Assessment of infection control practice in private dental hospital

Background: The purpose of this study was to assess the awareness and practice of infection control procedures among dental surgeons in the private dental hospital.Methods: This is an observational study conducted among thirty dental surgeons working in a private dental hospital in Gwalior, (M.P.) to evaluate the management policies and procedures associated with infection control and instrument decontamination. The doctors were indirectly interviewed by self-administered questionnaire consisted of twenty-one questions regarding the availability of infection control materials, use of personal protective devices, techniques of hand washing, sterilization methods, control of aerosols, status of immunization, asking about medical history, routine documentation of needle-prick injuries, methods of waste segregation etc. The study group was selected regardless of sex, age and field of expertise. This study was done in two weeks and in this time frame self-administered, pre-structured questionnaire was offered to professionals.Results: In this study it was found that although 95% of doctor’s wear gloves but only 6.6% doctors use protective eyewear and 3.3% use gowns for protection. The most of the doctor’s use soap bars for hand washing which is also not a good infection control practice method. There are only 10% doctors who use high-volume-evacuator but most of the time available evacuator is not in working state. Not a single doctor used rubber dam. Out of thirty 74% use gluteraldehyde, 67% use sodium hypochlorite, 54% use phenolic compounds as a surface disinfectant. Most of the doctors use non-sterilized hand pieces, burs, impression trays etc.Conclusions: The infection control actions implemented by dental surgeons were far from ideal. Efforts are needed to improve attitudes, encourage implementation, raise awareness, promote regular updating courses and motivate dental professionals in the correct and routine use of infection control measures. Apart from this, it is also important to improve the hospital management system

Factors that affect Early Sexual Initiation in a Sample of College Students in North-East Tennessee: The Role of Adverse Childhood Experiences, Economic Hardship, Family Structure and Religiosity.

Background Normal adolescent development often involves sexual activity. Early sexual initiation poses a challenge to health and well-being. In 2015, Tennessee had the 9th highest teen birth rate in the country. The structural, social and economic environments of growth define sexual risk taking, with poverty, Adverse Childhood Experiences (ACEs) religiosity and family structure known to affect adolescent and adult health. This study seeks to explore the effect of these factors on early sexual initiation. Methods A sample of college students taking the introductory psychology course participated in the study through the ETSU SONA system. They completed a self-reported web-based survey inquiring about their family structure growing up (between the ages of 5 and 15), exposure to adverse childhood experiences (ACEs), economic hardship, religious attendance at age 14 and sexual risk behaviors such as age of sexual debut and total lifetime number of sexual partners. Early sexual initiation was defined as having sexual intercourse with the opposite sex before 15 years of age. Of 385 students who completed the survey, final analysis included 352 (91.4%) students who were between ages 18-24. We used descriptive statistics to analyze survey responses. Chi square tests were done to determine the association of these exposures with age at sexual initiation. Bivariate logistic regression was used to explore the impact of the structural, social and economic environments while growing up on age at sexual initiation. All analyses were done on SAS 9.4. Results Of 352 included in the analysis, 239 (67.9%) were females, 264 (72.73%) are Non-Hispanic whites and 314 (89.2%) have never been married. About 60% had at least one ACE and 111 (31.53%) had high economic hardship. Mean age at sexual debut was 16.55 (16.56 for females and 16.53 for males). Only 7.1% had sexual initiation before 15. Based on chi square tests, early sexual initiation was associated with higher ACE scores, no / infrequent religious attendance and ‘not always living with biological or adoptive parents from birth to age 18’. Economic hardship was not associated with early sexual initiation. Bivariate logistic regression showed significantly higher chances of early sexual initiation (before 15 years) with one to three ACEs (P-value= 0.03) and ≥ 4 ACEs (P-value= 0.004). Conclusion The social, structural and economic environment of a child’s growth is a major determinant of sexual risk behaviors. Interventions should be aimed at modifying the environment in which children grow to reduce rates of teen pregnancy and sexually transmitted infections and improve health

