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Background: Faulty feeding practices and infections have a detrimental effect on an infant’s health. Although, breastfeeding is almost universal in India, rates of early initiation, Exclusive Breast Feeding (EBF) and timely complimentary feeds are far from desirable. This takes a heavy toll on their health and increases their susceptibility to develop several morbidities including Diarrhoea and Respiratory Tract Infections. Thus, this study was undertaken to assess the feeding practices and morbidity patterns of infants and to determine their association.Methods: It was a longitudinal study on a birth cohort of 99 infants in the rural field practice area of GMC, Amritsar who were followed up to 6 months of birth. Baseline data on sociodemographic profile and breast feeding was collected in the first visit. Weaning practices and any morbidity suffered during six months’ period were assessed at the follow up visit.Results: Breast feeding was initiated in majority 88.87% but it was delayed in more than half (54.02%) of infants. Customs like prelacteal feeding (76.8%) and discarding colostrum (50.57%) were quite prevalent. EBF was practiced by most 65.51%. In around a quarter of infants, delayed or faulty weaning was observed. Diarrhea was the commonest morbidity (49.09%) followed by ARI (32.73%). Significant association (p<0.05) was observed between the feeding practices and infant morbidities especially diarrhoea.Conclusions: Mothers should be educated more effectively regarding benefits of early and exclusive breast feeding and correct weaning practices. Emphasis should also be placed on increasing awareness in the community to bring about a significant change in the deleterious customs and traditions.
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Background: Liver functions tests suggest the underlying cause, estimate the severity, assess prognosis and monitor efficacy of therapy. Severity of liver dysfunction when performed serially may predict prognosis and may be helpful in assessing response to medical therapy or a surgical intervention.Methods: The data was collected in thirty cases of surgical obstructive jaundice in terms of age, sex, etiology, clinical presentation, surgical intervention for biliary drainage and the laboratory liver biochemical and coagulation profiles on a day prior to surgical intervention and post-operatively on 1st week and 4th week were recorded.Results: Of total 30 patients 56.66% were females. Patients with 73.68% of benign disease and 100% of malignant disease were of age more than 40 years. 63.33% of patients had benign cause for biliary obstruction. Choledochoithiasis and periampullary carcinoma were two most common causes of obstructive jaundice. The commonest complaints were; yellowish discolouration of sclera and skin, high colored urine (100%) and acholic stool (70%). Hepatomegaly, palpable gallbladder and ascites were observed in only malignant conditions. Serum bilirubin and transaminases were significantly higher in patients with malignant lesions on pre-operative and postoperative assessment. After decompression the rate of fall of serum bilirubin, serum glutamic-oxaloacetic transaminase and SGPT were almost identical in both benign and malignant biliary obstructions. However, a better biochemical recovery profile was observed in patients with benign lesions, as they returned to normal by 4 weeks but remained at 2 to 3 times of the normal in malignant lesions.Conclusions: Sequential biochemical assessment of liver functions has diagnostic as well as prognostic value in surgical obstructive jaundice.
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Background: Low level of education of the slum dwellers along-with poor socio- economic status and pathetic environmental conditions lead to their poor health indicators. Since the National Urban Health Mission (NUHM) was launched in 2013, the health services are still in their initial stages. Assessment of the availability as well as the utilization of health care services of the urban slums is the need of the hour.Methods: The cross-sectional study was conducted in randomly selected slum in Amritsar city. All the houses were enumerated and visited by the interviewer herself. The eldest adult member of the family was selected as key respondent and written, informed consent was obtained. Predesigned questionnaire was used to collect the data which was then compiled and analyzed using statistical tests.Results: Out of the total respondents, one third respondents had knowledge about the government health center nearby (statistically significant) while out of these, only one third utilized the services at the center (statistically non-significant). Almost half of the respondents had knowledge about the medical camps and out of these, two-thirds utilized the services at medical camps.Conclusions: Overall utilization of services is poor. More respondents were aware of the medical camps than the static government health facility and utilization of medical camps was also more. So the static health services under NUHM need to be further strengthened.
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Background: TORCH infection complex during pregnancy has bad obstetric outcomes starting from low birth weight to congenital anomalies, sensory neural deafness, mental retardation, cerebral palsy and sometimes to fatal outcomes like abortion and still birth. As these diseases remain mostly asymptomatic these are rarely tested during pregnancy. Serology is the mainstay of diagnosing these infections.. Methods: A cross sectional study was undertaken to estimate the burden of these infections in a rural belt of western Odisha where majority of the population depend upon agricultural work. A total number of 402 antenatal cases were screened by ELISA test for presence of IgG&IgM antibodies against toxoplasma, rubella virus, cytomegalovirus (CMV), herpes simplex virus (HSV) 1 & 2; RPR test was done to know seroprevalence of Syphilis. Results: It was found that Rubella is the most predominant infection being positive in 69.1% of the cases (IgG 68.4%, IgM 0.5%, and both IgG&IgM 0.25%), followed by CMV infection-66.7% (IgG 57.2%, IgM 1.7%, both 7.7%), Toxoplasma infection-39.8% (IgG 38.3%, IgM 0.7%, both 0.7%), HSV 1-23.6% (IgG 21.1%, IgM 2%, both 0.25%) and HSV 2 – 13.2% (IgG 11.7%, IgM 1.6%, both 0.25%). The seoprevalence of syphilis by RPR was least common with 0.5%. Conclusions: This study showed that most of the infections have occurred by 20 years of age and before or during the 1st pregnancy. It is less common among the antenatal cases who have better education and have spouses servicing in private or government sectors signifying the more health and sanitation awareness among this group.
