Poor Hygienic Conditions Research Articles

Efficacy of Dadruhara Lepa in Dadru W.S.R. Tinea Corporis: A Single Case Study

Skin is the largest organ of our body. It is important to take care of it. In today’s era, skin diseases are commonly found due to lifestyle changes. One of the very common skin problems is Fungal infection. In Ayurveda, we relate it with Dadru based on its signs and symptoms. The signs and symptoms of Dadru kushtha resemble Tinea corporis, which is a fungal infection caused by poor hygienic conditions. This Article is a case study of a 62-year-old male patient with signs and symptoms of Dadru kushtha registered from the OPD of Kayachikitsa, UAU, Gurukul Campus, Haridwar. We administered Dadruhara lepa and some oral ayurvedic medications after taking these medications patient gets relieved within 50 days from all signs and symptoms of Dadru.

Assessment of the impact of locally fabricated oven and sun drying method on the proximate, mineral and microbiological composition of Clarias gariepinus (catfish)

Drying is an age long practice which prevent fish from deterioration and spoilage, however, traditional drying is usually practiced in rural settings with poor hygienic conditions, thus, the nutritional and microbial quality of such products is uncertain. Therefore, the present study was aimed at evaluating the impact of a locally fabricated oven and sun drying method on the proximate, mineral and microbial composition of Clarias gariepinus (Catfish) using standard laboratory procedures. The results of the proximate analysis showed that the oven dried fish had the highest crude protein content (66.43 ± 3.37 %), crude lipid content (8.27 ± 0.28 %) and carbohydrate content (4.50 ± 0.22 %) which were statistically significant (p<0.05) when compared to the sun dried fish, while the sun dried fish had the highest ash content (16.30 ± 2.48 %) and moisture content (14.30 ± 0.82 %) which were statistically significant (p<0.05) when compared to the oven dried fish. Also, the mineral analysis showed that the oven dried fish had the highest calcium (821.49 ± 1.10 mg/kg), phosphorus (86.04 ± 0.83 mg/kg), potassium (254.72 ± 0.40 mg/kg), iron (40.73 ± 0.23 mg/kg), manganese (0.95 ± 0.01 mg/kg) and selenium (14.15 ± 0.39 mg/kg) content which were statistically significant (p<0.05) when compared to the sun dried fish, while the sun dried fish had the highest sodium (173.52 ± 0.12 mg/kg), cupper (0.87 ± 0.12 mg/kg), magnesium (39.01 ± 0.43 mg/kg) and zinc (2.83 ± 0.23 mg/kg) content which were also statistically significant (p<0.05) when compared to the oven dried fish. The study also showed that the total viable bacterial count was higher in the sun dried fish (6.23 x 105 cfu/g) which was not statistically significant (p<0.05) when compared to the oven dried fish (5.65 x 105cfu/g), while the fungal count was higher in the oven dried fish (6.55 x 105 cfu/g) which was also not statistically significant (p<0.05) when compared to the sun dried fish (5.01 x 105 cfu/g). The findings in this study showed that the locally fabricated oven was remarkably effective, yielding fish with significantly enhanced nutritional profiles and minimal microbial contamination. This approach offers a superior method for fish preservation, providing a promising alternative for improving food safety and nutritional quality.

Under five children diarrhea prevalence and associated factors in slum areas of Gondar City Northwest Ethiopia: a community based cross-sectional study

