Showing papers in "International Journal of Medical Science and Public Health in 2013"
TL;DR: A systematic literature search was done to identify relevant studies investigating the role of zinc in human health and the consequences of its deficiency as discussed by the authors, which indicated that zinc deficiency is a risk factor for immune deficiency and susceptibility to infection in the elderly.
Abstract: Zinc is an essential element whose significance to health is increasingly appreciated. In 1961 essentiality of zinc for humans was recognized. A systematic literature search was done to identify relevant studies investigating the role of zinc in human health. This review concerns the importance of zinc in health and the consequences of its deficiency. Zinc deficiency leads to complications of pregnancy and childbirth, low birth weight and poor growth in childhood, reduced immunocompetence, and increased infectious disease morbidity. Pregnant women with zinc deficiency are at risk of premature labour and miscarriages, inefficient labour and delivery, stillbirths, lower mental ability of the child, retarded foetal growth and low immunity of both mother and baby. Zinc can reduce the duration, severity and incidence of diarrhea in children. Zinc deficiency was indicated as a risk factor for immune deficiency and susceptibility to infection in the elderly. Zinc is used in preventive trials and treatment of diarrhea, pneumonia, common cold, respiratory infections and malaria. Sufficient zinc is essential in maintaining immune system function. Supplementation of zinc and with other micronutrients may be beneficial during periods of greatest vulnerability such as early childhood, pregnancy and elderly. Ensuring adequate levels of zinc intake should be a key component in efforts to reduce illness.
89 citations
TL;DR: To determine the pattern of physical morbidity in rural elderly population and to study health related quality of life and utilization of health services among them, a community based cross-sectional design was adopted for studying the health problems of elderly and their health relatedquality of life.
Abstract: Background: Population ageing is a recognized international reality, both in developed and developing countries. The number of elderly in the developing world is increasing due to demographic transition, whereas their condition is deteriorating as a result of fast eroding traditional family system coupled with rapid modernization and urbanization. Current statistics for the elderly gives a prelude to a new set of medical, social and economic problems that could arise if a timely initiative in this direction is not taken.
Aims & Objective: To determine the pattern of physical morbidity in rural elderly population and to study health related quality of life and utilization of health services among them.
Material and Methods: A community based cross-sectional design was adopted for studying the health problems of elderly and their health related quality of life, using WHO Quality of Life-BREF (WHOQOL-BREF) questionnaire. Simple random sampling technique was used for sample collection. A total of 660 individual ≥ 60 years of age were taken up for the study purpose.
Results: An overwhelming majority (68.2%) of elderly enjoyed a good quality of life, while those having a fair/poor quality of life were ≤ 15%. Quality of life was better in males in physical, psychological, social and environmental domains. It was more in subjects who had graduated and currently married, belonged to non-scheduled cast and living in extended families (p
57 citations
TL;DR: There was a highly significant negative correlation between obesity and VO2max, r= -0.88 p, and cardio respiratory fitness in terms ofVO2max was predicted by following the protocol of Treadmill Jogging Test (TMJ).
Abstract: Background: Maximal oxygen consumption (VO2max) is considered the gold standard of cardio-pulmonary and muscle cell fitness. Reduced cardiopulmonary fitness is associated with increased cardiovascular disease. Low cardio respiratory fitness in young adults has emerged as an important factor for developing cardiovascular comorbidies later in middle age. Obesity is a serious & widespread problem globally. Increased body fat as predicted by body mass index is an additional factor for developing cardiovascular diseases.
Aims & Objective: The current study was designed to evaluate cardio respiratory fitness in terms of VO2max in young healthy males and to correlate between obesity and cardio respiratory fitness.
Material and Methods: Sixty young healthy male subjects in the age group of 18 to 22 years were included in this study group. Body mass index was measured as weight in kilograms divided by height in meters square. Cardio respiratory fitness in terms of VO2max was predicted by following the protocol of Treadmill Jogging Test (TMJ).
Results: There was a highly significant negative correlation between obesity and VO2max, r= -0.88 p
56 citations
TL;DR: The prevalence of uncorrected refractive errors, especially myopia, was higher in older children, and causes of higher prevalence and barriers to refractive error correction services should be identified and addressed.
Abstract: Background: Refractive Error is an avoidable cause of visual impairment. Diagnosis and Treatment of refractive errors is the simplest and most effective forms of eye care.
Aims & Objective: To study the prevalence and determinants of uncorrected refractive errors, among school children of 7-15 years.
Material and Methods: The study was a cross sectional study of 1378 government school children of 7- 15 years age group in both rural and urban field practice areas of Dr. BR Ambedkar Medical College, Bangalore. Students were screened for defective vision with the help of Snellen’s chart and refractionist confirmed the findings. Students with refractive error were provided with spectacles free of cost. Data was analysed to determine the prevalence of refractive errors among the school children.
Results: 687 children of urban and 691 children of rural area were examined. 53.6% of the study population were boys and 46.4% were girls. The mean age of the study group was 12.4 years. The prevalence of uncorrected refractive error in urban and rural children was 7.03%. The prevalence of Myopia, Hypermetropia and Astigmatism in children was 4.4%, 1.03%, 1.6% respectively. Children 13 to years 15 attending urban schools were most likely to have uncorrected myopia. Hypermetropia was associated with younger age group and female children.
Conclusion: The prevalence of uncorrected refractive error, especially myopia, was higher in older children. Causes of higher prevalence and barriers to refractive error correction services should be identified and addressed. Eye screening of school children is recommended.
49 citations
TL;DR: Oligohydramnios is frequent occurrence and demands intensive fetal surveillance and proper antepartum and intrapartum care and decision between vaginal delivery and caesarean section should be well balanced so that unnecessary maternal morbidity prevented and other side timely intervention can reduce perinatal morbidity and mortality.
