Indian Journal of Public Health Research & Development, 2020
Introduction: Adolescence is the period of most rapid growth second to childhood. The physical an... more Introduction: Adolescence is the period of most rapid growth second to childhood. The physical and physiological changes that occur in adolescents place a great demand on their nutritional requirements and make them more vulnerable to anemia. Anemia in adolescence causes reduced physical and mental capacity and diminished concentration in work and also possess to major threat to future safe mother hood in girls. Medical students, even though from a good socioeconomic background, are vulnerable to anaemia because of poor diet and increased physiological demand.
Indian Journal of Public Health Research & Development, 2020
Background: Adolescence is a transitional stage of physical, physiological and psychological deve... more Background: Adolescence is a transitional stage of physical, physiological and psychological development from puberty to legal adulthood. Worldwide more than 1.2 billion are adolescents i.e. one in every six persons is an adolescent. About 21% of Indian population is adolescents. The health status of an adolescent determines the health status in his/her adulthood. Healthy dietary habits & physical activity among medical students are even more important as they are future physicians.
Journal of Medical Science And clinical Research, 2020
Purpose: To find out the relation between smoking status and perioperative complications among th... more Purpose: To find out the relation between smoking status and perioperative complications among the study subjects Materials and Methods: 120 subjects were studied to determine the effect of smoking cessation on the incidence of perioperative complications. Results: A total of 120 cases were studied from July 2017 to June 2019. Conclusion: Cessation of Smoking in the perioperative period has shown to reduce the complications in the postoperative period even if the abstinence from Smoking is as late as 48 hours before the surgery to reduce cardiovascular complications and post-operative wound healing. Keywords: Smoking, peri-operative complications.
Journal of Medical Science And clinical Research, 2020
Background: DM comprises a group of common metabolic disorder that shares the phenotype of
Hyperg... more Background: DM comprises a group of common metabolic disorder that shares the phenotype of Hyperglycemia. Aim: To evaluate the Microvascular and macrovascular complications of Type 2 Diabetes Mellitus among patients attending the General Medicine OPD and IPD. Materials and Methods: The study was a cross-sectional study done on patients with age more than 40 years with type 2 Diabetes Mellitus attending OPD and IPD for a period of 12 months. The sample size was 147 and estimated through purposive sampling method. The selected patients underwent detailed clinical and biochemical evaluations. Results: Maximum patients with diabetes were between 60 - 69 years of age. Of the total number of patients 49% were found to be hypertensive, 39% were found to be obese, 16% of the study population were smokers and 50% were found to have hypercholesterolaemia. The prevalence of retinopathy, neuropathy and nephropathy were 37%, 24% and 20% respectively. The prevalence of coronary artery disease, peripheral vascular disease and cerebrovascular disease was found to be 29%, 5% and 10% respectively. Conclusion: In this study 64% of patients were males and 36% were females. The mean age of the patients was 57 years. 52% of patients had duration of diabetes < 5 years. Hypertension was found in 49% of patients. Keywords: Diabetes Mellitus, Nephropathy, Neuropathy, Retinopathy
Need for the study: WHO recommends pre exposure prophylaxis in rabies endemic countries for all i... more Need for the study: WHO recommends pre exposure prophylaxis in rabies endemic countries for all individuals who are at increased risk of exposure to rabies such as veterinarians, rag-pickers, animal handlers, rabies researchers/laboratory workers, International travellers and children. Objectives: To assess the safety of rabies vaccine administered intradermally as pre-exposure prophylaxis among 3 high risk groups viz., children, rag-pickers and veterinarians. Methods: All the subjects who volunteered from each of the 3 risk groups were taken for the study and were given purified chick embryo cell rabies vaccine having a potency of >2.5 IU per dose, intradermally as pre exposure prophylaxis on days 0, 7 and 21. Subsequently, all were followed up to assess the safety of intradermal rabies vaccination by recording the adverse drug reactions from the day of administration of first dose of vaccination upto 2 weeks after the last dose of vaccination. Results: The present study included 150 children, 225 rag-pickers and 122 veterinary students. The adverse drug reactions to rabies vaccination among these groups were 5.1%, 5.0% and 10.4% respectively which were mild in nature and subsided spontaneously or by taking symptomatic treatment and none of the subjects dropped out because of adverse drug reactions. Conclusion: Pre exposure prophylaxis against rabies by intradermal route is safe and well tolerated by high risk groups, which may be considered as a strategy for eliminating the disease by 2030.
International Journal of Contemporary Pediatrics, 2019
Background: Neonatal Hyperbilirubinemia (NH) is the commonest abnormal physical finding during th... more Background: Neonatal Hyperbilirubinemia (NH) is the commonest abnormal physical finding during the first week of life and also the most common cause for readmission during the early neonatal period is a cause of concern for the parents as well as for the Pediatricians. Hence appropriate management of Neonatal Hyperbilirubinemia is of paramount importance. Phototherapy plays a significant role in prevention and treatment of hyperbilirubinemia. However, this treatment modality may itself result in inherent complications. The present study was carried out with the objective of evaluating the sodium and potassium changes in neonates receiving phototherapy for neonatal hyperbilirubinemia. Methods: A prospective hospital based observational comparative study conducted on 96 eligible term neonates admitted in the neonatal intensive care unit receiving phototherapy at a teaching Hospital from October 1st to December 31st 2018. A predesigned proforma has aided the enrolment of new-borns into the study according to AAP guidelines. Serum bilirubin, sodium and potassium were determined before and after termination of phototherapy. The first samples were considered as controls. A comparative study was made between before and after phototherapy groups to determine the incidence of sodium and potassium changes. Results: The study group included 96 term neonates that were managed with phototherapy. Incidence of low birth weight babies was 21.9%. Mean birth weight and gestational age was 2.76±0.38 kg and of 38.34±0.88 weeks respectively. Mean duration of phototherapy was 38.48±09.34 hours. The incidence of Sodium and potassium changes were found to be statistically significant after phototherapy (p<0.01) but neonates didn’t develop any signs of hyponatremia and hypokalemia. Conclusions: The study shows that neonates undergoing phototherapy are at a higher risk of sodium and potassium changes. This risk is greater in LBW babies and hence this group of babies should be closely monitored for changes in sodium, potassium and should be managed accordingly. Keywords: Neonatal hyperbilirubinemia, Phototherapy, Potassium, Sodium
Background: A proper infant-feeding practice is essential for child's survival, growth and develo... more Background: A proper infant-feeding practice is essential for child's survival, growth and development. Nearly half of all deaths in under-5 children are attributable to improper nutrition, which translates into unnecessary loss of 3 million young lives a year. The prevalence of malnutrition among children in India is among the highest in the world and the most common reason for malnutrition is improper feeding practices.
Indian Journal of Obstetrics and Gynecology Research, 2018
Anemia in pregnancy is a major health problem in developing countries. Haemorrhage ranks first in... more Anemia in pregnancy is a major health problem in developing countries. Haemorrhage ranks first in the list of maternal mortality in developing countries. Materials and Methods: A prospective study on all anaemic pregnant patients (according to WHO) admitted to labour room of more than 28 weeks gestational age from May 2015 to May 2017 in Sri Siddhartha Medical College, Tumkur were included in the study and appropriately treated. Demographic factors like age, education, socioeconomic status, parity, birth spacing and intake of iron supplements was studied. Maternal and perinatal outcome was also studied. Results: Among 2982 deliveries, 32 cases were excluded according to exclusion criteria. About 1903 were found to be anemic. In these cases, 61% were in 20-24yrs age group, 35% patients educated upto middle school, 71% belonged to low socioeconomic status, 62.1% had less than 2 years of birth spacing. All these factors were statistically significant. But 38% cases had not received iron supplements. Although mild anemia cases were uneventful, moderate and severe anaemia cases had maternal complications. In moderate anemia, 4% patients had PPH and received blood and blood products, 10 % had puerperial fever and rest uneventful. Severe anemia had significant outcome: preterm labour (38%), preeclampsia (20%), IUGR (10%), intrauterine fetal demise (8%), abruption placenta (7%), placenta previa (1%), puerperal fever (7.2%), cardiac failure (0.8%), PPH (8%). Maternal mortality was noted in 3 patients. About 35 neonates of mild anaemic cases,65 neonates of moderate anaemic cases and nearly 46.5% of severe anaemia cases had complications. Conclusion: Prevalence of anemia is most common in rural population. Demographic factors also play a very important role. Effective management of anemia cases definitely prevents maternal and perinatal mortality.
