Efficacy of targeted narrowband ultraviolet B therapy in vitiligo: a prospective study

Background: Vitiligo is an acquired disorder of skin pigmentation that is associated with tremendous psychological impact on the affected patients. Narrow-band ultraviolet B (NBUVB) is an emerging, effective and safe therapy for vitiligo. The objective of the study was to know the effi cacy and safety of NBUVB therapy in 31 vitiligo patients of various age groups.Methods: This was a prospective and non-randomised study carried out in GMERS Medical College, Gandhinagar, Gujarat during the period of 1st January 2011 to 30th June, 2014. This study was conducted in 31 patients of “stable” vitiligo involving less than 5% body surface area (BSA) after taking verbal and written consent of the patients. Study was done on OPD bases by giving targeted NB UVB lamp to various age groups of vitiligo patients along with topical momentasone cream at various stage of disease. This all patients were followed up at monthly interval. The repigmentation response was correlated with the duration of the disease, site of the involved lesion and age of the patient. Chisquare test was used for assessing the statistical significance of the results obtained and a p < 0.05 was considered as “statistically significant.”Results: Most of the patients (29 /31) enrolled for the study was suffering from “vitiligo vulgaris” and only 2 patients had segmental/focal type of vitiligo in the study group. Duration of vitiligo ranged from 1 year to 16 years with a mean of 4.19 years. The age of the enrolled patients ranged from 13 years to 48 years with a mean of 26.5 years. Complete repigmentation was achieved in 10 patients while 14 patients showed moderate to good improvement. Out of 23 lesions on face and neck, 12 (52.1%) showed 90-100% repigmentation. Out of 18 lesions on trunk, 8 (44.4%) showed 90-100% repigmentation. Out of 14 lesions upper limb, 7 (50%) lesions showed 90-100% repigmentation.Conclusions: NBUVB therapy is an effective and safe modality to treat vitiligo of all age groups with cosmetically acceptable repigmentation. Age of the patients or duration of vitiligo was seen to have minimal effect on the repigmentation response.

Knowledge and awareness of tuberculosis in caregivers of paediatric tuberculosis patients of north Gujarat region, India: a cross sectional study

Background: Tuberculosis (TB) continues to be one of the most important public health problems worldwide. Children are especially vulnerable to the effects of tuberculosis, which is often difficult to diagnose and therefore difficult to treat effectively. The compliance for treatment can be increased if caregivers of paediatric TB patients are well aware about the disease, treatment and preventive measures.Methods: This cross sectional observational, descriptive epidemiological study was conducted at GMERS medical college and hospital Dharpur-Patan located in north Gujarat during January 2015 to June 2015. The study was conducted among all the 151 pediatric TB patients who were currently under treatment at selected hospital. Caregivers of the patients were informed about the purpose of the study and their informed written consent was taken. By interviewing them on the basis of pre-designed and pre tested preform, information regarding socio demographic profile, knowledge and awareness regarding TB was collected. The collected data was analyzed using statistical package for social science (SPSS 17 Trial version).Results: Only 68 (45.0 %) caregivers of patients had knowledge regarding mode of spread of TB infection to others. 89 (58.9%) caregivers of patients knew about curability of the disease. 104 (68.9%) caregivers of patients had knowledge regarding DOTS (Directly Observed Treatment Short course chemotherapy) centre for TB treatment under RNTCP (Revised National Tuberculosis Control Programme). 32.3% caregivers of the patients knew that TB can be prevented by BCG vaccine. The literacy status had a significant influence on awareness about TB. Conclusions: Apart from pharmacological treatment poor knowledge of tuberculosis in caregivers of the paediatric TB patients also needs great attention for better control and prevention of TB in paediatric age group.

Impact of educational intervention regarding hazards of obesity and its preventive measures among students of commerce colleges of Ahmedabad city, Gujarat, India

