Vol 3, Issue 2, Apr-Jun, 2013

Background: The psychological morbidity of the geriatric people is very common. There are different socio-demographic factors affecting the psychological health of elderly, which have not been studied in detail in India. Objective: The present study was framed to fi nd out the association of different socio-demographic factors with the psychological morbidity of the elderly. Materials and Methods: It was a community-based cross-sectional study conducted in Municipal area of Tarakeswar, Hooghly District, West Bengal, India among the geriatric people using a pre-designed, pre-tested, semi-structured schedule to collect the socio-demographic data. General Health Questionnaire-28 was used to collect data regarding psychological morbidity. Statistical analysis was done using SPSS version 16.0. Results: It was revealed that only 29.4% of the respondents scored within normal range. Multiple linear regression taking total as well as domain-wise scoring as dependent variable revealed that increasing age, female sex, illiteracy, financial dependency on other family members, not living with spouse, and poor socio-economic status are significantly associated with psychological morbidity. Conclusion: Overall mental health condition of geriatric people is not good. Proper rehabilitation measures have to be taken by family members, society, and government like engaging them in light activities of their interest, old age pension scheme or forming self-help group among elderly, which would result in making them happy. Key words: Geriatric, GHQ-28, psychological morbidity

Background: There is limited research on patients’ involvement in healthcare in Sub-Saharan Africa. Patients’ involvement is important in improving health service delivery as well as health outcomes. Materials and Methods: A patients’ involvement assessment was carried between September and November 2010 in 18 different health facilities using an interviewer administered checklist. The purpose was to assess patients’ involvement from the provider perspective in HIV care hospitals and clinics with the aim of improving quality of care. A score ranging from zero to three was used to grade the different level of patient involvement at the health facilities. Results: Only 11% of the 18 different health facilities achieved the highest score of three, whereby consumer input is incorporated into setting quality goals and results of quality activities that are routinely communicated to patients and other consumers. The remaining 89% of the facilities had gaps with regard to patient involvement in health care. Conclusion: Majority of the facilities did not have structures that involve patients in quality improvement projects, advocacy and routinely communicating to patients and developing other patient centred quality activities. It is important to build sustainable and lasting partnerships for patients’ involvement in health systems and health delivery. Patients’ involvement should be placed as a fundamental priority in scaling up quality health services at the primary level. Key words: Patient involvement, health providers, quality improvement

Introduction: Nutrition counseling is an important tool for fostering healthy nutrition behavior among individuals. Physicians play a strategic role in imparting nutrition advice to their patient during daily encounters in healthcare settings. Present study explored nutritional counseling practices and attitudes of physicians working at district hospitals in Chhattisgarh state in India. Materials and Methods: A cross-sectional study was conducted to explore present scenario of nutritional counseling practices by Physicians from 1st April to 30th June 2011. Questionnaires and observation guides were framed based on previous studies. Both 3-point and 5-point Likert scale were used to explore the knowledge, satisfaction, and attitude related statements. Results: Majority of the respondents (76%) were strongly in favor of training in nutrition counseling and 35% believed that they should spend more time exploring dietary habit of patients in routine practice. Fifty-four percent of practitioners were of the opinion that counseling is futile and 62% considered counseling as time-consuming process. Majority of physician expressed their willingness to undergo additional training in nutrition. Discussion: In view of emerging burden of chronic disease related to nutrition and life style, it is imperative that physician should be trained adequately so as to advice their patients appropriately, pertaining to nutrition. Key words: Chhattisgarh, nutrition counseling, physician, primary care practice

