International Medical Journal

Journal ID : IMJ-26-05-2020-481

Total View : 383

Title : FINANCIAL PROTECTION FOR UNIVERSAL HEALTH COVERAGE IN INDIA: ASSESSING THE INTENSITY OF CATASTROPHIC HEALTH EXPENDITURES

Abstract : India is currently taking steps to provide Universal Health Coverage (UHC) to its population as envisaged in the National Health Policy 2017. Providing financial protection is considered the backbone of UHC. Out-of-pocket (OOP) health care payment is the most important mechanism for health care payment in India. This study aims to investigate the effect of OOP heath care payments on catastrophic health expenditures (CHE). This research seeks to inform policy makers and health financing practitioners about the characteristics of beneficiaries and types of services to be considered for reducing likelihood of CHE in a system that intends to provide UHC. Data from the recent national survey by the National Sample Survey Organization, Social Consumption in Health 2014 is used to investigate the effect of OOP health expenditure on household welfare in India. Three aspects of catastrophic expenditure were analyzed in this paper: (i) intensity of ‘catastrophic’ health expenditure, (ii) socioeconomic inequality in catastrophic health expenditures, and (iii) factors affecting intensity of catastrophic health expenditures. The sample consisted of 65,932 households. CHE incidence was 10.94% in the whole population. Mean positive overshoot was 35.94% higher than the 10% threshold level of total household consumption expenditure. The intensity of CHE were higher for the poorer households. The multiple regression model showed that the intensity of CHE was higher among households with members having chronic illness, and if members had higher duration of stay in the hospital. Subsidizing healthcare to the households having elderly members and children is necessary to reduce CHE. Expanding health insurance coverage, increasing coverage limits, and inclusion of coverage for outpatient and preventive services are vital to protect households. Strengthening public primary health infrastructure and setting up of a regulatory organization to establish policies and conducts regular audits to ensure that private hospitals do not increase hospitalizations and the duration of stay are necessary.
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International Medical Journal

Journal ID : IMJ-26-05-2020-480

Total View : 300

Title : L-arginineameliorates atherosclerosis by eliciting anti-inflammatory/antioxidant activity in rabbits

Abstract : The study was designed to investigate the effect of L-arginine on atherosclerosis particularly by identification of some elements of inflammatory and oxidative cascades. Eighteen local domestic rabbits (male) were introduced and allocated into 3 groups (6 rabbits per group) and the duration of the study was 12 weeks. The first one was considered as a negative control group in which animals received normal diet only. The second one was the group in which rabbits received dietenriched with cholesterol (5 %). The last group was the one in which received dietenriched with cholesterol (5 %) together with oral L-arginine (1.5%). At the end of the study, animals were sacrificed, and blood sampleswere to identify serumlevels endothelin-1(ET-1) and tumor necrosis factor-alpha (TNF-α). Lipid parameters (TC, TG, HDL-C, LDL-C and VLDL-C) were also determined in the serum. Aorta was isolated to detect total antioxidant capacity (TAC) and intimal thickness. Treatment of rabbit with L-arginine was associated withsignificant elevation of serum level of TC, HDL-C and LDL-C but insignificant reduction in TG and VLDL-C level when compared with untreated group. Treatment with L-arginine was associated withinsignificant elevation ofboth serum TNF-α level and aortic TAC andinsignificant reduction in serum ET-1andaortic intima thickness when compared with untreated rabbits. L-argininehas a potential ameliorating effect on atherosclerosis. This was mainly achieved by its inhibitory effects on some inflammatory and oxidative cascades.
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International Medical Journal

Journal ID : IMJ-24-05-2020-479

Total View : 252

Title : INCIDENCE OF CATASTROPHIC HEALTH EXPENDITURES IN INDIA: SOCIOECONOMIC INEQUALITY AND DETERMINANTS

Abstract : India is currently taking steps to provide Universal Health Coverage (UHC) to its population as envisaged in the National Health Policy 2017. Providing financial protection is considered the backbone of UHC. Out-of-pocket (OOP) health care payment is the most important mechanism for health care payment in India. This study aims to investigate the effect of OOP heath care payments on catastrophic health expenditures (CHE). This research seeks to inform policy makers and health financing practitioners about the characteristics of beneficiaries and types of services to be considered for reducing likelihood of CHE in a system that intends to provide UHC. Data from the recent national survey by the National Sample Survey Organization, Social Consumption in Health 2014 is used to investigate the effect of OOP health expenditure on household welfare in India. Three aspects of catastrophic expenditure were analyzed in this paper: (i) incidence of ‘catastrophic’ health expenditure, (ii) socioeconomic inequality in catastrophic health expenditures, and (iii) factors affecting incidence of catastrophic health expenditures. The sample consisted of 65,932 households. CHE incidence was 10.94% in the whole population. The odds of incidence of CHE were higher for the poorer households. Using the logistic regression model it was observed that the odds of incidence of CHE was higher among the households with at least one child aged less than 5 years, one elderly person, one secondary educated female member, and if at least one member in the household used a private healthcare facility for treatment. Subsidizing healthcare to the households having elderly members and children is necessary to reduce CHE. Expanding health insurance coverage, increasing coverage limits, and inclusion of coverage for outpatient and preventive services are vital to protect households. Strengthening public primary health infrastructure and setting up of a regulatory organization to establish policies and conducts regular audits to ensure that private hospitals do not increase hospitalizations and the duration of stay are necessary.
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International Medical Journal

