Showing papers in "International Journal of Research in Medical Sciences in 2017"

Socio-economic status scales updated for 2017

Abstract: The health status of any country depends on the socio-economic status (SES) and the per capita income of its citizens. The SES also decides the affordability and utilization of the health facilities. Constant changes in the price of goods in the country due to inflation make it mandatory to constantly update the income-based socioeconomic scales. This paper attempts to provide updates in Kuppuswamy, B.G. Prasad and udai pareek socioeconomic scales for 2017.

Prevalence of smart phone addiction, sleep quality and associated behaviour problems in adolescents

Abstract: Background: World is ever changing due to advancement in realm of science and technology, one such advancement is in field of smart phones. The ubiquity of smart phone technology raises concern for its addiction among adolescents and its relationship with quality of sleep, mental and physical health problems. Objective of the study was to investigate magnitude of smart phone addiction and evaluate the impact of smart phone addiction on their mental health and sleep quality. Methods: A cross‑sectional study was conducted on sample comprising of 587 students of repudiated school. Students were assessed with a specially designed proforma and Smart phone addiction scale (SAS) which was self‑administered by the students. Subjects were classified into smartphone non-user group, a low smartphone user group and a high smartphone user group. Subsequently depression anxiety and stress sub scores (DASS-21) scale were administered to asses associated behaviour problems, investigate sleep quality Pittsburgh sleep quality inventory was administered (PSQI). Results: Out of 587 subjects who completed the questionnaires 12.9% (n=76) were not using smart phones, (n=315) 53.62% were low users and (n=196) 33.3% were high users of Smart phone as estimated by Smart Phone addiction scale. Those who used smart phone excessively had high Global PSQI scores and DASS-21scores in terms of depression, anxiety and stress. Conclusions: With increasing popularity of smart phones, youths spend significant time on smart phone thereby developing addictive tendencies. This study concludes that youths are not only addicted but are also developing significant sleep and behaviour problems owing to excessive smart phone usage.

Colorectal cancer: a review

Abstract: Colorectal cancer (CCR) is the third most common cancer worldwide in men and women, the second largest cause of death related to cancer, and the main cause of death in gastrointestinal cancer. The risk of developing this cancer is related to bad alimentary habits, smoking, intestinal inflammatory disease, polyps, genetic factors, and aging. Of the patients that are diagnosed with colorectal cancer 90% are older than 50, with a median age of 64 years; however, the disease is more aggressive in patients that are diagnosed at younger ages. According to the American Cancer Association, it was accounted for more than 49,700 deaths in 2015. The goal is to reduce the mortality rate with early diagnosis and treatment. Currently, the survival rate is used to predict a patient’s prognosis. The patient is considered to have a positive familial history if a first-degree relative has been diagnosed with colorectal cancer or colonic polyps before the age of 60, or also if two or more first-degree relatives have been diagnosed with cancer or polyps at any age. There are several methods for detecting colorectal cancer, such as the guaiac test, immunochemical test of stool, DNA stool test, sigmoidoscopy, colonoscopy, and barium enema. The stage in which the cancer is detected determines the prognosis, survival, and treatment of the patient. Provide a review about generalities, genetic basis, risk factors, protective factors, clinical course, diagnostic methods, therapy and survival in colorectal cancer. Conducted research from different databases such as PubMed, Medline, MedScape, on the definition, genetic factors, classification, risk factors, protective factors, diagnostic methods, epidemiology, survival and treatment of colorectal cancer. Articles from 2000 to 2017 were included using the following keywords.

