Lower Socioeconomic Class Research Articles

[Artículo traducido] Influencia de los factores socioeconómicos y psicológicos en los resultados del tratamiento quirúrgico de la artrosis trapecio-metacarpiana

Objective: This study aimed to investigate to what extent people with carpometacarpal thumb osteoarthritis that are socioeconomically disadvantaged and have psychological disorders report higher pain levels and worse patient-rated upper-extremity functionality after surgical treatment.Material and method: A single center, retrospective observational cohort study analysing 100 patients diagnosed with thumb carpometacarpal osteoarthritis between 2013 and 2019. Patients were divided into two groups (50/50), depending on whether they received surgical or conservative treatment. The socio-economic status (ESeC classification) and presence of psychological comorbidities were investigated. Functional outcomes were assessed using the Visual Analogue Scale (VAS), Q-DASH questionnaire and Kapandji score. Current mental disorders were evaluated using STAI, PHQ-9 and PCS screening scales.Results: Measures of functional hand scores (Q-DASH) were higher and had considerably less pain in surgically treated participants, although thumb mobility (Kapandji) was more restricted. They were also associated with higher scores on psychological assessment scales. Sixty-four per cent of the patients came from lower socio-economic classes and suffered from poorer scores on the mental health screening questionnaires. Of the patients manage surgically, 54% were diagnosed of dysthymic disorder and showed significantly worse patient-rated upper-extremity function (Q-DASH questionnaire, median [IR]:31,8 [20,5-54,6] than patients without psychological disorders (median [IR]: 13,6 [2,3-36,5]). No differences were found for patients with and without disthymic disorder managed nonoperatively.Conclusions: Patients with higher rates of depression, anxiety and pain catastrophising behaviour showed significantly worse outcomes after surgery for osteoarthritis of the first carpometacarpal joint. Lower socio-economic class significantly influences levels of depression and anxiety but did not affect functional outcome. Surgical treatment of carpometacarpal thumb osteoarthritis achieved better self-perceived hand function (QDASH, VAS, Kapandji) than conservative treatment.

Study of clinical profile and outcome of viral hepatitis in children with reference to liver function test during covid pandemic admitted at tertiary care hospital

Background: Viral hepatitis is major health problem in both developing and developed country affecting millions of children worldwide. Viral hepatitis defined as inflammation of liver due to hepatotropic and/or non-hepatotropic viruses. Extent of disease vary from acute to chronic which ranges from asymptomatic to fatal acute and on other side from subclinical persistent to rapid progressive chronic disease. Aim of study was proportion and etiology with clinical profile and outcome relation to liver function test (LFT). Methods: This is retrospective observation study done at civil hospital, Ahmedabad during June 2019 to May 2021 during covid era in admitted patients from age of 6 month to 12 year diagnosed as viral hepatitis. Data collected from medical records and investigation from laboratory data. Results: In my study, Viral hepatitis was m/c seen in age group of 5 to 10 year in lower socioeconomic class with most common hepatotropic virus was hepatitis A (51.79%) and non-hepatotropic virus was dengue virus (17.86%). Most common presenting complain was fever (93.75%) and sign was jaundice (87.5%). Altered liver function seen in 96.57% patients. Outcome with 4.46% death due to covid19 virus. Conclusions: In my study during covid19 pandemic, still most common cause for viral hepatitis was hepatotropic virus–HEPATITIS A in admitted patients at tertiary care hospital. But case fatality rate was noted highest in COVID-19 virus among total death.

The Resilience and Lived Experiences of the Parents of Children With Autism in India: A Mixed-method Study

Background and Objectives: Families dealing with autism spectrum disorder (ASD) children try to adapt with different strategies. 1) To assess the resilience of parents dealing with children having ASD and its associated factors. 2) To explore the perspective and strategies of families dealing with children having ASD Methods: This was a mixed-methods study done over a period of 3 months among parents having children diagnosed with ASD; undergoing institutional therapy for more than 6 months in duration. Data collection was done using the PREQ questionnaire and key informant interviews (KII). Informed consent was taken prior to each interview and audio recordings. Relevant tests of significance and deductive analysis followed. Results: There was an equal divide observed between the low (50%) and high resilience (50%) groups. Binary logistic regression showed that the upper socio-economic class showed higher odds of better resilience (OR=4.038, 95% CI, 2.857%, 4.894%) as compared to the lower socio-economic class, and those with higher levels of education showed better resilience (OR=9.903, 95% CI, 2.502%, 3.483% than the lesser educated. KII explored different perspectives on personal experiences, concerns, challenges, attitudes, etc. where both perspectives such as benefits and hardships were addressed on an individual as well as a family basis, respectively Conclusion: Education and socio-economic backgrounds played a role in mending the resilience and other active measures such as peer support mechanisms and self-coping strategies also influenced the attitude and improved determination of parents dealing with children having ASD.

