bluuebunny/crossref_metadata_2025 huggingface dataset:
Hyperekplexia in a neonate: a seizure mimicker
Authors: Agarwalla Sunil Kumar , Patro Debasis , Ali Nasreen , Pattanaik Ankita
Published: December 2017

Hyperekplexia is an exaggerated startle to external stimuli associated with generalized increase in tone seen in a normal newborn with both sporadic as well as genetic predisposition. This is an uncommon neurological entity that is often confused with seizure in infancy. To date about 150 cases have been reported in the literature. We report a 6-week-old infant with characteristic intermittent generalized tonic spasm misdiagnosed as seizure disorder and was on phenobarbitone. With characteristic stiffening episode and exaggerated startle without habituation on tapping the nose we came to a clinical diagnosis of Hyperekplexia or Stiff baby syndrome or Startle disease. The child was started on Clonazepam to which he responded remarkably with decreased startle reflex. The aim of this case reporting is to through insight to this disease entity when we see an intermittent hypertonic infant.
Consanguineous marriages and their detrimental outcomes in Pakistan: an urgent need for appropriate measures
Authors: Ullah Muhammad Anzar , Husseni Aisha Maryam , Mahmood Syed Uzair
Published: December 2017

Consanguineous marriage is a union between first or second cousins. This practice is very common in developing Asian countries especially Pakistan. Around 70% of marriages in Pakistan are consanguineous. The major factors that promote consanguinity are arranged marriages, illiteracy and inter-caste marriages. The complications that follow include, small birth size, congenital malformations, neonatal mortality, rare genetic disorders, congenital deafness, congenital heart disorders and mental retardation. Serious steps must be taken to overcome this ongoing crises. Counselling, genetic screening, pre-natal diagnostic tests are some of the measures that are essential. Government involvement is also necessary to promote awareness and discourage consanguinity.
Risk of pancreatic cancer in Minia district, Egypt
Authors: Abdelrehim Marwa G. , Mahfouz Eman M. , Ewis Ashraf A. , Seedhom Amany E. , Afifi Hassan M. , Shebl Fatma M.
Published: December 2017

Background: Pancreatic cancer is considered one of the most lethal malignant neoplasms. Therefore, a better understanding of the etiology and identifying the risk factors are essential for the development of preventive strategies. Methods: This case-control study included pancreatic cancer patients attending Minia Cancer Center during the period from June 2014 to December 2015 and controls from the general population. Several suspected risk factors were evaluated during personal interviews with the study participants. Statistical analysis included crude odds ratio (OR) and multivariable logistic regression with an adjusted OR and 95% confidence interval (CI). Results: The study included 224 subjects, 75 pancreatic cancer cases, and 149 controls. Cases had higher age and male gender than controls. Bivariate analyses showed that age, sex, smoking, family history of pancreatic cancer, physical activity, mental stress, age at first birth, hormonal contraception, diabetes, hepatitis C virus (HCV) infection, pancreatitis, and cholecystitis were associated with pancreatic cancer. In the final multivariable analysis, smoking, physical activity, diabetes, HCV infection, and cholecystitis were significantly associated with pancreatic cancer risk. Conclusions: Pancreatic cancer risk is associated with some potentially modifiable factors like tobacco smoking and low physical activity and related health problems as diabetes, HCV infection, and cholecystitis. Control of known risk factors for pancreatic cancer should be considered to help in risk reduction and prevention.
Rapid diagnostic test versus microscopy in the diagnosis of acute malaria in a district hospital in Enugu state, Southeast Nigeria
Authors: Umegbolu Emmanuel I. , Madukwe Chinedu N.
Published: December 2017

Background: Malaria is a systemic disease caused by various species of Plasmodium, transmitted through the bite of a female Anopheles mosquito. According to the World Health Organisation, there were 214 million cases of malaria worldwide in 2015. Nigeria’s burden of malaria is about 51million cases and 207,000 deaths annually, accounting for 60% of outpatient visits to hospitals, 11% of maternal mortality, and 30% of child mortality. The study aimed to compare RDT and microscopy in malaria diagnosis in a District Hospital in Enugu state, Southeast Nigeria. Methods: Blood samples of 300 suspected cases of acute malaria were tested for malaria parasite using RDT and microscopy simultaneously. Results: In 2017, the study found a malaria prevalence of 25% (46.2% in children, and 18.1% in adults) in Awgu. RDT was positive in 38% and microscopy in 70.3% of cases. Both RDT and microscopy were positive in 36.3%, negative in 28.3%, and discordant in 35.4%. Sensitivity of RDT was 50.7% (89.4% in children, and 25.6% in adults). RDT had a specificity of 100% (both children and adults), positive predictive value of 1 (both children and adults), and negative predictive value of 0.6 (0.5 in children, 0.6 in adults). Conclusions: RDT (SD Malaria Ag P. f) had more sensitivity in children (89.4%) than adults (25.6%), and the occurrence of false negative results was more in adults (46.8%) than children (9.5%). All negative RDT results need to be examined microscopically, to rule out false negative cases.
Trend and outcome of acute poisoning case: an experience from emergency department of eastern Nepal
Authors: Bhandari Rabin , Bhandari Rupak , Gupta Pramendra Prasad
Published: December 2017

