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   2016| January-March  | Volume 5 | Issue 1  
    Online since June 24, 2016

 
 
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ORIGINAL ARTICLES
Chest pain in general practice: Frequency, management, and results of encounter
Thomas Frese, Jarmila Mahlmeister, Maximilian Heitzer, Hagen Sandholzer
January-March 2016, 5(1):61-66
DOI:10.4103/2249-4863.184625  PMID:27453845
Objective: Chest pain is a common reason for an encounter in general practice. The present investigation was set out to characterize the consultation rate of chest pain, accompanying symptoms, frequency of diagnostic and therapeutic interventions, and results of the encounter. Materials and Methods: Cross-sectional data were collected from randomly selected patients in the German Sδchsische Epidemiologische Studie in der Allgemeinmedizin 2 (SESAM 2) and analyzed from the Dutch Transition Project. Results: Overall, 270 patients from the SESAM 2 study consulted a general practitioner due to chest pain (3% of all consultations). Chest pain was more frequent in people aged over 45 years. The most common diagnostic interventions were physical examination, electrocardiogram at rest and analysis of blood parameters. For the majority of cases, the physicians arranged a follow-up consultation or prescribed drugs. The transition project documented 8117 patients reporting chest pain with a frequency of 44.5/1000 patient years (1.7% of all consultations). Physical examination was also the most common diagnostic intervention, and physician's advice the most relevant therapeutic one. Conclusion: The most common causes for chest pain were musculoskeletal problems followed by cardiovascular diseases. Ischemic heart disease, psychogenic problems, and respiratory diseases each account for about 10% of the cases. However, acutely dangerous causes are rare in general practice.
  7 1,823 402
REVIEW ARTICLE
Vaccine epidemiology: A review
Chandrakant Lahariya
January-March 2016, 5(1):7-15
DOI:10.4103/2249-4863.184616  PMID:27453836
This review article outlines the key concepts in vaccine epidemiology, such as basic reproductive numbers, force of infection, vaccine efficacy and effectiveness, vaccine failure, herd immunity, herd effect, epidemiological shift, disease modeling, and describes the application of this knowledge both at program levels and in the practice by family physicians, epidemiologists, and pediatricians. A case has been made for increased knowledge and understanding of vaccine epidemiology among key stakeholders including policy makers, immunization program managers, public health experts, pediatricians, family physicians, and other experts/individuals involved in immunization service delivery. It has been argued that knowledge of vaccine epidemiology which is likely to benefit the society through contributions to the informed decision-making and improving vaccination coverage in the low and middle income countries (LMICs). The article ends with suggestions for the provision of systematic training and learning platforms in vaccine epidemiology to save millions of preventable deaths and improve health outcomes through life-course.
  6 2,302 653
ORIGINAL ARTICLES
Household use of iodized salt in rural area
Rupali Roy, Manish Chaturvedi, Deepika Agrawal, Haroon Ali
January-March 2016, 5(1):77-81
DOI:10.4103/2249-4863.184628  PMID:27453848
Background: Iodine deficiency is the world's single greatest cause of preventable mental retardation. In developing countries, only 69% of households are consuming iodized salt. Objective: To assess knowledge and practices with respect to the current use of iodized salt, and to estimate its uptake at the household level. Materials and Methods: This cross-sectional survey was conducted in six villages under Rural Health Training Center. A total number of households surveyed were 253. The data collectors obtained verbal consent from the Family, and Pretested Standardized Questionnaire was administered in every selected household. The respondents were asked questions regarding salt purchasing and consumption habits, salt storage, awareness of iodized salt, and iodine deficiency diseases. Rapid iodized salt test kit (MBI kit) was used in the survey to assess iodine content in salt used in households. Results: In this study, 93.7% households were using packet salt. The most common source of information was a television (31.1%). More than half (53.8%) of the households were unaware of the benefits of iodine. About 62.5% of households were consuming adequately iodized salt. Significant association was found between the practice of storing salt in closed containers and use of packaged iodized salt (Chi-square value −37.6, P < 0.001), awareness about the benefits of iodine and type of salt used (P = 0.02) while no association was observed between the socioeconomic status and type of salt used in the household. Conclusions: Though the use of packet salt was more than 90%, adequately iodized salt was consumed only in 62.5%, and more than half of the subjects lacked the knowledge about iodine deficiency diseases.
  5 1,190 188
Physicians' professionalism at primary care facilities from patients' perspective: The importance of doctors' communication skills
Merry Indah Sari, Yayi Suryo Prabandari, Mora Claramita
January-March 2016, 5(1):56-60
DOI:10.4103/2249-4863.184624  PMID:27453844
Background: Professionalism is the core duty of a doctor to be responsible to the society. Doctors' professionalism depicts an internalization of values and mastery of professionals' standards as an important part in shaping the trust between doctors and patients. Professionalism consists of various attributes in which current literature focused more on the perspective of the health professionals. Doctors' professionalism may influence patients' satisfaction, and therefore, it is important to know from the patients' perspectives what was expected of medical doctors' professionalism. Objective: This study was conducted to determine the attributes of physician professionalism from the patient's perspective. Materials and Methods: This was a qualitative research using a phenomenology study design. In-depth interviews were conducted with 18 patients with hypertension and diabetes who had been treated for at least 1 year in primary care facilities in the city of Yogyakarta, Indonesia. The results of the interview were transcribed, encoded, and then classified into categories. Results: Communication skills were considered as the top priority of medical doctors' attributes of professionalism in the perspectives of the patients. Conclusion: This study revealed that communication skill is the most important aspects of professionalism which greatly affected in the process of health care provided by the primary care doctors. Doctor-patient communication skills should be intensively trained during both basic and postgraduate medical education.
  4 1,464 312
Association of quality of life of carers with quality of life and functional independence of stroke survivors
Deepak Ganjiwale, Jaishree Ganjiwale, Shweta Parikh
January-March 2016, 5(1):129-133
DOI:10.4103/2249-4863.184637  PMID:27453857
Background: Stroke has a great impact not only on patients' but also on their caregivers' lives. Carers may experience high levels of burden that can result in deterioration of their health status, social life, and well-being. Association between quality of life (QOL) of carers and that of stroke survivors in Indian setting is not much researched. Aims and Settings: To find out QOL and mental health of caregivers of individuals with stroke visiting Physiotherapy Department of Tertiary Care Center in Western India. Design and Methodology: A cross-sectional survey to find QOL and mental health of caregiver of stroke survivors, self-administered screening instrument WHO-QOL BREF, functional independence measurement (FIM) scale, and BRIEF COPE were used for data collection on adult populations. Statistical Analysis Used: The statistical analysis was performed by descriptive analysis and correlation. Result: Fifty-four stroke patients and their caregivers (all adults) were included in the study. Average FIM score was 83.75 (18.46) while median was 90 (25). FIM score of patients did not much affect QOL of caregivers. Discussion: Analysis of QOL data showed that QOL of caregivers was good in all domains, but patient's QOL was good only in social relations. There was no correlation found in QOL of carers and stroke survivors. Nine percent of change in caregivers social relationship scores can be attributed to patients' sphincter scores. Conclusion: QOL of carers and stroke survivors may be independent. Stroke patients in the study required a moderate assistance for their functional independence which does not seem to affect the caregivers QOL significantly.