Assessment of Quality of Life and Determinants Among the Elderly Population in Rural Areas of Puducherry: A Mixed Method Study

Background: Elderly people living in rural areas often faces unique challenges that affect their quality of life (QOL), including limited access to healthcare and social support. Understanding the factors influencing their well-being is essential to improve the quality of life. The study aims to assess the QOL and its determinants among the elderly in rural areas of Puducherry. Methods: A community based sequential explanatory mixed method study was conducted among the elderly residing in the rural field practice area of a medical college in Puducherry district. 200 participants were recruited by simple random sampling from the family health records in the Rural Health Training Centre of a medical college. WHO QOL-BREF questionnaire was used to assess the Quality of Life quantitatively and an interview guide to explore its determinants. Data were entered in MS excel and analyzed using SPSS v16.0. Results: The mean age of the participants was 68.8± 2.5 years with majority being females. The environmental domain scored the highest mean QOL and psychological domain the lowest mean QOL. The overall mean QOL was 234.8 ± 65.4. The main determinants of poor QOL are age ≥ 75 years, lower socio-economic class, those who are widow/separated and presence of comorbid conditions. The binary logistic regression predicts the factor for poor QOL was age ≥ 75 years with OR (95% CI) as 6.23 (2.44-15.91). Conclusion: The overall mean QOL was moderate. The factors identified for poor QOL need to be addressed with key intervention strategies. Quality affordable medical services at door step to improve physical domain and targeted health education for family members and the community, who form the immediate environment around the elderly, can play a crucial role in enhancing the social domain.

Costs of Disabling Musculoskeletal Pain in Children and Adolescents: A Cost-of-Illness Prospective Cohort Study.

OBJECTIVES: To (1) estimate the economic cost of disabling musculoskeletal pain in children and adolescents from a health care and societal perspective, (2) identify the characteristics of children and adolescents with higher costs, and (3) estimate the economic cost of children's pain to Brazil. DESIGN: Prospective cohort study. METHODS: We recruited children and adolescents with disabling musculoskeletal pain from public and private schools. The economic cost associated with disabling musculoskeletal pain was reported by parents each month for 1 year. The cost categories were health care, lost productivity, and patient/family costs. The sum of the categories resulted in the societal costs. Costs were reported using means, standard errors, medians, interquartile ranges, confidence intervals, and sum for each cost category. We compared participant characteristics between groups with low and high costs, and estimated the health and social cost of children's pain to the Brazilian federal budget. RESULTS: We included 237 children and adolescents with mean age of 11.8 years (standard deviation, 2.9). Total annual health care costs were $29.58 and $103.13 for health insurance/public health care and out-of-pocket, respectively, per child. Total annual societal costs were $177.62 per child. Individuals in low socioeconomic class E (with a monthly income of up to R$403.00) reported that heavy backpack weight, practice of fewer days of sports, and more negative psychosomatic symptoms were associated with higher health care costs. The annual costs to Brazil from the societal perspective was $1 001 329 553. CONCLUSION: Disabling musculoskeletal pain in children and adolescents in Brazil imposes a serious economic burden of up to $1 billion on the federal budget. J Orthop Sports Phys Ther 2024;54(12):1-10. Epub 4 November 2024. doi:10.2519/jospt.2024.12735.

