bluuebunny/crossref_metadata_2025 huggingface dataset:
Drug utilization study in OPD of a tertiary care hospital in a rural area of Jalna, Maharashtra, India by using WHO prescribing indicators
Authors: Chandra Shruti , Khan Imran Nawaz , Mateenudin Mohd , Chandrakapure Ajay , Maaz Syed , Mubin Faheem
Published: December 2017

Background: Drug utilization studies (DUS) are used as potential tool in the evaluation of healthcare system. DUS are conducted to facilitate the rational use of drugs in populations. The indicators of prescription in practice measure the performance of health care provider in several key dimensions related to appropriate use of drug. Therefore, the present study was undertaken to analyze the prescription written by doctors in a Tertiary Care Hospital in rural area.Methods: Present study is a cross sectional, prospective and observational study. The study was conducted in a rural tertiary, teaching hospital at JIIU’s Indian Institute of Medical Science and Research, Warudi, Taluka Badnapur from January 2017 to September 2017 for duration of 9 months. Data was obtained from 300 prescriptions. Data was analysed as per WHO prescribing indicators.Results: Average number of drugs in the present study was found to be 2.85. Percentage of drugs prescribed by generic name is 13.48%. Percentage of encounters with an antibiotic prescribed 60%. Percentage of encounters with an injection prescribed 4.33%. Percentage of drugs prescribed from essential drugs list 72.91%.Conclusions: These types of studies help to design policy for rational use of drugs and motivation of physician for rational use of drugs.
Study of awareness of insulin usage in diabetics attending NRI Medical College and General Hospital
Authors: A. Jagadeesh , K. Ravi Shankar , K. Krishnakanth
Published: December 2017

Background: India had 69.2 million diabetic patients. Insulin is an important part of diabetes treatment, but one-third of patients fail to take their insulin as prescribed, and many adults intentionally skip their doses. Since, diabetes treatment continues for lifetime, there is a need to assess the knowledge and understanding of patients in relation to their disease process and its management.Methods: A cross sectional, observational, knowledge and attitude survey were carried on patients with type II diabetes mellitus who are taking insulin therapy and attended medicine diabetes OPD in tertiary care Hospital during the period of April 2017 to Dec 2017. 200 diabetic patients’ ≥18 years of age who were willing to respond to the study questionnaire were interviewed.Results: Total of 200 study participants were interviewed using structured questionnaires, almost 75 (37.5%) of the respondents were age group of 41 - 50 years. 109 (54.5 %) male, 67 (33.5%)Hindus, 121 (60.5 %) married,79 (39.5%) were primary school, 120 (73.8%) were family history of diabetes, duration of treatment1-3 years 72 (31.5 %), 160 (63%) of the study subjects know about diabetes is high blood glucose, 119(59.5%)of subjects know complications of diabetes, 165(82.5%) were know about insulin used for diabetes, 115 (57.5%) of patients know other substitute for insulin, 94 (47%) of the study subjects have knowledge of complications of insulin therapy, 85 (42.5) were know different types of insulin preparations, 141 (70.5%) were know insulin is mandatory in some patients,159 (79.5%) were understood the route of administration of insulin.Conclusions: The finding of present study showed that, diabetes patients had average knowledge and less favourable attitude among diabetic patients toward insulin therapy.
Perceptions and practices of self-medication among undergraduate medical students at Gulbarga Institute of Medical Sciences, Kalaburagi, India
Authors: Bagewadi Harish G. , Deodurg Priyadarshini M. , Patil B. V. , Zahid Syed Hasan
Published: December 2017

Background: Self-medication practice is widespread in many countries and the irrational use of drugs is a cause of concern. It assumes a special significance among medical students as they are exposed to knowledge about diseases and drugs. To assess practice and perception of self-medication among undergraduate medical students.Methods: It is a descriptive study in which study population was comprised of 2nd year undergraduate medical students of Gulbarga Institute of Medical Sciences, Kalaburagi, Karnataka, India. Total 134 students were included in the study. Written informed consent was obtained from each volunteer prior to the study. Students were given a questionnaire that included both open and close ended questions about self-medication practice. Data was analysed and presented as counts and percentages.Results: It was found that 72 (54%) students practiced self-medication. The principal morbidity for seeking self-medication was cold and cough as reported by 70 (53%) students. Antibiotics were most commonly self-medicated as reported by 55 (36%) students. Only 34 (25%) students opined that self-medication is part of self-care.Conclusions: Self-medication is widely practiced among under­ graduate medical students. In this situation, we should educate the students about advantages and disadvantages of self-medication.
Comparative study of adverse effect profile of first line drugs Zidovudine (ZDV) + Lamivudine (3TC) + Nevirapine (NVP) Vs Tenofovir (TDF) + Lamivudine (3TC) + Atazanavir (ATV) + Ritonovir (RTV) in HIV/AIDS patients
Authors: Desai Savithri , Kurli Sankar , G. Harinika
Published: December 2017

