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ORIGINAL ARTICLES
Assessment of the food hygiene practices of food handlers in the Federal Capital Territory of Nigeria
Chigozie O Ifeadike, Okechukwu C Ironkwe, Prosper O. U. Adogu, Chinomnso C Nnebue
January-June 2014, 17(1):10-15
DOI:10.4103/1119-0388.130175  
Background: The principle of food hygiene implies that there should be minimal handling of food items. Food handlers are thus expected to observe proper hygiene and sanitation methods as the chances of food contamination largely depend on their health status and hygiene practices. Objective: This study assessed the food hygiene practices of food handlers and made recommendations for improved food safety measures within food establishments in the Federal Capital Territory. Materials and Methods: The study design was cross-sectional descriptive. A multistage sampling technique was employed to select 168 food handlers of various types. Data was collected using a mix of quantitative methods (structured interviewer-administered questionnaires and observation checklist). Data were analyzed using the statistical package for social sciences version 14. Results: Four categories of food handlers were identified in 45 food establishments. Seventy-one (42.3%) of the subjects are males, whereas 97 (57.7%) are females. Most of them, 122 (72.7%), had secondary education and above, whereas 46 (27.3%) had primary education and below. One hundred and fifty (89.3%) of them wash their hands after the use of toilets, whereas only 44 (26.7%) change their hand gloves at work. One hundred and twenty (71.4%) of them undergo regular medical checkup, whereas 53 (31.5%) are isolated from workplace when ill. A few of them, 51 (30.4%) use sanitizers/disinfectants at workplace, whereas 38 (22.6%) check food temperature with thermometer. Also, 103 (61.3%) use ideal waste disposal methods at workplace (P < 0.01). Conclusion: Establishments should train staff regularly on basic personal hygienic techniques, self care and good house-keeping practices.
  27,429 1,939 2
REVIEW ARTICLES
Innovation in prevention and treatment of pressure ulcer: Nursing implication
Eunice O Osuala
July-December 2014, 17(2):61-68
DOI:10.4103/1119-0388.140411  
A pressure ulcer is a localized injury to the skin or underlying tissue, usually over a bony prominence, due to unrelieved pressure. Pressure ulcers remain a major health problem affecting approximately three million adults. Prevalence differs based on settings but is 25% on the average. The cost of treatment of pressure ulcers is expensive. Cost of its treatment is two and a half times the cost of preventing them. Even though management of pressure ulcers involves multidisciplinary approach, its development is an index of poor Nursing care. Literature was reviewed and relevant information on the current trend in the prevention and management of pressure ulcers is provided to sensitize nurses of their indispensible role in pressure ulcer management. Management includes identifying at-risk persons and implementing specific prevention measures as well as wound care. Pressure ulcers significantly threaten the well-being of patients with limited mobility. It is associated with increased morbidity and mortality and lawsuits due to pressure ulcers are on the rise. Nursing remains at the forefront of protecting and safeguarding the patient from pressure ulcers. Every nurse must therefore embrace the new trend in the management of pressure ulcers to reduce cost of medical services, period of hospital stay as well as avoid litigation.
  23,232 4,367 1
ORIGINAL ARTICLES
Knowledge regarding antenatal care services, its utilization, and delivery practices in mothers (aged 15-49 years) in a rural area of North India
Rajiv Kumar Gupta, Tajali Nazir Shora, Aruna K Verma, Rayaz Jan
July-December 2015, 18(2):89-94
DOI:10.4103/1119-0388.158401  
Background: Antenatal care (ANC) is an effective tool to reduce both infant and maternal mortality rates. In spite of all efforts to reach and register every antenatal mother, the results are not up to desired level. Objectives: To assess the level of knowledge of pregnant women about ANC services and to find out the ANC utilization and factors affecting them. Materials and Methods: This cross-sectional study was carried out in October-November 2013 in Krishna Nagar village of Miran Sahib zone of block R.S. Pura. All the mothers (aged 15-49 years) in this village were interviewed using a predesigned, pretested, and semi-open-ended questionnaire. Results: The respondents had adequate knowledge about ANC services except for the minimum number of visits for ANC. Here, 89.6% (189) of the respondents had registered for ANC, of which 64.5% (136/211) and 9.9% (21/211) had registered in the 2 nd trimester and 1 st trimester, respectively. The results revealed that 79.1% of the deliveries were institutional. The age, literacy status, socioeconomic status (SES), and type of family had statistically significant associations with the utilization of ANC services. Conclusion: The results show that maternal literacy remains a key factor in the better utilization of antenatal services. Moreover, the role of health workers in increasing awareness among mothers about the importance of ANC in general and the danger signs of pregnancy in particular is of paramount concern.
