Lower Middle Socioeconomic Group Research Articles

Clinicopathological Profile of Sinonasal Masses in a Tertiary Care Center in Central India: A Retrospective Study.

Diseases of the nose and paranasal sinuses have a significant impact on the patient's functional and structural aspects. They affect all age groups and both sexes. Due to its proximity to vital structures, diseases of the nose and paranasal sinuses sometimes lead to very grave prognoses. This was a retrospective study done in one of central India's largest tertiary care centers. We studied 227 cases of sinonasal masses in both the non-neoplastic and neoplastic categories. Clinicopathological characteristics of masses were analyzed with the help of clinical and imaging findings and subsequently confirmed by tissue diagnosis. The mean age of presentation was 45.5 years, with a male-to-female ratio of 1.25:1. Most of our patients were from lower-middle socioeconomic groups with educational qualifications below the 10th standard. Nasal obstruction was the most common symptom. A computed tomography scan was the preferred radiological investigation. Sinonasal undifferentiated carcinoma was the most common variant of malignancy, with a total number of six out of 22 (27%). The evaluation of sinonasal masses should be carried out systematically and meticulously. Since the initial presentation of most of the diseases of the nose and paranasal sinuses is the same, a proper clinical, radiological, and tissue diagnosis should be carried out to avoid causing malignant lesions.

Pemanfaatan tanaman Toga sebagai minuman kesehatan tradisional bagi perempuan di Desa Dukuhmojo

Dukuhmojo Village, Mojoagung District, Jombang Regency, is a village where the majority of its population belongs to the lower-middle socioeconomic group, with farming as their main livelihood. Unfortunately, the community's understanding of the importance of maintaining health is still limited due to the influence of globalization, which has led to a tendency towards instant and unhealthy food consumption. Despite the abundance of family medicinal plants in the area, they are not fully utilized by the local residents, who prefer to purchase medicines from local shops. Therefore, this activity aims to accompany the community, especially the women of Dukuhmojo Village, in utilizing and processing the family medicinal plants (FMP) available in the vicinity, to create traditional herbal beverages as natural alternative remedies that can be sold as entrepreneurial products. The implementation method of the activity involves lectures, discussions, and assignments in several meetings with a group of ten women. The results of this community engagement demonstrate that the women's group in the village is capable of entrepreneurship and building self-confidence in creating a business of producing healthy beverages from medicinal plants, which they collectively named "Asmantoga." Overall, participation and mentoring can enhance the role of impoverished rural women in developing their natural and personal potential, providing economic and social benefits. This support also encourages the women's group to acquire the necessary knowledge and capital, enabling them to actively contribute to the economic arena and improve their standard of living.

Vaccine intention and hesitancy among Australian women who are currently pregnant or have recently given birth: the Birth in the Time of COVID-19 (BITTOC) national online survey

ObjectiveTo examine the prevalence of COVID-19 vaccination, and factors associated with vaccination intention and hesitancy in pregnant and postnatal women in Australia.Design and settingA national online survey was conducted over...

Attention Deficit Hyperactivity Disorder in Preschool Children: A Cross-Sectional Study of Clinical Profile and Co-morbidity.

Diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) in preschool children is challenging and complicated owing to the presence of developmentally appropriate overactivity and a dynamic developmental/learning phase shaping their behaviour. We aimed to study the clinical profile and co-morbidity of ADHD in preschool children. Fifty consecutively presenting preschool children with ADHD were enrolled from our child guidance clinic (CGC) between January 2017 and December 2018. The diagnosis and assessment of comorbidities were based on the DSM-5 criteria and Vanderbilt teacher and parent rating scales. Relevant clinical and sociodemographic profiles were assessed and analyzed for association with ADHD subtypes and comorbidity. Preschool children with ADHD constituted 8% of all patients visiting the CGC and one-fifth of all children with ADHD. Male:female ratio was 11.5:1. Hyperactive-impulsive was the commonest type, and oppositional defiant disorder (ODD) was the commonest comorbidity. Most children belonged to the lower-middle socioeconomic group. Language delay was observed in 20%. Median social quotient measured using the Vineland Social Maturity Scale was 83. Preschool children predominantly have the hyperactive impulsive type of ADHD. Isolated language delay was the predominant comorbid developmental disorder, and ODD was the predominant comorbid behavioural disorder. Addressing these issues would help in the appropriate management of these children.

