Risk of falls and its association with activities of daily living and depression among elderly residing in a rural area in Bangalore, Karnataka

Background: According to 2011 censes, elderly account for 8.6% of Indian population and is projected to become 20% by 2050. Early identification and prevention of fall-related factors would play a vital role in reducing the health costs in elderly. The objective of the study was to assess the risk of falls among elderly residing in Mugalur subcentre, Bangalore Urban.Methods: A cross-sectional study was conducted at the ten villages of Mugalur subcenter, from March-May 2019 using a structured questionnaire that was administered through a face-validated interview. Systemic random sampling was done from the ten villages, proportionate allocation was done to reach a calculated sample size of 220. Timed up and go test (TUG) was done for all participants.Results: Mean age of the study population was 69.05±8.3years. Among the study subjects, 40 (18.2%) had moderate risk of fall and 9 (4.1%) were seen to have high risk of fall. 26 (11.8%) subjects had a fall in past one year. TUG test showed a median value of 18.5 seconds, and 179 (18.4%) elderly had TUG result ≥13 sec. According to Geriatric Depression scale (GDS-15), 18 (8.2%) subjects were found to be severely depressed. Significant association was seen between the GDS-15 scores and risk of falls according to Fisher’s exact test. The mean TUG score was shown to have a significant association with the risk of falls according to ANOVA.Conclusions: Moderate to high risk of fall is seen among 22.3% of the elderly. Significant association was seen between age, TUG score and depression with risk of falls.  

Parotid fistula secondary to suppurative parotitis in a 13-year-old girl: a case report

<p>Abstract</p> <p>Introduction</p> <p>The most common cause of parotid fistula is trauma, followed by malignancy, operative complications (parotidectomy or rhytidectomy) and infection. Acute suppurative parotitis can rarely produce parotid fistula. There are various treatment options available, however it is necessary to standardize the treatment according to the duration of history and the patient's general condition.</p> <p>Case report</p> <p>A 13-year-old Indo-Caucasian girl presented to us with a two-year history of clear watery discharge from a wound just above and behind the angle of her right jaw. A diagnosis of salivary (parotid) fistula was made based on clinical examination and investigations. The parotid fistula was successfully managed.</p> <p>Conclusion</p> <p>Parotid fistula secondary to suppurative parotitis is rare and difficult to manage successfully. Meticulous dissection, complete excision of the fistulous tract with closure of the parotid fascia and layered closure of the incision followed by application of a post-operative pressure bandage, anticholinergic agents and antibiotics contribute significantly to the successful management of this difficult clinical condition.</p

Optic disc and retinal vessel changes in children with surgically treated hydrocephalus: a cross-sectional study

AIM: To study the optic disc and retinal vessel morphology using both indirect ophthalmoscopy and optical coherence tomography in children with surgically treated hydrocephalus. Methods: A cross-sectional study was performed with 50 children of surgically treated hydrocephalus as cases and compared them with 50 age matched controls. All children were examined by indirect ophthalmoscopy and optical coherence tomography for the evaluation of optic disc and retinal vessel changes. Results: Optic atrophy was found in six out of the fifty children (12%) tested. In comparison with the reference group, median optic disc area was significantly smaller (p<0.0001) in children with hydrocephalus. There was not much difference in cup area, but the rim area was smaller (p<0.0001) in children with hydrocephalus. On indirect ophthalmoscopy children with hydrocephalus had optic atrophy and abnormal retinal vascular pattern. Conclusion: Children with surgically treated hydrocephalus were found to have subnormal optic disc and neuro-retinal rim areas with abnormal vascular pattern. The importance of diagnosis of these optic disc and retinal vessel changes in children with surgically treated hydrocephalus by OCT imaging and follow up at regular intervals to look for any additional changes can help us to prevent further damage to the optic nerve

Mitomycin C in ophthalmology

Introduction to the use of Mitomycin C in ophthalmology was a significant development in the 1960s. Its use and application in ophthalmology has been increasing in recent years, because of its modulatory effects on wound healing. Current applications of this drug in ophthalmology include pterygium surgery, glaucoma surgery, corneal refractive surgery, cicatricial eye disease, conjunctival neoplasia, dacryocystorhinostomy surgeries, squint surgeries, and allergic eye disease. Although it has been used successfully in these conditions, it has also been associated with significant complications. This article reviews the current trends and uses of mitomycin C in the eye and its reported complications

Prevalence of thyroid disorders in type 2 diabetic patients – A 1-year cross-sectional study

