Knowledge, attitudes, and practices related to dietary salt among older adults in Abha, Saudi Arabia

The need to foster successful aging has intensified with the aging of the global population. This study aimed to assess the knowledge, attitudes, and practices (KAP) concerning dietary salt consumption and to investigate the correlations between sociodemographic variables and salt-related KAP. A structured interview was administered to a cohort of 200 older adults in Abha City, Saudi Arabia, recruited through a convenience sampling approach. The evaluation of salt-related KAP revealed widespread low knowledge (91.5%) as participants scored less than 3, negative attitudes (85.5%) scored less than 12, and predominantly unsatisfactory practices (69.5%) with scores less than 26. Noteworthy differences emerged between participants with poor overall KAP (81.5%) and those with good KAP (18.5%). Significantly weak negative correlations were found between age (r=-0.212), marital status (-0.236), and body mass index (-0.243) with overall KAP. Further examination revealed a significantly weak positive correlation between attitude and practice (r = 0.141). KAP scores show a highly significant positive correlation with overall KAP scores (r = 0.169, 0.352, 0.969). The uncovered correlations contribute to a valuable understanding of the complex dynamics surrounding salt-related KAP. This understanding guides the design of targeted interventions, such as health education programs, promoting successful aging and public health outcomes.

Examining the Prevalence of Congenital Anomalies in Newborns: A Cross-Sectional Study at a Tertiary Care Maternity Hospital in Saudi Arabia

Background: Congenital anomalies, representing structural or functional abnormalities present at birth, pose a substantial global health challenge, affecting 8 million newborns annually. With 3.3 million succumbing before age five and 3.2 million facing physical or mental disability, their diverse causes necessitate comprehensive understanding for effective healthcare planning. This study explores the prevalence of congenital anomalies among newborns in the Abha Maternity and Children Hospital (MCH) in Abha, Kingdom of Saudi Arabia. Methodology: A descriptive cross-sectional record-based study was conducted on newborns born between 2018 and 2022. Data were gathered in 4 months from September to December 2023. Purposive sampling was employed to select the case records of newborns with congenital anomalies after careful screening and considering inclusion and exclusion criteria. Data was acquired through a self-designed study tool, and the data were entered into Google Forms. Results: Congenital anomalies' five-year prevalence was 3.21%, and one year, in 2022, the prevalence was 4.02%. Female neonates exhibited higher anomalies (59.3%), and preterm births accounted for 39.6%, emphasizing their vulnerability. The findings indicate that consanguineous marriages are linked to 63.3% of anomalies, notably neural tube defects (25%) and congenital heart diseases (19.7%). Anomalies are not significantly associated with consanguinity or birth order, but maternal age, education, employment, and antenatal maternal medical issues are associated considerably. Conclusions: These study insights contribute to health planners planning targeted interventions and awareness programs that are crucial to mitigate risks associated with preterm births and consanguineous marriages. The promotion of 100% antenatal screening and prophylactic medication for high-risk women and couples is necessary to prevent inherited deformities. In future the Ministry of Health must plan large-group prospective research to better understand the associated risk factors that will help public health initiatives minimize congenital-associated neonatal mortality and improve pregnancy outcomes.

Study to Determine the Prevalence of Menstrual Migraine in Reproductive-Age Women in Saudi Arabia

BACKGROUND

Migraine is a common health condition in both men and women. Premenstrual syndrome (PMS) affects many women during their menstrual cycle, with around 50-60% of women with migraine attacks experiencing menstrual headaches. Most have mild symptoms, but 5-8% suffer from moderate to severe symptoms, causing distress and functional issues. Pure menstrual migraine (PMM) occurs in about 50% of women with migraine, and it can be debilitating in terms of frequency and severity. This information is crucial for Saudi Arabian medical professionals to provide better care and support, improving the quality of life for women with PMS and menstrual migraine (MM) attacks.

OBJECTIVES

To estimate the prevalence of MM in women, to evaluate the severity and frequency of MM in women with PMS, and to identify potential risk factors aggravating MM in women with PMS in Saudi Arabia.