Slum areas in Ethiopia have high poverty status. In addition, they possess poor water and sanitation accesses such as unsafe drinking water, a lower number of sanitation facilities and poor hygienic conditions. These scenarios are important in the occurrence of diarrhea among under five children’s. However, there are many studies conducted on diarrhea among under five children in Ethiopia, unfortunately, the majority usually didn’t give enough coverage for the burden of diarrhea among under five children in slum areas. This study aimed to determine the prevalence of diarrhea and associated factors among under five children in slum areas of Gondar City. This community-based cross-sectional study was conducted in slum areas of Gondar City among under five children from March 28 to April 28, 2023. A multi-stage sampling technique was used to collect a sample of 836 through interview-administered methods using a structured data collection tool. The collected data was manually checked for completeness, coded, and entered into EPI Info version 7.1.5.2 software. It was then exported to Stata version 14.1 software for descriptive analysis, as well as bivariable and multivariable binary logistic regression analyses, to identify factors associated with diarrhea among under five children. The prevalence of diarrhea among under five children at 95% confidence interval was 24.64% (CI 21.71–27.56). Mothers/caretakers age < 25 years (AOR = 1.88, 95% CI 1.16–3.06), mothers/caretakers age between 28 and 31 years (AOR = 1.82, 95% CI 1.08–3.05), mothers/caretakers who had no formal education (AOR = 3.18, 95% CI 1.86–5.41), mothers/caretakers who had primary education (AOR = 1.67, 95% CI 1.09–2.57), income level between 4877 and 5643 Ethiopian Birr (AOR = 1.81, 95% CI 1.04–3.15), family size greater than five (AOR = 1.54, 95% CI 1.00–2.36), flies around the house (AOR = 2.27, 95% CI 1.38–3.73), playground not clean (AOR = 2.70, 95% CI 1.62–4.50), breastfed for ≥ 1 year (AOR = 0.63, 95% CI 0.41–0.97), mothers/caretakers who did not wash their hands before food preparation and eating (AOR = 2.31, 95% CI 1.39–3.58), mothers/caretakers who did not wash their hands after visiting latrine (AOR = 1.60, 95% CI 1.07–2.38) were significantly associated factors with diarrhea among under five children in slum areas of Gondar City. The study indicates that the prevalence of diarrhea was higher among under five children in slum areas of Gondar City. The Gondar City Administration Education Bureau should give great emphasis on improving mother’s and caretaker’s education. In addition, the Gondar City Administration Health Bureau should educate mothers and caretakers about breastfeeding, sanitation, and hygiene in the slum areas of Gondar City.

The Questionnaire on the Use of Public Transportation and Well-Being (QUPTW): A national survey and validation in Paraguay

IntroductionThe impact of public transportation on the human emotional well-being is certainly under-studied, especially in the developing countries. This study proposes and validates a questionnaire aimed to assess the emotional well-being in the context of public transportation use in Paraguay (as in any other Spanish country). MethodsWe conducted an observational cross-sectional study using an online survey to address the relationship between the transport systems and mental health. The newly developed Questionnaire on the Use of Public Transportation and Well-Being (QUPTW) was evaluated for content and construct validity, criterion validity, and reliability. ResultsFindings from 918 respondents have shown that the QUPTW reports strong psychometric properties, including validity and reliability. Participants, primarily young, university-educated women residing in Greater Asunción, reported dissatisfaction with the public transportation services. Long commute times, discomfort, and poor hygiene and safety conditions are significant contributors leading to emotional distress. These findings underscore the potential impact of the inadequate public transportation systems on mental well-being, suggesting the need for policy interventions to enhance accessibility, comfort, and safety. ConclusionsThis study contributes to the understanding of the relationship between the public transportation use and the emotional well-being and provides a valuable tool for further research and policy development.

Candidiasis and Oral Health

Candidiasis, primarily caused by Candida albicans, poses significant oral health concerns. This review highlights its clinical manifestations, diagnostics, and management strategies. Predisposing factors include poor oral hygiene and systemic conditions like HIV/AIDS and diabetes. Clinical presentation varies from asymptomatic colonization to symptomatic mucosal infections, with complications such as denture stomatitis. Diagnostics encompass clinical examination and various laboratory methods, guiding tailored treatment with topical or systemic antifungals. Prevention strategies targeting modifiable risk factors are crucial. Despite challenges like antifungal resistance, interdisciplinary collaboration among healthcare providers is essential for the effective management of oral candidiasis and its impact on overall health. Keywords: Candidiasis; Candida albicans; Oral health; Diagnostics; Antifungals; Prevention strategies

Prevalence and transmission of the most relevant zoonotic and vector-borne pathogens in the Yucatan peninsula: A review.

