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   2018| July-August  | Volume 7 | Issue 4  
    Online since September 4, 2018

 
 
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ORIGINAL ARTICLES
Selfies: A boon or bane?
Agam Bansal, Chandan Garg, Abhijith Pakhare, Samiksha Gupta
July-August 2018, 7(4):828-831
DOI:10.4103/jfmpc.jfmpc_109_18  PMID:30234062
Background: Selfie deaths have become an emerging problem and we performed this study to assess the epidemiology of selfie-related deaths across the globe. Subject and Methods: We performed a comprehensive search for keywords such as “selfie deaths; selfie accidents; selfie mortality; self photography deaths; koolfie deaths; mobile death/accidents” from news reports to gather information regarding selfie deaths. Results: From October 2011 to November 2017, there have been 259 deaths while clicking selfies in 137 incidents. The mean age was 22.94 years. About 72.5% of the total deaths occurred in males and 27.5% in females. The highest number of incidents and selfie-deaths has been reported in India followed by Russia, United States, and Pakistan. Drowning, transport, and fall form the topmost reasons for deaths caused by selfies. We also classified reasons for deaths due to selfie as risky behavior or non-risky behavior. Risky behavior caused more deaths and incidents due to selfies than non-risky behavior. The number of deaths in females is less due to risky behavior than non-risky behavior while it is approximately three times in males. Conclusion: “No selfie zones” areas should be declared across tourist areas especially places such as water bodies, mountain peaks, and over tall buildings to decrease the incidence of selfie-related deaths.
  15,111 1,090 8
A study on menstruation of Indian adolescent girls in an urban area of South India
Shabnam Omidvar, Fatemeh Nasiri Amiri, Afsaneh Bakhtiari, Khyrunnisa Begum
July-August 2018, 7(4):698-702
DOI:10.4103/jfmpc.jfmpc_258_17  PMID:30234040
Background: Menstrual cycle is an important indicator of women's reproductive health. However, menstruation has a different pattern within a few years after menarche, which might not be well understood by many adolescent girls. Materials and Methods: A cross-sectional study was conducted on 536 healthy menstruating females aged 10–19 years. Standardized self-reporting questionnaires were used to obtain relevant data. The categorical data were analyzed using Chi-square or Fisher's exact test. Results: Mean age of menarche was 13 ± 1.1 years with wide variations, i.e., 10–17 years. 73.1% had cycle duration of 21–35 days. More than half of them reported 5–6 days' duration of menstrual blood flow and 12% of the participants had >7 days of flow. Long blood flow duration was more prevalent in early than in late adolescence. 30.1% reported abundant blood loss. 66.8% had dysmenorrhea and no difference was observed between early and late adolescents. Menstrual cycles tend to be shorter in early adolescence period. Conclusion: A comprehensive school education program on menarche and menstrual problems may help girls to cope better and seek proper medical assistance.
  6,343 522 3
Effect of intravenous iron sucrose on hemoglobin level, when administered in a standard-dose, to anemic pregnant women in rural Northern India
Partha Haldar, Shashi Kant, Vikas Yadav, Jitendra Majhi, Sumit Malhotra, Ravneet Kaur, Rakesh Kumar, Arvind Kumar Singh, Siddaiah Archana, Ayush Lohia, Ramashankar Rath, Farhad Ahamed
July-August 2018, 7(4):762-768
DOI:10.4103/jfmpc.jfmpc_303_17  PMID:30234050
Introduction: To combat anemia among pregnant women, in Haryana, Northern India, administration of intravenous iron sucrose (IVIS) was initiated in 2014 as a public-health measure. We assessed the effect of IVIS on hemoglobin (Hb) levels among the pregnant anemic women. Methods: Pregnant women identified as moderately or severely anemic (Hb <10.0 g/dL) in the second or third trimester during routine antenatal care were prescribed IVIS in a standard-dose of 400 mg given as 100 mg on alternate days. Neither dose calculation, nor allowance for iron-store, was included in this study. We analyzed the data collected between June 2014 and December 2015, at the two primary-health-centers, on Hb level (by HemoCue method) before start of the therapy (baseline), and 4-week or more after the last infusion (endline). Results: A total of 990 women received IVIS. Both baseline and endline Hg-levels were available for 763 (77%), who were included in the analysis. At baseline, the proportion of moderate and severe anemia was 87.94% and 12.06%, respectively. Mean (standard deviation)-Hb increased from 7.85 g/dL (0.80) at baseline, to 9.62 g/dL (1.30) at endline, with a mean increase of 1.76 g/dL (95% confidence interval 1.67, 1.85). The mean increase in Hb-level for pregnant women who had severe and moderate anemia at baseline was 2.54 g/dL and 1.65 g/dL, respectively. Overall, 15.33% of women achieved normal Hb-level by the time of endline measurement. No serious adverse reactions were reported during the observation period. Conclusion: Mean increase in Hb-level was 1.76 mg/dL. Severely anemic pregnant women had larger increase in Hb-level when compared with pregnant women with moderate anemia.
  5,829 287 -
A study to assess the knowledge, attitude, and practices about blood donation among medical students of a medical college in North India
Renu Chauhan, Rajesh Kumar, Supriya Thakur
July-August 2018, 7(4):693-697
DOI:10.4103/jfmpc.jfmpc_54_17  PMID:30234039
Introduction: Scarcity of blood and blood products is frequently encountered in health care institutions. Medical students can serve as an important pool of potential blood donors for the attached teaching hospitals. Aim: To determine the knowledge, attitude and practices (KAP) of medical students about voluntary blood donation. Settings and Design: It was a cross- sectional study conducted among medical students of Dr RPGMC Tanda in Himachal Pradesh, in the months of August to December, 2015. Material and Methods: All the students present on the day of the survey who expressed their consent for participation were enrolled in the study. A pre- tested, structured questionnaire was used as a study tool. After the collection of the baseline information, a brief interactive awareness session, addressing voluntary blood donation was organized for the participants and their willingness to donate blood was again noted at the conclusion of the session. The data was analyzed by using SPSS software. Results: 235 students participated in the study, 102 (43.4%) males and 133 (56.5%) females. The mean age was 20.42 ±1.38 years. Knowledge of Voluntary Blood Donation: The mean knowledge score of participants was 74.4%. Overall 225 (95.7%) participants were aware of their blood groups. Attitude related to blood donation: 91% study participants felt that people should donate blood and were themselves willing to donate blood. Practice Relating to Blood Donation: Out of the 235 study participants, only 54(22.9%) had donated blood so far. Willingness to donate blood after interactive awareness session increased from 91% to 97.5%. Conclusion: The study population has relatively good knowledge and a favourable attitude about voluntary blood donation. However the prevalence of blood donation among the students is still low, especially among the girls.