Background: Poisoning is common in Nepal. The objective of the study was to describe the profile of poisoning cases presenting to the emergency of a medical university in eastern Nepal. The specific focus was on to describe the presentation, demographics, delay to care and describe the triage parameters at presentation. Methods: An observational study was done. The secondary data from case files of all poisoning patients starting February 2012 to March 2013 were analyzed after retrieving them from Hospital record. Results: Poisoning constituted 3.89% of total emergency visits. Mean age was 24 years with female: male 1.32. Median time delay to presentation from the incident was 4 hours. Mortality rate was 5.1%, intubation rate 6.3%. Agricultural products ingestion (763/1399) was the commonest modality. The triage vitals were noted as median 110 mm of Hg (Q25, Q75 100, 120) for systolic blood pressure, median 87 mm of Hg (Q25, Q75 73, 93) for mean arterial pressure and median 97 (Q25, Q75 94, 98) for SPO2 by pulse oximetry. The level of consciousness was noted as alert (87.6%), response to verbal stimuli (3.7%), response to pain stimuli (7.1) and unconscious (1.6%). Comparison between mortality and no mortality groups showed significant difference for mean arterial pressure (n 1399, p<0.001, Kruskal Wallis Test), SPO2 (n 1399, p<0.001, Kruskal Wallis Test) and state of consciousness (n 1399, p<0.001, Chi Square test). Conclusions: Agricultural products are commonest, drugs and unknown poisons are significant. A large proportion is still unknown poisoning. Triage parameters can help to identify patients in risk of high mortality.
A cross sectional study to assess the knowledge, attitude about non-scalpel vasectomy and practices of any contraceptive method among females of reproductive age group in a urban slum, Chennai, Tamil Nadu, 2014
Authors: K. Kokila , K. Chellavel Ganapathi
Published: December 2017

Background: In India, non-scalpel vasectomy (NSV) technique was introduced in 1992 to improve the male participation in family planning, though it has failed to achieve its goal. Hence this study was planned to know the real concern about this condition. This study was carried out to assess the knowledge and attitude about non- scalpel vasectomy (NSV) and practices of any contraceptive methods among married females in reproductive age in an urban slum.Methods: This was a cross-sectional study done in urban field practice area of Institute of Community Medicine, Madras Medical College, Chennai-03, Tamil Nadu in the period July 2014 to August 2014 among Married females of reproductive age group (15-49 years).Specific questions on knowledge, attitude regarding NSV were asked. Data were entered in Microsoft Excel sheet and analysed in SPSS version 20. Results: This is a questionnaire based study. All (106 participants) were aware of vasectomy. Among them 50% knew that vasectomy is an option for permanent sterilization. About 36% of them knew that cash incentive is given for vasectomy & 30% knew that insurance given for pregnancy and other complications followed by vasectomy. Around 31% of the respondents knew that vasectomy does not affect sexual performance. About 29% knew that vasectomy does not need prolonged bed rest. Only 19% of the participants knew that vasectomy is done free of cost and as an OP procedure and 11.3% knew that vasectomy is done without any incision. Among the participants 81% agreed that limiting family size stabilizes the financial condition of the family. About 48% of the participants agreed that family planning is also a responsibility of males and 56% were willing to recommend vasectomy for others. Only 35% of the females agreed to adopt vasectomy for their spouse. Among the respondents 73.6% were practicing some form of contraception currently. Conclusions: We conclude that there is a need to design and develop a need based behavioural change communication strategy to bridge the existing information gap among the eligible couples about NSV & to improve the male participation in family planning. Involvement of media, community participation and successful stories of males who have adopted NSV would enhance the effectiveness of all the interventions.
Study of socio-demographic factors and morbidity profile of traffic policemen in Solapur city of Maharashtra
Authors: Haralkar Santosh J. , Gite Rahul N.
Published: December 2017

Background: The traffic policemen are engaged in controlling vehicular traffic and exposed to higher concentrations of air pollution as well as noise pollution daily. Hence they are at a risk of developing various health problems due to their occupation. Methods: The aim of study was to study socio-demographic characteristics and morbidity profile of traffic policemen. A cross sectional study was carried out on 114 traffic policemen form the traffic control branch of the city from the police headquarter of the city. History regarding symptoms experienced at the workplace, history of present illness, past history, personal history and family history was obtained and clinical examination was done. Statistical analysis was done with the help of percentages, chi-square test. Results: Majority (89.47%) of the traffic policemen were married. Nuclear family type was seen in majority (64.91%) of traffic policemen. Annoyance to noise (51.75%) and eye irritation (32.46%) were most common symptoms experienced at work place by the traffic policemen. Obesity was a major health problem in the study subjects (63.16%). Respiratory morbidity like URTI (14.91%) and chronic rhinitis (14.04%) were found significantly more in the traffic policemen. Conclusions: Annoyance to noise and eye irritation were most common symptoms experienced at work place by the traffic policemen. Respiratory morbidity like URTI, chronic rhinitis and chronic bronchitis were most common.
Barriers and facilitators of intention to organ donation among general people in state of Puducherry: a cross sectional study
Authors: Arunachalam D. , Subash Chandrabose G.
Published: December 2017

