Poor Socioeconomic Status Research Articles

The Sociodemographic Profile of Community-Dwelling Older Adults With Serious Mental Illness in Kerala - A Cross-Sectional Study.

Older adults with serious mental illness (OASMI) have to manage the twin challenges of old age and mental illness. Understanding their characteristics will help policymakers and researchers plan tailored interventions. The profile of OASMI is not described in any publication from India, and this paper addresses that gap. The information from this study will serve as a baseline for the planned periodic follow-up of the study participants. This study employed a cross- sectional design among a sample of OASMI identified through multistage cluster sampling from three districts in Kerala. We interviewed them in their households and collected sociodemographic data using a pretested tool. Among the 917 OASMI participants, 66% were females, 18% were the 'oldest-old' (≥80 years), 94.1% were unemployed, 51.7% were socially backward, 68.5% were financially weak, 10.1% were living alone, 59.4% were living without partners, and 63.7% had caregivers. Compared to the general population of older adults in Kerala, the OASMI have poorer socioeconomic status and higher rates of social isolation, and males are dying earlier. The profile of the OASMI depicts their multiple vulnerabilities and the need to address those.

PREVALENCE OF OSTEOPOROSIS IN WOMEN AGED 35 TO 65 YEARS IN TEA GARDEN COMMUNITY OF JORHAT DISTRICT

Background: Osteoporosis poses a huge challenge in India, as it is a developing country due to demographic transition and aging of the population along with limited resource availability in rural India.Osteoporosis predominantly affects postmenopausal women. The mal-nutrition, and smoking, consumption of liquor and tobacco may have an effect on bone mineral density (BMD) .Osteoporosis occurs in all populations, but not all populations are at equal risk. According to various studies, Asian women have higher predisposition for osteoporosis than their Caucasian people. Reasons attributed for lower bone mineral density (BMD) in Indians include possible genetic differences, nutritional deciency and smaller skeletal size. Smoking or tobacco intake, malnourishment, alcohol has a negative effect on bone mineral density [BMD]. Tea garden people are probably more affected than other communities in the surrounding area as evidence by high attendance of patients with osteoporosis & fragility fractures in Orthopaedic OPD of JMCH. Increase prevalence in the community might be wholly or partly due to poor socio-economic status , poor nutrition, lack of calcium and vitamin d in diet, dark skin and addiction to alcohol. Purpose of the study: to study the prevalence of osteoporosis in middle-aged to elderly tea garden women of Jorhat district. Materials and Methods: In this community based cross-sectional study, BMD (bone mineral density) of 360 female subjects, aged 35 to 65 years, were calculated using quantitative ultrasound bone densitometry.(QUS) In our study 24.7% were Results: osteoporotic, followed by 39.5% were osteopenic and 35.8% had normal BMD. Thus, the prevalence of osteoporosis in our study, in the female population of tea gardens of Jorhat district was 24.7%

Prevalence of Cervical Cancer and Associating Factors among HIV Infected Women of Omaruru District in Namibia

In 2015 Namibia reported 55 deaths due to cervical cancer, and the prevalence of HIV was 13,3% among adults aged between 15 -49. There is an increased risk of cervical cancer among women living with HIV, the prevalence of this type of cancer and the association with risk factors is unknown at the Omaruru Hospital. High prevalence of HPV infection, advanced HIV disease, tobacco, multiple sexual partners, parity, and poor socio-economic conditions are listed among contributing factors that increase morbidity and mortality of cervical cancer, which can be controlled & cured if diagnosed early. This research aimed to determine the prevalence of cervical Cancer among HIV-positive women on ARVs and assess the risk factors contributing to the emergence of cervix cancer in this population. The approach methodologic used was a retrospective cross-sectional of 49 women randomly selected among those who were done pap smears at the Omaruru ART clinic between August 2016 to August 2017. There was no positive result for cervical cancers found. Hence, the prevalence of HPV was found to be 16,32%, with Cervical dysplasia 3 cases of CIN I and 5 cases of CIN II with no association established with risk factors, and a case of CIN II in a primigravida with multiple sexual partners were found. To conclude, a meaningful analysis with STATA 14 revealed no positive results for cervical cancer from the 49 cases with no risk factors association established,30.61% of negative HPV (30 - 39 years;28.57% (40-50 years), CIN II aged 30 to 39 years (4%);4% (40- 50 years) 2% above 50 years old. The HPV prevalence (16,32%,),3 cases of CIN 1, and 5 cases of CIN II are indicators that more efforts need to be made. Keywords: Cervical cancer prevalence, Cervical cancer screening, HPV prevalence, HIV women on antiretroviral treatment, primigravida, multiple sexual partners.