Background: The biggest threat to mankind from the health perspective is probably the virus Human Immunodeficiency Virus (HIV) responsible for a serious disease known as Acquired Immune Deficiency Syndrome (AIDS). To compare the adverse effect profile of two antiretroviral regimens i.e, Zidovudine (ZDV) + Lamivudine (3TC) + Nevirapine (NVP) [regimen A] Vs Tenofovir (TDF) + Lamivudine (3TC) + Atazanavir(ATV) + Ritonavir (RTV) [regimen B] by clinical and biochemical methods.Methods: This prospective, observational study was carried out in 200 HIV positive patients receiving first line and second-line antiretroviral therapy (ART) at ART centre, GGH, Vijayawada. Out of 200 patients, 100 patients received regimen A [(ZDV) + (3TC) + (NVP)] and 100 patients were treated with regimen B [(TDF) + (3TC) + (ATV) + (RTV)]. The collected data has been analysed and presented.Results: Out of 200 patients, 110 patients developed ADRs. In this 110, 38 patients received regimen A and 18 patients received regimen B and had CD4 + count <250 cells/mm3. In the remaining 54 patients, 20 patients received regimen A and 34 patients received regimen B who had CD4+ count >250 cells/ mm3.Conclusions: The ADRs were most common in those patients whose CD4+ count is less than 250cells/cu mm. Though the patients on second line showed significant increase in CD4+count, number of patients with ADRs were also more with regimen B. Though atazanavir containing regimen is more efficacious than zidovudine containing regimen, but regimen B produces more serious adverse effects. So, second line drugs are reserved for treatment failures to first line, drug resistance and for those not tolerating first line drugs.
Quantification of rutin and quercetin by HPTLC/HPLC and in vitro immunomodulatory and anticancer activities of Capparis moonii fruits extracts
Authors: Doshi Gaurav Mahesh , Pawar Manjushree Kundalik , Chavda Kajal Haribhai
Published: December 2017

Background: The current research was undertaken on dried fruits of Capparis moonii to screen its potential for immunomodulatory and cancer indications with identification of phytoconstituents by chromatographic techniques.Methods: Methanolic (MECN), hydro-methanolic (HMECN) and aqueous extracts (AQCN) of Capparis moonii were subjected to high performance thin layer chromatography (HPTLC) and high-performance liquid chromatography (HPLC) after studying the total phenolic and flavonoid content by using rutin and gallic acid as standards respectively as well as undertaking powder characteristics and preliminary phytochemical screening. Immunomodulatory activities covered were hemagglutination antibody titre and delayed-type hypersensitivity reaction with the aid of sheep red blood cells (0.5×109) as antigens.  The extracts were studied for antioxidant potential. Anticancer prospects were focusing on in vitro cell lines screening (MCF 7 and HCT 15) by Sulforhodamine B assay method and potato disc assay.Results: The total phenolic and flavonoid content of MECM, HMECM and AQCM fruits extracts were found to be 0.20, 0.11 and 0.47 mg of gallic acid/g and 78.3, 18.8 and 64.4 mg of rutin/g respectively. Rutin and quercetin were confirmed by HPTLC and HPLC showing well resolved peaks. IC50 values in antioxidant studies were found to be significant with all the extracts. Significant immunomodulatory effect was noticed at 200mg/kg in both models (high antibody titre levels and decrease paw volume after 48 h). Unsatisfactory results were observed with selected cell lines and disc assay.Conclusions: Thus, selected fruits may probably have immunomodulatory potential due to presence of flavonols (rutin and quercetin).
Evaluation of antidiabetic potential of hydroalcoholic extract of Annona squamosa (HAEAS) leaf in alloxan monohydrate induced diabetic Albino rats
Authors: K. Ahmed S. , Cheekavolu Chakrapani , Alasyam Naveen , M. Sunil
Published: December 2017

Background: Diabetes is almost growing health concern worldwide and now emerging as an epidemic world over. Recently, full attention is being paid to the study of natural products as potential antidiabetics. Objective of the study was to evaluate the antidiabetic effect of hydroalcoholic leaf extract of Annona squamosa (HAEAS) plant in alloxan monohydrate induced diabetic albino rats.Methods: Almost a 30 Albino rats with 150- 200 grams weight were weighed and grouped into 5 equal groups taking 6 rats in every group. Group A served as normal control, Group B as diabetic control, received alloxan monnohydrate. Group C and D was received alloxan + HAEAS suspension at 350 and 700 mg/kg doses orally respectively, Group E was given alloxan + standard drug (Glibenclamide 5mg/kg) suspension for 28 successive days and the effect of HAEAS on blood sugar(BS) levels was measured at regular intervals. At the end portion of this investigational research study samples of blood were collected from all rats on 0day (initial), after 72 hrs and after 28th day (29thday) of given test drug HAEAS treatment for biochemical estimation of BS and the BS values were observed.Results: The present research study revealed that HAEAS leaves has antidiabetic effect against alloxan monohydrate induced diabetic rats on i.p. alloxan injection at 150mg/kg.b.w. and confirms that on i.p. alloxan injection causes a significant rise off BS in untreated albino rats when compared to control group. Diabetic rats treatment with HAEAS leaves for 28 days caused dose a dependent fall in BS values. Glibenclamide treated diabetic rats also showed a significant (P <0.00) fall in BS content after 28 days of treatment.Conclusions: This research study confirms that HAEAS leaves has shown significant antidiabetic effect at 350 and 700 mg/kg. b.w. doses in alloxan monohydrate induced diabetic rats.
Utility of vest high frequency chest wall oscillation device versus flutter device in acute exacerbation of chronic obstructive pulmonary disease
Authors: S. Farag Taghreed , EL-Syed Mariam
Published: December 2017

