International Journal of Medical Science and Public Health
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Editor: Dr. Jay Charan
ISSN: 2320–4664 (Print)
Frequency: 3 issues a year
Language: English
Open Access Peer-reviewed journal
Web site: https://www.ijmsph.com/
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Item Delayed onset renal failure following multiple bee stings.(2012-01) Patra, Pratap; Nayak, UmaBee sting is an uncommon pediatric emergency encountered worldwide and capable of causing acute renal failure, multiorgan dysfunction and occasionally death. We had a two year male child who suffered from multiple bee stings and delayed onset acute renal failure, survived following peritoneal dialysis.Item Item Why one more journal.(2012-01) Pandya, H P; Bhaumik, SoumyadeepItem Prevalence of overweight and obesity in affluent adolescent girls in Surat city, western India.(2012-01) Kumar, Nagendra; Goyal, Jagdish; Parmar, Indira; Shah, VijayBackground: Incidence of obesity is increasing day by day because of various factors. It is important to assess the trend of obesity in particular geographical area. Objective: To assess the prevalence of obesity and overweight in affluent schoolgirls aged 13 to 15 years in Surat, India. Methods: This cross-sectional study was conducted from July 2009 to April 2010. From a list of all private schools in Surat, with tuition fees more than Rs. 2,000 per monyh, two schools were selected randomly using a random table. Height and weight was measured and BMI was calculated. Overweight and obesity was assessed by BMI for age. Student who had BMI for age>85th and < 95th percentile of reference population were classified as overweight and BMI for age>95th percentile of reference population were classified as obese (IAP Growth Monitoring Guidelines for Children from Birth to 18 Year). Results: Prevalence of obesity and overweight amongst the study subjects was 6.6% and 13.5% respectively. Conclusion: There is significant prevalence of obesity in affluent schoolgirls in Surat, India.Item Sample size in clinical research, the number we need.(2012-01) Patra, PratapIn the era of evidence based medicine where we should base our clinical practice on the available evidence of growing medical literatures, large number of available published literatures do not have enough sample size to detect their desirable primary or secondary outcome. It is surprised that even in journal with high impact factors the sample size calculation is still inadequate, often erroneous and based on assumption which are inaccurate. Sample size calculation is always a difficult issue, which should be address diligently before commencement of the study. The objective of the current narrative review is to illustrate the methodology of sample size calculation for comparative and descriptive research, which will be most useful for the beginners.Item Beware – statistics may deceive you.(2012-01) Charan, JaykaranStatistics is a tool by which a researcher analyzes the data in his research. Sometimes statistics tend to be manipulated to get desired results. This article explains some methods researchers use to get results they desire, why these methods are incorrect and how they can be taken care of. Readers should be aware of these tricks and watch out for such instances of manipulation when analyzing a research paper.Item Red cell distribution width and high sensitivity C-reactive protein as risk markers in hypertension.(2012-07) Jithesh, T K; Mathew, Riju; Jayapal, V; Vijayakumar, TBackground: Even though red cell distribution width (RDW) and C reactive protein (CRP) are considered as markers of inflammation and cardiac injury studies on the diagnostic and/or prognostic applications of these parameters as renal markers in hypertension (HT) are scanty. Objective: To evaluate the association, if any, between RDW and high sensitive CRP (hs-CRP) with renal complication in HT. Materials and Methods: One hundred and twenty patients with clinically proved hypertension under treatment formed the test group and 60 age and sex matched healthy adults formed the control group. . Blood collected in EDTA was used for complete blood cell count (CBC). Serum was separated immediately after clotting and is used for the estimation of hs-CRP by particle enhanced immunonephelometry. Results: A significant elevation in hs-CRP was observed in both the male and female patients with HT compared to the control group. In the case of RDW even though the values were higher in the test group than control, the elevation was significant only in the male test subjects indicating they are at a higher risk than the females. Conclusion: The elevation of hs-CRP and RDW in the test group suggest that inflammation may be one of the cause or effect of hypertension. Long term inflammation may lead to chronic kidney disease and cardiovascular disease hence monitoring of these markers may be of use in predicting the outcome of hypertension.Item Efficacy of using who steps approach to identify “at risk” subjects for diet related non communicable diseases.