Epi Info Statistical Software Research Articles

Breastfeeding Practices among Lactating Mothers in a City of South India

Introduction: Breast feeding is the first fundamental right of the child. It provides a unique biological andemotional basis for the health and development of the children. The world health organization recommends that breastfeeding be initiated within one hour of birth. Early initiation of breastfeeding provides benefits for both mother and the baby.Objectives: To assess the knowledge and attitude and practices about breast-feeding and complimentary feeding practices among lactating mothers attending Outpatient department (OPD) of tertiary care centre in a city of South India.Materials and Methods: It was a cross-sectional observational study done amongst post-natal mothers attending OPD in Sri Siddhartha Medical College, Tumkur between October to November 2022. Data collected was entered on Microsoft Excel spread sheet. Descriptive statistics and Chi –square test as test of significance were used. P value less than 0.05 was taken as statistically significant. Statistical software Epi Info software version 7.2.5 was used for the statistical analysis.Results: Data was collected from 104 post-natal mothers attending the OPD. All of them knew about importance of exclusive breast-feeding, colostrum feeding (100%). 99% of them knew breast feeding improves immunity. 95 (91%) of the participants were willing to continue breastfeeding up to two years and beyond. Only 16 (15.4%) mothers fed the baby on demand, others followed scheduled feeding like once in 1-2 hours, once in 2 to 3 hours.In our study 78.8% women started complimentary feeding at 6 months.Conclusion: Healthy breastfeeding practices have significant effect on mothers and infants. The breastfeeding knowledge and positive practices are optimal among mothers. Focused breastfeeding counselling and advice by the health workers with emphasis on correct technique can improve the positive breastfeeding practices.

Presence of Pathogenic Enterobacteriaceae on Fingertips of Food Handlers

Abstract Introduction: Food handlers who prepare or handle food and utensils used to prepare or transport food can contaminate food directly or indirectly. Indirect transmission is generally caused by contamination of the fingers of the food handlers. Compared to other parts of the hand, the parts beneath the fingernails, which are the nail beds, can act as vectors that spread microorganisms through cross-contamination. Objectives: The objectives of this study are to determine the hygienic status and transport of pathogenic Enterobacteriaceae at the fingertips of food handlers, a study was carried out. Methodology: A community-wide cross-sectional study was conducted, considering 50 participants from the medical college; the swabs were taken from the nail beds and fingertips to the laboratory to inoculate over the selective medium, i.e., MacConkey agar and XLD agar. The data were analyzed using Epi Info statistical software. Results: Fifty participants were tested for the presence of pathogenic Enterobacteriaceae on both hands, of which only 11 (22%) participants tested negative for Enterobacteriaceae growth on either of their hands. Of 50, 30 participants had their nails properly trimmed and 31 participants said they would not work if they got sick. Conclusions: There is a need to educate food handlers about their hygiene and the effect of their hygiene on the possibility of contamination of food. Management must take active steps to minimize the possibility of food contamination.

A Study of Association of Serological Markers and Platelet count in Dengue Patients in GHMC limits, Hyderabad, Telangana

Introduction: Acute viral infections like Dengue which can result in Dengue Hemorrhagic fever (DHF) & DengueShock Syndrome (DSS) are potentially lethal. The measurement of released NS1 protein, IgM & IgG is a noveltechnique for identifying acute dengue infection. Platelet count is the only Non-dengue parameter that can supportthe diagnosis of DHF& DSS.1AIM: This study was done to evaluate the association of Platelet count and Dengue parameters singly positive andwhen combined positive.Materials and Methods: This was a Cross- Sectional prospective study conducted at Departments of Microbiology &Pathology at Telangana Diagnostics, Hyderabad which is a NABL accredited Central Laboratory run by Governmentof Telangana from Febraury 2022 to January 2023.All clinically suspected cases of Dengue reported in Outpatientdepartments of Primary Health Centers (PHCs), Community Health Centers (CHCs), Area Hospitals & DistrictHospital, Under GHMC limits Hyderabad were included in the study from February 2022 to January 2023Results: Out of 1100 samples received from clinically suspected cases of Dengue, 516 (46.9%) samples werepositive for Dengue, and out which 109 (21.12%) cases showed platelet count below 1.5 lakhs/cumm. Denguecases with positive NS1 and IgM were consistently associated with Thrombocytopenia in comparison with otherserological parameters. The Chi-Square test and statistical software Epi info and MS Excel was used to find out thestatistical significance.Conclusion: Detection of dengue specific serological parameters along with platelet count in diagnosis of Denguehelps in early diagnosis and prevent complications like Dengue Hemorrhagic fever & Dengue shock syndromethere by reducing mortality and morbidity.

