Rural–urban disparities in knowledge, attitude, and practice toward child oral health among mothers of 9–36-month-old children / Journal of Rural Medicine

Objective: To assess and compare the knowledge, attitude, and practice of mothers of pre-school children in urban and rural areas toward maintaining child oral health.Materials and Methods: A cross-sectional comparative study was conducted in a convenient sample of 400 mothers of pre-school children (aged 9 months to 3 years) visiting the outpatient department of the Department of Dentistry, Shyam Shah Medical College, Rewa (M.P), India between February 1 and April 21, 2022. The study sample was divided into two groups based on whether they belonged to a rural area (Group A) or urban area (Group B). Group A included 236 participants, and Group B 186 participants. They were served a 24-item questionnaire to assess and compare their knowledge, attitude, and practice toward child oral health. The data were represented as mean and proportions, and a student t test and analysis of variance were performed.Results: In Group A and Group B, 93.64% and 98.17% mothers respectively had the knowledge of cariogenic food. While 66.10% of mothers in Group A and 73.78% in Group B were aware that regular cleaning of teeth protects against tooth decay, only 5.49% of mothers in Group B and none in Group A reported taking their children to routine dental visits; the majority (94.07% in Group A and 78.05% in Group B) had never taken their children to the dentist. Urban background was significantly associated with better knowledge, attitude, and practice scores. Mother’s’ age and education level were significantly associated with better Knowledge, Attitude, and Practice scores in both groups.Conclusion: Mothers can play an important role in promoting positive attitudes and healthy practices toward oral health care in children. Knowledge, attitude, and practice score were found to be significantly low in mothers who belonged to the rural subgroup.

Bladder distension as a cause of abdominal compartment syndrome

Abdominal compartment syndrome [ACS] is increasingly identified in critically ill patient and its harmful effects are well documented. The disparity among the pressure, volume in abdominal cavity and its contents, results in ACS. The actual incidence of ACS is not known. However, it has been observed predominantly in patients with severe blunt and penetrating abdominal trauma, ruptured abdominal aortic aneurysms, retro- and intra-peritoneal hemorrhage, pneumoperitoneum, neoplasm, pancreatitis, ascites and multiple bone fracture. We present a case of 40-year female who underwent emergency cesarean section and developed abdominal compartment syndrome due to urinary bladder distension secondary to blockade of urinary catheter with blood clots. This is a very unusual cause of ACS

Serum hepcicin-25: a predictor of response to oral iron therpay

Background: Discovery of hepcidin, and its receptor in year 2000 has revolutionized iron metabolism studies. Measurement of serum hepcidin, may supplement existing investigational parameters of iron status in anemias. The aim of the study is to estimate baseline hepcidin level and evaluate it as a predictor of response after treatment of iron deficiency anemic with oral iron

Methods: This was a purposive follow up study; involving 102 patients aged 18 years and above selected from medical outpatient departments of a tertiary care hospital of Karachi. Baseline CBC, iron studies, and serum hepcidin-25 were measured. Patients of IDA were treated with oral ferrous sulphate 200mg thrice daily for 8 weeks. Repeat CBC on follow up visit assessed response, defined as increment in hemoglobin level by >1gm/dl post treatment. Logistic regression analysis was applied and receiver operating characteristics curves were plotted to find utility and identify hepcidin cutoff values as a predictor for response

Results: Mean baseline serum hepcidin-25 was 37.34+/-22.60 ng/mL. Regression models showed for every one unit increase of hepcidin, the odds of hemoglobin improvement decreased by [1-0.972]=0.028gm/dl, serum hepcidin-25 by itself significantly predicted improvement in hemoglobin level P=<0.05. The area under the curve for hepcidin compared with post treated hemoglobin was 0.73 [95% CI: 0.63-0.83]. For predicting response to therapy, hepcidin cutoff value of 40ng/mL, had sensitivity of 68%, specificity of 63%, positive predictive value of 85% and negative predictive value of 38%. Hepcidin quartiles were also constructed compairing 4th quartile parameters with 1st quartile parameters

Conclusion: Hepcidin 25 is a fair predictor for response of iron therapy in IDA patients; baseline hepcidin of 40ng/ml predicts treatment response