Patterns of epithelial cell abnormalities in Pap smears and its clinicopathological and demographic association: a descriptive study from Visakhapatnam city, Andhra Pradesh, India

Background: Cervical cancer is one of the leading cancers amongst women. Periodic pap screening is the simplest way to diagnose precancerous lesions. Factors such as ignorance, poverty poorly developed public healthcare delivery system put women in urban slums at a disadvantage for receiving any health screening activity. Objectives of the present study were to know the prevalence of epithelial cell abnormalities of the cervix among the subjects and to study the association with clinical and demographic characteristics.Methods: A camp based descriptive study was conducted in an urban ward. All women above the age of 20 years were included in the study. Data was recorded using a pretested questionnaire. Study variables included socio-demographic characteristics, symptoms of reproductive tract infection, findings of clinical examination, and Pap smear collection and evaluation. The latter was done from 194 women aged between 20-69 years. Pap smears were made by conventional Pap smear technique and reported according to The Revised Bethesda System of classification 2001(TBS).Results: Among the 194 women, in 8 subjects, the smears collected were unsatisfactory for evaluation. Analysis was done in the remaining 186 subjects. Among the latter, in 83.9%, the smears were negative for intraepithelial lesions (NIEL) and 16.1% revealed epithelial cell abnormalities (ECA). Among those with ECA, Atypical cells of undetermined significance (ASCUS) was identified in 66.67%, Low grade squamous intraepithelial lesions(LSIL) in 16.67%, Atypical squamous cells-cannot exclude HSIL (ASC-H) and Atypical glandular cells-not otherwise specified (AGC-NOS) in 6.67% each and High grade squamous intraepithelial lesions (HSIL) in 3.33%. Epithelial cell abnormalities were more common in women in the age group of 30-60 years (80%), they were more common in those with age at marriage between 13-18 years (63.3%) and in those with age at first child birth between 15-19 years (56.7%). Conclusions: Therefore there is a need for Pap screening at regular intervals through camp based approach in these populations to motivate the women, increase their awareness, ensure follow up and referral and timely intervention in appropriate cases.

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

IJCM_198A: Effectiveness of a video assisted awareness program on knowledge and practices of road safety among Medical students of Kakinada, Andhra Pradesh: An Interventional Study.

Background: Road safety is an issue of great concern across the world. In the last year 1,354,840 road users have died equivalent to 3712 deaths per day in the world. It is crucial to create awareness about the road safety to instill responsible behavior among citizens. Objectives: To assess baseline knowledge and practices of road safety among medical students. To compare the change in knowledge and practices assessed one month after a video assisted awareness program. Methodology: An interventional study was conducted among medical students from 1st professional year to final year, interns at Rangaraya medical college, Kakinada. Considering prevalence of 58.3% from previous study, allowable error 10%, sample size is calculated by using 4PQ/L2 as 287. Out of 1450 medical students, 287 were selected using Probability Proportionate to size sampling and 40, 50, 50, 48, 50, 49 from 2018-2023 batches using Simple Random Sampling. Students who gave written consent were included; non-drivers were excluded. Pre-tested semi-structured questionnaire was prepared and google form was shared to the study participants. A pilot study was done among 30 students. The study was approved by Institutional Ethics Committee. Data was analyzed using SPSS software Version 21. After baseline study, intervention will be done using a video assisted awareness program. Post-intervention results will be presented at the conference. Results: Among the participants, males and females were 46.5%, 53.5% respectively. Majority of them (77.7%) drive a two-wheeler. 70.3% have poor knowledge regarding airbag deployment during a crash, poor knowledge about vehicle maintenance (70.7%). About 77.7% do not use helmet, 44.9% do not use seat belt, 45.3% had distracted driving. Conclusion: The knowledge of participants was found to be fair and the practices were found to be poor

IJCM_323A: Assessment of Caregiver Burden Among Family Members of People Living with HIV/AIDS (PLHIV) in Costal Andhra Pradesh, India: - Mixed Method Study

Background: As PLHIV now live longer, family caregivers play a crucial role in providing physical, emotional, and financial support. This study investigates the burden experienced by family caregivers of People Living with AIDS (PLHIV) in Kakinada District, Andhra Pradesh. Objectives: 1. To assess burden Among caregivers (family members) of PLHIV. 2. To Explore care giver perspective of caring experiences Methodology: Methodology: The study is a cross-sectional study. By using mixed-method approach both qualitative and quantitative data was collected by convenient sampling method in an ART Centre of Kakinada District. Prior approval was taken from Institutional Ethics Committee. A pretested semi-structured questionnaire for socio-demographic information and validated, standardized 22-item Zarit Burden Interview (ZBI) tool to assess the perceived caregiver burden. Quantitative analysis done by using SPSS and Qualitative Information gathered through in-depth interviews. These were recorded, transcribed, translated, and later coded for analysis following thematic approach. Results: Demographics revealed that Female were 54.8% and Male were 45.2%. The mean age group was 38.38±11.5. In this study revealed that 22.6% were under severe burden & 12.9 % were moderate to severe &38.7% were mild to moderate burden. Mean Zarit Burden score was 36.32±18.8. Caregivers faced a range of challenges, pertaining to physical, psychological, emotional, social, and financial burden. Challenges experienced by the them regarding stigma and discrimination are more common. Conclusion: Majority of caregivers having Burden. Caring for someone with HIV/AIDS brings both positive and tough experiences for caregivers. ongoing support is crucial for families in this situation. Simple, focused measures can make a real difference in the well-being for caregivers and Improve Care givers experience

