Determinants of substance use among young people attending primary health centers in India

Background

Substance use is a complex condition with multidimensional determinants. The present study aims to find the prevalence and determinants of substance use among young people attending primary healthcare centers in India.

Methods

A multicentric cross-sectional study was conducted across 15 states in India on 1,630 young people (10-24 years) attending primary health centers. The Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) was used to capture data on substance use. The degree of substance involvement was assessed and multivariate regression analysis was conducted to determine the risk factors of substance use.

Results

The prevalence of substance use was 32.8%, with a median substance initiation age of 18 years. Among the substance users, 75.5% began before completing adolescence. Tobacco (26.4%), alcohol (26.1%) and cannabis (9.5%) were commonly consumed. Sociodemographic determinants included higher age, male gender, urban residence, positive family history, northeastern state residence and lower socioeconomic class. Over 80% of users had moderate or high involvement.

Conclusions

High substance use prevalence among young people in Indian healthcare centers underscores the urgency of targeted intervention. Insights on determinants guide effective prevention strategies for this complex public health issue.

Impact of health education intervention on menstruation and its hygiene among urban school-going adolescent girls in Thiruvallur, Tamilnadu

Introduction

Adolescent girls require specific and special attention since they are the most vulnerable group not only in terms of their social status but also their health. Poor menstrual hygiene can lead to developing infections and other complications. Therefore, this study was conducted with the aim of assessing the impact of health education on menstrual hygiene among urban school-going adolescent girls.

Methodology

A quasi-experimental, pre and post-test study was conducted among adolescent girls aged between 11 to 17 years from two public schools in the urban field practice area of tertiary care medical college in Thiruvallur district of Tamilnadu. A pre-interventional survey was done using a pretested validated questionnaire. Multipronged health education intervention was administered, and its effectiveness was measured after four months using the same tool. Frequencies, percentages, median, and range were used to describe variables. 'Wilcoxon signed-rank test' and the "Mann-Whitney U-" test were used for inferential statistics.

Results

There was a statistically significant (P = 0.0001) improvement in the knowledge of menstruation, perceived attitude, and practice of good menstrual hygiene from pre to post-test after the intervention. Demographic factors such as age, mother's education, and socio-economic status, and Menstrual characteristics such as age at menarche, regular menstrual flow, absence of dysmenorrhea, and getting menstruation advice before menarche were found to be significantly associated with the post-test median scores.

Conclusion

A planned and structured health education program should be addressed to adolescent girls both at schools and community settings for improving menstruation-related knowledge and practices.

Role of Nutritional and Environmental Factors in the Development of Essential Hypertension among School-going Adolescents in Chennai, Tamil Nadu

Background

Essential hypertension is one of the fastest rising noncommunicable diseases among adolescents and poses a major public health issue globally. This study aimed to estimate the prevalence of prehypertension and hypertension among school-going adolescents in Chennai and also to delineate the role of nutritional and environmental determinants in the development of hypertension.

Methods

This cross-sectional study was conducted among school-going adolescents aged 14 to 18 years in northern Chennai. Four schools (two private, two public) out of 21 were selected randomly using probability proportionate to sampling size and 401 students were recruited after consent. Data were collected using an adapted modified World Health Organization (WHO) Global School-based student Health Survey (GSHS) questionnaire; anthropometry and blood pressure measurements were done by trained healthcare professionals using standard procedures. Prehypertension was defined when systolic or diastolic pressure >90^th percentile and <95^th percentile; hypertension when systolic or diastolic pressure >95^th percentile. Data were analyzed using SPSS, descriptive statistics like frequencies, mean, and percentages were used and inferential statistics like Chi-square test and logistic regression were used to elicit predictors of essential hypertension.

Results

Out of 401 participants, 185 (46.1%) were males and 216 (53.9%) were females. Overall prevalence of prehypertension and hypertension was 14.2% and 5.5%, respectively. Gender (P = 0.039), overweight/obese (P = 0.000), junk food intake for >3 days/week (P = 0.000), physical inactivity for <3 days/week (P = 0.000), and parent's history (P = 0.005) were significant determinants in the development of prehypertension and hypertension.

Conclusions

Nutritional and environmental determinants play a critical role in influencing blood pressure status among adolescents, this requires lifestyle and behavioral modification.

Role of domestic migration stress in adapting precarious behaviours among interstate migrant workers in a semi-urban area of Tamil Nadu

Background

Migration is a process in which a person moves from one cultural setting to another for a long period of time or permanently, which induces increased adaptation of risky behaviors due to migration stress. This study aimed to identify domestic migration stress and to determine its role in practising precarious behaviours among interstate migrant workers.