  9,108 1,029 1
Early dengue diagnosis: Role of rapid NS1 antigen, NS1 early ELISA, and PCR assay
Vaishali N Solanke, Mohan G Karmarkar, Preeti R Mehta
July-December 2015, 18(2):95-99
DOI:10.4103/1119-0388.158402  
Context: Early and accurate dengue diagnosis is important for disease surveillance, and also to start effective control measures in endemic countries. Aims: In this study, we evaluated the performance of three techniques available for early dengue diagnosis, viz., rapid nonstructural 1 (NS1) antigen test, NS1 early enzyme-linked immunosorbent assay (ELISA) test, and reverse transcription polymerase chain reaction (RT-PCR) test. Settings and Design: Retrospective analytical study. Materials and Methods: Performance of three different techniques, viz., rapid NS1 antigen, NS1 early ELISA, and RT-PCR on serum samples of suspected dengue cases. Statistical Analysis Used: Sensitivity, specificity, negative predictive value, and positive predictive value calculated for rapid test and ELISA test, keeping PCR as the gold standard Results: Amongst 155 samples received from clinically-suspected dengue cases within 1-9 days of fever, 56 samples were received during 1-3 days, 52 samples were received during 4-6 days, and 47 samples were received during 7-9 days. Of these 155 samples, 38 (24.5%) were positive by rapid NS1 antigen, 47 (30.3%) by NS1 ELISA, and 54 (34.8%) by reverse transcriptase polymerase chain reaction (RT-PCR). Rapid NS1 antigen and NS1 ELISA showed the highest positivity on days 1-3, while highest positivity for PCR was on days 4-6. The sensitivity and specificity of NS1 ELISA were 66.6% and 89.1%, while sensitivity and specificity of rapid NS1 antigen were 55.5% and 92%, respectively. Conclusions: With high mortality and morbidity associated with dengue, it is imperative to diagnose the disease during the early phase. All three assay formats are helpful in early diagnosis and to provide information of dengue cases in time.
  7,353 533 5
REVIEW ARTICLE
Applications of Bacillus subtilis as an important bacterium in medical sciences and human life
Seyed Hossein Shahcheraghi, Jamshid Ayatollahi, Marzieh Lotfi
January-June 2015, 18(1):1-4
DOI:10.4103/1119-0388.152530  
Probiotics are a group of organisms without pathogenic effects. These organisms are known as creatures that have advantageous effects on the safety of their host. The most common kinds of microbes that are used as probiotics are Lactic acid bacteria (LAB) and bifidobacteria; but several yeasts and bacteria may also be used. In this study, we have reviewed the benefits of Bacillus subtilis as a probiotic bacterium. The journals published from 1989 to 2012, have been used in the study. At the start of the twentieth century, these organisms were thought to usefully affect their host by ameliorating the intestinal bacterial equilibrium, and therefore, injuncting the toxin-producing organisms and pathogens. Nowadays, particular health effects are being examined and documented, including the prohibition and remedy of pathogen-induced diarrhea, palliation of severe intestinal inflammatory diseases, urogenital infections, and atopic cases. Probiotics are generally used as a division of foods with particularly added active live cultures, including soy yogurt, yogurt or as dietary supplements. B. subtilis strains produce antibiotics and enzymes that are important in both medical and industrial sciences.
  6,681 771 -
ORIGINAL ARTICLES
Eosinophilia in dermatological diseases: A study of one hundred patients
Ambika Harihara Subramony, Chankramath Sujatha, Pratyusha Kolanuvada
July-December 2014, 17(2):109-111
DOI:10.4103/1119-0388.140430  
Introduction: Eosinophils are multifunctional cells that play a characteristic role in various diseases of allergic and infective etiology. Eosinophils play an important role in immunity hence eosinophilia occurs in various diseases of skin and systemic allergic disorders. Materials and Methods: One hundred patients admitted to the Dermatology ward with absolute eosinophil count (AEC) above 500 cells per cubic millimeter were included in the study. Detailed history, including, drug history, travel history, history of atopy, and insect bites, was taken. A complete hemogram, stool examination, chest x-ray, and serological test were done to rule out eosinophilia due to other causes. Results: In our study, most of the patients (40%) were between the age group of 40 and 60 years. Fifty-six percent were male patients. Most of the patients (98%) fell in the category of mild-to-moderate eosinophilia. Marked eosinophilia was seen in only 2%. Most common skin conditions were chronic urticaria (28%) followed by generalized pruritus (16%), eczema (10%), drug reaction (10%), psoriasis (7%), bullous diseases (6%), palmoplantar keratoderma (4%), and HIV (4%). Malignancy was seen in 2%. Other conditions constituted 13%. Out of all these, 12% had stool examination positive for ova and cysts. Histopathological examination was done in 22 patients, 12 of whom showed tissue eosinophilia. Conclusion: Peripheral blood eosinophilia and/or infiltration of skin by eosinophils occur in various skin diseases. Coexisting parasitic infestations may be a predominant contributing factor for eosinophilia in tropical countries.