Nutritional Status of School Going Adolescents in Rural and Urban Areas of Visakhapatnam

Introduction: One of the greatest health problems globally as well as in India is under-nutrition among children. Early adolescence is a nutritionally vulnerable time when rapid physical growth increases nutrient demands. Inspite of several heath programs, conditions such as infections and malnutrition continue to be major threat leading to morbidities. This research intends to study and compare the nutritional status of school going adolescents aged between 11 yrs to 15 yrs in rural and urban areas of Visakhapatnam. Methods: A cross sectional study was conducted among 800 early adolescents aged between 11 yrs to 15 yrs in government schools of rural and urban areas of Visakhapatnam. BMI-for-age was measured for assessment of nutritional status and BMI z scores were calculated based on WHO growth reference data for 5-19 yrs. Results: Among boys , 43.1% from rural and 35.11% from urban areas were thin ie having BMI for age < - 2SD. About 7.52% of boys in urban areas are in overweight or obese. Among girls (BMI for age <-2SD is almost similar in rural and urban areas. Anaemia is found to be more among adolescents residing in urban areas compared to rural. Conclusion: Malnutrition in both forms is more prevalent in boys both from rural and urban areas. Stringent implementation of Govt. schemes is needed to improve the nutritional status

IJCM_399A: Assessment of Utilization of Kilkari Services among Antenatal Women in the field practice area of a Government Medical College in Kakinada, Andhra Pradesh

Background: Kilkari is an interactive voice response based mobile service which gives information about maternal and child health through pre recorded voice calls to registered mobile number of pregnant women during the critical period of pregnancy and lactation period i.e. 4th month to until the child is one year of age providing knowledge regarding various health care aspects for the mother and child. There is paucity of literature regarding utilization kilkari in the community and the current study is conducted to asses the awareness among antenatal women. and augment the awareness. Objective: 1. To estimate the proportion of antenatal women aware of kilkari services. 2. To estimate the proportion of antenatal women utilizing kilkari services. 3. To identify the factors associated with non-utilization of kilkari services. Methodology: The current study is an observational cross-sectional study conducted in November 2023 among 100 antenatal women in field practice area of a Govt. Medical College. Data was collected by using semi structured questionnaire via google forms and analysis was done using Ms Excel 2007 and IBM SPSS 21. Prior approval was taken from Institutional Ethics Committee. Results: In the current study, 57.1% of antenatal women were aware of kilkari services and utilization of services was found among 44.8% of antenatal women. Factors associated with non-utilization of services were (65.5%) not aware of program, (55.2%) not informed by health team, (17.2%) no smart phone, (34.5%) call given but not connecting. Conclusion: There is a large gap in knowledge regarding kilakari among antenatal women for which education needs to be provided at gross root level in the community

Perceptions of 99dots among Health Staff and Beneficiaries Attending the Visakhapatnam District Hospital, Andhra Pradesh

Back Ground: The Need of the hour in TB treatment is compliance and motivation to prevent drug resistance TB. To achieve this one of the methods adopted keeping in mind the easy availability of mobile phones is 99DOTS. The study was conducted to know the perception of 99DOTS among Health staff and Beneficiaries. Methodology: A Qualitative study was conducted by doing In- depth interviews and Focus Group Discussions (FGDs) during November 2017 at ART Centre and TB Hospital. Sample size in- cluded beneficiaries on Phone call (22), one to one interviews (5) of Beneficiaries, Key informants (8), and FGDs (2). Results: Key informants perceived that it as a good programme as the reason being adherence and protection of patient identity is maintained. Problems regarding 99 dots are missing of direct ob- servation of the patient regarding consumption of the tablet and problem in usage of mobile phones by illiterates. Patients per- ceived the concept of 99 dots as a good programme as adherence is improved and their personal privacy is protected. Problems like lack of personal phone, difficulty in usage of phone, non- availability of Network and seeking help from others due to illiter- acy. Conclusion: 99DOTS improves convenience to patients and allows providers to focus on non-adherent patients. Patients have to be trained for using mobile features such as remainders, alerts

