International Journal of Community Medicine and Public Health

Permanent URI for this collection

https://imsear.searo.who.int/handle/123456789/156152

Editor-in-Chief: Dr. Bhaven C. Kataria
ISSN: 2394-6032 (Print):2394-6040 (Online)

Frequency: Quarterly

Language: English

Open Access Peer-reviewed journal

Web site: https://www.ijcmph.com/

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Now showing 1 - 20 of 2576

How multimorbidity relates to road traffic accident among older adults and elderly population: insights from longitudinal aging study in India (1st wave)
(Medip Academy, 2024-06) Halder, P.; Seth, A. K.; Kansal, S.; Pal, S.; Mamgai, A.
Background: Multimorbidity and road traffic accidents increase with increasing age. Supplemented with increasing life expectancy at birth, both multimorbidity and RTAs will contribute significantly to the growing disease burden of the country. The objective of the study was to determine the association between multimorbidity and RTAs among older adults (above 45 years) and the elderly (above 60 years) population in India. Methods: A secondary data analysis was conducted using the Longitudinal Ageing Study in India (LASI)-1st wave data (April 2017 to December 2018). Participants having at least two chronic health conditions were described as multimorbidity. Road traffic accidents (RTAs) was taken as the outcome variable. Univariate followed by multivariable logistic regression was conducted between the outcome variable and each explanatory variable. Results: Data extracted consisted of 34704 (51.1%) older adults and 31902 (47.9%) elderly. Multimorbidity was present in 25054 (37.6%) individuals. Among the RTA group, 325 (26.5%) individuals had multimorbidity. The elderly with multimorbidity (at least two) were associated with the RTA with an adjusted odds ratio (CI) of 0.55 (0.45-0.67) and p value of <0.001 in comparison to older adults. Clerical and skilled individuals with multimorbidity were associated with RTA in comparison to unemployed individuals with multimorbidity with an adjusted odds ratio (CI) of 1.40 (1.10-1.79) and p value of 0.007. Conclusions: The RTA was evident among males aged 45-60 years with multimorbidity. Clerical and skilled individuals with multimorbidity were more prone to RTA. These individuals should be encouraged to take necessary measures to promote healthy living and adhere to them.
Health care seeking behaviour and its socio-demographic determinants among women in rural area: a community based cross sectional study
(Medip Academy, 2024-06) Joshi, G. S.; Gurav, R. B.; Samel, D. R.
Background: The health care delivery system of a country determines the health seeking behaviour of that country’s population. Women’s health care seeking behaviour is undocumented because women suffer the disease in silence, without seeking appropriate remedy for her illness. Hence the study was planned to assess the health care seeking behaviour and factors associated with it among rural women. Methods: This cross-sectional study was conducted in the catchment area of Rural Health Training Centre located in Thane district in January 2024. Sample size of women aged 18 years and above was estimated. Subjects were interviewed after obtaining verbal consent. Data was recorded in pre-designed proforma and was analysed with the help of Microsoft excel. Descriptive and inferential statistics was applied. The statistical level of significance was fixed at p<0.05. Results: Of the 400 women studied, 63.50% were illiterate. 52.75% visit private practitioners for treatment. 56.50% could make own decision regarding their health while 43.50% need permission from senior family members to visit health care facility. Only 42.50% visit to health care facility at the onset of symptoms. Due to time consuming nature, 35.75% were not using government health care facilities. Also, 22.50% women experienced unfriendly behaviour of the health care staff working there. Conclusions: More than half of the women could not seek medical care immediately, two third were not aware of the various government health schemes, emphasizing the need to create awareness about it through grass root level health workers. There is an urgent need to rebuild community trust about public health care facilities.
Team based learning: an effective teaching-learning method in undergraduate teaching in community medicine
(Medip Academy, 2024-06) D., T.; E., K.; Norman, P.; M., G.; Felicia, P.; J., T.
