Browsing by Author "Sharma, N."

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    Assessment of knowledge Vis-à-vis Food Labels
    (Department of Community Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi- 221005, India., 2022-09) Sharma, N.; Bahurupi, Y.; Singh, M.; Singh, A.; Aggarwal, P.
    Background: Public health initiatives focused on improving food at the community level to reduce the risk of nutritionrelated disorders have gained pace in light of the enormous illness burden associated with chronic diseases connected to nutrition. Delivering straightforward, pertinent, and understandable information regarding the nutritional value of food is the goal of Front of Package Labelling (FoPLs), which are intended to assist consumers in choosing healthier foods at the point of purchase. Methodology: It was a cross-sectional study carried out online through a series of webinars using an online survey platform and a feedback-designed questionnaire to ascertain webinar participants' knowledge of front of package labeling. Results: Among the participants, only 75.4% correctly identified the characteristics of packaged foods that increase the risk of obesity. Also, it was found that 84.7% of the participants knew that food labels had to display complete nutritional information. About 93.6 percent of the individuals were aware of public health initiatives that raise awareness of FOPL. Only 38.9% of the individuals were aware that certain food products were free from labelling, in comparison. Conclusion: Front of package labelling (FOPL) regulation goals must be adopted in order to enable consumers to simply, quickly, and accurately identify items containing extra sugars, trans-fats, oils, and sodium. This will help the Government of India comply with WHO recommendations on unhealthy foods.
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    Comparison of exponential smoothing and ARIMA time series models for forecasting COVID-19 cases: a secondary data analysis
    (Medip Academy, 2023-05) Bahuguna, Abhinav; Uniyal, A.; Sharma, N.; Semwal, J.
    Background: In order to manage outbreaks and plan resources, health systems must be capable of accurately projecting COVID-19 case patterns. Health systems can effectively predict future illness patterns by using mathematical and statistical modelling of infectious diseases. Different methods have been used with comparatively good accuracy for various prediction goals in medical sciences. Some illustrations are provided by statistical techniques intended to forecast epidemic cases. In order to increase healthcare systems readiness, this study aimed to identify the most accurate models for COVID-19 with a high global prevalence of positive cases. Methods: Exponential smoothing model and ARIMA were employed on time series datasets to forecast confirmed cases in upcoming months and hence the effectiveness of these predictive models were compared on the basis of performance measures. Results: It was seen that the ARIMA (0,0,2) model is best fitted with smaller values of performance measures (RMSE=4.46 and MAE=2.86) while employed on the recent dataset for short duration. Holt-Winters Exponential smoothing model was found to be more accurate to deal with a longer period of time series based data. Conclusions: The study revealed that working with recent dataset is more accurate to forecast the number of confirmed cases as compared to the data collected for longer period. The early-stage warnings through these predictive models would be beneficial for governments and health professionals to be prepared with the strategies at different levels for public health prevention.
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    Comparison of exponential smoothing and ARIMA time series models for forecasting COVID-19 cases: a secondary data analysis
    (Medip Academy, 2023-05) Bahuguna, Abhinav; Uniyal, A.; Sharma, N.; Semwal, J.
    Background: In order to manage outbreaks and plan resources, health systems must be capable of accurately projecting COVID-19 case patterns. Health systems can effectively predict future illness patterns by using mathematical and statistical modelling of infectious diseases. Different methods have been used with comparatively good accuracy for various prediction goals in medical sciences. Some illustrations are provided by statistical techniques intended to forecast epidemic cases. In order to increase healthcare systems readiness, this study aimed to identify the most accurate models for COVID-19 with a high global prevalence of positive cases. Methods: Exponential smoothing model and ARIMA were employed on time series datasets to forecast confirmed cases in upcoming months and hence the effectiveness of these predictive models were compared on the basis of performance measures. Results: It was seen that the ARIMA (0,0,2) model is best fitted with smaller values of performance measures (RMSE=4.46 and MAE=2.86) while employed on the recent dataset for short duration. Holt-Winters Exponential smoothing model was found to be more accurate to deal with a longer period of time series based data. Conclusions: The study revealed that working with recent dataset is more accurate to forecast the number of confirmed cases as compared to the data collected for longer period. The early-stage warnings through these predictive models would be beneficial for governments and health professionals to be prepared with the strategies at different levels for public health prevention.
