National Journal of Community Medicine

Survival Analysis of Low-Birth-Weight Neonates in NICU At Dr. Wahidin Sudirohusodo Hospital Makassar, Indonesia

Fajriana Razak — 2024-05-01

Background: Currently, children face the highest risk of death during the neonatal phase. UNICEF data shows that in 2022, globally, approximately 2.3 million children died in the first month of life, accounting for about 6,400 neonatal deaths per day. The aim is determining the survival proportion of neonates, hazard ratios, and maternal factors influencing the survival of low-birth-weight neonates.

Methodology: A retrospective cohort study design using secondary data from 183 medical records of low-birth-weight neonates from 2020 to 2022. Kaplan-Meier analysis and life table were used to observe the time frame and survival proportion, as well as differences among independent variable groups. Cox regression analysis was conducted to estimate hazard ratios and the influence of independent variables.

Results: Gestational age (p=0.028, HR=2.7948, CI 95% = 1.1197-6.9757), ANC visits (p=0.000, HR=2.7057, CI 95% = 1.6320-4.4857), and maternal employment status (p=0.023, HR=2.6546, CI 95% = 1.1430-6.1651) are statistically significant variables that influence the survival of low-birth-weight neonates.

Conclusions: The survival proportion of low-birth-weight neonates is 60.80%. Gestational age, ANC visits, and maternal employment status significantly contribute to the survival of low-birth-weight neonates.

Employ the 5H Model, Evaluate its Efficacy, And Illustrate the Change in Elderly Depression Levels and Symptoms

Son Quang Le — 2024-05-01

Introduction: Age-related disorders include mental health. This reduction in intergenerational cohesion and filial responsibilities has caused older people's dissatisfaction, sadness, and grief. Depression and dementia impair elderly people worldwide by taking away their independence and autonomy.

Methodology: The authors use the experimental approach to implement the 5H model, evaluate its efficacy, and show the change in depression levels and symptoms in Quang Ngai's elderly. The author chose 26 senior persons from Truong Quang Trong Ward and 23 from Tinh Thien Village to engage in the intervention study. The semi-experimental study compared N=60 samples (Experimental Group=30 and Control Group=30). The elderly control group receives conventional therapy according to the local program, whereas the experimental group receives community intervention. The GDS-15 and ICD-10 examined the intervention's efficacy.

Results: This study found that I mild depression had a significant change post-intervention; (ii) the mean score of depression through 2 assessments (GDS-15 scale and ICD-10 clinical assessment) both showed a significant reduction; (iii) females tended to change more than males; (iv) elderly aged 60-70 were easier to change than those over 80 years old; and (v) community-based psychosocial therapy had a significant impact on depression.

Conclusion: Considering the aforementioned favourable results, the Quang Ngai city depression prevention intervention program for the elderly is practical and can reduce symptoms, severity, and reverse depression. Hence, the model is applicable across Quang Ngai City.

The Age- And Sex- Specific Burden of Transport Injuries in India Over a Decade From 2010-2019: A Systematic Analysis from Global Burden of Diseases 2019

Mohd Shanawaz — 2024-05-01

Background: In India, transport injuries persist as leading preventable causes of mortality and morbidity for a large number of people, including children, young adults and elderly people. The objective is to estimate the transport injury-related mortality and morbidity in India over the past decade from 2010-2019.

Methodology: By using the Global Burden of Diseases, Injuries, and Risk Factors 2019 Study (GBD), we analysed mortality, Disability-Adjusted Life-Years (DALYs), Years Lived in Disability (YLDs), Years of Life Lost (YLL), prevalence rate (per 100K) attributed to transport injuries for all ages, in India. Burden is reported in absolute numbers and percentage changes over a decade period from 2010 to 2019; stratified by sex ratio, and age groups, with 95% confidence intervals (CIs).

Results: Transport injuries had accounted for 235,444 deaths (2.51%) in 2019; and 231,177 deaths (2.68%) in 2010. Transport injuries are the leading cause of death among people aged 15-49 years with more than 50% of burden in India. Death-rate due to transport had declined from 18.77 to 16.93 per 100,000 populations over a decade (2010-2019).

Conclusions: Over a decade, progress made in the burden of transport injuries was limited and the burden had started to rise after achieving some success till 2016. India needs to sustain and improve the progress made in order to achieve UN goals for 2030.

Assessment of Morbidity Patterns and Occupational Hazards Among Food Handlers in Food Establishments in Tamilnadu, India

Priyadharshini P — 2024-05-01

Background: Rapid urbanization has increased the intake of external (outside) foods, causing a surge in food-borne diseases. In the South-East Asian region of the World Health Organization, 150 million people fall ill with foodborne diseases every year, of which, 1.75 lakhs perish. Occupational hazards are of public health importance as they cause permanent disability, loss of livelihood, and morbidity.

Methodology: This cross-sectional study was conducted among 235 food handlers working in food establishments of a private educational institution in Tamil Nadu using a semi-structured pre-tested questionnaire. Descriptive statistics, odds ratio and one-way ANOVA were used. Occupational risk score was calculated. Data were analyzed using SPSS 22.0.

