A Delphi survey-based development and validation of cognitive-communication assessment tool for Indian preschoolers

ABSTRACT Purpose To address the need for a standardized assessment tool for assessing cognitive-communication abilities among Indian preschoolers, the current study aimed at describing a Delphi based development and validation process for developing one such tool. The objectives of the research were to conceptualize and construct the tool, validate its content, and assess its feasibility through pilot testing. Methods The study followed a Delphi approach to develop and validate the tool across four phases i.e. conceptualization; construction; content validation; and pilot testing. The first three phases were performed with a panel of six experts including speech-language pathologists and preschool teachers while the pilot testing was done with 20 typically developing preschoolers. A literature review was also conducted with the Delphi rounds to support the developmental process. Results The first two rounds of the Delphi aided in the construction of a culturally and linguistically suitable story-based cognitive-communication assessment tool with the memory (free recall, recognition, and literary recall) and executive function (reasoning, inhibition, and switching) related tasks relevant for preschoolers. The content validation of the tool was continued with the experts till the revisions were satisfactory and yielded an optimum Content Validity Index. The pilot test of the finalized version confirmed its feasibility and appropriateness to assess developmental changes in the cognitive-communication abilities of preschoolers. Conclusion The study describes the Delphi-based conceptualization, construction, content validation, and feasibility check of a tool to assess cognitive-communication skills in preschool children.

Comparison of internet addictions and its mental effects in medical and engineering students of a private university at Pune

Background: There has been explosive growth in the use of the internet. Internet addiction is upcoming problem and less researched entity. Study is conducted to compare internet addiction in engineering and medical students.Methods: A self-administered pretested predesigned questionnaire was used for data collection. Total 303 medical and engineering students were participated in the study. Young’s internet addiction test and DASS scale is used to measure internet addiction and psychological variables.Results: 23% were normal users, 59.1% were mild internet addicts, 17.4% were moderate internet addicts and 0.3% were severe internet addicts. There was strong positive relation between internet addiction and depression anxiety and stress.Conclusions: Internet addiction is a growing problem so it is important to create awareness among students to have a healthy lifestyle.

Fast food consumption pattern amongst undergraduates of various disciplines of private colleges in Pune

Background: The consumption of various types of fast food is increasingly germinating in all components of the world, each in developed and developing countries.Methods: A cross sectional study was done to explore the perception and knowledge regarding fast food consumption from March 2019 to June 2019 amongst the 300 undergraduate students within the ages of 18 to 20 of three established private colleges of different disciplines in Pune. Paperless data was collected by a predesigned, pretested questionnaire with the help of google forms and statistical analysis was done.Results: The prevalence of consumption of fast food was found to be maximum in the undergraduates belonging to the high-income group (socio-economic class I). Around 85% of the undergraduates consumed fast foods and out of 85% nearly 17% consumed once a day. The undergraduates from all disciplines were also perceived as fast food consumption is measure of one’s socio-economic status, 76% for medical and the lowest for engineering undergraduates (55%). A significant difference between medical, engineering and architecture undergraduates was reported regarding the perception that fast food consumption has no harmful effect on body (40, 26 and 57, p<0.001). About 37% of the students had very poor knowledge, 40% of the students had poor knowledge,13% had average and only 10% had good knowledge regarding fast food consumption leading to non-communicable diseases.Conclusions: The consequences of this study propose that a requirement for health education programs that stimulate healthy eating habits and lifestyle for undergraduate college students.

Morbidity profile of the patients attending the health camp in Ramanagar district, Karnataka

