Search

Introduction: The number of internet users in 2018 was 4.021 billion, increased 7 percent year-on-year. More than nine-tenths of Indian teens use Internet. Due to social distancing norms put forward due to COVID-19 dependency and availability of Internet usage has increased.Objective: To assess the extent of Internet addiction and determine its predictors among college students of Surat city. Method: A cross sectional study was conducted from March-September 2021 among 400 first- and second-year students selected by systematic random sampling from four colleges selected purposively. Outcome variables were Young’s Internet addiction Test and Duke Health Profile Score which were assessed in terms of mean score. Univariate analysis was done, followed by t-test, ANOVA and Pearson Correlation to establish associations. Predictors were determined by Binary Logistic Regression.Results: Around one-tenth (12.8%) participants were seen with no Internet addiction, with majority being mildly (44.8%) and moderately (36.5%) addicted. Severe addiction was seen in around one out of twenty participants (6.1%). Social networking (32%) and education (34.5%) were the major reasons for use of Internet. Higher pocket money (aOR=4.3), greater monthly internet expenditure (aOR=2.8), ownership of internet enabled mobile phone (aOR=3.9), lying down posture while accessing internet (aOR=4.8) and evening (aOR=2.2) or night time (aOR=8.7) of internet access were significant predictors for Internet addicts. Conclusion: In this study more than four fifth of the college students had Internet Addiction even at young age. Physical, Mental, Social and General health were significantly negatively correlated with internet addiction.

ObjectivesTo evaluate coronary artery calcification (CAC) on routine CT chest in hospitalised HIV patients and to assess individual risk factors.MethodsRoutine CT chests, May 2010-November 2015, of 143 hospitalised HIV-positive patients were reviewed for qualitative assessment of calcification in major coronary arteries by two radiologists. Presence, location and burden of calcification were evaluated on 3 mm axial images of CT chest. Cardiovascular risk factors and HIV lab parameters such as CD4 count, viral load and duration, and status of antiretroviral treatment were collected. Statistical analysis including multivariate logistic regression was performed.ResultsForty-one patients (28.7%) showed CAC, left anterior descending (n = 38, 92.7%), circumflex (n = 18, 43.9%) and Right Coronary Artery (n = 13, 31.7%); mostly mild CAC burden and mostly proximal left coronary arteries with excellent interobserver and intraobserver agreements (K = 0.9, and 1). Age of CAC+ group (53.9 years) was significantly higher than CAC- group (43.4, p < 0.001, minimum age of CAC+, 27 years). No significant difference between two groups in sex, ethnicity and risk factors and HAART status. CAC+ group showed significantly longer HIV duration (12.3 years vs 8.6, p < 0.0344) and higher CD4 cell counts (mean = 355.9 vs 175.3, p = 0.0053) and significantly lower viral load (76 vs 414K, p = 0.02) than CAC- group. On multivariate logistic regression, age, HIV duration and CD4 were significantly associated with CAC+ (p-values < .05).ConclusionsOne-third of hospitalised HIV patients showed subclinical CAC on CT chest. HIV duration and age of patients were independent risk factors for developing CAC. Higher CD4 cell count was strongly associated with CAC+.Advances in knowledgeRoutine CT chest with or without contrast performed for non-cardiac indications is helpful in identification of subclinical CAC in HIV patients and radiologists should be encouraged to report CAC.CAC is seen in younger age group in HIV, and awareness of this finding on routine CT chest would help guiding clinicians to assess risk stratification for primary prevention of ischemic heart disease in this population at an earlier stage when compared to normal population.Duration of HIV infection and age of patients were independent risk factors for developing CAC in our study and CD4 count was strongly associated with presence of CAC.

