bluuebunny/crossref_metadata_2025 huggingface dataset:
Laparoscopic repair of umbilical and paraumbilical hernias: a prospective and interventional study in government hospital
Authors: Patel Kiren B. , Barot Mithun V.
Published: August 2019

Background: Umbilical and ventral hernia occurs as a result of weakness in musculofascial layer of anterior abdominal wall. The most important causes are congenital, acquired, incisional and traumatic. UH and VH can be repair by open surgical procedure. A successful series of laparoscopic repair of umbilical hernia and VH was done by Le blanc in 1993. The cost can be optimised by selection of mesh and optimal uses of transabdominal suture and various fixation devices. This original article reveals methods, techniques, indication, contraindication, post-op pain, operative time, surgical site infection recurrence and outcome of laparoscopic umbilical hernia and paraumbilical hernia repair.Methods: A total of 21 patients of ventral hernia (umbilical, paraumbilical and incisional), who underwent laparoscopic hernia repair from October 2014 to October 2016, were selected have taken part in study with valid consent, in B.J. Medical College Ahmedabad Gujarat. All patient study regarding operative time, postoperative pain, postoperative hospital stay, surgical site infection like wound infection, seroma, hernia defect size, mean drain removal and recurrence.Results: Out of 21 patients male are 33% and female are 67%. Mean age of patients is 45 yrs with range being 18-65 yrs. 28%, 33.33%, and 38.1% of patient had umbilical, paraumbilical and incisional hernia respectively. Mean size defect was 7.8 cm2. Mean operative time in this study is 98.6 minute. Mean drain removal is 2.80 day. Mean postoperative hospital stay was 3.3 days. 4.7% had wound infection, 9.5% had seroma formation. There is 0% recurrence in present study.Conclusions: The laparoscopic approach appears to be safe, effective and acceptable. It is also effective in those who are obese, with co morbidities (complex) and who have recurrence from prior open repair and having ascites.
A study to determine the incidence of carcinoma of the thyroid gland in patients treated for multinodular goiter
Authors: Yogish Vikram , Teja Challa , Grover Himanshi
Published: August 2019

Background: In the population today, the presence of multi nodular goiter (MNG) is found in quite a few people and this may be due to various reasons. The patients should be thoroughly evaluated and a detailed history must be collected. Surgical treatment is offered to patients for various reasons. The objective of this research article is, to determine the incidence and the type of carcinoma of the thyroid gland in patients treated for multinodular goiter.Methods: A total of 105 patients who had multinodular goiter were studied. The study was carried out at SRM Medical College Hospital and Research Center, Kattankulathur, Tamil Nadu, India, from March 2016 to February 2019, for a period of three years. A detailed history was obtained and a thorough clinical evaluation was done. Investigations such as, complete blood count, thyroid function tests, ultrasound of the neck, and fine needle aspiration cytology were done. The patients then underwent total thyroidectomy and the operated specimens were subjected to histopathological examination (HPE). Out of the total of 105 patients that were studied, 21 patients were found to have carcinoma of the thyroid gland. The statistics were analysed using SPSS package 16.0.Results: From the results it was seen that papillary carcinoma of the thyroid gland was most commonly found in the operated specimens. The findings were compared with other studies.Conclusions: In patients with multinodulargoiter, a thorough evaluation and a detailed histopathological examination of the operated specimens must be done.
A prospective study in peritonitis patients to compare the impact of subcutaneous negative suction closure, conventional primary closure of skin and subcutaneous tissue and open skin technique following laparotomy
Authors: Mathews Mano Zac , Subramanyam Sriram Gopalakrishnaiah , Mitta Nivedita
Published: August 2019

Background: Abdominal wall closure in the presence of sepsis presents a challenge to the surgeon. The objective of this study is to determine the advantages and disadvantages of each method to individualise the techniques based on patient profile about surgical site infection, duration of hospitalisation and morbidity.Methods: A prospective comparative study was conducted among 102 operated patients of peritonitis in the Department of General Surgery at St John’s Medical College and Hospital. The patients were divided into three groups, group A, group B and group C. In group A, skin and subcutaneous tissue was closed after draining the subcutaneous space by a negative-suction drain. In group B, the patient’s skin and subcutaneous tissues were closed primarily with continuous sutures without negative suction drain. In group C, the laparotomy wound was closed and the skin was left open. And the outcome compared in the form of wound infection, hospital stay and morbidity. Patients on immunosuppressive therapy and paediatric patients were excluded. Demographic and clinical variables were recorded at the time of admission. SPSS version 18 was used for analysis.Results: The study showed male preponderance and the mean age was 43.2 years. Duodenal perforation was the commonest cause of peritonitis in this study (38.2%). Incidence of surgical site infection was less in Group A (20.6%) compared to group B (52.9%) and group C (29.4%). Duration of hospital stay was also less in Group A patients (9.3±3.6 days) compared to other two groups. 37 patients who were included in the study were diabetic, out of which 25 patients (67.6%) developed surgical site infection.Conclusions: It can be concluded from this study that abdominal wall closure using a sub cutaneous negative suction drain in peritonitis cases reduces the incidence of surgical site infection, duration of hospital stays, subsequent surgeries related to wound dehiscence and its associated morbidity.
A study of factors determining difficult surgery among patients undergoing laparoscopic cholecystectomy
Authors: Akhtar Mohhamad Sadik , Alam Parwez , Alvi Yasir , Ali Rizvi Syed Amjad , Raza Mohhmad Habib
Published: August 2019