  5,175 496 2
Menstrual abnormalities and their association with lifestyle pattern in adolescent girls of Garhwal, India
Priyanka Negi, Aprajita Mishra, Pramesh Lakhera
July-August 2018, 7(4):804-808
DOI:10.4103/jfmpc.jfmpc_159_17  PMID:30234057
Background: This study tried to find out the prevalence of menstrual abnormalities in adolescent girls and their association with dietary and exercise pattern in Garhwal region of India. Materials and Methods: In this study, cross-sectional questionnaires survey was conducted in different schools of Garhwal. These questionnaires were based on socioeconomic data, dietary and physical activities, and menstrual abnormalities. Results: The age of menarche was 13.5 ± 0.64 years. Dysmenorrhea (62.75%), premenstrual syndrome (PMS) (40.42%), and irregular cycle (28.72%) were observed common problems among adolescent girls. The result showed that dysmenorrhea, PMS, and menstrual irregularities were directly associated with dietary habits and physical activities. Dysmenorrhea was associated with eating junk food (66.10%), and PMS was associated with lacking of physical activities (78.94%). Conclusion: The result suggests that feeding habit and physical activities directly affecting the menstrual health of adolescent girls.
  4,889 424 1
Impact of Indian public health standards for rural health care facilities on national programme for control of deafness in India: The results of a cohort study
Sanjeev Davey, Chaitanya Maheshwari, Santosh Kumar Raghav, Nirankar Singh, Khursheed Muzammil, Prakhar Pandey
July-August 2018, 7(4):780-786
DOI:10.4103/jfmpc.jfmpc_115_18  PMID:30234053
Introduction: In National Programme for Prevention and Control of Deafness (NPPCD), the management of ear diseases of rural India is now guided by Revised Indian Public Health Standards (IPHS) for Rural Health Facilities for providing quality ear care. However, despite the IPHS existence, coverage and quality ear care is questionable. Moreover, this issue has not yet been studied till now in the Indian context. The objective of the study was to assess the role of Private Medical College Training Center (Rural Health Training Centre [RHTC]) in augmenting quality of ear care services in NPPCD at district level by adopting IPHS Standards. Materials and Methods: A combined retrospective and prospective cohort study was done at RHTC of a Medical College in West Uttar Pradesh from January 1, 2013, to December 31, 2017, by retrospective approach of selecting all ear patients (n = 3840) and prospective way of assessing the impact of IPHS for ear care. The semi-structured Pro forma was used in exploring the coverage and quality of ear care. The data were analyzed by Epi Info version 7.2. Results: Out of total 4817 ear, nose, and throat (ENT) patients, the majority of ear patients (n = 3840) were initially dissatisfied with coverage and quality of ear services provided by ENT specialists at RHTC. However, when IPHS exposure was given from July 1, 2015 to December 31, 2017, not only majority of patients were satisfied (n = 3110, 81%) but also ear curative treatment was significantly higher (n = 2120, 68.1% vs. n = 130, 17.8%, odds ratio = 9.8, RR = 1.5, P < 0.00001). Conclusions: Adherence to IPHS in NPPCD is essential for delivering better ear care by RHTC through primary health-care approach.
  3,970 239 -
The prevalence of obesity among adult population and its association with food outlet density in a hilly area of Uttarakhand
Yashneel Singh Rautela, B Venkatashiva Reddy, Amit Kumar Singh, Arti Gupta
July-August 2018, 7(4):809-814
DOI:10.4103/jfmpc.jfmpc_161_17  PMID:30234058
Background: The rising burden of obesity is a threat to both developed and developing countries. Obesity is a killer lifestyle disease. Different aspects of the local environment play a key role in the occurrence of obesity. The present study was conducted to determine the prevalence of obesity among adult, its associated factors, and its relationship with retail food outlet density in Srikot, Uttarakhand. Materials and Methods: This study was a community-based cross-sectional study, carried out in Srikot, Uttarakhand, in 2016 among 155 adults systematically sampled, aged above 20 years. A semi-structured pretested questionnaire was used to interview the participants, and anthropometry measurements were done. The details regarding the geographic location and count of outlets were carried out. Obesity was considered body mass index ≥25 kg/m2. Results: In the present study, 61.3% were females. The mean age of the study participants was 38.3 (±13.6) years. The prevalence of overweight was 14.8% and obesity was 55.5%. A total of 92.9% of the study participants reported consumption of junk food. On mapping the study area, it was found that the total number of food outlets were 116. It was found that density of any food outlet per study participant was 0.7. Conclusion: The Srikot in Uttarakhand is in an early stage of urbanization as evident from the burden of obesity, and this might worsen by prevalent outlet density of food in the environment.
  3,555 309 2
Dysmenorrhea, associated symptoms, and management among students at King Khalid University, Saudi Arabia: An exploratory study
Mohammed Abadi Alsaleem
July-August 2018, 7(4):769-774
DOI:10.4103/jfmpc.jfmpc_113_18  PMID:30234051
Background: Dysmenorrhoea is a common health problem among females in their reproductive years. Available information on dysmenorrhoea in university student in abah, Saudi Arabia is limited. The objective of the study was to assess the prevalence of dysmenorrhea and associated menstrual symptoms and their self-management techniques among female university students of King Khalid University (KKU). Methods: This cross-sectional study was conducted at College of health science in KKU, Saudi Arabia. Sample: A total of 197 students aged between 18 and 23 years. A Self-administrated questionnaire was used to collect data. Results: Dysmenorrhea was reported by more than two-thirds of the girls (70.6%). In the 139 girls, who reported dysmenorrhea, its related information on severity of pain, medication use, and care-seeking behavior is detailed in the table. Severe pain was reported by (35.2%) respondents. Two-third of the respondents (66%) reported using medications for pain relief and use of herbal medicine was also found to be quite prevalent (69.1%). The gastrointestinal problems were the most common symptoms experienced by the students and were significantly high among the dysmenorrheal students. Less than one in four respondents (23%) reported consulting a doctor for their dysmenorrheal while most of them consulted with friends and family. Conclusion: Dysmenorrhea is a very common problem among the university students. A number of symptoms were related with dysmenorrhea. Even though it is common, and may not have a pathological cause, few students seek medical advice. Increasing the awareness can help in relieving the burden of this common health problem.
