Search results for: prevalence on smoking
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1997

Search results for: prevalence on smoking

1067 Validity of Simlified Javal’s Rule in 147 Pre-Operation Cataract Eyes

Authors: Mohammad Ghandehari Motlagh

Abstract:

Purpose: To evaluate validity of simplified Javal’s rule (Total Ast=Corneal Ast-0.50@9) in 147 pre-op cataract eyes. Methods: Due to change in lens tissue and structure in a cataract crystalline lens, we conceive the simplified javal’s rule may not be valid in cataract cases.In this cross-sectional study,147 pre-op cataract eyes without oblique astigmatism were enrolled in this study. Ocular biometry (with IOL master 500)and keratometry and refraction findings were recorded. Results: Mean age of our patients was 64.95 yrs/old (SD+_9.86) that confirms on senile cataract. Mean Axial length and average keratometry were respectively 23.86 and 44.62.Prevalence of systemic diseases diabet and high blood pressure were respectively 43 (29.25%) and 44 (29.93%)and shows importance of these diseases. The Corneal astigmatism axis is correlated with refractive astigmatism in cataract eyes (R=0.493). Simplified Javal’s rule is valid in cataract eyes (P<0.001). Conclusion: Simplified Javal’s rule is a valid formula in pre-op cataract eyes and can be used for keratometry results confirmation.

Keywords: javals rule, cataract, keratometry, ocular axial length

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1066 Assessing Musculoskeletal Disorder Prevalence and Heat-Related Symptoms: A Cross-sectional Comparison in Indian Farmers

Authors: Makkhan Lal Meena, R. C. Bairwa, G. S. Dangayach, Rahul Jain

Abstract:

The current study looked at the frequency of chronic illness conditions, accidents, health complaints, and ergonomic issues among 100 conventional and 100 greenhouse farmers. Data related to the health symptoms and ergonomic problems were collected through questionnaires by conducting direct interviews of farmers. According to the findings, symptoms of heat exposure (skin rashes, headache, dizziness, and lack of appetite) were substantially higher among conventional farmers than greenhouse farmers. The greenhouse farmers reported much more pain, numbness, or weakness in wrists/hands, fingers, upper back, hips, and ankles/feet than conventional farmers. The findings of the study suggest that suitable ergonomic knowledge and awareness campaign programs concentrating on safety at work, particularly low back pain, should be implemented in workplaces to allow for earlier detection of symptoms among the greenhouse farmers.

Keywords: accident, conventional farmer, ergonomics, health symptoms, greenhouse farmers, pesticide

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1065 Relation between Tourism and Health: Case Study AIDS in Lebanon

Authors: Viana Hassan

Abstract:

Each year, 600 million tourists travelled abroad to practice several types of tourism. Nowadays, whatever is the type of tourism practiced it considered as a real public health problem which can contribute the spread of several diseases such as AIDS, H1N1, NDM1 With regard to HIV/AIDS, Lebanon is always considered as a low HIV prevalence country. However, the potential risks associated with the mobility of the population, migration and tourism. The total number of cases reported by the ministry of health since 1989 until the end of 2011 is of 1455 cases, with an average of 85 new cases per year over the last three years. The main reason of the increased number is Travel and migration which represent 50% of the risks reported by cumulative cases. Given the interest of this kind of epidemic it would be interesting to study the Evolution of HIV/ AIDS and its relation with travel and tourism The main aim of this research is to study in general the relation between tourism and health, more specific to understand the relation between Tourism and AIDS, the problem of the transmission of HIV in Lebanon, the ways of contamination and the countries in which these people are contaminated.

Keywords: AIDS, tourism, health, Lebanon

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1064 Advances in the Design of Wireless Sensor Networks for Environmental Monitoring

Authors: Shathya Duobiene, Gediminas Račiukaitis

Abstract:

Wireless Sensor Networks (WSNs) are an emerging technology that opens up a new field of research. The significant advance in WSN leads to an increasing prevalence of various monitoring applications and real-time assistance in labs and factories. Selective surface activation induced by laser (SSAIL) is a promising technology that adapts to the WSN design freedom of shape, dimensions, and material. This article proposes and implements a WSN-based temperature and humidity monitoring system, and its deployed architectures made for the monitoring task are discussed. Experimental results of newly developed sensor nodes implemented in university campus laboratories are shown. Then, the simulation and the implementation results obtained through monitoring scenarios are displayed. At last, a convenient solution to keep the WSN alive and functional as long as possible is proposed. Unlike other existing models, on success, the node is self-powered and can utilise minimal power consumption for sensing and data transmission to the base station.

Keywords: IoT, network formation, sensor nodes, SSAIL technology

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1063 The Prevalence of X-Chromosome Aneuploidy in Recurrent Pregnancy Loss

Authors: Rim Frikha, Nouha Bouayed, Afifa Sellami, Nozha Chakroun, Salima Douad, Leila Keskes, Tarek Rebai

Abstract:

Recurrent pregnancy loss (RPL), classically defined as the occurrence of two or more failed pregnancies, is a serious reproductive problem, in which, chromosomal rearrangements in either carrier are a major cause; mainly the chromosome aneuploidy. This study was conducted to determine the frequency and contribution of X-chromosome aneuploidy in recurrent pregnancy loss. A retrospective study was carried out among 100 couples with more than 2 miscarriages, referred to our genetic counseling. In all the cases the detailed reproductive histories were taken. Chromosomal analysis was performed using RHG banding in peripheral blood. Of a total of 100 couples; 3 patients with a detected X-chromosome aneuploidy were identified with an overall frequency of 3%. Chromosome abnormalities are as below: a Turner syndrome with 45, X/46, XX mosaicism, a 47, XXX, and a Klinefelter syndrome with 46, XY/47, XXY. These data show a high incidence of X-chromosome aneuploidy; mainly with mosaicism; in RPL. Thus, couples with such chromosomal abnormality should be referred to a clinical geneticist with whom the option of pre-implantation genetic diagnosis in subsequent pregnancy should be discussed.

Keywords: aneuploidy, genetic testing, recurrent pregnancy loss, X-chromosome

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1062 Interpretation and Clustering Framework for Analyzing ECG Survey Data

Authors: Irum Matloob, Shoab Ahmad Khan, Fahim Arif

Abstract:

As Indo-Pak has been the victim of heart diseases since many decades. Many surveys showed that percentage of cardiac patients is increasing in Pakistan day by day, and special attention is needed to pay on this issue. The framework is proposed for performing detailed analysis of ECG survey data which is conducted for measuring prevalence of heart diseases statistics in Pakistan. The ECG survey data is evaluated or filtered by using automated Minnesota codes and only those ECGs are used for further analysis which is fulfilling the standardized conditions mentioned in the Minnesota codes. Then feature selection is performed by applying proposed algorithm based on discernibility matrix, for selecting relevant features from the database. Clustering is performed for exposing natural clusters from the ECG survey data by applying spectral clustering algorithm using fuzzy c means algorithm. The hidden patterns and interesting relationships which have been exposed after this analysis are useful for further detailed analysis and for many other multiple purposes.