  4 1,571 373
Effects of a physical activity program on the quality of life among elderly people in Brazil
Eduardo da Fonte, Pedro Henrique Feitosa, Luiz Teixeira de Oliveira Neto, Carla Leal de Araķjo, Josť Natal Figueiroa, Jo„o Guilherme Alves
January-March 2016, 5(1):139-142
DOI:10.4103/2249-4863.184639  PMID:27453859
Purpose: To assess the quality of life (QOL) of elderly people in the "Academia da Cidade program" (ACP), a public Brazilian Government Program encourages physical and leisure activity in Recife, Brazil. Materials and Methods: This cross-sectional study evaluated 181 elderly people attending the "ACP" at least twice a week. Demographic, socioeconomic, and clinical data were presented according to World Health Organization QOL (WHOQOL)-BREF and WHOQOL-OLD scores. Results: Univariate analysis showed that WHOQOL-BREF and WHOQOL-OLD scores were positively associated with longer duration of participation in "ACP," P < 0.030 and P < 0.003, respectively, a multivariate regression analysis showed that duration of participation in "ACP" remained associated with higher WHOQOL-BREF (P = 0.023) and WHOQOL-OLD (P = 0.038) scores. Conclusion: A longer duration of participation in a community-based physical activity program, "ACP," may contribute to a better QOL for the elderly in Brazil.
  4 1,058 193
Correlation between the percentage of body fat and surrogate indices of obesity among adult population in rural block of Haryana
Madhur Verma, Meena Rajput, Soumya Swaroop Sahoo, Navjot Kaur, Ravi Rohilla
January-March 2016, 5(1):154-159
DOI:10.4103/2249-4863.184642  PMID:27453862
Introduction: The increasing prevalence of overweight and obesity has raised concerns regarding the importance of different techniques, which are used to assess body growth composition that can be used at the level of primary health care settings with minimal knowledge. The purpose of this study was to evaluate the relationship between different surrogate indices of fatness (body mass index [BMI], waist circumference [WC], waist-to-hip ratio [WHR], waist-to-height ratio [WHtR], and body fat percentage [BF%]) with the percentage of body fat and their usefulness as a predictor of obesity among adult population. Materials and Methods: The community-based cross-sectional study done over a period of 1-year involved 1080 adult participants from a rural area in Haryana. Anthropometry, along with BF% (using hand held analyzer) were recorded using standard procedures. Results: The prevalence of overweight and obesity as per the modified criteria of BMI for the Asian Indians was found to be 15.0% and 34.6%, respectively. Positive correlation was seen among all the indices except between the WHR and body adiposity index (BAI) using Pearson's correlation analysis. Maximum correlation was seen between WHtR and WC (r = 0.923), whereas WHtR depicted maximum correlation (r = 0.810) with BF%. Receiver operating characteristic curve analysis revealed that the WHtR was the most sensitive and specific indicator for the study population to predict overweight and obesity comparable to that calculated by body fat analyser followed by BAI, BMI, and WHR. Conclusion: A single value of WHtR irrespective of gender and the area of residence can be used as a universal screening tool for the identification of individuals at high risk of development of metabolic complications.
  4 1,245 203
EDITORIAL
Training doctors for primary care in China: Transformation of general practice education
Donald Li
January-March 2016, 5(1):1-2
DOI:10.4103/2249-4863.184614  PMID:27453834
China is known for developing a cadre of "Barefoot Doctors" to address her rural healthcare needs in past. The tradition of barefoot doctors has inspired similar developments in several other countries across world. Recently China has embarked upon an ambitious new mission to create a primary care workforce consisting of trained general practitioners having international standard skillsets. This editorial provides an insight into the current status of policy deliberations with regards to training of primary care doctors and a new surge in general practice education in China.
  3 1,650 386
ORIGINAL ARTICLES
A household survey to assess community knowledge, attitude and practices on malaria in a rural population of Northern India
Rajiv Kumar Gupta, Sunil Kumar Raina, Tajali N Shora, Rayaz Jan, Renu Sharma, Shahid Hussain
January-March 2016, 5(1):101-107
DOI:10.4103/2249-4863.184632  PMID:27453852
Introduction: An extensive search on PubMed reveals very little in terms of evidence regarding the current knowledge, attitude, and practices (KAP) of the population in general and rural population, in particular, in this part of the country. Therefore, a study was conducted with the aim to assess the communities' knowledge of malaria transmission, recognition of signs and symptoms, treatment seeking. Materials and Methods: A stratified two-stage design was used to conduct a house-to-house survey using a semi-structured questionnaire in RS Pura block of Jammu District of Jammu and Kashmir State in North India. Results: A total of 300 households were included in the study. However, data on 4 households was found to be incomplete at the time of analysis and, therefore, were excluded. Out of 296 study participants interviewed 65.5% were males, while 34.5% females. All of the study participants (100%) had heard of malaria, and the main source of their information was television/newspaper. 92.5% of the study population considered malaria to be a serious health problem, thus reflecting their attitude to the disease. Regarding practices, 71.6% of the study participants preferred going to doctors at government hospitals for malaria treatment, and 56% were willing to seek medical help in <24 h in case of a child has a febrile episode. Conclusions: Results revealed that KAP among respondents were reasonably good and key sociocultural, and related indicators need to be identified as a part of malaria elimination strategy.
  3 1,526 264
A study of prevalence of depression and anxiety in patients suffering from tuberculosis
Kunal Kumar, Abhinit Kumar, Prakash Chandra, Hari Mohan Kansal
January-March 2016, 5(1):150-153
DOI:10.4103/2249-4863.184641  PMID:27453861
Objective: The study was conducted to determine the point prevalence of depression and anxiety in patients suffering from tuberculosis. Material and Methods: Total of 100 consecutive cases were included who were already diagnosed with tuberculosis after applying inclusion and exclusion criteria. Tools used were General Health Questionnaire 12 (GHQ-12), Beck Depression Inventory (BDI-II) and Hamilton Anxiety Rating Scale (HARS). Result: Out of 100 cases, 74 cases found to be having psychiatric symptoms, in which 35 cases were suffering from depression and 39 were suffering from anxiety. Conclusion: Psychiatric morbidity was present in the diagnosed cases of tuberculosis. Proper psycho education, timely intervention in the form of proper diagnosis and specific treatment was required. It should also be evaluated further on a bigger target population.
