A Prospective Clinical Study to Evaluate the Ocular Findings in Patients with Head Injury

Background: Ocular trauma is the reason of blindnessamongst more than half a million subjects around the worldand for partial sight loss amongst many more and it isfrequently the leading reason for unilateral loss of vision,especially amongst the people of developing nations. Thepresent study was aimed to assess the ocular findings inpatients with head injury.Materials and Methods: The mode of injury along with theclinical characteristics of the patient were recorded in astandard proforma. Glasgow comma scale was used toevaluate the state of consciousness of the patients. Intraocularpressure estimation was performed using Goldmannapplanation tonometer wherever required. CT scan of brain,skull and spine or MRI and B-Scan was done wheneverrequired. The required medical and surgical treatment wasgiven to the subjects as needed. All the data thus obtained wasarranged in a tabulated form and analyzed using SPSSsoftware.Results: There were 75 males and 25 females. There was1 subject less than 10 years of age. Majority subjects i.e. 30were between 21-30 years of age. There were 40 cases ofperiorbital ecchymosis, 7 cases of lid laceration, 20 cases ofsubconjunctival hemorrhage, 4 cases of proptosis, 7 casesptosis, 8 cases of corneoscleral rupture, 5 cases of hyphema.Conclusion: In our study, Periorbital ecchymosis was the mostcommonly observed finding in case of ocular trauma.

Factors associated with seeking treatment for postpartum morbidities in rural India / 한국역학회지

OBJECTIVES: To understand the prevalence of postpartum morbidities and factors associated with treatment-seeking behaviour among currently married women aged 15-49 residing in rural India. METHODS: We used data from the nationally representative District Level Household Survey from 2007-2008. Cross-tabulation was used to understand the differentials for the prevalence of postpartum morbidities and treatment-seeking behaviours across selected background characteristics. Two-level binary logistic regression was applied to understand the factors associated with treatment-seeking behaviour. RESULTS: Approximately 39.8% of rural women suffered from at least one of the six postpartum morbidities including high fever, lower abdominal pain, foul-smelling vaginal discharge, excessive bleeding, convulsions, and severe headache. Morbidities were more prevalent among poor, illiterate, Muslim, and high-parity women. About 55.1% of these rural women sought treatment/consultation for their problems. The odds of seeking treatment/consultation increased as economic status and years of schooling among both the woman and her husband increased. Poor, uneducated, unemployed, Hindu, and tribal women were less likely to seek treatment/consultation for postpartum morbidities than their counterparts were. The odds of seeking treatment/consultation decreased as the distance to the nearest private health facility increased. Most women visited a private hospital (46.3%) or a friend/family member's home (20.8%) for treatment/consultation. Only a small percentage visited publicly funded health institutions such as a primary health centre (8.8%), community health centre (6.5%), health sub-centre (2.8%), or district hospital (13.1%). Rural women from the northeast region of India were 50% less likely to seek treatment/consultation than women from the central region were. CONCLUSIONS: Providing antenatal and delivery care, and ensuring nearby government healthcare facilities are available to serve rural women might increase the likelihood of care-seeking for postpartum morbidities. Targeted interventions for vulnerable groups should be considered in future policies to increase the likelihood women will seek treatment or advice postpartum.

A Disaggregated Analysis of Change in Household Out-Of-Pocket Expenditure on Healthcare in India, 1995-2004

No study has yet attempted to measure mean out-of-pocket expenditure on health care at household level, separately for government and private health facilities in India. Therefore, this study analyses the change in the out-of-pocket expenditure between 1995-96 and 2004 for fifteen major states of India, separately for rural/urban sector and inpatient/outpatient care. Using data from the 52nd and 60th rounds of the National Sample Survey, we present a disaggregated analysis of the trends and patterns of inflation adjusted household expenditure on health care. The analysis of average household expenditure on health care demonstrated that the mean outpatient care expenditure in government health sector decreased marginally at the aggregate level in both rural and urban sector, whereas it showed a significant increase in private facilities. A substantial rural-urban differential was also observed regarding households’ mean hospitalization expenditure in private hospitals while the same was not true for government hospitals. Almost all states observed a very high growth in households’ mean hospitalization expenditure in the private sector, while it was quite low in the government sector and even negative in rural areas of some states. The same pattern was observed in the growth pattern of households’ outpatient care expenditure. The analyses indicated a little improvement in the performance of government health sector in terms of out-of pocket expenditure. The improvement was more visible in developed and less developed states than in least developed states. Similarly, the improvement was more visible in rural areas than in urban areas.

Prevalence of Microalbuminuria and Proteinuria In Patients of HIV/AIDS in Jammu.

There is scarcity of Indian studies as far as the renal spectrum in HIV is concerned and there is no data regarding the detection of microalbuminuria and proteinuria in HIV positive patients in Jammu region. The present prospective study was conducted in the Postgraduate Department of Medicine, Government Medical College, Jammu over a period of 1 year on 108 HIV/AIDS patients, out of which 71% were males and 29% females with a male:female ratio of 2.48:1. Highest incidence of HIV/AIDS (55.56%) was found in the age group of 26-35 years. Microalbuminuria was present in 21% HIV patients with majority (60.87%) being in the age group 26-35 years. Prevalence of microalbuminuria among males was 65.22% and among females 34.78% with 83% patients having microalbuminuria/urinary creatinine ratio of >10 mg/mmol and 17% having this ratio <10 mg/mmol. There was a significant correlation between CD4 count <200/ l and presence of microalbuminuria (p = 0.01). Significant proteinuria (0.15- 3 g/24 hour) was found in only 3 of those patients found positive for microalbuminuria. No patients had protein/creatinine ratio >3.5 (nephrotic range). Nephropathy is an important cause of morbidity and mortality in HIV positive patients. Use of microalbuminuria as a routine screening test in those who are HIV positive is recommended. Simple tests, like microalbuminuria, if applied in these patients in the very screening phase can help benefit the patients for years to come thereby helping in fighting the epidemic of HIV/AIDS in a better and a stronger way.