Restrictive gender norms and gender inequalities are replicated and reinforced in health systems, contributing to gender inequalities in health. In this Series paper, we explore how to address all three through recognition and then with disruptive solutions. We used intersectional feminist theory to guide our systematic reviews, qualitative case studies based on lived experiences, and quantitative analyses based on cross-sectional and evaluation research. We found that health systems reinforce patients' traditional gender roles and neglect gender inequalities in health, health system models and clinic-based programmes are rarely gender responsive, and women have less authority as health workers than men and are often devalued and abused. With regard to potential for disruption, we found that gender equality policies are associated with greater representation of female physicians, which in turn is associated with better health outcomes, but that gender parity is insufficient to achieve gender equality. We found that institutional support and respect of nurses improves quality of care, and that women's empowerment collectives can increase health-care access and provider responsiveness. We see promise from social movements in supporting women's reproductive rights and policies. Our findings suggest we must view gender as a fundamental factor that predetermines and shapes health systems and outcomes. Without addressing the role of restrictive gender norms and gender inequalities within and outside health systems, we will not reach our collective ambitions of universal health coverage and the Sustainable Development Goals. We propose action to systematically identify and address restrictive gender norms and gender inequalities in health systems.

Gallbladder cancer (GBC) starts in the epithelial tissue (lining of the bile duct and gallbladder). It is a type of aggressive cancer called adenocarcinoma that can spread to other tissues. Among all cases of biliary tract cancer, 50% is from GBC. It is a deadly cancer with a survival rate of 17.6% between 2007 and 2013. GBC is rarely found in the Western world, but it is commonly found in South Asia. In Southeast Asian countries, GBC plays a significant role in cancer-related morbidity and mortality. GBC incidence exhibits marked regional variability, a rare condition in the western population but having a higher frequency in India, especially the Indo-Gangetic belt and some northeast districts excluding Nagaland. This might be attributed to the differences in environmental factors and genetic predisposition modulating carcinogenesis. In GBC, only 10% of cases are identified in the early stages. The low rate of early detection is due to the lack of screening techniques and the aggressive characteristics of the tumor. Various risk factors are associated with GBC, for example, chronic cholecystitis with or without gallstones, obesity, exposure to heavy metals such as lead and arsenic, bacterial infection, congenital biliary cysts, and abnormal pancreaticobiliary duct junction. The risk factors can cause chronic gallbladder mucosa irritation, leading to dysplasia and neoplasia. GBC can form metaplasia to dysplasia in a time span of 5-15 years, then to carcinoma in situ, and finally to invasive cancer. Dysbiosis is responsible for various diseases, including cancer. Multiple triggers can cause dysbiosis, for example, environmental changes, inflammation, infection, medications, dietary changes, or genetic predisposition. Various researches show that Helicobacter pylori, human papillomavirus, Hepatitis B virus, and Hepatitis C virus microbial species can cause cancer. They are the major species responsible for 90% of infection-associated cancers. Various studies demonstrate that the strains of Salmonella and Helicobacter colonize are linked to developing GBC. While the mechanisms linking gut microbiota to GBC are not fully understood, several studies have suggested a potential association. According to a study, certain gut microbiomes, such as Fusobacterium nucleatum, found glut in GBC tissues, compared to adjacent normal tissues. By evaluating gut microbiome dysbiosis, we can see the potential link between gut microbiome dysbiosis and GBC; it may provide valuable insights into the development and progression of GBC. It could lead to the identification of new diagnostic markers and the development of novel therapeutic strategies. In GBC, the evaluation of gut microbiome dysbiosis (involving evaluating the composition, diversity, and functional capacity of the gut microbiome in patients) has emerged as a promising method for understanding the molecular mechanisms and identifying biomarkers for early prevention and detection of GBC and also investigating the possibility of any link between the gut microbiome and host immune response. In conclusion, evaluating gut microbiome dysbiosis in GBC is a promising direction for identifying potential early detection and prevention biomarkers. Additional investigation is therefore needed to determine the role of gut microbiome dysbiosis in the development and progression of GBC and to identify reliable biomarkers for clinical use. [ABSTRACT FROM AUTHOR]

