RESUMEN

Background: Arsenic has been associated with diabetes and impaired glucose tolerance in many studies, although some reports have shown null findings. Methods: We conducted a cross-sectional study among 300 adults in Bangladesh. Participants were randomly selected from a roster of 1800 people who previously participated in studies of arsenic and skin lesions. We measured fasting glucose and insulin levels. We assessed drinking water arsenic concentration using graphite furnace atomic absorption spectrophotometry (GF-AAS) and toenail arsenic concentration using inductively coupled mass spectrometry (ICP-MS). We ran covariant-adjusted, linear regression and spline models to examine associations of arsenic concentrations with the homeostatic model assessment of insulin resistance (HOMA-IR), a marker of insulin resistance, and HOMA of beta-cell function (HOMA-ß), a marker of beta-cell function. Results: Among 285 participants with complete data, the median (IQR) arsenic concentration was 4.0 (6.9) µg/g in toenails and 39.0 (188.5) µg/L in drinking water. Arsenic concentrations were not associated with insulin resistance or beta-cell function. HOMA-IR was 0.67% lower and HOMA-ß was 0.28% lower per µg/g increment in toenail arsenic, but these effect estimates were small, and confidence intervals crossed the null value. Conclusions: Although arsenic exposure has been associated with diabetes, we found no evidence of an adverse effect on insulin resistance or beta-cell function.

RESUMEN

Phagocytosis is an essential physiological mechanism; its impairment is associated with many diseases. A highly smart particle is required for understanding detailed sequential cellular events in phagocytosis. Recently, we identified an Indian traditional medicine named Godanti Bhasma (GB), a bioactive calcium sulfate particle prepared by thermo-transformation ofgypsum. Thermal processing of the gypsum transforms its native physicochemical properties by removing water molecules into the anhydrous GB, which was confirmed by Raman and FT-IR spectroscopy. GB particle showed a 0.5-5 µm size range and a neutral surface charge. Exposure of mammalian cells to GB particles showed a rapid cellular uptake through phagocytosis and induced massive cytoplasmic vacuolation in cells. Interestingly, no cellular uptake and cytoplasmic vacuolation were observed with the parent gypsum particle. The presence of the GB particles in intra-vacuolar space was confirmed using FESEM coupled with EDX. Flow cytometry analysis and live tracking of GB-treated cells showed particle internalization, vacuole formation, particle dissolution, and later vacuolar turnover. Quantification of GB-induced vacuolation was done using neutral red uptake assay in cells. Treatment of lysosomal inhibitors (BFA1 or CQ) with GB could not induce vacuolation, suggesting the requirement of an acidic environment for the vacuolation. In the mimicking experiment, GB particle dissolution in acidic cell-free solution suggested that degradation of GB occurs by acidic pH inside the cell vacuole. Vacuole formation generally accompanies with cell death, whereas GB-induced massive vacuolation does not cause cell death. Moreover, the cell divides and proliferates with the vacuolar process, intra-vacuolar cargo degradation, and eventually vacuolar turnover. Taken together, the sequential cellular events in this study suggest that GB can be used as a smart particle for phagocytosis assay development in animal cells.

Asunto(s)

RESUMEN

Bronchogenic cysts (BCs) are a congenital anomaly, forming fluid-filled sacs in the bronchial tree during fetal development, and are relatively rare in adults. Patients with large BCs in the mediastinum presenting with severe tracheal compression pose a significant challenge to anesthesiologists. The confined and narrow space of the mediastinum exacerbates the compression effect on surrounding structures, leading to potential respiratory or cardiovascular collapse during anesthesia and postoperatively. Herein, we report the stepwise anesthetic management of a patient with a BC in the paratracheal region of superior mediastinum, causing near-complete tracheal compression, scheduled for right posterolateral thoracotomy and tumor excision. The patient presented with dyspnea, chest pain, cough, and severe tracheal compression necessitating meticulous airway management. Utilizing awake fiberoptic intubation with a single-lumen endotracheal tube and one-lung ventilation facilitated by an EZ bronchial blocker, we successfully secured the airway, provided ideal surgical conditions through lung deflation, and ensured perioperative safety. This case underscores the crucial role of comprehending the underlying pathophysiology, anticipating complications, and meticulously planning, preparing, and executing strategies for airway management and perioperative care in patients with mediastinal masses leading to significant tracheal compression.

