Objectives: Malaria remains a serious public health challenge in tropical and subtropical regions, including Indonesia. Children under 5 years old face particular risk of contracting malaria due to low immunity. We examined potential factors associated with malaria infection among under-5 children in Papua Province, Indonesia. Methods: The study utilized secondary data from Indonesia Basic Health Research 2018.Multistage random sampling was employed, from the province level to census blocks (CBs).In Papua Province, interviews were conducted in 928 CBs. All 2,745 under-5 children wereselected. The dependent variable was laboratory-confirmed malaria positivity; independentfactors included residential area, socioeconomic characteristics, and behaviors such as sleepingunder an insecticide net impregnated ≤3 years ago and the use of ventilation barriers. We alsoexamined the conditions of the bedroom, kitchen, and living room according to the frequency ofwindow-opening, proportion of ventilation area to the floor, and radiance. Results: Not sleeping under an insecticide net impregnated within the last 3 years (adjusted odds ratio [aOR], 0.518; 95% confidence interval [CI], 0.391–0.685; p < 0.001); having a kitchen without windows (aOR, 0.491; 95% CI, 0.285–0.844; p = 0.01); rarely opening the living room window (aOR, 2.804; 95% CI, 1.232–6.383; p = 0.01), and having a windowless living room (aOR, 3.027; 95% CI, 1.369–6.696; p = 0.01) displayed significant relationships with malaria infection among under-5children. Conclusion Not using an insecticide-treated net impregnated ≤3 years ago, along with openingthe living room window daily and having a kitchen without windows, appear preventive of malaria infection among under-5 children.

Objectives: Malaria remains a serious public health challenge in tropical and subtropical regions, including Indonesia. Children under 5 years old face particular risk of contracting malaria due to low immunity. We examined potential factors associated with malaria infection among under-5 children in Papua Province, Indonesia. Methods: The study utilized secondary data from Indonesia Basic Health Research 2018.Multistage random sampling was employed, from the province level to census blocks (CBs).In Papua Province, interviews were conducted in 928 CBs. All 2,745 under-5 children wereselected. The dependent variable was laboratory-confirmed malaria positivity; independentfactors included residential area, socioeconomic characteristics, and behaviors such as sleepingunder an insecticide net impregnated ≤3 years ago and the use of ventilation barriers. We alsoexamined the conditions of the bedroom, kitchen, and living room according to the frequency ofwindow-opening, proportion of ventilation area to the floor, and radiance. Results: Not sleeping under an insecticide net impregnated within the last 3 years (adjusted odds ratio [aOR], 0.518; 95% confidence interval [CI], 0.391–0.685; p < 0.001); having a kitchen without windows (aOR, 0.491; 95% CI, 0.285–0.844; p = 0.01); rarely opening the living room window (aOR, 2.804; 95% CI, 1.232–6.383; p = 0.01), and having a windowless living room (aOR, 3.027; 95% CI, 1.369–6.696; p = 0.01) displayed significant relationships with malaria infection among under-5children. Conclusion Not using an insecticide-treated net impregnated ≤3 years ago, along with openingthe living room window daily and having a kitchen without windows, appear preventive of malaria infection among under-5 children.

