Uncovering The Sociological Interpretation of Visual Impairment-Related Inequities and Their Social Determinants in India

Introduction: Determinants of health are divided into four types, such as “Biological-Psychological-Environmental-Social Determinants”. The social determinants of health include gender disparities, economic status, ethnicity, race, geographic isolation, or having a specific health condition. Moreover, the social deter-minants are interdependent and interrelated with one another. There can also be a primary determinant that affects the other determinants. For example, educational level of the patients is associated with knowledge and awareness of eye care and its conditions. However, education might have a different effect than income in should be access of eye care when needed. Methodology: The study is mainly dependent on secondary data analysis. Results: The primary objective of the study is to illustrate the sociological aspects of visual impairment-related inequities and to identify the social determinants of visual impairments and disparities in India. An-other aim of the paper is to present a deeper understanding of how inequities impact the incidence of visual impairment and blindness based on the social determinants of health. The present study adopts the ecological and Commission on Social Determinants of Health (CSDH) framework 2008. We reaffirm the fact that inequi-ties negatively affect the visual impairment and blindness conditions. The national health policies should take into account the social determinants of visual impairment in their policies relating to comprehensive eye care. Social and economic factors are connected with health and welfare; those socio-economic inequalities con-tribute to health inequalities. For reducing the health inequalities around the world, we need effective policy implementation and proper fund pools. Furthermore, committed action on societal determinants of health, sufficient human resources are also necessary to control the health disabilities, include visual impairment

Strengthening the oral health system in Nigeria: A health systems building block approach

Aim: The present study aimed to describe the building blocks of the oral health system, including the role that the community plays in strengthening the oral health system in Nigeria. Methodology: This research was a scoping review of the existing literature retrieved from search engines and databases. Thus, we utilised grey literature, peer-reviewed literature, policy documents and websites. The oral health system was analysed using the World Health Organisation's Health systems framework, and we adapted this framework by introducing a seventh block, community participation. We also inserted the links between the oral health service delivery and oral health workforce blocks of the framework to improve the oral health outcomes. Results: More dental clinics are required to improve the availability and accessibility of oral health services. Dental workforce expansion is imperative. This can be approached by training of junior cadre dental professionals and incorporating community health practitioners to deliver basic oral care. There is an unregulated access to medication to treat dental conditions; hence, oral disease treatments need to be included in the country's treatment guidelines to improve standard of care. The government needs to improve on overall health spending and invariably increase oral health care allocation urgently. Furthermore, the country's stewardship of oral health care is hinged on well disseminated and implemented national policies on oral health. The oral health system can achieve its overall goals with community participation, engagement and ownership. Conclusion: Strengthening the oral health system in Nigeria requires urgent attention on each building block and cross-cutting interventions across the system's building blocks. The role of the community will need to be recognised because it is vital in sustaining any organisational change.

Profiles of sugar fermenting bacteria of the oral cavity among children with dental caries attending stomatology services at Ruhengeri referral hospital in Musanze District, Northern Rwanda

Background: Dental caries remains a public health threat of concern among children. About 2.3 billion people are affected by dental caries, of which 530 million are children globally. Objective: This study was carried out to identify sugar fermenting bacteria in the oral cavity and their antibiotic susceptibility pattern, assess the association with sugar fermenter bacteria and dental caries and evaluate dental caries outcomes among children. Materials and Methods: This was a cross-sectional study conducted between October 2021 and February 2022 at Ruhengeri Referral Hospital. About 136 oral swab samples were collected from children with and without dental caries at 1:1 ratio. The samples were put in Stuart sterile container and transported to INES-clinical microbiology laboratory for microbial identification. Logistic regression analysis of demographic characteristics was performed to study the relationship between demographic variables and dental caries. Chi-square test was performed for the association between variables. Results: About 67.6% were male, while children of age 7­9 years (64.7%) dominated the age groups. Lactobacilli spp (15.29%) and Streptococcus mutans (12.94%) were the most predominant microorganisms observed in the oral cavity among children with dental caries. The S. mutans (x2 = 27.03, P < 0.00001, 95% confidence interval [CI]=0.2901­0.5785), S. aureus (x2 = 34.59, P < 0.00001, 95% CI = 0.3541­0.6292), Enterobacter aerogenes (x2 = 13.5, P = 0.000239, 95% CI = 0.151­0.4622), Serratia marcescens (x2 = 11.64, P = 0.00645, 95% CI = 0.1275­0.4418) and Klebsiella pneumonia (x2 = 13.51, P = 0.000237, 95% CI = 0.1511­0.4623) were significantly associated with dental caries. Teeth loss (x2 = 51.04, P < 0.00001, 95% CI = 0.4757­0.7205), teeth pain (x2 = 5.05, P = 0.0246, 95% CI = 0.0249­0.33499), and infection (x2 = 4.73, P = 0.02964, 95% CI = 0.0186­0.3441) were dental outcomes associated with tooth decay. Ciprofloxacin, clindamycin, and amoxicillin were the most sensitive antibiotics, while vancomycin and chloramphenicol were the most resistant. Conclusion: Sugar consumption favours the growth of sugar fermenter bacteria that cause dental caries among children. Dental caries is associated with adverse oral health outcomes among children. Oral health education is recommended for children. Parents are advised to reduce the consumption of sugary food for their children for oral health safety.

