Infant and Young Child Feeding – Knowledge and Practices of ASHA workers of Doiwala Block, Dehradun District

Introduction: Promotion and support of breastfeeding is a global priority and an important child-survival intervention. Accredited Social Health Activists (ASHAs) can play a significant role in the promotion of breast-feeding. Present research paper reviews their knowledge & practices with respect to Infant and Young Child Feeding (IYCF) issues. Further, it also analyzes difficulties being faced by them in promoting positive IYCF practices so that necessary support can be provided for carrying out their desired role. Material and Methods: It was a descriptive, cross-sectional study conducted in the block Doiwala of Dehradun district, Uttarakhand. All 168 ASHAs were included in the study for the assessment of knowledge and practices by interview technique based on predesigned and pre-tested questionnaire. Results: 98% ASHAs had complete and correct information about exclusive breast feeding, however only 38% ASHAs were aware that breastfeeding should be started within 4 hours in children delivered by caesarean section. Only 18% ASHAs reported to be able to motivate mothers to practice exclusive breast feeding. Insufficient mother’s milk (55.4%), Caesarean sections (20.2%), coercion from elders in the family to start top milk were among the important factors attributed for failure of exclusive breastfeeding. Regarding complementary feeding, only 45% ASHAs knew the correct timing of initiation of complementary feeding; however 58% ASHAs had introduced the complementary feeding at 7th month in their children. 83.9% ASHAs knew that complementary food should be semisolid in consistency, while 87.5% and 32.7% ASHAs were aware that egg and non-vegetarian food items can be given as complementary food to the child. Bottle feeding had been practiced by about 33% of ASHAs in the past; however no ASHA had reported bottle feeding currently. Conclusion: Present research paper concludes that although knowledge level of ASHAs is high regarding IYCF practices but it does not match with the actual practices. They require skill building especially in the area of breastfeeding options for working women as well as complementary feeding

Questionnaire based survey on practicing OTC antimicrobials among 1st and 2nd year medical student of RIMS in Ranchi, India

Background: OTC (over the counter) drugs are defined as “Drugs available freely on the counter without prescription of a registered medical practitioner The WHO has also pointed out that responsible self-medication can help prevent and treat ailments that do not require medical consultation and provides a cheaper alternative for treating common illnesses. Studies have also found that educated people have a greater tendency to practice self-medication than illiterates. several studies have been carried out in different populations to evaluate the practice of self-medication there is a paucity of studies on self medication of antimicrobials among medical students.Methods: This was a questionnaire based study of one months duration. A prevalidated questionnaire was distributed to 258 students, to assess practice of otc anti-microbials in 1st (2nd semester) and 2nd (5th semester) year medical undergraduate students of Rajendra Institute of Medical science, Ranchi.Results: The results of this study showed that out of 258 students 208 (80.6%) students used antimicrobials as OTC. Out of 258 from both the year, 225 students had knowledge about OTC anti-microbials drug. Most common reason for practicing OTC anti-microbials was the minor ailment 86 (41.3%). Again most common indication was diarrhea 69 (33.3%). In this study we observed that the most common source of information regarding OTC anti-microbials were senior students 63 (30.4%) and most commonly used anti-microbials as self-medication were ciprofloxacin 92 (44.3%).Conclusions: This study highlights the very high prevalence of OTC anti-microbials use among medical students, inappropriate use due to the lack of knowledge. At the higher i.e. policy-making level, there is an urgent need to legislate and enforce laws which can restrict access to the supply of medicines without prescription by pharmacies and strict rules regarding pharmaceutical advertising. Again, there is a need for an impactful public enlightenment campaign to educate the people about the disadvantages and life-threatening complication of Otc anti-microbials. And at last emphasis should be given on rationalized use of anti-microbials

A rare case of chronic ectopic pregnancy: a diagnostic enigma

Clinical presentation of chronic ectopic pregnancy is often vague and confusing. Because of this diagnosis becomes delayed and difficult. Here we present one such case, reporting to our hospital. The low resource set up led to limitations in our approach and here we point out the factors which led to the diagnostic dilemma. We are reporting this case because similar challenges can be faced by other clinician in our field

