bluuebunny/crossref_metadata_2025 huggingface dataset:
Knowledge, attitudes and practice of adverse drug reaction monitoring among physicians in India
Authors: Sen Sukanta , Rahaman Sk. Rafikul , Chatterjee Dattatreyo , Mukherjee Shatavisa , Mondal Somnath , Tripathi S. K.
Published: May 2017

Background: Underreporting of ADRs still remains a major obstacle in the complete success of pharmacovigilance programs. In order to improve ADR monitoring, it is thus imperative to assess the current knowledge, attitude, and practices of doctors. Therefore, the primary objective of this study was to evaluate the knowledge, attitude, and practices (KAP) of the healthcare professionals about pharmacovigilance in various tertiary care government teaching hospital vis-a-vis private clinics in West Bengal.Methods: A cross sectional, questionnaire based survey was conducted among healthcare practitioners in several tertiary care government set-ups and private set-ups in the state of West Bengal (India). The study instrument was a pre-validated structured questionnaire designed to obtain information on the knowledge of the ADRs reporting, the attitudes towards the reporting, and the factors that in practice could hinder the reporting among the doctors.Results: About 89.62% public practitioners correctly spotted the WHO definition for pharmacovigilance, while 77.5% of the private practitioners did the same. Only 19.81% of the public practitioners documented a suspected ADR in any surveillance form, while there were only 3.75% private practitioners who documented it. About 59.43% of the physicians in government hospitals published an ADR case report in any medical journal, while 81.25% private practitioners did no.Conclusions: Study revealed lack of time, incentive less extra work load being major factors responsible for ADR underreporting. In order to improve ADR reporting, continuous medical education, training and proper sensitization of healthcare professionals can help combating the existing scenario and promising an improved tomorrow. The PvPI should be widely publicized in the visual and print media to make health professionals, as well as the general population at large aware of its presence and scope. Pharmacovigilance should be integrated in undergraduate and postgraduate medical courses.
Methimazole induced lichenoid eruptions: an unusual case
Authors: G. N. Vibhashree , H. V. Anuradha , Kalra Pramila
Published: May 2017

This is a case report of a 31-year-old male presented to the Endocrinology outpatient department of our hospital with hyperthyroidism and was prescribed tablet methimazole 30mg once daily and tablet propranolol 40mg once daily. After 3 months, the patient complained of violaceous papular lesions on both the extensor aspect of the arms and legs. Physical examination was remarkable for acute onset, raised, itchy, violaceous papular lesions over the defined areas. The drug methimazole was suspected to cause lichenoid drug eruptions and was withdrawn. This case illustrates methimazole otherwise an efficacious and widely used anti thyroid drug is an agent capable of inducing lichenoid eruptions. However in future the monitoring of methimazole is essential for such adverse reaction.
Sleep disorders in menopausal women
Authors: Singh Abha , Daharwal Abha , Kujur Avinashi
Published: May 2017

Background: Sleep disturbance is one of frequent sign and symptom encountered in post-menopausal women. It affects the quality of the life and may lead to depression in some women. Objective of present study was to find out the prevalence of sleep disorder in post-menopausal womenMethods: Prospective study done on the post-menopausal women coming to Gynaecology OPD of Dr Bheem Rao Ambedkar Hospital, Raipur. This study was a prospective cross sectional observational study, conducted in the outpatient department of Obstetrics and Gynecology from 1st August 2016 to 31st January 2017. It included 500 women of postmenopausal age. A detail Performa was provided to assess sleep patterns and disorders associated with it. All the data was analysed using chi square testResults: The prevalence of sleep disturbances was 29.58%. Home makers were affected more in comparison to working women, 71,43% women had problems in initiating sleep. About 2/3rd women in the study group developed insomnia within 5 years of menopause, whereas 1/3rd took more than 7years to develop insomnia. Co morbidities were present in 48% women. Our women have mean age of menopause around 45 years.Conclusions: Sleep disorders are common, with prevalence of 29.5% in menopausal women in present study. It significantly causes psychosocial problems in women. There is need for it to be asked for and to be treated promptly.
A comparative study between electrocautery and steel scalpel in making abdominal wall incision in caesarean section
Authors: Gupta Sonika , Mehta Anil , Gupta Vikrant
Published: May 2017

Background: Electrocautery is commonly used in surgical practice. However, its use has been limited in skin due to the fear of tissue scarring, impaired wound healing and wound infection due to damaged tissue. To evaluate and compare the use of electrocautery and steel scalpel in making abdominal skin and deeper tissue incisions in caesarean section pfannenstiel incision with regard to operating time and postoperative wound complication rate.Methods: The study was a prospective randomized type conducted in the Department of Gynaecology, Government Hospital, Gandhi Nagar, Jammu. 120 patients undergoing caesarean section were divided into two groups, scalpel group in which skin and deeper tissue of abdominal wall were cut by scalpel and cautery group with electrocautery. Comparison was made between the two groups based on the above objectives.Results: In this study, we find that the operating time was less in electrocautery group and postoperative wound complications were comparable between two groups.Conclusions: The study demonstrates that electrocautery can be used as an alternative to steel scalpel for making abdominal skin incisions.
Assessment of arrhythmias in 50 patients of ST-elevation myocardial infarction after thrombolysis: a 24 hour Holter study
Authors: Rajhans Rishi , Narayanan M.
Published: May 2017

