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 Table of Contents 
Year : 2018  |  Volume : 7  |  Issue : 8  |  Page : 1-61  

Platform presentation 1 30th July 2015 - session 1, room 1

Date of Web Publication24-Dec-2018

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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2249-4863.248471

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How to cite this article:
. Platform presentation 1 30th July 2015 - session 1, room 1. J Family Med Prim Care 2018;7, Suppl S2:1-61

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. Platform presentation 1 30th July 2015 - session 1, room 1. J Family Med Prim Care [serial online] 2018 [cited 2020 Feb 29];7, Suppl S2:1-61. Available from:

  1.1.1 Prevalence and determinants of work-related low back pain among the Information Technology Professionals: A cross-sectional study Top

A. S. Gagan Kumar1

1Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India

Background: Approximately 76% of the computer professionals from India reported musculoskeletal discomfort in various epidemiological studies (Talwar et al., 2009; Bhanderi et al., 2007; Sharma et al., 2006; and Bakhtia et al., 2003). Among them, lower back pain (LBP) is a very frequently occurring phenomenon. The objective of this study was to study the prevalence of Work-related LBP as one of the major Work-related Musculoskeletal Disorders among the Information Technology Professionals and establish the possible risk factors causing LBP. Hence, Cross-sectional study design was adopted. Methods: IT Professionals (N = 200) working in Bengaluru City of India were used for screening of this study. Cornell Musculoskeletal Discomfort Questionnaire was administered to capture the factors pertaining to the occurrence of LBP. The Chi-square test was employed to study the factors among the employees reported with LBP. Simple percentages and means were employed to study the factors. Results: It was inferred that 59% (N = 118) of the subjects (IT-Professionals) who participated in the study reported LBP. Conclusions: The study concludes that LBP is the major Work-related Musculoskeletal Disorder among the IT Professionals. In this study, 59% of them reported LBP. Appropriate preventions and intervention strategies could be emphasized to ensure a healthier working atmosphere, thereby improving productivity of the IT Employees. Further, large scale studies can be taken up to establish the causes and risk factors associated with LBP and other musculoskeletal disorders prevalent among the IT-Professionals.

  1.1.2 Study of serum Vitamin D level in breast cancer patients Top

K. S. Aananda Krishna1, Ursula Sampson1

1Meenakshi Medical College Hospital and Research Institute, Kanchipuram, Tamil Nadu, India

Background: Vitamin D receptors are said to be present in breast tissues and cause inhibition of Oncogenesis. In a conventional study done in Canada, women with Vitamin D deficiency have 12% more chances of getting breast cancer. Such data for Indian population are lagging. This triggered to compare the level of Vitamin D in patients diagnosed with breast cancer and age-matched control among various stages of breast cancer. Methods: This is cross-sectional study. Study Population: 75. 5 ml of blood is obtained from 75 patients after getting their written consent. From 5 ml, 2 ml of serum is obtained by centrifugation and analyzed for Vitamin D by ElectroChemiluminescence Roche. Patients are group according to American Joint Committee classification of staging for breast cancer. Inclusion Criteria Patients diagnosed with breast cancer, age-matched control without any Vitamin D deficiency and disorders. Exclusion Criteria: Patients having acute/chronic skin disease, patients having acute/chronic gastrointestinal diseases, and patients taking multi-vitamin tablets. Results: Vitamin D level in breast cancer – mean value 36 ng/dl (+6.2 standard deviation [SD]); in control population – mean value 21 ng/dl (+8.2 SD). Vitamin D level in patient with stage 0 – mean value 32 ng/dl (+11.2 SD); in patient with stage 1 – mean value 21 ng/dl (+11.2 SD); in patient with stage 2 – mean value 18 ng/dl (+3.2 SD); in patient with stage 3 – mean value 14 ng/dl (+8.2 SD); and in patient with stage 4 – mean value 6 ng/dl (+8.2 SD). Conclusions: Vitamin D level in patient with breast cancer is significantly reduced when compared with age-matched control and Vitamin D level decreases with advancement of stages.

  1.1.3 Clinical profile of chronic rhinosinusitis and polyposis Top

Abhiram Ramesh Mundle1, Kanchan Lanjewar1

1Indira Gandhi Government Medical College, Nagpur, Maharashtra, India

Background: Chronic rhinosinusitis is one of the commonly encountered problems in otorhinolaryngological practice. A study by NIAID recently concluded that 134 million Indians suffer from chronic rhinosinusitis (CRS) which is more than double the number of diabetic patients in India. Nasal Polyposis is considered a subgroup of CRS with an incidence of 25–30% of the patients suffering from CRS. Methods: The study was carried out in the Department of ENT, IGGMC, Nagpur, to analyze the demographics, clinical features in a group of patients with CRS and CRS with polyposis. The study population included 59 patients of CRS and 43 patients of CRS with polyposis after fulfilling the inclusion and exclusion criteria. Each patient had severity score for each symptom and Total Symptom Severity Score (TSSS). The patients were diagnosed and grouped into CRS and CRS with polyposis based on guidelines by the American Academy of Otolaryngology Head and Neck Surgery. Results: The prevalence of CRS and CRS with polyposis was more in urban areas. The most common symptom was nasal obstruction followed by nasal discharge. In CRS group, 72.9% of the patients had TSSS in the range ≤15 and that for CRS with polyposis group, 62.8% of the patients were in the range >15. In CRS group, in anterior rhinoscopy, inferior turbinate hypertrophy was most common (94.9%) while in CRS with polyposis group, nasal discharge was present in 100% of the population. Conclusions: The maximum number of patients having CRS was in the age group of 10–20 years and those with polyposis were in the age group 21–30 years. Male and female were almost equal in CRS group whereas in polyposis group females outnumbered males. The most common symptom was nasal obstruction followed by nasal discharge. The severity of symptoms was more in the CRS with polyposis group.

  1.1.4 Early detection of ovarian cancer through urinary CA-125 Top

Chandra Vedansh1, Lal Nirupma1

1Era's Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh, India

Background: Ovarian Cancer is the fifth leading cause of cancer deaths in females and accounts for approximately 50% of all deaths from gynecologic cancers. CA-125 is the gold standard tumor marker for ovarian cancer and is elevated in 80–90% of advanced stage ovarian cancers. CA-125 correlates with the state of the disease and can be used in monitoring progression of the disease. Serum and urinary CA-125 are significantly higher in ovarian cancer group. The present study was planned with the aim of detection of urinary CA-125 in benign and malignant epithelial ovarian tumor. Methods: The research was based on a case study done over a period of 4 months comprising 10 cases including both benign and malignant epithelial lesions of Ovary. Cases with metastasis to ovary or with positive diagnosis of AIDS/ tuberculosis/leprosy were excluded. Tissue excised was stained with hematoxylin and eosin for histopathological confirmation. The urine and serum samples were taken to measure CA-125 levels by the commercially available standard ELISA kit method using Calbiotech™ kit for urinary CA-125. Results: Of 10 cases, 5 cases were of benign tumors, 1 borderline tumor, and 4 of malignant tumors. Maximum serum and urinary CA-125 value was in a case of papillary serous adenocarcinoma with serum CA-125 957 U/ml and urinary CA-125 207.54 U/ml, whereas the lowest were in a case of mucinous cystadenoma with serum CA-125 19.5 U/ml and urinary CA-125 2.36 U/ml. Therefore, there is a significant and definite correlation in serum and urinary CA-125 values in ovarian malignant cases. Conclusions: Urinary CA-125 can be an important noninvasive diagnostic tool for early detection of ovarian cancer. Serum and urinary CA-125 levels are lower in benign cases and higher in malignant lesions with a significant correlation between their levels, thus making it a suitable marker for monitoring the progress of the disease.

  1.1.5 Epidemiology of occupational hand injuries and its functional outcome with reconstructive options and management Top

Garg Monal1, Mago Vishal1

1BPS Government Medical College, Haryana, India

Background: BPS Government Medical College KhanpurKalan hospital serves as an epicenter and receives hand injury patients from both agricultural areas like khanpurkalan as well as industrial areas such as Panipat, Jind, and Hisar in a significant number. Aim: the present study aims to find the epidemiology of occupational hand injuries and its functional outcome with reconstructive options and management. Methods: This is a retrospective study of 45 cases who reported in the Outpatient Department and Emergency Department of Plastic Surgery for 2 years. All the subjects were interviewed using a predesigned questionnaire. Personal particulars, date and time of injury, type of industry, mode of injury, safety awareness, contributing factors, and treatment given were recorded. Results: In our study, 91% of the patients were right hand dominant, 42.5% had only right hand injury, 40% had bilateral hand injury, and 17.5% had only left hand injury. Most of the injuries were due to thresher machines (78%). Contributing factors found were machinery malfunction (42%) and worker's carelessness (31%). A number of working days lost were 20% for 2–4 weeks, 76% for 4–8 weeks, and 4% for more than 8 weeks. Conclusions: Based on our survey, adequate safety training before induction along with regular safety drills and education can make a significant contribution to reduction in hand injuries.

  1.1.6 CD133 Stem cell markers in oral precancer and cancer Top

Giri Anjali1, A. N. Srivastava1

1Era's Lucknow Medical College, Lucknow, Uttar Pradesh, India

Background: Cancer stem cells (CSCs) detected in head/neck cancer have been found to be associated with poor response to treatment, recurrence and/or metastasis. Oral cancer needs detection and characterization of CSC as it will facilitate preplanning an aggressive treatment in these cases and help in detection of newer cancer treatments. Hence, this study was planned to evaluate CSCs characterized by CD133 as CSC stemness marker. Methods: Case only, prospective hospital-based study of four months duration comprising twenty cases of oral submucous fibrosis, leukoplakia, and oral cancer were examined for screap smear and tissue biopsy for histopathology and immunohistochemistry for CD133 using DAKO antibody kit from USA along with positive and negative controls. Results: The study demonstrated seven cases Cd133 positive and seven negative from a total of 14 cases of oral squamous cell carcinoma. There was one case CD133-positive of the three cases of oral leukoplakia; whereas, none of the three cases of submucous fibrosis were found CD133 positive. Conclusions: CD133-positive cells labeled as cancer stem cells were present in 50% cases of oral cancer cases. However, the study with larger number of cases is required to substantiate and correlate the findings, especially with different etiopathological causes of oral precancer and cancer prevalent in our country. Defining and characterization of CSCs will help in giving aggressive therapy and planning for newer strategies.

  1.1.7 Correlation of urinary cytology with tumor invasiveness in patients of urinary bladder cancer Top

Gul Aliya1, A. N. Srivastava1, Zaidi Noorin1, Siddiqui Zainab1, S. N. Sankhawar1, Singh Vishwajeet1

1Era Lucknow Medical College, Lucknow, Uttar Pradesh, India

Background: Carcinoma of urinary bladder is the second most frequent malignant tumor. Urinary cytology is still useful marker. This study was done to elucidate the usefulness of urine cytology examination in differentiating high-grade (with high invasive potential) urinary bladder cancers from low grade ones. Methods: To study the correlation of tumor invasiveness in patients of urinary bladder cancer. A hospital-based prospective case only pilot study was done for 4 months in 20 subjects. Urine samples were collected on 3 consecutive days; slides were prepared and stained by Papnicolaou stain. The stained slides were examined under microscope for the presence of cancer cells. Results: Of 20 cases that were registered in this hospital for 4 months, 9 cases were of high-grade tumor and 11 cases were low-grade tumor. By this method of urinary cytology, of 9 cases, 8 high-grade tumor were detected, the rest 11 cases of low-grade tumor showed negative urinary cytology. Conclusions: The study demonstrated that urinary cytology can detect 88% of high-grade cancer in the first instance and, thus, could be a good marker for follow-up studies through urinary cytology.

  1.1.8 Comparison of Effectiveness of Adenoidectomy, Grommet Insertion, and Myringotomy among Patients of Secretory Otitis Media Top

Gynanasuriya Prakashk1, Jayagar Prabhakar1

1Shri Lakshmi Narayana Institute of Medical Sciences, Puducherry, India

Background: Study design - case series prospective comparative study. Secretory Otitis Media (SOM) is one of the most common causes of hearing loss in school going children if undiagnosed early. The cross-sectional study for the prevalence of SOM in Puducherry and also prospective study was done to identify the various modes of presentation of SOM in children and to evaluate the various modalities of management in these cases. Methods: Fifty cases of bilateral SOM screened from various schools of Puducherry were referred to our institution for otoscopic and audiometric evaluation. Complete history and examination were done. Medical line of treatment was given for 3 months. These cases were then divided into four groups. Group A had 13 cases and underwent adenotonsillectomy and grommet (shepherd) insertion. Group B included 13 cases and underwent adenoidectomy and grommet insertion. Group C and D had 12 patients each and underwent grommet insertion and myringotomy, respectively. These cases were followed up at 6 weeks, 3 months, and 6 months after surgery. Audiological evaluation was done at each follow-up of the patients. Results: The prevalence of SOM among children of age 2–15 years is 12%. Fifty-six percent of the patients were in the age groups of 5–7 years, 34% in 8–12 years, 6% in 13–15 years, and 4% in 2–4 years. Hearing loss was 21–40 dB in 74% of the cases and 20 dB in 26%. The average improvement in hearing threshold was 24.42 dB in Group A, 21.9 dB in Group B, 17.41 dB in Group C and 14.37 dB in Group D, respectively after 6 months. Conclusions: The most common presentation was hard of hearing in children of the age group of 5–7 years. The improvement in hearing threshold was maximum in cases who underwent adenotonsillectomy with grommet insertion.

  1.1.9 MicroRNA 21 overexpression in cases of oral leukoplakia and cancer Top

Jain Chandni1, A. N. Srivastava1, Tandon Nishi1, Raza Tasleem1, Kawatra Rahul1, Bhargava Anuja1

1Era's Lucknow Medical College, Lucknow, Uttar Pradesh, India

Background: Oral cancer is the 6th most common cancer in world and most common in India. MicroRNAs are class of small, noncoding regulatory RNAs that are involved in regulating gene expression in majority of cancers including oral squamous cell carcinoma. The present study was planned to correlate MiRNA-21 expression in patients of precancerous and cancerous condition as it has been found to be expressed in several head and neck cancers. Methods: The present case–control study was done over a period of 4 months registering 20 cases including both oral leukoplakia and oral cancer and 20 controls. Tissue biopsy was taken for histopathological examination to confirm diagnosis and the remaining part of the sample was deep frozen −800°C for doing microRNA 21 overexpression studies using MirvanaTMMiRNA Isolation Kit (Ambion, Life Technologies, USA) detection was done using Taqman MicroRNA Assay (Life Technologies, USA) having a standard assay protocol on Applied Biosystems step one plus real-time polymerase chain reaction systems. Results: Of 20 samples collected, hematoxylin and eosin staining results showed that 14 were oral cancers and 6 were oral leukoplakia cases. Nine samples expressed microRNA 21 with varying degrees of intensity, 7 cases showed a higher microRNA 21 expression as compared to the remaining 2 cases which showed moderate expression. No microRNA 21 expression in 5 of 14 (oral cancer) and in controls was seen. Conclusions: It is concluded that microRNA 21 could be specifically used as a biomarker for early detection of patients suffering from oral cancer and or leukoplakia.

  1.1.10 Differentiation of round cells in semen: Correlation with total sperm count and sperm motility Top

R. B. Seema1, Vishrabdha Rahul Pawar1

1Bharati Vidyapeeth Deemed University Medical College and Hospital, Pune, Maharashtra, India

Background: Infertility is defined as the time of 1 year of unprotected intercourse without conception. Male factor contributes to 40–50% fertility problems. Semen analysis is the initial recommended investigation to fertility detection. This study was done to find out whether the inclusion of differentiation of round cells in semen would add to further details in a semen report. In addition, the analyses influence the medical management of an infertile couple. The objectives include: to perform routine semen analysis including physical, chemical, and microscopic examinations. Further to differentiate the round cells in the semen into immature germ cells and leukocytes. To seek a correlation between the total sperm count with round cells in the semen into immature germ cells and leukocytes. Methods: Semen samples were collected from the male patients who had come to Bharati Hospital, Sangli for evaluation of infertility in the period of July 2014 to September 2014. The study done was cross-sectional. It was a convenience sampling and those male patients were considered who had come for infertility evaluation. The data were subjected to the Student's t-tests to seek the correlation between the various parameters. The correlation that was sought was then statistically analyzed further to interpret the results. Results: The analysis revealed that the correlation between the total sperm cell count and immature germ cell count was negative. Similarly, the correlation of immature germ cell count and sperm motility was negative. Conclusions: Our study shows that inclusion of round cell count and their further differentiation into immature germ cell count and leukocytes and their correlation with the total sperm count becomes an essential part of the semen report. In addition, this helps in the initial screening of the cases. The differentiation of the round cells help the clinician to proceed with the treatment.

  1.1.11 Effect of earphone/cell phone usage in subclinical sensorineural hearing loss Top

M. Velusamy1, Jayagar Prabhakar1

1Shri Lakshmi Narayana Institute of Medical Sciences, Puducherry, India

Background: Sensorineural hearing loss (SNHL) is due to defects either in the sensory end organ of the cochlea or in neural transmission to the central nervous system. A defect exists either in the conversion of acoustic energy by the sense organ of the inner ear or in the transmission of neural impulses centrally. Noise-induced hearing loss is the second most common cause of SNHL after presbycusis. Both the intensity and the duration of noise exposure interact to influence potential damage to the hair cells of the inner ear. The regular use of MP3 players, cell phones can lead to irreversible hearing loss. Methods: In this study, 100 medical students with history of using earphones/cell phones for more than an hour/day were screened for subclinical SNHL after clinical ear examination and were subjected to pure tone audiometric evaluation. Their hearing levels were compared with 100 control medical students. Effects of hearing loss by earphones and cell phone over-usage were assessed. Results: Effects of hearing loss by earphones and cell phone over-usage were assessed and compared and were found to significantly reduce hearing levels (P < 0.01 significance) when compared with control medical students. Conclusions: Hence cell phone, earphone and mp3 player usage more than 30 min/day is not recommended for fear of developing early hearing loss.

  1.1.12 Anosmia in the elderly: A predictor of cognitive impairment Top

G. K. Yadav1, M. S. Pandhari Pande1, P. P. Joshi1

1Indira Gandhi Government Medical College, Nagpur, Maharashtra, India

Background: Anosmia and cognitive impairment are illnesses affecting the quality of life in the elderly. The present study is undertaken to assess the following objectives to find out (a) the prevalence of anosmia in the elderly, (b) prevalence of cognitive impairment in the elderly, and (c) the association of anosmia and cognitive impairment in the elderly. Methods: It is a hospital-based, observational, case–control study, in which 100 elderly subjects (age >65 years) (male:female ratio - 64:36), attending the geriatric Outpatient Department, were included as cases and 100 subjects (<65 years) (male:female ratio - 54:46) as controls. Anosmia was assessed by Indian Smell Identification Test, in which 10 essences were used and 1 point was awarded for correct and 0 for incorrect identification. A score of ≤4 indicates anosmia. Cognitive impairment was diagnosed by 30 point mini-mental state examination where scores <23 indicates cognitive impairment. Software “open Epi info version 2.6”, the Student's t-test and the Chi-square test were used for statistical analysis. P < 0.05 is considered statistically significant. Results: A maximum number of cases were in the age group of 65–69 years. The mean age in cases is 68.4 ± 3.71 years and in controls is 39.4 ± 7.91 years. Anosmia was reported in 64% cases and 4% controls, which shows a statistically significant difference in the prevalence of anosmia in cases (64%) and controls (4%), Chi-square = 80.21, P= 0.000 (P < 0.05). Cognitive impairment was present in 50% of the cases and 1% controls, Chi-square = 63.19, P= 0.000 (P < 0.05). Anosmia is found to be significantly associated with cognitive impairment in cases, Chi-square = 56.25, P= 0.000 (P < 0.05). Associated comorbidities were hypertension in 42%, ischemic heart disease in 20%, diabetes mellitus in 11%, and dyslipidemia in 72% of all the cases. Conclusions: Anosmia is prevalent in the elderly. Cognitive impairment is also prevalent in the elderly. In elderly subjects, anosmia is associated with cognitive impairment.

Platform presentation 1 30th July 2015 - session 1, room 2

  1.2.1 Sensorineural hearing loss among diabetics Top

Aftab Hossain1, Jayagar Prabhakar1

1Sri Lakshmi Narayana Institute of Medical Sciences, Puducherry, India

Background: The occurrence of sensorineural hearing loss (SNHL) in diabetes mellitus (DM) is known since long time in medical literature. In general, such hearing loss is bilateral, gradual onset, affecting higher frequencies. This study aims at knowing the incidence of SNHL in DM and its relation to age, sex, duration, genetic, and control of DM. Methods: It was a case–control study with 50 cases and 50 controls at Department of ENT for 2 years. All patients with diabetes mellitus who came to ENT. The Outpatient and Diabetic Clinic in the Medicine Department and individuals who came for general checkup were included in the study; pure tone audiogram; blood investigations (fasting blood sugar [FBS], postprandial blood sugar [PPBS], and glycosylated hemoglobin [HbA1c]). Results: Hearing impairment encountered was inferred to be of sensorineural type; 46% had SNHL with diabetes, and only 24% had SNHL in controls; duration and uncontrolled diabetes mellitus significantly increases the hearing impairment; advancing age was found to be correlated well with increasing hearing impairment. Conclusions: There is increased incidence of SNHL among diabetics. FBS, PPBS, and HbA1C when taken as parameters for control of diabetes; it showed no relation with occurrence of SNHL. This directs us to think a secondary mechanism, apart from microangiopathy of vessels of inner ear, which takes part in occurrence of SNHL. The secondary mechanism could be due to toxic neuritis of central auditory pathway.

  1.2.2 The prevalence of cardiovascular disease risk factors and use of therapy for prevention among persons with type 2 diabetes mellitus Top

Anand Bang1, Shilpa Gaidhane1

1Jawaharlal Nehru Medical College, Sawangi, Wardha, Maharashtra, India

Background: India is one of the highest prevalences of type 2 diabetes mellitus (T2DM) in the world; there are 65 million people with type 2 diabetes. Increased prevalence of diabetes and heart disease among Indians is due to increased tendency toward visceral adiposity along with it biochemical and metabolic changes take place, such as insulin resistance, which has now been linked with other risk factors for coronary artery disease such as hypertension, adverse lipoprotein profiles, and a pro-thrombotic state. This study has been designed to determine the prevalence of risk factors for cardiovascular diseases (CVDs) in patients with T2DM and determine the proportion of persons of T2DM who have ever undergone comprehensive risk assessment and who have received preventive therapy for CVD. Methods: The study was conducted at Acharya Vinoba Bhave Rural Hospital. It is a cross-sectional study, done from May to June 2014. The sample size was 96. Data collection was questionnaire based. Results: Two-third of the subjects had fasting blood sugar >100 (55.2% subjects) and postmovement beta synchronization >140 (62.5% subjects). Hypertension (49%) was present in nearly half of the participants. Low high-density lipoprotein-cholesterol (96%) was commonly found in the participants. Tobacco consumption (67.7%) and harmful use of alcohol (27.1%) were prevalent in the participants. Unhealthy diet (97.9%) was found to be more than 90%. Physical inactivity (56.2%) was present in over half of the patients. Moreover, we found that the lifestyle risk factors were highly prevalent. Conclusions: In our study, 75% of the participants had one or more risk factors for CVD. If it would have been a cohort or longitudinal study, more reliable results for prevalence of risk factors for CVD can be obtained as well as impact of interventions for risk reduction in CVD can be understood.

  1.2.3 Estimation of body mass index and risk evaluation of diabetes and cardiovascular diseases in undergraduate students Top

Anurag Srivastava1, M. Ravi Shankar1

1Adichunchanagiri Institute of Medical Sciences, Mandya, Karnataka, India

Background: The work was carried out at Adichunchanagiri Institute of Medical Sciences where the undergraduate students of the college participated. The body mass index (BMI) of the students was calculated, and they were categorized into different categories. The students who came into the risk zone were subjected to blood sugar and blood pressure (BP) measurements, and further evaluation was done. Methods: (1) It is mainly a cross-sectional analytical study which involved the students of 1st, 2nd, and 3rd and final year from Sri Adichunchanagiri Institute of Medical Sciences and Research Center. (2) Specifi c inclusion and exclusion criteria were set up and informed consent was obtained. (3) The clearance from the institute ethical committee was obtained Data collection - The weights and heights of the students were taken through standard methods and BMI was calculated. The students were categorized into overweight and obese were subjected to BP measurements, fasting blood glucose measurements, and fasting lipid levels measurement. The data obtained were subjected to statistical analysis such as the Chi-square and the Fisher's exact test. The data were managed according to the WHO-ISH guidelines for BP, there commendations by American Diabetes Association and WHO was used to manage the data on diabetes and the lipid levels of the subjects were analyzed according to the NCEP guidelines (NCEP-ATP 3 (2004 revision). Results: The total of 305 μg medical students participated in the study. 26 and 6 students were found to be overweight and obese, respectively. 16 of the overweight and 4 of the subjects were hypertensive and many more analyses were done in the study and significant results were found. Gender-wise distribution of the obese and overweight students was also done. Conclusions: (a) Difference prevalence of BP status across the overweight and obese BMI was found to be significant. (b) Increased risk of hypertension, diabetes, and hyperlipidemia in the overweight and obese undergraduate medical students.

  1.2.4 Correlative study of glycosylated hemoglobin levels and asymptomatic hypertension in type 2 diabetes mellitus Top

G. Nivetha1, D.C. Arumainayagam1

1Dr. M.G.R. University, Chennai, Tamil Nadu, India

Background: World is threatened by the morbidity and mortality of noncommunicable diseases and hypertension tops the list with 7.5 million (13%) deaths per year. Most of the hypertension cases are asymptomatic, and the condition worsens if diabetes mellitus is also added. Unfortunately, in India, study on such patients is scanty. Hence, an attempt was made to correlate the prevalence of diabetes-combined asymptomatic hypertension in rural population. Objective: To evaluate the prevalence of asymptomatic hypertension in type 2 diabetes mellitus and correlate it with glycosylated hemoglobin (HbA1c) levels. Methods: A cross-sectional study was done in the Outpatient Department of Medicine in Madha Medical College and Research Institute hospital. 100 patients (both males and females) in the age group of 30–70 years participated in the study. The study population was known diabetic patients without the typical symptoms of hypertension such as fatigue and sleepiness, breathlessness, profuse sweating, headache, and epistaxis (bleeding from the nose). Venous blood was collected under aseptic conditions, and HbA1c was estimated using Glycohemoglobin Kit (Ion Exchange Resin Method). Blood pressure (BP) was measured by conventional method using sphygmomanometer. Hypertension was determined by noting the BP level. Data were analyzed in Statistical Package for Social Sciences version 17 with correlation coefficient test. Results: Among study participants, the prevalence of asymptomatic hypertension was found to be 56% (systolic BP [SBP]) and 46% (diastolic BP [DBP]), and 61% with overall hypertension. The correlation coefficients between SBP and HbA1c levels and DBP and HbA1c levels were found to be 0.534 and 0.807, respectively. Conclusions: The results of the present study revealed that hypertension and diabetes mellitus are coexisting in many cases, but people are not aware of it. Hence, screening must be done for both.

  1.2.5 Correlation of fasting and postmeal plasma glucose level to increased HbA1C Level in type-2 diabetes mellitus Top

Gupta Shubham1, Puppalwar Priti1, Chalak Anita1

1Jawaharlal Nehru Medical College, Sawangi, Wardha, Maharashtra, India

Background: Various observational studies and clinical trials have demonstrated that intensive glycemic control prevents the development and progression of long-term diabetic micro-vascular complications and may reduce macrovascular complications. However, there are insufficient data to determine the contribution of fasting and postmeal plasma glucose to increased percentage of glycosylated hemoglobin (HbA1C) level. Therefore, it is desirable to know whether fasting or postprandial plasma glucose level alone or in combination will be necessary in adjusting the therapy to achieve optimal HbA1C levels in type-2 diabetes mellitus (T2DM). Aim: Correlation of fasting and postmeal plasma glucose level to HbA1C level in T2DM. Methods: The study was approved by Institutional Ethical Committee. The study type was observational study. Fifty diagnosed uncomplicated patients of T2DM under treatment in diabetic clinic of Acharya Vinoba Bhave Rural Hospital were enrolled for the study after obtaining written informed consent. Plasma obtained from patients was investigated for fasting and postmeal plasma glucose level and HbA1C. Statistical analysis was done using the Student's t-test and Pearson's correlation coefficient to find the statistical significance. Results: Both fasting as well as postmeal glucose levels had positive correlation with HbA1C, but higher correlation was seen with fasting plasma glucose values. Conclusions: Our study revealed that fasting plasma glucose value appreciably contributes to HbA1C as compared to postmeal glucose values.

  1.2.6 Focus on primary prevention: A study on awareness of diabetes mellitus and its complications among offsprings of diabetes patients Top

Minmini Selvam1, Suvetha Kannappan1

1PSG Institute of Medical Science and Research, Coimbatore, Tamil Nadu, India

Background: India is facing a major health care burden due to high prevalence of Type-2 diabetes mellitus. Early identification of at-risk individuals and appropriate lifestyle intervention would greatly help in preventing the onset of diabetes. The present study is, therefore, carried out with the objectives to find out the knowledge about the risk factors and complications of diabetes among offsprings of diabetic patients and to identify the modifiable risk factors of diabetes among them. Methods: A cross-sectional study was performed in a community-based rural setting among 100 offsprings of diabetic patients using an interview-based questionnaire, capturing information on the presence of risk factors of diabetes and practice of lifestyle modifi cations. Results: Both parents were diabetic in 17% of the participants; about 40% of the subjects had body mass index above 25 kg/m2. Most of the participants were aware of the risk factors of diabetes. Many of them also knew that diabetes could affect heart, kidney, and eyes. However, only few were aware that diabetes could also affect the brain and the oral cavity. Though 85% of the participants knew that periodic blood sugar monitoring necessary, only <50% was practicing. Among the 86% subjects who were aware of the dietary modifications, merely 48% were following. On the other hand, nearly 50% of the participants did not do any physical exercise. Conclusions: This study done among offsprings of diabetes patients revealed that the subjects had modifiable risk factors that need urgent intervention. While the subjects had considerable knowledge about diabetes, the practice of lifestyle modification is less. Education begins at home, but medical education of awareness and intervention in the form of knowledge/awareness of disease screening/awareness of exercise and diet as prevention should be aimed by the government at large at whatever section possible.

  1.2.7 Association of angiotensin-converting enzyme gene polymorphism in type-2 diabetes mellitus with hypertension among North Indian population Top

Paarth Garg1

1Era's Lucknow Medical College, Lucknow, Uttar Pradesh, India

Background: Type-2 diabetes mellitus (T2DM) and hypertension (HTN) is one of the biggest upcoming diseases worldwide, with the number of people affected continually increasing. This study includes 40 T2DM with HTN cases and 40 controls. Angiotensin-converting enzyme (ACE) gene polymorphisms in cases and controls were evaluated by polymerase chain reaction. Aims and Objectives: (1) To investigate the association of ACE gene polymorphism in T2DM with HTN among North Indians. (2) To study the different allele and genotype frequencies of ACE gene in T2DM with HTN and controls. Materials and Methods: DNA extraction 5 ml of peripheral blood was collected from all the subjects in 0.5M EDTA tubes. Reactions were performed with 10 pmol of each primer: forward primer 5'-CTGGAGACCACTCCCATCCTTTCT-3', reverse primer 5'-GATGTGGCCATCTTCGTCAGAT-3', in a final volume of 20 ml containing 3 mM MgCl2, 50 mM KCl, 10 mMTris-HCl (pH 8.4), 0.5 mM of each dNTPs and 2 U Taq polymerase. Polymerase chain reaction (PCR) amplification was carried out under the conditions: initial denaturation at 94°C for 5 min, followed by 35 cycles of denaturation at 94°C for 45 s, annealing at 60°C for 1.15 min, extension at 72°C for 2.30 min, and final extension at 72°C for 5 min. PCR products were separated on 2.0% ethidium bromide stained agarose gel and visualized by UVP BIOLMAGING gel doc system. Results: The products were 490 bp for allele I and 190 bp for allele D frequencies of ACE ID, DD, and II genotypes in T2DM with HTN cases and controls were 67.50%, 5.00%, and 27.50%; 62.50%, 25.00%, and 12.50%, respectively. Frequency of ACE I and D allele was 60%, 40% in cases and 42.5%, 57.5% in the controls, respectively. Findings of this study conclude that ACE gene polymorphism is associated with T2DM with HTN. Conclusions: In our study, among the 40 hypertensive and T2 diabetes mellitus cases, the genotype frequency of ACE I/D, D/D, and I/I was 67.50%, 5.00%, and 27.50%, respectively. Further investigation with larger sample size may be required to validate this study.