  2,971 339 2
A study on cervical cancer screening in asymptomatic women using Papanicolaou smear in a tertiary care hospital in an urban area of Mumbai, India
Omna Shaki, Barun Kumar Chakrabarty, N Nagaraja
July-August 2018, 7(4):652-657
DOI:10.4103/jfmpc.jfmpc_313_17  PMID:30234033
Introduction: Cervical cancer is the most common cause of death among women in developing countries. Among the Indian women, cervical cancer is the most common genital tract cancer. Papanicolaou (Pap) smear test plays a vital role in the detection of cervical cancer even in its premalignant condition. The aim of this study to evaluate the role of Pap smear in detecting premalignant and malignant lesions as well as nonneoplastic lesions of the cervix and to determine the prevalence of various lesions. Materials and Methods: We screened 1100 women in the age group of 21–65 years who attended our medical camp organized by the hospital in outdoor patient department. All women was willing to give consent for screening by Pap smear test were included. Results: Of 1100 cases, majority of the cases were benign comprising negative for intraepithelial neoplasia (NILM) of about 581 (52.8%) cases, 203 (18.4%) inflammatory, atypical squamous cells of undetermined significance 45 (4%), low-grade squamous intraepithelial lesion (LSIL) in 75 (6.8%), and high-grade squamous intraepithelial lesion (HSIL) in 74 (6%) women. Overall sensitivity and specificity for the detection of LSIL were 75.8% and 94.6% and those for the detection of HSIL were 68.9% and 98.6%. Conclusions: Pap smear test is a very easy, noninvasive, useful, simple, safe, and very economical tool to detect preinvasive cervical epithelial lesions. It is evident and proven that every woman above the age of 30–35 years must be subjected to cervical screening and this must be continued even in the postmenopausal period.
  2,883 380 2
Internet addiction and its mental health correlates among undergraduate college students of a university in North India
Aman Gupta, Amir Maroof Khan, OP Rajoura, Shruti Srivastava
July-August 2018, 7(4):721-727
DOI:10.4103/jfmpc.jfmpc_266_17  PMID:30234044
Introduction: Internet addiction (IA) is an emerging phenomenon among the youth of India. It has been found to be associated with mental health problems. This study was therefore conducted to find out the burden of IA among college students in Delhi, its risk factors and association with depression, anxiety, and stress. Methods: A cross-sectional study was conducted, with face-to-face interviews, among the nonprofessional college students of the University of Delhi. Simple random sampling was used to select the students from the list obtained from the three colleges. Young's IA test scale and depression, anxiety, and stress short scale were used to measure IA and the mental health correlates, respectively. Chi-square tests were applied for testing the association of IA with the sociodemographic variables, the variables related to internet usage patterns, and the mental health variables. Independent predictors were determined using logistic regression modeling. Results: The prevalence of IA was 25.3%. The mean (standard deviation) age of the participants was 19.1 (1.02) years and 62.1% were males. The median family income was INR 50,000. IA was significantly associated with higher family income, greater screen time, always online status, and greater duration of internet use per week. The independent predictors of IA were greater duration of internet use per week and always online status, depression, anxiety, and stress. Conclusion: The burden of IA among the college students was high. depression, anxiety, and stress were found to be independent predictors of IA.
  2,641 373 6
Relationship of physical activity with body image, self esteem sedentary lifestyle, body mass index and eating attitude in adolescents: A cross-sectional observational study
Preeti Gaddad, Harish Kumar Pemde, Srikanta Basu, Mukesh Dhankar, Sathya Rajendran
July-August 2018, 7(4):775-779
DOI:10.4103/jfmpc.jfmpc_114_18  PMID:30234052
Aim: To Study Relationship of physical activity (PA) with body image, self-esteem, body mass index (BMI), sedentary lifestyle and eating attitude in adolescents. Methods: An observational cross-sectional study done at the Centre for Adolescent Health, Kalawati Saran Children Hospital, Lady Hardinge Medical College, New Delhi, India. Volunteering adolescents between the age group of 13 and 18 years were included and assessed using PA questionnaire for adolescents Score, Body Shape Questionnaire-34 Score, Rosenberg self esteem Score, adolescent sedentary activity questionnaire score, eating attitude test (EAT-26) and BMI Z-score. Relationship of these scales to various parameters was assessed using correlation and regression. Results: A total of 191 boys and girls were included in the study; 25% had underweight, 75% were normal (only 1 child had overweight and none had obesity). Three fourth (77%) of the children had low PA. The girls were relatively more inactive (83.9% girls vs. 72.1%boys). Most (90.05%) subjects did not have any concerns related to body image. Almost all the subjects had normal or high self esteem. Nearly one quarter of the subjects (23.56%) had disordered eating behaviours. Multiple regression found the PA is positively dependent on EAT 26 score and adolescent sedentary activity questionnaire (ASAQ) score (sedentary score) in girls, whereas in males ASAQ (sedentary score) score was only variable related to physical activity questionnaire for adolescents score (PAQ-A). Conclusion: Normal weight and underweight adolescents had minimal PA and despite this, almost all had normal self-esteem and body image. PA was significantly related to eating and sedentary behaviours.
  2,256 360 -
Poliomyelitis era in Trinidad from 1940 to 1972 and beyond: Implications for effective global health governance for its eradication
Kameel Mungrue, Vijay Kumar Chattu
July-August 2018, 7(4):664-670
DOI:10.4103/jfmpc.jfmpc_319_17  PMID:30234035
Background: Acute poliomyelitis (APM/polio) is a viral infection caused by the polio virus that continues to have a fascinating social and economic impact on countries throughout the world. Humans acquire the virus by close personal contact with transmission occurring through the fecal–oral route. The majority of poliovirus infections results in no illness or produces only self-limited symptoms, however in approximately 5% of infected patients flaccid paralysis of the limbs can occur and 1% can die. Although APM is no longer a feared disease mainly due to the development of effective vaccines, its eradication remains elusive. Methods: The aim of this study is to review the historical impact of APM in Trinidad. A retrospective analysis of all cases occurring from 1939 to 1972 was undertaken. Data for the study were derived from two sources the Annual Statistical Reports of the Ministry of Health 1972–2000 and the epidemiological publications of the League of Nations Health Organization and the World Health Organization. Results: There were four outbreaks of APM in Trinidad 1941, 1942, 1954, and 1972. After the final outbreak in 1972, APM was eradicated not only from Trinidad but also all the countries of the Americas mainly through the effective use of the oral polio vaccine. Conclusion: Polio has brought together international agencies, governments, and the people to build an effective public health system around a common vision for health and wellbeing. The polio eradication and endgame strategic plan represents a major milestone in polio eradication developed by global polio eradication initiative. The initiative would still benefit from adopting some of the best practices in governance from other organizations in the global health sector.
