Circulatory Glutathion S Transferases Estimation in Chronic Alcoholics Vising Urban and Rural Health Center

Introduction: Excessive alcohol consumption is a global healthcare problem with enormous social, economic, and clinical consequences, accounting for 3.3 million deaths in 2012. Glutathione (GSH) is tri-peptide thiol with chemical name γ glutamyl-cysteinyl-glycine the properties of glutathione are conferred to it by highly reactive thiol present in one of its constituent amino acids- cysteine, hence they referred as GSH. Xenobiotics form thioether (-S) linkage with GSH. The reaction is catalysed by enzyme known as glutathione S Transferases (GSTs). The cytoplasmic GSTs are important in the xenobiotic metabolism and are present in higher concentration in liver. Materials and Methods: The present study was conducted in the Dept. of Biochemistry in collaboration with Dept. of General Medicine at Datta Meghe Medical College, Nagpur. In present study includes 40 diagnosed alcoholic liver disease patients and 40 non-alcoholic healthy subjects as control group who are permanent nt of study area. Results: The level of GST was raised in chronic alcoholic patients i.e. study group (43.25±15.94) as compare to control group (1.57±0.55). At the other hand the level of total thiol were decreased in study group (3.12±0.55) as compare to control group. Conclusions: The strong negative association between glutathione-s-transferase (GST) and total thiol (T-SH) levels suggested that as the concentration of total thiol (T-SH) decreased, glutathione-s-transferase activity increased (GST). This may be attributed to an increase in alcohol-induced oxidative stress and increased T-SH utilization from thiols.

The State of Oral Health and Dental Condition in Sindh's Rural Areas

Aims: To ascertain the prevalence of dental caries using DMFT scores, to characterize the oral health status and associated factors of patients attending the Nasirabad Rural Health Center Dental Clinic, and to develop tools and strategies for collecting data for rural oral hygiene statistics. The district collects baseline data to aid in the improvement of dental health initiatives in rural Sindh. Design: From August 2018 to May 2019, convenience sample research was undertaken. Patients aged 15 or older met the requirements. Adult Oral Health Assessment Form (WHO) was used to gather data on oral health examinations. The Nasirabad Rural Health Centre's Dental Unit used a basic mouth mirror and an explorer to interview and clinically examine all subjects. The tools are sterile. On proformas collected biographic and DMFT data. Microsoft Excel 2016 was used to enter and analyses data. The sample comprised both genders and ages. In this study, dentists calculated the mean DMFT score. Items from an adult oral health questionnaire were modified and categorized as Demographics and Clinical evaluation. Demographic data included the patient's age and gender. The dentition was examined for healthy, decaying, missing, and filled teeth (Ft). Results: Microsoft Excel was used to organize and analyses the data. Males made up 41% of the population, while females made up 59%. Caries prevalence was 96 percent overall, with 204(22%) having a low caries status, 250(26%) having a moderate caries status, and 451(48%) having a high caries status. The mean DMFT score was 11.1424017, the standard deviation was 8.0937, and the Significant Caries Index (SiC) was 20.99363057 based on the DMFT value and the number of participants. Conclusion: The research population had poor oral hygiene and dentition. The mean DMFT Score was 11.1424017 and the frequency of dental caries was 96%, with a female bias. Pakistan is a poor nation with little dental health resources and awareness. Providing public oral health education and motivation, water fluoridation, and adopting newer research-based treatments of remineralization of dental caries must be prioritized. It is a major job for the health profession and the government. This issue is critical for dental health and requires immediate care. Keywords: Dental Caries, DMFT Index, Oral Health, Prevalence, Rural Areas

Equity of Health Resources Allocation in Rural Guangxi from 2016 to 2019: An Empirical Analysis

Background: Since 2009, the main task of the new health reform in China is to increase the equity of health resources allocation in primary health care institutions. Health policies and strategies have been established to increase the capacity of PHC services, with improved equity as the most important goal. The objective of this study is to analyze the status quo and equity of health resources distribution in rural Guangxi from 2016 to 2019.Methods: Descriptive statistics analysis was used to analyze the status quo of health resource allocation in rural health center in Guangxi from 2016 to 2019. Lorenz curve, Gini coefficient and Theil index were used to evaluate the equity of health resource allocation in rural health center in Guangxi from 2016 to 2019, from three dimensions of population, geography and economy. Results: From 2016 to 2019, the total amount of health resources in rural health center in Guangxi was increased, but the professional title and education background of health workers is still low. In 2019, the Gini coefficient was 0.085-0.217 geographically, 0.080-0.367 demographically and 0.135-0.340 economically. The total Theil index was 013-0.211, and the majority of the contribution rate of within regions was greater than the between regions. Conclusion: From 2016 to 2019, the distribution of health resources in rural Guangxi was uneven among regions, and with great differences within regions.

