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1.
Sci Total Environ ; 792: 148367, 2021 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-34465041

RESUMO

Following the proven concept, capabilities, and limitations of detecting the RNA of Severe Acute Respiratory Coronavirus 2 (SARS-CoV-2) in wastewater, it is pertinent to understand the utility of wastewater surveillance data on various scale. In the present work, we put forward the first wastewater surveillance-based city zonation for effective COVID-19 pandemic preparedness. A three-month data of Surveillance of Wastewater for Early Epidemic Prediction (SWEEP) was generated for the world heritage city of Ahmedabad, Gujarat, India. In this expedition, 116 wastewater samples were analyzed to detect SARS-CoV-2 RNA, from September 3rd to November 26th, 2020. A total of 111 samples were detected with at least two out of three SARS-CoV-2 genes (N, ORF 1ab, and S). Monthly variation depicted a significant decline in all three gene copies in October compared to September 2020, followed by a sharp increment in November 2020. Correspondingly, the descending order of average effective gene concentration was: November (~10,729 copies/L) > September (~3047 copies/L) > October (~454 copies/L). Monthly variation of SARS-CoV-2 RNA in the wastewater samples may be ascribed to a decline of 20.48% in the total number of active cases in October 2020 and a rise of 1.82% in November 2020. Also, the monthly recovered new cases were found to be 16.61, 20.03, and 15.58% in September, October, and November 2020, respectively. The percentage change in the gene concentration was observed in the lead of 1-2 weeks with respect to the percentage change in the provisional figures of confirmed cases. SWEEP data-based city zonation was matched with the heat map of the overall COVID-19 infected population in Ahmedabad city, and month-wise effective gene concentration variations are shown on the map. The results expound on the potential of WBE surveillance of COVID-19 as a city zonation tool that can be meaningfully interpreted, predicted, and propagated for community preparedness through advanced identification of COVID-19 hotspots within a given city.


Assuntos
COVID-19 , Humanos , Índia/epidemiologia , Pandemias , RNA Viral , SARS-CoV-2 , Águas Residuárias
2.
J Assoc Physicians India ; 69(4): 11-12, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34470187

RESUMO

OBJECTIVE: Guidelines recommend prescription of statins in all high-risk patients with hypertension irrespective of their cholesterol levels. We performed a prescription audit in India to determine the application of recommendations. METHODS: A registry-based audit of patients with primary diagnosis of hypertension (n=3073) was performed. Details of co-morbidities and medications were obtained. Patients with known vascular disease were excluded. Patients were classified into subgroups based on risk factors and type of therapy. A multivariate model of risk was developed using clinical data and patients were classified into low, moderate and high risk. Statin prescriptions were divided into low, medium and high intensity based on US guidelines. Descriptive statistics are reported. RESULTS: Mean age of patients was 59±13 years, 47 % were women and 26 % were less than 50 years age. Diabetes was noted in 31.1 %, current smoking in 1.3 %, obesity in 14.7 % and hypothyroidism in 7.9 %. Statins were prescribed in 41.2 % (95% CI 39.4-42.9%), more in men compared to women (47.7% vs 33.7%, p<0.001). Most of the patients received moderate intensity statins (83.9%). In age-groups >40, 40-59, 60-79 and 80+ years, statins were prescribed in 18.7%, 36.5%, 49.5% and 49.4% respectively (ptrend <0.001). Statins were prescribed in 52.0% diabetics, 60.9% obese, 52.5% smokers and 34.8% hypothyroid. In the multivariate model statins use in low, medium and high risk patients was 28.4%, 46.6% and 55.1% respectively (ptrend <0.001). CONCLUSION: In an Indian secondary care practice only half of patients with moderate to high risk uncomplicated hypertension receive statins.