Background: Organ transplantation is taken into account one among the best advances of contemporary science that has given several patients a revived lease of life. The target of study resolve the barrier and supporter of organ donation among general public, and to spot the factors that influence organ donation assent and rejection in state of Puducherry, India. Methods: A cross-sectional study had below soft on a sample of a hundred and fifty subjects handily. The eligible subjects were administered a structured inquiries to assume barriers and facilitators of organ donation. The collected information’s were statistically analyzed. Results: Of the one hundred fifty subjects, the age groups were 58% 20-30 years, 26% 31-40 years, 12% 41 to 50 years and 4% 51-60 years. Male constituted 33.3% and females were 66.7% of the subjects. The mean data score of the themes were 4.74±1.45 (1-8). 80.6% according the intention to gift organ and 19.3% weren't willing to gift organ. The foremost necessary barriers were opposition from family (82.8%) and concern (72.4%). The foremost necessary facilitators were organ donation would save someone’s life (95.9%) and it improve the sense of human (95%). Education, occupation, married and financial gain square measure related to intention to gift organ. Conclusions: From the offered scientific proof it's conducted that information of organ donation stay still poor and therefore the indentified barriers and facilitators ought to be taken within the account whereas motivates the overall peoples to present organ to future.
Social determinants of health and well-being among municipal school children in Mumbai
Authors: Kazi Yasmeen K. , Shenoy Anita G. , Velhal Gajanan D. , Mate Suresh D. , Suryawanshi Sudam R.
Published: December 2017

Background: HBSC seeks to identify and explore the extent of the inequalities related to socioeconomic status (SES), age and gender among the younger age group, and highlight the need for preventive action. Hence, this study was carried out, to find out the social context as a determinant of their health and well-being. The objectives of the study were to study the socio-demographic characteristics of the students; to find the social determinants and its association with their perceived health outcomes.Methods: The study was carried out among 426 Municipal school students in Mumbai. They were enquired about their socio demographic characteristics, their personal habits and behaviour, relationship with their parents, siblings and friends, performance in school, academic pressures, and also about any health related complaints if they had. Results: The study shows less communication of students with their parents, more so with their fathers’. Students were seen to have more friends and would also spend more time with them, especially boys. Academic achievement was better among girls and those from less affluent families and it also showed a dip in the higher age groups. Regular consumption of breakfast, fruits, vegetables was seen less among girls and older students. Boys and those from less affluent families were seen to be more involved in high risk behaviour. Conclusions: All the factors mentioned in the study are shown to have adverse effects on the perceived health outcome of the students. These social factors need to be addressed to improve the health and well-being of the younger generations.
Screening of hypertension among rural community of Nepal
Authors: Agrawal Kapil H.
Published: December 2017

Background: Hypertension is the commonest cardiovascular disorder, posing a major public health challenge to population in socioeconomic and epidemiological transition. The objective of the study was to determine the prevalence of hypertension in the rural community. Methods: Community-based cross sectional study was conducted in Chotkiram nagar village of Rupandehi district of Western Nepal. Door to door screening for hypertension was done using mercury sphygmomanometer. Other study variables included demographic factors only such as age and sex. The data was collected from 7th June 2016 to 20th June 2016. All the households in the village were screened and all the persons over 18 years of age in the households were subjected to blood pressure measurement. Thus the sample size comprised of all persons above 18 years of age. Total subjects enrolled were 3158. All persons above (and completed) 18 years of age and holding permanent resident status in the study area at the time of study were included in the study. Pregnant women and persons not willing to give consent were the exclusion criteria set. Though, all the participants gave their consent. Results: The prevalence of hypertension in the study is 16.2%. Conclusions: Though the hypertension is significant in the current study, the prevalence is much lower than the studies done in other parts of Nepal. More prevalence studies are required in the rural areas of Terai region.
An overview of internet use among professionals of Moradabad: a critical appraisal
Authors: Priya Neha , Khan Samreen , Lal Sachin
Published: December 2017

