Determinants of COVID-19 Vaccine Acceptance in Ghana

Background: A proven strategy for saving lives from vaccine-preventable diseases is the timely vaccination of the people. In Ghana, there is considerable hesitation about the Covid-19 vaccines due to anxieties and uncertainties about their safety. With varying perceptions and believes being developed about Covid-19 vaccines, there is a likely negative effect on vaccine acceptance or otherwise. This study aims to ascertain the levels of acceptance of potential Covid-19 vaccine among Ghanaian adults, to identify predictors of vaccine acceptance or hesitance. Methodology: A web based cross-sectional survey conducted among Ghanaians above 18 years, conducted between the month of February and March, 2021. Data were collected by administering online google forms (Questionnaire). The questionnaire was shared through social media platforms. A snowball sampling technique was used where researchers shared google forms to close friends and family. Analyses were conducted at p-value <0.05 using descriptive statistics, cross-tabula­tions and logistic regression. Results: A total of 350 responses were achieved by end of data collection. Out of these, only 348 were considered for analysis based on the inclusion and exclusion criteria. Majority of the respondents (65.2%) were male, a third (30%) of them live in rural areas and about 57.5% were married. Factors such as age, educational level, prior vaccine acceptance history, personal vulnerability and self-feeling of health were significantly associated with covid-19 vaccine acceptance. Conclusion: The results depict low acceptance rate for potential covid-19 vaccine among Ghanaians. Government and MoH should engage the media on its role in combating misinformation with regards the Covid-19 vaccine. Key words: coronavirus disease 2019 (Covid-19), vaccine, hesitance, acceptance.

Degrees of Canal Stenosis, Levels of Interleukin-6 (IL-6) And C-Reactive Protein (CRP) Preoperative as Predictors of the Output of Neurogenic Claudication Outcome Score (NCOS) 8 Weeks Post-Decompression-Stabilization-Fusion in Degenerative Lumbar Spinal Stenosis Patients

Introduction: Lumbar Spinal Stenosis (LSS) or spinal stenosis is the most common spinal disease in elderly patients. LSS is also one of the leading causes of spinal surgery in the world. The problem that is often encountered is the limited predictor of outcomes that are considered affordable and accurate, so as to provide education to patients about possible output after the surgery process is carried out. Therefore, a predictor is needed that is considered accurate and affordable such as the degree of measurable canal stenosis of Magnetic resonance imaging (MRI), serum levels of C-Reactive Protein (CRP) and Interleukin-6 (IL-6) Method: This study used a prospective cohort design conducted to compare Neurogenic Claudication Outcome Score scores among people with degenerative lumbar canal stenosis whose post-decompression-stabilization-fusion had higher degrees of canal stenosis (measured through Schizas grading of Magnetic resonance Imaging/MRI) examinations), as well as high pre-operative CRP and IL-6 levels with those with normal CRP and IL-6 levels. From the population of lumbar spinal stenosis, the selection of samples was conducted consecutively sampling. After that, statistical tests in the form of descriptor tests, normality tests, risk factor assessments with 2x2 cross tabulation, and proportion comparison analysis using the Fisher Exact test. Result: Severe lumbar canal stenosis degrees resulted in worse NCOS 8 weeks postoperative than mild degrees of lumbar canal stenosis, with statistically significant differences (p=0.008; p < 0.05) and RR 6.4 (0.99-41.08). High CRP levels resulted in worse NCOS 8 weeks postoperative than mild lumbar degrees of canal stenosis, with statistically significantly differences (p=0.008; p < 0.05) and RR 6.4 (0.99-41.08). High pre-operative IL-6 levels resulted in worse NCOS 8 weeks postoperative than normal pre-operative IL-6 levels with statistically significantly differences (p=0.002; p < 0.05) and RR 8 (1.24-51.50). Conclusion: Degrees of preoperative (mild) canal stenosis, high pre-operative CRP levels, and high levels of pre-operative IL-6 were predictors for better 8-week NCOS scores in patients with post-decompression-stabilizing-fusion degenerative LSS disease. Key words: Degenerative lumbar spinal stenosis, IL-6, CRP, canal degree stenosis, NCOS.

