Open Access Review Article

Parenting Intervention Method in Improving Parenting Skills as a Reference in Reproductive Health Education in Families

Eti Rimawati, Slamet Isworo

Asian Journal of Medicine and Health, Page 40-61
DOI: 10.9734/ajmah/2020/v18i930236

Background and Objectives: The problem of reproductive health is not limited to adolescents, but it has shifted to early childhood. Parenting skill has an important role in shaping risky sexual behaviours. Some programs in improving communication and parenting self-efficacy are not effective enough to change those risky behaviours in children and adolescents. This study aims to describe the methods of an educational parenting intervention to improve parenting skills as a reference in reproductive health education in the family.

Methodology: The review process did not strictly follow the flow of the systematic review. The data have manually selected through some stages including selection, search, extraction, and analysis. The keyword in data search is a combination of parenting intervention (mother and father), sex education, reproductive health, and community-based programs.

Results: In improving parenting skills some methods used including special education and training programs for parents like optimizing the use of internet, photo voice, games, focused group discussion (FGD), and observation.

Conclusions: Structured programs of two-to-three-hour sessions found to be very effective.

Open Access Original Research Article

Perceived Constraints to Effective Clinical Assessment of Nursing Students Competencies among Nursing Students and Educators in Southwest Nigeria

Edith Chinonyelum Ike, Omotola Margaret Oseni, Detu Adesuwa Onwochei, Njideka Judith Esievo

Asian Journal of Medicine and Health, Page 1-13
DOI: 10.9734/ajmah/2020/v18i930231

Aim: This study investigated the perception of nursing students and educators on the constraints to effective clinical assessment of nursing students’ competencies and probed possible solutions to the identified constraints in Lagos, southwest Nigeria.

Methods: In this cross sectional study, 175 nursing students, and 49 nurse educators from five randomly selected nursing schools participated. The study adopted a triangulation approach of quantitative and qualitative method for data collection and analysis. A self-administered questionnaire was utilized to collect quantitative data from the nursing students and nurse educators and a response return rate of 163(93%) and 46(94%) were recorded respectively from both groups. Focus Group Discussion (FGD) was employed for qualitative data among 12 nursing students and 11 nurse educators in two nursing schools. Data was analyzed and relative importance index (RII) and its ranking (R) was utilized to establish the relative importance of the various constraints identified as responsible for effective clinical assessment of competencies.

Results: The result revealed as major constraints from the students; lack of confidence by the students in carrying out procedures in clinical setting and lack of materials and instruments for clinical practice with equal ranking (RII=0.78; R=1.5), similarly, the educators rated; Lack of confidence by the students in carrying out procedures in clinical setting (RII=0.74; R=1.0) as a key constraint. The Mann Whitney U test showed no statistical significant differences to the perception of the constraining factors and probable solutions by both groups (p>0.05)

FGD revealed; lack of clear objectives for each clinical posting, as both students and clinical assessors do not have clear idea of what competencies they are to acquire and assess as a major constraint.

Conclusion: The researchers recommend that clinical placement objectives should be set and communicated to the students, educators and assessors to direct nursing students’ clinical practice and evaluation and assessment formats developed in line with specific skills to be evaluated.

Open Access Original Research Article

Retracted: SARS-CoV-2 was Unexpectedly....

Willard Oodendijk, Michaël Rochoy, Valentin Ruggeri, Florian Cova, Didier Lembrouille, Sylvano Trottinetta, Otter F. Hantome, Nemo Macron, Manis Javanica

Asian Journal of Medicine and Health, Page 14-21

This article was retracted after reporting of serious scientific fraud.

Open Access Original Research Article

Effect of Vitamin C Supplementation on Serum Ascorbic Acid Level and Liver Function Profile in Healthy Individuals

Iffat Nayila

Asian Journal of Medicine and Health, Page 28-39
DOI: 10.9734/ajmah/2020/v18i930235

This study was conducted to explore the effects of ascorbic acid supplementation on serum liver function tests in healthy individuals. A total of 200 subjects were selected randomly. 100 were given ascorbic acid supplementation for 30 days. The other 100 were not given ascorbic acid supplementation, and serum ascorbic acid level and liver function profile was observed before and after intake of ascorbic acid in group A and without intake in group B. The liver function parameters determined were aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), serum total bilirubin, direct bilirubin, indirect bilirubin and serum protein (total protein, albumin and globulin). These parameters along with serum ascorbic acid were measured before and 30 days after vitamin C supplementation. Various parameters of liver function profile were improved swiftly when compared to other group which was not given ascorbic acid supplementation. While comparing the two treatment groups for 30 days, statistically significant improvement was seen in serum ascorbic acid levels (p<0.001) along with improvement in some components of liver function profile such as serum ALT (p<0.01), AST (p<0.01), Total Bilirubin (p<0.01) and Direct bilirubin (p<0.001), Total Proteins (p<0.01) and Albumin (p<0.001) in group A as compared to Group B (without vitamin C supplementation intake). Conclusively, Liver Functions were significantly improved with vitamin C supplementation, giving the supportive evidence of the use of vitamin C as an antioxidant.