Socio-Demographic Factors of Children with Nephrotic Syndrome and Their Clinical Correlation

Background: Nephrotic syndrome (NS) is a chronic kidney disease in children marked by variability in treatment response, potentially influenced by socio-demographic and clinical factors. In resource-limited settings such as Bangladesh, understanding these potential influences is crucial for tailored healthcare strategies. This study investigates the socio-demographic profile of children with nephrotic syndrome and its clinical correlation to treatment outcomes. Methods: This cross-sectional study was conducted at Dhaka Shishu (Children) Hospital over six months, involving 168 children with nephrotic syndrome selected through convenient purposive sampling. Data were collected via structured interviews, focusing on socio-demographic factors and clinical outcomes. Statistical analysis was conducted using SPSS, with chi-square tests used to examine associations between socio-demographic factors and treatment response. A p-value <0.05 was considered significant. Results: Of the 168 participants, 61.31% were male, and half were aged 4 to 7 years. Most participants (70.24%) resided in rural areas, with 64.88% belonging to the lower socio-economic class. In terms of treatment response, 48.81% achieved remission, 38.10% experienced a relapse, and 13.10% were resistant to treatment. Although trends were observed, such as higher relapse rates among male children and resistance in females, no statistically significant associations were found between socio-demographic factors and treatment outcomes. Conclusion: The study highlights observed trends in socio-demographic characteristics and treatment outcomes in children with nephrotic syndrome in Bangladesh; however, no significant associations were identified. These findings underscore the importance of larger, more comprehensive studies to further investigate these variables and support the development of tailored management approaches in resource-limited settings.

Socio-economic profile and prevalence of hypertension among type 2 newly diagnosed diabetes mellitus patients attending a tertiary hospital in Dhaka

Introduction: Untreated coexistence of hypertension and diabetes mellitus (DM) may result in more severe complications. The implementation of earlier intervention to prevent these complications can be facilitated by earlier identification of the conditions and their associated factors. Methods: This cross-sectional research was conducted at Sir Salimullah Medical College, Dhaka, between June 2020 and July 2021. Following the diagnosis of DM in the symptomatic patients, SPSS V 25 was utilized to collect socioeconomic history and blood pressure data for further analysis. Results : 271 (40 %) of the 542 diabetic patients were between 33 to 47 years of age. Most (332, 60.9%) were females. A majority of the patients (302.55.7%) belonged to lower socioeconomic classes, with incomes ranging from 1 thousand to 14 thousand taka. 253 patients (46.7%) had a familial predisposition to diabetes. Concurrent hypertension was observed in 193 (35.6%) diabetic patients; this was substantially correlated with advancing age, lower socioeconomic status, and higher body mass index (p< 0.05). Result: Diabetic hypertensive patients were more prevalent among those with lower socioeconomic status, a demographic that is least likely to pursue and adhere to treatment. Therefore, it is necessary to develop and execute policies that guarantee their appropriate treatment and avert subsequent complications. Conclusion A significant percentage of the participants simultaneously presented with diabetes mellitus and hypertension, both of which are life-threatening conditions if left untreated. The majority of patients belonged to the lower socioeconomic class, which increases the likelihood of inadequate diagnosis and treatment. It is imperative to develop policies that facilitate their convenient access to healthcare services, thereby enabling them to obtain appropriate treatment and prevent any subsequent complications. J Shaheed Suhrawardy Med Coll 2023; 15(1): 55-58

Association Between Spontaneous Preterm Labor and Genitourinary Tract Infections Among Pregnant Women in a Tertiary Care Hospital in South India: A Cross-Sectional Study.

