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Background: Exclusive breastfeeding is considered a major public health intervention to promote both child and maternal health. Introduction and awareness of infant milk substitutes among mothers appear as a threat to this important practice.Methods: The study is an observational cross-sectional study using a questionnaire containing socio-demographic variables. The study was conducted among 300 mothers who reported to immunization clinic and paediatrics OPD of a BFHI accredited hospital in Delhi. Data collected in the study has been analysed using SPSS version 21.0 and MS-Excel. Student 't' test for quantitative variables and 'chi square test' for categorical variable have been used for statistical significance. p-value <0.05 was considered to be significant.Results: In this study 78.7% mothers intended to breastfeed. 71.3% knew that breastfeeding should be continued up to 2 years and 96.3% knew exclusive breastfeed should be given till 6months. Major source of knowledge were doctors and elders of society. However, 49.6% mothers started breastmilk substitutes before 6 months of age. Major causes that appeared as barriers against exclusive breastfeeding were insufficient quantity of milk (23.4%), child refusal (61%) and maternal health problems (15.6%).Conclusions: Despite good knowledge about breastfeeding among upper middle-class mothers, practice of exclusive breastfeeding remains suboptimal. There is a need for more reinforcement upon importance of breastfeeding, its benefits for both mother and baby so as to foster the practice.
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Background: Microvascular complications of Type 2 Diabetes Mellitus (T2DM), (retinopathy and nephropathy) have a similar etiopathogenetic mechanism besides genetic predisposition. Even though these two complications frequently co-exist, their frequency varies. The association of these two significant complications and their co-existence needs a relook.Methods: Four hundred patients suffering from type 2 DM visiting a tertiary care hospital in Western India were included in this cross-sectional study. Of these, 200 patients were of Diabetic Nephropathy (DN) and 200 were without DN. The presence of albuminuria (urine albumin-creatinine ratio) was used to detect diabetic nephropathy. Fundoscopy was performed in all patients to look for Diabetic Retinopathy (DR).Results: In this study, 77.5% patients with DN had retinopathy, while in patients without DN, only 52% patients had retinopathy. This was a statistically significant finding. (p value <0.001). The distribution of types of retinopathy in patients with DN was 63.0% Non-Proliferative Diabetic Retinopathy (NPDR), 12.5% Proliferative Diabetic Retinopathy (PDR) and 2% Clinically Significant Macular Edema (CSME). While in those without DN, 50.5% had NPDR, 1.5% had PDR and none had macular edema.Conclusions: Microalbuminuria, which has been used so far to diagnose DN, may be considered as a reliable predicter of diabetic retinopathy in type 2 diabetes mellitus patients. This simple marker can help screen all patients with Diabetes for nephropathy and retinopathy both and should take place at the first visit/ contact of the healthcare personnel. This can help prevent microvascular complications early and help in goal directed therapy.
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Background: The World Health Organization defines exclusive breastfeeding (EBF) as giving baby only breast milk for the first 6 months without adding any additional drink including water or food. We undertook this study with an objective to assess the prevalence of breastfeeding among mothers in North Indian setting. Aims: The aims of this study were to assess the prevalence of EBF among mothers attending a well-baby clinic and to look for variable significantly impacting probability of breastfeeding and assessing the challenges faced and existing knowledge regarding breastfeeding. Materials and Methods: This was a questionnaire-based one-point survey to assess the prevalence of EBF. The questionnaire was based on the review of literature and included parameters considered significant by various studies. Mother's knowledge regarding breastfeeding was assessed by another questionnaire. Results: A total of 970 mothers were approached who visited immunization center and well-baby clinic during the study. After taking out those who were unwilling and did not meet the criteria, we had 634 mothers who participated in our study. They were divided into two groups based on whether they exclusive breastfed their babies for 6 months or not. Comparison of both these groups revealed breastfeeding counseling to be the most important variable. Statistical Analysis Used: It is a cross-sectional type of study with a questionnaire-based one-point survey. The minimum sample size required was calculated using Daniel's formula: n = z2pq/d. Consequent sampling was done. Chi-square test for independence was done to assess the association between both the groups for all the parameters recorded. Conclusions: All mothers were aware that breast milk is beneficial for their baby; however, the biggest problem was anxiety regarding the adequacy of their breast milk. There is also need for a widespread campaign related to harm done by prelacteals and substitutes of breast milk including cow milk.