Indian Journal of Obstetrics and Gynecology Research, 2018
Introduction: Pregnancy and child birth though considered as physiological process can become let... more Introduction: Pregnancy and child birth though considered as physiological process can become lethal for any woman. Childbirth was considered as rebirth to a woman in olden era. The atmost duty of an Obstetrician is to identify the abnormal events at the earliest, intervene appropriately and avoid the catastrophe. The importance of partogram is to prevent the maternal and perinatal complications. The World Health Organisation has simplified the partogram for its use by skilled birth attendants. Aims and Objectives: To study the progress and outcome of labour using modified WHO partogram in pontaneous labour in primigravidas. Materials and Methods: A cross sectional study of 200 women primigravidas admitted to Sree Siddhartha Medical College from December 2016 to November 2017 with spontaneous onset of labour at term with no high risk factors were recruited for the study using modified WHO Partogram. Augmentation of labour requirement, duration of active labour, mode of delivery, maternal and perinatal outcome were studied. Patients were divided into 2 groups – Group 1 and Group 2. Group 1- cervical dilatation and descent curve falling to the left of the alert line. Group 2- cervical dilatation and descent curve falling to the right of the alert line. Though Group 3 with women to right of action line was planned, there were no patients in group 3. Results: Most women belonged to age group of 21-25 years. The mean gestational age was 38.2 weeks. In Group 1, the mean duration of active phase of first stage of labour was 4.52±0.10 hours, where as it was 5.94±1.46 hours in Group 2. In Group 2, the mean duration of second stage of labour was 45.44±1.94 mins but it was 34.42±16.41mins in Group 1study subjects. Mean rate of cervical dilatation is 1.2 cm/hr. Seventy seven percent had normal delivery, 11% had caesarean delivery and 12% had instrumental delivery. Patient crossing the alert line had longer duration of labour. Augmentation was significantly higher in Group 2 (92.3%) than in Group 1 (67.8%). In the study group, there were no maternal and perinatal deaths. Conclusion: The partograph is an inexpensive and easily accessible tool that can effectively monitor the progress of labour. The WHO simplified partograph is highly useful in identifying when to intervene and also reduces perinatal and maternal mishaps. Keywords: WHO partogram, Alert line, Maternal outcome, Perinatal outcome.
Vernal Keratoconjunctivitis (VKC) is an allergic disease that typically affects young individuals... more Vernal Keratoconjunctivitis (VKC) is an allergic disease that typically affects young individuals, of which males are predominant. The disease involves the lids, conjunctiva, limbus and the cornea. The corneal changes range from punctate keratitis to shield ulcers. High incidences of keratoconus and abnormal corneal topographic patterns have been reported in these cases. The configuration of the corneal surface and the abnormal pattern of corneal surface can lead to vernal keratoconjunctivitis. Hence, an association between refractive errors and vernal keratoconjunctivitis was needed to be made.In our study we compared the refractive error with the stage of vernal keratoconjunctivitits (acute or chronic). Also we have tried to compare the type (limbal, bulbar or mixed) with the refractive error. Materials and methods: Fifty patients, ages ranging between 3 and 20 years, with Vernal Keratoconjunctivitis attending the ophthalmology outpatient department at Sri Siddhartha Medical College from December 2015 to December 2016 were included in the Study. The demographic data were noted, slit lamp evaluation and refractive error assessment were done for all patients. The data was compiled on a percentile basis of the two variables. Chi-square and Fisher's exact statistical analysis was used to study the association. Results: We found a male preponderance (78%) for the disease. Hypermetropia was the commonest (48% of patients) refractive error. Maximum patients manifested with signs of chronic Vernal Keratoconjunctivitis (76% patients). Bulbar type of Vernal Keratoconjunctivitis was commonest in our study group, (76% of patients). On evaluating the association of refractive error type with stage of Vernal Keratoconjunctivitis, the P value was not significant, thus indicating their independence. Also on evaluating the type of refractive error with the clinical variant of Vernal Keratoconjunctivitis, the p-value was not significant suggesting that they were independent. Conclusion: We found hypermetropia to be the commonest refractive error associated with VKC, followed by myopia and astigmatism. Perilimbal pigmentation suggestive of chronic Vernal Keratoconjunctivitis was the commonest stage of manifestation seen. Bulbar Vernal Keratoconjunctivitis was the commonest clinical type. There was no conclusive evidence to show an association between the refractive error and the stage and type of Vernal Keratoconjunctivitis
National Journal of Research in Community Medicine, 2019
Background: India is a rabies endemic country, where animal bites to humans are a major public he... more Background: India is a rabies endemic country, where animal bites to humans are a major public health problem and an estimated 17.4 million animal bites occur annually. It is more common in urban poor locality, since there is a combination of large human and dog populations in congested habitable areas. Seeking timely and correct post exposure prophylaxis by the exposed victims is important to prevent rabies. Objectives: 1. To know the characteristics of animal exposures. 2. To determine the post exposure prophylaxis seeking behaviour of individuals exposed to animals. Methodology: A community based cross-sectional study was conducted in urban poor locality of Tumkur District, Karnataka. The study subjects were interviewed using a pretested, semi-structured proforma to collect information regarding any history of animal exposures in last one year; if there were any animal exposures, a detailed history regarding the post exposure prophylaxis seeking behaviour was obtained. Results: A total of 11,289 individuals were surveyed, among whom 128 animal bite cases were reported giving the prevalence of 1.13%. In all the 128 cases, the biting animal was dog and 86.2% of them were unprovoked bites. The common bite injuries were abrasions (59.4%)) and were mainly on the limbs (97.6%); 52.4% of them were category III exposures. Among the exposed, 96.1% sought help from the medical doctor, among whom 61.7% from government health care facility. Conclusion: The post exposure prophylaxis seeking behaviour has to be further improved; since early and correct post exposure prophylaxis is necessary to prevent rabies. Key Words: health seeking behaviour, urban poor locality, rabies, animal bite, post exposure prophylaxis
Diabetes is one of the most common chronic conditions in the world. The worldwide prevalence
of d... more Diabetes is one of the most common chronic conditions in the world. The worldwide prevalence of diabetes mellitus (DM) has risen dramatically over the past two decades from 4.7% (1980) to 8.5% (2014). India has the largest number of diabetic population in the world (69.2 million). The prevalence of clinical depression and presence of elevated depressive symptoms are higher among persons with diabetes compared to the general population. This association may be bidirectional. Depressed patients are also reluctant, non-compliant and fail to adhere to anti diabetic drugs and show poorer self-management when compared with those without depression. Hence there is a need to study the importance of evaluation of depression in diabetes and how socio demographic characteristics contribute towards depression. This will help in better management of this infirmity. Objective: 1.To compare the proportion of depression among chronic type 2 diabetes patients of Government and Private tertiary care hospitals. 2. To assess the association between socio-demographic variables, disease duration and diabetic complications with the depression among chronic type 2 diabetes patients. Methodology: A comparative study done in Government and private tertiary care hospitals. Diabetes patients utilizing the healthcare facility (100 each from Government and private hospitals) were the study subjects. Data was collected through pretested semi-structured questionnaire. Depression was assessed using “Hamilton Depression scale”. Results and conclusion: About half of the diabetic patients had depression. There was a significant association between depression and complications like cardiovascular symptoms, neuropathy and retinopathy and glycaemic control of study subjects. Keywords: Depression, diabetes complications, diabetes, glycaemic control
The biomedical waste (BMW) poses significant hazardous risk to the patients, healthcare workers, ... more The biomedical waste (BMW) poses significant hazardous risk to the patients, healthcare workers, the community and environments. Healthcare professionals are at potential risk for hazards due to biomedical waste. Thus the knowledge regarding biomedical waste management among health care personnel has greater impact on health and environment. Aims: 1. To assess the knowledge regarding biomedical waste management. 2. To assess the attitude regarding biomedical waste management. Settings and Design: Hospital-based Descriptive study. Methods and Material: A questionnaire containing questions based on knowledge and attitude regarding BMW management was administered to the study participants (25 each of Professors, Associate Professors, Assistant Professors, Postgraduates, interns, senior & junior nurses, technicians, and class IV employees). Statistical analysis used: Descriptive statistics Results: The awareness about BMW management was poor among study subjects. Majority of them did not undergo regular training. Class IV staff were found to be unvaccinated against hepatitis B infection. BMW management attitude was found to be unsatisfactory. Conclusion: The study concluded that regular training and supervision is necessary for better healthcare waste management and implementation. Keywords: Biomedical waste; awareness; medical; nursing
International Journal of Preventive, Curative & Community Medicine, 2018
Introduction: Nutrition plays a major role in maternal and child health and it is perhaps the mos... more Introduction: Nutrition plays a major role in maternal and child health and it is perhaps the most influential non-genetic factor in foetal development. Understanding the relation between maternal nutrition and birth outcomes may provide a basis for developing nutritional interventions that will improve birth outcomes and long-term quality of life. Many research projects have studied maternal anthropometric indicators as predictors of birth weight; not many of them have focused on the question as to which is the best indicator for prediction of pregnancy outcomes with greater accuracy. Hence this study was taken up to assess the relationship between specific maternal anthropometric indicator including Mid-upper arm circumference (MUAC) and pregnancy outcome. The objective of the study was to assess the relationship between maternal anthropometric indicators and birth weight, crown-heel length and new-born's head circumference.