Socio-demographic and Clinical Profile of Covid-19 in Children

Introduction: The corona virus disease 2019 (COVID-19) is a pandemic disease. Infection by COVID-19 in children is not so common but gradually the numbers of children affected with COVID-19 are increasing day by day. The epidemiological importance and clinical pattern in children with COVID-19 is now a challenge to be described by the clinicians. Objectives: To describe socio-demographic and clinical characteristics of COVID-19 infected children. Material and Methods: This cross sectional observational study was conducted among 58 COVID-19 children who were admitted in COVID-19 dedicated Kurmitola General Hospital (KGH), Dhaka from March 2020 to July 2020. Their signs, symptoms, sex, age distribution, laboratory results and familial contact were analyzed. Results: Among 58 most of the children (63.8%) were in school going age (5-15years). The number of female (39) was more than male (19) and female-male ratio was 1:0.48. Most of the children (75.9%) came from urban lower middle socioeconomic group. About 84.4% children were affected from family member. Among all, (8.6%) patients had no symptoms. Main symptoms of the children were cough (36.2%), only fever (22.4%), fever with cough (8.62%) and diarrhoea (5.2%). About 12.06% of the children had additional symptoms including sore throat, nasal congestion, fatigue, headache, body ache, vomiting, abdominal pain, convulsion and rash, 6.9% had respiratory distress and one child came with convulsion. About 12.1% patients showed lymphopenia, 18.9% showed leucopenia, 13.8% patient had neutrophillia. C-Reactive Protein (CRP) and serum ferritin were high in only 12.1% and 8.6% cases respectively. There were 29.3% patients who had normal Chest X-Ray and 58.6% had mild lesion, 8.6% had bilateral consolidation and 3.4% had patchy opacities. Conclusions: COVID-19 is not so common in children and usually presents with mild form or no sign symptoms clinically and by laboratory analysis. But it is noteworthy that they may play role in transmission of disease. JAFMC Bangladesh. Vol 16, No 2 (December) 2020: 72-75

Clinical Profile of Women with Congenital Fetal Malformations: A Retrospective Cohort Study

Abstract Background Though this is an era of imaging, many women with fetal congenital malformations are presenting beyond 20 weeks of pregnancy posing problems in decision making. This study was undertaken to determine the prevalence of congenital fetal malformations presenting to tertiary health care and to analyse the gestational age at presentation and spectrum of malformations and the clinical and socio-demographic factors. Material and Methods This was a retrospective analysis of hospitalised women with diagnosis of congenital fetal malformations (CFM) from January 2017 to December 2017. The data was retrieved from Medical Records Section after due permissions and analysed with respect to socio-demographic status, age, consanguinity, type of congenital anomaly and gestational age at presentation. Results The prevalence of CFM was 1.56%. The majority (64%) of CFM were detected during the second trimester and 27% were detected in the 3rd trimester. The most common anomalies were CNS followed by multiple anomalies and 72% and 65% of them were live born respectively. The majority (90%) belonged to lower middle socioeconomic group and were from rural background (82%). The majority of women were less than 30 years of age (77.6%) and 38% were primigravidae. Consanguinity was present in 34%, medical disorders were associated in 29% and 3% had family history of congenital fetal anomalies. Conclusion The most common anomalies were CNS and majority were primigravidae. The most common medical disorder associated was diabetes. It is possible that they are deficient in folic acid and vitamin B12. Hence pre-conceptional control of medical disorders, nutritional counselling regarding intake of micronutrients and awareness programmes to take pre-conceptional folic acid and vitamin B12 are the need of the hour for prevention.