Introduction and objectives Preterm labor, defined by the WHO as the onset of labor between 20 and 37 weeks of gestation, is a major contributor to neonatal morbidity and mortality, with spontaneous preterm birth accounting for two-thirds of these cases. Genitourinary tract infections, particularly urinary tract infections (UTIs), are a significant risk factor for preterm labor, with studies suggesting that 40% of spontaneous preterm births are associated with genital tract infections. This study aims to determine the association between spontaneous preterm labor and genitourinary tract infections in a sample of antenatal women and evaluate its impact on maternal and neonatal outcomes. Methods This cross-sectional study included 144 antenatal women with spontaneous preterm labor, threatened preterm labor, or preterm premature rupture of membranes (PPROM), presenting between 28 and 37 weeks of gestation at Sri Ramachandra Medical College. Midstream urine samples and vaginal swabs were collected for culture and sensitivity testing. Additional parameters, such as maternal age, body mass index (BMI), parity, socioeconomic status (SES), and history of preterm births, were recorded. Blood tests were performed to measure total counts and C-reactive protein (CRP) levels. Maternal and neonatal outcomes, including birth weight and neonatal sepsis, were analyzed. Results Of the 144 women, 34 (24%) had a positive UTI culture, withEscherichia colibeing the most common organism isolated (35%). The majority of UTI-positive cases were observed in women aged 25-29 years (13, 38%) and those from lower socioeconomic classes (22, 65%). A significant association was found between positive UTI cases and elevated total white blood cell counts and CRP levels. Neonatal outcomes in UTI-positive cases included low birth weight (13, 38%) and neonatal sepsis (3, 9%), while maternal complications were mostly limited to asymptomatic bacteriuria and acute cystitis. Conclusion The study demonstrates a significant association between spontaneous preterm labor and UTIs. Regular screening for genitourinary infections in pregnancy, particularly in high-risk groups such as women from lower socioeconomic backgrounds, could help reduce the incidence of preterm labor and improve neonatal outcomes. Early diagnosis and treatment of UTIs are crucial for preventing complications in both mothers and neonates.

Evaluation of Postoperative Electrolyte Imbalance of Oral Squamous Cell Carcinoma Patients: A Study in a Tertiary Level Hospital

This cross-sectional observational study was performed to evaluate the post-operative electrolyte imbalance in oral squamous cell Carcinoma patients, and it was conducted at the Department of Oral & Maxillofacial Surgery in Dhaka Dental College & Hospital, Dhaka, Bangladesh during June 2022 to June 2023. A total of 100 patients who were clinically and histo-pathologically diagnosed as OSCC patients were enrolled in this study. The collected data were edited, coded processed for computer data entry. The data were analyzed using Statistical Package for Social Sciences (SPSS) software, version-23.0. Descriptive analysis was performed and the results were presented as tables and graphs. Unpaired t tests, Chi-square, Spearman’s rho correlation tests were performed to compare the mean and ratio correlation of the study variables where P<0.05 with 95%CI. The ethical clearance of this study was obtained from the Ethics Committee of Department of Oral & Maxillofacial Surgery in Dhaka Dental College & Hospital, Dhaka, Bangladesh. A total of 100 oral squamous cell carcinoma (OSCS) patients were enrolled in this study. The mean age of the patients was 56.63 ± 9.54 years. The mean BMI of the patients was 18.20 ± 0.60 kg/m2. The majority of the patients were male and it was 54% while female was 46%. 64% patients belonged to lower socio-economic class. 52% patients had the habit of betel nut which was the highest while 39 % had the habit of betel nut with tobacco. The majority, 32% of patients had Stage-I. The mean surgery duration was 5.45± 0:91 hours and 7.2±: 0:15 minutes. The mean blood required for the surgery 1.44±0.68 units. According to the distribution of the post-operative variations of electrolyte imbalances, Sodium (Na+) was observed, hypo 25(25%) and hyper0(0%) on day-1 and hypo 31(31%), and hyper 4(4%) was observed on day 3 and followed by Potassium (K+) hypo 5(5%) and hyper 2(2%) on day- 1 and hypo 7(7%) and, hyper2(25) on day- 3. In comparison of ratio between hypo and hyper of day1 and day-3, showed statistically significant relationship observed (p<0.05). According to postoperative electrolyte distribution, on day-1, mean Sodium (Na+) was observed 136.68±2.69 mmol/L whereas on day-3, mean Sodium (Na+) was observed 133.81±4.21 mmol/Land followed by on day-1 mean Potassium (K+),3.86±0.46mmol/L, day-3, mean Potassium (K+),3.74 ±0.45 mmol/L on day-1. Among the postoperative electrolyte, except, Potassium (K+), all were observed statistically significant (P<0.05). In conclusion, hypocalcaemia, hyponatremia, and hypomagnesaemia are the relatively common after maxillofacial surgeries. Beside this BMI could affect electrolyte abnormalities after maxillofacial surgery.

