Role of ‘One Stop Crisis Centre’ in Identifying and Assisting Victims of Violence in an Indian Health Care Setup

Introduction: Cases of female targeted violence often go uncounted in India. To identify the unreported cases of violence, Sukoon was established in 2014 as a hospital-based ‘One Stop Crisis Centre’ (OSCC). Sukoon provides counselling, police assistance and legal aid to the victims. The aim of the present study was to recognize the role of Sukoon in preventing violence against women (VAW) in the region.Methods: Secondary data was extracted from 430 victims who approached Sukoon from August 2014 through January 2017. Data was collected on different variables: age, marital status, nature of violence, medium through which victims approached Sukoon and type of assistance provided. Significance of association of studied factors with the type of assault was investigated using ?2 test.Results: Age of study-victims ranged from 4 to 75 years with a median age of 26 years and mean age of 27.61 years with standard deviation of 10.56 years. Major types of VAW (96.51%) were domestic violence, sexual assault, physical assault and poisoning. The types of violences were significantly associated with victims’ age (?2 =5.76, d.f.=1, p<0.05) and marital status (?2 = 98.23, d.f=4, p<0.001). About 78% of victims were identified from Sukoon through screening and counseling. Around 69% of the cases were resolved directly by Sukoon or through police assistance.Conclusion: The above results indicate a significant role of Sukoon in screening victims of violence and providing them required assistance within the hospital environment in one location. Such centers should be further promoted by the government to address the issues of VAW

Need for Couple’s Awareness About Sexual Health in COVID-19 Pandemic

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Non-Communicable Chronic Diseases Among Residents of a Remote Settlement in the Transbaikal Region of the Russian Federation

Introduction: Over a quarter of the population of the Russian Federation resides in rural communities. However, the data on chronic disease rates in these communities are limited, which makes screening for chronic diseases extremely important. The aim of this study was to measure the prevalence of chronic noncommunicable diseases among residents of a remote settlement in the Transbaikal region, Russian Federation.Methods: A sample of residents from the Transbaikal region settlement was screened in August 2017. The screening included a survey to determine the frequency of self-reported chronic diseases as well as sociodemographic and behavioral risk factors. Additionally, vascular stiffness was measured by volumetric sphygmography using the VaSera-1500 device. Descriptive statistics have been used for data analysis.Results: 126 residents were screened for this study. The prevalence of chronic non-communicable diseases and their risk factors were: hypertension (56.3%), gastrointestinal diseases (33.3%), chronic obstructive pulmonary disease (13.5%), smoking (35.7%), obesity (19.1%), and diabetes mellitus (6.3%). Pathological vascular changes typical of atherosclerosis were found by volumetric sphygmography in 17.5% of cases, with 5.5% of those cases corresponding to significant forms of severe peripheral atherosclerosis (ABI<0.9). An analysis of mortality causes for this settlement for 2016-2017 found that cardiovascular diseases accounted for over 50% of the total number of deaths.Conclusion: This study showed a high prevalence of detectable chronic non-communicable diseases and their associated risk factors. Cardiovascular diseases were the main cause of mortality. Active prevention programs and screenings are required to reduce the burden of chronic diseases in this region

Fructose Consumption among Students at The University of Guanajuato

Introduction: Fructose is a monosaccharide commonly found in fruits. However, it can also be found in carbonated beverages, cereals, fruit juices, and in other processed fruit. The consumption of fructose in moderate to high amounts increases levels of triglycerides in plasma and alters hepatic glucose homeostasis. Little information is avialble on fructose consumption in Mexico. The aim of this study was to determine the amount of fructose consumption among college students enrolled at the Unviersity of Guanajuato in Mexico (Celaya-Salvatierra Campus).Methods: This was an explorative, cross-sectional descriptive study. A total of 57 full time students attending Physical Therapy and Rehabilitation program were included in the analysis. Demographic data, food frequency questionnaire, and body mass index (BMI) were collected from all students. Data were analyzed by descriptive statistics; discrete variables were reported as frequencies or percentages and continuous variables were reported as means and standard deviations.Results: The average age of participants was 19.5 ± 2.8 years. 72% of participants were female and 28% were male. The average BMI was 24.0 ± 4.1 Kg / m2, indicating normal BMI range.  Fructose consumption was roughly 55g per day.Discussion: Previous research demonstrated that levels below 50 mg per day are safe. Madero et al. reported that that consumption of 50-70 g of fructose per day is considered to be moderate. We found that students consumed 55g of fructose, so their fructose intake is at a moderate level and should not be an obesity-inducing factor, also consistent with BMI ranges of our research participants. Considering obesity epidemic in Mexico, further studies examining the source of calories in Mexican poipualation are warranted, especially among young people

Trends and Determinants of Attitudes Towards People Living with HIV/AIDS Among Women of Reproductive Age in Tajikistan