Habitat modification and land use changes impact ecological interactions and alter the relationships between humans and nature. Mexico has experienced significant landscape modifications at the local and regional scales, with negative effects on forest cover and biological biodiversity, especially in the Yucatan peninsula in southeastern Mexico. Given the close relationship between landscape modification and the transmission of zoonotic and vector-borne diseases, it is essential to develop criteria for identifying priority zoonoses in the south of the country. We reviewed 165 published studies on zoonotic and vector-borne diseases in the region (2015-2024). We identified the most frequent vectors, reservoirs, and hosts, the most prevalent infections, and the factors associated with transmission risk and the anthropogenic landscape modification in urban, rural, ecotone, and sylvatic habitats. The most relevant pathogens of zoonotic risk included Trypanosoma cruzi, arboviruses, Leishmania, Rickettsia, Leptospira, and Toxoplasma gondii. Trypanosoma cruzi was the vector-borne agent with the largest number of infected vertebrate species across habitats, while Leishmania and arboviruses were the ones that affected the greatest number of people. Dogs, cats, backyard animals, and their hematophagous ectoparasites are the most likely species maintaining the transmission cycles in human settlements, while rodents, opossums, bats, and other synanthropic animals facilitate connection and transmission cycles between forested habitats with human-modified landscapes. Pathogens displayed different prevalences between the landscapes, T. cruzi, arbovirus, and Leptospira infections were the most prevalent in urban and rural settlements, whereas Leishmania and Rickettsia had similar prevalence across habitats, likely due to the diversity and abundance of the infected vectors involved. The prevalence of T. gondii and Leptospira spp. may reflect poor hygiene conditions. Additionally, results suggest that prevalence of zoonotic and vector-borne diseases is higher in deforested areas and agricultural aggregates, and in sites with precarious health and infrastructure services. Some hosts, vectors, and transmission trends of zoonotic and vector-borne diseases in the YP are well known but others remain poorly recognized. It is imperative to reinforce practices aimed at increasing the knowledge, monitoring, prevention, and control of these diseases at the regional level. We also emphasize the need to perform studies on a larger spatio-temporal scale under the socio-ecosystem perspective, to better elucidate the interactions between pathogens, hosts, vectors, environment, and sociocultural and economic aspects in this and many other tropical regions.

Novel thiolated pluronic anchored gastro-retentive SEDDS of azithromycin against peptic ulcer

Peptic ulcer disease is a substantial health issue worldwide, owing to excessive use of non-steroidal anti-inflammatory drugs (NSAIDs) and poor hygienic conditions. Numerous therapeutic approaches including antibiotics and PPIs are commonly used, but these therapies are rendered with multi-drug resistance, increased frequency of dosing, less retention time, deceased safety, efficacy, and non-patient compliance. Herein, azithromycin (AZM), an expansive-spectrum antibiotic with notable anti-ulcer efficiency was integrated into a thiolated pluronic self- emulsifying drug delivery system (SEDDS) to enhance its solubility, mucoadhesion, stability, gastro-retention, and targeted drug delivery. Pluronics are triblock copolymers with excellent biocompatibility and amphiphilic properties, widely used in drug delivery, disease diagnosis, and treatment, among other applications. In vitro and in vivo tests were performed to assess the drug-release kinetics, H-pylori clearance, and efficacy. The optimized formulation possessed a size of 357 nm, PDI ≤ 0.5 and a zeta potential of 30 mV. Drug release was 85 % in 72 h, following Korsmeyer-Peppas model. Thiolated SEDDS proved to be extremely potent in eradicating bacterial load (40-load) when compared to alternative formulations. Furthermore, the retention duration, biofilm elimination and nanoparticle uptake were maximized. This novel thiolated SEDDS composition is highly recommended as it holds promising potential to markedly enhance the therapeutic outcomes of AZM in peptic ulcer treatment and overcomes the restrictions of current methodologies. The study not only boosts scientific comprehension of more effective drug-delivery techniques but also recommends significant implications for the broader disciplines of gastroenterology and personalized medicine.

