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Purpose:The purpose of this study was to review the effect of the pre?operative use of clopidogrel and aspirin on peri?operative bleeding, blood product transfusion, and resource utilization after coronary artery bypass grafting (CABG). Materials and Methods: A total of 1200 patients who underwent off?pump CABG (OPCABG) between 2010 and 2012 were retrospectively studied. Patients were divided into three groups: group 1: discontinued aspirin and clopidogrel 6 days prior to surgery (n = 468), group 2: discontinued both drugs 3 to 5 days prior to surgery (n = 621), and group 3: discontinued both drugs 2 days prior to surgery (n = 111). The bleeding pattern and blood product transfusion were studied and compared between the groups. Patients having history of other drugs affecting the coagulation profile, other organ dysfunction, on?pump CABG, and the combined procedure were excluded from the study. Results: Group 2 patients had a higher rate of bleeding and a reduced mean value of hemoglobin (Hb) as compared to other groups. The same results were seen in blood and blood product transfusion. Patients of group 2 and group 3 were associated with higher blood loss in terms of drainage at 12 and 24 hours. Post?operatively, this was statistically significant. Re?exploration was statisitically significant in group 3 patients (9.01%) than in group 2 (2.58%) and group 1 (1.07%) patients. Conclusion: The pre?operative use of clopidogrel and aspirin in patients undergoing OPCABG showed limited clinical benefits; however, its use significantly increased the risk of bleeding and blood transfusion, thus increasing morbidity and resource utilization. Hence, clopidogrel and aspirin should be stopped at least 6 days prior to surgery.
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Introduction: The most common functional abnormality ofthe infant’s lacrimal apparatus is the congenital blockage ofthe nasolacrimal duct. Non-canalisation of the duct, presenceof epithelial debris, mucous plug and bony occlusion are someof the possible causes of blockage. This was a prospectivestudy to identify the etiological agents, predisposing factorsand clinical profile of patients with congenital dacryocystitis.Material and Methods: A prospective observationalhospital based study was conducted on 72 eyes of 61 childrenpresenting with congenital dacryocystitis, in the age group 0-4years, attending the ophthalmology outpatient department in atertiary care teaching hospital.Results: Congenital dacryocystitis was common in agegroup of 0-3 months (31.15%). The incidence of disease inage group 4-6 months was 24.59% and 7-12 months was13.11%. 55.74% of males were affected. 83.61% of patientshad unilateral congenital dacryocystitis. 80.33% of thechildren had a normal delivery. 66.66% of cases presentedwith epiphora and discharge. 31.95% of cases presented withepiphora only. Epiphora with mucopurulent discharge was themost common presentation. Regurgitation test was positive in88.89% of cases. The nature of regurgitate was mucopurulentin 42.19% of cases.Conclusion: Congenital dacryocystitis usually presents at anearly age with epiphora and mucopurulent discharge. Earlydiagnosis helps in management.
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Background: Tobacco use is a major preventable cause of morbidity as well as mortality worldwide. To combat the increasing trend of this problem, Government of India formulated the COTPA (Cigarettes and Other Tobacco Products Act) in 2003. The study aimed to assess the awareness about COTPA and impact of pictorial warnings among smokers attending outpatient services in a tertiary care hospital in Jammu.Method: The present study was conducted among 320 patients attending the outpatient department of Internal Medicine, Government Medical College, Jammu who happened to be cigarette smokers. The questionnaire was developed by authors with the help of literature review and pilot tested before its final use. Information was elicited about demographic details, awareness about COTPA and impact of pictorial warnings on quitting of smoking.Results: More than half of the respondents were in 30-50-year age group and were urban residents. Awareness about COTPA was good on some parameters but was relatively low on other parameters. Despite all, the respondents noticing pictorial warnings on tobacco packages, only 69.37% of them were contemplating to quit. About half of them were of the view that warning statements preferably be written in local languages.Conclusion: Health and pictorial warnings on tobacco packages remain an important pillar in filling the gap of knowledge and communicating the health risks of tobacco use to the consumers. Only 69.3% of the respondents were planning to quit and awareness levels about COTPA were mixed.