Evaluating the Association of Keratocunus with Consanguinity

Objective: Purpose of this study is to determine the frequency of keratoconus with consanguinity. Study Design: Comparative/cross-sectional study Place and Duration: This comparative/cross-sectional study was conducted at Shahida Islam Medical and Dental College Lodhran and Jinnah International Hospital, Abbottabad in the period from May, 2022 to October, 2022. Methods: Total 53 patients of keratoconus were presented in this study. Included patients were aged between 8-32 years. Participants completed a self-administered survey that inquired about demographic information, KC findings, clinical symptoms, and parental marital status. All data was analyzed using SPSS 20.0. Results: There were 31 (58.5%) females and 22 (41.5%) males in all cases. Mean age of the patients was 19.25±12.92 years. 35 (66.03%) cases had rural residency and 18 (33.97%) cases were had urban residency. 25 (47.2%) cases had poor socio-economic status. Of the patients surveyed, 29 (54.7%) had first-cousin weddings between their parents, 16 (30.2%) had second-cousin marriages, 5 (9.4%) had third-cousin marriages, and 3 (5.7%) had marriages beyond the immediate family. Significant associations between consanguinity and KC were found at the p <0.05 level. Patients with first-degree consanguineous parents were shown to be more likely to have keratoconus and to have more advanced cases of the disease. Conclusion: Results from this study provide credence to the idea that there is still a significant direct correlation between KC and consanguinity. According to the findings, first-degree parental consanguinity poses a much greater risk of KC development than other types of intermarriage. The progression of KC was shown to be faster in this vulnerable population. Keywords: Consanguinity, Inheritance,Genetics, Keratoconus

Frequency of in-Stent Restenosis in patients having DES, with Stent Length Greater than 30mm Presenting to Tertiary Care Center

Objective: The purpose of this study was to calculate the incidence of in-stent restenosis in patients with DES and stent lengths higher than 30mm who presented to a tertiary care hospital. Study Design: A Cross-sectional study Place and Duration: This cross-sectional study was conducted at Department of Cardiology, Rashid Latif Medical College, Lahore in the duration from February, 2022 to July, 2022. Methods: There were 83 patients of coronary artery disease (CAD)were included. After obtaining written consent from participants, researchers collected information about their participants' ages, sexes, body mass indexes, and co-morbidities. Atherosclerosis risk variables were collected with baseline investigations and an echocardiography for ejection fraction determination. Imaging studies were reviewed by board-certified interventional cardiologists, who found evidence of ISR. Past angioplasty information and stent details were recorded. Results: In our study mean age of the presented cases was 54.13±7.44 years and mean BMI 25.2±13.87 kg/m2. Most common comorbidity was diabetes found in 25 (30.1%) followed by hypertension in 23 (27.7%) and dyslipidemia in 20 (24.1%) cases. We found that 40 (48.2%) patients were smokers. Mean LDL cholesterol of the patients was 68.6±1.97 mg/dl and mean uric acid was 6.2±2.35 mg/dl. Majority of the cases 45 (54.2%) had poor socio-economic status. We found that frequency of ISR was higher among cases of biomatrix stent 24 (28.9%), followed by Xience stent in 22 (26.5%) cases, Ultimaster stent in 19 (22.9%) and Xlimus stent in 18 (21.7%) cases after coronary angiograpghy. Our results showed that the stents longer than 30mm were associated with a higher incidence of In-Stent Restenosis (p=0.03). Conclusion: Based on the findings of this study, we came to the conclusion that a previous diagnosis of diabetes mellitus and a longer stent length are both significant risk factors for developing in-stent restenosis. In our research, we found that instances with biomatrix stents had a greater incidence of ISR. Keywords: CAD, Drug eluting stents (DES), Coronary angiography, In-Stent Restenosis

