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Journal of the American Heart... Jun 2024High energy requirements and poor feeding can lead to growth failure in patients with ventricular septal defect (VSD), but effects of preoperative malnutrition on...
BACKGROUND
High energy requirements and poor feeding can lead to growth failure in patients with ventricular septal defect (VSD), but effects of preoperative malnutrition on surgical outcomes are poorly understood, especially in low-resource settings.
METHODS AND RESULTS
We analyzed a cohort of children <5 years of age undergoing VSD closure at 60 global centers participating in the International Quality Improvement Collaborative for Congenital Heart Disease, 2015 to 2020. We calculated adjusted odds ratios (ORs) for in-hospital death and major infection and adjusted coefficients for duration of intensive care unit stay for 4 measures of malnutrition: severe wasting (weight-for-height score, <-3), moderate wasting (-3
CONCLUSIONS
Malnutrition was associated with mortality, infection, and longer intensive care unit stay in a global cohort of children undergoing VSD closure.
PubMed: 38934862
DOI: 10.1161/JAHA.123.032662 -
Journal of the American Heart... Jun 2024A limited number of studies investigated the association between blood pressure variability (BPV) and cognitive impairment in patients with hypertension. This study...
BACKGROUND
A limited number of studies investigated the association between blood pressure variability (BPV) and cognitive impairment in patients with hypertension. This study aimed to identify the longitudinal association between BPV and cognitive decline and the role of blood pressure (BP) control in this association.
METHODS AND RESULTS
Participants with hypertension from the HRS (Health and Retirement Study), the ELSA (English Longitudinal Study of Ageing), and the CHARLS (China Health and Retirement Longitudinal Study) were included. Variation independent of the mean (VIM) was adopted to measure BPV. Cognitive function was measured by standard questionnaires, and a standardized score was calculated. Linear mixed-model and restricted cubic splines were adopted to explore the association between BPV and cognitive decline. The study included 4853, 1616, and 1432 eligible patients with hypertension from the HRS, ELSA, and CHARLS, respectively. After adjusting for covariates, per-SD increment of VIM of BP was significantly associated with global cognitive function decline in scores in both systolic BP (pooled β, -0.045 [95% CI, -0.065 to -0.029]) and diastolic BP (pooled β, -0.022 [95% CI, -0.040 to -0.004]) among hypertensive patients. Similar inverse associations were observed in patients with hypertension taking antihypertensive drugs and in patients with hypertension with well-controlled BP.
CONCLUSIONS
High BPV was independently associated with a faster cognitive decline among patients with hypertension, even those with antihypertensive medications or well-controlled BP. Further studies are needed to confirm our results and determine whether reducing BPV can prevent or delay cognitive decline.
PubMed: 38934858
DOI: 10.1161/JAHA.124.035504 -
Journal of the American Heart... Jun 2024We aimed to clarify the predictive value of cerebral small-vessel disease and intracranial large artery disease (LAD) observed in magnetic resonance imaging of the brain...
Small-Vessel Disease and Intracranial Large Artery Disease in Brain MRI Predict Dementia and Acute Coronary Syndrome, Respectively: A Prospective, Observational Study in the Population at High Vascular Risk.
BACKGROUND
We aimed to clarify the predictive value of cerebral small-vessel disease and intracranial large artery disease (LAD) observed in magnetic resonance imaging of the brain and magnetic resonance angiography on future vascular events and cognitive impairment.
METHODS AND RESULTS
Data were derived from a Japanese cohort with evidence of cerebral vessel disease on magnetic resonance imaging. This study included 862 participants who underwent magnetic resonance angiography after excluding patients with a modified Rankin Scale score >1 and Mini-Mental State Examination score <24. We evaluated small-vessel disease such as white matter hyperintensities and lacunes in magnetic resonance imaging and LAD with magnetic resonance angiography. Outcomes were incident stroke, dementia, acute coronary syndrome, and all-cause death. Over a median follow-up period of 4.5 years, 54 incident stroke, 39 cases of dementia, and 27 cases of acute coronary syndrome were documented. Both small-vessel disease (white matter hyperintensities and lacunes) and LAD were associated with stroke; however, only white matter hyperintensities were related to dementia. In contrast, only LAD was associated with acute coronary syndrome. Among the 357 patients with no prior history of stroke, coronary or peripheral artery disease, or atrial fibrillation, white matter hyperintensities emerged as the sole predictor of future stroke and dementia, while LAD was the sole predictor of acute coronary syndrome.