Objectives: Malaria remains a serious public health challenge in tropical and subtropical regions, including Indonesia. Children under 5 years old face particular risk of contracting malaria due to low immunity. We examined potential factors associated with malaria infection among under-5 children in Papua Province, Indonesia. Methods: The study utilized secondary data from Indonesia Basic Health Research 2018.Multistage random sampling was employed, from the province level to census blocks (CBs).In Papua Province, interviews were conducted in 928 CBs. All 2,745 under-5 children wereselected. The dependent variable was laboratory-confirmed malaria positivity; independentfactors included residential area, socioeconomic characteristics, and behaviors such as sleepingunder an insecticide net impregnated ≤3 years ago and the use of ventilation barriers. We alsoexamined the conditions of the bedroom, kitchen, and living room according to the frequency ofwindow-opening, proportion of ventilation area to the floor, and radiance. Results: Not sleeping under an insecticide net impregnated within the last 3 years (adjusted odds ratio [aOR], 0.518; 95% confidence interval [CI], 0.391–0.685; p < 0.001); having a kitchen without windows (aOR, 0.491; 95% CI, 0.285–0.844; p = 0.01); rarely opening the living room window (aOR, 2.804; 95% CI, 1.232–6.383; p = 0.01), and having a windowless living room (aOR, 3.027; 95% CI, 1.369–6.696; p = 0.01) displayed significant relationships with malaria infection among under-5children. Conclusion Not using an insecticide-treated net impregnated ≤3 years ago, along with openingthe living room window daily and having a kitchen without windows, appear preventive of malaria infection among under-5 children.

Objectives: Malaria remains a serious public health challenge in tropical and subtropical regions, including Indonesia. Children under 5 years old face particular risk of contracting malaria due to low immunity. We examined potential factors associated with malaria infection among under-5 children in Papua Province, Indonesia. Methods: The study utilized secondary data from Indonesia Basic Health Research 2018.Multistage random sampling was employed, from the province level to census blocks (CBs).In Papua Province, interviews were conducted in 928 CBs. All 2,745 under-5 children wereselected. The dependent variable was laboratory-confirmed malaria positivity; independentfactors included residential area, socioeconomic characteristics, and behaviors such as sleepingunder an insecticide net impregnated ≤3 years ago and the use of ventilation barriers. We alsoexamined the conditions of the bedroom, kitchen, and living room according to the frequency ofwindow-opening, proportion of ventilation area to the floor, and radiance. Results: Not sleeping under an insecticide net impregnated within the last 3 years (adjusted odds ratio [aOR], 0.518; 95% confidence interval [CI], 0.391–0.685; p < 0.001); having a kitchen without windows (aOR, 0.491; 95% CI, 0.285–0.844; p = 0.01); rarely opening the living room window (aOR, 2.804; 95% CI, 1.232–6.383; p = 0.01), and having a windowless living room (aOR, 3.027; 95% CI, 1.369–6.696; p = 0.01) displayed significant relationships with malaria infection among under-5children. Conclusion Not using an insecticide-treated net impregnated ≤3 years ago, along with openingthe living room window daily and having a kitchen without windows, appear preventive of malaria infection among under-5 children.

Objectives: Malaria remains a serious public health challenge in tropical and subtropical regions, including Indonesia. Children under 5 years old face particular risk of contracting malaria due to low immunity. We examined potential factors associated with malaria infection among under-5 children in Papua Province, Indonesia. Methods: The study utilized secondary data from Indonesia Basic Health Research 2018.Multistage random sampling was employed, from the province level to census blocks (CBs).In Papua Province, interviews were conducted in 928 CBs. All 2,745 under-5 children wereselected. The dependent variable was laboratory-confirmed malaria positivity; independentfactors included residential area, socioeconomic characteristics, and behaviors such as sleepingunder an insecticide net impregnated ≤3 years ago and the use of ventilation barriers. We alsoexamined the conditions of the bedroom, kitchen, and living room according to the frequency ofwindow-opening, proportion of ventilation area to the floor, and radiance. Results: Not sleeping under an insecticide net impregnated within the last 3 years (adjusted odds ratio [aOR], 0.518; 95% confidence interval [CI], 0.391–0.685; p < 0.001); having a kitchen without windows (aOR, 0.491; 95% CI, 0.285–0.844; p = 0.01); rarely opening the living room window (aOR, 2.804; 95% CI, 1.232–6.383; p = 0.01), and having a windowless living room (aOR, 3.027; 95% CI, 1.369–6.696; p = 0.01) displayed significant relationships with malaria infection among under-5children. Conclusion Not using an insecticide-treated net impregnated ≤3 years ago, along with openingthe living room window daily and having a kitchen without windows, appear preventive of malaria infection among under-5 children.

