IS RENAL IMPAIRMENT CONCEALED IN ELDERLY DIABETICS????

Objective: To compare and evaluate the renal profile of elderly and younger diabetics.Methods: This cross sectional study was conducted in a tertiary care teaching hospital. Patients with type-2-diabetes were grouped into elderly (age≥60years) and younger diabetics. Patients' demographics, duration of diabetes and serum creatinine were recorded. Cockcroft-Gault formula was used to calculate creatinine clearance (Clcr). Statistical analysis was done using Students'‘t' test and Pearson's correlation. Regression analysis to adjust for covariables was done wherever required.Results: A total of 477 diabetics were included (elderly n=320, young n=157). Body mass index (BMI) was significantly lower (p=0.003) and duration of diabetes was significantly longer (p=0.001) among elderly. Significant difference was noted in serum creatinine (1.06±0.32 vs 0.95±0.29 mg/dl; p=0.0002) and Clcr (57.82±17.41 vs 88.07±24.60 ml/min; p=0.001) between elderly and younger diabetics. Only 4.7% of elderly, whereas 47.8% of young had normal Clcr. Clcr showed a negative correlation with age in elderly (r=-0.389, p<0.001) and young (r=-0.396, p<0.001) and positive correlation with BMI in elderly (r=0.401, p<0.001) and young(r=0.337, p<0.001). Regression analysis of Clcr in elderly and young showed a positive correlation for BMI and inverse relationship for age and duration of diabetes mellitus.Conclusion: Almost 95% of the elderly and 50% of younger diabetics had impaired creatinine clearance. Renal impairment was concealed in most of them since mean serum creatinine was 1 mg/dl. Indian elderly diabetics should be considered renally impaired and drugs for all conditions need adjustment for creatinine clearance

Arecanut and Tobacco use Among School Children

BackgroundAreca nut is the fourth most commonly used psychoactive substance in the world after caffeine, alcohol and nicotine. Its use is considered a benign and socially acceptable habit among most Indians. Like tobacco, chewing areca nut also leads to oral and oropharyngeal cancers. Chewing of these substances usually starts early in life leading to a multitude of problems in adulthood. This study was conducted among high school students to determine the prevalence and explore the awareness of health hazards associated with these substances.Method  This cross sectional study was carried out in Vantamuri village, South India. All consenting school children of 7th, 8th and 9th class were interviewed individually using a pretested questionnaire about their chewing habits. This was followed by a thorough oral cavity examination for all.ResultsOut of 392 participants 62.5% were boys. Mean age of all participants was 14.8 ± 1.13 years.  The prevalence of areca nut usage among boys and girls was 27.3% and 6.1% while it was 2.4% for gutka (contains tobacco) amongst boys.  Majority of students started chewing between 13 and 14 years. About 49% of users were chewing these substances regularly for more than a year. Addictive tendencies were seen in two users. 43% of users chewed the same product used by their family members (

Assessment of knowledge, practice and perception of menstruation among adult women in the reproductive age group, in Mangalore, India

Background: Women often lack knowledge regarding reproductive health including menstruation which can be due to socio-cultural barriers in which they grow up. The present study is aimed at assessing the level of knowledge regarding menstruation and hygienic practices and perceptions during menstruation.Methods: It was a cross sectional study, conducted among 110 adult women to assess their knowledge regarding menstruation, practices followed during menstruation and their perceptionof menstruation. The collected data was analyzed using SPSS version 17. 0. Chi square test was applied. P<0.05 was considered to be significant.Results: Only 52% of the study population has satisfactory knowledge regarding menstruation. Women between 15 to 20 years of age and those from the middle and higher socio-economic groups seem to possess maximum knowledge regarding menstruation. Women of the higher socio-economic group practice better sanitary measures during menstruation with 100% of them using pads, as compared to women of lower socio economic group who showed a trend of using cloth (87.5%). Women of the upper socio-economic class (42.78%) had better perception towards menstruation (p<0.05).Conclusions: It is very important that lower socio-economic group should be educated about the importance of maintaining hygiene during menstruation by proper health education and equip them with skills regarding safe and hygienic practices to prevent the risk for reproductive tract infections

Lymphatic Filariasis and Mass Drug Administration

BackgroundA third of world’s filariasis cases occur in India. As a result Mass Drug Administration (MDA) was commenced in 1997 with the aim of eliminating this disease by 2015. However the coverage of MDA was not satisfactory. The underlying reasons for the poor coverage need to be identified. This study was conducted to assess the awareness of health personnel of lymphatic filariasis and the MDA programme.Method  This cross-sectional study was conducted in Kundapura taluk of Karnataka state in India during the 6th round of the MDA which was held between December 11 to 13, 2009. 78 health personnel who were posted for drug distribution were selected by convenience sampling. After obtaining informed consent health personnel were interviewed individually using a semi-structured questionnaire. Performance of health personnel was assessed according to points scored for their responses.ResultsThe mean age of all participants were 22.7± 8.9 years, 74(94.1%) were females and 58(74.4%) were nursing students. Only 17 (21.8%) participants had prior experience before taking part in this round of MDA. Only 4 (5.1%) participants achieved good scores while 45 (57.7%) got average scores. Performance scores were significantly better among paramedical workers (

