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1.
Sensors (Basel) ; 23(11)2023 May 31.
Artículo en Inglés | MEDLINE | ID: mdl-37299970

RESUMEN

The aim of this study was to find the correlation between failure modes and acoustic emission (AE) events in a comprehensive range of thin-ply pseudo-ductile hybrid composite laminates when loaded under uniaxial tension. The investigated hybrid laminates were Unidirectional (UD), Quasi-Isotropic (QI) and open-hole QI configurations composed of S-glass and several thin carbon prepregs. The laminates exhibited stress-strain responses that follow the elastic-yielding-hardening pattern commonly observed in ductile metals. The laminates experienced different sizes of gradual failure modes of carbon ply fragmentation and dispersed delamination. To analyze the correlation between these failure modes and AE signals, a multivariable clustering method was employed using Gaussian mixture model. The clustering results and visual observations were used to determine two AE clusters, corresponding to fragmentation and delamination modes, with high amplitude, energy, and duration signals linked to fragmentation. In contrast to the common belief, there was no correlation between the high frequency signals and the carbon fibre fragmentation. The multivariable AE analysis was able to identify fibre fracture and delamination and their sequence. However, the quantitative assessment of these failure modes was influenced by the nature of failure that depends on various factors, such as stacking sequence, material properties, energy release rate, and geometry.


Asunto(s)
Acústica , Fracturas Óseas , Humanos , Carbono , Fibra de Carbono , Análisis por Conglomerados
2.
Indian J Public Health ; 67(Suppl 1): S58-S64, 2023 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-38934883

RESUMEN

SUMMARY: Noncommunicable diseases (NCDs) pose a significant global health and economic burden, necessitating universal health coverage (UHC). Out-of-pocket (OOPs) payments for healthcare, particularly in low- and middle-income countries lacking social protection and health insurance, contribute to impoverishment and catastrophic expenditure. This scoping review aimed to assess the state of UHC for NCDs in India, including the progress made, coverage of government health insurance schemes, challenges faced, and their potential solutions. A literature search was performed in major databases such as PubMed, Ovid, Web of Science, Embase, Cochrane Library, and Google Scholar using appropriate keywords. Findings indicated that UHC remains a distant dream in India with a disproportionately high NCD burden and a substantial portion of health-care expenses (80% outpatient, 40% inpatient) relying on OOP expenditures, causing financial hardship. Limited universal social security exacerbates health-care access challenges. The coronavirus disease-2019 pandemic has further hindered NCD services and UHC progress. The Ayushman Bharat program, featuring health and wellness centers and the Pradhan Mantri Jan Arogya Yojana, aims to address primary health-care needs and provide NCD coverage in India. Despite this, challenges persist, including inadequate availability of essential medicines and technologies in health-care facilities, as well as gaps in rural health-care access. Telemedicine services like "eSanjeevani" have been implemented to improve access in remote areas. To achieve UHC for NCDs in India, it is crucial to strengthen primary health-care, ensure medicine availability, enhance human resources, establish a referral system, address social determinants, and implement social protection.


Asunto(s)
Enfermedades no Transmisibles , Cobertura Universal del Seguro de Salud , Humanos , India/epidemiología , Cobertura Universal del Seguro de Salud/economía , Cobertura Universal del Seguro de Salud/organización & administración , Enfermedades no Transmisibles/economía , Enfermedades no Transmisibles/terapia , Enfermedades no Transmisibles/epidemiología , COVID-19/epidemiología , Gastos en Salud/estadística & datos numéricos , Accesibilidad a los Servicios de Salud/economía , Seguro de Salud/economía , Seguro de Salud/organización & administración
3.
BMC Health Serv Res ; 22(1): 1590, 2022 Dec 28.
Artículo en Inglés | MEDLINE | ID: mdl-36578063