Abstract: Background: Decrease in amniotic fluid volume or Oligohydramnios has been correlated with increased risk of intrauterine growth retardation, meconium aspiration syndrome, severe birth asphyxia, low APGAR scores and congenital abnormities. Early detection of oligohydramnios and its management may help in reduction of perinatal morbidity and mortality one side and decreased caesarean deliveries on the other side.
Aims & Objective: (1) To study affects Oligohydramnios on fetal outcome in form of (a) Fetal distress (b) Growth retardation (c) NICU admission (2) To study APGAR scores of newborn babies in relation to Oligohydramnios (3) To study incidence of congenital malformation (4) To study early neonatal morbidity and mortality (5) To study maternal morbidity in form of operative delivery and induced labour.
Material and Methods: Present study was done over a period from May 2009 to November 2011. 100 patients in third trimester of pregnancy with Oligohydramnios selected randomly after satisfying inclusion and exclusion criteria. A detailed history and examination were done. All required investigation done. Oligohydramnios confirmed by measuring AFI.
Results: Mean maternal age-23.66 years. Incidence of oligohydramnios was more in primipara (52%) in our study. And operative morbidity was also more in primipara. Most common cause of Oligohydramnios is idiopathic (52%). Second commonest cause is PIH (25%). Operative morbidity is highest in PIH (60%). Operative morbidity was significantly higher in NST (non-stress test) non-reactive (3.12 ± 75=78.12%) group than NST reactive (26.47%) group. Most common reason to perform caesarean was fetal distress which was either due to cord compression or IUGR. 7% patients were found with fetoplacental insufficiency on Doppler study. Oligohydramnios was related to higher rate of growth retardation and NICU (neonatal intensive care unit) admission.
Conclusion: Oligohydramnios is frequent occurrence and demands intensive fetal surveillance and proper antepartum and intrapartum care. Due to intrapartum complication and high rate of perinatal morbidity and mortality, rates of caesarean section are rising, but decision between vaginal delivery and caesarean section should be well balanced so that unnecessary maternal morbidity prevented and other side timely intervention can reduce perinatal morbidity and mortality.
38 citations
TL;DR: Public health facilities should be strengthened for providing services of screening; early diagnosis and treatment within the public health care delivery system and efforts need to be done on implementing the clinical standards and guidelines developed under the Indian Public Health Standards.
Abstract: Non-communicable diseases (NCDs) are defined as diseases of long duration, and are generally slow in progression. NCDs are the leading cause of death in the world, responsible for 63% deaths worldwide in 2008. NCDs accounts for 53 percent of deaths in India. Based on available evidence cardiovascular diseases (24 percent), chronic respiratory diseases (11 percent), cancer (6 percent) and diabetes (2 percent) are the leading cause of mortality in India. Treatment cost is almost double for NCDs as compared to other conditions and illnesses. Burden of NCDs and resultants mortality is expected to increase unless massive efforts are made to prevent and control NCDs and their risk factors. India could develop a strategy for reducing out of pocket expenditure. Underlying determinants of NCDs mainly exist in non-health sectors, such as agriculture, urban development, education and trade. Inter-sectoral collaboration is therefore essential to create an enabling environment. Government of India had launched various vertical programmes such as National Cancer Control Programmes, National Tobacco Control Programme, National Programme for Prevention and Control of Cancer, Diabetes, CVD and Stroke (NPCDCS) etc. Strong surveillance, monitoring and evaluation system is required for successful implementation of the programmes. Public health facilities should be strengthened for providing services of screening; early diagnosis and treatment within the public health care delivery system. Efforts need to be done on implementing the clinical standards and guidelines developed under the Indian Public Health Standards (IPHS), and integrating NCD training into training curricula of health workforce.
37 citations
TL;DR: NAC spp.
Abstract: Background: The change in epidemiology and antifungal susceptibility has generated interest of Clinical Microbiologists in identification of Candida up to species level along with antifungal susceptibility pattern. Non-albicans Candida (NAC) has emerged as an important opportunist pathogen. Extracellular hydrolytic enzymes are one of the important virulence attributes of Candida species.
Aims & Objective: The present study aimed to determine the species distribution, virulence factors and antifungal susceptibility profile of NAC spp. isolated from various clinical specimens.
Material and Methods: Speciation of Candida was done by assessing the germ tube formation, assimilation and fermentation of sugars and colony color on HICHROM Candida agar. In-vitro extracellular hydrolytic enzymes production in NAC spp. was assessed. Antifungal susceptibility testing of the isolates was performed by Hicomb minimum inhibitory concentration (MIC) test.
Results: Majority of the isolates were obtained from urine sample (35.6%). C. tropicalis (29.4%) was the major isolate. Maximum extracellular hydrolytic enzymes activity was seen in C. tropicalis. A total of 79 (27.3%) isolates were resistant to fluconazole. Amphotericin B resistance was noted in 17 (5.8%) isolates.
Conclusion: NAC spp. cannot be overlooked as mere containment or non-pathogenic commensals as most of them show reduced susceptibility to commonly used antifungal drugs. Extracellular hydrolytic enzymatic activity of NAC Spp. would be an important tool to prove the relation between the infective species of Candida and infection.
37 citations
TL;DR: E. coli and S. aureus were the most common bacteria associated with neonatal sepsis and many of them were resistant to several groups of drugs.
Abstract: Background: Neonatal sepsis is one of the commonest causes of neonatal mortality in the developing world.
Aims & Objective: To determine the bacteriological profile of neonatal septicaemia, their antibacterial susceptibility pattern (AST) and production of extended spectrun β-lactamase (ESBL) by gram negative bacteria.