  1.2.8 A study on familial patterns of type 2 diabetes in a population in Punjab Top

Pradeep Atter1

1Punjab Institute of Medical Sciences, Jalandhar, Punjab, India

Background: The American Diabetes Association says that offspring of a diabetic has a chance between 14 and 11% of developing type 2 diabetes (T2D) with higher risk of diabetic a mother, passing on the disease. However, a study conducted in West Indian population pegs it at 58%. A significant contrast has therefore been demonstrated between American and Western Indian populations. Methods: This study was conducted under ICMR STS 2014. Structured interview was conducted on 141 patients previously diagnosed with T2D with questions pertaining to family history; age at diagnosis and body mass index (BMI) was calculated. Age- and sex-matched controls were taken and were subjected to a similar interview. The data were analyzed using IBM Statistical Package for Social Sciences v.20, presented as frequency percentages and compared using the Chi-square test. P< 0.05 was considered as statistically significant. Results: The study showed an excess maternal transmission of T2D in a sample of North Indian diabetic patients. No influence of a positive family history was found on BMI and age at diagnosis. Conclusions: Excess maternal transmission can be attributed to existing theories: Mitochondrial inheritance genetic imprinting and behavioral risk factors which are passed on preferentially by mother. It has been proposed that the lack of association between positive family history and the age at diagnosis is due to lack of awareness among the masses about the association of T2D with family history. The study has tried to justify the lack of association between familial history and BMI by throwing light upon the high prevalence of obesity and fat-rich diet in the tested population. The family history information may serve as a useful tool for public health because it reflects both genetic and environmental factors. Careful familial examination may be an invaluable approach for identifying the populations at risk for developing T2D.

  1.2.9 Prevalence and clinical profile of syndrome Z in type 2 diabetes mellitus Top

Sinha Nikita Arvindkumar1, Khot Rajashree1, Gaikwad Prasad1

1Indira Gandhi Government Medical College, Nagpur, Maharashtra, India

Background: Syndrome Z constitutes metabolic syndrome (MS) and obstructive sleep apnea (OSA). This study aims to find the prevalence of Syndrome Z in type 2 diabetes mellitus (T2DM) and its correlation with cardio metabolic risk factors. Methods: In this cross-sectional observational study, 94 patients of T2DM were assessed by NCEP ATP III criteria for MS and Berlin questionnaire for OSA. Patients having high risk for OSA and MS were diagnosed to have Syndrome Z. Sleep studies were conducted. Cardiometabolic risk factors were compared in those with and without Syndrome Z. Univariate and multivariate statistical Analysis done. Results: Of 134 diabetics, 48 (35.8%) had MS and 66 (49.2%) had OSA of which 32 (2.3.9%) were high risk and 34 (25.4%) low risk. 37 (27.6%) had Syndrome Z. The mean age was 58.32 ± 9.35 years with M:F ratio of 1:1.06. Mean duration of DM was 9.63 ± 3.92 years (P < 0.001). Significant cardio metabolic risk factors were hypertension; P= 0.034 and positive history of CAD; P= 0.046. Hypertension was an independent risk factor for syndrome Z. There was a positive correlation of body mass index (BMI) with MS; r = 0.38, OSA; r = 0.40 and maximum for syndrome Z; r = 0.57. Mean serum triglycerides were increased (P = 0.01) with no significant correlation with glycemic control (P = 0.49). Conclusions: The prevalence of syndrome Z is high in T2DM and increases with age and duration of Diabetes. Hypertension is an independent risk factor. Syndrome Z has a positive correlation with BMI, Hypertriglyceridemia, and increased waist circumference. Screening diabetic patients for syndrome Z can have important therapeutic and prognostic implications for future cardiovascular events.

  1.2.10 Profile and outcome of gestational diabetes mellitus in a Tertiary Care Teaching Hospital Top

S. Upadya1, R. Holla1, K. R. Meghavarshini1, P. Nayak, S. Rao1, A. Shettigar1, D. Gupta1

1Kasturba Medical College, Mangalore, Karnataka, India

Background: Gestational diabetes mellitus (GDM) is a glucose tolerance disorder first diagnosed during pregnancy. In poorly controlled cases of diabetes, fetal outcomes can range from still birth, fetal hypoglycemia, and congenital defects. Maternal complications include hypertension, candidiasis, preterm labor, abortion, preeclampsia, and urinary tract infections. The New American Diabetes Association criteria for diagnosis of GDM requires two plasma glucose values ≥95 mg/dl (fasting) and ≥180 mg/dl (1 h after glucose load). The aim is to describe the obstetric profile of the mothers, to assess the outcome of GDM among them, and to determine the outcome of GDM on the neonate. Methods: In this hospital-based retrospective study, case sheets of 257 pregnant women with GDM and their babies were analyzed for the obstetric profile, mode of delivery, complications in antepartum and postpartum periods, and neonatal outcomes. Data collected were entered into Statistical Package for Social Sciences 11.5 and variables such as mean, median were calculated. For qualitative data, the Chi-square test was used and P< 0.05 was considered statistically significant. Results: Pregnancy-induced hypertension was found to be more common in 20–24 years age group and among multigravida women. There was a statistically significant association between increasing parity and risk of hydramnios and between increasing gravidity and risk of antepartum complications. Statistically significant association between decreased parity and increasing APGAR score was found. About 34.21% of the study population had to undergo emergency lower segment caesarean section. 22% of the neonates were born with low birth weight. 16% of the neonates had to be admitted to the NICU, and 6% of the neonates were still born. Conclusions: Multiparous women with gestational diabetes are at higher risk for complications and pregnant women should be screened regularly for hypertension.

  1.2.11 Measurement of Atherogenic index in type 2 diabetic patients - Preliminary Studies on effect of tinospora cordifolia Top

Vikram Sarangan1, Pratiba Nadig1, Shivaprasad1, Shubhathara Deepak1

1Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India

Background: Diabetes mellitus is a group of metabolic disorders where blood sugar levels are elevated, and dyslipidemia is also a feature. Atherogenic index of plasma (AIP) is logarithm (base 10) of ratio of serum triglyceride and high-density lipoprotein levels - a predictor of cardiovascular complications. Statins are the first choice drugs to treat hyperlipidemia. Tinospora cordifolia (TC) is a remedy for diabetes in Ayurveda. This study was done to see the effect of TC on AIP and any adverse effects. Methods: A prospective randomized open label study was conducted on dyslipidemic type 2 diabetic patients. The patients were randomized into two groups of 15 each. One group was put on tablet rosuvastatin 10 mg (once daily, oral, and after lunch, for 90 days) and the other on tablet TC extract 250 mg capsules (once daily, oral, and after lunch, for 90 days). Patients were asked to continue Oral hypoglycemic medication as per endocrinologist's advice. Assessment of AIP and blood sugar levels was done at the beginning (0 months) and at the end of 3 months (follow-up). Statistical analysis was done using Mann–Whitney U-test. Five patients in each group were dropped from the study (Reason: noncompliance to the study procedure). Results: Mean AIP in the TC group reduced from 0.85 ± 0.09–0.7 ± 0.08 (P < 0.05). On comparing the reduction between the two groups, difference in reduction was not found to be significant statistically at P< 0.05 (Z = 0.8315, P= 0.40654, U = 38.5, critical U = 23). Headache was an observed side effect in five patients belonging to the test group. Conclusions: TC has antihyperlipidemic properties in type 2 diabetic patients. Further studies with a larger sample size and at different doses would establish its role conclusively.

Platform presentation 1 30th July 2015 - session 1, room 3

  1.3.1 Knowledge and practice of clinical ethics among dental and medical interns Top

P. S. Agrawal1, J. S. Wankhade1, M. Warhadpande1

1Government Dental College, Nagpur, Maharashtra, India

Background: Ethical conflicts are common during the initial years of a medical professional's career. Medical practice throughout the world has become increasingly commercialized, and ethics has taken a backseat. Against this background, this study was undertaken to assess the knowledge and attitudes to medical ethics among undergraduate students along with a comparison of the scores of students at different levels of seniority in the college. Aim: To examine the knowledge and practice of ethics in daily health care service among medical interns. Methods: An observational cross-sectional survey was conducted among 100 interns (50 MBBS and 50 BDS) for 1 week in Government Dental and Medical College. A self-administered, semi-structured questionnaire consisting 22 questions was given. A generalized data were collected which were sent for statistical analysis. Results: 40% interns' aim in profession is to provide proper healthcare to society, and 16% opted profession for financial stability. 64% interns can define healthcare ethics properly. 46% people strongly agreed upon maintaining confidentiality whereas 52% just agreed but 2% disagree. Obtaining a written consent before every treatment is necessary according to 72% interns. 52% stated that patient's dissatisfaction is major ethical problem and others named problems as status bias (20%), gender bias, and special preference. Reporting severity to the patient is alright according to 82% interns, but 12% would not consider severity while treatment. Conclusions: All the above findings of this study emphasize the importance of continuing ethical education throughout the undergraduate and internship curriculum. To strengthen ethical reasoning and judgment in decision making, clinically oriented measures such as case studies, seminars, and interactive workshops are needed. Limitations: samples are representative of the study population, but the number is too small to generalize the findings to all hospital interns.

  1.3.2 Who is more emotionally intelligent: Prospective doctors or engineers? Top

V. Ankita1, C. Y. Sudarshan1

1JJM Medical College, Davangere, Karnataka, India

Background: Even though intelligence quotient is considered an important aspect of a person, it plays only a partial role in academic and occupational achievement. Emotional intelligence as measured by emotional quotient (EQ) test, assumes importance in inter personal relationships. Doctors dealing with a patient, who is suffering, need to have optimum EQ to be good clinicians while, for engineers dealing with machines, it may not be so. However, for both, EQ is essential for success in life. EQ can be enhanced through adequate guidance. Methods: This is a cross-sectional, institute-based study. 75 medical students and 84 engineering students who consented were administered proforma for sociodemographic data, academic performance and the Goleman's EQ Test. Golemans's EQ test is a self-administered 10 item questionnaire yielding a total score ranging from 0 to 200 which can be categorized as low (scores 1–100), mid (scores 100–150), and high (scores 150–200). Relationship between EQ and other above-mentioned variables is measured using Statistical Package for Social Sciences 17. Results: Medical students were younger and hailed from nuclear families as compared to engineering students. Whole sample had low EQ. Mean EQ and those having mid-level EQ were more in medical students. Female medical students had higher EQ than male medical students while there was no gender difference among engineering students. There was no gender difference in both the groups with respect to level of EQ. Academic performance had no bearing on total EQ and level of EQ in both the groups. Conclusions: Low EQ in nearly three-fourths of the sample indicates an urgent need to include strategies to enhance EQ in students. The absence of relationship between academic performance and EQ suggests that EQ is a separate construct.

  1.3.3 Trends and profile of road traffic accident victims in Tertiary Care Center Top

K. S. Darshan1, T. Rekha1

1Kasturba Medical College, Mangalore, Karnataka, India

Background: Road traffic accidents are one of the leading causes of death in developing countries like India leading to mortality of 1.5 lakh people and injuring 3 million people every year. They constitute high human suffering and increase the socioeconomic costs on the society. This study is an attempt to estimate the magnitude of problem by finding out clinical profile, types of injuries and factors associated with road traffi c accidents. Methods: This descriptive hospital-based retrospective case record study was conducted from 15th to 31stJanuary 2013 at Tertiary Care Hospitals in South India. Semi-structured proforma was used for the data collection during the study period. Data were entered into MS Excel and analyzed using Statistical Package for Social Sciences version 11.5. Results: A total of 373 road traffic accident trauma victims were recorded during the study period. The majorities (88.7%) of the patients were males and (55.8%) were aged between 25 and 50 years. RTAs were more common among two-wheeler users (26.5%), drivers (29%), from 6 pm to 12 am (30.8%) and 22% of the accidents occurred under the influence of alcohol. 67.6% had major injury and commonest injury site were lower extremity (38.1%) and head and neck (36.2%) and 65% were treated conservatively. 41% didn't get any first aid. Orthopedics was the most frequently referred department with 6.1% incidence rate of death and 13.1% of disability. Conclusions: Road traffic Accidents, a major public health problem which results in mortality, morbidity, and disability among the population is totally preventable. Stringent legislative measures, educating the masses on preventive measures, improving emergency medical services, etc., will lower the incidence of road traffi c accidents.

  1.3.4 Private allopathic health care provider's perception toward reasons for diagnostic delay among pulmonary tuberculosis patients Top

Deeksha C. Mudadevannanavar1, P. S. Balu1, A. M. Renu Karadhya1

1JJM Medical College, Davangere, Karnataka, India

Background: Delayed diagnosis and treatment of tuberculosis (TB) results in severe disease and higher mortality. It also leads to an increased period of infectivity in the community. The objective of this study was to determine the length of delays in diagnosis of TB and reasons for delay as perceived by Private Allopathic Health Care provider. Methods: After taking consent, In-depth interviews were conducted using pretested validated questionnaire to collect information from 11 Private Allopathic Health Care provider's working in Harapanahallitaluk to collect their perception toward the reasons for delay in diagnosis of pulmonary TB patients. Data collected were analyzed and presented here. Results: In our study, the major reason identified by allopaths for delay in health seeking is difficulty in accessing health center (91%), followed by lack of awareness of TB (82%). 9% of providers told that time taken for diagnosis of TB in symptomatic patients is <3 days, 27% told it takes 3–7 days and 64% told >7 days to diagnose a symptomatic patient with TB in their clinic. The majority of patients are not willing to take treatment from government sector. Conclusions: The study clearly shows the need to develop interventions to improve symptom recognition among patients and develop strategies to reduce stigma at all levels, develop interventions to improve patients access to TB services and need for greater involvement of private sector in RNTCP activities.

  1.3.5 Is body image dissatisfaction a potential factor for causing poor nutritional status in female medical students? Top

S. R. Deoghare1, M. S. Phatak1

1Indira Gandhi Government Medical College, Nagpur, Maharashtra, India

Background: Perceived body image is an important criterion for determining the nutritional status of an individual. Nowadays, more and more young girls perceive to be thin. This has led to dissatisfaction with one's own body image. This trend is also observed in medical students. Nutritional status of an individual can be assessed by measuring their body composition. There are very few studies of perceived body image in Indian girls. Hence, we endeavored to study the association of body dissatisfaction and body composition in female medical students of Nagpur. Methods: This study done in July–August 2013 included 100 female medical students of age 19–23 years, residing in hostel. Body dissatisfaction, desired image, and the reason for having such perception of desired body image were found using a predesigned questionnaire. Height, weight, waist, and hip sizes were measured and were used to measure body composition using Bodystat® Quadscan 4000. For statistical analysis, two groups were made - one of satisfied and other of those who were dissatisfied with their body image. Body composition parameters were then compared in these two groups. Results: We found that 35% of girls reported body dissatisfaction. A very large number of girls (90%) desired to have a body image that is “neither too thin nor too fat”. Peer pressure (46%) was the most dominating factor that influenced their desired body image. Pvalue was found to be statistically insignificant when body composition parameters were measured in the two groups of girls. Conclusions: The prevalence of body dissatisfaction is less in medical students. The Pvalue being statistically insignificant was an important finding. It showed that the girls who were dissatisfied with their body image were unnecessarily concerned as the mean values of the body composition parameters were nearly close to each other in the two groups.

  1.3.6 Effect of doctor-patient relationship on the efficacy of treatment Top

Divya Gupta1, Tejal Kashyap1

1Gian Sagar Medical College, Patiala, Punjab, India

Background: The doctor–patient relationship remains a keystone of care: the medium in which data are gathered, diagnoses and plans are made, compliance is accomplished, and healing, patient activation, and support are provided. The relationship directly determines the quality and completeness of information elicited and understood. Satisfaction is a critical factor in people's decisions to join and stay with a specific organization. In this study, we sought to establish potential associations between attributes of the physician-patient relationship and efficacy of treatment. Methods: The patients coming to Gian Sagar Medical College and Hospital Outpatient Department, during the study period were provided with questionnaires - 18 and asked to complete it. The questionnaire used in the study had some questions based on previously published doctor–patient relationship questionnaires and others were new. The data were analyzed using parametric and nonparametric tests. Results: A total of 124 subjects were enrolled in this study. 58.87% of the subjects changed their dr. again and again and were visiting Gian Sagar for the first time. 76.53% said that Dr. explained the procedure and course of treatment. 81.46% said that Dr. contribute to much extent in making them fine approximately 50% believed it is better to solve general problems in home itself and 31.75% of the subjects thought that coming to Dr. is spending too much money in irrelevant tests. Conclusions: Most of the patients trusting the doctors were completing the course of medication, getting relief and were satisfied with the treatment as compared to those who did not trust the doctors. This shows that Good DPR resulted in good patient satisfaction and good compliance leading to efficient treatment.

  1.3.7 Assessment of knowledge and attitude regarding swine flu among dental house surgeons of two Dental Institutes in Belagavi City: A cross-sectional study Top

Shreya A. Nerli1, Shivayogi M. Hugar1

1KLE VK Institute of Dental Sciences, Belgaum, Karnataka, India

Background: The practice of dentistry exposes dentists to a variety of micro-organisms that are transmittable via blood, oral, or respiratory secretions. The recent outbreak of swine flu virus has posed a greater risk of occupational transmission to dentists as it can spread through the aerosols. As there is a scarcity of literature, the present study was undertaken to assess the knowledge and attitude of dentists regarding swine fl u in Belagavi City. Methods: A cross-sectional survey was conducted among 133 subjects in two dental institutes of Belagavi city. Close ended self-administered questionnaire was prepared. Reliability of the questionnaire was checked using Cron Bach, which was found to be 78.4. Data were analyzed using Statistical Package for Social Sciences 19. Descriptive statistics, the mean and standard deviation was used. Results: In the present study, there were 16.5% males and 83.5% females. The participants had significant knowledge regarding swine flu, but it was surprising to know that only 50% house surgeons knew correct answers. Conclusions: We conclude that dental house surgeons had limited knowledge about swine flu so emphasis during undergraduate teaching and continued dental educational campaigns on infectious diseases is recommended for the dentists, as preparedness for future disease outbreaks.

  1.3.8 Learning preferences of the second year undergraduate medical and physiotherapy students Top

Ghate Aishwarya Vittappa1, Suvarna Ganvir1

1PDVVPF's College of Physiotherapy, Ahmednagar, Maharashtra, India

Background: The learning styles are preferred methods of learning adopted by students in attaining, analyzing, and interpreting their knowledge. VARK model is one of the most commonly used modalities which are used to assess learning style among the students. This study was conducted to identify various learning styles of undergraduate medical students in a multi-professional setup. Methods: The learning styles are preferred methods of learning adopted by students in attaining, analyzing, and interpreting their knowledge. VARK model is one of the most commonly used modalities which are used to assess learning style among the students. This study was conducted on 100 students from medical and physiotherapy college. This study was conducted to identify various learning styles of undergraduate medical students in a multi-professional setup. Results: It was found that 27% of the students preferred multimodal learning style including all components of visual, auditory, read and write and kinesthetic whereas maximum 15% of students used unimodal learning style and that of kinesthetic. 13% of the students used multimodal learning style of auditory and kinesthetic dominance. Conclusions: Majority of the students preferred multimodal learning strategy which probably indicates the need for incorporating various teaching strategies to be adopted by the teachers for maximum benefit of the student.

  1.3.9 Impact of roommates on academic performance of health sciences students in Mangalore Top

S. Gupta1, S. Kotian1, N. Narayan1, M. Narendran1, R. Jain1, A. Kapoor1, P. Bhageria1

1Kasturba Medical College, Mangalore, Karnataka, India

Background: Roommate allocation provides a unique natural experiment in which the causal effect of a particular peer group (college roommates) on the students' college performance (measured by taking mean of their grades from previous two University Examinations) can be determined. The aim of the study was to determine the impact of roommates on the academic grades of health sciences students and to compare the academic performance of students living with a roommate to that of those not sharing a room. Methods: A cross-sectional study was conducted among 232 health sciences undergraduate students of Manipal University, Mangalore from 8th to 30th May 2014 using nonrandom sampling method. Data collection was done using a semi-structured questionnaire. Data analysis was done using Statistical Package for Social Sciences version 17.0. For comparison, the student's unpaired t-test was used. P< 0.05 was considered statistically significant. Results: Of 232 respondents, 56.4% were living with a roommate. Overall, no difference was noted between the mean academic grades of those living with a roommate and of those not sharing a room. Comparing across the professions, those living with a roommate of same profession had mean academic grade lesser (67.59%) than those living with roommate of different profession (67.75%). Those who studied alone performed better than those who studied with their roommates. The mean academic grade of those who were not sharing a room but facing distractions to studies was significantly lesser than those who were facing distractions but living with a roommate (P = 0.018). Conclusions: There was no difference between the academic performance of students living with a roommate and of those not sharing a room. The presence of roommates had no significant impact on the academic performance of students. However, those who had roommates from the different professional line had better academic results. Due to time constraints, the surveyed population was small.

  1.3.10 Comparative assessment of intelligence quotient among children living in high and low fluoride areas of Belgaum District: A cross-sectional study Top

Javalikar Sumedha1

1KLE VK Institute of Dental Sciences, Belgaum, Karnataka, India

Background: Moderate amounts of fluoride in drinking water lead to dental effects, but long-term ingestion of large amounts can lead to potentially severe skeletal problems and neurological consequences. The Aim of the study is to assess and compare intelligence quotient (IQ) of children living in high and low fluoride areas in Belgaum district, Karnataka. Methods: A descriptive cross-sectional study was conducted among 200 school children aged 8–10 years, living in Belgaum District, Karnataka. Telsung (2.3–3.0 mg/L) and Kineya (0.5 mg/L) were the two villages randomly selected to represent the high and low water fluoride areas respectively. Seguin Form Board Test was used to assess the IQ level of children. The statistical analysis was performed using the descriptive statistics and independent sample t-test. Results: Mean scores for average, shortest and total timing category were found to be significantly higher (P < 0.05) among children living in Telsung than among children living in Kineya. In both the villages, females had lower mean timing scores than males, but the difference was not statistically significant (P > 0.05). Conclusions: Chronic exposure to high levels of fluoride in water was observed to be associated with lower IQ.

  1.3.11 Knowledge, attitude, and practices of postpartum contraception Top

Kashyap Tejal1

1Gian Sagar Medical College, Patiala, Punjab, India

Background: Postpartum period begins immediately after child birth and extends for about 6 weeks. Despite the efforts for making contraceptives widely available, there is poor acceptance due to ignorance or fear of complications. Pregnancy within 12 months of giving birth is associated with increased risk of placental abruption and placenta previa who had previously delivery by Cesarean resulting in increase in maternal mortality and morbidity. Thus, there is inherent need to know Knowledge, Attitude, and Practices (KAP) regarding the contraceptive methods in postpartum period as this is when people are most receptive to family planning advice. The study aims to assess KAP of contraception among females in postpartum period. The objective of the study is to find the prevailing and most acceptable postpartum contraception practiced, and motivate and get a positive change in attitude of women toward contraceptives use. Methods: Study design - A KAP survey is a representative study of a specific population conducted in Gian Sagar Medical College and Hospital. A total of 30 subjects was enrolled. Data were collected through questionnaires and were analyzed. Inferences was made using metric and parametric tests. Results: 53% of the subjects were in age group of 20–25 years. This is in consistence with reproductive age group in which most pregnancies occur. In the study, 40% subjects fall under education status among 8–10 standard, 37% being post matric, and 23% with no schooling. 38% subjects used barrier methods, 24% copper-T, 19% used hormonal contraception, 5% had undergone tubectomy and rest prefer traditional method. The study revealed that 70% subjects practiced one or the other contraceptive method. Conclusions: Study reveals that education status has significant relation with family planning methods. According to the study, 70% of the mothers practice one or other contraceptive method. One possible improvement in the analysis can be done by making the sample size larger.

  1.3.12 Neck pain in computer users Top

Khan Aysha Siddiqua Kalim1, Mohammed Faizan1

1NKP Salve Institute of Medical Sciences and Research Centre, Nagpur, Maharashtra, India

Background: In the modern era of networking, data will be typed instead of writing, increase in industrialization and urbanization lead to increase in health issue related to its neck pain in computer users one of them. In this study, we found magnitude of neck pain among computer users and relationship between the neck pain and following factors among computer users: duration of job, daily hours of work, age, gender, special arrangement at desk, and physical exercises. Methods: This is observational study. Data were collected from computer users of our institute and other offices. The sample size is variable (number of individuals approached in a given period) computer users: In this study, computer users are defined as persons using computers daily for more than 6 h and weekly more than 36 h. Inclusion criteria: Persons using computers more than 6 h a day and weekly more than 36 h. Age (20–60) years. Exclusion criteria: All other persons who are not fulfilling the above mentioned criteria are excluded. Participants will be excluded if they have any specific medical condition affecting the cervical spine (such as ankylosingspondylitis, tumors, infection, rheumatoid arthritis), or any previous surgery that can cause neck pain. Information regarding neck pain and computer usage were collected through questionnaires. It included individual demographic characteristics, total duration of daily work, and postural care. The data will be analyzed using the Statistical Package for the Social Sciences software. Results: 28% of the computer users in our study had neck pain, only 30% of computer users do regular exercise, 40% of computer users have associated complaints such as upper limb pain or paresthesias which are related to neck posture. Conclusions: Neck pain or associated complaints related to neck posture are definitely having association with regular computer usage though this association is not statically significant.

  1.3.13 Health problems of adult population among three primitive tribes of Maharashtra, India: A clinico-epidemiological study Top

Y. E. Khandagale1, N. D. Sukhsohale1, M. Khamgoankar1, R. R. Tayade1

1Indira Gandhi Government Medical College, Nagpur, Maharashtra, India

Background: The tribal population has distinctive high burden of health and nutritional problems governed by their habitat, socioeconomic, cultural, and ecological settings. The present study is an attempt to study health problems prevalent in tribal adults' population and various clinic-epidemiological factors associated with it. Methods: A Community-based cross-sectional study was conducted among 100 tribal adults aged 30 years and above residing at tribal areas (Bhaurad, Beldur and Kalakamtha) of Taluka Malegaon, District Washim of Maharashtra State. A house to house survey was conducted and eligible adults were interviewed after obtaining written informed consent. Detailed history regarding socioeconomic, demographic, occupational history, habitat, and nutritional status was inquired. In addition, anthropometric measurements were estimated. Results: Maximum study subjects belonged to age group of 30–40 years (29%) followed by 60–70 years (27%). Males were 41% and females were 59%. Majority of tribals were illiterate (61%). Considering occupation maximum were involved in farming (75%) followed by biba worker (15%). Most of the tribes was addicted to tobacco (40%) and had multiple habits (37%). The prevalence of malnutrition was found to be 57% with underweight 49% and overweight 8%. The most common symptom was found to be weakness (84%) followed by acute respiratory infection (10%). The most common morbidities found in study works were anemia (36%), arcussenilis (33%), hypertension (17%), acute dermatits with allergic reaction of biba oil (16%), cataract (14%) followed by less common morbidities such as tuberculosis, goiter, blindness, bronchitis, and piles. Conclusions: High prevalence of malnutrition, Anemia, Arcussenilis, Hypertension, and Skin problems were reported in adult tribal population. This warrants the implementation of a special health care strategy to reduce the health problems. Emphasis should also be given to appropriate nutrition education in view of the high prevalence of undernutrition.

Platform presentation 1 30th July 2015 - session 1, room 4

  1.4.1 Correlation of intraocular pressure with blood pressure Top

Ameya Muzumdar1, Supriya Bankar1

1Smt. Kashibai Navale Medical College, Pune, Maharashtra, India

Background: Glaucoma is the third leading cause of blindness in India. However, it is preventable. Hypertension is an emerging lifestyle disorder, in today's fast pace life. The research question we had was whether hypertensive patients were at an increased risk of developing glaucoma. The aim of our study was to determine if there is any association between hypertension and glaucoma. If a causal relationship is determined, it will help in early detection and prompt management, thereby in prevention of glaucoma and, in turn, blindness. Methods: Outpatients coming to the Medicine and Ophthalmology Department of SKNMC and GH were screened for hypertension. After applying inclusion and exclusion criteria, patients were enrolled into the study by taking an informed consent. Blood pressure and intraocular pressure (IOP) were taken as a variable for determination of association. Blood pressure and IOP were recorded for each enrolled patient on monthly basis for 4 months. IOP was measured using applanation tonometry. The statistical technique was applied on the data to determine correlation. Results: IOPs were not signifi cantly correlated with systolic or diastolic blood pressures at both baseline and follow-up. The Pearson's correlation coefficient for IOP with systolic blood pressure was 0.192 (P = 0.053) and with diastolic blood pressure was 0.288 (P = 0.0032). The incidence of glaucoma in our study was 11.8%. Conclusions: There was no clear pattern observed relating IOP with Systolic or Diastolic blood pressure. On assessing the correlation in females and males, no particular gender bias was noticed. In addition, correlation was assessed for grades of hypertension. Our study suggests that there is no significant correlation between IOP and Blood pressure. However, another study with a larger sample size for longer duration would be helpful in giving a better evaluation.

  1.4.2 Intraocular pressure asymmetry: An indicator for glaucoma diagnosis Top

Banait Jerryl1

1NKP Salve Institute of Medical Sciences and Research Centre, Nagpur, Maharashtra, India

Background: Primary open-angle glaucoma is usually detected by elevated intraocular pressure (IOP). Inter-eye differences in IOP may be diagnostically significant. If symmetry is an indicator of NO glaucoma, it may result in the avoidance of unnecessary treatment which would result in better and cost effective care. Early diagnosis is the key to successful management of glaucoma. Hypothesis: IOP asymmetry between the fellow eyes is present in cases of untreated glaucoma, whereas asymmetry of IOP is rare or nonexistent in normal eyes. Methods: Type: Retrospective case–control study Site: Eye OPD, Lata Mangeshkar Hospital, Nagpur, India. Sample size: 84 diagnosed cases of glaucoma control group of 168 age and sex matched patients who do not have glaucoma. Data collected from Medical records of Glaucoma clinic from January 2013 to December 2013 (12 months). Glaucoma was defined based on characteristic glaucomatous optic nerve damage and characteristic confirmatory glaucomatous visual fi eld damage. IOP was not used as a diagnostic consideration when classifying patients as having glaucoma. Inclusion Criteria (Cases): Patients who were diagnosed as having POAG, Pigmentary glaucoma, Pseudoexfoliative glaucoma with unquestionable visual field loss and disc changes in one or both eyes, and who also had a documented pretreatment IOP measurement in each eye. Control group: Patients who do not have glaucoma based on the above guidelines. Results: Diagnosed cases of Glaucoma: 79.76% IOP asymmetry Control: 17.26% subjects showed asymmetry and 82.73% showed symmetrical IOP. Sensitivity of the test: 79% Specificity was 82.7%. Odds ratio: 18.89% there was no specific IOP asymmetry which can be used as diagnostically significant for Glaucoma. Conclusions: In patients who show consistent IOP asymmetry on repeated clinic visits, it should be considered a risk factor for glaucoma diagnosis, especially if recorded within 2 h of the same time of the day as the baseline IOP.