Ratio of Amylose and Amylopectin as indicators of glycaemic index and in vitro enzymatic hydrolysis of starches of long, medium and short grain rice

Abstract: Rice (Oryzasativa L.) is the most important cereal crop in the developing world and is the staple food of over half the world’s population. The major carbohydrate of rice is starch, which is about 72 to 75%. Rice can be classified into three different types: long-grain, medium-grain and short-grain rice. The three different types of rice grains are categorized based upon their length as compared to their width. If the length of rice grain is four times more than its width then it is considered to be a long grain rice. Short-grain rice is short and fat. It often looks round in shape because the width is close in size to the length. If the length of rice grain is three times more than its width then it is considered to be medium grain rice. Starch consists of two components: Amylose which is a long, unbranched chain with 200-1000 D-glucose units held by alpha (1-4) glyosidic linkages. It is water soluble in nature. White rice with low amylose content has high GI value as amylose content has a negative relationship with GI value. Amylopectin is a branched chain with alpha (1-6) glyosidic bonds at the branching points. ABSTRACT

Causalities of human wildlife conflict in Kashmir valley, India; a neglected form of trauma: our 10 year study

Abstract: Background: Human wild life conflict is increasing at an alarming rate. The topography of Kashmir valley, India makes the people at risk of wild life injuries all the time. We have been seeing increasing number of victims of wild life injuries during harvesting season for many years with maximum number of injuries due to bear maul. Objective was to see the incidence and pattern of injuries due to human wild life conflict besides surgical challenges and outcome of such injuries Methods: This was a retrospective study of 10 years duration done between 2005 to 2016. Data was collected from hospital records and records of wild life conservation department. Results: Human wild life conflict is increasing at an alarming rate. Bear was the most common animal responsible for human animal conflict, followed by leopard. Monkey and red fox attacks were less common and less lethal. Mortality was highest in leopard attacks. Conclusions: Human wild life conflict is certainly increasing. Most of the attacks due to bear and leopard are devastating. Most of the survivors of such attacks are left with some degree of disability and psychiatric disturbances. Maintaining ecological balance is the best way to control human animal conflict.

Prevalence of type 2 diabetes mellitus in rural population of India- a study from Western Uttar Pradesh

Abstract: Background: Diabetes is a major challenge for a resource-limited country like India. Majority of the patients are diagnosed late in the course of illness with presence of complications. There is limited data on diabetes from rural India. Present study is an attempt to provide data on diabetes in rural India. The overall objective of present study was to estimate the prevalence of Type 2 diabetes mellitus in rural population above 25 years age in district Etawah and neighbouring areas of Uttar Pradesh, India. Methods: The study was planned to determine the prevalence of diabetes mellitus in rural community by health camp and door to door approach. Fasting capillary blood glucose was first determined using a glucose meter (SD check code free, SD biosensor Inc. Korea). All the adults were given 75gm of glucose dissolved in 200ml water which was drunk over a period of up to 5 minutes and the 2-hour post load capillary blood glucose was estimated. Diabetic status was confirmed by taking blood samples for fasting and postprandial blood sugar levels in a fluoride vacutainer. Fasting plasma glucose ≥126mg/dl and or 2-hour postprandial glucose ≥200mg/dl were taken as the diagnostic criteria for diagnosis. Results: Prevalence of type 2 diabetes in the rural population was found to be 8.03%. Prevalence was higher in female population (9.91%) as compared to males (6.79%). 19.74 % of participants over 70 yrs of age were diabetics while diabetes was present only in 2.95% of participants in the age group of 25-39 year. The maximum number of diabetes were in the age group of 50-59 years. 10.04 % of participants were diagnosed to be Prediabetics. 35.77% of the diabetics were newly diagnosed. Conclusions: Present study shows there is high prevalence of type 2 diabetes in rural area of western Uttar Pradesh, India.

Bone marrow examination in cases of pancytopenia

Abstract: Background: Pancytopenia is a relatively common hematological entity. This study was undertaken to find out the various causes of pancytopenia by bone marrow examination of patients admitted to New civil hospital, Surat, Gujarat, India. Methods: This was a prospective study carried out to identify the causes of pancytopenia based on bone marrow examination. Bone marrow examinations were performed in 144 cases for different indications over a period of one year 2015, out of which 40 cases have fulfilled the criteria of pancytopenia. Results: Total 40 cases of pancytopenia were examined during period of one year. The commonest cause of pancytopenia was megaloblastic anemia (35%) followed by aplastic anemia (32.5%). other cause includes acute leukemia, myelodysplastic syndrome (MDS) and round cell tumor. Conclusions: Bone marrow aspiration coupled with trephine biopsy can diagnosed majority cases of pancytopenia. Megaloblastic anemia and aplastic anemia are the commonest causes of pancytopenia. A comprehensive clinical and hematological study of patients with pancytopenia will help in the identification of underlying cause.

