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2023| January-March | Volume 19 | Issue 1
March 28, 2023
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Re-emergence of monkeypox: Changing epidemiology, clinical manifestations, and preventive strategies
Abhinandh Babu, Chithira V Nair, Merlin Moni, Dipu Thareparambil Sathyapalan
January-March 2023, 19(1):2-8
Monkeypox (MPX), a zoonotic disease caused by an orthopoxvirus, results in a smallpox-like disease in humans. The Democratic Republic of the Congo (DRC) reported the first human cases of MPX in 1970. Before 2000, outbreaks of MPX were regularly reported in Africa Apart from the outbreaks in Congo (2007–2011) and Nigeria (2017–2018), the current outbreak includes mostly men who identified themselves as gay, bisexual or other men who have sex with men. Along with the COVID-19 pandemic, the recent rise in the number of MPX cases reported from non-endemic nations has sounded global concerns and warnings. The current outbreak of MPX in Western countries seems to be a milder disease with reported mortality only of 0.04%. However, according to the World Health Organization, rates of MPX deaths have been between 3% and 6% in recent years, and have reached 11% in the past. This review examines the existing scientific understanding of the disease and highlights the key difference from the classic description of MPX to that of the current epidemic and to provide insight into its changing epidemiology and clinical manifestations.
Path analysis of measured variables of subjective motivational values toward child gender tool tested in women of reproductive age in a Northern State of India
January-March 2023, 19(1):19-24
Structural equation modeling was done for path analysis among domain scores of motivational values toward child gender (MVCG) questionnaire. It was used to assess consistency between observed and estimated covariance matrix as theoretically assumed. The objective of the study is to identify paths to influence the power domain among selected women of Himachal Pradesh.
Materials and Methods:
A total of 655 women were interviewed and information was collected using the MVCG questionnaire. Responses to 28 questions of eight domains were used for path analysis. The model-building process was started from an assumed theoretical construct and referred to as Model-1 and changes in the model were done gradually by addition of pathway(s) within the construct. The addition of pathways was carried out to observe a good model fit.
Fit indices from Model-1 to -4 changed across models as the user-defined
/df ratio decreased from 56.8 to 5.8 indicating acceptable fit. Change across models for normed-fit index, comparative fit index, and Tucker Lewis index showed that a large improvement from 0.74 to 0.94, 0.73 to 0.95, and from 0.56 to 0.90 indicating a good fit, respectively. Likewise, root mean square error of approximation reduced from 0.29 to 0.08 and standardized root mean square from 0.07 to 0.03 from Model-1 to -4, indicative of a close fit. In final model (Model-3), significantly, tradition, hedonism, and security had negative whereas, benevolence, conformity, and self-direction had positive influence on power.
Path analysis observed the influence of motivational values on power through self-direction, achievement, and tradition. They were observed to be the main drivers toward decision-making process toward gender of child.
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Five-year trend of blood pressure among industrial workers in Haryana, India: A record-based analysis
Mitasha Singh, Pooja Goyal, Shweta Goswami, Kriti Yadav, Mithilesh Kumar, Sneha Kumari
January-March 2023, 19(1):9-13
The burden of noncommunicable diseases (NCDs) has very swiftly seeped into all the classes of our society. It was a belief, a few decades back, that these diseases cannot affect the labor class or industrial workers. However, this has been proved wrong.
To determine the trend of blood pressure among industrial workers at the same factory recorded between 2018 and 2022.
Materials and Methods:
A record-based analysis was conducted on the available records of health screening camps conducted at a steel dockyard located in Haryana, India. The blood pressure was measured using standard technique and was used as the outcome variable. Among all the records, data of 18 workers were available for all the five visits. Their trend was presented over the 5-year period. To account for regression to mean and effect of passage of time on blood pressure measurements of the industrial workers, repeated measures linear regression analysis was conducted on 18 observations at five points of time.
The prevalence of hypertension was 24.8% in the year 2018, it increased to 25.7% in 2020 and then drastically reduced to 16.8% in 2022. Among the 18 workers who were screened on all five visits, two were known hypertensives and taking treatment. Their mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) demonstrated a rising trend from baseline mean SBP of 126.61 ± 12.50 to 132.89 ± 16.19 mmHg and DBP of 81.72 ± 6.46 to 84.39 ± 12.31 mmHg. The estimated mean blood pressure in the repeated measures model was higher than the original means (although both followed the same trend over time). Although the blood pressure values of the industrial workers depicted a rising trend, the reported prevalence of hypertension was quite low. Therefore, the huge chunk of industrial population being constantly exposed to strenuous working conditions comprise of a highly vulnerable group warranting regular NCD screening and tracking.