  1.4.3 Quality of life and psychological well-being in women with polycystic ovarian syndrome attending a Tertiary Care Hospital in Mangalore Top

Garg Neha1

1Kasturba Medical College, Mangalore, Manipal, Karnataka, India

Background: Polycystic ovarian syndrome (PCOS) is an endocrine disorder with many symptoms which are painful, uncomfortable and culturally defined as unfeminine and undesirable by women. Consequently, they have a detrimental effect on their psychological stability. Thus, the aim of the study is to assess the Health-related quality of life (QOL) and the different aspects of psychological distress (depression, anxiety and self-esteem) in women with PCOS. Methods: In this case–control study, 47 cases and 47 controls were enrolled. The cases were women in the reproductive age group diagnosed with PCOS (revised Rotterdam criteria) attending KMC Attavar hospital. Age-matched subjects without PCOS were taken as controls. Institutional ethics committee clearance was obtained before the commencement of the study. Data were collected using semi-structured questionnaire consisting of Patient information, Rosenberg self-esteem scale to measure the level of self-esteem, Hospital Anxiety Depression Scale to measure clinical levels of anxiety and depression and 36-item short-form health survey to measure various aspects of QOL on 8 subscales. An informed consent was taken from the willing participants. Collected data were analyzed using Statistical Packages for Social Sciences ver. 17.0. The Student's unpaired t-test, Mann–Whitney U-test and Chi-square test were used; P< 0.05 was considered statistically significant. Results: Controls were found to have a better QOL than the cases in all the 8 domains (physical functioning, role limitation due to physical health and emotional problems, energy, emotional well-being, social functioning, pain, general health); P< 0.01. Mean scores for anxiety and depression were high in cases (10.7 ± 4.1 and 9.6 ± 4.8, respectively) versus controls (5.4 ± 3.3 and 4.0 ± 3.2, respectively); P< 0.001. Low levels of self-esteem were seen among cases (13.064 ± 7.496; P< 0.001). Conclusions: The study shows that women with PCOS have a poor QOL, low self-esteem, and high levels of anxiety and depression which demonstrates the need to regularly review the psychological health of these women.

  1.4.4 Study of the WHO near-miss tool: A new concept to improve obstetric care Top

Gauri Barlingay1, Anjali Kawthalkar1, Anuja Bhalerao1

1NKP Salve Institute of Medical Sciences and Research Centre, Nagpur, Maharashtra, India

Background: According to the WHO, a maternal near-miss case is defined as “a woman who nearly died but survived a complication that occurred during pregnancy, childbirth or within 42 days of termination of pregnancy”. Reviewing data on near-miss cases can be used to monitor maternal health care interventions and improve upon them. Since approximately 99% of maternal deaths occur in low resource countries, near-miss pregnancy data help pinpoint women at high-risk for maternal death, allowing the appropriate allocation of resources. Objectives: (1) To analyse life-threatening obstetric emergencies as per WHO near-miss tool. (2) To determine the prevalence of complications leading to near-miss obstetric cases and maternal mortality. Methods: Study Type: Records-based cross-sectional study Sample Size: 150–200 patients Duration: 1 year (January 2014–January 2015) the data was taken from the discharge summaries and admission notes of a tertiary care hospital. Inclusion Criteria: Severe postpartum hemorrhage, Severe preeclampsia, Eclampsia, Sepsis or severe systemic infection, Ruptured uterus According to the WHO near-miss tool, outcome measures reviewed included: Age, Gestational age, Parity, Conditions on arrival, Final mode of delivery, Obstetric complications, Critical interventions, Organ dysfunction, Contributory conditions, Medical treatment, Underlying cause of death/near-miss. Results: There were 3210 live births and 6 maternal deaths. Out of 180 cases of severe maternal complications, 62 were near-miss cases. The leading causes of near-miss maternal mortality were severe preeclampsia, severe postpartum hemorrhage and eclampsia. The most common organ dysfunctions were cardiovascular and respiratory. Conclusions: The WHO near-miss criteria are an important adjunct to the analysis of maternal mortality in India and can provide insight into processes leading to adverse maternal outcomes. These data can help improve the quality of care and interventions in tertiary care centers in India.

  1.4.5 Are the educated working women aware about emergency contraceptive pills: a hospital-based study from North India Top

Harne Prateek1, K. A. Maroof1

1University College of Medical Sciences and Guru Teg Bahadur Hospital, New Delhi, India

Background: Every fifth pregnancy in India resulting in live birth is mistimed or unplanned and contributes to increased maternal mortality and unplanned births. Emergency contraceptive pills (ECPs) are an effective method to prevent such unplanned pregnancies. Data on the awareness about ECPs among the working women in India are scarce. Thus, the present study was conducted to assess the level of awareness regarding ECPs among the working women and its associated sociodemographic factors. Methods: A cross-sectional study was conducted among 206 working women in the reproductive age group, attending the Obstetrics and Gynecology outpatient departments of a private hospital in the North West district of Delhi, selected by systematic random sampling. Using a schedule, information regarding their sociodemographic characteristics, awareness about ECPs, and contraceptive usage was collected. Data were analyzed using SPSS. The Chi-square test was used as a test of significance to find out the association of ECP awareness status with certain sociodemographic characteristics. Results: The mean standard deviation/age of the respondents was 27.7 (3.36) years. Nearly two-third of the respondents were married and all were educated, with the majority (96.1%) educated up to graduate or postgraduate. Around one-third (35%) of the respondents were not aware about ECPs. Awareness was higher in respondents attending the private OPDs, those having a professional type of occupation and those working in a private sector. Of those who had heard (n = 134), 81.3% were not aware of the use of ECPs as a method preventing pregnancy after unprotected intercourse. Conclusions: There is a gap in the level of awareness about ECPs among working women. Even among those who have heard of ECPs, a majority do not know about its indications, method of use, and side effects.

  1.4.6 Association between migraine and menstruation in young Indian female population Top

T. Jha1, A. Pawar1, K. M. Jha1, M. Monga1, S. Mondal1, A. Gandhi1

1Lady Hardinge Medical College, New Delhi, India

Background: Migraine headaches are known to occur more among women than in men. It is triggered by number of factors such as stress, lack of sleep, etc. Recent evidence suggests that estrogen plays an important role in the pathophysiology of these headaches, and increasing interest has been generated worldwide in the possibility of migraine linked with menstruation. However, there is lack of data regarding this in the Indian scenario. Methods: A longitudinal, descriptive study was done on 50 females of 18–23 years suffering from migraine. Only those patients who fulfilled the International Headache Society (ICHD 2004) criteria for migraine and had comparable levels of stress, sleep habits, workload (using Chi-square test) and marital status were selected. They were asked to fill out questionnaires regarding the history of their headaches, known triggers, average duration and frequency of the attacks. They were asked to maintain headache diaries for the next 4 months, regarding the occurrence and frequency of migraine attacks. At the end of 4 months, their headache diaries were analyzed. The occurrence and frequency of headaches during the period of menstruation, 5 days before (pre) or after this period (post) and during mid-cycle were compared using the Chi-square test. Results: A significant association was found between beginning of migraine attacks and menarche (P = 0.027). Significantly greater frequency of headaches were reported during menstruation (P = 0.016) and were similar in frequency in premenstrual period (P = 0.00006) as compared to postmenstrual phase (P = 0.56) and mid-cycle (P = 0.4). Conclusions: There is significant association between emergence of migraine and menarche in young females. In addition, frequency of migraine attack differs in various phases of menstruation, suggesting a link between the levels of estrogen and migraine.

  1.4.7 The danger of ignorance current knowledge, attitude, and practices about preeclampsia/eclampsia among pregnant women at Tertiary Care Hospital Top

S. Khasbage1, B. Kumare1

1NKP Salve Institute of Medical Sciences and Research Centre, Nagpur, Maharashtra, India

Background: To determine the knowledge about preeclampsia and eclampsia, risk factors and complications among pregnant women attending antenatal department. To determine pregnant women's attitude and beliefs regarding preeclampsia and eclampsia. Methods: A descriptive hospital-based cross-sectional study was conducted at a tertiary care hospital of Nagpur with a sample size 100 absolute neutrophil count (ANC) patients calculated with the help of mean, median, frequency, and percentage. Tables and charts were used to present summarized data. The data were collected by face to face interviews of the ANC patients with the help of predesigned and pretested questionnaire. Results: We found out that the source of information in women who had heard of preeclampsia and eclampsia was relatives and neighbor. Twelve percentage of women reported their self-experience as the source of knowledge, who suffered from raised blood pressure during pregnancy. Also that 90% of respondents had no knowledge of the risk factors, and only 10% were aware of the risk factors. Similarly, 87% of the respondents were not aware of warning symptoms of preeclampsia. Eighty-seven percent of the respondents did not know that early detection of disease could lead to better outcome and 88% had no knowledge about the complications of preeclampsia and eclampsia. Conclusions: Antenatal women generally have poor understanding of this particular disease even though they are well-educated and regularly attend antenatal clinics. Awareness program should be targeted more on pregnant women and their families, so they can identify warning symptoms and signs of the condition before irreversible complication sets in that might contribute to mortality and morbidity.

  1.4.8 A study on incidence of hypothyroidism and hyperprolactinemia in infertile women Top

Y. Lavanya1

1PSG Institute of Medical Sciences, Coimbatore, Tamil Nadu, India

Background: Nearly four of every 100 women in the reproductive age group suffer from hypothyroidism. The awareness about thyroid disorders in women especially among rural population is still marginal. Further, the cases of subclinical hypothyroidism are also increasing. This study aims at finding out the relative incidence of hypothyroidism and hyperprolactinemia in infertile women and the associated clinical findings. Methods: In this descriptive and retrospective study, we considered 300 infertile women (age: 15–45) who had attended the infertility clinic in the Department of Obstetrics and Gynaecology between July 2012 and March 2014. Using electrochemiluminesence, the thyroid-stimulating hormone (TSH) and prolactin (PRL) values were assayed. The T3 and T4 values were found if TSH screeing was positive. The associated clinical findings were recorded. Results: Of the 300 infertile women, 59 patients (19.67%) had hypothyroidism, and 32 patients (10.67%) had hyperprolactinemia. 17 of the (5.67%) patients had both hypothyroidism and hyperprolactinemia. Among the 59 hypothyroid patients, the mean TSH values are 7.23 ± 3.527 mIU/ml and among the 32 hyperprolactinemic patients, the mean PRL levels are 620.09 ± 96.87 mIU/L. Of the 59 hypothyroid patients, 29 (49.15%) had subclinical hypothyroidism. Secondary infertility was present in 135 women of the 300 and while menstrual irregularities, oligomenorrhea and polycystic ovarian syndrome was more common among hyperprolactinemic individuals, obesity was more prevalent in the hypothyroid women. Conclusions: The controversy remains whether to screen only the high-risk pregnant patients as per guidelines of the American College of Obstetrics and Gynaecology or to adopt a universal screening. Also, the cases with borderline TSH elevation (as in subclinical hypothyroidism) should be carefully evaluated in infertile women. Many cases of infertility can be treated with ease if these simple hormonal assays are performed right away.

  1.4.9 Top

  The comparative study of postoperative astigmatism between extracapsular, 4 mm small incision and phaco emulsification cataract surgery at Indira Gandhi Government Medical College Nagpur Top

Modak Durgalaxmi Dhananjay1

1Indira Gandhi Government Medical College, Nagpur, Maharashtra, India

Background: Cataract is defined as the opacification of the crystalline lens situated in the human eye associated with various factors. The progressive diminution of vision it causes brings visual disability to the person. The most comprehensive way to describe Cataract types is Congenital, developmental, juvenile, middle-aged and senile. The aim of this study is (1) Comparative study of postoperative astigmatism induced by the 3 most popular methods of cataract extraction, ie., extracapsular cataract extraction (ECCE), 4 mm small incision cataract surgery (SICS) and Phacoemulsification. (2) To evaluate and compare intra and postoperative complications arising from these 3 procedures. (3) To evaluate and compare pre- intra- and post-operative expenditure incurred by the patient, ie., the cost-effectiveness of the 3 procedures. Methods: A retrospective study was conducted on 70 cases undergoing 4 mm SICS and phacoemulsification cataract surgery. All the cases of ECCE were excluded from this study because of extreme temperatures in the city in the months of May and June 2013 leading to fewer cases presenting in the OPD than expected and reduced implementation of ECCE surgery due to more advanced methods present. Study setting-Indira Gandhi Government Medical college, Nagpur. Period - 2 months (May and June 2013). Population - 70. Analysis- (1) Follow-up of the patients after 1st, 2nd and 8th week of surgery for measurement of postoperative astigmatism done by: Keratometer and Autorefractometer (2) cost-effectiveness (3) intra- and post-operative complications. Results: The ratio of postoperative astigmatism induced by 4 mm SICS: Phacoemulsifi cation Cataract surgery is 5:2 by comparative analysis. Conclusions: The study thus proved that phacoemulsification cataract surgery is the best option for cataract extraction in terms of postoperative astigmatism, patient gratification, and cost-effectiveness.

  1.4.10 Hemodynamic changes in different trimesters of pregnancy Top

Samiksha Ganvir1

1NKP Salve Institute of Medical Sciences and Research Centre, Nagpur, Maharashtra, India

Background: Pregnancy is a stress imposed on the body and all the systems of the body react to this stress differently. It is associated with the substantial physiologic changes that require adaptation of the cardiovascular system. The major hemodynamic changes induced by pregnancy include an increase in cardiac output, sodium and water retention leading to blood volume expansion. The aim of the study is to study circulatory changes occurring during different trimesters of pregnancy. Methods: This is a cross-sectional study, done in NKPSIMS, Nagpur. The study comprised 30 female patients with single done pregnancies. 10 patients from each trimesters were taken. ECHO cardiography was done to know the cardiac parameters such as heart rate, end systolic volume, end diastolic volume, ejection fraction, duration of IVRT, systole and diastole, and left ventricular mass. Results: The Cardiac Output in the first trimester was 3402.27 ± 100.84, in the second trimester 3814.38 ± 86.12035 and the third trimester 4279.08 ± 251.7648. The end systolic volume in the first trimester was 32.46 ± 0.965171, in the second trimester 35.8 ± 1.581139 and the third trimester 38.52 ± 1.194245. The end diastolic volume in the first trimester was 82.53 ± 1.0133, in the second trimester 87.92 ± 1.204436 and the third trimester 92.79 ± 1.772913. The ejection fraction in the first trimester was 50.6 ± 1.577621, in the second trimester 54.6 ± 1.577621 and the third trimester 61 ± 3.126944. Conclusions: Progressive increase in Cardiac Output, end systolic volume and end diastolic volume throughout different trimesters was observed which is a result of increase in blood volume and decrease in peripheral resistance.

  1.4.11 Culture-bound beliefs during pregnancy and puerperium Top

Sanchit Mohan1, Madhuri Gawande1

1NKP Salve Institute of Medical Sciences and Research Centre, Nagpur, Maharashtra, India

Background: To assess culture-bound beliefs about pregnancy and puerperium in patients attending public hospitals, to educate women and elders about positive and negative influence of social customs. Methods: Study design: Cross-sectional, period - 2 months, sample size – 200, population of study - OPD and inpatient Department of Obstetrics and Gynaecology LMH. Results: Commonly held misconceptions were not to step out or not to use knife during eclipse; however, there is no scientific evidence to prove that it may lead to any complication related to pregnancy, not revealing pregnancy until 5 months there are many complications related to pregnancy eg many of the pregnancy undergo ectopic/congenital anamoley which will not be detected, “Baby shower” no harm in performing it except of exertion faced by mother during ceremony it may lead to preterm. Chewing pan may lead to IUGR but no scientific evidence to prove that it inducelabour. Sitting in antinatal helps in opening pelvis and facilitate delivery. Putting cotton balls in ear can cut extra sounds of environment but no scientifi c evidence to prove that it produces postpartum psychosis. Termeric and cow dung have antiseptic property, but dhuri may lead to allergic conditions in baby. Not eating vegetables such as banana and papaya may lead to deficient energy in mother leading to further complication. Applying kajal may be dangerous as it contains high amount of lead which is absorbed from pores near eyes, discarding collustrum may lead to various antibody deficiency in baby. Conclusions: Many of the culture-bound beliefs do not have scientific evidence but won't harm mother and baby if performed as misconceptions related to full moon, no moon eclipse, some beliefs such as applying kajal, exposure to dhuri giving golden ghutti, and some dietary misconceptions such as not eating green vegetables banana and papaya can be harmful to both mother and baby.

  1.4.12 Ear, nose, and throat complaints in pregnancy Top

P. S. Singla1

1Baba Farid University of Health Sciences, Faridkot, Punjab, India

Background: Hormonal changes in women during pregnancy extend beyond uterus and alter physiological processes of the body. Ear, nose, and throat (ENT) problems are seen in pregnancy. Generally, these changes cause no harm, but some can become pathological causing discomfort. This study aims to articulate a substantial measure to manage such patients. The signifi cance of the study lies in refining the quality of life of a pregnant woman by avoiding the use of drugs for these symptoms, especially in the first trimester. This model serves the purpose to expose the ENT issues. Their impact on maternal life can be significant. Methods: This retrospective study included 50 pregnant and postpartum (up to 1 week of delivery) women coming for ENT related issues. Detailed history including details about various ENT problems faced in different trimesters was reported. Results were analyzed using nonparametric tests (Chi-square test), parametric tests (two-tailed Student's t-test) and correlation (Pearson correlation coefficients) analysis. Results: Most of the complaints were seen in the third trimester. Complaints of hyperosmia in the first and second trimesters (P < 0.05) are significant as compared to the third trimester. Significant complaints of epistaxis, rhinitis and gastroesophageal reflux disease (P < 0.05) are observed in the third trimester. The incidence of snoring increases in the third trimester. Complaints of nausea, vomiting in first trimester were high. Postpartum patients did not complain of ENT problems. Their complaints resolved postpartum. Hearing disturbances were seen in the third trimester. Minor changes in hearing frequency which went unnoticed to the patients are not reported. Only clinical complaints are recorded. Conclusions: The Highest number of complaints is seen in the third trimester. Treatment is not required usually as complaints resolve postpartum. However, an appropriate way to manage such complaints should always be considered and kept in mind beforehand both by practitioner and patient.

Platform presentation 2 31st July 2015 - session 2, room 1

  2.1.1 Assessment of dental practitioner's attitude toward chairside screening of medical conditions in Belgavi City Top

Komal Kamath1

1KLE University, Belgavi, Karnataka, India

Background: Medical conditions such as diabetes mellitus, hypertension, and cardiovascular diseases represent a considerable health burden which may impede the treatment plan, and this usually goes unnoticed during dental treatment which further complicates various aspects of dental treatment and may ensue in medico legal issues. Oral healthcare professionals are therefore in a unique position whereby performing chair side medical screening, they could contribute to both delay in disease onset and control of disease severity. As there is scarcity in literature, this study was undertaken to assess the attitude of dental practitioners toward medical conditions. Hence, the objective of my study was to assess the dental practitioner's attitude toward chairside screening of medical conditions in Belgavi city. Methods: A descriptive cross-sectional study was done among dental practitioners of Belgavi city with the Ethical approval obtained from the institutional Ethical and Review Committee of KLE VKIDS. The first part of proforma consisted of the self-administered questionnaire comprising of 16 close ended questions. Before finalizing the questionnaire, it was pilot tested. Cronbach's coefficient was found to be 0.81, which showed a high internal reliability of the questionnaire. Based on this analysis, all necessary changes were introduced before the main study. Data obtained were analyzed using SPSS version 19; descriptive statistics (mean and standard deviation). Results: The mean age of the study participants were 38.81 ± 11.03 years. The survey sample consisted of 39.85% females and 60.2% males. When asked about the importance of conducting chairside screening, 78.3% females and 94.9% males agreed that it is important for dentists to conduct chairside screening. Conclusions: Dentists considered chairside screening important and were willing to incorporate it into their practices. Acceptance by patients of chairside medical screening in dental setting is critical element for successful implementation of the strategy.

  2.1.2 Assessment of physical activity levels among rural adults in central India Top

G. Kumar1, Sukhsohale. N. D1, M. Khamgaokar1

1Indira Gandhi Government Medical College, Nagpur, Maharashtra, India

Background: According to the World Health Organization, 23% of population are physically inactive globally. It amounts to be the fourth leading risk factor for global mortality. Due to the effects of globalization and liberalization, interests in dietary habits and physical activity have been affected in developing countries percolating even to rural areas. This study aimed to study the physical activity levels among rural adults of central India. Methods: This descriptive cross-sectional study was conducted in rural health administrative area of Indira Gandhi Government Medical College, Nagpur from March 2015 to May 2015. The study was conducted on 100 adults >40 years of age attending our outpatient department during the study period. Measurements such as height, weight, blood pressure, and blood sugar were recorded. The physical activity levels were calculated using the principles of 1985 FAO/WHO/UNU expert consultation (WHO, 1985). The analysis was done using Epi Info 7.1. Results: The prevalence of sedentary activity was found to be 18%. The majority of the study subjects were Hindus and educated up to 10th standard. Older age groups, i.e., 60–80years of age (P = 0.00005) and males (P = 0.01) were found to be more sedentary. The people who were more sedentary were more obese which was found statistically significant (P = 0.04). The mean blood sugar levels, diastolic blood pressure, and systolic blood pressure were 126 ± 48.11, 86.54 ± 9.09, and 137.24 ± 19.51, respectively. Conclusions: High sedentary activity among the rural adults is a major public health concern. There is an urgent need to make policies regarding active lifestyle, to educate about physical activity and promote healthy lifestyle.

  2.1.3 Trend analysis of quality indicators of Intensive Care Units Top

Megha Pai1, Suneel C. Mundkur1

1Kasturba Medical College, Manipal, Karnataka, India

Background: Efficiency of any healthcare unit is judged by its quality indicators. Intensive Care Unit (ICU) has the highest mortality rate when compared to any other unit in the hospital. The aim os the study is to study optimum utilization of ICU - bed utilization rate (BUR), length of stay (LOS), infection rates in ICU-ventilation associated pneumonia (VAP), catheter related-blood stream infection (CR-BSI), catheter-associated urinary tract infection (CAUTI), the safety of patients-iatrogenic pneumothorax, decubitus ulcer, and compliance to ICU processes-compliance to ICU consent form, readmission rate, and reintubation rates as quality indicators. Methods: A retrospective study (partly cross-sectional) in 15 ICUs, in a tertiary care teaching hospital attached to a medical college, from January 2014 to December 2014. All the data required for each parameter are taken from patients medical records. Quality indicators were calculated according to the respective formulae and for data analysis, SPSS version 20 was used. Results: BUR and LOS were highest between the months May and August, in most of the ICUs. VAP rates were maximum in multidisciplinary ICUs. CR-BSI rates were seen commonly in multidisciplinary ICUs and neonatal ICUs, between March and September. CAUTI rates were seen to be constant over the year, more in multidisciplinary ICUs and neurological ICU. There were no cases of iatrogenic pneumothorax. Very few cases of decubitus ulcers were seen, more commonly in multidisciplinary ICUs. ICU consent was obtained in 99% of the admissions. Readmission rates were significantly more in the months when BUR was high. Reintubation rate has decreased over the last year. Conclusions: ICU utilization was high in May–August. Infection rates were high in multidisciplinary ICUs. No iatrogenic pneumothorax and very few cases of decubitus ulcer were observed, and the compliance to ICU processes was satisfactory.

  2.1.4 Adherence to treatment and quality of life in patients with epilepsy Top

Monalisa Sahu1, Ananya Chakroborthy1

1Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India

Background: Nonadherence to anti-epileptic drugs (AEDs) is ubiquitous in epileptic patients. The study aims to evaluate the adherence of epileptic patient to AEDs their quality of life (QOL) and association between the adherence and QOL. Methods: Sixty patients clinically diagnosed with epilepsy under one AED for a minimum period of 1 month were selected. Adherence is assessed using Morisky medication adherence scale and QOL by QOLIE-10 questionnaire. Based on adherence score two categories, score ≤2 (Category A) and >2 (Category B) were plotted. Unpaired Student's t-test is used to analyze the data. Results: 71.67% are adherent to AEDs and 28.33% are nonadherent with a P< 0.0001. Adherence and QOL mean score of Category A is 0.63 ± 0.1246 and 70.08 ± 2.629 and for Category B is 4.41 ± 0.2720 and 56.21 ± 2.759, respectively. Further statistical analysis of the collected data showed demographic adherence level to AEDs and its effect on QOL. Conclusions: 71.67% of epileptic patients are adherent to AEDs. Patient with good adherence have an optimal QOL than the nonadherent patients.

  2.1.5 Health education as a tool to quit tobacco use among nonteaching staff in a medical college of North Karnataka Top

Priydarshini Ankita1, Shashikanth Yogesh Kumar1

1JN Medical College, Belagavi, Karnataka, India

Background: Nonteaching staff working in medical institute forms a formidable workforce and an important sector with respect to public health point of view. It is important to know the pattern of tobacco use among them and whether health education can act as an intervention to help them quit tobacco. Methods: An interventional study was conducted for the period of 2 months among 258 nonteaching staff in a medical college in North Karnataka. A self-administered questionnaire followed by intervention in the form of health education about the harms of tobacco was given to the participants. Further, follow-up was conducted after a week and at the end of 1 month using the same questionnaire to study the quit rate among the tobacco users. Appropriate statistical tests were used to analyze the results. Results: Among the total participants (258), 98 (38%) of them were using tobacco in any form. Smoking forms of tobacco was seen in 78 (79.6%) and combined smoking, and smokeless forms was seen in 20 (20.4%) participants. Among tobacco users, 41 (41.8%) users had tried to quit tobacco consumption without seeking any professional help but failed to do so. Only 92 participants were invited for intervention as six of them had quit the job during the study. Among them, 30 (32.60%) participants actually attended the intervention. First follow-up was attended by 26 participants of 30 with compliance rate of 86.67% but none of them had quit tobacco. Second follow-up was again attended by 26 participants. Among them, three participants had quit tobacco with quit rate of 11.54%, which is unsatisfactory. Conclusions: Tobacco consumption among the study participants was high. Compliance for health education to quit tobacco was poor among study participants. Similarly, tobacco quit rate among those who attended the intervention, and the two follow-up sessions were very poor.

  2.1.6 Effects of sleep deprivation on cardiovascular parameters, cognitive function and WHO well-being index of female medical students Top

Raghavi Abhilesh Bembey1, Asmita Phadake1

1Bhartiya Vidyapeeth Medical College, Pune, Maharashtra, India

Background: What is the difference between cardiovascular parameters, cognitive function and WHO well-being index of normal and sleep-deprived medical student? Methods: In a cross-sectional study, 100 female medical students were tested for sleep patterns using Pittsburgh Sleep Quality Index questionnaire and were classified as normal or sleep deprived and were checked for resting pulse rate and blood pressure using sphygmomanometer, WHO well-being index using standard 5 question questionnaire, Cognitive function by testing listening, memory, association skills, spatial anticipation, verbal fluency, and writing. Results: Around 70% students were sleep-deprived in the study and a significant increase in cardiovascular parameters and decrease in well-being index and cognitive function with P< 0.01.Conclusions: For good mental health, 7–8 h of peaceful sleep is required. A large number of our study population exhibited sleep deprivation. Sleep-deprived subjects showed altered cardiovascular parameters such as pulse rate, systolic blood pressure, and diastolic blood pressure. They exhibited lower values of subjective well-being. Sleep-deprived students also showed statistically significant lower scores in tests of cognitive functions. All the finding clearly point at creating awareness about detrimental effects of sleep deprivation in medical students and the importance of skillful time management to minimize sleep deprivation.

  2.1.7 Knowledge, practice, and the level of personal hygiene among the school children of Ahmednagar district Top

Reuben Roy1

1PDVVPF's College of Physiotherapy, Ahmednagar, Maharashtra, India

Background: Personal hygiene is important in every stage of life, but good cleanliness habits start from early childhood. Skin diseases, diarrheal diseases, dental diseases, and worm infestations are commonly associated with poor personal hygiene. This study was undertaken to find out the knowledge, practice, and the level of personal hygiene among the school children in Ahmednagar, to identify misconception among them regarding the maintenance of personal hygiene, and also to elicit a relationship between practice of personal hygiene among the children and the literacy status of their parents. Methods: A cross-sectional observational study was conducted among 500 primary school children in Ahmednagar district. The study was done from the age group of 10–16 years. Children were administered on the basis of two questionnaires. Consent was taken from the student's guardian/ teacher. To analyse the level of personal hygiene, a used form of the Department of P. S. M., S. M. S. Medical College, Jaipur questionnaire was used. To analyze the knowledge and practice of personal hygiene, a predesigned, pretested and a structured questionnaire was used. Results: It was found that female students were more knowledgeable than the male students regarding the maintenance of personal hygiene. There is a wide gap between the practice and knowledge of personal hygiene among the students. In spite of being aware, some did not practice. Even misconceptions do exist on certain indicators of personal hygiene among students. Statistically significant association was observed between practices of personal hygiene amongst school children and the literacy status of their parents.

  2.1.8 Tobacco and alcohol consumption habits in health professional students and their attitudes toward cessation Top

R. S. Sugandh1, R. A. Kolte1, A. P. Kolte1

1VSPM Dental College and Research Centre, Nagpur, Maharashtra, India

Background: Tobacco use and alcohol consumption is rising dramatically in the world today. All health professionals meet patients on a regular basis, so they can play a vital role in counseling the patients on health-related habits. Advice by a health professional can promote habit cessation. However, reports show that many of the health practitioners lack the competence to do so. Tobacco and alcohol use usually begins during adolescence. Hence, we not only need to be well aware of the tobacco and alcohol habits in health science students but also their attitude towards the de-addiction programs. The aim of this study is to assess the tobacco and alcohol consumption habits and knowledge and attitude towards cessation counseling amongst these students. Methods: A 20-item pretested and prevalidated questionnaire was delivered to the health professional students from the first to the final year at institutions in Central India. The Chi-square method was used to analyze the data. Results: The response rate was 31.25% and 62.5% from the medical and dental students respectively. 8.4% medical and 4.4% dental students gave the history of tobacco consumption. 18.4% medical 9.6% dental said that they consumed alcohol. 79.2% students reported that they never received any training on specific use cessation approach. A large number agreed that cessation techniques as a part of the curriculum would be extremely helpful. Conclusions: The tobacco and alcohol consumption habits are prevalent in health professional students. Their attitudes toward cessation seem positive, but they lack the competence to counsel their patients. Hence, the de-addiction methods should be included in the curriculum as a vital part.

  2.1.9 Predictors of mortality among patients living with HIV on anti-retroviral therapy in coastal South India: A retrospective cohort study Top

Shodhan Aithal1, Nithin Kumar1

1Kasturba Medical College, Mangalore, Karnataka, India

Background: HIV has high prevalence and incidence in India. Anti-retroviral therapy (ART) is provided extensively but still 1.5 lakh HIV patients die annually demanding increase in improvement of ART by determining the predictors of mortality. This study was conducted with objective of determining median survival rate and factors affecting mortality of HIV patients. Methods: A retrospective cohort study was conducted on patients in ART center associated with KMC, Mangalore enrolled from February 2012 to April 2015. Data collected were treatment details, follow-up details and investigations which were analyzed using Statistical Packages for Social Sciences 11.5. Cox proportional hazard survival regression was done to determine the factors associated with mortality, and P< 0.05 was considered statistically significant. Results: Total of 438 patients were enrolled in the period and mortality was 14.1% (n = 62). The mean age of patients was 42.78 ± 8.94 years. 61.4% (n = 269) of enrolled patients were male, 28% (n = 122) were in stage 4 disease, 43.8% (n = 190) were anemic, 25% (n = 105) had raised liver enzymes and 26% (n = 113) were underweight at time of presentation. Opportunistic infections was present in 41% (n = 178) of the patients. Mean hemoglobin of 12.18 ± 2.28 g% and mean body mass index of 20.36 ± 3.48). Median CD4 count was 327 cells/μl. Median survival time is 28.55 months. Family members with HIV, bedridden patients, stage 4 disease, anemia (<10 g%), leukopenia(<4000 cells), raised ESR and CD4 count <500 cells/μl were statistically significant predictors of mortality. Conclusions: Factors such as anemia, leukopenia, raised ESR, and low CD4 count can be looked for during anti-retroviral therapy and care for such patients can be given to decrease the mortality caused by HIV.