Diabetic foot ulcers: a review of current management

Abstract: Diabetic foot ulcers are a serious complication of diabetes mellitus which increases the patient morbidity and also have significant socioeconomic impact. The present review aims to summarize the causes and pathogenesis leading to diabetic foot ulcers, various classification systems and to focus on the current management of this significant and preventable health condition.

Clinico mycological study of dermatophytosis

Abstract: Background: Dermatophytoses is common, more prevalent in tropical and subtropical countries including India. Though not life threatening as it can cause great discomfort particularly in immunosuppressive conditions. It remains a general public health problem, which is prevalent in all age groups and both sexes. Aims: To study clinicomycological profile of patients. Methods: The Cross Sectional study was done on clinically diagnosed cases of Dermatophytosis with sample size of 200 cases for one and half year period. Results: The males to female ratio are 1.86:1. The common age group affected was 31-40years. Dermatophytosis was common in active workers, more common in urban than rural population particularly in low socioeconomic group of people and in summer season. Tinea corporis was the common clinical variant. 133 cases were both KOH and culture positive. The KOH mount was positive in 90% cases. In the present study 144 patients (72%) had positive culture results and 47 cases were KOH positive but culture negative, 11 cases were culture positive but KOH negative and 9 cases were both KOH and culture negative. Microsporum audoinii was isolated in 2%, Trichophyton mentagrophytes in 14%, Trichophyton rubrum in 52% and Trichophyton violaceum in 4%. Conclusions: Tinea corporis and Tinea cruris were the most common clinical types. Tinea corporis was predominantly a disease of adult males whereas Tinea capitis was seen mainly in pre- pubertal age group. Potassium hydroxide (KOH) wet mount and cultures were done for all the cases. T. rubrum was the commonest species isolated from most clinical types followed by T. mentagrophytes except T. capitis where T. violaceum was isolated.

Determinants of outcome in newborns with respiratory distress in Osogbo, Nigeria

Abstract: Background: Respiratory distress is one of the commonest presentations necessitating hospital admission in newborn unit. Regardless of the cause, if not recognized and managed quickly, respiratory distress can escalate to apnoea, respiratory failure, cardiopulmonary arrest and death. Methods: A cross-sectional and descriptive study of newborns with respiratory distress admitted into the SCBU of LAUTECH Teaching Hospital, Osogbo, Nigeria. Respiratory distress was diagnosed by grunting, inspiratory stridor, nasal flaring and tachypnea (more than 60 breaths per minute), retractions in the intercostal, subcostal, or supracostal spaces and cyanosis. At admission, every neonate had a complete physical examination. Results: Of 625 babies admitted, 384 (61.4%) were males while 241 (38.6%) were females and 164 (26.2%) had respiratory distress. Respiratory distress was commoner among the preterms than term newborns. c 2 = 44.7, p = 0.001. Leading causes of respiratory distress among the preterms were hyaline membrane disease, septicaemia, while among the term babies were perinatal asphyxia, transient tachypnoea of newborn and meconium aspiration. Sixty (36.6%) of the 164 babies with respiratory distress died. While 40.2% of the preterms died mainly from causes like hyaline membrane disease and septicaemia, 31.3% of term babies died from causes like perinatal asphyxia and meconium aspiration. Mortality from hyaline membrane disease was 46.9%, while perinatal asphyxia and meconium aspiration accounted for 38.9% and 40.0% respectively. Conclusions: Respiratory distress is therefore, a very common neonatal problem and it causes death of more than third of those affected. Emphasis should be geared towards reduction of preterm delivery, control of asphyxia and neonatal sepsis in order to reduce neonatal mortality in our environment.