Introduction: Despite having one of lowest rates of newly diagnosed HIV infections among former Soviet countries, Tajikistan has a substantial level of discriminatory attitudes towards people living with HIV/AIDS (PLWHA). While initial attempts were made to explore discriminatory attitudes of a wide range of professionals, women’s general attitudes towards PLWHA received less scholarly attention. Employing a nationally representative sample from the 2000 and 2005 Multiple Indicator Cluster Surveys (MICS), sociodemographic determinants of HIV-related discriminatory attitudes of women aged 15-49 in Tajikistan were identified and examined over time.Methods:  A representative sample included 5,453 women of reproductive age from the capital city and four regions of Tajikistan. Two dichotomized scenarios  representing the agreement to let an HIV-infected teacher continue teaching in school and the willingness to buy food from an HIV-infected cashier were constructed. Univariate and multivariable analyses of HIV-related discriminatory attitudes were obtained using Stata 14.Results: Insignificant but positive changes were observed in the women’s attitudes between 2000 and 2005. Logistic regression models showed that negative attitudes were associated with the lack of knowledge of HIV/AIDS prevention methods, endorsement of HIV/AIDS transmission misconceptions, and never having been tested for HIV (p?0.001). Women living in the rural areas, married, with lower education, and from low income households were less tolerant towards PLWHA.Conclusions: The data from Tajikistan underscore the persistence of HIV-related discriminatory attitudes among low socioeconomic status women. The study findings can be potentially used to target the disadvantaged groups and guide the design and implementation of programs that promote voluntary HIV-testing, raise awareness about HIV/AIDS prevention methods, and help dispel transmission misconceptions

Examining Students’ Motivations to Pursue a Bachelor’s Degree in Nutrition

Introduction: With high level of obesity in Mexico, there is a growing need to train more students in nutrition. Understanding what motivates students to choose pursuing degree in nutrition is very important for in post-secondary education. Better understanding of motivating factors may help educators to make sure that students complete their degress. The aim of this paper was to determine factors influencing student motivations for pursuing a bachelor’s degree in nutrition at the University of Guanajuato.Methods: This was a survey study targeting 50 students at the University of Guanajuato. Questions in the survey targeted the following issues: general student characteristics, main reason for the choice of study area, objectives of higher education, university study field, and future plans. The descriptive statistics were calculated for the data obtained. The Z test was applied to analyze the differences between the ages.Results: The mean age of these students was 19 years; 74% were female while 26% were male. The students reported that the main reason for choosing a career in nutrition was personal preference and pointed out that such degree will give them better career options in the future, including better financial renumeration in comparison to other careers. Most of the students stated that their main reason for choosing University of Guanajuato was its prestige at the national and international level.Conclusion:  Our study corroborates previously published study suggesting that students pursuing healthcare professions are motivaed by prestige and financial renumeration. With importance of nutrition in tackling obesity epidemic, it is very important to continue research on factors motivating students to choose careers in nutritio

Interval Hysterectomy for Placenta Percreta – a Case Report

Introduction: Placenta percreta is an abnormality of placentation where it invades the serosa and can go beyond it. Complications include massive hemorrhage, bladder dysfunction, and severe infections during delivery.  The aim of this study is to report a complex case of placenta percreta managed by interval hysterectomy.Case presentation: Pre-operative: 34 years old patient with previous three cesarean sections was followed in antenatal clinic. She came with repeated bouts of vaginal bleeding at 30-31 weeks. At 32 weeks and 4 days classical cesarean section was done with placenta left in situ. Prophylactic bilateral internal iliac artery balloon was inserted. Post cesarean section, uterine artery embolization was performed. Post-operative: Clinical features of pulmonary embolism (PE) developed about 4 hours later. Post-Operative Day 13: Total abdominal hysterectomy was done. After few days of discharge, the patient presented to the emergency department with shortness of breath. She was consequently diagnosed with chronic pulmonary embolism and treated with warfarin.Conclusion: This is a case of placenta percreta managed by interval hysterectomy. However, the most widely accepted method of management is cesarean hysterectomy. In this case, interval hysterectomy was done due to the possibility of bladder invasion by placenta, to decrease the amount of blood loss and to reduce the number of days stayed in hospital. Appropriate management for the patient must be personalized, whether it is by cesarean hysterectomy or interval hysterectomy,  as each has risks and benefits

Microbiological and Susceptibility Profile of Clinical Gram Positive Isolates at a Tertiary Pediatric and Maternity Hospital in Ulaanbaatar, Mongolia

