Hypertensives versus Normotensives: Study on Coping Strategies and Lifestyle Determinants among Industrial Workers, Hyderabad, South India.

Background: Establishing an association between the coping strategies, stress, and lifestyle determinants with blood pressure levels among industrial workers is very essential to incorporate in the management of hypertension. Material and Methods: A cross-sectional study was undertaken at three factories located in Hyderabad on a camp-based approach which employed the usage of two standardized data collection tools-brief cope inventory scale and perceived stress scale along with other lifestyle determinants. Results: There were 256 study participants consisting of 144 known diagnosed cases of hypertension and 112 normotensives. Overarching coping styles mainly emotion-focused and avoidant mean scores were found to be significantly higher among the hypertensive group compared to non-hypertensives with the following facets: planning, venting, self-distraction, substance use, and behavior disengagement having higher scores and low humor scores. Mean perceived stress score, increased mean body mass index, sedentary lifestyle, and family history of hypertension were found to be statistically significant with increased odds ratio among the hypertensives group. Conclusions: A need exists to target this group with psychological interventions of cognitive behavior therapy at the earliest to improve the coping strategies which can be incorporated into the management of hypertension.

Evaluation of simulation skills of healthcare workers at a tertiary care center: A perspective towards coronavirus disease 2019 (COVID-19) third wave preparation.

BACKGROUND: Simulation-based training for healthcare providers was established as an efficacious training tool to sharpen the performance skills of nontechnical team as necessary for the prevention of errors and adverse events in the pandemic. To tackle this third wave, our institute started preparations with a faculty development course of simulation-based learning to evaluate participants' knowledge and skills and their attitudes and feedback. MATERIALS AND METHODS: As part of the simulation workshop, a module was developed to train the staff on recognizing and responding to acute coronavirus disease 2019 affecting adults and children. Case-based scenarios were provided in the application. Pretest and posttest questionnaires were administered to all trainees. The questionnaires included questions on knowledge, skills confidence and attitude marked on a 5-point Likert scale. Data were entered and analyzed using the Microsoft Excel 2018. Qualitative variables were expressed as percentages, whereas mean and standard deviations were computed for quantitative variables. Paired t-test was used to test the difference between pre and post test scores; P < 0.05 was taken as significant value. RESULTS: A total of 296 participants were included in the study. A statistically significant increase in knowledge and skills confidence scores was found from pre-test to post-test. The most significant improvement was found in the assessment of pediatric hemodynamic status and the management of fluid and electrolytes. The most interesting benefit to the participants was the acquisition of knowledge about the proper use of technology after the faculty development course. CONCLUSIONS: Such workshops play a crucial role in training healthcare workers, especially as preparation for the pandemic. Most participants suggested that there should be such workshops at regular intervals to enhance their skills confidence in handling emergency situations in the clinical settings.

Menopause-Related Quality of Life among Urban Women of Hyderabad, India.

BACKGROUND: Menopause is regarded as the marker for various symptoms such as physical, psychological, vasomotor, and sexual impairing the quality of life (QOL). OBJECTIVES: To assess the menopause-related QOL and determine associated factors among postmenopausal women. MATERIALS AND METHODS: A cross-sectional study was conducted among 378 postmenopausal women attending the obstetrics and gynecology department of a tertiary care hospital using a standardized menopause-specific QOL (MENQOL) questionnaire consisting of physical, vasomotor, psychosocial, and sexual domains. RESULTS: The study included 378 women aged above 40 years, with majority belonging to the age group of 46-50 years. The total MENQOL mean score was found to be 19.35 ± 16.20, with physical domain score the highest 14.89 ± 11.85, followed by vasomotor 1.98 ± 3.83, psychosocial 1.82 ± 3.29, and the least as sexual domain with score of 0.624 ± 2.21. Post menopausal women with age less than 50 years, No formal education, High socio-economic status, Home makers and duration of menopause less than 5 years was found to have statistical significant association with higher vasomotor domain score; No formal education, higher socio economic status and duration of menopause with greater than 5 years was found to be significant with higher sexual domain scores. CONCLUSIONS: Menopause may be associated with a decrease in QOL. Certain sociodemographic variables showed a statistically significant association with the vasomotor and sexual domains. Awareness and interventions that affect the modifiable factors may help in increasing the QOL at menopause.

Homeopathic Remedies in COVID-19: Prognostic Factor Research.

BACKGROUND/OBJECTIVE: Coronavirus disease 2019 (COVID-19) is a new disease; its clinical profile and natural history are evolving. Each well-recorded case in homeopathic practice is important for deciding the future course of action. This study aims at identifying clinically useful homeopathic remedies and their prescribing symptoms using the prognostic factor research model. METHODS: This was an open-label, multi-centric, observational study performed from April 2020 to July 2020 at various public health care clinics. The data were collected prospectively from clinical practice at integrated COVID-19 care facilities in India. Good-quality cases were selected using a specific set of criteria. These cases were analyzed for elucidating prognostic factors by calculating the likelihood ratio (LR) of each frequently occurring symptom. The symptoms with high LR values (>1) were considered as prescribing indications of the specific remedy. RESULTS: Out of 327 COVID-19 cases reported, 211 met the selection criteria for analysis. The most common complaints were fatigue, sore throat, dry cough, myalgia, fever, dry mouth and throat, increased thirst, headache, decreased appetite, anxiety, and altered taste. Twenty-seven remedies were prescribed and four of them-Arsenicum album, Bryonia alba, Gelsemium sempervirens, and Pulsatilla nigricans-were the most frequently used. A high LR was obtained for certain symptoms, which enabled differentiation between the remedies for a given patient. CONCLUSION: Homeopathic medicines were associated with improvement in symptoms of COVID-19 cases. Characteristic symptoms of four frequently indicated remedies have been identified using prognostic factor research, findings that can contribute to accurate homeopathic prescribing during future controlled research in COVID-19.