Open Access Original Research Article

The Diagnostic Efficacy of MRI Dedicated-Epilepsy Protocol in Evaluation of Seizures

Rawa Saad, Fawaz Baddour, Hala Saeed

Asian Journal of Medicine and Health, Page 62-71
DOI: 10.9734/ajmah/2020/v18i930237

Aims: The aims of this study were to identify the diagnostic efficacy of dedicated epilepsy protocol in detecting possible structural abnormalities that underlie seizure disorders, and compare the diagnostic yields of MRI and electroencephalogram individually and in combination.

Study Design: This was a cross-sectional analytic study.

Place and Duration of Study: Medical Imaging and Diagnostic Radiology Department at Tishreen University Hospital, Lattakia, Syria; between July 2019 and July 2020.

Methodology: Our study included 100 cases (58 females, 41 males, age range 13-77 years) who presented with seizure over 18 months. Patients underwent complete neurological examination, EEG, and MRI with a standard and dedicated epilepsy protocol.

Results: We found epileptogenic lesions in MRI in 55.5%. MRI detected epileptogenic lesions in 74.5% patients who had focal onset seizures. Mesial temporal lobe sclerosis was the most common epileptogenic lesion (45.5%). The diagnostic efficacy of MRI had increased with dedicated epilepsy protocol compared to standard protocol. Abnormal MRI and EEG were compatible in 21%.

Conclusion: Dedicated epilepsy protocol increased the diagnostic efficacy of brain MRI in detecting a structural epileptogenic lesion, with 100% of mesial temporal sclerosis, the most common lesion in our study, was detected only in dedicated epilepsy protocol and missed in standard protocol.

Open Access Original Research Article

Prevalence and Pattern of Birth Defects among Pediatric Surgical Patients: A 12-Year Analysis in a Tertiary-level Government Hospital in Bangladesh

Tanvir Kabir Chowdhury, S. M. Humayun Kabir, Md. Afruzul Alam, Md. Tameem Shafayat Chowdhury, Rumana Khan, Tanzil Farhad, Md. Abdullah Al Farooq

Asian Journal of Medicine and Health, Page 84-93
DOI: 10.9734/ajmah/2020/v18i930239

Aims: Birth defects are structural or functional abnormalities which occur during the intrauterine life but can be identified at birth or a later age. Birth defects are major public health concerns and the World Health organization (WHO) is supporting countries for earlier diagnosis and better treatment of these conditions. The aim of the study was to assess the hospital-based prevalence and types of birth defects among the surgical children from a part of the world where these are underreported.

Materials and Methods: We retrospectively analyzed patients of birth defects admitted in the Department of Pediatric Surgery, Chattogram Medical College Hospital, Bangladesh for a period of 12 years (2008-2019). Data were extracted from annual admission reports, annual audits, mortality and morbidity audits, death registers and computerize data base. Yearly distribution of birth defects, type of defects and their systemic distribution and mortality were analyzed.

Results: Among a total of 30,301 admitted patients 30.72% (9307 patients) had birth defects. The most common system involved with birth defects was gastrointestinal (GI) system, 30.61% followed by genitourinary (GU), 29.15% system. Congenital inguinal hernia (17.50%) was the most common disease, followed by hypospadias (14.54%) and anorectal malformation (ARM); 13.98%. Mortality from birth defects were 53.25% of all mortalities. ARM was the most common cause of death (23%), followed by gastroschisis (16%) and intestinal atresia (11%). Highest mortality rates were in tracheo-esophageal fistula/esophageal atresia (TEF/EA)- 83.33%, gastroschisis-80.92%; intestinal atresia-42.53%; omphalocele-32.48%; and congenital diaphragmatic hernia (CDH)- 27.78%.

Conclusion: Pattern of birth defects and outcome varied from other countries. The prevalence is 31% among pediatric surgical admissions. Some conditions have extremely high mortality rates and need better management.

