bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence of thyroid dysfunction and impact on maternal and fetal outcome in Central Indian pregnant women
Authors: Pokhanna Joysee , Gupta Urvi , Alwani Madhuri , Tiwari Shruti Pathak
Published: September 2017

Introduction: Thyroid dysfunctions have become common endocrine problems in pregnant women. It is now well established that not only overt, but subclinical thyroid dysfunction also has adverse effects on maternal and fetal outcome. There are very few data from India about the prevalence of thyroid dysfunction in pregnancy. In this study, we determined the prevalence of thyroid dysfunction in pregnancy and its impact on obstetrical outcome in Central Indian Indore Pregnant Women.Methods: Total 300 pregnant women between the 13 and 26 weeks of gestation were recruited for this study who is residing in Indore. In all patients routine obstetrical investigations, TSH tests were done. Anti-TPO antibody tests and Free T4 were done in patients with deranged TSH. The obstetrical and perinatal outcomes were recorded. Almost all the patients were followed up to delivery.Results: The prevalence of hypothyroidism and hyperthyroidism was 13 and 4%, respectively. Adverse maternal effects in overt hypothyroidism included preeclampsia (22.2 versus 11.6%) and placental abruption (22.2 versus 2.0%). Subclinical hypothyroidism was associated with preeclampsia (30.0 versus 11.6%) as compared to the euthyroid patients. Adverse fetal outcomes in overt hypothyroidism included spontaneous abortion (22.2 versus 6.6%), preterm birth (44.4 versus 30.0%), low birth weight (66.6 versus 30.0%), intrauterine growth retardation (33.3 versus 10.0%), and fetal death (22.2 versus 0%) as compared to the euthyroid women. Adverse fetal outcomes in subclinical hypothyroidism included spontaneous abortion (2.0 versus 6.6%), preterm delivery (5.2 versus 30.0%), low birth weight (11.2 versus 30.0%), and intrauterine growth retardation (4.4 versus 10 %) as compared to the euthyroid women.Conclusions: The prevalence of thyroid disorders was high in our study with associated adverse maternal and fetal outcomes. Routine screening of thyroid dysfunction is recommended to prevent adverse fetal and maternal outcome.
Metastatic ovarian tumor of a lung cancer at the hospital center of Chauny (France): a case report
Authors: Roland Adjoby Cassou , Didier Kouamé Arthur , Achille Koffi , Charles Kakou , Joachim Konan , Zoly Andriamandimbison , Patrick Ahounkeng , Eric Nshimirimana
Published: September 2017

The ovary is an organ that can be the site of metastases for many cancers. In general, malignant ovarian tumors are primary; however, cases of extra gynecological metastatic tumors (breast, colon, stomach, and pancreas) have been reported. In most cases, the primary cancers of these ovarian tumors are gastrointestinal or gynecological, the lung being very rarely involved. We report a rare case of ovarian metastases of bronchial cancer discovered during an extensional assessment. The histological examination coupled with immunohistochemistry concludes that ovarian metastasis of small cell lung carcinoma. In addition to chemotherapy such as Taxol-Hycamtin, the management required cerebral radiotherapy for a cerebral metastasis detected.
Pemphigus vulgaris in pregnancy with transient neonatal pemphigus - can psychological stress be culprit?
Authors: Bhagat Nisha , Raj Rajnish , Arora Ritu
Published: September 2017

Pemphigus vulgaris (PV) is a rare life threatening, autoimmune bullous disease affecting mucous membrane and skin. Pregnancy and emotional stress may be the possible triggering factors for PV. It is a very rare phenomenon with less than 27 cases of pregnancy induced PV and only 9 cases of neonatal pemphigus reported in literature. The lesions may appear transient in neonate which resolve spontaneously over 2-3 weeks. We hereby, report a case of 26-year-old female who developed PV in second trimester of pregnancy with peripartum depression, which was managed by intravenous, oral and topical steroids and selective-serotonin reuptake inhibitor (SSRI). Furthermore, the development of transient neonatal pemphigus raises the possibility of genetic linkage from maternal to fetal transmission.
Laparoscopic management of an unruptured cesarean scar ectopic pregnancy
Authors: Bhate Anurag , Deshmukh Neelima , Chitnis Swati
Published: September 2017

Cesarean scar ectopic pregnancy (CSEP) is a rare form of ectopic pregnancy. With Cesarean deliveries on the rise, scar ectopic is being increasingly diagnosed. Also, more cases have led to better understanding of diagnosis and treatment of this condition. We present a case of scar ectopic which was initially diagnosed as retained products of conception. The ectopic mass was later resected laparoscopically, thus preserving the uterus and fertility.
Acute vulval edema leading to urinary retention in a lady with pre-eclampsia: case report
Authors: Mane Jitendra D.
Published: September 2017

Acute urinary retention is condition which requires immediate attention as it is associated with severe pain and which is relieved by simple procedure of catheterization. This complication is uncommon in women compare to males. It is much rarer during pregnancy. Presenting a case of acute retention of urine in a primigravida woman with vulval edema having severe pre-eclampsia in third trimester. She was initially managed with indwelling Foleys catheter followed by delivery which relieved her symptoms.
A case report: venous sinus thrombosis in pregnancy
Authors: Singh Abhilasha , Nanda Smiti
Published: September 2017

