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   Table of Contents - Current issue
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January-December 2022
Volume 9 | Issue 1
Page Nos. 1-43

Online since Friday, December 30, 2022

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EDITORIAL  

Biological plausibility of spirituality in public health p. 1
Rushabh J Dagli
DOI:10.4103/jhrr.jhrr_16_21  
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ORIGINAL ARTICLES Top

Speciation, risk factors, and antifungal susceptibility pattern of Candida isolates from urine sample of ICU patients: An observational cross-sectional study p. 3
Madhusmita Das, Abha Sharma, Poonam S Loomba, Bibhabati Mishra
DOI:10.4103/jhrr.jhrr_11_21  
Aim: The presence of Candida species in urine is rarely encountered in healthy people; however, it is of common occurrence in hospitalized patients and in critically ill patients and it may be life-threatening. It is a diagnostic dilemma to differentiate colonization from true infection. The aim of the study is to identify and speciate Candida species in urine, study associated risk factors, and determine the antifungal minimal inhibitory concentrations (MICs) for different species. Materials and Methods: The study was an observational cross-sectional study conducted from March 2019 to December 2019 at the Department of Microbiology, GIPMER, Delhi. All consecutive urine samples received from ICU patients suspected of having urinary tract infection were processed for culture and sensitivity as per standard techniques. CHROM agar and standard yeast identification protocol were used for speciation of Candida species. Antifungal susceptibility testing was performed by VITEK 2 automatic machine. Significant P-value (<0.05) was calculated using Fisher’s exact test. Results: Out of 2963 patients, 250 (8.43%) had candiduria and 50 (20%) had candiduria with pyuria (pus cells> 5/HPF). Out of these 50, 8 (16%) were identified as Candida albicans and 42 (84%) were non-albicans species. The most common species was Candida tropicalis (38%). Duration of catheterization had no significant association with the type of Candida spp. Mechanical ventilation was the most important risk factor associated with non-albicans candiduria when compared with C. albicans (P=0.02). Antifungal susceptibility according to MICs showed 100% resistance to amphotericin B by C. albicans and almost 90% resistance by non-albicans spp. Candida glabrata was 100% resistant to fluconazole, and Candida haemulonii was resistant to all antifungals. Conclusion: Non-albicans Candida are emerging nosocomial pathogens. Candida speciation is important to guide patient management as non-albicans Candida species are more resistant to antifungal drugs. Azoles are more sensitive when compared with amphotericin B.
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A role of community nurses and challenges faced by them toward providing MCH services in selected blocks in West Bengal: A cross-sectional study p. 10
Swatilekha Pradhan, Uma Rani Adhikari
DOI:10.4103/jhrr.jhrr_18_21  
Background and Aims: Community nurses have been providing health care to communities for many decades and have assumed a variety of roles, including community empowerment, the provision of services, and linking communities with health facilities. They face many challenges while providing community service. The present study has been conducted to assess the role of community nurses toward maternal and child health (MCH) services and to find out the challenges toward providing MCH services. Materials and Methods: After Institutional Ethics Committee approval, data were collected from 100 community nurses through multistage sampling. Data were collected through semi-structured and structured interview schedules. All tools were tested for validity and reliability before data collection. Data analysis was done through descriptive and inferential statistics. Results: Most of the community nurses adopted the role of educator (98.43%), administrator (97.63%), supervisor (95.5%), and coordinator (93.63%), respectively, toward MCH services; however, only 84.9% and 80%, respectively, performed a care provider’s and a collaborator’s role. The most common challenges faced by the community nurses were overburden, due to a high inflow of patients at the OPD (78%), the overload of handling written documents, and online data entry (69%). Conclusion: Administrators need to take proper steps to reduce the challenges faced by the community nurses, and there is a need for constant supervision and timely training for the community nurses.
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Lifestyle changes during the Covid-19 lockdown among young adults in Kerala in terms of physical activity, sleeping habits, and perceived psychological problems: A cross-sectional study p. 17
Sithara Sivaji, Panamoottil G Vijayamohanan, Pallipurath R Sreelakshmi
DOI:10.4103/jhrr.jhrr_1_22  
Aim: The aim of this article is to study the lifestyle changes such as physical activity, dietary habits, sleeping patterns, and psychological parameters during the COVID-19 lockdown among young adults. Materials and Methods: This was a cross-sectional study carried out by an online web-based survey. The survey was open for 2 weeks and was shared on all social media platforms. It was composed of 20 questions divided into sections, namely, general information and comorbidities, dietary pattern, physical activity, sleeping pattern, and self-reported psychological health. The data were analyzed using SPSS version 16. Results: Out of the 301 participants, majority were female students who belonged to higher socioeconomic status with a mean age of 23.31 years. Only 100 (33.2%) got involved regularly in any type of exercise during the lockdown period. The participants consumed cereals for a median number of 6 days in a week. One-third of the participants slept for 8–10 h daily during the lockdown period. Psychological issues were reported by 44% (132) of the individuals. Conclusion: Our study showed that only one-third of the participants had the habit of exercising regularly during the COVID-19 lockdown period. Almost half of the participants reported a significant change in their diet. There was an increase in the number of hours of sleep in a day. Psychological health problems in the form of stress, anxiety, and depression were reported by a high proportion of individuals.