  6,360 390 1
A study of the short-term cardiopulmonary effect of mawa chewing in rural India
Amrith Pakkala, Chitradurga Palaiah Ganashree, Thippeswamy Raghavendra
January-June 2014, 17(1):20-24
DOI:10.4103/1119-0388.130177  
Background: Tobacco is consumed in smoking and smokeless forms all over the world. Smokeless tobacco has been advocated as a substitute for cigarette smoking. On the contrary, the use of smokeless tobacco is fraught with health risk and needs to be discouraged. Previous reports have described long-term harmful effects of nicotine on various body parameters, little is known about the acute effect of smokeless tobacco, such as mawa, consumed very rampantly in rural India, on cardiopulmonary parameters. Use of smokeless tobacco indeed represents a health concern of growing magnitude among these groups. As a consequence of its addictive qualities, the consumption of smokeless tobacco often becomes a lifelong habit with cumulative and deleterious effects on health. Very few studies have been undertaken on the acute effect of use of mawa, a common form of tobacco used in India, on cardiopulmonary parameters of youngsters. Materials and Methods: Treadmill Exercise Testing and Pulmonary Function Tests were done before and after maximal exercise testing to assess cardiopulmonary efficiency in two groups, namely, healthy sedentary controls and healthy mawa chewers. Results: On studying the differences in cardiopulmonary efficiency in the two groups, the resting heart rate was found to be statistically significantly higher in the study group and the delta heart rate was found to be statistically significantly lower among mawa chewers. There was no significant difference seen in parameters such as VO 2max , maximum oxygen pulse, MVV, VE max as an acute effect of mawa. Conclusion: In this study, it appears that mawa chewers are physically fit similar to the controls, but immediately after smoking a lesser delta HR suggests a higher risk for cardiovascular mortality. Stopping mawa at this juncture can be helpful in reverting back the risk, and parameters such as resting HR, recovery HR, and delta HR can be used as prognostic assessment tools for any intervention therapy to stop mawa chewing in asymptomatic individuals.
  5,913 241 -
Challenges of data collection and disease notification in Anambra State, Nigeria
Chinomnso C Nnebue, Chika N Onwasigwe, Prosper O. U. Adogu, Echendu D Adinma
January-June 2014, 17(1):1-6
DOI:10.4103/1119-0388.130173  
Background/Objective: Disease surveillance and notification (DSN) in Nigeria have been characterized by weaknesses such as insufficiencies in health infrastructure, scientific methods, and concepts of operation; essential human, technical, and financial resources; and international or local policies as well as lack of intra- and intersectoral collaboration. These weaknesses in DSN system thus compromise efficiency and quality of data. This study examined the challenges of data collection and disease notification in Anambra state, Nigeria. Materials and Methods: This was a cross-sectional descriptive study of 270 healthcare workers selected by multistage sampling technique. Data collection was done using a mix method comprising interviewer administered questionnaires, health facility observational checklist, key informant interviews (KIIs), and desk review. Results: Commonest problems associated with DSN system as mentioned by the health workers were as follows: Most facility workers were not trained on DSN system (23.7%), lacked transportation (15.8%), poorly motivated/poor staff attitude (15.4%), inadequate supply of forms (11.8%), and poor funding (11.4%). An observational checklist on preparedness for DSN showed that 100% of primary and tertiary health facilities had facility records, while 81% at the secondary level had records. Only 51.9% facilities had community health officers (CHOs), while junior community health extension workers (JCHEWs) were more in primary health facilities compared to other levels of care (χ2 = 4.25, P = 0.040). Conclusion: Regular training program on DSN should be encouraged, while regular monthly supervision and quarterly meetings of health facilities should be organized for health facility workers. Regular and adequate information feedback should be emphasized.
  5,408 311 -
REVIEW ARTICLES
Ebola virus disease in the light of epidemiological triad
Gurmeet Kaur, Sandeep Sachdeva, Diwakar Jha, Anika Sulania
January-June 2017, 20(1):1-9
DOI:10.4103/1119-0388.198096  
Ebola virus disease (EVD) is one of the most virulent pathogens among viral hemorrhagic fevers affecting economically deprived countries of the world with reported case fatality rates of up to 90% due to multiorgan failure and severe bleeding complications. The most recent outbreak of 2014 has set the alarm bell ringing across the globe for increased focus, funding, research, and development toward the control and management of this emerging viral communicable disease that has a potential pandemic threat. This manuscript review and update current knowledge with regard to epidemiology of EVD problem statement, historical perspective, agent, host, environment, reservoir of infection, routes of transmission, pathogenesis, clinical features, laboratory diagnosis, management, and control. The review was undertaken using the key words epidemiology, public health, outbreak control of Ebola virus, EVD, emerging disease, and/or pandemic disease through medical search engines and abstracting databases such as Pubmed, Google Scholar, and websites of international health agencies such as the World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC).