Background: “Team-based learning (TBL)” is a special approach by using small groups that is student centered, teacher guided Teaching and Learning method. Medical Council of India (MCI) emphasizes small group teaching. With increasing student numbers and decreasing/no change in faculty strength, the need for an effective T-L method for incorporating small group teaching in a large group is essential. So, this study attempts to evaluate the effectiveness and student reaction for TBL. Methods: A cross sectional study was conducted among III-year MBBS students attending block posting in the Department of Community Medicine, KIMS and RC. Pre-test and post-test after Team based learning implementation by designated faculties was conducted, and scores were analysed. The feedback of TBL was collected by using a Likert scale from students and also from faculties. Results: The mean scores of pre- and post-test were analyzed by Paired T test which was statistically significant (p value <0.05). The student reaction evaluated by 7 items Likert scale questionnaire showed that most of the students either agreed or strongly agreed that TBL enhanced their learning experience and confidence. The faculty feedback about TBL was also positive. Conclusions: TBL can be effectively implemented in medical colleges for the better results and student reaction.
Assessment of demographic attributes and health profile of schedule caste of 5 villages of Aligarh District, Uttar Pradesh, India
(Medip Academy, 2024-06) Akhtar, S.; Mudassir, M.; Faiz, A.; Khan, P.; Afza, S.; Ahmad, F.; Ahmad, N. Z.
Background: Demography is the scientific study of human populations. It takes into account the quantitative aspects of their general characteristics. In this paper health profile and different attributes of demography like age, gender, caste, marital status, educational status, temperament and occupation etc of scheduled caste people of 5 villages of Aligarh district were assessed and documented. Methods: A pretested, predesigned questionnaire containing the demographic attributes was filled by researchers by face-to-face examination of the population through scheduled caste sub plan mobile health care OPD’s. Surveys were conducted from 2nd June to 25th September 2022. Results: Collected and analyzed data exhibits that there were marked difference with the age groups 0-15, 26-45 and 66-85, gender, caste, with religion of Hindu (90.83%) and Muslim (7.33%), educational status regarding illiterate (59.81) and graduate or above (1.65%), Mizaj, dietary habit and there were no significant differences regarding marital status, occupation and addiction behavior were noticed. Conclusions: It can be concluded that majority of the scheduled caste population was living in interiors of rural areas with low socio-economic and health status. Most visited gender were females which indicate poor nutrition, lack of immunity and excessive burden on them. Majority of the population belongs to Balghami Mizaj. Most preferred diets were mixed and main occupation of the scheduled caste population was agriculture. This study will make policy makers and health workers derive practical conclusions which will help in the upliftment of the scheduled caste populations.
Pattern of mortality in a tertiary care teaching hospital according to the 11th Revision International classification of disease
(Medip Academy, 2024-06) Shankar, G.; Kalburgi, E. B.; Tamilarasan, V. S.
Background: Mortality is the oldest known health care indicator and a valuable tool for planning and managing in hospitals. Identifying the causes of mortality in hospital is important to monitor the health of the nations, identifying priorities and burden of disease analysis to attempt to estimate the causes of loss of healthy life. Hence this study was done to know the causes of death as per International Classification of Diseases (ICD) 11 among patients who died in Hangal Sri Kumareshwar Hospital in the year 2023. Methods: A retrospective descriptive study was conducted from 01 January to 31 December 2023 in Hangal Sri Kumareshwar Hospital. All mortality data of the year 2023 in the hospital were included in the study. The content of format included demographic variables of patients on the patient record like age, sex, address, mortality and its causes and classified according to ICD 11. Collected data was analyzed using percentages and Chi-square test. Results: Out of 505 deaths in Hangal Sri Kumareshwar Hospital and Research centre in 2023, 305 (60.40%) were males and 200 (39.60%) were females. Majority of deaths (31.48%) occurred between 41 to 60 years age group followed by 31.29% deaths occurring between 61 to 80 years age group. Regarding cause of death according to ICD-11, majority (24.16%) had a circulatory disease followed by 16.24% due to an infectious disease. Conclusions: The National Health Program to combat non communicable diseases has been implemented and the 12th five-year plan has made specific provision for the management and control of non-communicable diseases.
A school based cross-sectional study to assess the health problems and health status among school going children at Akhorigola, Rohtas District, Bihar
(Medip Academy, 2024-06) Joseph, L.; Umar, M.; Kumari, S.; Kumar, D.; Kumari, M.
