Effectiveness of Structured Counseling and Preventive Strategies in Promoting Awareness and Expressed Habitual Practices Toward Prevention of Urinary Tract Infection Among Women of Reproductive Age Group: A Pilot Study

Objectives Urinary tract infection (UTI) is the most common infection that affects half of all women in their lifetime and one-fourth have recurrent infections. Health behaviors could prevent the recurrence of UTIs and therefore motivation and increasing awareness are necessary for healthy behavior change. This study was done to evaluate the effectiveness of structured counseling and preventive strategies (SCAPS) in promoting awareness and expressed habitual practices among the women of the reproductive age group to prevent UTI. Materials and Methods Block randomization with multiple interventions and follow-up were conducted among 60 women (30 in each group, randomly assigned using the SNOSE technique) attending the OBG and urology OPDs of a selected medical college hospital. Purposive sampling was used to select the subjects. Women who were positive for urine culture and experiencing typical symptoms of UTI, as assessed using the symptom score checklist, were recruited for the study. Pre-test awareness was assessed using a structured awareness questionnaire and a rating scale for expressed habitual practice. After the pre-test, on the same day, the experimental group received SCAPS intervention followed by a second session during the third month. At the third (before the second session) and the sixth-month post-tests were conducted by delivering the same tool to determine the post-test level of awareness and expressed habitual practice after the administration of SCAPS. Results The study shows there is a significant difference in the awareness and expressed habitual practice values in the experimental group (p < 0.005). The effectiveness of SCAPS showed that the mean ± standard deviation (SD) pre-test score of women (awareness - x̄1 ± SD = 9.47 ± 2.57, hygienic habitual practice - x̄1 ± SD = 20.93 ± 1.91, fluid and dietary practice - x̄1 ± SD = 7.73 ± 2.18 and sexual habits - x̄1 ± SD= 8.00 ± 3.33) was significantly lower than the mean ± SD post-test scores (awareness - x̄2 ± SD =11.37 ± 1.65, awareness - x̄3 ± SD = 12.00 ± 1.05), (hygienic habitual practice - x̄2 ± SD = 22.57 ± 2.16, x̄3 ± SD = 23.90 ± 1.99), (fluid and dietary practice - x̄2 ± SD = 10.07 ± 2.21, x̄3 ± SD =11.97 ± 1.79) and (sexual habits - x̄2 ± SD = 8.81 ± 2.51, x̄3 ± SD =9.81 ± 2.26). Conclusion SCAPS was found to be effective on awareness and preventive habitual practices with regard to UTI. SCAPS can be recommended for vulnerable groups such as females so that UTI could be prevented. Trial Registration CTRI/2018/10/016064 (Registration on 17/10/2018).

Correlation between Noncompliance Behavior and Biochemical Parameters of Chronic Kidney Disease Patients Undergoing Hemodialysis

Background and Objectives Compliance with dietary, fluid, and medication instructions is a critically significant factor for the health and well-being of patients undergoing hemodialysis for an extended period. The current study assessed the correlation between noncompliance behavior and biochemical parameters of chronic kidney disease (CKD) patients undergoing hemodialysis. The study's objectives were 1) to assess patients' noncompliance behavior using a questionnaire, 2) to determine the biochemical parameters of CKD patients having noncompliance behavior, and 3) to find the correlation between biological parameters and noncompliance behavior. Methods A cross-sectional study was conducted from July 12, 2018, to February 10, 2019. A purposive sampling technique was used to recruit the participants, and 100 participants were included in the study. The End-Stage Renal Disease–Adherence Questionnaire was used to assess the non-compliance behavior. Results Most dialysis patients (70%) were compliant with the therapeutic regime, while 30% failed to comply. The study revealed a significant positive correlation between noncompliance behavior and biochemical parameters of CKD patients undergoing hemodialysis (r = 0.578, p < 0.05). Conclusion Noncompliance behavior is significantly correlated with the biochemical parameters among patients with CKD on dialysis. Optimal health is possible through fluid and dietary compliance in these patients. Hence, adherence behavior plays a significant role in the health and recovery of dialysis patients with CKD.

Association Between Sensorineural Hearing Loss and Various Stages of Chronic Kidney Disease

Objectives To compare the proportion of sensorineural hearing impairment (SHI) among patients of chronic kidney disease (CKD) stages 3&4 with CKD stage 5. Materials and Methods This is a cross-sectional study of 30 patients with CKD stages 3 and 4 and 30 patients in stage 5. All patients had an audiological evaluation with pure tone audiometry. Results Our study had 49 males (82%) and 11 females (18%), with the age ranging from 20 to 60 years (mean: 45.13 years). The mean SHI values in stage 3&4 were 28.44 dB and in CKD stage 5 was 31.22 dB. In the right ear, the mean hearing loss in stage 3, stage 4, and stage 5 was 28.17 dB, 28.67 dB, and 31.84 dB, respectively. In the left ear, the mean SHI values in stage 3, stage 4, and stage 5 were 27.05 dB, 31.89 dB, and 30.61 dB, respectively.The mean SHI in stage 3&4 for age group 20 to 30 years was 13.66 dB, for 31 to 40 years was 26.33 dB, for 41 to 50 years was 35.18 dB, for 51 to 60 years was 37.12 dB. The mean SHI in stage 5 for the age group of 20 to 30 years was 16.48 dB, for 31 to 40 years was 28.29 dB, for 41 to 50 years was 31.82 dB, for 51 to 60 years was 34.35 dB. There was a significant correlation between hearing loss and CKD with respect to age (p < 0.001). The duration of renal illness and associated comorbidities was not a significant contributor to hearing loss in our study (p > 0.05). Conclusion As per our study, with progression in the stage of chronic kidney disease, the hearing loss also increased indicating a possible link between the two. We also noted that the hearing loss increased with the increasing age.