Venous sinus thrombosis (VST) should be considered in the differential diagnosis of all unexplained central nervous system disorders of sudden onset. Etiological factors are subclinical forms of several common thrombophilic states occurring together, rather than the typical inherited and rare causes. Diagnosis is often missed because of the heterogeneity in clinical presentation and radiological investigation is essential for the diagnosis. Prognosis depends on the early detection. By correcting the cause, the complications can be prevented.
HIV associated neurocognitive dysfunction and its association with CD4 count in HIV positive patients-a hospital based study
Authors: Balaini Neeraj , Sharma Ashima , Sharma Sudhi , Sharma Ashok
Published: September 2017

Background: The main objective of the present work was to study the neurocognitive dysfunction in HIV positive patients and to determine its relation with CD4 count. Further, an attempt has also been made to study the relationship of neurocognitive dysfunction with cART regimen.Methods: The study was a prospective observational study, conducted over a period of one year (from July 2012 to June 2013) in the Department of Medicine in collaboration with the Department of Psychiatry at Indira Gandhi Medical College and Hospital, Shimla.Results: HIV associated neurocognitive dysfunction (HAND) was found in 39.04% patients. Mean duration from diagnosis of HIV to detection of HAND was 3.77 ± 1.7 years. Mean nadir CD4 cell count was 126.1/mm3. 39.04% patients (n=41) were found to have HIV associated neurocognitive disorder out of 105 screened patients. 95.1% patients (n=39) had asymptomatic neurocognitive impairement, 4.9% patients (n=2) had mild cognitive impairment and 2.08% patients (n=1) had HIV associated dementia. Out of 41 patients having HIV associated neurocognitive disorder, 68.3% patients (n=28) were having CD4 count less than 150. Those having CD4 count less than 150/mm3 had scored less on dementia scales indicating severe disease. 31.7% patients (n=13) were having HIV associated neurocognitive disorder (HAND) and CD4 count was more than 150/mm3.Conclusions: The conclusion of the study is that HIV associated neurocognitive disorder is common and asymptomatic neurocognitive impairement is the commonest type of HIV associated neurocognitive disorder in HIV positive patients. It can be detected while patient is asymptomatic with help of simple neurocognitive tests. Although few studies reported higher prevalence of HIV associated neurocognitive disorder among patients on certain combined antiretroviral therapy (cART) regimen but our study didn’t indicate any such association.
Exploring patients satisfaction after the implementation of an electronic medical record system at Al-Wakrah primary health center, Qatar, 2016
Authors: Al-Dahshan Ayman F. , Al-Kubaisi Noura , Halim Chehab Mohamed Abdel , Al-Hanafi Nour
Published: September 2017

Background: The healthcare industry has focused much attention on patient satisfaction with the quality of healthcare services. However, there remains a lack of research on patient satisfaction towards the implementation of an electronic medical record system at a primary healthcare setting. This study aimed at assessing the level of patient satisfaction regarding primary health care services after the implementation of an electronic medical record (EMR) system. Methods: A descriptive cross-sectional study was conducted at the Al-Wakrah health care center, with a random/convenient sample of 52 patients attending the center. Furthermore, the investigators interviewed the participants, in the waiting area, regarding their satisfaction with the primary health care services provided following the EMR system implementation. A structured interview-based questionnaire for measuring patient satisfaction was employed. Results: The vast majority of participants indicated that the overall service at the health center greatly improved after EMR implementation. Furthermore, most interviewees were totally satisfied with the overall workflow at the health care center such as the time spent at the registration desk (76.9%), before seeing a physician (65.4%), while the physician used the computer (76.9%), physical examination (69.3%), laboratory testing (73.1%), and collecting the medication (65.4%). Regarding health education and informativeness, the participants found that labeling medication bottles was quite informative. However, less than two-thirds (61.5%) of the patients were satisfied with the health education delivered by physicians. Conclusions: The results revealed that although overall patient satisfaction was relatively high, certain aspects of the health care service remained to be a source of dissatisfaction. Thus, this study demonstrated patient acceptance and support for the electronic medical record system at the primary health care setting.
Perceptions and practices of oral rehydration therapy among caregivers in Cork, Ireland
Authors: Maduemem Kene E. , Rizwan Muhammad , Akubue Nnaemeka , Maris Ioana D.
Published: September 2017

