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Volume-20 (2021);
No. 1 (January-March)
Published on June 30, 2021
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2021;1:1
Original Article |
Rai S, Singh MS.
Rising Prevalence of Obesity and its Associated Socioeconomic Factors Among the Urban Women of Gangtok, Sikkim. |
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Abstract: Background: The prevalence of obesity is increasing worldwide. Several socioeconomic factors influence the lifestyle of the individual and society as a whole. Obesity is a risk factor for several health problems such as hypertension, diabetes mellitus, stroke, arthritis, gall stones and sleep apnea. Objective: The present study was conducted to find the prevalence of obesity and its associated socioeconomic factors among the urban women of Gangtok, Sikkim. Methods: The data was collected from 657 adult women aged between 20 to 60 years from urban areas of Gangtok through random sampling method. Anthropometric rod and weighing machine were used to measure height and weight respectively. Structured schedule was used to collect data on various socioeconomic conditions. Results: The frequencies of overweight and obesity among urban women in Gangtok were 30.4 percent and 15.1 percent respectively. The central obesity in the study population was 56.2 percent. The frequency of obesity was higher among married women (37.6%), middle income family (20.9%) and secondary education (24.6%). Conclusions: Various socioeconomic conditions like education, occupation, income, marital status and age group shows a significant association with the prevalence of overweight and obesity in the present study.
Key words: Obesity, Socioeconomic factors, Central obesity, Gangtok |
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2021;1:2
Original Article |
Thomas T, Kamath N, Kumar A, D'Silva F, Shetty PK.
Prevalence and Severity of Menopausal Symptoms Among Women – A Community-Based Cross-Sectional Study. |
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Abstract: The women aging process is characterized by a gradual transition from reproductive to non reproductive life period. These changes in aging during menopause are accompanied by a wide range of physiological as well as psychological disturbing symptoms. Menopausal symptoms have been widely studied in women from western societies, but less information is available for women of non-western ethnic groups. There is evidence of differences in the prevalence of symptoms in Asian versus Western women. This study evaluates the menopausal symptom of women aged between 48 to 55 years which is important to understand the prevalence and plan for the remedial measures and also to create health awareness among women. Objective: To assess the prevalence of menopausal symptoms among women. Methods: A community-based cross-sectional study was carried out, using a stratified sampling technique. The study was conducted in three Primary Health Centres of Mangalore Taluk: Kotekar, Natekal and Mudipu. A total of 1034 samples between the ages of 48–55 years were screened under 16 sub-centers. Results: The average age among menopausal women was 49.8 ± 1.51 years. The average age of attaining menopause among the participant was 48.26 years. The most common symptom reported under the domains of vasomotor is hot flushes. About 83% of the participants were experienced with hot flushes and 71% of participants are reported with night sweats. The most common psychosocial symptoms experienced by menopausal women were forgetfulness [72%], feeling anxious [52%]. The most reported physical symptoms among study participants were tiredness [80%], lack of energy [71.2%] and difficulty in sleeping [60%]. The least reported domains of menopausal symptoms were frequent urination and urinary tract infections. Under the sexual complaints, 82% of the participants reported changes in the sexual desire. Conclusion: The study has shown that the prevalence of classical menopause symptoms like profuse sweating along with hot flushes, increased anxiety, depression, wanting to be alone, and urinary tract infections were lower but, symptoms like hot flushes, night sweats, tiredness, difficulty in sleeping, changes in sexual desire were the prominent symptoms among the study participants.
Key words: Prevalence, menopausal symptoms, women, ASHA worker, community |
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2021;1:3
Original Article |
Korzh O, Nikolenko Y, Titkova A, Pavlova O, Vovk K.
The Long-Term Clinical Outcomes in Patients after Myocardial Infarction in Primary Care. |
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Abstract: The aim of this study was to investigate the effect of continuous multifaceted patient-centered interventions at primary care level in patients with myocardial infarction (MI) after discharge on achieving clinical practice guideline goals and reducing the rate of hospital readmissions for cardiovascular diseases. Methods: This prospective randomized clinical study was conducted enrolled patients with MI from January 2, 2017 to December 31, 2019. Patients received medication reconciliation and education from a family physician before hospital discharge. The intervention group (IG) received continuous consultations from the family physician after discharge, whereas the control group (CG) did not. Primary outcomes included achieving blood pressure < 140/90 mmHg, low-density lipoprotein-cholesterol (LDL-C) < 70 mg/dL, and hemoglobin A1c (HbA1c) < 7% targets. The secondary outcome was major adverse cardiac events (MACEs), defined as re-hospitalization due to MI, unstable angina and stroke. Results: Two hundred and nineteen patients completed the study protocol (110 in the IG and 109 in the CG). The rate of achieving blood pressure goal was similar between the two groups. More patients in the IG achieved LDL-C and HbA1c goals than those in the CG at 1 year and 2 years post discharge. However, there was no significant difference in the cumulative incidence of MACEs between the two groups. Diabetes was the only independent predictor of rehospitalization due to a MACE. Conclusions: Family physicians interventions led to a higher rate of optimal controlled modifiable risk factors but did not significantly reduce the MACE rate in the patients with MI.