Open Access Original Research Article

Evaluation of the Effects of Pediococcus acidilactici Isolated from Wara, a Nigerian Milk Product, in the Prevention of Diarrhea and the Modulation of Intestinal Microflora in Wistar Rats

Temidayo Emmanuel Olajugbagbe, Samson Oludare Ayodeji Odukoya, Bridget Okiemute Omafuvbe

Asian Journal of Medicine and Health, Page 94-106
DOI: 10.9734/ajmah/2020/v18i930240

Animals have been used in the evaluation of probiotic potentials of lactic acid bacteria for the development of functional food as only in-vitro tests may not be enough to ascertain the probiotic ability of an organism and its safety in a living host. The action of a probiotic Pediococcus acidilactici strain isolated from Wara, a Nigerian milk product, in the treatment of Diarrhea in wistar rats infected orally with Diarrhoeagenic Enterotoxigenic Escherichia coli as well as the survival and microflora modulation of the probiotic strain in the gastrointestinal tract were evaluated. Five groups of seven rats each were infected and treated as the case may be with the pathogen and probiotic respectively. Each group received specific treatments for 30 days, during which the animals were closely monitored and the faecal samples were analyzed for the trend of E. coli and LAB counts. Also, specific organs of the Gastrointestinal tract (GIT) were examined for any histomorphological disparity after 30 days of daily treatment. Clinical signs were observed in the pathogen challenged animals while the probiotic treated groups displayed less pronounced Diarrheal symptoms and a negligible E. coli count. The strain adhered to the mucosal wall and did not initiate any adverse effect on the organs of the GIT after treatment. It was concluded that Pediococcus acidilactici isolated from Wara, a Nigerian milk product, was able to improve gut health through pathogen exclusion and had no adverse effect on the general health of the host.

Open Access Original Research Article

Prevalence of Geohelminths among Primary School Children in Edoh Community, Esit Eket Local Government Area, Akwa Ibom State, Nigeria

M. N. Wogu, E. O. Onosakponome, U. A. Harry

Asian Journal of Medicine and Health, Page 123-127
DOI: 10.9734/ajmah/2020/v18i930243

Background: Geohelminths are responsible for some Neglected Tropical Diseases (NTDs) which have significant public health impacts in sub – Saharan Africa.

Aim: To evaluate the prevalence of geohelminths among primary school children.

Study Design: A cross – sectional randomized study.

Place and Duration of Study: The study was carried out in Salvation Army Primary School, Esit Eket Local Government Area, Akwa Ibom State, Nigeria. The study was conducted from June to December, 2018 (six months).

Materials and Methods: Stool samples were collected from each study participant, examined macroscopically (to detect the presence of blood, mucous, consistency and colour) and microscopically (to detect the presence of Geohelminths) using sedimentation concentration technique.

Results: An overall Geohelminths prevalence of 58.0% was recorded in this study and only four species of Geohelminths were identified with varying prevalence; Ascarislumbricoides 35.7%, Hookworm 26.6%, Trichuristrichiura 4.2% and Strongyloidesstercoralis 2.8% (P =.05). Age groups 12–14 years and 3–5 years had the highest and least prevalence of 70.0% and 55.6% respectively while males and females had prevalence of 62.7% and 52.9% respectively.

Conclusion: Geohelminths still have significant public health effects in Nigeria; prompt interventions such as accurate diagnosis, mass chemotherapy, periodic health education and improved living conditions will effectively reduce the menace of geohelminths.

Open Access Original Research Article

Analysis of All-Cause Mortality Population of Insurance Applicants

Muhammad Ghafoor Ali

Asian Journal of Medicine and Health, Page 128-138
DOI: 10.9734/ajmah/2020/v18i930244

Background: The risk of all-cause mortality is assessed in the study from factors consisting of BMI, medical history, socioeconomic status etc where factors are available in the life insurance organization data and submitted at the time of registration and subsequently in the death claim papers which gives detail about the state of health and cause of death.

Methods: A retrograde study has been carried out of 300 deceased life insured (2005-2014) from the data of a life insurance organization in Pakistan about all-cause mortality from the available factors in death claim files. The research instruments were consisting of death claim register, proposal forms, medical reports and death claim papers.

Results: The results indicate maximum deaths found due to Cardiovascular causes (43.34%) followed by Cancer (9.00%) while minimum found in, Endocrine disorders(0.33%)followed by Respiration(0.67%). However significant causes of death occurred due to Accident, Liver, CNS, Multisystem involvement, Natural disaster and Un- natural. The correlation co-efficient found as ‘0.07’ for all-cause mortality indicating positive relationship between BMI and Life Expectancy.

Conclusion: Medical history plays an important but not a compulsory role in mortality. Since BMI (WHO) showed higher mortality with normal BMI whereas BMI (Asia) showed it at-risk value therefore WHO should make separate criteria of standard of BMI as being different for different ethnicities. In Insurance organization NT-proBNP and BMI of ethnic area be used to asses life expectancy in applicants. Necessary measures should be opted for implementation of “The Sendai Framework for Disaster Risk Reduction 2015-2030”.

