Compliance to Treatment among Type II Diabetics receiving care at Peripheral Mobile Clinics in Kaniyambadi Block of Vellore District.

INTRODUCTION : Diabetes Mellitus has been recognized for long and in all ancient civilizations. The endeavour to understand and treat this condition is a long one. Numerous Studies have been conducted to understand its etiopathogenesis, progression and Treatment . The incidence of diabetes is increasing and the onset is at a younger Age. Diabetes related complications are on the rise, thereby creating a large burden On the health care system. OBJECTIVES : To measure ; 1. The rate of compliance to oral hypoglycemic agents, 2. The level of physical activity and caloric intake and 3. The level of glycemic control among diabetics managed in the periphery. 4. To measure the association between each of these factors independently and in combination with glycemic controls. METHODS : A cross sectional study was done. One hundred participants were randomly selected for the study. All those above the age of thirty, being treated for diabetes mellitus type 2 in the doctor-run mobile clinic were eligible to participate in the study. Those on insulin therapy and those bedridden were not included. The following parameters were measured for each person: (a) Diet intake, (b) Physical activity, (c) Compliance to therapy, (d) Glycated hemoglobin Correlation between these factors and glycemic control was measured. RESULTS : Out of the 100 participants, 74% were female, and47% were from the upper middle class. Those who were taking 80% of the expected number of pills were classified as compliant and it was found that 50.5% of those prescribed metformin were compliant and 45.3% of those prescribed glibenclamide were compliant. The mean caloric intake per day was 1614.83 Kcals (95%CI 1494.6- 1735.1) Out of the 100 participants 39% had a sedentary lifestyle and 60% had moderately active lifestyle. The mean Hba1c was 7.3% and 48.8% had ideal glycemic control. The remaining 25.6% had unsatisfactory control. No correlation was found between sedentary lifestyle and uncontrolled sugars. It was found that HbA1c significantly reduced with better adherence

Trends in caesarean section rates in a rural block of southern India

Background: Over the last decade many programmes have been implemented to improve the health of pregnant women and neonates. This study aims to look at the changes in modes of delivery and perinatal mortality rates in a rural block of Tamil Nadu between 2006 and 2015.Methods: Data on all the births that have occurred in this rural block of Tamil Nadu that has been prospectively collected between 2006 and 2015 was analysed. A longitudinal analysis was done to calculate the primary and overall caesarean section rate and the average annual rate of increase. The perinatal mortality rate was also calculated.Results: The primary LSCS rate has increased from 9.08% in 2005 to 16.1% in 2015. The overall caesarean section rate has increased from 11.7% to 19.2% in the same time with an average annual rate of increase of 5.1%. During this period the perinatal mortality has decreased from 33 per 1000 live births to 17 per 1000 live births.Conclusions: Though the overall caesarean section rate is higher than the 15% prescribed by WHO the rates are lower than the rest of the country and rural Tamil Nadu

Compliance to treatment among type 2 diabetics receiving care at peripheral mobile clinics in a rural block of Vellore District, Southern India

Background: Providing treatment to patients with diabetes mellitus in rural areas at a cost they can afford is a public health challenge. Aims: This study aims to measure the rate of compliance to oral hypoglycemic agents among patients with type 2 diabetes mellitus attending peripheral mobile clinics in rural South India. To study factors that impact glycemic control. Setting and Design: A cross-sectional study was done among patients attending peripheral mobile clinics in a rural block in Southern India. Materials and Methods: Pill counts were done to assess compliance. Participants' dietary intake was measured using a 24 h diet recall and their level of physical activity was measured using the WHO Global Physical Activity Questionnaire. Glycated hemoglobin (HbA1c) was measured for all participants. Statistical Analyses Used: Data were entered on EpiData and analyzed using SPSS. The prevalence of good glycemic control and good compliance was measured. A multiple linear regression was done to study factors affecting glycemic control. Results: Overall 52% of the participants were compliant to at least one drug and 50% had achieved good glycemic control. Compliance increased by 2.1% with every passing year since the diagnosis of diabetes. HbA1c reduced by 0.09% for every 10% increase in overall compliance. Conclusions: Levels of compliance and glycemic control achieved through this primary care team is comparable to those achieved through other systems

Prevalence and risk factors for neck pain among health care workers.

Background: Work related neck pain (WRNP) is common among professionals. Its cause is multifactorial and results in loss of productivity and avoidable morbidity. Aims & Objectives: To estimate the prevalence and risk factors of WRNP among the support staff of a tertiary hospital. Material & Methods: 558 support staff were randomly selected to estimate the prevalence of neck pain. Staff with severe WRNP were then included in a nested case control study to identify risk factors. Results: 37% of workers reported neck pain in the preceding 3 months. Female gender, improper posture, jobs requiring repetitive movements, perception of decreased job control, high body mass index and psychosocial stress were identified as the significant risk factors. Conclusion: Better ergonomics, improving the perception of job control and encouraging micro breaks during the work time may decrease WRNP