Keywords: arrhythmias, centroids, ECG, clustering, discernibility matrix

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1061 Dietary Vitamin D Intake and the Bladder Cancer Risk: A Pooled Analysis of Prospective Cohort Studies

Authors: Iris W. A. Boot, Anke Wesselius, Maurice P. Zeegers

Abstract:

Diet may play an essential role in the aetiology of bladder cancer (BC). Vitamin D is involved in various biological functions which have the potential to prevent BC development. Besides, vitamin D also influences the uptake of calcium and phosphorus , thereby possibly indirectly influencing the risk of BC. The aim of the present study was to investigate the relation between vitamin D intake and BC risk. Individual dietary data were pooled from three cohort studies. Food item intake was converted to daily intakes of vitamin D, calcium and phosphorus. Pooled multivariate hazard ratios (HRs), with corresponding 95% confidence intervals (CIs) were obtained using Cox-regression models. Analyses were adjusted for gender, age and smoking status (Model 1), and additionally for the food groups fruit, vegetables and meat (Model 2). Dose–response relationships (Model 1) were examined using a nonparametric test for trend. In total, 2,871 cases and 522,364 non-cases were included in the analyses. The present study showed an overall increased BC risk for high dietary vitamin D intake (HR: 1.14, 95% CI: 1.03-1.26). A similar increase BC risk with high vitamin D intake was observed among women and for the non-muscle invasive BC subtype, (HR: 1.41, 95% CI: 1.15-1.72, HR: 1.13, 95% CI: 1.01-1.27, respectively). High calcium intake decreased the BC risk among women (HR: 0.81, 95% CI: 0.67-0.97). A combined inverse effect on BC risk was observed for low vitamin D intake and high calcium intake (HR: 0.67, 95% CI: 0.48-0.93), while a positive effect was observed for high vitamin D intake in combination with low, moderate and high phosphorus (HR: 1.31, 95% CI: 1.09-1.59, HR: 1.17, 95% CI: 1.01-1.36, HR: 1.16, 95% CI: 1.03-1.31, respectively). Combining all nutrients showed a decreased BC risk for low vitamin D intake, high calcium and moderate phosphor intake (HR: 0.37, 95% CI: 0.18-0.75), and an increased BC risk for moderate intake of all the nutrients (HR: 1.18, 95% CI: 1.02-1.38), for high vitamin D and low calcium and phosphor intake (HR: 1.28, 95% CI: 1.01-1.62), and for moderate vitamin D and calcium and high phosphorus intake (HR: 1.27, 95% CI: 1.01-1.59). No significant dose-response analyses were observed. The findings of this study show an increased BC risk for high dietary vitamin D intake and a decreased risk for high calcium intake. Besides, the study highlights the importance of examining the effect of a nutrient in combination with complementary nutrients for risk assessment. Future research should focus on nutrients in a wider context and in nutritional patterns.

Keywords: bladder cancer, nutritional oncology, pooled cohort analysis, vitamin D

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1060 Using Linear Logistic Regression to Evaluation the Patient and System Delay and Effective Factors in Mortality of Patients with Acute Myocardial Infarction

Authors: Firouz Amani, Adalat Hoseinian, Sajjad Hakimian

Abstract:

Background: The mortality due to Myocardial Infarction (MI) is often occur during the first hours after onset of symptom. So, for taking the necessary treatment and decreasing the mortality rate, timely visited of the hospital could be effective in this regard. The aim of this study was to investigate the impact of effective factors in mortality of MI patients by using Linear Logistic Regression. Materials and Methods: In this case-control study, all patients with Acute MI who referred to the Ardabil city hospital were studied. All of died patients were considered as the case group (n=27) and we select 27 matched patients without Acute MI as a control group. Data collected for all patients in two groups by a same checklist and then analyzed by SPSS version 24 software using statistical methods. We used the linear logistic regression model to determine the effective factors on mortality of MI patients. Results: The mean age of patients in case group was significantly higher than control group (75.1±11.7 vs. 63.1±11.6, p=0.001).The history of non-cardinal diseases in case group with 44.4% significantly higher than control group with 7.4% (p=0.002).The number of performed PCIs in case group with 40.7% significantly lower than control group with 74.1% (P=0.013). The time distance between hospital admission and performed PCI in case group with 110.9 min was significantly upper than control group with 56 min (P=0.001). The mean of delay time from Onset of symptom to hospital admission (patient delay) and the mean of delay time from hospital admissions to receive treatment (system delay) was similar between two groups. By using logistic regression model we revealed that history of non-cardinal diseases (OR=283) and the number of performed PCIs (OR=24.5) had significant impact on mortality of MI patients in compare to other factors. Conclusion: Results of this study showed that of all studied factors, the number of performed PCIs, history of non-cardinal illness and the interval between onset of symptoms and performed PCI have significant relation with morality of MI patients and other factors were not meaningful. So, doing more studies with a large sample and investigated other involved factors such as smoking, weather and etc. is recommended in future.

Keywords: acute MI, mortality, heart failure, arrhythmia

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1059 Awareness, Attitude and Perception of the Farmers towards Adaptation to Climate Change: A Case Study in Kedah Malaysia

Authors: Rafia Afroz

Abstract:

This article examines the perceptions, consciousness and attitudes of farmers on climate change in Kedah Malaysia. To reach the objectives of this study, a survey was conducted on 350 farmers and the collected data were used to perform multiple regression analysis. The results show that factors such as age, farm income, farm experience, limited agricultural prevalence, inadequacies in credit availability and farm size are factors influencing adjustment practices. Moreover, farmers have a positive attitude through adaptation strategies that are appropriate for climate change issues. However, the study found that various adaptation barriers prevented farmers from implementing climate change adjustment policies. At present, Malaysia does not seem to have a specific policy aimed at counteracting the impacts and productivity of climate change on individual sectors. For this reason, the findings of this study will help policymakers to comply with an appropriate policy framework that takes into account the best fit alignment strategies that can come across all relevant obstacles.