UNSEEN TUBERCULOSIS: STUDY AMONG INPATIENTS OF A TERTIARY CARE HOSPITAL OF NORTH KARNATAKA

Objective: Tuberculosis (TB) remains a significant global health challenge, particularly in high-burden countries like India. However, high proportion of people never diagnosed or treated. Delayed diagnosis poses a significant threat to hospital inpatients, health-care workers, and medical trainees. Hence, systematic screening of high-risk groups, including hospital inpatients, has been recommended as a strategy to identify TB. Using signs and symptoms as an independent screening tool remains a global challenge for its relatively low accuracy. However, it could still be of value when it was used in a specific target population like inpatients of hospital. Hence, this study is aimed to determine the proportion of presumptive and active TB cases among inpatients. Methods: A hospital-based cross-sectional study was conducted among inpatients above 18 years of age admitted in non-emergency wards admitted during March to April 2023 at ESIC Hospital in Kalaburagi. A pre-existing TB diagnosis and patients admitted to critical care units were excluded. The convenient sampling method was used to recruit participants. Data were collected through using a pre-designed, semi-structured questionnaire. The patients who presented with one of the four symptoms for screening had undergone investigations such as cartridge-based nucleic acid amplification test, chest X-ray, and sputum microscopy to confirm the diagnosis, and the findings were recorded as proportion. Results: Out of 1363 inpatients, 35 (2.5%) patients had classified as presumptive TB case. Out of 35, 3 (8.57%) were found to be actual TB cases. All patients who had positive results for TB were young patients and belonged to low socioeconomic class. Two of three were rifampicin-sensitive TB cases. Conclusion: Timely screening of the patient’s is of utmost importance to avoid further spread of TB infection among inpatients. The higher prevalence of actual TB cases in younger adults needs further exploration.

High free sugars, insulin resistance, and low socioeconomic indicators: the hubs in the complex network of non-communicable diseases in adolescents

BackgroundNoncommunicable diseases (NCDs) predominantly affect adults, but pathophysiological changes begin decades earlier, as a continuum, with initial events apparent in adolescence. Hence, early identification and intervention are crucial for the prevention and management of NCDs. We investigated the complex network of socioeconomic, behavioral, and metabolic factors associated with the presence of NCD in Brazilian adolescents.MethodsWe conducted a cross-sectional study nested within the São Luís segment of the Ribeirão Preto, Pelotas, and São Luís (RPS) cohort’s consortium, focusing on 18–19-year-olds (n = 2515). Data were collected prospectively, from which we constructed a complex network with NCD-related factors/indicators as nodes and their co-occurrences as edges. General and sex-based models analyzed: socioeconomic status, behavioral (smoking, alcohol, and other drugs use, unhealthy diet, poor sleep, physical inactivity), and metabolic factors (overweight/obesity, elevated blood pressure, poor lipid profile). We also looked for NCDs in adolescence like asthma, abnormal spirometry, depression, suicide risk, and poor oral health. The network was characterized by degree, betweenness, eigenvector, local transitivity, Shannon entropy, and cluster coefficient.ResultsThe adolescents had an average age of 18.3 years, 52.3% were female and 47.7% male. 99.8% of them have a diet rich in free sugars, 15% are overweight/obese and 72.3% had an elevated TyG index. High free sugar emerged as the central hub, followed by high TyG index (an early marker of insulin resistance) and low socioeconomic class. In males, low fiber intake and a high triglycerides/HDL ratio highlighted cardiometabolic concerns; in females, sedentary behavior and poor sleep marked metabolic and psychological challenges, along with caries in both sexes.ConclusionsOur findings provide insights into central health challenges during adolescence, such as high free sugars, insulin resistance, and low socioeconomic indicators, suggesting that interventions targeted at these central hubs could have a significant impact on their NCD network.