Background: Objectives to assess the effectiveness of high frequency chest wall oscillation (HFCWO) vest system and Flutter devices in the treatment of patients with AECOPD, and to compare the efficacy of HFCWO vest system versus Flutter devices.Methods: We conducted an interventional study on 108 out of 129 patients presented with AECOPD, recruited from two-university hospitals. They were classified into three groups, HFCWO group (n=37), Flutter group (n=35), and control group (n=36). The HFCWO group and Flutter group were treated with AECOPD medications in addition to either HFCWO or Flutter physiotherapy, three sessions per week, for four weeks, while control group was treated by medications only. All patients were evaluated before and after treatment by spirometry, ABG, CAT score, and the BODE index.Results: Post treatment assessment for both HFCWO and Flutter groups demonstrated that most of spirometric indices (FEV1%, FVC%, FEV1/FVC %), oxygenations parameters (PaO2, SaO2 %) and CAT score, were significantly improved (p < 0.05). The level of perceived dyspnea decreased significantly, walking distance during 6-MWT was extended significantly, the BODE index and MMRC scale decreased significantly. While in control group only oxygenations parameters (PaO2, SaO2 %) was mildly improved. No statistical significant difference was found between vest HFCWO and Flutter device in all measured post treatment parameters (p > 0.05).Conclusions: Both vest HFCWO and Flutter device are highly effective in treatment of patients with AECOPD in terms of improvement in ventilatory function and oxygenation parameters with better exercise tolerance.
Evaluation of upper extremity anthropometric measurements in terms of sex estimation
Authors: Uzun Özlem , Yeginoğlu Gülay , Kalkışım Şahi Nur , Ertemoğlu Öksüz Canan , Zihni Nihat Burak
Published: December 2017

Background: One of the most important and broadest areas of forensic medicine is identification. Among the various parameters used, the most important criterion for identification is to determine the sex of the individual concerned. The aim of the current study was to develop models to determine the sex of subjects in case of forensic situations in which anatomical remains and residues of the upper extremity have to be identified.Methods: The research consisted of university students aged 18-25. Arm, forearm, upper extremity, hand, third finger and palmar length, hand width, wrist width, and wrist circumference measurements from 400 subjects were taken from the right and left upper extremities on the basis of anthropometric points. Models were than developed using logistic regression analysis.Results: The developed models provided valid and reliable sex estimates with high and accuracy rates and low prediction errors.Conclusions: The models are representative for the Turkish population in terms of identification. The study thesis can be regarded as an alternative method when economic or other difficulties are encountered in terms of DNA analysis.
Self-monitoring in third year medical students’ haematology clerkships
Authors: Vuma Sehlule , Sa Bidyadhar
Published: December 2017

Background: Self-monitoring by medical students is important for continued learning and development. It results in self-awareness and improved performance. It requires self-motivation, attentiveness and curiosity. However, students don’t have skills for self-monitoring when they enter university. These need development. The objective of the study was to evaluate the use of an online formative assessment, on subsequent summative examination performance in haematology clerkships among third-year medical students.Methods: Results of a formative, multiple choice question (MCQ) quiz were correlated with results of end of clerkship (EOC) summative examinations (free-response short-answer progressive disclosure questions-PDQ, and spotter-MCQ). t-ratio was calculated between students who took the quiz (responders) and non-responders. Descriptive statistics, Pearson correlations (r), and Chi square (χ2) were performed.Results: Of 241 students 75 (31.1%) took the quiz. t-ratio was 1.864 (P>0.05). Mean scores for EOC were higher for responders. Failure rate was higher for non-responders. Between the EOC-PDQ and EOC-spotter, for the whole group (N=241), r=0.414, for non-responders, (N=166), r=0.376, and responders r=0.473. For the responders, correlations between the quiz and PDQ, r=0.376, and between quiz and spotter, r=0.222. χ2 was significant at P<0.05.Conclusions: Quiz exercises are useful self-monitoring strategies. However online exercises require self-motivation. Students may not wish to do exercises that don’t count for summative scores. They should be encouraged to engage in these learning exercises. Timing is important. For the majority of students, the quiz was done the same week as PDQ for another course. Students chose to prioritize and concentrate on the summative PDQ. These exercises in themselves, would be useful time management lessons.
Salvage total hip arthroplasty (THA) for failed internal fixations of proximal hip fractures
Authors: S. Kawade Manish , S. Madan Harnam
Published: December 2017

Background: Failed proximal femoral fractures like operated transcervical neck fractures, intertrochanteric fractures and subtrochanteric fractures poses a great challenge to surgeon with limited options. Revision of failed internal fixation with hip arthroplasty, also known as Salvage THA (Total Hip Arthroplasty) is a promising surgical option in elderly patients providing early mobility and preventing age related complications.Methods: 45 patients with failed proximal hip fractures were treated over a period of 2 year with THA with modular cemented prosthesis by southern approach.Results: Fourty five patients were followed up for atleast 16 months with no radiological evidence of loosening and heterotrophic ossification and analyzed for pain, difficulty in walking, muscle power, range of motion of joint and functional status. The overall results were expressed in terms of Salvati-Wilson hip grading system.Conclusions: Revision of failed internal fixation with hip arthroplasty, also known as Salvage THA (Total Hip Arthroplasty) is a promising surgical option in elderly patients providing early mobility and preventing age related complications.
Study on prediction of type 2 diabetes mellitus in undergraduate MBBS students: a cross-section study in a tertiary health center, Kolkata
Authors: Mandal Murari M. , Garg Shobhit , Mishra R. N. , Maharana Swanya P.
Published: December 2017