Six-Minute Walk Test and its Correlation with Spirometry in Stable COPD Patients

Objectives An impaired exercise tolerance, the main feature in chronic obstructive pulmonary disease (COPD), occurs due to multiple factors. The 6-minute walk test (6MWT) is easy to perform, well-tolerated, and more reflective of activities of daily living. The facility of spirometry is unavailable in many areas of India, where 6MWT can be done easily. This study aims to compare the six-minute walk distance (6MWD) with various demographic, clinical, and spirometry parameters. Materials and Methods A total of 118 consecutive stable COPD patients fitting the criteria were included in the study. Spirometry was performed in these patients before and after giving a short-acting bronchodilator. 6MWT was performed according to the ATS guidelines. All patients underwent the 6MWT after 10 minutes of spirometry. Statistical analysis was done using GraphPad calculator and SPSS 24.0. Statistical Analysis All data were clubbed together in a single Excel chart. Statistical analysis was done using SPSS 24.0. Descriptive data are presented as mean ± standard deviation (SD). Qualitative data are presented as a percentage. Analysis of variance (ANOVA) was used to compare between means. The linear regression model was used to compare between variables. A p-value less than 0.05 was considered significant. Results The majority of the patients were > 60 years of age (mean age = 62.99 ± 6.68 years) and comprised males and females in the ratio 5.9:1. Smoking was determined to be the most important predisposing factor for the development of COPD. There was a significant negative correlation between 6MWD, age, and smoking index (p = 0.0075 and 0.0295 respectively). The 6MWD showed a significant positive correlation with FEV1 (in liters), FEV1 (%), FVC (in liters), and FVC (%). The 6MWD (meters) and % predicted 6MWD showed a significant negative correlation with a drop in SpO2 after the 6MWT (r = –0.36; p = 0.000769, r = –0.3; p = 0.004, respectively). Conclusion 6MWT can be used in cases of COPD where spirometry is unavailable as it correlates significantly with various parameters of the latter.

Effectiveness of School-Based Teaching Program on Knowledge Regarding Recognition and Management of Adolescent's Suicidal Behavior Among School Teachers in Selected Schools, Sikkim

Objective Suicide is a global public health concern. It is the second leading cause of death among 15 to 29 years old. Suicide ideation often emerges in adolescence and is prevalent among this age group. With the help of leaders, teachers as mentors can play an effective role in the prevention of suicide among children and young adults. The present study was performed to assess the effectiveness of school-based teaching programs on knowledge regarding the recognition and management of adolescent's suicidal behavior among school teachers. Materials and Methods A quantitative research approach with a pre-experimental (one group pre-test and post-test) research design was adopted. The study was conducted at Government schools of East Sikkim among 80 secondary school teachers. The samples were assigned through the purposive sampling technique. A pre-designed knowledge questionnaire was used to assess the knowledge of schoolteachers. A pre-test was conducted during the first week of data collection, which was followed by a school-based teaching program regarding recognition and management of adolescents' suicidal behavior on the second week. A post-test was conducted during the fourth week using the same pre-designed knowledge questionnaire. Data analysis was done using the SPSS version 25 applying descriptive and inferential statistical methods. Results The study findings revealed that in pre-test knowledge score, 5% had good knowledge, whereas in post-test, score 50% had good knowledge regarding recognition and management of adolescent's suicidal behavior. The mean score during the pre-test was 12.78 ± 2.87 and the mean score during the post-test was 16.44 ± 2.50. The computed paired “t” value (11.9) was higher than the tabled value (t79 = 1.99; p < 0.05). An association was found between pre-test knowledge score regarding recognition and management of adolescent's suicidal behavior with gender, religion, and years of working experience at p < 0.05 level. Conclusion The study concluded that school-based teaching programs helped secondary school teachers to improve their knowledge regarding adolescents' suicidal behavior. The gain in knowledge from the school-based teaching program will help them recognize and manage adolescents with suicidal behavior and initiate appropriate referrals in the future.