Background: With widespread use of laparoscopic cholecystectomy and its applicability in many difficult situation, the chances of complication and difficulty during surgery have increased. This study was done to determine the factors which could preoperatively predict difficulty undergoing laparoscopic cholecystectomy.Methods: The data were obtained from the patients admitted to in wards of General Surgery, JN Medical Collage, Aligarh Muslim University, and Aligarh, India undergoing laparoscopic cholecystectomy. The difficult laparoscopic cholecystectomy was defined as procedures exceeded 70 minutes in duration or those which were converted to open procedure. Dependent variable included demographic factors, clinical and sonographic findings. P value was kept at 0.05.Results: During the study duration, 200 patients were included in the study undergoing for the laparoscopic cholecystectomy and out of this 85 had difficult outcome procedure. High BMI, hypertension, previous upper abdomen surgery, deranges AST and serum creatinine along sonographic findings of gall balder wall thickening and pericholecytsic edema were found to be significantly associated with difficult LC.Conclusions: This study demonstrates that presence of various factors can predict the difficult outcome of laparoscopic cholecystectomy. This can help in minimizing the complication and council the patients regarding difficult procedure and need for conversion to open cholecystectomy, especially relevant for funds-limited settings like India.
A comparative study of open versus closed method of establishment of pneumoperitoneum in laparoscopic surgery
Authors: Jain Adeesh P. , Shah Sarav C. , Shah Purva C. , Patel Karan R.
Published: August 2019

Background: Laparoscopy has overtaken open surgery as the choice of procedure wherever feasible. More than 50% of complications in laparoscopy occur during creation of pneumoperitoneum. In this study, we are comparing open or Hasson's method and closed or vress method of creation of pneumoperitoneum.Methods: This is a prospective comparative parallel randomised control trial conducted at the Department of Surgery, Baroda Medical College and SSG Hospital from November, 2017 to November, 2018. We divided the patients (n=100) into two groups i.e., open method (group O) (n1=50) and closed method (group C) (n2=50) groups using the envelope method of randomisation. We compared the two techniques in terms of time required to complete the procedures and complications (major and minor) associated with creation of pneumoperitoneum.Results: All the patients that participated in this study belonged to the age group of 10-69 years out of which majority were 15-50 years old. In our study, the mean time required to create pneumoperitoneum by closed method (group C) was 9.3 seconds while by open method (group O), it was 7.84 seconds with p value <0.001. There were 15 cases of gas leak from the port side, all recorded in the open method of establishment of pneumoperitoneum.Conclusions: Even though the open method takes less time to create pneumoperitoneum, both methods are similar in terms of time taken to complete the operation and major and minor complications because there was no statistically significant difference in the frequency of these parameters between the two techniques.
Recurrence of keloids after application of epidermal growth factor
Authors: Joseph Aneesh , Kochunarayanan Ajayakumar , Varghese Fobin , Sadasivan Kalesh
Published: August 2019

Background: Exact aetiology for keloid formation is yet unknown. The prime goal of the therapy is to decrease the process of scarring. Many modalities of treatment are available for keloids. With current treatment modalities, recurrence rates approaches 75%. This study was conducted to find out whether application of Epidermal growth factor will reduce recurrence rates of keloids, after surgical excision.Methods: An observational study was conducted by collecting details of 40 patients who underwent surgical excision of keloids followed by epidermal growth factor application over the wounds. The patients have been followed up to 6th months post excision and recurrence rates of keloids as well as overall scar quality were analysed.Results: Out of 45 patients included in the study, 16 (35.6 %) were males and rest females. The median age of the study population was 18.0 (with an IQR 16.0; 26.0). Out of 45 patients, 12 patients had family history of keloids (73%). Out of 45 patients, 8 had keloid tendency which amounts to 82%. Out of 45 patient who underwent treatment, 22 patient developed recurrence which is 48.9% Out of 45 patients included in the study, 16 (35.6 %) were males and rest females. The median age of the study population was 18.0 (with an IQR 16.0; 26.0). Out of 45 patients, 12 patients had family history of keloids (73%). Out of 45 patients, 8 had keloid tendency which amounts to 82%. Out of 45 patient who underwent treatment, 22 patient developed recurrence which is 48.9%.Conclusions: There is a dearth of randomized controlled trials supporting the efficacy of epidermal Growth factor in preventing keloid recurrence. The subjective improvements seen in some cases are encouraging. This study will be a foundation for future studies and will highlight the breadth of knowledge yet to be explored by this therapy.
A case report on achalasia cardia type - II
Authors: Mustafavi Sadiya , Samee Atif Abdul , Siddiqui Shafia , Yousra Tanveer
Published: August 2019

