The COVID-19 pandemic and mental health outcomes - A cross-sectional study among health care workers in Coastal South India

Background: Frontline health care workers (HCWs) are at increased risk of developing unfavourable mental health outcomes and burnout, especially during the COVID-19 pandemic. Recognizing the early warning signs of mental distress is very important to ensure the provision of quality patient care. Methods: In this facility-based cross-sectional study, HCWs of the teaching hospitals affiliated to Kasturba Medical College, Mangalore were assessed regarding their mental health status using a semi-structured questionnaire. All doctors and nurses who were willing to participate from these teaching hospitals were included in the study. Data was collected over a period of four months (1 st March -30 th June 2021) till the required sample size was reached and analysed using IBM SPSS and expressed using mean (standard deviation), median (interquartile range), and proportions. Univariate analysis was done to identify the factors associated with mental health outcomes among the HCWs and the corresponding unadjusted odds ratio and 95% confidence interval were reported. Results: A total of 245 HCWs [52.2% (n=128) doctors and 47.8% (n=117) nurses] were included in our study. The proportion of participants with depressive symptoms, anxiety, and insomnia assessed using PHQ-9, GAD-7, and ISI-7 scales were 49% (n=119), 38% (n=93), and 42% (n=102) respectively. Depression, anxiety, and insomnia were more likely to be experienced by HCWs aged > 27 years, females, and involved in COVID-19 patient care. (p>0.05) Conclusions:  Our findings that 38% of the examined HCWs had clinically relevant anxiety symptoms and 49% had clinically relevant depression symptoms draws attention to the importance of systematically tracking the mental health of HCWs during this ongoing pandemic. HCWs should monitor their stress reactions and seek appropriate help both on a personal and professional level. Appropriate workplace interventions including psychological support should be provided to HCWs, to ensure provision of uncompromised quality patient care.

Risk Assessment for Diabetes Mellitus by Using Indian Diabetes Risk Score Among Office Workers of Health Institutions of South India

BACKGROUND

Diabetes mellitus (DM) is one of the non-communicable diseases plaguing the world and contributes a major part to the total disease burden. Diabetes has been prevalent in all countries throughout the years, with the majority of diabetics living in low- and middle-income countries. Madras Diabetes Research Foundation developed the Indian Diabetes Risk Score (IDRS), a simple and cost-effective method to assess the chances of developing diabetes.

OBJECTIVES

To assess the diabetes risk profile of office workers using IDRS and to determine the proportion of individual risk factors of diabetes among the participants.

METHODS

This cross sectional study included 94 non-diabetic office workers working in two health care institutions situated in coastal South India. Data was collected by a study questionnaire consisting of three sections. Section A included details related to participant characteristics, Section B included anthropometric measurements, and Section C consisted of the Indian Diabetes Risk Score. The collected data were coded and entered into Statistical Package for Social Sciences.

RESULTS

The mean age of the study participants was 40.88 (±9.761) years, and the mean BMI was 23.8 (±3.6) kg/m2. Majority (n=65, 67%) of the study participants did not have a family history of diabetes. One-third of the study participants had IDRS ≥ 60, which allocated them in the high risk category for type 2 diabetes (n=34, 35.1%).

CONCLUSION

It has been conclusively shown from the study that most of the office workers have moderate to high risk of developing diabetes and are also overweight or obese.

Quality of Life and Self-care Behavior Among People Living with Diabetes- A Study from Coastal South India

BACKGROUND

Diabetes mellitus is a serious chronic condition affecting millions of people globally. The focus of our future health care providers should not lie primarily on increasing the "quantity" of life but also on improving the Quality of Life of the patient. There is a serious lack of awareness and adherence regarding self-care for Diabetes in countries like India.

OBJECTIVES

To determine the Quality of Life and self-care behavior among people living with Diabetes.

METHODS

A cross-sectional study was carried out among 190 of all patients diagnosed with Diabetes mellitus type II of the duration of one year and more who came to Government Wenlock Hospital, Mangalore. The Quality of Life was assessed using the WHO BREF questionnaire. Data was entered and analyzed using the Statistical Package for Social Sciences.

RESULTS

Amongst 190 participants, 151 (79.5%) of them had a good physical and psychological QOL. In a social relationship and environmental health domain, good quality of life was observed among 81.6% (n=155) and 89.5% (n=170) of study participants, respectively. It was noted that out of 190 people with Diabetes, only 24 (12.6%) participants inspected their feet daily.

CONCLUSION

The Quality of Life was found to be good amongst the majority of the study participants. Results of the study point that the majority of the patients enjoy a good quality of life but also reinstate the importance of self-care activities for the betterment of health.

