Exploring effective coping strategies for wives living with spouses who have alcohol dependence: Insights from focus group discussions.

BACKGROUND: Alcohol dependence is a prevalent issue worldwide. The wives of persons with alcohol dependence (WPAD) often experience several psychological, physical, and social problems, and it is essential to identify their coping strategies. This study aims to explore the coping strategies employed by WPAD by conducting a focus group discussion (FGD). MATERIALS AND METHODS: This study was conducted among wives of persons with alcohol dependence during their husband's admission in the departments of Psychiatry and gastroenterology of St. John's Medical College Hospital, Bangalore, India, using qualitative research with phenomenological design. The inclusion criteria were being married and living with a person with alcohol dependence for more than three years and free from major psychiatric disorders and recruited through purposive sampling for six FGDs, which were conducted using a FGD guide and lasted approximately 60 to 90 minutes. The discussions were audio-recorded and transcribed verbatim. Thematic analysis was used to analyze the data. RESULTS: The study revealed that the WPAD adhered to various coping strategies to face the challenges of living with their husbands with alcohol dependence. It is observed that WPAD used emotion-focused coping, problem-focused coping and avoidance coping. CONCLUSIONS: This study highlighted the effective coping strategies adapted by WPAD to tackle the hardships related to their husband's alcoholic behavior and most of the WPAD used emotion-focused coping. This study provided valuable insights into the coping strategies used by wives of alcoholics and the challenges they faced in managing their spouse's addiction.

School-Based Educational Interventions on Prevention and Control of Malaria-A Systematic Review and Meta-Analysis.

Student messengers act as change agents for health and modify the behavior of their families as well as the community. Integration of the school health programs with malaria education enhances the participation of school teachers, parents, as well as the local community in malaria elimination. The objective of this review is to strengthen the evidence for school-based health educational interventions for malaria control and prevention activities. We searched six databases namely PubMed Central, Science Direct, CINAHL with full text, Google Scholar, Cochrane Library, and Pro-Quest to find relevant studies between January 2001 and March 2022 based on PRISMA guidelines. Randomized controlled trial, before-after intervention, and quasi-experimental study designs were included and a meta-analysis was carried out using the random-effect model to pool out the results by using Rev-man 5.4 software. In this review, 13 studies were included. The pooled outcome of school-based educational interventions on malaria was moderate (Standardized Mean Difference-2.59) and a significant difference was observed in intervention and control schools (Z = 7.33, P < 0.00001). In conclusion, this review identified the facts for the prevention and control of malaria through school-based educational interventions. Our findings strengthen the concept of malaria elimination through student messengers to mobilize the local community.

Reported hypoglycemia in Type 2 diabetes mellitus patients: Prevalence and practices-a hospital-based study.

INTRODUCTION: Hypoglycemia tops the list of hurdles in preventing tight glycemic control in diabetic patients. It is even considered as a cardiovascular risk factor. However, it continues to be a neglected complication with very limited epidemiological data in our country. AIM: To study the self-reported prevalence of hypoglycemia among type 2 diabetic patients and the practices adopted by them during and after the episodes to manage and avert future occurrences. MATERIALS AND METHODS: It is a questionnaire-based cross-sectional study done using systematic random sampling selecting every 5th patient attending the diabetic Out-Patient (OP) in a tertiary medical college hospital. RESULTS: There were 366 participants with median age of 60 years. Around 96% reported any one symptom of hypoglycemia, but 78% had eaten following the episode and got relieved of the symptoms. Weakness (76.2%) and dizziness (74%) were the most common symptoms reported by the patients. A quarter of them reported having severe attacks requiring somebody's assistance. Most patients resorted to timely meals (85%) to avert future attacks. Patients who took insulin along with oral hypoglycemic agents (OHAs) were at a higher risk (OR = 2.3) for hypoglycemia compared to patients taking only OHAs (P < 0.01). CONCLUSION: The reported prevalence of hypoglycemia among type 2 diabetes patients is quite high. This finding reiterates the importance of enquiring and educating every diabetic patient about hypoglycemic episodes during every health visit.