Background: School-going children constitute one-fifth of the total population. They are the future of the nation's successor generation; therefore, high-performing students are important investments in building the nation's future. This study aimed to identify the health problems among school-going children. Methods: The current research was a cross-sectional study conducted in the Akhorigola block of Rohtas, targeting school-going children. A total of 650 participants were selected through a purposive sampling technique and assessed using a pre-structured format. The acquired data was analyzed using the statistical package for the social sciences (SPSS) to calculate the results based on objectives and hypotheses. Results: The outcomes of the study showed that among the 360 school-age boy participants, 210 (58.33%) had a normal weight, 100 (27.79%) were underweight, and 50 (13.88%) were overweight. Among the 290 girl participants, 150 (51.82%) had a normal weight, 110 (37.84%) were underweight, and 30 (10.34%) were overweight. The study also revealed that the majority of the 650 participants, 149 (22.92%), had inadequate personal hygiene, 109 (16.76%) had dental caries, 78 (12%) were affected by worm infestation, 55 (8.46%) were anemic, 47 (7.23%) had vitamin-A deficiency, 44 (6.76%) had scalp and hair problems, 38 (5.84%) had ear problems, and 30 (4.61%) had impaired visual acuity. Conclusions: Implementing school health programs can pose several challenges, but these can be effectively tackled through the integration of activities between the health and education departments.
A study to evaluate the effectiveness of planned educational programme on knowledge and attitude regarding psychosocial problems of eating disorders among adolescent girls studying in selected P.U Colleges at Vijayapur
(Medip Academy, 2024-06) Nelson; Varghese, A.; Desai, S.; C. K., R.; Rathod, L.; Bhatangunaki, H.
Background: Eating problems are prevalent, with girls more likely to develop issues in adolescence. Concerning indicators include weight fluctuations, altered eating patterns, and excessive physical activity. Outpatient treatment is effective for most, but some may require hospitalization or residential programs for stability and care. Methods: This research adopted an evaluative research approach and employed a pre-experimental (one group pre-test post- test design), and a sample of 60 adolescent girls studying in PU College is recruited through simple random sampling technique. The investigation was conducted at selected PU colleges, Vijayapur. Karnataka, among the adolescents. Results: This study assessed the knowledge and attitudes of adolescent girls in PU colleges in Vijayapur regarding eating disorders. Pretest results showed a majority with moderate knowledge and unfavorable attitudes. Following an educational program, significant improvements in knowledge and attitudes were observed. The findings highlight the effectiveness of targeted interventions in enhancing awareness and promoting positive attitudes. H1: Post-test knowledge scores significantly improved compared to pre-test scores (p<0.05). H2: Post-test attitude scores significantly enhanced compared to pre-test scores (p<0.05). H3: No significant associations were found between knowledge and attitude scores and socio-demographic variables among adolescent girls. Conclusions: In summary, targeted interventions can enhance knowledge and attitudes about eating disorders among adolescent girls in PU colleges. Outpatient treatments and education are crucial for addressing these issues, but more research and interventions are needed to promote awareness and positive attitudes.
Childhood undernutrition and its determinants: a cross-sectional study among under-five children in a slum of Kolkata, West Bengal, India
(Medip Academy, 2024-06) Jana, D.; Paul, B.; Chakraborty, S.; Gun, P.; Bandyopadhyay, L.; Das, R.
Background: Undernutrition is an important risk for premature deaths and almost 45% of deaths in the under-five population are linked to undernutrition globally, where low- and middle-income countries (LMIC) bear a major share of it. This study aimed to measure the burden of such undernutrition and its determinants among the under-five children in a slum of Kolkata. Methods: A community-based cross-sectional study was conducted between Oct 2022-February 2023 among 164 children aged between 6-59 months. Participants were selected by probabilistic sampling method; Mothers were interviewed and anthropometry of the children were measured. Prevalence of undernutrition was assessed by the composite index of anthropometric failure (CIAF). Logistic regression analysis was done to find out the associates of undernutrition. Results: Median age of the study participants was 26.5 months, 54.3% of the participants being boy children. Regarding feeding of the child, 26.2% given prelecteal feeding, 17.7% didn’t receive colostrum, 33.5% had delayed initiation of breast feeding, only 57.9% child received exclusive breastfeeding. Of the participants, 11% child delivered by home delivery and 32.9% had low-birth-weights. According to CIAF 68.9% had undernutrition, while underweight, stunting, and wasting were reported as per conventional index 44.5%, 56.7%, and 16.5% respectively. In multivariable logistic analysis undernutrition have significant association with low birth weight and repeated episode of cough and running nose [aOR= 0.99(0.98-0.99). aOR=2.32(1.06-5.09)] respectively. Conclusions: Considerable proportion of children (two out of three) had undernutrition with CIAF. Preventive measures should include improvement in antenatal care, child feeding counselling and social determinants of health.