Open Access Original Research Article

The Effects of Participating in Recreational Games on Health Markers and Reaction Time in Middle-aged Tribal Women

Manoj Kumar Murmu, Gopal Chandra Saha

Asian Journal of Medicine and Health, Page 139-146
DOI: 10.9734/ajmah/2020/v18i930245

Background: Taking part in recreational activities, especially outdoors, can greatly improve physical health. People, who take part in park activities such as walking, hiking, or skiing, schedule fewer office visits, maintain lower body fat percentages, and have lower blood pressure and cholesterol levels. Although recreational games was proven to be a useful physical activity to stimulate some health benefits, we do not know if there are significant benefits of recreational games played on a smaller area with fewer players in the middle-age population. Because exercise is known to increase blood flow and oxygen to the skeletal muscles and the brain, it was inferred that exercise would also affect an individual’s reaction time.

Aims: The present study aimed to investigate whether recreational games could improve health and reaction time of middle-aged tribal women after 16 weeks of training. To determine this, twenty subjects gave baseline blood pressure, heart rate, and simple reaction time measurements.

Methodology: Twenty healthy middle-aged tribal women aged 50–55 were randomized in a group to involve in recreational games training (n = 20; age: 52.4 ± 2.48 years). The participants performed 3 training sessions of 40 min per week.

Results: Results from a repeated measure ANOVA indicated a time interaction (pre training, mid training and post training) for Blood Pressure (Systolic), Blood Pressure (Diastolic), Resting Heart Rate and Reaction Time (Audio) in favor of the participants. The results concluded that Recreational games can be an effective training modality to stimulate a decrease in resting HR and reaction time with small improvements in systolic and diastolic Blood Pressure.

Conclusion: To participate in Recreational games only three times per week shows helpful health-related adaptations and decreased reaction time, means there was significant improvement in health markers and reaction time abilities, which may be an affirmative impact to the reduction of the risk of developing lifestyle diseases and is beneficial to people in their daily live.

Open Access Minireview Article

Dentistry during the COVID-19 Era: Safety Protocols and Considerations

Rola Habashneh, Anas Alibrahim, Tahani Abu Alteen, Leen Al-Jabary, Sawsen Al-Omari

Asian Journal of Medicine and Health, Page 107-118
DOI: 10.9734/ajmah/2020/v18i930241

Objective: The dental surgery, where healthcare personnel work in close proximity to patients and perform aerosol-generating-procedures, is classified as a high exposure risk environment. Dentists should have thorough knowledge about the correct protective measures during clinical practice to reduce transmission of disease. This narrative review proposes comprehensive evidence-based and content-specific guidelines on infection control and communication strategies to help workers in the dental setting mitigate the risks of COVID-19 until effective vaccines are available and to also enhance cross contamination measures generally.

Methods: A review of pertinent literature was carried out in PubMED and other global sites including: American Dental Association, Occupational Safety, Health Administration and British Dental Association, NHS England and Faculty of General Dental Practice, to determine and summarize the current recommendations and safety measures specific to the dental setting throughout the world.

Results: Safety measures are needed to control transmission of COVID-19 at the administrative, clinical and environmental levels. Clinic and appointments should be prepared and arranged in a way to maximize social distancing and minimize virus transmission. Preoperative measures should be taken to reduce the chance of viral exposure and transmission. Personal protective measures should be handled properly by clinical and non-clinical staff members. Engineering measures should also be employed, such as economic air purifiers and ventilation systems should also be considered if Coronavirus is proven to be airborne.

Conclusion: This outbreak should serve as a chance for healthcare authorities and providers to invest in precautionary additional cross contamination measures. These should become part of standard practice, as there are other transmissible diseases which place the dental practitioner at risk of infection.

Open Access Minireview Article

Misclassification of Asymptomatic Infections of COVID-19

Verner N. Orish, Duniesky Martinez Lopez

Asian Journal of Medicine and Health, Page 119-122
DOI: 10.9734/ajmah/2020/v18i930242

Introduction: Several cases of asymptomatic infections of COVID-19 being reported by several countries in this pandemic and with the recent conflicting information of asymptomatic transmission of COVID-19, it is important to look critically on the true nature of these reported asymptomatic infections. There is a possibility most of the reported asymptomatic infections of COVID-19 are not truly asymptomatic but are either presymptomatic, mild infections or infections in the post-symptomatic phase.

Results: These infections misclassified as asymptomatic infections can result in misleading findings in studies attempting to understand asymptomatic transmission of COVID-19.