Prospective study of clinical profile and outcome of children presenting with poisoning

Background: Childhood poisoning covers the entire gamut from accidental ingestion in toddlers and preschool children to intentional overdosage in adolescents. To find the clinic- epidemiological profile of poisoning regarding age, sex, type of poison, manner of poisoning, common clinical features, duration between poisoning and presentation to hospital, duration of hospital stay, to find out the different agents involved duration of ICU stay, pre-referral treatment and treatment given.Methods: All children below 12 years of age admitted during the one-year study period with a history of poisoning were included. Animal bites, snake and scorpion envenomation, chronic poisoning, drug allergy was excluded. All children were examined, investigated and treated according to hospital policy. The outcome of poisoning was recorded.Results: There were 143 cases of children with poisoning admitted. Accidental poisoning constituted 88.1% cases (n126),7.7% (n11) was suicidal and the remaining 4.2%(n6) was homicidal. In most cases, poisoning was due to hydrocarbons followed by pesticides. kerosene oil was the most common substance followed by OPC.Conclusions: The highest incidence of poisoning was observed in children below 5 years of age and from the lower middle socio-economic group. Most of the poisons were household products and the most common nature of exposure was accidental in most of the cases, recovery was complete.

Cost effectiveness analysis in the management of stroke in a tertiary care hospital

Background: Stroke has a high economic impact on the society especially in a developing country like India. In India health insurance doesn’t cover all people leading to out of pocket expenditure. The objective of the present study was to study the cost of illness and outcome of stroke in a tertiary care hospital.Methods: Direct medical and nonmedical costs were obtained after 28 days of follow-up. The outcome of the stroke was measured by modified Rankin scale (mRS).Results: The mean age of the patients was 65.38±13.98 years. Majority of the patients suffered from ischemic stroke and belonged to lower middle socioeconomic group. The mean cost of stroke was INR 39819. There was improvement in the mRS score after 28 days following treatment of acute stroke.Conclusions:Direct medical costs forms major component of cost of stroke. Early management and hospital discharge can reduce the economic burden of stroke.

Prevalence of depression and anxiety among children in rural and suburban areas of Eastern Uttar Pradesh: A cross-sectional study.

Background:Psychiatric morbidity in children and adolescents is a major concern as they become more complex and intense with children's transition into adolescence.Aim:The aim of this study is to assess and compare the prevalence of depression and anxiety among children residing in rural and suburban area of eastern Uttar Pradesh and understand the burden of these problems in our society.Materials and Methods:Children, in the age group 11–18 years, were divided into 2 groups: Group I – 100 children from rural area Tikri; Group II – 100 children from suburban area Sunderpur. Their sociodemographic details were recorded. Children's Depression Inventory and Revised Children's Manifest Anxiety Scale were used to screen for depression and anxiety in children, respectively. The final diagnosis was done using present state examination in accordance with International Classification of Mental and Behavioral Disorders 10. Data were statistically analyzed using Chi-square test.Results:The prevalence of depression was found to be 14.5% while that of anxiety disorder was found to be 15%. There was no significant difference in the prevalence of depression or anxiety in rural and suburban areas (P > 0.05). Depression and anxiety were more prevalent in middle adolescence, in females, and in lower-middle socioeconomic group. Depression was more prevalent in the students of class 9th –12th, whereas anxiety was more in students of lower classes. Depression was more prevalent in joint families. These differences show some important trends regarding factors affecting these problems.Conclusion:This study yields useful information which could be of use in early management of psychiatric disorders present in the community and prevent their development into chronic disorders.

