Asian Pacific Journal of Health Sciences

A study of Extended Spectrum ß-Lactamases in Gram-negative Bacterial Isolates in a Tertiary Care Hospital in Mumbai

Anuradha Sharma — 2023-03-13

Background: Injudicious use of antimicrobials for any infection causes microbes to undergo changes through selective pressure and ultimately leads to the development of antimicrobial resistance. The production of ß-Lactamase is one of the most important mechanisms adopted by bacteria to evade action by penicillins and cephalosporins. Materials and Methods: This prospective in vitro study was conducted in a tertiary care hospital in Mumbai over a 6-month period with the aim of identifying extended spectrum b-lactamases (ESBLs) in Gram-negative bacteria in clinical isolates, by double disk diffusion test and E test. Results: Five thousand five hundred and forty-eight g-negative bacilli were isolated of which 2354 (42.42%) were ESBL producers. Maximum numbers of ESBL production were seen in isolates from the blood sample (53.91%) followed by pus (47%) and urine samples (42.27%). Conclusion: ESBL-producing organisms are increasing in the community; therefore, restricted and judicious use of the third generation cephalosporins is to be followed to prevent and control such types of resistance.

An Ethereal Study of Drakshavaleha and Punarnavadi Mandura in Managing Pandu Roga with Special Reference to Iron Deficiency Anemia

Pashmina Joshi — 2023-03-13

Introduction: Anemia is a public health problem affecting both developing and developed countries with major consequences for human health as well as social and economic development. We can find the references for numerous medications indicated for the treatment of Pandu in various treatises of Ayurveda. The formulations Punarnavadi Mandura and Drakshavaleha when administered in combination are supposed to act as iron and nutrition supplement, which will improve the overall health of the patients especially females of reproductive age group. Aim: The aim of the study was to evaluate the probable mode of action of Drakshavaleha and P. Mandura in Pandu Roga w.s.r to iron deficiency anemia. Materials and Methods: The information in this article is centered on various articles published in indexed and non-indexed journals of Ayurveda and Contemporary medical sciences, Ayurveda Samhitas, and their respective commentaries and textbooks of concerned subjects of both Ayurveda and Modern Medicine. Results: The ingredients of Drakshavaleha and P. Mandura mainly possess activities such as immunomodulatory, anti-oxidant, and bio-availability enhancers which can act collectively against the symptomatology of P. roga. Ingredients such as ManduraBhasma, Gomutra, Punarnava, Haridra, and Guda are proven to enhance the process of erythropoiesis. Conclusion: Based on the review, it can be considered that P. Mandura, a poly herb-mineral formulation and Drakshavaleha, a Naimittika Rasayana which can act as nutritional supplement, can counteract most of the pathological manifestations related to Pandu.

Zinc-Oxide Eugenol Paste, Antimicrobial Gel, and Ayurvedic Medicament in the Management of Alveolar Osteitis: A Prospective and Comparative Study

Ifra Iftikhar — 2023-03-13

Objectives: The objective of this study was to compare the three treatment strategies of zinc oxide eugenol (ZOE), metronidazole gel, and Aloe vera gel in the management of dry socket with respect to pain relief and mucosal healing. Methods: This was a comparative study in which 90 patients were recruited and randomly divided into three groups of 30. ZOE dressings were applied in Group A, Metronidazole gel in Group B, and Aloe vera gel was applied in Group C patients on the day of reporting. Patients were followed up for seven consecutive days. Day-wise pain and mucosal healing were assessed in each patient using the visual analog scale and mucosal healing index, respectively. Results: The mean age for the 90 patients recruited in the study was 44.02 (9.9). Male: Female ratio was 37:53. Higher values of pain were reported in Group A from day 1 to 6 (P < 0.01). However, the difference was not significant among the three groups (P > 0.05) on the 7th day. Significant differences were seen among groups (P < 0.01) for mucosal healing on days 2–6 with higher mean values in Group A. On day 1 and day 7, a non-significant difference was seen for the values across all three groups (P > 0.05). Conclusion: Metronidazole and Aloe vera gels were found effective in early pain relief while producing a similar amount of mucosal healing. These gels offer the potential to be used as alternative home remedies, thus reducing the number of dental appointments required in the case of ZOE dressings. However, further randomized and clinical studies are required to evaluate the three strategies for their potential adverse effects.

