Perceptions regarding an ‘effective medical teacher’ among undergraduate students of a medical college in Puducherry

Background: To find the characteristics of an effective medical teacher, as perceived by the under graduate medical students who are at different stages of the MBBS course.Methods: A cross sectional study was done among all the undergraduate medical students studying in a medical college and hospital in Puducherry. The undergraduate students were visited in batches and students were explained regarding objectives and those who consented for the study were administered with a validated and pretested questionnaire in line with the objective of the study. The results are expressed in the form of proportions and percentages and the chi-square-test was used to test the significance of difference observed between different batches of studentResults: The most important qualities perceived by the students for being an effective medical teacher are creating interest in the subject, having good communication skills, providing good resource material, inspiring and motivating students, being easily approachable, respecting students/ patients / other staff, being enthusiastic, energetic and good listener. There is a significant difference in the perceived importance among different batch of students in the domain of teaching skills of a medical teacherConclusions: This study identified qualities of medical teachers related to their teaching skills, usage of teaching learning methods, approach towards students and their personal qualities that are perceived to be more important by medical students

Common morbidities and felt needs of salt pan workers in a coastal area of Tamil Nadu, India

Background: The occupational hazards faced by salt pan workers during their occupation are myriad, a fact compounded by the lack of basic amenities at their workplace and lack of awareness regarding usage of personal protection equipment.Methods: This cross-sectional study was carried out among fifty-six salt pan workers in Marakkanam, Tamil Nadu to assess their common health problems and a qualitative component was added to assess their felt needs in work place and daily living. Data was collected using pre-designed data collection sheet for assessing the common morbidities. For the qualitative aspect of the study, in-depth interviews were conducted among twenty workers based on convenient sampling, using open ended questions. Data was collected after obtaining informed consent and steps were taken to ensure confidentiality at all stages.Results: The most common health problem of the workers in present study area included dental caries (41.7%), skin conditions (38.1%) musculoskeletal problems (36.7%) and anemia (35.1%) being other significant health problems. The qualitative aspect of the study revealed that the felt needs were improvement of their working conditions and more social support from the Government and the employers. There was very little awareness among the workers regarding use of PPE and none of them used any form of PPE.Conclusions: Salt pan workers had dental problems, dermatological problems and musculoskeletal problems as most common morbidities among them. Harsh working conditions, financial insecurity etc. are some of their work-related problems. Provision of housing facility and financial assistance during off- season by the government, basic amenities at the work place, paid leave in case of injuries, and insurance schemes for them by employer are their main felt needs. They also had no awareness regarding usage of personal protective equipment at the work place

Screening for retinopathy, risk factors, adherence to treatment and complications among diabetic and hypertensive individuals attending a primary care centre in Puducherry, India

Background: The increasing prevalence and incidence of diabetes and hypertension with increasing age and adult age group are at high risk of developing diabetic and hypertensive retinopathies.Methods: The study was conducted in a rural area of Puducherry, data collection was carried over a period of six months. Self-reported patients of diabetes and hypertension were included in the study and predesigned questionnaire was used to collect the information about socio-demographic details, risk factors, physical activity, history related to DM/HTN and history of fundus examination.Results: Majority of patients screened for diabetes 56% and hypertension 47% was by government hospital. The proportion of diabetics and hypertensives who had undergone fundus examination to rule out diabetic and hypertensive retinopathy was found to be 29.3% (12) and 14.5% (10). Complications such as neuropathy and retinopathy were given by 36.5% (15) and 2.4% (1) of diabetic patients Two third of the patients 64.1% had sedentary life style.Conclusions: Health care providers need to plan for larger coverage of fundus examination among diabetic and hypertensive patients

Nutritional status and various morbidities among school children of a coastal area in South India