RESUMEN

Although low-flow anesthesia is widely used due to its various advantages, there are concerns about potential and relative hypoxia. Furthermore, oxygen is also a drug with benefits and adverse effects. We aimed to evaluate and compare the effect of real-time oxygen consumption versus fixed flow-based low flow anesthesia on oxygenation and perfusion and to compare the economic benefits. With ethical approvals and informed consent, participants were randomly assigned to a dynamic group (13 males, and 27 females) receiving fresh gas flows depending on real-time oxygen consumption (dynamic O2: N2O), and a fixed group (20 males, and 13 females) receiving fixed fresh gas flows of 600 mL/min (with O2: N2O of 1:1). Oxygen partial pressure and serum lactate were comparable between groups. However, isoflurane consumed and costs incurred were significantly different. Total oxygen consumption per minute was also significantly lower in the dynamic group than the fixed group. No episodes of hypoxia were observed in either group. Real-time oxygen consumption-based low flow anesthesia is feasible and cost-effective without affecting the patient's global perfusion and outcome.

Asunto(s)

RESUMEN

BACKGROUND: Labor analgesia plays a crucial role in ensuring a comfortable and positive birthing experience. It provides physiological benefits to both the mother and the child. Knowledge, awareness, and communication between the anesthesiologist and the obstetrician are essential for the safe conduct of labor analgesia. We conducted this cross-sectional online survey amongst obstetric residents to assess their knowledge, attitude, and practices of labor analgesia. METHODS: A structured questionnaire consisting of 19 questions was circulated amongst obstetric residents of various hospitals via electronic mode of communication. The responses were analyzed using statistical methods. RESULTS: Among the obstetric residents that we surveyed, 75.7% of them only sometimes employed labor analgesia for their patients. The most commonly employed methods of pain relief are opioids and non-steroidal anti-inflammatory drugs (NSAID). Most of them feel that pain-free labor is necessary because it makes the whole labor process a pleasurable one. Labor analgesia was mostly advocated at patients' request and demand. The barrier to using labor analgesia was most commonly found to be the non-availability of labor analgesia services. CONCLUSION: Despite the increasing awareness of labor analgesia there still lies a gap between the attitude toward it and the practice of it. Further education to rectify the misconceptions and barriers needs to be taken for providing beneficial services to pregnant females.

RESUMEN

BACKGROUND: In the search for opioid-free anesthesia, notable numbers of drugs, singly or in combinations, have been tested with variable results. However, most of the drugs used are not as strong as opioids. Even if some non-opioid drugs are potent enough, they cause significant untoward effects, necessitating the use of lower effective dosages of multiple drugs as a substitute. The present pilot study evaluated low-dose combinations of ketamine, lignocaine, and dexmedetomidine (KeLiDex) against fentanyl-based anesthesia for analgesia and recovery profiles in laparoscopic nephrectomies. METHODS: Twenty patients (10 in each group) randomly received KeLiDex or fentanyl infusion as an analgesic component for balanced general anesthesia. Entire patients also received paracetamol and quadratus lumborum block-2. Anesthesia depth, neuromuscular blockade, and reversal were standardized. Intraoperative hemodynamic variation, time to extubation after reversal (T-tEAR) administration, postanesthesia care unit (PACU) discharge readiness assessed using modified Aldrete score, sedations using Richmond Agitation Sedation Scale, postoperative pain, and rescue analgesia consumptions were compared using different validated scales. P-value <0.05 was considered significant. RESULTS: The KeLiDex group had a significantly lower heart rate (HR) between 45-90 minutes and at the time of reversal. Mean arterial pressure (MAP) (mean ± standard deviation (SD)) differed significantly at only a 60-minute interval (KeLiDex group 80.90 ± 9.50 versus fentanyl group 92.60 ± 16.13 mmHg, p-value 0.041). The Friedman test for change in HR and MAP over time within each group was also insignificant. The mean ± SD of T-tEAR was 6.37 ± 2.13 in KeLiDex, and 8.18 ± 2.92 minutes in the fentanyl group, p-value 0.27. Sedation scores, Modified Alderette scores, pain scores, and rescue analgesic requirements were also comparable. CONCLUSION: KeLiDex could effectively control hemodynamics and pain both at rest and in movements in line with fentanyl-based anesthesia for laparoscopic nephrectomies. Further, recovery from the anesthesia, sedation, and PACU discharge readiness were similar.

