Cognitive Impairment and Its Correlation with Co morbidities among Elderly Residing in Old Age Homes in Southern India

Background: With aging process, cognitive levels decline which has affected nearly 50 million people worldwide. In view of this, our study aims to estimate the prevalence of cognitive impairment and its correlation with co morbidities among the elderly residing in old age homes in Southern India and determine its various risk factors among them. Methodology: This cross-sectional study was carried among 330 elderly living in old age homes by using multistage sampling method. Study population included Elderly above the age of 60 and residing in old age homes, who were willing to participate. A pretested structured questionnaire was used. Data was analysed using SPSS. Results: Of the 330 participants, nearly 44% had mild to moderate and 36% had severe cognitive impairment. The odds of developing cognitive impairment were 2.5 times more among individuals who had at least one feature of dementia when compared with those who did not have any symptoms. Conclusion: The strategies of National Programmes for Health Care of Elderly and National Mental Health Program do not cater specifically to cognitive impairment. Level of attention given towards Alzheimer抯 disease is more when compared to screening for cognitive impairment which is an early precursor for Alzheimer抯 disease.

Awareness, acceptance and practice of plastic ban legislation among residents of an urban area in Kanchipuram district, Tamil Nadu: a cross sectional study

Background: Convenience of plastic use pays a high price by negatively affecting health and environment. As nationwide ban on use of plastic carry bags failed, statewide ban was imposed in Tamil Nadu from 1st January 2019. This study was planned with the objective of determining the awareness, acceptance and practice of plastic ban legislation among residents in urban population in Kancheepuram district, Tamil Nadu.Methods: This community based cross sectional study was carried out with a sample size of 250 using systematic random sampling method. Data was collected using structured questionnaire and further analysis was done with SPSS Version 25 Software.Results: About 94% respondents were aware of legislation and 76% had a positive attitude towards the ban. About 52% participants continued using plastic bags despite the ban. Common source of knowledge about the ban was mass media (42%). About 80% were aware of the negative effects of plastic use and 70% were aware that plastics are non-bio-degradable. Statistically significant association was found between various socio demographic factors with the use of plastic bags. Alternate eco-friendly bags usage was found among 48% of respondents.Conclusions: Good awareness level about the ill effects of plastic use and its ban was observed but the level of implementation in their daily life was poor. Even after the preparatory period of six months given to get accustomed to eco-friendly alternatives, the use of plastic bags still remains rampant. IEC activities need to be intensified to bring about changes in the attitude and practice of plastic use.

Prevalence and determinants of dental caries among primary school children in urban area of Kancheepuram district, Tamil Nadu: a cross sectional study

Background: Dental caries is a preventable multi factorial disease which shows increase in prevalence over last five decades in India. In order to reduce its magnitude and for effective prevention and control, the risk factors and distribution should be well known. This study was planned with the objective of assessing the prevalence and determinants of dental caries among primary school children in an Urban area of Kancheepuram district, Tamil Nadu, India. Methods: This school based cross sectional study was carried out between November 2017 and February 2018 using a sample size of 430 selected from two schools by simple random sampling. Data were collected using a pre-tested, structured questionnaire, which were analyzed using SPSS version 16.0 and presented using descriptive and analytical statistics. Results: Among the study participants, 52.9% had dental caries. Plaque accumulation was noted in 46.2%. About 74% were taking junk foods daily. About 47.1% children were rinsing their mouth daily and 34.6% were brushing more than once daily. Factors found to be protective against dental caries were high socio economic class and daily mouth rinsing habit. Odds of getting dental caries was more among children with visible dental plaque, daily junk foods intake, brushing once daily and failing to brush after foods. Conclusions: Dental caries is a high prevalent, preventable disease affecting both young and old aged individuals that can be mitigated by health education activities. Proper oral hygiene can prevent dental caries. Hence more importance should be given for oral hygiene and behavioral changes in dietary habits.

