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Journal of Family Medicine and Primary... May 2024Postpartum hemorrhage (PPH) is defined by the World Health Organization as blood loss of ≥500 mL within 24 h of delivery. Globally, hemorrhage accounts for 27.1% of...
BACKGROUND
Postpartum hemorrhage (PPH) is defined by the World Health Organization as blood loss of ≥500 mL within 24 h of delivery. Globally, hemorrhage accounts for 27.1% of maternal deaths, making it the leading direct cause of maternal death. PPH has been identified in more than two-thirds of reported hemorrhage-related deaths, causing 38% of maternal deaths in India. Tranexamic acid, an antifibrinolytic, has been used to control bleeding after PPH is identified.
MATERIALS AND METHODS
Antenatal women admitted for elective cesarean section were randomized into two arms: the case group (received one gram of tranexamic acid 20 min prior to skin incision) and the control group (received a placebo), each group consisting of 36 participants. Clinical Trials Registry - India (CTRI) registration number - CTRI/2021/02/031579.
RESULTS
The mean (±standard deviation [SD]) intraoperative blood loss in the case group was 241.25 (±67.83) mL, and in the control group, it was 344.92 (±146.67) mL ( = 0.001), while postoperative blood loss did not differ significantly between the groups ( = 0.1470). In terms of the difference in hemoglobin, there was a significant difference between the two groups ( = 0.001). No significant maternal or neonatal side effects were found.
CONCLUSION
Preoperative tranexamic acid, when given in elective cesarean section, significantly reduces intraoperative blood loss.
PubMed: 38948612
DOI: 10.4103/jfmpc.jfmpc_1541_23 -
Journal of Family Medicine and Primary... May 2024There is a dearth of literature on the quality of life (QOL) experienced by the elderly population in the hilly terrains of the Himalayan region. The objective of this...
BACKGROUND
There is a dearth of literature on the quality of life (QOL) experienced by the elderly population in the hilly terrains of the Himalayan region. The objective of this study was to highlight the QOL among community-dwelling elderly residing in rural and urban areas of the Himalayan region, Northeast India.
MATERIALS AND METHOD
A cross-sectional study was conducted involving 450 participants (324 in rural and 126 in urban areas) aged 60 years and above. The QOL score was assessed with the help of the World Health Organisation Quality of Life-Brief Questionnaire (WHOQOL-BREF). Mann-Whitney U test was performed to find out the difference in QOL between rural and urban areas. Binary logistic regression was conducted to find the association of QOL with demographic variables.
RESULTS
The total mean QOL scores of elderlies in rural areas (39.4 ± 11.3) were significantly lower compared to urban areas (51.1 ± 11.5). QOL scores in all four domains were found to be low among elderly living in rural areas as compared to urban areas. Among the four domains, environmental QOL was found to be the lowest in both rural (29.5 ± 16.0) and urban areas (46.5 ± 17.2). Determinants of QOL differ in urban and rural areas.
CONCLUSION
QOL was found to be significantly lower among the elderly residing in rural areas as compared to urban areas. Targeted interventions and policies are necessary to address environmental challenges to improve the overall QOL of the elderly.
PubMed: 38948588
DOI: 10.4103/jfmpc.jfmpc_1426_23 -
Journal of Family Medicine and Primary... May 2024The World Health Organization (WHO) declared Coronavirus disease-19 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) a pandemic on March...
BACKGROUND
The World Health Organization (WHO) declared Coronavirus disease-19 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) a pandemic on March 11, 2020. On 16 January 2021, India began its vaccination programme using two COVID-19 vaccines (Covishield and Covaxin). Precautionary dose (booster shots) was administered to health and front-line workers in the beginning and then to all eligible populations.
MATERIAL AND METHODS
This was a descriptive observational study conducted in the COVID-19 vaccination centres of Karnal district and the ADR monitoring centre, KCGMC, Karnal. During the visits to vaccination centres, all beneficiaries of the precautionary third dose of COVID-19 vaccines as well as healthcare workers were sensitized to report in case of any adverse event following vaccination as part of the policy of the vaccination programme run by the government and Pharmacovigilance Programme of India. The data were collected in suspected adverse drug reaction (ADR) reporting form version 1.4, and causality assessment was done as per the WHO-UMC scale. The data were analysed as simple proportions and percentages.