Electrophoretic Pattern of Serum Proteins in Pregnancy: A Cross-sectional Study

Introduction: Nutritional status during pregnancy is a determining factor for maternal and neonatal health outcomes. Protein is an essential nutrient for foetal development. If pregnancy is associated with an improper diet leading to protein deficiency, the prospects for maternal and foetal outcomes may be catastrophic. An electrophoretic study of serum protein patterns in pregnancy can help identify pregnancy-specific protein markers and facilitate the monitoring of feto-maternal health. Aim: The aim of this study is to assess serum protein levels and their fractions (albumin, alpha-1 globulin, alpha-2 globulin, beta globulin, and gamma globulin) using gel electrophoresis in healthy pregnant women attending an antenatal clinic. Materials and Methods: This cross-sectional study was conducted in the Department of Medical Biochemistry in collaboration with the Department of Obstetrics and Gynecology at Sultania Zanana Hospital, associated with Gandhi Medical College, Bhopal, Madhya Pradesh, India, between January 2021 and February 2021. Fifty normal non-pregnant women of childbearing age and 50 normal pregnant women in the first trimester of pregnancy attending an antenatal clinic were enrolled and followed-up through the second and third trimesters for investigations. Serum total protein, albumin, and globulin levels were estimated using a fully automated chemistry analyser, and the electrophoretic patterns of serum protein fractions were analysed using an automated gel electrophoresis apparatus. EpiInfo statistical software was used for the statistical analysis of data, with p<0.05 considered the statistical significance level. Results: The serum total protein level in non-pregnant women was 6.36±0.40 g/dL, while in pregnant women, it was 8.01±0.40 g/dL, 8.00±0.42 g/dL, and 6.36±0.43 g/dL in the first (T1), second (T2), and third (T3) trimesters, respectively. The serum albumin level was 3.90±0.30 g/dL in non-pregnant women, while in pregnant women it was 4.24±0.38 g/dL, 4.58±0.34 g/dL, and 3.87±0.36 g/dL in T1, T2, and T3, respectively. The globulin level in non-pregnant women was 2.46±0.28 g/dL, while in T1, T2, and T3 it was 3.86±0.22 g/dL, 3.42±0.20 g/dL, and 2.49±0.24 g/dL, respectively. A significant difference was found among the groups for serum total protein, serum albumin, and serum globulin. In non-pregnant women, the protein fractions- albumin, alpha-1 globulin, alpha-2 globulin, beta globulin, and gamma globulindid not show any deviation from normal levels. However, there was a decrease in albumin and beta globulin levels, along with an increase in alpha-2 globulin levels in the first trimester. An increase in beta globulin and a decrease in gamma globulin levels were observed in the second trimester. In the third trimester, all these fractions did not show any significant alterations, except for gamma globulin. Conclusion: Serum total protein, serum albumin, and serum globulin levels showed a significant difference. However, a slight increase in serum globulin levels compensated for the fall in albumin levels during pregnancy. Variations in the levels of beta globulin, alpha-2 globulin, and gamma globulin were observed during pregnancy, while, on the other hand, alpha-1 globulin did not show any alterations in pregnant women during the first, second, and third trimesters, although its level was higher in pregnant women compared to non-pregnant women.

Randomized controlled trial comparing the effectiveness of tamsulosin, tamsulosin with tolterodine and double J stent position in controlling stent related symptoms after ureteroscopic lithotripsy

