Low Literacy Status Research Articles

The Effects of Anesthesia on Post-Operative Cognitive Dysfunction: A Systematic Review (P5-12.008)

<h3>Objective:</h3> This review aims to highlight the impacts of anesthesia in developing POCD <h3>Background:</h3> Postoperative cognitive dysfunction (POCD) is one of the most common postoperative complications, with a higher occurrence among the elderly. POCD is characterized by impaired memory, reduced attention deficit, and alteration in mood and personality changes. Its diagnosis is validated by conducting a baseline cognitive performance test preoperatively and compared with the mental status postoperatively. <h3>Design/Methods:</h3> Using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines a systematic review was conducted on the anesthesiological effects of POCD in the elderly. A PubMed search was performed with the keywords “Elderly”, “anesthesia”, and “postoperative cognitive dysfunction”. Four reviewers extracted the data independently and the risk of bias assessment was completed. <h3>Results:</h3> Of the 32 studies that were qualified, nineteen of them met the inclusion criteria and were finalized for review. The finalized studies concluded a 94% positive correlation between anesthesia and POCD and reported a wide range of cognitive function as early as six hours, seven days, and up to a year post-anesthesia. Some studies suggested the presence of other etiologies of POCD that were unmasked by anesthesia. These studies were well sampled from a similar demographic population regarding age, sex, cognitive function, and comorbidities. <h3>Conclusions:</h3> Despite the variation of type and route of administration of anesthetic, evidence from the analyzed studies highlights the increase in the incidence of POCD in the elderly who underwent anesthesia. Some factors contributing to the rise in the development of POCD include older age, pre-existing conditions, substance use, low literacy status, and coexistence of intra- and postoperative complications. Furthermore, the geriatric population has a higher probability of requiring surgical treatment and developing cognitive dysfunction, hence the need for more studies on this topic to better understand, prevent and manage these effects. <b>Disclosure:</b> Dr. Hassan has nothing to disclose. Dr. Dai has nothing to disclose. Dr. Mustafa has nothing to disclose. Dr. Nasereldin has nothing to disclose. Mrs. Advani has nothing to disclose. Dr. Alamin has nothing to disclose. Dr. Mezzoni has nothing to disclose. Dr. Elsheikh has nothing to disclose. Dr. Abdelrahman has nothing to disclose.

Prevalence of Anxiety Among Antenatal Women in An Urban Area of Belagavi

Background: A woman is highly vulnerable to anxiety and stress during her pregnancy causing negative effect in somatic and psychological forms like Intrauterine growth restriction, low birth weight and preterm birth in child. Maternal anxiety not only leads to adverse effect on pregnancy outcome but also decreases maternal competence in childcare. Aims/Objectives: To determine the prevalence of antenatal anxiety among women attending Ashok Nagar UHC and identify the associated risk factors. Methodology: A cross sectional study was done for 3 months in 320 antenatal women attending antenatal clinic at Ashok Nagar UHC. Data collection was done using a pre designed and pre tested questionnaire. Results: The prevalence of antenatal anxiety was 31.2%. Among them 30% had mild to moderate anxiety and only 1.2% had severe anxiety. Prevalence of anxiety was higher in younger women and with lower literacy status. Conclusion: Antenatal anxiety is of major public health importance but its effect on mother is not considered to be a serious issue in the society. There is a need for regular antenatal screening, assessment and treatment of antenatal anxiety.

Cataract and its associated risk factors among elderly population in a rural area of Belagavi: A cross sectional study

Background: The loss of sight of a person should not remain just a statistics but a personal tragedy, not only for the individual concerned, but for all of us who claim to be concerned. According to National Programme for Control of Blindness (NPCB) Pilot Survey 2001-2002, the prevalence of cataract in + 50 - year population was 62.6%. To assess the impact of the NPCB on reduction of avoidable blindness, this study would help in enlightening the present scenario in this region. Material and Method: The present community based cross sectional study was conducted among individuals aged 60 years and above residing in the area covered under Vantamuri Primary Health Centre, Belagavi from 1st January to 31st December 2016. Data was collected from the study subject regarding socio-demographic variables and personal history, external eye examination was conducted Results: The prevalence of cataract among elderly population in rural area was 40.16%. Out of 249 participants who had cataract, 18 (7.23%) had it only in right eye, 19 (7.63%) had in left eye and 212 (85.14%) had cataract in both eyes. The risk factors for cataract included belonging to Muslim and Jain religion, lower literacy status and increased exposure to indoor air pollution. Conclusion: The present cross sectional study, reveals that the prevalence of cataract among elderly in rural area in the past 15 years has reduced by about 20%. But still some socio-cultural factors prevail among the rural population like ignorance towards the effects of morbidity was the major setback for seeking treatment. Such behaviour was more common in elderly female, who were the most affected by it.