La telemedicina como herramienta para abordaje la salud mental de personas con enfermedades tropicales desatendidas

Neglected tropical diseases (NTDs) have been linked to poor socioeconomic conditions. In addition, its sequelae can cause chronic affectations, from physical disability to psycho-emotional, associated with social and individual stigma, due to physical appearance. Therefore, a descriptive study was carried out to assess the impact of the use of technologies in the mental health (SM) approach in 182 patients with EDT from endemic areas. Data was collected using mobile and landline phones. A survey was used to assess mental well-being (both subjective and objective), as well as their familiarity with and perspectives on ICTs. After establishing a baseline for the SM status of the community and linking the stigmas surrounding WBS. Patients were asked to complete a survey to express their feelings about the impact of stigma on MS in the community. The results showed that people living with EDT are more concerned about the limiting conditions of living and do not value the emotional and mental aspects as part of health and well-being, probably because they consider more relevant the organic alterations and physical sequelae they suffer from of their illness that limits and incapacitates them to work. However, the female sex turned out to be more vulnerable to presenting psychological alterations. In conclusion, the participants consider telemedicine a good tool that will help them face social stigma and reduce self-esteem; It will improve therapist-patient communication by providing them with adequate and timely treatment.

The forms and adverse effects of insecurities among internally displaced children in Ethiopia

BackgroundEthiopia has seen an increase in the number of internally displaced persons (IDPs) due to conflict and violence related to border-based disputes and climate change. This study examines the insecurities experienced by IDPs in the Burayu camp and how they navigate and challenge them. Violence and insecurity have daunted Ethiopian regions for decades, violated children’s rights, and impeded the achievement of the United Nation’s sustainable development goals related to children, such as good healthcare and mental health, quality education, clean water, and sanitation. The deteriorating security concerns in Ethiopia could also expose IDP children to poor health outcomes associated with a lack of access to healthcare services.MethodsThis was an exploratory qualitative case study guided by intersectionality theoretical lens to explore the forms of insecurities perceived and experienced by IDPs in Ethiopia. Participants were selected using a purposeful sampling approach. We interviewed 20 children, 20 parents or guardians, and 13 service providers. Interviews were audio recorded and transcribed verbatim in Afan Oromo, then translated into English. We used NVivo 12 qualitative data analysis software to analyze data following Braun & Clarke’s approach to thematic data analysis.ResultsThe participants reported that IDP children in Burayu town faced many challenges related to poor socioeconomic conditions that exposed them to several insecurities and negatively affected their well-being. They reported inadequate access to clothing and shelter, clean water, sanitary facilities, food, and adequate healthcare due to financial barriers, lack of drugs, and quality of care. Our data analysis shows that socioeconomic and contextual factors intersect to determine the health and well-being of children in the Ethiopian IDP camp studied. The children experienced insecurities while navigating their daily lives. This is compounded by institutional practices that shape gender relations, income status, and access to healthcare, education, and food. These deficiencies expose children to traumatic events that could decrease future livelihood prospects and lead to compromised mental health, rendering them susceptible to prolonged post-traumatic stress disorder and depression. Results are presented under the following topics: (1) basic needs insecurity, (2) healthcare insecurity, (3) academic insecurity, (4) economic insecurity, (5) food insecurity, and (6) physical and mental health insecurity.ConclusionSuccessful relocation and reintegration of IDPs would help to alleviate both parent and child post-conflict stressors. Managing and following up on economic reintegration efforts is needed in both the short and long term. Such measures will help to achieve goals for specific projects attached to donor support outcomes, consequently enabling social support and conflict resolution management efforts.