RESUMEN

BACKGROUND: BRAC (Bangladesh Rural Advancement Committee), the largest NGO globally, implemented a community-based comprehensive social behavior communication intervention to increase community resilience through prevention, protection, and care for COVID-19. We conducted implementation research to assess fidelity and explore the barriers and facilitators of this intervention implementation. METHODS: We adopted a concurrent mixed-method triangulation design. We interviewed 666 members of 60 Community Corona Protection Committees (CCPCs) and 80 members of 60 Community Support Teams (CSTs) through multi-stage cluster sampling using a structured questionnaire. The qualitative components relied on 54 key informant interviews with BRAC implementers and government providers. RESULTS: The knowledge about wearing mask, keeping social distance, washing hands and COVID-19 symptoms were high (on average more than 70%) among CCPC and CST members. While 422 (63.4%) CCPC members reported they 'always' wear a mask while going out, 69 (86.3%) CST members reported the same practice. Only 247 (37.1%) CCPC members distributed masks, and 229 (34.4%) donated soap to the underprivileged population during the last two weeks preceding the survey. The key facilitators included influential community members in the CCPC, greater acceptability of the front-line health workers, free-of-cost materials, and telemedicine services. The important barriers identified were insufficient training, irregular participation of the CCPC members, favouritism of CCPC members in distributing essential COVID-19 preventive materials, disruption in supply and shortage of the COVID-19 preventative materials, improper use of handwashing station, the non-compliant attitude of the community people, challenges to ensure home quarantine, challenges regarding telemedicine with network interruptions, lack of coordination among stakeholders, the short duration of the project. CONCLUSIONS: Engaging the community in combination with health services through a Government-NGO partnership is a sustainable strategy for implementing the COVID-19 prevention program. Engaging the community should be promoted as an integral component of any public health intervention for sustainability. Engagement structures should incorporate a systems perspective to facilitate the relationships, ensure the quality of the delivery program, and be mindful of the heterogeneity of different community members concerning capacity building. Finally, reaching out to the underprivileged through community engagement is also an effective mechanism to progress through universal health coverage.


Asunto(s)
COVID-19 , Humanos , COVID-19/epidemiología , COVID-19/prevención & control , Bangladesh/epidemiología , Actitud , Personal de Salud , Población Rural
4.
Monaldi Arch Chest Dis ; 92(4)2022 Mar 28.
Artículo en Inglés | MEDLINE | ID: mdl-35347974

RESUMEN

This study was conducted to assess the clinical characteristics, causative agents, complications, and outcomes of infective endocarditis (IE) among patients presenting to our tertiary care center over the last decade. This retrospective cohort study included all adult patients admitted to the Aga Khan University Hospital with the diagnosis of IE over a ten-year period from 2010 to 2020.  Outcomes variables included complications during hospitalization, surgical intervention, mortality, and length of stay. We identified a total of 305 cases out of which 176 (58%) were males and 129 (42%) were females. The mean age of the patients was 46.9±18.8 years. 95 (31%) had prosthetic valves in place. Staphylococcus aureus was isolated in 54 (39%) patients followed by coagulase-negative Staphylococcus in 23 (17%). Echocardiography revealed vegetations and abscesses in 236 (77%) and 4 (1%) patients, respectively. The most common valvular complication was mitral valve regurgitation found in 26 (9%) patients, followed by tricuspid valve regurgitation in 13 (4%) patients and aortic valve regurgitation in 11 (3%) patients. Furthermore, 81 (27%) patients suffered from heart failure and 66 (22%) from a stroke during hospitalization. The mean hospital length of stay was 10.4 ± 10.6 days. 64 (21%) patients required surgical repair and the overall mortality rate was 25%. Prosthetic valve endocarditis (OR = 3.74, 95% CI = 2.15-6.50, p<0.001), chronic kidney disease (OR = 2.51, 95% CI = 1.15-5.47, p=0.036), previous stroke (OR = 2.42, 95% CI = 1.18-4.96, p=0.026), and ischemic heart disease (OR = 3.04, 95% CI = 1.50-6.16, p=0.003) were significantly associated with an increased risk of mortality. In conclusion, our study provided valuable data on the clinical characteristics and outcomes of patients with IE in a developing country. S. aureus was the most common causative agent. Heart failure and stroke were the most common complications. The presence of prosthetic valves, history of chronic kidney disease, ischemic heart disease and previous stroke were associated with a significantly increased risk of mortality. Surgical management was not associated with improved outcomes.


