Issues and Development in Health Research Vol. 7

Background: Musculoskeletal disorders (MSD) have become very common condition. Brick kiln workers are a profession which is not spare from MSDs. The workers in such industries have no knowledge of ergonomics and health problems which add on to the existing MSDs. The aim of this study is to present a summary review of the current state of knowledge about musculoskeletal disorders in brick kiln workers by searching the literatures using health care databases and reviewing them using critical appraisal tools.

Methodology: The literatures were searched using various search engines and databases. Search engines were used are Google Scholar, Pub Med, Science Direct and Databases are COCHRANE, CINHAL, MEDLINE, PEDRO etc. The Source of the data has been electronic sources (Databases, Electronic libraries, Electronic Journals, Google Scholar) and print sources (Journals, Textbooks, Hand searching, Follow-up reference).

Result: Articles were tabulated revealing their title, author, year, study design. A total of 150  papers and reports were identified from the database search. These papers underwent title and abstract screening. 57 had full text screening, of which 13 articles did not include information on the prevalence of musculoskeletal disorders in brick kiln workers and were therefore excluded. So, total 44 articles were included for the review.

Conclusion: Brick making is a multitask activities where specific workers are involved in specific processes. Not to forget that all the brick making manufacturing processes requires time and is a obvious to occur. Also, the workers in such industries are uneducated with almost no knowledge of ergonomics and health problems which add on to the existing MSDs. Use of proper equipment like wheel barrow, trolley etc., frequent breaks, proper ergonomic training and health education are must for them to avoid or reduce the risk of developing WMSDs in brick kiln workers.

The present chapter aimed at focusing on conceptual understanding and insight into the function of academic stress in association with psychological factors. The COVID-19 has further supplemented more academic stress on adolescents; parental pressure and their expectation which has led them to take radical steps like suicide attempt, committing suicide and majority of them are suffering with depression and anxiety. Various researches have supported the same and reported that alarming rate has been noted of the children who are unable to cope up with the stressors faced by them in academics and unable to fulfill the parental expectations. Also, the pandemic has become one of the precursors to the same by not providing the adolescents with enough space and cope up with the demands of school and parents. These issues require immediate attention and focus; hence the present chapter focuses on academic stress and coping mechanism among Adolescents during pandemic Covid-19 in Indian perspective. In order to overcome such venerable affects faced by the youth the possible measures and recommendation to provide the child with healthy and fruitful environment and for parents are suggested in the chapter.

Over the years, the Government of Uganda in collaboration with key stakeholders has initialed health policy reforms aimed at enhancing equity in health care. These including increasing access to health care, enhancing quality of care, efficiency in health care delivery and finally reduction in catastrophic health expenditures. The objective of the analysis was to synthesis the various health reforms that have been initiated and how they have affected health equity in the country. This report is based on a review of both published and unpublished reports from the government of Uganda, multilateral organizational reports including World Bank and World Health organization, commissioned studies by government and development partners. Notable findings include inequities due to limited supply of drugs and other pharmaceutical supplies, quality concerns and a lack of high impact interventions. Other findings include existence of cases of under-table payments, unsustainable out-of pocket payments which contribute towards high incidences of catastrophic health spending, dilapidated health infrastructure in many parts of the country, low morale among the health personnel, and low levels of spending by the government on health care. The reforms have however, contributed towards efficiency gains in terms of increased use of lower-level government facilities including health centers and concomitant reductions in the use of hospital services. The report recommends for increased investment in the health sector; systematic planning and implementation of policies by involving all key stakeholders; strengthening supply of essential medicines, rehabilitating of health infrastructure, provision of incentives to health personnel. Other recommendations include supporting the operations of community health insurance and other pre-payment schemes meant to caution the poor from health expenditure catastrophe. Similarly, political commitment in increasing government spending on health care in line with the Abuja Declaration of 2001 is recommended, while putting in place policies aimed at enhancing efficiency in health care delivery.