Background: Objective of the study was to determine the effect of stent position and medications in preventing stent-related symptoms. Methods: This was a prospective study conducted at Meenakshi Mission Hospital and Research Centre Madurai, Tamil Nadu, India. 150 patients who underwent ureteroscopic lithotripsy with indwelling stent were distributed into three groups. On demand analgesics were given to group 1 (n=50), Tamsulosin 0.4 mg daily for group 2 (n=50) and tamsulosin 0.4 mg and tolterodine 4 mg daily for group 3 (n=50). The patients were also subclassified into appropriate or inappropriate group according to stent position. All patients completed various domains of Ureteral stent symptom questionnaire (USSQ) on 1st and 7th postoperative days. Appropriate tests statistics were performed using EPI-Info statistical software package. Results: In control group, patients with appropriate stent position had significantly lower symptom scores than those with inappropriate stent position (p value~0.0001) in all domains of USSQ except global quality of life score (p value=0.08). Addition of tamsulosin 0.4 mg (group 2) had superadded beneficial effect in appropriate position group, but not in patients with inappropriately positioned stents. Patients taking both tamsulosin 0.4 mg and tolterodine 4 mg (group 3) had no significant improvement in symptom scores in appropriate position group (all domains of USSQ) and inappropriate position group (most domains). Conclusions: Appropriate stent position is the most important independent factor than medications in preventing stent related symptoms; tamsulosin has superadded benefit in patients with correctly positioned stents.

Persistent symptoms and functional health status among Covid-19 patients after discharge from a Covid hospital

Background: After recovery from acute Covid infection, many patients are found to be experiencing persistent symptoms. Objectives: To find out the proportion of patients with persistent symptoms after discharge from a Covid hospital and to assess post-Covid-19 functional status. Materials and Methods: A descriptive cross-sectional study was conducted among patients discharged from a Covid hospital. Records of patients were obtained from the medical records department. Data were collected by using a prevalidated close-ended questionnaire. The questionnaire consisted of information regarding the socio-demographic status, history of persistent symptoms, and functional status of patients. Patients were contacted and interviewed telephonically. History regarding common persistent symptoms and functional status was asked. Statistical analysis was done by using Epi info statistical software. Results: Out of 133 patients, persistent symptoms after discharge were reported among 92 (69%) patients. The common symptoms reported by the patients were fatigue (48.12%), weakness (42.10%), dyspnea (27.82%), and myalgia (12%). Loss of taste was reported by 10 (7.5%) and loss of appetite by 8 (6.01%). Seventy-four (55.63%) patients reported functional limitations. Conclusions: The proportion of persistent symptoms among Covid-19 patients after discharge was found to be high. More than half of the patients reported functional limitations. Patients should be screened for persistent symptoms and health care services should be provided.

Child feeding practices of mothers of rural coastal area of Navsari district

Poor feeding habits are one of the most serious barriers to achieving and preserving health of children under the age of five, as they pose a significant challenge to social and economic growth. To know the socio-demographic profile and to study the prevalence of Infant and young child feeding practices of mothers A cross-sectional study in rural areas of Navsari district, Gujarat, included 243 women, who had one child aged 12 to 23 months preceding data collection. Data were analyzed using statistical software Epi Info 6. About 32% of the infants had received pre-lacteals feeds, most common feed was Gripe water (44.9%). The colostrum was fed by 90 % mothers. Half of mothers had initiated breast-feeding within 1 hour after delivery. Only 88 mothers (36.2%) had given exclusive breast-feeding for 6 months. About half of children had received complementary feeding during 6–9 months of age. Most of the mothers (96.7%) were washing their hands before each feeding of the child whereas 61.7 % were cooking special meal for the child. Majority of mothers (93.8%) think that breast-feeding should be continued for 1 to 2 years. Continuing to emphasise nutrition education could go a long way toward empowering mothers to avoid using pre-lacteal feeds, to sustain exclusive breastfeeding for a prescribed period, to incorporate complementary foods at the appropriate time, and to enhance overall child-care through optimum use of community health workers.

Study of her2/neu and ki-67 expression in invasive urothelial carcinoma of bladder and their correlation with grade and stage

Urinary bladder cancer is one of the costliest diseases, which requires lifelong surveillance due to its rapid aggressive clinical course. Here, HER2/neu and Ki-67 expression, is studied, as important prognostic marker with therapeutic implications in invasive urothelial bladder carcinoma (IUBC). To study expression of HER2/neu and Ki-67 in histologically diagnosed cases of IUBC and their clinicopathological correlation.An observational, cross-sectional, study was performed in Pathology Department, NRS Medical College, Kolkata, from February 2020 to July 2021. Tissue sections, after proper processing, were stained in H&E. A total of 75 IUBC cases were histopathologically diagnosed with grade and stage. HER2/neu and Ki-67 expression by immunohistochemistry was studied in them; which was compared with clinicopathological variables like age, sex, risk factors, histological type, grade, stage, etc. Statistical analysis software EPI INFO (TM) 7.2.2.2 was used, p<0.05 was taken to be statistically significant.Among 75 cases of IUBC, 60% were high grade and 72% were of lower (pT1) stage. HER2/neu was positive in 52% cases; significantly associated with males, haematuria, smoking, necrosis, high grade (p<0.00001) and higher stage (pT2/3/4) (p=0.0005). Ki-67 index was high in 56% cases; significantly associated with >50 years age group, haematuria, smoking, necrosis, LVI, high grade (p<0.00001) and higher stage (p<0.0001). Positive HER2/neu expression was also significantly associated with high Ki-67 index (p<0.00001).Positive HER2/neu expression and high Ki-67 index is significantly associated with high grade and stage of tumours. So, these patients may be considered for targeted therapy using Trastuzumab in addition to conventional therapy.