  2,284 148 -
Prevalence of anemia among the women of childbearing age belonging to the tea garden community of Assam, India: A community-based study
Rita Panyang, Anju Barhai Teli, Sidhartha Protim Saikia
July-August 2018, 7(4):734-738
DOI:10.4103/jfmpc.jfmpc_274_17  PMID:30234046
Background: Anemia is a condition in which the number of red blood cells becomes insufficient to meet the body's physiologic needs. Anemia is one of the major public health problems in India. The aim of this study was to find the prevalence and determinants of anemia among the adult females of tea garden community of Assam. Materials and Methods: A community-based cross-sectional study was conducted among 770 numbers of adult females belonging to the tea garden community. For all the samples, complete blood count, abnormal hemoglobin variants screening by high-performance liquid chromatography (HPLC), serum iron level, total iron binding capacity (TIBC), and serum ferritin concentrations were determined. Results: Out of 770 patients, 19.7% were severely anemic. Hb S and β-thalassemia were the only hemoglobin types detected in the study. Hemoglobin type, mean corpuscular volume, TIBC, and serum ferritin level were the important determinants of anemia in the present study. Conclusion: To reduce the burden of anemia among the adult females of tea garden community, the females should be screened periodically, and appropriate measures should be taken.
  1,857 349 -
Evaluation of thyroid function in type 2 diabetes in north-eastern part of India: A hospital-based study
Happy Chutia, Himashree Bhattacharyya, Alice Abraham Ruram, Kaustubh Bora, Montosh Chakraborty
July-August 2018, 7(4):752-755
DOI:10.4103/jfmpc.jfmpc_292_17  PMID:30234048
Background: Diabetes mellitus (DM) and thyroid dysfunctions are the two most common endocrine disorders to come across in any clinical practice. Both thyroid hormones and insulin act antagonistically in metabolic pathways or cycles of cells. The aim of our study is to look for thyroid dysfunction in patients with type 2 DM and its correlation with insulin resistance (IR). Methods: A cross-sectional study was carried out among 80 newly diagnosed type 2 diabetic patients. Thyroid-stimulating hormone (TSH), free triiodothyronine, free thyroxine, and insulin were measured in fasting serum sample. Homeostasis model assessment for IR was calculated as per formula. Results: Among 80 diabetic patients, 20 were hypothyroid, 4 were hyperthyroid, and 56 were found to be euthyroid. IR was found to be significantly higher in hypothyroid as compared to euthyroid patients. A positive association was found between TSH and IR (r = 0.230) among hypothyroid patients though association was not significant. In hyperthyroid patients, a strong negative correlation (r = −0.94933) was found between TSH and IR, but no association was found among euthyroid patients. Conclusion: The inability to recognize the presence of thyroid hormone dysfunction may be one of the important causes of poor management of type 2 DM. Therefore, there is a need for routine assay of thyroid hormones in type 2 diabetic patients to improve the medical management as well as to reduce the morbidity in them.
  1,761 276 1
EDITORIAL
The Delhi declaration 2018: “Healthcare for all rural people” – Alma Ata revisited
Raman Kumar
July-August 2018, 7(4):649-651
DOI:10.4103/jfmpc.jfmpc_217_18  PMID:30234032
In the 40th anniversary year of Alma Ata: Health for All by 2000 conference, Academy of Family Physicians of India organized the 15th WONCA World Rural Health conference in New Delhi from 26 to 29th April 2018. More than a thousand delegates (1044) from 40 countries participated in this international conference. The conference attracted a multidisciplinary participation from various backgrounds with an interest in rural primary healthcare. Theme of this conference was “Healing the Heart of Healthcare-Leaving No one behind”. The conference aspired to bring rural healthcare on global agenda. This was the first ever World Rural Health Conference organized in South Asia, incidentally a quarter of human population lives in South Asia, majority of which is based in rural habitat. The conference culminated with the unanimous adoption of the Delhi Declaration; calling for people living in rural and isolated parts of the to be given special priority, if nations are to achieve universal health coverage. The declaration has been cited at the website of the World Health Organization and is available in six languages (Chinese, English, French, Japanese, Portuguese, and Spanish.
  1,735 277 3
ORIGINAL ARTICLES
Correlation between the outcomes and severity of diabetic ketoacidosis: A retrospective pilot study
John Titus George, Ajay Kumar Mishra, Ramya Iyadurai
July-August 2018, 7(4):787-790
DOI:10.4103/jfmpc.jfmpc_116_18  PMID:30234054
Introduction: Diabetic ketoacidosis (DKA) is a serious acute metabolic complication of diabetes mellitus (DM). It is classified into mild, moderate, and severe based on severity as per the American Diabetes Association (ADA) guidelines. There are limited data on the correlation between the severity of DKA and its outcomes using this classification system. The aim is to study the correlation between the outcomes and severity of DKA in a tertiary care center in India. Methodology: In this retrospective pilot study, 1527 patients with DM were identified over a span of 3 years, of which 63 had a discharge diagnosis of DKA and 37 fulfilled the ADA criteria for DKA. Following inclusion details on clinical parameters and outcomes of patients with mild, moderate, and severe DKA were compared. Results: Mild, moderate, and severe DKA accounted for 8%, 41%, and 51% of the patients, respectively. Intensive Care Unit (ICU) care was required in 6.7% and 47.4% of those with moderate and severe DKA, respectively. Invasive ventilation (IV) was required in 47% (9) of those with severe DKA only. The mortality rates were 13.3% and 26% among those with moderate and severe DKA. The mean expenditure was ₹29,000, ₹30,000, and ₹64,000 among those with mild, moderate, and severe DKA, respectively. Conclusions: The ADA classification of severity of DKA correlates well with the duration of inhospital stay, costs of care, requirement of ICU care, need for IV or non-IV, and mortality. This suggests that this classification system could be a valuable tool in predicting outcomes.
  1,680 206 2
Patients satisfaction with consultation at primary health care centers in Abha City, Saudi Arabia
Abdullah Khlofh Tabekhan, Yahia Mater Alkhaldi, Abdullah Khalufah Alghamdi
July-August 2018, 7(4):658-663
DOI:10.4103/jfmpc.jfmpc_318_17  PMID:30234034
Aim of Study: This study aims to assess patients satisfaction regarding consultations at the General Clinics of primary health-care (PHC) centers, in Abha City. Patients and Methods: This cross-sectional study design was conduct among adult patients attending training PHC centers in Abha City, Saudi Arabia during September 2016. The researcher designed a data collection sheet that comprised patients' personal characteristics and the consultation satisfaction questionnaire, which contained 18 questions within four dimensions, i.e., general satisfaction; professional care; depth of relationship; and length of consultation. Results: The total number of the patient included in this study was 400, more than half of them were male (54%). Most of them were Saudi (90%), married (79%), and educated (93%). More than half 53% were dissatisfied, 20% were satisfied with consultation while 27% were natural. The most important factor affecting satisfaction with consultation was age, education level and income. Conclusions: Patients satisfaction toward their consultation experience at general clinics of training PHC centers in Abha City was suboptimal. Total consultation scores differ significantly according to their age groups, education level, and monthly income. Recommendations: PHC physicians should be more concerned with improving medical consultations provided to their patients. Continuing medical education and training of PHC physicians about provision of medical consultation.