  5,219 374 1
ORIGINAL ARTICLES
Cervical cancer screening: Awareness, attitude, and practice of Indian women
Sujindra Elamurugan, Praveena Rajendran, Sivashankari Thangamani
January-June 2016, 19(1):42-46
DOI:10.4103/1119-0388.172062  
Background: Cervical cancer is the most common cause of cancer-related deaths among women worldwide. It becomes a deadly disease once it reaches the invasive stages but is very much preventable if detected in its early stages. Cervical cancer screening using Papanicolaou (Pap) test prevents the development of cervical cancer by recognizing the precancerous state. Aims and Objectives: To determine the awareness and attitude and practice of Indian women toward screening for cervical cancer. Materials and Methods: Cross-sectional survey with pretested questionnaires on 200 women belonging to two categories comprising 100 high school teachers and 100 housewives. The questionnaire comprised 15 questions. Four questions were framed to gather the sociodemographic details and the remaining 11 were pertaining to knowledge, attitude, and practice (KAP). The results were tabulated as simple mean and percentage. KAP score was calculated by selecting seven questions from the questionnaire. Scores “1” and “0” were given for positive and negative responses, respectively. Results and Conclusion: Mean age of the teachers was 38.2 ± 13.2 years and of the housewives 40.38 ± 12.2 years. All the teachers had heard about cervical cancer, 98% about the availability of some screening method for cervical cancer, and 79% about Pap smear. Among the housewives, 72% knew about cervical cancer, 70% about the availability of screening methods, and 38% had heard about Pap smear. The practice of cervical cancer screening methods was not adequate among teachers and housewives. However, their knowledge and attitude were welcoming.
  4,435 556 1
REVIEW ARTICLE
Factors determining sanitation information-seeking behavior: A literature review
Oluwaseun O Fagbemiro, Iyabo Yewande Ademuyiwa, Opeyemi D Soyemi, Adedamola O Ojo
July-December 2016, 19(2):81-87
DOI:10.4103/1119-0388.185424  
This paper reviewed various assessments by different authors on sanitation information-seeking behavior of people in various areas and setting. Databases were used in the search for relevant academic published articles including Google Scholar and Google search engine. Articles for the review were drawn from peer-reviewed journals. Moreover, conference papers and research by recognized independent institutions. This review showed that factors determining sanitation-seeking behavior could be seen in various contexts: Economical, environmental, technological, and psychosocial. Therefore, the effective utilization of sanitation information will depend on social structures, level of education, cultural beliefs and practices, economic, government, and environmental conditions. Sanitation is the hygienic means of promoting health through prevention of human contact with hazards of waste as well as the treatment and proper disposal of sewage and wastewater. Strategic policy formation in the society should be based on information relating to sanitation, cleanliness, health promoting, and information-seeking behavior.
  2,481 2,194 -
ORIGINAL ARTICLES
Accuracy of clinical diagnosis of prostate cancer: Implications for patients' management
Igwebuike Victor Onyiaorah, Cornelius Ozobia Ukah, Daniel Chukwuemeka Anyiam, Michael Emeka Onwukamuche, Chilota Chibuife Efobi
July-December 2015, 18(2):61-67
DOI:10.4103/1119-0388.158396  
Background: Cancer of the prostate is the commonest cancer and the most frequent cause of cancer deaths in Nigerian males. In Nigeria, prostate cancer patients frequently present in the late stage of the disease with consequent poor prognosis. The outcome of the disease in our setting is also worsened by diagnostic errors; this fact has been underappreciated. In this study, we have assessed the accuracy of clinical diagnosis of prostate tumors by clinicians working in Anambra State, Nigeria. Materials and Methods: Retrospective data were retrieved for all histopathology requests for prostatectomy specimens submitted to three pathology laboratories in Anambra State, Nigeria. The working clinical diagnoses were compared with the corresponding histopathology diagnoses, and the diagnostic accuracy of the medical doctors was calculated statistically. Results: Our results showed that the clinicians studied have a low overall sensitivity (37,500 per 100,000 patients) in diagnosing prostate cancer. Furthermore, doctors working in public hospitals have a slightly lower sensitivity but higher specificity than doctors serving in private hospitals when it comes to diagnosing prostrate tumors. Conclusion: This study revealed a high specificity but low sensitivity in clinicians' ability to accurately diagnose prostatic cancer. Reliance on PSA needs to be reviewed. More so the serving laboratories in the index State may need to apply internal and external quality assurance systems to their PSA analysis. It will be instructive to search for other diagnostic tools with appreciably higher predictive value. Generally, more education, research and development is needed for improvement.
