Preparation, validation and user-testing of pictogram-based patient information leaflets for hemodialysis patients

AbstractBackground: Patient information leaflets are universally-accepted resources to educate the patients/users about their medications, disease and lifestyle modification. Objectives: The objective of the study was to prepare, validate and perform user-testing of pictogram-based patient information leaflets (P-PILs) among hemodialysis (HD) patients. Methods: The P-PILs are prepared by referring to the primary, secondary and tertiary resources. The content and pictograms of the leaflet have been validated by an expert committee consisting of three nephrologists and two academic pharmacists. The Baker Able Leaflet Design has been applied to develop the layout and design of the P-PILs. Results: Quasi-experimental pre- and post-test design without control group was conducted on 81 HD patients for user-testing of P-PILs. The mean Baker Able Leaflet Design assessment score for English version of the leaflet was 28, and 26 for Kannada version. The overall user-testing knowledge assessment mean scores were observed to have significantly improved from 44.25 to 69.62 with p value <0.001. Conclusion: The overall user opinion of content and legibility of the leaflets was good. Pictogram-based patient information leaflets can be considered an effective educational tool for HD patients

Factors determining the enrolment in community-based health insurance schemes: A cross-sectional study from coastal South India

Background: Community-based health insurance (CBHI) has been one of the options of health financing in India for a large number of population from the informal sector constituting about 90% of the total population. The objective of this study was to find out what are the factors which have influenced the beneficiaries to enroll in the schemes and also compared them to a noninsured group. Methods: A cross-sectional household survey, on 1639 households, was carried out, which had 1108 insured household and 530 noninsured households with a 2:1 ratio. A multivariate analysis was used to find out the determinants of enrolment. Results: The multivariate analysis revealed that household variables such as gender of household head, religion, and family size were determinants of enrolment. Conclusion: The sociodemographic characteristics of the households do influence the acceptability of the CBHI schemes

Expression of Fascin and SALL4 in odontogenic cysts and tumors: an immunohistochemical appraisal

Various stemness markers (SOX2, OCT4, and NANOG) have been studied in odontogenic cysts and tumors. However, studies on SALL4 having similar properties of stemness has not been documented, also insight into fascin as a migratory molecule is less explored.The expression of SALL4 and fascin were evaluated in ameloblastoma, adenomatoid odontogenic tumor (AOT), odontogenic keratocyst (OKC), dentigerous cyst (DC), radicular cyst (RC), and calcifying odontogenic cyst (COC)

Knowledge and attitude regarding STIs including HIV and RTIs among college adolescent girls in urban Udupi Taluk

Background: Adolescents compared to individuals in any other age group are most susceptible to sexually transmitted infections (STIs) including HIV (Human Immunodeficiency Virus) and reproductive tract infections (RTIs). Adolescents are vulnerable to STIs including HIV that account for 31 percent of the AIDS burden in India. Objective To assess knowledge and attitude among adolescent girls regarding STIs including HIV/AIDS and RTIs. Methods: A cross -sectional study was carried out among 17 -19 year old college going adolescents studying in degree colleges in the urban area of Udupi taluk. A total of 410 adolescent girls were selected using cluster sampling with proportionate allocation method. A pre-tested, self -administered questionnaire was used to collect data, and anonymity was maintained. SPPS version 15 was used to analyze the data. Findings were depicted as percentages and proportions. Results: Around 14% of the adolescent girls had comprehensive knowledge regarding HIV/AIDS. Poor knowledge was reported among adolescent girls regarding STIs/RTIs other than HIV/AIDS. Around 27% had heard of STIs while 15% had knowledge regarding RTIs. Conclusion: The study identified lacunae in knowledge regarding STIs/RTIs and misconceptions on HIV transmission. Adolescents need to be educated regarding sexual and reproductive health and also to focus on capacity building of mothers and teachers to improve adolescents’ knowledge and attitude

Potential Drug Interactions at One Indian Teaching Hospital.

BackgroundThe potential drug-drug interaction (pDDI) increases as the number of concomitant medications increases. Patients with cardiovascular disorders are at higher risk for drug-drug interactions because of the types and number of drugs they receive. While drug interactions are reported to be common, there is no published report of the prevalence of such interactions among Indian cardiac patients.  The aim of the present study was to identify the pattern of pDDI and document any observed interaction. It was also planned to evaluate the demography of patients and correlate it with the drug-drug interactions.Method  A prospective observational study from Oct 2007 to Apr 2008 was carried out in ‘cardiology department’ of a hospital in South India. Those patients who were taking at least two drugs and had a hospital stay of at least 48 hours were included in the study. The medications of the patients were analyzed for possible interactions. Factors associated with pDDI were studied. The actual interactions that were observed during the hospital stay in the study subjects were documented.ResultsA total of 812 patients were included in the study. 388 pDDIs were identified among 249 patients. The incidence of pDDI was 30.67%. The most common potential interactions were between aspirin & heparin (29.38%), and clopidogrel & heparin (7.21%). Drug class most commonly involved were antiplatelets, anticoagulants and diuretics. Majority of interactions were of moderate severity, delayed onset, and pharmacodynamic in nature. 68 actual interactions were observed in the observed cases.ConclusionThe present study identified pDDIs and also documented interactions in cardiovascular patients. Factors which had correlation with adverse drug interactions were identified. This study highlights the need for screening prescriptions of cardiovascular patients for pDDIs and proactive monitoring of patients who have identified risk factors; this helps in detection and prevention of possible adverse drug interactions.