Introduction: Information on microbiological and susceptibility profiles of Monoglian bacterial isolates is scarce. Resistance profiles, patient demographics and microbiological work-up of gram positive isolates were analyzed in order to develop infection control activities and policies at the National Center for Maternity and Children’s Health (NCMCH) in Ulaanbataar, Mongolia.Methods: All gram positive isolates of specimens submitted to the microbiology laboratory at NCMCH between January 2014 and August 2017 were included. Data collected included demographic data, specimen type, in-/outpatient status, hospital ward of sample origin, and antimicrobial susceptibility testing profile. Susceptibility testing was performed by trained microbiologists at the NCMCH microbiology laboratory. T-test, Mann-Whitney, Chi-square and Fisher exact tests were used as appropriate.Results: Of 11,889 isolates, 4012 (33.7%) were gram positive, with most identified as S. aureus (62.6%, n=2512). Rates of methicillin resistance (MRSA) remained stable at a quarter, but was significantly higher among inpatients (inpatients: 630/2002, 31.5%; outpatients 67/290, 23.1%; p?0.05) and sterile site isolates (sterile: 83/171, 48.5%; non-sterile: 416/1678, 24.8%; p?0.01). The vast majority of S. pneumoniae isolates (12/14; 85%) was found to be penicillin resistant by oxacillin disk diffusion. While identification of Group B streptococci was rare (n=137) due to of lack of diagnostic measures available, the number of enterococcal isolates identified increased signifi-cantly due to implementation of improved microbiological work-up (2015: n=7; 2016: n=26; 2017: n=83).Conclusion: Compared with published studies from neighboring nations, the rates of antimicrobial resistance among gram positive isolates at NCMCH, particularly with respect to S. aureus and S. pneumoniae, were much higher. Further improvement of microbiological diagnostics and collabo-ration of stakeholders is required to address the pressing infection control and stewardship issues and to ensure reliable identification of relevant pathogens in Mongolia

Sero-Occurrence of HBV/HCV Co-infection and Levels of Liver Enzymes among Patients at a Tertiary Care Hospital in Central India: a Pilot Study

Introduction: Hepatitis B and C viral infections share common modes of transmission and account for a large proportion of liver disease burden across the globe. Patients with Hepatitis B (HBV) and Hepatitis C virus (HCV) co-infection may have more severe liver disease and are potentially at higher risk for developing hepatocellular carcinoma. The aim of this study was to assess the sero-occurrence of HBV/HCV co-infection by examining the medical records of tertiary care hospital patients in Central India and determine the extent of liver damage based on liver function tests (LFTs).Methods: Patients with a positive test for HBV surface antigen (HBsAg) over a period of 10 years were identified from laboratory records in a tertiary care facility in central India. Records of 51,075 consecutive non-duplicate blood samples were then screened for a positive HBV and HCV tests. LFT, liver enzymes, and bilirubin data were also extracted. Means and standard deviations were determined for continuous variables, and the difference in means was compared using a independent samples t-test. Associations between HBV/HCV co-infection status and demographic variables were calculated using Pearson’s Chi-squared test. A p-value less than 0.05 was considered statistically significant.Results: In this study, 1674 (3.27%) screened patients were positive for HBsAg and the sero-occurrence of co-infection with HCV in HBsAg positive patients was reported in 28 individuals (1.67%). There was no significant gender difference for HBV/HCV co-infection (p>0.05). HBV/HCV co-infection was observed more frequently in the 31-60 year old age group (p=0.001). HBV/HCV co-infected patients had significantly higher levels of liver enzymes and bilirubin than those with HBsAg mono-infection (p=0.001).Conclusion: Liver function tests are potentially important predictors for HBV/HCV coinfection. Screening for HCV co-infection in HBsAg-positive patients is recommended in India. Detection of co-infection may enable timely preventive/therapeutic interventions aimed at preventing progression to hepatocellular carcinoma

Knowledge and Attitudes of Maintaining Bone Health among Post-Menopausal Women in Malaysia

Introduction: Public awareness of osteoporosis is low among women in the developing countries. Health education was shown to be effective in improving knowledge and awareness on maintaining bone health. This study aims to identify the level of knowledge and attitudes among post-menopausal women in Malaysia on achieving bone health throughout the menopausal transition period.Methods: A total of 116 post-menopausal female patients of orthopedic menopause clinic were recruited using a purposive sampling approach. Data on osteoporosis awareness and knowledge were collected using validated structured questionnaires Osteoporosis Prevention and Awareness Tool and Osteoporosis Attitude Knowledge Test. The chi-square test was used to determine the association between post-menopausal women’s socio-demographic characteristics and their knowledge and attitude towards maintaining bone health.Results: Participants’ age ranged between 49 and 82 years (61.84, SD=7.87). The knowledge of osteoporosis varied significantly by age (p=0.014) and education (p=0.001) among the studied population. No significant diffrences were found for participants’ attitude towards bone health.Conclusion: This study showed that the age and education levels have significantly different knowledge of bone health