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Background: Hypertension is a major risk factor contributing to cardiovascular and cerebrovascular diseases and death. Medical officers play an important role in Indian public health care system. The objective of this study was to evaluate the impact of training program on knowledge about hypertension among medical officers working in government health centres in Gujarat, India.Methods: A one day training program was conducted for medical officers of various Primary Health Centres (PHCs) and Community Health Centres (CHCs) in Narmada district of Gujarat. This training focussed on screening, diagnosis and management of hypertension, essential and secondary hypertension, lifestyle modifications, various anti-hypertensive drugs and practical aspects of examining a patient with hypertension. Impact of the training program was evaluated by a questionnaire consisting of 10 questions which was used as a pre-test and a post-test.Results: A total of 30 medical officers (18 male and 12 female) attended the training. The mean age of participants was 37.4 years and average clinical experience was 11 years. The pre-test mean score of participants was 4.52 and post-test mean score was 8.44. This improvement in the post-test mean score was found to be statistically significant. On comparison of questions answered incorrectly in pre-test and post-test, we found that there was a significant reduction in the number of questions answered incorrectly in the post-test.Conclusion: There was a significant improvement in the knowledge of medical officers regarding screening, diagnosis and management of hypertension as a result of their training.
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Background: Use of inappropriate medication is an important problem in present geriatric clinical practice. No specific potentially inappropriate medications (PIM) tools are available considering the availability of drugs in India. Aim and objective were to assess prevalence and pattern of potentially inappropriate medication (PIM) use in elderly inpatients by updated Beers criteria 2015 and EU(7) PIM list 2015.Methods: This cross-sectional study was carried out on medical records of elderly patients (?65 yrs) admitted in the internal medicine wards and intensive care units (ICU) over a period of 6 weeks. The medications were evaluated for the PIM use as per Beers criteria and EU(7) PIM list.Results: A total of 225 patients (mean age- 71.48 yrs) were admitted in internal medicine wards and ICU during study period. Total 184 PIM belonged to 33 different medications were used during study period. The prevalence of PIM in internal medicine wards and ICUs were 51.96% and 57.14%, respectively. The prevalence of PIM was significantly higher with the EU(7) PIM list than Beers criteria (49.77% vs. 21.77%) [p<0.0001]. The commonly prescribed PIM were dextromethorphan (13.33%), ranitidine (11.11%) and glipizide (10.22%).Conclusions: Elderly patients frequently receive PIM. EU(7) PIM list identifies more PIM among elderly inpatients than Beers criteria.
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Background: Pancytopenia is one of the common laboratory findings in patients presenting to us with varied clinical presentations. Risks of untreated Pancytopenia are high causing anxiety to treating doctors and patients alike. It also involves long list of investigations including a very painful marrow biopsy, life-threatening complications and treatment involves multiple blood component therapy. A total of 101 cases of pancytopenia over a period of 1 year were analysed retrospectively to find i) commonest presenting symptoms ii) commonest cause of pancytopenia, response to treatment iii) Depending on the cause, to consider if any measures can be taken for preventionMethods: Cross sectional study of 101 admitted patients of Pancytopenia on the basis of information extracted from the case sheets. The data was analyzed and presented as frequencies and Percentages.Results: Out of 101 cases analysed, 53 (52.47%) were females 48 (47.52%) patients males. Fatigue 74 patients (73.2%) was the commonest presenting symptom followed by fever 33 (32.6%), breathlessness 13 (12.87%) and bleeding 4(3.8%). Vitamin B12 deficiency 58 (57.6%) patients showed and was the commonest cause of pancytopenia. Infections in 24 (23.7%) like malaria16 (15.6%), dengue 5 (4.96%), PLHA 1(0.96%) and hepatitis B 2 (1.96%) was the second common cause in present study. Recovery of pancytopenia was prompt in Malaria Dengue. HIV, Hepatitis B viral infection showed persistent pancytopenia with hypoplastic marrow. Chronic liver disease portal hypertension splenomegaly accounted for 9 (8.9%) patients. Drug induced marrow suppression due to ongoing treatment for underling disease resulted in pancytopenia in 4 (3.96%) patients. Aplastic anaemia in3 (2.9%), myelodysplastic syndrome 2 (1.9%) and acute leukaemia 1 (0.96%) were the less common causes.Conclusions: Commonest symptom on presentation were related more to anaemia than to neutropenia and thrombocytopenia. megaloblastic anaemia due to Vitamin B12 deficiency was the leading reversible cause of pancytopenia in present study followed by infections like Malaria Dengue. Gujarat, India being predominantly vegetarian state, local dietary habits are thought to be responsible for inadequate B12 daily consumption, hence we suggest fortifying the daily diet with B12 supplementation at a larger scale just like iodisation of salt to counter iodine deficiency.
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Background: India is a hyper-endemic zone for malaria. We need tests which can be done easily and are cost effective to assess the severity of the disease and to help in prognostication. CRP is one such investigation which can be used. Aims And Objectives: We carried out this prospective study to find the correlation between the level of CRP and the complications in patients of P.vivax and P. falciparum malaria. Material and Methods: Level of C- reactive protein, was measured in 227 patients of P.vivax and P. falciparum malaria, admitted in GMERS medical college Gotri, Vadodara. It was then compared with single and multiple complications as well as with the duration of hospital stay in both vivax and falciparum patients.Statistical analysis was done using Chi-Square test, unpaired T-test and ROC curve. Results: Out of 227 patients,105(46.2%) had P.vivax and 122(53.7%) had P. falciparum malaria. CRP level was high in all patients. In vivax and falciparum patients with single complications, the mean CRP level was 24+11.6 mg/L and 24.1+6.2 mg/L respectively. Both types of malaria with multiple complications showed very high levels, 69.6 + 14.1mg/L in P.Falciparum and 71.6 + 6.5mg/L in P.vivax patients. Elevated CRP level (41.5 mg/L) also predicted a prolonged hospital stay. Conclusion: Our study corroborates the observation that high CRP level has a strong prognostic value for predicting the complications in malaria.
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With an alarming increase in the incidence of Diabetes, India isnow being considered as ‘Global Diabetes Capital’. Patient’s knowledge regarding Diabetes andself-care practicesare crucial to the success of any Diabetes Control Programme. Aims: To assess knowledge of Diabetes and self-care practices in chronic Diabetic patients.Materials and Methods: Hospital based cross sectional study involving 100 diabetic patients. Structured pre-tested questionnaires were employed. Responses that differed amongstvarious categories (gender, education and duration of Diabetes) were analysed using appropriate statistical test.Results: 58% were aware that diabetes can affect eyes, 54% aware about renal complications of DM and 44% knew that DM is a cardiovascular risk factor. 44 % knew that annual eye examinations were essential for early diagnosis and treatment. Only 14 % were aware of annual urine-protein check and only 30% got their lipids checked annually. 67% had regular BP checks and 28% did regular foot check.40% knew their target sugar levels. Only 5% were aware of Hba1C test. 84% patient knew about hypoglycaemiaandits treatment. 47% thought that DM is curable.An educational level of middle school or higher and duration of DM longer than 5years was associated with higher score.Conclusion: There remains largely inadequate knowledge about Diabetes, its complications and importance of annualscreening for complications. The importance of better glycaemic control and regular screening for complication should thus be emphasized by comprehensive education and awareness which will no doubt help in reducing the mortality and morbidity due to DM.