Screening of Candida spp. in wastewater in Brazil during COVID-19 pandemic: workflow for monitoring fungal pathogens

Fungal diseases are often linked to poverty, which is associated with poor hygiene and sanitation conditions that have been severely worsened by the COVID-19 pandemic. Moreover, COVID-19 patients are treated with Dexamethasone, a corticosteroid that promotes an immunosuppressive profile, making patients more susceptible to opportunistic fungal infections, such as those caused by Candida species. In this study, we analyzed the prevalence of Candida yeasts in wastewater samples collected to track viral genetic material during the COVID-19 pandemic and identified the yeasts using polyphasic taxonomy. Furthermore, we investigated the production of biofilm and hydrolytic enzymes, which are known virulence factors. Our findings revealed that all Candida species could form biofilms and exhibited moderate hydrolytic enzyme activity. We also proposed a workflow for monitoring wastewater using Colony PCR instead of conventional PCR, as this technique is fast, cost-effective, and reliable. This approach enhances the accurate taxonomic identification of yeasts in environmental samples, contributing to environmental monitoring as part of the One Health approach, which preconizes the monitoring of possible emergent pathogenic microorganisms, including fungi.

Risk Factors for Cervical Cancer in Ghana.

The major burden of cervical cancer occurs in low- and middle-income countries. In Ghana, it is the second most common cancer among women. Infection with high-risk human papilloma virus (HPV) has been established as the cause of cervical cancer. As such, it is important to identify risk factors that may affect progression from HPV infection to cancer. We assessed the risk factors assocaited with cervical cancer in Ghana. To identify the risk factors for cervical cancer, we conducted an unmatched case-control study in two hospitals in Ghana where most cervical cancer cases are diagnosed. Women with histologically confirmed cervical cancer were the cases, whereas women without cancer seeking care at the two hospitals were controls. A structured questionnaire was administered to the women, after which cervical samples were sent for HPV deoxyribonucleic acid (DNA) testing. Overall, 206 cases and 230 controls were recruited. After adjusting for possible confounders, women with the highest educational level had a significantly lower risk of cervical cancer than those with no or little formal education. Parity was a major risk factor (odd ratio [OR] for five or more children = 7.9; 95% CI: 2.3-27.6), with risk increasing with increasing parity (p for trend <0.001). Women reporting the use of a homemade sanitary towel during menstruation also had an increased risk of cervical cancer compared with women who used a pad (OR: 7.3; 95% CI: 2.5-22.0). In this Ghanaian population, high parity and poor personal hygienic conditions were the main contributing factors to the risk of cervical cancer after adjustment for the presence of high-risk HPV genotypes.

Challenges and Opportunities of Utilising School Nutrition Programme to Achieve Educational Goals in South African Rural Communities

This study explored the challenges and opportunities faced by schools in utilising the National School Nutrition Programme (NSNP) to achieve educational goals in South Africa. The NSNP was established in post-apartheid South Africa as a poverty alleviation and educational democratisation measure to improve educational access, attendance, and participation outcomes of learners from poor socio-economic backgrounds. The thesis of this paper was informed by Maslow’s theory of the hierarchy of needs to explain how food is a basic need for learners to ascend to the level of learning aspirations. The study adopted a phenomenological paradigm and a qualitative research approach. Purposive sampling was employed to select 2 secondary school principals, 8 teachers responsible for NSNP and 10 learners who were beneficiaries of the NSNP within a rural community setting. The study used face-to-face and focus group interviews and observations for data collection. Data was analysed and interpreted thematically. The study revealed that challenges such as poor hygienic conditions, poor quality and poor nutrition value of the menu, and consumption of teaching and learning time compromised the quality of NSNP provision in schools. However, despite these challenges, schools in rural communities use the NSNP for school attendance. Keywords: National School Nutrition Programme (NSNP), South Africa, Educational Goals, Maslow’s Theory, Socio-economic Development

Knowledge, Attitude, and Practices (KAPS) of the Inhabitants of Punjab, Pakistan toward XDR Typhoid Outbreak During COVID-19

