Population based screening for diabetes: experience in Mumbai slums, Maharashtra, India

Background: The number of diabetic patients has increased over the years due to urbanization, high intake of unhealthy diet and a sedentary lifestyle. Majority remain undiagnosed as no systematic screening programme exists in the country. There is evidence that early diagnosis through simple screening test followed by confirmatory test can help to diagnose asymptomatic diabetics, thereby reducing or delaying the onset of complications. The programme aims for early diagnosis of diabetes through a population based screening programme.Methods: In the selected area, house-to-house visit was done to identify individuals aged 25 and above with and without diabetes. Those without a history of diabetes and consenting to participating were subjected to random capillary blood glucose testing. Those found to have raised blood glucose levels were further offered confirmatory testing at the urban health training centre or referred to their physician for further evaluation.Results: The participation rate for random capillary blood glucose testing in the community was very high. 70% of those available were tested using rapid blood glucose testing device. Amongst the 315 individuals tested, mainly women, 14% were found to have blood glucose levels above 140 mgs%. However the number of persons reporting for further evaluation was very poor. Only one person reported for further evaluation and was diagnosed as diabetic and inititated on treatment.Conclusions: Though it is possible through a population based screening programme to identify individuals with raised blood glucose levels, to what extent it will translate into early diagnosis of diabetes is uncertain.

A Prospective Observational Study on Rational Use of Antibiotics for Paediatric Patients with Respiratory Tract Infections in a Tertiary Care Hospital

Background: Antibiotic drug overuse and inappropriate antibiotic drug selection are associated with increased drug resistance among respiratory pathogens (most notably, Streptococcus pneumoniae), possible progression to chronic disease, and increased treatment costs.[1] The selection of an antibiotic for prophylaxis should be based on known or likely target pathogens, for a short duration of time. Objective: To evaluate Rational use of antibiotics in Paediatric patients suffering from Respiratory tract    infections. Method: It was Prospective, observational study conducted by random selection of patients. Based on diagnosis, the study population was categorized into 2 groups: Upper respiratory tract infections and Lower respiratory tract infections. The study population was interviewed after obtaining written informed consent for information like demographics, diagnosis, treatment and antibiotics prescribed. Results and Discussion: In our study population, it was observed that male patient (74%) were higher than female patients (26%). Total number of antibiotics prescribed during the study period is 83. Most commonly prescribed antibiotic was Augmentin (Amoxicillin +Clavulanic acid) of dose (450mg IV BD) which is the combination drug, i.e, more effective than individual antibiotic drugs. Conclusion: In the present study it is observed that 4-different classes of antibiotics-Pencillins,Cephalosporins,Macrolides and Aminoglycosides were prescribed and used for different Respiratory diseases.The percentage of average antibiotic utilization is highest in Lower Respiratory Tract Infection with (55.22%).Mostly used Antibiotic in males for both LRTI and URTI is Augmentin with the percentage of (52%) and (80%) respectively.Where as in females it is observed that in both LRTI and URTI mostly used Antibiotic is Augmentin with percentage of (38.8%) and( 80%) respectively.Overall Second mostly used antibiotic is Ceftriaxone. Keywords: pediatrics, lower and upper respiratory tract infections, antibiotics.&nbsp