A 5-year Retrospective Review Of Attention Deficit Hyperactivity Disorder In Children In Zaria, North West Nigeria

Background:Attention deficit hyperactivity disorder (ADHD) is characterized by inattention and/or hyperactivity-impulsivity that impair an individuals functioning and development. Children with ADHD are at risk of poor academic performance, dropping out of school, low self-esteem, teenage pregnancies, engaging in criminal behaviour, sustaining physical injuries and poor social skills. Objective: We carried out a 5- year retrospective review of cases of ADHD in our Paediatrics Neurology Clinic to determine the epidemiology, symptomatology and risk factors for ADHD in our setting. Materials and Methods: Case folders of all children with an established diagnosis of ADHD who were being seen at the paediatric neurology clinic of Ahmadu Bello University Teaching Hospital, Zaria from 1st January 2015 to 31st December 2019 were retrieved and relevant information such as sociodemographic characteristics, symptoms, age at presentation and perinatal or childhood central nervous system insult were extracted. Statistical analysis was done using Epi Info statistical software version 7. Results: A total of thirty (30) children were on follow-up for ADHD in the Paediatrics Neurology clinic of Ahmadu Bello University Teaching Hospital, Zaria during the study period. Twenty-four of them were males (80%) while 6 were females (20%). Their ages at presentation ranged from 2 to 15 years for boys (mean±SD =5.2 ±2.99) and from 2 to 5 years for girls (mean±SD =3.0 ±1.26). More than half (63.3% n= 19/30) were less than 5 years of age as at the time of first presentation to the clinic. Majority, (93.3% ,n= 28/30) had a history of CNS insult prior to onset of ADHD symptoms. Conclusion: Attention deficit hyperactivity disorder (ADHD) is increasingly being seen in environment, most cases occur in boys less than 5 years of age. Avoiding injuries to a childs central nervous system early in life can significantly decrease the likelihood of ADHD in them.

Age-Old Dilemma of Pregnancy During Residency: A Cross-Sectional Study From Central India on Perceptions and Experiences of Female Medicos.

Introduction The integration of family and career poses a significant problem for women in the medical profession.Balancing residency program demands with burgeoning family issues has always been a dilemma for female medicos.Lack of support and sometimes hostility from life partners, program administrators, teachers, and other residents havebeen reported. The present study is an attemptto assess perceptions and experiences of female medicos regarding pregnancy during residency. Methods The present descriptive cross-sectional study was carried out in a government medical college and hospital, which is a tertiary care center as well as a public sector teaching and training institute located in central India. Data were collected by interview technique using apredesigned and pretested questionnaire.Data were analyzed using the statistical software Epi Info version 7.2.5 (CDC, Atlanta, Georgia). Mean and standard deviations were calculated for continuous variables and the chi-square test was applied for categorical variables. Results Of the 612 study subjects, 409 (66.8%) belonged to the clinical disciplines and 203 (33.2%) were from nonclinical and paraclinical disciplines. A total of 66 (32.5%)subjects from the paraclinical and nonclinical sides had experienced pregnancy during residency, whereas only 54 (13.2%)from the clinical side werepregnant during residency. Positive influences for pregnancy during residency were concerns about age and fertility, pressure from in-laws and parents, desire for family and pregnancy, etc., all with a mean score of 3.5 and above on a five-point Likert scale. Tight schedules,availability of childcare arrangements, support from faculty and other residents, etc. wererelatively negative influences with a mean score of less than 3.5. Around 66% of those from nonclinical and paraclinical groups had conceived before 26 years of their age, whereas only 30% of residents from clinical departments had experienced pregnancy before that age. Thus, the age at conception was relatively lower in residents from nonclinical and paraclinical disciplines as compared to their counterparts from clinical disciplines, and this difference was found to be statistically significant (p < 0.001). Thecomplications during pregnancyweremore in clinical residents than in those from the nonclinical and paraclinical side. Conclusions This study concludes that concerns about age and fertility, pressure from in-laws and parents, desire for family and pregnancy, and enjoying children are relatively positive influences on the occurrence of pregnancy, whereastight schedule,availability of childcare arrangements, support from faculty and other residents, and timing professionally are relatively negative influences.