Compliance to iron and folic acid supplementation and associated factors among antenatal mothers attending OPD in a tertiary care institute in India
(Medip Academy, 2024-06) B., A.; Rai, P.; Vasantha Kalyani, C.; Verma, B.
Background: Anaemia in pregnancy is a serious health issue faced globally by all countries. Noncompliance to iron and folic acid supplement plays a role in the high prevalence of anemia in pregnant women. Objectives: The objectives were to find out the proportion of compliance to iron and folic acid tablets (IFA) among antenatal mothers and to determine factors associated with it. Methods: A cross sectional study was conducted among 260 antenatal mothers attending antenatal clinic in a tertiary care hospital in Jharkhand from August 2023 to February 2024. Subjects were recruited through consecutive sampling. A pretested, predesigned, semi structured interview schedule was used to collect information. Data were analyzed using SPSS 15.0. Chi square was used to find out the association of compliance with independent variables. P value of <0.05 was considered as significant. Results: Among the study participants, majority (55.7%) were above 26 years’ age and 60% stayed in rural area. Overall, 64.2% stayed in joint family. The proportion of compliance to IFA among antenatal mothers was 58.8% (n=153), and the reason for noncompliance (n=107) in the majority was forgetfulness (46.7%) followed by “side effects” (28%). Factors like socio economic status and type of family have shown significant association with this compliance. Conclusions: This study highlighted that only around half of the pregnant women are compliant with IFA, and this situation demands for information education and communication activities to generate awareness.
Assessment of anemia in cases of acute myocardial infarction in a tertiary care hospital in central India
(Medip Academy, 2024-06) Thakur, A.; Peepre, K.; Pendro, B.; Dhakar, J. S.; Singh, T. P.; Lalu, A.
Background: Anemia is a known risk factor for ischemic heart disease and heart failure. It is also associated with increased mortality in acute myocardial infarction (AMI) patients. The study aimed to determine the anemia status of AMI patients and educate them on anemia and its impact on health. Methods: This was cross-sectional study conducted among 100 AMI patients admitted to ICCU of Hamidia hospital, Bhopal over 2 months. Haemoglobin levels were recorded and patients classified as non-anemic, mildly, moderately or severely anemic based on WHO criteria. Patients' sociodemographic profile and risk factors also collected. Results: Of the 100 patients (mean age 55.6 years), 76% were males. 88% patients had anemia-74% mild, 13% moderate and 1% severe. The 30-45 years age group reported the highest frequency of mild anemia cases (20 out of 31). Absence of anemia was highest among the younger <30 years group (9 out of 31). Anemia was higher in females, Patient with vegetarian diet had comparatively more anemia than the patient consuming mixed diet. Conclusions: A high prevalence of anemia was found among AMI patients. Counselling can help improve health by increasing awareness of anemia management. Screening AMI patients for anemia and therapeutic interventions were recommended.
Prevalence of behavioral risk factors of non-communicable diseases in Mumbai: a descriptive cross-sectional study
(Medip Academy, 2024-06) Paslawar, S. K.; Kalaskar, S. K.
Background: Globalization and urbanization have led to lifestyle changes among urban poor, which need to be understood, as the urban areas are undergoing rapid transitions. The behavioral risk factors are mainly responsible for the causation of non-communicable diseases (NCD). Objectives were to know prevalence and pattern of behavioral risk factors for NCDs in Naigoan, BDD Chawl, Mumbai to initiate steps for preventive interventions. Methods: This was community based cross-sectional study conducted among residents of Naigaon, BDD Chawl, Mumbai, India. Data were collected by the house-to-house survey using predesigned and pretested Performa. The world health organization-stepwise approach was used for chronic disease risk factor surveillance. Descriptive statistics and chi-square test were used for analysis. Results: About 65% of the respondents use smokeless form of tobacco, while 19% are using smoke form of tobacco. Among tobacco users nearly half have been using tobacco for the past 16 years. Nearly half (48%) of respondents were current alcohol drinkers. All the respondents in the study population consume less than five servings of fruits and vegetables which is less than WHO recommended servings. About 67% of the respondents were involved in the moderate type of activities. Conclusions: Study found high prevalence of NCD risk factors in the population. These risk factors have been prevalent since more than decade so, there may be very high burden of NCD soon in the study area. Screening and IEC activities need to be strengthened for diagnosis and preventive measures can be implemented at early stage of life.
