ASSESSMENT OF THYROID DYSFUNCTIONS IN PATIENTS WITH TYPE II DIABETES MELLITUS IN CENTRAL INDIA

Objective: The objective of the study was to assess the prevalence of thyroid disorders among diabetics in Central India. Methods: This study was conducted as a cross-sectional comparative study at the department of medicine, tertiary care center in Central India on a total of 100 diabetic patients admitted at the study area during the study period of 1 year. Cases in the study group with diabetes and control group (non-diabetic) were enrolled as per inclusion and exclusion criteria in 1:1 ratio. All the patients in both the groups were subjected to the estimation of thyroid function tests, that is, T3, T4, and TSH levels after overnight fasting. Results: Mean age of patients in the study group was 55.7±10.1 years whereas that of the control group was 53.9±10.6 years. Overall, thyroid dysfunctions were noted in 31% of cases in the study group and 12% of cases in the control group (p<0.05). The most common thyroid dysfunction was hypothyroidism, particularly subclinical hypothyroidism (19% and 8% in the study group and control group, respectively). Thyroid dysfunctions were associated with increased HbA1c in our study group (p<0.05). Conclusion: Thyroid dysfunctions are observed in higher proportions of cases with diabetes as compared to non-diabetes. All the parameters of thyroid function tests including T3 and T4 levels as well as TSH levels are found to be altered in higher number of diabetics. Poor glycemic control among diabetics is one of the important determinants of thyroid dysfunction in patients with diabetes

Evaluation of knowledge and awareness regarding usage of mcp card amongst health functionaries and beneficiaries

Introduction: Mother and child protection (MCP) card has been developed as a tool to help families to know about various types of services which they need to access for the health and well-being of women and children. The auxiliary nurse-midwife (ANM)/anganwadi worker (AWW) record the desired information in place provided in the card and the beneficiaries are pregnant women and mother/families of children up to 3 years of age. The present study was therefore undertaken with the objectives to assess the knowledge of health functionaries on appropriate usage of MCP card; to study the knowledge of beneficiaries about the MCP card and its importance in maternal and childcare. Material and Methods: This was a cross-sectional study, conducted from February 1, 2018 to April 30, 2018 on health functionaries at anganwadi center and beneficiaries of MCP card. One hundred and five anganwadis and 3 beneficiaries per anganwadi were selected using convenience sample consisting of one pregnant female, one mother/family member of child <6 months and one mother/family member of child between 6 months and 3 years. Data regarding sociodemographic details of health functionaries and beneficiaries along with data regarding usage of MCP card were assessed. Results: Overall knowledge regarding immunization was maximum (87.6%) among health functionaries, whereas knowledge regarding five cleans was minimum (10.5%). Only 56.3% and 76.5% AWW and ANM received orientation training regarding MCP card. Out of 315 beneficiaries, only 50.8% beneficiaries knew about correct validity of MCP card, i.e., 0–3 years and 190 (60.3%) beneficiaries found MCP card helpful during referral. Majority of beneficiaries wanted custody of MCP card to be with the mother or beneficiary themselves. Only 8.6% and 4.4% beneficiaries wanted custody of card to be with AWW and ANM, respectively. Conclusion: The MCP cards are being used adequately for keeping the background information, antenatal care provided to the mother, and immunization among both health functionaries and beneficiaries

A Study on Utilization and Satisfaction of ICDS Services in Aanganwadis of Urban Bhopal

Background: Though ICDS is the world’s largest community-based child nutrition and development program, even after more than 35 years of its implementation the dilemma still exists regarding the extent of utilization and quality of services provided through aanganwadis..Method: This was a cross-sectional study done in 40 aanganwadis of Bhopal city in a period of three months. Forty aanganwadis were selected from the urban area of Bhopal. Six registered beneficiaries from each of these 40 selected aanganwadis were interviewed.Results: Out of 240 beneficiaries, 35 (14.5) were pregnant women, 40 (16.67 ) were lactating females, 81 (33.75) were mothers of children aged greater than 0–3 years, 49 (20.42) were mothers of children aged 3–6 years, 32 (13.33) were adolescent girls (10–19 years) and 03 (01.25) were women of reproductive age. 166 (69.16%) were satisfied with the services, while the rest 74 (30.84%) were not satisfied with the services.Conclusions: Improvement in the quality of services is the need of the hour to keep the satisfaction and utilization level

In Patient Department Services at a Private Super Specialty Hospital of a Metrocity

Introduction: A patient’s episode of care should be planned before his/her admission and should take account of the entire “journey” up to and after discharge from hospital. Patients and their care-giver should be partners in this planning. Pre-admission assessment should be a standard requirement for all elective admissions. The anticipated length of stay for elective admissions should be indicated as early as possible to facilitate scheduling. Discharge plans agreed between the hospital and a key worker in primary care, discharge planning that commences on day of admission. Objectives • To study the admission process. • To study the discharge process. Methodology: A cross-sectional study was conducted in a private super specialty hospital of a metrocity. A check list was prepared for various desks of the hospital such as admission desk, discharge desk, cash desk, billing desk, etc. Also, descriptive data was collected from various departments. Observation andResults: The various sources of admission to hospital were: direct admission, general OPD, emergency department and consultants’ clinic. Registers maintained at the Admission desk: Handover Book, Admitted Patient Register, Bed management Register, Announcement Register, OT Register, Briefing Register, Counselling Register. Discharge Process: On being advised discharge, the billing prepares the patient bill in two copies. Process of discharge is initiated after administration/ consultant advice. A detailed discharge summary covering investigation reports, treatments given and advice on discharge will be provided by the attending doctor and it will be given to the patient at the time of discharge. Charges for the full day on the day of admission are applicable irrespective of time of check in. Patient is discharged after the payment of the bill. Recommendations: There should be a hanging bold-written signage for insured patients, strict adherence to the visiting hour timings. More number of staff needs to be deployed in the billing department as because of staff crunch the billing gets delayed. Discharges must be pre-decided so that the nurses get sufficient time to prepare the patient file

