Emerging Trends in Disease and Health Research Vol. 2

Introduction: Worldwide, breast cancer comprises 10.4% of all cancer incidence among women. In 2004, breast cancer caused 519,000 deaths worldwide (7% of cancer deaths; almost 1% of all deaths). Many women who undergo breast surgery suffer from ill-defined pain syndromes.

Statement of the Problem: A study to assess the effectiveness of twin therapeutic approaches on certain biophysiological parameters in breast cancer patients after breast surgery at selected hospital, Chennai.

Objectives: This study is to:

1. Assess the level of certain biophysiological parameters in women after mastectomy.
2. Assess the effectiveness of twin therapeutic approaches on certain biophysiological parameters in women after mastectomy
3. Correlate the practice of twin therapeutic approaches with certain biophysiological parameters .
4. Associate the selected demographic variables with certain biophysiological parameters in women after mastectomy

Research Design and Methods: Pre experimental research design was used. Fifty women were selected by using convenient sampling technique at government general hospital, Chennai.

Results: The Level of pain shows, in the study group 49(98%) of them had moderate in the pre test and after the intervention all of them had mild pain in the post test. In relation to level of shoulder function before the intervention shows that in the study group 49(98%) of them had movement towards gravity and after intervention 24 (48%) of them had movement against gravity maximum resistance . There was a significant reduction in pain and shoulder stiffness level at a ‘P’ level of <0.001. There was a negative correlation between the pranayama practice and the level of pain, there was a positive correlation between the arm exercise practice and the level of shoulder function. There was no significant association between demographic and clinical variables with the level of pain and shoulder function in the study.

Hypothesis: There is a significant difference in level of pain and shoulder function among women following breast surgery who receive pranayama & arm exercise programme. The pranayama  had effect in terms of reduction of pain, arm exercise programme  had effect in prevention of arm stiffness among  post operative  women following breast  surgery. Thus the stated hypothesis  was accepted.

Conclusion: On the basis of the findings of the present study there was Advancing age related to increasing risk of breast cancer, level of pain also the type of surgery was associated with level of pain and shoulder function, There fore it is to be concluded that the study participants may get benefited by practice of   pranayama  and arm exercise program.

Background: Pseudomonas aeruginosa is one of the most commonly encountered gram-negative aerobic bacilli in the differential diagnosis of several probable hospital-acquired infections. In bloodstream infections (BSIs) mortality due to Pseudomonas aeruginosa remains an issue of serious concern. The present study is designed to determine the Pseudomonas positivity and sensitivity in Invasive bloodstream infections using automated Bactec systems as the Antibiotic Sensitivity Profiles differ from one clinical setting to another.

Material and Methods: All the blood culture samples received in the Department of Microbiology for culture by Bactec Bd fx from July 2015 to June 2016 were included in the study. The blood culture was observed in the Bactec bd fx system for at least 5 days before they are reported as sterile.

Results: Among the total 1275 cultures which were positive for bacteria, 931(73.02%) were positive for gram-negative bacteria. Among the total of 931culture which were positive for gram- negative bacteria, Pseudomonas aeruginosa was isolated in 120(12.89%) cultures. Maximum was Pseudomonas spp isolates were 100.00% sensitive to Colistin followed by Levofloxacin 84.44%, Piperacillin Tazobactum 82.50%, PB 77.50%, Amikacin 75.00%, Cefepime 75.00% while Pseudomonas spp isolates were 90% resistant to Ampicillin followed by Ceftazidime clavulanic acid 82.64% and Aztreonam 70.31%.

Conclusion: Pseudomonas aeruginosa is one of the most common organisms among Gram- Negative isolates and the most commonly isolated in the neonate and infant age group. All the Pseudomonas isolates showed maximum sensitivity to Colistin followed by Levofloxacin, Piperacillin Tazobactum, Amikacin while they were most resistant to Ampicillin followed by Ceftazidime clavulanic acid and Aztreonam. Some alternative novel techniques need to be developed to counter the increasing menace of antibiotic resistance in this particular pathogenic bacteria.

