Do joint national committee VII criteria also need to take non pharmacological measures into consideration? evidence from slum resettlement colony

Abstract Background: Currently Joint National Committee (JNC) VII criteria are used worldwide to d hypertension but it does not take non pharmacological measures into consideration. Also, it does not consider Indian system of medicine. Objectives: To assess whether JNC or revision is required especially for Indian communities where such practices are prevalent. Material and methods: The present community based cross Nagri, a slum resettlement of East Delhi which comes u

Problem-based learning versus lecture-based learning in pharmacology in a junior doctor teaching program: a crossover study from northern India

Background: The undergraduate MBBS training in our country is still in the traditional mode. The main part of the curriculum consists of lecture, tutorial, practical and ward teaching classes with a limited number of problem based session. The objective of the study was undertaken to compare PBL with LBL in terms of students’ knowledge retention in the subject of Pharmacology in undergraduate medical training.Methods: The current survey was planned and executed by the Department of Pharmacology in collaboration with Medical Education Unit, MSDS Medical College, Fatehgarh in the batch currently posted in the Department of Pharmacology for practical classes. Fifty MBBS students posted were enrolled for the study and were divided in 2 groups. One of the topics was presented as LBL for the first group and as PBL for the second group. The other topic was presented as PBL for the first group and as LBL for the second group. Intervention and control groups were taken as those used PBL and LBL respectively. T test was used to compare mean scores obtained by students in the intervention and control groups.Results: Mean scores obtained by students in the intervention group (topics learnt with PBL) were higher (3.80 Vs 2.84) than mean scores obtained by students in the control group (topics learnt with LBL). Mean scores obtained by students in the intervention group were higher (3.72 Vs 2.96) than mean scores obtained by students in the control group.Conclusions: The current study indicates usefulness of Problem-based learning (PBL) over Lecture-based Learning (LBL) in terms of retention of knowledge. However further studies involving more number of students are warranted in order to generate stronger evidence on this tool for improving medical education in our setup.

Community knowledge, attitude, and practices for protection against the malaria: A cross-sectional study in a rural area of aspirational district in Haryana, India

INTRODUCTION: Malaria poses a great socioeconomic burden on humanity as it affects the majority of countries in the tropical and subtropical regions. The estimated number of malaria deaths stood at 445,000 in 2016, a similar to the previous year (446,000). This study was conducted with the aim to assess community knowledge, attitude, and practices (KAPs) for protection against the malaria. MATERIALS AND METHODS: This was community-based with a cross-sectional study conducted for 4 months in the 6 villages under the subcenter Sangail, with household as a sampling unit, and study participants were selected by randomized multistage sampling technique. A pretested, predesigned, standardized questionnaire with close-ended responses was developed for data collection. All tests were performed at a 5% level of significance. RESULTS: In the present study, more than one-fifth of participants believed that malaria is due to the wrath of almighty (22.3%) or bad air (30.2%), the restrain was observed in about half of households (54.5%) for indoor indoor residual spray, half of the participants strongly believed that malaria is not a public health issue (45.3%) and more than three-fourth of households (34.8%) were still preferring to sleep outside of their homes. CONCLUSION: KAP of malaria and its control was observed to be low among the study population. Misconceptions about malaria transmission still exist. The result of this study will bring forward the health-care workers with the desired need for health education and promotion on malaria at the first contact either in the health facilities or in the patient's family house on home visit

Study of skull fractures in fatal road traffic accident cases from rural Haryana

Introduction: Head injury is an important cause of mortality throughout the worldwide. The Head region is considered as one of the most vulnerable part of the body. Therefore, it is involved frequently and lead to morbidity and mortality in road traffic accidents (RTA). Aim: The present study was thus conducted to analyze the patterns of skull fractures in fatal road traffic accident cases amongst RTA victims brought to tertiary care hospital in rural Haryana. Methods: All the cases of fatal road traffic accidents subjected to medico legal autopsy at the department of forensic medicine of MM Institute of medical sciences. The detailed analysis of these cases was based on the inquest report, medical records, if patient was admitted in the past and evaluation of autopsy reports. Results: Of total 639 medico legal autopsies were conducted during the study period, 56.81% were of RTA. Fracture of skull was present in 85%. Combination of vault and base fracture was the most common (48.23%) distribution of skull fracture. Fracture of the vault of skull alone was seen in 36.47%. Commonest type of fracture present in the skull vault was linear/fissured fracture (54.83%) constituting 68 out of 124 sites followed by comminuted fracture being 40 out of 124 sites (32.25%). Middle cranial fossa was the commonest fossa involved. 36% died within 24 hours after the accident. 33% victims survived beyond 24 hours but died within one week. Conclusion: Skull fractures are not uncommon in fatal road traffic accident cases. Combination of vault and base fracture are commonly observed. Commonest type of fracture present in the skull vault was linear/fissured fracture. Middle cranial fossa was the commonest fossa involved. Data generated here can be utilized for implementing effective emergency services to reduce the trauma related mortality of fatal accidents

Therapeutic updates on the management of tinea corporis or cruris in the era of Trichophyton Indotineae: Separating evidence from hype—A narrative review

The emergence and spread of Trichophyton indotineae (T. indotineae) has led to a sea change in the prescription practices of clinicians regarding the management of dermatophytic skin infections. An infection easily managed with a few weeks of antifungals, tinea corporis or cruris, is now often chronic and recurrent and requires prolonged treatment. Rising resistance to terbinafine, with documented squalene epoxidase (SQLE) gene mutations, and slow clinical response to itraconazole leave clinicians with limited treatment choices. However, in these testing times, it is essential that the tenets of antifungal stewardship be followed in making therapeutic decisions, and that the existing armamentarium of antifungals be used in rationale ways to counter this extremely common cutaneous infection, while keeping the growing drug resistance among dermatophytes in check. This review provides updated evidence on the use of various systemic antifungals for dermatophytic infection of the glabrous skin, especially with respect to the emerging T. indotineae species, which is gradually becoming a worldwide concern