Occupational Diseases in Workers Engaged in Hydrocarbon Extraction in the Arctic

Introduction: Literary sources present rather contradictory data on the health of oil and gas industry workers in the Russian Arctic, which requires additional research. Objective: To assess causes and circumstances, structure and number of occupational diseases among employees engaged in hydrocarbon extraction in the Arctic. Materials and methods: We studied data of the public health monitoring on working conditions and occupational diseases in the Russian Arctic and the registry of extracts from occupational disease records (Order 176 of the Russian Ministry of Health dated May 28, 2001). The retrieved data were analyzed in Microsoft Excel 2016 and Epi Info statistical software, version 6.04d. Results: We have revealed a pronounced contrast in working conditions and the number of occupational diseases between coal miners in the Komi Republic (city of Vorkuta) and Chukotka Autonomous Area, on the one hand, and oil and gas production workers of the Nenets and Yamalo-Nenets Autonomous Areas, on the other, in the years 2007–2021. We estimated that 85.1 % of miners and only 3.1 % of gas and oil workers were employed at facilities characterized by extreme sanitary and epidemiological ill-being. Miners were diagnosed with 98.2 % of all occupational diseases registered in workers employed in the extraction of hydrocarbon resources, and the occupational disease incidence in them (201.71 per 10,000 workers) was 492 times higher than that in oil and gas workers (0.41 per 10,000). The most prevalent occupational diseases in the miners were chronic bronchitis (21.3 %), radiculopathy (21.0 %), and mono- and polyneuropathy (10.3 %) while workers of oil and gas companies mainly suffered from sensorineural hearing loss (46.3 %), radiculopathy (18.5 %), and vibration disease (16.7 %). Conclusion: Our findings confirm good health of oil and gas workers and necessitate urgent priority measures aimed at improvement of working conditions and all types of prevention of occupational conditions in coal miners working in the Arctic.

Bilateral retinal artery occlusion; A retrospective analysis of clinical presentation and management

Purpose: Retinal artery occlusion (RAO) is an ophthalmologic emergency and involvement of both eyes is rare. The aim of this study was to determine the pattern of presentation of bilateral RAO in south India and the associated systemic disorders. Methods: A retrospective review of the medical records of patients with bilateral RAO seen at a tertiary eye hospital in south India over a period of eight years was carried out. The patient's demographic and clinical data were extracted from the case files and analyzed using Epi Info statistical software. Results: Six hundred and seventy-four eyes of 662 patients were seen with RAO during the period of the study with 12 (1.8%) patients having bilateral involvement. The mean age of the patients was 58.3 years and males comprised 66.7%. There were 22 (91.7%) eyes with CRAO, and two (8.4%) with branch RAO. Three (25%) patients had simultaneous RAO. The median interval for the involvement of the fellow eye was 90 days. Hypertension and diabetes were the most commonly associated systemic disorders. Conclusion: Bilateral RAO is very rare and usually nonsimultaneous. Patients need to be aware of the possibility of involvement of the fellow eye after a unilateral RAO, and the importance of seeking medical care promptly if this occurs.

The Spectrum of Pathogenic Yeast Infection in a Tertiary Care Hospital in Assam, India.

