Australasian Medical Journal
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ENT Disorders in Ageing India
No full textBackgroundThe geriatric population in India accounts for 7.7% of the total population. This will rise to 10.4% by 2020 making 142 million people 60 years and above. Otorhinolaryngological problems interfere with the social interaction of some geriatric patients, which can worsen coexistent health problems. This study was undertaken to determine the prevalence of otorhinolaryngological disorders in geriatric population and their relationship with sociodemographic factors in a rural tertiary care hospital in India.Method A retrospective hospital record- based study using the medical records of 1270 patients (784 males, 486 females) aged 60 years and above attending the Out Patients Department (OPD) of Otorhinolaryngology of Pravara Rural Hospital, Loni, Maharashtra, India during the calendar year 2009.ResultsPresbycusis was the most common otological problem (53.9%). Other disorders of the otological group (10.2%) included presbyastasis, otitis and tinnitus. Vocal cord problems formed the second most common (21.8%) group of problems in otorhinolaryngology. Pharyngoesophageal complaints were diagnosed in 9.0%. Nasal disorders including sinusitis were evident in a smaller group (5%). Otorhinolaryngological diseases were found to be more common among males (61.7%), people with lower socioeconomic status (75%), illiterates (65%), landless labourers (65%) and the age group (65-69 years). ConclusionThis study suggests that hearing loss is the most common geriatric otorhinolaryngological problem. General practitioners should be able to recognize otorhinolaryngological problems in geriatrics and possess adequate skills to deal with them. Geriatric health problems are likely to gain public health importance because of the rising population in this age group
Estimation of Foetal Weight
Get PDFBackground Foetal weight is an important consideration when making decisions about intervention in labour. Although weight is estimated in the beginning of labour, the relevant decisions are made at the end of labour. It is not clear whether the estimation of weight at the beginning of labour is more accurate than the estimation at the end of labour. Method This prospective study included 214 pregnant women. Foetal weights were estimated at the time of admission, at full dilatation or before Cesarean section (CS) using Johnson’s formula and multiplying symphysio-fundal height by the abdominal girth measurement. Results The accuracy of estimation of weight by the Johnson formula (insert measuring tape) at the beginning of labour was similar to weight at the end of labour, but the weight obtained by multiplying the symphysio-fundal height by the abdominal girth (insert the measuring tape and holding it straight) at the beginning of labour was more accurate than the same process at the end of labour (p < 0.001). However, using the Johnson formula (holding the meter straight) at the end of labour was more accurate than it was at the beginning of labour (p = 0.02). Conclusion The accuracy of estimated weight varies depending on time, the method used, and the formula of measurement
Swine Flu and Haryana 2009
No full textBackgroundA swine flu pandemic hit the world and India was no exception. Many deaths were reported in metropolitan cities. Knowledge about the infection is an important element of control of the infection.Method This cross sectional survey was conducted at a tertiary care centre hospital where the patients are referred from different parts of Haryana accompanied by relatives therefore it was regarded as a potentially high-risk area for the spread of Influenza A (H1N1) and chosen to assess the knowledge, attitude and practice in relation to swine flu. A self administered questionnaire involved 42 hospital staff members (HS) and 358 general public (GP) accompanying the patients from 1st September 2009 to 15th October 2009.ResultsOut of all respondents only 25% had heard of swine flu before and out of which 65% HS & 37% GP knew more than three correct symptoms. There were 86% respondents (HS=95% & GP=80%) who thought that touching the eyes, nose or mouth without washing hands can spread the disease. Altogether 80% respondents thought that the disease was controllable while, nearly 92% of respondents knew about the nearest swine flu control or testing centre. Among all hardly 10% had attended some type of awareness program for swine flu control and 62% were taking precautions against the spread of swine flu. Nearly 70% of respondents thought that masks prevent the disease while about 98% washed their hands before having meal. Nearly 72% of this knowledge was from television and 20% from newspapers.ConclusionIn the present study group many of the respondents didn’t know about swine flu. Most were from the general population. We recommend a public health campaign in Haryana
Nutritional status in rural Karnataka
No full textBackgroundThe prevalence of underweight children in India is among the highest in the world, and is nearly double that of Sub-Saharan Africa. The effect of malnutrition is high morbidity and mortality among young children. The objective of this study was to determine the nutritional status of children aged between 3-6 years registered in government sponsored maternal and child care Anganwadi centres in India. Method A cross-sectional study was conducted in 35 centres in 11 villages situated in the field practice area of Community Medicine Department of a Medical College situated in Southern India.ResultsOf the 585 children in the study, 46.5% of the children were aged between 36 to 48 months. Assessment of nutritional status using the ICDS growth chart revealed malnourishment to be present among 189 (32.3%) children, of whom 166 children were grade I malnourished and 23 children were grade II malnourished. Proportionally girls (46.2%) were more malnourished than boys (33.6%). No significant association was found between the nutritional status of children and their duration of stay in an Anganwadi centre (p-value=0.56).ConclusionThe findings of this study indicate that malnutrition is still an important problem even among children attending Anganwadis. Further improvements in functioning of Integrated Child Development Services need to be made in order to address the problem of malnutrition