Non-communicable diseases can be recognized as fatal chronic diseases that ground for many side effects, complications, low quality of life, and silent deaths, for millions of people in the COVID-19 pandemic globally at present. Patients are required continuing care and awareness for a long time to maintain a better health condition and prevent complications in this COVID-19 pandemic environment to escape death. A patient with a low-quality lifestyle often receives such care of attention only at a medical clinic or a doctor's visit. However, the current quarantine curfew and the lockdown process in countries have made it very difficult to visit a medical clinic or a doctor. Hence, it is essential to identify alternatives for getting aware people of non-communicable diseases. This research study attempts to ascertain how people with non-communicable diseases can achieve a higher life expectancy escaping complications and deaths by controlling their blood sugar levels, cholesterol levels, high blood pressure, and BMI (Body Mass Index) in this COVID-19 outbreak. Here we conducted an at-home awareness program using popular social networking sites (SNS) WhatsApp and Facebook to improve the living conditions of patients suffering from non-communicable diseases to escape complications and deaths. The study was carried out on a group of 620 patients who registered in Rathnapura teaching hospital non-communicable disease clinic and 120 patients were selected randomly for the analysis. The majority of the patients' age is between 45 years and 65 years. Patients were divided into two groups randomly (60 per each); control and normal, and data were gathered. The independent t-test was used to test for differences between two groups, and a paired sample t-test was used to confirm the difference. Results revealed the positive impact of the at-home SNS awareness program on controlling LDL cholesterol, fasting blood sugar, and blood pressure (systolic and diastolic). Also, the factors have a strong relationship with the SNS awareness program. However, there is no impact on the BMI factor from the program. The SNS awareness program and the number of referring times of SNS impact significantly controlling the levels of LDL cholesterol, fasting blood sugar, and blood pressure. This would be better to explain to improve the quality of life of patients suffering from non-communicable diseases in this COVID-19 pandemic environment to escape complications and deaths. Future research directions should look at why the at-home SNS awareness program does not affect BMI well-being, which is another important factor in maintaining a high level of life expectancy in those patients.

Objectives: The objectives of this article are to highlight the importance of clinicopathological correlation in the diagnosis of a rare non-functional adrenal tumour in HIV patient with Pseudo-Cushing’s syndrome.

The presence of cortisol excess in the background of adrenal neoplasm indicated a radiological diagnosis of adrenocortical carcinoma. However, the histology showed an oncocytic tumour of uncertain malignant potential and high cortisol levels in blood, which remained elevated even after removal of the tumour. Ideally, these tumours are non-functional and are not related with increase in cortisol levels. But the histological diagnoses were not correlating with the biochemical findings.  After thorough search through previous medical history, it was found that the patient was a known HIV case on antiretroviral therapy. Finally, keeping everything in perspective, it was concluded that the hypercortisolemia was related to antiretroviral drug therapy and the tumour per se was a rare incidental, non-functional tumour.

The take home message was therefore, without proper clinical knowledge of drug therapy and HIV status of the patient, the diagnosis of a non-functional adrenal tumour in the presence of features of hypercortisolemia would have been questionable.

Introduction: We present a 70year old, HIV positive gentleman with a non-functional oncocytic adrenal neoplasm of uncertain malignant potential showing manifestation of Pseudo-Cushing’s syndrome.

Methods: Most of the data were collected from institutional clinical reports and radiological findings. These were compiled and compared with previous case reports on adrenal manifestations in HIV patients.

Results: It was found that HIV patients show varied endocrine manifestations ranging from adrenal, testicular, pituitary, pancreatic and thyroid abnormalities. The adrenal disorders mainly include adrenal insufficiency due to opportunistic infections or by tumours such as Kaposi’s sarcoma or Non-Hodgkin’s lymphoma (NHL).

Incidental adrenal oncocytic neoplasm of borderline malignant potential has not been reported till date in HIV patients.

Conclusion: A very rare tumour seen in HIV patient presenting with Pseudo-Cushing’s syndrome.

This study examines the factors associated with computer use for the self-management of health among individuals diagnosed with chronic diseases in Israel. We distinguish between (a) access to online health information and (b) use of online health services. A geographic representative sample comprising 2008 individuals was contacted. 1406 individuals (67.6%) reported using the computer for health concerns. We seek to show how the digital health information and services among individuals reporting a chronic condition (heart, cancer, diabetes and hypertension) use digital sources to manage their chronic condition (N=225). Our objective is to (a) highlight the extent the self-management among chronically ill is frequent (b) assess that use of online services is not necessarily related to the use of online health information and (c) explore the factors associated with the differential use of online health information and online health services.

Using a series of logit regression models it is shown that chronic disease increases access to online health information but its effect of use of online health services is specific to (a) type of chronic disease, i.e., heart condition and (b) type of provided service, i.e., medical updates. These results indicate that while computer use increases the odds for higher empowerment this may not necessarily lead to higher use of online health services provided by the healthcare provider among individuals diagnosed with chronic disease decreasing the likelihood for better self-management. Implications for health policy are discussed