Background: The prevalence of obesity has increased worldwide in almost every country in all the age groups. A college is a key location for educating students about health, hygiene and nutrition, and for putting in place interventions to promote the health of them. Objective of the study was to know the prevalence of obesity and overweight among students of commerce colleges of Ahmedabad city and to assess knowledge of these students regarding hazards of obesity and its preventive measures before and after educational interventional training.Methods: The present interventional study was undertaken during September 2011 to December 2011 in randomly selected 3 commerce colleges of Ahmedabad city, Gujarat. Total 627 students between the age group of 18 to 23 years were examined after taking written informed consent of their parents using pre-designed, pre-tested, semi-structured proforma. Anthropometric measurements were taken and BMI were calculated. The prevalence of overweight and obesity were determined based on the IOTF (International Obesity Task Force) criteria. Single educational training for 45 minutes was given to the students and their post-intervention knowledge for same was assessed after the training. Thus collected data was analyzed using SPSS 17 (Trial version).Results: Overall, the total number of obese adults identified in whole study population was 64 (10.2%) and numbers of overweight adults were 65 (10.3%). Baseline knowledge of the students regarding hazards of obesity like hypertension, cancer, heart attack and diabetes mellitus was 19.7%, 16.1%, 16.5% and 24.5% respectively which was significantly increased to 93.6%, 94.5%, 96.0% and 94.1% respectively after the intervention. Baseline knowledge of the students regarding preventive measure of obesity like avoiding junk food/ healthy diet, exercise and meditation was 23.6%, 24.4% and 25.9% respectively which was significantly increased to 95.3%, 96.9 and 97.4% respectively after the intervention.Conclusions: There was significant improvement in the knowledge regarding hazards of obesity and its preventive measures among college students after our single educational session

Profile of substance abusers attending at de-addiction center of GMERS medical college, Dharpur-Patan, Gujarat, India: a cross sectional study

Background: Although the history of substance abuse is as old as mankind itself, recently it has become a global problem that is influenced by social, economic, political, and psychosocial factors. The objective of the study was to study the socio-demographic profile of patients attending at de-addiction center.Methods: The present cross sectional study was conducted at de-addiction center of GMERS Medical College, Dharpur-Patan, North Gujarat, India during December 2014 to July 2015. After obtaining approval from Institutional ethical committee and taking written and verbal consent of patients, total 206 patients were interviewed using predesigned, pretested and semi structured proforma. Data thus collected were analysed using SPSS 17 (trial version).Results: Out of total 206 substance abusers, 138 (67%) patients were between the age group of 25 to 45 years.69% of the total abusers belonged to socio economic class 4 and 5. 14.6% substance abusers were illiterate 66.9% of the substance abusers were skilled and semi-skilled workers. Out of total 206 substance abusers, 102 (49.5%) patients had family history of substance abuse. 40.8% of the substance abusers had initiated substance abuse in adolescent age group while 45.6% of the substance abusers had initiated substance abuse between 20 to 30 years age group. Mean age of substance initiation in our study was 22±6 years. The mean duration of substance use was 18.1 years. Friends of substance abusers (peer pressure) were responsible for starting of substance abuse in majority of the substance abusers (81.6%). Out of total 206 substance abusers, 128 (62.1%) patients were addicted to alcohol.Conclusions: This study shows that youth is falling in vicious trap of drug abuse at early age. Awareness programs and camps need to be conducted at community level to address this major public health problem of substance use.

Prevalence of nutritional deficiencies other than anaemia among students of government commerce college of Gandhinagar, Gujarat: a cross sectional study

Background: Adolescence and young adulthood are periods of critical development and transition. Adolescent constitutes over 23% of the population in India. Nutrition and health needs of the adolescent are more because of more requirements for growth spurt and increase in physical activity. The aim was to study prevalence of nutritional deficiencies other than anaemia among students of Government Commerce College.Methods: The study was carried by Medicine Department, GMERS Medical College, Gandhinagar, India during period from July 2016 to August 2016 in purposively selected government college of Gandhinagar city. After taking the permission of principal of college and consent of the students, 421 students were examined for signs of various nutritional deficiencies other than anaemia. The data was collected by predesigned, pretested proforma and analyzed using SPSS 17.0 (Trial Version).Results: Out of total 421 students 205 (48.6%) were female. Mean age of the study students was 19.8±1.66 years. Maximum numbers of the students were in the age group of 18-21 years (60.5%). Mean age of female and male students was 19.7±1.79 years and 19.9±2.01 years respectively. The study revealed that vitamin A deficiency was present in 28 (7.0%) students. Vitamin B complex deficiency signs were seen in 96 (23.1%) students. Vitamin C deficiency signs were seen in 44 (10.5%) students. PEM was observed in 55 (13.2%) students. Essential fatty acid deficiency was observed in 60 (14.4%) students.Conclusions: High prevalence of nutritional deficiencies among these students needs great attention and health education

Socio demographic profile of pediatric tuberculosis patients of north Gujarat region, India: a cross sectional study