An Assessment of Wound Healing Potential of Argyreia speciosa

In North India, poultice of young unfolded leaves of Argyreia speciosa Linn. (Convolvulaceae) is used for healing wounds. In order to find scientific evidence for the traditional utilization of leaves of A. speciosa in wound healing, this investigation was carried out. A linear incision wound of about 3 cm in length and 2 mm in depth and circular excision wound of 177 mm(2) full thickness were made on the dorsal region of separate groups (n = 5) of anesthetized Swiss albino mice. A simple ointment, developed by including ethanol, ethanol-water, and water extracts (10% each, separately) of A. speciosa, was applied topically to mice once daily for 14 days after wounding. To evaluate the effect of each extract, wound contraction, epithelization period, wound breaking strength, and hydroxyproline content were determined. The water extract of A. speciosa showed accelerated wound healing activity as evidenced by fast wound contraction (96.30 ± 0.52%; P < 0.01), rapid epithelization period (11.40 ± 0.60 days; P < 0.001), greater wound breaking strength (376.56 ± 21.16 g; P < 0.001), and higher hydroxyproline content (16.49 ± 1.12 mg/g; P < 0.05) of granulation tissue. The present report supports the traditional use of Argyreia speciosa leaves for wound healing and signify its relevant therapeutic potential

अधिगम एंव जलवायु परिवर्तन से सामना (Learning & Coping Climate Change-ClimEd Series:2B)

The GULLS project funded by the Belmont Forum addresses coastal vulnerability issues,- specifically the challenges that arise in food security and sustaining coastal livelihoods as a result of global warming and increasing human coastal populations. It seeks to identify adaptation options and strategies for enhancing coastal resilience at the local level and in doing so will contribute to capacity building and local empowerment. The goal of the project is to provide insight to coastal communities to adapt to climate change through trans-disciplinary approach

Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Background: Understanding the health consequences associated with exposure to risk factors is necessary to inform public health policy and practice. To systematically quantify the contributions of risk factor exposures to specific health outcomes, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 aims to provide comprehensive estimates of exposure levels, relative health risks, and attributable burden of disease for 88 risk factors in 204 countries and territories and 811 subnational locations, from 1990 to 2021. Methods: The GBD 2021 risk factor analysis used data from 54 561 total distinct sources to produce epidemiological estimates for 88 risk factors and their associated health outcomes for a total of 631 risk–outcome pairs. Pairs were included on the basis of data-driven determination of a risk–outcome association. Age-sex-location-year-specific estimates were generated at global, regional, and national levels. Our approach followed the comparative risk assessment framework predicated on a causal web of hierarchically organised, potentially combinative, modifiable risks. Relative risks (RRs) of a given outcome occurring as a function of risk factor exposure were estimated separately for each risk–outcome pair, and summary exposure values (SEVs), representing risk-weighted exposure prevalence, and theoretical minimum risk exposure levels (TMRELs) were estimated for each risk factor. These estimates were used to calculate the population attributable fraction (PAF; ie, the proportional change in health risk that would occur if exposure to a risk factor were reduced to the TMREL). The product of PAFs and disease burden associated with a given outcome, measured in disability-adjusted life-years (DALYs), yielded measures of attributable burden (ie, the proportion of total disease burden attributable to a particular risk factor or combination of risk factors). Adjustments for mediation were applied to account for relationships involving risk factors that act indirectly on outcomes via intermediate risks. Attributable burden estimates were stratified by Socio-demographic Index (SDI) quintile and presented as counts, age-standardised rates, and rankings. To complement estimates of RR and attributable burden, newly developed burden of proof risk function (BPRF) methods were applied to yield supplementary, conservative interpretations of risk–outcome associations based on the consistency of underlying evidence, accounting for unexplained heterogeneity between input data from different studies. Estimates reported represent the mean value across 500 draws from the estimate's distribution, with 95% uncertainty intervals (UIs) calculated as the 2·5th and 97·5th percentile values across the draws. Findings: Among the specific risk factors analysed for this study, particulate matter air pollution was the leading contributor to the global disease burden in 2021, contributing 8·0% (95% UI 6·7–9·4) of total DALYs, followed by high systolic blood pressure (SBP; 7·8% [6·4–9·2]), smoking (5·7% [4·7–6·8]), low birthweight and short gestation (5·6% [4·8–6·3]), and high fasting plasma glucose (FPG; 5·4% [4·8–6·0]). For younger demographics (ie, those aged 0–4 years and 5–14 years), risks such as low birthweight and short gestation and unsafe water, sanitation, and handwashing (WaSH) were among the leading risk factors, while for older age groups, metabolic risks such as high SBP, high body-mass index (BMI), high FPG, and high LDL cholesterol had a greater impact. From 2000 to 2021, there was an observable shift in global health challenges, marked by a decline in the number of all-age DALYs broadly attributable to behavioural risks (decrease of 20·7% [13·9–27·7]) and environmental and occupational risks (decrease of 22·0% [15·5–28·8]), coupled with a 49·4% (42·3–56·9) increase in DALYs attributable to metabolic risks, all reflecting ageing populations and changing lifestyles on a global scale. Age-standardised global DALY rates attributable to high BMI and high FPG rose considerably (15·7% [9·9–21·7] for high BMI and 7·9% [3·3–12·9] for high FPG) over this period, with exposure to these risks increasing annually at rates of 1·8% (1·6–1·9) for high BMI and 1·3% (1·1–1·5) for high FPG. By contrast, the global risk-attributable burden and exposure to many other risk factors declined, notably for risks such as child growth failure and unsafe water source, with age-standardised attributable DALYs decreasing by 71·5% (64·4–78·8) for child growth failure and 66·3% (60·2–72·0) for unsafe water source. We separated risk factors into three groups according to trajectory over time: those with a decreasing attributable burden, due largely to declining risk exposure (eg, diet high in trans-fat and household air pollution) but also to proportionally smaller child and youth populations (eg, child and maternal malnutrition); those for which the burden increased moderately in spite of declining risk exposure, due largely to population ageing (eg, smoking); and those for which the burden increased considerably due to both increasing risk exposure and population ageing (eg, ambient particulate matter air pollution, high BMI, high FPG, and high SBP). Interpretation: Substantial progress has been made in reducing the global disease burden attributable to a range of risk factors, particularly those related to maternal and child health, WaSH, and household air pollution. Maintaining efforts to minimise the impact of these risk factors, especially in low SDI locations, is necessary to sustain progress. Successes in moderating the smoking-related burden by reducing risk exposure highlight the need to advance policies that reduce exposure to other leading risk factors such as ambient particulate matter air pollution and high SBP. Troubling increases in high FPG, high BMI, and other risk factors related to obesity and metabolic syndrome indicate an urgent need to identify and implement interventions

