Package For Social Sciences Software Research Articles

Relationship between household characteristics and food security among households with school going children 6-14 years in Turkana county, Kenya

Good nutrition is very essential for proper growth and development of school going children. Malnutrition among school-going children affects their physical and cognitive development leading to low-class attendance hence poor school performance. Despite the economic growth observed in developing countries in recent years, undernutrition is still predominant. This study aims to determine the household food and nutrition security among households with school going children 6-14 years in Turkana County. A cross-sectional study design was adopted where 386 children were sampled for study. Turkana West Sub- County was purposively selected and the wards, locations sub-locations and villages were randomly selected. Systematic random sampling was used to sample households with school going children 6-14 years. A structured questionnaire survey was conducted on parents/guardians. Statistical analysis was performed using Statistical Package for Social Sciences Software (SPSS) Version 25. Data was analyzed using descriptive and multivariate statistics at 95% confidence interval. About 60% (n=228) of the households were headed by males with 62.2% aged between 20-30years. The large proportion of the respondents (58.8%) had attained primary education level only. Charcoal and firewood selling (25.6%) was the main occupation of the household heads, 13.2 % provided agricultural labor and only 2.1% had a formal employment. The rest did not have any source of income. The average dietary diversity score of the individuals was 5 to7 food groups while the highest dietary diversity score was 8-10 food groups. The school going children (6-14 years) had a medium dietary score with 45.9% while 22.3% had a low dietary diversity score. The study indicated that there was a significant relationship between dietary diversity and the nutrition security of the school going children 6-14 years. Findings of this study are useful in informing the County government of Turkana in the planning and implementation of relevant food and nutrition security programs in the Turkana West community. The study recommends adequate nutrition support to be incorporated in the school feeding program in the locality. Key words: Household Food security, School going Children 6-14 years

Predictors of breast self-examination behavior among adult females in Najran city, Saudi Arabia.

This study aimed to explore the predictors of breast self-examination (BSE) behavior among adult females in Najran city, Saudi Arabia. A descriptive correlational design was utilized to recruit 1,075 participants from the primary health centers in Najran city, Saudi Arabia, from the beginning of March to the end of October 2021. A self-reported questionnaire was used for data collection; it consisted of demographic data and health history, breast cancer knowledge test and protection motivation theory (PMT) scale. Data analysis was performed using the Statistical Package for Social Science software, version 23 (IBM, Armonk, NY, USA). Only 38.2% of the study participants had ever-performed BSE. Participants' knowledge, education, previous family history of breast cancer, and personal history of benign breast tumors are significant socio-demographic predictors of BSE behavior (p < .001). Also, the higher threats appraisal, reward appraisal, and efficacy appraisal increased the participants' probability of practicing BSE (p < .001) compared to a low level as references based on binary logistic regression results. In addition, low response cost was another predictor for BSE behavior compared with higher levels (p < .001). Participants' knowledge, education, previous family history of breast cancer, and the PMT constructs (threats appraisal, reward appraisal, efficacy appraisal, and response cost) were significant predictors of BSE behavior.

COVID-19 vaccine acceptance, hesitancy, and associated factors among medical students in Sudan.