Background: Diabetes, is now a leading cause of morbidity and mortality worldwide. Prevalence of type-2 diabetes in children and adolescents is rapidly increasing worldwide. Adolescence and early youth period has pivotal importance for young people with diabetes risk when they usually start learning about how to take responsibility. With this background, present study was done to find out the proportion of various risk factors and future risk of developing diabetes among MBBS undergraduates in Kolkata.Methods: This study was a cross-sectional institution based study done from 1st June to 18th June 2017. Data was collected by interviewing each respondent with the help of structured pre-designed pre-tested schedule, after which clinical examination for height, weight, waist and hip circumference, blood pressure and RBS were done. Out of 150 undergraduates, 130 agreed to participate. Data was analysed with R software.Results: Mean age of the students was 20.45years. 48.5% of them were either overweight or obese. Nearly half of them had waist circumference and waist hip ratio in risk group. Only 65 were normotensive and 7 had high random blood sugar (≥140 mg/dl). 6 students were in high risk group according to both IDRS (≥60) and ADA (≥5) risk score. 66 students were in moderate risk (30-50) group as per IDRS risk score.Conclusions: The simple and cost-effective IDRS could serve as a screening tool health worker to identify at risk individuals at the earliest and enable primary prevention by encouraging these students to modify their life-style.
Evaluation of Bethesda system for reporting thyroid cytology with histopathological correlation
Authors: Reddy Purushotham , Prakash Akina , S. Giriyan Sujata
Published: December 2017

Background: The Bethesda system of reporting thyroid cytopathology is a standardised system, improving communication between cytopathologists and clinicians, leading to more consistent management approaches. The aim of the research work was to study the utility of Bethesda system in reporting thyroid cytology with histopathological correlation of all the cases undergoing surgical resection.Methods: We studied all the thyroid cytology cases received between November 2012 to April 2014, and classified them according to the Bethesda system. Histopathological correlation was done for all the cases which underwent surgical resection with evaluation of cyto-histological discrepancies.Results: Out of 484 cases studied, 432(89.2%) were benign lesions, 20(4.1%) were malignant,18 (3.7%) were Unsatisfactory/Nondiagnostic, 10(2%) were Follicular neoplasm/Suspicious for neoplasm, 3 (0.6%) were suspicious for malignancy, and 1(0.002%) case was reported as Atypia of undetermined significance. Out of the 54 cases available for histopathological follow-up, cyto-histological discrepancies were noted in 5 cases (9.2%). Statistical analysis of the present study showed that cytological analysis of thyroid lesions by Bethesda system has got high sensitivity (72.72%), high specificity (95.3%) with a positive predictive value of 80% and negative predictive value of 93.1% and a high accuracy (90.7%).Conclusions: Reviewing the thyroid FNAs (fine needle aspirates) using Bethesda system allowed a more specific cytological diagnosis with better interlaboratory agreement. As evidenced by its high sensitivity and specificity, Bethesda system has proven to be a very effective guide for the clinical management of thyroid nodules.
Trend of fatal poisoning in Kanpur: a two year autopsy based study
Authors: M. Awasthi Puneet , Verma Soni , Dev Rahul , Bajpai Anand
Published: December 2017

Background: Kanpur is not only the biggest city of the Uttar Pradesh but also 9th most populated city of the India and is the main centre of commercial and industrial activities. Kanpur is situated at the bank of holy river Ganga. It is very crowded city and facing the problems of population influx from neighboring towns and villages. Apart from fame for industry, Kanpur lies between two rivers Ganga and Pandu. The land of Kanpur district is plain and fertile with Cultivable Barren Land 185480 Hectare. Kanpur is an only notified metropolitan area by UP Government under Code of Criminal Procedure 1973, and therefore has a Chief Metropolitan Magistrate. Poisoning is an important public health issue in India and worldwide. The present study is aimed to assess the epidemiological variables of fatal poisonings in Kanpur.Methods: All medico legal autopsies of the city were conducted in the GSVM Medical College mortuary, Kanpur. During the study period, 582 cases of fatal poisoning were autopsied. Only autopsies with confirmed diagnosis of poisoning were included in this prospective study.Results: A total of 7648 medico legal autopsies were performed at the aforementioned centre. Poisoning deaths comprised 582 cases (7.6%) of the total autopsies conducted during the study period.Conclusions: Suicidal poisoning is accountable for majority of poisoning deaths in India. Societies at large owe a collective responsibility to this manner of death and mere condemnation or sympathy is not sufficient to curb these avoidable deaths.
Pattern and outcome of donor deferral -? need of hour
Authors: Chauhan Chitra , Chauhan Rashmi , Awasthi Seema , Dutta S. , Joshi Himanshu
Published: December 2017