A clinical study on hoarseness of voice, etiology and its management

Background: Voice is an inherent means of communication intended to convey feelings of intimacy. One of the most frequent symptoms otolaryngologist’s encounters is hoarseness. The aims of this study are to determine the causes of hoarseness predisposing factors, to assess the clinical profile as well as how to evaluate and treat hoarseness of voice. To estimate the proportion of common causes of hoarseness in patients, identify predisposing factors and evaluate outcomes of various treatment methods. Methods: This was a cross-sectional study conducted at ENT department of tertiary care center. A total of 80 cases presenting with hoarseness were studied. A detailed history was taken, followed by a comprehensive local and systemic examination, leading to a clinical diagnosis supported by relevant investigations. Results: The most frequent cause of hoarseness of voice among patients was determined to be laryngeal cancer, with a 32.5% incidence rate. The incidence of hoarseness was 0.40% among the total ENT cases. Out of total 80 study subjects with hoarseness of voice 40% were from lower socioeconomic class, 30% had habit of smoking. Among them,35% were treated medically, 50% were treated surgically/radiotherapy and for remaining 15% study subjects no treatment was given. Conclusion: Therefore, based on this study, we conclude that hoarseness of voice is a primary symptom warranting investigation, as it could signal early laryngeal malignancy.

The Impact of Social Marginalisation on Science Engagement and the Extent of Barrier Reduction

This paper examines the impact of social marginalisation, including race, gender, and social class, on science engagement. Socially marginalised groups, such as women, people of colour, and lower socioeconomic classes, face significant barriers in science education and careers due to discrimination, stereotyping, and limited access to science capital. The paper explores how these factors intersect to influence the formation of scientific identity and contribute to underrepresentation in scientific fields. Efforts to reduce these barriers, such as inclusive science communication and stereotype manipulation, are critically evaluated. Although these interventions offer potential solutions, they remain idealistic and face significant challenges. The paper concludes that addressing these barriers requires deep structural and cultural reforms within the scientific community.

Prevalence and Predictors of Domestic Violence in India: Complex Sample Analysis of a Nationally Representative Study Conducted Between 2019 and 2021.

Violence against women has been one of the dreaded social evils that humanity is facing. There have been concerted efforts to eliminate this evil, and sustainable development goals goal 5.2.1 gave it a timeline. The current study was carried out to estimate the burden of domestic violence (DV) against women and to investigate the sociodemographic correlates of DV victims in India. Data were drawn from the fifth National Family Health Survey round. According to Demographic Health Survey guidelines, DV is measured using a 13-item questionnaire in the women's survey. Complex sample analysis was done using a primary sampling unit, sample weight, and stratification variables to estimate the weighted prevalence. Chi-square and multivariate logistic regression determine the unadjusted and adjusted odds ratio. The analysis is carried out using SPSS version 26 (IBM Corp., Armonk, NY). The weighted prevalence of DV against women in India in 2019-2021 was 31.2%. Approximately 28.5%, 13.1%, and 5.7% of women reported experiences of physical, emotional, and sexual violence, respectively. Karnataka was the worst affected state, with 47.3% of women facing DV. Individual factors like education and occupation, household factors like husband'seducation, occupation, drinking habit, wealth index, and community-level factors like caste, religion, and place of residence were significant predictors of DV. Lower levels of education and lower socioeconomic status were essential predictors of DV. The importance of education for both females and males has repeatedly been directly associated with DV, but the interventions have failed to improve the situation and warranta new strategy. Awareness about the legal consequences of DV in lower socioeconomic classes also has the potential to cut down the numbers. Further research into the causality can improve the planning for better intervention modalities.

Risk Factor Profile for Cardiovascular Diseases Among Farmhouse Residents in Vijayapura District, Karnataka: A Cross-Sectional Study.

Background Cardiovascular illnesses are widely regarded as the leading cause of mortality worldwide, with 17.9 million deaths every year. Rheumatic heart disease, coronary heart disease, and cerebrovascular illness are among the conditions relating to the heart and blood vessels together, known as cardiovascular diseases. The main behavioural risk factors for heart disease and stroke include poor diet, inactivity, tobacco use, and excessive alcohol consumption. In contrast, one of the significant environmental risk factors is air pollution. People may experience high blood pressure and high blood sugar due to obesity and overweight as risk factors. Objectives This study aims to find the risk factor profile for cardiovascular diseases among the farmhouse residents of the Vijayapura district, India. Materials and methods A cross-sectional descriptive study was conducted with the farmhouse inhabitants of the Vijayapura district. Using a prestructured proforma that included details on the sociodemographic profile and risk factors of the farmhouse dwellers, 450 sample participants were questioned. Five families within a chosenprimary sampling unit (PSU) were chosen randomly from a pool of PSUs that were picked using a probability proportional to size sampling technique. All characteristics were summarized descriptively. Results The study included 450 participants, 50.9% males and 49.1% females. The age range of 21.4% of the male participants was between 41 and 50, whereas 21.7% of the female participants belonged to the 41 to 50 age group. The study showed a proportion of them had the habit of alcohol consumption (5.8%), chewing tobacco (2%), and smoking (1.6%). Compared to female participants (1.3% vs. 1.3%), the majority of male individuals (4.8% vs. 7%) had hypertension and diabetes mellitus, respectively. Conclusion The findings of the current research indicated that the majority of farm inhabitants in the rural Vijayapura district were illiterate, belonged to a lower socioeconomic class, and had intermediate and behavioural risk factors for cardiovascular illnesses.

