A cross-sectional study on adherence to treatment and life-style modifications in hypertensive patients attending the urban health centre of a teaching hospital in Hyderabad.

Introduction: The burden of hypertension is expected to double by 2025 and adherence to treatment has a key role in disease outcome. The World Health Organization defines adherence as the extent to which a person's behaviour of taking medication, following a diet and/or exceeding life-style changes, corresponds with the agreed recommendations of health care providers. The study tries to assess the level of adherence to medication and life-style modifications in hypertensive patients. Materials and Methods: It is a cross-sectional study among patients attending urban health centres of a teaching hospital. The study population included all hypertensive patients above 30 years. Based on the prevalence of non-adherence to hypertensive medication, 70% of the sample size is calculated as 182. A Morisky medication adherence scale is used to find adherence to treatment. Life-style modification was also assessed. Scoring was done based on their adherence to treatment and life-style modifications and quantified. Results: The mean age of the study population was 55 years (38-80 years). In total, 58.33% were illiterate and 21% were retired from work. Around 87.5% had to spend money on medication. Mean weight, height, hip and waist circumference was 66 kg, 157 cm, 108 cm and 100 cm, respectively. Mean BMI was 26.6. Prevalence of good adherence to medication was 129 (70.83%) and that of good life-style modifications was 127 (70.17%). Conclusion: The adherence to medication and life-style modification was satisfactory. Family physicians have a key role in Non communicable diseases (NCD) management and should focus on ongoing education programmes for treatment adherence and life-style modifications at a community level, and grass-root level workers should conduct regular follow-up activities.

Hepatitis B Surface Antibody Levels among Health-Care Personnel Vaccinated against Hepatitis B in a Teaching Hospital in South India.

Background: Hepatitis B virus infection is a global health priority, and health-care personnel (HCP) have 10 times higher prevalence than the general population. Seromonitoring identifies those with low titers and vaccine nonresponders with increased risk. Objective: The objective of the study was to assess hepatitis B surface antibody (anti-HBs) titers and associated factors among HCP vaccinated against hepatitis B in a teaching hospital in Kerala. Methods: A cross-sectional study was done among 454 vaccinated HCP, and anti-HBs antibody titers were assessed by enzyme-linked immunosorbent assay method. Results: Participants included 162 (35.7%) doctors, 132 (29.3%) nursing and laboratory personnel, and 160 (35.3%) supporting staff. The mean age was 38.06 ± 11.33 years, and 72% were female. Majority (92.5%, 420) were seroprotected and 78.9% (358) with high (>100 mIU) titers. Moderate (10-100 mIU) and low (<10 mIU) level seroprotection was seen in 13.7% (62) and 7.5% (34), respectively. Incomplete vaccination, >10 years since vaccination, and age >40 years were independent predictors for poor seroprotection, while increasing doses and boosters were positively associated. Conclusions: Majority of vaccinated HCP were seroprotected. Incomplete schedules, older age, and prolonged time since vaccination can lead to decline in titers, and periodical seromonitoring should guide hepatitis B revaccination strategies.

Prevalence and associated factors of domestic violence among married women in an urban slum in South India.

Introduction: Domestic violence (DV) is a public health problem with an estimated global prevalence of 35%. The prevalence rate of spousal domestic violence in Telangana is 36.4% which is higher than the national average of 25.3%. Despite being a punishable offense, DV is still on the rise in India. Hence, there is need to assess its extent and determining factors for planning of remedial measures. Objective: To estimate the prevalence of domestic violence and its associated factors among married women of an urban slum in Telangana. Methodology: A cross-sectional study was conducted among 18- to 45-year-old married women in urban slums of Telangana. The sample size was 200. Multistage random sampling was done. Data collection was done using questionnaire with information regarding socio-demographic details, types of domestic violence, help-seeking behaviours, awareness, and outcome. The victims were directed towards medical and legal help, and further counselling. Descriptive analysis was done to find proportion of domestic violence. The associated factors were found using Chi-square test and logistic regression. Results: Domestic violence was reported by 70.5% of the study participants. Physical abuse (67%) was the main offense followed by emotional abuse (38.5%). Though 89% of women were aware of domestic violence being punishable by law, only 9.5% of women sought help. Woman's older age (COR = 2.015, 95% CI: 1.088-3.733, P = 0.026), illiteracy (COR = 2.181,95% CI: 1.097-4.3381, P = 0.026), longer married life (COR = 1.961, 95% CI: 1.008-3.815, P = 0.047), husband's early exposure to abuse (COR = 4.439, 95% CI: 1-19.705, P = 0.034) and alcohol intake (COR: 1.995, 95% CI: 1.038-3.838, P = 0.037) were found to be significant factors in the bivariate analysis. Husband's exposure to abuse in childhood (AOR = 5.326, 95% CI: 1.163-24.400, P = 0.031) and alcohol intake (AOR = 2.206, 95% CI: 1.109-4.389, P = 0.024) were found to be independent predictors. Conclusion: Domestic violence is highly prevalent in urban slums of south India. A woman's age, education, duration of marriage, husband's early exposure to abuse, and alcohol intake are determining factors. Awareness programs need to be conducted regarding helplines, medical and legal aspects. All domestic violence cases should be registered, and social, psychological and legal support be provided to the victim.