  2.1.10 A short-term study to find the effect of yoga therapy in rehabilitation of chronic obstructive pulmonary disease patients Top

P. Shyam Karthik1, M. Chandrasekhar1

1Meenakshi Medical College Hospital and Research Institute, Kanchipuram, Tamil Nadu, India

Background: According to the global burden of disease study, chronic obstructive pulmonary disease (COPD) will be the third cause of death in first half of the 21st century. The objective is to find whether yoga can be used as a part of pulmonary rehabilitation to improve physical performance and quality of life. Methods: Fifty COPD patients of 40–60 years volunteered the study were randomly divided into control (n = 25) and study (n = 25) group. Patients in the study group were given yoga training for 40 min/ day for 6 weeks. They were allowed to continue their usual physical activity, medications for 6 weeks. Forced vital capacity (FVC), forced expiratory volume in first second (FEV1), peak expiratory flow rate (PEFR), breath holding time (BHT), 6 min walk test (6MWT), St. George's Respiratory Questionnaire (SGRQ) were measured in both groups before and after 6 weeks yoga training. SPSS 22.0 was used for statistical analysis. Results: After yoga training, we observe a significant increase in FVC (from 67 ± 4.2 to 79 ± 3.9) in study group than the control group (from 66 ± 4.1 to 68 ± 4.4); significant increase in FEV1 (from 59 ± 2.4 to 70 ± 2.1) in study group than the control group (from 58 ± 2.7 to 59 ± 2.3). PEFR was significantly increased in the study group (from 50 ± 0.9 to 64 ± 1.2) than the control group (from 51 ± 0.8 to 53 ± 1.2). BHT exp was significantly increased in the study group (from 20.15 ± 1.41 to 32.53 ± 3.78) than the control group. BHT insp was significantly increased in the study group (from 31.49 ± 5.38 to 43.07 ± 9.41) than the control group (from 30.42 ± 4.31 to 31.52 ± 3.12). 6MWT was significantly increased in the study group (from 262 ± 38 to 330 ± 47) than the control group (from 260 ± 40 to 268 ± 43). SGRQ shows statistically significant decrease in total score (from 47 ± 2.9 to 36 ± 2.3) in the study group than the control group. Conclusions: This study indicates that yoga can be a useful adjunct to other conventional form of therapy for COPD.

  2.1.11 Patients' awareness about their rights among patients admitted in teaching hospitals in South India Top

D. Trivedi1

1Kasturba Medical College, Mangalore, Karnataka, India

Background: Patients' expectations from the healthcare system are on the rise. Respecting patients' rights now is an indispensable part of healthcare. This study attempts to explore the awareness among patients of their rights and the privileges that they are entitled to. Methods: A cross-sectional questionnaire-based survey was conducted in a tertiary care hospital in South India to assess the level of awareness among 215 study participants. Results: A major proportion of the patients were aware of their right to receive all the necessary information to allow informed consent to be given for medical interventions (81.9%) and to be informed of the ill effects on health if treatment is refused (81.4%). Likewise, they were well aware of their right to be kept fully informed about the diagnosis and treatment plan (87.4%) and to be provided with a medical report summarizing their medical condition and course of treatment (81.4%). 80.9% of them were aware of their right to access medical records after discharge from the hospital. More than two-thirds of the patients were aware of their right to choose the treating physician (73%) and the right to discharge from the hospital on request (71.2%). Doctors were the most common source of these rights (45%), followed by nurses (18%) and then posters (12%). Conclusions: Majority of the participants were aware of these rights, the commonest source of information being the doctor. Signifi cant association was found between awareness of patients' rights, and gender and socioeconomic status. These results can provide a roadmap for making patients aware of their rights, as well as the privileges that they are entitled to. This, in turn, will motivate better healthcare delivery and enable effective utilization of the healthcare system.

  2.1.12 Effects of outdoor air pollution on pulmonary function of nonsmoking auto-rickshaw drivers in Bengaluru Top

Vedesh Kumar Babu1, S. D. Komala Devi1

1Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India

Background: Rapid urbanization of Bengaluru has led to sharp decline in outdoor air quality. The Central Pollution Control Board reported that levels of PM2.5, NO2, CO and O3, major components of outdoor air pollution, were dangerously higher than accepted levels in Bengaluru. Drivers of open-cabin vehicles such as auto-rickshaws are at highest risk of exposure to these pollutants; hence, the most suitable group to study the effects of outdoor air pollution on lung function. Our aim was to assess the degree of change in lung function of nonsmoking auto-rickshaw drivers in Bangalore with comparison to adjusted normal values. Methods: A cross-sectional study was performed on 33 nonsmoking male auto-rickshaw drivers working 6 h or more per day in various localities of Bengaluru for a minimum of 5 years. Informed consent was obtained, and thorough history and examination were performed. Any subject with a history of smoking or with signs of respiratory, cardiovascular or other chronic diseases was excluded from the study. Pulmonary function parameters (Forced vital capacity [FVC] (L), forced expiratory volume in first [FEV1] (L), FEV1/FVC (%),peak expiratory flow rate [PEFR] (L/Min), MVV (L/Min), FEF50 (L/Min), FEF25–75 (L/Min)] were tested and recorded using Helios 701 Portable Spirometer. Descriptive and inferential statistical analysis was performed using IBM-SPSS 21 software. Results: Data showed FVC were decreased by 20%, PEFR, MVV and FEF50 by 30%, and FEV1 and FEF25–75 by 10% in comparison to adjusted predicted values. All the parameters except FEV1/FVC% showed statistically significant reduction (P < 0.01). Conclusions: It is observed that exposure to outdoor air pollution leads to reduction of all parameters of lung function except FEV1/FVC%, suggesting a restrictive pattern of lung disease. Further studies using a larger sample with a cohort study model coupled with analysis of the effect of preventive measures against air pollution is required.

  2.1.13 Knowledge, attitude and practice of pharmacovigilance among consultants in a tertiary care hospital Top

Vikram G. K. Bhat1, Sheetal Ullal1

1Kasturba Medical College, Mangalore, Karnataka, India

Background: Adverse drug reactions (ADRs) are one of the major healthcare problems occurring throughout the world, causing both morbidity and mortality. Voluntary ADR reporting is a fundamental tool of drug safety surveillance. It is estimated that only 6% of ADRs are reported worldwide. Hence, this study was conducted to assess the knowledge, attitude and practice of pharmacovigilance among consultants. Methods: A suitable self-administered knowledge, attitude, and practice survey questionnaire was designed, validated and given to practicing physicians by random sampling, after obtaining their informed consent. Descriptive statistical methods were applied using SPSS (Statistical Package for the Social Sciences) software version 11.0. The study was approved by the Institutional Ethics Committee. Results: Of the 140 consultants approached, 96 agreed to participate. Only 45.83% of the doctors could correctly define pharmacovigilance, and 31.25% of them were aware of the location for International Pharmacovigilance Centre, whereas 48.95% of consultants were aware of the Central Drugs Standard Control Organization in India. 78.12% of the consultants had never been trained in reporting an ADR. 69.79% of the consultants prefer to have an ADR Monitoring Centre in every hospital and 67.71% of the consultants would like to attend a training workshop. Also, 69.79% consultants expressed a professional obligation for reporting an ADR and 39.58% of the consultants have not yet reported a single ADR. Conclusions: Most of the consultants were unaware about pharmacovigilance, and many do not actively indulge themselves in reporting of ADRs. Hence, some initiative has to be taken to train the consultants about reporting an ADR. Regular workshops and training sessions have to be conducted and ADR monitoring centers have to be established in every hospital.

Platform presentation 2 31st July 2015 - session 2, room 2

  2.2.1 Association of plasminogen activator inhibitor-1 and hypertriglyceridemia in ischemic stroke Top

Abraham Afreen1

1Goverment Kilpauk Medical College, Chennai, Tamil Nadu, India

Background: Stroke is one of the major causes of disability, dementia, and death. Atherosclerosis and alterations in thrombosis and fibrinolysis comprise important parts of stroke pathophysiology. Elevated triglyceride levels have been shown to be associated with abnormalities in the clotting-fibrinolytic cascade. Plasminogen activator inhibitor-1 (PAI-1) may be a critical crosstalk molecule that links mechanisms to outcomes. The aim of this study is to critically appraise triglycerides and PAI-1 as risk factors of stroke and to find the association between them. Methods: This case–control study was conducted during the months of August–September 2014 and included 88 patients, 44 ischemic stroke cases and 44 controls. The control group was age- and sex- risk factor-matched subjects. Demographic data were recorded, and blood was tested for fasting blood sugar, blood urea, serum creatinine, total cholesterol, TGL, high-density lipids (HDL), PAI-1. Spearman's rank correlation was used for univariate analysis. The groups were compared using analysis of variance and t-test. Results: There were 88 subjects participating in this study, consisting of 44 patients and 44 controls. Demographic data, fasting blood sugar and total cholesterol were similar between the 2 groups. HDL cholesterol was found to be significantly lowered in the cases (P = 0.016). PAI-1 levels were found to be significantly higher in the cases (P = 0.000). There was no significant correlation between triglycerides and PAI-1 (P = 0.44). Conclusions: There was a significant increase in the levels of PAI-1 and decrease in the levels of HDL in stroke patients when compared to the controls. However, a correlation could not be established between the levels of triglycerides and PAI-1. Limitations of the study were the small sample size and inability to confirm atherosclerosis as the causative agent of ischemic stroke. Further studies are warranted to investigate the clinical roles for PAI-1 as a biomarker for stroke risk and potential target for stroke prevention and acute combination treatments.

  2.2.2 Role of ergonomics in dentistry: A study to evaluate working posture in dental students using upper limb assessment Top

Pallabi Biswas1

1Kalinga Institute of Dental Sciences, Bhubaneshwar, Odisha, India

Background: Occupation related diseases are increasing day by day due to improper ergonomics. Recently dentistry has been considered as a demanding profession due to the need of high concentration and precision. However the study of ergonomics has not been tackled at the undergraduate level. A study was undertaken to determine the role of ergonomics in early intervention and prevention of musculo-skeletal disorders by the use of rapid upper limb assessment (RULA) Assessment tool to identify the risk group in dental students. Aim: To assess the dental students' posture while working in maxillary and mandibular arch to determine any of the arch predisposes to a wrong posture. Methods: Third year and final year dental students participated in this study that was evenly distributed in each group. One group consisted of 30 students who worked on the maxillary arch and the second group also consisted of 30 students who worked on the mandibular arch. Both the groups have done supra gingival hand scaling. Each observation took around 15–30 min for each dental student in both the group. The observation was carried out while the dental students worked on patients doing oral prophylaxis. RULA assessment was used which gave quick and systematic assessment for the dental students posture. Results: Ninety percentage of the students working on the mandibular arch and 86.7% of the students working on the maxillary arch had postures that require further investigations. 10% of the students working on the mandibular arch and 13.3% of the students working on the maxillary arch had a posture that has to be changed soon. Conclusions: The RULA scores obtained indicated that students working on both arches had postures that required further investigation and intervention to prevent occurrence of musculo-skeletal disorders in the long run.

  2.2.3 Awareness and knowledge of patient's coming for root canal treatment at government dental college and hospital, Nagpur Top

P. Khandelwal1, J. Wankhade1, M. Warhadpande1

1Government Dental College, Nagpur, Maharashtra, India

Background: Root canal treatment (RCT) is one of the options to get rid of toothache and also save the tooth in pulpally involved teeth. Patient's awareness and knowledge of RCT is a very important issue in everyday practice of a dentist. It influences significantly the course and effects of treatment. Aim is to assess the level of knowledge regarding root canal treatment, barriers to its acceptance by patients. Methods: Questionnaire surveys was conducted in a group of 100 patients coming for RCT at Government Dental College and Hospital (GDCH), Nagpur, consisting questions characterizing their awareness and knowledge about RCT. 48% were male and 50% were female. In male 4.17% were illiterate to 98.83 literate. In female 7.69%were illiterate to 92.30% literate. Results: Patients were reporting with multiple problems to GDCH which included tooth ache (74%), caries (32%), sensitivity (53%) and food lodgment (49%). 49% had never reported to a dentist because they thought it was not important (11%), hospital was not easily assessable (4%), reluctant to multiple seating (4%) and rest were not aware of the problem. Though 39% knew what RCT is, but did not have knowledge about it. 60% thought multiple seating was necessary. 80% wanted to save teeth while 20% choose extraction because it was a simpler procedure (9%), less seating required (9%)and was less painful (2%). 46% people were aware about cap placement after RCT. Conclusions: People are aware about importance of teeth saving (80%) and RCT (39%), though they do not have knowledge about it. The limitation of study is that it was done in comparatively short duration and the sample is small to generalize finding to all patients.

  2.2.4 Cardiovascular disease risk factors in individuals performing yoga residing in state of Delhi Top

Michelle Siew1, Manish Kumar Goel1, Rajiv Rastogi1, Binita1

1Lady Hardinge Medical College, New Delhi, India

Background: Ratiinale behind topic-yoga is a discipline that aims to achieve permanent peace it has shown to reduce the cardiovascular disease risk factors. The aim of this study is to show the beneficial effect of yoga in cardiovascular disease risk factors. Methods: Observational and descriptive. Cross-sectional study. 100 subjects, Age: ≥30, both male and female, Group 1: Individuals performing yoga regularly for >last 6 months, Group 2 - Individuals not performing yoga regularly or started recently (duration is <6 months from date of start of study). 5. Individuals with no history of current cardiovascular emergencies. Written consent taken. The parameters and blood sample was taken under supervision of the guide, undertaking all the measures of precautions as per universal precautions guidelines. The bio-medical waste generated, disposed according to standard guidelines. Interview technique, using preformed, semi-structured, pretested questionnaire. Weighing machine digital blood pressure apparatus. Height measuring scale Inchtape, red and greyvacutainers, gloves sterile cotton, isopropyl alcohol, rubber cuff, color coded disposal bags, hub cutter, tray disposable needles and syringes. Results: Subjects in group performing yoga regularly >6 months showed lower pulse rate, i.e., mean 79.44 ± 8.36 and higher high-density lipids (HDL), i.e., mean 43.58 ± 8.83 with P< 0.05. Body mass index, fasting blood sugar (FBS) and diastolic blood pressure better in yoga group >6 though the difference was not statistically significant. Cholesterol, triglyceride and systolic blood pressure mean were higher in >6 months group (but the Pvalue is also > 0.05). Conclusions: pulse, HDL, diastolic blood pressure, FBS were better among the individuals who were performing yoga for more than 6 months regularly.

  2.2.5 Evaluation of modified selvester QRS score for prediction of successful thrombolysis in acute myocardial infarction Top

S. Motwani1, R. Khot1, N. Sukhsohale1

1Indira Gandhi Government Medical College, Nagpur, Maharashtra, India

Background: Thrombolytic therapy is widely used in treatment of acute ST elevation myocardial infarction (STEMI) where facilities for percutaneous coronary intervention are not available. Modified selvester QRS score (QRSs) has been shown to be a good determinant of size of infarction. Hence this study was carried out with the objective of evaluating the score in prediction of successful reperfusion, in comparison with ST segment resolution. Methods: Thirty consecutive patients of STEMI admitted to our Critical Care Unit who were thrombolysed by streptokinase, 12 lead high quality electrocardiography recording was done before thrombolytic therapy, 90 min postthrombolysis and 24 h postthrombolysis. QRSs and ΣSTE were calculated at same time. A value of decrease in ΣSTE >50% at 24 h was taken as a criterion for resolution. Comparison of both scores was done for baseline characteristics, clinical features, complications and outcome. Statistical analysis was done using Student's t-test, Fishers exact test, mid P-test and Chi-square test. ΣSTE showed resolution in 14 patients and nonresolution in 16, with a mean age of cohort 55.9 ± 12.7 years and M:F ratio 2.5:1 versus 0.7:1. Results: Resolution was significantly more in inferior wall MI. Mean QRSs decreased significantly in resolution group from 11.3 ± 1.9 to 5.7 ± 2.3 after 24 h. QRSs co-related positively with ΣSTE at admission and 90 min and 24 h. QRSs correlated with extensive anterior wall MI (P = 0.03), cardiogenic shock (P = 0.02) and outcome (P = 0.001).QRSs was predictive of ST resolution with sensitivity = 61.53%, specificity = 58.82%, and positive predictive value of 53.33%. Conclusions: Modified Selvester QRS score can be used to predict resolution of ST indicative of successful thrombolysis in STEMI, and also complications and outcome.

  2.2.6 A cross-sectional study to identify the risk factors for ischemic heart disease in Akola district Top

Nagpal Malvika1, Ashtaputre1, Mukund1

1Government Medical College, Akola, Maharashtra, India

Background: Ischemic heart disease (IHD) is an important cause of morbidity and mortality in India. The prevalence of IHD has been increasing every year with a decreasing disparity in the number of the urban and rural cases. India suffers from a tremendous loss of productive working years due to IHD deaths. IHD being preventable to some extent. The study aims at finding the risk factors for IHD present in a given socioeconomic strata of Akola district. Methods: Present cross-sectional study was conducted on a random sample of the population aged ≥40 years, comprising of relatives of the patients at GMCH Akola. Sample size in the present study was 200 and study period was 2 months (i.e., from 15 March to 15 May). Data were collected through a pretested, semi structured questionnaire (Rose questionnaire). Demographic characteristics and self-reported details of smoking, alcohol intake, tobacco consumption, hypertension, diabetes, physical activity and dietary fat and fruit intake were recorded after obtaining informed consent. Anthropometric measurements focused on height, weight, sitting BP, waist and hip dimensions, pulse, using methodologies prescribed by WHO. The data collected were analysed using suitable statistical tools. Results: Tobacco consumption is 50% and is the most significant risk factor for this population. 35% are overweight where as 30% are obese. Physical inactivity is not a concern since majority are farm laborers. Conclusions: The findings of this study indicate that the prevalence of risk factors for IHD is high in Akola district. There is lack of awareness about modifiable risk factors, regular check up regarding blood pressure and sugar and severity of the course of the disease. Increasing population of tobacco consumers and lack of education are alarming in this population. The limitations of this study are that no blood samples could be drawn for sugar, serum cholesterol, LFT and KFT due to financial constraints.

  2.2.7 Association between hypertension and stress: A case–control study Top

Priyal Purushottam Yenurkar1, Ajeet Saoji1, Uday Narlawar1, Sonal Deshpande1

1NKP Salve Institute of Medical Sciences and Research Centre, Nagpur, Maharashtra, India

Background: Stress is one of the most important factor associated with many lifestyle diseases. Hence this study is conducted with objectives of finding out an association between stress and hypertension. Methods: This was a case–control study done at a tertiary care centre amongst hypertensive patients aged30 and above with age and gender matched controls in period of June2014 to August2014. Sample size: After estimation of sample size final sample size was decided as 102 cases and 102 controls. Study Universe: Criteria: Cases were selected from Medicine OPD. Controls were selected from OPDs other than Medicine OPD. Controls were group matched for gender and age (± 5years) History regarding socioeconomic variables were taken using predesigned proforma. Stress scale was assessed by using Gurmeet Singh et al. Presumptive stressful life events scale (PSLES) was translated in local language and by interview technique. Hypertension was classified as per JNC-VII21criteria. Statistical Analysis: Data was entered in excel and analysed by using Epi Info version 7.1.14 software. Chi-square test was used to determine the association. Univariate analysis for risk calculations was done by odds ratio and their 95% Confidence intervals. Results: Out of 102 cases and controls 54 (52.9%) were females and 48 (47.1%) were males each. Mean age of cases came out to be 58.62 ± 10.31 (range: 33–78) and control 54.54 ± 10.78 (range: 31–75) High stress was more among cases (91.2%) as compared to controls. High stress was 2.52 times higher among cases as compared to controls (P = 0.027). Statistically significant association between hypertension and stress was found. Conclusions: High stress was signifi cantly associated with hypertension with odds ratio of 2.52 (95% CI: 1.08–5.8).

  2.2.8 Study for exploration of efficacy of piperidine derivatives against Brugiamalayi by in vitro and bioinformatics study as a valid antifilarial candidate Top

Rao Sahitya1, Bhoj Priyanka1, Goswami Kalyan1

1Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, Maharashtra, India

Background: The presently available drug repertoire against lymphatic filariasis is inadequate and is fraught with serious administrative and infrastructural limitations. Also, there is no effective vaccine till date and the available mainstay drug, DEC, has indirect antifi larial effect with many adverse effects. Therefore, developing an effective chemotherapy against this infection will complement the effort towards eliminating it. In the present study, we have reported the in vitro biological evaluation of piperidine compounds with polyphenolic rings against Brugiamalayi and explored their possible mechanism of action. Methods: We analyzed the effect of these piperidine compounds in different concentrations on B. malayi microfilariae obtained from peritoneal lavage of infected JIRDS (merionesunguiculatus). Molecular docking was performed to virtually validate B. malayi dihydrofolatereductase (DHFR) enzyme as a plausible target of the drug. Further, acridine orange-ethylidine bromide staining was done to explore the apoptotic activity of the proposed compounds. Results: Two compounds, PI and PMI showed antifilarial activity against B. malayi in sub-micromolar concentrations. These drugs were surprisingly found to have direct antifilarial effect by activating apoptotic pathways contrary to the indirect antifilarial effect of DEC, the only currently available drug. Molecular docking with B. malayi DHFR showed remarkably effective binding parameters with lower inhibition constants of these ligands indicating a possible target. Conclusions: The result of this study suggests that DHFR could be considered as a potential target for anti-parasitic drug designing. This study opens new avenues for the discovery of lead molecules by exploiting the folate pathway against one of the major neglected tropical diseases, filariasis. DHFR inhibitors could be used as leads for development of new antifi larial drugs.

  2.2.9 Sesbaniagrandiflora (humming bird tree) in the management of anemia Top

Sanhitha Purushotham1, R. Rama Mishra1

1Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India

Background: Anemia is the most common disorder of the blood and a major causative factor in a number of clinical conditions. Current treatment includes oral/parenteral supplementation of iron which may not be afforded by all lower socioeconomic classes for the entire duration of treatment. Sesbania locally known as “agati” (in hindi) is a native of the Indian subcontinent. The leaf extract contains many chemical components, the important one being iron. Hence it has been selected for the study to understand its role in management of anemia. The primary objective of the study is to identify adults with Iron deficiency anemia, intervene in the form of Sesbaniagrandiflora supplementation and reassess the hemoglobin levels of the individual after intervention. Methods: One hundred anemic patients with iron deficiency anemia were identified, out of which 70 of them would be administered with 60 g of Sesbania per day for a period of 60 days and the other 30 (control group), to whom elemental iron is administered. It's a randomized controlled and prospective study. Results: In this study, the result observed after strict administration of Sesbania leaf powder for 60 days, was that 57% patients with moderate and 75% patients with mild anemia had showed significant improvement in their hemoglobin levels. Significant improvement in hemoglobin levels of the intervention group at the end of 2 months was seen. Sesbania leaf powder would be a good supplementation for both preventing and treating mild and moderate anemia. Conclusions: Use of Sesbaniagrandiflora leaf powder showed improvement in hemoglobin levels. Consistent usage will reduce the burden of Iron deficiency anemia in India and possibly reduce the number of borderline cases turning into anemia.

  2.2.10 Analysis of drug-drug interactions among intensive care patients in a Tertiary Care Hospital Top

P. Savinitha1, Bharti Chogtu1

1Kasturba Medical College, Mangalore, Karnataka, India

Background: Drug-drug interactions (DDIs) are estimated to account for 6–30% of all the adverse drug events and they cause significant harm to those who are hospitalized. Patients admitted to the Intensive Care Unit (ICU) are generally prescribed multiple drugs. Studies have demonstrated a positive correlation between polypharmacy and DDIs. ICU patients are therefore predisposed to the development of drug interactions. The present study was designed to analyse the DDIs encountered in ICU wards. Methods: This was a prospective cross-sectional study including 115 patients admitted to the ICU of a tertiary care hospital. Data was recorded from the case files of the patients as per the pro forma. The pro forma included demographic data as well as information regarding drugs. This information was analysed using a software that identifies interactions if present and classifies them into categories according to severity (contraindicated, major, moderate, minor and unknown). Results: Out of the 115 patients, 65.7% were males. The number of drugs received by patients ranged from 5 to 17. 66.35% of the patients had drug interactions, with a majority being moderate in severity. The number of DDIs per person ranged from 1 to 8. Out of the 202 drug interactions recorded, 61 were major, 137 were moderate, and 5 were classifi ed as minor. The most observed major and moderate reactions were between ondansetron-metronidazole and insulin-budesonide respectively. Drug interactions were commonly seen with patients who had Diabetes mellitus as a comorbidity. Conclusions: The study showed that potential DDIs are prevalent in the ICU. By enhancing knowledge in the predictions, health professionals can identify hazardous drug combinations, minimize the negative impact and provide optimal medical therapy.

  2.2.11 Knowledge, attitudes and practices of oral hygiene among health care students in Mangalore Top

S. Shah1, T. Rekha1, S. Bhattacharya1, A. Sharma1, S. Aswin1, N. Gaurav1, C. Karthika1

1Kasturba Medical College, Mangalore, Karnataka, India

Background: Dental care is an essential but often neglected part of a healthy life style. Medical and paramedical students can play a vital role in oral health care promotion by integrating and conducting oral health assessments across a wide range of practice settings. It's crucial that their knowledge should be adequate and oral health practices should be correct. This study aims at investigating and comparing the knowledge, attitude and practices of oral hygiene among medical, dental and nursing students in Mangalore. This will help in improving awareness, vis-a-vis oral hygiene. Knowledgeable clinicians and nursing staff will be in a better position to recognize and advice patients regarding oral health problems during routine health checkups. Methods: Cross-sectional study with self-administered questionnaire during April 2013 among students of Kasturba Medical College, Manipal College of Dental Sciences and three nursing colleges of Mangalore. Based on the results of a previous study, the sample size was calculated to be 450, comprising of 150 MBBS, dental and nursing students each. Data were analyzed using SPSS V 11.5. Results: Most subjects (56.2%) considered their oral hygiene to be good. Adequate knowledge about correct oral health practices and risk factors for poor oral health was present in 38.7%. 72.4% had a positive attitude towards improving their knowledge about maintenance of oral hygiene, attending educational programs and dental checkups. Correct practices regarding oral hygiene were present in 62.6%. Nursing students were most knowledgeable and had a positive attitude, whereas the best oral health practices were present in dental students. Conclusions: The study revealed that knowledge and practices were deficient in most students. Thus, oral health educational programs and frequent dental checkups should be arranged for the students. These will improve the oral health of the students as well as of the community.

  2.2.12 Do the patients coming to dental clinic have undiagnosed diabetes mellitus? Top

Shriya Murarka1, Omprakash Narware1, Alka Dive1, Vivek Pandey1

1VSPM's Dental College and Research Centre, Nagpur, Karnataka, India

Background: This research aimed to study the prevalence of undiagnosed diabetes mellitus among dental OPD patients in Tertiary Dental Care Centre. The objective was to detect undiagnosed diabetes mellitus by screening these OPD patients. Diabetes mellitus is a common condition and can have adverse effect on oral health. It has been reported that patients with poor blood sugar control have increased the incidence of dental pathologies including periodontitis, dental caries and Candida infections and, therefore, loose more teeth. Methods: Nondiabetic, patients attending OPD of VSPM's Dental College were subjected to blood sugar examination using standard glucometer. Patients with fasting blood sugar more than 126 mg% or random blood sugar (RBS) more than 200 mg% were given diagnosis diabetes mellitus, and appropriate advice was given to them. Only willing patients were included in this study. Total sample size was 200 patients in age group of 15–75 years. 200 patients attending dental OPD were included in this study. During this study, the patients willing were included only after filling the Informed Consent Form as return undertaking by the patients. Patients were explained thoroughly about the procedure been carried out with them. Results: Out of 200 patients screened, 15 patients were found positive for diabetes mellitus by glucometer test. Conclusions: All the dental professionals should keep a glucometer in their clinic and check the RBS for each patient before conducting any dental procedures on OPD basis, especially in patients after 40 years of age with predisposing risk factors. Dental professionals may be the first individual to diagnose prevailing condition of diabetes mellitus in a patient.

  2.2.13 To study the effects of 0.5% topical timolol on the healing of chronic nonhealing trophic ulcers and pressure sores in leprosy patients Top

Unnati N. Prajapati1, L. Bhoir1, H. Koushik1

1BJ Medical College, Pune, Maharashtra, India

Background: Chronic non healing wounds are a global burden which affects both the healthcare system and patient's quality of life. The etiology of these wounds includes systemic conditions such as diabetes, tuberculosis, leprosy, venous leg ulcers, etc., Presence of beta-2 adrenergic receptors along wound edges have been shown in various studies and activation of these receptors causing delayed wound healing have been well characterized. Hence by using topical timolol (nonselective beta blocker) solution of 0.5% w/v formulation, we propose a study to observe its effect (acceleration of wound healing) without major systemic side effects. Methods: A prospective cohort study was carried out. The patient was selected and edge biopsy (day 0) was taken and sent for histopathology. One drop of timolol solution was applied every 2 cm along the margins the wound twice weekly for 2 weeks. Biopsy was repeated on day 14. Results of biopsy done on day 0 and 14 were observed for re-epithelialization and proliferation of fibroblasts. Clinically wound was observed for contraction in the size. Sample size = 50 patients. Inclusion criteria-Leprosy patients with chronic nonhealing trophic ulcers. Exclusion criteria-Leprosy patients with chronic nonhealing ulcers having cardiac diseases, bronchial asthma, and the one taking systemic beta blockers. Analysis was carried out using Chi-square test and odd's ratio. Results: Thirty-seven patients out of 50 showed contraction in wound size. Of which 18.91% showed <50% reduction and 81.08% showed more than or equal to 50% reduction by 14th day, which was statistically significant (c2 = 55.598, P< 0.0001). Histopathology reports showed the presence of fibrovascular tissue and clinically the scar that formed was supple, thus in concordance with healing. Conclusions: Approximately 74% of patients showed reduction in wound size after the application of drug timolol maleate. Thus, we can say the outcome was statistically significant.

