ABSTRACT
Background: Diabetes affects all segments of the population and is one of the leading causes of premature morbidity and mortality and requires life-long healthcare services. The National Rural Health Mission launched in 2005 and the new pilot National Programme for Prevention and Control of Diabetes, Cardiovascular diseases and Stroke offer opportunities for improving care for diabetes and other non-communicable diseases through service provision at the primary and secondary levels of care. This article describes the health services related factors and ascertains the physical status of adult diabetic patients.Methods: It is an institution based, cross-sectional, descriptive study. Complete enumeration of all patients attending diabetic clinic of Bankura Sammilani Medical College and hospital, Bankura, West Bengal was done. Eligible consenting adult patients, who were diagnosed as a case of diabetes and on treatment were interviewed with review of medical record. The study was preceded after obtaining ethical clearance. Data were entered in MS Excel spread sheet. Calculation was done with the help of software SPSS 22.0 free version.Results: Only 5.3% of study subjects had drug supply from hospital fully but rest of them had to buy from the shop. 79.3% of study subjects skipped the drug when it was finished. Diabetic complication was found to be more when distance of home from hospital was more.Conclusions: Antidiabetic drug were not regularly available in hospital so all most all had to purchase drug from the shop when not available at hospital.
ABSTRACT
<p><b>INTRODUCTION</b>The introduction of highly active antiretroviral therapy (HAART) for the treatment of human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) has led to the reduction of mortality and the improvement of the quality of life of people living with HIV/AIDS (PLWHA). The present study was conducted to determine the pattern of adherence to HAART among PLWHA, and to assess the factor(s) affecting nonadherence, if any.</p><p><b>METHODS</b>This study was a hospital-based analytical, cross-sectional epidemiological study conducted between July and October 2011. A total of 370 adult HIV-positive patients registered in the Antiretroviral Therapy Centre of Burdwan Medical College and Hospital, West Bengal, India, were included. Nonadherence was defined as missing at least a single dose of medicine within the last four days. Data was analysed using the Statistical Package for the Social Sciences version 19.0 (IBM Corp, Armonk, NY, USA).</p><p><b>RESULTS</b>A total of 87.6% of patients were found to be adherent to HAART. Principal causes of nonadherence were forgetting to take medicine (70.2%), being away from home (65.2%), and busyness with other things (64.7%). Multivariate logistic regression analysis revealed that nonadherence was significantly associated with a positive family history of HIV/AIDS (odds ratio [OR] 16; 95% confidence interval [CI] 2.2-114.3; p = 0.01), occurrence of side effects with HAART (OR 9.81; 95% CI 1.9-51.7; p = 0.01) and employment (OR 5.93; 95% CI 1.5-23.2; p = 0.01).</p><p><b>CONCLUSION</b>Although overall adherence was high, the factors that affect nonadherence can be addressed with proper counselling and motivation of patients and their family members. Adherence to HAART could delay the progression of this lethal disease and minimise the risk of developing drug resistance.</p>
Subject(s)
Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Acquired Immunodeficiency Syndrome , Drug Therapy , Antiretroviral Therapy, Highly Active , Methods , Cross-Sectional Studies , Drug Resistance , HIV Infections , Drug Therapy , India , Medication Adherence , Odds Ratio , Quality of Life , Risk Factors , Surveys and Questionnaires , Tertiary Care CentersABSTRACT
A cross-sectional study was conducted with the aim to explore the present status of birth preparedness and complication readiness in rural area of West Bengal and determine the possible factor(s) influencing their knowledge and practice regarding this concern. Thirty villages with homogenous characteristics were identified by cluster sampling methods from a rural block (Bhatar, Burdwan district, West Bengal) of India on April 2013 to November 2013. From every cluster 7 mothers who had delivered baby within the last year and were available first, interviewed consecutively using a guided questionnaire adapted from JHPIEGO Maternal and Neonatal Health Programme survey tools. Multivariate logistic regression was applied in analysis to predict how much the independent variables influenced the birth preparedness of mothers. 62.4% mothers were found to be well prepared. Trained birth attendants and health facilities were identified before delivery in 81.9% and 78.1% cases respectively. Mode of transportation for complication management or delivery was pre-decided by about 60% of family. Only 35.7% family saved money for the same purpose. Logistic regression revealed that well preparedness increased 11 times with every new pregnancy, but it did not depend on caste and education status of the mothers. The overall birth preparedness status of the rural mothers is poor and they acquire more knowledge regarding birth preparedness from their self experience rather than from existing health system.