Background: Hemoglobinopathies comprising of thalassemias and various hemoglobin (Hb) variants continue to plague the health system of India. Aims: To fi nd out the prevalence of various hemoglobinopathies in the study population and to identify any association with the various ethnic groups residing in rural community of Darjeeling district, West Bengal. Materials and Methods: A community-based cross-sectional study was conducted in Naxalbari block of Darjeeling district, West Bengal from June 2011 to August 2011, involving hemoglobin variant screening by high-performance liquid chromatography (HPLC) method of 188 antenatal women, selected through multistage random sampling technique. Results: 26.6% of mothers had abnormal hemoglobin, the commonest being the Hemoglobin E (Hb E) trait (15.42%). The prevalence of homozygous HbE, HbE thalassemia, -thalassemia trait and hemoglobin S-trait in the studied population was 6.91%, 0.53%, 2.12% and 1.06% respectively. There was a single case of the rare hemoglobin J Meerut. Among those having abnormal hemoglobin, 66% belonged to one ethnic group, Rajbanshis. A statistically significant association was noted between Hb E syndrome (comprising of HbE trait, homozygous HbE, HbE-betathalassemia) and Rajbanshis (P < 0.05). Conclusion: Findings suggest a high prevalence of hemoglobinopathies particularly Hb E in the studied population, especially Rajbanshis and warrant the need of wider community-based initiative for carrier detection and awareness generation. Key words: Antenatal women, hemoglobinopathies, high-performance liquid chromatography, screening

Background: Nonalcoholic fatty liver disease (NAFLD) fi brosis score and BARD score are two of the many noninvasive scoring systems used in the evaluation of the fi brosis in patients with NAFLD biochemically. Ultrasound (USG) is the most common imaging modality for detection of hepatic fi brosis, as it is inexpensive and easily available. Aims: This study attempts to correlate the biochemical and ultrasonographic evidence of fi brosis. It tries to correlate two noninvasive tools for assessing fi brosis in overweight population with NAFLD. Materials and Methods: Prospective study was conducted in which 106 patients participated with BMI; more than 25 underwent ultrasonography for evidence of fatty liver, which was then categorized in three grades, and also scored using biochemical parameters to obtain the NAFLD fi brosis score and BARD score. The scores were then compared with the grades of fatty liver on USG to see for correlation between the two. Results: No statistically significant correlation was found between biochemical evidence of fi brosis and USG evidence of fi brosis in overweight patients of NAFLD. Conclusion: Thus, the biochemical evidence of fi brosis or NAFLD in the form of NAFLD fi brosis score did not correlate with USG evidence of fatty liver. The USG findings of fatty liver may not directly correlate with actual fi brosis in these patients. Context: NAFLD is also an emerging disease in developing countries, which remains silent for years. Noninvasive methods are required for early diagnosis. This study attempts to correlate two noninvasive tools for assessing fi brosis in overweight population of NAFLD. Most of the patients of NAFLD are asymptomatic thus invasive methods are not routinely recommended in them. Thus, it becomes pertinent to study the noninvasive tools extensively for their possible additive use. Key words: BARD score, imaging fatty liver, nonalcoholic fatty liver disease fi brosis score, nonalcoholic steatohepatitis

Non-communicable Diseases (NCDs) are emerging as a major cause of morbidity and mortality. Control of risk factors and early diagnosis and treatment are cost-effective modalities for prevention. To attain this, Preventive Medicine Clinics must become a regular feature in the government hospitals of India. Community Medicine and/ or Family Medicine specialists of medical colleges can establish these clinics. In addition to screening patients for NCDs and their risk factors, these clinics can screen patients who require primary health care and manage them appropriately. Key words: Non-communicable diseases, preventive medicine clinics, primary prevention, risk factors, screening, secondary prevention

A 23-year-old female sustained a large avulsion injury to the groin while water tubing on a local waterway. The laceration began at the mons pubis, extended along the labia majora with involvement of the external anal sphincter. The pubic bone and the pectineus muscle were exposed. Six weeks after surgery, she had resumed full activity without sequlae. Lack of data and the potential for significant injury caused by water tubing as described in this case report are a real concern. Water tubing injury should be classified as a primary accident type and analyzed by the U.S. Coast Guard. Key words: Avulsion, boating injury, straddle injury, water tubing

