A study of menstrual hygiene practices and associated environmental & social factors among adolescent girls in rural Puducherry

Introduction. Adolescent females were prevented from receiving the appropriate knowledge due to social restrictions and traditional beliefs, which in turn led to poor hygiene habits. Material and methods. A community-based descriptive cross-sectional study employing a semi-structured questionnaire was carried out in the rural field practice region of MGMCRI, Puducherry, between the 15th of March 2019 and the 31st of April 2021. The study was done in Puducherry. The comprehensive enumeration yielded a total of 528 countable teenage females. Results. The vast majority of the teenage females (89.2%) reported using sanitary pads, whereas just 6.6% and 4.2%, respectively, reported using fresh or reused towels. 65.3% of the girls changed their wet absorbent between two and five times during the day. The vast majority of the girls, or 60.8% of them, disposed of their spent absorbent by either burying it or burning it. 67.9% of the girls were cleansing their genitalia when they were urinating. 54.4% of people cleaned their hands using soap and water, whereas 1.4% utilized ash soil, muddy dirt, or other types of soil. There was a statistically significant correlation between the style of housing and the availability of sanitary latrines (p<0.005) in relation to menstrual hygiene behaviors. Conclusions. This research also highlighted the absence of sanitary toilet facilities in the majority of residences, which negatively impacted the girls' ability to maintain their privacy and led to bad practices around menstruation hygiene

Biosocial predictors and blood pressure goal attainment among postmenopausal women with hypertension

ObjectivesIn postmenopausal states, women may not maintain blood pressure (BP) in the same way as men, even though most women follow their treatment plans and prescriptions more consistently than men. Biological and lifestyle factors influence the progression of hypertension in postmenopausal women (PMW). This study aimed to determine biosocial predictors associated with achieving the target BP in PMW with hypertension.MethodsA prospective observational study was conducted in the General Medicine Department at Karuna Medical College Hospital, Kerala, India. The definition of BP goal attainment was established based on the guidelines outlined by the VIII Joint National Committee 2014 (JNC VIII). Multivariate logistic regression analysis was used to analyse biosocial predictors, such as educational status, employment status, body mass index (BMI), number of children, age at menarche, age at menopause, and number of co-morbidities, associated with BP goal achievement.ResultsOf the patients, 56.4% achieved their BP goals on monotherapy and 59.7% achieved it on combination therapy. Level of education [odds ratio (OR) = 1.275, 95% confidence interval (CI): 0.234–7.172], employment status (OR = 0.853, 95% CI: 0.400–1.819), age at menopause (OR = 1.106, 95% CI: 0.881–1.149), number of children (OR = 1.152, 95% CI: 0.771–1.720), BMI (OR = 0.998, 95% CI: 0.929–1.071), and number of co-morbidities (OR = 0.068, 95% CI: 0.088–1.093) did not show a significant relationship, and age at menarche (OR = 1.577, 95% CI: 1.031–2.412) showed a significant association with BP goal attainment among hypertensive postmenopausal women.ConclusionHalf of the hypertensive postmenopausal women did not achieve their BP goals. Interventions are required to expand screening coverage and, under the direction of medical professionals, there should be plans to improve hypertension control and increase awareness of the condition

Mortality in soft-tissue infections: Is it predictable?

Background: Soft-tissue infections are a common emergency surgical problem. The delayed presentation will lead to significant mortality and morbidity. There is no proper prognostication model available for this disease. Hence, we proposed this study to find factors predicting mortality in soft-tissue infections. Methodology: We conducted a case control study with a calculated sample size of 110. All the patients with soft-tissue infections who presented to our hospital were included after written consent. The data collected were analyzed for finding significant parameters predicting mortality using both univariate and multivariate analysis. Results: The factors that predicted mortality are, the requirement of ventilation during the treatment with a P = 0.000 (confidence interval [CI] - 0.001–0.074), and dialysis with a P = 0.026 (CI - 0.004–0.701). If these parameters were present during treatment for soft-tissue infections, the chances of mortality are high. Conclusion: Patients who require ventilator and dialysis assistance during treatment can be anticipated to have mortality from soft-tissue infections

Intravenous clonidine as a part of balanced anaesthesia for controlled hypotension in functional endoscopic sinus surgery: A randomised controled trial

Background and Aims: Controlled hypotension with balanced anaesthesia minimises blood loss. This study was done to evaluate the effectiveness of intravenous clonidine as a single bolus dose to establish controlled hypotension during functional endoscopic sinus surgery (FESS). Methods: This randomised, double-blind, placebo-controlled study was done in a tertiary hospital in India. Sixty American Society of Anesthesiologists physical status I and II patients (18–65 years) undergoing FESS were randomly allocated to one of the two groups. Placebo group (group A, n = 30) received sterile water whereas the clonidine group (group B, n = 30) received 3μg/kg of clonidine intravenously, 30 min prior to induction of anaesthesia. The primary outcome was to achieve a target mean arterial blood pressure (MAP) of 55–65 mmHg intraoperatively. The secondary outcomes measured were requirement of additional fentanyl and metoprolol, intra-operative blood loss, surgeon's opinion on the surgical field, pain, sedation score and complications requiring treatment. Results: Target MAP was easily achieved in clonidine group as against the placebo group (P < 0.001). Significant reduction in intra-operative blood loss (P = 0.0449), a better surgical site scoring (P = 0.02), less requirement of additional hypotensive drugs and good analgesia (P = 0.01) were seen in clonidine group. The complication rates were similar in both the groups. Conclusion: Clonidine is effective in achieving controlled hypotension in patients undergoing FESS. It reduces intra-operative blood loss, requirement of additional hypotensive drugs, improves the surgical field and offers good analgesia without significant side effects