(2012-07) Mehan, Meenakshi; Bhalla, Ruchika; Kohli, Chhavi; Kantharia, NehaObjective: The efficacy of using non invasive method of WHO’s STEP approach as compared to traditional biochemical assessment to identify “at risk” subjects (having constellation of ≥3 risk factors) was determined in productive industrial population. Materials and Methods: Information on the presence of metabolic risk factors in the employee’s was collected from the existing medical records and subjects with ≥3 risk factors by using NCEP ATP III definition of Metabolic Syndrome were identified. The behavioral and physical measurements of the identified metabolic syndrome subjects was done using pre tested and adapted WHO STEPS Questionnaire. Results: Out of 1059 employees, 251 employees (23.5%) were identified at risk through medical records. The most common (37.85%) combination prevalent was hypertension, obesity with dyslipidemia. The leading risk factors in them were overweight and obesity (89.54%), followed by low intake of fruits and vegetables (79.74%), high waist circumference (73.20%) and Physical inactivity (52.29%). The prevalence of hypertension was 46.41 % and pre hypertension was 57.52%. Tobacco usage in any form and alcohol consumption was 33.33% and 25.49% respectively. Conclusion: By non invasive STEPS methodology, 87.58% of the metabolic syndrome subjects were identified “at risk subjects”. Thus, it can be inferred that in place of routine biochemical assessment of the entire population, WHO STEPS methodology could be used for the identification of “at risk” subjects. This measure will also reduce the biochemical assessment costs. STEPS approach could thus be recommended to industries as an occupational safety measure to identify at risk subjects for diet related non communicable diseases.Item Need of medicines information OPD in tertiary health care settings: A cross sectional study .(2012-07) Giri, Kiran R; Pathak, Swanand; Giri, Reena R; Palandurkar, Kamlesh; Totade, Sangita; Jha, Rajesh; Patel, S SBackground: Population burden, illiteracy, availability of few doctors for larger group of population all these leads to many unanswered questions left in a patient’s mind. Incomplete information results into noncompliance, therapeutic failure, and adverse drug reactions (ADR). It is very important to establish a system which will provide noncommercial, independent, unbiased source of medicine information. Medicines Info OPD is a concept and step towards safe and appropriate use of medicines. Objective: (1) To assess the present status of knowledge about the medicines in the patients and its correlation with education. (2) To assess the medicine information dispensing modalities, their use and sufficiency from the patients view point. (3) To assess the overall need for Medicines Information OPD in present scenario. Materials and Methods: A pre-validated questionnaire based study was conducted amongst 500 patients of tertiary health care hospital. The questionnaire consisted of specific questions regarding understanding of prescription, knowledge about adverse drug reaction, view about self-medication and opinion regarding the need of Medicines Info OPD. Results: Significantly large proportion of patients opined that doctors do not have sufficient time in current Indian healthcare to explain the prescription and they are not aware of adverse drug reactions, expiry date or use the package inserts etc. Conclusion: Clinically relevant, up to date, user specific, independent, objective and unbiased Medicines Info OPD is essential for appropriate drug use and can help in a big way to common public to address many problems faced by them.Item The effect of maternal anthropometric characteristics and social factors on birth weight of child in small town hospital of Gandevi block of Navsari district.