Background: An outbreak of jaundice syndrome was reported from Sabarkantha district of Gujarat in February 2009. Initial investigation of serum specimens collected from the patients was positive for hepatitis B. The outbreak was investigated thoroughly. Materials and Methods: A confirmed case definition was made as a person residing in Sabarkantha district who developed jaundice symptoms with SGPT >400 IU and tested positive for HBsAg. A case-control study was conducted to identify the source of infection and to recommend public health measures. Results: Five-hundred and twenty-eight cases were reported of which, 93 died (Case fatality rate = 17.6%). Majority (61%) were males, and more than 77% were in the age group of 12-45 years. Eighty-four percent reported history of taking injections/needle prick in the last 6 months. In the case-control study there was strong association between cases and history of injection/needle prick (OR = 42.17). Hepatitis B mass vaccination was carried out to control the outbreak. Conclusion: This outbreak of hepatitis-B was associated with unsafe injection practices in private clinics of Sabarkantha district. Sensitization workshop for safe injection practices and waste management held among doctors. Legal actions were taken against the private practitioners involved in these unsafe injection practices. Key words: Hepatitis B outbreak, jaundice, mass vaccination, unsafe injection practice

Residents, young and old of the villages comprising the Saiyan block of the historic Indian city of Agra do not really have a reason to smile; not just because their teeth perennially bear ugly stains but more so because children and adults alike have been ‘cursed’ to lead a life of crippling disability. Yes, as they themselves put it proverbially, that they were destined to be children of the lesser god. This time, the adjacent villages of Gandeshpura, Ladhukheda and Lachipura were in news for rather bad reasons. A majority of the inhabitants in these villages were afflicted by varying grades of skeletal problems ranging from mild disability to major impairment and handicaps. Children bore the maximum brunt of all with a lot many born with deformed limbs that progressed further into their crippling forms in toddlerhood and later age groups. A preliminary survey was conducted by our team in these villages in order to decipher the likely cause and nature of the inciting problem that led to this high a magnitude of disability and its clustering among selected villages and hamlets.

The ultimate goal of any oral therapeutic procedure is to protect and maintain the patient’s natural dentition for his or her lifetime. A recent innovation in dentistry is the preparation and use of platelet-rich plasma (PRP), a concentrated suspension of the growth factors found in platelets. These growth factors are involved in wound healing and are postulated as promoters of tissue regeneration. PRP is a new application of tissue engineering, biotechnology and a rapidly developing area for clinicians and researchers today.[1] In real terms, PRP is just a volume of autologous plasma that has a platelet concentration above baseline. It is a storage vehicle for growth factors, especially which primarily influence bone regeneration. Because of its newness, there is a potential for misunderstanding, misuse, and application of what the practitioner may incorrectly think is PRP. Moreover, since this is an autologous preparation, any concerns regarding disease transmission and immunogenic reactions regarding allograftic and xenograftic preparations can be eliminated.

Teeth play a vital role in the maintenance of a positive self-image and outlook that is why event of loss of teeth results in considerable disabilities, which can intensely interrupt social activities and quality of life. World Health Organization has clearly reported that “people rarely visit the dentist and only in the event of pain, as oral rehabilitation is restricted to the necessity.”[1] Complete edentulism is the end result of a multifactorial process involving biological factors and patient-related factors. It is the major problem in the developing countries and is widely spread in the current population although the prevalence is declining and incidence of tooth loss is decreasing in the developed nations like India.[2,3] The overall rate of total edentulism is said to be increasing in developing countries chiefly due to the high prevalence of periodontal diseases and caries. This relative non-homogeneous allocation and prevalence of complete edentulism between developed and less developed countries is frequently associated with interrelated interaction between cultural, individual, attitude, behavior, dental attendance, etiopathogenesis of edentulism, access to care and socio-economic factors.[