Background: The use of oral rehydration therapy (ORT) remains limited despite international guidelines for diarrhoeal disease management. This study was done to assess the perception and practice of ORT among caregivers in the management of diarrhoeal disease. Methods: A descriptive cross-sectional study was conducted in the Paediatric Department of Cork University Hospital, Ireland. The study population consisted of parents/guardians of children attending the Paediatric Day Ward or Paediatric Outpatient Department. A questionnaire consisting of 30 questions was originally designed by the first author to include all the study variables, and was given to the participants. Results: Out of 402 respondents, 76.6% (n=308) could describe diarrhoea correctly and perceived it as a serious illness. 81.3% (n=327) of participants knew about ORT but only 27.2% (n=89) agreed it was an ideal first line of management of diarrhoeal disease. Diarrhoeal episodes in the preceding 12 months were reported predominantly in children under the age of 5 years (p<0.001). Only 8.7% (n=17) of caregivers used ORT for diarrhoeal management. Conclusions: Poor uptake of ORT appears to be due to caregivers’ negative perceptions of ORT. This emphasizes the need for correct and adequate education.
Seeking for ‘Self-Help’: Cross Cultural Dialogue with Sarvodaya Sri Lanka and Salvation Centre Cambodia
Authors: Yokoyama Taizo , Ariyaratne Vinya , Chea Ven Som
Published: September 2017

Background: The term ‘Self-Help’ has been attracting the attention of scholars across the globe,invested in sustainable-development especially after the Sustainable Development Goals (SDGs) were established by the United Nations in 2016. In this study, a joint discussion between NGOs from two nations, Sri Lanka and Cambodia was conducted to look into the successful factors in Self-Help development and the current challenges in both nations. Methods: In addition to literature reviews for theoretical discussion, the research sets the international dialogue in 23th May 2017 between Sarvodaya Sri Lanka and Salvation Centre Cambodia (n=7). The author also visited the local offices of Sarvodaya in Trincomalie and Batincaloa districts in Sri Lanka and interviewed the local officers (n=10) in addition to JICA (Japan International Cooperation Agency) volunteers (n=2) who work in a field of community welfare. In each district, five villagers (n=10) selected via snow ball sampling were also interviewed. Results: Self-Help starts from spiritual awareness, which leads to collective thinking and community practice. It is a crucial process to bring about change in a community through self-determination. Sarvodaya Sri Lanka has maintained its philosophy for decades and this implication provides an important perspective for the current challenges in Cambodia. The lessons learned from Sarvodaya punctuate ‘collective thinking’ and ‘integrated idea’ in implementing a holistic approach, recognized as strong impacts for Self-Help development. Conclusions: Being the key factor for sustainable development through Self-Help effort, collective thinking to define the issues is perceived to play a critical role in promoting integrated/holistic development.
Empowering the future mothers: a bottom up approach
Authors: Vyas Shaili , Aggarwal Pradeep , Singh Sadhna , . Deepshikha , Kakkar Rakesh , Kandpal S. D.
Published: September 2017

Background: In India, marriage at an early age is still common and unfortunately any institution does not provide any education either regarding safe maternal health and infant care. The first two years of child are very crucial for infant development and it is quite evident that the well-being and nutrition of the child and his or her future is totally dependent upon the knowledge of the mother that she has about child care. The aim of the study was to evaluate the awareness of breastfeeding amongst young female students from three different teaching institutions i.e. school, nursing and medical and to evaluate the influence of educational intervention on them.Methods: Dehradun has total 6 blocks of which 1 block was selected randomly i.e. CBD Doiwala. For selection of school, one school was randomly selected from the list of schools under CBD Doiwala. Out of 75 schools going young females 71 participated in the study. 66 Students each of 3rd Year Nursing and 3rd Year MBBS students of HIMS participated in the study.Results: In school girls scaling of awareness was maximally seen in average duration of breastfeed (35%) and adequacy of each breastfeed (27%). In nursing students scaling was maximum in awareness regarding breastfeeding a baby in HIV/TB infected mother (85%) and positioning of baby (52%), similarly, in medical students also, it was maximum in HIV/TB infected mother (81%) and positioning of baby during feeding (48%).Conclusions: Educational intervention is an effective tool to improve awareness regarding breastfeeding practices.
Comparative study of knowledge and practices regarding tuberculosis amongst the nursing staff of medical college and peripheral health care unit
Authors: Gupta Rajat , Sood Anuradha , Kaistha Madhvi , Bhardwaj Ashok , Sharma Tarun
Published: September 2017

Background: One of the major risk factor for tuberculosis (TB) includes working in close proximity to the patients. Recent evidence suggests that nursing professionals are vulnerable to tuberculosis not only because of elevated exposure, but also because of misinformation and lack of updated data regarding knowledge about the disease. Our study aimed to gather knowledge and health care practices related to TB amongst nurses in a medical college and that of a peripheral health care unit. The objectives of the study were to compare the level of knowledge regarding tuberculosis and practices related to it in nursing staff of a Medical College and nursing staff working at peripheral health care unit.Methods: This cross-sectional study was conducted in a rural medical college and a training centre for health professionals of Himachal Pradesh over a period of 3 months (w.e.f. October–December, 2014). A total of randomly selected staff nurses of medical college and nurses working at different levels of peripheral health care unit attending training at the Training Centre, Chheb Kangra were included in the study. A structured questionnaire was framed to collect data regarding tuberculosis and its practices. Results: It was observed that nursing staff posted in Medical College had less knowledge as compared to the nursing staff of a peripheral health care unit. Amongst the nursing staff of the periphery the best knowledge was observed in staff posted at Community Health Centre and lowest in staff posted at PHC. In Medical College to our surprise nursing staff of surgery and obstetrics and gynae had superior knowledge as compared to Medicine ward. Conclusions: Training under RNTCP should be targeted not only towards nurses working in peripheral health units but also in nurses working in medical colleges.
Unmatched case control study on risk factors of defaulter among newly diagnosed TB patients on DOTS registered under RNTCP in Hooghly district, West Bengal, India
Authors: Mallick Arkajyoti , Haldar Santanu , Sarkar Soma , Kundu Santanu , Sinha Samik , Sadhukhan Sanjoy K.
Published: September 2017