METHODOLOGY

A cross-sectional community-based study was conducted on reproductive-aged (18-50 years) women who had regular menstrual cycles and were diagnosed with PMS, using a self-administered questionnaire between December 2022 to May 2023 in Saudi Arabia.

RESULTS

Out of the 2130 female participants, 397 (18.6%) had migraine. Among these 397 migraine sufferers, 230 (57.9%) experienced MM, while 167 (42.1%) had non-MM. In reproductive women in general, MM occurred in 10.7% of cases, while non-MM was observed in 7.8%. There is a correlation between increasing BMI and an increased incidence of MM. About one-third of the participants experienced moderate disability due to migraine attacks, with 134 (33.8%) individuals affected. Additionally, most MM sufferers missed at least 3 days of work in the last 3 months due to their condition.

CONCLUSIONS

Migraine attacks occurring during the menstrual cycle impair the ability to engage in social, physical, household, and academic activities, often hindering the fulfillment of professional commitments. To gain a deeper understanding of menstrual and non-menstrual migraine attacks, it is essential to conduct extensive prospective studies aimed at developing effective management strategies.

Access, timeliness and retention for HIV testing under early infant diagnosis (EID) program, India

Early Infant Diagnosis of HIV infection services are crucial for managing the perinatally acquired HIV infection. Assessing the performance of the EID services and its underlying determinants is important for the National AIDS Control Program, India. The objectives of this study were to find out access to HIV testing, the timeliness of the testing cascade, and the proportion of HIV exposed infants who are followed up to 18 months for a definitive diagnosis of HIV. The study design was a mixed method. A total of 11 states accounting for 80% of HIV-positive pregnant women were selected. Program records from a total of 62 Integrated counselling and testing centres (ICTCs) served as the source of information. The qualitative component included interviews of program managers at the state and district level, service providers at the ICTC level, and caregivers of HIV exposed infants. In the sampled 62 ICTCs, 78% of the HIV exposed infants had at least one HIV test. Of the infants who had HIV tests, 50% had at first sample collected by 8 weeks of age. The median turnaround time from sample collection to DNA PCR testing was 36 (IQR 19-70) days and that to next sample collection in case of detection of virus in the first sample was 66 (IQR 55-116) days. At 18 months of age, 544 (62%) HIV exposed infants were retained in the EID testing cascade. A total of 30 infants were diagnosed with HIV at a median age of 421 (IQR 149-650) days. More than three fourth of the HIV exposed infants had access to early infant diagnosis (EID) services. Both demand and supply-side factors contribute to access, timeliness and retention and there is a need to address these factors.

Newborn Care Practices and Associated Factors Influencing Their Health in a Northern Rural India

INTRODUCTION

In developing countries, neonatal mortality is the most neglected health issue by the health system, leading to its emergence as a public health problem. A study was undertaken to assess the influence of factors and newborn care practices influencing newborn health in the rural area of Bareilly district.

METHODOLOGY

The descriptive cross-sectional study was organized in the rural areas of Bareilly. Study participants were selected based on the mothers who gave birth to a baby during the last six months. The mothers who delivered in that area within six months were included and, using the semi-structured questionnaire, data were collected. Data were analyzed using Microsoft Excel and SPSS 2021 version for windows.

RESULTS

Out of 300 deliveries, nearly one-quarter of the deliveries, 66 (22%), were happening in homes, and most of the deliveries, 234 (78%), happened in hospitals. It was observed that unsafe cord care practices were observed more among nuclear families, 8 (53.4%), than joint families, 7 (46.6%), and it was found to be statistically insignificant. The Unsafe feed was given 48 (72.7%) more commonly among home deliveries than institutional deliveries 56 (23.9%). Mothers' initiation of delayed breastfeeding was nearly the same in both home and hospital deliveries. Delayed bathing was observed in nearly three-fourths of mothers, 125 (70.1%), aged 24-29 years, followed by 29 (16.8%) in the age period of 30-35 years.

