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Volume-11 (2012);
Issue 1 (January-March)
Published on Apr 15, 2012
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2012;1-1
Review |
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Bhattacharya I, Ramachandran A, Jha BK.
Healthcare Analytics on the
Cloud.
Abstract:
Meaningful analysis of voluminous health information
has always been a challenge in most healthcare organizations. Accurate
and timely information required by the management to lead a healthcare
organization through the challenges found in the industry can be obtained
using business intelligence (BI) or business analytics tools. However,
these require large capital investments to implement and support the
large volumes of data that needs to be analyzed to identify trends.
They also require enormous processing power which places pressure on
the business resources in addition to the dynamic changes in the digital
technology. This paper evaluates the various nuances of business
analytics of healthcare hosted on the cloud computing environment. The paper explores BI being offered as Software as a Service (SaaS)
solution towards offering meaningful use of information for improving
functions in healthcare enterprise. It also attempts to identify the
challenges that healthcare enterprises face when making use of a BI
SaaS solution.
Key Words:
Business Analytics; Business Intelligence (BI);
Cloud computing; healthcare industry; Software as a service (SaaS). |
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2012;1-2
Review |
Balgir RS.
Health Care Challenges of
Hereditary Common Hematological Disorders in Odisha, India. |
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Abstract: Medical Genetics over the past few decades have emerged as an important
and powerful medical specialty with increasing appreciation of its role
and function in the biomedical sciences. This emergence is related to
a great extent to the progress in the Human Genome Project, which promises
wide-ranging applications in the diagnosis, treatment and prevention
of human diseases. Nevertheless, the discussion on the role of genetics
as the preventive medicine and public health care also lead to ethical,
legal and social concerns about general applicability of genetic testing
in the ethnic communities. The interpretation of prevention in the context
of genetic diseases leads to the unavoidable discussions of genetic
engineering, stem cell transplantation, prenatal diagnosis and selective
termination of pregnancy, as well as broader concerns about discrimination
in health care coverage, gender bias, employment and insurance in the
society. In Indian communities where consanguineous marriage is widely
practiced, recessive/x-linked genetic disorders such as sickle cell
disease and beta-thalassemia, will continue to gain greater prominence
in the overall spectrum of ill health. Developing an understanding of
these changes will require a wide-ranging and multidisciplinary investigative
approach for which public health genetics is ideally suited to conditions
in Odisha.
Key words: Medical Genetics; Sickle Cell Disease; b-Thalassemia; G6PD Deficiency;
Public Health Burden; Odisha. |
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2012;1-3
Original Article |
Gaikwad VS, Murthy TSM, Sudeepa D.
A Qualitative Study on Men’s
Involvement in Reproductive Health of Women among Auto-rickshaw Drivers
in Bangalore Rural. |
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Abstract: Background: Men’s reproductive health directly affects the
partner’s reproductive health. Men also may serve as gatekeepers to
women’s access to reproductive health services. “Male involvement” in reproductive health and
family planning programmes is not just promoting the use of male methods
of contraception, but men’s supportive roles in their families. Objectives: 1. To know the attitudes of men regarding the family
planning and women’s health. 2. To know the involvement and participation
of men in maternity, delivery, post-natal care and family planning.
3. To study the treatment seeking behaviour of men for the reproductive
health. problems. Methods: The study was conducted on the auto-rickshaw drivers
in the Hoskote town. Total 96 married men were interviewed using a well-designed
and pretested questionnaire. The aspects covered are awareness and practices
related to RTIs/STIs/HIV/AIDS, family planning, antenatal care and treatment
seeking behaviour for the reproductive health problems. Results: Majority (62.50%) of the men did not help their
wives seek antenatal care. Only few 7(7.29%) were aware of parameters
of antenatal care. There were 44 (45.83%) men who reported the symptoms
of reproductive tract infections (RTIs). Among the men suffering
from RTIs, only 32(72.73%) took treatment. Only 6(6.25%) people were
aware of the all family planning methods. There were 39 (40.63%) participants
having extramarital sexual relations with prostitutes or other females,
of which 25(64.10%) people do not use condoms while engaging in the
high risk sexual encounters. There were 34 (35.42%) men not aware of
HIV/AIDS. Conclusion: Antenatal care and family planning are considered
the primary responsibility of the women. Also majority of the men in
the study group have high risk sexual behaviour. The awareness regarding
HIV/AIDS is low.