Platform presentation 2 31st July 2015 - session 2, room 3

  2.3.1 A comparative study of quality of life and depression in elderly staying in old age homes and with their family Top

P. Amonkar1, M. Mankar1

1Mahatma Gandhi Missions Medical College, Navi Mumbai, Maharashtra, India

Background: With increase in life expectancy and changing family traditions for care of elderly, concept of old age homes is increasingly gaining momentum in India. While international interest has focused on quality of life (QOL) in old age, Indian elderly have been a subject of neglect. Hence, the aim of this project is to study and compare the QOL and prevalence of depression in two different residential settings: old age home (OAH) and family homes (FH). Methods: Sixty residents of an OAH and 120 elderly residing with their families were selected randomly and interviewed after taking consent. Those who were <60 years old, bed ridden, severely ill or audio-visually handicapped were excluded from the study. The WHO-QOL instrument–older adults module and geriatric depression scale-SF were used as tools of assessment. Chi-square and Mann–Whitney U-test were used for analysis. Results: Depression was present in 40% of OAH and 28% of FH residents (P = 0.115). The mean total score of WHOQOL-OLD out of 100 in OAH was 59.4 and FH residents was 64.4 (P = 0.11). Mean scores in the 6 domains of the questionnaire were: “Sensory Abilities” 71.9 (OAH) versus 75.83 FH, “Autonomy” 51.3 versus 60.6 (P = 0.008), “Past, present and future activities” 59.4 versus 66.1 (P = 0.039), “Social participation” 62.9 versus 70.6 (P = 0.013), “Death and dying” 70.4 versus 54.9 (P ≤ 0.001), “Intimacy” 41.1 versus 58.4 (P ≤ 0.001). Conclusions: The prevalence of depression was found to be high irrespective of the place of residence. Although overall QOL was similar in OAH and FH residents, when individual domains were compared, the QOL in “autonomy,” “past present and future activities,” “social participation” and “intimacy” was significantly poorer in OAH. However, for “death and dying,” the QOL was significantly poorer in FH residents. This shows the need for greater government involvement in geriatric care.

  2.3.2 Prevalence of depression and it's symptomatology among tenth graders 1 month before their board exams Top

Anurag Madhav Raje1, M. G. Raje1

1Institute of Medical Sciences and Research, Satara, Maharashtra, India

Background: WHO has stated that incidence of depression is rapidly rising, and threat looms that depression will be the most common disease, surpassing diabetes mellitus and cancer. Nowadays, depression and suicidal tendencies among students have clearly risen, especially before and after board exams. Does that mean board exams have a role attributing to depression among students? To find answer to this question, students of tenth grade were examined 1 month before the board exams. The level of depression was assessed along with symptomatology. The primary aim was to find the prevalence of depression among tenth graders 1 month before the board exams. Secondly, it was to assess the symptomatology of depression in the students and lastly to find answers to a research question that “does board exams attribute to depression in students?” Methods: A cross-sectional study among the tenth graders in rural areas, using the quick inventory of depressive symptomatology (QIDS16) self-assessment report, which is a world-renowned scale for assessment of depression was conducted and was done 1 month before their board exams. Results: The prevalence of depression according to QIDS was 166(40.78%) as moderate, 65(15.97%) as severe and 10(2.45%) as very severe in this study group, with approximately equal prevalence of depression in girls to that of depression in boys. The major symptomatology was somatic, i.e., weight gain or loss. Conclusions: Our findings conclude that majority of the students were suffering from depression in the preexam period. During the preexam period, there is a high prevalence of depression among students.

  2.3.3 A study if acute stress disorder as a psychological reaction to the 2015 Nepal earthquake in nursing and medical college students of Sikkim Top

Arunima Sharma1, S. Harshavardhan1

1Sikkim Manipal Institute of Medical Sciences, Tadong, Sikkim, India

Background: At 11:56 NST on April 25th 2015 an earthquake of magnitude 7.9 on Richter scale shook Nepal killing more than 8,800 people and injuring more than 23,000 with an estimated loss of 50 billion US dollars. Apart from the immediate threat to life and property, the psychological consequences of disasters are far-reaching and ominous. In various cross-sectional studies of selected subgroups following disasters, the prevalence of psychological distress and mental health problems, in particular posttraumatic stress disorder (PTSD), has been estimated to vary between 4% and 80%. Acute stress disorder (ASD) is a relatively new diagnostic entity characterized by onset of dissociative, anxiety, intrusive thoughts that occur in the immediate aftermath of a traumatic event which the sufferer tries to avoid. The scientific basis for the diagnostic category of ASD was justified by research showing that dissociative reactions immediately after a traumatic experience predicted later PTSD symptoms. Methods: A cross-sectional study was conducted on 300 MBBS and B.Sc Nursing students of Sikkim Manipal Institute of Medical Sciences who were present in Sikkim on 25th of April 2015 and experienced the aftershocks of the Nepal earthquake. After informed consent a sociodemographic proforma, Stanford Acute Stress Reaction Questionnaire and Media Exposure to Earthquake questionnaire were administered. The data was analysed using SPSS version 17. Results: It was found that 71 of the 300 students (23.7%) suffered from ASD. Media exposure to earthquake-related content was significantly associated with ASD diagnosis. Conclusions: Doctors and Nurses in the course of their profession are at increased risk of exposure to victims of trauma (both physical and psychological) leading to “secondary traumatization,” or “compassion fatigue”. Hence, it is imperative that healthcare providers be resilient and well prepared to tackle traumatic experiences at the level of their training as students.

  2.3.4 Does excessive concern and restrain from family precipitate alcohol withdrawal? Top

S. H. Azad1, M. D. Motlag1, P. P. Joshi1

1Indira Gandhi Government Medical College, Nagpur, Maharashtra, India

Background: Alcoholism affects almost all aspects of family life causing far greater impact on dependent family members than on alcoholic himself. The enormous stress and strain faced by the relatives make some alcoholics to abstain which precipitates alcohol withdrawal. Due to lack of awareness and ignorance, the withdrawal symptoms increases in severity and becomes more frightening. The distress associated with withdrawal makes the patient reluctant to contemplate abstinence. Hence, there is a need to educate the substance abuser as well as the family. Methods: This Cross-sectional study was carried out in the Department of Medicine, IGGMCH, Nagpur. Fifty-four cases presenting with alcohol withdrawal brought to the hospital, by their caregivers were assessed. The withdrawal symptoms were precipitated purely due to abstinence and not any intercurrent illnesses. Data was collected by an interview technique using two predesigned questionnaires for alcoholic and the caregiver respectively. Clinical institute withdrawal assessment scale of alcohol, revised (CIWA-Ar) and The family member impact score questionnaire (FMIS). Results: CIWA ranges from ≤15 (mild), 16–20 (moderate) and ≥20 (severe) withdrawal. The FMIS ranged from 15.5 ± 5.972 for mild withdrawal, 17.42 ± 13.08 for moderate withdrawal and 29.65 ± 11.19 severe withdrawal showing FMIS to be highest in cases of severe withdrawal and a statistical association was found between the two. Conclusions: Enormous stress and strain faced by the relatives as reflected by FMIS is significant with the severity of withdrawal symptoms. This probably suggests that family played a role in abstinence from alcohol leading to complex medical scenarios of alcohol withdrawal. The family members expressed willingness to assist in the de-addiction process and participate in family intervention therapy.

  2.3.5 Assessment of awareness of depression and anxiety in cancer patients and their caregivers and referral to psychiatric services: A pilot study Top

Borse Riddhi1, Subramanyam Alka1, Girishankar Vidya1

1Topiwala National Medical College and BYL Nair Charitable Hospital, Mumbai, Maharashtra, India

Background: Cancer causes 22% of all deaths due to noncommunicable diseases, ranking second worldwide. Every second 20,000 people are estimated to succumb to cancer. Not surprisingly, 1 in every 4 cancer patients suffers from depression at some point during their disease that requires psychiatric intervention. It often coexists with other conditions like anxiety, fatigue and pain disorders. Depressive symptoms in cancer patients range from adjustment disorders, major depressive disorders to mood disorders secondary to general medical conditions. This study is aimed at evaluating the awareness of depression and anxiety in the patients and their caregivers and if they got a psychiatric reference by the oncologist. Methods: Thirty randomly selected outpatients and their caregivers visiting an urban tertiary care hospital of a developing country were selected and administered HADS and PHQ9 questionnaires. Spearman Rank's correlation and Chi-square tables were used to analyse data. Results: It was found that 86 percent of the patients had depression of which 80% were severe. 73.33% had severe anxiety. 93.33% of the caregivers felt that their patient experienced depression and all of them felt that the patient had sadness of mood. No referrals were provided by the oncologist for psychiatric assessment of any patient. Conclusions: These results underline the need to sensitize patients, families and physicians to be in watchful expectation of an overt or covert psychological meltdown and take a psychiatric consultation. It highlights the deficient mental health awareness in these parts of the world, the need to focus on mental wellbeing as a vital component of physical health and embrace a multidisciplinary approach with the psychiatrist as an essential part of the team. A sound psychiatric support might not only delay caregiver burnout and ease the patient's personal suffering but would also nudge him to find meaning in his existence and cherish the sunset of his life.

  2.3.6 Breaking bad news of cancer diagnosis-the patient's perspective Top

A. Dhage1, A. Wilkinson1

1NKP Salve Institute of Medical Sciences and Research Centre, Nagpur, Maharashtra, India

Background: Communication between physicians and patients is a fundamental aspect of cancer care, especially when bad news is being communicated. Bad news could be defined as “any information, which adversely and seriously affects an individual's view of his or her future”. Communication between the patients and their physicians need to be improvised, but physicians lack knowledge with regard to the optimal way to approach the communication of bad news. The aim of the research study is to explore the perspective of patients receiving news about cancer and to show how satisfied the patients were about the way they received news and their expectations regarding the same. Methods: A cross-sectional study was carried out in our tertiary care teaching hospital. 30 consenting cancer patients from 18 to 60 years of age were interviewed in a period of 2 months, on the basis of a structured, pretested questionnaire. Results were analyzed using SPSS Version 20. Results: On analyses of the patients' answers, it was found that of 30, 22 were female and 8 were male, the average age being 50.07 years. The common diagnosis in females was found to be Breast cancer with 14 patients and Endobronchial, Tongue cancers in males with 2 each. All the patients wanted relatives present with them while the doctor broke the bad news. In 66.6% patients, the news was broken by a junior resident while 15% did not greet the patients. Unfortunately, it was found that to 10% of the patients, the news was broken suddenly to them while 99% if the doctors did not explain any positive aspects of the disease related to the treatment outcome. Conclusions: Based on the patients preferences, suggestions may be offered to the physicians on the importance of the technique of breaking bad news when a diagnosis of cancer is being communicated.

  2.3.7 Correlation of executive functions and memory in adult epilepsy patients Top

A. S. Kale1, R. S. Yadav1, S. V. Khadilkar1

1Grant Medical College and Sir JJ Group of Hospitals, Mumbai, Maharashtra, India

Background: In Epilepsy patients, memory problems and executive deficits render interictal livelihood difficult. Few reports suggested selective impact of executive deficits on memory modalities in temporal lobe epilepsy patients (TLE). However this data is scarce, and none of the previous studies explored such relationship in idiopathic generalized epilepsy (IGE), which is characterized by absence of any macroscopic lesion. Hence, we carried out this study aimed to assess relationship between executive function and memory in adult IGE and TLE patients. Methods: This cross-sectional study was carried out at Neurology Department of Tertiary Health Centre. Patients who fulfilled International League against Epilepsy (ILAE 1989) criteria for IGE (n = 22) and TLE (n = 22) were included and compared with healthy subjects (n = 22) in tests of executive functions and memory. Frontal assessment battery at bedside (FAB), Clock Drawing Test-an executive task (CLOX©), PGI memory scale Hindi version (PGIMS©) and Montreal Cognitive Assessment (MOCA) Hindi version were used. Results: Compared with healthy group significantly impaired executive functions, memory and global cognition were observed in IGE and TLE patients (P < 0.05). FAB significantly predicted similar pair retention score in IGE patients (P = 0.026). No relationship was evident in TLE patients. Conclusions: Executive deficits and memory impairments in Epilepsy are part of global cognitive decline rather than isolated decay of individual cognitive domains. Our findings advocate a significant selective impact of executive dysfunction on memory modalities in adult IGE patients. Findings of our study have clinically relevant implications in planning cognitive rehabilitation strategies as well as in better understanding of neuropsychology in adult IGE and TLE patients. Executive function enhancement techniques should be incorporated while tackling memory problems in Epilepsy patients.

  2.3.8 Study on psychosexual disorders amongst patients of opioid dependence: A cross-sectional study Top

Manik Inder Singh Sethi1, Himanshu Sareen1

1Punjab Institute of Medical Sciences, Jalandhar, Punjab, India

Background: Opiate misuse has increased in prevalence in the last few decades. Punjab is in hold of a drug epidemic. According to a household survey of three districts of Punjab prevalence of opium use was 5.76% of general population which largely comprised of youth. As literature lacks large-scale epidemiological data on sexual disorders, we aimed to add to the existing data, the prevalence of sexual problems in patients coming to the de-addiction clinic in our Tertiary Care Centre. The objective of the present study was to create knowledge about the psychosexual disorders due to opioid use which would help in dissuading the youth of this evil. This area is often neglected and hence unexplored in routine clinical care of opiate addicts. However, it is clinically relevant as it can lead to nonadherence of treatment and relapse. Methods: A total of 109 participants over a period of 2 months were subjected to an interview to asses various aspects of drug abuse related Sexual Dysfunction with the help of IIEF-15 (International Index of Erectile Function) and ASEX (Arizona Sexual Experience Scale) questionnaires. Data was collected and tabulated in Google sheets and analysed using IBM Statistical Package for Social Sciences (SPSS, version 20) software. Results: Mean age of participants was 29.9 years, most of them were farmers, 67% were married, and Heroin was the opioid of Choice for 81.7%.Low libido (59.6%) was the commonest psychosexual problem, followed by Premature Ejaculation (57.8%), Erectile Dysfunction (56.4%), Abating overall satisfaction (52.2%) and Waning Intercourse Satisfaction (46.7%). Conclusions: Results obtained in the study brought to light that the prevalence of Sexual Dysfunction increases two-fold with increase in duration of opioid abuse. The association of duration of opioid abuse with all modalities of sexual dysfunction was found to be extremely statistically significant.

  2.3.9 Risk factors for antenatal depression among women attending tertiary care hospitals in Mangalore Top

Nidhi1, Nithin Kumar1

1Kasturba Medical College, Mangalore, Karnataka, India

Background: Detection rates of depression in obstetric care are generally low, hence many women remain undiagnosed and do not receive adequate support. The present study aims at assessing the prevalence of antenatal depression and identifying the associated risk factors to safeguard the lives of those in need of interventions. Methods: In this cross-sectional study, 201 pregnant ladies attending antenatal clinics/admitted at the teaching hospitals affiliated under KMC, Mangalore were selected by convenient sampling and interviewed to assess their risk of antenatal depression using a pre-designed, semi-structured questionnaire modified from Edinburgh Postnatal Depression Scale. Institutional Ethics Committee Permission was obtained before commencement of study. Data was analysed using SPSS 11.5 and results expressed in mean and proportion. Chi-square test was applied to study the association between demographic, obstetric and social factors and the risk of antenatal depression among pregnant ladies. P < 0.05 was statistically significant association. Results: The mean age of the participant was 26.4 + 3.2 years with majority (52.7%) belonging to the age-group 26–30 years. High chance of depression was seen in 10.9% (n = 22). The risk of antenatal depression was found to be more among those aged >25 years (14.1%), lower-middle socioeconomic status (12.8%), primary school education (17.8%), multigravidas (16.7%), and who had in-law pressure (54.5%). Conclusions: Older age group multigravidas belonging to lower-middle socioeconomic status are at greater risk of developing antenatal depression. The risk factors include in-law pressure, gender preferences, educational status, husband and family support. These findings may provide scope for early identification and treatment of antenatal depression that will assist in planning interventions at the primary, secondary, and tertiary levels of prevention to improve pregnancy outcomes.

  2.3.10 Sleep deprivation-effect on the quality of life of undergraduate medical students in JNMC, Wardha Top

Sherwin Chacko1, Pradeep Patil1

1JNMC, Sawangi, Wardha, Maharashtra, India

Background: Sleep is essential to maintain and increase the cognitive performance and to avoid psychiatric disorders. This study focuses to emphasize the importance of sleep for students and future researchers by carrying out a study in the undergraduate medical students of JNMC to (1) study the effect of sleep on the quality of life and (2) determine and study the factors causing sleep deprivation. Methods: A prospective study will be conducted in the Department of Psychiatry of JNMC. A representative sample of 200 undergraduate medical students from JNMC were assessed by a self-administered questionnaire which measured sleep-related variables, academic performance and study time factors along with PSQI and WHOQOL scale with the inclusion criteria being their consent before answering the questionnaire and the exclusion criteria being Psychiatric or Medical illness. An informed consent will be signed by all the participants before they participate in the study that will subjectively evaluate their level of concentration, and effort, and the quality of their performance. Before the whole procedure, each subject will be explained about the procedure and will be given an opportunity to ask questions and clarify their doubts. All the information regarding the participants will be kept confidential. Results: Out of the 200 students (100 males and 100 females), quality of life was rated as “Very Good” in only 19% and “Poor” in 8.5%. Sleep quality was rated as “Very Good” by 30% girls and 23% boys and “Bad” by 5% girls and 9% boys. The most common factor affecting sleep deprivation in males and females was the use of internet during the night. Conclusions: Sleep deprivation is a significant issue among undergraduate medical students and improving the quality of sleep can significantly improve their quality of life.

  2.3.11 Assessment of emotional quotient of parents' of babies admitted to Neonatal Intensive Unit Top

Srushti Agrawal1, Anjali Edbor1, Pankaj Singh1

1NKP Salve Institute of Medical Sciences and Research Centre, Nagpur, Maharashtra, India

Background: Prematurity or low birth weight (LBW) is the most stressful experience a parent can have. With improving tertiary care facilities, the survival rate of premature and LBW babies has increased and this disturbs not only the financial status of the parents but also leads to emotional, social and familial imbalances along with interruption in their daily routine. For this, medical fraternity is stressing on early rooming in and also is concerned with parents' counselling and communication skills of junior doctors to allivate their anxiety. Methods: Seventy-six babies were admitted to the Neonatal Intensive Unit (NICU) of NKPSIMS and Lata Mangeshkar Hospital in the month of May and June, 2015. The emotional quotient of parents of these babies is assessed with the help of a prevalidated quotioner by IBHQ measuring 5 more areas. The socioeconomic status of almost all parents was lower middle class and the dead babies were excluded from the study. Proper statastical methods are used to analyse the data obtained. Results: The study shows significant t-values in the areas as; daily routine - 3.321, parental attitude - 4.646, financial status of parents -4.713. Conclusions: It is concluded from the studies that the studies that the emotional condition of the parents reflects in their physical health, daily routine and financial status because of the long stay of babies in the NICU which perhaps changes their attitude and are ready to risk the lives of their babies for want of early discharge.

  2.3.12 To study the effect of anxiety in adolescent patient of acne vulgaris a hospital based case–control study Top

Vairagade Abhishek Girish1, Milind Borkar1

1NKP Salve Institute of Medical Sciences and Research Centre, Nagpur, Maharashtra,India

Background: Acne vulgaris is very common problem of adolescents 'Acne is a chronic inflammatory disease of the pilosebaceous unit. It is characterized by seborrhoea, the formation of come dones, erythematous papules and pustule, less frequently by nodules and deep pustules, or pseudocysts and. In some accompanied by scarring. The main aims of the study is to evaluate the anxiety level amongst adolescents with acne vulgaris and correlate the severity of anxiety symptoms with the severity of acne vulgaris. Methods: This was case–control study to determine the incidence of anxiety in adolescents with or without acne vulgaris which includes 50 cases and 50 controls, who are the patients attending skin OPD of NKP SIMS Nagpur Maharashtra. Inclusion criteria (A) For case: Patient with acne lesion. Male and female patient of adolescent age (10–22 years) (B) for control: (1) Patient or normal adolescents without acne vulgaris. Exclusion criteria patient with history of a known mental disorder. Patient on antianxiety drugs. Patient on treatment for acne vulgaris. Patients were asked to fill the demographic data. In cases, we formulated the data of our study in various grades like Grade I, Grade II, Grade III, Grade IV according to Pillsbury classification. The anxiety is measured by the preformed Hamilton anxiety rating scale (HAM-A). The result was calculated using EPI INFO software. Results: On categorizing anxiety in terms of cases: 22% cases had mild anxiety, 62% were moderate, and 14% had severe anxiety level. In relation to controls, we found that 70% individuals have mild anxiety level, 30% had moderate, and none of this have severe anxiety. Conclusions: It can be concluded from this study that acne is likely to be associated with anxiety and it is also clear that as the grade of acne vulgaris increases anxiety level also increases.

Platform presentation 2 31st July 2015 - session 2, room 4

  2.4.1 To study the effect of different exercise regimes (yoga, aerobics, voluntary play) on attention and concentration in Indian children aged 9–12 years Top

V. Adlakha1, M. Monga1, K. Sharma1, A. Pawar1, A. Gandhi1, S. Mondal1

1LHMC, New Delhi, India

Background: Research has concluded that in adults, physical fitness (especially cardiorespiratory fitness) correlates positively with attention and concentration. Whether improved fitness correlates with better cognitive function in children is debatable due to a paucity of research. Furthermore, children follow various exercise regimes (yoga, aerobics, voluntary play) which may have a differential effect on physical fitness, and hence, cognitive functions. Hence, we tried to see whether different exercise regimes followed for an academic year differ with respect to effect on attention, concentration, and physical fitness in children. Methods: Design - Cross-sectional comparative study; Setting - Private schools where yoga, aerobics, voluntary play is performed; Methodology - Three groups were studied based on regime followed for one academic year. Yoga group (n = 12) performed yoga for 1 h 35 min a week. Aerobics group (n = 29) performed exercises 5 h a week. Voluntary play group (n = 30) played fun games for 5 h a week. Body mass index, waist circumference, flexibility, musculoskeletal fitness, and cardiorespiratory fitness of students were compared. Visual attention was tested by double letter cancelation test and auditory attention and concentration by forward digit span test. Results: In physical fitness tests, yoga group showed significantly better flexibility and musculoskeletal fitness, and aerobic group had signifi cantly better fl exibility, musculoskeletal fitness, and cardiorespiratory fitness compared to voluntary play group. In visual attention, auditory attention, and concentration tests, aerobics group performed best, followed by yoga and voluntary play. These differences were not significant. Conclusions: Preadolescents performing yoga and aerobics were physically fitter than those involved in voluntary play. However, even though aerobic group had significantly better cardiorespiratory fitness than voluntary play group, no differential effect of exercise regime on attention and concentration was observed. This suggests that a basic level of physical fitness may be sufficient to maintain adequate level of cognitive function, independent of exercise regime followed.

  2.4.2 Prelacteal feeds: The old and bad habits die hard Top

D. C. Anusha1, Madhu S. Pujar1

1JJMMC, Davangere, Karnataka, India

Background: Exclusive breastfeeding is recommended as the optimal way to feed infants for the first 6 months of life. The practice of giving prelacteal feeds (PLFs) interferes with the establishment of good breastfeeding practices and is contrary to Baby Friendly Hospital Initiatives (BFHIs). PLFs are those foods given to newborns before breastfeeding is established, usually on the 1st day of life. PLF is an underestimated problem in India and is common in our society due to different customs and misbelief. It not only leads to discarding of colostrum but also may deny the success of breastfeeding and paves way for infections. Methods: A cross-sectional study on infants was conducted in Davangere, India, and a total of 415 mothers were interviewed in three hospitals attached to JJM Medical College, Davangere, in a duration of 1 week. A questionnaire was used to collect data that included information regarding type and method of PLF. The factors such as effect of religion, sex and weight of the baby, and educational and economic status of the mother were also studied. Results: About 27.2% of the newborn received PLFs. The most common PLF given was honey (69%). The most frequent reasons for PLF are cultural practices (42.5%) and delayed lactation (21.2%). It is more common in Muslims compared to Hindus (56.25; P< 0.00). It is not associated with maternal educational and economic status, sex of the baby, and low birth weight. Conclusions: Practice of PLFs is high in our society. We have to strengthen the existing baby BFHI guidelines to overcome this bad practice to save our babies.

  2.4.3 Clinical profile of varicose veins in Tertiary Care Hospitals in Mangalore Top

Bhimesh Abhishai1, Joseph Nithin1, Mohammed Faizan1, Devi Uma1, Abna Ayesha1, Juneja Isha1

1KMC, Mangalore, Karnataka, India

Background: The etiology of varicose veins is still incompletely understood despite the fact that it is a very common disease affecting all ages. An understanding of the basis of its formation and its clinical presentation will provide possible tools for prevention and treatment. Only a limited number of comprehensive studies have been done on the topic. The objectives are to study the risk factors, the clinical presentations of varicose veins and to assess the methods of managing patients diagnosed with varicose veins in these hospitals. Methods: Retrospective record based cross-sectional study of the patients' case records in two Tertiary Care Hospitals over the past 3 years. Results: Around 170 case records were studied during this research. Varicose veins were seen more commonly in the age group of 40–50 years (31.2%). Varicose veins were seen to occur most common in occupations such as manual labor (55.8%); the major risk factor was found to be prolonged standing (57.05%). Chief presenting symptom was found to be pain (56.5%), variations in the skin (54.11%), and swelling of the ankle (43.52%). The chief sign was found to be tortuous dilated veins (77%). The most common complication was found to be ulceration. Limb elevation (43.1%) and compression stockings (31%) were the preferred conservative treatment modalities. Saphenous vein stripping (23.5%) was the most preferred surgical modality. Conclusions: Based on the current study, varicose veins was more commonly seen in the 4th and 5th decades of life; further, it is more commonly seen among manual laborers suggesting an association between its occurrence and prolonged standing. Surgical treatment modalities such as sclerotherapy which has less recurrence can be implemented. Time constraint and accuracy of records were the limitations.

  2.4.4 Dengue in children - A multi-faced monster Top

K. S. Chaitra1, P. S. Suresh Babu1

1JJMMC, Davangere, Karnataka, India

Background: Dengue is a debilitating mosquito borne disease caused by dengue viruses. Dengue in children is often fatal with varied clinical manifestations. Sometimes, symptoms are mild and can be mistaken for simple viral infection. It has a wide spectrum of presentation ranging from an inapparent fever to shock, multi organ failure, and death. Methods: A prospective study was done on the pediatric patients admitted to The Bapuji Child Health Institute, Davangere, for suspected dengue infection in the year 2014. Only the patients who tested positive for at least one among IgG, IgM, NS1 antigen were included. The clinical manifestations exhibited by them during the illness and the morbidity and mortality associated with them were studied. Results: Among 57 patients who were studied, 56 presented with fever, 31 vomiting, 20 chills, 15 pain abdomen, 12 cough, 10 myalgia, 7 abdominal distension, 6 with head ache, 6 convulsions, 5 anuria, 3 loose stools, 2 oliguria, 1 retro orbital pain, 1 altered sensorium, 1 nystagmus. Except for the 7 patients, all exhibited various hemorrhages such as skin rash-28, 15 with malena, 3 with epistaxis, 2 with pulmonary hemorrhage, 1 with profuse bleeding from the wound, 1 with bloody vomit. Five of them had history of previous dengue infection. On examination, 21 of them showed hepatomegaly, 7 ascites, 3 splenomegaly. Among them, 51 improved and were discharged. About 12% of children died due to disseminated intravascular coagulation, refractory shock, encephalopathy, respiratory distress. Low blood pressure, high WBC count, and low platelet count were also seen associated with the outcome. Conclusions: Dengue can manifest like any other viral infection with mild fever to multi organ failures. A strong suspicion of dengue should be made and serological test and management should be done to prevent morbidity and mortality, especially during epidemics of dengue.

  2.4.5 Predictors of acute urinary retention in benign prostatic hyperplasia: Its implication in management Top

Kumari Ayushree Prasad1, Chandrashekhar Mahakalkar1

1Jawaharlal Nehru Medical College, Wardha, Maharashtra, India

Background: Introduction - “Acute urinary retention (AUR) is one of the most significant complications or long-term outcomes of benign prostatic hyperplasia (BPH). Because of the high prevalence of BPH and its effect on the patient's quality of life, additional research is needed to better predict the risk factors of AUR. With this background, the present study was conducted to find out the incidence and factors responsible for retention of urine in BPH. Objectives: (1) To determine the incidence of AUR in patients of BPH. (2) To determine the factors responsible for AUR. (3) To monitor usefulness of precipitating symptoms in the management of patients. Methods: It is a prospective study conducted at Acharya Vinoba Bhave Rural Hospital, Sawangi (Meghe), Wardha of DMIMS (DU). The study included the patients admitted to the surgical wards admitted with the symptoms of LUTS. Duration of the study was 2 months. A total 40 patients will be studied over this duration. The data will be analyzed by SPSS and significance of association will be tasted by student test. Results: The mean age of presentation was 64.87 ± 7.85 with median age of 65 years (range 45–82 years) with mean international prostate symptom score of 17.45, and the mean postvoid residual was 110.80 ± 85.52 with median 110 (range 0–500). Maximum number of patients having Grade 3 and 4 enlargements had PSA level 9–12 ng/ml. The PSA levels and the grade of enlargement on ultrasonography were statistically significant (P = 0.004). Conclusions: The acute urinary retention and age and volume of prostate are the deciding factors for management of the patients in BPH.

  2.4.6 Infant and young child feeding practices among mothers in Hyderabad Top

Mane Sudhir Shankar1

1Osmania Medical College, Hyderabad, Telangana, India

Background: To assess infant and young child feeding (IYCF) practices using World Health Organization indicators in infants and young children attending immunization clinics. Methods: Design and setup - Hospital-based, cross-sectional study at an Urban Tertiary Care Hospital in Hyderabad. Period - May–June 2014. Results: A total of 520 mothers attending immunization clinics were interviewed. Mean age of the children was 32.5 weeks. About 50.1% and 47.6% belonged to Hindu and Muslim religion, respectively. Only 33.78% children were breastfed within 1 h of birth. Among those who had not initiated breastfeeding within 1 h of birth, 60.6% were not aware and the most common reason was cesarean section. In children older than 6 months, only 80% of children were exclusively breastfed for 6 months, and the most common reason was insufficient breast milk. Only 72.5% of mothers introduced complementary foods from 6 to 9 months. Conclusions: The study shows poor IYCF practices in children attending immunization clinic at an Urban Tertiary Care Hospital. There is a clear knowledge gap among mothers. These faulty practices need to be addressed to improve IYCF practices so as to maximize their benefits to the child. The study did not assess nutritional status of children. This would have been useful to see how inadequate IYCF Practices were associated with nutritional status of the children. The study was a hospital-based study. Hence, the results obtained in this study cannot be generalized for the entire region of Hyderabad.

  2.4.7 Patient delay among women with breast cancer in rural India Top

Manwatkar Shiva1, Gangane Nitin1, N. G. Anshu Nawi1, Anna Karin Hurtig1, Miguel S. Sebastián1

1MGIMS, Wardha, Maharashtra, India

Background: Women with breast cancer who wait more than 3 months after they notice first symptoms before attending a medical consultation are known to have signifi cantly lower survival rates compared to women who seek medical attention promptly. This study was conducted in rural Central India to identify the extent and the risk factors associated with patient delay. Methods: Of the 384 cases of breast cancer diagnosed between 2010 and 2012, 212 women were successfully interviewed by trained social workers using a prevalidated, semi-structured questionnaire. Sociodemographic characteristics, clinical histories of participants' knowledge of breast self-examination and breast cancer, time interval between seeking medical attention and appearance of symptoms, and reasons for delay were inquired. Patient delay was defined as more than 3 months between appearance of the first symptoms and the date of initial medical consultation. Chi-square tests and logistic regression were applied to assess the associations between the potential risk factors and patient delay. Results: Almost half the women (n = 103, 48.5%) with breast cancer experienced patient delay. Of the 202 women for whom the clinical stage was known, 122 (60%) presented in advanced stages of disease. Older age at diagnosis and advanced clinical stage of the disease were significantly associated with patient delay. Only 18% of patients (n = 39) were aware of breast cancer as a disease and only 6.6% of patients (n = 14) had heard about breast self-examination. Conclusions: Our study found that health-seeking behavior in relation to breast cancer in rural India is a major concern. Older age of patients, low travel cost to a PHC, and advanced stage of disease were associated with patient delay. Other factors such as education and poor financial status were not significantly associated with patient delay.