  1,659 225 1
Association of Vitamin D and secondary hyperparathyroidism with anemia in diabetic kidney disease
Satyendra Kumar Sonkar, Harendra Pratap Singh, Gyanendra Kumar Sonkar, Sant Pandey
July-August 2018, 7(4):815-818
DOI:10.4103/jfmpc.jfmpc_174_17  PMID:30234059
Introduction: Anemia is common in Chronic Kidney Disease (CKD) and diabetes is a major leading risk factor for it. In Diabetic Kidney Disease (DKD), it worsens more, which further increases cardiovascular morbidity and mortality. Despite of adequate iron stores anemia persist, which may be due to impaired iron release from body stores that is unable to meet the demand for erythropoiesis (also called reticuloendothelial cell iron blockade). High parathyroid hormone (PTH) along with vitamin D, may be attributable for anemia. Methods: A cross-sectional study of 150 advanced (Stage 4 & 5) pre dialyzed DKD patients (GFR <30ml/min/1.73 m2), aged 40-70 years were included over a period of 1 year. Any other concomitant illness/ drugs leading to anemia were excluded. Serum samples were collected and urea, creatinine, hemoglobin, iron profile, vitamin D, iPTH, uric acid, calcium, phosphorous and albumin levels were measured. A data base was constructed on Microsoft Excel 2007 and statistical analyses were performed using the SPSS software version 20.0 (IBM , NY, USA). Results: Stage 5 DKD had more pronounced anemia compared to stage 4 DKD (P < 0.001). Hemoglobin (Hb) was inversely correlated with iPTH (r = -0.74, P < 0.001) and was associated with vitamin D deficiency (r = 0.51, P < 0.001) but not with serum ferritin. DKD patients with low eGFR (r = -0.6, P < 0.001), vitamin D (r = -0.43, P < 0.001) and serum calcium (r = -0.37, P < 0.001) had higher iPTH. Secondary hyperparathyroidism (beta=-0.005; P < 0.001) and Vitamin D (beta=0.053; P < 0.01) were strong predictor for Hb while parameters of iron profile was not statistically significant. Conclusion: An efficient control of PTH hypersecretion is therefore required to achieve a better management of anemia as well as mineral metabolism in DKD patients.
  1,619 204 -
Tobacco use, exposure to second-hand smoke among pregnant women and their association with birth weight: A retrospective cohort study
Amrutha Varshani Krishnamurthy, Palanivel Chinnakali, Gowri Dorairajan, Shanthosh Priyan Sundaram, Gokul Sarveswaran, Midhune Sivakumar, Kishore Krishnamoorthy, Hemalatha Dayalane, Vijay Sinouvassan
July-August 2018, 7(4):728-733
DOI:10.4103/jfmpc.jfmpc_269_17  PMID:30234045
Background: There is paucity of studies on prevalence of SHS among pregnant women and its association with low birth weight (LBW). Objectives: The study was designed to determine the proportion of tobacco use, exposure to second hand smoke among pregnant women and their association with LBW. Materials and Methods: A Retrospective cohort study was conducted from March–June 2017 among 1043 pregnant women admitted for delivery in the Department of Obstetrics and Gynecology, JIPMER. Socio-demographic and obstetric characteristics, tobacco use and exposure to SHS during pregnancy were assessed by interviews. Birth weight of the baby was also extracted. Data was analysed using STATA v12. Univariate analysis was used to assess the association of socio-demographic, obstetric characteristics and exposure to SHS with LBW. Results: Out of 1043 pregnant women, the mean age was 25 (±3.9) years. More than half (57.4%) of women were primigravida. The proportion of women exposed to SHS during pregnancy was 69.9% (95% CI: 67.0-72.6) among which 24% of the women belonged to family, where family members were smokers. Only four had ever used tobacco in the past. However, none used any form of tobacco during pregnancy. LBW was present in 21.4% of the babies. There was no association between exposure to SHS and LBW [PR:0.98 (95% CI:0.71-1.35)]. Conclusion: The study shows that there was no significant association between the SHS exposure of pregnant women and low birth weight.
  1,567 197 2
Prevalence of metabolic syndrome and associated risk factors among geriatric population living in a high altitude region of rural Uttarakhand, India
Umesh Kapil, Ritika Khandelwal, Lakshmy Ramakrishnan, Preetika Khenduja, Aakriti Gupta, Neha Sareen, Ravindra Mohan Pandey, Hem Chandra Sati, Ravi Shankar Belwal
July-August 2018, 7(4):709-716
DOI:10.4103/jfmpc.jfmpc_261_17  PMID:30234042
Introduction: Metabolic syndrome (MetS) is responsible for 2.5-fold increase in cardiovascular mortality and a 5-fold higher risk of developing diabetes. Materials and Methods: A community-based cross-sectional study was conducted during 2015–2016 in District Nainital. A list of all villages was developed. From this list, thirty villages were identified using population proportionate to size sampling method. From each village, thirty geriatric subjects (GSs) were selected. The study population included 979 GSs aged 60 years and above. The data were collected on anthropometry, blood pressure, blood glucose, and lipid profile from all the enrolled subjects. The prevalence of MetS was estimated using International Diabetes Federation criteria. Univariate and multivariate analysis was done to identify factors associated with MetS. Results: The prevalence of MetS was found to be 28.6%. Step-wise multivariate logistic regression analysis found that female gender, higher income, and body mass index ≥25 were significant and independent risk factors of MetS amongst GP. Conclusion: There is a need for screening of GP living in high altitude region so that efforts can be initiated to prevent complications of MetS.
