Insulin therapy is the cornerstone treatment of diabetic patients. Most diabetic patients cannot selfadministrate insulin due to various reasons to depend on caregivers. Objectives: To assess the knowledge, attitude, and practice (KAP) on insulin administration among diabetic patients and their caregivers. Methods: A prospective cross-sectional study was conducted for seven months. All diabetic patients age above 18 years who were on insulin therapy for more than six months were included in the study. Patient medical records were used to collect demographic information such as age, gender, educational status, occupation, socioeconomic class, HbA1c, and insulin duration. The validated KAP questionnaire was used for the assessment of KAP among patients or caregivers. Results: A total of 255 patients were included, out of which 163 (63.92%) were male and 92 (36.07%) were female. The mean KAP score was 65.05 ± 14. There is no significant correlation between the HbA1c levels with KAP scores among diabetic patients. There is a significant link between the knowledge, attitude, and Overall KAP patients with education qualification (p < 0.05), occupation (p < 0.05), economic class of the patients (p < 0.05), and duration of insulin treatment (p < 0.05).
Conclusion:The patients average age was 55.74 years. The results showed that the mean KAP score was 65.05, which is less and most of the patients had not controlled their glycemic levels. Effective education regarding insulin administration and glycemic control improves the KAP among patients or caregivers.
There is not much information on hepatocellular carcinoma (HCC) in India. Here, we review the existing data, available treatment choices, and future directions in HCC management. An extensive search was conducted through PubMed and MEDLINE for studies published between January 2000 and June 2022 on the epidemiology of HCC in India using the following key words: atezolizumab, BCLC staging, hepatocellular carcinoma, immune checkpoint inhibitors, immunotherapy, and programmed cell death ligand-1, with the filters humans and English language. The most frequent risk factors for the development of HCC in India include nonalcoholic fatty liver disease, hepatitis B virus and hepatitis C virus infection, liver cirrhosis, and alcohol intake. On the basis of new findings, the Barcelona Clinic Liver Cancer (BCLC) Staging Criteria need to be revised. As most cases in India are discovered at a later stage, curative treatments such as surgical resection, ablation, or liver transplantation may not be an option. Clinical trials are underway for a number of immune checkpoint drugs that target cytotoxic T-cell lymphocyte-4 and programmed cell death-1/programmed cell death-ligand 1. In India, phase III trials of atezolizumab in combination with other drugs are underway for the treatment of various malignancies. Renin angiotensin system inhibitors, antivirals, primary hepatocyte transplantation, and bioartificial liver devices are among the future options for the management of HCC. In developing countries like India, HCC is often diagnosed at an advanced stage because of a delay in routine testing or screening. Therefore, developing effective treatment regimens for such stages is critical. Immunotherapy is a promising treatment option that has the potential to increase overall response and survival rate.
Background: The current study aimed to identify the perceptions and issues regarding the affordability, availability, and accessibility of COVID-19 vaccination and determine the extent of vaccine hesitancy among non-vaccinated individuals. Methods: A Prospective cross-sectional study was conducted among 575 individuals for a period of six months. All the relevant information was collected using the peer-validated survey questionnaire. An independent t-test was applied to check the association between variables. Result: Among 575 participants, 80.8% were vaccinated, and 19.2% were non-vaccinated. Among the vaccinated, 35.1% were vaccinated in private centres and 64.9% in public health centres (PHC). In total, 32% had accessibility issues and 24.5% had availability issues. However, responders vaccinated at PHC were having more issues in comparison to other groups which was statistically significant (p < 0.05). Among the 163 privately vaccinated participants, 69.9% found it completely affordable. Another 26.9% and 3.1% found vaccines partly affordable and a little unaffordable. Among the 110 non-vaccinated, 38.1% were found to be vaccine-hesitant. Conclusions: Individuals vaccinated at PHC experienced issues such as long waiting times, unavailability of doses, and registration. Further, a significant level of hesitancy towards COVID-19 vaccines was observed. The safety and efficacy of COVID-19 vaccines contributed to negative attitudes.
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