Background: Free health camp is an important means to cater health services to the needy people in an underdeveloped county like India with difficult geographical terrain. The objective of this study was to assess the morbidities of patients attending the free health camp in Ramanagara District, Karnataka. Methods: A cross sectional descriptive study was conducted at free health camp in Jogaradoddi, Ramanagara District, Karnataka, by the staff and interns of department of community medicine of a medical college. All the individuals who attended the camp were included in the study. Patients who attended the health checkup camp were assessed for morbidity. Data collected by semi structured questionnaire was entered into Microsoft Excel and analyzed using SPSS version-17.0. Results: A total of 123 patients visited the health camp, among them 68(55.28%) of them were males and 55 (44.71%) were females. 41 (33.8%) were in the age group of 21-30 years. Majority were skilled workers with 30(26.1%), 18 (15.7%) were unemployed and only 1 (0.9%) were professionals .About 47 (46.1%) had normal body mass index, 26 (25.5%) were overweight, 10 (9.8%) were obese and 19 (18.6%) were underweight. It was observed that diseases with musculoskeletal system and gastrointestinal system were reported among 35 (28.5%) and 20 (16.3%) of the attendees respectively, 9 (7.7%) individuals presented with hypertension, 6 (5.5%) with diabetes mellitus. Conclusions: The study helped identify the common diseases in the selected area, improve the health, provide counselling and create awareness at the community level.

Awareness about hypoglycemia among patients on insulin therapy in a tertiary care hospital: A cross-sectional study

Background: Diabetes is a chronic disease that requires continuous medical care and patient self-management education. For diabetic patients, hypoglycemia is a fact of life. Hypoglycemia is one of the most common acute complications in adolescents with diabetes in both type1 and type 2. Approximately 90% of all patients who receive insulin have experienced hypoglycemic episodes. Poor awareness among diabetics on hypoglycemic symptoms may lead to increased morbidity and mortality. Aims and Objectives: To study the awareness about symptoms, precipitating factors, and prevention of hypoglycemia among patients on insulin therapy. Materials and Methods: A cross-sectional study was done in a government tertiary care hospital. The study was conducted among diabetic patients who were on insulin therapy for at least 1 year. A pre-tested semi-structured questionnaire was used. The calculated sample size was 100. Results: Nearly 68.6% of the patients had faced at least one hypoglycemic attack. 65% were aware of at least three symptoms of hypoglycemia, but awareness was only 46% among illiterates compared to 86% of literates. 32% were unaware about the precipitating factors whereas 17% of the participants felt that the attacks were caused due to the wrong dosage therefore skipping medication or self-adjustment of dosage was mention as a preventing factor by them. Conclusion: Awareness of hypoglycemia was found to be average among participants. Diabetics on insulin therapy are more prone for hypoglycemia. Therefore knowing the awareness levels and perceptions is important. It may help to plan the necessary objectives of health education sessions among target population.

Role of Active Listening and Listening Effort on Contralateral Suppression of Transient Evoked Otoacousic Emissions

BACKGROUND AND OBJECTIVES: The present study aimed to investigate the effect of active listening and listening effort on the contralateral suppression of transient evoked otoacoustic emissions (CSTEOAEs). SUBJECTS AND METHODS: Twenty eight young adults participated in the study. Transient evoked otoacoustic emissions (TEOAEs) were recorded using ‘linear’ clicks at 60 dB peSPL, in three contralateral noise conditions. In condition 1, TEOAEs were obtained in the presence of white noise in the contralateral ear. While, in condition 2, speech was embedded into white noise at +3, −3, and −9 dB signal-to-noise ratio (SNR) and delivered to the contralateral ear. The SNR was varied to investigate the effect of listening effort on the CSTEOAE. In condition 3, speech was played backwards and embedded into white noise at −3 dB SNR. The conditions 1 and 3 served as passive listening condition and the condition 2 served as active listening condition. In active listening condition, the participants categorized the words in to two groups (e.g., animal and vehicle). RESULTS: CSTEOAE was found to be largest in the presence of white noise, and the amount of CSTEOAE was not significantly different between active and passive listening conditions (condition 2 and 3). Listening effort had an effect on the CSTEOAE, the amount of suppression increased with listening effort, when SNR was decreased from +3 dB to −3 dB. However, when the SNR was further reduced to −9 dB, there was no further increase in the amount of CSTEOAE, instead there was a reduction in the amount of suppression. CONCLUSIONS: The findings of the present study show that listening effort might affect CSTEOAE.