Morphological spectrum and epidemiological profile of ovarian tumours in black West African women at Lagos state university teaching hospital, Ikeja, Nigeria

Background: This study was done to evaluate the histological types, frequency and age distribution of ovarian tumours in Lagos State University Teaching Hospital (LASUTH), Ikeja, Lagos State. This study also aims to classify ovarian tumours in this centre according to the World Health Organisation (WHO).Methods: A retrospective, descriptive hospital study of all ovarian specimens that were sent to the department of pathology and forensic medicine, LASUTH between 1st January, 2011 and 31st December, 2019 was done. Relevant data composed of the age distributions and histopathological types were extracted from the departmental information system and filed documents. The data was analysed using the IBM-SPSS version 25.0.Results: There were 198 cases of ovarian tumours. The mean age at diagnosis of ovarian tumours was 34.6±15.3 years. Unilateral ovarian tumour was observed in 91.9%% of cases while bilateral disease was seen in 8.1%. Primary ovarian tumours constitute 97.0% of all diagnosed tumours of the ovary. Germ cell tumour was the most frequently diagnosed ovarian tumour; and teratoma was the most common, representing 91.2% of germ cell tumours and 47.0% of all ovarian tumours. Primary ovarian cancer peaked at the 6th decade of life and metastatic ovarian cancer was infrequently seen. Serous carcinoma is the most commonly diagnosed ovarian cancer.Conclusions: Ovarian tumour presents most frequently at the 4th decade of life, and germ cell tumour is the most common.

The Aftermath of Corona Pandemic on the Psychosocial Life of Coimbatore South Population: A Cross-sectional Study

Introduction: Coronavirus disease is an infectious disease caused by a newly discovered coronavirus. Since the new coronaviruscan spread unnoticed so easily, many governments have felt the best way to ensure people having minimal contact with eachother is to order total lockdowns. This study is performed a month after lockdown to evaluate the impact of corona pandemicon the psychosocial life of Coimbatore south population.Materials and Methods: A cross-sectional randomized study was conducted at Coimbatore South, Tamil Nadu, India, betweenApril 26, 2020, and April 30, 2020. The sample size was 600. Pre-tested structured and self-structured e-questionnaire wassent to the study population and the answers were viewed using separate email id.Results: Of the 600 people, 59.5% were males and 40.5% were females. The majority (82.5%) of people felt that they weresafe during the pandemic majority of people (61%) felt that the modern lifestyle was the cause for the pandemic and 66.9% ofthe people increased the usage of traditional and natural remedies during the lockdown.Conclusion: We infer that the majority of the people (55%) enjoyed the break from their routine with an eye on their educationand career.

Correlation of Risk Factors with Severity of Diabetic Retinopathy - A Retrospective Study.