Material and Methods: Blood culture specimens were collected from 238 neonates. Identification of organisms, their AST, methicillin resistant Staphylococcus aureus (MRSA) and ESBL detection was done.
Results: Gram negative bacteria were more frequently isolated than gram positive bacteria. The gram positive bacteria were highly resistant to penicillin. Vancomycin and amoxyclav exhibited good activity against both Staphylococcus aureus and coagulase negative Staphylococcus. Gram negative bacteria also exhibited high resistance to the commonly prescribed group of drugs such as penicillins, cephalosporins and aminoglycosides. Out of the total 16 isolates of S.aureus, 31.25% were MRSA. ESBL production was seen in 52.9% of Escherichia coli and 50% of Klebsiella pneumoniae.
Conclusion: E. coli and S. aureus were the most common bacteria associated with neonatal sepsis. Gram negative bacteria were isolated predominantly and many of them were resistant to several groups of drugs. Also high resistance was seen to third generation cephalosporins in case of E. coli and K. pneumoniae due to ESBL production.
35 citations
TL;DR: The elevated values of uncorrelated serum uric acid, serum creatinine or serum urea thus precludes them to be useful for consideration as consistent predictive indicator(s) for preeclampsia or pregnancy related hypertension.
Abstract: Background: Hypertensive disorders of human pregnancy, such as preeclampsia, complicate a sizeable percentage of all pregnancies, needing its early indication and warning.
Aim of the Study: To measure and compare serum uric acid, serum creatinine and serum urea in preeclamptic and normotensive groups.
Materials and Methods: This is a cross-sectional, hospital based study involving 105 age – matched women of South India (devoid of diabetes, urinary tract infections, renal or liver disorders), all in their third trimester singleton pregnancy, at the Obstetrics and Gynecology Department of Sri Ramachandra Medical College and Hospital, Chennai, India during the period of December 2008 to July 2009. The data were collected following standard procedures and statistical analysis was done using unpaired t – test.
Results: The levels of serum uric acid and serum creatinine, expressed in mg/ dL were significantly elevated in preeclamptics respectively (5.29 ± 0.84 and 0.72 ± 0.387) when compared to normotensives (3.86 ± 0.92 and 0.58 ± 0.283). There was a statistically insignificant and small increase in serum urea level in preeclamptics (28.07 ± 4.97) compared to normotensives (26.46 ± 3.55). There was a lack of any correlation between the positive differences in the values of each parameter with the extent of corresponding raised blood pressure.
Conclusions: the elevated values of uncorrelated serum uric acid, serum creatinine or serum urea thus precludes them to be useful for consideration as consistent predictive indicator(s) for preeclampsia or pregnancy related hypertension.
35 citations
TL;DR: Assessment of the prevalence of depression in elderly using the Geriatric Depression Scale (GDS), to determine the factors influencing depression and recommend preventive measures concluded that Depression in elderly is highly prevalent.
Abstract: Background: Aging is a progressive stage beginning with conception and ending with death. Growth in the elderly population has led to an increase in age related diseases and mainly depression affecting quality of life. Depression in old age is an emerging public health problem leading to morbidity and disability worldwide.
Aims and Objectives: To assess the prevalence of depression in elderly using the Geriatric Depression Scale (GDS), to determine the factors influencing depression and recommend preventive measures. Study design: A Community Based Cross Sectional Study. Setting: The study was conducted in the urban slums, field practice area of Community Medicine attached to a tertiary care hospital.
Materials and Methods: A Community Based Cross Sectional Study was done for six months in the urban slums and persons aged ≥ 60 years residing in the urban slums were included. Those with any psychiatric morbidity and without consent were excluded. A pre-designed, pre-tested proforma was used to collect information. GDS was used to assess depression
Results: Prevalence of depression was 29.36%. Females (31.39%) were more affected than males (25.93%). 41 (64.06%) among those who were not working were depressed. 45 (70.31%) among illiterates were depressed compared to 19 (29.69%) literates (X2=6.664, df=1, p=0.0098, NS). (64.06%) among those not working, (60.93%) elderly belonging to low socioeconomic status and (54.69%) indulging in substance abuse had depression.
Conclusions: Depression in elderly is highly prevalent. Quality health care of the elderly reduces the future burden of diseases and disabilities.
33 citations
TL;DR: The overall prevalence of autism in the primary school of Taif district whose age ranged from 7 to 12 years was 0.035 %, and the prevalence in male (0.031%) was greater than female ( 0.004%).
Abstract: Background: There has been a reported worldwide increase in the apparent prevalence of autism and related autism spectrum disorders, Such an increase, whether due to an actual increase in incidence of autism or better detection methods.
Aims & Objective: To determine the prevalence and describe the clinical characteristics of autism spectrum disorders (ASDs) in school-age children.
Material and Methods: The study proceeded in four steps: screening, sampling, and diagnostic assessment. All parents and teachers asked to complete the ASSQ. Children from regular schools were considered screen positive if they had a teacher-rated ASSQ score ≥10.
Results: The result of the current study have shown that the overall prevalence of autism in the primary school of Taif district whose age ranged from 7 to 12 years was 0.035 % from a sample population of 22950 student , the prevalence of autism in male (0.031%) was greater than female (0.004%). The general characteristic of autistic disorders present in the sample population was concentrated on certain items mainly, Has a different style to communicate with others, either formally or informally (80 %), Deal with others with his own style (80%).
Conclusion: The overall prevalence of autism in the primary school of Taif district whose age ranged from 7 to 12 years was 0.035 %.
TL;DR: A generic fuzzy expert system for the diagnosis of various heart diseases yields better result than the classic designed systems, because this system simulates the manner of an expert in true sense.