Equity of Health Resources Allocation in Rural Guangxi from 2016 to 2019: An Empirical Analysis

Background: Since 2009, the main task of the new health reform in China is to increase the equity of health resources allocation in primary health care institutions. Health policies and strategies have been established to increase the capacity of PHC services, with improved equity as the most important goal. The objective of this study is to analyze the status quo and equity of health resources distribution in rural Guangxi from 2016 to 2019.Methods: Descriptive statistics analysis was used to analyze the status quo of health resource allocation in rural health center in Guangxi from 2016 to 2019. Lorenz curve, Gini coefficient and Theil index were used to evaluate the equity of health resource allocation in rural health center in Guangxi from 2016 to 2019, from three dimensions of population, geography and economy. Results: From 2016 to 2019, the total amount of health resources in rural health center in Guangxi was increased, but the professional title and education background of health workers is still low. In 2019, the Gini coefficient was 0.085-0.217 geographically, 0.080-0.367 demographically and 0.135-0.340 economically. The total Theil index was 013-0.211, and the majority of the contribution rate of within regions was greater than the between regions. Conclusion: From 2016 to 2019, the distribution of health resources in rural Guangxi was uneven among regions, and with great differences within regions.

Malaria Temporal Variation and Modelling Using Time-Series in Sussundenga District, Mozambique

Malaria is one of the leading causes of morbidity and mortality in Mozambique, which has the fifth highest prevalence in the world. Sussundenga District in Manica Province has documented high P. falciparum incidence at the local rural health center (RHC). This study’s objective was to analyze the P. falciparum temporal variation and model its pattern in Sussundenga District, Mozambique. Data from weekly epidemiological bulletins (BES) was collected from 2015 to 2019 and a time-series analysis was applied. For temporal modeling, a Box-Jenkins method was used with an autoregressive integrated moving average (ARIMA). Over the study period, 372,498 cases of P. falciparum were recorded in Sussundenga. There were weekly and yearly variations in incidence overall (p < 0.001). Children under five years had decreased malaria tendency, while patients over five years had an increased tendency. The ARIMA (2,2,1) (1,1,1) 52 model presented the least Root Mean Square being the most appropriate for forecasting. The goodness of fit was 68.15% for malaria patients less than five years old and 73.2% for malaria patients over five years old. The findings indicate that cases are decreasing among individuals less than five years and are increasing slightly in those older than five years. The P. falciparum case occurrence has a weekly temporal pattern peaking during the wet season. Based on the spatial and temporal distribution using ARIMA modelling, more efficient strategies that target this seasonality can be implemented to reduce the overall malaria burden in both Sussundenga District and regionally.

Perception of Sexuality and Body Image among Adolescent Girls

Background: Adolescence is a phase during which major developments of sexuality take place. Development of sexuality is an important bio-psycho-social development, which takes an adult shape during this period. Objective: To study how adolescent girls perceive changes in their bodies during the growing period of adolescence and to study their sexual behaviour during this period. Methodology: The study was a community-based cross-sectional study conducted among adolescent girls undergoing vocational training course at the rural health center. 100 participants enrolled in the institute for the course were included. A semi-structured questionnaire was prepared with informed assent. One to one interviews were conducted maintaining privacy, Data were statistically analysed using SPSS version 23. Results: The mean age of the study participants was 16.02+/-1.2 years. We found that a prior awareness of menses is significantly related to a good feeling after menarche. About a third of the Community Health Workers (CHWs) felt shy or weird about their breast changes during adolescence and 66% were unhappy about their heights. 66% of the adolescents were practising masturbation and 38% among them were open to a physical relationship. 60% of them were not aware of medical intervention and 28% admitted to having experienced sexual assault. Conclusion: Understanding adolescent development and the factors influencing it is of utmost importance as it will help the parents to guide their children in the crossroads of adolescence. Due to incomplete knowledge, accepting bodily changes during adolescence becomes difficult. We, as public health experts, need to commit to an educative practice of support for adolescents.