Diabetic retinopathy (DR) is a major microvascular complication of diabetes. It is the most common cause of blindness in the working-age population in developed countries. We wanted to analyse the correlation between risk factors of blindness like duration of diabetes, dyslipidaemia, hypertension, HbA1c with severity of diabetic retinopathy in order to design appropriate strategies for prevention and treatment of diabetic retinopathy.METHODSThis was a retrospective study of all diabetic patients with diabetic retinopathy who presented to the eye OPD at KS Hegde Medical Academy from April 1st 2018 to March 31st 2019 that fulfilled the inclusion criteria. A dilated fundus examination was done to note the grade of diabetic retinopathy. The demographic data along with the duration of diabetes, HbA1c values, Cholesterol levels and Blood pressure were documented and correlated with the severity of diabetic retinopathy.RESULTSThe study included 92 patients, of which 63 were males and 29 were females with a mean age of 54.5±2.8 years. We found that there was statistically significant association between the duration of diabetes and HbA1c levels with severity of diabetic retinopathy (p= 0.022 and 0.034 association), whereas there was no statistically significant correlation between blood pressure and cholesterol levels with severity of diabetic retinopathy (p= 0.52 and 0.456 respectively)CONCLUSIONSDiabetic retinopathy showed a male preponderance, with risk factors like duration of diabetes and HbA1c levels having a significant association with the severity of diabetic retinopathy. Therefore, it is essential to have a good systemic control of diabetes with diet and suitable medications. Diabetic retinopathy is a preventable cause of blindness when diagnosed early and screening of diabetic retinopathy must be done in all diabetics to prevent the progression of the disease.

A rare case of multilocular cystic renal neoplasm of low malignant potential diagnosed on intra-operative fine needle aspiration cytology

Multi-locular Cystic Renal Cell Carcinoma (MCRCC) is now considered as Multilocular cystic renal neoplasm of low malignant potential (MCRNLMP) in World health organisation classification (WHO) 2016. It is usually seen in elderly people where it can mimic most of the time as benign cystic lesion. Authors are reporting a case of MCRNLMP in a 70 year male diagnosed intraoperative with the help of Fine Needle Aspiration Cytology (FNAC). Radiological and other clinical findings are in favour of cystic renal lesion. And it is very important to differentiate it from conventional renal cell carcinoma which requires radical nephrectomy. So, radiological finding and FNAC is instrumental in diagnosing this rare case which require different mode of surgical management.

A reforma da Organização Mundial da Saúde: processo, tendências atuais e desafios (1998-2014) / The reform of the World Health Organization: process current trends and challenges (1998-2014)

Este trabalho tem como objetivo analisar a atual proposta de reforma da Organização Mundial da Saúde (OMS), buscando identificar, descrever e avaliar as mudanças e continuidades entre o processo em curso e outras mudanças organizacionais (chamadas reformas) implementadas no período 1998-2014. Fez-se um repasse sobre a constituição histórica da OMS e os desafios que enfrentou para sua legitimação na arena internacional, incluindo os embates internos e externos que conduziram à discussão contemporâneo sobre sua reforma. O foco do estudo é a proposta de reforma de 2010, elaborada pela Diretora-Geral (DG) Dra. Margaret Chan, que trata do futuro do financiamento da OMS e da incapacidade da organização de responder, de forma rápida e ágil, aos desafios atuais da saúde global, centrados, segundo a DG, na insustentabilidade do atual modelo de gestão, financiamento e programação institucional, frente às necessidades de saúde das populações no século XXI. O estudo analisou as reformas elaboradas pelas gestões desse período, com foco nas propostas orçamentárias e planos de trabalho institucionais. Utilizou-se para análise a articulação entre diferentes abordagens teóricas, relacionadas aos impactos da globalização sobre a saúde das populações; a maior interdependência entre os países e a consequente ampliação da disputa de poder no sistema mundial; a relação entre a conformação do termo saúde global e a dinâmica entre as instituições que atuam na arena internacional do setor, assim como a importância da saúde nas relações internacionais contemporâneas e a chamada governança global na área. A estratégia metodológica foi de estudo de caso, amparada em técnicas qualitativas para o levantamento de dados – revisão bibliográfica; amplo levantamento e análise documental; e observação social direta do autor...