Introduction: The Global Hunger Index 2017 ranks India at 100
out of 118 countries. FAO estimates... more Introduction: The Global Hunger Index 2017 ranks India at 100 out of 118 countries. FAO estimates that about 190.7 million people are undernourished in India, which accounts for 14.5% of the population. Food security is a fundamental human right for all citizens in its interim constitution. It is also a determinant of nutritional outcomes, especially for children. An adequate food intake, in terms of quantity and quality, is a key to healthy life. Malnutrition is the most serious consequence of food insecurity and has a multitude of health and economic implications. Objective: The study conducted to determine the prevalence of food insecurity at the household level and to assess the association between food insecurity and malnutrition of under-five children. Methodology: This cross-sectional study was conducted among the mothers of under-five children in urban field practice area of Sri Siddhartha Medical College, Tumkur. Household Food Insecurity Access Scale (HFIAS) was administered to the mother to assess the food insecurity and anthropometric measurements were taken for under-five children. Results: In the present study, the prevalence of food insecurity was 33.5%. There was a statistically significant association between food insecurity and wasting and under-nutrition. There was no association between food insecurity and stunting. Key words: Food insecurity, under-five, malnutrition, hunger
Many newer rabies immune biologicals are available in the market. Therefore, there is a need for ... more Many newer rabies immune biologicals are available in the market. Therefore, there is a need for periodic reinforcement of safety, immunogenicity and clinical efficacy of these in post exposure prophylaxis. All confirmed rabies exposures, during the period of 6 years from January 2010 to December 2015, were retrieved. Assessment of safety of PEP was done by studying the documented immediate & delayed; adverse drug reac-tions. Assessment of immunogenicity was done in 27 volunteered bite victims on Day 14 by modified RFFIT at the Department of Neurovirology, NIMHANS, Bangalore, India which is a WHO collaborating centre for reference and research on rabies. The incidence of adverse drug events (ADEs) was found to be 7.5%. All the ADEs were mild and resolved without any complications. All the 27 volunteered subjects had adequate RVNA concentration of ≥ 0.5 IU/ mL on day 14. The geometric mean RVNA concentration was 8.12 IU/mL & all the 95 study subjects were healthy and alive, after 1 year of completing post exposure prophylaxis. In conclusion, the presently available rabies immune biologicals were found to be safe, immunogenic and clinically efficacious for post exposure prophylaxis.
Annals of Tropical Medicine and Public Health, 2017
Introduction: The government of Karnataka has introduced a new vaccine, i.e., pentavalent vaccine... more Introduction: The government of Karnataka has introduced a new vaccine, i.e., pentavalent vaccine (PVV) in the Universal Immunization Programme (UIP) schedule from 1st April, 2013. There are no published studies on vaccination coverage of this new vaccine. Objectives: 1. To assess the coverage of PVV of infants in a rural area. 2. To find out the reasons for immunization failure. 3. To describe the use of Global Positioning System (GPS) technology and Google Earth as new tools for spatial mapping the vaccine coverage. Methodology: This exploratory study was conducted in September, 2014 by covering three rural Primary Health Centers near Bangalore by a team of field investigators. The population studied was children aged between 6 and 23 months at the time of the survey. WHO’s standard EPI 30 cluster sampling technique was used for assessing the vaccine coverage. GarminGPS72H, a hand held GPS receiver, and Google Earth were used for spatial mapping the vaccination coverage. Results: A total of 210 children aged 6–23 months were included in the study. It was found that the completely immunized, partially immunized, and unimmunized children were 93.3%, 4.3%, and 2.4%, respectively. The most common cause for partial immunization and non-immunization was child being ill and the lack of information, respectively. Spatial mapping of vaccination coverage described the immunization coverage in the area and also gave insight into the probable reason for partial/non-immunized children. Conclusions: Coverage of PVV was very high and vaccine was well accepted by the community. GPS and Google Earth were useful in spatial mapping of the vaccination coverage. Keywords: GPS receiver, Google Earth, pentavalent vaccine, coverage evaluation surveys
International Journal of Community Medicine and Public Health, 2017
Background: Efforts to control and eliminate malaria are high-impact strategic investments that g... more Background: Efforts to control and eliminate malaria are high-impact strategic investments that generate significant returns for public health. In this regard, Government of India, launched NVBDCP in 2002, to control the disease. Since then, India has demonstrated significant achievements in malaria control with a progressive decline in total cases and deaths. Overall, malaria cases have consistently declined from 2 million in 2001 to 1.1 million cases in 2015. The decline in number of cases varied from region to region. In this background, the present study was conducted to know the trend of malaria in one of the endemic district Tumkur of Karnataka state. Methods: A case record analysis was done for the past 15 years (2001-2015) from the available data at district malaria office of Tumkur district and the data was analysed. Results: The present study showed that there is a gradual decline in the malaria cases from 27,553 in 2001 to 68 in 2015 and no deaths have been reported. The number of outbreaks is also declining with no outbreaks in the last 3 years. The present study also showed a seasonal trend in occurrence of malaria with increased incidence during June-October months. Conclusions: The trend in malaria cases is gradually declining, indicating that it is progressing towards malaria control and with sustained efforts, malaria can be reduced substantially and elimination can be achieved by 2030. Keywords: Malaria, Control, Trends, Tumkur
Indian Journal of Public Health Research & Development, 2020
Introduction: Adolescence is the period of most rapid growth second to childhood. The physical an... more Introduction: Adolescence is the period of most rapid growth second to childhood. The physical and physiological changes that occur in adolescents place a great demand on their nutritional requirements and make them more vulnerable to anemia. Anemia in adolescence causes reduced physical and mental capacity and diminished concentration in work and also possess to major threat to future safe mother hood in girls. Medical students, even though from a good socioeconomic background, are vulnerable to anaemia because of poor diet and increased physiological demand.
Indian Journal of Public Health Research & Development, 2020
Background: Adolescence is a transitional stage of physical, physiological and psychological deve... more Background: Adolescence is a transitional stage of physical, physiological and psychological development from puberty to legal adulthood. Worldwide more than 1.2 billion are adolescents i.e. one in every six persons is an adolescent. About 21% of Indian population is adolescents. The health status of an adolescent determines the health status in his/her adulthood. Healthy dietary habits & physical activity among medical students are even more important as they are future physicians.
Journal of Medical Science And clinical Research, 2020
Purpose: To find out the relation between smoking status and perioperative complications among th... more Purpose: To find out the relation between smoking status and perioperative complications among the study subjects Materials and Methods: 120 subjects were studied to determine the effect of smoking cessation on the incidence of perioperative complications. Results: A total of 120 cases were studied from July 2017 to June 2019. Conclusion: Cessation of Smoking in the perioperative period has shown to reduce the complications in the postoperative period even if the abstinence from Smoking is as late as 48 hours before the surgery to reduce cardiovascular complications and post-operative wound healing. Keywords: Smoking, peri-operative complications.