Medication strategies: enhancing symptom management and quality of life in palliative care
(Medip Academy, 2024-05) S. Matos, R.; Chyczij, F.; Fernandes, L.; Gonçalves, S.
Background: Palliative care is integral to addressing suffering during advanced illnesses, and tailored medication is crucial. This study aims to explore medication patterns in palliative care, focusing on understanding their impact on symptom management and patient well-being. Methods: Data collection involves a retrospective approach with patients referred to the Community Support Team in Palliative Care of the Trás-os-Montes and Alto Douro Local Health Unit between April 2022 and March 2023. Data are recorded, including demographic information, medical history, and pain-related details. Medication is administered based on healthcare professionals’ judgment, following established pain management guidelines. Descriptive and cross-tabulation techniques are employed for the statistical analysis. Results: Key findings highlight Morphine and Paracetamol as primary analgesics, constituting 14.6% and 13.8%, respectively. Fentanyl, identified as a potent opioid, addresses severe pain at a rate of 10.0%. The study also reveals that 23.7% of cancer patients receive palliative sedation, emphasising its role in symptom control and dignified care. Conclusions: This research provides significant insights into the intricate relationship between medication administration and palliative care outcomes. The study reveals key findings, such as the prominence of Morphine, Paracetamol, and Fentanyl as essential analgesics in addressing pain and improving patient comfort. Additionally, the high prevalence of palliative sedation among cancer patients underscores its crucial role in symptom control and ensuring dignified care at the end of life. The complexity of medication choices within palliative care settings is emphasised, highlighting the need for careful consideration and tailored approaches.
Influence of yoga on pain, lower extremity kinetics, kinematics and function in patients with knee osteoarthritis
(Medip Academy, 2024-06) Shetty, M.; Tambe, A.; Darekar, A.; Agrawal, R.; Bhalala, H.
Background: Knee osteoarthritis (OA), is one of the leading cause of disability that causes significant reduction in function and strength with an increase in pain. The present study evaluates effects of Yoga with Physiotherapy exercises on pain, kinetics, kinematics and function in patients with knee osteoarthritis. Methods: A randomized controlled trial was conducted for evaluating the effect of Yoga on pain, lower limb kinetics, kinematics and function in patients with knee osteoarthritis over a period of 6 weeks. A total of 50 participants volunteered for the study. The participants were randomly allocated into Control group (n=25) and Intervention group (n=25). The participants of control group performed conventional exercises. The participants of intervention group performed conventional exercises along with Yoga. Results: Findings from present study reported significant improvement in muscle flexibility of Rectus Femoris (p<0.05) and Tensor Fascia Lata (p<0.05) in the interventional group as compared to the control group. There was a significant improvement in knee flexion range of motion(p<0.05) in the interventional group compared to the control group. Lower extremity muscle strength evaluation demonstrated a significant improvement(p<0.05) in muscle strength of hip and knee musculature in the interventional group as compared to the control group. There was a significant reduction in pain scores(p<0.05) for stair climbing in the interventional group as compared to the control group. There was no significant improvement in function pre and post intervention. Conclusions: Findings from present study report yoga practice improves knee flexion range of muscle, muscle strength and flexibility in patients with knee osteoarthritis.
Dental health status and treatment needs among the adult population of western Indian city: a cross-sectional study
(Medip Academy, 2024-06) Modi, Y.; Desai, T.; Mandanka, S.; Soni, P.; Patel, R.
Background: Oral health is a key indicator for general health, overall well-being and quality of life. This study evaluated the oral hygiene knowledge, practice and its association with oral problems and create awareness about oral health, oral diseases and its treatment to the people in Ahmedabad. Methods: Sample size was estimated to be approximately 260 based on pilot study and by convenience sampling method. Chi-square test using SPSS statistical software. Results: It was observed that around 74.22% of participants felt tooth pain, of which female were more expressive of their pain as compared to their male counterpart. Of which a staggering 73.07% participants brushed their teeth only once in a day. It was observed that there was a failure among population to use interdental aids for cleaning and maintaining oral hygiene. Approximately 70% of population visited their dentist not even once in the year. Conclusions: It was observed and hence concluded on the basis of the derived results that there was a lack of appropriate oral health awareness among the local people in Ahmedabad even among the literate.