The COVID-19 vaccination in Sudan launched in March 2021 but the extent of its acceptance has not been formally studied. This study aimed to determine the acceptance and hesitancy of the COVID-19 vaccine and associated factors among medical students in Sudan. A descriptive cross-sectional study was conducted using an online self-administered questionnaire designed on Google Form and sent to randomly-selected medical students via their Telegram accounts from 30th June to 11th July 2021. Data were analyzed using Statistical Package for Social Sciences software. Chi-square or Fisher's exact test and logistic regression were used to assess the association between vaccine acceptance and demographic as well as non-demographic factors. Out of the 281 students who received the questionnaire, 220 (78%) responded, of whom 217 consented and completed the form. Males accounted for 46. 1%. Vaccine acceptance was 55. 8% (n = 121), and vaccine hesitancy was 44. 2% (n = 96). The commonly cited reasons for accepting the vaccine were to protect themselves and others from getting COVID-19. Concerns about vaccine safety and effectiveness were the main reasons reported by those who were hesitant. Factors associated with vaccine acceptance were history of COVID-19 infection (adjusted odds ratio (aOR) = 2. 2, 95% CI 1. 0-4.7, p = 0. 040), belief that vaccines are generally safe (aOR = 2.3, 95% CI 1. 2-4.5, p = 0.020), confidence that the vaccine can end the pandemic (aOR = 7.5, 95% CI 2. 5-22. 0, p<0.001), and receiving any vaccine in the past 5 years (aOR = 2.4, 95% CI 1.1-5.4, p = 0.031). No demographic association was found with the acceptance of the vaccine. This study has revealed a high level of COVID-19 vaccine hesitancy among medical students. Efforts to provide accurate information on COVID-19 vaccine safety and effectiveness are highly recommended.

Functional Strategies and Performance: Empirical Evidence from Commercial Banks in Nakuru County in Kenya

Business environment is characterized by high turbulence in organizational performance. Functional strategies play a role as banks aim at customer retention, increased profits, increased sale volumes, efficiency and increased market share. The research established the effect of operational, marketing, finance and human resource management strategies on organizational performance. The study used descriptive research design with a target population of 205. Questionnaire was used to collect primary data which was analyzed using descriptive and inferential statistics with the help of Statistical Package for Social Sciences software. Findings indicated that operational, marketing, finance and human resource management strategies affected the organizational performance. The correlation between the operational strategies and marketing together with human resource management strategies was negative and insignificant. The correlation between operational and finance strategies was positive and insignificant. Operational, finance, marketing and human resource strategies were not significant to organizational performance. It is recommended that functional strategies be improved.

Functional Strategies and Performance: Empirical Evidence from Commercial Banks in Nakuru County in Kenya

Business environment is characterized by high turbulence in organizational performance. Functional strategies play a role as banks aim at customer retention, increased profits, increased sale volumes, efficiency and increased market share. The research established the effect of operational, marketing, finance and human resource management strategies on organizational performance. The study used descriptive research design with a target population of 205. Questionnaire was used to collect primary data which was analyzed using descriptive and inferential statistics with the help of Statistical Package for Social Sciences software. Findings indicated that operational, marketing, finance and human resource management strategies affected the organizational performance. The correlation between the operational strategies and marketing together with human resource management strategies was negative and insignificant. The correlation between operational and finance strategies was positive and insignificant. Operational, finance, marketing and human resource strategies were not significant to organizational performance. It is recommended that functional strategies be improved.

A Cross-Sectional Online Survey on Knowledge, Awareness, and Perceptions of Hollywood Smile Among the Saudi Arabia Population

Background: Hollywood smile has gained popularity in recent times to improve aesthetics among the general population. Since patients’ perceptions of dental aesthetics play a vital role in planning and evaluating cosmetic dental treatment, it is essential to understand their knowledge, awareness, and factors that influence their perceptions of dental aesthetics. Objectives: The objective of this study was to assess the knowledge, awareness, and perceptions of Hollywood smile among the general population in Saudi Arabia. Methods: A close-ended questionnaire consisting of demographic information and 20 questions related to Hollywood smile was circulated through social media in Saudi Arabia. Statistical analyses of the data obtained were performed using Statistical Package for Social Sciences software (SPSS version 17, USA). Frequencies, percentages, and mean and standard deviation were calculated using descriptive statistics. Pearson chi-squared test was employed to test the association between the demographic variables, such as age, gender, and education levels, with the questionnaire items. Results: A total of 4104 participants responded to the study questionnaire. The responses to the questionnaire revealed that nearly half of the participants were not satisfied with their dental appearance (48.6%). The majority of the participants had heard or known about Hollywood smile (98%). About 42% of study participants were aware of the complications involved in the procedure. The results revealed that the younger generation (18 to 30 years) had more awareness and felt more need for dental aesthetics (p=0.001). The proportion of male participants who underwent Hollywood smile correction were more than females (p=0.001). Graduates showed more awareness regarding smile, dental aesthetics, and Hollywood smile than the other categories (p=0.001). Conclusion: This study has shown that the younger generation, female participants, and graduates had more awareness regarding smile, dental aesthetics, and Hollywood smile.