Abstract: Background: The logical thinking of medical practitioners play significant role in decision making about diagnosis. It exhibits variation in decisions because of their approaches to deal with uncertainties and vagueness in the knowledge and information. Fuzzy logic has proved to be the remarkable tool for building intelligent decision making systems for approximate reasoning that can appropriately handle both the uncertainty and imprecision.
Aims & Objective: To develop a generic fuzzy expert system framework that can be used to design specific fuzzy expert systems for particular medical domain.
Material and Methods: The generic fuzzy expert system has been designed for diagnosis of cardiac diseases. The interface between visual basic and MatLab is powerful feature of the system that offers user friendly graphical user interface.
Results: Need to arrive at the most accurate medical diagnosis in a timely manner is the main outcome that may reduce the further complications. A generic fuzzy expert system for the diagnosis of various heart diseases yields better result than the classic designed systems, because this system simulates the manner of an expert in true sense.
Conclusion: The particular focus is on diagnosis of heart disease by employing the fuzzy logic in expert systems.
The system has been designed and tested successfully. Exhaustive rule base specifically formed for almost all heart diseases ensures the accuracy to arrive at certain decision.
TL;DR: For successful implementation of cervical screening program, the nurses should be targeted first by education and sensitization so that they can play pivotal role in developing the awareness, confidence and compliance of women.
Abstract: Background : Estimated cervical cancer screening practice is very low and load of cases very high in India. The studies document that nurses play a crucial role of enlightening community about need and availability of Pap smear. It is important therefore to understand the perceptions and practices of nurses about cervical cancer and screening.
Objectives: To evaluate the Knowledge Attitude & Practices (KAP) of the Nurses on cervical cancer and screening.
Methods: A self-administered, structured, open ended and pretested questionnaire covering the general characteristics, KAP about cervical cancer and screening (Pap smear) was used to collect responses of nurses in a Teaching Hospital at Surat. The information thus collected was entered and analysed in Epi Info and Microsoft Excel software.
Results: Responses from 200 female nurses were recorded and analysed. Majority (88%) were married; most common age of marriage being 21 to 25 years. Nurses linked multiple sexual partners (61%), sex at an early age (44%), Human Papilloma Virus infection (38.6%) and heredity (31%) to cervical cancer. Approximately 70% believed that Ca cervix is preventable, detectable and curable if detected early. Pap smear was recognized as major screening technique by 74% nurses. Major (84%) source of information was health professional. Eighty percent nurses never took cervical screening while 87.5% did not recommend it to others.
Conclusions: For successful implementation of cervical screening program, the nurses should be targeted first by education and sensitization so that they can play pivotal role in developing the awareness, confidence and compliance of women.
TL;DR: Depression is relatively high in rural area, females, illiterates, singles and sufferers of stressful life events or chronic diseases, and there is a significant functional impairment with presence of Depression.
Abstract: Background: As the World’s population is ageing, there is growing interest in various morbidity patterns among the elderly. Depression and depressive symptoms are common in elder people. Often depression is difficult to recognize.
Aims & Objective: The study aims to assess the prevalence of Depression among study population and its relationship with socio demographic factors, co-morbid illness and functional impairment.
Material and Methods: A community based cross-sectional study was done in selected rural & urban field practice areas of Department of SPM by means of simple random sampling. 17,415 populations were screened from 3383 households in both rural and urban areas to identify 1200 elderly aged 60 and above were administered with pretested questionnaire incorporating geriatric depression scale for assessing Depression.
Results: The prevalence of Depression among study population was 31.7% (317/1000). The prevalence was high in rural areas (36%), as compared to urban areas (27%) and increasing with increasing age. It was significantly high among females (37.5%), singles (46%), staying alone (65%), low socio-economic group (34%), those with stressful life events (71%). The most common illnesses among the study population with depression were osteoarthritis (43.9%) cataract (25.2%), hypertension (17.6%), diabetes (7.6%) and heart diseases (3.9%). It was observed that functional impairment was high among those who have depression (6.5%).
Conclusion: Depression is relatively high in rural area, females, illiterates, singles and sufferers of stressful life events or chronic diseases. There is a significant functional impairment with presence of Depression.
TL;DR: The study revealed that the degree of satisfaction was mild to moderate with respect to waiting time and availability of specialist in the hospital, which need to be further explored and corrected.
Abstract: Background: Patient satisfaction is deemed to be one of the important factors which determine the success of health care facility. The real challenge is not getting ready with mere requirements, but also delivers services ensuring good quality. Thus, there is a need to assess the health care systems regarding patient satisfaction as often as possible.
Aims & Objective: To measure the patients’ satisfaction towards health care services.
Material and Methods: A randomly selected 100 patients were interviewed by using pre-structured questionnaires at the end of their O.P.D. visits for 5 days from 16th- 20th January, 2012 at Civil Hospital, Surendranagar. While analysing, they were grouped into categories like availability of services, clinical care, waiting time and cost.
Results: The overall opinion about the efficiency of hospital was satisfactory in 92% of patients. 68% respondents said that the time of coming to hospital and consulted by doctor was too long. Although in 75% of patients the time devoted by doctor was only between 0-5 min., the communication and explanation of disease by doctors were found satisfactory in 80% and 91% respectively. The need of investigations was necessary as per 90% of patients. Time required to locate and get medicines from pharmacy was satisfactory in nearby all patients.
Conclusion: According to patient’s opinion, the study revealed that the degree of satisfaction was mild to moderate with respect to waiting time and availability of specialist in the hospital, which need to be further explored and corrected
TL;DR: This study shows that second year students tend to have greater knowledge of appropriate self-medication, have a more confident as well as concerned attitude towards self-Medication, and tend to practice self- medication more often and appropriately.