A Case of Full Mouth Rehabilitation of a 5-year-old Child with Severe Early Childhood Caries

Pradnya D Pathak — 2023-03-13

An important health problem worldwide that adversely impacts infants and children’s oral health is early childhood caries. Early loss of primary teeth due to trauma or caries can result in decreased masticatory function, reduced esthetics, incorrect pronunciation of sounds, and the development of aberrant oral habits. Every child has a fundamental right to live happily and healthily; therefore, it should be addressed and managed to prevent further complications. This case report gives insight into the dental rehabilitation of the patient with mutilated primary dentition.

Right-Sided Pleural Effusion Secondary to Acute Pancreatitis: A Rare Entity

Omarbi Lalsiddiqui — 2023-03-13

Pleural effusion as a consequence of acute pancreatitis is transient, usually left-sided, and straw colored and accounts for 1% of all cases.[1] Rarely, it can be right-sided, causing difficulty in establishing the diagnosis, especially if new symptoms are disproportionate to the pre-existing symptoms. We present a case of a young chronic alcoholic male patient with gross right-sided pleural effusion and moderate ascites.

Is There a Link between the 2021 COVID-19 Vaccination Uptake in Europe and 2022 Excess All-Cause Mortality?

Jarle Aarstad — 2023-03-13

Purpose: We primarily study a possible link between 2021 COVID-19 vaccination uptake in Europe and monthly 2022 excess all-cause mortality, that is, mortality higher than before the pandemic. Methods and Results: Analyses of 31 countries weighted by population size show that all-cause mortality during the first 9 months of 2022 increased more the higher the 2021 vaccination uptake; a one percentage point increase in 2021 vaccination uptake was associated with a monthly mortality increase in 2022 by 0.105% (95% CI, 0.075–0.134). When controlling for alternative explanations, the association remained robust, and we discuss the result emphasizing causality as well as potential ecological fallacy. Furthermore, the study shows that 2021 all-cause mortality was lower the higher the vaccination uptake, but this association became non-significant when controlling for alternative explanations. Conclusion: Despite a possible preventive effect in 2021, we cannot rule out that COVID-19 vaccination uptake in Europe has led to increasing 2022 all-cause mortality between January and September.

Determinants of Tobacco Use among Immigrant Workers Around a University in South India – A Qualitative Approach

Roy Arora Swati — 2023-03-13

Background: According to the global adult tobacco survey – prevalence of smokeless tobacco (SLT) use in India is highest in the world and 60% of tobacco users in India currently use SLT products. The prevalence of SLT use among women in Karnataka is 14.7%, among immigrant women daily wage workers is 87.2%. There is paucity of information about tobacco consumption among females, especially which calls for an urgent need to address the issue. Aim: The aim of this study was to examine underlying factors which initiated SLT use and their knowledge levels about its ill effects among immigrant daily wage workers in a University setting of South India. Settings and Design: This was a qualitative study conducted at office sites (n = 6) within University Premises of Manipal, Karnataka. Materials and Methods: The focus group and interview guides were semi-structure in nature and developed in the context of a guide to a conversation/discussion. It covered all research questions that could be answered by this qualitative approach. Statistical Analysis: Thematic analysis was used to report and interpret the findings. Results and Conclusion: A total of six focus group discussion’s (n = 55 participants) and 20 in-depth interview’s (n = 20 participants) were conducted. Themes emerged – “Factors for uptake of SLT use,” “Poor knowledge on adverse effects of SLT use,” “Easy Availability and Accessibility,” and “Thoughts and Suggestions on quitting.” Reappraising social determinants in access to tobacco prevention and cessation support services to migrant construction workers may be a promising strategy to reduce health harms of SLT use.