Asunto(s)
Endocarditis Bacteriana , Endocarditis , Insuficiencia Cardíaca , Prótesis Valvulares Cardíacas , Accidente Cerebrovascular , Adulto , Masculino , Femenino , Humanos , Persona de Mediana Edad , Anciano , Endocarditis Bacteriana/diagnóstico , Staphylococcus aureus , Centros de Atención Terciaria , Estudios Retrospectivos , Pakistán/epidemiología , Prótesis Valvulares Cardíacas/efectos adversos , Endocarditis/complicaciones , Endocarditis/epidemiología , Endocarditis/diagnóstico , Insuficiencia Cardíaca/etiología , Accidente Cerebrovascular/complicaciones
5.
Educ Inf Technol (Dordr) ; 27(8): 11947-11969, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35645594

RESUMEN

It is well documented that learning oppourtunities afforded by mobile technology (m-learning) holds great potential to enhance technology-enhanced learning in countries and communities with low socio-economic conditions where web-based e-learning has failed because of limited infrastructure and resources. Despite the potential for m-learning, its actual uptake has been low. The extant literature in this sphere provides some theoretical insight, with evidence of limited on-the-ground practical studies that often do not progress beyond the pilot phase. Failure to embed sustainable learning opportunities has been attributed to the absence of a contextual framework suitable for the heterogeneous nature of many developing countries. This paper thus presents an m-learning framework that considers the sociocultural and socio-economic contexts of low-income economies. The framework is based on a range of studies conducted over four years, including the outcome of two empirical studies conducted in a Nigerian university. Documenting the research underpinning the design provides practitioners and policymakers with a framework for a potentially sustainable strategy for long-term mainstream m-learning integration in higher education in low-income countries.

6.
Anal Chem ; 93(45): 14955-14965, 2021 11 16.
Artículo en Inglés | MEDLINE | ID: mdl-34694783

RESUMEN

In the context of the recent pandemic, the necessity of inexpensive and easily accessible rapid-test kits is well understood and need not be stressed further. In light of this, we report a multi-nucleotide probe-based diagnosis of SARS-CoV-2 using a bioelectronics platform, comprising low-cost chemiresistive biochips, a portable electronic readout, and an Android application for data acquisition with machine-learning-based decision making. The platform performs the desired diagnosis from standard nasopharyngeal and/or oral swabs (both on extracted and non-extracted RNA samples) without amplifying the viral load. Being a reverse transcription polymerase chain reaction-free hybridization assay, the proposed approach offers inexpensive, fast (time-to-result: ≤ 30 min), and early diagnosis, as opposed to most of the existing SARS-CoV-2 diagnosis protocols recommended by the WHO. For the extracted RNA samples, the assay accounts for 87 and 95.2% test accuracies, using a heuristic approach and a machine-learning-based classification method, respectively. In case of the non-extracted RNA samples, 95.6% decision accuracy is achieved using the heuristic approach, with the machine-learning-based best-fit model producing 100% accuracy. Furthermore, the availability of the handheld readout and the Android application-based simple user interface facilitates easy accessibility and portable applications. Besides, by eliminating viral RNA extraction from samples as a pre-requisite for specific detection, the proposed approach presents itself as an ideal candidate for point-of-care SARS-CoV-2 diagnosis.


Asunto(s)
COVID-19 , SARS-CoV-2 , Inteligencia Artificial , Prueba de COVID-19 , Humanos , Nucleótidos , ARN Viral/genética , Sensibilidad y Especificidad
7.
J Pak Med Assoc ; 71(2(B)): 699-703, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33941962

RESUMEN

OBJECTIVE: To monitor the frequencies of different adverse transfusion reactions and to assess the compliance of clinical staff with the process of sending proper transfusion reaction workup within the specified time. METHODS: The retrospective audit was conducted at the blood bank of Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan, and comprised all transfusion reaction forms received from July 1, 2017, to June 30, 2018. The forms were analysed for type of blood component, time in which it was received by the blood bank, whether or not the form was completely filled, whether or not all required samples were provided, and the type of reaction. RESULTS: Of the 12,787 units dispensed and transfused, 50(0.39%) transfusion reactions were noted. Allergic was the most frequent type 24(48%). Red cells accounted for 38(76%) of the reactions. In 58(95%) cases, reaction forms were completely filled. Blood bags in 36(59%) and post-transfusion ethylenediaminetetra acetic acid samples in 35(57.3%) cases were received at blood bank within 2 hours of reaction. CONCLUSIONS: Incidence of transfusion reactions was found to be low as there was good compliance with procedures on the part of the clinical staff.