Abstract: Background: The misuse of non-prescription drugs amongst students has become a serious problem. The youth is especially exposed to the media and the increased advertising of pharmaceuticals poses a larger threat to the young population. There is a paucity of studies on self-medication among medical students. Medical students may differ from the general population because they are exposed to knowledge about diseases and drugs.
Aims & Objective: To determine the knowledge, attitude and practice of self-medication among medical students and to compare impact of pharmacology teaching among them.
Material and Methods: This study was questionnaire based exploratory study. A self-developed questionnaire consisting of both open-ended and close-ended questions were prepared and given to fill up to students of first and second year medical students. Data was analyzed and associations were tested using the Chi square test. The results expressed as counts and percentages.
Results: Out of 157 respondents, 78 were of first year and 79 were of second year. Among first year students 40 and 38, among second year students 58 and 21 were male and female respectively. Among first year students 21(26.92%) had knowledge of generic name, 40(51.28%) had knowledge of side effects and 72(92.33%) had knowledge of expiry date. Figure of knowledge among second year students were 70(88.6%), 72(91.13%) and 76(96.2%) respectively. Attitude wise 60(76.92%) of first year and 53(67.08%) of second year students believe in Ayurvedic/homeopathic medicines. 50(64.1%) of first year and 59(74.68%) of second year students had felt the necessity of medical knowledge towards self-medication. Practice wise 66(84.61%) of first year and 76(96.2%) of second year students had taken self-medication in last 6 months.
Conclusion: This study shows that second year students tend to have greater knowledge of appropriate self-medication, have a more confident as well as concerned attitude towards self-medication, and tend to practice self-medication more often and appropriately.
TL;DR: Knowing the factors that are associated with missed appointments facilitates the prospective identification of patients at risk of missing appointment and helps the continuous quality improvement for future planning which may include program modifications, and formulation of strategies to reduce the risk and rate of non-attendance.
Abstract: Background. Non-attendance in general practice has received increasing attention over the past few years. Its relationship with access to health care has been recognized. Missed appointments have serious clinical and economic consequences.
Study objectives: This study aims to identify the reasons for missing appointments in general clinics in Alwazarat health care center during the period from December 2010 to March 2011. Methods: All eligible patients who missed appointments to general clinics, in Alwazarat center and controls who show up for their appointment, were enrolled in the study using quasi-randomization for sample selection. On the same day of missing the appointment three clerks were assigned by the doctor in-charge of the center to assist in data collection. A structured phone interview was conducted with patients enrolled in the study and the control group using a validated questionnaire.
Results: The demographic factors associated with missing appointments were: female gender, younger age group and poor socioeconomic status. The important top five causes for missing appointments were: difficulty booking an appointment, work commitment, long distance travel, unavailability of transportation, visiting another health care facility. Among the group who missed appointment, the impact of missing appointment on health care service was unknown.
Conclusion: Knowledge of the factors that are associated with missed appointments facilitates the prospective identification of patients at risk of missing appointment and helps the continuous quality improvement for future planning which may include program modifications, and formulation of strategies to reduce the risk and rate of non-attendance.
TL;DR: Understanding the KAP about HIV/AIDS of Patients, care givers and in general populations will help in formulating strategy for prevention, treatment.
Abstract: Background: HIV, the disease, whose mode of transmission is known and is largely preventable, but due to lack of knowledge and practices about HIV/AIDS in general population causes its rapid spread. So, in this study we plan to assess and compare the knowledge, attitude and practices about HIV in patients group, care giver and in general population
Material and Method : A total of 102 HIV/AIDS patients , 60 care givers(35 attendent ,19 nurses, 6 doctors) and 40 general population (control) were included in the present study. The patients who were registered for study were followed up for three visits. The responses were recorded on a pre-designed and pre-tested, semi- structured questionnaire.
Results : Illiteracy was more common in HIV patient group (27.5%) . A high proportion of HIV/AIDS cases were engaged in transport/ production industry (24.5%) . Electronic media and print media are major source of information . 35.3% patients, 22.9% care givers and 47.5% general population group thought that with medication HIV is curable. Sexual contact (63.8%) was the commonest mode of transmission . 80.0% medical staff thought that a newly diagnosed HIV person, first to talk with doctor. After 6 month follow up: 82% patients write sexual contact as major mode of transmission, and Use of condom was most important preventive measure (68%) .
Conclusion : Understanding the KAP about HIV/AIDS of Patients, care givers and in general populations will help us in formulating strategy for prevention, treatment .
Keywords :KAP, HIV, Care givers, Medical staff
TL;DR: Wound infection was the most common hospital acquired infection and the use of Meropenem and Amikacin should be restricted to avoid the emergence of resistance against them.
Abstract: Background: Antimicrobial resistance is the major problem of the modern world, thus it needs urgent attention. Pseudomonas aeruginosa has the inherent property of developing the resistance. Hence, it is necessary to know the current resistance pattern for proper use of antipseudomonal agents.
Aims & Objective: (i) To evaluate the antibacterial resistance pattern in Pseudomonas aeruginosa in a tertiary care hospital in Central India; (ii) To provide base for formulating rational antibacterial guidelines to treat the infections caused by pseudomonas aeruginosa.
Material and Methods: The present study was an observational, longitudinal study over a period of three years from April 2007 to March 2010. The necessary data was obtained from Central Microbiology Laboratory of Government Medical College, Nagpur, India. Total 1001 samples were reported the presence of Pseudomonas aeruginosa in all the 11 types of biological sample. Antimicrobial susceptibility testing was performed using disk diffusion method with Pseudomonas species ATCC 27853, as per CLSI guidelines. Appropriate statistical analysis methods were applied to the data to fulfil the objectives of the study with the latest version of Graph pad prism software.