Infant and Young Child-Feeding Practices, Indicators and Index, and Role of Socio-economic Status

The present cross-sectional descriptive study was conducted at the paediatric OPD of a government and a private clinic to assess the indicators of Infant-and Young Child-feeding (IYCF) practices and compare them among lower middle and upper middle socioeconomic groups. The study enrolled 200 mother-child pairs with children aged 18-36 months, classified using Modified Kuppuswamy scale into Lower Middle Socioeconomic Group (LMSEG) (score: 11-15) and Upper Middle Socioeconomic Group (UMSEG) (score:16-25). IYCF indicators formed the basis of the questionnaire used to interview the mothers. This calculated the children’s dietary diversity score, meal frequency and IYCF index. Statistical analyses were performed using SPSS software (version 16.0) to determine the effect on socio-economic status on IYCF practices. P-value <0.05 was considered to be statistically significant. Only 52.5% (n=105) infant were exclusively breastfed for the first six months of life with significant difference between the two socioeconomic strata, with 64% (n=64) from LMSEG and 41% (n=41) from UMSEG (p=0.01). 67% (n=67) infants from LMSEG received breast milk till two years in contrast to 44% (n=44) infants from UMSEG (p=0.01). However, a higher frequency of food intake (p=0.03) and higher minimum dietary diversity score (p=0.012) was observed among UMSEG as compared to LMSEG. UMSEG mothers had greater prevalence of using bottles to feed their children as compared to LMSEG (n=51 vs n=27). Besides, it was found that educational qualification of the mothers had a positive impact on IYCF practices (p=0.015) but the mother’s employment or the child’s birth order had no significant effect. IYCF practices differed significantly among the two socioeconomic groups. LMSEG have better qualitative practices and UMSEG showed better quantitative factors. Health education as well as digital media may serve as important intervention programs to spread awareness to protect, promote and sustain optimal IYCF practices in Indian context.

Impact of socioeconomic status on municipal solid waste generation rate

The solid waste generation rate was expected to vary in different socioeconomic groups due to many environmental and social factors. This paper reports the assessment of solid waste generation based on different socioeconomic parameters like education, occupation, income of the family, number of family members etc. A questionnaire survey was conducted in the study area to identify the different socioeconomic groups that may affect the solid waste generation rate and composition. The average waste generated in the municipality is 0.41kg/capita/day in which the maximum waste was found to be generated by lower middle socioeconomic group (LMSEG) with average waste generation of 0.46kg/capita/day. Waste characterization indicated that there was no much difference in the composition of wastes among different socioeconomic groups except ash residue and plastic. Ash residue is found to increase as we move lower down the socioeconomic groups with maximum (31%) in lower socioeconomic group (LSEG). The study area is a coal based city hence application of coal and wood as fuel for cooking in the lower socioeconomic group is the reason for high amount of ash content. Plastic waste is maximum (15%) in higher socioeconomic group (HSEG) and minimum (1%) in LSEG. Food waste is a major component of generated waste in almost every socioeconomic group with maximum (38%) in case of HSEG and minimum (28%) in LSEG. This study provides new insights on the role of various socioeconomic parameters on generation of household wastes.

Clinical profile and outcome of poisoning in children admitted to a tertiary referral center in South India

Background: Childhood poisoning covers the entire gamut from accidental ingestion in toddlers and preschool children to intentional overdosage in adolescents. The poisons range from fuel to drugs and other chemicals. Objective: To determine the epidemiology, clinical profile, and outcome of children presenting with acute poisoning in a tertiary care center in south India. Materials and Methods: All patients from the age of 1 month to 18 years, admitted during the 1-year study period with a history of poisoning, were included. Animalbites, snake, and scorpion envenomation were excluded. The data were analyzed using SPSS software, version 16. A multivariate analysis was also done and a p&lt;0.05 was considerer significant. Results: There were 75 cases of poisoning out of the total 4074 admissions. Accidental poisoning constituted 73.3% cases and the remaining 26.7% were suicidal. In most of the cases, poisoning was due to fuel (28%) or drugs (21.3%), and kerosene oil was the most common causative substance (28.0%) followed by camphor (14.7%). The higher incidence of poisoning was found in lower middle socio-economic class (56.0%). An analysis of the outcome showed that92.0% were discharged home, 4.0% with sequelae, and death in 4.0% cases. Conclusion: The highest incidence of poisoning was observed in the lower middle socio-economic group. Most of the poisons were household products, and the most common nature of exposure was accidental. In most of the cases, recovery was complete.

