ABSTRACT
Introduction: Catastrophic health spending is one of the major factors pushing people into poverty. Reducing “out-of-pocket expenditure (OOPE)” on health through health insurance coverage is an effective approach. The objectives of this study are (1) to estimate health insurance coverage among rural and urban households (HHs) and (2) to determine the proportion of income spent on health as OOPE among the selected HHs. Material and Methods: A cross-sectional study was conducted in rural and urban parts of district Faridabad, Haryana. A sample of 374 were taken from rural and urban areas. The unit of the study was HHs in both the areas. The proportion of income spent on health care (both direct and indirect expenses included) as OOPE was taken as outcome variable. Results: Health insurance coverage was higher among urban HHs (58.0%) as compared to the rural (38.5%). The rural population was availing of private consultation, laboratory, and pharmacy services to a greater extent than the urban; hence, they were spending a substantial proportion of their income on health-care services. The majority of the HHs in the rural and urban areas spent up to 20% of their income on health care. Conclusion: Universal health coverage without health insurance is unlikely.
ABSTRACT
Background: It is common for patients with type 2 diabetes mellitus (T2DM) to have vitamin D deficiency. Aim of the study is to determine the metabolic effects of oral vitamin D supplementation in a cohort of T2DM subjects.Methods: Subjects with T2DM were divided into two groups. Group A (Control) included subjects who received the standard treatment (conventional antidiabetic drugs). Group B (Intervention), apart from the standard treatment (conventional antidiabetic drugs), was also supplemented with Vitamin D3. All the patients were followed up at baseline, 6 months, 12 months and 18 months.Results: Vitamin D deficiency was noted down in all the study subjects. Even after 18 months of supplementation, all subjects remained vitamin D deficient. There was a significant improvement in the circulating levels of 25-hydroxyvitamin D. Improvement in the lipid profile of subjects was observed as evidenced by a decrease in total cholesterol (5.0±0.92 mmol/l) as compared to baseline (5.5±1.6 mmol/l). HOMA-IR changed significantly after 18 months of supplementation from baseline (7.0±1.06 vs 10.8±1.96 nmol/l).Conclusions: Supplementation to achieve higher levels of vitamin D remains a promising adjuvant therapy for T2DM patients. Additionally, the intervention brought out a favourable change in HDL/LDL ratio among study subjects.
ABSTRACT
Introduction: Clinicians and anatomists have been examining coronary artery variations for a long time. However, there is still no consensus on the normality or abnormality of coronary arteries. The present survey was therefore conducted to find out the variations in left coronary artery (LCA) and right coronary artery (RCA) branches, the existence and occurrence of the median artery in northern Indian population.Material and methods: The present study was planned and conducted during March 2012 to September 2014 at Department of Anatomy, Major S. D. Singh Medical College, Fatehgarh; a tertiary care teaching hospital. The hearts of 40 adult northern Indian cadavers fixed with 10% formaldehyde were used. To determine the dominant circulation, the artery that supplies the posterior inter ventricular sulcus was investigated. Dissections were performed under a dissection microscope and photographed. Results: LCA branched out of the aortic sinus in all the hearts and had an average diameter of 4.44 ± 1.79 mm. In 45% hearts, the LCA was separated into the anterior inter ventricular branch and the circumflex branch (bifurcation). In 42.5% hearts, in addition to the anterior inter ventricular branch and the circumflex branch; there was a median artery that coursed on the front wall of the left ventricle (trifurcation). In 10% hearts, branching occurred as in trifurcation but with two median arteries emerging from the LCA (quadrifurcation). Myocardial bridges were found on the LCA branches in 19 of the 24 hearts in which the median artery existence of the median artery and myocardial bridges. The median artery might be important as it may not result in any clinical symptom for many years in a large number of subjects. Knowledge of individual and racial variations in coronary arteries is essential for the diagnosis and treatment of coronary artery patients.
ABSTRACT
Background: Identification of factors affecting utilization of primary eye health services would help the government and other eye care providers to address inequity issues in their eye care program. Aim: Therefore this study was planned to find out barrier to utilization of eye health services among people living in rural western Uttar Pradesh. Material and methods: The current community based cross-sectional survey which involved both qualitative and quantitative methods, was conducted among the residents. A total of 216 study subjects participated in the study. Factors in the supply side influencing utilization of eye health services by people from the community were sought through Focus Group Discussion (FGD) and Key Informant Interview (KII). Results: Almost 80% of the respondents had agriculture as their major occupation and > 1/4th were from lower caste community. Regarding the seeking of eye care services, 52.4% respondents who gave a positive history of an eye problem in the family told they attended the nearest health facility; CHC, PHC or SC while 19.2% did actually go to the eye health center. Only 4.8% respondent did not seek any service. Among 112 respondents who were aware of one or other eye diseases, 74.6% identified dirty things fallen into the eyes as the cause of an eye problem followed by 50.3% of the respondents who pointed out injury to the eyes as the culprit. For emergency problem in the eyes 79.2% respondents told that they sought services from health facilities without delay, while 15.4% gave priority to starting household treatment. Conclusion: Raising awareness of the community about eye diseases and the services available together with strengthening of primary eye health services available at the local health facilities could help bring eye health services in closer proximity to the rural population.
ABSTRACT
Background: Voluntary eye donation depends on the awareness levels of various stakeholders in the community. Today’s medical students are tomorrow’s stakeholders of the community. Medical professionals can enhance eye donation rates by educating and motivating the relatives in case of patient's death. Aim: Hence the present study was undertaken with an objective of assessing the promoting factors for eye donation among medical students. Material and methods: The present descriptive cross sectional study was carried out among undergraduate students of a medical college in western Uttar Pradesh in the month of February 2014 using pretested self administered questionnaire. Results: 77% students knew about eye donation. 51% of them were willing to donate their eyes. Only 39% students knew that the ideal time for eye donation is within 6 hours of death. 64% had knowledge about vitamin A’s important role in prevention of childhood blindness. TV, newspaper or other media were the most important channels of getting information for majority (60%) of the students. Regarding perceived promoting factors for eye donation by them, noble cause (57%), pleasure to help the blind (51%) and inspired by advertisement on television (42%) were 3 top most promoting factors. Conclusion: Inclusion of different preventive and promotive aspects of corneal blindness along with basic eye health care into the course curriculum is the need of the hour.