Background: Tuberculosis continues to be one of the most important public health problems worldwide. It infects one third of the world’s population at any point of time. Children are especially vulnerable to the effects of tuberculosis, which is often difficult to diagnose and therefore difficult to treat effectively. Pediatric TB results from failure of TB control in adults. The objective of the study was to study socio demographic profile of pediatric tuberculosis patients.Methods: This cross sectional observational, descriptive epidemiological study was conducted at GMERS medical college and hospital Dharpur-Patan located in north Gujarat during January 2015 to June 2015. The study was conducted among all the 151 pediatric TB patients who were currently under treatment at selected Hospital. Parents of the patient were informed about the purpose of the study and their informed written consent was taken. By interviewing them on the basis of pre-designed and pre tested proforma, socio demographic information was collected. The collected data was analyzed using statistical package for social science (SPSS 17 Trial version).Results: Out of 151 pediatric patients 87 (57.6%) were male. Age range of the children was 1 to 14 years. In our study mean age of children was 8.41±2.86 years. 68 (45.0%) patients were adolescents. 127 (84.1%) patients were from rural area. 63 (41.7%) heads of the family of patients were illiterate. 116 (76.8%) of the patients lived in joint family. 89 (58.9%) patients had kuccha house. Overcrowding was present in 86.7% of the patients. Family history of TB was present in only 23.2 % of the patients. 76.8% of the patients belonged to social IV and V according to modified Prasad’s classification. 105 (69.5%) patients had extra pulmonary TB. Category-1 constituted 125 (82.7%) cases. 3 % patients had HIV infection.Conclusions: Apart from pharmacological treatment, poor housing condition and illiteracy of the parents of these patients need to be addressed.

Impact of educational intervention regarding oral rehydration solution and zinc for management of diarrhoea among mothers of urban slums of Ahmedabad city, Gujarat, India: an interventional study

Background: Diarrhoea is one of the leading causes of morbidity and mortality among under-five children. Timely management of the children with oral rehydration solution (ORS) has substantially declined the mortality and morbidity from acute infectious diarrhea. The use of ORS largely depends on the level of knowledge and attitude of mothers. Mothers’ knowledge about diarrhoea can be improved through educational interventions. The objective of the study was to assess knowledge of mothers of urban slums of Ahmedabad city of Gujarat regarding ORS and Zinc for management of diarrhoea before and after training.Methods: This Interventional study was conducted among purposively selected 100 mothers of under five children of urban slums of Ahmedabad city of Gujarat, India during June to August 2011. After taking verbal consent, baseline knowledge of mothers regarding ORS and Zinc for management of diarrhoea was assessed by pre-designed, pre-tested and semi structured questionnaire. Single educational interventional training for 45 minutes was given to selected mothers Pre and post training assessment was done by scoring method and also mean, standard deviation, Wilcoxon sign rank test were applied.Results: Almost 83% of the mothers could define diarrhoea as the passage of watery stools three or more times a day, this knowledge was significantly increased to 100% after the training. Baseline knowledge of the mothers regarding causes of diarrhoea in children, signs and symptoms of dehydration in children, Correct method of preparation of ORS and importance of zinc therapy along with ORS was 4%, 22%, 39% and 26% respectively which was significantly increased to 73%, 90%, 89% and 76% respectively after the intervention.Conclusions: Knowledge of the mothers of under-five children regarding causes of diarrhoea, signs and symptoms of diarrhoea, correct method of preparation of ORS and importance of zinc therapy along with ORS has been significantly increased after intervention

A study on incidence of congenital anomalies in new borns and their association with fetal factors: a prospective study

