Background: The use of drugs by teenagers is a major health concern globally. At this transitional point, secondary school students are the most vulnerable and are susceptible to risks associated with lack of knowledge of substance use. Objective: The objective of this study was to evaluate the knowledge, attitude, and practice of substance use among Nsukka secondary school students. Methods: This was a cross-sectional study using a validated, self-administered questionnaire, comprising seven sections: demographic characteristics, knowledge of substance use, attitude toward substance use, practice of substance use, contributing factors, effects of substance use, and commonly used substance. Using IBM SPSS Statistics 20, the data were analyzed. To summarize the data, descriptive analysis (frequency, percentage, mean, and standard deviations) was used. Results: Over half of the respondents were female (57.5%) and were junior secondary school students (62.2%). Most of the respondents (80%) were conscious of substance abuse. More than half (52.5%) of the respondents had good knowledge of substance usage and only 9.6% of the respondents had a negative attitude toward drug use. It was deduced from the collected data that most students never carried out substance use activities. The respondents agreed that alcohol was the commonly used substance (52.4%) and curiosity (51.7%) was the major contributing factor among school students to substance use. Conclusion: The study found that students in secondary schools had sufficient awareness and a constructive outlook toward drug use, and that the majority did not use substance. Among high school students, alcohol was the most commonly used substance.

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Introduction: Conflicts abound in basic schools of nursing with consequences such as strained relationships among staff, collapsed agreement, poor academic performances, and disruption of planned academic activities. Conflicts can, however, be beneficial when well managed. Aim: This study aims at assessing the conflict management skills of nurse tutors in Enugu State Basic Schools of Nursing. Research Design: A prospective survey research method was adopted. Materials and Methods: Fifty nurse tutors in three Basic Schools of Nursing in Enugu State were studied from June to December, 2015. Modified Thomas Kilman's generated questionnaire was used for data collection. It has 46 items in two sections – Section A, on demographic data, consisting mainly of close-ended questions with few open-ended questions and Section B, formatted on a 6-point Likert scale of 1–6, containing questions to determine conflict management skills of nurse tutors. Convenient sampling technique was used for data collection. Data Analysis: Statistical Package for Social Sciences version 20.0 was used to analyze data. t-test and analysis of variance test were used to test the set hypotheses. Results: The mean scores for the various parameters were as follows: stress management skill (4.74 ± 0.666), social skills (5.10 ± 0.54), avoidance skills (3.99 ± 0.101), collaborative skills (4.5 ± 0.50), and competing skill (4.10 ± 0.69). Gender and cadre had no statistically significant influence on the conflict management skills of nurse tutors (P = 0.33). Conclusion: Nurse tutors in Enugu State Basic Schools of Nursing possessed good conflict management skills.

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Objective: Delay in complete blood count (CBC) analysis is likely in laboratories with very high workload or when the samples are collected off site for testing in centralized laboratories. This research was done to study the stability of blood cell parameters in automated CBC at the room temperature (20°C–24°C) storage after 24 h and refrigerated (2°C–8°C) storage after 24 and 48 h. Materials and Methods: Automated CBC was done initially on 500 randomly selected blood samples in a 3-part hematology analyzer. Of these, 250 samples were stored at the room temperature (20°C–24°C), and the rest were refrigerated at 2°C–8°C. Re-analysis after 24 h was done for both groups. Data were analyzed using the Pearson correlation coefficient, ANOVA, and repeated-measure ANOVA. Results: Refrigerated samples stored at 2°C–8°C showed good stability for all hematological parameters (P > 0.5), except for mean platelet volume (MPV) in comparison with those at the room temperature storage. MPV showed a statistically significant (P < 0.001) rise on refrigerated storage. In the room temperature storage group, hematocrit (Hct), mean corpuscular volume, mean corpuscular hemoglobin concentration, red cell distribution width, MPV, and granulocyte percentage showed significant difference compared to the initial values. In the extended 48 h refrigerated storage group, all CBC parameters except Hct showed acceptable stability. Conclusion: The storage of blood samples at the room temperature and on refrigeration (2°C–8°C) for 24 h has shown acceptable stability of most of the automated CBC parameters. Refrigeration retained the true values over the room temperature storage and should be recommended if a delay in testing is expected.

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Purpose: The goal of blood bank audit is to continuously improve services to the patients by reducing rework, wastage, and inappropriate care. This can be done by establishing certain quality indicators. The rate of discarded blood and its components due to wastage, expiry, and transfusion-transmitted infection are one of such indicator. Design: Retrospective data on the number of whole blood, components prepared, and discarded were collected from the blood bank information system and analyzed. Results: During the study period, the total number of blood and components prepared were 3922. Out of which, a total of 226 units (5.76%) were discarded. In order to alleviate the shortage of blood, we should do intermittent auditing, quality monitoring, thorough evaluation and training of staff, proper management of the resources, and workforce.