Nipah Virus Infection in Kozhikode, Kerala, South India, in 2018: Epidemiology of an Outbreak of an Emerging Disease.

BACKGROUND: An outbreak of the rare and highly pathogenic Nipah virus infection occurred in Kozhikode, Kerala, India, during May 2018. METHODOLOGY: Outbreak control activities included laboratory case confirmation and isolation. Contact surveillance was initiated and close contacts were home quarantined for the maximum incubation period of the disease. Field visits and verbal autopsy of the deaths were done to elicit the details of exposure. RESULTS: Of the 18 confirmed cases, 16 succumbed (case fatality rate, 88.8%). The mean incubation period was 9 days. The transmission was person to person wherein the primary case served as a point source for 15 other cases including 2 health-care workers. The mean age of the affected cases was 41 years with male preponderance. More than 2600 contacts were under surveillance. The outbreak was contained within 3 weeks and declared closed by July the same year. CONCLUSION: Early detection of the outbreak and prompt isolation of cases along with strengthening of infection control practices and barrier nursing helped in containing the outbreak.

Diabetes self care activities among adults 20 years and above residing in a resettlement colony in East Delhi.

BACKGROUND: Self-care activities are the cornerstone of diabetes care that ensures patients participation to achieve optimal glycemic control and to prevent complications. OBJECTIVE: The aim of this study is to find the level of self-care activities among diabetics aged ≥20 years residing in a resettlement colony in East Delhi and its association with sociodemographic factors, disease, and treatment profile. METHODS: Using cross-sectional survey, 168 known diabetic patients were selected from Nand Nagri, a resettlement colony in East Delhi. Data were collected using Hindi translation of revised version-Summary of Diabetic Self Care Activities along with a pretested semi-open-ended questionnaire. Self-care was assessed on six parameters as follows: (a) general diet, (b) specific diet, (c) exercise, (d) blood sugar testing, (e) foot-care, and (f) smoking. The study period was from November 2014 to April 2016. RESULTS: Nearly 35.1% of respondents belonged to 60-69 years age group. About 52.4% of respondents were female. Fifty-two diabetics (31%) reported having practised diet control on all 7 days in the past 1 week. Nearly 39.3% of patients did not perform any physical activity. The blood test was not practised by 92.3% of respondents. Foot-care was practised by only 19% of patients. There was a significant association between general diet among diabetics with family support (P = 0.020), place of diagnosis (P = 0.033), and treatment funds (P = 0.017). The exercise score among diabetics who were below the poverty line was higher than those above poverty line (P = 0.029). Younger age (P = 0.005) and treatment with insulin (P = 0.008) were positively associated with blood glucose testing. The foot-care practice was better in patients aware of complications and foot-care practices (P < 0.001). CONCLUSION: Self-care activities among diabetic patients were very poor. Self-management educational programs at hospitals along with information, education, and communication activities at the community level and one-to-one counseling are recommended.

Antibacterial and cytocompatible nanotextured Ti surface incorporating silver via single step hydrothermal processing.

Nanosurface modification of Titanium (Ti) implants and prosthesis is proved to enhance osseointegration at the tissue-implant interface. However, many of these products lack adequate antibacterial capability, which leads to implant loosening. As a curative strategy, in this study, nanotextured Ti substrates embedded with silver nanoparticles were developed through a single step hydrothermal processing in an alkaline medium containing silver nitrate at different concentrations (15, 30 and 75µM). Scanning electron micrographs revealed a non-periodically oriented nanoleafy structure on Ti (TNL) decorated with Ag nanoparticles (nanoAg), which was verified by XPS, XRD and EDS analysis. This TNLAg substrate proved to be mechanically stable upon nanoindentation and nanoscratch tests. Silver ions at detectable levels were released for a period of ~28days only from substrates incorporating higher nanoAg content. The samples demonstrated antibacterial activity towards both Escherichia coli and Staphylococcus aureus, with a more favorable response to the former. Simultaneously, Ti substrates incorporating nanoAg at all concentrations supported the viability, proliferation and osteogenic differentiation of mesenchymal stem cells. Overall, nanoAg incorporation into surface modified Ti via a simple one-step thermochemical method is a favorable strategy for producing implants with dual characteristics of antibacterial activity and cell compatibility.