A STUDY TO ASSESS THE CLINICAL AND BIOCHEMICAL PROFILE OF PATIENTS DIAGNOSED WITH HEPATITIS E IN A LARGE TEACHING HOSPITAL OF SOUTHERN INDIA

ABSTRACTObjective: Hepatitis E has been identified as a major health problem in developing countries and recently developed countries. To study the profile ofpatients diagnosed with hepatitis E infection in a tertiary care hospital in south India.Methods: A cross-sectional record-based study with the records of patients diagnosed with hepatitis E infection over a 40-month period from ateaching hospital in southern India and fulfilling the following criteria was performed.Results: The cases were predominant in the age group of 21-30 years with relative sparing of children. No seasonal variation in the occurrence orsecondary cases was observed. Temporary derangement of liver function tests was recorded in all cases. The study showed a male preponderance. Asdocumented in previous studies, the disease proved fatal in a primigravida who developed fulminant hepatic failure. Another interesting feature wasthe presence of leptospirosis, scrub typhus, and hepatitis A as co-infection with hepatitis E.Conclusion: In India, the awareness of the disease is also low, therefore, the diagnosis is usually not made in the majority of cases. Hence, theavailability of data regarding the clinical pattern of presentation and biochemical profile is restricted. However, there are some questions stillunanswered like the preference of the virus to infect individuals in the age group of 20-40 years, sparing of children, and increased rate of infectionamong the males. The cause of the increased morbidity and mortality of this virus in pregnant women is still not known. A larger sample size and thedata on the seroprevalence of this disease in the population under study are necessary for a meaningful interpretation of its epidemiological pattern.Keywords: Alanine transaminase, Alkaline phosphatase, Aspartate aminotransferase, Bilirubin, Liver

Reduced Pelvic Floor Muscle Tone Predisposes to Persistence of Lower Urinary Tract Symptoms after Puerperium

Pregnant primiparous women at term were enrolled in the study. ICIQ-FLUTS questionnaire was used to find out prevalence of LUTS. MOS was used to assess pelvic floor muscle strength. Women were followed up after 8–10 weeks of delivery to find out remission or persistence of these symptoms. We found that increased frequency of micturition was the most common (82%) LUTS seen in primiparous women at term. More than half (51%) of these women who complained of LUTS had a poor pelvic floor muscle tone (MOS grade 3). Out of those who had symptoms during pregnancy 11% remained symptomatic even after puerperium. Interestingly 61% of those with persistence of symptoms demonstrated a very poor pelvic floor muscle tone at term (MOS grade 2), while the remaining 39% also had a tone of only MOS grade 3. Thus women with LUTS during pregnancy should be screened for their pelvic floor muscle tone with simple MOS system which will help to predict the persistence of these symptoms later on. Women with a low score (three or less) should be triaged for regular pelvic floor muscle exercises

Preparedness and Response to COVID-19 Outbreak in Assam: An Experience from the Field

The world is now fighting against a new deadly virus disease, novel coronavirus disease (COVID-19), which is first declared as public health emergency and later declared as Pandemic by WHO. As COVID-19 spread around the world, governments, companies, international organizations announced measures to help contain the spread. Assam with 36 cases and the other north eastern (NE) states have been able to control the number of cases quite well compared to other states in India. To contain coronavirus spread in Assam, government leveraged nine projects implemented by Piramal Swasthya Management and Research Institute (PSMRI), in addition to other activities. This paper gives the elaborative listings of activities done by PSMRI in respond to COVID-19 outbreak to support the government respond to this pandemic. Activities are- Inbound calling, out bound calling, contact tracing, Visit and follow up of quarantined patients, data entry and updating Integrated Disease Surveillance Project (IDSP) portal and door step delivery of medicines. As on 26th April, 1,25,566 COVID-19 related calls received in 104-Health Helpline (HIHL). In addition, 37,886 beneficiaries called for quarantine follow up. Field staffs also visited households of home quarantined patients and screened more than 9000 people for COVID-19. PSMRI also supported in activities of Assam Cares Financial scheme and Dhanwantri Scheme.The above activities helped in mitigating the risk of coronavirus infection and also ‘helped in timely respond to the reported cases

IJCM_385A: Establishment of a CKD Screening and treatment program at a secondary care hospital in rural Karnataka - A case study