Background: Acute coronary syndrome represents a global epidemic. The purpose of this study was to evaluate the incidence of cardiac arrhythmias in acute myocardial infarction (AMI) in the first 24 hours of hospitalization post thrombolysis.Methods: 50 patients of AMI satisfying the inclusion criteria were included for this observational study. Philips Digitrak Holter was attached to the patient's chest for 24 hours and arrhythmias were noted.Results: In the study group 70% of cases were males, rest 30% females. Maximum incidence of AMI was seen between 4th and 7th decade of life. Incidence of diabetes and hypertension were 54% and 66% respectively either alone or in combination. Overall incidence of anterior wall was higher 56% than inferior wall which was 44%. Sinus tachycardia was seen in 54% of cases with higher incidence in anterior wall MI. Among the reperfusion arrhythmias incidence of frequent VPCs was highest with 66% followed by AIVR (42%) and NSVT (30%). AF was found in 3 cases i.e. 6% of which one died. One patient had VF to which she succumbed.Conclusions: It is a matter of debate whether arrhythmias being so common in AMI, should be considered under clinical spectrum or complication of AMI. An increasing belief that less serious arrhythmias may serve as a warning sign for potentially life threatening arrhythmias and timely intervention by drugs, D.C. shock or pacemakers can prevent mortality in these sets of patients.
Clinico-pathological study of primary carcinoma of the liver
Authors: Dasharatham P. , Kumar P. Arun
Published: May 2017

Background: Since the incidence of the primary carcinoma of the liver in Warangal is very high when compared to other parts of the country, the possible etiological factors have been studied for the increasing frequency of Primary carcinoma of the liver with a view for further follow up. The objective of the present study was to undertake a thorough study of histopathological changes, typing and its association with cirrhosis.Methods: A hospital based cross sectional study was carried for a period of three years among 56 cases of primary carcinoma of the liver at MGM hospital. Institutional Ethics Committee permission was obtained. Informed consent was taken from each and every patient. Detailed history, clinical examination and investigations were carried out for each and every included patient. Liver biopsy was done under strict aseptic precautions.Results: The incidence of Primary carcinoma of the liver was found to be highest in males as compared to females. The highest incidence of Primary carcinoma of the liver was found in the age group of 41-50 years. In only 14.3% of cases the Primary carcinoma of the liver was associated with cirrhosis of liver. The most common type of cell found on histopathology was cylindroids type in 35.7% of cases followed by trabecular type in 28.5% of cases.Conclusions: Incidence of Primary carcinoma of the liver was found to be very high. This was not associated with corresponding increase in cirrhosis. The cause of their increase was obscure.
A comparative study on the efficacy of honey and ethanol as cytological fixatives
Authors: M. Sona , S. Preethamol
Published: May 2017

Background: In cytological fixatives prior to Papanicolaou staining smears are fixed mostly in alcohol or any alcohol based special purpose fixative. Alcohols are costly, hazardous and also there is a problem of disposal. Here, a very cheap and easily available alternate for fixative was being used. The objective was to describe the efficacy of 20% honey as a cytological fixative in comparison to ethanol.Methods: The study was done on buccal smears from students of Department of MLT, Government Medical College, Thiruvananthapuram, Kerala, India for a period of six months after ethical approval. Two buccal smears were collected from either cheek using wooden spatula/blunt end of the Ayers spatula. One of the smear is fixed in ethanol (95%) and the other smear is fixed in honey (20%). The slides were scored based on the assessment parameters: nuclear staining, cytoplasmic staining, cell morphology, clarity of staining and uniformity of staining.Results: The study was done on buccal smears, the sample were smeared and fixed onto slides using two fixatives- 95% ethanol and 20% honey. Both reported good quality staining feature, preservation of morphology and a crisp nuclear and cytoplasmic staining. It has also added advantage of being nontoxic, economical, non-flammable, non-hazardous, no problems associated with license of purchase, reduces overall turnaround time and is easy to handle without any sort of irritation.Conclusions: Thus, the overall study shows that honey has got a fixative action, which can be implemented soon in the industry.
Intravenous clonidine for suppression of haemodynamic response to laparoscopy- a prospective randomised, placebo controlled, single centre study
Authors: Bhalerao Pradnya M. , Thombre Shalini K. , Kapse Upendra S. , Targe Kunal V.
Published: May 2017

Background: Laparoscopic surgeries, including cholecystectomy are being performed on a large scale owing to the improved tissue healing and minimal hospital stay. However the haemodynamic response to pneumoperitoneum could pose a problem in these patients. The primary objective of this study was to evaluate the effectiveness of 1µg/kg intravenous clonidine in suppression of this hemodynamic response. The secondary objective was to assess the postoperative analgesia and sedation.Methods: 60 patients posted for laparoscopic cholecystectomy were divided into two groups. 30 patients received intravenous midazolam 0.03mg/kg and pentazocine 0.3mg/kg and the other 30 received intravenous clonidine 1µg/kg 15 minutes prior induction.Results: Intraoperative mean pulse rate was 90.82±4.81 beats per minute in control group. In clonidine group it was 74.76±9.88 beats per minute (p<0.05 significant). Similarly the mean systolic blood pressure was 137.87±4.89 and 125.79±6.44 respectively (p<0.05-significant). The duration of postoperative analgesia was 334.83±24.65 and 116.05±19.17 minutes respectively (p<0.05).Conclusions: Premedication with intravenous clonidine, has been found to be relatively safe as well as an effective method that provides stable haemodynamics and protection against stress response induced by pneumoperitoneum in patients undergoing laparoscopic cholecystectomy.
Cytologic and colposcopic evaluation of all symptomatic women at tertiary care centre
Authors: Garg Richa , Desai Ranjana
Published: May 2017

