Australasian Medical Journal
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Profile of HIV Positive Patients
No full textBackgroundAn estimated 2.5 million Indians are currently living with HIV. In 2004, the Indian government began providing free antiretroviral therapy (ART), through ART centers. This was conducted to assess the socio-demographic and clinical profile, opportunistic infection and treatment pattern of ART center attendees.Method This record based cross sectional study was conducted at District Government Wenlock hospital, one of the teaching hospitals attached to Kasturba Medical College Mangalore, India. The hospital caters to patients from within and the neighbouring districts. Records of 233 seropositives were analyzed for a period of six months in 2008.ResultsAmong 233 seropositives, 150 (64.4%) were males, 51.5% were aged 30-40 years and 58.4% were married. 50.7% of the subjects were from Dakshina Kannada district. 84.1% of the attendees had availed the services through Voluntary Counselling and Testing Centre (VCTC) and 68.7% of the study subjects were in “working” and as per the WHO staging, 51.1% were in stage 3. Tuberculosis (32.3%) and diarrhoea (21%) were the most common opportunistic infections and 54.1% of the subjects received ART regimen 3. There was significant improvement in CD4 count, bodyweight and functional status of the subjects after receiving the ART on an average for 6 months.ConclusionThe economically productive & sexually active people and those with lesser education are at higher risk of becoming seropositive. TB and diarrhoea continue to be the most common opportunistic infection. The subjects showed significant improvement after receiving ART with respect to the CD4 count and average body weight
Drinking Water in an Urban Area of South India
Get PDFBackgroundGlobally, 1.1 billion people lack access to improved drinking water supply and drink water that is grossly contaminated. Hence, study of water treatment assumes utmost importance in order to ensure the safety of the water consumed especially in fast developing cities. This study would provide information of drinking water management practices in the study area. We studied the sources, the treatment and storage facilities of drinking water in households and assessed the free chlorine levels in the drinking water.Method This community based cross sectional study was conducted in Mangalore - a city of Karnataka State in South India. Using convenience sampling, 100 households were visited in the area of Boloor. Information was collected regarding demographic profile, household drinking water sources, treatment and storage practices followed by testing for free chlorine in the drinking water using O-Toluidine.ResultsStudy population had high literacy rate and 83% had their main source of drinking water from municipality, 17% had private water source. Among these 6% households had bore wells, 10% had protected dug well. Overall 99% had improved source of drinking water. Sumps were present in 32% of the households. Of these 34.4 % cleaned it once a month. Boiling was found to be the preferred choice of water treatment; but 5% of the population (lower socio economic status) did not use any method to treat water in their households. Overall, 43% households drank water by pouring to glass from storage vessel, 34% dipped glass into vessel using hands, 23% had tap system and 84.2% of the households cleaned their storage vessel daily. O-Toluidine test showed no free chlorine in drinking water in any of the homes.ConclusionStudy population had access to improved water. However households lacked appropriate storage and handling practices of drinking water which needs to be evaluated further
Effectiveness Of A Staff Motivation Program
Get PDFBackground: Improving the quality of care provided to patients by increased staff motivation, will increase patients’ satisfaction and leads to improved health.Method: An interventional study was carried out among ENT ward patients at NHSL over a period of 2 years. Satisfaction regarding different components of patient needs was assessed in an interviewer administered questionnaire prepared in Sinhala, English and Tamil. This contained statements about initial management of patients, time factors, treatment and attitudes of the staff members, tidiness and orderliness of the ward, information delivery, discharge and the clinic appointment system. Pre and post interventional patients were selected by systematic sampling, each group consisting of 200 patients.Results:The demographic distribution of the pre and post intervention categories was not significant. The mean score of satisfaction at base line was 3.68 (73.6 %).The mean score, 4.81(96.2%) following the intervention was significantly high. Also a statistically significant increase in the patient satisfaction was observed in initial management of the patients (
Emergency Contraception and Nursing Staff in Sikkim, India
No full textBackground Improved knowledge about emergency contraception (EC) may decrease the unplanned pregnancy rate, unsafe abortion and save many lives. This study aims to assess the knowledge, attitude and practice of EC amongst the nursing staff in Sikkim. Method This study was carried out among 131 nursing staff in Gangtok between 2008 to 2009. A predesigned self-administered questionnaire was used to collect the data. Results The majority of nursing staff stated that they had heard of EC. About 80% gained knowledge about EC from doctors and health personnel and 61% were willing to use contraceptives, but only 40% were in favor of using EC if required. Only 26 nursing staff had used one or more methods of EC. High dose oral contraceptive pills (OCP) were the preferred method of EC. Conclusion Awareness of EC was low among nursing staff. There appears to be an urgent need of education about EC and training programs to promote it