Hemostatic Markers as Predictors of Massive Blood Transfusion in Orthotopic Liver Transplantation

The aim of this study was to determine which standard preoperative laboratory results correlate to intraoperative transfusion requirement during orthotopic liver transplantation (OLT). We retrospectively analyzed data from 305 adult patients who underwent OLT between 2009 and 2013 using laboratory results: International Normalization Ratio, platelet count, fibrinogen, and hemoglobin and total blood transfusion requirements (group L ≤ 1 L, group M > 1 L). All statistical analyses were conducted using the Statistical Package for Social Sciences software (IBM Corp. Released 2012. IBM SPSS for Windows, Version 21.0; IBM Corp., Armonk, NY, United States). We found a positive correlation with hemoglobin and fibrinogen using multivariate analysis (P < .001). The receiver operating characteristic analysis in favor of total blood replacement > 1 L has shown a correlation with fibrinogen (cut-off value of 2.3 g/L, sensitivity of 85.8%, and specificity of 37.4%) and hemoglobin (cut-off 111 g/L, sensitivity of 69.9%, and specificity of 71.6%). This study has confirmed that preoperative fibrinogen and hemoglobin level, but not International Normalization Ratio and platelet count, are indicators of potential massive perioperative blood loss during OLT and that within our patient cohort a cut-off fibrinogen value of 2.3 g/L and Hb level of 110g/L can predict a blood replacement of >1 L.

Influence of Project Management Practices in the Implementation of Constituency Development Fund Projects in Rongai Sub-County, Kenya

Government projects are extremely important to the citizens and residents of any country since they are part of the foundation that supports national development . The CDF report 2017/2018 indicated that some constituencies in Kenya are unable to successfully implement their projects due to lack of clear implementation plans. This trend has left many stalled projects despite the huge amounts of resources allocated. It is, therefore, imperative to investigate the influence of leadership practices on implementation of constituency development fund projects. The specific objectives of this study were to examine the influence of staff analysis, time management, technology, and cost management on implementation of constituency development fund projects in Rongai Sub-County, Kenya. The study was guided by the trait theory of leadership, theory of constraints, diffusion of innovation theory, Pareto principal theory and theory of project implementation. A descriptive survey research design was adopted. The study targeted all the thirty-three (33) CDF projects in Rongai Sub-County for the financial year 2017/2018. The respondents were the project managers and the project administrators. Purposive sampling was used to select all the project managers and one of the project administrators from each of the 33 CDF projects in Rongai Sub-County hence a sample size of 66 participants. A structured questionnaire was used to facilitate data collection. The research questionnaire was subjected to a pilot test to determine its validity and reliability. The data was analyzed with the facilitation of the Statistical Package for Social Sciences software. Data analysis was subjected to both descriptive statistics and inferential statistics. The null hypotheses were tested using the t-statistics at 95% confidence level. The results of the study were presented in form of tables and were accompanied by relevant interpretations and discussions. From multiple regressions, it was inferred that technology was significant in explaining the implementation of constituency development fund projects at a 5% significance level, followed by time management and then cost management. Staff analysis was found to be insignificant in explaining the implementation of constituency development fund projects. The study concluded that when acquiring projects staff their previous experience in similar projects, their education and qualification in the project, and their skills in the project should be considered. The study conclude that time management contributes substantively in the timely completion and delivery of projects within the desired time. The study concluded that most of the project managers do not utilize technology in the implementation of constituency development fund projects. The study concludes that the constituency development fund projects are not normally completed within the approved budget. The study recommends the adoption of leadership practices by project managers who participate in constituency development fund projects and further research should be conducted to investigate the other factors that may influence implementation of constituency development fund projects

How innovation can influence customer satisfaction – case study of the Saccharum Hotel in Madeira