Background: To analyze various reasons for blood donor deferral and to study its long term impact on potential prospective blood donors.Methods: A total of 26029, otherwise healthy, prospective blood donors were studied retrospectively over a period of 5 years. WHO blood donor selection criteria and counseling guidelines were used for donor selection. Donor deferral data was evaluated with respect to age, sex and cause of deferral which was further analyzed as temporary or permanent deferral.Results: 1448 (5.56%) blood donors were deferred for various reasons. 1232 (4.89%) of total male donors and 216 (26.83%) of total female blood donors were deferred.1378 (95.16%) donors were deferred on temporary basis and only 70 (4.84 %) donors were permanently deferred. Anemia (42.26%) was observed to be the most common cause of temporary donor deferral while hypertension with cardiac disorder (1.93%) was the most common cause of permanent deferral. All the temporary deferred donors (1378) were called after the period of deferment. Out of total 1378 temporarily deferred donors, only 129 donors returned later for voluntary donation.Conclusions: Establishment of effective measures is needed in regard to consider the effect of donor deferrals on future availability of donor and donor return and to monitor necessity and effectiveness of deferrals and their reasons. As percentage of temporary deferral is higher, they should be efficiently managed, counseled, educated and encouraged for future donation which can compensate the increasing demand of blood donors.
Carotid artery intima media thickness in relation with atherosclerotic risk factors in patients with newly diagnosed type 2 diabetes mellitus in a rural tertiary care hospital in central India
Authors: Verma Vijay Kumar
Published: December 2017

Background: Vascular complications of atherosclerosis are major causes of morbidity and mortality in patients with type 2 diabetes mellitus (T2DM). The aim of the study was to study the correlation between carotid artery intima media thickness (CIMT) and risk factors for atherosclerosis and atherosclerotic vascular events in newly diagnosed type 2 diabetes mellitus patients with an objective to determine the predictive value of CIMT as an indicator of early atherosclerosis.Methods: The predictive value of CIMT as well as various atherosclerotic risk factors including ankle brachial index (ABI) were determined as an indicator of early atherosclerosis. Data were presented in form of percentage and proportions. Qualitative variables were tested using Chi square test and the p values were calculated between the groups having CIMT less than and more than 0.9 mm. p values of ≤0.05 were considered statistically significant. Averages were expressed between groups as mean ±standard deviation or as percentage. Multivariate analysis was done using the multiple linear regression model.Results: The study showed that though age, smoking and dyslipidemia did not show any association with CIMT; hypertension, ABI, glycosylated hemoglobin and urine albumin excretion rate had positive correlation with CIMT with statistically significant association between ABI and CIMT.Conclusions: Assessment of CIMT by B mode ultrasound is a relatively inexpensive means of measuring subclinical atherosclerosis. Present study showed that CIMT is significantly higher in those type 2 diabetic patients who had atherosclerotic events than in those type 2 diabetic patients who had only risk factors for atherosclerosis.
Serum sodium abnormality profile in hospitalized elderly patients in a tertiary care centre from north India: a cross sectional observational study
Authors: Kumar Soni , Guleria Trilok C. , Nand Laxmi , Gupta Dalip , Thakur Manish
Published: December 2017

Background: Serum sodium disorder is most common electrolyte disorder in hospitalized patients. It is associated with significant morbidity and mortality. In developing countries like India; there is continuous increase in elderly population due to improving health care. There is lack of sufficient Indian data on clinical profile, causes, and outcome in elderly hospitalized patients with sodium disorder. We studied incidence, etiology, clinical profile, and outcome of sodium disorders after the treatment during the hospital stay in elderly patients at our institution so that guidelines could be formulated to manage the patients.Methods: 100 consecutive patients of serum sodium abnormality coming to indoor wards of medicine department over a period of one year were enrolled. Detailed history was taken, clinical presentation reviewed and examination were carried out. All patients were followed closely during hospital stay and necessary investigations were done to establish the cause.Results: The mean age of patients in the study was 71.26 ±7.8 years (range 60-96 years). Maximum numbers of patients were in the age group of 61-65 years (31%). Out of 100 patients, 54% were males and 46% were females. Out of 100, 48% patients had HTN,38% had DM, 19% had CKD. Abnormal behavior, nausea, vomiting were the predominant symptoms. CKD and drugs intake were the chief causes of the serum sodium abnormality due to abnormal fluid and water homeostasis. The mortality rate was significantly higher in Hypernatremia patients i.e.62 % as compared to hyponatremia patients 26% which was related to severity of serum sodium abnormality, rapid onset, long hospital stays and severity of underling illness.Conclusions: In our study CKD, drugs chiefly thiazide like diuretics were the most common causes of hyponatremia and dehydration was most common cause for hypernatrmia. Serum sodium disorders were associated with high mortality and morbidity in elderly hospitalized patients.
Utilization of individual birth plan during pregnancy and its determinants in Makueni County, Kenya
Authors: Ndeto John Kyunguti , Barasa Sammy Onyapidi , Murigi Mary Wanjiru , Keraka Margaret Nyanchoka , Osero Justus O. S.
Published: December 2017