Key words: Men’s involvement; Reproductive health; Contraception;
Antenatal care. |
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2012;1-4
Original Article |
Majgi SM, Soudarssanane BM, Roy G, Das AK.
Risk Factors of Diabetes Mellitus in Rural Puducherry. |
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Abstract: Purpose: Prevalence of type 2 diabetes is increasing in India.
Rural area constitutes 80% of India. Hence it is essential to understand the epidemiology for
appropriate interventions. Objectives: to identify risk factors of type 2 diabetes mellitus in rural Puducherry. Methodology: Cross sectional study in two villages of Puducherry, India. 1403 subjects above 25 years from 2 villages.
Study measured demographic variables, Body Mass Index (BMI), physical activity, family history of Diabetes Mellitus, smoking and
alcohol consumption. Fasting blood glucose was measured for study subjects. Further, those with >126 mg/dl were subjected for Oral
Glucose Tolerance Test. Univariate and multivariate analysis was done. Receiver Operating characteristic Curve was plotted to find out cut off for Diabetic Risk Score.
Findings: The prevalence of type 2 Diabetes Mellitus (DM) was 5.8%.
The response rate was (88%). In univariate analysis age, occupation, Socio Economic Status, BMI, physical activity, family history were significant for
DM. In multivariate analysis age, BMI, family history of diabetes and occupation were significant for type 2 DM. The ‘diabetes risk score’ generated by the study
using age, BMI and family history of DM, had specificity, sensitivity and accuracy of 54%, 77% and 76.2% respectively. The area under curve for scoring system was 0.784
(<0.05). Conclusions: Identified risk factors are useful for early diagnosis by using
‘diabetes risk score’ – thus uncovering the iceberg of disease.
Key words: Type 2 Diabetes; Risk factors; Diabetes risk scoring. |
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2012;1-5
Original Article |
Dhruva GA, Agravat AH, Pujara KM.
Seroprevalence of HIV, HBV, HCV
and Syphilis in
Blood Donors in Saurashtra Region of Gujarat: Declining Trends Over
a Period of 3½ Years. |
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Abstract: Background: Transfusion of blood
and blood products is a life saving intervention and benefits innumerous
patients worldwide. At the same time it could be an ominous mode of
infection transmission to recipients. In 15 percent of total patients
infected with HIV, blood transfusion has been the responsible mechanism
of transmission. Methods: In this study, we aimed
to access the prevalence and trend of HIV, HBV, HCV and Syphilis over
the last 3½ years (January 2008 to June 2011) among the blood donors
who came to donate blood at Blood Bank, P.D.U. Medical College &
Hospital, Rajkot as well as in various blood donation camps organized
by the same blood bank. Results: From the total of 30,178
blood donors, 711 (2.35%) had serological evidence of infection with
at least one pathogen, either of HIV, HBV, HCV or Syphilis. These included
131 (0.43%) with HIV, 293 (0.97%) with HBV, 124 (0.41%) with HCV and
94 (0.31%) with Syphilis. Moreover, significantly declining trends of
HIV, HBV and Syphilis was observed over the study period.
Conclusion: A substantial percentage
of blood donors harbor HIV, HBV, HCV and Syphilis infections. Strict
selection of blood donors and comprehensive screening of donors’ blood
using standard methods are highly recommended to ensure the safety of
blood for recipient.
Key words: Blood donors; HIV;
HBV; HCV; Syphilis; Transfusion transmissible infection (TTI). |
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This Article |
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2012;1-6
Original Article |
Vella SC, Pai NB.
Prevalence
& Prescription: Prescribing Practices of Clozapine in Australia
between 2005 & 2010. |
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Context: Clozapine is an anti-psychotic used to treat refractory schizophrenia.