Breastfeeding in Rural India
No full textBackgroundBreastfeeding and weaning practices vary among different regions and communities. In India, breastfeeding in rural areas appears to be shaped by the beliefs of a community, which are further influenced by social, cultural, and economic factors. Malnutrition is often associated with inappropriate feeding practices; occur during the first year of life. This study was undertaken with an aim to investigate feeding and weaning practices along with the nutritional status of under five children in rural Maharashtra, India.Method A cross-sectional descriptive study was conducted at Pravara Rural Hospital, Loni from February 2009 to September 2009. A structured questionnaire was used to interview 300 mothers of children between age group 0-5 years attending immunization clinic and Paediatric O.P.D. Clinical examination of the children was performed. Information was collected on socio-demographic characteristics, breastfeeding and weaning practices. ResultsThere were 61.3% male children and 37.3% female children. A highly significant association with malnutrition was associated with mother‘s educational status, family’s socio economic status and family structure. However, no significant association with malnutrition was noted with religion. Highly significant association was noted between the mothers’ educational status and the time of initiation as well as duration of breast feeding and also with the time of initiation of complimentary feeding. It was observed that only 43% children could be labelled as normal while 57% fell in various grades of malnutrition. ConclusionThe critical window of the first five years of life highlights the importance of appropriate feeding and weaning practices in infants and toddlers. For most problems related to malnutrition may be tackled by engendering awareness in rural mothers and thereby promoting healthy eating.
Osteoarthritis of the Knee
Get PDFBackground:Osteoarthritis affects 15% of Australians or around 3.2 million people. This figure will rise owing to the ageing of the Australian population. Over 38000 knee arthroplasties are performed each year in Australia. There are limited resources for arthroplasty and ever increasing numbers of patients with osteoarthritis of the knee that will ultimately require one. It is therefore paramount to promptly diagnose the condition and utilise simple efficacious management options to alleviate suffering for patients and the overburdened health system. Evaluation of current investigations and management in comparison with published guidelines is the first step.Method: Ninty-five patients with 100 symptomatic knees referred from their GP with a provisional diagnosis of osteoarthritis, were surveyed on the investigations and management they had received prior to presentation. The results were then compared with accepted clinical guidelines.Results:There is a disparity between the clinical guidelines and the results of the survey from clinical practice. 27.5% of patients had not undertaken the gold standard weight bearing radiograph prior to presentation. With 6% of patients not having a plain radiograph at all. Simple efficacious treatments with high levels of evidence such as physiotherapy and weight loss had only been utilised in 41% and 58% respectively. Whilst 55% had used glucosamine which is not recommended in the guidelines. Conclusion: A better awareness of the rationale for investigations by GPs and improved communication between specialists and GPs can prevent duplication of resources and minimise the costs of investigations. Increased awareness of the efficacy of simple treatment modalities can increase their utilisation. Streamlining of investigation and management requires a multidisciplinary approach and both patient and service provider education.
Protecting Against Diabetic Foot Disease
No full textBackground: In diabetic individuals (DI), neuropathy hinders the redistribution of plantar pressure points thus leading to susceptible areas where there is constant capillary blanching which may develop into trophic ulcers. The redistribution of pressure points may precede evidence of clinical neuropathy. In this study we compare temporal redistribution of plantar pressure points (areas of capillary blanching) between normal subjects taken as controls and DI with no clinical signs of neuropathy. Method: Four adults (45±4.55 years) diagnosed to have Type-2 Diabetes, without signs of clinical neuropathy and age -matched controls (43±3.74 years) were studied. The subjects were asked to stand on a glass slab and a 10 minute video recording of 10 selected plantar pressure points was made. Changes in the distance of these points with reference to a defined point on Mayer’s line were measured at every 10 seconds. Standard deviation of difference of redistributed consecutive pressure point (SDPP) in cms., and fractal dimension (FD) was used to compare the two groups. Results: Combined mean SDPP (DI =0.013 ± 0.008 cms, controls= 0.196±0.233 cms,