The incidence of undernutrition among children is high in India. Undernutrition in children leads to growth failure, increased morbidity rates, decreased life expectancy, declined cognitive function and development, decreased learning ability, poor academic performance, suboptimal adults’ efficiency, and decreased economic growth for nations. The health mix is the most popular, convenient, easy to prepare and healthy dish for the children. This chapter deals with the development of cheaper and nutritious health mix for improving the nutritional status and cognitive function in children. The raw ingredients were procured, processed, powdered and mixed into 5 variations of health mix. The developed health mixes were analyzed for their nutritional and sensory qualities. The results stated that the health mix III with the combination of multi grain such as redrice (25 g), bajra (25 g), greengram (20 g), soyabean (10 g), riceflakes (10 g), jaggery (8 g) and brahmi leaves (2 g) received significantly higher scores and also selected as best in having high amount of essential nutrients namely, protein (14.9 g), fat (1.68 g), iron (6.52 g), zinc (1.91 mg), selenium (445 mg)required for the improvement of nutritional status and cognitive function. And also, the prepared health mix variation IIIgained the highest rating in many sensory qualities and their results were comparable to the control sample. Therefore, thehealth mixprepared with the combination of various multigrain along withbrahmi leaves, as one of the most convenient food formulas for supplementation to the undernourished children. Future studies on such supplementation to improve the nutritional status and cognitive function of the undernourished children is recommended.

Introduction: Geriatrics and widows are neglected in the society. The geriatrics age groups are seen as unproductive. Widows, on the other hand, are humiliated traditionally by their husbands’ family members and community. They face surmounting problems which shadow their urge to seek medical attention. 

Aim: To determine the burden of Ear, Nose and Throat (ENT) and medical diseases in Geriatrics and Widows through identification of common ENT and medical conditions in them.

Objectives: To identify the ear diseases among geriatrics at the Dagomo foundation home for the elderly.

To identify the ear diseases among widows in Ubiaja community.

To identify the medical conditions among the widows in Ubiaja community.

Methods: This study was a 7months prospective study from September, 2017 to April, 2018. The study centers were Dagomo foundation home for the elderly in Benin City and St. Benedict Catholic Church, Ubiaja in Edo central. Total population sampling technique was used. All the elderly and widows who gave consent to the study constituted the sample size. Health talk was given; history taking, Ear, Nose, Throat and general body examinations were done. Data on the disease burden identified were recorded. Those that needed further evaluation and management were referred accordingly. Data was statistically analyzed with SPSS Version 20. P value < 0.05 was considered statistically significant.

Results: 50 geriatrics and 67 widows participated. The age range was from 60 – 90 years (mean age of 69.50±7.78years) and 36 – 85years (mean age of 59.61±9.36) for Geriatrics and widows respectively. Among the geriatrics were 13 males and 37 females while widows were 67. Seventeen (17) different ENT diseases were identified in Geriatrics while 7 ENT conditions and 12 medical conditions were identified in the widows. Predominant ENT diseases were Otitis Media with Effusion (34.9%), Left Cerumen Auris and Otomycosis in similar proportion (20.9%) in Geriatrics. Right Cerumen Auris predominated in widows (65.6%) followed by Left Cerumen auris (50.0%) and Otitis Externa (28.1%). Osteoarthritis was the commonest medical condition (90.6%) in widows. Tests of association were not statistically significant.

Conclusion: There is significant burden of Ear, Nose, Throat and medical diseases in the Geriatrics and widows.

Recommendations: Government should plan specialist healthcare measures to improve the quality of life of geriatrics and widows.

Government should ensure an educational policy to develop age-appropriate training protocols for children and young adults on the challenges associated with aging.

Context: Health sector has been working untiringly since the COVID 19 pandemic emerged as Public health emergency of International Concern. FLHCWs are those who are in close contact with the COVID-19 cases and witness the suffering caused by COVID 19 on patients which can have direct effect on mental health.

Aims: The study was planned to assess the COVID anxiety, stress and work & social adjustment and factors influencing the same among FLHCWs working in a COVID care center.

Settings and Design: This was hospital based study carried out for period of 4 months from July to October 2020 in a Covid Care center, Kolar.