IJCM_397A: A Cross-Sectional Study on Dietary Intake In Relation To Sleep Quality Among Undergraduate Engineering Students

Background: Sleep is an important resting state and essential part of life that could have effect on many aspects of life. Life style factors such as physical activity and consumption of certain foods have effect on quality and quantity of sleep. In this context, there were very few studies done in comparing dietary intake & sleep pattern. So, the present study is planned to be conducted among undergraduate engineering students. Objective: 1. To assess the dietary intake and sleep patterns among undergraduate students. 2. To determine the relationship between dietary intake and sleep quality. Methodology: A Cross-sectional analytical study was done among the undergraduate students of a government engineering college in November 2023. Students (n=200) were randomly selected and data was collected using pre-tested, semi structured questionnaire to assess the dietary intake and Pittsburgh sleep quality index questionnaire (PSQI) to assess sleep quality. Results: The mean age of the study population was 20.2 ± 1.6 years and 54.5% were female. Sleep quality was fairly good among 58%, good in 29%,fairly bad in 11.5%,and very bad in 1.5%. Participants skipping breakfast, lunch and dinner more than three times a week was reported to be 21%,10%, and 16.5% respectively. Conclusion: The quality and quantity of sleep can be influenced by the eating habits. Specific awareness regarding sleep and food intake should be created among the students, as in the long run NCD s can be prevented and to form a healthy nation

IJCM_176A: Prehypertension and its association with anthropometric indices among young adult Bank Employees of a city in coastal district of Andhra Pradesh-A cross-sectional study.

Background: Hypertension is a rapidly emerging modifiable lifestyle disease and is often called as the silent killer. Owing to a steady increase in the prevalence it is of public health concern. Hypertension develops gradually preceded by prehypertension as evidenced by longitudinal studies. Bank employees lead a sedentary and highly stressful life that often leads to developing NCD’s such as hypertension. The study aims to assess the prevalence of prehypertension among them. Objectives: 1. To assess the prevalence of Prehypertension among bank employees. 2. To determine the association between various anthropometric measurements and Prehypertension among bank employees. Methodology: A Cross-sectional Study was carried out among the bank employees of urban Kakinada, during October & November 2023 and their hypertension status was assessed. List of banks in the city was obtained and 32 of them were selected by simple random sampling using lottery method. Sample size was calculated using the formula=z2pq/l2 with an allowable error of 15% of prevalence.Prevalence(55.3%) was taken from the study done by Sira Jam Munira and sample size was 140.Young adults(25-44years) of age from the rank of Clerk and above were included in the study. Modified WHO STEPS questionnaire was used to collect data using Kobo toolbox and the data was analysed using MS Excel 2019 and SPSS 21. Prior approval was taken from Institutional Ethics Committee. Results: A total of 308 respondents constituted the study population. The mean age of the participants was 52.80±10.97 years. Among various domains of QOL, mean scores were found to be maximum for environmental domain (54.08± 14.76). Females have lower scores among various QOL domains as compared to their male counterparts. Age was found to be independent predictor for all the domains of QOL. Literacy, monthly family income, presence of self-reported stress and duration of the diabetes were all significantly associated with majority of domains of QOL on multivariate analysis (P<0.05). Conclusion: Advancing age and duration of diabetes were found to be among important predictors of QOL. Conclusion: Young adult bank employees had high prevalence of prehypertension and it was more prevalent among females

IJCM_260A: Utilization of dbt(direct benefit transfer) under Nikshay poshan yojana by tuberculosis patients attending to tuberculosis unit in a government general hospital.

Background: Nikshay Poshan Yojana was launched by MoH&FW, a centrally sponsored scheme under National Health Mission (NHM)on April 2018. Under the programme financial incentive of Rs.500/- per month is given for each notified TB patient, whether treated in public or private sector notified on the Nikshay platform. This study aims to understand the utilization of NPY. Objectives: 1. To know the purpose of utilizing the NPY by the TB patients. 2. To assess the gaps for delay in credit the amount. Methodology: It’s a cross-sectional study done among patients who were registered at DTC-TB unit of Government Medical College Kakinada through telephonic interview. Sample size was estimated to be 64 taking prevalence of NPY as 80% with absolute error of 10%. Data was collected by using questionnaire in November 2023 and analyzed by SPSS 21.0. Prior permission from Institutional Ethics committee was obtained. Results: Mean age of participants was 41.4+12.4yrs. Males contributing 85.4% and females 14.6%. Nearly half (48%) has taken 2months of treatment, 97.9%were under category I treatment and all were enrolled under NPY. Awareness on NPY was 79.2% and 95.8% reported irregularity in getting NPY. Out of those who received NPY, only 42.1% utilized it for nutrition. Conclusion: DBT enrolment was good. Availability of DBT to the patients was very minimal