  1,411 183 4
Factors affecting primary health-care physicians' emergency-related practice; Eastern Province, KSA
Salma Hussain Abu-Grain, Sanaa Sadiq Alsaad, Dalia Yahia El Kheir
July-August 2018, 7(4):739-751
DOI:10.4103/jfmpc.jfmpc_284_17  PMID:30234047
Background: Being the first in-line care providers, primary health-care (PHC) physicians may encounter all forms of emergencies, ranging from minor complaints to life-threatening events. This wide variation of cases challenges the physicians to be competent in emergency medicine. Informative literature describing and assessing the factors affecting PHC physicians' emergency medical services (EMS)-related practice is deficient (nationally and internationally). The aim of this study is to assess PHC physicians' practice related to EMS, the factors affecting it, as well as their learning needs and preferred methods of continuous training in emergency medicine. Methods: All physicians working in the selected centers were invited to complete a self-administered questionnaire addressing their EMS-related practice. Moreover, physicians were invited to participate in face-to-face semi-structured interviews and focus group discussions. Results: The study revealed that 87.3% of physicians had a good diagnostic knowledge score while only 47.6% had a good management score. Nonetheless, 63.5% of physicians had a neutral attitude toward EMS. The most common reported emergencies encountered are bronchial asthma (86.51%), cut wounds (83.33%), and burns (76.19%). About 62% of participants reported that their greatest needs for further training were in cardiovascular and central nervous system emergency management, preferably by practical training in hospital emergency department (80%). Conclusions: Dammam PHC physicians have a good knowledge, neutral attitude, and fair practice concerning the emergency cases encountered. The majority of physicians reported their need for further hands-on training in emergency medicine. Settings and Design: A cross-sectional, mixed methods study was conducted in 13 out of 26 PHC centers of Dammam, Saudi Arabia.
  1,419 141 2
Nursing students: A vulnerable health-care worker for needlesticks injuries in teaching hospitals
Vivek Hada, Kumar Saurabh, Anuradha Sharma, Vijaya Lakshmi Nag, Ravi Sekhar Gadepalli, Anand Kumar Maurya
July-August 2018, 7(4):717-720
DOI:10.4103/jfmpc.jfmpc_265_17  PMID:30234043
Background: Occupational exposure to bloodborne pathogen is a significant risk to health-care workers. In any teaching hospital apart from regular health-care workers and employees, there are significant population of students and trainee. It is important to assess the health-care worker in hospital which has maximum chances of exposure to these pathogens. The aim of this study is to determine the most susceptible job group for needlestick injury (NSI) reported in a newly established teaching medical institute in the Western part of Rajasthan, India. Methods: This is a retrospective analysis of data of NSI occurred during September 2014 to January 2017. Results: Sixty three NSIs were reported during the study. Nursing students were the most vulnerable group who reported maximum number of NSI. Among the nursing students, 72% were completely vaccinated against hepatitis B virus. Conclusions: Nursing students are at utmost risk for NSIs, the prevention of which requires regular training and education.
  1,364 184 3
Household food security in an urban slum: Determinants and trends
Nikitha Dharmaraju, Sonam Shah Mauleshbhai, Nirupama Arulappan, Beeson Thomas, D Sam Marconi, Sherin Susan Paul, Venkat Raghava Mohan
July-August 2018, 7(4):819-822
DOI:10.4103/jfmpc.jfmpc_185_17  PMID:30234060
Introduction: As we are moving from millennium development goals to sustainable development goals, food insecurity is imposing a formidable challenge to the policymakers, especially in developing countries such as India. A survey conducted in the urban slum areas of Vellore district, 6 years back, had reported food insecurity as high as 75%. The current study was a resurvey to assess the food security status in the aforementioned area. Materials and Methods: A community-based survey was conducted in which data were collected using a self-administered questionnaire from 150 households, selected through multistaged cluster sampling, who had given oral consent to be a part of the survey. The prevalence of food security calculated from this study was compared with the results from a previous survey to look for any significant improvement. Results: Nearly 42.7% of the households were food secure, while 26.7% were food insecure without hunger and 30.6% were food insecure with some degree of hunger. Low socioeconomic status (odds ratio [OR]: 3.25, 95% confidence interval [CI]: 1.29–8.16; P < 0.012) and presence of debt (OR: 3.84, 95% CI: 1.90–7.73; P < 0.001) were the major risk factors for food insecurity. A comparison with the findings from the previous study has shown a statistically significant improvement in food security from 25.4% to 42.7% (Chi-square: 27.072, df: 2, P < 0.0001). Conclusion: Although food security levels have shown marked improvement over the years, much needs to be done for India to be free from the shackles of hunger.
  1,362 184 2
Determinants of wasting among schoolchildren in a Southwestern state of Nigeria: Implications to strengthen the nutritional component of primary health-care model
Taiwo A Obembe, Winifred U Adenuga, Michael C Asuzu
July-August 2018, 7(4):671-677
DOI:10.4103/jfmpc.jfmpc_324_17  PMID:30234036
Background: Wasting is linked to about one-third of mortality among school-age children. More studies have centered on stunting among under-five children, with few documented studies exploring comparability and determinants of wasting among school pupils in southwestern Nigeria. This study aimed to investigate the comparability and determinants of wasting among schoolchildren in rural and urban communities of Obafemi-Owode local government area, Ogun State, Nigeria. Methods: A cross-sectional study utilizing a quantitative approach was carried out among children both in rural and urban primary schools. Data were collected through interviewer-administered questionnaires. EPI-INFO version 6.03 was used, children were classified as wasted if weight-for-height Z-scores were <2 standard deviations below the National Center for Health Statistics/World Health Organization median. Associations were tested using t-tests and Chi-square test, while predictors were examined with logistic regression at 95% level of significance. Results: Male gender was predominant (54.6%). Significantly more pupils from rural areas lived with grandparents and other guardians (60.3%) compared to their urban counterparts (39.7% P = 0.005). Pupils from rural schools were four times more likely to be wasted compared to those located in urban regions (odds ratio [OR]: 4.2; 95 confidence interval [CI] = 2.24–7.69). Male pupils were twice likely to be wasted compared to the female pupils (OR: 2.08; 95 CI = 1.22–3.55). Conclusion: Conclusively, the study revealed that the prevalence of wasting was higher among children from rural schools than in urban schools. There is an urgent need to implement viable interventions and policies that address nutritional deficiencies in primary school pupils, particularly in rural areas.
  1,380 163 1
The mental health needs of women in natural disasters: A qualitative study with a preventive approach
Shahin Shooshtari, Mohammad Reza Abedi, Masoud Bahrami, R Samouei
July-August 2018, 7(4):678-683
DOI:10.4103/jfmpc.jfmpc_333_17  PMID:30234037
Context: Considering the importance of psychological issues during disasters and the key role of women in the family and society, a preventive approach toward mental health improvement in women is of great importance. Aims: This study aimed to identify the mental health needs of women in natural disasters through a preventive approach. Settings and Design: The present qualitative study was conducted through content analysis method and semi-structured interviews with 40 specialists and seven women who had experienced natural disasters. The study participants were selected through snowball and purposive sampling. Subjects and Methods: A heterogeneous sample was selected. To ensure the reliability and verifiability of data, the texts of the interviews were approved by each interviewee. Statistical Analysis Used: Thematic analysis was used to report findings. Results: In this study, two themes, seven main categories, and 21 subcategories and secondary codes were extracted. The themes were internal physical (biological) and external environmental (social, political and legal measures, cultural and spiritual measures, psychology, and lifestyle) factors. Conclusions: The dimensions related to the mental health of women are multifactorial and beyond only psychological variables. The improvement of the mental health of women can be achieved through aggregation of perspectives in different organizational, governmental, and political areas in collaboration within the society with a healthy gender perspective free of discrimination, inequality, and injustice.