  2.4.8 Association between carcinoma breast and hyperthyroidism: A case–control study Top

Nethagani Sanjana1

1Osmania Medical College, Hyderabad, Telangana, India

Background: To explore the possible association between thyroid dysfunction and carcinoma breast. Methods: This is a case– control study. A total of 100 participants were chosen (50 cases and 50 controls) Women in the age group of 30–60 years (without any known thyroid disorders) who were already diagnosed with infiltrative ductal cell carcinoma were selected as cases. The diagnosis was confirmed by doing fine-needle aspiration cytology, mammography, and histopathology. Immunohistochemistry examination for estrogen receptor (ER), progesterone receptor, and human epidermal growth factor receptor-2 was also done. Controls were age-matched individuals with no thyroid disorders or breast cancer. Results: The difference between case and controls in serum T3 levels was not statistically signifi cant. Mean T4 levels were significantly higher in the case group compared to the control group. Mean thyroid-stimulating hormone (TSH) levels were significantly lower in the case group than the individuals in the control group. Hyperthyroidism was more frequently present among postmenopausal patients, as shown by a higher mean T3, T4 and significantly low TSH in this group of cases when compared to controls. Majority of ER-positive tumors were clustered among the postmenopausal group, and all cases exhibiting subclinical hyperthyroidism were ER-positive. Conclusions: This study stresses the importance of evaluation of serum thyroid hormone levels in breast cancer patients and its use as a biomarker and also as a screening instrument in detection of breast cancer along with other biomarkers.

  2.4.9 Prevalence of varicose veins among healthcare professionals based on hospitals under a Medical College in Mangalore: A cross-sectional study Top

Ramaswamy Akash1

1KASTURBA Medical College, Mangalore, Karnataka, India

Background: Varicose veins are common in the general population. It is estimated that 15–20% of the Indian population is suffering from varicose veins. Varicose veins is better known as an occupational hazard and is common among teachers, laborers, nurses, etc. Research on the prevalence of varicose veins among healthcare professionals is scant. Current status of varicose veins in nursing population of India is still in the dark. The same is true for doctors including surgeons. The objectives are to describe its current prevalence, associated risk factors among healthcare professionals and to identify and compare the prevalence of its complications. Methods: Cross-sectional study involving 225 healthcare professionals (nurses and doctors) randomly selected had collected data using proformas. Positive cases for varicose veins were subjected to clinical examination. Results: In total, 225 subjects were included in the study. Majority of the respondents (81.8%) were females. 23.6% were doctors and 76.4% nurses. 28% of the study population had varicose veins (34.1% nurses and 9.6% doctors). 23.4% were suffering from complications. Most common symptoms were calf pain (81.3%) and muscle cramps (75%). A history of prolonged standing was present in 96.9% of positive responders and 43.8% had a family history for varicose veins. Bilateral involvement was noted in 45% and unilateral involvement in 55%. Conclusions: Based on the current study, the proportion of healthcare professionals suffering from varicose veins is 28%. A higher prevalence is seen among nurses compared to doctors. The study revealed that almost one-fourth of them had already started developing complications. The study also showed strong relation with prolonged standing, pregnancy, and family history. Probably, different result could be obtained if study duration was extended and population increased.

  2.4.10 Prevalence of adenomatous hyperplasia in a carcinoma gall bladder endemic zone Top

Rana Amber1, A. N. Srivastava1, Gupta Parul1, Fatima Naseem1, Musa Usman1

1ERA's Lucknow Medical College, Lucknow, Uttar Pradesh, India

Background: Carcinoma gall bladder is quite prevalent in North India, specially in UP, Lucknow. Various factors such as use of mustard oil, condiments, and pesticides have been proposed as etiopathological factors along with cholelethiasis. With this background, the present study was planned to investigate the incidence of adenomatous hyperplasia of gall bladder which has been hypothesized as a precursor for carcinoma gall bladder. Methods: The present case was done to study the incidence of adenomatous hyperplasia among inflammatory gall bladder disease in carcinoma gall bladder endemic zone (Lucknow), a retrospective and prospective study for 6 months in which the cases were histopathologically segregated into chronic cholecystitis with hyperplasia of mucosa including adenomatous hyperplasia and carcinoma gallbladder. Results: Out of total 575 cases of cholecystitis received in this hospital between January 2012 and July 2014, 49 showed adenomatous hyperplasia (10.78%). Many of these cases showed dysplastic changes. This gives weightage to the hypothesis of inflammation -> hyperplasia -> carcinoma gall bladder development and indicates indepth studies of etiopathogenesis and adenomatous hyperplasia. Conclusions: The study demonstrated that a significant percentage of cases of chronic inflammatory gall bladder disease in this endemic zone had adenomatous hyperplasia which is a precursor to cancer and thus needs deeper, prolonged and multicentric studies.

  2.4.11 Assessment of quality of life in children with thalassemia and their caregivers Top

Sharma Sapna1, Seth Bageshree1, Setia Maninder Singh1

1MGM Medical College, Navi Mumbai, Maharashtra, India

Background: Thalassemias are a group of blood disorders which occurs due to quantitative reduction in beta-globin chains. Being the most common hemoglobinopathy in India, knowledge of health-related quality of life (HRQOL) among children with beta-thalassemia major is essential, in determining how far treatment and disease compromise the child's QoL to improve treatment outcomes. Our aim was to assess and compare QoL of children with beta-thalassemia major on regular transfusion therapy with normal children and QoL of the caregivers of children with beta-thalassemia major with that of caregivers of normal children. Methods: We conducted a case–control, quantitative study in which 75 children with thalassemia and 80 normal children were administered PedsQL 4.0 generic core scale questionnaire. Sociodemographic data were collected using the case study form. Caregivers were administered the short form-36 health survey (SF-36 v2) questionnaire. Statistical analysis was performed using SPSS v.16, independent t-test, and Chi-square test. Results: The assessment of QoL domains in cases versus the controls were as follows as per child-self report: physical functioning 88.2 (19.5) versus 99.2 (2.4) (P ≤ 0.001); emotional functioning 79.3 (17.5) versus 93.3 (9.8) (P ≤ 0.001); social functioning 98.1 (7.5) versus 99.2 (2.7) (P = 0.258); school functioning 75.3 (13.5) versus 98.6 (3.6) (P ≤ 0.001); psychosocial functioning 84.3 (9.6) versus 97.0 (4.1) (P ≤ 0.001). The total scores were 83.7 (10.8) versus 97.6 (3.3) (P ≤ 0.001). Similar results were obtained according to parent proxy report. The QoL scores of caregivers of cases with that of controls in the General health domain were as follows: good health 53.0 (70.7) versus 78.0 (97.5) and poor health 22.0 (29.3) versus 2 (2.5) (P ≤ 0.001). Conclusions: HRQOL is significantly affected across all age groups, gender, and socioeconomic classes in children with beta-thalassemia major on regular transfusion therapy among all domains except social functioning. HRQOL of caregivers of thalassemia patients is significantly affected.

  2.4.12 Effectiveness of decompressive craniectomy in traumatic brain injury: A retrospective study Top

P. Trilokhya1, Vidya1

1Dr. NTR Health University, Andhra Pradesh, India

Background: Decompressive craniectomy is removal of skull bone in patients with traumatic brain injury with acute subdural hematoma, contusions, epidural hematoma or diffuse cerebral edema with raised intracranial pressure. The aim of the study is to evaluate the outcome of patients undergoing decompressive craniectomy in traumatic brain injury and to identify the factors predicting outcome. Methods: A total of 219 patients with traumatic brain injury operated with decompressive craniectomy from January 2008 to January 2015, by a single neurosurgeon were included in this study. The data were collected retrospectively and analyzed, and patients were followed-up for a mean period of 6 months. Results: There were 80% male with a median age of 39 years; the youngest age is 4 years and the oldest was 80 years. Patients with traumatic brain injury undergoing decompressive craniectomy are more between age group 21–30 years (23%) and mortality is more in age group above 50 years (59%). Based on Glasgow Coma Scale (GCS), 34 patients with mild head injury (GCS 14–15), 90 patients with moderate head injury (GCS 9–13), and 95 patients with severe head injury (GCS <9) underwent decompressive craniectomy and the incidence was 15.5%, 41%, 43.3%, respectively. The mortality rate was 0%, 11%, and 23%, respectively in mild, moderate, and severe head injury. Unequal pupils were present in 33 cases, out of which 7 patients (21%) expired. Hypotension was present in 11 patients, out of which 2 patients (18.18%) expired. Conclusions: Younger age group had less mortality compared to older age group. GCS at admission was important predictive factor of outcome as patients with less GCS have high mortality compared to patients with good GCS. Unequal pupils and hypotension at admission are not significant prognostic factors. Review of recent literature shows the mortality in traumatic brain injury to be ranging from 12% to 55%.

  2.4.13 Knowledge, attitude, and practices of breastfeeding in primigravida women Top

A. R. Waikar1, A. Bhalerao1

1NKP Salve Institute of Medical Sciences and Research Centre, Nagpur, Maharashtra, India

Background: There are gaps between UNICEF and Baby Friendly Hospital Initiatives recommendations and actual implementations of breastfeeding practices due to inadequate counseling of primigravida on breastfeeding which is reflected nationally as poor infant nutritional status. The study aims to assess the knowledge, attitude, and practices of primigravida about breastfeeding, counsel the primigravida women on the prescribed scientific breastfeeding methods to analyze the change in their perspective about breastfeeding after counseling and to suggest recommendations based on findings. Methods: Questionnaire-based descriptive, cross-sectional study was conducted after the Ethics Committee approval on selected 75 primigravida with gestational age of 36 weeks or more attending Antenatal care Outpatient Department or admitted to NKPSIMS during April and May 2014 after consent. A structured validated pre-/post-test questionnaire was designed with direct, easy to answer questions with all possible options as answers were provided to assess the knowledge, attitude, and practices of breastfeeding in participants. Demographic variables were recorded. Pretest was conducted. Followed by counseling on the importance of breastfeeding, colostrum, maternal nutrition, duration of exclusive breastfeeding, mother's and baby's position during breastfeeding using flashcards, and pictures for effective communication which was followed by posttest on the same questionnaire. The data were analyzed using SPSS software OpenEpi Info version 2.3 year 2009. P< 0.05 was considered as statistically significant. Results: Statistically significant change (P < 0.05) in importance of exclusive breastfeeding, colostrum, early initiation, suitable position and duration of breastfeeding, perception baby's satisfaction and stool color, maternal nutrition, and breast problems during lactation after counseling was observed after comparing pre- and post-test results. Conclusions: Antenatal breastfeeding counseling must have a multi-pronged individualized approach with repeated reinforcement focusing on recommended practices to promote and sustain breastfeeding to improve infant nutritional status and contribute to national development.

Platform presentation 3 1st August 2015 - session 3, room 1

  3.1.1 Prevalence of catheter-related blood stream infection in patients undergoing hemodialysis Top

S. R. Arvindh Santhosh1, R. Deepa1

1Madras Medical College, Chennai, Tamil Nadu, India

Background: Intravascular catheter-related infections leading to catheter-related bloodstream infections (CRBSI) are a major cause of morbidity and mortality in patients undergoing hemodialysis. Clinical findings are often unreliable for establishing a diagnosis because of their poor specificity and sensitivity. Evidence-based management is therefore necessary for selection of appropriate antibiotics and to decide on removal of the catheter. This cross-sectional study was undertaken to determine the prevalence and etiological agents of CRBSI and catheter colonization and their antimicrobial susceptibility pattern. Methods: Semi-quantitative and quantitative culture of catheter tip, quantitative culture of catheter hub blood, and peripheral venous blood were collected from 36 males and 14 females undergoing hemodialysis and presenting with symptoms of local or systemic signs of infection. Statistical Package for Social Sciences software, Chi–square, and Pearson correlation were used. Pvalue kept signifi cant at <0.05. Results: CRBSI was detected in 12% of the patients. 24% had exit site infections and 42% had catheter colonizations. Gram-negative bacilli such as  Pseudomonas aeruginosa Scientific Name Search d  Acinetobacter baumannii Scientific Name Search the predominant causative agents of CRBSI. These isolates showed no marked multidrug resistance. Diphtheroids spp., a skin commensal in the immunocompetent, was found to cause CRBSI. The duration of catheter in situ was found to be significant risk factor for CRBSI. Conclusions: The prevalence of CRBSI was 12%. Gram-negative bacilli are leading causes of CRBSI. The duration of catheter in situ was found to be a significant predisposing factor.

  3.1.2 Bacteriological profile, antibiotic sensitivity pattern, and detection of extended-spectrum β-lactamase production in the isolates of urinary tract infection in Tertiary Care Hospital Top


1JJM Medical College, Davangere, Karnataka, India

Background: Urinary tract infection (UTI) is a very common disease that can affect anyone at any age where the infection rate is higher in women than men. The aims and objectives of this study were to determine the etiological bacterial pathogens of the UTI and to determine the antibiotic sensitivity pattern of pathogens isolated as well as to identify extended-spectrum b-lactamase (ESBL) producers. Methods: This was a hospital-based, cross-sectional study, in which 120 midstream urine samples were collected from April 2015 to June 2015 from clinically suspected UTI patients of various departments. Urine culture was done, using conventional microbiological techniques. Biochemical testing was used to identify the organisms and antibiotic sensitivity was done by the Kirby-Bauer disc diffusion method. Further, ESBLs were detected by double disc synergy and combined disc diffusion test. Results: Out of 120 tested samples, 48 showed growth of pathogens among the most prevalent were  Escherichia More Details coli (29.17%) followed by Klebsiella (22.92%). The majority of the isolates were from female (77.08%). ESBL production was observed in 35.71% of E. coli strain and 27.27% of Klebsiella strains. High rates of resistance were found with ceftazidime (81.58%), ceftazidime + clavulanic acid (76.32%), erythromycin (53.33%), cefotaxime (53.19%), ciprofloxacin (45.83%), and norfloxacin (43.33%) among the isolates, but nitrofurantoin (37.93%), gentamycin (22.97%) and amikacin (18.75%) are comparatively sensitive. Conclusions: The study revealed that E. coli was the predominant bacterial pathogen of UTIs. An increasing trend in production of ESBLs among UTI pathogens was noted. Proper knowledge of susceptibility pattern of uropathogens is crucial, to discourage the indiscriminate use of antibiotics as well as in formulating effective empiric therapy.

  3.1.3 Retrospective analysis of maternal infections and their outcome Top

M. Brunda1, H. Emavathi1

1Sapthagiri Institute of Medical Science and Research Center, Bengaluru, Karnataka, India

Background: Human immunodeficiency virus (HIV), hepatitis B virus (HBV), and syphilis infection in pregnancy can be transmitted to the child. Timely antiretroviral treatment and HBV immunoprophylaxis reduce the risk of transmission from 90% to 30% for HIV and 10–20% for HBV. Fetal death and morbidity due to congenital syphilis are preventable. This study was to know the burden and the outcome of these infections among the pregnant women in our hospital. Aims and objectives of this study are to know the proportion of HIV, HBV, and syphilis among antenatal cases and also to study the treatment outcome of HIV, HBV, and syphilis among babies born to infected mothers. Methods: Retrospective data, regarding tests done, the mother and child treatment and its outcome, were analyzed from the Departments of Microbiology, Obstetrics, and Pediatrics. Sera were screened for HIV by Comb acquired immune deficiency syndrome (AIDS) and seropositives confirmed by - SD Bioline, Tridot or ELISA as per strategy III of the National AIDS Control Organization; HBV screened by Virocheck or Hepacard and seropositives confirmed by ELISA; syphilis by RPR tests, seropositives confirmed by  Treponema pallidum Scientific Name Search magglutination test. Results: Out of 1285 cases studied, 12 (0.9%) were positive for any one of the STIs, among which 7 (0.54%) were reactive for HIV, 5 (0.34%) were positive for HBV, and none were positive for syphilis. All positive mother and child pairs received treatment and none of the children born to STI positive mothers were seropositive. Conclusions: (1) All pregnant women need to be tested for STIs in pregnancy. (2) The data help to treat Antenatal Cares more effectively and to establish effective preventive programs in reducing the prevalence of congenital infections.

  3.1.4 Prevalence and antibiotic sensitivity profiles of nonfermenting Gram-negative bacilli infection in a Tertiary Care Hospital Top

U. S. Grewal, R. Bakshi, G. Walia

1Government Medical College, Patiala, Punjab, India

Background: Nonfermenting Gram-negative bacilli (NFGNB) have become a major cause of life-threatening nosocomial infections and are also emerging as multidrug resistant (MDR) nosocomial pathogens. The aim of the study was to know the prevalence and antibiotic sensitivity profiles of NFGNB isolated from various clinical specimens. Methods: This prospective study was done from January 2014 to December 2014. The NFGNB were isolated from a variety of clinical specimens such as pus swabs, blood, and urine and identified using standard procedures. Antibiotic sensitivity was determined by Kirby–Bauer disc diffusion method on Mueller Hinton Agar using antimicrobial discs. Results: NFGNB were isolated from 216 out of 1854 samples, giving an isolation rate of 11.65%. Age of the cases ranged from 6 months to 75 years and male to female ratio was 1.2:1. Pus swab was the most common specimen accounting for 87 (40%) positive samples. Pseudomonas aeruginosa was the most common isolate, accounting for 190 (87.96%), followed by Acinetobacter baumannii 17 (7.87%) and Alcaligenes faecalis Scientific Name Search  5 (2.31%). Burkholderia cepacia,Pseudomonas stutzeri, and  Stenotrophomonas maltophilia Scientific Name Search arely isolated, accounting together for 1.85% of the isolates. Overall, most of the isolates were sensitive to imipenem (82.9%), polymyxin B (62.5%), cefoperazone + sulbactum (50.9%), and amikacin (47.2%). Conclusions: This study shows high isolation rate and increased antibiotic resistance among NFGNB, especially P. aeruginosa and A. baumannii. The results are quantitatively higher or at par with similar studies conducted by various workers in the past. Antibiotic sensitivity testing and infection control measures are needed to prevent the emergence and spread of MDR NFGNB in health care settings.

  3.1.5 Study of the spectrum of bacteria causing diabetic foot ulcer and biofilm formation Top

Janani Rajkumar1, Asima Banu1

1Bangalore Medical College, Bengaluru, Karnataka, India

Background: India leads the world with largest number of diabetic subjects. In diabetic patients, the most common devastating complication is nontraumatic lower limb amputation mostly due to diabetic foot ulcers (DFU) and diabetic foot infections (DFI). In India, the incidence of foot ulcers ranges from 8% to 17%. DFIs are predominantly polymicrobial, multidrug resistant with the ability to form biofilm, which is an important virulence factor and results in treatment failure. The main objectives of the study are to identify the spectrum of bacteria causing these infections and antibiotic sensitivity pattern and to detect the biofilm formation. Methods: This was a prospective study at a tertiary care hospital. Hundred patients, between the above the age of 18 years, having DFU, attending the surgery Outpatient Department, were included. Samples of pus were collected and processed using standard techniques for culture and sensitivity. Biofilm detection was done. Results were compiled and statistically analyzed. Results: Of the 100 samples processed, 82 yielded positive cultures of which Staphylococcus aureus Scientific Name Search  was the predominant organism, followed by Pseudomonas. Biofilm formation was seen in 38 (46.34%) of the organisms. Biofilms were formed predominantly by S.aureus (20%). Around 80 isolates (97.56%) were multidrug resistant (MDR) with 37 (46.25%) of the MDR isolates also showing biofilm formation. Conclusions: MDR was widespread among the organisms causing chronic diabetic ulcers. Biofilm forming organisms were commonly MDR and this was observed in long-term diabetics. Hence, screening for biofilm formation along with the usual antibiogram as a routine needs to be performed in chronic diabetic ulcers to formulate effective treatment strategies for these patients.

  3.1.6 Pattern and distribution of diabetic foot ulcers with its clinico-microbiological correlation Top

Jyothi Janardhanan1

1Jawaharlal Nehru Medical College, Wardha, Maharashtra, India

Background: Worldwide, diabetic foot lesions are a major medical, social, and economic problem and are the leading cause of hospitalization for patients with diabetes. A sound knowledge of symptomatology, clinical signs, and etiology can prevent most of the disease burden and complications and thus reduce social burden. The aim of this study was to determine the pattern of diabetic foot ulcers and associated complications. Methods: This study was conducted in AVBRH, Sawangi, over a period of 4 months. Wound swab samples were cultured from 30 patients admitted for the treatment of diabetic foot infections. Specimens were tested by Gram-stain, culture, and antibiotic sensitivity. Statistical analysis was done using Student's t-test. Results: Gram-negative bacteria were the most frequently isolated organisms, pseudomonas being the most common (56.67%). Most of the organisms showed multidrug resistance. Imipenem and amikacin were found to be effective for Gram-negative organisms. Most of the patients had Wagners Grade 3 (30%) and 40% belonged to class IIB according the University of Texas Wound classification. The duration of diabetes, peripheral arterial disease, and hypertension was found to be predictors. Conclusions: Because of the emergence of multidrug resistant organisms, the inadvertant use of antibiotics should be avoided. Close monitoring and regular follow-up of diabetic foot patients is required as it is associated with inadequate glycemic control and prolonged duration of diabetes mellitus, and the protocol for treatment of complications should be standardized.

  3.1.7 Antibacterial activity of garlic and ginger on multidrug resistant bacteria Top

K. Keshava Pavan1, P. Shrikara Mallya1

1Manipal University, Manipal, Karnataka, India

Background: Many common food ingredients, including garlic (Allium sativum L.) containing allicin and ginger (Zingiber officinale Roscoe) containing gingerol, have been traditionally used extensively against many diseases for a long time and have been found to be useful. We did this study to find out the level of antibacterial activity of garlic and ginger against multidrug resistant bacteria and thus help to promote use of garlic and ginger in clinical practice. Methods: This was a cross-sectional study. Aqueous and ethanolic extracts of garlic and ginger were prepared. Antibiotic susceptibility testing was performed on isolates of four Gram-negative bacteria, namely Escherichia coli, Kebsiella sp., Enterobacter sp., and Pseudomonas aeruginosa and one Gram-positive bacterium, Staphylococcus aureus. Zones of inhibition were measured in two concentrations, 50 μg/ml and 100 μg/ml. Statistical analysis was done by two-sample independent t-test, and P< 0.05 was considered significant. Results: Both garlic and ginger showed antibacterial activity against most of the pathogens. The diameter of zone of inhibition varied between 7.50 mm and 17.10 mm in garlic and between 5.00 mm and 16.55 mm in ginger. Ethanolic extract was better than aqueous extract. However, extract of garlic was more effective than extract of ginger in case of all the species under study except E. coli and S. aureus. Conclusions: There is a wide body of scientific evidence to show that garlic and ginger have great potential in the treatment of many microbial diseases, even in the current era of antimicrobial resistance. This study proves their extraordinary potential to yield biologically active materials which could be valuable in the treatment of many microbial diseases. This should be fully explored in proper clinical approach.

  3.1.8 Analysis of antibiotic resistance of uropathogens causing urinary tract infection: Retrospective study in Tertiary Care Hospital, South Karnataka Top

Kundu Sumona1, P. Shenoy Revathi1

1Kasturba Medical College, Mangalore, Karnataka, India

Background: With hardly any new drugs in the development pipeline, the menace of antimicrobial resistance is a major threat to public health. Urinary tract infection (UTI) being one of the most common bacterial infections managed in health care, this project aims at knowing the main uropathogens and understanding their resistance pattern. Our objective is to analyze the susceptibility pattern of the main bacteria, to detect any change in resistance, and to optimize the use of empiric therapy. Methods: It was a 2 months, hospital record-based, retrospective study on patients above 18 years with symptoms of UTI and positive urine culture test attending Kasturba Hospital, Manipal. Culture sensitivity data obtained from the Microbiology laboratory reports were treated using SPSS ver.20. Resistance rate is expressed as percentage with 95% confidence interval. Results: Among a total of 96 patients, the highest number of cases was reported in the age group of 40–60 years. Of the 11 types of bacteria isolated, 71 cases showed the growth of Escherichia coli followed by Klebsiella pneumonia isolated in 16 samples. Sensitivity patterns of each organism were tested for penicillin and cephalosporin group, norfl oxacin, etc., and reserved drugs such as aztreonam and sulbactum. Amikacin is the most effective first-line drug, and cefoperazone and sulbactam are the most effective reserve drugs. Conclusions: The finding indicates that there is a definite increase in resistance among the uropathogens. This is associated with the danger that clinicians will respond by increasing their use of newer antibiotics as empirical therapy resulting in a vicious cycle of driving resistance up further. These results, taken together with evidence that recent antibiotic prescribing is major risk factor for being infected with a resistant organism, should encourage a more cautious use of any antibiotic.

  3.1.9 Evaluation of baseline Widal titers in healthy individuals of Kancheepuram District, Tamil Nadu Top

Manivannan Mullai1, Beulah Edwin1

1MGR University, Chennai, Tamil Nadu, India

Background: Enteric fever is a public health problem in India. Widal test is the cost effective and easily available method for the diagnosis of enteric fever. Since some amount of antibodies is always present in our blood, it is necessary to find the baseline Widal titer in our locality to use Widal as a diagnostic test. The aim of our study is to determine the baseline Widal titers in healthy individuals of Kancheepuram District. Methods: A total of 108 apparently healthy blood donors who attended Tagore Medical College and Hospital were selected, and informed consent was obtained from them. All blood donors who did not have obvious signs and symptoms of the disease were selected. Those who had history of fever in the past 3 months or have had typhoid vaccination were rejected. About 3 ml of blood was collected and slide agglutination was done to the separated serum samples and for those which were positive tube agglutination was done and the titers were noted. Results: The mean titer value for O and H antigen is 3.15. For Paratyphi AH and BH, none of the individuals showed positive value. A titer value of <20 was seen in 106 individuals and a titer of 20 and 320 in one individual and a titer of 160 in two individuals. This study shows that apparently normal individuals do not show antibodies for  Salmonella More Details species except for three individuals out of 108. This differs from studies in different parts of India. Conclusions: The present study has revealed that the Widal antibody titer is <20 and only around 1% of individuals showed the presence of salmonella antibodies. Hence, a titer of 40 and above can be taken as positive in Kancheepuram District.

  3.1.10 Bacterial contamination of white coats: A cross-sectional study among medical students and interns Top

S. V. Mathai1, A. Hegde1

1Kasturba Medical College, Mangalore, Karnataka, India

Background: White coats are potential fomites for hospital-acquired infections as they are linked to colonization by nosocomial pathogens. This study was done to assess the level and type of bacterial contamination of white coats, a vector for transmission of nosocomial infections and also, the relation between white coat handling practices and contamination. Methods: A total of 55 medical students and 55 interns participated in this cross-sectional study. Samples were obtained using convenience sampling from the collar, pockets, and sides of the coat using a sterile swab and examined according to standard laboratory procedures. The participants were asked to fill a questionnaire to assess white coat handling practices. The collected data were analyzed using SPSS version 11.5. Results were expressed as proportions and for comparison, Chi-square test was used, and P< 0.05 was considered statistically significant. Results: Of the 110 white coats examined, 109 (99.1%) were contaminated. The sides and pockets were more contaminated than the collars (P = 0.01). The Gram-positive isolates were Staphylococcus aureus, Coagulase Negative Staphylocococcus and Diptheroids. The most commonly isolated organism was S. aureus (182 [40%], of which 55 [30.2%] were MRSA). Gram-negative isolates were Pseudomonas aeruginosa, Klebsiella spp., Acinetobacter spp., Citrobacter spp., Enterobacter spp., and Escherichia coli. Gram-positive organisms were mostly resistant to erythromycin. Among the Gram-negative organisms, P. aeruginosa showed maximum resistance. White coats of males, students, and coats washed at home showed greater contamination. There was no statistically significant association between contamination of white coats, duration of use, frequency of washing, cleaning agents employed, and place of wash. Most of the participants (74.5%) cited 'uniform' as the reason for wearing white coat. Conclusions: Considering the high rate of bacterial colonization of the coats, it is necessary to enforce measures to control contamination and hence prevent cross infection.

  3.1.11 Pattern of opportunistic infections and immune reconstitution syndrome in patients with human immunodeficiency virus/tuberculosis co-infection at Tertiary Care Hospitals in Mangalore Top

D. Patil1, A. Jain1, R. K. Deshpande1

1Kasturba Medical College, Mangalore, Karnataka, India

Background: Opportunistic infections (OIs) are common in human immunodeficiency virus-acquired immune deficiency syndrome (HIV) patients. HIV-infected patients die mostly due to the OIs. Immune Reconstitution Infl ammatory Syndrome (IRIS) is a host immune reaction. The exact mechanism remains uncertain. Possible mechanisms include delayed hypersensitivity reaction, decrease in immunity, and response to mycobacterial antigen. In India, studies regarding prevalence of IRIS in tuberculosis (HIV/TB), co-infected patients are scarce. Hence, this study will provide insight to clinicians regarding its prevalence, early diagnosis and apt management. Methods: Retrospective study from 12th April to 29th April 2013 in KMC and Wenlock Hospital. HIV-TB co-infected patients from January 1, 2007, to December 31, 2011, were included. Sample size was 136. Data were analyzed using SPSS-17. Association of risk factors and variables in this study was calculated using Chi-square test. P< 0.05 was considered significant. Results: Around 96 (70.6%) were male and 40 (29.4%) were female. Out of 136 cases, 64 (47%) had OIs. Out of 64 patients with OIs, maximum 30 (46.8%) suffered from respiratory disease followed by oral candidiasis 17 (26.5%). The least common was cerebral toxoplasmosis 1 (1.5%). Of 136 patients with HIV-TB co-infection, 74 were started on antiretroviral therapy (ART). Among them, 10 (13.5%) developed IRIS within 3 months of therapy. Conclusions: Of 64 patients with OIs, maximum patients 30 (46.8%) suffered from respiratory disease followed by oral candidiasis 17 (26.5%). Out of 74 patients on ART, 10 (13.5%) patients developed IRIS within 3 months of ART. This study shall assist physicians in implementing ART in the context of OIs and IRIS and for treatment of OIs. With reports of IRIS growing in frequency, clinical trials in developing countries need to be conducted. Appropriate therapy should be maintained in the face of apparently worsening clinical symptoms. Use of corticosteroids has found to be successful in decreasing IRIS without compromising clinical care.

  3.1.12 Antibiotic sensitivity profile of bacterial pathogens in postoperative wound infections Top

Pothuraju Lathasree1

1Osmania Medical College, Hyderabad, Telangana, India

Background: Postoperative wound infections always overweigh the benefits of surgery. Hence, the study is aimed to evaluate the rate and other factors influencing it, common organisms involved and to study the antimicrobial sensitivity pattern of isolates so that recommendations can be made for their prevention and treatment. Methods: Prospective study conducted on 100 patients who underwent surgery under both elective and emergency conditions meeting inclusion and exclusion criteria for period of 2 months at Osmania General Hospital. Specimens collected were processed for aerobic bacterial cultures with antibiotic susceptibility profile by standard guidelines. Relevant information of all the patients was taken on a proforma. Results: Out of 100 patients, 11 patients developed postoperative wound infection. About six types of organisms were isolated from 14 specimens. Gram-negative organisms predominate with 64.3% than Gram-positive organisms (35.7%). Among Gram-negative and Gram-positive organisms, Escherichia coli (28.6%) is the most common followed by Klebsiella (21.42%) and Staphylococcus aureus (21.42%), respectively. Gram-negative and Gram-positive organisms had shown sensitive for quinolones, third generation cephalosporins, imipenem, and quinolones and aminoglycosides, respectively. Emergency surgeries (18.8%) were statistically more likely to develop postoperative wound infections than elective procedures (7.4%). Patients with age group between 30 and 55 years, patients having addictions, anemic, increased duration of operative procedure, long postoperative stay, and increased frequency of wound dressings were found to have increased rate of postoperative wound infections. Conclusions: Overall incidence of postoperative wound infection was 11%. Most of the organisms isolated in our study were Gram-negative organisms which showed sensitive to quinolones, third generation cephalosporins, and imipenem. Hence, third generation cephalosporins and quinolones can be given as prophylactic antibiotic to reduce postoperative wound infections as imipenem is highly cost-effective. Update knowledge about antibiotic sensitivity pattern of bacterial pathogens among surgeons helps in decreasing rate of postoperative wound infections. All the other factors should also be taken into account to reduce postoperative wound infections.