Background: Tuberculosis is still a major public health problem in India and in addition to this, non-adherence to DOTS makes it more difficult to manage and increase risk of drug resistance. The objective was to study the factors associated with defaulter to DOTS among newly diagnosed TB patients treated under RNTCP registered in Hooghly district, West Bengal, India. Methods: A community based unmatched case control study was conducted with the help of predesigned pretested schedule among 99 defaulters and 103 non defaulters aged 15 years and above and registered between 1st April 2013 to 31st March 2014. Data was analyzed using SPSS software (version 20). Univariate analysis was done to find out the association of outcome with different variables under study. Variable with odd ratio 3 or more included in multivariate logistic regression model. Results: If patients were main earning member, smoker, lacking of perception regarding fatality of TB, having information source other than DOTS provider and sub center as treatment center, were found as significantly associated with defaulting in final multivariate regression model. Conclusions: An approach, towards modification of smoking behavior, adequate health education and information dissemination and qualitative improvement of treatment center including training of health staffs are essential for treatment adherence.
A cross sectional study on nutritional status and dental caries among rural preschool children of Sullia taluk, Karnataka
Authors: P. V. Dinesh , S. V. Bhargav , Kulkarni Annarao Gunderao
Published: September 2017

Background: A double burden of malnutrition in children, in the form of undernutrition and obesity exists in our world. Poverty and various other sociocultural factors act as important determinants of malnutrition. There exist varying prevalence rates in different places. Under nutrition has also a role in dental caries. The objective of this study was to find the prevalence of malnutrition and dental caries among children going to Anganwadi’s in rural Sullia taluk of Karnataka. Methods: Line listing of Anganwadi children was done and by random sampling method, 205 children were selected for study. Nutritional status was assessed by anthropometric measurements and dental examination done according to WHO standards. Results: The prevalence of underweight, wasting and stunting were 27%, 11% and 40% respectively. 49% of children studied had dental caries. Conclusions: According to the classification for assessing severity of malnutrition by prevalence ranges among children, the study area is classified as a high prevalence area for malnutrition according to WHO. Dental caries was present in 49.27% of the children.
Work or family…? Huge conflict in working population: a cross sectional study in a city in Karnataka
Authors: K. Ratnaprabha G. , P. Sindhu , Kumar Aswin , Kengnal Prakash R. , M. S. Ashok kumar
Published: September 2017

Background: Work and family are the most important responsibilities of an adult. The last two decades have been marked by striking changes in the world of work and nature of the family. Work schedules, work orientation, marriage, children and spouse employment patterns may all produce pressures to effectively exhibit ones work role or the family role, which are interdependent. The objectives of the study were to assess work family conflict (WFC) among the working population in a city in Karnataka, and its determinants.Methods: A community based cross sectional study was carried out during August-September 2015 among 400 adult working population of Davangere city, working in different sectors (hospitals, schools, colleges, banks and police department). A pretested structured self-administered questionnaire consisting of socio-demographic details, Carlson’s Work-Family Conflict Scale was used. Data was analyzed using SPSS 10 for frequencies, Chi square test, student’s T test and ANOVA. Results: Out of 400 study participants, 62% were men. Mean scores of work to family conflict was 27.28±5.68 and that of family to work conflict was 25.37±5.61. Time based work to family conflict was more compared to strain and behaviour based. Conflict scores were higher for females, >45 years age, employees who had children, especially child under 5 years of age. WFC was found to be highest among doctors, police and nurses. Conclusions: Work to family conflict was higher than family to work conflict, especially time based.
Compliance to antihypertensive medication: a cross-sectional study in Aligarh
Authors: Khwaja Mariyam , Ansari M. Athar , Mehnaz Saira
Published: September 2017

Background: Hypertension is a global public health issue. Hypertensive heart disease is one of the top ten leading causes of death in the world. It was responsible for an estimated 1.1 million deaths worldwide in 2012. To prevent some of the complications of hypertension regular intake of the prescribed treatment in the form of medicines (pills) is essential. Poor compliance to anti-hypertensive therapy is usually associated with bad outcome of the disease and wastage of limited health care resources. With these viewpoints the study aimed to assess the level of compliance of hypertensive patients to their anti-hypertensive medications and to determine the socio-demographic correlates of compliance. Methods: This was community based cross sectional study conducted in urban and rural areas in Aligarh. A total of 350 hypertensive patients were selected using simple random sampling. A pretested semi-structured questionnaire was used. Compliance was measured by Morisky 8-item Medication Adherence scale. Analysis was done using proportions and Chi-square test. Results: The overall compliance of study population was 23.7%. It was found to be significantly associated with gender, education, social class and associated co morbidities. Education, higher social class and duration of hypertension were found to be the main facilitators to adherence. The barriers to adherence were cost of drug and more number of pills per day. Conclusions: Patient education, family counselling and social support networks should be strengthened in health promotion programs in order to enhance compliance of hypertensive patients with the therapeutic regimen and to improve their quality of life.
Is problem based learning a better teaching tool as compared to didactic lectures for the undergraduate students?
Authors: Joshi Hari Shankar , Katyal Rashmi , Singh Arun , Joshi Gaurav , Chandra Shalini , Singh Kashmir
Published: September 2017