Background Typhoid fever, caused by the bacterium Salmonella typhi, is the most prevalent in areas that have poor hygienic conditions. The most alarming situation is the development of the resistant strains of Salmonella typhi, first reported in 2016 in Hyderabad, Sindh. Later, there was a widespread outbreak of extensively drug-resistant (XDR) typhoid. This survey aims to investigate the risk factors for the spread of XDR typhoid in Pakistan based on the knowledge, attitude, and practices (KAPs) of the affected or at-risk population to help plan preventive actions. Method For this purpose, a community-based random KAP study was conducted in Punjab, Pakistan. Data was collected online and also by face-to-face interaction from those who had no access to the Internet. Result More than half of the respondents were aware of the fact that bacteria is the causative agent (60.6%) of XDR. Similarly, with regard to practice, it was found that 67.7% of them washed their hands before eating and 88.8% washed their hands after using the toilet. A common practice in the form of using filtered water for drinking purposes was adhered to by 73.8% of respondents. Conclusion The study concluded that preventative and control measures are necessary to avoid XDR typhoid pandemic spread.

Childhood Intestinal Parasitic Reinfection, Sanitation and Hygiene Practice in Eastern Ethiopia: Case Control Study.

The recurrence of intestinal parasitic infections (IPIs) can lead to different problems that can be transferred from generation to generation. Sanitation and hygienic practices have vital role in the parasitic reinfection. In poor hygienic and sanitation condition children may live in a continuous cycle of infection and reinfection. To assess childhood IP reinfection and its association with sanitation and hygienic practice in eastern Ethiopia. A population-based case-control design was used in this study. Data were collected from 75 reinfected cases and 147 unmatched controls. Fecal specimens were observed for parasites using direct smear and formol ether techniques. Epi-Info and SPSS (the statistical package for social science) were used for data entry and analysis, respectively. Logistic regression analysis was conducted to identify significant associations (P<0.05) between variables. The overall IP reinfection rate within 24 weeks after treatment was 33.8% (75/222), with a 95% CI=27.7%-40.5%. The frequency of intestinal protozoa was 18%, and for helminths was 15.8%. Children who swam in a polluted water had 3.7 times greater odds of IP reinfection than children who did not swim (P =0.01, 95% CI: 1.4-10.0). Children who regularly bathed in streams and children who bathed both at home and in streams were found to have 12.6 times and 5.8 times higher odds of IP reinfection than children who bathed regularly at home (P=0.002, 95% CI:2.5-64.8) and (P = 0.042, 95% CI:1.1-31.3), respectively. Children in households that owned domestic animals had 4.5 times higher odds of IP reinfection than the reference group (P = 0.013, 95% CI: 1.3-12.5). IP reinfection rates were significantly associated with habits of swimming in a polluted water, places of bathing, and ownership of domestic animals. Therefore, efforts should be made considering such factors to minimize IP reinfection in the area.

Detection of Hepatitis E Virus (HEV) in Pork Sold in Saint-Louis, the North of Senegal.

The hepatitis E virus (HEV) is a zoonotic pathogen with various hosts, including pigs, which act as reservoirs. In industrialized countries, sporadic cases caused by genotype 3, contracted by ingesting contaminated uncooked or undercooked meat, have been reported. However, in developing countries, HEV infection is mainly dominated by genotype 2 and often associated with poor hygiene conditions and drinking water supplies. HEV infection and its circulation in domestic fauna in West Africa are poorly documented. This study aimed to assess the presence of HEV in pork sold in Saint-Louis, Senegal. Meat products (250 g samples, n = 74) were purchased in August 2022 from three locations. Then, 2 g/sample was minced to extract total nucleic acids using the Purelink™ Viral DNA/RNA kit. RT-PCR reactions were performed using the One-Taq™ One-Step RT-PCR kit targeting the HEV ORF2 genomic region. The products obtained were visualized on a 1% agarose gel. Of a total of 74 samples, divided into pork meat (n = 65) and pork liver (n = 9), 5.4% (n = 4) tested positive for HEV. In both cases, two samples were positive, representing a rate of 3.1% and 22.2% for meat and pork liver, respectively. All new viral sequences were obtained from a monophyletic group within HEV genotype 3. This study is the first to report the presence of HEV in pork sold in Senegal and the results reveal a potential circulation of HEV in the pig population. The high proportion of contamination in the pork liver samples highlights a major risk associated with their consumption.