Prevalence, predictors, causes of treatment refusal and abandonment in children with acute lymphoblastic leukaemia over 18 years in North India. Treatment phase affecting factors: A step towards better focussed counselling

BackgroundTreatment refusal or abandonment are among the major causes of the survival gap between developed and developing countries. MethodsThis retrospective observational study analyzed records of children aged <18 years with acute lymphoblastic leukemia (ALL) registered for treatment at a tertiary-care teaching hospital, North India, between 1995 and 2012. Children who refused or abandoned therapy were tracked, and reasons for refusal/abandonment were recorded by telephone interviews or by surface mail. Sociodemographic parameters were compared using chi-square/Student t-test to identify predictors of refusal/abandonment. ResultsTreatment refusal was noted in 16.8% (96/572) of children with ALL; it was statistically higher for infants (p = 0.004), girls (p = 0.04), children of parents with poor literacy (p < 0.001), and those of lower socioeconomic status (p < 0.001). Main causes of treatment refusal were financial constraints (59.4%) and a misplaced belief about the incurability of cancer (22.9%). Therapy once started, was abandoned by 139/476 children (29.2%), the majority (41%) during induction, followed by maintenance (17.9%). Major reasons for abandonment were financial constraints (34.5%), false perception of cure (20%), poor general condition of the child (15%), no improvement in the child (13%), and blood donation refusal (3%). The reasons cited were different in different treatment phases. Abandonment was statistically higher in children from rural background (p < 0.001) or lower socioeconomic status (p < 0.001), and in those with fathers having a lower literacy status (p < 0.001). Low hemoglobin (p = 0.01) and severe wasting (p = 0.01) was greater in children who abandoned treatment. ConclusionTreatment refusal or abandonment, noted in 40% of children, was due mainly to monetary difficulties, disbeliefs regarding curability, or false perceptions of cure; these factors need to be addressed to improve survival, particularly in children from rural areas and those of parents with a lower literacy status.

Microbiological Study of Genital Ulcers at Tertiary Care Hospital

In all societies sexually transmitted infections rank among the most common of all infection diseases. Whereas the comparable figure in Europe and North America is at most 5%. The infection with HIV remains a leading cause of death in persons 25 to 44 years of age in the United State, as in developing countries, despite the advent of potent anti- retro viral therapy. The study is done to determine the etiology of genital ulcers, to assess the correlation between the clinical and laboratory diagnosis and to assess the prevalence of human immune deficiency virus infection in ulcer patients. A total of 125 patients with genital ulcers attending the sexually transmitted diseases clinic in Rajiv Gandhi Institute of Medical Sciences (RIMS) Adilabad and private STD Clinics at Adilabad were included in our study during the period Dec 2013 - Jan 2015. Of the 125 patients 102 (81.6%) were males and 23 (18.4%) were females. The maximum incidence of genital ulcers was found in the age group 20 to 29 Years. Genital ulcers disease is more common among patient with low literacy status. Of the 125 patients with genital ulcer diseases (29) were positive for syphilis 20 for herpes simplex, Candidalbalanoposthitis were seen in 20 patients (among these 20 cases 12 were with diabetes mellitus 2 cases of LGV). Mixed infections with herpes simplex and syphilis in 9 cases, 2 cases with herpes simplex and candidalbalanoposthitis, 7 cases with syphilis & HIV 9 cases with HSV & HIV, 2 cases with CBP & HIV. No cases of chanchroid in our study. LGV were seen only in 2 patients.

Prevalence and risk factors of diarrhea morbidity among under-five children in India: A systematic review and meta-analysis

