ABSTRACT
Background: Diarrhoea is an important communicable disease which can be prevented by proper hygiene and other simple practical measures. We assessed the knowledge, attitude and practices among mothers regarding childhood diarrhoea in a secondary care hospital in Dimapur, Nagaland.Methods: Cross-sectional observational study conducted over a period of one year including 449 mothers in the age group <45 years with atleast one child under 5 years of age using an interviewer administered, pilot tested, semi-structured questionnaire under the following as categories demography, knowledge, attitude and practices.Results: 97.8% had good knowledge regarding causes and prevention of diarrhoea, 65% had good knowledge regarding the management of diarrhoea while 31% mothers had moderate knowledge. 98% mothers had good attitude but only 17.8% had good practice scores. Multivariate regression analysis showed education > class 10 and residence in urban area were significantly associated with good knowledge and education >class 10, age of mothers ≥29 years, employed mothers, family income Rs. ≥28000 were significantly associated with good practice.Conclusions: Good knowledge and attitude regarding diarrhoea prevention and management among our study population did not translate to good practice. These could also be due to the lower knowledge about management of diarrhoea. Widespread prevalence of wrong practices in the community like irrational use of antibiotics could also have resulted in low practice scores. The gaps between knowledge and attitude and practices among the mothers need to be addressed.
ABSTRACT
BACKGROUND: Carotid artery intimal medial thickness is a simple, non-invasive and reproducible clinical tool to evaluate atherosclerosis and predict coronary artery disease. Lipoprotein(a) levels are related to both atherogenesis and thrombogenesis and may be a key link between lipid and coronary artery disease. This study evaluated the association of carotid intimal medial thickness and lipoprotein(a) with coronary artery disease. METHODS AND RESULTS: We studied 185 randomly selected patients hospitalized for coronary angiogram in our institute. There were 110 angiographically proven patients of coronary artery disease with mean age of 55.8 +/- 9 years (range 34-72 years) and 75 subjects with normal coronary artery anatomy with mean age of 54.8 +/- 8 years (range 34-68 years). The mean carotid intimal medial thickness of subjects with coronary artery disease was significantly higher than in subjects without coronary artery disease (0.84 +/- 0.16 mm v. 0.65 +/- 0.15 mm, p<0.001). The mean carotid intimal medial thicknesses in patients with triple vessel, double vessel and single vessel disease were 0.96 +/- 0.12 mm, 0.84 +/- 0.11 mm and 0.78 +/- 0.13 mm, respectively (p=0.05). The mean lipoprotein(a) of subjects with coronary artery disease was significantly higher than in subjects without coronary artery disease (35.9 +/- 22.3 mg/dl v. 19.1 +/- 21.2 mg/dl, p<0.001). Mean lipoprotein(a) levels in subjects with carotid intimal medial thickness <0.80 was 26.4 +/- 24.2 mg/dl and in subjects with carotid intimal medial thickness > or = 0.80 was 32.1 +/- 22.1 mg/dl (p=0.05). CONCLUSIONS: There is a strong correlation between carotid and coronary atherosclerosis and carotid intimal medial thickness is a good predictor of presence and extent of coronary artery disease. Lipoprotein(a) level is a powerful independent risk factor for atherosclerosis. Carotid intimal medial thickness and lipoprotein(a) in conjoint can predict coronary artery disease reliably.