Hygienic status of beef butcher shop facilities and antibiotic resistance profile ofSalmonella enterica in Ethiopia.

The microbiological quality of meat is influenced by the conditions of hygiene prevailing during production and handling.Thus, thisstudy aimed to assess the prevalence ofSalmonella entericaand its antimicrobial resistance, load of hygiene indicator bacteria including E. coli(ECC), coliforms (CC), total coliform (TCC), Enterobacteriaceae(EB) and aerobic plate count (APC), and meat handler's food safety knowledge and hygiene practices in butcher shops in two cities, Addis Ababa and Hawassa in Ethiopia, during 2020 and 2021. A total of 360 samples of beef carcasses (n = 120), knives (n = 60), chopping boards (n = 60), weighing balance (n = 60), and personnel's hands (n = 60) were randomly collected for microbial analysis. Besides, 120 participants were selected to participate in a food safety knowledge and hygiene practices assessment. TheS. entericaisolates were identified by agglutination test followed by qPCR targeting invA gene. Phenotypic antimicrobial resistance profiles ofS. entericawere determined using disk diffusion assays as described in CLSI. TheECC, CC, TCC, EB, and APC populations were quantified by plating ontopetrifilmplates.A structured questionnaire was used to determine food safety knowledge and hygiene practices of participants. Overall prevalence of S. enterica was 16.7% (95% CI, 8.3-26.7) and location seems to have no effect (p = 0.806).Only 20% of the S. entericawere resistant to ampicillin and tetracycline. However, the majority (80%) ofS. entericaisolates were susceptible to the panel of 11 antimicrobials tested.The overall mean ± SD (log CFU/cm2) of ECC, CC, TCC, EB, and APCwere 4.31 ± 1.15; 4.61 ± 1.33; 4.77 ± 1.32; 4.59 ± 1.38 and 5.87 ± 1.52,respectively.No significant difference (p = 0.123) in E. coli contamination was observed between samples of beef carcasses and chopping boards. The EB contamination showed no significant difference (p > 0.05) among sample sources. The APC contamination levels on beef carcass were significantly higher (p > 0.05) than other sample sources. A total of 56% (95% CI: 46.7 - 65.0) of the participants had poor knowledge and 65% (95% CI: 56.7 - 73.3)had poor hygiene practices towards food safety. This study highlighted the poor hygiene status of butcher facilities with a potential risk of beef safety. Thus, appropriate food safety control strategies and inspection is needed at retail establishments.

Rapunzel syndrome’s silent cry: addressing neglect and psychiatric factors in pediatric cases

IntroductionRapunzel syndrome is a very rare form of trichobezoar. It is strongly linked to psychiatric conditions; trichotillomania and trichophagia. These conditions in the pediatric population point to the presence of childhood stressors like child neglect, abuse, etc. This case report highlights that child neglect may be an underlying contributing factor in selected cases of Rapunzel syndrome. Hence, a multidisciplinary approach should be sought in all cases of Rapunzel syndrome, catering to the emotional and psychological needs of the pediatric population.Case presentationA 7-year-old girl from a low socioeconomic background presented with periorbital and facial swelling, abdominal distension, and pallor. On physical examination, she showed bilateral pitting edema and a distended abdomen with poor overall hygienic condition. Her family history was positive for Wilson’s disease. Lab investigations highlighted iron deficiency anemia (Hb 8.2 g/dL), with normal liver function. Ultrasound demonstrated ascites, liver changes, and pleural effusion. The work-up for Wilson’s disease was unremarkable. During the hospital course, her abdominal distention lessened; a non-tender epigastric mass (4 × 5 cm) was thus discovered. An abdominal X-ray revealed an entangled mass outlining the gastric shadow. Her parents also revealed a history of trichophagia. Suspecting a large trichobezoar, a laparotomy was performed. After the midline incision, the stomach was opened anteriorly between stay sutures along the curvature. It delivered a large trichobezoar, 65 cm in length extending up to the proximal jejunum. Rapunzel syndrome diagnosis was finally established.ConclusionThis unique presentation emphasizes the need to consider this rare etiology, even with unusual clinical histories especially with a history of child neglect, while collaborative surgical interventions facilitate successful outcomes.