BACKGROUND AND PURPOSE: Parkinson's disease (PD) is a major neurological disorder that requires lifelong treatment, and the combined presence of Helicobacter pylori (H. pylori) infection can increase the required anti-PD medications. We aim to investigate the effect of H. pylori infection in Indian PD patients. METHODS: We prospectively recruited 36 PD patients from December 2007 to January 2011. All patients underwent a detailed neurological evaluation and serological examination for H. pylori infection. Seropositive and seronegative patients were considered to be the cases and controls, respectively. All patients who were seropositive received triple therapy for 2 weeks. Outcome measures of the mean ‘off’ Unified Parkinson's Disease Rating Scale (UPDRS)-III score, mean ‘on’ UPDRS-III score, mean onset time, mean ‘on’ duration, and mean daily ‘on’ time were measured at baseline and at a 3-week follow-up. RESULTS: H. pylori-IgG positivity was present in 18 (50%) PD patients. The prevalence of men (72.2% vs. 33.3%), mean duration of disease (13.8 vs. 12.5) and mean levodopa equivalent daily dose (824 mg vs. 707 mg) were significantly higher among H. pylori positive patients than in controls (p<0.0001). Controls had a significantly longer ‘on’ duration and daily ‘on’ time, and better ‘on’ UPDRS-III scores. Seropositive patients took a significantly longer time to turn ‘on’ after a levodopa challenge. At the 3-week follow-up, H. pylori eradication significantly improved the mean ‘on’ UPDRS-III score, onset time, ‘on’ duration, and daily ‘on’ time. CONCLUSIONS: H. pylori infection was present in 50% of Indian PD patients. H. pylori seropositivity was associated with a poor response to levodopa and increased medication usage, while eradication therapy was associated with better patient outcomes.
Follow-Up Studies ; Helicobacter pylori* ; Helicobacter* ; Humans ; Levodopa ; Male ; Nervous System Diseases ; Outcome Assessment (Health Care) ; Parkinson Disease* ; Prevalence ; Prospective Studies

BACKGROUND AND PURPOSE: Vitamin D deficiency is common across all age groups and may contribute to cardiovascular diseases. Serum 25-hydroxyvitamin D deficiency causing ischemic stroke has been documented in recent reports. AIM: To investigate the association of serum 25-hydroxyvitamin D deficiency with ischemic stroke and subtypes. METHODS: We recruited 250 consecutive ischemic stroke patients and 250 age and sex matched controls attending the Department of Neurology, at Yashoda hospital, Hyderabad, India, from January 2011 to December 2012. All ischemic stroke patients underwent stroke subtyping. We measured 25-hydroxyvitamin D by chemiluminescence test, serum calcium, phosphorus, alkaline phosphatase, and C-reactive protein (CRP) in cases and controls. RESULTS: Out of 250 stroke patients, 190 (76%) were men and mean age was 58.4+/-11.1 years (age range-26-89 years). 25-hydroxyvitamin D deficiency was observed in 122 (48.8%) stroke patients and 79 (31.6%) controls (P=0.001). Among stroke patients, serum 25-hydroxyvitamin D deficiency was found in 54.9% (50/91) of patients with large artery atherosclerosis, 54% (20/37) in cardioembolic stroke, 44.4% (20/45) in small artery diseases, 42.8% (15/35) in stroke of other determined etiology and 40.4% (17/42) in stroke of un-determined etiology. Multiple logistic regression analysis showed an independent association of 25-hydroxyvitamin D deficiency with ischemic stroke (odds ratio: 1.6; 95% CI 1.2-2.8). The association was strongest with large artery atherosclerosis (odds ratio: 2.4; 95% CI 1.6-3.5) and cardioembolic stroke (odds ratio: 2.0; 95% CI 1.0-3.2). CONCLUSIONS: We found that 25-hydroxyvitamin D deficiency had an independent association with ischemic stroke. The association was established in large artery arthrosclerosis and cardioembolic stroke.
Alkaline Phosphatase ; Arteries ; Atherosclerosis ; C-Reactive Protein ; Calcium ; Cardiovascular Diseases ; Humans ; India ; Logistic Models ; Luminescence ; Male ; Neurology ; Phosphorus ; Stroke* ; Vitamin D Deficiency