Achalasia cardia is the rare chronic neurodegenerative disorder of the esophagus which causes progressive delay in contractility of lower esophageal muscles during swallowing leading to backup of food contents and fluids in later stages within the region of esophagus. It is considered as the common leading cause of motor dysphagia. The underlying etiology include autoimmune disorder, nervous degeneration due to loss of inhibitory ganglion in myenteric plexus of esophagus, presence of inhibitory neurotransmitters such as nitric oxide and its receptors in lower esophagus. At initial presentation drugs are prescribed as the symptoms mimic other GI disorders which often lead to delayed diagnosis. The symptoms mainly include severe pain or discomfort of chest after eating, weight loss, regurgitation of bland undigested food or saliva, severe heartburn, dysphagia, aspiration. Initial treatment includes the pharmacotherapeutic management to alleviate the symptoms and improve the esophageal outflow. Surgical treatment involves pneumatic dilatation, Heller’s myotomy, preoral endoscopic myotomy, esophagectomy. Heller’s myotomy may be performed by open or laparoscopic procedure. It is done along with Dor’s fundoplication. Case report discussed below is of a 55 years old female patient presented with dysphagia for one year. The symptoms of which worsened for 2 months along with vomiting of undigested foul-smelling food.
Hemobilia: an unusual and life threatening complication of laparoscopic cholecystectomy
Authors: Luthra Ashish , Das Deepak , Mohapatra Manoranjan , Panigrahi Sudhir Kumar , Pujari P. S.
Published: August 2019

Hemobilia though rare, occurs due to abnormal vascular and biliary communication established as a result of trauma, gallstones, neoplasms, inflammatory process and vascular disorders. It can rarely complicate a laparoscopic cholecystectomy as a result of hepatic artery injury, clip migration, clip erosion, diathermy and subsequent arteriobiliary fistula, or pseudoaneurysm eroding into the extra hepatic bile ducts. A 34 years female underwent laparoscopic cholecystectomy for cholelithiasis, suffered bile leak that settled on by 13th postoperative day, met with sudden right upper abdominal pain and hypovolemic shock on 15th postoperative day due to massive hemobilia arising out of rupture of pseudoaneurysm of the right hepatic artery into the biliary system. Urgent CT Angiography showed a large pseudoaneurysm of right hepatic artery branch with adjacent small collection, IHBR and CBD dilatation suggestive of hemobilia. Emergency CT guided trans-arterial hepatic artery embolization done to control hemobilia and save the patient. An immediate CT angiography for early diagnosis, in all postoperative laparoscopic cholecystectomy cases with suspicion of hemobilia due to an underlying hepatic artery pseudoaneurysm, followed by CT guided trans-arterial hepatic artery embolization forms the gold standard management in such patients.
Hydrocele of canal of Nuck in an adult female: a case report
Authors: Parikh Atish K. , Bakhshi Girish D. , Gadekar Deepak B. , Rahul Kushagra , Garg Kritika
Published: August 2019

A hydrocele of canal of Nuck is a rare condition seen in females, commonly in the pediatric age group. The canal of Nuck is an extension of peritoneum into the inguinal canal through the deep ring, analogous to the processus vaginalis in males. Incomplete proximal obliteration and collection of serous fluid in the sac leads to the formation of a hydrocele of canal of Nuck. Here we present a rare case of hydrocele of canal of Nuck in an adult female.
Complications of laparoscopic cholecystectomy performed by junior surgeon in resource-restricted settings
Authors: Vedamanickam Pon Rachel
Published: August 2019

Background: The aims of this audit were to determine the rate of complications of laparoscopic cholecystectomy performed by a junior surgeon, to identify changes that can be made to reduce the complications, and to re-audit the complication rate after the changes have been made.Methods: Laparoscopic cholecystectomies performed by the surgeon between August and November, 2018 were assessed retrospectively. Data was collected from electronic records and operation notes and entered in the format as enclosed within. A re-audit was conducted between December 15th, 2018 and June 15th, 2019.Results: In the initial audit, the complication rate of laparoscopic cholecystectomy was 40% and the incidence of bile leaks was 6%. The re-audit showed a significant reduction in the overall complication rate to 24% with no incidence of bile leaks.Conclusions: The learning curve of surgeons for laparoscopic procedures is steep and cases should be chosen carefully depending on the current skill set and comfort level of the surgeon. Recommended standard practices should be followed in all situations, and all the team members should be involved in identifying risks during the surgery.
Prevalence of hypertension in patients attending dermatology outpatient department: a cross-sectional study of 1023 patients and discussion of the implications
Authors: Gupta Nakul , Garg Preeti , Gupta Surinder , Gupta Nikita
Published: August 2019

