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Volume-18 (2019);
No. 4 (October-December)
Published on Feb 28, 2020
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2019;4:1
Original Article |
Singh MS.
Determinants of Underweight and Overweight Among Khasi Males of Saiden Village of Meghalaya, Northeast India. |
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Abstract: Background: Problems of underweight and overweight are caused by chronic imbalance between energy intake and actual energy needs of the body.Both over nutrition and under nutrition can have detrimental health consequences. The World Health Organization considers that poor nutrition is the single most important threat to the world’s health. Many developing countries face the double burden of malnutrition affecting the whole populations. Methods: Cross-sectional data on 125 Khasi males aged between 14 and 60 years was collected through random sampling. The subjects were divided as adolescents (14-19 years) and adults (20+ years). An anthropometric rod and a weighing scale to the nearest of 0.1 cm and 0.5 kg respectively was used to measure height and weight with subjects wearing light clothes following the standard technique of Lohman et al. Results: The overall prevalence of underweight and overweight/obese among males was 28.80 percent and 18.40 percent respectively. The higher frequency of overweight/obesity (26.19%) was found among middle income group. The frequencies of underweight 31.48 percent, 28.57 percent and 24.14 percent were found among lower income group, middle income group and high income group respectively. The frequency of overweight/obesity (33.33%) was found higher among the graduate and above level of education. Conclusions: Present study indicates the double burden of underweight and overweight. Poor nutrition, unhygienic environment and improper health facilities may expose many individuals to underweight. On the other hand, socio-economic development, increasing urbanization and modernization may lead to overweight and obesity to some sections of the society.
Key words: Overweight, socio-economic, lifestyle, Khasi |
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2019;4:2
Original Article |
Khiamniungan KS, Mondal PR.
Mid-Upper Arm Circumference: An Alternative to BMI for Screening Overweight and Obesity Among the Khiamniungan Tribal Children and Adolescents of Nagaland, Northeast India. |
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Abstract: Background: Body mass index (BMI) is recommended globally as the optimal, straight forward measure of obesity. Nonetheless, in a resource-poor setting, Mid-upper-arm circumference (MUAC) is considered as a key indicator for overweight and obesity. Objective: The present study is an attempt to determine the accuracy of MUAC for the assessment of overweight and obesity among children and adolescents of Khiamniungan tribe. Methods: This is a cross-sectional study which includes 960 Khiamniungan tribal children and adolescents of both sexes aged 5-16 years. All the somatometric measurements were assessed objectively. Result: MUAC was found to be strongly correlated with height, weight, waist circumference and body mass index in both children (r≥0.617; p<0.001) and adolescents (r≥0.74, p<0.001). The MUAC cut-off to identify BMI-defined overweight/obesity among children 16.50 cm and adolescent’s 21.50 cm. AUC results were ‘fair’ for children and ‘excellent’ for adolescents (0.75 and 0.95, respectively). Conclusion: MUAC can be preferred over conventional BMI as an alternative screening tool in a resource-poor setting as it is simple, inexpensive, easy to use, and non-invasive method.
Key words: Children, Adolescents, Overweight, Obesity, Mid-upper arm circumference |
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2019;4:3
Original Article |
Osadchuk MA, Vasilieva IN, Trushin MV.
Gender Aspects of Cardiovascular System Functional Status in Senile Patients with Hypertension. |
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Abstract: Objective: This study is aimed at studying the gender characteristics of the functional state of the cardiovascular system in elderly patients. Material and Methods: 74 senile patients (32 males and 42 females) aged 75-90 years old were examined in an outpatient department. Each patient was performed clinical and laboratory examination, electrocardiographic and echocardiographic examination, daily monitoring of blood pressure, determination of the actual biological age, adaptation potential of the cardiovascular system and features of vegetative regulation. Results: The results of the study confirm that the human body of old age despite the involutive changes does not lose over the years the ability to adapt, adapt and function. In men, the excess of biological age testified to the presence of their more significant influence of age factor. In elderly women, less pronounced signs of pathological cardiac remodeling and a greater ability to adapt were revealed. Conclusion: Involutive changes of the whole body make a special contribution to systemic hemodynamics, which should be taken into account by the attending physician in the treatment of elderly patients.
Key words: Senility, Biological age, Gender differences, Orthostatic hypotension, Hemodynamics |
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2019;4:4
Original Article |
Orji CJ, Chime OH, Ugwuonah C.