A Review on the Effect of Fabric Reinforcement on Strength Enhancement of Natural Fiber Composites

The main objective of this study is to examine the impact of reinforcements on the strength of natural fiber composites. Recent advancements in natural fiber composites have minimized the usage of man-made fibers, especially in the field of structural applications such as aircraft stiffeners and rotor blades. However, large variations in the strength and modulus of natural fiber degrade the properties of the composites and lower the safety level of the structures under dynamic load. Without compromising the safety of the composite structure, it is significant to enrich the strength and modulus of natural fiber reinforcement for real-time applications. The strength and durability of natural fiber can be enriched by reinforcing natural fiber. The reinforcement effect on natural fiber in their woven, braided, and knit forms enhances their structural properties. It improves the properties of natural fiber composites related to reinforcement with short and random-orientation fibers. The article also reviews the effect of the hybridization of natural fiber with cellulosic fiber, synthetic fiber, and intra-ply hybridization on its mechanical properties, dynamic mechanical properties, and free vibration characteristics, which are important for predicting the life and performance of natural fiber composites for weight-sensitive applications under dynamic load

Genetic Diversity and Structure of <i>Terminalia bellerica</i> (Gaertn. Roxb.) Population in India as Revealed by Genetic Analysis

In this study, an extensive exploration survey of wild progeny was conducted which yielded 18 candidate plus trees (CPTs) of Terminalia bellerica. Seeds of these CPTs were collected from diverse locations between 10°54′ and 28°07′ E longitude, and 76°27′ and 95°32′ N latitude, covering 18 different locations across 5 states of the Indian subcontinent. The objective of the progeny trial was to assess genetic associations and variability in growth and physio-chemical characteristics. Significant variations (p 2b) estimates were consistently high, exceeding 80% for all growth and physiological related traits under investigation except for plant height, leaf length, and girth at breast height. A correlation study revealed that selecting based on plant height, leaf area, and girth at breast height effectively enhances T. bellerica volume. A moderate genetic advance in percent of the mean (GAM) was observed for most traits, except leaf length, leaf width, girth at breast height, and plant height. Across all 13 traits, phenotypic coefficient of variation (PCV) surpassed genotypic coefficient of variation (GCV). Utilizing principal component analysis (PCA) and dendrogram construction categorized the genotypes into seven distinct groups. In conclusion, the study has demonstrated that targeting girth at breast height and plant height would be a highly effective strategy for the establishment of elite seedling nurseries and clonal seed nurseries for varietal and hybridization programs in the future

Impact of an antimicrobial stewardship intervention in India: Evaluation of post-prescription review and feedback as a method of promoting optimal antimicrobial use in the intensive care units of a tertiary-care hospital

OBJECTIVE: Antimicrobial stewardship programs (ASPs) are effective in developed countries. In this study, we assessed the effectiveness of an infectious disease (ID) physician-driven post-prescription review and feedback as an ASP strategy in India, a low middle-income country (LMIC). DESIGN AND SETTING: This prospective cohort study was carried out for 18 months in 2 intensive care units of a tertiary-care hospital, consisting of 3 phases: baseline, intervention, and follow up. Each phase spanned 6 months. PARTICIPANTS: Patients aged ≥15 years receiving 48 hours of study antibiotics were recruited for the study. METHODS: During the intervention phase, an ID physician reviewed the included cases and gave alternate recommendations if the antibiotic use was inappropriate. Acceptance of the recommendations was measured after 48 hours. The primary outcome of the study was days of therapy (DOT) per 1,000 study patient days (PD). RESULTS: Overall, 401 patients were recruited in the baseline phase, 381 patients were recruited in the intervention phase, and 379 patients were recruited in the follow-up phase. Antimicrobial use decreased from 831.5 during the baseline phase to 717 DOT per 1,000 PD in the intervention phase (P \u3c .0001). The effect was sustained in the follow-up phase (713.6 DOT per 1,000 PD). De-escalation according to culture susceptibility improved significantly in the intervention phase versus the baseline phase (42.7% vs 23.6%; P \u3c .0001). Overall, 73.3% of antibiotic prescriptions were inappropriate. Recommendations by the ID team were accepted in 60.7% of the cases. CONCLUSION: The ID physician-driven implementation of an ASP was successful in reducing antibiotic utilization in an acute-care setting in India