26 research outputs found
An evaluation of the effect of infertility on marital, sexual satisfaction indices and health-related quality of life in women
No full textBackground : The effect of infertility on marital and sexual functioning, health-related quality of life (QoL) and the acceptability of the treatment modalities is a poorly researched area in India. Aims and Objectives : To measure and compare the impact of infertility on marital adjustment, sexual functioning, QoL and the acceptability of various treatment modalities in infertility. Design and Setting : Hospital-based cross-sectional controlled study. Materials and Methods : Data regarding infertility, socio-demographic characteristics and treatment acceptability was obtained via a semi-structured questionnaire. validated, standardized scales were used to measure marital adjustment (abbreviated dyadic adjustment scale), sexual functioning (abbreviated sexual functioning questionnaire) in cases and controls, and quality of life (FertiQol) in cases. Data from 106 women attending tertiary infertility centers who met the definition of primary infertility and 212 controls attending the medical outpatient department in the same centers was obtained. Results : Body mass index and socioeconomic status were significant (P < 0.006 and < 0.0001 respectively) for infertility. Fertility-enhancing regimens and adoption had the highest acceptability with a wide dispersion of range for adoption and least acceptance for sperm, egg, embryo donation and surrogate motherhood. Logistic regression analysis revealed a significant effect size of infertility on marital adjustment (Nagelkerke R 2 0.725, Cohen′s D 0.86) and sexual functioning (Nagelkerke R 2 0.73, Cohen′s D 0.815). QoL showed a decrease in mean scores on the FertiQol scale similar to normative data. Conclusions : Effective counseling, reassurance and measures to reduce the impact of the condition on marital and sexual life, overall QoL are needed to impart a holistic treatment in infertility
Social Class Differentiation and Its Impact on Quality of Life Among Diabetic Patients
No full textSocial class is a significant modifier of quality of life in diabetic patients which we sought to measure in this study. A hospital based, cross sectional descriptive was conducted in diabetic patients using a semi structured questionnaire. A total of 103 diabetic patients consented and participated in the study. The sample consisted of 58 males and 45 females and most respondents had a duration of onset of diabetes between 1-5 years (47%). 68 (66%) of the respondents belonged to lower class, 27 (26%) to the middle class and 8 (8%) to the upper class. 92 (89.32%) of the respondents were using oral hypoglycemic agents and 11 (10.68%) used injectable insulin. Socioeconomic status was significant for the number of missed doses (P < 0.04). The mean scores for upper, middle and lower class on the items of financial burden were 3.99 ± 0.906, 3.37 ± 1.079, 3.00 ± 0.756, for general health were 3.49 ± 0.837, 2.96 ± 0.706, 2.63 ± 0.744 and for psychological distress were 3.56 ± 0.835, 2.70 ± 0.609 and 2.75 ± 0.707 respectively. Social class has a significant impact on quality of life and therapy compliance and measures to address this must be undertaken while providing comprehensive healthcare in diabetes for an optimal outcome
An epidemiological study of urinary incontinence and its impact on quality of life among women aged 35 years and above in a rural area
No full textBackground : There have been few community-based epidemiological studies on urinary incontinence (UI) evaluating the risk factors and impact on quality of life (QOL) in India.
Objectives : This study was designed (1) to estimate age-specific prevalence and risk factors of UI among women aged 35 years and above in a rural area and (2) to analyze the impact of UI on the QOL of incontinent women.
Design and Setting : A cross-sectional descriptive study was conducted.
Materials and Methods: A semi-structured questionnaire assessing socio-demographic factors, severity and type of incontinence, and obstetrical and other risk factors along with impact on QOL was administered in two clusters (villages) in Karimnagar district through multistage cluster sampling.