Background: Internet is a boon and has certainly helped to bring the world closer. It has been a great medium for students to communicate and get information by transforming the academic landscape. However the excessive and undisciplined use of internet by individuals especially in the last decade, has led to the emergence of the concept of internet addiction. Therefore, a cross sectional study has been conducted to investigate the use of internet facility among undergraduate students from Teerthankar Mahaveer University using a validated questionnaire. There were about 42 million active internet users in urban India in 2008 when compared to 5 million in 2000. India now has the world’s third-largest national digital population, with approximately, 159 million Internet users in 2014, which is projected to reach 314 million by 2017 (IMRB 2014). The aim was to study prevalence and pattern of internet usage among undergraduate students in Moradabad. Methods: A cross sectional study was conducted among medical students (n=382) belonging to all the professionals of medical college, to assess the pattern of internet usage. A semi-structured proforma along with Young’s internet addiction scale was used. Results: Of the 382 adolescents who took part in the study, 150 (39.27%) were female and 232 (60.73%) were males. Their mean age was 16.20 years. Using Young’s original criteria, 22 (5.76%) were found to be addicts, 230 (60.21%) were moderately addicted, 45 (11.78%) were average users while in 85 (22.25%) of student’s internet use was less than average. Most of internet use was for social networking 183(47.9%), downloading media files 125 (32.7%), online gaming 45 (11.8%), academic purposes 10 (2.6%) and others 19 (5%). About 275 (72%) of the students were using smart phones to access the internet. Conclusions: Most of the internet usage was for the purpose of social networking (Facebook, Whats App, Mails, etc). Availability of high speed free wi-fi internet on mobile phones as well as more reliance on virtual friendship than real may be the reason for spending more time on social network websites.
Are we are equipped to handle an epidemic of chronic kidney diseases?
Authors: T. S. Selvavinayagam
Published: December 2017

Background: The utilization pattern under Tamil Nadu state health insurance program, namely The Chief Minister’s Comprehensive Health Insurance Scheme (CMCHISTN) reveals that chronic kidney disease (CKD) is one of the high expenditure elements and this study explores need and availability of facilities to handle the CKD in the state. The objectives of the study were to estimate the requirement of renal replacement therapy (RRT) including haemodialysis and renal transplant surgery in the population; to compute the available facility and measure the shortfall if any, so as to create an evidence-based comprehensive strategy to handle CKD in Tamil Nadu. Methods: Based on the existing data, the estimated prevalence of CKD is calculated and it is matched with a utilization of services under CMCHISTN so as to arrive the requirements and gaps in RRT. Results: The existing system is able to cover only around 3% of the estimated population needing RRT and projected shortfall is around 68% in HD machines. Conclusions: The government needs to create RRT facility in the public sector covering both MHD and RT along with the suitable preventive strategy to reduce the risk factors and promote an early screening of diabetes and hypertension.
Genetic demographic profile of two endogamous sub-populations of Rellis
Authors: Mandarapu Ramesh , Konathala Geetha Kumari
Published: December 2017

Background: Relli caste group was chosen for the present population genetic study, as it is one of the scheduled caste groups. The present work was designed to be a descriptive study mainly aiming at unveiling a precise population genetic profile of Relli caste. Methods: A community-based cross-sectional study was done among 428 Relli families belonging to two subsets (Relli-I: 208; Relli-II: 220) residing in different localities of Visakhapatnam city. The demographic information regarding age, occupation, economic status, marriage patterns and reproductive events were collected. The data was processed and analyzed by using software SPSS V.19. Results: The age composition in both the subgroups of Rellis indicates a high proportion of children and a low proportion of older people which are the common characteristics of a rapidly growing population. The overall consanguinity is more among Relli-II (42.3%) than among the Relli-I (36.9). The highest mean marital distance is recorded in Relli-I (37.9 km). The mean ages at marriage, first conception, and menopause are found to be slightly higher among the Relli-I. Whereas, the mean ages of menarche and last conception were higher in Relli-II. Tubectomy records the highest frequency in Relli-II group and vasectomy registered the highest frequency among Relli-I group. Conclusions: The demographic and reproductive structure of the Rellis in the present study indicates that observations made with regard to most of the variables fall well within the ranges observed for other caste populations of Andhra Pradesh.
Clinical profile of scrotal swellings in Jharkhand, India: our experience of four rural health camps
Authors: Munda Vishnu Singh , Murmu Nagendra Nath , Kumar Sanjeev , Bhengra Ajay , Korah Manoj Kumar , Kumar Rakesh
Published: December 2017

Background: Scrotal swellings are one of the common problems in all age groups. Since these swellings are usually painless and can attain a very big size without causing much discomfort; the patients are reluctant to seek medical advice. Social stigma, embarrassment and fear of getting under the knife are the other reasons for late presentation. However in developing countries like India; the poverty, illiteracy, unawareness and poor health care facilities are the common reasons for late presentation. The objective of the study was to bring forward the volume of problem and morbidity associated with scrotal swellings in rural populations of Jharkhand, India.Methods: This study was based on the four health camps with emphasis on scrotal swellings organized in the rural areas East Singhbhum, West Singhbhum and Simdega districts of Jharkhand state in Eastern India between December 2015 and June 2017. Data obtained from these camps were analyzed retrospectively.Results: A total of 1567 persons were screened for scrotal swellings in four camps; 180 (11.4%) of them found to have some scrotal pathology. Most of the cases were in the age group of 31-50 years (61.35%), scrotal swelling being main complaint. Out of the 180 cases with scrotal swelling, Primary vaginal hydrocoele was found in 78.9% (n=142); followed by sebaceous cyst and epididymal cyst. The majority of cases had symptom duration of 1 to 2 years– 33.9% (n=61), followed by 2 to 5 years– 23.23% (n=42); the duration of symptoms ranged from 2 weeks to 12 years.Conclusions: Although the diagnosis and treatment of scrotal swellings are relatively simple the number of patients with scrotal swellings is high, especially in the rural areas of developing countries like India. The rural health camps can be effective in decreasing the morbidities of scrotal swellings.
A cross sectional study on prevalence of hypertension and its associated risk factors among rural adults in Kanchipuram district, Tamil Nadu
Authors: Raja T.  K. , Muthukumar T. , Mohan P. Anisha
Published: December 2017