Materials and Methods: Study participants were frontline health care workers (FLHCW) like doctors and nurses who were part of Covid care of patients who had not contracted the infection, working in COVID related wards and Out-patient department. Sample size was calculated based on previous study which was 360.

Statistical Analysis Used: Descriptive statistics applied where ever needed and to check for association between factors Chi-square was applied with level of significance defined as p value less than 0.05. Multinomial logistic regression was done to identify the factors.

Results: Out of 362 FHCWs, 142(39.2%) belonged to age group of 21-25 years, 243(67.1%) were female FHCW, 86(23.8%) were Junior Residents, 105(29%) were working in COVID ward, 187(51.7%) were working more than 8 hours, 189(52.2%) Perceived their workload during COVID duties as medium, 265(73.2%) followed Regular working Shifts followed during COVID. Out of 362 FLHCWs, 45 (12.4%) had high stress. With respect to work and social adjustment, severe psychopathology was seen in 178(49.2%) and 196(54.1%) had Corona anxiety.

Conclusions: Gender, occupation and marital status were found to have statistically significant association with work and social adjustment. Working hours per day, occupation, perceived workload during duties, regular shifts during COVID duties and hours of rest during COVID duties were few factors which were found to have statistically significant association with Corona anxiety.

Key Messages: The present study stresses the importance of recognizing the psychological consequences of the newer disease outbreaks among health care workers working in treating center being very crucial but still failed to be taken care by guiding policies and hospital authorities to maintain healthy psychological well-being. Health institutions addressing such pandemics need to regularly screen FLHCWs for mental health issues and intervene at early so as to keep the health worker resource adequate to fight the pandemic till the advent of vaccine or curative  drug.

This study examines the relationship between the internality-externality (I-E) scale as an indicator of coping styles and the Kessler 6 (K6) scale as an indicator of psychological distress and analyzes the effect of sociodemographic and employment-related factors on this relationship. Employees from Akita prefecture in Japan were invited to complete self-administered questionnaires. A uniform pattern of findings emerged in the relationship between the two scales: all the significant correlations were negative; that is, as the I-E score increased, the K6 score decreased. Furthermore, significant effects were observed for the I-E scale regarding sex, age, education, employee type, employment status, and the K6 scale with multiple regression analyses. Among these, the effect of the K6 scale was significant for the I-E scale in both males and females. The results of this study may help improve mental health clinicians' understanding of psychological distress in employees.

It is obviously the role of probiotics in preventing or treating different health disorders, from those on nutritional status to medical conditions throughout the body such as gastrointestinal diseases, diabetes, high cholesterol, obesity and certain types of cancer and some probiotics provide benefits for healthy individuals, such as reducing the risk of common infectious diseases. Many probiotic have shown promise in selected clinical conditions where aberrant microbiota have been reported.however it is necessary to establish regulations for the use of porbiotics and to carry out more research to determine the strains and appropriate dose for each treatment and to identify the long-term effects and the influence of probiotics when used in combination with drug-based treatment. The objective of this revision is to acknowledge the importance probiotics in the prevention and treatment of different health disorder through the collection and comparison of different research works on the topic in recent years.

We report here on the schoolchildren’s perception of anti-smoking messages (ASM). First study (SI) was conducted in the private school in 2016. The total of 58 ninth-and tenth-graders, of both sexes, were recruited in the study. The second study (SII) was conducted in the same private school in 2022, in the period of the burst of COVID in Georgia. The total of 61 ninth-and tenth-graders, of both sexes, were recruited in the study. In both, SI and SII, participants received typed anti-smoking messages (ASM) such as following 1. Smoking changes the color of teeth, 2. Smoking causes a bad breath, 3. Smoking makes skin spotted, 4. Smoking causes lung cancer, 5. Stories of smoker, died of smoking and 6. Smoking causes sexual impotency. ASM were accompanied with relevant illustrations. Participants were instructed to decide, if ASM is convincing to stop smoking and to score each type of ASM. Score 1 corresponded to “not convincing at all” and score 5 - “convincingly strong”. School Biology textbooks for ninth-and tenth-graders were analyzed regarding the anti-smoking information, presented in the text. In the SI, ASM 1, 2 and 3 was scored much higher as compared to the 4, 5 and 6. The data obtained may be ascribed to the special concern of teenagers with their appearance. No significant difference in the scores between ASM 1,2,3,4 and 6 was found in the SII.  Presumably, living in stressogenic situation makes schoolchildren more sensitive to ASM, concerning the risk of smoking for life threatening diseases and loosing life. School Biology textbooks were found to contain information on the negative influence of smoking on body organs with relevant inscriptions. Story of famous actor, died of smoking was represented in one textbook. Only one textbook was found containing information about the effect of smoking on appearance. For further improvement of anti-smoking propaganda targeted at school pupils, we recommend to highlight the negative influence of smoking on kids’ appearance in the health educational information, included in school textbooks.