Knowledge of hypoglycemia and its associated factors among type 2 diabetes mellitus patients in a Tertiary Care Hospital in South India.

INTRODUCTION: Hypoglycemia being the rate limiting complication in the attainment of strict glycemic control in diabetes management, in this study, we intended to study the knowledge of its symptoms, target blood levels during treatment and ways of prevention among type 2 diabetes patients attending Outpatient Department (OPD) of a medical college hospital. MATERIALS AND METHODS: Every fifth patient attending the OPD during the 4 months between March and June 2013 was interviewed using a questionnaire. RESULTS: The study included 366 type 2 diabetic patients, of which 76.5% were females. The target fasting and postprandial blood glucose levels while on treatment was known to 135 (36.9%) and 126 (34.4%) patients, respectively. The common symptoms of hypoglycemia known to the study subjects were dizziness (81.4%), weakness (73.8%), and drowsiness (72.1%). Overall, 242 (66.1%) diabetic patients had good knowledge on hypoglycemia (knowledge of at least three symptoms of hypoglycemia together with at least one precipitating factor and at least one remedial measure). Higher age, illiteracy, low socioeconomic status were associated with poor knowledge whereas treatment with insulin along with oral hypoglycemic agents was associated with good knowledge on hypoglycemia. Sex and duration of disease were not associated with knowledge on hypoglycemia. CONCLUSION: Although the knowledge on symptoms of hypoglycemia, precipitating factors, remedial measures are high in this study, the target blood levels, complications were known to just a third of them. There is a knowledge gap on important aspects of hypoglycemia among type 2 diabetic patients.

National health programs in the field of endocrinology and metabolism - Miles to go.

The endocrine and metabolic diseases of childhood obesity, diabetes mellitus, hypertension, iodine deficiency disorders, vitamin D deficiency, and osteoporosis are major public health problems. Different programs including National Program for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke address these problems although some are yet to be addressed. National surveys have shown high prevalence of these disorders and their risk factors. Most of the programs aim at awareness raising, lifestyle modification, (primary prevention) and screening (secondary prevention) for the disease conditions as these are proven to be cost-effective compared to late diagnosis and treatment of various complications. Urgent concerted full scale implementation of these programs with good coordination under the umbrella of National Rural Health Mission is the need of the moment. The referral system needs strengthening as are the secondary and tertiary levels of health care. Due attention is to be given for implementation of these programs in the urban areas, as the prevalence of these conditions is almost equal or even higher among urban poor people where primary and secondary prevention measures are scarcely available and treatment costs are sky-high.

Are the current Indian growth charts really representative? Analysis of anthropometric assessment of school children in a South Indian district.

BACKGROUND: India currently is posed by the double threat of thinness and overweight/obesity among children. Different growth charts have taken different population and give different cut-off points to assess these conditions. OBJECTIVE: The objective of this study is to assess the anthropometry of school children, 5-18 years of age and thereby estimate the prevalence of childhood thinness, overweight and obesity. To analyze how the study population compares with that of Agarwal's growth chart. MATERIALS AND METHODS: The anthropometric measurements of all the students who were studying from 1(st) to 12(th) standards were taken from 27 randomly selected Government and private schools. Prevalence of thinness, overweight and obesity were assessed using two standards - Indian standard given by Agarwal and International Standards given by International Obesity Task Force (IOTF). RESULTS: The prevalence of thinness, overweight and obesity among 18,001 students enrolled as per Indian standard were 12.2%, 9.5% and 3% and as per International standard were 15.3%, 8.1% and 2.6% respectively. The mean and the 95(th) percentile values of body mass index for both boys and girls at all ages in this study are falling short of Agarwal's and IOTF values. Using international cut-offs as well as Indian cut-offs given by Agarwal, underestimate the prevalence of obesity among boys and girls of all age groups. CONCLUSION: This study shows that under and over-nutrition among school children is in almost equal proportions. There is an underestimation of obesity among children whenever an Indian or an International growth chart is used. Thus, this study brings out the need for a really representative growth chart.