Incidence and Pattern of Adverse Events Following Immunization in the 2017/2018 Measles Vaccination Campaign in Nigeria. |
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Abstract: Introduction: A national post - campaign coverage survey was performed in Nigeria at the end of the measles vaccination campaign in 2017/2018. This study aims to assess the incidence and pattern of adverse events following immunization (AEFI) among Nigerian children aged 9 -59 months. Methods: A stratified two stage- cluster sampling design was used. From each state 210 households were selected using the national census sampling frame. Data was analysed using STATA version 14 software. Results: Out of the 10153 eligible children that were sampled during the survey, a total of 19.1% of AEFI cases were reported nationally. The AEFI reporting rate was highest for systemic reactions which occurred in the 24-59 months age group (33.9%), in males (11.6%) and rural dwellers (12.1%). Conclusions: This study reveals that the AEFI reporting rate was relatively low. Mild systemic reactions accounted for majority of the AEFIs.
Key words: Adverse events following immunization, Nigeria, Children, Surveillance |
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2019;4:5
Original Article |
Hafneeda H, Padmanabhan M, Sindhu ER.
Variations of Serum PSA Values at Different Time Points of Treatment Based on D’Amico Risk Stratification Groups - An Observational Analysis. |
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Abstract: Prostate cancer-the most common malignancy- among men worldwide, is among ten leading cancers in Kerala. The changes in serum PSA values at different time points of treatment might be of prognostic importance. The objective of this retrospective study was to stratify patients with prostate cancer according to D’AMICO risk stratification groups and correlate it with pre and post treatment PSA values. PSA, ALP as well as Gleason score noted in initial stage of diagnosis and during follow-up. There is a significant difference between pre and post treatment PSA (p <0.001). PSA values in risk assessment groups based on D'Amico Risk stratification was found significant (p<0.001). The number of patients in high risk category at 3 months follow-up (70%) indicating a slower response to treatment of prostate cancer and maximum in intermediate risk (82.4%) and low risk (64%) category at 12 and 24 months interval indicating a better response to treatment.
Key words: Prostate Cancer, D’Amico risk stratification, Prostate Specific Antigen, Gleason Score, Alkaline Phosphatase |
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2019;4:6
Original Article |
Smita MS, Wavare SS, Gajul S, Sajjan AG.
Bacterial Profile of Urinary Tract Infections and Antibiotic Resistance Pattern in a Tertiary Care Hospital. |
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Abstract: Background: Due to, emergence of multidrug resistance, empirical treatment of Urinary tract infections is becoming intricate. Aim: To know the bacteria causing UTI, their antibiogram and possibility of using fosfomycin as an empirical drug. Material and Methods: Urine sample from suspected UTI cases were cultured by standard method. Identification of bacterial isolate, antimicrobial susceptibility and ESBL production was performed by standard protocol. Results: Of the 1674 urine samples 529 samples showed significant growth of which 386 were Gram negative bacilli, 107 Gram positive cocci and 36 Candida species. Most prevalent pathogens were E. coli (47.4%) among the Gram negative group and Enterococci (13%) among the Gram positives. A good number of bacteria were susceptible to fosfomycin. Conclusions: Routine surveillance studies are needed to have knowledge about the most effective empirical treatment. Fosfomycin looms out as the drug of choice for empirical treatment of UTI in this area.
Key words: ESBL, fosfomycin, MDR, UTI |
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2019;4:7
Original Article |
Salati SA.
Awareness About Testicular Cancer and Testicular Self-Examination (TSE) in Indian Expatriates in the Middle East. |
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Abstract: Objective: The study was conducted to assess the level of awareness about testicular cancer and the prevalence of the practice of testicular self-examination (TSE) in the Indian expatriates in the Middle East and thereby propose appropriate interventions. Methods: A cross-sectional survey was conducted in a random sample of Indian subjects aged 15-35 years and working in various sectors in Al-Qassim region of the Kingdom of Saudi Arabia. A questionnaire was self-designed and filled during interviews to study the awareness levels related to testicular cancer and testicular self-examination. Results: Overall awareness level related to testicular cancer was found to be poor in 89%, fair in 10% and good in 1% of the participants of the study. The practice of correct monthly testicular self-examination was virtually non-existent. Conclusion: Awareness regarding testicular cancer and testicular self-examination in Indian men aged 15-35 years, working in Saudi Arabia is low. Dedicated efforts are required in order to educate this large segment of at-risk population. Healthcare providers of Indian origin working in the Middle East can play effective role on this front.