Background: Hypertension is one of the non-communicable diseases, which is an important global public health problem and also the most leading cause for cardiovascular disease in both developed and developing countries. The aim and objectives of the study were to estimate the prevalence of hypertension and to assess the associated risk factors among adults of rural population.Methods: A community based cross sectional study was done on 225 study subjects, using systemic random sampling method at Kancheepuram district, Tamil Nadu. Results: The study included 225 participants of which 53% were male and 47% were female. The overall prevalence of hypertension among the study population was 26.2%. Risk among male was greater than female (OR=1.390). Factors like age, body mass index, diet, family history of hypertension had significant association (p<0.05) with hypertension. Conclusions: Regular screening for hypertension among adults should be done in the general OPD as well as in health camps so that they have a knowledge regarding their own blood pressure status. Among those who already have hypertension, anti -hypertensive drugs, timely blood pressure check-up, screening for cardio vascular diseases and self-care management of hypertension need to be promoted.
Measuring malnutrition: needs a comprehensive indicator
Authors: Akhade Kiran Swapnil
Published: December 2017

Background: There are various classifications for grading the degrees of under nutrition. Different reference values and cut off points has been a major hindrance in comparing data across various studies and countries. Methods: Community based cross sectional study. Children from urban slums were examined. Anthropometric measurements were taken. Data was analyzed with the help of SPSS ver 20 and appropriate tests were applied. Results: 400 children were examined. As per Z score classification, 39.8%, 36.5% and 24.8% of children are underweight, stunted and wasted respectively. As per IAP criteria, 44.7% are undernourished and 3.2% are severely undernourished (Grade III & IV). Compared to this, the Z score system identifies a much higher prevalence of severe undernutrition (15%) compared to IAP system. Composite index of anthropometric failure (CIAF) identifies 42% of underfive children are normal i.e. no failure, while 58% of children are undernourished. Conclusions: The current study suggests that conventional measures of undernutrition may be missing out a considerable proportion of undernourished children present in the population. CIAF can be used to measure overall prevalence of undernutrition.
Assessment of self-care practices among hypertensive patients: a clinic based study in rural area of Singur, West Bengal
Authors: Dasgupta Aparajita , Sembiah Sembagamuthu , Paul Bobby , Ghosh Ayon , Biswas Bijit , Mallick Nazrul
Published: December 2017

Background: Hypertension, also known as high blood pressure is a global public health concern. It is an important modifiable risk factor for cardiovascular disease and stroke. It remains silent, being generally asymptomatic during its clinical course and it accounts for a large proportion of cardiovascular deaths; lifestyle modification is the first line of intervention for all patients with hypertension, yet it was never been empirical. The aim of the study was to assess the pattern of self-care practices, if any and also to find out the factors associated with it, among the hypertensive patients in the outpatient department. Methods: A clinic-based, observational, cross-sectional study was conducted at health center under RHU & TC, Singur, which is the rural field practice area of All India Institute of Hygiene and Public Health, Kolkata among 124 hypertensive subjects. Binary logistic regression was done to find out the factors associated with the self-care practices using SPSS software. Results: In the present study, 62.9% of study participants suffering from hypertension had unfavourable self-care practices. Logistic regression showed age above 60 years (OR-3.1), primary level education (OR-5.6), poor socio economic status (OR-2.4), widow/separated (OR-3.3) and people with self-perceived poor health status (OR-2.8)had significant association with unfavourable self-care practices. After adjusting with other variables, age (AOR-2.3) and education (AOR-3.8) remained significant predictor of outcome. Conclusions: The findings revealed that the self-care practices among hypertensive patients were unfavourable in rural area. This calls for a deep need in increasing the awareness about healthy lifestyle among hypertensive patients. This study provides key elements to affect policy changes and social interventions.
Gender difference in health seeking behaviour among mothers of under five children in Lucknow
Authors: Katiyar Rahul , Ahmed Naim , Singh Jai Veer , Singh Vijay Kumar
Published: December 2017

