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Volume-8 (2009);
Issue 4 (October-December) Published on Apr 30, 2010
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2009;4-1
Opinion |
Yathish TR, Manjula
CG.
How to Strengthen
and Reform
Indian Medical Education System:
Is Nationalization the Only Answer?. |
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Abstract: As India marches towards an exciting new future of growth and progress,
medical education will play pivotal role in crafting a sustained
development
agenda. Efforts have to be undertaken to create a medical educational
system that nourishes innovation, entrepreneurship and addresses the
skill requirement of the growing economy. Last decade has been witness to phenomenal growth in numbers of the
medical colleges, nursing colleges and other similar training
institutions. This
unregulated rapid growth in number
of medical colleges has adversely impacted quality of training in
India’s medical institutions. The
policy of privatization of medical care has seriously undermined health
services and further limited the access of the underprivileged.
Therefore
the only solution is centralization or nationalization or globalization
of the entire medical education and health sectors or to join hands
with world health organization, So that a uniform health cares facility
can be given to each and every human
being.
Key words: India, medical education, medical colleges, Faculty
shortage, Reformation, Nationalization |
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2009;4-2
Review |
Ghosh
S, Koch M, Suresh Kumar V, Rao AN.
Do Alternative
Therapies Have a Role in Autism? |
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Abstract: Interventions
considered to be branches of Complementary & Alternative Medicine
(CAM) for autism are on the rise. Many new treatments have emerged &
traditional beliefs of Ayurveda, Yoga, Behavioral therapy, Speech therapy and
Homoeopathy have gained popularity and advocacy among parents. It is imperative
that data supporting new treatments should be scrutinized for scientific study
design, clinical safety, and scientific validity, before embarking on them as
modes of therapy. Practitioners take care in explaining the rationale behind the
various approaches that they practice, it is important to indicate possible
limitations too during the initial clinical examination and interactive session.
Clinicians must remember that parents may have different beliefs regarding the
effectiveness of treatment since their information is derived more from the
‘hear-say’ route when they compare benefits/effects of CAM therapies on other
children and often underestimate differential tolerance for treatment risks. It
is thus significant that practitioners do not assume a "don't ask, don't tell"
posture. The scientific validation and support for many interventions is
incomplete and very different from the recommendations of the American Academy
of Pediatrics Policy Statement. In this article, we discuss the various modes of
CAM and their utilities and limitations in relation to autism.
Key words: Ayurveda,
Homoeopathy, Hyperbaric therapy, Autism, Behavioral therapy,
Occupational
therapy, Yoga |
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This Article |
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2009;4-3
Review |
Dongre AR, Deshmukh PR, Kalaiselvan G, Upadhyaya S.
Application
of Qualitative Methods in Health Research: An
Overview.. |
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Abstract: Qualitative research is type of formative research that includes specialized techniques for obtaining in-depth responses about what people think and how they feel. It is seen as the research that seeks answer to the questions in the real world. Qualitative researchers gather
what they see, hear, read from people and places, from events and activities, with the purpose to learn about the community and to generate new understanding that can be used by the social world. Qualitative research have often been conducted to answer the question “why” rather than “what”. A purpose of qualitative research is the construction of new understanding.
Here, we present an overview of application of qualitative methods in health research. We have discussed here the different types of qualitative methods and how we and others have used them in different settings/scenarios; sample size and sampling techniques; analysis of qualitative data; validity in qualitative research; and ethical issues.
Key words: Participatory research techniques, PRA, In-depth techniques, systematic techniques |
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This Article |
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2009;4-4
Review |
Najafabadi AT, Pourhassan M.
Web GIS and Public Health.. |
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Abstract: Both government and private sector
organizations are seeking ways to maintain and improve the health of
the public in the world to control the costs at the same time. For this
aim internet and use of georeferenced public health information for
Geographic Information System application is an important and exciting
development for the nation’s Department of Health and Human Services
and other health agencies. Technological progress towards public health
geospatial data integration, analysis, and visualization of space-time
events using the Web portends eventual robust use of Geographic
Information
System by public health and other sectors of the economy. Increasing
Web resources from distributed spatial data portals and global
geospatial
libraries, and a growing suite of Web integration tools, will provide
new opportunities to advance disease surveillance, control and
prevention,
and insure public access and community empowerment in public health
decision making.
Key words: Web GIS; Internet; Public Health; Management. |
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This Article |
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2009;4-5
Original Article |
Balgir RS.
