Background: Obesity and hypertension among school children have a huge impact on public health. Hence, we estimated the prevalence and sociodemographic correlates of childhood obesity and elevated ...blood pressure (BP) among adolescent schoolchildren (11-19 years) in urban areas of Gangtok, Sikkim, India. Materials and Methods: A population based cross-sectional study was conducted on 979 school children, during November 1, 2009 - April 30, 2010 in Gangtok, East Sikkim India. Anthropometric measurements and BP were recorded among the study population. Obesity and hypertension prevalent among adolescent school children and their correlates were analyzed. Results and Conclusion: Prevalence of obesity, overweight, and hypertension was 2.04%, 14.5% and 5.62%, respectively. The average fast food intake, screen time and limited outdoor activities were significantly associated with obesity. Increase in abdominal height positively correlated with increase in body mass index and body fat; however waist - hip ratio was not a reliable index. The burden of overweight/obesity as well as hypertension with all its associated risk was found to high among our study population, which necessitates framing of policies and actions at national level to address the risk associated with these noncommunicable diseases.
Snakebite envenoming is listed as category 'A' Neglected Tropical Disease. To achieve the target of WHO (World Health Organization) 2019, it becomes necessary to understand various attributes ...associated with snakebite including community awareness, improvisation of medical facilities and to map the potential distribution of venomous snakes responsible for the bite. Hence this study is conducted in Sikkim, India to understand the epidemiology of snakebite in Sikkim. The potential distribution and risk mapping of five common venomous snakes are done for effective management of snakebite cases.
The snakebite cases registered in six district hospitals and four PHCs (Primary Health Centers) of Sikkim were collected from the year 2011 to 2018. Community survey was also conducted to supplement the data. Ecological Niche Modeling (ENM) was performed to predict the potential habitat of five common venomous snakes of Sikkim. The risk modeling of snakebite cases was done at the level of Gram Panchayat Unit (GPU) using Geographically Weighted Regression (GWR) and Ordinary Linear Square (OLS) model. We found higher number of male victims inflicted with snakebite envenomation. The potential distribution of the five venomous snakes showed satisfactory mean AUC (Area under Curve) value. Both the models showed significant positive association of snakebite cases with habitat suitability of the venomous snakes. Hospital data revealed no death cases whereas community data reported 24 deaths.
Death from snakebite reflected in community data but not in hospital data strongly indicates the people's belief in traditional medicine. Though people of Sikkim have rich traditional knowledge, in case of snakebite traditional practices may be ineffective leading to loss of life. Sensitizing people and improving medical facilities along with proper transport facilities in rural areas might significantly reduce the snakebite casualties in the state.
Background. In most settings, patients receive phase 1 cardiac rehabilitation in CTVS ICU at the hospital, but there are several barriers to follow-up after patients are discharged from the hospital. ...Physiotherapists play an important role in the enrolment and continuation of cardiac rehabilitation. Thus, we aim to study the knowledge, attitude, and practice of physiotherapists about CR program adherence among patients discharged from the hospital after cardiac surgery. Objectives. (i) To study the knowledge of physiotherapists about the importance of cardiac rehabilitation after discharge; (ii) to know the attitude of physiotherapists towards cardiac surgery patients after discharge; and (iii) to know what approach various centres are applying for patients after discharge to ensure adherence to cardiac rehabilitation. Methods. A questionnaire was developed with reference to the objectives of the study, which was answered by a total of 127 physiotherapists. Results. The overall response rate was 42.3%; nearly 35.4% of the participants indicated that they knew a lot about CR, while 5.5% said they knew very little. Regarding the program’s content, 36.2% of participants reported having a medium degree of awareness of the diverse CR components, while 8.6% reported having very little knowledge of them. Only about one-third, 35.7% stated that CR in India is effective and 95% believed that CR will have an added value for the country. Approximately 80% of respondents thought that it would be challenging for a physiotherapist to recommend patients to a CR in the nation. Nearly 35% of respondents believed that they, “themselves as physios,” needed to commence CR, and slightly less than 70% thought that doctors were required to choose and refer the patients when asked who should take the initiative to start this kind of programme in the country. A little over 40% of respondents said that insurance firms are also involved in starting a CR programme. Conclusion. Physiotherapists have good knowledge of cardiac rehabilitation. However, their attitude and practice towards adherence to exercise protocols are confounded by various clinician- and patient-level factors.