Effect of Vowel Context on the Recognition of Initial Consonants in Kannada

BACKGROUND AND OBJECTIVES: The present study was carried out to investigate the effect of vowel context on the recognition of Kannada consonants in quiet for young adults. SUBJECTS AND METHODS: A total of 17 young adults with normal hearing in both ears participated in the study. The stimuli included consonant-vowel syllables, spoken by 12 native speakers of Kannada. Consonant recognition task was carried out as a closed-set (fourteen-alternative forced-choice). RESULTS: The present study showed an effect of vowel context on the perception of consonants. Maximum consonant recognition score was obtained in the /o/ vowel context, followed by the /a/ and /u/ vowel contexts, and then the /e/ context. Poorest consonant recognition score was obtained in the vowel context /i/. CONCLUSIONS: Vowel context has an effect on the recognition of Kannada consonants, and the vowel effect was unique for Kannada consonants.

Effect of Vowel Context on the Recognition of Initial Consonants in Kannada

BACKGROUND AND OBJECTIVES: The present study was carried out to investigate the effect of vowel context on the recognition of Kannada consonants in quiet for young adults. SUBJECTS AND METHODS: A total of 17 young adults with normal hearing in both ears participated in the study. The stimuli included consonant-vowel syllables, spoken by 12 native speakers of Kannada. Consonant recognition task was carried out as a closed-set (fourteen-alternative forced-choice). RESULTS: The present study showed an effect of vowel context on the perception of consonants. Maximum consonant recognition score was obtained in the /o/ vowel context, followed by the /a/ and /u/ vowel contexts, and then the /e/ context. Poorest consonant recognition score was obtained in the vowel context /i/. CONCLUSIONS: Vowel context has an effect on the recognition of Kannada consonants, and the vowel effect was unique for Kannada consonants.

Assessment of risk of type 2 diabetes using the Indian Diabetes Risk Score in an urban slum of Pune, Maharashtra, India: a cross-sectional study.

Background: The urban poor is a group that is known to be vulnerable to adoption of a more urbanized lifestyle that places them at a higher risk for diabetes. Individuals who are unaware of their disease status are more prone to micro- and macrovascular complications. Hence, it is necessary to detect this large pool of undiagnosed participants with diabetes and offer them early therapy. The aim of this study was to use the Indian Diabetes Risk Score, developed by the Madras Diabetes Research Foundation (MDRF-IDRS), to assess the prevalence of people at high risk for developing diabetes, and the correlation with known risk factors. Methods: A cross-sectional study was conducted in the field practice area of the urban health training centre of a private medical college in Pune, Maharashtra. A total of 425 participants aged 20 years and above were screened for risk factors, including age, waist circumference, family history of diabetes and physical activity. Random testing of the blood glucose level of participants with a high risk score was carried out using a glucometer. Statistical analysis of the data was performed by using the chi-squared test and logistic regression analysis. Results: The prevalence of people at high risk of diabetes was 36.55%. Among high-risk participants on univariate analysis, primary education (P = 0.004), lower socioeconomic class (P = 0.002), less physical activity (P < 0.001) and high waist circumference (P < 0.001) were major contributing factors, while in the moderate-risk group, lower socioeconomic class and high waist circumference were the prominent risk factors for diabetes. Multivariate analysis showed that higher education, moderate to vigorous activity and high waist circumference were significantly associated with risk status. Out of 140 high-risk participants, 68 (49%) had a random capillary blood glucose level of 110 mg/dL or above. Conclusion: As the prevalence of people at high risk for diabetes was high, lifestyle changes and awareness regarding risk factors is needed to take control of the diabetes in the study population.

Can chemo-radiotherapy for non-laryngeal cancer affect acoustics of voice – a preliminary study.

Background: Treatment for cancer using chemo-radiotherapy and radiotherapy are age old treatment procedures which are found to be efficient in eradicating cancerous cells thereby improving overall quality of life of the individual. Though they seem to improve the disease condition, they adversely affect different bodily systems and functions. One such effect is noted in literatures on regard of voice acoustics. Knowledge in voice acoustics in these participants would adequately provide management options before and after treatment. In our study we aim to estimate extend of voice changes in participants undergoing radiation therapy for non-laryngeal head and neck cancer. Methods: Multidimensional voice profile (MDVP) was used to assess voice parameters on three time basis such as pre-treatment, immediate post treatment and one month after post treatment. Results: Significant difference was seen between all the three time points namely; pre-treatment, post treatment and one month after post treatment were observed. Conclusion: The study revealed that, radiation therapy significantly affects the voice parameters in the same way as it affects other parts of the body. Though these effects seem to be of higher significance, during and immediate treatment; the recovery on late post treatment is satisfactory.