Inherited hemolytic disorders
with high occurrence of beta-thalassemia in Sindhi community of
Jabalpur town in Madhya Pradesh, India. |
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Abstract: Hereditary hemolytic disorders such as hemoglobin disorders,
b-thalassemia
syndrome, G6PD deficiency, and ABO and Rhesus blood groups are the most
common public health problems in India. Community genetic screening
provides multifaceted information for finding prevalence, level of
health
education, preventive strategies such as genetic/marriage counseling
to relieve the burden of vulnerable communities. However, such genetic
screening studies are scanty in India. This study aims to find the
prevalence
of inherited hemolytic disorders in Sindhi community, identify the
persons
for genetic/marriage counseling and to suggest the relevant strategies
for prevention and control to the affected families. A cross-sectional
random study of 508 persons of Sindhi community belonging to all ages
and both sexes was conducted for screening of hemoglobin disorders,
G6PD deficiency and ABO and Rhesus (D) blood groups following the
standard
procedures and techniques from Jabalpur town in Central India. High
frequency of b-thalassemia
trait (20.5%), Hb D trait (2.2%) and hemoglobin D/b-thalassemia
(0.2%), G6PD deficiency
(0.8%), and a low prevalence of Rhesus negative (3.0%) blood group was
observed in Sindhi community of Jabalpur town in Madhya Pradesh. A case
of b-thalassemia
major and Hb D-thalassemia were also encountered. Double heterozygosity
of Hb D/b-thalassemia
showed hypochromic and microcytic red cell morphology with mild anemia.
Inherited hemolytic disorders are an important public health challenge
in Sindhi community. Preventive genetics program needs to be vigorously
taken up to ameliorate the sufferings of at risk communities in India.
Key words: Public health, Blood groups, Hemoglobin disorders, b-thalassemia
syndrome,
G6PD deficiency, India |
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This Article |
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2009;4-6
Original Article |
Dixit S, Khatri AK, Taneja G, Saroshe S, Baghel SS, Jaiswal S, Soni
S, Sengar SS.
Impact of Educational Intervention Measures on Knowledge regarding HIV/ Occupational
Exposure and Post Exposure
Prophylaxis among Final Year Nursing Students of
a Tertiary Care Hospital in Central India. |
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Abstract: Amongst the
different Health Care Personnel nurses are at a greater risk of being
accidentally exposed to HIV and other Blood Borne Pathogens. The present
study was conducted among 50 final year nursing students of a Medical
College Hospital to assess the knowledge regarding HIV, occupational
exposure and Post Exposure Prophylaxis (PEP) among the students and
analyses the impact of educational intervention measures on the issues
amongst the study subjects. A Pre-designed and Pre-tested
semi-structured
questionnaire was used to evaluate the level of knowledge before and
after educational intervention sessions. Knowledge regarding risk of
transmission of HIV by needle-stick injury and body fluids against which
universal precautions were mandatory increased by 72% following the
intervention sessions (χ2
= 53.202, p <0.001). 72% and 36% respondents correctly knew the
duration
within which to start PEP and the drugs available for PEP, post
educational
sessions 98% and 96% students were aware of it: the difference being
statistically significant (χ2
= 11.294, p <0.001) and (χ2
= 37.748, p <0.001) respectively. The mean pre-intervention score
was 8.32; mean post-intervention score was 14.40: statistical analysis
showed the results to be significant (t= 13.857, p< 0.001). The study
reflects that there is a dearth of knowledge among the study group.
Incorporating the concerned issues in the academic curriculum to provide
the students with adequate knowledge and information during their
formative
years is needed.
Key words:
Nurses,
Occupational
exposure, Post Exposure Prophylaxis
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This Article |
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2009;4-7
Original Article |
Ugwuja EI, Akubugwo EI.
Impact of Maternal Helicobacter pylori
Infection on Trace Elements (copper Iron and Zinc) and Pregnancy
Outcomes. |
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Abstract: Background:
H. pylori infection has been suggested to interfere with
micronutrient
metabolism and influence pregnancy outcomes. Objectives:
This study therefore seeks to document the prevalence of H. pylori
seroposivity among pregnant women and to determine its impact on some
trace element status and pregnancy outcomes. Materials and methods:
Three hundred and forty nine consenting pregnant women aged 15-40 years
(mean; 27. 04 ± 4. 75 years) and gestational age ≤ 25 weeks (mean
21.77 ± 3.14 wks) attending antenatal clinic at Federal Medical Centre,
Abakaliki, between July 2007 and September 2008 participated in the
study. H. Pylori antibody (IgG) was determined by a new
generation
ELISA method. Plasma copper, iron and zinc were analysed using flame
atomic absorption spectrophotometer (Bulk Scientific AVG 210 Model)
while haemoglobin and albumin were analysed using standard
haematological
and biochemical techniques. Both maternal sociodemographic and
anthropometric
parameters were recorded at recruitment. The women were followed-up
till delivery after which neonatal anthropometrics and other birth
outcomes
were recorded. Results: H. pylori seroprevalence of 24.1%
(84/349) was recorded with higher prevalence in multiparous and older
women. H. pylori infected women had significantly higher BMI
(29.00 ± 3.89 vs. 26.86 ± 4.10, p = 0.020) and lower (p > 0.05)
plasma levels of Cu, Fe, Zn, albumin, and haemoglobin when compared
to non-infected women. Also H. pylori infected women had
significantly
(p < 0.05) higher rates of convulsion and concomitant illnesses than
their non-infected counterparts, although there was no difference in
the two groups for other pregnancy outcomes. Conclusion:
H. pylori infection during pregnancy seems to interfere with
trace element metabolism and contribute significantly to increased
maternal
morbidity. Prior to confirmation of these findings in a well controlled
randomised trial, it is suggested that pregnant women be screened for
H. pylori infection to reduce H. pylori associated
morbidities
during pregnancy.