Community medicine learning - medical student’s perspective

Background: The goal of teaching Community Medicine in undergraduate medical curriculum is to ensure that medical graduates acquire competencies needed to solve common health problems of the community. This study aims to determine the perceptions of medical students in learning Community Medicine as part of their MBBS curriculum and to assess their preference of the subject for post-graduate studies.Methods: This study was conducted among third year MBBS students of a private Medical College. Universal sampling method was adopted and data was collected using a pre-tested, self-administered questionnaire. A three-point Likert scale was used to assess the perceptions of the medical students in learning Community Medicine. Data analysis was done using SPSS version 16.0.Results: Out of 183 students, 166 students participated in the study of which 42.8% were males and 57.2% were females. Nearly 89% of students agreed that learning community medicine during MBBS is very essential. About 83.7% felt more field visits or practical assignments need to be added to the curriculum to enhance students’ interest in the subject. Community medicine was preferred for post-graduation by only 12% of students. Interest in clinical specialties, limited career growth and less social recognition was the main reasons quoted by the students for not choosing the specialty for post-graduation.Conclusions: Learning Community Medicine is essential to produce community oriented primary health care physicians. Community Medicine as a future career option was found to be limited among the medical students. More exposure is needed on the wide career opportunities available after post-graduation. Community Medicine learning should be made more interesting, highlighting its importance in public health, primary health care & family medicine services.

Visual rehabilitation of patients with low vision in uveitis

Purpose: To elucidate the clinical profile of visual impairment (VI) and rehabilitation of the uveitic patients with irreversible low vision. Methods: Retrospective analysis of visual rehabilitation of patients with uveitis suffering from poor vision with low vision devices (LVD). Results: Most common cause of uveitis was choroiditis (46.29%), followed by retinitis (25.92%), retinochoroiditis (18.51%), and chronic panuveitis sequelae (9.25%). Of these 54 cases, 35.18% had moderate VI, 25.92% had severe VI, 20.37% had mild VI, and 18.51% had profound VI or blindness. Statistically significant improvement (P < 0.05) in near vision was seen in choroiditis (52%) and retinitis (72%), whereas clinically significant improvement in distance vision was found in patients with choroiditis. Most commonly prescribed LVD was half-eye prismatic spectacle magnifier (22.2%). Conclusion: Rehabilitation of the uveitic patients with low vision is challenging. LVD may be a beneficial tool in these patients to help them perform their day-to-day activities independently.

Exploring plant growth-promotion actinomycetes from vermicompost and rhizosphere soil for yield enhancement in chickpea

Abstract The main objective of the present study was to isolate and characterize actinomycetes for their plant growth-promotion in chickpea. A total of 89 actinomycetes were screened for their antagonism against fungal pathogens of chickpea by dual culture and metabolite production assays. Four most promising actinomycetes were evaluated for their physiological and plant growth-promotion properties under in vitro and in vivo conditions. All the isolates exhibited good growth at temperatures from 20 °C to 40 °C, pH range of 7–11 and NaCl concentrations up to 8%. These were also found highly tolerant to Bavistin, slightly tolerant to Thiram and Captan (except VAI-7 and VAI-40) but susceptible to Benlate and Ridomil at field application levels and were found to produce siderophore, cellulase, lipase, protease, chitinase (except VAI-40), hydrocyanic acid (except VAI-7 and VAI-40), indole acetic acid and β-1,3-glucanase. When the four actinomycetes were evaluated for their plant growth-promotion properties under field conditions on chickpea, all exhibited increase in nodule number, shoot weight and yield. The actinomycetes treated plots enhanced total N, available P and organic C over the un-inoculated control. The scanning electron microscope studies exhibited extensive colonization by actinomycetes on the root surface of chickpea. The expression profiles for indole acetic acid, siderophore and β-1,3-glucanase genes exhibited up-regulation for all three traits and in all four isolates. The actinomycetes were identified as Streptomyces but different species in the 16S rDNA analysis. It was concluded that the selected actinomycetes have good plant growth-promotion and biocontrol potentials on chickpea.

Assessment of knowledge regarding 'essential obstetrics care' among rural pregnant women in Kancheepuram District of Tamil Nadu, India.