Secondary Amenorrhea from Long Forgotten Intracervical Herbal Concoction Pessary: A Case Report and Review of Literature

Vaginal pessaries are used in gynaecology to treat utero-vaginal prolapse or urinary incontinence (pelvic floor disorders). However, self-administered or provider-administered per vagina insertion of herbal materials and concoctions is a practice prevalent amongst the low socioeconomic class of developing nations with poor access to good comprehensive health care. These oftentimes unhygienic and toxic materials may present with symptoms of immediate and or long-term complications. Asymptomatic cases may be forgotten only to be discovered incidentally. This study reports the case of a 47-year-old nullipara with amenorrhoea and infertility with an incidental finding of long forgotten intracervical herbal packing. The prolonged herbal pessary caused chemical vaginitis, scarring and subsequent cervical stenosis and amenorrhoea.

A Ten-Year Review of Neonatal Tetanus Seen in a Tertiary Health Facility in Sokoto North-Western Nigeria: Before and During the Covid-19 Pandemic

Background: Neonatal tetanus (NNT) remains among the leading cause of preventable morbidity and mortality among neonates in Nigeria. Nigeria remains among the countries carrying the global NNT burden. At the onset of the COVID-19 pandemic, reports have predicted that the pandemic will significantly impact on the health system globally, and low-resource countries where vaccination programs fared even worse are likely to see a surge in vaccine-preventable diseases during and after COVID-19 pandemic. Aims: To determine the prevalence, yearly trend, risk factors, and outcome of NNT cases seen in the Special Care Baby Unit (SCBU) of Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto, Nigeria over a ten year period: before and during COVID-19 pandemic. Methods: This was a retrospective study. Data was retrieved from all the case notes of neonates admitted with a clinical diagnosis of NNT into the SCBU of the UDUTH, Sokoto from 1st January, 2013 to 31st December, 2022. The data obtained was analyzed using SPSS version 21. Results: During the 10 years period of the study, NNT accounted for 0.4% of admissions. The majority 15(57.0%) of the mothers of the neonates with NNT were from rural areas, 15(56.0%) had no antenatal care (ANC), and only 10(37.0%) of the mothers received vaccination against tetanus. All the mothers were from lower socio-economic classes. Most 17(63.0%) of the neonates were delivered at home by traditional birth attendants. The umbilical cord was the portal of entry in 26(96.0%) of cases, while 1(4.0%) followed traditional uvulectomy. Cord care was done using hot water fermentation in more than half of the neonates 17(63.0%), while only 1(4.0%) of the mothers used chlorhexidine gel for cord care. The case- fatality rate was 6(22.0%). the yearly trend showed an increased incidence of NNT admissions in 2022. Conclusion: The study showed that NNT is still a public health problem, with an increased scourge during the COVID-19 pandemic, which can be tackled through health education of mothers via mass media, improving the quality and access to ANC services, tetanus toxoid vaccination, hospital delivery and avoidance of traditional uvulectomy particularly in rural areas by the Sokoto state government. Antenatal and vaccination services should be given priority in response to future pandemics to sustain gains of the SDG 3.