Results : In a sample of 552 women, 53 (10%) reported episodes of UI. The prevalence of UI showed significant association with increasing age (P < 0.01). Fifty-seven percent of the women had symptoms of stress incontinence, 23% of urge, and 20% mixed symptoms. Obstetrical factors associated with UI included high parity (P < 0.003), young age at first childbirth (P < 0.01), forceps delivery (P < 0.001), and prolonged labor (P < 0.001). Chronic constipation, chronic cough, and history of urinary tract infection were predictors of UI in regression analysis (Nagelkerke R 2 = 0.7). Women with stress incontinence had the severest perceived impact on QOL on a five-point scale questionnaire, mean 24.87 (95% CI 21.26-28.47).
Conclusion : One in 10 women reported episodes of UI with impaired QOL. The outcome is predicted both by obstetric and other risk factors
Impairment of nutritional, educational status and quality of life among children infected with and belonging to families affected by human immunodeficiency virus/acquired immune deficiency syndrome
No full textEvaluation Of Knowledge and Self Care Practices in Diabetic Patients and Their Role in Disease Management
No full textBackground: Poor awareness and practices among diabetic patients are some of the important variables influencing the progression of diabetes and its complications, which are largely preventable through education and involvement of the patient.
Methods: A hospital based cross sectional study was conducted among type 2 diabetics attending diabetes clinic in tertiary care hospital. Knowledge and self care practices were evaluated using a semi structured questionnaire. Statistical methods used included frequencies, proportions and chi square test.
Results: A total of 117 diabetic patients consented and participated in the study of whom 63 (53.85%) were male and 54 (46. 15%) female. Majority of the respondents (45.30%) between the age of 41-50 years,75 (64.10 %) belonged to lower class, and 60 (51.28 %) had a duration of disease between 1 to 5 years. 71 (61.68%) were aware of importance of exercise for the control of disease while 88 (75.21%) said that modification in diet is essential for the control of the disease. 75 (64%) of the respondents had achieved glycemic control. Among self care practices, following a controlled diet (p = 0.04), regular exercise (p = 0.04) and compliance with drugs (p = 0.03) were significantly associated with the achieving glycemic control.
Conclusion: As evidenced by the study, patients who were regularly involved in self care practices have achieved better glycemic control
Predictors of no-scalpel vasectomy acceptance in Karimnagar district, Andhra Pradesh
No full textIntroduction: Karimnagar District has consistently achieved highest rates of no-scalpel vasectomy (NSV) in the past decade when compared to state and national rates. This study was conducted to elucidate the underlying causes for higher acceptance of NSV in the district.
Materials and Methods: A community-based, case control study was conducted. Sampling techniques used were purposive and simple random sampling. A semi-structured questionnaire was used to evaluate the socio-demographic, family characteristics, contraceptive history and predictors of contraceptive choice in 116 NSV acceptors and 120 other contraceptive users (OCUs). Postoperative complications and experiences were ascertained in NSV acceptors.
Results: Age (χ2 =11.79, P value = 0.008), literacy (χ2 =17.95, P value = 0.03), duration of marriage (χ2 =14.23, P value = 0.008) and number of children (χ2 =10.45, P value = 0.01) were significant for acceptance of NSV. Among the predictors, method suggested by peer/ health worker (OR = 1.5, P value = 0.01), method does not require regular intervention (OR = 1.3, P value = 0.004) and permanence of the method (OR = 1.2, P value = 0.031) were significant. Acceptors were most satisfied with the shorter duration required to return to work and the most common complication was persistent postoperative pain among 12 (10.34%) of the acceptors.