Molecular evidence of toxoplasmosis in people living with HIV in Pakistan.

Toxoplasma gondii is a zoonotically important parasite infecting almost all vertebrates. The parasite can easily infect humans through the fecal-oral route, particularly immunocompromised individuals, and children. Due to lack of epidemiological data regarding the occurrence of Toxoplasma gondii in people living with HIV in Pakistan, the present study was designed to estimate the prevalence of Toxoplasma gondii in people living with HIV. Briefly, 384 blood samples were randomly collected from people living with HIV registered under Punjab AIDS Control Program. DNA of all samples was extracted and the 18S rRNA gene of T. gondii was amplified through polymerase chain reaction (PCR) by using genus-specific primers. The amplicons were spread on 1.5% agar rose gel and visualized under gel documentation system. Then the amplicons were purified from the gel and subjected to sequence and phylogenetic analysis. Overall prevalence of T. gondii was observed as 23.96%. The prevalence of T. gondii was significantly (p <0.05) higher in females and in middle age group (26-40years). Similarly, the prevalence was significantly (p <0.05) higher in people with poor socioeconomic status, symptomatic patients, drugs users and people using unfiltered water for drinking. Furthermore, bodyweight (46-70kg) and dry seasons also significantly (p <0.05) affected the prevalence of T. gondii. Our findings illustrated a high infection rate of toxoplasmosis in people living with HIV which could be a significant cause of mortality. More studies need to be conducted for other opportunistic infections caused by parasites and other pathogens.

Socio-demographic inequalities in satisfaction with primary health care and utilization of chosen doctors’ services: a cross-sectional study

Aim: The aim of the study was to examine socio-demographic inequalities in user satisfaction with PHC and utilization of chosen doctors’ services. Methods: This cross-sectional study was conducted in 2016 among 232 respondents who participated in PHC user satisfaction survey in PHC center Valjevo, Serbia. Inclusion criteria were an age of at least 20 years, sufficient skills of Serbian language to fill in questionnaires and consent to participation. Two hundreds and six patients completed an anonymous questionnaire about the user satisfaction with PHC. Results: The chosen doctor was seven times more often visited by the elderly (OR=7.03) and almost three times more often by the middle-aged (OR=2.66) compared to the youngest category of respondents. Those with low education and poor financial status of the household visited a doctor four (OR=4.14) and almost nine times (OR=8.66) more often, respectively, compared to those with high education and good socioeconomic status. A statistically significant higher level of PHC satisfaction was recorded in the rural population (p&lt;0.001) and among respondents with poor socioeconomic status of the household (p=0.014). Conclusion: The chosen doctor was more frequently visited by respondents with low education and those with poor socioeconomic status of the household, while a higher degree of satisfaction with PHC was recorded in the rural population as well as in those with poor socioeconomic status of the household.

Prevalence of Anemia among Children and Adolescents of Bangladesh: A Systematic Review and Meta-Analysis.

The prevalence of anemia is high among children and adolescents in low- and middle-income countries because of undernutrition resulting from their poor socioeconomic status and lack of knowledge on proper nutrition. We conducted a systematic review and meta-analysis to determine the prevalence of anemia among children and adolescents aged between 6 months and 19 years in Bangladesh. Databases such as PubMed, Scopus, and Google Scholar were searched to identify the studies that reported the prevalence of anemia among children and adolescents. A total of 24 studies, including the data of 14,062 cases, were included in the systematic review and meta-analysis of the time period between 1997 and 2019. The random-effects model was used to calculate the summary estimates. The protocol was registered with PROSPERO (CRD42021246960). The pooled prevalence of anemia, iron deficiency anemia (IDA), and non-severe and severe anemia were 46.8% [95% CI: 36.0-57.6], 13.6% [95% CI: 8.0-19.2], 56.4% [95% CI: 39.6-73.1] and 0.7% [95% CI: 0.1-1.4], respectively. Prevalence of anemia exhibited the highest among the children aged ≤2 years. Briefly, 91.67% of the studies were of high quality. No significant publication bias was found; however, two outlier studies were detected. The prevalence of anemia among children and adolescents was estimated as high in Bangladesh.