Influencia de los factores socioeconómicos y psicológicos en los resultados del tratamiento quirúrgico de la artrosis trapecio-metacarpiana

ObjectiveThis study aimed to investigate to what extent people with carpometacarpal thumb osteoarthritis that are socioeconomically disadvantaged and have psychological disorders report higher pain levels and worse patient-rated upper-extremity functionality after surgical treatment. Material and methodA single center, retrospective observational cohort study analysing 100 patients diagnosed with thumb carpometacarpal osteoarthritis between 2013 and 2019. Patients were divided into two groups (50/50), depending on whether they received surgical or conservative treatment. The socio-economic status (ESeC classification) and presence of psychological comorbidities were investigated. Functional outcomes were assessed using the Visual Analogue Scale (VAS), Q-DASH questionnaire and Kapandji score. Current mental disorders were evaluated using STAI, PHQ-9 and PCS screening scales. ResultsMeasures of functional hand scores (Q-DASH) were higher and had considerably less pain in surgically treated participants, although thumb mobility (Kapandji) was more restricted. They were also associated with higher scores on psychological assessment scales. Sixty-four per cent of the patients came from lower socio-economic classes and suffered from poorer scores on the mental health screening questionnaires. Of the patients manage surgically, 54% were diagnosed of dysthymic disorder and showed significantly worse patient-rated upper-extremity function (Q-DASH questionnaire, median [IR]:31,8 [20,5-54,6] than patients without psychological disorders (median [IR]: 13,6 [2,3-36,5]). No differences were found for patients with and without disthymic disorder managed nonoperatively. ConclusionsPatients with higher rates of depression, anxiety and pain catastrophizing behaviour showed significantly worse outcomes after surgery for osteoarthritis of the first carpometacarpal joint. Lower socio-economic class significantly influences levels of depression and anxiety but did not affect functional outcome. Surgical treatment of carpometacarpal thumb osteoarthritis achieved better self-perceived hand function (QDASH, VAS, Kapandji) than conservative treatment.

Social class, smartphone advertising exposure, self‐esteem, and materialism: The case of children in Lebanon

AbstractThe current compounded economic crisis in Lebanon has increased poverty rates and widened the gap between families of different socioeconomic classes. Little is known about the impact of advertising, particularly smartphone advertising, on the self‐esteem and materialism levels of children in developing countries like Lebanon. This study aimed to measure the differences among children coming from lower and upper socioeconomic classes in the following: smartphone advertising exposure, materialism and self‐esteem, vulnerability to the effects of smartphone advertising exposure on materialism, and vulnerability to the effects of materialism on self‐esteem. It was found that advertising affected negatively the self‐esteem of the children coming from lower social classes, including the “newly poor,” because in the current economic situation, children who are more exposed to advertising are more likely to believe in advertising, have lower self‐satisfaction, and believe themselves to be inferior for not owning the various products that are advertised, which lead them to become more materialistic than children from wealthier families. On the other hand, advertising had a reinforcing effect on materialism among more affluent children. In addition, and contrary to the expected, children from higher social classes, and not children from deprived households, were more susceptible to the impact of advertising on materialism. These findings enlighten us on the significant role that today's advertising plays in societies with wide socioeconomic disparities.

Childhood poisoning: a 10-year experience in a tertiary hospital in Enugu State, Nigeria

Childhood Poisoning is a common cause of emergency room presentation, more so in underdeveloped countries where it contributes to a high incidence of hospitalization with variability in morbidity and mortality. This study retrospectively assessed the sociodemographic profiles, poisoning agents, clinical features and management of cases of childhood poisoning admitted at Enugu State University Teaching Hospital, Enugu. It was a 10-year retrospective study of all the cases of childhood poisoning admitted within the period of study at the Children’s Emergency Room of Enugu State University Teaching Hospital (ESUTH), Enugu. The prevalence of childhood poisoning in the study was 0.3%. Of all the subjects, 78.4% were ≤5 years and more than half were males and from lower socioeconomic classes. Accidental poisoning accounted for 70.3%; the predominant agents were kerosene and organophosphates. Palm oil was used by 67.6% of the participants as an intervention before presentation. Pneumonitis was the most common complication. Patients with peripheral oxygen saturation (SpO2) < 95% were 14 times more likely to have complications than those with SpO2 ≥ 95%. The duration of hospital stay was ≤3 in 59% of the cases and no mortality was recorded in this study.Childhood poisoning remains prevalent in our environment with kerosene being the commonest agent. Palm oil administration as a predominant pre-hospital intervention worsens outcomes. Duration of hospitalization depends on SpO2 at presentation, need for antibiotic therapy, and intention.