Conclusion: Advocating and implementing family planning is of high significance in view of the population growth in India and drawing from the demographic profile, predictors, pool of trainers and experiences in Karimnagar District, a similar achievement of higher rates of this simple procedure with few complications can be replicated
Utility of numerical and visual analog scales for evaluating the post-operative pain in rural patients
No full textBackground: Visual analog scales (VAS) and numeric analog scales (NAS) are used to assess post-operative pain, but few studies indicate their usefulness in rural illiterate population in India. Aims: This study was designed to 1) Compare the impact of literacy on the ability to indicate pain rating on VAS and NAS in post-operative rural patients. 2) Assess the level of agreement between the pain scales. Setting and Design: Cross sectional, hospital based study. Methods: Informed consent was obtained from patients prior to undergoing surgical procedures in a teaching hospital. Post surgery, patients who were conscious and coherent, were asked to rate pain on both VAS and NAS. The pain ratings were obtained within 24 hours of surgery and within 5 minutes of each other. Statistical Methods: Percentages, chi square test, regression analysis. Results: A total of 105 patients participated in the study. 43 (41%) of the sample was illiterate. 82 (78.1%) were able to rate pain on VAS while 81 (77.1%) were able to rate pain on NAS. There was no significant association between pain ratings and type of surgery, duration of surgery and nature of anaesthesia. In multivariate analysis, age, sex and literacy had no significant association with the ability to rate pain on VAS (P value 0.652, 0.967, 0.328 respectively). Similarly, no significant association was obtained between age, sex and literacy and ability to rate pain on NAS (P value 0.713, 0.405, 0.875 respectively). Correlation coefficient between the scales was 0.693. Conclusion: VAS and NAS can be used interchangeably in Indian rural population as post-operative pain assessment tools irrespective of literacy status
SOCIAL CLASS DIFFERENTIATION AND ITS IMPACT ON QUALITY OF LIFE AMONG DIABETIC PATIENTS
No full textABSTRACT Social class is a significant modifier of quality of life in diabetic patients which we sought to measure in this study. A hospital based, cross sectional descriptive was conducted in diabetic patients using a semi structured questionnaire. A total of 103 diabetic patients consented and participated in the study. The sample consisted of 58 males and 45 females and most respondents had a duration of onset of diabetes between 1-5 yrs (47%). 68 (66%) of the respondents belonged to lower class, 27 (26%) to the middle class and 8 (8%) to the upper class. 92 (89.32%) of the respondents were using oral hypoglycemic agents and 11 (10.68%) used injectable insulin. Socioeconomic status was significant for the number of missed doses (P < 0.04). The mean scores for upper, middle and lower class on the items of financial burden were 3.99 ± 0.906, 3.37 ± 1.079, 3.00 ± 0.756, for general health were 3.49 ± 0.837, 2.96 ± 0.706, 2.63 ± 0.744 and for psychological distress were 3.56 ± 0.835, 2.70 ± 0.609 and 2.75 ± 0.707 respectively. Social class has a significant impact on quality of life and therapy compliance and measures to address this must be undertaken while providing comprehensive healthcare in diabetes for an optimal outcome
IMS: The New Generation of Internet-Protocol-Based Multimedia Services
No full textLegacy networks, both fixed and mobile, which were originally designed for voice communications, are progressively migrating to new infrastructures that promise to revolutionize the services offered. In this paper, we will cover this new generation of personal communication services, with an emphasis on the family of Internet protocol (IP)-based multimedia subsystem (IMS)-aided infrastructure that relies on the session initiation protocol (SIP). As a benefit, the end users will enjoy a new generation of personal communications services that are accessible anywhere and anytime. These services are timedia subsystem (IMS)-aided infrastructure that relies on the directly related to the end users rather than to their diverse devices. It is anticipated that the new deployments of next-of the IMS technology. generation networks (all-IP based) will accelerate the adoptio
Dénivellations de la géographie postale et polarisations urbaines, l'exemple de la France du Nord-Ouest de Louis XV à Napoléon Ier
No full textPhilippe Guignet, Postal Geography Levels and Urban Polarizations, the Example of North- Western France from Louis XV to Napoléon I.
Relying on the too scarce sources permitting to find out the activity of the post offices, the author of this paper focuses on a close examination of the volumes of mail having the cities of the various « countries » stretching from the Seine to the Belgian border as their nervous centres. He aims at shedding light on the major features of the postal geography on these regions while making out the various tiers of urban hierarchy.
The countries that eventually formed the Somme department have nothing to be ashamed of thanks to the dynamism of Amiens and Abbeville. The postal indicator confirms that the Artois, the Boulonnais and the Calaisis, that merged into the Pas-de-Calais department in 1790, are inequally polarized spaces, as the relative weight of the harbour cities (Calais and Boulogne) increases to the detriment of Arras and Saint-Omer. The Ardennes are not after all a zone of postal low pressure. It is the Oise department that offers the most harmoniously distributed implantation in an area boasting postal quotities of a rather fair standing.