RESULTS
The booster dose was administered to 72,853 individuals, while the 1 dose and 2 dose were given to 13,30,042 and 10,73,050, respectively. Only three ADRs were reported with the booster dose in 34 vaccination centres in the Karnal district. These three ADRs were classified as unlikely on causality assessment and hence not included in the analysis.
CONCLUSION
The booster dose administered for the prevention of COVID-19 has been found to be reasonably safe. The population who received COVID-19 booster doses was significantly less than the populations who received the first and second doses, which suggests a low acceptance rate.
PubMed: 38948581
DOI: 10.4103/jfmpc.jfmpc_973_23 -
F1000Research 2024This scoping review will identify existing literature regarding contextual factors relevant to vector-control interventions to prevent malaria. We will use the findings... (Review)
Review
OBJECTIVE
This scoping review will identify existing literature regarding contextual factors relevant to vector-control interventions to prevent malaria. We will use the findings of the scoping review to produce an interactive evidence and gap map. The map will assist in the priority setting, development, and conduct of targeted systematic reviews. These systematic reviews seek to assist the Vector Control and Insecticide Resistance Unit of the World Health Organization's Global Malaria Programme by informing recommendation development by their Guidelines Development Group.
INTRODUCTION
Malaria contributes substantially to the global burden of disease, with an estimated 247 million cases and 619,000 deaths in 2021. Vector-control is key in reducing malaria transmission. Vector-control interventions directly target the mosquito, reducing the potential for parasite infections. These interventions commonly include insecticides used in indoor residual spraying or insecticide-treated nets and larval source management. Several new vector-control interventions are under evaluation to complement these. In addition to estimating the effects of interventions on health outcomes, it is critical to understand how populations at risk of malaria consider them in terms of their feasibility, acceptability, and values.
INCLUSION CRITERIA
Eligible studies will have assessed the contextual factors of feasibility or acceptability of the interventions of interest, or the valuation of the outcomes of interests. These assessments will be from the perspective of people who receive (residents) or deliver (workers or technicians) the vector-control intervention for the purpose of preventing malaria.
METHODS
We will conduct this scoping review in accordance with the JBI methodology for scoping reviews and report in line with the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews (PRISMA-ScR). We will construct the evidence and gap map following guidance from the Campbell Collaboration.
Topics: Malaria; Humans; Mosquito Control; Animals; Insecticides; Mosquito Vectors
PubMed: 38948349
DOI: 10.12688/f1000research.144661.1 -
Heliyon Jun 2024Cattle ranching is a fundamental economic activity in northern Peru, where proper management of water resources is crucial. This study, a pioneer in the region,...
Cattle ranching is a fundamental economic activity in northern Peru, where proper management of water resources is crucial. This study, a pioneer in the region, evaluated water quality and its suitability for human consumption, vegetable irrigation, and livestock production. It is also the first study to document the presence of metals and metalloids in vulnerable areas because they are located at the headwaters of river watersheds. The spatiotemporal evaluation of physicochemical parameters, metals, and metalloids was performed in five micro-watersheds (Cabildo, Timbambo, Pomacochas, Atuen, and Ventilla) from water samples collected in the dry season (October 2017) and wet season (March 2018). The parameters were analyzed using microwave plasma atomic emission spectrometry. The results were contrasted with international and Peruvian quality standards related to dairy cow production. The highest values of pH, total dissolved solids, and electrical conductivity were reported during the dry season, and the highest turbidity during the wet season. Of the metals evaluated, arsenic (As) was omnipresent in all the micro-watersheds, followed by lead (Pb). In contrast to World Health Organization regulations, concentrations of As, cadmium (Cd), Pb, and iron represent a risk; according to Peruvian regulations, As and Pb exceed the concentrations established for use in animal drinking water and vegetable irrigation, and according to water guidelines for dairy cattle, concentrations of As, Pb, Cd, and Al exceed the permitted limits. The high concentrations of these metals in the study area are attributable to a synergy between natural factors, such as Andean geology and livestock activity. The data reported will allow for proper water resource management, pollution prevention, and the design and adoption of mitigation measures.