Supervised Physical Therapy Versus Video-Assisted Technique for Chronic Mechanical Low Back Pain: A Comparative Study

Objective To compare the effect of supervised physical therapy versus video-assisted technique in patients with chronic mechanical low back pain. Materials and Methods This is a comparative study. Forty-two patients were recruited in the study where they were randomized by simple random sampling. Group A (n = 21) received supervised physical therapy, and Group B (n = 21) received the video-assisted technique. The intervention was given 45 minutes per day for 15 days. The measures of visual analog scale (VAS) and Roland–Morris Disability Questionnaire (RMQ) were taken both at baseline and after 15 days of intervention. Results Comparison between the two groups using Mann–Whitney U test, supervised physiotherapy group showed significant improvement in VAS on activity, RMQ, and RMQ percentage (p < 0.005). However, Group A, VAS on rest was not significant (p > 0.005). Conclusion Supervised physical therapy is effective in reducing pain on activity and improved the disability of patients with chronic mechanical low back pain than the video-assisted technique.

Effect of N-95 Mask on Oxygen Saturation Level in Health Care Workers and Their Experience While Using N-95 Mask

Background N-95 masks are in high demand during this COVID-19 pandemic but wearing an N-95 mask is a real challenge to the health workers during their duty hours. The present study aims to measure the effect of the N-95 mask on oxygen saturation level in the blood and the discomforts experienced while using it. Materials and Methods Oxygen saturation was measured in 80 health care workers before and after wearing the N-95 mask continuously for more than 6 hours. The participants were asked to fill a questionnaire regarding various discomforts of N-95 mask usage, which consisted of 14 questions. Results The most common discomfort was pain around the pinna followed by difficulty in breathing and fogging of spectacles or goggles. In addition, 71% of them had decreased oxygen saturation by 1%. Conclusion N-95 mask can alter the oxygen saturation but it does not produce significant effects in healthy individuals. It can significantly affect patients with compromised airways.

Knowledge of Polycystic Ovarian Syndrome, Its Complications, and Management among Lebanese Women: A Cross-Sectional Survey

Introduction Polycystic ovarian syndrome (PCOS) is a multi-spectrum disease where a failure to address it correctly can result in various clinical complications. This study aimed to assess the Lebanese women's knowledge and perceptions of PCOS and its management. Materials and Methods This cross-sectional study included women whose ages ranged between 18 and 45 years. Women's demographic characteristics, reproductive health, knowledge, and perception of PCOS were analyzed through an online validated questionnaire. Results Among the 450 included women, 196 (43.6%) had good knowledge about PCOS. The majority of participants were aware that menstrual irregularity is a symptom of PCOS, 327 (72.7%), while only 231 (51.3%) women knew that PCOS may lead to infertility. Almost two-thirds of women were aware of the contribution of metformin, diet, and exercise in refining the progress of the disease. More than 60% of participants believed that PCOS patients need social support and have a low body image. Married women (p < 0.001) and those with undergraduate/ postgraduate degrees (p < 0.001) had better PCOS knowledge. Conclusion A significant percentage of Lebanese women have inadequate knowledge of PCOS and its complications.

Eco-friendly and Economical Spectrophotometric Estimation of the Low Water-Soluble Drug (Norfloxacin) Applying the Concept of Mixed Hydrotropy

Objectives The main aim of the research was to analyze an economical and eco-friendly approach to improve the solubility of norfloxacin. The current analysis was to utilize the hydrotropic solutions to extract the drugs from their dosage forms, avoiding the use of costlier and harmful organic solvents. Materials and Methods In this study, an ultraviolet–visible spectrophotometer (model 1800, Shimadzu Corporation) was used to analyze the norfloxacin drug. The mixed hydrotropy approach was used to determine the solubility of norfloxacin. In this work, a blend solution (20% of urea + 20% of sodium benzoate) was used as a hydrotropic solubilizing agent. Results The solubility of norfloxacin drug in water was very low at ∼0.88 mg/mL and the solubility of norfloxacin drug in the blend solution was 11 mg/mL. From 98.96 (tablet II) to 99.35 (tablet I), the percent estimation value was achieved. This value was nearly 100, so the proposed method was correct. Standard deviation (0.2540–0.4156), percentage coefficient of variation (0.2566–0.4183), and the value of standard error (0.1481–0.2415) are also very low; hence, we can say that the proposed method is accurate. Conclusion To avoid the use of organic solvents, the mixed hydrotropy concept can be used for spectrophotometric estimation of low water-soluble drugs from bulk drug samples. It provides an economical and environmentally friendly mechanism.

A Rare Case of Sporadic Inclusion Body Myositis with Atypical Presentation

Sporadic inclusion body myositis (IBM) is the most common acquired inflammatory myopathy that occurs after the age of 50 years. IBM typically involves wrist and finger flexors and quadriceps, but all sporadic IBM may not have the classic presentation of distal arm and proximal leg involvement. Treating physicians must be aware of this atypical presentation to avoid the misdiagnosis of IBM, leading to treatment with immunosuppressive agents. The aim of this study is to increase the awareness among physicians about the atypical presentation of IBM and to emphasize the importance of muscle biopsy in such cases. Here we report a case of 52 years old male diagnosed with sporadic IBM by muscle biopsy presented with atypical presentation.