Prevalence of Helicobacter Pylori in Asymptomatic Paediatrics Patients in a Tertiary Hospital: A Cross- Sectional Study

The present hospital based cross sectional study was done on 214 paediatric patients attending O.P.D for symptoms other than those of gastrointestinal disorders and the prevalence of H.pylori was found using Stool Ag card test. Out of these 214 patients,112 were found positive for H.pylori by stool antigen card test giving a prevalence of 52.34.%. A detailed proforma was filled having information regarding age and sex of the patient, education and occupation of the head of the family, sanitary practices, dietary habits of the patient was also observed for pallor. Among a total of 117 males, 64 were positive for H.pylori (54.7%) and among 97 females, 48 were positive (49.5%). Age wise distribution showed maximum prevalence of H.pylori in the age group of 15–18 years (75.9%) and minimum in the age group of 3–6 years (30.4%). A higher prevalence of H.pylori was found among non-vegetarians (53.1%) and among patients having pallor (75.8%) which was significant. A study of socio-economic status showed a prevalence of H.pylori as 52% in upper lower and 52.6% in lower middle socio-economic group.

Clinco-Epidemiologic Study of Cutaneous Leishmaniasis in Bikaner, Rajasthan, India

Cutaneous leishmaniasis is endemic to the Thar Desert of Rajasthan, Bikaner, India. The present study describes clinico-epidemiologcial data of all cases of cutaneous leishmaniasis CL in this region during 2001-2011. A total of 1,379 patients with 2,730 lesions were reported during the study period. Ages of patients ranged from 3 months to 86 years, and there was a predominance of infections in males. Most patients were from urban areas and lower middle socioeconomic groups. Lesions were dry, ulcerated nodules or plaques of different sizes commonly over face and upper limb. Skin smears were positive for parasites in 958 (69.5%) patients, and the remaining 45.8% (193 of 421) patients were positive by skin biopsy. Histopathologic analysis of the skin showed mixed granulomas consisting of macrophages, lymphocytes, epitheloid, and plasma cells. Species identification was conducted for 45 randomly selected patients by polymerase chain reaction, the infective species was Leishmania tropica. Most patients were treated with intra-lesional injections of sodium stibogluconate.

Prevalence of Bulimic Behaviors and Bulimia among a Sample of the General Population

Data are presented on the prevalence of bulimic symptoms and bulimia among a sample of adults residing in north-central Florida (n = 2,075). The data were gathered between 1984 and 1986. The sample included 1,736 whites and 339 blacks, of whom 1,040 were females and 1,035 were males. A current diagnosis of bulimia was made using the criteria of the Diagnostic and Statistical Manual, Third Edition (DSM-III), of the American Psychiatric Association. Females had significantly higher rates than did males on nine of the 10 bulimic symptoms. Blacks had symptom rates equal to or greater than whites on eight of the 10 items, and those in the lowest socioeconomic groups (SES) had rates greater than those in the highest SES group on nine of the 10 symptoms. Eight persons, 0.4% of the total sample, met the DSM-III criteria for a diagnosis of bulimia. These included six white females and two black males. Five of the females were aged 18-29 years; one was over 45. Five of the females were in the lower middle SES group; one was in the upper middle SES group. Both of the black males were aged 30-44, and both were in the lowest SES group. The data emphasize the need to distinguish between bulimic type symptoms and bulimia when estimating the prevalence of eating-related problems in the general population.