Malnutrition among under-five children in Nepal: A focus on socioeconomic status and maternal BMI

IntroductionMalnutrition stands as the primary contributor to morbidity and mortality in children under the age of five. Nepal, situated in South Asia and classified as a low-income country, grapples with a significant malnutrition challenge. The elevated rates of malnutrition in Nepal are further compounded by its unfavorable socio-economic conditions, limited access to healthcare, poor maternal nutritional status, food insecurity, poor hygienic conditions, and geographical challenges. The consequences of mortality and illness associated with malnutrition directly undermine human capital and economic productivity. The main aim of the study is to determine the risk factors associated with stunting, underweight and wasting among under five children in Nepal. Subjects & methodsNepal Demographic and Health Survey 2016 (NDHS) data was used for the study. The outcome measures were stunting, underweight and wasting. Predictor variables were categorized as mother, child and household related factors. The association between malnutrition and predictor variables were assessed by multivariate logistic regression using Stata 16.0 software and odds ratio (OR) with 95% confidence interval was reported. ResultsA total of 2381 children under five years were included in this study for analysis. The magnitude of stunting (36%) was higher than underweight (27%) and wasting (10%) among under five children. Children from middle and rich households were 49% (OR = 0.51; 95%CI = 0.37–0.71) and 47% (OR = 0.53; 95%CI = 0.36–0.74) less risk of being stunted than children from poorest households. The odds of a child to be stunted was 1.6 times higher in those children living with 3–4 children than children with 1–2 children in their families (OR = 1.6; 95%CI = 1.24–2.07). Mother's BMI in category of normal (OR = 0.56; 95%CI 0.42–0.75) and overweight (OR = 0.30; 95%CI = 0.19–0.47) and larger birth spacing (OR = 0.53; 95%CI 0.36–0.74) were significantly associated with underweight and stunting among children, respectively. ConclusionIn Nepal, the problem of malnutrition among under five children is still high (36% of stunting and 10% of wasting). The study suggests that target-based approach and interventions should be administered for children from socio-economically deprived areas. Strategies should focus on preconceptions and the mother's nutritional status.

Kejadian Penyakit Kulit Akibat Kebiasaan Anak-Anak Mandi di Suangai Tello Kota Makassar

Clean and healthy living behavior is the main factor determining people's health status. Skin disease is a common disease that occurs at all ages. Skin diseases can be caused by several factors, namely living habits and the environment. Skin diseases can develop in poor personal hygiene and environmental hygiene conditions. Bathing habits are one of the factors associated with the incidence of dermatitis. Bathing is an important part of maintaining personal hygiene. Bathing can eliminate odors, remove dirt, stimulate blood circulation, and provide freshness to the body. It's best to shower twice a day, the main reason is to keep your body healthy and fresh. Many factors cause skin diseases, one of which is bathing habits. Water is the main requirement for life processes on earth, so there would be no life if there was no water on earth. However, water can be disastrous if it is provided in incorrect conditions, both in quality and quantity. Humans really need clean water, both for daily needs such as drinking, bathing, washing and so on. The target village is being revitalized with the aim of increasing public knowledge about the causes of dermatitis. Based on the results of interviews with village communities, the problem is the low level of public knowledge about the causes of dermatitis. To overcome the problems faced, namely outreach to increase public knowledge about the causes of dermatitis in the village.

Recurrence Rate and Influencing Factors of Helicobacter Pylori Infection After Successful Eradication in Southern Coastal China.