Background: Congenital malformation represents defects in morphogenesis during early fetal life. Congenital anomalies account for 8–15% of perinatal deaths and 13–16% of neonatal deaths in India. The objective was to study incidence of clinically detectable congenital malformations in new-borns delivered at a tertiary hospital and their association with fetal factors.Methods: The present study is a prospective study of all the newborns delivered at Obstetrics and Gynecology Department, New Civil Hospital, Surat for a period of one year from 1st January 2010 to 31st December 2010. Total 5518 consecutive births including both live born babies and still born babies were examined after taking verbal and written consent of their mothers for a visible structural anomalies to determine the overall incidence and distribution of congenital malformations and their association with fetal factors. Data were statistically analyzed using SPSS software (trial version).Results: A total of 5518 babies were born out of which 75 were twins. Total numbers of malformed babies were 68, so total point incidence of congenital anomalies turned out to be 1.23%. There were 2963 male new-borns, out of that 40 were congenitally malformed (1.34%) and out of 2555 female new-borns 28 were congenitally malformed (1.09%). No significant association was found between congenital malformation and sex of the child. Out of total 5518 new-borns 5316 were live births and 202 were still births and out of 5316 live births 48 babies were malformed and out of 202 still births 20 babies were malformed. Out of total 5518 new-borns 1227 had birth weight less than 1500 grams and out of them 12 (0.97%) babies were congenitally malformed. Out of 5518 new-borns 221 were preterm babies and out of 221 preterm babies 26 (12.32%) babies were congenitally malformed.Conclusions: From present study it has been concluded that congenital anomalies in new-borns were significantly associated with fetal factors like still birth, prematurity and low birth weight

Evaluation of intravenous iron sucrose therapy for management of moderate to severe anaemia in pregnancy

Background: Iron deficiency anaemia (IDA) is the most common nutritional deficiency in pregnancy and major contributory factor to maternal morbidity and mortality. Objective of present study was to evaluate the response and effectof parenteral iron sucrose complex therapy in iron deficiency anemia in pregnancy.Methods: A prospective observational study was conducted at GMERS Medical College, Dharpur-Patan over a period extending from September 2014 to August 2017. A total of 150 Antenatal women, between 26-32 weeks of pregnancy with hemoglobin between 5-9 gm% were selected for study by purposive sampling. They were given intravenous iron sucrose complex in a dose of 200 mg (2 ampules of 5 ml each) in 100 ml normal saline over a period of 15-20 minutes, on alternate day. Repeat CBC was done after a period of 6 weeks.Results: Age range of the patients was 20 to 34 years. Out of total 150 women, 72 women (48%) were in age group of 20-24 years. 64.6% women had 27-29 weeks of pregnancy. 58 (38.6%) women had <8 gm% of Hb before treatment and 108 (72%) women achieved Hb of 10 gm% after treatment. The mean haemoglobin raised from 7.9±0.92 gm% to 10.3±0.83 gm% (P<0.001) after six weeks of therapy. There was significant rise in MCV levels (from 67.7±5.1 fl to 78.9±6.4fl) (P<0.001). Major side effects or anaphylactic reactions were occurred in none of the women during study period. 93.3% of patients, treated for anemia were delivered at full term, either vaginally (67.3%) or by LSCS (26%). Most of the delivered babies (80%), had birth weight of more than 2.5 kgs.Conclusions: Parentral iron therapy was effective in increasing haemoglobin and other haematological parameters in pregnant women with moderate to severe anaemia

Efficacy of misoprostol over dinoprostone gel as a cervical ripening agent: a comparative study

Background: Timely induction of labour could reduce maternal mortality and morbidity as well as assure a delivery of healthy baby. The objective of this study was to evaluate the efficacy of Misoprostol as a cervical ripening agent and its comparison with Dinoprostone gel in terms of success rate, safety, side effects and patient compliance.Methods: A total of 250 pregnant women requiring induction of labor were recruited. Out of 250 cases, 150 were induced with 50 microgram Misoprostol and 100 cases with 0.5 mg intracervical Dinoprostone gel during September 2014 to August 2017 at the department of Obstetrics and Gynaecology, GMERS Medical College, Dharpur-Patan. Written and informed consent was taken from the patients. Outcome measures, such as change in Bishop's score, need of augmentation, induction delivery interval; complications like hyperstimulation, fever and meconium passage were compared between two groups. Statistical analysis was performed by Epi Info 7.Results: Age range of the patients was 21 to 35 years. 74.8% of the patients were in 21-25 years age groups. 50.4% patients were multigravida. 57.6% patients had more than 37 weeks of pregnancy. 50.4% of the patients had premature rupture of membrane as indication of labour. The mean Bishop's score for induction was 3.21 in Misoprostol group. 81.3% patients in Misoprostol group and 93% of patients in Dinoprostone group were delivered by vaginal delivery. 60% patients delivered within 6 hours in Misoprostol group. (Misoprostol: 60%, Dinoprostone: 27%, p<0.001). Incidence of thin meconium was 11.3% in Misoprostol group, 9% in Dinoprostone group. In Misoprostol group 3.3 women had fever after induction.Conclusions: Vaginal misoprostol is more efficacious in cervical ripening and for induction of labor than Dinoprostone