(2012-07) Solanki, Nitin; Kavishwar, Abhay; Chaudhari, Vipul; Chhasatiya, NilayBackground:In India low birth weight (LBW) (<2500 g), is the strongest determinant of infant morbidity and mortality. Objective:To quantify the effect of maternal anthropometry, education and socio-economic status on birth weight. Materials and Methods:Study Design: Prospective, Observational, Hospital based study.Study Setting: Gram Seva trust Hospital at Gandevi Block of Navsari district.Study Period: Sep 2009.Study Population:105 women who delivered in this hospital.Study Variable: Age of the mother at time of delivery, socio-economic status, education, parity, height and weight of mother, no. of ANC visits, sex of the delivered child.Outcome Variable: Low birth weight (LBW).Statistical analysis: Receiver Operative Characteristic (ROC)curve, chi square test, multivariate logistic regression Results:Low birth weight was found in around 35 % of infants. Bivariate analysis revealed that Maternal age less than 20 years (p= 0.02), education (p= 0.009), socio economic status (p =0.001) was significantly associated with low birth weight. Maternal age <20 years, number of years of education < 7 found to increase risk of LBW. Maternal height, weight, BMI, parity, sex of the child, number of ANC visits and type of family had no statistically significant effect on determining the risk for LBW. However, adjusted Odds ratio was found significant for only BPL status and pre term. Conclusion:Maternal age, Education, Economic states and Pre term were found to be the most important maternal parameters, which influence birth weight and the risk for LBW. However, Multivariate Logistic analysis revealed only BPL status and preterm had effect on LBW.Item Correlation of plasma fibrinogen and lipoproteins in diabetic hypertensive patients .(2012-07) Rachaiah, Niranjan; Malleshappa, VijayBackground: Diabetic hypertensive patients have higher cardiovascular morbidity and mortality than general population. Various risk factors like age, BMI (Body mass index), hypertension, smoking, dyslipidemia, etc. have been extensively studied, but still these together cannot explain increased cardiovascular morbidity and mortality in diabetes. Several studies have shown that fibrinogen is a powerful independent risk factor for cardiovascular disease. Hence fibrinogen levels and its correlation to lipoproteins in diabetic hypertensives were studied. Objective: To estimate plasma fibrinogen levels in patients with type 2 diabetes mellitus and hypertension and to correlate plasma fibrinogen with Lipoproteins and also with BMI. Materials and Methods: A Prospective cross sectional study conducted in a tertiary care hospital. Data collected by simple random sampling method and analysis of various parameters done by using chi square-test and correlated with pearson’s correlation coefficient “r”. Results: The higher plasma fibrinogen levels were found in diabetic hypertensives (449.06 ± 131.26) when compared to controls. The mean total cholesterol, TG (triglycerides), LDL (Low density lipoprotein), VLDL (Very low density lipoprotein), HDL (High density lipoprotein) among cases were 195.82 ± 26.92 mg/dl, 243.62 ± 45.83 mg/dl, 104.15 ± 25.76 mg/dl, 48.72 ± 9.17 mg/dl, 38.21 ± 4.03 mg/dl respectively and the mean BMI of cases was 26.16 ± 5.36 kg/m2. The plasma fibrinogen is positively correlated to BMI and total cholesterol levels which is statistically significant. Conclusion: The plasma fibrinogen levels could potentially be considered for screening programs to identify people at high risk of vascular events.Item Isolation of Candida Species in clinical specimens and its virulence factor: The biofilm .(2012-07) Nerurkar, Alka; Solanky, Priti; Chavda, Nilesh; Baria, Hinal; Desai, BinitaBackground: Candida species are now recognized as major causative agents of hospital-acquired infection. One of the major factors contributing to the virulence of Candida is its ability to form surface-attached microbial communities known as "biofilms". The importance of Candida biofilms is because of its increased resistance to antifungal therapy and the ability of cells within biofilms to withstand host immune defenses. Objective: This study was undertaken with the objectives of isolating the Candida species and identifying its virulence factor – the biofilm and to determine the role of biofilm in pathogenicity. Materials and Methods: A cross sectional study was conducted amongst the clinical specimens collected from the critical care wards of a tertiary care Hospital at Navi Mumbai from Jan 2009- Feb 2010. Care was taken to collect the samples before any anti fungal treatment. Candida spp were isolated and identified by standard techniques. Results: Out of total 200 different clinical specimens collected and processed, the most commonly isolated species was C. albicans(61.36 %) along with non albicans like C. parapsilosis (9.1%) C. pseudotropicalis (13.64 %) and C. glabrata (15.9%). Conclusion: The data suggests that the capacity of Candida species to produce biofilm appears to be a reflection of the pathogenic potential of the isolates. Isolates of Candida parapsilosis, Candida pseudotropicalisand Candida glabrata all gave significantly less biofilm growth then C. albicans.Item A case of ewings sarcoma involving mandible, an unusual site.