CONCLUSIONS
Among cerebral vessels, small-vessel disease could underlie the cognitive impairment while LAD was associated with coronary artery disease as atherosclerotic vessel disease.
PubMed: 38934848
DOI: 10.1161/JAHA.123.033512 -
Indian Journal of Public Health Oct 2023Because of COVID's impact on social behavior, students have become more reliant on computer-facilitated communication to continue their studies and interact with...
INTRODUCTION
Because of COVID's impact on social behavior, students have become more reliant on computer-facilitated communication to continue their studies and interact with friends. While it is known that the association between screen exposure and psychological well-being is both harmful and stronger among adolescents than younger children, what is less studied are the causal factors that may mediate the relationship.
OBJECTIVES
The objectives of this study were to analyze the relationship between screen exposure and two psychological outcomes, sleep quality and loneliness, using digital eye strain as a mediating factor. Eye strain is expected to have a direct and harmful influence on psychological well-being.
MATERIALS AND METHODS
A structured and validated questionnaire was transcribed and administered online. A nonrepresentative sample of 497 female college students in a North Indian city participated in the study. Digital eye strain, quality of sleep, and feeling of loneliness scores were assessed using latent class analysis.
RESULTS
The selected latent model suggested that Class 2 had a high percentage of students with network issues, the problem with space and noise, and various financial hardships, which had almost doubled the rate of loneliness (53.28%) and sleep-wake difficulties (75.41%) among the students affected with computer vision syndrome (89.75%).
CONCLUSION
There is an urgent need to examine the implications of digital exposure across gender and age to prevent future complications. Further, awareness for improving holistic well-being in the digital era should be promoted through various platforms.
Topics: Humans; Female; India; Loneliness; Students; Young Adult; COVID-19; Adolescent; Prevalence; Universities; Sleep Quality; Surveys and Questionnaires; Adult; Asthenopia
PubMed: 38934830
DOI: 10.4103/ijph.ijph_1761_22 -
Indian Journal of Public Health Oct 2023To trigger quit intention and practice of preventive measures for COVID-19 among tobacco users; it is imperative for them to be well aware of the fact that they are at...
BACKGROUND
To trigger quit intention and practice of preventive measures for COVID-19 among tobacco users; it is imperative for them to be well aware of the fact that they are at higher risk of COVID-19 infection and should be at higher efficacy to practice preventive measures for the disease as compared to nonusers of tobacco.
OBJECTIVES
This community-based cross-sectional analytical study was conducted from April 2020 to May 2020 among 1203 adult participants to compare the threat and efficacy perception among users and nonusers of tobacco.
MATERIALS AND METHODS
Perception of threat was assessed using three questions on perceived threat and one question on perceived susceptibility; whereas perception of efficacy was assessed using four questions each on self-efficacy and response efficacy through telephonic interview.
RESULTS
There was no significant difference in the overall threat perception among users and nonusers of tobacco. However, state-wise analysis showed that tobacco users had higher perception of threat for SARS-CoV-2 infection in all the states except Telangana. The overall perception of efficacy among tobacco users was significantly higher as compared to nonusers of tobacco.
CONCLUSION
The study calls for active collaboration between tobacco control enthusiasts and the Government to promote awareness of a higher risk of COVID-19 disease among tobacco users. In essence, the study's implications extend beyond COVID-19 and can guide targeted efforts to promote awareness, behavior change, and collaboration in the context of other infectious diseases among tobacco users.
Topics: Humans; COVID-19; Cross-Sectional Studies; India; Male; Female; Adult; Middle Aged; Health Knowledge, Attitudes, Practice; SARS-CoV-2; Self Efficacy; Young Adult; Tobacco Use
PubMed: 38934829
DOI: 10.4103/ijph.ijph_1438_22 -
Indian Journal of Public Health Oct 2023Polycystic ovarian syndrome (PCOS) is one of the most common reproductive endocrinological disorders affecting 6%-8% of women in reproductive years. An early liberal...