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    Effect of COVID-19 on Menstruation: An Observational Study
    (MRI Publication Pvt. Ltd., 2023-06) Singh, M; Kaur, M; Verma, A; Sharma, N.
    Introduction: COVID-19 patients have been reported to have systemic complications. Analyzing its effect on the endocrine system is essential to ensure women’s reproductive health. Aim: This study aimed to determine the effect of COVID-19 disease on menstruation. Methods: It was a hospital-based cross-sectional study conducted from October 2021 to April 2022, using a validated questionnaire to collect the data. The study included females (15 to 49 years) who had confirmed COVID infection. Results: A total of 132 females participated in the study. For 29 (22%) patients presenting with menstrual cycle changes, most common change was prolonged cycle (14%). An increase in menstrual volume was reported by 12%, where as 35% of patients experienced more pain during menstruation. Menstrual irregularities were significantly higher in severe infection (p-value 0.04). Conclusion: There were transient changes in menstruation in COVID-19-infected patients, with a higher probability of menstruation abnormalities among severely infected patients.
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    Mortality due to ectopic pregnancy revealed by police surgeon
    (Medip Academy, 2023-12) Sharma, N.; Yadav, N.
    A pregnancy is said to be ectopic when implantation of fertilized ovum occurs other than uterine cavity. The incidence of ectopic pregnancy is increasing globally over time and carries significant maternal mortality due to the risk of rupture of ectopic pregnancy. Ruptured ectopic pregnancy is a life threatening surgical emergency. Usually, any abnormality in tubal morphology or function may lead to tubal ectopic pregnancy. Also an altered hormonal ratio (i.e. estrogen/progesterone) may affect tubal motility and cause ectopic pregnancy. To make diagnosis of ectopic pregnancy merely on the basis of symptoms is difficult and challenging task for clinician due to its non-specific clinical manifestations and such cases can be present with normal intrauterine pregnancy. Authors report a case of ruptured tubal ectopic pregnancy which remained undiagnosed clinically because clinician refer the patient to higher center for ultrasonography to confirm or rule out the ectopic pregnancy as there was non-availability of bed side ultrasonography machines in rural health care centers in developing countries like our country. but patient died in ambulance before reaching to higher center. The autopsy revealed 1.5-liter fluid and clotted blood in the peritoneal cavity. The right fallopian tube was bulged along with a tear evident on the anterior and superior aspect. Complete dissection revealed a gestational sac of diameter 7.5 cm containing a foetus and placenta. All other organs were pale and normal. The uterine cavity was found empty. The cause of death was attributed to ruptured ectopic pregnancy. This case emphasizes the fact that “health for all” and importance of the availability of various radiological investigations including ultrasonography, prompt diagnosis, laparoscopic management are the minimal demand of rural health care centers which play a major role in saving of life. Furthermore, this report envisions benefitting clinicians and autopsy surgeons facing similar cases in their practice. Finally, this case is another addition in maternal mortality data.
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    Post-valuation quality check of multiple-choice questions
    (Medip Academy, 2023-02) Jaiswal, K. M.; Dudhgaonkar, S.; Gharade, P.; Sharma, N.
    Background: Multiple choice questions find important place in assessment in medical curriculum. Each MCQ is called item. Item analysis is quality check of MCQs after valuation of response sheets. This serves to recognize flaws in MCQs so that the given questions can be preserved in question bank, modified or deleted., , Methods: 140 medical students of second MBBS were assessed pharmacology through 20 single best response type MCQ. Post exam validation of MCQs was done by item analysis. Each item was analyzed for level of difficulty, ability of the question to discriminate between poor and good performing students and distracter effectiveness., , Results: Score ‘1’ was given for correct and ‘0’ for incorrect or no response. The mean score of the test was found to be 10.58±2.48, with a range 5-18. The whole test had an acceptable difficulty level with 43.25±17.81 mean difficulty index. The discrimination index of the whole test was found to be 0.123±0.184 mean PBI correlation coefficient, which is not satisfactory. Out of 60 distractors, 51 were found to be functional, hence distractor efficiency of the given test was 85%±19.96% which is acceptable., , Conclusions: 60% questions were found to be ideal and 25% were acceptable with revision of stem or options. One question was easy with poor discrimination which needs major modification in construct or subject to be placed in question bank while another one question was difficult but had negative biserial index which needs to be deleted from the question bank.
