ABSTRACT
Background: It has been observed that besides intensification of routine immunization, more strategic interventions are essential to strengthen the different aspects of immunization services like cold-chain management and monitoring/supportive supervision. The present study was considered as a part of ongoing UNICEF funded project on Supportive Supervision of Routine Immunization in Jashpur and Sarguja districts undertaken by the Department of Community Medicine, GMC Rajnandgaon with the objectives to assess the status of cold chain equipment and logistics management practices, knowledge and practice of cold chain handler (CCHs) about cold chain equipment and logistics management.Methods: A cross-sectional facility based study was conducted from August 2017 to February 2018. Among 18 cold chain points (CCPs), 9 from Jashpur and 9 from Sarguja district were considered for analysis using structured questionnaires provided by UNICEF.Results: In 83.33% CCPs cold chain technician or annual maintenance contract/computer-mediated communication service provider visit for preventive maintenance in the last 4 months. Vaccine CCHs carries out the daily and weekly planned preventive measures as per the checklist in 83.33% CCPs during our visit. In all CCPs iced line refrigerator (ILR) and deep freezer (DF) were placed as per specified guidelines. In 66.66% CCPs there was documentation of monthly review of temperature records. In all CCPs visited standard vaccine and logistics stock/issue registers were available.Conclusions: Most of the components of cold chain and logistics management practices were satisfactory while there is a gap in other components which needs to be improved by means of ongoing project of strengthening of SSRI in both districts.
ABSTRACT
Background: Obesity constitutes a major health issue in the modern world. The purpose of this prospective study was to assess the effect of obesity on ventricular function by conventional 2D echocardiography and echocardiogram for assessment of early cardiac changes.Methods: In the present study, 50 asymptomatic obese subjects having BMI >30 were compared with 50 normal individuals having BMI in the range 20-24.9 to assess cardiac performance. The study was conducted over a period of 2 years, from 2009 to 2011.Results: There were 20(40%) males and 30(60%) females in both the groups. The ejection fraction was not significantly affected in obese subjects (60.86�34%) than normal individual (60.42�18%) which was found to be statistically not significant. So, in this study systolic function was not affected. The thickness of left ventricle was significantly increased in obese subjects (1.016�113 cm) than normal individual (0.77+0.073 cm) which was found to be statistically significant.Conclusions: The current study revealed increased wall thickness and mass of Left Ventricle (LV), significantly increased risk of LV diastolic dysfunction, evidence of Left Atrial (LA) enlargement associated with diastolic dysfunction, evidence of subclinical LV systolic dysfunction and Right Ventricular (RV) dysfunction among obese subjects in comparison with normal individuals.
ABSTRACT
Background: Diseases of the heart valves constitute a major cause of cardiovascular morbidity and mortality worldwide with an enormous burden on healthcare resources. The present study was undertaken to study incidence and demography of valvular heart disease, to assess echocardiography and colour doppler findings of patients with valvular heart disease and to find out complications in patients with valvular heart disease.Methods: A hospital based longitudinal case study was undertaken at medicine department of Dr. V.M. Government Medical College, Solapur, Maharashtra, India for a period of two years. One hundred and twenty-four (124) patients attending OPD participated in the study.Results: In the present study, out of 124 patients, mitral valve was most commonly involved, 105(84.67%) and the least common involved was tricuspid 1(0.81%). The most common aetiology was rheumatic origin 75(94.94%). In the present study the most common complication was pulmonary hypertension 69(55.65%), followed by congestive cardiac failure (33.87%), acute pulmonary edema (12.09%), infective endocarditis (4.84%), cerebrovascular accident (4.03%), left atrial thrombus (3.23%) and death (3.23%).Conclusions: Multiple valves were affected in more than a third of all cases, although recent research in India continue to demonstrate a declining trend in the prevalence of RHD, rheumatic involvement is still the dominant form of valvular heart disease in India.