Chemistry of Upper Ionosphere-A Study

In the upper ionosphere (above about 200 or 250 km) electron and ion concentrations are not governed solely by considerations of photochemical equilibrium, because the rates of diffusion of ions and electrons are comparable with the rates of chemical loss processes. Thus the position of F2 peak is governed by the competition between chemical recombination and diffusio

Neurogenic pulmonary edema in a child with status epilepticus

Neurogenic pulmonary edema (NPE) is defined as acute pulmonary edema after a sudden neurologic insult. It develops after a significant central nervous system insult such as trauma, hemorrhage or seizures and can occur both in adults and children. A 6-year-old male child, known case of cerebral palsy was brought to the emergency department in status epilepticus. He had severe respiratory distress with pink frothy secretions pouring from the mouth. Clinical and radiological examination was suggestive of NPE. Child was immediately ventilated and all supportive measures were started. Child showed marked improvement within 48 h of admission with diuresis and positive end-expiratory pressure (PEEP) assisted ventilation

Transient blindness due to ketamine anaesthesia in a child

We report a 10 years old male child apparently normal till he suddenly developed generalised edema and decreased urine output of 10 days duration. A renal biopsy was done under aseptic conditions with Inj Midazolam and Inj Ketamine given for anaesthesia. The child complained of blindness after waking up. The blindness was transient and lasted for about 30min. Child’s vision completely recovered. Renal biopsy was suggestive of rapidly progressive glomerulonephritis (RPGN). Treatment was started with intravenous highdose methylprednisolone, intravenous cyclophosphamide and mycophenolate as mainstay medication. Thetreatment was rapidly effective with immediate decrease in anti-GBM titres and plasma creatinine. On follow up, the child has normal kidney function, blood pressure and no residual disease. This case report is to stress on an extremely rare side effect of ketamine, a commonly used anaesthetic drug for short procedures

Preferences in Timing of Sex Education Instruction among Tennessee Sex Education Providers and ETSU College Students