PurposeThe main goal of innovation is to improve customer service and products and also customer satisfaction. Taking into account the four types of innovation recognized by organization for economic co-operation and development, the purpose of this research is to understand how innovation can influence customer satisfaction, specifically in the hotel industry.Design/methodology/approachThe data collection was done through qualitative (interview) and quantitative methods (questionnaire). For the quantitative data processing, the Statistical Package for Social Science software was used through statistical inference methods.FindingsThe results show the influence of the four dimensions of innovation on customer satisfaction. These results confirm previous studies on the influence of service, marketing and process innovation on customer satisfaction. However, the results also show the positive relation between customer satisfaction and organizational innovation as well as the relationship between organizational innovation and the other types of innovation.Research limitations/implicationsThe results of this study were based only on one hotel unit. The extension to other cases may strengthen the results.Practical implicationsThe confirmation that customer satisfaction is associated with innovation, in its four dimensions, can contribute to better decision-making, not only for the hotel in the study but also for the sector.Originality/valueFocusing on understanding the relation between the rate of innovation and its impact on customer satisfaction, the study expands the knowledge about the importance of services innovation on a specific hotel in Madeira.

Parkinson's Disease Medication Prescribing and Administration During Unplanned Hospital Admissions.

Parkinson's disease (PD) is the second most common neurodegenerative disease with a lifetime risk of 1% to 3%. Treatment includes supplementation of central dopaminergic neurotransmission with levodopa preparations and dopamine agonists. Misprescribing and delayed administration of these medications on admission to hospital can result in increased morbidity and mortality. We aimed to assess the accuracy of time-critical PD medication prescribing and administration during unplanned hospital admissions. Patients admitted during a 15-month period with PD on time-critical PD medications were included. Their electronic patient records were compared with the pharmacist medication reconciliation to assess accuracy of admission prescribing. Accuracy of administration was assessed by comparing the time medications were administered to the time they were due. Statistical Package for Social Sciences software was used to perform statistical analysis in this study. A total of 102 admissions of 70 patients (67% men) were included for analysis. These patients were on 1.6 ± 0.8 time-critical PD medications before admission, accounting for 4.1 ± 1.8 administrations per day. Time-critical medications were prescribed correctly on admission in 50% of admissions, with errors in medication timing most common (31.6%). Of all doses, 51.7% were administered >30minutes late, and 29.7% of doses were administered >1 hour late. Female sex, a higher number of medications, and more frequent administrations were significantly associated with the rate of medication error. This study demonstrates high rates of inaccurate prescribing and inaccurate administration of time-sensitive medication in a cohort of patients with PD admitted acutely to hospitals.

Anthropometric parameters as alternatives to identify visceral fat and cardiovascular risk in hepatitis C patients

Objective: To analyze the anthropometric parameters used as alternatives to identify visceral fat and cardiovascular risk in patients with hepatitis C. Methodology: Study carried out between June to November of 2017, with hepatitis C patients. Social data, lifestyle and biochemical parameters were collected. Anthropometric assessment was carried out, being measured height, weight, waist circumference and hip circumference were measured. Then, body mass index, waist and height ratio, waist-to-hip ratio, visceral adiposity index and Framinghan risk score were calculated. For statistical analysis, chi-square test was applied, and simple and multiple logistic regressions have been performed to explore the correlation between anthropometric parameters and Framingham risk score, adopting a 5% significance level. Statistical Package for Social Science software was used. Results: 55 patients evaluated. It was observed that 56.36% presented cardiovascular risk according to waist circumference and waist-to-hip ratio, 78.18% according to the waist and height ratio, and 74.55% according to the visceral adiposity index. In the relation between Framingham risk score and anthropometric parameters it was observed that waist-to-hip ratio was considered a significant independent predictor (OR=14.7000; CI95% = 3.5360 – 61.1180). Conclusion: For the identification of visceral fat, it is suggested to use the waist-to-hip ratio because it indicated a probability for the development of cardiovascular events in individuals with hepatitis C.