Background: Cervical cancer in India ranks as the 2nd most frequent cancer among women and the 2nd most frequent cancer among women between 15 and 44 years of age. Invasive carcinoma of cervix is preventable as it is associated with pre-invasive stage which occurs 10-15 years prior to it, thus permitting early detection by screening and leading to effective treatment and thereby reducing mortality rate with greater impact on lives saved. Objectives were to correlate the findings of Pap smear with colposcopy in evaluation of all symptomatic women; and to assess the utility of colposcopy in detecting the premalignant and malignant lesions of cervix.Methods: This was a prospective observational study of 200 symptomatic women attending the Gynecology OPD of Umaid Hospital Dr. S. N. Medical College Jodhpur, Rajasthan, India from February 2015 to October 2016. Evaluation of all symptomatic women done with Pap smear, colposcopy and biopsy in selected cases and findings were noted.Results: Commonest complaint was white discharge per vaginum in 58.5% followed by pelvic pain in 24% women. 8% women had abnormal pap smear findings with 4% of women had ASCUS, 0.5% had ASC-H, 3% had LSIL and 0.5% had HSIL,73% had inflammatory and 19% with normal smear. 38.5% had abnormal colposcopy with maximum 28% women had acetowhite lesions. Sensitivity of pap smear was 44.44% while sensitivity of colposcopy was 88.88%.Conclusions: Pap smear had poor sensitivity as compared to colposcopy. Hence simultaneous use of colposcopy has shown to increase in the rate of carcinoma cervix detection in symptomatic women.
Role of cerebrospinal fluid, creatine kinase and lactate dehydrogenase enzyme levels in diagnostic and prognostic evaluation of tubercular and pyogenic meningitis
Authors: Jha Abhishek , Dwivedi Narendra C. , Verma Sujit K. , Chaurasia Ajeet K.
Published: May 2017

Background: Etiological diagnosis for meningitis remains a challenge and often a cerebrospinal fluid (CSF) examination may not give the precise diagnosis. Many enzymes are known to be present in abundance in nervous system. In meningitis, nerve tissue damage leads to release of these enzymes into CSF, which may have important diagnostic and prognostic role. Aim was to evaluate the diagnostic and prognostic significance of creatine kinase (CK) and lactate dehydrogenase (LDH) enzymes in CSF of tubercular and pyogenic meningitis.Methods: A prospective case control study of 50 subjects with pyogenic or tubercular meningitis, admitted in Department of Medicine, S.R.N. Hospital, M.L.N.M.C. Allahabad, Uttar Pradesh, India from September 2015-August 2016 was done. Level of CK and LDH were estimated in CSF and serum on day of admission and 7th day. 50 subjects with non-neurological diseases were taken as control.Results: Out of total 50 patients, 36 were of tubercular meningitis and 14 were of pyogenic meningitis. Mean CSF CK and CSF LDH levels were significantly raised in both conditions with respect to controls (p<0.001 and p<0.05 respectively). Mean CSF CK and CSF LDH level were significantly reduced from day of admission to 7th day in both tubercular and pyogenic meningitis patients.Conclusions: Enzymes level in CSF like CK and LDH are significantly raised in pyogenic and tubercular meningitis. Accessing its value can be an important diagnostic and prognostic marker.
Accuracy of transverse cerebellar diameter measurement by ultrasonography in the evaluation of foetal age
Authors: L. Ravindernath M. , Reddy Mahender , Reddy Nihar
Published: May 2017

Background: Assessment of accurate gestational age of fetus is very imperative for proper obstetric management of normal as well as IUGR pregnancies. The objective of this study was to evaluate the accuracy of transverse cerebellar diameter as against the conventional parameters of Biparietal diameter, head circumference, abdominal circumference and femur length in normal pregnant mothers between 15 to 40 weeks and in antenatal diagnosis of intrauterine growth retardation.Methods: Study done on 100 women attending antenatal department, 80 were normal pregnancy cases and 20 were clinically suspected IUGR cases. In each patient BPD, HC, AC, FL and TCD was measured. Correlation of TCD was done with other measured parameters as well as with estimated gestational age of fetus.Results: There was no statistically significant difference between the age and parity distributions of two groups It was seen that 18 cases were below the fifth percentile for AC and HC, 19 cases were below the fifth percentile for BPD and 16 cases were below the fifth percentile for FL. In 16 out of 20 cases the TCD values were within the normal range. Only in 4 cases the TCD values were below the 5th percentile. This difference in number of cases below the 5th percentile for BPD, HC, AC, FL and TCD was statistically significant (p-value=0.001). In 20 IUGR cases the gestational age predicted by transverse cerebellar diameter measurements closely correlated with gestational age predicted by last menstrual period.Conclusions: It was found that there is good correlation between TCD and other parameters. Also, TCD shows good correlation with gestational age. It is better than BPD in circumstances like excessive moulding and dolichocephaly. Also, TCD measurement is not fraught with problems as encountered in FL measurement.
A case of classical sweet syndrome with episcleritis
Authors: Samuel Hanock Unni , Thulaseedharan N. K.
Published: May 2017