Results: Pus samples showed highest culture positivity for P. aeruginosa followed by sputum. The highest resistance was reported to ciprofloxacin while the lowest resistance to Meropenem.
Conclusion: Wound infection was the most common hospital acquired infection. The use of Meropenem and Amikacin should be restricted to avoid the emergence of resistance against them. Such studies should be performed regularly to recognize the recent trends.
TL;DR: The overall life-time prevalence of for substance abuse among college students was found to be 31.3%.
Abstract: Background:-Substance abuse disorder is among the leading public health problems in modern day world as they cause enormous human suffering in terms of morbidity, mortality and economic loss; and threatens the very social fabric of almost all communities around the world and as such is a great threat to the global health, economy and peace. Like most social behaviors the etiology of substance abuse is complex, varying through time, geographical regions and by demographic characteristics. Among young people, students are the most vulnerable group as the initiation into substance abuse first starts during this period. Aims and Objectives:-To find out the prevalence and pattern of substance abuse and its association with various socio-cultural and demographic variables.
Material & Methods: Multi-stage random sampling method was adopted to select the study subjects. The study subjects were asked about the substance abuse and related socio-demographic variables by means of WHO model core questionnaire format and results were subjected to statistical analysis.
Results: The overall life-time prevalence of for substance abuse among college students was found to be 31.3%. Male students had significantly higher prevalence of substance abuse as compared to female counterparts(37.5% versus 19.6% respectively).The most common substance being abused was Tobacco products(22.5%) followed by solvents (10.0%), alcohol (6.2%), sedatives (5.9%), cannabis (4.4%), amphetamine products (2.1%), hallucinogens (0.5%) and cocaine (0.3%). Age, gender and family type were found to be strongly associated with substance abuse (p
TL;DR: High burnout was found to be strongly associated with several of the variables under study, especially low job satisfaction, expressed intention to change job, tobacco consumption and use of psychotropic medication, younger age, recent graduation, married and board qualified doctors.
Abstract: Background: Burnout is associated with decreased job performance and low career satisfaction. It has a special significance in health care, where staff experience both psychological–emotional and physical stress.
Aims & Objective: This study was conducted to determine the prevalence of burnout, and its associated factors, amongst primary care doctors (PHC) in Riyadh Military Hospital RMH.
Material and Methods: A cross-sectional survey of PHC was conducted using a custom-designed and validated questionnaire which incorporated the Maslach Burnout Inventory Human Services Survey (MBI-HSS) as well as questions about demographic factors, working experience, health, lifestyle and job satisfaction. MBI-HSS scores were analyzed in the three dimensions of emotional exhaustion (EE), depersonalization (DP) and personal accomplishment (PA).
Results: Almost 200 questionnaires were distributed, and 144 were returned to give a response rate of 72%. In terms of burnout, 53.5% of respondents scored high for EE burnout, 38.9% for DP and 28.5% for PA, with 2.78% scoring high burnout in all three dimensions. Just over one-quarter of doctors did not score high for burnout in any dimension. High burnout was found to be strongly associated with several of the variables under study, especially low job satisfaction, expressed intention to change job, tobacco consumption and use of psychotropic medication, younger age, recent graduation, married and board qualified doctors.
Conclusion: Burnout seems to be a common problem in PHC doctors in RMH and is associated with personal and workload indicators. Recommendations for improving employment conditions of PHC physicians and future research is needed to explore the problem in depth, develop models to describe the phenomenon and to identify causative factors and effective intervention strategies.
TL;DR: Higher prevalence of hypothyroidism was observed in patients (especially females) in their second & third decade of life, which supports the usefulness of screening of thyroid function compulsory after age of 30 years, for early detection and treatment to reduce the ill effects of thyroid dysfunctions.
Abstract: Background: Hypothyroidism is a widespread thyroid problem, but there are no reports on the incidence and prevalence of hypothyroidism in this part of our country, that is western UP.
Aims & Objective: The aim of the present study was to assess the prevalence of hypothyroidism in Meerut and nearby areas.
Material and Methods: This retrospective hospital based study involved 4739 patients having undergone thyroid function assay, in the central clinical biochemistry laboratory of Subharti Medical College and its associated hospital. These patients were evaluated for thyroid hormonal assay-tri iodo thyronine (T3), tetra iodo thyronine (T4) and thyroid stimulating hormone (TSH) by Mini Vidas auto analyzer using enzyme linked fluorescent assay technique. Statistical analysis was performed by SPSS version 17 software.
Results: Our study shows high prevalence of abnormal thyroid hormone levels (hypothyroidism was 8.2% & subclinical hypothyroidism was 8.4%) with female preponderance.
Conclusion: The study has defined thyroid function status in thyroid patients of Meerut, Uttar Pradesh (U.P). Higher prevalence of hypothyroidism was observed in patients (especially females) in their second & third decade of life. The findings also supports the usefulness of screening of thyroid function compulsory after age of 30 years, for early detection and treatment to reduce the ill effects of thyroid dysfunctions.
TL;DR: Percutaneous ultrasound guided needle aspiration has acceptable failure rate and is an effective alternative to open surgical drainage of puerperal breast abscess especially for those present early and of small size.
Abstract: Background: The treatment of puerperal breast abscess is a clinical dilemma which ranges from conservative treatment to surgical intervention. A recently highlighted approach is drainage of pus by needle aspiration with ultrasound guidance under antibiotic cover. This approach had advantage of complete resolution without incision scar, less morbidity and will allow the patient to carry on breast feeding.
Aims & Objective: The aim of this study is to compare the management of puerperal breast abscess by percutaneous ultrasound guided needle aspiration versus open surgical drainage with special attention to resolution and complications.
