Australasian Medical Journal
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Stress Amongst Nurses at Tertiary Hospitals in Delhi
No full textBackgroundNursing is known to be a stressful profession. Nursing staff working at the bottom of the hierarchy and in public hospitals are the ones who are more stressed out. There is a paucity of data on prevalence of stress amongst nurses in the Indian setting. The individual contribution of various stressors, operational in nurse’s personal and professional life, to the overall stress levels also needs to be studied.Method A hospital based cross sectional study was carried out on 87 randomly selected staff nurses working in two tertiary care teaching hospitals of Central Delhi. Data was collected using pre-tested and self-administered questionnaire. Socio-demographic profile, stressors in daily life, stressors at workstation and total stress level was also assessed. The data was fed and analysed using WHO’s EPI-INFO 2005 software.Results87.4% of nurses from the sample reported occupational stress. The prevalence of occupational stress amongst nurses was 87.4%. ‘Time Pressure’ was found to be the most stressful whereas ‘Discrimination’ was the least stressful of the given possible sources of stress in everyday life. Other highly stressful sources were: handling various issues of life simultaneously with occupation such as caring for own children/parents, own work situation and personal responsibilities. ‘High level of skill requirement of the job’ was the most important stressor and ‘helpfulness of supervisors/senior sisters’ was the least significant stressor directly related to nursing profession. Other significant work related stressors were: the fact that their jobs required them to learn new things and that they had to attend to, too many patients at the same time.ConclusionHigh prevalence of stress was found amongst nurses, and suggests the need for stress reduction programmes targeting specific important stressors
Awareness of HIV / AIDS in rural India
No full textBackground HIV has reduced life expectancy by more than 20 years, slowed economic growth, and deepened household poverty, and many women in the rural areas still lack complete information on how to avoid exposure to the infection. Method A Cross sectional study was carried out among 167 married women in the age group of 15-45 years during the month of July and August 2009 in the Rural Health Training centre of the Community Medicine department. A modified National Family Health Survey-3 (NFHS-3) questionnaire was used to collect the data and was analyzed using Statistical Package for Social Sciences (SPSS) version 11.5. Results Majority of the women belonged to the age group of 21 -30 years (73.7%). About 67% of them were housewives. Over 80% of the women knew about modes of transmission of HIV. Only 30% of the women were aware that HIV infection can also be present in healthy looking persons whereas 62.5% of them were unsure regarding this matter. Approximately 87(54%) respondents were aware of the anti-retroviral drugs. Only 14% of the women had positive attitudes towards HIV positive people. Conclusion Misconceptions about HIV/AIDS existed although level of awareness about the infection was acceptable among the study population. This gap in the knowledge suggests the need for better awareness campaigns targeting rural women
Obesity Among High School Students Kerala, India
No full textBackground Obesity is a complex condition with serious social and psychological dimensions, that affects virtually all age and socioeconomic groups and threatens to overwhelm both developed and developing countries. This problem is increasing in adolescents and various factors contribute to it. As there is paucity of data regarding this problem in Kerala, India, the present study was undertaken to find the magnitude and to explore the factors associated with it. Method A cross sectional study was conducted among 8, 9 and 10 standard students of high schools of Thiruvananthapuram City Corporation,Kerala,India. The sample size estimated using formula is 859 and it was doubled to overcome the design effect so the sample size of this study was 1718 and the technique adopted is Multistage and stratified random sampling. Ethical clearance was obtained and permission from respective authorities of schools was also taken. Data was collected using pre designed and pretested semi structured questionnaire which is self administered. Body mass index was calculated based on physical measurements such as height and weight using standard methods. Results The prevalence of overweight and obesity is found to be 18.3%. The prevalence of overweight alone is 12% and obesity is 6.3%. Binary logistic regression analysis revealed that family h/o overweight/obesity, maternal occupation of business/services, watching TV/computer use more than 16 hrs/week, fast food consumption, not involved in sports and inadequate aerobic exercise are significantly associated with overweight/obesity. Conclusion There is increased prevalence of overweight/obesity among adolescents and many factors associated with it are modifiable