Conclusion: It is therefore crucial that rigorous and detailed data be collected during contact tracing to accurately identify and classify asymptomatic infections COVID-19.

Open Access Short Communication

Depression, Anxiety and Stress among Nurses Working in a Tertiary Care Centre in Southern India

D. Mohan Kishore, N. K. Manjunath, Kashinath Metri, Natesh Babu, Basavaraj Angadi

Asian Journal of Medicine and Health, Page 147-152
DOI: 10.9734/ajmah/2020/v18i930246

Purpose: Nursing professionals have to meet huge expectations on one side and cope with the demanding situations on the other side. The purpose of the present study was to evaluate the prevalence of depression, anxiety, and stress among nurses working at a tertiary care centre in South India.

Design: Cross-sectional survey design.

Methods: 387 female nursing professionals aged 20-50 years, working at a tertiary care centre for a minimum of two years, voluntarily participated in the study. Individuals with a history of psychiatric illness, major health problems, or those on sleep medication were excluded. Anxiety, depression, and stress levels were assessed by administering the DASS 21 questionnaire. Descriptive statistics and percentages were calculated using Microsoft Excel.

Findings: The results showed prevalence of: Anxiety (63.3%); depression (56.05%); and stress (36.17%) in those who participated in the survey. Anxiety was highest, followed by depression, and lastly, stress.

Conclusions: Work-related anxiety is the commonest mental health issue reported by professional nurses, followed by depression and stress. Yoga-based intervention would be efficacious if implemented within hospitals both to prevent and manage mental health problems associated with the nursing profession.

Open Access Opinion Article

Recognising Fetal Compromise in the Cardiograph during the Antenatal Period: Pearls and Pitfalls

Susana Pereira, Caron Ingram, Neerja Gupta, Mandeep Singh, Edwin Chandraharan

Asian Journal of Medicine and Health, Page 72-83
DOI: 10.9734/ajmah/2020/v18i930238

There are several national and international guidelines to aid the interpretation of the cardiotocograph (CTG) trace during labour. These guidelines are based on assessing changes in the fetal heart rate (i.e. cardiograph) in response to mechanical and hypoxic stresses during labour secondary to ongoing frequency, duration and strength of uterine contractions (i.e. tocograph). However, during the antenatal period, uterine contractions are absent, and therefore, these intrapartum CTG guidelines cannot be used to reliably identify fetuses at risk of compromise. Computerised analysis of CTG using the Dawes-Redman Criteria could be used to detect fetal compromise. However, clinicians should be aware of the multiple pathways of fetal damage (i.e. inflammation, infection, intrauterine fetal stroke, chronic fetal anaemia, acute feto-maternal haemorrhage and fetal cardiac or neurological disorders) which can cause changes on the CTG trace which may not be recognised by using CTG guidelines.

Open Access Systematic Review Article

The Role of Sensor Based Insole as a Rehabilitation Tool in Improving Walking among the Patients with Lower Limb Arthroplasty: A Protocol for Systematic Review

Sumit Raghav, Anshika Singh, Suresh Mani, Gokulakannan Kandasamy, Amber Anand

Asian Journal of Medicine and Health, Page 22-27
DOI: 10.9734/ajmah/2020/v18i930233

Objectives: The purpose of this review protocol is to assess the role of sensor based insole in improving walking in patients with lower limb arthroplasty and to rule out the demand and advantage of sensor based insole in utilizing such types of problems at clinical setup.

Methodology: A systematic review will be conducted by two independent reviewers who will search articles using electronic search for publications in seven databases: Google Scholar, Index Copernicus, JSTOR, PubMed/Medline, Science Direct, Scopus and Web of Science. After applying the selection criteria, study papers published between the years 2001 to 2019 will be selected. Studies of human participants of 45-75 years of age having history of lower limb arthroplasty will be eligible. All the study papers will be analyzed using Modified Downs and Black scale and scores will be awarded for the items selected on a 27 point scale.

Findings: The findings of this review will be disseminated through presentations and peer-reviewed publication. The systematic review will direct the attention of the physiotherapists to assess and evaluate the patient’s walking pattern, as alterations in the biomechanics of joints of lower limb can produce far-reaching effects in the ideal or normal gait. The results of this review will provide evidence regarding changes in gait parameters in patients with lower limb arthroplasty and this information will be useful in planning for rehabilitation in improving walking of patients after lower limb arthroplasty.

Novelty: Many studies have been carried on sensor insole technology for monitoring gait. However, there is scarcity of literature based on the systematic reviews on the use of smart sensor insole in improving walking among patients with lower limb arthroplasty.