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Introduction: Cataract is a major cause of impaired vision andblindness. Study aimed to find out if there is any associationbetween dyslipidemia and cataract.Material and methods: This cross sectional hospital basedstudy was performed in a tertiary care center of Jharkhandbetween June 2017 to March 2018. Total 223 patients whowere diagnosed with senile cataract were included in the study.Detailed history, ophthalmologic and systemic examinationwas done. Dyslipidemia is defined as:Hypercholesterolemia(total cholesterol > 220 mg/dl), or Hypertriglyceridemia (totaltriglyceride > 150 mg/dl), or Low density lipoprotein > 130mg/dl.Results: Out of total 223 patients 134 were men and 89were women. 70% patients had dyslipidemia. Prevalenceof dyslipidemia was associated significantly (< 0.05) withnuclear and cortical cataract but not significant (> 0.05) forposterior sub capsular cataract.Conclusion: Dyslipidemia maybe considered having anassociation with nuclear and cortical cataract directly orindirectly.
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Background: Climate change has emerged as one of the greatest challenges of the present century. The current study explores the knowledge, attitudes and practices about climate change of the adults aged 18 years and above in Jammu city of North India.Methods: A cross-sectional study was conducted among attendants of the patients visiting medical OPD of a tertiary care teaching hospital. A pilot tested questionnaire eliciting information on knowledge, attitudes and practices about climate change was administered to those who were willing to participate. The data collected was presented in proportions.Results: Majority (95%) of the respondents had heard of the term climate change, and 43.9% of them related it to changes in the weather pattern. Plastic use as a major cause of climate change was agreed upon by 95% of the respondents. About half of the respondents were very much concerned about climate change and 80% of them were very much interested in knowing more about climate change and its impact. Only 24.8% of the respondents read/watch stories on climate change.Conclusions: Knowledge levels of the respondents were found to be reasonably good but the same cannot be said about their attitude and practices. Role of NGOs, social communities and media is of utmost importance to make people aware of the harmful effects of climate change on both the environment as well as the health of the people.
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Chronic respiratory diseases(CRD) remain a formidable challenge for public health experts acrossthe world due to their ever increasing morbidity and mortality. This study investigated various riskfactors for CRD among rural adults aged 20 years and above. The study was conducted in fourvillages under sub-health centre Domana in Kot Balwal health block and these villages wereselected randomly. For this cross-sectional population based study, a pre-tested respiratory healthquestionnaire was used. Those respondents who were found to be diagnosed cases of CRD werefurther enquired in detail about various risk factors for CRD. Out of 2018 respondents surveyed,177confirmed cases of CRD were detected.Various risk factors like being male, smoking, overcrowding,recurrent chest infections and use of non-clean fuel (wood, cow dung) were found to bestatistically significant. Among other risk factors, ventilation and history of allergy were found tobe highly significant statistically (p< 0.000). Smoking, recurrent chest infections, use of biomass fuel,ventilation and history of allergy were risk factors for CRD in rural adults aged 20 years andabove.
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Background: Cervical cancer is known for its late detection due to a variety of reasons chiefly lack of knowledge, undesirable attitudes and poor practices. Early screening and adequate knowledge about the disease remains the important safe guards against this disease. The study aimed to assess the knowledge, attitudes and practices of the women aged 18 years and above regarding cervical cancer visiting a tertiary care teaching hospital.Methods: The present cross sectional hospital based study was conducted in Jammu city, Jammu and Kashmir, India. All the women aged 18 years and above visiting OPD of gynaecology-obstetrics department of Government Medical College Jammu and willing to participate were administered a pretested questionnaire to collect the relevant data.Results: It was found that 91.56% of the respondents had heard of cervical cancer with 83% reporting that it was both preventable as well as curable. Multiple sex partners were the most important risk factor identified. Among the attitudes, 62% agreed that screening was harmless to the client. Only one third knew about the availability of preventive vaccine. About 83.6% of them had never been screened by Pap smear. However willingness to get HPV vaccination was found to be high.Conclusions: Though knowledge among the respondents was found to be adequate but it lacked transformation into attitudes and practices. In this connection, authors recommend health promotion campaigns to educate women and the community about cervical cancer and its preventability through screening.