Background: Discrimination and gender gaps have been observed even in early years of life. Although overall sex ratio in India has improved from 933 to 940 in the last decade, it declined from 927 to 914 in children aged less than five. Girls, less than five years, show steadily high mortality/morbidity compared to boys. This study was conducted to find the gender inequality in health seeking behaviour (HSB) among mothers of under five children. Methods: This community based cross sectional study was conducted in rural area of Lucknow, between September 2014 to August 2015. A total of 221 households having 376 under-five children were selected by multistage sampling technique from rural area of Lucknow. Mothers were interviewed about health seeking behavior for their ill child. Data were entered and analyzed using SPSS v21. Results: About 95% of the male child and 86.4% of the female child sought treatment. Of the total females that were treated, 67.3% were taken to a health facility/provider while the rest got treated at-home against 76.4% males that got treatment outside home. Conclusions: Gender discrimination do exist in the rural area at each step of seeking health-care for girl child. Adequate measures should be taken to improve their health status and consequently sex ratio as early as possible.
Objective structured clinical examination for formative assessment of final year part-1 MBBS students
Authors: Chajhlana Sunil Pal singh , Bhumi Manoj Aravind , Narashima Mahabhashyam Rama Krishna , A. Sai Ram , Mannava Varaprasada Maruti Sarma
Published: December 2017

Background: The aim of medical education is to develop overall medical student’s clinical competency at all the levels. Practical examinations play a major role in the overall assessment of the cognitive, affective as well as psychomotor domains of the individuals. Different variability in clinical examination, student’s variability, the examiner’s variability and the patient’s variability and the attitude towards disease may have effect on the assessment of the students. Objective structured clinical examination (OSCE) was designed to test the clinical competence by bed side while simultaneously improving objectivity and reliability. The objectives of the study were to assess the effectiveness of OSCE for assessment tool as compared to traditional method of assessment; to know the perception of students participated toward OSCE. Methods: Study was conducted among a batch of 25 students of VIth semester student posted in Department of Community medicine. After undergoing traditional method of examination, all the participating students underwent OSCE and the marks were recorded. Student’s perception regarding OSCE was recorded using a questionnaire. Results: Marks scored by the students in OSCE were significantly higher than traditional practical examination. 92% students agree that OSCE useful tool in overall assessment of the student, better form of assessment & learning, easy to pass and score better marks than traditional method of examination. Conclusions: OSCE useful tool in overall assessment of the student, better form of assessment & learning, score better marks and has less emotional stress in OSCE, when compared to viva voce.
A study on prevalence of reproductive tract infections among women in a rural area of Tamil Nadu
Authors: B. Kamini , V. Srisanthanakrishnan
Published: December 2017

Background: Reproductive tract infections, adding burden to the morbidities in women especially in developing countries. Women, who are in reproductive age group, are at higher risk of contracting RTIs easily. Bacterial vaginosis, candidiasis and trichomoniasis are the commonly reported RTIs in India. Hence this study was planned to find the prevalence of self reported symptoms of RTIs and the prevalence of RTIs of public health importance in women of reproductive age group 15-49 years in a rural area.Methods: A community based, cross sectional study was conducted among 461 women, who gave written consent. Participants were interviewed and if they have more than two symptoms of RTIs, they were included for gynecological examination and laboratory investigations at the rural health center.Results: The prevalence of self reported RTIs was found to be 55.5% and 27.55% of participants had two or more symptoms of RTIs. Based on examination, Prevalence of cervisitis, vaginitis and pelvic inflammatory diseases were reported as 9.54%, 12.15% and 3.25% respectively. Based on laboratory investigation, candidiasis, bacterial vaginosis and trichomoniasis were reported as 6.075, 5.86% and 2.6% respectively.Conclusions: With the prevailing burden of RTIs, it is important to create awareness and to health educate all women to reduce increasing trend of RTIs. This is possible with proper planning and implementation of health programmes in such a way that it should reach every women residing in the rural areas also.
Assessment of self-medication patterns in a rural area of south India: a questionnaire based study
Authors: Kumar Chandani Ashok , Revannasiddaiah Niroop
Published: December 2017

Background: Self-medication is an important health issue especially in developing countries like India, where universal access to health care is yet to be achieved. It is a type of self care behavior, promoted by WHO, since it reduces the cost of treatment, physicians’ and patient’s time and reduces the burden on the understaffed health system. This study aimed at determining the prevalence and patterns of self medication in rural areas.Methods: This cross sectional study was conducted in villages covered under rural health centre attached to a medical institution. By systematic random sampling, 458 people from 167 households were administered a pretested questionnaire after obtaining informed consent.Results: This study reports the prevalence of self medication to be 51.75%. Age, gender and marital status showed a statistically significant higher usage of self medication (p<0.01). Advice from friends, family and neighbours was the commonest mode of attaining self medication, while simple nature of disease was the common reason cited. Fever, myalgia and headache were the common symptoms reported where self medication was used. More than 90% of the respondents considered self medication to be harmless and acceptable (74.3%); and 92.8% would like to continue the practice in future.Conclusions: Self-medication is one of the common and preferred modes resorted to by the patients, which impacts medical care affecting diagnosis of underlying conditions resulting in delay of appropriate treatment. Awareness and education programs using mass media with involvement of community will help in the rational approach towards self medication.
An observational hospital based study to compare hemoglobin level among cancer patients
Authors: Kumar Sharma Munesh , Gour Neeraj , Pandey Awadhesh , Srivastava Dhiraj
Published: December 2017