Asunto(s)
Neoplasias , Reacción a la Transfusión , Instituciones Oncológicas , Humanos , Neoplasias/epidemiología , Pakistán/epidemiología , Estudios Retrospectivos
8.
J Pak Med Assoc ; 70(4): 636-649, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32296208

RESUMEN

OBJECTIVE: To determine the association among number of factors influenced by asthma using geographic information system. METHODS: The cross-sectional study was conducted in Landhi and Korangi towns of Karachi from 2011 to 2013, and comprised ecological mapping and multi-criteria evaluation techniques to discover the relationship of local environmental settings with asthma. Additionally, exacerbating environment and the root causes within the local settings were assessed. Data was gathered using an extended version of the questionnaire developed by the International Union against Tuberculosis and Lung Disease. Data was analysed by using ArcGIS 10. RESULTS: The findings are very alarming as almost 40% (468,930 estimated pop 1998 census) of the study population lived in high asthma-prone environment, having a very high risk of respiratory disorders, including asthma. CONCLUSIONS: The integrated environmental effect in the form of respiratory disorders was appraised, focusing on asthma by using multi-criteria analysis.


Asunto(s)
Asma , Monitoreo del Ambiente , Sistemas de Información Geográfica/estadística & datos numéricos , Medición de Riesgo , Asma/diagnóstico , Asma/epidemiología , Asma/prevención & control , Estudios Transversales , Fenómenos Ecológicos y Ambientales , Monitoreo del Ambiente/métodos , Monitoreo del Ambiente/estadística & datos numéricos , Mapeo Geográfico , Humanos , Pakistán/epidemiología , Salud Pública , Medición de Riesgo/métodos , Medición de Riesgo/normas , Medición de Riesgo/estadística & datos numéricos , Análisis Espacial
9.
BMC Public Health ; 19(1): 1437, 2019 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-31675943

RESUMEN

BACKGROUND: The period from birth to two years is the "critical window" for achieving optimal growth and development. An inadequate quality and quantities of complementary foods, poor child-feeding practices and infection negatively impact the growth of under-twos. Approximately one-third of under-fives in developing countries are stunted; many are also micronutrient deficient. An estimated 6% of mortalities among under-fives can be prevented by ensuring optimal complementary feeding. The objective of the study was to assess the ability of a 12-month integrated nutrition intervention to improve the nutritional status (length-for-age Z-score) of 6 to 12-month-old children in rural Bangladesh. METHODS: In this community-based randomized controlled trial, the intervention group received a package of interventions that includes, food vouchers; to prepare egg-based nutritious snacks (suji firni for < 1-year-olds, suji halwa for > 1-year-olds), micronutrient powder to fortify children's food at home, child feeding counselling and water, sanitation and hygiene (WASH), behaviour change communication. The control group received routine health messages provided by the government. Baseline and endline surveys were conducted; Data collection was performed monthly on children's growth, food voucher utilization, child feeding and morbidity. In addition, we assessed the cognitive development of the children after 12 months of intervention. CONCLUSION: This trial aims to explore whether an integrated nutrition intervention can mitigate childhood stunting during the critical window of opportunity in rural Bangladesh. The results may provide robust evidence to improve the linear growth of children in developing countries. TRIAL REGISTRATION: The study was retrospectively registered on August 17, 2018 and is available online at ClinicalTrials.gov (ID: NCT02768181).


