South Eastern European Journal of Public Health

Comparative Study Of Thyroid Hormone Levels In Newborns With And Without Perinatal Asphyxia In Dr Sushila Tiwari Hospital

Dr. Ajay Anand Goswami, Dr. Prerna Chamoli, Dr. Ritu Rakholia — 2025-09-02

Background: Perinatal asphyxia remains a leading cause of neonatal morbidity and mortality, particularly in low- and middle-income countries like India. While its neurological and systemic sequelae are well recognized, its endocrine effects—especially on the hypothalamic-pituitary-thyroid (HPT) axis—are less explored. Thyroid hormones are essential for early neurodevelopment, and hypoxia may impair their regulation, contributing to further neonatal complications.

Objectives: To compare thyroid hormone levels (T3, T4, TSH) between term neonates with and without perinatal asphyxia and to assess their association with hypoxic-ischemic encephalopathy (HIE) staging and neonatal outcomes in a tertiary care setting.

Methods: A cross-sectional, hospital-based study was conducted at Dr. Sushila Tiwari Hospital, Haldwani, including 130 term neonates—65 with perinatal asphyxia and 65 healthy controls. Blood samples were collected at 72 hours of life for thyroid hormone analysis. Clinical data including birth weight, mode of delivery, Apgar scores, and multi-organ function parameters were recorded. HIE was staged using Sarnat and Sarnat criteria. Statistical analysis was done using SPSS; p<0.05 was considered significant.

Results: Mean T3 and T4 levels were significantly lower, while TSH was markedly elevated in asphyxiated neonates (p<0.001). Thyroid dysfunction severity correlated with HIE stage and low birth weight. Multi-organ dysfunction and need for ventilatory support were significantly associated with altered thyroid status. Logistic regression identified low T3, severe HIE, and low maternal education as predictors of mortality.

Conclusion: Perinatal asphyxia significantly alters thyroid function, with prognostic implications. Routine screening for thyroid dysfunction may guide timely intervention.

Spectrum Of Diseases On Bone Marrow Aspiration In Cases Of Pancytopenia In A Tertiary Care Centre

Dr. Pranjali Dwivedi, Dr. Prabhu M.H., Dr. Sweta Sangma, Dr. Tanvi Mehta — 2025-09-02

Background: Pancytopenia is a hematological condition characterized by a reduction in all three blood cell lines—erythrocytes, leukocytes, and platelets. It is a manifestation of various underlying pathologies affecting the bone marrow and peripheral blood.

Objectives: To determine the spectrum of diseases diagnosed on bone marrow aspiration in cases of pancytopenia in a tertiary care setting.

Methods: This prospective study was conducted over 18 months on 100 pancytopenic patients. Bone marrow aspiration and relevant hematological investigations were performed, and data were statistically analyzed.

Results: Megaloblastic anemia (47%) was the most common cause, followed by aplastic anemia (19%) and acute leukemia (13%). Hypercellular marrow was observed in 52% of cases. Peripheral smear findings correlated well with bone marrow diagnoses.

Conclusion: Bone marrow aspiration remains a crucial diagnostic tool in evaluating pancytopenia and helps in guiding appropriate patient management.

Technological Dimension Of E-Governance And Organizational Change – Exploring Transformation In Government Departments

Sabin Sameed, Dr. C. Ramesh Kumar — 2025-09-02

This study explores the technological dimensions of e-Governance and their influence on organizational change in government departments in Kerala, with particular focus on the revenue department involving village assistants and village officers. A structured questionnaire survey was administered to 385 respondents, examining seven technological dimensions—ICT infrastructure, system integration, interoperability, data security and privacy, technical skill and training, automation and digitalization, and technology adoption rate—as predictors of organizational change.

Descriptive statistics revealed relatively higher levels of system integration and technical skill development, while automation and digitalization lagged behind, indicating uneven progress across dimensions. Multiple regression analysis confirmed that interoperability, automation and digitalization, technical skill and training, and data security significantly and positively contributed to organizational change. In contrast, system integration exerted a significant negative influence, suggesting transitional challenges associated with integration processes. ICT infrastructure and technology adoption rate were found to be statistically insignificant. The model explained 37.3% of the variance in organizational change, demonstrating the substantial yet differentiated impact of technological factors.