Natural resource rents and regime durability: Identifying cross-country durability regimes

Natural resource abundance is sometimes seen as both a blessing and a curse by the possessing countries. However, the conclusions that are drawn for either of these scenarios are questionable, as they are based on an ad hoc selection of countries. This paper analyzes the effects of natural resource abundance on political regime durability based on an endogenous classification of countries. A finite mixture model is applied to a large sample of 129 countries over the 1980–2020 period. The results show that patterns of political regime durability can be segmented into three regime types. The first type is characterized by the absence of a link between natural resources and regime durability. The second type reflects the fact that natural resource rents reinforce political regime durability. The third type is marked by a reduction in political regime durability by natural resource abundance. The results also show that countries at low risk for internal and external conflicts and ethnic tensions are more likely to belong to the second regime type. Finally, countries with a high risk of corruption and poor socioeconomic conditions are less likely to belong to the third regime type. These results underscore the need for resource-rich countries to improve institutional quality by reducing the risks associated with conflict, tension, and corruption.

Helicobacter Pylori Infection in Children with the Rescue Therapy; A Case Report

Background: Helicobacter pylori infection affects more than half of the world population and it occurs generally in childhood. Risk factors include residence in a developing country, poor socio-economic status, overcrowding family, ethnic and genetic predisposition. There is a difficulty eradicating this bacterium due to its high antimicrobial resistance. We aim to discuss enforcement and management of Helicobacter pylori infection in children. Case Presentation: A 5 year 10 months old girl diagnosed with recurrent abdominal pain due to Helicobacter pylori infection. The patient often had recurrent abdominal pain located specifically on epigastrium area. Laboratory findings demonstrated H. pylori IgM positive and negative IgG level. The result of endoscopy and biopsy revealed gastritis and mild intestinal metaplasia and moderate Helicobacter pylori density. The patient still experienced abdominal pain despite the standard therapy, and later received rescue therapy. Conclusion: Eradication of H. pylori was failed with standard therapy and continued with rescue therapy. Keywords: Helicobacter pylori infection, rescue therapy, standard therapy, case report.

Demographic profile of HIV and helminth-coinfected adults in KwaZulu-Natal, South Africa.

Helminth and HIV infections are endemic among poor populations. Studies investigating the socio-demographic and economic risk factors associated with dual HIV and helminth coinfection are scarce. This study aimed to describe risk factors associated with HIV and helminth coinfections among peri-urban South African adults residing in poorly developed areas with high poverty levels, lack of sanitation and a clean water supply. Adult participants (n = 414) were recruited from clinics in the south of Durban, KwaZulu-Natal, South Africa. Participants' demographic, socio-economic, sanitation and household information, anthropometric measurements and HIV status were collected. Stool samples were donated for coproscopy to detect helminths using the Kato-Katz and Mini Parasep techniques. Blood was collected to confirm participants' HIV status and to determine Ascaris lumbricoides-specific immunoglobulin E (IgE) and immunoglobulin G4 (IgG4) levels to improve microscopy sensitivity. Overall coinfection was 15%, and single helminth and HIV prevalence were 33% and 52%, respectively. Ascaris lumbricoides was predominant (18%). Univariate analysis of variance (ANOVA) showed that coinfection was 11.9% and 19.8%, respectively, among the 18-34 years and 35-59 years age groups (p = 0.0006), 16.4% and 19.9%, respectively, for the no income and < R1000.00 groups (p = 0.0358) and 22.8% and 17.1%, respectively, for the pit or public toilets and toilets not connected to sewage groups (p = 0.0007). Findings suggest that the dual infection with HIV and helminth infections among adults residing in under-resourced areas with poor sanitary conditions is frequent. Older age, poor toilet use and low income are associated with coinfection. More attention is required to break the cycle of coinfections and possible disease interactions. The study highlights the importance of determining and treating helminth infections among adult population during HIV and helminth coinfection and the influence of poor sanitation and socioeconomic status on disease transmission.