PubMed: 38948038
DOI: 10.1016/j.heliyon.2024.e33013 -
Cureus May 2024Health literacy is a critical determinant of a patient's overall health status, and studies have demonstrated a consistent link between poor health literacy and negative...
INTRODUCTION
Health literacy is a critical determinant of a patient's overall health status, and studies have demonstrated a consistent link between poor health literacy and negative health outcomes. The Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) advise that patient educational materials (PEMs) should be written at an eighth-grade reading level or lower, matching the average reading level of adult Americans. The purpose of this study was to investigate the ability of generative artificial intelligence (AI) to edit PEMs from orthopaedic institutions to meet the CDC and NIH guidelines.
METHODS
PEMs about lateral epicondylitis (LE) from the top 25 ranked orthopaedic institutions from the 2022 U.S. News & World Report Best Hospitals Specialty Ranking were gathered. ChatGPT Plus (version 4.0) was then instructed to rewrite PEMs on LE from these institutions to comply with CDC and NIH-recommended guidelines. Readability scores were calculated for the original and rewritten PEMs, and paired t-tests were used to determine statistical significance.
RESULTS
Analysis of the original and edited PEMs about LE revealed significant reductions in reading grade level and word count of 3.70 ± 1.84 (p<0.001) and 346.72 ± 364.63 (p<0.001), respectively.
CONCLUSION
Our study demonstrated generative AI's ability to rewrite PEM about LE at a reading comprehension level that conforms to the CDC and NIH guidelines. Hospital administrators and orthopaedic surgeons should consider the findings of this study and the potential utility of artificial intelligence when crafting PEMs of their own.
PubMed: 38947706
DOI: 10.7759/cureus.61384 -
Cureus May 2024Neonatal tetanus (NT) remains the leading cause of death in underdeveloped countries, although it is relatively rare in developed countries. Umbilical stump sepsis in...
Neonatal tetanus (NT) remains the leading cause of death in underdeveloped countries, although it is relatively rare in developed countries. Umbilical stump sepsis in newborns born to unvaccinated mothers is a major risk factor for NT. The World Health Organization describes NT as an infection that affects infants who lose the ability to suck between 3 and 28 days of age, becoming rigid and having spasms. Limited resources in underdeveloped countries have made the management of NT difficult. In this report, we describe a fatal case of NT in a newborn born to a mother who had not received any tetanus toxoid-containing vaccine. This study aims to make neonatal health professionals aware of the symptoms of NT so that they can diagnose it early and provide the appropriate care to save lives, and stress the importance of tetanus vaccination and maintaining hygienic conditions throughout pregnancy and childbirth to prevent this disease.
PubMed: 38947596
DOI: 10.7759/cureus.61410 -
Cureus May 2024Introduction The World Health Organization (WHO) Safe Surgery Checklist significantly decreases morbidity and mortality in regular operating room cases. However,...
Adaptation of the World Health Organization (WHO) Safe Surgery Checklist for Use With Cesarean Sections: Implementation and Outcomes With the Safe Cesarean Section Checklist.
Introduction The World Health Organization (WHO) Safe Surgery Checklist significantly decreases morbidity and mortality in regular operating room cases. However, significant differences in workflow and processes exist between regular operating room cases and cesarean sections performed on the labor and delivery unit. The aim of this study is to adapt the WHO Safe Surgery Checklist for the labor and delivery unit and cesarean sections to improve communication and patient safety. Methods A multidisciplinary team consisting of all major stakeholders reviewed and revised the WHO Safe Surgery Checklist making it more applicable to cesarean section operations. The new Safe Cesarean Section Checklist was tested and then integrated into the electronic medical record and utilized on the labor and delivery unit. A specific cesarean section safety attitudes questionnaire was developed, validated, and administered prior to and one year after implementation. Results Usage of the Safe Cesarean Section Checklist was greater than 95% after initial implementation. Significant improvements were reported by the staff on the cesarean section attitudes questionnaire for several key areas including the feeling that all necessary information was available at the beginning of the procedure, decreases in communication breakdowns and delays, and fewer issues related to not knowing who was in charge during the procedure. Discussion Implementation of the Safe Cesarean Section Checklist was successfully adopted by the staff, and improvements in staff perceptions of several key safety issues on our unit were demonstrated. Additional studies should be undertaken to determine if clinical outcomes from this intervention are comparable to those seen with the use of the WHO Safe Surgery Checklist.
