Background Morbidity increases with age and enhances the burden of health problems that result in new challenges to meet additional demands. In the ageing population, health problems, and health care utilization should be assessed carefully and addressed. This study aimed to identify chronic morbidities, health problems, health care seeking behaviour and health care utilization among the elderly. Methods We conducted a community based, cross-sectional study in urban areas of the Sunsari district using face-to-face interviews. A total of 530 elderly participants were interviewed and selected by a simple proportionate random sampling technique. Results About half, 48.3%, elderly were suffering from pre-existing chronic morbidities, of which, 30.9% had single morbidity, and 17.4% had multi-morbidities. This study unfurled more than 50.0% prevalence of health ailments like circulatory, digestive, eye, musculoskeletal and psychological problems each representing the burden of 68.7%, 68.3%, 66.2%, 65.8% and 55.7% respectively. Our study also found that 58.7% preferred hospitals as their first contact facility. Despite the preferences, 46.0% reported visiting traditional healers for treatment of their ailments. About 68.1% reported having difficulty seeking health care and 51.1% reported visits to a health care facility within the last 6 months period. The participants with pre-existing morbidity, health insurance, and an economic status above the poverty line were more likely to visit health care facilities. Conclusion Elderly people had a higher prevalence of health ailments, but unsatisfactory health care seeking and health care utilization behaviour. These need further investigation and attention by the public health system in order to provide appropriate curative and preventive health care to the elderly. There is an urgent need to promote geriatric health services and make them available at the primary health care level, the first level of contact with a national health system.
Septic encephalopathy is a systemic inflammatory disease and is characterized by change in neurotransmitter release, dysregulated production of cytokines, organ dysfunction and long-term cognitive and emotional impairments. In the present study, it was investigated whether administration of ethanolic extract and chloroform fraction of Santalum album can affect the behavioural, oxidative stress parameters and brain oedema in sepsis-surviving mice. Septic encephalopathy was induced in albino mice of either sex (20-30 gm body weight) by cecal ligation and puncture technique. Ethanolic extract of Santalum album was prepared by microwave assisted extraction and various fractions were prepared. Behavioural parameters like neurological examination and exploratory behaviour were studied after 3 hours and 24 hours of sepsis induction. Santalum album extract showed significant (p<0.001) improvement in depression, memory, neurological severity score and exploratory behaviour in surviving animals. Further glutathione level and catalase level was found to be elevated with ethanolic extract and chloroform fraction at 200mg/kg body weight whereas level of malondialdehyde (MDA) was found to decrease in chloroform fraction, at a dose of 200 mg/kg body weight. Brain oedema was found to be increased approximately 20% in diseased group, which was reduced after treatment. Thus, based on the results, it may be concluded that Santalum album shows neuroprotective effect against septic encephalopathy via reduction of oxidative stress and improvement in learning and memory, neurological severity score and exploratory behaviour.
Background: The global aging population is in increasing trend. Morbidity increases with age and enhances the burden of health problems that result in new challenges to meet additional demands. There can be various types of issues such as health problems, health care utilization, physical and social care which should be carefully assessed and addressed. This study aimed to assess the unmet health care needs among elderly. Methods: A Community based, House to House, Cross-sectional study was conducted in urban areas of the sunsari district using face to face interviews. The sample size of 530 elderly was selected by a systematic proportionate random sampling technique. Results: This study unfurled the prevalence of unmet need for consultation for Nearsightedness 52.3%, Farsightedness 53.7%%, Hearing 79.7%, Dental 79.4%, Hypertension 6.7%, Diabetes 3.9%, CVD 5.3 % among those with these specific health needs and of at least one Unmet Health care need to be 64.9% among the studied participants. At least one unmet health need was significantly associated with higher odds among elderly age more than 70, of dalit and janajati ethnicity, illiterate, poor, those with difficulty leaving home, the distance of health facility > 30 mins, and those with depressive symptoms. Conclusion: The study highlighted the higher prevalence and associated factors related to unmet health care needs among the elderly which should be addressed to promote healthy ageing. There is an urgent need to promote geriatric health services and make it available at the primary health care level the first level of contact with a national health system.
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