Journal of Medical Science And clinical Research, 2020
Background: DM comprises a group of common metabolic disorder that shares the phenotype of
Hyperg... more Background: DM comprises a group of common metabolic disorder that shares the phenotype of Hyperglycemia. Aim: To evaluate the Microvascular and macrovascular complications of Type 2 Diabetes Mellitus among patients attending the General Medicine OPD and IPD. Materials and Methods: The study was a cross-sectional study done on patients with age more than 40 years with type 2 Diabetes Mellitus attending OPD and IPD for a period of 12 months. The sample size was 147 and estimated through purposive sampling method. The selected patients underwent detailed clinical and biochemical evaluations. Results: Maximum patients with diabetes were between 60 - 69 years of age. Of the total number of patients 49% were found to be hypertensive, 39% were found to be obese, 16% of the study population were smokers and 50% were found to have hypercholesterolaemia. The prevalence of retinopathy, neuropathy and nephropathy were 37%, 24% and 20% respectively. The prevalence of coronary artery disease, peripheral vascular disease and cerebrovascular disease was found to be 29%, 5% and 10% respectively. Conclusion: In this study 64% of patients were males and 36% were females. The mean age of the patients was 57 years. 52% of patients had duration of diabetes < 5 years. Hypertension was found in 49% of patients. Keywords: Diabetes Mellitus, Nephropathy, Neuropathy, Retinopathy
Need for the study: WHO recommends pre exposure prophylaxis in rabies endemic countries for all i... more Need for the study: WHO recommends pre exposure prophylaxis in rabies endemic countries for all individuals who are at increased risk of exposure to rabies such as veterinarians, rag-pickers, animal handlers, rabies researchers/laboratory workers, International travellers and children. Objectives: To assess the safety of rabies vaccine administered intradermally as pre-exposure prophylaxis among 3 high risk groups viz., children, rag-pickers and veterinarians. Methods: All the subjects who volunteered from each of the 3 risk groups were taken for the study and were given purified chick embryo cell rabies vaccine having a potency of >2.5 IU per dose, intradermally as pre exposure prophylaxis on days 0, 7 and 21. Subsequently, all were followed up to assess the safety of intradermal rabies vaccination by recording the adverse drug reactions from the day of administration of first dose of vaccination upto 2 weeks after the last dose of vaccination. Results: The present study included 150 children, 225 rag-pickers and 122 veterinary students. The adverse drug reactions to rabies vaccination among these groups were 5.1%, 5.0% and 10.4% respectively which were mild in nature and subsided spontaneously or by taking symptomatic treatment and none of the subjects dropped out because of adverse drug reactions. Conclusion: Pre exposure prophylaxis against rabies by intradermal route is safe and well tolerated by high risk groups, which may be considered as a strategy for eliminating the disease by 2030.
International Journal of Contemporary Pediatrics, 2019
Background: Neonatal Hyperbilirubinemia (NH) is the commonest abnormal physical finding during th... more Background: Neonatal Hyperbilirubinemia (NH) is the commonest abnormal physical finding during the first week of life and also the most common cause for readmission during the early neonatal period is a cause of concern for the parents as well as for the Pediatricians. Hence appropriate management of Neonatal Hyperbilirubinemia is of paramount importance. Phototherapy plays a significant role in prevention and treatment of hyperbilirubinemia. However, this treatment modality may itself result in inherent complications. The present study was carried out with the objective of evaluating the sodium and potassium changes in neonates receiving phototherapy for neonatal hyperbilirubinemia. Methods: A prospective hospital based observational comparative study conducted on 96 eligible term neonates admitted in the neonatal intensive care unit receiving phototherapy at a teaching Hospital from October 1st to December 31st 2018. A predesigned proforma has aided the enrolment of new-borns into the study according to AAP guidelines. Serum bilirubin, sodium and potassium were determined before and after termination of phototherapy. The first samples were considered as controls. A comparative study was made between before and after phototherapy groups to determine the incidence of sodium and potassium changes. Results: The study group included 96 term neonates that were managed with phototherapy. Incidence of low birth weight babies was 21.9%. Mean birth weight and gestational age was 2.76±0.38 kg and of 38.34±0.88 weeks respectively. Mean duration of phototherapy was 38.48±09.34 hours. The incidence of Sodium and potassium changes were found to be statistically significant after phototherapy (p<0.01) but neonates didn’t develop any signs of hyponatremia and hypokalemia. Conclusions: The study shows that neonates undergoing phototherapy are at a higher risk of sodium and potassium changes. This risk is greater in LBW babies and hence this group of babies should be closely monitored for changes in sodium, potassium and should be managed accordingly. Keywords: Neonatal hyperbilirubinemia, Phototherapy, Potassium, Sodium
Background: A proper infant-feeding practice is essential for child's survival, growth and develo... more Background: A proper infant-feeding practice is essential for child's survival, growth and development. Nearly half of all deaths in under-5 children are attributable to improper nutrition, which translates into unnecessary loss of 3 million young lives a year. The prevalence of malnutrition among children in India is among the highest in the world and the most common reason for malnutrition is improper feeding practices.
Indian Journal of Obstetrics and Gynecology Research, 2018
Anemia in pregnancy is a major health problem in developing countries. Haemorrhage ranks first in... more Anemia in pregnancy is a major health problem in developing countries. Haemorrhage ranks first in the list of maternal mortality in developing countries. Materials and Methods: A prospective study on all anaemic pregnant patients (according to WHO) admitted to labour room of more than 28 weeks gestational age from May 2015 to May 2017 in Sri Siddhartha Medical College, Tumkur were included in the study and appropriately treated. Demographic factors like age, education, socioeconomic status, parity, birth spacing and intake of iron supplements was studied. Maternal and perinatal outcome was also studied. Results: Among 2982 deliveries, 32 cases were excluded according to exclusion criteria. About 1903 were found to be anemic. In these cases, 61% were in 20-24yrs age group, 35% patients educated upto middle school, 71% belonged to low socioeconomic status, 62.1% had less than 2 years of birth spacing. All these factors were statistically significant. But 38% cases had not received iron supplements. Although mild anemia cases were uneventful, moderate and severe anaemia cases had maternal complications. In moderate anemia, 4% patients had PPH and received blood and blood products, 10 % had puerperial fever and rest uneventful. Severe anemia had significant outcome: preterm labour (38%), preeclampsia (20%), IUGR (10%), intrauterine fetal demise (8%), abruption placenta (7%), placenta previa (1%), puerperal fever (7.2%), cardiac failure (0.8%), PPH (8%). Maternal mortality was noted in 3 patients. About 35 neonates of mild anaemic cases,65 neonates of moderate anaemic cases and nearly 46.5% of severe anaemia cases had complications. Conclusion: Prevalence of anemia is most common in rural population. Demographic factors also play a very important role. Effective management of anemia cases definitely prevents maternal and perinatal mortality.
Indian Journal of Obstetrics and Gynecology Research, 2018
Introduction: Pregnancy and child birth though considered as physiological process can become let... more Introduction: Pregnancy and child birth though considered as physiological process can become lethal for any woman. Childbirth was considered as rebirth to a woman in olden era. The atmost duty of an Obstetrician is to identify the abnormal events at the earliest, intervene appropriately and avoid the catastrophe. The importance of partogram is to prevent the maternal and perinatal complications. The World Health Organisation has simplified the partogram for its use by skilled birth attendants. Aims and Objectives: To study the progress and outcome of labour using modified WHO partogram in pontaneous labour in primigravidas. Materials and Methods: A cross sectional study of 200 women primigravidas admitted to Sree Siddhartha Medical College from December 2016 to November 2017 with spontaneous onset of labour at term with no high risk factors were recruited for the study using modified WHO Partogram. Augmentation of labour requirement, duration of active labour, mode of delivery, maternal and perinatal outcome were studied. Patients were divided into 2 groups – Group 1 and Group 2. Group 1- cervical dilatation and descent curve falling to the left of the alert line. Group 2- cervical dilatation and descent curve falling to the right of the alert line. Though Group 3 with women to right of action line was planned, there were no patients in group 3. Results: Most women belonged to age group of 21-25 years. The mean gestational age was 38.2 weeks. In Group 1, the mean duration of active phase of first stage of labour was 4.52±0.10 hours, where as it was 5.94±1.46 hours in Group 2. In Group 2, the mean duration of second stage of labour was 45.44±1.94 mins but it was 34.42±16.41mins in Group 1study subjects. Mean rate of cervical dilatation is 1.2 cm/hr. Seventy seven percent had normal delivery, 11% had caesarean delivery and 12% had instrumental delivery. Patient crossing the alert line had longer duration of labour. Augmentation was significantly higher in Group 2 (92.3%) than in Group 1 (67.8%). In the study group, there were no maternal and perinatal deaths. Conclusion: The partograph is an inexpensive and easily accessible tool that can effectively monitor the progress of labour. The WHO simplified partograph is highly useful in identifying when to intervene and also reduces perinatal and maternal mishaps. Keywords: WHO partogram, Alert line, Maternal outcome, Perinatal outcome.
