Intersex/Differences of sex development: Human rights at the intersection of cure and care

Intersex people are viewed from the medicalised lens of having a “disorder” of sex development rather than a difference in sex development. This inherent indifference to diversity is also visible in LGBTQIA+ advocacy, as they were initially excluded from the Yogyakarta Principles promoting the human rights of sexual and gender minorities. This paper attempts to explore the issues of discrimination, social exclusion, and unnecessary medical treatments through the lens of the Human Rights in Patient Care framework to advance the human rights of the intersex community and highlight the need for the state to take responsibility. The discussion touches upon intersex people’s right to bodily integrity; the right to freedom from torture and cruel, inhuman, and degrading treatment; the right to the highest attainable standard of health; and the right to legal and social recognition. The concept of human rights in patient care moves beyond the traditional philosophical principles of bioethics as it applies legal norms in a patient care context derived from judicial interpretations and international conventions upholding human rights at the intersection of cure and care. As socially accountable health professionals, it is our duty to defend the human rights of intersex people who are marginalised within the marginalised community.

A Randomized controlled trial to assess the effectiveness of group-based Diabetes Self-Management Education (DSME) program on glycemic control and self-care activities among type-2 diabetics in South-East Delhi

Introduction: India has the second-largest population of diabetes globally. The long-term complications due to poor glycemic control are concerning. Diabetes Self-Management Education (DSME) is a fundamental component in managing diabetes better. Objectives: This study was conducted to compare the effectiveness of group-based DSME in achieving glycemic control and improving self-care practices among people with type-2 diabetes as against the usual care. Methods: A nonblinded parallel-arm RCT among adults (? 30 years) diagnosed with Type-2 DM. Written informed consent was taken from each patient before enrollment. The sample size is estimated to be 85 in each arm according to the formula for equivalence design for an RCT. Randomization was done using a computer-generated random number table. The control arm received usual care, while the intervention group received group-based DSME in addition to usual care. At the end of 6 months, the change in glycemic control and self-care activity scores were compared between the two arms. Results: A total of 139 individuals (intervention =69; control =70) were analyzed. The proportion of females (62.1%) was higher than males (37.9%). There was no statistically significant difference at baseline. At end line, HbA1c showed a reduction from 9.3% to 6.9% in the intervention arm (P<0.001), which was greater than that in the control arm (p=0.017). All the self-care components showed a statistically significant improvement, except the medication score. Conclusions: Group-based DSME effectively increases self-care practices among people with diabetes, resulting in better glycemic control.

Reading And Texting While Walking: Effect On Gait Indices In Healthy Young Females

Background: Mobile phones are becoming one of the necessities now a day. Divided attention leads to affected performance in one or both tasks. Effects of such dual tasking using mobile while walking needs to be explored as the use of mobile phones during walking/stair climbing etc. are very common. Methods: 132 female students of age 18 yrs to 21 yrs were made for walking under three conditions (walking, walking and reading on mobile, walking and texting). Gait indices (step and stride length, toe out angle) were compared in all conditions using the paired t-test. Results: Step length, stride length reduced and angle of toe out increased significantly in reading during walking and texting during walking as compared to only walking (p<0.0001). Parameters during texting while walking showed maximum affection. Conclusion: Reading or texting during walking can affect walking performance adversely. You are texting while walking is most deleterious in the above three conditions.

Perceived stressors of oral hygiene students in the dental environment

Background. University students are exposed to a multitude of stressors that may impact on their performance. The nature of health sciences education generally involves early engagement with patients and communities; which may add to the stressors inherent to university life. There is sparse information on stressors in the oral hygiene educational environment. Objective. To determine perceived stressors and the level of burnout among oral hygiene students at the University of the Western Cape; Cape Town; South Africa. Method. A descriptive; cross-sectional study design was used. The study sample included all students in the Bachelor of Oral Health (BOH) degree during 2012 (N=89). A self-administered questionnaire was used to gather data. Three parameters were measured; i.e. (i) demographic characteristics; (ii) perceived sources of stress; using a modified Dental Environment Stress (DES) questionnaire; and (iii) burnout; using the Maslach Burnout Inventory (MBI). Results. Respondents were mostly female (74%) and primarily in the 18 - 25-year age group (92%). First- and 2nd-year students identified fear of failing and study load as major stressors. Stressors related to a lack of basic needs were identified as major stressors by 25% of 1st-year students. Third-year students identified clinical quotas; supervision and patients being late as major stressors. MBI scores indicated that students were not at risk forburnout; however; most students (66.2%) scored high on emotional exhaustion (EE). Conclusion. Oral hygiene students identified stressors in their learning environment. There was a progressive increase in EE across academic years. The results suggest that interventions should be tailored for specific academic year groups

Spousal concordance of diabetes mellitus among women in Ajman, United Arab Emirates

Objectives: Spousal concordance is defined as similar behaviours and associated health statuses between spouses. This study aimed to identify the concordance of diabetes mellitus [DM] and related variables among genetically unrelated couples in Ajman, United Arab Emirates [UAE]

Methods: This cross-sectional study included 270 married women attending either the Mushairef Health Center or the Gulf Medical College Hospital in Ajman between May and November 2012. A validated questionnaire was designed to determine sociodemographic characteristics and a history or family history of DM, hypertension, coronary artery disease or dyslipidaemia among the women and their husbands. The weight, height, body mass index, waist circumference, fasting blood sugar and glycated haemoglobin [HbA1c] levels of all women were measured

