfermeiras (131 = 52%) possuíam bons conhecimentos sobre vários aspectos dos cuidados e manejo da traqueostomia. Os piores escores foram em relac¸ão à pressão adequada do cuff (38,9%), à pressão de aspirac¸ão adequada (39,4%) e primeiros socorros em caso de obstruc¸ão da cânula (31,1%). Os melhores escores foram encontrados no grupo 26 a 30 anos (54,2%) e aqueles com experiência clínica de 1-3 anos (41,2%). Não houve associac¸ão estatisticamente significante entre o conhecimento sobre os cuidados com a traqueostomia, idade e gênero e os anos de prática de médicos e enfermeiras.

Psycological distress and life satisfaction among female commercial sex workers

Background: Psychological distress is higher in women working in the sex industry. The aim of the study was to determine the psychological distress and life satisfaction among female commercial sex workers (FCSWs). Methodology: In the present study hundred (100) female commercial sex workers were selected from Lamjingshai targeting center project under Meghalaya Aids Control Society, Shillong, Meghalaya. For the recruitment of sample simple random sampling procedure was followed, Socio-Demographic data sheet, Kessler Psychological Distress Scale (K10) and Satisfaction with the life scale were administered. Results: Among the total participants 53 % of the respondents were having moderate mental disorder, 25% were having severe mental disorder, 10% were having mild mental disorder and 12% of the respondents were normal. Majority of the respondents score average (75 %) in Satisfaction with life scale, 13% score high in to Satisfaction with life, 6% score very high in Satisfaction with life and 6% score slightly below average in Satisfaction with life scale. Psychological distress has a significant negative correlation with life satisfaction (r=-.176, p<0.05). Conclusion: Assessment of the psychological distress in female commercial sex worker is significant in developing health policy and interventions to reduce their impact on their wellbeing.

Mindfulness, Resilience and Psychological Distress among Youth in a University Setting

Background: University students experience psychological distress during their first year of joininguniversity and this can have a negative impact on their physical and mental health. Resilience andmindfulness can reduce stress and can help to enhance their coping and wellbeing. To investigate therelationship between mindfulness, resilience and psychological distress among first year undergraduateuniversity students.Methodology: The cross- sectional study was conducted at Tezpur University, Assam and the University ofScience, Technology and Management, Meghalaya. Purposive sampling was used to select the universities.A total of 300 participants were selected for the present study using convenience sampling technique. Sociodemographic data sheet, the Resilience scale, Depression Anxiety Stress Scale-21, and Freiburg MindfulnessInventory was administered.Results: In the study, 9.5% were having moderate level of depression, 6.7% had a severe level of anxietyand 1.4% had extremely severe level of anxiety. 15.4 % had moderate level of stress. 3.2% had a very lowlevel of resilience. Psychological distress had significant negative correlation with mindfulness (r= -0.229; p> 0.01) and resilience (r = -0.325; p > 0.01). Resilience (Beta= -0.283, t= -4.857; p= 0.0001) and Mindfulness(Beta= -0.149; t= -2.566; p= 0.01) strongly contributed to the variance on the overall psychological distress(depression, anxiety & stress).Conclusion: The findings show resilience and mindfulness are significant predictors of psychologicaldistress among university students. There is a need for resilience and mindfulness-based training programmefor the university first year students

Prognostic value of blood count parameters in patients with acute coronary syndrome