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Background: Slums are not new phenomenon. They are characterized by insanitary condition, crime, drug abuse etc. The male youth living in the slums, are prone to various health impacting conditions including substance use like alcohol consumption, smoking, tobacco chewing, drugs etc.Methods: Cross-sectional study was conducted in the four selected urban slums of Amritsar city. From each slum 250 male youth aged 15-24 years were included in the study, so total 1000 respondents were interviewed and required information was filled in pre-designed semi-structured proforma. Data was compiled, analysed and valid conclusions were drawn.Results: The overall prevalence of substance use among the respondents was 25.9% and as the age increases the prevalence of substance use also increases. Among substance users, tobacco (86.8%) was the most common substance consumed both in smoking form (52.1%) and smokeless form (34.7%), followed by the alcohol (72.2%) and then drugs (12%). Majority (62.1%) of respondents had initiated the substance use between 15-19 years of age. Factors like illiteracy, migration, joint family, married status and increased mental stress were significantly associated with substance use, however no association was found with socio economic status of the respondents.Conclusions: Government should take robust steps to improve the awareness and education status of the youth living in the slums. As the younger ages are most vulnerable ones, health education, IEC and BCC activities regarding the harmful effects of substance use along with life skills should be incorporated into the school curriculum.
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Background: Diabetes has become global issue due to premature illness and death due to its complications. Awareness about good health seeking practices are essential for prevention, early detection and management of diabetic complications. Objective of the study was to evaluate the health seeking practices among diabetics (>10 years of duration) in the field practice areas of Government Medical College, Amritsar.Methods: A community based cross-sectional study was conducted in rural and urban areas of district, Amritsar. A total of 200 diabetic patients who had diabetes equal to or more than 10 years of duration were interviewed using pretested and predesigned questionnaire. Data such collected was analysed at p<0.05.Results: Out of total 200 diabetic respondents, 50% (100) were from urban and 50% (100) were from the rural area. In both urban and rural areas, majority were literate i.e. 80% (161) and employed i.e. 51% (103). The mean age of diabetic respondents was 58.05 years with a male to female ratio of 1.1:1. The majority 82% (165) were diagnosed in the private sector and 99% (198) were on allopathic treatment. Oral hypoglycaemic agents were used by 77% (153) patients to manage their disease. 23% (45) were using both oral hypoglycaemic agents and insulin. About 48% (96) were monitoring their RBS regularly, 76% (151) were on regular treatment for diabetes and 55 (27%) were doing physical activity.Conclusions: Poor health seeking practices and less awareness about non pharmacological measures are main factors for development of complications among diabetics.
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Background: Health care expenses induced impoverishment in the poverty stricken strata of rural India is a major issue. The government of India has come up with various services in public health facilities, but there are various factors which curtail the utilization of available services and people have to visit some private health facility. The present study deals with the extent of utilization of services of government health facility and the factors impeding the utilization.Methods: The present cross sectional study was conducted in village Nagkalan, district Amritsar, where the eldest adult members present in the house at the time of the visit, and are interviewed using a semi-structured and predesigned questionnaire. A total of 1123 families were included in the final analysis. Data was compiled, analysed and valid conclusions drawn.Results: Almost all the respondents were aware about the existence of subsidiary health centre in the village. However, out of those who were aware, 40.8% never visited the centre. Utilization was more in the lower socio economic status. Immunization services followed by treatment for common ailments constituted the top two reasons for visiting the centre. Out of those visiting the centre, 80.7% were not satisfied with the current timings of the centre; only 20.2% were attended by the doctor and 33.3% reported that the prescribed medicines were never available at the centre.Conclusions: Regular supply of prescribed medicines, availability of the doctor and appropriate timings are critical for utilization of health care services at the government health facility.
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Background: Slums are most vulnerable and deprived areas within a city. The unhygienic and polluted environment, overcrowding, poor housing and absence of educational exposure affect youth in slums. Consequently, their health is affected adversely.Methods: This cross-sectional study was conducted in four slums, one each from four different directions (north, south, east and west) of Amritsar city. A total of 1000 respondents, 250 from each slum were interviewed by using pre-tested semi-structured questionnaire. Data was compiled and statistically analysed.Results: Out of total study population, 41.2% of the families had migrated from other states, Overcrowding was present in majority (92%) of the families, 20% of the respondents didn’t have latrine facility at their home, 44.4% respondents throw their garbage waste in the open space nearby their dwellings and 45% of population was not satisfied with the cleanliness of their slum, 54.6% of the respondents reported to have some kind of health problem during last three months. Educational status, socio-economic status and overcrowding were significant factors affecting their health.Conclusions: Important factor in causation of disease were found to be poor socio-economic status, lack of education and overcrowding. There is a strong need to intensify the IEC/BCC activities to raise the awareness about the health-related issues.