HER2 Positive Gastric and Gastroesophageal Adenocarcinoma: A Tertiary Center Experience in (NICRH) Bangladesh

Background: Gastric cancer is the fourth commonest cancer worldwide. It is also recognized as the second commonest cause of cancer related death in the global perspective. Although the incidence of gastric cancer has gradually decreased over the last half of the century, it varies among the different part of the world and different ethnic group. Mortality from gastric cancer extremely high, and it is second only to lung cancer. Gastric cancer occurs more frequently in men than in women. Aim of the study: Aim of the study was to find the clinic-profile outcome HER2 Positive Gastric and Gastroesophageal Adenocarcinoma.Methods:This cross sectional study was conducted in the Department of Surgical Oncology of National Institute of Cancer, Research and Hospital, Mohakhali, Dhaka. The study period was from March, 2014 to April, 2015. A total of 80 patients were included for the study. After receiving the gastrectomy specimen, it was fixed in 10% formaldehyde. Data were compiled and necessary statistical analysis were carried out using computer based software package for social science (SPSS 16.1). Ethical clearance was taken from the ethical committee of NICRH.Results:The highest patients were from 61-70 years’ age group and the lowest were from 71-80 years. The mean age of the patients was 59.71 (±10.19) years. The female to male ratio in this study was 1: 2.48. 66 (82.5%) patients were presented with anemia which was followed by 39 (48.75%) cases with dehydration. Most of the tumors were located in the distal part of the stomach (11.67%). Regarding staging 79(12.65%) patients were in the advanced stage of the disease. The correlation between HER2 overexpression and TNM staging has been tabulated below where it is shown that only Nodal (N) staging has the significant correlation with the HER2 overexpression.Conclusion:It is already mentioned that, in early history of immunohistochemistry, HER2 overexpression in case of carcinoma stomach was highly varied in different studies (from 9-92%). But recently, it was found around 9-32%, in several studies all over the world. It is necessary to conduct further studies with larger samples and long term follow-up in order to draw definite conclusions regarding the role of HER2/neu overexpression.

Burnout in oral and maxillofacial surgeons in Brazilian population during the COVID-19 pandemic: a critical analysis

The training and activities of an oral and maxillofacial surgeon, although stimulating, motivating, and satisfactory, are not exempt from technical and psychological challenges. Residency training programs aim to develop necessary skills of resistance and rational decision-making under pressure in clinical, outpatient, and complex hospital interventions. Furthermore, these programs also require the fulfillment of activities outside the operating room, such as issuing diagnoses and planning high complexity procedures with a high risk of complications. The aim of this study was to evaluate the levels of burnout in attending surgeons and residents from oral and to maxillofacial surgery residency programs located in the State of Ceará, Brazil, during the SARS CoV-2 (COVID-19) disease pandemic. This observational, cross-sectional study with a quantitative approach was conducted on attending surgeons and residents registered at the Regional Council of Dentistry – Ceará Section. Data were obtained through an online questionnaire with three sets of questions: 1) professional factors; 2) the Oldenburg Burnout Inventory instrument; and 3) sociodemographic aspects. Quantitative data were analyzed with the Statistical Package for Social Science software. Nonparametric statistical analysis (Fisher and Kruskal-Wallis Exact tests) was used, in addition to the Chi-square test, adopting a significance level of 5%. A sample of 78 participants was obtained, in which most attendings (58.7%) and residents (40%) demonstrated moderate levels of burnout. We can conclude that the levels of burnout in oral and maxillofacial attending surgeons and residents from the State of Ceará during the COVID-19 pandemic were moderate, not resulting in high levels of emotional exhaustion and depersonalization.