This study reviews the rates of clozapine prescription for refractory
schizophrenia in a region of Australia and compares the prescribing
patterns to the estimated prevalence rates of refractory schizophrenia
in the region. Utilising a pharmacoepidemiological approach; the results
indicated that only 8.4% of the individuals estimated to be suffering
from refractory schizophrenia in the region were prescribed clozapine
between 2005 and 2010, with only 4.1% continuing clozapine to the conclusion
of the study. In conclusion it is evident that clozapine is widely
under-prescribed in this area of Australia.
Key words: Clozapine; Treatment-resistant schizophrenia; Prevalence
rates; Australia
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This Article |
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2012;1-7
Original Article |
Latha KS, Nair RB, Bhat SM.
Frequency of Parental Psychopathology in Children
with Attention Deficit Hyperactivity Disorder. |
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Abstract: Parental mental health concerns
place children at a significantly greater risk of lower social, psychological
and physical health than children in families not affected by mental
illness. Several studies have examined
the extent to which psychopathology in children are closely related
to parental substance use disorders or to other mental disorders. This
study intended to investigate the frequency of occurrence of parental
psychopathology in children with Attention Deficit/Hyperactivity Disorder
and compare the characteristics of children with and without parental
psychopathology. Fifty children between 7-14 years
of either sex fulfilling the ICD-10 criteria for ADHD comprised the
sample of this study.It would be a chart review of in-patients and out-patients
who have consulted at Kasturba Hospital, Department of Psychiatry, Manipal
over a two year period. Parents diagnosed with Substance Use Disorders
(SUD) and other psychiatric morbidity according to ICD-10 was compared
with those parents without any psychiatric illness on various Sociodemographic,
clinical characteristics. Most of the parents were in the
second or third decade of their life. Of the fifty patients 41(82%)
were males and 9 (18%) were females. In 36(87.0 %) of the fathers had
a history of substance use disorder and 5(13.0 %) it was absent. Other
morbidities were also present in both parents. The findings are discussed
in light of the implications.
Key words: ADHD; Parental psychopathology; Substance use; Alcohol
Dependence Syndrome |
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2012;1-8
Original Article |
Nagaraja V, Sankapithilu GB, Khan MA.
DOTS Awareness and the Myths and Misconceptions about DOTS among Medical Practitioners in Mysore. |
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Abstract: Background: Annually 2 million people in India develop Tuberculosis
and 330,000 die. WHO-recommended DOTS strategy was pilot-tested in 1993 and launched as Revised National Tuberculosis Control Program
(RNTCP) in 1997. Awareness of DOTS among the doctors in the private sector was appalling although nationwide coverage was attained by
2006. OBJECTIVE: To study awareness of DOTS among Medical Practitioners of urban and rural Mysore. Methodology:
401 Medical
practitioners in hospitals and nursing homes of urban and rural areas of Mysore who treated Tuberculosis patients (private and public
sector) were approached. They were grouped under different specialties as per the year of graduation (before or after introduction of DOTS). Results:
38 % doctors who graduated before the introduction of DOTS didn’t follow DOTS compared to 14.9% doctors who graduated
later. 100% doctors working in Government sector felt that DOTS was better than daily regimen while 85% from the private sector felt so.
Only 47.9% of the doctors in the private sector practiced DOTS compared to 95.1 % in the Govt. Sector. Hence, the number of doctors
practicing DOTS in Private Sector was less than 50 % of that in the Govt. Sector. Both of these comparisons were found to be
statistically highly significant (p<0.001). Awareness of DOTS was alarmingly low among Orthopedic Surgeons, Gynecologists and
Pediatricians when compared to Physicians and General Practitioners. Conclusions:
DOTS awareness is still low among doctors
who graduated before the introduction of DOTS. Private practitioners harbored myths and misconceptions about DOTS.
Key words: DOTS Awareness; Tuberculosis; Medical Practitioners |
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2012;1-9
Original Article |
Karthikeyan G, Sinha AG, Sandhu JS.