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    Practices and challenges in implementing tuberculosis program at medical colleges in Karnataka, India
    (Medip Academy, 2023-11) D. Hiremath, L.; Sharma, N.; D., S.; Shivaramakrishna, H. R.; Warbhe, N.; Lonimath, A.; Burugina Nagaraja, S.
    Background: The study aimed to evaluate the implementation status of the National Tuberculosis Elimination Program (NTEP) at medical colleges in Karnataka, India, and identify the challenges encountered by the medical college core committee members. Methods: A cross-sectional study was conducted among 14 medical colleges in 2019-20, using a pre-tested, semi-structured questionnaire to collect data on various NTEP components. Results: The implementation status of NTEP activities was categorized as adequate, partially adequate, or inadequate. Results showed that certain activities such as TB notification, DMC infrastructure, TB-HIV coordination, and the formation of the NTEP core committee were adequately implemented. However, challenges such as work overload, lack of dedicated manpower, and salary constraints were encountered. Conclusions: Overall, the medical colleges involved in the study were actively implementing NTEP, but there is still room for improvement to fully optimize the implementation.
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    Prevalence and socio-demographic and obstetric factors for anaemia among pregnant women in second and third trimester in a tertiary hospital of Delhi
    (Medip Academy, 2024-05) Sharma, N.; Kishore, J.; Gupta, M.; Singla, H.; Dayma, R.; Sharma, J. B.
    Background: Anaemia during pregnancy continues to be a major public health problem especially in developing nations like India. The study was performed to assess the prevalence and severity of anaemia and the associated socio-demographic and obstetric factors during pregnancy in a tertiary referral hospital of Delhi, India. Method: This cross sectional study was carried out on 430 pregnant women in second and third trimester of pregnancy using systematic random sampling attending antenatal clinic of Vardhman Mahavir Medical College and Safdarjung Hospital of Delhi. A predesigned and structured questionnaire proforma was used to collect information regarding socio-demographic and obstetric factors. Haemoglobin levels were estimated using Hemocue method. Statistical analysis was carried out using STATA version 18.0 statistical software. Results: The overall prevalence of anaemia during pregnancy was 48.84% with 25.81% mild anaemia, 15.81% moderate anaemia, 6.98% severe anaemia and 0.24% very severe anaemia. Anaemia was found to be more common in younger women (<25 years) and in joint family. Anaemia was more commonly seen in low socio-economic status, low family income and in illiterate and primary education. Anaemia especially severe anaemia was more common in third gravidas and above. Anaemia was more common with advancing gestation. Anaemia was more common with no or irregular antenatal care and with no or single tetanus toxoid injection. Conclusions: The prevalence of anaemia is high in Delhi. Regular and timely antenatal care, improving socio-economic status and having lesser children can reduce prevalence of anaemia during pregnancy.
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    Prevalence of mastitis in cow heifers and associated risk factors in Himalayan region, India
    (Triveni Enterprises, 2020-07) Kour, S.; Sharma, N.; Huma, Z.I.; Devi, S.; Ahmed, T.; Singh, R.; Kumar, A.
    Aim: The present study was aimed to understand the prevalence of heifer mastitis and its associated risk factors in Jammu region.Methodology: A total of 250 pregnant heifers (1000 quarters) were screened, and lacteal secretions were collected from 915 quarters individually, in order to estimate the prevalence of heifers mastitis by culturing. The prevalence was estimated based on the results of microorganism culture. Results: The overall prevalence of heifer mastitis was 90.80% by cultural examination whereas only 30% of the animals produced clinical signs. The prevalence was higher in organized management system and prime risk factors associated with mastitis were season of calving, prepartum intra-mammary infections, poor udder hygiene, etc., in both organized and unorganized managements. Interpretation: High pre-valence of heifer mastitis (as evidenced by presence of microorganisms) is alarming situation for dairy farming in India. Season of calving, milk leakage at calving, prepartum IMI, poor udder hygiene, sanitation, beddings, floor type, and contact of heifers with older cows could be the important risk factors.
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    Study of anaemia in type 2 diabetes mellitus and its correlation with albuminuria and eGFR
    (Medip Academy, 2023-08) Sharma, N.; Rawat, S.; Marwah, S.; Verma, V.