(2012-07) Diwan, Rishi; Mathur, Manu; Mathur, DevendraEwings sarcoma /PNET are defined as round cell sarcomas that shows varying degree of neuroectodermal differentiation.ES/PNET is the second most common primary malignant tumour of bone in childhood and adolescent. The median age for patient with Ewings family of tumour is 15 years and more than 50% of the patients are adolescents. Primary malignant tumours of jaws and ES of the mandible is rare. (though more common than the maxillary involvement. Present case was mistaken as dental inflammation and resulted in delayed diagnosis.Item Importance of cardiac marker enzymes (Aspartate transaminase and troponin I) in acute myocardial infarction: A case-control study from South India .(2012-07) Prabodh, Vuddandi; Prakash, Deva; Sudhakar, Godi; Reddy, Yeruva; Chowdary, Nadella; Desai, Sripada; Shekhara, RaviBackground: Cardiac marker enzymes are measured to evaluate the heart function. The diagnosis of acute myocardial infarction can be achieved by electrocardiogram (ECG) changes and elevation of cardiac marker enzymes like creatine kinase, lactate dehydrogenase (LDH), aspartate transaminase (AST) and troponin I. Objective: To estimates the levels of AST and troponin I among patients of acute myocardial infarction, and to compare with those among health controls. Materials and Methods: This study was carried out among 50 cases of acute myocardial infarction and 50 age and sex matched healthy individuals. Serum samples of cases, collected after 5 hours and within 24 hours from the onset of chest pain and of controls were analyzed for AST by modified IFCC method and for troponin I by chemiluminescence – sandwich method. Results: The mean levels of AST and troponin I in cases and controls revealed that mean levels of AST and cardiac troponin I in cases (296.02±SD 135.69 IU/L and 57.34±SD 12.83 ng/ml, erspectively) are significantly higher than among controls (25.50±SD 6.22 IU/L and 0.31±SD 0.15 ng/ml, respectively). The differences between cases and controls are statistically significant (p<0.0001). Conclusion: The diagnostic efficiency of AST and troponin I were superior because they are specific to myocardial injury.Item A case report on variant ulnar artery.(2012-07) Sawant, Sharadkumar P; Shaikh, Shaguphta T; More, Rakhi MDuring routine dissection for 1st MBBS students on 65 year old donated embalmed male cadaver in the Department of Anatomy, K.J.Somaiya Medical College, Sion, Mumbai, India, we observed an unusual branch of the brachial artery. The brachial artery terminated in the cubital fossa into radial and common interosseous arteries. The radial artery had normal course and branches. The common interosseous artery was deeper and gave anterior and posterior ulnar recurrent arteries, and terminated into anterior and posterior interosseous arteries. The unusual large branch from the brachial artery was a variant of ulnar artery, arose from the lateral side of the brachial artery, descended on the lateral side upto the cubital fossa and crossed the fossa from lateral to medial, superficial to median nerve. It then descended superficial to the muscles arising from medial epicondyle of the humerus and was covered by the deep fascia of the forearm, pierced the deep fascia proximal to the wrist, crossed the flexor retinaculum, and formed the superficial palmar arch. Throughout its course, this artery gave no branch. There was no associated altered anatomy of the nerves observed in the specimen. The left upper limb of the same cadaver was normal. The photographs of the variations were taken for proper documentation and for ready reference. The embryological basis of the variation is presented.Item Sexual behaviour, knowledge, attitude and practices regarding HIV/AIDS amongst female sex workers (FSWs) in red light area of Mumbai city.