Vernal Keratoconjunctivitis (VKC) is an allergic disease that typically affects young individuals... more Vernal Keratoconjunctivitis (VKC) is an allergic disease that typically affects young individuals, of which males are predominant. The disease involves the lids, conjunctiva, limbus and the cornea. The corneal changes range from punctate keratitis to shield ulcers. High incidences of keratoconus and abnormal corneal topographic patterns have been reported in these cases. The configuration of the corneal surface and the abnormal pattern of corneal surface can lead to vernal keratoconjunctivitis. Hence, an association between refractive errors and vernal keratoconjunctivitis was needed to be made.In our study we compared the refractive error with the stage of vernal keratoconjunctivitits (acute or chronic). Also we have tried to compare the type (limbal, bulbar or mixed) with the refractive error. Materials and methods: Fifty patients, ages ranging between 3 and 20 years, with Vernal Keratoconjunctivitis attending the ophthalmology outpatient department at Sri Siddhartha Medical College from December 2015 to December 2016 were included in the Study. The demographic data were noted, slit lamp evaluation and refractive error assessment were done for all patients. The data was compiled on a percentile basis of the two variables. Chi-square and Fisher's exact statistical analysis was used to study the association. Results: We found a male preponderance (78%) for the disease. Hypermetropia was the commonest (48% of patients) refractive error. Maximum patients manifested with signs of chronic Vernal Keratoconjunctivitis (76% patients). Bulbar type of Vernal Keratoconjunctivitis was commonest in our study group, (76% of patients). On evaluating the association of refractive error type with stage of Vernal Keratoconjunctivitis, the P value was not significant, thus indicating their independence. Also on evaluating the type of refractive error with the clinical variant of Vernal Keratoconjunctivitis, the p-value was not significant suggesting that they were independent. Conclusion: We found hypermetropia to be the commonest refractive error associated with VKC, followed by myopia and astigmatism. Perilimbal pigmentation suggestive of chronic Vernal Keratoconjunctivitis was the commonest stage of manifestation seen. Bulbar Vernal Keratoconjunctivitis was the commonest clinical type. There was no conclusive evidence to show an association between the refractive error and the stage and type of Vernal Keratoconjunctivitis
National Journal of Research in Community Medicine, 2019
Background: India is a rabies endemic country, where animal bites to humans are a major public he... more Background: India is a rabies endemic country, where animal bites to humans are a major public health problem and an estimated 17.4 million animal bites occur annually. It is more common in urban poor locality, since there is a combination of large human and dog populations in congested habitable areas. Seeking timely and correct post exposure prophylaxis by the exposed victims is important to prevent rabies. Objectives: 1. To know the characteristics of animal exposures. 2. To determine the post exposure prophylaxis seeking behaviour of individuals exposed to animals. Methodology: A community based cross-sectional study was conducted in urban poor locality of Tumkur District, Karnataka. The study subjects were interviewed using a pretested, semi-structured proforma to collect information regarding any history of animal exposures in last one year; if there were any animal exposures, a detailed history regarding the post exposure prophylaxis seeking behaviour was obtained. Results: A total of 11,289 individuals were surveyed, among whom 128 animal bite cases were reported giving the prevalence of 1.13%. In all the 128 cases, the biting animal was dog and 86.2% of them were unprovoked bites. The common bite injuries were abrasions (59.4%)) and were mainly on the limbs (97.6%); 52.4% of them were category III exposures. Among the exposed, 96.1% sought help from the medical doctor, among whom 61.7% from government health care facility. Conclusion: The post exposure prophylaxis seeking behaviour has to be further improved; since early and correct post exposure prophylaxis is necessary to prevent rabies. Key Words: health seeking behaviour, urban poor locality, rabies, animal bite, post exposure prophylaxis
Diabetes is one of the most common chronic conditions in the world. The worldwide prevalence
of d... more Diabetes is one of the most common chronic conditions in the world. The worldwide prevalence of diabetes mellitus (DM) has risen dramatically over the past two decades from 4.7% (1980) to 8.5% (2014). India has the largest number of diabetic population in the world (69.2 million). The prevalence of clinical depression and presence of elevated depressive symptoms are higher among persons with diabetes compared to the general population. This association may be bidirectional. Depressed patients are also reluctant, non-compliant and fail to adhere to anti diabetic drugs and show poorer self-management when compared with those without depression. Hence there is a need to study the importance of evaluation of depression in diabetes and how socio demographic characteristics contribute towards depression. This will help in better management of this infirmity. Objective: 1.To compare the proportion of depression among chronic type 2 diabetes patients of Government and Private tertiary care hospitals. 2. To assess the association between socio-demographic variables, disease duration and diabetic complications with the depression among chronic type 2 diabetes patients. Methodology: A comparative study done in Government and private tertiary care hospitals. Diabetes patients utilizing the healthcare facility (100 each from Government and private hospitals) were the study subjects. Data was collected through pretested semi-structured questionnaire. Depression was assessed using “Hamilton Depression scale”. Results and conclusion: About half of the diabetic patients had depression. There was a significant association between depression and complications like cardiovascular symptoms, neuropathy and retinopathy and glycaemic control of study subjects. Keywords: Depression, diabetes complications, diabetes, glycaemic control
The biomedical waste (BMW) poses significant hazardous risk to the patients, healthcare workers, ... more The biomedical waste (BMW) poses significant hazardous risk to the patients, healthcare workers, the community and environments. Healthcare professionals are at potential risk for hazards due to biomedical waste. Thus the knowledge regarding biomedical waste management among health care personnel has greater impact on health and environment. Aims: 1. To assess the knowledge regarding biomedical waste management. 2. To assess the attitude regarding biomedical waste management. Settings and Design: Hospital-based Descriptive study. Methods and Material: A questionnaire containing questions based on knowledge and attitude regarding BMW management was administered to the study participants (25 each of Professors, Associate Professors, Assistant Professors, Postgraduates, interns, senior & junior nurses, technicians, and class IV employees). Statistical analysis used: Descriptive statistics Results: The awareness about BMW management was poor among study subjects. Majority of them did not undergo regular training. Class IV staff were found to be unvaccinated against hepatitis B infection. BMW management attitude was found to be unsatisfactory. Conclusion: The study concluded that regular training and supervision is necessary for better healthcare waste management and implementation. Keywords: Biomedical waste; awareness; medical; nursing
International Journal of Preventive, Curative & Community Medicine, 2018
Introduction: Nutrition plays a major role in maternal and child health and it is perhaps the mos... more Introduction: Nutrition plays a major role in maternal and child health and it is perhaps the most influential non-genetic factor in foetal development. Understanding the relation between maternal nutrition and birth outcomes may provide a basis for developing nutritional interventions that will improve birth outcomes and long-term quality of life. Many research projects have studied maternal anthropometric indicators as predictors of birth weight; not many of them have focused on the question as to which is the best indicator for prediction of pregnancy outcomes with greater accuracy. Hence this study was taken up to assess the relationship between specific maternal anthropometric indicator including Mid-upper arm circumference (MUAC) and pregnancy outcome. The objective of the study was to assess the relationship between maternal anthropometric indicators and birth weight, crown-heel length and new-born's head circumference.
Introduction: The Global Hunger Index 2017 ranks India at 100
out of 118 countries. FAO estimates... more Introduction: The Global Hunger Index 2017 ranks India at 100 out of 118 countries. FAO estimates that about 190.7 million people are undernourished in India, which accounts for 14.5% of the population. Food security is a fundamental human right for all citizens in its interim constitution. It is also a determinant of nutritional outcomes, especially for children. An adequate food intake, in terms of quantity and quality, is a key to healthy life. Malnutrition is the most serious consequence of food insecurity and has a multitude of health and economic implications. Objective: The study conducted to determine the prevalence of food insecurity at the household level and to assess the association between food insecurity and malnutrition of under-five children. Methodology: This cross-sectional study was conducted among the mothers of under-five children in urban field practice area of Sri Siddhartha Medical College, Tumkur. Household Food Insecurity Access Scale (HFIAS) was administered to the mother to assess the food insecurity and anthropometric measurements were taken for under-five children. Results: In the present study, the prevalence of food insecurity was 33.5%. There was a statistically significant association between food insecurity and wasting and under-nutrition. There was no association between food insecurity and stunting. Key words: Food insecurity, under-five, malnutrition, hunger
Many newer rabies immune biologicals are available in the market. Therefore, there is a need for ... more Many newer rabies immune biologicals are available in the market. Therefore, there is a need for periodic reinforcement of safety, immunogenicity and clinical efficacy of these in post exposure prophylaxis. All confirmed rabies exposures, during the period of 6 years from January 2010 to December 2015, were retrieved. Assessment of safety of PEP was done by studying the documented immediate & delayed; adverse drug reac-tions. Assessment of immunogenicity was done in 27 volunteered bite victims on Day 14 by modified RFFIT at the Department of Neurovirology, NIMHANS, Bangalore, India which is a WHO collaborating centre for reference and research on rabies. The incidence of adverse drug events (ADEs) was found to be 7.5%. All the ADEs were mild and resolved without any complications. All the 27 volunteered subjects had adequate RVNA concentration of ≥ 0.5 IU/ mL on day 14. The geometric mean RVNA concentration was 8.12 IU/mL & all the 95 study subjects were healthy and alive, after 1 year of completing post exposure prophylaxis. In conclusion, the presently available rabies immune biologicals were found to be safe, immunogenic and clinically efficacious for post exposure prophylaxis.
