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   2014| October-December  | Volume 39 | Issue 4  
    Online since October 15, 2014

 
 
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LETTERS TO EDITOR
Determinants which influence to donate blood voluntarily at a Northeast District of the State of Tamil Nadu, South India
Umakanth Siromani, Thankamony Thasian, Kurusilappattu Gurupachai Selvaraj, Dolly Daniel, Joy J Mammen, Sukesh Chandra Nair, Rita Isaac
October-December 2014, 39(4):250-250
DOI:10.4103/0970-0218.143031  PMID:25364151
  10,861 167 -
CME4 - STRATEGIC MANAGEMENT AND LEADERSHIP FOR HEALTH PROFESSIONALS
Building and leading teams
Sanjiv Kumar, Vaishali Deshmukh, Vivek S Adhish
October-December 2014, 39(4):208-213
DOI:10.4103/0970-0218.143020  PMID:25364143
  7,684 639 -
SHORT COMMUNICATIONS
Effect of Kangaroo mother care on vital physiological parameters of the low birth weight newborn
Alpanamayi Bera, Jagabandhu Ghosh, Arun Kumarendu Singh, Avijit Hazra, Tapas Som, Dinesh Munian
October-December 2014, 39(4):245-249
DOI:10.4103/0970-0218.143030  PMID:25364150
Objectives: Low birth weight (LBW; <2500 g), which is often associated with preterm birth, is a common problem in India. Both are recognized risk factors for neonatal mortality. Kangaroo mother care (KMC) is a non-conventional, low-cost method for newborn care based upon intimate skin-to-skin contact between mother and baby. Our objective was to assess physiological state of LBW babies before and after KMC in a teaching hospital setting. Materials and Methods: Study cohort comprised in-born LBW babies and their mothers - 300 mother-baby pairs were selected through purposive sampling. Initially, KMC was started for 1 hour duration (at a stretch) on first day and then increased by 1 hour each day for next 2 days. Axillary temperature, respiration rate (RR/ min), heart rate (HR/ min), and oxygen saturation (SpO 2 ) were assessed for 3 consecutive days, immediately before and after KMC. Results: Data from 265 mother-baby pairs were analyzed. Improvements occurred in all 4 recorded physiological parameters during the KMC sessions. Mean temperature rose by about 0.4°C, RR by 3 per minute, HR by 5 bpm, and SpO 2 by 5% following KMC sessions. Although modest, these changes were statistically significant on all 3 days. Individual abnormalities (e.g. hypothermia, bradycardia, tachycardia, low SpO 2 ) were often corrected during the KMC sessions. Conclusions: Babies receiving KMC showed modest but statistically significant improvement in vital physiological parameters on all 3 days. Thus, without using special equipment, the KMC strategy can offer improved care to LBW babies. These findings support wider implementation of this strategy.
  5,707 263 -
CME
Clinical trials: Changing regulations in India
Pikee Saxena, Rohit Saxena
October-December 2014, 39(4):197-202
DOI:10.4103/0970-0218.143018  PMID:25364141
  4,635 418 -
Indoor air pollution in India: Implications on health and its control
Ankita Kankaria, Baridalyne Nongkynrih, Sanjeev Kumar Gupta
October-December 2014, 39(4):203-207
DOI:10.4103/0970-0218.143019  PMID:25364142
  4,302 374 -
ORIGINAL ARTICLES
Level of motivation amongst health personnel working in a Tertiary care Government Hospital of New Delhi, India
Poonam Jaiswal, Ashok K Singhal, Adesh K Gadpayle, Sandeep Sachdeva, Rabindra Padaria
October-December 2014, 39(4):235-240
DOI:10.4103/0970-0218.143027  PMID:25364148
Aims: To assess the level and factors of motivation amongst permanent government employees working in a tertiary health care institution. Material and Methods: A sample of 200 health personnel (50 in each category) i.e. doctors, nurses, technician, and support staff were contacted through face to face interview. Motivation was measured as the degree to which an individual possessed various identified motivation domains like Drive, Control, Challenge, Relationship and Rewards. Each domain was represented by 4 dimensions- accordingly a closed-ended statement represented each of these dimensions and responses were assessed on a Likert based scale. Data management was done using SPSS, ver. 19. Results: The average age for different health personnel were: Doctors 48.68 (±8.53), nurses 40.72 (±7.76), technician 38.4 (±10.65) and support staff 43.24 (±9.52) years. The average year of work experience was: Doctor 19.09 (±9.77), nurses 17.2 (±8.420), technician 14.84 (±10.45), support staff 18.24 (±10.28). A comparison of overall motivation index (mean score) revealed that nurse had highest level (3.47), followed by support staff (3.46), doctor (3.45) and technician (3.43). Based on their individual mean scores, the healthcare providers were categorised into three different levels of motivation and it was found that majority of the health personnel i.e.70% of support staff, 62% nurse, 56% doctor and technician, had high to very high level of motivation index. The mean scores for all the five factors as well as their respective ranks were also found out and it was deduced that "relationship" assumed first rank for doctors (mean score: 3.71) and technician (mean score: 3.75), whereas "control" assumed greatest significance for nurses (mean score, 3.62) and support staff (mean scores, 3.61). Based upon the mean scores, "reward" assumed third rank among all the four categories. Kruskal-Wallis test was applied to test if the different categories of health personnel varied with respect to five factors of motivation and it was found that their orientation towards the various motivational components differed significantly only with respect to Drive (P < 0.01). Conclusion: There is scope for enhancing staff motivation.
