Issues and Development in Health Research Vol. 4

Given the scourge's harmful influence on society's underserved and devalued populations, the social work profession, more than any other, is most harmed by the raging corona virus (aka, COVID-pandemic). More importantly, the pandemic has shattered the profession's long-standing dedication to social justice and human rights, as well as its insistence on the value of human relationships.  The goal of this paper is to explain how social work and the COVID-19 epidemic are linked. While emphasising the profession's deafening silence in the global pandemic discourse, it argues that our reaction must be urgent if our profession is to gain meaningful public value amid the current loss of life and risks to human rights. The strategies for our professional action in limiting the contagion's effect are laid out.Our profession may continue to be called into question, first by critics, citizens, then by our client-systems, and finally by ourselves, unless we act quickly to address the world's major concerns.

75 countries had less than 2.5 health workers per 1000 people.Countries with less than 2.28 doctors, nurses, and midwives per 1000 people failed to fulfil the aim of 80 percent skilled birth attendance and child immunisation, according to the World Health Report. Due to the lack, patients, particularly the poor and disadvantaged, have been forced to seek health care from the informal sector as they are more socially and community focused Appropriate formal health workforce is required to build an effective, efficient, and equitable health system that improves population health. There is a scarcity and a crisis of it. Healthcare-seeking is not a simple human behavioral nature.  The combined efforts of the public and private sectors nearly impossible  to produce the required formal health workforce. Transform unregistered health care service providers (HCSP) into government-registered, well-trained HCSP. It would be able to prevent malpractice, ensure standard treatment, and hold people accountable for referral responsibility. Both primary and secondary data were collected. A face-to-face interview and a focus group discussion were conducted.  People who are illiterate (no education) as well as literate (completed primary school to a higher level of education) seek out informal healthcare providers. Households with incomes ranging from $10,000 to $30,000 were classified as low, middle, and upper middle, with people aged zero to sixty having the option of receiving health services from a traditional healer (kobiraj), homoeopathy, RMP, and drug seller.

Health care services are not only service delivery at the hospital from outdoor, indoor and consultation but also providing health promotional services. Health promotional services have very important role to grow awareness, improve knowledge on practices regarding health. This assist mass population to change knowledge, attitude and practice on different health issues. The sustainable financial independence changes the test and demand for a living. This change plays an important role in changes the lifestyle and behavior pattern of human being.  The three most important factors for human lives are work, family and friend, and health. Occupation (work) gives people’s individual identity and recognition in society and world. Successful accomplishment of each task gives people’s confidence and strength. People’s gets peace from family and friends. These two issues are also responsible for social pathology. It leads to deteriorating mental stability and people’s suffering from stress, tension, depression, and anxiety. Lastly, the health by nature people invest on health getting everyday food and people didn’t give concern on health during the healthy time or up to middle age or till fall complete sickness. Present world people were suffering from non-communicable diseases. The causes of this diseases mostly due to the important three issues of human life. Altering of the physiological function of the human body due to the practice of unhealthy lifestyle and social pathology. This paper discusses the connection of lifestyle and behavior with the onset of non-communicable diseases. It will also present the preventive measures for these unhealthy practices and its role to prevent onset, delayed onset of consequences of diseases.

Background: A variety of approaches have been developed for the control of dental caries, a pathology with high incidence and prevalence worldwide. The use of probiotic strains for the modulation of dental biofilm in the prevention of caries has been studied, but the available evidence shows varied methodologies; and the strains tested differ from one study to another.

Objective: To analyze the efficacy of using probiotic strains to prevent caries through the modulation of biofilm and immune response associated to oral mucosa.

Methods: A search was made in the scientific bases PubMed, Cochrane and Science Direct, prioritizing randomized double and triple-blind clinical trials from 2010 to 2020, including a total of 20 studies to be analyzed. The selection criteria were consistent with the Preferred Reporting Items for Systematic Reviews protocol.

Results: Within the studies, different types of probiotic bacteria were analyzed, dominating Lactobacillus paracasei. While most clinical trials show a favorable response in terms of a significant reduction of Streptococcus mutans in the oral microbiota, very few studies evaluated salivary pH and sIgA levels.