Annals of Tropical Medicine and Public Health, 2017
Introduction: The government of Karnataka has introduced a new vaccine, i.e., pentavalent vaccine... more Introduction: The government of Karnataka has introduced a new vaccine, i.e., pentavalent vaccine (PVV) in the Universal Immunization Programme (UIP) schedule from 1st April, 2013. There are no published studies on vaccination coverage of this new vaccine. Objectives: 1. To assess the coverage of PVV of infants in a rural area. 2. To find out the reasons for immunization failure. 3. To describe the use of Global Positioning System (GPS) technology and Google Earth as new tools for spatial mapping the vaccine coverage. Methodology: This exploratory study was conducted in September, 2014 by covering three rural Primary Health Centers near Bangalore by a team of field investigators. The population studied was children aged between 6 and 23 months at the time of the survey. WHO’s standard EPI 30 cluster sampling technique was used for assessing the vaccine coverage. GarminGPS72H, a hand held GPS receiver, and Google Earth were used for spatial mapping the vaccination coverage. Results: A total of 210 children aged 6–23 months were included in the study. It was found that the completely immunized, partially immunized, and unimmunized children were 93.3%, 4.3%, and 2.4%, respectively. The most common cause for partial immunization and non-immunization was child being ill and the lack of information, respectively. Spatial mapping of vaccination coverage described the immunization coverage in the area and also gave insight into the probable reason for partial/non-immunized children. Conclusions: Coverage of PVV was very high and vaccine was well accepted by the community. GPS and Google Earth were useful in spatial mapping of the vaccination coverage. Keywords: GPS receiver, Google Earth, pentavalent vaccine, coverage evaluation surveys
International Journal of Community Medicine and Public Health, 2017
Background: Efforts to control and eliminate malaria are high-impact strategic investments that g... more Background: Efforts to control and eliminate malaria are high-impact strategic investments that generate significant returns for public health. In this regard, Government of India, launched NVBDCP in 2002, to control the disease. Since then, India has demonstrated significant achievements in malaria control with a progressive decline in total cases and deaths. Overall, malaria cases have consistently declined from 2 million in 2001 to 1.1 million cases in 2015. The decline in number of cases varied from region to region. In this background, the present study was conducted to know the trend of malaria in one of the endemic district Tumkur of Karnataka state. Methods: A case record analysis was done for the past 15 years (2001-2015) from the available data at district malaria office of Tumkur district and the data was analysed. Results: The present study showed that there is a gradual decline in the malaria cases from 27,553 in 2001 to 68 in 2015 and no deaths have been reported. The number of outbreaks is also declining with no outbreaks in the last 3 years. The present study also showed a seasonal trend in occurrence of malaria with increased incidence during June-October months. Conclusions: The trend in malaria cases is gradually declining, indicating that it is progressing towards malaria control and with sustained efforts, malaria can be reduced substantially and elimination can be achieved by 2030. Keywords: Malaria, Control, Trends, Tumkur
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Papers by Chandana Krishna
subjects
Materials and Methods: 120 subjects were studied to determine the effect of smoking cessation on the
incidence of perioperative complications.
Results: A total of 120 cases were studied from July 2017 to June 2019.
Conclusion: Cessation of Smoking in the perioperative period has shown to reduce the complications in
the postoperative period even if the abstinence from Smoking is as late as 48 hours before the surgery to
reduce cardiovascular complications and post-operative wound healing.
Keywords: Smoking, peri-operative complications.
Hyperglycemia.
Aim: To evaluate the Microvascular and macrovascular complications of Type 2 Diabetes Mellitus among
patients attending the General Medicine OPD and IPD.
Materials and Methods: The study was a cross-sectional study done on patients with age more than 40
years with type 2 Diabetes Mellitus attending OPD and IPD for a period of 12 months. The sample size
was 147 and estimated through purposive sampling method. The selected patients underwent detailed
clinical and biochemical evaluations.
Results: Maximum patients with diabetes were between 60 - 69 years of age. Of the total number of
patients 49% were found to be hypertensive, 39% were found to be obese, 16% of the study population
were smokers and 50% were found to have hypercholesterolaemia. The prevalence of retinopathy,
neuropathy and nephropathy were 37%, 24% and 20% respectively. The prevalence of coronary artery
disease, peripheral vascular disease and cerebrovascular disease was found to be 29%, 5% and 10%
respectively.
Conclusion: In this study 64% of patients were males and 36% were females. The mean age of the patients
was 57 years. 52% of patients had duration of diabetes < 5 years. Hypertension was found in 49% of
patients.
Keywords: Diabetes Mellitus, Nephropathy, Neuropathy, Retinopathy
Methods: A prospective hospital based observational comparative study conducted on 96 eligible term neonates admitted in the neonatal intensive care unit receiving phototherapy at a teaching Hospital from October 1st to December 31st 2018. A predesigned proforma has aided the enrolment of new-borns into the study according to AAP guidelines. Serum bilirubin, sodium and potassium were determined before and after termination of phototherapy. The first samples were considered as controls. A comparative study was made between before and after phototherapy groups to determine the incidence of sodium and potassium changes.
Results: The study group included 96 term neonates that were managed with phototherapy. Incidence of low birth weight babies was 21.9%. Mean birth weight and gestational age was 2.76±0.38 kg and of 38.34±0.88 weeks respectively. Mean duration of phototherapy was 38.48±09.34 hours. The incidence of Sodium and potassium changes were found to be statistically significant after phototherapy (p<0.01) but neonates didn’t develop any signs of hyponatremia and hypokalemia.
Conclusions: The study shows that neonates undergoing phototherapy are at a higher risk of sodium and potassium changes. This risk is greater in LBW babies and hence this group of babies should be closely monitored for changes in sodium, potassium and should be managed accordingly.
Keywords: Neonatal hyperbilirubinemia, Phototherapy, Potassium, Sodium
Childbirth was considered as rebirth to a woman in olden era. The atmost duty of an Obstetrician is to identify the abnormal
events at the earliest, intervene appropriately and avoid the catastrophe. The importance of partogram is to prevent the maternal
and perinatal complications. The World Health Organisation has simplified the partogram for its use by skilled birth attendants.
Aims and Objectives: To study the progress and outcome of labour using modified WHO partogram in pontaneous labour in
primigravidas.
Materials and Methods: A cross sectional study of 200 women primigravidas admitted to Sree Siddhartha Medical College
from December 2016 to November 2017 with spontaneous onset of labour at term with no high risk factors were recruited for the
study using modified WHO Partogram.
Augmentation of labour requirement, duration of active labour, mode of delivery, maternal and perinatal outcome were studied.
Patients were divided into 2 groups – Group 1 and Group 2. Group 1- cervical dilatation and descent curve falling to the left of
the alert line. Group 2- cervical dilatation and descent curve falling to the right of the alert line. Though Group 3 with women to
right of action line was planned, there were no patients in group 3.
Results: Most women belonged to age group of 21-25 years. The mean gestational age was 38.2 weeks. In Group 1, the mean
duration of active phase of first stage of labour was 4.52±0.10 hours, where as it was 5.94±1.46 hours in Group 2. In Group 2, the
mean duration of second stage of labour was 45.44±1.94 mins but it was 34.42±16.41mins in Group 1study subjects. Mean rate
of cervical dilatation is 1.2 cm/hr. Seventy seven percent had normal delivery, 11% had caesarean delivery and 12% had
instrumental delivery. Patient crossing the alert line had longer duration of labour. Augmentation was significantly higher in
Group 2 (92.3%) than in Group 1 (67.8%). In the study group, there were no maternal and perinatal deaths.
Conclusion: The partograph is an inexpensive and easily accessible tool that can effectively monitor the progress of labour. The
WHO simplified partograph is highly useful in identifying when to intervene and also reduces perinatal and maternal mishaps.
Keywords: WHO partogram, Alert line, Maternal outcome, Perinatal outcome.
Key Words: health seeking behaviour, urban poor locality, rabies, animal bite, post exposure prophylaxis
of diabetes mellitus (DM) has risen dramatically over the past two decades from 4.7% (1980) to 8.5% (2014). India
has the largest number of diabetic population in the world (69.2 million). The prevalence of clinical depression
and presence of elevated depressive symptoms are higher among persons with diabetes compared to the general
population. This association may be bidirectional. Depressed patients are also reluctant, non-compliant and fail to
adhere to anti diabetic drugs and show poorer self-management when compared with those without depression.