Risk factors for malnutrition among preschool children in rural Karnataka: a case-control study

Abstract Background The prevalence of malnutrition among children in developing countries is very high. As a step towards reducing the prevalence of malnutrition, there is a need to identify the important determinants of malnutrition in the specific population so that preventive and control measures can be implemented. The objective of the study is to determine the risk factors for malnutrition among preschool children in Rural Karnataka, South India. Methods A case-control study was carried out among preschool children, aged between three to six years, attending the Anganwadi centers and their mothers’ in Udupi district of Karnataka, India. A total of 570 children (190 cases and 380 controls) were selected by multistage cluster sampling technique. A semi-structured risk factors questionnaire was used to identify the risk factors for malnutrition among children. Results The majority (45.8 and 45.5%) of the children in the study were in the age group of 3.0 to 4.0 years in case and control groups respectively. There was a slight preponderance of illiterate parents among cases in comparison to the controls. Largely, 87.4% of the children belonged to poor socio-economic status in the case groups compared to 82.4% in the control group. After adjusting for the confounders, underweight was significantly associated with socio-economic status of the parents (aOR: 2.05, 95% CI: 1.06, 3.96), birth weight < 2000 g (aOR: 25, 95% CI: 0.10, 0.59), recurrent diarrhoea (aOR: 2.74, 95% CI: 1.56, 4.83), recurrent cold and cough (aOR: 3.88, 95% CI: 1.96, 7.67), worm infestation (aOR: 2.0, 95% CI: 1.19, 3.38) and prelacteal feed given (aOR: 3.64, 95% CI: 2.27, 5.86). Conclusion Parental education, childhood illness, short birth interval, open defecation, type of weaning and complimentary food given to children were some of the significant determinants of underweight that were found in the study. Information, Education and Communication (IEC) campaigns alleviating food habits and taboos and promoting birth spacing is the need of the hour for preventing the occurrence of undernutrition among preschool children

A diagnostic randomised controlled trial to study the impact of rapid diagnostic tests in patients with Acute febrile illness when compared to conventional diagnostics (DRACO study)

[Extract] Dear editor In the paper by Feagins et al., the authors discuss the utility and limitations of rapid diagnostic tests (RDTs) in patients with meningitis.1 To explore the clinical utility of RDTs in patients with Acute febrile illness (AFI), we designed this study. The clinical presentation of AFIs are often overlapping; therefore, arriving at an etiological diagnosis requires serological tests. Conventionally, serological tests like Enzyme-linked immunosorbent assay (ELISA) are used, but they have a long turnaround time. We postulated that the use of RDTs with a short turnaround time might result in a reduced hospital stay and reduced antibiotic consumption

Effectiveness and Safety of Heparinized Saline versus Normal Saline in Maintaining Patency of Peripheral Intravenous Locks in Neonates at a Tertiary Care Hospital

Introduction: Heparinized saline is usually used as a regular flush solution to prevent occlusion of peripheral intravenous locks in neonates but the risks associated with the use of heparin cannot be ignored in these patients. Aim: To assess and compare the efficacy and safety of Heparinized Saline (HS) and Normal Saline (NS) flush solution in neonates. Materials and Methods: A prospective study was conducted for a period of 12 months using 1 unit/ml HS and NS 0.9% solution. The mean number of catheters removed due to nonelective reasons was calculated to evaluate the effectiveness of flushing solutions. To evaluate the safety, the reason for catheter removal was noted and platelet nadir was used to assess the thrombocytopenia. Poisson regression, Pearson Chi-square test and stratified analysis were conducted. Results: Data were analysed from 100 neonates. We found no significant difference between HS and NS flushes in neonates in maintaining the patency of 24 gauge peripheral intravenous locks {rate ratio= 1.12, p-value =0.584}. Gestational age, body weight and site of insertion did not significantly affect the patency. The reasons for removal of catheter were similar in both the groups and majority were due to non-elective reasons. HS group reported more cases of thrombocytopenia that was attributed to sepsis. Conclusion: Standard NS can be considered as an alternative flush in neonates as both the solutions were found to be equally efficacious and safe in our patient group. Factors like gestational age, body weight and site of insertion did not significantly affect the patency

Superoxide dismutase enzyme and thiol antioxidants in gingival crevicular fluid and saliva

Background: The possibility of impaired antioxidant status and so increased oxidative damage in periodontal disease is being conjectured. The present randomized controlled study was carried out with the objective of analyzing the activity of superoxide dismutase enzyme and thiol antioxidants in gingival crevicular fluid (GCF) and saliva as indicators of response to periodontal therapy. Materials and Methods: Subjects were screened and randomly divided into three groups: 23 periodontally healthy controls, 24 with gingivitis, and 23 with periodontitis. Based on the clinical attachment levels, the periodontitis group was further divided into subgroups, including mild, moderate, and severe periodontitis. GCF and saliva samples were collected for estimation of superoxide dismutase and thiol antioxidant concentrations at baseline and 15 days after nonsurgical treatment. Intragroup comparisons were statistically analyzed using repeated measures analysis of covariance (P value <0.05). Results: Superoxide dismutase was present in greater quantities in the GCF compartment (100.32±3.67 U/0.5 mL) than in saliva (39.99±3.52 U/0.5 mL), with elevated levels in mild and moderate subgroups as compared with severe periodontitis. Thiol concentrations were comparable in these media, 14.43±1.57 micromol /L in GCF and 15.09±2.26 micromol/L in saliva. Following treatment, superoxide dismutase and thiol antioxidant concentrations significantly improved in all the patient groups. Conclusion: The reduction of the inflammatory response following therapy resulted in improved antioxidant profiles in both the GCF and salivary compartments