  3 1,432 313
Profile of deliberate self-harm patients presenting to Emergency Department: A retrospective study
Moses Kirubairaj Amos Jegaraj, Shubhanker Mitra, Sathish Kumar, Bagyalakshmi Selva, Manimaran Pushparaj, Bijesh Yadav, Abhilash Kundavaram Paul Prabhakar, Alex Reginald
January-March 2016, 5(1):73-76
DOI:10.4103/2249-4863.184627  PMID:27453847
Background: Deliberate self-harm (DSH) is a major under-recognized epidemic in the low- and middle-income countries. This is a large retrospective study form the Emergency Department (ED) of Tertiary Care Center of South India to describe the clinicodemographic features of DSH cases. Materials and Methods: This is a retrospective study conducted at ED of Christian Medical College, Vellore, India from January 01, 2011 to December 31, 2013. All cases of DSH were included in the study. The demographic details, mode of DSH and clinical outcome were extracted from the electronic medical record. Descriptive statistics are presented. Chi-square test was used to compare categorical variables. For all tests, a two-sided P ≤ 0.05 was considered statistically significant. Results: Total of 1228 patients were admitted to ED for DSH during the study period. Male and female occurred in equal ratio. More than half of the cases occurred among age group below 30 years. Consumption of pesticides (agricultural chemicals) was the single most common mode of DSH (46%), especially among men, followed by medication overdose (29.8%). Consumption of plant poison and tablet overdose was higher among women. Overall mortality due to DSH was low (1.5%) in our study. Conclusion: DSH is under-recognized major public health problem in low-middle income countries like India. Most cases occur among young and productive age group and in equal frequencies among men and women. Timely and the appropriate institution of treatment can decrease the morbidity and mortality due to DSH remarkably.
  3 1,089 179
CASE REPORTS
Neuroleptic malignant syndrome
Bino Rajamani, Yashwant Kumar, Sajitha M.F. Rahman
January-March 2016, 5(1):178-180
DOI:10.4103/2249-4863.184660  PMID:27453870
Neuroleptic malignant syndrome (NMS) is a life-threatening emergency that is often seen as a complication of antipsychotic agents. It is characterized by a tetrad of motor, behavioral, autonomic, and laboratory abnormalities. We report a case of a 34-year-old man with a history of newly diagnosed Type 2 diabetes mellitus, mental retardation, and behavioral abnormalities who developed NMS after starting on antipsychotic agents. He presented with high temperature, muscle rigidity, tachycardia, and elevated blood pressure. After a week of hospital treatment in the general ward of a secondary care unit, he was discharged in a hemodynamically and mentally stable state.
  2 1,291 276
ORIGINAL ARTICLES
Choosing to become a general practitioner - What attracts and what deters? An analysis of German medical graduates' motives
Tobias Deutsch, Stefan Lippmann, Maximilian Heitzer, Thomas Frese, Hagen Sandholzer
January-March 2016, 5(1):34-41
DOI:10.4103/2249-4863.184620  PMID:27453840
Background: To be able to counter the increasing shortage of general practitioners (GPs) in many countries, it is crucial to remain up-to-date with the decisive reasons why young physicians choose or reject a career in this field. Materials and Methods: Qualitative content analysis was performed using data from a cross-sectional survey among German medical graduates (n = 659, response rate = 64.2%). Subsequently, descriptive statistics was calculated. Results: The most frequent motives to have opted for a GP career were (n = 74/81): Desire for variety and change (62.2%), interest in a long-term bio-psycho-social treatment of patients (52.7%), desire for independence and self-determination (44.6%), positively perceived work-life balance (27.0%), interest in contents of the field (12.2%), and reluctance to work in a hospital (12.2%). The most frequent motives to have dismissed the seriously considered idea of becoming a GP were (n = 207/578): Reluctance to establish a practice or perceived associated risks and impairments (33.8%), stronger preference for another field (19.3%), perception of workload being too heavy or an unfavorable work-life balance (15.0%), perception of too low or inadequate earning opportunities (14.0%), perception of the GP as a "distributor station" with limited diagnostic and therapeutic facilities (11.6%), perception of too limited specialization or limited options for further sub-specialization (10.6%), rejection of (psycho-) social aspects and demands in general practice (9.7%), and perceived monotony (9.7%). Conclusion: While some motives appear to be hard to influence, others reveal starting points to counter the GP shortage, in particular, with regard to working conditions, the further academic establishment, and the external presentation of the specialty.
  2 1,745 236
Validity and reliability of the developmental assessment screening scale
Ajay Singh, Jane Squires, Chia Jung Yeh, Kay H Heo, Hui Bian
January-March 2016, 5(1):124-128
DOI:10.4103/2249-4863.184636  PMID:27453856
Objectives: To develop and validate the 6-year Ages and Stages Questionnaire (ASQ) for school-age children. Methods: Parents/caregivers of children 66-78 months were recruited from 6 countries and 15 states in the United States. Similar to other ASQ intervals, the 6-year ASQ has five developmental domains targeted for children from 66 months to 78 months of age. We assessed internal consistency reliability, test-retest reliability, the scale structure, validity (correlation coefficients), and utility of the 6-year ASQ. The 6-year ASQ screens development in five domains using 30 items. Results: Coefficient alpha measuring internal consistency was 0.97. Test-retest reliability was estimated by having parents complete two ASQ's on the same child within a week interval. Correlations between scores of the two ASQ's reflected stability of scores. Test-retest reliability results were robust with an intraclass correlation coefficient of 0.94. Factor analysis results resulted in a five factors structure. The Pearson correlations coefficients between the latent variables were moderate to large and statistically significant, P < 0.0001. The 6-year ASQ screens development in five domains using 30 items. The administration time varied from 10 to 60 min with a mean of 15.17 min. General utility result shows that the 6-year ASQ can be used with satisfaction by caregivers, pediatricians, professionals, and parents. Conclusions: Preliminary data on the 6-year ASQ reflected promising results. An easy-to-administer, accurate caregiver-completed screening tool may increase the frequency of screening for school-age children.