Assuntos
Inibidores de Hidroximetilglutaril-CoA Redutases , Hipertensão , Adulto , Idoso , Feminino , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Hipertensão/tratamento farmacológico , Hipertensão/epidemiologia , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Prescrições , Fatores de Risco
3.
J Assoc Physicians India ; 69(4): 11-12, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34470189

RESUMO

BACKGROUND: Hyperuricemia is found to be associated with the development and progression of gout, chronic kidney disease, cardiovascular diseases and several others. However, consistent recommendation in the management of hyperuricemia among physicians in India is absent. This study was done to assess the knowledge, attitude, practice (KAP) and barriers in the management of hyperuricemia among physicians in India. METHODS: A cross-sectional study using a telephonically-administered questionnaire was distributed to 350 physicians treating hyperuricemia patients with co-morbidities like hypertension, diabetes mellitus, metabolic syndrome etc. The questionnaire included 25 questions on qualitative and quantitative aspects. Descriptive statistics were used for demographic characteristics. Inferential statistics (binary logistic regression) was used to identify the relationship between knowledge scores across different physician factors. RESULTS: A total of 350 responses were obtained with a response rate of 100%. Majority of the physicians (90%) were male and 10% were female with median age of 45.5 ± 12.2 years. Mean scores for knowledge and attitude were 7.4 ± 2.35 and 12.1 ± 1.6, respectively. 66.1% (230) of physicians had adequate knowledge score, while the remaining 33.9% (118) had inadequate score. Irrespective of comorbidity status, no change in the attitude of physicians towards management of hyperuricemia was found. CONCLUSION: This study demonstrated that the majority of physicians demonstrated adequate level of knowledge, positive/favourable attitude and reported optimal treatment practices for the management of hyperuricemia while exhibiting a few perceived barriers. Nevertheless, facilitating widespread physician awareness about the benefits of optimal management of hyperuricemia is warranted.


Assuntos
Hiperuricemia , Médicos , Adulto , Estudos Transversais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Hiperuricemia/epidemiologia , Hiperuricemia/terapia , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários
4.
J Assoc Physicians India ; 69(4): 11-12, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34470190

RESUMO

AIMS: Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder characterized by impaired gut-brain interaction. Considering the paucity of evidence in the Indian setting, the current study was conducted to determine the sociodemographics, clinical profiles, management practices, and patients' perception among newly diagnosed patients with IBS. METHODS: This was a cross-sectional, single-visit, observational, non-interventional, epidemiological study conducted across 12 centres. The primary objective was evaluation of sociodemographic and clinical profiles. The key secondary objective was assessment of gastrointestinal symptom severity including evaluation of anxiety and depression using the hospital anxiety and depression scale (HADS) scores. Knowledge, attitude, and practices (KAP) were evaluated as an exploratory objective. RESULTS: Out of 300 enrolled patients, 120 (40%) were aged 31-45 years (mean age: 38.55±12.45 years), and 204 were men (68%). Overall, 40% of patients belonged to the upper-middle-class, with a Kuppuswamy score of 16-25. Most patients (91%) did not work in night shifts. Only 13% of patients performed more than recommended physical activity. Stress and food were the leading triggers for IBS (29%). Abdominal pain and diarrhoea as cardinal symptoms were reported by 43.3% and 33.0% patients, respectively. Borderline abnormal anxiety and depression were reported by 21.3% and 26.7% of patients, respectively. KAP assessment revealed that 56.0% of patients had poor knowledge, 26.3% had moderate knowledge, and 17.7% had good knowledge about IBS; nevertheless, 43% of patients maintained high levels of precaution towards managing symptoms. CONCLUSION: Given the limited knowledge about IBS in India among newly diagnosed patients, strategies to enhance awareness about the condition are warranted.


Assuntos
Síndrome do Intestino Irritável , Adulto , Ansiedade/epidemiologia , Ansiedade/etiologia , Estudos Transversais , Depressão/epidemiologia , Depressão/etiologia , Humanos , Índia/epidemiologia , Síndrome do Intestino Irritável/epidemiologia , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Índice de Gravidade de Doença , Inquéritos e Questionários
7.
J Assoc Physicians India ; 69(6): 11-12, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34472779