Sweet's syndrome (acute febrile neutrophilic dermatosis) is characterized by a constellation of clinical symptoms, physical features, and pathologic findings which include fever, neutrophilia, tender erythematous skin lesions (papules, nodules, and plaques), and a diffuse infiltrate consisting predominantly of mature neutrophils that is typically located in the upper dermis. Sweet's syndrome presents in three clinical settings: classical (or idiopathic), malignancy-associated, and drug-induced. Classical Sweet's syndrome (CSS) usually presents in women between the age of 30 to 50 years, is often preceded by an upper respiratory tract infection and may be associated with inflammatory bowel disease and pregnancy. We report here a case of classical sweets syndrome with the typical histopathological findings who reported well to treatment.
Avascular necrosis of bone with hemiparesis: a rare presentation of primary antiphospholipid antibody syndrome
Authors: Bhandari Sudhir , Gupta Vishal , Sengupta Kushan , Goyal Jaswant , Kumar Uttam
Published: May 2017

Vascular complications are well known manifestations of primary antiphospholipid antibody syndrome but the concurrent existence of avascular necrosis of bone and stroke due to vasculitic infarct is a very rare presentation. We report a case of a middle-aged man who presented with right knee pain and left hemiparesis and was subsequently diagnosed to have primary antiphospholipid antibody syndrome.
Surveillance in Peutz-Jeghers syndrome: a case report
Authors: Ramanathan Sabarinathan , Thangavel Pugazhendhi , Kini Ratnakar , Mohamed Kani Shaikh , Karunakaran Premkumar , Ananthavadivelu Murali
Published: May 2017

Study performed surveillance endoscopy in a 23-year-old male patient with Peutz-Jeghers syndrome (PJS) who underwent right hemicolectomy with ileo-colic anastamosis for ileo-colic intussusception three years back. On evaluation, he found to have multiple upper gastrointestinal and ileal polyps. Subsequently he underwent polypectomies in three sessions by combined standard snare polypectomy and endoscopic mucosal resection (EMR) method without any complication. We present a case report that emphasizes the importance of surveillance and the role of prophylactic polypectomy in patients with PJS.
Dengue-free community as an approach for understanding the value and challenges of inter-agencies partnerships in an intervention program
Authors: Othman Hidayatulfathi , Nordin Saiful Azlan , Rashid Norazimah Abdul , Hisham Abas Mohamed Badrul , Hod Rozita , Sahani Mazrura
Published: May 2017

Background: One of the key requirements for accomplishing a mutual goal is the formation of partnerships. ‘Partnership’ is an ill-defined concept, subject to multiple interpretations and frequently used interchangeably with alliance, coalition, network and collaboration among other terms. World Health Organisation had emphasized dengue prevention and control as a top priority, thus an inter agencies strategy and intervention study was launched to document the effectiveness of a local-level inter agencies approach and partnerships.Methods: The Free-Dengue Community approach, which involved stakeholder partnerships between parties such as the Ministry of Health, Ministry of Science, Technology, Local Municipalities, Health District Offices and National University of Malaysia, was developed as an inter-agencies plan for dengue prevention, of which the core objective was to design and implement activities for communication and social mobilization. In the control area, routine dengue control activities continued without additional input.  Entomological indices were compared within and between the areas before and after the 12 week intervention period.Results: The approach consolidated the inter-agencies partnerships whereby the dengue cases in the localities had dropped and via this study, the module of Dengue-Free Community was mapped and documented. The result also highlighted the contributions made by each of the partner in bringing down the dengue cases in the selected localities. Furthermore, the number of ovitrap index also decreasing proving that the approach is effective. The community kit and home-kit provided to the community also helped in reducing the number of Aedes eggs in the intervention program.Conclusions: The partnership using the Dengue-Free Community approach achieved its aim of increasing the level of cooperation between the authorities to support social mobilization, and results shed light on how to tackle the challenges of inter-agency partnerships and the required approach for a better understanding of the levels at which individuals operate within such partnerships.
Factors influencing public hospital nurses’ intentions to leave their current employment in Jordan
Authors: Al Momani Mohammed
Published: May 2017