Conclusions: The heterogeneity of the studies analyzed and the multifactorial nature of dental caries do not allow us to ensure that probiotic therapy is completely effective in preventing this pathology. Although probiotic therapy can help by regulating the microbiological factor, there are other determinants that can favor the development of caries and that are barely approached in their relationship with bacteriotherapy. Future studies that homogeneously evaluate the use of probiotics could give us a clearer idea of their effectiveness.

Introduction: Nicotine metabolising enzymes CYP2B6 and CYP2A6 are implicated in the treatment of nicotine addiction.Even though evidence suggests they may interact to influence nicotine dependence treatment outcomes in terms of nicotine dependence and withdrawal syndromes, as well as therapy types (placebo, bupropion, and NRT), the importance of their interaction in nicotine cessation has yet to be fully substantiated and clarified.

Methods: A total of 1862 people were analysed, including Caucasians and African Americans. The Fagerström Test for Nicotine Dependency (FTND) and Wisconsin Inventory of Smoking Dependence Motives (WISDM) measures were used to assess nicotine dependence and withdrawal syndrome, respectively. Participants were needed to smoke at least ten cigarettes per day and to use one of three types of therapy (placebo, NRT, or bupropion) for two weeks before reporting their quitting status six months later. Participants were also screened for SNPs CYP2A6*1A (rs1137115), *1H (rs616636070),*4A (rs28399434), *9A (rs28399443),*12A (rs28399442), and CYP2B6*6(rs3745274) for nicotine genotype analysis.

Results: The chi-squared test revealed that gene variations were consistently distributed in the population withp-values > 0.05. According to logistic regression analysis, CYP2A6*4A was most significantly associated with the odds ratio (OR) of quitting smoking in each treatment group with nicotine dependence syndrome (OR=1.61, 95% CI 1.31-1.96), and *4A in individuals with nicotine withdrawal syndrome (OR=1.70, 95% CI 1.15-1.95). In the bupropion group, the ANOVA test revealed a significant main interaction effect between CYP2B6*6, *1A, *4A, and *12A gene variants.

Conclusion: CYP2A6 and CYP2B6*6 may interact to improve the chances of nicotine addiction treatment success.

Background: Infections obtained at a hospital or other healthcare facility in which the illness was not present or incubating at the time of admission are known as hospital-acquired infections (HAIs). Illnesses acquired at the hospital but showing up after discharge, as well as infections among the facility's health care employees, are included. Nurses are major contributors to care in all health care settings, and their knowledge and behaviors are critical in the control and prevention of HAIs.

Objective: The goal of this study was to determine the level of awareness and practice of standard precautions among the staff nurses.

Materials and Methods: The present study was a hospital-based descriptive study that took place from January to March 2017 at Chamarajanagar Institute of Medical Sciences at Chamarajanagar. A total of 40 staff nurses were chosen using simple random sampling, and data was collected using a pretested and semi-structured questionnaire. Microsoft Office Excel 2007 was used to conduct the statistical analysis.

Results: The majority, 35 (87.5%), knew about the Infection Control Committee (ICC) and the Central Supply and Sterilization Department (CSSD), and > 90% knew about segregation and disposal according to BMW guidelines. The majority of staff nurses, 38 (95%), cleaned their hands before and after touching patients and donned personal protective equipment. More than half i.e. 23 (57.5%) of the participants in the study had experienced a needle stick injury, yet only 19 (47.5%) of them reported it and sought treatment. 24 (60%) of the staff nurses received a hepatitis B immunization.

Conclusion: The current study reveals that the staff nurses have a sufficient degree of knowledge and practices regarding standard precautions, and also identifies several places where educational interventions are required.