Background: Teaching methods have failed to keep up with the pace of the changing curriculum. Clinical practice, an essential part of nursing education, links theory with practice, particularly in ...midwifery nursing. Thus, this study aimed to compare the effects of video-assisted teaching programs and traditional demonstration on nursing students learning obstetrical palpation skills. Materials and Methods: This is a quasi-experimental research work with pretest, posttest, control group design in which 60 third-year students of Bachelor of Science in Nursing were selected and assigned randomly, by lottery method, into an experimental group (video-assisted teaching program) and a control group (traditional demonstration) regarding obstetrical palpation. The data were collected through a self-designed rating scale. The validity of the rating scale was established by a panel of seven experts from the field of obstetrical and gynecological nursing, and the reliability was established through Cronbach's α(0.78), which showed the tool was consistent among the population. Results: The results showed a significant difference between the pretest and posttest skill scores of students who were exposed to video-assisted teaching program and traditional demonstration (t = 18.35, p < 0.001). Although both the methods were equally effective in enhancing skill, traditional demonstration scored much better than the video-assisted teaching program when the posttest skills were compared (t = 36.40, p = 0.001). Conclusions: The routine educational method, i.e., demonstration, is more effective in developing skills emphasizing the reinforcement of academicians in enhancing teaching skills by adopting blended teaching technique for enhancing memory storage, retrieval, cognition, and learning.
Diabetes mellitus (DM) is a common chronic condition that mainly affects older adults. It's important to identify it early to prevent complications. Machine learning is essential for early detection ...of DM. This article introduces a new method for detecting DM using a random forest ensemble within an optimized framework. The optimized forest framework depends on finding the best DM features, which are identified using the binary multineighborhood artificial bee colony (BMNABC) technique. During preprocessing, the BMNABC algorithm efficiently identifies important features and then inputs them into the random forest within the optimized forest framework for accurate classification. Five modern DM datasets were used to validate the suggested model. The comparison of the proposed model with other leading models revealed significant insights. The BMNABC + ODF(RFE) model demonstrated exceptional proficiency in detecting diabetes mellitus (DM) across various datasets. It achieved an accuracy of 96.36% and a sensitivity of 99.95% on the merged dataset (130 US and PIMA images). The Iranian Ministry of Health dataset showed an accuracy of 97.28% and a sensitivity of 97.12%. In the Sylhet Diabetes Hospital dataset, the accuracy and sensitivity were 96.81% and 98.07% respectively. However, on the PIMA dataset, the model displayed a nuanced performance, with an accuracy of 77.21% and a sensitivity of 68.83%. Lastly, on the questionnaire dataset, the BMNABC + ODF(RFE) model achieved an accuracy of 96.43% and a sensitivity of 97.15%. These findings emphasize the model's ability to adapt and perform effectively in different clinical environments, outperforming other models in terms of accuracy and sensitivity in detecting DM.
Introduction. Prehypertension is a precursor for developing hypertension and is a risk factor for cardiovascular diseases. Yoga therapy may have a role in lowering the blood pressures in ...prehypertension and hypertension. This systematic review aims to synthesize the available literature for the same. Methodology. Databases such as PubMed, Embase, Scopus, and Web of Science were searched for randomised control trials only in the time duration of 2010–2021. The main outcome of interest was systolic and diastolic blood pressures. Articles were screened based on the inclusion criteria, and 8 articles were recruited for the review. Meta-analysis was done for suitable articles. RevMan 5.4 by Cochrane was used for meta-analysis and forest plot construction. Risk of bias was determined using the Downs and Black checklist by three independent authors. Results. The meta-analysis of the articles favoured yoga intervention over the control intervention. Yoga therapy had significantly reduced the systolic pressure (−0.62 standard mean difference, at IV fixed 95% CI: −0.83, −0.41) and diastolic pressure (−0.81 standard mean difference, at IV random 95% CI: −1.39, −0.22). Secondary outcome measures studied were heart rate, weight, BMI, waist circumference, and lipid profile. The main protocol of yoga therapy included postures, breathing exercises, and different meditation techniques. A significant reduction in secondary outcomes was observed, except for HDL values in lipid profile which showed a gradual increase in yoga group in comparison with alternative therapy. Conclusion. Yoga therapy has shown to be significant in the reduction of systolic and diastolic pressure in prehypertensive population. Supporting evidence lacks in providing a proper structured dosage of yoga asanas and breathing techniques. Considering the existing literature and evidence, Yoga therapy can be used and recommended in prehypertensive population and can be beneficial in reducing the chances of developing hypertension or cardiovascular diseases.