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Aim: To guarantee safe motherhood, women are advised to adequately space their deliveries. The World Health Organization advocated for a birth interval between 3 and 5 years, yet closed birth spacing continues to be a problem in Nigeria, resulting in poor infant, child, and maternal health. This study explored the determinants of three classes of birth interval (too short, adequate, and too long) among 534 women drawn from three rural communities in Delta State, Southern Nigeria. Methods: The study is an analytical cross-sectional household survey which used a pretested structured questionnaire to elicit information from 534 women in their homes. Extracted data were analyzed with Stata version 13.0. Frequency and simple proportion were used to describe the characteristics of the women. Bivariate analysis was undertaken to show the association between birth intervals and various sociodemographic factors. Determinants of birth interval were measured by multivariate logistic regression. Statistical significance was set at P < 0.05. Results: The mean maternal age is 35.3 years (standard deviation = 7.3 years). According to the results, 74.2% (396/354) of the women reported short birth interval (<24 months), 13.7% (73/534) reported adequate birth interval, and 12.2% (65/534) reported too long birth interval. According to the multivariate logistic regression, short birth interval is significantly influenced by education, media exposure, use of contraceptive, unmet need of contraceptive, and age at marriage. Adequate birth interval is determined by education and unmet need of contraceptive. Long birth interval is predicted by education and ideal birth spacing. Conclusion: In order to encourage adequate birth spacing, education and employment opportunities should be expanded for women in the study area, and the use of modern contraceptive should be encouraged.

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Background: In the area of adolescent health, there is growing evidence that effective health promotion interventions among adolescents, providing skills and knowledge, may have direct effects on a range of health outcomes. Thus, the study aimed to assess the effect of mixed-method intervention on self-esteem, body image satisfaction, eating disorders among adolescent school students. Materials and Methods: The cross-sectional study was conducted among high school students in a metropolitan city. At baseline, self-esteem, perception of body image, and pressure by media of participants were assessed using validated self-reported measures. The mixed-method intervention was a body image enhancement program conducted over 6 weeks through six 45–60 min sessions. Postintervention, participants' scores in the above-mentioned domains were assessed using the same self-reported measures. Data analysis was done using SPSS 23.0, and Fisher's exact test, paired t-test, etc., were applied as appropriate. Results: Out of 60 participants, 47% were girls and 53% were boys. Baseline self-esteem scores of girls were lower as compared to boys and were significantly higher in both postintervention. Body image satisfaction among girls improved from 53.57% to 78.57% after intervention. At baseline, higher proportion of girls had likelihood of developing an eating disorder which reduced postintervention. Conclusions: The school-based mixed-method intervention was effective in improving self-esteem, body image satisfaction, and reducing the influence of sociocultural attitudes on appearance in adolescent students.

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Introduction: Creatinine in urine and serum are used in the assessment of renal function. It is commonly estimated by Jaffe's and enzymatic method. In many institutions, serum creatinine is estimated by (POCT) Point of care testing device (Enzymatic method) and follow-up of the patients with creatinine results by other methods, analyzed in the Biochemistry laboratory. If the results of POCT do not correlate with the Jaffe method, it leads to differences in serum creatinine values and wrong treatment decisions during the follow-up of the patients. Hence, this study was done to know the difference between the two methods in a tertiary care hospital. Aim and Objective: To estimate creatinine by Jaffe's and enzymatic method and to compare the serum creatinine values between the two methods. Materials and Methods: It is an observational cross-sectional study, for a period of 17 months from November 2018 to March 2020. Seventy-five samples were analyzed for serum creatinine by Jaffe's method in the Biochemistry laboratory and by enzymatic method in the emergency department in POCT device. Results: Mean differences between Jaffe's and enzymatic method were −0.063 mg/dL, 0.070 mg/dL, 0.198 mg/dL, and 0.0685 in Group I, II, III, and all the groups together. The overall intraclass correlation coefficient including all the three groups (0.995) indicates a very good correlation between the two methods. Conclusion: Our study showed a good agreement and good correlation between the two methods, which is similar to other studies analyzed on same instrument.