CONCLUSION

The practice of essential newborn care still needs to improve in Bareilly; there is a need to create awareness among the mothers and family members on newborn and early neonatal care aspects, such as promoting exclusive and early initiation of breastfeeding and delayed bathing practices.

Impact of an Alcohol-based hand sanitizer usage during COVID-19 pandemic on disulfiram treatment: A South Indian psychiatrist's practice experiences

Background: Alcohol-based hand sanitizer (ABHS) usage has become one of the COVID-19 pandemic-related adapted responses. Some disulfiram-ethanol reactions are reported in people who use alcohol-based hand rub/sanitizer and take Disulfiram as a treatment for their alcohol use disorders. Aim & Objective: To determine the practice experiences of psychiatrists on disulfiram prescription to alcohol use disorder victims. Methodology: A cross-sectional study on the psychiatrists to find the experiences of disulfiram prescription to their clients with alcohol use disorders during the COVID-19 pandemic. Results: Nearly 84 (51%) were reverted with a completed questionnaire. Among the respondents, 28 (33.3%) of the respondents decreased to prescribe Disulfiram, 48 (57.1%) reported that their patients stopped using ABHS due to fear of Disulfiram-Ethanol Reaction (DER), and 20 (23.8%) responders notified that their patients were expressed their worry on DER with Disulfiram and ABHS. Conclusion: Disulfiram prescribed for alcohol use disorders; treatment got peculiar experiences with the incidences of DER reported with Alcohol-based hand sanitizer. Many practitioners were scared to prescribe disulfiram due to DER with ABHS. The prevailing evidence that there is no possibility of cutaneous application of ABHS producing enough significant DER. Hence using ABHS is not a contraindication for disulfiram prescription.

Comparisons and Associations between Hip-Joint Position Sense and Glycosylated Hemoglobin in Elderly Subjects with Type 2 Diabetes Mellitus-A Cross-Sectional Study

Hip-joint position sense (JPS) accuracy may be impaired in individuals with type 2 diabetes mellitus (T2DM). An impaired hip JPS can alter postural control and bodily balance. The objectives of this study are to (1) compare the hip JPS between T2DM and asymptomatic and (2) assess the relationship between hip JPS and glycosylated hemoglobin (HbAlc). This comparative cross-sectional study included 117 elderly individuals with T2DM (mean age: 59.82 ± 6.80 y) and 142 who were asymptomatic (mean age: 57.52 ± 6.90 y). The hip JPS was measured using a digital inclinometer. The individuals were repositioned to a target position with their eyes closed, and the magnitudes of matching errors were estimated as reposition errors. The hip JPS was evaluated in the flexion and abduction directions. The magnitude of reposition errors was significantly larger in the T2DM group in the right flexion (p < 0.001), the right abduction (p < 0.001), the left flexion (p < 0.001), and the left abduction (p < 0.001) directions compared to the asymptomatic group. HbA1c values showed a significant positive correlation with JPS in the right-hip flexion (r = 0.43, p < 0.001), the right-hip abduction (r = 0.36, p < 0.001), the left-hip flexion (r = 0.44, p < 0.001), and the left-hip abduction (r = 0.49, p < 0.001) directions. Hip JPS testing may be considered when assessing and formulating treatment strategies for individuals with type 2 diabetes. Future research should focus on how hip JPS can impact balance and falls in individuals with T2DM.

Perception about Health Applications (Apps) in Smartphones towards Telemedicine during COVID-19: A Cross-Sectional Study

BACKGROUND

The use of health applications (apps) in smartphones increased exponentially during COVID-19. This study was conducted the with the aim to understand the factors that determine the consumer's perception of health apps in smartphones towards telemedicine during COVID-19 and to test any relation between these factors and consumers towards Telemedicine in India.