RESUMO

BACKGROUND AND OBJECTIVES: The frequency of outbreaks, pandemics is increasing across the globe which can be probably due to increased medical tourism, expansion of international exchange, travel and global warming. COVID-19 outbreak spread across the world within a few months of initiation from Wuhan City of China and affected all the countries across the globe except Antarctica. From the psychopathological view, this current COVID -19 is a stressor, trauma or stigma for health care workers as well as general population. Mental health and psychosocial consequences of COVID 19 has a serious impact on various categories of people : a) those directly involved with viral overload b) health care workers c) general population who are following social media d) quarantined individuals and their family members. The aim of our study was to determine the unforeseen psychosocial impact of COVID 19 pandemic on mental status of health care workers and general population. MATERIAL AND METHODS: A cross sectional online survey using an anonymous questionnaire using snowball sampling strategy was done. The study included 480 respondents, out of which 197 were health care workers and 283 were general population. The participation was totally voluntary. Data collection took place over fifteen days .We included additional questions which were related to COVID-19 outbreak. The structured questionnaire used, consisted of questions that covered several areas. Anxiety level was assessed based on Hamilton Anxiety Rating scale ranging from 0-4 , consisted of 14 items. RESULTS AND CONCLUSION: According to Hamilton anxiety rating scale it was seen that out of 197 health care workers, 27% had mild anxiety (<17), 18.7% had mild to moderate (18-24), 17.7% had moderate to severe (25-30), and 35.5% had very severe(>31). Out of 283 respondents representing general population, 26.14% had mild anxiety (<17), 17.31% had mild to moderate (18-24), 19.08% had moderate to severe (25-30), 37.45% had very severe(>31). The two groups were analyzed statistically, Z test applied between the two groups and it was found that the difference between the mean was found to be statistically significant with p value < 0.0001. The confidence interval was kept at 95%. Concerns about one's own health and that of their beloved ones (particularly elderly or suffering from any physical illness), as well as uncertainty about the future, can generate or exacerbate fear, depression, and anxiety.


Assuntos
COVID-19 , Pandemias , Idoso , Ansiedade , Estudos Transversais , Depressão , Pessoal de Saúde , Humanos , Índia/epidemiologia , SARS-CoV-2 , Inquéritos e Questionários
8.
J Assoc Physicians India ; 69(6): 11-12, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34472787

RESUMO

BACKGROUND: The present study intended to estimate the comorbidities and risk factors among patients with hypertension in India. Further, the current practice of hypertension management was evaluated and the choice of therapy was assessed based on hypertension grade, risk factors, and comorbidities. METHODS: Electronic medical record data (June 2017-June 2019) of Indian adult hypertensive patients (≥140/90 mmHg) who had two blood pressure (BP) readings were retrospectively analyzed. Demographic characteristics, BP readings, comorbidities, medications and co-medications, and laboratory data were collected at baseline. Grids based on hypertension grade (I, II, and III), demographic factors, risk factors, and comorbidities were created and prescribed antihypertensive drugs (AHDs) in each grid were evaluated. RESULTS: Among 100,075 patients, the proportion of patients in 18-40 year, 40-65 year, and >65 year age groups were 11.4%, 65.1%, and 23.4%, respectively. Proportion of men and women was similar (52.0% vs 47.9%). Proportion of patients with BMI <25 Kg/m2 was 8.1%, 25-29.9 Kg/m2 was 11.9%, and >30 Kg/m2 was 8.8%. Mean BP of patients with hypertension was: grade I (145.05/90.73 mmHg), grade II (160.07/95.64 mmHg), and grade III (180.82/102.76 mmHg). Mean low density lipoprotein (113.26 mg/dL), serum creatinine (2.28 mg/dL), mean HbA1c (8.7%) levels were highest among patients with grade III hypertension. Commonly observed comorbidities were type 2 diabetes mellitus (T2DM: 51.5%), dyslipidemia (36.4%), and chronic kidney disease (CKD: 4.4%). Top concomitant medications included anti-diabetic therapies (34.6%), drugs for dyslipidemia (30.0%), and anti-platelet therapies (6.9%). CONCLUSION: Most prescribed AHD monotherapies were angiotensin receptor II blockers (ARBs) and calcium channel blockers (CCBs) and most prescribed combination therapies were ARBs + diuretics and ARBs + CCBs. Telmisartan and amlodipine+telmisartan for patients with comorbid T2DM or dyslipidemia and metoprolol for those with coronary artery disease were the commonly prescribed AHDs.