Assessment of Postmenopausal Symptoms among women Residing in Urban Slums

Background: Menopause is a normal physiological change and an important transition in women’s life. Onset of menopause has important implications on women’s fertility and health. Menopausal symptoms vary in severity and may decrease quality of life Thise is, because the majority of women still do not take treatment for these symptoms as most Indian women have a history of self-denial and neglect. This study is conducted to find the prevalence of postmenopausal symptoms among women resisting in urban slums&#x0D; Methods: This was a community based, cross-sectional study conducted among 334 postmenopausal women (45-60) residing in urban slums by systematic random sampling. Menopause Rating Scale (MRS) was used to assess postmenopausal symptoms Pre-designed, pre-tested proforma was used for collecting data to identify the factors affecting it. General physical examination was carried out and anthropometric measurements were recorded. Data were entered in excel sheet and analysed using SPSS software version 20. Results were expressed as descriptive statistics and Chi-square test was used to find the association between two attributes.&#x0D; Results: 69.76% of participants had mild symptoms, 23.95% moderate symptoms and only 2.1% suffered from severe symptoms. The per MRS. Prevalence of somatic symptoms was 93.11%, psychological symptoms 85.33% and urogenital symptoms was 33.53%. 44.31% of women from class 4 of SES suffered from mild to severe symptoms, followed by class 3 with 20.06% (p= 0.00005). 73.86% from nuclear families and 66.67% for three generations in their families suffered from mild symptoms (p=0.0001)&#x0D; Conclusion: The prevalence of somatic postmenopausal symptoms was high compared to psychological and urogenital using MRS. Factors like age, poor socio-economic status, marital and educational status played a role in postmenopausal symptoms. Measures should be taken for early recognition of symptoms and treatment. To achieve this, the government, private, and voluntary organizations can establish postmenopausal clinics as soon as possible at the earliest at all levels of healthcare.

Antenatal gut microbiome profiles and effect on pregnancy outcome in HIV infected and HIV uninfected women in a resource limited setting

BackgroundHuman immunodeficiency virus (HIV) severely damages the epithelial cells of the gut lining leading to an inflamed leaky gut, translocation of microbial products, and dysbiosis resulting in systemic immune activation. Also, microbiota composition and maternal gut function can be altered in pregnancy through changes in the immune system and intestinal physiology. The aim of this study was to investigate the gut microbiota in HIV-infected and HIV-uninfected pregnant women and to compare and identify the association between gut microbial composition and adverse birth outcomes.ResultsA total of 94 pregnant women (35 HIV-infected and 59 HIV-uninfected controls) were recruited in Harare from 4 polyclinics serving populations with relatively poor socioeconomic status. Women were of a median age of 28 years (interquartile range, IQR: 22.3–32.0) and 55% of women were 35 weeks gestational age at enrolment (median 35.0 weeks, IQR: 32.5–37.2). Microbiota profiling in these participants showed that species richness was significantly lower in the HIV-infected pregnant women compared to their HIV-uninfected peers and significant differences in β-diversity using Bray–Curtis dissimilarity were observed. In contrast, there was no significant difference in α-diversity between immune-compromised (CD4+ < 350 cells/µL) and immune-competent HIV-infected women (CD4+ ≥ 350 cells/µL) even after stratification by viral load suppression. HIV infection was significantly associated with a reduced abundance of Clostridium, Turicibacter, Ruminococcus, Parabacteroides, Bacteroides, Bifidobacterium, Treponema, Oscillospira, and Faecalibacterium and a higher abundance of Actinomyces, and Succinivibrio. Low infant birth weight (< 2500 g) was significantly associated with high abundances of the phylum Spirochaetes, the families Spirochaeteceae, Veillonellaceae, and the genus Treponema.ConclusionThe results reported here show that the species richness and taxonomy composition of the gut microbiota is altered in HIV-infected pregnant women, possibly reflecting intestinal dysbiosis. Some of these taxa were also associated with low infant birth weight.