Acute diarrhea accounts for a huge burden of infectious diseases in under-five children. This systematic review was carried out to study the prevalence and associated risk factors of diarrhea among Indian children aged <5 years. Papers were identified by a comprehensive electronic search of relevant medical subject heading (MeSH) terms in PubMed. Identified articles were independently reviewed against inclusion/exclusion criteria and rated for quality. 15 articles were abstracted and reviewed to identify the reported prevalence and risk factors for childhood diarrhea. Meta-analysis was done for calculating the pooled prevalence of diarrhea and point estimates of risk factors using random effects model with use of appropriate population weights, and depicted using forest plot. The overall prevalence of diarrhea between 2002 and 2013 was 21.70% (95% confidence interval [CI]: 11.24-34.46). The significantly associated risk factors were malnutrition (odds ratio [OR]: 1.73, 95% CI: 1.53-1.96) and anemia (OR: 1.71, 95% CI: 1.29-2.28) in child, and low socioeconomic status (OR: 7.14, 95% CI: 2.19-23.32). Age of the child <24 months, not breastfeeding, mothers' low literacy status and untreated drinking water did not show a significant association. Sex of the child, religion, higher education of mothers, and seasonality were found to be inconsistently associated in single studies. It was concluded that there is sufficient evidence on the association of childhood diarrhea with socio-demographic factors, but evidence on other contributory factors including breastfeeding and vaccination is inconclusive. There is need to conduct more analytical studies on lesser known risk factors of diarrhea to establish their risk factors in Indian children.

Burden of Undernutrition, Composite Index of Anthropometric Failure (CIAF) and Perception of Caregivers about Undernutrition among Under Five Children in Rural India

Undernutrition interferes with growth and development of a child and may predispose to infection and/or chronic disease. The present study was undertaken to assess the nutritional status of under five children by the 2006 WHO growth standards; Composite Index of Anthropometric Failure (CIAF) which is a single aggregate indicator of undernutrition was calculated and the perception of caregivers about undernutrition and child development of a child were assessed. A cross sectional study was conducted in rural children in North India. Anthropometry was done according to the standard procedures. Overall, 938 children were included in the study. The prevalence of under nutrition was 25.3 % (22.4-28.1). CIAF showed a higher prevalence of undernutrition with 53.1% of the children suffering from anthropometric failure. The prevalence of stunting was highest in 36-47 months. There was a significant association between undernutrition and low literacy status of mother, duration of pregnancy, administration of pre lacteal feeds and time of initiation of weaning. More than half of the caregivers perceived that undernutrition was due to disease (55.5%), lack of food (35.5%) or congenital (31.6%). There was a high prevalence of undernutrition among rural under five children in North India. There was a lacuna in knowledge of caregivers about the causes of undernutrition and delayed development.

Evaluation of mucociliary clearance among women using biomass and clean fuel in a periurban area of Chennai: A preliminary study

Background:Nasal mucociliary clearance (NMC) plays a crucial role in the defense of the airways against inhaled substances and is affected by various factors. The effect of particulate matter on NMC in women using biomass fuel has not been well studied.Aim:This cross-sectional study was conducted to assess the NMC time in biomass fuel users and compare it with that of clean fuel users.Materials and Methods:NMC time and Peak Expiratory Flow Rate (PEFR) were determined in women of age ranging from 18 to 45 years using biomass fuel (n=30) and clean fuel (n=30). The time taken to perceive the sweet taste, following placement of saccharin 1 cm behind the anterior end of inferior turbinate was recorded as NMC time. PEFR was measured using mini-Wright peak flow meter. Comparison between groups was analyzed using t-test and ANOVA in R statistical software.Results:NMC time was significantly prolonged in biomass fuel users (765.8 ± 378.16 s) in comparison to clean fuel users (545.4 ± 215.55 s). PEFR was significantly reduced (319.3 l/min) in biomass fuel users compared to clean fuel users (371.7 l/min). Women from lower socioeconomic status, lower literacy status, older undernourished women and women cooking for>15 years had prolonged Saccharin Transit Time (STT) and reduced PEFR.Conclusions:This study highlights the effects of indoor air pollution on respiratory defense mechanism. This simple noninvasive, inexpensive, screening test can be used as an early indicator of respiratory damage caused by exposure to air pollutants.

Literacy and Informed Consent

Literacy and Informed Consent

Assessment of Cervical Erosion in Hamedan City, Iran

The purpose of this study was to determine the role of socio-economic factors and cytology in cervical erosion. A cross-sectional study involving 410 females in the reproductive age group was conducted in urban health centers in Hamedan city, Iran. Data were collected through interviews with women, gynecological examination in the clinics in the health centers and laboratory tests. Cervical erosion was detected in 68 (16.6%) females. Out of these mild dysplasia was seen in (8.8%) females. High percentages of inflammatory smears (58.8%) were obtained in women with cervical erosion. Cervical erosion was more common in illiterate and women with low literacy status as compared to women with higher education. Majority of cases of cervical erosion were detected in women with high parity. A statistically significant relationship was found between lower socio-economic status and cervical erosion (p < 0.05). Regular cytological screening by Pap smear will help in early detection of carcinoma cervix.