Keywords: climate change, adaptation, awareness, perception, attitude

Procedia PDF Downloads 246
1058 Analysis of ECGs Survey Data by Applying Clustering Algorithm

Authors: Irum Matloob, Shoab Ahmad Khan, Fahim Arif

Abstract:

As Indo-pak has been the victim of heart diseases since many decades. Many surveys showed that percentage of cardiac patients is increasing in Pakistan day by day, and special attention is needed to pay on this issue. The framework is proposed for performing detailed analysis of ECG survey data which is conducted for measuring the prevalence of heart diseases statistics in Pakistan. The ECG survey data is evaluated or filtered by using automated Minnesota codes and only those ECGs are used for further analysis which is fulfilling the standardized conditions mentioned in the Minnesota codes. Then feature selection is performed by applying proposed algorithm based on discernibility matrix, for selecting relevant features from the database. Clustering is performed for exposing natural clusters from the ECG survey data by applying spectral clustering algorithm using fuzzy c means algorithm. The hidden patterns and interesting relationships which have been exposed after this analysis are useful for further detailed analysis and for many other multiple purposes.

Keywords: arrhythmias, centroids, ECG, clustering, discernibility matrix

Procedia PDF Downloads 351
1057 The Effect of Intimate Partner Violence Prevention Program on Knowledge and Attitude of Victims

Authors: Marzieh Nojomi, Azadeh Mottaghi, Arghavan Haj-Sheykholeslami, Narjes Khalili, Arash Tehrani Banihashemi

Abstract:

Background and objectives: Domestic violence is a global problem with severe consequences throughout the life of the victims. Iran’s Ministry of Health has launched an intimate partner violence (IPV) prevention program, integrated in the primary health care services since 2016. The present study is a part of this national program’s evaluation. In this section, we aimed to examine spousal abuse victims’ knowledge and attitude towards domestic violence before and after receivingthese services. Methods: To assess the knowledge and attitudes of victims, a questionnaire designed by Ahmadzadand colleagues in 2013 was used. This questionnaire includes 15 questions regarding knowledge in the fields of definition, epidemiology, and effects on children, outcomes, and prevention of domestic violence. To assess the attitudes, this questionnaire has 10 questions regarding the attitudes toward the causes, effects, and legal or protective support services of domestic violence. To assess the satisfaction and the effect of the program on prevention or reduction of spousal violence episodes, two more questions were also added. Since domestic violence prevalence differs in different parts of the country, we chose nine areas with the highest, the lowest, and moderate prevalence of IPVfor the study. The link to final electronic version of the questionnaire was sent to the randomly selected public rural or urban health centers in the nine chosen areas. Since the study had to be completed in one month, we used newly identified victims as pre-intervention group and people who had at least received one related service from the program (like psychiatric consultation, education about safety measures, supporting organizations and etc.) during the previous year, as our post- intervention group. Results: A hundred and ninety-two newly identified IPV victims and 267 victims who had at least received one related program service during the previous year entered the study. All of the victims were female. Basic characteristics of the two groups, including age, education, occupation, addiction, spouses’ age, spouses’ addiction, duration of the current marriage, and number of children, were not statistically different. In knowledge questions, post- intervention group had statistically better scores in the fields of domestic violence outcomes and its effects on children; however, in the remaining areas, the scores of both groups were similar. The only significant difference in the attitude across the two groups was in the field of legal or protective support services. From the 267 women who had ever received a service from the program, 91.8% were satisfied with the services, and 74% reported a decrease in the number of violent episodes. Conclusion: National IPV prevention program integrated in the primary health care services in Iran is effective in improving the knowledge of victims about domestic violence outcomes and its effects on children. Improving the attitude and knowledge of domestic violence victims about its causes and preventive measures needs more effective interventions. This program can reduce the number of IPV episodes between the spouses, and satisfaction among the service users is high.

Keywords: intimate partner violence, assessment, health services, efficacy

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1056 Prevalence of Cryptosporidium spp. in Free-Living Wild Birds by Using Carbol Fuchsin Staining Methods in Konya, Turkey

Authors: Nermin Isik

Abstract:

Cryptosporidiosis is one of the most common parasitic infection in domesticated, caged, wild birds. Cryptosporidium sp. has been reported in over 30 avian species worldwide. Cryptosporidium meleagridis, Cryptosporidium baileyi and Cryptosporidium galli are recognised avian species of Cryptosporidium. This study was carried out to determine the prevalance of Cryptosporidium sp. in wild birds in Konya province, Turkey. Faecal samples were collected from 65 wild birds including 52 Podicipedidae (Podiceps cristatus), 11 Rallidae (Fulicia Atra), 2 Anitadia (Aytha ferina). Faecal samples were stained with Modified Ziehl-Neelsen staining technigue, they were examined under light microscope for the presence of Cryptosporidium sp. oocyts. Among the 65 faecal samples, 11 (16.9%) were found to be infected with Cryptosporidium sp. oocysts. The results of this study indicate that wild birds may play an important role in the epidemiology of Cryptosporidium. In conclusion, Cryptosporidiosis has suggested zoonotic potential and thus warrant further attention. In addition, biological and genetic studies are required to provide more information on Cryptosporidiosis.

Keywords: Cryptosporidium sp, wild birds, Konya, Turkey

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1055 Promoter Methylation of RASSF1A and MGMT Genes in Head and Neck Squamous Cell Carcinoma

Authors: Vitor Rafael Regiani, Carlos Henrique Viesi Do Nascimento Filho, Patricia Matos Biselli-Chicote, Claudia Aparecida Rainho, Luiz Sergio Raposo, José Victor Maniglia, Eny Maria Goloni-Bertollo, Erika Cristina Pavarino

Abstract:

Promoter hypermethylation of tumor-related genes has been associated with prognosis in early-stage head-and-neck cancers, providing strong evidence that these hypermethylated genes are valuable biomarkers for prognostic evaluation. Hence, we selected the MGMT and RASSF1A genes to examine the methylation status in head and neck squamous cell carcinomas (HNSCC) samples matched with non-tumor tissues (tumor-surrounding tissues or peripheral blood samples). DNA methylation analysis was based on Methylation-Sensitive High Resolution Melting, and the methylation status was correlated with clinic-pathological characteristics of the patients. RASSF1A and MGMT promoter methylation was detected in 43.24% (16/37) and in 44.44% (16/36) of the tumors, respectively. RASSF1A and MGMT methylation was significantly more frequent in tumor tissue than non-tumor tissues, as well as, simultaneous methylation of RASSF1A and MGMT also was higher in tumor tissue than non-tumor tissues. In relation to anatomic site, larynx cancer presented significant methylation of MGMT gene compared to tumor-surrounding tissue. The frequency of RASSF1A and MGMT promoter methylated was higher in tumor tissues in relation to peripheral blood from the same patient. No association was found between methylation and the variables analyzed, including gender, age, smoking or alcohol drinking habits. Clinic-pathological characteristics also showed no association in the presence of methylation. The Kaplan–Meier's method showed no association of methylation and both disease-free and overall survival. In conclusion, the presence of epigenetic abnormalities in normal-appearing tissue corroborates the hypothesis of the ‘field cancerization', or it can reflect preneoplastic and/or preinvasive. Moreover, MGMT methylation may serve as an important laryngeal cancer biomarker because it showed significant difference between laryngeal cancer and surrounding tumor tissues.