Assessment of risk factors in pyogenic liver abscesses in children.

Pyogenic liver abscess (LA) is a significant contributor to morbidity and mortality in developing countries like India. The risk factors predisposing to the LA specifically in children are not known. Studies done in the past largely remain inconclusive and have identified only probable causes. The cause of LA in children with no coexisting illness remains unknown. This prospective observational study was conducted at a tertiary teaching hospital located in New Delhi, India. All children between 2 months and 12 years of age with sonographically confirmed LA presenting to the hospital were included and managed with appropriate intravenous antibiotics and relevant investigations. A total of 52 children were included. The mean age was 6 years and 4 months, and the male: female ratio was 1.4:1. Around 50% of the patients were malnourished. Fever, abdominal pain and loss of appetite were the most common symptoms. Nine patients (17%) were managed conservatively, 13 (25%) needed percutaneous needle aspiration and 30 (57.69%) required drainage using a pigtail catheter. Poor socioeconomic status and anaemia were found to be the most commonly associated risk factors. Selective immunoglobulin A (IgA) deficiency was the most common primary immunodeficiency disorder followed by T-cell defect. On multivariate analysis, it was seen that in those with clinical icterus, gamma-glutamyl transferases >350 IU/m, and those with impending rupture, the time to defervescence was significantly different (P = 0.05). Poor socioeconomic status causing malnutrition emerged as a significant risk factor for LA in children. Selective IgA deficiency was the most common immunodeficiency seen in a few children. Adopting a conservative approach like aspiration and percutaneous drainage led to lower mortality and good recovery rates.

Right to read: what we can learn from neurosciences to augment childhood and literacy policies1

Abstract Early adverse experiences are associated with a diverse range of health and learning issues, and scientific evidence suggests that they might have a long-term impact on the developing brain. Poor socioeconomic conditions also appear to reinforce stress-inducing experiences related to adversity and are connected to a disadvantageous literacy environment. There are indications that these factors play a role in early cognitive gaps in essential literacy skills that might place children in a cumulative disadvantage path in literacy and consequent academic trajectory. This literature review analyzes the effects of early adverse experiences, such as poverty, violence, abuse, neglect, and hunger, on the development of key brain areas and cognitive skills related to reading to propose policies that, following neuroscientific knowledge, can contribute to minimizing the impacts caused by such stressors on the academic trajectory of vulnerable students. Historically in Brazil, the impacts of stressors are vaguely considered in the formulation of education public policies. Understanding how such negative experiences influence neurodevelopment and seeking actions to combat them can be the key to providing healthy cognitive development and guaranteeing children’s right to reading.

Is Revascularization the Only Mode of Treatment for Diabetic Foot Ulcer?