  1,660 2,352 -
REVIEW ARTICLES
Cathelicidin expression and role in oral health and diseases: A short review
Mythri Potturu, Prem Anand Prabhakaran, Neetu Oommen, Deepa Muraleedharan Sarojini, Sukumaran Nair Sunil
July-December 2014, 17(2):69-75
DOI:10.4103/1119-0388.140414  
The oral cavity is a unique environment in which antimicrobial peptides play a key role in maintaining health. Cathelicidins are small cationic antimicrobial host defense peptides that possess broad-spectrum antimicrobial activity. Humans possess a single cathelicidin, which was first cloned from human bone marrow cDNA. Its mature form is known as LL-37. Various immune and epithelial cells secrete LL-37, and its level varies in response to caries, periodontal, congenital, inflammatory, and malignant diseases in the oral region. Human cathelicidin peptide LL-37 exhibits antimicrobial activity against bacteria that cause oral pathological conditions, including cariogenic disease and periodontitis. Further research on LL-37 is needed as its usefulness as a new class of antimicrobial drugs still remains to be proven and may have future therapeutic applications.
  2,689 829 1
ORIGINAL ARTICLES
The pattern of antihypertensive medication use among elderly patients in a tertiary care teaching hospital in South India
Sandeep Kumar Gupta, Roopa Prasad Nayak
July-December 2014, 17(2):81-85
DOI:10.4103/1119-0388.140418  
Background: The blood pressure (BP) control rates in elderly patients remain low and hypertension in them is a management dilemma to the treating physician. Objective: The primary objective of this study was to characterize the prescribing pattern of antihypertensive agents among elderly patients in a tertiary care teaching hospital. Materials and Methods: This study was part of a larger cross-sectional retrospective study to assess the pattern of prescribing for inpatient hypertensive cases in the Inpatient Department of General Medicine at Dhanalakshmi Srinivasan Medical College and Hospital (DSMCH), Perambalur (Tamil Nadu). The data were collected for a period of 10 months. Only elderly patients who are 65 and above and those who were suffering from essential hypertension and had been prescribed at least one antihypertensive drug with or without other co-morbid conditions were included. Results: Among 106 patients studied, approximately 51% and 49% were on monotherapy and combination therapy, respectively. The antihypertensive drugs were prescribed alone or in combination in the following order: Calcium channel blockers (CCBs), diuretic, beta blockers (BBs), ACE inhibitors (ACEIs), and angiotensin receptor blockers (ARBs). The commonest monotherapy agents prescribed were CCBs (29.2%), followed by diuretic (11.3%), ACEI (4.7%), BB (4.7%), and ARBs (0.9%). The most prevalent two-drug therapy was with a CCB and diuretic (19.8%), followed by a CCB and BB (7.5%), CCB and ACEI (1.9%), ACEI and diuretic (2.8%), CCB and ARB (1.9%), BB and diuretic (1.9%), BB and ACEI (0.9%), and BB and ARB (0.9%). The commonest three-drug therapy was with a CCB, BB, and diuretic (2.8%). Other three-drug therapies were an ACEI + CCB + BB (0.9%), an ARB + diuretic + CCB (0.9%), a BB + CCB + ARB (0.9%), a BB + ACEI + diuretic (0.9%), a BB + ARB + diuretic (0.9%), and a CCB + diuretic + ACEI (0.9%). The commonest four-drug therapy was with a CCB, BB, ARB, and diuretic (1.9%) followed by a CCB + BB + ACEI + diuretic (0.9%). Conclusion: The most commonly prescribed antihypertensive drug was CCBs followed by diuretics, BBs, ACEIs, and ARBs. Overall, there was less utilization of diuretics and ACEIs or ARBs.
  3,162 303 -
Prevalence and pattern of major extremity amputation in a tertiary Hospital in Nnewi, South East Nigeria
Chibuzo U Ndukwu, Chigozie A Muoneme
July-December 2015, 18(2):104-108
DOI:10.4103/1119-0388.158405  
Introduction: Amputation surgery is an orthopedic surgical procedure carried out as the last resort, when limb salvage is not feasible. It is usually associated with social, emotional and psychological disturbances to the patient and the family. Objectives: To determine the prevalence and pattern of amputation surgeries in the Orthopedic unit of the Nnamdi Azikiwe University teaching hospital (NAUTH) Nnewi. This will be compared with trends in similar studies. Patients and Methods: This was a 2 year retrospective analysis of major limb amputations in NAUTH Nnewi from January 2011 to December 2012. Information extracted from the case notes included the biodata, indication for amputation, levels of amputation, complications and prosthetic use. Result: A total of 90 patients had major extremity amputations. All the cases were unilateral amputations. The age range was 17 to 89 years with a mean of 58.3 ± 15.9 years. The male to female ratio was 1.5:1. The amputation prevalence amongst all orthopedic surgeries within the period was 21.8%. Diabetic foot gangrene was the most common indication for amputation in 65 (72.2%) patients. Below knee amputation was the most common level of amputation (64.4%). Wound dehiscence was the most common complication. Only 10 patients used prosthesis and the mortality rate was 34.1%. Conclusion: There is a high prevalence of limb amputation in this study with diabetic gangrene being a leading cause. The public should be enlightened to adopt a better health-seeking attitude which may help to drastically control the almost epidemic menace of diabetes and the complications.