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Outcomes of patients with end-stage kidney disease hospitalized with COVID-19: A single-center experience from Eastern India p. 22
Aruna Acharya, Haladhar Naik, Rohit Gaude
DOI:10.4103/jhrr.JHRR_21_21  
Aim: This study aimed to describe the clinical characteristics, survival outcome, and its correlation with biochemical parameters in coronavirus disease-2019 (COVID-19)-infected patients with end-stage kidney disease (ESKD). Materials and Methods: A prospective observational study was on hospitalized patients with confirmed COVID-19 infection from September 1, 2020 to October 31, 2020. Data related to demographics, baseline history of comorbid conditions, dialysis-specific data, details on hospital admissions, COVID-19 treatment regimen, laboratory investigations, computed tomography (CT) severity score, COVID-19 Reporting and Data System score, and clinical outcomes (improved/death), duration of hospital stay, oxygen/vasopressor support were collected. Results: A total of 216 ESKD patients with COVID-19 infection were included in this study. The median age was 48.0 years (74.5% men, 25.5% women). Severe acute respiratory infection (44.7%), hypertension (28.2%), and type 2 diabetes mellitus (22.4%) were the most common comorbidities. Elevated levels of serum creatinine (9.3 mg/dL) and blood urea nitrogen (84.8 mg/dL) were observed in the patients with COVID-19 infection. The change in mean levels of serum creatinine and estimated glomerular filtration rate from baseline to post-treatment was significant (0.9 [95% CI: 0.7, 1.1; P < 0.001] and 3.4 [95% CI: 3.2, 3.6; P < 0.001], respectively). Approximately, 79.6% (n = 172) of patients improved post-treatment. Serum creatinine (1.786, 95% CI: 1.031, 3.095; 0.039) and ferritin levels (51.959, 95% CI: 7.901, 341.685; P < 0.001) remained significantly and independently associated with survival. The median time to clinical survival was 17.0 days. Conclusion: Serum creatinine and ferritin levels were independently associated with survival.
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A comparative analysis of sonographic carotid artery Doppler indices in type 2 diabetics and non-diabetics p. 30
Emmanuel Chibueze Nwokorie, Faosat Olayiwola Jinadu, Tawaqualit Abimbola Ottun, Ayokunle Moses Olumodeji
DOI:10.4103/jhrr.jhrr_10_21  
Background and Aim: Diabetes mellitus type 2 is a chronic metabolic disorder of global concern with signs of hyperglycemia due to insulin resistance, relative lack of insulin, or both. Stroke is a possible complication of this metabolic disorder as a result of advanced carotid artery atherosclerosis, which diabetic patients develop with attendant carotid blood flow changes. The present study evaluated sonographic carotid artery blood flow velocities in individuals with type 2 diabetics and compared with values in normoglycemic controls. Materials and Methods: This was a prospective case–control study, in which we evaluated carotid Doppler indices in 125 consenting confirmed type 2 diabetics (cases) and 125 age- and gender-matched normoglycemic healthy controls for a period of 6 months (October 2019 to March 2020). The diabetics (cases) were recruited using systematic sampling method and the controls via convenience sampling. Demographic data and anthropometric measurements as well as ultrasound findings were entered into a Microsoft Office Excel Database and analyzed using International Business Machines (IBM) Statistical Package for Social Sciences (SPSS) Version 21. Tables, scatter-plot graphs, and bar charts were used in showing and evaluating the findings. Pearson’s correlation coefficient was used to assess correlation between two continuous variables. Results: The mean age of type 2 diabetics was 67.06±9.8 years, whereas that of the non-diabetics was 66.98±10.7. Females were in majority in both groups (64 in diabetics and 70 in non-diabetics). There were 61 males in the diabetics and 55 males in the non-diabetics. The mean carotid blood flow velocities in the diabetics and non-diabetics were, respectively, as follows: common carotid artery (CCA) end-diastolic velocity (EDV) 21.03±2.3 and 25.22±2.5, CCA peak systolic velocity (PSV) 81.70±4.1 and 83.60±3.6, internal carotid artery (ICA) EDV 17.99±5.6 and 21.57±2.0, ICA PSV 69.30±5.1 and 73.87±2.1, and ICA/CCA PSV ratio 0.83±01 and 0.91±0.1. Conclusion: Type 2 diabetics had significantly lower carotid blood flow velocities than non-diabetics. This suggests that proper management and compliance with care may reduce the development of features of atherosclerosis in type 2 diabetics.
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The pH and titration values of commonly used beverages in Trinidad: A cross-sectional study p. 39
Fiayaz A Shaama, Ann M Wilson, Reisha N Rafeek
DOI:10.4103/jhrr.jhrr_3_22  
Background: The erosion of tooth structure caused by exposure to acidic environment can be described as a chronic noncommunicable degenerating disease. This occurs when drinks and citrus fruits that are acidic are used over a prolonged period of time. Materials and Methods: The most popular drinks consumed in Trinidad and Tobago were determined from data collected using questionnaires. Data were collected from grocery stores, pharmacies, and minimarts. We also measured the pH of four categories of the most popular drinks, namely water, carbonated nonalcoholic “soft drinks,” juices, and alcoholic beverages. The pH was determined from repeated measures using a calibrated pH meter and the acid content by titrimetric analysis. Results: The results found that all the beverages were acidic varying from pH 2.26 to 5.74. The lowest average pH readings were for Coke and Sprite, 2.26 and 2.94, respectively. The juices followed by the alcoholic drinks were still acidic and even the Dasani water recorded an average pH of 4.83, all under the critical pH of 5.5. Titration found that the acidic content was lower than the pH recorded. Conclusions: It was found that soft drinks, juices, and alcoholic beverages were mostly very acidic. As there is an ever-increasing production of beverages, notable energy drinks, there should be a more comprehensive measure of the acidity across all categories of drinks consumed. It would certainly be in the public health interest if there are labels with some information with the pH and the erosive potential of consuming acidic drinks.
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