Introduction and Objective: Diabetic foot infection is a common cause for hospital admissions among diabetics in India. This could be attributed to sociocultural practices, such as walking barefoot, inequitable access to diabetes care, poor education, and poor socioeconomic conditions. The purpose of this study is to highlight the role of diabetic footwear in care of diabetic foot. Materials and Methods: The observational study included 170 patients, presenting with diabetic foot ulcers, studied over a period of 19 months. The patients were categorised in those suffering from neuropathic ulcers and neuroischemic ulcers using biothesiometery and Ankle Brachial Pressure Index. Diabetic foot wears were prescribed based on plantar pressure measurement. The mode of management was noted and need for incidence on follow up was recorded. Results: Our study population predominantly consisted of elderly males with a mean age of 63.2 years and 71.7 % males. Out of 170 patients presenting with diabetic foot ulcer, neuroischemic ulcers were diagnosed in 35 patients, and the rest 135 patients were diagnosed to have neuropathic ulcers. (Graph 1) NIU was observed more common among male patients with 25 males out of 35 patients [71.4 %], similarly NPU were more common in males [72.8 %]. Among the 35 patients who were diagnosed to have neuroischemic ulcers, all required diabetic foot wear, however 10 patients required revascularization procedure, 2 patients required Prostaglandin therapy infusion and 1 patient required stem cell implantation. The group of patients who were diagnosed to have neuropathic ulcers, required only diabetic foot wear and medical therapy which involved antibiotics, antiplatelets, vasodilators and Prostaglandin infusion. Amputation was required in 8 (23%) out of 35 patients suffering from NIU and in 12 (9%) out of 135 patients suffering from NPU. Conclusion: ABI, bioethesiometry and plantar pressure measurement play an important role in planning management and need of diabetic foot wear. Majority of the patients may have neuropathic involvement with recurrence rate and need of amputation significantly reduced by use of diabetic foot wear.

Gingival Recession: Prevalence, Extent, and Severity in Women Belonging to Self-help Groups from a Panchayat in Kerala

Background: Self-help groups (SHGs) were devised by the Indian Government, essentially to uplift women with poor socioeconomic status. Gingival recession (GR) has worldwide prevalence ranging from 22% to 100%. It leads to multiple dental problems affecting the quality of life. Poor socioeconomic conditions are closely related to the severity of GR. Aims: This study aims to assess the prevalence, extent, and severity of GR in women belonging to SHGs from a panchayat in Kerala. Also to determine etiological factors for GR in the given population. Materials and Methods: A total of 354 women from SHGs of a panchayat in Kerala were included in the study. All participants answered a questionnaire containing demographic details, behavioral factors, and comorbidities. Clinical examination was carried out to assess GR, plaque index, gingival index, presence of attached gingiva, frenal attachment, biotype, trauma from occlusion, and malocclusion. All categorical variables were expressed as frequencies and percentage whereas continuous variables were expressed as mean and standard deviation. The association between GR and its etiological factors was analyzed by Chi-square test followed by multivariate logistic regression analysis. Results: The prevalence of GR in this population was 88.4%. The extent of GR was at least one site and Class III-B was found in 4.2% of the population. Significant association between age, gingival inflammation, and GR were observed. Conclusions: GR was found to be highly prevalent (GR II-B most prominent) in this population. Age and presence of severe gingival inflammation were found to be the possible risk factors.

Infant & Child Mortality in Pakistan and its Determinants: A Review.

Over the years, several developing countries have been suffering from high infant and child mortality rates, however, according to the recent statistics, Pakistan falls high on the list. Our narrative review of copious research on this topic highlights that several factors, such as complications associated with premature births, high prevalence of birth defects, lack of vaccination, unsafe deliveries, poor breastfeeding practices, complications during delivery, sudden infant death syndrome (SIDS), poor socioeconomic conditions, and a struggling healthcare system, have influenced these rates. Bearing in mind the urgency of addressing the increased infant and child mortality rate in Pakistan, multiple steps must be taken in order to prevent unnecessary deaths. An effective initiative could be spreading awareness and education among women, as a lack of education among women has been indirectly linked to increased child mortality in Pakistan across many researches conducted on the issue. Furthermore, the government should invest in healthcare by hiring more physicians and providing better supplies and improving infrastructure, especially in underdeveloped areas, to decrease child mortality due to lack of clean water and poor hygiene. Lastly, telemedicine should be made common in order to provide easy access to women who cannot visit the hospital.