Material and Methods: In this interventional study, 70 puerperal breast abscess cases were randomly divided and undergone either percutaneous ultrasound guided niddle aspiration (Group A) or open surgical drainage (Group B) and results were compared.
Results: Failure rate for aspiration therapy was17.14% with 06 patients requiring conversion to open surgical drainage after aspiration and were excluded from study. The resolution time was less in aspiration group. Painful and cumbersome daily changes of dressing, mammry fistula in 3 patients with ugly scar were the main drawback of open surgical drainage as compared to aspiration. However, there was high failure rate of aspiration therapy in abscesses presenting later than 5 days (45.83%) and those with >5 cm size (55.55%) on ultrasonography.
Conclusion: Percutaneous ultrasound guided needle aspiration has acceptable failure rate and is an effective alternative to open surgical drainage of puerperal breast abscess especially for those present early and of small size.
TL;DR: There is a need to increase the awareness of ergonomics to improve the current practice of laptop’s usage and to minimize health problems among students.
Abstract: Background: In recent years, laptop computers were popular among college students for the purpose of education as well as recreation.
Aims & Objective: The present study was designed to evaluate the current practice of Laptop computer and computer related health problems among college students, based on ergonomics.
Material and Methods: The cross-sectional study was conducted over a three month timeframe, from April to June, 2013 in tertiary care hospital and teaching medical college. We included 100 students with age group 22-28 years, using laptop computer. Pre-designed and content validated, self-reporting questionnaire was used for data collection. Student’s refusal for participation and incomplete questionnaire were excluded in the study.
Results: Current practice of laptop’s usage was ergonomically improper. Prolonged usage in improper posture has created various musculoskeletal problems among medical students.
Conclusion: Current practice of laptop’s usage exposes students to prolonged poor postures which leads to various musculoskeletal problems. There is a need to increase the awareness of ergonomics to improve the current practice of laptop’s usage and to minimize health problems among students.
TL;DR: First year MBBS students’ perception of OSPE is an objective, unbiased and consistent method of examination and they could perform better compared to TCE as there was no fear of examiners.
Abstract: Background: An integral part of a medical curriculum is an appropriate assessment of clinical competencies of the medical students. The Objective Structured Practical Examination (OSPE) can assess practical competencies in an appropriate, step-wise, methodical, objective and time-orientated manner with direct observation of the student’s performance during planned clinical test stations.
Aims & Objective: The purpose of the study was to determine first year MBBS students’ perception of OSPE in comparison of their views of Traditional clinical examination (TCE) in Human Physiology.
Material and Methods: A total of 50 first MBBS Students in Physiology were administered a questionnaire for quantitative as well as qualitative analysis. Quantitative analysis of students’ perception involved a 5 point Likert scale containing 5 broad themes as (1) Is OSPE a better stimulus to learning ? (2) Content of the OSPE (3) Is OSPE a reliable and fair examination? (4) Administration of OSPE, (5) OSPE vs. Traditional clinical exam with 23 questions and their opinion regarding both the assessment tools were noted for qualitative analysis.
Results: Results showed a positive perception of the OSPE as a better stimulus to learning (58%) with satisfactory content of OSPE (72%) , OSPE being objective, fair and unbiased (54%), having effective administration (60%) and the OSPE being better than TCE (52%).They felt lack of fear of facing the examiner which relieved their anxiety for the examination.
Conclusion: The students felt that the OSPE is an objective, unbiased and consistent method of examination. They could perform better compared to TCE as there was no fear of examiners.
TL;DR: Alcoholic liver disease was seen among the productive age group with high morbidity and mortality and Mortality and morbidity associated with this disease is matter of serious economic loss to the nation and grief for the society.
Abstract: Background: Alcohol is most common substance abused. Alcoholic liver disease is a major health care problem in India. Alcohol consumption is directly associated with liver disease mortality and accounts for increased social and economic costs. Alcoholic liver disease may take the forms of acute involvement (alcoholic hepatitis) or chronic liver disease (steatosis, steatohepatitis, fibrosis and cirrhosis. The severity and prognosis of alcohol- induced liver disease depends on the amount, pattern and duration of alcohol consumption, as well as on the presence of liver inflammation, diet, nutritional status and genetic predisposition of an individual. While steatosis is complete benign disease, liver cirrhosis is associated with marked morbidity, mortality and life expectancy shortening.
Aims & Objective: To study alcoholic liver disease, clinical presentation, to access the severity of alcoholic liver disease and its complications and their treatment response and overall outcome among patients using laboratory and radiological parameters.
Material and Methods: A total of 50 patients were studied and their clinical profile, laboratory parameters and radiological investigations were taken.
Results: Among 50 patients 58 % belonged to age group 40-49 years. All were male. 78 % of patients from urban areas, with 60 % belonging to middle class.60 % of patients have chief complaint of abdominal distension and melena each. Jaundice (60%) and ascites (60%) were commonest finding. All patients had raised SGPT, SGOT, S.AlPO4 and S. bilirubin suggesting liver damage. Prolonged PT and reduced S. albumin suggested reduced protein synthesis because of liver disease. Alcoholic hepatitis was in24% cases, while 40% had fatty liver and 36 % had alcoholic cirrhosis. Overall mortality rate was 20 %. , most common cause is encephalopathy (40%), coagulopathy leading to DIC (40%) and hepatorenal syndrome (20%).
Conclusion: Alcoholic liver disease was seen among the productive age group with high morbidity and mortality. Mortality and morbidity associated with this disease is matter of serious economic loss to the nation and grief for the society
TL;DR: Establishment of national AEFI database can be a worthy long term goal in Indian context and most of the adverse events reported were mild and non-serious.