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BACKGROUND: There is deficit of data from India on elderly patients with cancer. Comprehensive geriatric assessment may lead to a better decision making capacity in this population. However, routine implementation of such assessment is resource consuming. AIM: The aim of this study was to determine the patterns of care in elderly patients treated at a tertiary rural cancer center in India. MATERIALS AND METHODS: All patients with age 70 or above with solid tumors without any definitive treatment prior to the registration at our center and registered between 01/01/2010 and 31/12/2011 were selected for this study. The baseline demographic pattern and the pattern of care of treatment were analyzed. SPSS version 16 (IBM Inc, Armonk, New York, U.S.) was used for analysis. Descriptive data are provided. RESULTS: A total of 761 patients were evaluable subject to the aforementioned inclusion criteria. The median age of this cohort was 75 years (70‑95 years). The most frequent primary sites of malignancies in 451 males were head neck (32.4%), lung (23.3%) and gastrointestinal (23.3%). In 310 females, the most common sites were head neck (31.6%), gynecological (18.4%) and gastrointestinal (24.5%). 228 (30%) of the patients had localized disease, 376 (49.4%) had loco‑regionally advanced disease and 145 (19.1%) had distant metastases at presentation. 334 (46.32%) of patients were treated with curative intent. On logistic regression analysis the factors that predicted use of curative intent treatment were age <75 years, performance status 0‑1, primary site and clinical extent of disease. CONCLUSION: Routine comprehensive geriatric assessment needs to be implemented in our setting as almost 50% of our geriatric patients undergo curative intent treatment.
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On August 29, 2012, a court in Ahmedabad ruled in a case involving 61 individuals accused of the massacre of 96 Muslims in Naroda Patiya, Gujarat, on February 28, 2002. The massacres occurred a day after a terrible fire engulfed a train near Godhra, Gujarat, in which 59 karsevaks (volunteer workers for a religious cause) were burnt alive, and more than 100 injured. The karsevaks were returning from Ayodhya where they were participating in a campaign to build a temple dedicated to Ram on a site where a mosque had stood. Subsequently, Naroda Patiya was one of many towns in Gujarat affected by riots in which thousands of individuals, mainly Muslims, were murdered, raped, looted, and displaced, their homes ransacked, their livelihoods destroyed by activists of Hindu fundamentalist organisations. For over a decade, victims of these pogroms have sought justice for their murdered kin and for their own injuries, physical and psychological.
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Ethics, Medical , Hinduism , Humans , India , Islam , Mass Casualty Incidents/legislation & jurisprudence , Physician's Role , Physicians/legislation & jurisprudence , Riots/legislation & jurisprudenceABSTRACT
Natural polymers are used as lead compounds for design of therapeutic drug delivery systems for treatment of different ailments. Chitosan and gelatin have proven wound healing properties individually. As both have wound healing property, the combination of these two polymers and incorporation of drugs into the composite films may show improvement in wound healing property. Thus, the composite films and drug loaded films were evaluated for various in vitro evaluation tests and to ascertain the applicability of prepared combination for wound healing activity. The composite films were prepared with increase in gelatin concentration. The drug loaded films were prepared with increasing concentrations of drug. These films were evaluated for thickness, folding endurance, water absorption capacity, antibacterial activity, tensile strength, in vitro drug release by diffusion studies and in vivo studies by excision wound model. The drug loaded films shown significant difference in folding endurance, water absorption capacity, antibacterial activity when compared to optimized composite film. There was no significant difference in thickness and tensile strength of drug loaded films when compared to blank composite films. Percentage of wound contraction was more for wounds treated with gentamicin loaded chitosan-gelatin composite film than blank composite film. With the above results, gentamicin loaded chitosan-gelatin combination had shown better results when compared to chitosan-gelatin film, chitosan film alone in wound healing activity.