Keywords: head and neck cancer, DNA methylation, MGMT promoter methylation, RASSF1A promoter methylation

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1054 Unveiling the Mystery: Median Arcuate Ligament Syndrome in a Middle-Aged Female Presenting with Abdominal Pain

Authors: Thaer Khaleel Swaid, Maryam Al Ahmad, Ishtiaq Ahmad

Abstract:

47-year-old female, known to have a liver cyst and hemangiomas, presented to the gastroenterology clinic for chronic moderate postprandial epigastric pain, which is aggravated by food, leaning forward and relieved on lying flat. The pain was associated with nausea, vomiting, heartburn and excessive burping. She opened her bowel daily, having well-formed stools without blood or mucus. The patient denied NSAID intake, smoking or alcohol. On physical examination during the episode of pain abdomen revealed a soft, lax abdomen and mild tenderness in the epigastric region without organomegaly. Bowel sounds were audible. Her routine hematological and biochemical parameters were within normal, including CBC, Celiac serology, Lipase, Metabolic profile and H pylori stool antigen. The patient underwent an Ultrasound of the abdomen which showed multiple liver cysts, hemangioma, normal GB and biliary tree. Based on the clinical picture and to narrow our differential diagnosis, an ultrasound Doppler for the abdomen was ordered, and it showed celiac artery peak systolic velocity in expiration is 270cm/s, suggestive of median arcuate ligament syndrome. She Had computerized tomography abdomen done and showed a Narrowing of the celiac artery at the origin, likely secondary to low insertion of the median arcuate ligament. Furthermore, Gastroscopy and, later on colonoscopy were done, which was unremarkable. A laparoscopic decompression of the celiac trunk was indicated, for which the patient was referred to vascular surgery. This case confirms that Median Arcuate Ligament syndrome is an unusual diagnosis and is always challenging. Usually, patients undergo extensive workups before a final diagnosis is achieved. Our case highlights the challenge of diagnosing MALS since this entity is rare. It is a good choice to perform abdominal ultrasound with Doppler imaging on a patient with symptoms such as postprandial angina.

Keywords: Unveiling the Mystery, MALS, rare entity, Rare vascular phenomenon

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1053 Development and Validation of a Coronary Heart Disease Risk Score in Indian Type 2 Diabetes Mellitus Patients

Authors: Faiz N. K. Yusufi, Aquil Ahmed, Jamal Ahmad

Abstract:

Diabetes in India is growing at an alarming rate and the complications caused by it need to be controlled. Coronary heart disease (CHD) is one of the complications that will be discussed for prediction in this study. India has the second most number of diabetes patients in the world. To the best of our knowledge, there is no CHD risk score for Indian type 2 diabetes patients. Any form of CHD has been taken as the event of interest. A sample of 750 was determined and randomly collected from the Rajiv Gandhi Centre for Diabetes and Endocrinology, J.N.M.C., A.M.U., Aligarh, India. Collected variables include patients data such as sex, age, height, weight, body mass index (BMI), blood sugar fasting (BSF), post prandial sugar (PP), glycosylated haemoglobin (HbA1c), diastolic blood pressure (DBP), systolic blood pressure (SBP), smoking, alcohol habits, total cholesterol (TC), triglycerides (TG), high density lipoprotein (HDL), low density lipoprotein (LDL), very low density lipoprotein (VLDL), physical activity, duration of diabetes, diet control, history of antihypertensive drug treatment, family history of diabetes, waist circumference, hip circumference, medications, central obesity and history of CHD. Predictive risk scores of CHD events are designed by cox proportional hazard regression. Model calibration and discrimination is assessed from Hosmer Lemeshow and area under receiver operating characteristic (ROC) curve. Overfitting and underfitting of the model is checked by applying regularization techniques and best method is selected between ridge, lasso and elastic net regression. Youden’s index is used to choose the optimal cut off point from the scores. Five year probability of CHD is predicted by both survival function and Markov chain two state model and the better technique is concluded. The risk scores for CHD developed can be calculated by doctors and patients for self-control of diabetes. Furthermore, the five-year probabilities can be implemented as well to forecast and maintain the condition of patients.

Keywords: coronary heart disease, cox proportional hazard regression, ROC curve, type 2 diabetes Mellitus

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1052 Prevalence of Occupational Asthma Diagnosed by Specific Challenge Test in 5 Different Working Environments in Thailand

Authors: Sawang Saenghirunvattana, Chao Saenghirunvattana, Maria Christina Gonzales, Wilai Srimuk, Chitchamai Siangpro, Kritsana Sutthisri

Abstract:

Introduction: Thailand is one of the fastest growing countries in Asia. It has emerged from agricultural to industrialized economy. Work places have shifted from farms to factories, offices and streets were employees are exposed to certain chemicals and pollutants causing occupational diseases particularly asthma. Work-related diseases are major concern and many studies have been published to demonstrate certain professions and their exposures that elevate the risk of asthma. Workers who exhibit coughing, wheezing and difficulty of breathing are brought to a health care setting where Pulmonary Function Test (PFT) is performed and based from results, they are then diagnosed of asthma. These patients, known to have occupational asthma eventually get well when removed from the exposure of the environment. Our study, focused on performing PFT or specific challenge test in diagnosing workers of occupational asthma with them executing the test within their workplace, maintaining the environment and their daily exposure to certain levels of chemicals and pollutants. This has provided us with an understanding and reliable diagnosis of occupational asthma. Objective: To identify the prevalence of Thai workers who develop asthma caused by exposure to pollutants and chemicals from their working environment by conducting interview and performing PFT or specific challenge test in their work places. Materials and Methods: This study was performed from January-March 2015 in Bangkok, Thailand. The percentage of abnormal symptoms of 940 workers in 5 different areas (factories of plastic, fertilizer, animal food, office and streets) were collected through a questionnaire. The demographic information, occupational history, and the state of health were determined using a questionnaire and checklists. PFT was executed in their work places and results were measured and evaluated. Results: Pulmonary Function test was performed by 940 participants. The specific challenge test was done in factories of plastic, fertilizer, animal food, office environment and on the streets of Thailand. Of the 100 participants working in the plastic industry, 65% complained of having respiratory symptoms. None of them had an abnormal PFT. From the participants who worked with fertilizers and are exposed to sulfur dioxide, out of 200 participants, 20% complained of having symptoms and 8% had abnormal PFT. The 300 subjects working with animal food reported that 45% complained of respiratory symptoms and 15% had abnormal PFT results. From the office environment where there is indoor pollution, Out of 140 subjects, 7% had symptoms and 4% had abnormal PFT. The 200 workers exposed to traffic pollution, 24% reported respiratory symptoms and 12% had abnormal PFT. Conclusion: We were able to identify and diagnose participants of occupational asthma through their abnormal lung function test done at their work places. The chemical agents and exposures were determined therefore effective management of workers with occupational asthma were advised to avoid further exposure for better chances of recovery. Further studies identifying the risk factors and causative agents of asthma in workplaces should be developed to encourage interventional strategies and programs that will prevent occupation related diseases particularly asthma.