Background: PBL is an educational approach in which complex problems serve as the context and the stimulus for learning. In PBL classes, students work in teams to solve one or more complex and compelling "real world" problems. They develop skills in collecting, evaluating, and synthesizing resources as they first define and then propose a solution to a multi‑faceted problem. The objectives of the study were to acknowledge the students about problem based learning; to assess the effectiveness and outcome of the teaching methodologies i.e. didactic lectures versus PBL; recommendation of incorporation of PBL or traditional teaching method as a teaching tool. Methods: Medical undergraduate (UG) students admitted in RMCH, Bareilly, India. A total of 112 students divided into three batches (36, 33 and 33 students) participated in a systematically conducted PBL session in community Medicine department during the middle of their academic year after having experienced at least 4 months of traditional teaching in community medicine. Perception of the faculty was also taken on Likert’s scale. Responses to the items in the questionnaire was scored as follows: traditional much better (1), traditional better (2), both the same (3) PBL better (4), or PBL much better (5). Appropriate Statistical analysis using appropriate tests will be done.Results: Information gathering and student-teacher relationship is more through traditional method of teaching as compared to PBL which is more in favour of development of interest, motivation, learning efficiency, curiosity, questioning attitude, interpersonal relationship, independent thinking and reasoning.. Conclusions: It can be very well included that introduction of PBL as the teaching modality among the students can improve the quality of medical education as per the evaluation done through the introduction of Likert’scale.
A study of treatment compliance of dog bite cases reporting to anti-rabies clinic of M.K.C.G Medical College, Odisha, India
Authors: Jena Dhaneswari , Tripathy R. M. , Pradhan Srabani , Mahapatra Dillip Kumar
Published: September 2017

Background: Rabies a dreadful disease can easily be prevented by immediate wound care, vaccination and immunoglobin administration. Prognosis depends on the promptness of initiation, regularity and completion of treatment, determined by patient’s compliance. It partly depends on the patience and devotion of doctor for counselling the patient. The objectives of the study were to assess the treatment compliance of dog bite cases attending tertiary care centre for post exposure prophylaxis (PEP) of Rabies. Methods: It is a record based longitudinal study, conducted in Anti- Rabies Clinic of M.K.C.G Medical College from January 2016 to July 2016. Patients registered on first visit followed up to the 4th dose, the last cases registered on June 15th was followed up to July31st to declare it as completed, delayed or defaulted as decided. Results: Total 1658 cases were registered during the study period. Most of them were male (73.8%) and ≤20 yrs of age. 1222 cases (73.7%) completed treatment, out of which 793 cases completed on schedule and 429 cases delayed the doses. 436 (26.3%) cases had defaulted treatment i.e. missed one or more dose. Significant associations were found between treatment completion status and place of residence, education and age of the participants. Reporting within 1 day of the bite is associated with better compliance to PEP, showing their good health seeking behaviour. Completion rate was significantly higher in category III cases. Conclusions: Intensive counselling needs to be done on day 1 and day 7th day of vaccination.
Prevalence and risk factors of obesity among senior high school students in the Adansi North district of Ghana
Authors: Amoh Isaac , Appiah-Brempong Emmanuel
Published: September 2017

Background: Obesity is one of today's noticeable yet neglected public health problem with serious health consequences such as hypertension, type 2 diabetes that affect individuals of all ages globally. Adolescents are particularly prone to obesity owing to their reduction in physical activity. This study was to determine the prevalence and risk factors of obesity among Senior High School Students in the Adansi North District of Ghana. Methods: A descriptive cross- sectional survey was conducted among 306 adolescents aged 12- 19 years. The adolescents were recruited from the five senior high schools in the district using stratified random sampling technique. Data was collected by the use of structured questionnaire and anthropometric data sheet to calculate for BMI levels. STATA version 11.1, and Microsoft Excel was used to analyze the data collected. Results: Results from the chi-square test indicated that, there was a significant relationship between leisure activities and obesity such as playing computer games (x2=7.5086, df=9, p<0.05), and TV watching (x2=6.3576, df=2, p<0.05). A significant relationship was between food consumption pattern and obesity (x2=21.6181, df=9, p<0.05). Overall prevalence of obesity among the adolescents was found to be 47.06%. Conclusions: The study concludes that, the prevalence of obesity among the adolescents in the district is quite high compared to rates in some developed countries. There is the need to plan for the most efficient and effective interventions not only to ensure food security, but also maintain healthy lifestyles, so as to reduce the prevalence of obesity among the adolescents in the district and in Ghana as a whole.
Professional outcome of medical graduates: a 17 year cross-sectional study from India
Authors: Pandey Avinash , Mishra Richa , Markandeywar Neeraj
Published: September 2017