BACKGROUND
Polycystic ovarian syndrome (PCOS) is one of the most common reproductive endocrinological disorders affecting 6%-8% of women in reproductive years. An early liberal PCOS screening appears to be a cost-effective strategy, benefiting earlier diagnosis and intervention.
OBJECTIVES
The objectives are to measure the prevalence of PCOS and factors associated with PCOS among young girl students of a University in Central Gujarat.
MATERIALS AND METHODS
All consenting girl medical students enrolled in MBBS curriculum during 2013-2017 were given a self-administered questionnaire (for signs and symptoms of PCOS), taking due prior permissions; during January 2018-June 2019. Using Rotterdam (2006) criteria, those who were screened for PCOS were subjected to abdominal ultrasonography (USG) and if required, laboratory investigations (random blood sugar, thyroid-stimulating hormone, and free testosterone). The proportion of young women having PCOS as per the Rotterdam and European Society for Human Reproduction and Embryology (EHSRE) Criteria are reported.
RESULTS
The study enrolled 308 girl medical students. More than one-tenth of the study participants (11.7%, 36/308) had confirmed PCOS (Rotterdam Criteria). As per the EHSRE criteria, 24/36 had classic PCOS, 11/36 had ovulatory phenotype, and 01/36 had the non-hyperandrogenic phenotype PCOS. USG was required in 123/308 (39%); of which 91 consented and 16/91 (18%) had conclusive PCOS. Twenty-three girls required laboratory investigations, of which two had abnormal values suggestive of PCOS. Irregular menses and hirsutism were significantly associated with the PCOS (P < 0.05).
CONCLUSION
The proportion of young medical students with PCOS was 12%. Irregular menses and hirsutism were significantly associated with PCOS.
Topics: Humans; Polycystic Ovary Syndrome; Female; Cross-Sectional Studies; India; Adolescent; Prevalence; Universities; Young Adult; Students, Medical; Hirsutism
PubMed: 38934823
DOI: 10.4103/ijph.ijph_1508_22 -
Indian Journal of Public Health Oct 2023Comprehensive primary health care (CPHC) is an effective way to respond to the challenges of changing epidemiology, growing population expectations, and universal health...
BACKGROUND
Comprehensive primary health care (CPHC) is an effective way to respond to the challenges of changing epidemiology, growing population expectations, and universal health coverage. A set of demand and supply improvement strategies was developed to support primary health center provision and pilot tested in three model health and wellness centers (HWCs) in Punjab.
OBJECTIVE
The study aimed to assess the early effects of interventions on the inputs, processes, and outputs for optimal implementation of the AyushmanBharat-HWC (AB-HWC) program.
MATERIALS AND METHODS
Cross-sectional facility assessments were conducted using a standardized methodology at three time points to identify the changes in inputs and processes at subcenter-HWCs from 2019 to 2021. In addition, daily and month-wise service utilization data of model HWCs and nonmodel HWCs in the intervention block and control block in a district of Punjab from the AB-HWC portal were analyzed from May 2020 to April 2021.
RESULTS
The difference-in-difference analysis indicated that the CPHC strengthening interventions in the model HWCs improved the mean number of people screened for noncommunicable diseases, mean newly diagnosed patients with hypertension and diabetes, mean hypertensive and diabetic patients on treatment, mean outpatient attendance, and mean number of wellness sessions by 265.71, 21.31, 29.48, 102.17, and 4.88 units per month, compared to control HWCs.
CONCLUSION
The success of the initiatives can be attributed to an integrated approach encompassing multistakeholder planning of interventions, community involvement, empowerment of service providers, and consistent supportive supervision. The long-term success will be contingent on the quality of training, team dynamics, community participation, social accountability, and supervision support.