Keywords: occupational asthma, pulmonary function test, specific challenge test, Thailand

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1051 Isolation of Vibrio harveyi and Vibrio alginolyticus Strains from Cultured Seabass (Dicentrarchus labrax L.) and Seabream (Sparus auratus L.) in Egypt

Authors: M. Khallaf, R. Khalil, H. Ghetas

Abstract:

In the present study, V. harveyi and V. alginolyticus were isolated from cultured seabass and seabream at Damietta Governorate, Egypt, during summer season. Isolates were biochemically and molecularly identified using primers for Vhh and Collagenase genes. The most prominent clinical observations of diseased fish were exophthalmia, abdominal distension, and multifocal cutaneous hemorrhagic ulceration on the dorsal musculature and caudal peduncle. Physicochemical characteristics of water samples indicated that the unionized ammonia, nitrate, and hydrogen sulphate concentrations were higher than the acceptable limits. Heavy metals concentrations in water samples exhibited higher concentrations than the permissible levels for fish culture, which was considered as chemical stressors that increase the prevalence of these bacterial diseases. Immune parameters were lower in diseased seabass and seabream than apparently healthy fish. Lesions of different fish organs were identified histopathologically.

Keywords: seabass, seabream, Vibrio alginolyticus, Vibrio harveyi

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1050 Political Alienation: Paving the Road to Corruption

Authors: Mabrouka Al-Werfalli

Abstract:

This paper aims to highlight reasons beyond the prevalence of “culture of corruption” amongst Libyans. One of the most prominent reason for the Libyan revolution in February 2011 was the pervasiveness of corruption. Corruption in Libya remained a significant problem despite harsh legislation and a robust anti-corruption discourse undertaken by the previous regime. The long-standing political corruption in Libya has offered ample opportunity for the evolution of a structure of negative values and morals. This has formed what is termed as a “culture of corruption”, which has induced people to accept and justify corrupt behaviour. The paper is a part of a study concerns the phenomenon of political alienation in Libya which was based on a survey conducted in 2001 in the city of Benghazi. The finding shows that abuse of power looms large within all activities. Embezzlement and misuse of public funds for personal enrichment is thought to be rife within public bodies, institutions, companies, factories, banks and enterprises owned entirely or partially by the state.

Keywords: corruption, culture of corruption, participation in corruption, abuse of power, embezzlement, political alienation, anti-corruption

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1049 Evaluation of Indoor Radon as Air Pollutant in Schools and Control of Exposure of the Children

Authors: Kremena Ivanona, Bistra Kunovska, Jana Djunova, Desislava Djunakova, Zdenka Stojanovska

Abstract:

In recent decades, the general public has become increasingly interested in the impact of air pollutions on their health. Currently, numerous studies are aimed at identifying pollutants in the indoor environment where they carry out daily activities. Internal pollutants can be of both natural and artificial origin. With regard to natural pollutants, special attention is paid to natural radioactivity. In recent years, radon has been one of the most studied indoor pollutants because it has the greatest contribution to human exposure to natural radionuclides. It is a known fact that lung cancer can be caused by radon radiation and it is the second risk factor after smoking for the onset of the disease. The main objective of the study under the National Science Fund of Bulgaria, in the framework of grant No КП-06-Н23/1/07.12.2018 is to evaluate the indoor radon as an important air pollutant in school buildings in order to reduce the exposure to children. The measurements were performed in 48 schools located in 55 buildings in one Bulgarian administrative district (Kardjaly). The nuclear track detectors (CR-39) were used for measurements. The arithmetic and geometric means of radon concentrations are AM = 140 Bq/m3, and GM = 117 Bq/m3 respectively. In 51 school rooms, the radon levels were greater than 200 Bq/m3, and in 28 rooms, located in 17 school buildings, it exceeded the national reference level of 300 Bq/m3, defined in the Bulgarian ordinance on radiation protection (or 30% of the investigated buildings). The statistically significant difference in the values of radon concentration by municipalities (KW, р < 0.001) obtained showed that the most likely reason for the differences between the groups is the geographical location of the buildings and the possible influence of the geological composition. The combined effect of the year of construction (technical condition of the buildings) and the energy efficiency measures was considered. The values of the radon concentration in the buildings where energy efficiency measures have been implemented are higher than those in buildings where they have not been performed. This result confirms the need for investigation of radon levels before conducting the energy efficiency measures in buildings. Corrective measures for reducing the radon levels have been recommended in school buildings with high radon levels in order to decrease the children's exposure.

Keywords: air pollution, indoor radon, children exposure, schools

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1048 Role of HLA Typing in Celiac Disease

Authors: Meriche Hacene

Abstract:

Introduction: Celiac disease (CD) is a chronic immune-mediated enteropathy triggered by gluten found in wheat or oats or rye. Celiac disease is associated with the HLA-DQ2 and HLA-DQ8 susceptibility alleles. This association with the HLA DQ2/DQ8 molecules confirmed the responsibility of genetic factors that intervene in the triggering of the autoimmune process of this condition. Objective: To evaluate the results of HLA DQ2 and HLA DQ8 typing of 40 patients suspected of having CD by PCR-SSP (Polymerase Chain Reaction Sequence Specific Primers). Material and method : 40 patients suspected of celiac disease with IgA transglutaminase serology (-) and duodenal biopsy (+). HLADR/DQ PCR-SSP (fluogen-innotrain) typing was carried out. Results : The average age of adults was 40 years, children: 4 years, the sex ratio was 1M/3F. In our patients the HLA DQ2 allele is found with a frequency of 75%, the DQ8 with a frequency of 25%, 17.5% were HLA-DQ2 homozygous and 15% were HLADQ2/HLADQ8. In our series, HLADQ2, DQ8 are found in almost all patients with a frequency of 95%. 30% of patients in our study had associated positivity of HLA-DRB3, DRB4 or DRB5 alleles. Conclusion : A high prevalence of positivity of HLADQ2 alleles at the expense of HLA DQ8 was found, which is consistent with literature data. These molecules constitute an additional marker for screening and diagnosis of CD.