Key words: Myocardial infarction, Primary care, Family physician, Education. |
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2021;1:4
Original Article |
Alkhaffaf WH.
Evaluation of Sensory Nerve Conduction Abnormalities in Patients with Amyotrophic Lateral Sclerosis. |
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Abstract: Background: Amyotrophic lateral sclerosis (ALS) is one of progressive neurodegenerative diseases. Although motor dysfunction is the most prominent problem, some patients identified objective sensory signs. Aims: To determine the presence of electrophysiological sensory nerve abnormalities in ALS patients and to study if there are possible relations between these findings with the gender, age, illness duration, functional status, and receiving Edaravone injection. Materials and methods: Thirty patients diagnosed as definite ALS according to the El Escorial World Federation of Neurology criteria (nineteen of them have received Edaravone injection), and sixty healthy persons, were examined following regular electrophysiological examination routines. Those with abnormal Sensory Nerve Conduction Study (SNCS) were determined, then the possible relations between the abnormal findings with the gender, age, duration of illness, functional status (assessed by using ALS Functional Rating Scale), and receiving Edaravone treatment were studied. Results: The percentage of abnormal SNCS was significantly higher in the patient group, 30% vs. 6.6% in the control group, In the patient group, the relations between these abnormal findings with the age, illness duration, functional status, and receiving of Edaravone drug, all were significant. Conclusion: Numerous studies indicate the involvement of the peripheral nervous system in the ALS disease where the sensory neurons and their axons are affected also. This information is supported by the results of this study in which the extension of sensory involvement is corresponding to the increasing of age, illness duration, functional disabilities, and non-receiving Edaravone drug.
Key words: Amyotrophic lateral sclerosis, ALS Functional Rating Scale, Edaravone injection, Sensory Nerve Conduction Study. |
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2021;1:5
Original Article |
Avirneni HT, Nandi P, Pawar SJ.
Economic Burden of CKD Among the Beneficiaries of a State-Run Insurance Scheme. |
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Abstract: Since the adoption of Universal Health Coverage (UHC), there has been a series of health insurance schemes launched across the country. All these schemes aimed at achieving UHC, mainly by providing financial risk protection to the respective citizens who are deprived by poverty. Tamil Nadu Chief Ministers Comprehensive Health Insurance Scheme (TNCMCHIS) is one such policy reform launched to provide free of cost quality health care services to its beneficiaries. Through this community based longitudinal study, we aimed to see the economic burden of CKD among the beneficiaries by estimating the Out of Pocket Expenditures recorded by them for a period of six months in the dairies given to them. The study results provide an evidence that although the beneficiaries had OOPE, the catastrophic effects of OOPE was not present in majority of them, thus showing the role of scheme in reducing the economic burden of ill-health among the beneficiaries.
Key words: Catastrophic Health Expenditures, Financial risk protection, Government financed health insurance schemes, Tamil Nadu Chief Ministers Comprehensive Health Insurance Scheme, Policy reforms, Universal health coverage |
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2021;1:6
Original Article |
Kumar NP, Chandermani.
Taking Dialysis Near the Doorstep: A GIS Based Approach for Catchment Area Analysis and Insight into Hemodialysis Patient’s Perceptions of Extra Mural Dialysis Services in India. |
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Abstract: Background: Geographic Information System (GIS) is a modern technological tool for plotting and analysing data and making intelligent decisions out of it. Chronic Kidney Disease is one of the leading cause of deaths among non-communicable diseases. It is observed that CKD patients face problems as they have to frequently travel to dialysis centre, which involves time and money. Due to poor accessibility to dialysis centres, around half such patients are lost to follow-up. It was therefore decided to find ways to solve the problems of shortage of dialysis centers and accessibility using GIS. Methodology: Observational study, with retrospective analysis of demographic data of all existing dialysis patients on outpatient basis at this hospital for past three years. Based on the pin codes of the localities, we mapped the places of origin of patients. A self-administered questionnaire was study tool that we distributed and collected one time to understand their perceptions on travel costs, convenience. Results: It was found that 77% of patients were from low income families. The age group is 22 to 58 years of age. 62 patients who required dialysis were not given appointment due to lack of available time slots. Patients were willing to pay more for dialysis done at doorstep. This reduces the financial burden to the family members on transportation, food, accommodation costs at our hospital. Conclusion: Setting up extra-mural (beyond hospital walls) dialysis services could act as a novel approach to reaching out to the masses for improving access to specialized healthcare and reducing healthcare burden on the overburdened primary institution at the same time. In addition, it could improve patient retention and compliance rates, having a positive impact on the market share and hospital revenue.
