Dyslipidemia Among Overweight and Obese Children in Jharkhand: A Hospital-Based Study.

OBJECTIVE: To study the prevalence of common dyslipidemia among overweight and obese children between 2-18 years in a tribal region. METHODS: This cross-sectional study was carried out in 151 overweight and obese children aged 2-18 years, who visited the pediatric outpatient department of a tertiary care hospital in Jharkhand between 1 August and 30 November, 2022. Dyslipidemia was defined as anyone of the following: a total cholesterol level of 240 mg/dL, a triglyceride level of 150 mg/dL, a low-density lipoprotein cholesterol level (LDL-C) of 140 mg/dL, a high-density lipoprotein cholesterol level (HDL-C) of 40 mg/dL, or the use of a lipid-lowering drug [8]. Overweight and obesity were defined as per World Health Organization criteria. RESULTS: The prevalence of dyslipidemia was 63.6%. The most common type of dyslipidemia was low HDL-C + high TG levels found in 32.5% (n=49) children. The most prevalent pattern of dyslipidemia in overweight children was low HDL-C (19, 32.3%); and in obese children low HDL-C and high TG levels (39, 42.3%). CONCLUSION: The prevalence rate of dyslipidemia was high among overweight and obese children in this region. There was a positive association between dyslipidemia and body mass index.

Comprehensive assessment of holding urine as a behavioral risk factor for UTI in women and reasons for delayed voiding.

BACKGROUND: Women of reproductive age group have greater predilection to urinary tract infections (UTI). Various risk factors increase the prevalence in women. Emergence of multidrug resistant uropathogens make clinical management of UTI challenging. Here we assess holding of urine as risk factor of UTI in women and reasons for delayed voiding. We also investigate the relationship between frequency of UTIs and overall behavioural features, menstrual hygiene and attitude of women towards their own health issues. METHODS: A questionnaire based cross-sectional study was performed with 816 hostel residents with written consent. Self-reported data was statistically analysed using SPSS software. Urinalysis and urine culture were done for 50 women by random sampling to obtain the information on leading causative agents of UTI in the study population and their antimicrobial resistance profile. RESULTS: The prevalence of UTI among the participants without risk factors was found to be 27.5 (95% CI: 24.4-30.7). Attitude of women towards their own personal health issues and use of public toilets showed a correlation with prevalence of infection. Delay in urination on habitual basis was found to be associated with UTI. Uropathogens isolated by random sampling were resistant to multiple drugs that are generally used to treat UTI. CONCLUSIONS: Holding urine for long time had proven to be an important risk factor and amongst different reasons of holding urine, holding due to poor sanitary condition of public toilets was the most common. Higher frequency of self-reported UTIs is related to holding of urine, behavioural features and attitude of women.

Can Flip-Chart Assisted Maternal Education Improve Essential New Born Care Knowledge and Skills? A Randomized Controlled Trial.

BACKGROUND: Despite the implementation of essential newborn care (ENC) by the World Health Organization, knowledge gaps among postpartum women persist. Inappropriate breastfeeding practices and lack of knowledge regarding ENC among mothers has resulted in higher neonatal mortality. PURPOSE: Our study focused on evaluating the effectiveness of flip-chart assisted postpartum maternal education in improving ENC knowledge and skills. MATERIAL AND METHODS: A single blind parallel randomized controlled trial was carried out with 120 primigravidae. Participants were allocated to the intervention group (IG) or the control group (CG) by block randomization. A pretested validated questionnaire was administered to participants in both groups within 24 h post-delivery. Women in the IG were provided flip-chart assisted education regarding ENC approximately 24 h post-delivery. Women in both groups received verbal advice on ENC from the postnatal ward nurses, as per the existing hospital policy. ENC skills were observed in all participants in postnatal wards by independent observers. 6 months later, knowledge retention was assessed and analyzed in both groups. RESULTS: Antenatal education remained at 32% among all postnatal women. Postnatal flip-chart-assisted maternal education had a significant impact on ENC skills in the IG (p < 0.01) and precipitated higher knowledge scores at the end of 6 months (p < 0.01) in the IG. CONCLUSION FOR PRACTICE: Flip-chart assisted education soon after delivery had a sustained effect on ENC knowledge and practices that persisted for 6 months post-delivery.

Course of Hyposmia and Hypogeusia and their Relationship with Severity of COVID-19 Disease among Indian Population.