Background: Shortage of nurses resulting from nurses migration, has created a health care crisis in developing countries and has adversely affected the quality of nursing care provided to patients. The main objective of this study was to investigate the factors influencing Jordanian public hospital nurses’ intent to leave their current employment. Methods: A cross-sectional survey was conducted among 348 registered nurses randomly selected from two public referral hospitals, Al Bashier Teaching Hospital, and Amirah Basma Teaching Hospital, Jordan. Data to investigate the nurses’ satisfaction and their intention to leave were collected using self-administered questionnaire compromised 28 factors included in seven dimension: Administrative support, supervision and leadership, interaction with co-workers, work related factors, staff development practices, pay and promotion system, and control and responsibility. Data collected over a 4-month period (December 13, 2015 to April 7, 2016). Results: of the 348 registered nurses 212 (60.9%) had an intention to leave their current work. The average satisfaction rate for all dimensions was (2.83). The dominant factors were not satisfied nurses (mean<3) and influencing their intention to leave were Pay and benefits, nurse to bed ratio due to shortage of nurses, and praising and recognitions for achievement. The variables gender, work experience, and nursing role yielded significant associations with intent to leave (p<0.05). Conclusions: The study showed that the majority of nurses were dissatisfied and had intention to leave their current job. Developing strategies to increase retention of nurses such as salaries and benefits should be periodically reviewed in light of the national consumer index, in addition to other strategies could improve nursing retention and quality of nursing care.
Health seeking behavior among women in Bhimtar, Sindhupalchowk district of Nepal
Authors: Shrestha Marina V. , Paudel Leela , Pant Smriti , Neupane Samikchya , Manandhar Naresh
Published: May 2017

Background: When assessing and monitoring the health of a population, it is important to describe not only classical mortality and morbidity indicators but also, perceived illness, visits to primary health services, and utilization of the healthcare services provided. Objectives of the study were to determine the health status and factors affecting health seeking behaviour of women.Methods: A descriptive study was done at Bhimtar, Sindhupalchowk District in Nepal, involving 147 subjects sampled by purposive sampling. Study population consisted of women. Data was collected by house to house interview with pretested questionnaire during month of September 2016. Data was entered and then analysed using Statistical Package for the Social Sciences (SPSS) 20. Simple measures of statistics like frequency, percentages, means were used to represent the data in tables as a part of descriptive analysis and chi-square test was applied to see the association with dependent variables.Results: Among 80.9% women who had gynaecological problems, the highest prevalence rate of the disease was low back pain (60.5%) followed by lower abdominal pain (35.2%), dysmenorrhea (27.3%) and menstrual irregularities (27.3%). The first approach of seeking health for the reported illness among women was the traditional healer (51%). Regarding attitude towards modern medicine, 47.6% respondents replied that facilities were not available locally. Similarly regarding hindering factors for not utilizing health services, lack of female doctors (43.75%) and far distance of health care centre (37.5%) were the most common ones.Conclusions:Higher percentage of women in Bhimtar sought after the traditional healer as the best way for utilizing health services. Modern health care utilization was less because of the distance to be covered during illness and lack of doctors in the health centre.
Tobacco use and its determinants among 13-15 year old adolescents of two central government schools of New Delhi district
Authors: Kedar Ashwini , Gupta Sanjay , Singh Khangembam Jitenkumar
Published: May 2017

Background: The burden of Non Communicable Diseases (NCDs) is on the rise globally as well as in India. Tobacco use is one of the important behavioural risk factors which can be recognized and modified at a young age. Objectives: To assess tobacco use among school going adolescents and to determine the factors affecting this NCD risk factor.Methods: The study was conducted among adolescents aged 13 years to 15 years studying in class eighth to tenth from two central government schools of New Delhi district. Self-administered questionnaires were used to collect data from students and their parents. Data gathered from 438 students was analyzed using SPSS version 20.Results: 30 participants were found to ever use tobacco, and 25 were current users. Majority (17) ever tobacco users started using tobacco at 11 years or less. Tobacco use among family members, friends was found to be an important predictor for, ever and current tobacco use. Film actors were an important source of inspiration for tobacco use followed by family members and friends. Health education at school had a strong protective effect especially for current tobacco use.Conclusions: A decreasing age of initiation for tobacco use and a strong influence of family members were found. Greater emphasis on health education activities at school may help to decrease tobacco use among children. School based interventions involving families of students may help in controlling this behavioural risk factor.
Satisfaction of patients attending a rural hospital of Darjeeling district in West Bengal, India
Authors: Agarwal Priti , Biswas Romy
Published: May 2017

Background: Patient satisfaction is a means of measuring the effectiveness of health care delivery. This serves as a means of improvement among health care providers to give an acceptable level of patient satisfaction. Aims and Objectives: To assess the level of satisfaction and reasons of dissatisfaction among patients regarding health care services in a rural hospital of Darjeeling District, West Bengal.Methods: A cross-sectional survey was done on 110 patients with the help of PSQ-18 questionnaire. The samples were drawn by systematic random sampling            .Results: The overall mean satisfaction score was 3.57 and S.D. ±0.69. The mean score was highest in general satisfaction domain which was found to be 3.76 with S.D ± 1.08 and lowest in time spent with doctor where mean score was 2.92 and S.D. ±1.07. 69.3% of the patients were satisfied with the services offered by the hospital. The time spent by the doctor with the patient was less and this was the major reason of dissatisfaction.Conclusions: More than half of the patients were satisfied with the services provided by the hospital. The findings of the study can facilitate the development of targeted, objectively prioritized programs for the improvement and advancement of health care delivery systems.
Assessment of sub-centres of Belagavi district according to Indian public health standards 2012 guidelines: a cross sectional study
Authors: Patil Shrinivas K. , M. S. Shivaswamy
Published: May 2017