Background: With the rapidly increasing incidence of kidney disease due to the rise in non- communicable diseases like diabetes and hypertension in India, a felt need for easily accessible Dialysis unit was found during the community assessment. Chronic Kidney Disease (CKD) education and screening program was also proposed to be established along with this to improve awareness and early detection. This would help in health system strengthening and prevent patients from travelling to far away locations for the dialysis sessions. Objective: 1. To conduct CKD education and screening camps in rural areas of Karkala taluk Methodology: The project was implemented for a duration of 12 months starting from July 2021. Camps were held along with help from local clubs & Rotary Club. The following blood tests were carried out: Glycosylated Hemoglobin, Random Blood Sugar (RBS) or Fasting Blood Sugar (FBS), Serum Creatinine and Lipid Profile. These tests were done free of cost for all camp attendees. If the parameters were found to be abnormal, they were referred to Dr TMA Pai Rotary Hospital, Karkala for confirmation of the diagnosis and further management. Along with screening, Health education sessions were also be carried out to create awareness regarding diabetes and Chronic Kidney Disease among the rural population. The Dialysis unit was set up with 3 dialysis machines with funding from Rotary International under the Global Grant scheme. Dialysis was provided at subsidized to Below Poverty Line (BPL) patients. Results: A total of 10 CKD screening & awareness camps were held during the project period. A total of 588 patients were screened. 132 were referred for further management. 8 patients were referred for Dialysis. Average of 170 dialysis sessions are carried out per months. 805 participants attended the training sessions. Conclusion: Similar set ups in rural areas will help in early detection of CKD and make dialysis more affordable and accessible

Reduced Pelvic Floor Muscle Tone Predisposes to Persistence of Lower Urinary Tract Symptoms after Puerperium

Pregnant primiparous women at term were enrolled in the study. ICIQ-FLUTS questionnaire was used to find out prevalence of LUTS. MOS was used to assess pelvic floor muscle strength. Women were followed up after 8–10 weeks of delivery to find out remission or persistence of these symptoms. We found that increased frequency of micturition was the most common (82%) LUTS seen in primiparous women at term. More than half (51%) of these women who complained of LUTS had a poor pelvic floor muscle tone (MOS grade 3). Out of those who had symptoms during pregnancy 11% remained symptomatic even after puerperium. Interestingly 61% of those with persistence of symptoms demonstrated a very poor pelvic floor muscle tone at term (MOS grade 2), while the remaining 39% also had a tone of only MOS grade 3. Thus women with LUTS during pregnancy should be screened for their pelvic floor muscle tone with simple MOS system which will help to predict the persistence of these symptoms later on. Women with a low score (three or less) should be triaged for regular pelvic floor muscle exercises

Perceptions and practices regarding use of personal listening devices among medical students in coastal South India

Today′s generation enjoys having music at their fingertips. This has led to an increase in the usage of personal listening devices (PLDs) over the past decade. There are significant concerns regarding harmful effects of PLD use. To find out the perception and practice of medical students regarding use of PLDs. Cross-sectional study was carried out in Mangalore, Coastal south India. Data were collected using a 31 item semi structured questionnaire that was distributed among 570 medical students, of which 485 completed questionnaire were received giving an overall response rate of 86.14%. The study was approved by the departmental review board. Statistical analysis used: data were analyzed using SPSS Version 11.5, Chi-square test for association was used and P<0.05 was considered statistically significant. Of the total study participants, 83.1% of them used PLDs regularly, of whom 77.7% used it for more than 1 h a day. Overall, 18.0% of the study population was aware that prolonged use of PLDs could be harmful to their health. Majority of the study subjects (72.4%) felt that the safe duration of listening to PLDs is 3 to 5 h. Among the subjects using PLDs ≥ 1 h, 60.1% preferred ear phones and among those using PLDs <1 h, 44.1% preferred earphones. Overall, 12.4% experienced temporary hearing loss on usage of PLDs. The use of PLDs among the medical students is on the rise, and they should be made more aware of the harmful effects associated with its use

Community based study to assess the prevalence of diabetic foot syndrome and associated risk factors among people with diabetes mellitus

Abstract Background Diabetic foot is one of the most significant and devastating complication of diabetes. The objective of this study was to assess the prevalence of diabetic foot syndrome (DFS) and the associated risk factors among people with diabetes mellitus. Methods A community based cross-sectional study was carried out among 620 subjects with diabetes mellitus (DM) in rural areas of Udupi district. The Michigan Neuropathy Screening Instrument was used to identify peripheral neuropathy. Ankle brachial index was used to identify peripheral arterial disease (PAD). Subjects with diabetic foot syndrome were classified according to the International Working Group on Diabetic Foot (IWGDF) classification system. Results The overall prevalence of DFS was 51.8%. Among them 31.3, 11.9 and 8.5% belonged to category 1, 2 and 3 respectively. Multivariate logistic regression analysis showed advancing age, low socio-economic status, sedentary physical activity and longer duration of DM were significant independent correlates of DFS. Conclusion The overall prevalence of DFS was high among the study population; hence the screening for foot complications should start at the time of diagnosis of diabetes integrated with sustainable patient education at primary care level by training of health care providers at primary care level