An Explorative Study to Assess the Prevalence of Social Anxiety Disorder (SAD) and Its Determinants among High School Students of Selected High School of Bagalkot

Introduction: As per research studies have shown that social anxiety disorder has a worldwide prevalence of 5 to 10% and a lifetime prevalence rate of 8.4% to 15% among high school students.1 Rural Indian children are facing this problem of lethal evil more as compared to Urban high school students in India. Objective: To assess the prevalence of social anxiety disorder [sad] and its determinants among high school students of selected high school of Bagalakote. Methods: Descriptive survey approach was used for the study with cross sectional survey design. 120 high school students between 14 years to 16 years of age were selected Disproportionate stratified random sampling technique method from high school students studying in selected high school of Bagalkot. The data regarding determinants was collected by structured interview schedule and self-report method. The Social Phobia Inventory (abbreviated as SPIN) is a five point scale was used to categories the high school students according to their social anxiety disorders. The association was explored by Chi square test, Fisher’s exact probability test and linear regression. Results: Total 120 high school students were responded for Social Phobia Inventory (SPIN) scale, in that level of social anxiety disorders had reveals that majority 83.3% had non phobic, 15.8% had mild and 0.8% had moderate, there is no extremely phobic. A significant association was found between the social anxiety disorders of adolescents and their selected socio-demographic variables like monthly income (χ2= 21.199; P<0.05). Conclusion: The findings revealed that there was a positive correlation found between the psychological wellbeing and academic performance among adolescents, recommended health education, early recommended understanding the social anxiety disorder and its determinants by their students especially among the fresher`s. Effectiveness of teaching programmes regarding impact of its determinants on level of social anxiety disorders among adolescents can be done had positive effect on adolescents health, which were also statistically significant. Key words: Social anxiety disorder, Determinants, Adolescents, high school students, academic performance, Spin scale.

Duration of Type II DM, HbA1C Levels, TNF-α and IL-10 as Risk Factors for Level Charcot Joint Foot and Ankle in Type II DM Patients

Introduction: Type II Diabetes Mellitus has complications including disorders of the musculoskeletal system or what is often called diabetic charcot joint or charcot neuroarthropathy. Various risk factors are thought to increase the incidence of Charcot joint foot and ankle. Various studies have been made to assess these risk factors with the aim of reducing the occurrence of these complications. Material and Methods: The study used an analytical observational design with a case study and control approach to determine whether Type II DM II ≥ 10 years, HbA1c levels II ≥ 7%, TNF-α levels II ≥ 1.0 ng/L and IL-10 levels ≤ 255 pg/mL as factors. risk of Charcot joint foot and ankle in Type II DM patients. Where the sample involves 24 case groups and 24 control groups. Then a descriptive analysis was performed, bivariate inferential analysis using the chi-square test and an assessment of the risk factor odds ratio (OR). Then multivariate analysis was performed to assess the strength of the influence of risk factors using logistic regression test Results: There is a significant difference between Type II DM II ≥ 10 years, HbA1c levels II ≥ 7%, TNF-α levels II ≥ 1.0 ng/L, and IL-10 levels ≤ 255 pg/mL which are risk factors for the occurrence of charcot joint foot and ankle in Type II DM patients. The duration of type II DM II ≥ 10 years had the strongest relationship while IL-10 ≤ 255 pg/mL had the weakest relationship for the occurrence of Charcot joint foot and ankle in Type II DM patients. Conclusion: Increased duration of Type II DM, HbA1c level and TNF-α level above certain level and low IL-10 amount are risk factor for Charcot joint foot and ankle in Type II DM patients, with the duration of type II DM being the strongest risk factor. Key words: Diabetes mellitus type II, charcot joint foot and ankle, risk factors.

Evaluation of Risk Factors for Preterm Birth Outcome in Gujarat, India

Background: Preterm birth (PTB) is a leading cause of neonatal survival complications, mortality, and morbidity worldwide. In India 35% of all neonatal deaths are due to PTB with 36th global ranking, hence, India's healthcare sector has been working towards reducing the rate of PTB effectively. Objective: This study aimed to assess the risk factors such as environmental and pathophysiological causes associated with preterm birth in the population of Gujarat, India. Materials and Methods: In this study, multivariate random sampling was performed and systematically 200 pregnant mothers [PTB <37 weeks (N=100), Full-term >37 weeks (N=100)] were chosen after excluding mothers with vaginal infection, multiple gestations, fetal anomalies, non-cephalic presentation, cesarean delivery, and pregnancy with Mullerian anomalies. Statistical analysis was performed by Chi-square test, and variables with p-value <0.05 were considered statistically significant. Results: Out of all the variables, maternal age below 20 years, extreme BMI, high blood pressure during pregnancy, maternal health complications, medication and doctor's consultation were highly significant (p < 0.0001). Furthermore, variables like type of area, diet, education, Hb levels below 9 g/dL and above 13 g/dL and blood-group of the mother were also significantly associated with PTB outcome (p < 0.05). Among the sub-categories of PTB (extreme-, very-, moderate/late- PTB), maternal age, Hb level and the past obstetric outcome showed very high significance (p < 0.0001). Conclusion: For the prediction of birth outcome, mother's internal physiological and lifestyle factors need to be taken into consideration, and mothers at risk priorly can be screen out, followed by proper healthcare assistance to decrease the preterm birth rate and its consequences. Key words: Preterm birth, maternal age, blood pressure, past obstetric outcome, risk factors