Measurement of Service Quality Gaps in Dental Services using SERVQUAL in Public Hospitals of Rawalpindi

Objectives: To measure service quality gaps in dental services provided at public hospitals of the district, Rawalpindi. Methods: A cross-sectional survey was conducted in two of the public hospitals of the district, Rawalpindi from April to October 2019. Non-probability consecutive sampling was used to include a total number of 400 patients, equally divided between Rural health center (RHC) and Tehsil headquarter (THQ). Face to face interviews were done using a 32-item SERVQUAL in the form of a structured questionnaire where one part of the questionnaire was filled before the treatment and the other after the treatment. Cronbach’s alpha coefficient was found to be 0.90. It was analyzed using SPSS version 25 with descriptive and parametric tests, and further multiple linear regression was done. Results: The quality of services provided to patients was significantly lower than their expectations in both RHC (-14.48 ± 7.96) and THQ (-9.97 ± 7.97). Independent t-test showed a significant difference in service quality between both the hospitals (-4.41), with a better quality of services in THQ. Association of service quality gap was statistically significant with gender, education, occupation, monthly income, and the number of visits to the hospital with p-value < 0.05. The type of hospital was the strongest predictor (ß = 4.12) of the outcome variable. Conclusion: The findings reveal that patients’ expectations exceed their perception of dental services provided in public hospitals. THQ provided a better quality of services compared to RHC. doi: https://doi.org/10.12669/pjms.37.3.3436 How to cite this:Riaz A, Sughra U. Measurement of Service Quality Gaps in Dental Services using SERVQUAL in Public Hospitals of Rawalpindi. Pak J Med Sci. 2021;37(3):---------. doi: https://doi.org/10.12669/pjms.37.3.3436 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Malaria Temporal Variation and Modelling Using Time-Series in Sussundenga District, Mozambique

Malaria is one of the leading causes of morbidity and mortality in Mozambique with the 5th highest prevalence in the world. Sussundenga district in Manica Province has documented high P. falciparum incidence at the local rural health center (RHC). Sussundenga is a rural district located along the Mozambique, Zimbabwe border. P. falciparum transmission in this area is unique as there are differing control policies on each side of the international border. The study objective was to analyze the P. falciparum temporal variation and model its pattern in Sussundenga district, Mozambique. Data from weekly epidemiological bulletins (BES) were collected from 2015 to 2019, which records confirmed P. falciparum cases from health facilities. These data categorize confirmed cases into two age groups: under 5 years and 5-years and older. P. falciparum incidence and temporal variation were calculated. Temporal clusters were identified using dendrograms. A time-series analysis was carried out. For temporal modeling a Box-Jenkins method was used applying an autoregressive integrated moving average (ARIMA). Over the study period, 372,498 cases of P. falciparum were recorded in Sussundenga, 177,957 from under 5 years (47.5 %) and 194,541 (52.2 %) from 5 years and older. There were weekly and yearly variations in incidence overall (p < 0.001). There was a decreasing trend in cases for those under 5 years while there was a slight increase in those 5 and older. For those under 5, week 2 of the year had the highest number of cases (1170 Sd 34 ) while week 35 had the fewest (354 Sd 17.8). For those 5-years and older, cases also peak at week 2 (1295 Sd 245) with week 31 having the fewest cases (341 Sd 193.5). The findings indicate that cases are decreasing in those under 5 years and are increasing slightly in those 5 years and over. The P. falciparum case occurrence presents a weekly temporal pattern peaking during the wet season. Based on the temporal distribution and using ARIMA modelling, more efficient strategies that target this seasonality can be implemented to reduce the overall malaria burden in Sussundenga District, and regionally.

First Reported Death of a Postpartum Woman Due to Coronavirus Disease 2019 in Nepal: A Lesson Learnt

The first case of coronavirus disease 2019 was reported on December 31, 2019 in Wuhan, China where the average case fatality rate was 6.1 ± 2.9%. There are 453 deaths as of September 24, 2020 in Nepal. We report the first death of a 29-years-old postpartum woman due to COVID-19 in Nepal who was referred from a rural health center to Dhulikhel Hospital. On arrival, she was taken to the acute respiratory zone of the emergency department to provide immediate lifesaving procedures. Despite the repeated resuscitative measures, return of spontaneous circulation could not be achieved. The real time polymerase chain reaction test was positive. Our case report highlights the importance of early clinical suspicion, importance of “safety first” in healthcare settings, and the chain of management in such patients. We consider the fact that a postpartum woman registered as the first case of COVID-19 related death in Nepal to be an area of further study.