Recurrence rate of Helicobacter pylori (H. pylori) infection after successful eradication have gained attention. This study was to assess the recurrence rate of H. pylori infection after successful eradication in the southern coastal provinces of China and to analyze its factors. 975 patients with upper gastrointestinal symptoms who were diagnosed with H. pylori infection using the 13C or 14C-urea breath test (UBT) underwent eradication treatment between August 2021 and December 2022. After eight to twelve weeks, repeat UBT was performed. Besides, 824 patients with successful eradication underwent a repeat UBT by completing questionnaires after a year. The 1-year recurrence rate was calculated, and the differences were analyzed based on baseline data, sociological characteristics, and lifestyle. A total of 734 patients completed the 1-year follow-up, out of which 26 (3.5%) patients experienced a recurrence of H. pylori infection. Exposure to other individuals infected with H. pylori (χ2=12.852, P<0.001), poor hygiene conditions at dining out places (χ2=6.839, P=0.009), frequent dining out (χ2=24.315, P<0.001), smoking (χ2=7.510, P=0.006), consumption of non-purified water (χ2=16.437, P<0.001), consumption of pickled foods (χ2=5.682, P=0.017), irregular meal patterns (χ2=16.877, P<0.001) and age (χ2=9.195, P=0.010) were significant factors for H. pylori infection recurrence. Exposure to other individuals infected with H. pylori, poor hygiene conditions at dining out places, consumption of non-purified water, frequent dining out and irregular meal patterns were independent risk factors (P=0.022, 0.016, 0.002, <0.001, <0.001; 95% CI 0.146-0.861, 0.121-0.806, 1.715-10.845, 0.085-0.521, 2.291-14.556). The one-year recurrence rate of H. pylori infection post-eradication in the southern coastal provinces of China is 3.5%. Contacting with infected individuals, poor hygiene in dining places, consumption of non-purified water, frequent dining out, and irregular meal patterns were identified as significant independent factors influencing H. pylori recurrence.

Management of Stomatitis Apthous Recurrent in Patients with Multiple Systemic Diseases - Case Report

Introduction: A 63 year old patient with multiple systemic diseases came in complaining that there were many ulcer in his oral cavity. Providing the best treatment for ulcers in the patient's oral cavity. Case Report: A 63 year old male patient came to RSGM YARSI on March 20 2019 with complaints of mouth ulcers on the left side of his tongue for the previous 3 days. The patient had a history of heart disease and hypertension for 8 years and had undergone heart surgery. History of stroke occurred 3 months ago. During the visit, the patient also informed that he was taking medication related to his illness. Discussion: The patient received garg therapy. Chlorhexidine gluconate 0.2% and ungt. Triamcinolone acetonide 0.1% 5gr to reduce pain and eliminate bacteria and fungi. During the 1 week follow-up, there were still lesions but they were no longer painful. In the second week, the lesions had disappeared and healed. Conclusion: In this case, we found an ulcerated lesion on the patient's left ventral tongue. The cause of the lesion is unknown but is suspected to be predisposing factors such as drugs, systemic disease and poor oral hygiene conditions.

IMDDHH: A Contribution to the Understanding of the Disease

Inborn Errors of Immunity (IEI) is an extremely rare group of heterogenous disorders which are characterized by predisposition to severe unusual and recurrent infections, severe allergies, features suggestive of autoimmune conditions and sometimes malignancies. We report a two-year-old female child presented to our emergency department with complaints of a history of recurrent respiratory infections, recurrent skin infections and a recent history of purulent discharge from both ears. Clinical examination revealed acute otitis media, pneumonia, multiple healed skin lesions associated with soft non-tender hepatomegaly and normal cardiac findings. Elevated hepatic transaminases and hypogammaglobulinemia suggested the possibility of an inborn error of immunity. A whole exome sequencing study performed on the patient established a diagnosis of IMDDHH (Immunodeficiency, Developmental Delay, and Hypohomosyteinemia) by revealing a missense mutation in the NFE2L2 gene of chromosome 2q31. Diagnosing such conditions with inborn errors of immunity requires a high index of suspicion combined with a comprehensive knowledge of the structure and function of both innate and adaptive immune systems. Recurrent skin and respiratory infections in a growing child belonging to a low-and-middle-income country like India is a common clinical scenario encountered frequently in pediatric clinic practice and is often ignored after attributing it to poor hygienic conditions. However, with careful history taking and examination, a sub-group of such patients may be isolated with a high probability of an underlying IEI, which can later be confirmed by genetic work-up.