Methodology

A community-based cross-sectional study was conducted among 313 migrant workers in the Kanchipuram district using a simple random sampling method for recruitment. A pretested semi-structured questionnaire was used to collect data with details on socio-demographic characteristics and precarious behavior profiles, and the 'domestic migration stress scale' was validated. For analysis, variables were described using frequencies, proportions and mean ± standard deviation, appropriately. Inferential statistics like the 'Chi-square test and multiple logistic regressions' were performed to establish the relationship between migration stress and high-risk behavior.

Results

Among respondents, 286 (91.37%) were males. The majority were chronic alcoholics [151 (48.56%)], followed by tobacco chewers [106 (33.86%)], chronic smokers [83 (26.51%)], had illicit sexual activity [59 (18.84%)] and drug abusers [4 (1.27%)]. About 247 (78.93%) were under domestic migration stress. Smokers, tobacco chewers and those involved in illicit sexual activity were significant predictor factors.

Conclusion

Stress management is paramount, and having the knowledge about their precarious behavior and stress among workers will help in the further development of health promotion strategies for migrant workers.

Significance of Laboratory Markers in Predicting the Severity of COVID-19 in the Central Reserve Police Force Front-line Workers with a Review of Literature

COVID-19 disease has variable clinical presentations, ranging from asymptomatic to mild symptoms to severe manifestation with pneumonia, acute respiratory distress syndrome, septic shock, disseminated intravascular coagulation, and/or multiple organ failure. The real-time reverse transcription-polymerase chain reaction is gold standard test for severe acute respiratory syndrome-coronavirus-2 detection. In the present study, we aimed to predict the significance of various hematological and biochemical markers for early identification of complications and assessing the severity of the disease. A total of cases were divided into two study groups, namely, severe and nonsevere based on clinical presentation. Out of 210 cases, 186 (88.5%) cases were nonsevere and 24 (11.5%) cases were severe. Among various hematological and biochemical markers studied, hemoglobin, total leukocyte count, neutrophil count, lymphocyte count, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, albumin, lactate dehydrogenase, C-reactive protein, ferritin, D-dimer, and interleukin-6 are found to have P < 0.05 and significantly correlated with the severity of disease.

Global Awareness of Myocardial Infarction Symptoms in General Population: a Systematic Review and Meta-Analysis

Seventy percent people are able to recognize chest pain as myocardial infarction (MI) symptoms. There is no difference in awareness of MI symptoms between male and female. There is wide variation in awareness of MI symptoms. The prevalence varies from less than 5% in African countries such as Kenya, Tanzania and in Asian countries such as Nepal to as high as 90% in Germany.

Background and Objectives

Knowledge about myocardial Infarction (MI) symptoms is crucial because inadequate awareness ensures direct association with patient delay and adverse health events subsequently.

Methods

PRISMA guidelines were followed while conducting the systematic review with PROSPERO number CRD42020219802. An electronic search was conducted comprehensively through 5 databases to find those relevant articles systematically. Prevalence was calculated for each typical symptom of MI separately and subgroup analysis according to continent, country, gender and ethnicity was done. Meta-Analysis was conducted by using statistical software R version 3.4.3. A random-effects model was used.

Results

Studies from 35 different countries with 120,988,548 individuals were included in the final analysis. The prevalence of chest pain awareness was highest, while it was lowest for jaw, back, and neck pain. There was no difference in terms of awareness in males and females. Prevalence of awareness of typical MI symptoms was higher in the Caucasian white, white, and non-Hispanic white groups than in other groups. The prevalence varies from less than 5% in African countries such as Kenya, Tanzania and Asian countries such as Nepal to as high as 90% in Germany.

Conclusions

People are well aware of chest pain as a symptom of MI. However, there is limited knowledge regarding other typical symptoms of MI.

Impact of Health Education Intervention on Breast Cancer Awareness among Rural Women of Tamil Nadu

Background:

The most common cancer among Indian females is breast cancer. Limited access to early detection and treatment is responsible for more than half of the deaths, primarily in rural areas, where organized mammography screening is neither affordable nor feasible. Therefore, imparting awareness on breast health and breast self-examination (BSE) is highly recommended. This study aimed to assess the impact of a health education interventional program on breast health awareness and BSE among rural women of Tamil Nadu.

Methodology:

A quasi-experimental study was conducted among 266 women. A preinterventional survey was done using a pretested validated questionnaire. A multipronged breast health education intervention was administered and its effectiveness was measured after 3 months using the same tool.

Results:

There was a statistically significant (P = 0.0001) improvement in the knowledge of breast health, perceived susceptibility, and reasons for practice and proficiency of BSE practice of the interventional group from pre- to post-test. After the interventional program, 71.8% of increase in knowledge about breast health and BSE was observed. In addition, 64.7% of the women practiced BSE compared to 7.14% pretest.

Conclusion:

This study highlights the awareness needs by the women and application of extensive strategies to increase the acceptance of cancer screening programs.