A study of the health benefits of the Yoga Prana Vidya healing camp conducted at YPV Ashram in December 2022
(Medip Academy, 2024-06) Neravetla, J. R.; Nanduri, V. S.
Background: Several YPV Healing Camp programmes in the past have assisted people of all ages in treating and resolving their current health problems and lowering their chance of developing future chronic illnesses, which typically begin early and get worse with age. This paper presents one such camp and its outcomes successfully conducted at the YPV Ashram in December 2022. Methods: An interventional method for evaluating the outcomes of this camp is used. Patients’ data was collected before and after this camp by a team of 6 YPV healers who performed healing services using YPV protocols. The patient sample consisted of 29 adults (20 female and 9 male) from various places in the country who registered their voluntary participation. Results: Measured parameters such as body weight (Wt.), body mass index (BMI), V Fat, waist circumference, blood pressure (both Systolic and diastolic), and O2 saturation showed statistically significant improvements for the group. The patients experienced considerable improvements in their conditions such as pain in various parts of the body, and other physiological, psychological, and mental health issues. Conclusions: The key success aspects of the YPV healing and wellness camps are the teamwork, preparation and scheduling, expertise, competence, and dedication of the healers. The Yoga Prana Vidya method, as a supplementary and alternative medicine, has had such an impact on the healthcare system that those who have sought this therapeutic system have experienced it well. More research is recommended on this topic utilizing suitable techniques and samples.
Spatial hearing abilities among children with bimodal versus unilateral cochlear implant: parents report on spatial hearing questionnaire
(Medip Academy, 2024-06) Natarajsivam, A. K.; Thontadarya, S.; Asuri, S.; Babu, P.
Background: Spatial hearing questionnaire (SHQ) is a questionnaire developed and validated for evaluating the spatial hearing abilities for the tasks of localization of sound to complex task of speech perception in noise. SHQ is adapted in Dutch language, and in Persian language. The study aimed to compare the spatial hearing abilities of children using bimodal cochlear implant and unilateral cochlear implant using spatial hearing questionnaire a subjective assessment tool, SHQ. Methods: The participants of the study included parents of 30 cochlear implant using children of age range 5-10 years, among 30 participants, 16 belonged to parents of children using unilateral cochlear implant and 14 were parents of children using bimodal cochlear implants. SHQ consisted of 24 questions distributed under 8 domains and the responses from the parents were collected over telephonic interview and statistically analyzed across domains. Results: The results revealed that there was no significant difference observed between both the groups across all the 8 domains, except perception of children’s voice, showed statistical difference between 2 groups. The baseline of spatial skills in children population using unilateral and bimodal cochlear implants was analysed. Conclusions: Across the 8 domains of spatial hearing questionnaire there were no significant statistical difference found between unilateral and bimodal cochlear implanted groups.
Relevance of copper/zinc ratio and its association with redox status in chronic obstructive pulmonary disease
(Medip Academy, 2024-06) Das, S.; John, M.; Adiody, S.
Background: Chronic obstructive pulmonary disease is a progressive and persistent inflammatory condition associated with significant morbidity and mortality. Increased oxidative stress amongst others, plays an important role in the pathogenesis of this disease. The objective of the present study was to conduct a preliminary yet comprehensive examination of metal exposure specifically copper and zinc levels and their association with overall oxidative stress in COPD. Methods: A cross sectional study was carried out in a tertiary care hospital in South India. Two groups were included in the study. One group with 20 COPD patients and the other group of 20 healthy controls. Plasma samples were obtained from both the groups and serum levels of copper and zinc were studied by atomic absorption spectrometry. Cu/Zn ratio obtained from the results was further correlated with oxidative stress index calculated from total oxidant status and total antioxidant status in COPD with respect to controls. Results: The copper levels were significantly higher and the zinc levels lower in the COPD group as compared to the control group. The copper/zinc ratio was higher in COPD as compared to control population. The correlation between Cu/Zn ratio and oxidative stress index showed a positive correlation with a regression coefficient of 0.7. Conclusions: The study throws light on the trace element imbalance in COPD and how these could induce oxidative stress, contributing to persistent inflammation in COPD. In the clinical perspective, monitoring Cu/Zn ratio in COPD patients may lead to better risk mitigation and thereby better therapeutic management of the disease.
