Validity of point-of-care device for diagnosing anemia in workers exposed to lead

Detecting anemia in occupational health settings is critical in a high-risk population for anemia like the lead-exposed. Whether the point-of-care devices are sensitive to detect anemia in individuals with high levels of lead exposure is unknown. We compared hemoglobin (Hb) levels from HemoCue® Hb 301 System and standard analyzer, Mindrey-BC 5300, in individuals (n=58) exposed to lead (mean levels = 44.9 ?g/dL) for a chronic period (mean duration of exposure = 105 months). We observed high sensitivity (0.95), specificity(0.95) in detecting anemia by hemocue, and high agreement between the methods. The significant difference in Hb values between the methods (0.171g/dL, p=0.018) was clinically minimal. We conclude that hemocue is a good method for rapidly detecting anemia and estimating Hb levels among the lead-exposed in resource-limited settings

Analysis of out-of-pocket expenditure in utilization of maternity care services in urban slums of Rajkot City, Gujarat

Background: India contributes 20% global maternal deaths every year. An important reason of such maternal mortality is due to cost of maternity services which makes it in accessible to the poor. Knowledge of maternity-related expense and its determinants is useful for health authorities to focus public resources and target financial assistance or exemption guidelines toward the “neediest.” Methodology: It was a cross-sectional descriptive study conducted amongst 180 women living in urban slums and who had delivered a baby within 1 year of the interview date. Results: The mean cost of delivery was around Rs. 8880. The average delivery cost of private institutions was significantly higher than that of government hospitals or home delivery. Around 75% of women delivered in private institution had health expenditure of more than 10% of total annual family income – catastrophic expenditure. Conclusion: In spite of significantly higher maternity care-related costs in private institutes than government hospitals, majority of mothers had utilized services from private clinics and had suffered catastrophic expenditures during utilization of maternity care services. This study highlights the need for birth preparedness counseling as well as effective implementation of maternity benefit schemes to prevent families from pushing downward to the poverty line

A two wave comparison of characteristics of hospitalized patients with severe and non-severe pandemic influenza A (H1N1) 2009 (H1N1pdm09) in Saurashtra Region, India

Objective: The primary objective of the following study was to determine and secondarily to compare the clinical and epidemiological characteristics of hospitalized patients with severe and non-severe pandemic influenza A (H1N1) during two waves from September 2009 to January 2011. Materials and Methods: A total of 274 cases were hospitalized during the first wave from September 2009 to March 2010 and from June 2010 to February 2011, 237 cases hospitalized in different hospitals of Rajkot during the second wave. Real-time reverse-transcriptase-polymerase-chain-reaction testing was used to confirm infection. Two wave′s comparison was made for factors associated with disease severity. Results: During the first wave 87 (31.8%) patients had severe disease with mortality of 81.6% while during the second wave there were 53 (22.36%) patients having severe disease with higher mortality (94.3%) than the first wave. There were more children up to 15 years of age that required intensive care during the second wave (30.2%) compared to the first wave (20.7%). First wave reported more females and cases from an urban area. Presence of co-existing condition, especially pregnancy was a significant risk factor during the first wave, but not during the second wave. All patients have received antiviral drug oseltamivir during both waves. During the second wave, 39.6% of patients with severe cases received it within 2 days of onset of illness. This was higher than the first wave (19.5%). Conclusion: Higher mortality was reported during the second wave of pandemic influenza A (H1N1) 2009 (H1N1pdm09). There were more cases among the younger age group than adults during the second wave

Sleep Quality – A Potential Link in the Relation Between Occupational Stress and Inflammation