Identification and analysis of dental education quality in Saudi Arabia

Objectives: Saudization can be defined as recruiting and hiring Saudis in both the governmental and private sectors. This process is being introduced by the Ministry of Labor to reduce the number of unemployed. Lowering the unemployment rate from 11.6% to 7% is one of the new vision goals to be reached by 2030. The SERVQUAL model is used to assess customer perceptions of service quality in service and retail organizations through five dimensions: tangibility, reliability, responsiveness, assurance, and empathy. This study aims to measure the effect of these quality dimensions on students' willingness to be and satisfaction being educated by Saudi faculty in dental colleges. The focus of this research is to determine which quality dimensions most affect students while being educated by Saudi faculty in dental colleges. The contribution of this research will help future research to develop strategic operational objectives to enhance education quality. Materials and Methods: A cross-sectional survey was performed. A total of 432 participants (198 male students and 234 female students) were included in the study. An electronic questionnaire with a scale from 0 to 5 using the SERVQUAL model was formulated. Results: The results were analyzed by the Statistical Package for Social Sciences software (SPSS, version 21, Chicago, Illinois, USA). The weighted scale was 4.01, 4.12, 4.03, 3.25, and 3.78 for reliability, assurance, accountability, empathy, and education quality of Saudi faculty, respectively. Furthermore, the weighted scale was 3.7 and 3.71 for students' satisfaction and student willingness to attend future lectures, respectively. Conclusion: Students had high agreement with the reliability, accountability, and education quality of Saudi dental faculty. However, the assurance dimension showed significant side effects on student willingness to attend future lectures. On the other hand, the empathy dimension showed significant side effects on participants' perception of satisfaction and student willingness to attend future lectures.

Comparison of Rate of Tooth Movement, Root Resorption and Pulp Vitality during En masse Anterior Retraction with Micro-osteoperforation and Low Level Laser Therapy: A Randomised Clinical Trial

Introduction: Micro-osteoperforation (MOP) and Low Level Laser Therapy (LLLT) are rapidly gaining popularity in clinical practice due their proven success in accelerating tooth movement and acceptable patient compliance. However, literature shows an inconsistent and variable evidence of their iatrogenic effects on the root and pulp due to biological variations of the samples chosen by the previously studies. Aim: To evaluate and compare the rate of tooth movement, changes in amount of external root resorption and pulp vitality in teeth during en masse anterior retraction associated with MOP and LLLT using split mouth technique. Materials and Methods: This was a double blinded, single center split mouth randomised clinical trial conducted at Faculty of Dental Sciences, MS Ramaiah University of Applied Sciences, Bangalore, Karnataka, India from March 2019 to October 2019. Total of 11 patients with bimaxillary dentoalveolar protrusion which required all four first premolar extractions were included in the study. Nickel Titanium (NiTi) closed coil springs were used for en masse retraction in upper and lower arches with force of 150g per side. Root resorption of all anterior teeth was evaluated using Cone Beam Computed Tomography systems (CBCT) and pulp vitality was checked using cold test after 4 months. The data was entered in Microsoft excel and the Statistical Package for Social Sciences software (SPSS) version 18.5 (SPSS Inc, Chicago) software was used for data entry and statistical analysis. A p-value of less than 0.05 was considered as statistically significant. Results: Total of 11 patients in which 9 were females and 2 males aged between 18-30 years with mean age 19±4.21 year, participated in this trial. LLLT (4 mm) and MOP (4.05 mm) showed similar performance in acceleration of tooth compared to each other. The overall root resorption was more in the experimental groups (LLLT- 2.60 mm, MOP- 2.84 mm) compared to the allotted controls. However, the canine showed less root resorption in both the experimental groups compared to the control. The overall root resorption was similar in both the experimental groups. The canine in LLLT group (0.30 mm) showed less root resorption compared to canine in MOP group (0.59 mm). There was no change in the pulp vitality status in both the experimental groups and the control groups. Conclusion: The overall root resorption in a given quadrant increases with increased rate of tooth movement. The tooth which was subjected to acceleratory orthodontic technique showed less root resorption compared to control. The tooth subjected to LLLT showed less root resorption as compared to the tooth subjected to MOP.