Background: Staphylococcus haemolyticus is a clinically significant Coagulase Negative Staphylococci (CoNS) accountable for various infections and is often multi-drug resistant along with resistance to linezolid. Aim and Objectives: This study was carried out to detect the presence of cfr and optrA gene in clinical isolates of linezolid resistant S. haemolyticus in a tertiary care hospital. Material and Methods: A total of 227 clinical isolates of S. haemolyticus recovered from various clinical samples were tested to determine susceptibility to linezolid by phenotypic method. Further, the presence of cfr & optrA gene was looked for, in clinical isolates of S. haemolyticus. Results: S. haemolyticus was isolated predominantly from inpatient department mainly from blood culture (85%). Linezolid resistance was confirmed in 9.2% isolates of S. haemolyticus phenotypically and they were also methicillin resistant. On genotypic characterization, cfr gene could be detected in 7.04% the isolates. However, all the isolates were negative for optrA gene. Conclusion: Emergence of resistance to linezolid in S. haemolyticus was reported for the first time. The presence of cfr gene is the most common mechanism of resistance to linezolid. Correct identification of these isolates and adherence to strict infection control protocols will help in better clinical outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Children still experience enteric fever as a severe health problem in developing countries like India. It is an infectious disease that exclusively affects humans. In the developing world, it is one of the most prevalent bacterial causes of acute febrile sickness and is spread by the consumption of unhygienic food or water. Aim: To identify the incidence and resistance pattern of Salmonella Typhi and Salmonella Paratyphi isolated from school-age children. Materials and Methods: This cross-sectional study was conducted among children with Salmonella enterica infections in the Department of Microbiology, Santosh Medical College and Hospital in Ghaziabad, Uttar Pradesh, India. During the study period, (July 2021-June 2022) a total of 776 blood samples were obtained from school going children (03-17 years old) and immediately inoculated into Bact/Alert aerobic blood culture bottle and incubated at 37°C for upto five days. After receiving a positive result from Bact/Alert, Gram staining was done. Standard microbiological procedures were followed such as different biochemical reactions, agglutination with different antisera for the identification of Salmonella serotypes. Antibiotic susceptibility testing was done using the Kirby-Bauer Disk Diffusion method. Data was analysed by software version 16.0 of the Statistical Programme for the Social Sciences (SPSS). Results: Total 88 Salmonella isolates were found, of which 21 (23.86%) were Salmonella Paratyphi A and 67 (76.14%) were Salmonella Typhi. Infection rate was more common in summer season. S. Typhi as well as S. Paratyphi A was found to be most resistance to Nalidixic acid {58 (86.6%), 19 (90.5%)} followed by ciprofloxacin {42 (62.7%), 18 (85.7%)}. Ceftriaxone and azithromycin resistance pattern among S. Typhi isolates was 07 (10.4%) and 15 (22.4%), respectively and among S. Paratyphi A it was found to be 07 (33.33%) and 06 (28.6%), respectively. Conclusion: This study found an increase in resistance to ceftriaxone and azithromycin, which are frequently thought of as the best medications for empiric therapy in children. Regular monitoring of the resistance pattern is necessary for doctors to select the appropriate empiric therapy due to the increasing resistance to the available class of antibiotics. [ABSTRACT FROM AUTHOR]

Box 1 The Global strategy for women's, children's and adolescents' health (2016-2030) Objectives of the global strategy: * Survive: end preventable mortality; * Thrive: promote health and well-being; and * [...]

Background:To improve learning and knowledge skills it is important to change the teaching and assessment methods.The study was conducted to introduce newer tool for practical assessment i.e. OSPE and to obtain feedback for the same. Research Methodology: A crosssectional educational trial was conducted in Department of Microbiology, Santosh Medical College and Hospitals, Ghaziabad with students of MBBS Phase II of batch 2020.A total of 84 students from batch of 100 students participated in the study.A session on Stool examination was taken to assess the teaching, learning and assessment.An OSPE module was prepared with questionnaires at different stations. The students were allowed to perform at stations and were directly observed while performing. A predesigned checklist was used for evaluation and results were statistically analyzed.Post assessment feedback was taken was taken from the students. Results:The mean score of assessment was higher in OSPE i.e 11.85 ±1.23 than the conventional viva voce which was 7.43 ±1.67 which was statistically significant. After evaluation,feedback was taken which concluded that OSPE is less stressful (10%) than viva voce (41.7%).Examiners bias is ruled out in OSPE(28.3%) and OSPE is a better way to improve skills in Microbiology(53.3%).79.7% of students agreed that OSPE should be included in Microbiology practical examination. Conclusion:The study concluded that OSPE was a better tool in teaching, learning and assessment and should be applied regularly in Microbiology. [ABSTRACT FROM AUTHOR]

Issues relating to the heterosexual transmission of HIV, which is the most common model of transmission globally, are examined.