GC-MS analysis of phytocomponents in resin of Araucaria Columnaris (Cook Pine) and its medicinal uses.

Plants produce a diverse range of bioactive compounds making them rich source of different types of medicines. The plants are mostly cultivated for decoration and to enhance the appearance of houses, gardens, road sides, and also for commercial purposes such as floral decorations in form of bouquet. They are also source of fragrant oils for perfume making and cosmetic. However only very few of these plant species have found to be used in medicine and little or no literature exit on their chemical and biological activities. Araucaria columnaris is an ornamental plant, commonly known as Christmas tree, belonging to the family Araucariaceae. Plant resin was used for the present study, antibacterial activity and GC-MS analysis of Araucaria columnaris resin was carried out. The resin was subjected to solvent extraction using decreasing polarity solvents (aqueous, methanol, ethyl acetate and benzene). TLC profiling of all the extracts gives an idea about the presence of various phytochemicals and its fractions were checked for antibacterial activity against major clinical pathogens. It was found that fraction 4 (F4) of methanolic extact showed maximum zone of inhibition against Gram positive organisms. This fraction was subjected to GC-MS analysis; the result revealed the presence of a board range of many medicinal compounds and antioxidant activity of resin of Araucaria columnaris were identified.

Tuberculosis awareness program and associated changes in knowledge levels of school students

To assess the effectiveness of tuberculosis awareness program amongst school students. School-based interventional type of study. The study was done on 135 secondary school students of 8th and 9th standard of randomly selected private English medium school, in field practice area of Urban Health Training Center [UHTC] of a private medical college in Pune city. Health awareness session on tuberculosis was conducted by using various visual and audiovisual aids by the medical college undergraduate students. A pre-test and post-proforma was filled before and after the session. Paired t-test was used to assess the effectiveness of awareness program. There was a highly significant [P = 0] increase in the knowledge of school students after the tuberculosis awareness program by medical undergraduate students. The mean pre-test scores were 6.31 [52.58%], and the mean post-test scores were 10.20 [85%]. This activity also helped medical undergraduate students to acquire skills related to communication, working in a team, preparation and presentation of various visual aids for health awareness program; they also gained knowledge of research methodology. Health education program by medical students helped significantly to improve the knowledge of school students regarding tuberculosis. Thus, medical college students can be involved to some extent for conducting health-related behavioral change communication [BCC] activities in schools during their Community Medicine morning posting. Collaboration of private medical colleges, schools, and district tuberculosis units [DTUs] can be ideally achieved under public private partnership [PPP] for health awareness programs

Evaluation of examination stress in I MBBS medical students.

Background : As academic examination stresses are associated with changes in the mental and physical health such as increasing anxiety, increasing negative mood. Objective : The objectives for the study were to assess anxiety and sympathetic activity using TMAS and CPT respectively one month before examination and hour before examination .Both these parameters were compared and analysed. Method: Parameters were recorded with the help of Taylor manifest anxiety scale questionnaire and cold pressor test. Students were subjected to the tests between 9:30 to 10:30am one month prior to examination and one hour prior to preliminary practical examination in Physiology. Collected data was analysed using MW test and paired ‘t’test. Result : It was observed that students were having high level of anxiety even before one month of examination. Approximately 64 % of males and 53% of females were having high anxiety one month before examination. However, only 54% males and 53% females were having high anxiety one hour prior to examination. Another finding was increase in systolic and diastolic BP one hour before to examination compared to one month before examination, though the difference was not statistically significant. Conclusion: It is evident from the study that thought the results are not statistically significant basal increase in anxiety score indicates that medical students exhibit higher anxiety levels even in the absence of examination.

Post operative(laparoscopic sleeve gastrectomy) - gastro pulmonary fistula.