Q fever is an infectious disease caused by Coxiella burnetii which is an obligatory intracellular parasite. Globally Q fever is a widespread zoonosis. It is characterized by headaches, sudden fever and atypical pneumonia. In the rural environment, the main reservoir includes goats, sheep, cows, dogs, cats and rabbits. The main reservoir of this bacteria is considered domestic animals. They produce in a large number in amniotic fluid and placenta during childbirth. The main route of infection is inhalation. Q fever can cause both acute and chronic infection, mostly asymptomatic in humans and animals. Inactivated whole-cell bacteria vaccination strategy has been performed which provides effective outcomes in humans and animals but many side effects have been observed. The recombinant vaccine has been developed and provides many effective results in experimental conditions. One of the major challenges is the lack of accurate diagnosis facilities if it becomes possible, the prognosis of disease development can be reduced. Direct detection of bacteria is the accurate test for the diagnosis. Different procedures are involved in this method such as immunodetection, PCR amplification and shell vial cell culture. Due to the severe infectivity of C. burnetii all these procedures require a biosafety level 3 lab and qualified staff. Q fever is a challenging disease for scientists to reduce its burden globally. The prevalence of Q fever can have a significant economic impact on animal trade, reproduction and the commercialization of different animal products. The review discloses the Coxiella burnetii genome, the clinical manifestation of Q fever as well as emerging issues, diagnosis, treatment, prevention and future directions.

Economic insecurity, lack of career possibilities, social rejection, and gender-based violence and abuse are all issues that male to female transgender people face. As a result, they are at risk of becoming one of the groups afflicted by the HIV epidemic. Due to lack of education and employment, they are forced to engage in sex work, with research indicating that 90% of Male to Female Transgender in India engage in sex work, making them exposed to HIV infection. This necessitated a thorough examination of condom usage patterns as well as the factors that influence condom use.

Objectives: Study the condom usage patter among the respondents and also the various factors that determine their condom usage.

Methodology: In June 2016, 784 Male to Female Transgender enrolled in the CBO - Thozhi, 275 in Transgender Rights Association (TRA) and 282 in Tamil Nadu Aravanigal Association (THAA).  A total of 299 people were included in the study. In depth interviews (9) and three focus group discussions (6 respondents in each group) were done as part of a mixed method study to obtain qualitative data.

Finding: One fourth (25%) of the respondents lived alone, while nearly one-fifth (18%) of the respondents lived with their male sex partners. Sex work was the primary occupation of more than a quarter (28%) of those surveyed, while it was the secondary occupation of a third (34%) of those surveyed. Only 40% of the 120 people who worked in the sex industry used condoms on a regular basis, and only 40% of the 134 people who had permanent male partners used condoms on a regular basis. Need for more money (69 percent), alcohol influence (63 percent), refusal to use by law enforcement and anti-socialists (24 percent), for sexual pleasure (74 percent), and with attractive clients (54 percent). For respondents who had permanent partners, love/scared of getting disserted/inability to use with husband was some of the responses expressed by the respondents.

In this paper, a number of outdated but still prevailing medical doctrines are critically reviewed, in particular, Hippocrates’s hypothesis of the brain as a repository of all mental processes; I.M. Sechenov’s hypothesis of the psyche as a derivate of the brain reflexes; I.P. Pavlov’s hypothesis of the higher nervous activity as an equivalent of the psyche. Currently, therapy of mental disorders is conducted mostly by means of psychopharmacology, which targets the exchange of neurotransmitters in the synaptic cleft and thus is supposed to influence the psyche. In his research, the author refers to studies of feral children, studies of memory and subliminal perception, discovery of mirror neurons and contemporary views of the academic science on information. The author proves the non-materiality of the psyche and the role of the brain as a biological interface between the ideal and the real. The new approach would require changing the traditional paradigm as well as all our approaches to studying the psyche and treating mental disorders. What remains to be said is of so novel and unheard of a character that I not only fear injury to myself from the envy of a few, but I tremble lest I have mankind at large for my enemies, so much to wont and custom that become as another nature, and doctrine once sown that hath struck deep root, and respect for antiquity, influence all men. William Harvey. In “On the Motion of the Heart and Blood” (1628).

Indians have higher homocysteine (Hcy) levels than westerners. Hyperhomocysteinemia (HHcy) is a distinct, strong, graded, and easily quantifiable early risk factor for stroke, MI, and other vascular diseases. It could be caused by a vitamin deficiency or a hereditary abnormality. The majority of vegetarian Indians have low amounts of Vitamin B12, Vitamin B6, and folic acid, all of which are necessary for methionine metabolism. Epidemiological studies have discovered a dose-dependent link between modest to moderate increases in plasma Hcy and the risk of neurodegenerative disorders. Hcy is a neurotoxic agent that acts as a surrogate marker for vitamin deficiency. Very high Hcy concentration in patients leads to high incidence of atherosclerotic events.  Hyperhomocysteinemia is a prevalent condition among the elderly. Hcy levels are higher in patients with neurologic disorders, according to the findings of this study. Hcy levels are statistically significant in both male and female individuals. Male individuals with neurological diseases have greater Hcy levels. In hyperhomocystemic high-risk patients, the availability of vitamin-fortified foods, particularly cereals, will help to prevent or delay the onset of age-related neurological problems.