Celiac disease in children with failure to thrive and our experience in a tertiary care hospital of Kashmir in north India
(Medip Academy, 2024-06) Mehraj, Junaid; Ahmad, M.; Saleem Beigh, M.; Nisar Ahmad, S.; Ahmad Mir, O.; Yousuf Mir, N.
Background: Celiac disease (CD) is an autoimmune gastrointestinal disease caused by intolerance to gluten. Celiac disease is an important cause of failure to thrive in children. In addition to intestinal and extra intestinal clinical features, the diagnosis of CD is based up on histological findings in duodenal or jejunal biopsies, which may present in various forms. Methods: The study was a prospective observational, cohort study, including all children between 2-18 yrs. of age presented with failure to thrive fulfilling criterias of study. The patients with increased levels of IgA anti tTGA were selected for upper gastrointestinal endoscopy and duodenal biopsy. The aim of study is to study the prevalence and clinical profile of CD in children with failure to thrive. Results: A total of 66 cases of failure to thrive/short stature were enrolled, with prevalence of 24.2% of CD. Male: Female ratio was 1:1 in children with CD. Clinical features include weight loss (62.5%), irritability (37.5%), anemia (37.5%), diarrhea (37.5%). On biopsy cases 87.5% cases of failure to thrive had Marsh grading of grade 3 and 12.5% had Marsh grade 2. Conclusions: Failure to thrive patients with diarrhea and anemia should be evaluated upfront for celiac disease.
Comparison of blood loss in total knee replacement surgery with and without tranexamic acid: a prospective, time framed and observational analytical study
(Medip Academy, 2024-06) Mandal, S.; Chatterjee, B. D.; Kar, A.; Agarwal, S.
Background: Total knee replacement is one of the common orthopaedic procedures performed worldwide. Blood transfusion is one of the major requirements in TKR procedure due to the amount of blood loss during and after the procedure. We carried out a prospective study to determine the efficacy of tranexamic acid in controlling blood loss during TKR procedure. Methods: Study was conducted at a tertiary care centre, involving cases operated by a single surgeon. Study included 140 patients undergoing primary TKR for advance degenerative disease of knee and were divided into two groups of 70 each, one group that received tranexamic acid before surgery and another group that did not receive tranexamic acid before surgery. Patient with allergy to the drug, hepato/renal dysfunction, DVT, abnormal PT and INR were not included. Tranexamic acid was given intravenously as well as intra-articular. Results: Pre-operative haemoglobin ranged from 10.2 gm% to 14.4 gm% in the group getting tranexamic acid and from 10% to 14 % in the group not getting tranexamic acid. Post operatively haemoglobin varied from 8.4 gm% to 12.8 gm% in Group 1 and from 7.8 gm% to 12 gm% in Group 2. Difference of mean post-operative Hb (p=0.0045) and PCV (p=0.0024) in two groups was statistically significant. Conclusions: We concluded that administration of tranexamic acid reduces the blood loss as well as need of blood transfusion in a patient undergoing total knee replacement.
Evaluation and comparison of the oral health status of children in government and private schools between 6 to 9 years of age in Sangli city
(Medip Academy, 2024-06) Rane, S.; Shigli, A.
Background: To evaluate and compare the Oral health status of children in Government and Private schools between 6 TO 9 years of age in Sangli City Methods: Subjects were selected by Cluster Random Sampling and all students between 6 to 9 years of age from the selected schools were examined. Screening was done on the basis of WHO oral health assessment form for children (2013). Consent was taken from the parents or the concerned authorities prior to the examination of the children. The examination was carried out by one trained and calibrated investigator using a mouth mirror and CPI probe under natural daylight. Results: A total of 1000 children (500 governments and 500 private) were examined in the study. The estimates of non-carious teeth, carious teeth, enamel fluorosis and dental trauma between private and government school children were compared. There was significant difference found in non- carious tooth estimate (p=0.003) and carious teeth estimate (p=0.005). The children in private school had more non carious teeth (mean: 16.45) when compared to government children (mean: 15.89). Similarly, the children in private school had less amount of carious teeth (mean: 3.31) when compared to government children (mean: 3.84). There was no significant difference found with respect to fluorosis (p=0.683) and dental trauma (0.319) in the children of government and private schools. Conclusions: The prevalence of oral diseases was relatively less among children from private schools in comparison with those from government schools.

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