METHODS

This questionnaire-based cross-sectional study was conducted from July 2021 to December 2021 in India. Out of 600 selected participants, 594 responded and in that 535 valid questionnaires were measured. The questionnaire consists of close-ended responses, with the first part consisting of demographic information, the second part consisting of questions associated with consumers' perceptions and the third part kept for suggestions and complaints. The questionnaire was distributed using digital platforms via WhatsApp or email. A 5-point Likert scale, ranging from strongly agree' (5) to strongly disagree (1) was used to record responses.

RESULTS

Results revealed a high response rate of 90%. The highest score was obtained for the question assessing the satisfaction of the users towards health apps [1175 = 500 (agree-4) + 675 (Strongly agree-5)]. The interface of the app scored very low, showing disagreement (514) with app functionality, and was the most common disadvantage as perceived by patients. The mean scores of reliabilities and vicinity of health services; efficacy and comprehensive health information; development and improvement of health apps and telemedicine (3.24, 3.18, 3.62, 3.49), respectively, show the difference in attraction existing between groups. There is a strong positive correlation between the variables except for efficacy and comprehensive information about health and Telemedicine (-0.249), development and improvement of health apps, and reliability and vicinity of health services (-0.344) which have a negative correlation.

CONCLUSIONS

The findings of this survey reveal a positive outlook of health apps toward telemedicine. This research also found a strong forecaster of the consumer's perception of health apps in smartphones towards telemedicine. In the broad spectrum, the future of health app affiliates for telemedicine is better affected by the consumer's perception of health app efficacy. This study suggests that health app marketers develop more innovative apps to increase usage and help consumers.

Enhancement in the Structural, Electrical, Optical, and Photocatalytic Properties of La2O3-Doped ZnO Nanostructures

A lanthanum oxide (La₂O₃)-ZnO nanostructured material was synthesized in the proposed study with different La₂O₃ concentrations, 0.001 g to 5 g (named So to S7), using the combustion method. X-ray diffraction (XRD), scanning electron microscopy (SEM), and Fourier transformation infrared spectroscopy (FT-IR) were utilized for investigating the structure, morphology, and spectral studies of the La₂O₃- ZnO nanomaterials, respectively. The results obtained from previous techniques support ZnO's growth from crystalline to nanoparticles' fine structure by changing the concentrations of lanthanum oxide (La₂O₃) dopants in the host matrix. The percentage of ZnO doped with La- influences the ZnO photocatalytic activity. SEM analysis confirmed the grain size ranged between 81 and 138 nm. Furthermore, UV-Vis diffuse reflectance spectroscopy was performed to verify the effects of La₂O₃ dopants on the linear optical properties of the nano-composite oxides. There was a variation in the energy bandgaps of La₂O₃-ZnO nanocomposites, increasing the weight concentrations of lanthanum dopants. The AC electrical conductivity, dielectric properties, and current-voltage properties support the enactment of the electrical characteristics of the ZnO nanoparticles by adding La₂O₃. All the samples under investigation were used for photodegradation with Rhodamine B (RhB) and Methylene Blue (MB). In less than 30 min of visible light irradiation, S4 (0.5 g) La₂O₃-ZnO reached 99% of RhB and MB degradation activity. This study showed the best photocatalytic effect for RhB and MB degradation of 0.13 and 0.11 min^-1 by 0.5 g La₂O₃-ZnO. Recycling was performed five times for the nanocatalysts that displayed up to 98 percent catalytic efficiency for RhB and MB degradation in 30 min. The prepared La₂O₃-ZnO nanostructured composites are considered novel candidates for various applications in biomedical and photocatalytic studies.

Medication Adherence Among Hypertensive Patients Attending Different Primary Health Centers in Abha, Saudi Arabia: A Cross-Sectional Study

BACKGROUND AND OBJECTIVES

Optimal blood pressure control is achieved by medication adherence. This will reduce the risk of associated morbidities and mortalities. The present study aimed to determine medication adherence and its associated factors among hypertensive patients attending different primary health centers (PHC) in Abha, Saudi Arabia (KSA).