The inhabitants of the Seine-Inférieure are the most assiduous users of postal services. Rouen's primacy in unquestionable at the time of Fontenoy as well under the Consulat. One of the most original contribution of this study concerns the assessment of the postal dynamism of the Nord. No one can deny that the Nord in 1745 as well as in 1801 is a department in which postal relations are intense, particularly if one compares them to those of the neighbouring departments. Yet, given the number of its inhabitants, its postal revenues can't stand the comparison with those of the Seine-Inférieure.En prenant appui sur les trop rares sources permettant de connaître l'activité des bureaux de poste, l'auteur s'attache à scruter le volume des communications postales dont les villes sont les centres nerveux dans les « pays » entre la Seine et la frontière belge. Il s'efforce de mettre en lumière les grands équilibres de la géographie postale de ces régions, tout en dégageant les étages de la hiérarchie urbaine.
Les contrées ayant formé le département de la Somme ne font pas trop pâle figure grâce au dynamisme d'Amiens et Abbeville. L'indicateur postal confirme que l'Artois, le Boulonnais et le Calaisis ayant constitué en 1790 le département du Pas-de-Calais sont des espaces inégalement polarisés, alors que le poids relatif des villes portuaires (Calais et Boulogne) se renforce au détriment d' Arras et de Saint-Omer. Les Ardennes ne sont pas à tout prendre une zone de basse pression postale. C'est le département de l'Oise qui présente le semis le plus harmonieusement distribué dans l'espace de quotités postales d'assez belle tenue. Ce sont les habitants de la Seine-Inférieure qui sont les usagers les plus assidus des services postaux. La primauté rouennaise est incontestable au temps de Fontenoy comme sous le Consulat. Un des apports les plus originaux de cet article concerne l'évaluation du tonus postal du Nord. Nul ne peut contester que le Nord en 1745 comme en 1801 est un département où les relations postales sont intenses, surtout si on les compare à celles des départements circonvoisins. En revanche rapportés au nombre des habitants, ses revenus postaux ne soutiennent pas la comparaison avec ceux de la Seine-Inférieure.Philippe Guignet, Hoogten en laagten in de verspreiding van de post en de polarisatie van de steden ; het voorbeeld van Noordwestfrankrijk van Lodewijk XV tot Napoleon I.
Aan de hand van de te zeldzame bronnen over de postactiviteit probeert de auteur na te gaan welk volume post in de steden, de zenuwcentra van een streek, voorkwam tussen de Seine en de grens met België. De grote evenwichten van de postale geografie komen zo aan het licht evenals een hiérarchie tussen de steden.
De streken waarui het département Somme bestaat komen er nog goed uit wegens het dynamisme van Amiens en Abbeville. De postindex bevestigt dat Artesië, de streken van Boulogne en Calais, die in 1790 het département Pas-de-Calais vormden, een ongelijk gepolariseerd veld zijn, waarin het gewicht van de havensteden (Calais en Boulogne) rela- tief toeneemt ten nadele van Arras en Saint-Omer. Zelfs de Ardennen zijn geen postale laagvlakte. Het département Oise vertoont de meest harmonieuze spreiding van respecta- bele postquota.
De inwoners van het département Seine-Inférieure gebruiken het meest de postdienst. In de tijd van Fontenoy en het Consulaat staat Rouen aan de top. Origineel in dit artikel is de aandacht voor de post in het département Nord. Niemand zal betwisten dat er daar in 1745 zoals in 1801 een drukke postdienst is, zeker in vergelijking met de nabije departementen. Maar als men de inkomsten van de post meet aan het aantal inwoners, blijft de Seine-Inférieure belangrijker.Guignet Philippe. Dénivellations de la géographie postale et polarisations urbaines, l'exemple de la France du Nord-Ouest de Louis XV à Napoléon Ier. In: Revue du Nord, tome 82, n°335-336, Avril-septembre 2000. pp. 353-366