A Study to Assess the Prevalence of Polycystic Ovarian Disease among Girls Aged 15–21 Years from Selected Schools and Colleges in Bhopal City

Background: Polycystic Ovarian Syndrome (PCOS) is the most common endocrine disorder among girls. It is one of the leading causes of female subfertility. It has a heterogeneous presentation which includes hyperandrogenism, hirsutism and ovulatory dysfunction. It is a disorder of peri-pubertal onset, so it is a disorder of significant health concern; this necessitates estimation of proportion of women affected by PCOS in the population. This study was conducted to find out the prevalence of PCOS amongst adolescentgirls in Bhopal city.Materials and Methods: A cross-sectional study was conducted for the duration of 4 months from November 2016 to February 2017. 840 girls of age group 15–21 years were interviewed regarding PCOS using Rotterdam criteria in three schools and three colleges in Bhopal city. After screening for PCOS, all suspected girls were confirmed by USG. Data was compiled using MS Excel and analyzed using Epi info 7.Result: Out of 840 girls, 217 (25.5%) complained of irregular menses, out of 217 only 96 (44%) were approached for USG screening. PCOS was present in 77 (80.2%) girls out of 96 girls screened with USG.Also, PCOS was present in 43.2% girls with BMI >25 and 50.8% girls having waist-hip ratio more than 0.96.Conclusion: This study estimated prevalence of about 8.34% in the study population. Lack of awareness (health-seeking behavior) was prominent in the study population. Significant association was foundbetween PCOS and BMI, WAIST-HIP ratio. More education sessions should be held in schools and colleges about PCOS

Comparison of performance of digital hemoglobinometer over automated hematology analyzer for hemoglobin estimation and its user-friendliness among the pregnant women in selected district hospitals of Madhya Pradesh

Context: There is a need for a simple screening method for the detection of anemia that can be used by public health workers in the field. Aims: The aim of this study was to compare two methods for hemoglobin estimation, i.e., automated hematology analyzer and Digital Hemoglobinometer, and to find out the sensitivity and specificity of Digital Hemoglobinometer for the estimation of hemoglobin. Subjects and Methods: A hospital-based cross-sectional study was carried out for 6 months from April to September 2017 in a District Hospital of five High Priority Districts of Madhya Pradesh. Two hundred and sixty antenatal females per district were selected for the study. Results: The mean hemoglobin by autoanalyzer is 10.19, and that by Digital Hemoglobinometer device is 9.89. Overall, sensitivity of Digital Hemoglobinometer for hemoglobin estimation was calculated to be 89.4% and specificity was calculated to be 63.6%. Positive predictive value was found to be 82.6% and negative predictive value was 75.8% compared against AutoAnalyser (gold standard). Conclusions: As the Digital Hemoglobinometer device has high sensitivity and specificity and good diagnostic accuracy, it must be used at the community level in resource-poor setting for hemoglobin estimation. In primary health-care conditions, Digital Hemoglobinometer can significantly reduce misdiagnosis of anemia compared with clinical assessment alone

Effect of Skipping Breakfast on Young Girls’ Menstruation

Introduction: Breakfast is often referred to as the most important meal of the day. Evidence suggests that breakfast contributes to wellbeing in a number of areas. First, it is a central component of nutritional wellbeing, contributing to total daily energy and nutrient intake. Nearly 15% of college girls rarely or never ate breakfast, and those who ate breakfast almost every day (and did not often eat between meals) reported slightly but significantly better physical health than skippers. Eating breakfast is important for the health and development of young women. From clinical experience, there is great evidence that the frequency of irregular menstruation and intensity of dysmenorrhea was increased in young women, who were currently skipping meals, suggesting that diet in adolescence has long-lasting adverse effects on reproductive function in young women. Menstrual disorders frequently affect the quality of life of adolescents and young adult women. Breakfast as a part of healthful diet and lifestyle can positively impact children’s and young adults’ health and wellbeing. Daily eating habits significantly influence menstrual function in young women. We conducted the study to explore the association of skipping breakfast on menstruation.Objectives • To find out the proportion of girls with menstrual irregularity in those skipping breakfast; • To find out effect of breakfast skipping on menstruation among girls of age group 17–22 years. Method and Material: A cross-sectional study was used. The studied sample consisted of 90 female students of a selected college of Bhopal city. Data were collected by using an interviewing questionnaire. Analysis of the findings was done using Epi Info 7 software. Results: Mean age of the study participants was 20+3.66 years. Out of 90 students, 82% were found to have been skipping breakfast for more than 3 days a week. The study also revealed that dysmenorrhea was more in girls who skipped breakfast than in those who had breakfast (P=0.0001). Conclusion: From the above finding, we can conclude that episodes of dysmenorrhea occurred more in female students who skipped the breakfast meal more than those who took breakfast regularly