Background: Hypertension is a very big global burden of disease with high incidence of morbidity and mortality (cardiovascular, stroke, renal and retinopathy) making it a leading cause of death all over the world. It is multifactorial in etiology and is difficult to manage at later stages once systemic organ damage has set in. But early detection can prevent this disease and intervention, if needed, can prevent morbidity and mortality in large number of patients. This study was done to find out the prevalence of hypertension in our area, in North India.Methods: A cross-sectional study was conducted in 1023 patients (including their attendants and staff) attending dermatology outpatient department of Maharaja Agrasen Medical College (MAMC), Agroha, Haryana, representing population from North India. Both urban and rural population was included with age 20 years and above.Results: The prevalence of hypertension in age group above 20 years was 31.1% (37.7% males and 22.6% females). The prevalence in age group above 30 years was 46% (54.4% males and 35% females), which showed a rising trend with age.Conclusion: High prevalence of hypertension was found in this study which increased with increasing age. We infer that more epidemiological studies should be done in India to detect hypertension at early stage which can help in preventing or early intervention in the treatment of hypertension and help in policy formulation at national level.
A cross sectional study to assess the awareness and satisfaction level among the beneficiaries regarding Mission Indradhanush in selected districts of Indore division
Authors: Patidar Anand Kumar , Khatri Aaditya Kumar , Waskel Bhagwan , Dixit Sanjay
Published: August 2019

Background: Only 62% (NFHS-4) of the infants in India are fully immunized which is much less than the desired goal of achieving 85% coverage. To accelerate the process of immunization by covering 5% and more children every year, the Mission Mode has been adopted to achieve target of full coverage by 2020. Mission Indradhanush will target all children under the age of two years and pregnant women with all available vaccines.Methods: It is a cross sectional study done in 3 randomly selected districts of Indore division. The beneficiaries selected were children <2 years and pregnant women. The selection of beneficiaries was done by exit interview technique. Data collection was done by using pre-designed, semi-structured questionnaire which assess the awareness and satisfaction level of the beneficiaries.Results: About 88% were aware about the immunization. Overall 78% beneficiaries agreed that vaccination is compulsory, 62% agreed that vaccination schedule should be followed, 30% beneficiaries considered that vaccination was harmful. Most of the beneficiaries were satisfied with behaviour of the health provider, with all key messages given by health provider.Conclusions: Most common reasons found for drop out or left out were, fear of side effects due to vaccination followed by lack of awareness regarding session sites. Satisfaction level was found relatively low regarding difficulty in finding the place where vaccination was done and distance of session sites.
A study on prevalence of overweight and obesity in school going adolescents and its association with socio-demographic factors in Lucknow district
Authors: Mishra Sudhanshu , Gupta Pratibha , Srivastava Mrinal Ranjan , Sachan Beena , Zaidi Zeashan Haider
Published: August 2019

Background: Overweight and obesity are defined as abnormal or excessive fat accumulation that presents a risk to health. Obesity has become a global public health issue and is widely recognized as a key risk factor for coronary heart disease, hypertension, diabetes and many other health problems. The objectives of present study were to assess the prevalence of overweight and obesity and its association with socio-demographic factors amongst school-going adolescents in Lucknow district.Methods: This study was a school-based cross-sectional study and was carried out in urban and rural areas of Lucknow, from January 2018 to June 2018. Sample size was 620. A multi-stage random sampling technique has been used to select the required sample size. Data analysis was done using software MS Office excel and SPSS 18 for windows.Results: A total of 620 adolescents were studied. Majority (82.1%) of adolescents were found to be non-overweight/obese while 17.9% were found to be overweight/obese. Majority (66.7%) of students were overweight or obese, belonging to social class I while only 15.7% students were overweight or obese belonging to social class V.Conclusions: The results of our study show that overweight/obesity continues to be a public health concern in adolescents. The current study shows that adolescent overweight and obesity are increasing even in low socio-economic status. Emphasis should be placed on awareness program for obesity prevention among school students by strengthening lifestyle change.
Knowledge, attitude and practices study on reproductive health among adolescent school students in a city of Central India
Authors: Baghel Anil Singh , Chourasiya Sanjay Kumar , Pal Ravindra , Sharda Ruchika
Published: August 2019

Background: Ujjain is holy city of Lord Mahankal. It is an ancient city on the eastern bank of the Kshipra River. There were total 2508 students studying in 11th and 12th standards in various higher secondary schools of Ujjain city. Reproductive health is a crucial part of general health and a central feature of human development. It is a reflection of health during childhood and crucial during adolescence and adulthood, sets the stage for health beyond the reproductive years. Adolescence is a complex period of myriad of physiological as well psychological changes. This is a time for them to prepare for making responsibilities, a time of exploration and widening horizons and a time to ensure healthy all-around development. Adolescents lack knowledge regarding reproductive health problems. The present study is conducted to assess the knowledge, attitude and practices regarding selected aspects of reproductive health with special reference to knowledge of Reproductive tract infections (RTI) among adolescent school students.Methods: This was a cross sectional study carried out among randomly selected school students of Ujjain city.Results: It was observed that 86% of the students had adequate knowledge in the area of pregnancy and care during pregnancy. The mean score percentage of reproductive tract infection was found to be 56.92%. 90.50% students agreed that Menstruation is normal phenomenon.Conclusions: There is need of imparting sex education in schools across the country with the help of specially trained teachers and peer educators.
Predictors of hypertension among rural people of western Maharashtra: a multivariate analysis
Authors: Kharde Anup L. , Phulambrikar Rutuja M. , Deshpande Jayant D. , Mahavarkar Varsha N. , Kharde Amruta A.
Published: August 2019