Background: All pregnant women are required to have an individual birth plan (IBP) to be discussed during each antenatal care clinic (ANC) visit. Birth preparedness increases the likelihood of seeking skilled care which can lead to positive birth outcomes. However, there is paucity of literature on utilization of IBP in rural Kenya. This study aimed at assessing the level of utilization of IBP and it’s determinants in Makueni County, Kenya. Methods: Descriptive cross-sectional design was used to study 326 postnatal mothers in three primary health facilities. Systematic sampling technique was used. We collected data using a researcher-administered structured questionnaire and focused group discussion. Quantitative data analysis was conducted using statistical package for Social Sciences (SPSS) version 20.0 and involved univariate and bivariate analysis. Chi- square were used to test the significance of the association between the dependent and independent variables (p<0.05). Qualitative data was analyzed by thematic content analysis. Results: IBP utilization was low 48.2% (95% CI (42.7%-58.6%) despite high ANC attendance. Identifying a blood donor was the least utilized component (25%). Being middle aged, high education level, attending ANC clinic 4 times and being married were significantly associated with utilization of an IBP, (OR=2.108, p=0.005), (OR=12.828, p<0.001), (OR 30.942 (95% CI 4.128-231.954) p<0.001) and (OR=2.20, p=0.001) respectively. Perceptions of high cost, long distance and disrespect from staff reduced IBP utilization by 65%, 80% and 47% respectively. Conclusions: Birth preparedness is low despite high antenatal clinic attendance. Stakeholders ought to address factors influencing birth preparedness.
Burden of anemia in hospital attendees in Tayma general hospital, Tabuk, Saudi Arabia
Authors: Jayaraman Prabakaran , Alshay Mohammad , Alanazi Saad Eid , Al Maswari Abdul Malik Hasan , Hammad Zakaria , El Mofadi Abdulaziz Abd Elkrim , Alshooli Abdulaziz S.
Published: December 2017

Background: Anemia, a low hemoglobin (Hb) status in the body is a serious nutritional public health problem in the world. It causes divergent morbidity and mortality in the affected population. Prevalence of anemia among women of reproductive age (women ages 15-49 years) in Saudi Arabia was 40.30% in 2011. In this study, we attempted to explore the burden of anemia in Hospital attendees in Saudi Arabia. Methods: A cross sectional study was conducted with the laboratory hematological values of walk-in clients from January 2016 and February 2016. Client's sex, Hb, HCT, MCV, MCH, MCHC values were collected. Hb values categorized as mild anemia: Male: 11-12.9 gm/dl; Female: 11-11.9 g/dl., moderate anemia 8-11 gm/dl and severe anemia <8 g/dl. Data entry done was using Microsoft Excel and data analysis by STATA 15. Results: Out of total 2805 client's data, 49% (n=1377) were male and 51% (n=1428) were females. The mean Hb% was 12.31 g/dl (SD–2.54), 11.50 g/dl in females and 13.13 g/dl in males. The overall prevalence of anemia was 48.73% (CI: 46.87%-50.6%) as per WHO criteria and it was higher in females (45.53%, CI: 42.88-48.21) in men and 51.82% (CI: 49.19-54.44) in women). Severe anemia was also higher in women (Male: 2.76% vs. Females: 7.49%) while mild anemia was high in men (Male: 28.61% vs. Female: 17.79%). Prevalence of anemia was 25.6% and 40.7% if lower margin of Hb kept at 11 g/dl and 12 g/dl respectively. Conclusions: The prevalence of anemia in Tayma region was high which needs integrated intervention at different levels to improve Hb status in the community.
Road safety and the community: an awareness survey among the coastal population of Karnataka
Authors: Shetty Ranjitha S. , Pahwa Vandita , S. P. Vibha , Kamath Asha , Nair Suma
Published: December 2017

Background: Road traffic accidents (RTAs) pose a significant burden on the health care system in India with high out of pocket medical expenditure. Awareness about this public health problem is necessary to combat it and this study was carried out to assess knowledge and practice towards road safety among the adult population in the coastal region of Udupi taluk in Karnataka. Methods: A cross-sectional survey was carried out among 381 adults aged 18 years and above residing in the region for more than one year. A semi-structured questionnaire was used to assess their knowledge and practice towards road safety measures. Results: Most of the participants were in the age bracket of 18-44 years (61.4%), were females (65.1 %) and had up to 10 years of schooling. Overall knowledge was found to be low with only 30% reporting good knowledge. As regards practice, drivers fared better with a good majority (87%) reporting desirable practice. Younger age (OR=0.57, 95% CI, 0.36-0.92), male gender (OR=0.14, 95% CI, 0.08-0.23), higher level of schooling (OR=0.32, 95% CI, 0.20 -0.50) and knowing to drive (OR=0.04, 95% CI, 0.02-0.07) were found to be significantly associated with a greater level of knowledge regarding road safety measures. Conclusions: The study showed inadequate knowledge and poor road safety practices among good number of participants. This emphasises the need for a customized community based awareness campaign on road safety measures coupled with stringent legislation measures to bring about the desired change.
Evaluate the factors affecting health seeking behaviours of women rag pickers in Mumbai
Authors: Wasnik Sumit Ghansham , Bhate Kamaxi , Mehta Arjun , Sadawarte Mandar
Published: December 2017