SELF-REPORTED HEALTH, ILLNESS AND SELF-CARE AMONG DOCTORS OF MEERUT

Abstract: This document provides insight on lifestyle and healthcare status of doctors based on key findings from a survey conducted in Meerut City, (U.P.) India. Objectives: 1.To study the lifestyle pattern among the doctors of Allopathy and Ayurveda & teachers of local private Medical college, local private Dental college. 2. To study the (self-reported) prevalence of common non-communicable diseases in the same. 3. To know the pattern of healthy lifestyle practices adopted by the doctors. Material & Methods: The Cross-sectional study was conducted with the help of a pre-designed and pre-tested questionnaire which was filled by the faculty of local private Medical College, Dental college, Ayurvedic doctors and local practicing doctors of allopathy and Ayurveda. Verbal consent was implied. A purposive sample of 240 doctors [60 each from Medical and Dental colleges and 60 each from allopathy private practitioners (p.p.allo.) and ayurvedic private practitioners (p.p.ayur.)] were given the questionnaire-and response rate was 84%. The data was entered in Microsoft excel 2007 to know the frequency of the various lifestyle pattern. Results: 47.5% of the doctors had raised B.M.I. (Body Mass Index- more than 25); 21% of the doctors were smokers, 10% were current drinkers and 32% were hypertensive. Only 2.5% were found to be diabetic in our study. About 52% of the doctors exercised regularly. 32.5% were trained for yoga. Conclusion:This study implies that a large proportion of doctors themselves do not follow the healthy lifestyle and are having lifestyle diseases like obesity, hypertension etc. Interestingly, there was not much difference between doctors doing private practice or teaching in Medical/Dental College

A comparative study of antinociceptive effect of paroxetine with pethidine in acute pain in albino rats

Background: Pain is the most common reason patients seek medical care. Increased level of monoamines (serotonin and norepinephrine) in synaptic clefts lead to changes in pain threshold and induce antinociception. The study was carried out to evaluate antinociceptive effect of paroxetine in albino rats and to probe into its possible mechanism of action. The study was carried out to evaluate anti-nociceptive effect of paroxetine in albino rats.Methods: Male Albino rats of average weight 150-240gms were used. The drugs used were paroxetine 5mg/Kg, pethidine 5mg/kg (standard drug). Anti-nociceptive effect tested by using thermal method i.e. Tail flick response and Tail warm water immersion method.Results: In this study, Anti-nociceptive effect of respective drugs were measured by using two methods i.e. tail flick test and tail warm water immersion method at 0 min., 30 min., 60 min. and 90min.after administration of drugs. Reaction time started to increase from baseline at 0 min. and peak effect was seen at 60 min. then it started to decrease at 90 min. in almost all the groups except in control group.Conclusions: Paroxetine have significant analgesic effect in acute pain, which may be mediated via central and peripheral mechanisms. Efficacy of Paroxetine is almost equal to that of standard drug pethidine in acute pain management

Antimicrobial susceptibility pattern of urine culture isolates in a tertiary care hospital of Jharkhand, India

Background: Urinary tract infection (UTI) is one of the common infections encountered by the clinicians. Though a good number of antimicrobial agents are available, still UTIs have become difficult to treat due to development of resistance by the uropathogens. So, regional data regarding the common uropathogens and their sensitivity pattern is required to guide the clinicians to start empirical therapy while managing UTIs. The purpose of the study was to identify different species of microorganisms, along with their antimicrobial susceptibility pattern, causing urinary tract infection in outpatient and indoor patients at RIMS, Ranchi, Jharkhand.Methods: Observational study was conducted using urine culture and sensitivity reports collected retrospectively from records maintained in the department of Microbiology over a period from July 2016 to Feb 2017 in tertiary care hospital.Results: UTI was more common in females (57.74%) than in males (42.26%). Among the uropathogens isolated Escherichia coli (37.41%) was found to be the predominant organism followed by Klebsiella species (32.79%), Pseudomonas species (25.86%), and gram-positive bacteria Staphylococcus aureus accounted (3.92%) of total cases. The most common isolates were E. coli showed high sensitivity to amikacin (79.24%), followed by levofloxacin (77.21%) and gentamycin (62.26%). It was found to be resistant to norfloxacin (86%), nalidixic acid (86.76%) and cefotaxime (69.88%).Conclusions: Though various microorganisms are responsible for UTI. Escherichia coli species is the most common organism. Antimicrobial resistance has already emerged against many antibiotics, making empirical treatment of these infections challenging

Association of angiotensin-converting enzyme, methylene tetrahydrofolate reductase and paraoxonase gene polymorphism and coronary artery disease in an Indian population

Background: Coronary artery disease (CAD) and cancer remain the leading causes of death in most developed countries. Elucidating the genetic components that contribute to their pathogenesis is challenging. In this case-control association study, we examine the association of single nucleotide polymorphisms (SNPs) in paraoxonase 573 A/G genes, methylene tetrahydrofolate reductase (MTHFR) 677 C/T and angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism with CAD independently, as well as synergistically, in a north Indian population. Methods and results: Patients with at least 50% stenosis of at least one major coronary artery were classified as cases. The controls had no myocardial infarction. Polymerase chain reactions (PCR) followed by restriction fragment length polymorphism (RFLP) analyses were carried out to determine the SNPs. No significant association of the polymorphisms of the ACE or MTHFR genes with the risk of CAD was observed. However, the allele frequencies of the 573 A/G polymorphism of the paraoxonase gene differed significantly among cases and controls before and after controlling for confounding factors. The frequencies of AG vs AA genotypes and GG+AG vs AA genotypes also differed significantly in the two groups (p = 0.0002). The interaction of paraoxanase with both MTHFR and ACE independently showed significant positive associations Conclusions: The identification of ‘at risk’ individuals by genetic mapping of susceptible genes for effective control of other host factors will be a very effective and practical approach for prevention, as well as the development of improved therapy for patients. (Cardiol J 2011; 18, 4: 385–394