Back ground and Objective: Both plasmapheresis and intra venous immunoglobulin (IVIG) are effective for Guillain-Barré syndrome (GBS) but differ in cost and ease of administration. The aim of this study was to evaluate and compare clinical outcome after treatment with IVIg and plasmapheresis in patients with various GBS subtypes and assess their cost effectiveness. Methods: Thirty seven consecutive GBS patients, recruited from May 2008 to September 2012, from Department of Neurology, Yashoda hospital Hyderabad, underwent detailed clinical and electrophysiological assessment. Patients randomly received either IVIG or plasmapheresis. Outcome was measured using change in mean motor power and Hughes grade at discharge. Effectiveness and duration of hospital stay was compared with cost effectiveness of both therapies. Results: Out of 37 patients; men were 23 (62.1%), mean age was 42.3 +14.1 years. Electro physiologically acute inflammatory demyelinating neuropathy (AIDP) was most common (56.7%). Nineteen patients (51.3%) received IVIG and plasmapheresis was done in 18 (48.6%). Cost of plasmapheresis was significantly lower (mean USD 2,584.5 versus USD 4,385.3) (p=0.01). At discharge, significant and similar improvement was noted in both groups although duration of hospital stay was longer in plasmapheresis group Three patients (2 in plasmapheresis and one in IVIG group) died. Conclusion: In developing countries, plasmapheresis may be a better option in treatment of GBS.

This study described the clinical and paraclinical features of south Indian patients with longitudinally extensive transverse myelitis (LETM) and contrasted the findings betweenaquaporin-4 positive versus negative patients. The subjects were recruited between2010 and 2013.The distinctive features among71 LETM patients were compared and it was observed that 56% of the total subjects were found to be AQP4-Ab positive. The ratio of female tomale was found to be higher in the AQP4-Ab positive group. Magnetic resonance imaging showed holocord involvement more commonly in AQP4-Abnegative than positive group. The presence of hypointense lesions did not correlate with severity. The main distinctive features between AQP4-Abpositive and negative cases include older onset age, higher proportion of female, low frequency of conus involvement and higher prevalence of coexisting autoimmune disorders in AQP4-Ab positive cases. Therewas no difference in attack severity, onset of optic neuritis, and spasms between the two groups. Our results suggest that the clinical and spinal cord neuro-imaging information can aid in distinguishing between the positive and negative group of patients with LETM. The early detection of AQP4-Ab positive status predicts the recurrence of LETM or occurrence of optic neuritis duringthe study period.

Purpose: Addressing health inequities is an integral part of contemporary medical education (ME), yet traditional lecture-based formats often fail to develop students’ deeper understanding and engagement. This study examined how a project-based learning (PjBL) approach influenced students’ learning experiences related to health equity. Methods: This was a qualitative phenomenology study. We designed an elective course on health equity using the PjBL approach and active learning methods. All participating students were asked to complete a group project aimed at addressing a specific health inequity issue from the surrounding community. Data were collected through reflective writing at the end of the course and analyzed using deductive thematic analysis. Twenty-seven codings were identified from 259 meaningful quotes (interrater agreement 99.62%) and grouped into four categories: character, role, competence, and learning experience. Results: Three major themes emerged from data analysis: (1) key learning experiences during the ME course (active learning, role-modeling, collaborative learning, comprehensive learning, and affective learning); (2) topics that facilitated students’ understanding of health inequities and physicians’ roles, particularly in addressing health inequities in Indonesia; and (3) the influence of the ME course on students’ outlook and beliefs. Conclusion Although this study did not introduce a novel method of instruction, it underscores the value of PjBL in enhancing students’ capacity to understand and tackle health inequities.