Background Recent studies have shown that complete blood count (CBC) parameters can effectively predict long-term mortality and re-infarction rates in acute coronary syndrome (ACS). However, the role of these parameters in predicting short term mortality has not been studied extensively. The main objective of this study was to determine whether CBC parameters can predict 30-days mortality and the incidence of major adverse cardiac event (MACE) in ACS patients. Methodology A total of 297 patients with ACS were recruited in this prospective study. The relationship of baseline white blood cell (WBC) to mean platelet volume ratio (WMR) with MACE and mortality was assessed during a 30-days follow up. The patients were divided into two groups: Group A [WMR < 1000] and Group B [WMR > 1000]. Multivariate COX regression was performed to calculate hazard ratios (HR). Results WMR had the highest area under receiver operating characteristics curve and highest discriminative ability amongst all CBC parameters in predicting mortality. Patients in Group B had a higher mortality rate (p < 0.001) than patients in Group A. WBC count (p = 0.02), platelet count (p = 0.04), WMR (p = 0.008), platelet to lymphocyte ratio (p < 0.001) and neutrophil to lymphocyte ratio (p = 0.03) were significantly higher in the MACE-positive group as compared to MACE-negative. In multivariate cox regression analysis, WMR > 1000 (HR = 2.9, 95% confidence interval 1.3–6.5, p = 0.01) was found to be strongest biochemical marker in predicting mortality. Conclusion WMR is an easily accessible and an inexpensive indicator, which may be used as a prognostic marker in patients with ACS.

Analysis for the presence of determinants involved in the transport of mercury across bacterial membrane from polluted water bodies of India

Abstract Mercury, which is ubiquitous and recalcitrant to biodegradation processes, threatens human health by escaping to the environment via various natural and anthropogenic activities. Non-biodegradability of mercury pollutants has necessitated the development and implementation of economic alternatives with promising potential to remove metals from the environment. Enhancement of microbial based remediation strategies through genetic engineering approaches provides one such alternative with a promising future. In this study, bacterial isolates inhabiting polluted sites were screened for tolerance to varying concentrations of mercuric chloride. Following identification, several Pseudomonas and Klebsiella species were found to exhibit the highest tolerance to both organic and inorganic mercury. Screened bacterial isolates were examined for their genetic make-up in terms of the presence of genes (merP and merT) involved in the transport of mercury across the membrane either alone or in combination to deal with the toxic mercury. Gene sequence analysis revealed that the merP gene showed 86–99% homology, while the merT gene showed >98% homology with previously reported sequences. By exploring the genes involved in imparting metal resistance to bacteria, this study will serve to highlight the credentials that are particularly advantageous for their practical application to remediation of mercury from the environment.

Terrorist attacks in the largest metropolitan city of Pakistan: Profile of soft tissue and skeletal injuries from a single trauma center / 世界急诊医学杂志（英文）

BACKGROUND: Pakistan has been hugely struck with massive bomb explosions (car and suicide bombs) resulting in multiple casualties in the past few years. The aim of this study is to present the patterns of skeletal and soft tissue injuries and to review the outcome of the victims who presented to our hospital. METHODS: This is a retrospective chart review from January 2008 to December 2012. The medical record numbers of patients were obtained from the hospital Health Information and Management Sciences (HIMS) as per the ICD-9 coding. RESULTS: During the study period, more than 100 suicide and implanted bomb blast attacks took place in the public proceedings, government offices, residential areas and other places of the city. Altogether 262 patients were enrolled in the study. The mean age of the patients was 31±14 years. The shrapnel inflicted wounds were present on to the upper limb in 24 patients and the lower limb in 50. CONCLUSION: Long bone fractures were the most common skeletal injuries. The fractures were complicated by penetrating fragments and nails which result in post operative infections and prolonged hospital stay.

Social marketing and awareness about routine immunization among the parents of children under 5 years coming to a private hospital in Khyber Pakhtunkhwa

Introduction: Social marketing is a key strategy to influence the health seeking behavior of human beings on a large scale. Although social marking approach is applied to address a variety of social concerns, it also has a vital role in the health promotion and disease prevention.

