Surgical Outcomes of Myelomeningocele Repair: a 20-Year Experience from a Single Center in a Middle-Income Country

Objective Spina bifida primarily affects people of low and middle socioeconomic status. Herein, we describe the outcome of myelomeningocele surgical management in Iran and predictors of its postoperative complications and mortality. Methods This retrospective chart review studies the children who underwent surgical management for myelomeningocele in Shiraz, Fars province, Iran, from May 2001 to September 2020. To this end, we investigated mortality and 30-day complications and the factors that determined the operation's outcome. Results 256 patients were enrolled. The median age at the operation was roughly eight days (IQR: 7). The most common site of involvement of Myelomeningocele (MMC) was Lumbosacral (86%, n = 204). At the evaluation conducted prior to operation, CSF leaking was observed in 7% (n=16) of the patients. Postoperatively, 5.7% of the patients were expired in the 30 days following the operation (n = 14), while 24% needed readmission (n = 47). The most common complications leading to readmission included wound dehiscence (n = 10, 42%) and wound purulence (n = 6, 25%). No variable was significantly associated with postoperative complication except for the site of the lesion (p-value = 0.035) and the presence of the lipid content in the defect (p-value = 0.044). Conclusions Most patients born with MMC are referred for the neurosurgical evaluation following their birth; however, as results show there is much left to be desired compared with the 48h recommended by The Congress of Neurological Surgeons. Here, we concluded that presence of lipid compartment in the lesion and the site of the lesion are the two factor that were associated with the rate of mortality. However, further investigation into preoperative interventions and risk factors to mitigate risk of postoperational complications and mortality is highly encouraged. We highly advocate for the investigation and dissemination of the outcome of the conventional surgical management of MMC in financially restrained areas; because they can show the limitation these settings are confronted with (that are in a way unique to them and different from the resourceful settings) and provide a model for other similar areas with limited suitable care.

Nutritional Status of Adolescent Girls in Corporation Schools in India: Still the Goal is Far Ahead

Adolescence is a vulnerable period for the incidence of malnutrition, as rapid growth takes place in this phase of life. Malnutrition, especially among adolescent girls, adversely affects future generations and indirectly impedes national productivity. Maternal malnutrition also contributes significantly to maternal mortality. It is required to be reduced to 70 per lac live births in 2030 from 167 per lac live births in 2013 to achieve sustainable development goals. The other crucial sustainable development goal is improvement in nutritional status in all phases of life. In the present study, we assessed the healthy situation by Body mass index and Haemoglobin estimation of adolescent girls incorporation school located at Pimpri, Pune, India. Most of the girls belonged to lower-middle to middle socioeconomic status. 67.9% of AGs under study were malnourished, while 8.6% were overweight. Only 3.5% of them had Haemoglobin in the normal range, 1% had severe, 65% of adolescent girls understudy had moderate anemia, and the rest had mild anemia. Results of the study show that India is still far away from attaining Sustainable development goals regarding the nutrition of adolescent girls and will have to take great efforts by existing program evaluation, modification, and strict implementation.

Elementary Students’ Reasoning in Drawn Explanations Based on a Scientific Theory

Constructing explanations of scientific phenomena is a high-leverage practice that promotes student understanding. In the context of this study, we acknowledge that children are used to receiving explanations from teachers. However, they are rarely encouraged to construct explanations about the causes and consequences of phenomena. We modified a strategy to elicit and analyze primary students’ reasoning based on scientific theory as a methodological advance in learning and cognition. The participants were fourth-graders of middle socioeconomic status in Chile’s geographical zone with high seismic risk. They drew explanations about the causes and consequences of earthquakes during a learning unit of eighteen hours oriented toward explanation-construction based on the Tectonic Plates Theory. A constant comparative method was applied to analyze drawings and characterize students’ reasoning used in pictorial representations, following the first coding step of the qualitative Grounded Theory approach. The results show the students expressed progressive levels of reasoning. However, several participants expressed explanations based on the phenomena causes even at an early stage of formal learning. More sophisticated reasoning regarding the scientific theory underpinning earthquakes was found at the end of the learning unit. We discuss approaching elementary students’ scientific reasoning in explanations based on theory, connected with context-based science education.