In view of the growing incidence of pathogenic yeast infection all over the world, this study was undertaken to understand its etiology and epidemiology in Assam. To characterize and study the antifungal susceptibility pattern of the pathogenic yeasts from the clinical samples. The study was a hospital-based cross-sectional study. 150 patients were enrolled in the study and from which clinical samples were collected. A total of 83 samples showing the growth of yeast in culture were included in the study. The yeasts were identified by conventional and BioMerieux ID 32C and VITEK 2TM. Antifungal susceptibility test was done by disk diffusion method as per Clinical and Laboratory Standards Institute (CLSI), M44-A2. Data was analyzed using statistical software Epi-Info 7.1.2.0 (2013; CDC, Atlanta, USA). For comparison of categorical data, the Chi-square test or Fisher exact test was used. A value of p less than 0.05 was considered statistically significant. The most affected population was the age group of ≤10 years (32.5%) with male preponderance (67.5%). Yeasts were mostly isolated bloodstream infections (49.3%). The major risk factorwas prolonged antibiotic intake. Predominant yeast isolates were Candida albicans (43.4%) followed by Candida tropicalis (19.3%). Emerging yeasts like Kodaemea ohmeri (4.8%), Pichia anomala (2.4%), and Candida auris (1.2%) were also isolated. Amphotericin B was effective against all yeast isolates. All the isolates of Candida krusei were resistant to all the azoles. The study reflects that there is a growing incidence of emerging yeast infections and efforts are to be made for their identification and antifungal susceptibility testing for the initiation of appropriate therapy.

Effectiveness of using the program “Frequency of audiological monitoring in children of the first year of life with risk factors for hearing loss and deafness”

Purpose. To present data on testing the program, which allows optimizing audiological monitoring in children with risk factors for the development of hearing loss and deafness.Characteristics of children and research methods. 217 children who underwent audiological monitoring at the consultative аnd diagnostic center in Morozov Children’s City Clinical Hospital were examined. The research was a prospective longitudinal study with cross-sectional elements. The children were divided into 2 groups. The first group (main) consisted of 136 children who underwent audiological monitoring based on the developed program, and the second (comparison) included 81 children (the program was not applied). Statistical software packages SPSS and Epi info were used to process the obtained data.Results. In the main group, the most common age of children with primary treatment was (3.0 ± 0.5) months, and in the comparison group — (6.0 ± 0.5) months. In the main group, in the period of (3.0 ± 0.5) months of life, out of 129 children, neurosensory hearing loss was detected in 27 (21.0%), in the period of (6.0 ± 0.5) in 19 of 134 (14.0%), and in the periods of (9.0 ± 0.5) and (12.0 ± 0.5) in 19 (13.4%) and 5 of 136 children, respectively. In 22 children out of 136, hearing decline was transient. In the comparison group at the age of (3.0 ± 0.5) months, neurosensory hearing loss was detected in 2 children, at (6.0 ± 0.5) months in 4 out of 15, at (9.0 ± 0.5) in 1 child out of 25, and at (12.0 ± 0.5) in 9 patients out of 35 children.Conclusion. The application of the developed program will allow neonatologists and primary care physicians to fully comply with the deadlines for audiological monitoring.

Health worker motivation to deliver quality care in western Nigeria

Abstract Background Motivation of health service providers (HSPs) is an important factor for delivering quality services and achieving client satisfaction. Understanding the motivation to perform is therefore important in providing evidence for interventions. Objective To assess motivation to deliver quality service among antenatal care service providers in public secondary health facilities in western Nigeria. Method A cross-sectional, facility-based study was conducted using a validated, semi-structured self-administered questionnaire. In all, 280 HSPs were recruited using multistage sampling method. Data were analyzed using Epi-info statistical software. Inferential statistics such as chi square and binary regression were applied. Results Factors with high mean scores as motivators were those related to individual aspects especially conscientiousness, cooperativeness, timeliness and attendance, and appreciation from patients. Factors with the lowest mean scores were those linked with work organization such as limited resources (insufficient staff and equipment) and poor promotion processes. Overall, only 69 (24.5%) of HSPs reported that they were motivated to deliver quality care. Predictors of motivation were nonphysician cadre and longer years of service. Nurse/midwives, lab scientists/lab technicians, and pharmacist/pharmacy technicians were all more likely to be motivated than physicians. HSPs with more than 10 years experience on their current job were almost 9 times more likely to be motivated than those who had spent a lesser duration [odds ratio (OR), 1.14; 95% CI, 1.06–1.22]. Conclusion HSPs were not motivated to deliver quality care, especially physicians and those who had spent lesser duration on their current job. Interventions should focus on the provision of adequate resources and improving promotion process.