Comparison of outcomes of acute kidney injury in elderly and non-elderly hospitalized patients in a tertiary care hospital in India: a prospective observational study

Background: The prevalence of acute kidney injury (AKI) progressively increases with age. A higher rate of dialysis dependency and mortality is observed in elderly with AKI. Here we have studied the comparison of clinical features, outcomes of AKI between elderly (age ³60 years) and non-elderly AKI patients and their risk factors for mortality. Methods: This prospective observational study enrolled 100 patients with AKI, with elderly and non-elderly in a 1:1 ratio for comparison, from September 2021 to January 2023 at AIIMS Rishikesh in India. Detailed history, clinical examination, relevant laboratory and radiological investigations were done to evaluate for the cause of AKI. Etiological causes, complications of AKI, and in-hospital outcomes were observed. They were given standard treatment and dialysis as per standard indications. We analysed the mortality risk of these groups using the Cox proportional hazards model. Results: The in-hospital mortality rates among these two groups were non-significant (p=0.29). A significantly higher number of patients with non-elderly AKI were HD-dependent at discharge (p=0.027). Elderly patients had significantly lesser complications like uremic encephalopathy and fluid overload compared to non-elderly. There was a significant association between mortality and female gender, intensive care unit (ICU) admissions, hospital-acquired AKI, pre-renal/renal causes, chronic obstructive pulmonary disease (COPD) as comorbidity, multiple organ dysfunction syndrome (MODS), mechanical ventilation requirement, vasopressor support requirement, need for hemodialysis and prolonged ICU stay. Conclusions: Elderly patients with AKI do not experience worse mortality outcomes than non-elderly patients with AKI. Therefore, elderly patients should not be denied timely treatment, solely based on their age

The Theme of Diaspora in the Novel of Jhumpa Lahiri

The paper on the Indian Diaspora, discussion of multiculturalism in relation to the theme of alienation, identity and multiculturalism in the novel of Jhumpa Lahiri. The term of “Diaspora” is used to refer such people or population to leave their own homeland and settled down to another place which is so far from their own traditional homeland. Jhumpa Lahiri writes about Diaspora and alienation and between the memory of homeland and the new land, the immigrants are in a permanent mental and emotional war between the myth and customs of the old world and; freedom of the new one. In her novel, “The Namesake “(2004), she writes about the generation gap between immigrants, conflict of east-west beliefs nostalgia, cultural displacement loss of identity, alienation and despair

Infant and Young Child Feeding – Knowledge and Practices of ASHA workers of Doiwala Block, Dehradun District

Introduction: Promotion and support of breastfeeding is a global priority and an important child-survival intervention. Accredited Social Health Activists (ASHAs) can play a significant role in the promotion of breast-feeding. Present research paper reviews their knowledge & practices with respect to Infant and Young Child Feeding (IYCF) issues. Further, it also analyzes difficulties being faced by them in promoting positive IYCF practices so that necessary support can be provided for carrying out their desired role. Material and Methods: It was a descriptive, cross-sectional study conducted in the block Doiwala of Dehradun district, Uttarakhand. All 168 ASHAs were included in the study for the assessment of knowledge and practices by interview technique based on predesigned and pre-tested questionnaire. Results: 98% ASHAs had complete and correct information about exclusive breast feeding, however only 38% ASHAs were aware that breastfeeding should be started within 4 hours in children delivered by caesarean section. Only 18% ASHAs reported to be able to motivate mothers to practice exclusive breast feeding. Insufficient mother’s milk (55.4%), Caesarean sections (20.2%), coercion from elders in the family to start top milk were among the important factors attributed for failure of exclusive breastfeeding. Regarding complementary feeding, only 45% ASHAs knew the correct timing of initiation of complementary feeding; however 58% ASHAs had introduced the complementary feeding at 7th month in their children. 83.9% ASHAs knew that complementary food should be semisolid in consistency, while 87.5% and 32.7% ASHAs were aware that egg and non-vegetarian food items can be given as complementary food to the child. Bottle feeding had been practiced by about 33% of ASHAs in the past; however no ASHA had reported bottle feeding currently. Conclusion: Present research paper concludes that although knowledge level of ASHAs is high regarding IYCF practices but it does not match with the actual practices. They require skill building especially in the area of breastfeeding options for working women as well as complementary feeding