Assuntos
Diabetes Mellitus Tipo 2 , Hipertensão , Antagonistas de Receptores de Angiotensina/farmacologia , Inibidores da Enzima Conversora de Angiotensina , Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea , Diabetes Mellitus Tipo 2/tratamento farmacológico , Feminino , Humanos , Hipertensão/tratamento farmacológico , Hipertensão/epidemiologia , Índia/epidemiologia , Masculino , Morbidade , Estudos Retrospectivos , Fatores de Risco
9.
J Assoc Physicians India ; 69(8): 11-12, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34472801

RESUMO

OBJECTIVES: The purpose of this study was to identify the relationship between socio-psychological factors and TB patients as well as to determine whether the association differs from treated and untreated persons. METHODS: This was a prospective study in a municipal corporation hospital in Pune district. A total 104 patient sample were selected from the population; criteria covered age group of 25 to 60 years along with their education and economic background. Trained study nurses then collected baseline information from consenting participants using a questionnaire. RESULTS: After being cured from the disease, patients share clothes or utensils with their family members. For a few patients psychological improvements were observed after some period of treatment whereas as in majority of patients psychological support by their family and friends was not received. This caused increase in emotional stress despite patients got cured off the TB infection. CONCLUSION: The important point noticed about the cured patients was augmented fighting spirit against this deadly disease. Recovered patients want to live more with the same joy and happiness after treatment.


Assuntos
Tuberculose , Adulto , Aconselhamento , Humanos , Índia/epidemiologia , Pessoa de Meia-Idade , Estudos Prospectivos , Tuberculose/epidemiologia
10.
J Assoc Physicians India ; 69(8): 11-12, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34472802

RESUMO

AIMS AND OBJECTIVES: To study the incidence,risk factors and in hospital mortality of Type I Cardiorenal syndrome(CRS1). To study the incidence of hyperkalemia in patients receiving Acei, ARB's or MRA Materials and Methods: Prospective observational cohort study done between June and December 2015 in Madras Medical Mission, Chennai. Consecutive patients admitted with ACS/ADHF were studied and clinical, biochemical and laboratory data was collected. The development of CRS1 was determined by KDIGO criteria. Statistical analysis was done using IBM SPSS version 21. RESULTS: Among 460 patients studied, 153 (34%) developed CRS 1 according to KDIGO criteria. The number of diabetics and patients with pre-existing CKD was significantly higher in the CRS 1 group (p=0.00). Mortality was significantly higher in the CRS 1 group (20.2% vs. 7.8% p=0.00). The presence of CKD, Diabetes mellitus, inotropic requirement and eGFR, 60 ml/min/1.73 m2 were significant predictors of CRS 1. Among patients with CRS1, 55 patients (23.5%) needed renal replacement therapy (15.6 % acute peritoneal dialysis, 20.2% SLED). There was no significant difference in the incidence of hyperkalemia in patients who were on prior Acei, ARBs and MRA. CONCLUSION: There is a high incidence of CRS 1 in our setting and the mortality is significantly higher in this group of patients. Early nephrology referral and prompt stoppage of nephrotoxic agents can significantly reduce the incidence and risk of CRS1.


Assuntos
Síndrome Cardiorrenal , Antagonistas de Receptores de Angiotensina , Inibidores da Enzima Conversora de Angiotensina , Síndrome Cardiorrenal/epidemiologia , Síndrome Cardiorrenal/terapia , Humanos , Índia/epidemiologia , Estudos Prospectivos , Fatores de Risco , Atenção Terciária à Saúde
11.
J Assoc Physicians India ; 69(8): 11-12, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34472809

RESUMO

INTRODUCTION: Candidemia is the fourth common cause of blood stream infection worldwide leading to increased mortality and morbidity. A paradigm shift of Candida albicans to Non-albicans candida (NAC) had led to the increase in resistance to empirically used antifungals. So, an epidemiological study and antifungal susceptibility is essential for meticulous use of antifungals. AIMS AND OBJECTIVES: To find out the prevalence and antifungal susceptibility of Candida species causing candidemia. METHODS: automated blood culture done in BACTEC system followed by its identification and susceptibility testing in VITEK-2 system. RESULTS: Non-albicans candida was isolated from 73% cases of candidemia. The commonest isolate among neonates and adults were C.krusei and C.tropicalis respectively. C.haemulonii was significantly high among adult population while C.krusei was significantly high among the neonates. 10.4% NAC isolates were resistant to amphotericin B, flucytosine resistance among 37% NAC isolates and among 44% C.albicans isolates, fluconazole resistance was found among 13% and 15% of NAC and C. albicans respectively. Echinocandins were comparatively sensitive to the candida spp.