RESUMEN

Aneurysmal atrial septal defects (ASDs) represent a rare subset of congenital cardiac anomalies, characterized by bulging of the interatrial septum. This condition poses unique challenges in diagnosis, management, and outcomes due to its variable clinical presentation and associated complications. While echocardiography remains the cornerstone of diagnosis, advanced imaging modalities such as cardiac magnetic resonance imaging (MRI) and computed tomography (CT) may provide additional insights. Optimal management strategies for aneurysmal ASDs require careful consideration of patient-specific factors, including the size and location of the defect, associated cardiovascular abnormalities, and the presence of pulmonary hypertension. Surgical repair, whether through conventional open-heart techniques or transcatheter interventions, remains the primary treatment modality; however, the approach may vary based on individual patient characteristics. Anesthetic considerations, including hemodynamic monitoring and perioperative care, are crucial in optimizing outcomes and reducing the risk of complications during surgical interventions. Long-term follow-up is essential to monitor potential complications such as residual shunting, arrhythmias, and the development of pulmonary vascular disease. Collaborative efforts among cardiologists, cardiothoracic surgeons, anesthesiologists, and other multidisciplinary specialists are paramount in providing comprehensive care for patients with aneurysmal ASDs.

RESUMEN

The global need for energy is increasing at a high rate and is expected to double or increase by 50%, according to some studies, in 30 years. As a result, it is essential to look into alternative methods of producing power. Solar photovoltaic (PV) power plants utilize the sun's clean energy, but they're not always dependable since they depend on weather patterns and requires vast amount of land. Space-based solar power (SBSP) has emerged as the potential solution to this issue. SBSP can provide 24/7 baseload carbon-free electricity with power density over 10 times greater than terrestrial alternatives while requiring far less land. Solar power is collected and converted in space to be sent back to Earth via Microwave or laser wirelessly and used as electricity. However, harnessing its full potential necessitates tackling substantial technological obstacles in wireless power transmission across extensive distances in order to efficiently send power to receivers on the ground. When it comes to achieving a net-zero goal, the SBSP is becoming more viable option. This paper presents a review of wireless power transmission systems and an overview of SBSP as a comprehensive system. To introduce the state-of-the-art information, the properties of the system and modern SBSP models along with application and spillover effects with regard to different sectors was examined. The challenges and risks are discussed to address the key barriers for successful project implementation. The technological obstacles stem from the fact that although most of the technology is already available none are actually efficient enough for deployment so with, private enterprises entering space race and more efficient system, the cost of the entire system that prevented this notion from happening is also decreasing. With incremental advances in key areas and sustained investment, SBSP integrated with other renewable could contribute significantly to cross-sector decarbonization.