Emissions from Road Transport Vehicles and Respiratory Health in Rural and Urban Communities, Kano State, Nigeria: A Comparative Cross Sectional Study

Rapid urbanization and population migration encountered in developing countries results in an increasing need for transportation. To investigate the impact of vehicular emissions on air pollution/quality and respiratory health we conducted a comparative 2:1 cross-sectional study in rural and urban communities, 150 adult respondents and 30 children comprised the study population. Structured interviewer administered questionnaires; Clinical respiratory examination and digital Spirometry were conducted. Informed consent was obtained; data were analyzed using Epi info statistical software version 7. Results showed Mean age: (36.3± 12.9 years), Linear height: (median 1.65, range: 1.40 – 1.86). Adult Male: female ratio 1:1. Average Distance of households to roads/highway: 36.03±23.79 meters and prevalent duration of daily transit 2- 5 hours. In urban settlements: distance to highway/road <50 meters (OR 32.4, 95% CI: 8.57- 122.3) and Non-use of protective devices (OR: 12.43, 95% CI: 2.60-59.34) showed significant associations. Twenty two (22) Spirometry results were within the obstructive index. Abnormalities detected on Spirometry in the absence of a history of respiratory conditions or abnormalities on clinical chest examination require further investigation. Recommendations were targeted to improve health education, provide sustainable mass transit, urban planning, support focused research and ensure effective emissions control.

HUMAN BRUCELLOSIS AMONG PYREXIA OF UNKNOWN ORIGIN CASES IN TWO TERTIARY HOSPITALS, IN SANA'A, YEMEN

Background and objectives: Brucellosis continues a most important health problem in numerous parts of the world and in the Middle East regions is a significant origin of acute febrile illness. This study was conducted to determine Brucella antibodies among patients with PUO, the association of brucellosis with demographic characteristics, identify clinical symptoms and risk factors for Brucella infection among PUO cases. Materials and Methods: This cross-sectional research study was conducted in two health institutions; Al-Jumhouri Hospital and Al-Thawra Hospital, between January 2021 to January 2022. The required data were gathered from each patient by using pre-defined standardized questionnaire. Five mL of sterile whole blood was collected from each patient and then tested for Brucella antibodies using a standard tubular agglutination test. The data were then analyzed using the statistical software Epi Info version 6. Results: Among the 241 PUO patients, females were 72.2% and males 27.8%. The mean ± SD for total age was 28.8±15.8 years. The rate of Brucella antibody among patients with PUO was 29%, females 78.6% higher than males by 21.4%. Clinical characteristics of PUO patients were persistent fever (36.9%), intermittent fever (63.1%), sweating (63.5%), shivering (61.4%), joint pain (78.4%), muscle pain (78.4%), back pain (74.7) back head pain (66.4%), headache (60.4%), weight loss (52.9%), body weakness (89.2%), loss of appetite (50.6%), and nausea (46.1%). The risk factors for brucellosis among the PUO patients was handling of animals during parturition (69.2%, OR=7, p&lt;0.0001). Conclusion: These findings revealed a high prevalence of human brucellosis among PUO patients in Sana'a city and will becoming a serious problem that threats the health care system in Yemen. So, awareness programs should be provided to doctors, population about Brucella infection and its risk factors. Peer Review History: Received: 4 January 2022; Revised: 16 February; Accepted: 10 March, Available online: 15 March 2022 Academic Editor: Dr. Amany Mohamed Alboghdadly, Princess Nourah bint abdulrahman university, Riyadh, amalbgadley@pnu.edu.sa UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. Received file: Reviewer's Comments: Average Peer review marks at initial stage: 6.0/10 Average Peer review marks at publication stage: 7.5/10 Reviewers: Dr. Bilge Ahsen KARA, Ankara Gazi Mustafa Kemal Hospital, Turkey, ahsndkyc@gmail.com Dr. Wadhah Hassan Ali Edrees, Hajja University, Yemen, edress2020@gmail.com Similar Articles: PATTERNS OF ANTIMICROBIAL RESISTANCE AMONG MAJOR BACTERIAL PATHOGENS ISOLATED FROM CLINICAL SAMPLES IN TWO TERTIARY’S HOSPITALS, IN SANA'A, YEMEN

Socio-Demographic Profile and Treatment Outcomes of Tuberculosis Patients Diagnosed In a Government Civil Hospital of Northern India: A Cross-Sectional Study