Background: Hypertension causes morbidity as well as increases mortality either by acting independently or by affecting multiple organ system. Risk factors of hypertension are categorized as modifiable or non-modifiable risk factors. Early identification of these risk factors is not only essential for prediction of hypertension and but also to reduce effect associated with it.Methods: The present descriptive cross-sectional study was carried out at field practice area of tertiary care teaching hospital of western Maharashtra. Total 1537 sample sized was achieved using systematic random sampling technique. All the village individuals, both male and female, over 18 years of age were included in the study whereas, pregnant women, extremely debilitated persons and subjects who were not willing to give informed consent were excluded. A pre-designed and pre-tested questionnaire was used for data collection.Results: In present study the prevalence of hypertension and pre-hypertension was 11.49% (117). On regression analysis risk factors like age, BMI, high salt intake, family history of blood pressure etc., were found to be associated with hypertension.Conclusions: The present study showed a higher prevalence of both hypertension among the rural population and risk factors such as age, obesity, elite social class, high salt intake, family history of blood pressure were the predictors of the hypertension.
Assessment of immunization status among under five children in rural Mangaluru: a cross sectional study
Authors: Manglik Chandana Gopal , N. Shrivathsa Dala
Published: August 2019

Background: Immunization is the process whereby a person is made immune resistant to an infectious disease, typically by the administration of vaccine. If exposure to a disease occurs in a community there is a little to no risk of an epidemic if people have been immunized. This study was to assess the immunization status among children up to 5 years in rural Mangaluru.Methods: A community based cross sectional study was conducted among children of 0-5 years of age group (n=93) in rural Mangaluru using convenient sampling technique. After obtaining oral consent from parents, immunization status of children was assessed using validated questionnaire and details of child found to be partially immunized or not at all, reasons for not giving the vaccine were also collected.Results: 52.7% of the study population was partially immunized and 46.2% were fully immunized; only 83.9% possessed an immunization card. Majority of them have not taken measles/MR (55.9%) and also IPV 1 (46.2%) and Vitamin A2 (61.3%) because of unaware need for further immunization (58%).Conclusions: According to the survey, conducted in rural fields, we found that half of the population was partially immunized. Reasons being lack of awareness, negligence of parents, unaware of 2nd and 3rd dose of vaccines.
A study on out of pocket expenditure among the urology patients covered under health schemes in a teaching hospital
Authors: Asheela Safiyath , Qadiri Ghulam Jeelani , Shet Nagaraj , Sharma Prajna
Published: August 2019

Background: Health is one of the most important components of an effective poverty reduction strategy. However, use of health services is sometimes associated with out-of-pocket (OOP) payments. Urology disorders are often chronic and affect individuals not by shortening survival, but by impairing quality of life hence posing a substantial economic impact for patients. A well-planned health finance systems protects population against the financial risks of ill-health. This study addressed concerns over high levels of out-of-pocket payments even by those who have insurance coverage.Methods: Descriptive study was conducted among 160 patients admitted in Urology Department who are covered under various health schemes for the duration of 6 months.Results: Of the 160 study participants studied, 129 (80.62%) were males, 37 (23.13%), 64 (40%) were illiterates and most of the families 127 (79.38%) were from rural area. Various health schemes availed were, 120 (75%) Arogya Karnataka, 8 (11.25%) RBSY Kerala and 6 (3.75%) Sampoorna Suraksha. Expenses other than medical included home care assistance, adaptations to home and cost of parallel treatment. The main source for out of pocket expenditure was borrowing money from relatives or friends 70 (43.8%), self-finance 46 (28.7%) and selling valuables 28 (17.5%). Prevalence of catastrophic health expenditure in our study was 8.75%.Conclusions: The government should increase the public health spending to reduce the out of pocket expenditure by the families and the public must be educated about the availability of insurance scheme and their efficient/optimum utilization.
Determinants of menstrual hygiene among the adolescent girls in a South Indian village
Authors: Budimelli Swapna , Chebrolu Kalyan
Published: August 2019

Background: Adolescent girls constitute a vulnerable group, particularly in India where female child is neglected one. Menstruation is still regarded as something unclean or dirty in Indian society. Although menstruation is a natural process, it is linked with several misconceptions and practices, which sometimes result into adverse health outcomes. Women having better knowledge regarding menstrual hygiene and safe practices are less vulnerable to reproductive tract infections and its consequences. The objective of the present study is to determine the factors affecting the existing practices of menstrual hygiene among the adolescent girls and to study the beliefs, conception and source of information regarding menstruation among the study population.Methods: A pre-tested semi-structured schedule containing information like socio-demographic factors, perceptions about menstruation, practice of menstrual hygiene, restrictions practiced during menstruation was administered to 200 adolescent girls by paying house to house visits. The data was entered in Microsoft Excel and analysed using Epi Info software version 7.2.3.Results: : Nearly three-fourths of the adolescent girls attained menarche before the age of 14 years and 87% had no knowledge about it prior to attaining menarche. Majority (86%) respondents use sanitary pads, while only 14 (7%) use new cloth pieces, 6 (3%) use reused cloth pieces. Except for attending school, many restrictions were imposed on them during menstruation including participation in religious activities, festivals, attending household chores, food restrictions, etc.Conclusions: Various cultural practices and ignorance are affecting the menstrual hygiene of the adolescent girls and they need to be educated in this regard.
Household food security in rural Tamil Nadu: a survey from Kaniyambadi block, Vellore district
Authors: Kailasam Abirami , Kannan Bharathi , Lochan Eashwar Barath , K. Sathya Narayanan , Chaudhuri Sirshendu , Mohan Venkata Raghava
Published: August 2019