  3,161 278 1
Infection control by nurses in selected hospitals in Anambra State, Nigeria
Eunice Ogonna Osuala, O Abimbola Oluwatosin
January-June 2017, 20(1):53-60
DOI:10.4103/1119-0388.198122  
Background: Client safety in the health-care environment requires the reduction of microorganism transmission. Infection control practices are directed at controlling or eliminating source of infection in the health-care agency, home, or communities to reduce the occurrence and transmission of infectious diseases. Among health workers, nurses spend the greatest time in caregiving setting. Nurses' involvement in infection control measures will yield positive results in infection prevention and control in hospitals. Aim: To evaluate the knowledge, attitude, and practice of nurses in the state on infection control and barriers to practice to generate information that would guide future interventions to scale up practices. Methods: It is a cross-sectional study of descriptive design. Multistage sampling technique was adopted. The hospitals in the state were stratified according to ownership - federal, state, mission, and private. Using balloting, three categories of hospitals were randomly selected out of the four. One hospital each was selected from the three main cities in the state based on federal, state, and mission ownership, respectively. Instrument for data collection was a self-structured questionnaire, which was validated and with a reliability value of 0.82 computed on ten nurses in a pilot study. The population of nurses in the three hospitals was small (310). Using convenient sampling method, nurses on morning duty were selected. A sample of 202 nurses based on shift duty, out of the 310 nurses from the three selected hospitals constituted the study population even though only 197 out of the 202 nurse participants returned their questionnaire. Descriptive and inferential statistics using Spearman's rho correlation were applied. Results: Out of the 197 respondents, 84 (42.6%) responded that their hospital has infection control unit and 66 (34.1%) stated that they have infection control committee in their hospitals. Respondents with a knowledge score above 60% were only 20 (10.2%), but 170 (86.3%) and 120 (60.9%) had attitude and practice score above 60%, receptively. Only 5 respondents (2.5%) strongly agreed that hand washing is the key to infection control. Conclusion: There is a need to explore the discrepancy between knowledge, attitude, and practice. Facility monitoring is vital to effective infection control practices and should be the focus of intervention.
  3,139 273 -
A morphological and morphometric study of placenta with its clinical implications
Chandni Gupta, Hemant Ashish Harode, Antony Sylvan D'souza, Ankur Sharma
July-December 2015, 18(2):85-88
DOI:10.4103/1119-0388.158400  
Objective: In the idiopathic intrauterine growth restriction where there are no clear maternal or fetal causes, the placenta may hold the key to its etiology. So, this study was undertaken to look for any placental and umbilical cord abnormality and to establish the relationship of fetal birth weight with placental measurements. Materials and Methods: In this study, 100 freshly delivered placentae were collected. The placenta and the umbilical cord were examined to look for any abnormalities in the shape, cord insertion, and vessels in the cord; placenta weight, its circumference, diameter, volume, and thickness at the level of cord insertion were also noted. Baby's weight at birth and age in weeks, maternal history about diabetes and hypertension were also noted down. IBM SPSS Statistics for Windows version 20.0, USA was used to do statistical analysis of the measurements. Results: In the present study, placenta weight, volume, diameter, and circumference show a strong correlation with fetal weight. We found placenta of round and abnormal shapes in 89% and 11% of cases, respectively. In 76% of cases, we got normal cord insertion and in 24% of cases, abnormal cord insertion. Statistical analysis of all the parameters of the placenta was done. Conclusion: In our study, placenta weight, volume, diameter, and circumference showed a strong correlation with fetal weight. The knowledge of these measurements on the placenta and umbilical cord will be helpful to the pediatrician and obstetrician in clinical practice.