    Background: Diabetes mellitus (DM) is a common metabolic disease. Anaemia is a common accompaniment to diabetes, particularly in patients with albuminuria or reduced renal function. Anaemia is more frequent and more severe at any level of glomerular filtration rate (GFR) in diabetics compared to nondiabetic patients. Methods: One hundred patients with type 2 diabetes mellitus were included in the study. Complete blood count, serum iron profile, ferritin, vitamin B12 and folate, kidney function tests and urine albumin creatinine ratio were assessed for these patients. Estimated glomerular filtration rate (eGFR) was calculated with MDRD-4 variable formula. Results: Fifty-four patients (54%) were found to be anaemic. Serum ferritin <50 µg/l was taken as cut off for defining iron deficiency anaemia. 21 patients had iron deficiency anaemia (IDA) and 33 had anaemia of chronic disease (ACD). Serum vitamin B12 and folate levels were within normal limits in all the patients. There was a rise in the prevalence of anaemia from 25.9% in patients with a normal ACR to 59.2% in those with microalbuminuria and to 75% in macroalbuminuria. Conclusions: Any degree of renal impairment and albuminuria are the risk factors for anaemia in these patients. Hence screening, characterization and treatment of aneamia in type 2 DM may be helpful in management of these patients.
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    Study to determine the prevalence of urinary tract infection and to identify the causative organism and their antibiotic sensitivity pattern in severe acute malnourished children
    (Educational Society for Excellence, 2017) Sharma, IK; Garg, KK; Saxena, D; Sharma, N.
    Background: Malnutrition generally implies under-nutrition and refers to all deviations from adequate and optimal nutritional status in infants, children and in adults. In children, under-nutrition manifests as underweight and stunting (short stature), while severely undernourished children present with the symptoms and signs that characterize conditions known as kwashiorkor, marasmus or marasmic-kwashiorkor. Materials and methods: The present study was carried out in the department of pediatrics and microbiology at UP Rural Institute of Medical Sciences and Research, Saifai, Etawah (U.P) during April 2014 to March 2015. Total 85 children were included in study. Results: Although under reported UTI is common in children with SAM as came out in our study. Prevalence of UTI is common (22.4%) in children with SAM in our study. In our study, Urinary tract infection was more common in females than males in SAM children with maximum prevalence among 37-59 months of age .but there is no significant difference between sex. Sharma IK, Garg KK, Saxena D, Sharma N. Study to determine the prevalence of urinary tract infection and to identify the causative organism and their antibiotic sensitivity pattern in severe acute malnourished children. IAIM, 2017; 4(7): 89-104. Page 90 Conclusion: Most sensitive first line oral Antibiotic was Nitrofurantoin and parentral antibiotic was Amikacin for UTI in children with SAM, in our study.
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    To boost or not? Serum anti-COVID IgG in double vaccinated MBBS students: a cross-sectional study
    (Medip Academy, 2024-08) Sharma, N.; Jain, P.
    Background: Aim of the study was to estimate the prevalence of sero-positivity i.e. serum anti-covid IgG >1.4 AU/ml in MBBS students of our Institute. Methods: This study was carried out on 75 MBBS students of our institute (10% of 750 MBBS students of Amaltas institute of Medical Sciences Dewas M.P. India) during period of August 2022 to November 2022. All serum anti-covid IgG titres above 1.4 AU/ml were considered sero-positive and the prevalence of sero-positivity was calculated. MBBS students were asked to fill out a questionnaire regarding their clinical history of testing positive for covid, exposure to COVID-19 patients, their covid appropriate behavior, etc. After obtaining informed consent, 4 ml venous blood samples were collected for determining serum anti-covid IgG titre on Chemiluminescence analyzer. 75 MBBS students divided into 2 groups � those who completed between 6-9 months and those who have completed more than 9 months after the 2nd dose of vaccine. The mean serum anti-covid IgG titre was compared. Results: The prevalence of sero-positivity was 94.66% calculated in MBBS students of our institute. The total antibody sero-positivity was higher in males (98.11%) than in females (86.36). The duration after 2nd dose of vaccine; over the time 6-9 months serum anti-covid IgG titre significantly high but after more than 9 months serum anti covid IgG titre significantly decline (p<0.001) and significant correlation was found between duration after 2nd dose of vaccine and serum anti-covid IgG titres (p<0.001). Conclusions: This study; strongly recommended the need for booster doses for long-duration protection against COVID-19 re-infection and its emerging new variants.