Background: Malnutrition and poor health among school children is the common cause of low school enrolment, high absenteeism, early dropout and poor classroom performance. This study was conducted to assess the various morbidities and nutritional status among school children.Methods: This descriptive study was conducted during year 2013 in a higher secondary school located in a coastal area of Puducherry. A total of 714 students were interviewed and examined. A pre-designed and pre-tested questionnaire was used to interview and examine all the participated students. Body weight and height were measured using standardized procedures. WHO criteria for classification of nutritional status was used. Visual acuity and colour vision was assessed using Snellen’s chart and Ishihara’s pseudo isochromatic chart respectively. Mean scores and proportions were calculated and chi-square test was applied. P value of <0.05 was considered as statistically significant.Results: Among 714 student, 369 (51.4%) were males and 345 (48.6%) were females. The mean age of children was 10.2 ± 3.1 years. Among all age groups and both sexes, the observed BMI was lower as compared to the reference values. The prevalence of underweight among children of 5-9 years was (30.7%) and (1.1%) were severely underweight. The prevalence of stunting was 10.4%, including 0.1% of severely stunted children. A total of 30.7% children were thin (low BMI for age). Pallor (39.5%), myopia (34.9%) and dental caries (14.7%) were the common morbidities observed among children. The pallor was observed more commonly among girls and this difference was statistically significant (p value <0.05).Conclusion: Under-nutrition is a prevalent condition among school children. Apart from various nutritional programmes, health education to parents, community and school teachers are quite important to address this problem.

Patient and health system delay among new pulmonary tuberculosis patients diagnosed at medical college hospitals in Puducherry, India

Background:Early diagnosis of the disease and prompt initiation of treatment are essential for an effective tuberculosis (TB) control program. The delay in the diagnosis and treatment may worsen the disease, increases the risk of death and enhances tuberculosis transmission in the community. This study was done to assess the extent of various delays and their determinants among TB patients.Methods:A cross-sectional study including retrospective medical record review and patient interviews was conducted during the year 2010 in and around union territory of Puducherry in India. A structured questionnaire used in the WHO multi-country study to estimate the diagnostic and treatment delay in TB was used to interview the patients. Average estimates and proportions were calculated for continuous and categorical variables respectively. Unadjusted odds ratios (OR) were calculated. Level of significance was determined at 95% confidence level (P value <0.05) and all tests applied were two-sided.Results:A total of 138 new sputum smear positive TB patients were included in the study. The mean age of participants was 41.8 years ± 17.3 years (range 15-87 years). Majority (67.4%) of the patients were male and married (68.8%). Majority (86%) of the patients were literate. The median patient delay, health system delay and total delay was 36 days, 28.5 days and 81 days respectively. The place of residence (OR = 0.39, 95% CI = 0.18-0.87) and family size (OR = 0.45, 95% CI = 0.21-0.97) were found as the determinants of various delays for TB patients.Conclusion:Patient and health care system delay for TB patients is long. There is need to improve the referral mechanism to ensure an early initiation of treatment for TB patients diagnosed a tertiary care hospitals.

Role of active and passive surveillance in early case detection and prevention of disease spread in COVID-19 pandemic: our experience

Background: Strong surveillance systems which include both active and passive surveillance are the important steps to halt a disease outbreak by early case detection and management, which helps in breaking the chain of transmission. The main aim of this article is to share our experience regarding the active and passive surveillance done during COVID 19 spread in the year 2021.Methods: The early case detection of COVID 19 cases through active and passive surveillance was slightly different from the usual methods that are carried out for regular known communicable diseases. Active surveillance was done round the clock by screening of all vehicles entering the union-territory of Puducherry and by house-to-house survey. Passive surveillance was carried out by screening of various symptomatic patients attending to hospitals which needed motivation of health personnel as well as awareness among the general public.Results: Out of 12 Govt. PHCs (3,30,000population) where active and passive surveillance was conducted, the total number of individuals referred to designated COVID centre by active and passive surveillance is 30 and 110 respectively for COVID testing and further management.Conclusions: Active and Passive surveillance plays a major role in early case detection and prevention of disease spread in COVID-19 pandemic

Association of Wilms tumor-1 protein in urinary exosomes with kidney injury: a population-based cross-sectional study