Asunto(s)
Trastornos del Crecimiento/prevención & control , Promoción de la Salud/métodos , Fenómenos Fisiológicos Nutricionales del Lactante , Estado Nutricional , Población Rural/estadística & datos numéricos , Bangladesh , Humanos , Lactante , Evaluación de Programas y Proyectos de Salud , Proyectos de Investigación
11.
BMC Psychiatry ; 17(1): 281, 2017 08 01.
Artículo en Inglés | MEDLINE | ID: mdl-28826398

RESUMEN

BACKGROUND: Autism spectrum disorders (ASD) are a group of complex neurodevelopmental disorders. The prevalence of ASD in many South Asian countries is still unknown. The aim of this study was to systematically review available epidemiological studies of ASD in this region to identify gaps in our current knowledge. METHODS: We searched, collected and evaluated articles published between January 1962 and July 2016 which reported the prevalence of ASD in eight South Asian countries. The search was conducted in line with the PRISMA guidelines. RESULTS: We identified six articles from Bangladesh, India, and Sri Lanka which met our predefined inclusion criteria. The reported prevalence of ASD in South Asia ranged from 0.09% in India to 1.07% in Sri Lanka that indicates up to one in 93 children have ASD in this region. Alarmingly high prevalence (3%) was reported in Dhaka city. Study sample sizes ranged from 374 in Sri Lanka to 18,480 in India. The age range varied between 1 and 30 years. No studies were found which reported the prevalence of ASD in Pakistan, Nepal, Bhutan, Maldives and Afghanistan. This review identifies methodological differences in case definition, screening instruments and diagnostic criteria among reported three countries which make it very difficult to compare the studies. CONCLUSIONS: Our study is an attempt at understanding the scale of the problem and scarcity of information regarding ASD in the South Asia. This study will contribute to the evidence base needed to design further research and make policy decisions on addressing this issue in this region. Knowing the prevalence of ASD in South Asia is vital to ensure the effective allocation of resources and services.


Asunto(s)
Pueblo Asiatico/psicología , Pueblo Asiatico/estadística & datos numéricos , Trastorno del Espectro Autista/epidemiología , Bangladesh/epidemiología , Humanos , India/epidemiología , Sri Lanka/epidemiología
12.
J Med Virol ; 88(5): 790-7, 2016 May.
Artículo en Inglés | MEDLINE | ID: mdl-26399724

RESUMEN

Suboptimal viral suppression and CD4 response to antiretroviral treatment (HAART) is known to cause poor outcomes with the increase cost of treatment. We aimed to assess factors associated with such control among HIV/AIDS patients in Malaysia. Four hundred and six HIV/AIDS patients, using Antiretroviral Therapy (ART) for at least the past three months, treated as outpatients at medication therapy adherence clinics (MTAC) were recruited. CD4 cell counts, viral load readings along with co-variants such as socio-demographic factors, adverse drug reactions, comorbidities, and medication record were obtained. Statistical Package for Social Sciences (SPSS(®)) version 18 and STATA IC(®) version 12 were used for data analysis. CD4 counts were found highest among those within the age category 41-50 years (390.43 ± 272.28), female (402.64 ± 276.14), other ethnicities (400.20 ± 278.04), and participants with no formal education (414.87 ± 290.90). Patients experiencing adverse effects had a 2.28 (95%CI:1.25-4.18) fold greater risk of poor CD4 control, while patients with comorbidities had 2.46 (95%CI:1.02-5.91) fold greater risk of mild viral suppression. Adverse drug reactions, co-morbidities were found to be significantly associated with poor immunological and virological outcomes in HIV/AIDS patients. However, a comprehensive evaluation is needed to better understand other confounders.


Asunto(s)
Antirretrovirales/uso terapéutico , Linfocitos T CD4-Positivos/inmunología , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/patología , Carga Viral , Adolescente , Adulto , Anciano , Recuento de Linfocito CD4 , Femenino , Infecciones por VIH/epidemiología , Humanos , Malasia/epidemiología , Masculino , Persona de Mediana Edad , Factores de Riesgo , Insuficiencia del Tratamiento , Adulto Joven
13.
J Pediatr Hematol Oncol ; 38(5): 378-83, 2016 07.
Artículo en Inglés | MEDLINE | ID: mdl-27164519