Factors Influencing the Uptake of Short Term Contraceptives Among Women in Afghanistan: Further Analysis of Afghanistan Demographic and Health Survey 2015 (A Cross Sectional Study)

Objective: The aim of this study is to assess factors that influence the uptake of short term contraceptives among married women aged between 15-49 years in Afghanistan.Method: The cross sectional Afghanistan 2015 Demographic and Health Survey provided the dataset for this analysis. We included 22,974 women and applied multivariable logistic regression to investigate the influencing factors for the uptake of short term contraceptives.Results: 95% of Afghan women knew at least one type of contraception but only 16% were using short term contraceptives. Short term contraceptive use was most prevalent among women in the age group between 30 and 40 who were educated, employed, and rich. Most of users were living in the western parts of Afghanistan and belong to Balooch and Pashtun ethnic groups. Media exposure and women empowerment were also positively associated with the use of short term contraceptives. However, we did not find an association with living in urban or rural settings.Conclusion: FP in Afghanistan requires multisectorial efforts, tailored to the needs of women stemming from low and middle socioeconomic status. Health promotion 5 activities, empowering women, strengthening education, and training of FP service providers on effective counseling are good options to address the issue.

Factors Influencing the Uptake of Short-term Contraceptives Among Women of Reproductive Age in Afghanistan Further Analysis of Afghanistan Demographic and Health Survey 2015 (A Cross Sectional Study)

ObjectiveThe aim of this study is to assess factors that influence the uptake of short term contraceptives among married women aged between 15-49 years in Afghanistan.MethodThe cross sectional Afghanistan 2015 Demographic and Health Survey provided the dataset for this analysis. We included 22,974 women and applied multivariable logistic regression to investigate the influencing factors for the uptake of short term contraceptives.Results95% of Afghan women knew at least one type of contraception but only 16% were using short term contraceptives. Short term contraceptive use was most prevalent among women in the age group between 30 and 40 who were educated, employed, and rich. Most of users were living in the western parts of Afghanistan and belong to Balooch and Pashtun ethnic groups. Media exposure and women empowerment were also positively associated with the use of short term contraceptives. However, we did not find an association with living in urban or rural settings.ConclusionFP in Afghanistan requires multisectoral efforts, tailored to the needs of women stemming from low and middle socioeconomic status. Health promotion activities, empowering women, strengthening education, and training of Family Planning service providers on effective counseling are good options to address the issue.

Parasympathetic Activity, Emotion Socialization and Internalizing and Externalizing Problems in Children: Longitudinal Associations Between and Within Families

Biopsychosocial models of children’s socioemotional development highlight the joint influences of physiological regulation and parenting practices. Both high and low levels of children’s baseline respiratory sinus arrhythmia (RSA) have been associated with children’s maladjustment, indicative of nonlinear associations. Negative or unsupportive parental responses to children’s emotions are consistently linked with internalizing (IP) and externalizing problems (EP), although few studies have examined how associations vary within families. This study examined within- and between-person associations of children’s quadratic baseline RSA, negative maternal emotion socialization, and children’s problems over six years. RSA was measured in 133 3.5-year-old children (72 female) in predominantly middle- to upper-middle socioeconomic status, Caucasian families. Mothers reported on their emotion socialization practices and their children’s adjustment concurrently and 1, 5, and 7 years later. Multilevel structural equation models revealed quadratic associations between baseline RSA and both IP and EP at the between-person level, suggesting that children with moderate RSA had fewer adjustment problems, on average, than children with lower or higher RSA. Across time and between families, children displayed more problems if their mothers reported more negative responses to their children’s emotions. Within families, IP were elevated on years when mothers reported higher than usual negative responses, and children with either high or low baseline RSA had more problems on years when mothers reported greater than usual negative responses to their children’s emotions. Altogether, these findings suggest that high and low baseline RSA may increase the risk for maladjustment, particularly in the time-varying context of aversive emotion socialization practices.

The pattern of suicide poisoning cases in the Tertiary care Centre in Chengalpet district, Tamil Nadu, India