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Introduction: Child abuse is an increasing social problem with serious lifetime impact. Almost half of the violence cases affect the head-and-neck region, so dentists can play a proactive role in identifying and reporting possible cases of child abuse. Aim: This study aims to assess the knowledge and attitude about physical and social indicators, legal aspects, and barriers in reporting mechanisms toward child abuse among dentists in Ludhiana city. Methodology: With prior consent, a self-administered structured questionnaire comprising 21 questions was distributed to 100 state-registered dentists of Ludhiana city. The data collected were descriptively analyzed using Pearson Chi-square test. Results: A total of 92 dentists responded to the questionnaire, with a response rate of 92%. Among them, 43% were females, while males were 57% and 64.4% of dentists were specialists, out of which 21% were pedodontists. A moderate proportion of the dentists (68%) had knowledge about indicators. The knowledge of indicators was more among pedodontists. However, no significant difference was seen between other respondents and pedodontists. Almost 79% knew their legal duty to report the suspected case. Forty percent of the dentist had encountered with child abuse cases with a significant difference among pedodontists when compared to other respondents, but only 23% reported a case. Fear of litigation, lack of referral knowledge, and uncertainty of diagnosis were major barriers in reporting. Ninety-two percent showed a positive attitude for further training in identification and reporting mechanisms for suspected cases. Conclusion: The respondent dentists had moderate knowledge regarding child abuse, positive attitude toward dealing with child abuse, but they were diffident and unaware of the appropriate authority to report. Considering this fact, a systematic educational program in diagnosis and reporting of child abuse is advised to provide adequate knowledge than lecture-based learning.

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Background: Despite maternal iron deficiency anemia being a worldwide medical complication, very few studies have been performed to evaluate the efficacy of iron supplementations for treating and preventing adverse pregnancy sequelae. This study attempts to show the impact of maternal iron deficiency anemia on the mother and the fetus and whether treatment can reverse the physiological and pathological effects of anemia on the mother as well as the fetus. Objective: To evaluate the effect of vascular adaptation and extent of compensatory changes in the fetus with the change in maternal hemoglobin (Hb) levels and to study maternal and perinatal outcomes after treatment of maternal iron deficiency anemia. Methodology: The present study was an observational prospective study conducted on 50 pregnant women in GMC, Srinagar from January 2016 to June 2017. The study population was divided into two groups-Group A-Patients with moderate anemia – Hb 7–9 g/dl and Group B-Patients with severe anemia – Hb <7 g/dl. Group A received parenteral iron preparation and Group B received blood transfusion or packed red blood cells until Hb exceeded 7 g/dL, then parenteral iron was used. Maternal Hb and color Doppler were performed before and after treatment of anemia. Results: There was a decrease in the umbilical artery resistivity index (RI) after treatment of maternal anemia in both the groups and the decrease was more in those who received blood transfusion. There was an improvement in middle cerebral artery RI in both the groups after treatment and the increase was statistically significant. The C/U ratio was normalized to >1.1 in both the study groups after treatment of anemia. Conclusion: Our data support the fact that maternal Hb content of <7 g/dl is strongly associated with marked fetal hemodynamic adaptation and must be treated with acute red cell transfusion. Moderate anemia (>7 g/dl) is not sufficient to trigger fetal blood flow redistribution and can be treated with parenteral iron. Close monitoring of the fetal umbilical and cerebral circulation by Doppler examination in anemic pregnancies allows the measurement of the amplitude of fetal vascular response, early assessment of fetal damage and helps in improving fetal outcome as well.

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Introduction: Modern society is creating a severe threat to the health. Such as physical inactivity leading to muscle weakness, air pollution causing respiratory distress etc. But the relationship between hand grip muscle strength (HGS) and pulmonary function is not clear. Hence, the present study was designed to investigate is there any association of handgrip muscle strength and endurance with pulmonary function test (PFT) parameters in healthy young adults. Materials and Methods: In this cross-sectional study, 80 healthy volunteers of 18–21 years of age had participated. PFT was done using portable spirometer. For measurement of muscle strength and endurance, handgrip dynamometer was used. Statistical analysis was done using SPSS 26 software. Mean was calculated for the general characteristics. Pearson correlation coefficient was calculated to analyze the association of handgrip muscle strength and various indices of pulmonary function. Results: In this study (47), 58.8% were male and (33) 41.3% were female. Muscle strength, endurance, forced vital capacity (FVC), forced expiratory flow in 1 s (FEV1), peak expiratory flow rate (PEFR) were significantly higher in males than females. There were significantly positive correlation of handgrip muscle strength with FVC (r = 0.522**, P = 0.000) and FEV1 (r = 0.486**, P = 0.000). Muscle endurance was significantly positively correlated with FVC (r = 0.397**, P = 0.000), FEV1 (r = 0.438**, P = 0.000) and PEFR (r = 0.221*, P = 0.049). Conclusions: Hence, it can be concluded that there is a positive correlation of handgrip muscle strength and endurance with pulmonary function. Hence, HGS can also be used to predict pulmonary function.