Impact of COVID-19 pandemic on mental health among Indians: A posttraumatic stress disorder.

BACKGROUND: Post Traumatic stress disorder usually occurs after a traumatic event and nowadays we are all facing the pandemic - the COVID-19 which has effected our mental health to a great extent. So this study was taken up to assess the risk of Post traumatic stress disorder symptoms using impact of event scale-revised (IES-R), their main stressors and coping measurements. MATERIALS AND METHODS: A telephonic interview schedule was adopted to fill the online questionnaire among general population of age group 20-55 years covering different states using snow ball technique. RESULTS: depicted 8.2% at risk of post traumatic stress disorder symptoms and 32.5% at risk of suppressed immune system functioning which is presumed to have its effect for the next 10 years. The main stressors of Covid -19 with increased score were worry about economic influences, effect of social media on daily life, lack of social support and poor knowledge. Coping measurements with brief resilient coping scale found 40.5% as low resilient copers who had higher mean scores of IES-R. CONCLUSIONS: This needs to be addressed earlier to bring up preventive strategies to ameliorate by including counselling services in the routine health care services of India.

Performance of Indian diabetic risk score as a screening tool of diabetes among women of industrial urban area.

INTRODUCTION: Hyderabad, the capital hub of Diabetes mellitus type 2 due to the epidemiological transition and varied lifestyle of urbanization. Indian Diabetes Risk Score (IDRS)is used to detect undiagnosed Type 2 diabetes. AIM: This study was taken up with an aim to assess the performance of IDRS as a screening tool to detect undiagnosed cases of type 2 Diabetes mellitus among women in Industrial urban area. SETTING AND DESIGN: A Community based cross sectional study was undertaken at urban field practice area attached to our medical college, Hyderabad. METHODS AND MATERIAL: Women with already diagnosed type 2 Diabetes mellitus and those who were unwilling to give informed consent were excluded from the study. IDRS was used to to detect undiagnosed diabetes. Diabetes was confirmed using blood sugar levels on fasting venous sample. STATISTICAL ANALYSIS USED: Data was entered in Microsoft excel 2010 and was analysed as frequency, Mean+ Standard deviation along with sensitivity and specificity of the test. RESULTS: As per the classification of IDRS 22% were at low risk, 40% medium risk and 38% at high risk. Components of IDRS noted majority about 45.4% with waist circumference > 90cms, no exercise among 66.6% and one parent having diabetes among 26%. Sensitivity was 59.4% and specificity was 37.3% of IDRS with the gold standard test (Fasting blood glucose) to assess the performance. CONCLUSION: IDRS is a cost effective tool which can be used for screening among undiagnosed cases.

Impact of social determinants on well-being of urban construction workers of Hyderabad.

BACKGROUND: Hyderabad has witnessed one of the largest labor immigration in recent years and these construction workers are highly vulnerable in terms of health. Social determinants of health (SDH) arise from conditions in which they live and these factors interact with each other to produce direct impact on health. OBJECTIVES: (1) To evaluate the sociodemographic and job characteristics of the construction workers. (2) To assess the impact of social determinants on well-being. MATERIALS AND METHODS: A sample size of 135 construction workers working at three sites of HITEC city were interviewed using semi-structured questionnaire. Health perception and the impact on well-being was measured using the Healthy Days Module and Kessler's Psychological Distress Scale. SDH were measured on a 27-item questionnaire with responses on a Likert scale ranging from 0 to 4. Proportions, percentages, P values, and mean scores were obtained. RESULTS: The mean age of the sample was 35.4 ± 11.94 years. Seventeen (12.6%) of the workers reported a high risk score on the Kessler's Psychological Distress Scale. Binary logistic regression analysis was used to identify significant domains of social determinants independently associated with the well being of construction workers and significant among the nine domains of social determinants were addiction score domain with odds of 2.259 and a P value of 0.015 and the distress domain with odds of 1.108 and a P < 0.001. CONCLUSIONS: There is a significant impairment of physical and mental health due to various factors including SDH, such as addictive habits and psychological distress, which are amenable to prevention.

Comparison of syndromic diagnosis of reproductive tract infections with laboratory diagnosis among rural married women in Medak district, Andhra Pradesh.

INTRODUCTION: In developing countries, reproductive tract infections (RTI) commonly affect the quality of life. Many reproductive tract infections including sexually transmitted infections (STI) and cervical cancers remain asymptomatic for long periods. Syndromic case management (SCM) is the mainstay in the control of RTI/STI, especially at primary level, where laboratory diagnosis is not possible. However, lab diagnosis should be used when it is available. OBJECTIVE: To assess the consistency of syndromic diagnosis with laboratory diagnosis. MATERIALS AND METHODS: A total of 407 women were screened. Women were categorized according to Syndromic Diagnosis of RTI/STI based on history and clinical examination. Microbiological tests and Pap smears were done to confirm the diagnosis and compared with Syndromic Diagnosis. RESULTS: Microbiologically, 33.14% were positive for at least one organism. Bacterial vaginosis was the most common finding (14%). Pap smear showed 32.9% inflammatory changes and 0.25% low-grade squamous intraepithelial lesion. Sensitivity and specificity of syndromic diagnosis with laboratory findings: Vaginal discharge syndrome with microbiological tests- (Se 58.9; Sp55.1%) Lower abdominal pain syndrome with microbiological tests-(Se 14.4%; Sp76.6%) CONCLUSION: The findings of this study highlight the wide variation of syndromic and laboratory diagnosis.