The sudden precipitation of the pandemic forced undergraduates to take refuge at home, deserting the campus. Consequently, the age-old classroom in person teaching-learning (T-L) method shifted and ...lessons had to be conducted online. In previous decades, archetypical classroom lectures survived a lot of criticism in the face of the quasi-passive nature of T-L methodology. There are very few studies that reflect undergraduate students' perceptions of lectures. This study aimed to evaluate undergraduate students' perceptions of lectures using an online questionnaire with 13 items, which was circulated to undergraduate students of medical, physiotherapy, and nursing courses in three settings at different locations of private and public health schools. There was a total of 877 responses. The surveyed students were in favor of lectures and considered them indispensable for undergraduate learning. They preferred it as a kind of organized learning through the teacher's own experiences. Our study suggests that it is not the 'lecture' that requires mending but possibly teachers require better training, application of effective audio-visual aids, and innovative techniques to sustain students' interest in the class.
Background and Objectives: Diabetes mellitus (T2DM) and obstructive sleep apnea (OSA) are common disorders that not only often coexist but also have a bidirectional association where each condition ...exacerbates the other. The present study was performed to ascertain the occurrence and predictors of risk factors of OSA in patients with type 2DM. Materials and Methods: A cross-sectional hospital-based study recruiting 164 patients for over 2 months was conducted, in which each diabetic patient was assigned to complete a questionnaire on various variables followed by a general physical examination for associated comorbidities diabetic complications (neuropathy, nephropathy, and retinopathy). Their fasting blood glucose (FBG) and hemoglobin A1c (HbA1c) levels were recorded, following which they were administered and assessed using Berlin Questionnaire and Epworth Sleepiness Score for risk category and daytime sleepiness. Patients with already diagnosed OSA including ones receiving treatment for it were excluded from the study. Results: Of the 164 diabetic patients recruited in the study, 64 (39%) were at high risk for OSA in contrast to the 100 (61%) who were at low risk for OSA. Neck circumference, waist circumference, presence of hypertension and more than one comorbidities along with patients who experienced witnessed apnea at least three times a week, excessive daytime sleepiness, and habitual snorers found to be significant risk factors and practices in posing DM patients at a higher risk for OSA. Patients with body mass index ≥25 were more likely to have a high risk of OSA. FBG and HbA1c were not significant risk factors for OSA. Conclusions: OSA has a high prevalence in subjects with T2DM which reinforces the clinicians to remain observant for signs and symptoms of OSA in diabetic patients and monitor their compliance in terms of weight management, diet control, and medication adherence.
Filtering noises/artifacts from the electrocardiogram (ECG) can sustain the efficient clinical decision making. Comparative analysis of several filtering techniques is proposed: two adaptive noise ...cancellation techniques, Least Mean Square (LMS), Recursive Least Square (RLS); Savitzky-Golay (SG) smoothing filter and Discrete Wavelet Transform (DWT). These methods are implemented on 60 Hz Power-Line Interference (PLI), ECG signals of FANTASIA database and MIT-BIH Arrhythmia Database. Here, Short-Term Fourier Transforms (STFT) and Continuous Wavelet Transform (CWT) is introduced as a graphical tool to measure the noise level in the filtered ECG signals and also to validate the filtering performances of the proposed techniques. Statistical evaluation is also performed calculating the Signal to Noise Ratio (SNR), Mean Square Error (MSE), the Root Mean Square Error (RMSE), Peak Signal to Noise Ratio (PSNR) and Peak to Peak Amplitude (P2P) change before and after filtering of the ECG signals. The graphical results (frequency domain analysis using STFT and CWT) and statistical observation suggest that the noise cancellation performance of DWT is better, over other techniques.
The sudden precipitation of the pandemic forced undergraduates to take refuge at home, deserting the campus. Consequently, the age-old classroom in person teaching-learning (T-L) method shifted and ...lessons had to be conducted online. In previous decades, archetypical classroom lectures survived a lot of criticism in the face of the quasi-passive nature of T-L methodology. There are very few studies that reflect undergraduate students' perceptions of lectures. This study aimed to evaluate undergraduate students' perceptions of lectures using an online questionnaire with 13 items, which was circulated to undergraduate students of medical, physiotherapy, and nursing courses in three settings at different locations of private and public health schools. There was a total of 877 responses. The surveyed students were in favor of lectures and considered them indispensable for undergraduate learning. They preferred it as a kind of organized learning through the teacher's own experiences. Our study suggests that it is not the 'lecture' that requires mending but possibly teachers require better training, application of effective audio-visual aids, and innovative techniques to sustain students' interest in the class.
PDF