Hence there is a need to study the importance of evaluation of depression in diabetes and how socio demographic
characteristics contribute towards depression. This will help in better management of this infirmity. Objective: 1.To
compare the proportion of depression among chronic type 2 diabetes patients of Government and Private tertiary
care hospitals. 2. To assess the association between socio-demographic variables, disease duration and diabetic
complications with the depression among chronic type 2 diabetes patients. Methodology: A comparative study done
in Government and private tertiary care hospitals. Diabetes patients utilizing the healthcare facility (100 each from
Government and private hospitals) were the study subjects. Data was collected through pretested semi-structured
questionnaire. Depression was assessed using “Hamilton Depression scale”. Results and conclusion: About half of
the diabetic patients had depression. There was a significant association between depression and complications like
cardiovascular symptoms, neuropathy and retinopathy and glycaemic control of study subjects.
Keywords: Depression, diabetes complications, diabetes, glycaemic control
community and environments. Healthcare professionals are at potential risk for hazards due to biomedical waste.
Thus the knowledge regarding biomedical waste management among health care personnel has greater impact
on health and environment. Aims: 1. To assess the knowledge regarding biomedical waste management. 2. To
assess the attitude regarding biomedical waste management. Settings and Design: Hospital-based Descriptive study.
Methods and Material: A questionnaire containing questions based on knowledge and attitude regarding BMW
management was administered to the study participants (25 each of Professors, Associate Professors, Assistant
Professors, Postgraduates, interns, senior & junior nurses, technicians, and class IV employees). Statistical analysis
used: Descriptive statistics Results: The awareness about BMW management was poor among study subjects. Majority
of them did not undergo regular training. Class IV staff were found to be unvaccinated against hepatitis B infection.
BMW management attitude was found to be unsatisfactory. Conclusion: The study concluded that regular training
and supervision is necessary for better healthcare waste management and implementation.
Keywords: Biomedical waste; awareness; medical; nursing
out of 118 countries. FAO estimates that about 190.7 million people
are undernourished in India, which accounts for 14.5% of the population.
Food security is a fundamental human right for all citizens
in its interim constitution. It is also a determinant of nutritional
outcomes, especially for children. An adequate food intake, in
terms of quantity and quality, is a key to healthy life. Malnutrition
is the most serious consequence of food insecurity and has a multitude
of health and economic implications.
Objective: The study conducted to determine the prevalence of
food insecurity at the household level and to assess the association
between food insecurity and malnutrition of under-five children.
Methodology: This cross-sectional study was conducted among
the mothers of under-five children in urban field practice area of
Sri Siddhartha Medical College, Tumkur. Household Food Insecurity
Access Scale (HFIAS) was administered to the mother to assess
the food insecurity and anthropometric measurements were taken
for under-five children.
Results: In the present study, the prevalence of food insecurity
was 33.5%. There was a statistically significant association between
food insecurity and wasting and under-nutrition. There was no association
between food insecurity and stunting.
Key words: Food insecurity, under-five, malnutrition, hunger
of these in post exposure prophylaxis. All confirmed rabies exposures, during the period of 6 years from January 2010 to December 2015, were retrieved. Assessment
of safety of PEP was done by studying the documented immediate & delayed; adverse drug reac-tions. Assessment of immunogenicity was done in 27 volunteered
bite victims on Day 14 by modified RFFIT at the Department of Neurovirology, NIMHANS, Bangalore, India which is a WHO collaborating centre for reference
and research on rabies.
The incidence of adverse drug events (ADEs) was found to be 7.5%. All the ADEs were mild and resolved without any complications. All the 27 volunteered subjects
had adequate RVNA concentration of ≥ 0.5 IU/ mL on day 14. The geometric mean RVNA concentration was 8.12 IU/mL & all the 95 study subjects were healthy
and alive, after 1 year of completing post exposure prophylaxis. In conclusion, the presently available rabies immune biologicals were found to be safe, immunogenic
and clinically efficacious for post exposure prophylaxis.
the Universal Immunization Programme (UIP) schedule from 1st April, 2013. There are no published studies
on vaccination coverage of this new vaccine. Objectives: 1. To assess the coverage of PVV of infants in a rural
area. 2. To find out the reasons for immunization failure. 3. To describe the use of Global Positioning System
(GPS) technology and Google Earth as new tools for spatial mapping the vaccine coverage. Methodology:
This exploratory study was conducted in September, 2014 by covering three rural Primary Health Centers
near Bangalore by a team of field investigators. The population studied was children aged between 6 and 23
months at the time of the survey. WHO’s standard EPI 30 cluster sampling technique was used for assessing the
vaccine coverage. GarminGPS72H, a hand held GPS receiver, and Google Earth were used for spatial mapping the
vaccination coverage. Results: A total of 210 children aged 6–23 months were included in the study. It was found
that the completely immunized, partially immunized, and unimmunized children were 93.3%, 4.3%, and 2.4%,
respectively. The most common cause for partial immunization and non-immunization was child being ill and the
lack of information, respectively. Spatial mapping of vaccination coverage described the immunization coverage
in the area and also gave insight into the probable reason for partial/non-immunized children. Conclusions:
Coverage of PVV was very high and vaccine was well accepted by the community. GPS and Google Earth were
useful in spatial mapping of the vaccination coverage.
Keywords: GPS receiver, Google Earth, pentavalent vaccine, coverage evaluation surveys
Methods: A case record analysis was done for the past 15 years (2001-2015) from the available data at district malaria office of Tumkur district and the data was analysed.
Results: The present study showed that there is a gradual decline in the malaria cases from 27,553 in 2001 to 68 in 2015 and no deaths have been reported. The number of outbreaks is also declining with no outbreaks in the last 3 years. The present study also showed a seasonal trend in occurrence of malaria with increased incidence during June-October months.
Conclusions: The trend in malaria cases is gradually declining, indicating that it is progressing towards malaria control and with sustained efforts, malaria can be reduced substantially and elimination can be achieved by 2030.
Keywords: Malaria, Control, Trends, Tumkur
subjects
Materials and Methods: 120 subjects were studied to determine the effect of smoking cessation on the
incidence of perioperative complications.
Results: A total of 120 cases were studied from July 2017 to June 2019.
Conclusion: Cessation of Smoking in the perioperative period has shown to reduce the complications in
the postoperative period even if the abstinence from Smoking is as late as 48 hours before the surgery to
reduce cardiovascular complications and post-operative wound healing.
Keywords: Smoking, peri-operative complications.
Hyperglycemia.
Aim: To evaluate the Microvascular and macrovascular complications of Type 2 Diabetes Mellitus among
patients attending the General Medicine OPD and IPD.
Materials and Methods: The study was a cross-sectional study done on patients with age more than 40
years with type 2 Diabetes Mellitus attending OPD and IPD for a period of 12 months. The sample size
was 147 and estimated through purposive sampling method. The selected patients underwent detailed
clinical and biochemical evaluations.
Results: Maximum patients with diabetes were between 60 - 69 years of age. Of the total number of
patients 49% were found to be hypertensive, 39% were found to be obese, 16% of the study population
were smokers and 50% were found to have hypercholesterolaemia. The prevalence of retinopathy,
neuropathy and nephropathy were 37%, 24% and 20% respectively. The prevalence of coronary artery
disease, peripheral vascular disease and cerebrovascular disease was found to be 29%, 5% and 10%
respectively.
Conclusion: In this study 64% of patients were males and 36% were females. The mean age of the patients
was 57 years. 52% of patients had duration of diabetes < 5 years. Hypertension was found in 49% of
patients.
Keywords: Diabetes Mellitus, Nephropathy, Neuropathy, Retinopathy
Methods: A prospective hospital based observational comparative study conducted on 96 eligible term neonates admitted in the neonatal intensive care unit receiving phototherapy at a teaching Hospital from October 1st to December 31st 2018. A predesigned proforma has aided the enrolment of new-borns into the study according to AAP guidelines. Serum bilirubin, sodium and potassium were determined before and after termination of phototherapy. The first samples were considered as controls. A comparative study was made between before and after phototherapy groups to determine the incidence of sodium and potassium changes.
Results: The study group included 96 term neonates that were managed with phototherapy. Incidence of low birth weight babies was 21.9%. Mean birth weight and gestational age was 2.76±0.38 kg and of 38.34±0.88 weeks respectively. Mean duration of phototherapy was 38.48±09.34 hours. The incidence of Sodium and potassium changes were found to be statistically significant after phototherapy (p<0.01) but neonates didn’t develop any signs of hyponatremia and hypokalemia.
Conclusions: The study shows that neonates undergoing phototherapy are at a higher risk of sodium and potassium changes. This risk is greater in LBW babies and hence this group of babies should be closely monitored for changes in sodium, potassium and should be managed accordingly.