Key words: Testicular cancer, testicular self-examination (TSE), awareness, health education, social media |
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2019;4:8
Original Article |
Nayak SB, Shetty SD.
High Incidence of Sutural Bones, Especially at the Asterion - A South Indian Study. |
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Abstract: Background: The sutural or wormian bones are small bones that are frequently found within the sutures and fontanelles of the skull. They are often considered to be a simple anatomical variant. They are most commonly located in the lambdoid suture, second highest site for sutural bones being lambda with least incidence at bregma. Material and Methods: In the present study, twenty seven adult human skulls were examined for the presence of these bones. Results: Among the 27 skulls studied, 24 (88.8%) skulls had sutural bones and 3 skulls were without any sutural bones. Asterion was the commonest region of the skull to have sutural bones. Conclusions: It is essential for neurosurgeons and radiologists to be aware of the occurrence of sutural bones as they may be misguided for fractures in cases of head injuries. Therefore, this study may be useful to the neurosurgeons, radiologist, and anthropologists.
Key words: Sutural bones, cranium, asterion, lambda, bregma, anatomical variant |
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This Article |
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2019;4:9
Original Article |
Purohit BC.
Changing Demand for Healthcare in India. |
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Abstract: Healthcare consumers may be behaving to some extent based on the nature of healthcare being a necessity or otherwise. The choice of either of public and private providers may depend upon factors like availability, accessibility, cost and quality. To some extent, this is revealed through their elasticities based on income, cost, quality and socio-economic factors. Objective of this paper is to explore the demand for healthcare services in India and estimate consumers’ elasticities to these factors. Using logit results we find that an individual may choose his preference for private or public based on distance of facility from residence. It may also depend whether it is rural or urban area and whether the income levels of state are below or above all India average. Comparing our results for two all India surveys, it is observed that people’s perception and thus preferences are mostly based on choices of nearby location, suitable timings, presence of medical personnel and less waiting time. The presence of insurance either by a national or state sponsored scheme seems to have changed the nature of healthcare demand in India from a stark necessity to a matter of better choice.
Key words: Healthcare, availability, accessibility, quality, socio-economic factors |
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2019;4:10
Review |
Davydkin IL, Tereshina OV, Kuzmina TP, Naumova KV, Osadchuk MA, Osadchuk AM, Trushin MV.
Methods of Detecting the Reduction of Myocardial Contractility in Patients with Oncohematological Profile in the Course of Polychemotherapy. |
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Abstract: The article is devoted to the modern representation of methods of diagnostics of subclinical myocardial contractile dysfunction in oncohematological patients in the course of chemotherapeutic treatment. Taking into account that the possibilities of standard echocardiographic examination not always allow to identify the subclinical dysfunction of the left ventricle (LV) myocardium, it is necessary to use more sensitive diagnostic strategies for the monitoring of myocardial function. The aim of this literature review is to present problems and prospects for detecting early, subclinical changes in the contractility of the LV myocardium in oncohematological patients who have undergone chemotherapeutic treatment, and to assess their significance as predictors of late chemotherapeutic cardiotoxicity. Echocardiography to assess global longitudinal strain (GLS), stress echocardiography (SE) with determination of the contractile reserve (CR) have a predictive role in the diagnosis of changes in myocardial contractility at early stages and the use of these methods in the examination of oncohematological patients will improve their quality of life and increase its duration.
Key words: Echocardiography, ejection fraction, global longitudinal strain, stress echocardiography, left ventricular contractile reserve. |
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2019;4:11
Review |
Dongre AR.
Relevance of Educational Theories in Medical Education. |
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Abstract: In modern times, learning in the medical profession is taking place on a large scale in various settings such as classroom, patient’s bedside, simulation laboratory and community. It is important for a teacher to understand how learning can take place in these settings and ensure that the desired learning outcomes are achieved. The purpose of the present article is to review the explanations of the various ways the learning can take place in various settings and explore where and how educational theories can help us in planning the student learning. The understanding of educational theories has implications for session planning, planning an educational research and programme evaluation. Thus, the teachers’ subject knowledge and their assumptions on how learning could take place, forms the base for effective student learning, educational evaluation and research. These theories were developed over the period of years and there is no single theory which alone can explain the process of learning in all the situations. Hence, the teachers should be able to make a choice of educational theory to explain the learning process for the given teaching-learning activity. The faculty should develop the practice of considering educational theories while planning their teaching assignment and educational research.