ObjectiveLoss of Wilms tumor-1 (WT1) protein, a podocytopathy marker, through urine exosome (uE), could be an early indication of kidney injury. We examined WT1 in uE (uE-WT1), along with other urine markers of glomerular and kidney tubule injury, in individuals without chronic kidney disease (CKD).MethodologyThe cross-sectional study included individuals who reported having no evidence of chronic kidney disease (CKD). Albumin-to-creatinine ratio (ACR) and estimated glomerular filtration rate (eGFR) were used to assess kidney function. eGFR was calculated using the 2009 CKD-EPI (CKD-Epidemiological) equation. WT1 was analyzed in uE from humans and Wistar rats (before and after the 9th week of diabetes, n = 20). uE-WT1, urinary neutrophil gelatinase-associated lipocalin (NGAL), and kidney injury molecule-1 (KIM-1) were estimated using ELISA. The Kruskal-Wallis H test, Mann-Whitney U test, and stepwise multivariable linear regression were performed.ResultsUrine NGAL and ACR increase with uE-WT1 quartiles (n = 146/quarter). Similarly, uE-WT1, KIM-1, and NGAL were positively associated with ACR. Furthermore, KIM-1, NGAL, and uE-WT1 correlated with ACR. uE-WT1 outperformed KMI-1 and NGAL to explain ACR variability (25% vs. 6% or 9%, respectively). Kidney injury in streptozotocin-induced diabetic rats was associated with a significant rise in uE-WT1. Moreover, the findings were confirmed by the histopathology of kidney tissues from rats.ConclusionuE-WT1 was strongly associated with kidney function in rats. In individuals without CKD, uE-WT1 outperformed NGAL as a determinant of differences in ACR

Prevalence of pulmonary tuberculosis among the tribal populations in India

IMPORTANCE: There is no concrete evidence on the burden of TB among the tribal populations across India except for few studies mainly conducted in Central India with a pooled estimation of 703/100,000 with a high degree of heterogeneity. OBJECTIVE: To estimate the prevalence of TB among the tribal populations in India. DESIGN, PARTICIPANTS, SETTING: A survey using a multistage cluster sampling design was conducted between April 2015 and March 2020 covering 88 villages (clusters) from districts with over 70% tribal majority populations in 17 States across 6 zones of India. The sample populations included individuals ≥15 years old. MAIN OUTCOME AND MEASURES: Eligible participants who were screened through an interview for symptoms suggestive of pulmonary TB (PTB); Two sputum specimens were examined by smear and culture. Prevalence was estimated after multiple imputations for non-coverage and a correction factor of 1.31 was then applied to account for non-inclusion of X-ray screening. RESULTS: A total of 74532 (81.0%) of the 92038 eligible individuals were screened; 2675 (3.6%) were found to have TB symptoms or h/o ATT. The overall prevalence of PTB was 432 per 100,000 populations. The PTB prevalence per 100,000 populations was highest 625 [95% CI: 496–754] in the central zone and least 153 [95% CI: 24–281] in the west zone. Among the 17 states that were covered in this study, Odisha recorded the highest prevalence of 803 [95% CI: 504–1101] and Jammu and Kashmir the lowest 127 [95% CI: 0–310] per 100,000 populations. Findings from multiple logistic regression analysis reflected that those aged 35 years and above, with BMI <18.5 Kgs /m(2), h/o ATT, smoking, and/or consuming alcohol had a higher risk of bacteriologically positive PTB. Weight loss was relatively more important symptom associated with tuberculosis among this tribal populations followed by night sweats, blood in sputum, and fever. CONCLUSION AND RELEVANCE: The overall prevalence of PTB among tribal groups is higher than the general populations with a wide variation of prevalence of PTB among the tribal groups at zone and state levels. These findings call for strengthening of the TB control efforts in tribal areas to reduce TB prevalence through tribal community/site-specific intervention programs

Expanding the role of Medical Colleges in RNTCP towards End TB strategy: Scope and Challenges

Tuberculosis (TB) remains a major global public health problem and it has been the leading cause of death due to an infectious agent in the past five years. During the last decade, the global and national efforts have been focused on achieving the targets set by the Millennium Development Goals (MDGs) and the Stop TB Strategy to reduce the burden of tuberculosis disease. In 2016, the Sustainable Development Goals (SDG) framework of goals, targets and indicators were adopted and in line with it End TB Strategy was unanimously endorsed by all WHO member states for the period of 2016 – 2035 (1). Based on these global efforts, India which accounts for about one quarter of world TB cases has formulated the National Strategic Plan (NSP) for TB elimination 2017-2025 to guide the activities of all stakeholders whose work is relevant to TB elimination in India