Australasian Medical Journal
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Obesity in a Rural Population in India.
No full textBackgroundObesity is a disease condition that is highly prevalent in both developed and developing countries. Obesity accounts for 60% of cases of diabetes, 40% cases of hypertension and 20% of coronary heart disease and stroke. Although obesity is a silent killer in the third world countries, there is less focus on the problem, as the nations are still staggering with problems due to infectious and parasitic diseases. So, the current study was undertaken to highlight the problem.Method A cross-sectional community based survey, among individuals of either sex, aged 30 years and above was carried out on 1,239 respondents, using a two-stage stratified, random sampling technique. Data was collected by personal face to face interview using a pre-designed questionnaire and analyzed using Statistical Package for Social Sciences (SPSS) version 11.5. ResultsThe overweight category included 21.4% of the subjects. Obesity as per Body Mass Index (BMI) criteria was seen in 6.6% of the individuals but abdominal and truncal obesity was present among 51.7% and 62.1% respectively. Literacy up to secondary education and graduation were identified by the multivariate analysis to be associated with obesity. ConclusionThe prevalence of central obesity was found to be high, and hence, lifestyle changes and improved physical activity needs promotion among the general population.
Cytology or Histopathology for Salivary Gland Swellings?
No full textBackgroundSalivary gland swellings can result from tumours, an inflammatory process, or cysts. It can sometimes be difficult to establish whether pathology arises from the salivary gland itself or adjacent structures. Fine needle aspiration cytology (FNAC) is a simple, rapid and safe method to diagnose salivary gland swelling. FNAC has high sensitivity, specificity and accuracy. The aims of this study are to correlate FNAC diagnoses with histopathology and to establish the sensitivity and specificity of FNAC in diagnosis of salivary gland swellings in our institution.Method The study was conducted in the department of pathology, Sri Venkateshwara Medical college Hospital and research Centre, Pondicherry, India. Data was collected retrospectively for the time period 2007-2008 and prospectively for that obtained between January 2009 and June 2010. Results of cytologicial assessment were compared with histopathological data where possible to establish sensitivity and specificity of FNAC.ResultsDuring the study period, 1309 FNAC were undertaken of which 96 FNAC were of salivary gland swellings. Correlation of cytology from FNAC with histopathology tissue was possible in 56 cases. Of the 96 cases for which FNAC data was available, 38.56% were from male and 61.45% were from female patients. The age of the patients ranged from 8 to 69 years. 48.95% cases were benign swellings, 13.54% were malignant, 6.25% were cysts and 31.25% had an inflammatory aetiology. Comparison of FNAC findings with histopathology specimens was available for 56 (58.33%) cases, following which the sensitivity and specificity of cytology were found to be 76.9% and 97.1% respectively.ConclusionFNAC is highly sensitive and specific technique for diagnosis of most of the salivary gland swelling. FNAC can be used preoperatively to avoid unnecessary surgery and discomfort associated with open biopsy
Microbiological Diagnosis of Endophthalmitis
Get PDFBackgroundEndophthalmitis is an ocular emergency and bacteria are the commonest aetiological agents of infectious endophthalmitis. Any delay in treatment will result in serious complications like complete loss of vision. Therefore, obtaining the most appropriate sample is of paramount importance for a microbiologist to identify the aetiological agents that help the ophthalmologist in planning treatment.Objective This study was undertaken to determine the intraocular specimen that is most likely to yield a positive culture on microbiological examination.MethodsFrom 60 cases, intraocular samples were collected in the operation theatre under anaesthesia. The samples obtained were aqueous humour and vitreous humour by vitreous tap, vitreous biopsy or pars plana vitrectomy. The specimens were processed within half an hour, first by inoculating onto culture media and then direct smear examination by Gram’s StainResultsEighty samples were obtained from 60 cases of which the most were vitreous fluid (vitreous biopsy/tap + vitrectomy fluid), i.e., 75%. Culture was positive in 88% vitrectomy fluid as compared to 74% in vitreous tap/biopsy followed by 20% in aqueous fluid. ConclusionsVitrectomy fluid appears to be the best sample for culture from clinically diagnosed endophthalmitis cases
Multiple-Choice Questions or Short-Answer Tests?