RESUMEN

OBJECTIVE: Obesity and type 2 diabetes (DM) are risk factors for severe coronavirus disease 2019 (COVID-19) outcomes, which disproportionately affect South Asian populations. This study aims to investigate the humoral and cellular immune responses to SARS-CoV-2 in adult COVID-19 survivors with overweight/obesity (Ov/Ob, BMI ≥ 23 kg/m2) and DM in Bangladesh. METHODS: In this cross-sectional study, SARS-CoV-2-specific antibody and T-cell responses were investigated in 63 healthy and 75 PCR-confirmed COVID-19 recovered individuals in Bangladesh, during the pre-vaccination first wave of the COVID-19 pandemic in 2020. RESULTS: In COVID-19 survivors, SARS-CoV-2 infection induced robust antibody and T-cell responses, which correlated with disease severity. After adjusting for age, sex, DM status, disease severity, and time since onset of symptoms, Ov/Ob was associated with decreased neutralizing antibody titers, and increased SARS-CoV-2 spike-specific IFN-γ response along with increased proliferation and IL-2 production by CD8 + T cells. In contrast, DM was not associated with SARS-CoV-2-specific antibody and T-cell responses after adjustment for obesity and other confounders. CONCLUSION: Ov/Ob is associated with lower neutralizing antibody levels and higher T-cell responses to SARS-CoV-2 post-COVID-19 recovery, while antibody or T-cell responses remain unaltered in DM.

Asunto(s)

RESUMEN

A barrier to meeting the goal of universal health coverage in India is the inequality in utilisation of health services between indigenous and non-indigenous people. This study aimed to explore the determinants of utilisation, or non-utilisation, of public healthcare services among the Santals, an indigenous community living in West Bengal, India. The study holistically explored the utilisation of public healthcare facilities using a framework that conceptualised service coverage to be dependent on a set of determinants - viz. the nature and severity of the ailment, availability, accessibility (geographical and financial), and acceptability of the healthcare options and decision-making around these further depends on background characteristics of the individual or their family/household. This cross-sectional study adopts ethnographic approach for detailed insight into the issue and interviewed 422 adult members of Santals living in both rural (Bankura) and urban (Howrah) areas of West Bengal for demographic, socio-economic characteristics and healthcare utilisation behaviour using pre-tested data collection schedule. The findings revealed that utilisation of the public healthcare facilities was low, especially in urban areas. Residence in urban areas, being female, having higher education, engaging in salaried occupation and having availability of private allopathic and homoeopathic doctors in the locality had higher odds of not utilising public healthcare services. Issues like misbehaviour from the health personnel, unavailability of medicine, poor quality of care, and high patient load were reported as the major reasons for non-utilisation of public health services. The finding highlights the importance of improving the availability and quality of care of healthcare services for marginalised populations because these communities live in geographically isolated places and have low affordability of private healthcare. The health programme needs to address these issues to improve the utilisation and reduce the inequality in healthcare utilisation, which would be beneficial for all segments of Indian population.

Asunto(s)

RESUMEN

Dust pollution is common in Indian roads and several industrial settings (including mines) that affects human health. Identification and characterization of the dust particles in the mining area is essential for knowing the properties of the dust that effectively causes ailments to humans, particularly among workers those who are working in unorganized industrial settings. The present study aimed to determine the level of dust pollution and to know the size and characterize the dust particles in the Pachami-Hatgacha stone mine areas of Birbhum district, West Bengal, India. Dust samples were collected and analysed for Dynamic Light Scattering (DLS) to determine the size and shape of the particles, Fourier Transform Infrared Spectroscopy (FT-IR) to determine the free silica content, and X-ray Florence (XRF) analysis for quantitative estimation of components in the sample. All the analyses were done following standard instrumentation and techniques. The size of the dust particles was much less (ranges 101-298 nm) than the size of respirable particles (2500 nm). Those were mostly generated as well as precipitated during peak working hours of the day. Presence of considerable amounts of silica was confirmed by the FT-IR (strong and broad band at 1000 cm-1) and XRF analysis (76.85% SiO2). Exposure to these dust particles may cause severe health impairments. Therefore, interventions like wet drilling and blasting, sprinkling of water during peak working hours, and awareness of use of personal protective devices among workers are required to reduce the risk and hazards associated with dust pollution to the health of miners and inhabitants around the mines.