Assuntos
Candida , Candidemia , Adulto , Antifúngicos/farmacologia , Antifúngicos/uso terapêutico , Candidemia/tratamento farmacológico , Candidemia/epidemiologia , Fluconazol/farmacologia , Humanos , Índia/epidemiologia , Recém-Nascido , Testes de Sensibilidade Microbiana
12.
J Assoc Physicians India ; 69(8): 11-12, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34472814

RESUMO

Around 300- 400 AD, ancient Indian physicians described a condition akin to diabetes mellitus which was called "Madhumeha". Sushrutha and Charaka, are also credited with describing two types of diabetes which would roughly correspond to type 1 diabetes and type 2 diabetes. However, little is known about the history of diabetes in India between the first and 19th century AD. A thorough search of literature revealed a large number of publications on diabetes from India in the 1800s and early 1900s, mostly from Calcutta and the Madras Presidency, suggesting that the prevalence of diabetes was high in these two places. Building on the observations made by a number of English physicians, Chunilal Bose in 1907 suggested the link between diabetes and lifestyle in India. Amazingly, India did not have to wait long after the discovery of insulin by Banting and Best at Toronto in 1921, to get its own supply. Around this time, Dr. J.P. Bose, eminent physician and diabetologist from Calcutta made remarkable contributions to the study of diabetes in India. He was also the first to describe the dramatic effects of insulin administration to children with type 1 diabetes in India. All these facts have remained largely forgotten which prompted the authors to delve deep into the history of diabetes in pre-independence India. This has led to the unearthing of several pearls of knowledge which are presented in this article as a fitting tribute to the 100th year of Insulin Discovery.


Assuntos
Diabetes Mellitus Tipo 1 , Diabetes Mellitus Tipo 2 , Médicos , Criança , Diabetes Mellitus Tipo 1/tratamento farmacológico , Diabetes Mellitus Tipo 1/epidemiologia , Diabetes Mellitus Tipo 2/tratamento farmacológico , Diabetes Mellitus Tipo 2/epidemiologia , História do Século XX , Humanos , Índia/epidemiologia , Insulina , Masculino
13.
J Glob Health ; 11: 04038, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34484706

RESUMO

Background: By 2030, Sustainable Development Goal 3.4 aims to reduce the premature mortality caused by non-communicable diseases through prevention and treatment. Chronic obstructive pulmonary disease is the second leading cause of mortality and disability-adjusted life years in India. This review was conducted to estimate the prevalence of COPD using systematic review and meta-analysis technique. Method: Search was conducted using six databases for studies on COPD among population above 30 years in India between years 2000 to 2020. Cross-sectional and cohort studies reporting prevalence of COPD and associated risk factors were included in the present review. Screening and data extraction was done by two authors independently. Studies were appraised for quality using the modified New Castle Ottawa scale and reporting quality was assessed using STROBE guidelines. Result: Our search returned 8973 records, from which 23 records fulfilled the eligibility criteria. Overall, the prevalence of COPD among population aged 30 years and above in India was 7%. Risk factors like active and passive smoking, biomass fuel exposure, environmental tobacco smoke, occupational exposure to dust, indoor and outdoor pollution, and increasing age were reported to have a significant association with COPD among Indian population. Conclusion: Our findings suggest the need for a multicentric national-level research study to understand COPD burden and its contributing risk factors. The findings also suggest the need for COPD sensitive health literacy program focused on early screening and primary prevention of risk factors for COPD, which may help early initiation of self-management practices, that are crucial for better quality of life.


Assuntos
Doença Pulmonar Obstrutiva Crônica , Qualidade de Vida , Estudos Transversais , Humanos , Índia/epidemiologia , Prevalência , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Fatores de Risco
14.
BMJ Glob Health ; 6(Suppl 5)2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34475116