  2,435 301 -
LETTERS TO EDITOR
Time-motion study to know: Efficiency and effectiveness of clinical care is essential to hospital function?
Leena Bhargo, Ashok Mishra, Anil Kumar Agarwal
October-December 2014, 39(4):254-255
DOI:10.4103/0970-0218.143035  PMID:25364154
  2,319 146 -
ORIGINAL ARTICLES
Oral health care availability in health centers of Mangalore taluk, India
Arun K Simon, Ashwini Rao, Gururaghavendran Rajesh, Ramya Shenoy, Mithun B Pai
October-December 2014, 39(4):218-222
DOI:10.4103/0970-0218.143023  PMID:25364145
Background: Community-oriented oral health programs are seldom found in India. When primary health care systems were in the 1980s, dentistry was not adequately included. This has left oral health far behind other health services. Objectives: To find the availability of dental professionals, infrastructure, equipment, and treatments provided in health centers of Mangalore taluk. Materials and Methods: A cross-sectional study was conducted among medical officers and dentists working in all the health centers of Mangalore taluk, using an interview schedule, the oral health care availability inventory (ORAI). Results: Among 23 health centers of Mangalore taluk, dental services were available at six health centers (26%) [two community health centers (CHCs) and four primary health centers (PHCs)]. Mouth mirrors, dental explorers, and extraction instruments were available at six health centers [two CHCs (100%) and four PHCs (19%)]. No health centers provided orthodontic tooth corrections, removal of impacted teeth, oral biopsies, and fabrication of removable dentures. Conclusions: Availability of dental services was limited in the health centers, and a vast majority of the rural population in Mangalore taluk did not have access to dental care.
  2,086 263 -
LETTERS TO EDITOR
Control group and refusal rate critiques about hepatitis C virus infection in HIV positive cases
Ali Kabir
October-December 2014, 39(4):251-251
DOI:10.4103/0970-0218.143032  PMID:25364152
  2,147 79 -
ORIGINAL ARTICLES
Healthcare seeking behavior for back and Joint pain in rural Gadchiroli, India: A population-based cross-sectional study
Sona A Deshmukh, Yogeshwar V Kalkonde, Mahesh D Deshmukh, Anand A Bang, Abhay T Bang
October-December 2014, 39(4):229-234
DOI:10.4103/0970-0218.143026  PMID:25364147
Background: Musculoskeletal back and joint pain is common in rural agrarian communities in India. Objectives: To understand the healthcare seeking behavior for back and joint pain among adults in rural Gadchiroli, India. Materials and Methods: A cross-sectional survey of 315 randomly selected respondents from 84 villages between 30 and 60 years of age was conducted by community health workers (CHWs) between October 2010 and January 2011. Results: Among 280 respondents on whom good quality data were available, 215 (76.8%) respondents had back and/or joint pain in 6 months preceding the survey. A majority of the respondents with pain had sought care (170; 79.1%), mainly from private practitioners (116; 68.2%). Severe pain and inability to work were the reasons to seek care. Complete pain relief was considered the major indicator of an effective treatment. Injectable medications (127; 59.1%) and intravenous fluids (92; 42.8%) were considered highly effective; while about 50% were unaware of the role of physiotherapy and surgery for this problem. When asked about the preferred provider who should provide village level treatment of this problem, more than half (135; 62.8%) of the respondents chose a trained village health worker. Conclusions: A majority of the individuals with back and/or joint pain in rural Gadchiroli seek care, mainly from private practitioners. However, for the village-level treatment of this problem, respondents preferred a trained village level worker. High expectation of complete pain relief, preference for injectable medications, and low awareness about nonpharmacological modalities will be the major challenges while providing community level care for this problem.
  1,726 416 -
EDITORIAL COMMENTARY
Zinc: An effective but neglected child survival intervention
Davendra Kumar Taneja, Akash Malik
October-December 2014, 39(4):191-193
DOI:10.4103/0970-0218.143016  PMID:25364139
  1,685 420 -
VIEW POINT
Medical research misconduct need regulatory reforms
Neeraj Bedi
October-December 2014, 39(4):194-196
DOI:10.4103/0970-0218.143017  PMID:25364140
The medical research misconduct has become a global problem. Except from countries like the USA, China, and Germany the exact figures of misconduct are not available. The research misconduct include fabricating the data, falsifying data, and plagiarism. The irresponsible research practices are publishing research data more than once, conflicts of interest is not declared, selective reporting of data and including an author who has not contributed at all and many more. About 2% of scientists have been found to admit the fabricating the data and 33% researchers were involved in irresponsible research practices. There is no formal regulatory programs available to monitor the research projects. Few developed countries like the USA, Germany, and China tried to develop programs which can monitor the medical research misconduct. There is a need to develop a regulatory system at national and institutional level to regulate the research activity to ensure that good ethical and scientific standards are practiced by medical researchers.