Laparoscopic sleeve Gastrectomy (LSG) is a new restrictive bariatric procedure increasingly indicated in the treatment of morbid obesity. Postoperative complications are mainly represented by gastric fistula with an occurrence rate of 0% to 5.1% in the literature. This complication is difficult to manage and requires multiple radiological, endoscopic, and surgical procedures. We are reporting second such case till date following Laparoscopic sleeve Gastrectomy. The present report describes the serious nature of this complication in a patient after an uneventful Laparoscopic sleeve Gastrectomy.

Voice in chronic hemodialyzed individuals.

Objective: Chronic hemodialysis affects various body systems, one of which is the respiratory system. Since respiration is the prime source for speech, vocal dysfunctions are expected to be present in patients with chronic hemodialysis. The present study attempts to shed light on the changes in acoustic and aerodynamic characteristics of voice, if any, in patients with chronic hemodialysis. Materials and Methods: Phonation of sustained vowel/a/sample was subjected to acoustic analysis using VAGHMI software. Sustained duration of/a/,/s/, and/z/ was recorded for the purpose of aerodynamic analysis. The independent t test was employed to find the significant difference between the two groups. Results: Chronic hemodialyzed subjects showed significant deviation in frequency, perturbation, and aerodynamic measures when compared to normal subjects. These results are discussed with respect to the underlying pathophysiology. Conclusion: The results of the present study revealed that subjects with chronic hemodialysis exhibit clinical evidence of voice disorders. Vocal deviations in chronic hemodialyzed subjects are explained due to the influence of the renal system on the respiratory and the phonatory system and the negative fluid balance effect of hemodialysis.

Iodine losses in iodised salt following different storage methods.

Iodine retention in three types of iodised salt viz., powdered salt, white crystal and brown crystal salt was estimated at an interval of 15 days following commonly practised storage methods i.e., glass jar with lid, plastic jar with lid, earthernware pot with lid, cut open salt packet and salt pack as it is. Highest percent retention of iodine irrespective of type of salt was noticed in intact salt packet (97.19%). The iodine retention was above 80% in other methods--88.41% retention in cut open salt packet, 84.72% in glass jar, 82.86% in earthern pot and 80.85% in plastic jar. Powdered salt had maximum iodine retention (91.16%) followed by brown crystal salt (84.24%) and white crystal salt (76.71%). Even though the iodine content was found to decrease during storage, the powdered salt and brown crystal salt had iodine in the recommended level. On the contrary, white crystal salt contained only half (7 ppm) that recommended at the retail level (15 ppm).

Intestinal glucoamylase & other disaccharidases in children with protracted diarrhoea.

Brush border lactase, sucrase and glucoamylase activities were assessed in jejunal mucosal biopsy specimens from 34 children (median age 11 months; range 1.5-38) having protracted diarrhoea with failure to thrive and 8 well nourished children with normal jejunal mucosal histology (median age 10.2 months; range 2-37). All enzymes showed progressive decrease in activity which was directly in relation to increasing degree of mucosal injury (P less than 0.002). Lactase was significantly reduced even in patients with protracted diarrhoea and normal mucosa (P less than 0.05). Glucoamylase and sucrase were significantly reduced only in the presence of mucosal injury (P less than 0.01). Our data suggest that most children with protracted diarrhoea may not tolerate lactose containing feeds and may need lactose-free diets preferably based on starch. A small number of children with protracted diarrhoea, who have severe mucosal injury may not be able to handle even starch and may require diets based on short chain glucose polymers. The findings of this study, need to be corroborated with well-controlled metabolic balance studies.

Electrophoretic study of the genome of human rotavirus in rural Indian community.

A rural cohort of 507 children, less than 3 yr of age was kept under weekly surveillance for 12 months, for morbidity due to diarrhoea. Stool specimens for rotavirus detection were obtained in 346 of the 360 diarrheal episodes occurring in 354 children and in 211 children without diarrhoeal symptoms. Rotavirus was detected by an ELISA test in 4 per cent of children with diarrhoea and 6.6 per cent of control subjects. Viral genome RNA was extracted by phenol chloroform method from all the positive samples and analysed by polyacrylamide gel electrophoresis followed by silver staining. All the strains isolated, exhibited the same electropherotype with a 'long' RNA migration pattern. This result contrasts with the genomic variability amongst rotavirus strains usually observed in different settings.