Satisfaction with Quality in Asian Hospitals
No full textBackgroundHospitals in Asia recognize the importance of delivering patient satisfaction as a strategic variable and a crucial determinant of long-term viability and success. The aim of this review is to identify the factors that determine patient satisfaction in Asian Hospitals. Methods This review presents issues arising from over 33 patient satisfaction surveys conducted in Asia. Patient satisfaction was analysed according to the literature on service related factors, demographic and psychosocial variables. Studies that were analysed were commonly cross sectional studies and data had been collected via interviewer administered and self administered questionnaires. Results Demographic factors such as age, gender, education level and socio-economic status have an effect on patient satisfaction regarding quality of health care. The effect was not equally observed in all countries in Asia. Health provider related factors such as type of hospital, technical and physical facilities and quality of health professional-patient relationship also change patients’ satisfaction. As similar to previous observation, their effects on satisfaction varied from country to country.Conclusion The effect of various predictive factors of patient satisfaction on the quality of health care differs from one country to another. Knowing patient characteristics which govern satisfaction regarding health care, can be effectively utilized by one country, to modify their own health system and increase patient satisfaction
The History of Diabetes Mellitus
No full textDiabetes has been recognised since antiquity. The first description that resembles the features of the disease is found in Ebers papyrus (1550 BC). The term ";diabetes"; was first coined by Aretaeus of Cappadocia. Galen described it as a disease specific to the kidneys because of a weakness in their retentive faculties. Word mellitus was added by Thomas Willis in 1675 after rediscovering the sweetness of urine and blood of patients (first noticed by the ancient Indians, Chinese and Japanese). He later noticed that some urine samples were sweet (diabetes mellitus) whereas others were tasteless (diabetes insipidus). Later Cullen and John Rollo confirmed these two types. It was only in 1776 that Dobson firstly confirmed the presence of excess sugar in urine and blood as a cause of their sweetness. Claude Bernard discovered in 1857 that liver releases a substance i.e. glycogen which affects blood sugar level. The role of the pancreas in pathogenesis of diabetes was discovered by Mering and Minkowski in 1889. In 1909, Jean De Meyer named glucose lowering hormone as insulin whose existence was hypothetical at that time. Banting and Macleod got Noble prize for isolating insulin in 1923. Discovery of insulin for the treatment of diabetes represents one of the major humanitarian and scientific milestones of the 20th century. Oral hypoglycemic drugs were introduced later. Today researchers are working on insulin patch, implantable pump, insulin-sensitizers, pancreatic or islet cell transplantation and oral insulin solution
Medicon 2010: The Missing Domain
Get PDFMedicon 2010 is an annual flagship medical students' research conference of The Forum for Medical Students' Research (India). This is a conference report of Medicon 2010 hosted at PSGIMSR Coimbatore (India
Iron Supplements in Pregnancy
No full textBackgroundIron deficiency is the most prevalent nutritional deficiency on the globe. In India, pregnant women are amongst the most vulnerable population for iron deficiency anaemia. Even though iron supplements are prescribed, the compliance to therapy is inconsistent. Since India has a predominant rural population, shortage of medical manpower and lack of healthcare facilities may contribute to poor compliance with therapy. Method A controlled trial study was conducted with 140 pregnant women, from a rural area of J N Medical College, Belgaum, India. Direct observers were assigned as volunteers, who monitored consumption of oral iron supplementation tablets by pregnant women. The direct observer was a consenting adult from the same village. Detailed history and baseline investigations were done before the initiation of study and periodical assessment of haemoglobin levels were used to monitor progress. ResultsThe mean adherence rate and haemoglobin levels in the direct observers’ group were higher compared to the control group, across all visits. The mean haemoglobin value of participants in study group during 1st visit was 7.97 gm%, whereas in control group, it was 7.98 gm%; in the 2nd visit, mean haemoglobin level in the study group was 8.47 gm% and 8.18 gm% in the control group; in the 3rd visit, mean haemoglobin was 8.99 gm% in the study group and 8.42 gm% in control group. There was no statistical difference in the mean haemoglobin values between two groups in the first two visits. Although the mean haemoglobin values were similar on baseline investigations (1st visit), there was a difference of 0.30 gm% in 2nd visit and 0.57 gm% difference in the 4th Visit. The difference in haemoglobin values at 4th visit was statistically significant.ConclusionThe deployment of a direct observer, to monitor the administration of oral iron supplementation is feasible and helps to improve compliance with oral iron tablets