Search

Mobile Medical Units (MMUs) are one of the major initiatives under the National Rural Health Mission. These MMUs help people in remote, underserved areas access healthcare at affordable prices on their doorstep. The present record-based study aimed to assess the morbidity profile of the patients attending Mobile Medical Unit camps in the Yadadri-Bhuvanagiri district between April 2022 and December 2022. The MMU is run by the Department of Community and Family Medicine, AIIMS, Bibinagar, in six selected villages of the Yadadri-Bhuvanagiri district. (Figure 1). A register is maintained to record the details of patients visiting the MMU camp. Patient's name, age, gender, place, mobile number, height, weight, blood pressure (BP), glucometer Random Blood Sugar, diagnosis, and details of medication dispensed were entered in the register. Diabetes, hypertension, and obesity were diagnosed using the World Health Organization (WHO) criteria, the Eighth Joint National Committee guidelines, and WHO Asia Pacific guidelines, respectively. Mobile Medical Unit Camp data are entered into the Excel database at the end of every month. Since it is a record-based analysis, we used data for analysis between April 7, 2022, and December 31, 2022. A total of 1494 patients were treated in the MMU camps during this period. Among them, 89.4% were adults, and 10.6% were children (less than 18 years). Among 1,336 adult patients, the majority of participants suffered from osteoarthritis, followed by non-communicable diseases (NCDs). The mean scores of systolic and diastolic BP of the adult population were obtained at 131±21 and 77±13 mm Hg, respectively. The mean random blood glucose level of the adult population was 150±74 mg/dl. A total of 158 children were younger than 18 years old, out of whom 78 and 80 participants were males and females, respectively. Moreover, 23.1% and 25% of males and females suffered from upper respiratory tract infections, respectively. The study further suggests that the NCD epidemic is spreading to rural areas where necessary health infrastructure is insufficient. MMUs can bring a significant change to the public health system, which needs to re-orient its priorities. [ABSTRACT FROM AUTHOR]

Introduction: Lockdown measures in response to the COVID-19 pandemic had an appreciable impact on the education of all medical, dental and non-medical healthcare professional students. These included the closure of universities necessitating a rapid move to e-learning and a new practical approach to conducting teaching-learning classes. However, initially, there was a lack of knowledge and expertise regarding e-learning approaches and the affordability of internet bundles and equipment. Materials and Methods: We conducted two pilot studies to assess such current challenges, replaced by a two-stage approach including a full investigation involving 32 private and public universities during the early stages of the pandemic, followed by a later study assessing the current environment brought about by the forced tops. Results: The top challenges at the start of the pandemic included a lack of familiarity with the e-learning approaches, the cost of the internet, a lack of IT equipment and the quality of the classes. To address identified challenges, universities offered support to staff and students. Since then, e-learning approaches have widened the possibilities for teaching and learning at convenient times. However, challenges remain. Conclusions: There were considerable challenges at the start of the pandemic. Several key issues have been addressed with hybrid learning here to stay. The remaining challenges include a lack of ICT equipment. However, new innovations will continue.

The present review was intended to explore the effectiveness of perinatal services such as antenatal care (ANC) and post-natal care (PNC) on the health indicators such as maternal, child and neonatal mortality. Globally, indicators are considered very important in determining the health status and the overall performance of a country's healthcare system. A literature search was conducted using maternal mortality, child mortality, neonatal mortality, ANC and PNC in the PubMed, Google, Academia, The Lancet and Journal of the American Medical Association databases. Globally, implementing integrated perinatal care services has brought positive changes in the maternal, child and neonatal mortality indices. The United Nations (UN) is committed to improving the overall living conditions in all countries, significantly improving the population's health status. The UN came up with eight Millennium Development Goals in 2000, aiming to eliminate poverty and increase development in member states. The World Health Organization was a partner in implementing these goals. Later, the UN introduced 17-fold Sustainable Development Goals in 2015 as a blueprint for peace and prosperity for all citizens towards a better future by 2030. As a result, many countries have experienced positive changes in most indicator areas, including service utilisation, maternal mortality and child mortality. Some Sub-Saharan African and South Asian countries are progressing, however, slowly.

Introduction: The early approaches to prevent the spread of COVID-19 included lockdown and social distancing measures, leading to university closures. These measures forced unparalleled changes to the delivery of healthcare education. Concerns included the preparedness of faculty and students to e-learning as well as the routine availability and funding of equipment and internet bundles. This needed addressing with fully trained healthcare professionals required given rising inappropriate use of antibiotics in India, growing prevalence of non-communicable diseases as well as an increasing number of patients with joint comorbidities. Consequently, there is a need to ascertain the current impact of the pandemic on healthcare student education across India. Materials and Methods: This was a pilot study among 10 purposely selected healthcare educators in both private and public universities. The questionnaire built on published studies. Results: Identified challenges included a lack of familiarity with online education, no bedside teaching, lack of equipment and affordability of internet bundles, poor internet connectivity and postponed examinations. Ways forward included training faculty on e-learning, providing students with loans and other financial support to purchase equipment and internet bundles, establishing COVID-19 prevention protocols and protective equipment, recording lectures and tutorials to make up for lost time and simulated methods to teach clinical aspects. Conclusion: Despite challenges, there was a rapid move to online learning among surveyed universities. Alongside this, courses to address lack of familiarity with e-learning approaches with hybrid teaching approaches here to stay. The next step will be to undertake a wider study and to use the combined findings to provide future guidance.