Results: The mean age of the food handlers was 30.7 (SD=10.3). Of the 235 participants, the majority were Males (86%). The commonest acute morbidity was Acid peptic disease (48.5%). Hypertension was reported in 26% of subjects. The most common occupational hazard was prickly heat (74.9% of the subjects). Work-related stress was reported by 72% of the food handlers. Physical hazards were high with a Mean value of 11.67 (SD=5.9)

Conclusion: Half the subjects reported Acid Peptic Disease as the most common morbidity. Burns at work and psycho-social issues were found at higher rates. Periodic deworming, vaccination against enteric organisms, routine examinations and ergonomically designed workplaces can prevent outbreaks and preserve workers’ health.

Caffeine Consumption, Sleep Quality and Mental Health Outcomes Among Malaysian University Students

Norhaslina Sulaiman — 2024-05-01

Background: Recognizing the scarcity of data on caffeine consumption among university students in Malaysia, this study was designed to first characterize the habitual caffeine intake within this group. This study further investigated the potential association between these caffeine consumption patterns and sleep quality and mental health status.

Methodology: The study employed an online self-administered questionnaire to assess habitual caffeine intake from various products. Sleep quality and mental health were evaluated using the Pittsburgh Sleep Quality Index (PSQI) and the Depression, Anxiety, and Stress Scale-21 (DASS-21), respectively.

Results: 78% of the respondents consumed caffeinated products daily within the safe level recommended by the European Food Safety Authority (£400mg/day). Only 2.6% of the students consumed caffeine exceeding the recommended limit. The median total daily caffeine intake was 100mg/day. Most students had poor sleep quality (77.3%), with 43.5%, 49.5%, and 33.0% reporting varying levels of depression, anxiety, and stress, respectively. Odds ratio calculations revealed respondents consuming less than or more than 400 mg/day of caffeine did not show significantly different odds of poor sleep quality, depression, anxiety, or stress compared to non-consumers.

Conclusions: This study highlights the need for further localized research on caffeine's effects among Malaysian university students regarding caffeine consumption, sleep, and mental health.

Effectiveness of Nutrition Education as Intervention on Complementary Feeding Practices & Growth of Children in Rural Area

Vidya Mallesh — 2024-05-01

Background: The first 2years of a child's, feeding-pattern is an important determinant of childhood-malnutrition. Nutritional education on complementary feeding was provided, and the impact on Minimum-Meal-Diversity [MMD], Minimum-Meal-Frequency [MMF] & the children's growth, was evaluated & compared between the education-intervention group and the control group.

Methodology: The study was conducted in 2villages of Vijayapura-district 5Anganwadi from each village was selected for study and compared. Primary-outcome: improvement in MMD, MMF Secondary-outcome: weight for age Z-score [WAZ], weight for age Z-score [HAZ] &mid-arm-circumference.

Results: Overall education-intervention-group showed better weight-gain than control-arm significant-difference was observed in WAZi.e1.36 v/s1 (p<0.0017*) & HAZ-3.82 v/s -4 (p<0.00078*) respectively. In Intervention-arm mothers following MMF significantly increased &was statistically significant. There was a significant rise in the percentage of mothers in the intervention group who adopted MMD for their children. (p<0.0001*). Gender differences in mean WAZ scores &HAZ were observed in both groups persistently throughout the study period & were statistically significant.

Conclusion: Program interventions need to understand the local practices &needs of mothers & tailor interventions and nutritional education to improve child feeding practices including hygienic practices with regular follow-ups, is vital to prevent the vicious cycle of malnutrition.

Assessment of Intestinal Parasitic Infection and Personal Hygiene Practice Among School Children in A Primary School in A Village in Jakarta, Indonesia

Ika Puspa Sari — 2024-05-01

Background: Intestinal parasitic infections (IPI) are still among developing countries' most prevalent parasitic infections. IPI is closely linked to nutrition, personal hygiene, environmental sanitation, income, climate, and education. Aims/Objectives: To assess the IPI and personal hygiene status among school children in the flood-prone area in Jakarta, Indonesia.

Methodology: A cross-sectional study was conducted in a government primary school in South Jakarta, Indonesia, involving 157 students. A structured questionnaire was developed to assess the personal hygiene behavior of the students. A physical examination of the nail fingers was conducted as well. Feces samples were collected from each student and examined using direct smear techniques to identify intestinal parasite infection.

Results: The prevalence of IPI was 38.2% in single and mixed infections. Intestinal parasites recorded in this study were Blastocystis hominis, Giardia lamblia, Trichuris trichiura, hookworm eggs, and non-pathogen protozoa Entamoeba coli. There is no significant difference between the prevalence of IPI with footwear usage, nail-cutting once a week (p=0.718), handwashing before the meal (p=0.688), handwashing after defecations (p=0.618); however, there is a significant difference between nail cleanliness and IPI (p=0.003).

Conclusions: The prevalence of IPI in these school children was high and required interventions like health education and action on nail and hand hygiene behavior from school personnel or teachers.