Background: The first step towards achieving the goals of Reproductive and Child Health programme is to create awareness and educate the pregnant women about salient features of essential & emergency obstetric care and neonatal care provided. Objectives: To assess the level of knowledge on essential obstetrics care among pregnant women in a rural area. Methods: This cross sectional study was done in a rural area of Kancheepuram District in Tamil Nadu State, using a sample size of 100 pregnant women, arrived based on the prevalence of knowledge on antenatal care available from literature. The participants were selected by simple random sampling and data collected regarding the knowledge on ‘essential obstetrics care’, using a structured interview schedule based on the Mother Child Protection card. Results: About 45% of the participants had adequate knowledge regarding antenatal care, 46% had adequate knowledge on danger signs and symptoms of pregnancy, but only 13% of them had adequate knowledge regarding obstetric care. Knowledge regarding obstetrics care was found to have significant association with the educational status of pregnant mothers. Conclusions: The knowledge gap found in this study points to the need for re-evaluation of the effectiveness of health education measures given through the health care delivery system and the need for improved / revamped content and quality of health education materials to create better awareness among the pregnant women.

Assessment of knowledge regarding new-born care among mothers in Kancheepuram district, Tamil Nadu.

Background: Educating mothers to create awareness about essential obstetric and neonatal care are the key steps in achieving the goals of reproductive and child health programme. In this study, we aimed to assess the level of knowledge regarding essential new born care among the mothers. Methods: This community based cross sectional study was done in Kancheepuram district, using a sample size of 100 mothers arrived based on the expected number of pregnancies in the area. The participants were selected by simple random sampling and data collected regarding the knowledge on new-born care among the mothers, using a structured interview schedule. Results: The study result showed that mean age of mothers was 25 years and mean weight of babies was about 3 kg. Regarding the education status, 67% studied up to 10th standard and 18% studied up to plus two levels. Majority of them got information on new born care from health workers (44%) and family members (36%). The level of adequate knowledge regarding new-born care was present only in 15%, feeding practices in 39%, various components of immunization in 8%, growth and development in 42% and about new-born illness in 33% of the mothers. The knowledge regarding new born care was found to have a significant association with the educational status of the mothers. Conclusions: This study outcome shows the need for a better revamped awareness and education program coupled with effective health care delivery system to improve the level of knowledge among mothers on new born care, in achieving better health indicators as far as RCH services are concerned.

Prevalence of metabolic syndrome among rural women in a primary health centre area in Tamil Nadu.

A study was conducted to estimate prevalence of metabolic syndrome among 150 rural women in the age group of 30-50 years in a primary health centre area in Tamil Nadu. Prevalence of metabolic syndrome was estimated using National Cholesterol Education program (NCEP), Third report Adult Treatment Panel ATP III criteria, and Modified NCEP ATP III criteria for Asian Indians. Prevalence of metabolic syndrome was found to be 30.7% based on NCEP, ATP-III Criteria. Based on the Modified NCEP, ATP-III Criteria, the prevalence was found to be 36%.The most commonly observed components of metabolic syndrome in this study was increased waist circumference (56.0%) followed by low HDL (45.3%), high triglyceride (37.3%), high blood pressure 29.3%, and fasting blood sugar 12.7%. Identifying the risk factors and treating patients with the metabolic syndrome is a public health challenge especially in the rural population.

An educational approach to treat patients rationally in primary healthcare.

Primary healthcare is the first level of contact between the community and the national healthcare delivery system for treating the commonly occurring illnesses. Appropriate treatment and the provision of essential drugs are the two vital components of the primary healthcare concept. Graduate medical education in India is oriented towards training of medical students to undertake the responsibilities of a primary healthcare physician. Clinical training for medical students often focuses on diagnostic, rather than therapeutic skills. They are not often taught how to properly prescribe a drug for their patient's benefit. Bad prescribing habits lead to ineffective and unsafe treatment, exacerbation or prolongation of illness, distress and harm to the patient and higher costs. The requirements for rational use of drugs will be fulfilled if the process of prescribing is appropriately followed. Medical students and the practicing primary healthcare physicians need to be well trained in good prescribing practices. The objective of this article is to highlight the importance of the step by step “Guide to Good Prescribing” in helping the medical students to learn the art of treating patients rationally in primary health care settings.