Keywords: HLA typing, coeliac disease, HLA DQ 2, HLA DQ8

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1047 KAP Study on Breast Cancer Among Women in Nirmala Educational Institutions-A Prospective Observational Study

Authors: Shaik Asha Begum, S. Joshna Rani, Shaik Abdul Rahaman

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INTRODUCTION: Breast cancer is a disease that creates in breast cells. "KAP" study estimates the Knowledge, Attitude, and Practices of a local area. More than 1.5 million ladies (25% of all ladies with malignancy) are determined to have bosom disease consistently all through the world. Understanding the degrees of Knowledge, Attitude and Practice will empower a more effective cycle of mindfulness creation as it will permit the program to be custom-made all the more properly to the necessities of the local area. OBJECTIVES: The objective of this study is to assess the knowledge on signs and symptoms, risk factors, provide awareness on the practicing of the early detection techniques of breast cancer and provide knowledge on the overall breast cancer including preventive techniques. METHODOLOGY: This is an expressive cross-sectional investigation. This investigation of KAP was done in the Nirmala Educational Institutions from January to April 2021. A total of 300 participants are included from women students in pharmacy graduates & lecturers, and also from graduates other than the pharmacy. The examiners are taken from the BCAM (Breast Cancer Awareness Measure), tool compartment (Version 2). RESULT: According to the findings of the study, the majority of the participants were not well informed about breast cancer. A lump in the breast was the most commonly mentioned sign of breast cancer, followed by pain in the breast or nipple. The percentage of knowledge related to the breast cancer risk factors was also very less. The correct answers for breast cancer risk factors were radiation exposure (58.20 percent), a positive family history (47.6 percent), obesity (46.9 percent), a lack of physical activity (43.6 percent), and smoking (43.2 percent). Breast cancer screening, on the other hand, was uncommon (only 30 and 11.3 percent practiced clinical breast examination and mammography respectively). CONCLUSION: In this study, the knowledge on the signs and symptoms, risk factors of breast cancer - pharmacy graduates have more knowledge than the non-pharmacy graduates but in the preventive techniques and early detective tools of breast cancer -had poor knowledge in the pharmacy and non-pharmacy graduate. After the awareness program, pharmacy and non-pharmacy graduates got supportive knowledge on the preventive techniques and also practiced the early detective techniques of breast cancer.

Keywords: breast cancer, mammography, KAP study, early detection

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1046 Association of Overweight and Obesity with Breast Cancer

Authors: Amir Ghasemlouei, Alireza Khalaj

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In women, cancer of the breast is one of the most common incident cancer and cause of death from cancer .we reviewed the prevalence of obesity and its association with breast cancer. In this study, a total of 25 articles regarding the subject matter of the article have been presented in which 640 patients were examined that 320 patients with breast cancer and 320 were controls. The distribution of breast cancer patients and controls with respect to their anthropometric indices in patients with higher weight, which was statistically significant (60.2 ± 10.2 kg) compared with control group (56.1 ± 11.3 kg). The body mass index of patients was (26.06+/-3.42) and significantly higher than the control group (24.1+/-1.7). Obesity leads to increased levels of adipose tissue in the body that can be stored toxins and carcinogens to produce a continuous supply. Due to the high level of fat and the role of estrogen in a woman is endogenous estrogen of the tumor and regulate the activities of growth steroids, obesity is a risk factor for breast cancer is confirmed. Our study and other studies show that obesity is a risk factor for breast cancer. And with a weight loss intervention for breast cancer can be prevented in the future.

Keywords: breast cancer, review study, obesity, overweight

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1045 Detection of Arterial Stiffness in Diabetes Using Photoplethysmograph

Authors: Neelamshobha Nirala, R. Periyasamy, Awanish Kumar

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Diabetes is a metabolic disorder and with the increase of global prevalence of diabetes, cardiovascular diseases and mortality related to diabetes has also increased. Diabetes causes the increase of arterial stiffness by elusive hormonal and metabolic abnormalities. We used photoplethysmograph (PPG), a simple non-invasive method to study the change in arterial stiffness due to diabetes. Toe PPG signals were taken from 29 diabetic subjects with mean age of (65±8.4) years and 21 non-diabetic subjects of mean age of (49±14) years. Mean duration of diabetes is 12±8 years for diabetic group. Rise-time (RT) and area under rise time (AUR) were calculated from the PPG signal of each subject and Welch’s t-test is used to find the significant difference between two groups. We obtained a significant difference of (p-value) 0.0005 and 0.03 for RT and AUR respectively between diabetic and non-diabetic subjects. Average value of RT and AUR is 0.298±0.003 msec and 14.4±4.2 arbitrary units respectively for diabetic subject compared to 0.277±0.0005 msec and 13.66±2.3 a.u respectively for non-diabetic subjects. In conclusion, this study support that arterial stiffness is increased in diabetes and can be detected early using PPG.

Keywords: area under rise-time, AUR, arterial stiffness, diabetes, photoplethysmograph, PPG, rise-time (RT)

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1044 Observational Study -HIV/ AIDS and Medical Personnel in Mangalore, India

Authors: Anjana Sreedharan, Harish Rao

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Background: India has the world’s third largest population of people living with HIV/AIDS, with a prevalence rate of 0.69 in the state of Karnataka. This study aims at assessing the HIV/AIDS related knowledge, attitude and behavior of the medical personnel in 3 hospitals in the city of Mangalore. Methods: Surgeons, Anesthetists, OT staff nurses, ward nursing staff, House surgeons working in the hospitals associated with Kasturba Medical college, Mangalore were given questionnaires and interviewed. Their knowledge about HIV, their attitude towards HIV positive patients and bias in management of the patients was assessed. Conclusion: So far, it has been found that amongst doctors, discrimination was mainly in the form of HIV testing without consent and a lack of confidentiality. However, the doctors rarely changed the treatment plan on knowing the HIV status of the patient. Amongst the nursing staff and interns, there is a serious lacuna of knowledge regarding HIV transmission, as compared to consultants. The patient seldom faced verbal abuse from the team. Use of universal precautions is less among the entire team due to insufficient availability of the same.

Keywords: discrimination, HIV/ AIDS, medical colleges, stigma

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1043 Ocular Complications in Type 1 Diabetes Mellitus in Zahedan: A Tropical Region in Southeast of Iran

Authors: Mohammad Hossain Validad, Maryam Nakhaei-Moghadam, Monire Mahjoob

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Introduction: The prevalence of type 1 diabetes is increasing worldwide, and given the role of ethnicity and race in complications of diabetes, this study was designed to evaluate the ocular complications of type 1 diabetes mellitus in Zahedan. Methods: This prospective cross-sectional study was conducted on Type 1 diabetic children that referred to Alzahra Eye Hospital. All patients had a dilated binocular indirect ophthalmoscopy using a +90 D condensing lens and slit-lamp biomicroscopy. Age, gender, onset, duration of diabetes, and HbA1c level were recorded. Results: 76 type 1 diabetes patients with an age of 11.93 ± 3.76 years participated in this study. Out of 76 patients with diabetes, 19 people (25%) had ocular complications. There was a significant difference in age (P=0.01) and disease duration (P=0.07) between the two groups with and without ocular complications. Odd ratios for ocular complications with age and duration of diabetes were 1.32 and 1.32, respectively. Conclusion: Cataract was the most common ocular complication in type 1 diabetes in Zahedan, a tropical region that was significantly related to the duration of the disease and the age of the patients.