Key words: |
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This Article |
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2009;4-8
Original Article |
Prakash M, Anwar N, Tilak P, Shetty MS, Prabhu LS, Kedage V, Muttigi
MS, Devaramane V, Bhandary PV.
A
Comparative Study Between Alcoholics of Koraga Community, Alcoholics of General Population and Healthy Controls for Antioxidant
Markers and Liver Function Parameters. |
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Abstract: Objectives:
It is well established that long-term alcohol consumption leads to liver
cirrhosis and other related disorders. Sufficient work has been done
on biochemical markers of liver damage and antioxidant status of chronic
alcoholics in general population. In the current study chronic
alcoholics
from a community called Koraga are analysed for the same parameters
in a view to assess the extent of liver damage as compared to healthy
controls and other alcoholics. Methods:
Serum and urine samples from Koraga alcoholics (n=28), general
alcoholics
(n=30) and healthy controls (n=31) were analysed for liver function
parameters and antioxidant markers. Liver function parameters were
determined
by automated analyzer. Markers of antioxidant status were estimated
spectrophotometrically. The data was analysed using SPSS version 16.0. Results:
There was significant increase in serum AST, serum ALT, serum GST and
urine GST in both general and Koraga alcoholics when compared to healthy
controls (p<0.0001). Serum ALT, serum GST and urine GST activity
was significantly higher in general alcoholics when compared to
Koraga
alcoholics (p<0.001). Serum and urine total thiol levels were
significantly
lower in general alcoholics when compared to healthy controls and
Koraga
alcoholics (p<0.0001). We have observed no difference in total thiols
level between healthy controls and Koraga alcoholics, in fact,
there was significant increase in urine total thiols level in Koraga
alcoholics compared to healthy controls (p<0.001). On Pearson’s
correlation serum AST, serum ALT correlated positively with serum and
urine GST (p<0.0001) and negatively with serum total thiols
(p<0.0001).
Serum GST correlated negatively with serum total thiols
(p<0.0001). Conclusion:
Results of our study possibly indicate that the extent of alcohol
induced
liver damage in Koraga subjects is comparatively lower than general
alcoholics, even though the alcohol consumption is found to be higher
in them. There may be some mechanism that is rendering them resistant
to alcoholic liver damage which needs to be explored through further
studies at molecular level.
Key words: Koraga, alcoholics, total thiols, GST, cirrhosis, antioxidant
status |
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This Article |
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2009;4-9
Original Article |
Reddy EP, Reddy VS, Chandra Mouli K, Rao PVLNS.
Physiological
antioxidant system and oxidative stress in stomach cancer patients with
normal renal and hepatic function. |
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Abstract: Role of free
radicals has been proposed in the pathogenesis of many diseases. Gastric
cancer is a common disease worldwide, and leading cause of cancer death
in India. Severe oxidative stress produces reactive oxygen species (ROS)
and induces uncontrolled lipid peroxidation. Albumin, uric acid (UA)
and Bilirubin are important physiological antioxidants. We aimed to
evaluate and assess the role of oxidative stress (OS) and physiological
antioxidant system in stomach cancer patients. Lipid peroxidation
measured
as plasma Thio Barbituric Acid Reactive substances (TBARS), was found
to be elevated significantly (p=0.001) in stomach cancer compared to
controls along with a decrease in plasma physiological antioxidant
system.
The documented results were due to increased lipid peroxidation and
involvement of physiological antioxidants in scavenging free radicals
but not because of impaired hepatic and renal functions.
Key words: Oxidative stress, Lipid peroxidation, Antioxidants, Stomach cancer. |
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2009;4-10
Original Article |
Adiga MNS, Alwar MC, Pai MRSM, Adiga US.
Pattern
of antimicrobial agents use in hospital deliveries: A
prospective comparative study. |
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Abstract: Objective:
Drug utilization pattern identifies the problems that arise from the
drug usage in health
care delivery system and highlights the current approaches to the
rational
use of drugs. The
present study evaluates the utilization pattern of antimicrobial agents
in hospital
deliveries
of different setups. Methodology:
Two hundred hospital deliveries from a government hospital GroupI (G-I)
and 100 cases each from two private hospitals Group II & Group III
(G II & G III) were studied. Groups, drugs, numbers of antimicrobials used,
duration with indication
for their use were the criteria taken into consideration for comparison.