No full textBackgroundPeople forget much of what they learn, therefore students could benefit from learning strategies that yield long-lasting knowledge. Yet surprisingly, little is known about how long-term retention is most efficiently mastered. We studied the value of teacher made in class tests as learning aids and compared two types of teacher-made tests (multiple choice and short-answer tests) with a no test (control) to determine their value as aids to retention learning.Method The study was conducted on two separate batches of medical undergraduate students. This study compared two types of tests [multiple choice questions (MCQs) and short answer questions (SAQs)] with a no test (control) group. The investigation involved initial testing at the end of the lecture (post instruction), followed by an unannounced delayed retention test on the same material three weeks later. The unannounced delayed test comprising of MCQs and SAQs on the same material was given three weeks later to all the three groups.ResultsIn batch I, the MCQ group had a higher mean delayed retention score of 10.97, followed by the SAQ group (8.42) and the control group (6.71). Analysis of variance (ANOVA) test and least significance difference (LSD) post hoc test revealed statistically significant difference between the means of the three groups. Similar results were obtained for batch II ConclusionClassroom testing has a positive effect on retention learning; both short-answer and multiple-choice tests being more effective than no test in promoting delayed retention learning, however, multiple-choice tests are better
Resilience Among Medical Students
No full textBackgroundResilience is the capacity to recover and to cope successfully with everyday challenges. Resilience has intrinsic and extrinsic components and an effort has been made to study the intrinsic component and its association with socio-demographic factors, among the entry level students of the Integrated Bachelor of Medicine and Bachelor of Surgery (MBBS) course. MethodThe present study was conducted in Gulf Medical University, using a self-administered questionnaire comprising of two parts, distributed to all the students who consented to participate. The first part contained questions on socio-demographic details while the second part contained questions on the intrinsic and extrinsic components of resilience of the students. The data collected was analysed using Predictive Analytic Software (PASW) 18.0 using frequency, mean, SD and median. ResultsAmong the 58 students who participated, 24 (41.4%) were males and 34 (58.6%) females, of which 70.7% were 20 years. The mean score for the intrinsic component of resilience was 48.9 (SD, 5 and range 35–60). The median scores showed no significant variation (
The Utilization of Antenatal Care in Uganda
No full textBackgroundUganda records an inadequate utilisation of antenatal care programmes. The study set out to investigate the factors associated with the use of antenatal care content to inform policy makers of the pertinent factors that need to be influenced by policy.Method Data for the study was taken from a nationally representative Uganda Demographic and Health Survey (UDHS) 2006. The study employed both descriptive and community fixed effects approaches to examine the factors associated with the use of antenatal care content in Uganda. ResultsOn average, only 16% of women used the full content of antenatal care. Only 12% of women had a urine sample taken, 28% a blood sample taken, and 53% their blood pressure measured. Almost two-thirds of women (63%) took iron supplements, 77% had their weight measured, and 27% were given drugs for intestinal parasites. The utilisation of the content of care was significantly associated with education of the mother and her partner, wealth status, location disparities, timing and frequency of antenatal visits, nature of facility visited, access to media, family planning, and utilisation of professional care.ConclusionEfforts are needed to educate girls beyond secondary level, establish village outreach clinics with qualified staff to attract the hard to reach women in the rural areas, and facilitate antenatal care utilisation irrespective of the ability to pay
Food Security Issues Among Low-Income Earners Living with Diabetes
Get PDFBackground Diabetes prevalence is increasing worldwide. More than 800,000 Australians live with diabetes, and there are stark inequities in prevalence and clinical outcomes among Indigenous people and low socio-economic groups. Aims This paper focuses on food security issues experienced by low-income earners living with type 2 diabetes in Perth, Western Australia. The results presented here are part of a broader qualitative study exploring the impact of socio-economic disadvantage on diabetes. Method Data was collected through focus groups and semi-structured interviews conducted from October 2008 to November 2009. The sample, comprising 38 participants (Indigenous and non-Indigenous), was recruited from areas with high indices of socio-economic disadvantage in Perth. Deductive data analysis identified categories from an existing conceptual framework for the relationship between socio-economic position and diabetes health outcomes, while an inductive approach was adopted to identify new themes. Results Participants had a good understanding of their dietary requirements. However, access to healthy food was not always realised, as many participants depended on others for food provision and meal preparation and had little control over their diets. Furthermore, the majority struggled to accommodate the price of healthy food within a limited budget. Conclusion In this study, low-income earners living with diabetes faced food security issues. Participants reported cost barriers, but also physical barriers relating to functional limitations and lack of transport. This study highlights that the socio-economic circumstances in which vulnerable populations experience their disease need to be understood and addressed in order to reduce the inequities surrounding diabetes outcomes.
Dose Administration Aids: Pharmacists’ Role in Improving Patient Care
Get PDFDose administration aid (DAA) usage has become increasingly prevalent among populations worldwide and as such has become an important part of pharmacy practice. The evidence for the use of these aids has been favourable in Australia resulting in 2006 in a community based DAA program being considered by the Professional Programs and Services Advisory Committee and the first phase of this program implemented in October 2007. The program was established under the Better Community Health Initiative of the 4th Community Pharmacy Agreement with the Government. The aim of this program is to reduce medication-related hospitalizations and adverse events through improved medication management and adherence for people in the community. The most common patient groups that access this service include the elderly, who are often on several different medications and patients with cognitive disabilities who may have trouble understanding or remembering their dosage regimes. Repackaging of a medication, involving removal from its primary packaging invalidates the stability guarantee of the manufacturer. It is in fact the role of the health team to ensure patient care by making an informed judgment as to the effect on the quality and safety of this repackaging process. Drug manufacturers, on the whole, tend to discourage repackaging of medications and as there is little quality data available to support this process. Indeed, only a small number of medications have been investigated for their stability following repackaging into DAAs, namely atenolol, paracetamol, frusemide, prochlorperazine, sodium valproate, aspirin (dosette boxes) and clozapine. This paper will review the repackaging of medications into DAAs and the role that the pharmacist plays in this process to improve patient care, in addition to presenting the Australian research that has contributed substantially to the body of information available internationally on the quality implications, relating to the stability of repackaging medicines into DAAs
Seven years of P-drug selection: My experiences.
No full textPersonal or P-drug selection teaches students to use impartial, objective information to make prescribing decisions. It is an important exercise recommended to reduce irrational prescribing and improve prescribing behavior of healthcare professionals. The exercise of P-drug selection has not been widely implemented in health professions schools in South Asia. In this article the author describes his experiences with P-drug selection teaching-learning and assessment in two Nepalese medical schools, Manipal College of Medical Sciences, Pokhara and KIST Medical College, Lalitpur.