Background: Adequate and safe food is a basic requirement for every individual. Inadequate food leads to food insecurity. Household-level food insecurity may directly influence the health of an individual. We aimed to assess the prevalence of household-level food insecurity in the rural areas of Kaniyambadi block and to assess the household level determinants of food insecurity.Methods: A cross-sectional study was conducted in villages of Kaniyambadi block, a rural development block of Vellore district in Tamil Nadu. Households were the unit of study. The interview was conducted with a pre-tested, semi-structured questionnaire in Tamil. ‘U.S. Food Security Survey module’, September 2012, for a reference period of 30 days was used to determine food security status.Results: One hundred and fifty households were selected; 15 from each 10 randomly selected villages. Prevalence of food insecurity we got as 52.7% [95% CI: 44.6%, 60.8%]. Determinants like ‘low (<1225 INR/ month) per capita income’ [Adjusted odds ratio (AOR)- 6.7; 95% CI: 3.3,13.6]; ‘presence of debt at the time of interview’ [AOR- 3.5; 95% CI:1.7, 7.3] and ‘presence of at least one smoker in the family’ [AOR- 3.2; 95% CI:1.5, 6.8], were found to be associated significantly with food insecurity, after adjusting for the clusters by multi-level modelling.Conclusions: Food insecurity is a hidden phenomenon in India. Poverty is the key determinant behind this. To alleviate food insecurity, it will be logical to adopt multi-dimensional approaches with thrust on implementing the existing poverty alleviating programs.
Attitude of health care professional students towards hand hygiene
Authors: Jayan Rintu , Paul Riya , Abraham Riyamol , Roy Riyamol , Dominic Roniya , Abraham Roselin , D’souza Renita Priya , Aranha Priya Reshma
Published: August 2019

Background: Hands are the principal route of nosocomial infections or hospital acquired infections or health associated infections. Hand hygiene is effective in reducing infection rates. Hand hygiene among the health care professionals play a pivotal role in preventing the transmission of hospital acquired infections. The aim of the study was to assess the attitude regarding hand hygiene among students of healthcare professions.Methods: Quantitative research approach and descriptive survey design were used for the study. The purposive sampling technique was adopted to select 100 samples, 25 each from MBBS, BDS, B.Sc. Nursing and BPT. A structured attitude scale was used to collect the data. The collected data was analyzed using descriptive and inferential statistics.Results: The study results showed that majorities (55%) of sample were in the age of 22 years, majorities (90%) were females, and majority (98%) of sample had previous information regarding hand hygiene. The entire study sample had favorable attitudes towards hand hygiene. The study showed a significant association between attitude scores and receiving previous information on hand hygiene.Conclusions: The study concluded that health professional students have favorable attitude towards hand hygiene.
Screening for autonomic neuropathy using validated non-invasive scale among diabetes patients treated in the selected primary health centres of Puducherry, India: an operational research
Authors: Thekkur Pruthu , Muruganandam Vignesh , A. Narayan K. , Boovaragasamy Chithra
Published: August 2019

Background: Diabetes autonomic neuropathy (DAN) is a complication of diabetes which has direct implications on the mortality of diabetes patients. American Diabetes Association (ADA-2017) guidelines recommend early recognition and treatment of DAN. In this regard, we conducted a study among diabetic patients treated in the selected PHCs of Puducherry to determine the proportion with DAN and to assess the factors associated with DAN.Methods: A cross-sectional analytical study was conducted among diabetics and information on socio-demographic details, morbidity and behavioural risk factors were elicited using semi-structured interview schedule. The COMPASS-31 questionnaire was administered to assess the autonomic neuropathy symptoms. The data was captured using EpiCollect mobile app and analysed using Stata 12.0 software. The proportion of DAN was expressed as percentage with 95% confidence interval. The association between independent factors and DAN was assessed using multivariate generalized linear models. The prevalence ratio with 95% CI was used to express the strength of association.Results: Of the total 303 individuals with diabetes, 32 {10.6% (95% CI: 7.3%-14.6%)} were screened positive for autonomic neuropathy using COMPASS-31 scale. The number of individuals with diabetes who needed to be screened (NNS) for finding one with autonomic neuropathy was 10 (303/32).Conclusions: One in ten individuals with diabetes was screened positive for autonomic neuropathy. With good yield, there is need for including autonomic neuropathy screening as a component in the comprehensive care provided to diabetes patients in the primary health centres.
A study on physical activity in shift workers in an urban city of India
Authors: Das Shubhabrata , Das Munmee , Ray Shomik
Published: August 2019