Key words: Medical Education, Theory, Student, Learning |
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2019;4:12
Review |
Meitei KT, Singh HS.
Prevalence of Depression Among Indian Population. |
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Abstract: Depression becomes one of the most serious global health problems affecting at every stage of an individual life, thereby imparting the ability to function one's daily activities. India was accounting for about 13.98 % of the total population with depression in the world. The present paper attempts to understand the prevalence of depression among the Indian population. Relevant studies were identified using an electronic database such as PubMed, Medline, PsycINFO, and Google Scholar and included those studies which show the prevalence of depression among the Indian population for the last fifteen years. The overall prevalence of depression was pooled using random-effect models. The prevalence rate of depression varied from adolescents (6.7 to 79.21 %), college students (16.5 to 71.3 per cent), elderly population (8.9 to 77 %) and general population (6 to 52.7 per cent) with an overall pooled prevalence of depression 36.2 per cent (95% CI 31.6 to 41.8 %). Poor academic performance, family problems, and female gender are highly associated with depression among adolescents and college students. Among Elderly and General population groups increasing age, illiterate, unemployment, female gender, and medical comorbidities are highly associated with depression. Depression can be controlled by giving public awareness about its health consequences and educate people that mental illness is the same as other types of illnesses like diabetes, heart attack, liver problems, and one's need to take counseling or medications with the advice of mental health professionals.
Key words: Depression, Mental illness, Adolescents, College students, Elderly, General population, Mental health professionals |
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2019;4:13
Case Report |
Shanthakumari BR, Singh VK, Ramakrishnan K, Belurkar S.
Pediatric Chronic Myeloid Leukemia: Case Report of a Disease with a Unique Biology. |
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Abstract: Pediatric chronic myeloid leukemia constitutes around 3-5% of all childhood malignancies. It is characterized by t(9;22) with BCR-ABL1 fusion and p210 transcript. A 9-year-old male child presented with hepatosplenomegaly, anemia, marked leucocytosis, basophilia, myelocyte metamyelocyte peak,and 4% blasts in the differential count. Leukocyte alkaline phosphatase score was reduced and p210 transcript of BCR-ABL1 was identified by a polymerase chain reaction. Bone marrow was hypercellular with increased granulopoiesis, dyspoietic megakaryocytes and grade III reticulin fibrosis. The patient was treated with imatinib and showed a hematological response within one month and has a stable disease for the last 24 months. Owing to lack of specific guidelines on management and monitoring of pediatric chronic myeloid leukemia, it managed according to the adult guidelines by European leukemia Net or National Comprehensive Cancer Network guidelines. Drug toxicities, effect on growth, vaccination, and fertility are pressing issues in management of pediatric chronic myeloid leukemia with current first-line therapy with tyrosine kinase inhibitors.
Key words: Chronic myeloid leukemia, pediatric, BCR-ABL1, splenomegaly, imatinib |
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2019;4:14
Case Report |
Chandrappa DH, Pai K.
Neuroendocrine Carcinoma of Urinary Bladder: Misdiagnosed Neoplasm. |
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Abstract: Neuroendocrine carcinoma of the urinary bladder is an exceedingly rare pathology, comprising 0.35- 0.70% of all bladder cancers. The presenting symptoms and gross morphology are identical to conventional urothelial carcinoma, but the prognosis is much worse with frequent metastasis. Neuroendocrine carcinoma has been subdivided into small cell and large cell carcinoma. Hematuria is the main symptom with some patients having associated paraneoplastic conditions. The cell of origin of neuroendocrine carcinoma is from a multipotential stem cell with the ability to differentiate to other types.
We report a case of 76 yr old male who presented with history of hematuria was diagnosed on bladder biopsy as neuroendocroine carcinoma bladder (100%) with diffuse synaptophysin positivity, Ki 67 indexx of 85% and negative p63. The treatment of neuroendocrine carcinoma of the bladder is not standardised and the prognosis is poor; however, cisplatin-based chemotherapy regimens seem to have a better prognosis.
Key words: Neuroendocrine carcinoma, urinary bladder |
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