RESUMEN

OBJECTIVE: To describe the initial experience and demographics of T2* cardiac magnetic resonance-based myocardial-iron quantification of transfusion-dependent thalassemia-major (TM) patients from Pakistan and the correlation with serum ferritin. METHODS: Eligible TM patients presenting between April 2014 and April 2015 to Aga Khan University Hospital, Pakistan, for T2*CMR were included. The severity of myocardial-iron deposition was defined as follows: normal T2*>20 ms, mild-moderate T2*10 to 20 ms, and severe T2*<10 ms. Cardiac symptoms were classified using the NYHA functional classification. Echocardiographic systolic and diastolic functions were performed. Continuous variables were presented as the median (minimum-maximum value). Correlation was measured using the Spearman rank correlation. Multivariate logistic regression was used to determine factors associated with the NYHA functional class. RESULTS: A total of 83 patients (49 male and 34 female) with TM, age 19 (5 to 45) years at presentation for T2*CMR, were reviewed. At presentation, 70% of the patients were classified as NYHA class II or worse. T2*<20 ms was observed in 62.6% of the patients, with 47% showing severe iron deposition (T2<10 ms). No correlation of T2*<20 ms (r=-0.157, P=0.302) and T2*<10 ms (r=-0.128, P=0.464) was observed with serum ferritin. On multivariate analysis, lower T2* values correlated with a worsening NYHA functional class. CONCLUSIONS: There is a high prevalence of severe myocardial iron load in Pakistani TM patients. Serum ferritin did not correlate with T2* values. Lower T2* was the only clinical factor associated with the NYHA functional class.


Asunto(s)
Enfermedades Endémicas , Siderosis/etiología , Talasemia beta/complicaciones , Adolescente , Adulto , Cardiomiopatías/diagnóstico por imagen , Cardiomiopatías/etiología , Niño , Preescolar , Ecocardiografía , Femenino , Ferritinas/sangre , Humanos , Hierro/metabolismo , Sobrecarga de Hierro , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Pakistán , Siderosis/diagnóstico por imagen , Adulto Joven , Talasemia beta/epidemiología
14.
Health Expect ; 18(6): 2841-52, 2015 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-25228140

RESUMEN

BACKGROUND: Understanding patients' knowledge and belief towards disease could play a vital role from an outcome perspective of disease management and HIV/AIDS patients are not exception to that. METHODS: Qualitative methodology was used to explore Malaysian HIV/AIDS patients' perspectives on disease and status disclosure. A semi structured interview guide was used to interview the patients and a saturation point was reached after the 13th interview. All interviews were audio-recorded and subjected to a standard content analysis framework. RESULTS: Understandings and beliefs towards HIV/AIDS and Perspective on disease disclosures were two main themes derived from patients' data. Beliefs towards causes and cure emerged as sub-themes under disease understandings while reasons for disclosure and non-disclosure were resulted as main sub-themes under disease disclosure. Majority of patients apprehended HIV/AIDS and its causes to acceptable extent, there were elements of spirituality and lack of education involved with such understandings. Though beliefs existed that knowing status is better than being ignorant, fear of stigma and discrimination, social consequences and family emotions were found important elements linked to disease non-disclosure. CONCLUSIONS: The outcomes provided basic information about patients' perceptions towards disease and status disclosure among HIV/AIDS patients which can help in the designing and improvising existing strategies to enhance disease awareness and acceptance and will also serve as baseline data for future research further focusing on this subject.


Asunto(s)
Infecciones por VIH/psicología , Autorrevelación , Adolescente , Adulto , Actitud Frente a la Salud , Femenino , Infecciones por VIH/etiología , Infecciones por VIH/terapia , Conocimientos, Actitudes y Práctica en Salud , Humanos , Entrevistas como Asunto , Malasia , Masculino , Prejuicio , Investigación Cualitativa , Estereotipo , Adulto Joven
15.
Health Expect ; 18(5): 1363-70, 2015 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-24010818

RESUMEN

BACKGROUND: Health-related quality of life (HRQoL) is increasingly recognized as an important outcome and as a complement to traditional biological end points of diseases such as mortality. Unless there is a complete cure available for HIV/AIDS, development and implementation of a reliable and valid cross cultural quality of life measure is necessary to assess not only the physical and medical needs of HIV/AIDS people, but their psychological, social, environmental, and spiritual areas of life. METHODS: A qualitative exploration of HIV/AIDS patients' understanding, perceptions and expectations will be carried out with the help of semi structured interview guide by in depth interviews, while quantitative assessment of patient reported adverse drug reactions and their impact on health related quality of life will be carried out by using data collection tool comprising patient demographics, SF-12, Naranjo scale, and a clinical data sheet. RESULTS/OUTCOMES: The findings may serve as baseline QOL data of people living with HIV/AIDS in Malaysia and also a source data to aid construction of management plan to improve HIV/AIDS patients' QOL. It will also provide basic information about HIV/AIDS patients' perceptions, expectations and believes towards HIV/AIDS and its treatment which may help in designing strategies to enhance patients' awareness which in turn can help in addressing issues related to compliance and adherence.