Asunto(s)

RESUMEN

A bacterium, strain PS-8T of the genus Chryseobacterium, was isolated from the skin of freshwater pufferfish (Tetraodon cutcutia). Strain PS-8T is a Gram-negative, aerobic, non-motile, and rod-shaped bacterium. Colonies appear in yellowish-orange colors. The major cellular fatty acids were C15:0 iso, C17:0 iso 3OH, C15:0 iso 3OH, and C11:0 anteiso. The predominant polar lipids were phosphatidylethanolamine and amino lipids. The genome size is 4.83 Mb. The G + C content was 35.6%. The in silico dDDH homology, ANI, and AAI were below the cutoff value, 70% and 95% to 96%, respectively, suggesting that strain PS-8T represents a defined species. The phylogenetic tree based on core and the non-recombinant genes showed the strain PS-8T clustered with Chryseobacterium gambrini DSM 18014T. Genome-wide analysis decodes several virulence factors of the genus Chryseobacterium, including genes for adherence, biofilm and stability, proliferation, resistance to immune response, and host-defense evasion system. The cladogram of the virulence genes showed a phylogenetic relationship among the Chryseobacterium species. Knowledge of the association of Chryseobacterium with freshwater pufferfish adds a new ecological niche to this bacterium.

Asunto(s)

RESUMEN

Bone is the most favored site for metastasis for each major subtype of breast cancer. Therapeutic modalities for alleviation of clinical symptoms associated with bone metastasis include surgical resection, radiation, and bone-targeted therapies, including bisphosphonates (e.g., zoledronic acid; ZA) and a humanized antibody against receptor activator of nuclear factor-κB ligand (denosumab). However, the bone-targeted therapies are expensive, and have poor pharmacokinetic attributes and/or serious adverse effects. Therefore, novel strategies are needed for treatment of bone metastasis or to increase effectiveness of existing bone-targeted therapies. We have shown previously that benzyl isothiocyanate (BITC) is a novel inhibitor of osteoclast differentiation in vitro and bone metastasis in vivo. The present study shows that BITC + ZA combination synergistically inhibits osteoclast differentiation induced by addition of conditioned media from breast cancer cells. These effects were associated with a significant increase in levels of several antiosteoclastogenic cytokines, including interferons, interleukin (IL)-3, IL-4, and IL-27. Kyoto Encyclopedia of Genes and Genomes pathway analysis of RNA-seq data from BITC and/or ZA-treated cells revealed downregulation of genes of many pathways (e.g., actin cytoskeleton, Hippo signaling, etc.) by treatment with BITC + ZA combination, but not by BITC alone or ZA alone. Confocal microscopy confirmed severe disruption of actin cytoskeleton upon treatment of MCF-7 and MDA-MB-231 cells with the BITC + ZA combination. This combination also decreased the nuclear level of yes-associated protein, a core component of Hippo signaling. In conclusion, the present study offers a novel combination for prevention or treatment of bone metastasis of breast cancer.

Asunto(s)

RESUMEN

A Gram-negative, aerobic bacterial strain RR6T was isolated from the sea sand to produce lipase and proposed as a novel species of Halopseudomonas. The optimum growth occurred at 28–37 °C, and the pH was 6.0–8.0. The optimum growth occurred at 3.0 -6.5% (w/v) NaCl. The major cellular fatty acids were C10:0 3OH, C12:0, C16:1 ω7c/16:1 ω6c, 18:1 ω7c and/or 18:1 ω6c, and C16:0. The predominant polar lipids were phosphatidylglycerol, diphosphatidylglycerol, phosphatidylethanolamine, phosphatidylcholine, unidentified phospholipid, and unidentified lipids. The genome is 3.93 Mb, and the G + C content is 61.3%. The 16S rRNA gene sequences shared 99.73–99.87% sequence similarity with the closely related type strains of Halopseudomonas. The average nucleotide identity and average amino acid identity of strain RR6T with reference type strains were below 95–96%, and the corresponding in-silico DNA–DNA hybridization values were below 70%. Strain RR6T clustered with Halopseudomonas gallaeciensis V113T and Halopseudomonas pachastrellae CCUG 46540 T in the phylogenetic tree. Further, lipase produced by this bacterium belongs to α/β hydrolase lipase family and exhibits structural similarity to the lactonizing lipase. Based on the polyphasic analysis, the new isolates RR6T represent a novel species of Halopseudomonas for which Halopseudomonas maritima sp. nov. is proposed. The type strain is RR6T (= NBRC 115418 T = TBRC 15628 T).(AU)