(2012-07) Giri, Purushottam A; Hiremath, Renuka C; Kasbe, Abhiram MBackground: HIV/AIDS is not only a public health problem but also a social, political and economic challenge. The key concern with HIV infection is not only about infected person, but also about the chain of people infected by that individual and that h/she will probably infect in the future. The prevalence of HIV infection in India has been steadily increasing over the past few decades. Commercial sex workers and their clients are at highest risk for HIV infection and transmission. Objective: The present study describes the sexual behaviour, knowledge, attitude and practices in context to HIV/AIDS amongst female sex workers (FSWs) in red light area of Mumbai city. Materials and Methods: A cross-sectional community based study was conducted among female sex workers in red light area of Mumbai city during period of October 2008 to September 2009. A total 103 female sex workers were selected and interviewed. The statistical analysis was performed using SPSS software (version 13.0). Results: In the present study, the mean age of the FSWs was 26.4 ± 5.2 years and 43.8% belonged to lower middle class socio-economic status. Most of the FSWs responded poverty (84%) and broken family (76%) as the main reasons for resorting to the sex trade. Majority of the FSWs (72.8%) were illiterate and more than half (67%) did not have any children. Most of the FSWs (84.5%) were aware about HIV/AIDS but only 33% were aware of the status of their partner. Only 13.6% FSWs knew that HIV could be transmitted to the child through breast feeding from an infected mother. Conclusion: Misconception about HIV was very high. Most of the FSWs in the present study had first sexual debut at a very young age. Routine screening and periodic surveys are warranted in order for early detection of infections including HIV and other STDs.Item Pattern of craniofacial injuries and socio demographic distribution of road traffic accidents in Bangalore: Autopsy study.(2012-07) Hanumantha; Narapureddy, Bayapareddy; Madithati, PallaviBackground: Among all types of accidents, those caused by motor vehicles claim the largest toll of life and tend to be most serious, road traffic accidents (RTA) continues to be growing menace incurring heavy loss of valuable man –power, along with corresponding drain of potential economic growth of country. Objective: Present study was taken up with the aim to assess the Socio demographic distribution of road traffic accidents and the pattern of craniofacial injuries occurred in RTA. Materials and Methods: A Descriptive Cross sectional study was conducted on the post mortems of RTA cases. Convenient purposive sampling technique was applied to select the sample of 113 road traffic accident autopsies. Results: Majority of the victims aged between 21 to 40 years (50.44%), most of the victims were males 104 (92.0%), and Hindus 102 (90.27%). More crashes 42 (37.17%) took place between 6:00 PM to 12:00 PM on weekends 62 (54.87%) at city cross roads 62 (54.87%). Most of the accidents occurred by heavy motor vehicle 45(39.82%). Most of the times in road traffic accidents, productive age group males (21-40 years) were injured or lost their life. More than fifty per cent of the accidents were found to occur during the weekend evenings from 6:00PM to 12:00PM. Conclusion: Since the road traffic traumas are worsening each year, to minimise the severity of injury, man's interaction with the motor car may have been somewhat modified by crash protection devices, such as helmets, seat belts and air bags.Item Epidemiological profile of acute respiratory infections (ari) in under five age group of children in urban and rural communities of ahmedabad district, gujarat.(2012-07) Prajapati, Bipin; Talsania, Nitiben J; Lala, Mrudula K; Sonalia, Kantilal NBackground: Acute respiratory tract infection is a major cause of morbidity and mortality in developing and also developed countries. About 13 Million under 5 children dies every year in the world, 95% of them in developing countries, one third of total deaths are due to ARI. Objective: To study the epidemiological profile of ARI and find out associated risk factors of ARI in under 5 children living in urban and rural areas of Ahmedabad district. Materials and Methods: A cross sectional study was covering 500 under 5 children living in urban (five zone) and rural (five PHC of Sanand taluka) area of Ahmedabad district from September 2008 to March 2009. Results: Occurrence of ARI was found to be 22%, it was lower in urban area (17.2%) as compare to rural area (26.8%) higher in. A significant association was found between ARI and low social class, overcrowded houses low birth weight, delay start initiation of breast feeding, prelactal feeding, timely given complementary feeding and immunization status. Conclusion: The study strongly towards the importance of basic health promotional measures like proper infant feeding practices, proper nutrition of the child and socio-economic improvement in prevention and control of ARI.Item Bacteriology of urinary tract infection and antibiotic susceptibility pattern in a tertiary care hospital in South India .