BACKGROUND: Diabetes is one of the commonest health problem and has become a major health challenge worldwide. There is evidence from the literature suggesting that the intricate bond between Thyroid disorder and diabetes mellitus deceivingly contributes to micro and macro-vascular complications. OBJECTIVE: This study is being undertaken to determine an association between prevalence of thyroid disorders in Type 2 diabetic patients. MATERIAL AND METHODS: A hospital based prospective cross sectional study was carried out in the department of Medicine, at a tertiary care hospital in Belgaum. The study included 100 Type 2 diabetic patients who were interviewed for demographic details, duration of diabetes and history of other comorbid conditions. The patients were subjected to clinical examination and were investigated for fasting blood sugars, post prandial blood sugars, glycosylated haemoglobin (HbA1C), free triiodothyronine (T3), free thyroxine (T4) and thyroid-stimulating hormone (TSH). Data was analysed using SPSS statistical software version 20.0. RESULTS: The prevalence of thyroid disorder in type 2 diabetic patients was 35%. Of them 16% had subclinical hypothyroidism. The males outnumbered the females in the study and 22% of the males had thyroid disorder (P = 0.8390).Subjects in the age group of 61 to 70 years, prevalence was higher as compared to other groups (P = 0.0569).There was an increased risk of thyroid dysfunction in long standing type 2 diabetics (P = 0.0240).The prevalence was higher in patients with poor glycemic control, though the findings were not statistically significant (P = 0.1021). CONCLUSION: Thyroid Dysfunction is widely prevalent in patients with type 2 diabetes in our study. Hence it is prudent to screen routinely for Thyroid dysfunction in type 2 Diabetic patients, which will help in improving the quality of life and reduce the mortality rate

An intersection of right to privacy and surrogacy law: Experiences from other countries

Privacy is an essential component of human existence, and is now a fundamental right of every individual. It is realised that this fundamental right to maintain one's secrecy and solitude according to one's whims requires a definitive meaning and strict practical application to ensure citizens autonomy. The necessity for privacy regulations and civil rights of privacy for every individual, regardless of sexual choice, sparked the privacy debate in the twenty-first century. However, because privacy is not an absolute right, every invasion must be justified by law and must be founded on legality, need, and proportionality in order to protect this prized right. One such on-going instance is the relationship between the Surrogacy Bill and the Right to Privacy. The Bill is heavily criticised for being discriminatory, prejudicial, and invasive of the fundamental right to privacy. In the paper, the author traces out &nbsp;how the Right to Privacy pertains to one's body with regard to the Surrogacy Bill. Issues of bodily autonomy, consent, information sharing, and so on are thoroughly discussed in the paper.&nbsp

Endoscopic Ostium Assessment Following Endonasal Dacryocystorhinostomy with Mitomycin C Application

Aim: The aim of the study is to visualize the patency and measure the ostium size at the end of Endonasal DCR with mitomycin C (MMC) versus control and to assess the role of Mitomycin C in maintaining patency of nasolacrimal drainage system. Design: Prospective randomized controlled study Participants: Sixty patients who consented for this study was subjected to endonasal DCR and randomised into 2 groups (30 cases with mitomycin – C and 30 cases without MMC). Methods: Mitomycin-C 0.2mg/ml was applied intra-operatively for 5mins to the ostium site at the end of endonasal DCR in the MMC group. Results: In the mitomycin C group, 97% (29/30) of the ostium was found to be patent while in the control group 87% (26/30) were found to be patent. It was found that there was statistically significant difference in the osteotomy surface area between the MMC group and control group (p < 0.001).Both groups had a mean follow-up of 24-36 months. No complications were associated with use of Mitomycin-C. Conclusion: Intra-operative use of Mitomycin- C in endonasal DCR is safe and effective in maintaining the ostium size and thereby increasing the success rate

Assessment of hearing in patients undergoing tympanoplasty with and without cortical mastoidectomy for chronic otitis media: A hospital-based, randomized controlled trial

Aims: To assess hearing in patients undergoing tympanoplasty with and without cortical mastoidectomy for chronic otitis media. Settings and Design: A hospital-based, randomized controlled study. Subjects and Methods: The study included sixty patients. Patients were randomly allocated into two groups of thirty each. In Group 1, patients underwent tympanoplasty alone. In Group 2, patients underwent tympanoplasty with cortical mastoidectomy. Hearing assessment was done by pure tone audiometry. Follow-up period was 3 months. Statistical Analysis Used: Paired and unpaired t-tests were used for quantitative variables and Chi-square test was used for qualitative ones. P< 0.05 was considered statistically significant. Results: The mean pre- and post-operative pure-tone average was 42.4 ± 10.53 dB and 32.8 ± 13.02 dB in Group 1, with a mean hearing gain of 9.5 ± 11.33 dB. The mean pre- and post-operative pure-tone average was 42 ± 10.43 dB and 34.9 ± 9.94 dB in Group 2, with a mean hearing gain of 7.1 ± 8.85 dB. The mean pre- and post-operative air-bone gap was 37.27 ± 9.51 dB and 24.21 ± 11.64 dB in Group 1, with improvement in air-bone gap of 13.07 ± 12.93 dB. The mean pre- and post-operative air-bone gap was 32.27 ± 11.53 dB and 23.75 ± 9.91 dB in Group 2, with improvement in air-bone gap of 8.52 ± 9.13 dB. No statistically significant difference was seen between the two groups. Conclusions: Combining cortical mastoidectomy with tympanoplasty in the patients of chronic otitis media, mucosal disease, offers no additional benefit in terms of hearing improvement compared to tympanoplasty alone