  2 1,494 251
Organizational commitment and intrinsic motivation of regular and contractual primary health care providers
Pawan Kumar, Anu Mehra, Deep Inder, Nandini Sharma
January-March 2016, 5(1):94-100
DOI:10.4103/2249-4863.184631  PMID:27453851
Background: Motivated and committed employees deliver better health care, which results in better outcomes and higher patient satisfaction. Objective: To assess the Organizational Commitment and Intrinsic Motivation of Primary Health Care Providers (HCPs) in New Delhi, India. Materials and Methods: Study was conducted in 2013 on a sample of 333 HCPs who were selected using multistage stage random sampling technique. The sample includes medical officers, auxiliary nurses and midwives, and pharmacists and laboratory technicians/assistants among regular and contractual staff. Data were collected using the pretested structured questionnaire for organization commitment (OC), job satisfiers, and intrinsic job motivation. Analysis was done by using SPSS version 18 and appropriate statistical tests were applied. Results: The mean score for OC for entire regular staff is 1.6 ± 0.39 and contractual staff is 1.3 ± 0.45 which has statistically significant difference (t = 5.57; P = 0.00). In both regular and contractual staff, none of them show high emotional attachment with the organization and does not feel part of the family in the organization. Contractual staff does not feel proud to work in a present organization for rest of their career. Intrinsic motivation is high in both regular and contractual groups but intergroup difference is significant (t = 2.38; P < 0.05). Contractual staff has more dissatisfier than regular, and the difference is significant (P < 0.01). Conclusion: Organizational commitment and intrinsic motivation of contractual staff are lesser than the permanent staff. Appropriate changes are required in the predictors of organizational commitment and factors responsible for satisfaction in the organization to keep the contractual human resource motivated and committed to the organization.
  2 1,208 209
CASE REPORTS
Warfarin-induced leukocytoclastic vasculitis and proteinuria
Khalid Jumean, Ahmad Abu Arqoub, Amer Hawatmeh, Firas Qaqa, Ayham Bataineh, Hamid Shaaban
January-March 2016, 5(1):160-162
DOI:10.4103/2249-4863.184643  PMID:27453863
Warfarin is typically prescribed for patients with thromboembolic diseases and atrial fibrillation. In addition to the complications of bleeding, allergic skin reaction is one of its rare adverse effects. We herein report a case of a 79 year old male patient with leukocytoclastic vasculitis and proteinuria secondary to warfarin. The warfarin was discontinued and oral prednisone therapy was initiated. The cutaneous lesions and the proteinuria resolved thereafter.
  1 1,138 165
Massive ovarian edema: A case report presenting as a diagnostic dilemma
Amit Varma, Preeti Rihal Chakrabarti, Garima Gupta, Priyanka Kiyawat
January-March 2016, 5(1):172-174
DOI:10.4103/2249-4863.184658  PMID:27453868
Massive ovarian edema is a rare clinical entity, posing a significant clinical challenge as it can be easily mistaken for neoplasm. Our case was a 20-year-old young woman who presented with a self-limiting episode of abdominal pain along with large solid pelvis mass. On physical examination, she had abdominal tenderness with guarding. Ultrasound examination revealed large solid ovarian mass with moderate ascites. With the diagnosis of ovarian neoplasm, laparotomy was performed, and intraoperative frozen section excluded malignancy with differentials suggesting of fibromatosis/massive ovarian edema. The patient underwent unilateral salpingo-oophorectomy. Histopathological examination confirmed the diagnosis of massive ovarian edema. Massive ovarian edema should be suspected in women at the fertility age range with solid enlargement of the ovary so that these young patients can be treated conservatively where fertility preservation is mandatory.
  1 855 165
COMMENTARIES
Medical Education: The Hot Seat
Ranabir Pal, Raman Kumar, Shrayan Pal, Vidyasagar , Bijay Mukherji, Sarbapalli Debabrata
January-March 2016, 5(1):20-23
DOI:10.4103/2249-4863.184618  PMID:27453838
Medical science has eventually metamorphosed from 'Knowledge based' to 'Skill based' applied social science. So, the age-old traditional courses and curriculums in Indian medical education need a overhauling with radical modifications. With a paradigm shift, we have to take into account not only the help of scientific feedback from the teachers and students but also from all the stakeholders of health care delivery system.
  1 981 145
FAQS: FAMILY MEDICINE
Frequently asked questions about family medicine in India
Raman Kumar
January-March 2016, 5(1):3-6
DOI:10.4103/2249-4863.184615  PMID:27453835
Family medicine (FM) is an independent and distinct medical specialty in the developed countries such as USA, UK, Australia, and Canada since 1960s. FM teaching is imparted at undergraduate and postgraduate levels in countries such as Nepal, Pakistan, and Sri Lanka. Family practice is the practicing vocation of the majority doctors in India. The practitioners of FM include general practitioners, family physicians, FM specialists, and medical officers in the public sector. Medical students are largely unaware about FM career as this concept is not introduced at MBBS level. Faculty and senior doctors from other disciplines are also not able to answer the queries related to FM as they themselves also have gone through the same education system for last three decades, largely unexposed to the concept of academic family medicine. This article is a compilation of frequently asked questions, and their appropriate responses, presented here to dispel myths and misinformation about FM specialty. The answers are deliberated upon by Dr. Raman Kumar the founder president of the Academy of Family Physicians of India and the chief editor of the Journal of Family Medicine and Primary Care. This article was originally published as an interview in Docplexus, a popular online network and website for medical doctors in November 2015.
  1 4,541 378
LETTERS TO EDITOR
Natal and neonatal teeth: Terminologies with diverse superstitions!!
Ujwala Rohan Newadkar, Lalit Chaudhari, Yogita K Khalekar
January-March 2016, 5(1):184-185
DOI:10.4103/2249-4863.184663  PMID:27453872
  1 1,253 145
ORIGINAL ARTICLES
Statistical methods and errors in family medicine articles between 2010 and 2014-Suez Canal University, Egypt: A cross-sectional study
Hebatallah Nour-Eldein
January-March 2016, 5(1):24-33
DOI:10.4103/2249-4863.184619  PMID:27453839
Background: With limited statistical knowledge of most physicians it is not uncommon to find statistical errors in research articles. Objectives: To determine the statistical methods and to assess the statistical errors in family medicine (FM) research articles that were published between 2010 and 2014. Methods: This was a cross-sectional study. All 66 FM research articles that were published over 5 years by FM authors with affiliation to Suez Canal University were screened by the researcher between May and August 2015. Types and frequencies of statistical methods were reviewed in all 66 FM articles. All 60 articles with identified inferential statistics were examined for statistical errors and deficiencies. A comprehensive 58-item checklist based on statistical guidelines was used to evaluate the statistical quality of FM articles. Results: Inferential methods were recorded in 62/66 (93.9%) of FM articles. Advanced analyses were used in 29/66 (43.9%). Contingency tables 38/66 (57.6%), regression (logistic, linear) 26/66 (39.4%), and t-test 17/66 (25.8%) were the most commonly used inferential tests. Within 60 FM articles with identified inferential statistics, no prior sample size 19/60 (31.7%), application of wrong statistical tests 17/60 (28.3%), incomplete documentation of statistics 59/60 (98.3%), reporting P value without test statistics 32/60 (53.3%), no reporting confidence interval with effect size measures 12/60 (20.0%), use of mean (standard deviation) to describe ordinal/nonnormal data 8/60 (13.3%), and errors related to interpretation were mainly for conclusions without support by the study data 5/60 (8.3%). Conclusion: Inferential statistics were used in the majority of FM articles. Data analysis and reporting statistics are areas for improvement in FM research articles.