Determinants of Satisfaction and Deep Structure Usage of Post-acceptance Learning Management Systems by Malaysian Higher Education Lecturers

This study investigates factors influencing satisfaction and deep structure usage of Learning Management Systems (LMS) using a revised expectation-confirmation model of information system continuance. It addresses the gaps in the existing literature that primarily focused on behavioral intention in the acceptance stage instead of deep structure usage in the post-acceptance stage. Deep structure usage refers to using LMS features to support an underlying teaching task. The study population consists of 54 lecturers in Malaysian private universities in the post-acceptance stage of LMS implementation. Data was gathered using a web-based survey questionnaire. Various variables were analyzed through statistical correlation and regression using a statistical package for social science software. This study concludes that confirmation of expectation and perceived usefulness positively impacted satisfaction; confirmation of expectation was the strongest predictor of satisfaction. Additionally, the combined effects of satisfaction, confirmation of expectation, and perceived usefulness positively correlated with deep structure usage of LMS. This study investigates whether lecturers would use the system to its full capacity if they found the LMS features useful to a specific teaching task and if the system provides satisfaction and fulfills the lecturers’ expectations. Future research recommends extending the model to investigate determinants of satisfaction and confirmation of expectations of specific LMS features in terms of technical, design, capability, and experiential aspects. This extension would enable a more detailed understanding of aspects that determine satisfaction and confirmation of expectation, directly influencing deep structure usage.

Placental Changes in Perinatal DeathAn Observational Study from a Tertiary Care Centre in North Karnataka

Introduction: Placenta is poetically described as a diary which bears the events of intrauterine life; hence examining them, especially in perinatal death can provide valuable information regarding the cause of death and sometimes gives an idea about recurrence of such events. Aim: To describe the various placental lesions in perinatal death and compare them with equal number of normal placentae. Materials and Methods: This prospective, comparative, crosssectional study was conducted in tertiary care centre, Karnataka Institute of Medical Sciences, Hubballi, Karnataka, India. All placentae, irrespective of the gestational age, received in the Department of Pathology, from October 1st 2017 to March 31st 2019 were collected after taking an informed consent. A total of 539 cases were received in this time frame, of which 121 (22.45%) were dead and included in the study and were compared with 121 normal placentae (alive), without any maternal co-morbidities. The placentae were grossed and assessed according to Amsterdam guidelines. The significance of the difference observed was established by Chi-square test using Statistical Package for Social Sciences software (SPSS) version 21.0. Results: Of these 121 cases, 89 (73.5%) cases had placental changes, whereas 32 (26.5%) cases were devoid of placental changes. Placental infarct and increased syncytial knots were seen contributing maximum to foetal death in 31 (25.6%) cases followed by chorioamnionitis. Rare cases like Twin Reversed Arterial Perfusion (TRAP) syndrome, Persistent Right Umbilical Vein (PRUV), maternal floor infarct were also reported. Conclusion: Despite many antenatal imaging advances, placental examination still remains valuable in diagnosing cause of death and growth restriction in the foetus especially recurrent causes, favouring clinical intervention in those cases.

Pre-anaesthetic sonographic assessment of gastric antrum in parturient scheduled for elective caesarean section - A prospective cross-sectional study.

Background and Aims:Point-of-care ultrasonography (USG) of the gastric antrum can help to evaluate the aspiration risk and improve the safety of anaesthesia. The aim was to assess the gastric antrum in term parturients scheduled for elective caesarean section using bedside USG.Methods:After obtaining institutional ethics committee approval and written informed consent, 250 term parturients (≥36 weeks gestational age) with body mass index 18.5–30 kg/m2, and scheduled for elective caesarean delivery were included in this study. The parturients were instructed to follow standard fasting guidelines. In the preoperative area, ultrasonographic examinations were performed 15 min before the scheduled time of the caesarean section. The primary outcome was the qualitative assessment (grade 0–2) of the gastric antrum, and the secondary outcome was the quantitative assessment (antral cross-sectional area [CSA]) of gastric antrum in supine and right lateral decubitus (RLD) position. Data analysis was done using Statistical Package for Social Sciences Software (version 19).Results:Among the 234 parturients who completed the study, 191 exhibited grade 0 antrum, 42 had grade 1 antrum, and one parturient had grade 2 antrum. Overall, 83% of participants had an antral CSA ≤4.25 cm2 [95% confidence interval (CI), 2.52–5.67 cm2] in the RLD position, equivalent to an estimated gastric volume of ≤43 ml (95% CI, 32–68 mL) or ≤1.5 ml/kg (95% CI, 0.49–1.23 ml/kg).Conclusion:Majority of fasted term parturients scheduled for elective caesarean section had a grade 1 gastric antrum on bedside USG. This study also establishes cutoff values of antral CSA and gastric volume in both supine and RLD position for fasted term parturients.