Background: Cancer related anemia (CRA) is a major healthcare problem. In the Indian context, these figures are likely to be higher due to the prevailing malnutrition in the general population. We have conducted this observational hospital based study on cancer patients with following objectives: 1) to assess the socio demographic profile of different cancer patients admitted at hospital; 2) to measure hemoglobin level among different cancer patients admitted at hospital on the basis of socio demographic profile and type of cancer.Methods: The registers maintained in the department of Radiotherapy were checked and those belonging to the year 2011-12 were utilized to analyze the cancer patient’s data in respect to age, type of cancer, hemoglobin level admitted in health care facility.Results: As far as distribution of Hb level is concerned among all cancer patients, 87.56% patients were having Hb level more than 9gm% and around 12.43% patients were having Hb level less than 9 gm%. Majority of patients whose Hb level was less than 9gm% were belonging to age group more than 45 years.Conclusions: It is very much evident that anemia among cancer patients is a major healthcare problem and should be taken seriously.
Factors influencing observation of standard precautions among nursing staff in tertiary care setting in Mangalore
Authors: Rashmi Anusha , Kundapur Rashmi
Published: December 2017

Background: Health care professionals and particularly nurses are often exposed to microorganisms, many of which can cause serious infections. Although the potential for HBV transmission in the workplace setting is greater than for HIV, the mode of transmission for these two viruses are the same. Because of the environment in which they work, many health care workers are at an increased risk of accidental needle stick injuries (NSI) and blood borne pathogens such as HIV, Hep B, and HCV. The objectives of the study were to assess the knowledge, attitude and practice of standard precautions among nursing staff working in 5 tertiary care hospitals attached to teaching institutions in Mangalore and to assess the factors associated with non-compliance with standard precautions among nursesMethods: The study was done in 5 tertiary care hospitals attached to teaching institutions in Mangalore among the working nursing staff in these hospitals. A pre-tested questionnaire was used to collect the information regarding knowledge, attitude and practice and the reasons for non-adherence to standard precautions. Results: Regarding standard precautions 66.7% had a good knowledge, 74.7% had good practice and 87.3% had a positive attitude towards it. 26.34% attributed noncompliance to excess workload. Increasing age and increase in duration of nursing practice showed a significant increase in KAP scores. Conclusions: The duration of nursing practice influenced the knowledge and the compliance to standard precautions.
Excessive daytime sleepiness and its determinants: do they have a pattern with study semesters among postgraduate medical resident doctors?
Authors: H. S. Siddalingaiah , Chaudhuri Aditi , D. Chandrakala , Singh Amarjeet
Published: December 2017

Background: Residency is a stressful period in the career of a medical professional. Excessive daytime sleepiness (EDS) is a major problem among resident doctors due to long work hours, stress, sleep deprivation, shift work, lack of sleep hygiene and other lifestyle related factors. The sleep problems and related factors need to be studied among resident doctors to know if any cumulative effect exists. Methods: A cross sectional study design with pre-validated sleep assessment proforma, Epworth sleepiness scale (ESS), and sleep hygiene index (SHI) as study tools which were self-administered among a total of 428 enrolled eligible resident doctors. Results: A total of 350 resident doctors returned the filled proforma, ESS and SHI (response rate 81.7%). Prevalence of EDS was found to be highest in 2nd (51.1%), 3rd (55.2%) and 5th (47.1%) semesters. Socio-demographic factors did not vary much across semesters except for slight increase in quantity of coffee/tea intake. No major changes in shift pattern, total sleep hours were found across semesters but work hours differed significantly. Sleep latency was least in 3rd semester where EDS was highest. Similarly, sleep quality, sleep hygiene and weekly sleep hours were least in 2nd and 3rd semester where EDS prevalence was high. In addition, as per visual analogue scale ratings by resident doctors, those in 2nd and 3rd semesters were maximally tired and maximally sleepy which is consistent with the finding of high prevalence of EDS in these semesters as recorded by ESS. Conclusions: Sleep quality, sleep quantity, sleep hygiene and weekly work hours emerged as important and sensitive predictors of EDS across study semesters. These components must be present in any intervention package to address EDS especially in the first three semesters of residency program and other similar occupational settings.
Economic burden of silent mental disorders: a case study of agnosia in schizophrenia
Authors: Chattu Vijay Kumar , Mahon Paula
Published: December 2017