  1 1,006 227
Risk factor distribution for cardiovascular diseases among high school boys and girls of urban Dibrugarh, Assam
Gupta Ekta, Mahanta Goswami Tulika
January-March 2016, 5(1):108-113
DOI:10.4103/2249-4863.184633  PMID:27453853
Introduction: Chronic noncommunicable diseases (NCDs) including cardiovascular diseases (CVDs) are the leading cause of death in the world, and their incidence is rising rapidly due to increasing rates of risk factors such as hypertension, dyslipidemia, diabetes, obesity, physical inactivity, and tobacco use. These risk factors track from childhood to adulthood, and their distribution varies among males and females; hence, there is a need to determine risk factor prevalence among adolescent age group so as to plan preventive strategies. Objective: To determine the distribution of risk factors of CVDs amongst high school boys and girls of urban Dibrugarh, Assam. Subjects and Methods: A cross-sectional study was conducted from October 2012 to June 2013 in the schools of urban Dibrugarh, Assam wherein data was collected from 1000 students of Class 8-10 using multistage random sampling and risk factors were assessed using WHO steps methodology. Statistical Analysis: Statistical analysis was done using SPSS 16 software and test of differences used were Chi-square test and t-test. Results: The prevalence of ever tobacco use was 32.3% among boys and 6.6% among girls (P < 0.001) while ever alcohol use was reported by 11.9% boys and 1% girls (P < 0.001). Prevalence of overweight and hypertension was found to be higher among girls (11.7% and 24.1%) as compared to boys (6.8% and 18.1%). Prevalence of hypercholesterolemia was higher among boys while high triglycerides levels were more prevalent among girls. Conclusion: The study revealed a high prevalence of various risk factors among boys and girls. There is a need to reduce the risk factor prevalence of CVD among this group of the population to address the future epidemic of NCD. Different health promotional activities need to be implemented to target boys and girls as the risk factor distribution among these groups is different.
  1 934 201
Modifiable risk factors of hypertension: A hospital-based case-control study from Kerala, India
Zarin Pilakkadavath, Muhammed Shaffi
January-March 2016, 5(1):114-119
DOI:10.4103/2249-4863.184634  PMID:27453854
Introduction: Hypertension is a major cause of cardiovascular morbidity and mortality in Kerala. Excess dietary salt, low dietary potassium, overweight and obesity, physical inactivity, excess alcohol, smoking, socioeconomic status, psychosocial stressors, and diabetes are considered as modifiable risk factors for hypertension. Objectives: To estimate and compare the distribution of modifiable risk factors among hypertensive (cases) and nonhypertensive (controls) patients and to estimate the effect relationship of risk factors. Materials and Methods: Age- and sex-matched case-control study was conducted in a tertiary care hospital in Kerala using a pretested interviewer-administered structured questionnaire based on the WHO STEPS instrument for chronic disease risk factor surveillance. Bivariate and multiple logistic regression analyses were done. Results: A total of 296 subjects were included in the study. The mean age of study sample was 50.13 years. All modifiable risk factors studied vis-ΰ-vis obesity, lack of physical activity, inadequate fruits and vegetable intake, diabetes, smoking, and alcohol use were significantly different in proportion among cases and controls. Obesity, lack of physical activity, smoking, and diabetes were found to be significant risk factors for hypertension after adjusting for other risk factors. Conclusion: Hypertension is strongly driven by a set of modifiable risk factors. Massive public awareness campaign targeting risk factors is essential in controlling hypertension in Kerala, especially focusing on physical exercise and control of diabetes, obesity, and on quitting smoking.
  1 1,872 361
Correlation study between platelet count, leukocyte count, nonhemorrhagic complications, and duration of hospital stay in dengue fever with thrombocytopenia
Hari Kishan Jayanthi, Sai Krishna Tulasi
January-March 2016, 5(1):120-123
DOI:10.4103/2249-4863.184635  PMID:27453855
Introduction: Dengue is one of the common diseases presenting as fever with thrombocytopenia, also causing significant morbidity and complications. Objectives: Though the correlation between platelet count, bleeding manifestations and hemorrhagic complications has been extensively studied, less is known about the correlation between platelet count and non hemorrhagic complications. This study was done to see the correlation between platelet count and non hemorrhagic complications, duration of hospital stay and additive effect of leucopenia with thrombocytopenia on complications. Methods: Our study is prospective observational study done on 99 patients who had dengue fever with thrombocytopenia. Correlations were obtained using scatter plot and SPSS software trail version. Results: Transaminitis (12.12%) was the most common complication followed by acute renal injury (2%). In our study we found that, as the platelet count decreased the complication rate increased (P = 0.0006). In our study duration of hospital increased (P is 0.00597) with decreasing platelet count when compared to other study where there was no correlation between the two. There was no correlation between thrombocytopenia with leucopenia and complications (P is 0.292), similar to other study. Conclusion: Platelet count can be used to predict the complication and duration of hospital stay and hence better use of resources.
