Profile and Predictors of Maternal Quality of Life During Physiological Pregnancy: A Cross-Sectional Analysis

BackgroundQuality of Life (QoL) and its determinants are significant in all stages of life, including pregnancy. The physical and emotional changes during pregnancy affect the QoL of pregnant women, affecting both maternal and infant health. Hence, assessing the QoL of pregnant women is gaining interest in literature. We, therefore, aimed to describe the QoL of pregnant women during physiological pregnancy and to identify its associated predictors in women attending a public healthcare institute of Quetta city, Pakistan.MethodsA cross-sectional study was conducted at the Obstetrics and Gynecology Department of Sandeman Provincial Hospital Quetta city, Pakistan. The respondents were asked to answer the Urdu (lingua franca of Pakistan) version of the Quality of Life Questionnaire for Physiological Pregnancy. Data were coded and analyzed by SPPS v 21. The Kolmogorov–Smirnov test was used to establish normality of the data and non-parametric tests were used accordingly. Quality of Life was assessed as proposed by the developers. The Chi-square test was used to identify significant associations and linear regression was used to identify the predictors of QoL. For all analyses, p < 0.05 was taken significantly.ResultsFour hundred and three pregnant women participated in the study with a response rate of 98%. The mean QoL score was 19.85 ± 4.89 indicating very good QoL in the current cohort. The Chi-Square analysis reported a significant association between age, education, occupation, income, marital status, and trimester. Education was reported as a positive predictor for QoL (p = 0.006, β = 2.157). On the other hand, trimester was reported as a negative predictor of QoL (p = 0.013, β = −1.123).ConclusionImproving the QoL among pregnant women requires better identification of their difficulties and guidance. The current study highlighted educational status and trimester as the predictors of QoL in pregnant women. Health care professionals and policymakers should consider the identified factors while designing therapeutic plans and interventions for pregnant women.

Knowledge, attitude and practices of residences toward antimicrobial usage and resistance in Gondar, Northwest Ethiopia

Background Antimicrobials are essential for human and animal health. Drug resistance to an antimicrobial agent follows the introduction of a new antimicrobial agent. Evidence suggests that the public plays an important role in the risk, increase, and spread of antimicrobial resistance. The purpose of this study was to assess the knowledge, attitudes, and practices of the Gondar city residences regarding antimicrobial use and resistance. Methods A cross-sectional study was conducted from April to July 2021 on 400 randomly selected Gondar city residents using a pretested semi-structured questionnaire. The descriptive and Chi-square tests were used to analyse the data. Results The response rate was one hundred percent. Approximately 75% of respondents were men, with 32% having completed secondary school. Nearly 74% and 35% of participants were married and worked in various government jobs, respectively. Furthermore, 48%, 54%, and 50% of respondents, respectively, had moderate knowledge, a positive attitude, and good practice concerning antimicrobial use and resistance. The chi-square analysis revealed a significant (p < 0.05) disparity between knowledge and educational level, marital status, and position in the house. The respondents' attitude level was also significantly associated (p < 0.05) with their educational level, marital status, occupation, and position in the house. Respondents' practice level was also significantly associated (p 0.05) with their educational level and occupation. The study also found a significant relationship between respondents' knowledge and attitude (χ2 = 215.23, p ≤ 0.001), knowledge and practice (χ2 = 147.2, p ≤ 0.001), and attitude and practice (χ2 = 116.03, p ≤ 0.001). Conclusion This study found that study participants had some misconceptions about antimicrobial use and resistance. As a result, enforcing antimicrobial regulation and educating people about antimicrobial use are both recommended.