Journal ID : IMJ-23-05-2020-478

Total View : 243

Title : Hyperpigmentation in Primigravida Pregnant Ladies in Relation to Foetal Gender

Abstract : Hyperpigmentation is most common cutaneous manifestation in pregnancy due to elevated serum levels of melanocyte stimulating hormones, estrogen or progesterone. Estrogen increases the output of melanin by the melanocytes and the effect of estrogen is augmented by progesterone, resulting in melanin deposition into epidermal cells and dermal macrophages, clinically either generalized hyperpigmentation or more commonly areas that are already physiologically dark become more obvious such as areolas, nipples, genitalia, axillae, periumbilical area, and inner thighs. Linae nigra, melasma, and longitudinal melanonychia are also more common with pregnancy. Assessment of hyperpigmentation during pregnancy in the third trimester in relation to foetus gender. A cross sectional study and convenient sampling method included all primigravida ladies in the third trimester were carried out. 309 pregnant ladies were collected from Al-Kindy teaching hospital, Al-mustanseryah and Bab Al-muatham primary health care centres during period from first of October 2018 till 29th of february 2020. Direct interview was made with pregnant ladies and check list was fulfilled. There was no significant correlation between foetus gender and development of melasma and melanonychia in pregnant ladies with p values 0.426 and 0.074 respectively, while there was significant correlation between foetus gender and the development of linea nigra, hyperpigmentation of areolas and flexures and generalized pigmentation in pregnant ladies with male foetuses with p value 0.018, 0.001 and 0.001 respectively. Hyperpigmentation was more in pregnant ladies with male foetuses than female foetuses.
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International Medical Journal

Journal ID : IMJ-23-05-2020-477

Total View : 308

Title : Fracture Resistance of Endodontically Treated Teeth Restored by Full Crown and Two Endocrowns Preparation Design Made from Lithium Disilicate Material (A Comparative in Vitro Study)

Abstract : The purpose of this in vitro study was to evaluate the effect of preparation design of glass fiber post retained crowns, endocrowns with shoulder finish line and endocrowns with butt joint margin on fracture resistance and failure mode of maxillary first premolar restored by lithium disilicate material. Thirty-six sound maxillary first premolars were used that decapitated 2 mm above CEJ from proximal surface and endodontically treated. They were randomly divided into 3 groups (n=12), in which, teeth were prepared to receive all- ceramic restorations made from lithium disilicate material (IPS E-max CAD, Ivoclar-Vivadent). GA: Endodontically treated teeth (ETT) restored with fiber posts and cores prepared with shoulder finish line retained crowns (n=12), GB: ETT restored with endocrowns with shoulder finish line(n=12) and GC: ETT restored with endocrowns with butt joint margin. Teeth of all groups were prepared by (Computerized numerical controlled milling machine (CNC milling machine) then the lithium disilicate restorations were made by CAD/CAM system and adhesively cemented with dual-cure resin cement. Specimens were mounted in a universal testing machine (LARYEE Universal testing machine, China). Each specimen was loaded to failure at a crosshead speed of 0.5 mm /min. Mode of failure was also observed. Data were analyzed using one-way analysis of variance (ANOVA) and Tukey’s post hoc significance difference tests. Differences were considered significant at P<0.05. One -way ANOVA test showed that group (GC) recorded statistically significant (p<0.05) with the highest mean value (1698.92) followed by (GA) (1444.17) then (GB) (1271 N) recorded the lowest mean value. Pair-wise Tukey’s post-hoc test showed significant (p<0.05) difference between GC and GB groups. The clinical significance of this study relates to decision which restoration is most suitable for severely damage endodontically treated and if conservative preparation have effect on the fracture resistance of classical crown with ferrule retained by post –core restoration, endocrown with ferrule or endocrown butt joint margin.
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Submission Deadline ( Vol 30 , Issue 04 )
20 Apr 2023

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Publish On ( Vol 30 , Issue 03 )
31 Mar 2023