Elimination of Lymphatic Filariasis in Southern India
No full textBackgroundLymphatic filariasis is an important public health problem in India. Inspite of National filarial control programme (NFCP) being in place for lymphatic filariasis (LF) elimination, several important issues need to be addressed. There is uncertainty about the coverage and compliance to treatment in order to achieve elimination. Method A community based cross-sectional study was conducted as per the National Vector Borne Disease Control Programme (NVBDCP) directions. The study included survey of 200 households of Dakshina Kannada District, South India where the Mass drug administration (MDA) program was conducted. The main objective of the study was to assess the coverage and compliance to MDA. ResultsOut of the total 1050 eligible people, 876 (83%) received the DEC tablets; so, the coverage was 83%. Among those who received the tablets, only 777 (88.7%) received the adequate dose and only 670 (76.8%) people actually consumed the tablets. Hence, compliance rate was only 76.8%.ConclusionThe planning and implementation of MDA programme needs to be strengthened by efficient micro planning, inter sectoral co-ordination and motivating the community to participate in the MDA programme
Knee Arthroplasty And The Patellar Tendon Reflex
No full textBackground: There may be a perception in clinical practice that any deficit in the patellar tendon reflex arc could be attributed to a total knee arthroplasty (TKA). There is no evidence in the literature to support this conclusion. Methods: Sixty-six knees were examined to determine whether TKA affects the patellar tendon reflex.Results: There was no difference observed between the knees with a history of TKA and those knees without a history of TKA.Discussion: There is no plausible reason that TKA should affect the patellar tendon reflex. Despite this, in clinical practice TKA is often thought to be responsible for absent patellar tendon reflexes. This study supports the hypothesis that there is no effect of TKA on patellar tendon reflexes
Complicated Incarcerated Rectal Prolapse
Get PDFComplete rectal prolapse is a distressing condition that represents full-thickness protrusion of the rectum through the anal sphincters mechanism. Incarceration and strangulation of an acute rectal prolapse is a rather unusual entity that represents a surgical emergency. We report a rare case of an 80-year-old woman on antiplatelet drug (Clopidogrel) presenting with acute bowel obstruction secondary to a strangulated loop of small bowel, entrapped in an irreducible bleeding rectal prolapse. She required emergency transperineal small bowel resection and proctosigmoidectomy with colo-anal anastomosis (Altemeier's procedure) followed up by laparoscopic division of adhesions, control of small bowel anastomosis and formation of a defunctioning loop colostomy. The patient had an uneventful post-operative recovery. Since closure of her colostomy five months later her bowel movements are back to normal and she denies any residual incontinence.This case is a very unusual presentation of a complicated acute rectal prolapse dealt successfully with minimally invasive surgical approach that combined perineal bowel resections along with laparoscopy. Emergency procedures tend to have higher rates of post-operative complications as compared to elective ones. Furthermore, with the widen use of more efficient antiplatelet agents such as Clopidogrel, there is an increased risk of encountering early per- or post-operative bleeding that might significantly worsen patients’ outcome. Whenever possible, a planed more ‘conservative’ surgical approach should always be attempted in emergency situations as clearly demonstrated in our case
Glucose-6-Phosphate Dehydrogenase Deficiency and Malaria
No full textGlucose-6-phosphate dehydrogenase (G6PD) deficiency is the most prevalent enzyme disorder, estimated to affect 400 million people worldwide. Mutations in the G6PD gene, situated in the long arm of the X chromosome, result in different G6PD deficiency variants, producing a wide range of biochemical and clinical phenotypes, which can be further distinguished by differences at the molecular levels. Drug related haemolytic anaemia was first observed with the use of Primaquine, and was subsequently discovered to be caused by G6PD deficiency. The link between G6PD deficiency and malaria is further bolstered by the observation of the global distribution of G6PD deficiency being parallel with that of malaria. This observation led to the suggestion that G6PD deficiency has protective advantage as a defence against malaria. Different G6PD deficiency variants have different propensities to cause haemolytic anaemia on exposure to oxidant drugs. Knowledge of the different biochemical and molecular variants of G6PD deficiency is important not only between people in different continents but even between people in different regions of the same country. G6PD deficiency produces a wide spectrum of clinical disorders, whose observable differences can be due to different oxidant drugs, different infections, and even different age groups.