Creación de un programa pionero de educación interprofesional para una asistencia sanitaria óptima

Critical adjustments are needed in the health professions curricula to produce prepared graduates for the workforce. Our goal was to consider the applicability and use of the interprofessional education program (IPD) design for the Department of Health Sciences at North-West University in South Africa. This research used an ordered multidisciplinary design to create an IPD curriculum for a South African medical faculty. To summarize the global organization, development, and execution processes of IPD programs, a scoping review was done. An examination of IPD programs from institutions across five continents came next. The viewpoints of worldwide specialists on the creation and execution of IPD programs were subsequently investigated in a qualitative study. After that, the setting of universities was examined, and a draft IPD program was developed utilizing the data compiled from all earlier investigations. Faculty members were given the program to review and comment using an insignificant group technique. The IPD program development process was established in ten parts for the scoping study. Through each phase, manual and to-do lists were supplied for the subjective analysis of documents to assist educators in conceptualizing, creating, executing, and reviewing their IPD programs. Four themes were found during the personal exploratory, descriptive design transcript analysis. To prepare for full academic incorporation of the IPD into the teaching staff of Health care programs throughout subsequent development of the health science curricula, a three-year option IPD program was created. The established alternative 3-year IPD program will act as an example of how a credit-bearing IPD doctorate can eventually be incorporated into the academic programs of the Department of Health Sciences.En los planes de estudio de las profesiones sanitarias se necesitan ajustes críticos para producir graduados preparados para la fuerza laboral. Nuestro objetivo fue considerar la aplicabilidad y el uso del diseño del programa de educación interprofesional (IPD) para el Departamento de Ciencias de la Salud de la Universidad North-West de Sudáfrica. Esta investigación utilizó un diseño multidisciplinar ordenado para crear un plan de estudios IPD para una facultad de medicina sudafricana. Para resumir la organización global, el desarrollo y los procesos de ejecución de los programas IPD, se realizó una revisión del alcance. A continuación se examinaron los programas de DPI de instituciones de los cinco continentes. Posteriormente, se investigaron en un estudio cualitativo los puntos de vista de especialistas de todo el mundo sobre la creación y ejecución de programas de DPI. A continuación, se examinó el entorno de las universidades y se elaboró un borrador de programa de DPI utilizando los datos recopilados de todas las investigaciones anteriores. Se entregó el programa a los miembros del profesorado para que lo revisaran y comentaran mediante una técnica de grupo insignificante. El proceso de desarrollo del programa IPD se estableció en diez partes para el estudio de alcance. A lo largo de cada fase, se suministraron manuales y listas de tareas para el análisis subjetivo de documentos con el fin de ayudar a los educadores a conceptualizar, crear, ejecutar y revisar sus programas de DPI. Se encontraron cuatro temas durante el análisis de transcripciones de diseño personal exploratorio y descriptivo. Para preparar la plena incorporación académica del IPD en el profesorado de los programas de asistencia sanitaria a lo largo del desarrollo posterior de los planes de estudios de ciencias de la salud, se creó un programa IPD alternativo de tres años. El programa IPD alternativo de tres años establecido actuará como ejemplo de cómo un doctorado IPD con créditos puede eventualmente incorporarse a los programas académicos del Departamento de Ciencias de la Salud

Use of electronic information sources at the College of Fisheries, Mangalore, India

234-245Examines the use of electronic information sources (EIS) by the teachers/scientists, research scholars and postgraduate students in the College of Fisheries, Mangalore. A survey was administered among the academic community along with observations and informal interviews at the College of Fisheries, Mangalore. Demonstrates and elaborates the various aspects of EIS use such as frequency and purpose of EIS use, frequently used EIS, methods of learning to use EIS, benefits of EIS use, constraints faced in the use of EIS and the satisfaction level of users in the use of EIS. Suggestions have been given to strengthen the existing electronic information sources and services and to maximize the use of EIS among the fisheries institution academic community