Background: In the public sector, a sub-health centre (sub-centre) is the most peripheral and first point of contact between the primary health care system and the community. The current level of functioning of the Sub-centres is much below the expectations. Objective: To assess sub-centres of Belagavi District according to Indian public health standards 2012 guidelines.Methods: A facility based cross-sectional study was conducted in Belagavi district of Karnataka. forty SCs, four SC from each of the 10 Talukas of Belagavi district were selected by simple random sampling. Study period: 1st January to 31st December 2014. Data collected - using a predesigned and structured questionnaire for IPHS facility survey.Results: The study showed 35% of SCs were catering the services for population as per the norms. Services like ante-natal clinics, post-natal clinics and immunization sessions were conducted regularly in all the SCs. About 33% of SCs had no buildings. A deficiency worth highlighting in the present study was the absence of residential facilities for the staff in half of the SCs. Proper supervision and monitoring of the service delivery activities of the SC staff was done only in 70% of SCs.Conclusions: IPHS guidelines are not being followed at SC level in the district. Recruitment of SC staff especially the Health Worker Male post should be filled at all the SCs for efficient functioning of the SCs. The SC should be periodically surveyed to identify the deficiency and necessary action could be taken to correct it.
Study of workplace violence, its risk factors and perceptions about workplace security in doctors of Paithan
Authors: Pund Sandeep B. , Kuril Bina M. , Doibale Mohan K. , Ankushe Rajendra T. , Kumar Purushottam , Siddiqui Nafeha
Published: May 2017

Background: Of all work settings, hospitals carry the greatest risk of verbal abuse and threats, with 73% of staff on medical premises suffering abuse. The scenario in Indian subcontinent is also not so bright. Doctors are frequently assaulted in India as well where doctors are shot, even stabbed. Thus this study was undertaken to know the exact prevalence of such incidences in Paithan taluka of Aurangabad district. Methods: A community based cross-sectional study was done in the Paithan taluka of Aurangabad district in Maharashtra from October 2015 to December 2015. All the doctors in the urban as well as rural areas of Paithan were interviewed to know their experiences about episodes of workplace violence (WPV) during last 12 months as well as their lifetime experiences. Some of the factors associated with the WPV were also asked along with the perceived reasons for such type of incidences. Results: The prevalence of workplace violence in the last 12 months was found to be 63.41%, whereas the lifetime prevalence was found to be 78.05%. It was observed that 21.95% of the doctors were demanded for extortion money and 11.27% experienced intentional destruction of their hospital property. Workplace violence was seen to be significantly more associated with younger doctors, highly educated doctors, doctors in government service and doctors with comparatively lesser practice experience. Lack of communication was perceived by the doctors as the most common reason for these incidences.Conclusions: Workplace violence is emerging as a bane to the medical profession and has to be dealt with urgently. Poor communication with patients along with other factors should be dealt with to mitigate this problem.
A study on knowledge and practice of road safety among medical students of S.N. Medical College, Karnataka
Authors: R. Manjula , H. Vijaylaxmi B. , Dorle Ashok S.
Published: May 2017

Background: Globally 1.25 million people die each year as a result of road traffic crashes. Road traffic injuries are the leading cause of death among young people, aged 15–29 years. 90% of the world's fatalities on the roads occur in low- and middle-income countries. Aims and objectives: to know the socio- demographic profile and knowledge, attitude and practice among medical students in S.N. Medical College Bagalkot.Methods: A cross sectional study. Study was conducted from March-June 2016. Data collected from 90 undergraduate medical students after obtaining informed consent. It was semi- structured questionnaire. Results: Good knowledge was seen among 74 (82.2%) of the participants. Majority had good attitude 80 (88.9%) about RTA. But the good practice is seen only among 53 (58.9%) and 37 (41.1%) have poor practice among participants. Gender is statistically significant with knowledge (p value-0.015). Conclusions: The knowledge didn’t translate into practice. Hence laws should be made stringent.
Prevalence and severity of genu valgum among school children aged 6-12 years in rural South India
Authors: Holyachi Sharankumar , Biradar Mallikarjun K. , Bhovi Ravindranath A.
Published: May 2017

Background: Fluorine is the most abundant element in nature, and about 96% of fluoride in the human body is found in bones and teeth. Fluorosis is caused by exposure to a continuous high level of fluoride for a long time leads to dental and skeletal deformities. Study was done to assess the prevalence and severity of genu valgum among the school children in rural Koppal. Methods: The present cross-sectional study was carried out among all the students, in the age group 6-12 years in Koppal taluk from August 2016 to December 2016. Data was compiled, tabulated and analyzed using proportions and chi-square test. Results: The total school children enrolled in study 1722, the mean age group was 9.24. 31.4 % were in the age group of 10-11, Male students constituted about 45.1%. Majority of the students had nuclear family in their house (59.8%). Almost half of the study subjects were in class III socio-economic status (42.7%).The prevalence of genu valgum was 11.2%. Conclusions: The study finding interprets the prevalence of genu valgum is high in the community.
An assessment of facilities and activities under integrated child development services in a city of Darjeeling district, West Bengal, India
Authors: Saha Mausumi , Biswas Romy
Published: May 2017