(2012-07) Razak, Shamataj Kattalagere; Gurushantappa, VishwanathBackground: Urinary tract infection is one of the most common bacterial infections seen in clinical practice particularly in developing countries. The causative agents for Urinary tract infection vary from place to place and they also vary in their susceptibility and resistance patterns. Objective: Studies to know the most common causative agents and their susceptibility pattern will help the clinicians to choose the antibiotic for empirical treatment. This study was done to find out the common bacteria causing UTI and to determine the antibiotic susceptibility pattern of the urinary pathogens from a tertiary care hospital in South India. Materials and Methods: A total of 573 mid-stream urine samples from the suspected UTI patients were tested microbiologically and antimicrobial susceptibility test were performed for the isolated pathogens using Kirby-Bauer disk diffusion method. Results: The rate of culture positivity in females was 87.82% and in males was 27.92%. E-coli was the most frequently isolated urinary pathogen (37.95%), followed by Klebsiella(21.41%) and Acinetobacter(10.94%). E-coli was highly sensitive to Nitrofurantoin(81.92%) and Amikacin(69.88%) and it was highly resistant to Ampicillin(1.0%). Klebsiella was highly sensitive to Impinem and it was highly resistant to Ampicillin. Conclusion: Higher prevalence of UTI was seen in females. Gram negative organisms were the most commonly isolated organisms in UTI. Urinary pathogens showed resistance to commonly used antibiotics like Ampicillin, Norfloxacin and Nalidixic acid. The susceptibility and resistance patterns of urinary pathogens should be considered before starting empirical treatment for UTI.Item A study of sacrum with three pairs of sacral foramina in western India .(2012-07) Kubavat, Dharati M; Nagar, Shaileshkumar K; Lakhani, Chintan; Ruparelia, Srushti S; Patel, Shilpa; Varlekar, PadmaBackground: The sacrum is a large, triangular fused five sacral vertebrae and forms the postero-superior wall of the bony pelvis. Numerous anatomical variations of the sacrum have been reported including complete bilateral lumbarization of the first sacral vertebra in different race generates sacrum with three pairs of sacral foramina. There has never been reported among Gujarati population in Western India. These variations may be found in the living during radiological investigations for pain and neurological symptoms of patients or may be found during post mortem examination or during dissection of human body and osteology class for first M.B.B.S students. Objective: The study was designed to know the prevalence of sacrum with three pairs of sacral foramina among Gujarati population in Western India as there is paucity of available literature. Considering the variation, we conduct this study as a prelude to any type of experimental work in biomechanics, for diagnostic and therapeutic purposes in low back pain, spinal surgery and for interventional procedures like spinal anaesthesia and lumbar puncture. Materials and Methods: Observational study was carried out on 189 dry human sacra of known sex(115 male and 74 female) were studied from Department of Anatomy, B.J. Medical college Ahmedabad, Government Dental college Ahmedabad, Medical college Vadodara and Government Medical College, Surat in Gujarat. Morphological study was done on the sacrum. The sacra consisting of four vertebral segments were selected. The specimens were then carefully examined and recorded. Results: 189 dry human sacra were studied. Sacra with three pairs of sacral foramina were recorded. We founded 3 (1-Male, 2-Female) specimens of sacrum with three pairs of sacral foramina representing Bilateral complete lumbarization of first sacral vertebra. The degree of lumbarization varied: Bilateral complete lumbarization in 3 specimens and did not found Unilateral complete lumbarization specimen. Conclusion: The present study shows that the incidence of sacrum with three pairs of sacral foramina among Gujarati population in Western India is 1.58 %.The knowledge of this anatomical variation is of paramount importance to spinal surgeons, radiologists, forensic experts, morphologists and clinical anatomists.