  3.1.13 Evaluation of E-test and comparison with broth microdilution: Antifungal susceptibility testing for clinical isolates of Aspergillus Top

B. Suruthi1

1Madras Medical College, Chennai, Tamil Nadu, India

Background: Aspergillosis is common among patients with prolonged immunosuppression. With increasing emergence of resistance, susceptibility testing of various species of Aspergillus to drugs such as amphotericin B, voriconazole, and itraconazole becomes important. The standardized method for this is broth microdilution procedure. However, it is labor intensive whereas E-test is much simpler. Hence, this study aims to compare the effectiveness of E-test with broth microdilution. Methods: Prospective study with 50 Aspergillus isolates obtained from Dr. Rajiv Gandhi Government General Hospital, Chennai, over a period of 2 months. Isolates containing Aspergillus species alone are included. Isolates from patients on antifungals are excluded. The isolates are grown on potato dextrose agar at 35C for 7 days. E-test is done by applying E-test strips onto 150 mm diameter plates containing RPMI1640 agar streaked with saline suspension of the inoculum. It is incubated at 35C and read after 48 h. The drug concentration at which the elliptical zone of inhibition intersects the strip gives the minimum inhibitory concentration (MIC). For broth microdilution technique, 0.1 ml each of stock solution and drug dilutions (two-fold) both prepared with 100% dimethyl sulfoxide are dispensed onto 96 well microtiter trays, incubated at 35C, and read at 48 h. The minimum concentration of drug producing complete inhibition of growth gives MIC. Results: The percentage of agreement was calculated with MICs from the two methods. The percentage of agreement between E-test and broth microdilution was 68% for amphotericin B, 78% for itraconazole, 82% for voriconazole. Conclusions: The percentage of agreement was best for voriconazole, followed by itraconazole and amphotericin B. Hence, E-test could be used instead of labor intensive broth microdilution method as it proves to be more quicker and nearly equally effective.

  3.1.14 Ventilator-associated pneumonia; bacteriology, antibiogram, and clinical outcome Top

Vasundhra Teotia1, V. L. Jayasimha1, K. S. Mayuri1, ArunkumarAjjappa1, K. G. Basavarajappa1

1SS Institute of Medical Sciences and Research Centre, Davangere, Karnataka, India

Background: Ventilator-associated pneumonia (VAP) is the most common form of nosocomial pneumonia that occurs in patients receiving mechanical ventilation for longer than 48 h associated with purulent tracheal secretions, blood leukocytosis (>12 × 109 white blood cells/L), or leukopenia (<4 × 109 white blood cells/L) and temperature >38.3°C.The present study aims to show the bacteria and its antibiotic sensitivity pattern isolated from endotracheal tubes of ICUs and clinical outcome. Methods: The present study is an institutional-based prospective study. Endotracheal aspirations were collected from the ICU patients of SSIMS and RC who presented with the clinical manifestations of pneumonia. The samples were transferred to the laboratory, serially diluted and inoculated on 5% sheep blood agar. Subcultures were done following which the antimicrobial susceptibility testing was performed to isolate bacteria by disk diffusion method as per standard guidelines. Statistical analysis of the results was done using SSPS software. Results: A total of 100 cases were included in this study. Out of which, 65 patients developed VAP who were on mechanical ventilation. The most frequent cause of ICU admission was closed head injury because of road traffic accidents followed by birth asphyxia due to meconium aspiration and poisoning. Most of the Gram-negative bacteria's are sensitive to amikacin, cefepime + sulbactam. Conclusions: Simple and effective preventive measures of infection control such as hand hygiene, elevation of head, oral and not nasal cannulation, minimization of sedation, institution of weaning protocols, and judicious use of antibiotics will go a long way in preventing ICU infections.

Platform presentation 3 1st August 2015 - session 3, room 2

  3.2.1 Incidence and prevalence of sickle cell and thalassemia in anemic patients in a Tertiary Health Care Hospital Top

H. J. Ashtankar1, A. D. Patrikar1

1NKP Salve Institute of Medical Sciences and Research Centre, Nagpur, Maharashtra, India

Background: Hemoglobinopathies are inherited single gene disorders and inherit as autosomal recessive trait. It contributes 3.4% of mortality in children worldwide. Among those disorders, sickle cell and thalassemia constitute major public health problems and are increasing due to unawareness and lack of screening facilities. Aim of the study is to determine the incidence of hemoglobinopathies in anemic patients (hb < 10 g%) and counseling people (create awareness) about hemoglobinopathies. To assess suitability of screening tests, SICKLEVEU (solubility test) for sickle cell and THALVEU (turbidemetric test) for thalassemia is used. Methods: Observational - descriptive study for 2 months at Tertiary Health Care Hospital. Reference population - anemic patients (Pathology Outpatient Department). Sample size - 300 statistical analysis of collected data carried out by evaluating the complete blood count counts (MENTZER INDEX) and results of screening tests confirmed by electrophoresis. Results: Sickle cell trait (AS) was observed in 8%, sickle cell disease (SS) – 1.67%, and thalassemia trait (AA2) – 1% of screened population. Screening tests were found to be suitable for mass screening; whereas, mentzer index found to be suitable for hospital patients screening. Out of total 32 positive cases, 20 (62.5%) cases were female. A total number of unknown cases who screened positive were more among sickle cell trait (87.5%). Conclusions: It is mandatory for a patient who diagnosed anemic must be screened for sickle cell and thalassemia prophylactically, considering high prevalence in the region. Screening tests found to be suitable for detection of sickle cell and thalassemia. Patients were counseled and advised-regular health checkups, healthy lifestyle, proper marriage counseling, and awareness was created among population. Limitations: Mentzer index used in study is not applicable in severely anemic patients and can be used as alternative to screening tests only. Screening tests must be confi rmed by Hb-electrophoresis because it might be false positive.

  3.2.2 Epidemiology of leprosy in Mangalore: A retrospective data analysis of leprosy cases from January 2003 to March 2013 Top

Chaturvedi Abhinav1, Kumar Pramod1, Gatti Nithin1

1Kasturba Medical College, Mangalore, Karnataka, India

Background: The study was aimed at studying the clinico-epidemiological and demographic profile of leprosy, factors associated with different type of leprosy, and pattern of morbidities among leprosy cases. Methods: It is retrospective record based study conducted in District Leprosy Office in Mangalore. It included all diagnosed cases of leprosy from January 2003 to March 2013. Data collected using structured proforma and sampling method was universal sampling. Data analysis was done using SPSS version 11.5. Results: A total of 847 confi rmed leprosy cases, majority were male (n = 573). The mean age of the study participant is 34.3 years, and number of cases are decreased from 2003 to 2013 with marginal inter year variation from 2006 to 2013. Majority of cases were paucibacillary (70.3%, n = 147) in <20 year age group, compared to multibacillary leprosy (70.5%, n = 412 in 20–40 and 79.6% n = 43 in 60 and above) in older age group. Among those who had some morbidities, most (90.0%, n = 63) of them belonged to multibacillary group. In males, multibacillary cases (66.1%, n = 379) were more. Conclusions: It was noticed that significant drop in prevalence rate in Mangalore with paucibacillary more in young and multibacillary more in males with equitable distribution in females. Morbidity was associated more with multibacillary leprosy.

  3.2.3 Splenomegaly in adults: Clinical and hematological profile Top

Dsouza Vivian1

1NKP Salve Institute of Medical Sciences and Research Centre, Nagpur, Maharashtra, India

Background: Splenomegaly is an important clinical sign of an underlying serious disorder, in which cause and etiology should be thoroughly investigated. Indian data of this condition are sparse. Aim of the study was to find out clinico-hematological profile and etiology of splenomegaly and to relate this to salient clinical features. Methods: Postpermission from Institute's Ethics Committee, 50 patients volunteers with splenomegaly in medicine ward of a tertiary care hospital in Central India, were enrolled for cross-sectional observational study, after their informed written consent was taken. Each patient underwent comprehensive history taking, along with thorough general and systemic clinical examination. On perabdominal examination, severity of splenomegaly was graded. Laboratory studies were carried out. Data on demographic parameters and medical tests were obtained. Nominal and real/interval scale parameters were summarized. Analysis was performed using statistical tools. Results: Most cases were seen in 21–30 years age group (32%) with male preponderance (66%). Stage I and II was seen in 88% patients. Moderate splenomegaly was commonest grade (50%). Commonest presenting feature was jaundice followed by fever, abdominal distension, vomiting, right upper quadrant liver pain, pedal edema, loose stools, and melena in decreasing order of frequency. The most common sign associated with splenomegaly was anemia (84%) followed by ascites (28%), hepatomegaly (24%), and lymphadenopathy and others (4% each). The most common etiology was congestive disorders (50%) followed by infective (22%), hematologic (20%), and obscure (4%) cases. Splenomegaly was detected by palpation and abdominal ultrasonography, which was useful in detecting and confirming mild splenomegaly. Conclusions: Splenomegaly is an important finding seen in clinical practice. Congestive splenomegaly, secondary to cirrhosis with portal hypertension was found to be the most common cause followed by infective etiology. In 4% cases, etiology could not be found with routine hematological and imaging tests. Ongoing evaluation and study of spleen and associated organs with its illness need to be carried out to alleviate the effects of diseases involving it.

  3.2.4 Study to correlate peripheral blood smear with hemoglobin value and red cell distribution width in anemic patients Top

P. Hari1, A. Khare1, R. S. Hari1

1Subharti Medical College, Meerut, Uttar Pradesh, India

Background: Anemia is a global problem and affects 1.62 billion people worldwide with the greatest number of individuals affected being reproductive age group females. Prevalence of anemia in female (20–50 years) is 70.1% and in male (20–50 years) 53.2%. The peripheral blood smear is an inexpensive but powerful diagnostic tool for diagnosing and categorizing the type of anemia. The red blood cell distribution width (RDW) is a red cell measurement that quantitates cellular volume heterogeneity and has been proposed to be a more sensitive indicator to reflect the range of red cell sizes. The present study was undertaken to study and correlate the peripheral blood smear findings with hemoglobin values and RDW in anemic patients. Methods: A total of 203 anemic patients including 83 male and 120 female were randomly selected in the study with hemoglobin (Hb) values <10 g%. The blood samples were taken for complete blood count, RDW, and peripheral blood smear examination. Results: 25 patients had Hb values <6 g%, 36 had 6–8%, and 142 had 8–10 g%. Patients having RDW values <11% were 16, 11–16% were 161, and RDW values >16% were 26. Patients with mild anemia (Hb 10–8 g%) had normocytic normochromic blood picture with minimal change in RDW (RDW 13 ± 2.1). In moderate anemia (Hb 8–6 g%), blood picture was of mixed type with less change in red blood cell (RBC) morphology and relatively normal RDW value(13.7 ± 1.6). Severely anemic patients (Hb < 6 g%) showed marked change in RBC morphology and thus, RDW of these patients was markedly high (RDW 14.7 ± 2.2). Conclusions: Thus in working up a patient of anemia, complete blood count and peripheral blood smear findings should be correlated with RDW to find out the degree and type of anemia.

  3.2.5 Hematological profile of patients with chronic kidney disease with and without dialysis Top

Kudaravalli Pujitha1, Mary Mathew1, Deepak Nayak1, Swati Sarma1

1Kasturba Medical College, Mangalore, Karnataka, India

Background: The disease burden of chronic kidney disease (CKD) in India with a population of 1 billion is approximately 7.85 million. There is a paucity of literature in Indian cohort on novel platelet indices such as mean platelet volume (MPV), plateletcrit (PCT), and platelet distribution width (PDW) in patients with CKD. This study aims at identifying the risk factors in CKD and comparing the role of platelet parameters in patients with and without dialysis. Methods: Study design -Cross-sectional record-based study. Study population - A period of 6 months data of the patients 144 cases, adult and children with CKD, were reviewed from the Medical Records Department and Clinical Laboratory at Kasturba Hospital, Manipal. In total, 125 patients served as controls. Platelet and hematological and biochemical data of the patients were collected and the risk factors contributing to CKD were collated. Frequency tables and descriptive statistics were analyzed using statistical tools SPSS and Pvalue and Chi-square were calculated for the hematological parameters and the risk factors of CKD collated. Results: The results of the study showed that a significant number of patients on dialysis had thrombocytopenia, a high MPV, and a wide PDW which were statistically significant (P < 0.001). Conclusions: Dialysis has a statistically significant effect on platelet parameters. We observed a decrease in platelet count, increase in platelet size and distribution width and low PCT in dialyzed patients. Chronic diseases such as hypertension (91.8%) and DM (44.5%) were more prevalent in India when compared to the western population in CKD patients. Limitation: We suggest a prospective study with pre- and post-dialysis analysis of the same patient.

  3.2.6 Assessment of efficacy of six different moisturizing creams in maintaining the hydration of skin over dorsum of the hand: Randomized controlled study Top

Lambghare Nancy Sudhir1, Sushil Pandey1

1NKP Salve Institute of Medical Sciences and Research Centre, Nagpur, Maharashtra, India

Background: Moisturizer is a cosmetic preparation as a cream or lotion used to restore moisture in the skin. Moisturizers are extensively promoted by various cosmetic companies in print and electronic, media making tall claims of their effi cacy. Such products enter the market without proper clinical studies. Consumers using creams have little knowledge about it. The aim is to study moisture levels over skin sites before application of moisturizers and to calculate average moisture levels of skin over dorsum of the hand. Furthermore, to compare safety of six different commonly used skin moisturizers. Methods: The study includes 30 volunteers. In this study, we used six different commercially available moisturizers, namely (1) emoderm cream (2) secalia cream (3) amylac cream (4) ponds cream (5) nivea cream (6) dove cream. We selected six random sites on the dorsum of hand and named it as A, B, C, D, E, and F. Baseline reading of these areas was taken. Moisturizers were applied on these sites, respectively. Sites were kept for 15 min and then the reading was taken with the instrument called Digital Skin Analyzer. Readings were taken at 15 min, 30 min, and 1 h after application of the cream. Results: Secalia moisturizer produced the maximum increase in moisture level over the baseline at the end of 1 h − 21.99%. Conclusions: The main objective of this study was to evaluate the hydration effect of three medically approved and three commercially available moisturizers using noninvasive bioelectrical techniques. We conclude that epidermal hydration produced by moisturizers influences the electrical properties of skin. Noninvasive skin electrical measurements are appropriate for an objective and quantitative evaluation of the complex effect of different moisturizers on epidermal water content. Commercially available moisturizers are a mixture of various substances while the many of the medically approved moisturizers contain single active ingredient making them reliable for specifi c treatment.

  3.2.7 Assessing the specificity and sensitivity of various red blood cell indices for screening beta thalassemia trait in patients with microcytic hypochromic anemia Top

Meenakshi1, Sunita1

1Lady Hardinge Medical College, New Delhi, India

Background: Prevalence of beta-thalassemia trait (BTT) is 3–5% in Indian population and is increasing; diagnosing the presence in both parents is the most definitive step to reducing the birth of thalassemia major children. BTT presents as mild microcytic hypochromic anemia. Hemoglobin (Hb) high performance liquid computed tomography (HPLC) is the gold standard test for diagnosing BTT is an expensive test, and large scale screening is not practical using red blood cell (RBC) indices from complete blood count is affordable. Methods: The study was designed in two parts (1) to determine the sensitivity and specificity of each of the seven RBC Indices namely England Fraser, Mentzer, Shine and Lal, red cell distribution width, red blood cell distribution width (RDWI), Pearson's threshold, and linear discriminant function and identify a set of RBC indices to diagnose BTT, on 60 patients with Hb HPLC-positive and 60 Hb HPLC-negative with microcytic hypochromic anemia (2) to apply indices on the next 50 cases of microcytic hypochromic anemia, evaluate if RBC indices score served as a screening test by corroborating with Hb HPLC test. Combination of RDWI, linear discriminant function, Mentzer Index, and England Fraser index was applied on test population. Positive index was given a score of one point. Results: Shine and Lal and Pearson's Index are least specific. England Fraser, RDWI, Mentzer, and linear discriminant function are more specific for screening for BTT. RDWI was the single most useful index. Total score was used as a screening tool score of 3 and above picked up all Hb HPLC-positive cases and had no false negatives. Prevalence of BTT was 10%. Conclusions: Combination of Mentzer, Linear Discrimination function, RDWI, and England Fraser Index is the best for screening for BTT score of at least 3 of 4 indices (or 5 or more out of 7) is 100% sensitive for screening BTT.

  3.2.8 Prevalence and etiology of thrombocytopenia in pregnant women in a Tertiary Care Hospital in Delhi Top

Oberoi Mansi1, Singh Sarika1, Puri Manju1

1Lady Hardinge Medical College, New Delhi, India

Background: Thrombocytopenia (platelet count <150,000 ml−1) occurs commonly during pregnancy resulting from various causes such as gestational thrombocytopenia (GT), hypertensive disorders, and nutritional deficiencies which may lead to maternal, fetal, and neonatal morbidity and mortality. It is often underdiagnosed and mismanaged condition in India. Objectives are to find the prevalence of thrombocytopenia in pregnant women and the etiological factors responsible for it. Methods: It was a cross-sectional study involving 1000 pregnant women admitted in Smt. Sucheta Kriplani Hospital, New Delhi. Subjects were screened for thrombocytopenia by automated hematology analyzer. Written consent was taken. History of petechiae, bruising, nausea/vomiting, drugs, viral infection, neurological deficits, fever, bleeding, blood transfusion, and obstetrical, past, personal and family history was elicited. Clinical examination performed to find out any signs of thrombocytopenia. Routine blood investigations and other confirmatory tests were done. Statistical analysis and Chi-squared test was used to find association between different causes using SPSS software. P< 0.05 was considered significant. Results: Total 1000 pregnant women were studied; prevalence of thrombocytopenia was found to be 13.4%. Majority (53.7%) had moderate thrombocytopenia, 35.8% had mild, and 10.4% had severe thrombocytopenia. Majority (93.3%) of thrombocytopenic patients were of third trimester (P = 0.000). Majority belonged to 21–25 years of age (P = 0.017) and had B+ blood group (P = 0.011). Most common etiology found was GT (34.3%) and majority of them had mild-moderate thrombocytopenia (P = 0.000) followed by anemia in 27%. Other causes were pregnancy-induced hypertension (12.7%), deranged liver function test (6%), viral infections (HepB, HIV, TORCH) (5.2%), hypothyroidism (3.7%), antepartum-hemorrhage (3%), infections (malaria, typhoid) (3%), preeclampsia (2.2%), HELLP (1.5%), eclampsia (1.5%), idiopathic thrombocytopenic purpura (0.7%), and APLA (0.7%). Conclusions: Prevalence of thrombocytopenia in pregnancy was found to be 13.4%. Major causes were gestational thrombocytopenia, anemia, and hypertensive disorders. Anemia was the second most frequent cause for thrombocytopenia contrary to western data. Thus platelet estimation should be done in first antenatal visit and repeated in subsequent trimesters for timely diagnosis and favorable fetomaternal outcome.

  3.2.9 A questionnaire-based study on awareness of sickle cell disease and prevention of sickle cell crisis in patients of sickle cell disease Top

Rautray Kaushika1, Acharya Sourya1, Nayak Smriti1

1Jawaharlal Nehru Medical College, Sawangi, Wardha, Maharashtra, India

Background: Sickle cell disease (SCD) is wide spread among tribal communities in India. This study aimed to assess the knowledge and attitude of sickle cell disease patients and their practice in preventing sickle cell crisis. The objectives of this study were to create awareness, motivate, and impart health education and to provide prospective and retrospective genetic/marriage counseling to affected persons and families. Second, to evaluate the outcome of periodic follow-up, clinical management, and intervention through local Primary Health Centers (PHCs)/hospitals. Methods: It was a cross-sectional study, conducted on 50 patients aged 3–33 years attending the sickle cell clinic or admitted in AVBRH with sickle cell crisis, by giving them a questionnaire in local language. The study included patients from pediatrics, gynecology and medicine department. Results: A total of 50 patients were surveyed in this study and only 32 (64%) were aware of being sickle cell positive, 14 (28%) of them knew how it is caused and 13 (26%) of them knew it is a hereditary disease. Even though 70% were counseled about the disease, only 8% underwent premarital counseling. Approximately, 34% are availing the treatment and adapting lifestyle modifications. Only 22% are aware and practice vaccination against Haemophilus influenza and pneumococcal infections. Negative attitude towards sickle cell disease was observed among 70–88% patients. Conclusions: Despite fair knowledge of sickle cell anemia and disease in the Vidarbha region, there is a need for improving intervention programs regarding sickle cell, since negative attitude and improper habits toward sickle cell have been documented. It was noticed that upon creating awareness among the patients through this survey, a positive response was received.

  3.2.10 Study of pattern and prevalence of thrombocytopenia in neonates Top

Sahgal Vidushi1, Nandyal S. Sonam1, P. Shashikala1

1SS Institute of Medical Sciences and Research Centre, Davangere, Karnataka, India

Background: Neonatal thrombocytopenia is defined as a platelet count <150 × 109/L regardless of gestational age and is classified as early onset and late onset. The present study conducted highlights the etiology, pattern, prevalence, and severity of neonatal thrombocytopenia encountered in our hospital. Methods: A prospective observational study was conducted at Neonatal Intensive Care Unit (NICU) of Pediatric Department and Hematology Laboratory of Pathology Department for a period of 2 months (May and June 2014) in a Tertiary Care Hospital. Neonates admitted to NICU with different clinical problems were evaluated for platelet count and counts <150 × 109/L were included in this study. Blood samples were sent to hematology laboratory and analyzed by automated hematology analyzer. Neonates were categorized depending on presentation, time of onset of thrombocytopenia, presence of risk factor, etiology, and severity. Pattern of onset of thrombocytopenia was classified as early if it developed <72 h of birth and late >72 h. Severity of thrombocytopenia was graded as mild, moderate, and severe. Results: Out of 155 consecutive neonates admitted to NICU, 99 developed thrombocytopenia with a high prevalence of 63.8%. About 43.4% had early onset and 56.5% had late onset thrombocytopenia. The most common cause of neonatal thrombocytopenia was prematurity (38.3%) followed by neonatal sepsis (22.2%). Mild and moderate thrombocytopenia was found in 17.1% of the neonates each while severe was more common accounting for 65.6% of cases. Conclusions: As neonatal thrombocytopenia is common in NICU and its clinical course and outcome depend on etiology, an appropriate diagnostic workup is essential for early diagnosis and better management.

  3.2.11 Cross-sectional study on perception about blood donation among college students of Mangalore City Top

D. Shankar1, H. N. Kumar1, A. Agarwal1, S. V. Mathai1, A. Panwar1, D. Singh1, S. S. Ali1

1Kasturba Medical College, Mangalore, Karantaka, India

Background: There is a serious mismatch between demands and availability of blood in India. Voluntary blood donation is only 52%. NACO aims to raise the voluntary blood donation to 90%. This study was aimed to assess the level of perception of voluntary blood donation among college students of Mangalore. Methods: This is a questionnaire-based, cross-sectional study using convenience sampling, conducted among students pursuing bachelors and masters in colleges in Mangalore City. A questionnaire was constructed to test students' perception of blood donation. It was pretested and modified for our use. Using formula for infinite population, n = Z2pq/d2, accounting for nonresponse, total sample size came out to be 415. Perception was scored on a scale of 50. The data were analyzed using SPSS version 12. Results were expressed as proportions in appropriate tables and graphs. Student's independent t-test was used to know if the difference in means were statistically significant. Results: In total, 389 students participated in the study, out of which 345 (88.7%) had favorable perception and 44 (11.3%) had unfavorable perception. Two factors were found to have significant association with intention to donate blood (t value [P value]): A. K favorable perception (−1.99 [0.0480]), and unfavorable perception (4.061 [0.000]), and nonscience students (2.622 [0.009]) were less likely to donate blood. Majority (n = 343, 88.17%) of them wished to donate blood in future. Conclusions: Majority of the students had favorable perception of blood donation.

Platform presentation 3 1st August 2015 - session 3, room 3

  3.3.1 Profile of ligature materials used in case of hanging in Sapthagiri Institute of Medical Sciences and Research Centre, Bengaluru Top

Ashwin Kamal1, S. Yadukul1

1Sapthagiri Institute of Medical Science and Research Center, Bengaluru, Karnataka, India

Background: Suicide by hanging is the most common manner of unnatural death that has been rapidly increasing in rural India. Choice of hanging depends on accessibility and availability of the means. Various ligature materials ranging from rope, dupatta, dhoti to a handkerchief, metallic chains, etc., are being used. Aims and Objectives: To study the profile of ligature materials used, type of knot used, choice of ligature materials by different genders, and choice of point of suspension. Methods: This prospective study was conducted in all cases of death due to hanging as part of ICMR project during the period from February 27, 2014, to July 27, 2014 coming for postmortem examination at Sapthagiri Institute of Medical Sciences and Research Centre, Bengaluru. Detailed history from the police and relatives along with pretested questionnaire with variables regarding the type of ligature material used, point of suspension, type of hanging, type and position of knot, etc., was collected. Results: (1) Autopsy of 26 hanging cases were conducted and analyzed during the study period. (2) Half of hanging victims (12) used saree and six victims had used rope; rest of victims, two used towel, two used dhoti, two used dupatta, and two used either bed sheet or lungi in each. (1) In 22 cases, the type of knot was fixed, and the point of suspension was found to be ceiling fan. (2) Male victims (20) outnumbered the female victims (6). Conclusions: The study will: (1) provide awful information for the Investigating Officer (Police and Magistrate) in investigating cases of hanging. (2) suggest the mind-set of the individual who had the intention to choose a particular point of suspension to hang. (3) educate about the ease of an individual in opting for that particular ligature material.

  3.3.2 Variant motor supply to the long head of triceps muscle Top

Bapat Supriya1, Sawant Sharad1

1K J Somaiya Medical College, Mumbai, Maharashtra, India

Background: Normally, motor innervation to the long head of triceps is by radial nerve (branch of posterior cord of brachial plexus). However, variation can be observed in the motor nerve supply. Methods: 10 embalmed cadavers were studied in the dissection hall of Department of Anatomy of KJSMC by 1st year Medical Students (2014–2015). Meticulous dissection was done and any variations seen were noted. Results: From the 10 cadavers (20 upper limbs) that were dissected, in 1 cadaver, the long head of triceps of the right upper limb showed abnormal motor supply by the branch of axillary nerve instead of normal motor supply by radial nerve. Conclusions: The variation in the motor nerve supply of long head of triceps is clinically important for surgeons, orthopedicians, and anesthetists performing pain management therapy and might complicate surgical repair in the upper limb.

  3.3.3 Morphometric analysis of distal femoral and proximal tibial condyles and its clinical applications Top

A. Chaurasia1, B. Rathinam1, J. A. Santoshi1

1All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India

Background: The knowledge of normal morphometry of the femoral and tibial condyles is indispensable for effective designing of implants and prostheses which are required for various corrective and reconstructive surgeries of the knee joint. The existing precontoured ones are designed based on Caucasian morphometric analysis and may not be appropriate for the Indian subcontinent. The aim of the present study is to measure various parameters of the distal femoral and proximal tibial condyles in the Indian population. Methods: A total of 104 dry bones of Central Indian population (femur-53, tibia-51) were included in the study and morphometric measurements such as anteroposterior, mediolateral diameters, and geometric arcs were recorded using Vernier caliper and radius gauges. The measurements were analyzed for the mean values and their Pearson correlation determined using standard statistical software. Results: In our study, the mean values for several parameters such as length, maximum anteroposterior, mediolateral, and intercondylar width along with the mean values of geometric arcs in the anterior, distal, and posterior parts of both medial and lateral condyles were estimated. These values were compared against the ones recorded by other studies and were found to have variable similarities and differences from them. We also fitted femoral and tibial precontoured implants which are currently available in the Indian market and found that the tibial implant was grossly off the flare of the lateral condyle while the femoral one was just about fitting, reiterating that the implants currently available are not appropriate for the ethnic Indian population and need further modification in design. Conclusions: The present study is a comprehensive attempt at measuring the three dimensional morphometry of the knee joint which will help in designing of well-fitting implants and prostheses for the Indian population. The results of this study will be helpful for anatomists, anthropologists, and orthopedics.

  3.3.4 Abnormal origin of the flexor carpi ulnaris Top

Desai Tanisha1, Sawant Sharad1

1K J Somaiya Medical College, Mumbai, Maharashtra, India

Background: Normally, the flexor carpi ulnaris muscle originates from two heads-ulnar and humeral connected by a tendinous arch and inserted into the hamate and fifth metacarpal bone. The aim is to study the variations in the origin of the two heads of this muscle and their fusion. Methods: Around 10 embalmed cadavers were studied in the dissection hall of Department of Anatomy of KJSMC by the 1st year medical students (2014–2015). Meticulous dissection was done and any variations observed were noted. Results: Out of 10 cadavers (20 upper limbs) that were studied, one of them showed separate ulnar and humeral heads of flexor carpi ulnaris, separated by the ulnar nerve, In the right forearm, the tendons of these two heads fused just before insertion; the left forearm was normal. Conclusions: Knowledge of variations of flexor carpi ulnaris is essential for anatomists, orthopedicians, plastic surgeons doing flap surgeries, and surgeons dealing with cubital tunnel syndrome.

  3.3.5 Higher bifurcation of popliteal artery Top

Gala Rajvee1, Sawant1

1K J Somaiya Medical College, Mumbai, Maharashtra, India

Background: Popliteal artery is a continuation of femoral artery. It extends from hiatus magnus to lower border of popliteus muscle where it bifurcates into anterior and posterior tibial arteries. In rare cases, this bifurcation takes place at a level higher than normal. The aim of this study is to shed light upon the variant branching patterns of popliteal artery. Methods: In total, 10 embalmed cadavers were studied in the dissection hall of Department of Anatomy of KJSMC by the 1st year medical students (2014–2015). Meticulous dissection was done and variations present were noted. Results: Out of 10 cadavers (20 lower limbs) studied, one of them showed higher bifurcation of the popliteal artery (above popliteus muscle) on the left side. The right side was normal. Conclusions: During knee joint surgery and total knee arthroplasty knowledge of the anatomical variations in branching patterns must be kept in mind to minimize surgical complications. Therefore, origin of posterior tibial artery from popliteal artery proximal to the popliteus muscle is an important anatomical variation for surgeons operating on aneurysms of popliteal artery and by radiologists performing angiographic study.

  3.3.6 Estimation of stature from hand dimensions Top

A. Jachak1, N. Wakode1

1NKP Salve Institute of Medical Sciences and Research Centre, Nagpur, Maharashtra, India

Background: The stature or body height prediction occupies a relatively central position in the anthropological research and in identification necessitated by the medical jurisprudence or by medicolegal experts. The objective of the study was to measure the hand length, to estimate stature from hand length, and to find out any regression equation and multiplication factor for it. Methods: The present study was descriptive, cross-sectional type done on 200 adult individuals from NKPSIMS ageing between 17 and 25 years. Stature was measured using a standard anthropometer and hand length with sliding caliper and were recorded in centimeters to the nearest of 0.1 cm. These measurements were analyzed statistically to establish relation between the stature and hand length by using regression equation and multiplication factor. Results: Regression equations are derived for both the sexes using regression formula y−y' = πdy/dx (x−x')−y', and calculated as y = 4.3526x + 91.6307 for male and y = 4.6872x + 79.37577 for female, where y stands for standing height and x stands for hand length. Multiplication factors were also calculated in the study and these are 9.2666 and 9.1699 for male and 9.5674 and 9.4694 for female for right and left hand, respectively. Conclusions: Calculated stature from the regression equation is close to the actual height, variation being ± 4 cm in most of the cases. It is more reliable and accurate method. There are significant bilateral variations in hand length statistically.