Population Based Electronic Surveillance Tool to Identify Risk Factors for Developing Cervical Cancer- A Study Protocol

CNV SAI Bharath — 2024-05-01

Background: Cervical cancer remains a significant global health concern, with well-established risk factors. Population-based electronic surveillance tools offer a promising avenue for identifying risk factors associated with cervical cancer development way before it becomes an actual concern for a woman. The objective of this study is to understand and to support the app- based decision-making tool for identifying risk factors of cervical cancer for the women between 30-60 years of age.

Method: The study will be conducted in the selected Sampoorna Non-Communicable Diseases (NCD) clinics at Lucknow, Uttar Pradesh (UP). A rigorous review of database was conducted to summarize the evidence on informatics available for early identification of cervical cancer app. An app-based decision- making tool will be developed to identify and detect the high- risk population developing cervical cancer. The app then will be shared with health workers at Sampoorna clinics and will be capacitated for using it to collect real time data.

Conclusion: The utilization of a population-based electronic surveillance tool will facilitate the identification of various risk factors contributing to cervical cancer development. The methodology process will help to comprehend the analysis providing the insights. This approach has the potential to enhance targeted interventions, public health policies, and personalized screening programs to mitigate the burden of cervical cancer. The objective of this paper is to understand and to support the design of dashboards for creating transparency and accountability.

A Review of Clinical Practice Guidelines for Physiotherapy Management of Patients with Non-Specific Low Back Pain

Harikrishnan Ranganathan — 2024-05-01

Background: Despite the availability of various clinical practice guidelines (CPGs) offering evidence-based recommendations, there exists a global diversity in physiotherapy practices for managing patients with non-specific low back pain (NSLBP). In this review, we aim to critically appraise and map the current evidence regarding physiotherapy management for patients with NSLBP.

Methods: A search strategy was formulated and searched in MEDLINE, Scopus, EBSCOhost, PEDro and Google Scholar between 2013 and 2023 in English. Critical appraisal was performed using International Centre for Allied Health Evidence (iCAHE) guideline checklist.

Results: A total of 12 CPGs met the selection criteria were synthesised. Exercise therapy, physical activity and manual therapy were consistently recommended for patients with NSLBP across most guidelines, irrespective of symptom duration. Cognitive-behavioural therapy was frequently advised for those with chronic NSLBP. However, notable absences of recommendations for electrotherapy, mechanical traction, bed rest, and lumbar corsets in NSLBP management. Moreover, emerging treatments such as shock wave therapy and cognitive-functional therapy were not extensively addressed in the guidelines.

Conclusion: Multimodal and active forms of physiotherapy management were predominantly recommended in most of the guidelines. However, there is a clear necessity for updated CPG that effectively integrate biopsychosocial approaches into the management of patients with NSLBP.

Unveiling Mental Health Perspectives: Nursing Students' Attitudes Towards Spirituality

Jigyasha Sharma — 2024-05-01

Background: The correlation between spirituality and mental health has transmute a subject of growing significance and importance, particularly within the realms of educational institutions and healthcare facilities. Student nurses encounter difficulties in providing spiritual care to patients and consider it beyond their area of expertise on account of inadequate nursing education and training. The primary objective of this quantitative survey was to ascertain the perceptions and attitudes of nursing students towards spirituality, as well as their perspectives on its integration within their professional practice.

Methodology: Eighty subjects were randomly included in the study. The subjects were between 17 to 24 years and belonged to all the four religions. They filled the Likert scale having items pertaining to their attitude towards spirituality. The data analysis was conducted using IBM SPSS version 20.

Result: The mean attitude score was 3.71 ± 0.45. Most (69.3%) of the students responded “agree and strongly agree” to the items in the scale reflecting their favorable attitude towards spirituality. The religion significantly affected their attitude (p<0.05). A correlation was also observed between students' religious beliefs and their spiritual orientation.

Conclusion: The present study conclude that the students possess a favorable attitude towards spirituality.

A Study on The Assessment of Cognitive Impairment Among Elderly Patients Visiting Rural Health and Training Centre

Kashif AR Mohammed — 2024-05-01

Background: According to the United Nations, about one in five Indians will be 60 years or older by year 2050. Following this demographic shift, an increase in the proportion of cognitive disorders is expected. This study aims to identify those who have cognitive impairment among the rural elderly and study the factors associated.

Methodology: The cross-sectional study was done on patients attending rural health and training centre of a tertiary care medical college and hospital in Chennai. One hundred seventy-eight participants above 60 years of age were screened with the Mini-Cog^TM tool. Those who scored less than 4 on the Mini-Cog scale were referred for cognitive evaluation by a clinical psychologist.

Results: The overall prevalence of individuals positive for cognitive impairment was 41.6%. On bivariate analysis, individuals older than 65 years of age, those who were leading a retired life, not living with spouse, current alcoholics and smokers were associated with impaired cognition. Multivariate logistic regression analysis revealed participants who were retired and not living with spouse were independently associated with cognitive impairment.

Conclusion: A high proportion of participants screened positive for cognitive impairment. Integrating cognitive health with primary care can help in giving attention and support for the ageing population.

Universal Health Insurance for Lower Income and Lower Middle-Income Countries: A Lesson from India

Prakash Patel — 2024-05-01