Effect of Wheelchair Running on Recovery of Blood
Lactate and Physical Performance after High-Intensity Intermittent Exercise – An Experimental Trial. |
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Abstract: Background and Purpose: Repetitive sprint sport players perform
high intensity exercise only for a small percentage of a total game and such periods are often instrumental in determining the eventual
outcome. Recovery is a key factor for performance, and constant lack of recovery or insufficient recovery turns into overtraining which
is detrimental in achieving peak performance. The purpose was to find out the effect of wheelchair running on the physical performance
recovery after high-intensity intermittent exercise.
Method: Ten sportsmen having the age range from 20 to 29, VO2max Ranges from 60.51 to 64.29 were randomly divided into experimental and
control groups. After filling pre-participation questionnaire and 30-min of supine rest, Blood lactate and the field tests for the
measurement of static balance, power, speed and agility were applied. The subjects were made to run in the treadmill and to increase
the intensity to reach the Target Heart Rate (THR). After 1-min the subjects were given rest for 15-s and after that they started
exercise again and thus the subjects completed several bouts of such exercises until exhaustion followed by either Passive rest or
wheelchair running for the duration of 10 minutes. Parameters were measures after completed the exercise bout and after the recovery.
Results: After the recovery in experimental group significant improvement found only in blood lactate (p<0.01) and no significant changes
found in other parameters while in control group no significant changes found in all parameters. There was no significant difference found in
all the parameters including blood lactate between the groups. Conclusion: Both wheelchair running and passive recovery are same in the
efficiency of blood lactate removal and restoration of physical performance following intense intermittent exercise.
Key words: Blood lactate; Wheelchair running; Recovery; Physical
performance. |
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2012;1-10
Original Article |
Hamid S, Andrabi SAH, Fazli A, Jabeen R.
Immunization of Children in a Rural Area of North Kashmir, India: A KAP
Study. |
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Abstract: Background: Knowledge, attitude and practices about
immunization among mothers of children aged 1-2 years was assessed. Method: 300 mothers were administered a semi-structured
questionnaire at PHC Hajan from 1st march to 1st may 2011 to elicit the information about the knowledge, attitude and
practices of the mothers regarding immunization. Results: 100% of mothers knew that vaccination is beneficial and protects their
children from diseases. 39% knew OPV protects from polio while only 1% were aware of protective role of BCG. All mothers
knew about immunization in pregnancy but 86% were unaware about its preventive role. 26% mothers believed that 3 doses of
T.T (tetanus toxoid) are to be given during pregnancy. Whereas 98% of children were completely immunized, 93% completed on
schedule. Eighty percent of mothers reported of fever following DPT. All mothers had received tetanus toxoid during pregnancy. Conclusion:
Considering mothers' poor knowledge and good attitude, health education on immunization is emphasized to improve their practices.
Key words: Mothers; Knowledge; Attitude; Practices; Immunization; Children. |
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This Article |
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2012;1-11
Short Report |
Malhotra V.
Lessons from Observation of Supplementary Immunization Activity in India. |
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Abstract: Successful conduction of supplementary immunization activity
is vital both for prevention of transmission of Wild Polio Viruses, as well as outbreaks due to importation of infection to India.
The present study attempts to identify reasons that restrict parents to bring their children to polio booths on ‘Polio Sunday’,
and highlights the need for concerted house-to-house ‘search and vaccinate’ activities to ensure near 100% coverage of target
children to achieve the aim of Polio Free India.
Key words: Supplementary immunization; Pulse Polio; India. |
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This Article |
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2012;1-12
Short Report |
Agarwal S.