Background: There are genuine reasons why rag pickers are considered one of the worst form of labour. The risk related to rag pickers’ health and physical development, as well as the hindrance these work places have on their education and psychological development; make rag picking a particularly adverse occupation for women and children. The objectives of the study were to explore the health profile and to identify the factors affecting the health seeking behaviours of women rag pickers. Methods: This study was done with the help of NGO working for women rag pickers. 120 rag pickers were participated in the study during study period (Jan 2012 to July 2012). Results: Almost all rag pickers were having some or other type of physical or mental ailments in minor or major form. It is seen that ignorance about health and disease is because of illiteracy, lower socioeconomic condition, unavailability of good health care facility nearby to their locality, difficulty in getting time to visit nearest health care facility from their 10-12 hours of duty etc. Conclusions: It was found that these rag pickers prefers to visit private clinics as they are open in evening time and most of the time were affordable for minor ailments.
Ocular morbidity and its relation to classroom lighting among middle-school students of government high schools in Goa
Authors: Cacodcar Jagadish A. , Bicholkar Abhishek , Wagle Nikita , Oliveira Annet
Published: December 2017

Background: School children form an important target group for a Nation and any ocular morbidity in this age group has huge physical, psychological and socio-economical implications. Research studies have shown that illumination has a significant effect not only on scholastic performance of the students, but also on their physical and mental health. The current study was carried out to assess the prevalence of ocular morbidities among students of high schools of Sanquelim Taluka in Goa, and to assess possible association between ocular morbidity and level of classroom and blackboard illumination. Methods: Students of class 6, 7 and 8 of eight randomly selected schools were interviewed using a semi-structured questionnaire for personal details and visual symptoms. Visual acuity testing was done using Snellen’s chart. Classroom and blackboard illumination were assessed separately using standard calibrated digital Lux meter (LX-10101B). Results: Using Snellen’s chart, 83 (18%) of the study subjects were found to have visual morbidity. The measurement of illumination levels showed that out of the 24 classrooms and blackboards evaluated, 15 (62.5%) classrooms and 9 (37.5%) blackboards had inadequate illumination. Classroom illumination was found to have significant association (p=0.04) with visual morbidity. Conclusions: A significant number of classrooms (62.5%) and blackboards (37.5%) had below recommended illumination levels. Regular evaluation of infrastructure should be done to ensure adequate artificial illumination of the classrooms.
Morbidity pattern among primary school children in a tribal area of Maharashtra
Authors: Gokhale Chinmay N. , Borgaonkar Chaitali A. , Shanbhag Sunita S. , Solanki Mridula J. , Rasal Milind M.
Published: December 2017

Background: A child spends more time at school than anywhere else, except home. The health and well-being of children is a fundamental issue in education. Indeed, active promotion of health is now seen as a priority for schools. Mortality in school age children is low but morbidity and physical defects constitute major problems. With this background the present study was conducted to explore the prevalence morbidity patterns and their socio-demographic co-relates among the primary school children in a Tribal area. The objectives of the study were to study morbidity profile and assess nutrition status of tribal primary school children; to determine factors influencing morbidity profile of tribal primary school children; to suggest recommendations based on study findings. Methods: This study was a cross-sectional study conducted in Zila Parishad school located in village-Durves, tribal area of District-Palghar. Children enrolled in class 1 to 5were included using convenient sampling. A thorough clinical examination was carried out to assess the morbidities and nutrition status. Data was entered in Microsoft Excel Spread sheet and analyzed using SPSS. Results: Out of 126 students, 68 were girls and 58 were boys. The teeth hygiene was most compromised and dental caries was the commonest morbidity. Around 30% were malnourished as per WHO weight-for-age standards. Younger students i.e. those enrolled in class 1–3 had higher proportions of morbidities as compared to their elder counterparts. It was seen that male gender and children enrolled in class 1–3 had more morbidities. Conclusions: The study showed a poor attendance of merely 40% with 73% of study subjects having one or other kind of morbidities. Health education sessions on personal hygiene and nutrition must be carried out both for students and their parents to improve nutrition status and reduce proportion of morbidities.
Assessment of utilization of maternal health care services in rural field practice areas of VIMS, Ballari
Authors: N. Neeta P. , A. R. B. Sameena , C. M. Suresh , Goud Gangadhar , . Bharat , Sajjan Saraswati , . Chetana
Published: December 2017

Background: Maternal mortality and morbidity remains high even though national programs exist for improving maternal and child health in India. This could be related to several factors, an important one being non-utilization or delay in seeking care of maternal health-care services, especially amongst the rural poor and urban slum population due to either lack of awareness or access to health-care services. Our study was aimed to know the utilization of maternal health care services during antenatal and post natal period and factors affecting them.Methods: A Community based cross sectional study was carried in the rural field practice areas of VIMS, Ballari (three primary health centres (PHC) Kudithini, Koluru, Kurugodu) among all married women in the age group of 15-45 years who were in the post natal period (less than 2 months) at time of interview. A total 152 women were included in the study by door to door survey, among all the 3 PHC’s. The women absent during the survey were excluded.Results: Only 101 (66.44%) of women utilized antenatal care and 18 (11.8%) utilized post natal care (at least three postnatal visits) from the health care facility. Mothers who were of Muslim religion, <20 years of age, higher education of participant as well as husband, higher occupation status, high SES, less parity had higher odds of utilizing antenatal care. Health education by the health worker regarding post natal services to women ranged from 62.5-90.8%. Mothers of Muslim religion, higher education, higher occupation status, normal vaginal delivery and home delivery had higher odds of utilizing postnatal servicesConclusions: The study shows unacceptably low utilization of postnatal care services. It shows the coverage of postnatal care services is inadequate. This is an important message to health service providers and policy makers to strengthening not only antenatal health services and institutional deliveries but also postnatal care services to reduce maternal and neonatal morbidity and mortality.
Tobacco use among rural women in reproductive age group and its association with regularity of menstrual cycles and dysmenorrhoea: a community based cross sectional study
Authors: Kulkarni Namratha , Hawal Nikhil , Naik Vijaya A.
Published: December 2017