A Study on Health-care Utilization and Health-care Seeking Behavior of People Approaching Two Institutions (Ayurveda and Allopathic PHCs) in Vengara Panchayat of Malappuram District, Kerala

Asif Asfan Parangodath — 2023-03-21

Background: To make health for all a reality, we need individuals and communities with access to high-quality health services to take care of their health and of their families. There is a need to undertake a more systematic analysis to examine AYUSH and Allopathic care utilization across regional, socioeconomic, and demographic groups. In a country like India, which is home to many traditional medicine systems, it is also essential to understand how Ayush coexists with allopathic system. Methods: The study used a cross-sectional study design using a self-made questionnaire to find healthcare utilization and healthcare-seeking behaviour. Results: Factors determining health-care utilization such as prior experience in care (AOR 3.47; 95% CI 0.52–23.37), affordability (AOR 11.48; 95% CI 2.31–57.08), availability of essential medicines and their quality (AOR 35.28; 95% CI 5.32–234.20), and acceptability of treatment (AOR 4.51; 95% CI 0.91–22.41) were shown to be a positive predictor for choosing Allopathic PHC. At the same time, healthcare services such as screening and basic management of mental health ailments (AOR 0.20; 95% CI 0.02–2.26) and care in pregnancy and childbirth (AOR 0.54; 95% CI 0.12–2.32) were shown to be negative predictors for allopathic. Conclusion: The study findings highlighted the need for systematic information on the usage of healthcare services and people’s healthcare-seeking behaviours. It would help policymakers and stakeholders set up specific strategies to ensure the effective utilization and distribution of existing resources and enforce the country’s sufficient delivery of healthcare services.

Stage-stratified Analysis of Handgrip Strength and Body Composition of Chronic Kidney Disease Patients

Anjani Bakshi — 2023-04-08

Handgrip strength (HGS) is strongly associated with lean muscle mass and can accurately determine nutritional compromised state of chronic kidney disease (CKD) patients at all stages of illness. Methodology: In this cross-sectional study, 114 CKD patients from different stages were enrolled. HGS of the patients was measured by Jamar Hydraulic Hand Dynamometer. Body composition for 47 patients was measured by body composition monitor. Stage stratified analysis was done using various statistical tests. Results: CKD patients had low HGS at all stages. Patients at Stage 4 had significantly (P < 0.001) lower HGS (19.45 ± 7.09 kg) than patients of stage 2 (25.7 ± 8.53 kg). With one unit increase in age, the value of HGS significantly (P < 0.001) decreased by 6.35 units. Female patients had significantly lower HGS by 21.36 unit, (P < 0.001) at all age groups as compared to males. The value of lean tissue mass (LTM) was significantly (P = 0.03) low at Stage 4 as compared to Stage 2. HGS was positively correlated with LTM (r = 0.65). Muscle strength and muscle mass were strongly related with disease progression. Conclusion: Timely assessment of HGS and muscle mass of CKD patients determine nutritional status at early stage of illness.

Knowledge and Awareness of HIV/AIDS, Mental Health Problems, and Stigma among HIV/AIDS Children: A Mediation Analysis

Varsha Singh — 2023-04-08

Stigma is a significant obstruction, restricting factor, and hurdle in HIV/AIDS prevention and treatment. It has serious psychosocial consequences for HIV/AIDS patients’ children. In India, 35% of maximum AIDS cases reported are in the most productive age bracket of 10–21 years, showing the younger population’s exposure to the infection. The goal of this study is to determine the stigma associated with HIV/AIDS, as well as HIV/AIDS knowledge and awareness, and mental health problems among HIV/AIDS children. It also intends to investigate the relationship between these variables. Children with HIV/AIDS (n = 90) from Motilal Nehru Hospitals in Allahabad, Uttar Pradesh, India, were included in the study. To achieve the study’s goal, descriptive statistics, correlational, and regression analysis, as well as mediation analysis, were used. Correlational analysis reveals that, HIV/AIDS knowledge and awareness are considerably adversely connected with HIV/AIDS related stigma (r [88] = −0.448, p = 0.01), but mental health problems are strongly positively correlated with HIV/AIDS stigma (r [88] = 0.753, P = 0.01). Using hierarchical regression analysis, it was discovered that HIV/AIDS knowledge and awareness contributed 18.8% of the variation in HIV/AIDS stigma, while HIV/AIDS stigma contributed 45.9% of the variance in mental health problems. The results of the mediation analyses support the significance of HIV/AIDS stigma in mediating the affiliation concerning HIV/AIDS knowledge and awareness and mental health problems (r = −0.19, CI: [−0.661]–[−0.038] P = 0.024). These findings add to empirical evidence about psychological predictors and the observable consequences of H/A related stigma.