Abstract: Background: Vaccination is an essential component of the public health programs and among most cost effective medical intervention. Vaccines like other pharmaceutical product are not entirely risk free; while most known side effects are mild and non-serious. But some vaccines have been associated with very rare but serious side effect. So, there is a need of a surveillance program to monitor and record such events.
Aims & Objective: To detect adverse events following immunizations (AEFI) in children and find vaccine responsible for them.
Material and Methods: A one year, prospective, vaccine safety study was undertaken in 2011 covering a pediatric population who were administered vaccines. A two-phase telephone survey of all patients was conducted, comprising of an initial call at 1 week and a follow-up call at 30 days after the vaccine administration date. All AEFI were recorded in Vaccine Adverse Event Reporting System (VAERS) form.
Results: Of a total sample of 4320 children, ranging in age from 0 to 14 years, 10110 vaccine doses were given. Each child received 2.34 vaccines on an average. Out of 4320 children, 899 children (20.8%) suffered 1003 AEFI. The most frequent types of adverse reactions to vaccines were fever (34.33 per 1000 doses), excessive crying (30.95 per 1000 doses) and injection site swelling (18.57 per 1000 doses). AEFI rate per 1000 doses was 99.2%.
Conclusion: Most of the adverse events reported were mild and non-serious. Establishment of national AEFI database can be a worthy long term goal in Indian context.
TL;DR: Results of present study demonstrated that with worsening of glycaemic control, severity of periodontitis significantly increases even when examined for similar oral hygiene status.
Abstract: Background-Peridontal disease and diabetes share a two way relationship because of common pathways of disease progression.
Aims-Extensive study on various population worldwide were carried out but there is a limited data for Indian population, Hence, the present study was done to evaluate the prevalence and severity of peridontitis in type 2 diabetes mellitus of Bareilly region of Uttar Pradesh (India).
Material and Methods- 1000 individuals of type 2 diabetes mellitus were categorized as good, average and poor glycaemic control on the basis of glycosylated hemoglobinA1C(HbA1C). Periodontal examination was done by recording oral hygiene index simplified, clinical attachment loss and gingival bleeding index. This periodontal result was correlated with glycaemic status and duration of diabetes since diagnosis.
Results- Results showed a 91.7% prevalence of periodontitis, predominating with 41.3% cases of moderate periodontitis followed by 26.2% of severe and 24.2% of slight and 8.3% of gingivitis cases. In poor oral hygiene strata; the amount of severe periodontitis cases increased from 0% to 26.2% and up to 73.8%; as the glycaemic control deteriorated from good to average to poor. Similar results were reported for good and fair oral hygiene strata.
Conclusion-Results of present study demonstrated that with worsening of glycaemic control, severity of periodontitis significantly increases even when examined for similar oral hygiene status.
TL;DR: Squash smear preparation proved to be a simple, inexpensive and rapid technique for intraoperative consultation of CNS tumours and can be effectively utilized as a diagnostic tool for intraoper diagnosis in absence of frozen section facility.
Abstract: Background: Neurosurgical practice frequently requires intraoperative consultation to optimize surgical procedure. Frozen section and Squash smear cytology can offer the same. As brain tissue is friable & predisposed to show ice crystal artefacts, frozen section is often difficult to interpret. Squash smear examination provides good cytological details to offer diagnosis in most cases except where anatomical correlation is needed. Present study was undertaken to evaluate the efficacy of Squash smear in absence of frozen section facility.
Aims & Objective: To evaluate the value of Squash smear cytology for rapid intraoperative diagnosis in CNS lesions and its correlation with final histomorphological diagnosis.
Material and Methods: Total 35 case of CNS tumours were examined by squash smear technique for cytomorphological analysis followed by histomorphological correlation on paraffin section.
Results: Complete correlation with histomorphological findings was observed in 82.35% of cases. Complete correlation was observed more with glial neoplasm.
Conclusion: Squash smear preparation proved to be a simple, inexpensive and rapid technique for intraoperative consultation of CNS tumours and can be effectively utilized as a diagnostic tool for intraoperative diagnosis in absence of frozen section facility.
TL;DR: The pattern of use of antihypertensive drugs in 50 hypertensive-diabetic patients was evaluated in correlation with its renal function and BP control achieved was compared in patients with and without reduced renal function.
Abstract: Background: The benefits of optimum blood pressure (BP) control in patients with diabetes exceed the benefits of glycaemic control and extend to the prevention of both macro-vascular and micro-vascular complications in patients suffering from both hypertension and diabetes mellitus.
Aims & Objective: To investigate the utilization patterns of anti-hypertensive drugs and to evaluate blood pressure (BP) control among diabetic-hypertensive patients with and without reduced renal function.
Material and Methods: A prospective, observational study carried out at medicine department of SBKS Medical College and Research Centre, Piparia. The pattern of use of antihypertensive drugs in 50 hypertensive-diabetic patients was evaluated in correlation with its renal function and BP control achieved was compared in patients with and without reduced renal function.
Results: Total 63 antihypertensive medication episodes were prescribed for 50 patients. Out of which 76% patients were receiving 1 drug, 22% receiving 2 drugs and 2% receiving 3 drugs of different antihypertensive class. Most patients were receiving Angiotensin-Converting-Enzyme-Inhibitors (ACE-I)/Angiotensin-Receptor-Blockers (ARBs) (60%), followed by CCBs (24%), beta-blockers (20%), and diuretics (16%). Patients on monotherapy were mostly receiving ACE-I/ARB (65.78%). Beta blockers were more commonly prescribed in patients with reduced renal function (p=0.005). BP control was achieved in 63.15% patients in monotherapy and 33.33% in polytherapy group. Control of systolic and diastolic BP was significantly higher in patients without reduced renal function than patients with reduced renal function (p