Mental health problems affect society as a whole, and not just a small, isolated segment. In developed countries with well-organized healthcare systems, between 44% and 70% of patients with mental disorders do not receive treatment whereas in developing countries the treatment gap being close to 90%. Schizophrenia is a severe mental disorder affecting more than 21 million people worldwide. People with schizophrenia are 2-2.5 times more likely to die early than the general population. The case study highlights about agnosia in a schizophrenic patient in a primary care setting and how to address the management at a broader perspective using the appropriate antipsychotic medication and ensuring the support from a family without violating the human rights of the patient. The World Economic Forum estimated that the cumulative global impact of mental disorders in terms of lost economic output will amount to US$ 16 trillion over the next 20 years, equivalent to more than 1% of the global gross domestic product. Mental health should be a concern for all of us, rather than only for those who suffer from a mental disorder. The mental health action plan 2013-2020, endorsed by the World Health Assembly in 2013, highlights the steps required to provide appropriate services for people with mental disorders including schizophrenia. A key recommendation of the action plan is to shift services from institutions to the community. Mental health must be considered a focus of renewed investment not just in terms of human development and dignity but also in terms of social and economic development.
The role of platelet rich plasma injection in the management of early osteoarthritis of the knee
Authors: Subash Yeshwanth , K. Kamalakumar , M. Lydia
Published: December 2017

Background: Osteoarthritis of the knee is a degenerative disorder associated with significant morbidity in the form of pain, knee stiffness and decrease in the functional capacity of the affected limb leading to a decrease in the quality of life for the patient. Various modalities of treatment are available for the management of this condition. The aim of this study was to evaluate the role of platelet rich plasma (PRP) injection in the management of early osteoarthritis of the knee and to compare the functional outcome with the studies of various authors as available in literature.

Methods: 60 patients with Kellgrenn and Lawrence grade 1 and 2 osteoarthritis of the knee were studied from January 2014 to January 2015 and were followed up for a period of 1 year.

Results: There were 39 males and 21 female patients in our study with the right side being more commonly affected. There was a significant decrease in the VAS score and the WOMAC score at 1, 3, 6 and 12 months follow up as compared to the pre-injection baseline scores. All patients were satisfied with the procedure in terms of functional outcome.

Conclusions: PRP injection is a cost effective, safe and efficient procedure with easily reproducible results and gives good functional results in terms of pain relief, improvement of range of movements and mobility, and improves the quality of life in patients with early osteoarthritis of the knee.
A prospective study of intra-articular injections of platelet rich plasma in early osteoarthritis knee joint
Authors: Vamshi Rentala , Bheemisetty Vivekananda , Bollabathini Raju , Mahadevuni Vishwanath
Published: December 2017

Background: Platelet-rich plasma (PRP) is a natural concentrate of autologous blood growth factors experimented in different fields of medicine in order to test its potential to enhance tissue regeneration. The aim of our study is to study the effects of intra articular injections of autologous “Platelet Rich Plasma“ in the osteoarthritis of knee joint and to assess the functional outcome after injecting platelet rich plasma in osteoarthritic knee joints and compare the results with standard studies and draw conclusions.

Methods: This is a prospective study done on 161 Kellgren-Lawrence radiological grade I and grade II knee joints, between August 2013 and March 2016 which, were treated with PRP intra-articular injections. The procedure consisted of injection of 8 ml platelet concentrate into the knee joint with an 18- gauge needle without local anaesthetic. Patients were assessed with WOMAC (Western Ontario McMaster Universities Arthritis Index) scoring pre injection of PRP and post injection period of 1 month and 6 months. A reduction in WOMAC score is suggestive of improvement in the patient’s condition.

Results: There is a significant improvement in WOMAC score of all the patients and the results sustained for more than 6 months. Though there is clinically better results are seen in grade I knee joints than grade II knee joints, these results are statistically not significant.

Conclusions: Osteoarthritis (Grade I and Grade II) of Kellgren Lawrence radiological grading does give relief from pain, stiffness and improves functionality without any major side effects and can be recommended as a viable modality of treatment. 
Comparative study of titanium elastic nailing v/s dynamic compression plating for the management of fracture shaft of femur in adolescent age group
Authors: D. V. Mahesh , C. D. Deepak , K. G. Gunnaiah , Pasha Moinuddin
Published: December 2017

Background: Femoral fractures are one of the common long bones fractured in paediatric age group. Over the past 20 years, there has been a dramatic and sustained trend toward the operative stabilization of femoral shaft fractures in school-aged children. Femoral fracture demands stable fixation in adolescent.

Methods: A retrospective cohort study was conducted in a tertiary care hospital. All children’s between the age 11 to 18 years with femur fracture managed with either TENS or dynamic compression plating between march 2014 to march 2017 were included into the study.

Results: most common mode of injury was RTA. Middle third being the most common site for fracture. There was100% union in our study. The mean time of union in TENS group was 12 weeks and that of Plating group Was 13.1 weeks. Irritation at entry site was seen in 11 (22.9%) out of 48 patients. Malunion was seen in 9 out of 48 children’s in group a, whereas malunion in group b seen in 1 child. All the malunion was less than 5 degree and Varus being most common type of malunion. Limb length discrepancy in group A was observed in 5 patents (10.5%) out which 3 were shortening and 2 were lengthening. In group b 1pateint had shortening at end of follow up. In group B superficial infection was seen in 4 (15%) out of 33 children’s and in group A it was observed in 2 children’s (5%).

Conclusions: we concluded that compression plating in adolescent age group especially older and obese children for the management fracture shaft of femur comparatively better than TENS.

 