Asunto(s)

RESUMEN

Soft robots are becoming more popular because they can solve issues stiff robots cannot. Soft component and system design have seen several innovations recently. Next-generation robot-human interactions will depend on soft robotics. Soft material technologies integrate safety at the material level, speeding its integration with biological systems. Soft robotic systems must be as resilient as biological systems in unexpected, uncontrolled situations. Self-healing materials, especially polymeric and elastomeric ones, are widely studied. Since most currently under-development soft robotic systems are composed of polymeric or elastomeric materials, this finding may provide immediate assistance to the community developing soft robots. Self-healing and damage-resilient systems are making their way into actuators, structures, and sensors, even if soft robotics remains in its infancy. In the future, self-repairing soft robotic systems composed of polymers might save both money and the environment. Over the last decade, academics and businesses have grown interested in soft robotics. Despite several literature evaluations of the soft robotics subject, there seems to be a lack of systematic research on its intellectual structure and development despite the rising number of articles. This article gives an in-depth overview of the existing knowledge base on damage resistance and self-healing materials' fundamental structure and classifications. Current uses, problems with future implementation, and solutions to those problems are all included in this overview. Also discussed are potential applications and future directions for self-repairing soft robots.

RESUMEN

Three closely related, aerobic, Gram-stain-negative, motile, rod-shaped bacterial strains (PS-2T, PS-17, and PS-19) were isolated from the skin of freshwater pufferfish (Tetraodon cutcutia). Colonies are pinkish-colored. The optimum growth occurred at 28-30 °C, and the pH was 6.5-7. The major cellular fatty acids were C16:1 ω7c, iso-C15.0, C17:1 ω8c, C18:1 ω7c, and C16:0. The predominant polar lipids were phosphatidylglycerol, phosphatidylethanolamine, and amino lipids. The genome size of strain PS-2T is 4.8 Mbp, and the G + C content was 46.0%. The major fraction of genes were associated with biological processes (45.64%), followed by molecular function (29.86%) and cellular components (24.49%). The unique genes identified in strain PS-2T secreted cyanophycinase, UDP-N-acetylglucosamine 2-epimerase, methyltransferase, kynureninase, ADA regulatory protein, biphenyl degradation, thermostable carboxypeptidase 1, tetrathionate respiration, etc. In addition, alanine and glutamate racemases were present. The 16S rRNA gene sequences shared 98.83-99.24% similarity with the closely related type strains of Shewanella. The ANI and AAI of strain PS-2T with reference type strains of the genus Shewanella were below 95-96%, and the corresponding dDDH values were below 70%. A phylogenetic tree based on 16S rRNA gene sequences and genome-wide core genes revealed that strain PS-2T clustered with Shewanella oneidensis LMG 19005T in both phylogenetic trees. Based on the polyphasic analysis, the new isolates (PS-2T, PS-17, and PS-19) represent a novel species of Shewanella, for which Shewanella cutis sp. nov. is proposed. The type strain is PS-2T (= TBRC 15838T = NBRC 115342T).