  2,934 340 3
A quantitative assessment of “chikungunya” research publications, 2004-2013
Shri Ram
January-June 2016, 19(1):52-60
DOI:10.4103/1119-0388.172067  
Introduction: This study has been carried out with an objective to analyze research publications on chikungunya virus (commonly known as “chikungunya”) available in Scopus multidisciplinary database. The data were screened and retrieved from Scopus using keywords “chikungunya virus” or “chikungunya” published from 2004 to 2013. Materials and Methods: The quantitative analysis was carried out in terms of the characteristics of chikungunya publication, citation analysis, average citation per papers (ACPPs), productivity by country, institutions, authors and journals, and impact factor (IF) for the year 2013. Results: There were 1,783 chikungunya articles published in over 613 journals and have been written by 9,200 authors either singly or in joint authorship. India is found to be the most productive country (378; 21.27%), and M.M. Parida of the Defense Research and Development Establishment, India, is the most productive author. Most of the institutions with the highest productivity are in France. Conclusion: Chikungunya has emerged as a threat to public health in Africa, the Indian Ocean region, Southeast Asia, the Pacific Islands, Europe, and Latin America. The results of this study have shown the prevalence of literature in these regions.
  2,941 309 -
Intrauterine contraceptive device acceptors in Nnamdi Azikiwe University Teaching Hospital, Nnewi, Southeastern Nigeria - A 5-year review
VO Dinwoke, CI Okafor, A Eke
July-December 2015, 18(2):68-73
DOI:10.4103/1119-0388.158397  
Background: Unsafe abortions of unintended pregnancies contribute significantly to maternal deaths in Nigeria. The intrauterine device (IUD) is a widely used method of contraception. Objectives: This study aimed to determine the contraceptive prevalence at this center, the proportion of the acceptors adopting the IUD method, and the sociodemographic characteristics and other parameters among the IUD clients. Findings from this study and the analysis of similar studies elsewhere will help improve contraceptive services, especially counseling and acceptance. Materials and Methods: This was a retrospective study of the period January 2004-Dec. 2008. The family planning register was used to trace the case records of the clients who had accepted IUDs over the 5-year period. Labor ward registers were used to calculate the number of deliveries over the same period. EPI Info Version 6 (2002) for Windows was used to analyze the data. Chi-squared tests were used and differences were considered significant if P < 0.05. Results: The total number of deliveries at our center in the studied period was 2,791, while the total number of contraceptive clients (for all methods) was 607, giving a contraceptive prevalence rate of 21.75%. IUD was the most accepted method, used by 344 (56.67%) women, followed by injectable progestogens, used by 172 (28.34%).  Among IUD acceptors, most were multiparous women (para 2-5), numbering 168 (50.91%); most were in the age group of 26-30 years 100 (30.30%); male sterilization was not done at all (0%). Conclusion: IUD is a preferred contraceptive option among our women; however, the prevalence rate of modern contraceptive use at our center is still unacceptably low. More aggressive health education using the mass media, nongovernmental organizations (NGOs), religious and community leaders, and easy access to the  commodities are required to reverse the trend.
  2,440 806 1
SHORT COMMUNICATION
Public health interventions to combat the menace of food adulteration in developing countries
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
July-December 2014, 17(2):125-126
DOI:10.4103/1119-0388.140439  
It has been estimated that more than 200 diseases are spread through the medium of food. The practice of adulteration of food is a serious threat to health of the members of community. From the consumer point of view, firstly, he is paying more money for a foodstuff of lower quality and secondly, some forms of adulteration are injurious to health, even resulting to death. To conclude, realizing the scope of adulteration and the associated detrimental effects on the health of a consumer, there is an urgent need to formulate sound and holistic strategies to enhance the food safety standards.
  2,884 348 -
CASE REPORTS
Scrub typhus: An under diagnosed re-emerging zoonotic disease
Ruchi Sachdeva, Sandeep Sachdeva
July-December 2014, 17(2):133-136
DOI:10.4103/1119-0388.140445  
A 63-year-old male presented with chief complaints of dry cough since 20 days, breathlessness since 20 days, rash since 19 days, high-grade fever with chills and rigors since seven days, and myalgia and joint pain since seven days. On the basis of high clinical suspicion and skin lesion, a diagnosis of scrub typhus was made that was later confirmed by serology. In the context of changing epidemiological, geographical, environmental, human migration, and access to diagnostic laboratories, a differential of scrub typhus should be borne in mind among patients with similar presentations. We report a case of scrub typhus in an urban setting along with a review of literature.
  2,689 216 -
An ulcerated mass in the cervix: Carcinoma or tuberculosis
Deepa Kapoor, Prerna Kapoor, Niraj Kumari, Narendra Krishnani, Pallavi Aga
January-June 2014, 17(1):48-50
DOI:10.4103/1119-0388.130186  
Tubercular involvement of the cervix is rare and the clinical presentation often simulates that of cervical carcinoma leading to misdiagnosis. We report here the case of a 31-year-old female who presented with secondary amenorrhea, post-coital vaginal bleeding, lower abdominal pain, and mild low-grade fever. Cervical examination revealed an unhealthy cervix, with an irregular, ulcerated mass that bled on touch, raising the suspicion of a cervical malignancy. Histopathology of the cervical biopsy revealed typical necrotizing granulomas and also confirmed the presence of acid fast bacilli in the specimen. Antitubercular therapy was started and the patient responded, with rapid amelioration of symptoms and regression of the cervical mass. Tuberculosis of the cervix is an uncommonly encountered entity and presentation may closely resemble that of cervical carcinoma. Tuberculosis should be considered an important differential diagnosis of a malignant-appearing lesion of the cervix, especially in areas where it is endemic.