  1 1,339 293
Depressive symptoms and bone mineral density in menopause and postmenopausal women: A still increasing and neglected problem
Abdulbari Bener, Najah M Saleh, Dinesh Bhugra
January-March 2016, 5(1):143-149
DOI:10.4103/2249-4863.184640  PMID:27453860
Background: The association between depression and loss of bone mineral density (BMD) has been reported as controversial. Objective: The objectıve of the current study was to investigate whether an association exists between depression and low BMD during the menopausal and postmenopausal period. Materials and Methods: A cross-sectional descriptive study was used to generate menopause symptoms experienced by Arabian women at the Primary Health Care Centers in Qatar. A multi-stage sampling design was used, and a representative sample of 1650 women aged 45-65 years were included during July 2012 and November 2013. This prospective study explored the association between bone density and major depressive disorder in women. Bone mineral densitometry measurements (BMD) (g/m 2 ) were assessed at the BMD unit using a lunar prodigy DXA system (Lunar Corp., Madison, WI). Data on body mass index (BMI), clinical biochemistry variables including serum 25-hydroxyvitamin D were collected. The Beck Depression Inventory was administered for depression purposes. Results: Out of 1650 women 1182 women agreed to participate in the study (71.6%). The mean age and standard deviation (SD) of the menopausal age were 48.71 ± 2.96 with depressed and 50.20 ± 3.22 without depressed (P < 0.001). Furthermore, the mean and SD of postmenopausal age were 58.55 ± 3.27 with depression and 57.78 ± 3.20 without depression (P < 0.001). There were statistically significant differences between menopausal stages with regards to a number of parity, and place of living. There were statistically significant differences between menopausal stages with regards to BMI, systolic and diastolic blood pressure, Vitamin D deficiency, calcium deficiency and shisha smoking habits. Overall, osteopenia and osteoporosis and bone loss were significantly lower in postmenopausal women than in menopausal women (P < 0.001). Similarly, T-score and Z-score were lower with depression menopause and postmenopausal women (P < 0.001). The multivariate logistic regression analyses revealed that the depression, the mean serum Vitamin D deficiency, calcium level deficiency, less physical activity, comorbidity, number of parity, systolic and diastolic blood pressure and shisha smoking habits were considered as the main risk factors associated with bone mineral loss after adjusting for age, BMI and other variables. Conclusion: Depression is associated with low BMD with a substantially greater BMD decrease in depressed women and cases of clinical depression. Depression should be considered as an important risk factor for osteoporosis.
  1 1,148 245
The influence of escort during upper endoscopy and colonoscopy on patient satisfaction and anxiety
Jafar Nasiri, Narges Khatib, Soleiman Kheiri, Mostafa Najafi
January-March 2016, 5(1):134-138
DOI:10.4103/2249-4863.184638  PMID:27453858
Aim: Endoscopy, including esophagogastroduodenoscopy (EGD) and colonoscopy (CS), is a diagnostic and treatment method for various diseases. We aimed to evaluate the effects of the presence of an escort by the patient on patients' satisfaction and anxiety level before and after upper endoscopy and CS. Subjects and Methods: Patients who referred to the Hajar Hospital for elective EGD and CS were recruited. The patients were divided into two groups: The first group underwent endoscopy/CS with an escort beside the patient and the escort was waiting in the waiting room in the second group. After interventions, patients' and their escort's levels of anxiety and satisfaction were evaluated. Anxiety level was compared before and after endoscopy. Results: Of 211 patients, 106 were referred for EGD and 105 for CS. Anxiety was same in both groups before the interventions (P > 0.05), which decreased in both after the EGD or CS (P < 0.05). Anxiety reduction after CS was influenced by the presence of the escort and the level of anxiety was less in this group than other group (P < 0.05). Satisfaction of the EGD and CS in the group that had an escort by their side was more than the other (P < 0.05). Escorts had a moderate level of anxiety in both groups with a marked reduction after endoscopy and CS (P < 0.05). However, the level of anxiety before and after endoscopy was similar in both groups (P > 0.05). Conclusion: Having an escort at the time of endoscopy or CS appears to be an effective costless complication-free measure for increasing satisfaction and reducing anxiety in patients.
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Has the inclusion of a longitudinally integrated communication skills program improved consultation skills in medical students? A pilot study
Sameena Shah, Marie Andrades, Fasia Basir, Anila Jaleel, Iqbal Azam, Muhammad Islam, Rashida Ahmed
January-March 2016, 5(1):45-50
DOI:10.4103/2249-4863.184622  PMID:27453842
Background: Evidence highlights a lack of communication skills in doctors leading to dysfunctional consultations. To address this deficit, a private medical college instituted curricular reforms with inclusion of a longitudinal communication skills program. A pilot study was undertaken to evaluate the effectiveness of this program by comparing the consultation skills of medical students of this college with a medical college without a communication skills program. Methods: A 4-station Objective Structured Clinical Examination (OSCE) was conducted in the third and final year. Mann-Whitney U-test was used to compare the difference in the distribution between OSCE stations total and construct scores. Results: At the end of the third year, 21 (31.34%), students of the study site (medical college 1 [college with integrated longitudinal communication skills program]) and 31 (46.26%) students from the comparison site (medical college 2 [comparable college without communication skills program]) consented. Medical college 1 achieved a significantly higher overall mean total station score of 68.0% (standard deviation [SD] =13.5) versus 57.2% (SD = 15.4) (P < 0.001). Significantly higher mean scores were achieved on three stations. At the end of the final year, 19 students (29.3%) from medical college 1 and 22 (34%) students from medical college 2 consented. The difference in overall mean total station score reduced from 9.2% to 7.1% (70.2) (SD = 13.7) versus 63.1 (SD = 15.2) (P = 0.004). The mean scores of both colleges decreased in "Patient presenting with Hepatitis C Report" station (P values 0.004 and 0.775) and in "Patient Request for Faith Healing Therapy in Diabetes Mellitus" station (P values 0.0046 and 0.036), respectively. Conclusion: Longitudinal communication skills in an undergraduate curriculum positively impacted consultation skills. Community-based training and faculty development are required to develop effective patient-centered consultation skills.
  1 1,068 213
CASE REPORTS
Recurrent mania consequent to quinolones exposure: A case report and review of literature
Swapnajeet Sahoo, Jitender Aneja, Debasish Basu
January-March 2016, 5(1):163-165
DOI:10.4103/2249-4863.184654  PMID:27453864
Antibiotics are the one of the most commonly used group, of drugs, in general medical and surgical practice. The quinolone antibiotics can lead to a range of adverse neuropsychiatric effects with most of the reports due to ciprofloxacin and ofloxacin. Here, we report an interesting and rarely described psychiatric manifestation of recurrent mania following the use of quinolone antibiotics, and briefly review the available literature.
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Hymenolepis diminuta infection in a young boy from rural part of Northern India
Pratibha Mane, Jyoti Sangwan
January-March 2016, 5(1):166-167
DOI:10.4103/2249-4863.184655  PMID:27453865
Hymenolepis diminuta (H. diminuta) is primarily a parasite of rats and mice. Humans are infected by eating meal contaminated with these arthropods. This infection is not seen commonly in Indian population. We present here a case report of infection with H. diminuta in a young boy from a rural area of the North India.
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Split-hand/feet malformation: A rare syndrome
Bahubali D Gane, P Natarajan
January-March 2016, 5(1):168-169
DOI:10.4103/2249-4863.184656  PMID:27453866
Split-hand/split-foot malformation (SHFM) is mainly inherited as an autosomal dominant trait with incomplete penetrance and characterized by malformation of the limb involving the central rays of the autopod. It presents with a deep median cleft of the hand and/or foot, aplasia/hypoplasia of the phalanges, metacarpals, and metatarsals. Pathogenic mechanism is a failure to maintain signaling from the median apical ectodermal ridge. Without this signaling, cells of the underlying progress zone stop proliferation and differentiation which in turn results in defects of the central rays. We describe a case of SHFM in 10-year-old boy.