Epidemiologic Disparities in Colon Cancer Screening and Adherence during the COVID-19 Pandemic: A Retrospective Cohort Analysis

Background: Colorectal cancer (CRC) is the second-leading cause of death in the US. Despite the National Colorectal Roundtable goal of achieving 80% adherence, CRC screening remains underutilized, especially in the underinsured populations. Screening programs have been heavily disrupted during the COVID-19 pandemic. Aim: This research was performed to explore the impact of the pandemic on the existing ethnic and gender disparities prevalent in CRC screening. Methods: Patients were identified 1 year before and after COVID-19 precautions began, using March 1, 2020, as the inflection point. For each year, the primary inclusion criterion was an ordered colonoscopy. The outcome of interest was a colonoscopy performed. Differences by year and race were assessed using Chi-square analysis. A cohort of 1413 patients between age 45 and 75 for whom a colonoscopy was ordered was selected from EHR at a single large institution. 897 patients were in the pre-COVID group, and 516 were in the post-COVID group. Results: There was a 51% reduction in screening colonoscopies performed. White patients had a decrease of 49%, and African Americans had a 55% reduction. Stool testing increased from 47% prior to the pandemic to 94% during the pandemic representing a greater than 100% increase in stool testing uptake. Conclusion: The true impact of COVID-19 on colorectal cancer is yet to be uncovered as future mortality estimates from CRC are ongoing. Due to the widespread closure of endoscopy centers and delay in screening, we believe that the pandemic worsened the screening disparities most prevalent among minority populations. Our retrospective analysis over the last two years points to the drastic reduction of screening for all races, and especially for African Americans. As life gradually returns to normal, it would be interesting to see how the past year has impacted the incidence and prevalence of CRC.

Assessing Sexual Behavior Patterns among Student Athletes of Senior High Schools in the Upper East Region, Ghana

The purpose of this study was to investigate the sexual behavior patterns of student athletes of senior high schools in the Upper East Region of Ghana and to assess the differences in sexual behavior patterns between male and females. A sample of 400 student athletes using a convenience sampling technique from public senior high schools was drawn to complete a self-designed research study. Descriptive statistics and the Chi-square test tool were used to analyze the collected data. The results showed that student athletes practiced various forms of sexual behaviors such as celibacy, foreplay, vaginal-penile sex, sexual fantasy, masturbation, oral sex, and anal sex. The Chi-square analysis showed significant gender differences in prevalence of masturbation (χ2 (1, n = 400) = 4.6962, probability = 0.030) and sexual fantasy (χ2 (1, n = 400) = 6.8477, probability = 0.009), but not vaginal-penile intercourse (χ2 (1, n = 400) = 1.3197, probability = 0.251) and celibacy (χ2, (1, n = 400) = 0.0721, probability = 0.788). The study concludes that student athletes of senior high schools might be vulnerable to unplanned parenthood and are at risk of STIs, including HIV. Regular health promotion campaigns on sexual risk-taking behaviors are required to help reduce the prevalence of student athletes’ indulgence in risky sexual behavior patterns that can harm their health. It is essential to implement gender-specific interventions (e.g., decision-making skills) when addressing the problems of sexual behaviors among the student athletes in the region.

Assessment of Biochemical Changes Among Covid-19 Cases in a Tertiary Hospital of Bangladesh During Early Pandemic

Background: Corona virus disease 2019 (COVID-19) involves various organs of the body causing several biochemical changes which plays an essential role in estimating the patients’ condition and prognosis, directing treatment, and even evaluating the curative effects. The present study aimed to assess the biochemical changes among the COVID-19 patients during early pandemic. Methods: This cross sectional study was conducted at Combined Military Hospital (CMH) Dhaka among purposively selected 237 confirm COVID-19 cases. Data were collected through face to face interview and review of medical records using a pre-tested semi-structured questionnaire. The study was conducted in the Combined Military Hospital Dhaka from 15 April 2020 to 31 May 2020 Results: Highest number of the respondents were in the age group of 31-40 years (37.1%) with male predominance (83.1%). About 95.6% were Muslim and 58.6% were educated up to secondary level. About 87.8% had contact with a confirmed case and having 47.7%, 37.2%, 15.1% cardiovascular, endocrine and respiratory comorbidities respectively. Fever (34.6%) was the most common presenting symptoms followed by cough (22.9%), sore throat (10.6%). Neutrophilia observed in 26.16%, lymphopenia in 20.7%, thrombocytopenia in 14.3% cases, 30.0% with positive D-dimer test, 22.4% either sepsis or systemic infection in procalcitonin estimation, 28.3% with increased ferritin, 28.7% with positive C reactive protein, 21.1% with increased LDH. Chi-square analysis revealed a statistically significant association between cardiovascular and endocrine diseases with several biochemical changes (p<0.05). Conclusion: Early identification of various biochemical changes would help the physician for appropriate assessment and management. JOPSOM 2021; 40(1): 34-42