Bacteriological profile and antimicrobial sensitivity pattern in neonatal sepsis: a study from North India

Abstract: Background: Neonatal sepsis is a leading cause of neonatal mortality and continues to be a formidable problem for neonatologists and pediatricians world over. Knowledge of microbial flora and their susceptibility will help us to decide empirical treatment for the neonatal sepsis. The objective of this study was to determine the bacteriological flora prevalent in NICU and the antimicrobial sensitivity pattern. Methods: The blood culture reports of all the neonates with culture proven neonatal sepsis during the period July 2010 to September 2013 were reviewed retrospectively. A retrospective review in tertiary care teaching medical college. The data was entered in Excel sheets and percentages of various outcomes were calculated. Results: A total of 28,927 babies were born during the study period and 336 among them had positive blood culture. The incidence of neonatal sepsis was 11.62 per 1,000 live births. Three hundred fifty- six microbes were isolated, out of which 50% presented as early onset sepsis and remaining as late onset sepsis. Pseudomonas aeruginosa was the most common organism encountered in both early (43.82%) and late onset sepsis (51.35%). Gram negative bacilli were sensitive to carbapenems (92%) followed by piperacillin-tazobactam (90%) whereas linezolid (90%) was most sensitive antimicrobial for gram positive cocci. Conclusions: Pseudomonas was most commonly isolated in both early and late onset sepsis. Gram negative bacilli were most sensitive to piperacillin-tazobactam and the carbapenems whereas linezolid and vancomycin were most effective against the gram-positive cocci. Resistance to third generation cephalosporins was rampant. Continuous surveillance for microbial flora, their antibiotic susceptibility, rational use of antibiotics and the strategy of antibiotic cycling may be of help to curtail emerging antimicrobial resistance.

Guidelines for analysis on measuring interrater reliability of nursing outcome classification

Abstract: Indicators in nursing outcome classification (NOC) need to be tested for their validity and reliability. One method to measure reliability of NOC is by using interrater reliability. Kappa and percent agreement are common statistic analytical methods to be used together in measuring interrater reliability of an instrument. The reason for using these two methods at the same time is that those statistic analytical methods have easy reliability interpretation. Two possible conflicts may possibly emerge when there are asynchronies between kappa value and percent agreement. This article is aimed to provide guidance when a researcher faces these two possible conflicts. This guidance is referring to interrater reliability measurement using two raters.

Prevalence and determinants of prehypertension and hypertension among adolescents: a school based study in a rural area of Kerala, India -

Abstract: Background: Raised blood pressure is the leading cause of death and disability world-wide. Though hypertension is a problem of adults the aetiologic process and risk behaviours start early in life. The objective of the study was to assess the prevalence and determinants of prehypertension and hypertension among adolescents from high schools in a rural area of Kerala, India. Methods: A cross sectional analytical study was carried out in 1000 adolescents from randomly selected Government, Aided and Unaided high schools of Ettumanoor, Kerala proportionate to sampling frame using WHO designed Global School based student Health Survey (GSHS) questionnaire. Anthropometry and blood pressure recordings were done by trained team members. Statistical analysis was done using SPSS 21. Chi-square test was used to find out the association between categorical variables. Significant variables were entered into logistic regression model to find out Adjusted Odds Ratio (AOR). Results: Out of 1000 study subjects, 409(40.9%) were males and 591(59.1%) were females. Overall prevalence of prehypertension and hypertension was 24.5% (males-30.5%, females-20.3%) and 0.6% (males-0.98%, females-0.34%) respectively. Male sex (AOR-1.67 95%CI-1.23-2.28), low socio-economic status (AOR-1.55 95%CI-1.15-2.11), overweight/obese (AOR-5.7 95%CI- 2.4-13.6), low fruit consumption (AOR-2.02 95% CI-1.499-2.7) and high soft drink consumption (AOR-2.21 95%CI- 1.446-3.39) were the significant risk factors for prehypertension and hypertension. Conclusion: Male sex, Low socio-economic status, obesity/overweight, low fruit and high soft drink consumption are the significant determinants of Pre hypertension and hypertension among adolescents. The findings may be used in developing messages to provide awareness of dangers of raised blood pressure among adolescents and its behavioural determinants.