Job stress by effort-reward imbalance (ERI) is a predictor of burnout. Job stress is associated with inflammation, that is a forerunner of distal outcomes, including mortality. Sleep quality, an important association between job stress and inflammation has not been extensively studied. A cross-sectional study was conducted to examine the relationship between job stress, sleep quality, and inflammation among female nurses. As the primary outcome measure, a composite inflammation score was constructed from five interleukins (IL-6, 8, 10, 1β, TNF-α). Among fifty participants (mean age 32±7 years, work experience 105±8 months), there was poor sleep quality among the high ERI group (p=0.021). Overcommitment(OC), an intrinsic component of the ERI, was related to poor sleep quality (β =0.21, p =0.025). High OC (β =2.4, p = 0.025) and increased sleep latency (β = 8.3, p =0.027) were associated with elevated inflammation. There was a significant interaction between ERI and OC on inflammation (β =5.186, p =0.017) and conditional effects of ERI on OC to inflammation only in the high ERI group (p =0.002), not in the low ERI group (p = 0.839). Composite inflammation scores from various inflammatory markers may be potential indicators of adverse outcomes in burnout studies among healthcare workers

Association between coronary artery calcification score and air pollutant exposure: An explorative hospital-based study using microenvironmental modeling

Background and Objective: This study aimed to explore the association between coronary artery calcification and air pollutant exposure from all potential sources using microenvironment modeling. Methods: The present study recruited consecutive consenting patients, who visiting the radiology division of the tertiary cardiac specialty hospital for coronary artery calcification (CAC) evaluation, after obtaining institutional human ethics approval. Fifty participants each with CAC scores <100, 100–399, and ≥400, categorized as low, intermediate, and high risk, respectively, were recruited. Details on basic demographics and exposure to the potential sources of air pollutants from individual microenvironments, namely indoors, workplace, and outdoors, were collected by interview, using prevalidated, semi-structured questionnaire by trained staff. The cumulative exposure was reported as exposure risk hours, from the individual microenvironments and total exposure was estimated using mathematical modeling. In addition, cumulative (particulate matter) PM2.5 exposure for participants residing adjacent to air monitoring stations was estimated. The association between exposure to air pollutants and risk for coronary artery disease was evaluated with standard statistics. Results: Basic demographics revealed a significant association between CAC groups and age (i.e., “low,” “intermediate,” and “high” risk were, respectively, 54.7 ± 10.12, 58.52 ± 8.89, and 64.38 ± 8.74 years, respectively) and gender; wherein higher age and male sex were associated with higher CAC scores. Cumulative PM2.5 exposure was significantly different among the risk categories (i.e., “low,” “intermediate,” and “high” risk were, respectively, 976.14 ± 371.7, 975.78 ± 433.2, and 1215.58 ± 265.5 units). Further, exposure to the potential pollutants at outdoors and at workplace was independently associated with high CAC risk with statistical significance (P 0.05). Conclusion: Exposure to air pollutants from the workplace and outdoors was significantly associated with higher coronary artery calcification, thereby increasing the risk for coronary artery diseases

SARS-CoV-2 seroprevalence among the general population and healthcare workers in India, December 2020–January 2021

Background: Earlier serosurveys in India revealed seroprevalence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) of 0.73% in May–June 2020 and 7.1% in August–September 2020. A third serosurvey was conducted between December 2020 and January 2021 to estimate the seroprevalence of SARS-CoV-2 infection among the general population and healthcare workers (HCWs) in India. Methods: The third serosurvey was conducted in the same 70 districts as the first and second serosurveys. For each district, at least 400 individuals aged ≥10 years from the general population and 100 HCWs from subdistrict-level health facilities were enrolled. Serum samples from the general population were tested for the presence of immunoglobulin G (IgG) antibodies against the nucleocapsid (N) and spike (S1-RBD) proteins of SARS-CoV-2, whereas serum samples from HCWs were tested for anti-S1-RBD. Weighted seroprevalence adjusted for assay characteristics was estimated. Results: Of the 28,598 serum samples from the general population, 4585 (16%) had IgG antibodies against the N protein, 6647 (23.2%) had IgG antibodies against the S1-RBD protein, and 7436 (26%) had IgG antibodies against either the N protein or the S1-RBD protein. Weighted and assay-characteristic-adjusted seroprevalence against either of the antibodies was 24.1% [95% confidence interval (CI) 23.0–25.3%]. Among 7385 HCWs, the seroprevalence of anti-S1-RBD IgG antibodies was 25.6% (95% CI 23.5–27.8%). Conclusions: Nearly one in four individuals aged ≥10 years from the general population as well as HCWs in India had been exposed to SARS-CoV-2 by December 2020