RESUMO

Phone surveys are a rapid and cost-effective way to collect primary data for research, monitoring and evaluation purposes. But for these data to be precise, reliable and unbiased, women's perspectives must be accurately represented. Throughout 2020, we conducted seven household surveys in rural India to understand households' experiences of the COVID-19 pandemic and contemporaneous relief programmes. Given social distancing protocols, we conducted these surveys over the phone, using household phone numbers collected during earlier, face-to-face research. Analysing metadata from these surveys (along with women's responses to questions about phone use), we determine how gaps in phone access inhibit women's representation in phone surveys. We find that the prevalence of male management of household phones significantly reduces access to female respondents. This is a problem for two reasons. Firstly, men are usually the first to pick up the phone: in two surveys in which we tracked the gender of the person who picked up, men picked up 63.2% and 71.1% of the time, respectively. Moreover, only a small minority of those we reached by phone were able and willing to pass the phone to a household member of the opposite gender, when prompted (with no statistically significant difference between pass rates for women and men). This low immediate pass rate, in combination with low female pickup, led to fewer women respondents. As such, we recommend that researchers dedicate time and resources to taking appointments and making call-backs to reach more women. We also show that the use of female enumerators improves households' willingness to participate in women-centred surveys, and call for more investment into female enumerator teams.


Assuntos
COVID-19 , Telefone Celular , Feminino , Humanos , Índia/epidemiologia , Masculino , Pandemias , SARS-CoV-2 , Inquéritos e Questionários
15.
Medicine (Baltimore) ; 100(35): e26752, 2021 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-34477115

RESUMO

ABSTRACT: To describe the outcomes of elective cancer surgeries and adverse consequences on the patients and medical staff due to the surgical interventions in children during the Coronavirus Disease 2019 (COVID-19) pandemic.The study included children younger than 15 years who underwent elective cancer surgeries from March 4, 2020 and December 3, 2020.A total of 121 patients (62% male; median age, 3 years) underwent surgery. The surgical procedures included nephrectomies (n = 18), neuroblastoma (n = 26) and soft tissue tumor resections (n = 24) and complex surgical procedures like extended liver resections (n = 2), intra-atrial thrombectomy under cardiopulmonary bypass (n = 2), pancreatoduodenectomy (n = 1), and free microvascular flaps (n = 7). Clavien-Dindo Grade III complications were 5% (n = 6), and there were no postoperative deaths. Preoperative COVID-19 testing was performed in 82% of children, and only 2% showed severe acute respiratory syndrome coronavirus 2 positivity. Postoperatively, 26 children were tested because of specific symptoms and, 6 tested positive for severe acute respiratory syndrome coronavirus 2. Except for a median delay of 23 days in treatment, none of the patients with COVID-19 required critical hospital management. None of the surgical residents or faculty acquired COVID-19, while 4 each medical and support staff were tested positive in the study period.COVID-19 was not a deterrent for continued cancer care, and surgeries could be safely performed adopting universal preventive measures without any added morbidity from COVID-19. Caregivers and centers dealing with childhood cancers can be encouraged to sustain or seek early healthcare.


Assuntos
Procedimentos Cirúrgicos Eletivos/estatística & dados numéricos , Neoplasias/cirurgia , Adolescente , COVID-19/diagnóstico , COVID-19/epidemiologia , Criança , Pré-Escolar , Feminino , Humanos , Índia/epidemiologia , Lactente , Masculino , Pandemias , Estudos Retrospectivos , SARS-CoV-2 , Centros de Atenção Terciária/estatística & dados numéricos
16.
Niger Postgrad Med J ; 28(2): 108-111, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34494596

RESUMO

Context: Ovarian tumours are known to be diverse biologically, varying from non-malignant to malignant tumours having implication on course of the management and prognosis. To address the paucity of such study on ovarian neoplasm from our region of West Bengal, we planned and executed this study. The aim of the study was to analyse the distribution of various ovarian tumours and classify them according to the biological behaviour, age, laterality, and mode of the presentation. Setting and Design: It was a retrospective study done in a tertiary care center of Kolkata, India. Methodology: A retrospective data of 4 years comprising 84 cases were included in the study from January 2016 to December 2019. All the slides were retrieved from the archives and re-evaluated and cross-checked with patients' clinical history, demographic, and macroscopic findings. Results: Out of these 84 tumours, maximum cases were of surface epithelial neoplasms (69%) followed by germ cell tumours (26.1%). Age interval of 19-40 years accounted for the highest number of individuals with equal predominance of both sites of the ovary. Serous cyst adenocarcinoma was the most common malignant tumour. Conclusion: Histological examination remains the mainstay in the early diagnosis of ovarian tumours and facilitates timely appropriate management of patients, and hence, reduces overall mortality in women.