A comparative study to assess the awareness of palliative care between urban and rural areas of Ernakulum district, Kerala, India

AIM: To assess the knowledge and attitude toward palliative care among people residing in urban and rural areas. MATERIALS AND METHODS: This cross-sectional study was conducted among 185 urban and 165 rural households. Senior-most member of the household present was interviewed using a questionnaire. Only those people who have heard about palliative care were included in the study. RESULTS: Out of 350 people, 47 (13.4%) have heard about palliative care. Of these 38 (20.5%) belonged to urban and 9 (5.4%) belonged to rural areas (P < 0.0001).Twenty-nine (15.7%) participants in urban and 7 (4.2%) in rural areas had some knowledge about palliative care (P = 0.0002). Source of information for 25 (53.2%) participants was newspapers followed by television 17 (36.2%). Thirty-three (86.8%) participants in urban and 7 (77.8%) in rural areas felt that palliative care helps in improving quality of life. Twenty (52.6%) participants in urban and 4 (44.4%) participants in rural areas felt that palliative care can be better provided at homes than hospitals. Thirty (78.9%) urban participants felt that bad news about the patient's condition needs to be told to the patient first and then to their family members. In case of rural participants majority 7 (77.8%) said vice versa (P = 0.0039). CONCLUSION: Overall awareness of palliative care was poor. This calls for large-scale awareness campaigns. As home-based palliative care was preferred by many, home visits by care providers and training of family members of patient's needing palliative care needs to be practiced widely

Comparison of Normal Resident Flora on the Face of Medical Students who use and who do not use Cosmetics

Introduction: Normal flora of the skin plays a beneficial role in preventing the pathogenic organisms from colonizing the skin and causing infection. It is possible that the facial cosmetics may cause a change in the normal flora disrupting its protective function. Aim: To find out the effect of cosmetics, those that are applied on to the face on resident normal flora of the face. Materials and Methods: This was a cross-sectional study involving medical students aged 19 to 25 years, of whom 42 were regular cosmetic users and another 42 were non cosmetic users. Swabs were taken from the face of the subjects after a face wash with soap and water and eluted in 1 ml sterile peptone water. Tenfold dilutions of the sample were made and 100 ìl of the diluted sample was spread over the surface of Trypticase soy agar, Mac Conkey’s agar and blood agar. The colonies were counted and also identified. Statistical evaluation was done by Chi-square test using SPSS version 16. Results: We isolated Coagulase Negative Staphylococci (CoNS), Micrococcus spp. and methicillin sensitive S.aureus, non-fermenting oxidase negative gram negative bacilli and diphtheroids from both the groups. We found that most of the students who were regular cosmetic users 22 (52.38%) yielded negligent growth in comparison with non-cosmetic users (16, 38%). CoNS was less frequently isolated from regular cosmetic users 10 (23.8%) in comparison with those who do not use cosmetics 17 (40.47%). Conclusion: It is possible that regular use of cosmetics does reduce the normal flora but further studies with larger sample size are required to prove and confirm this finding

Psychiatry as a career choice: Perception of students at a private medical college in South India

Background and Aim: People with mental illness are often subjected to stigma and discrimination. The poor popularity of Psychiatry as a field of specialty has been a global concern. Any preconceived notions, perceptions and formative influences among medical students could have strong influence on their future choice of career. This study aimed to determine the students′ perception of Psychiatry as career choice and the factors influencing their perception and career choice. Subjects and Methods: Following approval from Institutional Ethics Committee and necessary permissions, consenting medical students at a private medical college in Mangalore, India were surveyed using a pilot-tested questionnaire. The responses were compiled and data analyzed using Statistical Package for the Social Sciences (SPSS) version 10. Chi-square test was performed and P < 0.05 was considered significant. Results: Of the 250 participants, 152 (60.8%) were males while 96 (38.4%) were females aged 17-25 years. Only 28 (11.2%) wanted to pursue Psychiatry as a career while 97 (38.8%) considered it as an option although not their first choice. There was no association between gender and completion of Psychiatry postings on the decision regarding Psychiatry as a career. However, an exposure to a mentally ill person had a statistically significant association with Psychiatry as career choice (P < 0.001). Conclusion: Very few students aspire for Psychiatry. Targeted interventions including focused approach and creating an interest during undergraduate posting may inspire more students to take up Psychiatry