The new RN residency program provides transitional experiences to integrate nursing knowledge, skills, and attitudes of newly graduated nurses before they assume the professional nurses’ roles. It also benefits students by improving clinical competence, confidence, and socialization skills. The study examined the levels of perceived clinical competency, confidence, and professional role development skills of 115 culturally diverse novice nurses enrolled in 12-15 weeks of a collaborative RN residency program at a state-funded California university during academic years 2009-2014. Descriptive pre-and post-program measures study assessed core competency and confidence of participants before and after the residency program using three instruments; a modified quality and safety education for nurses (QSEN) competency questionnaire, Preceptorship Experience Questionnaire, and Graduate Nurse Survey. Results show that, compared to the pre-program sum, participants report to perceive the significantly higher levels of the post-program sum of competency skills in applying QSEN concepts and nursing process cycles that include assessment, planning, implementation, and evaluation as well as professional role development. Interestingly, participants report feeling it is very important to develop a trusting relationship with their preceptor and a positive relationship with staff nurses. Participants also report perceiving a higher level of confidence in carrying out nursing care at the end of the program. Findings suggest that newly graduated nurses perceive the increased levels of clinical competency and confidence in their self-administered report after participating in the RN residency program.

Aims: To compare the signs and symptoms in COVID-19 and another respiratory virus, among children.

Introduction: Coronaviruses belong to the Coronaviridae family in the Nidovirales order. This virus grew more in human airway epithelial cells than tissue culture cells, suggesting the potential for increased infectivity.

Study Design: A cross-sectional study was designed based on data from the National

Epidemiological Surveillance System of the General Directorate of Epidemiology. Place and Duration of Study: All registries in database of confirmed and discarded cases of COVID-19 from Guanajuato State, Mexico in the period March-July 2020.

Methodology: A confirmed case was one with clinical data mainly fever, cough and dyspnea, who had traveled to a country affected by the pandemic or had had contact with a confirmed case, and a positive rRT-PCR test for SARS -CoV-2. The cases discarded were those with the negative rRT-PCR test. The presence of clinical data among those under 18 years of age, of confirmed and discarded cases in the state of Guanajuato, was compared with Z for two proportions and P-value.

Results: The sample included 446 confirmed cases and 2,134 discarded cases. The average age of those confirmed was 9.60 /(/pm/) 5.46 years and 8.01 /(/pm/) 5.39 years, among those discarded (P <.05). In both groups, male predominated (P = .91). Fever, myalgia, arthralgia, and conjunctivitis show statistically significant differences between confirmed and discarded cases (P < .05).

Conclusion: There are not differences in signs and symptoms in COVID-19 and another respiratory virus. It is concluded that since the characteristics of COVID-19 are like the ones of other viral infections, the diagnosis cannot be made merely based on signs and symptoms.

Nowadays, the health industry is one of the largest industries in the world which includes more than 10% of gross domestic product in developed countries. Health industry consists of patient information management subsets, pharmaceutical and biomedical research, prescription and drug use management, medical records and test results, telemedicine, claim and payment of health insurance, supply chain management agent set, production, marketing, distribution, Sales, communication with stakeholders, internal and external commerce, monitoring and tracking of health-oriented products, especially human medicine. The many challenges that disrupt the effective processes in healthcare operational cycles have been identified and analyzed in this paper, to identify the impact of applying emerging blockchain technology solutions and their benefits, especially in health-centric businesses. Increasing growth of information technology, information science and its applications, especially the emergence and penetration of blockchain technology, not only have benefits for production, sales, support and supervision of health-oriented products, especially human-based medicines, but also can transform information and communication infrastructures, blockchain-based systems, capabilities, accuracy, speed and trust in health industry systems and in the supply of raw materials and requirements, marketing , sales, customer relationship management, Standards, Requirements and Supervisory Levels Drugs in organizations, companies and individuals involved in this industry with creating new business models, the annoying challenges will be fixed  then  the  health industry of the world will transform.

Research Methodology: By conducting open interviews with health industry experts, the process of identifying and determining independent and dependent variables, a questionnaire was designed based on the objectives and hypotheses of the research and then the validity and reliability of the questionnaire by surveying experts and pre-test, case was reviewed and approved. The results were analyzed and interpreted by distributing, completing and collecting questionnaires and performing statistical analysis on the data using SPSS 26.

Findings and Conclusions: Applying solutions based on blockchain technology and Utilizating its benefits for the components of the health industry, including a system for tracking, tracking and controlling the authenticity of health-oriented goods, electronic health record system and competitiveness in international and global trade, is a necessary, meaningful and With a positive effect.