Objectives: 1-To elaborate the source of social marketing for the promotion of routine immunization among children under-5 years. 2-To assess the determinants of social marketing in term of promotion of routine immunization

Material and Methods: The survey was conducted in the Department of Pediatrics of the Rehman Medical Institute [RMI] Peshawar KPK over a period of two months. Self-administered questionnaire-based survey was used to address the objectives. The questionnaire catered to the four Ps [Promotion, Personnel, Partnership, and Proof] that are the basic themes of social marketing applicable for promotion of immunization. Parents of children under-5 years of age were included as subjects. Data were analyzed by using SPSS version 15.0

Results: A total of 63 parents were surveyed during two months of data collection period. About 54% of them were unaware about National immunization days. However 84% had got information about immunization, where 63% had got information from print media and perceived that the information was sufficient to convince them

Conclusion: Social marketing is an effective tool in ensuring health seeking behavior especially in immunization of under-5 year children; however health promotion activities by vaccinators, others health care professionals and governmental and non-governmental organization linked with low immunization are lacking in the region

Bioluminescent bioreporter for assessment of arsenic contamination in water samples of India.

In the present study the most efficient R-factor controlling the ars operon was selected after screening of 39 Escherichia coli isolates by minimum inhibitory concentration test (MIC) studies from water samples of different geographical locations of India. Among all, strain isolated from Hooghly River (West Bengal) was found to have maximum tolerance towards arsenic and was further used for the development of bioreporter bacteria. Cloning of the ars regulatory element along with operator-promotor and luxCDABE from Photobacteria into expression vector has been accomplished by following recombinant DNA protocols. The bioreporter sensor system developed in this study can measure the estimated range of 0.74–60 μg of As/L and is both specific and selective for sensing bioavailable As. The constructed bacterial biosensor was further used for the determination of arsenic ion concentration in different environmental samples of India.

Homocysteine in occlusive vascular disease: A risk marker or risk factor.

Homocysteine has emerged as a significant marker for occlusive vascular disease, but there has been some debate as to whether it is just an association (risk marker) or actually a causative factor (risk factor). To elucidate this, a retrospective statistical analysis was done of data generated in the course of our study on homocysteine and vascular disease. Homocysteine, lipid profile components and lipoprotein(a) were estimated in fasting blood samples drawn from 252 controls and 536 patients of occlusive vascular disease. The data were analyzed by SPSS version 17. Mean homocysteine levels were significantly higher (p<0.001) in all patients categories, as compared to controls. In fact, homocysteine level was the most significant biochemical risk factor for vascular disease. The odds ratios due to hyperhomocysteinemia varied from 3.170-4.153. When the cut-off was increased by 5 µmol/L, the odds ratio became almost three-fold. The prevalence of hyperhomocysteinemia increased by @20%, when the cut-off was reduced by 5 µmol/L. Statistical analysis of our data revealed that homocysteine conformed to Hill’s criteria of causation. Moreover, hyperhomocysteinemia was treatable by the administration of B-vitamins, even if the cause was genetic. Hence morbidity due to vascular disease could be reduced by identification and treatment of hyperhomocysteinemia.

Molecular studies of E. coli mercuric reductase gene (merA) and its impact on human health.

Bacterial plasmids encode resistance systems for toxic metal ions including Hg2+ functioning by energy-dependent efflux of toxic ions. The inducible mercury resistance (mer) operon encodes both a mercuric ion uptake and a detoxification enzymes. In Gram-negative bacteria especially in E. coli, a periplasmic protein, MerP, an inner- membrane transport protein, MerT, and a cytoplasmic enzyme, mercuric reductase (the MerA protein), are responsible for the transport of mercuric ions into cell and their reduction to elemental mercury, Hg0. Phytoremediation involves the use of plants to extract, detoxify and/or sequester environmental pollutants from soil and water. Transgenic plants cleave mercury ions from methyl-mercury complexes; reduce mercury ions to the metallic form; take up metallic mercury through their roots; and evolve less toxic elemental mercury. PCR were performed to detect 1695 bp of mercuric reductase gene (merA), which is mainly responsible for the conversion of mercuric (Hg+2) and mercurous (Hg+1) ions into non-toxic elemental mercury. PCR products of putative merA genes from environmental E. coli strains were purified and cloned into a plant expression vector pRT100. The construct will be transformed in calli of Nicotiana plants.