Keywords: diabet mellitus type one, cataract, ocular complication, hemoglobin A1C

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1042 Comparison of the Dose Reached to the Rectum and Bladder in Two Treatment Methods by Tandem and Ovoid and Tandem and Ring in the High Dose Rate Brachytherapy of Cervical Cancer

Authors: Akbar Haghzadeh Saraskanroud, Amir Hossein Yahyavi Zanjani, Niloofar Kargar, Hanieh Ahrabi

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Cervical cancer refers to an unusual growth of cells in the cervix. The cervix is the lower part of the uterus, which connects to the vagina. Various risk factors such as human papillomavirus (HPV), having a weakened immune system, smoking or breathing in secondhand smoke, reproductive factors, and obesity play important roles in causing most cervical cancers. When cervical cancer happens, surgery is often the first treatment option to remove it. Other treatments might include chemotherapy and targeted therapy medicines. Radiation therapy with high-energy photon beams also may be used. Sometimes combined treatment, including radiation with low-dose chemotherapy, was applied. Intracavitary brachytherapy is an integral part of radiotherapy for locally advanced gynecologic malignancies such as cervical cancer. In the treatment of cervical cancer, there are different tools for doing brachytherapy. Two combinations of different applicators for this purpose are Tandem and Ovoid and Tandem and Ring. This study evaluated the dose differences between these two methods in the organs at risk of the rectum, sigmoid, and bladder. In this study, the treatment planswere simulated by the Oncentra treatment planning system and Tandem, Ovid, and Rings of different sizes. CT scan images of 23 patients were treated with HDR_BT Elekta Flexitron system were used for this study. Contouring of HR-CTV, rectum and bladder was performed for all patients. Then, the received dose of 0.1 and 0.2cc volumes of organs at risk were obtained and compared for these two methods: T-Ovoid and T-Ring. By doing investigations and dose measurements of points A and B and the volumes specified by ICRU, it seems that when comparing ring and ovoid to tandem and ovoid, the total dose to the rectum was lower by about 11%, and the bladder was 7%. In the case of HR CTV, this comparison showed that this ratio is about 7% better. Figure 1 shows the amount of decrease in rectum dose in the T-Ring method compared to T-Ovoid. Figure 2 indicates the amount of decrease in bladder dose in the T-Ring method compared to T-Ovoid. Finally, figure 3 illustrates the amount of HR-CTV coverage in the T-Ring method compared to the T-Ovoid.

Keywords: cervical cancer, brachytherapy, rectum, tandem and ovoid, tandem and ring.

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1041 Comparison of the Efficacy of Ketamine-Propofol versus Thiopental Sodium-Fentanyl in Procedural Sedation in the Emergency Department: A Randomized Double-Blind Clinical Trial

Authors: Maryam Bahreini, Mostafa Talebi Garekani, Fatemeh Rasooli, Atefeh Abdollahi

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Introduction: Procedural sedation and analgesia have been desirable to handle painful procedures. The trend to find the agent with more efficacy and less complications is still controversial; thus, many sedative regimens have been studied. This study tried to assess the effectiveness and adverse effects of thiopental sodium-fentanyl with the known medication, ketamine-propofol for procedural sedation in the emergency department. Methods: Consenting patients were enrolled in this randomized double-blind trial to receive either 1:1 ketamine-propofol (KP) or thiopental-fentanyl (TF) 1:1 mg: Mg proportion on a weight-based dosing basis to reach the sedation level of American Society of Anesthesiologist class III/IV. The respiratory and hemodynamic complications, nausea and vomiting, recovery agitation, patient recall and satisfaction, provider satisfaction and recovery time were compared. The study was registered in Iranian randomized Control Trial Registry (Code: IRCT2015111325025N1). Results: 96 adult patients were included and randomized, 47 in the KP group and 49 in the TF group. 2.1% in the KP group and 8.1 % in the TF group experienced transient hypoxia leading to performing 4.2 % versus 8.1 % airway maneuvers for 2 groups, respectively; however, no statistically significant difference was observed between 2 combinations, and there was no report of endotracheal placement or further admission. Patient and physician satisfaction were significantly higher in the KP group. There was no difference in respiratory, gastrointestinal, cardiovascular and psychiatric adverse events, recovery time and patient recall of the procedure between groups. The efficacy and complications were not related to the type of procedure or patients’ smoking or addiction trends. Conclusion: Ketamine-propofol and thiopental-fentanyl combinations were effectively comparable although KP resulted in higher patient and provider satisfaction. It is estimated that thiopental fentanyl combination can be as potent and efficacious as ketofol with relatively similar incidence of adverse events in procedural sedation.

Keywords: adverse effects, conscious sedation, fentanyl, propofol, ketamine, safety, thiopental

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1040 Increasing Prevalence of Multi-Allergen Sensitivities in Patients with Allergic Rhinitis and Asthma in Eastern India