Bacterial and clinical profile of diabetic foot ulcer using optimal culture techniques

Abstract: Background: Diabetic foot ulcers (DFU) are the complications of diabetes mellitus. The diabetic foot ulcer infections are polymicrobial in nature. If they are not recognized and controlled it leads to many devastating consequences like limb amputation, sepsis, and even mortality. Hence, the present study was undertaken to determine the bacterial and clinical profile of diabetic foot ulcer using optimal culture techniques and the antimicrobial sensitivity pattern of the isolates. Methods: A total number of 103 patients with a foot ulcer of Wagner’s grade II or more and evidence of purulent exudates or edema were included in the study. Swab samples were obtained from the base of ulcers and were sent for bacteriological study. The specimen was processed in the microbiology laboratory for Gram stain, aerobic culture, and anaerobic culture. The organisms isolated were identified by standard procedures and antimicrobial susceptibility was done by Kirby-Bauer disc diffusion method. Results: A total no of 253 organisms were isolated from 103 patients. Out of these, 217 aerobes were isolated, and the most common organism isolated from gram positive bacteria was Staphylococcus aureus , 53 (24.42 %). Pseudomonas aeruginosa , 42 (19.35 %) was the predominant organism isolated from gram negative bacteria. Among the total 36 anaerobes, Bacteroides fragilis group, 17 (47.22 %) was the most common organism isolated. All the gram positive aerobic organisms were found to be sensitive for vancomycin. Among the gram negative organisms, E. coli, Proteus mirabilis, Proteus vulgaris , showed more sensitivity to cefotaxime (90.62%, 91.66%, 75%) respectively. Metronidazole was the drug of choice in case of anaerobes followed by imipenem. Conclusions: It is necessary to identify the etiological factors and susceptible microorganisms responsible for causation of DFU. So that prompt management of diabetic foot ulcers is possible for successful outcome. Appreciation of the causative organisms in diabetic foot and their antibiotic sensitivity is essential for institution of appropriate antibiotic therapy.

Role of fine needle aspiration cytology in diagnosis of breast lumps

Abstract: The diagnostic process in breast cancer involves the “Triple test” consisting of clinical examination, mammography and fine needle aspiration cytology (FNAC). FNAC is a quick, simple, reliable and inexpensive procedure in diagnosing breast lumps. It is reported in different studies that FNAC have 80% to 98% sensitivity and more than 99% specificity. The main purpose of fine needle aspiration cytology (FNAC) of breast lumps is to confirm cancer pre-operatively and to avoid surgery in specific benign conditions.

A study on the bacteriological profile of urinary tract infection in adults and their antibiotic sensitivity pattern in a tertiary care hospital in central Kerala, India

Abstract: Background: Urinary tract infection is one of the most common bacterial infections in humans and a major cause of morbidity. The etiology of UTI and the antibiotic sensitivity pattern varies with the widespread availability of antimicrobial agents; UTI has become difficult to treat because of appearance of pathogens with increasing resistance to antimicrobial agents. Methods: A descriptive study done during January-June 2013. All positive urine culture and sensitivity reports of males and females aged 20-70years were included. A total of 373 positive urine culture cases were taken from the culture and sensitivity register from Microbiology department and details were entered using a questionnaire. Results: Out of 373 adults, males were 137 (36.7%) and females were 236 (63.3%). E. coli (74.3 %) was the most common organism, followed by Klebsiella (15.8%), Enterococcus, Pseudomonas and Staphylococcus . The incidence of UTI was more in patients in the age group of 60-70years. E. coli and Klebsiella were sensitive to Amikacin (97.1%), Nitrofurantoin (90.7%), Gentamycin and Imipenem. Both organisms were resistant to Ampicillin (>90%). Conclusions: In this study, females were mostly affected and the most common organisms were E.Coli and Klebsiella. These organisms were most sensitive to Amikacin, Nitrofurantoin and resistant predominantly to Ampicillin. The sensitivity and resistance pattern of uropathogens to common antimicrobial agents must be taken into account when selecting treatment plans for UTI.