COVID-19-infected patients require an intact immune system to suppress viral replication and prevent complications. However, the complications of SARS-CoV-2 infection that led to death were linked to the overproduction of proinflammatory cytokines known as cytokine storm syndrome. This article reported the various checkpoints targeted to manage the SARS-CoV-2-induced cytokine storm. The literature search was carried out using PubMed, Embase, MEDLINE, and China National Knowledge Infrastructure (CNKI) databases. Journal articles that discussed SARS-CoV-2 infection and cytokine storm were retrieved and appraised. Specific checkpoints identified in managing SARS-CoV-2 induced cytokine storm include a decrease in the level of Nod-Like Receptor 3 (NLRP3) inflammasome where drugs such as quercetin and anakinra were effective. Janus kinase-2 and signal transducer and activator of transcription-1 (JAK2/STAT1) signaling pathways were blocked by medicines such as tocilizumab, baricitinib, and quercetin. In addition, inhibition of interleukin (IL)-6 with dexamethasone, tocilizumab, and sarilumab effectively treats cytokine storm and significantly reduces mortality caused by COVID-19. Blockade of IL-1 with drugs such as canakinumab and anakinra, and inhibition of Bruton tyrosine kinase (BTK) with zanubrutinib and ibrutinib was also beneficial. These agents' overall mechanisms of action involve a decrease in circulating proinflammatory chemokines and cytokines and or blockade of their receptors. Consequently, the actions of these drugs significantly improve respiration and raise lymphocyte count and PaO2/FiO2 ratio. Targeting cytokine storms' pathogenesis genetic and molecular apparatus will substantially enhance lung function and reduce mortality due to the COVID-19 pandemic.

Type 2 diabetes mellitus is increasingly being associated with cognition dysfunction. Dementia, including vascular dementia and Alzheimer’s Disease, is being recognized as comorbidities of this metabolic disorder. The progressive hallmarks of this cognitive dysfunction include mild impairment of cognition and cognitive decline. Dementia and mild impairment of cognition appear primarily in older patients. Studies on risk factors, neuropathology, and brain imaging have provided important suggestions for mechanisms that lie behind the development of dementia. It is a significant challenge to understand the disease processes related to diabetes that affect the brain and lead to dementia development. The connection between diabetes mellitus and dysfunction of cognition has been observed in many human and animal studies that have noted that mechanisms related to diabetes mellitus are possibly responsible for aggravating cognitive dysfunction. This article attempts to narrate the possible association between Type 2 diabetes and dementia, reviewing studies that have noted this association in vascular dementia and Alzheimer’s Disease and helping to explain the potential mechanisms behind the disease process. A Google search for “Diabetes Mellitus and Dementia” was carried out. Search was also done for “Diabetes Mellitus”, “Vascular Dementia”, and “Alzheimer’s Disease”. The literature search was done using Google Scholar, Pubmed, Embase, ScienceDirect, and MEDLINE. Keeping in mind the increasing rate of Diabetes Mellitus, it is important to establish the Type 2 diabetes’ effect on the brain and diseases of neurodegeneration. This narrative review aims to build awareness regarding the different types of dementia and their relationship with diabetes.

There is an increasing focus on researching children admitted to hospital with new variants of COVID-19, combined with concerns with hyperinflammatory syndromes and the overuse of antimicrobials. Paediatric guidelines have been produced in Bangladesh to improve their care. Consequently, the objective is to document the management of children with COVID-19 among 24 hospitals in Bangladesh. Key outcome measures included the percentage prescribed different antimicrobials, adherence to paediatric guidelines and mortality rates using purposely developed report forms. The majority of 146 admitted children were aged 5 years or under (62.3%) and were boys (58.9%). Reasons for admission included fever, respiratory distress and coughing; 86.3% were prescribed antibiotics, typically parenterally, on the WHO ‘Watch’ list, and empirically (98.4%). There were no differences in antibiotic use whether hospitals followed paediatric guidance or not. There was no prescribing of antimalarials and limited prescribing of antivirals (5.5% of children) and antiparasitic medicines (0.7%). The majority of children (92.5%) made a full recovery. It was encouraging to see the low hospitalisation rates and limited use of antimalarials, antivirals and antiparasitic medicines. However, the high empiric use of antibiotics, alongside limited switching to oral formulations, is a concern that can be addressed by instigating the appropriate programmes.