METHODS

A cross-sectional study was conducted among ten different PHCs in Abha, KSA. Simple random sampling procedure was utilized to choose 400 participants. A structured anonymous questionnaire was used in the present study. Analysis of the data was done using the SPSS program, version 23. A logistic regression statistical test was applied to identify the independent associated factors of medication adherence. Furthermore, we have applied Spearman's test to find the correlation between overall B-IPQ score and medication adherence score.

RESULTS

A total of 400 hypertensive patients responded in the present survey. More than one-third of the participants (36.3%) were in the high adherence category group, while the remaining participants (63.7%) were either low or medium adherence category. The binary logistic regression analysis revealed that low and medium adherence category is significantly associated with age (adjusted odds ratio [AOR] = 0.96, 95% CI =0.93-0.99, p = 0.021), married participants (AOR = 0.42, 95% CI =0.33-0.58, p = 0.001), residing at village (AOR = 1.49, 95% CI =1.14-1.73, p = 0.038), and participants with monthly family income of 5000 to 7000 SAR (AOR = 3.06, 95% CI =1.62-5.79, p = 0.001). A negligible positive correlation was revealed between illness perception and medication adherence.

CONCLUSION

The present study revealed that hypertensive patients poorly adhere to their antihypertensive medications. This low adherence is significantly associated with the age, monthly income, people living in rural areas, and married participants. The present study results recommend sustained efforts to implement health education programs and awareness-raising interventions targeted at hypertensive patients.

Development of a community orientation program (COP) as a community-based medical education method for undergraduate medical students: an experience from India

BACKGROUND

Intra-regional cultural and linguistic differences are common in low- and middle-income countries. To sensitise undergraduate medical students to the social and contextual determinants of health to achieve the 'health for all' goal, these countries must focus on innovative teaching methods. The early introduction of a Community Orientation Program (COP) as a Community-based Medical Education (CBME) method could be a game changing strategy. In this paper the methods, evaluation, and implication of the COP in an Indian setting are described.

METHODS

The curriculum of the COP was developed based on the analysis, design, development, implementation, and evaluation (ADDIE) model for educational intervention. In this learner-centric and supervised educational program, the key aim was to focus on developing students' communication skills, observation power and enhancing their motivation for learning through collaborative learning. To meet the objectives of the COP, a situated learning model under the constructivism theory was adopted.

RESULTS

Between 2016 and 2019, 557 students were trained through the COP by visiting more than 1300 households in ten villages. To supplement the students' observations in the community, more than 150 small group discussions, a health education programme for the community and summary presentations were conducted. The students' feedback indicated the need to improve the clinical examinations demonstration quality and increase the number of instruments for clinical examinations. More than 80% of students felt that the program would assist them to improve their communication skills, their understanding of the various socio-demographic factors associated with the common diseases, and it will enable them to respect the local culture during their clinical practice.

CONCLUSIONS

Early initiation of the COP as a CBME method in the undergraduate medical curriculum in an Indian setting has shown promising results. Further evidence is required to adopt such a program routinely for under-graduate medical teaching in the low- and middle- income settings.

A descriptive cross-sectional study on COVID-19 knowledge, attitude, and practices of South Indian population

BACKGROUND

The 2019-novel coronavirus (2019-nCoV) started as an epidemic later transformed into a pandemic causing a threat to public health globally. Any community to fight the COVID-19 pandemic requires adequate knowledge, attitude of the people, and practice of the government-imposed laws and regulations. Based on these factors, we framed the objectives to find the sociodemographic profile of the study group and to assess their knowledge, attitude, and practice (KAP) toward COVID-19. These results will help the health planners and administrators in each state to find out the gap in health education efforts.

MATERIALS AND METHODS

A descriptive, cross-sectional study was conducted on South Indian population to know KAP toward COVID-19. A convenient sampling technique was used to collect the data using Google forms, and analysis was done using the SPSS software version 21. The questionnaire includes sociodemographic information, KAP questions toward COVID-19, and perception toward national and community responses.

RESULTS

A total of 1644 were participated; the average knowledge score was 17.5 (+1.9). Most of them (92.9%) respondent's perceived that early detection will have a better outcome from COVID-19, whereas the knowledge compared with practice, there is a significant difference Pearson correlation (0.404) P is < 0.001.