PubMed: 38947575
DOI: 10.7759/cureus.61330 -
Frontiers in Public Health 2024The Eastern Mediterranean Regional Office (EMRO) region accounts for almost 8% of all global (TB) cases, with TB incidence rates ranging from 1 per 100,000 per year in...
Epidemiology and antimicrobial resistance of spp. in the United Arab Emirates: a retrospective analysis of 12 years of national antimicrobial resistance surveillance data.
INTRODUCTION
The Eastern Mediterranean Regional Office (EMRO) region accounts for almost 8% of all global (TB) cases, with TB incidence rates ranging from 1 per 100,000 per year in the United Arab Emirates (UAE) to 204 per 100,000 in Djibouti. The national surveillance data from the Middle East and North Africa (MENA) region on the epidemiology and antimicrobial resistance trends of TB, including MDR-TB remains scarce.
METHODS
A retrospective 12-year analysis of = 8,086 non-duplicate diagnostic complex (MTB complex) isolates from the UAE was conducted. Data were generated through routine patient care during the 2010-2021 years, collected by trained personnel and reported by participating surveillance sites to the UAE National Antimicrobial Resistance (AMR) Surveillance program. Data analysis was conducted with WHONET, a windows-based microbiology laboratory database management software developed by the World Health Organization Collaborating Center for Surveillance of Antimicrobial Resistance, Boston, United States (https://whonet.org/).
RESULTS
A total of 8,086 MTB-complex isolates were analyzed. MTB-complex was primarily isolated from respiratory samples (sputum 80.1%, broncho-alveolar lavage 4.6%, pleural fluid 4.1%). Inpatients accounted for 63.2%, including 1.3% from ICU. Nationality was known for 84.3% of patients, including 3.8% Emiratis. Of UAE non-nationals, 80.5% were from 110 countries, most of which were Asian countries. India accounted for 20.8%, Pakistan 13.6%, Philippines 12.7%, and Bangladesh 7.8%. Rifampicin-resistant MTB-complex isolates (RR-TB) were found in 2.8% of the isolates, resistance to isoniazid, streptomycin, pyrazinamide, and ethambutol, was 8.9, 6.9, 3.4 and 0.4%, respectively. A slightly increasing trend of resistance among MTB-complex was observed for rifampicin from 2.5% (2010) to 2.8% (2021).
CONCLUSION
Infections due to MTB-complex are relatively uncommon in the United Arab Emirates compared to other countries in the MENA region. Most TB patients in the UAE are of Asian origin, mainly from countries with a high prevalence of TB. Resistance to first line anti-tuberculous drugs is generally low, however increasing trends for MDR-TB mainly rifampicin linked resistance is a major concern. MDR-TB was not associated with a higher mortality, admission to ICU, or increased length of hospitalization as compared to non-MDR-TB.
Topics: United Arab Emirates; Humans; Retrospective Studies; Tuberculosis, Multidrug-Resistant; Male; Mycobacterium tuberculosis; Female; Adult; Antitubercular Agents; Middle Aged; Drug Resistance, Bacterial; Adolescent; Microbial Sensitivity Tests; Young Adult; Population Surveillance
PubMed: 38947352
DOI: 10.3389/fpubh.2024.1244353 -
Global Heart 2024[This corrects the article DOI: 10.5334/gh.1313.].
Correction: Decentralization and Integration of Advanced Cardiac Care for the World's Poorest Billion Through the PEN-Plus Strategy for Severe Chronic Non-Communicable Disease.
[This corrects the article DOI: 10.5334/gh.1313.].
PubMed: 38947254
DOI: 10.5334/gh.1338