Background: In India, long term data regarding professional outcomes and geographical distribution of enrolled medical graduates is lacking. This adversely impacts policy for efficient healthcare delivery. Methods: A cross sectional survey of students enrolled as medical graduates in year 2001 was done at single point follow up after 17 years. Along with demographic data, gender, seat quota, post-graduate qualification, type of practice, discipline of choice and current geographic locations were collected. Logistical regression model with odds ratio was used to analyse association between variables. Results: 192/200 medical graduates were analysed. Male: female ratio was 119: 73. 109 (56%) had post-graduate degree, 35 (18%) had post-graduate diploma, while another 24 (12.8%) completed super-specialty degree.125 (65%) completed post-graduation in clinical disciplines. 103 (54%) are serving government institutes. 54 (28%) practice in metro cities, while 48 (25%) are in non-metro capital urban locations. Only 44 (23%) are serving rural Indian population, while 17 (9%) are at foreign countries. General medicine (12.5%), obstetrics (8%), paediatrics (8%) anaesthesia (7%) and general surgery (6.7%) were the most common broad clinical specialities. Females had high likelihood to pursue obstetrics/ gynaecology {OR-11.4 (95%CI-2.6-48.7)}; while males were more likely to select medical {OR-0.54 (95% CI-0.25-1.0)} and surgical disciplines {OR- 0.42 (95% CI-0.18-0.98)}. Conclusions: Majority of medical graduates complete post-graduation courses, with preference for clinical disciplines. Less than one fourth of doctors serve rural population.
Pattern of current tobacco use in a rural block of North India
Authors: Jangra Anuj , Malik J. S. , Singh Srishti , Sharma Nitika
Published: September 2017

Background: Tobacco is the only legal drug that kills many of its users when used exactly as intended by manufacturers. WHO has estimated that tobacco use (smoking and smokeless) is currently responsible for the death of about six million people across the world each year. Although often associated with ill-health, disability and death from non-communicable chronic diseases, tobacco smoking is also associated with an increased risk of death from communicable diseases. This study was conducted with aim to observe the current pattern of tobacco use in a rural block of north India. Methods: The study was conducted in Lakhanmajra block (rural) of Haryana, India, in year 2015-2016 among 1000 study subjects aged 15-64 years selected by systematic random sampling technique. Results: The overall prevalence of current tobacco-smoking use to be 12.8% and it was higher among males (11.2%) as compared to females (3.2%). The median age for initiation of smoking tobacco was 18 years, smokeless tobacco was 20 years. Conclusions: Our study stresses is the need to have rural orientation in the National Tobacco Control Programme since the poorly educated individuals living in rural areas are at the maximum risk of using tobacco, identifying ways and means of reaching out to these communities will be critical to the success or failure of the program.
A study of self medication among the adult people of the Nanded city, western India
Authors: Gadekar Rambhau Dhondibarao , Gattani Prakash Laxminarayan , Dhande Vishal Samadhan
Published: September 2017

Background: Modern medicines are of prime importance to human being and are potentially hazardous when taken indiscriminately in the form of self medication. The main objective was to study the practice of self medication and the common ailments, drugs used, sources of information and the reasons for it.Methods: A community based cross sectional study was carried out on 300 urban adults. From the four zone of Nanded city, one zone was selected by lottery method and from that zone one pharmacy (medical) shop was selected randomly for data collection. Adult people who bought medicines from the selected shop without any prescription were interviewed for information regarding sociodemographic factors like age, sex, residence, education, occupation etc and information about over the counter drug such as which drug they purchased, what was the main symptom of their illness, reasons for not consulting doctor, sources of information about over the counter drug etc. were collected on predesigned and pretested semi structured proforma.Results: Out of 300 study subjects 78.3% were males and 21.7% were females. Maximum study subjects, 39.0% were from 30-39 years of age group and 23% study subjects were educated up to secondary school level. Most common symptom was fever (21%) followed by headache (15%). The commonest category of drug used for self medication was analgesic drugs (27%) and majority of study subjects said pharmacist was the main source of information about OTC drugs (48.7%). 45% study subject stated that reason for self medication was high consultation fees of private doctors.Conclusions: Active age group male members in the family were more involved in self medication and high consultation fees of private doctors was the main reason for not consulting the doctor and practicing self medication.
Road traffic accident victims socio-demographic profiles: a community based study in Central India
Authors: Gharde Pramita Muntode , Quazi Syyed Zahiruddin , Wagh Vasant V.
Published: September 2017