Myiasis in different types of carcinoma cases in southern India.

Myiasis maggots were isolated from the cancerous wounds, when the patients reported to the Department of ENT-OPD, JIPMER, Pondicherry. Maggots were identified to Chrysomyia bezziana based on characteristic patterns of posterior and anterior spiracles. Although the categories of cancer wounds were different, invasions were due to C. bezziana, which is very common in suburban areas of Tamil Nadu and Pondicherry in southern parts of India. This observation showed the importance of hygiene and sanitation in tropical countries with high fly population and emphasised the need for correct diagnosis of this obligatory myiasis, which was destructive. Through proper health care, further destabilization due to myiasis was avoided.

Acquaintance with the actuality: community diagnosis programme of Kathmandu Medical College at Gundu village, Bhaktapur, Nepal.

INTRODUCTION: In Nepal, various field programs such as community diagnosis programmes (CDP) have been initiated to make the education of doctors, nurses and dentists more community oriented and relevant and suited to the health care scenario. Community diagnosis refers to the identification and quantification of the health problems in a community and identification of their correlates for the purpose of defining those individuals or groups at risk or those in need of health care. The article presents the main activities of community diagnosis as a core component of community-based education for the medical students at Kathmandu Medical College, Kathmandu, Nepal. METHODOLOGY: A 4 weeks' Community Diagnosis Programme was conducted by MBBS II students (9th Batch) of the Kathmandu Medical College under the supervision of the Department of Community Medicine in November 2006 in the rural community of Gundu VDC (village development committee). The tools used included pre-tested questionnaires, weighing machines, measuring tapes, stethoscopes and sphygmomanometers. After the data collection and compilation, the students presented their findings in oral presentations, accompanied by a written report, including essential recommendations for improving the health status of these communities. RESULTS: The students benefited from the necessary process of integrating clinical skills and a public health approach, so as to enhance their epidemiological thinking and be of greater use to the communities where they will practice. The community also benefited by achievement of behavioral changes leading to healthier lifestyles and increased awareness of health-related matters and their role in quality of life. CONCLUSIONS: CDP is a way to practically demonstrate that the link between a medical college and society is possible. That is, a medical college can serve the community and thus society, with specific activities to improve health and the skills of students who will serve as future health professionals.

Shone's Anomaly - A Case Report.

Shone's anomaly, a rare congenital cardiac malformation consists of multiple levels of left heart obstruction - supravalvar mitral ring, parachute mitral value, subaortic stenosis and coarctation of the aorta. Although they present with a wide spectrum of major anatomical and haemodynamic abnormalities, a satisfactory outcome is possible for most patients. The operative mortality and outcome is affected by the severity of mitral value disease and the need for multiple operative procedures. We report one such case with this anomaly who presented to us in the third decade. He underwent a two - stage procedure in a single sitting successfully.

Dropouts during treatment for leprosy (a study in the ELEP leprosy control project, Dharmapuri district, Tamilnadu during 1975-77).

Certain Social and Related Factors responsible for 231 dropout leprosy patients from treatment are discussed. Dropout rate was lowest among lepromatous patients (1.2% Vs 10.9% among nonlepromatous patients); patients with stigma/deformity were significantly less (P less than .001); among dropouts; proportion of wage-earners was high in them (p less than .001); student dropouts were few (Z-2.78, P less than .05, X2 - 10.32, d.f.-1, P less than .005); there was little association between socioeconomic status and dropout rate (P greater than .5); dropouts amongst patients who self-registered for treatment were much less than in those who were enlisted for treatment during survey (P less than .05); 38% had dropped out within the first six months of registration for treatment; lepromatous patients attended clinics for more than 25 months before becoming dropouts; fear of loss of wages, belief that it was not leprosy, social stigma attached to the disease, disinterest for treatment when lesions were small and few, dissatisfaction with treatment, and belief that patches self-healed were the main causes for discontinuance of treatment; all those who dropped out due to shyness were women of 15-44 age-group.