Keywords: Neonatal hyperbilirubinemia, Phototherapy, Potassium, Sodium
Childbirth was considered as rebirth to a woman in olden era. The atmost duty of an Obstetrician is to identify the abnormal
events at the earliest, intervene appropriately and avoid the catastrophe. The importance of partogram is to prevent the maternal
and perinatal complications. The World Health Organisation has simplified the partogram for its use by skilled birth attendants.
Aims and Objectives: To study the progress and outcome of labour using modified WHO partogram in pontaneous labour in
primigravidas.
Materials and Methods: A cross sectional study of 200 women primigravidas admitted to Sree Siddhartha Medical College
from December 2016 to November 2017 with spontaneous onset of labour at term with no high risk factors were recruited for the
study using modified WHO Partogram.
Augmentation of labour requirement, duration of active labour, mode of delivery, maternal and perinatal outcome were studied.
Patients were divided into 2 groups – Group 1 and Group 2. Group 1- cervical dilatation and descent curve falling to the left of
the alert line. Group 2- cervical dilatation and descent curve falling to the right of the alert line. Though Group 3 with women to
right of action line was planned, there were no patients in group 3.
Results: Most women belonged to age group of 21-25 years. The mean gestational age was 38.2 weeks. In Group 1, the mean
duration of active phase of first stage of labour was 4.52±0.10 hours, where as it was 5.94±1.46 hours in Group 2. In Group 2, the
mean duration of second stage of labour was 45.44±1.94 mins but it was 34.42±16.41mins in Group 1study subjects. Mean rate
of cervical dilatation is 1.2 cm/hr. Seventy seven percent had normal delivery, 11% had caesarean delivery and 12% had
instrumental delivery. Patient crossing the alert line had longer duration of labour. Augmentation was significantly higher in
Group 2 (92.3%) than in Group 1 (67.8%). In the study group, there were no maternal and perinatal deaths.
Conclusion: The partograph is an inexpensive and easily accessible tool that can effectively monitor the progress of labour. The
WHO simplified partograph is highly useful in identifying when to intervene and also reduces perinatal and maternal mishaps.
Keywords: WHO partogram, Alert line, Maternal outcome, Perinatal outcome.
Key Words: health seeking behaviour, urban poor locality, rabies, animal bite, post exposure prophylaxis
of diabetes mellitus (DM) has risen dramatically over the past two decades from 4.7% (1980) to 8.5% (2014). India
has the largest number of diabetic population in the world (69.2 million). The prevalence of clinical depression
and presence of elevated depressive symptoms are higher among persons with diabetes compared to the general
population. This association may be bidirectional. Depressed patients are also reluctant, non-compliant and fail to
adhere to anti diabetic drugs and show poorer self-management when compared with those without depression.
Hence there is a need to study the importance of evaluation of depression in diabetes and how socio demographic
characteristics contribute towards depression. This will help in better management of this infirmity. Objective: 1.To
compare the proportion of depression among chronic type 2 diabetes patients of Government and Private tertiary
care hospitals. 2. To assess the association between socio-demographic variables, disease duration and diabetic
complications with the depression among chronic type 2 diabetes patients. Methodology: A comparative study done
in Government and private tertiary care hospitals. Diabetes patients utilizing the healthcare facility (100 each from
Government and private hospitals) were the study subjects. Data was collected through pretested semi-structured
questionnaire. Depression was assessed using “Hamilton Depression scale”. Results and conclusion: About half of
the diabetic patients had depression. There was a significant association between depression and complications like
cardiovascular symptoms, neuropathy and retinopathy and glycaemic control of study subjects.
Keywords: Depression, diabetes complications, diabetes, glycaemic control
community and environments. Healthcare professionals are at potential risk for hazards due to biomedical waste.
Thus the knowledge regarding biomedical waste management among health care personnel has greater impact
on health and environment. Aims: 1. To assess the knowledge regarding biomedical waste management. 2. To
assess the attitude regarding biomedical waste management. Settings and Design: Hospital-based Descriptive study.
Methods and Material: A questionnaire containing questions based on knowledge and attitude regarding BMW
management was administered to the study participants (25 each of Professors, Associate Professors, Assistant
Professors, Postgraduates, interns, senior & junior nurses, technicians, and class IV employees). Statistical analysis
used: Descriptive statistics Results: The awareness about BMW management was poor among study subjects. Majority
of them did not undergo regular training. Class IV staff were found to be unvaccinated against hepatitis B infection.
BMW management attitude was found to be unsatisfactory. Conclusion: The study concluded that regular training
and supervision is necessary for better healthcare waste management and implementation.
Keywords: Biomedical waste; awareness; medical; nursing
out of 118 countries. FAO estimates that about 190.7 million people
are undernourished in India, which accounts for 14.5% of the population.
Food security is a fundamental human right for all citizens
in its interim constitution. It is also a determinant of nutritional
outcomes, especially for children. An adequate food intake, in
terms of quantity and quality, is a key to healthy life. Malnutrition
is the most serious consequence of food insecurity and has a multitude
of health and economic implications.
Objective: The study conducted to determine the prevalence of
food insecurity at the household level and to assess the association
between food insecurity and malnutrition of under-five children.
Methodology: This cross-sectional study was conducted among
the mothers of under-five children in urban field practice area of
Sri Siddhartha Medical College, Tumkur. Household Food Insecurity
Access Scale (HFIAS) was administered to the mother to assess
the food insecurity and anthropometric measurements were taken
for under-five children.
Results: In the present study, the prevalence of food insecurity
was 33.5%. There was a statistically significant association between
food insecurity and wasting and under-nutrition. There was no association
between food insecurity and stunting.
Key words: Food insecurity, under-five, malnutrition, hunger
of these in post exposure prophylaxis. All confirmed rabies exposures, during the period of 6 years from January 2010 to December 2015, were retrieved. Assessment
of safety of PEP was done by studying the documented immediate & delayed; adverse drug reac-tions. Assessment of immunogenicity was done in 27 volunteered
bite victims on Day 14 by modified RFFIT at the Department of Neurovirology, NIMHANS, Bangalore, India which is a WHO collaborating centre for reference
and research on rabies.
The incidence of adverse drug events (ADEs) was found to be 7.5%. All the ADEs were mild and resolved without any complications. All the 27 volunteered subjects
had adequate RVNA concentration of ≥ 0.5 IU/ mL on day 14. The geometric mean RVNA concentration was 8.12 IU/mL & all the 95 study subjects were healthy
and alive, after 1 year of completing post exposure prophylaxis. In conclusion, the presently available rabies immune biologicals were found to be safe, immunogenic
and clinically efficacious for post exposure prophylaxis.
the Universal Immunization Programme (UIP) schedule from 1st April, 2013. There are no published studies
on vaccination coverage of this new vaccine. Objectives: 1. To assess the coverage of PVV of infants in a rural
area. 2. To find out the reasons for immunization failure. 3. To describe the use of Global Positioning System
(GPS) technology and Google Earth as new tools for spatial mapping the vaccine coverage. Methodology:
This exploratory study was conducted in September, 2014 by covering three rural Primary Health Centers
near Bangalore by a team of field investigators. The population studied was children aged between 6 and 23
months at the time of the survey. WHO’s standard EPI 30 cluster sampling technique was used for assessing the
vaccine coverage. GarminGPS72H, a hand held GPS receiver, and Google Earth were used for spatial mapping the
vaccination coverage. Results: A total of 210 children aged 6–23 months were included in the study. It was found
that the completely immunized, partially immunized, and unimmunized children were 93.3%, 4.3%, and 2.4%,
respectively. The most common cause for partial immunization and non-immunization was child being ill and the
lack of information, respectively. Spatial mapping of vaccination coverage described the immunization coverage
in the area and also gave insight into the probable reason for partial/non-immunized children. Conclusions:
Coverage of PVV was very high and vaccine was well accepted by the community. GPS and Google Earth were
useful in spatial mapping of the vaccination coverage.
Keywords: GPS receiver, Google Earth, pentavalent vaccine, coverage evaluation surveys
Methods: A case record analysis was done for the past 15 years (2001-2015) from the available data at district malaria office of Tumkur district and the data was analysed.
Results: The present study showed that there is a gradual decline in the malaria cases from 27,553 in 2001 to 68 in 2015 and no deaths have been reported. The number of outbreaks is also declining with no outbreaks in the last 3 years. The present study also showed a seasonal trend in occurrence of malaria with increased incidence during June-October months.
Conclusions: The trend in malaria cases is gradually declining, indicating that it is progressing towards malaria control and with sustained efforts, malaria can be reduced substantially and elimination can be achieved by 2030.
Keywords: Malaria, Control, Trends, Tumkur