Background: Suicide is an important public health problem, every year 800000 people due to suicide, Suicide is the third leading cause of death in 15-19-year-old only. Most (79%) of the suicide happened in low and middle-income countries. Among them consuming poisoning is 25.8%. In India 2019 incidence of suicides 10.4 per one lakh (1,00,000) of population. Tamil Nadu is the state of India sharing most of the suicide deaths, second position (9.7%) in 2019 next to Maharashtra (13.6%).Methods: This is a Hospital-based cross-sectional study, this study was conducted among suicide patients who consumed poison by using nonprobability, consecutive sampling. A pretested questionnaire was administered, and information regarding socio-demographic factors, type of poisoning, and outcome of poisoning was obtained. Statistical analysis was done through Statistical package for social sciences (SPSS) version 21.Results: Of 111 suicide poisoning patients admitted, were female (50.5%) and the majority were from a rural area (70.3%). Among suicidal, tablet poisoning was predominant (27.7%), followed by Organophosphorus poisoning (26.8%) and rat killer poisoning (17.1%). The major reason for suicidal poisoning was family problems (58.6%), and the majority of Suicidal poisoning was more among the age group of 11–30 years (67.6%) and middle socioeconomic status (50.5%). The majority of patients were admitted to the hospital with median days of 2 days (range 1-12). Among 111 patients 109 are cured and discharged and death of 2 cases.Conclusions: Suicides are avoidable and preventable deaths, there are so many measures are there in individuals levels particularly high-risk persons and community level also. So many poisoning cases are tablets and organophosphorus so to take steps for reducing access for that like legislative measures and regulations. Early identification of the mentally disturbed persons and to give counselling.

FROM HOME TO DORM: VIEWS ON ITS INFLUENCE

This study aimed to determine the views of students on the influences of living in a dormitory/boarding house on their academic performance. The study tested to prove if there is a significant difference present in the views of fifty-two (52) respondents on the influences of living in a dormitory on academic performance between male and female, Course A and Course B, and the socioeconomic status. This employed a descriptive research design with quantitative. The 2-tailed t-test, two-way ANOVA, and weighted mean were utilized to analyze and statistically treat the data. Findings showed that the mean grade of the respondents is 1.78568462 which is very good. It concluded that living in a dormitory/boarding house does not adversely affect the students’ academic performance. It brought about more of a positive impact on their studies than the negative. They performed better when living independently rather than with their families. Regardless of sex, the respondents manifested similar views on the influence of living in a dormitory/boarding house on academic performance. In terms of the courses, Course B respondents have better views on the influence of living in a dormitory/boarding house on academic performance. While, in socioeconomic status, the respondents with high socioeconomic status have better views compared to those with low and middle socioeconomic status.

Technology Integration of Turkish Elementary School: Teaching Literacy Skills in the Post-COVID-19 Era

This research aimed to explore the elementary school classroom teachers’ perceptions of technology integration into teaching literacy skills. A total of 122 elementary school classroom teachers working at different elementary schools from the middle socioeconomic status setting, enrolled in the study voluntarily. In this study, a self-report questionnaire developed by the researchers was used. The data was analyzed using Microsoft Excel spreadsheet to get descriptive statistics (frequencies) corresponding the research questions. The research findings indicated that most of the elementary school teachers employ different perspectives, including whole language, literature-based and balanced instruction, and curriculum and related textbooks to teach literacy skills. In addition, the findings showed that teachers use technology to increase the effectiveness of teaching literacy skills and their goals of technology integration to teach literacy skills differentiate. The teachers also benefit from the social media applications and professional organizations in increasing their awareness of technology integration into teaching literacy skills. These results expand our understanding of Turkish elementary school classroom teachers’ technology integration into teaching literacy skills by revealing their perceptions.

Anorexia Nervosa in Thai Male Adolescents: Case Report

Anorexia nervosa (AN) is an eating disorder that is uncommonly reported from developing countries such as Thailand. The authors aim to report the clinical presentation and course of two Thai adolescent males, one with restricting type and one with binge-purge type. The first was a 16-year-old boy who presented with facial puffiness, bilateral leg edema, normotensive bradycardia, chronic kidney disease, and persistent metabolic alkalosis. Diagnosis of AN binge-purge type, mild severity was made. Beyond clinical presentation, this case highlights the relevance of psychosocial assessments for adolescents. The second patient was a 13-year-old boy who presented with significant weight loss, sinus bradycardia, hypercholesterolemia, transaminitis, and euthyroid sick syndrome secondary to AN extreme severity. This patient’s presentation was typical for AN and highlights the severity of the illness that can present in male adolescents. Both lived in rural regions of Northeastern Thailand and experienced symptoms as young as 13 and 12 years of age. Even though, AN is uncommon in males, two cases presented at the authors’ tertiary care center in two consecutive years. Each case had different subtypes, but what they had in common were low to middle socioeconomic status and living in rural areas, which confirms that AN is found in both females and males in Asian cultures. Further studies to estimate the prevalence of eating disorders should be done to understand the disease in both male and female Thais. Keywords: eating disorder, male, Asian, renal insufficiency, depression, adolescent