Biogenic synthesis of silver nanoparticles from waste banana plant stems and their antibacterial activity against Escherichia coli and Staphylococcus Epidermis

Abstract: Background: This study for the first time presents an eco-friendly and room temperature procedure for biologically synthesizing silver (Ag) nanoparticles from waste banana plant stems. Methods: A simple and straightforward green chemistry based technique used waste banana plant stems to act as both reducing agent and capping agent to produce Ag nanoparticles, which were subsequently characterized. In addition, antibacterial studies were conducted using the Kirby-Bauer sensitivity method. Results: Advanced characterisation revealed the Ag nanoparticles had a variety of shapes including cubes, truncated triangular and hexagonal plates, and ranged in size from 70 nm up to 600 nm. The gram-negative bacteria Escherichia coli showed the maximum inhibition zone of 12 mm. Conclusions: The study has shown that waste banana plant stems can generate Ag nanoparticles with antibacterial activity against Escherichia coli and Staphylococcus epidermis.

Burnout among nurses working in critical care settings: a case of a selected tertiary hospital in Rwanda

Abstract: Burnout is characterized by loss of emotional strength, not valuing human beings living together with or offering service and decreased in job performance and success due to lack of interest related to occupational stressors.1Burnout was recognized as work related danger among human oriented professionals including health care professionals since they are required to work many hours to help humans and face a challenge of high demand and low resources. Burnout is due to prolonged work related stress that is not managed. In a work environment this leads to high worker turnover, absenteeism, compromise of interpersonal relationships, reduced productivity and low personal achievement.

Economic burden of diabetes mellitus and its socio-economic impact on household expenditure in an urban slum area

Abstract: Background: India is on the brink of an epidemic of diabetes mellitus (DM). In the near future, DM will pose a severe burden on the already fragile and under-resourced health care system in India. Methods: A prospective community based cohort study was taken up for assessing the financial burden on households of patients with DM in an urban slum of Mumbai to reflect the economic implications of DM. Results: The mean age of participants was 51 years. Forty (33.33%) out of 120 were suffering from diabetes for more than 5 years and it was proved statistically that the total cost of expenditure on treatment per month was significantly related to the duration of DM. On an average the monthly direct expenditure was INR 687.5 per patient and indirect expenditure was INR 348.75 per patient. Catastrophic expenditure was borne by 5.8% of the participants. Conclusions: Direct cost forms the major component of the total cost of DM management. The expenditure on the management of Diabetes increases with the duration of the illness. As the out-of-pocket expenditure is the mainstay of financing the cost of diabetes mellitus in India, there is a possibility of these households of DM patients might be pushed into the poverty trap. It is recommended that the Government facilities for management of DM should be strengthened and quality of services should be improved in the interest of diabetic patients. Public awareness campaigns about the economic implications of DM and services provided by the government should be carried out.

Resolving ABO discrepancies by serological workup-an analysis of few cases

Abstract: Background: ABO discrepancies occur whenever the results of red cell grouping and serum grouping are in disagreement. The reasons for discrepancies both clinical and technical have to be sorted out. Further analysis is essential to resolve such discrepancies. If discrepancies are encountered, the interpretation of the ABO grouping has to be delayed until the same has been resolved. The aim of the study was to resolve ABO discrepancies encountered, by serological work up. Methods: All cases of discrepant samples received between August 2014 and May 2016 at the Department of Transfusion Medicine, The Tamilnadu Dr. MGR Medical University, Chennai, India were analyzed to determine the etiology by serological workup. Results: A total of twenty-one samples were analyzed and resolved. Fifteen cases of Type IV discrepancy, two cases of Type II discrepancy, one case Type III discrepancy, one case Type I discrepancy and two cases of technical errors were identified. Conclusions: ABO discrepancies can be resolved serologically if properly worked up. As ABO blood grouping is indispensible in blood transfusion service, it is imperative to resolve such discrepancies before transfusion.