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The current cross-sectional study was conducted over a period of on eyear. Eight villages were chosen from Miran Sahib zone of R.S Pura block using simple random sampling. A pre-designed, pre-structured and validated questionnaire was applied to all persons aged ?60 Years. A total of 418 subjects (191 males and 227 females) comprised the study population.64.40% of the respondents belonged to 60-69 year age group. Among the morbidity distribution in the study population, visual impairment (54.06%) was the most common, followed by hypertension (35.89%), arthritis (34.21%), diabetes mellitus (12.92%) and chronic obstructive pulmonary disease (5.50%). COPD was higher in males and arthritis was higher in females and the gender disease association was found to be statistically significant (p<0.05). The results have shown high morbidity in the study population especially of visual impairment and cardio-vascular diseases. Respiratory diseases especially COPD morbidity was higher in males, while arthritis morbidity was more in females.
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During recent Influenza A H1N1(swine flu) outbreak the current study was undertaken to assess knowledge, attitude and practices (KAP) of rural population of Jammu region regarding swine flu. 270 participants were administered a pre-designed and pre-tested questionnaire consisting of 26 questions evaluating KAP. Overall knowledge score was 62.9%. More than 90% had heard of swine flu, knew prevalent season and had knowledge of disease symptoms. However, knowledge about preventing vaccine was low (27.7%). Overall attitude score was 79.5%. Higher number of the participants expressed willingness to seek more knowledge about disease prevention , though half of them were not satisfied with health authorities efforts. The total practice rate was 60%.Preference for nutritious diet and willingness to use tissue/handkerchief was over 80% ,but only 40% expressed willingness to use mask. On most of the parameters of KAP, there was no difference on gender basis except for swine flu treatment ,panic reaction and preference for herbal medication in females. The current study found good KAP regarding swine flu in the rural area of Jammu. However, unwillingness to use mask, dissatisfaction with health agencies and lack of knowledge about population at risk is a matter of concern.
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The present study was carried out to assess the lung functions of traffic policemen in Jammu region. A cross sectional study was carried out among 100 traffic policemen and compared with healthy persons with the subgroup comparison among rural and urban areas. Lung function like FVC, FEV1 , FEV3,PEFR & MVV on computerized spirometry. The results revealed that all lung functions were lower than the healthy controls and differences were statistically marked in FVC,FEV1, ,PEFR. Intergroup comparison between rural and urban revealed that police personnel's posted in rural areas had better lung function than urban counterpart which varied among each other statistically significantly .(FVC -0.04,FEV1- 0.0003,FEV3-0.0001,MVV-0.003,PEFR-0.03). The traffic policemen exposed to air pollution have lower lung function than the healthy persons and those posted at rural areas have better lung function
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The formation of hypertrophic scars is common following healing of the burn wound, particularly in children. The face is one of the areas of the body most frequently affected by burns. Scar formation as a result of burn wounds leads to contraction of the formed granulation tissue, which causes both aesthetic and functional impairment for the patient. Scarring has major psychological and physical repercussions. Scarring on the face and visible regions of the body can be very distressing for the patient. Prevention of scars involves early and continuous use of a compressive orthesis. However, their efficacy is often limited to the facial region because of the contours of this area of body. This paper describes a clinical case of post-burn hypertrophic scars treated with silicone gel sheeting applied with pressure under custom made auto-polymerizing resin stent.