Food Insecurity: Child Care Programs’ Perspectives

Background Households experiencing "food insecurity" have limited access to food due to a lack of money or resources. Poor nutrition, from food insecurity, can impact physical and cognitive development of children. Study objectives were to document the prevalence of Tennessee child care programs screening for food insecurity, explore differences between programs receiving child and adult care food program (CACFP) funding and those screening for food insecurity, and understand possible burdens food insecurity places on child care families as perceived by child care program directors. Methods In this cross-sectional study of licensed Tennessee child care programs, a 10-question survey and four-question follow-up survey were electronically distributed. Analysis included descriptive statistics, a chi-square of programs receiving CACFP funds and screening for food insecurity, and themes analysis of open-ended responses. Results The average child care program enrollment (N = 272) was 80.16 with programs serving mostly preschoolers (98.53%) and toddlers (91.91%). Over half (56.99%) of programs reported they received CACFP funding, yet only 9.19% screen for food insecurity. Chi-square analysis found that programs receiving CACFP funds differ significantly on whether they screen households for food insecurity $$\chi$$ χ 2 (1, n = 237) = 16.93, p ≤ 0.001. Themes analysis (n = 41) revealed that many child care program directors do not view food insecurity as a burden for families. Conclusions Child care programs receiving CACFP funds are more likely to screen families for food insecurity than programs who do not. Programs indicate a willingness to include food insecurity screening questions on child care paperwork.

Correlation of SOFA Score and Hormone Value for Predicting 28-days Mortality for Septic Patients

Introduction. Sepsis is a group of symptoms of organ dysfunction that can be life-threatening because of dysregulation of body response toward ongoing infection. Organ dysfunction in sepsis can be measured by Sequential Organ Failure Assessment (SOFA) and T3 hormone. The study was aimed to identify the correlation of T3 in predicting mortality of 28 days patients in Intensive Care Unit RSMH Palembang. Method. This study design is cohort prospective. The inclusion criteria consist of a patient diagnosed with sepsis and septic shock in the Intensive Care Unit, 18-64 years old. Patients with a history of thyroid disease, pregnant or post-pregnancy, the patient admitted in referral from other hospitals, and patients with a history of psychiatry medication and thyroid medication were excluded. Data collected is the patient whose stay in Intensive Care Unit RSMH followed in 28 days from January 2021 until the sample was fulfilled (39 samples). Analyzing data was SPSS version 23 with chi-square analysis and Fisher's Exact to identify the relationship. Pearson correlation to identify correlation coefficient, and Medical application to measure AUC, cutoff value, sensitivity, and specificity. Result. The result showed that age (p=0,445). gender (p=1,00), need of ICU (p=0,228), isolation-nonisolation ward (p=0,437) didn't have any significant relationship toward mortality. SOFA score correlate statistically with positive correlation and medium strength (0,633) toward mortality of sepsis patient (p=0,000). T3 hormon correlate positively with medium strength (0,514) toward mortality of sepsis patient (p=0,001). T3 hormone toward SOFA correlate negatively (-0,365) with significant correlation (p=0,22). T3 hormone has AUC 0,291 with sensitivity 3,3% and specificity 67,7%. Conclusion. T3 hormone has a significant negative correlation to mortality in sepsis patients but cannot be used to predict mortality with a low AUC value (0,291).