A prospective study on the effectiveness of a combination regime (Mifepristone and Misoprostol) in comparison with Misoprostol for missed abortion

Introduction: Misoprostol is widely used in the medical management of missed abortions. However, pretreatment with Mifepristone has shown to be effective but still not recommended to be used in missed abortions. Aims and Objectives: To compare the outcome of medically managed missed abortion or blighted ovum using combination regime (Mifepristone and Misoprostol) vs Misoprostol alone. Materials and Methods: It was a prospective single-centre study performed in the Department of Obstetrics and Gynaecology, HIMSR and HAHC hospital, New Delhi, over, for one year. All the patients with diagnosed missed abortions were randomized into two groups (Group A and Group B). Group A was given Mifepristone 200 mg orally followed by Misoprostol 800 microgram per vaginal. Group B was given Misoprostol 800 microgram per vaginal. All the patients were observed for 24 hours for the expulsion of products of conception following the given regime. Ethical approval was taken from the Institutional Ethical Committee. Results: Both groups were comparable in demographic characteristics. On applying Fisher's exact test, it has been observed that the odds of nonexpulsion of the product of conception, time taken in expulsion, and surgical evacuation because of excessive bleeding were significantly higher in Group B (Misoprostol) compared with Group A (Mifepristone followed by Misoprostol). The cost-effective analysis showed that the cost is higher among Misoprostol Group B compared with combination drugs of Group A (Mifepristone + Misoprostol), but this result is not significant. Conclusion: Mifepristone can be considered before Misoprostol in missed abortions. This regime might decrease the need for surgical evacuation

Leadership Training for Nursing Professionals in India: A Workshop Evaluation

Introduction: Nurses are the backbone of the healthcare system, and an attempt can be made to improve the quality of care if every individual is empowered with leadership skills. While several leadership workshops and seminars have been conducted to sensitize doctors in India, there have hardly been any for nurses. A two-day workshop for orientation on leadership for nurses was conducted using multimedia presentations, talks by accomplished speakers and activities like role plays.Objective: The current study was undertaken to determine the impact of the workshop on the self-reported competence of nurses; with a secondary objective of evaluating the workshop and suggesting modifications for the future.Methodology: A pre- and post-workshop questionnaire (Crohnbach’s alpha: 0.874) was used to assess the impact of the workshop in self-reported competence. Self-administered structured questionnaires were used to evaluate the relevance of each session and suggestions for improvement. Paired t-test was used to assess difference in pre- and post-workshop competence. Weighted scores were used to rank sessions, and responses of qualitative data were grouped in suitable themes.Results: A total of 29 nurses participated in the workshop. There was a significant rise in knowledge in all the domains of the competence (p-value <0.05). The greatest increase in knowledge was in understanding the relevance of interpersonal skills. Maximum number of participants learnt the importance of effective communication (38%). Almost all the sessions were marked as relevant, and “conflict management” was the highest-ranking session, while the session on “planning and evaluation” was the least favored. The most popular suggested theme for further training was on stress management.Conclusion: The two-day workshop has been successful in raising self-reported competence of nursing professionals, and with minor modifications, regular trainings may go a long way in empowering nurses with leadership qualities

Updated BG Prasad socioeconomic classification, 2014: A commentary

Modified BG Prasad socioeconomic scale is widely used to determine the socioeconomic status of study subjects in health studies in India. It is an income-based scale and, therefore, has to be constantly updated to take inflation and depreciation of rupee into account. The Consumer Price Index (CPI) for industrial workers (IW) is used to calculate updated income categories for January 2014. Details of the calculations involved will enable young researchers to calculate specific income categories for their research work. State-specific CPI values are also available on the Department of Labour website and should be used to determine more accurate income categories for the study area

Coronavirus disease (covid-19) and public health issues in developing countries-focus on biomedical waste management

India as a 2nd largest populous country with a high population density with lack of awareness, burden of neglected tropical diseases and a rising prevalence of non communicable diseases, have overburdened health infrastructure. In such conditions Covid-19 pandemic is stretching the health system to its limit. Most of population is a daily wager; unawareness is there already for many basic habits. There is poor access to safe food availability, safe water and sanitation, poor food storage facility or access to processed foods , affordability of processed foods and necessity supply chain are lacking. All such aspects have a public health importance. Meanwhile to protect the community from the covid infection has led to an increase in the Biomedical Waste (BMW) production for which no separate guideline is formulated as the WHO guidelines for waste management suffice to manage covid related waste too. The segregation of COVID waste as per requirements of Schedule I of the BMW Management Rules 2016 with some additional safety criteria is sufficient to handle the waste. The waste generated at hospital and quarantine camps or houses if handled according to the guidelines then the problem can be steadily tackled with minimum problems.This pandemic Covid-19 disease can be used as a tool to educate the population. “Empowering masses about modes of transmission, debunking myths, associated risks and preventive strategies” and this will be is a cost effective key instrument not only for Covid 19 but also for other infectious disease.</p

A prospective study of incidence and assessment of Adverse Cutaneous Drug Reactions as a part of Pharmacovigilance from a rural northern Indian medical school

Abstract Background: The wide and indiscriminate use of drugs has increased the incidence and the modes of presentation of cutaneous drug rea down the search for the offending agent