Reflective practice as a method of learning in medical education: history and review of literature

Abstract: Modern medical education and profession needs innovative methods to improve learning among the students. Reflective practice is one of the time-tested tool to improve students’ learning following a teaching encounter. Reflective practice is an analytical practice in which an individual adds a personal reflection about the action, incident, situation or thought. Purpose of this article is to review the literature to find out history, various models, genesis and application of reflective practice in medical education. Through the present paper, attempt has been made to focus on role of reflective practice in present medical education and profession.

Fetal kidney length as a parameter for determination of gestational age from 20th week to term in healthy women with uncomplicated pregnancy

Abstract: Background: Accurate assessment of gestational age is pivotal to give quality maternity care. Ultrasonographic fetal biometry is the most widespread method used to establish GA. Sonographic biometric parameters commonly used are Crown rump Length (CRL), Biparietal diameter (BPD), Head circumference (HC), Abdominal circumference (AC) and Femur length (FL). Fetal Kidney Length (FKL) is one of nontraditional parameter and more accurate method of GA estimation than BPD, FL, HC and AC after 24th week of gestation. This study evaluates role of FKL in estimation of GA and compared its accuracy with other established biometric indices. Methods: Present study is a cross sectional study and includes healthy women who were certain of their LMP with prior regular menstrual cycles with uncomplicated pregnancy between 20 weeks of gestation to term. Maximum length of anyone single fetal kidney is measured from upper pole to lower pole at least thrice and mean of the measurements was taken. The data has been analyzed in SPSS-21 version and Microsoft word, excel have been used to generate graphs, tables etc. Results: Linear regression equation showed kidney length could predict gestational age with an accuracy ±9.048 days and predictability when combined with other biometric indices was ±8.299 days. Conclusions: The study shows good correlation between gestational age derived from FKL and gestational age from established biometric indices like BPD, HC, AC, and FL.FKL can be combined with the other four biometric indices to give a fair estimation of gestational age.

Knowledge and attitude of basic life support (BLS) among school teachers in Hebron, Palestine

Abstract: Background: Patients in all settings fully expect that they will be resuscitated if they have a cardiac arrest. It is therefore necessary to increase the number of qualified people, including school teachers and students who can play a vital role in performing basic and advanced cardiac life support at the scene of a medical emergency. Since life threatening events, such as cardiac arrest, must be responded to within six minutes, the retention of skills becomes a key concern in all urgent cases. The purpose of this study was to assess the existing knowledge of BLS among primary and secondary school teachers in Hebron, Palestine. Methods: After approval from Institute Ethical Committee and informed consent from the participant, the present study was conducted among primary and secondary school teachers. A self-administered questionnaire based on knowledge and attitude of BLS was used to collect data. Results: In general, only 42.5%of school teachers knew about CPR, but 57.5% had no previous information about CPR. Sources of information about CPR included television (26.5%), nurses and Drs (25.8), and the Internet (18.7%). Approximately 53% agreed that CPR training courses should be mandatory. Only 18.1% of teachers didn’t know the contact numbers for emergency services. Conclusions: This study has highlighted a critical issue that a majority of school teachers have limited knowledge about CPR. We recommend the mandatory implementation of CPR and basic life-support training for all school teachers across Palestine, and the need for incorporation of the BLS teaching into the Palestinian schools’ curricula without delay.

A study on correlation between depression, fear of fall and quality of life in elderly individuals

Abstract: Background: Fear of falling in elderly is a major cause of loss of independence, which has an effect on the physical function in elderly individuals. Depression is another important public health problem for older adults, because late life depression might have devastating consequences, such as an increase in mortality. QOL of older adults has become an important issue, because of demographic changes resulting from the ageing of the population. The goal of the study was to assess the depression and fear of fall which will provide further insights into the relationship between QOL, depression and fear of fall among elderly individuals in India. Methods: The sample consisted of 62 elderly people of age between 65 years to 75 years (mean=71.96, SD±5.92) were taken in the study. Depression was assessed using the 30-item geriatric depression scale (GDS), fear of falling was measured using falls efficacy scale (FES), QOL was assessed using the 26-item, World Health Organization Quality of Life, brief version (WHOQOL-BREF). Results: The data was analysed using Pearson co-efficient of correlation to examine the relationship between GDS, FES, and WHOQOL-BREF. The correlation co-efficient between GDS and FES was 0.5257 (p<0.05) and correlation coefficient between GDS and WHOQOL was 0.4372 (p<0.05). Conclusions: This study concluded that there was a significant association between the depression, fall efficacy, and QOL in the elderly people. This relationship has an important implication for the development of the rehabilitation programs that aim to improve the balance confidence and motivation will diminish its impact on QOL in elderly people.