CONCLUSIONS

Although a high level of knowledge on COVID-19 in the public gradually decreasing the practice of preventive measures, the government should continue the consistent efforts to change the behavioral communication and motivate the public social responsibility to adhere to the health protocols, masking, hand hygiene, social distancing, and vaccination to prevent expected COVID-19 subsequent episodes.

COVID-19 Vaccine Acceptance: Beliefs and Barriers Associated with Vaccination Among the Residents of KSA

INTRODUCTION

COVID-19 was declared a pandemic in March 2020 by the World Health Organization. Control of COVID-19 depends on the potential vaccine and its successful delivery to a large portion of the population to develop herd immunity. All the governments have made a robust plan to distribute the vaccine to their people, but many countries could not achieve adequate vaccination coverage. Hence, this study explores people's beliefs and barriers to vaccination and provides valuable inputs to the government to attain adequate vaccination.

OBJECTIVE

To know the knowledge level about the COVID-19 vaccine among the residents of KSA. To find out the various concerns (beliefs) about COVID-19 and its vaccine among the residents of KSA. To estimate the vaccine acceptance and understand the barriers to accepting the COVID-19 vaccine among residents of KSA.

MATERIALS AND METHODS

A web-based, cross-sectional study was conducted from April to June 2021 in a restricted environment on the adult (>18 years) residents of Saudi Arabia. The minimum calculated sample was 685; 796 study samples were finally studied to minimize the sampling error. Snowball sampling was used to select the study samples, after meeting the inclusion criteria.

RESULTS

A total of 796 people responded. Only 782 (98.2%) were finally considered after excluding the incomplete information forms. The selected participant's age ranges from 18 years to 80 years. Almost 723 (92%) of the study group knew COVID vaccines. Most of the participants, 370 (47%), preferred USA-manufactured vaccine followed by Saudi Arabia 217 (28%). A total of 259 (33.1%) participants were hesitant to receive the vaccine. Out of 782, half of the participants, 386 (50%), believed the COVID vaccine will prevent the infection.

CONCLUSION

The government must implement appropriate culturally accepted interventional vaccination educational campaigns to remove the beliefs, worries regarding the safety and efficacy of COVID-19 vaccines, to increase vaccine acceptance rates.

Utilization of Janani Shishu Suraksha Karyakram and estimation of out of pocket expenditure: A prospective follow-up study among mothers and newborns in Chittoor

Introduction:

Janani Sishu Suraksha Karyakram (JSSK) is a flagship program of India to reduce out of pocket expenditure (OOPE) of the families during childbirth and neonatal sicknesses.

Objectives:

To assess the utilization of JSSK while availing services for childbirth and newborn care in a secondary care hospital in Southern India; estimate the OOPE in services covered by JSSK and identify the associated factors with OOPE.

Methods:

228 mothers who delivered in the previous 2 days, were recruited from a secondary-level government hospital in Chittoor. Expenditure incurred under various components of JSSK was asked during the recruitment and subsequently through telephonic interviews.

Results:

All components of JJSK, except transport, were fully utilized by the families. 138 mothers (60.5%, 95% CI: 54.0, 67.0), and all sick children (n = 138, 100%) who visited government hospital, incurred OOPE in the form of transport cost. The median expenditure of transport (from home to hospital and hospital to home) of the mothers was 250 INR (IQR: 100-513 INR). Transport expenditure was greater for the rural families (300 INR) than the urban families (100 INR) (p < 0.05). In multiple logistic regression, nuclear families were associated with high OOPE (AOR- 2.0, 95% CI: 1.1- 3.7). Though education of the mother showed high association (AOR- 2.7, 95% CI: 1.0- 7.8), it was not statistically significant (p = 0.05).

Conclusion:

The families utilize most of the components of JSSK, except transport. Family-centric counselling of the beneficiaries during antenatal check-ups and home visits by the healthcare workers can reduce transport-related OOPE.