Authors: Sujoy Khan

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There is a rising concern with increasing allergies affecting both adults and children in rural and urban India. Recent report on adults in a densely populated North Indian city showed sensitization rates for house dust mite, parthenium, and cockroach at 60%, 40% and 18.75% that is now comparable to allergy prevalence in cities in the United States. Data from patients residing in the eastern part of India is scarce. A retrospective study (over 2 years) was done on patients with allergic rhinitis and asthma where allergen-specific IgE levels were measured to see the aero-allergen sensitization pattern in a large metropolitan city of East India. Total IgE and allergen-specific IgE levels were measured using ImmunoCAP (Phadia 100, Thermo Fisher Scientific, Sweden) using region-specific aeroallergens: Dermatophagoides pteronyssinus (d1); Dermatophagoides farinae (d2); cockroach (i206); grass pollen mix (gx2) consisted of Cynodon dactylon, Lolium perenne, Phleum pratense, Poa pratensis, Sorghum halepense, Paspalum notatum; tree pollen mix (tx3) consisted of Juniperus sabinoides, Quercus alba, Ulmus americana, Populus deltoides, Prosopis juliflora; food mix 1 (fx1) consisted of Peanut, Hazel nut, Brazil nut, Almond, Coconut; mould mix (mx1) consisted of Penicillium chrysogenum, Cladosporium herbarum, Aspergillus fumigatus, Alternaria alternate; animal dander mix (ex1) consisted of cat, dog, cow and horse dander; and weed mix (wx1) consists of Ambrosia elatior, Artemisia vulgaris, Plantago lanceolata, Chenopodium album, Salsola kali, following manufacturer’s instructions. As the IgE levels were not uniformly distributed, median values were used to represent the data. 92 patients with allergic rhinitis and asthma (united airways disease) were studied over 2 years including 21 children (age < 12 years) who had total IgE and allergen-specific IgE levels measured. The median IgE level was higher in 2016 than in 2015 with 60% of patients (adults and children) being sensitized to house dust mite (dual positivity for Dermatophagoides pteronyssinus and farinae). Of 11 children in 2015, whose total IgE ranged from 16.5 to >5000 kU/L, 36% of children were polysensitized (≥4 allergens), and 55% were sensitized to dust mites. Of 10 children in 2016, total IgE levels ranged from 37.5 to 2628 kU/L, and 20% were polysensitized with 60% sensitized to dust mites. Mould sensitivity was 10% in both of the years in the children studied. A consistent finding was that ragweed sensitization (molecular homology to Parthenium hysterophorus) appeared to be increasing across all age groups, and throughout the year, as reported previously by us where 25% of patients were sensitized. In the study sample overall, sensitizations to dust mite, cockroach, and parthenium were important risks in our patients with moderate to severe asthma that reinforces the importance of controlling indoor exposure to these allergens. Sensitizations to dust mite, cockroach and parthenium allergens are important predictors of asthma morbidity not only among children but also among adults in Eastern India.

Keywords: aAeroallergens, asthma, dust mite, parthenium, rhinitis

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1039 Mediterranean Diet, Duration of Admission and Mortality in Elderly, Hospitalized Patients: A Cross-Sectional Study

Authors: Christos Lampropoulos, Maria Konsta, Ifigenia Apostolou, Vicky Dradaki, Tamta Sirbilatze, Irini Dri, Christina Kordali, Vaggelis Lambas, Kostas Argyros, Georgios Mavras

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Objectives: Mediterranean diet has been associated with lower incidence of cardiovascular disease and cancer. The purpose of our study was to examine the hypothesis that Mediterranean diet may protect against mortality and reduce admission duration in elderly, hospitalized patients. Methods: Sample population included 150 patients (78 men, 72 women, mean age 80±8.2). The following data were taken into account in analysis: anthropometric and laboratory data, dietary habits (MedDiet score), patients’ nutritional status [Mini Nutritional Assessment (MNA) score], physical activity (International Physical Activity Questionnaires, IPAQ), smoking status, cause and duration of current admission, medical history (co-morbidities, previous admissions). Primary endpoints were mortality (from admission until 6 months afterwards) and duration of admission, compared to national guidelines for closed consolidated medical expenses. Logistic regression and linear regression analysis were performed in order to identify independent predictors for mortality and admission duration difference respectively. Results: According to MNA, nutrition was normal in 54/150 (36%) of patients, 46/150 (30.7%) of them were at risk of malnutrition and the rest 50/150 (33.3%) were malnourished. After performing multivariate logistic regression analysis we found that the odds of death decreased 30% per each unit increase of MedDiet score (OR=0.7, 95% CI:0.6-0.8, p < 0.0001). Patients with cancer-related admission were 37.7 times more likely to die, compared to those with infection (OR=37.7, 95% CI:4.4-325, p=0.001). According to multivariate linear regression analysis, admission duration was inversely related to Mediterranean diet, since it is decreased 0.18 days on average for each unit increase of MedDiet score (b:-0.18, 95% CI:-0.33 - -0.035, p=0.02). Additionally, the duration of current admission increased on average 0.83 days for each previous hospital admission (b:0.83, 95% CI:0.5-1.16, p<0.0001). The admission duration of patients with cancer was on average 4.5 days higher than the patients who admitted due to infection (b:4.5, 95% CI:0.9-8, p=0.015). Conclusion: Mediterranean diet adequately protects elderly, hospitalized patients against mortality and reduces the duration of hospitalization.

Keywords: Mediterranean diet, malnutrition, nutritional status, prognostic factors for mortality

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1038 Wealth-Based Inequalities in Child Health: A Micro-Level Analysis of Maharashtra State in India

Authors: V. Rekha, Rama Pal

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The study examines the degree and magnitude of wealth-based inequalities in child health and its determinants in India. Despite making strides in economic growth, India has failed to secure a better nutritional status for all the children. The country currently faces the double burden of malnutrition as well as the problems of overweight and obesity. Child malnutrition, obesity, unsafe water, sanitation among others are identified as the risk factors for Non-Communicable Diseases (NCDs). Eliminating malnutrition in all its forms will catalyse improved health and economic outcomes. The assessment of the distributive dimension of child health across various segments of the population is essential for effective policy intervention. The study utilises the fourth round of District Level Health Survey for 2012-13 to analyse the inequalities among children in the age group 0-14 years in Maharashtra, a state in the western region of India with a population of 11.24 crores which constitutes 9.3 percent of the total population of India. The study considers the extent of health inequality by state, districts, sector, age-groups, and gender. The z-scores of four child health outcome variables are computed to assess the nutritional status of pre-school and school children using WHO reference. The descriptive statistics, concentration curves, concentration indices, correlation matrix, logistic regression have been used to analyse the data. The results indicate that magnitude of inequality is higher in Maharashtra and child health inequalities manifest primarily among the weaker sections of society. The concentration curves show that there exists a pro-poor inequality in child malnutrition measured by stunting, wasting, underweight, anaemia and a pro-rich overweight inequality. The inequalities in anaemia are observably lower due to the widespread prevalence. Rural areas exhibit a higher incidence of malnutrition, but greater inequality is observed in the urban areas. Overall, the wealth-based inequalities do not vary significantly between age groups. It appears that there is no gender discrimination at the state level. Further, rural-urban differentials in gender show that boys from the rural area and girls living in the urban region experience higher disparities in health. The relative distribution of undernutrition across districts in Maharashtra reveals that malnutrition is rampant and considerable heterogeneity also exists. A negative correlation is established between malnutrition prevalence and human development indicators. The findings of logistic regression analysis reveal that lower economic status of the household is associated with a higher probability of being malnourished. The study recognises household wealth, education of the parent, child gender, and household size as factors significantly related to malnutrition. The results suggest that among the supply-side variables, child-oriented government programmes might be beneficial in tackling nutrition deficit. In order to bridge the health inequality gap, the government needs to target the schemes better and should expand the coverage of services.

Keywords: child health, inequality, malnutrition, obesity

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