  1,335 186 1
Managerial dynamics influencing doctor–nurse conflicts in two Nigerian hospitals
Taiwo A Obembe, Ademola T Olajide, Michael C Asuzu
July-August 2018, 7(4):684-692
DOI:10.4103/jfmpc.jfmpc_353_17  PMID:30234038
Background: In the hospital, authority does not usually comes from a single person nor is it exercised in a single chain of command as is obtainable in most formal organizations. Doctors exercise substantial authority within the organizational structure of the hospital and therefore enjoy high autonomy in the hospital setting. This nature of autonomy within the medical and its allied professions has the propensity to incite conflicts within the hospital settings. The study thus sought to examine how the relationship of authority and influence between doctors and nurses within the hospital organization generates conflicts and to evaluate the effectiveness of managerial procedures utilized to resolve doctor–nurse conflict in the selected hospitals. Methods: Semi-structured questionnaires were self-administered to 323 health workers who were sampled from one secondary and the only one tertiary hospital in the state at the time. Focus group discussions (FGDs) were conducted with three groups each of doctors and nurses in the selected hospitals. The organograms of both organizations were also reviewed to evaluate structural relationships of authority between doctors and nurses. Data were analyzed using unadjusted odd ratios at 95% level of significance. Results: Respondents were also twice likely to attest that the command structure and its ability to resolve conflicts was below average in assessment (odds ratio [OR] – 2.05; 95% confidence interval [CI] – 1.27–3.29). Undue advantage (partisan approach) for a particular group by management to conflict resolution was thrice likely to be practiced in both hospitals but more in state hospital compared to the federal medical center (OR – 2.93; 95% CI – 1.54–5.58). Some findings from respondents in the FGDs revealed lackadaisical approach by the management in tackling conflicts among health workers. Conclusion: Doctor–nurse conflict is caused by several organizational and managerial factors. Hospital management must understand the interplay of these factors and institute appropriate managerial policies to tackle the problem appropriately.
  1,291 142 1
Immunization uptake and its determinants among the internal migrant population living in nonnotified slums of Hyderabad city, India
Jagjivan Babu Geddam, Prasad Rao Kommu, Satyendra Nath Ponna, Raja Sriswan Mamidi, Suresh Babu Kokku, Shankar Reddy Dudala, Bontha Babu Veerraju
July-August 2018, 7(4):796-803
DOI:10.4103/jfmpc.jfmpc_146_17  PMID:30234056
Background: The aim of this study is to assess the childhood immunization uptake and its determinants among the internal migrant population living in nonnotified slums of Hyderabad City, India. Methodology: This is a cross-sectional study of 768 rural-urban migrant mothers with a child under 2 years of age residing for period minimum of 30 days, but not more than 10 years. Data were collected for sociodemographic details, health-seeking behavior, antenatal, postnatal services, and reception of vaccines appropriate for age. Results: Full immunization coverage among the children of migrants was same as the general population of the State of Telangana (66.7%). The likelihood of child's reception of full immunization decreases with age of the mother and rose with the attainment of higher education. The head of household of salaried class, expectant mothers utilizing antenatal services, and the visit of postnatal health worker for counseling of expectant mothers, were significantly associated with reception of full immunization. Immunization coverage rates of children of 12–23 months age is lower than the general population of Telangana. The frequency of visits by health worker is low. Conclusion: Immunization uptake among the migrants and vulnerable segments of the population can be increased by locating new settlements, improving utilization of services and capacity building of health staff.
  1,227 127 2
Technical and Alarm signs for referral in adult patients with acute febrile illness: A study from a tertiary care hospital in North India
Nitin Gupta, Ankit Mittal, Sharada V Kutty, Arvind Kumar, Naveet Wig
July-August 2018, 7(4):832-835
DOI:10.4103/jfmpc.jfmpc_138_18  PMID:30234063
Context: There is a huge burden of patients with acute febrile illness (AFI) during the post-monsoon season in India. It is very important to have a functioning triage system, whereby patients with high likelihood of developing a severe illness are referred to higher levels of care. Aim: The objective of this study was to identify the alarm signs which would help in triaging of those patients with AFI without any specific diagnosis. Methods: This was a retrospective review of records, whereby clinical and laboratory parameters of patients with AFI admitted in our tertiary care center between July 2016 and October 2016 were reviewed. Statistical Analysis Used: Appropriate tests of significance were applied using SPSS 21(Chicago, IL, USA) to find statistically significant differences between those who required mechanical ventilation, intensive care, ionotropic support, or higher intravenous antibiotics and those who recovered with minimal supportive care. Results: Presence of comorbidities, dyspnea, altered sensorium, features of myocarditis, hypotension, leukocytosis (>11,000/μL), and acute kidney injury were significantly associated with requirement of higher levels of care, while presence of arthralgia, serositis, and leucopenia indicated a higher likelihood of recovery with minimal support. Conclusion: This article highlights the possibility of identification of simple alarm signs in patients with AFI which would indicate the need for higher levels of care.
  1,206 124 -
Integrated counseling and HIV testing centers of Delhi: An evaluation
Vinoth Gnana Chellaiyan, Deepak K Raut, Anita Khokhar
July-August 2018, 7(4):791-795
DOI:10.4103/jfmpc.jfmpc_128_17  PMID:30234055
Background: HIV counseling and testing services are a key entry point in prevention of HIV infection, treatment, and care of people with HIV. Evaluation of counseling, testing, and referral services help to increase the effectiveness, efficiency, and quality of services delivered by providers by improving any deficiencies in availability, accessibility, and acceptability of testing and counseling services. The objective of this study was to evaluate the integrated counseling and testing centers (ICTC) in New Delhi. Materials and Methods: The evaluation study was conducted among ICTCs during 2014–2015. Twenty ICTCs of New Delhi were selected on the basis of population proportion to the size of clients catered. The study tool was pretested structured tool for evaluating HIV voluntary counseling and testing (VCT). The evaluation tool consists of an assessment of components including the availability of infrastructure, laboratory services, referral services, and staff availability. Counseling sessions were also observed for assessing content and quality. Means and proportions were calculated. Results: Twelve (60%) ICTCs had dedicated counseling rooms ensuring privacy for the clients. Waiting space was reported to be adequate in 16 (80%) ICTCs. Space within counseling room was observed to be adequate in 8 (40%) ICTCs. Counselors of both sexes were present in 12 (60%) ICTCs. Both external and internal quality assurance was observed in all ICTCs. Standard operating procedures were followed in 15 (75%) ICTCs. On observation of the counseling sessions, it was found that 67.4% of male counselors and 67.2% of female counselors addressed all the issues of content of counseling. Conclusion: ICTCs lack waiting area and adequate space in counseling room and required staff personnel. Records maintenance and laboratory quality control maintained by ICTCs were found to be adequate. The counseling rooms lack privacy that may compromise the confidentiality of clients. Few components of counseling need improvement.