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Disseminated tuberculosis with varied paradoxical reactions
Amit Kumar Dey, Ira Shah
January-March 2016, 5(1):170-171
DOI:10.4103/2249-4863.184657  PMID:27453867
Paradoxical reactions are immune-mediated exacerbations of disease triggered by tuberculosis (TB) treatment. We describe a case of varied paradoxical reactions in a 9-year-old girl who was diagnosed with mediastinal TB and tuberculous ascites. The development of paradoxical reaction was gradual with pericardial effusion occurring first followed by pleural effusion and subsequently bilateral papilledema.
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Colloidal silver-based nanogel as nonocclusive dressing for multiple superficial pellet wounds
Ganesh Singh Dharmshaktu, Aanshu Singhal, Tanuja Pangtey
January-March 2016, 5(1):175-177
DOI:10.4103/2249-4863.184659  PMID:27453869
A good dressing is mandatory to an uncomplicated wound healing, especially when foreign particles contaminate the wound. Various forms of dressing preparations are available for use and differ in chemical composition and efficacy. Silver has been a known agent with good antimicrobial and healing properties and recent times has seen an upsurge in various silver-based dressing supplements. We describe our report of use and efficacy of a silver nanoparticle- based gel dressing in the healing of multiple superficial firearm pellet wounds.
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An unusual case of adolescent type 2 diabetes mellitus: Prader-Willi syndrome
Riyas Basheer, Muhammed Jasim Abdul Jalal, Ramesh Gomez
January-March 2016, 5(1):181-183
DOI:10.4103/2249-4863.184661  PMID:27453871
Prader-Willi syndrome (PWS) is a complex genetic disorder, characterized by neonatal hypotonia, developmental delay, short stature, childhood obesity, hypogonadism, and characteristic facial features. Here we report a 21-year-old male who presented with uncontrolled glycemic status. He was diagnosed to have diabetes mellitus at the age of 15 with osmotic symptoms - polyuria, polydipsia, and polyphagia. In the early period, after diagnosis, his blood sugars were reasonably controlled with oral hypoglycemic agents. However, a year back, he was switched onto insulin therapy due to secondary OHA failure. On examination, his body mass index was 36 kg/m 2 . He had bilateral gynecomastia, decreased biparietal diameter, almond shaped eyes with esotropia. He had hypogonadism and also had mild cognitive impairment. He did not have any proximal myopathy or other focal neurological deficits. Hormonal evaluation showed low testosterone and inappropriately normal fluorescence in situ hybridization suggestive of central hypogonadism. With fetal and neonatal hypotonia, delayed developmental milestones, hypogonadism, and early onset diabetes, he fulfilled the clinical criteria for the diagnosis of PWS. Multidisciplinary approach of clinicians together with family and social support are essential to bring out the optimal outcome for such syndromic cases.
  - 1,091 165
COMMENTARIES
Domestic violence in the Solomon Islands
Mikaela A Ming, Molly G Stewart, Rose E Tiller, Rebecca G Rice, Louise E Crowley, Nicola J Williams
January-March 2016, 5(1):16-19
DOI:10.4103/2249-4863.184617  PMID:27453837
The Solomon Islands has one of the highest rates of family and sexual violence (FSV) in the world with 64% of women aged 15-49 have reported physical and/or sexual abuse by a partner. The National Referral Hospital (NRH) in the capital, Honiara, is the only tertiary hospital for the country. Our 4-week medical elective at the NRH was spent reflecting on healthcare challenges including FSV, with the aim of identifying cases of FSV and assessing on the current strategies to improve care for victims. Throughout our placement, we encountered many cases of probable FSV, particularly in the Emergency Department and Obstetrics and Gynecology. These patients were often not managed effectively, largely due to time pressures and overcrowding in the hospital. However, we identified a number of strategies, which have recently been implemented in order to help FSV victims in the Solomon Islands. These include strategies within the healthcare setting, in particular, the commencement of FSV reporting within the hospital, and the production of a manual to enable healthcare worker education on the issue. Strategies within the criminal justice system are also in place. These include recent changes in legislation and the work of the volunteer police force, Royal Assist Mission to the Solomon Islands, to improve attitudes toward FSV. These approaches to tackle the problem of FSV are currently in their early stages and have largely stemmed from Western policies and ideals. This report concludes that more time is needed to accurately assess the impact of the current changes before further recommendations are made.
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LETTERS TO EDITOR
Toothbrush contamination: Often neglected health hazard
Rohit Bhoil, Rohan Bhoil
January-March 2016, 5(1):186-186
DOI:10.4103/2249-4863.184664  PMID:27453873
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Indian adolescents and human immunodeficiency virus: A pilot study from Delhi
Bhanu Mehra, Preena Bhalla, Deepti Rawat
January-March 2016, 5(1):187-189
DOI:10.4103/2249-4863.184665  PMID:27453874
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Comment on the maternal and neonatal outcomes of gestational diabetes
Marie Gilbert Majella, Bijaya Nanda Naik, T Mahalakshmy, Palanivel Chinnakali
January-March 2016, 5(1):190-191
DOI:10.4103/2249-4863.184666  PMID:27453875
  - 635 103
Mobile health: Applications in tackling the Ebola challenge
Neha Dahiya, Ashish Kumar Kakkar
January-March 2016, 5(1):192-193
DOI:10.4103/2249-4863.184667  PMID:27453876
  - 667 107
Comment on "correlates of overweight and obesity among urban adolescents in Bihar, India"
Madhavi Bhargava, Anurag Bhargava
January-March 2016, 5(1):194-194
DOI:10.4103/2249-4863.184668  PMID:27453877
  - 637 104
Prehospital trauma care in South India: A glance through the last 15 years
Debasis Das Adhikari, Benita Florence, Suresh Samuel David
January-March 2016, 5(1):195-196
DOI:10.4103/2249-4863.184669  PMID:27453878
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NATIONAL CONSULTATION ON FAMILY MEDICINE PROGRAMME 2013: REPORT AND RECOMMENDATIONS
National Consultation on Family Medicine Programme 2013: Report and Recommendations
Convened by National Health System Resource Centre (NHSRC) National Health Mission (NHM) MHOFW (Ministry of Health and Family Welfare) Government of India


January-March 2016, 5(1):197-197
DOI:10.4103/2249-4863.184687  PMID:27453879
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ORIGINAL ARTICLES
Primary health care teaching to postgraduate public health students, comparison of two models: A natural experiment
Smita Sinha, Binod Kumar Patro
January-March 2016, 5(1):42-44
DOI:10.4103/2249-4863.184621  PMID:27453841
Background: Primary health care as an approach forms an integral part of any public health curricula. The knowledge regarding primary health care can be delivered to public health trainee through conventional or the modular teaching models. Objectives: We aimed to observe whether there was any difference in the summative assessment scores between two different modalities of teaching primary health care to public health trainee at School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India. Methods: The present study was a natural experiment. Students of Masters of Public Health (MPH) and MD (Community Medicine) formed two natural groups. They were taught by modular and conventional methods of teaching respectively. A total of seven MPH students and nine MD students, participated in the study. Results: Overall summative assessment score among MPH students was 63.9 ± 10.0 in comparison to 61.1 ± 10.9 among MD students. The difference in total scores was not statistically significant. Conclusion: We conclude that approaching a complex topic such as primary health care requires a mix of both modular and non-modular teaching to maximize outputs.