Effect of Biohythane Production from Distillery Spent Wash with Addition of Landfill Leachate and Sewage Wastewater

Rapid development of the industrial and domestic sectors has led to the rise of several energy and environmental issues. In accordance with sustainable development and waste minimization issues, biohydrogen production along with biomethane production via two-stage fermentation process using microorganisms from renewable sources has received considerable attention. In the present study, biohythane production with simultaneous wastewater treatment was studied in a two-stage (Biohydrogen and Biomethane) fermentation process under anaerobic conditions. Optimization of high organic content (COD) distillery spent wash effluent (DSPW) with dilution using sewage wastewater was carried out. Addition of leachate as a nutrient source was also studied for effective biohythane production. The experimental results showed that the maximum biohythane production at optimized concentration (substrate concentration of 60 g/L with 30% of leachate as a nutrient source) was 67 mmol/L bio-H₂ and with bio-CH₄ production of 42 mmol/L. Graphical Abstract.

Distress and Its Effect on Adherence to Antidiabetic Medications Among Type 2 Diabetes Patients in Coastal South India

Background:

Distress can bring about an unfavorable attitude among the patients toward tackling their disease which can affect adherence to medications. The purpose of this study was to assess the effect of distress on adherence to medication among patients with diabetes.

Methodology:

In this cross-sectional study, 124 type 2 diabetes patients above 18 years, attending the hospitals affiliated to Kasturba Medical College, Mangalore, selected using nonprobability sampling were interviewed to assess the presence of diabetes-related distress (DRD) and their level of adherence to medications. Distress was assessed using diabetes distress scale. Morisky Adherence Questionnaire was used to assess the level of adherence. Approval was obtained from the Institutional Ethics Committee. Multivariate logistic regression was conducted to assess the influence of domains of distress on adherence to antidiabetic medication and P < 0.05 was considered statistically significant.

Results:

In our study, 41.9% (n = 52) of the participants had high diabetes distress. Exactly 43.5% (n = 54) of the participants had low adherence to antidiabetic medications. On univariate analysis, participants with low regimen distress, low physician distress, and low interpersonal distress were found to have good adherence to antidiabetic medication. However, on multivariate analysis, only low regimen distress was found to be significantly associated with good adherence to medication among the study participants.

Conclusion:

DRD is a problem in our study participants which affects the adherence to medications. Identifying distress at an early stage can help doctors formulate and implement remedial measures, thereby improving adherence to medications.

Preparation and characterization of green bricks using pharmaceutical industrial wastes

This paper reports on recycling of industrial wastes (three pharmaceutical industrial sludges) into environmental friendly value-added materials. Stabilization/Solidification (S/S or bricks) process was applied to make a safer way for the utilization of pharmaceutical waste. The additives in this study include binders (cement, lime and bentonite) and strengthening material (pulverized fuel ash (PFA), silica fume and quarry dust) was used at different compositions. Bricks were cured for 28 days, and the following analysis-like compressive strength, leachability of heavy metals, mineralogical phase identity by X-ray diffraction (XRD) spectroscopy, Fourier transform infrared spectroscopy (FTIR) and thermal behaviour by thermogravimetric-differential thermal analysis (TG-DTA) had done. All the bricks were observed to achieve the standard compressive strength as required for construction according to BIS standards. Metal concentration in the leachate has reached the dischargeable limits according to Brazilian standards. Results of this study demonstrate that production of bricks is a promising and achievable productive use of pharmaceutical sludge.

Stigmatization and Discrimination toward People Living with HIV/AIDS in a Coastal City of South India

BACKGROUND

The HIV/AIDS scenario all over the world is complicated by the stigmatic and discriminative attitudes toward the HIV-infected individuals.

METHODOLOGY

In this facility-based, cross-sectional study, 104 HIV-positive patients were assessed regarding their personal experience with HIV-related stigma and discrimination using a Revised HIV Stigma Scale. The association between stigma and factors such as socioeconomic status and gender was tested using chi-square test, and P < .05 was considered statistically significant.

RESULTS

A large proportion (41.3%) of the participants were in the age-group of 26 to 35 years. Confidentiality of the HIV positivity status was maintained only in 14.4% of the participants. Compared to females (48.2%), more than half (51.5%) of the male participants had experienced HIV/AIDS-related personalized stigma ( P > .05).

CONCLUSION

HIV-related stigma and discrimination are the major social determinants driving the epidemic, despite the advances in medical treatment and increases in the awareness about the disease.

Effect of operational parameters on heavy metal removal by electrocoagulation

In the present paper, the performance of electrocoagulation (EC) for the treatability of mixed metals (chromium (Cr), copper (Cu), lead (Pb), nickel (Ni), and zinc (Zn)) from metal plating industrial wastewater (EPW) has been investigated. The study mainly focused on the affecting parameters of EC process, such as electrode material, initial pH, distance between electrodes, electrode size, and applied voltage. The pH 8 is observed to be the best for metal removal. Fe-Fe electrode pair with 1-cm inter-electrode distance and electrode surface area of 40 cm(2) at an applied voltage of 8 V is observed to more efficient in the metal removal. Experiments have shown that the maximum removal percentage of the metals like Cr, Ni, Zn, Cu, and Pb are reported to be 96.2, 96.4, 99.9, 98, and 99.5 %, respectively, at a reaction time of 30 min. Under optimum conditions, the energy consumption is observed to be 51.40 kWh/m(3). The method is observed to be very effective in the removal of metals from electroplating effluent.