Prevalence and Determinants of Domestic Accidents in a Rural Area of Kanchipuram District, Tamil Nadu

Accident is defined as, ‘‘an unintentional injury which is undesirable, incidental and unplanned event that could have been prevented under circumstances leading to the accident being recognized’’. Accidents are of different types and domestic accidents are a worldwide threat but have seen resurgence in rural India. The main purpose of this study was to determine the prevalence and determinants of domestic accidents in rural area of Tamil Nadu and educate the people to reduce its burden. Materials and method: A community based cross sectional study, using a pre designed and pretested questionnaire was done in a rural area of Kanchipuram district, Tamil Nadu from 4th January 2017 to 31st January 2017. Data was collected from 1560 adults of both sexes and those who were the permanent residents of the study area. History of accident/injury during the past 3 months was obtained to avoid the recall bias. Results: It was found that 11.8 %( n=184) of the total study participants had a history of some form of accident/injury during the past 3 months. Out of these 184 subjects, 56.5 %(n=104) had domestic accidents. It was found that 51 %( n=53) of the domestic accidents have occurred due to ‘Fall’. Maximum numbers of the domestic accidents (42.3%) have occurred while the study subjects were working. Conclusion: Domestic accidents similar to any other disease have their own natural history and a sound knowledge about various determinants is essential to plan and administer prevention and control measures, and thereby reduce their burden especially in rural population. Increased awareness about the determinants will reduce the burden of the domestic accidents as they don’t simply befall on us from fate or bad luck. Keywords: Domestic, Accidents, Injury, Fal

An update on B. G. Prasad’s socioeconomic scale: May 2016

Modified BG Prasad socioeconomic scale is a simple and widely used scale used by researchers to determine the socioeconomic status of study subjects in health studies in India. It is a scale based on the per capita income of an individual and hence 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. The Consumer Price Index is updated every month and the same is available at the Labour Bureau of India website on the last day of every month. 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

Assessment of innovations in tutorial method of teaching among medical students

Background: The main focus of a tutorial is to make learning more interactive. Enthusiasm and innovations of tutors make tutorials more effective. This study was done to assess the usefulness of few innovative approaches applied during a tutorial session among medical students.Methods: A total of 84 medical undergraduate students were divided in to seven groups with 12 students in each group with a faculty as a facilitator. A pretest was conducted among the students to assess their knowledge and understanding on the topic of discussion. Then the students were given a review article on the topic of discussion to read followed by group discussion. After this each group was assessed by the way of a quiz programme and individually by a post test.Results: The mean scores obtained in the pretest increased significantly in the post test from 53.6% to 83.7%. Most of the students agreed upon the various advantages of this method of teaching. About 97% of the students rated this method of teaching as good and above.Conclusions: Tutorials are effective methods of teaching medical graduates. The innovations used in this study were well appreciated by the students

Prevalence and determinants of peripheral neuropathy among diabetics in a rural cum costal area of Villupuram district, Tamil Nadu

Background: Diabetes mellitus is characterised by persistent hyperglycaemia that may be due to absolute or relative insulin deficiency. It was estimated that there would be 285 million diabetics by 2010 in the world. This estimate is projected to increase by 65% to become 438 million in the year 2030. Similarly in India it is estimated to increase by 58% from 51 million people in the year 2010 to 87 million people by the year 2030.  Methods: The study was carried out as cross sectional study among 235 diabetic OPD attendants of rural health centre aged 30 years and above. TCSS was used for diagnosis diabetic peripheral neuropathy. Data was entered in MS excel 2007 and analysis was done using SPSS version 17.0. Chi square test was applied to find statistical difference in proportions and a p value of <0.05 was considered statistically significant.  Results: The overall prevalence of peripheral neuropathy among the study participants was observed to be 13.2%, while none of the study subjects presented with severe form of the disease. Nearly half of the patient who participated in the study also had co existing systemic hypertension. Also 12.3% of the study subjects had a positive history of foot ulcers.Conclusions: The prevalence of DPN increased with increasing age and it is observed to be associated with duration of diabetes, physical activity, smoking habit and systemic hypertension.

Morphometric analysis of menisci of adult human knee joint in North Indian population

Background: Of the synovial joints in the body knee joint is the largest. Each meniscus is a piece of fibrocartilage with a thickened outside edge and a thin inner edge so that it is wedge-shaped in cross section. The purpose of the present study was to establish database on standard dimensions in knee menisci of adults of north Indian population.Methods: The sample for this study was collected from April, 2012 to June, 2013. For this study, 200 menisci (100 right and left each) of 50 adult humans were taken for analysis. Measurements were done with the help of non-elastic thread and digital vernier calipers. All dissections were performed in a systematic fashion.Results: The width of the lateral meniscus was significantly different form medial meniscus with lateral and medial menisci widest in middle and posterior third respectively. The middle one third of both lateral and middle menisci was the thickest.Conclusions: It is always good to have a set of anatomical morphometric parameters of the menisci like the width and thickness. The measurements of suitable grafts may provide a more acceptable meniscal replacement in the future

Nutritional status and various morbidities among school children of a coastal area in South India