The findings emphasize that e-Governance transformation extends beyond infrastructure investment or adoption efforts; it requires effective interoperability, robust security mechanisms, employee capacity-building, and streamlined processes. The study contributes to e-Governance literature by highlighting the uneven role of technological dimensions in driving organizational transformation and offers actionable insights for policymakers seeking to strengthen digital governance initiatives.

Post-Conflict Health System Recovery: A Descriptive Synthesis Across Surgical, Rehabilitation And Governance Domains

2025-10-09

Background: Post-conflict health systems face complex challenges in restoring essential services, particularly surgical capacity, rehabilitation, and system-wide governance. While global frameworks offer guidance, empirical evidence on recovery trajectories remains fragmented.

Objectives: This review synthesizes evidence across three domains—health-system reform, surgical setup restoration, and rehabilitation integration—to identify patterns, gaps, and actionable strategies for post-conflict recovery.

Methods: A systematic search of peer-reviewed and grey literature was conducted across five databases and institutional repositories. Seventy-eight studies met inclusion criteria, spanning 22 conflict-affected countries. Data were extracted on study design, geographic scope, health system function, and reported outcomes. A descriptive synthesis was applied, supported by comparative tables and thematic mapping.

Results: Recovery is feasible even in fragile settings, with safe surgery and service delivery re-established through standardized protocols and targeted investments. However, evidence is uneven by geography and domain. South Asia contributes only surgical studies; Sub-Saharan Africa lacks rehabilitation data. Outcome reporting clusters around safety and governance, with limited data on workforce, functional recovery, capacity, and financial protection. Rehabilitation is underrepresented despite its long-term impact. Observational designs dominate, with few embedded program evaluations.

Conclusion: Post-conflict systems recover fastest when enabling functions are restored, financial access is protected, and rehabilitation is integrated early. Co-governance with humanitarian partners and standardized indicators are essential. Investment in locally led evaluation—especially in underrepresented regions and rehabilitation—is critical to building resilient, equitable care.

Predictors Of Neonatal Complications In Emergency Cesarean Deliveries: Insights From Prenatal Profiles At Omdurman Maternity Hospital

2025-10-09

Background: Emergency cesarean deliveries are associated with elevated neonatal risks, particularly in low-resource settings. Identifying prenatal predictors of adverse outcomes is essential for improving perinatal care.

Objective: To evaluate maternal and prenatal factors associated with neonatal complications following emergency cesarean sections at Omdurman Maternity Hospital.

Methods: This study investigates prenatal predictors of neonatal complications following emergency cesarean deliveries at Omdurman Maternity Hospital. A retrospective analysis of 300 cases was conducted using multivariate logistic regression. Key predictors included maternal illiteracy, lack of antenatal care, and late hospital presentation. These findings underscore the need for targeted public health interventions to improve prenatal education, access to care, and early triage systems in low-resource settings.

Results: Cord prolapse and uterine rupture were significantly associated with NICU admission (>40%) and neonatal death (>7%). Neonatal mortality was highest among infants born to illiterate mothers (7.5%) compared to university graduates (0.7%). Blood transfusion and prolonged NICU stay were strong predictors of adverse neonatal outcomes. Maternal age, parity, and antenatal care attendance showed moderate correlation with neonatal complications.

Conclusion: Prenatal factors such as maternal education, antenatal care quality, and clinical indications for cesarean delivery are critical predictors of neonatal outcomes. Strengthening prenatal screening and labor triage protocols may reduce neonatal morbidity in emergency cesarean settings.

Etiological And Clinical Profile Of 3rd, 4th, 6th, And Multiple Cranial Nerve Palsies In A Tertiary Care Center

Saqib, Shahidah Zaman, Ammar bin Ahsan, Nida, Awais Amjad, Fauzia Raza — 2025-09-02

Introduction
Lower motor neuron cranial neuropathies, whether isolated or combined, pose significant diagnostic and therapeutic challenges due to diverse underlying causes. Regional data on their distribution and determinants remain limited, particularly in this study aimed to analyze the incidence, clinical spectrum, and etiological patterns of third, fourth, sixth, and multiple cranial nerve palsies in patients attending a tertiary care hospital.