  3.3.7 Footprint ratio as a predictor of pes planus Top

Kalra Yashika1

1Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India

Background: Pes planus (flat foot) refers to a change in foot shape in which the foot does not have a normal arch when standing. The main purpose of this study is to apply quantitative and qualitative analysis of dynamic footprints to find the incidence of pes planus in a young South Indian population. Methods: Dynamic footprints of both feet of 284 subjects of both sexes (142 males + 142 females) aged between 18 and 24 years from Vydehi Institute of Medical Science and Research Centre were taken to determine the incidence of pes planus by arch index method along with their grading into one of the 4 grades of pes planus. Results: 113/284 subjects had pes planus which included 62/142 males and 51/142 females. Totally 178/568 feet were flat, i.e., had pes planus. Furthermore, out of the 62 male subjects having pes planus, 26 had unilateral flat foot and 36 had bilateral flat foot. Among the 51 female subjects with pes planus, 22 had unilateral flat foot and 29 had bilateral flat foot. Conclusions: This research project will prove highly useful for orthopedics, anatomists, and podiatrists and in forensic medicine for determining the prevalence of pes planus and possibly predicting the pathologic foot conditions, and it may serve as an early warning sign of structural and functional defects of the foot in a given population.

  3.3.8 Abnormal termination of the sciatic nerve Top

Mahajan Sharvari1, Sawant Sharad1

1K J Somaiya Medical College, Mumbai, Maharashtra, India

Background: The sciatic nerve, thickest nerve in the body originates from L4-S3 of the lumbosacral plexus and terminates as the common peroneal and popliteal nerves in popliteal fossa normally. However, in rare cases, variations can be seen. The aim of the study is to find such variations of the sciatic nerve. Methods: 10 embalmed cadavers were studied in the dissection hall of Department of Anatomy of KJSMC by the 1st year medical students (2014–2015). Meticulous dissection was done and any variations present were noted. Results: Out of 10 cadavers (20 lower limbs) that were studied, in 1 cadaver, there was abnormal termination of the sciatic nerve in both limbs which was seen as a trifurcation to give superficial peroneal, deep peroneal, and tibial nerves which differs from the known facts. Conclusions: Knowledge of potential variant anatomy of sciatic nerve will aid surgeons in locating nerves and avoiding potentially unnecessary complications.

  3.3.9 Estimation of stature from radiological determination of femur length among a sample of South Indian adults Top

Rao Pragnya1, B. Jatti Vijayakumar1, S. Y. Rajkumar1

1SS Institute of Medical Sciences and Research, Davangere, Karnataka, India

Background: Lack of up-to-date information on the population groups of South India makes estimation of stature from bones in this area subject to possible error. The present study was undertaken to set a general formula for stature estimation using femur length for South Indian individuals and also assess its validity on another independent sample. Methods: The maximum radiological femur length of 100 South Indian subjects (50 males, 50 females) was determined by X-ray imaging. The actual height of these was also measured. Two separate formulae were obtained for males and females using linear regression. On a secondary 40 subject sample, who were categorized depending on bone length - short, medium, and tall, the resultant data were analyzed for validation of the obtained equations using ANOVA. Results: Regression formulae obtained were - for male: stature = 55.16 + 2.51 × femur length and female: stature = 53.89 + 2.52 × femur length. The variances between means of actual stature and estimated stature was insignificant in nature, but for that in short category of women (P = 0.018). Conclusions: The femur is a reliable long bone for stature estimation and there is a significant correlation between femur length and stature. Equations obtained in this model will immensely help in establishing identity of missing persons, highly decomposed bodies, bodies obtained in mass disasters, etc., where only lower limbs might be intact, and also in some civil cases, in South India. Regression models must be developed from time to time and this study must be conducted on a large scale, to achieve higher accuracy in the ultimate goal of the identification process.

  3.3.10 Study of finger print patterns to evaluate the role of dermatoglyphics in early detection of bronchial asthma Top

S. Singh1, P. Chaware1, A. K. Khurana1

1All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India

Background: The study of the epidermal ridge patterns of the skin of the fingers, palms, toes, and soles is known as dermatoglyphics. The resulting ridge patterns are genetically determined and the patterns which are once established never change throughout life. Bronchial asthma is also infl uenced by genetic factors. As the dermatoglyphic patterns and bronchial asthma both are genetically determined, these two have a correlation. Hence, this study was planned to prepare the data to establish the correlation between fingerprint patterns and bronchial asthma to see whether these parameters have any diagnostic value in bronchial asthma. Methods: The study was carried out in Outpatient Department of Pulmonary Medicine Department of AIIMS, Bhopal. The sample size was 50 cases of bronchial asthma and 50 controls. After taking consent, the fingerprints of both the cases and controls were taken on glossy papers. Those fingerprints were studied under a hand lens. Parameters studied and analyzed were: (a) whorls, (b) arches, (c) radial loops, (d) ulnar loops, (e) absolute finger ridge count (AFRC), and (f) total finger ridge count (TFRC). Results: There was a significant decrease in mean value of the arches and increase in mean value of the ulnar loops in patients than in the controls. The increase in the mean values of TFRC, AFRC, and whorls was observed in patients in comparison with controls, which was statistically not significant. Conclusions: The decreased number of arches, increased number of ulnar loops, and some respiratory ailments can be used as the early diagnostic criteria for bronchial asthma. More elaborated studies are needed to find out usefulness of dermatoglyphic patterns as early diagnostic tool in bronchial asthma.

  3.3.11 Assessment of mental foramen in panoramic radiographs: A useful tool for sex determination in forensic odontology Top

Tyagi Parul1

1KLE Institute of Dental Sciences, Belagavi, Karnataka, India

Background: Sex determination is the first step of personal identification in the field of forensics and is essential for reconstructive profiling. The skull appears to be the most reliable bone apart from pelvis in sex determination and its size, robustness, and metric characteristics aid in distinguishing male and female skulls. Among many anatomical landmarks in the skull, the mental foramen is stable landmark and shows variation with age and gender. This study aims to analyze the mental foramen on panoramic radiograph in a population of Belagavi City for sex determination. Methods: A total of 100 panoramic radiographs of 100 subjects (50 males and 50 females) aged between 18 and 70 years of age were selected for the analysis of mental foramen. The radiographs were digitalized and analyzed with Adobe Photoshop CS3.Using the lassos tool, the distances of the foramen from the upper and lower border of the mandible were measured. The possible sex dimorphism in location of mental foramen will be evaluated using t-test and logistic regression analysis performed to ascertain their usefulness in sex prediction. Results: There was a significant difference in the location of the mental foramen between males and females. Conclusions: The distances from the mental foramen to the lower border of the mandible exhibit sexual dimorphism in Belagavi City. Though the sex identification accuracy for mental foramen in Indians is relatively moderate (~61%), it can be used as an adjunct for sexing of adult Indians in forensic contexts.

  3.3.12 Morphometric variations if the jugular foramen of the human skull in South Indian population Top

Vini Talwar1

1Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India

Background: Jugular foramen is a hiatus at the base of the skull between the temporal and occipital bones. It is divided into three compartments through which structures of clinical importance travel. It varies considerably in shape and size from side to side in the same and in different crania, also in racial groups and sex. Pathologies such as meningiomas and glomusjugulare and most of the surgical approaches involve the bone around the jugular foramen. Thus, the knowledge of dimensions of jugular foramen in the regional population would be of great help to ENT surgeons, neurosurgeons, radiologist, anatomist, and forensic experts. Methods: The study was undertaken using 100 adult dry human skulls procured from the Department of Anatomy, VIMS and RC. Malformed, damaged, and fetal skulls were excluded. Digital Vernier Caliper, was utilized to measure the parameters in mm as follows: anteroposterior diameter taken from the posterior border of the carotid canal anteriorly to the posterior wall of the foramen posteriorly, mediolateral diameter taken from the root of the styloid process laterally to the medial end of the foramen medially, depth from the floor of the fossa to the summit on the wall, presence/absence of septations. the septa present from the anterior to the posterior end completely dividing the foramen were considered as complete while if the septa were not touching both ends it was taken as incomplete. Statistical analysis of the data was done. The student's t-test was used. Results: The AP, ML diameters, and depth were greater on the right in 55%, 53%, and 68% skulls, respectively. Incomplete septa were found in 79% and 82% on the right and left, respectively. Conclusions: The observations were the right jugular foramen was larger than the left.

Platform presentation 3 1st August 2015 - session 3, room 4

  3.4.1 Study of risk of chronic obstructive pulmonary disease among successfully treated old pulmonary tuberculosis Patients Top

Ahlawat Raunak1, A. Agrawal1, C. Madaan1

1BPS Government Medical College, Haryana, India

Background: The study aims to identify the role of pulmonary tuberculosis (PTB) as a causative factor for chronic obstructive pulmonary disease (COPD) by analyzing PFT changes in successfully treated PTB patients and studying the correlation between radiological lesion &amp;amp; PFT in old PTB patients. Methods: A hospital-based case–control study was conducted and four groups each having 50 subjects were made (1) successfully treated PTB patients, (2) individuals with history of biomass fuel smoke exposure, (3) asymptomatic smokers, (4) healthy individuals. Results: Statistically signifi cant diminution of FEV1% and FVC% of Group 1 subjects was observed in comparison to healthy controls. Similar was the case with Group 2 &amp;amp; (3) no significant correlation was found between lung function indices and radiological changes in Group 1 subjects. Conclusions: PTB has a deep impact on lung mechanics as well as lung function &amp;amp; is definitely a risk factor for the development of COPD.

  3.4.2 Is there an association between duration of exposure and development of symptoms of hand-arm vibration syndrome? Top

Amruta Biradar1, Asha Kamath1

1Kasturba Medical College, Manipal, Karnataka, India

Background: Various studies in the west showed an increased risk of developing the symptoms of hand-arm vibration syndrome (HAVS) such as tingling, numbness, whitening of fingers, pain in muscles and joints of hand and neck, weakness, and difficulty in handling small objects with prolonged use of vibratory hand held machinery. As not much data are available about this association in Manipal, this study aims to estimate the time requisite for manifestation of symptoms among construction workers. Methods: The type of research that was used is cross-sectional study design. Various construction sites in Manipal were visited and data collected from 200 construction workers using vibratory tools regularly. A written informed consent was obtained from each participant after whom they were subjected to a set of questions obtaining the demographic, work details, and symptoms pertaining to the syndrome. Chi-square test was applied for analysis. Results: Among people working for <6 h in a day in their previous and current jobs, tingling was most common ranging from 36.4 to 53.3%, between 6 and 8 h muscle and joint pain ranging from 27.3 to 33%, and between 8 and 12 h tingling ranging from 18.2 to 23.3% followed by numbness 18.6–21.2% and muscle and joint pain 16.3–21.2%. For those working for more than 12 h, numbness was most common ranging from 66.7–100%. Conclusions: The study shows a higher risk of developing features of HAVS with increased duration of exposure to vibratory tools. Simple measures such as use of gloves and reducing the continuous exposure help to reduce the risk. Inability of the workers to recall details of their previous jobs and answering long questionnaire were the limitations.

  3.4.3 To study the radiological and biochemical aspect of alcoholic liver disease Top

S. B. Bhargava1

1Baba Farid University of Health Sciences, Faridkot, Punjab, India

Background: Alcoholic cirrhosis is one of the leading causes for liver transplantation. Predictors of morbidity and mortality are often unnoticed and the patient usually presents in hospital with end stage disease. There is need to study the radiology and underlying biochemical changes for early diagnosis to reduce morbidity and mortality and to encourage people for abstinence. Failure to recognize alcoholism impairs efforts at both the prevention and the management of patients. Methods: Two-month prospective study included 30 patients suffering from adrenoleukodystrophy (ALD). Patients of either sex above 18 years were included. Radiological features of liver were studied. An effort was made to correlate age with various biochemical parameters. The data were presented as mean ± standard deviation. The relation obtained from the scales was compared using student's t-test. Results: Cirrhosis was found in 56.6% of the patients followed by 30% cases of fatty liver. 13.33% had deranged liver function tests (LFTs) with normal radiograph. Ultrasonography (USG) abdomen showed highest incidence of ascites (94.1%), followed by portal hypertension (70.5%) and splenomegaly (70.5%) in alcoholic cirrhosis, encephalopathy, varices, and pleural effusion. In fatty liver, ascites (88.9%) is reported the highest, followed by common bile duct dilatation (44.4%), splenomegaly, and cholelithiasis. Deranged LFTs were seen on biochemical examination. On correlation of age of the patient with biochemical parameters, no statistically significant (P > 0.05) results were found. Conclusions: Most of the patients of alcoholic liver disease are coming to the hospital with end stage cirrhosis explaining the increased mortality and morbidity associated with ALD. USG revealed the morphological changes occurring in liver. Findings of this study help us to understand underlying pathological manifestations of disease, also telling about derangements of LFTs seen in ALD.

  3.4.4 Functional dyspepsia and its related factors in central India: Hospital-based, cross-sectional study Top

Deep Dhawan1, T. Manohar1

1NKP Salve Institute of Medical Sciences and Research Centre, Nagpur, Maharashtra, India

Background: Functional dyspepsia is characterized by persistent or recurrent upper abdominal pain or discomfort, following intake of food accompanied by postprandial fullness, early satiety, nausea, and bloating having no definite structural or biochemical abnormality. According to currently accepted criteria, i.e., ROME III criteria, it must include one or more of the following symptoms: bothersome postprandial fullness, early satiation, epigastric pain, epigastric burning with no structural disease, including the use of upper GI endoscopy, which is likely to explain the symptoms, for at least 3 months with onset 6 months before. Studies in India revealed that 7.6–49% prevalence. However, Rome criteria and validated questionnaires were not used so variation was reported. The objective of this study is to determine the prevalence of functional dyspepsia and its' sub classification, i.e., epigastric pain syndrome (EPS) and postprandial distress syndrome based on Rome III questionnaire and its associated factors. Methods: After taking approval from the Institutes' Ethics Committee, this hospital-based, cross-sectional study was undertaken in a Tertiary Care Hospital in Central India catering predominantly rural population. After taking written consent, 320 subjects of age 18 and above were enrolled in this study and given ROME III questionnaire. Subjects having known organic cause of dyspepsia and any dyspeptic subject with alarm symptoms or signs were excluded. Results: Prevalence of functional dyspepsia was found to be 9.34% with 53.58% with EPS and 46.42% with postprandial distress syndrome. There was no significant relationship found between FD and other sociodemographic parameters and dietary factors, but statistically nonsignificant relation was found with age, female sex, smoking, alcoholism, education level, marital status, spicy food, and employment status. Conclusions: Functional dyspepsia is a common disorder in clinical practice. With little changes in lifestyle, stopping smoking and proper diet intake can definitely make impact in life of patients with FD.

  3.4.5 Prevalence and predictors of irritable bowel syndrome: A randomized study Top

C. Gaganadeepa1, H. N. Dinesh1, Shrivathsa K. Merta1

1Mysore Medical College and Research Institute, Mysore, Karnataka, India

Background: Irritable bowel syndrome (IBS) is a functional disorder. In IBS, function of the gut is normal, but all parts of the gut look normal, even when looked under microscope. IBS is defined as “functional bowel disorder in which abdominal pain is associated with defecation or change in bowel habit, with the features of disordered defecation and distention.” The exact cause is unknown. Stress and other emotional factors may trigger symptoms in some people. Medical education is among the most challenging and stressful education. Change in lifestyle, their busy schedule may predispose to high rates of IBS. The objectives of the following study were to determine (1) prevalence and (2) predictors of IBS among medical students. Methods: A cross-sectional, randomized study was conducted over a period of 2 months (May 2014–June 2014) among 250 medical students of Mysore Medical College and Research Institute (MMCRI), Mysore. Institutional ethical clearance and informed consent were taken. Detailed history was taken using proforma. Student stress scale was used to assess stress. Rome III criteria were used. Inclusion criteria were all 1st and final year students of MMCRI. Exclusion criteria were students with preexisting IBS and those who are not willing to take part in study. Softwares used for analysis were Microsoft Office Excel and Epi-Info statistical package. Results: The prevalence in this study was 5.83%. The stress score was more than 300 in affected population and females were affected more. Conclusions: The prevalence in this study was 5.83%. Stress is a predictive factor. In India, there is no much studies done on IBS. Many more studies with larger population need to be done.

  3.4.6 Prevalence of prehypertension and hypertension in rural area of Vidarbha region of Maharashtra Top

Ganorkar Rohit1, Wasnik Preetam1

1Government Medical College, Nagpur, Maharashtra, India

Background: Objective of study is to know prevalence of prehypertension and hypertension in rural area of Maharashtra. Main problem in potential rural areas is ignorance about hypertension. Methods: This is prospective observational type of community based cross-sectional study. Study population is adults of 20–65 years age of Karajgaon Village of Amravati, Maharashtra. This study was conducted for 1 month peroid. Sample size is calculated using formula n = 4pq/L2 for statistical significance of study anticipating prevalence 50% for L = 0.07. 204 participants from consecutive houses were included. Hypertension diagnosed as per US Seventh JNC on detection, evaluation and treatment of hypertension criteria with help of standardized mercury column sphygmomanometer and stethoscope. Data entry and analysis done in MS excel sheet. Results: Prevalence of prehypertension and hypertension was found to be 21% (n = 43) and 24% (n = 49) respectively. Prehypertension and hypertension are highly prevalent in 35–50 years and 50–65 years age group respectively. Significant increasing trend of systolic blood pressure seen with age in population. Conclusions: Prevalence of prehypertension and hypertension were relatively high among young adults in rural Amravati of Vidarbha region of central India. This study had reduced white coat phenomenon and false positive result for blood pressure as it is not hospital based but community based home to home survey. By early detection of prehypertension, management can be started at earlier stage. Intervention to prevent further complications needs to be done early with lifestyle modification because blood pressure is associated with modifiable risk factors, such as body mass index and total activity.

  3.4.7 Study on prevalence and determinants of high blood pressure among medical students Top

Jain Pranshi1, Parashar Pawan1, Kiran Chhavi1

1Subharti Medical College, Meerut, Uttar Pradesh, India

Background: Hypertension is one of the noncommunicable diseases which affect 1 billion population worldwide contributing more than 7.5 million death per year (WHO-2008), and a current trend has shown a shift toward younger age group. The present study was undertaken to estimate the prevalence of increased blood pressure and to determine the correlation between increased blood pressure and lifestyle-associated risk factors (physical inactivity, body mass index, stress, salt intake, and smoking). Methods: A cross-sectional study was performed on representative subset of 100 medical students of the third year professional of Subharti Medical College, Meerut (2013–2014); 50 girls and 50 boys of age range 21–23 years. The sample was selected by purposive sampling technique, and data were compiled using pretested and preschedule close-ended questionnaire (includes K-10 scale to evaluate stress score). Manual sphygmomanometer was used for measuring systolic and diastolic blood pressure. The gathered data were analyzed using mean and proportions. A JNC7 criterion was used to categorize the population based on their blood pressure readings. Results: Forty five percent of students were found to be normotensive, 54% were prehypertensive (36% boys and 18% girls), and 1% were hypertensive as per JNC 7 criteria. Prehypertensive and hypertensive students have mean body mass index of 26 and 35, respectively. Prehypertensive and hypertensive students have severe stress level, i.e., >30 (according to K10 scale),35% of Prehypertensive students are smokers, 30% of prehypertensives add extra salt in their meals, 44.4% of prehypertensives perform physical activity for <30 min/day and 37% of prehypertensives does not perform any physical activity in comparison to normotensives. Conclusions: A statistically significant correlation exists between risk factors and increased systolic and diastolic blood pressure in young adults. Data are also suggestive of reducing the prevalence of high blood pressure with lifestyle modification through various techniques.

  3.4.8 Prevalence of nonalcoholic fatty liver disease in obese and overweight adolescents Top

S. R. Lalwani1, M. S. Pandharipande1, P. P. Joshi1

1Indira Gandhi Government Medical College, Nagpur, Maharashtra, India

Background: Nonalcoholic fatty liver disease (NAFLD) is a multicluster disease ranging from intrahepatic simple steatosis to nonalcoholic steatohepatitis. The growing obesity epidemic is believed to be a main driver of the rising prevalence of NAFLD in adolescents and risk of morbidities and co morbid conditions such as metabolic syndrome, insulin resistance, and cardiovascular morbidity associated to it in long-term. The aim of the study was to find the prevalence of NAFLD in obese and overweight adolescents and to compare prevalence of NAFLD in normal weight and obese adolescents. Methods: Study design - case–control study. Setting - medicine outpatient clinic, IGGMC and Mayo Hospital, Nagpur. Participants - adolescents (age 13–19 years) attending medicine outpatient clinic between April and June 2014. The subjects were evaluated through interviewer administrated questionnaire for history of obesity, physical activity, diet. Physical measurements were taken for blood pressure; anthropometry and biochemical measurements were done to estimate blood sugar, liver function tests - alanine transaminase, aspartate transaminase, bilirubin, and total serum cholesterol. Abdominal ultrasound was done in all the subjects. Fatty liver was defined as presence of an ultrasonographic pattern consistent with “bright liver,” RUMAC CRITERIA was used to classify NAFLD in grades. Sensitivity of ultrasonography is found to be 90-94% and specificity of 95% in detection of moderate and severe hepatic steatosis. Results: In the present study, we found the prevalence of NAFLD to be 46.66% in obese adolescents, 26.66% in overweight, and 6.66% in controls (P = 0.0021). Conclusions: The study revealed that the prevalence of NAFLD is significantly high in obese and overweight adolescents as compared to normal weight adolescent subjects. Hypercholesterolemia, sedentary lifestyle, and extra calorie consumption are factors significantly associated with NAFLD in obese and overweight adolescents.

  3.4.9 Assessment of cognitive functioning and quality of life in sickle cell anemia patients taking hydroxyurea versus those not taking hydroxyurea Top

Sakhare Vaibhav Vikas1

1Government Medical College, Nagpur, Maharashtra, India

Background: Sickle cell disease (SCD) is a group of inherited red blood cell disorders in which patient suffers from different complications such as vaso-occlusive and hematological and infectious crises. Measurement of quality of life is important for knowing the effect of disease on psychosocial parameters and to judge adequacy of treatment and compliance of the patient with the therapy. Hydroxyurea is used to decrease the crises in patient of sickle cell disease. Extremely scarce data are available regarding comparison of disease related quality of life of patients with SCD who are receiving hydroxyurea therapy compared to patients with SCD who are not receiving therapy. Hence, the present study was planned with the objective of assessing and comparing disease specific quality of life (QoL) using SCD-QoL and cognitive functioning using mini mental state exam (MMSE) in SCD adolescent patients taking hydroxyurea and those not taking hydroxyurea. Methods: Total 60 SCD patients included out of which 30 patients were included in hydroxyurea group and 30 patients were included in nonhydroxyurea group. Patients in the age group of 13-18 years, having Hb-SS pattern and who completed Sickle cell disease quality of life questionnaire and MMSE questionnaire during their visit to GMC, Nagpur, were included in the study. GraphPad prism 5.01 was used for statistical analysis. Results: Mean age of patients on hydroxyurea was 15.96 ± 15.35 years while those not taking hydroxyurea was 16.68 ± 18.32 years. Significantly higher MMSE summary score was seen in SCD patients on hydroxyurea treatment (28.23 ± 1.278; P< 0.0001). No significant difference was seen between the two groups in terms of overall SCD-QoL score. Conclusions: No beneficial effect on disease specific quality of life has been observed in hydroxyurea group. Hydroxyurea has beneficial effect on cognition although the mechanisms by which hydroxyurea may improve cognitive outcomes are not clear which warrants further clinical trial in this regard.

  3.4.10 Prevalence of undiagnosed diabetes in patients with chronic liver disease and the utility of glycated hemoglobin in these patients when compared with oral glucose tolerance test Top

Sehrawat Tejasav1, Kohli Paaras1, Gupta Yashdeep1, Jindal Anurag1, Kaur Jasbinder1, Sachdev Atul1

1Government Medical College and Hospitals, Chandigarh, India

Background: Patients with chronic liver disease (CLD) are at increased risk of developing type 2 diabetes mellitus (T2DM). As there are limited data on this aspect, the objective was to understand the distribution of T2DM and prediabetes in patients with CLD. The utility of HbA1c in diagnosis of diabetes in CLD as compared to oral glucose tolerance test (OGTT) has never been evaluated before, which was another objective of this study. Methods: This cross-sectional study included patients with a diagnosis of CLD (n = 124), recruited from gastroenterology outpatient Department and wards. The diagnosis was made clinically, confirmed with ultrasonography and its severity calculated using model for end-stage liver disease and child-turcotte-pugh (CTP) scores. A 75 g OGTT (0 and 2 h) was used for glycemic status categorization. Utility of HbA1c was compared against OGTT. Results: 95 (76.6%) were dysglycemic, including 43 (34.7%) and 52 (41.9%) with T2DM and prediabetes, respectively. The prevalence of diabetes was lowest in CTP class B (24%) as compared to class A (41%) and class C (38%). ADA recommended threshold HbA1c value >48 mmol/mol (6.5%) had a sensitivity and specificity of 82.5% and 91.4% respectively for T2DM. The prevalence of anemia (hemoglobin <12 mg%) was high (74.2%) in our study. The sensitivity of glycated hemoglobin (HbA1c) was less (74%) in anemic patients as compared to nonanemic ones (100%). Conclusions: The extremely high diabetes reported in this study reinforced the need for mandatory screening for T2DM in patients with CLD. Despite high prevalence of anemia in CLD, HbA1c has good utility in evaluation for diabetes.

  3.4.11 A study of factors affecting patients' compliance to antihypertensive medication among adults in the Outpatient Department of a Tertiary Care Hospital, Mumbai Top

Shah Ayushi1, Singh Vijay Kumar1

1Lokmanya Tilak Municipal Medical College, Mumbai, Maharashtra, India

Background: Hypertension is a silent invisible killer that rarely causes symptoms. Hypertension accounts for 9.4 million deaths worldwide yearly. Prevention and control of it must receive priority. This epidemic can be halted by early screening of the population and regular anti-hypertensive medication. Compliance is the extent to which a person's behavior co-incides with medical advice given by a health care provider. Presently noncompliance has only been assumed as the predominant reason for the failure of anti-hypertensive therapy. This study aims to determine the proportion of treatment compliance among hypertensive patients and identify demographic factors affecting compliance. Methods: Design - A cross-sectional study. Population - Patients having hypertension, who were using anti-hypertensive treatment and attending the Medicine Outpatient Department. Sampling size - 330. Simple random sampling was employed. Data were collected using a structured questionnaire. Data analysis was performed using SPSS and MS Excel. Results: It was found that only 39.4% of the study participants were compliant to their treatment & 60.6% of the participants were noncompliant. Of the male, 38% were compliant and of all the female, 42% were compliant. Higher proportion of compliance was recorded among the married (75%) than the unmarried (68.5%). Those who never went to school had higher compliance (80.5%) than those who received education (68.75%). Among those who smoked 21% were compliant, whereas 81% of nonsmokers were compliant. Among those who consumed alcohol, 21% were compliant and 79% were noncompliant. Conclusions: Among the hypertensive participants included in the study, 60.6% were noncompliant and 39.4% compliant. There was an association between compliance and sex with females having higher proportion of compliance than males. Association between education and treatment compliance was found, compliance to anti-hypertensive medication being higher in those who never went to school. Those who were having addictions such as alcoholism and smoking had lesser compliance to treatment.

  3.4.12 Prevalence of symptoms of hand-arm vibration syndrome among construction workers in Manipal Top

Subhashini Bhaskar Rao1, Asha Kamath1

1Kasturba Medical College, Mangalore, Karnataka, India

Background: This study aims at identifying the burden of hand-arm vibration syndrome (HAVS) among the study population, which is triggered by the continuous use of handheld vibratory tools. The syndrome affects the nerves, joints, blood vessels, or connective tissue of hand and forearm producing symptoms such as tingling, numbness, whitening of fingers, muscle and joint pain, neck pain, weakness, difficulty in handling small objects, and opening tight jars in the long run, thus lowering the work efficiency of the individual and making it a social burden. As not much information is available on the prevalence of this syndrome among construction workers in this area our study will help in discerning this syndrome in Manipal. Methods: A cross-sectional study involving 200 construction workers using vibratory tools regularly was conducted in various construction sites in Manipal. A written informed consent was obtained after which they were subjected to a set of questions obtaining the demographic, work details, and symptoms pertaining to the syndrome. Data were subjected to descriptive analysis by assessing the frequency and percentage. Results: Among the 200 people interviewed, the prevalence of various symptoms of HAVS ranged from 5 to 26%. In 140 workers with history of previous jobs, the prevalence of symptoms of HAVS ranged from 0.7 to 30%. Among people having second jobs (2) currently, no one showed any symptoms. There was also an increasing trend in the symptoms with increasing age. Conclusions: The study showed a significant prevalence of the symptoms of HAVS in Manipal. This can be controlled by regular screening programs. Study conducted during working hours and the long questionnaires were the drawbacks.


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   1.2.4 Correlativ...
   1.2.5 Correlatio...
   1.2.6 Focus on p...
   1.2.7 Associati...
   1.2.8 A study o...
   1.2.9 Prevalenc...
   1.2.10 Profile ...
   1.2.11 Measureme...
   1.3.1 Knowledge ...
   1.3.2 Who is mo...
   1.3.3 Trends an...
   1.3.4 Private a...
   1.3.5 Is body i...
   1.3.6 Effect of...
   1.3.7 Assessmen...
   1.3.8 Learning ...
   1.3.9 Impact of ...
   1.3.10 Comparat...
   1.3.11 Knowledg...
   1.3.12 Neck pai...
   1.3.13 Health p...
   1.4.1 Correlatio...
   1.4.2 Intraocul...
   1.4.3 Quality of...
   1.4.4 Study of ...
   1.4.5 Are the e...
   1.4.6 Associati...
   1.4.7 The dange...
   1.4.8 A study o...
   The comparative ...
   1.4.10 Hemodyna...
   1.4.11 Culture-b...
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   2.1.1 Assessmen...
   2.1.2 Assessmen...
   2.1.3 Trend ana...
   2.1.4 Adherence...
   2.1.5 Health ed...
   2.1.6 Effects of...
   2.1.7 Knowledge...
   2.1.8 Tobacco a...
   2.1.9 Predictors...
   2.1.10 A short-...
   2.1.11 Patients...
   2.1.12 Effects o...
   2.1.13 Knowledg...
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   2.2.3 Awareness ...
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   2.2.5 Evaluatio...
   2.2.6 A cross-s...
   2.2.7 Associati...
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   2.2.9 Sesbaniag...
   2.2.10 Analysis...
   2.2.11 Knowledg...
   2.2.12 Do the pa...
   2.2.13 To study...
   2.3.1 A compara...
   2.3.2 Prevalenc...
   2.3.3 A study i...
   2.3.4 Does exce...
   2.3.5 Assessment...
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   2.3.12 To study ...
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   2.4.6 Infant an...
   2.4.7 Patient d...
   2.4.8 Associati...
   2.4.9 Prevalence...
   2.4.10 Prevalen...
   2.4.11 Assessme...
   2.4.12 Effectiv...
   2.4.13 Knowledg...
   3.1.1 Prevalenc...
   3.1.2 Bacteriol...
   3.1.3 Retrospect...
   3.1.4 Prevalence...
   3.1.5 Study of t...
   3.1.6 Pattern an...
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