Indices of physical build, nutrition and obesity in school-going children.

Physical growth and growth indices were determined in 728 school children aged 5–15 years from low and lower middle socioeconomic groups (LSE) and 512 school children from high socioeconomic group (HSE). Growth of children from HSE group was comparable to Harvard standards and it was higher than ICMR: Class-I; and that of children from LSE group was very low compared to Harvard and ICMR Class I standards. It is suggested that growth norms of Indian children belonging to high socioeconomic class could be taken as standards for comparison.

Growth performance of Punjabi children aged 6-12 years.

The study aims at evaluating the growth performance of primary school children of Patiala (Punjab, India) belonging to lower and lower middle socio-economic groups, with special emphasis on the effects of social class and urbanization. Cross-sectional data on 1380 children (656 boys and 724 girls) ranging in age from 6 to 12 years were collected during 1974. Dimensions measured were height, weight, circumferences of chest and upper arm, triceps, subscapular and suprailiac skinfolds. Standard techniques (Weiner and Lourie 1969) were followed for taking these measurements. The boys are significantly taller and heavier than the girls, whereas the girls possess significantly more amounts of subcutaneous tissue, from 6 to 12 years. The Punjabi children are taller than the combined Indian sample. On average, the children of the present study are smaller in size and lighter in body weight than the British children and fall between the 3rd and 25th centiles of the British standards. Children belonging to lower and lower-middle socio-economic classes are significantly lighter in body weight and smaller in height than their coevals of higher groups. The urban boys are taller and heavier than their rural peers, however, the differences are not as marked and clear as those of socio-economic groups.

Order of birth and growth in weight and height of Punjabi girls from 6 to 12 years.

Prepubertal Punjabi girls ranging in age from 16 to 12 years and belonging to lower and lower-middle socio-economic groups were included in the study. The data on 692 girls for weight, height and sitting height were collected during 1974–75 from various schools of Patiala city. The differences in body weight, height and sitting height at various ages among different birth ranking girls are non-significant. The physical growth patterns among different groups are almost similar. The home environment which can reasonably be assumed to be better for the first child has little if any impact on the physical growth of Punjabi girls.

Physical growth of pre-pubertal Punjabi girls

Cross-sectional data on 724 pre-pubertal Punjabi girls ranging in age from 6 to 12 years, were collected from the primary sections of various schools of Patiala city during 1974. Children belonging to the lower and lower-middle socio-economic groups were included in the present study. Nine anthropometric measurements including three skinfolds were taken on each subject. Statistical constants like mean, standard deviation and standard error of mean have been calculated. Growth standards of girls in terms of percentiles for these age groups have been constructed for some selected measurements. The resluts show that the velocity of weight increases in the successive ages up to 10–11 years. All other anthropometric measurements excluding skinfolds, show a general trend of decline in the rate of growth of body measurements up to 10–11 years. The girls ef this sample seem to pick up accelerated growth during the 11–12 year age interval to enter the adolescent growth spurt. The pattern of change of subcutaneous tissue provides two types of pictures-suprailiac and subscapular skinfolds show continuous increase during the period under study whereas the triceps skinfold decreases up to 9 years and again increases. The velocity curves of the skinfolds do not indicate any appreciable trend of increase or decrease. Linear regression equations were fitted to height, weight, log weight, and sitting height measurements. It is noticed that log weight measurements provide a better fit upon age than the weight measurements taken as such.

Dental conditions in high school students, Sydney, 1972

Dental examinations of 1,895 first year students of nine Sydney metropolitan State high schools were carried out in 1972. The schools were chosen from three socio-economic areas representing upper-middle, lower-middle, and working class groups. Minimal differences were shown in the prevalence of dental diseases, treatment needs, and dental practices between the upper-middle and lower-middle socio-economic groups. The working class group showed a higher prevalence of dental caries, gingivitis, and treatment needs and reported different dental health practices from the other groups.