Background: A road traffic injury is any injury caused due to crashes originating, terminating or involving a vehicle partially or fully on a public highway.The road crashes are unlike communicable diseases where the role of agent, host and environment is more defined. The aim and objective was to study of the socio-demographic profile of victims of road traffic accidents.Methods: A community based cross-sectional study was conducted from November 2010 to September 2012 in 3 blocks of Wardha district, in Central India. The sample size was estimated using purposive sampling technique. The data was analyzed using EPI-Info version 3.5.4. Results: Out of 385 study subjects, maximum victims were in 30-60 years age group, 320 were males and 16.88% i.e. 65 were females. The total numbers of literate victims were 94.80%. Maximum accidents were seen in victims who were employed in service 151 (39.22%), followed by self employed 27%. Conclusions: Maximum victims were in 30-60 years age group which is the productive age group and male dominance was also observed which means loss of work days leading to loss of wages and loss of family income hence directly affecting the family economy.
Knowledge, attitude and practice of infection control methods among health care workers
Authors: Devaliya Jaydeep J. , Damor Raman D. , Chawada Bansari L.
Published: September 2017

Background: Disposal of biomedical waste is neglected issue even in the urban heath care settings. So chances of transmission of infection increase which leads to high morbidity and mortality. Spread of disease can also be controlled by establishing isolation ward and it can be monitored through Hospital Infection Control Committee. Methods: This is a cross sectional study conducted in urban and rural health care settings of Ahmedabad district to assess the knowledge, attitude and practice of health care workers. In the present study 300 HCWs including Doctors, Nurses, Technicians and Servants were interviewed. Pre-tested questionnaire was used to collect the data regarding knowledge of infection control methods and various waste disposal practices. Results: Only 51% of health care workers were aware about the Isolation ward and 60% of HCWs were aware about hospital infection control committee. 87% nurses were correctly disposing gloves in urban health care settings. All the HCWs were using disposable syringe. Even in urban settings also 33% of doctors and 20% of nurses were recapping needle after using it. Conclusions: Constant reinforcement of knowledge should be done and regular training should be given to change the behavior regarding biomedical waste disposal.
A study to assess the utilization of health care services among fishermen communities in urban slums of Visakhapatnam city: a cross sectional study
Authors: Ramana B. V. , Gayatri Dasari , Radha Kumari P.
Published: September 2017

Background: In spite of an extensive primary health care system exists in India, yet it is inadequate in terms of coverage of the population, especially in rural areas and urban slums, and gross underutilization. Assessment of the utilization of health services is important for the health of a nation. Methods: A cross sectional study was conducted during October 2012- September 2013 among 215 families residing in Kotha Jalaripeta fishermen community of urban slums of Visakhapatnam city. A semi-structured questionnaire was used to collect data and was analyzed using SPSS 20 and valid inferences were drawn. Results: Majority (60.9%) of the slum dwellers preferred Government hospitals for adult health problems and (56.3%) for child health problems. Majority (82.4%) of them utilized Government Hospitals for maternal health services and (73.5%) for Inpatient care. Majority (80.9%) of them preferred Anganwadi centers for immunization services. Antenatal care utilization by slum women was found satisfactory. Conclusions: This study revealed a relatively higher utilization of government health services for different health problems when compared to the other studies regarding various aspects and dimensions of health services. But still health problems exist to a great extent and there is an urgent need to improve health services in urban slums.
Analysis of the profile of blood donors in a blood bank of a private medical college of Kolkata
Authors: Haldar Debdutta , Majumdar Kunal Kanti , Karir Shilpa , Chakraborty Arun Kumar , Dey Ankita , Mandal Asok Kumar
Published: September 2017

Background: Blood is the only oxygen transporter in the body and is crucial in saving lives. Research has failed to find a true substitute for blood and blood components and depends on human donors. There are several infectious and non-infectious risks associated with transfusion. An unsafe transfusion is very costly from both human and economic points of view. In that perspective the present study is aimed to assess the profile of blood donors. The objectives of the study were to assess the profile of blood donors as per records of Blood Bank of a private medical college of Kolkata and to find out the prevalence and trends of transfusion transmitted infections among those donors.Methods: A record based cross sectional study was conducted for the period May 2013 to April 2016 at Blood Bank of a private medical college and information regarding 5383 blood donor’s profile were collected and analysed. Results: The total donors were found to be 5383 out of which (87.72%) were voluntary donors and (12.28%) replacement donors. The donors had a male predominance (79.84%). The most available blood group was B+ (49.42%) and the least available blood group was A- (0.38%). The commonest transfusion transmitted infection was Hepatitis B (1.11%) followed by Hepatitis C (0.28%) and HIV (0.21%). The transfusion transmitted infections (TTI) shows a decreasing trend over the 3 years. Conclusions: The voluntary donors have increased over the 3 years but there is always a male predominance. The pattern of TTIs in the blood bank depicts the national trend too.
Study on self care and adherence to therapy among diabetic patients at a tertiary care center in Mysore
Authors: Majgi Sumanth Mallikarjuna , Anitha Sreekumar Aiswarya Lakshmi , Balagopal Aparna , S. Nivedha
Published: September 2017