Reanalysis of Aglietti
Procedure (A Method of Corrective Supracondylar Femoral Osteotomy). |
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Abstract: Objective: Supracondylar femoral osteotomy is the time tested
method, used for correcting the angular (varus & valgus) deformities
at the knee. Traditionally, Coventry type of osteotomy where a medial
or lateral based wedge of bone is removed or an open wedge osteotomy
is made & the space filled with bone graft, is done to achieve the
desired correction. This osteotomy is subsequently stabilized with Kirschner
wires or plates & screws. Later the limb is externally supported
in brace or plaster cast. Here we present a case
series of 10 cases, where we have analyzed the efficacy of Aglietti
procedure, as a method of femoral supracondylar osteotomy for correcting
the valgus deformity at the knee. Methods: Ten valgus adolescent knees were operated
in 7 patients by following the Aglietti procedure for correcting the
angular deformity at the knee. The results were analyzed taking into
consideration the operating time, blood loss during surgery estimated
by the number of surgical mops used, stability of the osteotomy in the
post-operative period & ultimate range of motion (ROM) obtained
at the end of 6 months after the surgery. Results: The average age of patients dealt with was 12.6 years
(n=7) with females predominating (n=5) against 2 males. The average
time was 47.5 minutes. The average size of the surgical mops used was
15x20 cms. Surgical mops used per patient were 1.6. The average range
of flexion achieved at the end of 6 months after surgery was 131.45
degrees ( Rounded average to a measurable value being 131 degrees). Conclusion: In our case series we found
Aglietti procedure as an effective method
to correct the valgus deformity in adolescent knees. Supracondylar femoral osteotomies are not only for varus an valgus corrections; this osteotomy
is used as well for rotation correction and flexion and extension correction,
mainly in CP patients. But we used the Agelietti procedure for the correction of angular deformities(varus/valgus) in patients of nutritional
rickets. However
more number of cases need to be done to make a final conclusion of establishing
the superiority of this method over other methods.
Key words: Aglietti procedure; Supracondylar femoral osteotomy;
Valgus knee |
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2012;1-13
Case Report |
Vasudev
DS, Kaler AK.
Non-Hodgkin’s Lymphoma of the Uterine Cervix. |
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Abstract: Non Hodgkin’s Lymphoma (NHL) causes many deaths worldwide
and its incidence is increasing. They occur commonly in middle aged
and elderly people and are disseminated at diagnosis. We present an
interesting case of NHL in a 52 years old female, who presented with
past a history of postmenopausal bleeding. A 3 x 5 cms endocervical
polyp was noticed in the cervix. Biopsy of the polyp revealed it to
be a CD20-positive diffuse large B-cell (DLBCL)-type NHL. She was diagnosed
as stage IE after staging work-up. She attained a complete response,
and has been in remission for 1 year 8 months.
Key words: Non-Hodgkin's lymphoma; Vaginal bleeding; Uterine cervix. |
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2012;1-14
Case Report |
Jagtap SV, Nikumbh DB, Khirsagar AY, Jagtap SS, Shamima.
Primary Signet-Ring Carcinoma
(Linitus Plastica) of the Colorectum presenting as Subacute Intestinal
Obstruction. |
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Abstract: Primary Signet-ring cell carcinoma (Linitus Plastica)
of the colon and rectum is a rare form of adenocarcinoma of the large
intestine and has been reported to have an extremely poor prognosis. We report a case of Primary Signet-ring cell carcinoma
of the colorectum in a thirty one year old man presented in Surgical
OPD of our hospital with chief complaints of persistent pain in abdomen
and vomiting since two days. Since the prognosis of primary Signet ring carcinoma
(SRCC) is extremely poor (in view of more malignant behavior than ordinary
colorectal carcinoma), early diagnosis and aggressive treatment strategy
are necessary.
Key words: Signet ring cell carcinoma; Colorectal neoplasm;
Linitus plastica. |
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2012;1-15
Case Report |
Ded
KS, Khurana MS, Narang GS, Gupta AK, Kaur L.
GIST- A Rare Tumor in Paediatric
Age Group. |
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Abstract: A 13 years old male child
presented to us with complaints of pain abdomen, radiating towards back.
Child underwent CT-abdomen with contrast which showed volvulus and child
was operated immediately and resected part of gut was sent for histopathology
examination. Histopathology report showed features suggestive of gastrointestinal
stromal tumour and tumour marker CD-117 was sent for confirmation and
report was found to be positive.
Key words: GIST; Mesenchymal tumor. |
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2012;1-16
Case Report |
Sood RG, Sharma S, Mokta JK, Jhobta A, Bhatia
V, Panda P.