Bacterial vaccines, the bacterins are of both prophylactic and therapeutic potential s .Autogenous bacterins ,however, are of profound importance in certain clinical settings like complicated urinary tract infections. The aim of the present work was at development, cellular immune features and immune interference of combined E.coli and P,aeruginosa in rabbits. Single E.coli and single P. aeruginosa as well as balanced [1xE-1xP,2xE-2x P strength], and unbalanced [1xE-2xP, 2xE-1xP strength] heat killed bacterin combinations were prepared, developed and evaluated on laboratory scale. The developmental features were found; pure, safe, antigenic and immunogenic. These combined bacterins induced an increase in mitotic index of bone marrow cells, significant leukocyte inhibitory factors, increased spleen body index. Balanced one x and two x combined bacterins induced higher IL10 mean values than normal. 2x strength bacterin combinations initiate higher IL2 concentration mean values than single bacterin and control. Both of the unbalanced bacterin combinations were rising up the TNF alpha concentration means than that of single bacterin and control. In practical sense, the immune interference in rabbits primed with the study bacterin combination lead to, either of three results as; one damp the other, one enhance the other and one doesn’t affect the other. The immune interference appeared in the form of; one enhance the other like that of IL2 and IL10 cytokine responses. The present findings are being novel in cases of Pseudomonas lung and urinary tract infections as potential experimental therapeutic bacterin. As well as they may be of help in cases of cancer immunotherapy in man and laboratory animals.

Oral mucosal epithelia as other types of mucosal epithelia are known traditionally as protective tissues. In the present chapter, attempts were made to introduce oral epithelia as non-lymphoid, non-myeloid tissue with an immune potentials. Epithelia is the plural of the singular epithelium. They are specialized layers that covered the external surface of the organs forming the body. Today, opinions holds the believe that oral epithelial cells have TLR system and can recognize microbial invaders .Microbial invaders in turn, induce epithelia to produce pro-inflammatory TH1,TH2 cytokines and Chemokines. The induction processes described as species and strain specific. Natural epithelial cytokine production have been assured by a number of an in-vitro models. Oral epithelial cytokine interplayed several immune functions like regulation of local immune responses, mediate autoimmune disease and induce tissue damage in case of increased secretion. They express multi-factorial influences on mucosal immune compartment, be an integral part of the local innate immune responses and might have a future implication in vaccine immunity .

Introduction: Lung cancer is one of the most common causes of mortality worldwide. An increasing number of lung and mediastinal lesions are found by MDCT, and histological identification is frequently required to determine the best treatment option for these lesions.     At this article we have the aims to describe the invasive procedures of the chest lesions - indications, contraindications, technical aspects, and diagnostic accuracy of the percutaneous lung biopsies.

Methods: In patients with lung lesions, fine-needle aspiration biopsy (FNAB) and core-needle biopsy (CNB) are the methods of choice for collecting tissue specimens.Treatment procedures are frequently based on histology diagnosis. When logistically feasible or when other procedures (such as bronchoscopy with lavage) are equivocal, FNAB biopsy is performed in 85 of the 97 patients in our study, and CNB is performed in 12 of the 97 patients. The needles used were 19-22G disposable needles.

Results: FNAB under CT control was conducted on all 76 patients, ages 21 to 79, who had lung lesions with a diameter of 2.0 cm or less. Due to the superficial localisation of the lesions, FNAB under US control is performed in 13 patients. All patients have their tissues samples analysed cytologically and histologically.The diagnostic sensitivity and accuracy, as well as the type of complications that occurred, are calculated. CNB showed a small improvement in overall sensitivity, specificity, and accuracy.

Conclusion: Percutaneous FNAB and CNB are the  safe procedures for diagnostic evaluation of focal pulmonary lezions. The complications are  rare: pneumothorax, pulmonary haemorrhage but some, like air embolism and metastatic seeding are with severe consequences.

During the last decades, the importance of micronutrients has been extensively reviewed, and it was concluded that the prevention and treatment of periodontitis should include correct daily nutrition and a correct balance between antioxidants, probiotics, natural agents, vitamin D, and calcium. Recently, there has been growing interest in the literature on the impact of nutraceutical dietary aliments on oral and general health. Periodontal diseases, chewing disorders, and many destructive oral inflammatory diseases are usually caused by an imbalance between host defense and environmental factors like smoking, poor nutrition, and a high percentage of periodontopathogenic bacteria. For these reasons, it is important also to focus attention on plaque control and also on improving host resistance through smoking and stress reduction, and a healthy diet. Numerous clinical and experimental studies have highlighted the presence of a strong association between periodontitis and some systemic diseases, in particular, cardiovascular diseases, diabetes, lung diseases and complications of pregnancy. The objective of this chapter was to analyze the impact of diet, micro- and macronutrients on oral health and to provides a current and thoughtful perspective on the relationship of diet and natural agents on oral and periodontal diseases through a correct clinical approach with the last and most important evidence that may determine good oral conditions and high quality of life.