  2,721 180 1
Open pathological dislocation of the hip secondary to trochanteric decubitus ulcer
Chima C Ihegihu, Ebere Y Ihegihu
January-June 2014, 17(1):42-44
DOI:10.4103/1119-0388.130183  
This is a case report of a 30-year-old male hand digging manual borehole driller who became quadriplegic as a result of a complete cervical cord injury at the level of C5. He subsequently developed a trochanteric decubitus ulcer through which the head of the femur dislocated; a rare and unusual complication which has not been previously described in adult quadriplegics.
  2,710 141 -
ORIGINAL ARTICLES
Clinical and biochemical profile of Indians with type 2 diabetes mellitus: A problem lurking for India
Sandeep Singh, Ajay Pal Singh, Manish Kishore Multani, Ashish Purohit
July-December 2014, 17(2):91-98
DOI:10.4103/1119-0388.140424  
Background: To define the profile of type 2 diabetes mellitus population from the Gwalior region of Madhya Pradesh, as the previous published data shows a pattern and profile variability of type 2 diabetes mellitus from India. Materials and Methods: A case control study was carried out in the Department of Medicine comprising 50 newly diagnosed type 2 diabetes mellitus patients and 50 healthy controls. Results: The body mass index (BMI) of the study subjects was - cases - 23.94 ± 1.83 kg/m 2 , controls - 22.8 ± 1.38 kg/m 2 ( P < 0.001). Prevalence of an abnormal value of waist-to-hip ratio (WHR) was found to be 46% in the cases. Of the cases, 58% had poor glycemic control. The dominating symptoms were polyuria 30% (15, P < 0.05) and tingling and numbness 26% (13, P < 0.01). The most prevailing complications were retinopathy 26% (13; P < 0.01) and neuropathy 26% (13; P < 0.01). Dyslipidemia was present in the 88% of the cases. Discussion and Conclusion: This study found that a vast proportion of the cases had poor glycemic control. Central obesity was present in the studied population, with generalized obesity, making the population prone to insulin resistance. Presence of the classical symptoms of diabetes on the back-foot in the studied subject suggests that the disease might be on track of changing its trend or the patients are reporting at a late stage due to health disparities. Dyslipidemia in retinopathic subjects suggests derangement of the lipid profile, which is a risk for retinopathy. The most prevalent form of dyslipidemia in diabetic males was low high density lipoprotein cholesterol (HDL-c), while in females it was high low density lipoprotein cholesterol (LDL-c), and high triglycerides (TG). The pattern of dyslipidemia differed from typical diabetic dyslipidemia.
  2,483 304 -
Dietary habits and physical activity among medical students of a teaching hospital in South India: A descriptive analysis
SV Saranya, Chythra R Rao, Sravan C Kumar, Veena Kamath, Asha Kamath
July-December 2016, 19(2):172-177
DOI:10.4103/1119-0388.185450  
Context: Among the college population, it is assumed that medical students have better knowledge about healthy lifestyle and dietary practices when compared to other students. However, there is no evidence to indicate that this knowledge translates into practice in terms of maintaining good health. Also, medical students have been known to exhibit early risk factors for chronic diseases. Aim: To assess dietary practices and physical activity among medical students. Materials and Methods: A cross-sectional study was done among 438 medical students from a teaching hospital in South India. A predesigned questionnaire was used to assess diet and current physical activity levels [using the International Physical Activity Questionnaire (IPAQ) short version] among consenting medical students. Statistical Analysis Used: Data were analyzed using statistical package for social sciences (SPSS) version 15.0 from SPSS South Asia Bangalore, India. Chi-square test was used for univariate analysis. Results: Among 438 medical students, 97% were aware of balanced diet, but only 42.9% were following it. Nearly, 9.4% of students consumed junk foods everyday. Compared to the previous year, junk food intake had increased in 40.4% and fruit intake had decreased in 50% of students. Significant association was noted between overweight and obesity and daily consumption of junk foods. Over 95% of students were physically active. In comparison to the previous year, nearly 67% of students had increased their physical activity by walking. Conclusions: Although unhealthy eating habits were prevalent among medical students, practice of physical activity was good. It is, therefore, essential to identify and take corrective actions to promote healthy lifestyle practices.
  2,458 324 -
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