Key words: Geographical Information System (GIS), Chronic Kidney Disease, Sustainable healthcare models, Mobile dialysis, Distance. |
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2021;1:7
Original Article |
Chandar S, Pandurangan V, Madhavan S, Srinivasan D, Bhaskar E, Marappa L, Varadaraj P, Nair AM, Rajendran V.
Clinical Profile and Outcome of Severe Sepsis Related Acute Kidney Injury Among Patients Admitted in Intensive Care Unit – An Observational Prospective Study. |
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Abstract: Background: Critically ill patients in Intensive care unit (ICU) are at a high risk of developing Acute Kidney Injury (AKI) and sepsis is attributed as a cause for AKI in almost half of them. Sepsis related AKI (S-AKI) causes 6 to 8 fold increase in mortality. Aim: To study the clinical profile and outcome of patients with severe sepsis related AKI and to assess the factors associated with fatal outcome among those patients. Methods: This study was a prospective observational design done over a period of 18 months among patients admitted in ICU in a tertiary care hospital in South India. Patients above 18 years of age satisfying case definition of severe sepsis, who had AKI or developed AKI were studied. During their course of stay, timing of onset of AKI, primary source of infection, need for ventilatory support and renal replacement therapy (RRT) were noted. Outcome was categorized as survivors and non-survivors and factors associated with mortality was assessed.
Results: Among the total 304 patients studied, 68.1% (n=207) were males and 31.95 (n=97) were females. Mean AKI onset was 1.62 days with 80% having onset <48 hours. Most common source of sepsis was respiratory tract source (n=97, 31.9%) followed by urinary tract source (n=62, 20.39%). Non survivors were 203 (66.8%) and survivors were 101 (33.2%). Primary source of infection significantly associated with fatal outcome in our study includes respiratory tract source (p=0.008), urinary tract source (p=0.002) and soft tissue infection (p=0.006). Need for mechanical ventilation support is significantly associated with mortality (p<0.001) and early AKI tends to have more severe acidosis ( mean serum bicarbonate of 16meq/L), higher leucocytosis (mean white cell count of 22217 cells/mm3) among non-survivors. Mortality rate observed was 66.8%. Sixty six patients (21.7%) required RRT, renal recovery was seen in 26% (n=79) and 34.6% (n=35) of survivors did not had renal recovery. Conclusion: Early AKI presentation (< 48hours) seems to be more common in severe sepsis. Primary source of infection such as respiratory tract, urinary tract, soft tissue infection and need for ventilatory support is associated with fatal outcome among patients with severe sepsis and AKI.
Key words: Severe Sepsis, Acute Kidney Injury, Mortality |
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2021;1:8
Original Article |
Rather AA, Salati SA.
Retroperitoneal Laparoscopic Pyelolithotomy for Unilateral Large Sized Staghorn Renal Calculi. |
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Abstract: Background: The introduction of endourological procedures such as percutaneous nephrolithotomy and extracorporeal shock wave lithotripsy have led to a revolution in the management of nephrolithiasis. But in large sized staghorn calculi with branching, laparoscopic pyelolithotomy has a role and in recent years, retroperitoneal laparoscopic pyelolithotomy (RPPL) approach has been reported as a feasible alternative in various series. Aims and Objectives: To study the safety and efficacy of retroperitoneal laparoscopic pyelolithotomy (RPPL) in management of renal calculi bigger than 4 cm. Methods: This prospective study was conducted from January 2017 to June 2020 at the Department of Surgery, SKIMS Medical College, Bemina, Srinagar, Kashmir, India. The study included a total of 20 cases with the diagnosis of solitary renal pelvic calculi sized 4 cm and above. Results: There were 16 males and 4 females. The mean operative time was 107 min (range 86min-124 min) and the approximate mean blood loss was above 98.2 ml (range 74 ml – 144ml). Stone clearance was achieved in 18 cases and 2 cases were converted to the open procedure due to technical difficulties. Conclusion: Retroperitoneal laparoscopic pyelolithotomy (RPPL) is a safe, simple and feasible option that can be recommended for management of large sized staghorn renal calculi, if proper logistics and skilled personnel are available.
Key words: Retroperitoneal laparoscopic pyelolithotomy, Renal calculi, Nephrolithiasis, Percutaneous nephrolithotripsy, Extra corporeal shock wave lithotripsy. |
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