Pneumothorax and Pneumomediastinum in a Sputum Positive Tuberculosis Patient: The Continuous Diaphragm
Sign. |
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Abstract: Secondary pneumothorax is a very common
medical emergency. At times it is associated with pneumomediastinum, which could be fatal at times if not identified. We present a case
of a 11 years old sputum positive child who presented with both
these conditions and was diagnosed on chest x ray.
Key words: Pneumothorax; Pneumomediastinum; Continuous
diaphragm sign. |
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2012;1-17
Case Report |
Rathod PS, Reddihalli PV, Devi UK, Bafna UD.
A Rare Primary Pelvic Hydatid Cyst Presenting as Sciatica. |
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Abstract: Primary hydatid cyst in the pelvis is rare, and usually
presents with pressure symptoms affecting the adjacent abdominal organs.
We describe a rare hydatid cyst which was eroding the sacral hallow,
protruding into the right sciatic foramen and presenting as a radiating
pain and weakness of right lower limb due to compression of the lumbosacral
nerve roots. Laparotomy with removal of cyst and postoperative treatment
with albendazole is effective in controlling the disease and preventing
recurrence.
Key words: Lower limb paresis; Primary pelvic hydatid cyst;
Sciatica. |
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2012;1-18
Case Report |
Bansal S, Dhingra S, Kanojia R, Gupta A.
Lymphangioma Neck Presenting as a Secondary Lesion of the Tongue. |
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Abstract: Lymphangiomas are uncommon, benign, congenital tumors of the
lymphatic system, usually occurring in the head and neck but rarely involve the tongue. They cause both aesthetic anomalies and
obstructive symptoms. Early recognition and surgical excision of these tumors is essential. In recent years, sclerosing therapy
with OK-432 has become the preferred treatment. This case presents a very unusual presentation of a lymphangioma neck presenting
as a secondary lesion on the tongue post sclerotherapy.
Key words: Lymphangioma neck; Tongue; Sclerotherapy; Excision. |
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2012;1-19
Case Report |
Bhagat S, Varshney S, Bist SS, Mishra S, Aggarwal V.
Adenoid Cystic Carcinoma of External Auditory Canal. |
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Abstract: Adenoid cystic carcinoma is extremely rare tumour that accounts
for approximately 5% of primary malignancy of external auditory canal. These tumours are related with a high risk of recurrences
and significant morbidities from surgical management and adjuvant radiotherapy. Despite the aggressive management for these
tumours, many patients succumb to distant metastasis, making overall prognosis of these tumours poor. Although ACC of EAC has
been reported in 5th decade, but its occurrence in young patient is very rare. We report a rare case of ACC in a young 22
years old female, who presented with ear canal mass and ear pain. Biopsy suggested mass to be ACC. Patient underwent wide local
excision followed by adjuvant radiotherapy.
Key words: Adenoid cystic carcinoma; External auditory canal; Malignant tumour. |
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2012;1-20
Case Report |
Shakuntala PN, Isaac P, Rashmi, Appaiah N, Thomas M.
A Rare Case of Reversible Encephalopathy Syndrome Accompanying Late
Postpartum Eclampsia or Hypertensive Encephalopathy-A Clinical Dilemma. |
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Abstract: Posterior Reversible Encephalopathy Syndrome (PRES) refers to a
clinic-radiologic diagnosis. Clinically it is characterized by non specific symptoms such as headache,
confusion, visual disturbances and seizures. The radiological findings
in PRES are thought to be due to vasogenic oedema, predominantly in
the posterior cerebral hemispheres, and are reversible with appropriate
management. We report a case of reversible encephalopathy diagnosed
by MRI scan occurring in atypical areas like the caudate and lentiform
nuclei of the brain following an uneventful lower segment caesarean
section in a normotensive patient, who was successfully
treated with antihypertensives, anticonvulsants and supportive treatment. The differential diagnosis of convulsions
in the post-partum period is discussed.
Key words: PRES; Vasogenic edema; Postpartum; Normotensive. |
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2012;1-21
Case Report |
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