Background: Tobacco is a killer of men and women but sex specific differences exists. Along with the risk of suffering from the various health hazards from tobacco use, women are more prone to unique risks related to menstrual and reproductive function reproductive health hazards. This study was done to know the prevalence of tobacco consumption among the rural women in the reproductive age group and its association with the regularity of menstrual cycles and dysmenorrhoea.Methods: A community based cross sectional study, conducted from January 2011 to December 2011 among 1200 rural women aged between 15 years to 49 years residing in Primary Health Centre (PHC) Vantmuri area, Belgaum, Karnataka, India. Statistical analysis was done using rates, ratios and chi-square tests.. Results: The prevalence of tobacco consumption was 9.7%. 11 (10.9%) of currently pregnant women were consuming tobacco. Among the tobacco users, 89 (76.1%) had regular cycles. The association of tobacco consumption with irregular menstrual cycles was statistically significant (χ2=5.575, df=1, p=0.018). Further in this study, a very high percentage of 100 (85.5%) of the tobacco users had dysmenorrhoea. The difference was statistically strongly significant. (χ2=266.593, df=1, p<0.001). Among the tobacco users with irregular menstrual cycles, the most common manifestation was oligomenorrhoea 12 (42.9%) followed by 9 (32.1%) and 7 (25%) of menorrhagia and polymenorrhoea respectively. Conclusions: Significant association was found between tobacco consumption and the irregularity of menstrual cycles and dysmenorrhoea. It has become the need of the hour to provide enough evidence on the correlates of tobacco use in the community to assist government policy makers, health professionals and the public in developing realistic models towards effective tobacco control to cater to different sections of community in need.
A study on demographic factors affecting quality of life among HIV positive individuals attending a district anti retroviral treatment centre in Mangalore
Authors: Rashmi Anusha , Kundapur Rashmi
Published: December 2017

Background: Prevention and treatment in HIV greatly influences the quality of life (QOL). The objective of the study was to assess QOL of individuals with HIV and its association with demographic factors. Methods: 400 patients with HIV attending the district anteretroviral treatment (ART) centre were interviewed with WHO QOL BREF questionnaire using systematic random sampling. Descriptive statistics, Chi square and independent t test and logistic regression was done to analyse the results. Results: Mean quality of life score was highest in the physical domain (Mean=14.93, ±3.59). Least score was seen for Social domain (Mean=12.30, ±2.37). The physical domain score was highest among those belonging to class 1 SES (Mean=17.50, ±0.707). Domain scores varied significantly (p>0.05) with respect to gender. There was significant variation in domain scores across the different socioeconomic groups except in social domain. Conclusions: Gender, Socioeconomic and marital status significantly affected the QOL of People Living with HIV.
Are good knowledge and positive attitudes regarding the cigarettes and other tobacco products act prevalent among rural Indian adults?
Authors: R. Pracheth , N. Varun , Y. M. Ravindra , S. Preethi , K. Tasmiya , N. I. Naveed
Published: December 2017

Background: Cigarettes and other tobacco products (COTPA) Act is a legislation passed to curb tobacco use in India by imposing restrictions on tobacco products. This study appraised knowledge and attitudes regarding COTPA Act among adults in a rural area and elicited socio-demographic predictors of knowledge and attitudes regarding COTPA Act among study participants.Methods: A cross-sectional study was conducted from September to December 2014 on adults (aged ≥18 years) in a rural area of Coastal Karnataka. A pre-designed, pre-tested proforma was used to collect information from study participants regarding their knowledge and attitudes about COTPA Act. Knowledge and attitude scores were computed. A score of ≥4 was good knowledge and ≥3 was regarded as positive attitudes.Results: Nearly 49.14% had good knowledge, while 51.29% displayed positive attitudes. Those belonging to upper and upper middle socio-economic class (Class I+Class II) had higher odds for good knowledge (AOR=2.09, 95% CI=0.82-5.92), when compared to their counterparts belonging to other socio-economic classes. Age ≥60 years (AOR=3.80, 95% CI= 0.30-9.98), education beyond primary school (AOR=2.88, 95% CI=1.24-6.19), upper and upper middle class socio-economic status (AOR=3.68, 95% CI=1.34-7.02) were the key predictor variables for positive attitudes.Conclusions:Nearly half the study participants had good knowledge and positive attitudes towards COTPA Act. High socio-economic status could predict good knowledge, while age ≥60 years, education beyond primary school and a high socio-economic status were the key variables predicting positive attitudes. Educational campaigns can help improve knowledge. Assessment of knowledge and attitude is imperative prior to implementation of policies to ensure effectiveness.