The Positivity of Anti-TPO and Anti-tTGA in Children with Type 1 Diabetes Mellitus in Albania

Background: Type 1 diabetes mellitus (T1 DM) is the most common type of diabetes in children. T1DM patients are also at higher risk of other comorbid autoimmune diseases, including autoimmune thyroid disease (AITD), celiac disease (CD). The thyroid-specific immune damage of AITD is strongly associated with elevated serum thyroid peroxidase (TPO). Tissue transglutaminase antibody (tTGA) is a specific antibody and a serological marker of CD. This study aimed to evaluate the positivity of anti - TPO and anti - tTGA in children with T1DM after they were diagnosed. Materials and Methods: This study was conducted from January 2019 to October 2020, included 105 children with T1DM. 44 children matching in aged (1 - 14 years) and gender were taken as control with other diagnoses (16 with viral infection, 24 with short stature, 4 with genetic disorders). The antibodies were checked up for the first time after they were diagnosed. Anti - TPO and anti - tTGA were carried out by ELISA. Results: 55.2% of T1DM children were girls. The anti-TPO was positive in 30.5% of T1DM children compared to 4.5% of children in control group. The anti-tTGA was positive in 7.6% of T1DM children compared to 2.3% of children in control group. Risk of Hashimoto's hypothyroidism was more in children older than 10 years old. 21.9% of children 11 - 14 years old were anti - TPO positive, but it was 16.2%, more common in girls. While, anti - tTGA was positive in 3.85% of children 1 - 5 years old with no difference between boys and girls. Conclusion The most frequent autoimmune disease resulted Hashimoto's hypothyroidism. Girls with T1DM have a higher predisposition to Hashimoto's Hypothyroidism in the 11-14 age group compared to boys. Children with T1DM were found to have a lower predisposition to CD. Children with T1DM have a higher predisposition to develop CD at the age of 1 - 5 years. In conclusion we can say that antibodies to other autoimmune diseases must be performed together with diagnostic examinations for T1DM. Key words: Type 1 diabetes mellitus, Autoimmune Thyroid Disease, Celiac Disease, Thyroid Peroxidase, Tissue Transglutaminase Antibody.

Family Biopsychosocial Characteristics on Stunting Events in Children in Stunting Locus Areas Tapalang Barat District

Background: Nutrition in the first five years of life is very important because at this time physical and brain development is most rapid. Nutrition at this time will affect future developments (Data, Information and Health, 2016). Anthropometric monitoring is also needed, as an initial screening of nutritional problems, including stunting and wasting, to facilitate interventions to be carried out to prevent long-term effects and the next stage in the toddler development cycle (Ramos, Dumith and César, 2015). The research method used in this study was case control, while the research was conducted from April to September 2020. Purpose: This study aims to determine the relationship between biopsychosocial and stunting in children under five years in the stunting locus area, West Tapalang District. Method: This study uses a case control research design with the number of respondents each as many as 57 people. The sampling method used is total sampling Results: There is a statistical relationship between exclusive breastfeeding and the incidence of stunting. The p value is 0.01 with an OR value of 0.38. Meanwhile, maternal height has a p value of 0.84 (OR 1.08), family support has a p value of 0.49 (OR 0.49), exposure to cigarette smoke has a p value of 0.09 (OR 0.31) and socioeconomic has no statistical relationship. Conclusion: There is a relationship between exclusive breastfeeding and the incidence of stunting. Meanwhile, maternal height, family support, and exposure to cigarette smoke did not show a statistical relationship with the incidence of stunting Key words: Stunting, Toddler, psychosocial.

The Status of First Aid Skills Mastery and Training Preferences of College Students: A Cross-Sectional Survey