Background: Physical inactivity has been identified as one of the leading risk factors for non-communicable diseases. Several studies have established the fact that shift working is associated with various non communicable diseases. Studies assessing the knowledge, attitude and practice towards physical activity amongst shift workers is almost non-existence even though it has been established that mediators like knowledge and attitude affect healthy behaviour and adoption of health improving behaviour. Thus this study aims to assess the knowledge-attitude-practice of physical activity among shift workers in Gurugram city which is the centre of various BPO/KPO companies in India.Methods: The present study is an organization based cross sectional study. Interviewer administered questionnaire were used to capture information on physical activity. Information on knowledge and attitude was collected using a piloted and pretested questionnaire. Practice of physical activity was collected using global physical activity questionnaire (GPAQ). Descriptive and linear regression analyses were performed using Ms-Excel and STATA (13).Results: Our study found that nearly fifty percent of the study participants were physically inactive and only 18% of the study participants knew recommended minimum weekly intensity of physical activity. Physical activity was found to be significantly associated with overall knowledge score (p<0.01).Conclusions: Knowledge regarding physical activity among the study participants was not adequate as reflected in their physical activity practice, hence knowledge and awareness towards physical activity should be enhanced to prevent non communicable diseases amongst the shift workers.
Patterns of antenatal care services utilization in rural Amroha, Uttar Pradesh: a community based cross sectional study
Authors: Watode Bhaskar K. , Srivastava Anurag , Kumar Rajeev
Published: August 2019

Background: Antenatal care (ANC) services are considered to be the crucial element in the primary health care delivery system of a country. World Health Organization (WHO) estimates suggested that almost all of the maternal deaths (99%) and child deaths (98%) occurred in developing countries. These maternal deaths could have been prevented if the pregnant women or adolescent girls had been able to access quality antenatal care. The objectives of the present study were conducted in rural parts of district Amroha, Uttar Pradesh for assessing the patterns of utilization of the ANC services and to ascertain the factors influencing utilization of ANC services.Methods: The present study was a cross sectional in nature. Recently delivered women were selected as study subject. A multi-stage stratified sampling design with random approaches had been used. Total 360 subjects included in the study.Results: Respondents age, education, occupation, socio economic status, family type and family size were the factors that influenced the utilization of the ANC services. With 100% ANC registration, sub centre was the most preferred place for registration. 76.9% of woman received more than 3 ANC visits. 315 (87.5%) and (71.9%) respondents received 2 doses to TT vaccine and more than 100 IFA tablets respectively.Conclusions: Utilization of ANC services are on rise in rural parts of Amroha, Uttar Pradesh. Still significant proportions of women are doesn’t return to health facility after the ANC registration. Intensification of efforts is needed to cater this left out group through improving community awareness and motivation.
Knowledge regarding reproductive health among women of reproductive age group in three sub-centre areas of a primary health center, Sarjapur, Bengaluru, Karnataka: a cross sectional study
Authors: Jose Maria Jessy , Fathima Farah Naaz , Joseph Sincy Treesa , Fernandez Aneurin Cornelius , Siangshai Shanborlang , Vadakkan Nikhil , Agrawal Twinkle
Published: August 2019

Background: Reproductive health plays a significant role in a woman’s life. Women of child bearing age group in developing countries suffer ill health due to lack of knowledge on reproductive health issues. The objective of the present study was to assess the knowledge regarding reproductive health among women and the associated socio-demographic factors.Methods: A total of 345 women of age group 15-44 years were recruited using cluster sampling in 15 clusters from among 28 villages under a Primary Health Center from May to July 2017. Data on sociodemographic details and knowledge of reproductive health under the following domains: menstruation, contraception, reproductive tract infections and marriage and pregnancy were collected using a modified interview schedule.Results: The mean age of the study population was 28.59±9.08 years. Majority of them belonged to age group 15-30 years (60%), attained school level education (55.7%), 45% were gainfully employed, married (65.5%) and from middle class (40.6%). It was found that out of 345 study population; only 19% had adequate knowledge on reproductive health. The proportion of women who had adequate knowledge in each domain was marriage and pregnancy (47.5%), menstruation (29.9%), contraception (17.4%) and least being reproductive tract infections (15%). Knowledge on reproductive health was significantly inadequate among women in the age group 31-44 years, illiterate women, who belongs to lower class and students. Only, socio-economic status and occupation were the significant predictors of knowledge.Conclusions: Knowledge regarding reproductive health was inadequate among women in reproductive age group in rural areas.
A cross sectional screen for diabetes correlating physical activity and blood glucose levels
Authors: Sinha Kulshreshth , Kolla Andrea Pereira , Bajpai Rakhi , Kolla Varaprasad
Published: August 2019