Development and Validation of RP-HPLC for Estimation of Brexpiprazole in Bulk Drugs

Komal Kashinath Andhale — 2023-03-13

A simple, rapid, accurate, and sensitive method was developed for quantitative analysis of Brexpiprazole in bulk dosage form using reverse phase high-performance liquid chromatography with UV detection. The chromatography separation was achieved on Kromasil -C18, (250 mm × 4.6 mm i.d., 5 μm particle size), at column temperature 25°C ± 2, in the isocratic mobile phase mode using acetonitrile 5% ortho-phosphoric acid: water (60:40 v/v) at a flow rate of 1.0 mL/min. The determination was performed using waters HPLC with UV detector set at 216 nm. Samples were prepared with diluent methanol, and the volume injected was 20 μL. The retention time for brexpiprazole was 3.89 min. The analytical curve was linear (r2=0.99994) over a wide concentration range (0.51–7.50 μg/mL). The presence of components of the bulk did not interfere in the results of the analysis. The method showed adequate precision with a relative standard deviation <2%.

Impact of Diet on Nutrient Intake, Glycemic Index and Glycemic Load of Meals of Urban Indian Diabetic Population

Hitha Parshva Bhankharia — 2023-04-20

Background: India is heading toward becoming the global diabetic capital directly interconnected to poor lifestyle and obesity. Aims and Objectives: The aim of the study was to find an association between glycemic index (GI) and glycemic load (GL) with macronutrients and fiber in the diet of the urban Indian population. Materials and Methods: The dietary intake using food frequency questionnaire and 24–h dietary recall of 240 recruited subjects (male and female), between 25 and 60 years were taken in the study. GI and GL of all meals were calculated using values from National and the International Table of GI and GL. Results: Average mean and standard deviation of GI and GL of major meals were on the higher side. A significant correlation between GI of lunch and dinner with total available carbohydrate (CHO) and total starch intake. A positive significant correlation was observed between GI to energy intake at dinner, total available CHO, and total starch. GL of breakfast was negatively correlated to iron, zinc, insoluble, and soluble fiber intake in females. GL for lunch was positively correlated to the intake of total available CHO, total starch, insoluble, and soluble fiber. Conclusion: The present study showed high GI and GL of processed foods and refined CHO indicating that dietary habits with high GI and GL foods are an indicator to risk of diabetes and pre-diabetes among both genders.

Nutrient Diversity and its Association with Type 2 Diabetes Mellitus in Urban Indian Population

Hitha Parshva Bhankharia — 2023-04-20

Background: Nutrient diversity is one of the key factors of a balanced diet because of its correlation with macronutrients and micronutrients. Aims and Objectives: The objective of the study was to assess daily dietary intake and get urban Indian data based on the regional dietary intake of the subjects. Materials and Methods: Nutrient diversity was inferred using a food frequency questionnaire and 24-h dietary recall along with other variables such as demographic data, income, education, lifestyle, number of meals per day, and addictions. Average, mean, and standard deviation were calculated for all of these. Results: Results showed a positive correlation between nutrient diversity and its association with type 2 diabetes mellitus. The average dietary intake of the study showed that the subjects consumed a diet high in carbohydrates and fat while the protein and micronutrient intake was on the lower side. A large variation was observed in the average nutrient intake from different food groups. Conclusion: The current study concluded that the nutrient diversity amongst the subjects is an indicator to risk of diabetes and pre–diabetes.

Masters Says…

Ayush Kumar — 2023-04-23

Homoeopathy is a holistic form of medicine that has been practiced for over two centuries. Many homoeopathic masters have developed clinical tips and guidelines for selecting and prescribing homoeopathic remedies based on their extensive clinical experience. Some of the key clinical tips offered by homoeopathic masters include taking a thorough case history, paying careful attention to the patient’s unique symptoms and constitution, and selecting remedies based on the principle of “like cures like.” Homoeopathic masters, such as Dr. Hahnemann, Dr. Hering, Dr. Kent, and Dr. Boericke developed homoeopathic materia medica to guide the selection of homoeopathic remedies based on the patient’s symptoms. These resources provide detailed information on the properties and indications of various homoeopathic drugs, allowing practitioners to match the patient’s symptoms with the most appropriate remedy, but sometimes applying the knowledge of materia medica in clinical practice is difficult. Hence, our homoeopathic masters had given some advice for clinical application of homoeopathic materia medica. These advices and tips are scatter in various homoeopathic books and literatures. In this manuscript, important clinical tips were collected after reviewing various homoeopathic books and literatures.