Seafood is a common item in the world diet. The increase in production and consumption has resulted in more frequent reports of adverse reactions, highlighting the need for more specific diagnosis and treatment of seafood allergy. Tropomyosin, which causes IgE-mediated hypersensitivity, has been identified as the major allergen in shellfish. The symptoms range from oral allergy syndromes to urticaria and anaphylaxis. Cross-reactivity among shellfish is common. Studies are needed to address clinical cross-reactivity with other species as well as possible new therapeutic strategies. The knowledge on diagnosis, treatment and regulation discussed in this chapter helps to avoid the occurrence of seafood allergy.

This review aimed at evoking attention of sodium pyruvate effects on healthy aging relative to the nicotinamide adenine dinucleotide oxidized form (NAD⁺) and senolytics. In last decades, healthy aging has become one of research hotspots in life science. It is well known that NAD⁺ level in cells decreases with aging and aging-related diseases. Several years ago, one of NAD⁺ precursors was first demonstrated with its new role in DNA damage repairing in mice, restoring old mice to their physical state at young ones. The finding encourages extensive studies in animal models and patients. NAD⁺ and its precursors have been popular products in nutrition markets. Alternatively, it was also evidenced that clearance of cellular senescence by senolytics preserved multiorgan (kidney and heart) function and extended healthy lifespan in mice. Subsequent studies confirmed findings in elderly patients subjected with idiopathic pulmonary fibrosis. The senolytic therapy is now focused on various diseases in animal and clinical studies. However, pyruvate, as both a NAD⁺ substitute and a new senolytic, may be advantageous, on the equimolar basis, over current products above in preventing and treating diseases and aging. Pyruvate-enriched fluids, particularly pyruvate oral rehydration salt, may be a novel intervention for diseases and aging besides critical care. Albeit the direct evidence that benefits healthy aging is still limited to date, pyruvate, as both NAD⁺ provider and senolytic agent, warrants intensive research to compare NAD⁺ or senolytics for healthy aging, specifically on the equimolar basis, in effective blood levels. This review briefly discussed the recognition of healthy aging by comparing NAD⁺ and Senolytics with sodium pyruvate from the clinical point of view.

Kenya like many world economies adopted and implemented universal health coverage as evidenced in the various policy initiatives and reforms. In the chapter, a critical review of the various initiatives that the government has over the years initiated towards the realization of Universal Health Care and how this has impacted on health equity. To realize this, both primary and secondary data were collected. Whereas secondary data was largely collected through critical review of policy documents and commissioned studies by the Ministry of Health and Development partners, primary data was collected through in-depth interviews with various stakeholders involved in UHC including policy makers, implementers, researchers and health service providers. Notable findings include political commitment towards UHC; minimal solidarity in financing; dysfunctional health care management; disruption by COVID 19; lack of continuous medical training; supply side rigidities that contribute to stock-outs; dilapidated health infrastructure. Other findings include weak governance at NHIF coupled with inadequate skilled labour, high operational costs, low capitation, and investment in non-priority expenditures, among others. In lieu of these, various recommendations are suggested including promotion of solidarity in health care financing that are reliable and economical in collecting; political will to enhance commitment towards devolution of health care, involvement of various stakeholders at both county and national government; investment in health infrastructure and training of human resources; revamping NHIF into a full-fledged social health insurance scheme, and enhancing capacity of NHIF human resources.