  - 930 142
State of family medicine practice in Lebanon
Mariana Helou, Grace Abi Rizk
January-March 2016, 5(1):51-55
DOI:10.4103/2249-4863.184623  PMID:27453843
Background: Many difficulties are encountered in family medicine practice and were subject to multinational studies. To date, no study was conducted in Lebanon to assess the challenges that family physicians face. This study aims to evaluate the family medicine practice in Lebanon stressing on the difficulties encountered by Lebanese family physicians. Materials and Methods: A questionnaire was sent to all 96 family medicine physicians practicing in Lebanon. Participants answered questions about characteristics of family medicine practice, evaluation of the quality of work, identification of obstacles, and their effect on the medical practice. Results: The response rate was 59%, and the average number of years of practice was 10.7 years. Physicians complain mainly of heavy load at work, too many bureaucratic tasks, demanding patients, and being undervalued by the specialists. Most physicians are able to adapt between their professional and private life. Conclusion: Despite all the obstacles encountered, Lebanese family physicians have a moderate satisfaction toward their practice. They remain positive and enthusiastic about their profession. Until the ministry of public health revises its current health system, the primary care profession in Lebanon will remain fragile as a profession.
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The value of an ENT specialist outreach service in a Family Medicine Unit for the urban poor in India
Mary John, Alicia Parsons, Sunil Abraham
January-March 2016, 5(1):67-72
DOI:10.4103/2249-4863.184626  PMID:27453846
Objectives: To assess the function of an otolaryngology (ENT) specialist outreach service in a Family Medicine (FM) Unit for the urban poor attached to a Tertiary Teaching Hospital in India. Materials and Methods: The study investigated the pattern of ENT diseases in patients who came to the FM Unit and the proportion of these patients who were referred to the ENT specialist clinic at the unit. The study also analyzed the ENT problems that were managed by the ENT specialist at the unit and the conditions, which needed referral to the Tertiary Hospital. Data was collected by chart review. Setting: Weekly ENT specialist outreach service in an FM Unit for the urban poor in India attached to a Tertiary Teaching Hospital. Results: Among the outpatients who attended the unit in 12 months, 12.89% had ENT-related problems, of which 23.9% were referred to the visiting ENT specialist, 88.30% of these patients were managed in the FM Unit with basic ENT facilities. Conclusion: This study demonstrated that majority of the patients with ENT-related problems who presented to an FM Unit could be managed by the FM specialists. Of those patients who required the expertise of a specialist in ENT, the majority could be managed in the FM Unit, with basic ENT examination and treatment facilities. Triage and management by the family physician and the visiting ENT surgeon in the FM Unit is a prudent use of resources and will improve the quality of care people receive for their ENT problems.
  - 1,117 129
Sociodemographic characteristics of tobacco users as determinants of tobacco use screening done by healthcare providers: Global Adult Tobacco Survey India 2009-2010
Rohini Ruhil
January-March 2016, 5(1):82-88
DOI:10.4103/2249-4863.184629  PMID:27453849
Introduction: World Health Organization and Indian Public Health Standards recommend provision of tobacco use screening and cessation help at primary care settings. Evidence shows that brief advice by healthcare provider helps tobacco user quit. It starts with asking the patient about his tobacco use status. The rate of tobacco use screening done by healthcare providers is very low and also depends on sociodemographic characteristics of patients along with several other factors. Objectives: This paper intends to study how sociodemographic characteristics (age, gender, residence [rural/urban], education, and occupation) of tobacco users influence the tobacco use screening done by healthcare providers. Materials and Methods: The study was a secondary data analysis of the Global Adult Tobacco Survey India 2009-2010. There were 4958 smokers and 7255 smokeless tobacco users included in the study who visited healthcare provider in the past 12 months prior to the survey. Results and Discussion: The results showed that male smokers were more likely to be screened for smoking by healthcare providers as compared to female smokers. Furthermore, tobacco users in younger age groups were less likely to be screened for tobacco use by healthcare providers as compared to tobacco users in older age groups. Urban smokeless tobacco users were more likely to be screened for tobacco use by healthcare provider as compared to rural smokeless tobacco users. Conclusion: Healthcare providers were being biased in tobacco use screening of their patients based on demographic characteristics of patients, i.e., their age, gender, and rural/urban residence. However, the evidence shows that it is very imperative to screen each and every patient for tobacco use habit.
  - 761 128
Perception of red eye among senior secondary students in Sagamu, Southwest Nigeria
Olubunmi Temitope Bodunde, OO Sholeye, OO Onabolu, TO Otulana, HA Ajibode
January-March 2016, 5(1):89-93
DOI:10.4103/2249-4863.184630  PMID:27453850
Background: Red eye is a very common presenting complaint in clinical practice among all age groups, including adolescents. Health habits formed during adolescence is carried to adulthood and is often a consequence of their perception. This study, therefore, determined the perception of students toward the red eye. Aim: To determine the perception of red eye and its associated factors among secondary school students in Sagamu. Methods: A cross-sectional descriptive study was carried out among 1082 senior secondary school students in Sagamu local government area, using a semi-structured self-administered questionnaire. Data were analyzed using SPSS Version 20. Relevant descriptive and inferential statistics were calculated. Results: The mean age of respondents was 15.27 ± 1.48 years. There were more females (54.8%) than males. Majority (81%) had heard of red eye, and this was mainly from neighbors; 58.4% felt they could not contact red eye from an infected person. About 35% would instill onion if they had a red eye. About 50.2% felt red eye could lead to blindness. Awareness of red eye was associated with age (P = 0.005), but not with sex and religion. Among respondents, 95.5% and 96.2% had a poor perception as well as a poor attitude toward red eye, respectively. Conclusion: The perception and attitude of senior secondary school students in Sagamu to red eye is poor. Appropriate eye health education and promotional services, including periodic eye examination of students, should be carried out in school health services. Early presentation to eye care centers for its treatment should be encouraged.
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