Background: Tuberculosis remain a worldwide public health problem and is one of the top 10 causes of death globally. Millions of people continue to fall sick with TB each year. We conducted the present study to evaluate the Socio-demographic Profile and treatment outcomes of Tuberculosis Patients Diagnosed in a Government Civil Hospital of Northern India. Material and Methods: This cross-sectional record-based study was conducted at Civil Hospital Jogindernagar of Himachal Pradesh. We collected information using a self-designed, structured questionnaire containing information regarding various sociodemographic and clinical variables. Information was collected from Tuberculosis (TB) notification register kept at DOTS centre. Statistical analysis was done using statistical software Epi Info v7.2.2. Results: There were total 74 patients of tuberculosis were registered from Jan 2020 to June 2020 at DOTS center in Civil Hospital, Jogindernagar, Himachal Pradesh Among the total, 54 27(73%%) were 21-60 years of age. Mean age of patients were 44.78±17.01 years. Majority of patients, 56(75.7%) were male and 51(68.9%) belong to lower middle class. 46 (62.25) were pulmonary TB cases while 28 (37.8%) were extra pulmonary cases. Among the total, 26(35.1%) cases were clinically diagnosed, 11(14.9%) cases were Clinically diagnosed or Diagnosed by FNAC while 37(50.0%) cases Microbiological confirmed cases. 29( 39.2%) cases were Contact of TB/DRTB Cases , 29(39.2%) were tobacco user while 16(21.6%) had other risk factors. None of the case Reactive HIV status, 8(10.8%) had Diabetes while 27(35.5%) had associated Cervical lymphadenopathy. 71(95.8%) were cured after completing ATT, 1(1.4%) were become defaulter , 1(1.4%) Shifted to MDR Treatment and (1.4%) was died. Conclusion: Study concluded that most of the patients were males, belonged to lower socioeconomic status , in productive age group and of pulmonary TB. Treatment success rate is good but still need to improve, to make it 100 percent.

Use of Complementary and Alternative Medicine Among Patients on Long Term Treatment in a Tertiary Health Institution in Jos Nigeria.

Background:The use of Complementary and Alternative Medicine (CAM) is on the increase globally and found to be more pronounced among those with chronic illnesses even in the face of insufficient scientific evidence to support its efficacy. Hence, this study was conducted to assess the level of use of CAM and its predictors among patients on long term care in tertiary health institution.Methods:This was a cross-sectional study conducted among 176 patients accessing treatment for chronic medical conditions in Jos University Teaching Hospital using quantitative method of data collection. Epi Info statistical software version 7 was used for data analysis and a value of P < 0.05 was considered statistically significant.Results:The median age of respondents was 50 (IQR 30–84) years with 83 (47.2%) being 51 years and above. Utilization of CAM was reported among 72 (40.9%) with herbal preparation ranking highest among 56 (77.8%) the respondents. Absence of side effects (AOR = 2.23; 95% CI = 1.6918–3.2135) and consistency with culture (AOR = 4.46; 95% CI = 1.4695–6.1851) were identified predictors of CAM use.Conclusions:This study has demonstrated a relatively high level of CAM use with perceived absence of side effects, peer influence, and consistency with culture predicting its use.

NOTTINGHAM HISTOLOGICAL GRADING OF CASES OF PRIMARY INVASIVE CARCINOMA OF THE BREAST AT LAUTECH TEACHING HOSPITALS, NIGERIA

Background Breast cancer has since been known to be a global public health problem being the most common malignancy in women worldwide. The incidence in Nigeria is yet to be determined but is said to range from three and a half to thirteen and a half percent in hospital-based reports. Objective Our study aimed at grading the cases of primary invasive carcinoma of the breast using the Nottingham Histological System of grading. Methods The study was a hospital-based retrospective study carried out at LAUTECH Teaching Hospitals in Osogbo and Ogbomoso with ethical approval being obtained from the research and Ethics Committee of LAUTECH Teaching Hospital Ogbomoso. The original request cards were retrieved, studied and essential clinical details which include age, and the side (right or left) of the breast tumor were extracted. Tissue blocks were also retrieved and fresh sections about 3-5µm were cut from formalin-fixed and paraffin-embedded blocks and stained with Hematoxylin and Eosin dyes for histological analyses. Data obtained was analyzed using both Microsoft Excel and EPI Info statistical software and statistical package for social sciences. The information obtained was reported using frequencies and percentages. Quantitative data were presented as mean ± SD [Standard Deviation]. A 95% confidence interval was used in this study and a P-value of ≤ 0.05 was considered statistically significant. Result Our study revealed the commonest histological variant of primary invasive carcinoma of the female breast to be infiltrating ductal carcinoma, not specified type with 305 cases (88.9%).