Background: Adherence to lifestyle modification and self-care are vital elements in the management of diabetes mellitus and the reason for poor adherence and poor self-care could vary from person to person. The study aimed to assess the level of adherence to therapy, the self-care practices and the barriers preventing adherence among diabetic patients attending a tertiary care hospital in Mysore. Methods: A mixed methods study was conducted among an estimated sample of 150 patients attending a tertiary care teaching hospital in Mysore, Karnataka. Diabetes self-care activities was assessed using modified Summary of Diabetes Self-Care Activities (SDSCA) questionnaire. An in depth interview was conducted for 20 subjects for understanding the factors contributing to their level of adherence / non-adherence. The quantitative data was analysed with standard statistical methods and qualitative data through content analysis. Results: The adherence to the drugs was found to be 86.6%.The median number of days during which target diet plan was achieved, at least 30 minutes of physical activity undertaken and foot care was 5.5 and 0 respectively. Lack of awareness and socioeconomic barriers were cited by the patients as the barriers preventing adherence to drug therapy, diet and exercise. Conclusions: Lack of awareness of the disease and cost of the pharmacological therapy are potentially modifiable reasons of poor adherence. Health education is to be provided by the healthcare providers focusing on the importance of adherence to drugs, diet and exercise.
Study on urinary tract infection among females of reproductive age group in a rural area of Kancheepuram district, Tamil Nadu
Authors: M. Muthulakshmi , S. Gopalakrishnan
Published: September 2017

Background: Urinary tract infection (UTI) is defined as the presence of microbial pathogens in the urinary tract and women of the reproductive age group (15-44 years) are the most vulnerable population. UTIs are one of the most common bacterial infections seen in primary care. This study aims to estimate the prevalence rate of UTI among females of reproductive age group and to determine the association between socio demographic factors and prevalence of UTI.Methods: This is a cross sectional descriptive study carried out in the rural field practice area attached to a Medical college in Kancheepuram district. The study group were 250 women of reproductive age group (15-44 years). The data was collected using a structured interview schedule followed by collection of urine for microscopic examination and culture. Data was analysed using SPSS 15 software. Prevalence of UTI was calculated using percentages and strength of association was tested between socio-demographic characteristics and prevalence of UTI.Results: Prevalence of UTI among females of reproductive age group was found to be 20.4%. There was a strong statistical significant association between levels of education of the study subjects (Odds Ratio 18.11, p value <0.05), the socio economic status (Odds ratio 6.36, p value <0.05) and UTI.Conclusions: UTI is a serious public health problem if untreated. Early diagnosis and prompt treatment will prevent the chances of developing further complication of UTI and will help to reduce the sufferings of the patient, hospital stay and economic loss.
Therapeutic interventions in vertigo management
Authors: Kameshwaran Mohan , Sarda Kushal
Published: September 2017

Vertigo is a condition associated with a spectrum of symptoms and ~30% of general population experience vertigo in their life time. In spite of being of high clinical importance, the management of vertigo is quite challenging. Though the literature supports the availability of various therapeutic interventions used in vertigo treatment, their effectiveness depends on accurate diagnosis, appropriate use of intervention, and physician’s awareness of the overlap between vestibular, autonomic, and psychological aspects of vestibular pathology. Unfortunately, several drugs act as tranquilizers and impede the process of vestibular compensation. Betahistine, a histamine analogue, is one of the most commonly used anti-vertigo drugs worldwide and has been supported by many clinical trials. There have been several oral communications in international conferences on the efficacy of using betahistine in several clinical vertiginous syndromes. The current review assesses the use of betahistine 48 mg twice daily for three months as an efficient and well-tolerated treatment for vertigo. Additionally, it highlights the low incidence of side effects even at high doses of betahistine and suggests that it may be considered as the first-line of treatment for vestibular dysfunction.
Perceptive analysis of nasal surgery outcomes for headache
Authors: C. Sreenivas , Awasthi Sanjeev Kumar
Published: September 2017

Background: Headache is the most common symptom requiring visit to a medical practitioner, sinus headache is one of the sub types of headache. Sinus related headaches are curable by surgical methods with a view to restore the functions of the maxilla-ethmo-turbinal ventilation. In this background we conducted a prospective study to investigate the perceptive relief of symptom of proven rhinosinugenic headache in patients undergoing functional endoscopic sinus surgery with septoplasty.

Methods: Prospective study, done at a command hospital, Bangalore, a tertiary PG Teaching Hospital during 2010-2011. Even though 200 patients enrolled for the study, only 98 subjects could be assessed at the end of 1 year duration. A patient centric subjective perceptional questionnaire was given preoperatively and then postoperatively on definitive intervals and the patient’s subjective score was tabulated.  

Results: Rhinosinugenic headache is common amongst 36.73% of the population in the age group of 20 to 30 years age group, followed by 25.5% in the 41 to 50 years age group. Gender distribution- 56% of females in the age group of 31 to 50 years are suffering from headache, and 28% of women in the age group of 31 to 40 years. The most common endoscopic findings were bulla ethmoidalis with a prevalence of 37.75%, followed by middle turbinate anomalies of 31.63%.

Conclusions: Endoscopy could not pick up any finding in 8.16% of the study group which was picked up by the non-contrast computerized tomography, perceptive analysis– there was an overall improvement of patient centric headache symptom alleviation of 98% after FESS with septoplasty.