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Background: Port site infection (PSI), although infrequent, isone of the bothersome complications which undermine thebenefits of minimal invasive surgery. The aim of this study toevaluated the frequency of Port Site infections (PSI) inlaparoscopic cholecystectomies.Materials & Methods: This is a hospital based observationalstudy done on 20 cases with port site infection afterlaparoscopic cholecystectomy in the department of GeneralSurgery, Government Medical College, Pali. Wounds wereassessed clinically a week after surgery and in case infectionhad occurred; once weekly until 4 weeks in the out-patientsclinic. The frequency of port site infection studied in relationextent of infection, duration of surgery, intra-operative findings,site of port that was infected.Results: The mean age of patients was 43.26 years.According to the site of port infection, 19 patients (95%)developed an infection at the epigastric port and one patient(5%) developed an infection at the umbilical port, which was Pvalue was >0.05. The mean duration of surgery was 63.5minutes. The port site infection was present in 18 (90%)patients at 7 days and only 1 (5%) case had port site infectionat 30 days in our study.Conclusion: Laparoscopic cholecystectomy is associated witha low risk of port-site infection which in most the cases is onlysuperficial responding to local measures. Complication canoccur even in the best of hands and it is vital that these arerecognized properly and immediately addressed.
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Aims: The study aims at mitigating pulp kappa number before bleaching to minimize pollution load. Study Design: An experimental study. Methodology: The various parameters of direct fungal (Coprinellus disseminatus MLK01) treatment (F-stage) of unbleached kraft pulp of Anthocephalus cadamba were optimized and compared with the results of enzymatically pre-bleaching. Finally, the pulp was bleached by EQP three-stage and XECEHH six stages bleaching sequences. Results: Direct fungal treatment (F-stage) delignified the Anthocephalus cadamba kraft pulp more selectively with Coprinellus disseminatus MLK01 compared to xylanase prebleached pulp from the same fungus and oxygen delignification. F-stage mitigated the unbleached pulp kappa number by 55.0% and improved brightness and viscosity by 17.3 and 7.63% respectively. Kappa number reduction and brightness improvement were 22.1 and 6.3% more in F-stage compared to XE-stage. The kappa number and pulp brightness of oxygen delignified were 0.9 and 5.2% less compared to F-stage. The viscosity of oxygen delignified pulp reduced drastically due to alkaline peeling reactions compared to XE-stage (‒26.86%) and F-stage (‒27.09%). The brightness and viscosity of XECEHH bleached pulp were 80.1% and 7.4 cps at a chlorine demand of 4.3% while FEQP bleached pulp produced brightness of 79.7% and viscosity 8.2 cps. COD and colour values in effluent generated during FEQP bleaching were 53.29% and 54.36% less compared to CEHH bleaching.
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This study was to know the opinion of health supervisors towards activities of health care workers. The study was undertaken among 207 health supervisors coming for in service training at Health and Family Welfare training centre, Amritsar (Punjab). They were provided with questionnaire following the registration for training. It was found that majority of the participants (87.9%) agreed that planning of health workers activities should be as a team work, while about 16% of respondents denied that supervision is required for daily activities of the health workers. Punctuality is important; however, this study showed that health supervision (6.8%) stressed more on the punctuality of workers that female health supervisors (11.8%).This study also revealed that female’s supervisors (45.7%) have more courage to accept blame for the mistake commits by workers than male supervisors (7.4%). This study revealed that there is no doubt majority of participants have positive opinions towards health workers activities. But in service sector all types of behaviour is required in different working situations, but most of the time democratic and participative type behaviour is very effective for a team work.
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Right sided heart involvement in infective endocarditis in non drug addicts is rare.We report a case of isolated pulmonary valve endocarditis in a non drug addict male.
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In this prospective randomized parallel study, the antihypertensive effect of oral carvedilol and amlodipine was evaluated on systolic blood pressure (SBP) and diastolic blood pressure(DBP) in patients of mild to moderate hypertension over a period of 12 weeks. Eighty two patients who fulfilled the inclusion criteria were randomized to receive amlodipine (n=42) 5-10mg/day and carvedilol (n=40) 25-50mg/day. Blood pressure was recorded in the sitting and standing position during follow up visits at 2,4,8 and 12 weeks using mercury sphygmomanometer. Dosage adjustments if needed were made at 4 and 8 weeks of study. Both carvedilol and amlodipine produced a statistically significant (P<0.001) and dose related fall in SBP and DBP , which became evident at two weeks of initiation of therapy and continued till 12 weeks. On comparative analysis of the effect of carvedilol and amlodipine on BP, amlodipine produced a greater fall in sitting and standing SBP at all study intervals as compared to carvedilol, with statistically significant fall at 8 and 12 weeks (P<0.01). However, the fall in sitting and standing DBP was statistically comparable with both the drugs. The findings of the present study indicate that carvedilol has become an alternative treatment for mild to moderate hypertension.