Asunto(s)
Terapia Antirretroviral Altamente Activa , Infecciones por VIH/tratamiento farmacológico , Seguridad del Paciente , Calidad de Vida , Síndrome de Inmunodeficiencia Adquirida/tratamiento farmacológico , Terapia Antirretroviral Altamente Activa/psicología , Estudios Transversales , Femenino , Infecciones por VIH/psicología , Humanos , Malasia , Masculino , Investigación Cualitativa , Proyectos de Investigación , Encuestas y Cuestionarios
17.
Cureus ; 16(4): e58653, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38770470

RESUMEN

Background Postpartum depression (PPD) is a significant public health concern globally characterized by a spectrum of mood disturbances ranging from mild mood swings to severe depressive episodes initiating within four weeks post childbirth and potentially persisting up to 12 months. Besides affecting the mother, it also affects the mental health and development of the babies born to affected mothers. Despite its considerable burden and potential adverse effects on both maternal and child well-being, PPD often goes undetected and untreated. Materials and methods A cross-sectional study was conducted from January 2024 to March 2024 at a tertiary care center in Gorakhpur to assess PPD in 280 postpartum women. The Edinburgh Postnatal Depression Scale (EPDS) score ≥ 10 was used to confirm depression. Data collection involved a pretested, structured questionnaire. Data were analyzed using SPSS version 22 (IBM Corp., Armonk, NY). A p-value < 0.05 was considered statistically significant. Results The prevalence of PPD was 12.14%. Age and education were significant sociodemographic risk factors (p < 0.05). In psychosocial factors, adverse life events (p < 0.001), wishing for a male child but giving birth to a female (p = 0.01), domestic violence (p = 0.005), relationship issues, an alcoholic spouse (p = 0.01), and poor in-law relations (p < 0.001) were found to be linked to PPD. Obstetric factors such as complicated antenatal history, physical illness, cesarean section, complicated intranatal history, and postpartum complications were also found to be important factors. Conclusion PPD affects many women, emphasizing the need for effective measures. Initiatives like the appointment of healthcare counselors and PPD screening programs in healthcare settings are essential to detect and support affected mothers.

18.
Cureus ; 16(3): e56069, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38618403

RESUMEN

Spinal anesthesia is one of the most widely used techniques in modern anesthesia practice. It involves the injection of local anesthetic drugs into the cerebrospinal fluid (CSF) within the subarachnoid space. The choice of drug, its concentration, and baricity play a crucial role in determining the characteristics of the spinal block and has evolved over the years with continuous advancements in drug formulations and administration methods. Spinal anesthesia with hypobaric drugs represents a valuable technique in the armamentarium of anesthesiologists, offering distinct advantages in terms of targeted action, reduced systemic toxicity, and enhanced hemodynamic stability. This review aims to scan the characteristics of hypobaric drugs, factors influencing their spread within the spinal canal, challenges associated with their use, clinical applications in various surgical scenarios, and potential implications for patient outcomes and healthcare practice. PubMed and Google Scholar databases were searched for relevant articles and a total of 23 relevant articles were selected for the review based on inclusion and exclusion criteria. Hypobaric drugs have many advantages in high-risk morbidly ill patients for some select surgical procedures and daycare surgeries. The concentration and volume of hypobaric drugs need to be selected according to the extensiveness of the surgery and the desired block can be achieved by giving spinal injection in specific positions. The dynamic field of anesthesiology encompasses the integration of emerging technologies and evidence-based practices, which will contribute to further refining the safety and efficacy of spinal anesthesia with hypobaric drugs.