Assuntos
Neoplasias Ovarianas , Adulto , Feminino , Humanos , Índia/epidemiologia , Nigéria , Neoplasias Ovarianas/diagnóstico , Neoplasias Ovarianas/epidemiologia , Estudos Retrospectivos , Centros de Atenção Terciária , Adulto Jovem
17.
BMC Pediatr ; 21(1): 334, 2021 08 06.
Artigo em Inglês | MEDLINE | ID: mdl-34362329

RESUMO

BACKGROUND: Vitamin D is an essential micronutrient for the overall health and well-being of individuals. For strong musculoskeletal and neurological development of human body, vitamin D levels during childhood and adolescence have key importance. This is the first national-level study that analyzes the deficiency and concentration of serum 25-Hydroxyvitamin D [25(OH)D)] among Indian children and adolescents with respect to various demographic and socioeconomic characteristics. METHODS: Data of Comprehensive National Nutrition Survey (CNNS, 2016-18) was utilized for the present study. Vitamin D levels were assessed based on serum 25-hydroxyvitamin D concentration. Prevalence of vitamin D deficiency has been shown for the three age groups: 0-4 years (n = 12,764), 5-9 years (n = 13,482), 10-19 years (n = 13,065). Vitamin D deficiency was defined as: serum 25(OH)D < 12 ng/mL; and insufficiency as: 12 ng/ml ≤ 25(OH) < 20 ng/ml. 25(OH) D level higher than 20 ng/mL was accepted as adequate. Random slope multilevel logistic regression models were employed to assess the demographic and socioeconomic correlates of vitamin D deficiency. RESULTS: Mean serum 25(OH)D concentration level was found to be 19.51 ± 8.76, 17.73 ± 7.91, and 17.07 ± 8.16 ng/ml in age group 0-4 years, 5-9 years and 10-19 years respectively. 49.12% of the children aged 0-4 years were having insufficient level of vitamin D. Prevalence of vitamin D deficiency was comparatively higher among female adolescents (76.16%), adolescents living in rural region (67.48), Sikh individuals (0-4 years: 76.28%; 5-9 years: 90.26%; 10-19 years: 89.56%), and adolescents coming from rich households. North-Indian individuals were having substantially higher odds of vitamin D deficiency in all the three age groups. CONCLUSION: The present study demonstrated that the prevalence of vitamin D deficiency is considerably high among children and adolescents of India. The study highlights high-risk group which require prompt policy interventions.


Assuntos
Deficiência de Vitamina D , Vitamina D , Adolescente , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Índia/epidemiologia , Lactente , Recém-Nascido , Prevalência , Vitamina D/análogos & derivados , Deficiência de Vitamina D/diagnóstico , Deficiência de Vitamina D/epidemiologia
18.
J Glob Health ; 11: 04037, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34386214

RESUMO

Background: Poor nutritional status and educational outcomes are associated with adverse health consequences throughout the life course. Objectives: We examined the associations of sex, iron and folic acid (IFA) supplementation, deworming, and dietary diversity with nutritional status and learning outcomes among Indian adolescents. Methods: Data of 12 035 adolescents from two rounds (2015-16 and 2018-19) of the Understanding the Lives of Adolescents and Young Adults surveys in Uttar Pradesh and Bihar, India were used. Multivariate linear and logistic regression models were used to estimate the prospective relationships of explanatory variables in the first round of the survey with nutritional status (ie, hemoglobin, BMI- and height-for-age z-scores, and incidence of anemia, stunting, and underweight) and learning outcomes (ie, reading proficiency, math proficiency, and school dropout) in the second round of the survey. The multivariable models were adjusted for a range of confounders, clustering by the population sampling unit and sampling weights. Results: Girls had a lower hemoglobin (adjusted mean difference (aMD) = -2.07; 95% confidence interval (CI) = -2.20, -1.94; P < 0.001) and height-for-age z-score (aMD = -0.45; 95% CI = -0.53, -0.38; P < 0.001) and higher BMI-for-age z-score (aMD = 0.36; 95% CI = 0.27, 0.44; P < 0.001) compared to boys. Girls had poorer reading (adjusted odds ratio (aOR) = 0.81; 95% CI = 0.70, 0.95; P = 0.01) and math proficiency (adjusted odds ratio aOR = 0.36; 95% CI = 0.31, 0.42; P < 0.001), and increased risk of school dropout (aOR = 1.65; 95% CI = 1.40, 1.95; P < 0.001) than boys. Receiving IFA tablets was not significantly associated with hemoglobin levels of adolescents overall, however we noted a significant beneficial relationship among girls (aMD = 0.41; 95% CI = 0.00, 0.82) but not among boys (aMD = 0.02; 95% CI = -0.38, 0.43) (P for interaction = 0.09). Receiving IFA tablets was positively associated with reading proficiency (aOR = 1.47; 95% CI = 1.07, 2.01; P = 0.02), math proficiency (aOR = 1.51; 95% CI = 1.16, 1.98; P < 0.001) and a reduced risk of school dropout (aOR = 0.72; 95% CI = 0.54, 0.96; P = 0.03). Deworming was not associated with nutritional status and learning outcomes. Diverse dietary intake was positively associated with hemoglobin, height-for-age z-score and math proficiency, and a reduced risk of school dropout in adolescents. Conclusion: Integrated nutritional and health interventions and strengthening the existing nutrition supplementation program are critical to address adolescents' nutritional needs and improve educational outcomes.