  1,161 97 -
Family physicians health-related absenteeism at the Al-Wazarat Healthcare Center
Meshari Nawar Alotaibi, Osama Abdelhay
July-August 2018, 7(4):823-827
DOI:10.4103/jfmpc.jfmpc_42_18  PMID:30234061
Background: In general, physicians and family physicians more specifically tend to treat themselves in an informal matter. The evidence suggests that family physicians have a tendency not to consult other physicians while they are sick and tend to self-treat. Health-related absenteeism among family physicians in primary care settings is an issue that needs to be addressed. Aim: The aim of this study is to identify the prevalence of health-related absenteeism among family physicians in Al-Wazarat Health Center and to investigate the medical causes associated with sickness absence. Methods: The study used cross-sectional design to investigate the prevalence of health-related absenteeism among family physicians in a primary care setting. Results: The study included 108 physicians from the Al-Wazarat Healthcare Center in Riyadh, KSA. On average, the physicians were absent for 2 days over the last year with 53.3% (64/108) have no health-related absence days. The most common recorded reasons for work absence are the severity of illness 75.0% (81/108) and workload 63.0% (68/108). Influenza was the most common health condition that causes absenteeism 60.2% (65/108). The attitude toward working while ill scored 2.3 ± 2.5, being responsible for affecting the patients if working while ill 8.0 ± 2.8, physicians with chronic diseases should stay away from work 3.7 ± 3.7, and the quality of healthcare service could be affected by the physician's illness 7.5 ± 2.5. Conclusions: Further investigations are needed for more understanding of the physicians' tendencies and casual approach toward working with illness. Such understanding will help to formulate better guidelines for medical practices.
  1,134 101 -
Knowledge and attitude of mandatory infectious disease notification among final year medical students
Htoo Htoo Kyaw Soe, Nan Nitra Than, Htay Lwin, Khine Lynn Phyu, Mila Nu Nu Htay, Soe Moe, Adinegara Lutfi Abas
July-August 2018, 7(4):756-761
DOI:10.4103/jfmpc.jfmpc_300_17  PMID:30234049
Background: Disease surveillance is one of the major components to combat against infectious diseases. As health-care professionals are indispensable to mandatory notifiable disease surveillance, their knowledge and attitudes toward infectious disease notification played an important role for timely and effective reporting to the surveillance system. Therefore, we aimed to determine the knowledge of mandatory notifiable infectious diseases in Malaysia and attitude towards infectious disease reporting among final year medical students. Methods: A cross-sectional study was conducted from May to June 2017 in the private medical college in Malaysia. Materials and Methods: We purposively selected the final year (semester 10) medical students and a total of 124 students participated in this study. We collected data using a self-administered, structured questionnaire. Data were analyzed using descriptive statistics, independent t-test, and one-way analysis of variance. Results: Among the final year medical students, 47.5% had moderate knowledge but 4.2% had good knowledge of mandatory infectious disease notification. Only 3.2% of the students correctly answered all the notifiable diseases listed in the questionnaire. Most of the students had positive attitude toward communicable diseases reporting, rewards, and penalty for notification. There was no significant relationship between sociodemographic characteristics and knowledge and attitude of infectious disease notification. Conclusions: The majority of the final year medical students had moderate level of knowledge and positive attitude of infectious disease notification; however, there were some deficiencies. Better instruction and training on infectious disease notification procedures of Malaysia should be provided to the final year medical students which could not only reduce underreporting but also improve timely and effective reporting in future.
  1,079 152 -
Utilization of institutional rehabilitation service in pediatric patients with disability in Southwest Rajasthan
Kriti Mishra, V Siddharth
July-August 2018, 7(4):703-708
DOI:10.4103/jfmpc.jfmpc_260_17  PMID:30234041
Background: Rehabilitating disabled child maximizes functional independence, thereby, enhancing the quality of life and better community participation. Utilization of rehabilitation services is a significant issue in developing countries like India. This study aims to observe the pattern of utilization of institutional rehabilitation services by pediatric patients with disability. Methods: This was an observational study (descriptive cross-sectional study) conducted at Department of Physical Medicine and Rehabilitation in a tertiary care set-up. Descriptive data from an ongoing study involving children with and without developmental delay (DD) over 1 year were collected in terms of age, gender, distance from the institute, diagnosis, and frequency of visit. Utilization pattern for rehabilitation services among pediatric patients was analyzed with respect to diagnosis and frequency of visit under each diagnosed category. The demographic variable of age, gender, and distance from the institute was further correlated to frequency of visit. IBM SPSS statistics 22 was used for descriptive statistical analysis and correlation of variables. Results: Of 464 disabled children using rehabilitation service, data for 399 (M: 255, F: 144) children were complete with age ranging from 3 months to 18 years and distance from 1 km to 600 km from institute. There were 330 children with DD and 69 in non-DD category. Two hundred and sixty-eight cases used one-time consultancy, 86 preferred intermittent services, and 45 patients were regular. Negligible correlation with a trend toward negative values was observed between frequency of service utilization and distance (Rho = −0.139 Sig. = 0.006, at 0.01 level) and between age and utilization frequency (Rho = −0.074, Sig = 0.140). Conclusions: The study showed that children with DD were main utilizers of rehabilitation services. Nearly 67% of disabled children utilized services only once with a trend toward younger age group and those nearer to institute were noted.
  1,004 111 -
LETTERS TO EDITOR
Effectiveness of iron-fortified infant cereals on prevalence of anemia among children
Jogender Kumar
July-August 2018, 7(4):836-837
DOI:10.4103/jfmpc.jfmpc_123_18  PMID:30234064
  878 102 -
Target hansen's disease
P Thangaraju, S Venkatesan, E Sivashanmugam, MK Showkath Ali
July-August 2018, 7(4):838-838
DOI:10.4103/jfmpc.jfmpc_15_18  PMID:30234065
  776 92 -
ERRATUM
Erratum: Burnout and depression among medical residents in the United Arab Emirates: A multicenter study

July-August 2018, 7(4):839-839
DOI:10.4103/2249-4863.240419  PMID:30234066
  741 100 -
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