19.
Trans R Soc Trop Med Hyg ; 118(6): 399-404, 2024 Jun 04.
Artículo en Inglés | MEDLINE | ID: mdl-38324406

RESUMEN

BACKGROUND: In a rabies-endemic country like India, every animal bite is potentially taken as rabid exposure and timely and appropriate postexposure prophylaxis (PEP) is crucial as rabies is an almost 100% fatal disease. METHODS: A retrospective record-based study was conducted at an anti-rabies clinic (ARC) in Eastern Uttar Pradesh, India. Data of the animal bite victims attending the ARC for PEP from January to December 2022 were extracted from the records. A semistructured questionnaire was used for collecting information regarding the interval between exposure and the initiation of anti-rabies PEP, age, gender, residence, the bite site on the body, category of exposure and other risk factors associated with the delay in PEP. RESULTS: Most of the victims were male (67.6%), from an urban background (61.3%) and aged up to 20 y (43.9%). Out of the 222 victims, 62 (27.9%) had delayed initiation of PEP (>48 h after exposure). Factors found to be significantly associated with delayed initiation of PEP were residence (p=0.01), age (p=0.04) and the type of biting animal (p=0.002). CONCLUSIONS: Delayed initiation of PEP is common among animal bite victims in this region of India, although PEP is affordable. Educational programmes and awareness-raising campaigns for timely administration of PEP should be a priority, especially targeting rural residents, those aged<18 y and those bitten by animals other than dogs.


Asunto(s)
Mordeduras y Picaduras , Profilaxis Posexposición , Rabia , Humanos , Rabia/prevención & control , Rabia/epidemiología , India/epidemiología , Masculino , Profilaxis Posexposición/estadística & datos numéricos , Femenino , Mordeduras y Picaduras/epidemiología , Animales , Adulto , Adolescente , Niño , Estudios Retrospectivos , Adulto Joven , Persona de Mediana Edad , Factores de Riesgo , Preescolar , Prevalencia , Vacunas Antirrábicas/administración & dosificación , Perros , Factores de Tiempo , Encuestas y Cuestionarios , Tiempo de Tratamiento/estadística & datos numéricos
20.
Cureus ; 16(3): e55753, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38586741

RESUMEN

Introduction Cerebral palsy (CP) characterizes a range of permanent, nonprogressive symptoms of postural and motor dysfunction caused by an insult to the developing central nervous system in a fetus or an infant. CP manifests early in life, often within the first two to three years of age. CP is associated with poor growth, that is the deviation from the normal growth parameters. The prevalence of CP ranges from 2.0 to 3.5 per 1000 live births in high-income countries which is comparable to the estimates from low-income countries. Antenatal and perinatal insults are among the most commonly reported causes of CP; however, a large number of cases do not have an identifiable etiology of CP. The current study aims to examine the relationship between malnutrition and gross motor function in children with CP. Materials and Methods This study was conducted at the Department of Pediatrics and Neonatology, Nehru Hospital, Baba Raghav Das (BRD) Medical College, Gorakhpur (UP) over a period of one year (August 2020 to July 2021) after obtaining ethical clearance from the College Research Council. Children of age 1-15 years with CP attending the pediatric outpatient and inpatient departments were enrolled as the study participants after obtaining informed consent from a legal guardian. Assessment of motor function was done using the gross motor function classification system (GMFCS). Associations of malnutrition across levels of gross motor function were tested using Chi-square or Fisher's exact test whichever was applicable. Statistical significance was set at p < 0.05 as significant. Data was analyzed using IBM SPSS Statistics for Windows, Version 21 (Released 2012; IBM Corp., Armonk, New York, United States). Result We analyzed 110 children with a diagnosis of CP (median age 6.5 years, interquartile range (IQR) 4.4-9.0 years). The majority (65/110; 59%) of the patients were male, and 68 (61.8%) delivered at term gestation. The most common presenting symptom among children with CP was seizures (79/110; 72.3%), the second most common being delayed milestones among 73 (66.8%), followed by difficulty in breathing among 63 (57.5%). The association between the anthropometric index of participants and GMFCS was found to be highly significant. Conclusion Most CP patients were facing gross motor disturbances. Spastic type of CP was most frequent, and more than half of the patients experienced feeding difficulty. A statistically significant association was found between gross motor functioning and the prevalence of malnutrition and stunting.

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