Method
A cross-sectional observational study was conducted at Avicenna Medical College (AMC) and Hospital from November 2024 to April 2025. Consecutive cases of third, fourth, sixth, or combined lower motor neuron cranial nerve palsies were enrolled. Patients with first or second nerve involvement, neuromuscular junction disease, or primary muscle pathology were excluded. Detailed clinical evaluation, laboratory testing, electrophysiology, and neuroimaging were performed. Associations were analyzed using chi-square and correlation tests.

Results
A total of 388 patients were assessed. The mean age at presentation was 53.5 years, with male predominance across all groups. Third nerve palsy was most frequent (26.6%), followed by fourth (21.5%), sixth (19.8%), and multiple (9.2%). Ischemic cerebrovascular disease was the leading cause, especially in single nerve palsies, while tumors, aneurysms, and trauma were more frequent in multiple involvement. Hypertension, diabetes, smoking, and alcohol emerged as major risk factors.

Conclusion
Cranial nerve palsies predominantly affect middle-aged men, with ischemia and vascular comorbidities as key contributors. Infections and neoplastic processes remain important in younger or multiple nerve presentations. Recognition of demographic and risk factor patterns may guide timely diagnosis and management.

Prevention Of Type-2 Diabetes Mellitus In High-Risk Adults Using Lifestyle Interventions In Primary Care Settings: A Scoping Review

Abdelrazig E. Abdelbari — 2025-09-15

Background: Type 2 diabetes mellitus (T2DM) is a major global health concern, with rising prevalence among adults at high risk due to obesity, sedentary lifestyles, and genetic predisposition. Primary care settings offer a strategic platform for implementing lifestyle interventions aimed at prevention.

Objective: This scoping review aims to map global evidence on the effectiveness of lifestyle interventions in preventing T2DM among high-risk adults within primary care and community-based settings.

Methods: Following the Joanna Briggs Institute methodology, a comprehensive search was conducted across PubMed, MEDLINE, CINAHL, AMED, and Google Scholar for studies published between 2000 and 2023. Eligible studies included adults aged 18 and above at high risk for T2DM, and evaluated lifestyle interventions—dietary changes, physical activity, and weight management—delivered through primary care or community channels.

Results: Thirty studies met inclusion criteria, predominantly randomized controlled trials and implementation studies. Combined lifestyle interventions significantly reduced the incidence of T2DM, with sustained weight loss emerging as the most consistent predictor of success. Group-based programs and culturally tailored approaches enhanced feasibility and adherence. However, implementation barriers such as limited resources, staff training, and participant engagement were noted, particularly in low-resource settings.

Conclusion: Lifestyle interventions in primary care are effective in preventing T2DM among high-risk adults. Scaling these interventions requires contextual adaptation, policy support, and sustainable delivery models. Future research should focus on long-term outcomes and strategies to overcome implementation challenges.

Association Of Tobacco Use And Cancer Incidence In India; A Systematic Review

2025-09-09

Purpose- To determine extent to which tobacco use and cancer incidence are related in Indian population. Materials And Methods-Data from the Virtual Health Library, PubMed, and Embase was accessed from the databases' creation until April 30, 2022. Other than the English language and human investigation, there were absolutely no limitations. Cohort and case-control studies investigating the association between tobacco use and cancer incidence were chosen. The requirements of the Preferred Reporting Items for Systematic Reviews and Meta Analyses were adhered. Results - The majority of them were case-control designs (60, 89.6%), and they covered a variety of geographical areas, with Kerala (12, 20%) and Maharashtra (18, 30%) being the most researched. Males were associated with smoked tobacco at 2.35 (95% CI, 2.05 to 2.65), while females were associated with smokeless tobacco at 1.77 (95% CI, 1.47 to 2.07) and 2.34 (95% CI, 1.26 to 3.42). Conclusion- In order to help stakeholders and policymakers develop tobacco-specific interventions, investigation emphasises that both smoked and smokeless tobacco are equally detrimental to human health within Indian population.