Public health: A public good
January-March 2023, 19(1):1-1
Development of home-based care intervention module for filarial lymphedema patients
Divya Sethi, Shyama Devi, Manish Taywade
January-March 2023, 19(1):14-18
The study aims to describe the development and validation of an intervention module based on home-based care training for patients with filarial lymphedema. Qualitative and quantitative approaches were followed for the development of the intervention module. Initial steps involved the framing of the intervention module. Direct observation, interviews with patients, suggestions from five experts in community medicine, community health nursing, and plastic surgery department were conducted. The experts and patients for the discussion were chosen with the help of convenient sampling. The experts rated the usefulness and feasibility of the components on a scale of 1–5 (5 extremely helpful). The ingredients derived for the intervention module included washing and drying of limb, prevention, care of entry lesions, light oil massage, the exercise of limb, the elevation of the stem, wearing of appropriate footwear, and management of adenolymphangitis (ADL). The intervention included individual sessions with demonstration and return demonstration. The final version of the module was pilot tested among five patients and had been found to improve the quality of life. Home-based care training with low-cost interventions can improve patients’ quality of life.
Eyes cannot see what the mind does not know!
Asmita Anilkumar Mehta, Nandita Shashindran, Akhilesh Kunoor, Lakshmi Theja
January-March 2023, 19(1):32-35
We present a previously healthy female who presented with life-threatening bilateral pneumonia causing respiratory failure associated with severe hemolysis. Because of their endemicity in India, malaria, dengue, and leptospirosis top the list of differential diagnosis in such cases. However, we found an alternate cause.
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A case of Takayasu arteritis presenting with sensorineural hearing loss as first manifestation
Priya Baluni, Damanjit Duggal
January-March 2023, 19(1):29-31
We report the case of a 26-year-old male patient diagnosed with Takayasu arteritis after 4 years of first manifestation. He developed sensorineural hearing loss in left ear, followed 2 years later by acute onset paraparesis and hypertension, and followed another 2 years later by short duration of upper backache, chest pain, palpitations, and breathlessness. On examination, he had hypertension without any significant blood pressure (BP) difference within arms with all peripheral pulses palpable. Diagnosis confirmed with computerized tomography aortography showing multifocal wall thickenings in entire aorta. In our case, the first presentation was otological followed 2 years later by hypertension. Our report points toward fact that hypertension, though the most common, may not be the first manifestation and characteristic examination finding of BP difference, and pulselessness may not be seen in all cases. High risk of suspicion and early use of specific investigation in cases of multisystem involvement in young hypertension are crucial for timely diagnosis.
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Perceptions of undergraduate students of allied health sciences program toward online assessments
Poornima Baby, Sumithra C N Unni, Natasha Radhakrishnan, Suja Gopalakrishnan, Anu Sasidharan, Suchithra Sivadas
January-March 2023, 19(1):25-28
The coronavirus disease-2019 (COVID-19) pandemic changed the pattern of learning from regular face-to-face classes to entirely digital and virtual learning. Assessments also had to be, and were, conducted online. Hence, we thought of assessing the level of satisfaction toward this mode of assessment among the allied health students in our institute.
The aim of this study was to assess the level of satisfaction and usefulness with the online practical and theory assessments among different phases of allied health sciences students belonging to different programs.
Materials and Methods:
A questionnaire was prepared after discussions among faculty members of the medical education department, appropriately validated and administered as Google Forms to the participants. Consecutive sampling technique was followed. Of the total 59 participants, 31 belonged to BSc Optometry and 28 belonged to BSc. Medical laboratory technology (MLT) courses.
The mean ± standard deviation (SD) of satisfaction of online theory/ practical assessments among the students of BSc. MLT was 5.893 ± 2.097 and BSc. Optometry was 6.194 ± 2.227. Usefulness of online theory/ practical assessments in testing knowledge and practical skills of BSc. MLT was 5.607 ± 2.061 and BSc. Optometry was 6.419 ± 2.363. Both of these were not found to be statistically significant. The median (Q1–Q3) of usefulness of online assessment in testing practical skills of students among the four phases was 5(2–6), 3(2–3), 2(2–6) and 3(3–5) and was found to be statistically significant.
Most of the students felt that online assessments were useful only for theory examinations and that this modality was unsuitable to test practical skills.
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