Introduction: NAFLD is emerging as an important cause of liver disease in India. It is estimated that 16-32% of general population in India (nearly 120 million) has NAFLD., Objective: This study aimed to identify the risk factors of NAFLD and to identify the association of lifestyle (dietary and physical activity), genetic, and environmental factors with NAFLD in India., Materials and Methods: A systematic literature search was conducted using an international electronic database: PubMed (MEDLINE) and Google Scholar from the date of inception 31 st March 2021 to 28 th September 2021. We included studies examining patients with NAFLD: Adults above 18 years of age. Studies with or without a control population were both eligible. The studies with a diagnosis of NAFLD based solely on abnormal liver tests were excluded. We tried to get unpublished data but they were not of the quality of inclusion. Meta-analysis was performed using the software STATA 14.2 (StataCorp, College Station, TX, USA). For each of the studies, the standard error was calculated using the reported number of outcomes and the sample size. A forest plot was used to graphically represent the study-specific and pooled prevalence estimates for overall and subgroup analysis., Results: In a systematic review and meta-analysis of 8 studies including data from over 1800 individuals, we found that among components of lipid profile, LDL and HDL had a negative effects on NAFLD while triglycerides had a positive effect on NAFLD., Conclusion: Type 2 Diabetes Mellitus, Hypertension, and Obesity were the potential risk factors for NAFLD but the evidence generated was only from single studies., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Education and Health Promotion.)

Summary: Over the past few decades, hypertension (HTN) has affected both young and old people. The public health problem has an enormous economic impact on societies as well. The present review aimed to understand and compare the differences from the available literature on HTN treatment at the primary care level in various states and at the national level in India. We reviewed the latest international, national, and state guidelines/protocols available for the treatment of HTN. In addition, we also searched the PubMed database with relevant Medical Subject Headings terms and included the articles published in the last 5 years. A total of 204 articles were screened and finally, eligible 5 articles were included in the review. International guidelines preferred thiazide diuretics as a drug of choice. While the state protocols and national guidelines preferred calcium channel blockers, followed by angiotensin receptor blockers as the drug of choice. All these guidelines focused on low-dose monotherapy. These guidelines also summarized additional drugs required in case of comorbid conditions. However, the new Essential Medicine List published by the World Health Organization prefers low-dose fixed-drug combination (two-drug regimen) at the primary care level for treatment of HTN. There was not much cost difference between monotherapy and fixed-drug regimens based on the published studies. With due rise in HTN cases, the standardized protocol is ubiquitously needed for better application, comparison, and streamline of the program. Fixed-drug combination therapy can be considered for better control rates among hypertensives by improving adherence and efficacy., (Copyright © 2023 Copyright: © 2024 Indian Journal of Public Health.)

Neuraminidase-1 (NEU1) is the predominant sialidase expressed in human airway epithelia and lung microvascular endothelia where it mediates multiple biological processes. We tested whether the NEU1-selective sialidase inhibitor, C9-butyl-amide-2-deoxy-2,3-dehydro-N-acetylneuraminic acid (C9-BA-DANA), inhibits one or more established NEU1-mediated bioactivities in human lung cells. We established the IC50 values of C9-BA-DANA for total sialidase activity in human airway epithelia, lung microvascular endothelia and lung fibroblasts to be 3.74 µM, 13.0 µM and 4.82 µM, respectively. In human airway epithelia, C9-BA-DANA dose-dependently inhibited flagellin-induced, NEU1-mediated mucin-1 ectodomain desialylation, adhesiveness for Pseudomonas aeruginosa and shedding. In lung microvascular endothelia, C9-BA-DANA reversed NEU1-driven restraint of cell migration into a wound and disruption of capillary-like tube formation. NEU1 and its chaperone/transport protein, protective protein/cathepsin A (PPCA), were differentially expressed in these same cells. Normalized NEU1 protein expression correlated with total sialidase activity whereas PPCA expression did not. In contrast to eukaryotic sialidases, C9-BA-DANA exerted far less inhibitory activity for three selected bacterial neuraminidases (IC50 > 800 µM). Structural modeling of the four human sialidases and three bacterial neuraminidases revealed a loop between the seventh and eighth strands of the β-propeller fold, that in NEU1, was substantially shorter than that seen in the six other enzymes. Predicted steric hindrance between this loop and C9-BA-DANA could explain its selectivity for NEU1. Finally, pretreatment of mice with C9-BA-DANA completely protected against flagellin-induced increases in lung sialidase activity. Our combined data indicate that C9-BA-DANA inhibits endogenous and ectopically expressed sialidase activity and established NEU1-mediated bioactivities in human airway epithelia, lung microvascular endothelia, and fibroblasts in vitro and murine lungs in vivo., (© The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)