Background: ICDS is the unique community based programme for early childhood care and development. The objective of the study were to assess the facilities and activities of ICDS centres and the utilization of ICDS services among children aged 6 months to 6 years in a city of Darjeeling district, West Bengal, India. Study setting and design – Community based cross-sectional study done in a city of Darjeeling District of West Bengal, India during June – September 2016.Methods: 30 ICDS centres were selected by cluster sampling method. From each cluster 7 households were selected randomly with help of register of AWCs. 30 AWWs and 210 mothers of 6 months – 6 years children were interviewed with pre-designed, pre-tested schedule.Results: 86.66% AWCs were running in pukka building. Toilet facility was absent in 43.33% AWC. All AWCs were well equipped & all workers were literate. 65.12% male child and 70.74% female child had received supplementary nutrition. Immunization records were present in all AWC. NHED was celebrated in all AWC twice monthly. 80% AWC referred sick children verbally. 17.61% of children took the meal to their home and 29.57% mother didn’t attend NHED meeting.Conclusions: There was gap in infrastructural facility and some activities. Mothers were satisfied with overall functioning of AWC.
Knowledge and practices regarding standard precautions among health functionaries of peripheral health institutions of Haryana
Authors: Chawla Suraj , Verma Ramesh , Khanna Pardeep
Published: May 2017

Background: Healthcare workers (HCWs) are at risk of infections due to blood-borne pathogens as they are potentially exposed to blood and body fluids in the course of their work. Standard precautions aim to both protect health care workers (HCWs) and prevent them from transmitting the infections to their patients.Methods: The study was conducted among health functionaries of all health centres whether govt. or private of community development block Beri, District Jhajjar, Haryana. A pre-tested semi-structured questionnaire was administered to the study subjects and the responses were recorded by the investigator himself. The questionnaire included information pertaining to knowledge and compliance with standard precautions among HCWs.Results: Knowledge among staff nurses and laboratory technicians was having wide variations as 53% to 93% of them gave correct replies for different components of standard precautions. Similarly, when knowledge of multipurpose health workers was assessed only half or less than half of them were having correct knowledge for most of the components.Conclusions: To conclude, the HCWs in peripheral health institutes had inadequate knowledge of and poor compliance with SPs. Enhancement of the existing training and system for monitoring the appropriate use of personal protective equipment is need of the hour.
Socio demographic and clinical profile of dengue fever cases at a tertiary care hospital, Hyderabad, Telangana
Authors: Chajhlana Sunil Pal singh , Mahabhasyam Ramakrishna Narashimha , Varaprasada Maruti Sarma Mannava , Reddy Anukolu Ravi Shankar
Published: May 2017

Background: Dengue fever is caused by Dengue Virus, belonging to the family Flaviviridae, transmitted by Aedes aegypti and Aedes albopictus mosquito. There are four distinct dengue virus serotypes (DEN-1, DEN-2, DEN-3, and DEN-4). This viral disease of humans has become a major international public health concern in recent years. Differential diagnosis based on symptoms is challenging due to dengue’s non-specific symptoms such as fever, aches and fatigue that are often overlap with other endemic infections. Dengue-associated mortality can be reduced from 20–30% in severe cases to less than 1% with appropriate fluid replacement and supportive care, which is greatly facilitated by early diagnosis. Aim and objective: To study the demographic factors and clinical features of dengue fever cases in urban areas of Hyderabad.Methods: The present study was conducted by Department of Community Medicine in collaboration with Department of Microbiology, Kamineni academy of medical sciences and research center, Hyderabad. Study subjects: “Probable” dengue cases admitted in the various departments during July –December 2016. Data collection was done using a structured questionnaire. Serum samples were tested for NS1 antigen, IgM, IgG antibodies by rapid visual immunochromatography.Results: Out of 137 samples of clinically suspected dengue cases, 119 were found positive for dengue infection. Fever was the most common symptom found in all the patients Majority of cases, 56.3% were males. Thrombocytopenia, leucopenia and bleeding manifestation were found in 84.0 %, 84.8% and 58.8% patients respectively.Conclusions: Fever was the most common symptom found in all the patients. Majority of cases showed thrombocytopenia. Significant difference was found in the clinical signs and symptoms like fever, myalgia, hypotension, thrombocytopenia and leucopenia in dengue cases than controls.
Immunization coverage among anganwadi preschool children in Kannur, Kerala, India
Authors: S. S. Anitha , Jayasree A. K. , Antherjanam S. Devaki
Published: May 2017