Objective structured practical examination (OSPE) as a tool in formative assessment of II MBBS students, in pathology

Abstract: Background: Assessment drives the student learning. Regular periodical assessment not only improves learning habits, but also enhances the competence in all levels of medical education. Traditional practical examination is more subjective. It depends on examiners subjectivity, varying difficulty level of various experiments, and also internal marks variation etc. These flaws can be overcome by newer methods like OSPE. The aim of the study was to implement OSPE as a tool of internal assessment for practical skills in the II MBBS. To compare this with traditional practical examination (TPE). To obtain the students and faculty feedback regarding OSPE as a tool of assessment. Methods: A cross sectional study was carried out for 158 students in II internal pathology practical examination for six days in the second week of September 2016 at Department of Pathology, Dr. Pinnamaneni Siddhartha institute of medical sciences & Research Foundation, Chinnaoutpalli. Faculty and students were sensitized; blueprint were used to arrange twenty OSPE stations for the exercises conducted as per TPE and for the same 25 marks as per TPE. Simultaneously, all the students were subjected to both TPE and OSPE at the same time and venue. TPE was assessed by two professors and OSPE by separate eight faculty members independently without interaction with the students. The procedural stations were evaluated by using checklist and the response stations which consisted of short answers and MCQs, facilitated correction. Feedback was given to the student on their performance and feedback was obtained from the students and faculty regarding OSPE by questionnaire with Yes/No answers. Results: Performance score of students in OPSE (13.73 ±2.49) was higher as compared to TPE (9.27±1.86) which was statistically significant. Based on the response to the questionnaire, students perception towards OSPE was analyzed. Majority strongly agree OSPE to be fairer, more transparent and objective in comparison to TPE. In contrast, all the faculty members unanimously opined that OSPE was difficult to arrange, time taken and faculty versus students ratio was high for evaluation. Though, the faculty (91%) overall opined that OSPE should be included as a method of assessment. Conclusions: Present study revealed that OSPE was acceptable, feasible and reliable to the students as well as for faculty for the internal assessment in pathology. Opinions of both students and faculties strongly agreed that OPSE is more effective objective assessment tool.

Prevalence of metabolic syndrome in a rural population- a cross sectional study from Western Uttar Pradesh, India

Abstract: Background: Prevalence of non-communicable diseases like hypertension, diabetes mellitus and coronary artery disease is on the rise due to the change in lifestyle, unfavourable dietary habits and obesity. Metabolic syndrome is a simple tool by which we can predict the future risk of diabetes mellitus and cardiovascular disease. Studies showed that prevalence of metabolic syndrome is rising in Indian population, but majority of them were done in urban population. This study was conducted to look into the current status of the metabolic syndrome in rural population. Methods: The study was conducted among a population of 2982. Each participant was subjected to clinical examination, anthropometric measurements and necessary laboratory investigations. Metabolic syndrome was diagnosed based on modified NCEP: ATP III criteria. Results: The prevalence of metabolic syndrome was found to be 11.7% and was higher among female population (13.8%) as compared to males (9.6%). The prevalence of metabolic syndrome increased with increasing age. 28.3% of the participants over the age of 50 years had metabolic syndrome whereas it was only 0.4% below the age of 20 years. Nearly half (47.1%) of the obese individuals were suffering from metabolic syndrome implicating obesity as one of the most important risk factors in the etiopathogenesis of metabolic syndrome. The prevalence was only 1.1% among the underweight group. Conclusions: Present study has shown moderate prevalence of metabolic syndrome among the rural population of Western Uttar Pradesh, India with a more female predisposition.