Safer citalopram use in primary care: Can staff education and prescribing prompts improve adherence to national guidance? A closed loop clinical audit, service evaluation and quality improvement study.

Citalopram is a drug with many important safety considerations in prescribing including dosage adjustments, pre-prescription testing and multiple interactions. Because of this, the UK government issued advice regarding the prescription of citalopram and escitalopram in its Drug Safety Update Vol 5 Issue 5, Dec 2011,[1] and the expectation is that all prescribers adhere to this. To establish the adherence to prescribing guidance of citalopram at the practice level, implement change to address the lack of adherence and then evaluate the effectiveness of the change using re-audit techniques. Patients were identified using data searching techniques on EMIS for February-April 2020. Parameters searched for included age, hepatic impairment, cardiac disease, known QT prolongation and concomitant use with other QT-prolonging medication. Following the first cycle teaching on the safer use of citalopram was delivered to all prescribers and an EMIS prompt was also set up. A second audit cycle was then carried out. Data was analysed using Statistical Package for Social Sciences software to assess the significance of the results. Following the presentation of the first cycle findings and the introduction of the EMIS safety prompt, there was a statistically significant reduction in incorrect citalopram dose prescription in the over 65s (8 vs 1), a statistically significant reduction in the incidence of dangerous drug interactions involving citalopram (44 vs 8) and a significant reduction in the incidence of unsafe prescribing of citalopram overall (47 vs 9). The introduction of an EMIS prompt and one-off prescriber teaching resulted in a statistically significant reduction in incorrect prescriptions of citalopram when re-audited a year later. These interventions resulted in improved patient safety and more effective use of resources and could easily be replicated at other practices throughout the country both for citalopram and other drugs with multiple safety considerations.

Special Protection and Provision of Rest during Work and Occupational Health Hazards: A Survey among Steel and Power Industry Workers in Odisha, India

Introduction: In India, there are many labour laws implemented for the legal provision of working hours, services, and employment conditions of workers. Special protection and rest provision plays a pivotal role in occupational injuries and illness. Aim: To determine the special protection and various provision of rest at the workplace. Materials and Methods: A survey was conducted among steel and power industry workers in Odisha, India. The study was conducted with 425 male respondents by adopting the population proportion sampling technique. The primary data was taken from a Steel and Power limited industry situated in Angul district of Odisha from February 2019 to October 2019. Statistical Package for Social Sciences software (SPSS version 25.0) was used in the analysis process by using the univariate and bivariate models to assess the objectives. Results: The study showed 92.5% of respondents were provided rest, and 59.1% of respondents were in the employment contract. More than 43.3% of respondents reported they received compensation during occupational injury and diseases, whereas 45.6% didn’t get any compensation in the event of occupational diseases. Out of the 393 workers got rest, a vast majority (95.4%) of respondents reported that they were allowed night rest, and 84.5% were allowed for meal breaks during work. More than 59% of respondents receive short breaks during work, and 52.9% were entitled to weekly breaks/rest. Religion, caste, education, technical education, occupation, type of work, and the number of working hours were strongly associated with the respondent's characteristics. Conclusion: Special protection provisions are critical factors for the treatment of occupational health hazards. It has been confirmed that night rest and meal break rest were provided to the workers. Except for the shift work rest and extended workload rest, the provision of rest was sufficiently provided at the workplace. Special protections are expected to strengthen the occupational health of workers and stay away from medical expenses.