Background: The Government of India launched the Expanded Programme on Immunization (EPI) in 1978 with the objective of reducing the mortality and morbidity resulting from vaccine-preventable diseases of childhood. The Coverage Evaluation Survey by UNICEF in 2009 reported that the percentage of children fully immunized in India is only 61%. The objective of this study was to assess the immunization coverage among preschool children attending Anganwadi in Kannur district.Methods: Cross-sectional study done during July 2013- June 2014 among Anganwadi pre-school children. Anganwadi centres were selected using multistage random sampling. The data regarding immunization and socio-demographic factors were collected by interviewing the mothers using a standardized questionnaire. Data was entered in Epi Data version 3.1 and analysis was carried out using the Statistical Package for the Social Sciences (SPSS) version 19 software.Results: In this study 456 preschool children (3-6 years) were studied. Among the study population, 429 children (94.1%) were fully immunized, 25 (5.5%) were partially immunized and 2 (0.4%) were non-immunized. The major reasons for not taking immunization as stated by the respondents were: religious beliefs, personal engagements at the time of immunization, fear of fever after immunization, and that the child had fever at the proposed date.Conclusions: The present study shows that regular follow up and motivation through systems like Anganwadi can improve immunization coverage. The study also identified that children taking vaccination from government sector are more likely to complete the schedule.
Telephonic follow-up to assess compliance to advice regarding lifestyle modification and confirmation of diagnosis given during a diabetes screening camp
Authors: Pardeshi Geeta S. , Daral Shailaja , Das Timiresh , Kumar Mukesh , Parija Pragyan , Smanla Shalini , Kishore Jugal
Published: May 2017

Background: Compliance to the advice given in the diabetes screening camp will ensure timely diagnosis and lifestyle modification in high risk individuals. The objective of the study was to determine factors associated with follow up telephonic contacts and compliance to advice regarding lifestyle modification and confirmation of diagnosis. Methods: A prospective cohort study was conducted among persons aged more than 30 years attending a diabetes screening camp in outpatient department of a tertiary care hospital. Follow up telephonic contact to assess compliance was done among those with random blood sugar level >140mg/dl. Fisher’s exact test and relative risk with 95% confidence interval were calculated. Results: Out of the 1798 individuals attending the screening camp, 170 (9.4%) had raised random blood sugar level. Of these, 113 (66%) could be contacted telephonically. Male gender (RR=1.45, 95% CI=1.12-1.89; p=0.002), formal education (RR=1.85, 95% CI=1.20-2.86; p=0.00), gainful employment (RR=1.31, 95% CI=1.002-1.72; p=0.04) and perception of diabetes as serious and fatal disease (RR=1.26, 95% CI=1.02-1.55;p=0.04) were significantly associated with successful follow up contact. Of the 103 eligible individuals followed up for assessment of compliance, 82 (80%), 63 (61%) and 50 (49%) were compliant to advice regarding diet, physical activity and follow up visits for confirmation of diagnosis respectively. None of the independent factors were significantly associated with compliance. Confirmation of diagnosis of diabetes and initiation of antidiabetic treatment was reported by 33 respondents. Conclusions: A robust and holistic follow up mechanism to ensure better compliance to lifestyle modification and confirmation of diagnosis after a diabetes screening camp is needed.
Prevalence of depression among hypertensive individuals in urban Trivandrum: a cross sectional study
Authors: T. Prathibha M. , Varghese Sara , Dev V. Gokul , J. Jincy
Published: May 2017

Background: People with chronic diseases are more likely to have depression than those without any physical illness. Lack of adherence to treatment, poor compliance to life style modification therapy and lost to follow up are major concerns raised in the management of hypertension among subjects with co-morbid depression. Hence it is very important to explore the epidemiology of depression among hypertensives. Methods: The study was conducted in Medical College health unit area of urban Trivandrum as a cross sectional survey among adults >18 years who were diagnosed to have hypertension. The subjects were interviewed using a semi structured questionnaire to collect the socio-demographic variables and the 9 item Patient Health Questionnaire (PHQ 9) to capture depression. Data from a sample of 432 hypertensive individuals collected were analyzed and Chi square, t test, was done to find the associated factors. Results: Mean age of the study subjects was 62.47 years. Among the study subjects the blood pressure was under control among only 33.8% of the study population. The prevalence of depression was found to be 33.3% (144) with 95% C.I (27.98-39.14). Gender, Socio economic status, marital status, low educational status, regular physical activity, duration of hypertension, uncontrolled BP, were found to be significantly associated with depression. Conclusions: The prevalence of depression among hypertensive individuals is high in this study population. Adequate control of BP along with awareness among primary care physicians in identifying those with hypertension and co-morbid depression is essential.
An experience of facility based management at one of the malnutrition treatment centre in district Baran of Rajasthan, India
Authors: Mulla Shakila , Gupta Pankaj Kumar
Published: May 2017

Background: To assess performance of one of the Malnutrition Treatment Centre (MTC) in district Baran of Rajasthan. India. Methods: An observational prospective study was conducted at MTC where 132 Severe Acute Malnutrition (SAM) children were recruited. Their socio-demographic details and anthropometric measurements were recorded. These SAM children were followed till the period of 4 follow-up visits to measure their weight. MTC performance indicators were assessed. Results: Majority of SAM children belong to age group less than 2 years, gender female, caste OBC (Other Backward Class), SC (Scheduled Caste) and ST (Scheduled Tribe). ASHAs (Accredited Social Health Activists) are playing key role in referring them to MTC. Death rate was 0%, cure (recovery) rate 42.4%, defaulter rate 25.8%, mean length of stay (days) at MTC was 8.04 and mean weight gain was 5.926 g/kg/day. Performance indicators are significantly affected by length of stay at MTC. Follow-up rate was poor with no significant weight gain observed after discharge. Conclusions: MTCs are effective in saving lives of SAM children but not in maintaining long term control on malnutrition.