Results: Beta-lactams, nitroimidazoles and fluoroquinolones
were commonly prescribed
groups of antimicrobials. The duration of prophylaxis was 6.73±1.79, 5.77±1.10
&5.14±1.53
days in three groups respectively which was significantly different (p<0.01).
Caesarian section, episiotomy were the commonest prophylactic
indications. Conclusion: The present study calls for an urgent review on rational use of antimicrobial
for prophylaxis.
Key words: Antimicrobial
agents, Infection, Prophylaxis, Hospital deliveries |
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This Article |
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2009;4-11
Original Article |
Salati SA, Rather A.
Awareness regarding female breast cancer in Kashmiri males - A study. |
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Abstract: Breast cancer is a major
killer disease in females globally and in developing regions, where
the early cancer detection facilities are unavailable, prognosis is
even worse. Awareness about this disease can lead to early detection
and thereby decrease the morbidity and mortality. A self
designed
questionnaire was used to study the level of awareness regarding breast
cancer among males. The questionnaire had 15 questions and on
the basis on score attained, the
subjects were classified as having poor, average or good breast cancer
awareness. Out of
624 participants, 555(89%) had poor breast cancer awareness and
47(7.5%) had average awareness. Only
22 (3.5%) had good awareness about breast cancer. The level of awareness
regarding female breast cancer in Kashmiri males is very low.
Measures need to be taken to spread awareness about this
disease in males so that they can play a vital role in early detection
of this disease.
Key words: Breast cancer,
males, cancer awareness, teacher |
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2009;4-12
Original Article |
Patil P, Gaikwad RD, Sawane MV, Waghmare VS.
Effect of Neem Oil on
Sperm Mitochondrial Activity. |
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Abstract: It is a known
fact that neem oil has some effect on motility of sperm. Motility
of sperm depends on mitochondrial activity present in mid-piece of
sperm. In the present study, the mitochondrial activity of sperm was evaluated
after treating semen with the different quantities of neem oil. The
mitochondrial activity was also evaluated after subjecting the semen
samples for different incubation periods keeping the quantity of semen
as well as that of neem oil same. Tests were done on thirty
normozoospermic semen samples with motile score more than
75%. It was found that as the quantity of neem oil increases, the mitochondrial activity
decreases significantly (P < 0.001). Similar results were
found, when same quantity of neem oil was treated with same quantity of semen,
but incubating for different time durations. The mitochondrial
activity decreases significantly (P < 0.001) from one minute to twenty
minutes. So, it indicates that as the contact period between neem oil and semen
increases the mitochondrial activity decreases significantly.
Key words: Normozoospermia, Neem Oil, Sperm Mitochondrial Activity |
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2009;4-13
Case Report |
Bhagat S, Varshney S, Singh R, Bist SS, Gupta N.
Malignant Melanoma of Nose and Paranasal Sinuses: 2 Case Reports. |
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Abstract: Malignant
melanoma is one of the rare and highly aggressive diseases of the
sinonasal
cavity. High index of suspicion is required for diagnosis as the patient
usually presents with non specific signs and symptoms. In the natural
course of the disease, higher rate of loco regional recurrences and
distant metastasis are seen making the overall prognosis of disease
very poor. In reviewing the various treatment modalities used in the
past, surgical resection of the tumour with postoperative radiotherapy
is preferred one. Advances in surgery, radiotherapy and chemotherapy
don’t have any impact on improved survival, which remains poor in
this disease. We report two cases of malignant melanoma, which were
treated at our institute.
Key words: Malignant Melanoma, Nose, Paranasal sinuses |
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2009;4-14
Case Report |
Sharma M, Satish Kumar, Prashar A, Sharma A.
An interesting case
of suicidal poisoning. |
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Abstract: Aconite is one of the most
poisonous known herbs. It has been known to be used as a homicidal
poison
from long time in history. However this is rarely known to be used as suicidal poison. Poisoning
with aconite is usually fatal and death commonly occurs due to arrhythmias and cardiotoxicity.
We report a case of attempted suicidal poisoning by aconite where
patient
survived in spite of documented cardiotoxic effects of the poison.
Key words: Suicidal poisoning, aconite, mohra |
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2009;4-15
Case Report |
Salati SA, Rabah SM.
Kienbock Disease. |
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Abstract: A case of a
27 years old female with history of pain in left wrists is presented.
Investigations revealed necrosis of left lunate (Kienbock disease).
Key words: Kienbock disease, Lunate necrosis |
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