Background: Malnutrition and poor health among school children is the common cause of low school enrolment, high absenteeism, early dropout and poor classroom performance. This study was conducted to assess the various morbidities and nutritional status among school children.Methods: This descriptive study was conducted during year 2013 in a higher secondary school located in a coastal area of Puducherry. A total of 714 students were interviewed and examined. A pre-designed and pre-tested questionnaire was used to interview and examine all the participated students. Body weight and height were measured using standardized procedures. WHO criteria for classification of nutritional status was used. Visual acuity and colour vision was assessed using Snellen’s chart and Ishihara’s pseudo isochromatic chart respectively. Mean scores and proportions were calculated and chi-square test was applied. P value of <0.05 was considered as statistically significant.Results: Among 714 student, 369 (51.4%) were males and 345 (48.6%) were females. The mean age of children was 10.2 ± 3.1 years. Among all age groups and both sexes, the observed BMI was lower as compared to the reference values. The prevalence of underweight among children of 5-9 years was (30.7%) and (1.1%) were severely underweight. The prevalence of stunting was 10.4%, including 0.1% of severely stunted children. A total of 30.7% children were thin (low BMI for age). Pallor (39.5%), myopia (34.9%) and dental caries (14.7%) were the common morbidities observed among children. The pallor was observed more commonly among girls and this difference was statistically significant (p value <0.05).Conclusion: Under-nutrition is a prevalent condition among school children. Apart from various nutritional programmes, health education to parents, community and school teachers are quite important to address this problem.

Treatment of benign bone tumors: judicious use of adjuvants result in better functional outcomes

Background: While curettage has been a common treatment option for low grade benign lytic bone lesions, a careful extension of curettage enhances it’s efficacy without compromising the integrity of surrounding normal bone. Many adjuvants are used for extension of curettage, but all are not universally available, and each has it’s own drawbacks. We report outcome of extended curettage of benign lytic bone lesions using high-speed burr, electrocautery, hydrogen-peroxide, and pulsatile lavage. Methods: The study was conducted on 25 patients,10 to 40 years in age, with lytic bone lesions proven benign. Tumors belonged to Campanacci Grade 1 and 2 of varying histological types. High-speed burr, electrocautery, hydrogen-peroxide, and pulsatile lavgage were extensively used after curetting the lesions with sharp curettes. Defects were filled with bone graft or substitute where needed, if the cavity size was more than 1/3rd of the width of the bone on radiographic assessment. Patients were reviewed for minimum 18months. Results: All defects reverted to near-normal radiological appearance with excellent functional outcome recorded in most cases. Eighty percent patients recovered uneventfully. Mild limited complications were noted as prolonged period of pain in 12% and superficial infection in 8%. No local recurrence was observed. Conclusions: This study demonstrates the efficacy of extended curettage in treatment of benign tumors and tumor like lesions of bone using simple cheap modalities which are &nbsp;universally available. In properly selected cases of benign bone tumors, a meticulously performed extended curettage provides an effective treatment option that safeguards functionality without compromising on safety

Patient and health system delay among new pulmonary tuberculosis patients diagnosed at medical college hospitals in Puducherry, India

Background:Early diagnosis of the disease and prompt initiation of treatment are essential for an effective tuberculosis (TB) control program. The delay in the diagnosis and treatment may worsen the disease, increases the risk of death and enhances tuberculosis transmission in the community. This study was done to assess the extent of various delays and their determinants among TB patients.Methods:A cross-sectional study including retrospective medical record review and patient interviews was conducted during the year 2010 in and around union territory of Puducherry in India. A structured questionnaire used in the WHO multi-country study to estimate the diagnostic and treatment delay in TB was used to interview the patients. Average estimates and proportions were calculated for continuous and categorical variables respectively. Unadjusted odds ratios (OR) were calculated. Level of significance was determined at 95% confidence level (P value <0.05) and all tests applied were two-sided.Results:A total of 138 new sputum smear positive TB patients were included in the study. The mean age of participants was 41.8 years ± 17.3 years (range 15-87 years). Majority (67.4%) of the patients were male and married (68.8%). Majority (86%) of the patients were literate. The median patient delay, health system delay and total delay was 36 days, 28.5 days and 81 days respectively. The place of residence (OR = 0.39, 95% CI = 0.18-0.87) and family size (OR = 0.45, 95% CI = 0.21-0.97) were found as the determinants of various delays for TB patients.Conclusion:Patient and health care system delay for TB patients is long. There is need to improve the referral mechanism to ensure an early initiation of treatment for TB patients diagnosed a tertiary care hospitals.

Limited Laminectomy and Restorative Spinoplasty in Spinal Canal Stenosis

Study DesignProspective cohort study.PurposeEvaluation of the clinico-radiological outcome and complications of limited laminectomy and restorative spinoplasty in spinal canal stenosis.Overview of LiteratureIt is critical to achieve adequate spinal decompression, while maintaining spinal stability.MethodsForty-four patients with degenerative lumbar canal stenosis underwent limited laminectomy and restorative spinoplasty at our centre from July 2008 to December 2010. Four patients were lost to follow-up leaving a total of 40 patients at an average final follow-up of 32 months (range, 24-41 months). There were 26 females and 14 males. The mean±standard deviation (SD) of the age was 64.7±7.6 years (range, 55-88 years). The final outcome was assessed using the Japanese Orthopaedic Association (JOA) score.ResultsAt the time of the final follow-up, all patients recorded marked improvement in their symptoms, with only 2 patients complaining of occasional mild back pain and 1 patient complaining of occasional mild leg pain. The mean±SD for the preoperative claudication distance was 95.2±62.5 m, which improved to 582±147.7 m after the operation, and the preoperative anterio-posterior canal diameter as measured on the computed tomography scan was 8.3±2.1 mm, which improved to 13.2±1.8 mm postoperatively. The JOA score improved from a mean±SD of 13.3±4.1 to 22.9±4.1 at the time of the final follow-up. As for complications, dural tears occurred in 2 patients, for which repair was performed with no additional treatment needed.ConclusionsLimited laminectomy and restorative spinoplasty is an efficient surgical procedure which relieves neurogenic claudication by achieving sufficient decompression of the cord with maintenance of spinal stability