Topics: Humans; Primary Health Care; Cross-Sectional Studies; India; Comprehensive Health Care; Noncommunicable Diseases; Health Services Needs and Demand
PubMed: 38934822
DOI: 10.4103/ijph.ijph_885_22 -
Indian Journal of Public Health Oct 2023Pattern of physical growth and pubertal changes among 59 girls, aged 8-15 years, diagnosed as cases of HIV on anti-retroviral therapy was cross-sectionally studied....
Pattern of physical growth and pubertal changes among 59 girls, aged 8-15 years, diagnosed as cases of HIV on anti-retroviral therapy was cross-sectionally studied. Besides, measurement of body weight, height, and body mass index, breast development stage, presence or absence of pubic and axillary hair, and age of attainment of menarche were also noted in these subjects in the growth clinic of the department. With the advancement of age, the weight and height of HIV girls increased; however, they were lighter and shorter compared to their normal peers. 15.3% of HIV girls were short-statured and underweight. None of the study participants were found to be overweight or obese. 40.7% of HIV girls had attained menarche (mean age: 12.58 ± 1.349 years). The appearance of pubic (13.45 ± 1.64 years) and axillary hair (13.73 ± 1.41 years) occurred around 1 year later. The delayed physical growth and puberty attainment of HIV girls than their normal counterparts may be due to the influence of the disease.
Topics: Humans; Female; Adolescent; Child; HIV Infections; Cross-Sectional Studies; Puberty; Body Mass Index; Menarche; Body Height; India; Body Weight; Child Development
PubMed: 38934819
DOI: 10.4103/ijph.ijph_1651_22 -
Indian Journal of Public Health Oct 2023Depression is a common illness, it being the fourth-leading cause of disability in the world. The global lifetime prevalence falls between 8% and 12%, with female...
Depression is a common illness, it being the fourth-leading cause of disability in the world. The global lifetime prevalence falls between 8% and 12%, with female preponderance. A cross-sectional study was designed to assess the burden of depression among married women in a rural setting in North Kerala and identify its sociodemographic risk factors. The sample size was calculated to be 453 (prevalence = 24.9%; error = 20%; design-effect = 1.5). Systematic random sampling was used to select the participants from the eligible couple register. They were interviewed using MINI and Montgomery-Ashberg Depression Rating Scales. Descriptive analysis showed that 24.2% was suffering from current depression, mostly mild and none severe. Two percent reported past depression and 5.4% experienced spousal violence. Poor family support, experience of domestic violence, morbidity, and older spouses were found to be significant risk factors. The provision of mental health services by trained personnel and strict vigilance against the marriage of girls below the legal age and domestic violence are need of the hour.
Topics: Humans; Female; Cross-Sectional Studies; India; Prevalence; Adult; Rural Population; Depression; Risk Factors; Middle Aged; Socioeconomic Factors; Young Adult; Marriage; Spouses; Sociodemographic Factors; Domestic Violence
PubMed: 38934818
DOI: 10.4103/ijph.ijph_1543_22 -
Indian Journal of Public Health Oct 2023Good glycemic control is the aim of managing type 2 diabetes mellitus (T2DM) which is crucial for the prevention of long-term complications in individuals with T2DM. The...
Good glycemic control is the aim of managing type 2 diabetes mellitus (T2DM) which is crucial for the prevention of long-term complications in individuals with T2DM. The aim of this study was to identify the factors associated with good glycemic control in individuals with T2DM following up at a rural health-care facility (HCF) in Goa. A cross-sectional study was conducted among 120 individuals with T2DM who regularly followed up at a rural HCF in Goa. Participants were selected using simple random sampling. It was found that the participants belonging to the 60-89 years of age group and those on mono/dual oral therapy were more likely to have good glycemic control. Participants' glycated hemoglobin A1c decreased by 0.083% for every year of increase in age and increased by 0.044% for every centimeter increase in abdominal girth.
Topics: Humans; Diabetes Mellitus, Type 2; Cross-Sectional Studies; Middle Aged; Male; Female; Aged; Glycated Hemoglobin; Aged, 80 and over; Glycemic Control; India; Age Factors; Rural Health Services; Adult; Hypoglycemic Agents; Rural Population
PubMed: 38934817
DOI: 10.4103/ijph.ijph_1654_22