The mid-arm circumference and triceps skin-fold thickness in rural schoolchildren aged 5 to 13 years were investigated in a cross-sectional study. The research was conducted in Maharashtra, India, at Sangli district schools. A total of 910 students from rural schools (500 boys and 410 girls) were studied. Mid-arm circumference provides overall information regarding the status of muscle development.  Girls in rural schools had higher mid-arm circumferences and triceps skin-fold thicknesses than boys. As there was no established Indian norm for mid-arm circumference, the results of this study were compared to those of other researchers who conducted their research in well-nourished and affluent schoolchildren who were not limited in their growth by malnutrition or infection. Rural schoolchildren had smaller mid-arm circumference and triceps skin-fold thickness than well-fed, affluent schoolchildren, which might be linked to the latter's improved socioeconomic standing.

Background: Pancytopenia is not a disease by itself; but a common hematological problem which is characterized by simultaneous presence of anemia, leucopenia and thrombocytopenia. The disease pattern associated with pancytopenia varies with geographic location, age group, nutritional status, drug intake and prevalence of infective disorder.

This prospective study was to investigate and identify different causes of pancytopenia, to ascertain percentage of occurrence of pancytopenia, and to determine its incidence in relation to sex and age, as well as to compare the findings with those of other similar studies.

Methods: 80 patients diagnosed with pancytopenia were clinically evaluated, with complete blood count, peripheral smears, and bone marrow aspiration-biopsy whenever possible in Justice K. S. Hegde Hospital attached to Nitte University, Deralakatte, Mangalore, from June 2012 to June 2014.

Results: Among the 80 cases analyzed, most of the cases were seen in the age group of 41-50 years, with male predominance. Hypersplenism (28.75%), malaria (16.25%) and megaloblastic anemia (13.75%) were the three commonest causes in our hospital. In 13 cases of malaria, Plasmodium vivax (8 cases) was most commonly noted.

Conclusion: The present study concludes that varied causes of pancytopenia can be attributed to the geographic area, nutritional and drug intakes, personal habits, infective causes, stringency of diagnostic criteria, and differences in methodology used. Hence, a detailed clinical history and meticulous examination along with hematological investigations provide invaluable information in the complete workup of patients with pancytopenia for understanding the disease processes, planning further investigations and management, and ascertain the cause.

Portfolio assessment is increasingly used in competency-based health professions education. However, this method of assessment is not commonly used in Medical Laboratory Sciences. This study evaluated the adoption of portfolio assessment in medical laboratory sciences in Uganda. The objectives included to determine acceptance of portfolio assessment, if it promoted feedback, reflection, and student engagement. Eighteen final year students developed portfolios of learning during their clinical laboratory training. These were examined as part of exit examinations using a rubric that considered documentation, reflection, evaluation, presentation, and decision. The study used questionnaire to gather information about participants’ views of the process.  Results show that the participants received the process very well and that it encouraged feedback and students’ engagement. However, it should not be used as a sole method of assessment. The study concludes that assessment of learning portfolio is a valid method of determining professional growth and development in medical laboratory sciences.

Annotation: Many of clinical trials failed due to absence of needed per protocol recruitment of patients. Recruitment of patients in centralized trials is announcing by PI of clinical sites during the feasibility stage. This is subjective decision of investigator based on integral approach like experience, incidence of disease and many other parameters. The objective approach like calculation is apparently needed for calculation of proposed recruitment on the stage of feasibility.

Materials and Methods: retrospective analysis data of four clinical trials II-III phases, conducted since 2007 to 2017 years.

Study Objectives: to find out the approach for calculation of proposed by sites the recruitment on particular study on the satge of feasibility.

Statistical Analysis: data had been collected from feasibility questionnaires, open statistical sources.

Results: It was proposed the formula for calculation of proposed recruitment of patients on the stage of feasibility.

Discussion: Recruitment of patients might be calculated which will decrease the number of failed clinical trials. We called the calculation “Calculated proposed recruitment of patients” - CPRP».