Road kills of the endemic snake Perrotet’s Shieldtail Plectrurus perrotetii, Dumeril, 1851 (Reptilia: Squamata: Uropeltidae) in Nilgiris, Tamil Nadu, India

Twenty seven road killed specimens of Plectrurus perrotetii were recorded in Emerald and its surrounding areas in the Nilgiris. Among the road kills, fourteen of them were females, seven were males and six are juveniles. Among the road kill female specimens of this species, it was observed that seven were gravid with fully developed young. Three to six developing young ones were observed

Musculoskeletal morbidity among construction workers: A cross-sectional community-based study

Background:

Construction industry is one of the stable growing industries in India. People working in construction industries are at a risk of various occupational diseases. Musculoskeletal disorder (MSD) is the single largest cause of work-related illness, accounting for over 33% of all newly reported occupational illnesses in the general population and approximately 77% in construction workers. In spite of the high prevalence and wide range of adverse consequences, the studies highlighting the burden and impact of musculoskeletal morbidities are very scarce in India. The current study is aimed at filling this vital gap in the current knowledge.

Objective:

To assess the musculoskeletal morbidities among construction workers using the modified Nordisk Scale.

Materials and Methods:

A cross-sectional community-based study was conducted by 30 × 10 multistage cluster random sampling method in Chennai Metropolitan city.

Results:

Out of the 308 participants included in the final analysis, majority were 21–40 years. Working hours ranged from 8 to 12 hours. Duration of work ranged from 2 months to 20 years. Out of 308 participants, 104 workers (33.8%) had musculoskeletal problems. Three most common disorders discovered were low backache seen in 64 (20.8%), shoulder pain seen in 36 (11.7%), and wrist pain seen in 36 (11.7%) participants. The proportion of hospitalized participants in the last 1 year was 7.8%. Total duration in the construction field, duration of work hours, and higher age had statistically significant impact on musculoskeletal morbidity.

Conclusion:

The prevalence of musculoskeletal morbidity was very high in construction workers, with resulting adverse impact on the workers. Immense attention, in the form of appropriate prevention measures, is needed to effectively address this public health problem.

Comparison of different glucocorticoid regimens in the management of classical congenital adrenal hyperplasia due to 21-hydroxylase deficiency

BACKGROUND

There are recommendations regarding the total dose of hydrocortisone to be administered in the treatment of classical congenital adrenal hyperplasia (CAH) to achieve the twin objectives of glucocorticoid replacement and control of hyperandrogenism. However, there is evidence gap regarding the breakup, timing and type of the steroid regimen.

OBJECTIVES

Efficacy of three different glucocorticoid regimens having the same total dose of steroid, differing in either the timing or type of evening steroid administered, in achieving biochemical control of the disease was assessed.

MATERIALS AND METHODS

The study was done in 13 prepubertal children with classical CAH over a 6-month period with 2 months devoted to each regimen. We used a prospective cross-over design using 10-15 mg/m(2) total dose of hydrocortisone. Two-fifths of the total dose of hydrocortisone was administered in the morning and one-fifth of the total dose was administered at noon in all the regimens. The regimens differed in the timing of the evening dose of hydrocortisone, 06.00-07.00 pm in regimen 1 and 09.00-10.00 pm in regimen 2. The third regimen had the evening dose of hydrocortisone replaced by an equivalent dose of prednisolone suspension which was administered at 10.00 pm. Serum 17-hydroxyprogesterone and testosterone levels were compared to assess the efficacy of treatment regimens.

RESULTS

The three different regimens were found to be similar in their ability to control 17-hydroxyprogesterone and testosterone levels. The percentage of patients with predefined criteria for biochemically controlled disease was similar in all the three regimens. However, there was a trend toward better control of 17-hydroxyprogesterone levels in patients receiving evening dose of prednisolone.

CONCLUSIONS

There is no significant advantage in administering the hydrocortisone dose late at night in patients with classical CAH.

Turner syndrome and its variants

Case records of female patients with karyotype proven turner syndrome were analyzed. 11 patients had classic Turner karyotype (Group 1) and 13 patients had karyotype suggestive of one of the variants of Turner syndrome (Group 2). There was a median difference of 3 years between the age of presentation and the age of diagnosis in Group 2. Out of the thirteen patients in Group 2, 4 had no clinical stigmata of Turner Syndrome; the rest (n=9) had one or more of the typical clinical stigmata of Turner Syndrome. One patient with a complex mosaic karyotype also had an intracranial medulloblastoma. One patient in each group had coarctation of the aorta. 5 patients in Group 1 and 3 patients in Group 2 had primary hypothyroidism and received levothyroxine. The median Thyroid Stimulating Hormone levels were significantly higher among patients in group 1 than in group 2.