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Objective: The objective of the study is to assess the sensitivity and specificity of T2 shading and T2 dark spot sign in the diagnosis of endometriotic cysts. Materials and Methods: The present study evaluated adnexal hemorrhagic lesions without solid component investigated using sonography and 1.5 Tesla magnetic resonance imaging machine for the presence of T2 shading and T2 dark spot sign and their statistical value in the diagnosis of endometriotic cysts. The final study included 64 patients. Results: The T2 shading sign had the sensitivity and specificity of 85.71% and 37.5%, respectively. The T2 dark spot sign had the sensitivity and specificity of 76.79% and 100%, respectively. Conclusion: T2 shading sign is highly sensitive for the diagnosis of endometriotic cysts, whereas the T2 dark spot sign is highly specific for the diagnosis of endometriotic cysts. T2 shading sign has low specificity and T2 dark spot sign has low sensitivity.

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Introduction: Aging is irreversible process accompanied by an increased risk of disease, disability, decreased functional capacity, and eventually death. It affects every individual, family, community, and society. Objectives: The study was to assess the sociodemographic profile, morbidity pattern, and quality of life (QOL) among the geriatric population living in the urban field practice of a Medical College in Kolkata. Methodology: A community-based study was designed to study the morbidity pattern and QOL of elderly residing in the urban field practice of Medical College in Kolkata. As per availability and feasibility, a total of 247 geriatric people were interviewed by visiting house to house. To assess the QOL of elderly people, the World Health Organization BREF questionnaire was used for the study. It consists of physical, psychological, environmental, and social relationship domains. Results: The mean QOL score varied significantly with religion in psychological, social, and environmental health domains, with age in physical, social, and environmental health domains with the type of family in physical and psychological health domains and with marital status in the social relationship domain. Conclusion: The present study revealed that hypertension and diabetes mellitus were the most common morbidities among the elderly study participants, occurring more commonly in females than in males. Among the four domains, the mean QOL score was maximum in the social relationship domain.

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Background: Abnormal vaginal discharge (VD), which is a recurring problem for most of the women at reproductive age, is a good predictor for many gynecological morbidities. Many women constantly neglect abnormal VD because of the prevailing “culture of silence.” Women who live in urban slum are vulnerable to many unhealthy practices and have a high prevalence of reproductive tract infection, especially sexually transmitted infections. Hence, this study aimed to describe urban slum women' understanding, attitudes, and related practices for abnormal VD. Materials and Methods: This community-based cross-sectional study was conducted among 550 women living in urban slum in the Colombo Municipal Council area, Colombo District, Sri Lanka, during September 2015–March 2016. A multistage cluster sampling technique was used. A validated, pretested, interviewer-administered questionnaire was used to collect information from females. Data were analyzed using descriptive and relevant inferential statistics (Chi-square test and one-way analysis of variance). Results: The mean age of the women was 32.51 (standard deviation [SD] ±7.94) years. The mean knowledge score was 29.18 (SD ± 8.68). Most of the women (97.1%) had inadequate level of knowledge (<50%). A significant association was observed between the knowledge score levels with the participants' educational level (P = 0.00). Major areas of knowledge deficit include causes for pathological VD and reproductive tract infections. Majority (95.9%) agreed that abnormal VD should be taken seriously but from the women who accepted (78.2%) that VD has ever been a concern to them, only 59% had consulted a general practitioner. There was a significant relationship with having accompanying symptoms such as burning sensation and lower abdominal pain and consulting a general practitioner (P < 0.05). Conclusions: Culture-specific health education intervention measures need to be targeted in order to improve their knowledge, attitudes, and practices toward VD.

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Introduction: Medical education aims at training an individual with respect to the knowledge, clinical skills, communication skills, and soft skills and building the highest standards of morale. While majority of training programs offer considerable technical skills only a few incorporate the remaining assets. Methods: A curriculum innovation project “Foundation Course” aiming to achieve the above goals, designed for the students entering a medical college was conducted for 74 students joining M. B. B. S. course in a Government Medical College in Port Blair in the year 2015. The feedback from students and teachers was collected at the end of entire activity in the form of a specially designed structured questionnaire with open as well as close-ended questions. Qualitative analysis was performed for students' and teachers' feedback on the open-ended questions. Results: The response rate was 100%. Students perceived foundation course as an excellent opportunity to acquire basic knowledge, attitude, and skills required for subsequent phases in MBBS course. The students opined that teachers who were friendly and approachable enhanced their learning. The attitude of teachers, the methodology of teaching, and the cooperation of peers all played a significant role in enhancing the learning. This course was helpful and increased their orientation to the curriculum and eased out the apprehension to cope up with the challenges. Conclusion: This foundation course enhanced their orientation to the curriculum and campus, boosted confidence to cope up with the challenging syllabus, helped them develop time and stress management skills, and sensitized them to achieve the highest standards of morale required to ensure ethical practice. Students' feedback revealed that how the faculty taught and interacted with the students had more impact than the content.