RESUMEN

Basic amines show broad bioactivity and remain a promising source of new medicines. The direct photoalkylation of imines offers a promising strategy for complex amines. However, the lack of efficient imine photoreactivity hinders this reaction and remains a fundamental limitation in organic photochemistry. We report an efficient photoalkylation of imines that provides primary amines directly without protecting or leaving groups. The transformation effects C-H addition across N-H imines under energy-transfer photocatalysis by a ketone. Our method is distinguished from organometallic, metal-catalyzed, and photoredox approaches to imine alkylation by its lack of protecting groups and its broad scope, which includes unactivated alkanes, protic substrates, basic amines, heterocycles, and ketone imines. We highlight this scope through the condensation and alkylation of two pharmaceutical ketones, providing complex amines succinctly. Our mechanistic analysis supports a three-step process, involving hydrogen-atom transfer to an imine triplet excited state, intersystem crossing, and radical recombination, with photocatalytic enhancement through energy transfer. We further show that N-H imines are more photoreactive than N-substituted imines, a distinction partially explained by sterics and side reactions. To fully explain this distinction, we introduce the thermodynamic parameter excited-state hydrogen-atom affinity, which is highly effective at predicting the photoreactivity of imines.

RESUMEN

Until recently, members of the classical Bordetella species comprised only pathogenic bacteria that were thought to live exclusively in warm-blooded animals. The close phylogenetic relationship of Bordetella with Achromobacter and Alcaligenes, which include primarily environmental bacteria, suggests that the ancestral Bordetellae were probably free-living. Eventually, the Bordetella species evolved to infect and live within warm-blooded animals. The modern history of pathogens related to the genus Bordetella started towards the end of the 19th century when it was discovered in the infected respiratory epithelium of mammals, including humans. The first identified member was Bordetella pertussis, which causes whooping cough, a fatal disease in young children. In due course, B. bronchiseptica was recovered from the trachea and bronchi of dogs with distemper. Later, a second closely related human pathogen, B. parapertussis, was described as causing milder whooping cough. The classical Bordetellae are strictly host-associated pathogens transmitted via the host-to-host aerosol route. Recently, the B. bronchiseptica strain HT200 has been reported from a thermal spring exhibiting unique genomic features that were not previously observed in clinical strains. Therefore, it advocates that members of classical Bordetella species have evolved from environmental sources. This organism can be transmitted via environmental reservoirs as it can survive nutrient-limiting conditions and possesses a motile flagellum. This study aims to review the molecular basis of origin and virulence properties of obligate host-restricted and environmental strains of classical Bordetella.

Asunto(s)

Asunto(s)

RESUMEN

Background: Maternal and child health (MCH) care is one of the essential routine healthcare services, which got affected during the coronavirus disease 2019 (COVID-19) pandemic. Modeled projections had anticipated an 8.3%-38.6% rise in maternal mortality from different countries globally. In view of limited studies pertaining to issues related to accessing MCH services in the event of a pandemic, this study was carried out on pregnant and postnatal mothers in Odisha, India. Methods: An explorative qualitative study through 36 in-depth interviews (IDIs) was conducted among 16 (44.4%) antenatal and 20 (55.5%) postnatal mothers in six of thirty districts of Odisha, India, from February to April 2021. The districts and blocks were randomly selected for better representativeness. The IDIs were conducted using a predesigned and pretested guide among mothers who had undergone delivery or availed of antenatal, postnatal, or child health services from October 2020 to April 2021. The IDIs were conducted till data saturation. The data were analyzed using MAXQDA software. Results: The average age of mothers was 27.6 (+/- 2.2) years. Among the participants, 16 (44.4%) were antenatal and 20 (55.6%) were postnatal mothers; 19 (52.8%) were primipara and 17 (47.2%) were multipara. The majority explained that they received enormous support including door-to-door services from the community health workers (CHWs) even during the difficult times of the pandemic. Reduced transportation facility and fear of contracting the infection were reasons behind the unwillingness to visit health facilities and preference for home delivery. Furthermore, the pandemic had physical, mental, social, and financial impacts among pregnant and postnatal women. Conclusion: The unprecedented COVID-19 pandemic has affected access to MCH services by antenatal and postnatal mothers. Health system preparedness and appropriate strategies including better community engagement and participation could avert such challenges in the future.