Objective： Bystander first aid can improve the survival rate after out-of-hospital cardiac arrest or trauma, College students are potential bystanders of first aid in society. In the research, we aim to determine the universality of first aid training and the mastery of first aid skills among college students in order to implement first aid. Methods：From January to October 2021, Carry out questionnaire surveys by WeChat push, A random cross-sectional study was conducted on students from five universities in Wenzhou. In order to understand the knowledge and skills of first aid, Respondents accepted the first aid scenario that answered two hypotheses. Results：Among the 1,171 college students interviewed. Among them, 37.23% are males and 62.77% are females; 78.31% have first aid training experience, and 21.69% have no first aid training experience; 71% of college students acquire theoretical knowledge and practical skills through first aid training conducted by the Red Cross, medical emergency centers or hospitals, etc. 22% of college students study through the information network; All college students interviewed expressed their willingness to participate in first aid training. But 21.69% of college students have not received first aid training, The reason for the inability to participate in the training is that they do not understand the ways to participate in first aid training, accounting for 37.01%; Lack of confidence accounted for 19.69%, and lack of time accounted for 35.04%; In the hypothetical emergency scene, In the male group, 48.96% were willing to treat the injured, and 36.19% in the female group. There is a statistical difference between the two (P＜0.01); The junior college student group and the undergraduate student group are 28.09% and 44.09% separately. The medical professional group and the students with the first aid training group are 60.4% and 43.51% separately, The willingness to implement first aid has a clear advantage over the non-medical and non-trained two groups. The comparison between the two groups was statistically significant (P <0.01). The first aid skills are well mastered: chest compression 46.19%, judgment awareness 35.95%, hemostasis bandaging 32.88%, The worse ones were artificial respiration 24.67%, open airway 23.56%, and fracture fixation 8.96%. Conclusion: College students have a positive attitude towards learning first aid knowledge. However, it was found that the first aid skills were not well mastered, and the training was insufficient. Colleges and universities should provide first aid-related courses, extracurricular intensive training and other methods, Increase the knowledge of college students to deal with emergencies and improve basic first aid skills. Incorporating first aid skills training into university curricula and implementing it is a long-term strategy. Improve college students' awareness of first aid knowledge to obtain better social benefits. Key words: Attitude, First aid skills, college student training.

A Study on COVID-19 Vaccine Hesitancy in Bhopal

Background: The coronavirus has become a global pandemic and to overcome the pandemic crisis vaccine were launched in India. COVID-19 mass immunisation has emerged as a crucial preventive technique. COVID-19 vaccine hesitancy may become a distinctive element of the pandemic's next stage. The loss of public trust in vaccines around the world is a source of concern and a serious problem for public health professionals. A study was therefore planned in Bhopal to determine whether hesitancy is present in a population and to distinguish hesitancy from other reasons why adults do not get vaccinated. The study was conducted with the objective as to assess the vaccine hesitancy in Bhopal. Methodology: This is a cross-sectional study conducted among the general population of Bhopal during the time period between 2oth Jan to Feb 2021. 381 participants were administered with a predesigned pretested questionnaire. Results: The mean age of the participants was 33.8 years. Majority was unskilled workers, Hindu by religion and most of them were married. 57.3 % showed hesitancy for COVID vaccination. Majority had the knowledge of vaccine. Television was the major source of information. Almost 80% responded as they would continue practicing personal protective measures even after vaccination. The major reasons for hesitancy were lack of information, safety about vaccination, and side effects from the same. The public demands the proper information about the vaccine and educate the general public and communicate the important information regarding vaccinations. Conclusion: Routine monitoring of vaccine hesitancy plays a valuable role in identifying early vaccine concerns. And adopt the strategies to address these concerns, through in-depth understanding of the nature of hesitancy, as well as who is hesitating. Given the dynamic and changing nature of vaccine hesitancy, the importance of ongoing monitoring cannot be overstated. Key words: COVID-19, COVID-19 Vaccine, SARS-COV2 vaccine, Vaccine hesitancy, Vaccine resistance, Vaccine opposition.

The First Stage of Acquired Syndactyly Reconstruction - A Rare Case Report

Background: Acquired syndactyly is a very rare disorder on the interdigital area. Syndactyly with only soft tissue involvement can be a sequela of trauma, such as burn, inflammation or infection in the interdigital area, resulting in bony fusion following crush injury. Case Report: An 8-year-old boy came to our department with fusion from the base to the tip of the first to fourth right toes since the accidental step on burnt plastic 5 years ago. He complained of a poor appearance and discomfort when walking. Then we performed zigzag incision for first to second toes and third to fourth toes. Skin graft closure was performed to cover the defect on third to fourth toes. The second reconstruction surgery will be scheduled 6 months later. Discussion: The surgical techniques for foot syndactyly were derived from those for hand syndactyly, which are to separate the digital fusion by creating local skin flap. Additionally, skin graft might be necessary when recent surgeons avoid the use of skin graft for open treatment, primary closure by defatting, or intricate local flaps. These can shorten the operation time and minimize donor site morbidity. However, surgeons should consider the free tension closure of the wound by combining the skin graft after the flap. Conclusion: Reconstruction procedure for foot syndactyly aims to improve the appearance and function of the toes as well as to avoid progressive deformity through development. The skin graft addition in combination of skin flap shows promising outcome. Key words: acquired syndactyly, syndactyly reconstruction, zigzag flap, skin graft.