This study examined the current World Health Organisation (WHO) reform proposal with a view to identifying, describing and evaluating changes and continuities between the present process and other organisational changes (termed reforms) implemented between 1998 and 2014. The formation of the WHO was reviewed historically, along with the challenges it faced in gaining international legitimacy, including the internal and external conflicts that led to the present discussion over reform. The focus of the study is the 2010 reform proposal prepared by WHO Director-General (DG) Dr Margaret Chan, which addresses the future of WHO funding and the organisation’s inability to respond, quickly and agilely, to today’s global health challenges, which she sees as centred in a lack of sustainability of the present model of organisational management, funding and planning in light of populations health needs in the 21st century. They study examined the reforms drawn up by the various administrations over the period, focussing on budget proposals and institutional work plans. The analysis deployed a combination of different theoretical approaches relating to the impacts of globalisation on population-wide health; the greater interdependence among countries and the consequent broadening of power disputes in the world system; the relation between the term global health and the dynamics among institutions operating in the international health sector arena; and the importance of health in contemporary international relations and ‘global governance’ of the field...

Abordando la crisis de los Recursos Humanos para la Salud: ¿Hasta dónde hemos llegado? ¿Qué podemos esperar lograr al 2015? / Addressing the Human Resources for Health crisis in countries: How far have we gone? What can we expect to achieve by 2015?

El reporte mundial de la Salud del 2006 (World Health Report 2006) ha identificado 57 países en los que la densidad de trabajadores de salud con respecto a la población general se encuentra por debajo del umbral crítico de 2,3 por 1000 habitantes. Esto significa que por debajo de este umbral crítico, un país no sería capaz de brindar los servicios básicos para su población, definidos como el 80 por ciento de coberturas de inmunización y 80 por ciento de atención calificada del parto. De los 57 países, 36 pertenecen al África. Este artículo revisa el progreso realizado por los países para afrontar su crisis de recursos humanos en salud. Cita tres de los estudios mundiales más recientes y los indicadores utilizados para medir el progreso. Asimismo, se presenta la experiencia de ocho países: Malawi, Perú, Etiopía, Brasil, Tailandia, Zambia y Mali. Ello brinda un panorama diverso de esfuerzos, retos y éxitos en cada uno de estos países. El artículo lanza la interrogante sobre si la meta de una reducción del 25 por ciento en el número de países en crisis puede lograrse para el año 2015, objetivo definido por la Asamblea Mundial de la Salud en el 2008. El optimismo que los autores quisieran mantener sobre los esfuerzos orientados a esta meta, debe ir sin embargo a la par con un adecuado nivel de inversión de los países en recursos humanos en salud. Los siguientes cuatro años nos mostrarán cuánto en realidad puede ser logrado.

The World Health Report 2006 identified 57 countries world-wide whose health worker to population density fell below a critical threshold of 2.3 per 1,000 population. This meant that below this critical threshold, a country could not provide the basic health services to its population, defined here as 80 percent immunization coverage and 80 percent skilled birth attendance at delivery. Of the 57 countries, 36 are located in Africa. This article reviews the progress countries have made in addressing their health workforce crisis. It cites 3 of the most recent global studies and the indicators used to measure progress. It also features the experiences of 8 countries, namely Malawi, Peru, Ethiopia, Brazil, Thailand, Philippines, Zambia, Mali. Their situations provide a diverse picture of country efforts, challenges, and successes. The article asks the question of whether the target of 25 percent reduction in the number of crisis countries can be achieved by 2015. This was a goal set by the World Health Assembly in 2008. While the authors wish to remain optimistic about the striving towards this target, their optimism must be matched by an adequate level of investment in countries on HRH development. The next four years will show how much will really be achieved.

International Health Regulations A Major Paradigm Shift from 1969 to 2005.

The International Health Regulations (IHR 1969), replaced by IHR 2005 had been adopted by the World Health Assembly on 23 May 2005 and came into force on 15 June 2007. IHR 2005 are a legally binding agreement among World Health Organisation (WHO) member states and other states that have agreed to be bound by them. New revision was necessitated by concerns about increasing global health threats and the need to respond with more effective surveillance and control practices. The limitations of IHR 1969, which led to their revision, related to their narrow scope, their dependence on official country notifications, and their lack of a formal internationally coordinated mechanism to contain international disease spread. The IHR 2005, which is firmly based on practical experiences, has broaden the scope of IHR 1969 to cover existing, new and re-emerging diseases, including emergencies caused by non-infectious disease agents.