Kangaroo Mother Care Induced Serum Oxytocin Facilitates Prolactin and IL-10 Among Emergency Cesarean Mothers.

Background: The rate of cesarean section is increasing from 15% to 40% in recent years. The type of delivery influences the hormonal, emotional and mental health of the mother, which correlates positively or negatively with the health benefits of the newborn. There have been many published studies on kangaroo mother care for mothers undergoing elective cesarean section, but there is still a lack of understanding about emergency cesarean section. Objective: This study aimed to evaluate the benefits of KMC practice for mothers undergoing emergency cesarean section in terms of hormone levels such as oxytocin, cortisol, prolactin, interleukin-6 and interleukin-10. Methods: This retrospective analysis used remnant serum (KMC group = 16; control group = 9), and clinical data such as KMC practice (15-30 minutes three or four times daily until discharge), breastfeeding initiation time, feeding time, crying time and hospital stay were extracted from the electronic database. All hormone and cytokine expressions were quantitatively determined by ELISA. Comparisons within and between groups were performed using appropriate statistical tests. Results: In the KMC group, increased levels of the hormone oxytocin significantly reduced cortisol and IL-6 and negatively influenced prolactin and IL-10 levels. The elevated prolactin facilitates overall lactation behaviour, of which 64% reported breastfeeding directly at the breast. The cytokine analysis revealed a reduction in pro-inflammatory cytokines and thereby an improved wound healing was seen in the KMC group. Conclusion: These quantitative results strongly encourage the use of KMC for mothers undergoing emergency cesarean section. These simple yet effective breastfeeding strategies promote maternal and infant health, which can reduce medication use.

Empowering Self-Efficacy by Using Patient Empowerment among Chronic Obstructive Pulmonary Disease: Pre-Post-Test Study.

Patient empowerment is increasingly acknowledged as a milestone of high-quality patient-centered care. This study was conducted using COPD Self-Efficacy Scale to determine the effectiveness of the patient empowerment intervention program among chronic obstructive pulmonary disease patients on self-efficacy. We employed an interventional design with a pre-test and post-test. Sixty COPD patients comprised the final sample of the study. The current study revealed significant improvement in overall self-efficacy factors among most participants. Statistically significant positive correlations were found between the total self-efficacy post-empower intervention model scores concerning age, sex, work, educational level, and marital status. The study's findings revealed that the patient empowerment intervention program positively affected COPD patients' self-efficacy.

Empowerment of Primary Healthcare Providers on the Prevention and Management of Dental or Oral Health Issues among Postchemotherapy Patients in Pandemic.

Objectives: The study aim was to evaluate the empowerment of primary healthcare providers on the prevention and management of dental or oral health issues among postchemotherapy (PC) patients, in selected rural regions, India, during a pandemic. Methods: Initially, 240 PHPs were recruited by convenient and snow ball sampling with 90.3% response rate. A descriptive, cross-sectional study was adopted using a self-administered questionnaire with 5 sections: demographics, identification of dental/oral health issues, knowledge, attitude, and practice on prevention and management of dental/oral health problems in PC patients. Statistical Packages for Social Sciences (SPSS) version 23.0 was used for statistical analysis. Results: The overall knowledge was better among nurses (64.56%), followed by pharmacists (54.5%). 81.65% of PHPs were willing to learn more and expressed the need for collaboration with dentists. In the past 3 months, 18.81% of them had PC patients with dental/oral health issues, but only 3.5% of nurses and 0.8% of pharmacists treated them. The logistic regression model revealed higher scores in mucositis/mucosal pain (OR = 1.41), altered taste sensation (OR = 1.34), sensitive gums (OR = 1.71), and dental caries (OR = 1.32) domains (p < 0.05). Those who had readiness to learn (OR = 5.37), nurses and pharmacists, and having less years of experience (OR = 1.31) and higher degree (OR = 1.4) had a positive attitude (p < 0.05). Conclusion: PHPs had limited empowerment in terms of knowledge and practice but showed a positive attitude toward the prevention and management of dental/oral health issues of PC patients. For better practice, continuing education and collaboration with dental professionals is essential.

A Subset of Primary Polydipsia, "Dipsogneic Diabetes Insipidus", in Apparently Healthy People Due to Excessive Water Intake: Not Enough Light to Illuminate the Dark Tunnel.

Dipsogenic diabetes insipidus (DDI) is a subtype of primary polydipsia (PP), which occurs mostly in healthy people without psychiatric disease. In contrast, PP is characterized by a polyuria polydipsia syndrome (PPS) associated with psychiatric illness. However, the pathogenesis of DDI is not well established and remains unexplored. In order to diagnose DDI, the patient should exhibit excessive thirst as the main symptom, in addition to no history of psychiatric illness, polyuria with low urine osmolality, and intact urine concentrating ability. Treatment options for DDI remain scarce. On this front, there have been two published case reports with successful attempts at treating DDI patients. The noteworthy commonalities in these reports are that the patient was diagnosed with frequent excessive intake of water due to a belief that drinking excess water would have pathologic benefits. It could therefore be hypothesized that the increasing trend of excessive fluid intake in people who are health conscious could also contribute to DDI. Hence, this review provides an overview of the pathophysiology, diagnosis, and treatment, with a special emphasis on habitual polydipsia and DDI.