Introduction In 2015, compared to the national rates, Tennessee had the 9th highest teen birth rate, 15th highest rate of reported cases of chlamydia, and 14th highest rate of reported cases of gonorrhea. Sex education that includes instruction on contraception along with abstinence has been found to delay sexual initiation, decrease number of sexual partners, and increase condom or contraceptive use. These behavioral choices by young people can help reduce teen pregnancies and Sexually Transmitted Infections (STIs). Introduction of contraception topics in earlier grades can equip young people with necessary tools to prevent unwanted pregnancies and STIs before they become sexually active. We explored the grades in which sex education providers taught topics such as birth control, condoms, and abstinence and the lowest grade at which they prefer to teach these topics. We then compared providers’ responses with responses from ETSU college students who had their sex education in TN. Methods To obtain information from sex education providers in TN public schools, we sent a recruitment email or letter with a weblink to a web-based survey from April to June 2017, to 3,249 potential providers. Of all potential providers, 509 completed the survey, yielding a response rate of 15.7%. Of those who completed the survey, final analysis included 137 providers who taught sex education in the 2015-2016 school year to any of grades 5 through 12 students. To get information from recipients of sex education in TN schools, a convenience sample of ETSU college students were asked to complete a survey using the ETSU SONA system in Fall 2017 semester. Of 385 students who completed the survey, final analysis included 216 (56.1%) students who were between ages 18-24 and attended the grade in which they had most of their sex education in TN. Provider and student surveys had similar items on grades in which sex education topics were taught and the lowest grade in which they would want these topics to be covered. Survey responses were analyzed using descriptive tests. Results Most providers (83.9%) taught abstinence by grade 12, and 37.2% had taught it by middle school (i.e. at or before 8th grade). Similarly, many students mentioned that abstinence was taught by 12th grade (92.1%) and by 8th grade (62.5%). Whereas, fewer providers taught topics, such as, birth control (65.0%), how to use condoms (22.6%), how to use and where to get birth control (31.4%), and much fewer providers taught these topics by middle school (17.5%, 8.0%, 8.8%, respectively). Most students expressed that these topics be taught by 12th grade (97.7%, 97.2%, 96.3%, respectively), and over two-thirds preferred that these topics be taught by middle school (71.8%, 67.6%, 63.9%, respectively). Also, about half of providers expressed that these topics be taught by middle school (68.6%, 46.7%, 51.8%, respectively). Conclusion This study finds that students want contraception topics to be taught in earlier grades, and that providers also prefer to teach these topics earlier. Future research should focus on factors that can enable providers to teach these topics in earlier grades

A pilot study on the knowledge of sex- trafficking in the United States among a sample of college students at a university in North- East Tennessee.

Introduction Sex- trafficking is a disturbing reality occurring in the United States, which calls for immediate action, before it becomes an epidemic, difficult to contain. Major constraints like, misidentification of the victims, lack of awareness, measures of estimate which do not include adult trafficking and improper tracking protocols, make actual prevalence rates difficult to estimate, however, the closest estimate provided by Esteis and Weiner, is that between 244,000 and 325,000 youth in America are at risk of sexual exploitation. According to the National Juvenile Arrest Data (2003), 1400 youth were arrested nationwide, for prostitution and commercial sex crimes, and these numbers increased 31% between 1994 and 2003. According to the 2015 annual report of National Human Trafficking Resource center, it received 24,757 signals nationwide, of which 555 (2.5%) were from students. 74.6% of the cases reported were of sex trafficking. Studies by Reid (2010) and later Farrel et al (2012), have revealed that most often, internet has been used as a victim solicitation tool. The aim of this study is to explore the college students’ perception of the prevalence of sex trafficking in the United States and understanding of the training, if any, received by them, including the cautious use of the internet. Method A convenience sample of college students (N=353), completed self-reported questionnaires via the REDCAP survey platform, using the ETSU SONA system. Questions were asked to assess their awareness about sex trafficking in the United States, any training received to protect themselves, from being ensnared by the traffickers. A descriptive analysis of the survey results was employed to further explore college students’ understanding of sex trafficking. Results 76% (N=268) of the respondents said that sex trafficking is a problem in the United States, 24% (N=85), view it is as not being a problem in the United States. 95% (N=334) had not received any training to protect themselves from being trafficked, of which only 5.26% (N=1), had been told about the safe use of internet. 3.6%(N=13), respondents have reported, that they know someone who has been approached for sex trafficking. Conclusion The findings of this study suggest that, students are aware that sex trafficking might be a problem in the United States, and some participants indicated that they know someone who has been approached. Preliminary analysis shows that a greater awareness, and knowledge about sex trafficking is needed, and future research may be indicated with the focus on individuals, who are at risk of being trafficked, with the goal of identifying interventions for, at-risk populations