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Background: Till date, no data has been published about the use of intravenous (IV) thrombolysis in acute ischemic stroke (AIS) from Kashmir valley. Objective: The objective of the study is to assess and determine the pattern of use of IV thrombolysis for AIS in Kashmir, including its efficacy and the difficulties faced in providing this modality of treatment. Materials and Methods: This was a prospective cross-sectional observational study conducted from July 2016 to July 2018. All those patients who were admitted with a diagnosis of stroke and gave informed consent were included in this study. Results: A total of 2023 patients of stroke presented to our emergency department during the study period. Out of them, 1085 (53.6%) cases were found to have hemorrhagic stroke and 938 (46.3%) patients were having ischemic stroke. 9.2% patients of ischemic stroke presented within the window period of thrombolysis, but only 34 (3.6%) patients received IV alteplase. The mean onset to door time in those who received thrombolysis was 103.5 ± 51.17 min. Door-to-needle time (DNT) of ≤60 min was achieved in only 14 (41.2%) cases, whereas mean DNT was 82.7 ± 49.17. There was a statistically significant improvement in the National Institutes of Health Stroke Scale in those who received thrombolysis as compared to those who did not receive it. Conclusion: Hemorrhagic stroke occurs in majority of stroke patients (53.6%) in our community. 3.6% of ischemic stroke patients were thrombolyzed. Thrombolytic therapy presented positive outcomes in comparison to nonthrombolyzed patients which, however, was not statistically significant.

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Introduction: India has diverse dietary culture where salt and spices are used extensively, but up-to-date figures on population salt consumption are very limited. Objectives: The objective of this study is to assess the perception and practices of females doing household cooking regarding extra salt consumption and to have a rural–urban comparison on a specified population. Materials and Methods: A community-based cross-sectional study was conducted among 480 homemakers residing in a rural and urban (Madhupur, Sepahijala district and Dukli, West Tripura district, respectively) area of Tripura for a period of 6 months. A predesigned, pretested, semi-structured interview schedule divided into two parts was used to collect the required information, and scores were given for each response regarding perception and practice of the participants. Results: The mean age of the respondents was 38.48 ± 14.063 years and 37.30 ± 12.087 years, respectively, for rural and urban areas, and both the populations were comparable in their baseline characteristics. Majority of the participants believed recommended daily salt consumption per person daily was >5–10 g (62.9% of rural and 59.6% of the urban participants) which was too high, and significant difference (P value 0.002) was found in practice regarding extra salt consumption among rural and urban participants. Conclusion: This study revealed good perception and significantly better practice regarding extra salt consumption among the urban population. Social caste in the rural population and socioeconomic status in both the study groups were the factors responsible for extra salt consumption in this study.

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Background: Fluorosis is caused because of excessive fluoride intake. Karnataka is one among the states that have reported high fluoride content in the groundwater. This study aimed to determine the prevalence of and clinical manifestations suggestive of fluorosis, along with the causes for fluorosis among the population of Kaiwara village. Methodology: The present cross-sectional survey was performed among 3003 permanent residents of Kaiwara village. Demographic details such as age, occupation, education, economic status, and anthropometric details were recorded. Parameters such as predominant diet, genu valgum, and grades of goiter were studied and recorded to determine their association with fluorosis. Dean's index was used to detect dental fluorosis. The levels of fluoride in urine were estimated using the ELICO-LI-126 Fluoride ion analyzer. Results: The most observed age group among study subjects was 10–49 years (males: 813 and females: 1304). Age, diet, genu valgum, and grade of goiter were significantly (P < 0.001) associated with Dean's index. Of the study subjects, about 11.8% were unable to touch their toes indicating fluorosis. 2.075 mg/dl was the mean baseline fluoride level found in all the four samples from the main water tanks supplying water to the village. Out of 100 urine samples randomly taken, all had fluoride levels above the acceptable levels (>0.1 ppm). Conclusion: Hydric fluorosis is endemic among the general population of Kaiwara village in Karnataka. The main leading cause for fluorosis occurrence in this region might be due to high fluoride levels reported in the groundwater.

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