AIMS: Hyposmia and hypogeusia are one of the symptoms of COVID-19. Occurrence and course of these symptoms and their relationship with severity of COVID-19 disease are studied. MATERIALS AND METHODS: This was a prospective cohort study, including consenting adult SARS CoV-2 positive patients of both genders, admitted to a Covid Hospital in Puducherry, India. This questionnaire- based study was conducted for a period 4 months from 1st October 2020 to 31st January 2021, and collected data was analyzed using SPSS version 24.0 software. RESULTS: Out of 639 participants, 412 (64.5%) were males, 227 (35.5%) were females. Total cases of new onset hyposmia were 167 (26.1%), and total patients with new onset hypogeusia were 172 (26.91%). 216 (33.80%) had either hyposmia/hypogeusia. First symptom as hyposmia was noted in 49 (7.67%) patients, and as hypogeusia in 20 (3.13%) patients before development of any other symptoms. 216 (33.80%) patients had either smell or taste disturbance as one of their symptoms. By the end of 5 weeks of illness, 96.41% of hyposmic patients, and 97.67% of hypogeusic patients recovered fully. There was no statistically significant difference between presence or absence of hyposmia/hypogeusia and severity of COVID-19 disease (p value = 0.95). CONCLUSION: The occurrence of hyposmia and hypogeusia among Indian COVID-19 patients is more than 26%. Presence or absence of hyposmia/hypogeusia is not a predictor of severity of COVID-19 disease. More than 96% of the patients fully recovered their sense of smell and taste sensation by the end of 5 weeks.

Pain Management in Children With Cancer Using World Health Organization Guidelines at a Tertiary Cancer Center in Rural India.

Management of cancer pain among children is a difficult process due to the way they perceive pain, their dependence on parents, complexity of assessment, and limited availability of safe analgesics. Pain among children with cancer is still a less explored problem in India. This descriptive study was carried out in a tertiary cancer center to explore the characteristics of pain and its management among the children with cancer. We analyzed children diagnosed with hematologic malignancies, aged 4-18 years, admitted between January 2013 and December 2017. This retrospective cohort study involved the review of patient records available at the medical records department. During the study period, there were 290 admission episodes, of which 93 (32.1%) episodes were associated with pain. Of these 93 episodes, 14 (15%) were primarily for pain management. Step I analgesic was utilized in the majority (83%) of the admission episodes involving younger age group (4-9 years) children, whereas for the older age group (10-18 years) Step 2 analgesic (tramadol) was utilized in 29 (58%) episodes, and this was found to be statistically significant (P < .001). Only in 9 (9.7%) episodes Step 3 analgesic was utilized. A significant proportion of children with hematologic malignancies had pain episodes, and these episodes in older age group children were managed with weak opioids.

Opportunistic Screening for Hypertension and Selected Cardiovascular Risk Factors among Adults Attending a Primary Health Center in Puducherry, India.

BACKGROUND: India is currently suffering from an epidemic of noncommunicable diseases; it is thus imperative to screen for cardiovascular risk factors in people visiting Primary Health Centers (PHCs). The objective of the study was to measure the amount of undiagnosed hypertension and selected cardiovascular risk factors present among the adult population through opportunistic screening at the PHC. METHODS: A facility-based opportunistic screening program was carried out in a PHC in rural Puducherry. Patients and accompanying persons aged 30 years and above, who attended the daily outpatient department (OPD) were included. The OPD provides outpatient services and medical procedures or tests without requirement of an overnight stay, and functions for 4 h a day. Known hypertensive patients and pregnant women were excluded. Information on age, gender, diabetes status, and personal history of tobacco and alcohol use were collected using an interview schedule. Height, weight and waist circumference were measured, along with blood pressure and blood sugar using standard protocols. Systolic blood pressure (SBP) ≥140 and/or diastolic blood pressure (DBP) ≥90 mm Hg was taken as hypertension. SBP of 120-139 mm Hg and/or DBP of 80-89 mm Hg were taken as prehypertension. RESULTS: A total of 324 participants were screened; 56.8% were females. The mean standard deviation (SD) age of the participants was 47.7 (SD 12.6) years. Hypertension and prehypertension were present in 17.9% and 37.7% of the participants respectively. 17.3% participants had diabetes. 22.2% and 21.3% of all participants were current users of tobacco and alcohol respectively. Generalized obesity was present in 31.8% of the participants; 19.1% were overweight. 45.1% participants had central obesity. CONCLUSIONS: A relatively large proportion of adults were found to have prehypertension and obesity, thus showing the need for early intervention.