Assuntos
Ferro , Estado Nutricional , Adolescente , Estudos Transversais , Suplementos Nutricionais , Feminino , Humanos , Índia/epidemiologia , Estudos Longitudinais , Masculino , Estudos Prospectivos , Adulto Jovem
19.
Pan Afr Med J ; 38: 409, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34381553

RESUMO

Introduction: the crude mortality rate due to infectious diseases in India is approximately 417 per one lakh persons and pyogenic infections are one of the significant contributor. Poor antimicrobial stewardship in India has led to an increase in multidrug resistant superbugs in both community as well as hospital settings. The aim of this study was to identify the bacterial etiology of pyogenic infections and to evaluate their antimicrobial resistance profile. Methods: this is a retrospective observational study from January, 2018 to December, 2018. A total 1851 samples, collected as a part of patient care were included in this study. Specimens were subjected to culture on Blood agar and MacConkey agar and incubated at 37°C for 48 hours. Species identification was done as per standard laboratory protocol. Antimicrobial susceptibility testing was performed using Kirby-Bauer disc diffusion according to Clinical and Laboratory Standards Institute guidelines. Results: of total 1851 samples, culture was positive in 61.54%. A total 70.59%, Gram negative organisms were isolated followed by Gram positive cocci in 45.48%, yeast in 1.05%, coryneform bacteria in 0.79% and in one case, non-tubercular mycobacteria was isolated. Staphylococcus aureus (30.9%) was the predominant organism isolated. Most common multi drug resistant isolates were Klebsiella spp. (74.79%) and Acinetobacter spp. (74.32%). Conclusion: this study gives an insight about the prevalence and common etiology of pyogenic infections along with their antimicrobial resistance profile in north western region of India. This study will contribute in formulating antibiotic stewardship program by selecting the antibiograms of pyogenic isolates.


Assuntos
Antibacterianos/farmacologia , Bactérias/isolamento & purificação , Infecções Bacterianas/epidemiologia , Adulto , Bactérias/efeitos dos fármacos , Infecções Bacterianas/tratamento farmacológico , Infecções Bacterianas/microbiologia , Testes de Sensibilidade a Antimicrobianos por Disco-Difusão , Farmacorresistência Bacteriana Múltipla , Feminino , Humanos , Índia/epidemiologia , Masculino , Prevalência , Estudos Retrospectivos , Adulto Jovem
20.
J Pak Med Assoc ; 71(8): 2093-2096, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34418039

RESUMO

Diabetes mellitus has reached pandemic proportions throughout the globe. Though hyperglycaemia is the hall mark feature of diabetes, there are several variations in its etiology, clinical presentation, and associated complications. Some of these variations have been distinctly described in specific regions and ethnicities across India and other regions in the world. In this commentary we describe these endemic syndromes associated with diabetes to improve their awareness, recognition and management. A focused attention on these relatively neglected clinical challenges would encourage future discussion and research to address these conditions.


Assuntos
Diabetes Mellitus , Hiperglicemia , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/terapia , Humanos , Índia/epidemiologia , Síndrome
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