  1,642 205 -
ORIGINAL ARTICLES
Pre and post-stroke use of statins improves stroke outcome
Majaz Moonis, Rajat Kumar, Nils Henninger, Kevin Kane, Marc Fisher
October-December 2014, 39(4):214-217
DOI:10.4103/0970-0218.143021  PMID:25364144
Introduction: Although there is sufficient evidence that HMG CoA Reductase Inhibitors reduce stroke recurrence in patients with or ischemic heart disease, it remains unclear whether they also improve outcomes given before or after stroke onset and whether such an effect is more robust with pre-stroke or post-stroke use of statins. Materials and Methods: We carried out a retrospective analysis of a large University Health Consortium Database. Patients with statin use before or after stroke onset were included in the analysis. Twenty patients discontinued statins after stroke onset. The outcome measures were discharge home or long-term care facility and/or death within 45 days. Results: Patients with prior statin use were more likely to be discharged home (1.67, CI 1.12-2.49), as were post stroke statin patients who had a more robust effect OR 2.63, CI 1.61-4.53). Conclusions: Patients started on statins after stroke were more likely to be discharged home versus patients already on statins before stroke onset. However, both groups were also more likely to be discharged home than those patients not on statins.
  1,516 259 -
Trends in average living children at the time of terminal contraception: A time series analysis over 27 years using ARIMA (p, d, q) nonseasonal model
Sachin S Mumbare, Shriram Gosavi, Balaji Almale, Aruna Patil, Supriya Dhakane, Aniruddha Kadu
October-December 2014, 39(4):223-228
DOI:10.4103/0970-0218.143024  PMID:25364146
Background: India's National Family Welfare Programme is dominated by sterilization, particularly tubectomy. Sterilization, being a terminal method of contraception, decides the final number of children for that couple. Many studies have shown the declining trend in the average number of living children at the time of sterilization over a short period of time. So this study was planned to do time series analysis of the average children at the time of terminal contraception, to do forecasting till 2020 for the same and to compare the rates of change in various subgroups of the population. Materials and Methods: Data was preprocessed in MS Access 2007 by creating and running SQL queries. After testing stationarity of every series with augmented Dickey-Fuller test, time series analysis and forecasting was done using best-fit Box-Jenkins ARIMA (p, d, q) nonseasonal model. To compare the rates of change of average children in various subgroups, at sterilization, analysis of covariance (ANCOVA) was applied. Results: Forecasting showed that the replacement level of 2.1 total fertility rate (TFR) will be achieved in 2018 for couples opting for sterilization. The same will be achieved in 2020, 2016, 2018, and 2019 for rural area, urban area, Hindu couples, and Buddhist couples, respectively. It will not be achieved till 2020 in Muslim couples. Conclusion: Every stratum of population showed the declining trend. The decline for male children and in rural area was significantly faster than the decline for female children and in urban area, respectively. The decline was not significantly different in Hindu, Muslim, and Buddhist couples.
  1,500 259 -
SHORT COMMUNICATIONS
Role of hospital-based cancer registries: A decade of experience of cancer cervix from a Tertiary Care Centre, India
Shalini Rajaram, Sruthi Bhaskaran, Shagun Sinha, Sarla Agarwal
October-December 2014, 39(4):241-244
DOI:10.4103/0970-0218.143028  PMID:25364149
Background: Hospital-based registries are important tools for policy formulations and region-specific data creation, particularly in case of cervical cancer, which is preventable by an effective screening program. Objective: To study the epidemiological characteristics and trends in cervical neoplasia in an urban population over a decade. Materials and Methods: Data were collected from the histopathological records of patients from January 2000 to December 2009. Results: A total of 1315 gynecological malignancies were reported with cancer cervix being the most common (70.4%) with a progressive increase in the number from 56 in 2000 to 157 in 2009. Squamous cell cancer was the predominant variant with majority in advanced stage. The mean age was 50.1 years with doubling of cases in the ≤35-year category. Of 742 colposcopic biopsies performed, cervical intraepithelial neoplasia (CIN) 1 was diagnosed in 34.9%, CIN 2 in 11.8%, CIN 3 in 7.8%, and microinvasive cancer in 0.8% cases. Conclusion: Though screening programs are in place, their effectiveness can be judged only by such reporting systems that aid in modifying the current cancer control strategies.
  1,338 244 -
LETTERS TO EDITOR
Association of overweight and obesity with breast cancer in India: Scope for improvement
Sushama Subhash Thakre, Subhash Bapuraoji Thakre
October-December 2014, 39(4):252-253
DOI:10.4103/0970-0218.143033  PMID:25364153
  851 196 -
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  2007 - Indian Journal of Community Medicine | Published by Wolters Kluwer - Medknow
  Online since 15th September, 2007