Results: Of the women, 39.3% of those with diabetic husbands and 39.9% of those with non-diabetic husbands were diabetic themselves [P >0.050]. The prevalence of DM spousal concordance was 17.8%. A history of hypertension, coronary artery disease and dyslipidaemia was significantly more frequent among women whose husbands had a history of the same conditions [P = 0.001, 0.040 and 0.002, respectively]. Spousal concordance of abnormal glycaemia among non-diabetic women with diabetic husbands was significant [P = 0.001]. Having a diabetic husband [P = 0.006] and being obese [P = 0.009] were the only significant predictors of hyperglycaemia among non-diabetic women after controlling for confounding factors

Conclusion: There was significant concordance of abnormal glycaemia among non-diabetic women with diabetic husbands. The spouses of diabetic patients may therefore be a target population for regular hyperglycaemia and DM screening

Knowledge regarding risk factors of hypertension among entry year students of a medical university

Hypertension in youth is increasing, but there is a dearth of data about the knowledge of risk factors in this age group. To assess the knowledge of risk factors of hypertension among university students and associate it with the blood pressure, physical activity, family history of cardiovascular disease [CVD], and sociodemographic variables. A cross-sectional survey among students enrolled in the first year, in the four academic programs, with the use of a validated, self-administered questionnaire on physical activity in the past 30 days and knowledge of risk factors of hypertension. A score of 6 on 11 was considered as good knowledge for modifiable risk factors. Blood pressure was also measured. The data was analyzed using PASW-17, Chi square test, and binary logistic regression analysis was done. Of the 110 participants, 69.2% were < 20 years of age, 76.4% were females, and 40% were Arabs. Stress, high cholesterol, obesity, and smoking were identified as risk factors by 75.5, 73.6, 77.6, and 71.8%, respectively; 69.1% considered high salt intake and 62.7% considered high calorie diet as risk factors. Energy drink was considered as a risk factor by 64.5%, coffee consumption 35.5%, physical inactivity 47%, and oral contraceptives 13.6%. Half the group did not consider a family history of CVD as a risk factor, 60% did not consider older age as a risk factor, and 88% did not think male gender was a risk factor. Knowledge of modifiable risk factors was better than that of non-modifiable risk factors. Although nationality, course of study, raised blood pressure, and history of diabetes showed significant association with good knowledge, their net effect was not significant by the Adjusted Odd's Ratio. The study identified some gaps in knowledge regarding both modifiable and non-modifiable risk factors of hypertension among students. A larger study would enable health promotion activities tailored to the needs of this age group

Prevalence and distribution of soil-transmitted helminthiases among Orang Asli children living in peripheral Selangor, Malaysia.

Soil-transmitted helminthiases are a public health problem in rural communities. A cross-sectional study of the prevalence and distribution of Ascaris lumbricoides, Trichuris trichiura and hookworm was conducted in 281 Orang Asli children (aborigines) aged between 2 and 15 years, from 8 Orang Asli villages in Selangor, Malaysia. All the children were infected with soil-transmitted helminthes, with 26.3% of the children infected either with A. lumbricoides, T. trichiura or hookworm and 72.6% having mixed infection. The overall prevalences of A. lumbricoides, T. trichiura and hookworm were 61.9, 98.2 and 37.0%, respectively. Approximately 19.0, 26.0 and 3.0% of the children had severe infection of ascariasis, trichuriasis and hookworm infection, respectively. The prevalences and mean egg per gram (epg) counts for A. lumbricoides and T. trichiura were not significantly dependent on age, therefore age-dependent convexity was not seen in this study. However, the results of this study reveal an age-dependent prevalence and mean epg count in children with hookworm infection. We conclude that ascariasis, trichuriasis and hookworm infection are still prevalent and therefore a public health concern in Orang Asli communities. Severe ascariasis and trichuriasis may lead to other health and medical problems.

Antithrombotic activity of clove oil

Clove oil inhibited human platelet aggregation induced by arachidonic acid [AA], platelet-activating factor [PAF] or collagen. Clove oil was a more effective inhibitor for aggregation induced by AA and PAF [IC[50]: 4 and 6 micro M respectively] than collagen [IC[50] : 132 micro M]. The in vivo experiments in rabbits showed that clove oil [50-100mg/kg] afforded 100% protection against PAF [11mg/kg, i.v.] and 70% protection against AA [2.0 mg/kg, i.v.]- induced thrombosis and shock due to pulmonary platelet thrombosis. It also inhibited thromboxane-A[2] and 12-HETE production by human platelets incubated with [C[14]] AA. These results are indicative that clove oil is inhibitory of platelet aggregation and thromboxane synthesis and may act as anti- thrombotic agent

Incidence of intestinal parasites in children of different socio-economic population of Dacca city.

Stool samples of 1500 children of different socio-economic status of Dacca city was examined for the presence of intestinal parasites. Samples were collected on voluntary basis which may be treated as randomised. Out of these 1500 children, 816 were male and 684 were female. The overall incidence of parasites was 65.80%, the male children slightly prepondering over the female children. Children of age group 6-10 years showed high incidence of almost all the parasites. Children of Basti area showed the highest incidence (about 90%) and most of them harboured multiple parasites. About 27.13% of infants under the age of one year (mostly from Basti area) harboured parasites. Intestinal parasites were observed that both housing and economic status played vital roles in the occurrence of intestinal parasitosis but the housing and environmental conditions were found to be in a stronger position than economic status.