Positive Cumulative Fluids Balance Related to Mortality Events in Sepsis Patients Treated at Intensive Care Unit, Dr. Mohammad Hoesin General Hospital Palembang

Introduction. Sepsis is a syndrome that describes physiological dysfunction, pathological, and biochemistry caused by infection. Fluid balance is an indicator that can monitor input and output. This study was aimed to evaluate the relationship between positive cumulative fluid balance and the mortality rate of sepsis patients treated in the intensive care unit. Method: This study design is a retrospective study. The inclusion criteria consist of patients diagnosed with sepsis written in the medical record, 18-65 years old, and patients admitted in intensive care unit dr Moh. Hoesin General Hospital. Data were analyzed using SPSS 22.0 with the normality of data distribution, independent sample t-test, Mann-Whitney analysis, chi-square, Fisher’s Exact to measure the relationship, and using Medcalc version 14 application to measure cut-off value, ROC curve AUC, cross-sectional point, sensitivity, and specificity. Result. The result showed that characteristic between age (p=0,491), gender (p=0,703) did not differ significantly between survived and non-survived patient. Length of stay (p=0,002), balance (p=0,000), and ward unit (p=0,014) has a significant different between survived and non survived patient. In chi square analysis, p value=0,000with odds ratio 7,083. Cut-off value of ROC curve is -97 mL with AUC 0,844, sensitivity 76,1% and specificity 79,3%. Conclusion. Cumulative positive balance patient in the sepsis patient correlates with increased mortality in a sepsis patient in Dr. Mohammad Hoesin General Hospital Palembang.

Is mother’s financial autonomy associated with stunting among children aged 7–35 months: An empirical study from India

Stunting depicts chronic deprivation and is a huge public health problem in several developing countries. Considering the sociocultural and sociodemographic factors of India, we aimed to examine the relationship between maternal autonomy and stunting among children <35 months. We have used the data from the latest round of National Family health survey conducted in 2015–16. The main exposure variable was women’s autonomy which are represented in our study by the four dimensions- decision-making, physical mobility, financial autonomy, attitudes towards domestic violence, the main predictor variable was stunting among children. Chi-square analysis, univariate and multivariable binary logistic regression analysis were performed to find the association of childhood stunting and women’s autonomy. The results were reported at 5% level of significance. All the autonomy variables have shown a significant association with child stunting at 5% level of significance. The unadjusted odds of stunting were found to be significant with respect to all the four dimensions of autonomy variables except physical autonomy. However, after adjusting for other explanatory factors attenuated these relationships and made them statistically insignificant except for women’s economic autonomy (AOR = 0.91; 95% C.I.-(0.85, 0.98)) which was found to be significantly affecting the child’s status of stunting. Our study reinforces that maternal autonomy is a significant predictor of childhood stunting. Hence, we recommend that policy makers, while designing interventions and policies, must address the socioeconomic inequalities at the community level while devising ways to improve women’s empowerment. As it has far-reaching consequences on the nutrition status of the upcoming generations.

Analysis the agronomic character and inheritance of fragrant genes in F2 progenies of Sigupai and Yinzhan

Sigupai is one of Aceh’s local rice that highly popular because of the distinctive scent. Sigupai is still widely grown by the farmers in the southern western region of Aceh. However, this local rice has inferior production, height plant architecture, deep age and the average of production about 4 tons ha-1. The improvement of Sigupai local rice from the agronomic character and the harvest age can be done through crosses with Yinzhan varieties that carry sd-1 genes. The study aims to analyze changes in agronomic character and fragrant gene inheritance in Sigupai/Yinzhan F2 derived. Analysis of agronomic character is carried out by observing harvest age, plant height, weight of 1000 grains, grain weight per clump and yield potential per hectare. The planting material used was F2 derivative of Sigupai/Yinzhan as many as 104 individuals planted in pots. PCR analysis was conducted to analyze the presence of fragrant genes in F2 progenies of Sg/Yz. The data was analyzed with Chi-Square analysis. The results showed 104 plant genotypes analyzed by PCR, 64.42% of F2 progenies Sigupai/Yinzhan inherited the fragrant gene. The results of analysis of agronomic character showed 62 genotypes there were 95.08% of ripening aged, 59.01% had a short stem architecture and 6 genotypes (9.83%) had a potential yield of 4,04,-5,33 tons ha-1.