Background: Diabetes, a chronic disease, is presently a rapidly growing epidemic globally. The risk of diabetes type 2 is greatly increasing with change in lifestyle factors, urbanization, high blood pressure, overweight or obesity, physical inactivity and poor diet. It’s one of the reasons for premature death and disability and the number of cases are drastically increasing every year.Methods: 81 subjects above 18 years of age were considered for the screening. Random blood glucose levels were tested using the Thyrocare Sugar scan glucometer strips. Physical activity data was collected using a questionnaire. Based on the extent of physical activity, the subjects we grouped into three different categories. Data was analyzed and expressed using basic statistical tools in MS Excel 2007.Results: 6.17% of the rural population of Kendri, with mean age 47.4 years, had undiagnosed diabetes. The mean blood glucose level in diabetes positive cases was 279.8 mg/dL. A correlation of random blood glucose levels of the subjects with the extent of their physical activity was observed, where a decrease in physical activity/increase in physical inactivity showed an increase in blood glucose levels.Conclusions: From our study we conclude that undiagnosed diabetes is prevalent amongst the rural populations of Kendri, Chhattisgarh and low physical activity correlated with an increase of blood glucose levels, suggesting an urgent need to create health awareness, with emphasis on increase in physical activity, literacy and diabetes management, obesity, specifically among the illiterate and underprivileged rural populations.
Global outbreak of deadly measles in 2019
Authors: Mishra Ved Prakash , Twanabasu Suraj , Kusma Susan , Paudel Sunil
Published: August 2019

Measles is an infection of the respiratory system caused by a virus, especially a Paramyxovirus of the genus Morbillivirus, a single stranded negative sense RNA virus. Infants younger than 12 months, school-aged children or young adults depending upon local immunization practice are highly susceptible for the disease.
Swimmer’s ear: how does ear canal pave its way from ‘sensitivity to septicity’?
Authors: Ballal Venkatesh , Basavannaiah Sphoorthi
Published: August 2019

Background: Otitis externa is a condition that causes inflammation of the external ear canal. It is estimated that around 1 in 10 people will be affected by this condition at some point in their lives. It is relatively common in occurrence and is referred to as "swimmer's ear" because swimming in polluted water is a common way to contract it, but it is also possible from water trapped in the ear canal after a shower, especially in a humid climate. Hence, repeated exposure to water can make the ear canal more vulnerable to inflammation and infection. The aim of the present study is to find out the aetiology of this condition and also to educate the population regarding adapting and implementing measures so as to avoid the triggers that causes this condition.

Methods: 89 patients who consulted the ENT outpatient department were clinically evaluated and diagnosis was made and treated accordingly.

Results: As per the study, 79% patients in the infective group superseded 21% patients in the reactive group with the predominance of 58% patients with acute cases in terms of disease course and progression. 30% patients had repeated trauma to the ear canal as the common stimulant for the infection, that led to 25% patients with otomycosis as the commonest cause for otitis externa.

Conclusions: Ear canal infection ranges from simple irritation to severe inflammation and in either scenario it should not be ignored and overlooked upon.
Sensorineural hearing loss in chronic otitis media: analysis of an overlooked entity!
Authors: Shetty Kishore C. , Jayaramaiah Samatha K. , Kolathingal Biniyam , Alva Shravan
Published: August 2019

Background: In developing countries, hearing loss continues to be the major public health problem. Among the various causes of hearing loss, chronic otitis media (COM) is one of the commonest. In COM, the presence of sensorineural hearing loss is well established. Our study intends to determine the prevalence of sensorineural hearing loss in chronic otitis media.

Methods: This was a cross sectional descriptive study of 151 subjects between the age group of 10 and 60 years. Patients having unilateral chronic otitis media of both mucosal and squamosal types were selected. All patients were evaluated clinically and audiologically. The type, duration of disease and type of perforation is correlated with degree of sensorineural hearing loss. Interaural differences in bone conduction thresholds at 500 Hz, 1 kHz, 2 kHz and 4 kHz were also noted.  

Results: A statistically significant correlation was noted between type of disease and perforation with hearing loss. A significant interaural difference was noted across the speech frequencies. Sensorineural hearing loss of 19.1% was seen.

Conclusions: Significant sensorineural hearing loss is seen in chronic otitis media which was greater in squamosal disease. Statistically significant correlation was noted between type of disease and type of perforation with hearing loss.
Partidos políticos, representação e estrutura organizacional partidária: um debate conceitual
Authors: Silva Facio Jessica , Quintanilha Gomes Angela
Published: August 2019

O presente artigo busca fazer uma discussão teórica sobre o surgimento dos partidos políticos, sua utilidade como principais meios de representação democrática, além de ressaltar sua organização com base em fatores internos a partir das concepções de alguns autores como Giovanni Sartori, Maurice Duverger e Robert Michels. Para tanto, resgata a emergência e a necessidade de métodos representativos que suprissem as demandas da sociedade pelo pensamento de Hannah Pitkin e Bernard Manin. Somando a isso, esta argumentação traz à tona o processo ideológico, isto é, de identidade partidária, bem como a identificação pessoal por parte do eleitorado através da figura do candidato. Estas questões possibilitam a visualização de duas abordagens que tratam os partidos políticos como instituições dotadas de fragilidade institucional, ou então, de atributos que os tornam em um meio representativo forte. Nesse sentido, disponibiliza um breve histórico dos partidos no Brasil que mostra suas especificidades em “solo verde e amarelo”.